Transactions of The Royal Society of Tropical Medicine and Hygiene最新文献

Over the past 2 decades there has been good progress in the control of many of the neglected tropical diseases (NTDs) treatable by preventative chemotherapy (PC). Continued major drug donations from pharmaceutical companies, support from philanthropic organizations and heightened international recognition of the health impacts of these diseases have each played an important role in lowering the global health burden due to NTDs. However, considerable improvement in data collection is required to accurately assess this progress as we move towards the 'end game' of eliminating these infections as a source of morbidity and mortality. The data quality, type and format collected by the Expanded Special Project for the Elimination of Neglected Tropical Diseases database from the African Ministries of Health are discussed and suggestions made for improvements in collection and presentation.

This commentary reflects on the ongoing challenges and strategies in malaria elimination, built on insights from Greenwood's 2009 commentary, alongside more recent publications and developments up to 2024. Many of the challenges and strategies discussed by Greenwood remain relevant today. Furthermore, several of Greenwood's predictions have proven accurate 15 years on. Despite significant global progress, malaria elimination faces its toughest challenge, particularly in high-transmission areas. As we confront tougher challenges in malaria elimination, it becomes clear that we must go beyond mere reliance on any single solution.

This study investigated urban-rural differences in the prevalence of unmet need for family planning among women of reproductive age in Kano State, Nigeria, and identified factors contributing to these disparities. Rural-urban disparities in unmet need for family planning outcomes and women's characteristics were assessed. Univariate multilevel mixed-effect logistic regression models were employed to quantify the association between rural/urban residences and each unmet need for family planning and related outcomes. In urban areas, factors associated with unmet need for family planning included husband/partner (OR: 0.25, 95% CI 0.07 to 0.88, p=0.031) and joint decision-making about medical treatment (OR: 0.27, 95% CI 0.09 to 0.80, p=0.018). In rural areas, middle wealth categories (OR: 1.92, 95% CI 1.07 to 3.47, p=0.029), women with 3-4 (OR: 5.41, 95% CI 1.07 to 27.1, p=0.040) and ≥5 birth events (OR: 8.44, 95% CI 1.74 to 40.82, p=0.008) and those who work but are not paid in cash (OR: 0.46, 95% CI 0.21 to 0.99, p=0.049) were associated with unmet need for family planning. Tailored interventions considering socioeconomic, cultural and geographical factors are essential to reduce barriers to family planning services and promote informed decision-making among women in Kano State.

The One Health concept systematically considers the health of humans, animals and the environment, emphasizing population and ecosystem health based on individual health. Strongyloides stercoralis is a soil-transmitted opportunistic pathogenic parasite that can cause strongyloidiasis in both humans and animals, potentially leading to severe disease or even death in immunocompromised hosts. This article outlines the epidemiological status, diagnosis and treatment methods of strongyloidiasis. It also discusses effective response strategies based on the One Health approach to actively cope with the zoonotic risk of S. stercoralis and promote human health development.

Background: Leishmaniasis still imposes a heavy burden on many health systems and remains a public health problem. Early diagnosis in dogs, which act as a major reservoir for the pathogen, is central. The intention of epidemiologic studies is to identify the disease early, allowing rapid intervention to reduce its effects. This study aimed to develop two types of diagnostics tools, an enzyme-linked immunosorbent assay (ELISA) and a lateral flow immunochromatography assay for recognizing canine visceral leishmaniasis (CVL).

Methods: Multiwell ELISA plates were sensitized and strips were designed with the same chimeric recombinant antigen from Leishmania spp. (LeQuiDi) and the results were compared. The sera panel contained 409 samples, including 244 positives and 165 negatives. Of the 165 negative sera, 67 were obtained from Corrientes city, an endemic area for CVL in Argentina, and 98 of this group from La Plata city, a non-endemic area in Argentina (they were seropositive for other infections, as specificity control).

Results: Serum with an elevated concentration of lipids, or bilirubin, or a variable percentage of haemolysis were tested without interference. Both the sensitivity and specificity of the LeQuiDi-based tests were high: ≥93% for ELISA and ≥87% for LFIA.

Conclusions: Our study introduces LeQuiDi as a promising antigen for CVL diagnosis, regardless of the test format.

Snakebites are a significant health risk in India, with the 'Big Four' venomous species often overshadowing other deadly snakes like the hump-nosed pit viper (Hypnale hypnale). Despite its increasing recognition for causing severe envenomation, this species remains under-reported and inadequately addressed in treatment protocols. A woman aged in her sixties was bitten by a suspected hump-nosed pit viper while working in the fields. Despite receiving 26 vials of polyvalent antisnake venom, she developed persistent coagulopathy and anaphylaxis, requiring fresh frozen plasma and antibiotics. Coagulopathy and bleeding were controlled by day 5.This case highlights the need for species-specific antivenoms and improved management protocols for envenomation by Hypnale hypnale.

Introduction: Community engagement with public health efforts often depends on existing knowledge of a health issue.

Methods: Here, qualitative analysis of archival material from the Jamaica Hookworm Commission (1919-1936) and quantitative analysis of prevalence data are used to assess knowledge of and ecological interactions between different helminths during a historical hookworm eradication campaign.

Results: Archival sources demonstrate that Jamaicans were familiar with Ascaris lumbricoides. Surveys revealed a high prevalence of hookworm (62% of individuals infected), Ascaris (30%) and Trichuris trichiura (32%) in communities targeted for hookworm control. Community prevalence of Trichuris was positively associated with the prevalence of Ascaris and hookworm. Many individuals were infected with more than one parasite. At an individual level, data from hospital patients and soldiers showed significant associations between all three parasites. The co-occurrence of hookworm and Ascaris, alongside folk treatment of Ascaris with the same plant used by the Hookworm Commission (Chenopodium ambrisoides) to treat hookworm, made biomedical claims about hookworm credible and biomedical treatment more acceptable. Expulsions of Ascaris following treatment also provided dramatic proof of the effectiveness of treatment, further facilitating engagement.

Discussion/conclusion: Knowledge of Ascaris and other helminths directly shaped engagement with hookworm treatment, demonstrating how folk medical knowledge, grounded in the biology of the worms, aided a biomedical public health program.

The self-medication practices in India may pose challenges to malaria elimination efforts. While individuals often seek immediate relief from symptoms, the indiscriminate use of antimalarial medications can lead to increased resistance among malaria parasites. This study highlights the implications of self-medication on public health, exploring their impact on malaria elimination. Public awareness campaigns highlighting the risks of self-treatment, necessity of professional medical consultation and the need for malaria diagnosis prior to initiating treatment should be carried out. Addressing self-treatment practices will improve patient outcomes, mitigate the development of drug resistance in parasites and contribute to the goal of a malaria-free India.