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Nogueira de Brito R, Tanner S, Runk JV, Hoyos J. Looking through the lens of social science approaches: A scoping review of leishmaniases and Chagas disease research. Acta Trop 2024; 249:107059. [PMID: 37918504 DOI: 10.1016/j.actatropica.2023.107059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/04/2023]
Abstract
Scholars have called for increased attention to sociocultural, economic, historical, and political processes shaping Neglected Tropical Diseases (NTDs) ecology. We conducted a scoping review to identify major research themes and the knowledge gaps in social science literature in leishmaniases or Chagas disease (CD). Following the scoping review protocol, we first determined the focus of the review to be centered on identifying research that approaches leishmaniases and CD from social science perspective and was indexed by large, biomedically focused databases. We then searched PubMed and Web of Science using "Leishmaniasis" and "Chagas disease" with "social science" or "anthropology" as search terms. We analyzed 199 articles (123 on leishmaniases and 76 on CD), categorizing them into three main research themes. Sociocultural dimensions of the diseases (leishmaniases=60.2 %; CD=68.4 %) primarily focused on individuals' knowledge, practices, and behaviors, barriers to accessing healthcare (especially in endemic regions), psychosocial effects, stigma, and traditional treatments. Research focused on socioeconomic dimensions of the diseases (leishmaniases=29.3 %; CD=19.7 %) included topics like household characteristics, social capital, and infrastructure access. A final theme, the historical and political contexts of the diseases (Leishmaniases=10.5 %; CD=11.9 %) was less common than other themes. Here, studies consider civil war and the (re)emergence of leishmaniasis, as well as the significance of CD discovery for scientific and public health in Brazil, which is the most common country for research on both leishmaniases and CD that draws on social science approaches. Future directions for research include focusing on how social institutions and economic factors shape diseases education, control measures, healthcare access, and quality of life of people affected by NTDs. Greater attention to social sciences can help mitigate and undo the ways that structural biases have infiltrated biomedicine.
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Affiliation(s)
- Raíssa Nogueira de Brito
- Department of Anthropology, University of Georgia, Athens, GA 30602, United States; Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA 30602, United States.
| | - Susan Tanner
- Department of Anthropology, University of Georgia, Athens, GA 30602, United States
| | - Julie Velásquez Runk
- Environment and Sustainability Studies Program, Wake Forest University, Winston Salem, NC 27109, United States; Smithsonian Tropical Research Institute, Balboa, Ciudad de Panamá 0843-03092, Republic of Panama
| | - Juliana Hoyos
- Odum School of Ecology, University of Georgia, Athens, GA 30602, United States
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Castro EA, Silva E, Benito PJ, Neiva CM, Pessôa Filho DM. Effects of Training on Running Cost and Aerobic Capacity in Individuals with Obesity. Int J Sports Med 2023; 44:1075-1085. [PMID: 37827497 DOI: 10.1055/a-2156-7142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
This study investigated running cost (CRun), peak oxygen consumption (V̇ O2peak), and ventilatory threshold (VT1) responses to exercise programs for individuals with obesity. Ninety-four individuals (38.2±7.7 years; 33.4±2.9 kg/m²) were assigned into strength (n=24), endurance (n=26), combined (n=22), and physical activity (control, n=22) groups for 22 weeks, plus diet recommendation. The V̇ O2peak, VT1, and CRun were assessed through a maximal incremental step test. The change of V̇ O2peak in combined (9.9%) differed from the other groups, with lower values in women than men (0.7% vs. 6.2%). The VT1 change in combined (16.4%) differed from the strength (4.9%) and physical activity (1.2%) groups, with the change in endurance (12.7%) also being higher than the physical activity group. Only men in the combined group increased absolute V̇ O2peak, while both sexes increased VT1 in the endurance and combined groups. No effects for groups and sex were significant for CRun in moderate (VT1) running zones, despite CRun changes in VT1 zones correlated with the alterations of V̇ O2peak and VT1 (r²=0.29-0.59). Therefore, moderate aerobic exercise stimulus is suitable for VT1 improvement in individuals with obesity, with the increase in CRun associated to the chances of increasing V̇ O2peak in men and when combining strength with aerobic exercises.
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Affiliation(s)
- Eliane Aparecida Castro
- Department of Physical Education, Faculty of Science (FC), São Paulo State University (UNESP) at Bauru, Brazil
- LFE Research Group, Department of Health and Human Performance. Faculty of Physical Activity and Sport Science-INEF. Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Elisangela Silva
- Federal Institute of Education, Science and Technology of South of Minas Gerais - IFSULDEMINAS at Muzambinho, Brazil
| | - Pedro J Benito
- LFE Research Group, Department of Health and Human Performance. Faculty of Physical Activity and Sport Science-INEF. Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Cassiano Merussi Neiva
- Department of Physical Education, Faculty of Science (FC), São Paulo State University (UNESP) at Bauru, Brazil
- Graduate Program in Human Developmental and Technologies, Biosciences Institute (IB), São Paulo State University (UNESP) at Rio Claro, Brazil
- College of Medicine, Ribeirão Preto University, Ribeirão Preto, Brazil
| | - Dalton Müller Pessôa Filho
- Department of Physical Education, Faculty of Science (FC), São Paulo State University (UNESP) at Bauru, Brazil
- Graduate Program in Human Developmental and Technologies, Biosciences Institute (IB), São Paulo State University (UNESP) at Rio Claro, Brazil
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Khabsa J, Jain S, El-Harakeh A, Rizkallah C, Pandey DK, Manaye N, Honein-AbouHaidar G, Halleux C, Dagne DA, Akl EA. Stakeholders’ views and perspectives on treatments of visceral leishmaniasis and their outcomes in HIV-coinfected patients in East Africa and South-East Asia: A mixed methods study. PLoS Negl Trop Dis 2022; 16:e0010624. [PMID: 35969636 PMCID: PMC9410553 DOI: 10.1371/journal.pntd.0010624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 08/25/2022] [Accepted: 06/29/2022] [Indexed: 12/03/2022] Open
Abstract
Background In visceral leishmaniasis (VL) patients coinfected with human immunodeficiency virus (HIV), combination therapy (liposomal amphotericin B infusion and oral miltefosine) is being considered as an alternative to liposomal amphotericin B monotherapy. We aimed to assess the views of stakeholders in relation to these treatment options. Methodology In a mixed methods study, we surveyed and interviewed patients, government functionaries, programme managers, health service providers, nongovernmental organizations, researchers, and World Health Organization (WHO) personnel. We used the Evidence to Decision (EtD) framework for data collection planning and analysis. Constructs of interest included valuation of outcomes, impact on equity, feasibility and acceptability of the treatment options, implementation considerations, monitoring and evaluation, and research priorities. Principal findings/Conclusion Mortality and non-serious adverse events were rated as “critical” by respectively the highest (61%) and lowest percentages (47%) of survey participants. Participants viewed clinical cure as essential for patients to regain productivity. Non-patient stakeholders emphasized the importance of “sustained” clinical cure. For most survey participants, combination therapy, compared with monotherapy, would increase health equity (40%), and be more acceptable (79%) and feasible (57%). Interviews revealed that combination therapy was more feasible and acceptable than monotherapy when associated with a shorter duration of hospitalization. The findings of the interviews provided insight into those of the survey. When choosing between alternative options, providers should consider the outcomes that matter to patients as well as the impact on equity, feasibility, and acceptability of the options. In East Africa and South Asia, the number of patients with visceral leishmaniasis (VL) co-infected with human immunodeficiency virus (HIV) has been increasing over the years. In addition to independently posing major health challenges, the two conditions have detrimental effects on each other. In light of new evidence on treatment regimens for this patient population, the World Health Organization (WHO) recently updated its evidence-based region-specific treatment recommendations. To inform this process, we assessed the views of stakeholders on the outcomes of interest and on medication treatment options. The mixed methods study consisted of an online survey and semi-structured interviews. Outcomes such as mortality, complications, clinical cure, relapse and serious adverse events were viewed as important because of the burden associated with their experience, their consequences, and the co-infection status of the patients. Outcomes such as non-serious adverse events were viewed as less important for reasons relating to patient tolerability and ease of treatment. As compared to monotherapy, combination therapy was found to be more equitable, acceptable, and feasible. While our findings are important to consider by clinicians treating patients with VL patients coinfected with HIV, they also inform decisions made by other stakeholders such as guideline developers and program managers.
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Affiliation(s)
- Joanne Khabsa
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Saurabh Jain
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Amena El-Harakeh
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Cynthia Rizkallah
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Dhruv K. Pandey
- Kala-azar Elimination Programme, World Health Organization Country Office, New Delhi, India
| | - Nigus Manaye
- Neglected Tropical Diseases, World Health Organization Country Office, Addis Ababa, Ethiopia
| | | | - Christine Halleux
- Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Daniel Argaw Dagne
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Elie A. Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- * E-mail:
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Asrat B, Lund C, Ambaw F, Garman EC, Schneider M. Major depressive disorder and its association with adherence to antiretroviral therapy and quality of life: cross-sectional survey of people living with HIV/AIDS in Northwest Ethiopia. BMC Psychiatry 2020; 20:462. [PMID: 32972394 PMCID: PMC7513286 DOI: 10.1186/s12888-020-02865-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/10/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Major depression is believed to affect treatment adherence and overall quality of life (QoL) of people living with HIV/AIDS (PLWHA). Comorbid major depression contributes to a two-fold higher risk of mortality among PLWHA. Understanding the relationships of major depression, adherence to antiretroviral therapy (ART) and QoL is important to identify areas for intervention. The aim of this study is to examine relationship of major depressive disorder (MDD) and adherence to ART with QoL, and to investigate socio-demographic and clinical factors associated with MDD, adherence and QoL among PLWHA in Northwest Ethiopia. METHOD A cross-sectional study was conducted in the ART clinic of Felege-Hiwot referral hospital in Northwest Ethiopia from July to October 2019. Adult PLWHA were selected using a systematic random sampling technique. Data were collected using interview administered questionnaires and chart reviews. Mini International Neuropsychiatric Interview and WHOQOL-HIV-BREF-Eth instruments were used to measure MDD and QoL respectively. Adherence to ART was assessed using pill count data from patients' adherence monitoring chart. Univariate and multivariate Poisson regressions were used to assess associations of socio-demographic and clinical factors with MDD and adherence to ART. A multivariate linear regression was used to examine the associations of both MDD and adherence with overall QoL. RESULT Of the total of 393 invited participants, 391 (99.5%) completed the interviews. MDD was negatively associated with overall QoL: participants with MDD had a lower QoL score of 0.17 points compared to those with no MDD. MDD was associated with reduced adherence to ART when functional disability was controlled (RR = 1.43; 95%CI = 1.05, 1.96; p = 0.025). However, there was no statistical association between adherence to ART and overall QoL. Functional disability was associated with both MDD (RR = 5.07; 95%CI = 3.27,7.86; p < 0.001) and overall QoL (β = 0.29; 95%CI = 0.21,0.36; p < 0.001). CONCLUSION The relationship between MDD and QoL indicates the need for feasible, acceptable and evidence-based mental health interventions to reduce depression and improve overall QoL of PLWHA. We recommend future studies investigate causal relationships of MDD, adherence to ART and QoL of PLWHA to better understand priority areas for intervention.
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Affiliation(s)
- Biksegn Asrat
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
| | - Crick Lund
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Centre for Global Mental Health, Department of Health Services and Population Research, King's Global Health Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Fentie Ambaw
- School of Public Health, College of medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Emily Claire Garman
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Marguerite Schneider
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Pires M, Wright B, Kaye PM, da Conceição V, Churchill RC. The impact of leishmaniasis on mental health and psychosocial well-being: A systematic review. PLoS One 2019; 14:e0223313. [PMID: 31622369 PMCID: PMC6797112 DOI: 10.1371/journal.pone.0223313] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 09/18/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Leishmaniasis is a neglected tropical parasitic disease endemic in South Asia, East Africa, Latin America and the Middle East. It is associated with low socioeconomic status (SES) and responsible for considerable mortality and morbidity. Reports suggest that patients with leishmaniasis may have a higher risk of mental illness (MI), psychosocial morbidity (PM) and reduced quality of life (QoL), but this is not well characterised. The aim of this study was to conduct a systematic review to assess the reported impact of leishmaniasis on mental health and psychosocial wellbeing. METHODS A systematic review of the literature was carried out. Pre-specified criteria were applied to identify publications including observational quantitative studies or systematic reviews. Two reviewers screened all of the titles, abstracts and full-studies and a third reviewer was consulted for disagreements. Data was extracted from papers meeting the criteria and quality appraisal of the methods was performed using the Newcastle-Ottawa Scale or the Risk of Bias in Systematic Review tool. RESULTS A total of 14 studies were identified from 12,517 records. Nine cross-sectional, three case-control, one cohort study and one systematic review were included. Eleven assessed MI outcomes and were measured with tools specifically designed for this; nine measured PM and 12 measured QoL using validated measurement tools. Quality appraisal of the studies showed that six were of good quality. Cutaneous leishmaniasis and post kala-azar dermal leishmaniasis showed evidence of associated MI and PM including depression, anxiety and stigma, while all forms of disease showed decreased QoL. The findings were used to inform a proposed model and conceptual framework to show the possible links between leishmaniasis and mental health outcomes. CONCLUSION There is evidence that leishmaniasis has an impact on MI, PM or QoL of patients and their families and this occurs in all the main subtypes of the disease. There are however large gaps in the evidence. Further research is required to understand the full extent of this problem and its mechanistic basis.
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Affiliation(s)
- Malini Pires
- Mental Health Research Group, Hull York Medical School and Dept. of Health Sciences, University of York, England, United Kingdom
| | - Barry Wright
- Mental Health Research Group, Hull York Medical School and Dept. of Health Sciences, University of York, England, United Kingdom
| | - Paul M. Kaye
- Centre for Reviews and Dissemination, University of York, England, United Kingdom
- Centre for Immunology and Infection, Hull York Medical School and Dept. of Biology, University of York, England, United Kingdom
| | | | - Rachel C. Churchill
- Centre for Reviews and Dissemination, University of York, England, United Kingdom
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Veeri RB, Gupta AK, Pal B, Siddiqui NA, Priya D, Das P, Pandey K. Assessment of quality of life using WHOQOL-BREF in patients with visceral leishmaniasis. Health Qual Life Outcomes 2019; 17:53. [PMID: 30922346 PMCID: PMC6437940 DOI: 10.1186/s12955-019-1112-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 02/26/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study was aimed to assess the impact of quality of life using WHOQOL-BREF in patients with Visceral leishmaniasis (VL). METHODS A total of 95 VL cases and 95 healthy participants filled out the questionnaires. Data on socio-demographic aspects along with disease duration were collected. Data were compared using a t-test, analysis of variance and chi-square test. RESULTS VL patients experienced very high impact on their quality of life. Study cohort had male preponderance (72.63%). Majority (64.21%) were aged < 40 years. Longer disease duration was found to have significantly poor quality of life (p < 0.05). The physical domain was found to be most affected domains of quality of life (QOL). QOL was affected most in illiterate, married, housewife, rural population and patients with longer disease duration (p < 0.05). The psychological and environmental domains were significantly affected in > 40 years of age group married patients (p < 0.05). CONCLUSIONS VL significantly impaired the patients' (QOL) in all four domains (physical, psychological, social relationship and environmental). Physical domain was significantly the most affected domain.
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Affiliation(s)
- Rajendra Babu Veeri
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur, 844102 India
| | - Ashok Kumar Gupta
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur, 844102 India
| | - Biplab Pal
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur, 844102 India
| | - Niyamat Ali Siddiqui
- Department of Bio Statistics, Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Agamkuan, Patna, 800007 India
| | - Devi Priya
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur, 844102 India
| | - Pradeep Das
- Department of Molecular Biology, Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Agamkuan, Patna, 800007 India
| | - Krishna Pandey
- Department of Clinical Medicine, Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Agamkuan, Patna, 800007 India
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