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A Journey of Hope: giving research participants a voice to share their experiences and improve community engagement around advanced HIV disease in Uganda 希望之旅:让研究参与者有机会分享他们的经验,并在乌干达改善社区对晚期艾滋病毒疾病的参与
Q2 Multidisciplinary Pub Date : 2020-07-27 DOI: 10.12688/aasopenres.13104.1
F. Cresswell, J. Kasibante, E. Martyn, L. Tugume, G. Stead, Kenneth Ssembambulidde, M. Rutakingirwa, E. Kagimu, Laura Nsangi, Carol Namuju, J. F. Ndyetukira, C. Ahimbisibwe, Florence Kugonza, Alisat Sadiq, Alice Namudde, Joanna Dobbin, Diksha Srishyla, C. Quinn, Mable Kabahubya, C. Muzoora, Stephen Watiti, D. Meya, A. Elliott
Over the last decade excellent progress has been made globally in HIV management thanks to antiretroviral therapy (ART) rollout and international guidelines now recommending immediate initiation of ART in people living with HIV. Despite this, advanced HIV disease (CD4 less than 200 cells/mL) and opportunistic infections remain a persistent challenge and contribute significantly to HIV-associated mortality, which equates to 23,000 deaths in Uganda in 2018 alone. Our Meningitis Research Team based in Uganda is committed to conducting clinical trials to answer important questions regarding diagnostics and management of HIV-associated opportunistic infections, including tuberculosis and cryptococcal meningitis. However, clinical research is impossible without research participants and results are meaningless unless they are translated into benefits for those affected by the disease. Therefore, we held a series of community engagement events with the aims of 1) giving research participants a voice to share their experiences of clinical research and messages of hope around advanced HIV disease with the community, 2) dispelling myths and stigma around HIV, and 3) raising awareness about the complications of advanced HIV disease and local clinical research and recent scientific advances. The purpose of this Open Letter is to describe our community engagement experience in Uganda, where we aimed to give clinical research participants a greater voice to share their experiences. These activities build upon decades of work in HIV community engagement and lays a platform for future research and engagement activities.
在过去十年中,由于抗逆转录病毒疗法(ART)的推广以及目前建议艾滋病毒感染者立即开始抗逆转录病毒疗法的国际指南,全球在艾滋病毒管理方面取得了巨大进展。尽管如此,晚期艾滋病毒疾病(CD4细胞低于200细胞/mL)和机会性感染仍然是一个持续的挑战,并显著导致艾滋病毒相关死亡率,仅2018年乌干达就有2.3万人死亡。我们在乌干达的脑膜炎研究小组致力于开展临床试验,以回答与艾滋病毒相关的机会性感染(包括结核病和隐球菌性脑膜炎)的诊断和管理方面的重要问题。然而,没有研究参与者的临床研究是不可能的,除非将结果转化为对受疾病影响的人的益处,否则这些结果是没有意义的。因此,我们举办了一系列的社区参与活动,目的是1)让研究参与者有机会与社区分享他们的临床研究经验和关于晚期艾滋病毒疾病的希望信息,2)消除对艾滋病毒的误解和污名,以及3)提高对晚期艾滋病毒疾病并发症和本地临床研究和最新科学进展的认识。这封公开信的目的是描述我们在乌干达的社区参与经验,我们的目标是让临床研究参与者有更大的发言权来分享他们的经验。这些活动建立在数十年来艾滋病毒社区参与工作的基础上,并为未来的研究和参与活动奠定了平台。
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引用次数: 1
Strengthening research management and support services in sub-Saharan African universities and research institutions. 加强撒哈拉以南非洲大学和研究机构的研究管理和支助服务。
Q2 Multidisciplinary Pub Date : 2020-07-20 DOI: 10.12688/aasopenres.13100.1
J. Pulford, Susie Crossman, Sara Begg, Jessica Amegee Quach, P. Abomo, T. El Hajj, I. Bates
Background: International development partners and research councils are increasingly funding research management and support (RMS) capacity strengthening initiatives in sub-Saharan Africa (SSA) as part of a broader investment in strengthening national and regional research systems.  However, the evidence-base to inform RMS capacity strengthening initiatives is limited at present. This research note presents a synthesis of 28 RMS capacity assessments completed in 25 universities/research institutions from across 15 SSA countries between 2014 and 2018.  Methods: All 28 capacity assessments were completed following a standardised methodology consisting of semi-structured interviews conducted with research and research support staff at the respective institution as well as document reviews and observation of onsite facilities. Data were extracted from the 28 reports detailing the findings of each assessment according to a framework synthesis approach. Results: In total, 13 distinct capacity gap categories emerged from across the 28 RMS capacity assessment reports.  Almost all the institutions assessed faced significant gaps in RMS capacity within and across each of these 13 categories. The 13 categories were not independent of each other and were often closely inter-connected. Commonalities were also evident across multiple categories, the two most obvious of which were severe fiscal constraints and the often-complex bureaucracy of the institutional operating environment. Conclusions: The synthesis findings reveal multiple, commonly shared RMS capacity gaps in universities and research institutions across SSA. No single intervention type, or focus, would be sufficient to strengthen capacity across all 13 areas; rather, what is needed to facilitate a significant shift in RMS capacity within such SSA universities and research institutions is a combination of interventions, consisting of differing levels of cost and complexity, variously led (or supported) by both internal and external actors.
背景:国际发展伙伴和研究理事会越来越多地资助撒哈拉以南非洲(SSA)的研究管理和支持(RMS)能力加强倡议,作为加强国家和区域研究系统的更广泛投资的一部分。然而,目前为RMS能力加强举措提供信息的证据基础有限。本研究报告综合了2014年至2018年间在15个SSA国家的25所大学/研究机构完成的28项RMS能力评估。方法:所有28项能力评估均按照标准化方法完成,该方法包括与各自机构的研究和研究支持人员进行半结构化访谈,以及文件审查和现场设施观察。数据摘自28份报告,其中详细介绍了根据框架综合方法进行的每次评估的结果。结果:在28份RMS能力评估报告中,总共出现了13种不同的能力差距类别。几乎所有被评估的机构在这13个类别内和之间都面临着显著的RMS能力差距。这13个类别并不是相互独立的,往往是紧密相连的。在多个类别中也有明显的共性,其中最明显的两个是严重的财政限制和机构运作环境中往往复杂的官僚主义。结论:综合研究结果揭示了整个SSA地区的大学和研究机构存在多重共同的RMS能力差距。任何单一的干预类型或重点都不足以加强所有13个领域的能力;相反,在这些SSA大学和研究机构中,促进RMS能力的重大转变所需要的是由内部和外部行动者不同程度地领导(或支持)的干预措施的组合,这些干预措施由不同水平的成本和复杂性组成。
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引用次数: 4
Impact of malaria on haematological parameters of urban, peri-urban and rural residents in the Ashanti region of Ghana: a cross-sectional study. 疟疾对加纳阿散蒂地区城市、城郊和农村居民血液学参数的影响:一项横断面研究。
Q2 Multidisciplinary Pub Date : 2020-07-09 eCollection Date: 2019-01-01 DOI: 10.12688/aasopenres.12979.3
Abdul-Hakim Mutala, Kingsley Badu, Christian Owusu, Samuel Kekeli Agordzo, Austine Tweneboah, Dawood Ackom Abbas, Matthew Glover Addo

Background: We aimed at investigating the impact of malaria on the haematological parameters of residents from different demographic settlements in the Ashanti Region of Ghana. Malaria parasites trigger changes in certain haematological parameters, which may result in a number of clinical manifestations. Differences in demographic settlements, such as rural, peri-urban and urban settlements may also influence these changes, but this has not been extensively studied in Ghana. Methods: We conducted a hospital-based, cross-sectional study from January to December 2018 in three different settlements. A total of 598 participants were recruited. Blood smears were examined to detect and quantify malaria parasitaemia, while haematological parameters were measured using a haematology analyser. Results: Participants from the rural settlement had the highest malaria prevalence (21.3%) compared to urban (11.8%) and peri-urban areas (13.3%); however, the peri-urban area had the highest median parasite density (568; IQR=190.0-1312.0). Age was significantly associated with the odds of malaria positivity (OR: 0.97; CI:0.96 - 0.99;  p=4.96*10 -4). When haematological parameters of the malaria-infected study participants were compared to the parameters of uninfected participants, red blood cell count (p=0.017), haemoglobin (p=0.0165), haematocrit (p=0.0015), mean corpuscular volume (p=0.0014), plateletcrit (p<0.0001) and platelet count (p<0.0001) were all significantly lower in the malaria infected group. In addition to age, haemoglobin and plateletcrit levels were also inversely correlated with the odds of testing positive for malaria, suggesting that children who were anaemic and/or thrombocytopaenic were likely to be infected. After fitting the data to a logistic regression model comprising the three variables, the model correctly categorised 78% of uninfected study participants, but only 50% of the malaria-positive participants. Conclusions: Study participants who were positive for malaria were younger and had low haemoglobin and plateletcrit levels compared to uninfected individuals. Further studies are needed to more precisely elucidate the relationship between malaria infection,demographic and haematological parameters.

背景:我们的目的是调查疟疾对加纳阿散蒂地区不同人口居住区居民血液学参数的影响。疟疾寄生虫会引起某些血液参数的变化,从而导致一系列临床表现。农村、城郊和城市等不同人口居住区的差异也可能影响这些变化,但加纳尚未对此进行广泛研究。研究方法我们于 2018 年 1 月至 12 月在三个不同的居住区开展了一项基于医院的横断面研究。共招募了 598 名参与者。对血液涂片进行检查,以检测和量化疟疾寄生虫血症,同时使用血液分析仪测量血液学参数。结果显示与城市地区(11.8%)和城郊地区(13.3%)相比,农村地区的疟疾感染率最高(21.3%);然而,城郊地区的寄生虫密度中位数最高(568;IQR=190.0-1312.0)。年龄与疟疾阳性几率明显相关(OR:0.97;CI:0.96 - 0.99;P=4.96*10 -4)。与未感染者相比,疟疾检测呈阳性的研究参与者更年轻,血红蛋白和血小板crit水平更低。需要进一步研究,以更准确地阐明疟疾感染、人口统计学和血液学参数之间的关系。
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引用次数: 0
Economic value, endogenous knowledge and distribution of Picralima nitida (Stapf) T. Durand and H. Durand in Africa 非洲野檀(Picralima nitida, Stapf) T. Durand和H. Durand的经济价值、内生知识和分布
Q2 Multidisciplinary Pub Date : 2020-07-06 DOI: 10.12688/aasopenres.13087.1
G. C. Akabassi, E. Padonou, Achille Ephrem Assogbajo, Noël Zirihi Guede
Background: Picralima nitida (Apocynaceae) is an important African medicinal plant species. It is frequently used in traditional medicine and pharmaceutical industries for manufacture of drugs against infectious diseases, malaria, diabetes and cancer. Despite its important, the species can be rare, especially in the Dahomey Gap (in contrast to the Guineo-Congolese region). There is also a controversy on its distribution. Without knowing the drivers of plant species rarity it is impossible to address the issue of the controversy of its distribution and unsustainable use as well as safeguarding endogenous knowledge of its uses.  Methods: Ethnobotanical surveys were conducted in the Dahomey Gap with 120 informants randomly interviewed. A literature review of scientific papers and books was used to provide information on the uses, distribution and threats of the species in the Guineo-Congolese region. Results: The results revealed that P. nitida products were more expensive in the Dahomey Gap than the Guineo-Congolese region. All parts of the species were collected and used for 34 treatments. The species had low density and distribution in Dahomey Gap compared to the Guineo-Congolese region. Conclusions: P. nitida is used across its distribution areas with important economic values. Adapted management strategies are needed for the sustainable use and conservation of the species..
背景:夹竹桃是非洲重要的药用植物。它经常被用于传统医学和制药行业,用于生产抗传染病、疟疾、糖尿病和癌症的药物。尽管它很重要,但这种物种可能很罕见,尤其是在达荷美峡谷(与几内亚-刚果地区形成对比)。关于它的分布也存在争议。如果不了解植物物种稀有性的驱动因素,就不可能解决其分布和不可持续使用的争议问题,也不可能保护其使用的内在知识。方法:在达荷美峡谷进行民族植物学调查,随机抽取120名调查对象。对科学论文和书籍进行了文献综述,以提供有关该物种在几内亚-刚果地区的使用、分布和威胁的信息。结果:结果显示,尼蒂达在达荷美峡的产品比几内亚-刚果地区更贵。收集了该物种的所有部分,并进行了34次处理。与几内亚-刚果地区相比,该物种在达荷美峡的密度和分布较低。结论:P.nitida在其分布区域具有重要的经济价值。为了可持续利用和保护该物种,需要采取适当的管理策略。。
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引用次数: 4
COVID-19 and the HIV care continuum in Uganda: minimising collateral damage 乌干达的COVID-19和艾滋病毒护理连续性:尽量减少附带损害
Q2 Multidisciplinary Pub Date : 2020-07-02 DOI: 10.12688/aasopenres.13099.1
E. Kagimu, E. Martyn, J. Gakuru, J. Kasibante, M. Rutakingirwa, Richard Kwizera, K. Ssebambulidde, Darlisha A Williams, J. Ellis, F. Cresswell, D. Meya
The novel coronavirus, SARS-CoV-2, has spread across the world within months of its first description in Wuhan, China in December 2019, resulting in an unprecedented global health emergency. Whilst Europe and North America are the current epicentres of infection, the global health community are preparing for the potential effects of this new disease on the African continent. Modelling studies predict that factors such as  youthful and rural population may be protective in mitigating the spread of COVID-19 in the World Health Organisation (WHO) African Region, however, with 220 million infections and 4.6 million hospitalisations predicted in the first year of the pandemic alone, fragile health systems could still be placed under significant strain. Furthermore, subsequent disruptions to the provision of services for people living with HIV, or at risk of acquiring HIV, are predicted to lead to an extra 500,000 adult HIV deaths and a 2-fold increase in mother to child transmission of HIV in sub-Saharan Africa in 2020-2021. Ignoring these predictions may have severe consequences and we risk “stepping back in time” in AIDS-related deaths to numbers seen over a decade ago. Reflecting on our current experience of the COVID-19 pandemic in Uganda, we explore the potential impact of public health measures implemented to mitigate spread of COVID-19 on the HIV care continuum, and suggest areas of focus for HIV services, policy makers and governments to urgently address in order to minimise the collateral damage.
新型冠状病毒,即SARS-CoV-2,在2019年12月在中国武汉首次被描述后的几个月内就在世界各地传播,导致了前所未有的全球卫生紧急情况。虽然欧洲和北美是目前的感染中心,但全球卫生界正在为这种新疾病对非洲大陆的潜在影响做准备。建模研究预测,年轻人和农村人口等因素可能对减缓新冠肺炎在世界卫生组织(世界卫生组织)非洲地区的传播具有保护作用,然而,仅在大流行的第一年就预测有2.2亿人感染和460万人住院,脆弱的卫生系统仍可能面临巨大压力。此外,预计2020-2021年,为艾滋病毒感染者或有感染艾滋病毒风险的人提供服务的后续中断将导致撒哈拉以南非洲新增50万成人艾滋病毒死亡,艾滋病毒母婴传播增加2倍。忽视这些预测可能会产生严重后果,我们有可能将艾滋病相关死亡人数“倒退”到十多年前的水平。根据我们目前在乌干达新冠肺炎大流行的经验,我们探讨了为减缓新冠肺炎传播而实施的公共卫生措施对艾滋病毒护理连续性的潜在影响,并建议艾滋病毒服务、政策制定者和政府紧急解决的重点领域,以最大限度地减少附带损害。
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引用次数: 2
COVID-19 and food security in Africa: Building more resilient food systems. 2019冠状病毒病与非洲粮食安全:建设更具抵御力的粮食系统。
Q2 Multidisciplinary Pub Date : 2020-06-26 eCollection Date: 2020-01-01 DOI: 10.12688/aasopenres.13078.1
Helena Shilomboleni

The COVID-19 pandemic has exposed the fragility of our food systems. Despite increased efficiencies in producing and supplying large volumes of food, our current food systems have generated multiple adverse outcomes comprising high greenhouse gas emissions, persistent hunger, and livelihood stress for farmers around the world. Nowhere else than in Africa have large numbers of people experienced more acutely these adverse shocks emanating from our food systems. Thus, building more resilient African food systems, which take a radical change of direction, is fundamentally a matter of survival. While there is broad consensus around a need for transformational change in food systems, what that entails is not always clear, and there are divergent views amongst experts on how to re-orient research priorities and agricultural solutions in ways that effectively address hunger and inequality while also protecting agrobiodiversity and the environment more broadly. This article engages with this debate and proposes an agricultural research for development agenda in Africa that balances technology transfer with realigning societal values, institutional arrangements, and policy decision-making towards the realization of greater sustainability and inclusive outcomes.

2019冠状病毒病大流行暴露了我们粮食系统的脆弱性。尽管大量粮食的生产和供应效率有所提高,但我们目前的粮食系统产生了多种不利后果,包括温室气体排放高、持续饥饿和世界各地农民的生计压力。在非洲,没有任何地方比非洲更严重地经历了来自我们粮食系统的这些不利冲击。因此,建立更具抵御力的非洲粮食系统,彻底改变方向,从根本上说是关乎生存的问题。虽然人们普遍认为需要对粮食系统进行转型变革,但这需要什么并不总是明确的,专家们对如何重新确定研究重点和农业解决方案的方向存在分歧,以便有效解决饥饿和不平等问题,同时更广泛地保护农业生物多样性和环境。本文参与了这一辩论,并提出了一项促进非洲发展议程的农业研究,以平衡技术转让与重新调整社会价值观、制度安排和政策决策,以实现更大的可持续性和包容性成果。
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引用次数: 13
Seroprevalence, risk factors and impact of Toxoplasma gondii infection on haematological parameters in the Ashanti region of Ghana: a cross-sectional study. 加纳阿散蒂地区弓形虫感染的血清流行率、风险因素及其对血液学参数的影响:一项横断面研究。
Q2 Multidisciplinary Pub Date : 2020-06-17 eCollection Date: 2019-01-01 DOI: 10.12688/aasopenres.13022.2
Samuel Kekeli Agordzo, Kingsley Badu, Mathew Glover Addo, Christian Kwasi Owusu, Abdul-Hakim Mutala, Austine Tweneboah, Dawood Ackom Abbas, Nana Kwame Ayisi-Boateng

Background: Toxoplasma gondii is an obligate, intracellular, apicomplexan parasite that causes toxoplasmosis. Although the global prevalence of toxoplasmosis has been estimated to be approximately 30%, there is limited seroprevalence data in Ghana, with a dearth of information on the impact of T. gondii on haematological parameters in exposed persons. Methods: Questionnaires were administered to 300 consenting individuals to obtain demographic information and assessment of their risk of exposure to T. gondii. Using anti- T. gondii IgG/IgM combo test kits, seropositivity to parasite-specific IgG and/or IgM was determined. A haematological analyser was used to measure haematological parameters. Results: There was an overall seroprevalence of 50.3% (n=151), with 49.7% (n=149) of the study participants seropositive for IgG and 1% (n=3) testing positive for IgM. Furthermore, the observed seroprevalence among pregnant women was 56.4% (n=62). With regard to settlement type, a seroprevalence of 55.6% was observed in the rural community, 50.6% in the peri-urban community and 47.1% in the urban community. The study identified cat ownership, contact with cat litter, contact with raw meat  [RR (95% CI: 1.76 (1.23-2.53), 1.66 (1.03-2.67), 1.25(1.00-1.57)] and age (p<0.001) as risk factors for infection. Analyses of haematological data revealed significant reduction in the white blood cell, lymphocytes and mean corpuscular volume levels in seropositive males (p=0.0223, 0.0275, and 0.0271) respectively. Only the mean corpuscular volume of seropositive females reduced significantly as compared to the seronegative counterparts (p=0.0035).  Conclusions: About half of the study population, including women of reproductive age carried antibodies against T. gondii, raising concerns about the risk of congenital toxoplasmosis and anaemia. We, therefore, recommend that screening for Toxoplasma gondii be included in the routine screening of pregnant women seeking antenatal care and further investigation should be conducted on the haematological implications of infection in humans.

背景:弓形虫(Toxoplasma gondii)是一种必须寄生于细胞内的 apicomplexan 寄生虫,可导致弓形虫病。尽管弓形虫病的全球流行率估计约为 30%,但加纳的血清流行率数据有限,而且有关弓形虫对接触者血液学参数的影响的信息也很匮乏。研究方法对 300 名征得同意的人进行问卷调查,以获得人口统计学信息并评估他们暴露于淋病的风险。使用抗淋病双球菌 IgG/IgM 组合检测试剂盒,测定寄生虫特异性 IgG 和/或 IgM 的血清阳性率。使用血液分析仪测量血液参数。结果总体血清阳性率为 50.3%(n=151),其中 49.7%(n=149)的参与者 IgG 血清阳性,1%(n=3)的参与者 IgM 阳性。此外,在孕妇中观察到的血清阳性率为 56.4%(n=62)。在居住地类型方面,农村社区的血清阳性率为 55.6%,城郊社区为 50.6%,城市社区为 47.1%。该研究确定了养猫、接触猫砂、接触生肉[RR(95% CI:1.76(1.23-2.53)、1.66(1.03-2.67)、1.25(1.00-1.57)]和年龄(p结论:包括育龄妇女在内的研究人群中约有半数携带淋球菌抗体,这引起了人们对先天性弓形虫病和贫血风险的担忧。因此,我们建议将弓形虫筛查纳入孕妇产前检查的常规项目,并进一步研究人类感染弓形虫对血液学的影响。
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引用次数: 0
Ethical challenges in community engagement practices in research during the COVID-19 pandemic in Africa 非洲新冠肺炎大流行期间社区参与研究实践中的伦理挑战
Q2 Multidisciplinary Pub Date : 2020-06-11 DOI: 10.12688/aasopenres.13084.1
P. Tindana, J. de Vries, Dorcas Kamuya
Community engagement (CE) has been highlighted as a key process in the prevention and transmission control of coronavirus disease 2019 (COVID-19). However, the nature of the virus and national response strategies such as social distancing have challenged traditional methods of community engagement. In this paper, we discuss the role of community engagement in research during COVID-19. We first set out the case for community engagement that emerges from international guidance for research during public health emergencies. We then describe the challenges that are emerging with community engagement in health research generally, and on COVID-19 related research specifically in Africa in the context of the COVID-19 pandemic. We further describe the strengths and weaknesses of the current engagement and communication platforms, and suggest ways to overcome some of these challenges. We provide an ethical argument for researchers and research institutions to respond directly to addressing the COVID-19 pandemic by responding to emergency health care needs of the community; and provide some challenges and critiques of such an approach. Finally, we support the call for concerted efforts in responding to the global pandemic, requiring flexibility in funding.
社区参与(CE)已被强调为2019冠状病毒病(新冠肺炎)预防和传播控制的关键过程。然而,病毒的性质和保持社交距离等国家应对策略对传统的社区参与方法提出了挑战。在这篇论文中,我们讨论了新冠肺炎期间社区参与在研究中的作用。我们首先阐述了公共卫生紧急情况下国际研究指导意见中提出的社区参与的理由。然后,我们描述了社区参与卫生研究的总体挑战,以及在新冠肺炎大流行背景下,特别是在非洲开展的新冠肺炎相关研究的挑战。我们进一步描述了当前参与和沟通平台的优势和劣势,并提出了克服其中一些挑战的方法。我们为研究人员和研究机构提供了一个道德论据,通过应对社区的紧急医疗需求,直接应对新冠肺炎大流行;并对这种方法提出了一些挑战和批评。最后,我们支持一致努力应对全球疫情的呼吁,这需要资金的灵活性。
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引用次数: 11
Impact of malaria on haematological parameters of urban, peri-urban and rural residents in the Ashanti region of Ghana: a cross-sectional study. 疟疾对加纳阿散蒂地区城市、城郊和农村居民血液参数的影响:一项横断面研究。
Q2 Multidisciplinary Pub Date : 2020-06-05 DOI: 10.12688/aasopenres.12979.2
Abdul-Hakim Mutala, K. Badu, C. Owusu, Samuel Kekeli Agordzo, Austine Tweneboah, Dawood Ackom Abbas, M. Addo
Background: We aimed at investigating the impact of malaria on the haematological parameters of residents from different demographic settlements in the Ashanti Region of Ghana. Malaria parasites trigger changes in certain haematological parameters, which may result in a number of clinical manifestations. Differences in demographic settlements, such as rural, peri-urban and urban settlements may also influence these changes, but this has not been extensively studied in Ghana. Methods: We conducted a hospital-based, cross-sectional study from January to December 2018 in three different settlements. A total of 598 participants were recruited. Blood smears were examined to detect and quantify malaria parasitaemia, while haematological parameters were measured using a haematology analyser. Results: Participants from the rural settlement had the highest malaria prevalence (21.3%) compared to the urban (11.8%) and peri-urban areas (13.3%); however, the peri-urban area had the highest median parasite density (568; IQR=190.0-1312.0). Age was significantly associated with the odds of malaria positivity (OR: 0.97; CI:0.96 - 0.99). When haematological parameters of the malaria-infected study participants were compared to the parameters of uninfected participants, red blood cell count (p=0.017), haemoglobin (p=0.0165), haematocrit (p=0.0015), mean corpuscular volume (p=0.0014), plateletcrit (p<0.0001) and platelet count (p<0.0001) were all significantly lower in the malaria infected group. In addition to age, haemoglobin and plateletcrit levels were also inversely correlated with the odds of testing positive for malaria, suggesting that children who were anaemic and/or thrombocytopaenic were likely to be infected. After fitting the data to a logistic regression model comprising the three variables, the model correctly categorised 78% of uninfected study participants, but only 50% of the malaria-positive participants. Conclusions: Study participants who were positive for malaria were younger and had low haemoglobin and plateletcrit levels compared to uninfected individuals. Further studies are needed to more precisely elucidate the relationship between malaria infection,demographic and haematological parameters.
背景:我们旨在调查疟疾对加纳阿散蒂地区不同人口住区居民血液学参数的影响。疟疾寄生虫引发某些血液学参数的变化,这可能导致一些临床表现。人口住区,如农村、城郊和城市住区的差异也可能影响这些变化,但在加纳尚未对此进行广泛研究。方法:2018年1月至12月,我们在三个不同的定居点进行了一项以医院为基础的横断面研究。总共招募了598名参与者。检查了血液涂片以检测和量化疟疾寄生虫病,同时使用血液学分析仪测量了血液学参数。结果:农村居民点疟疾患病率最高(21.3%),高于城市(11.8%)和城郊(13.3%);城市周边地区寄生虫中位密度最高(568;差= 190.0 - -1312.0)。年龄与疟疾阳性的几率显著相关(OR: 0.97;Ci:0.96 - 0.99)。当将疟疾感染研究参与者的血液学参数与未感染参与者的参数进行比较时,疟疾感染组的红细胞计数(p=0.017)、血红蛋白(p=0.0165)、红细胞比容(p=0.0015)、平均红细胞体积(p=0.0014)、血小板比容(p<0.0001)和血小板计数(p<0.0001)均显著低于未感染组。除年龄外,血红蛋白和血小板水平也与疟疾检测呈阳性的几率呈负相关,这表明贫血和/或血小板减少的儿童很可能受到感染。在将数据拟合到包含三个变量的逻辑回归模型后,该模型正确地分类了78%的未感染研究参与者,但只有50%的疟疾阳性参与者。结论:与未感染的个体相比,疟疾阳性的研究参与者更年轻,血红蛋白和血小板水平也较低。需要进一步的研究来更准确地阐明疟疾感染、人口统计学和血液学参数之间的关系。
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引用次数: 0
Impact of 1.5 oC and 2 oC global warming scenarios on malaria transmission in East Africa. 1.5℃和2℃全球变暖情景对东非疟疾传播的影响。
Q2 Multidisciplinary Pub Date : 2020-06-03 eCollection Date: 2020-01-01 DOI: 10.12688/aasopenres.13074.3
Obed Matundura Ogega, Moses Alobo

Background: Malaria remains a global challenge with approximately 228 million cases and 405,000 malaria-related deaths reported in 2018 alone; 93% of which were in sub-Saharan Africa. Aware of the critical role than environmental factors play in malaria transmission, this study aimed at assessing the relationship between precipitation, temperature, and clinical malaria cases in East Africa and how the relationship may change under 1.5 oC and 2.0 oC global warming levels (hereinafter GWL1.5 and GWL2.0, respectively). Methods: A correlation analysis was done to establish the current relationship between annual precipitation, mean temperature, and clinical malaria cases. Differences between annual precipitation and mean temperature value projections for periods 2008-2037 and 2023-2052 (corresponding to GWL1.5 and GWL2.0, respectively), relative to the control period (1977-2005), were computed to determine how malaria transmission may change under the two global warming scenarios. Results: A predominantly positive/negative correlation between clinical malaria cases and temperature/precipitation was observed. Relative to the control period, no major significant changes in precipitation were shown in both warming scenarios. However, an increase in temperature of between 0.5 oC and 1.5 oC and 1.0 oC to 2.0 oC under GWL1.5 and GWL2.0, respectively, was recorded. Hence, more areas in East Africa are likely to be exposed to temperature thresholds favourable for increased malaria vector abundance and, hence, potentially intensify malaria transmission in the region. Conclusions: GWL1.5 and GWL2.0 scenarios are likely to intensify malaria transmission in East Africa. Ongoing interventions should, therefore, be intensified to sustain the gains made towards malaria elimination in East Africa in a warming climate.

背景:疟疾仍然是一项全球挑战,仅2018年就报告了约2.28亿例病例和40.5万例与疟疾有关的死亡;其中93%在撒哈拉以南非洲。认识到环境因素在疟疾传播中的关键作用,本研究旨在评估东非降水、温度与临床疟疾病例之间的关系,以及在1.5 oC和2.0 oC全球变暖水平下(分别为GWL1.5和GWL2.0)这种关系如何变化。方法:通过相关分析,建立年降水量、平均气温与临床疟疾病例的相关性。计算了2008-2037年和2023-2052年期间(分别对应GWL1.5和GWL2.0)的年降水量和平均温度值预估与对照期(1977-2005年)的差异,以确定在两种全球变暖情景下疟疾传播可能发生的变化。结果:临床疟疾病例与气温/降水呈显著正/负相关。与对照期相比,两种变暖情景下降水均未出现重大变化。而GWL1.5和GWL2.0的升温幅度分别为0.5 oC ~ 1.5 oC和1.0 oC ~ 2.0 oC。因此,东非更多地区可能面临有利于增加疟疾病媒数量的温度阈值,从而可能加剧该区域的疟疾传播。结论:GWL1.5和GWL2.0情景可能加剧东非的疟疾传播。因此,应加强目前的干预措施,以在气候变暖的情况下维持东非在消除疟疾方面取得的成果。
{"title":"Impact of 1.5 <sup>o</sup>C and 2 <sup>o</sup>C global warming scenarios on malaria transmission in East Africa.","authors":"Obed Matundura Ogega,&nbsp;Moses Alobo","doi":"10.12688/aasopenres.13074.3","DOIUrl":"https://doi.org/10.12688/aasopenres.13074.3","url":null,"abstract":"<p><p><b>Background:</b> Malaria remains a global challenge with approximately 228 million cases and 405,000 malaria-related deaths reported in 2018 alone; 93% of which were in sub-Saharan Africa. Aware of the critical role than environmental factors play in malaria transmission, this study aimed at assessing the relationship between precipitation, temperature, and clinical malaria cases in East Africa and how the relationship may change under 1.5 <sup>o</sup>C and 2.0 <sup>o</sup>C global warming levels (hereinafter GWL1.5 and GWL2.0, respectively). <b>Methods:</b> A correlation analysis was done to establish the current relationship between annual precipitation, mean temperature, and clinical malaria cases. Differences between annual precipitation and mean temperature value projections for periods 2008-2037 and 2023-2052 (corresponding to GWL1.5 and GWL2.0, respectively), relative to the control period (1977-2005), were computed to determine how malaria transmission may change under the two global warming scenarios. <b>Results</b>: A predominantly positive/negative correlation between clinical malaria cases and temperature/precipitation was observed. Relative to the control period, no major significant changes in precipitation were shown in both warming scenarios. However, an increase in temperature of between 0.5 <sup>o</sup>C and 1.5 <sup>o</sup>C and 1.0 <sup>o</sup>C to 2.0 <sup>o</sup>C under GWL1.5 and GWL2.0, respectively, was recorded. Hence, more areas in East Africa are likely to be exposed to temperature thresholds favourable for increased malaria vector abundance and, hence, potentially intensify malaria transmission in the region. <b>Conclusions</b>: GWL1.5 and GWL2.0 scenarios are likely to intensify malaria transmission in East Africa. Ongoing interventions should, therefore, be intensified to sustain the gains made towards malaria elimination in East Africa in a warming climate.</p>","PeriodicalId":34179,"journal":{"name":"AAS Open Research","volume":" ","pages":"22"},"PeriodicalIF":0.0,"publicationDate":"2020-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8008358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25585287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
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AAS Open Research
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