Agazi Fitsum Gebreselassie, Natnael Shimelash, Ahamed Kallon, George Mkondo, Tonya Huston, Janna M Schurer
Background: Podoconiosis is a non-infectious neglected tropical disease caused by long-term exposure to irritant volcanic soils. It results in severe physical, psychological and financial consequences. Heart and Sole Africa (HASA) is a non-governmental, community-based organization providing management to podoconiosis patients in Rwanda. We sought to analyze the impact of their program on the lives of patients.
Methods: Quantitative surveys recorded the participants' demographics, adherence to HASA's management recommendations and changes in quality of life (QOL). Qualitative questions were used to gather respondent perspectives on HASA programming.
Results: We interviewed 127 patients from HASA's Musanze (n=47) and Burera (n=80) clinics. Almost all participants (98.4%) reported statistically significant (p<0.01) improvements in their QOL, and more than one-half (51.2%) had a favorable adherence score of >80%. Qualitative feedback identified specific challenges to adherence and recognition of program success in symptom management.
Conclusions: Our study demonstrated the value of community-based podoconiosis programming in improving the lives of patients. Practices such as regular feet washing, emollient application, shoe wearing and limb raising can result in a marked reduction of morbidity. Our findings support the argument for scaling up these management practices across Rwanda.
背景:足癣是一种被忽视的非传染性热带疾病,由长期暴露于刺激性火山土壤引起。这种疾病会导致严重的身体、心理和经济后果。Heart and Sole Africa(HASA)是一个非政府组织,以社区为基础,为卢旺达的足癣患者提供治疗。我们试图分析他们的项目对患者生活的影响:定量调查记录了参与者的人口统计学特征、对 HASA 管理建议的遵守情况以及生活质量(QOL)的变化。定性问题用于收集受访者对 HASA 计划的看法:我们对来自 HASA Musanze(47 人)和 Burera(80 人)诊所的 127 名患者进行了访谈。几乎所有参与者(98.4%)都报告说,在统计意义上(P80%),他们都能坚持治疗。定性反馈确定了在症状管理方面坚持和认可项目成功所面临的具体挑战:我们的研究证明了基于社区的足癣防治计划在改善患者生活方面的价值。定期洗脚、涂润肤剂、穿鞋和抬高肢体等做法可显著降低发病率。我们的研究结果支持在卢旺达全国推广这些管理方法的论点。
{"title":"'We no longer experience the same pain': a cross-sectional study assessing the impact of Heart and Sole Africa's podoconiosis prevention education program.","authors":"Agazi Fitsum Gebreselassie, Natnael Shimelash, Ahamed Kallon, George Mkondo, Tonya Huston, Janna M Schurer","doi":"10.1093/trstmh/trae007","DOIUrl":"10.1093/trstmh/trae007","url":null,"abstract":"<p><strong>Background: </strong>Podoconiosis is a non-infectious neglected tropical disease caused by long-term exposure to irritant volcanic soils. It results in severe physical, psychological and financial consequences. Heart and Sole Africa (HASA) is a non-governmental, community-based organization providing management to podoconiosis patients in Rwanda. We sought to analyze the impact of their program on the lives of patients.</p><p><strong>Methods: </strong>Quantitative surveys recorded the participants' demographics, adherence to HASA's management recommendations and changes in quality of life (QOL). Qualitative questions were used to gather respondent perspectives on HASA programming.</p><p><strong>Results: </strong>We interviewed 127 patients from HASA's Musanze (n=47) and Burera (n=80) clinics. Almost all participants (98.4%) reported statistically significant (p<0.01) improvements in their QOL, and more than one-half (51.2%) had a favorable adherence score of >80%. Qualitative feedback identified specific challenges to adherence and recognition of program success in symptom management.</p><p><strong>Conclusions: </strong>Our study demonstrated the value of community-based podoconiosis programming in improving the lives of patients. Practices such as regular feet washing, emollient application, shoe wearing and limb raising can result in a marked reduction of morbidity. Our findings support the argument for scaling up these management practices across Rwanda.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Reagan Nzundu Boigny, Kellyn Kessiene de Sousa Cavalcante, Caroline Mary Gurgel Dias Florencio, Paula Sacha Frota Nogueira, Ciro Martins Gomes, Carlos Henrique Alencar
Background: To analyse the temporal trends and spatiotemporal distribution of leprosy relapse in Brazil from 2001 to 2021.
Methods: An ecological study with a temporal trend approach and space-time analysis of leprosy relapse in Brazil was carried out with data from the Notifiable Diseases Information System.
Results: A total of 31 334 patients who experienced leprosy relapse were identified. The number of recurrent cases tended to increase throughout the study period, and this increase was significant among females and in almost all age groups, except for those <15, 50-59 and ≥70 y. Several clusters of high- and low-risk patients were identified across all regions with a heterogeneous distribution.
Conclusions: The burden of relapse showed an increasing trend in some groups and was distributed in all regions.
{"title":"Temporal trends and space-time distribution of leprosy relapse in Brazil from 2001 to 2021.","authors":"Reagan Nzundu Boigny, Kellyn Kessiene de Sousa Cavalcante, Caroline Mary Gurgel Dias Florencio, Paula Sacha Frota Nogueira, Ciro Martins Gomes, Carlos Henrique Alencar","doi":"10.1093/trstmh/trae021","DOIUrl":"10.1093/trstmh/trae021","url":null,"abstract":"<p><strong>Background: </strong>To analyse the temporal trends and spatiotemporal distribution of leprosy relapse in Brazil from 2001 to 2021.</p><p><strong>Methods: </strong>An ecological study with a temporal trend approach and space-time analysis of leprosy relapse in Brazil was carried out with data from the Notifiable Diseases Information System.</p><p><strong>Results: </strong>A total of 31 334 patients who experienced leprosy relapse were identified. The number of recurrent cases tended to increase throughout the study period, and this increase was significant among females and in almost all age groups, except for those <15, 50-59 and ≥70 y. Several clusters of high- and low-risk patients were identified across all regions with a heterogeneous distribution.</p><p><strong>Conclusions: </strong>The burden of relapse showed an increasing trend in some groups and was distributed in all regions.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lucas Almeida Andrade, Wandklebson Silva da Paz, Rosália E Santos Ramos, Welde N Borges de Santana, Thuelly Juvêncio da Rocha, Flávia Silva Damasceno, Allan Dantas Dos Santos, Débora Dos Santos Tavares, Rodrigo Feliciano do Carmo, Carlos Dornels Freire de Souza, Deborah Aparecida Negrão-Corrêa, Ricardo Toshio Fujiwara, Abelardo Silva-Júnior, Wagnner José Nascimento Porto, Márcio Bezerra-Santos
Background: Schistosomiasis continues to represent a serious public health problem in Brazil. With the coronavirus disease 2019 (COVID-19) pandemic, several control strategies were suspended, probably compromising the goals of eradicating the disease in the country. We aimed to assess the impact of the COVID-19 pandemic on Schistosomiasis Control Program (PCE) actions in all endemic states of Brazil.
Methods: We performed an ecological study using spatial analysis techniques. The PCE variables assessed were the population surveyed, the number of Kato-Katz tests, positive cases of schistosomiasis and the percentage of cases treated between 2015 and 2021. The percent change was calculated to verify if there was an increase or decrease in 2020 and 2021, along with time trend analyses provided by the Joinpoint model. Spatial distribution maps were elaborated considering the percent change.
Results: The surveyed population decreased in 2020 (-65.38%) and 2021 (-37.94%) across Brazil. There was a proportional reduction in the number of Kato-Katz tests (2020, -67.48%; 2021, -40.52%), a decrease in the percentage of positive cases (2020, -71.16%; 2021, -40.5%) and a reduction in the percentage of treated cases (2020, -72.09%; 2021, -41.67%). Time trend analyses showed a decreasing trend in most PCE variables.
Conclusions: The PCE activities were impacted by the COVID-19 pandemic in Brazil and PCE strategies must be urgently reviewed, focusing on investments in all endemic areas.
{"title":"The COVID-19 pandemic impacted the activities of the Schistosomiasis Control Program in Brazil: is the goal of controlling the disease by 2030 at risk?","authors":"Lucas Almeida Andrade, Wandklebson Silva da Paz, Rosália E Santos Ramos, Welde N Borges de Santana, Thuelly Juvêncio da Rocha, Flávia Silva Damasceno, Allan Dantas Dos Santos, Débora Dos Santos Tavares, Rodrigo Feliciano do Carmo, Carlos Dornels Freire de Souza, Deborah Aparecida Negrão-Corrêa, Ricardo Toshio Fujiwara, Abelardo Silva-Júnior, Wagnner José Nascimento Porto, Márcio Bezerra-Santos","doi":"10.1093/trstmh/trae024","DOIUrl":"10.1093/trstmh/trae024","url":null,"abstract":"<p><strong>Background: </strong>Schistosomiasis continues to represent a serious public health problem in Brazil. With the coronavirus disease 2019 (COVID-19) pandemic, several control strategies were suspended, probably compromising the goals of eradicating the disease in the country. We aimed to assess the impact of the COVID-19 pandemic on Schistosomiasis Control Program (PCE) actions in all endemic states of Brazil.</p><p><strong>Methods: </strong>We performed an ecological study using spatial analysis techniques. The PCE variables assessed were the population surveyed, the number of Kato-Katz tests, positive cases of schistosomiasis and the percentage of cases treated between 2015 and 2021. The percent change was calculated to verify if there was an increase or decrease in 2020 and 2021, along with time trend analyses provided by the Joinpoint model. Spatial distribution maps were elaborated considering the percent change.</p><p><strong>Results: </strong>The surveyed population decreased in 2020 (-65.38%) and 2021 (-37.94%) across Brazil. There was a proportional reduction in the number of Kato-Katz tests (2020, -67.48%; 2021, -40.52%), a decrease in the percentage of positive cases (2020, -71.16%; 2021, -40.5%) and a reduction in the percentage of treated cases (2020, -72.09%; 2021, -41.67%). Time trend analyses showed a decreasing trend in most PCE variables.</p><p><strong>Conclusions: </strong>The PCE activities were impacted by the COVID-19 pandemic in Brazil and PCE strategies must be urgently reviewed, focusing on investments in all endemic areas.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Badi A Alotaibi, Jehad A Aldali, Hamzah J Aldali, Ali Alaseem, Abdulaziz M Almuqrin, Abdulrahman Alshalani, Hamood AlSudais, Nasser A Alshehri, Nasser B Alamar, Mogtba A Alhejji
Background: The current study is a retrospective study designed to evaluate changes in complete blood count and coagulation parameters in adult coronavirus disease 2019 (COVID-19) patients at a prominent Saudi tertiary center to predict disease severity and mortality.
Methods: The cohort consisted of 74 800 adult patients divided into four groups based on a COVID-19 test and the patient's sex: 35 985 in the female negative COVID-19 group, 23 278 in the male negative COVID-19 group, 8846 in the female positive COVID-19 group and 6691 in the male positive COVID-19 group.
Results: Patients with COVID-19 demonstrated decreased white blood cell counts and increased red blood cell counts. Also, COVID-19-positive participants exhibited more prolonged partial thromboplastin time and lower D-dimer levels than those of COVID-19-negative subjects (p<0.05). The study also revealed gender-dependent impacts on platelet counts, implying a possible relationship with the greater infection mortality rate in men than in women (p<0.001). In addition, the study found a link between changes in coagulation test results and death in COVID-19 patients (p<0.001). The evidence regarding the effects of COVID-19 on blood cell counts and coagulation, on the other hand, is conflicting, most likely due to variances in study populations and the timing of testing postinfection.
Conclusions: According to the findings, COVID-19-related alterations in blood cell count and clotting ability may be risk factors for death.
{"title":"Assessing the impact of severe acute respiratory syndrome coronavirus 2 infection on hematological parameters.","authors":"Badi A Alotaibi, Jehad A Aldali, Hamzah J Aldali, Ali Alaseem, Abdulaziz M Almuqrin, Abdulrahman Alshalani, Hamood AlSudais, Nasser A Alshehri, Nasser B Alamar, Mogtba A Alhejji","doi":"10.1093/trstmh/trae047","DOIUrl":"https://doi.org/10.1093/trstmh/trae047","url":null,"abstract":"<p><strong>Background: </strong>The current study is a retrospective study designed to evaluate changes in complete blood count and coagulation parameters in adult coronavirus disease 2019 (COVID-19) patients at a prominent Saudi tertiary center to predict disease severity and mortality.</p><p><strong>Methods: </strong>The cohort consisted of 74 800 adult patients divided into four groups based on a COVID-19 test and the patient's sex: 35 985 in the female negative COVID-19 group, 23 278 in the male negative COVID-19 group, 8846 in the female positive COVID-19 group and 6691 in the male positive COVID-19 group.</p><p><strong>Results: </strong>Patients with COVID-19 demonstrated decreased white blood cell counts and increased red blood cell counts. Also, COVID-19-positive participants exhibited more prolonged partial thromboplastin time and lower D-dimer levels than those of COVID-19-negative subjects (p<0.05). The study also revealed gender-dependent impacts on platelet counts, implying a possible relationship with the greater infection mortality rate in men than in women (p<0.001). In addition, the study found a link between changes in coagulation test results and death in COVID-19 patients (p<0.001). The evidence regarding the effects of COVID-19 on blood cell counts and coagulation, on the other hand, is conflicting, most likely due to variances in study populations and the timing of testing postinfection.</p><p><strong>Conclusions: </strong>According to the findings, COVID-19-related alterations in blood cell count and clotting ability may be risk factors for death.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Trust is an important driver of various outcomes, but little is known about whether trust in institutions affects actual vaccination campaign outcomes rather than only beliefs and intentions.
Methods: We used nationally representative, individual-level data for 114 countries and combined them with data on vaccination policies and rates. We measured the speed of the vaccination campaign for each country using the estimated growth rate of a Gompertz curve. We then performed country-level regressions in the global sample and explored heterogeneity across World Bank development groups.
Results: Globally, higher trust in institutions significantly increased vaccination rates (p<0.01) and vaccination speed (p<0.01). The effect was strong in low- and middle-income countries but statistically not significant in high-income countries.
Conclusions: Our findings have implications for the design of vaccination campaigns for national governments and international organizations. The findings highlight the importance of trust in institutions when designing communication strategies around vaccination campaigns in low- and middle-income countries.
{"title":"Trust in institutions affects vaccination campaign outcomes.","authors":"David Leblang, Michael D Smith, Dennis Wesselbaum","doi":"10.1093/trstmh/trae048","DOIUrl":"https://doi.org/10.1093/trstmh/trae048","url":null,"abstract":"<p><strong>Background: </strong>Trust is an important driver of various outcomes, but little is known about whether trust in institutions affects actual vaccination campaign outcomes rather than only beliefs and intentions.</p><p><strong>Methods: </strong>We used nationally representative, individual-level data for 114 countries and combined them with data on vaccination policies and rates. We measured the speed of the vaccination campaign for each country using the estimated growth rate of a Gompertz curve. We then performed country-level regressions in the global sample and explored heterogeneity across World Bank development groups.</p><p><strong>Results: </strong>Globally, higher trust in institutions significantly increased vaccination rates (p<0.01) and vaccination speed (p<0.01). The effect was strong in low- and middle-income countries but statistically not significant in high-income countries.</p><p><strong>Conclusions: </strong>Our findings have implications for the design of vaccination campaigns for national governments and international organizations. The findings highlight the importance of trust in institutions when designing communication strategies around vaccination campaigns in low- and middle-income countries.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephen A Klotz, Geoffrey T Smelski, Sarah A Watkins, F Mazda Shirazi
Background: There are 7000-8000 venomous snake bites annually in the USA. Antibiotics are commonly administered to bite victims because infection is difficult to differentiate from local tissue injury following envenomation.
Methods: The Arizona Poison and Drug Information Center (APDIC) in Tucson oversees antivenom administration for 14 Arizona counties. Records (1999-2021) were searched for antibiotic use and confirmed infections after a rattlesnake bite.
Results: There were 4160 calls to APDIC regarding rattlesnakes. After excluding bites to animals, 'dry bites', prisoners and records with missing data, 2059 records were evaluated. Systemic antibiotics were administered to 206 patients (10% of bite victims). Twenty patients (0.97%) had confirmed infections, including cellulitis (n=10), fasciitis (n=4), abscess (n=3) and osteomyelitis (n=3). Five of the victims had positive blood cultures. The presence of tissue necrosis, leukocytosis, fever and elevated fibrinogen levels did not discriminate between toxic effects of venom and infection.
Conclusions: Confirmed infections following a rattlesnake bite are uncommon (0.97% of bites). Physicians should refrain from prescribing antibiotics, as they are not justified for most rattlesnake bite victims and the variety of pathogens encountered precludes use of any single effective antibiotic.
{"title":"Infections following rattlesnake envenomation and use of antibiotics.","authors":"Stephen A Klotz, Geoffrey T Smelski, Sarah A Watkins, F Mazda Shirazi","doi":"10.1093/trstmh/trae044","DOIUrl":"https://doi.org/10.1093/trstmh/trae044","url":null,"abstract":"<p><strong>Background: </strong>There are 7000-8000 venomous snake bites annually in the USA. Antibiotics are commonly administered to bite victims because infection is difficult to differentiate from local tissue injury following envenomation.</p><p><strong>Methods: </strong>The Arizona Poison and Drug Information Center (APDIC) in Tucson oversees antivenom administration for 14 Arizona counties. Records (1999-2021) were searched for antibiotic use and confirmed infections after a rattlesnake bite.</p><p><strong>Results: </strong>There were 4160 calls to APDIC regarding rattlesnakes. After excluding bites to animals, 'dry bites', prisoners and records with missing data, 2059 records were evaluated. Systemic antibiotics were administered to 206 patients (10% of bite victims). Twenty patients (0.97%) had confirmed infections, including cellulitis (n=10), fasciitis (n=4), abscess (n=3) and osteomyelitis (n=3). Five of the victims had positive blood cultures. The presence of tissue necrosis, leukocytosis, fever and elevated fibrinogen levels did not discriminate between toxic effects of venom and infection.</p><p><strong>Conclusions: </strong>Confirmed infections following a rattlesnake bite are uncommon (0.97% of bites). Physicians should refrain from prescribing antibiotics, as they are not justified for most rattlesnake bite victims and the variety of pathogens encountered precludes use of any single effective antibiotic.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Chagas disease has a varying latency period, the time between infection and onset of cardiac symptoms, due to multiple factors. This study seeks to identify and understand these factors to enhance our knowledge of the disease.
Methods: A retrospective follow-up study was conducted in Colombia on patients with indeterminate chronic Chagas disease. Medical files were examined to evaluate the disease latency time using time ratios (TRs) and the AFT Weibull model.
Results: The study followed 578 patients, of whom 309 (53.5%) developed cardiac disease, with a median latency period of 18.5 (95% CI 16 to 20) y for the cohort. Those with the TcISyl genotype (TR 0.72; 95% CI 0.61 to 0.80), individuals who lived 5-15 y (TR 0.80; 95% CI 0.67 to 0.95), 15-30 y (TR 0.63; 95% CI 0.53 to 0.74) or >30 y (vs 5 y) in areas with high disease prevalence had shorter latency periods. On the other hand, undergoing treatment increased the latency period (TR: 1.74; 95% CI 1.52 to 1.87).
Conclusions: The latency period of Chagas disease was found to be independently related to male gender, receipt of etiological treatment, length of time spent in an endemic area and the TcISyl genotype. The implications of these findings are discussed.
背景:南美锥虫病的潜伏期(从感染到出现心脏症状的时间)因多种因素而异。本研究旨在确定和了解这些因素,以增进我们对该疾病的了解:方法:在哥伦比亚对不确定的慢性南美锥虫病患者进行了一项回顾性随访研究。研究采用时间比率(TRs)和AFT Weibull模型对医疗档案进行检查,以评估疾病的潜伏时间:该研究跟踪了 578 名患者,其中 309 人(53.5%)罹患心脏疾病,中位潜伏期为 18.5 年(95% CI 16-20 年)。那些具有TcISyl基因型(TR 0.72;95% CI 0.61至0.80)、在疾病高发地区生活了5至15年(TR 0.80;95% CI 0.67至0.95)、15至30年(TR 0.63;95% CI 0.53至0.74)或超过30年(vs 5年)的人的潜伏期较短。另一方面,接受治疗会延长潜伏期(TR:1.74;95% CI 1.52 至 1.87):结论:研究发现恰加斯病的潜伏期与男性性别、接受病因治疗的时间、在流行地区居住的时间和 TcISyl 基因型无关。本文讨论了这些发现的意义。
{"title":"Exploring the latency period in Chagas disease: duration and determinants in a cohort from Colombia.","authors":"Mario Javier Olivera, Lyda Muñoz","doi":"10.1093/trstmh/trae004","DOIUrl":"10.1093/trstmh/trae004","url":null,"abstract":"<p><strong>Background: </strong>Chagas disease has a varying latency period, the time between infection and onset of cardiac symptoms, due to multiple factors. This study seeks to identify and understand these factors to enhance our knowledge of the disease.</p><p><strong>Methods: </strong>A retrospective follow-up study was conducted in Colombia on patients with indeterminate chronic Chagas disease. Medical files were examined to evaluate the disease latency time using time ratios (TRs) and the AFT Weibull model.</p><p><strong>Results: </strong>The study followed 578 patients, of whom 309 (53.5%) developed cardiac disease, with a median latency period of 18.5 (95% CI 16 to 20) y for the cohort. Those with the TcISyl genotype (TR 0.72; 95% CI 0.61 to 0.80), individuals who lived 5-15 y (TR 0.80; 95% CI 0.67 to 0.95), 15-30 y (TR 0.63; 95% CI 0.53 to 0.74) or >30 y (vs 5 y) in areas with high disease prevalence had shorter latency periods. On the other hand, undergoing treatment increased the latency period (TR: 1.74; 95% CI 1.52 to 1.87).</p><p><strong>Conclusions: </strong>The latency period of Chagas disease was found to be independently related to male gender, receipt of etiological treatment, length of time spent in an endemic area and the TcISyl genotype. The implications of these findings are discussed.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alex de O Vasconcelos, Sandro J Bedoya-Pacheco, Rafael R Cunha E Silva, Mônica de A F M Magalhães, Tayana P S O de Sá, Cristina M G Dias, Patrícia S Meneguete, Paula M P de Almeida, Maria Inês F Pimentel
Background: Visceral leishmaniasis results from complex interactions among humans, dogs and environment. Brazil accounts for 97% of cases in the Americas.
Methods: Twenty years (2001-2020) of the endemic disease in the state of Rio de Janeiro were studied. Incidence, lethality, sociodemographic and clinical characteristics were investigated, complemented with spatial methodologies (kernel and clusters).
Results: Ninety-seven human cases and 625 dogs were reported. Of the 92 cities, 22 were human endemic areas. The state had a low incidence level (0.6 per 100 000). Lethality was higher compared with the Brazilian average. More than 90% of infections occurred in urban areas. Most cases (66%) occurred in men. The predominant age groups were 0-4 y (28.7%) and 20-39 y (32.9%). Fever (89.5%), splenomegaly (83.2%) and hepatomegaly (76.8%) were the main clinical manifestations. Spatial analysis showed a displacement of the human endemic: in the first decade (2001-2010), cases were concentrated in the Metropolitan region, and in the second decade (2011-2020) in the Médio Paraíba region of the state. Most of the endemic area (56.4%) had canine infections without reported human cases.
Conclusions: Disorderly urbanisation and precarious living conditions favour the transmission of the disease. Changes in the environment and migratory processes contribute to its expansion.
{"title":"Spatial-temporal distribution of visceral leishmaniasis in Rio de Janeiro, Brazil, 2001-2020: expansion and challenges.","authors":"Alex de O Vasconcelos, Sandro J Bedoya-Pacheco, Rafael R Cunha E Silva, Mônica de A F M Magalhães, Tayana P S O de Sá, Cristina M G Dias, Patrícia S Meneguete, Paula M P de Almeida, Maria Inês F Pimentel","doi":"10.1093/trstmh/trae009","DOIUrl":"10.1093/trstmh/trae009","url":null,"abstract":"<p><strong>Background: </strong>Visceral leishmaniasis results from complex interactions among humans, dogs and environment. Brazil accounts for 97% of cases in the Americas.</p><p><strong>Methods: </strong>Twenty years (2001-2020) of the endemic disease in the state of Rio de Janeiro were studied. Incidence, lethality, sociodemographic and clinical characteristics were investigated, complemented with spatial methodologies (kernel and clusters).</p><p><strong>Results: </strong>Ninety-seven human cases and 625 dogs were reported. Of the 92 cities, 22 were human endemic areas. The state had a low incidence level (0.6 per 100 000). Lethality was higher compared with the Brazilian average. More than 90% of infections occurred in urban areas. Most cases (66%) occurred in men. The predominant age groups were 0-4 y (28.7%) and 20-39 y (32.9%). Fever (89.5%), splenomegaly (83.2%) and hepatomegaly (76.8%) were the main clinical manifestations. Spatial analysis showed a displacement of the human endemic: in the first decade (2001-2010), cases were concentrated in the Metropolitan region, and in the second decade (2011-2020) in the Médio Paraíba region of the state. Most of the endemic area (56.4%) had canine infections without reported human cases.</p><p><strong>Conclusions: </strong>Disorderly urbanisation and precarious living conditions favour the transmission of the disease. Changes in the environment and migratory processes contribute to its expansion.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lymphatic filariasis (LF) is a significant public health issue in India. Despite 10-15 rounds of mass drug administration (MDA) in India, the global LF elimination target of 2030 appears challenging. To strengthen the program, community and provider perspectives on ways to bridge a gap in MDA are needed. Through the motivation-opportunity-ability-behaviour (MOAB) lens, we systematically reviewed the facilitators and barriers encountered in LF elimination in India. We followed Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. We searched PubMed, Embase, ProQuest and Google Scholar databases to explore factors related to MDA program implementation in India through 30 June 2021. We analysed the data using a thematic framework. We identified 576 studies; of these, 20 studies were included. This review revealed that the public health system for distributing MDA drugs in India created a better enabling environment, including zero out-of-pocket expenditure, door-step distribution of medicines and ample capacity-building training and follow-up. However, community members were unaware of the rationale for drug consumption, leading to a gap in drug distribution and consumption. Motivation is required among community members, which suggests capacity-building training for service providers to counsel the community.
{"title":"Motivation-opportunity-ability-behaviour of community members and program implementers towards mass drug administration for lymphatic filariasis elimination in India: a systematic review and implementation priority.","authors":"Abhinav Sinha, Sumegha Mohapatra, Krushna Chandra Sahoo, Shubhashisha Mohanty, Banamber Sahoo, Sanghamitra Pati, Prakash Kumar Sahoo","doi":"10.1093/trstmh/trae008","DOIUrl":"10.1093/trstmh/trae008","url":null,"abstract":"<p><p>Lymphatic filariasis (LF) is a significant public health issue in India. Despite 10-15 rounds of mass drug administration (MDA) in India, the global LF elimination target of 2030 appears challenging. To strengthen the program, community and provider perspectives on ways to bridge a gap in MDA are needed. Through the motivation-opportunity-ability-behaviour (MOAB) lens, we systematically reviewed the facilitators and barriers encountered in LF elimination in India. We followed Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. We searched PubMed, Embase, ProQuest and Google Scholar databases to explore factors related to MDA program implementation in India through 30 June 2021. We analysed the data using a thematic framework. We identified 576 studies; of these, 20 studies were included. This review revealed that the public health system for distributing MDA drugs in India created a better enabling environment, including zero out-of-pocket expenditure, door-step distribution of medicines and ample capacity-building training and follow-up. However, community members were unaware of the rationale for drug consumption, leading to a gap in drug distribution and consumption. Motivation is required among community members, which suggests capacity-building training for service providers to counsel the community.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oluwatoyin Olawunmi Adeyelu, Edidiong Nkiruka Essien, Valentine Adebote, Abraham Ajayi, Utibeima Udo Essiet, Adeyemi Isaac Adeleye, Stella Ifeanyi Smith
Background: Genetic determinants are known to promote antibiotic resistance through horizontal gene transfer.
Methods: We molecularly characterized integrons, plasmid replicon types and metallo-β-lactamase-encoding genes of 38 Pseudomonas aeruginosa strains isolated from clinical samples.
Results: The P. aeruginosa isolates displayed high resistance (97.4%) to β-lactams. Seventeen (44.74%) of them possessed plasmids. Of the 17 isolates that possessed plasmids, 11 (64.7%) of them harboured IncFIA plasmid replicon type, while 6 (35.3%), 5 (29.4%) and 5 (29.4%) were of the IncFIB, IncF and IncW types, respectively. The intI1 gene was detected in 19 (50%) of the isolates. The blaNDM-A, blaNDM-B and blaVIM genes were detected in 14 (35.9%), 4 (10.3%) and 5 (12.8%) of the isolates, respectively.
Conclusions: High resistance to β-lactams was observed among P. aeruginosa strains of clinical origin in this study. They possessed transmissible genetic elements indicating the potential for continuous dissemination, thus continuous surveillance is advocated.
{"title":"Antimicrobial resistance genetic determinants and susceptibility profile of Pseudomonas aeruginosa isolated from clinical samples in a tertiary hospital in Ogun State, Nigeria.","authors":"Oluwatoyin Olawunmi Adeyelu, Edidiong Nkiruka Essien, Valentine Adebote, Abraham Ajayi, Utibeima Udo Essiet, Adeyemi Isaac Adeleye, Stella Ifeanyi Smith","doi":"10.1093/trstmh/trae012","DOIUrl":"10.1093/trstmh/trae012","url":null,"abstract":"<p><strong>Background: </strong>Genetic determinants are known to promote antibiotic resistance through horizontal gene transfer.</p><p><strong>Methods: </strong>We molecularly characterized integrons, plasmid replicon types and metallo-β-lactamase-encoding genes of 38 Pseudomonas aeruginosa strains isolated from clinical samples.</p><p><strong>Results: </strong>The P. aeruginosa isolates displayed high resistance (97.4%) to β-lactams. Seventeen (44.74%) of them possessed plasmids. Of the 17 isolates that possessed plasmids, 11 (64.7%) of them harboured IncFIA plasmid replicon type, while 6 (35.3%), 5 (29.4%) and 5 (29.4%) were of the IncFIB, IncF and IncW types, respectively. The intI1 gene was detected in 19 (50%) of the isolates. The blaNDM-A, blaNDM-B and blaVIM genes were detected in 14 (35.9%), 4 (10.3%) and 5 (12.8%) of the isolates, respectively.</p><p><strong>Conclusions: </strong>High resistance to β-lactams was observed among P. aeruginosa strains of clinical origin in this study. They possessed transmissible genetic elements indicating the potential for continuous dissemination, thus continuous surveillance is advocated.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}