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Influence of women empowerment on childhood (12-23 months) immunization coverage: Recent evidence from 17 sub-Saharan African countries. 增强妇女权能对儿童(12-23个月)免疫覆盖率的影响:来自17个撒哈拉以南非洲国家的最新证据。
IF 4.5 Q1 TROPICAL MEDICINE Pub Date : 2023-11-14 DOI: 10.1186/s41182-023-00556-2
Abigail Amoah, Jacob Issaka, Castro Ayebeng, Joshua Okyere

Background: There is a global consensus that child immunization plays an important role in promoting the health and well-being of children. Despite the quintessential role of immunization, not all children receive full immunization coverage. We examined the association between women empowerment and childhood immunization coverage in sub-Saharan Africa (SSA).

Methods: The most recent Demographic and Health Survey data of 17 SSA countries were used for the analysis, with a sample of 19,223. The outcome and exposure variables were full immunization coverage and women empowerment, respectively. Full immunization was computed from percentage of children between the ages of 12 and 23 months who had received the following vaccines at any point in time: one dose of Bacille Calmette-Guérin, three doses of the vaccine protecting against diphtheria, pertussis, and tetanus or the tetravalent/pentavalent vaccine, three doses of the polio vaccine, and one dose of the measles vaccine (either as a standalone measles vaccine or as part of a combination with other immunogens). Women's empowerment was an index of labour participation, acceptance towards spousal violence, decision-making capacity and general knowledge level. Descriptive analysis and multilevel logistic regression were performed. Results were reported in adjusted odds ratio with a corresponding 95% confidence interval.

Results: The study found that 56.6% of children were fully immunized. Children of employed mothers were 1.16 times more likely to be fully immunized. Children of mothers with higher acceptance toward violence were less likely to be fully immunized [aOR = 0.90, CI 0.81, 0.99]. The odds of full immunization were higher among children born to mothers with high [aOR = 1.11, CI 1.01, 1.22] decision-making capacity. Higher odds of full immunization were found among children born to mothers with medium [aOR = 1.24, CI 1.13, 1.36] to high [aOR = 1.44, CI 1.27, 1.63] general knowledge level.

Conclusions: We conclude that empowering women through livelihood empowerment interventions can increase their decision-making capacity and foster their resolve to ensure the full immunization of their children. This can be achieved by consciously investing in initiatives such as vocational training programs, job placement services, or support for entrepreneurship initiatives to encourage and support women's workforce participation.

背景:全球一致认为,儿童免疫在促进儿童健康和福祉方面发挥着重要作用。尽管免疫发挥着至关重要的作用,但并非所有儿童都能获得全面免疫覆盖。我们研究了撒哈拉以南非洲(SSA)妇女赋权与儿童免疫覆盖率之间的关系。方法:使用17个SSA国家最新的人口与健康调查数据进行分析,样本为19,223人。结果和暴露变量分别是完全免疫覆盖率和妇女赋权。全面免疫是根据在任何时间点接种过下列疫苗的12至23个月儿童的百分比计算的:一剂卡介苗-谷氏疫苗、三剂白喉、百日咳和破伤风疫苗或四价/五价疫苗、三剂小儿麻痹症疫苗和一剂麻疹疫苗(作为单独的麻疹疫苗或与其他免疫原组合使用的一部分)。赋予妇女权力是劳动参与、对配偶暴力的接受程度、决策能力和一般知识水平的指标。进行描述性分析和多水平逻辑回归。结果以校正后的优势比和相应的95%置信区间进行报道。结果:研究发现56.6%的儿童完全免疫。有工作的母亲的孩子获得充分免疫的可能性是前者的1.16倍。母亲对暴力的接受程度越高,其子女接受完全免疫的可能性越小[aOR = 0.90, CI 0.81, 0.99]。决策能力高[aOR = 1.11, CI 1.01, 1.22]的母亲所生的儿童获得全面免疫的几率更高。一般知识水平中[aOR = 1.24, CI 1.13, 1.36]至高[aOR = 1.44, CI 1.27, 1.63]的母亲所生儿童获得全面免疫的几率较高。结论:我们的结论是,通过生计赋权干预措施赋予妇女权力,可以提高她们的决策能力,并增强她们确保子女全面免疫的决心。这可以通过有意识地投资于诸如职业培训计划、就业安置服务或支持创业倡议等举措来实现,以鼓励和支持妇女参与劳动力。
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引用次数: 0
Deforestation inhibits malaria transmission in Lao PDR: a spatial epidemiology using Earth observation satellites. 老挝境内森林砍伐抑制疟疾传播:利用地球观测卫星进行的空间流行病学研究。
IF 4.5 Q1 TROPICAL MEDICINE Pub Date : 2023-11-02 DOI: 10.1186/s41182-023-00554-4
Emilie Louise Akiko Matsumoto-Takahashi, Moritoshi Iwagami, Kei Oyoshi, Yoshinobu Sasaki, Bouasy Hongvanthong, Shigeyuki Kano

Background: The present study aimed to analyze the impact of deforestation on the malaria distribution in the Lao People's Democratic Republic (Lao PDR), with consideration of climate change.

Methods: Malaria distribution data from 2002 to 2015 were obtained from the Ministry of Health of Lao PDR and each indicator was calculated. Earth observation satellite data (forested area, land surface temperature, and precipitation) were obtained from the Japan Aerospace Exploration Agency (JAXA). Structured equation modeling (SEM) was conducted to clarify the relationship between the malaria incidence and Earth observation satellite data.

Results: As a result, SEM identified two factors that were independently associated with the malaria incidence: area and proportion of forest. Specifically, malaria was found to be more prevalent in the southern region, with the malaria incidence increasing as the percentage of forested land increased (both p < 0.01). With global warming steadily progressing, forested areas are expected to play an important role in the incidence of malaria in Lao PDR. This is believed because malaria in Lao PDR is mainly forest malaria transmitted by Anopheles dirus.

Conclusion: To accelerate the elimination of malaria in Lao PDR, it is important to identify, prevent, and intervene in places with increased forest coverage (e.g., plantations) and in low-temperature areas adjacent to malaria-endemic areas, where the vegetation is similar to that in malaria-endemic areas.

背景:本研究旨在分析砍伐森林对老挝人民民主共和国疟疾分布的影响,同时考虑到气候变化。方法:从老挝卫生部获得2002年至2015年的疟疾分布数据,并计算每个指标。地球观测卫星数据(森林面积、地表温度和降水量)是从日本宇宙航空研究开发机构(JAXA)获得的。进行了结构方程建模(SEM),以阐明疟疾发病率与地球观测卫星数据之间的关系。结果:扫描电镜确定了和疟疾发病率独立相关的两个因素:森林面积和比例。具体而言,疟疾在南部地区更为普遍,疟疾发病率随着林地比例的增加而增加(两者均为p 结论:为了加快在老挝消灭疟疾,重要的是在森林覆盖率增加的地方(如种植园)和疟疾流行区附近的低温地区进行识别、预防和干预,因为那里的植被与疟疾流行区的植被相似。
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引用次数: 0
Comparative analysis of the susceptibility of Aedes aegypti and Japanese Aedes albopictus to all dengue virus serotypes. 埃及伊蚊和日本白纹伊蚊对所有登革热病毒血清型易感性的比较分析。
IF 4.5 Q1 TROPICAL MEDICINE Pub Date : 2023-11-02 DOI: 10.1186/s41182-023-00553-5
Daisuke Kobayashi, Izumi Kai, Astri Nur Faizah, Meng Ling Moi, Shigeru Tajima, Tomohiko Takasaki, Toshinori Sasaki, Haruhiko Isawa

Background: Dengue fever, caused by the dengue virus (DENV), is the most common viral infection transmitted by Aedes mosquitoes (mainly Ae. aegypti and Ae. albopictus) worldwide. Aedes aegypti is not currently established in Japan, and Ae. albopictus is the primary vector mosquito for DENV in the country, but knowledge of its viral susceptibility is limited. Therefore, we aimed to clarify the status of DENV susceptibility by comparing the infection and dissemination dynamics of Japanese Ae. albopictus to all known DENV serotypes with those of Ae. aegypti.

Methods: After propagation of each DENV serotype in Vero cells, the culture supernatants were mixed with defibrinated rabbit blood and adenosine triphosphate, and the mixture was artificially blood-sucked by two colonies of Ae. albopictus from Japan and one colony of Ae. aegypti from a dengue-endemic country (Vietnam). After 14 days of sucking, the mosquito body was divided into two parts (thorax/abdomen and head/wings/legs) and total RNA was extracted from each sample. DENV RNA was detected in these extracted RNA samples using a quantitative RT-PCR method specific for each DENV serotype, and infection and dissemination rates were analyzed.

Results: The Japanese Ae. albopictus colonies were susceptible to all DENV serotypes. Its infection and dissemination rates were significantly lower than those of Ae. aegypti. However, the number of DENV RNA copies in Ae. albopictus was almost not significantly different from that in Ae. aegypti. Furthermore, Japanese Ae. albopictus differed widely in their susceptibility to each DENV serotype.

Conclusions: In Japanese Ae. albopictus, once DENV overcame the midgut infection barrier, the efficiency of subsequent propagation and dissemination of the virus in the mosquito body was comparable to that of Ae. aegypti. Based on the results of this study and previous dengue outbreak trends, Ae. albopictus is predicted to be highly compatible with DENV-1, suggesting that this serotype poses a high risk for future epidemics in Japan.

背景:登革热是由登革病毒(DENV)引起的,是全球最常见的由伊蚊(主要是埃及伊蚊和白纹伊蚊)传播的病毒感染。埃及伊蚊目前尚未在日本建立,白纹伊蚊是该国DENV的主要媒介蚊子,但对其病毒易感性的了解有限。因此,我们的目的是通过比较日本白纹伊蚊对所有已知DENV血清型和埃及伊蚊的感染和传播动态来阐明DENV的易感性状况。方法:每种DENV血清型在Vero细胞中繁殖后,将培养上清液与去纤维兔血和三磷酸腺苷混合,并由两个来自日本的白纹伊蚊和一个来自登革热流行国(越南)的埃及伊蚊人工吸血。吮吸14天后,将蚊子的身体分为两部分(胸部/腹部和头部/翅膀/腿),并从每个样本中提取总RNA。使用对每个DENV血清型特异的定量RT-PCR方法在这些提取的RNA样品中检测DENV RNA,并分析感染率和传播率。结果:日本白纹伊蚊群体对所有DENV血清型均敏感。其感染率和传播率明显低于埃及伊蚊。然而,白纹伊蚊的DENV RNA拷贝数与埃及伊蚊几乎没有显著差异。此外,日本白纹伊蚊对每种登革病毒血清型的易感性差异很大。结论:在日本白纹伊蚊中,DENV一旦克服中肠感染屏障,病毒在蚊子体内的繁殖和传播效率与埃及伊蚊相当。根据这项研究的结果和以前登革热爆发的趋势,白纹伊蚊被预测与DENV-1高度兼容,这表明该血清型在日本未来流行的风险很高。
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引用次数: 0
Depression and anxiety symptoms among Vietnamese migrants in Japan during the COVID-19 pandemic. 新冠肺炎大流行期间,在日本的越南移民出现抑郁和焦虑症状。
IF 4.5 Q1 TROPICAL MEDICINE Pub Date : 2023-10-31 DOI: 10.1186/s41182-023-00542-8
Tadashi Yamashita, Pham Nguyen Quy, Emi Nogami, Erina Seto-Suh, Chika Yamada, Saori Iwamoto, Kyoko Shimazawa, Kenji Kato

This study aimed to examine the mental health status and related factors among Vietnamese migrants in Japan during the COVID-19 pandemic. We conducted an online cross-sectional survey between September 21 and October 21, 2021. Along with Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7) scores, we collected data on demographics, changes in socioeconomic status due to the pandemic, language proficiency, social support, and health conditions. Multivariate logistic regression was performed to identify factors related to symptoms of depression and anxiety. Among 621 participants who completed the questionnaire, moderate-to-severe symptoms of depression (PHQ-9 score ≥ 10 points) and mild-to-severe symptoms of anxiety (GAD-7 score ≥ 5 points) were observed in 203 (32.7%) and 285 (45.9%) individuals, respectively. Factors related to depressive symptoms were age (95% confidence interval [CI]=0.89-0.99), pre-existing health conditions (95% [CI]=1.61-3.76), and a low subjective socioeconomic status (95% [CI]=1.64-3.71). Factors related to anxiety symptoms were being single (95% [CI]=1.01-2.93), having pre-existing health conditions (95% [CI]=1.63-3.88), subjective socioeconomic status (95% [CI]=1.87-3.97), and absence of a partner to discuss one's health with (95% [CI]=1.11-2.47). Vietnamese migrants in Japan experienced a decrease in income, worsening working conditions, and poor mental health status during the COVID-19 pandemic. Further investigations are necessary to find an effective way to increase their social support and mitigate socioeconomic adversities.

本研究旨在调查新冠肺炎大流行期间在日本的越南移民的心理健康状况和相关因素。我们在2021年9月21日至10月21日期间进行了一项在线横断面调查。除了患者健康问卷-9(PHQ-9)和广泛性焦虑症7项(GAD-7)评分外,我们还收集了人口统计数据、疫情导致的社会经济地位变化、语言水平、社会支持和健康状况。采用多因素逻辑回归分析来确定与抑郁和焦虑症状相关的因素。在完成问卷调查的621名参与者中,中度至重度抑郁症症状(PHQ-9分 ≥ 10分)和轻度至重度焦虑症状(GAD-7分 ≥ 5分)分别在203(32.7%)和285(45.9%)个体中观察到。与抑郁症状相关的因素是年龄(95%置信区间[CI]=0.89-0.99)、先前存在的健康状况(95%[CI]=1.63-7.76)和较低的主观社会经济地位(95%[CI]=1.64-3.71),在新冠肺炎大流行期间,在日本的越南移民经历了收入下降、工作条件恶化和精神健康状况不佳。有必要进行进一步的调查,以找到一种有效的方法来增加他们的社会支持,缓解社会经济困境。
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引用次数: 0
Use of wild edible and nutraceutical plants in Raya-Azebo District of Tigray Region, northern Ethiopia. 埃塞俄比亚北部提格雷地区Raya Azebo区野生食用和营养植物的使用。
IF 4.5 Q1 TROPICAL MEDICINE Pub Date : 2023-10-24 DOI: 10.1186/s41182-023-00550-8
Mirutse Giday, Tilahun Teklehaymanot

Background: Although there is a wide use of wild edible plants (WEPs) in Ethiopia, very little work has so far been done, particularly, in the Tigray Region, northern Ethiopia, to properly document the associated knowledge. The purpose of this study was, therefore, to document knowledge and analyze data related to the use of wild edible and nutraceutical plants in Raya-Azebo District of Tigray Region. The district was prioritized for the study to avoid the further loss of local knowledge and discontinuation of the associated practices because of the depletion of wild edible plants in the area mainly due to agricultural expansion and largely by private investors.

Methods: A cross-sectional ethnobotanical study was carried out in the study District to collect data through individual interviews held with purposively selected informants, observation, market surveys, and ranking exercises. Descriptive and inferential statistical methods were employed to analyze and summarize the data using Statistical Package for Social Sciences (SPSS) version 16.

Results: The study documented 59 WEPs, the majority of which (57.63%) were sought for their fruits. Most of the WEPs (49 species) were consumed in the autumn, locally called qewei, which includes the months of September, October, and November. Ziziphus spina-christi L. Desf., Balanites aegyptiaca (L.) Del. and Opuntia ficus-indica (L.) Miller were the most preferred WEPs. Both interviews and local market surveys revealed the marketability of Opuntia ficus-indica, Ziziphus spina-christi, Ficus vasta Forssk., Ficus sur Forssk., and Balanites aegyptiaca. Of the total WEPs, 21 were reported to have medicinal (nutraceutical) values, of which Balanites aegyptiaca and Acacia etbaica scored the highest rank order priority (ROP) values for their uses to treat anthrax and skin infections, respectively.

Conclusions: The current investigation demonstrated the wide use of WEPs in the district. In future nutritional composition analysis studies, priority should be given to the most popular WEPs, and nutraceutical plants with the highest ROP values.

背景:尽管埃塞俄比亚广泛使用野生可食用植物,但迄今为止,特别是在埃塞俄比亚北部的提格雷地区,为妥善记录相关知识所做的工作很少。因此,本研究的目的是记录和分析提格雷地区Raya Azebo区野生食用和营养植物使用的相关知识和数据。该地区被列为研究的优先地区,以避免当地知识的进一步丧失和相关做法的中断,因为该地区野生可食用植物的枯竭主要是由于农业扩张,主要是由私人投资者造成的。方法:在研究区进行了一项横断面的民族植物学研究,通过对有意选择的线人进行个人访谈、观察、市场调查和排名练习来收集数据。采用描述性和推断性统计方法,使用社会科学统计软件包(SPSS)第16版对数据进行分析和总结。结果:该研究记录了59个WEP,其中大多数(57.63%)是为了寻找其成果。大多数WEP(49种)在秋季被消耗,当地称为qewei,包括9月、10月和11月。金合欢。,埃及Balanites aegyptiaca(L.)Del.和仙人掌(Opuntia ficus indica(L.)Miller)是最受欢迎的WEP。采访和当地市场调查都揭示了仙人掌、刺叶榕、榕树的市场性。,福斯克河畔菲库斯。,和埃及Balanites aegyptiaca。据报道,在总共的WEP中,有21种具有药用(营养)价值,其中埃及Balanites aegyptiaca和Acacia etbaica在治疗炭疽病和皮肤感染方面的优先级(ROP)值最高。结论:目前的调查表明WEP在该地区的广泛使用。在未来的营养成分分析研究中,应优先考虑最受欢迎的WEP和ROP值最高的营养植物。
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引用次数: 0
Follow-up assessment of visceral leishmaniasis treated patients and the impact of COVID-19 on control services in Nepal. 对接受内脏利什曼病治疗的患者的随访评估以及新冠肺炎对尼泊尔控制服务的影响。
IF 4.5 Q1 TROPICAL MEDICINE Pub Date : 2023-10-20 DOI: 10.1186/s41182-023-00549-1
Anand Ballabh Joshi, Megha Raj Banjara, Murari Lal Das, Nav Raj Bist, Krishna Raj Pant, Uttam Raj Pyakurel, Gokarna Dahal, Krishna Prasad Paudel, Chuman Lal Das, Axel Kroeger, Abraham Aseffa

Background: Follow-up assessment of visceral leishmaniasis (VL) treated cases is important to monitor the long term effectiveness of treatment regimens. The main objective of this study was to identify the gaps and challenges in the follow-up of treated VL cases, to monitor treatment outcome and to assess the impact of COVID-19 on VL elimination services and activities.

Methods: Clinicians treating VL patients, district focal persons for VL, and patients treated for VL in seven high endemic districts in Nepal during 2019-2022 were interviewed to collect data on challenges in the follow-up of VL treated patients as per national strategy.

Results: Follow up status was poor in two districts with the largest number of reported cases. The majority of cases were children under 10 years of age (44.2%). Among 104 VL treated cases interviewed, 60.6% mentioned that clinicians had called them for follow-up but only 37.5% had complied. Among 112 VL treated cases followed up, 8 (7.14%) had relapse and 2 (1.8%) had PKDL. Among 66 cases who had VL during the COVID-19 lock down period, 32 (48.5%) were diagnosed within 1 week; however, 10 (15.1%) were diagnosed only after 4 weeks or more. During the COVID-19 pandemic, there was no active search for VL because of budget constraints and lack of diagnostic tests, and no insecticide spraying was done.

Conclusion: Relapses and PKDL are challenges for VL elimination and a matter of concern. Successful implementation of the national strategy for follow up of treated VL cases requires addressing elements related to patients (awareness, transport, communication) clinicians (compliance) and organization of service delivery (local health worker training and deployment). COVID-19 did not have much impact on VL diagnosis and treatment; however, public health programmes including active case detection and insecticide spraying for vector control were severely reduced.

背景:内脏利什曼病(VL)治疗病例的随访评估对于监测治疗方案的长期有效性很重要。本研究的主要目的是确定治疗后VL病例随访中的差距和挑战,监测治疗结果,并评估新冠肺炎对VL消除服务和活动的影响。方法:在2019-2022年期间,采访了治疗VL患者的临床医生、VL的地区联络人以及尼泊尔七个高流行地区的VL患者,以收集根据国家战略对VL治疗患者进行随访的挑战数据。结果:报告病例最多的两个地区的随访情况较差。大多数病例是10岁以下的儿童(44.2%)。在104例接受VL治疗的病例中,60.6%的患者提到临床医生曾要求他们随访,但只有37.5%的患者遵守了。在112例VL治疗的随访病例中,8例(7.14%)复发,2例(1.8%)PKDL。在新冠肺炎封锁期间患有VL的66例病例中,32例(48.5%)在1周内确诊;然而,10人(15.1%)在4周或更长时间后才被确诊。在新冠肺炎大流行期间,由于预算限制和缺乏诊断测试,没有积极寻找VL,也没有喷洒杀虫剂。结论:复发和PKDL是消除VL的挑战,也是一个值得关注的问题。成功实施治疗后VL病例随访的国家战略需要解决与患者(意识、运输、沟通)、临床医生(合规性)和服务提供组织(当地卫生工作者培训和部署)相关的要素。新冠肺炎对VL的诊断和治疗没有太大影响;然而,公共卫生方案,包括积极的病例检测和用于病媒控制的杀虫剂喷洒严重减少。
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引用次数: 0
Trend of sociodemographic and economic inequalities in the use of maternal health services in Lao People's Democratic Republic from 2006 to 2017: MICS data analysis. 2006年至2017年老挝人民民主共和国在使用孕产妇保健服务方面的社会人口和经济不平等趋势:多指标类集调查数据分析。
IF 4.5 Q1 TROPICAL MEDICINE Pub Date : 2023-10-19 DOI: 10.1186/s41182-023-00548-2
Noudéhouénou Credo Adelphe Ahissou, Daisuke Nonaka, Rie Takeuchi, Calvin de Los Reyes, Manami Uehara, Phongluxa Khampheng, Sengchanh Kounnavong, Jun Kobayashi

Background: Maternal mortalities remain high in the Lao People's Democratic Republic (Lao PDR). Since 2012, to improve access to maternal health services for all women, the country implemented several policies and strategies including user fee removal interventions for childbirth-related care. However, it remains unclear whether inequalities in access to services have reduced in the post-2012 period compared to pre-2012. Our study compared the change in sociodemographic and economic inequalities in access to maternal health services between 2006 to 2011-12 and 2011-12 to 2017.

Methods: We used the three most recent Lao Social Indicator Survey datasets conducted in 2006, 2011-12, and 2017 for this analysis. We assessed wealth, area of residence, ethnicity, educational attainment, and women's age-related inequalities in the use of at least one antenatal care (ANC) visit with skilled personnel, institutional delivery, and at least one facility-based postnatal care (PNC) visit by mothers. The magnitude of inequalities was measured using concentration curves, concentration indices (CIX), and equiplots.

Results: The coverage of at least one ANC with skilled personnel increased the most between 2012 and 2017, by 37.1% in Hmong minority ethnic group women, 36.1% in women living in rural areas, 31.1%, and 28.4 in the poorest and poor, respectively. In the same period, institutional deliveries increased the most among women in the middle quintiles by 32.8%, the poor by 29.3%, and Hmong women by 30.2%. The most significant reduction in inequalities was related to area of residence between 2006 and 2012 while it was based on wealth quintiles in the period 2011-12 to 2017. Finally, in 2017, wealth-related inequalities in institutional delivery remained high, with a CIX of 0.193 which was the highest of all CIX values.

Conclusion: There was a significant decline in inequalities based on the area of residence in the use of maternal health services between 2006 and 2011-12 while between 2011-12 and 2017, the largest decrease was based on wealth quintiles. Policies and strategies implemented since 2011-12 might have been successful in improving access to maternal health services in Lao PDR. Meanwhile, more attention should be given to improving the uptake of facility-based PNC visits.

背景:在老挝人民民主共和国,产妇死亡率仍然很高。自2012年以来,为了改善所有妇女获得孕产妇保健服务的机会,该国实施了多项政策和战略,包括对分娩相关护理的用户费用减免干预措施。然而,与2012年前相比,2012年后获得服务的不平等现象是否有所减少,目前尚不清楚。我们的研究比较了2006年至2011年12月和2011年至2017年期间在获得孕产妇保健服务方面社会人口和经济不平等的变化。方法:我们使用了2006年、2011年至2012年和2017年进行的三个最新老挝社会指标调查数据集进行分析。我们评估了财富、居住地区、种族、教育程度以及妇女在使用至少一次由熟练人员进行的产前护理(ANC)访问、机构分娩和母亲至少一次基于设施的产后护理(PNC)访问方面与年龄相关的不平等。使用浓度曲线、浓度指数(CIX)和等位曲线来测量不等式的大小。结果:2012年至2017年间,至少一个拥有熟练人员的ANC的覆盖率增长最快,苗族少数民族妇女增加了37.1%,农村妇女增加了36.1%,最贫穷和穷人分别增加了31.1%和28.4%。在同一时期,机构分娩在中等五分位数的妇女中增加最多,增加了32.8%,穷人增加了29.3%,苗族妇女增加了30.2%。2006年至2012年期间,不平等现象的最显著减少与居住面积有关,而2011年至2017年期间,这是基于财富五分位数。最后,2017年,与财富相关的机构交付不平等现象仍然很高,CIX为0.193,是所有CIX值中最高的。结论:2006年至2011-12年间,基于居住地区的孕产妇保健服务使用不平等现象显著下降,而2011-12年至2017年间,基于财富五分位数的不平等现象下降幅度最大。自2011-12年以来实施的政策和战略可能在改善老挝获得孕产妇保健服务方面取得了成功。同时,应更多地注意提高基于设施的PNC访问的接受率。
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引用次数: 0
Bacterial contamination of healthcare workers' mobile phones in Africa: a systematic review and meta-analysis. 非洲医护人员手机的细菌污染:一项系统综述和荟萃分析。
IF 4.5 Q1 TROPICAL MEDICINE Pub Date : 2023-10-05 DOI: 10.1186/s41182-023-00547-3
Demisu Zenbaba, Biniyam Sahiledengle, Girma Beressa, Fikreab Desta, Zinash Teferu, Fikadu Nugusu, Daniel Atlaw, Zerihun Shiferaw, Bereket Gezahegn, Ayele Mamo, Tesfaye Desalegn, Wogene Negash, Getahun Negash, Mohammedaman Mama, Eshetu Nigussie, Vijay Kumar Chattu

Background: Mobile phones are potential reservoirs for pathogens and sources of healthcare-associated infections. More microbes can be found on a mobile phone than on a man's lavatory seat, the sole of a shoe, or a door handle. When examining patients, frequent handling of mobile phones can spread bacteria. Nevertheless, evidence of bacterial contamination of mobile phones used by healthcare workers in Africa was inconclusive. Thus, this meta-analysis and systematic review was conducted to estimate the pooled prevalence of bacterial contamination of mobile phones used by healthcare workers and the most frequent bacterial isolates in Africa.

Methods: We systematically retrieved relevant studies using PubMed/MEDLINE, POPLINE, HINARI, Science Direct, Cochrane Library databases, and Google Scholar from July 1, 2023 to August 08, 2023. We included observational studies that reported the prevalence of bacterial contamination of mobile phones among healthcare workers. The DerSimonian-random Laird's effect model was used to calculate effect estimates for the pooled prevalence of bacterial contamination in mobile phones and a 95% confidence interval (CI).

Results: Among 4544 retrieved studies, 26 eligible articles with a total sample size of 2,887 study participants were included in the meta-analysis. The pooled prevalence of mobile phone bacterial contamination among healthcare workers was 84.5% (95% CI 81.7, 87.4%; I2 = 97.9%, p value < 0.001). The most dominant type of bacteria isolated in this review was coagulase-negative staphylococci (CONS) which accounted for 44.0% of the pooled contamination rate of mobile phones used by healthcare workers, followed by Staphylococcus aureus (31.3%), and Escherichia coli (10.7%).

Conclusions: In this review, the contamination of mobile phones used by HCWs with various bacterial isolates was shown to be considerable. The most prevalent bacteria isolates were coagulase-negative staphylococci, Staphylococcus aurous, and Escherichia coli. The prevalence of bacterial contamination in mobile phones varies by country and sub-region. Hence, healthcare planners and policymakers should establish norms to manage healthcare workers' hand hygiene and disinfection after using mobile phones.

背景:手机是病原体的潜在宿主,也是医疗相关感染的来源。手机上的微生物比男人的马桶座、鞋底或门把手上的微生物还多。在检查病人时,频繁使用手机会传播细菌。尽管如此,非洲医护人员使用的手机受到细菌污染的证据还没有定论。因此,进行了这项荟萃分析和系统综述,以估计医护人员使用的手机中细菌污染的合并流行率和非洲最常见的细菌分离株。方法:我们使用PubMed/MEDLINE、POPLINE、HINARI、Science Direct、Cochrane Library数据库和Google Scholar从7月1日起系统检索了相关研究,2023年至2023年8月8日。我们纳入了观察性研究,这些研究报告了医护人员中手机细菌污染的流行率。DerSimonian随机Laird效应模型用于计算手机细菌污染合并流行率的效应估计值和95%置信区间(CI)。结果:在4544项检索到的研究中,26篇符合条件的文章被纳入荟萃分析,总样本量为2887名研究参与者。医护人员中手机细菌污染的合并患病率为84.5%(95%CI 81.7,87.4%;I2 = 97.9%,p值 结论:在这篇综述中,HCW使用的手机受到了各种细菌分离株的严重污染。最常见的细菌分离株是凝固酶阴性葡萄球菌、金黄色葡萄球菌和大肠杆菌。手机中细菌污染的流行率因国家和次区域而异。因此,医疗保健规划者和政策制定者应该制定规范,管理医护人员使用手机后的手部卫生和消毒。
{"title":"Bacterial contamination of healthcare workers' mobile phones in Africa: a systematic review and meta-analysis.","authors":"Demisu Zenbaba, Biniyam Sahiledengle, Girma Beressa, Fikreab Desta, Zinash Teferu, Fikadu Nugusu, Daniel Atlaw, Zerihun Shiferaw, Bereket Gezahegn, Ayele Mamo, Tesfaye Desalegn, Wogene Negash, Getahun Negash, Mohammedaman Mama, Eshetu Nigussie, Vijay Kumar Chattu","doi":"10.1186/s41182-023-00547-3","DOIUrl":"10.1186/s41182-023-00547-3","url":null,"abstract":"<p><strong>Background: </strong>Mobile phones are potential reservoirs for pathogens and sources of healthcare-associated infections. More microbes can be found on a mobile phone than on a man's lavatory seat, the sole of a shoe, or a door handle. When examining patients, frequent handling of mobile phones can spread bacteria. Nevertheless, evidence of bacterial contamination of mobile phones used by healthcare workers in Africa was inconclusive. Thus, this meta-analysis and systematic review was conducted to estimate the pooled prevalence of bacterial contamination of mobile phones used by healthcare workers and the most frequent bacterial isolates in Africa.</p><p><strong>Methods: </strong>We systematically retrieved relevant studies using PubMed/MEDLINE, POPLINE, HINARI, Science Direct, Cochrane Library databases, and Google Scholar from July 1, 2023 to August 08, 2023. We included observational studies that reported the prevalence of bacterial contamination of mobile phones among healthcare workers. The DerSimonian-random Laird's effect model was used to calculate effect estimates for the pooled prevalence of bacterial contamination in mobile phones and a 95% confidence interval (CI).</p><p><strong>Results: </strong>Among 4544 retrieved studies, 26 eligible articles with a total sample size of 2,887 study participants were included in the meta-analysis. The pooled prevalence of mobile phone bacterial contamination among healthcare workers was 84.5% (95% CI 81.7, 87.4%; I<sup>2</sup> = 97.9%, p value < 0.001). The most dominant type of bacteria isolated in this review was coagulase-negative staphylococci (CONS) which accounted for 44.0% of the pooled contamination rate of mobile phones used by healthcare workers, followed by Staphylococcus aureus (31.3%), and Escherichia coli (10.7%).</p><p><strong>Conclusions: </strong>In this review, the contamination of mobile phones used by HCWs with various bacterial isolates was shown to be considerable. The most prevalent bacteria isolates were coagulase-negative staphylococci, Staphylococcus aurous, and Escherichia coli. The prevalence of bacterial contamination in mobile phones varies by country and sub-region. Hence, healthcare planners and policymakers should establish norms to manage healthcare workers' hand hygiene and disinfection after using mobile phones.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"51 1","pages":"55"},"PeriodicalIF":4.5,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10552405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41149204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epidemiology, clinical presentation, and predictors of outcome in nontuberculous mycobacterial central nervous system infection: a systematic review. 非结核分枝杆菌中枢神经系统感染的流行病学、临床表现和预后预测因素:一项系统综述。
IF 4.5 Q1 TROPICAL MEDICINE Pub Date : 2023-09-25 DOI: 10.1186/s41182-023-00546-4
Durga Shankar Meena, Deepak Kumar, Vasudha Meena, Gopal Krishana Bohra, Vibhor Tak, Mahendra Kumar Garg

Background: CNS manifestations represent an emerging facet of NTM infection with significant mortality. Due to protean presentation and low index of suspicion, many cases are often treated erroneously as tubercular meningitis or fungal infections.

Objectives: Literature on NTM CNS disease is scarce, with most available data on pulmonary disease. This systematic review aimed to evaluate the epidemiology, clinical presentation, diagnostic modalities, and predictors of outcome in CNS NTM infection.

Methods: The literature search was performed in major electronic databases (PubMed, Google Scholar, and Scopus) using keywords "CNS," "Central nervous system," "brain abscess," "meningitis," "spinal," "Nontuberculous mycobacteria," "NTM". All cases of CNS NTM infection reported between January 1980 and December 2022 were included.

Results: A total of 77 studies (112 cases) were included in the final analysis. The mean age of all patients was 38 years, with most patients male (62.5%). Mycobacterium avium complex (MAC) was the most common aetiology, followed by M. fortuitum and M. abscessus (34.8%, 21.4% and 15.2%, respectively). The disseminated disease was found in 33% of cases. HIV (33.9%) and neurosurgical hardware (22.3%) were the common risk factors. Intracranial abscess (36.6%) and leptomeningeal enhancement (28%) were the most prevalent findings in neuroimaging. The overall case fatality rate was 37.5%. On multivariate analysis, male gender (adjusted OR 2.4, 95% CI 1.2-7.9) and HIV (adjusted OR 3.7, 95% CI 1.8-6.1) were the independent predictors of mortality). M. fortuitum infection was significantly associated with increased survival (adjusted OR 0.18, 95% CI (0.08-0.45), p value 0.012).

Conclusions: Current evidence shows the emerging role of rapid-grower NTM in CNS disease. Male gender and HIV positivity were associated with significant mortality, while M fortuitum carries favourable outcomes.

背景:中枢神经系统表现是NTM感染的一个新方面,具有显著的死亡率。由于变形杆菌的表现和低怀疑指数,许多病例经常被错误地视为结核性脑膜炎或真菌感染。目的:关于NTM中枢神经系统疾病的文献很少,肺部疾病的可用数据最多。本系统综述旨在评估中枢神经系统NTM感染的流行病学、临床表现、诊断模式和预后预测因素。方法:在主要的电子数据库(PubMed、Google Scholar和Scopus)中使用关键词“CNS”、“中枢神经系统”、“脑脓肿”、“脑膜炎”、“脊柱”、“非结核分枝杆菌”和“NTM”进行文献检索。纳入1980年1月至2022年12月期间报告的所有中枢神经系统NTM感染病例。结果:共有77项研究(112例)纳入最终分析。所有患者的平均年龄为38岁,大多数患者为男性(62.5%)。偶然性和M。脓肿(分别为34.8%、21.4%和15.2%)。在33%的病例中发现了传播性疾病。HIV(33.9%)和神经外科硬件(22.3%)是常见的危险因素。颅内脓肿(36.6%)和软脑膜强化(28%)是神经影像学中最常见的表现。总病死率为37.5%。在多变量分析中,男性(校正OR 2.4,95%CI 1.2-7.9)和HIV(校正OR 3.7,95%CI 1.8-6.1)是死亡率的独立预测因素。M。偶然感染与生存率增加显著相关(校正OR 0.18,95%CI(0.08-0.45),p值0.012)。结论:目前的证据表明快速生长的NTM在中枢神经系统疾病中的作用正在显现。男性和HIV阳性与显著的死亡率相关,而M偶然性具有有利的结果。
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引用次数: 0
Head lice as vectors of pathogenic microorganisms. 头虱作为病原微生物的媒介。
IF 4.5 Q1 TROPICAL MEDICINE Pub Date : 2023-09-20 DOI: 10.1186/s41182-023-00545-5
Hermann Feldmeier

Body lice and head lice are the most common ectoparasites of humans. Head lice (Pediculus humanus capitis) occur worldwide in children and their caretakers, irrespective of their social status. In contrast, body lice (Pediculus humanus corporis) are confined to marginalized population groups in countries of the Global South, homeless people, and refugees. Body lice are known to transmit an array of bacterial pathogens, such as R. prowazekii, R. rickettsii, C. burneti, B. quintana, B. recurrentis, and Y. pestis. The vector capacity of head lice is still a matter of debate. The objective of the review was to scrutinize the existing evidence on the vector capacity of head lice for the transmission of bacterial pathogens. The PUBMED database was searched using a combination of the terms "pediculus humanus" OR "body lice" OR "head lice" AND "pathogen" OR "Rickettsia prowazekii" OR "Bartonella quintana" OR "Borrelia recurrentis" OR "Coxiella burneti" without a time limit. Data from epidemiological studies as well as historical observations demonstrate that body lice and head lice can carry the same array of pathogens. Since the presence of a bacterial pathogen in an arthropod is not sufficient to state that it can be transmitted to humans, and since experimental models are lacking, as yet one cannot conclude with certainty that head lice serve as vectors, although this review presents circumstantial evidence that they do. Adequately designed experimental and epidemiological studies are needed to ascertain the exact transmission potential of head lice.

体虱和头虱是人类最常见的体外寄生虫。头虱(Pediculus humanus capitis)发生在世界各地的儿童及其看护人身上,无论他们的社会地位如何。相比之下,体虱(Pediculus humanus corporis)仅限于全球南方国家的边缘化人口群体、无家可归者和难民。众所周知,体虱会传播一系列细菌病原体,如普氏乳杆菌、立克次体乳杆菌、burneti乳杆菌、昆塔纳乳杆菌、复发乳杆菌和鼠疫杆菌。头虱的媒介能力仍然是一个有争议的问题。审查的目的是仔细审查关于头虱传播细菌病原体的媒介能力的现有证据。PUBMED数据库是使用术语“人类足癣”或“体虱”或“头虱”和“病原体”或“原瓦泽基立克次体”或“五分巴尔托内拉”或“复发性疏螺旋体”或”烧伤Coxiella burneti”的组合进行搜索的,没有时间限制。流行病学研究和历史观察的数据表明,体虱和头虱可以携带相同的病原体。由于节肢动物中细菌病原体的存在不足以说明它可以传播给人类,而且缺乏实验模型,因此目前还不能肯定地得出头虱是媒介的结论,尽管这篇综述提供了间接证据。需要进行充分设计的实验和流行病学研究,以确定头虱的确切传播潜力。
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引用次数: 0
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