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Prevalence of Strongyloides stercoralis and other helminths in four districts of Madagascar. 马达加斯加四个地区盘尾丝虫和其他蠕虫的流行情况。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-07-29 DOI: 10.1186/s41182-024-00619-y
Salvatore Scarso, Rivo Andry Rakotoarivelo, Jana Christina Hey, Tahinamandranto Rasamoelina, Anjarasoa Ravo Razafindrakoto, Zaraniaina Tahiry Rasolojaona, Nantenaina Mathieu Razafindralava, Aaron Remkes, Njary Rakotozandrindrainy, Clara Fabienne Rasoamanamihaja, Norbert Georg Schwarz, Jürgen May, Raphael Rakotozandrindrainy, Valentina Marchese, Fabio Formenti, Francesca Perandin, Francesca Tamarozzi, Cristina Mazzi, Daniela Fusco, Dora Buonfrate

Background: Estimation of prevalence of Strongyloides stercoralis infection is required in endemic areas, in order to identify areas in need of control programmes. Data on prevalence of strongyloidiasis in Madagascar are scant. Aim of this work was to estimate prevalence of S. stercoralis in four districts of Madagascar.

Methods: Fecal and serum samples collected in the context of a previous study on schistosomiasis were tested with S. stercoralis real-time PCR and serology, respectively. A multiplex real-time PCR for Ascaris lumbricoides, Ancylostoma duodenalis, Necator americanus, and Trichuris trichiura was done on fecal samples collected in the areas demonstrating higher prevalence of strongyloidiasis. Comparisons between proportions were made using Fisher exact test, with false discovery rate correction used for post-hoc comparisons. A multivariable Firth logistic regression model was used to assess potential risk factors for S. stercoralis infection.

Results: Overall, 1775 serum samples were tested, of which 102 of 487 (20.9%) and 104 of 296 (35.2%) were serological-positive in Marovoay and in Vatomandry districts (both coastal areas), respectively, compared to 28 of 496 (5.6%) and 30 of 496 (6.1%) in Tsiroanomandidy and in Ambositra districts (both highlands), respectively (adj. p < 0.001). PCR for S. stercoralis was positive in 15 of 210 (7.1%) and in 11 of 296 (3.7%) samples from Marovoay from Vatomandry, respectively, while was negative for all samples tested in the other two districts. High prevalence of A. lumbricoides (45.9%), hookworm (44.6%) and T. trichiura (32.1%) was found in Vatomandry. In the multivariable analysis, strongyloidiasis was associated with hookworm infection. Hookworm infection was also associated with male sex and lower education level.

Conclusions: S. stercoralis prevalence proved higher in coastal areas compared to highlands. Different climatic conditions may explain this distribution, along with previous rounds of anthelminthics distributed in the country, which may have reduced the parasite load in the population. The high prevalence of the other soil-transmitted helminths (STH) in Vatomandry was unexpected, given the good coverage with benzimidazole in control campaigns. Further studies are needed to explore the risk factors for STH and S. stercoralis infections in Madagascar, in order to align with the WHO recommendations.

背景:需要对流行地区的盘尾丝虫病感染率进行估计,以确定需要实施控制计划的地区。马达加斯加的盘尾丝虫病感染率数据很少。这项工作的目的是估计马达加斯加四个地区的盘尾丝虫病流行率:方法:对之前血吸虫病研究中采集的粪便和血清样本分别进行了盘尾丝虫实时 PCR 检测和血清学检测。在强直性脊柱炎发病率较高的地区采集的粪便样本进行了蛔虫、十二指肠锚疽、美洲奈卡特氏虫和毛滴虫的多重实时 PCR 检测。比例之间的比较采用费舍尔精确检验,事后比较采用假发现率校正。采用多变量费思逻辑回归模型评估感染斯特氏虫的潜在风险因素:结果:共检测了 1775 份血清样本,其中马罗沃伊区和瓦托曼德里区(均为沿海地区)的血清阳性样本分别为 487 份中的 102 份(20.9%)和 296 份中的 104 份(35.2%),而齐罗亚诺曼德里区和安博西特拉区(均为高原地区)的血清阳性样本分别为 496 份中的 28 份(5.6%)和 496 份中的 30 份(6.1%)(adj.p):与高地相比,沿海地区的盘尾丝虫病流行率更高。不同的气候条件可能是造成这种分布的原因,另外,前几轮在该国发放的驱虫药可能减少了寄生虫在人口中的数量。鉴于苯并咪唑在防治活动中的良好覆盖率,瓦托曼德里其他土壤传播蠕虫(STH)的高发病率出乎意料。为了与世界卫生组织的建议保持一致,有必要开展进一步研究,探讨马达加斯加感染 STH 和盘尾丝虫的风险因素。
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引用次数: 0
Descriptive analyses of knowledge, attitudes, and practices regarding rabies transmission and prevention in rural communities near wildlife reserves in Uganda: a One Health cross-sectional study. 对乌干达野生动物保护区附近农村社区有关狂犬病传播和预防的知识、态度和做法的描述性分析:一项 "同一健康 "横断面研究。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-07-19 DOI: 10.1186/s41182-024-00615-2
Collins G K Atuheire, James Okwee-Acai, Martha Taremwa, Odoch Terence, Sarah N Ssali, Frank N Mwiine, Clovice Kankya, Eystein Skjerve, Morten Tryland

Background: Despite urban (domestic dog) rabies cycles being the main target for rabies elimination by 2030, sylvatic (wildlife) rabies cycles can act as rabies spillovers especially in settlements contiguous to wildlife reserves. Rural communities next to wildlife reserves are characterized by unique socio-demographic and cultural practices including bat consumption, hunting for bushmeat, and non-vaccination of hunting dogs against rabies among others. This study aimed to compare the knowledge, attitudes, and practices (KAPs) related to rabies transmission and prevention in the three districts of Uganda; (1) Nwoya, neighboring Murchison Falls National Park (MFNP) in the north, (2) Kamwenge neighboring Kibaale National Park (KNP), Queen Elizabeth National Park (QENP) and Katonga Game Reserve (KGR) in the west, and (3) Bukedea, neighboring Pian Upe Game Reserve (PUGR) in the east of Uganda.

Methods: A community-based cross-sectional survey was conducted in settlements contiguous to these wildlife reserves. Using a semi-structured questionnaire, data were collected from 843 households owning dogs and livestock. Data were collected between the months of January and April 2023. Stratified univariate analyses by district were carried out using the Chi-square test for independence and Fisher's exact test to compare KAPs in the three study districts.

Results: The median age of study participants was 42 years (Q1, Q3 = 30, 52) with males comprising the majority (67%, n = 562). The key findings revealed that participants from the Nwoya district in the north (MFNP) had little knowledge about rabies epidemiology (8.5%, n = 25), only 64% (n = 187) of them knew its signs and symptoms such as a rabid dog presenting with aggressiveness and showed negative attitudes towards prevention measures (15.3%, n = 45). Participants in the Kamwenge district-west (KNP, QENP, and KGR) had little knowledge and negative attitude towards wildlife-human interaction pertaining to rabies transmission and prevention especially those with no or primary level of education (20.9%, n = 27) while participants from Bukedea in the east (PUGR) had remarkedly poor practices towards rabies transmission, prevention, and control (37.8%, n = 114).

Conclusions: Rabies from sylvatic cycles remains a neglected public health threat in rural communities surrounding national parks and game reserves in Uganda. Our study findings highlight key gaps in knowledge, attitudes, and practices related to rabies transmission and prevention among such communities. Communication and action between veterinary services, wildlife authority, public health teams, social science and community leaders through available community platforms is key in addressing rabies among the sympatric at-risk communities in Uganda.

背景:尽管城市(家犬)狂犬病循环是到 2030 年消除狂犬病的主要目标,但系统(野生动物)狂犬病循环也会造成狂犬病蔓延,尤其是在野生动物保护区附近的居民区。野生动物保护区附近的农村社区具有独特的社会人口和文化习俗,包括食用蝙蝠、狩猎丛林肉类、猎犬不接种狂犬病疫苗等。本研究旨在比较乌干达三个地区有关狂犬病传播和预防的知识、态度和做法(KAPs):(1)北部与默奇森瀑布国家公园(MFNP)相邻的恩沃亚(Nwoya);(2)西部与基巴莱国家公园(KNP)、伊丽莎白女王国家公园(QENP)和卡通加猎物保护区(KGR)相邻的卡姆文盖(Kamwenge);(3)东部与皮安乌佩猎物保护区(PUGR)相邻的布克德亚(Bukedea):方法:在这些野生动物保护区附近的居民点开展了一项社区横断面调查。采用半结构式问卷,从 843 个拥有狗和牲畜的家庭中收集了数据。数据收集时间为 2023 年 1 月至 4 月。采用卡方检验(Chi-square test)和费雪精确检验(Fisher's exact test)对三个研究区的 KAPs 进行了分区单变量分析:研究参与者的年龄中位数为 42 岁(Q1、Q3 = 30、52),男性占多数(67%,n = 562)。主要结果显示,北部恩沃亚区(MFNP)的参与者对狂犬病流行病学知之甚少(8.5%,n = 25),只有 64% 的参与者(n = 187)知道狂犬病的症状和体征,如狂犬表现出攻击性,并且对预防措施持消极态度(15.3%,n = 45)。卡姆文盖区西部(KNP、QENP 和 KGR)的参与者对狂犬病传播和预防方面的野生动物与人类互动知之甚少,态度消极,尤其是那些没有受过教育或只受过初级教育的参与者(20.9%,n = 27),而东部布克德亚(PUGR)的参与者在狂犬病传播、预防和控制方面的做法明显较差(37.8%,n = 114):结论:在乌干达国家公园和野生动物保护区周边的农村社区,狂犬病仍是一个被忽视的公共卫生威胁。我们的研究结果凸显了这些社区在狂犬病传播和预防的相关知识、态度和实践方面存在的主要差距。通过现有的社区平台,兽医服务、野生动物管理局、公共卫生团队、社会科学和社区领袖之间的沟通和行动是解决乌干达同栖高危社区狂犬病问题的关键。
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引用次数: 0
Discovery of antimalarial drugs from secondary metabolites in actinomycetes culture library. 从放线菌培养库中的次级代谢物中发现抗疟疾药物。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-07-09 DOI: 10.1186/s41182-024-00608-1
Awet Alem Teklemichael, Aiko Teshima, Asahi Hirata, Momoko Akimoto, Mayumi Taniguchi, Gholam Khodakaramian, Takashi Fujimura, Fuyuki Tokumasu, Kenji Arakawa, Shusaku Mizukami

Background: Natural products play a key role as potential sources of biologically active substances for the discovery of new drugs. This study aimed to identify secondary metabolites from actinomycete library extracts that are potent against the asexual stages of Plasmodium falciparum (P. falciparum).

Methods: Secondary metabolites from actinomycete library extracts were isolated from culture supernatants by ethyl acetate extraction. Comprehensive screening was performed to identify novel antimalarial compounds from the actinomycete library extracts (n = 28). The antimalarial activity was initially evaluated in vitro against chloroquine/mefloquine-sensitive (3D7) and-resistant (Dd2) lines of P. falciparum. The cytotoxicity was then evaluated in primary adult mouse brain (AMB) cells.

Results: Out of the 28 actinomycete extracts, 17 showed parasite growth inhibition > 50% at a concentration of 50 µg/mL, nine were identified with an IC50 value < 10 µg/mL, and seven suppressed the parasite significantly with an IC50 value < 5 µg/mL. The extracts from Streptomyces aureus strains HUT6003 (Extract ID number: 2), S. antibioticus HUT6035 (8), and Streptomyces sp. strains GK3 (26) and GK7 (27), were found to have the most potent antimalarial activity with IC50 values of 0.39, 0.09, 0.97, and 0.36 µg/mL (against 3D7), and 0.26, 0.22, 0.72, and 0.21 µg/mL (against Dd2), respectively. Among them, Streptomyces antibioticus strain HUT6035 (8) showed the highest antimalarial activity with an IC50 value of 0.09 µg/mL against 3D7 and 0.22 µg/mL against Dd2, and a selective index (SI) of 188 and 73.7, respectively.

Conclusion: Secondary metabolites obtained from the actinomycete extracts showed promising antimalarial activity in vitro against 3D7 and Dd2 cell lines of P. falciparum with minimal toxicity. Therefore, secondary metabolites obtained from actinomycete extracts represent an excellent starting point for the development of antimalarial drug leads.

背景:天然产物作为生物活性物质的潜在来源,在新药研发中发挥着关键作用。本研究旨在从放线菌文库提取物中鉴定对恶性疟原虫(P. falciparum)无性阶段有效的次级代谢物:方法:放线菌文库提取物中的次生代谢物通过乙酸乙酯萃取从培养上清液中分离出来。对放线菌文库提取物(n = 28)进行了全面筛选,以确定新型抗疟化合物。首先在体外对恶性疟原虫的氯喹/甲氟喹敏感株(3D7)和抗性株(Dd2)进行了抗疟活性评估。然后在原代小鼠脑(AMB)细胞中评估其细胞毒性:结果:在 28 种放线菌提取物中,有 17 种在 50 微克/毫升的浓度下对寄生虫的生长抑制率大于 50%,其中 9 种的 IC50 值分别为 0.39、0.09、0.97 和 0.36 微克/毫升(针对 3D7 株系)以及 0.26、0.22、0.72 和 0.21 微克/毫升(针对 Dd2 株系)。其中,抗生素链霉菌菌株 HUT6035 (8) 的抗疟活性最高,对 3D7 的 IC50 值为 0.09 µg/mL,对 Dd2 的 IC50 值为 0.22 µg/mL,选择性指数(SI)分别为 188 和 73.7:从放线菌提取物中获得的次生代谢物在体外对恶性疟原虫3D7和Dd2细胞系表现出良好的抗疟活性,且毒性极低。因此,从放线菌提取物中获得的次生代谢物是开发抗疟药物线索的绝佳起点。
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引用次数: 0
Development of a LAMP method with lateral flow DNA chromatography to diagnose toxoplasmosis in immunocompromised patients. 利用侧流 DNA 层析技术开发 LAMP 方法,用于诊断免疫功能低下患者的弓形虫病。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-07-08 DOI: 10.1186/s41182-024-00613-4
Kei Mikita, Takehiko Mori, Tamayo Komine, Seiki Kobayashi, Satoshi Iwata, Koichi Suzuki, Naoki Hasegawa

Background: Rapid and accurate diagnosis of toxoplasmosis is critical, particularly for immunocompromised patients. Several molecular methods could have value for toxoplasmosis diagnosis, but often require sophisticated and expensive equipment, and as such are impractical for use in resource-limited countries. Our study aimed to develop a new rapid diagnostic test for toxoplasmosis that can be used in developed countries as well as low- or middle-income countries.

Methods: Common primers for conventional loop-mediated isothermal amplification (LAMP) and the new LAMP DNA chromatography method were designed based on a 529-bp repeat present in Toxoplasma gondii genomic DNA. A total of 91 clinical samples from 44 patients suspected of having toxoplasmosis who were treated at several hospitals across Japan were tested using the new LAMP DNA chromatography method, conventional LAMP, and nested PCR and the sensitivity and specificity of the methods was compared.

Results: The LAMP DNA chromatography method showed better sensitivity and specificity (68.2% and 100%, respectively) compared with the nested PCR (45.4% and 100%, respectively) and conventional LAMP (63.6% and 100%, respectively) methods for diagnosis of toxoplasmosis in immunocompromised patients. LAMP DNA chromatography also has better sensitivity and specificity (75% and 100%, respectively) than nested PCR (50.0% and 93.5%, respectively) and conventional LAMP (62.5% and 100%, respectively) to diagnose toxoplasma encephalitis using CSF samples.

Conclusion: We developed a LAMP DNA chromatography method to detect T. gondii DNA in clinical samples. This method also successfully detected T. gondii DNA in CSF from patients with toxoplasma encephalitis. This newly developed method can be a valuable rapid diagnostic test for toxoplasmosis in a range of settings, including resource-limited areas like those in low- or middle-income countries.

背景:快速准确地诊断弓形虫病至关重要,尤其是对免疫力低下的患者。有几种分子方法可用于弓形虫病的诊断,但往往需要复杂而昂贵的设备,因此在资源有限的国家不切实际。我们的研究旨在开发一种新型弓形虫病快速诊断检测方法,既可用于发达国家,也可用于中低收入国家:方法:根据弓形虫基因组 DNA 中存在的 529-bp 重复设计了用于传统环介导等温扩增(LAMP)和新型 LAMP DNA 层析法的通用引物。使用新 LAMP DNA 层析法、传统 LAMP 和巢式 PCR 对在日本多家医院接受治疗的 44 名疑似弓形虫病患者的 91 份临床样本进行了检测,并比较了这些方法的灵敏度和特异性:结果:与巢式 PCR(分别为 45.4% 和 100%)和传统 LAMP(分别为 63.6% 和 100%)方法相比,LAMP DNA 层析法诊断免疫功能低下患者弓形虫病的灵敏度和特异性更高(分别为 68.2% 和 100%)。与巢式 PCR(分别为 50.0% 和 93.5%)和传统 LAMP(分别为 62.5% 和 100%)相比,LAMP DNA 色谱法使用 CSF 样本诊断弓形虫脑炎的灵敏度和特异性(分别为 75% 和 100%)也更好:结论:我们开发了一种LAMP DNA层析方法来检测临床样本中的弓形虫DNA。结论:我们开发了在临床样本中检测弓形虫 DNA 的 LAMP DNA 色谱法,该方法也成功检测出弓形虫脑炎患者 CSF 中的弓形虫 DNA。这种新开发的方法可作为弓形虫病的一种重要快速诊断检测方法,适用于各种环境,包括中低收入国家等资源有限的地区。
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引用次数: 0
Addressing bottlenecks in Lassa fever treatment: overcoming the ribavirin parenteral formulation challenge. 解决拉沙热治疗瓶颈:克服利巴韦林肠外制剂的挑战。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-07-08 DOI: 10.1186/s41182-024-00609-0
Qudus Olajide Lawal, Joseph Okoeguale, Sebastine Oseghae Oiwoh, ThankGod Akhigbe, Reuben Agbons Eifediyi, Sylvanus Akhalufo Okogbenin

Ribavirin ampoule formulation remains a major challenge in managing Lassa fever disease. Lassa fever is an endemic viral hemorrhagic fever in the West Africa subregion, which has high-dose ribavirin as the standard of care. The high-dose therapy required makes the 200 mg/ml ampoule dosing of ribavirin a daunting task to administer, especially during disease outbreaks. This commentary highlights the challenges and makes a passionate call for vial dosage adjustment to fit the high-dose requirement of Lassa fever disease.

利巴韦林安瓿制剂仍然是治疗拉沙热疾病的一大挑战。拉沙热是西非次区域的一种地方性病毒性出血热,其治疗标准是大剂量利巴韦林。由于需要大剂量治疗,因此 200 毫克/毫升安瓿剂量的利巴韦林是一项艰巨的任务,尤其是在疾病爆发期间。本评论强调了这一挑战,并热情呼吁调整安瓿剂量,以适应拉沙热疾病的大剂量要求。
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引用次数: 0
A prospective cohort study in depression and anxiety among Vietnamese migrants in Japan during the early to mid-COVID-19 pandemic. 前瞻性队列研究:COVID-19 大流行初期至中期在日越南移民的抑郁和焦虑情况。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-07-01 DOI: 10.1186/s41182-024-00605-4
Tadashi Yamashita, Pham Nguyen Quy, Chika Yamada, Emi Nogami, Kenji Kato

Introduction: The enduring COVID-19 pandemic has had persistent, intermittent socioeconomic impacts on migrants. This raises the concern that many Vietnamese migrants in Japan may have developed mental health issues due to the socioeconomic impact. The study aimed to examine changes in the socio-economic and mental health status of Vietnamese migrants in Japan and factors affecting mental health status during the early to mid-COVID-19 period.

Methods: We conducted a prospective cohort study among Vietnamese migrants in Japan from September to October 2021 (baseline) and from May to June 2022 (follow-up) using an online questionnaire. Multiple linear regression analyses were conducted to examine the association between changes in socioeconomic status and alterations in symptoms of depression and anxiety within this demographic.

Results: The mean age of the 159 participants was 26.1 ± 4.9 years, with a mean length of residency in Japan of 4.0 ± 4.1 years. The mean PHQ-9 score exhibited a significant decrease from 7.89 (SD = 6.34) to 6.62 (SD = 5.87) (p = 0.01). Variables associated with changes in depression and anxiety included subjective socioeconomic status (unstandardized partial regression coefficient (UPRC): 1.901, 95% confidence interval (CI) 0.30 to 3.50, p = 0.02) and (UPRC: 2.060, 95% CI 0.80 to 3.32, p = 0.002), as well as changes in having someone with whom to discuss one's health (UPRC: 2.689, 95% CI 0.89 to 4.49, p = 0.004) and (UPRC: 1.955, 95% CI 0.54 to 3.38, p = 0.007).

Conclusions: In this prospective cohort study of depression and anxiety, depressive symptoms among Vietnamese migrants decreased from 2021 to 2022. Key findings underscore the importance of socioeconomic status improvement and having someone to discuss to about their health as protective factors against mental health challenges. Employment and social support have emerged as crucial determinants of mental health among Vietnamese migrants in Japan, emphasizing the necessity for comprehensive support strategies addressing both economic vulnerabilities and social connectedness.

导言:持续的 COVID-19 大流行对移民的社会经济产生了持续的、间歇性的影响。这使人们担心,许多在日本的越南移民可能会因社会经济影响而产生心理健康问题。本研究旨在探讨在日本的越南移民在COVID-19初期至中期的社会经济和心理健康状况的变化,以及影响心理健康状况的因素:我们使用在线问卷对 2021 年 9 月至 10 月(基线)和 2022 年 5 月至 6 月(随访)的在日越南移民进行了前瞻性队列研究。我们进行了多元线性回归分析,以研究社会经济地位的变化与该人群抑郁和焦虑症状变化之间的关联:结果:159 名参与者的平均年龄为 26.1 ± 4.9 岁,在日本的平均居住时间为 4.0 ± 4.1 年。平均 PHQ-9 分数从 7.89(标准差 = 6.34)大幅降至 6.62(标准差 = 5.87)(p = 0.01)。与抑郁和焦虑变化相关的变量包括主观社会经济地位(非标准化部分回归系数 (UPRC):1.901,95% 置信区间(CI)为 0.30 至 3.50,p = 0.02)和(UPRC:2.060,95% CI 为 0.80 至 3.32,p = 0.002),以及是否有人与自己讨论健康问题的变化(UPRC:2.689,95% CI 为 0.89 至 4.49,p = 0.004)和(UPRC:1.955,95% CI 为 0.54 至 3.38,p = 0.007):在这项关于抑郁和焦虑的前瞻性队列研究中,越南移民的抑郁症状从 2021 年到 2022 年有所减少。主要研究结果表明,社会经济地位的提高以及有人与他们讨论健康问题是应对心理健康挑战的重要保护因素。在日本的越南移民中,就业和社会支持已成为心理健康的重要决定因素,这强调了针对经济脆弱性和社会联系的综合支持战略的必要性。
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引用次数: 0
Fetal femur length and risk of diabetes in adolescence: a prospective cohort study. 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 : 2024-07-01 DOI: 10.1186/s41182-024-00611-6
Urme Binte Sayeed, Evana Akhtar, Anjan Kumar Roy, Sharmin Akter, Ondine S von Ehrenstein, Rubhana Raqib, Yukiko Wagatsuma

Background: Diabetes is more apparent in adulthood but may be dormant in childhood and originates during early fetal development. In fetal biometry, femur length (FL) is crucial for assessing fetal growth and development. This study aimed to assess potential associations between fetal femur growth and prediabetic biomarkers in Bangladeshi children.

Methods: A cohort study embedded in a population-based maternal food and micronutrient supplementation (MINIMat) trial was conducted in Matlab, Bangladesh. The children in the cohort were followed up until 15 years of age. In the original trial, pregnancy was confirmed by ultrasound before 13 gestational weeks (GWs). Afterward, ultrasound assessments were performed at 14, 19, and 30 GWs. FL was measured from one end to the other, capturing a complete femoral image. The FL was standardized by GW, and a z-score was calculated. FBG and HbA1c levels were determined in plasma and whole blood, and the triglyceride-glucose index, a biomarker of insulin resistance, was calculated as Ln [fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2]. Multivariable linear regression analysis using a generalized linear model was performed to estimate the effects of FL at 14, 19 and 30 GWs on prediabetic biomarkers at 9 and 15 years of age. Maternal micronutrient and food supplementation group, parity, child sex, and BMI at 9 years or 15 years were included as covariates.

Results: A total of 1.2% (6/515) of the participants had impaired fasting glucose during preadolescence, which increased to 3.5% (15/433) during adolescence. At 9 years, 6.3% (32/508) of the participants had elevated HbA1c%, which increased to 28% (120/431) at 15 years. Additionally, the TyG index increased from 9.5% (49/515) (during preadolescence) to 13% (56/433) (during adolescence). A one standard deviation decrease in FL at 14 and 19 GWs was associated with increased FBG (β = - 0.44 [- 0.88, - 0.004], P = 0.048; β = - 0.59 [- 1.12, - 0.05], P = 0.031) and HbA1c (β = - 0.01; [- 0.03, -0.005], P = 0.007; β = - 0.01 [- 0.03, - 0.003], P = 0.018) levels at 15 years. FL was not associated with diabetic biomarkers at 9 years.

Conclusion: Mid-trimester impaired femur growth may be associated with elevated prediabetic biomarkers in Bangladeshi adolescents.

背景:糖尿病在成年期更为明显,但在儿童期可能处于休眠状态,并起源于胎儿的早期发育。在胎儿生物测量中,股骨长度(FL)对评估胎儿的生长发育至关重要。本研究旨在评估孟加拉国儿童胎儿股骨生长与糖尿病前期生物标志物之间的潜在关联:方法:在孟加拉国的马特拉布(Matlab)进行了一项队列研究,其中包含一项基于人群的孕产妇食物和微量营养素补充试验(MINIMat)。对队列中的儿童进行了跟踪调查,直至他们 15 岁。在最初的试验中,怀孕是在 13 孕周(GWs)之前通过超声波确认的。之后,分别在 14、19 和 30 孕周进行超声波评估。FL的测量是从一端到另一端,采集完整的股骨图像。FL按GW标准化,并计算出z分数。测定血浆和全血中的 FBG 和 HbA1c 水平,并计算甘油三酯-葡萄糖指数(胰岛素抵抗的生物标志物),即 Ln [空腹甘油三酯(毫克/分升)×空腹葡萄糖(毫克/分升)/2]。使用广义线性模型进行多变量线性回归分析,以估计 FL 在 14、19 和 30 GWs 时对 9 岁和 15 岁糖尿病前期生物标志物的影响。母亲微量营养素和食物补充组别、胎次、儿童性别以及9岁或15岁时的体重指数均被列为协变量:结果:在青春期前,共有 1.2%(6/515)的参与者空腹血糖受损,在青春期则增至 3.5%(15/433)。9 岁时,6.3%(32/508)的参与者 HbA1c% 升高,15 岁时升至 28%(120/431)。此外,TyG 指数从 9.5%(49/515)(青春期前)上升到 13%(56/433)(青春期)。14 和 19 岁时 FL 下降一个标准差与 FBG 增加有关(β = - 0.44 [- 0.88, - 0.004],P = 0.048;β = - 0.59 [- 1.12,- 0.05],P = 0.031)和 15 岁时的 HbA1c(β = - 0.01;[- 0.03,- 0.005],P = 0.007;β = - 0.01 [- 0.03,- 0.003],P = 0.018)水平。FL与9岁时的糖尿病生物标志物无关:结论:妊娠中期股骨发育受损可能与孟加拉国青少年糖尿病前期生物标志物升高有关。
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引用次数: 0
Impact of targeted drug administration and intermittent preventive treatment for forest goers using artesunate-pyronaridine to control malaria outbreaks in Cambodia. 使用青蒿琥酯-吡咯那啶对森林居民进行定向给药和间歇性预防治疗以控制柬埔寨疟疾爆发的影响。
IF 4.5 Q1 Medicine Pub Date : 2024-06-11 DOI: 10.1186/s41182-024-00607-2
Dysoley Lek, Nguon Sokomar, Top Samphornarann, Jeanne Rideout, Saad El-Din Hassan, Tol Bunkea, Saing Sam Ath, Rothpisey Seng, John Hustedt, Thomas J Peto, Jayme Hughes, Ke Kimmen, Khoy Dy, Bipin Adhikari

Introduction: The national malaria programme of Cambodia targets the rapid elimination of all human malaria by 2025. As clinical cases decline to near-elimination levels, a key strategy is the rapid identification of malaria outbreaks triggering effective action to interrupt local transmission. We report a comprehensive, multipronged management approach in response to a  2022 Plasmodium falciparum outbreak in Kravanh district, western Cambodia.

Methods: The provincial health department of Pursat in conjunction with the Center for Parasitology, Entomology and Malaria Control (CNM) identified villages where transmission was occurring using clinical records, and initiated various interventions, including the distribution of insecticide-treated bed nets, running awareness campaigns, and implementing fever screening with targeted drug administration. Health stations were set up at forest entry points, and later, targeted drug administrations with artesunate-pyronaridine (Pyramax) and intermittent preventive treatment for forest goers (IPTf) were implemented in specific village foci. Data related to adherence and adverse events from IPTf and TDA were collected. The coverage rates of interventions were calculated, and local malaria infections were monitored.

Results: A total of 942 individuals were screened through active fever surveillance in villages where IPTf and TDA were conducted. The study demonstrated high coverage and adherence rates in the targeted villages, with 92% (553/600) coverage in round one and 65% (387/600) in round two. Adherence rate was 99% (551/553) in round one and 98% (377/387) in round two. The study found that forest goers preferred taking Pyramax over repeated testing consistent with the coverage rates: 92% in round one compared to 65% in round two. All individuals reachable through health stations or mobile teams reported complete IPTf uptake. No severe adverse events were reported. Only six individuals reported mild adverse events, such as loss of energy, fever, abdominal pain, diarrhoea, and muscle aches. Two individuals attributed their symptoms to heavy alcohol intake following prophylaxis.

Conclusions: The targeted malaria outbreak response demonstrated high acceptability, safety, and feasibility of the selected interventions. Malaria transmission was rapidly controlled using the available community resources. This experience suggests the effectiveness of the programmatic response for future outbreaks.

导言:柬埔寨国家疟疾计划的目标是到 2025 年迅速消灭所有人类疟疾。随着临床病例下降到接近消灭的水平,一项关键战略是迅速识别疟疾疫情,采取有效行动阻断当地传播。我们报告了柬埔寨西部 Kravanh 县为应对 2022 年恶性疟原虫疫情而采取的综合、多管齐下的管理方法:方法:菩萨省卫生厅与寄生虫学、昆虫学和疟疾控制中心(CNM)通过临床记录确定了发生传播的村庄,并启动了各种干预措施,包括分发驱虫蚊帐、开展宣传活动、实施发烧筛查和有针对性的药物治疗。在森林入口处设立了卫生站,随后在特定的村庄病灶实施了青蒿琥酯-吡咯那啶(Pyramax)靶向给药和森林居民间歇性预防治疗(IPTf)。收集了有关 IPTf 和 TDA 的依从性和不良事件的数据。计算了干预措施的覆盖率,并监测了当地的疟疾感染情况:结果:通过在开展 IPTf 和 TDA 的村庄进行发热监测,共筛查了 942 人。研究表明,目标村庄的覆盖率和坚持率都很高,第一轮覆盖率为 92%(553/600),第二轮覆盖率为 65%(387/600)。第一轮的坚持率为 99%(551/553),第二轮为 98%(377/387)。研究发现,与重复检测相比,森林居民更喜欢服用派瑞美,这与覆盖率一致:第一轮为 92%,第二轮为 65%。所有可通过保健站或流动小组接触到的人都报告完全服用了 IPTf。没有严重不良事件的报告。只有 6 人报告了轻微的不良反应,如体力不支、发烧、腹痛、腹泻和肌肉酸痛。有两人将症状归咎于预防后大量饮酒:有针对性的疟疾疫情应对措施表明,所选干预措施的可接受性、安全性和可行性都很高。利用现有的社区资源迅速控制了疟疾的传播。这一经验表明,在未来的疫情暴发中,该方案的应对措施是有效的。
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引用次数: 0
Contribution of wastewater irrigated vegetables to the prevalence of soil-transmitted helminth infection among female farmers in Addis Ababa, Ethiopia 废水灌溉蔬菜对埃塞俄比亚亚的斯亚贝巴女性农民土壤传播蠕虫感染率的影响
IF 4.5 Q1 Medicine Pub Date : 2024-06-06 DOI: 10.1186/s41182-024-00604-5
Bethlhem kinfu Gurmassa, Sirak Robele Gari, Ephrem Tefera Solomon, Michaela L. Goodson, Claire L. Walsh, Bitew K. Dessie, B. Alemu
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引用次数: 0
Development of two multiplex PCR assays for rapid detection of eleven Gram-negative bacteria in children with septicemia. 开发两种多重 PCR 检测方法,用于快速检测脓毒血症患儿体内的 11 种革兰氏阴性细菌。
IF 4.5 Q1 Medicine Pub Date : 2024-06-05 DOI: 10.1186/s41182-024-00606-3
Gabriel Miringu, Abednego Musyoki, Betty Muriithi, Ernest Wandera, Dan Waithiru, Erick Odoyo, Hisashi Shoji, Nelson Menza, Yoshio Ichinose

Aim: This study aimed to develop a multiplex PCR assay for simultaneous detection of major Gram-negative etiologies of septicemia and evaluate its performance.

Methods: Multiplex PCR (mPCR) assays were developed targeting 11 bacterial strains. Species-specific primers were confirmed using known clinical isolates and standard strains. Gradient PCR was performed on each primer against its target bacterial gene to determine its optimal amplification condition. The minimum detectable DNA concentration of the two assays was evaluated by adjusting bacterial DNA concentration to 100 ng/μL and, tenfold serially diluting it up to 10 pg/μL with DNAse-free water. The diagnostic accuracy of mPCR assays was established by subjecting the assays to 60 clinical blood samples.

Results: Two mPCR assays were developed. Optimal primer annealing temperature of 55 °C was established and utilized in the final amplification conditions. The assays detected all targeted bacteria, with a 100 pg minimum detectable DNA concentration. Pathogens were not detected directly from whole blood, but after 4 h and 8 h of incubation, 41% (5/12) and 100% (12/12) of the bacteria were detected in culture fluids, respectively. The assays also identified Salmonella spp. and Klebsiella pneumoniae co-infections and extra pathogens (1 E. coli and 2 K. pneumoniae) compared with culture. The sensitivity and specificity of the mPCR were 100.0% (71.7-100.0) and 98.0% (90.7-99.0), respectively. The area under the ROC curve was 1.00 (1.00-1.00).

Conclusions: The mPCR assays demonstrated substantial potential as a rapid tool for septicemia diagnosis alongside the traditional blood culture method. Notably, it was able to identify additional isolates, detect co-infections, and efficiently detect low bacterial DNA loads with high sensitivity, implying its value in enhancing efficiency of diagnosis of septicemia.

目的:本研究旨在开发一种多重 PCR 检测方法,用于同时检测败血症的主要革兰氏阴性病原菌,并评估其性能:方法:针对 11 种细菌菌株开发了多重 PCR(mPCR)检测方法。使用已知的临床分离菌株和标准菌株确认了菌种特异性引物。针对每个引物的目标细菌基因进行梯度 PCR,以确定其最佳扩增条件。通过将细菌 DNA 浓度调整为 100 纳克/微升,并用无 DNAse 水将其稀释 10 倍至 10 pg/微升,评估了两种检测方法的最低 DNA 检测浓度。通过对 60 份临床血液样本进行检测,确定了 mPCR 检测方法的诊断准确性:结果:开发出两种 mPCR 检测方法。确定了最佳引物退火温度为 55 °C,并将其用于最终扩增条件。这些检测方法可检测到所有目标细菌,最低 DNA 检测浓度为 100 pg。虽然不能直接从全血中检测到病原体,但在培养 4 小时和 8 小时后,分别从培养液中检测到 41% (5/12)和 100% (12/12)的细菌。与培养相比,该检测方法还能发现沙门氏菌属和肺炎克雷伯菌合并感染以及额外的病原体(1 个大肠杆菌和 2 个肺炎克雷伯菌)。mPCR 的灵敏度和特异性分别为 100.0%(71.7-100.0)和 98.0%(90.7-99.0)。ROC曲线下面积为1.00(1.00-1.00):mPCR 检测作为一种快速诊断败血症的工具,与传统的血液培养方法相比具有巨大的潜力。值得注意的是,它能识别更多的分离株,检测合并感染,并能以高灵敏度有效检测低细菌 DNA 负荷,这意味着它在提高败血症诊断效率方面具有重要价值。
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引用次数: 0
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Tropical Medicine and Health
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