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pH-dependent virucidal effects of weak acids against pathogenic viruses. 弱酸对致病病毒的杀毒作用取决于酸碱度。
IF 4.5 Q1 Medicine Pub Date : 2024-01-12 DOI: 10.1186/s41182-023-00573-1
Weiyin Hu, Hiroshi Shimoda, Yoshihiro Tsuchiya, Mikiya Kishi, Daisuke Hayasaka

Background: Weak acids, such as acetic acid, show virucidal effects against viruses, and disinfectants are considered effective virucidal agents possibly because of their low pH, depending on the proton concentration. This study aimed to evaluate the efficacy of different weak acids (acetic, oxalic, and citric acids) and eligible vinegars under different pH conditions by comparing their inactivation efficacies against enveloped and non-enveloped viruses.

Methods: Acetic, oxalic, and citric acids were adjusted to pH values of 2, 4 and 6, respectively. They were also diluted from 1 M to 0.001 M with distilled water. Enveloped influenza A virus (FulV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and non-enveloped feline calicivirus (FCV) were treated with adjusted weak acids for up to 30 min. These viruses were also reacted with white distilled vinegar (WDV) and grain-flavored distilled vinegar (GV) for up to 30 min. Infectious viral titers after the reactions were expressed as plaque-forming units per mL.

Results: Acetic acid showed virucidal effects against FulV at pH 4, whereas citric and oxalic acids did not. Acetic and citric acids inactivated SARS-CoV-2 at pH 2, whereas oxalic acid did not. All acids showed virucidal effects against FVC at pH 2; however, not at pH 4. The virucidal effects of the serially diluted weak acids were also reflected in the pH-dependent results. WDV and GV significantly reduced FulV titers after 1 min. SARS-CoV-2 was also susceptible to the virucidal effects of WDV and GV; however, the incubation period was extended to 30 min. In contrast, WDV and GV did not significantly inactivate FCV.

Conclusions: The inactivation efficacy of weak acids is different even under the same pH conditions, suggesting that the virucidal effect of weak acids is not simply determined by pH, but that additional factors may also influence these effects. Moreover, eligible vinegars, the main component of which is acetic acid, may be potential sanitizers for some enveloped viruses, such as FulV, in the domestic environment.

背景:弱酸(如醋酸)对病毒有杀灭作用,消毒剂之所以被认为是有效的杀病毒剂,可能是因为其 pH 值较低,取决于质子浓度。本研究旨在通过比较不同弱酸(乙酸、草酸和柠檬酸)和合格醋在不同 pH 值条件下对包膜和非包膜病毒的灭活效果,评估它们的功效:方法:将醋酸、草酸和柠檬酸的 pH 值分别调至 2、4 和 6。它们还用蒸馏水从 1 M 稀释到 0.001 M。有包膜的甲型流感病毒(FulV)、严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)和无包膜的猫嗜热病毒(FCV)用调节后的弱酸处理长达 30 分钟。这些病毒还与白蒸馏醋(WDV)和谷物味蒸馏醋(GV)反应长达 30 分钟。反应后的感染性病毒滴度以每毫升斑块形成单位表示:结果:在 pH 值为 4 时,醋酸对 FulV 有杀毒作用,而柠檬酸和草酸没有。在 pH 值为 2 时,乙酸和柠檬酸能灭活 SARS-CoV-2,而草酸不能。所有酸在 pH 值为 2 时都对 FVC 有杀毒作用,但在 pH 值为 4 时则没有。1 分钟后,WDV 和 GV 能明显降低 FulV 滴度。SARS-CoV-2 也易受 WDV 和 GV 的杀毒作用影响,但培养时间延长至 30 分钟。相比之下,WDV 和 GV 对 FCV 的灭活效果并不明显:结论:即使在相同的 pH 值条件下,弱酸的灭活效果也是不同的,这表明弱酸的杀病毒效果并不仅仅由 pH 值决定,其他因素也可能影响这些效果。此外,主要成分为醋酸的合格醋可能是家庭环境中某些包膜病毒(如 FulV)的潜在消毒剂。
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引用次数: 0
The impact of home-based management of malaria on clinical outcomes in sub-Saharan African populations: a systematic review and meta-analysis 家庭疟疾管理对撒哈拉以南非洲人口临床结果的影响:系统回顾和荟萃分析
IF 4.5 Q1 Medicine Pub Date : 2024-01-08 DOI: 10.1186/s41182-023-00572-2
Kok Pim Kua, Shaun Wen Huey Lee, Bunchai Chongmelaxme
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引用次数: 0
Enhancing child dietary diversity through cooking demonstration and nutritional education in rural Lao PDR 在老挝人民民主共和国农村地区通过烹饪示范和营养教育提高儿童饮食多样性
IF 4.5 Q1 Medicine Pub Date : 2024-01-08 DOI: 10.1186/s41182-023-00571-3
Yu Sato, Somboun Khamphithoun, Khamphanavanh Saiyachak, Hisao Ando, Takaaki Ishizuka, Shinjiro Saeki, Miki Miyoshi
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引用次数: 0
A scoping review on efficacy and safety of medicinal plants used for the treatment of diarrhea in sub-Saharan Africa. 对撒哈拉以南非洲地区用于治疗腹泻的药用植物的疗效和安全性进行范围审查。
IF 4.5 Q1 Medicine Pub Date : 2024-01-03 DOI: 10.1186/s41182-023-00569-x
Moitshepi T A Plaatjie, ThankGod E Onyiche, Tsepo Ramatla, Johannes J Bezuidenhout, Lesetja Legoabe, Nthatisi I Nyembe, Oriel Thekisoe

Background: In sub-Saharan Africa (SSA), significant morbidity and mortality have been linked to diarrhea, which is frequently caused by microorganisms. A rise in antimicrobial-resistant pathogens has reignited the search for alternative therapies. This scoping review aims to map the literature on medicinal plants in relation to their anti-diarrheal potential from SSA.

Methods: Studies published from 1990 until April 2022 on medicinal plants used for the treatment of diarrhea from each country in SSA were searched on Scopus, Web of Science, Science Direct and PubMed. The selection of articles was based on the availability of data on the in vitro and/or in vivo, ethnobotanical, and cross-sectional studies on the efficacy of medicinal plants against diarrhea. A total of 67 articles (ethnobotanical (n = 40); in vitro (n = 11), in vivo (n = 7), cross-sectional (n = 3), in vitro and in vivo (n = 2) and ethnobotanical and in vitro (n = 2), were considered for the descriptive analysis, which addressed study characteristics, herbal intervention information, phytochemistry, outcome measures, and toxicity findings.

Results: A total of 587 different plant species (from 123 families) used for diarrhea treatment were identified. Most studies were conducted on plants from the Fabaceae family. The plants with the strongest antimicrobial activity were Indigofera daleoides and Punica granatum. Chromatographic methods were used to isolate six pure compounds from ethyl acetate extract of Hydnora johannis, and spectroscopic methods were used to determine their structures. The majority of anti-diarrheal plants were from South Africa (23.9%), Ethiopia (16.4%), and Uganda (9%). This study highlights the value of traditional remedies in treating common human diseases such as diarrhea in SSA.

Conclusion: Baseline knowledge gaps were identified in various parts of SSA. It is therefore recommended that future ethnobotanical studies document the knowledge held by other countries in SSA that have so far received less attention. Additionally, we recommend that future studies conduct phytochemical investigations, particularly on the widely used medicinal plants for the treatment of diarrheal illnesses, which can serve as a foundation for future research into the development of contemporary drugs.

背景:在撒哈拉以南非洲地区(SSA),严重的发病率和死亡率与腹泻有关,而腹泻通常是由微生物引起的。抗生素耐药性病原体的增加再次激发了人们对替代疗法的探索。本范围综述旨在对撒哈拉以南非洲地区有关药用植物止泻潜力的文献进行梳理:方法:在 Scopus、Web of Science、Science Direct 和 PubMed 上检索了 1990 年至 2022 年 4 月期间发表的有关撒南非洲各国用于治疗腹泻的药用植物的研究。选择文章的依据是是否有关于药用植物对腹泻疗效的体外和/或体内、人种植物学和横断面研究的数据。共有 67 篇文章(民族植物学(n = 40);体外(n = 11)、体内(n = 7)、横断面(n = 3)、体外和体内(n = 2)以及民族植物学和体外(n = 2))被考虑用于描述性分析,其中涉及研究特征、草药干预信息、植物化学、结果测量和毒性结果:结果:共发现了 587 种用于治疗腹泻的不同植物(来自 123 个科)。大多数研究都是针对豆科植物进行的。抗菌活性最强的植物是茵陈和石榴。使用色谱法从 Hydnora johannis 的乙酸乙酯提取物中分离出六种纯化合物,并使用光谱法确定其结构。大多数止泻植物来自南非(23.9%)、埃塞俄比亚(16.4%)和乌干达(9%)。这项研究强调了传统疗法在治疗撒哈拉以南非洲地区人类常见疾病(如腹泻)方面的价值:结论:研究发现了撒南非洲各地的基线知识差距。因此,建议今后的民族植物学研究记录迄今为止关注较少的撒南非洲其他国家所拥有的知识。此外,我们还建议今后的研究开展植物化学调查,特别是对广泛用于治疗腹泻疾病的药用植物进行调查,这可作为今后研究开发现代药物的基础。
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引用次数: 0
Factors associated with undiagnosed hypertension among Tongan adults: a cross-sectional study. 汤加成年人未确诊高血压的相关因素:一项横断面研究。
IF 4.5 Q1 Medicine Pub Date : 2024-01-02 DOI: 10.1186/s41182-023-00570-4
Seini Siahi Talanoafoou Fifita, Daisuke Nonaka, Mele Tilema Cama, Mele Inu Filise

Background: Hypertension is responsible for many premature deaths worldwide. However, many individuals with hypertension remain undiagnosed. Tonga is one of the countries that has had a steep increase in hypertension, thus undiagnosed hypertension could also be increasing. Purpose of this study was to assess the prevalence and factors associated with undiagnosed hypertension among Tongan adults.

Methods: This cross-sectional study used data collected from conveniently sampled 473 participants using electronic questionnaire and digital sphygmomanometer through household visits between February and March 2023. Inclusion criteria were age of 18-65 years, residence in the villages for at least six months, and not being pregnant. Fisher's exact test and mixed-effect logistic regression were performed using the EZR software to assess the association between undiagnosed hypertension and predictor variables.

Results: The prevalence of undiagnosed hypertension was 22.4% (106/473). Five variables that were significantly associated with undiagnosed hypertension in Fisher's exact test were included in the multivariate logistic regression. Overall, only three variables remained significant. First, participants who never had their blood pressure measured had higher prevalence compared to those who had it checked recently (33.3% vs. 19.1%); odds ratio: 2.24). Secondly, participants who were not aware of the risk of developing hypertension were significantly more likely to have undiagnosed hypertension compared to those who were aware (27.9% vs. 16.7%; odds ratio: 1.81). Lastly, middle-aged participants (30-49 years) and older (50-65 years), were significantly more likely to have undiagnosed hypertension compared to those who were 18-29 years old (30.0% and 23.7% vs. 11.8%; odds ratio: 3.58 and 3.38 vs. 1.00).

Conclusion: The prevalence of undiagnosed hypertension could be substantial among Tongan adults, implicating a need to address this issue by doing further research and review current public health work to address hypertension in Tonga. Undiagnosed hypertension was associated with having no experience of blood pressure measurement, lack of awareness about hypertension, and age. Tongan government should provide people with more opportunities to have their blood pressure measured and to improve their awareness.

背景:高血压是导致全球许多人过早死亡的原因。然而,许多高血压患者仍未得到诊断。汤加是高血压发病率急剧上升的国家之一,因此未确诊的高血压患者也可能在增加。本研究旨在评估汤加成年人中未确诊高血压的患病率和相关因素:这项横断面研究使用电子问卷和数字血压计,在 2023 年 2 月至 3 月期间通过家访从方便抽样的 473 名参与者中收集数据。纳入标准为年龄在 18-65 岁之间、在村庄居住至少 6 个月且未怀孕。使用 EZR 软件进行了费雪精确检验和混合效应逻辑回归,以评估未确诊高血压与预测变量之间的关联:未确诊高血压的患病率为 22.4%(106/473)。在费雪精确检验中与未确诊高血压明显相关的五个变量被纳入了多变量逻辑回归。总体而言,只有三个变量仍然具有重要意义。首先,从未测量过血压的参与者比最近测量过血压的参与者患病率更高(33.3% 对 19.1%);几率比:2.24)。其次,与了解高血压风险的参与者相比,不了解高血压风险的参与者未确诊高血压的几率明显更高(27.9% 对 16.7%;几率比:1.81)。最后,与 18-29 岁的参与者相比,中年参与者(30-49 岁)和老年参与者(50-65 岁)未确诊高血压的几率明显更高(30.0% 和 23.7% 对 11.8%;几率比:3.58 和 3.38 对 1.00):汤加成年人中未确诊的高血压患病率可能很高,这意味着需要通过进一步研究和审查当前的公共卫生工作来解决这一问题,以应对汤加的高血压问题。未确诊的高血压与没有测量血压的经验、缺乏对高血压的认识和年龄有关。汤加政府应为人们提供更多测量血压的机会,并提高他们的认识。
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引用次数: 0
Applicability of artificial intelligence-based computer-aided detection (AI-CAD) for pulmonary tuberculosis to community-based active case finding. 基于人工智能的肺结核计算机辅助检测(AI-CAD)在社区主动病例发现中的适用性。
IF 4.5 Q1 Medicine Pub Date : 2024-01-02 DOI: 10.1186/s41182-023-00560-6
Kosuke Okada, Norio Yamada, Kiyoko Takayanagi, Yuta Hiasa, Yoshiro Kitamura, Yutaka Hoshino, Susumu Hirao, Takashi Yoshiyama, Ikushi Onozaki, Seiya Kato

Background: Artificial intelligence-based computer-aided detection (AI-CAD) for tuberculosis (TB) has become commercially available and several studies have been conducted to evaluate the performance of AI-CAD for pulmonary tuberculosis (TB) in clinical settings. However, little is known about its applicability to community-based active case-finding (ACF) for TB.

Methods: We analysed an anonymized data set obtained from a community-based ACF in Cambodia, targeting persons aged 55 years or over, persons with any TB symptoms, such as chronic cough, and persons at risk of TB, including household contacts. All of the participants in the ACF were screened by chest radiography (CXR) by Cambodian doctors, followed by Xpert test when they were eligible for sputum examination. Interpretation by an experienced chest physician and abnormality scoring by a newly developed AI-CAD were retrospectively conducted for the CXR images. With a reference of Xpert-positive TB or human interpretations, receiver operating characteristic (ROC) curves were drawn to evaluate the AI-CAD performance by area under the ROC curve (AUROC). In addition, its applicability to community-based ACFs in Cambodia was examined.

Results: TB scores of the AI-CAD were significantly associated with the CXR classifications as indicated by the severity of TB disease, and its AUROC as the bacteriological reference was 0.86 (95% confidence interval 0.83-0.89). Using a threshold for triage purposes, the human reading and bacteriological examination needed fell to 21% and 15%, respectively, detecting 95% of Xpert-positive TB in ACF. For screening purposes, we could detect 98% of Xpert-positive TB cases.

Conclusions: AI-CAD is applicable to community-based ACF in high TB burden settings, where experienced human readers for CXR images are scarce. The use of AI-CAD in developing countries has the potential to expand CXR screening in community-based ACFs, with a substantial decrease in the workload on human readers and laboratory labour. Further studies are needed to generalize the results to other countries by increasing the sample size and comparing the AI-CAD performance with that of more human readers.

背景:基于人工智能的肺结核计算机辅助检测(AI-CAD)已经投入商业使用,并且已经开展了几项研究来评估 AI-CAD 在临床环境中治疗肺结核的效果。然而,人们对其在基于社区的结核病主动病例查找(ACF)中的适用性知之甚少:我们分析了从柬埔寨一个社区 ACF 中获得的匿名数据集,该 ACF 的目标人群是 55 岁或以上的老人、有任何结核病症状(如慢性咳嗽)的人以及结核病高危人群,包括家庭接触者。所有参加 ACF 的人都由柬埔寨医生进行了胸部 X 光检查(CXR),并在符合痰液检查条件时进行了 Xpert 检测。由经验丰富的胸科医生对 CXR 图像进行解读,并使用新开发的 AI-CAD 对异常情况进行评分。以 Xpert 阳性肺结核或人工判读为参考,绘制接收器操作特征曲线(ROC),通过 ROC 曲线下面积(AUROC)评估 AI-CAD 的性能。此外,还考察了其在柬埔寨社区 ACF 中的适用性:结果:AI-CAD 的结核病评分与根据结核病严重程度进行的 CXR 分级有明显相关性,其作为细菌学参考的 AUROC 为 0.86(95% 置信区间为 0.83-0.89)。以分流为阈值,所需的人工读片和细菌学检查分别降至 21% 和 15%,可检测出 95% 的 ACF Xpert 阳性肺结核。就筛查而言,我们可以发现 98% 的 Xpert 阳性肺结核病例:结论:AI-CAD 适用于结核病高负担地区的社区 ACF,因为这些地区缺乏有经验的 CXR 图像阅读者。在发展中国家使用 AI-CAD 有可能扩大社区 ACF 的 CXR 筛查范围,同时大幅减少人工读片员和实验室劳动力的工作量。还需要进一步研究,通过增加样本量和比较人工智能-计算机断层扫描与更多人工读片机的性能,将结果推广到其他国家。
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引用次数: 0
Leadership of school principals for school health implementation among primary schools in Mataram, Indonesia: a qualitative study. 印度尼西亚马塔兰小学校长对学校卫生实施工作的领导力:一项定性研究。
IF 4.5 Q1 Medicine Pub Date : 2024-01-02 DOI: 10.1186/s41182-023-00568-y
Hirono Sasaki, Dian Puspita Sari, Cut Warnaini, Fahrin Ramadan Andiwijaya, Rie Takeuchi, Hamsu Kadriyan, Fumiko Shibuya, Jun Kobayashi

Background: Health-promoting schools (HPS) are acknowledged as a comprehensive approach to improving children's health and educational outcomes through learning and school life. Principals are key players in HPS implementation. However, concrete leadership practices in HPS in low- to middle-income countries have not been clarified. Therefore, this study aimed to explore and generate themes surrounding the leadership practices of principals in implementation of school health in Indonesia, a predominantly Muslim country consisting of diverse religions that have expanded HPS at the national level.

Methods: In-depth interviews and focus group discussions (FGDs) were conducted with the principals, teachers, parent representatives, and school board committee members in 10 target schools. FGDs were conducted with school health supervisory board members in Mataram City. All interviews were recorded and transcribed. Thematic analysis was undertaken to generate themes.

Results: The principals demonstrated leadership practices based on their religious beliefs, values, and morals. This may suggest that beliefs and morals support an understanding of their responsibility to ensure the well-being of all school community members, regardless of religion, in a diverse environment that is predominantly Muslim but also multicultural and multi-religious. Further, these beliefs and morals might reinforce implementation of school health. Importantly, the principals' coordination skills in cooperating with multiple sectors might contribute to successful implementation of school health. Also, principals emphasized they were tasked to develop capacity for implementation of school health. Thus, principals should understand leadership in the implementation of school health as their duty from the training stage to encourage health at the school level.

Conclusion: In this study, "have professional educators' beliefs and religious beliefs and Indonesia's morals" was generated as a new theme, whereas several common themes were found as in previous studies. The results of this study suggested the importance of leadership by principals in the implementation of school health. Strengthening the capacity of school principals by integrating the contents of school health leadership practice into pre- and in-service training through the development of a policy on principals' duties in school health might contribute to the successful implementation of school health.

背景:促进健康学校(HPS)被认为是一种通过学习和学校生活改善儿童健康和教育成果的综合方法。校长是实施健康促进学校计划的关键人物。然而,在中低收入国家,健康促进学校的具体领导实践尚未明确。因此,本研究旨在探讨印度尼西亚校长在实施学校保健方面的领导实践,并提出相关主题,印度尼西亚是一个以穆斯林为主的国家,由多种宗教组成,已在全国范围内推广保健计划:对 10 所目标学校的校长、教师、家长代表和学校董事会成员进行了深入访谈和焦点小组讨论(FGD)。还与马打兰市的学校卫生监督委员会成员进行了小组讨论。所有访谈都进行了录音和誊写。对访谈内容进行了主题分析,以确定访谈主题:结果:校长们根据自己的宗教信仰、价值观和道德观进行领导实践。这可能表明,在一个以穆斯林为主,同时也是多元文化和多宗教的多样化环境中,信仰和道德有助于他们理解自己的责任,即确保所有学校社区成员的福祉,无论其宗教信仰如何。此外,这些信念和道德观念可能会加强学校卫生工作的实施。重要的是,校长们与多部门合作的协调能力可能有助于成功实施学校卫生工作。校长们还强调,他们的任务是发展实施学校卫生的能力。因此,校长应从培训阶段就将领导学校卫生工作的实施视为己任,以鼓励学校层面的卫生工作:在本研究中,"拥有专业教育工作者的信仰和宗教信仰以及印度尼西亚的道德观 "是一个新的主题,而在以往的研究中也发现了几个共同的主题。本研究的结果表明,校长的领导力在实施学校卫生工作中非常重要。通过制定有关校长在学校卫生方面职责的政策,将学校卫生领导实践的内容纳入职前和在职培训,从而加强校长的能力,这可能有助于学校卫生的成功实施。
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引用次数: 0
Epidemiology of soil-transmitted helminth infections and the differential effect of treatment on the distribution of helminth species in rural areas of Gabon. 加蓬农村地区土壤传播蠕虫感染的流行病学以及治疗对蠕虫种类分布的不同影响。
IF 4.5 Q1 Medicine Pub Date : 2024-01-02 DOI: 10.1186/s41182-023-00567-z
Jean Ronald Edoa, Bayodé Roméo Adégbitè, Yabo Josiane Honkpéhèdji, Jeannot Fréjus Zinsou, Stravensky Térence Boussougou-Sambe, Tamirat Gebru Woldearegai, Benjamin Mordmüller, Ayola Akim Adegnika, Jean Claude Dejon-Agobé

Background: Soil-transmitted helminth (STH) infections are a public health concern in endemic areas. For efficient control, the epidemiology of the disease needs to be monitored. This report assesses the prevalence, incidence, post-treatment infection (PTI) rate, and risk factors for STH infections in two rural areas of Gabon.

Method: In this longitudinal and prospective study, participants aged six to 30 years from the vicinity of Lambaréné and selected households using a simple randomization process were included and followed in two consecutive periods of six and nine months. Stool samples were obtained at the beginning and the end of each follow-up phase (FUP). The Kato-Katz technique was used for the detection of STH eggs, while the Harada-Mori technique and coproculture were used for the detection of larvae in stool processed within a maximum of four hours of collection. Prevalence was determined at the three main time points of the study, incidence was assessed during the two study phases, and PTI was defined as an infection detected nine months post-treatment.

Results: A total of 262 participants were included. The overall prevalence of STH infections was 42% (95%CI: 34-50) and 44% (95%CI: 37-51) at baseline for the six and nine month FUPs, respectively. Trichuris trichiura was the most prevalent species at each time point of assessment. The cumulative incidence of STH at the 6- and 9-month follow-ups was 18% (95%CI: 12-27) and 35% (95%CI: 27-43), respectively, while the incidence rates were 41 (95%CI: 28-55) and 56 (95%CI: 46-67) per 100 person-years, respectively. The PTI rates at the 9-month follow-up for T. trichiura, hookworm, and Ascaris lumbricoides were 58% (95%CI: 41-74), 31% (95%CI: 11-59) and 18% (95%CI: 5-40), respectively. The STH infection intensity was generally light.

Conclusion: The prevalence level of STH infection is moderate in the vicinity of Lambaréné, with T. trichiura being the most prevalent species. Our results reveal a rapid spread of the disease in the population mainly following intervention, particularly for trichuriasis, and therefore call for the full implementation of the World Health Organization's recommendations in the area. Trial registration clinicaltrials.gov Identifier NCT02769013. Registered 21 April 2016, https://clinicaltrials.gov/study/NCT02769013.

背景:土壤传播蠕虫(STH)感染是流行地区的公共卫生问题。为有效控制该疾病,需要对其流行病学进行监测。本报告评估了加蓬两个农村地区的流行率、发病率、治疗后感染率(PTI)以及感染性传播疾病的风险因素:在这项纵向和前瞻性研究中,研究人员从兰巴雷内附近地区和通过简单随机程序选出的家庭中抽取了 6 至 30 岁的参与者,并对其进行了为期 6 个月和 9 个月的连续跟踪调查。在每个随访阶段(FUP)开始和结束时采集粪便样本。采用 Kato-Katz 技术检测 STH 虫卵,采用 Harada-Mori 技术和共培养技术检测收集后最多 4 小时内处理的粪便中的幼虫。流行率在研究的三个主要时间点确定,发病率在两个研究阶段评估,PTI 被定义为治疗后 9 个月发现的感染:结果:共纳入 262 名参与者。在为期 6 个月和 9 个月的家庭综合方案中,感染性传播疾病的总发病率基线分别为 42%(95%CI:34-50)和 44%(95%CI:37-51)。在每个评估时间点,毛滴虫都是最常见的感染物种。在 6 个月和 9 个月的随访中,STH 的累计发病率分别为 18%(95%CI:12-27)和 35%(95%CI:27-43),而发病率分别为每 100 人年 41 例(95%CI:28-55)和 56 例(95%CI:46-67)。随访 9 个月时,毛滴虫、钩虫和蛔虫的 PTI 感染率分别为 58% (95%CI: 41-74)、31% (95%CI: 11-59) 和 18% (95%CI: 5-40)。性传播疾病的感染强度普遍较轻:结论:兰巴雷内附近地区的性传播疾病感染率处于中等水平,其中最常见的是毛滴虫。我们的研究结果表明,主要在采取干预措施(尤其是针对毛滴虫病的干预措施)后,该疾病在人群中迅速蔓延,因此需要在该地区全面实施世界卫生组织的建议。试验注册 clinicaltrials.gov Identifier NCT02769013。2016年4月21日注册,https://clinicaltrials.gov/study/NCT02769013。
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引用次数: 0
Women in low- and middle-income countries receive antenatal care at health institutions, yet not delivered there: a multilevel analysis of 2016-2021 DHS data. 中低收入国家的妇女在医疗机构接受产前护理,但未在医疗机构分娩:对 2016-2021 年人口与健康调查数据的多层次分析。
IF 4.5 Q1 Medicine Pub Date : 2024-01-02 DOI: 10.1186/s41182-023-00561-5
Mehari Woldemariam Merid, Dagmawi Chilot, Zeamanuel Anteneh Yigzaw, Alemakef Wagnew Melesse, Menberesibhat Getie Ferede, Fantu Mamo Aragaw, Desalegn Anmut Bitew

Background: The institutional delivery dropout (IDD) is a major problem that disproportionately affects low- and middle-income countries (LMICs). It is associated with increased risks of adverse birth outcomes among pregnant women. Hence, this study assessed the pooled estimate and determinants of IDD after antenatal care (ANC) visit among women in LMICs.

Method: The Demographic and Health Survey (DHS) data from 29 LMICs were used for this study. Data analysis was performed with STATA version 14. The forest plot was used to estimate the pooled prevalence of IDD. Multilevel binary logistic regression was fitted to identify determinants of IDD. The statistical significance level between the outcome and independent variables was determined through the adjusted odds ratio (AOR) with 95% CI and p-value less than 0.05.

Result: The pooled prevalence of IDD after ANC booking among reproductive age women in LMICs was 22.25% (95%CI: 18.25, 26.25). Additionally, the prevalence of IDD was highest (29.83%) among women from the South and Central Europe and the Caribbean countries and lowest (13.72%) in Central/Western Asia and the Oceania. In the multilevel analysis; no education (AOR = 2.92; 95% CI: 2.72, 3.13), poorest wealth index (AOR = 3.46; 95% CI: 3.28, 3.66), inadequate ANC visits (AOR = 1.73; 95% CI: 1.39, 1.77), no media exposure (AOR = 1.27; 95% CI: 1.23, 1.30), rural (AOR = 1.50; 95% CI: 1.43, 1.54), distance a big problem (AOR = 1.28; 95% CI: 1.25, 1.31), and women located in the South/Eastern Europe and Caribbean region 6.67 (AOR = 6.67; 95% CI: 6.20, 7.20), women lived in low-income countries 7.05 (AOR = 7.05; 95% CI: 6.57, 7.56), and women from lower middle-income countries 5.34 (AOR = 5.57; 95% CI: 4.93, 5.78), had increased odds of IDD after ANC among women in LMICs. However, women who had ever born one child (AOR = 0.29; 95% CI: 0.28, 0.31), and women from Central and Western Asia and the Oceania (AOR = 0.78; 95%CI: 0.74, 0.82) had decreased odds of IDD.

Conclusion: The IDD was high among women in LMICs and significantly increased among women with no education, from poorest household, had inadequate ANC visit, no media exposure, rural, distance a big problem. Hence, interventions to reduce IDD should focus on addressing the gaps related to maternal education, access to media, and number of ANC visits among women in LMICs.

背景:住院分娩辍学(IDD)是一个严重影响中低收入国家(LMICs)的主要问题。它与孕妇不良分娩结局风险的增加有关。因此,本研究评估了低收入和中等收入国家妇女产前检查(ANC)后IDD的综合估计值和决定因素:本研究采用了 29 个低收入和中等收入国家的人口与健康调查(DHS)数据。数据分析采用 STATA 14 版本。森林图用于估算IDD的总体患病率。多层次二元逻辑回归用于确定 IDD 的决定因素。结果与自变量之间的统计学显著性水平是通过调整后的几率比(AOR)(95% CI)和小于 0.05 的 p 值来确定的:在低收入和中等收入国家,育龄妇女在产前检查预约后的 IDD 患病率为 22.25%(95%CI:18.25, 26.25)。此外,南欧、中欧和加勒比海国家妇女的 IDD 患病率最高(29.83%),中亚/西亚和大洋洲妇女的 IDD 患病率最低(13.72%)。在多层次分析中,未受过教育(AOR = 2.92;95% CI:2.72, 3.13)、最贫穷指数(AOR = 3.46;95% CI:3.28, 3.66)、产前检查次数不足(AOR = 1.73;95% CI:1.39,1.77)、无媒体接触(AOR = 1.27;95% CI:1.23,1.30)、农村(AOR = 1.50;95% CI:1.43,1.54)、距离是个大问题(AOR = 1.28;95% CI:1.在低收入和中等收入国家的妇女中,农村妇女(AOR = 1.50;95% CI:1.43,1.54)、距离是个大问题(AOR = 1.28;95% CI:1.25,1.31)、南欧/东欧和加勒比海地区妇女 6.67(AOR = 6.67;95% CI:6.20,7.20)、低收入国家妇女 7.05(AOR = 7.05;95% CI:6.57,7.56)、中低收入国家妇女 5.34(AOR = 5.57;95% CI:4.93,5.78)在产前检查后患 IDD 的几率增加。然而,曾经生育过一个孩子的妇女(AOR = 0.29;95% CI:0.28,0.31)以及来自中亚、西亚和大洋洲的妇女(AOR = 0.78;95%CI:0.74,0.82)患 IDD 的几率有所下降:结论:在低收入和中等收入国家的妇女中,IDD 的发生率很高,在未受过教育、来自最贫困家庭、产前检查次数不足、未接触过媒体、农村、距离是个大问题的妇女中,IDD 的发生率明显增加。因此,减少IDD的干预措施应重点解决低收入和中等收入国家妇女在孕产妇教育、接触媒体和产前检查次数方面的差距。
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引用次数: 0
Efficacy and safety of praziquantel treatment against Schistosoma mansoni infection among pre-school age children in southern Ethiopia. 吡喹酮治疗埃塞俄比亚南部学龄前儿童曼氏血吸虫感染的有效性和安全性。
IF 4.5 Q1 Medicine Pub Date : 2023-12-20 DOI: 10.1186/s41182-023-00562-4
Tafese Tadele, Ayalew Astatkie, Birkneh Tilahun Tadesse, Eyasu Makonnen, Eleni Aklillu, Solomon Mequanente Abay

Background: Preventive chemotherapy with a single dose of praziquantel given to an all-at-risk population through mass drug administration is the cornerstone intervention to control and eliminate schistosomiasis as a public health problem. This intervention mainly targets school age children, and pre-school age children (pre-SAC) are excluded from receiving preventive chemotherapy, partly due to scarcity of data on praziquantel treatment outcomes.

Methods: We conducted active efficacy and safety surveillance of praziquantel treatment among 240 Schistosoma mansoni-infected pre-SAC who received a single dose of praziquantel (40 mg/kg) in southern Ethiopia. The study outcomes were egg reduction rates (ERR) and cure rates (CRs) four weeks after treatment using the Kato-Katz technique and treatment-associated adverse events (AEs) that occurred within 8 days post-treatment.

Results: The overall ERR was 93.3% (WHO reference threshold ≥ 90%), while the CR was 85.2% (95% CI = 80.0-89.5%). Baseline S. mansoni infection intensity was significantly associated with CRs, 100% among light infected than moderate (83.4%) or heavy (29.4%) infected children. An increase of 100 in baseline S. mansoni egg count per gram of stool resulted in a 26% (95% CI: 17%, 34%) reduction in the odds of cure. The incidence of experiencing at least one type of AE was 23.1% (95% CI: 18.0%, 29.0%). Stomachache, diarrhea, and nausea were the most common AEs. AEs were mild-to-moderate grade and transient. Pre-treatment moderate (ARR = 3.2, 95% CI: 1.69, 6.14) or heavy infection intensity (ARR = 6.5, 95% CI: 3.62, 11.52) was a significant predictor of AEs (p < 0.001). Sex, age, or soil-transmitted helminth coinfections were not significant predictors of CR or AEs.

Conclusions: Single-dose praziquantel is tolerable and effective against S. mansoni infection among pre-SAC, and associated AEs are mostly mild-to-moderate and transient. However, the reduced CR in heavily infected and AEs in one-fourth of S. mansoni-infected pre-SAC underscores the need for safety and efficacy monitoring, especially in moderate-to-high infection settings. Integrating pre-SACs in the national deworming programs is recommended to accelerate the elimination of schistosomiasis as a public health problem.

背景:通过大规模给药,对所有高危人群进行单剂量吡喹酮预防性化疗,是控制和消除血吸虫病这一公共卫生问题的基础性干预措施。这种干预措施主要针对学龄儿童,学龄前儿童(pre-SAC)被排除在预防性化疗之外,部分原因是缺乏吡喹酮治疗结果的数据:我们在埃塞俄比亚南部对240名感染曼氏血吸虫的学龄前儿童进行了吡喹酮治疗的有效性和安全性监测,这些儿童接受了单剂量吡喹酮治疗(40 mg/kg)。研究结果为使用Kato-Katz技术进行治疗四周后的减蛋率(ERR)和治愈率(CRs),以及治疗后8天内发生的与治疗相关的不良事件(AEs):总ERR为93.3%(世界卫生组织参考阈值≥90%),CR为85.2%(95% CI = 80.0-89.5%)。曼氏沙门氏菌基线感染强度与CR显著相关,轻度感染儿童的CR为100%,而中度(83.4%)或重度(29.4%)感染儿童的CR为100%。每克粪便中的曼氏沙门氏菌卵数基线每增加 100 个,治愈几率就会降低 26% (95% CI: 17%, 34%)。至少一种 AE 的发生率为 23.1%(95% CI:18.0%,29.0%)。胃痛、腹泻和恶心是最常见的不良反应。这些不良反应均为轻度至中度,且为一过性。治疗前的中度感染强度(ARR = 3.2,95% CI:1.69, 6.14)或重度感染强度(ARR = 6.5,95% CI:3.62, 11.52)是AEs的重要预测因素(P 结论:单剂量吡喹酮可显著减少AEs的发生:单剂量吡喹酮对SAC前期的曼森氏杆菌感染具有耐受性和有效性,相关的AEs大多为轻度至中度,且为一过性。然而,重度感染者的 CR 值降低以及四分之一感染曼森氏杆菌的前沙士患者出现的 AEs,都强调了对安全性和有效性进行监测的必要性,尤其是在中度至高度感染的情况下。建议将前SAC纳入国家驱虫计划,以加速消除血吸虫病这一公共卫生问题。
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