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A tuberculosis elimination-focused geospatial approach to optimising access to diagnostic GeneXpert machines in Fiji. 在斐济采用以消除结核病为重点的地理空间方法,优化基因Xpert诊断仪的使用。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-01 Epub Date: 2024-06-04 DOI: 10.1111/tmi.14023
George Bates, Philip C Hill, Isireli Koroituku, Donald Wilson, Mun Reddy, Mike Kama

Objectives: Fiji could be the first country to eliminate tuberculosis. To inform this strategy, we aimed to identify how many GeneXpert® machines are required to enable over 90% of Fijians to be within one-hour easy access.

Methods: We used Geographic Information System (Quantum GIS; QGIS), OpenStreetMap and population data (Kontur) to map possible facilities in relation to QGIS generated 60-min drive-time isochrones, with correction for missing road data. For outer islands, we calculated a distance to nearest hub operation.

Results: The solution comprised 24 GeneXpert® machines, allocating 7 GeneXpert® to Viti Levu, 6 GeneXpert® to Vanua Levu and 11 to other islands. This resulted in 827,810 people, 93.6% of Fiji's population, being within 1 h of a machine. Twenty-one thousand four hundred seventy-nine people on outer islands were an average of 43 km by water from the nearest facility.

Conclusions: We conclude that over 90% of Fijians could be within an hour of a GeneXpert® machine with placement of 24 machines.

目标:斐济有可能成为第一个消灭结核病的国家。为了为这一战略提供信息,我们旨在确定需要多少台 GeneXpert® 设备才能让 90% 以上的斐济人在一小时内方便地获得服务:我们使用地理信息系统(Quantum GIS;QGIS)、OpenStreetMap 和人口数据(Kontur)绘制了与 QGIS 生成的 60 分钟车程等时线相关的可能设施地图,并对缺失的道路数据进行了校正。对于外岛,我们计算了到最近的枢纽运行的距离:解决方案包括 24 台 GeneXpert®,其中 7 台分配给维提岛,6 台分配给瓦努阿图,11 台分配给其他岛屿。这使得 827 810 人(占斐济总人口的 93.6%)在 1 小时内就能用上基因检测仪。外岛的 2.1479 万人距离最近的设施平均有 43 公里的水路距离:我们的结论是,如果安装 24 台 GeneXpert® 设备,90% 以上的斐济人可在 1 小时内到达设备所在地。
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引用次数: 0
The prevention of congenital toxoplasmosis using a combination of Spiramycin and Cotrimoxazole: The long-time experience of a tertiary referral centre. 使用螺旋霉素和复方新诺明预防先天性弓形虫病:一家三级转诊中心的长期经验。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-01 Epub Date: 2024-06-06 DOI: 10.1111/tmi.14021
Marco De Santis, Silvio Tartaglia, Massimo Apicella, Daniela Visconti, Giuseppe Noia, Piero Valentini, Antonio Lanzone, Rosaria Santangelo, Lucia Masini

Background: Toxoplasmosis is a parasitic infection caused by Toxoplasma gondii and is responsible for gestational and congenital infections worldwide. The current standard therapy is based on the administration of Spiramycin to prevent trans-placental transmission. Other therapies are being studied to reduce the rates of foetal transmission and symptomatic congenital infection.

Objectives: We report our long-standing experience in maternal toxoplasmosis infection treatment using a combination of Spiramycin-Cotrimoxazole, assessing its effectiveness in preventing vertical transmission compared to the expected incidence of congenital infection.

Methods: We retrospectively collected cases of pregnant women referred to our centre for suspected toxoplasmosis infection according to Lebech criteria, treated with Spiramycin-Cotrimoxazole.

Results: Of 1364 women referred to our centre, postnatal follow-up of primary toxoplasmosis was available in 562 cases (73.9%). The overall vertical transmission rate was 3.4% in women treated immediately with Spiramycin-Cotrimoxazole after the diagnosis of infection. In comparison, it was 7.7% in women undergoing the same therapy but late or with poor compliance. The foetal transmission rate was 71.4% in untreated cases. All the infected newborns of mother treated adequately with Spiramycin-Cotrimoxazole were asymptomatic afterbirth, while 6/21 infected infants of the inadequate Spiramycin-Cotrimoxazole therapy group had postnatal sequelae (28.5%). The incidence of transmission after appropriate Spiramycin-Cotrimoxazole therapy was significantly lower than the expected rate reported in literature.

Conclusions: A combination of Spiramycin and Cotrimoxazole is safe and effective in preventing foetal congenital toxoplasmosis and reducing sequelae in case of in-utero infection. The timing and adherence to the therapy are crucial to lowering the risk of congenital infection and neonatal morbidity.

背景:弓形虫病是由弓形虫引起的寄生虫感染,是全球妊娠和先天性感染的罪魁祸首。目前的标准疗法是使用螺旋霉素来预防经胎盘传播。目前正在研究其他疗法,以降低胎儿传播率和无症状先天性感染率:我们报告了长期以来使用螺旋霉素-复方新诺明治疗母体弓形虫感染的经验,并评估了该疗法在预防垂直传播方面的有效性与预期的先天感染率:我们回顾性地收集了根据勒贝赫标准转诊至本中心的疑似弓形虫感染孕妇的病例,并使用螺旋霉素-复方新诺明进行治疗:在转诊至本中心的 1364 名孕妇中,有 562 例(73.9%)在产后对原发性弓形虫病进行了随访。在确诊感染后立即接受螺旋霉素-复方新诺明治疗的妇女中,总体垂直传播率为 3.4%。相比之下,接受同样治疗但治疗较晚或依从性较差的妇女的垂直传播率为 7.7%。在未经治疗的病例中,胎儿传染率为 71.4%。所有接受过螺旋霉素-复方新诺明治疗的母亲的受感染新生儿在出生后都没有症状,而螺旋霉素-复方新诺明治疗不当组中有 6/21 的受感染新生儿在出生后出现了后遗症(28.5%)。经过适当的螺旋霉素-复方新诺明治疗后,传播的发生率明显低于文献报道的预期发生率:结论:螺旋霉素和复方新诺明联合治疗在预防胎儿先天性弓形虫病和减少宫内感染后遗症方面安全有效。治疗时机和坚持治疗对降低先天性感染和新生儿发病率的风险至关重要。
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引用次数: 0
Prevalence of non‐communicable diseases among household contacts of people with tuberculosis: A systematic review and individual participant data meta‐analysis 结核病患者家庭接触者的非传染性疾病患病率:系统综述和个体参与者数据荟萃分析
IF 3.3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-27 DOI: 10.1111/tmi.14038
Yohhei Hamada, Matteo Quartagno, Farihah Malik, Keolebogile Ntshamane, Anna Tisler, Sanjay Gaikwad, Carlos Acuna‐Villaorduna, Perumal Kannabiran Bhavani, Bachti Alisjahbana, Katharina Ronacher, Lika Apriani, Mercedes Becerra, Alexander L. Chu, Jacob Creswell, Gustavo Diaz, Beatriz E. Ferro, Jerome T. Galea, Louis Grandjean, Harleen M. S. Grewal, Amita Gupta, Edward C. Jones‐López, Léanie Kleynhans, Leonid Lecca, Peter MacPherson, Megan Murray, Diana Marín, Blanca I. Restrepo, Shri Vijay Bala Yogendra Shivakumar, Eileen Shu, Dhanasekaran Sivakumaran, Luan Nguyen Quang Vo, Emily L. Webb, Andrew Copas, Ibrahim Abubakar, Molebogeng X. Rangaka
ObjectiveTo investigate the prevalence of non‐communicable diseases among household contacts of people with tuberculosis.MethodsWe conducted a systematic review and individual participant data meta‐analysis. We searched Medline, Embase and the Global Index Medicus from inception to 16 May 2023. We included studies that assessed for at least one non‐communicable disease among household contacts of people with clinical tuberculosis. We estimated the non‐communicable disease prevalence through mixed effects logistic regression for studies providing individual participant data, and compared it with estimates from aggregated data meta‐analyses. Furthermore, we compared age and sex‐standardised non‐communicable disease prevalence with national‐level estimates standardised for age and sex.ResultsWe identified 39 eligible studies, of which 14 provided individual participant data (29,194 contacts). Of the remaining 25 studies, 18 studies reported aggregated data suitable for aggregated data meta‐analysis. In individual participant data analysis, the pooled prevalence of diabetes in studies that undertook biochemical testing was 8.8% (95% confidence interval [CI], 5.1%–14.9%, four studies). Age‐and sex‐standardised prevalence was higher in two studies (10.4% vs. 6.9% and 11.5% vs. 8.4%) than the corresponding national estimates and similar in two studies. Prevalence of diabetes mellitus based on self‐report or medical records was 3.4% (95% CI 2.6%–4.6%, 14 studies). Prevalence did not significantly differ compared to estimates from aggregated data meta‐analysis. There were limited data for other non‐communicable diseases.ConclusionThe prevalence of diabetes mellitus among household contacts was high while that of known diabetes was substantially lower, suggesting the underdiagnosis. tuberculosis household contact investigation offers opportunities to deliver multifaceted interventions to identify tuberculosis infection and disease, screen for non‐communicable diseases and address shared risk factors.
方法我们进行了一项系统性综述和个体参与者数据荟萃分析。我们检索了 Medline、Embase 和 Global Index Medicus 从开始到 2023 年 5 月 16 日的数据。我们纳入了对临床结核病患者的家庭接触者中至少一种非传染性疾病进行评估的研究。对于提供个体参与者数据的研究,我们通过混合效应逻辑回归估计了非传染性疾病的患病率,并将其与汇总数据荟萃分析的估计值进行了比较。此外,我们还将年龄和性别标准化的非传染性疾病患病率与国家级的年龄和性别标准化估计值进行了比较。结果我们确定了 39 项符合条件的研究,其中 14 项提供了个体参与者数据(29 194 名接触者)。在其余 25 项研究中,18 项研究报告了适合进行汇总数据荟萃分析的汇总数据。通过对个体参与者数据的分析,在进行了生化检测的研究中,糖尿病的汇总患病率为 8.8%(95% 置信区间 [CI],5.1%-14.9%,4 项研究)。在两项研究中,年龄和性别标准化患病率(10.4% 对 6.9% 和 11.5% 对 8.4%)高于相应的全国估计值,而在两项研究中,年龄和性别标准化患病率与全国估计值相近。根据自我报告或医疗记录得出的糖尿病患病率为 3.4%(95% CI 2.6%-4.6%,14 项研究)。与汇总数据荟萃分析的估计值相比,患病率没有明显差异。结论 家庭接触者中糖尿病的患病率很高,而已知糖尿病的患病率则低得多,这表明存在诊断不足的情况。结核病家庭接触者调查为提供多方面的干预措施提供了机会,以确定结核病感染和疾病、筛查非传染性疾病并解决共同的风险因素。
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引用次数: 0
Rickettsia africae infections in sub-Saharan Africa: A systematic literature review of epidemiological studies and summary of case reports. 撒哈拉以南非洲的非洲立克次体感染:流行病学研究的系统文献综述和病例报告摘要。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-05-30 DOI: 10.1111/tmi.14002
Elizabeth Y Zhang, Prarthana Kalmath, Haley A Abernathy, Dana A Giandomenico, Melissa S Nolan, Michael H Reiskind, Ross M Boyce

Rickettsia africae is a tick-borne bacteria known to cause African tick bite fever (ATBF). While the disease was first described more than 100 years ago, knowledge of transmission risk factors and disease burden remain poorly described. To better understand the burden of R. africae, this article reviewed and summarized the published literature related to ATBF epidemiology and clinical management. Using a systematic approach, consistent with the PRISMA guidelines, we identified more than 100 eligible articles, including 65 epidemiological studies and 41 case reports. Most reports described R. africae in ticks and livestock, while human studies were less common. Human disease case reports were exclusively among returning travellers from non-endemic areas, which limits our disease knowledge among at-risk populations: people living in endemic regions. Substantial efforts to elucidate the ATBF risk factors and clinical manifestations among local populations are needed to develop effective preventative strategies and facilitate appropriate and timely diagnosis.

非洲立克次体是一种蜱媒细菌,已知可引起非洲蜱咬热(ATBF)。虽然这种疾病早在 100 多年前就已被首次描述,但有关传播风险因素和疾病负担的知识仍然很少。为了更好地了解非洲蜱咬热的负担,本文回顾并总结了已发表的与非洲蜱咬热流行病学和临床管理相关的文献。我们采用符合 PRISMA 指南的系统方法,确定了 100 多篇符合条件的文章,其中包括 65 篇流行病学研究和 41 篇病例报告。大多数报告描述了蜱虫和牲畜中的非洲蜱,而人类研究则较少见。人类疾病病例报告仅涉及从非流行地区返回的旅行者,这限制了我们对高危人群(即流行地区的居民)疾病的了解。为了制定有效的预防策略并促进适当和及时的诊断,我们需要做出巨大努力来阐明当地人口中的ATBF风险因素和临床表现。
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引用次数: 0
Evaluation of nutritional status using the minimum dietary diversity for women of reproductive age (MDD-W) tool in breastfeeding mothers in Madagascar. 使用马达加斯加育龄妇女最低膳食多样性(MDD-W)工具评估母乳喂养母亲的营养状况。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-05-08 DOI: 10.1111/tmi.14004
Rosita Rotella, José M Soriano, Isabel Peraita-Costa, Agustín Llopis-González, María Morales-Suarez-Varela

Objectives: Women of reproductive age in low-income countries are especially nutritionally vulnerable given the strain that pregnancy and lactation places on the body. The aim of this study was to identify dietary diversity and its associated factors among mothers with young children.

Methods: It is a cross-sectional study conducted in Ampefy, Madagascar from 1 November 2022 to 31 March 2023. Dietary diversity was determined using the minimum dietary diversity for women of reproductive age tool. Data were collected through face-to-face interviews using validated structured questionnaires, and anthropometric status was examined. Frequencies and percentages were calculated, and the comparison of variables was performed between mothers with acceptable and unacceptable dietary diversity using the chi-square test for qualitative variables. A logistic regression analysis was also conducted.

Results: A total of 437 mothers with young children participated in the study, resulting in a response rate of 95.0%. The mean age of the participants was 25.84 years (SD = 6.30). The study revealed that 32.95% of participants had unacceptable dietary diversity scores and the associated profile included low education, no transport, homebirth not by personal choice, not breastfeeding within the first hour of birth, not breastfeed exclusively for 6 months, no dietary changes during pregnancy or lactation, and no use of folic acid supplements.

Conclusion: This study's findings underscore the importance of providing nutrition information to women, in order to improve dietary diversity and overall maternal and child health.

目的:鉴于怀孕和哺乳对身体造成的压力,低收入国家的育龄妇女在营养方面尤其脆弱。本研究旨在确定有幼儿的母亲的饮食多样性及其相关因素:这是一项横断面研究,于 2022 年 11 月 1 日至 2023 年 3 月 31 日在马达加斯加安佩菲进行。使用育龄妇女最低膳食多样性工具确定膳食多样性。通过使用经过验证的结构化问卷进行面对面访谈收集数据,并检查人体测量状况。计算了频率和百分比,并对定性变量采用卡方检验对膳食多样性可接受和不可接受的母亲进行了变量比较。此外,还进行了逻辑回归分析:共有 437 名有幼儿的母亲参加了研究,回复率为 95.0%。参与者的平均年龄为 25.84 岁(标准差 = 6.30)。研究显示,32.95%的参与者的饮食多样性得分不可接受,相关特征包括受教育程度低、无交通工具、非个人选择在家分娩、出生后一小时内未进行母乳喂养、6 个月内未进行纯母乳喂养、孕期或哺乳期未改变饮食习惯以及未使用叶酸补充剂:这项研究的结果强调了向妇女提供营养信息的重要性,以便改善饮食多样性和整体母婴健康。
{"title":"Evaluation of nutritional status using the minimum dietary diversity for women of reproductive age (MDD-W) tool in breastfeeding mothers in Madagascar.","authors":"Rosita Rotella, José M Soriano, Isabel Peraita-Costa, Agustín Llopis-González, María Morales-Suarez-Varela","doi":"10.1111/tmi.14004","DOIUrl":"10.1111/tmi.14004","url":null,"abstract":"<p><strong>Objectives: </strong>Women of reproductive age in low-income countries are especially nutritionally vulnerable given the strain that pregnancy and lactation places on the body. The aim of this study was to identify dietary diversity and its associated factors among mothers with young children.</p><p><strong>Methods: </strong>It is a cross-sectional study conducted in Ampefy, Madagascar from 1 November 2022 to 31 March 2023. Dietary diversity was determined using the minimum dietary diversity for women of reproductive age tool. Data were collected through face-to-face interviews using validated structured questionnaires, and anthropometric status was examined. Frequencies and percentages were calculated, and the comparison of variables was performed between mothers with acceptable and unacceptable dietary diversity using the chi-square test for qualitative variables. A logistic regression analysis was also conducted.</p><p><strong>Results: </strong>A total of 437 mothers with young children participated in the study, resulting in a response rate of 95.0%. The mean age of the participants was 25.84 years (SD = 6.30). The study revealed that 32.95% of participants had unacceptable dietary diversity scores and the associated profile included low education, no transport, homebirth not by personal choice, not breastfeeding within the first hour of birth, not breastfeed exclusively for 6 months, no dietary changes during pregnancy or lactation, and no use of folic acid supplements.</p><p><strong>Conclusion: </strong>This study's findings underscore the importance of providing nutrition information to women, in order to improve dietary diversity and overall maternal and child health.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"622-632"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epidemiology of cutaneous leishmaniasis in children of Khyber Pakhtunkhwa, Pakistan. 巴基斯坦开伯尔-普赫图赫瓦儿童皮肤利什曼病流行病学。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-05-13 DOI: 10.1111/tmi.14005
Chao Lu, Khurshaid Khan, Fawad Khan, Safeer Ullah Shah, Muhsin Jamal, Noor Badshah

Objectives: In Pakistan, cutaneous leishmaniasis is an emerging tropical disease and a very high number (>70%) of children are afflicted by this marring infection. This study aimed to scrutinise the prevalence, spatial distribution and socio-demographic and behavioural risk factors associated with cutaneous leishmaniasis in children aged <5-15  years in Khyber Pakhtunkhwa.

Methods: A total of 1, 559 clinically confirmed records of children diagnosed with cutaneous leishmaniasis (January-December) from 2020 and 2022 were obtained from selected district hospitals. In addition, a risk factors-related questionnaire was administered to 1, 011 households (400 in 2020 and 611 in 2022) in nine districts during a household survey.

Results: The maximum number of cutaneous leishmaniasis cases was recorded in 2022 (n = 877, 56.25%) as compared to 2020 (n = 682, 43.75%). The hospital records showed a greater number of male patients in the 2022 cohort (n = 603, 68.76%). The highest number of cases were observed in children aged 5-9 years in 2022 (n = 282, 32.16%) and 2020 (n = 255, 37.39%). In 2020 and 2022, cutaneous leishmaniasis cases showed peak aggregation in March (n = 118, 17.3%) and January (n = 322, 36.72%). From a spatial analysis, the maximum number of cutaneous leishmaniasis cases was recorded at 59-1700 m elevation in various land-use/land-cover and climatic regions with quaternary alluvium rock formations. A multivariate logistic regression model analysis of risk factors from the households survey suggested that age group, socio-economic status, construction materials of the house, use of insect repellents, Afghan refugee camps in the village/district, knowledge and biting times of sand flies, frequent use of mosquito bed nets, presence of domestic animals in the house, knowledge of the transmission period and peak month of leishmaniasis infection increased the risk of acquiring cutaneous leishmaniasis (p  value < 0.05).

Conclusion: Our analysis demonstrated that cutaneous leishmaniasis in children is influenced by a variety of environmental, socio-demographic and behavioural risk factors in Khyber Pakhtunkhwa. The increase in recorded cases of cutaneous leishmaniasis in children in 2022 compared to 2020 suggests that the infection likely extended to new foci in the province.

目标:在巴基斯坦,皮肤利什曼病是一种新出现的热带疾病,有大量儿童(超过 70%)受到这种严重感染的困扰。本研究旨在仔细研究与皮肤利什曼病相关的儿童患病率、空间分布、社会人口和行为风险因素:从选定的地区医院获取了 1 559 份经临床确诊的 2020 年至 2022 年(1 月至 12 月)皮肤利什曼病儿童病历。此外,在家庭调查期间,还对九个地区的 1 011 个家庭(2020 年 400 个,2022 年 611 个)进行了风险因素相关问卷调查:与 2020 年(682 例,43.75%)相比,2022 年的皮肤利什曼病病例数最多(877 例,56.25%)。医院记录显示,2022 年男性患者人数较多(n = 603,68.76%)。2022 年和 2020 年,5-9 岁儿童病例数最多,分别为 282 例(32.16%)和 255 例(37.39%)。2020 年和 2022 年,皮肤利什曼病病例在 3 月(118 例,17.3%)和 1 月(322 例,36.72%)出现聚集高峰。从空间分析来看,在海拔 59-1700 米的不同土地利用/土地覆盖和气候区域以及第四纪冲积岩层中,皮肤利什曼病病例数最多。对住户调查中的风险因素进行的多变量逻辑回归模型分析表明,年龄组、社会经济地位、房屋的建筑材料、驱虫剂的使用、村/区内的阿富汗难民营、对沙蝇的了解和叮咬时间、蚊帐的频繁使用、屋内是否有家畜、对利什曼病传播期和感染高峰月的了解都会增加感染皮肤利什曼病的风险(P 值 结论):我们的分析表明,开伯尔巴图克瓦省的儿童皮肤利什曼病受到各种环境、社会人口和行为风险因素的影响。与 2020 年相比,2022 年记录在案的儿童皮肤利什曼病病例有所增加,这表明该省的利什曼病感染可能扩展到了新的病灶。
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引用次数: 0
Risk factors for the development of severe or very severe respiratory syncytial virus-related lower respiratory tract infection in Indian infants: A cohort study in Melghat, India. 印度婴儿发生严重或极严重呼吸道合胞病毒相关下呼吸道感染的风险因素:印度梅尔加特的一项队列研究。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-05-13 DOI: 10.1111/tmi.14003
Rowena Crow, Ashish Satav, Varsha Potdar, Shilpa Satav, Vibhawari Dani, Eric A F Simões

Objectives: Respiratory syncytial virus (RSV) is undoubtedly the single most important cause of severe lower respiratory tract infection (LRTI) globally. While new prevention measures in young infants have become available, their use in developing countries is likely many years away. While risk factors for severe or very severe RSV LRTI in impoverished rural areas likely differ to urban areas, there are very few studies, especially those conducted in India, the major country contributing to the global burden of disease.

Methods: Active surveillance for acute LRTI in enrolled infants and children <2 years of age, was conducted through weekly home visits in 93 villages of Melghat, India, from August 2016 to December 2020. Local hospitals and primary health centres were surveyed for admissions of enrolled subjects. Nasopharyngeal swabs were collected from children with severe, or very severe LRTIs and all who died, with RSV testing using nucleic acid tests at ICMR, National Institute of Virology Pune. Risk factors for both RSV associated and non-RSV associated, severe and very severe LRTI were identified through univariate and multivariate logistic regression.

Results: There were 483 severe or very severe RSV LRTI cases and 2807 non-RSV severe or very severe LRTI infections in a cohort of 13,318 children. Weight for age z-score ≤-2, the use of kerosene or wood for cooking, obtaining drinking water from a public tap and low gestational age significantly increased the risk of RSV LRTI. A higher wealth score index and water purification were protective. Comparison with non-RSV LRTI showed male sex as an additional risk factor. The analysis highlighted the risk of kerosene use [OR = 17.8 (3.0-104.4) (p ≤ 0.001)] and [OR = 3.4 (0.8-14.4) (p ≤ 0.05)] for RSV and non-RSV LRTIs, respectively.

Conclusions: Nutritional status and environmental air quality are predisposing factors for developing an RSV LRI in young children, factors which are amenable to environmental and behavioural interventions.

目的:呼吸道合胞病毒(RSV)无疑是导致全球严重下呼吸道感染(LRTI)的最重要原因。虽然已经有了针对幼儿的新预防措施,但在发展中国家使用这些措施可能还需要很多年。虽然贫困农村地区发生严重或非常严重的 RSV LRTI 的风险因素可能与城市地区不同,但这方面的研究却很少,尤其是在造成全球疾病负担的主要国家印度:方法:对入组婴幼儿的急性 LRTI 进行主动监测 结果:共发现 483 例严重或非常严重的 LRTI:在 13,318 名儿童中,有 483 例严重或非常严重的 RSV LRTI 病例和 2807 例非 RSV 严重或非常严重的 LRTI 感染。体重年龄 Z 值≤-2、使用煤油或木柴做饭、从公共水龙头获取饮用水和低胎龄会显著增加 RSV LRTI 的风险。较高的财富指数和水净化则具有保护作用。与非 RSV LRTI 相比,男性是另一个风险因素。分析结果表明,使用煤油[OR = 17.8 (3.0-104.4) (p ≤ 0.001)]和[OR = 3.4 (0.8-14.4) (p ≤ 0.05)]对RSV LRTI和非RSV LRTI分别具有风险:营养状况和环境空气质量是幼儿患 RSV LRI 的易感因素,这些因素可通过环境和行为进行干预。
{"title":"Risk factors for the development of severe or very severe respiratory syncytial virus-related lower respiratory tract infection in Indian infants: A cohort study in Melghat, India.","authors":"Rowena Crow, Ashish Satav, Varsha Potdar, Shilpa Satav, Vibhawari Dani, Eric A F Simões","doi":"10.1111/tmi.14003","DOIUrl":"10.1111/tmi.14003","url":null,"abstract":"<p><strong>Objectives: </strong>Respiratory syncytial virus (RSV) is undoubtedly the single most important cause of severe lower respiratory tract infection (LRTI) globally. While new prevention measures in young infants have become available, their use in developing countries is likely many years away. While risk factors for severe or very severe RSV LRTI in impoverished rural areas likely differ to urban areas, there are very few studies, especially those conducted in India, the major country contributing to the global burden of disease.</p><p><strong>Methods: </strong>Active surveillance for acute LRTI in enrolled infants and children <2 years of age, was conducted through weekly home visits in 93 villages of Melghat, India, from August 2016 to December 2020. Local hospitals and primary health centres were surveyed for admissions of enrolled subjects. Nasopharyngeal swabs were collected from children with severe, or very severe LRTIs and all who died, with RSV testing using nucleic acid tests at ICMR, National Institute of Virology Pune. Risk factors for both RSV associated and non-RSV associated, severe and very severe LRTI were identified through univariate and multivariate logistic regression.</p><p><strong>Results: </strong>There were 483 severe or very severe RSV LRTI cases and 2807 non-RSV severe or very severe LRTI infections in a cohort of 13,318 children. Weight for age z-score ≤-2, the use of kerosene or wood for cooking, obtaining drinking water from a public tap and low gestational age significantly increased the risk of RSV LRTI. A higher wealth score index and water purification were protective. Comparison with non-RSV LRTI showed male sex as an additional risk factor. The analysis highlighted the risk of kerosene use [OR = 17.8 (3.0-104.4) (p ≤ 0.001)] and [OR = 3.4 (0.8-14.4) (p ≤ 0.05)] for RSV and non-RSV LRTIs, respectively.</p><p><strong>Conclusions: </strong>Nutritional status and environmental air quality are predisposing factors for developing an RSV LRI in young children, factors which are amenable to environmental and behavioural interventions.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"612-621"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of a rapid diagnostic test for detection of Vibrio cholerae O1 in the Democratic Republic of the Congo: Preventative intervention for cholera for 7 days (PICHA7 program). 刚果民主共和国霍乱弧菌 O1 检测快速诊断测试评估:霍乱 7 天预防性干预(PICHA7 计划)。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-05-22 DOI: 10.1111/tmi.13998
Christine Marie George, Alves Namunesha, Willy Felicien, Kelly Endres, Wensheng Luo, Lucien Bisimwa, Camille Williams, Jean-Claude Bisimwa, Presence Sanvura, Jamie Perin, Justin Bengehya, Ghislain Maheshe, David A Sack, Cirhuza Cikomola, Alain Mwishingo

Objective: Globally, there are estimated to be 2.9 million cholera cases annually. Early detection of cholera outbreaks is crucial for resource allocation for case management and for targeted interventions to be delivered to stop the spread of cholera. In resource limited settings such as Eastern Democratic Republic of the Congo (DRC), there is often limited laboratory capacity for analysing stool samples for cholera by bacterial culture. Therefore, rapid diagnostic tests (RDTs) for cholera present a promising tool to rapidly test stool samples in a health facility setting for cholera. Our objective is to evaluate the Crystal VC O1 RDT for cholera detection compared with bacterial culture and polymerase chain reaction (PCR) for Vibrio cholerae.

Methods: From March 2020 to December 2022, stool samples were collected from 644 diarrhoea patients admitted to 94 health facilities in Bukavu in Eastern DRC. Patient stool samples were analysed by Crystal VC O1 RDT for cholera and by bacterial culture and PCR for V. cholerae O1.

Results: Twenty six percent of diarrhoea patients (166/644) had stool samples positive for cholera by RDT, and 24% (152/644) had stool samples positive for V. cholerae O1 by bacterial culture or PCR. The overall specificity and sensitivity of the Crystal VC O1 RDT by direct testing was 94% (95% confidence interval [CI]: 92%-96%) and 90% (95% CI, 84%-94%), respectively, when compared with either a positive result by bacterial culture or PCR.

Conclusion: Our findings suggest that the Crystal VC O1 RDT presents a promising tool for cholera surveillance in this cholera endemic setting in sub-Saharan Africa.

目标:全球每年估计有 290 万例霍乱病例。及早发现霍乱疫情对于分配资源进行病例管理以及采取有针对性的干预措施阻止霍乱蔓延至关重要。在刚果民主共和国东部(DRC)等资源有限的地区,实验室通过细菌培养分析霍乱粪便样本的能力往往有限。因此,霍乱快速诊断检测(RDT)是在卫生机构环境中快速检测粪便样本是否含有霍乱的一种很有前途的工具。我们的目标是评估 Crystal VC O1 RDT 在霍乱检测中与细菌培养和聚合酶链反应(PCR)检测霍乱弧菌的效果:从 2020 年 3 月到 2022 年 12 月,在刚果民主共和国东部布卡武的 94 家医疗机构采集了 644 名腹泻患者的粪便样本。通过 Crystal VC O1 RDT 对患者粪便样本进行霍乱分析,并通过细菌培养和 PCR 对霍乱弧菌 O1 进行分析:26%的腹泻患者(166/644)粪便样本经 RDT 检测霍乱呈阳性,24%的腹泻患者(152/644)粪便样本经细菌培养或 PCR 检测霍乱弧菌 O1 呈阳性。与细菌培养或 PCR 阳性结果相比,直接检测 Crystal VC O1 RDT 的总体特异性和灵敏度分别为 94%(95% 置信区间 [CI]:92%-96%)和 90%(95% CI:84%-94%):我们的研究结果表明,在撒哈拉以南非洲霍乱流行的环境中,Crystal VC O1 RDT 是一种很有前途的霍乱监测工具。
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引用次数: 0
Tuberculosis impacts multiple aspects in quality of life in a Romanian cohort of drug-susceptible and drug resistant patients: A patient-reported outcome measures study. 结核病对罗马尼亚一批药物敏感和耐药患者生活质量的多方面影响:患者报告结果测量研究。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-05-24 DOI: 10.1111/tmi.13996
Ioana Margineanu, Teodora Butnaru, Marjolein Lam, Dragos Baiceanu, Raluca Dragomir, Adriana Sorete Arbore, Beatrice Mahler, Ioana Munteanu, Florin Mihaltan, Onno Akkerman, Jan-Willem Alffenaar, Ymkje Stienstra

Background: Tuberculosis (TB), and especially its drug resistant forms, is responsible for not only significant mortality, but also considerable morbidity, still under-quantified. This study used four Patient-Reported Outcome Measures (PROMS) to assess the status of persons affected by drug-susceptible and drug-resistant TB during their TB treatment or after treatment completion, in Romania, the highest TB burden country in the EU.

Methods: People affected by TB in two different regions in Romania were included during and after treatment, following a cross-sectional design. PROMs used were SF-36, EQ-5D-5L, WPAI and the app-based audiometry screening tool 'uHear.' Descriptive statistics and relevant statistical tests were used to compare groups between themselves and with the general Romanian population.

Results: Both patients with drug-susceptible and drug-resistant TB experience, with drug-resistant patients experiencing statistically significantly more pain and hearing loss. PROMs show some improvement in the after-treatment group; however, compared with the general Romanian population for which data were available, all groups scored lower on all outcome measures.

Conclusion: PROMs offer the possibility of obtaining a more comprehensive view of patients' status, by involving them directly in the medical process and could guide a rehabilitation strategy.

背景:结核病(TB),尤其是耐药性结核病,不仅造成了大量死亡,而且还导致了相当高的发病率,但目前对结核病的发病率仍未充分量化。本研究使用了四种患者报告结果测量方法(PROMS),以评估欧盟结核病负担最重的国家罗马尼亚的耐药性结核病患者在结核病治疗期间或治疗结束后的状况:方法:采用横断面设计,将罗马尼亚两个不同地区的结核病患者纳入治疗期间和治疗结束后的情况。使用的 PROMs 包括 SF-36、EQ-5D-5L、WPAI 和基于应用程序的听力筛查工具 "uHear"。描述性统计和相关统计检验用于比较各组之间以及与罗马尼亚一般人群之间的差异:结果:耐药性和药敏性肺结核患者都经历了疼痛和听力损失,耐药性患者的疼痛和听力损失明显高于药敏性患者。PROMs显示,治疗后组别患者的情况有所改善;然而,与有数据可查的罗马尼亚普通人群相比,所有组别的患者在所有结果指标上的得分都较低:通过让患者直接参与医疗过程,PROM 可以更全面地了解患者的状况,并为康复策略提供指导。
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引用次数: 0
Neighbourhood factors and tuberculosis incidence in Cape Town: A negative binomial regression and spatial analysis. 开普敦的邻里因素与结核病发病率:负二项式回归与空间分析。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-05-16 DOI: 10.1111/tmi.14001
M Molemans, L Kayaert, Q Olislagers, S Abrahams, N Berkowitz, E Mohr-Holland, D McKelly, R Wood, F van Leth, S Hermans

Objectives: Although the link between poverty and tuberculosis (TB) is widely recognised, limited studies have investigated the association between neighbourhood factors and TB incidence. Since the factors influencing different episodes of TB might be different, this study focused on the first episode of TB disease (first-episode TB).

Methods: All first episodes in previously linked and geocoded TB notification data from 2007 to 2015 in Cape Town, South Africa, were aggregated at the neighbourhood level and merged with the 2011 census data. We conducted an ecological study to assess the association between neighbourhood incidence of first-episode TB and neighbourhood factors (total TB burden [all episodes] in the previous year, socioeconomic index, mean household size, mean age, and percentage males) using a negative binomial regression. We also examined the presence of hotspots in neighbourhood TB incidence with the Global Moran's I statistic and assessed spatial dependency in the association between neighbourhood factors and TB incidence using a spatial lag model.

Results: The study included 684 neighbourhoods with a median first-episode TB incidence rate of 114 (IQR: 0-345) per 100,000 people. We found lower neighbourhood socioeconomic index (SEI), higher neighbourhood total TB burden, lower neighbourhood mean household size, and lower neighbourhood mean age were associated with increased neighbourhood first-episode TB incidence. Our findings revealed a hotspot of first-episode TB incidence in Cape Town and evidence of spatial dependency in the association between neighbourhood factors and TB incidence.

Conclusion: Neighbourhood TB burden and SEI were associated with first-episode TB incidence, and there was spatial dependency in this association. Our findings can inform targeted interventions to reduce TB in high-risk neighbourhoods, thereby reducing health disparities and promoting health equity.

研究目的尽管贫困与肺结核(TB)之间的联系已得到广泛认可,但有关邻里因素与肺结核发病率之间关系的研究却十分有限。由于影响不同肺结核发病的因素可能不同,本研究重点关注肺结核病的首次发病(首次肺结核):我们将南非开普敦 2007 年至 2015 年的结核病通报数据与 2011 年的人口普查数据进行了邻里层面的汇总,并合并了这些数据。我们进行了一项生态学研究,采用负二项回归法评估了邻近地区肺结核首次发病率与邻近地区因素(前一年的肺结核总负担[所有发病]、社会经济指数、平均家庭规模、平均年龄和男性比例)之间的关联。我们还利用全球莫兰 I 统计检验了邻近地区肺结核发病率是否存在热点,并利用空间滞后模型评估了邻近地区因素与肺结核发病率之间的空间依赖性:研究共包括 684 个社区,其肺结核首次发病率中位数为每 10 万人 114 例(IQR:0-345)。我们发现,较低的居民区社会经济指数(SEI)、较高的居民区结核病总负担、较低的居民区平均家庭规模和较低的居民区平均年龄与居民区结核病首次发病率的增加有关。我们的研究结果表明,开普敦是肺结核首次发病的热点地区,也证明了邻里因素与肺结核发病率之间的空间依赖性:结论:邻里肺结核负担和 SEI 与肺结核首次发病率有关,而且这种关联存在空间依赖性。我们的研究结果可为有针对性的干预措施提供依据,以减少高风险社区的结核病发病率,从而缩小健康差距,促进健康公平。
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引用次数: 0
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Tropical Medicine & International Health
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