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Natividade M, Pereira M, Stauber C, Miranda S, Teixeira MG, Souza RAD, Anjos MSD, Barros R, Morato DG, Aragão E, Pereira SM, Costa MDCN. Impact of the improvement of living conditions on tuberculosis mortality in Brazil: an ecological study. SAO PAULO MED J 2024; 142:e2023279. [PMID: 39194067 PMCID: PMC11364171 DOI: 10.1590/1516-3180.2023.0279.r1.13052024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 05/13/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND The risk of death due to tuberculosis (TB) in Brazil is high and strongly related to living conditions (LC). However, epidemiological studies investigating changes in LC and their impact on TB are lacking. OBJECTIVES To evaluate the impact of LC on TB mortality in Brazil. DESIGN AND SETTING This ecological study, using panel data on spatial and temporal aggregates, was conducted in 1,614 municipalities between 2002 and 2015. METHODS Data were collected from the Mortality Information System and the Brazilian Institute of Geography and Statistics. The proxy variable used for LC was the Urban Health Index (UHI). Negative binomial regression models were used to estimate the effect of the UHI on TB mortality rate. Attributable risk (AR) was used as an impact measure. RESULTS From 2002 to 2015, TB mortality rate decreased by 23.5%, and LC improved. The continuous model analysis resulted in an RR = 0.89 (95%CI = 0.82-0.96), so the AR was -12.3%. The categorized model showed an effect of 0.92 (95%CI = 0.83-0.95) in municipalities with intermediate LC and of 0.83 (95%CI = 0.82-0.91) in those with low LC, representing an AR for TB mortality of -8.7% and -20.5%, respectively. CONCLUSIONS Improved LC impacted TB mortality, even when adjusted for other determinants. This impact was greater in the strata of low-LC municipalities.
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Affiliation(s)
- Marcio Natividade
- Adjunct Professor, Department of Public Health, Institute of Collective Health, Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil
| | - Marcos Pereira
- Adjunct Professor, Department of Public Health, Institute of Collective Health, Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil
| | - Christine Stauber
- Professor, Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, United States
| | - Samilly Miranda
- Adjunct Professor, Department of Public Health, Institute of Collective Health, Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil
| | - Maria Glória Teixeira
- Department of Public Health, Institute of Collective Health, Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil
| | - Ramon Andrade de Souza
- Nurse, Postgraduate Program in Collective Health, Institute of Collective Health, Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil
| | - Marilia Santos Dos Anjos
- Nurse, Postgraduate Program in Collective Health, Institute of Collective Health, Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil
| | - Rafael Barros
- Adjunct Professor in Nursing School, Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil
| | - Daniela Gonçalves Morato
- Bachelor of Science in Biological Sciences, Institute of Collective Health, Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil
| | - Erika Aragão
- Associate Professor, Department of Public Health, Institute of Collective Health, Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil
| | - Susan Martins Pereira
- Associate Professor, Department of Public Health, Institute of Collective Health, Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil
| | - Maria da Conceição Nascimento Costa
- Associate Professor, Department of Public Health, Institute of Collective Health, Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil
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Ehrenberg JP, Chernet A, Luján M, Utzinger J. One Health as a potential platform to rescue the neglected fruit trees in Yucatan, Mexico. SCIENCE IN ONE HEALTH 2024; 3:100073. [PMID: 39206126 PMCID: PMC11350262 DOI: 10.1016/j.soh.2024.100073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 07/18/2024] [Indexed: 09/04/2024]
Abstract
Neglected and underutilized species of plants (NUS) have been identified by the Food and Agriculture Organization as valuable resources for fighting poverty, hunger and malnutrition as they can help make agricultural production systems more sustainable and resilient. Adaptation of NUS to changing environments over several millennia has rendered most of these plants resistant to pests and climate change. In this paper, we explore the potential values of some of the Mayan fruit trees justifying conservation efforts in their native habitats. Our research was primarily based on a scoping review using Google Scholar. We considered articles published in English, Spanish and Portuguese. Our review rendered two sets of articles including those focusing on the nutritional and medicinal properties of NUS and their products, and those focusing on their uses in traditional medicine. Both sets of papers strongly support arguments for conservation of NUS. Additionally, our scoping review expands and includes a case study on the conservation of NUS, highlighting the critical role of civil society on how it can spearhead rescue efforts of botanical resources through the creation of what is possibly the first arboretum of its kind in the Americas. Among the project's key selling points was not only the rescue of an important component of Yucatan's cultural heritage but its nutritional value as well as its potential medicinal properties. Our paper is not prescriptive on how to preserve or even commercially exploit NUS. It is intended as a thought-provoking piece on the potential of a One Health approach as a multisectoral platform to support conservation efforts, while stimulating greater interest in the subject and encouraging more action from the academic and pharmaceutical sectors as well as civil society.
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Affiliation(s)
- John P. Ehrenberg
- Avenida Cedro 9, # 303, Cholul, Merida, Yucatan, 97305, Mexico
- Retired, World Health Organization, Manila, 1000, Philippines
| | - Afona Chernet
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4001 Basel, Switzerland
| | - Manuel Luján
- Royal Botanic Gardens, Kew, Richmond, Surrey, TW9 3AB, UK
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4001 Basel, Switzerland
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Kumar S, Chhabra V, Mehra M, K S, Kumar B H, Shenoy S, Swamy RS, Murti K, Pai KSR, Kumar N. The fluorosis conundrum: bridging the gap between science and public health. Toxicol Mech Methods 2024; 34:214-235. [PMID: 37921264 DOI: 10.1080/15376516.2023.2268722] [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: 08/18/2023] [Accepted: 10/04/2023] [Indexed: 11/04/2023]
Abstract
Fluorosis, a chronic condition brought on by excessive fluoride ingestion which, has drawn much scientific attention and public health concern. It is a complex and multifaceted issue that affects millions of people worldwide. Despite decades of scientific research elucidating the causes, mechanisms, and prevention strategies for fluorosis, there remains a significant gap between scientific understanding and public health implementation. While the scientific community has made significant strides in understanding the etiology and prevention of fluorosis, effectively translating this knowledge into public health policies and practices remains challenging. This review explores the gap between scientific research on fluorosis and its practical implementation in public health initiatives. It suggests developing evidence-based guidelines for fluoride exposure and recommends comprehensive educational campaigns targeting the public and healthcare providers. Furthermore, it emphasizes the need for further research to fill the existing knowledge gaps and promote evidence-based decision-making. By fostering collaboration, communication, and evidence-based practices, policymakers, healthcare professionals, and the public can work together to implement preventive measures and mitigate the burden of fluorosis on affected communities. This review highlighted several vital strategies to bridge the gap between science and public health in the context of fluorosis. It emphasizes the importance of translating scientific evidence into actionable guidelines, raising public awareness about fluoride consumption, and promoting preventive measures at individual and community levels.
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Affiliation(s)
- Sachindra Kumar
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Vishal Chhabra
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - Manmeet Mehra
- Department of Pharmacology, Guru Nanak Dev University, Amritsar, India
| | - Saranya K
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - Harish Kumar B
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Smita Shenoy
- Department of Pharmacology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Ravindra Shantakumar Swamy
- Division of Anatomy, Department of Basic Medical Sciences (DBMS), Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Krishna Murti
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - K Sreedhara Ranganath Pai
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Nitesh Kumar
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Hajipur, India
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Nacife MBPESL, Siqueira LMV, Barbosa KF, Vianna VN, Masioli CZ, da Silva JC, Zicker F, Coelho PMZ, Katz N, Machado-Coelho GLL. Prevalence of helmintic infections in Brazilian Maxakali indigenous: a repeated cross-sectional design. Int J Equity Health 2024; 23:18. [PMID: 38302951 PMCID: PMC10832216 DOI: 10.1186/s12939-024-02105-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 01/13/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND The prevalence of intestinal parasites is known to be high among Amerindian populations; further, there are serious problems in the healthcare of these populations in Brazil. The Maxakali, located in the northeastern region of Minas Gerais, Brazil, is an indigenous group that still preserves many of its cultural aspects. This study aimed to compare the positivity rate of schistosomiasis and soil-transmitted helminths in this ethnic group in epidemiological surveys conducted in 1972 and 2014. METHODS Stool parasitological examinations were performed by the Kato-Katz technique during both periods in this population. In 2014, the parasitological diagnosis was also realized with the TF-Test® technique. RESULTS In 1972, 270 inhabitants were examined. The positivity rates were 67.4% for Schistosoma mansoni, 72.9% for hookworms, 43.7% for Ascaris lumbricoides, and 23.7% for Trichuris trichiura. In 2014, 545 individuals were examined, and the positivity rates obtained were 45.7% for S. mansoni, 22.8% for hookworms, 0.6% for A. lumbricoides, and 2.8% for T. trichiura. CONCLUSIONS The comparison of the parasitological surveys conducted in 1972 and 2014, indicates that the indigenous Maxakali remained neglected by the health and indigenous protection authorities during these four decades. The infection rate observed in 2014 for schistosomiasis and hookworm remains high, considering the current epidemiological view of these diseases in the Brazilian population.
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Affiliation(s)
- Maria Beatriz Pena E Silva Leite Nacife
- Universidade Federal de Ouro Preto, Escola de Medicina, Laboratório de Epidemiologia, Rua Dois s/n, sala 203, Campus Universitário Morro do Cruzeiro, Ouro Preto, Minas Gerais, CEP 35402-145, Brasil
| | | | - Keila Furbino Barbosa
- Universidade Federal de Ouro Preto, Escola de Medicina, Laboratório de Epidemiologia, Rua Dois s/n, sala 203, Campus Universitário Morro do Cruzeiro, Ouro Preto, Minas Gerais, CEP 35402-145, Brasil
| | - Valeska Natiely Vianna
- Universidade Federal de Ouro Preto, Escola de Medicina, Laboratório de Epidemiologia, Rua Dois s/n, sala 203, Campus Universitário Morro do Cruzeiro, Ouro Preto, Minas Gerais, CEP 35402-145, Brasil
| | - Cássio Zumerle Masioli
- Universidade Federal de Ouro Preto, Escola de Medicina, Laboratório de Epidemiologia, Rua Dois s/n, sala 203, Campus Universitário Morro do Cruzeiro, Ouro Preto, Minas Gerais, CEP 35402-145, Brasil
| | - Jaime Costa da Silva
- Ministério da Saúde, Distrito Sanitário Especial Indígena/Minas Gerais-Espírito Santo, Belo Horizonte, Minas Gerais, Brasil
| | | | | | - Naftale Katz
- Fundação Oswaldo Cruz, Instituto René Rachou, Belo Horizonte, Minas Gerais, Brasil
| | - George Luiz Lins Machado-Coelho
- Universidade Federal de Ouro Preto, Escola de Medicina, Laboratório de Epidemiologia, Rua Dois s/n, sala 203, Campus Universitário Morro do Cruzeiro, Ouro Preto, Minas Gerais, CEP 35402-145, Brasil.
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Khatri RB, Erku D, Endalamaw A, Wolka E, Nigatu F, Zewdie A, Assefa Y. Multisectoral actions in primary health care: A realist synthesis of scoping review. PLoS One 2023; 18:e0289816. [PMID: 37561811 PMCID: PMC10414560 DOI: 10.1371/journal.pone.0289816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/27/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Multisectoral actions (MSAs) on health are key to implementation of primary health care (PHC) and achieving the targets of the Sustainable Development Goal 3. However, there is limited understanding and interpretation of how MSAs on health articulate and mediate health outcomes. This realist review explored how MSAs influence on implementing PHC towards universal health coverage (UHC) in the context of multilevel health systems. METHODS We reviewed published evidence that reported the MSAs, PHC and UHC. The keywords used in the search strategy were built on these three key concepts. We employed Pawson and Tilley's realist review approach to synthesize data following Realist and Meta-narrative Evidence Syntheses: Evolving Standards publication standards for realist synthesis. We explained findings using a multilevel lens: MSAs at the strategic level (macro-level), coordination and partnerships at the operational level (meso-level) and MSAs employing to modify behaviours and provide services at the local level (micro-level). RESULTS A total of 40 studies were included in the final review. The analysis identified six themes of MSAs contributing to the implementation of PHC towards UHC. At the macro-level, themes included influence on the policy rules and regulations for governance, and health in all policies for collaborative decision makings. The meso-level themes were spillover effects of the non-health sector, and the role of community health organizations on health. Finally, the micro-level themes were community engagement for health services/activities of health promotion and addressing individuals' social determinants of health. CONCLUSION Multisectoral actions enable policy and actions of other sectors in health involving multiple stakeholders and processes. Multisectoral actions at the macro-level provide strategic policy directions; and operationalise non-health sector policies to mitigate their spillover effects on health at the meso-level. At micro-level, MSAs support service provision and utilisation, and lifestyle and behaviour modification of people leading to equity and universality of health outcomes. Proper functional institutional mechanisms are warranted at all levels of health systems to implement MSAs on health.
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Affiliation(s)
- Resham B. Khatri
- School of Public Health, the University of Queensland, Brisbane, Australia
- Health Social Science and Development Research Institute, Kathmandu, Nepal
| | - Daniel Erku
- Centre for Applied Health Economics, School of Medicine, Griffith University, Nathan, Australia
- Menzies Health Institute Queensland, Griffith University, Nathan, Australia
| | - Aklilu Endalamaw
- School of Public Health, the University of Queensland, Brisbane, Australia
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eskinder Wolka
- International Institute for Primary Health Care-Ethiopia, Addis Ababa, Ethiopia
| | - Frehiwot Nigatu
- International Institute for Primary Health Care-Ethiopia, Addis Ababa, Ethiopia
| | - Anteneh Zewdie
- International Institute for Primary Health Care-Ethiopia, Addis Ababa, Ethiopia
| | - Yibeltal Assefa
- School of Public Health, the University of Queensland, Brisbane, Australia
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Chen Y, Zhou Q, Yang X, Shi P, Shen Q, Zhang Z, Chen Z, Pu C, Xu L, Hu Z, Ma A, Gong Z, Xu T, Wang P, Wang H, Hao C, Li C, Hao M. Influence of Public Health Services on the Goal of Ending Tuberculosis: Evidence From Panel Data in China. Front Public Health 2022; 10:826800. [PMID: 35309188 PMCID: PMC8931334 DOI: 10.3389/fpubh.2022.826800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/11/2022] [Indexed: 11/23/2022] Open
Abstract
Background The World Health Organization has proposed an initiative to “end tuberculosis (TB).” Unfortunately, TB continues to endanger the health of people worldwide. We investigated the impact of public health services (PHS) in China on TB incidence. In this way, we provided policy ideas for preventing the TB epidemic. Methods We used the “New Public Management Theory” to develop two indicators to quantify policy documents: multisector participation (MP) and the Assessable Public Health Service Coverage Rate (ASCR). The panel data from 31 provinces in Chinese mainland were collected from 2005 to 2019 based on 1,129 policy documents and the China Statistical Yearbook. A fixed-effect model was used to determine the impact of MP and the ASCR on TB incidence. Results From 2005 to 2019, the average MP increased from 89.25 to 97.70%, and the average ASCR increased from 53.97 to 78.40% in Chinese mainland. However, the development of ASCR between regions was not balanced, and the average level in the western region was lower than that in the eastern coastal provinces. With an increase in MP and the ASCR, the TB incidence had been decreasing gradually in recent years. The panel analysis results showed that MP (β = −0.76, p < 0.05). and ASCR (β = −0.40, p < 0.01) had a negative effect on TB incidence, respectively. Even if the control variables were added, the negative effects of MP (β = −0.86, p < 0.05) and ASCR (β = −0.35, p < 0.01) were still statistically significant. Conclusions Promoting the participation of multiple departments, as well as emphasizing the quality of PHS delivery, are important ways to alleviate the TB epidemic. The settings of evaluation indices for PHS provision should be strengthened in the future.
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Affiliation(s)
- Yang Chen
- Research Institute of Health Development Strategies, Fudan University, Shanghai, China
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China
| | - Qingyu Zhou
- Research Institute of Health Development Strategies, Fudan University, Shanghai, China
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China
| | - Xinmei Yang
- Research Institute of Health Development Strategies, Fudan University, Shanghai, China
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China
| | - Peiwu Shi
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- Zhejiang Academy of Medical Sciences, Hangzhou, China
| | - Qunhong Shen
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- School of Public Policy and Management, Tsinghua University, Beijing, China
| | - Zhaoyang Zhang
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- Project Supervision Center of National Health Commission of the People's Republic of China, Beijing, China
| | - Zheng Chen
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- Department of Grassroots Public Health Management Group, Public Health Management Branch of Chinese Preventive Medicine Association, Shanghai, China
| | - Chuan Pu
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Lingzhong Xu
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- School of Public Health, Shandong University, Jinan, China
| | - Zhi Hu
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- School of Health Service Management, Anhui Medical University, Hefei, China
| | - Anning Ma
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- School of Management, Weifang Medical University, Weifang, China
| | - Zhaohui Gong
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- Committee on Medicine and Health of Central Committee of China Zhi Gong Party, Beijing, China
| | - Tianqiang Xu
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- Institute of Inspection and Supervision, Shanghai Municipal Health Commission, Shanghai, China
| | - Panshi Wang
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- Shanghai Municipal Health Commission, Shanghai, China
| | - Hua Wang
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- Jiangsu Preventive Medicine Association, Nanjing, China
| | - Chao Hao
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- Changzhou Center for Disease Control and Prevention, Changzhou, China
| | - Chengyue Li
- Research Institute of Health Development Strategies, Fudan University, Shanghai, China
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China
- *Correspondence: Chengyue Li
| | - Mo Hao
- Research Institute of Health Development Strategies, Fudan University, Shanghai, China
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China
- Mo Hao
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Mao FZ, Chen YY, Xu XZ, Ni BX, Jin XL, Dai Y, Cao J. Multi-intervention integrated deworming strategy for sustained control of soil-transmitted helminths infections: a case study in Jiangsu Province, China. Infect Dis Poverty 2021; 10:116. [PMID: 34507609 PMCID: PMC8434715 DOI: 10.1186/s40249-021-00903-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/02/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Soil-transmitted helminths (STH) infections still present a global health problem. Mass drug administration (MDA) is a widely applied strategy to reduce morbidity and mortality caused by STH. Yet, this approach has some shortcomings. In this study, we analyzed the impact of a multi-intervention integrated deworming approach including MDA, health education (HE), and environmental sanitation improvements (ESI) for sustained STH control in Jiangsu Province of China that was applied from 1989 to 2019. METHODS Data, including infection rate of STH, medications used, coverage of the medication, non-hazardous lavatory rate, and household piped-water access rate in rural areas, and actions related to HE and ESI were collected (from archives) and analyzed in this retrospective descriptive study. Pearson's correlation analysis was applied to test correlations. RESULTS There was a dramatic decline in the infection rate of STH from 1989 (59.32%) to 2019 (0.12%). From 1995 to 1999, MDA and HE were recommended in rural areas. A negative correlation was observed between infection rate and medication from 1994 to 1998 (r = - 0.882, P = 0.048). From 2000 to 2005, targeted MDA was given to high-risk populations with HE continuously promoting good sanitation behaviors. From 2006 to 2014, targeted MDA + HE and ESI were used to consolidate the control effect. ESI was strengthened from 2006, and a negative correlation was observed between the coverage rate of the non-hazardous lavatory and the infection rate from 2006 to 2019 (r = - 0.95, P < 0.001). The targeted MDA was interrupted in 2015, while continuous efforts like HE and ESI contributed in sustaining STH control. CONCLUSIONS Multi-intervention integrated deworming strategy contributes to the reduction of STH infections. This approach is a valuable example of how different interventions can be integrated to promote durable STH control.
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Affiliation(s)
- Fan-Zhen Mao
- National Health Commission (NHC) Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory On Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi City, Jiangsu Province, 214064, People's Republic of China
| | - Yu-Ying Chen
- Center for Global Health, Nanjing Medical University, Nanjing City, Jiangsu Province, 211166, People's Republic of China
| | - Xiang-Zhen Xu
- National Health Commission (NHC) Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory On Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi City, Jiangsu Province, 214064, People's Republic of China
| | - Bi-Xian Ni
- National Health Commission (NHC) Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory On Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi City, Jiangsu Province, 214064, People's Republic of China
| | - Xiao-Lin Jin
- National Health Commission (NHC) Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory On Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi City, Jiangsu Province, 214064, People's Republic of China
| | - Yang Dai
- National Health Commission (NHC) Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory On Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi City, Jiangsu Province, 214064, People's Republic of China.
- Center for Global Health, Nanjing Medical University, Nanjing City, Jiangsu Province, 211166, People's Republic of China.
| | - Jun Cao
- National Health Commission (NHC) Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory On Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi City, Jiangsu Province, 214064, People's Republic of China.
- Center for Global Health, Nanjing Medical University, Nanjing City, Jiangsu Province, 211166, People's Republic of China.
- Public Health Research Center, Jiangnan University, Wuxi City, Jiangsu Province, 214064, People's Republic of China.
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García Guerrero JE, Rueda López R, Luque González A, Ceular-Villamandos N. Indigenous Peoples, Exclusion and Precarious Work: Design of Strategies to Address Poverty in Indigenous and Peasant Populations in Ecuador through the SWOT-AHP Methodology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020570. [PMID: 33445450 PMCID: PMC7826826 DOI: 10.3390/ijerph18020570] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/29/2020] [Accepted: 01/07/2021] [Indexed: 11/16/2022]
Abstract
This research analysed the options that, following decent employment and the social economy, can allow the human development of poor, excluded and vulnerable indigenous populations in Ecuador. A set of strategies were developed which can be implemented by public authorities and by community organisations. They were designed from two types of expert consultations: the Delphi method and the analysis of Strengths, Weaknesses, Opportunities and Threats (SWOT) combined with Analytic Hierarchy Process method (AHP) for hierarchizing the criteria collected and obtaining strategies. The proposed strategies are as follows: adopting appropriate legal frameworks, respecting peoples' rights, better distribution of public resources, implementing monitoring systems, developing solidarity markets and recognizing the participation of the poor as a subject of rights. This investigation revealed differences between the state, which identifies the poor with monetary indicators, and the indigenous peoples, who see it as the lack of community links, by conceiving the poor as a beneficiary of official assistance, despite the fact that a strong community and peasant organisation could be used. The value of an economy based on reciprocity and confidence was also recognized, identifying niches of production and consumption to create partnerships and ensure the participation of indigenous peoples in decision-making areas.
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Affiliation(s)
- Jorge E. García Guerrero
- Department of Statistic, Econometrics, Operational Research, Business Organisation and Applied Economics, University of Cordoba, 14071 Córdoba, Spain; (J.E.G.G.); (N.C.-V.)
| | - Ramón Rueda López
- Department of Statistic, Econometrics, Operational Research, Business Organisation and Applied Economics, University of Cordoba, 14071 Córdoba, Spain; (J.E.G.G.); (N.C.-V.)
- Correspondence:
| | - Arturo Luque González
- Faculty of Social Sciences, Technical University of Manabi, 130105 Portoviejo, Ecuador;
- School of Administration-Research Group in Direction and Management, University of Rosario, 111711 Bogotá, Colombia
| | - Nuria Ceular-Villamandos
- Department of Statistic, Econometrics, Operational Research, Business Organisation and Applied Economics, University of Cordoba, 14071 Córdoba, Spain; (J.E.G.G.); (N.C.-V.)
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Monnier N, Barth-Jaeggi T, Knopp S, Steinmann P. Core components, concepts and strategies for parasitic and vector-borne disease elimination with a focus on schistosomiasis: A landscape analysis. PLoS Negl Trop Dis 2020; 14:e0008837. [PMID: 33125375 PMCID: PMC7598467 DOI: 10.1371/journal.pntd.0008837] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/01/2020] [Indexed: 12/19/2022] Open
Abstract
Efforts to control and eliminate human schistosomiasis have accelerated over the past decade. In a number of endemic countries and settings, interruption of schistosome transmission has been achieved. In others, Schistosoma infections continue to challenge program managers at different levels, from the complexity of the transmission cycle, over limited treatment options and lack of field-friendly accurate diagnostics, to controversy around adequate intervention strategies. We conducted a landscape analysis on parasitic and vector-borne disease elimination approaches with the aim to identify evidence-based strategies, core components and key concepts for achieving and sustaining schistosomiasis control and for progressing elimination efforts towards interruption of transmission in sub-Saharan Africa. A total of 118 relevant publications were identified from Web of Science, Pubmed and the grey literature and reviewed for their content. In addition, we conducted in-depth interviews with 23 epidemiologists, program managers, policymakers, donors and field researchers. Available evidence emphasizes the need for comprehensive, multipronged and long-term strategies consisting of multiple complementary interventions that must be sustained over time by political commitment and adequate funding in order to reach interruption of transmission. Based on the findings of this landscape analysis, we propose a comprehensive set of intervention strategies for schistosomiasis control and elimination. Before deployment, the proposed interventions will require review, evaluation and validation in the frame of an expert consultation as a step towards adaptation to specific contexts, conditions and settings. Field testing to ensure local relevance and effectiveness is paramount given the diversity of socio-ecological and epidemiological contexts. This landscape analysis explored successful concepts, approaches and interventions of past and ongoing parasitic and vector-borne disease elimination efforts and programs with regard to relevance for progress in the elimination of human schistosome infections. Schistosomiasis is a disabling, water borne parasitic disease of public health concern with an estimated 250 million people infected worldwide. The long-term morbidity of this neglected tropical disease significantly impacts growth, cognition and socioeconomic development at all ages. Despite increased global efforts to control morbidity and advance elimination, challenges in view of the complex life cycle which involves freshwater sources, intermediate snail hosts and humans, remain. This calls for targeted interventions and concerted programs. According to the evidence from the literature and as proposed by a wide range of key informants, comprehensive, multipronged and long-term strategies supported by strong political commitment and adequate funding are required in order to achieve and sustain the set goals. Based on the findings, we propose here a comprehensive set of intervention strategies for schistosomiasis control and elimination for review and evaluation to inform implementation research needs and elimination program design.
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Affiliation(s)
- Nora Monnier
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
| | - Tanja Barth-Jaeggi
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Stefanie Knopp
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Abe EM, Tambo E, Xue J, Xu J, Ekpo UF, Rollinson D, Yang K, Li SZ, Zhou XN. Approaches in scaling up schistosomiasis intervention towards transmission elimination in Africa: Leveraging from the Chinese experience and lessons. Acta Trop 2020; 208:105379. [PMID: 32006521 DOI: 10.1016/j.actatropica.2020.105379] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 01/29/2020] [Accepted: 01/29/2020] [Indexed: 12/20/2022]
Abstract
Schistosoma japonicum, differs from the African species including S. mansoni and S. haematobium, is a zoonotic parasite as it infects both human and animals including domestic ruminant animals such as cattle and animals from the wild. Considering China's success story in the elimination of schistosomiasis, the China-Africa collaboration on schistosomaisis elimination in Africa is an important cooperative health development initiative. This review examines the importance of China-Africa collaboration on schistosomiasis elimination using effective surveillance-response intervention strategy as the platform to effectively drive the elimination of schistosomiasis in Africa. Three conclusions were made after reviewing the similarity and differences in schistososmiasis control programmes between China and African continent as follows: (i) Politically, China's lessons is that leveraging on the integrated control strategies and the recognition that schistosomiasis is a public health problem which prompted the interest of government in China. It is necessary for African leaders and governments to recognize schistosomiasis as a public health challenge that must be given serious attention in terms of funding and setting up frameworks to complement control efforts. (ii) Technically, efficient monitoring and surveillance system mechanism will facilitate contextual and effective management of schistosomiasis elimination across different environment, and African programme managers should embrace the use of appropriate diagnostic tools to guide treatment strategies at different thresholds of schistosomiasis control. (iii) Strategically, effective control of snail intermediate hosts and precision mapping of snail distribution should be prioritized for successful schistosomiasis elimination in Africa.
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Affiliation(s)
- Eniola M Abe
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China.
| | - E Tambo
- Département de Biochimie et Science Pharmaceutiques, Université des Montagnes, Bagangté, République du Cameroon.
| | - Jingbo Xue
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China.
| | - Jing Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China.
| | - Uwem F Ekpo
- Department of Pure and Applied Zoology, Federal University of Agriculture, Alabata Road, Abeokuta, 110001, Nigeria.
| | - David Rollinson
- The Natural History Museum, Cromwell Road, London SW7 5BD, United Kingdom.
| | - Kun Yang
- Jiangsu Institute of Parasitic Diseases, Wuxi, China.
| | - Shi-Zhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China.
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China.
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Juárez V, Quintana R, Crespo ME, Aciar M, Buschiazzo E, Cucchiaro NL, Picco E, Ruiz M, Sánchez JA, Franco R, Estrella N, Jorge S, Retamozo C, Silvestre AMR, García V, Pelaez-Ballestas I, Pons Estel BA. Prevalence of musculoskeletal disorders and rheumatic diseases in an Argentinean indigenous Wichi community. Clin Rheumatol 2020; 40:75-83. [PMID: 32504194 DOI: 10.1007/s10067-020-05130-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 03/26/2020] [Accepted: 04/23/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To estimate the prevalence of musculoskeletal disorders (MSK) and rheumatic diseases in an indigenous Wichi population in Argentina. METHODS This is a cross-sectional, community-based study using the Community-Oriented Program for the Control of Rheumatic Diseases (COPCORD) methodology in ≥ 18-year-old subjects. Validated surveys were conducted by trained interviewers. Subjects with MSK pain (positive cases) were evaluated by internists and rheumatologists for diagnosis and treatment. RESULTS A total of 648 interviews were performed (90.4% of the census population). Mean age was 37.5 years (SD 14.8), and 379 (58.5%) were female. The mean years of education was 7.0 (SD 3.7); 552 subjects (85.2%) were covered by the public health care system. A total of 216 (33.3%) subjects had MSK pain in the last 7 days. Rheumatic disease prevalence was as follows: mechanical back pain (19.0%), rheumatic regional pain syndrome (5.2%), osteoarthritis (3.2%), rheumatoid arthritis (RA) (3.2%), inflammatory back pain (1.2%), undifferentiated arthritis (0.3%), Sjögren syndrome (0.15%), and fibromyalgia (0.15%). RA patients included 19 (90.5%) women and 9 (42.9%) with RA family history. One hundred percent were seropositive and 66.7% showed radiologic erosions. The mean of Disease Activity Score [DAS-28 (ESR)] at the time of diagnosis was 5.1 (SD 1.5) and the Health Assessment Questionnaire Disability Index (HAQ-DI) was 0.8 (SD 0.4). CONCLUSION RA prevalence was 3.2%, one of the highest reported using the COPCORD methodology in indigenous and non-indigenous peoples in Latin America, with a high percentage of family cases. Pain and functional capacity were the variables allowing patients' early referral to a specialist. Key Points • The RA prevalence was 3.2%, one of the highest reported using COPCORD methodology in indigenous and non-indigenous peoples in Latin America. • The patients with RA had high percentage of familiar history of RA. • The pain and functional capacity were the variables associated with a diagnosis of any rheumatic disease and should be considered for early referral. • The mean of the delay in the diagnosis was 5.8 years. In this community, the lack of the "migration health" phenomenon may be a social determinant that negatively impacts their health.
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Affiliation(s)
| | - Rosana Quintana
- Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Santa Fe, Argentina.
| | | | | | | | | | | | - Mario Ruiz
- Hospital Arturo Oñativia, Salta, Argentina
| | | | - Rodolfo Franco
- Centro de Salud Misión Chaqueña el Algarrobal, Embarcación, Salta, Argentina
| | | | - Silvia Jorge
- Hospital San Bernardo de Salta, Salta, Argentina
| | | | - Adriana M R Silvestre
- Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Santa Fe, Argentina
| | - Vanina García
- Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Santa Fe, Argentina
| | | | - Bernardo A Pons Estel
- Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Santa Fe, Argentina
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Castro-Arroyave DM, Duque-Paz LF. Documentary research on social innovation in health in Latin America. Infect Dis Poverty 2020; 9:41. [PMID: 32321575 PMCID: PMC7175528 DOI: 10.1186/s40249-020-00659-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 04/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Identifying social innovation in health initiatives, promoting quality of life through them, and transforming current health conditions demand the knowledge, comprehension and appropriation of the theoretical and methodological developments of this concept. Academic developments in social innovation have mainly occurred in and been documented for English-speaking countries, although relevant experiences have been implemented in Latin America. In this article, we describe and analyze how social innovation in health is being approached and understood in this region. MAIN TEXT To identify the theoretical and methodological developments of social innovation in health between 2013 and 2018, a scoping review with a mixed approach was carried out. Eighty texts in English, Spanish and Portuguese were selected for a process of reflexive analysis of intra and intertextual reading. The approaches identified in the studied initiatives were complementary. The most applied approaches were innovation in health, technological innovation in health and social innovation, each with twelve publications, and social innovation in health and ecohealth with ten and seven publications respectively. The approaches showed a general interest in reaching the goals of the Sustainable Development Goals (SDGs), the Alma Ata Declaration and the Ottawa Letter. CONCLUSIONS The social innovation in health approach in Latin America adopts educational strategies, identifies risk factors, optimizes resources, promotes interculturality, participation, community empowerment, and enhances intersectorality and interdisciplinarity. As an approach, process, program or solution, social innovation in health is a conceptual category under construction. This research provides a baseline for other systematic reviews on the subject.
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Affiliation(s)
- Diana María Castro-Arroyave
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Icesi University, Cali, Colombia
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Avila-Granados LM, Garcia-Gonzalez DG, Zambrano-Varon JL, Arenas-Gamboa AM. Brucellosis in Colombia: Current Status and Challenges in the Control of an Endemic Disease. Front Vet Sci 2019; 6:321. [PMID: 31616678 PMCID: PMC6768962 DOI: 10.3389/fvets.2019.00321] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 09/09/2019] [Indexed: 12/20/2022] Open
Abstract
Brucellosis is a zoonosis of nearly worldwide distribution. The disease is considered to be endemic in most of the developing countries with a substantial impact on both human and animal health as well as on the economy. The aim of this scoping review is to provide an overview of the brucellosis status in Colombia and the factors associated with its persistence, to highlight the strengths and gaps of the adopted countermeasures and to supply evidence to policy-makers on the best approaches to mitigate the disease burden. Due to the presence of brucellosis in several susceptible production livestock systems scattered throughout the country, a plan for its control, prevention and eradication was established almost 20 years ago. However, despite extensive efforts, brucellosis prevalence has fluctuated over the years without any trend of decreasing. The restricted budget allocated for brucellosis control is a limiting factor for the success of the program. For instance, the absence of indemnities for farmers results in infected animals remaining on farms which potentially increases the risk of disease spread. Likewise, disease surveillance is restricted to Brucella abortus and excludes other Brucella species of importance, such as B. melitensis and B. suis. The countermeasures are mostly focused on cattle and only a few actions are in place for the management of brucellosis in other livestock species. In humans, cases of brucellosis are annually diagnosed, although the disease remains highly underreported. High impact educational and training programs are required to address the disease in a comprehensive manner, including vulnerable groups, such as traditional smallholders and low-productivity regions, as well as other stakeholders, such as healthcare and veterinary authorities. Important financial investments based on sustained cooperation between governmental institutions, industry, and farmers are important for developing affordable and effective strategies to control the disease.
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Affiliation(s)
- Lisa M Avila-Granados
- Department of Veterinary Pathobiology, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, United States.,Departamento de Salud Animal, Facultad de Medicina Veterinaria y de Zootecnia, Universidad Nacional de Colombia, Bogota, Colombia
| | - Daniel G Garcia-Gonzalez
- Department of Veterinary Pathobiology, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Jorge L Zambrano-Varon
- Departamento de Salud Animal, Facultad de Medicina Veterinaria y de Zootecnia, Universidad Nacional de Colombia, Bogota, Colombia
| | - Angela M Arenas-Gamboa
- Department of Veterinary Pathobiology, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, United States
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Nikiphorou E, Lempp H, Kohrt BA. Treatment failure in inflammatory arthritis: time to think about syndemics? Rheumatology (Oxford) 2019; 58:1526-1533. [PMID: 31236573 PMCID: PMC6735768 DOI: 10.1093/rheumatology/kez222] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 04/25/2019] [Indexed: 11/13/2022] Open
Abstract
Social determinants of health play a crucial role in health and disease. In current times, it has become increasingly known that biological and non-biological factors are potentially linked and help to drive disease. For example, links between various comorbidities, both physical and mental illnesses, are known to be driven by social, environmental and economic determinants. This contributes to worse disease outcomes. This article discusses the concept of syndemics, which although well-described in some conditions, represents a novel concept in the context of rheumatic and musculoskeletal diseases. Written in the form of a viewpoint, the article focuses on a novel theoretical framework for studying inflammatory arthritis, based on a syndemic approach that takes into account the social context, biocultural disease interaction, and socio-economic characteristics of the setting. Syndemics involving inflammatory arthritis may be most likely in a social context involving limited access to health care, lack of physical activity and obesogenic diets, high rates of alcohol consumption, and high exposure to stressful life events.
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Affiliation(s)
- Elena Nikiphorou
- Centre for Rheumatic Diseases, Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences & Medicine, King's College London
- Department of Rheumatology, King’s College Hospital, London, UK
| | - Heidi Lempp
- Centre for Rheumatic Diseases, Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences & Medicine, King's College London
| | - Brandon A. Kohrt
- Department of Psychiatry and Behavioral Sciences, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Salm A, Gertsch J. Cultural perception of triatomine bugs and Chagas disease in Bolivia: a cross-sectional field study. Parasit Vectors 2019; 12:291. [PMID: 31182163 PMCID: PMC6558697 DOI: 10.1186/s13071-019-3546-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 05/30/2019] [Indexed: 01/09/2023] Open
Abstract
Background Chagas disease remains a major public health risk in Bolivia, particularly among rural indigenous communities. Here we studied the cultural perception of the triatomine vectors and Chagas disease among selected rural and urban ethnic groups from different socio-economic and geographical milieus. We focused on the indigenous communities in the Bolivian Chaco where the disease is hyperendemic. Methods A cross-sectional study using field observations and structured interviews was carried out among 480 informants in five different regions of Bolivia. Additional semi-structured interviews were conducted. Statistical analyses were performed to determine the correlation of socio-economic variables and indigenous Chagas disease knowledge systems. A total of 170 domestic Triatoma infestans vectors were collected and infection with Trypanosoma cruzi was analyzed by real-time PCR. Results Triatomine bugs were associated with Chagas disease in 70.2% (n = 480) of the responses (48.0% Ayoreo, 87.5% Chiquitano, 83.9% Guaraní, 72.2% Quechua, 46.1% La Paz citizens and 67.7% Santa Cruz citizens). Generally, indigenous informants have been educated on the association between triatomine bugs and Chagas disease by institutional anti-Chagas disease campaigns. While communities were largely aware of the vectors as a principal mode of disease transmission, rather unexpectedly, health campaigns had little influence on their prevention practices, apparently due to cultural constraints. Overall, 71.9% of the collected domestic vectors in the Chaco region were infected with T. cruzi, matching the high infection rates in the indigenous communities. Conclusions Among the Guaraní, Ayoreo and Quechua communities, the groups living in traditional houses have not integrated the scientific knowledge about Chagas disease transmission into their daily hygiene and continue to cohabit with T. infestans vectors hyperinfected with T. cruzi. An effective translation of Western disease concepts into traditional preventive measures is missing because asymptomatic infections are not generally perceived as threat by the communities. New participatory approaches involving existing ethnomedical knowledge systems could be a successful strategy in the control of T. cruzi infection.
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Affiliation(s)
- Andrea Salm
- Institute of Biochemistry and Molecular Medicine, University of Bern, 3012, Bern, Switzerland
| | - Jürg Gertsch
- Institute of Biochemistry and Molecular Medicine, University of Bern, 3012, Bern, Switzerland.
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Nieto-Sanchez C, Bates BR, Guerrero D, Jimenez S, Baus EG, Peeters Grietens K, Grijalva MJ. Home improvement and system-based health promotion for sustainable prevention of Chagas disease: A qualitative study. PLoS Negl Trop Dis 2019; 13:e0007472. [PMID: 31194754 PMCID: PMC6592574 DOI: 10.1371/journal.pntd.0007472] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 06/25/2019] [Accepted: 05/16/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Human transmission of Chagas disease (CD) most commonly occurs in domiciliary spaces where triatomines remain hidden to feed on blood sources during inhabitants' sleep. Similar to other neglected tropical diseases (NTDs), sustainable control of CD requires attention to the structural conditions of life of populations at risk, in this case, the conditions of their living environments. Considering socio-cultural and political dynamics involved in dwellings' construction, this study aimed to explore social factors that contribute or limit sustainability of CD's prevention models focused on home improvement. METHODS AND MAIN FINDINGS Using Healthy Homes for Healthy Living (HHHL)-a health promotion strategy focused on improvement of living environments and system-based health promotion-as a reference, a qualitative study was conducted. Research participants were selected from three rural communities of a CD endemic region in southern Ecuador involved in HHHL's refurbishment and reconstruction interventions between 2013 and 2016. Folowing an ethnographic approach, data were collected through interviews, participant observation, informal conversations and document analysis. Our results indicate that the HHHL model addressed risk factors for CD at the household level, while simultaneously promoting wellbeing at emotional, economic and social levels in local communities. We argue that sustainability of the CD prevention model proposed by HHHL is enhanced by the confluence of three factors: systemic improvement of families' quality of life, perceived usefulness of control measures, and flexibility to adapt to emerging dynamics of the context. CONCLUSION HHHL's proposed home improvement, facilitated through system-based rather than disease specific health promotion processes, enhances agency in populations at risk and facilitates community partnerships forged around CD prevention. Although an independent analysis of cost-effectiveness is recommended, structural poverty experienced by local families is still the most important factor to consider when evaluating the sustainability and scalability of this model.
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Affiliation(s)
- Claudia Nieto-Sanchez
- Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
- Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, United States of America
- Medical Anthropology Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Benjamin R. Bates
- Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, United States of America
- School of Communication Studies, Ohio University, Athens, Ohio, United States of America
| | - Darwin Guerrero
- Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Sylvia Jimenez
- Facultad de Arquitectura, Arte y Diseño, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Esteban G. Baus
- Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Koen Peeters Grietens
- Medical Anthropology Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Mario J. Grijalva
- Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
- Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, United States of America
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Laboudi M, Sahibi H, Elabandouni M, Nhammi H, Ait Hamou S, Sadak A. A review of cutaneous leishmaniasis in Morocco: A vertical analysisto determine appropriate interventions for control and prevention. Acta Trop 2018; 187:275-283. [PMID: 30056074 DOI: 10.1016/j.actatropica.2018.07.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 07/24/2018] [Accepted: 07/24/2018] [Indexed: 11/24/2022]
Abstract
Leishmaniasis is considered one of the most neglected diseases worldwide. In Morocco, cutaneous leishmaniasis is an important public health problem. Leishmania major and Leishmania tropica are the two major species in this country. Despite all efforts, monitoring and control of the cutaneous leishmaniasis is still challenging. We used for the first time a vertical analysis of the control of cutaneous leishmaniasis in Morocco from the document review and publications. This analysis allowed us to develop an epidemiological model that emphasized key possible interventions. No evaluation studies of these interventions in Morocco were done. Global Evidence underline the effectiveness of preventive interventions produced in integrate inter-sectorial strategy framework (e.g use of insecticide-treated bednets, indoor residual spraying and rodents' control) rather than treatments such as based thermotherapy, cryotherapy, photodynamic therapy, CO2 laser and paromomycin. Therefore, integrated vector management control (IVMC) with communityc participation is recommended as effective strategy. Strengthening of the IVMC with community involvement are necessary conditions to improve the program of cutaneous leishmaniasis and prevent epidemic foci appearance.
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Peláez-Ballestas I, Granados Y, Quintana R, Loyola-Sánchez A, Julián-Santiago F, Rosillo C, Gastelum-Strozzi A, Alvarez-Nemegyei J, Santana N, Silvestre A, Pacheco-Tena C, Goñi M, García-García C, Cedeño L, Pons-Éstel BA. Epidemiology and socioeconomic impact of the rheumatic diseases on indigenous people: an invisible syndemic public health problem. Ann Rheum Dis 2018; 77:1397-1404. [DOI: 10.1136/annrheumdis-2018-213625] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 06/04/2018] [Accepted: 06/22/2018] [Indexed: 11/03/2022]
Abstract
Epidemiological studies in Latin America suggest indigenous people lack proper healthcare for musculoskeletal (MSK) and rheumatic diseases.ObjectivesThis study aimed to estimate the prevalence of MSK disorders and rheumatic diseases in eight Latin American indigenous communities, and to identify which factors influence such prevalence using network analysis and syndemic approach.MethodsThis is a cross-sectional, community-based census study according to Community-Oriented Program for the Control of Rheumatic Diseases methodology. Individuals with MSK pain, stiffness or swelling in the past and/or during the last 7 days were evaluated by participating physicians. A descriptive, univariable and multivariable analysis was performed, followed by a network analysis.ResultsWe surveyed 6155 indigenous individuals with a mean age of 41.2 years (SD 17.6; range 18–105); 3757 (61.0%) were women. Point prevalence in rank order was: low back pain in 821 (13.3%); osteoarthritis in 598 (9.7%); rheumatic regional pain syndromes in 368 (5.9%); rheumatoid arthritis in 85 (1.3%); undifferentiated arthritis in 13 (0.2%); and spondyloarthritis in 12 (0.1%). There were marked variations in the prevalence of each rheumatic disease among the communities. Multivariate models and network analysis revealed a complex relationship between rheumatic diseases, comorbidities and socioeconomic conditions.ConclusionsThe overall prevalence of MSK disorders in Latin American indigenous communities was 34.5%. Although low back pain and osteoarthritis were the most prevalent rheumatic diseases, wide variations according to population groups occurred. The relationship between rheumatic diseases, comorbidities and socioeconomic conditions allows taking a syndemic approach to the study.
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da Silva RE, Amato AA, Guilhem DB, de Carvalho MR, Novaes MRCG. International Clinical Trials in Latin American and Caribbean Countries: Research and Development to Meet Local Health Needs. Front Pharmacol 2018; 8:961. [PMID: 29354059 PMCID: PMC5760498 DOI: 10.3389/fphar.2017.00961] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 12/18/2017] [Indexed: 02/05/2023] Open
Abstract
Introduction: Although international health research involves some benefits for the host countries, such as access to innovative treatments, the research itself may not be aligned with their communities' actual health needs. Objective: To map the global landscape of clinical trials run in Latin American and Caribbean countries and discuss the addressing of local health needs in the agenda of international clinical trials. Methods: The present study is a cross-sectional overview and used data referent to studies registered between 01/01/2014 and 12/31/2014 in the World Health Organization's (WHO) International Clinical Trials Registry Platform (ICTRP). Results: Non-communicable diseases such as diabetes, cancer, and asthma—studies which were financed mainly by industries—were the conditions investigated most in the region of Latin America and the Caribbean. The neglected diseases, on the other hand, such as Chagas disease, and dengue, made up 1% of the total number of studies. Hospitals and nonprofit nongovernmental organizations prioritize resources for investigating new drugs for neglected diseases, such as Chagas disease and dengue. Conclusion: The international multicenter clinical trials for investigating new drugs are aligned with the health needs of the region of Latin America and the Caribbean, when one considers the burden resulting from the non-communicable diseases in this region. However, the transmissible diseases, such as tuberculosis and AIDS, and the neglected diseases, such as Chagas disease and dengue, which have an important impact on public health in this region, continue to arouse little interest among the institutions which finance the clinical trials.
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Affiliation(s)
- Ricardo E da Silva
- Office of Clinical Trials, Brazilian Health Regulatory Agency (Anvisa), Brasília, Brazil.,Health Sciences, University of Brasília, Brasília, Brazil
| | | | | | - Marta R de Carvalho
- School of Medicine, Health Sciences Education and Research Foundation, Brasília, Brazil
| | - Maria R C G Novaes
- Health Sciences, University of Brasília, Brasília, Brazil.,School of Medicine, Health Sciences Education and Research Foundation, Brasília, Brazil
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Fontes AM, Gusson VP, De Souza AA, De Souza MAA. Identification of enteroparasites in recreation areas of elementary schools in Northern Espírito Santo, Brazil. Rev Salud Publica (Bogota) 2017; 19:795-799. [DOI: 10.15446/rsap.v19n6.57474] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 04/08/2017] [Indexed: 11/09/2022] Open
Abstract
Objetivo Dado que la arena es un medio importante de contagio infantil por enteroparásitos, este estudio tuvo como objetivo realizar una evaluación parasitológica en áreas recreativas de escuelas primarias y centros de educación infantil, en São Mateus-ES.Materiales y Métodos Se tomaron muestras de arena en siete escuelas primarias municipales, en un jardín de infantes y en una guardería municipal. Para la recuperación de huevos de helmintos y quistes de protozoos, se usaron las técnicas de flotación y de sedimentación espontánea.Resultados Se encontró que el 77 % de las instituciones analizadas dieron positivo para huevos y larvas de helmintos. Entre los huevos y larvas identificados los principales fueron Ascaris lumbricoides y Toxocara canis. La prueba de ji-cuadrado de Pearson identifica los mejores resultados cuando se usa el método de sedimentación espontánea.Conclusión Teniendo en cuenta que las personas, especialmente los niños que viven en malas condiciones de saneamiento, son más propensas a enteropatías, los estudios apuntan a la necesidad de la aplicación de medidas preventivas y de educación sanitaria para la población inscrita en las escuelas municipales de São Mateus.
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Curval LG, França ADO, Fernandes HJ, Mendes RP, de Carvalho LR, Higa MG, Ferreira EDC, Dorval MEC. Prevalence of intestinal parasites among inmates in Midwest Brazil. PLoS One 2017; 12:e0182248. [PMID: 28934218 PMCID: PMC5608187 DOI: 10.1371/journal.pone.0182248] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 07/14/2017] [Indexed: 11/21/2022] Open
Abstract
Background Intestinal parasitic infections constitute a public health issue in developing countries, with prevalence rates as high as 90%, a figure set to escalate as the socioeconomic status of affected populations deteriorates. Investigating the occurrence of these infections among inmates is critical, since this group is more vulnerable to the spread of a number of infectious illnesses. Methods This cross-sectional, analytical, quantitative study was conducted in July 2015 at prison facilities located in Midwest Brazil to estimate the prevalence of parasitic infection among inmates. For detection of parasites, 510 stool samples were examined by ether centrifugation and spontaneous sedimentation. Results Eight parasitic species were detected, with an overall prevalence of 20.2% (103/510). Giardia lamblia and Entamoeba histolytica/dispar were the most frequent pathogenic parasites. Endolimax nana was the predominant non-pathogenic species. Nearly half of the subjects (53/103; 51.4%) were positive for mixed infection. Logistic regression revealed that inmates held in closed conditions were more likely to contract parasitic infections than those held in a semi-open regime (OR = 1.97; 95% CI = 1.19–3.25; p = 0.0085). A higher prevalence of parasitic infections was observed among individuals who had received no prophylactic antiparasitic treatment in previous years (OR = 10.2; 95% CI = 5.86–17.66; p < 0.001). The other factors investigated had no direct association with the presence of intestinal parasites. Conclusion Infections caused by directly transmissible parasites were detected. Without adequate treatment and prophylactic guidance, inmates tend to remain indefinitely infected with intestinal parasites, whether while serving time in prison or after release.
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Affiliation(s)
- Larissa Gabrielle Curval
- Graduate Program in Infectious and Parasitic Diseases, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
- * E-mail:
| | - Adriana de Oliveira França
- Graduate Program in Infectious and Parasitic Diseases, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Henrique Jorge Fernandes
- Department of Animal Sciences, Universidade Estadual de Mato Grosso do Sul, Aquidauana, MS, Brazil
| | - Rinaldo Pôncio Mendes
- Visiting Professor, School of Medicine, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Lídia Raquel de Carvalho
- Department of Biostatistics, Biosciences Institute of Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Minoru German Higa
- Graduate Program in Infectious and Parasitic Diseases, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
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22
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Muñoz-Antoli C, Pavón A, Pérez P, Toledo R, Esteban JG. Soil-transmitted Helminth Infections in Schoolchildren of Laguna de Perlas (Nicaragua). J Trop Pediatr 2017; 63:124-134. [PMID: 27616686 DOI: 10.1093/tropej/fmw061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Soil-transmitted helminth (STH) prevalence, intensity, polyparasitism and co-infections in 425 children from 3 schools of Laguna de Perlas (Nicaragua) were investigated. Single stool samples were analysed by the formalin-ether method and the Kato-Katz. A total of 402 (94.6%) children were infected. Trichuris trichiura 308 (72.4%), Ascaris lumbricoides 115 (27.1%) and Hookworms 54 (12.7%) were the most prevalent STHs. Polyparasitism (322; 75.8%) with two species was most prevalent (109; 25.6%). T. trichiura with A. lumbricoides (19.3%) and T. trichiura with Hookworm (6.8%) were the most common combinations. Positive associations were observed between T. trichiura and A. lumbricoides and T. trichiura and Hookworm (p = 0.0001). Highest Hookworm intensities appeared when three STH co-infections occurred. Moderate- heavy STH intensities appear in up to 42.1% in trichuriasis, 57.5% in ascariasis and 11.1% in Hookworm infections. Integrated control interventions covering children need to be implemented mainly in a rural environment.
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Affiliation(s)
- C Muñoz-Antoli
- Facultad de Farmacia, Departamento de Parasitología, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, Burjassot-Valencia 46100, Spain
| | - A Pavón
- Departamento Bionálisis Clínico, Instituto Politécnico de la Salud (IPS-Polisal), Universidad Nacional Autónoma de Nicaragua, Managua, Nicaragua
| | - P Pérez
- Facultad de Farmacia, Departamento de Parasitología, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, Burjassot-Valencia 46100, Spain
| | - R Toledo
- Facultad de Farmacia, Departamento de Parasitología, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, Burjassot-Valencia 46100, Spain
| | - J G Esteban
- Facultad de Farmacia, Departamento de Parasitología, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, Burjassot-Valencia 46100, Spain
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Queiroz ACL, Cardoso LSDM, Heller L, Cairncross S. Integrating surveillance data on water-related diseases and drinking-water quality; action-research in a Brazilian municipality. JOURNAL OF WATER AND HEALTH 2015; 13:1048-1054. [PMID: 26608766 DOI: 10.2166/wh.2015.078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The Brazilian Ministry of Health proposed a research study involving municipal professional staff conducting both epidemiological and water quality surveillance to facilitate the integration of the data which they collected. It aimed to improve the intersectoral collaboration and health promotion activities in the municipalities, especially regarding drinking-water quality. We then conducted a study using the action-research approach. At its evaluation phase, a technique which we called 'the tree analogy' was applied in order to identify both possibilities and challenges related to the proposed interlinkage. Results showed that integrating the two data collection systems cannot be attained without prior institutional adjustments. It suggests therefore the necessity to unravel issues that go beyond the selection and the interrelation of indicators and compatibility of software, to include political, administrative and personal matters. The evaluation process led those involved to re-think their practice by sharing experiences encountered in everyday practice, and formulating constructive criticisms. All this inevitably unleashes a process of empowerment. From this perspective, we have certainly gathered some fruit from the Tree, but not necessarily the most visible.
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Affiliation(s)
- Ana Carolina Lanza Queiroz
- Departamento de Engenharia Sanitária e Ambiental, Av. Antônio Carlos, 6627, Bloco 1, 4° andar, Sala 4402 A - Pampulha, Belo Horizonte, MG CEP 31270-901, Brazil E-mail:
| | - Laís Santos de Magalhães Cardoso
- Departamento de Engenharia Sanitária e Ambiental, Av. Antônio Carlos, 6627, Bloco 1, 4° andar, Sala 4402 A - Pampulha, Belo Horizonte, MG CEP 31270-901, Brazil E-mail:
| | - Léo Heller
- Departamento de Engenharia Sanitária e Ambiental, Av. Antônio Carlos, 6627, Bloco 1, 4° andar, Sala 4527 - Pampulha, Belo Horizonte, MG CEP 31270-901, Brazil
| | - Sandy Cairncross
- Department of Disease Control, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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Peebles K, Nchimba L, Chilengi R, Bolton Moore C, Mubiana-Mbewe M, Vinikoor MJ. Pediatric HIV-HBV Coinfection in Lusaka, Zambia: Prevalence and Short-Term Treatment Outcomes. J Trop Pediatr 2015; 61:464-7. [PMID: 26338421 PMCID: PMC4852213 DOI: 10.1093/tropej/fmv058] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Hepatitis B virus (HBV) is endemic in Africa, where it may occur as an HIV coinfection. Data remain limited on HIV-HBV epidemiology in Africa, particularly in children. Using programmatic data from pediatric HIV clinics in Lusaka, Zambia during 2011-2014, we analyzed the prevalence of chronic HBV coinfection (defined as a single positive hepatitis B surface antigen [HBsAg] test) and its impact on immune recovery and liver enzyme elevation (LEE) during the first year of antiretroviral therapy. Among 411 children and adolescents, 10.4% (95% confidence interval, 7.6-14.1) had HIV-HBV. Coinfected patients were more likely to have World Health Organization stage 3/4, LEE and CD4 <14% at care entry (all p < 0.05). During treatment, CD4 increases and LEE incidence were similar by HBsAg status. HBsAg positivity decreased (11.8% vs. 6.6%; p = 0.24) following HBV vaccine introduction. These findings support screening pediatric HIV patients in Africa for HBV coinfection. Dedicated cohorts are needed to assess long-term outcomes of coinfection.
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Affiliation(s)
- Kathryn Peebles
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lweendo Nchimba
- Department of Pediatrics, University Teaching Hospital, Lusaka, Zambia
| | - Roma Chilengi
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Carolyn Bolton Moore
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia,Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA,Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Michael J. Vinikoor
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia,Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Evaluation of Water Sanitation Health Education Programme: Working with the Knowledge of the Basic Sanitation Services in a Developing Community in Rural Haiti after the 2010 Earthquake. W INDIAN MED J 2015; 63:616-9. [PMID: 26237369 DOI: 10.7727/wimj.2013.258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 12/12/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study is to measure the knowledge regarding the new sanitation water system being implemented in Dessources, a rural community in the municipality of Croix-des-Bouquets in Haiti after a two-year intervention programme. DESIGN AND METHODS A cross-sectional epidemiologic design was used to measure the knowledge of the people in the community using a semi-structured questionnaire. Data collection followed a face-to-face interview process in all houses of the community. The instrument content validity was performed by a panel of experts followed by Cronbach's alpha test to establish the reliability of knowledge scale. In addition, association measures were done using Stata 11.0 statistical package. RESULTS Content validity test were performed with minimum changes and an alpha of 0.74 was obtained for the scale. Response rate was 65.57% (41/60 houses); non-participants were only those who did not meet the inclusion criteria. Most of the participants (77.5%) were 21-49 years old and 85% had been living in the community for more than 20 years. Bivariate analysis showed that the people of Dessources had adequate knowledge. Significant differences, however, were found among the zones that are not in use of the new sanitary systems and among families with more than seven members per house. CONCLUSIONS Differences found can be explained based on the Rogers theoretical diffusion of innovation model. The evaluation shows that people of Dessources in Haiti have a high knowledge regarding the new water sanitation system and provided evidence of an adequate health education programme intervention.
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Sánchez-Montes S, Espinosa-Martínez DV, Ríos-Muñoz CA, Berzunza-Cruz M, Becker I. Leptospirosis in Mexico: Epidemiology and Potential Distribution of Human Cases. PLoS One 2015; 10:e0133720. [PMID: 26207827 PMCID: PMC4514770 DOI: 10.1371/journal.pone.0133720] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 06/19/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Leptospirosis is widespread in Mexico, yet the potential distribution and risk of the disease remain unknown. METHODOLOGY/PRINCIPAL FINDINGS We analysed morbidity and mortality according to age and gender based on three sources of data reported by the Ministry of Health and the National Institute of Geography and Statics of Mexico, for the decade 2000-2010. A total of 1,547 cases were reported in 27 states, the majority of which were registered during the rainy season, and the most affected age group was 25-44 years old. Although leptospirosis has been reported as an occupational disease of males, analysis of morbidity in Mexico showed no male preference. A total number of 198 deaths were registered in 21 states, mainly in urban settings. Mortality was higher in males (61.1%) as compared to females (38.9%), and the case fatality ratio was also increased in males. The overall case fatality ratio in Mexico was elevated (12.8%), as compared to other countries. We additionally determined the potential disease distribution by examining the spatial epidemiology combined with spatial modeling using ecological niche modeling techniques. We identified regions where leptospirosis could be present and created a potential distribution map using bioclimatic variables derived from temperature and precipitation. Our data show that the distribution of the cases was more related to temperature (75%) than to precipitation variables. Ecological niche modeling showed predictive areas that were widely distributed in central and southern Mexico, excluding areas characterized by extreme climates. CONCLUSIONS/SIGNIFICANCE In conclusion, an epidemiological surveillance of leptospirosis is recommended in Mexico, since 55.7% of the country has environmental conditions fulfilling the criteria that favor the presence of the disease.
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Affiliation(s)
- Sokani Sánchez-Montes
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Centro de Medicina Tropical, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Deborah V. Espinosa-Martínez
- Museo de Zoología “Alfonso L. Herrera”, Departamento de Biología Evolutiva, Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - César A. Ríos-Muñoz
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Centro de Medicina Tropical, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Museo de Zoología “Alfonso L. Herrera”, Departamento de Biología Evolutiva, Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Miriam Berzunza-Cruz
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Centro de Medicina Tropical, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Ingeborg Becker
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Centro de Medicina Tropical, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Huamaní C, Romaní F, González-Alcaide G, Mejia MO, Ramos JM, Espinoza M, Cabezas C. South American collaboration in scientific publications on leishmaniasis: bibliometric analysis in SCOPUS (2000-2011). Rev Inst Med Trop Sao Paulo 2015; 56:381-90. [PMID: 25229217 PMCID: PMC4172108 DOI: 10.1590/s0036-46652014000500003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 02/25/2014] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Evaluate the production and the research collaborative network on Leishmaniasis in South America. METHODS A bibliometric research was carried out using SCOPUS database. The analysis unit was original research articles published from 2000 to 2011, that dealt with leishmaniasis and that included at least one South American author. The following items were obtained for each article: journal name, language, year of publication, number of authors, institutions, countries, and others variables. RESULTS 3,174 articles were published, 2,272 of them were original articles. 1,160 different institutional signatures, 58 different countries and 398 scientific journals were identified. Brazil was the country with more articles (60.7%) and Oswaldo Cruz Foundation (FIOCRUZ) had 18% of Brazilian production, which is the South American nucleus of the major scientific network in Leishmaniasis. CONCLUSIONS South American scientific production on Leishmaniasis published in journals indexed in SCOPUS is focused on Brazilian research activity. It is necessary to strengthen the collaboration networks. The first step is to identify the institutions with higher production, in order to perform collaborative research according to the priorities of each country.
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Affiliation(s)
| | | | | | - Miluska O Mejia
- Facultad de Medicina Humana ?San Fernando?, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - José Manuel Ramos
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain
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Okello AL, Beange I, Shaw A, Moriyón I, Gabriël S, Bardosh K, Johansen MV, Saarnak C, Mukaratirwa S, Berkvens D, Welburn SC. Raising the political profile of the neglected zoonotic diseases: three complementary European commission-funded projects to streamline research, build capacity and advocate for control. PLoS Negl Trop Dis 2015; 9:e0003505. [PMID: 25741705 PMCID: PMC4351249 DOI: 10.1371/journal.pntd.0003505] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Anna L. Okello
- Division of Pathway Medicine and Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
- * E-mail:
| | - Iona Beange
- Division of Pathway Medicine and Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
| | - Alexandra Shaw
- Agriculture and Veterinary Information and Analysis (Avia-GIS), Zoersel, Belgium
| | - Ignacio Moriyón
- Instituto de Salud Tropical y Depto Microbiología y Parasitología, Universidad de Navarra, Pamplona, Spain
| | | | - Kevin Bardosh
- Centre of African Studies, School of Social and Political Science, The University of Edinburgh, Edinburgh, United Kingdom
| | | | - Maria Vang Johansen
- Section for Parasitology and Aquatic Diseases, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christopher Saarnak
- Section for Parasitology and Aquatic Diseases, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Samson Mukaratirwa
- School of Life Sciences, University of KwaZulu‐Natal, Durban, South Africa
| | | | | | | | - Susan C. Welburn
- Division of Pathway Medicine and Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
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Nakagawa J, Ehrenberg JP, Nealon J, Fürst T, Aratchige P, Gonzales G, Chanthavisouk C, Hernandez LM, Fengthong T, Utzinger J, Steinmann P. Towards effective prevention and control of helminth neglected tropical diseases in the Western Pacific Region through multi-disease and multi-sectoral interventions. Acta Trop 2015; 141:407-18. [PMID: 23792012 DOI: 10.1016/j.actatropica.2013.05.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 04/22/2013] [Accepted: 05/21/2013] [Indexed: 12/13/2022]
Abstract
Neglected tropical diseases (NTDs) cause serious health, social and economic burdens in the countries of the World Health Organization Western Pacific Region. Among the NTDs, helminth infections are particularly prominent with regard to the number of infected individuals and health impact. Co-endemicity is common among impoverished and marginalized populations. To achieve effective and sustainable control of helminth NTDs, a deeper understanding of the social-ecological systems governing their endemicity and strategies beyond preventive chemotherapy are required to tackle the multiple causes of infection and re-infection. We discuss the feasibility of implementing multi-disease, multi-sectoral intervention packages for helminth NTDs in the Western Pacific Region. After reviewing the main determinants for helminth NTD endemicity and current control strategies, key control activities that involve or concern other programmes within and beyond the health sector are discussed. A considerable number of activities that have an impact on more than one helminth NTD are identified in a variety of sectors, suggesting an untapped potential for synergies. We also highlight the challenges of multi-sectoral collaboration, particularly of involving non-health sectors. We conclude that multi-sectoral collaboration for helminth NTD control is feasible if the target diseases and sectors are carefully selected. To do so, an incentive analysis covering key stakeholders in the sectors is crucial, and the disease-control strategies need to be well understood. The benefits of multi-disease, multi-sectoral approaches could go beyond immediate health impacts by contributing to sustainable development, raising educational attainment, increasing productivity and reducing health inequities.
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Affiliation(s)
- Jun Nakagawa
- World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines
| | - John P Ehrenberg
- World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines
| | - Joshua Nealon
- World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines
| | - Thomas Fürst
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; University of Basel, P.O. Box, CH-4003 Basel, Switzerland
| | - Padmasiri Aratchige
- World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines
| | - Glenda Gonzales
- World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines
| | - Chitsavang Chanthavisouk
- World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines
| | - Leda M Hernandez
- Infectious Disease Office, National Centre for Disease Prevention and Control, Department of Health, Sta. Cruz, 1000 Manila, Philippines
| | - Tayphasavanh Fengthong
- Department of Hygiene and Health Promotion, Ministry of Health, P.O. Box 1232, Vientiane, Lao People's Democratic Republic
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; University of Basel, P.O. Box, CH-4003 Basel, Switzerland
| | - Peter Steinmann
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; University of Basel, P.O. Box, CH-4003 Basel, Switzerland.
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Bardosh K. Global aspirations, local realities: the role of social science research in controlling neglected tropical diseases. Infect Dis Poverty 2014; 3:35. [PMID: 25320672 PMCID: PMC4197218 DOI: 10.1186/2049-9957-3-35] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 09/16/2014] [Indexed: 11/23/2022] Open
Abstract
Neglected Tropical Diseases (NTDs) are both drivers and manifestations of poverty and social inequality. Increased advocacy efforts since the mid-2000s have led to ambitious new control and elimination targets set for 2020 by the World Health Organisation. While these global aspirations represent significant policy momentum, there are multifaceted challenges in controlling infectious diseases in resource-poor local contexts that need to be acknowledged, understood and engaged. However a number of recent publications have emphasised the “neglected” status of applied social science research on NTDs. In light of the 2020 targets, this paper explores the social science/NTD literature and unpacks some of the ways in which social inquiry can help support effective and sustainable interventions. Five priority areas are discussed, including on policy processes, health systems capacity, compliance and resistance to interventions, education and behaviour change, and community participation. The paper shows that despite the multifaceted value of having anthropological and sociological perspectives integrated into NTD programmes, contemporary efforts underutilise this potential. This is reflective of the dominance of top-down information flows and technocratic approaches in global health. To counter this tendency, social research needs to be more than an afterthought; integrating social inquiry into the planning, monitoring and evaluating process will help ensure that flexibility and adaptability to local realities are built into interventions. More emphasis on social science perspectives can also help link NTD control to broader social determinants of health, especially important given the major social and economic inequalities that continue to underpin transmission in endemic countries.
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Affiliation(s)
- Kevin Bardosh
- Centre of African Studies, School of Social and Political Science, College of Humanities and Social Science, The University of Edinburgh, 58 George Square, Edinburgh, EH8 9LD UK ; Division of Pathway Medicine and Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB UK
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Rosecrans K, Cruz-Martin G, King A, Dumonteil E. Opportunities for improved chagas disease vector control based on knowledge, attitudes and practices of communities in the yucatan peninsula, Mexico. PLoS Negl Trop Dis 2014; 8:e2763. [PMID: 24676038 PMCID: PMC3967964 DOI: 10.1371/journal.pntd.0002763] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 02/14/2014] [Indexed: 11/19/2022] Open
Abstract
Background Chagas disease is a vector-borne parasitic disease of major public health importance. Current prevention efforts are based on triatomine vector control to reduce transmission to humans. Success of vector control interventions depends on their acceptability and value to affected communities. We aimed to identify opportunities for and barriers to improved vector control strategies in the Yucatan peninsula, Mexico. Methodology/principal findings We employed a sequence of qualitative and quantitative research methods to investigate knowledge, attitudes and practices surrounding Chagas disease, triatomines and vector control in three rural communities. Our combined data show that community members are well aware of triatomines and are knowledgeable about their habits. However, most have a limited understanding of the transmission dynamics and clinical manifestations of Chagas disease. While triatomine control is not a priority for community members, they frequently use domestic insecticide products including insecticide spray, mosquito coils and plug-in repellents. Families spend about $32 US per year on these products. Alternative methods such as yard cleaning and window screens are perceived as desirable and potentially more effective. Screens are nonetheless described as unaffordable, in spite of a cost comparable to the average annual spending on insecticide products. Conclusion/Significance Further education campaigns and possibly financing schemes may lead families to redirect their current vector control spending from insecticide products to window screens. Also, synergism with mosquito control efforts should be further explored to motivate community involvement and ensure sustainability of Chagas disease vector control. Chagas disease is an important parasitic disease transmitted by triatomine bugs. Current prevention efforts are based on eliminating triatomines from homes to reduce disease transmission to humans. However, the success of these control interventions depends on their acceptability and value to affected communities. We aimed to identify opportunities for and barriers to triatomine control strategies in the Yucatan peninsula, Mexico. We used a sequence of group discussion, interviews, and a survey to investigate the perception and knowledge of communities on Chagas disease and triatomines in three villages from the Yucatan peninsula, Mexico. Inhabitants are rather familiar with triatomine bugs, but do not associate well these bugs with Chagas disease and its clinical manifestations. Mosquito rather than triatomine control is a common preoccupation, and households frequently use insecticide spray, mosquito coils and plug-in repellents, spending about $32 US per year on these products. Alternative methods such as yard cleaning and window screens are perceived as desirable and potentially more effective. Screens are nonetheless described as unaffordable. The promotion of education campaigns and possibly financing schemes could help families to redirect their current spending from insecticide products to window screens. Also, synergism with mosquito control efforts should be further explored to motivate community involvement and ensure sustainability of Chagas disease vector control.
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Affiliation(s)
- Kathryn Rosecrans
- Laboratorio de Parasitología, Centro de Investigaciones Regionales “Dr. Hideyo Noguchi”, Universidad Autónoma de Yucatán, Mérida, Yucatán, Mexico
| | - Gabriela Cruz-Martin
- Laboratorio de Parasitología, Centro de Investigaciones Regionales “Dr. Hideyo Noguchi”, Universidad Autónoma de Yucatán, Mérida, Yucatán, Mexico
| | - Ashley King
- Laboratorio de Parasitología, Centro de Investigaciones Regionales “Dr. Hideyo Noguchi”, Universidad Autónoma de Yucatán, Mérida, Yucatán, Mexico
- Department of International Health, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, United States of America
| | - Eric Dumonteil
- Laboratorio de Parasitología, Centro de Investigaciones Regionales “Dr. Hideyo Noguchi”, Universidad Autónoma de Yucatán, Mérida, Yucatán, Mexico
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, United States of America
- * E-mail: ,
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Smits HL. Prospects for the control of neglected tropical diseases by mass drug administration. Expert Rev Anti Infect Ther 2014; 7:37-56. [DOI: 10.1586/14787210.7.1.37] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Ndongo PY, Fond-Harmant L, Deccache A. Approches communautaires dans la lutte contre l'ulcère de Buruli : revue de la littérature. SANTE PUBLIQUE 2014. [DOI: 10.3917/spub.140.0039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Singer M, Bulled N. INTERLOCKED INFECTIONS: THE HEALTH BURDENS OF SYNDEMICS OF NEGLECTED TROPICAL DISEASES. ANNALS OF ANTHROPOLOGICAL PRACTICE 2013. [DOI: 10.1111/napa.12007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Rollinson D, Knopp S, Levitz S, Stothard JR, Tchuem Tchuenté LA, Garba A, Mohammed KA, Schur N, Person B, Colley DG, Utzinger J. Time to set the agenda for schistosomiasis elimination. Acta Trop 2013; 128:423-40. [PMID: 22580511 DOI: 10.1016/j.actatropica.2012.04.013] [Citation(s) in RCA: 376] [Impact Index Per Article: 34.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 04/25/2012] [Accepted: 04/27/2012] [Indexed: 12/19/2022]
Abstract
It is time to raise global awareness to the possibility of schistosomiasis elimination and to support endemic countries in their quest to determine the most appropriate approaches to eliminate this persistent and debilitating disease. The main interventions for schistosomiasis control are reviewed, including preventive chemotherapy using praziquantel, snail control, sanitation, safe water supplies, and behaviour change strategies supported by information, education and communication (IEC) materials. Differences in the biology and transmission of the three main Schistosoma species (i.e. Schistosoma haematobium, S. mansoni and S. japonicum), which impact on control interventions, are considered. Sensitive diagnostic procedures to ensure adequate surveillance in areas attaining low endemicity are required. The importance of capacity building is highlighted. To achieve elimination, an intersectoral approach is necessary, with advocacy and action from local communities and the health community to foster cooperative ventures with engineers, the private sector, governments and non-governmental organizations specialized in water supply and sanitation. Examples of successful schistosomiasis control programmes are reviewed to highlight what has been learnt in terms of strategy for control and elimination. These include St. Lucia and other Caribbean islands, Brazil and Venezuela for S. mansoni; Saudi Arabia and Egypt for both S. mansoni and S. haematobium; Morocco, Tunisia, Algeria, Mauritius and the Islamic Republic of Iran for S. haematobium; Japan and the People's Republic of China for S. japonicum. Additional targets for elimination or even eradication could be the two minor human schistosome species S. guineenisis and S. intercalatum, which have a restricted distribution in West and Central Africa. The examples show that elimination of schistosomiasis is an achievable and desirable goal requiring full integration of preventive chemotherapy with the tools of transmission control. An agenda for the elimination of schistosomiasis would aim to identify the gaps in knowledge, and define the tools, strategies and guidelines that will help national control programmes move towards elimination, including an internationally accepted mechanism that allows verification/confirmation of elimination.
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Affiliation(s)
- David Rollinson
- Wolfson Wellcome Biomedical Laboratories, Department of Zoology, Natural History Museum, Cromwell Road, London SW7 5BD, UK.
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Ajayi IO, Jegede AS, Falade CO, Sommerfeld J. Assessing resources for implementing a community directed intervention (CDI) strategy in delivering multiple health interventions in urban poor communities in Southwestern Nigeria: a qualitative study. Infect Dis Poverty 2013; 2:25. [PMID: 24156481 PMCID: PMC4177198 DOI: 10.1186/2049-9957-2-25] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 10/18/2013] [Indexed: 11/23/2022] Open
Abstract
Background Many simple, affordable and effective disease control measures have had limited impact due to poor access especially by the poorer populations (urban and rural) and inadequate community participation. A proven strategy to address the problem of access to health interventions is the Community Directed Interventions (CDI) approach, which has been used successfully in rural areas. This study was carried out to assess resources for the use of a CDI strategy in delivering health interventions in poorly-served urban communities in Ibadan, Nigeria. Methods A formative study was carried out in eight urban poor communities in the Ibadan metropolis in the Oyo State. Qualitative methods comprising 12 focus group discussions (FGDs) with community members and 73 key informant interviews (KIIs) with community leaders, programme managers, community-based organisations (CBOs), non-government organisations (NGOs) and other stakeholders at federal, state and local government levels were used to collect data to determine prevalent diseases and healthcare delivery services, as well as to explore the potential resources for a CDI strategy. All interviews were audio recorded. Content analysis was used to analyse the data. Results Malaria, upper respiratory tract infection, diarrhoea and measles were found to be prevalent in children, while hypertension and diabetes topped the list of diseases among adults. Healthcare was financed mainly by out-of-pocket expenses. Cost and location were identified as hindrances to utilisation of health facilities; informal cooperatives (esusu) were available to support those who could not pay for care. Immunisation, nutrition, reproductive health, tuberculosis (TB) and leprosy, environmental health, malaria and HIV/AIDs control programmes were the ongoing interventions. Delivery strategies included house-to-house, home-based treatment, health education and campaigns. Community participation in the planning, implementation and monitoring of development projects was reported as common practice. The resources available for these activities and which constitute potential resources for the CDI process include community volunteers, CBOs and NGOs. Others are landlords; professional, women and youth associations; social clubs, religious organisations and the available health facilities. Conclusion This study’s findings support the feasibility of using the CDI process in delivering health interventions in urban poor communities and show that potential resources for the strategy abound in the communities.
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Affiliation(s)
- Ikeoluwapo O Ajayi
- Epidemiology and Biostatistics Research Unit, Institute of Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria.
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Balen J, Liu ZC, McManus DP, Raso G, Utzinger J, Xiao SY, Yu DB, Zhao ZY, Li YS. Health access livelihood framework reveals potential barriers in the control of schistosomiasis in the Dongting Lake area of Hunan Province, China. PLoS Negl Trop Dis 2013; 7:e2350. [PMID: 23936580 PMCID: PMC3731233 DOI: 10.1371/journal.pntd.0002350] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 06/19/2013] [Indexed: 01/02/2023] Open
Abstract
Background Access to health care is a major requirement in improving health and fostering socioeconomic development. In the People's Republic of China (P.R. China), considerable changes have occurred in the social, economic, and health systems with a shift from a centrally planned to a socialist market economy. This brought about great benefits and new challenges, particularly for vertical disease control programs, including schistosomiasis. We explored systemic barriers in access to equitable and effective control of schistosomiasis. Methodology Between August 2002 and February 2003, 66 interviews with staff from anti-schistosomiasis control stations and six focus group discussions with health personnel were conducted in the Dongting Lake area, Hunan Province. Additionally, 79 patients with advanced schistosomiasis japonica were interviewed. The health access livelihood framework was utilized to examine availability, accessibility, affordability, adequacy, and acceptability of schistosomiasis-related health care. Principal Findings We found sufficient availability of infrastructure and human resources at most control stations. Many patients with advanced schistosomiasis resided in non-endemic or moderately endemic areas, however, with poor accessibility to disease-specific knowledge and specialized health services. Moreover, none of the patients interviewed had any form of health insurance, resulting in high out-of-pocket expenditure or unaffordable care. Reports on the adequacy and acceptability of care were mixed. Conclusions/Significance There is a need to strengthen health awareness and schistosomiasis surveillance in post-transmission control settings, as well as to reduce diagnostic and treatment costs. Further studies are needed to gain a multi-layered, in-depth understanding of remaining barriers, so that the ultimate goal of schistosomiasis elimination in P.R. China can be reached. China has made great strides toward reducing the burden of schistosomiasis, facilitated by sustained political commitment and a multi-faceted, integrated control strategy. The ultimate goal is disease elimination, which might be challenging due to high rates of re-infection, clusters of re-emergence, and growing health disparities. Market-oriented reforms and system-wide policies within the health care system offer new opportunities, but also entail challenges for the national schistosomiasis control program. Few studies have examined systemic barriers to equitable and effective schistosomiasis control in China. We explored the five core dimensions of access to health care, placing emphasis on schistosomiasis in the Dongting Lake area of Hunan Province. We collected and analyzed perspectives from staff working at local anti-schistosomiasis control stations and designated schistosomiasis hospitals, and from patients with advanced schistosomiasis. Our data suggest that a lack of affordability and high out-of-pocket expenditure posed a major barrier to the health care users, as did a lack of relevant health-information, and poorly accessible diagnostic and specialized surgical services. The lessons learned from this work are important in the design and development of disease control programs and entail key policy implications for schistosomiasis elimination.
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Affiliation(s)
- Julie Balen
- Molecular Parasitology Laboratory, Division of Infectious Diseases, Queensland Institute of Medical Research, Brisbane, Australia.
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Sherriff N, Gugglberger L. A European Seal of Approval for ‘gay’ businesses: findings from an HIV-prevention pilot project. Perspect Public Health 2013; 134:150-9. [DOI: 10.1177/1757913913481540] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Aims: ‘Gay’ businesses can be important settings through which to deliver health promotion interventions to vulnerable populations, such as men who have sex with men (MSM) regarding HIV prevention. This article draws on data from the European Everywhere project, which represents the first scheme to develop and pre-test a common framework for HIV/STI prevention in ‘gay’ businesses across eight European countries. Methods: The scientific basis of the Everywhere framework was developed using a comprehensive consensus-building process over 30 months. This process included: formative scoping research; interviews with 54 ‘gay’ businesses; meetings/workshops with representatives from project partners, ‘gay’ businesses, public health administrations and external experts; 15 interviews and three focus groups with project partners; a five-month pilot action phase in eight countries, together with support from the project’s Advisory Group; and all Everywhere project partners including the Scientific Steering Committee. Results: A voluntary European code setting out differentiated HIV/STI-prevention standards for ‘gay’ businesses (including sex venues, ‘gay’ and ‘gay’ friendly social spaces, travel agencies, hotels, dating websites) was developed and piloted in eight European cities. During a five-month pilot action, 83 ‘gay’ businesses were certified with the Everywhere Seal of Approval representing a considerable increase on the expected pilot target of 30. Conclusions: Everywhere offers a major contribution to the public health and/or health promotion field in the form of a practical, policy-relevant, settings-based HIV-prevention framework for ‘gay’ businesses that is common across eight European countries. Findings suggest that a European-wide model of prevention is acceptable and feasible to businesses.
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Affiliation(s)
- Nigel Sherriff
- Centre for Health Research, University of Brighton, Falmer, Brighton, UK
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Peres F, Claudio L. Fifteen years of occupational and environmental health projects support in Brazil, Chile, and Mexico: a report from Mount Sinai School of Medicine ITREOH program, 1995-2010. Am J Ind Med 2013; 56:29-37. [PMID: 22593011 DOI: 10.1002/ajim.22066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2012] [Indexed: 11/07/2022]
Abstract
BACKGROUND The Fogarty International Center of the National Institutes of Health created the International Training and Research Program in Occupational and Environmental Health (ITREOH program) in 1995 with the aim to train environmental and occupational health scientists in developing countries. Mount Sinai School of Medicine was a grantee of this program since its inception, partnering with research institutions in Brazil, Chile, and Mexico. This article evaluates Mount Sinai's program in order to determine whether it has contributed to the specific research capacity needs of the international partners. METHODS Information was obtained from: (a) international and regional scientific literature databases; (b) databases from the three participating countries; and (c) MSSM ITREOH Program Database. RESULTS Most of the research projects supported by the program were consistent with the themes found to be top priorities for the partner countries based on mortality/morbidity and research themes in the literature. Indirect effects of the training and the subsequent research projects completed by the trained fellows in the program included health policy changes and development of collaborative international projects. CONCLUSION International research training programs, such as the MSSM ITREOH, that strengthen scientific research capacity in occupational and environmental health in Latin America can make a significant impact on the most pressing health issues in the partner countries.
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Affiliation(s)
- Frederico Peres
- Center for Studies in Workers Health and Human Ecology, National School of Public Health, The Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Prioritizing research for "One health - One world". Infect Dis Poverty 2012; 1:1. [PMID: 23849840 PMCID: PMC3710101 DOI: 10.1186/2049-9957-1-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Accepted: 08/30/2012] [Indexed: 12/01/2022] Open
Abstract
Infectious diseases of poverty, a collective term coined for infections known to be particularly prevalent amongst poor populations, is increasingly used for neglected tropical diseases (NTDs) with special transmission routes, such as depending on vectors and/or intermediate hosts. The journal Infectious Diseases of Poverty (IDP) is launched to explore new avenues in research to better understand the relationship between infectious diseases and poverty, and to contribute to priority settings for plans to control them. Introducing the “One health - One world” concept, IDP will publish original and empirical work based on analyses of disease burdens, their distribution and research needs in this area. The new journal will not only bring out research articles but also scoping reviews and highlights of trans-disciplinary work undertaken to combat the infectious diseases of poverty, wherever in the world they exist.
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Jia TW, Melville S, Utzinger J, King CH, Zhou XN. Soil-transmitted helminth reinfection after drug treatment: a systematic review and meta-analysis. PLoS Negl Trop Dis 2012; 6:e1621. [PMID: 22590656 PMCID: PMC3348161 DOI: 10.1371/journal.pntd.0001621] [Citation(s) in RCA: 276] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2011] [Accepted: 03/01/2012] [Indexed: 01/08/2023] Open
Abstract
Background Soil-transmitted helminth (STH) infections (i.e., Ascaris lumbricoides, hookworm, and Trichuris trichiura) affect more than a billion people. Preventive chemotherapy (i.e., repeated administration of anthelmintic drugs to at-risk populations), is the mainstay of control. This strategy, however, does not prevent reinfection. We performed a systematic review and meta-analysis to assess patterns and dynamics of STH reinfection after drug treatment. Methodology We systematically searched PubMed, ISI Web of Science, EMBASE, Cochrane Database of Systematic Reviews, China National Knowledge Infrastructure, WanFang Database, Chinese Scientific Journal Database, and Google Scholar. Information on study year, country, sample size, age of participants, diagnostic method, drug administration strategy, prevalence and intensity of infection pre- and posttreatment, cure and egg reduction rate, evaluation period posttreatment, and adherence was extracted. Pooled risk ratios from random-effects models were used to assess the risk of STH reinfection after treatment. Our protocol is available on PROSPERO, registration number: CRD42011001678. Principal Findings From 154 studies identified, 51 were included and 24 provided STH infection rates pre- and posttreatment, whereas 42 reported determinants of predisposition to reinfection. At 3, 6, and 12 months posttreatment, A. lumbricoides prevalence reached 26% (95% confidence interval (CI): 16–43%), 68% (95% CI: 60–76%) and 94% (95% CI: 88–100%) of pretreatment levels, respectively. For T. trichiura, respective reinfection prevalence were 36% (95% CI: 28–47%), 67% (95% CI: 42–100%), and 82% (95% CI: 62–100%), and for hookworm, 30% (95% CI: 26–34%), 55% (95% CI: 34–87%), and 57% (95% CI: 49–67%). Prevalence and intensity of reinfection were positively correlated with pretreatment infection status. Conclusion STH reinfections occur rapidly after treatment, particularly for A. lumbricoides and T. trichiura. Hence, there is a need for frequent anthelmintic drug administrations to maximize the benefit of preventive chemotherapy. Integrated control approaches emphasizing health education and environmental sanitation are needed to interrupt transmission of STH. Infections with soil-transmitted helminths (the roundworm Ascaris lumbricoides, the whipworm Trichuris trichiura, and hookworm) affect over 1 billion people, particularly rural communities in the developing world. The global strategy to control soil-transmitted helminth infections is ‘preventive chemotherapy’, which means large-scale administration of anthelmintic drugs to at-risk populations. However, because reinfection occurs after treatment, ‘preventive chemotherapy’ must be repeated regularly. Our systematic review and meta-analysis found that at 3, 6, and 12 months after treatment, A. lumbricoides prevalence reached 26% (95% confidence interval (CI): 16–43%), 68% (95% CI: 60–76%) and 94% (95% CI: 88–100%) of pretreatment levels, respectively. For T. trichiura, respective reinfection prevalence at these time points were 36% (95% CI: 28–47%), 67% (95% CI: 42–100%), and 82% (95% CI: 62–100%); and for hookworm, 30% (95% CI: 26–34%), 55% (95% CI: 34–87%), and 57% (95% CI: 49–67%). Prevalence and intensity of reinfection were positively correlated with pretreatment infection status. Our results suggest a frequent anthelmintic drug administration to maximize the benefit of preventive chemotherapy. Moreover, an integrated control strategy, consisting of preventive chemotherapy combined with health education and environmental sanitation is needed to interrupt transmission of soil-transmitted helminths.
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Affiliation(s)
- Tie-Wu Jia
- Key Laboratory on Biology of Parasites and Vectors, MOH, WHO Collaborating Center on Malaria, Schistosomiasis and Filariasis, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
- * E-mail: (T-WJ); (X-NZ)
| | - Sara Melville
- Hughes Hall College, Cambridge University, Cambridge, United Kingdom
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States of America
| | - Xiao-Nong Zhou
- Key Laboratory on Biology of Parasites and Vectors, MOH, WHO Collaborating Center on Malaria, Schistosomiasis and Filariasis, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
- * E-mail: (T-WJ); (X-NZ)
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Affiliation(s)
- Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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Alencar CH, Ramos AN, dos Santos ES, Richter J, Heukelbach J. Clusters of leprosy transmission and of late diagnosis in a highly endemic area in Brazil: focus on different spatial analysis approaches. Trop Med Int Health 2012; 17:518-25. [PMID: 22248041 DOI: 10.1111/j.1365-3156.2011.02945.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The Brazilian National Hansen's Disease Control Program recently identified clusters with high disease transmission. Herein, we present different spatial analytical approaches to define highly vulnerable areas in one of these clusters. METHOD The study area included 373 municipalities in the four Brazilian states Maranhão, Pará, Tocantins and Piauí. Spatial analysis was based on municipalities as the observation unit, considering the following disease indicators: (i) rate of new cases/100,000 population, (ii) rate of cases <15 years/100,000 population, (iii) new cases with grade-2 disability/100,000 population and (iv) proportion of new cases with grade-2 disabilities. We performed descriptive spatial analysis, local empirical Bayesian analysis and spatial scan statistic. RESULTS A total of 254 (68.0%) municipalities were classified as hyperendemic (mean annual detection rates >40 cases/100,000 inhabitants). There was a concentration of municipalities with higher detection rates in Pará and in the center of Maranhão. Spatial scan statistic identified 23 likely clusters of new leprosy case detection rates, most of them localized in these two states. These clusters included only 32% of the total population, but 55.4% of new leprosy cases. We also identified 16 significant clusters for the detection rate <15 years and 11 likely clusters of new cases with grade-2. Several clusters of new cases with grade-2/population overlap with those of new cases detection and detection of children <15 years of age. The proportion of new cases with grade-2 did not reveal any significant clusters. CONCLUSIONS Several municipality clusters for high leprosy transmission and late diagnosis were identified in an endemic area using different statistical approaches. Spatial scan statistic is adequate to validate and confirm high-risk leprosy areas for transmission and late diagnosis, identified using descriptive spatial analysis and using local empirical Bayesian method. National and State leprosy control programs urgently need to intensify control actions in these highly vulnerable municipalities.
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Affiliation(s)
- Carlos H Alencar
- Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
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Price J, Asgary R. Women's Health Disparities in Honduras: Indicators and Determinants. J Womens Health (Larchmt) 2011; 20:1931-7. [DOI: 10.1089/jwh.2010.2615] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Joan Price
- Global Health Center, WHO Collaborating Centre in Children's Environmental Health, Mount Sinai School of Medicine, New York, New York
| | - Ramin Asgary
- Global Health Center, WHO Collaborating Centre in Children's Environmental Health, Mount Sinai School of Medicine, New York, New York
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Llovet I, Dinardi G, De Maio FG. Mitigating social and health inequities: community participation and Chagas disease in rural Argentina. Glob Public Health 2011; 6:371-84. [PMID: 21229423 DOI: 10.1080/17441692.2010.539572] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Chagas disease (CD) causes 12,500 deaths annually in Latin America. As a neglected disease primarily associated with poverty, it is a major driver of health inequity. Argentina's efforts to control vector transmission have been unsuccessful. Using new survey data (n=400 households), we compare the social patterning of the burden of CD by examining socio-demographic predictors of self-reported CD and the presence of vinchucas in two areas of rural northern Argentina known to have experienced different interventions in surveillance and control. Our analyses suggest that Avellaneda, an area known for horizontal intervention strategies which nurture community participation is quite distinct from Silipica, an area which has experienced a vertical intervention strategy since 1990. Avellaneda has higher level of self-reported Chagas infection and lower level of vinchuca presence; Silipica has pronounced and statistically significant differences patterned by the head of household's level of educational attainment. A greater awareness of the disease and its transmission, along with community mobilisation and spraying, may bring about more self-reported CD and less vinchuca presence in Avellaneda than in Silipica. This suggests that strategies based on community participation may be effective in reducing the social patterning of the burden of disease, even in poor places.
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Affiliation(s)
- Ignacio Llovet
- Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina.
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Miller CL, Bangsberg DR, Tuller DM, Senkungu J, Kawuma A, Frongillo EA, Weiser SD. Food insecurity and sexual risk in an HIV endemic community in Uganda. AIDS Behav 2011; 15:1512-9. [PMID: 20405316 PMCID: PMC3110536 DOI: 10.1007/s10461-010-9693-0] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Food insecurity has been linked to high-risk sexual behavior in sub-Saharan Africa, but there are limited data on these links among people living with HIV/AIDS, and on the mechanisms for how food insecurity predisposes individuals to risky sexual practices. We undertook a series of in-depth open-ended interviews with 41 individuals living with HIV/AIDS to understand the impact of food insecurity on sexual-risk behaviors. Participants were recruited from the Immune Suppression Clinic at the Mbarara University of Science and Technology in Mbarara, Uganda. Interviews were recorded, transcribed verbatim, translated, and coded following the strategy of grounded theory. Four major themes emerged from the interview data: the relationship between food insecurity and transactional sex for women; the impact of a husband’s death from HIV on worsening food insecurity among women and children; the impact of food insecurity on control over condom use, and the relationship between food insecurity and staying in violent/abusive relationships. Food insecurity led to increased sexual vulnerability among women. Women were often compelled to engage in transactional sex or remain in violent or abusive relationships due to their reliance on men in their communities to provide food for themselves and their children. There is an urgent need to prioritize food security programs for women living with HIV/AIDS and address broader gender-based inequities that are propelling women to engage in risky sexual behaviors based on hunger. Such interventions will play an important role in improving the health and well-being of people living with HIV/AIDS, and preventing HIV transmission.
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Affiliation(s)
- Cari L. Miller
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC Canada
| | - David R. Bangsberg
- Mbarara University of Science and Technology, Mbarara, Uganda
- Ragon Institute of MGH, MIT, and Harvard, Massachusetts General Hospital Center for Global Health, Harvard Medical School, Boston, MA USA
| | - David M. Tuller
- School of Public Health and Graduate School of Journalism, University of California at Berkeley, Berkeley, CA USA
| | - Jude Senkungu
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Annet Kawuma
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Edward A. Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Sheri D. Weiser
- Division of HIV/AIDS, San Francisco General Hospital and Center for AIDS Prevention Studies, University of California, San Francisco, 995 Potrero Street, Building 80, Box 0874, San Francisco, CA 94110 USA
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Utzinger J, N’Goran EK, Caffrey CR, Keiser J. From innovation to application: social-ecological context, diagnostics, drugs and integrated control of schistosomiasis. Acta Trop 2011; 120 Suppl 1:S121-37. [PMID: 20831855 DOI: 10.1016/j.actatropica.2010.08.020] [Citation(s) in RCA: 150] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Revised: 08/29/2010] [Accepted: 08/30/2010] [Indexed: 12/11/2022]
Abstract
Compared to malaria, tuberculosis and HIV/AIDS, schistosomiasis remains a truly neglected tropical disease. Schistosomiasis, perhaps more than any other disease, is entrenched in prevailing social-ecological systems, since transmission is governed by human behaviour (e.g. open defecation and patterns of unprotected surface water contacts) and ecological features (e.g. living in close proximity to suitable freshwater bodies in which intermediate host snails proliferate). Moreover, schistosomiasis is intimately linked with poverty and the disease has spread to previously non-endemic areas as a result of demographic, ecological and engineering transformations. Importantly though, thanks to increased advocacy there is growing awareness, financial and technical support to control and eventually eliminate schistosomiasis as a public health problem at local, regional and global scales. The purpose of this review is to highlight recent progress made in innovation, validation and application of new tools and strategies for research and integrated control of schistosomiasis. First, we explain that schistosomiasis is deeply embedded in social-ecological systems and explore linkages with poverty. We then summarize and challenge global statistics, risk maps and burden estimates of human schistosomiasis. Discovery and development research pertaining to novel diagnostics and drugs forms the centrepiece of our review. We discuss unresolved issues and emerging opportunities for integrated and sustainable control of schistosomiasis and conclude with a series of research needs.
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Bonfim C, Alves A, Costa TR, Alencar F, Pedroza D, Portugal JL, Medeiros Z. Spatial analysis and privation index to identify urban areas with a high risk of lymphatic filariasis. Trop Med Int Health 2011; 16:748-55. [DOI: 10.1111/j.1365-3156.2011.02758.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Schneider MC, Aguilera XP, Barbosa da Silva Junior J, Ault SK, Najera P, Martinez J, Requejo R, Nicholls RS, Yadon Z, Silva JC, Leanes LF, Periago MR. Elimination of neglected diseases in latin america and the Caribbean: a mapping of selected diseases. PLoS Negl Trop Dis 2011; 5:e964. [PMID: 21358810 PMCID: PMC3039687 DOI: 10.1371/journal.pntd.0000964] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Accepted: 01/12/2011] [Indexed: 11/17/2022] Open
Abstract
In Latin America and the Caribbean, around 195 million people live in poverty, a situation that increases the burden of some infectious diseases. Neglected diseases, in particular, are often restricted to poor, marginalized sections of the population. Tools exist to combat these diseases, making it imperative to work towards their elimination. In 2009, the Pan American Health Organization (PAHO) received a mandate to support the countries in the Region in eliminating neglected diseases and other poverty-related infections. The objective of this study is to analyze the presence of selected diseases using geo-processing techniques. Five diseases with information available at the first sub-national level (states) were mapped, showing the presence of the disease ("hotspots") and overlap of diseases ("major hotspots"). In the 45 countries/territories (approximately 570 states) of the Region, there is: lymphatic filariasis in four countries (29 states), onchocerciasis in six countries (25 states), schistosomiasis in four countries (39 states), trachoma in three countries (29 states), and human rabies transmitted by dogs in ten countries (20 states). Of the 108 states with one or more of the selected diseases, 36 states present the diseases in overlapping areas ("major hotspots"). Additional information about soil-transmitted helminths was included. The analysis suggests a majority of the selected diseases are not widespread and can be considered part of an unfinished agenda with elimination as a goal. Integrated plans and a comprehensive approach, ensuring access to existing diagnostic and treatment methods, and establishing a multi-sectoral agenda that addresses social determinants, including access to adequate water and sanitation, are required. Future studies can include additional diseases, socio-economic and environmental variables.
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