Research and Reports in Tropical Medicine最新文献

Background: Scorpion envenomation is a global health problem that results in life-threatening medical emergencies in the tropical and subtropical regions. Pediatric victims are at a higher risk of severe envenomation than are adults.

Objective: This study aimed to determine the clinical features and outcomes of patient's hospitalized for scorpion stings at Tesseney Community Hospital.

Material and methods: A prospective, descriptive, cross-sectional study was conducted from 1^st June 2019 to 31^st May 2020 in patients hospitalized due to scorpion stings at the Tesseney Community Hospital.

Results: About 165 scorpion-sting patients were admitted during the study period. The majority of cases were older than 15 years (61.8%) with an approximately equal male-to-female sex ratio (0.94:1), and the scorpion sting cases largely occurred in urban areas (57%) compared to rural areas. The black scorpion (38.8%) was the predominant scorpion; however, in some cases, the scorpion color was undetermined (31.5%). The foot was the predominant sting site (64.8%), followed by the hand (31.5%). Single stings (91.5%) were more frequent than multiple stings (8.5%). The majority (94.8%) of scorpion sting cases occurred during summer, with the highest scorpion sting cases occurring in September and October. The main clinical manifestations upon presentation were localized pain (70.3%) and sweating (56.4%), with more severe symptoms exhibited among age groups less than 15 years. The fatality rate (4.8%) was largely associated with age groups less than 15 years and class three scorpion stings.

Conclusion: Our study found that children experienced more severe envenoming symptoms and related mortality than adults did. This study may be a tool to identify at-risk population groups and build measures to prevent scorpion stings within the western lowlands of Eritrea.

Background: Podoconiosis and lymphatic filariasis are the most frequent causes of elephantiasis.

Objective: The purpose of this study is to determine the etiology of Elephantiasis and associated factors in Hawella Tula, Sidama Region Ethiopia.

Methods: From February to May 2024, a community-based cross-sectional survey was carried out to determine etiologies of elephantiasis in selected kebeles (the lowest administrative units) in Hawella Tula district, Sidama region, Ethiopia. Seven kebeles were included in the study because elephantiasis cases were quite high, according to woreda's neglected tropical disease (NTD) information office report. Each respondent was interviewed and physically examined, a filariasis test strip (FTS) antibody test was performed for all elephantiasis cases diagnosed clinically, thick blood film was performed for only FTS-positive cases, and a soil study from selected kebeles (based on office's report) was conducted to identify the irritant soil mineral responsible.

Results: Among the 361 respondents, elephantiasis (Podoconiosis and lymphatic filariasis) accounted for 100 (27.7%). Podoconiosis accounted for 94 (94%) of the 100 elephantiasis cases, whereas lymphatic filariasis accounted for 6(6%). Forty percent of those affected were men, while 60% were women. Walking barefoot raised the chance of developing elephantiasis (AOR=40.088, 95% CI = 8.198, 146.484, P<0.001). Spending the majority of time outdoor raised the risk of having elephantiasis (AOR=6.252, 95% CI= 3.507, 11.144, P<0.001) and staying in the district (mentioned kebeles) for prolonged time increased the chance of having elephantiasis (AOR=2.753, 95% CI=1.545, 4.903, P=0.001). Podoconiosis cases observed in Tulla geter (25), Finchawa (25) and Harenfama (16) kebeles were directly related to the greatest proportion of silicon mineral concentration.

Conclusion: Both Podoconiosis and lymphatic filariasis were observed as causes of elephantiasis in Hawella Tula district. Further study is recommended, and steps should be made to prevent and treat both causes of elephantiasis.

Purpose: Epidemiological surveillance is recommended in health systems to monitor existing and emerging health threats and guide the response to epidemics. This study was conducted to assess the distribution of tools and practice of epidemiological surveillance in health facilities in the littoral region of Cameroon.

Materials and methods: This cross-sectional descriptive study was conducted in the health districts of the littoral region of Cameroon from April to May 2024. This study targeted health facilities selected through stratified random sampling from eight health districts. Surveyors collected data using a face-to-face structured questionnaire administered to the head of each health facility on the implementation of epidemiological surveillance activities.

Results: Of the 345 health facilities reached, 320 (92.8%) consented to participate. Of 320 health facilities, 252 (78.8%) declared that they were involved in the implementation of epidemiological surveillance. None of the eight health districts had all of their facilities involved in disease surveillance. Less than 30% of health facilities conduct surveillance for hemorrhagic fever while approximately 80-90% conduct surveillance for cholera, measles, and yellow fever. Only 14 (5.6%) health facilities declared to conduct surveillance of all events. A total of 200 (79.4%) health facilities had at least one personnel trained in epidemiological surveillance and the mean number of personnel trained per health facility was 2.2 (±1.7). Nurses were the category more frequently involved in epidemiological surveillance (95.2%). A total of 123 (48.8%), 78 (31.0%), and 217 (86.1%) health facilities had registers/line listings, integrated disease surveillance and response guide, and notification forms, respectively.

Conclusion: Health facilities' coverage regarding the implementation of epidemiological surveillance remains limited with the situation being more critical in private confessional health facilities. The implementation of epidemiological surveillance in health facilities needs to be monitored, and personnel training and surveillance tools should be considered.

Visceral leishmaniasis (VL) is a neglected tropical disease (NTD) that affects millions of people globally, particularly in low- and middle-income countries. It is caused by the Leishmania parasite, transmitted through sandfly bites, leading to severe illness and high mortality if untreated. Globally, VL is prevalent in East Africa, South Asia, and parts of South America, with East Africa accounting for a significant proportion of cases. Somalia, a country with a fragile healthcare system, faces a growing burden of the disease, particularly in rural and conflict-affected areas. Despite efforts to control the disease, it remains a public health challenge due to a lack of comprehensive data on its exact burden. In Somalia, VL service delivery is hindered by several barriers, including an under-resourced health system, shortages of skilled healthcare providers, inadequate diagnostic equipment, medication shortages, and weak infrastructure. The ongoing conflict and insecurity have exacerbated these challenges, particularly in areas most affected by VL. Stigma, cultural misconceptions, economic constraints, and limited access to healthcare further impede effective VL management. Current programs, supported by international organizations, provide some relief but are insufficient to address the widespread challenges comprehensively. To improve VL service delivery in Somalia, several strategies are recommended. Integration of VL services into primary healthcare, expanding training for healthcare workers, and increasing domestic funding are critical steps to reduce dependency on international aid. Strengthening community engagement, increasing awareness about VL, and leveraging technological innovations like telemedicine and DHIS2 for surveillance and care are vital. Public-private partnerships should be enhanced to ensure the availability of affordable treatments. Through a multifaceted approach that addresses systemic barriers and builds local capacities, sustainable improvements in VL control and service delivery in Somalia can be achieved.

Zoonotic pathogens such as arboviruses, arenaviruses, filoviruses, coronaviruses, highly pathogenic Avian Influenza A (H5N1) viruses, vesiculoviruses, and many others are emerging and reemerging worldwide, jeopardizing global veterinary and public health. Parasitic diseases such as visceral and cutaneous leishmaniasis, trypanosomiasis (Trypanosoma cruzi), myiasis, and river blindness (Onchocerca volvulus) are also paramount for public health in the Americas and elsewhere. In the fall 2024, a group of experts convened in Chiapas, Mexico, for the Fourth Mesoamerican Symposium "Dr. Roberto Navarro López" on Arboviruses and Emerging Zoonotic Diseases. Here, we highlight the importance of some zoonotic pathogens and parasites affecting human health that are being impacted by anthropogenic activities. In this context, there are drivers such as changes in climate and landscape transformations, unsound agricultural practices, and wildlife niche replacement delivering numerous opportunities for zoonotic pathogens to emerge and threaten human health and food security.

Background: Schistosomiasis persists as a public health problem in Hadhramout, the largest governorate in the eastern part of Yemen. Despite its endemicity, epidemiological patterns in many districts remain unclear. Therefore, this study aimed to determine the prevalence and factors associated with schistosomiasis among schoolchildren in the Amd District of Hadhramout Valley.

Methods: A cross-sectional study was conducted with 380 schoolchildren aged 6-16 years. Data on the children's sociodemographic characteristics, infection-related behaviors, and environmental factors were collected using a structured questionnaire. Urine filtration and Kato-Katz techniques were used to detect and count the eggs of Schistosoma haematobium and S. mansoni, respectively. Data were analyzed using appropriate statistical tests, and multivariable binary logistic regression analysis was performed to identify predictors of schistosomiasis.

Results: In Amd District, 33.7% (95% CI: 28.9-38.7) of schoolchildren had light-intensity infection with any Schistosoma species, indicating a moderate risk level, specifically S. haematobium among 31.6% (95% CI: 26.9-36.3) and S. mansoni among 2.1% (95% CI: 0.7-3.6) of children. Macrohematuria, microhematuria, and proteinuria were significantly associated with S. haematobium infection. However, neither hematochezia nor diarrhea was significantly associated with S. mansoni infection. Multivariable binary logistic regression analysis identified male gender (AOR = 4.2; 95% CI: 2.48-7.12; P <0.001), age ≥10 years (AOR = 3.1; 95% CI: 1.70-5.56; P <0.001), and contact with natural water sources (AOR = 2.0; 95% CI: 1.06-3.58; P = 0.032) as independent predictors of schistosomiasis.

Conclusion: The risk of schistosomiasis in Amd District is moderate and predominated by S. haematobium, with light-intensity infections affecting approximately one-third of schoolchildren. Therefore, biannual preventive chemotherapy with praziquantel is recommended for all enrolled and non-enrolled school-age children. Macrohematuria, microhematuria, and proteinuria are important indicators of S. haematobium infection. Meanwhile, male gender, older age, and water contact can independently predict infection.

Background: This study aimed to determine the seroprevalence of toxoplasmosis in people living with HIV (PWH) in Maputo, Mozambique, exploring the interactions between HIV/acquired immunodeficiency syndrome (AIDS) and toxoplasmosis, including HIV-related factors such as the World Health Organization (WHO) HIV/AIDS clinical stage, degree of immunosuppression based on CD4⁺ T-cell count, and associated risk factors. Additionally, it aimed to assess the prevalence of neurological and psychiatric disorders (NPD) among study participants and its possible association with toxoplasmosis seropositivity.

Methods: We conducted a descriptive, cross-sectional study of 200 patients aged >18 years who were admitted to Maputo Central Hospital, Maputo, Mozambique, between March 2020 and October 2021. The participants were recruited by convenience, regardless of the reason for their admission. Sociodemographic and clinical data, such as age, sex, WHO HIV/AIDS stage, and CD4⁺ T-cell count, were collected. NPD disorders were assessed using the International Classification of Diseases criteria. Venous blood (5 mL) was obtained from each participant to determine anti-Toxoplasma gondii IgM and IgG antibodies using commercial enzyme-linked immunosorbent assay.

Results: Participants were aged 18-72 years, with the majority being female (64%) and unemployed (57%). Overall, 54.5% of patients tested positive for at least one anti-Toxoplasma gondii IgG (52%) or IgM (6.5%). Risk factors for Toxoplasma gondii infection (p < 0.05) were associated with age group 18-28 years, being male and unemployed. Moreover, 68.5% of the participants had NPD and of those, 65.1% exhibited anti-Toxoplasma antibodies. We found a significant association between anxiety and IgM seropositivity for p = 0.016. Though three out of four participants with positive anti-Toxoplasma gondii IgG had mood disorders, no significant association was found between Toxoplasma gondii infection with mood disorders, nor with other NPD assessed (56% depression, 33% motor disorder, 25.5% psychosis, 17% cognitive impairment, 7.5% mental retardation).

Conclusion: Toxoplasmosis may contribute to NPD in PWH patients. Further studies are recommended to better understand the complex interactions between Toxoplasma gondii, NPD disorders, and HIV.

Allergic conditions, including asthma, allergic rhinitis, and atopic dermatitis, are increasingly recognized as critical global health concerns in tropical regions. The unique environmental characteristics of the tropics, such as high humidity, diverse vegetation, persistent pollen exposure, and elevated levels of mold and insect allergens, increase the prevalence and severity of allergic diseases. Addressing these challenges requires tailored strategies that are both practical and evidence-based. This review introduces a comprehensive seven-day and seven-step framework for managing allergies in tropical climates. This is designed to empower individuals with actionable steps and scientifically supported interventions. Databases such as PubMed, Scopus, Web of Science, and EMBASE were used. The search strategy includes specific keywords and Medical Subject Headings (MeSH) terms related to allergies or offering insights into preventive measures. The plan encompasses a structured approach, beginning with identifying triggers and creating an allergen-friendly environment. Symptoms management, prevention of cross-contamination, dietary optimization, and long-term evaluation. Emphasis is placed on the adaptability of these measures to resource-constrained settings in tropical regions by integrating modern scientific insights with practical, step-by-step guidance. This framework addresses the distinct challenges of managing allergies in tropical environments but also highlights the importance of education, environmental control, and community-level engagement. This review underscores the need for sustainable and locally relevant solutions to improve health outcomes and enhance the quality of life for individuals living in tropical climates.

Toxoplasma gondii is a world-wide parasite, with an estimated prevalence of approximately 30%. Toxoplasmosis is a severe disease in the immunocompromised, but few symptoms are exhibited by patients with an intact immune system, making this parasite a worldwide burden. Currently, few drugs exist in treating acute toxoplasmosis and no drugs exist to eliminate the bradyzoite of T. gondii. Effective therapies against acute and chronic toxoplasmosis are urgently needed to reduce the burden of this disease. This review aims to give a summary of recent findings in the bradyzoite form of Toxoplasma gondii and the implication of these findings on drug development. A thorough search of PubMed and Google Scholar databases was used to identify studies within the past 10 years that illustrate targetable key elements in the differentiation and formation of the bradyzoite form of T. gondii.

Background: The perception of black African subjects toward hemorrhoidal disease is surrounded by myths and misconceptions in sub-Saharan Africa. This study aimed to determine the magnitude of knowledge, attitudes, and practices (KAPs) of black African subjects toward hemorrhoidal disease and the impact of knowledge on their attitudes and practices.

Methods: A cross-sectional KAP survey was conducted through convenience sampling of 735 participants (mean age, 38.8 years; men, 59.2%) from urban and rural areas in Côte d'Ivoire. They received an auto questionnaire of 25 items on Likert scales depicting their KAP toward hemorrhoidal disease. A mean score of KAP < 50 points was considered low. Logistic and linear regression models were used to determine the factors associated with self-reported hemorrhoidal disease and the impact of knowledge on attitudes and practices.

Results: The overall Cronbach score was 0.75, and the sample proportions of self-reported or symptom-based hemorrhoidal disease were 44.4% (9% CI: 41-48) and 21.2% [95% CI: 18.4-24.4], respectively. The overall mean (SD) scores of KAP were low: 49 (34.4), 43.4 (18.7), and 33.6 (21.7), respectively. The attitudes and practices of the participants remained unchanged regardless of their knowledge. Hemorrhoidal disease was negatively associated with attitudes (beta = -3.1, p = 0.02) or practices (beta = -3.4, p < 0.05). Overall, the participants agreed that hemorrhoidal disease led to sexual dysfunction (85.2%) and infertility (67.1%). They preferred indigenous (52.4%) over modern treatments (30.2%) and perceived surgery for hemorrhoidal disease to be dangerous (24.4%) and not recommended (56.6%).

Conclusion: Knowledge did not change the attitudes and practices of black African subjects toward hemorrhoidal disease.