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Lee J, Lee S. Spatial Analysis of Health System Factors in Infectious Disease Management: Lessons Learned from the COVID-19 Pandemic in Korea. Healthcare (Basel) 2024; 12:1484. [PMID: 39120187 PMCID: PMC11312003 DOI: 10.3390/healthcare12151484] [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: 06/26/2024] [Revised: 07/21/2024] [Accepted: 07/24/2024] [Indexed: 08/10/2024] Open
Abstract
Infectious disease outbreaks present ongoing and substantial challenges to health systems at local, national, and global levels, testing their preparedness, response capabilities, and resilience. This study aimed to identify and analyze critical health system-level factors that influence infection outbreaks, focusing on the experience of the COVID-19 pandemic in Korea. Conducted as a secondary data analysis, this study utilized national datasets from Korea. Given the inherent spatial dependencies in the spread of infectious diseases, we employed a spatial lag model to analyze data. While city-specific characteristics did not emerge as significant factors, health system variables, particularly the number of community health centers and health budgets, showed significant influence on the course of the COVID-19 outbreak, along with spatial autocorrelation coefficients. Our findings underscore the importance of enhancing public healthcare infrastructure, considering regional specificities, and promoting collaboration among local governments to bolster preparedness for future outbreaks. These insights are crucial for policymakers and healthcare professionals in formulating effective strategies to prevent, manage, and mitigate the impact of infectious disease outbreaks.
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Affiliation(s)
- Jeongwook Lee
- Graduate School of Public Administration, Seoul National University, Seoul 08826, Republic of Korea;
| | - SangA Lee
- Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA
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Carvalho RGD, Pinheiro MCC, Damasceno Morais FJ, Galvão RLDF, Barbosa L, Souza Sá SLC, Scherr TF, Bezerra FSDM. Immunochromatographic POC-CCA Test for the diagnosis of intestinal schistosomiasis in a high endemic region in Brazil: Differences in the interpretation of results. Acta Trop 2024; 254:107181. [PMID: 38503365 DOI: 10.1016/j.actatropica.2024.107181] [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: 11/22/2023] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/21/2024]
Abstract
The POC-CCA test is subject to variations in reading interpretations depending on the intensity of its results, and trace test reading have implications for determining prevalence. The aim of this study was to assess whether the readings obtained from the POC-CCA tests, conducted using a semi-quantitative scale (the G-score classification for test determination), exhibited concurrence with the direct visual interpretation (positive, negative, or trace) performed by two distinct analysts, using photographs from previously performed POC-CCA test carried out in the municipality of Maruim, in the state of Sergipe-Brazil, a region of high endemicity. The devices used to read the photographs were smartphones, so as to simulate field usage, and a desktop, a tool with higher image quality that would help the researchers in the evaluation and establishment of the final result at a later. In direct visual interpretation of the POC-CCA photographs, the most discordant results occurred in the identification of the trace response (T). The Kappa index established for the direct visual interpretation between the two analysts, in which T is considered as positive, in the desktop was κ=0.826 and in the smartphone, κ=0.950. When we use the G-score as a reading standardization technique and classify the results according to the manufacturer, with trace being evaluated as positive, the highest level of agreement was obtained. Some disagreement remains between the direct visual interpretation and the G-score when performed on the desktop, with more individuals being classified as negative in the direct visual interpretation, by both analysts. However, this result was not statistically significant. The use of the G-score scale proved to be an excellent tool for standardizing the readings and classifying the results according to the semi-quantitative scale showed greater concordance of results both among analysts and among the different devices used to view the photographs.
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Affiliation(s)
- Roberta Gomes de Carvalho
- Laboratory of Parasitology and Mollusc Biology, Department of Clinical Analysis and Toxicology, Federal University of Ceará, Rua Pastor Samuel Munguba 1210, Fortaleza, Ceará 60.430-272, Brazil
| | - Marta Cristhiany Cunha Pinheiro
- Laboratory of Parasitology and Mollusc Biology, Department of Clinical Analysis and Toxicology, Federal University of Ceará, Rua Pastor Samuel Munguba 1210, Fortaleza, Ceará 60.430-272, Brazil
| | - Francisca Janaína Damasceno Morais
- Laboratory of Parasitology and Mollusc Biology, Department of Clinical Analysis and Toxicology, Federal University of Ceará, Rua Pastor Samuel Munguba 1210, Fortaleza, Ceará 60.430-272, Brazil; Pathology Postgraduate Program, Department of Pathology and Legal Medicine, School of Medicine, Universidade Federal do Ceará, Rua Monsenhor Furtado s/n, Fortaleza, Ceará, 60.441-750, Brazil
| | - Rosangela Lima de Freitas Galvão
- Laboratory of Parasitology and Mollusc Biology, Department of Clinical Analysis and Toxicology, Federal University of Ceará, Rua Pastor Samuel Munguba 1210, Fortaleza, Ceará 60.430-272, Brazil; Pathology Postgraduate Program, Department of Pathology and Legal Medicine, School of Medicine, Universidade Federal do Ceará, Rua Monsenhor Furtado s/n, Fortaleza, Ceará, 60.441-750, Brazil
| | - Luciene Barbosa
- Parasitology and Tropical Entomology Laboratory, Department of Morphology, Federal University of Sergipe, Avenida Marechal Rondon Jardim s/n, São Cristóvão, Sergipe, 49.100-000, Brazil
| | - Sidney Lourdes Cesar Souza Sá
- Epidemiological Monitoring. State's Office for Health of Sergipe. Avenida Augusto Franco 3150, Aracaju, Sergipe 49097-670, Brazil
| | - Thomas Foster Scherr
- Department of Chemistry, Vanderbilt University, 1234 Stevenson Center Lane, Nashville, Tennessee 37240, USA
| | - Fernando Schemelzer de Moraes Bezerra
- Laboratory of Parasitology and Mollusc Biology, Department of Clinical Analysis and Toxicology, Federal University of Ceará, Rua Pastor Samuel Munguba 1210, Fortaleza, Ceará 60.430-272, Brazil; Pathology Postgraduate Program, Department of Pathology and Legal Medicine, School of Medicine, Universidade Federal do Ceará, Rua Monsenhor Furtado s/n, Fortaleza, Ceará, 60.441-750, Brazil; Medical Sciences Postgraduate Program, Department of Internal Medicine, School of Medicine, Universidade Federal do Ceará, Rua Monsenhor Furtado s/n Fortaleza, Ceará, 60.441-75, Brazil.
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Silva TD, Gonçalves-Santos E, Gonçalves RV, Souza RLM, Caetano JE, Caldas IS, Diniz LF, Marques MJ, Novaes RD. Matrix metalloproteinases inhibition reveals the association between inflammation, collagen accumulation and intestinal translocation of Schistosoma mansoni eggs in vivo. Int Immunopharmacol 2024; 127:111353. [PMID: 38086267 DOI: 10.1016/j.intimp.2023.111353] [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: 11/08/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 01/18/2024]
Abstract
Schistosomiasis mansoni is a parasitic infection that causes enterohepatic morbidity associated with severe granulomatous inflammation triggered by parasite eggs. In this disease, granulomatous inflammation leads to intestinal erosion and environmental excretion of S. mansoni eggs from feces, an essential process for propagating the parasite and infecting host organisms. Metalloproteinases (MMP) are involved in S. mansoni-induced hepatic granulomatous inflammation and fibrosis. However, the relationship between MMP and collagen accumulation with the intestinal excretion of parasite eggs remains unclear. Thus, the present study investigated whether MMP inhibition is capable of modulating granulomatous inflammation, collagen accumulation and mechanical resistance to the point of influencing the dynamics between intestinal retention and excretion of S. mansoni eggs in infected mice. Our findings indicated that doxycycline (a potent MMP inhibitor) aggravates intestinal inflammation and subverts collagen dynamics in schistosomiasis. By attenuating MMP-2 and MMP-9 activity, this drug is capable of enhancing fibrosis and mechanical resistance of the intestinal wall, hindering S. mansoni eggs translocation. Although collagen content was not correlated with MMP activity, intestinal retention and fecal excretion of parasite eggs in untreated mice; these correlations were observed for doxycycline-treated animals. Thus, our study provides evidence that doxycycline is able to attenuate fecal elimination of S. mansoni eggs by inhibiting MMP-2 and MMP-9 activity, events potentially associated with excessive collagen accumulation, which increases intestinal mechanical resistance and hinders eggs translocation through the intestinal wall. Variations in intestinal collagen dynamics are relevant since they may represent changes in the environmental dispersion of S. mansoni eggs, bringing repercussions for schistosomiasis propagation.
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Affiliation(s)
- Thiago D Silva
- Programa de Pós-Graduação em Biociências Aplicadas à Saúde, Universidade Federal de Alfenas, Alfenas 37130-000, Minas Gerais, Brazil
| | - Elda Gonçalves-Santos
- Programa de Pós-Graduação em Biociências Aplicadas à Saúde, Universidade Federal de Alfenas, Alfenas 37130-000, Minas Gerais, Brazil
| | - Reggiani V Gonçalves
- Departamento de Biologia Animal, Universidade Federal de Viçosa, Viçosa 36570-900, Minas Gerais, Brazil
| | - Raquel L M Souza
- Instituto de Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas 37130-000, Minas Gerais, Brazil
| | - José Edson Caetano
- Programa de Pós-Graduação em Ciências Biológicas, Universidade Federal de Alfenas, Alfenas 37130-000, Minas Gerais, Brazil
| | - Ivo S Caldas
- Instituto de Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas 37130-000, Minas Gerais, Brazil; Programa de Pós-Graduação em Ciências Biológicas, Universidade Federal de Alfenas, Alfenas 37130-000, Minas Gerais, Brazil
| | - Livia F Diniz
- Instituto de Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas 37130-000, Minas Gerais, Brazil; Programa de Pós-Graduação em Ciências Biológicas, Universidade Federal de Alfenas, Alfenas 37130-000, Minas Gerais, Brazil
| | - Marcos J Marques
- Instituto de Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas 37130-000, Minas Gerais, Brazil; Programa de Pós-Graduação em Ciências Biológicas, Universidade Federal de Alfenas, Alfenas 37130-000, Minas Gerais, Brazil
| | - Rômulo D Novaes
- Programa de Pós-Graduação em Biociências Aplicadas à Saúde, Universidade Federal de Alfenas, Alfenas 37130-000, Minas Gerais, Brazil; Departamento de Biologia Animal, Universidade Federal de Viçosa, Viçosa 36570-900, Minas Gerais, Brazil; Instituto de Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas 37130-000, Minas Gerais, Brazil; Programa de Pós-Graduação em Ciências Biológicas, Universidade Federal de Alfenas, Alfenas 37130-000, Minas Gerais, Brazil.
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Sousa MS, Meneses GC, van Dam GJ, Corstjens PLAM, Galvão RLDF, Pinheiro MCC, Martins AMC, Daher EDF, Bezerra FSDM. Subclinical signs of podocyte injury associated with Circulating Anodic Antigen (CAA) in Schistosoma mansoni-infected patients in Brazil. Rev Soc Bras Med Trop 2023; 56:e0341. [PMID: 36820657 PMCID: PMC9957141 DOI: 10.1590/0037-8682-0341-2022] [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: 08/02/2022] [Accepted: 11/22/2022] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND The long-term effects of schistosomiasis on the glomerulus may contribute to the development of chronic kidney disease. This study aimed to investigate baseline Schistosoma mansoni-Circulating Anodic Antigen (CAA) levels and their association with kidney biomarkers related to podocyte injury and inflammation in long-term follow-up after praziquantel (PZQ) treatment. METHODS Schistosoma infection was diagnosed by detecting CAA in urine using a quantitative assay based on lateral flow using luminescent up-converting phosphor reporter particles. A cutoff threshold of 0.1 pg/mL CAA was used to diagnose Schistosoma infection (baseline) in a low-prevalence area in Ceará, Northeast, Brazil. Two groups were included: CAA-positive and CAA-negative individuals, both of which received a single dose of PZQ at baseline. Urinary samples from 55 individuals were evaluated before (baseline) and at 1, 2, and 3 years after PZQ treatment. At all time points, kidney biomarkers were quantified in urine and adjusted for urinary creatinine levels. RESULTS CAA-positive patients had increased baseline albuminuria and proteinuria and showed greater associations between kidney biomarkers. CAA levels correlated only with Vascular Endothelial Growth Factor (VEGF) (podocyte injury) levels. Increasing trends were observed for malondialdehyde (oxidative stress), monocyte chemoattractant protein-1 (inflammation marker), and VEGF. In the follow-up analysis, no relevant differences were observed in kidney biomarkers between the groups and different periods. CONCLUSIONS S. mansoni-infected individuals presented subclinical signs of glomerular damage that may reflect podocyte injury. However, no causal effect on long-term renal function was observed after PZQ treatment.
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Affiliation(s)
- Mariana Silva Sousa
- Universidade Federal do Ceará, Departamento de Análises Clínicas e Toxicológicas, Laboratório de Pesquisa em Parasitologia e Biologia de Moluscos, Fortaleza, CE, Brasil. , Universidade Federal do Ceará, Programa de Pós-graduação stricto senso em Ciências Médicas, Fortaleza, CE, Brasil.
| | - Gdayllon Cavalcante Meneses
- Universidade Federal do Ceará, Programa de Pós-graduação stricto senso em Ciências Médicas, Fortaleza, CE, Brasil.
| | - Govert Jan van Dam
- Leiden University Medical Centre, Department of Parasitology, Leiden, The Netherlands.
| | | | - Rosangela Lima de Freitas Galvão
- Universidade Federal do Ceará, Departamento de Análises Clínicas e Toxicológicas, Laboratório de Pesquisa em Parasitologia e Biologia de Moluscos, Fortaleza, CE, Brasil. , Universidade Federal do Ceará, Programa de Pós-graduação stricto senso em Patologia, Fortaleza, CE, Brasil.
| | - Marta Cristhiany Cunha Pinheiro
- Universidade Federal do Ceará, Departamento de Análises Clínicas e Toxicológicas, Laboratório de Pesquisa em Parasitologia e Biologia de Moluscos, Fortaleza, CE, Brasil.
| | - Alice Maria Costa Martins
- Universidade Federal do Ceará, Programa de Pós-graduação stricto senso em Ciências Farmacêuticas, Fortaleza, CE, Brasil.
| | - Elizabeth de Francesco Daher
- Universidade Federal do Ceará, Programa de Pós-graduação stricto senso em Ciências Médicas, Fortaleza, CE, Brasil.
| | - Fernando Schemelzer de Moraes Bezerra
- Universidade Federal do Ceará, Departamento de Análises Clínicas e Toxicológicas, Laboratório de Pesquisa em Parasitologia e Biologia de Moluscos, Fortaleza, CE, Brasil. , Universidade Federal do Ceará, Programa de Pós-graduação stricto senso em Ciências Médicas, Fortaleza, CE, Brasil. , Universidade Federal do Ceará, Programa de Pós-graduação stricto senso em Patologia, Fortaleza, CE, Brasil.
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Mendes RJDA, Cantanhede SPD, Pereira Filho AA, Nogueira ADJL, Silva IPD, Rosa IG. Spatial distribution of the positivity of Schistosomiasis mansoni in Maranhao State, Northeastern Brazil, from 2007 to 2016. Rev Inst Med Trop Sao Paulo 2022; 64:e53. [PMID: 36074448 PMCID: PMC9448253 DOI: 10.1590/s1678-9946202264053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 07/05/2022] [Indexed: 11/22/2022] Open
Abstract
Schistosomiasis is considered one of the Neglected Tropical Diseases (NTDs), which affects around 240 million people worldwide. In Brazil, Schistosomiasis mansoni has been registered in 19 states, predominantly in rural areas. This study aimed to analyze the spatial distribution of Schistosomiasis mansoni cases in the Maranhao State from 2007 to 2016, as well as the temporal trend over this period. The data were obtained from secondary sources: Schistosomiasis Control Program of Maranhao (PCE-MA) and Information System for Notifiable Diseases (SINAN). The State Health Regions (HRs) were considered analysis units. Maranhao had a positivity rate of 3.8 for the period. The Regions that presented the highest percentages of positivity in the state were Pinheiro (7.92), Ze Doca (3.30), and Viana (3.10). Municipalities such as Bacuri, Serrano do Maranhao, and Bequimao, located in the Pinheiro HR, showed positivity rates of 16.56, 13.31, and 11.01 respectively. The spatial analysis of schistosomiasis cases showed that Maranhao has two main centers for the spread of the disease, both located in the northern portion of the state, namely the Baixada Maranhense and the east coast. This study concluded that the positivity of Schistosomiasis mansoni in Maranhao was stable over the analyzed period. The state still maintains the Baixada Maranhense micro-region as an important area for the spread of the disease reaching socially vulnerable population groups.
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Affiliation(s)
- Renato Juvino de Aragão Mendes
- Universidade Federal do Maranhão, Centro de Ciências Biológicas e da Saúde, Programa de Doutorado em Biotecnologia, São Luís, Maranhão, Brazil.,Rede Nordeste de Biotecnologia, São Luís, Maranhão, Brazil
| | | | | | - Aline de Jesus Lustosa Nogueira
- Universidade Federal do Maranhão, Centro de Ciências Biológicas e da Saúde, Programa de Pós-Graduação em Saúde e Ambiente, São Luís, Maranhão, Brazil
| | - Isaias Pereira da Silva
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Geografia, São Luís, Maranhão, Brazil
| | - Ivone Garros Rosa
- Universidade Federal do Maranhão, Centro de Ciências Biológicas e da Saúde, Departamento de Patologia, Núcleo de Imunologia Básica e Aplicada, São Luís, Maranhão, Brazil
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Galvão RLDF, Meneses GC, Pinheiro MCC, Martins AMC, Daher EDF, Bezerra FSM. Kidney injury biomarkers and parasitic loads of Schistosoma mansoni in a highly endemic area in northeastern Brazil. Acta Trop 2022; 228:106311. [PMID: 35038425 DOI: 10.1016/j.actatropica.2022.106311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 12/21/2021] [Accepted: 01/12/2022] [Indexed: 01/20/2023]
Abstract
Schistosomiasis affects approximately 240 million people worldwide. In Brazil, it is estimated that 1.5 million people are infected with Schistosoma mansoni and up to 15% of diagnosed individuals develop kidney damage. Renal involvement in schistosomiasis mansoni is characterized by glomerular lesions, with a high incidence, especially in chronically infected patients living in areas of high endemicity. Renal damage occurs slowly and is often asymptomatic, with a long-term manifestation of chronic kidney disease, with progressive loss of kidney functions, and early detection of subclinical kidney disease is of great importance. The aim of this study was to investigate kidney damage in patients infected with S. mansoni through urinary biomarkers of kidney injury and their association with the different parasite loads found. The patients were divided into two groups based on the diagnosis of infection by S. mansoni by the Kato-Katz and IgG-ELISA-SEA method: group of individuals infected by S. mansoni, Kato-Katz positive (PG); and group of individuals not infected by S. mansoni, Kato-Katz-negative (NG). Urinary creatinine and albuminuria were determined by immunoturbidimetry and proteinuria by the colorimetric method. The urinary biomarkers of podocyte injury (VEGF and Nephrin) and glomerular inflammation (MCP-1) were quantified by immunoassay and expressed by the urinary creatinine ratio. Urinary VEGF showed significantly higher levels in PG compared to NG (p = 0.004), increasing at all intensities of infection including low parasite load (p = 0.020). Our results show increased signs of podocyte damage in patients with schistosomiasis mansoni regardless of the parasite load, evidenced by increased urinary VEGF levels. However, further studies are needed since data related to schistosomiasis glomerulopathy and its association with new urinary biomarkers of kidney injury are scarce in the literature.
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Li S, Gong Y, Feng J, Luo Z, Xue J, Guo Z, Zhang L, Xia S, Lv S, Xu J. Spatiotemporal heterogeneity of schistosomiasis in mainland China: Evidence from a multi-stage continuous downscaling sentinel monitoring. ASIAN PAC J TROP MED 2022. [DOI: 10.4103/1995-7645.335700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Silva BMD, Ferreira AF, Silva JAMD, Amorim RGD, Domingues ALC, Pinheiro MCC, Bezerra FSDM, Heukelbach J, Ramos Jr AN. High schistosomiasis-related mortality in Northeast Brazil: trends and spatial patterns. Rev Soc Bras Med Trop 2022; 55:e0431. [PMID: 35674559 PMCID: PMC9176732 DOI: 10.1590/0037-8682-0431-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 12/17/2021] [Indexed: 11/22/2022] Open
Abstract
Background: We analyzed the trends and spatial patterns of schistosomiasis-related mortality in Northeast Brazil in 2000-2019. Methods: A mixed population-based ecological study was conducted, using information on the underlying or associated causes of death. We used Joinpoint regression analysis to calculate the trends. The spatial analysis included rates, spatial moving averages, and standardized mortality rates. The spatial dependence analysis was based on Getis-Ord's G and Gi* indices (Gi star) and local Moran’s index to check for autocorrelation. Results: A total of 5,814,268 deaths were recorded, of which 9,276 (0.16%) were schistosomiasis-related; 51.0% (n=4,732, adjusted rate 0.90/100,000 inhabitants [95% confidence interval (CI) 0.88-0.93]) were males; 40.0% (n=3,715, adjusted rate 7.40/100.000 inhabitants [95%CI: 7.16-7.64]) were ≥70 years old; 54.8% (n=5,087, crude rate 0.80/100,000 inhabitants) were of mixed/Pardo-Brazilian ethnicity; and 77.9% (n=7,229, adjusted rate 0.86/100,000 inhabitants [95%CI: 0.84-0.88]) lived outside state capitals. The highest proportion of deaths was in the state of Pernambuco (53.9%, n=4,996, adjusted rate 2.72/100,000 inhabitants [95%CI: 2.64-2.79]). Increasing mortality rate was verified in the state of Sergipe. On the coast of the state of Rio Grande do Norte and Bahia, there was spatial dependence of spatio-temporal risk patterns with clusters. Throughout the study period, we found positive spatial autocorrelation and cluster formation. Conclusions: In Northeast Brazil, schistosomiasis persists with a high mortality rate, especially in the coastal region, with heterogeneous spatial and temporal patterns. To eliminate schistosomiasis by 2030, it is necessary to strengthen the financing and management of the unified health system (SUS).
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Persistence of Schistosomiasis-Related Morbidity in Northeast Brazil: An Integrated Spatio-Temporal Analysis. Trop Med Infect Dis 2021; 6:tropicalmed6040193. [PMID: 34842851 PMCID: PMC8628971 DOI: 10.3390/tropicalmed6040193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/08/2021] [Accepted: 10/19/2021] [Indexed: 12/03/2022] Open
Abstract
Objective: To analyze the temporal trend and spatial patterns of schistosomiasis-related morbidity in Northeast Brazil, 2001–2017. Methods: Ecological study, of time series and spatial analysis, based on case notifications and hospital admission data, as provided by the Ministry of Health. Results: Of a total of 15,574,392 parasitological stool examinations, 941,961 (6.0%) were positive, mainly on the coastline of Pernambuco, Alagoas and Sergipe states. There was a reduction from 7.4% (2002) to 3.9% (2017) of positive samples and in the temporal trend of the detection rate (APC—11.6*; Confidence Interval 95%—13.9 to −9.1). There was a total of 5879 hospital admissions, with 40.4% in Pernambuco state. The hospitalization rate reduced from 0.82 (2001) to 0.02 (2017) per 100,000 inhabitants. Conclusion: Despite the reduction in case detection and hospitalizations, the persistence of focal areas of the disease in coastal areas is recognized. This reduction may indicate a possible positive impact of control on epidemiological patterns, but also operational issues related to access to healthcare and the development of surveillance and control actions in the Unified Health System.
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Jiang H, Deng W, Zhou J, Ren G, Cai X, Li S, Hu B, Li C, Shi Y, Zhang N, Zheng Y, Chen Y, Jiang Q, Zhou Y. Machine learning algorithms to predict the 1 year unfavourable prognosis for advanced schistosomiasis. Int J Parasitol 2021; 51:959-965. [PMID: 33891933 DOI: 10.1016/j.ijpara.2021.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/23/2021] [Accepted: 03/28/2021] [Indexed: 12/10/2022]
Abstract
Short-term prognosis of advanced schistosomiasis has not been well studied. We aimed to construct prognostic models using machine learning algorithms and to identify the most important predictors by utilising routinely available data under the government medical assistance programme. An established database of advanced schistosomiasis in Hunan, China was utilised for analysis. A total of 9541 patients for the period from January 2008 to December 2018 were enrolled in this study. Candidate predictors were selected from demographics, clinical features, medical examinations and test results. We applied five machine learning algorithms to construct 1 year prognostic models: logistic regression (LR), decision tree (DT), random forest (RF), artificial neural network (ANN) and extreme gradient boosting (XGBoost). An area under the receiver operating characteristic curve (AUC) was used to evaluate the model performance. The important predictors of the optimal model for unfavourable prognosis within 1 year were identified and ranked. There were 1249 (13.1%) cases having unfavourable prognoses within 1 year of discharge. The mean age of all participants was 61.94 years, of whom 70.9% were male. In general, XGBoost showed the best predictive performance with the highest AUC (0.846; 95% confidence interval (CI): 0.821, 0.871), compared with LR (0.798; 95% CI: 0.770, 0.827), DT (0.766; 95% CI: 0.733, 0.800), RF (0.823; 95% CI: 0.796, 0.851), and ANN (0.806; 95% CI: 0.778, 0.835). Five most important predictors identified by XGBoost were ascitic fluid volume, haemoglobin (HB), total bilirubin (TB), albumin (ALB), and platelets (PT). We proposed XGBoost as the best algorithm for the evaluation of a 1 year prognosis of advanced schistosomiasis. It is considered to be a simple and useful tool for the short-term prediction of an unfavourable prognosis for advanced schistosomiasis in clinical settings.
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Affiliation(s)
- Honglin Jiang
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Shanghai 200032, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Shanghai 200032, China; Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Shanghai 200032, China
| | - Weicheng Deng
- Hunan Institute for Schistosomiasis Control, Yueyang, Hunan Province, China
| | - Jie Zhou
- Hunan Institute for Schistosomiasis Control, Yueyang, Hunan Province, China
| | - Guanghui Ren
- Hunan Institute for Schistosomiasis Control, Yueyang, Hunan Province, China
| | - Xinting Cai
- Hunan Institute for Schistosomiasis Control, Yueyang, Hunan Province, China
| | - Shengming Li
- Hunan Institute for Schistosomiasis Control, Yueyang, Hunan Province, China
| | - Benjiao Hu
- Hunan Institute for Schistosomiasis Control, Yueyang, Hunan Province, China
| | - Chunlin Li
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Shanghai 200032, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Shanghai 200032, China; Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Shanghai 200032, China
| | - Ying Shi
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Shanghai 200032, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Shanghai 200032, China; Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Shanghai 200032, China
| | - Na Zhang
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Shanghai 200032, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Shanghai 200032, China; Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Shanghai 200032, China
| | - Yingyan Zheng
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Shanghai 200032, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Shanghai 200032, China; Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Shanghai 200032, China
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Crescent, Ottawa, Ontario K1G 5Z3, Canada
| | - Qingwu Jiang
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Shanghai 200032, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Shanghai 200032, China; Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Shanghai 200032, China
| | - Yibiao Zhou
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Shanghai 200032, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Shanghai 200032, China; Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Shanghai 200032, China.
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