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Trends and inequalities in the use of deworming medication during pregnancy in Sierra Leone, 2008-2019. 2008-2019 年塞拉利昂孕期使用驱虫药的趋势和不平等现象。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-11-04 DOI: 10.1186/s41182-024-00638-9
Augustus Osborne, Alpha Umaru Bai-Sesay, Alieu Tommy, Camilla Bangura, Bright Opoku Ahinkorah

Background: Intestinal worm infections are a significant public health concern for pregnant women in low- and middle-income countries. These infections can lead to anaemia, malnutrition, and adverse pregnancy outcomes, including premature birth and low birth weight. Deworming medication during pregnancy is a safe and effective strategy to prevent these complications and improve maternal and child health. This study aims to investigate the trends and inequalities in the use of deworming medication during pregnancy among women in Sierra Leone between 2008 and 2019.

Methods: The study utilised data from the Sierra Leone Demographic Health Surveys conducted in 2008, 2013, and 2019. We used the Health Equity Assessment Toolkit developed by the World Health Organisation to calculate various measures of inequality, including difference, ratio, population attributable risk, and population attributable fraction. An inequality assessment was conducted for five stratifiers: age, economic status, level of education, place of residence, and sub-national province.

Results: The prevalence of deworming medication during pregnancy was 43.8% in 2008, 72.4% in 2013, and 83.5% in 2019 in Sierra Leone. There was a decrease in age-related inequality from a difference of 3.7% in 2008 to -0.8% in 2019. Economic-related inequality increased from a difference of -8.5% in 2008 to -8.2% in 2019. Both population attributable fraction and population attributable risk were zero in all survey years for economic status, indicating no improvement in the setting average without economic-related inequality. Inequality in education increased from a difference of -8.9% in 2008 to -8.4% in 2019 and decreased from a difference of -2.6% in 2008 to -5.5% in 2019 for place of residence. Provincial inequality decreased from a difference of 29.5% in 2008 to 11.8% in 2019. The population attributable risk for province reveals that the setting average could have been 10.5 percentage points lower in 2008, 8.2 percentage points lower in 2013, and 5.9 percentage points lower in 2019 without provincial inequality.

Conclusion: The prevalence of deworming medication use during pregnancy substantially increased from 2008 to 2019 (43.8% to 83.5%) in Sierra Leone. This suggests a positive public health trend in maternal healthcare access and education. Inequalities related to economic status and education increased slightly while age-related, place of residence and provincial inequalities decreased. This indicates an inequitable distribution of this essential healthcare intervention across these stratifiers. The government and policymakers should continue efforts to raise awareness and promote the use of deworming medication during pregnancy.

背景:肠道蠕虫感染是中低收入国家孕妇的一个重大公共卫生问题。这些感染可导致贫血、营养不良和不良妊娠结局,包括早产和出生体重不足。孕期驱虫药是预防这些并发症和改善母婴健康的安全有效的策略。本研究旨在调查 2008 年至 2019 年期间塞拉利昂妇女在孕期使用驱虫药的趋势和不平等现象:研究利用了 2008 年、2013 年和 2019 年进行的塞拉利昂人口健康调查的数据。我们使用世界卫生组织开发的健康公平评估工具包来计算各种不平等度量,包括差异、比率、人口可归因风险和人口可归因分数。对年龄、经济状况、教育水平、居住地和次国家级省份这五个分层因素进行了不平等评估:塞拉利昂孕期驱虫药的使用率在 2008 年为 43.8%,2013 年为 72.4%,2019 年为 83.5%。与年龄相关的不平等有所减少,从 2008 年的 3.7% 降至 2019 年的-0.8%。与经济相关的不平等从 2008 年的-8.5% 增加到 2019 年的-8.2%。在经济状况的所有调查年份中,人口可归因分数和人口可归因风险均为零,表明在没有经济相关不平等的情况下,环境平均值没有改善。教育方面的不平等从 2008 年的-8.9%增至 2019 年的-8.4%,居住地方面的不平等从 2008 年的-2.6%降至 2019 年的-5.5%。各省的不平等从 2008 年的 29.5%下降到 2019 年的 11.8%。各省的人口可归因风险显示,如果没有各省的不平等,2008 年的环境平均值可能会降低 10.5 个百分点,2013 年降低 8.2 个百分点,2019 年降低 5.9 个百分点:从 2008 年到 2019 年,塞拉利昂的孕期驱虫药使用率大幅提高(从 43.8% 提高到 83.5%)。这表明在孕产妇保健和教育方面出现了积极的公共卫生趋势。与经济地位和教育有关的不平等略有增加,而与年龄、居住地和省份有关的不平等则有所减少。这表明,在这些分层中,这一基本医疗保健干预措施的分配并不公平。政府和政策制定者应继续努力提高人们的认识,促进孕期驱虫药的使用。
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引用次数: 0
Comments on: prevalence and risk factors for tuberculosis and HIV coinfections in Kenyan prison inmates. 评论:肯尼亚监狱囚犯中结核病和艾滋病毒合并感染的流行率和风险因素。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-10-31 DOI: 10.1186/s41182-024-00650-z
Muhammad Hamza, Zil-E-Huma Jalil, Abid Jan Abdul Sattar, Hamnah Sohail, Malik Olatunde Oduoye

The study by Mwatenga et al. found a tuberculosis (TB) prevalence of 10.2% and an HIV prevalence of 19.1% among inmates, with all TB cases co-infected with HIV. Education level, smoking history, and substance use are key predictors of coinfections. Although informative, its single-centred design and reliance on sputum samples may be insufficient for some patient groups, potentially compromising diagnostic accuracy. Expanding the study to include several jails and employing more diagnostic procedures may increase reliability and the ability to generalize. The report also notes the lack of debate on broader socioeconomic variables and structural barriers to healthcare in jails, which are crucial to understanding inmates' health challenges. Overcrowding, malnutrition, and a poor healthcare system are examples of environmental factors that probably contribute to the spread of tuberculosis and make managing HIV more difficult. Additionally, not enough is known about the dietary habits of prisoners and other health conditions like diabetes or mental health, which may have an impact on the course of HIV and TB. Future studies should take these extra characteristics into account to create more comprehensive approaches to controlling HIV coinfections and TB in prison populations. This will help build more effective therapies.

Mwatenga 等人的研究发现,在囚犯中,结核病(TB)发病率为 10.2%,艾滋病毒(HIV)发病率为 19.1%,所有结核病病例都同时感染了艾滋病毒。教育水平、吸烟史和药物使用是预测合并感染的关键因素。尽管该研究信息丰富,但其单一中心的设计和对痰样本的依赖可能无法满足某些患者群体的需求,从而可能影响诊断的准确性。将研究范围扩大到多个监狱并采用更多的诊断程序可能会提高可靠性和推广能力。报告还指出,对于监狱中更广泛的社会经济变量和医疗保健的结构性障碍缺乏讨论,而这些对于了解囚犯的健康挑战至关重要。过度拥挤、营养不良和糟糕的医疗保健系统都是环境因素的例子,这些因素可能会导致结核病的传播,并使艾滋病毒的管理变得更加困难。此外,人们对囚犯的饮食习惯和其他健康状况(如糖尿病或精神健康)的了解还不够,而这些可能会对艾滋病和结核病的病程产生影响。未来的研究应考虑到这些额外的特征,以制定更全面的方法来控制监狱人群中的艾滋病病毒并发感染和结核病。这将有助于建立更有效的疗法。
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引用次数: 0
Reply to: Comment on: Fetal femur length and risk of diabetes in adolescence: a prospective cohort study. 答复评论胎儿股骨长度与青春期糖尿病风险:一项前瞻性队列研究。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-10-30 DOI: 10.1186/s41182-024-00646-9
Urme Binte Sayeed
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引用次数: 0
Comment on: Fetal femur length and risk of diabetes in adolescence: a prospective cohort study. 评论胎儿股骨长度与青少年糖尿病风险:一项前瞻性队列研究。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-10-30 DOI: 10.1186/s41182-024-00627-y
Zainab Fatima, Arifa Inayatullah, Usama Idrees, Malik Olatunde Oduoye, Uzodinma Nwadinigwe

We read the article "Fetal Femur Length and Risk of Diabetes in Adolescence: A Prospective Cohort Study" by Sayeed et al. with great interest. The authors present compelling evidence linking mid-trimester impaired femur growth with elevated prediabetic biomarkers in Bangladeshi adolescents. However, we believe the study would benefit from considering additional factors. Maternal gestational diabetes, a well-known risk factor for type 2 diabetes mellitus (T2DM) in offspring, and family history of diabetes, which reflects genetic predisposition, should be included. Socioeconomic factors, which influence health outcomes, also warrant attention. Including these variables would provide a more comprehensive understanding of the relationship between fetal femur length and T2DM risk in adolescents.

我们饶有兴趣地阅读了 Sayeed 等人撰写的文章 "胎儿股骨长度与青春期糖尿病风险:前瞻性队列研究 "一文。作者提出了令人信服的证据,证明孟加拉青少年怀孕中期股骨生长受损与糖尿病前期生物标志物升高有关。然而,我们认为这项研究还需要考虑更多的因素。母体妊娠糖尿病是导致后代患上 2 型糖尿病(T2DM)的一个众所周知的风险因素,而糖尿病家族史则反映了遗传易感性。影响健康结果的社会经济因素也值得关注。纳入这些变量将有助于更全面地了解胎儿股骨长度与青少年T2DM风险之间的关系。
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引用次数: 0
Treatment-seeking behaviours of patients with tungiasis in endemic areas of Homa Bay County, Kenya: a mixed-methods study. 肯尼亚霍马湾县地方病流行地区的牛皮癣患者寻求治疗的行为:一项混合方法研究。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-10-22 DOI: 10.1186/s41182-024-00639-8
Kana Suzuki, Asiko Ongaya, Gordon Okomo, Muuo Nzou, Evans Amukoye, Yasuhiko Kamiya

Background: Tungiasis, an ectoparasitic disease caused by sand fleas, causes suffering to millions of people in the tropics. Although the Kenyan National Policy Guidelines list tungiasis treatments as including disinfectants, flea repellents, and botanical oil, the insufficient knowledge and financial constraints of affected communities have led to neglect and inappropriate self-treatment. Current reports show insignificant progress on educational activities at the community level. Therefore, we investigated community residents' treatment-seeking behaviour concerning tungiasis, using an endemic area of Kenya as the research setting.

Methods: A cross-sectional mixed-methods design was employed. Quantitative data were collected from the participants-410 adults who had experienced tungiasis-using a questionnaire, while qualitative data were collected from 20 older adults to 10 medical staffs using semi-structured individual interviews. The study was conducted in two sub-counties of Homa Bay County, Kenya.

Results: Factors significantly correlated with using non-guideline-listed treatments for tungiasis were 'not knowing the causse of tungiasis', 'not seeking treatment from healthcare facilities and traditional healers', and 'wait and see to prevent infection in non-affected members'. The interviews with the older adults revealed 19 self-treatment options for tungiasis, and 40% of the participants opted for self-removal using sharp objects. Only two of these treatments were listed in the guidelines. The most frequently mentioned reason for using a self-treatment option was 'Someone else's idea'. The most frequently mentioned reason for choosing the best self-treatment option was 'Effectiveness'. Interviews with medical staff revealed 11 treatment options; only five of these treatments are listed in the guidelines. The most frequently mentioned reason for selecting/using the treatment was 'Supply situation'.

Conclusions: Residents' socioeconomic factors, cultural factors, and access to appropriate treatment, as well as knowledge of medical staff were significant factors that influenced the residents' tungiasis treatment-seeking behaviours. This study provides feasibility and baseline data to establish an effective, safe, and sustainable treatment for tungiasis.

背景:沙皮蝇蛆病是一种由沙皮蝇引起的体外寄生虫病,给热带地区数百万人带来痛苦。尽管肯尼亚国家政策指南列出了包括消毒剂、驱蚤剂和植物油在内的治疗 Tungiasis 的方法,但由于受影响社区的知识不足和经济拮据,导致了忽视和不适当的自我治疗。目前的报告显示,社区层面的教育活动进展甚微。因此,我们以肯尼亚的一个地方病流行区为研究背景,调查了社区居民寻求治疗牛皮癣的行为:方法:采用横断面混合方法设计。采用问卷调查的方式从参与者--410 名曾感染过牛皮癣的成年人中收集定量数据,同时采用半结构化个别访谈的方式从 20 名老年人和 10 名医务人员中收集定性数据。研究在肯尼亚霍马湾县的两个分县进行:结果:与使用非指南所列治疗方法治疗牛皮癣明显相关的因素是 "不知道牛皮癣的病因"、"不寻求医疗机构和传统医士的治疗 "以及 "观望以防止非患者感染"。在对老年人的访谈中,发现了 19 种治疗牛皮癣的自我疗法,其中 40% 的参与者选择了使用尖锐物品进行自我清除。这些治疗方法中只有两种被列入指南。最常提到的使用自我治疗方法的原因是 "别人的主意"。选择最佳自我疗法的最常提及的原因是 "效果"。与医务人员的访谈显示有 11 种治疗方法,其中只有 5 种被列入指南。最常提及的选择/使用治疗方法的原因是 "供应情况":结论:居民的社会经济因素、文化因素、获得适当治疗的机会以及医务人员的知识是影响居民治疗牛皮癣行为的重要因素。这项研究为建立有效、安全和可持续的牛皮癣治疗方法提供了可行性和基线数据。
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引用次数: 0
Assessment of gestational diabetes mellitus knowledge, attitudes, and practices and associated factors among pregnant women at a district hospital in Coastal Kenya. 评估肯尼亚沿海地区一家地区医院孕妇对妊娠糖尿病的认识、态度和做法以及相关因素。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-10-22 DOI: 10.1186/s41182-024-00630-3
Nanyangwe Siuluta, Miho Sato, Le Khac Linh, Violet Wanjihia, Mwatasa Salim Changoma, Nguyen Tien Huy, Satoshi Kaneko

Background: Gestational diabetes mellitus (GDM) is any degree of glucose intolerance first recognized during pregnancy. GDM awareness among pregnant women translates into GDM prevention and early diagnosis.

Objective: To establish the underlying factors influencing GDM Knowledge Attitude and Practices (KAP) among pregnant women at Kinango District Hospital.

Method: An explanatory mixed-methods design was implemented by initially assessing GDM KAP quantitatively [QUAN], followed by the qualitative [qual] exploration of contextual factors behind quantitative results. In the [QUAN] strand, 354 pregnant women were interviewed from January to February 2019. Thereafter, in the [qual] strand, key informant interviews were conducted among four pregnant women and three healthcare workers; a focus group discussion was held among nine pregnant women, from May to June 2019. STATA V15 software package was used to analyze the quantitative data. Qualitative data were analyzed manually using thematic analysis.

Result: Among 354 pregnant women, 29.0% were knowledgeable, 46.98% had good attitude and 60.17% had good practice. Attending at least one antenatal clinic visit and having heard about diabetes mellitus were associated with good GDM attitude and practices. Among the knowledgeable pregnant women, one-third (33.33%) obtained GDM information from a health facility. Discussions with pregnant women and the interviews with healthcare workers highlighted that daily health talks during antenatal clinic, included GDM and diabetes mellitus information. Furthermore, attendance of at least one antenatal clinic visit was low (85.88%), among pregnant women (87.86%) who were expected to have attended at least one antenatal clinic visits.

Conclusion: Despite low GDM knowledge, pregnant women had relatively good GDM attitudes and good GDM practices. Daily health talks conducted during antenatal clinic as well as indigenous knowledge among pregnant women, influenced the latter. Hence, GDM information dissemination needs to be enhanced for the improvement of GDM KAP among pregnant women for GDM prevention.

背景:妊娠糖尿病(GDM)是指在怀孕期间首次发现的任何程度的葡萄糖不耐受。孕妇对 GDM 的认识有助于 GDM 的预防和早期诊断:确定影响 Kinango 地区医院孕妇 GDM 知识、态度和做法 (KAP) 的潜在因素:采用解释性混合方法设计,首先对 GDM KAP 进行定量[QUAN]评估,然后对定量结果背后的背景因素进行定性[Qual]探索。在[QUAN]方面,于2019年1月至2月对354名孕妇进行了访谈。此后,在[质]方面,于2019年5月至6月对4名孕妇和3名医护人员进行了关键信息提供者访谈;对9名孕妇进行了焦点小组讨论。定量数据采用 STATA V15 软件包进行分析。采用专题分析法对定性数据进行人工分析:在 354 名孕妇中,29.0% 具备相关知识,46.98% 态度良好,60.17% 实践良好。至少参加过一次产前检查和听说过糖尿病与 GDM 的良好态度和做法有关。在了解情况的孕妇中,有三分之一(33.33%)是从医疗机构获得 GDM 信息的。与孕妇的讨论以及与医护人员的访谈都强调,产前门诊的日常健康讲座包括了 GDM 和糖尿病的相关信息。此外,在本应至少参加一次产前检查的孕妇(87.86%)中,至少参加一次产前检查的比例较低(85.88%):结论:尽管孕妇对 GDM 的了解较少,但她们对 GDM 的态度和做法相对较好。产前检查期间举办的日常健康讲座以及孕妇的本土知识对后者产生了影响。因此,需要加强 GDM 信息的传播,以改善孕妇的 GDM KAP,从而预防 GDM。
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引用次数: 0
Age at first sex and other determinants of multiple sexual partnerships among sexually active adolescent girls in Ghana: a regression analysis of the 2022 Ghana demographic and health survey. 加纳性行为活跃少女的初次性行为年龄及其他多重性伴侣关系的决定因素:对 2022 年加纳人口与健康调查的回归分析。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-10-22 DOI: 10.1186/s41182-024-00644-x
Desmond Klu, Micheal Larbi Odame, Evelyn Acquah, Charity Akpene Dansu

Background: Early sexual debut is a widely recognized public health issue due to its influence on lifetime multiple sexual partners which can lead to complications such as teenage pregnancy, abortion, HIV/AIDS and other sexually transmitted infections. However, there is paucity of research evidence on sexual behaviour such as age at first sexual intercourse and the number of sexual partnerships among adolescent girls in Ghana. This study aims to examine the influence of age at first sexual intercourse and other determinants on multiple sexual partnerships among adolescent girls aged 15-19 years in Ghana.

Methods: Data for this study were obtained from the 2022 Ghana Demographic and Health Survey (GDHS) conducted between October 17, 2022 and January 14, 2023. A total weighted sample of 719 sexually active adolescent girls who reported having sexual partners was extracted from the women's data file. Data were analyzed with SPSS version 27, employing multilevel logistics regression modelling. Statistical significance was set at p < 0.05.

Results: The average age at sexual debut for adolescent girls aged 15-19 years in Ghana is 15.5 years. A little over half (51.6%) of adolescent girls reported having two or more lifetime sexual partners. Adolescent girls who initiated sex before reaching age 15 were more likely (aOR = 2.00; C.I 1.39-2.87) to have multiple partners compared to those who had their first sex before attaining age 20. After controlling for other factors, girls who had their sexual debut before age 15 had higher odds (aOR = 1.85; C.I:1.30-3.31) of engaging in multiple sexual partnerships. Girls living female headed households (aOR = 2.25; C.I:1.18-4.29] and consuming alcohol (aOR = 2.38; C.I 2.38-1.09-5.17) had higher odds of having multiple sexual partners.

Conclusion: The study findings show that early sexual debut, living in female headed household, and consuming alcohol are strong predictors of multiple sexual partnerships among adolescent girls in Ghana. It suggests the need for policies promoting delayed sexual debut and empowering adolescents to make informed decisions to improve sexual health outcomes.

背景:初次性行为过早是一个公认的公共卫生问题,因为它影响到终生多个性伴侣,可能导致少女怀孕、流产、艾滋病毒/艾滋病和其他性传播感染等并发症。然而,有关性行为(如初次性交年龄和加纳少女的性伴侣数量)的研究证据却很少。本研究旨在探讨初次性交年龄和其他决定因素对加纳 15-19 岁少女多重性伴侣关系的影响:本研究的数据来自 2022 年 10 月 17 日至 2023 年 1 月 14 日进行的 2022 年加纳人口与健康调查(GDHS)。从妇女数据文件中抽取了 719 名报告有性伴侣的性活跃少女作为加权样本。数据使用 SPSS 27 版进行分析,采用多层次物流回归模型。统计显著性以 p 为标准:加纳 15-19 岁少女初次性行为的平均年龄为 15.5 岁。略高于半数(51.6%)的少女表示一生中有过两个或两个以上的性伴侣。与那些在 20 岁之前发生首次性行为的少女相比,在 15 岁之前开始性行为的少女更有可能拥有多个性伴侣(aOR = 2.00;C.I 1.39-2.87)。在控制了其他因素后,15 岁前初次性行为的女孩有更高几率(aOR = 1.85;C.I:1.30-3.31)有多个性伴侣。生活在女户主家庭(aOR = 2.25;C.I:1.18-4.29)和饮酒(aOR = 2.38;C.I 2.38-1.09-5.17)的女孩有多个性伴侣的几率更高:研究结果表明,初次性行为过早、生活在女户主家庭和饮酒是预测加纳少女有多个性伴侣的重要因素。这表明有必要制定政策,促进推迟初次性行为,并增强青少年做出知情决定的能力,以改善性健康成果。
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引用次数: 0
Presence of Plasmodium falciparum strains with artemisinin-resistant K13 mutation C469Y in Busia County, Western Kenya. 肯尼亚西部布西亚县存在耐青蒿素 K13 突变 C469Y 的恶性疟原虫菌株。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-10-18 DOI: 10.1186/s41182-024-00640-1
Mark Makau, Bernard N Kanoi, Calvin Mgawe, Michael Maina, Mimie Bitshi, Edwin K Too, Taeko K Naruse, Hussein M Abkallo, Harrison Waweru, Ferdinand Adung'o, Osamu Kaneko, Jesse Gitaka

Malaria remains a key health and economic problem, particularly in sub-Saharan Africa. The emergence of artemisinin drug resistance (ART-R) parasite strains poses a serious threat to the control and elimination of this scourge. This is because artemisinin-based combination therapies (ACTs) remain the first-line treatment in the majority of malaria-endemic regions in Sub-Saharan Africa. Certain single-nucleotide polymorphisms in the propeller domains of Plasmodium falciparum Kelch 13 protein (K13) have been associated with delayed parasite clearance in vivo and in vitro. These mutations serve as vital molecular markers for tracking the emergence and dispersion of resistance. Recently, there have been increasing reports of the emergence and spread of P. falciparum ART-R parasites in the Eastern Africa region. This necessitates continued surveillance to best inform mitigation efforts. This study investigated the presence of all reported mutations of K13 propeller domains in the parasite population in Busia County, Kenya, a known malaria-endemic region. Two hundred twenty-six participants with microscopically confirmed uncomplicated malaria were recruited for this study. They were treated with artemether-lumefantrine under observation for the first dose, and microscopic examination was repeated 1 day later after ensuring the participants had taken the second and third doses. P. falciparum DNA from all samples underwent targeted amplification of the K13 gene using a semi-nested PCR approach, followed by Sanger sequencing. The recently validated ART-R K13 mutation C469Y was identified in three samples. These three samples were among 63 samples with a low reduction in parasitemia on day 1, suggesting day 1 parasitemia reduction rate is a useful parameter to enrich the ART-R parasites for further analysis. Our findings highlight the need for continuous surveillance of ART-R in western Kenya and the region to determine the spread of ART-R and inform containment.

疟疾仍然是一个主要的健康和经济问题,尤其是在撒哈拉以南非洲地区。青蒿素抗药性(ART-R)寄生虫菌株的出现对控制和消除这一祸害构成了严重威胁。这是因为在撒哈拉以南非洲的大多数疟疾流行地区,青蒿素类复方疗法(ACTs)仍然是第一线治疗方法。恶性疟原虫凯氏 13 蛋白(K13)螺旋桨结构域中的某些单核苷酸多态性与体内和体外寄生虫清除延迟有关。这些突变是追踪抗药性出现和扩散的重要分子标记。最近,有关恶性疟原虫抗逆转录病毒寄生虫在东非地区出现和扩散的报道越来越多。因此有必要继续进行监测,以便为缓解工作提供最佳信息。本研究调查了已知疟疾流行地区肯尼亚布西亚县寄生虫群体中 K13 螺旋桨结构域所有已报道突变的存在情况。这项研究招募了 226 名经显微镜确诊为无并发症疟疾的患者。他们在观察下接受了第一剂蒿甲醚-本芴醇治疗,并在确保参与者服用第二剂和第三剂后,于一天后再次进行显微镜检查。所有样本中的恶性疟原虫 DNA 都使用半嵌套 PCR 方法进行了 K13 基因的定向扩增,然后进行了 Sanger 测序。在三个样本中发现了最近验证的 ART-R K13 突变 C469Y。这三个样本是第 1 天寄生虫血症下降率较低的 63 个样本中的一个,这表明第 1 天寄生虫血症下降率是一个有用的参数,可用于进一步分析 ART-R 寄生虫。我们的研究结果突出表明,有必要在肯尼亚西部和该地区对 ART-R 进行持续监测,以确定 ART-R 的传播情况并为遏制提供信息。
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引用次数: 0
Correction: Enhanced clindamycin delivery using chitosan-coated niosomes to prevent Toxoplasma gondii strain VEG in pregnant mice: an experimental study. 更正:利用壳聚糖包衣的niosomes加强克林霉素的输送以防止弓形虫菌株VEG在妊娠小鼠中的感染:一项实验研究。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-10-15 DOI: 10.1186/s41182-024-00643-y
Mitra Sadeghi, Seyed Abdollah Hosseini, Shahabeddin Sarvi, Pedram Ebrahimnejad, Hossein Asgaryan Omran, Zohre Zare, Shirzad Gholami, Alireza Khalilian, Seyedeh Melika Ahmadi, Fatemeh Hajizadeh, Mostafa Tork, Ahmad Daryani, Sargis A Aghayan
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引用次数: 0
Individual and community-level factors associated with adequate antenatal care service utilization in sub-Saharan Africa. 撒哈拉以南非洲与适当利用产前护理服务有关的个人和社区因素。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-10-15 DOI: 10.1186/s41182-024-00631-2
Setegn Muche Fenta, Haile Mekonnen Fenta, Seyifemickael Amare Yilema, Ding-Geng Chen, Amsalu Worku Mekonnin

Background: Sub-Saharan Africa (sSA) continues to rank among the regions in the world with the highest rates of maternal mortality and the lowest rates of utilization of maternal health care. The risk of death for women in sSA is 268 times higher than that of women in high-income nations. Adequate antenatal care (ANC) services utilization is essential to the mother's and the baby's survival and well-being. This study aimed to identify both individual and community-level factors associated with adequate antenatal care services utilization in sSA.

Method: We used data from the most recent Health and Demographic Surveys (DHS), which were carried out between 2012 and 2022 in 33 sSA countries. A total of 240,792 women were included in this study. The two-level mixed-effects logistic regression model was used to identify the individual and community-level factors associated with the use of adequate ANC service.

Results: The pooled prevalence of adequate ANC service utilization in sSA was 55.48% (95% CI: 55.28-55.68). The study showed that secondary and above-educated women (AOR = 2.13, 95% CI 2.07-2.19, secondary and above-educated husbands (AOR = 1.55, 95% CI 1.51-1.60), rich women AOR = 1.26, 95% CI 1.24-1.29), women 35-49 years of age (AOR = 1.36, 95% CI 1.32-1.41) and distance to a health facility is not a big problem (AOR = 1.13; 95% CI 1.11-1.16) was significantly and positively correlated with the use of adequate ANC services. However, rural women (AOR = 0.80; 95% CI 0.78-0.82), not having mass media access (AOR = 0.74, 95% CI 0.72-0.75), 5 and above birth order (AOR = 0.73, 95% CI 0.68-0.78) were significantly and negatively correlated with the use of adequate ANC services. Additionally, the random effects model showed that variables at the community and individual levels were responsible for approximately 62.60% of the variation in the use of adequate ANC services.

Conclusion: The sSA countries had a low prevalence of adequate utilization of ANC with a significant variation among countries. Moreover, public health initiatives should focus on rural women, poor women, and uneducated women to enhance maternal health services utilization. Furthermore, policies and programs that address cluster variations in the utilization of adequate ANC services must be developed, and their implementation must be vigorously pursued.

背景:撒哈拉以南非洲地区仍然是世界上孕产妇死亡率最高、孕产妇保健利用率最低的地区之一。撒哈拉以南非洲地区妇女的死亡风险是高收入国家妇女的 268 倍。充分使用产前保健(ANC)服务对母婴的存活和福祉至关重要。本研究旨在确定与南部非洲充分使用产前保健服务相关的个人和社区因素:我们使用了最新的健康与人口调查(DHS)数据,该调查于 2012 年至 2022 年间在 33 个南部非洲国家进行。本研究共纳入 240,792 名妇女。研究采用两级混合效应逻辑回归模型来确定与使用适当产前保健服务相关的个人和社区因素:结果:在南部非洲,充足的产前保健服务使用率为 55.48%(95% CI:55.28-55.68)。29)、35-49 岁的妇女(AOR = 1.36,95% CI 1.32-1.41)以及与医疗机构的距离问题不大(AOR = 1.13;95% CI 1.11-1.16)与使用适当的产前保健服务呈显著正相关。然而,农村妇女(AOR = 0.80;95% CI 0.78-0.82)、无法接触大众媒体(AOR = 0.74,95% CI 0.72-0.75)、5 胎及 5 胎以上(AOR = 0.73,95% CI 0.68-0.78)与使用适当的产前护理服务呈显著负相关。此外,随机效应模型显示,社区和个人层面的变量约占适当产前保健服务使用率差异的 62.60%:结论:南部非洲国家充分使用产前保健服务的普及率较低,各国之间差异显著。此外,公共卫生措施应重点关注农村妇女、贫困妇女和未受过教育的妇女,以提高孕产妇保健服务的利用率。此外,还必须制定政策和计划,以解决在充分利用产前护理服务方面存在的群组差异,并大力实施这些政策和计划。
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Tropical Medicine and Health
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