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Witek-McManus S, Simwanza J, Msiska R, Mangawah H, Oswald W, Timothy J, Galagan S, Pearman E, Shaikh M, Legge H, Walson J, Juziwelo L, Davey C, Pullan R, Bailey RL, Kalua K, Kuper H. Disability in childhood and the equity of health services: a cross-sectional comparison of mass drug administration strategies for soil-transmitted helminths in southern Malawi. BMJ Open 2024; 14:e083321. [PMID: 39242171 PMCID: PMC11381638 DOI: 10.1136/bmjopen-2023-083321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND School-based approaches are an efficient mechanism for the delivery of basic health services, but may result in the exclusion of children with disabilities if they are less likely to participate in schooling. Community-based 'door to door' approaches may provide a more equitable strategy to ensure that children with disabilities are reached, but disability is rarely assessed rigorously in the evaluation of health interventions. OBJECTIVES To describe the prevalence and factors associated with disability among children aged 5-17 years and to assess the relative effectiveness of routine school-based deworming (SBD) compared with a novel intervention of community-based deworming (CBD) in treating children with disabilities for soil-transmitted helminths. SETTING DeWorm3 Malawi Site (DMS), Mangochi district, Malawi. PARTICIPANTS All 44 574 children aged 5-17 years residing within the DMS. PRIMARY AND SECONDARY OUTCOME MEASURES Disability was defined as a functional limitation in one or more domains of the Washington Group/UNICEF Child Functioning Module administered as part of a community-based census. Treatment of all children during SBD and CBD was independently observed and recorded. For both intervention types, we performed bivariate analyses (z-score) of the absolute proportion of children with and without disabilities treated (absolute differences (ADs) in receipt of treatment), and logistic regression to examine whether disability status was associated with the likelihood of treatment (relative differences in receipt of treatment). RESULTS The overall prevalence of disability was 3.3% (n=1467), and the most common domains of disability were hearing, remembering and communication. Boys were consistently more likely to have a disability compared with girls at all age groups, and disability was strongly associated with lower school attendance and worse levels of education. There was no significant difference in the proportion of children with disabilities treated during SBD when assessed by direct observation (-1% AD, p=0.41) or likelihood of treatment (adjusted risk ratio (aRR)=1.07, 95% CI 0.89 to 1.28). Treatment of all children during CBD was substantially higher than SBD, but again showed no significant difference in the proportions treated (-0.5% AD, p=0.59) or likelihood of treatment (aRR=1.04, 95% CI 0.99 to 1.10). CONCLUSION SBD does not appear to exclude children with disabilities, but the effect of consistently lower levels of educational participation of children with disabilities should be actively considered in the design and monitoring of school health interventions. TRIAL REGISTRATION NUMBER NCT03014167.
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Affiliation(s)
- Stefan Witek-McManus
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - James Simwanza
- Blantyre Institute for Community Outreach, Blantyre, Malawi
| | - Rejoice Msiska
- Blantyre Institute for Community Outreach, Blantyre, Malawi
| | | | - William Oswald
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Joseph Timothy
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Sean Galagan
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Emily Pearman
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Mariyam Shaikh
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Hugo Legge
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Judd Walson
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Lazarus Juziwelo
- National Schistosomiasis and STH Control Programme, Community Health Sciences Unit, Ministry of Health & Population, Lilongwe, Malawi
| | - Calum Davey
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Rachel Pullan
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Robin L Bailey
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Khumbo Kalua
- Blantyre Institute for Community Outreach, Blantyre, Malawi
- Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Hannah Kuper
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Hailemichael Y, Novignon J, Owusu L, Okyere D, Mtuy T, Alemu AY, Ocloo EK, Koka E, Palmer J, Walker SL, Gadisa E, Kaba M, Pitt C. The role of economic factors in shaping and constituting the household burden of neglected tropical diseases of the skin: Qualitative findings from Ghana and Ethiopia. Soc Sci Med 2024; 356:117094. [PMID: 39032192 PMCID: PMC11370647 DOI: 10.1016/j.socscimed.2024.117094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 04/09/2024] [Accepted: 07/03/2024] [Indexed: 07/22/2024]
Abstract
Tracers of health system equity, neglected tropical diseases (NTDs) disproportionately affect marginalized populations. NTDs that manifest on the skin - "skin NTDs" - are associated with scarring, disfigurement, physical disability, social exclusion, psychological distress, and economic hardship. To support development and evaluation of appropriate intervention strategies, we aimed to improve understanding of the role of economic factors in shaping and constituting the burden that skin NTDs place on households. We collected data in 2021 in two predominantly rural districts: Atwima Mponua in Ghana (where Buruli ulcer, yaws, and leprosy are endemic) and Kalu in Ethiopia (where cutaneous leishmaniasis and leprosy are endemic). We conducted interviews (n = 50) and focus group discussions (n = 14) that explored economic themes with affected individuals, caregivers, and community members and analysed the data thematically using a pre-defined framework. We found remarkable commonalities across countries and diseases. We developed a conceptual framework which illustrates skin NTDs' negative economic impact, including financial costs of care-seeking and reductions in work and schooling; categorises coping strategies by their degree of risk-pooling; and clarifies the mechanisms through which skin NTDs disproportionately affect the poorest. Despite health insurance schemes in both countries, wide-ranging, often harmful coping strategies were reported. Traditional healers were often described as more accessible, affordable and offering more flexible payment terms than formal health services, except for Ethiopia's well-established leprosy programme. Our findings are important in informing strategies to mitigate the skin NTD burden and identifying key drivers of household costs to measure in future evaluations. To reduce skin NTDs' impact on households' physical, mental, and economic wellbeing, intervention strategies should address economic constraints to prompt and effective care-seeking. While financial support and incentives for referrals and promotion of insurance enrolment may mitigate some constraints, structural interventions that decentralise care may offer more equitable and sustainable access to skin NTD care.
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Affiliation(s)
| | - Jacob Novignon
- Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana; Department of Economics, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana.
| | - Lucy Owusu
- Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana
| | - Daniel Okyere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Tara Mtuy
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Abebaw Yeshambel Alemu
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia; Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Edmond Kwaku Ocloo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana; Department of Sociology and Anthropology, University of Cape Coast, Cape Coast, Ghana
| | - Eric Koka
- Department of Sociology and Anthropology, University of Cape Coast, Cape Coast, Ghana
| | - Jennifer Palmer
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Stephen L Walker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Mirgissa Kaba
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Catherine Pitt
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Ricafort JAC, Ricafort JBC, Recopuerto-Medina LM, Dagamac NHA. Correlating Cases of Soil-Transmitted Helminths and Remote Sensing Covariates: A Case Study Utilizing 2015, 2017, and 2019 Metadata of Camarines Sur, Philippines. Acta Parasitol 2024:10.1007/s11686-024-00909-9. [PMID: 39217274 DOI: 10.1007/s11686-024-00909-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 08/13/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION Soil-transmitted helminth (STH) is a group of helminths that are considered to be neglected tropical diseases (NTDs) and, globally, affect more than 1.5 to 2.6 million people yearly. Depending on the species, they can be acquired by ingesting embryonated eggs from contaminated matter or by skin penetration. Most species of STH are found in the tropics, such as the Philippines. Despite the Mass Drug Administration (MDA), the cases of STH infection continue to rise in the country. Surveys from the Research Institute of Tropical Medicine (RITM) indicate that a high prevalence of STH (Ascaris lumbricoides, Trichuris trichiura, and Necator americanus) was primarily observed in the provinces of the country, such as in Camarines Sur. OBJECTIVES To correlate remote sensing covariates such as Normalized Difference Vegetation Index (NDVI) and Normalized Difference Built-up Index (NDBI) - to STH-infected cases of the 37 municipalities of Camarines Sur. METHODOLOGY The available public health record of STH cases from 2015 to 2019 were calculated using the Quantum Geographic Information System (QGIS)and correlated using Pearson Correlation Coefficient. RESULTS The results showed that infection was higher in children than adults, and A. lumbricoides caused 60% of infection. No correlation of indices with infection cases during 2015 and 2017 was observed; however, 2019 showed a moderate strength (p = 0.037) in correlation. CONCLUSION This indicates that infection relied not mainly on vegetation and urbanization but on additional environmental factors and non-environmental variables.
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Affiliation(s)
- John Albert C Ricafort
- Department of Biological Science, College of Science, University of Santo Tomas, 1008, Manila, Philippines
| | - John Benedict C Ricafort
- Department of Biological Science, College of Science, University of Santo Tomas, 1008, Manila, Philippines
| | - Loida M Recopuerto-Medina
- Department of Biological Science, College of Science, University of Santo Tomas, 1008, Manila, Philippines
| | - Nikki Heherson A Dagamac
- Department of Biological Science, College of Science, University of Santo Tomas, 1008, Manila, Philippines.
- Research Center for the Natural and Applied Sciences, University of Santo Tomas, 1008, Manila, Philippines.
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Grossi de Oliveira AL, Brito RMDM, Siqueira WF, Parreiras de Jesus AC, Bueno LL, Fujiwara RT. IgG seroprevalence of Toxoplasma gondii and Leishmania infantum in leprosy patients: Implications for screening and management of co-infections. Diagn Microbiol Infect Dis 2024; 110:116405. [PMID: 38906031 DOI: 10.1016/j.diagmicrobio.2024.116405] [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: 04/05/2024] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 06/23/2024]
Abstract
Parasitic co-infections are common in developing countries and can interfere with leprosy treatment, leading to an increased risk of inflammatory leprosy reactions. This study assessed serum immunoglobulin G (IgG) levels against Toxoplasma gondii and Visceral Leishmaniasis (VL) antigens in 270 leprosy patients from Brazilian states. Regarding the respective cut-offs, the prevalence of IgG seropositivity for T. gondii and VL were 21.05 % and 47.36 % in the leprosy-negative group, and 77.7 % and 52.6 % in the leprosy-positive group. Of the 270 leprosy patients, 158 (58.5 %) presented with inflammatory leprosy reactions. Of those, 72 (59.5 %) had neuritis, 35 (48.6 %) had reverse reactions, and 28 (38.9 %) had ENL in both Brazilian states. Leprosy patients with anti-Leishmania IgG seropositivity were 3.25 times more likely to develop neuritis (95 % C.I.: 1.187 - 9.154; p = 0.019). These findings are particularly relevant for clinical settings where both leprosy and parasitic diseases are prevalent and could provide essential guidance for detecting and addressing complications arising from parasitic co-infections in leprosy patients, thereby improving clinical management strategies.
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Affiliation(s)
- Ana Laura Grossi de Oliveira
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Laboratório de Imunobiologia e Controle de Parasitos, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Ramayana Morais de Medeiros Brito
- Programa de Pós-Graduação em Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Laboratório de Imunobiologia e Controle de Parasitos, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Williane Fernanda Siqueira
- Laboratório de Imunoquímica de Proteínas, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Augusto César Parreiras de Jesus
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Laboratório de Imunobiologia e Controle de Parasitos, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Lilian Lacerda Bueno
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Programa de Pós-Graduação em Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Laboratório de Imunobiologia e Controle de Parasitos, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Ricardo Toshio Fujiwara
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Programa de Pós-Graduação em Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Laboratório de Imunobiologia e Controle de Parasitos, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Caron FS, Rivadeneira D, Rabinovich J, Pie MR, Morimoto J. Range size positively correlates with temperature and precipitation niche breadths but not with dietary niche breadth in triatomine insects, vectors of Chagas disease. PLoS Negl Trop Dis 2024; 18:e0012430. [PMID: 39150980 DOI: 10.1371/journal.pntd.0012430] [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: 05/03/2024] [Revised: 08/28/2024] [Accepted: 08/05/2024] [Indexed: 08/18/2024] Open
Abstract
Ecological theory predicts that species that can utilise a greater diversity of resources and, therefore, have wider niche breadths should also occupy larger geographic areas (the 'niche breadth-range size hypothesis'). Here, we tested this hypothesis for a blood-sucking group of insects of medical significance: the Triatominae (aka 'kissing bugs') (Hemiptera: Reduviidae). Given that niches can be viewed from different perspectives, we tested this hypothesis based on both dietary and climatic niches. We assembled the most complete dataset of triatomine feeding patterns to date by reviewing 143 studies from the literature up to 2021 and tested whether the niche breadth-range size hypothesis held for this group for both dietary and climatic components of the niche. Temperature and precipitation niche breadths were estimated from macro-environmental variables, while diet breadth was calculated based on literature data that used PCR and/or ELISA to identify different types of hosts as blood sources per triatomine species. Our results showed that temperature and precipitation niche breadths, but not dietary breadth, were positively correlated with range sizes, independent of evolutionary history among species. These findings support the predictions from the range size-niche breadth hypothesis concerning climate but not diet, in Triatominae. It also shows that support for the niche breadth-range size hypothesis is dependent upon the niche axis under consideration, which can explain the mixed support for this hypothesis in the ecological literature.
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Affiliation(s)
- Fernanda S Caron
- Programa de Pós-graduação em Ecologia e Conservação, Universidade Federal do Paraná, Curitiba, Brazil
| | - Daniel Rivadeneira
- Programa de Pós-graduação em Zoologia, Universidade Federal do Paraná, Curitiba, Brazil
| | - Jorge Rabinovich
- Centro de Estudios Parasitológicos y de Vectores (CEPAVE CONICET-CCT La Plata, Universidad Nacional de La Plata), La Plata, Province of Buenos Aires, Argentina
| | - Marcio R Pie
- Programa de Pós-graduação em Ecologia e Conservação, Universidade Federal do Paraná, Curitiba, Brazil
- Programa de Pós-graduação em Zoologia, Universidade Federal do Paraná, Curitiba, Brazil
- Department of Biology, Edge Hill University, Ormskirk, Lancashire, United Kingdom
| | - Juliano Morimoto
- Programa de Pós-graduação em Ecologia e Conservação, Universidade Federal do Paraná, Curitiba, Brazil
- Institute of Mathematics, University of Aberdeen, King's College, Aberdeen, United Kingdom
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Girma A, Genet A. Prevalence and factors associated with intestinal parasitic infections among preschool-aged children in Ethiopia: A systematic review and meta-analysis. Parasite Epidemiol Control 2024; 26:e00368. [PMID: 39076827 PMCID: PMC11284566 DOI: 10.1016/j.parepi.2024.e00368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 05/28/2024] [Accepted: 07/05/2024] [Indexed: 07/31/2024] Open
Abstract
Intestinal parasitic infections (IPIs) pose a serious public health threat across the globe, particularly in children residing in poor and most deprived communities like Ethiopia. Many published articles were available separately, and a detailed nationwide review was essential to combine all the results to draw a conclusion and avoid any informational conflicts, ambiguities, or misunderstandings. Therefore, this systematic review and meta-analysis aimed to provide pooled estimates for the individually available data on IPIs and its determinant factors among preschool-aged children (PSAC) in Ethiopia. Published and unpublished articles from various electronic databases were accessed using MeSH terms and keywords. I 2 and sensitivity analysis tests were used to assess potential sources of heterogeneity across studies. Funnel plot, Begg's, and Egger's regression tests were used to check publication bias. A random-effects model with a 95% confidence interval (CI) was used to calculate the pooled estimate of IPI. In this meta-analysis, a total of 14,994 PSAC were included in the 32 eligible studies. The pooled national prevalence of IPIs among PSAC was 32.52% (95% CI: 26.24, 38.80). Of these, single and mixed infections contribute 31.08% and 1.44%, respectively. According to the subgroup analysis, the highest prevalence was observed in simple random studies (39.61%; 95% CI: 29.19, 50.03), the Tigray region (58.00%; 95% CI: 54.10, 61.90), studies conducted in >384 (39.47%; 95% CI: 27.73, 51.20) sample sizes, cross-sectional studies (32.76%), community-based studies (42.33%; 95% CI: 31.93, 52.74), and from 2005 to 2016 (34.53%; 95% CI: 20.13, 48.92) study periods. Intestinal parasites were significantly associated with eating raw fruits and vegetables (aOR = 3.21; 95%CI: 1.11-5.31). The high prevalence of STHs observed in this systematic review and meta-analysis underscores the need for appropriate control and prevention strategies suitable for PSAC in Ethiopia.
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Affiliation(s)
- Abayeneh Girma
- Department of Biology, College of Natural and Computational Science, Mekdela Amba University, P.O. Box 32, Tulu Awuliya, Ethiopia
| | - Amere Genet
- Department of Biology, College of Natural and Computational Science, Mekdela Amba University, P.O. Box 32, Tulu Awuliya, Ethiopia
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Amaral CA, Higino TMM, Silva KFC, dos Reis NR, Pereira MG, de Miranda RDCM, Aliança ASDS. Spatio-Temporal Analysis and Clinical-Epidemiological Characterization of Visceral Leishmaniasis in Maranhão, Brazil, from 2009 to 2020. Trop Med Infect Dis 2024; 9:76. [PMID: 38668537 PMCID: PMC11054192 DOI: 10.3390/tropicalmed9040076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/06/2024] [Accepted: 03/13/2024] [Indexed: 04/29/2024] Open
Abstract
This study was carried out to identify the spatial distribution and characterize the clinical-epidemiological profile of Visceral Leishmaniasis (VL) in Maranhão state, Brazil, from 2009 to 2020. This descriptive ecological study collected sociodemographic and clinical data of VL cases from the Brazilian Notifiable Diseases Information System database. A spatial autocorrelation analysis (Moran statistics) was performed. From 2009 to 2020, 5699 cases of VL were reported, with incidence of 6.5 cases/100,000 and prevalence of 7.1 cases/100,000. The temporal analysis showed a significant growth in incidence from 2009 to 2018, followed by a significant decrease between 2019 and 2020. The Moran map shows hotspots of high values in the central-west and central-east regions, and hotspots of low values in the northern region of Maranhão. The profile of patients affected by VL comprises males (OR = 1.8; IC95% = 1.72-1.92), aged under 14 years, brown, and with incomplete elementary schooling. The main symptoms reported were fever, fatigue, and edema. The main diagnostic method was laboratory. The mortality rate was 6.8%, and co-infection with HIV was reported by 8.5% of patients. The results of this study indicated the increase in incidence and lethality, as well as the expansion, of leishmaniasis in the state of Maranhão.
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Affiliation(s)
- Carolina Azevedo Amaral
- Postgraduate Program in Microbial Biology, Programa de Pós-Graduação em Biologia Microbiana, Universidade CEUMA, São Luís 65075-120, MA, Brazil; (C.A.A.); (M.G.P.)
| | | | - Karen Fernanda Castro Silva
- Curso de Graduação em Biomedicina, Universidade CEUMA, São Luís 65075-120, MA, Brazil; (K.F.C.S.); (N.R.d.R.)
| | - Nathalia Rodrigues dos Reis
- Curso de Graduação em Biomedicina, Universidade CEUMA, São Luís 65075-120, MA, Brazil; (K.F.C.S.); (N.R.d.R.)
| | - Mariana Gomes Pereira
- Postgraduate Program in Microbial Biology, Programa de Pós-Graduação em Biologia Microbiana, Universidade CEUMA, São Luís 65075-120, MA, Brazil; (C.A.A.); (M.G.P.)
| | | | - Amanda Silva dos Santos Aliança
- Postgraduate Program in Microbial Biology, Programa de Pós-Graduação em Biologia Microbiana, Universidade CEUMA, São Luís 65075-120, MA, Brazil; (C.A.A.); (M.G.P.)
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Labana RV, Borda MCNM, Campo RTA, Ocampo MAV. The Interplay Between Household Risk Perception of Parasitic Infections and Water, Sanitation, and Hygiene (WASH) Practices: Evidence From an Urban Poor Community in the Philippines. Cureus 2024; 16:e57532. [PMID: 38707156 PMCID: PMC11067986 DOI: 10.7759/cureus.57532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Parasitic diseases pose challenges in impoverished urban settlements with limited access to clean water, proper hygiene, and sanitation (WASH). This study assesses WASH practices and risk perceptions of parasitic infections among households in the Bataan Shipyard and Engineering Corporation (BASECO) Compound in Manila, an urban poor community in the Philippines. METHODS A cross-sectional study design was employed to collect data through a self-administered questionnaire. Descriptive statistical analysis was performed to assess the sociodemographic profile, household WASH practices, and respondents' risk perception of parasitic infections. Linear regression analysis was utilized to examine the relationship between these variables. RESULTS A survey was conducted with 363 households, of which 237 (65.3%) used distilled and purified water from the water refilling stations in the community for drinking. Meanwhile, 120 households (33.10%) consumed tap water. Boiling water was a commonly used method (n=146; 56.60%) for treating drinking water. Most households had flush toilets with septic tanks (n=244; 67.20%), water sources for handwashing (n=307; 84.57%) and soap for handwashing (n=356; 98.10%). On average, they washed their hands 6-10 times daily (n=159; 43.80%). Most households were aware that drinking untreated water (n=318; 87.6%), improper food washing (n=309; 85.1%), using contaminated water sources (n=301; 82.9%), and consuming raw or undercooked meat (n=298; 82.1%) could lead to parasitic infections. 316 respondents (87.1%) identified diarrhea as the most common symptom of parasitic infection. Relationships were found between access to drinking water and the number of household members (B=0.191; p-value=0.001), personal hygiene and the respondents' knowledge of parasitic infections (B=0.112; p-value=0.047), and the overall WASH score with household income (B=0.105; p-value=0.045). CONCLUSIONS The WASH conditions in BASECO, Manila need improvement. Factors associated with their WASH practices include risk perception of parasitic diseases, socioeconomic disparity, and household overcrowding. These factors play a crucial role in identifying areas for improvement and promoting health policies for urban poor communities in the Philippines.
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Affiliation(s)
- Ryan V Labana
- Center for Integrated Community Science Research, Research Institute for Science and Technology, Polytechnic University of the Philippines, Manila, PHL
- Department of Biology, College of Science, Polytechnic University of the Philippines, Manila, PHL
| | - Ma Cate Nicole M Borda
- Department of Biology, College of Science, Polytechnic University of the Philippines, Manila, PHL
| | - Ryan Toribio A Campo
- Department of Biology, College of Science, Polytechnic University of the Philippines, Manila, PHL
| | - Maria Antonia V Ocampo
- Department of Biology, College of Science, Polytechnic University of the Philippines, Manila, PHL
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Cozer AWD, Souza FCV, Santiago LD, Lima MR, Pimenta SJ, Fernandes BL, Enes BN, Gama RS, Gomides TAR. Effects of Iron-Fortified Foods on the Nutritional Status of Children Residing in Regions Vulnerable to Parasitic Diseases: A Systematic Review. Prev Nutr Food Sci 2024; 29:8-17. [PMID: 38576884 PMCID: PMC10987379 DOI: 10.3746/pnf.2024.29.1.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/09/2024] [Accepted: 02/22/2024] [Indexed: 04/06/2024] Open
Abstract
Parasitic infections (PIs) remain a public health concern among school-age children living in areas of greater socioeconomic vulnerability, especially in Brazil, Russia, India, China, and South Africa. PIs can promote nutritional deficiencies, increasing the risk of anemia and impaired physical and cognitive development. Thus, fortified foods have been considered as a promising strategy for improving the nutritional status of children and preventing PI complications. This systematic review aimed to present the effects of iron-fortified foods for deworming and improving blood parameters in schoolchildren residing in areas that are vulnerable to PIs. This review is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines of randomized clinical trials addressing the use of fortified foods and micronutrients in children living in areas endemic for PIs. The PubMed, LILACS, Scopus, and Cochrane databases were searched to identify articles published between 2000 and 2020. A total of 153 records were retrieved from the databases, 10 of which were considered eligible for this study. On the basis of our analysis, most of the selected studies showed that the inclusion of fortified foods in the diet improved blood and infectious parameters. Therefore, fortified foods can be used as an important tool for controlling the adverse outcomes of PIs among children living in areas of greater vulnerability. However, more studies on this topic are needed to provide more evidence and consolidate strategies using iron-fortified food.
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Affiliation(s)
| | | | | | - Marlucy Rodrigues Lima
- Department of Pharmacy, Vale do Rio Doce University, Governador Valadares - MG 35020-220, Brazil
| | - Sabrina Julie Pimenta
- Department of Dentistry, Vale do Rio Doce University, Governador Valadares - MG 35020-220, Brazil
| | - Bárbara Leles Fernandes
- Department of Pharmacy, Vale do Rio Doce University, Governador Valadares - MG 35020-220, Brazil
| | - Barbara Nery Enes
- Department of Nutrition, Vale do Rio Doce University, Governador Valadares - MG 35020-220, Brazil
| | - Rafael Silva Gama
- Department of Pharmacy, Vale do Rio Doce University, Governador Valadares - MG 35020-220, Brazil
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10
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van Zwieten A, Dai J, Blyth FM, Wong G, Khalatbari-Soltani S. Overadjustment bias in systematic reviews and meta-analyses of socio-economic inequalities in health: a meta-research scoping review. Int J Epidemiol 2024; 53:dyad177. [PMID: 38129958 PMCID: PMC10859162 DOI: 10.1093/ije/dyad177] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Overadjustment bias occurs when researchers adjust for an explanatory variable on the causal pathway from exposure to outcome, which leads to biased estimates of the causal effect of the exposure. This meta-research review aimed to examine how previous systematic reviews and meta-analyses of socio-economic inequalities in health have managed overadjustment bias. METHODS We searched Medline and Embase until 16 April 2021 for systematic reviews and meta-analyses of observational studies on associations between individual-level socio-economic position and health outcomes in any population. A set of criteria were developed to examine methodological approaches to overadjustment bias adopted by included reviews (rated Yes/No/Somewhat/Unclear). RESULTS Eighty-four reviews were eligible (47 systematic reviews, 37 meta-analyses). Regarding approaches to overadjustment, whereas 73% of the 84 reviews were rated as Yes for clearly defining exposures and outcomes, all other approaches were rated as Yes for <55% of reviews; for instance, 5% clearly defined confounders and mediators, 2% constructed causal diagrams and 35% reported adjusted variables for included studies. Whereas only 2% included overadjustment in risk of bias assessment, 54% included confounding. Of the 37 meta-analyses, 16% conducted sensitivity analyses related to overadjustment. CONCLUSIONS Our findings suggest that overadjustment bias has received insufficient consideration in systematic reviews and meta-analyses of socio-economic inequalities in health. This is a critical issue given that overadjustment bias is likely to result in biased estimates of health inequalities and accurate estimates are needed to inform public health interventions. There is a need to highlight overadjustment bias in review guidelines.
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Affiliation(s)
- Anita van Zwieten
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, NSW, Australia
| | - Jiahui Dai
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Fiona M Blyth
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, NSW, Australia
| | - Germaine Wong
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, NSW, Australia
- Centre for Transplant and Renal Research, Westmead Hospital, Westmead, NSW, Australia
| | - Saman Khalatbari-Soltani
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, NSW, Australia
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11
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Njikho SL, Quan VC, Mbonane TP, Van Wyk RH. Evaluating the Prevalence and Risk Factors of Schistosomiasis Amongst School-Aged Children in Low- and Middle-Income Communities: Ehlanzeni District Municipality, South Africa, 2015-2021. Trop Med Infect Dis 2023; 8:522. [PMID: 38133454 PMCID: PMC10748275 DOI: 10.3390/tropicalmed8120522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
This study aimed to assess the prevalence and identify risk factors of schistosomiasis among school-aged children in low- and middle-income communities. A retrospective cross-sectional study was conducted to review patient records of school-age children. Data on gender, age, sub-district, area residing in, patient status, history of bilharzia, presence of blood in the urine, and schistosomiasis diagnoses were collected. The data were analyzed using IBM Statistical Package for the Social Sciences (SPSS) version 27. Logistic regression was employed to determine the factors associated with schistosomiasis. The overall prevalence of schistosomiasis in the study population was 75%, with higher prevalence observed among male children (89%), children aged between 10 and 14 years (59%), urban areas (51%), and rural-dominated districts, particularly Bushbuckridge (42%) and City of Mbombela (51%). Age, especially 10-14 years old (p ˂ 0.01; 95%CI: 1.98-2.29), a history of bilharzia (p = 0.01; 95%CI: 1.15-1.96), and the presence of blood in urine (p ˂ 0.01; 95%CI: 2.02-2.40) were significantly associated with schistosomiasis while being a female child was found to be a protective factor (AOR: 0.35; CI 0.35-0.41). This study underscores the importance of implementing robust screening procedures and the necessity for health education to mitigate the high prevalence of schistosomiasis and prevent its further spread.
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Affiliation(s)
- Sunnieboy Lot Njikho
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2001, South Africa; (S.L.N.); (T.P.M.)
- Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg 2001, South Africa;
| | - Vanessa Cecilia Quan
- Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg 2001, South Africa;
| | - Thokozani Patrick Mbonane
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2001, South Africa; (S.L.N.); (T.P.M.)
| | - Renay Helouise Van Wyk
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2001, South Africa; (S.L.N.); (T.P.M.)
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12
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Yamada K, Tazaki A, Ushio-Watanabe N, Usui Y, Takeda A, Matsunaga M, Suzumura A, Shimizu H, Zheng H, Ariefta NR, Yamamoto M, Hara H, Goto H, Sonoda KH, Nishiguchi KM, Kato M, Nishikawa Y, Toyokuni S, Kaneko H. Retinal ferroptosis as a critical mechanism for the induction of retinochoroiditis during ocular toxoplasmosis. Redox Biol 2023; 67:102890. [PMID: 37738924 PMCID: PMC10519826 DOI: 10.1016/j.redox.2023.102890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 09/13/2023] [Indexed: 09/24/2023] Open
Abstract
Toxoplasmosis is a major infectious disease, affecting approximately one-third of the world's population; its main clinical manifestation, ocular toxoplasmosis (OT), is a severe sight-threatening disease. Nevertheless, the diagnosis of OT is based on clinical findings, which needs improvement, even with biochemical tests, such as polymerase chain reaction and antibody detections. Furthermore, the efficacy of OT-targeted treatment is limited; thus, additional measures for diagnosis and treatments are needed. Here, we for the first time report a significantly reduced iron concentration in the vitreous humor (VH) of human patients infected with OT. To obtain further insights into molecular mechanisms, we established a mouse model of T. gondii infection, in which intravitreally injected tracer 57Fe, was accumulated in the neurosensory retina. T. gondii-infected eyes showed increased lipid peroxidation, reduction of glutathione peroxidase-4 expression and mitochondrial deformity in the photoreceptor as cristae loss. These findings strongly suggest the involvement of ferroptotic process in the photoreceptor of OT. In addition, deferiprone, an FDA-approved iron chelator, reduced the iron uptake but also ameliorated toxoplasma-induced retinochoroiditis by reducing retinal inflammation. In conclusion, the iron levels in the VH could serve as diagnostic markers and iron chelators as potential treatments for OT.
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Affiliation(s)
- Kazuhisa Yamada
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
| | - Akira Tazaki
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
| | - Nanako Ushio-Watanabe
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, 080-8555, Japan.
| | - Yoshihiko Usui
- Department of Ophthalmology, Tokyo Medical University, Tokyo, 160-8402, Japan.
| | - Atsunobu Takeda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Masaaki Matsunaga
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, 470-1192, Japan.
| | - Ayana Suzumura
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
| | - Hideyuki Shimizu
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
| | - Hao Zheng
- Department of Pathology and Biological Responses, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
| | - Nanang R Ariefta
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, 080-8555, Japan.
| | - Masahiro Yamamoto
- Department of Immunoparasitology, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan.
| | - Hideaki Hara
- Department of Biofunctional Evaluation, Molecular Pharmacology, Gifu Pharmaceutical University, Gifu, 501-1196, Japan.
| | - Hiroshi Goto
- Department of Ophthalmology, Tokyo Medical University, Tokyo, 160-8402, Japan.
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Koji M Nishiguchi
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
| | - Masashi Kato
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
| | - Yoshifumi Nishikawa
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, 080-8555, Japan.
| | - Shinya Toyokuni
- Department of Pathology and Biological Responses, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan; Center for Low-Temperature Plasma Sciences, Nagoya University, Furo-Cho, Chikusa-ku, Nagoya, 464-8603, Japan.
| | - Hiroki Kaneko
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
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Santos ALS, Rodrigues IA, d’Avila-Levy CM, Sodré CL, Ritmeijer K, Branquinha MH. Therapeutic Strategies against Leishmania and Trypanosoma. Pathogens 2023; 12:1263. [PMID: 37887779 PMCID: PMC10610452 DOI: 10.3390/pathogens12101263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023] Open
Abstract
Human African trypanosomiasis (also known as sleeping sickness, with Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense as etiological agents), American trypanosomiasis (also known as Chagas disease, with Trypanosoma cruzi as the etiological agent), and leishmaniasis (including cutaneous, mucocutaneous, and visceral forms, with multiple species belonging to the Leishmania genus as etiological agents) are recognized as neglected tropical diseases (NTDs) [...].
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Affiliation(s)
- André L. S. Santos
- Laboratório de Estudos Avançados de Microrganismos Emergentes e Resistentes (LEAMER), Departamento de Microbiologia Geral, Instituto de Microbiologia Paulo de Góes (IMPG), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, RJ, Brazil;
| | - Igor A. Rodrigues
- Departamento de Produtos Naturais e Alimentos, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, RJ, Brazil;
| | - Claudia M. d’Avila-Levy
- Laboratório de Estudos Integrados em Protozoologia, Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Coleção de Protozoários da Fiocruz, Rio de Janeiro 21040-900, RJ, Brazil;
| | - Cátia L. Sodré
- Departamento de Biologia Celular e Molecular (GCM), Instituto de Biologia (IB), Universidade Federal Fluminense (UFF), Niterói 24210-201, RJ, Brazil;
| | - Koert Ritmeijer
- Public Health Department, Médecins Sans Frontières, 1018 DD Amsterdam, The Netherlands;
| | - Marta H. Branquinha
- Laboratório de Estudos Avançados de Microrganismos Emergentes e Resistentes (LEAMER), Departamento de Microbiologia Geral, Instituto de Microbiologia Paulo de Góes (IMPG), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, RJ, Brazil;
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Martínez-Sáez L, Dulac Q, Montaner-Angoiti E, Marín-García PJ, Llobat L. Prevalence and Factors Related to Leishmania infantum Infection in Healthy Horses ( Equus caballus) from Eastern Spain. Animals (Basel) 2023; 13:2889. [PMID: 37760289 PMCID: PMC10525090 DOI: 10.3390/ani13182889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/25/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Leishmaniosis is a zoonosis caused by Leishmania spp., an intracellular protozoan parasite. This parasite is transmitted by sandflies, and the disease is endemic in the Mediterranean basin. In recent years, the number of species which could be a reservoir of the parasite is increased. One of the most relevant species is the horse, due to their contact with humans and ability to control the disease, thus being a possible silent reservoir. In this study, we have analyzed the prevalence and factors related to L. infantum infection in healthy horses in the Mediterranean region. Epidemiological data and serum samples were obtained from 167 apparently healthy horses, and the presence of L. infantum was evaluated via the ELISA method and real-time PCR. The results show 27.5% of prevalence and that the main factors related to infection are equine breed, morphotype, outdoor living, use, and season. In conclusion, the prevalence of L. infantum infection in apparently healthy horses from eastern Spain (Mediterranean basin) is elevated. To control this zoonosis, it would be advisable to carry out more studies on this and other species that could be silent reservoirs of the parasite, as well as carry out measures such as the use of repellents on a regular basis.
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Affiliation(s)
- Lola Martínez-Sáez
- Molecular Mechanisms of Zoonotic Diseases (MMOPS) Research Group, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (L.M.-S.); (Q.D.); (E.M.-A.)
| | - Quentin Dulac
- Molecular Mechanisms of Zoonotic Diseases (MMOPS) Research Group, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (L.M.-S.); (Q.D.); (E.M.-A.)
| | - Esperanza Montaner-Angoiti
- Molecular Mechanisms of Zoonotic Diseases (MMOPS) Research Group, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (L.M.-S.); (Q.D.); (E.M.-A.)
| | - Pablo Jesús Marín-García
- Department of Animal Production and Health, Veterinary Public Health and Food Science and Technology (PASASPTA), Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain;
| | - Lola Llobat
- Molecular Mechanisms of Zoonotic Diseases (MMOPS) Research Group, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (L.M.-S.); (Q.D.); (E.M.-A.)
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15
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Alharazi T. Prevalence and risk factors of intestinal parasitic infections among pregnant women in Taiz Governorate, Yemen: A hospital-based study. Helminthologia 2023; 60:201-207. [PMID: 38152474 PMCID: PMC10750245 DOI: 10.2478/helm-2023-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/22/2023] [Indexed: 12/29/2023] Open
Abstract
Background Intestinal parasitic infections in pregnant women have been associated with severe adverse outcomes such as anemia, low birth weight, and mother and fetus morbidity and mortality. This study aimed to determine the prevalence of intestinal parasitic infection and its associated risk factors among pregnant women in Taiz, Yemen. Methods A cross-sectional study was conducted between July 2022 and January 2023. Sociodemographic and other explanatory variables were obtained via face-to-face interviews using a structured questionnaire. The wet-mount and formol-ether concentration techniques were applied to identify the IPIs. Data were analyzed using SPSS, version 20, and p-values < 0.05 were considered statistically significant. An analysis of descriptive statistics and multivariate logistic regression was conducted. A p-value < 0.05 was deemed statistically significant. The study included a total of 393 pregnant women. Results Of the 393 pregnant women screened for intestinal parasites, 144 (36.6 %) had at least one parasite. The most common intestinal parasite was Giardia lamblia (12.2 %), followed by Ascaris lumbricoides (10.9 %), Entamoeba histolytica/dispar (7.4 %), Enterobius vermicularis (14.3 %), and Hymenolepis nana (1.8 %). Being a farmer (AOR = 2.7, 95% CI: 1.69-4.26, p = 0:003) and drinking from unsafe water wells, streams, rain, and dams (AOR = 2:6, 95% CI: 1.68-4.25, p ≤ 0:001) were significantly associated with IPIs. Conclusion Pregnant women in the study area still face a severe health burden due to intestinal parasitic infection. Therefore, it is recommended that health education should be improved, and safe tap water should be provided to pregnant women to reduce the incidence of IPIs.
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Affiliation(s)
- T. Alharazi
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail, Kingdom of Saudi Arabia
- Department of Medical Microbiology and Immunology, Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen
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16
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Arjyal A, Parajuli A, Kharel C, Del Barrio MO, Baral SC. Understanding gender and its intersection with social stratifiers on prevention and care seeking behavior of lymphatic filariasis in Nepal. Infect Dis Poverty 2023; 12:77. [PMID: 37608332 PMCID: PMC10463999 DOI: 10.1186/s40249-023-01126-8] [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: 03/06/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Lymphatic filariasis (LF) is a debilitating and painful neglected tropical disease and is one of the leading causes of permanent disability. In many countries, the intersection of gender with various social stratifiers has influenced exposure to LF and ultimately impacting the disease burden and its elimination. This study aimed to explore the influence of gender and its intersection with other social stratifiers for the prevention and care seeking behavior of LF in Nepal. METHODS This study employed qualitative research methods: in-depth interviews (IDIs) and focus group discussions (FGDs) for data collection in Bardiya, Nepal. A total of 22 IDIs (11 male, 11 female) and 2 FGDs (1 male and 1 female) were conducted with the community people between January and March 2020. The participants were purposively selected to represent different social stratifiers including age, sex, ethnicity, occupation. The data collected were analyzed using a thematic framework approach with use of intersectional gender analysis matrix. RESULTS The study findings revealed that men spend more time outside their household compared to women while fulfilling their roles and responsibilities, largely determined by societal expectations and gender norms. This resulted in limited access to preventive health services for men, as they often missed annual mass drug administration programme in their community and limited access to preventive methods. Further traditional occupation, specific to particular ethnicity, influenced the vulnerability to LF for certain ethnic groups. The ability to prevent exposure varied among individuals. Although women made decisions regarding the use of protective methods, it was influenced by patriarchal and gender norms. They often felt a responsibility to take care and priorities males and other family members when resources are limited. The intersectionality of gender with other social stratifiers such as marital status, ethnicity, and geographical areas influenced individual's ability to access information related to LF and care seeking. CONCLUSIONS Overall, the findings emphasized how access to resources, division of work, norms and values and decision-making power alone and its interaction with various social stratifiers shaped peoples' vulnerability to disease, ability to prevent exposure and response to illness.
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Affiliation(s)
| | | | - Chandani Kharel
- UNICEF, UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Mariam Otmani Del Barrio
- UNICEF, UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
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17
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Oliveira LMA, Kozik A, Milligan-McClellan K, Hagan AK. Editorial: Advancing social equity through microbiology. Front Cell Infect Microbiol 2023; 13:1260284. [PMID: 37600937 PMCID: PMC10434235 DOI: 10.3389/fcimb.2023.1260284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 08/22/2023] Open
Affiliation(s)
- Laura M. A. Oliveira
- Departamento de Microbiologia Médica, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ariangela Kozik
- Department of Molecular, Cellular, and Developmental Biology, University of Michigan, Ann Arbor, MI, United States
| | | | - Ada K. Hagan
- Alliance SciComm & Consulting, LLC, Russellville, TN, United States
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18
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Williams T, Karim MJ, Uddin S, Jahan S, Asm SM, Forbes SP, Hooper A, Taylor MJ, Kelly-Hope LA. Socio-economic and environmental factors associated with high lymphatic filariasis morbidity prevalence distribution in Bangladesh. PLoS Negl Trop Dis 2023; 17:e0011457. [PMID: 37432968 DOI: 10.1371/journal.pntd.0011457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 06/12/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Lymphatic filariasis (LF) is a vector-borne parasitic disease which affects 70 million people worldwide and causes life-long disabilities. In Bangladesh, there are an estimated 44,000 people suffering from clinical conditions such as lymphoedema and hydrocoele, with the greatest burden in the northern Rangpur division. To better understand the factors associated with this distribution, this study examined socio-economic and environmental factors at division, district, and sub-district levels. METHODOLOGY A retrospective ecological study was conducted using key socio-economic (nutrition, poverty, employment, education, house infrastructure) and environmental (temperature, precipitation, elevation, waterway) factors. Characteristics at division level were summarised. Bivariate analysis using Spearman's rank correlation coefficient was conducted at district and sub-district levels, and negative binomial regression analyses were conducted across high endemic sub-districts (n = 132). Maps were produced of high endemic sub-districts to visually illustrate the socio-economic and environmental factors found to be significant. RESULTS The highest proportion of rural population (86.8%), poverty (42.0%), tube well water (85.4%), and primary employment in agriculture (67.7%) was found in Rangpur division. Spearman's rank correlation coefficient at district and sub-district level show that LF morbidity prevalence was significantly (p<0.05) positively correlated with households without electricity (district rs = 0.818; sub-district rs = 0.559), households with tube well water (sub-district rs = 0.291), households without toilet (district rs = 0.504; sub-district rs = 0.40), mean annual precipitation (district rs = 0.695; sub-district rs = 0.503), mean precipitation of wettest quarter (district rs = 0.707; sub-district rs = 0.528), and significantly negatively correlated with severely stunted children (district rs = -0.723; sub-district rs = -0.370), mean annual temperature (district rs = -0.633.; sub-district rs = 0.353) and mean temperature (wettest quarter) ((district rs = -0.598; sub-district rs = 0.316) Negative binomial regression analyses at sub-district level found severely stunted children (p = <0.001), rural population (p = 0.002), poverty headcount (p = 0.001), primary employment in agriculture (p = 0.018), households without toilet (p = <0.001), households without electricity (p = 0.002) and mean temperature (wettest quarter) (p = 0.045) to be significant. CONCLUSIONS This study highlights the value of using available data to identify key drivers associated with high LF morbidity prevalence, which may help national LF programmes better identify populations at risk and implement timely and targeted public health messages and intervention strategies.
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Affiliation(s)
- Tijana Williams
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Mohammad Jahirul Karim
- Filariasis Elimination and STH Control Programme, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Shihab Uddin
- Pedodontics Department, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Sharmin Jahan
- Centre for Injury Prevention and Research, Dhaka, Bangladesh (CIPRB)
| | - Sultan Mahmood Asm
- Filariasis Elimination and STH Control Programme, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Shaun P Forbes
- Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island, United States of America
| | - Anna Hooper
- University of Nottingham, Nottingham, United Kingdom
| | - Mark J Taylor
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Louise A Kelly-Hope
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
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Costa ILV, da Costa PF, da Silva SM, Gobbo AR, Pinto PDDC, Spencer JS, da Silva MB, Salgado CG. Leprosy among children in an area without primary health care coverage in Caratateua Island, Brazilian Amazon. Front Med (Lausanne) 2023; 10:1218388. [PMID: 37425318 PMCID: PMC10323681 DOI: 10.3389/fmed.2023.1218388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction The detection of leprosy in children is an important epidemiological marker of the disease, indicating the community's early exposure to Mycobacterium leprae and active transmission of the infection. Methods In order to detect new cases among children by combining clinical evaluation and laboratory tests, we conducted an active case finding among individuals under 15 years old on Caratateua Island, located in the city of Belém, in the Pará state, an endemic region in the Amazon. Dermato-neurological examination, collection of 5 mL of peripheral blood for IgM anti-PGL-I antibody titration, and intradermal scraping for bacilloscopy and amplification of the specific RLEP region by qPCR were performed. Results Out of the 56 examined children, 28/56 (50%) new cases were identified. At the time of evaluation, 38/56 (67.8%) children presented one or more clinical alterations. Seropositivity was detected in 7/27 (25.9%) new cases and 5/24 (20.8%) undiagnosed children. DNA amplification of Mycobacterium leprae was observed in 23/28 (82.1%) of new cases and in 5/26 (19.2%) of non-cases. Out of the total cases, 11/28 (39.2%) were exclusively diagnosed by clinical evaluation performed during the active case finding. Seventeen new cases (60.8%) were detected considering the clinical alterations found in addition to positive results for qPCR. In this group, 3/17 (17.6%) qPCR-positive children presented significant clinical changes 5.5 months after the first evaluation. Discussion Our research detected a number of cases 5.6 times higher compared to the total number of pediatric cases recorded throughout the year 2021 in the municipality of Belém, which shows a critical scenario of underdiagnosing of leprosy among children under 15 years old in the region. We propose the use of qPCR technique to identify new cases among children with oligosymptomatic or early disease in endemic areas, in addition to the training of Primary Health Care professionals and the implementation of the Family Health Strategy coverage in the visited area.
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Affiliation(s)
| | | | | | - Angélica Rita Gobbo
- Laboratório de Dermato-Imunologia, Universidade Federal do Pará, Marituba, Pará, Brazil
| | - Pablo Diego do Carmo Pinto
- Laboratório de Dermato-Imunologia, Universidade Federal do Pará, Marituba, Pará, Brazil
- Laboratório de Genética Humana e Médica, Instituto de Ciência Biológicas, UFPA, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médicas, UFPA, Belém, Pará, Brazil
| | - John Stewart Spencer
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, United States
| | | | - Claudio Guedes Salgado
- Laboratório de Dermato-Imunologia, Universidade Federal do Pará, Marituba, Pará, Brazil
- Coordenação de Atenção às Doenças Transmissíveis na Atenção Primária à Saúde, Departamento de Gestão do Cuidado Integral, Secretaria de Atenção Primária à Saúde, Ministério da Saúde, Brasília, Distrito Federal, Brazil
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[Synthesis of evidence and recommendations: guideline for the treatment of leishmaniasis in the Region of the AmericasSíntese de evidências e recomendações: diretrizes para o tratamento das leishmanioses na Região das Américas]. Rev Panam Salud Publica 2023; 47:e43. [PMID: 37123638 PMCID: PMC10135436 DOI: 10.26633/rpsp.2023.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/16/2022] [Indexed: 05/02/2023] Open
Abstract
Introduction Leishmaniasis continues to be a neglected infectious disease of great importance, mainly affecting the poorest people with the least access to health services. In the Americas, it is a public health problem due to its magnitude, wide geographical distribution, and levels of morbidity and mortality. Objective Summarize the recommendations included in Guideline for the Treatment of Leishmaniasis in the Region of the Americas, published by the Pan American Health Organization/World Health Organization, in order to provide adequate management of patients diagnosed with leishmaniasis, reduce clinical complications and deaths caused by drug toxicity, reduce the lethality of visceral leishmaniasis, and address key aspects of implementation of the guidelines. Methods The guideline and its recommendations were summarized and a systematic search was carried out in PubMed, Lilacs, Health Systems Evidence, Epistemonikos, and gray literature for other studies conducted in the Region of the Americas, in order to identify barriers, facilitators, and implementation strategies. Results Recommendations are presented, addressing the pharmacological treatment of patients diagnosed with cutaneous, mucosal, and visceral leishmaniasis in the Americas, as well as case management and secondary prophylaxis in patients coinfected with visceral leishmaniasis and HIV, and patients with other diseases that cause immunosuppression. Conclusions The recommendations aim to provide the government entities and health professionals that care for leishmaniasis patients in the Americas with knowledge on management of the disease. Barriers are discussed (related to human resources, knowledge of guidelines, inputs, costs, access, and patient access), as well as facilitators and strategies to support implementation.
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Affiliation(s)
- Organización Panamericana de la Salud
- Organización Panamericana de la SaludWashington, D.C.Estados Unidos de AméricaOrganización Panamericana de la Salud, Washington, D.C., Estados Unidos de América.
- Ludovic Reveiz,
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Benitez-Bolivar P, Rondón S, Ortiz M, Díaz-Díaz J, León C, Riveros J, Molina H, González C. Morphological and molecular characterization of the parasite Dipylidium caninum infecting an infant in Colombia: a case report. Parasit Vectors 2022; 15:463. [PMID: 36514137 PMCID: PMC9746177 DOI: 10.1186/s13071-022-05573-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/02/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Dipylidium caninum is the causal agent of dipylidiasis affecting mainly cats and dogs worldwide. Human cases of dipylidiasis are rare, and the diagnosis is prevalently based on morphological features of the parasite. Here we report the diagnosis of dipylidiasis through morphological and molecular characterization of D. caninum infecting an 11-month-old boy in Cajicá, Colombia. METHODS Fresh faecal samples were obtained from the infant, and morphological identification of the parasite was performed through faecal smears. DNA was extracted from proglottids and used in PCR analyses for amplification of a 653-bp fragment of the nuclear ribosomal RNA (rRNA) encoding the 28S rRNA gene. A phylogeny study to better characterize the obtained DNA sequence was inferred using the maximum likelihood method and the Tamura-Nei model. RESULTS After morphological and molecular analyses, D. caninum was identified as the etiological agent causing the infection in the infant. Results of phylogenetical analyses showed that the obtained sequence clusters within the feline genotype clade. After the diagnosis of the parasite, effective treatment with praziquantel was administered to the infant. CONCLUSIONS This is the third human case of dipylidiasis reported in Colombia, and the first study in South America to provide a molecular identification of D. caninum.
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Affiliation(s)
- Paula Benitez-Bolivar
- grid.7247.60000000419370714Centro de Investigaciones en Microbiología Y Parasitología Tropical (CIMPAT), Departamento de Ciencias Biológicas, Universidad de los Andes, Cra. 1 N° 18A-12, Bogotá, Colombia
| | - Silvia Rondón
- grid.7247.60000000419370714Centro de Investigaciones en Microbiología Y Parasitología Tropical (CIMPAT), Departamento de Ciencias Biológicas, Universidad de los Andes, Cra. 1 N° 18A-12, Bogotá, Colombia
| | - Mario Ortiz
- grid.7247.60000000419370714Centro de Investigaciones en Microbiología Y Parasitología Tropical (CIMPAT), Departamento de Ciencias Biológicas, Universidad de los Andes, Cra. 1 N° 18A-12, Bogotá, Colombia
| | - Juana Díaz-Díaz
- grid.7247.60000000419370714Centro de Investigaciones en Microbiología Y Parasitología Tropical (CIMPAT), Departamento de Ciencias Biológicas, Universidad de los Andes, Cra. 1 N° 18A-12, Bogotá, Colombia
| | - Cielo León
- grid.7247.60000000419370714Centro de Investigaciones en Microbiología Y Parasitología Tropical (CIMPAT), Departamento de Ciencias Biológicas, Universidad de los Andes, Cra. 1 N° 18A-12, Bogotá, Colombia
| | - Juan Riveros
- Unidad de Gastroenterología, Hepatología y Nutrición Pediátrica, Juan Pablo Riveros SAS, Bogotá, Colombia
| | - Helverth Molina
- Unidad de Gastroenterología, Hepatología y Nutrición Pediátrica, Juan Pablo Riveros SAS, Bogotá, Colombia
| | - Camila González
- grid.7247.60000000419370714Centro de Investigaciones en Microbiología Y Parasitología Tropical (CIMPAT), Departamento de Ciencias Biológicas, Universidad de los Andes, Cra. 1 N° 18A-12, Bogotá, Colombia
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Rivas F, Del Mármol C, Scalese G, Pérez-Díaz L, Machado I, Blacque O, Medeiros A, Comini M, Gambino D. New multifunctional Ru(II) organometallic compounds show activity against Trypanosoma brucei and Leishmania infantum. J Inorg Biochem 2022; 237:112016. [PMID: 36244312 DOI: 10.1016/j.jinorgbio.2022.112016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022]
Abstract
Human African trypanosomiasis (sleeping sickness) and leishmaniasis are prevalent zoonotic diseases caused by genomically related trypanosomatid protozoan parasites (Trypanosoma brucei and Leishmania spp). Additionally, both are co-endemic in certain regions of the world. Only a small number of old drugs exist for their treatment, with most of them sharing poor safety, efficacy, and pharmacokinetic profiles. In this work, new multifunctional Ru(II) ferrocenyl compounds were rationally designed as potential agents against these trypanosomatid parasites by including in a single molecule 1,1'-bis(diphenylphosphino)ferrocene (dppf) and two bioactive bidentate ligands: 8-hydroxyquinoline derivatives (8HQs) and polypyridyl ligands (NN). Three [Ru(8HQs)(dppf)(NN)](PF6) compounds were synthesized and fully characterized. They showed in vitro activity on bloodstream Trypanosoma brucei (IC50 140-310 nM) and on Leishmania infantum promastigotes (IC50 3.0-4.8 μM). The compounds showed good selectivity towards T. brucei in respect to J774 murine macrophages as mammalian cell model (SI 15-38). Changing hexafluorophosphate counterion by chloride led to a three-fold increase in activity on both parasites and to a two to three-fold increase in selectivity towards the pathogens. The compounds affect in vitro at least the targets of the individual bioactive moieties included in the new chemical entities: DNA and generation of ROS. The compounds are stable in solution and are more lipophilic than the free bioactive ligands. No clear correlation between lipophilicity, interaction with DNA or generation of ROS and activity was detected, which agrees with their overall similar anti-trypanosoma potency and selectivity. These compounds are promising candidates for further drug development.
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Affiliation(s)
- Feriannys Rivas
- Área Química Inorgánica, Facultad de Química, Universidad de la República, Montevideo, Uruguay; Programa de Posgrado en Química, Facultad de Química, Universidad de la República, Montevideo, Uruguay
| | - Carolina Del Mármol
- Área Química Inorgánica, Facultad de Química, Universidad de la República, Montevideo, Uruguay
| | - Gonzalo Scalese
- Área Química Inorgánica, Facultad de Química, Universidad de la República, Montevideo, Uruguay
| | - Leticia Pérez-Díaz
- Laboratorio de Interacciones Moleculares, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - Ignacio Machado
- Área Química Analítica, Universidad de la República, Montevideo, Uruguay
| | - Olivier Blacque
- Department of Chemistry, University of Zurich, Zurich, Switzerland
| | - Andrea Medeiros
- Group Redox Biology of Trypanosomes, Institut Pasteur de Montevideo, Montevideo, Uruguay; Departamento de Bioquímica, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Marcelo Comini
- Group Redox Biology of Trypanosomes, Institut Pasteur de Montevideo, Montevideo, Uruguay
| | - Dinorah Gambino
- Área Química Inorgánica, Facultad de Química, Universidad de la República, Montevideo, Uruguay.
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Tropical diseases and risk of hypertension in the Amazon Basin: a cross-sectional study. J Hum Hypertens 2022; 36:1121-1127. [PMID: 34775497 DOI: 10.1038/s41371-021-00633-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/23/2021] [Accepted: 10/29/2021] [Indexed: 12/14/2022]
Abstract
Although infectious diseases have been associated with cardiovascular conditions, little is known about tropical disease burden and hypertension. We hypothesized that a history of tropical infections was associated with hypertension. We examined participants from outpatient clinics in the Amazon Basin who were interviewed about prior exposure to tropical diseases, including dengue, malaria hospitalization, and leishmaniasis. Hypertension was defined as a prior physician diagnosis of hypertension, treatment with anti-hypertensive medication, or a systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg. We used logistic regression models to examine the relationship between tropical infectious disease and hypertension. We included 556 participants (mean age 41 ± 15 years, 61% women) of whom 214 (38%) had hypertension and 354 (64%) had a history of tropical infectious disease. The distribution of tropical diseases was: dengue 270 (76%), malaria hospitalization 104 (29%) and leishmaniasis 48 (14%). Any prior tropical infection was significantly associated with prevalent hypertension (odds ratio 1.76 [95% CI 1.22-2.54], P = 0.003) and the association remained significant after adjusting for age, sex, body mass index, diabetes, hypercholesterolemia, socioeconomic status, smoking, vegetable intake and serum creatinine. Persons with a history of ≥2 tropical infections (n = 64) had the greatest risk of hypertension (odds ratio 2.04 [95% CI 1.15-3.63], P = 0.015). In adjusted models, prior infection with dengue was associated with hypertension (P = 0.006), but no associations were found with malaria hospitalization (P = 0.39) or leishmaniasis (P = 0.98). In conclusion, a history of tropical infectious disease was associated with hypertension. This finding supports the idea that pathogen burden may be related to cardiovascular conditions.
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Nieto-Sanchez C, Hatley DM, Grijalva MJ, Peeters Grietens K, Bates BR. Communication in Neglected Tropical Diseases' elimination: A scoping review and call for action. PLoS Negl Trop Dis 2022; 16:e0009774. [PMID: 36228006 PMCID: PMC9595560 DOI: 10.1371/journal.pntd.0009774] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/25/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Although the practice of communication is often called upon when intervening and involving communities affected by NTDs, the disciplinary framework of health communication research has been largely absent from NTD strategies. To illustrate how practices conceptualized and developed within the communication field have been applied in the context of NTD elimination, we conducted a scoping review focusing on two diseases currently targeted for elimination by the WHO: lymphatic filariasis and Chagas disease. METHODS We examined studies published between 2012 and 2020 in five electronic databases. Selected articles were required to (i) have explicit references to communication in either the abstract, title, or key words; (ii) further elaborate on the search terms (communication, message, media, participation and health education) in the body of the article; and (iii) sufficiently describe communication actions associated to those terms. Using the C-Change Socio-Ecological Model for Social and Behavior Change Communication as a reference, the articles were analysed to identify communication activities, theoretical frameworks, and/or rationales involved in their design, as well as their intended level of influence (individual, interpersonal, community, or enabling environment). RESULTS AND IMPLICATIONS A total of 43 articles were analysed. Most interventions conceptualized communication as a set of support tools or supplemental activities delivering information and amplifying pre-defined messages aimed at increasing knowledge, encouraging community involvement, promoting individual behavior change, or securing some degree of acceptability of proposed strategies. Although important attempts at further exploring communication capabilities were identified, particularly in participation-based strategies, for most studies, communication consisted of an underdeveloped and under-theorized approach. We contend that a more complex understanding of the capacities offered by the health communication field could help attain the biomedical and social justice goals proposed in NTD elimination strategies. Three ways in which the field of health communication could further enhance NTD efforts are presented: informing interventions with theory-based frameworks, exploring the political complexity of community participation in specific contexts, and identifying conceptualizations of culture implied in interventions' design. CONCLUSION This article is a call to action to consider the resources offered by the health communication field when researching, designing, or implementing NTD interventions.
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Affiliation(s)
- Claudia Nieto-Sanchez
- Socio-Ecological Health Research Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- * E-mail:
| | - David M. Hatley
- Department of Epidemiology, University of London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Mario J. Grijalva
- Infectious and Tropical Disease Institute (ITDI), Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, United States of America
- Center for Research in Health in Latin America (CISeAL), Facultad de Ciencias Exactas y Naturales, Pontifical Catholic University of Ecuador, Quito, Ecuador
| | - Koen Peeters Grietens
- Socio-Ecological Health Research Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Nagasaki, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Benjamin R. Bates
- Infectious and Tropical Disease Institute (ITDI), Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, United States of America
- Center for Research in Health in Latin America (CISeAL), Facultad de Ciencias Exactas y Naturales, Pontifical Catholic University of Ecuador, Quito, Ecuador
- School of Communication Studies, Ohio University, Athens, Ohio, United States of America
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Brandão-Bezerra L, Aparecida da Rosa A, Figueiredo de Oliveira RM, Neves RH, Corrêa CL, Machado-Silva JR. Impact of acute schistosomiasis mansoni and long-term ethanol intake on mouse liver pathology. Exp Parasitol 2022; 242:108388. [PMID: 36174706 DOI: 10.1016/j.exppara.2022.108388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 09/08/2022] [Accepted: 09/21/2022] [Indexed: 11/26/2022]
Abstract
While the effect of ethanol and schistosomiasis mansoni on liver injury has been well-documented, the influence of comorbidity on liver pathology remains unclear. To address this gap, schistosomiasis-infected mice were given one daily dose of 18% ethanol for 28 consecutive days, from day 35 post-infection. Mice were assigned to four groups: A. control; B. uninfected/ethanol gavage; C. infected; and D. infected/ethanol gavage. At day 64 post-infection, mice were euthanized by CO2 asphyxiation, livers were excised, fixed in 10% buffered formalin, paraffin embedded and cut into 5 μm sections. These were stained with hematoxylin and eosin (HE), Lennert's Giemsa and picrosirius red (for polarization microscopy) to assess histopathological and stereological changes. Group B showed alcoholic liver disease (ALD), including microsteatosis, hepatocyte karyopyknosis, karyorrhexis, karyolysis, increased frequency of Kupffer cells, hydropic degeneration of hepatocyte, thickened plasma membrane and binucleated hepatocytes. Infected mice showed typical exudative and exudative-productive hepatic granulomas, and destruction of the adjacent hepatic parenchyma, resulting in necrotic tissue and periovular leukocyte infiltrate. Group D showed hyperemia (parenchymal panlobular lesions), and liquefactive necrosis in hepatic abscess area. There was also reduced liver collagen deposition (-76%; p = 0.0001) and reduced microsteatosis (-80%, p = 0.0079) compared to group C and group B, respectively. In conclusion, comorbidity exacerbated liver damage.
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Affiliation(s)
- Luciana Brandão-Bezerra
- Romero Lascasas Porto Laboratory of Helminthology, Department of Microbiology, Immunology and Parasitology, Medical Sciences College (FCM), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Aline Aparecida da Rosa
- Romero Lascasas Porto Laboratory of Helminthology, Department of Microbiology, Immunology and Parasitology, Medical Sciences College (FCM), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Regina Maria Figueiredo de Oliveira
- Romero Lascasas Porto Laboratory of Helminthology, Department of Microbiology, Immunology and Parasitology, Medical Sciences College (FCM), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Renata Heisler Neves
- Romero Lascasas Porto Laboratory of Helminthology, Department of Microbiology, Immunology and Parasitology, Medical Sciences College (FCM), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Christiane Leal Corrêa
- Department of Pathology and Laboratories, Medical Sciences College (FCM), Rio de Janeiro State University (UERJ), Brazil. Medical College, Estácio de Sá University, Rio de Janeiro, Brazil
| | - José Roberto Machado-Silva
- Romero Lascasas Porto Laboratory of Helminthology, Department of Microbiology, Immunology and Parasitology, Medical Sciences College (FCM), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil.
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Gnimavo RS, Sopoh GE, Djossou P, Anagonou EG, Ayélo GA, Wadagni ACA, Barogui YT, Houezo JG, Johnson RC. Associated factors study into the belated screening for leprosy in Benin. PLoS Negl Trop Dis 2022; 16:e0010533. [PMID: 35737675 PMCID: PMC9223314 DOI: 10.1371/journal.pntd.0010533] [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: 10/12/2021] [Accepted: 05/24/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction
In the absence of early treatment, leprosy, a neglected tropical disease, due to Mycobacterium leprae or Hansen Bacillus, causes irreversible grade 2 disability (G2D) numerous factors related to the individual, the community and the health care system are believed to be responsible for its late detection and management. This study aims to investigate the factors associated with belated screening for leprosy in Benin.
Methods
This was a cross-sectional, descriptive, and analytical study conducted from January 1 to June 31, 2019, involving all patients and staff in leprosy treatment centers and public peripheral level health structures in Benin. The dependent variable of the study was the presence or not of G2D, reflecting late or early screening. We used a logistic regression model, at the 5% threshold, to find the factors associated with late leprosy screening. The fit of the final model was assessed with the Hosmer-Lemeshow test.
Results
A number of 254 leprosy patients were included with a mean age of 48.24 ± 18.37 years. There was a male dominance with a sex ratio of 1.23 (140/114). The proportion of cases with G2D was 58.27%. Associated factors with its belated screening in Benin were (OR; 95%CI; p) the fear of stigma related to leprosy (8.11; 3.3–19.94; <0.001), multiple visits to traditional healers (5.20; 2.73–9.89; <0.001) and multiple visits to hospital practitioners (3.82; 2.01–7.27; <0.001). The unawareness of leprosy by 82.69% of the health workers so as the permanent decrease in material and financial resources allocated to leprosy control were identified as factors in link with the health system that helps explain this late detection.
Conclusion
This study shows the need to implement strategies in the control programs to strengthen the diagnostic abilities of health workers, to improve the level of knowledge of the population on the early signs and symptoms of leprosy, to reduce stigmatization and to ban all forms of discrimination against leprosy patients.
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Affiliation(s)
- Ronald Sètondji Gnimavo
- Public Health Regional Institute- Comlan Alfred Quenum, Ouidah, University of Abomey-Calavi, Benin
- Center for Leprosy and Buruli’s Ulcer Screening and Treatment « Raoul et Madeleine Follereau » of Pobè, Benin
- * E-mail:
| | - Ghislain Emmanuel Sopoh
- Public Health Regional Institute- Comlan Alfred Quenum, Ouidah, University of Abomey-Calavi, Benin
- National Leprosy and Buruli’s Ulcer Control Program, Health Department, Benin
| | - Parfait Djossou
- Interfaculty Training Center for Environmental Research for Sustainable Development, University of Abomey-Calavi, Benin
| | | | - Gilbert Adjimon Ayélo
- Center for Buruli’s Ulcer Screening and Treatment « Le Luxembourg » of Allada, Benin
| | | | | | - Jean Gabin Houezo
- National Leprosy and Buruli’s Ulcer Control Program, Health Department, Benin
| | - Roch Christian Johnson
- Interfaculty Training Center for Environmental Research for Sustainable Development, University of Abomey-Calavi, Benin
- Fondation Raoul Follereau, Health Department, Paris, France
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Prevalence of Intestinal Parasitic Infections and Their Associated Risk Factors among Pregnant Women Attending Antenatal Care Center at Woreilu Health Center, Woreilu, Northeast Ethiopia. J Parasitol Res 2022; 2022:5242252. [PMID: 35450129 PMCID: PMC9017482 DOI: 10.1155/2022/5242252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 03/29/2022] [Indexed: 11/18/2022] Open
Abstract
Background Intestinal parasitic infections (IPIs) affect millions of pregnant women worldwide and if left untreated can cause adverse effects for mothers, fetuses, and newborns. This study was aimed at determining the prevalence and associated risk factors of intestinal parasitic infections among pregnant women in Woreilu, Northeast Ethiopia. Methods A cross-sectional study was conducted in Woreilu Health Center from October 2018 to February 2019. A convenient sampling technique was used to select the study subjects. The data related to the sociodemographic information and associated risk factors were collected by the interview technique, and fresh stool samples were collected from each pregnant woman. The microscopic examination of the stool samples was done by using direct wet mount preparations in normal saline and formol ether concentration techniques. Descriptive statistics and binary logistic regression were used. A p value < 0.05 was taken as statistically significant. Results A total of 331 pregnant women were included. The mean ± standard deviation of age of the participants was 26.3 ± 5.96 years ranging between 16 and 43 years. The overall prevalence of IPIs was 144 (43.5%) with the predominance of E. histolytica/dispar (44.4%) followed by A. lumbricoides (15.7%). Being a student (AOR = 3.35, 95% CI: 1.01-11.09, p = 0.047), second trimester (AOR = 3.94, 95% CI: 1.46-10.64, p = 0.007), third trimester (AOR = 3.32, 95% CI: 1.15-9.6, p = 0.027), and using spring water for drinking (AOR = 2.91, 95% CI: 1.62-5.22, p ≤ 0.001) were significantly associated with IPIs. Conclusion The prevalence of IPIs was high in this study. Being a student, second and third trimester, and using spring water for drinking were associated factors with IPIs. Therefore, improving the sanitation of the students and providing clean drinking water for the women should be strengthened. Screening women and providing health education during their antenatal care (ANC) visits are also recommended.
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Muñoz-Antoli C, Pérez P, Pavón A, Toledo R, Esteban JG. High intestinal parasite infection detected in children from Región Autónoma Atlántico Norte (R.A.A.N.) of Nicaragua. Sci Rep 2022; 12:5872. [PMID: 35393466 PMCID: PMC8990018 DOI: 10.1038/s41598-022-09756-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/24/2022] [Indexed: 11/09/2022] Open
Abstract
There is a lack of epidemiological information concerning intestinal parasitic infections, and especially in soil-transmitted helminths, occurring in some departments of Nicaragua. Up to now, this is the first study involving two nearby areas (Puerto Cabezas and Siuna municipalities) of the Región Autónoma Atlántico Norte (R.A.A.N.). One stool sample was analyzed by Kato-Katz, formaldehyde-ethyl acetate concentration method and modified Ziehl-Neelsen technique, and a simple questionnaire concerning demographic, sanitary and behavioral data was distributed among 735 children and evaluated. Overall prevalence of infection reached 97.0%, being the highest prevalences detected in all Nicaragua. The higher protozoan prevalence appears in Siuna (94.5%), a rural interior municipality, with a typical tropical monsoon climate, while the higher helminths rates were reached in Puerto Cabezas (92.8%), the urbanized coastal capital, with a typical tropical rainforest climate. No statistical differences were found with regard to sex. However, the 6-11-year age-group children presented the highest prevalences. Most T. trichiura infections (59.4%) were of light intensity, while 51.7% of Ascaris lumbricoides were of moderate intensity. Multivariable logistic regression analysis indicated that those who drink rainwater and walk barefoot were 2.9 and 2.5 times more likely to have helminth infections, respectively. Results from one geographical setting might not be applied to other nearby with different climatic conditions. The use of anthelmintic drugs only will not be sufficient to bring prevalence to low levels. It is necessary to design geographically more specific intervention, with communication and interaction between different disciplines (e.g. parasitology, biochemistry, molecular biology, epidemiology, public health, etc.) being imperative to reduce STH infection.
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Affiliation(s)
- Carla Muñoz-Antoli
- Área Parasitología, Departamento Farmacia y Tecnología Farmacéutica y Parasitología, Facultad Farmacia, Universidad Valencia, Valencia, Spain.
| | - Paloma Pérez
- Área Parasitología, Departamento Farmacia y Tecnología Farmacéutica y Parasitología, Facultad Farmacia, Universidad Valencia, Valencia, Spain
| | - Aleyda Pavón
- Departamento Bioanálisis Clínico, Instituto Politécnico de La Salud (IPS-Polisal), Universidad Nacional Autónoma de Nicaragua, Managua, Nicaragua
| | - Rafael Toledo
- Área Parasitología, Departamento Farmacia y Tecnología Farmacéutica y Parasitología, Facultad Farmacia, Universidad Valencia, Valencia, Spain
| | - José Guillermo Esteban
- Área Parasitología, Departamento Farmacia y Tecnología Farmacéutica y Parasitología, Facultad Farmacia, Universidad Valencia, Valencia, Spain
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Chan YL, Patterson CL, Priest JW, Stresman G, William T, Chua TH, Tetteh K, Lammie P, Drakeley C, Fornace KM. Assessing seroprevalence and associated risk factors for multiple infectious diseases in Sabah, Malaysia using serological multiplex bead assays. Front Public Health 2022; 10:924316. [PMID: 36388287 PMCID: PMC9641279 DOI: 10.3389/fpubh.2022.924316] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 10/07/2022] [Indexed: 01/24/2023] Open
Abstract
Background Infectious diseases continue to burden populations in Malaysia, especially among rural communities where resources are limited and access to health care is difficult. Current epidemiological trends of several neglected tropical diseases in these populations are at present absent due to the lack of habitual and efficient surveillance. To date, various studies have explored the utility of serological multiplex beads to monitor numerous diseases simultaneously. We therefore applied this platform to assess population level exposure to six infectious diseases in Sabah, Malaysia. Furthermore, we concurrently investigated demographic and spatial risk factors that may be associated with exposure for each disease. Methods This study was conducted in four districts of Northern Sabah in Malaysian Borneo, using an environmentally stratified, population-based cross-sectional serological survey targeted to determine risk factors for malaria. Samples were collected between September to December 2015, from 919 villages totaling 10,100 persons. IgG responses to twelve antigens of six diseases (lymphatic filariasis- Bm33, Bm14, BmR1, Wb123; strongyloides- NIE; toxoplasmosis-SAG2A; yaws- Rp17 and TmpA; trachoma- Pgp3, Ct694; and giardiasis- VSP3, VSP5) were measured using serological multiplex bead assays. Eight demographic risk factors and twelve environmental covariates were included in this study to better understand transmission in this community. Results Seroprevalence of LF antigens included Bm33 (10.9%), Bm14+ BmR1 (3.5%), and Wb123 (1.7%). Seroprevalence of Strongyloides antigen NIE was 16.8%, for Toxoplasma antigen SAG2A was 29.9%, and Giardia antigens GVSP3 + GVSP5 was 23.2%. Seroprevalence estimates for yaws Rp17 was 4.91%, for TmpA was 4.81%, and for combined seropositivity to both antigens was 1.2%. Seroprevalence estimates for trachoma Pgp3 + Ct694 were 4.5%. Age was a significant risk factors consistent among all antigens assessed, while other risk factors varied among the different antigens. Spatial heterogeneity of seroprevalence was observed more prominently in lymphatic filariasis and toxoplasmosis. Conclusions Multiplex bead assays can be used to assess serological responses to numerous pathogens simultaneously to support infectious disease surveillance in rural communities, especially where prevalences estimates are lacking for neglected tropical diseases. Demographic and spatial data collected alongside serosurveys can prove useful in identifying risk factors associated with exposure and geographic distribution of transmission.
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Affiliation(s)
- YuYen L. Chan
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- *Correspondence: YuYen L. Chan
| | - Catriona L. Patterson
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jeffrey W. Priest
- Division of Foodborne, Waterborne, and Environmental Diseases, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Gillian Stresman
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Timothy William
- Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
| | - Tock H. Chua
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Kevin Tetteh
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Patrick Lammie
- Division of Parasitic Diseases and Malaria, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Chris Drakeley
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Kimberly M. Fornace
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
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Njenga D, Mbugua AK, Okoyo C, Njenga SM. Intestinal Parasite Infections and Associated Risk Factors among Pre-School Aged Children in Kibera Informal Settlement, Nairobi, Kenya. East Afr Health Res J 2022; 6:86-97. [PMID: 36424950 PMCID: PMC9639646 DOI: 10.24248/eahrj.v6i1.683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/08/2022] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Infections with intestinal parasites are a major public health problem in children in developing countries like Kenya. School going children are considered at most risk and are included in school-based de-worming program. Less focus is given to pre-school children and information is scarce about intestinal parasitosis among this age group. In this study, we determined the prevalence and intensity of protozoa and helminth infections, and associated risk factors in an informal settlement. METHODS A community based cross-sectional study was conducted from October 2016 to January 2017 among 406 children aged 2-5 years in Kibera informal settlements in Nairobi County, Kenya. Structured interviewer-administered questionnaire was used to collect sociodemographic information and data on associated factors. Stool samples were examined microscopically using formal ether concentration, iodine wet mounting, modified Ziehl-Neelsen staining, and Kato-Katz methods. Multivariable logistic regression analysis was used to identify risk factors associated with intestinal parasites. RESULTS The overall prevalence of any helminth and protozoa infections was 13.1% 53/406) and 22.4% (91/406) respectively. The predominant parasites were Giardia lamblia (13.8%), Ascaris lumbricoides (11.3%), Entamoeba histolytica/dispar (9.4%), Trichuris trichiura (3.9%), Entamoeba coli (1.5%) and hookworm (0.2%). Prevalence of co-infection with any helminths or protozoan was 2.7%. About 10.8% (44/406) and 20.7% (84/406) children were infected with single species of helminth and protozoan parasites. All helminth infections were light, with a mean intensity of 592 egg per gram. Intensity of any protozoan infections was heavy 62.6% (57/406). Dirt floors in the household (aOR = 2.22, p = .046), dirty toilets (aOR = 2.33, p=.014), water from communal taps (aOR = 0.27, p=.019), parent's education level (aOR=0.27, p=.032) and parent's earning (aOR =3.34, p=.007) were factors significantly associated with intestinal parasites. CONCLUSION The study found both helminth and protozoan parasites to be prevalent among pre-school aged children in Kibera. Intervention measures including education on the improvement of hygiene and health, socio-economic conditions, sanitation, and provision of safe drinking water could reduce the prevalence of these infections.
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Affiliation(s)
- Daniel Njenga
- College of Health Sciences (COHES), Jomo Kenyatta University of Agriculture and Technology (JKUAT), Nairobi, Kenya
| | - Amos K. Mbugua
- College of Health Sciences (COHES), Jomo Kenyatta University of Agriculture and Technology (JKUAT), Nairobi, Kenya
| | - Collins Okoyo
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Sammy M. Njenga
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
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Vande Velde F, Overgaard HJ, Bastien S. Nudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment. PLoS Negl Trop Dis 2021; 15:e0009239. [PMID: 34723983 PMCID: PMC8584752 DOI: 10.1371/journal.pntd.0009239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 11/11/2021] [Accepted: 10/13/2021] [Indexed: 12/19/2022] Open
Abstract
Background Nudging, a strategy that uses subtle stimuli to direct people’s behavior, has recently been included as an effective and low-cost behavior change strategy in low- and middle- income countries (LMIC), targeting behavior-based prevention and control of neglected tropical diseases (NTDs). The present scoping review aims to provide a timely overview of how nudge interventions have been applied within this field. In addition, the review proposes a framework for the ethical consideration of nudges for NTD prevention and control, or more broadly global health promotion. Methods A comprehensive search was performed in several databases: MEDLINE, PsycINFO, and Embase (Ovid), Web of Science Core Collection, CINAHL, ERIC and Econ.Lit (EBSCO), as well as registered trials and reviews in CENTRAL and PROSPERO to identify ongoing or unpublished studies. Additionally, studies were included through a handpicked search on websites of governmental nudge units and global health or development organizations. Results This scoping review identified 33 relevant studies, with only two studies targeting NTDs in particular, resulting in a total of 67 nudge strategies. Most nudges targeted handwashing behavior and were focused on general health practices rather than targeting a specific disease. The most common nudge strategies were those targeting decision assistance, such as facilitating commitment and reminder actions. The majority of nudges were of moderate to high ethical standards, with the highest standards being those that had the most immediate and significant health benefits, and those implemented by agents in a trust relationship with the target audience. Conclusion Three key recommendations should inform research investigating nudge strategies in global health promotion in general. Firstly, future efforts should investigate the different opportunities that nudges present for targeting NTDs in particular, rather than relying solely on integrated health promotion approaches. Secondly, to apply robust study designs including rigorous process and impact evaluation which allow for a better understanding of ‘what works’ and ‘how it works’. Finally, to consider the ethical implications of implementing nudge strategies, specifically in LMIC. Behavior is at the core of neglected tropical disease (NTD) prevention and control, certainly within low-, and middle- income countries (LMIC) where resources are often limited. Therefore, strategies to promote behavior change should be included and investigated in future efforts. Nudging, a low-cost strategy that subtly directs people towards positive behavioral choices, has recently gained attention in global health promotion. Nudge strategies have been applied to a wide range of health-promoting behaviors such as handwashing. To understand which strategies were used, where and how these were applied, and whether these were ethically informed and implemented, we undertook a comprehensive review of the available sources. This resulted in 33 included studies, with a total of 67 nudge strategies for behavior-based prevention and control of NTDs in LMIC. Only two studies targeted NTDs in particular, the other 31 included studies were focused on more general health promoting behaviors, with the majority targeting handwashing with soap. The most common nudge strategies were those targeting decision assistance, such as fostering commitment and reminder actions. In general, the ethical assessment presented favorable results. We identified the need for robust study designs to better understand how nudges can be implemented in the future.
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Affiliation(s)
- Fiona Vande Velde
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
- * E-mail:
| | - Hans J. Overgaard
- Faculty of Science and Technology, Norwegian University of Life Sciences, Ås, Norway
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sheri Bastien
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
- The Centre for Evidence-Based Public Health: A JBI Affiliated Group, Department of Public Health Science, NMBU, Ås, Norway
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Towards global control of parasitic diseases in the Covid-19 era: One Health and the future of multisectoral global health governance. ADVANCES IN PARASITOLOGY 2021; 114:1-26. [PMID: 34696842 PMCID: PMC8503781 DOI: 10.1016/bs.apar.2021.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Human parasitic infections—including malaria, and many neglected tropical diseases (NTDs)—have long represented a Gordian knot in global public health: ancient, persistent, and exceedingly difficult to control. With the coronavirus disease (Covid-19) pandemic substantially interrupting control programmes worldwide, there are now mounting fears that decades of progress in controlling global parasitic infections will be undone. With Covid-19 moreover exposing deep vulnerabilities in the global health system, the current moment presents a watershed opportunity to plan future efforts to reduce the global morbidity and mortality associated with human parasitic infections. In this chapter, we first provide a brief epidemiologic overview of the progress that has been made towards the control of parasitic diseases between 1990 and 2019, contrasting these fragile gains with the anticipated losses as a result of Covid-19. We then argue that the complementary aspirations of the United Nations Sustainable Development Goals (SDGs) and the World Health Organization (WHO)’s 2030 targets for parasitic disease control may be achieved by aligning programme objectives within the One Health paradigm, recognizing the interdependence between humans, animals, and the environment. In so doing, we note that while the WHO remains the preeminent international institution to address some of these transdisciplinary concerns, its underlying challenges with funding, authority, and capacity are likely to reverberate if left unaddressed. To this end, we conclude by reimagining how models of multisectoral global health governance—combining the WHO's normative and technical leadership with greater support in allied policy-making areas—can help sustain future malaria and NTD elimination efforts.
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Martins-Melo FR, Castro MC, Werneck GL. Levels and trends in Chagas disease-related mortality in Brazil, 2000-2019. Acta Trop 2021; 220:105948. [PMID: 33971159 DOI: 10.1016/j.actatropica.2021.105948] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/06/2021] [Accepted: 04/29/2021] [Indexed: 10/21/2022]
Abstract
Chagas disease remains an important public health problem with high morbidity and mortality in several Latin American countries. This nationwide population-based ecological study analyzes the epidemiological characteristics and time trends of Chagas disease-related mortality in Brazil, 2000-2019. We included all deaths reported in Brazil in which Chagas disease was mentioned in the death certificate either as an underlying or associated cause of death (multiple causes of death). Crude and age-adjusted mortality rates (per 100,000 inhabitants) were calculated and time trends analysis was performed using joinpoint regression models. In the study period, a total of 22,663,092 deaths were recorded in Brazil. Chagas disease was identified in 122,291 deaths (0.54%), 94.788 (77.5%) as an underlying cause and 27,503 (22.5%) as an associated cause. Average annual age-adjusted mortality rate was 3.22 deaths/100,000 inhabitants (95% confidence interval [CI]: 3.14-3.30). Chronic Chagas disease with cardiac involvement was the predominant clinical presentation mentioned. The highest mortality rates were observed in males, age group ≥80 years, black race/skin color, schooling 1-3 years of study, and residents in the Central-West region. Age-adjusted mortality rates showed a significant declining trend at the national level in the period (Average Annual Percent Change: -3.1%; 95% CI: -3.3; -3.0), with different local patterns and a more pronounced reduction in important endemic areas in the past. The findings show that, despite a consistent decline in mortality rates in Brazil over the study period, Chagas disease remains an important and neglected cause of death in the country, showing a marked regional variation that has social and health care implications. In addition to the control measures for disease transmission, it is necessary to guarantee access, coverage, and quality of health care to Chagas disease patients, seeking to prevent the occurrence of severe forms and deaths from the disease.
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Magoulas GE, Afroudakis P, Georgikopoulou K, Roussaki M, Borsari C, Fotopoulou T, Santarem N, Barrias E, Tejera Nevado P, Hachenberg J, Bifeld E, Ellinger B, Kuzikov M, Fragiadaki I, Scoulica E, Clos J, Gul S, Costi MP, de Souza W, Prousis KC, Cordeiro da Silva A, Calogeropoulou T. Design, Synthesis and Antiparasitic Evaluation of Click Phospholipids. Molecules 2021; 26:4204. [PMID: 34299479 PMCID: PMC8305768 DOI: 10.3390/molecules26144204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 12/02/2022] Open
Abstract
A library of seventeen novel ether phospholipid analogues, containing 5-membered heterocyclic rings (1,2,3-triazolyl, isoxazolyl, 1,3,4-oxadiazolyl and 1,2,4-oxadiazolyl) in the lipid portion were designed and synthesized aiming to identify optimised miltefosine analogues. The compounds were evaluated for their in vitro antiparasitic activity against Leishmania infantum and Leishmania donovani intracellular amastigotes, against Trypanosoma brucei brucei and against different developmental stages of Trypanosoma cruzi. The nature of the substituents of the heterocyclic ring (tail) and the oligomethylene spacer between the head group and the heterocyclic ring was found to affect the activity and toxicity of these compounds leading to a significantly improved understanding of their structure-activity relationships. The early ADMET profile of the new derivatives did not reveal major liabilities for the potent compounds. The 1,2,3-triazole derivative 27 substituted by a decyl tail, an undecyl spacer and a choline head group exhibited broad spectrum antiparasitic activity. It possessed low micromolar activity against the intracellular amastigotes of two L. infantum strains and T. cruzi Y strain epimastigotes, intracellular amastigotes and trypomastigotes, while its cytotoxicity concentration (CC50) against THP-1 macrophages ranged between 50 and 100 μM. Altogether, our work paves the way for the development of improved ether phospholipid derivatives to control neglected tropical diseases.
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Affiliation(s)
- George E. Magoulas
- National Hellenic Research Foundation, Institute of Chemical Biology, 11653 Athens, Greece; (G.E.M.); (P.A.); (K.G.); (M.R.); (T.F.); (K.C.P.)
| | - Pantelis Afroudakis
- National Hellenic Research Foundation, Institute of Chemical Biology, 11653 Athens, Greece; (G.E.M.); (P.A.); (K.G.); (M.R.); (T.F.); (K.C.P.)
| | - Kalliopi Georgikopoulou
- National Hellenic Research Foundation, Institute of Chemical Biology, 11653 Athens, Greece; (G.E.M.); (P.A.); (K.G.); (M.R.); (T.F.); (K.C.P.)
| | - Marina Roussaki
- National Hellenic Research Foundation, Institute of Chemical Biology, 11653 Athens, Greece; (G.E.M.); (P.A.); (K.G.); (M.R.); (T.F.); (K.C.P.)
| | - Chiara Borsari
- Department of Biomedicine, University of Basel, 4058 Basel, Switzerland;
| | - Theano Fotopoulou
- National Hellenic Research Foundation, Institute of Chemical Biology, 11653 Athens, Greece; (G.E.M.); (P.A.); (K.G.); (M.R.); (T.F.); (K.C.P.)
| | - Nuno Santarem
- i3S–Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal; (N.S.); (A.C.d.S.)
- Parasite Disease Group, IBMC-Instituto de Biologia Molecular e Celular, 4150-180 Porto, Portugal
| | - Emile Barrias
- Instituto Nacional de Ciência e Tecnologia em Biologia Estrutural e Bioimagens, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (E.B.); (W.d.S.)
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Ilha do Fundão, Rio Janeiro 21941-902, Brazil
| | - Paloma Tejera Nevado
- Bernhard Nocht Institute for Tropical Medicine, 20359 Hamburg, Germany; (P.T.N.); (J.H.); (E.B.); (J.C.)
| | - Julia Hachenberg
- Bernhard Nocht Institute for Tropical Medicine, 20359 Hamburg, Germany; (P.T.N.); (J.H.); (E.B.); (J.C.)
| | - Eugenia Bifeld
- Bernhard Nocht Institute for Tropical Medicine, 20359 Hamburg, Germany; (P.T.N.); (J.H.); (E.B.); (J.C.)
| | - Bernhard Ellinger
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 22525 Hamburg, Germany; (B.E.); (M.K.); (S.G.)
- Fraunhofer Cluster of Excellence for Immune-Mediated Diseases CIMD, 22525 Hamburg, Germany
| | - Maria Kuzikov
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 22525 Hamburg, Germany; (B.E.); (M.K.); (S.G.)
- Fraunhofer Cluster of Excellence for Immune-Mediated Diseases CIMD, 22525 Hamburg, Germany
| | - Irini Fragiadaki
- Department of Clinical Microbiology and Microbial Pathogenesis, Faculty of Medicine, University of Crete, 70013 Heraklion, Greece; (I.F.); (E.S.)
| | - Effie Scoulica
- Department of Clinical Microbiology and Microbial Pathogenesis, Faculty of Medicine, University of Crete, 70013 Heraklion, Greece; (I.F.); (E.S.)
| | - Joachim Clos
- Bernhard Nocht Institute for Tropical Medicine, 20359 Hamburg, Germany; (P.T.N.); (J.H.); (E.B.); (J.C.)
| | - Sheraz Gul
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 22525 Hamburg, Germany; (B.E.); (M.K.); (S.G.)
- Fraunhofer Cluster of Excellence for Immune-Mediated Diseases CIMD, 22525 Hamburg, Germany
| | - Maria Paola Costi
- Department of Pharmacy, Università degli Studi di Modena e Reggio Emilia, 41125 Modena, Italy;
| | - Wanderley de Souza
- Instituto Nacional de Ciência e Tecnologia em Biologia Estrutural e Bioimagens, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (E.B.); (W.d.S.)
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Ilha do Fundão, Rio Janeiro 21941-902, Brazil
| | - Kyriakos C. Prousis
- National Hellenic Research Foundation, Institute of Chemical Biology, 11653 Athens, Greece; (G.E.M.); (P.A.); (K.G.); (M.R.); (T.F.); (K.C.P.)
| | - Anabela Cordeiro da Silva
- i3S–Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal; (N.S.); (A.C.d.S.)
- Parasite Disease Group, IBMC-Instituto de Biologia Molecular e Celular, 4150-180 Porto, Portugal
- Departmento de Ciências Biológicas, Faculdade de Farmácia, Universidade do Porto, 4099-002 Porto, Portugal
| | - Theodora Calogeropoulou
- National Hellenic Research Foundation, Institute of Chemical Biology, 11653 Athens, Greece; (G.E.M.); (P.A.); (K.G.); (M.R.); (T.F.); (K.C.P.)
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Omondi I, Odiere MR, Rawago F, Mwinzi PN, Campbell C, Musuva R. Socioeconomic determinants of Schistosoma mansoni infection using multiple correspondence analysis among rural western Kenyan communities: Evidence from a household-based study. PLoS One 2021; 16:e0253041. [PMID: 34161354 PMCID: PMC8221481 DOI: 10.1371/journal.pone.0253041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/28/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Socioeconomic inequality including wealth distribution is a barrier to implementation of health policies. Wealth distribution can be measured effectively using household data on durable assets. Compared to other methods of analysing Socio-economic Status (SES) using durable assets, Multiple Correspondence Analysis (MCA) can create more reliable wealth quintiles. We therefore evaluated socioeconomic determinants of Schistosoma mansoni using MCA on household data among adult population in western Kenya. The hypothesis of this study was that MCA would be a useful predictor of S. mansoni prevalence and/or intensity. METHODOLOGY Twelve villages, 6 villages that had showed the greatest decrease in S. mansoni prevalence (Responder villages) and 6 villages that showed relatively lower decrease (Hotspot villages) between the year 2011 and 2015 were randomly selected for this study. This was according to a previous Schistosomiasis Consortium for Operational Research and Elimination (SCORE) report from western Kenya. From each village, convenience sampling was used to identify 50 adults from 50 households for inclusion in this study. An interview with a questionnaire based upon MCA indicators was conducted. One stool sample from each of the 600 adults was examined based on four slides for S. mansoni eggs using Kato Katz technique. Mean Eggs per gram(EPG) was calculated by taking the average of the readings from the four slides. A log binomial regression model was used to identify the influence of the various age-groups(<30 years, 30-60 years and >60 years), household size, wealth class, occupation, education status, main water supply, sex and sub-county of residence on S. mansoni infection. EPG was then compared across variables that were significant based on multivariate log binomial model analysis using a mixed model. PRINCIPAL FINDINGS Overall prevalence of S. mansoni was 41.3%. Significantly higher prevalence of S. mansoni were associated with males, those aged below 30 years, those who use unsafe water sources (unprotected wells, lakes and rivers), residents of Rachuonyo North, Hotspot villages and those earning livelihood from fishing. Only sex and household size were significant predictors in the multivariate model. Males were associated with significantly higher prevalence compared to the females (aPR = 1.37; 95% CI = 1.14-1.66). In addition, households with at least four persons had higher prevalence compared to those with less than four (aPR = 1.29; 95% CI = 1.03-1.61). However, there was no difference in prevalence between the wealth classes(broadly divided into poor and less poor categories). Intensity of infection (Mean EPG)was also significantly higher among males, younger age group, Rachuonyo North residents and Hotspot Villages. CONCLUSION Socioeconomic status based on an MCA model was not a contributing factor to S. mansoni prevalence and/or intensity possibly because the study populations were not sufficiently dissimilar. The use of convenience sampling to identify participants could also have contributed to the lack of significant findings.
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Affiliation(s)
- Isaiah Omondi
- Neglected Tropical Diseases Branch, Center for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Maurice R. Odiere
- Neglected Tropical Diseases Branch, Center for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Fredrick Rawago
- Neglected Tropical Diseases Branch, Center for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Pauline N. Mwinzi
- Neglected Tropical Diseases Branch, Center for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Carl Campbell
- Center for Tropical and Emerging Global Diseases and Department of Microbiology, University of Georgia, Athens, Georgia, United States of America
| | - Rosemary Musuva
- Neglected Tropical Diseases Branch, Center for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
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Souza MDR, de Jesus DMS, Santos AHC, Lima SVMA, Dos Santos A, Tavares DDS, de Araújo KCGM, Bezerra-Santos M. Risk clusters of Schistosoma mansoni infection in an endemic state of Brazil: space-time modelling and association with socio-economic and environmental factors. Trans R Soc Trop Med Hyg 2021; 116:108-116. [PMID: 34134133 DOI: 10.1093/trstmh/trab090] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/24/2021] [Accepted: 06/02/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We analysed the spatial distribution and the socio-economic and environmental factors (SEFs) associated with Schistosoma mansoni infection in the state of Alagoas, an important tourist area in northeastern Brazil. METHODS We conducted an ecological time-series study (2007-2016) on schistosomiasis cases and SEFs. We evaluated the temporal trends of schistosomiasis cases (annual percentage change [APC]) and their correlation with SEFs. Spatial analysis maps were built using QGIS and TerraView software. RESULTS We observed that 4.9% of the municipalities had a high prevalence of S. mansoni infection and were located mainly in the coastal strip of Alagoas state. The positivity rate for schistosomiasis decreased during the period (8.1% in 2007 to 4.9% in 2016; APC=-5.71). There was a reduction in the number of tests performed (APC=-5.05). There was a negative correlation between S. mansoni infection and the municipal human development index (ρ=-0.34) and schooling rate (ρ=-0.24). The main species of snail was Biomphalaria glabrata (94.79%), but Biomphalaria straminea showed a higher percentage of S. mansoni detection (10.11%). Lastly, Biomphalaria tenagophila specimens were identified for the first time in Alagoas (n=28). CONCLUSIONS Despite a reduction in the number of cases, intestinal schistosomiasis still represents a serious public health concern in Alagoas. It urgently requires planning and improvements in diagnosis, prevention programs and the state's socio-economic indicators.
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Affiliation(s)
- Mariana do Rosário Souza
- Parasitic Biology Graduate Program, Universidade Federal de Sergipe, Aracaju, Sergipe, Brazil.,Health Sciences Graduate Program, Universidade Federal de Sergipe, Aracaju, Sergipe, Brazil
| | | | | | - Shirley V M Almeida Lima
- Department of Nursing, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil.,Post Graduate Program of Nursing, Universidade Federal de Sergipe, Aracaju, Sergipe, Brazil
| | - Allan Dos Santos
- Department of Nursing, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil.,Post Graduate Program of Nursing, Universidade Federal de Sergipe, Aracaju, Sergipe, Brazil
| | | | - Karina Conceição G M de Araújo
- Parasitic Biology Graduate Program, Universidade Federal de Sergipe, Aracaju, Sergipe, Brazil.,Health Sciences Graduate Program, Universidade Federal de Sergipe, Aracaju, Sergipe, Brazil.,Department of Morphology, Universidade Federal de Sergipe, Aracaju, Sergipe, Brazil
| | - Márcio Bezerra-Santos
- Parasitic Biology Graduate Program, Universidade Federal de Sergipe, Aracaju, Sergipe, Brazil.,Health Sciences Graduate Program, Universidade Federal de Sergipe, Aracaju, Sergipe, Brazil.,Department of Morphology, Universidade Federal de Sergipe, Aracaju, Sergipe, Brazil.,Immunology and Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, Aracaju, Brazil
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Low awareness and common misconceptions about schistosomiasis in endemic lowland areas in Western Ethiopia: a mixed-methods study. BMC Public Health 2021; 21:1064. [PMID: 34088297 PMCID: PMC8178865 DOI: 10.1186/s12889-021-11106-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/17/2021] [Indexed: 11/28/2022] Open
Abstract
Background Understanding the health behavior of the target population is crucial for sustainable schistosomiasis control. The aim of this study was to assess schistosomiasis related levels of knowledge, attitude, and practices of communities in lowland areas of western Ethiopia, where schistosomiasis is endemic. Methods A community-based multilevel triangulation mixed-methods design was conducted in three schistosomiasis endemic villages in the Abbey and Didessa valleys of the Benishangul Gumuz Region of Western Ethiopia, where mass drug administration (MDA) was done 30 years back and again the last 5 years. A structured survey questionnaire, in-depth interviews, focused group discussions, and observation was conducted to assess levels of knowledge, attitude, and practices related to schistosomiasis in the communities. Results Among the survey participants, 13% reported having heard of schistosomiasis, locally called Pecka (meaning worm). The majority of this 13% believe that schistosomiasis is caused by the biting of the worm Pecka, while others say drinking dirty water is the cause of infection, or they didn’t know what the cause is. A majority of respondents answered “I don’t know” to most of the questions about established knowledge of schistosomiasis. Male participants and students were more aware of schistosomiasis than their counterparts, and awareness increased with the educational level. Only one participant perceived that schistosomiasis was a serious disease. There were negative attitudes and misconceptions about the drug used in the mass treatment and many complaints were raised related to the size of the tablet and its side effects. There was no local budget and specific plan to prevent and control the disease. Local health personnel had insufficient knowledge about schistosomiasis, and the diagnosis and treatment capacities of local health institutions were poor. Conclusion In the current research area, schistosomiasis prevention and control recommendations should be redesigned to change the knowledge, attitudes, and practices of the community and local health workers. It is also necessary to have the local budget and trained manpower in order to diagnose and treat schistosomiasis locally. There is a great need to have a safer Praziquantel pediatric formulation. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11106-y.
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Rufalco-Moutinho P, Moura Kadri S, Peres Alonso D, Moreno M, Carrasco-Escobar G, Prussing C, Gamboa D, Vinetz JM, Mureb Sallum MA, Conn JE, Martins Ribolla PE. Ecology and larval population dynamics of the primary malaria vector Nyssorhynchus darlingi in a high transmission setting dominated by fish farming in western Amazonian Brazil. PLoS One 2021; 16:e0246215. [PMID: 33831004 PMCID: PMC8031405 DOI: 10.1371/journal.pone.0246215] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 03/23/2021] [Indexed: 11/21/2022] Open
Abstract
Vale do Rio Juruá in western Acre, Brazil, is a persistent malaria transmission hotspot partly due to fish farming development that was encouraged to improve local standards of living. Fish ponds can be productive breeding sites for Amazonian malaria vector species, including Nyssorhynchus darlingi, which, combined with high human density and mobility, add to the local malaria burden.This study reports entomological profile of immature and adult Ny. darlingi at three sites in Mâncio Lima, Acre, during the rainy and dry season (February to September, 2017). From 63 fishponds, 10,859 larvae were collected, including 5,512 first-instar Anophelinae larvae and 4,927 second, third and fourth-instars, of which 8.5% (n = 420) were Ny. darlingi. This species was most abundant in not-abandoned fishponds and in the presence of emerging aquatic vegetation. Seasonal analysis of immatures in urban landscapes found no significant difference in the numbers of Ny. darlingi, corresponding to equivalent population density during the rainy to dry transition period. However, in the rural landscape, significantly higher numbers of Ny. darlingi larvae were collected in August (IRR = 5.80, p = 0.037) and September (IRR = 6.62, p = 0.023) (dry season), compared to February (rainy season), suggesting important role of fishponds for vector population maintenance during the seasonal transition in this landscape type. Adult sampling detected mainly Ny. darlingi (~93%), with similar outdoor feeding behavior, but different abundance according to landscape profile: urban site 1 showed higher peaks of human biting rate in May (46 bites/person/hour), than February (4) and September (15), while rural site 3 shows similar HBR during the same sampling period (22, 24 and 21, respectively). This study contributes to a better understanding of the larvae biology of the main malaria vector in the Vale do Rio Juruá region and, ultimately will support vector control efforts.
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Affiliation(s)
- Paulo Rufalco-Moutinho
- Departamento de Bioestatística, Biologia Vegetal, Parasitologia e Zoologia, Instituto de Biociências de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
- * E-mail:
| | - Samir Moura Kadri
- Instituto de Biotecnologia, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Diego Peres Alonso
- Instituto de Biotecnologia, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Marta Moreno
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Gabriel Carrasco-Escobar
- Laboratorio ICEMR-Amazonia, Laboratorios de Investigacion y Desarrollo, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Catharine Prussing
- Department of Biomedical Sciences, School of Public Health, State University of New York-Albany, Albany, NY, United States of America
- New York State Department of Health, Wadsworth Center, Albany, NY, United States of America
| | - Dionicia Gamboa
- Facultad de Ciencias y Filosofía, Departamento de Ciencias Celulares y Moleculares, Universidad Peruana Cayetano Heredia, Lima, Peru
- Instituto de Medicinal Tropical “Alexander von Humboldt”, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Joseph M. Vinetz
- Laboratorio ICEMR-Amazonia, Laboratorios de Investigacion y Desarrollo, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru
- Instituto de Medicinal Tropical “Alexander von Humboldt”, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, United States of America
| | - Maria Anice Mureb Sallum
- Faculdade de Saúde Pública, Departamento de Epidemiologia, Universidade de São Paulo, São Paulo, Brazil
| | - Jan E. Conn
- Department of Biomedical Sciences, School of Public Health, State University of New York-Albany, Albany, NY, United States of America
- New York State Department of Health, Wadsworth Center, Albany, NY, United States of America
| | - Paulo Eduardo Martins Ribolla
- Departamento de Bioestatística, Biologia Vegetal, Parasitologia e Zoologia, Instituto de Biociências de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
- Instituto de Biotecnologia, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
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Poverty, sanitation, and Leptospira transmission pathways in residents from four Brazilian slums. PLoS Negl Trop Dis 2021; 15:e0009256. [PMID: 33788864 PMCID: PMC8041187 DOI: 10.1371/journal.pntd.0009256] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 04/12/2021] [Accepted: 02/19/2021] [Indexed: 11/19/2022] Open
Abstract
Residents of urban slums suffer from a high burden of zoonotic diseases due to individual, socioeconomic, and environmental factors. We conducted a cross-sectional sero-survey in four urban slums in Salvador, Brazil, to characterize how poverty and sanitation contribute to the transmission of rat-borne leptospirosis. Sero-prevalence in the 1,318 participants ranged between 10.0 and 13.3%. We found that contact with environmental sources of contamination, rather than presence of rat reservoirs, is what leads to higher risk for residents living in areas with inadequate sanitation. Further, poorer residents may be exposed away from the household, and ongoing governmental interventions were not associated with lower transmission risk. Residents at higher risk were aware of their vulnerability, and their efforts improved the physical environment near their household, but did not reduce their infection chances. This study highlights the importance of understanding the socioeconomic and environmental determinants of risk, which ought to guide intervention efforts. Globally, more than 1 billion residents live in urban slums, where inadequate sanitation increases the spread of pathogens and their animal hosts. Leptospirosis is a globally distributed bacterial disease, and in urban areas the bacteria is spread by brown rats. Humans become infected upon exposure to water or soil/mud that was contaminated with the urine of infected rats. In four urban slums in the city of Salvador, Brazil, we used a range of individual, socioeconomic, and environmental variables to understand how they influence to one another and define o leptospirosis exposure in residents. Poverty and sanitation influenced the degree to which residents were exposed to sewer water and mud. Further, we found that while residents tried to improve the physical environment near their household, living in an area with poor sanitation mean that their infection risk remained high. This work highlight the importance of socioeconomic and environmental factors in determining disease risk, and suggests that governmental interventions should focus on improving sanitation changes in the poorest parts of the community.
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Bouton J, Ferreira de Almeida Fiuza L, Cardoso Santos C, Mazzarella MA, Soeiro MDNC, Maes L, Karalic I, Caljon G, Van Calenbergh S. Revisiting Pyrazolo[3,4- d]pyrimidine Nucleosides as Anti- Trypanosoma cruzi and Antileishmanial Agents. J Med Chem 2021; 64:4206-4238. [PMID: 33784107 DOI: 10.1021/acs.jmedchem.1c00135] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Chagas disease and visceral leishmaniasis are two neglected tropical diseases responsible for numerous deaths around the world. For both, current treatments are largely inadequate, resulting in a continued need for new drug discovery. As both kinetoplastid parasites are incapable of de novo purine synthesis, they depend on purine salvage pathways that allow them to acquire and process purines from the host to meet their demands. Purine nucleoside analogues therefore constitute a logical source of potential antiparasitic agents. Earlier optimization efforts of the natural product tubercidin (7-deazaadenosine) involving modifications to the nucleobase 7-position and the ribofuranose 3'-position led to analogues with potent anti-Trypanosoma brucei and anti-Trypanosoma cruzi activities. In this work, we report the design and synthesis of pyrazolo[3,4-d]pyrimidine nucleosides with 3'- and 7-modifications and assess their potential as anti-Trypanosoma cruzi and antileishmanial agents. One compound was selected for in vivo evaluation in an acute Chagas disease mouse model.
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Affiliation(s)
- Jakob Bouton
- Laboratory for Medicinal Chemistry (Campus Heymans), Ghent University, Ottergemsesteenweg 460, B-9000 Gent, Belgium
| | - Ludmila Ferreira de Almeida Fiuza
- Laboratório de Biologia Celular, Instituto Oswaldo Cruz (FIOCRUZ), Fundação Oswaldo Cruz, Rio de Janeiro, Avenida Brasil 4365, Manguinhos, 21040-360 Rio de Janeiro, Brazil
| | - Camila Cardoso Santos
- Laboratório de Biologia Celular, Instituto Oswaldo Cruz (FIOCRUZ), Fundação Oswaldo Cruz, Rio de Janeiro, Avenida Brasil 4365, Manguinhos, 21040-360 Rio de Janeiro, Brazil
| | - Maria Angela Mazzarella
- Department of Pharmaceutical Sciences, University of Perugia, Via del Liceo 1, Perugia 06100, Italy
| | - Maria de Nazaré Correia Soeiro
- Laboratório de Biologia Celular, Instituto Oswaldo Cruz (FIOCRUZ), Fundação Oswaldo Cruz, Rio de Janeiro, Avenida Brasil 4365, Manguinhos, 21040-360 Rio de Janeiro, Brazil
| | - Louis Maes
- Laboratory of Microbiology, Parasitology and Hygiene (LMPH), University of Antwerp, Universiteitsplein 1, B-2610 Wilrijk, Belgium
| | - Izet Karalic
- Laboratory for Medicinal Chemistry (Campus Heymans), Ghent University, Ottergemsesteenweg 460, B-9000 Gent, Belgium
| | - Guy Caljon
- Laboratory of Microbiology, Parasitology and Hygiene (LMPH), University of Antwerp, Universiteitsplein 1, B-2610 Wilrijk, Belgium
| | - Serge Van Calenbergh
- Laboratory for Medicinal Chemistry (Campus Heymans), Ghent University, Ottergemsesteenweg 460, B-9000 Gent, Belgium
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Virtual Screening Based on QSAR and Molecular Docking of Possible Inhibitors Targeting Chagas CYP51. J CHEM-NY 2021. [DOI: 10.1155/2021/6640624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Chagas is a neglected tropical disease caused by the parasite Trypanosoma cruzi with no effective treatment in all its forms. There is a need to find more effective therapeutic alternatives with reduced toxicity. In this contribution, multiple linear regression models were used to identify the molecular descriptors that best describe the inhibitory activity of 52 fenarimol analogues against Trypanosoma cruzi. The topological, physicochemical, thermodynamic, electronic, and charge descriptors were evaluated to cover a wide range of properties that frequently encode biological activity. A model with high predictive value was obtained based on geometrical descriptors and descriptors encoding hydrophobicity and London dispersion forces as necessary for the inhibition of Trypanosoma cruzi-CYP51. Docking methodology was implemented to evaluate molecular interactions in silico. The virtual screening results in this study can be used for rational design of new analogues with improved activity against Chagas disease.
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Torres-Vitolas CA, Dhanani N, Fleming FM. Factors affecting the uptake of preventive chemotherapy treatment for schistosomiasis in Sub-Saharan Africa: A systematic review. PLoS Negl Trop Dis 2021; 15:e0009017. [PMID: 33465076 PMCID: PMC7846123 DOI: 10.1371/journal.pntd.0009017] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 01/29/2021] [Accepted: 11/30/2020] [Indexed: 11/29/2022] Open
Abstract
Background Schistosomiasis affects nearly 220 million people worldwide, mainly in Sub-Saharan Africa (SSA). Preventive chemotherapy (PC) treatment, through regular mass-drug administration (MDA) of Praziquantel tablets remains the control measure of choice by Ministries of Health. Current guidelines recommend that 75% of school-aged children receive treatment. Many programmes, however, struggle to achieve this target. Given the risk of high reinfection rates, attaining sustained high levels of treatment coverage is essential. This study provides a comprehensive review of the barriers and facilitators operating at different levels of analysis, from the individual to the policy level, conditioning the uptake of PC for schistosomiasis in SSA. Methodology/Principal findings A systematic literature search was conducted in several databases for publications released between January 2002 and 2019 that examined factors conditioning the uptake of Praziquantel in the context of MDA campaigns in SSA. A total of 2,258 unique abstracts were identified, of which 65 were selected for full text review and 30 met all eligibility criteria. Joanna Briggs Institute’s Critical Appraisal and the Mixed-Methods Assessment tools were used to assess the strength of the evidence. This review was registered with PROSPERO (CRD42017058525). A meta-synthesis approach was used. Results indicated publication bias, with the literature focusing on East African rural settings and evidence at the individual and programmatic levels. The main influencing factors identified included material wellbeing, drug properties, knowledge and attitudes towards schistosomiasis and MDAs, fears of side effects, gender values, community and health systems support, alongside programme design features, like training, sensitisation, and provision of incentives for drug-distributors. The effect of these factors on determining Praziquantel uptake were explored in detail. Conclusions/Significance Multiple determinants of treatment uptake were found in each level of analysis examined. Some of them interact with each other, thus affecting outcomes directly and indirectly. The promotion of context-based transdisciplinary research on the complex dynamics of treatment uptake is not only desirable, but essential, to design effective strategies to attain high levels of treatment coverage. Schistosomiasis is a parasitic infection that affects nearly 220 million people worldwide. Long-term effects include anaemia, growth stunting, bladder cancer and infertility. Currently, the main approach to schistosomiasis control involves mass preventive chemotherapy treatment. Current guidelines recommend treating 75% of school-aged children but many programmes struggle to achieve this target. This study conducted a comprehensive review of factors conditioning the uptake of treatment in Sub-Saharan Africa across different levels of analysis: individual, interpersonal, organisational, community and policy. This examination showed, first, that the literature suffers of publication bias, with most studies based in rural East African sites and focusing in discussing individual- and policy-level factors. It indicated as well that people’s livelihoods, food security, and school-enrolment, alongside knowledge and attitudinal factors influenced treatment uptake at the individual level. Various contextual factors concerning interpersonal relations, organisations’ resources, and prevalent socio-cultural features (e.g., gender) further shaped people’s responses to MDA campaigns. Finally, it was observed that the effectiveness of programme-level decisions on sensitisation, training, and drug-delivery strategies were constantly re-shaped by mediating factors operating at lower levels of analysis. We conclude that the promotion of context-based transdisciplinary research is essential to design effective strategies to promote sustainable high levels of treatment coverage.
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Affiliation(s)
- Carlos A. Torres-Vitolas
- SCI Foundation, London, United Kingdom
- School of Public Health, Imperial College, London, United Kingdom
- * E-mail:
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Whiteman A, Loaiza JR, Yee DA, Poh KC, Watkins AS, Lucas KJ, Rapp TJ, Kline L, Ahmed A, Chen S, Delmelle E, Oguzie JU. Do socioeconomic factors drive Aedes mosquito vectors and their arboviral diseases? A systematic review of dengue, chikungunya, yellow fever, and Zika Virus. One Health 2020; 11:100188. [PMID: 33392378 PMCID: PMC7772681 DOI: 10.1016/j.onehlt.2020.100188] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 12/17/2022] Open
Abstract
As the threat of arboviral diseases continues to escalate worldwide, the question of, "What types of human communities are at the greatest risk of infection?" persists as a key gap in the existing knowledge of arboviral diseases transmission dynamics. Here, we comprehensively review the existing literature on the socioeconomic drivers of the most common Aedes mosquito-borne diseases and Aedes mosquito presence/abundance. We reviewed a total of 182 studies on dengue viruses (DENV), chikungunya virus (CHIKV), yellow fever virus (YFVV), Zika virus (ZIKV), and presence of Aedes mosquito vectors. In general, associations between socioeconomic conditions and both Aedes-borne diseases and Aedes mosquitoes are highly variable and often location-specific. Although 50% to 60% of studies found greater presence or prevalence of disease or vectors in areas with lower socioeconomic status, approximately half of the remaining studies found either positive or null associations. We discuss the possible causes of this lack of conclusiveness as well as the implications it holds for future research and prevention efforts.
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Affiliation(s)
- Ari Whiteman
- Smithsonian Tropical Research Institute, Panama City, Panama
| | - Jose R. Loaiza
- Smithsonian Tropical Research Institute, Panama City, Panama
- Instituto de Investigaciones Científicas & Servicios de Alta Tecnología, Edificio 219, Clayton PO 0843–01103, Ciudad del Saber, Panama
- Programa Centroamericano de Maestría en Entomología, Universidad de Panamá, Panama
| | - Donald A. Yee
- School of Biological, Environmental, & Earth Sciences, University of Southern Mississippi, Hattiesburg, MS, United States of America
| | - Karen C. Poh
- Department of Entomology, Pennsylvania State University, University Park, PA, United States of America
| | | | - Keira J. Lucas
- Collier Mosquito Control District, Naples, FL, United States of America
| | - Tyler J. Rapp
- University of North Carolina School of Medicine, Chapel Hill, NC, United States of America
| | - Lillie Kline
- Woodward Academy, Atlanta, GA, United States of America
| | - Ayman Ahmed
- Institute of Endemic Diseases, University of Khartoum, Sudan
- World Reference Center for Emerging Viruses and Arboviruses, The Institute for Human Infections and Immunity, Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, United States of America
| | - Shi Chen
- Public Health Sciences, University of North Carolina at Charlotte, United States of America
| | - Eric Delmelle
- Geography and Earth Sciences, University of North Carolina at Charlotte, United States of America
| | - Judith Uche Oguzie
- College of Natural Sciences Redeemer's University, Ede Osun State, Nigeria
- African Center of Excellence for Genomics of Infectious Diseases Redeemer's University Ede, Osun State, Nigeria
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Level of Knowledge and Risk Factors for Visceral Leishmaniasis in a Mining Area of Minas Gerais State, Brazil. Interdiscip Perspect Infect Dis 2020; 2020:6301310. [PMID: 33273915 PMCID: PMC7695497 DOI: 10.1155/2020/6301310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/21/2020] [Accepted: 11/09/2020] [Indexed: 11/17/2022] Open
Abstract
Aiming to optimize and adjust leishmaniasis prevention and control measures for the resident population of Pains, state of Minas Gerais, Brazil, a structured questionnaire containing conceptual questions and questions about household characteristics was used to evaluate knowledge level and exposure risk. A total of 396 individuals were interviewed revealing unscientific and fragmented knowledge about the subject for most of the studied population. The female population was found to have 1.68 times more chance of knowing about the disease than the male population, while highly educated individuals were found to have 2.92 times more chances of knowing about leishmaniasis compared to basic educated individuals. All of the respondents reported the presence of, at least, one risk factor, while ages ≥40 years were considered a protective factor compared to younger ages, indicating that older individuals are more likely to recognize risks and protect themselves against leishmaniasis. These results will contribute to the production of didactic materials for the population with respect to their previous knowledge and will provide a basis for control and prophylactic measures.
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Paz WSD, Gomes DS, Ramos RES, Cirilo TM, Santos IGA, Ribeiro CJN, Araújo KCGMD, Jesus AMRD, Santos ADD, Bezerra-Santos M. Spatiotemporal clusters of schistosomiasis mortality and association with social determinants of health in the Northeast region of Brazil (1980-2017). Acta Trop 2020; 212:105668. [PMID: 32805215 DOI: 10.1016/j.actatropica.2020.105668] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 11/16/2022]
Abstract
The Northeast region of Brazil includes the states with the highest prevalence for schistosomiasis mansoni (SM). This study aimed to evaluate the spatiotemporal patterns of SM mortality and to analyze this association with social determinants in health. We conducted an ecological time series study (1980-2017), using spatial analysis tools. Time trend analysis was performed by joinpoint regression. Maps representing mortality rates for SM were constructed and Moran Index was calculated to analyze spatial autocorrelation. A total of 13,720 deaths from SM were reported in this period. The states of Pernambuco (PE) (50.62%) and Alagoas (AL) (22.09%) had the highest mortality percentages. The mortality rate decreased from 1.28 to 0.63 along the time. Although most states showed a stable trend, Sergipe (SE) and Bahia (BA) showed increasing trends in the latest years. Additionally, the spatial analysis showed the concentration of municipalities that presented high risk in the coastal region of the states of PE, AL, SE, and BA. Lastly, mortality rates were correlated with social and educational indicators and hospitalizations for diarrhea. Altogether, these results demonstrate that some states showed stable or increasing trends of SM mortality in the last period of the studied time interval.
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Affiliation(s)
- Wandklebson Silva da Paz
- Laboratório de Imunologia e Biologia Molecular, Departamento de Patologia, Universidade Federal de Sergipe, Aracaju, Sergipe, Brasil; Programa de Pós-Graduação em Biologia Parasitária, Universidade Federal de Sergipe (PROBP/UFS), São Cristóvão, Sergipe, Brasil.
| | - Dharliton Soares Gomes
- Programa de Pós-Graduação em Biologia Parasitária, Universidade Federal de Sergipe (PROBP/UFS), São Cristóvão, Sergipe, Brasil
| | - Rosália Elen S Ramos
- Programa de Pós-Graduação em Biologia Parasitária, Universidade Federal de Sergipe (PROBP/UFS), São Cristóvão, Sergipe, Brasil
| | - Tatyane Martins Cirilo
- Programa de Pós-Graduação em Biologia Parasitária, Universidade Federal de Sergipe (PROBP/UFS), São Cristóvão, Sergipe, Brasil
| | - Israel Gomes A Santos
- Departamento de Biologia, Universidade Estadual de Alagoas, Santana do Ipanema, Alagoas, Brasil
| | - Caíque Jordan N Ribeiro
- Instituto Federal de Educação, Ciência e Tecnologia de Sergipe (IFS), São Cristóvão, Sergipe, Brasil
| | - Karina Conceição Gomes M de Araújo
- Programa de Pós-Graduação em Biologia Parasitária, Universidade Federal de Sergipe (PROBP/UFS), São Cristóvão, Sergipe, Brasil; Departamento de Morfologia, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brasil
| | - Amélia Maria Ribeiro de Jesus
- Laboratório de Imunologia e Biologia Molecular, Departamento de Patologia, Universidade Federal de Sergipe, Aracaju, Sergipe, Brasil; Departamento de Medicina, Universidade Federal de Sergipe, Aracaju, Sergipe, Brasil
| | - Allan Dantas Dos Santos
- Programa de Pós-graduação em Enfermagem, Universidade Federal de Sergipe (PPGEN/UFS), São Cristóvão, Brasil
| | - Márcio Bezerra-Santos
- Laboratório de Imunologia e Biologia Molecular, Departamento de Patologia, Universidade Federal de Sergipe, Aracaju, Sergipe, Brasil; Programa de Pós-Graduação em Biologia Parasitária, Universidade Federal de Sergipe (PROBP/UFS), São Cristóvão, Sergipe, Brasil; Departamento de Morfologia, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brasil
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Friedler A. Sociocultural, behavioural and political factors shaping the COVID-19 pandemic: the need for a biocultural approach to understanding pandemics and (re)emerging pathogens. Glob Public Health 2020; 16:17-35. [PMID: 33019889 DOI: 10.1080/17441692.2020.1828982] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Although there has been increasing focus in recent years on interdisciplinary approaches to health and disease, and in particular the dimension of social inequalities in epidemics, infectious diseases have been much less focused on. This is especially true in the area of cultural dynamics and their effects on pathogen behaviours, although there is evidence to suggest that this relationship is central to shaping our interactions with infectious disease agents on a variety of levels. This paper makes a case for a biocultural approach to pandemics such as COVID-19. It then uses this biocultural framework to examine the anthropogenic dynamics that influenced and continue to shape the COVID-19 pandemic, both during its initial phase and during critical intersections of the pandemic. Through this understanding of biocultural interactions between people, animals and pathogens, a broader societal and political dimension is drawn as a function of population level and international cultures, to reflect on the culturally mediated differential burden of the pandemic. Ultimately, it is argued that a biocultural perspective on infectious disease pandemics will allow for critical reflection on how culture shapes our behaviours at all levels, and how the effects of these behaviours are ultimately foundational to pathogen ecology and evolution.
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Affiliation(s)
- Anna Friedler
- Département des sciences humaines et sociales, École des Hautes Études en Santé Publique - Campus de Paris, Saint-Denis, France.,l'Unité des Virus Emergents, Aix-Marseille Université, Marseille, France
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Bryson JM, Bishop-Williams KE, Berrang-Ford L, Nunez EC, Lwasa S, Namanya DB, Indigenous Health Adaptation To Climate Change Research Team, Harper SL. Neglected Tropical Diseases in the Context of Climate Change in East Africa: A Systematic Scoping Review. Am J Trop Med Hyg 2020; 102:1443-1454. [PMID: 32228798 DOI: 10.4269/ajtmh.19-0380] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
East Africa is highly affected by neglected tropical diseases (NTDs), which are projected to be exacerbated by climate change. Consequently, understanding what research has been conducted and what knowledge gaps remain regarding NTDs and climate change is crucial to informing public health interventions and climate change adaptation. We conducted a systematic scoping review to describe the extent, range, and nature of publications examining relationships between NTDs and climatic factors in East Africa. We collated all relevant English and French publications indexed in PubMed®, Web of Science™ Core Collection, and CAB Direct© databases published prior to 2019. Ninety-six publications were included for review. Kenya, Tanzania, and Ethiopia had high rates of publication, whereas countries in the Western Indian Ocean region were underrepresented. Most publications focused on schistosomiasis (n = 28, 29.2%), soil-transmitted helminthiases (n = 16, 16.7%), or human African trypanosomiasis (n = 14, 14.6%). Precipitation (n = 91, 94.8%) and temperature (n = 54, 56.3%) were frequently investigated climatic factors, whereas consideration of droughts (n = 10, 10.4%) and floods (n = 4, 4.2%) was not prominent. Publications reporting on associations between NTDs and changing climate were increasing over time. There was a decrease in the reporting of Indigenous identity and age factors over time. Overall, there were substantial knowledge gaps for several countries and for many NTDs. To better understand NTDs in the context of a changing climate, it would be helpful to increase research on underrepresented diseases and regions, consider demographic and social factors in research, and characterize how these factors modify the effects of climatic variables on NTDs in East Africa.
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Affiliation(s)
- Julia M Bryson
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada.,Department of Population Medicine, University of Guelph, Guelph, Canada
| | | | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
| | - Emily C Nunez
- Department of Epidemiology and Biostatistics, Western University, London, Canada.,Department of Population Medicine, University of Guelph, Guelph, Canada
| | - Shuaib Lwasa
- Department of Geography, Geo-Informatics and Climatic Sciences, Makerere University, Kampala, Uganda
| | - Didacus B Namanya
- Department of Community Health, Ugandan Ministry of Health, Kampala, Uganda
| | | | - Sherilee L Harper
- Department of Population Medicine, University of Guelph, Guelph, Canada.,School of Public Health, University of Alberta, Edmonton, Canada
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Botanical Products in the Treatment and Control of Schistosomiasis: Recent Studies and Distribution of Active Plant Resources According to Affected Regions. BIOLOGY 2020; 9:biology9080223. [PMID: 32823660 PMCID: PMC7464741 DOI: 10.3390/biology9080223] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/01/2020] [Accepted: 08/10/2020] [Indexed: 11/21/2022]
Abstract
Schistosomiasis, a parasitic disease caused by trematodes of the genus Schistosoma, is the second most prevalent parasitic disease in the world. It affects around 200 million people. Clinical treatment, prophylaxis, and prevention are performed in countries susceptible to schistosomiasis. In the pharmacological treatment for an acute form of schistosomiasis, the use of antiparasitics, mainly praziquantel, is more common. As an alternative way, prevention methods such as reducing the population of intermediate hosts (mollusks) with molluscicides are important in the control of this disease by interrupting the biological cycle of this etiological parasite. Despite the importance of pharmacological agents and molluscicides, they have side effects and environmental toxicity. In addition, they can lead to the development of resistance enhancing of parasites, and lead to the search for new and effective drugs, including resources of vegetal origin, which in turn, are abundant in the affected countries. Thus, the purpose of this review is to summarize recent studies on botanical products with potential for the control of schistosomiasis, including anti-Schistosoma and molluscicide activities. In addition, species and plant derivatives according to their origin or geographical importance indicating a possible utility of local resources for countries most affected by the disease are presented.
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Gebretsadik D, Tesfaye M, Adamu A, Zewde G. Prevalence of Intestinal Parasitic Infection and Its Associated Factors Among School Children in Two Primary Schools in Harbu Town, North East Ethiopia: Cross-Sectional Study. Pediatric Health Med Ther 2020; 11:179-188. [PMID: 32607051 PMCID: PMC7297451 DOI: 10.2147/phmt.s252061] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/30/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Intestinal parasitic infections (IPIs) are major health problems in many developing countries. School children between the ages of 5 and 15 years suffer the highest infection rate and parasitic burden that are attributed to poor sanitation and hygiene. In Ethiopia, the prevalence of IPIs among school children is high (ranging from 66.7% to 83.8%). METHODS School-based cross-sectional study was conducted in two primary schools at Harbu Town, Northeast Ethiopia from February to May, 2018. Systematic random sampling technique was employed to select study participants from the two school compounds. The sample size was determined by a single population proportion statistical formula and the minimum numbers of study participants defined were 400 school children. Socio-demographic and risk factor-related information were collected using structured questionnaire. Data about detection and identification of intestinal parasites were obtained from laboratory examination of stool specimen by using wet mount and formol-ether concentration techniques. Stool specimen from each study participant was collected using clean, properly labeled and leak-proof stool cup. The data were processed and analyzed using SPSS version 20 software. RESULTS Out of a total of 400 study participants, 86 (21.5%) were found with one or more IPIs. Six different types of intestinal parasites were identified, Entamoeba histolytica was the most 33 (8.3%) detected parasite followed by Hymenolopis nana 19 (4.8%) and Schistosoma mansoni 19 (4.8%). The least identified parasite was Giardia lamblia, detected only from four study participants. Male study participants showed 2.42 times risk (AOR = 2.42, 95% CI = 1.25-4.7, P = 0.009) of acquiring parasitic infection than female. Presence of water body near to home and having contact with water bodies showed 7.64 (AOR= 7.64, 95% CI= 3.3-17.8, P= 0.000) and 4.6 (AOR=4.6, 95% CI: 2.04-10.57, P= 0.000) times risk of infection with parasitic infection among school children, respectively. CONCLUSION IPIs were highly prevalent health problem among the two primary school children in Harbu Town. Sex, availability of water bodies near to house and contact with water bodies were having significant association with the prevalence of IPIs.
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Affiliation(s)
- Daniel Gebretsadik
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Melkam Tesfaye
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Aderaw Adamu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Gashaw Zewde
- Ataye District Hospital, Ataye, North Shoa, Ethiopia
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Wallar LE, De Prophetis E, Rosella LC. Socioeconomic inequalities in hospitalizations for chronic ambulatory care sensitive conditions: a systematic review of peer-reviewed literature, 1990-2018. Int J Equity Health 2020; 19:60. [PMID: 32366253 PMCID: PMC7197160 DOI: 10.1186/s12939-020-01160-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/09/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Hospitalizations for chronic ambulatory care sensitive conditions are an important indicator of health system equity and performance. Chronic ambulatory care sensitive conditions refer to chronic diseases that can be managed in primary care settings, including angina, asthma, and diabetes, with hospitalizations for these conditions considered potentially avoidable with adequate primary care interventions. Socioeconomic inequities in the risk of hospitalization have been observed in several health systems globally. While there are multiple studies examining the association between socioeconomic status and hospitalizations for chronic ambulatory care sensitive conditions, these studies have not been systematically reviewed. The objective of this study is to systematically identify and describe socioeconomic inequalities in hospitalizations for chronic ambulatory care sensitive conditions amongst adult populations in economically developed countries reported in high-quality observational studies published in the peer-reviewed literature. METHODS Peer-reviewed literature was searched in six health and social science databases: MEDLINE, EMBASE, PsycInfo, CINAHL, ASSIA, and IBSS using search terms for hospitalization, socioeconomic status, and chronic ambulatory care sensitive conditions. Study titles and abstracts were first screened followed by full-text review according to the following eligibility criteria: 1) Study outcome is hospitalization for selected chronic ambulatory care sensitive conditions; 2) Primary exposure is individual- or area-level socioeconomic status; 3) Study population has a mean age ± 1 SD < 75 years of age; 4) Study setting is economically developed countries; and 5) Study type is observational. Relevant data was then extracted, and studies were critically appraised using appropriate tools from The Joanna Briggs Institute. Results were narratively synthesized according to socioeconomic constructs and type of adjustment (minimally versus fully adjusted). RESULTS Of the 15,857 unique peer-reviewed studies identified, 31 studies met the eligibility criteria and were of sufficient quality for inclusion. Socioeconomic constructs and hospitalization outcomes varied across studies. However, despite this heterogeneity, a robust and consistent association between lower levels of socioeconomic status and higher risk of hospitalizations for chronic ambulatory care sensitive conditions was observed. CONCLUSIONS This systematic review is the first to comprehensively identify and analyze literature on the relationship between SES and hospitalizations for chronic ambulatory care sensitive conditions, considering both aggregate and condition-specific outcomes that are common to several international health systems. The evidence consistently demonstrates that lower socioeconomic status is a risk factor for hospitalization across global settings. Effective health and social interventions are needed to reduce these inequities and ensure fair and adequate care across socioeconomic groups. TRIAL REGISTRATION PROSPERO CRD42018088727.
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Affiliation(s)
- Lauren E Wallar
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada
| | - Eric De Prophetis
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada
| | - Laura C Rosella
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada.
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