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Laurie E, Siebert S, Yongolo N, Halliday JEB, Biswaro SM, Krauth SJ, Kilonzo KG, Mmbaga BT, McIntosh E. Evidencing the clinical and economic burden of musculoskeletal disorders in Tanzania: paving the way for urgent rheumatology service development. Rheumatol Adv Pract 2023; 8:rkad110. [PMID: 38143512 PMCID: PMC10748784 DOI: 10.1093/rap/rkad110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2023] [Indexed: 12/26/2023] Open
Affiliation(s)
- Emma Laurie
- School of Geographical and Earth Sciences, University of Glasgow, Glasgow, UK
| | - Stefan Siebert
- School of Infection & Immunity, University of Glasgow, Glasgow, UK
| | - Nateiya Yongolo
- Department of Clinical Research, Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
- Department of Internal Medicine, Kilimanjaro Clinical Medical University College, Moshi, United Republic of Tanzania
| | - Jo E B Halliday
- School of Biodiversity, One Health & Veterinary Medicine, University of Glasgow, Glasgow, UK
| | - Sanjura M Biswaro
- Department of Clinical Research, Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
| | | | - Kajiru Gad Kilonzo
- Department for Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
| | - Blandina T Mmbaga
- Department of Clinical Research, Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
- Department of Internal Medicine, Kilimanjaro Clinical Medical University College, Moshi, United Republic of Tanzania
| | - Emma McIntosh
- School of Health & Wellbeing, University of Glasgow, Glasgow, UK
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Calabrese S, Markl AM, Neugebauer M, Krauth SJ, Borst N, von Stetten F, Lehnert M. Reporter emission multiplexing in digital PCRs (REM-dPCRs): direct quantification of multiple target sequences per detection channel by population specific reporters. Analyst 2023; 148:5243-5254. [PMID: 37727114 DOI: 10.1039/d3an00191a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Digital PCRs (dPCRs) are widely used methods for the detection and quantification of rare abundant sequences relevant to fields such as liquid biopsy or oncology. In order to increase the information content and save valuable sample materials, there is a significant need for digital multiplexing methods that are easy to establish, analyse, and interpret, and ideally allow the usage of existing lab equipment. Herein, we present a novel reporter emission multiplexing approach for the digital PCR method (REM-dPCR), which meets these requirements. It further increases the multiplexing capacity of commercial dPCR devices. For example, we present a stepwise increase in multiplexing degrees from a monochrome two-plex assay in one detection channel to a six-plex REM-dPCR assay in a three-color dPCR device for KRAS/BRAF single nucleotide polymorphism (SNP) target sequences. The guidelines for the REM-dPCR design are presented, and the process from duplex to six-plex assay establishment, taking into account the target sequence-dependent effects on assay performance, is discussed. Furthermore, the assay-specific, sensitive and precise quantification of different fractions of KRAS mutant and wild-type DNA sequences in different ratios is demonstrated. To increase the device capacitance and the degree of multiplexing, the REM-dPCR uses the advantage of n target-independent reporter molecules in combination with target sequence-specific mediator probes. Different reporter types are labelled with fluorophores of different signal intensities but not necessarily different emission spectra. This leads to the generation of n independent single-positive populations in the dataspace, created by k detection channels, whereby n > k and n ≥ 2. By usage of target-independent but population-specific reporter types, a fixed set of six optimized signalling molecules could be defined. This reporter set enables the robust generation and precise differentiation of multiple fluorescence signals in dPCRs and can be transferred to new target panels. The set which enables stable signal generation and differentiation in a specified device would allow easy transfer to new target panels.
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Affiliation(s)
| | - Anja M Markl
- Hahn-Schickard, 79110 Freiburg, Germany.
- Faculty of Chemistry and Pharmacy, Albert-Ludwigs-Universität Freiburg, 79104 Freiburg, Germany
| | - Maximilian Neugebauer
- Hahn-Schickard, 79110 Freiburg, Germany.
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, 79110 Freiburg, Germany
| | - Stefanie J Krauth
- School of Biodiversity, One Health, and Veterinary Medicine, University of Glasgow, Glasgow, UK
- School of Health and Wellbeing, General Practice and Primary Care, University of Glasgow, Glasgow, UK
| | - Nadine Borst
- Hahn-Schickard, 79110 Freiburg, Germany.
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, 79110 Freiburg, Germany
| | - Felix von Stetten
- Hahn-Schickard, 79110 Freiburg, Germany.
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, 79110 Freiburg, Germany
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Yongolo NM, Krauth SJ, Biswaro SM, Moshi B, Mwanswila M, Hemed A, Njau R, Ng’unda NA, Walker R, Kilonzo K, Siebert S, Halliday J, McIntosh E, Kelly C, Mmbaga B, Temu G. P208 A retrospective survey of arthritis among inpatients at a consultant hospital in Northern Tanzania from 2017 to 2019. Rheumatology (Oxford) 2022. [DOI: 10.1093/rheumatology/keac133.207] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Aims
Musculoskeletal (MSK) disorders affect many people worldwide, but there is minimal access to medical care in low and middle-income countries (LMICs). Few hospital-based studies on MSK disorders have been conducted and there are limited prevalence data on MSK diseases in sub-Saharan Africa (SSA). Arthritis is the most common MSK condition, both reducing physical activity and increasing the risk of disability and other non-communicable diseases (NCDs). Given the high prevalence of MSK disorders and the associated significant clinical and economic burden in developed countries, an estimate of the frequency of these conditions in SSA is overdue. We aimed to determine the recorded prevalence of arthritis and related clinical features among patients admitted to a tertiary care hospital in Northern Tanzania from 2017-19.
Methods
Ethical approval was obtained to review the medical records retrospectively for all patients aged over 13 admitted to medical wards at Kilimanjaro Christian Medical Centre, a zonal tertiary care hospital, over this 3-year period. We collected demographic characteristics including age, gender, diagnoses and outcome. Diagnoses specifying arthritis were specifically sought. The prevalence of arthritis among inpatients over this period estimated. Analysis was conducted using STATA version 15 with categorical variables summarized using frequency and percentage.
Results
A total of 8023 patient files were examined with a slight majority of males 4181 (52.1%). An arthritis was recorded in 129 (1.6%) with 71 (55%) aged ≥60 years and 74 (57.4%) being female. The commonest presenting symptoms were joint pain in 69 (53.5%), swelling in 38 (29.5%) and stiffness in 18 (14%). A precise diagnosis for the arthritis was rarely recorded, although rheumatoid arthritis and gout were specified in a minority. Overall mortality was 12.4% among patients with arthritis. In addition, a diagnosis of systemic lupus erythematosus was recorded in a further 16 (0.2%) patients.
Conclusion
The recorded prevalence of arthritis among hospital inpatients in this LMIC study was low but the associated mortality appeared high. The retrospective nature of the data is highly likely to have underestimated the true prevalence of MSK disease and emphasizes the need for improved awareness of MSK diagnostic and management strategies. A teaching and training program has been developed to assist with this.
Disclosure
N.M. Yongolo: None. S.J. Krauth: None. S.M. Biswaro: None. B. Moshi: None. M. Mwanswila: None. A. Hemed: None. R. Njau: None. N. Allen Ng’unda: None. R. Walker: None. K. Kilonzo: None. S. Siebert: None. J. Halliday: None. E. McIntosh: None. C. Kelly: None. B. Mmbaga: None. G. Temu: None.
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Affiliation(s)
- Nateiya M Yongolo
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, TANZANIA, UNITED REPUBLIC OF
- Institute of Health and Wellbeing, The University of Glasgow, Glasgow, UNITED KINGDOM
| | - Stefanie J Krauth
- Institute of Biodiversity, Animal Health and Comparative Medicine, The University of Glasgow, Glasgow, UNITED KINGDOM
| | - Sanjura M Biswaro
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, TANZANIA, UNITED REPUBLIC OF
| | - Baraka Moshi
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, TANZANIA, UNITED REPUBLIC OF
| | - Manasseh Mwanswila
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, TANZANIA, UNITED REPUBLIC OF
| | - Asia Hemed
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, TANZANIA, UNITED REPUBLIC OF
| | - Rosalia Njau
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, TANZANIA, UNITED REPUBLIC OF
| | - Neema Allen Ng’unda
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, TANZANIA, UNITED REPUBLIC OF
| | - Richard Walker
- Newcastle University, Northumbria Healthcare NHS, Newcastle, UNITED KINGDOM
| | - Kajiru Kilonzo
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, TANZANIA, UNITED REPUBLIC OF
| | - Stefan Siebert
- Institute of Infection, Immunity and Inflammation, The University of Glasgow, Glasgow, UNITED KINGDOM
| | - Jo Halliday
- Institute of Biodiversity, Animal Health and Comparative Medicine, The University of Glasgow, Glasgow, UNITED KINGDOM
| | - Emma McIntosh
- Institute of Health and Wellbeing, The University of Glasgow, Glasgow, UNITED KINGDOM
| | - Clive Kelly
- Newcastle University, Northumbria Healthcare NHS, Newcastle, UNITED KINGDOM
| | - Blandina Mmbaga
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, TANZANIA, UNITED REPUBLIC OF
- Kilimanjaro Christian Medical University College, Kilimanjaro Christian Medical University College, Moshi, TANZANIA, UNITED REPUBLIC OF
| | - Gloria Temu
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, TANZANIA, UNITED REPUBLIC OF
- Kilimanjaro Christian Medical University College, Kilimanjaro Christian Medical University College, Moshi, TANZANIA, UNITED REPUBLIC OF
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Krauth SJ, Yongolo N, Biswaro S, Kelly C, Walker RW, Siebert S, Deidda M, Wyke S, Halliday J, Mmbaga BT, McIntosh E. P105 Prevalence and associated factors of musculoskeletal joint disease in the community setting in Hai district, northern Tanzania. Rheumatology (Oxford) 2022. [DOI: 10.1093/rheumatology/keac133.104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Aims
There is little evidence on the prevalence of musculoskeletal (MSK) joint disorders, in particular around inflammatory and degenerative arthritis, in sub-Saharan Africa. In Tanzania specifically, the prevalence and distribution of these conditions in the population has never been studied and the nature of existing joint disorders and the associated factors are therefore unknown. The aim of this study is to establish the prevalence of MSK joint disease and associated factors among the rural population in Tanzania.
Methods
Households in the Hai district were randomly selected using a two-stage cluster sampling approach with villages selected with a probability proportional to size. Consenting individuals aged 5 years and above were screened for the presence of MSK joint problems using the Gait Arms Legs and Spine (GALS) examination. Individuals screened positive by the GALS exam, were further assessed using the Regional Examination of the Musculoskeletal System (REMS). Demographic and other information were gathered via questionnaire and subsequently checked for association with a positive REMS exam. Data were analysed in STATA using a mixed model logistic regression with village, household, and examiner as random effects.
Results
The overall prevalence of MSK joint disease (REMS positive) among the 2697 examined individuals (1969 Adults & 728 children <18 years) was 5.9 % (CI: 5.1%-6.9%). Adult females have significantly higher odds of screening positive than adult males (Odds Ratio (OR): 2.2; CI: 1.5-3.2; p < 0.01). The prevalence of MSK joint problems varied significantly with age, with only 0.1 % (CI: 0%-0.75%) of children aged 5-18 years screening positive with REMS compared to 1.3% (CI: 0.7%-2.3%) of people aged 18-45 years, 9.1% (CI: 7.0%-11.6%) aged 46-65 years, 21.7% (CI: 17.1%-26.8%) aged 66-85 years, and 31.8% (CI: 20.6%-44.7%) of those aged over 85. We found that people living in mid-level altitudes had the highest odds of screening positive with REMS (OR midland vs lowland = 2.1; CI: 1.4-3.3, p = 0.01; OR highland vs lowland = 1.5; CI: 1-2.3, p = 0.081).
Conclusion
Our study provides new insight into the prevalence and distribution of MSK joint disease in rural communities in Tanzania and into the factors associated with higher odds of screening positive with the REMS examination. Results from this study will help build the evidence around the prevalence of MSK joint diseases and factors associated with them in Tanzania. This will enable researchers and practitioners to facilitate the diagnosis and management of Arthritis and other MSK conditions in the population and to improve the health of people living with these diseases in Tanzania.
Disclosure
S.J. Krauth: None. N. Yongolo: None. S. Biswaro: None. C. Kelly: None. R.W. Walker: None. S. Siebert: None. M. Deidda: None. S. Wyke: None. J. Halliday: None. B.T. Mmbaga: None. E. McIntosh: None.
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Affiliation(s)
- Stefanie J Krauth
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Nateiya Yongolo
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Center, Moshi, TANZANIA, UNITED REPUBLIC OF
| | - Sanjura Biswaro
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Center, Moshi, TANZANIA, UNITED REPUBLIC OF
| | - Clive Kelly
- James Cook University Hospital, James Cook University Hospital, Middlesbrough, UNITED KINGDOM
| | - Richard W Walker
- Department of Medicine, Newcastle University, Newcastle upon Tyne, UNITED KINGDOM
| | - Stefan Siebert
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Manuela Deidda
- Health Economics and Health Technology Assessment, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Sally Wyke
- Institute of Health & Wellbeing Social Sciences, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Jo Halliday
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Blandina T Mmbaga
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical University College, Moshi, TANZANIA, UNITED REPUBLIC OF
| | - Emma McIntosh
- Health Economics and Health Technology Assessment, University of Glasgow, Glasgow, UNITED KINGDOM
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Khaliq A, Amreen, Jameel N, Krauth SJ. Knowledge and Practices on the Prevention and Management of Diarrhea in Children Under-2 Years Among Women Dwelling in Urban Slums of Karachi, Pakistan. Matern Child Health J 2022; 26:1442-1452. [PMID: 35247160 PMCID: PMC9174301 DOI: 10.1007/s10995-022-03391-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2022] [Indexed: 11/28/2022]
Abstract
Background Diarrhea is the second leading cause of death especially among children. The age-proportionate mortality of diarrheal disease in infants under 2 years is 72%, among children under 5 years of age. Children living in urban slums are more prone to develop diarrhea. Although the disease can be prevented by many simple cost-effective interventions, i.e. proper sanitation and hygiene, appropriate feeding, and timely vaccination, poverty and lack of basic life amenities often potentiate diarrhea mortality. Gadap town is the largest town of Karachi with a deprived health system. This study aims to assess pediatric diarrhea prevalence and related knowledge-practice gaps in the slums of Gadap Town, Karachi, Pakistan. Method A community-based cross-sectional study was conducted from November 2016 to May 2017 among mothers of children under 2 years, who were residents of Gadap Town, Karachi, Pakistan. The participants were approached by a multistage sampling method. A validated dichotomous questionnaire, piloted on 40 participants, translated into local language Urdu was used for data collection and the data was analyzed by SPSS® version 20.0. Results 51.8% (n = 199) of participants were aged between 25 and 34 years. Among all participants, 68% (n = 261) had primary level education or less, compared to 4.7% (n = 18) of women who had graduate-level education. The mean number of children per woman was 2.52 ± 1.62. Self-reported pediatric diarrhea incidence was 72.1% (n = 277). More than half (55.2% n = 149) of participants reported frequent diarrhea episodes during the 2nd year of their child’s life. In this survey, we found the knowledge of women regarding diarrhea management and how to reduce diarrhea morbidity to be inadequate (p > 0.05). However, many women reported appropriate practices which can significantly reduce diarrhea morbidity (p < 0.05). Conclusion While the knowledge among women on preventive measures for pediatric diarrhea was insufficient, the translation of the right knowledge into appropriate practices showed promising outcomes for reducing diarrhea morbidity. An integrated approach for improving feeding, sanitation, and hygiene practices along with continuous health education could curtail the burden of diarrhea among infants living in urban slums.
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Affiliation(s)
- Asif Khaliq
- Department of Community Medicines, Baqai Medical University, Karachi, Pakistan. .,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia. .,Department of Paediatrics and Child Health, Aga Khan University Hospital, Karachi, Pakistan.
| | - Amreen
- Department of Psychiatry, Dow University of Health Sciences, Karachi, Pakistan
| | - Nazia Jameel
- Department of Community Medicines, Baqai Medical University, Karachi, Pakistan
| | - Stefanie J Krauth
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK.
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Traoré SI, Achi LY, Krauth SJ, Sanogo M, Zinsstag J, Utzinger J, N'Goran EK. Distribution of bovine <em>Fasciola gigantica</em> (Cobbold, 1885) in the district des Savanes, northern Côte d'Ivoire. Geospat Health 2021; 16. [PMID: 34730317 DOI: 10.4081/gh.2021.976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/30/2021] [Indexed: 06/13/2023]
Abstract
Fascioliasis, caused by an infection with liver flukes of the genus Fasciola, is an important disease of livestock in most parts of the world. However, little is known about the distribution of fascioliasis in sub-Saharan Africa. We report results of a cross-sectional study conducted in 2014 in the district des Savanes in the northern part of Côte d'Ivoire. We obtained 275 livers from bovine suspected with fascioliasis and 51 unsuspected livers from 24 slaughterhouses. Livers were dissected using a standard operating procedure and all Fasciola gigantica flukes were removed from the tissues of the liver and the biliary ducts. We found F. gigantica in 125 livers from bovines suspected with fascioliasis (45.5%) in 10 departments of the district des Savanes. Among the unsuspected livers, five were positive for F. gigantica (9.8%). The distribution of fascioliasis showed considerable spatial heterogeneity, both at regional (ranging from 18.0% to 52.3%) and departmental level (ranging from 14.3% to 64.0%). Poro region was the most affected (52.3%) with a relatively homogeneous distribution. The departments most affected by fascioliasis were M'Bengué (64.0%), Sinématiali (62.1%) and Ferkessédougou (52.9%). Our study confirms that fascioliasis is an important veterinary disease in the northern part of Côte d'Ivoire, and hence, high-risk areas need to be targeted for prevention and control measures.
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Affiliation(s)
- Seïdinan I Traoré
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Laboratoire National d'Appui au Développement Agricole, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan.
| | - Louise Y Achi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Ecole de Spécialisation en Elevage et Métiers de la Viande de Bingerville, Abidjan.
| | - Stefanie J Krauth
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow.
| | - Moussa Sanogo
- Laboratoire National d'Appui au Développement Agricole, Abidjan.
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel.
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel.
| | - Eliézer K N'Goran
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan.
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Kouassi BL, Barry A, Heitz-Tokpa K, Krauth SJ, Goépogui A, Baldé MS, Barry O, Niamey ML, Bockarie MJ, Koudou BG, Utzinger J. Perceptions, knowledge, attitudes and practices for the prevention and control of lymphatic filariasis in Conakry, Republic of Guinea. Acta Trop 2018; 179:109-116. [PMID: 29224979 DOI: 10.1016/j.actatropica.2017.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 10/16/2017] [Accepted: 12/01/2017] [Indexed: 11/16/2022]
Abstract
Little is known about the perceptions, attitudes and practices of lymphatic filariasis in Conakry, Republic of Guinea. Yet, such knowledge is important for an optimal design and implementation of setting-specific prevention and control measures. We conducted a cross-sectional study using a mixed methods approach. Qualitative data related to people's general experience with lymphatic filariasis, their perception of the causes of the disease, the onset of elephantiasis, care-seeking behaviour and the socioeconomic impact of lymphatic filariasis were collected through in-depth interviews with 85 respondents. Quantitative data related to strategies for prevention and the knowledge of the causes of the disease were collected by interviewing 429 people. A total of 514 individuals (313 females and 201 males), aged 10-84 years, participated. Most participants were well aware of lymphatic filariasis and they recognized the disease mainly by its disfiguring manifestation, collectively termed "elephantiasis" or "leg-swelling disease". Morbidity patterns due to filarial infection showed an increase with age (from 30 to 50 years) independent of sex. Most patients with lymphatic filariasis abandoned their jobs (73.9%) or sought other work (21.7%). The main perceived causes of acquiring lymphatic filariasis were of supernatural origin (as stated by 8.7% of patients and 5.7% of healthy subjects), while mosquito bites were mentioned by fewer participants (4.3% of patients and 4.2% of healthy subjects). A number of other causes were reported that relate to both medical and non-medical conceptions. The study also identified socioeconomic impairments and stigmatization due to elephantiasis. Taken together, community perception of lymphatic filariasis in Conakry is influenced by sociocultural conceptions. Appropriate health education campaigns aimed at enhancing community understanding of the transmission of lymphatic filariasis are required to increase the success of mass drug administration implemented for the elimination of this disease. There is a need for a morbidity management programme to alleviate lymphatic filariasis-related physical and emotional burden in Conakry.
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Affiliation(s)
- Bernard L Kouassi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Unité de Formation et de Recherche Science de la Nature, Université Nangui Abrogoua, Abidjan, Côte d'Ivoire.
| | - Aboulaye Barry
- Programme National de Lutte contre l'Onchocercose, le Trachome et les autres Maladies Tropicales Négligées, Ministère de la Santé Publique, Conakry, Republic of Guinea
| | - Kathrin Heitz-Tokpa
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; University of Basel, Basel, Switzerland
| | - Stefanie J Krauth
- University of Basel, Basel, Switzerland; Swiss Tropical and Public Health Institute, Basel, Switzerland; École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Andre Goépogui
- Programme National de Lutte contre l'Onchocercose, le Trachome et les autres Maladies Tropicales Négligées, Ministère de la Santé Publique, Conakry, Republic of Guinea
| | - Mamadou S Baldé
- Programme National de Lutte contre l'Onchocercose, le Trachome et les autres Maladies Tropicales Négligées, Ministère de la Santé Publique, Conakry, Republic of Guinea
| | - Oumar Barry
- Programme National de Lutte contre l'Onchocercose, le Trachome et les autres Maladies Tropicales Négligées, Ministère de la Santé Publique, Conakry, Republic of Guinea
| | - Marie L Niamey
- Programme National de Lutte contre l'Onchocercose, le Trachome et les autres Maladies Tropicales Négligées, Ministère de la Santé Publique, Conakry, Republic of Guinea
| | - Moses J Bockarie
- Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Benjamin G Koudou
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Unité de Formation et de Recherche Science de la Nature, Université Nangui Abrogoua, Abidjan, Côte d'Ivoire; Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Jürg Utzinger
- University of Basel, Basel, Switzerland; Swiss Tropical and Public Health Institute, Basel, Switzerland
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Greter H, Krauth SJ, Ngandolo BNR, Alfaroukh IO, Zinsstag J, Utzinger J. Validation of a Point-of-Care Circulating Cathodic Antigen Urine Cassette Test for Schistosoma mansoni Diagnosis in the Sahel, and Potential Cross-Reaction in Pregnancy. Am J Trop Med Hyg 2015; 94:361-4. [PMID: 26556831 DOI: 10.4269/ajtmh.15-0577] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Accepted: 09/25/2015] [Indexed: 01/10/2023] Open
Abstract
On the shores of Lake Chad, schistosomiasis among mobile pastoralists was investigated in a field laboratory. Point-of-care circulating cathodic antigen (POC-CCA) cassette test, reagent strip, and filtration were conducted on urine samples. Fresh stool samples were subjected to the Kato-Katz technique, and fixed samples were examined with an ether-concentration method at a reference laboratory. POC-CCA urine cassette tests revealed a Schistosoma mansoni prevalence of 6.9%, compared with only 0.5% by stool microscopy. Three pregnant women with otherwise negative urine and stool testing had positive POC-CCA. This observation raises concern of cross-reactivity in pregnancy. Hence, two pregnant women in Switzerland with no history of schistosomiasis were subjected to POC-CCA and one tested positive. Our data suggest that POC-CCA can be performed under extreme Sahelian conditions (e.g., temperatures > 40°C), and it is more sensitive than stool microscopy for S. mansoni diagnosis. However, potential cross-reactivity in pregnancy needs further investigation.
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Affiliation(s)
- Helena Greter
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Institut de Recherche en Elevage pour le Développement, N'Djamena, Chad
| | - Stefanie J Krauth
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Institut de Recherche en Elevage pour le Développement, N'Djamena, Chad
| | - Bongo N R Ngandolo
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Institut de Recherche en Elevage pour le Développement, N'Djamena, Chad
| | - Idriss O Alfaroukh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Institut de Recherche en Elevage pour le Développement, N'Djamena, Chad
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Institut de Recherche en Elevage pour le Développement, N'Djamena, Chad
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Institut de Recherche en Elevage pour le Développement, N'Djamena, Chad
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Krauth SJ, Greter H, Stete K, Coulibaly JT, Traoré SI, Ngandolo BNR, Achi LY, Zinsstag J, N'Goran EK, Utzinger J. All that is blood is not schistosomiasis: experiences with reagent strip testing for urogenital schistosomiasis with special consideration to very-low prevalence settings. Parasit Vectors 2015; 8:584. [PMID: 26554822 PMCID: PMC4641389 DOI: 10.1186/s13071-015-1165-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 10/14/2015] [Indexed: 01/02/2023] Open
Abstract
Background Reagent strip testing for microhaematuria has long been used for community diagnosis of Schistosoma haematobium. Sensitivities and specificities are reasonable, and hence, microhaematuria can serve as a proxy for S. haematobium infection. However, assessment of test performance in the context of the underlying S. haematobium prevalence is rare and test parameters other than sensitivity and specificity have been neglected. Methods Data about the association between microhaematuria and urine filtration results from three studies were compared and put into context with findings from a recent Cochrane review. Data were stratified by S. haematobium prevalence to identify prevalence-related differences in test performance. Kappa agreement and regression models were employed to compare data for different S. haematobium prevalence categories. Results We found a “background” prevalence of microhaematuria (13 %, on average) which does not seem to be associated with schistosomiasis in most settings, irrespective of the prevalence of S. haematobium. This background level of microhaematuria might be due to cases missed with urine filtration, or alternative causes apart from S. haematobium. Especially in very-low prevalence settings, positive results for microhaematuria likely give an inaccurate picture of the extent of S. haematobium, whereas negative results are a sound indicator for the absence of infection. Conclusions Reagent strip testing for microhaematuria remains a good proxy for urogenital schistosomiasis, but implications of test results and scope of application differ depending on the setting in which reagent strips are employed. In very-low prevalence settings, microhaematuria is an unstable proxy for urogenital schistosomiasis and treatment decision should not be based on reagent strip test results alone. Our findings underscore the need for highly accurate diagnostic tools for settings targeted for elimination of urogenital schistosomiasis.
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Affiliation(s)
- Stefanie J Krauth
- Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland. .,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
| | - Helena Greter
- Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland. .,Institut de Recherches en Élevage pour le Développement, N'Djamena, Chad.
| | - Katarina Stete
- Center for Infectious Diseases and Travel Medicine, University Hospital Freiburg, Freiburg, Germany.
| | - Jean T Coulibaly
- Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland. .,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.
| | - Seïdinan I Traoré
- 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. .,Laboratoire Régional de Korhogo du Laboratoire National d'Appui au Développement Agricole, Korhogo, Côte d'Ivoire.
| | - Bongo N R Ngandolo
- Institut de Recherches en Élevage pour le Développement, N'Djamena, Chad.
| | - Louise Y Achi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire. .,École de Spécialisation en Élevage de Bingerville, Bingerville, Côte d'Ivoire.
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Eliézer K N'Goran
- 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.
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
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10
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Krauth SJ, Musard C, Traoré SI, Zinsstag J, Achi LY, N'Goran EK, Utzinger J. Access to, and use of, water by populations living in a schistosomiasis and fascioliasis co-endemic area of northern Côte d'Ivoire. Acta Trop 2015; 149:179-85. [PMID: 26004285 DOI: 10.1016/j.actatropica.2015.05.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 05/18/2015] [Accepted: 05/20/2015] [Indexed: 12/29/2022]
Abstract
Water is an essential element of life, but it can also be a source of disease. Apart from direct consumption of unsafe water, direct contact and indirect consumption puts people at risk of many different types of pathogens. Employing a mixed methods approach, consisting of questionnaires and direct observations, we assessed access to, and use of, different water sources by the participants of the district des Savanes in northern Côte d'Ivoire. The use of water sources was put in relation to the potential risk of acquiring schistosomiasis and fascioliasis. Overall, 489 people aged 8 to 82 years participated. While all participants had access to safe water, 63% were in direct contact with unimproved water and 31% directly consumed unsafe water. More than a third of the people who otherwise reported using only improved water for all activities came in contact with unimproved water through crossing open water when going to their workplace, school or other destinations. Self-reported blood in urine - a marker for Schistosoma haematobium with reasonable sensitivity and specificity - was reported by 6% (n=30), self-reported blood in stool - an unspecific marker for Schistosoma mansoni - was reported by 7% (n=35), while blood co-occurring in both urine and stool was reported by another 10% (n=48) of participants. Accessing unimproved water for any activity (including crossing) was associated with higher odds of reporting blood in urine and/or blood in stool (odds ratio: 1.90; 95% confidence interval: 1.07-3.36). Our results have important rami-fications for intervention programmes targeting neglected tropical diseases, and emphasize the need for a wider supply of safe water to rural populations, since the water supply at the workplace needs to be considered as well next to the water supply at home. Crossing of open water sources is an important risk factor for sustained transmission of schistosomiasis.
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Affiliation(s)
- Stefanie J Krauth
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Capucine Musard
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Department of Environmental Systems Science, ETH Zurich, Zurich, Switzerland
| | - Seïdinan I Traoré
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Laboratoire Regional d'Appui au Développement Agricole de Korhogo, Korhogo, Côte d'Ivoire
| | - Jakob Zinsstag
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Louise Y Achi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Ecole de Spécialisation en Elevage de Bingerville, Bingerville, Côte d'Ivoire
| | - Eliézer K N'Goran
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Université Félix Houphouët-Boigny, 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.
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11
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Stete K, Krauth SJ, Coulibaly JT, Knopp S, Hattendorf J, Müller I, Lohourignon LK, Kern WV, N'goran EK, Utzinger J. Dynamics of Schistosoma haematobium egg output and associated infection parameters following treatment with praziquantel in school-aged children. Parasit Vectors 2012; 5:298. [PMID: 23259435 PMCID: PMC3558406 DOI: 10.1186/1756-3305-5-298] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 12/11/2012] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Praziquantel is the drug of choice in preventive chemotherapy targeting schistosomiasis. Increasing large-scale administration of praziquantel requires monitoring of drug efficacy to detect early signs of development of resistance. Standard protocols for drug efficacy monitoring are necessary. Here, we determined the optimal time point for praziquantel efficacy assessment against Schistosoma haematobium and studied the dynamics of infection parameters following treatment. METHODS Ninety school-aged children from south Côte d'Ivoire with a parasitologically confirmed S. haematobium infection were treated with a single oral dose of praziquantel (40 mg/kg) and followed up for 62 days post-treatment. Urine samples were collected on 23 schooldays during this period and were subjected to visual examination (macrohaematuria), urine filtration and microscopy (S. haematobium eggs) and reagent strip testing (microhaematuria, proteinuria and leukocyturia). RESULTS Observed cure and egg reduction rates were highly dependent on the time point post-treatment. Egg reduction rates were high (>97%) in weeks 3-9 post-treatment. Cure rates were highest in weeks 6 (92.9%) and 9 (95.0%) post-treatment. The prevalence of infection-associated parameters decreased after treatment, reaching a minimum of 2.4% in weeks 5 (proteinuria) and 7 (leukocyturia) post-treatment, and 16.3% at the end of week 8 (microhaematuria). Macrohaematuria disappeared between weeks 3 and 6 post-treatment. CONCLUSIONS For monitoring praziquantel efficacy against S. haematobium, we recommend that the cure rate is assessed at week 6 post-treatment. The egg reduction rate can be evaluated earlier, from day 14 post-treatment onwards. Reagent strips are a useful additional tool for evaluating treatment outcomes in areas with high endemicity, preferably at weeks 5 and 6 post-treatment. The delayed decrease of microhaematuria confirms that lesions in the urinary tract persist longer than egg excretion post-treatment.
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Affiliation(s)
- Katarina Stete
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
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Krauth SJ, Coulibaly JT, Knopp S, Traoré M, N'Goran EK, Utzinger J. An in-depth analysis of a piece of shit: distribution of Schistosoma mansoni and hookworm eggs in human stool. PLoS Negl Trop Dis 2012; 6:e1969. [PMID: 23285307 PMCID: PMC3527364 DOI: 10.1371/journal.pntd.0001969] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Accepted: 10/30/2012] [Indexed: 12/11/2022] Open
Abstract
Background An accurate diagnosis of helminth infection is important to improve patient management. However, there is considerable intra- and inter-specimen variation of helminth egg counts in human feces. Homogenization of stool samples has been suggested to improve diagnostic accuracy, but there are no detailed investigations. Rapid disintegration of hookworm eggs constitutes another problem in epidemiological surveys. We studied the spatial distribution of Schistosoma mansoni and hookworm eggs in stool samples, the effect of homogenization, and determined egg counts over time in stool samples stored under different conditions. Methodology Whole-stool samples were collected from 222 individuals in a rural part of south Côte d'Ivoire. Samples were cut into four pieces and helminth egg locations from the front to the back and from the center to the surface were analyzed. Some samples were homogenized and fecal egg counts (FECs) compared before and after homogenization. The effect of stool storing methods on FECs was investigated over time, comparing stool storage on ice, covering stool samples with a water-soaked tissue, or keeping stool samples in the shade. Principal Findings We found no clear spatial pattern of S. mansoni and hookworm eggs in fecal samples. Homogenization decreased S. mansoni FECs (p = 0.026), while no effect was observed for hookworm and other soil-transmitted helminths. Hookworm FECs decreased over time. Storing stool samples on ice or covered with a moist tissue slowed down hookworm egg decay (p<0.005). Conclusions/Significance Our findings have important implications for helminth diagnosis at the individual patient level and for epidemiological surveys, anthelmintic drug efficacy studies and monitoring of control programs. Specifically, homogenization of fecal samples is recommended for an accurate detection of S. mansoni eggs, while keeping collected stool samples cool and moist delayed the disintegration of hookworm eggs. An accurate diagnosis of parasitic worm (helminth) infections is important for adequate patient treatment and disease control programs. Helminth eggs in human stool samples are used as an indicator of infection intensity and morbidity. However, little is known about the exact distribution of helminth eggs in stool samples. Homogenization has been suggested to improve the diagnostic accuracy. Hookworm eggs disintegrate over time, which makes their detection challenging in epidemiological surveys. We determined the location of helminth eggs in entire stool samples from 222 individuals in Côte d'Ivoire. We also investigated whether homogenization has an effect on the detection of eggs, and determined egg counts over time in stool samples stored on ice, covered with a moist tissue, or kept in the shade. No clear pattern of helminth egg distribution was found in human stool samples. Homogenization resulted in more accurate egg counts of the blood fluke Schistosoma mansoni, while it did not affect other helminths. Keeping stool samples on ice or covered with a wet tissue slows down the disintegration of hookworm eggs. Our findings have important implications for individual patient management and the design and implementation of epidemiological surveys and helminth disease control programs.
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Affiliation(s)
- Stefanie J. Krauth
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- 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
- University of Basel, Basel, Switzerland
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche Biosciences, Université de Cocody, Abidjan, Côte d'Ivoire
| | - Stefanie Knopp
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Mahamadou Traoré
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Eliézer K. N'Goran
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche Biosciences, 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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Utzinger J, Rinaldi L, Malone JB, Krauth SJ, Kristensen TK, Cringoli G, Bergquist R. Geospatial health: the first five years. Geospat Health 2011; 6:137-154. [PMID: 22216480 DOI: 10.4081/gh.2011.166] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Geospatial Health is an international, peer-reviewed scientific journal produced by the Global Network for Geospatial Health (GnosisGIS). This network was founded in 2000 and the inaugural issue of its official journal was published in November 2006 with the aim to cover all aspects of geographical information system (GIS) applications, remote sensing and other spatial analytic tools focusing on human and veterinary health. The University of Naples Federico II is the publisher, producing two issues per year, both as hard copy and an open-access online version. The journal is referenced in major databases, including CABI, ISI Web of Knowledge and PubMed. In 2008, it was assigned its first impact factor (1.47), which has now reached 1.71. Geospatial Health is managed by an editor-in-chief and two associate editors, supported by five regional editors and a 23-member strong editorial board. This overview takes stock of the first five years of publishing: 133 contributions have been published so far, primarily original research (79.7%), followed by reviews (7.5%), announcements (6.0%), editorials and meeting reports (3.0% each) and a preface in the first issue. A content analysis of all the original research articles and reviews reveals that three quarters of the publications focus on human health with the remainder dealing with veterinary health. Two thirds of the papers come from Africa, Asia and Europe with similar numbers of contributions from each continent. Studies of more than 35 different diseases, injuries and risk factors have been presented. Malaria and schistosomiasis were identified as the two most important diseases (11.2% each). Almost half the contributions were based on GIS, one third on spatial analysis, often using advanced Bayesian geostatistics (13.8%), and one quarter on remote sensing. The 120 original research articles, reviews and editorials were produced by 505 authors based at institutions and universities in 52 countries. Importantly, a considerable proportion of the authors come from countries with a low or medium human development index (29.3%). In view of the increasing number of submissions, we are considering to publish more than two issues per year in the future. Finally, our vision is to open-up a new section predominantly based on visual presentations, including brief video clips, as discussed in a symposium at the 60th annual meeting of the American Society of Tropical Medicine and Hygiene in December 2011.
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Affiliation(s)
- Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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