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Factors related to the incidence of unmet need in couples of reproductive age in the working area of Marawola Health Center. GACETA SANITARIA 2021; 35 Suppl 2:S176-S179. [PMID: 34929805 DOI: 10.1016/j.gaceta.2021.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/30/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study aimed at determining factors associated with the incidence of unmet need for family planning among couples of reproductive age in the working area of Marawola Health Center, Sigi Regency. METHOD This research was an analytic observational study with a cross-sectional study design. The variables in this study included age, education, family planning history, husband's support and unmet need. Data were in the form of primary and secondary data. Data were collected using a questionnaire. The data were analyzed using univariate and bivariate analysis utilizing the Chi-Square test. Population in this study were 4715 couples of reproductive age in the working area of Marawola Health Center. By using Lemeshow's calculation technique and simple random sampling, a sample of 90 people was obtained. RESULT The results demonstrated a relationship between age and the incidence of unmet need with p value=0.004 (p-value ≤0.05); education and the incidence of unmet deed with p value=0.005 (p-value ≤0.05); family planning history and the incidence of unmet need with p value=0.002 (p-value ≤0.05); as well as husband's support and the incidence of unmet need with p value=0.001 (p-value ≤0.05). CONCLUSION This study concludes that there is a relationship between age, education, family planning history, and husband's support and the incidence of unmet need for family planning in the working area of Marawola Health Center, Sigi Regency. Therefore, health workers, local governments, and traditional institutions are expected to provide education about family planning to couples of reproductive age (husband and wife) as an attempt to reduce the number of unmet needs in the working area of Marawola Health Center.
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Jurado Medina L, Chassaing E, Ballering G, Gonzalez N, Marqué L, Liehl P, Pottel H, de Boer J, Chatelain E, Zrein M, Altcheh J. Prediction of parasitological cure in children infected with Trypanosoma cruzi using a novel multiplex serological approach: an observational, retrospective cohort study. THE LANCET. INFECTIOUS DISEASES 2021; 21:1141-1150. [PMID: 33836157 DOI: 10.1016/s1473-3099(20)30729-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/03/2020] [Accepted: 08/26/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Assessment of therapeutic response with standard serological diagnostic assays in patients with chronic Chagas disease is a major challenge due to the long persistence of parasite-specific antibodies. The current consensus for parasitological cure is to monitor conversion from positive to negative Trypanosoma cruzi serology (seroreversion). However, because of robust humoral immune response, seroreversion by standard serological tests can take years to decades. Developing novel tests of parasitological cure or surrogates is thus a priority in the Chagas disease field. We aimed to evaluate the MultiCruzi assay as a predictive tool for parasitological cure in a cohort of treated infants and children with acute and chronic Chagas disease enrolled in a long-term retrospective longitudinal study with clinical, serological, and parasitological follow-up, and to explore whether MultiCruzi could predict parasitological cure more quickly than the current reference method. METHODS Patients from two retrospective paediatric Chagas disease cohort studies with clinical, serological, and parasitological follow-up, diagnosed and treated at the parasitology service, Hospital de Niños Ricardo Gutierrez (Buenos Aires, Argentina) were included in this retrospective cohort study. Serum samples were collected every 6 months to 12 months between Oct 22, 1990, and June 3, 2019, for cohort 1 and 1 month after birth for cohort 2 and then every 3 months for a year between July 23, 2012, and April 19, 2016. We evaluated serological follow-up with the Chagatest ELISA (Wiener Lab, Rosario, Argentina) and used this as a clinical reference method for the evaluation of seroreversion. We compared Chagatest ELISA results with results of MultiCruzi (InfYnity Biomarkers, Lyon, France), a novel antibody profiling multiplex assay, investigating seroreversion events with both of the assays and prediction of seroreversion with MultiCruzi using an interpretation formula. FINDINGS Combining experimental data from discrete analysis of 15 T cruzi antigens efficiently predicted seroreversion at an early stage, which was later confirmed by conventional T cruzi serology. In cohort 1 (n=69), which included children of three different age groups, we observed differences 2 years after therapy. In the 27 individuals from cohort 1 who were treated within the first 12 months of age, MultiCruzi predicted early seroreversion in 21 (78%) patients whereas nine (33%) patients showed seroreversion with Chagatest ELISA (seroreversion difference 0·44, 95% CI 0·26-0·63; p=0·0005). In the 12 patients from cohort 1 treated between 1 year and 2 years of age, MultiCruzi predicted early seroreversion in six (50%) patients, whereas only one (8%) patient was confirmed to be seronegative with Chagatest ELISA (seroreversion difference 0·42, 95% CI 0·14-0·70; p=0·0253). In the 30 patients from cohort 1 who were treated between 2 years and 19 years of age, MultiCruzi predicted early seroreversion in five (6%) patients, whereas no patients were found to be seronegative with Chagatest ELISA (seroreversion difference 0·17, 0·03-0·30; p=0·0253). In cohort 2 (n=27), which included only children younger than 1 year of age and had a shorter follow up (between 5 months and 32 months), the proportion of reported events was significantly different 180 days after treatment for the T cruzi-positive group (early seroreversion predicted in nine [90%] of ten patients with MultiCruzi and confirmed seroreversion in four [40%] of ten patients with Chagatest ELISA; seroreversion difference 0·50, 95% CI 0·19-0·81; p=0·0253) and for the T cruzi-negative group 90 days (early seroreversion predicted in five [29%] of 17 patients with MultiCruzi and confirmed seroreversion in one [6%] of 17 patients with Chagatest ELISA; seroreversion difference 0·24, 0·03-0·44; p=0·0455) and 180 days (early seroreversion predicted in 17 [100%] of 17 patients with MultiCruzi and confirmed seroreversion only in seven [41%] of 17 patients with Chagatest ELISA; seroreversion difference 0·59, 0·35-0·82; p=0·0016) after treatment. INTERPRETATION The MultiCruzi assay can be used as a predictive monitoring tool to assess parasitological cure in children. This approach might be a solution to forecast forthcoming seroreversion in treated adults infected with T cruzi, but this requires further investigation. FUNDING Drugs for Neglected Diseases initiative. TRANSLATIONS For the Spanish, Portuguese and French translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Laura Jurado Medina
- Parasitology Service, Hospital de Niños "Ricardo Gutierrez" and Instituto Multidisciplinario de Investigacion en Patologias Pediatricas (IMIPP)-CONICET-GCBA, Buenos Aires, Argentina
| | | | - Griselda Ballering
- Parasitology Service, Hospital de Niños "Ricardo Gutierrez" and Instituto Multidisciplinario de Investigacion en Patologias Pediatricas (IMIPP)-CONICET-GCBA, Buenos Aires, Argentina
| | - Nicolas Gonzalez
- Parasitology Service, Hospital de Niños "Ricardo Gutierrez" and Instituto Multidisciplinario de Investigacion en Patologias Pediatricas (IMIPP)-CONICET-GCBA, Buenos Aires, Argentina
| | | | | | - Hans Pottel
- Faculty of Medicine, University of Leuven (KULAK), Kortrijk, Belgium
| | - Jasper de Boer
- Faculty of Medicine, University of Leuven (KULAK), Kortrijk, Belgium
| | - Eric Chatelain
- Drugs for Neglected Diseases initiative (DNDi), Geneva, Switzerland
| | | | - Jaime Altcheh
- Parasitology Service, Hospital de Niños "Ricardo Gutierrez" and Instituto Multidisciplinario de Investigacion en Patologias Pediatricas (IMIPP)-CONICET-GCBA, Buenos Aires, Argentina
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Thompson AM, O'Connor PD, Marshall AJ, Francisco AF, Kelly JM, Riley J, Read KD, Perez CJ, Cornwall S, Thompson RCA, Keenan M, White KL, Charman SA, Zulfiqar B, Sykes ML, Avery VM, Chatelain E, Denny WA. Re-evaluating pretomanid analogues for Chagas disease: Hit-to-lead studies reveal both in vitro and in vivo trypanocidal efficacy. Eur J Med Chem 2020; 207:112849. [PMID: 33007723 DOI: 10.1016/j.ejmech.2020.112849] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 09/08/2020] [Accepted: 09/12/2020] [Indexed: 01/08/2023]
Abstract
Phenotypic screening of a 900 compound library of antitubercular nitroimidazole derivatives related to pretomanid against the protozoan parasite Trypanosoma cruzi (the causative agent for Chagas disease) identified several structurally diverse hits with an unknown mode of action. Following initial profiling, a first proof-of-concept in vivo study was undertaken, in which once daily oral dosing of a 7-substituted 2-nitroimidazooxazine analogue suppressed blood parasitemia to low or undetectable levels, although sterile cure was not achieved. Limited hit expansion studies alongside counter-screening of new compounds targeted at visceral leishmaniasis laid the foundation for a more in-depth assessment of the best leads, focusing on both drug-like attributes (solubility, metabolic stability and safety) and maximal killing of the parasite in a shorter timeframe. Comparative appraisal of one preferred lead (58) in a chronic infection mouse model, monitored by highly sensitive bioluminescence imaging, provided the first definitive evidence of (partial) curative efficacy with this promising nitroimidazooxazine class.
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Affiliation(s)
- Andrew M Thompson
- Auckland Cancer Society Research Centre, School of Medical Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
| | - Patrick D O'Connor
- Auckland Cancer Society Research Centre, School of Medical Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Andrew J Marshall
- Auckland Cancer Society Research Centre, School of Medical Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Amanda F Francisco
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
| | - John M Kelly
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
| | - Jennifer Riley
- Drug Discovery Unit, School of Life Sciences, University of Dundee, Dow Street, Dundee, DD1 5EH, United Kingdom
| | - Kevin D Read
- Drug Discovery Unit, School of Life Sciences, University of Dundee, Dow Street, Dundee, DD1 5EH, United Kingdom
| | - Catherine J Perez
- Department of Parasitology & Veterinary Sciences, Murdoch University, South Street, Murdoch, Western Australia, 6150, Australia
| | - Scott Cornwall
- Department of Parasitology & Veterinary Sciences, Murdoch University, South Street, Murdoch, Western Australia, 6150, Australia
| | - R C Andrew Thompson
- Department of Parasitology & Veterinary Sciences, Murdoch University, South Street, Murdoch, Western Australia, 6150, Australia
| | - Martine Keenan
- Epichem Pty Ltd, Suite 5, 3 Brodie-Hall Drive, Technology Park, Bentley, Western Australia, 6102, Australia
| | - Karen L White
- Centre for Drug Candidate Optimisation, Monash University, 381 Royal Parade, Parkville, Victoria, 3052, Australia
| | - Susan A Charman
- Centre for Drug Candidate Optimisation, Monash University, 381 Royal Parade, Parkville, Victoria, 3052, Australia
| | - Bilal Zulfiqar
- Discovery Biology, Griffith Institute for Drug Discovery, Griffith University, Don Young Road, Nathan, Queensland, 4111, Australia
| | - Melissa L Sykes
- Discovery Biology, Griffith Institute for Drug Discovery, Griffith University, Don Young Road, Nathan, Queensland, 4111, Australia
| | - Vicky M Avery
- Discovery Biology, Griffith Institute for Drug Discovery, Griffith University, Don Young Road, Nathan, Queensland, 4111, Australia
| | - Eric Chatelain
- Drugs for Neglected Diseases initiative, 15 Chemin Louis Dunant, 1202, Geneva, Switzerland
| | - William A Denny
- Auckland Cancer Society Research Centre, School of Medical Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
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