Journal of Tropical Medicine最新文献

Background: Anemia has up to 87% prevalence in high tuberculosis (TB) and human immunodeficiency virus (HIV) burden settings of the sub-Saharan Africa (SSA) including Ethiopia. It increases lost to follow-up (LTFU) rate, reduces quality of life, and shortens the survival of TB/HIV coinfected patients. However, there is limited information on severity level and determinants of anemia in TB/HIV coinfected adults in the study setting in particular. Therefore, this study is aimed to assess severity level and determinants of TB/HIV-associated anemia.

Methods: A hospital based retrospective study was conducted among 305 TB/HIV coinfected adults who enrolled for antiretroviral therapy (ART) from January, 2009 to December, 2016 in two public hospital of Mekelle, Ethiopia, by reviewing ART register. A multiple logit model was fitted to identify the baseline determinants of anemia using 95% confidence level or 5% level of significance for adjusted odds ratio (AOR).

Results: In the current study, the cumulative baseline prevalence of anemia was 59.0% (95% CI: 53.3%-64.6%). Considering severity level, the prevalence was 6.2%, 28.2%, and 24.6% for severe, moderate, and mild anemia, respectively. Being female (AOR = 0.380; 95% CI: 0.226-0.640), body mass index (AOR = 0.913; 95% CI: 0.836-0.998) reduces the odds of developing anemia whereas baseline ambulatory functional status (AOR = 2.139; 95% CI: 1.189-3.846), bedridden functional status (AOR = 2.208; 95% CI: 1.002-4.863), HIV clinical stage III (AOR = 2.565; 95% CI: 1.030-6.384), and HIV clinical stage IV (AOR = 2.590; 95% CI: 1.006-6.669) increased the odds of developing anemia for TB/HIV coinfected adults.

Conclusions: In the current study, significant TB/HIV-associated severe anemia was assessed which accounted for nearly one-ninth of all anemia cases while nearly half were moderate anemia. Therefore, curious attention has to be given for the management of TB/HIV-associated severe anemia in particular and anemia in general to reducing anemia associated bad outcomes most importantly death.

Considering the importance of merozoite surface proteins (MSPs) as vaccine candidates, this study was conducted to investigate the polymorphism and genetic diversity of Plasmodium vivax merozoite surface protein 3-alpha (PvMSP-3α) in Thailand. To analyze genetic diversity, 118 blood samples containing P. vivax were collected from four malaria-endemic areas in western and southern Thailand. The DNA was extracted and amplified for the PvMSP-3α gene using nested PCR. The PCR products were genotyped by PCR-RFLP with Hha I and Alu I restriction enzymes. The combination patterns of Hha I and Alu I RFLP were used to identify allelic variants. Genetic evaluation and phylogenic analysis were performed on 13 sequences, including 10 sequences from our study and 3 sequences from GenBank. The results revealed three major types of PvMSP-3α, 91.5% allelic type A (∼1.8 kb), 5.1% allelic type B (∼1.5 kb), and 3.4% allelic type C (∼1.2 kb), were detected based on PCR product size with different frequencies. Among all PvMSP-3α, 19 allelic subtypes with Hha I RFLP patterns were distinguished and 6 allelic subtypes with Alu I RFLP patterns were identified. Of these samples, 73 (61%) and 42 (35.6%) samples were defined as monoallelic subtype infection by Hha I and Alu I PCR-RFLP, respectively, whereas 77 (65.3%) samples were determined to be mixed-allelic subtype infection by the combination patterns of Hha I and Alu I RFLP. These results strongly indicate that PvMSP-3α gene is highly polymorphic, particularly in blood samples collected from the Thai-Myanmar border area (the western part of Thailand). The combination patterns of Hha I and Alu I RFLP of the PvMSP-3α gene could be considered for use as molecular epidemiologic markers for genotyping P. vivax isolates in Thailand.

Drug-resistant malaria parasites pose a threat to global malaria control efforts, and it is important to know the extent of these drug-resistant mutations in each region to determine appropriate control measures. Chloroquine (CQ) was widely used in Cameroon for decades, but its declining clinical efficacy due to resistance prompted health authorities in 2004 to resort to artemisinin-based combination therapy (ACT) as the first-line treatment for uncomplicated malaria. Despite numerous efforts to control malaria, it persists, and the emergence and spread of resistance to ACTs make the development of new drugs or the possible reintroduction of discontinued drugs increasingly urgent. Malaria-positive blood samples were collected from 798 patients on Whatman filter paper to determine the status of resistance to CQ. DNA was extracted by boiling in Chelex and analysis of Plasmodium species. Four hundred P. falciparum monoinfected samples, 100 per study area, were amplified by nested PCR, and allele-specific restriction analysis of Pfmdr1 gene molecular markers was performed. Fragments were analyzed using a 3% ethidium bromide-stained agarose gel. P. falciparum was the most abundant Plasmodium species, accounting for 87.21% of P. falciparum monoinfections only. No infection with P. vivax was detected. The majority of samples contained the wild type for all 3 SNPs evaluated on the Pfmdr1 gene with N86, Y184, and D1246 accounting for 45.50%, 40.00%, and 70.00%, respectively. The most abundant haplotype observed was the Y184D1246 double wild type at 43.70%. The results suggest that P. falciparum is the major infecting species and that P. falciparum species with the susceptible genotype are gradually recapturing the parasite population.

Background: In regions of the world with low resources, such as Ethiopia, intestinal parasite diseases are still highly prevalent, especially in children. Poor personal and environmental hygiene, as well as unsafe and low-quality drinking water, are the main causes of this. This investigation aimed to determine the frequency of intestinal parasites and risk factors among children under 5 years age at Bachuma Primary Hospital in 2022.

Materials and methods: : A cross-sectional study was carried out from October 2022 to December 2022 at Bachuma Primary Hospital, West Omo Zone, Southwest Ethiopia. Stool sample was collected from randomly selected children who were ordered to have their stool examined at the hospital laboratory and wet mount was prepared using normal saline to detect the different stage of intestinal parasites microscopically. Moreover, data related to the sociodemographic and associated risk factors was collected using a structured questionnaire. Descriptive statistics were computed to describe the characteristics of the study participants and determine the prevalence of intestinal parasites. Data were entered into Epi-data manager and analysed using statistical packages for social sciences (SPSS) version 25.0, respectively. Bivariate and multivariate logistic regression analyses were performed, with variables with a p value of <0.05 considered statistically significant.

Result: : Infection with at least one intestinal parasite among children was 29.4% (95% CI: 24.5-34.7). Ascaris lumbricoide and Giardia lamblia were responsible for 8% (26/323) and 4% (13/323) of the prevalence of helminth and protozoans, respectively. A multivariate logistic regression analysis revealed that children whose residence was rural had an adjusted odds ratio (AOR) of 5.048 (p=0.001), those who did not wash their hands before meals had an AOR of 7.749 (p=0.001), a child with not trimmed fingernails had an AOR of 2.752 (p=0.010), a child who frequently experienced stomach pain and whose source of water was pond had an AOR of 2.415 (p=0.028) and 3.796 (p=0.040), respectively.

Conclusion: In this study, the prevalence of intestinal parasites recorded was low. Rural residency, absence of child hand washing practice before meal, and not trimming fingernail were among factors significantly associated with intestinal parasite infection.

Background: Malaria remains a serious public health problem, particularly in resource scarce areas of the world. The number of malaria cases has dropped remarkably in Ethiopia over the last decade, and efforts to eliminate the disease are underway. Asymptomatic infections may pose significant challenges to the elimination program. The essence of this study was to assess the prevalence of asymptomatic Plasmodium infection and the associated factors among communities of the selected districts in the Kaffa zone.

Materials and methods: April to May and September to October 2021, were the two seasons in which the community-based cross-sectional survey was conducted. Capillary blood from a finger prick was examined by light microscopy (LM) and screened using rapid diagnostic tests (RDTs). The participants' sociodemographic characteristics and malaria prevention measures were collected using a pretested semistructured questionnaire. Data entry and analyses were carried out using EpiData and SPSS version 25.0. Logistic regression (bivariate and multivariable) analyses were carried out to assess the possible associations between the dependent variable and the associated factors.

Results: 566 study participants were involved in the two cross-sectional surveys, including 234 male and 332 female subjects with a mean age of 18.486 (SD ± 15.167). Thirty-eight blood samples (6.7%) were found to be positive for Plasmodium species tested by both LM and RDT. Last night's use of long-lasting insecticidal net (LLIN) (AOR = 2.448, 95% CI: 1.009 5.938, p=0.048), presence of eave (AOR = 4.144, 95% CI: 1.049-16.363, p=0.043), and house sprayed in the last year (AOR = 5.206, 95% CI: 2.176-12.455, p < 0.001) were among factors that showed significant association with asymptomatic Plasmodium infection.

Conclusion: The asymptomatic Plasmodium infection prevalence recorded in the study area was low. Last night's LLIN usage, the presence of an eave, a house sprayed in the last year, and the presence of stagnant water near the home of the study participants were among the factors associated with an increased risk of catching the disease.

Cuminum cyminum L. is a widespread medicinal plant with a broad spectrum of biological activity. In the present study, the chemical structure of its essential oil was examined utilizing GC-MS analysis (gas chromatography-mass spectrometry). Then, a nanoemulsion dosage form was prepared with a droplet size and droplet size distribution (SPAN) of 121 ± 3 nm and 0.96. After that, the dosage form of the nanogel was prepared; the nanoemulsion was gelified by the addition of 3.0% carboxymethyl cellulose. In addition, the successful loading of the essential oil into the nanoemulsion and nanogel was approved by ATR-FTIR (attenuated total reflection Fourier transform infrared) analysis. The IC50 values (half maximum inhibitory concentration) of the nanoemulsion and nanogel against A-375 human melanoma cells were 369.6 (497-335) and 127.2 (77-210) μg/mL. In addition, they indicated some degrees of an antioxidant activity. Interestingly, after treatment of Pseudomonas aeruginosa with 5000 µg/mL nanogel, bacterial growth was completely (∼100%) inhibited. In addition, the growth of Staphylococcus aureus after treatment with the 5000 μg/ml nanoemulsion was decreased by 80%. In addition, nanoemulsion and nanogel LC50 values for Anopheles stephensi larvae were attained as 43.91 (31-62) and 123.9 (111-137) µg/mL. Given the natural ingredients and promising efficacy, these nanodrugs can be regarded for further research against other pathogens or mosquito larvae.

Background: Streptococcus agalactiae apart from being a colonizer in the genital region is also associated with several other invasive infections in all age groups. With the varied distribution of serotypes across different regions of the world, universal vaccination is also unattainable. However, in India, the knowledge of group B Streptococcus (GBS) genotype distribution is deficient. Thus, this study was initiated to add data on this aspect. Methodology. A cross-sectional study was conducted using isolates of group B Streptococcus from all clinical specimens. Along with that, the clinical specimen type and the antibiotic resistance profile of the isolates were correlated with the genotypes recognized through a multiplex PCR assay.

Results: Among the 86 isolates subjected to multiplex PCR for genotype identification, five genotypes were identified with genotype Ib as the predominant one (34.9%), followed by III (20.9%), II (16.3%), Ia (12.7%), and V (11.6%).

Conclusion: The results demonstrated a correlation of types Ib and III with vaginal colonization and type II with urine specimens in the current study. This preliminary study exhibited the distribution of common genotypes and their antibiotic resistance profiles in various GBS isolates. However, multiple studies across the country with larger sample sizes are needed to validate these findings.

The volatiles and antioxidant capacity of essential oils (EOs) extracted from freshly immature and mature leaves of Blumea balsamifera at various hydrodistillation times were investigated. Seven major terpenoids were identified: two monoterpenes, camphor and L-borneol, and five sesquiterpenes, silphiperfol-5-ene, 7-epi-silphiperfol-5-ene, ß-caryophyllene, ɤ-eudesmol, and α-eudesmol. The quantity and terpenoid composition of the EOs were impressed by leaf maturity and hydrodistillation times. The yield of EOs from the immature leaves was 1.4 times that of mature leaves, with 73% of the yield acquired within the first 6 hours (hrs) of hydrodistillation. Approximately 97% of camphor and L-borneol, 80% of ß-caryophyllene, silphiperfolene, and 7-epi-silphiperfolene, 32% of ɤ-eudesmol, and 54% α-eudesmol were collected in the first 6 hrs of hydrodistillation. More ß-caryophyllene, ɤ-eudesmol, and α-eudesmol were found in the mature leaf EOs. The antioxidant capacity of the EOs was proportionally related to their terpenoid contents. The EOs extracted from immature leaves at 0-6 hrs of hydrodistillation demonstrated distinctive antibacterial activity against Staphylococcus aureus, with minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values of 0.5 mg/mL and 1 mg/mL, respectively.

Background: There are about 13 parasitic infections that are responsible for significant morbidity and mortality but have not received the attention they deserve; thus, they are now known as "neglected tropical diseases" (NTDs). This study was aimed at evaluating the antihelminthic activities of Lophira lanceolata using an automated high-throughput method.

Methods: The antihelminthic activity effect of the extracts against H. polygyrus was determined using an automated high-throughput method. For the egg-hatching test, 100 μL of embryonated egg suspension (60 eggs) was added to 100 μL of various concentrations of extracts, levamisole, and 1.5% DMSO in a 96-well round-bottom microtitre plate. After mixing, the 96-well microplate was placed in WMicroTracker and incubated for 24 h at 25°C; the movements were recorded every 30 minutes. The same procedure was used for the larval motility assays, where 100 μL of L1 or L2 larvae (50 larvae) were put in contact with 100 μL of various concentrations of extracts.

Results: The ovicidal activity (hatching) had an IC₅₀ of 1.4 mg/mL for the ethanol extract. The aqueous and ethanol extracts of L. lanceolata showed larvicidal activity on the L1 larvae with IC₅₀ of 1.85 mg/mL and 2.4 mg/mL, respectively, as well as on the L2 larvae with IC₅₀ values of 1.08 mg/mL and 1.02 mg/mL for the aqueous and ethanol extracts, respectively. These results showed that the aqueous extract exhibited a stronger inhibitory power on the hatching rate of parasites than ethanol extracts, while the contrary effect was observed for the larval motility assays.

Conclusion: This study provides scientific data on the use of L. lanceolata by the local population for the treatment of helminthiases. However, in vivo and toxicity tests are necessary to assess its activity and safety.

An effective strategy for combatting AMR in Indonesia is to make the use of antibiotics in hospitals more rational with the help of an Antimicrobial Resistance Control Program (AMR-CP). This study aims to analyze the implementation of the AMR-CP in hospitals by conducting in-depth interviews with health professionals from ten hospitals and health officers of ten provincial health offices in ten different provinces and observation towards its documents. The sample location was selected by purposive sampling. Informants at the hospitals were hospital directors, chairmen of the AMR-CP team, chairmen of the medical committee, persons in charge of the microbiology laboratory, clinicians, nurses, clinical pharmacists, and those program managers at the provincial health offices who are responsible for administering antibiotics. Information is first collected and then a thematic analysis is applied along with triangulation to confirm the validity of information from multiple sources, including document observation results. The analysis is adapted to the framework of the system (i.e., input, process, and output). Results show that hospitals in Indonesia already have the resources to implement AMR-CP, including AMR-CP team and microbiology laboratories. Six hospitals examined also have clinicians trained in microbiology. Though hospital leadership and its commitment to implementing AMR-CP are favorable, there is room for improvement. AMR-CP teams organize routine activities for socialization and training, develop standard operating procedures (SOPs) for antibiotic use, antibiotic patterns surveillance, and bacterial mapping. Some obstacles to implementing AMR-CP policies are posed by the human resources, facilities, budget, antibiotics and reagent shortages, and clinician compliance with SOPs. The study concludes that there was an improvement in antibiotic sensitivity patterns, rational use of antibiotics, use of microbiological laboratories, and cost-efficiency. It recommends the government and healthcare providers continue to improve AMR-CP in hospitals and promote AMR-CP policy by making the regional health office of the hospital a representative of the regional government.