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Estimating dengue burden among family contacts through cluster investigation around probable cases in 2022 and 2023 in the Central Region, Burkina Faso. 通过对布基纳法索中部地区 2022 年和 2023 年可能出现的病例进行分组调查,估算家庭接触者的登革热负担。
IF 8.1 1区 医学 Pub Date : 2024-06-12 DOI: 10.1186/s40249-024-01212-5
Jean Claude Romaric Pingdwindé Ouédraogo, Sylvain Ilboudo, Prosper Bado, Tegwindé Rebeca Compaoré, Alix Tougma, Mathieu Nitiéma, Abdou Azaque Zouré, Lazare Belemnaba, Sylvin Ouédraogo, Léon Gueswendé Blaise Savadogo

Background: In 2023, Burkina Faso experienced the largest dengue epidemic ever in Africa. This study aimed to estimate the prevalence of symptomatic, subclinical, and asymptomatic dengue and determine the associated factors among adult contacts of dengue in the Central Region, Burkina Faso.

Methods: This cross-sectional study included contacts of dengue probable cases through cluster sampling in 2022-2023. These suspected cases that tested positive were identified from the five health facilities (Pissy CMA, Saaba CM, Kossodo CMA, Samandin CM, and Marcoussis CSPS) that reported the highest number of cases in 2021 per district. All participants underwent dengue and malaria rapid diagnostic tests (RDT). Samples positive for non-structural 1 protein antigen (AgNS1) and/or immunoglobulin M (IgM) were tested for serotype detection by reverse transcription polymerase chain reaction (RT-PCR). Binary logistic regression was done to identify the determinants of asymptomatic, subclinical, and symptomatic dengue among contacts of probable dengue cases.

Results: A total of 484 contacts were included, mostly in 2023 (75.2%). Most participants were females (58.6%), residing (24.3%) and passing their daytime (23.1%) in Saaba. The overall prevalence of dengue was estimated at 15.1% [95% confidence interval (CI): 12.0-18.6%], representing cases not seeking care in hospitals. Asymptomatic cases represented 2.9% (95% CI: 1.6-4.8%). Subclinical and symptomatic cases accounted for 6.0% (95% CI: 4.1-8.5%) and 6.2% (95% CI: 4.2-8.7%), respectively. Of the 58 samples tested by RT-PCR, 10 were confirmed for serotype 3 in 2023. Malaria cases were estimated at 5.6% (95% CI: 3.7-8.0%). After adjustment, participants claiming that a virus transmits dengue were likelier to have asymptomatic dengue [adjusted odds ratio (aOR) = 7.1, 95% CI: 2.4-21.0]. From the multivariable analysis, subclinical dengue was statistically associated with being included in the study in 2023 (aOR = 30.2, 95% CI: 2.0-455.5) and spending the daytime at Arrondissement 4 (aOR = 11.5, 95% CI: 1.0-131.0). After adjustment, symptomatic dengue was associated with living less than 50 m away from cultivated land (aOR = 2.8, 95% CI: 1.1-6.9) and living less than 50 m from a stretch of water (aOR = 0.1, 95% CI: 0.0-0.6).

Conclusions: The overall burden of dengue among populations not seeking care in hospitals was quite high, with few asymptomatic cases. Efforts to manage dengue cases should also target non-hospital cases and raise population awareness. The 2023 epidemic could be due to dengue virus (DENV)-3.

背景:2023年,布基纳法索经历了非洲有史以来最大规模的登革热疫情。本研究旨在估算布基纳法索中部地区成年登革热接触者中有症状、亚临床和无症状登革热的流行率,并确定相关因素:这项横断面研究在 2022-2023 年期间通过集群抽样的方式纳入了登革热疑似病例的接触者。这些检测呈阳性的疑似病例来自五个医疗机构(Pissy CMA、Saaba CM、Kossodo CMA、Samandin CM 和 Marcoussis CSPS),这五个医疗机构是 2021 年每个地区报告病例数最多的医疗机构。所有参与者都接受了登革热和疟疾快速诊断检测(RDT)。对非结构 1 蛋白抗原 (AgNS1) 和/或免疫球蛋白 M (IgM) 呈阳性的样本进行了反转录聚合酶链反应 (RT-PCR) 血清型检测。对可能登革热病例的接触者进行二元逻辑回归,以确定无症状、亚临床和有症状登革热的决定因素:共纳入了 484 名接触者,其中大部分为 2023 人(75.2%)。大多数参与者为女性(58.6%),居住在萨巴(24.3%),白天在萨巴逗留(23.1%)。登革热的总体流行率估计为 15.1%[95%置信区间 (CI):12.0-18.6%],其中包括未到医院就诊的病例。无症状病例占 2.9%(95% 置信区间:1.6-4.8%)。亚临床和无症状病例分别占 6.0% (95% CI: 4.1-8.5%) 和 6.2% (95% CI: 4.2-8.7%) 。在 RT-PCR 检测的 58 个样本中,2023 年有 10 个样本被确诊为血清 3 型。疟疾病例估计为 5.6%(95% CI:3.7-8.0%)。经过调整后,声称某种病毒会传播登革热的参与者更有可能感染无症状登革热[调整后的几率比(aOR)= 7.1,95% CI:2.4-21.0]。从多变量分析来看,亚临床登革热与 2023 年被纳入研究(aOR = 30.2,95% CI:2.0-455.5)和白天在第 4 区逗留(aOR = 11.5,95% CI:1.0-131.0)有统计学关系。经调整后,无症状登革热与居住地距离耕地不足 50 米(aOR = 2.8,95% CI:1.1-6.9)和居住地距离水域不足 50 米(aOR = 0.1,95% CI:0.0-0.6)有关:未到医院就诊的人群中登革热的总体负担相当高,无症状病例很少。管理登革热病例的工作也应针对非医院病例,并提高人们的认识。2023 年的流行病可能是由登革热病毒 (DENV)-3 引起的。
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引用次数: 0
Phylodynamics unveils invading and diffusing patterns of dengue virus serotype-1 in Guangdong, China from 1990 to 2019 under a global genotyping framework. 在全球基因分型框架下,系统动力学揭示了 1990 年至 2019 年登革热病毒血清 1 型在中国广东的入侵和扩散模式。
IF 8.1 1区 医学 Pub Date : 2024-06-11 DOI: 10.1186/s40249-024-01211-6
Lingzhai Zhao, Xiang Guo, Liqiang Li, Qinlong Jing, Jinmin Ma, Tian Xie, Dechun Lin, Li Li, Qingqing Yin, Yuji Wang, Xiaoqing Zhang, Ziyao Li, Xiaohua Liu, Tian Hu, Minling Hu, Wenwen Ren, Jun Li, Jie Peng, Lei Yu, Zhiqiang Peng, Wenxin Hong, Xingyu Leng, Lei Luo, Jone Jama Kpanda Ngobeh, Xiaoping Tang, Rangke Wu, Wei Zhao, Benyun Shi, Jiming Liu, Zhicong Yang, Xiao-Guang Chen, Xiaohong Zhou, Fuchun Zhang

Background: The strong invasiveness and rapid expansion of dengue virus (DENV) pose a great challenge to global public health. However, dengue epidemic patterns and mechanisms at a genetic scale, particularly in term of cross-border transmissions, remain poorly understood. Importation is considered as the primary driver of dengue outbreaks in China, and since 1990 a frequent occurrence of large outbreaks has been triggered by the imported cases and subsequently spread to the western and northern parts of China. Therefore, this study aims to systematically reveal the invasion and diffusion patterns of DENV-1 in Guangdong, China from 1990 to 2019.

Methods: These analyses were performed on 179 newly assembled genomes from indigenous dengue cases in Guangdong, China and 5152 E gene complete sequences recorded in Chinese mainland. The genetic population structure and epidemic patterns of DENV-1 circulating in Chinese mainland were characterized by phylogenetics, phylogeography, phylodynamics based on DENV-1 E-gene-based globally unified genotyping framework.

Results: Multiple serotypes of DENV were co-circulating in Chinese mainland, particularly in Guangdong and Yunnan provinces. A total of 189 transmission clusters in 38 clades belonging to 22 subgenotypes of genotype I, IV and V of DENV-1 were identified, with 7 Clades of Concern (COCs) responsible for the large outbreaks since 1990. The epidemic periodicity was inferred from the data to be approximately 3 years. Dengue transmission events mainly occurred from Great Mekong Subregion-China (GMS-China), Southeast Asia (SEA), South Asia Subcontinent (SASC), and Oceania (OCE) to coastal and land border cities respectively in southeastern and southwestern China. Specially, Guangzhou was found to be the most dominant receipting hub, where DENV-1 diffused to other cities within the province and even other parts of the country. Genome phylogeny combined with epidemiological investigation demonstrated a clear local consecutive transmission process of a 5C1 transmission cluster (5C1-CN4) of DENV-1 in Guangzhou from 2013 to 2015, while the two provinces of Guangdong and Yunnan played key roles in ongoing transition of dengue epidemic patterns. In contextualizing within Invasion Biology theories, we have proposed a derived three-stage model encompassing the stages of invasion, colonization, and dissemination, which is supposed to enhance our understanding of dengue spreading patterns.

Conclusions: This study demonstrates the invasion and diffusion process of DENV-1 in Chinese mainland within a global genotyping framework, characterizing the genetic diversities of viral populations, multiple sources of importation, and periodic dynamics of the epidemic. These findings highlight the potential ongoing transition trends from epidemic to endemic status offering a valuable insight into early warning, prevention and control of ra

背景:登革热病毒(DENV)的强侵袭性和快速扩张对全球公共卫生构成了巨大挑战。然而,人们对登革热流行模式和基因尺度上的机制,尤其是跨境传播方面,仍然知之甚少。输入性登革热被认为是中国登革热疫情暴发的主要驱动因素,自 1990 年以来,由输入性病例引发的大规模疫情暴发频繁发生,并随后蔓延至中国西部和北部地区。因此,本研究旨在系统揭示1990年至2019年DENV-1在中国广东的入侵和扩散模式:这些分析是在中国广东本土登革热病例的179个新组装基因组和中国大陆记录的5152个E基因完整序列上进行的。在基于DENV-1 E基因的全球统一基因分型框架下,通过系统发生学、系统地理学和系统动力学分析了在中国大陆流行的DENV-1的遗传种群结构和流行模式:结果:多种血清型的 DENV 在中国大陆共同流行,尤其是在广东和云南两省。结果:在中国大陆,特别是广东和云南两省,多种血清型的 DENV 共同流行,共发现了 38 个支系的 189 个传播群,分别属于 DENV-1 基因型 I、IV 和 V 的 22 个亚基因型,其中 7 个关注支系(COCs)是 1990 年以来大规模疫情爆发的原因。根据数据推断,流行周期约为 3 年。登革热传播事件主要从中国大湄公河次区域(GMS-China)、东南亚(SEA)、南亚次大陆(SASC)和大洋洲(OCE)分别向中国东南部和西南部的沿海和陆地边境城市传播。其中,广州是最主要的接收中心,DENV-1在广州扩散到省内其他城市甚至全国其他地区。基因组系统发育结合流行病学调查表明,2013年至2015年期间,广州存在一个明显的DENV-1 5C1传播集群(5C1-CN4)的本地连续传播过程,而广东和云南两省在登革热流行模式的持续转变中发挥了关键作用。在入侵生物学理论的背景下,我们提出了一个衍生的三阶段模型,包括入侵、定殖和传播阶段,该模型有望加深我们对登革热传播模式的理解:本研究在全球基因分型框架内展示了登革热病毒-1在中国大陆的入侵和传播过程,描述了病毒种群的遗传多样性、多种输入来源以及疫情的周期性动态。这些发现凸显了登革热从流行到流行的潜在过渡趋势,为中国乃至全球登革热的早期预警、预防和控制提供了宝贵的见解。
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引用次数: 0
Zoonotic human liver flukes, a type 1 biocarcinogen, in freshwater fishes: genetic analysis and confirmation of molluscan vectors and reservoir hosts in Bangladesh. 淡水鱼类中的人畜共患人类肝吸虫(一种 1 型生物致癌物):基因分析和孟加拉软体动物媒介与水库宿主的确认。
IF 8.1 1区 医学 Pub Date : 2024-06-01 DOI: 10.1186/s40249-024-01209-0
Sharmin Shahid Labony, Md Abdul Alim, Muhammad Mehedi Hasan, Md Shahadat Hossain, Sharmin Akter, Joydeep Paul, Thahsin Farjana, Md Haydar Ali, Mohammad Zahangir Alam, Takeshi Hatta, Hayato Kawada, Keiko Mizutani, Naotoshi Tsuji, Anisuzzaman

Background: Opisthorchiid flukes, particularly Opisthorchis viverrini, Opisthorchis felineus, Clonorchis sinensis, and Metorchis spp. are the most common fish-borne zoonotic human liver flukes (hLFs). Liver fluke infections are more prevalent in resource-deprived and underprivileged areas. We herein estimated the prevalence of the metacercariae (MC) of major hLFs in common large freshwater fishes (lFWF) marketed for human consumption from some selected areas of Bangladesh along with detection of their molluscan vectors and reservoirs.

Methods: The current status of fish-borne zoonotic hLF infections in lFWF was investigated along with their molluscan vectors and mammalian reservoir hosts in Mymensingh and Kishoreganj in Bangladesh from July 2018-June 2022 using conventional and multiple molecular techniques, such as PCR, PCR-restriction fragment length polymorphism (RFLP), sequencing, and bioinformatic analyses. The infection rate of fishes was analyzed using the Z-test and the loads of MC were compared using the chi-squared (χ2) test.

Results: The MC of C. sinensis, Opisthorchis spp., and Metorchis spp. were detected in 11 species of common and popular lFWF. In lFWF, the estimated prevalence was 18.7% and the mean load was 137.4 ± 149.8 MC per 100 g of fish. The prevalence was the highest (P < 0.05) in spotted snakehead fishes (Channa punctata, 63.6%). The highest rate of infection (P < 0.05) was observed with the MC of C. sinensis (11.8%). Metacercariae were almost equally (P > 0.05) distributed between the head and body of fishes. The infection rate was slightly higher in cultured (19.6%) fishes. The MC of C. sinensis, O. felineus, O. viverrini, and Metorchis orientalis in fishes were confirmed using PCR, PCR-RFLP and bioinformatics. The cercariae of opisthorchiid (Pleurolophocercus cercariae) flukes were only recovered from Bithynia spp. (3.9%, 42 out of 1089). The ova of hLFs from dogs (4.3%, 5 out of 116) and cats (6.0%, 6 out of 100), and adult flukes (M. orientalis) from ducks (41.1% 113 out of 275) were detected.

Conclusions: The MC of hLFs are highly prevalent in fresh water fishes in Bangladesh. Reservoir hosts, such as street dogs, cats, and ducks carried the patent infection, and residents of Bangladesh are at risk.

背景:肝吸虫(Opisthorchiid flukes),尤其是蝰蛇吸虫(Opisthorchis viverrini)、猫吸虫(Opisthorchis felineus)、中华绒吸虫(Clonorchis sinensis)和甲吸虫(Metorchis spp.),是最常见的鱼源性人畜共患人类肝吸虫(hLFs)。肝吸虫感染在资源匮乏和贫困地区更为普遍。在此,我们估算了孟加拉国一些选定地区市场上供人类食用的常见大型淡水鱼(lFWF)中主要肝吸虫变态蛔虫(MC)的流行率,并检测了其软体动物载体和水库:方法:2018 年 7 月至 2022 年 6 月期间,在孟加拉国的迈门辛和基肖尔甘杰,采用常规和多种分子技术,如 PCR、PCR-限制性片段长度多态性(RFLP)、测序和生物信息学分析等,调查了鱼源性人畜共患 hLF 感染的现状及其软体动物载体和哺乳动物水库宿主。用Z检验分析鱼类的感染率,用秩方(χ2)检验比较MC的载量:结果:在 11 种常见和常用的淡水鱼类中检测到了中华绒螯鱼、鲤形鳃鳃藻属和鲶形鳃鳃藻属的 MC。在淡水鱼中,估计流行率为 18.7%,每 100 克鱼的平均 MC 含量为 137.4 ± 149.8。鱼头和鱼身的感染率最高(P 0.05)。养殖鱼类的感染率略高(19.6%)。利用聚合酶链式反应(PCR)、聚合酶链式反应-RFLP和生物信息学方法确认了鱼类中的中华绒螯虫、绒螯虫、绒螯虫和东方绒螯虫。仅在 Bithynia spp.(1089 条中有 42 条,占 3.9%)中发现了钝头栉孔吸虫(Pleurolophocercus cercariae)的蚴虫。狗(4.3%,116 只中有 5 只)和猫(6.0%,100 只中有 6 只)的 hLFs 卵和鸭子(41.1%,275 只中有 113 只)的成虫(M. orientalis)也被检测到:结论:孟加拉国淡水鱼类中 hLFs MC 的流行率很高。街狗、猫和鸭等宿主携带专利感染,孟加拉国居民面临风险。
{"title":"Zoonotic human liver flukes, a type 1 biocarcinogen, in freshwater fishes: genetic analysis and confirmation of molluscan vectors and reservoir hosts in Bangladesh.","authors":"Sharmin Shahid Labony, Md Abdul Alim, Muhammad Mehedi Hasan, Md Shahadat Hossain, Sharmin Akter, Joydeep Paul, Thahsin Farjana, Md Haydar Ali, Mohammad Zahangir Alam, Takeshi Hatta, Hayato Kawada, Keiko Mizutani, Naotoshi Tsuji, Anisuzzaman","doi":"10.1186/s40249-024-01209-0","DOIUrl":"10.1186/s40249-024-01209-0","url":null,"abstract":"<p><strong>Background: </strong>Opisthorchiid flukes, particularly Opisthorchis viverrini, Opisthorchis felineus, Clonorchis sinensis, and Metorchis spp. are the most common fish-borne zoonotic human liver flukes (hLFs). Liver fluke infections are more prevalent in resource-deprived and underprivileged areas. We herein estimated the prevalence of the metacercariae (MC) of major hLFs in common large freshwater fishes (lFWF) marketed for human consumption from some selected areas of Bangladesh along with detection of their molluscan vectors and reservoirs.</p><p><strong>Methods: </strong>The current status of fish-borne zoonotic hLF infections in lFWF was investigated along with their molluscan vectors and mammalian reservoir hosts in Mymensingh and Kishoreganj in Bangladesh from July 2018-June 2022 using conventional and multiple molecular techniques, such as PCR, PCR-restriction fragment length polymorphism (RFLP), sequencing, and bioinformatic analyses. The infection rate of fishes was analyzed using the Z-test and the loads of MC were compared using the chi-squared (χ<sup>2</sup>) test.</p><p><strong>Results: </strong>The MC of C. sinensis, Opisthorchis spp., and Metorchis spp. were detected in 11 species of common and popular lFWF. In lFWF, the estimated prevalence was 18.7% and the mean load was 137.4 ± 149.8 MC per 100 g of fish. The prevalence was the highest (P < 0.05) in spotted snakehead fishes (Channa punctata, 63.6%). The highest rate of infection (P < 0.05) was observed with the MC of C. sinensis (11.8%). Metacercariae were almost equally (P > 0.05) distributed between the head and body of fishes. The infection rate was slightly higher in cultured (19.6%) fishes. The MC of C. sinensis, O. felineus, O. viverrini, and Metorchis orientalis in fishes were confirmed using PCR, PCR-RFLP and bioinformatics. The cercariae of opisthorchiid (Pleurolophocercus cercariae) flukes were only recovered from Bithynia spp. (3.9%, 42 out of 1089). The ova of hLFs from dogs (4.3%, 5 out of 116) and cats (6.0%, 6 out of 100), and adult flukes (M. orientalis) from ducks (41.1% 113 out of 275) were detected.</p><p><strong>Conclusions: </strong>The MC of hLFs are highly prevalent in fresh water fishes in Bangladesh. Reservoir hosts, such as street dogs, cats, and ducks carried the patent infection, and residents of Bangladesh are at risk.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"13 1","pages":"40"},"PeriodicalIF":8.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11143560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141185785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epidemiological and clinical trends of visceral leishmaniasis in Portugal: retrospective analysis of cases diagnosed in public hospitals between 2010 and 2020. 葡萄牙内脏利什曼病的流行病学和临床趋势:2010 年至 2020 年公立医院诊断病例的回顾性分析。
IF 8.1 1区 医学 Pub Date : 2024-06-01 DOI: 10.1186/s40249-024-01204-5
Rafael Rocha, Cláudia Conceição, Luzia Gonçalves, Carla Maia

Background: Leishmania infantum is endemic in the Mediterranean region, presenting mostly as visceral leishmaniasis (VL). In Portugal, reporting of VL cases to public health authorities is mandatory, but significant underreporting is likely. This study aimed to describe the epidemiological and clinical aspects of the VL cases diagnosed in hospitals of the Portuguese National Health Service (NHS), between 2010 and 2020.

Methods: Collaboration was requested to every hospital of the Portuguese NHS in Mainland Portugal. Cases were screened through a search of diagnostic discharge codes or, if not available, by a search of positive laboratory results for Leishmania infection. Sociodemographic and clinical data was retrieved from medical records. Simultaneously, the National Health authority was contacted to request access to data of notified cases of VL between 2010 and 2020. Descriptive, hypothesis testing and multiple binary logistic regression models were performed.

Results: A total of 221 VL cases were identified. A significant increase in estimated national incidence was seen in the years after 2016 (P = 0.030). VL was predominantly diagnosed in people living with HIV (PLWH) and in children (representing around 60% of the new cases), but the outcome was generally poorer in non-HIV patients with associated immunosuppression, with significantly lower rates of clinical improvement at 7 (P = 0.003) and 30 days (P = 0.008) after treatment. Atypical presentations, with gastrointestinal and/or respiratory involvement, were seen in 8.5% of VL cases. Hemophagocytic lymphohistiocytosis was diagnosed in 40.0% of children under 5 years of age. Only 49.7% of incident VL cases were reported. Simultaneous involvement of the skin was confirmed in 5.9% of patients.

Conclusions: VL presents a continuing threat in Portugal, especially to PLWH and children, and an increasing threat to other immunosuppressed groups. Recent increases in incidence should be closely monitored to allow prompt interventions. Programs to control the disease should focus on providing tools for earlier diagnosis and on reducing underreporting and promoting an integrated surveillance of human and animal disease. These data should be combined with asymptomatic infection and vector information, following a One Health approach.

背景:婴儿利什曼病在地中海地区流行,主要表现为内脏利什曼病(VL)。在葡萄牙,向公共卫生部门报告 VL 病例是强制性的,但可能存在严重的漏报现象。本研究旨在描述 2010 年至 2020 年葡萄牙国家卫生服务系统(NHS)医院诊断的 VL 病例的流行病学和临床方面:方法:要求葡萄牙国家医疗服务系统(NHS)在葡萄牙大陆的每家医院开展合作。病例通过搜索诊断出院代码进行筛选,如果没有,则通过搜索利什曼原虫感染的阳性实验室结果进行筛选。从医疗记录中检索社会人口学和临床数据。同时,我们还联系了国家卫生部门,要求其提供 2010 年至 2020 年间已通报的 VL 病例数据。研究采用了描述性、假设检验和多元二元逻辑回归模型:结果:共发现 221 例 VL 病例。在 2016 年之后的几年中,全国估计发病率出现了大幅增长(P = 0.030)。VL主要在艾滋病病毒感染者(PLWH)和儿童中确诊(约占新病例的60%),但在伴有免疫抑制的非艾滋病病毒感染者中,结果普遍较差,治疗后7天(P = 0.003)和30天(P = 0.008)的临床改善率明显较低。8.5%的VL病例有非典型表现,胃肠道和/或呼吸道受累。40.0% 的 5 岁以下儿童确诊为嗜血细胞性淋巴组织细胞增多症。只有 49.7% 的 VL 病例被报告。5.9%的患者证实皮肤同时受累:在葡萄牙,VL 仍是一种威胁,尤其是对 PLWH 和儿童,对其他免疫抑制群体的威胁也在增加。应密切关注近期发病率的增长,以便及时采取干预措施。控制该疾病的计划应侧重于提供早期诊断工具,减少漏报,促进对人类和动物疾病的综合监测。这些数据应与无症状感染和病媒信息相结合,采用 "统一健康 "方法。
{"title":"Epidemiological and clinical trends of visceral leishmaniasis in Portugal: retrospective analysis of cases diagnosed in public hospitals between 2010 and 2020.","authors":"Rafael Rocha, Cláudia Conceição, Luzia Gonçalves, Carla Maia","doi":"10.1186/s40249-024-01204-5","DOIUrl":"10.1186/s40249-024-01204-5","url":null,"abstract":"<p><strong>Background: </strong>Leishmania infantum is endemic in the Mediterranean region, presenting mostly as visceral leishmaniasis (VL). In Portugal, reporting of VL cases to public health authorities is mandatory, but significant underreporting is likely. This study aimed to describe the epidemiological and clinical aspects of the VL cases diagnosed in hospitals of the Portuguese National Health Service (NHS), between 2010 and 2020.</p><p><strong>Methods: </strong>Collaboration was requested to every hospital of the Portuguese NHS in Mainland Portugal. Cases were screened through a search of diagnostic discharge codes or, if not available, by a search of positive laboratory results for Leishmania infection. Sociodemographic and clinical data was retrieved from medical records. Simultaneously, the National Health authority was contacted to request access to data of notified cases of VL between 2010 and 2020. Descriptive, hypothesis testing and multiple binary logistic regression models were performed.</p><p><strong>Results: </strong>A total of 221 VL cases were identified. A significant increase in estimated national incidence was seen in the years after 2016 (P = 0.030). VL was predominantly diagnosed in people living with HIV (PLWH) and in children (representing around 60% of the new cases), but the outcome was generally poorer in non-HIV patients with associated immunosuppression, with significantly lower rates of clinical improvement at 7 (P = 0.003) and 30 days (P = 0.008) after treatment. Atypical presentations, with gastrointestinal and/or respiratory involvement, were seen in 8.5% of VL cases. Hemophagocytic lymphohistiocytosis was diagnosed in 40.0% of children under 5 years of age. Only 49.7% of incident VL cases were reported. Simultaneous involvement of the skin was confirmed in 5.9% of patients.</p><p><strong>Conclusions: </strong>VL presents a continuing threat in Portugal, especially to PLWH and children, and an increasing threat to other immunosuppressed groups. Recent increases in incidence should be closely monitored to allow prompt interventions. Programs to control the disease should focus on providing tools for earlier diagnosis and on reducing underreporting and promoting an integrated surveillance of human and animal disease. These data should be combined with asymptomatic infection and vector information, following a One Health approach.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"13 1","pages":"41"},"PeriodicalIF":8.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11143621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141185571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction: Malaria epidemiology, surveillance and response for elimination in Lao PDR. 更正:老挝人民民主共和国的疟疾流行病学、监测和消除对策。
IF 8.1 1区 医学 Pub Date : 2024-05-31 DOI: 10.1186/s40249-024-01210-7
Chawarat Rotejanaprasert, Vilayvone Malaphone, Mayfong Mayxay, Keobouphaphone Chindavongsa, Virasack Banouvong, Boualam Khamlome, Phoutnalong Vilay, Viengxay Vanisavaeth, Richard J Maude
{"title":"Correction: Malaria epidemiology, surveillance and response for elimination in Lao PDR.","authors":"Chawarat Rotejanaprasert, Vilayvone Malaphone, Mayfong Mayxay, Keobouphaphone Chindavongsa, Virasack Banouvong, Boualam Khamlome, Phoutnalong Vilay, Viengxay Vanisavaeth, Richard J Maude","doi":"10.1186/s40249-024-01210-7","DOIUrl":"10.1186/s40249-024-01210-7","url":null,"abstract":"","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"13 1","pages":"42"},"PeriodicalIF":8.1,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11140943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141187184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of test-and-treat model with direct-acting antiviral for hepatitis C virus infection in migrants: a prospective interventional study in Italy. 针对移民丙型肝炎病毒感染的直接作用抗病毒药物试验-治疗模式的有效性:意大利前瞻性干预研究。
IF 8.1 1区 医学 Pub Date : 2024-05-28 DOI: 10.1186/s40249-024-01200-9
Nicola Coppola, Loredana Alessio, Stefania De Pascalis, Margherita Macera, Giovanni Di Caprio, Vincenzo Messina, Lorenzo Onorato, Carmine Minichini, Maria Stanzione, Gianfranca Stornaiuolo, Mario Starace, Caterina Monari, Federica Calò, Caterina Sagnelli, Mariantonietta Pisaturo

Background: Migrants, mainly undocumented and low-income refugees, are at high risk of hepatitis C virus (HCV) infection, but are a difficult-to-reach and to-treat population. The aim of the study was to evaluate the effectiveness of a test and treat model with direct-acting antiviral for HCV infection in these migrants coming from low-income and living in southern Italy.

Methods: A prospective, multicenter, collaborative study based on a four-phase-program (educational counseling, screening, linkage-to-care and treatment) was designed in southern Italy; the study started in June 2018, was stopped in February 2020 because of the outbreak of SARS-CoV2 infection in Italy and was resumed in February 2021 until November 2021. After educational counseling on infectious diseases that are transmitted through blood or sexually pseudonymized HCV screening was offered to all undocumented migrants and low-income refugees observed at one of the 1st level clinical centers. The HCV-RNA-positive subjects were referred to one of the 3rd level units of Infectious Diseases (ID) and treated with a 12-week course of sofosbuvir-velpatasvir and observed for 12 weeks after the end of direct antiviral agents (DAA) treatment.

Statistical analysis: For the descriptive analysis, the categorical variables were reported as absolute numbers and relative frequencies. Continuous variables were summarized as mean and standard deviation (SD) if normally distributed, or as a median and interquartile range (IQR) if not normally distributed. We used Pearson chi-square or Fisher's exact test for categorical variables and Student's t test or Mann-Whitney test for continuous variables. A P value < 0.05 was considered to be statistically significant. Analyses were performed with SPSS 21.0.

Results: Of the 3501migrants observed in the study period, 3417 (97.6%) agreed to be screened; 185 (4.7%) were anti-HCV-positive and, of these, 53 (28.6%) were HCV-RNA-positive. Of these 53 subjects, 48 (90.5%) were referred to an ID unit and started DAA treatment. The HCV-RNA-positive-subjects were older [median 36 years (IQR: 32-21) vs 27.19 (IQR: 30.5-19.25); P = 0.001], and less frequently males [35 (66.03 %) vs 119 (90.1%), P < 0 .0001] than seronegative participants. They more frequently came from Eastern Europe (70.8%) stayed longer in Italy [months of stay in Italy, mean ± SD: 51.02 ± 52.84 vs 25.7 ± 42.65, P = 0.001], and had more years of schooling [years of schooling, mean ± SD: 9.61±2.81 vs 7.10 ± 4, P = 0.0001]. HCV-RNA-positive-subjects less frequently reported piercing, tattoos and tribal scars as risk factors (23.6%). Of these 48 HCV RNA positive subjects who started DAA, 47 (97.9%) showed a sustained virological response and one dropped-out in follow-up after DAA treatment. No subject had any adverse event.

Conclusions: This model of HCV screening and linkage to care seems e

背景:移民(主要是无证移民和低收入难民)是丙型肝炎病毒(HCV)感染的高危人群,但却是难以接触和治疗的人群。该研究旨在评估直接作用抗病毒药物检测和治疗模式对这些来自意大利南部低收入地区的移民感染丙型肝炎病毒的有效性:在意大利南部设计了一项基于四阶段计划(教育咨询、筛查、链接到护理和治疗)的前瞻性多中心合作研究;该研究于2018年6月启动,因意大利爆发SARS-CoV2感染而于2020年2月停止,并于2021年2月恢复至2021年11月。在对通过血液或性行为传播的传染病进行教育咨询后,在一家一级临床中心观察到的所有无证移民和低收入难民都接受了化名 HCV 筛查。HCV-RNA阳性受试者被转诊到传染病(ID)三级单位之一,接受为期12周的索非布韦-韦帕他韦治疗,并在直接抗病毒药物(DAA)治疗结束后观察12周:在描述性分析中,分类变量以绝对数和相对频率表示。连续变量如果呈正态分布,则以平均值和标准差(SD)表示;如果不呈正态分布,则以中位数和四分位数间距(IQR)表示。对于分类变量,我们采用皮尔逊卡方检验或费雪精确检验;对于连续变量,我们采用学生 t 检验或曼-惠尼检验。A P 值 结果:在研究期间观察到的 3501 名移民中,有 3417 人(97.6%)同意接受筛查;185 人(4.7%)为抗-HCV 阳性,其中 53 人(28.6%)为 HCV-RNA 阳性。在这 53 名受试者中,48 人(90.5%)被转诊至 ID 部门并开始接受 DAA 治疗。与血清阴性受试者相比,HCV-RNA 阳性受试者年龄更大[中位数为 36 岁(IQR:32-21) vs 27.19 岁(IQR:30.5-19.25);P = 0.001],男性更少[35 人(66.03%) vs 119 人(90.1%),P < 0.0001]。他们更多来自东欧(70.8%),在意大利逗留的时间更长[在意大利逗留的月数,平均±标准差:51.02±52.84 vs 25.7±42.65,P = 0.001],受教育年限更长[受教育年限,平均±标准差:9.61±2.81 vs 7.10±4,P = 0.0001]。HCV-RNA阳性受试者较少报告穿孔、纹身和部落疤痕是风险因素(23.6%)。在开始接受DAA治疗的48名HCV RNA阳性受试者中,47人(97.9%)出现了持续的病毒学应答,1人在DAA治疗后的随访中退出。没有受试者出现任何不良反应:结论:这种 HCV 筛查和联系治疗模式似乎能有效消除难以接触和治疗人群(如无证移民和低收入难民)的 HCV 感染。文化调解人参与这项研究,使移民与医生之间有了更好的互动,这一点从大量受试者的登记中可以看出。从公共卫生和医疗保健的角度来看,消除移民中的丙型肝炎病毒将产生长期的积极影响,因为这将减少可能患上丙型肝炎病毒相关并发症(如肝硬化和肝细胞癌)的人数,并减少丙型肝炎病毒在移民所在地区的传播,而这些地区(如意大利)往往是丙型肝炎病毒感染的低流行区。
{"title":"Effectiveness of test-and-treat model with direct-acting antiviral for hepatitis C virus infection in migrants: a prospective interventional study in Italy.","authors":"Nicola Coppola, Loredana Alessio, Stefania De Pascalis, Margherita Macera, Giovanni Di Caprio, Vincenzo Messina, Lorenzo Onorato, Carmine Minichini, Maria Stanzione, Gianfranca Stornaiuolo, Mario Starace, Caterina Monari, Federica Calò, Caterina Sagnelli, Mariantonietta Pisaturo","doi":"10.1186/s40249-024-01200-9","DOIUrl":"10.1186/s40249-024-01200-9","url":null,"abstract":"<p><strong>Background: </strong>Migrants, mainly undocumented and low-income refugees, are at high risk of hepatitis C virus (HCV) infection, but are a difficult-to-reach and to-treat population. The aim of the study was to evaluate the effectiveness of a test and treat model with direct-acting antiviral for HCV infection in these migrants coming from low-income and living in southern Italy.</p><p><strong>Methods: </strong>A prospective, multicenter, collaborative study based on a four-phase-program (educational counseling, screening, linkage-to-care and treatment) was designed in southern Italy; the study started in June 2018, was stopped in February 2020 because of the outbreak of SARS-CoV2 infection in Italy and was resumed in February 2021 until November 2021. After educational counseling on infectious diseases that are transmitted through blood or sexually pseudonymized HCV screening was offered to all undocumented migrants and low-income refugees observed at one of the 1st level clinical centers. The HCV-RNA-positive subjects were referred to one of the 3rd level units of Infectious Diseases (ID) and treated with a 12-week course of sofosbuvir-velpatasvir and observed for 12 weeks after the end of direct antiviral agents (DAA) treatment.</p><p><strong>Statistical analysis: </strong>For the descriptive analysis, the categorical variables were reported as absolute numbers and relative frequencies. Continuous variables were summarized as mean and standard deviation (SD) if normally distributed, or as a median and interquartile range (IQR) if not normally distributed. We used Pearson chi-square or Fisher's exact test for categorical variables and Student's t test or Mann-Whitney test for continuous variables. A P value < 0.05 was considered to be statistically significant. Analyses were performed with SPSS 21.0.</p><p><strong>Results: </strong>Of the 3501migrants observed in the study period, 3417 (97.6%) agreed to be screened; 185 (4.7%) were anti-HCV-positive and, of these, 53 (28.6%) were HCV-RNA-positive. Of these 53 subjects, 48 (90.5%) were referred to an ID unit and started DAA treatment. The HCV-RNA-positive-subjects were older [median 36 years (IQR: 32-21) vs 27.19 (IQR: 30.5-19.25); P = 0.001], and less frequently males [35 (66.03 %) vs 119 (90.1%), P < 0 .0001] than seronegative participants. They more frequently came from Eastern Europe (70.8%) stayed longer in Italy [months of stay in Italy, mean ± SD: 51.02 ± 52.84 vs 25.7 ± 42.65, P = 0.001], and had more years of schooling [years of schooling, mean ± SD: 9.61±2.81 vs 7.10 ± 4, P = 0.0001]. HCV-RNA-positive-subjects less frequently reported piercing, tattoos and tribal scars as risk factors (23.6%). Of these 48 HCV RNA positive subjects who started DAA, 47 (97.9%) showed a sustained virological response and one dropped-out in follow-up after DAA treatment. No subject had any adverse event.</p><p><strong>Conclusions: </strong>This model of HCV screening and linkage to care seems e","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"13 1","pages":"39"},"PeriodicalIF":8.1,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141159259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of climate change on the global circulation of West Nile virus and adaptation responses: a scoping review. 气候变化对西尼罗河病毒全球循环的影响及适应对策:范围审查。
IF 8.1 1区 医学 Pub Date : 2024-05-24 DOI: 10.1186/s40249-024-01207-2
Hao-Ran Wang, Tao Liu, Xiang Gao, Hong-Bin Wang, Jian-Hua Xiao

Background: West Nile virus (WNV), the most widely distributed flavivirus causing encephalitis globally, is a vector-borne pathogen of global importance. The changing climate is poised to reshape the landscape of various infectious diseases, particularly vector-borne ones like WNV. Understanding the anticipated geographical and range shifts in disease transmission due to climate change, alongside effective adaptation strategies, is critical for mitigating future public health impacts. This scoping review aims to consolidate evidence on the impact of climate change on WNV and to identify a spectrum of applicable adaptation strategies.

Main body: We systematically analyzed research articles from PubMed, Web of Science, Scopus, and EBSCOhost. Our criteria included English-language research articles published between 2007 and 2023, focusing on the impacts of climate change on WNV and related adaptation strategies. We extracted data concerning study objectives, populations, geographical focus, and specific findings. Literature was categorized into two primary themes: 1) climate-WNV associations, and 2) climate change impacts on WNV transmission, providing a clear understanding. Out of 2168 articles reviewed, 120 met our criteria. Most evidence originated from North America (59.2%) and Europe (28.3%), with a primary focus on human cases (31.7%). Studies on climate-WNV correlations (n = 83) highlighted temperature (67.5%) as a pivotal climate factor. In the analysis of climate change impacts on WNV (n = 37), most evidence suggested that climate change may affect the transmission and distribution of WNV, with the extent of the impact depending on local and regional conditions. Although few studies directly addressed the implementation of adaptation strategies for climate-induced disease transmission, the proposed strategies (n = 49) fell into six categories: 1) surveillance and monitoring (38.8%), 2) predictive modeling (18.4%), 3) cross-disciplinary collaboration (16.3%), 4) environmental management (12.2%), 5) public education (8.2%), and 6) health system readiness (6.1%). Additionally, we developed an accessible online platform to summarize the evidence on climate change impacts on WNV transmission ( https://2xzl2o-neaop.shinyapps.io/WNVScopingReview/ ).

Conclusions: This review reveals that climate change may affect the transmission and distribution of WNV, but the literature reflects only a small share of the global WNV dynamics. There is an urgent need for adaptive responses to anticipate and respond to the climate-driven spread of WNV. Nevertheless, studies focusing on these adaptation responses are sparse compared to those examining the impacts of climate change. Further research on the impacts of climate change and adaptation strategies for vector-borne diseases, along with more comprehensive evidence synthesis, is needed to inform effective policy responses tailored to local cont

背景:西尼罗河病毒(WNV)是全球分布最广的黄病毒,可引起脑炎,是一种具有全球重要性的病媒传播病原体。不断变化的气候将重塑各种传染病的格局,尤其是像西尼罗河病毒这样的病媒传播疾病。了解气候变化导致疾病传播的预期地理和范围变化以及有效的适应战略,对于减轻未来的公共卫生影响至关重要。本范围综述旨在整合有关气候变化对 WNV 影响的证据,并确定一系列适用的适应策略:我们系统分析了来自 PubMed、Web of Science、Scopus 和 EBSCOhost 的研究文章。我们的标准包括 2007 年至 2023 年间发表的英文研究文章,重点关注气候变化对 WNV 的影响以及相关的适应策略。我们提取了有关研究目标、研究人群、地域重点和具体发现的数据。文献主要分为两个主题:1)气候与 WNV 的关联;2)气候变化对 WNV 传播的影响。在2168篇被审查的文章中,有120篇符合我们的标准。大多数证据来自北美(59.2%)和欧洲(28.3%),主要关注人类病例(31.7%)。关于气候与 WNV 相关性的研究(n = 83)强调温度(67.5%)是关键的气候因素。在分析气候变化对 WNV 的影响时(n = 37),大多数证据表明,气候变化可能会影响 WNV 的传播和分布,影响程度取决于当地和区域条件。尽管很少有研究直接涉及针对气候引起的疾病传播实施适应策略,但提出的策略(n = 49)可分为六类:1)监视和监测(38.8%);2)预测建模(18.4%);3)跨学科合作(16.3%);4)环境管理(12.2%);5)公众教育(8.2%);6)卫生系统准备(6.1%)。此外,我们还开发了一个可访问的在线平台,以总结气候变化对 WNV 传播影响的证据 ( https://2xzl2o-neaop.shinyapps.io/WNVScopingReview/ )。结论:本综述显示,气候变化可能会影响 WNV 的传播和分布,但文献仅反映了全球 WNV 动态的一小部分。目前迫切需要采取适应性应对措施,以预测和应对由气候驱动的 WNV 传播。然而,与研究气候变化影响的研究相比,关注这些适应性应对措施的研究还很少。需要进一步研究气候变化的影响和病媒传播疾病的适应策略,并进行更全面的证据综合,以便为因地制宜的有效对策提供信息。
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引用次数: 0
Geography and health: role of human translocation and access to care. 地理与健康:人类迁移和获得医疗服务的作用。
IF 8.1 1区 医学 Pub Date : 2024-05-23 DOI: 10.1186/s40249-024-01205-4
Norbert Brattig, Robert Bergquist, Danielle Vienneau, Xiao-Nong Zhou

Natural, geographical barriers have historically limited the spread of communicable diseases. This is no longer the case in today's interconnected world, paired with its unprecedented environmental and climate change, emphasising the intersection of evolutionary biology, epidemiology and geography (i.e. biogeography). A total of 14 articles of the special issue entitled "Geography and health: role of human translocation and access to care" document enhanced disease transmission of diseases, such as malaria, leishmaniasis, schistosomiasis, COVID-19 (Severe acute respiratory syndrome corona 2) and Oropouche fever in spite of spatiotemporal surveillance. High-resolution satellite images can be used to understand spatial distributions of transmission risks and disease spread and to highlight the major avenue increasing the incidence and geographic range of zoonoses represented by spill-over transmission of coronaviruses from bats to pigs or civets. Climate change and globalization have increased the spread and establishment of invasive mosquitoes in non-tropical areas leading to emerging outbreaks of infections warranting improved physical, chemical and biological vector control strategies. The translocation of pathogens and their vectors is closely connected with human mobility, migration and the global transport of goods. Other contributing factors are deforestation with urbanization encroaching into wildlife zones. The destruction of natural ecosystems, coupled with low income and socioeconomic status, increase transmission probability of neglected tropical and zoonotic diseases. The articles in this special issue document emerging or re-emerging diseases and surveillance of fever symptoms. Health equity is intricately connected to accessibility to health care and the targeting of healthcare resources, necessitating a spatial approach. Public health comprises successful disease management integrating spatial surveillance systems, including access to sanitation facilities. Antimicrobial resistance caused, e.g. by increased use of antibiotics in health, agriculture and aquaculture, or acquisition of resistance genes, can be spread by horizontal gene transfer. This editorial reviews the key findings of this 14-article special issue, identifies important gaps relevant to our interconnected world and makes a number of specific recommendations to mitigate the transmission risks of infectious diseases in the post-COVID-19 pandemic era.

历史上,自然和地理障碍限制了传染病的传播。在当今这个相互联系的世界中,这种情况已不复存在,再加上前所未有的环境和气候变化,强调了进化生物学、流行病学和地理学(即生物地理学)之间的交叉。在题为 "地理与健康:人类迁移的作用和获得护理的机会 "的特刊中,共有 14 篇文章记录了疟疾、利什曼病、血吸虫病、COVID-19(严重急性呼吸系统综合征冠状病毒 2)和奥罗普切热等疾病的传播,尽管有时空监测。高分辨率卫星图像可用于了解传播风险和疾病传播的空间分布情况,并强调冠状病毒从蝙蝠向猪或果子狸的溢出传播是增加人畜共患病发病率和地理范围的主要途径。气候变化和全球化加剧了入侵蚊虫在非热带地区的传播和定居,导致新出现的传染病爆发,需要改进物理、化学和生物病媒控制策略。病原体及其病媒的转移与人类的流动、迁移和全球货物运输密切相关。其他促成因素包括森林砍伐和城市化侵蚀野生动物区。自然生态系统遭到破坏,再加上低收入和社会经济地位低下,增加了被忽视的热带病和人畜共患病的传播几率。本特刊中的文章记录了新出现或再次出现的疾病以及对发热症状的监测。健康公平与医疗保健的可及性和医疗保健资源的针对性密切相关,因此有必要采用空间方法。公共卫生包括整合空间监测系统的成功疾病管理,包括卫生设施的使用。抗生素耐药性是由卫生、农业和水产养殖业中抗生素使用量的增加或耐药性基因的获得等因素造成的,可通过水平基因转移进行传播。这篇社论回顾了本特刊 14 篇文章的主要研究成果,指出了与我们这个相互联系的世界相关的重要差距,并提出了一些具体建议,以降低后 COVID-19 大流行时代的传染病传播风险。
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引用次数: 0
Malaria epidemiology, surveillance and response for elimination in Lao PDR. 老挝人民民主共和国的疟疾流行病学、监测和消除对策。
IF 8.1 1区 医学 Pub Date : 2024-05-23 DOI: 10.1186/s40249-024-01202-7
Chawarat Rotejanaprasert, Vilayvone Malaphone, Mayfong Mayxay, Keobouphaphone Chindavongsa, Virasack Banouvong, Boualam Khamlome, Phoutnalong Vilay, Viengxay Vanisavaeth, Richard J Maude

Background: Lao PDR has made significant progress in malaria control. The National Strategic Plans outline ambitious targets, aiming for the elimination of Plasmodium falciparum and P. vivax malaria from all northern provinces by 2025 and national elimination by 2030. This article presents an overview of malaria epidemiology, surveillance, and response systems in Lao PDR, emphasizing experiences and achievements in transmission reduction.

Methods: Data on surveillance, monitoring and evaluation systems, human resources, infrastructure, and community malaria knowledge during 2010-2020 were systematically gathered from the national program and relevant documents. The collected information was synthesized, and discussions on challenges and future prospects were provided.

Results: Malaria control and elimination activities in Lao PDR were implemented at various levels, with a focus on health facility catchment areas. There has been significant progress in reducing malaria transmission throughout the country. Targeted interventions, such as case management, vector control, and community engagement, using stratification of control interventions by catchment areas have contributed to the decline in malaria cases. In elimination areas, active surveillance strategies, including case and foci investigation, are implemented to identify and stop transmission. The surveillance system has facilitated timely detection and response to malaria cases, enabling these targeted interventions in higher-risk areas.

Conclusions: The malaria surveillance and response system in Lao PDR has played a crucial role in reducing transmission and advancing the country towards elimination. Challenges such as importation, drug resistance, and sustaining support require ongoing efforts. Further strengthening surveillance, improving access to services, and addressing transmission determinants are key areas of focus to achieve malaria elimination and enhance population health in Lao PDR.

背景:老挝人民民主共和国在疟疾控制方面取得了重大进展。国家战略计划列出了雄心勃勃的目标,旨在到 2025 年在北部所有省份消灭恶性疟原虫和间日疟原虫疟疾,到 2030 年在全国消灭疟疾。本文概述了老挝人民民主共和国的疟疾流行病学、监测和应对系统,强调了在减少传播方面的经验和成就:方法:从国家计划和相关文件中系统地收集了2010-2020年期间有关监测、监控和评估系统、人力资源、基础设施和社区疟疾知识的数据。方法:从国家计划和相关文件中系统地收集了 2010-2020 年期间有关监测、监控和评估系统、人力资源、基础设施和社区疟疾知识的数据,并对收集到的信息进行了综合,讨论了挑战和未来前景:老挝人民民主共和国在各级开展了疟疾控制和消除活动,重点是卫生设施集水区。在减少全国疟疾传播方面取得了重大进展。有针对性的干预措施,如病例管理、病媒控制和社区参与,利用按集水区分层的控制干预措施,促进了疟疾病例的减少。在消除疟疾地区,实施了积极的监测战略,包括病例和病灶调查,以确定和阻止传播。监测系统有助于及时发现和应对疟疾病例,从而能够在高风险地区采取有针对性的干预措施:老挝人民民主共和国的疟疾监测和应对系统在减少传播和推动该国实现消灭疟疾目标方面发挥了至关重要的作用。进口、抗药性和持续支持等挑战需要不断努力。进一步加强监测、改善服务获取途径以及解决传播决定因素是老挝人民民主共和国实现消除疟疾和提高人口健康水平的关键重点领域。
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引用次数: 0
Need for operational simplicity and timely disbursal of benefits-a qualitative exploration of the implementation of a direct benefit transfer scheme for persons with tuberculosis in India. 简化操作和及时发放福利的必要性--对印度肺结核患者直接福利转移计划实施情况的定性探讨。
IF 8.1 1区 医学 Pub Date : 2024-05-23 DOI: 10.1186/s40249-024-01206-3
Malu Mohan, Jeromie W V Thangaraj, Sumit Pandey, G Sri Lakshmi Priya, Sivavallinathan Arunachalam, Rahul Sharma, Hemant Deepak Shewade, B Aishwarya, K Afeeq, Afsana Khatoon, B Gokulvijay, Gude Sireesha, Kavita Chandra, S Nandhakumar, Prince Samuel, C Nanditha Viswanathan, Devika Shanmugasundaram, Raghuram Rao, Manoj V Murhekar, Kathiresan Jeyashree

Background: Ni-kshay Poshan Yojana (NPY) is a direct benefit transfer scheme of the Government of India introduced in 2018 to support the additional nutritional requirements of persons with TB (PwTB). Our recent nationwide evaluation of implementation and utilization of NPY using programmatic data of PwTB from nine randomly selected Indian states, reported a 70% coverage and high median delay in benefit credit. We undertook a qualitative study between January and July 2023, to understand the detailed implementation process of NPY and explore the enablers and barriers to effective implementation and utilization of the NPY scheme.

Methods: We followed a grounded theory approach to inductively develop theoretical explanations for social phenomena through data generated from multiple sources. We conducted 36 in-depth interviews of national, district and field-level staff of the National Tuberculosis Elimination Programme (NTEP) and NPY beneficiaries from 30 districts across nine states of India, selected using theoretical sampling. An analytical framework developed through inductive coding of a set of six interviews, guided the coding of the subsequent interviews. Categories and themes emerged through constant comparison and the data collection continued until theoretical saturation.

Results: Stakeholders perceived NPY as a beneficial initiative. Strong political commitment from the state administration, mainstreaming of NTEP work with the district public healthcare delivery system, availability of good geographic and internet connectivity and state-specific grievance redressal mechanisms and innovations were identified as enablers of implementation. However, the complex, multi-level benefit approval process, difficulties in accessing banking services, perceived inadequacy of benefits and overworked human resources in the NTEP were identified as barriers to implementation and utilization.

Conclusion: The optimal utilization of NPY is enabled by strong political commitment and challenged by its lengthy implementation process and delayed disbursal of benefits. We recommend greater operational simplicity in NPY implementation, integrating NTEP activities with the public health system to reduce the burden on the program staff, and revising the benefit amount more equitably.

背景:Ni-kshay Poshan Yojana(NPY)是印度政府于 2018 年推出的一项直接福利转移计划,旨在支持肺结核患者(PwTB)的额外营养需求。我们最近利用随机抽取的印度九个邦的肺结核患者的计划数据,对 NPY 的实施和利用情况进行了全国范围的评估,结果表明,该计划的覆盖率为 70%,福利信贷的中位延迟率较高。我们在 2023 年 1 月至 7 月期间开展了一项定性研究,以了解 NPY 的详细实施过程,并探讨有效实施和利用 NPY 计划的促进因素和障碍:我们采用了基础理论方法,通过多种来源的数据,归纳出对社会现象的理论解释。我们对国家消除结核病计划(NTEP)的国家级、地区级和实地级工作人员以及来自印度 9 个邦 30 个地区的 NPY 受益者进行了 36 次深入访谈,这些访谈是通过理论抽样选出的。通过对一组六次访谈进行归纳编码,形成了一个分析框架,为后续访谈的编码提供了指导。通过不断比较产生了类别和主题,数据收集工作一直持续到理论饱和为止:利益相关者认为 NPY 是一项有益的举措。州政府强有力的政治承诺、NTEP 工作与地区公共医疗保健服务系统的主流化、良好的地理和互联网连接以及各州特有的申诉处理机制和创新被认为是实施的推动因素。然而,复杂、多层次的福利审批程序、获得银行服务方面的困难、福利不足的看法以及国家医疗保险计划人力资源的过度劳累被认为是实施和利用的障碍:结论:强有力的政治承诺使国家养老金计划得到了最佳利用,但其漫长的实施过程和延迟发放福利的做法则使其面临挑战。我们建议在实施 NPY 的过程中简化操作,将 NTEP 活动与公共卫生系统结合起来,以减轻计划工作人员的负担,并更加公平地修订福利金额。
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引用次数: 0
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Infectious Diseases of Poverty
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