Journal of Tropical Medicine最新文献

Background: Preventive chemotherapy with anthelminthic drugs is meant to control soil-transmitted helminthiases, but some children may experience adverse reactions.

Objective: This study investigated why some school-age children did not receive the medication as well as the side effects experienced by those who did during the 2019 preventive chemotherapy in Krachi East Municipal, Oti Region, Ghana.

Methods: Using a two-stage stratified sampling, a community-based cross-sectional study was conducted among 352 school-age children and their caregivers living in three urban and five rural communities.

Results: Most children (93.8%) were in primary school, aged 11 to 12 years (28.1%), male (53.1%), and resided in an urban area (83.8%). Due to concerns about side effects (28.1%), absenteeism (25.0%), and sickness (9.4%), 32 (9.09%) children did not receive the anthelminthic medication. Of the 320 children who received and ingested the anthelmintic drug, 50.3% experienced at least one side effect. Common side effects included dizziness (58.4%), feeling weak (27.3%), and stomach issues such as vomiting (17.4%), abdominal pain (11.8%), and nausea (6.2%). In adjusted analyses, children aged 11-12 years had higher odds of side effects (aOR: 2.40, 95% CI: 1.22-4.76) than children aged 7-8 years. Male children were also less likely than female children to experience adverse effects (aOR: 0.43, 95% CI: 0.27-0.68). Discussion. Ghana's national goal of 100% therapeutic coverage was unmet. Medication consumption during prophylactic chemotherapy may be hampered due to the high prevalence of side effects among school-age children. It is necessary to educate caregivers on how to handle these negative effects.

The economic burden of brucellosis care on patients can lead to significant financial strain, despite partial coverage by medical insurance. However, there is limited research on the out-of-pocket costs faced by brucellosis patients. Therefore, our study aimed to investigate the costs and out-of-pocket expenses of brucellosis care, specifically examining the varying socioeconomic status of patients in Xinjiang, China. We collected cost and demographic data from 563 respondents and their hospital bills and employed latent variable analysis to assess socioeconomic status. The majority of patients belonged to the middle and lower socioeconomic status categories (85.97%), and they were primarily farmers and herders (82.77%). The median direct cost per brucellosis episode was USD 688.65, with out-of-pocket expenses amounting to USD 391.44. These costs exceeded both the 2020 Xinjiang and national per capita health expenditures (USD 233.66 and USD 267.21, respectively). Notably, the overall medical reimbursement rate was 48.60%, and for outpatient costs, it was merely 12.82%. Despite higher out-of-pocket costs among high socioeconomic status patients, the percentage of income spent was higher (37.23%) for patients in the lower socioeconomic status group compared to other groups (16.25% and 12.96%). In conclusion, our findings highlight that brucellosis patients are predominantly from the middle and lower socioeconomic status, with high out-of-pocket expenses placing them under significant financial pressure. Moreover, there is notable inequity in economic consequences across different socioeconomic status groups. These results call for policy interventions aimed at reducing brucellosis-related poverty and promoting equitable access to care.

Modified landscapes could create breeding habitats for mosquitoes and affect their community structure and susceptibility with implications for their management. Hence, in this study, household mosquito control methods in two urbanized landscapes; industrial and residential human settlements, in Ghana and insecticide susceptibility of the inhabiting Anopheles populations were assessed. Household knowledge and usage pattern of mosquito control methods in the modified landscapes were obtained using a questionnaire. Female adult Anopheles mosquitoes were also subjected to susceptibility tests using mosquito coils (0.08% meperfluthrin, 0.03% dimefluthrin, and 0.3% transfluthrin) and World Health Organization (WHO) insecticide test papers (0.05% deltamethrin, 4% DDT, 0.1% bendiocarb, 0.25% pirimiphos-methyl, and 5% malathion). Although insecticide-treated nets and aerosols were used for mosquito control, mosquito coils were the most common and widely preferred household method. The Anopheles mosquitoes were resistant to all the insecticides (mosquito coils and WHO test papers) except pirimiphos-methyl. Land use type did not affect insecticide resistance, but the insecticide type did. The findings indicate the effect of household insecticide usage practices on local mosquito populations and their implications for effective vector management and disease control in modified landscapes.

Mosquitoes, notorious for their deadly impact as disease vectors, also hold economic value owing to their roles in disease transmission. The present study focuses on the importance of understanding mosquito gut microbiota for implementing innovative vector control strategies, thereby mitigating disease transmission. The study was conducted in the Gampaha Medical Office of Health (MOH) area of Sri Lanka with the focus of elucidating the microbial diversity within the midgut of Culex quinquefasciatus, a crucial step to support ongoing paratransgenesis efforts. Sampling was performed by utilizing standard mosquito sampling techniques and their midgut homogenates were plated on Plate Count Agar to isolate bacteria, which were then identified through biochemical tests. Subsequently, the most abundant bacterial families were subjected to DNA extraction, PCR amplification, and gene sequencing for species identification. The study revealed the presence of four bacterial families (Staphylococcaceae, Streptococcaceae, Neisseriaceae, and Moraxellaceae) in adult mosquitoes, while larvae harbored an additional family, Micrococcaceae. Interestingly, the relative distribution of midgut bacteria varied significantly among field-caught larval and adult strains from different study areas (chi-square = 1.673; P < 0.05), indicating similar bacterial flora across mosquito life stages and geographical locations. Of particular interest is the identification of Lysinibacillus sphaericus, a bacterium with potential for paratransgenesis applications. Given the high mosquito density in the study area, leveraging paratransgenesis for Cx. quinquefasciatus control is recommended. Furthermore, insights into gut microbes could inform the integration of gut microflora from modified strains into existing Sterile Insect Technique (SIT) and Incompatible Insect Technique (IIT) approaches in Sri Lanka.

Background: Schistosomiasis is a common public health problem throughout the world and Schistosoma mansoni is the most prevalent species in Africa. Most endemic countries use the Kato-Katz (KK) stool smear examination for diagnosis, mapping, and monitoring of intervention programs. However, its poor sensitivity calls for an urgency to evaluate and use more accurate diagnostic tools, of which detection of circulating cathodic antigen (CCA) in urine seems promising.

Methods: Studies published until May 2022 were searched from PubMed, Google Scholar, and grey literature for systematic review and meta-analysis following the PRISMA guideline. Eligible studies were selected based on preset inclusion and exclusion criteria. Quality of included studies was assessed using the QUADAS-2 tool. Heterogeneity between studies was assessed using Cochrane Q test and I ² test statistics. Data were analyzed using Review Manager 5.4.1 and Meta-DiSc 1.4 software programs.

Results: Thirty-seven studies published in 29 papers and enrolling 21159 study participants were included for analysis. Overall analysis of Point-of-Care Circulating Cathodic Antigen (POC-CCA) test against KK reference standard revealed a pooled sensitivity and specificity of 0.86 (95% CI: 0.85-0.87) and 0.66 (95% CI: 0.65-0.67), respectively. Subgroup analysis among 24 studies comparing single POC-CCA with test single KK revealed a high sensitivity (0.88) but low specificity (0.66). Based on findings of 24 studies, the area under the curve (AUC) for the systematic receiver operating characteristic (SROC) curve was 0.7805, indicating that the POC-CCA test effectively separates those with the disease from those who do not have it. Higher sensitivity estimates of 0.93 and 0.90 were reported when comparisons were made between test results of 2 urine and 1 stool samples, and 3 urine and 3 stool samples, respectively. Single POC-CCA test resulted in a pooled sensitivity estimate of 0.81 (95% CI: 0.78-0.84) as evaluated by the polymerase chain reaction (PCR) reference test.

Conclusions: The POC-CCA test has higher sensitivity than KK and may serve as a routine diagnostic alternative for disease diagnosis, mapping, and monitoring of interventions. However, its accuracy should further be evaluated at different transmission settings and infection intensity.

Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality worldwide. It also contributes significantly to hospital admissions, particularly in low-income countries such as Ethiopia, where it accounts for major public health problems. This could be attributed to the increasing prevalence of antibiotic-resistant pathogens in CAP patients. This study aimed to identify and assess the antibiotic resistance patterns of bacterial isolates from CAP patients at the Adama Hospital Medical College in Adama City, Ethiopia. A cross-sectional study was conducted from November 10, 2022, to November 30, 2023. Demographic, clinical data, and sputum samples were collected from patients with CAP (n = 369). Sputum samples were subjected to standard microbiological procedures, including culture, Gram staining, and a panel of different biochemical tests for the identification of pathogenic bacterial isolates. The Kirby-Bauer disc diffusion method was used for drug susceptibility testing. Descriptive statistics were computed by using SPSS (version 26). Of the 369 patients with CAP, bacterial pathogens were identified in 31.7% (n = 117, 95% CI: 27.0%-36.7%). The most common isolates were Moraxella catarrhalis (n = 15; 12.8%), Staphylococcus aureus (n = 15; 12.8%), Klebsiella pneumoniae (n = 12; 10.3%), Escherichia coli (n = 11; 9.4%), Pseudomonas aeruginosa (n = 11; 9.4%), Enterobacter species (n = 11; 9.4%), and Citrobacter species (n = 11; 9.4%). Among the identified isolates, resistance rates were high in Enterobacteriaceae, followed by Gram-positive bacteria, and non-Enterobacteriaceae. Overall, 68 (58.1%) of the identified bacterial isolates were multidrug resistant (MDR), with K. pneumoniae accounting for the highest proportion of multidrug resistant isolates (91.7%), while P. aeruginosa accounted for the lowest proportion (9.1%) of MDR isolates. This study revealed a high prevalence (31.7%) of bacterial pathogens in CAP patients and higher (58.1%) MDR bacterial pathogens. Therefore, regular surveillance and monitoring systems are warranted for assessing predominant pathogens and antibiotic resistance patterns.