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Impact of integrated WASH and maternal and child health interventions on diarrhea disease prevalence in a resource-constrained setting in Kenya. 在肯尼亚资源有限的环境中,讲卫生运动和妇幼保健综合干预措施对腹泻疾病流行的影响。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-08-30 DOI: 10.1186/s41182-024-00616-1
Betty Muriithi, Ernest Apondi Wandera, Rie Takeuchi, Felix Mutunga, Cyrus Kathiiko, Mary Wachira, Joseph Tinkoi, Mirasine Meiguran, Pius Akumu, Valeria Ndege, Ryoichiro Mochizuki, Satoshi Kaneko, Kouichi Morita, Collins Ouma, Yoshio Ichinose

Background: Water, sanitation and hygiene (WASH) and child health interventions are proven simple and cost-effective strategies for preventing diarrhea and minimizing excess mortality. Individually, they are able to prevent diarrhea though sub-optimally, and their effectiveness when combined may be higher. This study examined the effect of integrated WASH and maternal and child health (MCH) interventions on prevalence of diarrhea, in a resource-limited setting in Kenya.

Methods: A controlled intervention was implemented in Narok County. The interventions included WASH interventions integrated with promotion of MCH. A structured questionnaire was used to collect data on targeted indicators before and after the interventions. Data were analyzed using descriptive statistics and Chi-square to establish the impact of the interventions.

Results: A total of 431and 424 households and 491 and 487 households in intervention and control sites, respectively, participated in the baseline and endline surveys. Following implementation of the interventions, prevalence of diarrhea decreased by 69.1% (95% CI: 49.6-87.1%) and 58.6% (95% CI: 26.6-82.4%) in the intervention and control site, respectively. Treatment of drinking water and animal husbandry practices were significantly associated with diarrhea post-interventions.

Conclusions: Integrating WASH interventions with other diarrhea control strategies and contextualizing them to meet site-specific needs may effectively prevent diarrhea.

背景:事实证明,水、环境卫生和个人卫生(WASH)以及儿童健康干预措施是预防腹泻和最大限度降低超额死亡率的简单而经济有效的策略。单独使用这些干预措施可以预防腹泻,但效果并不理想,如果将它们结合起来,效果可能会更好。本研究考察了在肯尼亚资源有限的环境中,综合讲卫生运动和妇幼保健(MCH)干预措施对腹泻发病率的影响:方法:在纳罗克县实施了一项对照干预措施。方法:在纳罗克县实施了一项对照干预措施,干预措施包括讲卫生运动干预措施与促进妇幼保健相结合。采用结构化问卷收集干预前后的目标指标数据。使用描述性统计和卡方对数据进行分析,以确定干预措施的影响:共有 431 和 424 个家庭参加了基线和终点调查,干预点和对照点分别有 491 和 487 个家庭参加。干预措施实施后,干预点和对照点的腹泻发病率分别下降了 69.1%(95% CI:49.6-87.1%)和 58.6%(95% CI:26.6-82.4%)。饮用水处理和畜牧业做法与干预后的腹泻显著相关:结论:将饮水、环卫和讲卫生运动干预措施与其他腹泻控制策略相结合,并根据具体地点的需求加以调整,可有效预防腹泻。
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引用次数: 0
Actinomyces funkei bacteraemia and infected pulmonary cavities in an intravenous drug user: a case report. 一名静脉注射吸毒者的放线菌菌血症和肺腔感染:病例报告。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-08-26 DOI: 10.1186/s41182-024-00610-7
Tanaraj Perinpanathan, Katherine Beckett, Chris Smith

Background: Actinomyces spp. are most commonly found in human commensal flora; however, they have also been shown to cause suppurative infections. We present a case of a rare Actinomyces funkei bacteraemia from an infected deep vein thrombosis in a patient who went on to develop pulmonary cavities secondary to septic emboli. Infected thrombi and septic emboli have been associated with other Actinomyces spp. in the literature, often posing a diagnostic challenge and, in some cases, causing drastic clinical deterioration in patients. The literature regarding Actinomyces funkei is scarce and to our knowledge there are no reports of a relationship between this Actinomyces subspecies and infected thrombi or septic emboli.

Case presentation: The patient was a 39-year-old known intravenous drug user who presented with a groin injecting site sinus and systemic symptoms. The bacteria was first observed by gram staining of a blood culture sample after 48 h of incubation and the species was identified using matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) as Actinomyces funkei. Sputum cytology/histology with cell block revealed a branching gram-positive species suspicious of slow growing bacteria or fungus. CT imaging of his lower limb and chest revealed an extensive DVT with inflammatory changes and pulmonary cavities respectively. The patient was treated with Ceftriaxone before being discharged with a 6-month course of Linezolid. He made a good recovery with reduction in size of the cavitating lung lesions on follow-up imaging.

Conclusions: This case report presents a difficult-to-diagnose bacterial infection in an intravenous drug user, complicated by bacteraemia and secondary septic emboli. Relatively little is known about Actinomyces funkei, and therefore this report aims to increase clinician awareness of diagnosis, management, and complications.

背景:放线菌属最常见于人类共生菌群,但也被证明可引起化脓性感染。我们介绍了一例罕见的放线菌菌血症病例,患者因感染深静脉血栓而继发肺腔化脓性栓塞。在文献中,感染性血栓和化脓性栓子与其他放线菌属有关,往往给诊断带来困难,在某些情况下还会导致患者临床症状急剧恶化。有关放线菌的文献很少,据我们所知,还没有关于这种放线菌亚种与感染性血栓或化脓性栓子之间关系的报道:患者是一名 39 岁的已知静脉注射吸毒者,出现腹股沟注射部位窦道和全身症状。培养 48 小时后,通过对血液培养样本进行革兰氏染色首次观察到该细菌,并使用基质辅助激光解吸电离飞行时间(MALDI-TOF)鉴定出其为放线菌。痰细胞学/组织学检查和细胞阻断发现了一种革兰氏阳性分支菌,怀疑是生长缓慢的细菌或真菌。下肢和胸部的 CT 成像显示,深静脉血栓广泛存在,并分别伴有炎症变化和肺空洞。患者接受了头孢曲松治疗,出院前服用了为期 6 个月的利奈唑胺。患者恢复良好,随访造影显示肺部空洞病灶缩小:本病例报告了一名静脉注射吸毒者因细菌感染而导致的难以诊断的并发菌血症和继发性化脓性栓塞。人们对放线菌的了解相对较少,因此本报告旨在提高临床医生对诊断、处理和并发症的认识。
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引用次数: 0
Prevalence and associated factors of TB and HIV coinfections among adult inmates with presumptive pulmonary TB in a Kenyan prison. 肯尼亚一所监狱中患有肺结核推定病症的成年囚犯中结核病和艾滋病毒合并感染的流行率和相关因素。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-08-16 DOI: 10.1186/s41182-024-00623-2
Suleiman Athuman Mwatenga, Ali A Musa, Margaret W Muturi, Abednego Moki Musyoki

Background: Tuberculosis (TB) is more than ten times higher in prisons compared to the general population, and HIV-infected persons are at increased risk of developing active TB and death. In the World Health Organization (WHO) African region, however, where the TB and HIV coinfections are highest, and prisons rarely factored in national disease surveillance, epidemiological data to inform TB control interventions in correctional facilities is limited. In this study, we assessed the prevalence of TB and HIV coinfections, as well as the factors associated with coinfections in our study setting.

Methods: This was a prospective cross-sectional study among 157 adult (≥ 18 years) prisoners presenting with symptoms of pulmonary TB at Shimo La Tewa Prison, Kenya, between January and June 2023. The study excluded those with a history of anti-TB drugs use or on treatment follow-up and collected demographic and clinical characteristics data using a questionnaire. Sputum samples were collected and processed immediately using Xpert® MTB/RIF assay or stored at 4 °C for three (3) days in case of delay.

Results: The overall prevalence of TB among inmates with presumptive pulmonary TB was 10.2%, 95% CI 6.37-16.91% (16/157), HIV 19.1%, 95% CI 13.73-25.97% (30/157). All the TB cases were positive for HIV (16/16, 100%), translating to TB/HIV coinfection of 10.2%, 95% CI 6.37-16.91% (16/157), and there was no rifampicin resistance. TB and HIV coinfection cases were found among underweight (100%, 16/16) prisoners. The independent factors associated with TB and HIV coinfections were education level (adjusted OR = 0.17, p = 0.007), smoking history (adjusted OR = 3.01, p = 0.009) and illegal drug use history (adjusted OR = 4.55, p = 0.044).

Conclusion: We report a high prevalence of pulmonary TB and HIV coinfections among adult inmates with presumptive pulmonary TB in Kenya, with education level, smoking status, and illegal drug use as the independent factors associated with the coinfection. The authority should take measures to protect HIV-positive prisoners from TB, focusing on education, nutrition, smoking, and illegal drug use.

背景:监狱中结核病(TB)的发病率是普通人群的十倍以上,而艾滋病毒感染者罹患活动性结核病和死亡的风险更高。然而,在世界卫生组织(WHO)非洲地区,结核病和艾滋病病毒的合并感染率最高,而且监狱很少被纳入国家疾病监测范围,因此为惩教机构结核病控制干预提供信息的流行病学数据非常有限。在这项研究中,我们评估了结核病和艾滋病病毒双重感染的流行情况,以及在我们的研究环境中与双重感染相关的因素:这是一项前瞻性横断面研究,研究对象是 2023 年 1 月至 6 月期间在肯尼亚 Shimo La Tewa 监狱出现肺结核症状的 157 名成年(≥ 18 岁)囚犯。研究排除了有抗结核药物使用史或治疗随访史的囚犯,并通过问卷调查收集了人口统计学和临床特征数据。痰液样本收集后立即使用 Xpert® MTB/RIF 检测法进行处理,如需延迟处理,则在 4 °C 下保存三(3)天:结果:在推测患有肺结核的囚犯中,结核病的总发病率为 10.2%,95% CI 为 6.37-16.91%(16/157),艾滋病毒感染率为 19.1%,95% CI 为 13.73-25.97%(30/157)。所有肺结核病例的艾滋病毒检测结果均呈阳性(16/16,100%),因此肺结核/艾滋病毒合并感染率为 10.2%,95% CI 为 6.37-16.91%(16/157),且无利福平耐药性。体重不足的囚犯(16/16,100%)中发现了结核病和艾滋病毒合并感染病例。与肺结核和艾滋病病毒双重感染相关的独立因素是受教育程度(调整后 OR = 0.17,p = 0.007)、吸烟史(调整后 OR = 3.01,p = 0.009)和非法吸毒史(调整后 OR = 4.55,p = 0.044):我们报告了肯尼亚推定肺结核成年囚犯中肺结核和艾滋病毒合并感染的高流行率,教育水平、吸烟状况和非法使用毒品是与合并感染相关的独立因素。当局应采取措施保护艾滋病毒呈阳性的囚犯免受肺结核感染,重点关注教育、营养、吸烟和非法使用毒品等问题。
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引用次数: 0
Factors associated with the uptake of COVID-19 vaccination, testing and medical care among Myanmar migrants in Japan: a cross-sectional study. 在日本的缅甸移民中接受 COVID-19 疫苗接种、检测和医疗护理的相关因素:一项横断面研究。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-08-06 DOI: 10.1186/s41182-024-00621-4
Moe Moe Thandar, Azusa Iwamoto, Haru Angelique Hoshino, Kyoko Sudo, Mihoko Fujii, Miwa Kanda, Saki Ikeda, Masami Fujita

Background: Migrants are individuals who move to a different country from their usual place of residence. Japan's migrant population, particularly technical interns and students, has been growing. Even before the pandemic, previous studies have highlighted difficulties faced by migrants in utilizing healthcare services. This study examined the uptake of COVID-19 vaccination, testing, and medical care among Myanmar migrants in Japan; identified the factors associated with this uptake; and described the difficulties encountered when utilizing these services.

Methods: A cross-sectional study was conducted between March and April 2023 targeting Myanmar migrants over 18 years residing in Japan for more than 6 months. An online self-administered questionnaire in Myanmar language covered socioeconomic characteristics; history of COVID-19 vaccination, testing, and medical care; and difficulties encountered while utilizing these services with multiple-choice questions. Multivariate logistic regression analysis was performed separately to identify the factors associated with the uptake of COVID-19 vaccination, testing, and medical care.

Results: Among the 207 participants, 52% (n = 108) were under 30 years, 30% (n = 62) were male, and 31% (n = 65) were low-skilled workers (technical interns and students). Overall, 91% (n = 189) had received the COVID-19 vaccination, 76% (n = 157) had been tested for COVID-19, and 43% (n = 68) tested positive. However, only 77% (n = 52) of COVID-19 patients sought medical care. Participants under 30 years of age were less likely to receive the COVID-19 vaccine compared to those aged 30 and older (adjusted odds ratio [aOR] 0.10, 95% confidence interval [CI] 0.01-0.88, p = 0.038). Low-skilled workers were less likely to seek medical care compared to those holding other categories of residential status (aOR 0.12, 95% CI 0.02-0.79, p = 0.027). Among service users, 5% faced difficulties with COVID-19 vaccination, 10% with testing, and 17% with receiving medical care. Long waiting times and complex reservation processes were the main difficulties encountered.

Conclusions: The uptake of COVID-19 vaccination, testing, and medical care in this sample was reasonably good. However, individuals under 30 years of age showed lower uptake of vaccination, while low-skilled workers had lower uptake of medical care. Strengthening education and support for young migrants and low-skilled workers regarding COVID-19 and other infectious diseases is essential, especially in workplaces and educational institutions.

背景:移民是指从常住地迁移到不同国家的人。日本的移民人口,尤其是技术实习生和学生,一直在不断增长。即使在流感大流行之前,以往的研究也曾强调过移民在利用医疗保健服务方面所面临的困难。本研究调查了在日本的缅甸移民对 COVID-19 疫苗接种、检测和医疗服务的接受情况,确定了与接受情况相关的因素,并描述了在利用这些服务时遇到的困难:2023 年 3 月至 4 月期间进行了一项横断面研究,研究对象是在日本居住 6 个月以上、年满 18 岁的缅甸移民。在线缅语自填问卷涵盖了社会经济特征、COVID-19 疫苗接种史、检测史和医疗史,以及在利用这些服务时遇到的困难等多项选择题。我们分别进行了多变量逻辑回归分析,以确定与接受 COVID-19 疫苗接种、检测和医疗服务相关的因素:在 207 名参与者中,52%(108 人)在 30 岁以下,30%(62 人)为男性,31%(65 人)为低技能工人(技术实习生和学生)。总体而言,91%(n = 189)的人接种过 COVID-19 疫苗,76%(n = 157)的人接受过 COVID-19 检测,43%(n = 68)的人检测结果呈阳性。然而,只有77%(n = 52)的COVID-19患者就医。与 30 岁及以上的参与者相比,30 岁以下的参与者接种 COVID-19 疫苗的可能性较低(调整赔率比 [aOR] 0.10,95% 置信区间 [CI] 0.01-0.88,p = 0.038)。与其他居住身份类别的人相比,低技术工人就医的可能性较低(aOR 0.12,95% CI 0.02-0.79,p = 0.027)。在服务使用者中,5%的人在接种COVID-19疫苗时遇到困难,10%的人在检测时遇到困难,17%的人在接受医疗护理时遇到困难。等待时间长和预约程序复杂是遇到的主要困难:结论:在此次抽样调查中,COVID-19 疫苗接种、检测和医疗服务的覆盖率相当不错。然而,30 岁以下人群的疫苗接种率较低,而低技能工人的医疗护理率较低。加强对年轻移民和低技能工人有关 COVID-19 和其他传染病的教育和支持至关重要,尤其是在工作场所和教育机构。
{"title":"Factors associated with the uptake of COVID-19 vaccination, testing and medical care among Myanmar migrants in Japan: a cross-sectional study.","authors":"Moe Moe Thandar, Azusa Iwamoto, Haru Angelique Hoshino, Kyoko Sudo, Mihoko Fujii, Miwa Kanda, Saki Ikeda, Masami Fujita","doi":"10.1186/s41182-024-00621-4","DOIUrl":"10.1186/s41182-024-00621-4","url":null,"abstract":"<p><strong>Background: </strong>Migrants are individuals who move to a different country from their usual place of residence. Japan's migrant population, particularly technical interns and students, has been growing. Even before the pandemic, previous studies have highlighted difficulties faced by migrants in utilizing healthcare services. This study examined the uptake of COVID-19 vaccination, testing, and medical care among Myanmar migrants in Japan; identified the factors associated with this uptake; and described the difficulties encountered when utilizing these services.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between March and April 2023 targeting Myanmar migrants over 18 years residing in Japan for more than 6 months. An online self-administered questionnaire in Myanmar language covered socioeconomic characteristics; history of COVID-19 vaccination, testing, and medical care; and difficulties encountered while utilizing these services with multiple-choice questions. Multivariate logistic regression analysis was performed separately to identify the factors associated with the uptake of COVID-19 vaccination, testing, and medical care.</p><p><strong>Results: </strong>Among the 207 participants, 52% (n = 108) were under 30 years, 30% (n = 62) were male, and 31% (n = 65) were low-skilled workers (technical interns and students). Overall, 91% (n = 189) had received the COVID-19 vaccination, 76% (n = 157) had been tested for COVID-19, and 43% (n = 68) tested positive. However, only 77% (n = 52) of COVID-19 patients sought medical care. Participants under 30 years of age were less likely to receive the COVID-19 vaccine compared to those aged 30 and older (adjusted odds ratio [aOR] 0.10, 95% confidence interval [CI] 0.01-0.88, p = 0.038). Low-skilled workers were less likely to seek medical care compared to those holding other categories of residential status (aOR 0.12, 95% CI 0.02-0.79, p = 0.027). Among service users, 5% faced difficulties with COVID-19 vaccination, 10% with testing, and 17% with receiving medical care. Long waiting times and complex reservation processes were the main difficulties encountered.</p><p><strong>Conclusions: </strong>The uptake of COVID-19 vaccination, testing, and medical care in this sample was reasonably good. However, individuals under 30 years of age showed lower uptake of vaccination, while low-skilled workers had lower uptake of medical care. Strengthening education and support for young migrants and low-skilled workers regarding COVID-19 and other infectious diseases is essential, especially in workplaces and educational institutions.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"52 1","pages":"53"},"PeriodicalIF":3.6,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11302098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898346","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
Non-random distribution of Plasmodium Species infections and associated clinical features in children in the lake Victoria region, Kenya, 2012-2018. 2012-2018年肯尼亚维多利亚湖地区儿童疟原虫感染的非随机分布及相关临床特征。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-08-05 DOI: 10.1186/s41182-024-00622-3
Protus Omondi, Brian Musyoka, Takatsugu Okai, James Kongere, Wataru Kagaya, Chim W Chan, Mtakai Ngara, Bernard N Kanoi, Yasutoshi Kido, Jesse Gitaka, Akira Kaneko

Background: While Plasmodium falciparum (Pf) stands out as the most lethal malaria parasite species in humans, the impact of other species should not be dismissed. Moreover, there is a notable lack of understanding of mixed-species infections and their clinical implications.

Methods: We conducted eight school-based cross-sectional malariometric surveys in the Lake Victoria region of western Kenya between January-February 2012 and September-October 2018. In each survey, a minimum of 100 children aged 3 to 15 years were randomly chosen from a school in Ungoye village on the mainland and as well as from each school selected in every catchment area on Mfangano island. Plasmodium infection was determined by microscopy and nested polymerase chain reaction (PCR). The multiple-kind lottery (MKL) model calculated the expected distribution of Plasmodium infections in the population and compared it to observed values using a chi-squared test (χ2).

Results: The Plasmodium prevalence was 25.9% (2521/9724) by microscopy and 51.1% (4969/9724) by PCR. Among all infections detected by PCR, Pf, P. malariae (Pm), and P. ovale (Po) mono-infections were 58.6%, 3.1%, and 1.8%, respectively. Pf/Pm, Pf/Po, Pm/Po, and Pf/Pm/Po co-infections were 23.5%, 4.3%, 0.1%, and 8.6%, respectively. MKL modelling revealed non-random distributions, with frequencies of Pf/Pm and Pf/Pm/Po co-infections being significantly higher than expected (χ2 = 3385.60, p < 0.001). Pf co-infections with Pm and Po were associated with a decreased risk of fever (aOR 0.64, 95% CI 0.46-0.83; p = 0.01) and increased risks of splenomegaly (aOR 12.79, 95% CI 9.69-16.9; p < 0.001) and anaemia (aOR 2.57, 95% CI 2.09-3.15; p < 0.001), compared to single-species infections.

Conclusion: This study sheds light on the potential interaction between Pf and Pm and/or Po. Given the clinical significance of mixed-species infections, improved diagnostics, and case management of Pm and Po are urgently needed.

背景:虽然恶性疟原虫(Pf)是人类最致命的疟疾寄生虫,但也不应忽视其他种类寄生虫的影响。此外,人们对混合疟原虫感染及其临床影响明显缺乏了解:我们于 2012 年 1 月至 2 月和 2018 年 9 月至 10 月期间在肯尼亚西部维多利亚湖地区进行了八次基于学校的横断面疟疾测量调查。在每次调查中,我们从大陆 Ungoye 村的一所学校和 Mfangano 岛上每个集水区的每所学校中随机抽取了至少 100 名 3 至 15 岁的儿童。疟原虫感染情况通过显微镜和巢式聚合酶链反应(PCR)进行检测。多种类抽签(MKL)模型计算了人群中疟原虫感染的预期分布,并使用卡方检验(χ2)将其与观察值进行比较:显微镜检测的疟原虫感染率为 25.9%(2521/9724),PCR 检测的疟原虫感染率为 51.1%(4969/9724)。在 PCR 检测到的所有感染中,疟原虫、疟疾疟原虫(Pm)和卵形疟原虫(Po)单一感染分别占 58.6%、3.1% 和 1.8%。Pf/Pm、Pf/Po、Pm/Po 和 Pf/Pm/Po 合并感染的比例分别为 23.5%、4.3%、0.1% 和 8.6%。本研究揭示了 Pf 与 Pm 和/或 Po 之间潜在的相互作用。鉴于混合物种感染的临床意义,迫切需要改进 Pm 和 Po 的诊断和病例管理。
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引用次数: 0
Spatio-temporal occurrence and habitat characteristics of Aedes aegypti (Diptera: Culicidae) larvae in Southern Afar region, Ethiopia. 埃塞俄比亚南阿法尔地区埃及伊蚊(双翅目:幼虫科)幼虫的时空分布和栖息地特征。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-08-02 DOI: 10.1186/s41182-024-00612-5
Mohammed Seid, Esayas Aklilu, Abebe Animut

Background: Describing spatio-temporal occurrence and habitat characteristics of Aedes mosquito larvae is crucial for the control of Aedes borne viral diseases. This study assessed spatio-temporal abundance and habitat characteristics of Aedes larvae in the Southern Afar Region, Ethiopia.

Methods: Immature mosquitoes were surveyed in Awash Sebat, Awash Arba, and Werer towns of the Southern Afar Region once per month from May 2022 to April 2023. Larvae and pupae surveys were carried out along the available water-holding containers. The collected larvae/pupae were reared to adults and identified by  species/genus morphologically. The physical and chemical properties of the habitats were also characterized.

Results: A total of 9099 Aedes larvae/pupae were collected, of which 53.6% (4875) were from Awash Sebat, 29.5% (2687) from Awash Arba and 16.9% (1537) from Werer. Water-holding tyres harboured the highest number of Aedes larvae/pupae followed by water-storage drums. All the Aedes larvae/pupae reared to adults were morphologically identified as Aedes aegypti. The overall Container Index was 47.28%, House Index 18.19%, Breteau Index 59.94% and Pupal Index 171.94. Significant positive relations were observed in the occurrences of Ae. aegypti larvae/pupae with water-holding tyre (AOR = 15.89, CI = 3.55-71.09, p < 0.001), water storage drums (AOR = 19.84, CI = 4.64-84.89, p < 0.001), domestic habitat (AOR = 3.76, CI = 1.27-11.12, p = 0.017), and significant negative relations were observed with Ae. aegypti larvae/pupae occurrence and tap water source (AOR = 0.08, CI = 0.02-0.31, p = 0.001). Ae. aegypti larvae/pupae densities showed positive relations with dissolved oxygen (β = 0.523, p < 0.001) and total hardness (β = 0.475, p = 0.034) of water.

Conclusions: Diverse types of artificial water-holding containers were positive for Ae. aegypti larvae/pupae. Ae. aegypti larvae/pupae were abundant in used water-holding tyres, water storage drums, and cement tanks in Awash Sebat, Awash Arba, and Werer towns. This could  put the residents of the towns at high risk of infections with Ae. aegypti transmitted viral diseases such as chikungunya and dengue outbreaks. Thus, we recommend artificial water-holding container management as a strategy to control Ae. aegypti and hence the arboviral diseases transmission.

背景:描述伊蚊幼虫的时空分布和栖息地特征对于控制伊蚊传播的病毒性疾病至关重要。本研究评估了埃塞俄比亚南阿法尔地区伊蚊幼虫的时空丰度和栖息地特征:从 2022 年 5 月到 2023 年 4 月,在南阿法尔地区的 Awash Sebat、Awash Arba 和 Werer 镇每月调查一次未成熟蚊子。幼虫和蛹的调查沿着现有的盛水容器进行。收集到的幼虫/蛹被饲养成成虫,并按物种/属进行形态鉴定。此外,还对栖息地的物理和化学特性进行了鉴定:结果:共收集到 9099 头伊蚊幼虫/蛹,其中 53.6%(4875 头)来自阿瓦士塞巴特,29.5%(2687 头)来自阿瓦士阿尔巴,16.9%(1537 头)来自韦勒。蓄水轮胎中伊蚊幼虫/蛹的数量最多,其次是蓄水桶。所有饲养成虫的伊蚊幼虫/蛹经形态鉴定均为埃及伊蚊。总体容器指数为 47.28%,房舍指数为 18.19%,布雷图指数为 59.94%,蛹指数为 171.94。埃及伊蚊幼虫/蛹的出现与蓄水轮胎有显著的正相关关系(AOR = 15.89,CI = 3.55-71.09,p):不同类型的人工盛水容器对埃及蚁幼虫/蛹均呈阳性反应。在阿瓦什-塞巴特、阿瓦什-阿尔巴和韦勒镇,埃及蚁幼虫/蛹大量存在于旧的盛水轮胎、储水桶和水泥罐中。这可能会使这些城镇的居民面临感染埃及蚁传播的病毒性疾病(如基孔肯雅病和登革热爆发)的高风险。因此,我们建议将人工蓄水容器管理作为控制埃及蚁进而控制虫媒病毒疾病传播的一种策略。
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引用次数: 0
Dengue virus type 3 infection in a traveler returning from Costa Rica to Japan in 2023. 2023 年一名从哥斯达黎加返回日本的旅客感染 3 型登革热病毒。
IF 3.6 Q1 TROPICAL MEDICINE Pub Date : 2024-08-01 DOI: 10.1186/s41182-024-00620-5
Tadahiro Sasaki, Ryo Morita, Ikuko Aoyama, Takashi Baba, Tetsushi Goto, Ritsuko Kubota-Koketsu, Yoshihiro Samune, Emi E Nakayama, Tatsuo Shioda, Michinori Shirano

The number of dengue cases has increased dramatically in recent years. In Latin America, the number of cases and deaths in 2023 was the highest ever recorded. We report on a patient who had been infected with dengue virus during his stay in Costa Rica in September 2023, and developed the disease after returning to Japan. Plasma obtained from the patient was used for diagnosis and dengue virus serotyping by real-time PCR. The nucleotide sequence of the envelope region of dengue virus was then determined by the direct sequencing method, and this sequence was used for phylogenetic analyses. The patient was found to be infected with dengue virus type 3 genotype III. The sequence from the present case was more homologous with sequences registered in Florida, USA, associated with travel to Cuba in 2022 than with sequences registered in Costa Rica 10 years ago. The Pan American Health Organization reported that only dengue virus type 1 and 2 cases were reported in Costa Rica in 2019-2021, whereas dengue virus type 3 and 4 cases started being reported in 2022. In 2023, the reported numbers of cases with dengue virus types 3 and 4 exceeded those of dengue virus types 1 and 2. In addition, regional differences in endemic strains have been observed in Costa Rica. Our findings suggest that the dengue virus type 3 that infected the patient was more likely an influx of a strain that had been circulating in Caribbean countries such as Cuba in recent years, rather than a re-emergence of an indigenous virus in Costa Rica. The serotypes of dengue virus prevalent in Costa Rica have been changing since 2022. All four serotypes were prevalent in 2023, with a particularly sharp increase in the number of cases of dengue virus types 3 and 4. Future monitoring and surveillance are essential because changes in endemic serotypes can cause antibody-dependent enhancement, which can lead to severe dengue disease presentations.

近年来,登革热病例数量急剧增加。在拉丁美洲,2023 年的病例数和死亡人数均创下历史最高纪录。我们报告了一名于 2023 年 9 月在哥斯达黎加逗留期间感染登革热病毒,并在返回日本后发病的患者。从该患者身上获取的血浆用于诊断,并通过实时 PCR 对登革热病毒进行血清分型。然后通过直接测序法测定了登革热病毒包膜区的核苷酸序列,并将该序列用于系统发育分析。结果发现该患者感染了登革病毒 3 型基因 III 型。与 10 年前在哥斯达黎加登记的序列相比,该病例的序列与 2022 年在美国佛罗里达州登记的与古巴旅行有关的序列同源性更高。泛美卫生组织报告称,2019-2021 年哥斯达黎加只报告了 1 型和 2 型登革热病例,而 3 型和 4 型登革热病例从 2022 年开始报告。2023 年,报告的 3 型和 4 型登革热病毒病例数超过了 1 型和 2 型登革热病毒病例数。此外,在哥斯达黎加还观察到流行毒株的地区差异。我们的研究结果表明,感染该患者的 3 型登革热病毒更有可能是近年来在古巴等加勒比国家流行的病毒株的流入,而不是哥斯达黎加本土病毒的再次出现。自 2022 年以来,哥斯达黎加流行的登革热病毒血清型一直在变化。2023 年,所有四种血清型都很流行,登革热病毒 3 型和 4 型的病例数尤其急剧增加。未来的监测和监控至关重要,因为流行血清型的变化可能会导致抗体依赖性增强,从而导致登革热病的严重表现。
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引用次数: 0
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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Tropical Medicine and Health
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