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Ockenden ES, Frischer SR, Cheng H, Noble JA, Chami GF. The role of point-of-care ultrasound in the assessment of schistosomiasis-induced liver fibrosis: A systematic scoping review. PLoS Negl Trop Dis 2024; 18:e0012033. [PMID: 38507368 PMCID: PMC10954168 DOI: 10.1371/journal.pntd.0012033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 02/28/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Abdominal ultrasound imaging is an important method for hepatic schistosomiasis diagnosis and staging. Several ultrasound staging systems have been proposed, each attempting to standardise schistosomal periportal fibrosis (PPF) diagnosis. This review aims to establish the role of ultrasound in the diagnosis and staging of schistosomal PPF, and to map the evolution of ultrasound staging systems over time, focusing on internal validation and external reproducibility. METHODS A systematic search was undertaken on 21st December 2022 considering the following databases: PubMed/MEDLINE (1946-present), Embase (1974-present), Global Health (1973-present), Global Index Medicus (1901-present), and Web of Science Core Collection-Science Citation Index Expanded (1900-present) and the Cochrane Central Register of Controlled Trials (1996-present). Case reports, systematic reviews and meta-analyses, and studies exclusively using transient or shear-wave elastography were excluded. Variables extracted included study design, study population, schistosomal PPF characteristics, and diagnostic methods. The PRISMA-ScR (2018) guidelines were followed to inform the structure of the scoping analysis. RESULTS The initial search yielded 573 unique articles, of which 168 were removed after screening titles and abstracts, 43 were not retrieved due to full texts not being available online or through inter-library loans, and 170 were excluded during full text review. There were 192 remaining studies eligible for extraction. Of the extracted studies, 61.8% (76/123) of studies that reported study year were conducted after the year 2000. Over half of all extracted studies (59.4%; 114/192) were conducted in Brazil (26.0%; 50/192), China (18.8%; 36/192) or Egypt (14.6%; 28/192). For the species of schistosome considered, 77.6% (149/192) of studies considered S. mansoni and 21.4% (41/192) of studies considered S. japonicum. The ultrasound staging systems used took on three forms: measurement-based, feature-based and image pattern-based. The Niamey protocol, a measurement and image pattern-based system, was the most used among the staging systems (32.8%; 63/192), despite being the most recently proposed in 1996. The second most used was the Cairo protocol (20.8%; 40/192). Of the studies using the Niamey protocol, 77.8% (49/63) only used the image patterns element. Where ultrasound technology was specified, studies after 2000 were more likely to use convex transducers (43.4%; 33/76) than studies conducted before 2000 (32.7%; 16/49). Reporting on ultrasound-based hepatic diagnoses and their association with clinical severity was poor. Just over half of studies (56.2%; 108/192) reported the personnel acquiring the ultrasound images. A small number (9.4%; 18/192) of studies detailed their methods of image quality assurance, and 13.0% (25/192) referenced, discussed or quantified the inter- or intra-observer variation of the staging system that was used. CONCLUSIONS The exclusive use of the image patterns in many studies despite lack of specific acquisition guidance, the increasing number of studies over time that conduct ultrasound staging of schistosomal PPF, and the advances in ultrasound technology used since 2000 all indicate a need to consider an update to the Niamey protocol. The protocol update should simplify and prioritise what is to be assessed, advise on who is to conduct the ultrasound examination, and procedures for improved standardisation and external reproducibility.
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Affiliation(s)
- Eloise S. Ockenden
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Sandrena Ruth Frischer
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Huike Cheng
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - J. Alison Noble
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom
| | - Goylette F. Chami
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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2
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Åström M, Thet Lwin ZM, Teni FS, Burström K, Berg J. Use of the visual analogue scale for health state valuation: a scoping review. Qual Life Res 2023; 32:2719-2729. [PMID: 37029258 PMCID: PMC10474194 DOI: 10.1007/s11136-023-03411-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 04/09/2023]
Abstract
OBJECTIVES The visual analogue scale (VAS) has been used in the context of health and healthcare for various purposes, for example, to measure pain and to provide a single-index measure of health-related quality of life (HRQoL). This scoping review aims to describe how the VAS has been used for health state valuation in the published literature. METHODS The search was carried out in Medline, Web of Science and PsycInfo. The findings of the included articles were tabulated and presented descriptively using frequencies and proportions. RESULTS The database search yielded 4856 unique articles, out of these, 308 were included. In 83% of the articles, the main purpose for using a VAS was to value health states. The two most common perspectives when valuing health states with a VAS were hypothetical (44%) and own health (34%). Some (n = 14) articles used the VAS in the context of economic evaluations, including calculating quality-adjusted life years (QALYs). A large variation in the design of the VAS was found, including the description of the lower and upper anchors. Advantages and disadvantages with using a VAS were mentioned in 14% of the included articles. CONCLUSION The VAS has been a common method for valuing health states, both as a stand-alone method and in combination with other valuation methods. Despite its widespread use, the design of the VAS has been inconsistent which makes comparison of results across studies challenging. Further research on the role of using the VAS in economic evaluations is warranted.
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Affiliation(s)
- Mimmi Åström
- Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden.
- Equity and Health Policy Research Group, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
- Centre for Health Economics, Informatics and Health Services Research, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
| | - Zin Min Thet Lwin
- Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden
| | - Fitsum Sebsibe Teni
- Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden
| | - Kristina Burström
- Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden
- Equity and Health Policy Research Group, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Jenny Berg
- Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden
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Wang Q, Zhong Y, Chen N, Chen J. From the immune system to mood disorders especially induced by Toxoplasma gondii: CD4+ T cell as a bridge. Front Cell Infect Microbiol 2023; 13:1078984. [PMID: 37077528 PMCID: PMC10106765 DOI: 10.3389/fcimb.2023.1078984] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/23/2023] [Indexed: 04/05/2023] Open
Abstract
Toxoplasma gondii (T. gondii), a ubiquitous and obligatory intracellular protozoa, not only alters peripheral immune status, but crosses the blood-brain barrier to trigger brain parenchymal injury and central neuroinflammation to establish latent cerebral infection in humans and other vertebrates. Recent findings underscore the strong correlation between alterations in the peripheral and central immune environment and mood disorders. Th17 and Th1 cells are important pro-inflammatory cells that can drive the pathology of mood disorders by promoting neuroinflammation. As opposed to Th17 and Th1, regulatory T cells have inhibitory inflammatory and neuroprotective functions that can ameliorate mood disorders. T. gondii induces neuroinflammation, which can be mediated by CD4+ T cells (such as Tregs, Th17, Th1, and Th2). Though the pathophysiology and treatment of mood disorder have been currently studied, emerging evidence points to unique role of CD4+ T cells in mood disorder, especially those caused by T. gondii infection. In this review, we explore some recent studies that extend our understanding of the relationship between mood disorders and T. gondii.
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Roriz SJ, Pereira TA, Vaz de Melo Trindade G, Caporali JFDM, Lambertucci JR. Quality of Life Assessment Among Patients Living With Hepatosplenic Schistosomiasis and Schistosomal Myeloradiculopathy. Front Med (Lausanne) 2021; 8:629484. [PMID: 34141713 PMCID: PMC8203918 DOI: 10.3389/fmed.2021.629484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 05/10/2021] [Indexed: 12/12/2022] Open
Abstract
Schistosomiasis is a major public health problem in tropical areas of the world. Health-related quality of life (HRQOL) measurement is being widely used to evaluate the impact of a disease or treatment in several aspects of daily life. However, few studies evaluated the impact of severe forms of schistosomiasis on HRQOL of affected individuals and compared them to healthy controls with a similar socio-demographic background. Our aims were to evaluate the HRQOL in patients with hepatosplenic schistosomiasis (HS) and schistosomal myeloradiculopathy (SMR) and healthy volunteers (HV) and determine if clinical complications of the disease are associated with HRQOL scores. We interviewed and evaluated the HRQOL in 49 patients with HS, 22 patients with SMR, and 26 HV from an outpatient clinic of the Federal University of Minas Gerais University Hospital using the WHOQOL-BREF questionnaire. SMR and HS patients had a significantly lower overall quality of life score when comparing with the HV control group (p = 0.003 and p = 0.005, respectively). Multivariate ordinal regression model adjusted for sex, age, and educational level indicated that HS and SMR patients have three and five times more chances of having a lower quality of life than healthy volunteers (Odds Ratio 3.13 and 5.04, respectively). There was no association between complications of HS disease and quality of life scores. In contrast, worse quality of life was observed in SMR patients that presented back or leg pain, leg paresthesia, and bladder dysfunction. In conclusion, HS and SMR significantly impact the overall quality of life of the affected individuals, reinforcing the importance of efforts to control and eradicate this debilitating disease and suggesting that multidisciplinary clinical management of schistosomiasis patients would be more appropriate and could potentially improve patient's quality of life.
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Affiliation(s)
- Silvana Júnia Roriz
- Graduate Program in Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Thiago Almeida Pereira
- Graduate Program in Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.,Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Guilherme Vaz de Melo Trindade
- Graduate Program in Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.,Physiology, School of Medicine, National University of Ireland, Galway, Galway, Ireland
| | - Júlia Fonseca de Morais Caporali
- Graduate Program in Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.,Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - José Roberto Lambertucci
- Graduate Program in Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.,Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Wu LL, Hu HH, Zhang X, Zhou XN, Jia TW, Wang C, Hong Z, Xu J. Cost-effectiveness analysis of the integrated control strategy for schistosomiasis japonica in a lake region of China: a case study. Infect Dis Poverty 2021; 10:79. [PMID: 34049589 PMCID: PMC8161988 DOI: 10.1186/s40249-021-00863-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/19/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Schistosomiasis japonica remains an important public health concern due to its potential to cause severe outcomes and long-term sequelae. An integrated control strategy implemented in the Peoples' Republic of China has been shown to be effective to control or interrupt the transmission of schistosomiasis. The objective of this study is to estimate the disease burden of schistosomiasis and assess the cost-effectiveness of the integrated control strategy focused on different major interventions at three stages for schistosomiasis control in a lake setting, to provide reference for policy making or planning. METHODS Annual cost data of schistosomiasis control during 2009-2019 were obtained from the control program implementers in Jiangling County, Hubei Province, China. Economic costs are provided in constant 2009 Chinese Yuan (CNY). Epidemiological data of schistosomiasis were collected from the Jiangling county station for schistosomiasis control. Disease burden of schistosomiasis was assessed by calculating years of life lost (YLLs) owing to premature death, years lived with disability (YLDs) and disability-adjusted life years (DALYs). DALYs were calculated as the sum of YLLs and YLDs. We then conducted a rudimentary cost-effectiveness analysis by determining the ratio by dividing the difference between the average cost of integrated control strategy at transmission control (2013-2016) or transmission interruption (2017-2019) and the average cost at stage of infection control (2009-2012) with the difference between the DALYs of schistosomiasis at different control stages. Descriptive statistics on the costs and DALYs were used in the analysis. RESULTS The total economic costs for schistosomiasis control in Jiangling County from 2009 to 2019 were approximately CNY 606.88 million. The average annual economic costs for schistosomiasis prevention and control at stages of infection control (2009-2012), transmission control (2013-2016), and transmission interruption (2017-2019) were approximately CNY 41.98 million, CNY 90.19 million and CNY 26.06 million respectively. The overall disease burden caused by schistosomiasis presented a downward trend. Meanwhile, the disease burden of advanced cases showed an upward trend with the DALY increased from 943.72 to 1031.59 person-years. Most disease burden occurred in the age group over 45 years old (especially the elderly over 60 years old). Taking the infection control stage as the control, the incremental cost-effectiveness ratio of integrated control strategy was CNY 8505.5 per case averted, CNY 60 131.6 per DALY decreased at transmission control stage and CNY -2217.6 per case averted, CNY -18 116.0 per DALY decreased at transmission interruption stage. CONCLUSIONS The disease burden of schistosomiasis decreased significantly with the implementation of the integrated prevention and control strategy. Surveillance and management on elder population should be strengthened to decrease diseases burden. There remains a need for well-conducted studies that examine the long-term cost-effectiveness of the integrated control strategy for schistosomiasis. GRAPHIC ABSTARCT.
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Affiliation(s)
- Ling-Ling Wu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, Shanghai, 200025, China
| | - He-Hua Hu
- Jiangling Station of Schistosomiasis Control, Hubei Province, Jiangling, 434100, China
| | - Xia Zhang
- Jiangling Station of Schistosomiasis Control, Hubei Province, Jiangling, 434100, China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, Shanghai, 200025, China
| | - Tie-Wu Jia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, Shanghai, 200025, China
| | - Can Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, Shanghai, 200025, China
| | - Zhong Hong
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, Shanghai, 200025, China
| | - Jing Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, Shanghai, 200025, China.
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6
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Wang J, Wang X, Li H, Yang L, Li Y, Kong C. Spatial distribution and determinants of health loss from Kashin-Beck disease in Bin County, Shaanxi Province, China. BMC Public Health 2021; 21:387. [PMID: 33607974 PMCID: PMC7893884 DOI: 10.1186/s12889-021-10407-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background Kashin-Beck disease (KBD) is one of the major endemic diseases in China, which severely impacts the physical health and life quality of people. A better understanding of the spatial distribution of the health loss from KBD and its influencing factors will help to identify areas and populations at high risk so as to plan for targeted interventions. Methods The data of patients with KBD at village-level were collected to estimate and analyze the spatial pattern of health loss from KBD in Bin County, Shaanxi Province. The years lived with disability (YLDs) index was applied as a measure of health loss from KBD. Spatial autocorrelation methodologies, including Global Moran’s I and Local Moran’s I, were used to describe and map spatial clusters of the health loss. In addition, basic individual information and environmental samples were collected to explore natural and social determinants of the health loss from KBD. Results The estimation of YLDs showed that patients with KBD of grade II and patients over 50 years old contributed most to the health loss of KBD in Bin County. No significant difference was observed between two genders. The spatial patterns of YLDs and YLD rate of KBD were clustered significantly at both global and local scales. Villages in the southwestern and eastern regions revealed higher health loss, while those in the northern regions exhibited lower health loss. This clustering was found to be significantly related to organically bound Se in soil and poverty rate of KBD patients. Conclusions Our results suggest that future treatment and prevention of KBD should focus on endemic areas with high organically bound Se in soil and poor economic conditions. The findings can also provide important information for further exploration of the etiology of KBD. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10407-6.
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Affiliation(s)
- Jing Wang
- Key Laboratory for Geographical Process Analysis & Simulation, Research Institute of Sustainable Development, Central China Normal University, Wuhan, 430079, China.,Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
| | - Xiaoya Wang
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
| | - Hairong Li
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China. .,College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, People's Republic of China.
| | - Linsheng Yang
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China. .,College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, People's Republic of China.
| | - Yingchun Li
- Binxian Center for Disease Prevention and Control, Binxian, 713500, China
| | - Chang Kong
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
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Assessing the Health Loss from Kashin-Beck Disease and Its Relationship with Environmental Selenium in Qamdo District of Tibet, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010011. [PMID: 33375039 PMCID: PMC7792790 DOI: 10.3390/ijerph18010011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/18/2020] [Accepted: 12/19/2020] [Indexed: 01/04/2023]
Abstract
Kashin-Beck Disease (KBD) is one of major endemic diseases in China. In this study, we estimated the health loss from KBD in Qamdo district of Tibet using the years lived with disability (YLD) metric and investigated the influence of environmental selenium (Se) on it by multiple regression model. The results showed that YLD rates produced a different ranking of health loss of KBD from that produced by prevalence rates between Basu and Luolong County, with higher health loss from KBD (43.61 YLD/1000) but lower prevalence (17.86%) in Basu County. YLD rates in two counites were both highest for the 45-64 years age group. Compared with the prevalence rate, the YLD rate had a closer relation to environmental Se and was significantly negatively correlated with Se in both soil and highland barley. The multiple linear regression further revealed that Se contents in cultivated soil and highland barley were main influencing factors for the health loss of KBD, which could explain 90.5% of the variation in YLD rates. The information obtained highlights the significance of the YLD metric in exploring the environmental etiology of KBD and provides important information on which to base decisions on future prevention and control of endemic diseases.
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Jimam NS, Ismail NE, Dayom WD. Evaluation of Psychometric Quality of EQ-5D-5L Scale for Assessing Health-Related Quality of Life of Malaria Patients. Value Health Reg Issues 2020; 22:15-22. [DOI: 10.1016/j.vhri.2019.08.478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/06/2019] [Accepted: 08/21/2019] [Indexed: 11/30/2022]
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Turner HC, French MD, Montresor A, King CH, Rollinson D, Toor J. Economic evaluations of human schistosomiasis interventions: a systematic review and identification of associated research needs. Wellcome Open Res 2020; 5:45. [PMID: 32587899 PMCID: PMC7308887 DOI: 10.12688/wellcomeopenres.15754.2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Schistosomiasis is one of the most prevalent neglected tropical diseases (NTDs) with an estimated 229 million people requiring preventive treatment worldwide. Recommendations for preventive chemotherapy strategies have been made by the World Health Organization (WHO) whereby the frequency of treatment is determined by the settings prevalence. Despite recent progress, many countries still need to scale up treatment and important questions remain regarding optimal control strategies. This paper presents a systematic review of the economic evaluations of human schistosomiasis interventions. Methods: A systematic review of the literature was conducted on 22nd August 2019 using the PubMed (MEDLINE) and ISI Web of Science electronic databases. The focus was economic evaluations of schistosomiasis interventions, such as cost-effectiveness and cost-benefit analyses. No date or language stipulations were applied to the searches. Results: We identified 53 relevant health economic analyses of schistosomiasis interventions. Most studies related to Schistosoma japonicum followed by S. haematobium. Several studies also included other NTDs. In Africa, most studies evaluated preventive chemotherapy, whereas in China they mostly evaluated programmes using a combination of interventions (such as chemotherapy, snail control and health education). There was wide variation in the methodology and epidemiological settings investigated. A range of effectiveness metrics were used by the different studies. Conclusions: Due to the variation across the identified studies, it was not possible to make definitive policy recommendations. Although, in general, the current WHO recommended preventive chemotherapy approach to control schistosomiasis was found to be cost-effective. This finding has important implications for policymakers, advocacy groups and potential funders. However, there are several important inconsistencies and research gaps (such as how the health benefits of interventions are quantified) that need to be addressed to identify the resources required to achieve schistosomiasis control and elimination.
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Affiliation(s)
- Hugo C. Turner
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary’s Campus, Imperial College London, London, W2 1PG, UK
- Oxford University Clinical Research Unit, Wellcome Africa Asia Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Antonio Montresor
- Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, USA
| | - David Rollinson
- Global Schistosomiasis Alliance, Natural History Museum, London, UK
| | - Jaspreet Toor
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
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10
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Turner HC, French MD, Montresor A, King CH, Rollinson D, Toor J. Economic evaluations of human schistosomiasis interventions: a systematic review and identification of associated research needs. Wellcome Open Res 2020; 5:45. [PMID: 32587899 PMCID: PMC7308887 DOI: 10.12688/wellcomeopenres.15754.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2020] [Indexed: 11/05/2023] Open
Abstract
Background: Schistosomiasis is one of the most prevalent neglected tropical diseases (NTDs) with an estimated 229 million people requiring preventive treatment worldwide. Recommendations for preventive chemotherapy strategies have been made by the World Health Organization (WHO) whereby the frequency of treatment is determined by the settings prevalence. Despite recent progress, many countries still need to scale up treatment and important questions remain regarding optimal control strategies. This paper presents a systematic review of the economic evaluations of human schistosomiasis interventions. Methods: A systematic review of the literature was conducted on 22nd August 2019 using the PubMed (MEDLINE) and ISI Web of Science electronic databases. The focus was economic evaluations of schistosomiasis interventions, such as cost-effectiveness and cost-benefit analyses. No date or language stipulations were applied to the searches. Results: We identified 53 relevant health economic analyses of schistosomiasis interventions. Most studies related to Schistosoma japonicum followed by S. haematobium. Several studies also included other NTDs. In Africa, most studies evaluated preventive chemotherapy, whereas in China they mostly evaluated programmes using a combination of interventions (such as chemotherapy, snail control and health education). There was wide variation in the methodology and epidemiological settings investigated. A range of effectiveness metrics were used by the different studies. Conclusions: Due to the variation across the identified studies, it was not possible to make definitive policy recommendations. Although, in general, the current WHO recommended preventive chemotherapy approach to control schistosomiasis was found to be cost-effective. This finding has important implications for policymakers, advocacy groups and potential funders. However, there are several important inconsistencies and research gaps (such as how the health benefits of interventions are quantified) that need to be addressed to identify the resources required to achieve schistosomiasis control and elimination.
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Affiliation(s)
- Hugo C. Turner
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary’s Campus, Imperial College London, London, W2 1PG, UK
- Oxford University Clinical Research Unit, Wellcome Africa Asia Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Antonio Montresor
- Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, USA
| | - David Rollinson
- Global Schistosomiasis Alliance, Natural History Museum, London, UK
| | - Jaspreet Toor
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
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Araujo Navas AL, Osei F, Soares Magalhães RJ, Leonardo LR, Stein A. Modelling the impact of MAUP on environmental drivers for Schistosoma japonicum prevalence. Parasit Vectors 2020; 13:112. [PMID: 32122402 PMCID: PMC7053105 DOI: 10.1186/s13071-020-3987-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 02/21/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The modifiable areal unit problem (MAUP) arises when the support size of a spatial variable affects the relationship between prevalence and environmental risk factors. Its effect on schistosomiasis modelling studies could lead to unreliable parameter estimates. The present research aims to quantify MAUP effects on environmental drivers of Schistosoma japonicum infection by (i) bringing all covariates to the same spatial support, (ii) estimating individual-level regression parameters at 30 m, 90 m, 250 m, 500 m and 1 km spatial supports, and (iii) quantifying the differences between parameter estimates using five models. METHODS We modelled the prevalence of Schistosoma japonicum using sub-provinces health outcome data and pixel-level environmental data. We estimated and compared regression coefficients from convolution models using Bayesian statistics. RESULTS Increasing the spatial support to 500 m gradually increased the parameter estimates and their associated uncertainties. Abrupt changes in the parameter estimates occur at 1 km spatial support, resulting in loss of significance of almost all the covariates. No significant differences were found between the predicted values and their uncertainties from the five models. We provide suggestions to define an appropriate spatial data structure for modelling that gives more reliable parameter estimates and a clear relationship between risk factors and the disease. CONCLUSIONS Inclusion of quantified MAUP effects was important in this study on schistosomiasis. This will support helminth control programmes by providing reliable parameter estimates at the same spatial support and suggesting the use of an adequate spatial data structure, to generate reliable maps that could guide efficient mass drug administration campaigns.
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Affiliation(s)
- Andrea L. Araujo Navas
- Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, PO Box 217, 7500 AE Enschede, The Netherlands
| | - Frank Osei
- Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, PO Box 217, 7500 AE Enschede, The Netherlands
| | - Ricardo J. Soares Magalhães
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, QLD 4343 Australia
- Child Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane, QLD 4101 Australia
| | - Lydia R. Leonardo
- Department of Parasitology, College of Public Health, University of the Philippines Manila, 1000 Manila, Philippines
| | - Alfred Stein
- Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, PO Box 217, 7500 AE Enschede, The Netherlands
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Nascimento GL, Domingues ALC, Ximenes RADA, Itria A, Cruz LN, Oliveira MRFD. Quality of life and quality-adjusted life years of chronic schistosomiasis mansoni patients in Brazil in 2015. Trans R Soc Trop Med Hyg 2019; 112:238-244. [PMID: 29945168 DOI: 10.1093/trstmh/try038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 04/12/2018] [Indexed: 02/06/2023] Open
Abstract
Background Measures of health-related quality of life (HRQoL) have been used to express the impact of neglected diseases and to generate indicators for health economic assessments. Schistosomiasis mansoni is a neglected disease with various clinical manifestations, including severe repercussions, caused by parasitic worms. Here we describe the quality of life of chronic schistosomiasis mansoni patients and estimate the quality-adjusted life years (QALYs) associated with chronic schistosomiasis mansoni in Brazil in 2015. Methods A HRQoL study was carried out using the three-level European Quality of Life 5-Dimensions (EQ-5D-3L) questionnaire in 147 chronic schistosomiasis mansoni patients at an outpatient monitoring facility of an endemic state for schistosomiasis. Results Losses in HRQoL were observed in all five dimensions of the EQ-5D-3L. Patients >60 y and 40-49 y of age reported the highest frequencies of problems. The average utility index was 0.71, and the median index was significantly lower among female patients and patients with comorbidities (0.68; p<0.05) compared with the entire sample. Approximately 26.7 QALYs were estimated for the study population and 31.2 QALYs for the chronic schistosomiasis mansoni patients in Brazil. Conclusions The advanced forms of schistosomiasis mansoni, even during treatment, contribute to important health losses in the population dealing with the disease.
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Affiliation(s)
- Gilmara Lima Nascimento
- Núcleo de Medicina Tropical - Universidade de Brasília. Campus Universitário Darcy Ribeiro, S/N. Asa Norte. Brasília-DF
| | - Ana Lúcia Coutinho Domingues
- Universidade Federal de Pernambuco, Programa de Pós-Graduação em Medicina Tropical. Av. Prof. Moraes Rego - s/n. 50670-901 - Cidade Universitária, Recife-PE
| | - Ricardo Arraes de Alencar Ximenes
- Universidade Federal de Pernambuco, Programa de Pós-Graduação em Medicina Tropical. Av. Prof. Moraes Rego - s/n. 50670-901 - Cidade Universitária, Recife-PE.,National Institute for Science and Technology for Health Technology Assessment (IATS/CNPq), Porto Alegre, Rio Grande do Sul, Brazil
| | - Alexander Itria
- National Institute for Science and Technology for Health Technology Assessment (IATS/CNPq), Porto Alegre, Rio Grande do Sul, Brazil.,Instituto de Patologia Tropical e Saúde Pública - Universidade Federal de Goiás. Rua 235 s/nº - Esq. com 1ª Avenida - Setor Universitário. Goiânia - GO
| | - Luciane Nascimento Cruz
- National Institute for Science and Technology for Health Technology Assessment (IATS/CNPq), Porto Alegre, Rio Grande do Sul, Brazil.,Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630 sala 815. Porto Alegre - RS
| | - Maria Regina Fernandes de Oliveira
- Núcleo de Medicina Tropical - Universidade de Brasília. Campus Universitário Darcy Ribeiro, S/N. Asa Norte. Brasília-DF.,National Institute for Science and Technology for Health Technology Assessment (IATS/CNPq), Porto Alegre, Rio Grande do Sul, Brazil
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Araujo Navas AL, Osei F, Leonardo LR, Soares Magalhães RJ, Stein A. Modeling Schistosoma japonicum Infection under Pure Specification Bias: Impact of Environmental Drivers of Infection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E176. [PMID: 30634518 PMCID: PMC6351909 DOI: 10.3390/ijerph16020176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/18/2018] [Accepted: 01/03/2019] [Indexed: 12/16/2022]
Abstract
Uncertainties in spatial modeling studies of schistosomiasis (SCH) are relevant for the reliable identification of at-risk populations. Ecological fallacy occurs when ecological or group-level analyses, such as spatial aggregations at a specific administrative level, are carried out for an individual-level inference. This could lead to the unreliable identification of at-risk populations, and consequently to fallacies in the drugs’ allocation strategies and their cost-effectiveness. A specific form of ecological fallacy is pure specification bias. The present research aims to quantify its effect on the parameter estimates of various environmental covariates used as drivers for SCH infection. This is done by (i) using a spatial convolution model that removes pure specification bias, (ii) estimating group and individual-level covariate regression parameters, and (iii) quantifying the difference between the parameter estimates and the predicted disease outcomes from the convolution and ecological models. We modeled the prevalence of Schistosoma japonicum using group-level health outcome data, and city-level environmental data as a proxy for individual-level exposure. We included environmental data such as water and vegetation indexes, distance to water bodies, day and night land surface temperature, and elevation. We estimated and compared the convolution and ecological model parameter estimates using Bayesian statistics. Covariate parameter estimates from the convolution and ecological models differed between 0.03 for the nearest distance to water bodies (NDWB), and 0.28 for the normalized difference water index (NDWI). The convolution model presented lower uncertainties in most of the parameter estimates, except for NDWB. High differences in uncertainty were found in night land surface temperature (0.23) and elevation (0.13). No significant differences were found between the predicted values and their uncertainties from both models. The proposed convolution model is able to correct for a pure specification bias by presenting less uncertain parameter estimates. It shows a good predictive performance for the mean prevalence values and for a positive number of infected people. Further research is needed to better understand the spatial extent and support of analysis to reliably explore the role of environmental variables.
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Affiliation(s)
- Andrea L Araujo Navas
- Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, PO Box 217, 7500 AE Enschede, The Netherlands.
| | - Frank Osei
- Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, PO Box 217, 7500 AE Enschede, The Netherlands.
| | - Lydia R Leonardo
- Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, PO Box 217, 7500 AE Enschede, The Netherlands.
| | - Ricardo J Soares Magalhães
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton 4343 QLD, Australia.
- Child Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane 4101 QLD, Australia.
| | - Alfred Stein
- Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, PO Box 217, 7500 AE Enschede, The Netherlands.
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Araujo Navas AL, Soares Magalhães RJ, Osei F, Fornillos RJC, Leonardo LR, Stein A. Modelling local areas of exposure to Schistosoma japonicum in a limited survey data environment. Parasit Vectors 2018; 11:465. [PMID: 30103810 PMCID: PMC6090730 DOI: 10.1186/s13071-018-3039-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 07/27/2018] [Indexed: 01/14/2023] Open
Abstract
Background Spatial modelling studies of schistosomiasis (SCH) are now commonplace. Covariate values are commonly extracted at survey locations, where infection does not always take place, resulting in an unknown positional exposure mismatch. The present research aims to: (i) describe the nature of the positional exposure mismatch in modelling SCH helminth infections; (ii) delineate exposure areas to correct for such positional mismatch; and (iii) validate exposure areas using human positive cases. Methods To delineate exposure areas to Schistosoma japonicum, a spatial Bayesian network (sBN) was constructed. It uses data on exposure risk factors such as: potential sites for snails’ accessibility, geographical distribution of snail infection rate, and cost of the community to access nearby water bodies. Prior and conditional probabilities were obtained from the literature and inserted as weights based on their relative contribution to exposure; these probabilities were then used to calculate joint probabilities of exposure within the sBN. Results High values of probability of S. japonicum exposure correspond to polygons where snails could potentially be present, for instance in wet soils and areas with low slopes, but also where people can easily access water bodies. Low correlation (R2 = 0.3) was found between the percentage of human cases and the delineated probabilities of exposure when validation buffers are generated over the human cases. Conclusions The utility of a probabilistic method for the identification of exposure areas for S. japonicum, with wider application for other water-borne infections, was demonstrated. From a public health perspective, the schistosomiasis exposure sBN developed in this study could be used to guide local schistosomiasis control teams to specific potential areas of exposure, and improve efficiency of mass drug administration campaigns in places where people are likely to be exposed to the infection. Electronic supplementary material The online version of this article (10.1186/s13071-018-3039-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrea L Araujo Navas
- Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, PO Box 217, 7500 AE, Enschede, The Netherlands.
| | - Ricardo J Soares Magalhães
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, QLD, Gatton, 4343, Australia.,Child Health and Environment Program, Child Health Research Centre, The University of Queensland, QLD, South Brisbane, 4101, Australia
| | - Frank Osei
- Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, PO Box 217, 7500 AE, Enschede, The Netherlands
| | - Raffy Jay C Fornillos
- Institute of Biology, College of Science, University of the Philippines Diliman, 1101, Quezon, Philippines
| | - Lydia R Leonardo
- Department of Parasitology, College of Public Health, University of the Philippines Manila, 1000, Manila, Philippines
| | - Alfred Stein
- Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, PO Box 217, 7500 AE, Enschede, The Netherlands
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Li G, Zhou X, Liu J, Chen Y, Zhang H, Chen Y, Liu J, Jiang H, Yang J, Nie S. Comparison of three data mining models for prediction of advanced schistosomiasis prognosis in the Hubei province. PLoS Negl Trop Dis 2018; 12:e0006262. [PMID: 29447165 PMCID: PMC5831639 DOI: 10.1371/journal.pntd.0006262] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 02/28/2018] [Accepted: 01/23/2018] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND In order to better assist medical professionals, this study aimed to develop and compare the performance of three models-a multivariate logistic regression (LR) model, an artificial neural network (ANN) model, and a decision tree (DT) model-to predict the prognosis of patients with advanced schistosomiasis residing in the Hubei province. METHODOLOGY/PRINCIPAL FINDINGS Schistosomiasis surveillance data were collected from a previous study based on a Hubei population sample including 4136 advanced schistosomiasis cases. The predictive models use LR, ANN, and DT methods. From each of the three groups, 70% of the cases (2896 cases) were used as training data for the predictive models. The remaining 30% of the cases (1240 cases) were used as validation groups for performance comparisons between the three models. Prediction performance was evaluated using area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy. Univariate analysis indicated that 16 risk factors were significantly associated with a patient's outcome of prognosis. In the training group, the mean AUC was 0.8276 for LR, 0.9267 for ANN, and 0.8229 for DT. In the validation group, the mean AUC was 0.8349 for LR, 0.8318 for ANN, and 0.8148 for DT. The three models yielded similar results in terms of accuracy, sensitivity, and specificity. CONCLUSIONS/SIGNIFICANCE Predictive models for advanced schistosomiasis prognosis, respectively using LR, ANN and DT models were proved to be effective approaches based on our dataset. The ANN model outperformed the LR and DT models in terms of AUC.
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Affiliation(s)
- Guo Li
- Department of Epidemiology and Health Statistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Xiaorong Zhou
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Jianbing Liu
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Yuanqi Chen
- Department of Mathematics, Wuhan University, Wuhan, Hubei, China
| | - Hengtao Zhang
- Department of Mathematics, Wuhan University, Wuhan, Hubei, China
| | - Yanyan Chen
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Jianhua Liu
- Yichang Center for Disease Control and Prevention, Yichang, Hubei, China
| | - Hongbo Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Junjing Yang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Shaofa Nie
- Department of Epidemiology and Health Statistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Mazumder GA, Uddin A, Chakraborty S. Comparative analysis of codon usage pattern and its influencing factors in Schistosoma japonicum and Ascaris suum. Acta Parasitol 2017; 62:748-761. [PMID: 29035868 DOI: 10.1515/ap-2017-0090] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 07/21/2017] [Indexed: 12/30/2022]
Abstract
Schistosoma japonicum and Ascaris suum are considered as the major parasites of human which cause various life threatening diseases such as schistomiasis and ascariasis. The codon usage bias (CUB) is known as the phenomenon of more usage of a specific codon than the other synonymous codons for an amino acid. The factors that influence the codon usage bias are mutation pressure, natural selection, gene expression, gene length, GC content, RNA stability, recombination rates, codon position etc. Here we had used various bioinformatic tools and statistical analyses to understand the compositional features, expression level and codon usage bias in the genes of these two species.After estimating the effective number of codon (ENC) in both the species, codon usage bias was found to be low and gene expression was high. The nucleobase A and T were used most often than C and G. From neutrality plot and correspondence analysis it was found that both natural selection and mutation pressure played an important role in shaping the codon usage pattern of both species. Moreover, natural selection played a major role while mutation pressure played a minor role in shaping the codon usage bias in S. japonicum and A.suum. This is the first report on the codon usage biology in S. japonicum and A.suum, and the factors influencing their codon usage bias. These results are expected to be useful for genetic engineering and evolutionary studies.
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17
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Wu HW, Fu ZQ, Lu K, Pond-Tor S, Meng R, Hong Y, Chu K, Li H, Jiz M, Liu JM, Hou M, Park S, Lin JJ, Kurtis JD. Vaccination with recombinant paramyosin in Montanide ISA206 protects against Schistosoma japonicum infection in water buffalo. Vaccine 2017; 35:3409-3415. [PMID: 28504194 PMCID: PMC5508600 DOI: 10.1016/j.vaccine.2017.05.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 04/11/2017] [Accepted: 05/03/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Schistosomiasis japonica is a zoonosis and presents significant public health problems in China and the Philippines. Vaccines targeting domestic animals constitute attractive control measures. METHODS We conducted three vaccine trials to evaluate the protective efficacy of recombinant full-length paramyosin (rSj97) in water buffalo. Animals were immunized with 3 doses of rSj97 adjuvanted with ISA206 at 250μg/dose or 500μg/dose at 4wk intervals before challenge with 1000 Schistosoma japonicum cercariae. The primary outcome was worm burden assessed by portal perfusion 8-10weeks post challenge. Safety measures included weight, temperature, body condition score, hemogram and routine assays for hepatic and renal function. RESULTS The three-dose regimen was well tolerated in all three trials. In the first trial, vaccinated buffalo had 51.5% lower worm burden post challenge compared to controls. In the second trial, buffalo immunized with 500μg/dose of rSj97 had 57.8% lower worm burden compared to controls (p=0.026). A similar but not significant reduction (60.9%) was observed with animals administered with 250ug rSj97/dose. In the third trial, buffalo immunized with a 500μg/dose of rSj97 had 57.8% lower worm burden compared to controls (p=0.014). CONCLUSIONS These findings indicated that rSj97 is a safe and promising vaccine candidate for schistosomiasis japonica in water buffalo.
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Affiliation(s)
- Hannah Wei Wu
- Center for International Health Research, Rhode Island Hospital, Brown University Medical School, Providence, RI 02903, USA.
| | - Zhi-Qiang Fu
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, 518 Ziyue Road, Minhang, Shanghai 200241, China
| | - Ke Lu
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, 518 Ziyue Road, Minhang, Shanghai 200241, China
| | - Sunthorn Pond-Tor
- Center for International Health Research, Rhode Island Hospital, Brown University Medical School, Providence, RI 02903, USA
| | - Rui Meng
- Department of Pathogen Biology, Nanjing Medical University, 140 Hanzhong Road, Nanjing 210029, China
| | - Yang Hong
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, 518 Ziyue Road, Minhang, Shanghai 200241, China
| | - Kai Chu
- Department of Pathogen Biology, Nanjing Medical University, 140 Hanzhong Road, Nanjing 210029, China
| | - Hao Li
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, 518 Ziyue Road, Minhang, Shanghai 200241, China
| | - Mario Jiz
- Department of Immunology, Research Institute of Tropical Medicine, Manila, Philippines
| | - Jin-Ming Liu
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, 518 Ziyue Road, Minhang, Shanghai 200241, China
| | - Ming Hou
- Department of Pathogen Biology, Nanjing Medical University, 140 Hanzhong Road, Nanjing 210029, China
| | - Sangshin Park
- Center for International Health Research, Rhode Island Hospital, Brown University Medical School, Providence, RI 02903, USA
| | - Jiao-Jiao Lin
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, 518 Ziyue Road, Minhang, Shanghai 200241, China
| | - Jonathan D Kurtis
- Center for International Health Research, Rhode Island Hospital, Brown University Medical School, Providence, RI 02903, USA.
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Wang W, Li Q, Wei Y, Xue J, Sun X, Yu Y, Chen Z, Li S, Duan L. Novel carbazole aminoalcohols as inhibitors of β-hematin formation: Antiplasmodial and antischistosomal activities. INTERNATIONAL JOURNAL FOR PARASITOLOGY-DRUGS AND DRUG RESISTANCE 2017; 7:191-199. [PMID: 28395189 PMCID: PMC5384886 DOI: 10.1016/j.ijpddr.2017.03.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 03/29/2017] [Accepted: 03/29/2017] [Indexed: 01/24/2023]
Abstract
Malaria and schistosomiasis are two of the most socioeconomically devastating parasitic diseases in tropical and subtropical countries. Since current chemotherapeutic options are limited and defective, there is an urgent need to develop novel antiplasmodials and antischistosomals. Hemozoin is a disposal product formed from the hemoglobin digestion by some blood-feeding parasites. Hemozoin formation is an essential process for the parasites to detoxify free heme, which is a reliable therapeutic target for identifying novel antiparasitic agents. A series of novel carbazole aminoalcohols were designed and synthesized as potential antiplasmodial and antischistosomal agents, and several compounds showed potent in vitro activities against Plasmodium falciparum 3D7 and Dd2 strains and adult and juvenile Schistosoma japonicum. Investigations on the dual antiparasitic mechanisms showed the correlation between inhibitory activity of β-hematin formation and antiparasitic activity. Inhibiting hemozoin formation was identified as one of the mechanisms of action of carbazole aminoalcohols. Compound 7 displayed potent antiplasmodial (Pf3D7 IC50 = 0.248 μM, PfDd2 IC50 = 0.091 μM) and antischistosomal activities (100% mortality of adult and juvenile schistosomes at 5 and 10 μg/mL, respectively) and exhibited low cytotoxicity (CC50 = 7.931 μM), which could be considered as a promising lead for further investigation. Stoichiometry determination and molecular docking studies were also performed to explain the mode of action of compound 7. Carbazole aminoalcohol was confirmed as a novel antiplasmodial and antischistosomal scaffold. The mechanism of action relied on β-hematin formation inhibition. The carbazole aminoalcohols interacted with hematin through forming a 1:1 complex. Compound 7 showed potent antiplasmodial ability (Pf3D7 IC50 = 0.248 μM, PfDd2 IC50 = 0.091 μM). In vitro antischistosomal effect of 7 meets the WHO's criterion of “hit” for schistosomiasis control.
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Affiliation(s)
- Weisi Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Malaria, Schistosomiasis, and Filariasis, Key Laboratory of Parasitology and Vector Biology of the Chinese Ministry of Health, Shanghai 200025, China; ZJU-ENS Joint Laboratory of Medicinal Chemistry, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Qiang Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Malaria, Schistosomiasis, and Filariasis, Key Laboratory of Parasitology and Vector Biology of the Chinese Ministry of Health, Shanghai 200025, China
| | - Yufen Wei
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Malaria, Schistosomiasis, and Filariasis, Key Laboratory of Parasitology and Vector Biology of the Chinese Ministry of Health, Shanghai 200025, China
| | - Jian Xue
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Malaria, Schistosomiasis, and Filariasis, Key Laboratory of Parasitology and Vector Biology of the Chinese Ministry of Health, Shanghai 200025, China
| | - Xiao Sun
- Shanghai Key Laboratory of New Drug Design, School of Pharmacy, East China University of Science and Technology, Shanghai 200237, China
| | - Yang Yu
- Shanghai Key Laboratory of New Drug Design, School of Pharmacy, East China University of Science and Technology, Shanghai 200237, China
| | - Zhuo Chen
- Shanghai Key Laboratory of New Drug Design, School of Pharmacy, East China University of Science and Technology, Shanghai 200237, China
| | - Shizhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Malaria, Schistosomiasis, and Filariasis, Key Laboratory of Parasitology and Vector Biology of the Chinese Ministry of Health, Shanghai 200025, China
| | - Liping Duan
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Malaria, Schistosomiasis, and Filariasis, Key Laboratory of Parasitology and Vector Biology of the Chinese Ministry of Health, Shanghai 200025, China; Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China.
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Park JI, Jung HH. Estimation of years lived with disability due to noncommunicable diseases and injuries using a population-representative survey. PLoS One 2017; 12:e0172001. [PMID: 28196151 PMCID: PMC5308848 DOI: 10.1371/journal.pone.0172001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 01/30/2017] [Indexed: 01/22/2023] Open
Abstract
The Global Burden of Disease 2010 and the WHO Global Health Estimates of years lived with disability (YLDs) uses disability-weights obtained from lay health-state descriptions, which cannot fully reflect different disease manifestations, according to severity, treatment, and environment. The aim of this study was to provide population-representative YLDs of noncommunicable diseases and injuries using a prevalence-based approach, with the disability weight measured in subjects with specific diseases or injuries. We included a total of 44969 adults, who completed the EQ-5D questionnaire as participation in the Korea National Health and Nutrition Examination Survey 2007-2014. We estimated the prevalence of each of 40 conditions identified from the noncommunicable diseases and injuries in the WHO list. Modified condition-specific disability-weight was determined from the adjusted mean difference of the EQ-5D index between the condition and reference groups. Condition-specific YLDs were calculated as the condition's prevalence multiplied by the condition's disability-weight. All-cause YLDs, estimated as "number of population × (1 - mean score of EQ-5D)" were 2165 thousands in 39044 thousand adults aged ≥20. The combined YLDs for all 40 conditions accounted for 67.6% of all-cause YLDs, and were 1604, 2126, 8749, and 12847 per 100000 young (age 20-59) males, young females, old (age ≥60) males, and old females, respectively. Back pain/osteoarthritis YLDs were exceptionally large (442/40, 864/146, 2037/836, and 4644/3039 per 100000 young males, young females, old males, and old females, respectively). Back pain, osteoarthritis, depression, diabetes, periodontitis, and stroke accounted for 22.3%, 9.1%, 4.6%, 3.3%, 3.2%, and 2.9% of all-cause YLDs, respectively. In conclusion, this estimation of YLDs using prevalence rates and disability-weights measured in a population-representative survey may form the basis for population-level strategies to prevent age-related worsening of disability.
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Affiliation(s)
- Ji In Park
- Department of Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Gangwon-do, South Korea
| | - Hae Hyuk Jung
- Department of Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Gangwon-do, South Korea
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Kinung’hi S, Magnussen P, Kaatano G, Olsen A. Infection with Schistosoma mansoni has an Effect on Quality of Life, but not on Physical Fitness in Schoolchildren in Mwanza Region, North-Western Tanzania: A Cross-Sectional Study. PLoS Negl Trop Dis 2016; 10:e0005257. [PMID: 28027317 PMCID: PMC5222294 DOI: 10.1371/journal.pntd.0005257] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 01/09/2017] [Accepted: 12/14/2016] [Indexed: 01/19/2023] Open
Abstract
Background Infection with Schistosoma mansoni negatively impact children’s physical health and may influence their general well-being. The aim of this study was to investigate the effect of S. mansoni infections on a panel of morbidity indicators with emphasis on quality of life (PedsQL; measured in four different dimensions) and physical fitness (measured as VO2 max) among 572 schoolchildren aged 7–8 years. Methodology/Principal findings Prevalence of S. mansoni infections was 58.7%, with an arithmetic mean (95% CI) among positives of 207.3 (169.2–245.4) eggs per gram (epg). Most infections were light (56.5%), while 16.4% had heavy infections. Girls had significantly higher arithmetic mean intensities (95% CI) than boys (247.4 (189.2–305.6) vs. 153.2 (110.6–195.8); P = 0.004). A total of 30.1% were anaemic with no sex difference. Stunting and wasting was found in less than 10% of the population. There was no association between S. mansoni prevalence or intensities and the following parameters: anthropometry, anaemia, liver or spleen pathology in neither univariable nor multivariable linear regression analyses. However, in univariable analyses children with S. mansoni infection had a significantly lower score in emotional PedsQL (95% CI) than uninfected (77.3 (74.5–80.1) vs. 82.7 (79.9–85.5); P = 0.033) and infected children had a higher VO2 max (95% CI) compared to uninfected (51.4 (51.0–51.8) vs. 50.8 (50.3–51.3); P = 0.042). In multivariable linear regression analyses, age, S. mansoni infection, haemoglobin and VO2 max were significant predictors for emotional PedsQL while significant predictors for VO2 max were physical PedsQL, height, age and haemoglobin. S. mansoni infection was thus not retained in the multivariable regression analyses on VO2 max. Conclusions/Significance Of the measured morbidity parameters, S. mansoni infection had a significant effect on the emotional dimension of quality of life, but not on physical fitness. If PedsQL should be a useful tool to measure schistosome related morbidity, more in depth studies are needed in order to refine the tool so it focuses more on aspects of quality of life that may be affected by schistosome infections. Millions of school-age children in Tanzania are infected with Schistosoma mansoni which have an impact on their physical health by reducing growth and fitness, causing anaemia and liver and spleen pathology. Apart from these measurable physical parameters, self-rating of well-being by administration of quality of life questionnaires has been proposed for measuring schistosome related morbidity. A total of 572 schoolchildren aged 7–8 years were examined for S. mansoni infection, anaemia, malnutrition and liver/spleen enlargement. Furthermore, the children participated in a 20 metres shuttle run fitness test and answered a quality of life questionnaire for children. While there was no association between S. mansoni prevalence or intensities and anaemia, malnutrition, fitness or organ enlargement, S. mansoni infected children had a significantly lower self-perceived emotional quality of life. Thus, infected children were more often scared, sad, angry or worried about their future compared to their uninfected peers. More in depth studies are needed in order to refine the questionnaire so it focuses more on aspects of quality of life that may be affected by schistosome infections.
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Affiliation(s)
- Safari Kinung’hi
- National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania
| | - Pascal Magnussen
- Parasitology and Aquatic Diseases, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Centre for Medical Parasitology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Godfrey Kaatano
- National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania
| | - Annette Olsen
- Parasitology and Aquatic Diseases, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
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Lee BY, Bartsch SM, Gorham KM. Economic and financial evaluation of neglected tropical diseases. ADVANCES IN PARASITOLOGY 2015; 87:329-417. [PMID: 25765199 DOI: 10.1016/bs.apar.2015.01.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Economic and financing studies are particularly important for decision-making when resources are scarce or considerably limited. This is the case for neglected tropical diseases (NTDs). In fact, the definition of NTDs is an economic one. The shortage of resources for NTD control may be due in large part to the fact that the burden of NTDs and economic value of control measures have not been fully characterized. A number of economic study methodologies are available: cost of illness can quantify the extent, magnitude, and change of a problem; cost of intervention studies can outline the feasibility and guide the design of a policy or intervention; and cost-benefit, cost-effectiveness, and return-on-investment studies can determine the potential value of different interventions and policies. NTDs have unique characteristics that require special consideration in such analyses. Hence, approaches used for other diseases may need modifications to capture the full impact of NTDs. While the existing literature has made important findings, there is a need for substantially more work, as many NTDs and their associated interventions and policies require more evaluation. With increasing work in this area, NTDs may not be as 'neglected' in the future as they are now.
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Affiliation(s)
- Bruce Y Lee
- Public Health Computational and Operations Research (PHICOR) and International Vaccine Access Center (IVAC), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sarah M Bartsch
- Public Health Computational and Operations Research (PHICOR) and International Vaccine Access Center (IVAC), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Katrin M Gorham
- Public Health Computational and Operations Research (PHICOR) and International Vaccine Access Center (IVAC), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Wang L, Li Z, Shen J, Liu Z, Liang J, Wu X, Sun X, Wu Z. Exosome-like vesicles derived by Schistosoma japonicum adult worms mediates M1 type immune- activity of macrophage. Parasitol Res 2015; 114:1865-73. [PMID: 25855345 DOI: 10.1007/s00436-015-4373-7] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 02/04/2015] [Indexed: 02/08/2023]
Abstract
Exosomes are 30-100-nm membrane vesicles of endocytic origin that are released into the extracellular space upon fusion of the multi-vesicular bodies (MVB) with the plasma membrane, while initial studies described that the role of exosomes was a reticulocyte cargo-disposal mechanism allowing remodeling of the plasma membrane during the maturation of reticulocytes to erythrocytes. Recent studies indicate that exosomes are secreted by most cells and pathogens and play an important role in intercellular signaling and exert regulatory function by carrying bioactive molecules. As numerous pathogens, adult worm of Schistosoma japonicum (S. japonicum) reside in mesenteric veins of definitive host including man and mammal animals. It was reported that the worms or the eggs also have specialized secretion systems to export effector proteins or other molecules into host target cells. However, the mechanisms involved remained unclear. This study investigated the isolation of the exosome-like vesicles secreted by S. japonicum adult worms and its immune activity on microphage in vitro. In this report, we identified exosome-based secretion as a new mechanism for protein secretion by S. japonicum. Electron microscopy tomography revealed the previously unidentified ultrastructural detail of exosome-like vesicles with high resolution; they were found to be typical spherical shape and to have a diverse population that varies in size of 30-100 nm. Exosome-like vesicles isolated from S. japonicum contained a significantly different protein compared with debris pelleted and the apoptosis body. We also demonstrate that macrophages were preferentially differentiated into the M1 subtype while being treated with S. japonicum exosome-like vesicles. This study reveals there are exosome-like vesicles derived by S. japonicum adult worms, and the exosome-like vesicles can mediate M1-type immune- activity of macrophage.
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Affiliation(s)
- Lifu Wang
- Key Laboratory of Tropical Diseases and Control of the Ministry of Education, Sun Yat-sen University, Guangzhou, China
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Yang GJ, Utzinger J, Zhou XN. Interplay between environment, agriculture and infectious diseases of poverty: case studies in China. Acta Trop 2015; 141:399-406. [PMID: 23906612 PMCID: PMC7117482 DOI: 10.1016/j.actatropica.2013.07.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 07/14/2013] [Accepted: 07/17/2013] [Indexed: 11/28/2022]
Abstract
Changes in the natural environment and agricultural systems induced by economic and industrial development, including population dynamics (growth, urbanization, migration), are major causes resulting in the persistence, emergence and re-emergence of infectious diseases in developing countries. In the face of rapid demographic, economic and social transformations, the People's Republic of China (P.R. China) is undergoing unprecedented environmental and agricultural change. We review emerging and re-emerging diseases such as schistosomiasis, dengue, avian influenza, angiostrongyliasis and soil-transmitted helminthiasis that have occurred in P.R. China due to environmental and agricultural change. This commentary highlights the research priorities and the response strategies, namely mitigation and adaptation, undertaken to eliminate the resurgence of those infectious diseases.
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Affiliation(s)
- Guo-Jing Yang
- Jiangsu Institute of Parasitic Diseases, Wuxi 214064, People's Republic of China; Key Laboratory on Control Technology for Parasitic Diseases, Ministry of Health, Wuxi 214064, People's Republic of China; School of Public Health and Primary Care, The Chinese University of Hong Kong, Satin, Hong Kong
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; University of Basel, P.O. Box, CH-4003 Basel, Switzerland
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, People's Republic of China; Key Laboratory on Biology of Parasite and Vector, Ministry of Health, Shanghai 200025, People's Republic of China; WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, People's Republic of China.
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King CH. Health metrics for helminth infections. Acta Trop 2015; 141:150-60. [PMID: 24333545 DOI: 10.1016/j.actatropica.2013.12.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 11/30/2013] [Accepted: 12/03/2013] [Indexed: 01/13/2023]
Abstract
Health metrics based on health-adjusted life years have become standard units for comparing the disease burden and treatment benefits of individual health conditions. The Disability-Adjusted Life Year (DALY) and the Quality-Adjusted Life Year (QALY) are the most frequently used in cost-effect analyses in national and global health policy discussions for allocation of health care resources. While sometimes useful, both the DALY and QALY metrics have limitations in their ability to capture the full health impact of helminth infections and other 'neglected tropical diseases' (NTDs). Gaps in current knowledge of disease burden are identified, and interim approaches to disease burden assessment are discussed.
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Eco-social determinants of Schistosoma japonicum infection supported by multi-level modelling in Eryuan county, People's Republic of China. Acta Trop 2015; 141:391-8. [PMID: 24751418 DOI: 10.1016/j.actatropica.2014.04.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 04/03/2014] [Accepted: 04/08/2014] [Indexed: 01/25/2023]
Abstract
Schistosomiasis remains of considerable public health concern in many tropical and subtropical regions of the world, including the People's Republic of China (P.R. China). The effectiveness of schistosomiasis control interventions are, among other factors, governed by the social-ecological context. However, eco-social determinants of schistosomiasis are poorly understood, particularly at the household or village levels. In the current study, residents in 26 villages of Eryuan county, Yunnan province, P.R. China, were screened for Schistosoma japonicum infection with a serological assay that was followed by stool examination for sero-positive individuals. Bayesian multilevel models with spatial random effects were employed to profile the S. japonicum infection risk based on known transmission sites of S. japonicum that are scattered across individual land parcels in this part of the country. The key risk factors identified with this approach were the absence of a sanitary stall house for livestock and presence of living and infected intermediate host snails in close proximity. We conclude that a spatially explicit Bayesian multilevel approach can deepen our understanding of eco-social determinants that govern schistosomiasis transmission at a small geographical scale.
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Xu JF, Lv S, Wang QY, Qian MB, Liu Q, Bergquist R, Zhou XN. Schistosomiasis japonica: modelling as a tool to explore transmission patterns. Acta Trop 2015; 141:213-22. [PMID: 25004441 DOI: 10.1016/j.actatropica.2014.06.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 06/22/2014] [Accepted: 06/27/2014] [Indexed: 11/26/2022]
Abstract
Modelling is an important tool for the exploration of Schistosoma japonicum transmission patterns. It provides a general theoretical framework for decision-makers and lends itself specifically to assessing the progress of the national control programme by following the outcome of surveys. The challenge of keeping up with the many changes of social, ecological and environmental factors involved in control activities is greatly facilitated by modelling that can also indicate which activities are critical and which are less important. This review examines the application of modelling tools in the epidemiological study of schistosomiasis japonica during the last 20 years and explores the application of enhanced models for surveillance and response. Updated and timely information for decision-makers in the national elimination programme is provided but, in spite of the new modelling techniques introduced, many questions remain. Issues on application of modelling are discussed with the view to improve the current situation with respect to schistosomiasis japonica.
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Hürlimann E, Houngbedji CA, Yapi RB, Ndri PB, Silué KD, Soro G, Kouamé FN, Fürst T, Utzinger J, N'Goran EK, Raso G. Health-related quality of life among school children with parasitic infections: findings from a national cross-sectional survey in Côte d'Ivoire. PLoS Negl Trop Dis 2014; 8:e3287. [PMID: 25474579 PMCID: PMC4256278 DOI: 10.1371/journal.pntd.0003287] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 09/22/2014] [Indexed: 12/28/2022] Open
Abstract
Background Parasitic infections are still of considerable public health relevance, notably among children in low- and middle-income countries. Measures to assess the magnitude of ill-health in infected individuals, however, are debated and patient-based proxies through generic health-related quality of life (HrQoL) instruments are among the proposed strategies. Disability estimates based on HrQoL are still scarce and conflicting, and hence, there is a need to strengthen the current evidence-base. Methodology Between November 2011 and February 2012, a national school-based cross-sectional survey was conducted in Côte d'Ivoire. Children underwent parasitological and clinical examination to assess infection status with Plasmodium and helminth species and clinical parameters, and responded to a questionnaire interview incorporating sociodemographic characteristics, self-reported morbidity, and HrQoL. Validity analysis of the HrQoL instrument was performed, assessing floor and ceiling effects, internal consistency, and correlation with morbidity scores. Multivariate regression models were applied to identify significant associations between HrQoL and children's parasitic infection and clinical status. Principal Findings Parasitological examination of 4,848 children aged 5–16 years revealed Plasmodium spp., hookworm, Schistosoma haematobium, Schistosoma mansoni, Ascaris lumbricoides, and Trichuris trichiura prevalences of 75.0%, 17.2%, 5.7%, 3.7%, 1.8%, and 1.3%, respectively. Anemic children showed a significant 1-point reduction in self-rated HrQoL on a scale from 0 to 100, whereas no significant negative association between HrQoL and parasite infection was observed. The 12-item HrQoL questionnaire proofed useful, as floor and ceiling effects were negligible, internally consistent (Cronbach's alpha = 0.71), and valid, as revealed by significant negative correlations and associations with children's self-reported and clinically assessed morbidity. Conclusions/Significance Our results suggest that HrQoL tools are not sufficiently sensitive to assess subtle morbidities due to parasitic infection in Ivorian school-aged children. However, more advanced morbid sequelae (e.g., anemia), were measurable by the instrument's health construct. Further investigations on health impacts of parasitic infection among school-aged children and refinement of generic HrQoL questionnaires are warranted. Infectious diseases like malaria and parasitic worms affect hundreds of millions of people, and impact physical and cognitive development of children in Africa, Asia, and the Americas. Over the past 20 years, it was debated how the magnitude of ill-health due to these conditions should be assessed. One proposed strategy was to include patient-based ratings of wellbeing by administration of health-related quality of life (HrQoL) questionnaires. In order to provide new evidence on disability from parasitic infections, we conducted HrQoL interviews with children aged 5–16 years from 92 schools across Côte d'Ivoire. Children were examined for parasitic infections and clinical signs like anemia, malnutrition, and organ enlargement. We compared the self-rated HrQoL of infected and non-infected children and also considered their sociodemographic background. We could not identify lowered HrQoL in infected children, but we found that children with anemia reported a 1-point lower score on a 100-point HrQoL scale in comparison with their non-anemic counterparts. We consider our HrQoL questionnaire as useful and valid, but would recommend its further testing and development in few purposefully selected settings. Further investigation of disability induced by malaria and parasitic worm infections is warranted.
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Affiliation(s)
- Eveline Hürlimann
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Clarisse A. Houngbedji
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche Sciences de la Nature, Université Nangui Abrogoua, Abidjan, Côte d'Ivoire
| | - Richard B. Yapi
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Prisca B. Ndri
- Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche Sciences de la Nature, Université Nangui Abrogoua, Abidjan, Côte d'Ivoire
| | - Kigbafori D. Silué
- Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Gotianwa Soro
- Programme National de Santé Scolaire et Universitaire, Abidjan, Côte d'Ivoire
| | - Ferdinand N. Kouamé
- Programme National de Santé Scolaire et Universitaire, Abidjan, Côte d'Ivoire
| | - Thomas Fürst
- Centre for Health Policy, Imperial College London, London, United Kingdom
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Eliézer K. N'Goran
- Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Giovanna Raso
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- * E-mail:
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Involvement of IL-13 and tissue transglutaminase in liver granuloma and fibrosis after schistosoma japonicum infection. Mediators Inflamm 2014; 2014:753483. [PMID: 25110399 PMCID: PMC4106180 DOI: 10.1155/2014/753483] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 05/20/2014] [Accepted: 06/05/2014] [Indexed: 11/24/2022] Open
Abstract
Schistosomiasis, one of the most devastating parasitic diseases, is caused by Schistosoma japonicum (Sj) infection resulting in serious liver fibrosis. Interleukin- (IL-) 13, which is produced by TH2 cells, is a critical profibrotic cytokine found in various organs, including the liver. Tissue transglutaminase (tTG), a group of multifunctional enzymes, serves a central function in the pathogenesis of chronic liver diseases. However, the relationship between IL-13, tTG, and liver fibrosis during Schistosoma infection has not been established. This study investigated the involvement of IL-13 and tTG in liver fibrogenesis during Sj infection in mice. Five weeks after Sj infection, granuloma and fibrosis development in the liver coincided with an increase in IL-13 and tTG in the liver and the upregulation of serum IL-13 in infected mice. Administration of cystamine, an inhibitor of tTG, abrogated the increase in both tTG and IL-13 in infected mice and ameliorated liver fibrogenesis and granuloma development. This result establishes a novel link among IL-13, tTG, and liver granuloma and fibrosis under Sj infection. Based on their important functions in liver fibrosis induced by Sj infection, IL-13 and tTG could be promising potential drug targets against schistosomiasis.
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Chen MG. Assessment of morbidity due to Schistosoma japonicum infection in China. Infect Dis Poverty 2014; 3:6. [PMID: 24529186 PMCID: PMC3928580 DOI: 10.1186/2049-9957-3-6] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 02/11/2014] [Indexed: 12/27/2022] Open
Abstract
This paper presents a historical assessment of morbidity due to the Schistosoma japonicum infection in China. Due to the socio-economic situation, which did not allow for a control program to be implemented until the early 1950s, morbidity was serious and mortality was high before this. Based on a few investigations and published papers, it can be said that the disease caused millions of deaths, and destroyed numerous families and villages. Since the 1950s, there has been a national control program, intensive control and prevention work has been carried out, and consequently the disease is being controlled. At present, both the prevalence and the morbidity of the disease have been decreasing substantially. The morbidity of the three phases of the disease is outlined in this paper. Comparatively higher morbidity is seen in the acute and advanced phases of the disease. The four major forms of advanced schistosomiasis i.e., ascites, megalosplenia, dwarfism, and colonic tumoroid proliferation, are outlined with their characteristic clinical presentations; their proportions are different during various periods of the national control program. Ectopic schistosomiasis and the relationship between the S. japonicum infection and colorectal cancer are also discussed. Post-transmission schistosomiasis is briefly discussed (which can happen even if the disease reaches the criteria of elimination, and the infection and transmission have stopped, but yet it still develops). The problem of mammalian reservoir hosts of S. japonicum makes the epidemiology and control of schistosomiasis in China even more complicated and arduous, and the control progress in animal reservoirs is briefly presented.
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Affiliation(s)
- Ming-Gang Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China.
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Xu J, Zhang H, Chen L, Zhang D, Ji M, Wu H, Wu G. Schistosoma japonicum infection induces macrophage polarization. J Biomed Res 2014; 28:299-308. [PMID: 25050114 PMCID: PMC4102844 DOI: 10.7555/jbr.27.20130072] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 07/26/2013] [Accepted: 11/19/2013] [Indexed: 01/30/2023] Open
Abstract
The role of macrophages (Mφ) as the first line of host defense is well accepted. These cells play a central role in orchestrating crucial functions during schistosomal infection. Thus, understanding the functional diversity of these cells in the process of infection as well as the mechanisms underlying these events is crucial for developing disease control strategies. In this study, we adopted a Mφ polarization recognition system. M1 macrophage was characterized by expressing CD16/32, IL-12 and iNOS. M2 macrophage was characterized by expressing CD206, IL-10 and arg-1. In vivo (mouse peritoneal macrophages of different infection stages were obtained) and in vitro (different S. japonicum antigens were used to stimulate RAW264.7) were characterized by using the above mentioned system. NCA and ACA stimulated RAW264.7 express significantly higher levels of IL-12 while significantly higher levels of IL-10 were detected after soluble egg antigen (SEA) stimulation. The results showed that dramatic changes of antigen in the microenvironment before and after egg production led to macrophage polarization. Furthermore, through TLR blocking experiments, the TLR4 signaling pathway was found to play a role in the process of macrophage polarization toward M1. Our data suggest that macrophage polarization during S. japonicum infection had significant effects on host immune responses to S. japonicum.
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Affiliation(s)
- Jingwei Xu
- Department of Pathogen Biology and Immunology, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Hao Zhang
- Department of Pathogen Biology and Immunology, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Lin Chen
- Department of Pathogen Biology and Immunology, Nanjing Medical University, Nanjing, Jiangsu 210029, China. ; Jiangsu Province Key Laboratory of Modern Pathogen Biology, Nanjing, Jiangsu 210029, China
| | - Donghui Zhang
- Department of Pathogen Biology and Immunology, Nanjing Medical University, Nanjing, Jiangsu 210029, China. ; Jiangsu Province Key Laboratory of Modern Pathogen Biology, Nanjing, Jiangsu 210029, China
| | - Minjun Ji
- Department of Pathogen Biology and Immunology, Nanjing Medical University, Nanjing, Jiangsu 210029, China. ; Jiangsu Province Key Laboratory of Modern Pathogen Biology, Nanjing, Jiangsu 210029, China
| | - Haiwei Wu
- Department of Pathogen Biology and Immunology, Nanjing Medical University, Nanjing, Jiangsu 210029, China. ; Jiangsu Province Key Laboratory of Modern Pathogen Biology, Nanjing, Jiangsu 210029, China. ; Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Guanling Wu
- Department of Pathogen Biology and Immunology, Nanjing Medical University, Nanjing, Jiangsu 210029, China. ; Jiangsu Province Key Laboratory of Modern Pathogen Biology, Nanjing, Jiangsu 210029, China
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Won KY, Abudho B, Blackstock AJ, Montgomery SP, Kennedy ED, Person B, Mwinzi PNM, Ochola EA, Foo KT, Hightower AW, Karanja DMS, Secor WE. Assessment of quality of life as a tool for measuring morbidity due to Schistosoma mansoni infection and the impact of treatment. Am J Trop Med Hyg 2013; 90:322-8. [PMID: 24323511 DOI: 10.4269/ajtmh.13-0361] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Recently, health measurements have broadened to include the assessment of quality of life (QOL). This study was conducted to assess whether the short form of the World Health Organization (WHO) QOL questionnaire (WHOQOL-BREF) was an effective tool for measuring morbidity due to Schistosoma mansoni infection and whether it could detect an impact of treatment with praziquantel. A total of 724 adults 18-85 years of age were enrolled. At baseline, S. mansoni prevalence was 73.2% by stool examination and 75.4% by circulating cathodic antigen, and there was no association between infection status and WHOQOL-BREF scores. Six months after treatment, S. mansoni prevalence was lower and the proportion of persons with higher WHOQOL-BREF scores significantly increased among persons who were infected at baseline. However, a similar increase was observed in persons not infected at baseline. In areas of high prevalence, the WHOQOL-BREF may not be able to detect the benefits of schistosomiasis control programs.
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Affiliation(s)
- Kimberly Y Won
- Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
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Abou-Zeid AH, Abkar TA, Mohamed RO. Schistosomiasis infection among primary school students in a war zone, Southern Kordofan State, Sudan: a cross-sectional study. BMC Public Health 2013; 13:643. [PMID: 23845226 PMCID: PMC3729662 DOI: 10.1186/1471-2458-13-643] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 07/10/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schistosomiasis is a major health problem adversely affecting the health of vulnerable populations in Sudan. METHODS We conducted a school-based survey to estimate the prevalence of schistosomiasis in 36 villages in Southern Kordofan (SK) State. A total of 2,302 primary school students were recruited. Each student completed a questionnaire and submitted one urine and one stool sample. RESULTS The prevalence of schistosomiasis haematobium was 23.7%, while schistosomiasis mansoni was not detected among the study participants. S. haematobium infection was identified in all areas, with the highest prevalence in the western locality of SK State. The infection was associated with the distance between home/school and open water sources. In addition, S. haematobium infection was associated with the existence of and distance to open water sources, higher frequency of contact with open water, absence of a health advocacy group in the school and history of schistosomiasis treatment. CONCLUSIONS This study highlights schistosomiasis as a public health problem in SK State. The findings will guide the schistosomiasis Control Program of the State Ministry of Health in developing and applying treatment plans for schistosomiasis in SK State.
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Affiliation(s)
- Alaa H Abou-Zeid
- Public Health Department, Faculty of Medicine, Cairo University, Kasr Al Ainy St., Cairo, Egypt.
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Kumar S, Biswal DK, Tandon V. In-silico analysis of caspase-3 and -7 proteases from blood-parasitic Schistosoma species (Trematoda) and their human host. Bioinformation 2013; 9:456-63. [PMID: 23847399 PMCID: PMC3705615 DOI: 10.6026/97320630009456] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Revised: 10/21/2012] [Accepted: 04/17/2013] [Indexed: 12/24/2022] Open
Abstract
Proteolytic enzymes of the caspase family, which reside as latent precursors in most nucleated metazoan cells, are core effectors of apoptosis. Of them, the executioner caspases- 3 and -7 exist within the cytosol as inactive dimers and are activated by a process called dimerization. Caspase inhibition is looked upon as a promising approach for treating multiple diseases. Though caspases have been extensively studied in the human system, their role in eukaryotic pathogens and parasites of human hosts has not drawn enough attention. In protein sequence analysis, caspases of blood flukes (Schistosoma spp) were revealed to have a low sequence identity with their counterparts in human and other mammalian hosts, which encouraged us to analyse interacting domains that participate in dimerization of caspases in the parasite and to reveal differences, if any, between the host-parasite systems. Significant differences in the molecular surface arrangement of the dimer interfaces reveal that in schistosomal caspases only eight out of forty dimer conformations are similar to human caspase structures. Thus, the parasite-specific dimer conformations (that are different from caspases of the host) may emerge as potential drug targets of therapeutic value against schistosomal infections. Three important factors namely, the size of amino acids, secondary structures and geometrical arrangement of interacting domains influence the pattern of caspase dimer formation, which, in turn, is manifested in varied structural conformations of caspases in the parasite and its human hosts.
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Affiliation(s)
- Shakti Kumar
- Bioinformatics Centre, North-Eastern Hill University, Shillong 793022, Meghalaya, India
- Department of Zoology, North-Eastern Hill University, Shillong 793022, Meghalaya, India
| | - Devendra Kumar Biswal
- Bioinformatics Centre, North-Eastern Hill University, Shillong 793022, Meghalaya, India
| | - Veena Tandon
- Bioinformatics Centre, North-Eastern Hill University, Shillong 793022, Meghalaya, India
- Department of Zoology, North-Eastern Hill University, Shillong 793022, Meghalaya, India
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Lv S, Tian LG, Liu Q, Qian MB, Fu Q, Steinmann P, Chen JX, Yang GJ, Yang K, Zhou XN. Water-related parasitic diseases in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:1977-2016. [PMID: 23685826 PMCID: PMC3709360 DOI: 10.3390/ijerph10051977] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 05/01/2013] [Accepted: 05/02/2013] [Indexed: 12/17/2022]
Abstract
Water-related parasitic diseases are directly dependent on water bodies for their spread or as a habitat for indispensable intermediate or final hosts. Along with socioeconomic development and improvement of sanitation, overall prevalence is declining in the China. However, the heterogeneity in economic development and the inequity of access to public services result in considerable burden due to parasitic diseases in certain areas and populations across the country. In this review, we demonstrated three aspects of ten major water-related parasitic diseases, i.e., the biology and pathogenicity, epidemiology and recent advances in research in China. General measures for diseases control and special control strategies are summarized.
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Affiliation(s)
- Shan Lv
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China; E-Mails: (S.L.); (L.-G.T.); (Q.L.); (M.-B.Q.); (Q.F.); (P.S.); (J.-X.C.)
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, China
| | - Li-Guang Tian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China; E-Mails: (S.L.); (L.-G.T.); (Q.L.); (M.-B.Q.); (Q.F.); (P.S.); (J.-X.C.)
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, China
| | - Qin Liu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China; E-Mails: (S.L.); (L.-G.T.); (Q.L.); (M.-B.Q.); (Q.F.); (P.S.); (J.-X.C.)
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, China
| | - Men-Bao Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China; E-Mails: (S.L.); (L.-G.T.); (Q.L.); (M.-B.Q.); (Q.F.); (P.S.); (J.-X.C.)
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, China
| | - Qing Fu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China; E-Mails: (S.L.); (L.-G.T.); (Q.L.); (M.-B.Q.); (Q.F.); (P.S.); (J.-X.C.)
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, China
| | - Peter Steinmann
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China; E-Mails: (S.L.); (L.-G.T.); (Q.L.); (M.-B.Q.); (Q.F.); (P.S.); (J.-X.C.)
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, China
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, University of Basel, Basel 4051, Switzerland
| | - Jia-Xu Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China; E-Mails: (S.L.); (L.-G.T.); (Q.L.); (M.-B.Q.); (Q.F.); (P.S.); (J.-X.C.)
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, China
| | - Guo-Jing Yang
- Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China; E-Mails: (G.-J.Y.); (K.Y.)
- School of Public Health and Primary Care, The Jockey Club Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kun Yang
- Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China; E-Mails: (G.-J.Y.); (K.Y.)
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China; E-Mails: (S.L.); (L.-G.T.); (Q.L.); (M.-B.Q.); (Q.F.); (P.S.); (J.-X.C.)
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, China
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Terer CC, Bustinduy AL, Magtanong RV, Muhoho N, Mungai PL, Muchiri EM, Kitron U, King CH, Mutuku FM. Evaluation of the health-related quality of life of children in Schistosoma haematobium-endemic communities in Kenya: a cross-sectional study. PLoS Negl Trop Dis 2013; 7:e2106. [PMID: 23505590 PMCID: PMC3591318 DOI: 10.1371/journal.pntd.0002106] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 01/29/2013] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Schistosomiasis remains a global public health challenge, with 93% of the ~237 million infections occurring in sub-Saharan Africa. Though rarely fatal, its recurring nature makes it a lifetime disorder with significant chronic health burdens. Much of its negative health impact is due to non-specific conditions such as anemia, undernutrition, pain, exercise intolerance, poor school performance, and decreased work capacity. This makes it difficult to estimate the disease burden specific to schistosomiasis using the standard DALY metric. METHODOLOGY/PRINCIPAL FINDINGS In our study, we used Pediatric Quality of Life Inventory (PedsQL), a modular instrument available for ages 2-18 years, to assess health-related quality of life (HrQoL) among children living in a Schistosoma haematobium-endemic area in coastal Kenya. The PedsQL questionnaires were administered by interview to children aged 5-18 years (and their parents) in five villages spread across three districts. HrQoL (total score) was significantly lower in villages with high prevalence of S. haematobium (-4.0%, p<0.001) and among the lower socioeconomic quartiles (-2.0%, p<0.05). A greater effect was seen in the psychosocial scales as compared to the physical function scale. In moderate prevalence villages, detection of any parasite eggs in the urine was associated with a significant 2.1% (p<0.05) reduction in total score. The PedsQL reliabilities were generally high (Cronbach alphas ≥0.70), floor effects were acceptable, and identification of children from low socioeconomic standing was valid. CONCLUSIONS/SIGNIFICANCE We conclude that exposure to urogenital schistosomiasis is associated with a 2-4% reduction in HrQoL. Further research is warranted to determine the reproducibility and responsiveness properties of QoL testing in relation to schistosomiasis. We anticipate that a case definition based on more sensitive parasitological diagnosis among younger children will better define the immediate and long-term HrQoL impact of Schistosoma infection.
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Affiliation(s)
- Carolyn C. Terer
- Department of Public Health, School of Health Sciences, Kenyatta University, Nairobi, Kenya
| | - Amaya L. Bustinduy
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Ruth V. Magtanong
- Department of Anthropology, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Ng'ethe Muhoho
- Department of Pathology, School of Health Sciences, Kenyatta University, Nairobi, Kenya
| | - Peter L. Mungai
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Eric M. Muchiri
- Division of Vector Borne and Neglected Tropical Diseases, Ministry of Public Health and Sanitation, Nairobi, Kenya
| | - Uriel Kitron
- Department of Environmental Studies, Emory University, Atlanta, Georgia, United States of America
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Francis M. Mutuku
- Department of Environmental Studies, Emory University, Atlanta, Georgia, United States of America
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Salomon JA, Vos T, Hogan DR, Gagnon M, Naghavi M, Mokdad A, Begum N, Shah R, Karyana M, Kosen S, Farje MR, Moncada G, Dutta A, Sazawal S, Dyer A, Seiler J, Aboyans V, Baker L, Baxter A, Benjamin EJ, Bhalla K, Bin Abdulhak A, Blyth F, Bourne R, Braithwaite T, Brooks P, Brugha TS, Bryan-Hancock C, Buchbinder R, Burney P, Calabria B, Chen H, Chugh SS, Cooley R, Criqui MH, Cross M, Dabhadkar KC, Dahodwala N, Davis A, Degenhardt L, Díaz-Torné C, Dorsey ER, Driscoll T, Edmond K, Elbaz A, Ezzati M, Feigin V, Ferri CP, Flaxman AD, Flood L, Fransen M, Fuse K, Gabbe BJ, Gillum RF, Haagsma J, Harrison JE, Havmoeller R, Hay RJ, Hel-Baqui A, Hoek HW, Hoffman H, Hogeland E, Hoy D, Jarvis D, Karthikeyan G, Knowlton LM, Lathlean T, Leasher JL, Lim SS, Lipshultz SE, Lopez AD, Lozano R, Lyons R, Malekzadeh R, Marcenes W, March L, Margolis DJ, McGill N, McGrath J, Mensah GA, Meyer AC, Michaud C, Moran A, Mori R, Murdoch ME, Naldi L, Newton CR, Norman R, Omer SB, Osborne R, Pearce N, Perez-Ruiz F, Perico N, Pesudovs K, Phillips D, Pourmalek F, Prince M, Rehm JT, Remuzzi G, Richardson K, Room R, Saha S, Sampson U, Sanchez-Riera L, Segui-Gomez M, Shahraz S, Shibuya K, Singh D, Sliwa K, Smith E, Soerjomataram I, Steiner T, Stolk WA, Stovner LJ, Sudfeld C, Taylor HR, Tleyjeh IM, van der Werf MJ, Watson WL, Weatherall DJ, Weintraub R, Weisskopf MG, Whiteford H, Wilkinson JD, Woolf AD, Zheng ZJ, Murray CJL, Jonas JB. Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010. Lancet 2012; 380:2129-43. [PMID: 23245605 PMCID: PMC10782811 DOI: 10.1016/s0140-6736(12)61680-8] [Citation(s) in RCA: 886] [Impact Index Per Article: 73.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disability weights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensive debate about a range of conceptual and methodological issues concerning the definition and measurement of these weights. Our primary objective was a comprehensive re-estimation of disability weights for the Global Burden of Disease Study 2010 through a large-scale empirical investigation in which judgments about health losses associated with many causes of disease and injury were elicited from the general public in diverse communities through a new, standardised approach. METHODS We surveyed respondents in two ways: household surveys of adults aged 18 years or older (face-to-face interviews in Bangladesh, Indonesia, Peru, and Tanzania; telephone interviews in the USA) between Oct 28, 2009, and June 23, 2010; and an open-access web-based survey between July 26, 2010, and May 16, 2011. The surveys used paired comparison questions, in which respondents considered two hypothetical individuals with different, randomly selected health states and indicated which person they regarded as healthier. The web survey added questions about population health equivalence, which compared the overall health benefits of different life-saving or disease-prevention programmes. We analysed paired comparison responses with probit regression analysis on all 220 unique states in the study. We used results from the population health equivalence responses to anchor the results from the paired comparisons on the disability weight scale from 0 (implying no loss of health) to 1 (implying a health loss equivalent to death). Additionally, we compared new disability weights with those used in WHO's most recent update of the Global Burden of Disease Study for 2004. FINDINGS 13,902 individuals participated in household surveys and 16,328 in the web survey. Analysis of paired comparison responses indicated a high degree of consistency across surveys: correlations between individual survey results and results from analysis of the pooled dataset were 0·9 or higher in all surveys except in Bangladesh (r=0·75). Most of the 220 disability weights were located on the mild end of the severity scale, with 58 (26%) having weights below 0·05. Five (11%) states had weights below 0·01, such as mild anaemia, mild hearing or vision loss, and secondary infertility. The health states with the highest disability weights were acute schizophrenia (0·76) and severe multiple sclerosis (0·71). We identified a broad pattern of agreement between the old and new weights (r=0·70), particularly in the moderate-to-severe range. However, in the mild range below 0·2, many states had significantly lower weights in our study than previously. INTERPRETATION This study represents the most extensive empirical effort as yet to measure disability weights. By contrast with the popular hypothesis that disability assessments vary widely across samples with different cultural environments, we have reported strong evidence of highly consistent results. FUNDING Bill & Melinda Gates Foundation.
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Fürst T, Silué KD, Ouattara M, N'Goran DN, Adiossan LG, N'Guessan Y, Zouzou F, Koné S, N'Goran EK, Utzinger J. Schistosomiasis, soil-transmitted helminthiasis, and sociodemographic factors influence quality of life of adults in Côte d'Ivoire. PLoS Negl Trop Dis 2012; 6:e1855. [PMID: 23056662 PMCID: PMC3464303 DOI: 10.1371/journal.pntd.0001855] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 08/27/2012] [Indexed: 12/02/2022] Open
Abstract
Background Burden of disease estimates are widely used for priority setting in public health and disability-adjusted life years are a powerful “currency” nowadays. However, disability weights, which capture the disability incurred by a typical patient of a certain condition, are fundamental to such burden calculation and their determination remains a widely debated issue. Methodology A cross-sectional epidemiological survey was conducted in the recently established Taabo health demographic surveillance system (HDSS) in south-central Côte d'Ivoire, to provide new, population-based evidence on the disability caused by schistosomiasis and soil-transmitted helminthiasis. Parasitological results from stool, urine, and blood examinations were juxtaposed to quality of life (QoL) questionnaire results from 187 adults. A multivariable linear regression model with stepwise backward elimination was used to identify significant associations, considering also sociodemographic characteristics obtained from the Taabo HDSS database. Principal Findings Prevalences for hookworm, Plasmodium spp., Trichuris trichiura, Schistosoma haematobium and Schistosoma mansoni were 39.0%, 18.2%, 2.7%, 2.1% and 2.1%, respectively. S. mansoni and T. trichiura infections of any intensity reduced the participants' self-rated QoL by 16 points (95% confidence interval (CI): 4–29 points) and 13 points (95% CI: 1–24 points), respectively, on a scale from 0 (worst QoL) to 100 points (best QoL). The only other statistically significant effect was a 1-point (95% CI: 0.1–2 points) increase on the QoL scale per one unit increase in a calculated wealth index. Conclusions/Significance We found consistent and significant results on the negative effects of schistosomiasis and soil-transmitted helminthiasis on adults' self-rated QoL, also when taking sociodemographic characteristics into account. Our results warrant further investigation on the disability incurred by helmintic infections and the usefulness of generic QoL questionnaires in this endeavor. In public health, "burden" estimates should capture the human suffering caused by certain health states, and the estimates are often used for priority setting. However, such "burden" estimates need to assess not only the number of affected people by certain conditions, but also the disability incurred by the average patient, and the determination of the degree of disability remains a widely debated issue. In order to provide new, population-based evidence on the disability caused by infections with parasitic worms, we administered a quality of life (QoL) questionnaire to 187 adults in rural Côte d'Ivoire and concurrently examined them for parasitic worm infections. We also considered sociodemographic characteristics in our analysis. In comparison with their non-infected counterparts, infected people reported a 13–16 points lower QoL on a scale from 0 (worst QoL) to 100 points (best QoL). At the same time, a one unit increase in a calculated wealth index revealed a 1-point increase in the participants' QoL. The results are consistent and warrant further investigation on the disability induced by parasitic worm infections and the usefulness of QoL questionnaires in this endeavor.
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Affiliation(s)
- Thomas Fürst
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Kigbafori D. Silué
- Unité de Formation et de Recherche Biosciences, Université de Cocody, Abidjan, Côte d'Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Mamadou Ouattara
- Unité de Formation et de Recherche Biosciences, Université de Cocody, Abidjan, Côte d'Ivoire
| | - Dje N. N'Goran
- Programme National de Lutte contre la Schistosomiase, les Géohelminthiases et la Filariose Lymphatique, Abidjan, Côte d'Ivoire
| | | | - Yao N'Guessan
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Fabian Zouzou
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Siaka Koné
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Eliézer K. N'Goran
- Unité de Formation et de Recherche Biosciences, Université de Cocody, Abidjan, Côte d'Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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Abou-Zeid AHA, Abkar TA, Mohamed RO. Schistosomiasis and soil-transmitted helminths among an adult population in a war affected area, Southern Kordofan state, Sudan. Parasit Vectors 2012; 5:133. [PMID: 22759923 PMCID: PMC3481353 DOI: 10.1186/1756-3305-5-133] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 07/03/2012] [Indexed: 12/03/2022] Open
Abstract
Background Schistosomiasis remains a major health problem at global and national levels, contributing to the vulnerability of the poor people in Sudan. Southern Kordofan is affected by Schistosomiasis but the disease prevalence was unknown. Methods 1826 adults were recruited in a community-based survey. Each recruited subject submitted at least 10 ml urine and one stool sample; they were also interviewed and filled in a questionnaire. Results 1826 adults were recruited in a community-based survey. Each recruited subject submitted at least 10 ml urine and one stool sample; they were also interviewed and filled in a questionnaire. The prevalence of S. haematobium was 6.9 % among the adult population. We estimated S. mansoni prevalence as 0.0 %. S. haematobium infection was focally distributed at the village level. The infection was associated with non preference of latrine use – if available, use of open water source for household affairs such as cleaning and also with the history of schistosomiasis treatment. The prevalence of soil transmitted helminths (STH) was also reported as high at 7.8 %, and two species were identified; Hymenolepis nana and Giardia lamblia. Conclusion Schistosomiasis is a significant health problem among the adult population in Southern Kordofan. The estimated prevalence will serve as a guide in developing a Schistosomiasis Control Program and applying treatment plans.
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Affiliation(s)
- Alaa Hammad Ali Abou-Zeid
- Public Health Department, Faculty of Medicine, Cairo University, Kasr Al Ainy St, Manial, Cairo, Egypt.
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Zhang SH, Zhu DD, Chang MX, Zhao QP, Jiao R, Huang B, Fu JP, Liu ZX, Nie P. Three goose-type lysozymes in the gastropod Oncomelania hupensis: cDNA sequences and lytic activity of recombinant proteins. DEVELOPMENTAL AND COMPARATIVE IMMUNOLOGY 2012; 36:241-246. [PMID: 21756934 DOI: 10.1016/j.dci.2011.06.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Revised: 06/24/2011] [Accepted: 06/25/2011] [Indexed: 05/31/2023]
Abstract
Three goose-type (g-type) lysozymes, designated as OHLysG1, OHLysG2 and OHLysG3 were identified from expressed sequence tags (ESTs) of a gastropod Oncomelania hupensis, the intermediate host of Schistosoma japonicum. The full cDNA sequences of OHLysG1, OHLysG2 and OHLysG3 consisted of 735, 909 and 808 nucleotides, with an open reading frame of 198, 214 and 249 codons containing a 21, 7 and 8 amino acid (aa) signal peptide at the N-terminus, respectively. The three g-type lysozymes shared conserved features with other g-type lysozymes, such as the substrate binding sites, the catalytic residues critical for the fundamental structure and function of g-type lysozymes. It seems possible that g-type lysozymes in molluscs shared one conserved cysteine with those in birds and mammals, and six conserved cysteines were observed for mollusc g-type lysozymes, with two unique cysteines present in the g-type lysozymes of O. hupensis. The three lysozyme genes were expressed mainly in hepatopancreas, with relatively low expression level observed in head-foot muscle and intestine. When comparing S. japonicum-infected and uninfected snails, significant increase (P<0.05) was observed for all the three lysozymes in infected snails, with the highest increase detected in hepatopancreas, and lowest in intestine, implying their defensive role in the host-parasite, i.e. snail-trematode system. The three recombinant lysozymes expressed in Escherichia coli strain M15 showed lytic activity against Aeromonas hydrophila, Vibrio fluvialis, Aeromonas sobria and Micrococcus lysodeikticus. In conclusion, the finding of three g-type lysozymes in O. hupensis provides structural and functional evidence of multiple g-type lysozymes in gastropod, which may have evolutional implication in the snail-trematode system.
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Affiliation(s)
- Shu H Zhang
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, Hubei Province 430072, China
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Qian MB, Chen YD, Fang YY, Xu LQ, Zhu TJ, Tan T, Zhou CH, Wang GF, Jia TW, Yang GJ, Zhou XN. Disability weight of Clonorchis sinensis infection: captured from community study and model simulation. PLoS Negl Trop Dis 2011; 5:e1377. [PMID: 22180791 PMCID: PMC3236727 DOI: 10.1371/journal.pntd.0001377] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2010] [Accepted: 09/13/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Clonorchiasis is among the most neglected tropical diseases. It is caused by ingesting raw or undercooked fish or shrimp containing the larval of Clonorchis sinensis and mainly endemic in Southeast Asia including China, Korea and Vietnam. The global estimations for population at risk and infected are 601 million and 35 million, respectively. However, it is still not listed among the Global Burden of Disease (GBD) and no disability weight is available for it. Disability weight reflects the average degree of loss of life value due to certain chronic disease condition and ranges between 0 (complete health) and 1 (death). It is crucial parameter for calculating the morbidity part of any disease burden in terms of disability-adjusted life years (DALYs). METHODOLOGY/PRINCIPAL FINDINGS According to the probability and disability weight of single sequelae caused by C. sinensis infection, the overall disability weight could be captured through Monte Carlo simulation. The probability of single sequelae was gained from one community investigation, while the corresponding disability weight was searched from the literatures in evidence-based approach. The overall disability weights of the male and female were 0.101 and 0.050, respectively. The overall disability weights of the age group of 5-14, 15-29, 30-44, 45-59 and 60+ were 0.022, 0.052, 0.072, 0.094 and 0.118, respectively. There was some evidence showing that the disability weight and geometric mean of eggs per gram of feces (GMEPG) fitted a logarithmic equation. CONCLUSION/SIGNIFICANCE The overall disability weights of C. sinensis infection are differential in different sex and age groups. The disability weight captured here may be referred for estimating the disease burden of C. sinensis infection.
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Affiliation(s)
- Men-Bao Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborative Center for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
| | - Ying-Dan Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborative Center for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
| | - Yue-Yi Fang
- Center for Disease Control and Prevention of Guangdong Province, Guangzhou, People's Republic of China
| | - Long-Qi Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborative Center for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
| | - Ting-Jun Zhu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborative Center for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
| | - Tan Tan
- Center for Disease Control and Prevention of Shunde District, Shunde, People's Republic of China
| | - Chang-Hai Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborative Center for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
| | - Guo-Fei Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborative Center for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
| | - Tie-Wu Jia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborative Center for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
| | - Guo-Jing Yang
- Jiangsu Institute of Parasitic Diseases, Wuxi, People's Republic of China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborative Center for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
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Noyes J, Edwards RT. EQ-5D for the assessment of health-related quality of life and resource allocation in children: a systematic methodological review. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2011; 14:1117-1129. [PMID: 22152182 DOI: 10.1016/j.jval.2011.07.011] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2010] [Revised: 06/23/2011] [Accepted: 07/01/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES EQ-5D is widely used in studies with adults as a source of generic health-related quality of life information and utility weights to inform resource allocation decisions. This methodological systematic review describes the extent to which EQ-5D has been used in the evaluation of children's health care, assesses psychometric properties, and makes recommendations for future good practice. METHODS Systematic searches of databases and the Internet to identify studies published during 2000-2010 that either used EQ-5D with children younger than age 19 years as an outcome measure or reported psychometric data. Study characteristics, including measures and psychometric data, were extracted into tables for analysis. RESULTS We identified 29 studies that used four versions of the EQ-5D: adult EQ-5D, EQ-5D-Y, Dutch EQ-5D child, and extended with cognitive dimension, EQ-5D+C. Twelve of 29 studies did not specify the EQ-5D version used. Existing literature lacks detail on the specific use of EQ-5D and its potential effects on findings. Version use and psychometric properties were inadequately reported. There are large gaps in current knowledge of psychometric properties across all versions when used with children. CONCLUSIONS For reasons of comparability with resource use across adult and children's services, there are arguments for continued use of EQ-5D in studies with children. We recommend use of EQ-5D alongside children-specific quality of life measures and disease-specific measures. Researchers are encouraged to undertake methodological and philosophical analyses to better understand and improve evidence as to how adults who make decisions about resource allocation can best take account of children in decision making.
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Affiliation(s)
- J Noyes
- Centre for Health-Related Research, School of Healthcare Sciences, Bangor University, Bangor, Gwynedd, UK
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King CH, Olbrych SK, Soon M, Singer ME, Carter J, Colley DG. Utility of repeated praziquantel dosing in the treatment of schistosomiasis in high-risk communities in Africa: a systematic review. PLoS Negl Trop Dis 2011; 5:e1321. [PMID: 21949893 PMCID: PMC3176745 DOI: 10.1371/journal.pntd.0001321] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Accepted: 08/04/2011] [Indexed: 11/30/2022] Open
Abstract
Background Controversy persists about the optimal approach to drug-based control of schistosomiasis in high-risk communities. In a systematic review of published studies, we examined evidence for incremental benefits from repeated praziquantel dosing, given 2 to 8 weeks after an initial dose, in Schistosoma-endemic areas of Africa. Methodology/Principal Findings We performed systematic searches of electronic databases PubMed and EMBASE for relevant data using search terms ‘schistosomiasis’, ‘dosing’ and ‘praziquantel’ and hand searches of personal collections and bibliographies of recovered articles. In 10 reports meeting study criteria, improvements in parasitological treatment outcomes after two doses of praziquantel were greater for S. mansoni infection than for S. haematobium infection. Observed cure rates (positive to negative conversion in egg detection assays) were, for S. mansoni, 69–91% cure after two doses vs. 42–79% after one dose and, for S. haematobium, 46–99% cure after two doses vs. 37–93% after a single dose. Treatment benefits in terms of reduction in intensity (mean egg count) were also different for the two species—for S. mansoni, the 2-dose regimen yielded an weighted average 89% reduction in standardized egg counts compared to a 83% reduction after one dose; for S. haematobium, two doses gave a 93% reduction compared to a 94% reduction with a single dose. Cost-effectiveness analysis was performed based on Markov life path modeling. Conclusions/Significance Although schedules for repeated treatment with praziquantel require greater inputs in terms of direct costs and community participation, there are incremental benefits to this approach at an estimated cost of $153 (S. mansoni)–$211 (S. haematobium) per additional lifetime QALY gained by double treatment in school-based programs. More rapid reduction of infection-related disease may improve program adherence, and if, as an externality of the program, transmission can be reduced through more effective coverage, significant additional benefits are expected to accrue in the targeted communities. Infection by Schistosoma worms causes serious disease among people who live in areas of Africa, South America, and Asia where these parasites are regularly transmitted. Although yearly treatment with the drug praziquantel is fairly effective in reducing or eliminating active infection, it does not cure everyone, and reinfection remains a continuing problem in high-risk communities. Studies have suggested that a repeat dose of praziquantel, given 2 to 8 weeks after the first dose, can improve cure rates and reduce remaining intensity of infections in population-based programs. Our systematic review of published research found that, on average, in Africa, such repeated dosing appears to offer particular advantages in the treatment of S. mansoni, the cause of intestinal schistosomiasis, but there was less consistent improvement after double-dosing for S. haematobium, the cause of urogenital schistosomiasis. Based on this evidence, we used a calibrated life-path model to predict the costs and benefits of a single-dose vs. a double-dose strategy in a typical high-risk community. Our projections suggest cost-effective incremental benefits from double dosing in terms of i) limiting a person's total years spent infected and ii) limiting the number of years they spend with heavy infection, with consequent improvements in quality of life.
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Affiliation(s)
- Charles H King
- Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
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Utzinger J, N’Goran EK, Caffrey CR, Keiser J. From innovation to application: social-ecological context, diagnostics, drugs and integrated control of schistosomiasis. Acta Trop 2011; 120 Suppl 1:S121-37. [PMID: 20831855 DOI: 10.1016/j.actatropica.2010.08.020] [Citation(s) in RCA: 150] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Revised: 08/29/2010] [Accepted: 08/30/2010] [Indexed: 12/11/2022]
Abstract
Compared to malaria, tuberculosis and HIV/AIDS, schistosomiasis remains a truly neglected tropical disease. Schistosomiasis, perhaps more than any other disease, is entrenched in prevailing social-ecological systems, since transmission is governed by human behaviour (e.g. open defecation and patterns of unprotected surface water contacts) and ecological features (e.g. living in close proximity to suitable freshwater bodies in which intermediate host snails proliferate). Moreover, schistosomiasis is intimately linked with poverty and the disease has spread to previously non-endemic areas as a result of demographic, ecological and engineering transformations. Importantly though, thanks to increased advocacy there is growing awareness, financial and technical support to control and eventually eliminate schistosomiasis as a public health problem at local, regional and global scales. The purpose of this review is to highlight recent progress made in innovation, validation and application of new tools and strategies for research and integrated control of schistosomiasis. First, we explain that schistosomiasis is deeply embedded in social-ecological systems and explore linkages with poverty. We then summarize and challenge global statistics, risk maps and burden estimates of human schistosomiasis. Discovery and development research pertaining to novel diagnostics and drugs forms the centrepiece of our review. We discuss unresolved issues and emerging opportunities for integrated and sustainable control of schistosomiasis and conclude with a series of research needs.
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Müller I, Coulibaly JT, Fürst T, Knopp S, Hattendorf J, Krauth SJ, Stete K, Righetti AA, Glinz D, Yao AK, Pühse U, N'Goran EK, Utzinger J. Effect of schistosomiasis and soil-transmitted helminth infections on physical fitness of school children in Côte d'Ivoire. PLoS Negl Trop Dis 2011; 5:e1239. [PMID: 21811643 PMCID: PMC3139653 DOI: 10.1371/journal.pntd.0001239] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Accepted: 05/26/2011] [Indexed: 01/28/2023] Open
Abstract
Background Schistosomiasis and soil-transmitted helminthiasis are important public health problems in sub-Saharan Africa causing malnutrition, anemia, and retardation of physical and cognitive development. However, the effect of these diseases on physical fitness remains to be determined. Methodology We investigated the relationship between schistosomiasis, soil-transmitted helminthiasis and physical performance of children, controlling for potential confounding of Plasmodium spp. infections and environmental parameters (i.e., ambient air temperature and humidity). A cross-sectional survey was carried out among 156 school children aged 7–15 years from Côte d'Ivoire. Each child had two stool and two urine samples examined for helminth eggs by microscopy. Additionally, children underwent a clinical examination, were tested for Plasmodium spp. infection with a rapid diagnostic test, and performed a maximal multistage 20 m shuttle run test to assess their maximal oxygen uptake (VO2 max) as a proxy for physical fitness. Principal Findings The prevalence of Schistosoma haematobium, Plasmodium spp., Schistosoma mansoni, hookworm and Ascaris lumbricoides infections was 85.3%, 71.2%, 53.8%, 13.5% and 1.3%, respectively. Children with single, dual, triple, quadruple and quintuple species infections showed VO2 max of 52.7, 53.1, 52.2, 52.6 and 55.6 ml kg−1 min−1, respectively. The VO2 max of children with no parasite infections was 53.5 ml kg−1 min−1. No statistically significant difference was detected between any groups. Multivariable analysis revealed that VO2 max was influenced by sex (reference: female, coef. = 4.02, p<0.001) and age (years, coef. = −1.23, p<0.001), but not by helminth infection and intensity, Plasmodium spp. infection, and environmental parameters. Conclusion/Significance School-aged children in Côte d'Ivoire showed good physical fitness, irrespective of their helminth infection status. Future studies on children's physical fitness in settings where helminthiasis and malaria co-exist should include pre- and post-intervention evaluations and the measurement of hemoglobin and hematocrit levels and nutritional parameters as potential co-factors to determine whether interventions further improve upon fitness. The burden of parasitic worm infections is considerable, particularly in developing countries. It is acknowledged that parasitic worm infections negatively impact on children's school performance and physical development. A deeper understanding of these linkages is important for updating burden of disease measures. We investigated the relationship between worm infection status and physical fitness of 156 school children from Côte d'Ivoire and controlled for potential confounding of Plasmodium infection (the causative agent of malaria) and environmental parameters (temperature and humidity). Children were diagnosed for parasitic worm and Plasmodium infections, examined by a physician, and participated in a 20 m shuttle run test to assess their maximal oxygen uptake (VO2 max) as a proxy for physical fitness. Most of the children had parasitic worms and a Plasmodium infection. Nevertheless, their physical fitness was excellent (average VO2 max: 52.7 ml kg−1 min−1). The level of VO2 max was only influenced by sex and age, but not by parasitic worms and Plasmodium infections. In future studies, the dynamics of children's physical performance should be assessed before and after control interventions, including the assessment of blood hemoglobin, hematocrit, and nutritional indicators to determine whether physical fitness in worm- and Plasmodium-infected individuals can be further improved.
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Affiliation(s)
- Ivan Müller
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Department of Public Health, Institute for Sports and Sports Sciences, University of Basel, Basel, Switzerland
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Jean T. Coulibaly
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Université de Cocody, Abidjan, Côte d'Ivoire
- University of Basel, Basel, Switzerland
| | - Thomas Fürst
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Stefanie Knopp
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jan Hattendorf
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Stefanie J. Krauth
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- University of Basel, Basel, Switzerland
| | - Katarina Stete
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg im Breisgau, Germany
| | - Aurélie A. Righetti
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- University of Basel, Basel, Switzerland
| | - Dominik Glinz
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Human Nutrition Laboratory, Institute of Food, Nutrition, and Health, Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Adrien K. Yao
- Services de Santé Scolaire et Universitaire, Agboville, Côte d'Ivoire
| | - Uwe Pühse
- Department of Public Health, Institute for Sports and Sports Sciences, University of Basel, Basel, Switzerland
| | - Eliézer K. N'Goran
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Université de Cocody, Abidjan, Côte d'Ivoire
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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Fürst T, Müller I, Coulibaly JT, Yao AK, Utzinger J, N'Goran EK. Questionnaire-based approach to assess schoolchildren's physical fitness and its potential role in exploring the putative impact of helminth and Plasmodium spp. infections in Côte d'Ivoire. Parasit Vectors 2011; 4:116. [PMID: 21702903 PMCID: PMC3157450 DOI: 10.1186/1756-3305-4-116] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 06/24/2011] [Indexed: 11/22/2022] Open
Abstract
Background Disability weights (DWs) are important for estimating burden of disease in terms of disability-adjusted life years. The previous practice of eliciting DWs by expert opinion has been challenged. More recent approaches employed quality of life (QoL) questionnaires to establish patient-based DWs, but results are ambiguous. Methods In early 2010, we administered a questionnaire pertaining to physical fitness to 200 schoolchildren in Côte d'Ivoire. Helminth and Plasmodium spp. infections were determined and schoolchildren's physical fitness objectively measured in a maximal multistage 20 m shuttle run test. Associations between objectively measured and self-reported physical fitness and between self-reported physical fitness and infection status were determined. Spearman rank correlation coefficient, uni- and multivariable linear regression models adjusting for children's age and sex, ambient air temperature and humidity, Fisher's test, χ² and t-test statistics were used for statistical analysis. Results The prevalence of Schistosoma haematobium, Plasmodium spp., Schistosoma mansoni, hookworm and Ascaris lumbricoides in 167 children with complete parasitological results was 84.4%, 74.9%, 54.5%, 14.4% and 1.2%, respectively. High infection intensities and multiple species parasite infections were common. In the 137 children with complete data also from the shuttle run test, we found statistically significant correlations between objectively measured and self-reported physical fitness. However, no statistically significant correlation between the children's parasitic infection status and self-reported physical fitness was identified. An attrition analysis revealed considerably lower self-reported physical fitness scores of parasitized children who were excluded from shuttle run testing due to medical concerns in comparison to parasitized children who were able to successfully complete the shuttle run test. Conclusions Our QoL questionnaire proofed valid to assess children's physical fitness in the current study area. Reasons why no differences in self-reported physical fitness in children with different parasitic infections were found are manifold, but do not preclude the use of QoL questionnaires in the elicitation of DWs. Indeed, the questionnaire was particularly useful in assessing physical fitness of those children, who were - supposedly due to parasitic infections - unable to complete the shuttle run test. Hence, we encourage others to use QoL questionnaires to determine not only physical fitness, but also more subtle morbidities.
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Affiliation(s)
- Thomas Fürst
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
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Sun S, Chen J, Johannesson M, Kind P, Xu L, Zhang Y, Burström K. Population health status in China: EQ-5D results, by age, sex and socio-economic status, from the National Health Services Survey 2008. Qual Life Res 2011; 20:309-20. [PMID: 21042861 PMCID: PMC3052443 DOI: 10.1007/s11136-010-9762-x] [Citation(s) in RCA: 165] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2010] [Indexed: 01/10/2023]
Abstract
PURPOSE To measure and analyse national EQ-5D data and to provide norms for the Chinese general population by age, sex, educational level, income and employment status. METHODS The EQ-5D instrument was included in the National Health Services Survey 2008 (n = 120,703) to measure health-related quality of life (HRQoL). All descriptive analyses by socio-economic status (educational level, income and employment status) and by clinical characteristics (discomfort during the past 2 weeks, diagnosed with chronic diseases during the past 6 months and hospitalised during the past 12 months) were stratified by sex and age group. RESULTS Health status declines with advancing age, and women reported worse health status than men, which is in line with EQ-5D population health studies in other countries and previous population health studies in China. The EQ-5D instrument distinguished well for the known groups: positive association between socio-economic status and HRQoL was observed among the Chinese population. Persons with clinical characteristics had worse HRQoL than those without. CONCLUSIONS This study provides Chinese population HRQoL data measured by the EQ-5D instrument, based on a national representative sample. The main findings for different subgroups are consistent with results from EQ-5D population studies in other countries, and discriminative validity was supported.
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Affiliation(s)
- Sun Sun
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Nobels väg 15a, 171 77 Stockholm, Sweden
- Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Nobels väg 15a, 171 77 Stockholm, Sweden
| | - Jiaying Chen
- School of Health Policy and Management, Nanjing Medical University, Hanzhong Rd 140, 210 029 Nanjing, P. R. China
| | - Magnus Johannesson
- Department of Economics, Stockholm School of Economics, Box 6501, 113 83 Stockholm, Sweden
| | - Paul Kind
- Centre for Health Economics, University of York, York, YO10 5DD UK
| | - Ling Xu
- Centre for Health Statistics and Information, Ministry of Health, Xizhimenwainanlu 1, 100 044 Beijing, P. R. China
| | - Yaoguang Zhang
- Centre for Health Statistics and Information, Ministry of Health, Xizhimenwainanlu 1, 100 044 Beijing, P. R. China
| | - Kristina Burström
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Nobels väg 15a, 171 77 Stockholm, Sweden
- Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Nobels väg 15a, 171 77 Stockholm, Sweden
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Jia TW, Utzinger J, Deng Y, Yang K, Li YY, Zhu JH, King CH, Zhou XN. Quantifying quality of life and disability of patients with advanced schistosomiasis japonica. PLoS Negl Trop Dis 2011; 5:e966. [PMID: 21358814 PMCID: PMC3039691 DOI: 10.1371/journal.pntd.0000966] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Accepted: 01/18/2011] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The Chinese government lists advanced schistosomiasis as a leading healthcare priority due to its serious health and economic impacts, yet it has not been included in the estimates of schistosomiasis burden in the Global Burden of Disease (GBD) study. Therefore, the quality of life and disability weight (DW) for the advanced cases of schistosomiasis japonica have to be taken into account in the re-estimation of burden of disease due to schistosomiasis. METHODOLOGY/PRINCIPAL FINDINGS A patient-based quality-of-life evaluation was performed for advanced schistosomiasis japonica. Suspected or officially registered advanced cases in a Schistosoma japonicum-hyperendemic county of the People's Republic of China (P.R. China) were screened using a short questionnaire and physical examination. Disability and morbidity were assessed in confirmed cases, using the European quality of life questionnaire with an additional cognitive dimension (known as the "EQ-5D plus"), ultrasonography, and laboratory testing. The age-specific DW of advanced schistosomiasis japonica was estimated based on patients' self-rated health scores on the visual analogue scale of the questionnaire. The relationships between health status, morbidity and DW were explored using multivariate regression models. Of 506 candidates, 215 cases were confirmed as advanced schistosomiasis japonica and evaluated. Most of the patients reported impairments in at least one health dimension, such as pain or discomfort (90.7%), usual activities (87.9%), and anxiety or depression (80.9%). The overall DW was 0.447, and age-specific DWs ranged from 0.378 among individuals aged 30-44 years to 0.510 among the elderly aged ≥ 60 years. DWs are positively associated with loss of work capacity, psychological abnormality, ascites, and active hepatitis B virus, while splenectomy and high albumin were protective factors for quality of life. CONCLUSIONS/SIGNIFICANCE These patient-preference disability estimates could provide updated data for a revision of the GBD, as well as for evidence-based decision-making in P.R. China's national schistosomiasis control program.
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Affiliation(s)
- Tie-Wu Jia
- Key Laboratory on Biology of Parasites and Vectors, MOH, WHO Collaborating Center on Malaria, Schistosomiasis and Filariasis, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Jürg Utzinger
- Department of Public Health and Epidemiology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Yao Deng
- Jiangsu Institute of Parasitic Diseases, Wuxi, People's Republic of China
| | - Kun Yang
- Jiangsu Institute of Parasitic Diseases, Wuxi, People's Republic of China
| | - Yi-Yi Li
- Hunan Institute of Parasitic Diseases, Yueyang, People's Republic of China
| | - Jin-Huan Zhu
- Hunan Institute of Parasitic Diseases, Yueyang, People's Republic of China
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States of America
| | - Xiao-Nong Zhou
- Key Laboratory on Biology of Parasites and Vectors, MOH, WHO Collaborating Center on Malaria, Schistosomiasis and Filariasis, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
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Zhou XN, Bergquist R, Leonardo L, Yang GJ, Yang K, Sudomo M, Olveda R. Schistosomiasis japonica control and research needs. ADVANCES IN PARASITOLOGY 2010; 72:145-78. [PMID: 20624531 DOI: 10.1016/s0065-308x(10)72006-6] [Citation(s) in RCA: 125] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Schistosomiasis japonica, a chronic and debilitating disease caused by the blood fluke Schistosoma japonicum, is still of considerable economic and public health concern in the People's Republic of China, the Philippines, and Indonesia. Despite major progress made over the past several decades with the control of schistosomiasis japonica in the aforementioned countries, the disease is emerging in some areas. We review the epidemiological status and transmission patterns of schistosomiasis japonica, placing it into a historical context, and discuss experiences and lessons with national control efforts. Our analyses reveal that an integrated control approach, implemented through intersectoral collaboration, is essential to bring down the prevalence and intensity of Schistosoma japonicum infections and disease-related morbidity, and to sustain these parameters at low levels. The need for innovation and a sufficiently flexible control approach to adapt interventions in response to the changing nature and challenges of schistosomiasis control from the initial phase of morbidity control to the final state of elimination is emphasised. The aim of the presentation and the analyses is to inspire researchers and disease control managers elsewhere in Asia, Africa, and the Americas to harness the experiences gained and the lessons presented here to improve the control and eventual elimination of schistosomiasis and parasitic diseases.
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Affiliation(s)
- Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
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Utzinger J, Bergquist R, Olveda R, Zhou XN. Important helminth infections in Southeast Asia diversity, potential for control and prospects for elimination. ADVANCES IN PARASITOLOGY 2010; 72:1-30. [PMID: 20624526 DOI: 10.1016/s0065-308x(10)72001-7] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Besides the 'big three'-HIV/AIDS, malaria and tuberculosis-there are a host of diseases that, by comparison, are truly neglected. These so-called neglected tropical diseases (NTDs), many of which caused by helminths, are intimately linked with poverty and are rampant where housing is poor; access to clean water and adequate sanitation is lacking; hygiene and nutrition is substandard and populations are marginalized and vulnerable. More than a billion people are affected by NTDs, mainly in remote rural and deprived urban settings of the developing world. An overview of papers published in two special thematic volumes of the Advances in Parasitology is provided here under the umbrella of current status of research and control of important helminth infections. A total of 25 comprehensive reviews are presented, which summarise the latest available data pertaining to the diagnosis, epidemiology, pathogenesis, prevention, treatment, control and eventual elimination of NTDs in Southeast Asia and neighbourhood countries. The focus of the first volume provides the current regional status of schistosomiasis, lymphatic filariasis, food-borne trematodiases, echinococcosis and cysticercosis/taeniasis, less common parasitic diseases that can cause epidemic outbreaks and helminth infections affecting the central nervous system. The second volume deals with the tools and strategies for control, including diagnostics, drugs, vaccines and cutting-edge basic research (e.g. the '-omics' sciences). Moreover, cross-cutting themes such as multiparasitism, social sciences, capacity strengthening, geospatial health technologies, health metrics and modelling the potential impact of climate change on helminthic diseases are discussed. Hopefully, these two volumes will become useful for researchers and, most importantly, disease control managers for integrated and sustainable control, rigorous monitoring and eventual elimination of NTDs in Southeast Asia and elsewhere.
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Affiliation(s)
- Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
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Olveda R, Leonardo L, Zheng F, Sripa B, Bergquist R, Zhou XN. Coordinating research on neglected parasitic diseases in Southeast Asia through networking. ADVANCES IN PARASITOLOGY 2010; 72:55-77. [PMID: 20624528 DOI: 10.1016/s0065-308x(10)72003-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The new dialogue between stakeholders, that is, scientists, research administrators and donors as well as the populations victimized by endemic infections, is initiating a virtuous circle leading to lower disease-burdens, improved public health and the mitigation of poverty. There is now general agreement that control activities need research collaboration to advance, while surveillance plays an increasingly important role in sustaining long-term relief. On the part of the Regional Network on Asian Schistosomiasis and Other Helminth Zoonoses (RNAS(+)), this has led to a new vision not only focused on general strengthening of research capabilities but also on furthering efforts to close the gap between research and control and bridge different branches of science. From its original, exclusive focus on schistosomiasis, RNAS(+) has expanded to include food-borne and soil-transmitted helminth infections as well. Its current repository of data on the distribution, prevalence and severity of these diseases is increasingly utilised by decision makers charged with epidemiological control in the endemic countries. Thanks to a more rapid translation of research results into control applications and the dissemination of data and new technology through networking, the overall situation is improving. Working as a virtual organisation of researchers and control officers in the endemic countries of Southeast Asia, RNAS(+) is playing an important role in this conversion. Its responsibilities are divided along disease lines into five main areas, but no serious, endemic disease is considered to be outside the network's sphere of interest. This chapter recounts some of the more important RNAS(+) accomplishments, pinpoints potential directions for future operations and highlights areas where research is most needed.
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Affiliation(s)
- Remigio Olveda
- Department of Health, Research Institute of Tropical Medicine (RITM), Muntinlupa, Manila, Philippines
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