Tropical Medicine & International Health最新文献

Background: Rapid diagnostic tests for the serological detection of gambiense human African trypanosomiasis (gHAT) have been developed to overcome the limitations of the traditional screening method, CATT/T. b. gambiense. The Abbott Bioline human African trypanosomiasis (HAT) 2.0 rapid diagnostic test has recently been developed by Abbott using only recombinant antigens. The objective of this study was to evaluate its clinical sensitivity and specificity, in comparison with the other available rapid diagnostic tests and CATT.

Methodology/principal findings: For this study, archived plasma samples from 150 gHAT cases and 150 endemic controls originating from Chad, Guinea, the Democratic Republic of the Congo and Uganda were analysed on the following tests: CATT/T. b. gambiense, the HAT Sero K-SeT, SD BIOLINE HAT and Abbott Bioline HAT 2.0 rapid diagnostic tests, and the immune trypanolysis test. The sensitivity and specificity of Abbott Bioline HAT 2.0 were 96.7% and 78.4%, respectively, and the sensitivity and specificity of SD BIOLINE HAT were 99.3% and 74.1%. The sensitivity and specificity of CATT were 98.7% and 89.2%. The sensitivity and specificity of HAT Sero K-SeT were 99.3% and 81.3%.

Conclusions/significance: The sensitivity and specificity of the Abbott Bioline HAT 2.0 are comparable to those of its predecessors HAT Sero K-SeT and SD BIOLINE HAT. However, considering the decreasing prevalence of gHAT, a higher specificity of the tests used for screening is desirable to improve their positive predictive value.

Background: The study aims to determine the host preference for blood feeding among potential hosts of Anopheles stephensi in Iran, using the Multiplex-PCR method. An. stephensi is the primary malaria vector in urban areas of South Asia and the Middle East, including southern Iran, where approximately 30.21% of malaria cases are urban. This trend has become more evident during the recent outbreaks in Iran, driven by infections of Plasmodium falciparum, Plasmodium vivax, and as well as mixed infections. Hormozgan province, one of the most endemic areas in Iran, was selected for its critical public health significance. This study builds on the validated efficiency of Multiplex-PCR for blood meal analysis by applying it to mosquitoes in southern Iran.

Methods: In 2021, mosquitoes were collected monthly from three coastal villages in Bandar Abbas county, Hormozgan province, using WHO-recommended collection methods. Blood-fed An. stephensi mosquitoes were dissected, and their stomach contents analysed via Multiplex-PCR to identify human and animal blood sources.

Results: Of 77 An. stephensi samples analysed, humans were the most common host was humans (29.9%), followed by mammals (19%), dogs (2.6%), and birds (1.3%). Mixed blood meals were detected in 34% of samples, including 23% with human and other hosts. Informal observations suggest that domestic animals such as goats, sheep, and chickens are commonly present near homes in these areas.

Conclusion: Approximately 50% of An. stephensi blood meals were sourced from humans, with 29% exclusively from humans and 23% from mixed hosts. Domestic animals such as goats, sheep, and chickens appear to attract mosquitoes, highlighting their potential role in malaria dynamics. Zooprophylaxis, alongside existing measures like insecticide residual spraying, insecticide-treated bed nets, and personal protection strategies, may strengthen urban malaria control. Further research on the ecological and behavioural drivers of mosquito host selection in urban settings is warranted.

Objective: Snakebite envenoming remains a public health threat in many tropical countries. While community knowledge of local snakes and snakebite first-aid and prevention are needed to reduce snakebite incidence and improve the outcomes for snakebite patients, it is poor in many communities. We assessed community health workers and community members regarding their knowledge on local snakes, snakebite first-aid and prevention in Neno district, Malawi.

Methods: In November 2022, we conducted a cross-sectional survey among 312 community health workers and 379 community members in the Neno District of Malawi to assess their knowledge of snake identification, snakebite first-aid, and prevention. Different questions were asked in these sections and summarised as linear scores ranging from 0% to 100%. Scores of 0%-49%, 50%-70%, and >70% were considered inadequate, fairly adequate, and adequate, respectively. Along with data collected during knowledge assessments, the socio-demographic characteristics of participants were collected. To assess knowledge differences between community health workers and community members, Pearson's chi-square or Fisher's exact tests were used, and linear regression was calculated to investigate possible predictors of knowledge.

Results: Overall, 66.6% of participants were females with a median age of 39 (IQR = 30-48) years. Of the 89% (n = 615) who agreed to view snake pictures, only 1.3% had adequate snake identification knowledge. Less than 5% (n = 33) had adequate knowledge of first aid measures, and 14.3% (n = 99) had adequate knowledge of prevention practices. Overall, less than 1% (n = 3) had adequate knowledge across the three assessment sections, with no significant difference between community health workers (n = 1, 0.3%) and community members (n = 2, 0.5%) (p > 0.949).

Conclusion: Both community health workers and community members had inadequate knowledge regarding local snake species, first aid for snakebites and prevention measures. The effect of awareness campaigns and other education initiatives could be explored to help improve these gaps.

Objectives: Influenza outbreaks of varying size occur every year, but during the COVID-19 pandemic, many countries experienced influenza at lower levels. However, following the relaxation of COVID-19 prevention measures in 2022, the incidence of influenza began to increase gradually. Thus, this study compared the occurrence of influenza from week 36 of 2017, before the COVID-19 outbreak, until 2023.

Methods: The analysis was conducted using influenza-like illness occurrence data available from the Korea Disease Control and Prevention Agency infectious disease website. Additionally, to examine the changes in COVID-19 and influenza occurrence during the pandemic, COVID-19 incidence data from 20 January 2020 to 31 August 2023 were obtained from the KDCA Coronavirus Disease 19 homepage.

Results: During the COVID-19 pandemic, which corresponds to the 2020/2021 and 2021/2022 influenza seasons, there was no seasonal influenza epidemic, and the incidence rates were below the usual outbreak levels. However, in the 2022/2023 season, when the spread of COVID-19 had eased, a seasonal pattern similar to that observed before the COVID-19 pandemic was noted. Furthermore, correlation analysis between the rates of influenza-like illness and COVID-19 incidence showed no significant correlation during the entire period. However, a significant correlation emerged in 2023 (r = 0.393, p <0.05). These results suggest that influenza was suppressed during the COVID-19 pandemic but returned to typical seasonal patterns after the COVID-19 prevention policies were eased.

Conclusion: The positive correlation observed between the incidences of COVID-19 and influenza in 2023 indicates that COVID-19, no longer a novel pandemic-causing infectious disease, may have transitioned to an endemic pattern similar to seasonal influenza.

Objectives: This study aimed to describe the prevalence of lymphatic filariasis (LF), soil-transmitted helminthiasis (STH) and schistosomiasis (SC) in Indonesia before and after PC implementation through a systematic review and meta-analysis.

Methods: Embase, MEDLINE, PubMed, Scopus, Web of Science and Google Scholar were searched for articles published between 1 January 1992 and 31 December 2022, reporting LF, STH and SC in Indonesia. Using the Ministry of Health lists of districts receiving PC programs, we identified whether data collection was conducted before or after PC implementation in that particular district. A meta-analysis was performed with a random-effects model applied to pool pre- and post-PC prevalence of LF, STH and SC.

Results: Overall, 195 studies were included. The pooled prevalence of LF was 9.72% (95% CI, 5.56%-13.87%). The pre-PC pooled prevalence of LF was 11.48% (95% CI, 5.52%-17.45%). The prevalence decreased after PC implementation, and the pooled prevalence was 7.12% (95% CI, 1.79%-12.44%). The overall prevalence of STH was 35.16% (95% CI, 30.36%-39.96%). The pre-PC prevalence of STH was 36.29% (95% CI, 30.37%-42.20%). The post-PC prevalence of STH decreased at 31.93% (95% CI, 24.25%-39.62%), although the difference between before and after PC was not significant (p = 0.379). Only nine studies investigated the prevalence of SC; based on the random-effects model, the pooled prevalence was 21.90% (95% CI, 4.88%-38.92%). Owing to the scarcity of studies, we could not perform the funnel tests for publication bias and moderating variables of the pooled prevalence for SC.

Conclusions: The prevalence of LF and STH decreased after PC implementation, although it was not significant. The difference for SC could not be assessed because of limited post-PC data. The uneven distribution of research and the lack of standardised sampling methods may not fully capture the situation.

Sickle cell disease is a genetic disorder characterised by abnormal haemoglobin production. This study aims to investigate the associations between haematological and inflammatory biomarkers and brain volumes in patients with sickle cell anaemia and compare brain structure between patients with sickle cell anaemia and healthy controls. This retrospective cross-sectional study included 130 participants (70 sickle cell anaemia patients and 60 healthy controls) who underwent brain MRI examinations at King Fahad Central Hospital between January 2010 and October 2022. Demographic data and haematological and inflammatory biomarkers were collected to examine their relationships with brain volumes. Brain volumes were measured using FreeSurfer. Specific haematological and inflammatory biomarkers were correlated with brain volume in patients with sickle cell anaemia, p < 0.05. Sickle cell anaemia patients exhibited smaller volumes in the brainstem, corpus callosum and amygdala compared to healthy controls. Males had significantly higher iron levels (p < 0.001) and larger various brain structure volumes (p < 0.05) than females. This study demonstrates significant associations between specific biomarkers and brain volume in sickle cell anaemia patients, underscoring the importance of monitoring these biomarkers for early detection and management of neurological complications in sickle cell anaemia.

Background: Accidents caused by snakes constitute a serious public health problem in Latin America and worldwide. The situation in the Brazilian Amazon region is neglected, resulting in the highest incidence of cases per capita in the country. Furthermore, the distance from urban areas makes it difficult for the population to access timely and effective medical care, including antivenom treatment. The Brazilian Amazon is characterised by high ethnic and cultural diversity, yet it lacks robust epidemiological information that would allow for the development of surveillance and prevention policies. This study aimed to assess the epidemiological profile of individuals affected by snakebite accidents from 2007 to 2021 in a poorly studied region of the Brazilian Amazon.

Methods: To assess the relationship between snakebite accidents, rainfall and river flood levels, cross-correlation functions were employed. Data from the public healthcare system database was used for this analysis.

Results: The results indicate that the study area experiences a snakebite rate 10 times greater than the Brazilian average and double that of other Amazonian regions. The most affected victims consist of adult males residing in rural areas, with snakebite accidents being more common during the rainy season. Viperid snakes were responsible for most bites, with the lower limbs being the most common location of injury. The data revealed a positive correlation between the number of snakebite accidents both rainfall and fluvial data.

Conclusions: The accident peak coincides with the Brazil nut harvest season, a highly significant forest product for the economy of rural communities. Our data reinforces the need for public policies focused on environmental education and prevention, such as the use of boots and leg guards. These preventive measures have the potential to reduce the number of snakebites accidents by approximately 85%.

Introduction: Mozambique is among the highest-burden countries for drug-resistant tuberculosis in the world. However, the spatial distribution of drug-resistant tuberculosis, in the country is unknown. Therefore, we aimed to analyse the spatial distribution, predictors, and hotspot districts for drug-resistant tuberculosis incidence in Mozambique.

Method: We carried out an ecological study using the district as the unit of analysis where we included all cases of drug-resistant tuberculosis diagnosed in Mozambique from 2016 to 2020. We obtained the data from the Minister of Health and other open sources. Parameters of interest were estimated through a spatial Bayesian Poisson regression model using Markov Chain Monte Carlo simulation.

Results: A total of 5092 people with drug-resistant tuberculosis in Mozambique were diagnosed during our study period. We found heterogeneity in the spatial distribution of drug-resistant tuberculosis incidence across the country. Higher incidence rates were mainly observed in the south and central regions, and 26 (16.9%) districts out of 154 were identified as hotspot areas. The incidence of drug-resistant tuberculosis increased with an increase in the HIV prevalence (Relative risk [RR]: 1.53; 95% Credibility Interval [CrI]: 1.32 to 1.76), electricity coverage rate (RR: 1.59; 95% CrI: 1.19 to 2.09), and population density (RR: 1.36; 95% CrI: 1.08 to 1.69) and decreased with an increase in the proportion of people with a bank account per district (RR: 0.71; 95% Crl: 0.51 to 0.96).

Conclusion: The incidence of drug-resistant tuberculosis was not homogeneous, and it was associated with social determinants of health. Targeting interventions in hotspot districts and addressing social determinants is crucial for tuberculosis elimination in Mozambique.