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.
{"title":"Efficacy and safety of praziquantel treatment against Schistosoma mansoni infection among pre-school age children in southern Ethiopia.","authors":"Tafese Tadele, Ayalew Astatkie, Birkneh Tilahun Tadesse, Eyasu Makonnen, Eleni Aklillu, Solomon Mequanente Abay","doi":"10.1186/s41182-023-00562-4","DOIUrl":"10.1186/s41182-023-00562-4","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"51 1","pages":"72"},"PeriodicalIF":4.5,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10731898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138831749","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}
Pub Date : 2023-12-19DOI: 10.1186/s41182-023-00563-3
Hiroki Hashizume, Suguru Taga, Masayuki K Sakata, Mahmoud Hussein, Emmanuel Edwar Siddig, Toshifumi Minamoto, Ahmed Hassan Fahal, Satoshi Kaneko
Background: Mycetoma is a chronic disease affecting the skin and subcutaneous tissue endemic in the tropical and subtropical regions. Several bacteria and fungi can cause mycetoma, but fungal mycetoma (eumycetoma) is challenging because the treatment requires a combination of a long-term antifungal agent and surgery. Although the transmission route has not yet been elucidated, infection from the soil is a leading hypothesis. However, there are few soil investigation studies, and the geographical distribution of mycetoma pathogens is not well documented. Here, we used multiplex real-time PCR technology to identify three fungal species from soil samples.
Methods: In total, 64 DNA samples were extracted from soil collected in seven villages in an endemic area in Sennar State, Sudan, in 2019. Primers and fluorescent probes specifically targeting the ribosomal DNA of Madurella mycetomatis, Falciformispora senegalensis, and F. tompkinsii were designed.
Results: Multiplex real-time PCR was performed and identified the major pathogen, M. mycetomatis that existed in most sites (95%). In addition, two other pathogens were identified from some sites. This is the first report on the use of this technique for identifying the eumycetoma causative microorganisms.
Conclusions: This study demonstrated that soil DNA investigation can elucidate the risk area of mycetoma-causative agents. The results will contribute to the design of prevention measures, and further large-scale studies may be effective in understanding the natural habitats of mycetoma pathogens.
背景:霉菌瘤是一种影响皮肤和皮下组织的慢性疾病,是热带和亚热带地区的地方病。几种细菌和真菌都可引起霉菌瘤,但真菌性霉菌瘤(真菌瘤)的治疗具有挑战性,因为治疗需要结合长期抗真菌药物和手术。虽然传播途径尚未明确,但从土壤中感染是一个主要假设。然而,土壤调查研究很少,霉菌瘤病原体的地理分布也没有很好的记录。在此,我们利用多重实时 PCR 技术从土壤样本中鉴定了三种真菌:方法:2019 年,我们从苏丹森纳尔州一个地方病流行区的七个村庄采集的土壤中总共提取了 64 份 DNA 样本。设计了专门针对Madurella mycetomatis、Falciformispora senegalensis和F. tompkinsii核糖体DNA的引物和荧光探针:结果:进行了多重实时 PCR 检测,确定了主要病原体霉浆菌存在于大多数地点(95%)。此外,还在一些地点发现了另外两种病原体。这是第一份使用该技术鉴定真菌瘤致病微生物的报告:结论:这项研究表明,土壤 DNA 调查可以阐明霉菌瘤致病因子的风险区域。研究结果将有助于制定预防措施,进一步的大规模研究可能会有效了解霉菌瘤病原体的自然栖息地。
{"title":"Environmental detection of eumycetoma pathogens using multiplex real-time PCR for soil DNA in Sennar State, Sudan.","authors":"Hiroki Hashizume, Suguru Taga, Masayuki K Sakata, Mahmoud Hussein, Emmanuel Edwar Siddig, Toshifumi Minamoto, Ahmed Hassan Fahal, Satoshi Kaneko","doi":"10.1186/s41182-023-00563-3","DOIUrl":"10.1186/s41182-023-00563-3","url":null,"abstract":"<p><strong>Background: </strong>Mycetoma is a chronic disease affecting the skin and subcutaneous tissue endemic in the tropical and subtropical regions. Several bacteria and fungi can cause mycetoma, but fungal mycetoma (eumycetoma) is challenging because the treatment requires a combination of a long-term antifungal agent and surgery. Although the transmission route has not yet been elucidated, infection from the soil is a leading hypothesis. However, there are few soil investigation studies, and the geographical distribution of mycetoma pathogens is not well documented. Here, we used multiplex real-time PCR technology to identify three fungal species from soil samples.</p><p><strong>Methods: </strong>In total, 64 DNA samples were extracted from soil collected in seven villages in an endemic area in Sennar State, Sudan, in 2019. Primers and fluorescent probes specifically targeting the ribosomal DNA of Madurella mycetomatis, Falciformispora senegalensis, and F. tompkinsii were designed.</p><p><strong>Results: </strong>Multiplex real-time PCR was performed and identified the major pathogen, M. mycetomatis that existed in most sites (95%). In addition, two other pathogens were identified from some sites. This is the first report on the use of this technique for identifying the eumycetoma causative microorganisms.</p><p><strong>Conclusions: </strong>This study demonstrated that soil DNA investigation can elucidate the risk area of mycetoma-causative agents. The results will contribute to the design of prevention measures, and further large-scale studies may be effective in understanding the natural habitats of mycetoma pathogens.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"51 1","pages":"71"},"PeriodicalIF":4.5,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138809179","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}
Pub Date : 2023-12-19DOI: 10.1186/s41182-023-00564-2
Calvin R Wei, Samuel Kamande, Godwin C Lang'at
Background: Vaccine inequity is a reality facing the Sub-Saharan Africa region as vaccine nationalism from high-income countries (HICs) leads to limited access to the lifesaving vaccines needed to end the pandemic. In Africa, a significant portion of the population has yet to be vaccinated against Covid-19; however, the barriers to accessing such vaccines, including capacity challenges, still persist despite the implementation of the COVAX facility meant to support the lower- and middle-income countries (LMICs) to boost vaccination.
Methods: This study involved a systemic narrative review where literature search was conducted using the NCBI's PMC and BMC databases based on defined keywords. Three authors were involved in the literature search and consensus was applied to settle disagreements and validate the findings.
Results: In this systematic narrative review, we report that vaccine nationalism remains a challenge for LMICs as HICs still hoard vaccines and even bypass COVAX to procure doses directly from the manufacturers. Factors that promote vaccine hesitancy in Africa include misinformation regarding the Covid-19 vaccine, a lack of trust in politicians and the pharmaceutical industry, and concerns about vaccine safety and efficacy. The policies implemented to enhance vaccine coverage in Africa, such as mandates, community engagement, and partnerships, all seek to promote equity of vaccination and ending Covid-19.
Conclusion: Covid-19 vaccine inequity persists and contributes to prolonged pandemic in LMICs. In response, African governments have taken certain measures to enhance vaccine uptake but more needs to be done to address resistance to vaccines.
{"title":"Vaccine inequity: a threat to Africa's recovery from COVID-19.","authors":"Calvin R Wei, Samuel Kamande, Godwin C Lang'at","doi":"10.1186/s41182-023-00564-2","DOIUrl":"10.1186/s41182-023-00564-2","url":null,"abstract":"<p><strong>Background: </strong>Vaccine inequity is a reality facing the Sub-Saharan Africa region as vaccine nationalism from high-income countries (HICs) leads to limited access to the lifesaving vaccines needed to end the pandemic. In Africa, a significant portion of the population has yet to be vaccinated against Covid-19; however, the barriers to accessing such vaccines, including capacity challenges, still persist despite the implementation of the COVAX facility meant to support the lower- and middle-income countries (LMICs) to boost vaccination.</p><p><strong>Methods: </strong>This study involved a systemic narrative review where literature search was conducted using the NCBI's PMC and BMC databases based on defined keywords. Three authors were involved in the literature search and consensus was applied to settle disagreements and validate the findings.</p><p><strong>Results: </strong>In this systematic narrative review, we report that vaccine nationalism remains a challenge for LMICs as HICs still hoard vaccines and even bypass COVAX to procure doses directly from the manufacturers. Factors that promote vaccine hesitancy in Africa include misinformation regarding the Covid-19 vaccine, a lack of trust in politicians and the pharmaceutical industry, and concerns about vaccine safety and efficacy. The policies implemented to enhance vaccine coverage in Africa, such as mandates, community engagement, and partnerships, all seek to promote equity of vaccination and ending Covid-19.</p><p><strong>Conclusion: </strong>Covid-19 vaccine inequity persists and contributes to prolonged pandemic in LMICs. In response, African governments have taken certain measures to enhance vaccine uptake but more needs to be done to address resistance to vaccines.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"51 1","pages":"69"},"PeriodicalIF":3.6,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138809180","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}
Background: Severe acute respiratory infection (SARI) is a leading cause of mortality globally, peaking during the COVID-19 pandemic. We analyzed SARI-associated deaths during the pre-and-pandemic periods in Bangladesh to identify the contributing factors.
Methods: We analyzed data from hospital-based influenza surveillance at nine tertiary-level hospitals in Bangladesh. We considered March 2018-February 2020 as the pre-pandemic period and March 2020-February 2022 as the pandemic period and included adult (≥ 18 years) participants in our study. Surveillance physicians identified WHO-SARI case definition meeting inpatients and collected demographics, clinical characteristics, and outcomes at hospital discharge and 30 days post-discharge. We performed rRT-PCR for influenza and SARS-CoV-2 viruses on collected nasopharyngeal and oropharyngeal swabs. We used multivariable Cox's regression models to calculate the hazard ratio (HR) for factors associated with SARI deaths in these adult patients.
Results: We enrolled 4392 SARI patients during the pre-pandemic and 3824 SARI patients during the pandemic period. Case fatality ratio was higher during the pandemic: 13.62% (521) [in-hospital: 6.45% (247); post-discharge: 7.17% (274)] compared to pre-pandemic, 6.01% (264) [in-hospital: 2.01% (89), post-discharge: 4% (175)] (p < 0.001). Pre-pandemic, influenza was detected in 14% (37/264) of SARI deaths. Influenza was detected during the pandemic in 2.3% (12/521), SARS-CoV-2 in 41.8% (218/521), and both viruses in only one SARI death. History of smoking and the presence of 1 or more co-morbid conditions independently attributed to SARI deaths in adults in the pre-pandemic period. SARI deaths in such patients were also associated with respiratory difficulties on admission in both pre-pandemic (aHR 2.36; 95% CI:1.65-3.36) and pandemic period (aHR 2.30; 95% CI: 1.57-3.35) after accounting for age, sex, smoking status, presence of 1 or more co-morbid conditions, and detection of influenza and SARS-CoV-2 viruses.
Conclusions: During the pandemic, SARI mortality increased; influenza-associated mortality declined, and SARS-CoV-2 caused over a third of SARI deaths. Post-discharge mortality was higher than in-hospital mortality during both periods. Limiting premature discharge and strengthening post-discharge monitoring and nursing services could reduce unexpected deaths. Formative research to better understand post-discharge mortality is essential to reduce SARI deaths.
背景:严重急性呼吸道感染(SARI)是全球死亡的主要原因之一,在 COVID-19 大流行期间达到高峰。我们分析了孟加拉国大流行前期与 SARI 相关的死亡病例,以确定导致死亡的因素:我们分析了孟加拉国九家三级医院的医院流感监测数据。我们将 2018 年 3 月至 2020 年 2 月视为大流行前期,2020 年 3 月至 2022 年 2 月视为大流行期,并将成年(≥ 18 岁)参与者纳入研究范围。监测医生确定了符合 WHO-SARI 病例定义的住院患者,并收集了出院时和出院后 30 天的人口统计学、临床特征和结果。我们对采集的鼻咽和口咽拭子进行了流感和 SARS-CoV-2 病毒的 rRT-PCR 检测。我们使用多变量考克斯回归模型计算了这些成人患者中与 SARI 死亡相关因素的危险比 (HR):我们共收治了大流行前的 4392 名 SARI 患者和大流行期间的 3824 名 SARI 患者。与大流行前的 6.01% (264) [院内:2.01% (89);出院后:4% (175)]相比,大流行期间的病死率更高:13.62% (521) [院内:6.45% (247);出院后:7.17% (274)](P 结论:在大流行期间,SARI 患者的病死率比大流行前更高:大流行期间,SARI 死亡率上升;流感相关死亡率下降,SARS-CoV-2 导致的 SARI 死亡占三分之一以上。在这两个时期,出院后死亡率均高于院内死亡率。限制过早出院、加强出院后监测和护理服务可以减少意外死亡。为更好地了解出院后死亡率而开展的形成性研究对于减少 SARI 死亡至关重要。
{"title":"Characterizing deaths among adult patients with severe acute respiratory infection: during the pre- and COVID-19 pandemic periods in Bangladesh, 2018-2022.","authors":"Md Zakiul Hassan, Md Ariful Islam, Homayra Rahman Shoshi, Md Kamal Hossain, Tahmina Shirin, Fahmida Chowdhury","doi":"10.1186/s41182-023-00565-1","DOIUrl":"10.1186/s41182-023-00565-1","url":null,"abstract":"<p><strong>Background: </strong>Severe acute respiratory infection (SARI) is a leading cause of mortality globally, peaking during the COVID-19 pandemic. We analyzed SARI-associated deaths during the pre-and-pandemic periods in Bangladesh to identify the contributing factors.</p><p><strong>Methods: </strong>We analyzed data from hospital-based influenza surveillance at nine tertiary-level hospitals in Bangladesh. We considered March 2018-February 2020 as the pre-pandemic period and March 2020-February 2022 as the pandemic period and included adult (≥ 18 years) participants in our study. Surveillance physicians identified WHO-SARI case definition meeting inpatients and collected demographics, clinical characteristics, and outcomes at hospital discharge and 30 days post-discharge. We performed rRT-PCR for influenza and SARS-CoV-2 viruses on collected nasopharyngeal and oropharyngeal swabs. We used multivariable Cox's regression models to calculate the hazard ratio (HR) for factors associated with SARI deaths in these adult patients.</p><p><strong>Results: </strong>We enrolled 4392 SARI patients during the pre-pandemic and 3824 SARI patients during the pandemic period. Case fatality ratio was higher during the pandemic: 13.62% (521) [in-hospital: 6.45% (247); post-discharge: 7.17% (274)] compared to pre-pandemic, 6.01% (264) [in-hospital: 2.01% (89), post-discharge: 4% (175)] (p < 0.001). Pre-pandemic, influenza was detected in 14% (37/264) of SARI deaths. Influenza was detected during the pandemic in 2.3% (12/521), SARS-CoV-2 in 41.8% (218/521), and both viruses in only one SARI death. History of smoking and the presence of 1 or more co-morbid conditions independently attributed to SARI deaths in adults in the pre-pandemic period. SARI deaths in such patients were also associated with respiratory difficulties on admission in both pre-pandemic (aHR 2.36; 95% CI:1.65-3.36) and pandemic period (aHR 2.30; 95% CI: 1.57-3.35) after accounting for age, sex, smoking status, presence of 1 or more co-morbid conditions, and detection of influenza and SARS-CoV-2 viruses.</p><p><strong>Conclusions: </strong>During the pandemic, SARI mortality increased; influenza-associated mortality declined, and SARS-CoV-2 caused over a third of SARI deaths. Post-discharge mortality was higher than in-hospital mortality during both periods. Limiting premature discharge and strengthening post-discharge monitoring and nursing services could reduce unexpected deaths. Formative research to better understand post-discharge mortality is essential to reduce SARI deaths.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"51 1","pages":"70"},"PeriodicalIF":3.6,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138809178","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}
Pub Date : 2023-12-01DOI: 10.1186/s41182-023-00552-6
Katherine-Sofia Candray-Medina, Y. Nakagama, Masamichi Ito, Shun Nakagama, E. Tshibangu-Kabamba, Norihiko Takeda, Yuki Sugiura, Y. Nitahara, Yu Michimuko-Nagahara, N. Kaku, Yoko Onizuka, C. Arias, M. Mejía, Karla Alas, Susana Peña, Yasuhiro Maejima, Issei Komuro, J. Nakajima-Shimada, Yasutoshi Kido
{"title":"Differential cardiomyocyte transcriptomic remodeling during in vitro Trypanosoma cruzi infection using laboratory strains provides implications on pathogenic host responses","authors":"Katherine-Sofia Candray-Medina, Y. Nakagama, Masamichi Ito, Shun Nakagama, E. Tshibangu-Kabamba, Norihiko Takeda, Yuki Sugiura, Y. Nitahara, Yu Michimuko-Nagahara, N. Kaku, Yoko Onizuka, C. Arias, M. Mejía, Karla Alas, Susana Peña, Yasuhiro Maejima, Issei Komuro, J. Nakajima-Shimada, Yasutoshi Kido","doi":"10.1186/s41182-023-00552-6","DOIUrl":"https://doi.org/10.1186/s41182-023-00552-6","url":null,"abstract":"","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":" 83","pages":""},"PeriodicalIF":4.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138611852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-24DOI: 10.1186/s41182-023-00558-0
Bethlhem Kinfu Gurmassa, Sirak Robele Gari, Ephrem Tefera Solomon, Michaela L Goodson, Claire L Walsh, Bitew K Dessie, Bezatu Mengistie Alemu
Background: Helminth infections are a public health issue in countries with poor sanitation facilities. However, there little information on the epidemiological association between helminths in wastewater and soil samples and rates of helminth infection among farming households along the Akaki River in Addis Ababa, Ethiopia.
Methods: A cross-sectional study was conducted between November 2021 and February 2022. A stratified random sampling technique was used to select farming households. The sample size for each district was determined by a proportionate allocation to the number of households. From wastewater-irrigated farms, 70 wastewater samples, 28 soil samples, and 86 farmers' stool samples were collected and analyzed for helminths. A questionnaire was used to gather ethnographic data, about farming households, whereas wastewater and soil sample analysis was used to generate quantitative data on helminth loads. The data were systematically analysed by developing themes, and bias evaluated using triangulation validation methodologies. Potential pathways to helminth infection were evaluated by measuring. Total number of helminth eggs in wastewater, soil samples and farmer's stools was investigated using Poisson regression.
Results: In this study, 82.9% of wastewater samples, 57.1% of soil samples, and 18.6% of farmers' stool samples contained helminth eggs. The most prevalent helminth was Ascaris lumbricoides in all samples (wastewater 67%, soil 25%, and stool 10.5%), followed by hookworm (wastewater 10%, soil 21.4%, and stool 6.9%) and Trichuris trichiura eggs (wastewater 5.7%, soil 10.7%, and stool 1.2%). There was a positive association between the total number of helminth eggs in wastewater and soil samples with counts in farmers' stool. The Poisson regression coefficients for wastewater and soil were, 1.63 (95% CI = 1.34-1.92) and 1.70 (95% CI = 1.39-2.01), (p < 0.05).
Conclusions: This research has shown a clear association between the total helminth eggs in wastewater and soil samples and farmer stools along the Akaki River. Therefore, an integrated approach is essential to address the issue in this area and prevent the spread of further helminth infections.
背景:在卫生设施差的国家,寄生虫感染是一个公共卫生问题。然而,关于埃塞俄比亚亚的斯亚贝巴Akaki河沿岸农户中废水和土壤样本中的蠕虫与蠕虫感染率之间的流行病学关联的信息很少。方法:在2021年11月至2022年2月期间进行横断面研究。采用分层随机抽样方法对农户进行抽样。每个地区的样本量由按比例分配的家庭数量决定。从废水灌溉农场收集了70份废水样本、28份土壤样本和86份农民粪便样本,并对其进行了蠕虫分析。使用问卷收集有关农户的人种学数据,而使用废水和土壤样本分析来生成关于蠕虫负荷的定量数据。通过开发主题对数据进行系统分析,并使用三角测量验证方法评估偏倚。通过测量来评估寄生虫感染的潜在途径。采用泊松回归法对污水、土壤样品和农民粪便中的蠕虫卵总数进行了调查。结果:82.9%的污水样本、57.1%的土壤样本和18.6%的农民粪便样本中含有蠕虫卵。所有样本中最常见的蠕虫是类蚓蛔虫(废水67%,土壤25%,粪便10.5%),其次是钩虫(废水10%,土壤21.4%,粪便6.9%)和毛滴虫卵(废水5.7%,土壤10.7%,粪便1.2%)。污水中虫卵总数、土壤样品中虫卵总数与农民粪便中虫卵数呈正相关。废水和土壤的泊松回归系数分别为1.63 (95% CI = 1.34 ~ 1.92)和1.70 (95% CI = 1.39 ~ 2.01)。(p)结论:赤明河流域废水和土壤样品中总虫卵与农民粪便有明显的相关性。因此,必须采取综合办法来解决这一领域的问题,防止寄生虫感染进一步蔓延。
{"title":"Distribution of helminth eggs in environmental and stool samples of farming households along Akaki River in Addis Ababa, Ethiopia.","authors":"Bethlhem Kinfu Gurmassa, Sirak Robele Gari, Ephrem Tefera Solomon, Michaela L Goodson, Claire L Walsh, Bitew K Dessie, Bezatu Mengistie Alemu","doi":"10.1186/s41182-023-00558-0","DOIUrl":"10.1186/s41182-023-00558-0","url":null,"abstract":"<p><strong>Background: </strong>Helminth infections are a public health issue in countries with poor sanitation facilities. However, there little information on the epidemiological association between helminths in wastewater and soil samples and rates of helminth infection among farming households along the Akaki River in Addis Ababa, Ethiopia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between November 2021 and February 2022. A stratified random sampling technique was used to select farming households. The sample size for each district was determined by a proportionate allocation to the number of households. From wastewater-irrigated farms, 70 wastewater samples, 28 soil samples, and 86 farmers' stool samples were collected and analyzed for helminths. A questionnaire was used to gather ethnographic data, about farming households, whereas wastewater and soil sample analysis was used to generate quantitative data on helminth loads. The data were systematically analysed by developing themes, and bias evaluated using triangulation validation methodologies. Potential pathways to helminth infection were evaluated by measuring. Total number of helminth eggs in wastewater, soil samples and farmer's stools was investigated using Poisson regression.</p><p><strong>Results: </strong>In this study, 82.9% of wastewater samples, 57.1% of soil samples, and 18.6% of farmers' stool samples contained helminth eggs. The most prevalent helminth was Ascaris lumbricoides in all samples (wastewater 67%, soil 25%, and stool 10.5%), followed by hookworm (wastewater 10%, soil 21.4%, and stool 6.9%) and Trichuris trichiura eggs (wastewater 5.7%, soil 10.7%, and stool 1.2%). There was a positive association between the total number of helminth eggs in wastewater and soil samples with counts in farmers' stool. The Poisson regression coefficients for wastewater and soil were, 1.63 (95% CI = 1.34-1.92) and 1.70 (95% CI = 1.39-2.01), (p < 0.05).</p><p><strong>Conclusions: </strong>This research has shown a clear association between the total helminth eggs in wastewater and soil samples and farmer stools along the Akaki River. Therefore, an integrated approach is essential to address the issue in this area and prevent the spread of further helminth infections.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"51 1","pages":"67"},"PeriodicalIF":4.5,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138300117","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}
Pub Date : 2023-11-21DOI: 10.1186/s41182-023-00557-1
Ritu Shrivastava, Thomas Stevens, Larry Westerman, David Bressler, Elsie van Schalkwyk, Cristina Bressler, Ken Ugwu, Christina Mwangi, Joel Peter Opio, Joseph Nkodyo, Jane W Mwangi, Monte D Martin, Shanna Nesby-O'Dell
Introduction: The African Center for Integrated Laboratory Training (ACILT) in Johannesburg, South Africa offered a laboratory biosafety program to improve laboratory biosafety practices in 22 President's Emergency Plan for AIDS Relief (PEPFAR) supported countries. This manuscript evaluates the transference of newly gained knowledge and skills to the participants' place of employment for HIV and TB diagnostic laboratory programs. It also serves as a follow-on to a previously published manuscript that measured training effectiveness for all courses offered at ACILT.
Methods: ACILT offered 20 Laboratory Biosafety and Infrastructure courses (2008-2014), also referred as biosafety course/course comprising of 14 core laboratory safety elements to 402 participants from 22 countries. In 2015, participants received 22 e-questions divided into four categories: (1) Safety Policies, (2) Management's Engagement, (3) Safety Programs and (4) Assessments of Safety Practices to determine retrospectively the training effectiveness of biosafety practices in their place of employment 6 months before and after attending their course. We used Kirkpatrick model to assess the transference of knowledge, skills and obstructive factors.
Results: 20% (81/402) of the participants completed the e-questionnaire. The overall percentage of positive responses indicating implementation of new safety practices increased from 50% to 84%. Improvement occurred in all four categories after attending the course, with the greatest increases in Safety Policies (67-94%) and Safety Programs (43-91%). Creating a safety committee, allocating resources, and establishing a facility safety policy were important drivers for implementing and maintaining laboratory safety practices. In addition, accredited laboratories and countries with national safety regulations or policies had a higher percentage of improvements. The most reported challenges were inadequate funding and lack of management enforcement.
Conclusions: PEPFAR and other partners' investments in training institutions, such as ACILT, were effective in building sustainable country ownership to strengthen biosafety practices and were leveraged to combat zoonotic diseases and COVID-19. Although support continues at the national/regional level, a standardized, coordinated and continent-wide sustainable approach to offer a biosafety program-like ACILT is missing. Continuous offerings of biosafety programs similar to ACILT could contribute to sustainable strengthening of laboratory biosafety, QMS and pandemic preparedness.
{"title":"Measuring training effectiveness of laboratory biosafety program offered at African Center for Integrated Laboratory Training in 22 President's Emergency Plan for AIDS Relief supported countries (2008-2014).","authors":"Ritu Shrivastava, Thomas Stevens, Larry Westerman, David Bressler, Elsie van Schalkwyk, Cristina Bressler, Ken Ugwu, Christina Mwangi, Joel Peter Opio, Joseph Nkodyo, Jane W Mwangi, Monte D Martin, Shanna Nesby-O'Dell","doi":"10.1186/s41182-023-00557-1","DOIUrl":"10.1186/s41182-023-00557-1","url":null,"abstract":"<p><strong>Introduction: </strong>The African Center for Integrated Laboratory Training (ACILT) in Johannesburg, South Africa offered a laboratory biosafety program to improve laboratory biosafety practices in 22 President's Emergency Plan for AIDS Relief (PEPFAR) supported countries. This manuscript evaluates the transference of newly gained knowledge and skills to the participants' place of employment for HIV and TB diagnostic laboratory programs. It also serves as a follow-on to a previously published manuscript that measured training effectiveness for all courses offered at ACILT.</p><p><strong>Methods: </strong>ACILT offered 20 Laboratory Biosafety and Infrastructure courses (2008-2014), also referred as biosafety course/course comprising of 14 core laboratory safety elements to 402 participants from 22 countries. In 2015, participants received 22 e-questions divided into four categories: (1) Safety Policies, (2) Management's Engagement, (3) Safety Programs and (4) Assessments of Safety Practices to determine retrospectively the training effectiveness of biosafety practices in their place of employment 6 months before and after attending their course. We used Kirkpatrick model to assess the transference of knowledge, skills and obstructive factors.</p><p><strong>Results: </strong>20% (81/402) of the participants completed the e-questionnaire. The overall percentage of positive responses indicating implementation of new safety practices increased from 50% to 84%. Improvement occurred in all four categories after attending the course, with the greatest increases in Safety Policies (67-94%) and Safety Programs (43-91%). Creating a safety committee, allocating resources, and establishing a facility safety policy were important drivers for implementing and maintaining laboratory safety practices. In addition, accredited laboratories and countries with national safety regulations or policies had a higher percentage of improvements. The most reported challenges were inadequate funding and lack of management enforcement.</p><p><strong>Conclusions: </strong>PEPFAR and other partners' investments in training institutions, such as ACILT, were effective in building sustainable country ownership to strengthen biosafety practices and were leveraged to combat zoonotic diseases and COVID-19. Although support continues at the national/regional level, a standardized, coordinated and continent-wide sustainable approach to offer a biosafety program-like ACILT is missing. Continuous offerings of biosafety programs similar to ACILT could contribute to sustainable strengthening of laboratory biosafety, QMS and pandemic preparedness.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"51 1","pages":"65"},"PeriodicalIF":4.5,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10662895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138291873","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}
Pub Date : 2023-11-15DOI: 10.1186/s41182-023-00551-7
Nadine Kalenda Kayiba, Evariste Tshibangu-Kabamba, Angel Rosas-Aguirre, Natsuko Kaku, Yu Nakagama, Akira Kaneko, Dieudonné Mvumbi Makaba, Doudou Yobi Malekita, Brecht Devleesschauwer, Joris Losimba Likwela, Pius Kabututu Zakayi, Patrick DeMol, Georges Mvumbi Lelo, Marie-Pierre Hayette, Paul Lusamba Dikassa, Yasutoshi Kido, Niko Speybroeck
Context: The Democratic Republic of Congo (DRC), one of the most malaria-affected countries worldwide, is a potential hub for global drug-resistant malaria. This study aimed at summarizing and mapping surveys of malaria parasites carrying molecular markers of drug-resistance across the country.
Methods: A systematic mapping review was carried out before July 2023 by searching for relevant articles through seven databases (PubMed, Embase, Scopus, African Journal Online, African Index Medicus, Bioline and Web of Science).
Results: We identified 1541 primary studies of which 29 fulfilled inclusion criteria and provided information related to 6385 Plasmodium falciparum clinical isolates (collected from 2000 to 2020). We noted the PfCRT K76T mutation encoding for chloroquine-resistance in median 32.1% [interquartile interval, IQR: 45.2] of analyzed malaria parasites. The proportion of parasites carrying this mutation decreased overtime, but wide geographic variations persisted. A single isolate had encoded the PfK13 R561H substitution that is invoked in artemisinin-resistance emergence in the Great Lakes region of Africa. Parasites carrying various mutations linked to resistance to the sulfadoxine-pyrimethamine combination were widespread and reflected a moderate resistance profile (PfDHPS A437G: 99.5% [IQR: 3.9]; PfDHPS K540E: 38.9% [IQR: 47.7]) with median 13.1% [IQR: 10.3] of them being quintuple IRN-GE mutants (i.e., parasites carrying the PfDHFR N51I-C59R-S108N and PfDHPS A437G-K540E mutations). These quintuple mutants tended to prevail in eastern regions of the country. Among circulating parasites, we did not record any parasites harboring mutations related to mefloquine-resistance, but we could suspect those with decreased susceptibility to quinine, amodiaquine, and lumefantrine based on corresponding molecular surrogates.
Conclusions: Drug resistance poses a serious threat to existing malaria therapies and chemoprevention options in the DRC. This review provides a baseline for monitoring public health efforts as well as evidence for decision-making in support of national malaria policies and for implementing regionally tailored control measures across the country.
{"title":"The landscape of drug resistance in Plasmodium falciparum malaria in the Democratic Republic of Congo: a mapping systematic review.","authors":"Nadine Kalenda Kayiba, Evariste Tshibangu-Kabamba, Angel Rosas-Aguirre, Natsuko Kaku, Yu Nakagama, Akira Kaneko, Dieudonné Mvumbi Makaba, Doudou Yobi Malekita, Brecht Devleesschauwer, Joris Losimba Likwela, Pius Kabututu Zakayi, Patrick DeMol, Georges Mvumbi Lelo, Marie-Pierre Hayette, Paul Lusamba Dikassa, Yasutoshi Kido, Niko Speybroeck","doi":"10.1186/s41182-023-00551-7","DOIUrl":"10.1186/s41182-023-00551-7","url":null,"abstract":"<p><strong>Context: </strong>The Democratic Republic of Congo (DRC), one of the most malaria-affected countries worldwide, is a potential hub for global drug-resistant malaria. This study aimed at summarizing and mapping surveys of malaria parasites carrying molecular markers of drug-resistance across the country.</p><p><strong>Methods: </strong>A systematic mapping review was carried out before July 2023 by searching for relevant articles through seven databases (PubMed, Embase, Scopus, African Journal Online, African Index Medicus, Bioline and Web of Science).</p><p><strong>Results: </strong>We identified 1541 primary studies of which 29 fulfilled inclusion criteria and provided information related to 6385 Plasmodium falciparum clinical isolates (collected from 2000 to 2020). We noted the PfCRT K76T mutation encoding for chloroquine-resistance in median 32.1% [interquartile interval, IQR: 45.2] of analyzed malaria parasites. The proportion of parasites carrying this mutation decreased overtime, but wide geographic variations persisted. A single isolate had encoded the PfK13 R561H substitution that is invoked in artemisinin-resistance emergence in the Great Lakes region of Africa. Parasites carrying various mutations linked to resistance to the sulfadoxine-pyrimethamine combination were widespread and reflected a moderate resistance profile (PfDHPS A437G: 99.5% [IQR: 3.9]; PfDHPS K540E: 38.9% [IQR: 47.7]) with median 13.1% [IQR: 10.3] of them being quintuple IRN-GE mutants (i.e., parasites carrying the PfDHFR N51I-C59R-S108N and PfDHPS A437G-K540E mutations). These quintuple mutants tended to prevail in eastern regions of the country. Among circulating parasites, we did not record any parasites harboring mutations related to mefloquine-resistance, but we could suspect those with decreased susceptibility to quinine, amodiaquine, and lumefantrine based on corresponding molecular surrogates.</p><p><strong>Conclusions: </strong>Drug resistance poses a serious threat to existing malaria therapies and chemoprevention options in the DRC. This review provides a baseline for monitoring public health efforts as well as evidence for decision-making in support of national malaria policies and for implementing regionally tailored control measures across the country.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"51 1","pages":"64"},"PeriodicalIF":4.5,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10647042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134649924","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}
Pub Date : 2023-11-14DOI: 10.1186/s41182-023-00559-z
Isra Masood, Muhammad Junaid Tahir, Ather Naeem, Oadi N Shrateh, Ali Ahmed
Congo virus, or Crimean-Congo hemorrhagic fever (CCHF), is a tick-borne disease caused by a single-stranded RNA virus (genus nairovirus, Bunyaviridae family). It spreads through infected ticks' bites or contact with viremic individuals or livestock. Factors supporting its spread include hot, humid climates, limited pesticide use, poor animal control, inadequate irrigation during monsoons, and vector control deficiencies. Nosocomial transmission in under-resourced hospitals poses a threat to healthcare workers. Decades of CCHF cases persist in Pakistan due to these factors, with six deaths reported by June 2023. To combat the epidemic, Pakistan should raise awareness, improve irrigation, establish surveillance systems, and implement livestock quarantine and vaccination.
{"title":"The new wave of Congo virus in Pakistan: emerging threat.","authors":"Isra Masood, Muhammad Junaid Tahir, Ather Naeem, Oadi N Shrateh, Ali Ahmed","doi":"10.1186/s41182-023-00559-z","DOIUrl":"10.1186/s41182-023-00559-z","url":null,"abstract":"<p><p>Congo virus, or Crimean-Congo hemorrhagic fever (CCHF), is a tick-borne disease caused by a single-stranded RNA virus (genus nairovirus, Bunyaviridae family). It spreads through infected ticks' bites or contact with viremic individuals or livestock. Factors supporting its spread include hot, humid climates, limited pesticide use, poor animal control, inadequate irrigation during monsoons, and vector control deficiencies. Nosocomial transmission in under-resourced hospitals poses a threat to healthcare workers. Decades of CCHF cases persist in Pakistan due to these factors, with six deaths reported by June 2023. To combat the epidemic, Pakistan should raise awareness, improve irrigation, establish surveillance systems, and implement livestock quarantine and vaccination.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"51 1","pages":"62"},"PeriodicalIF":4.5,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92156845","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}