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Arney JK, Headland MK, Bertone AM, Meite A, Ettiegne-Traore V, Asemanyi-Mensah K, Dede Teiko Dzathor I, Kargbo-Labour I, Jalloh U, Houck P, Stukel D. Synthesis of findings from the literature and a qualitative research study on the impacts of gender, disability, and ethnicity in Neglected Tropical Diseases programs. PLoS Negl Trop Dis 2023; 17:e0011782. [PMID: 38048347 PMCID: PMC10721307 DOI: 10.1371/journal.pntd.0011782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 12/14/2023] [Accepted: 11/09/2023] [Indexed: 12/06/2023] Open
Abstract
INTRODUCTION Act to End NTDs | West, a USAID-funded program that supports national governments to eliminate or control five neglected tropical diseases (NTDs) in West Africa including trachoma, lymphatic filariasis (LF), onchocerciasis, schistosomiasis and soil-transmitted helminthiasis, conducted a gender and social inclusion analysis to determine how NTDs differentially impact various populations and how gender and social norms impact NTD programs to inform future programming. METHODS The study used a mixed methods approach including a literature review; primary qualitative data collection; and monitoring data in Côte d'Ivoire, Sierra Leone, and Ghana. RESULTS Women and girls face additional health risks from many NTDs compared to men and boys. In addition to differential health burden, the social and economic impacts of NTD-related disability or infertility can be particularly dire for women and girls. Men were somewhat less likely to participate in mass drug administration (MDAs) due to: lack of information about campaigns, lack of access due to work, and higher levels of mistrust of the government and concerns about side effects of the medicines. Pregnant and breastfeeding women were sometimes excluded by community drug distributors (CDDs) from certain types of MDAs for which they are eligible. Training participation rates for CDDs and supervisors were nearly universally higher for men than women, even though feedback on the effectiveness of female CDDs was overwhelmingly positive, and female CDDs often have more access to other women in conservative households. The role of a CDD can lead to career and social opportunities for women. However, challenges faced by CDDs were seen as a greater barrier for women, including transportation, safety, household responsibilities, lower education levels, and low or lack of wages. DISCUSSION Programs to address NTDs can promote equity and improve programming by increasing women's participation as CDDs and providing financial compensation. Additionally, programs should prioritize inclusive training for CDDs, and inclusive messaging about MDA for communities.
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Affiliation(s)
| | | | | | - Aboulaye Meite
- Programme National de Lutte Contre les Maladies Tropicales Négligées à Chimiothérapie Préventive, Ministry of Health, Abidjan, Côte d’Ivoire
| | | | - Kofi Asemanyi-Mensah
- Neglected Tropical Diseases Programme, Disease Control and Prevention Department, Ghana Health Service, Public Health Division, Accra, Ghana
| | | | - Ibrahim Kargbo-Labour
- Neglected Tropical Disease Programme, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Umu Jalloh
- Helen Keller International, Freetown, Sierra Leone
| | - Patricia Houck
- Helen Keller International, NYC, New York, United States of America
| | - Diana Stukel
- FHI 360, Washington, DC, United States of America
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Loechl CU, Datta-Mitra A, Fenlason L, Green R, Hackl L, Itzkowitz L, Koso-Thomas M, Moorthy D, Owino VO, Pachón H, Stoffel N, Zimmerman MB, Raiten DJ. Approaches to Address the Anemia Challenge. J Nutr 2023; 153 Suppl 1:S42-S59. [PMID: 37714779 PMCID: PMC10797550 DOI: 10.1016/j.tjnut.2023.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 07/21/2023] [Accepted: 07/31/2023] [Indexed: 09/17/2023] Open
Abstract
Anemia is a multifactorial condition; approaches to address it must recognize that the causal factors represent an ecology consisting of internal (biology, genetics, and health) and external (social/behavioral/demographic and physical) environments. In this paper, we present an approach for selecting interventions, followed by a description of key issues related to the multiple available interventions for prevention and reduction of anemia. We address interventions for anemia using the following 2 main categories: 1) those that address nutrients alone, and, 2) those that address nonnutritional causes of anemia. The emphasis will be on interventions of public health relevance, but we also consider the clinical context. We also focus on interventions at different stages of the life course, with a particular focus on women of reproductive age and preschool-age children, and present evidence on various factors to consider when selecting an intervention-inflammation, genetic mutations, nutrient delivery, bioavailability, and safety. Each section on an intervention domain concludes with a brief discussion of key research areas.
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Affiliation(s)
- Cornelia U Loechl
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Ananya Datta-Mitra
- Department of Pathology and Laboratory Medicine, University of California, Davis, Davis, CA, United States
| | - Lindy Fenlason
- Bureau for Global Health, USAID, Washington, DC, United States
| | - Ralph Green
- Department of Pathology and Laboratory Medicine, University of California, Davis, Davis, CA, United States
| | - Laura Hackl
- USAID Advancing Nutrition, John Snow Inc., Arlington, VA, United States
| | - Laura Itzkowitz
- Bureau for Global Health, USAID, Washington, DC, United States
| | - Marion Koso-Thomas
- Eunice Kennedy Shriver National Institute of Child Health and Development, National Institutes of Health, Bethesda, MD, Unites States
| | - Denish Moorthy
- USAID Advancing Nutrition, John Snow Inc., Arlington, VA, United States.
| | | | - Helena Pachón
- Food Fortification Initiative, Emory University, Atlanta, GA, United States
| | - Nicole Stoffel
- Laboratory of Human Nutrition, Department of Health Sciences and Technology, ETH Zurich, Zu¨rich, Switzerland; MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Michael B Zimmerman
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Daniel J Raiten
- Eunice Kennedy Shriver National Institute of Child Health and Development, National Institutes of Health, Bethesda, MD, Unites States
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Beitze DE, Kavira Malengera C, Barhwamire Kabesha T, Frank J, Scherbaum V. Disparities in health and nutrition between semi-urban and rural mothers and birth outcomes of their newborns in Bukavu, DR Congo: a baseline assessment. Prim Health Care Res Dev 2023; 24:e61. [PMID: 37870120 PMCID: PMC10594532 DOI: 10.1017/s1463423623000518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 03/29/2023] [Accepted: 08/28/2023] [Indexed: 10/24/2023] Open
Abstract
AIM This research aimed to evaluate health and nutritional practices of mothers during pregnancy and birth outcomes of their newborns in Bukavu, Democratic Republic of the Congo (DRC), comparing semi-urban and rural areas. BACKGROUND Health and nutrition during pregnancy are crucial for adequate development of the fetus. Health care plays an important role but is often poor in rural areas of developing countries. METHODS A baseline survey of a nutritional follow-up study was conducted in two semi-urban and one rural hospital in the vicinity of Bukavu, DRC. In total, 471 mother-child pairs were recruited after delivery. Data collection included socio-demographic parameters, nutrition and health measures during pregnancy, and anthropometric parameters. Semi-urban and rural study locations were compared and predictors of birth weight evaluated. FINDINGS Semi-urban and rural mothers differed significantly in nutrition and health practices during pregnancy, as well as birth outcomes. In the rural area, there was a higher rate of newborns with low birth weight (10.7%) and lower rates of antimalarial medication (80.8%), deworming (24.6%), consumption of nutritional supplements (81.5%), and being informed about nutrition by medical staff (32.8%) during pregnancy as well as practicing family planning (3.1%) than in the semi-urban areas (2.7%, 88.6%, 88.3%; 89.3%, 46.5%, and 17.1%, respectively). Birth weight was positively predicted by increasing maternal MUAC, age, and gestational age and negatively by rural location, being primipara, being a farmer, and female newborn sex. CONCLUSION The findings highlight the importance of strengthening antenatal care activities especially in rural areas in order to ameliorate both maternal and infantile health and ensure appropriate development.
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Affiliation(s)
| | - Céline Kavira Malengera
- School of Public Health, Faculty of Medicine, Université de Goma, Goma, DR Congo
- School of Medicine and Public Health, Université Evangélique en Afrique, Bukavu, DR Congo
- Département de Nutrition, Centre de Recherche en Sciences Naturelles/Lwiro, D.S. Bukavu, DR Congo
| | - Theophile Barhwamire Kabesha
- School of Medicine and Public Health, Université Evangélique en Afrique, Bukavu, DR Congo
- Faculty of Medicine, Official University of Bukavu, Bukavu, DR Congo
| | - Jan Frank
- Institute of Nutritional Sciences, University of Hohenheim, Stuttgart, Germany
- Food Security Center, University of Hohenheim, Stuttgart, Germany
| | - Veronika Scherbaum
- Institute of Nutritional Sciences, University of Hohenheim, Stuttgart, Germany
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Soil-Transmitted Helminth Infections among Antenatal Women in Primary Care Settings in Southern India: Prevalence, Associated Factors and Effect of Anti-Helminthic Treatment. Trop Med Infect Dis 2023; 8:tropicalmed8010048. [PMID: 36668955 PMCID: PMC9865432 DOI: 10.3390/tropicalmed8010048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/19/2022] [Accepted: 12/28/2022] [Indexed: 01/11/2023] Open
Abstract
Community-based studies from India on prevalence of soil-transmitted helminth (STH) infections have reported estimates as high as 50% in children. However, prevalence estimates during pregnancy in India are lacking. We aimed to describe the burden, associated factors of STH and cure rate after deworming in primary care settings. Pregnant women were recruited from four urban and five rural centers in Puducherry, South India, from December 2019 to April 2022. One stool sample was collected from each participant before deworming and one repeat sample was collected from STH positive woman after three weeks of deworming. The samples were processed with saline; iodine wet mount, and microscopic concentration techniques. Cure rate (CR) was assessed using Kato-Katz thick smear. Of 650 women included, 49 (7.5%, 95% CI 5.6-9.8) had one of the STH infections; the prevalence of Ascaris lumbricoides, hookworm and Strongyloides was 5.4%, 1.8% and 0.3%, respectively. The prevalence of any STH was higher among ages 26-30 years (9.1%), working women (8.3%), multigravida (8.3%), urban setting (8.3%), those who did not wash their hands before food (9%) and anemic women (8.9%), compared to their counterparts, but not statistically significant. The CR for hookworm was 100% and Ascaris lumbricoides was 88.6%. To conclude, the prevalence of STH was low among pregnant women compared to school aged children. Continued deworming activities along with improved sanitation could further reduce the burden.
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Specht S, Keiser J. Helminth infections: Enabling the World Health Organization Road Map. Int J Parasitol 2022:S0020-7519(22)00180-1. [PMID: 36549443 DOI: 10.1016/j.ijpara.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/19/2022] [Accepted: 10/25/2022] [Indexed: 12/24/2022]
Abstract
Helminthiases are considered among the most persistent public health problems. Control and/or elimination remains a global health challenge and the World Health Organization Road Map highlights critical gaps and actions required to reach the 2030 targets, among them the need for new and more effective treatment options. Stronger collaborations across different fields are required to reach these goals. The helminth elimination platform is one example of how knowledge of two different disease areas can be aligned to fuse expertise and break disease silos.
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Affiliation(s)
- Sabine Specht
- Drugs for Neglected Diseases Initiative, 15 Camille-Vidart, 1202 Geneva, Switzerland.
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, P.O. Box, 4002, Basel, Switzerland; University of Basel, P.O. Box, 4003, Basel, Switzerland
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Ellwanger JH, Ziliotto M, Kulmann-Leal B, Chies JAB. Iron deficiency and soil-transmitted helminth infection: classic and neglected connections. Parasitol Res 2022; 121:3381-3392. [PMID: 36258094 DOI: 10.1007/s00436-022-07697-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/14/2022] [Indexed: 10/24/2022]
Abstract
Beyond participating in the oxygen transport by red blood cells, iron is an essential micronutrient and contributes to different physiological pathways and processes, such as cell proliferation, DNA repair, and other homeostatic functions. Iron deficiency affects millions of people, especially children and pregnant women. The consequences of iron deficiency are diverse, including inadequate child development, impaired cognition, and reduced productivity. Several factors contribute to iron deficiency, such as iron-poor diet, genetic factors, and infection with soil-transmitted helminths (STHs), especially roundworms (Ascaris lumbricoides), hookworms (Necator americanus and Ancylostoma duodenale), and whipworms (Trichuris trichiura). This review updates and summarizes the role of STHs as drivers of iron deficiency. Also, the poorly explored connections between STH infection, geophagia (a pica manifestation), immune response, and iron deficiency are discussed, highlighting how iron deficiency may act as a risk factor for infections by STHs, in addition to being a consequence of intestinal parasitic infections. Finally, strategies for control and management of iron deficiency and STH infection are described.
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Affiliation(s)
- Joel Henrique Ellwanger
- Laboratory of Immunobiology and Immunogenetics (Prédio 43323, Laboratório 212), Department of Genetics, Postgraduate Program in Genetics and Molecular Biology (PPGBM), Instituto de Biociências, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Bento Gonçalves, 9500, Campus do Vale, Rio Grande do Sul, Porto Alegre, Brazil.
| | - Marina Ziliotto
- Laboratory of Immunobiology and Immunogenetics (Prédio 43323, Laboratório 212), Department of Genetics, Postgraduate Program in Genetics and Molecular Biology (PPGBM), Instituto de Biociências, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Bento Gonçalves, 9500, Campus do Vale, Rio Grande do Sul, Porto Alegre, Brazil
| | - Bruna Kulmann-Leal
- Laboratory of Immunobiology and Immunogenetics (Prédio 43323, Laboratório 212), Department of Genetics, Postgraduate Program in Genetics and Molecular Biology (PPGBM), Instituto de Biociências, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Bento Gonçalves, 9500, Campus do Vale, Rio Grande do Sul, Porto Alegre, Brazil
| | - José Artur Bogo Chies
- Laboratory of Immunobiology and Immunogenetics (Prédio 43323, Laboratório 212), Department of Genetics, Postgraduate Program in Genetics and Molecular Biology (PPGBM), Instituto de Biociências, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Bento Gonçalves, 9500, Campus do Vale, Rio Grande do Sul, Porto Alegre, Brazil
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Muchomba FM. Effect of Schooling on Anemia and Nutritional Status Among Women: A Natural Experiment in Ethiopia. Am J Epidemiol 2022; 191:1722-1731. [PMID: 35762153 DOI: 10.1093/aje/kwac111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/28/2022] [Accepted: 06/23/2022] [Indexed: 01/29/2023] Open
Abstract
This study estimates the effect of length of schooling on anemia and nutritional status and evaluates the cost-effectiveness of primary schooling as an anemia intervention for women of childbearing age in Ethiopia. In 1994-1995, Ethiopia abolished primary school tuition fees and embarked on a large-scale educational investment program, which increased primary school enrollment and retention. An instrumented regression-discontinuity design was used to examine the effect on anemia risk and body mass index (BMI) of an increase in length of schooling resulting from the reforms, as a natural experiment. Anemia and BMI biomarkers and demographic data for 13,984 women were obtained from the 2011 and 2016 Ethiopia Demographic and Health Surveys, with the 2019 Mini Demographic and Health Survey used for robustness checks. Results indicate that each additional year of schooling reduced anemia risk by 3 percentage points (9.2%-11.2% reduction) and increased BMI (weight (kg)/height (m)2) by 0.26-0.42. Primary education was cost-effective-based on World Health Organization cost-effectiveness thresholds-as an anemia intervention, with a cost per anemia case averted of US$1,654. The findings suggest that investment in education reduces anemia risk later in life.
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8
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Prevalence and predictors of anemia among pregnant women in Ethiopia: Systematic review and meta-analysis. PLoS One 2022; 17:e0267005. [PMID: 35895619 PMCID: PMC9328503 DOI: 10.1371/journal.pone.0267005] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 03/31/2022] [Indexed: 11/19/2022] Open
Abstract
Background
In Ethiopia limited information is available regarding the prevalence and predictors of anemia in pregnancy. This systematic review and meta-analysis estimated the pooled prevalence of anemia among pregnant women in Ethiopia and also identified its predictors.
Materials and methods
The published primary studies were searched in the following electronic databases; PubMed/Medline, Google scholars, AJOL, and EMBASE. All primary studies published from 01/01/2010 to 30/05/2020 and written in English language were included without restriction on study setting and design. Critical appraisal of all available articles was done and extracted data was analyzed using STATA software version 14. The pooled prevalence of anemia was presented using a forest plot. The I2 statistical test for heterogeneity, and the Egger’s and Begg’s tests for publication bias were used. The relative risk was used to assess the association of predictor variables with anemia.
Result
After screening 274 articles, sixty studies were included in the analysis. The pooled prevalence of anemia among pregnant women was 26.4(95% CI: 23.1, 29.6). Sub-group analysis showed higher pooled prevalence from community-based studies than institutional-based studies. Factors that were protective against maternal anemia included urban residence, formal education and smaller family size. Short birth interval and not having antenatal care (ANC) are associated with a higher risk of maternal anemia. Women with low dietary diversity [RR: 2.61(95% CI, 1.85, 3.68)], mid-upper arm circumference (MUAC) less than 23 cm [RR: 2.35(95% CI, 1.53, 3.68)] and those not taking iron-folic acid [RR: 1.53(95% CI: 1.30, 1.81)] also had a higher risk of anemia.
Conclusion
Almost one in four pregnant women in Ethiopia had anemia. Being literate, living in urban areas with small family size and adequate birth spacing, as well as good dietary diversity are associated with a lower risk of anemia in pregnancy.
Registration number
(ID: CRD42020211054).
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Gibbs L, Fairfax KC. Altered Offspring Immunity in Maternal Parasitic Infections. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2022; 208:221-226. [PMID: 35017211 PMCID: PMC8769501 DOI: 10.4049/jimmunol.2100708] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/10/2021] [Indexed: 01/17/2023]
Abstract
Maternal infection during pregnancy is known to alter the development and function of offspring's immune system, leading to inappropriate immune responses to common childhood infections and immunizations. Although this is an expanding field, maternal parasitic infections remain understudied. Millions of women of reproductive age are currently at risk for parasitic infection, whereas many pregnant, chronically infected women are excluded from mass drug administration due partially to a lack of resources, as well as fear of unknown adverse fetal developmental outcomes. In areas endemic for multiple parasitic infections, such as sub-Saharan Africa, there are increased rates of morbidity and mortality for various infections during early childhood in comparison with nonendemic areas. Despite evidence supporting similar immunomodulatory effects between various parasite species, there is no clear mechanistic understanding of how maternal infection reprograms offspring immunity. This brief review will compare the effects of selected maternal parasitic infections on offspring immunity.
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Affiliation(s)
- Lisa Gibbs
- Department of Pathology, Division of Microbiology and Immunology, University of Utah, Salt Lake City Utah, USA
| | - Keke C. Fairfax
- Department of Pathology, Division of Microbiology and Immunology, University of Utah, Salt Lake City Utah, USA
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Lee AC, Abate FW, Mullany LC, Baye E, Berhane YY, Derebe MM, Eglovitch M, Fasil N, Olson IE, Kidane WT, Shiferaw T, Shiferie F, Tsegaye F, Tsegaye S, Yibeltal K, Chan GJ, Christian P, Isanaka S, Kang Y, Lu C, Mengistie MM, Molina RL, Stojanov MD, Van Dyk F, Tadesse AW, Wondale AT, Wylie BJ, Worku A, Berhane Y. Enhancing Nutrition and Antenatal Infection Treatment (ENAT) study: protocol of a pragmatic clinical effectiveness study to improve birth outcomes in Ethiopia. BMJ Paediatr Open 2022; 6:e001327. [PMID: 36053580 PMCID: PMC8762145 DOI: 10.1136/bmjpo-2021-001327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 11/07/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The WHO Nutrition Target aims to reduce the global prevalence of low birth weight by 30% by the year 2025. The Enhancing Nutrition and Antenatal Infection Treatment (ENAT) study will test the impact of packages of pregnancy interventions to enhance maternal nutrition and infection management on birth outcomes in rural Ethiopia. METHODS AND ANALYSIS ENAT is a pragmatic, open-label, 2×2 factorial, randomised clinical effectiveness study implemented in 12 rural health centres in Amhara, Ethiopia. Eligible pregnant women presenting at antenatal care (ANC) visits at <24 weeks gestation are enrolled (n=2400). ANC quality is strengthened across all centres. Health centres are randomised to receive an enhanced nutrition package (ENP) or standard nutrition care, and within each health centre, individual women are randomised to receive an enhanced infection management package (EIMP) or standard infection care. At ENP centres, women receive a regular supply of adequately iodised salt and iron-folate (IFA), enhanced nutrition counselling and those with mid-upper arm circumference of <23 cm receive a micronutrient fortified balanced energy protein supplement (corn soya blend) until delivery. In standard nutrition centres, women receive routine counselling and IFA. EIMP women have additional screening/treatment for urinary and sexual/reproductive tract infections and intensive deworming. Non-EIMP women are managed syndromically per Ministry of Health Guidelines. Participants are followed until 1-month post partum, and a subset until 6 months. The primary study outcomes are newborn weight and length measured at <72 hours of age. Secondary outcomes include preterm birth, low birth weight and stillbirth rates; newborn head circumference; infant weight and length for age z-scores at birth; maternal anaemia; and weight gain during pregnancy. ETHICS AND DISSEMINATION ENAT is approved by the Institutional Review Boards of Addis Continental Institute of Public Health (001-A1-2019) and Mass General Brigham (2018P002479). Results will be disseminated to local and international stakeholders. REGISTRATION NUMBER ISRCTN15116516.
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Affiliation(s)
- Anne Cc Lee
- Department of Pediatric Newborn Medicine, Global Advancement of Infants and Mothers, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | | | - Luke C Mullany
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Estifanos Baye
- Department of Pediatric Newborn Medicine, Global Advancement of Infants and Mothers, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | | | | | - Michelle Eglovitch
- Department of Pediatric Newborn Medicine, Global Advancement of Infants and Mothers, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Nebiyou Fasil
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Ingrid E Olson
- Department of Pediatric Newborn Medicine, Global Advancement of Infants and Mothers, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - Tigest Shiferaw
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Fisseha Shiferie
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Fitsum Tsegaye
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Sitota Tsegaye
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | | | - Grace J Chan
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Medical Critical Care, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Parul Christian
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sheila Isanaka
- Departments of Nutrition and Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Yunhee Kang
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Chunling Lu
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - Rose L Molina
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Michele D Stojanov
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Fred Van Dyk
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Amare Worku Tadesse
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Asresie T Wondale
- Debretabor Referral Hospital, Amhara Regional Health Bureau, Bahir Dar, Ethiopia
| | - Blair J Wylie
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Alemayehu Worku
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
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Kaforau LS, Tessema GA, Bugoro H, Pereira G, Jancey J. Lived experiences of women with low birth weight infants in the Solomon Islands: A descriptive qualitative study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001008. [PMID: 36962868 PMCID: PMC10022132 DOI: 10.1371/journal.pgph.0001008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/04/2022] [Indexed: 12/12/2022]
Abstract
Every year, around 20 million women worldwide give birth to low birth weight (LBW) infants, with majority of these births occurring in low-and middle-income countries, including the Solomon Islands. Few studies have explored the pregnancy lived experience of women who deliver LBW infants. The aim of the study is to understand the lived experience of women in the Solomon Islands who gave birth to LBW infants by exploring their personal (socio-demographic and health), behavioural, social and environmental contexts. We used a qualitative descriptive approach and purposely selected 18 postnatal women with LBW infants in the Solomon Islands for an in-depth interview. All data were analysed using thematic analysis in NVivo. We identified six themes reported as being related to LBW: health issues, diet and nutrition, substance use, domestic violence, environmental conditions and antenatal care. Our findings suggest that women in the Solomon Islands are exposed to various personal, behavioural, social and environmental risk factors during pregnancy that can impact birth outcomes, particularly LBW. We recommend further research should be redirected to look at the factors/themes identified in the interviews.
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Affiliation(s)
- Lydia S Kaforau
- Curtin School of Population Health, Curtin University, Perth, Australia
- School of Nursing and Allied Health Sciences, Solomon Islands National University, Honiara, Solomon Islands
| | - Gizachew A Tessema
- Curtin School of Population Health, Curtin University, Perth, Australia
- School of Public Health, The University of Adelaide, South Australia, Australia
| | - Hugo Bugoro
- School of Nursing and Allied Health Sciences, Solomon Islands National University, Honiara, Solomon Islands
| | - Gavin Pereira
- Curtin School of Population Health, Curtin University, Perth, Australia
- Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway
- enAble Institute, Curtin University, Perth, Australia
| | - Jonine Jancey
- Curtin School of Population Health, Curtin University, Perth, Australia
- enAble Institute, Curtin University, Perth, Australia
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12
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Taghipour A, Ghodsian S, Jabbari M, Olfatifar M, Abdoli A, Ghaffarifar F. Global prevalence of intestinal parasitic infections and associated risk factors in pregnant women: a systematic review and meta-analysis. Trans R Soc Trop Med Hyg 2021; 115:457-470. [PMID: 33007067 DOI: 10.1093/trstmh/traa101] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/04/2020] [Accepted: 09/10/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Intestinal parasitic infections (IPIs) during pregnancy, if left untreated, can cause adverse effects for the mothers, foetuses and newborns. However, limited information is available about the global status of IPIs in pregnant women. Here we undertook a meta-analysis to estimate the global prevalence of IPIs and associated risk factors in pregnant women. METHODS We searched the PubMed, Science Direct, Scopus, Web of Science and Google Scholar databases for relevant studies that were published between 1 January 1987 and 30 December 2019. A random effects meta-analysis model was used to estimate the pooled prevalence, odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS A total of 114 studies comprising 98 342 pregnant women across 35 countries were included in the systematic review and meta-analysis. Among IPIs identified from pregnant women, three helminth infections (hookworm 19% [95% CI 15 to 23], Ascaris lumbricoides 17% [95% CI 13 to 21] and Trichuris trichiura 11% [95% CI 7 to 16]) and three protozoan infections (Blastocystis sp. 21% [95% CI 4 to 46], Entamoeba histolytica/dispar 9% [95% CI 3 to 19] and Giardia sp. 8% [95% CI 4 to 13]) were identified as the most prevalent intestinal parasites. Moreover, we found that there was a significant association between IPIs with increased risk of anaemia in pregnant women (OR 2.65 [95% CI 2.08 to 3.37]). The prevalence of IPIs was slightly higher in geophagic pregnant women compared with controls, but this was not significant (OR 1.22 [95% CI 0.87 to 1.71]). According to species, the pooled OR of A. lumbricoides infection had a significantly higher risk in geophagic pregnant women compared with controls (OR 2.66 [95% CI 1.37 to 5.16]). There was a positive relationship between the high prevalence of IPIs in pregnant women living in rural areas compared with urban residents (OR 3.36 [95% CI 1.57 to 7.19]). CONCLUSIONS The current review revealed a relatively high prevalence of IPIs in pregnant women, especially in some low- and middle-income countries. These results suggest a need for improved prevention and control efforts to reduce the health risks to pregnant women.
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Affiliation(s)
- Ali Taghipour
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box 14115-111, Tehran, Iran
| | - Sahar Ghodsian
- Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Jabbari
- Department of Microbiology, Faculty of Basic Science, Tabriz Branch, Islamic Azad University, Tabriz, Iran
| | - Meysam Olfatifar
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Abdoli
- Department of Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Fatemeh Ghaffarifar
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box 14115-111, Tehran, Iran
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13
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Garrison A, Boivin M, Khoshnood B, Courtin D, Alao J, Mireku M, Ibikounle M, Massougbodji A, Cot M, Bodeau-Livinec F. Soil-transmitted helminth infection in pregnancy and long-term child neurocognitive and behavioral development: A prospective mother-child cohort in Benin. PLoS Negl Trop Dis 2021; 15:e0009260. [PMID: 33739991 PMCID: PMC7978343 DOI: 10.1371/journal.pntd.0009260] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 02/21/2021] [Indexed: 12/14/2022] Open
Abstract
Background An estimated 30% of women in Sub-Saharan Africa suffer from soil-transmitted helminth infection during pregnancy (SHIP), which has been shown to increase risk of pre-term birth, low birth weight, and maternal anemia. A previous study in Benin found that SHIP was associated with impaired cognitive and gross motor development scores in 635 one-year-old children. The objective of the present study was to follow children prospectively to investigate whether the association between SHIP and child neurocognitive and behavioral development persisted at age six. Principal findings Our prospective child cohort included 487 live-born singletons of pregnant women enrolled in the Malaria in Pregnancy Preventive Alternative Drugs clinical trial in Allada, Benin. SHIP was assessed at three antenatal visits (ANVs) through collection and testing of stool samples. Neurocognitive and behavioral development was assessed in six-year-old children by trained investigators using the Kaufman Assessment Battery for Children 2nd edition and the parent-reported Strengths and Difficulties Questionnaire (SDQ). Multiple linear regression models generated coefficients and 95% confidence intervals and potential mediating factors were tested. Prevalence of SHIP was 13% at the 1st ANV, 9% at the 2nd ANV, and 1% at delivery. SHIP was not associated with low neurocognitive scores in children at six years. Higher SDQ internalizing scores, indicating increased emotional impairments in children, were associated with helminth infection at the 2nd ANV/delivery 1.07 (95% CI 0.15, 2.00) and at least once during pregnancy 0.79 (95% CI 0.12, 1.46) in adjusted models. Mediation analysis did not reveal significant indirect effects of several mediators on this association. Conclusions Our study shows that while SHIP is not associated with impaired long-term neurocognitive development, infections may have significant negative impacts on emotional development in six-year-old children. SHIP remains a critical public health issue, and adequate prevention and treatment protocols should be enforced in low- and middle-income countries. Soil-transmitted helminth infections impact 1.5 billion individuals, primarily in low- and middle- income countries, each year and contribute to malnutrition, anemia, and impaired neurocognitive development in children. However, these infections in pregnancy and their impact on offspring have been less studied. One previous study found associations between soil-transmitted helminth infection during pregnancy and impaired cognitive functioning in offspring one year after birth. The current study aimed to follow these children prospectively until six years in order to confirm whether these associations persisted or not. Infections during pregnancy were no longer associated with cognitive or motor functioning in children; however, infections were associated with impaired behavioral development. Animal-based models have hypothesized maternal inflammation and poor birth outcomes to be the mechanisms behind this relationship; however, our findings did not support these mechanisms. This is one of very few prospective cohort studies in Sub-Saharan Africa to investigate these associations, and more research is needed to corroborate results. Limitations include limited power and the possibility that results are due to chance from multiple statistical tests. Adequate and accessible prevention and treatment efforts in pregnancy and childhood should be provided to populations in low- and middle- income countries at high risk of infection.
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Affiliation(s)
- Amanda Garrison
- Département Méthodes Quantitatives en Santé Publique (METIS), Ecole des Hautes Etudes en Santé Publique, Rennes, France
- Université de Paris, Center of Research in Epidemiology and Statistics/CRESS, INSERM, INRA, Paris, France
- Sorbonne Universités, Université de Paris, Paris, France
- * E-mail:
| | - Michael Boivin
- Departments of Psychiatry and Neurology/Ophthalmology, Michigan State University, East Lansing, Michigan, United States of America
| | - Babak Khoshnood
- Département Méthodes Quantitatives en Santé Publique (METIS), Ecole des Hautes Etudes en Santé Publique, Rennes, France
| | | | - Jules Alao
- Service de Pédiatrie, CHU de la Mère et de l’Enfant-Lagune de Cotonou, Cotonou, Benin
| | - Michael Mireku
- School of Psychology, University of Lincoln, Lincoln, England
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, England
| | - Moudachirou Ibikounle
- Centre de Recherche pour la lutte contre les Maladies Infectieuses Tropicales, Université d’Abomey-Calavi, Cotonou, Benin
| | | | - Michel Cot
- Université de Paris, MERIT, IRD, Paris, France
| | - Florence Bodeau-Livinec
- Département Méthodes Quantitatives en Santé Publique (METIS), Ecole des Hautes Etudes en Santé Publique, Rennes, France
- Université de Paris, Center of Research in Epidemiology and Statistics/CRESS, INSERM, INRA, Paris, France
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14
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Cohn DA, Kelly MP, Bhandari K, Zoerhoff KL, Batcho WE, Drabo F, Negussu N, Marfo B, Goepogui A, Lemoine JF, Ganefa S, Massangaie M, Rimal P, Gnandou I, Anagbogu IN, Ndiaye M, Bah YM, Mwingira UJ, Awoussi MS, Tukahebwa EM, Stelmach RD, Mingkwan PC, Pou B, Koroma JB, Rotondo LA, Kraemer JD, Baker MC. Gender equity in mass drug administration for neglected tropical diseases: data from 16 countries. Int Health 2019; 11:370-378. [PMID: 30845318 PMCID: PMC6748770 DOI: 10.1093/inthealth/ihz012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 01/25/2019] [Accepted: 02/20/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Gender equity in global health is a target of the Sustainable Development Goals and a requirement of just societies. Substantial progress has been made towards control and elimination of neglected tropical diseases (NTDs) via mass drug administration (MDA). However, little is known about whether MDA coverage is equitable. This study assesses the availability of gender-disaggregated data and whether systematic gender differences in MDA coverage exist. METHODS Coverage data were analyzed for 4784 district-years in 16 countries from 2012 through 2016. The percentage of districts reporting gender-disaggregated data was calculated and male-female coverage compared. RESULTS Reporting of gender-disaggregated coverage data improved from 32% of districts in 2012 to 90% in 2016. In 2016, median female coverage was 85.5% compared with 79.3% for males. Female coverage was higher than male coverage for all diseases. However, within-country differences exist, with 64 (3.3%) districts reporting male coverage >10 percentage points higher than female coverage. CONCLUSIONS Reporting of gender-disaggregated data is feasible. And NTD programs consistently achieve at least equal levels of coverage for women. Understanding gendered barriers to MDA for men and women remains a priority.
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Affiliation(s)
- Daniel A Cohn
- RTI International, 701 13th St NW, Suite 750, Washington, DC USA
| | - Maureen P Kelly
- RTI International, 701 13th St NW, Suite 750, Washington, DC USA
| | - Kalpana Bhandari
- RTI International, 701 13th St NW, Suite 750, Washington, DC USA
| | | | - Wilfrid E Batcho
- National Communicable Disease Control Program, Ministry of Health, 01 BP 882, Cotonou, Republic of Benin
| | - François Drabo
- National Neglected Tropical Disease Control Program, Disease Control Directorate, Ministry of Health, Ouagadougou, Burkina Faso
| | - Nebiyu Negussu
- Neglected Tropical Diseases Team, Disease Prevention and Control Directorate, Federal Ministry of Health, Addis Ababa, Federal Democratic Republic of Ethiopia
| | - Benjamin Marfo
- National NTD Program, Ghana Health Service, Accra, Republic of Ghana
| | - André Goepogui
- National Onchocerciasis and Blindness and Neglected Tropical Disease Control Program, National Prevention and Community Health Directorate, Ministry of Health, BP 585, Conakry, Republic of Guinea
| | - Jean-Frantz Lemoine
- National Malaria Control Program, Ministry of Public Health and Population, 30 Rue Mercier Laham, Delmas 60, Republic of Haiti
| | - Sitti Ganefa
- Sub-Directorate of Filariasis & Helminthiasis Control, Directorate of Vector Borne Disease Control, Directorate General of Communicable Disease and Environmental Health, Ministry of Health, Jl. Percetakan Negara No. 29, Jakarta, Republic of Indonesia
| | - Marilia Massangaie
- Department of Other Infectious Diseases, Ministry of Health, AV. Eduardo Mondlane e Salvador Allende, Maputo, Republic of Mozambique
| | - Pradip Rimal
- Epidemiology and Disease Control Division, Department of Health Services, Ministry of Health, Teku, Kathmandu, Federal Democratic Republic of Nepal
| | - Issa Gnandou
- National Bilharzia and Soil-Transmitted Helminths Control Program, Ministry of Public Health, Niamey, Republic of Niger
| | - Ifeoma N Anagbogu
- Department of Public Health, Neglected Tropical Diseases Division, Federal Ministry of Health, Federal Secretariat Complex Phase 3, Ahmadu Bello Way, CBD, Abuja, Federal Republic of Nigeria
| | - Mamadou Ndiaye
- Neglected Tropical Disease Control Program, Disease Control Directorate, Ministry of Health and Social Work, Dakar, Republic of Senegal
| | - Yakuba Madina Bah
- NTD Programme, Ministry of Health and Sanitation, Freetown, Republic of Sierra Leone
| | - Upendo J Mwingira
- Neglected Tropical Diseases Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, United Republic of Tanzania
- National Institute for Medical Research, 2448 Barack Obama Dr, Box 9653, Dar es Salaam, United Republic of Tanzania
| | - Marcel S Awoussi
- National Neglected Tropical Disease Control Program, General Directorate of Health, Ministry of Health and Social Welfare, Lomé, Republic of Togo
| | | | | | - Pia C Mingkwan
- RTI International, 701 13th St NW, Suite 750, Washington, DC USA
| | - Bolivar Pou
- FHI 360, 1825 Connecticut Avenue NW, Washington, DC, USA
| | - Joseph B Koroma
- FHI 360, 1st Floor, Marvel House, 148A Giffard Road, East Cantonments, Accra, Ghana
| | - Lisa A Rotondo
- RTI International, 701 13th St NW, Suite 750, Washington, DC USA
| | - John D Kraemer
- RTI International, 701 13th St NW, Suite 750, Washington, DC USA
- Department of Health Systems Administration, Georgetown University, 3700 Reservoir Road NW, Washington, DC, USA
| | - Margaret C Baker
- RTI International, 701 13th St NW, Suite 750, Washington, DC USA
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15
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Gitaka J, Mwaura P, Oware K, Kongere J, Wasonga J, Matendechero S. Evaluating community’s knowledge on integrated malaria, schistosomiasis and soil transmitted helminth (STH) infections in a Lake Victoria island, Kenya: A mixed method approach. AAS Open Res 2019. [DOI: 10.12688/aasopenres.12897.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The burden of malaria, schistosomiasis and soil transmitted helminthes (STH) in the islands of Lake Victoria, Kenya, poses a considerable public health challenge. Although many studies have been conducted on the co-infection arising from these parasites, few have evaluated communities’ knowledge of the same. Increasing the level of knowledge about a disease or preventive chemotherapy is important, but efforts need to be focused on community perception and understanding of the problem so as to encourage engagement with the proposed control measures. This study aimed at understanding a community’s knowledge of malaria, schistosomiasis and STH in Lake Victoria island where an integrated preventive chemotherapy intervention was implemented. Methods: This study was conducted in Ngodhe Island in Lake Victoria in Homa Bay County, western Kenya region between April and May 2016. The study adopted a mixed method approach where both qualitative and quantitative data collection was performed concurrently. Results: A total of 239 people participated in this study. All the respondents reported that they had heard about malaria, 89.1% had heard about schistosomiasis while 87.4% had heard about STH. The majority of the respondents (93.3%) drew their drinking water directly from the lake and 80.3% reported bathing in the lake. Out of all the respondents, 96.2% knew about the ongoing preventive chemotherapy. Most respondents (94.1%) said they would participate in a preventive chemotherapy again, while 0.4% was not sure. The majority of the respondents (86.6%) reported that integrated strategy is the most effective approach to control the three infections in the Island. Conclusion: The findings show a very high knowledge about these diseases. Although this study found majority of the respondents are aware of the co-infection of malaria, schistosomiasis and STH, their behaviors such as bathing in the lake exacerbates the problem.
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16
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Paltridge M, Traves A. The Health Effects of Strongyloidiasis on Pregnant Women and Children: A Systematic Literature Review. Trop Med Infect Dis 2018; 3:tropicalmed3020050. [PMID: 30274446 PMCID: PMC6073583 DOI: 10.3390/tropicalmed3020050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 05/11/2018] [Accepted: 05/15/2018] [Indexed: 12/26/2022] Open
Abstract
Strongyloidiasis is a helminth infection that remains under-researched despite its ability to cause significant illness. Women and children may be at particular risk of health consequences from this parasite. This systematic literature review aims to examine research on the long-term health effects that strongyloidiasis has in pregnant women and children. We conducted a structured search using multiple databases to collect all primary studies discussing health effects of strongyloidiasis in the aforementioned groups. The review included 20 results: 16 primary studies and four case reports. The methodological quality of studies was substandard, and there was substantial heterogeneity to the statistical analysis and outcomes assessed in the literature. Statistically significant associations were found between strongyloidiasis and low birth weight, as well as wasting. No links were found between strongyloidiasis and anaemia. Due to testing methods used in the studies, the prevalence of Strongyloides stercoralis in these studies was probably under-estimated. Current research is suggestive that strongyloidiasis has long-term adverse health effects on the offspring of infected mothers and in chronically-infected children. Data analysis was hindered by both methodological and statistical flaws, and as such, reliable conclusions regarding the health impacts could not be formed.
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Affiliation(s)
- Matthew Paltridge
- College of Medicine and Dentistry, James Cook University, Smithfield QLD 4878, Australia.
| | - Aileen Traves
- College of Medicine and Dentistry, James Cook University, Smithfield QLD 4878, Australia.
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17
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Abstract
Helminths are parasitic nematodes and trematodes, grouped together because of morphological similarities and commonalities in the effects infections have on hosts. These include complications such as anemia and biasing of immune responses, which can alter susceptibility for other diseases. For pregnant women, these complications might have implications for pregnancy outcomes or neonatal health. Here, I review studies of helminth infections during pregnancy, and ask the following questions: Do helminths affect maternal health or pregnancy outcomes? Are there consequences of maternal infection for infants? What are the effects of antihelminth treatment during pregnancy? The evidence suggests that the answers to these questions depend on the particular helminth species in question, maternal nutritional status, and the presence or absence of comorbid infection with other species, such as malaria. Moreover, there may also be unexpected consequences of treatment, as maternal infections can affect the priming of infant immune systems, with potential effects on infants later in life. These complex interactions suggest that a consideration of the evolutionary history of human–helminth interactions, as well as the ecological context of infections, can help to clarify an understanding of these host–parasite interactions and provide direction for future investigations.
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Affiliation(s)
- Aaron D Blackwell
- Department of Anthropology, University of California, Santa Barbara, Santa Barbara, CA, USA
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18
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Campbell SJ, Nery SV, Doi SA, Gray DJ, Soares Magalhães RJ, McCarthy JS, Traub RJ, Andrews RM, Clements ACA. Complexities and Perplexities: A Critical Appraisal of the Evidence for Soil-Transmitted Helminth Infection-Related Morbidity. PLoS Negl Trop Dis 2016; 10:e0004566. [PMID: 27196100 PMCID: PMC4873196 DOI: 10.1371/journal.pntd.0004566] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Soil-transmitted helminths (STH) have acute and chronic manifestations, and can result in lifetime morbidity. Disease burden is difficult to quantify, yet quantitative evidence is required to justify large-scale deworming programmes. A recent Cochrane systematic review, which influences Global Burden of Disease (GBD) estimates for STH, has again called into question the evidence for deworming benefit on morbidity due to STH. In this narrative review, we investigate in detail what the shortfalls in evidence are. METHODOLOGY/PRINCIPAL FINDINGS We systematically reviewed recent literature that used direct measures to investigate morbidity from STH and we critically appraised systematic reviews, particularly the most recent Cochrane systematic review investigating deworming impact on morbidity. We included six systematic reviews and meta-analyses, 36 literature reviews, 44 experimental or observational studies, and five case series. We highlight where evidence is insufficient and where research needs to be directed to strengthen morbidity evidence, ideally to prove benefits of deworming. CONCLUSIONS/SIGNIFICANCE Overall, the Cochrane systematic review and recent studies indicate major shortfalls in evidence for direct morbidity. However, it is questionable whether the systematic review methodology should be applied to STH due to heterogeneity of the prevalence of different species in each setting. Urgent investment in studies powered to detect direct morbidity effects due to STH is required.
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Affiliation(s)
- Suzy J. Campbell
- Research School of Population Health, College of Medicine, Biology, and Environment, The Australian National University, Canberra, Australian Captial Territory, Australia
| | - Susana V. Nery
- Research School of Population Health, College of Medicine, Biology, and Environment, The Australian National University, Canberra, Australian Captial Territory, Australia
| | - Suhail A. Doi
- Research School of Population Health, College of Medicine, Biology, and Environment, The Australian National University, Canberra, Australian Captial Territory, Australia
| | - Darren J. Gray
- Research School of Population Health, College of Medicine, Biology, and Environment, The Australian National University, Canberra, Australian Captial Territory, Australia
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Ricardo J. Soares Magalhães
- Children's Health and Environment Program, Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Queensland, Australia
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - James S. McCarthy
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia
- Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Rebecca J. Traub
- Faculty of Veterinary and Agricultural Science, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ross M. Andrews
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Archie C. A. Clements
- Research School of Population Health, College of Medicine, Biology, and Environment, The Australian National University, Canberra, Australian Captial Territory, Australia
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19
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Mahande AM, Mahande MJ. Prevalence of parasitic infections and associations with pregnancy complications and outcomes in northern Tanzania: a registry-based cross-sectional study. BMC Infect Dis 2016; 16:78. [PMID: 26874788 PMCID: PMC4753041 DOI: 10.1186/s12879-016-1413-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 02/04/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Parasitic infection(s) during pregnancy have been associated with increased risk of pregnancy complications and adverse outcomes in low resource settings. However, little is known about their influence on pregnancy outcomes. This study aimed to determine the prevalence of parasitic infections and their association with pregnancy complications and adverse outcomes. METHODS A retrospective cross-sectional study was conducted using maternally-linked data from Kilimanjaro Christian Medical Center (KCMC) medical birth registry. Birth records from all women who delivered singleton infants from 2000-2011 were utilized. We excluded multiple gestations and rural medical referral for various medical complications. A total of 30,797 births were evaluated. Data analysis was performed using SPSS version 18.0. Odds ratio (ORs) with 95 % confidence intervals (CIs) for adverse pregnancy outcomes and complications associated with parasitic infections were estimated using multiple logistic regression models. A p-value of less than 5 % was considered statistically significant. RESULTS The most prevalent parasitic infection recorded was malaria (17.0 %), while helminths and amebiasis were infrequently recorded (0.6 % vs. 0.7 %, respectively). Women who had malaria during pregnancy had 13 % increased odds of having a preterm delivery (OR = 1.13; 95 % CI: 1.01-1. 26) as compared to those who were not infected. They also had 33 % increased odds of getting maternal anemia (OR = 1.33; 95 % CI: 1.11-1.72). Likewise, pregnant women who were recorded with helminths infections had 29 % increased odds of having maternal anemia as compared to those who had no helminths infection (OR = 1.29; 95 % CI:0.48-3.53). Moreover, pregnant women who were recorded to have amebiasis had 79 % increased odds of having a preterm delivery as compared to those who had no ameba infection (OR = 1.79; 95 % CI: 1.12-2.91). CONCLUSIONS Malaria was the prevalent parasitic infection in the studied population while helminth and ameba infections were infrequently reported. These parasitic infections were also associated with increased risk of anemia and delivery of a preterm infant. These were the only three infections/infestations which were evaluated. Our analysis revealed that malaria, helminth and ameba infections during pregnancy is dangerous and has life threatening consequences. This highlight the need to provide early diagnosis and treatment for infected women to prevent pregnancy complications and associated adverse pregnancy outcomes.
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Affiliation(s)
- Aneth Mkunde Mahande
- Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical College, Moshi, Tanzania
| | - Michael Johnson Mahande
- Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical College, Moshi, Tanzania
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20
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Valerio E, Favot F, Mattei I, Cutrone M. Congenital isolated Iso-Kikuchi syndrome in a newborn. Clin Case Rep 2015; 3:866-9. [PMID: 26509026 PMCID: PMC4614659 DOI: 10.1002/ccr3.367] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 06/14/2015] [Accepted: 08/06/2015] [Indexed: 01/16/2023] Open
Abstract
Classic CO (also called Iso–Kikuchi syndrome) represents a benign, isolated condition associated with normal patient outcome. Nevertheless, clinical follow-up and/or further clinically-based tests are needed to exclude other nail diseases associated with multisystem pathology; complete family history is also important to determine sporadic or hereditary transmission of such condition.
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Affiliation(s)
- Enrico Valerio
- Department of Woman and Child Health, Neonatal Intensive Care Unit, Medical School, University of Padua Padova, Italy
| | - Francesca Favot
- Department of Pediatrics, Pediatric Dermatology Unit, Ospedale Dell'Angelo Mestre (VE), Italy
| | - Ilaria Mattei
- Department of Pediatrics, Pediatric Dermatology Unit, Ospedale Dell'Angelo Mestre (VE), Italy
| | - Mario Cutrone
- Department of Pediatrics, Pediatric Dermatology Unit, Ospedale Dell'Angelo Mestre (VE), Italy
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