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Malaria parasite burden and heterogeneity of risk factors among Central African Republic refugees: a cross-sectional study in the Gado-Badzere refugee camp in Eastern Cameroon. 中非共和国难民的疟疾寄生虫负担和风险因素的异质性:在喀麦隆东部加多-巴泽雷难民营进行的横断面研究。
Pub Date : 2024-01-01 Epub Date: 2024-12-02 DOI: 10.3389/fitd.2024.1508750
Zidedine Nematchoua Weyou, Felicite Djemna Djieyep, Rene Ning Teh, Michel Lontsi-Demano, Cheikh Cambel Dieng, Roland Bamou, Eugenia Lo, Helen Kuokuo Kimbi, Irene Ule Ngole Sumbele

Background: Refugees are vulnerable populations especially in malaria endemic areas where the disease claims many lives and constitutes an emerging challenge for humanitarian response. This study assessed how the influx and settlement of Central African Republic (CAR) refugees influences malaria burden in the Gado-Badzere refugee camp, Eastern Cameroon.

Methods: A cross-sectional malariometric survey was conducted between November 2022 and October 2023 in 324 households comprising 1,304 individuals aged 1 month and above. Malaria parasite burden was determined using rapid diagnostic tests (RDTs) and Giemsa-stained microscopy. Demographic characteristics, malaria risk factors, treatment-seeking behaviors and costs to cure malaria were assessed using semi-structured questionnaires.

Results: Of the 1,304 participants, 525 (40.3%) were malaria parasite positive with moderate geometric mean parasite density (GMPD) of 1100 parasites/μl of blood. Plasmodium falciparum was the main species (99.8%), with mixed P. vivax infections (0.2%). Insecticide treated net (ITN) ownership was 53.7%, but its utilization was significantly low (22.4%) (P < 0.001). Reason for no ITN ownership was net damaged (74.7%). Net insufficiency (77.8%) accounted for non-frequent ITN use. Mean expenditure to treat malaria in the hospital was higher (USD 13.64 ± 8.67) than auto-medication (USD 1.13 ± 1.18). Significantly, malaria parasite prevalence and risk were higher for 0-5 years age (43.7%, OR = 1; P = 0.02), residents of sector 8 (49.2%, OR = 2.53; P < 0.001) of the camp, non-frequent ITN users (41.7%, OR = 2.08; P < 0.001), people living around stagnant water (44.4%, OR = 1.55; P < 0.001) and during the rainy season (43.5%, OR = 1.31; P = 0.02). The GMPD/μl was significantly higher in the 0-5 years age group (1456, P < 0.0001), inhabitants of sector 9 (1626, P = 0.04) and participants living around stagnant water (2097, P = 0.01).

Conclusion: The malaria burden in CAR refugees may represent the reservoir for malaria transmission, especially with the circulation of P. vivax. The improper use of ITNs could be ameliorated through sensitization. Seasonal chemoprevention mainly during the rainy season and Indoor Residual Spraying (IRS) might be implemented for effective malaria control in refugee settings.

背景:难民是弱势群体,特别是在疟疾流行地区,这种疾病夺走了许多人的生命,对人道主义反应构成了新的挑战。本研究评估了中非共和国(CAR)难民的涌入和定居如何影响喀麦隆东部Gado-Badzere难民营的疟疾负担。方法:于2022年11月至2023年10月对324户1个月及以上人口1304人进行疟疾横断面调查。使用快速诊断试验(RDTs)和吉姆萨染色显微镜确定疟疾寄生虫负担。采用半结构化问卷对人口统计学特征、疟疾危险因素、寻求治疗行为和治愈疟疾的成本进行了评估。结果:1304名参与者中疟原虫阳性525人(40.3%),平均寄生虫几何密度(GMPD)为1100只/μl。以恶性疟原虫感染为主(99.8%),间日疟原虫混合感染为主(0.2%)。杀虫剂处理过的蚊帐(ITN)拥有率为53.7%,但使用率极低(22.4%)(P < 0.001)。没有ITN所有权的原因是净损坏(74.7%)。净不足(77.8%)占不频繁使用ITN的原因。在医院治疗疟疾的平均费用(13.64±8.67美元)高于自动用药(1.13±1.18美元)。值得注意的是,0-5岁儿童的疟疾寄生虫患病率和风险较高(43.7%,OR = 1;P = 0.02),第8区居民(49.2%,OR = 2.53;P < 0.001),非频繁ITN使用者(41.7%,OR = 2.08;P < 0.001),居住在死水周围的人(44.4%,OR = 1.55;P < 0.001)和雨季(43.5%,OR = 1.31;P = 0.02)。GMPD/μl在0 ~ 5岁年龄组(1456人,P < 0.0001)、9区居民(1626人,P = 0.04)和生活在死水周围的参与者(2097人,P = 0.01)中显著高于其他年龄组(1456人,P < 0.0001)。结论:中非共和国难民的疟疾负担可能是疟疾传播的水库,特别是间日疟原虫的传播。ITNs的不当使用可以通过增敏来改善。为有效控制难民环境中的疟疾,可采取以雨季为主的季节性化学预防和室内滞留喷洒(IRS)。
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引用次数: 0
Improved prevention of female genital schistosomiasis: piloting integration of services into the national health system in Côte d’Ivoire 更好地预防女性生殖器血吸虫病:在科特迪瓦试点将服务纳入国家卫生系统
Pub Date : 2023-12-22 DOI: 10.3389/fitd.2023.1308660
Ashley Preston, Carlos Torres Vitolas, Alain Claver Kouamin, Johara Nadri, Suzanne Lobohon Lavry, Neerav Dhanani, Norbert Dje, Alain Toh, Fiona M. Fleming, A. Méité
Female genital schistosomiasis (FGS) is a neglected gynecological condition, putting women at-risk of poor sexual and reproductive health (SRH), including pregnancy complications or infertility. Early treatment of schistosomiasis with praziquantel is important to avoid disease progression to FGS as it is not always possible to reverse these symptoms. However, prevention programs with praziquantel have historically focused on school-aged children. Therefore, there is a gap to provide prevention services for young women in endemic areas, including Côte d’Ivoire.We piloted integration of FGS prevention services into routine SRH care in seven health centers (Soubré district, Côte d’Ivoire, November 2020 to April 2021) and enrolled 56 health workers. We used mixed methods including key informant interviews, focus group discussions, and questionnaires to determine effectiveness, feasibility and acceptability of integration across health system decision makers, health workers and female patients (15 to 29 years old). For qualitative data, we used an inductive coding process to analyze themes. We used descriptive statistics to analyze quantitative data.Interviewed health workers perceived that the integrated services increased access and improved health outcomes for women (15 to 29 years old) due to the more comprehensive approach, although barriers to access included lack of transportation. Female patients surveyed at baseline (n=448) indicated there were no routine FGS prevention services. During the pilot, FGS prevention services were provided to >8500 women at-risk. Health workers interviewed at the end of the pilot indicated they could feasibly provide FGS prevention services as part of routine patient consultations, and they maintained knowledge from training on the key FGS health education points and the consultation processes to follow. The greatest challenge expressed by health workers was the high workload.Provision of integrated healthcare in the health center setting is an effective and acceptable way to increase access to prevention services and provide holistic care for women (15 to 29 years old) in this setting in Côte d’Ivoire. Future scale-up will require further streamlining of the strategy, building on existing platforms, whilst ensuring reduced impact on workload and consideration of how to overcome barriers to accessing health centers.
女性生殖器血吸虫病(FGS)是一种被忽视的妇科疾病,它使妇女面临性健康和生殖健康(SRH)不良的风险,包括妊娠并发症或不孕症。早期使用吡喹酮治疗血吸虫病对于避免疾病发展为 FGS 非常重要,因为这些症状并不总能逆转。然而,使用吡喹酮的预防计划历来侧重于学龄儿童。我们在七个医疗中心(科特迪瓦苏布雷区,2020 年 11 月至 2021 年 4 月)试行将 FGS 预防服务纳入常规性健康和生殖健康护理,并招募了 56 名医疗工作者。我们采用了混合方法,包括关键信息提供者访谈、焦点小组讨论和问卷调查,以确定整合在卫生系统决策者、卫生工作者和女性患者(15 至 29 岁)中的有效性、可行性和可接受性。对于定性数据,我们采用归纳编码过程来分析主题。受访的卫生工作者认为,由于采用了更全面的方法,综合服务增加了女性(15 至 29 岁)获得服务的机会,并改善了她们的健康状况,但获得服务的障碍包括缺乏交通工具。基线调查中接受调查的女性患者(n=448)表示,她们没有接受过常规的 FGS 预防服务。试点期间,为超过 8500 名高危女性提供了 FGS 预防服务。试点结束时,接受访谈的医务工作者表示,他们可以在常规患者咨询中提供 FGS 预防服务,并且他们在培训中掌握了 FGS 健康教育要点和咨询流程。在保健中心提供综合保健服务是一种有效且可接受的方式,可增加科特迪瓦妇女(15 至 29 岁)获得预防服务的机会,并为她们提供整体护理。未来的推广工作将需要在现有平台的基础上进一步简化战略,同时确保减少对工作量的影响,并考虑如何克服进入保健中心的障碍。
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引用次数: 0
First report of Mansonella sp. and Dipetalonema gracile in the Amazonian city-dwelling threatened primate, Saguinus bicolor 首次报告亚马逊城市居住的濒危灵长类动物 Saguinus bicolor 中的 Mansonella sp.
Pub Date : 2023-12-19 DOI: 10.3389/fitd.2023.1080218
Cindy Alves Dias, Túllio Romão Ribeiro da Silva, Marcelo Gordo, D. F. Conga, Natália Aparecida de Souza Lima, A. V. S. D. Medeiros, Edson Rodrigues Costa, Sérgio Luiz Bessa Luz, Carlos Henrique Aguiar Costa, Ana Carolina Paulo Vicente, Thaís Pinto Nascimento, Francisca Helena Aguiar-Silva, Viviane Costa da Silva, Diogo César Lagroteria, Laerzio Chiesorin Neto, Alessandra Ferreira Dales Nava
The pied tamarin, or Saguinus bicolor, is a callitrichid that inhabits Amazon Forest fragments encased within the municipalities of Manaus, Rio Preto da Eva, and Itacoatiara and their outskirts. Therefore, this primate lives in great proximity to humans, and is in critical danger of extinction, resulting from ongoing anthropogenic pressures, with habitat fragmentation being the most prominent threat. Greater conservation efforts and more studies concerning public health need to be carried out in this situation, such as the study of infectious diseases that can affect this primate, including those involving helminths. In this study, we combined necropsy, microscopy with blood smears and quick Panoptic stains, and molecular methods like nested polymerase chain reaction (PCR) targeting the internal transcribed spacer-1 (ITS-1) region, Sanger sequencing and shotgun sequencing to detect and identify filarial parasites in 71 S. bicolor samples. We detected 24 adult filarial worms in 6.45% of the thoracic cavities, microfilaria in 6.38% from blood smears, and filarial DNA in 28.57% positive blood samples via PCR. We identified eight of the adult worms as being from the Onchocercidae family using Sanger sequencing and one specifically as Dipetalonema gracile, using shotgun sequencing. For the positive blood samples, 70.58% of them were for Mansonella sp., 17.64% for Dipetalonema sp., and 11.76% could only be identified as belonging to the Onchocercidae family. There was an event of coinfection that involved Dipetalonema sp. adult worm and Mansonella sp. microfilaria. This is the first report of the detection of Dipetalonema gracile and the genus Mansonella in S. bicolor, as well as an event of coinfection, pointing out this primate as a new host. It is also another step to understand the situation of filarial infections occurring in Amazonian Regions and its municipalities.
斑狨(Saguinus bicolor)是一种茧毛类动物,栖息在马瑙斯、里约普雷图达伊娃和伊塔科蒂亚拉市及其郊区的亚马逊森林片段中。因此,这种灵长类动物的生活环境与人类非常接近,而且由于持续不断的人为压力而濒临灭绝,其中栖息地破碎化是最突出的威胁。在这种情况下,需要加大保护力度,并开展更多有关公共卫生的研究,例如研究可能影响这种灵长类动物的传染病,包括涉及蠕虫的传染病。在这项研究中,我们结合尸体解剖、血液涂片显微镜检查和快速泛影染色法,以及巢式聚合酶链式反应(PCR)、桑格测序和枪式测序等分子方法,检测和鉴定了 71 个双色猴样本中的丝虫寄生虫。通过 PCR,我们在 6.45% 的胸腔中检测到了 24 只成虫,在 6.38% 的血液涂片中检测到了微丝蚴,在 28.57% 的阳性血液样本中检测到了丝虫 DNA。我们利用桑格测序法确定了其中 8 条成虫属于盘尾丝虫科,并利用霰弹枪测序法确定了其中 1 条成虫为蟛蜞菊丝虫(Dipetalonema gracile)。在阳性血样中,70.58%为曼氏沙门氏菌,17.64%为双盘虫,11.76%只能确定为盘尾丝虫科。有一次共感染事件涉及到双盘螺母成虫和曼氏丝虫微丝蚴。这是首次报告在 S. bicolor 中检测到 Dipetalonema gracile 和 Mansonella 属,以及共同感染事件,指出这种灵长类动物是一种新的宿主。这也是了解亚马逊地区及其城市丝虫感染情况的又一进展。
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引用次数: 0
Improving access to lymphatic filariasis MMDP services through an enhanced evidence-based, cascaded training model for health worker capacity strengthening in Ghana: an evaluation study 通过强化循证、逐级培训模式提高加纳卫生工作者的能力,改善淋巴丝虫病 MMDP 服务的可及性:一项评估研究
Pub Date : 2023-12-06 DOI: 10.3389/fitd.2023.1282218
C. Ahorlu, S. Atinbire, K. M. Sedzro, Bright Alomatu, Dziedzom K. de Souza, Kofi Asamenyi-Mensah, Joseph Opare, Paul Saunderson, Stefanie Weiland
Ghana has made significant progress in reducing the transmission rate of lymphatic filariasis. However, very little progress has been made in the provision of morbidity management and disability prevention (MMDP) services, which is one of the key requirements for certification of elimination as a disease of public health importance. This study was designed to compare pre-post- intervention to determine the feasibility and effectiveness of a cascade training model for health worker capacity strengthening in Ghana, using the WHO recommended minimum intervention package to improve access to MMDP services.This study used a quasi-experimental design to assess the impact of evidence-based training of patients with lymphatic filariasis (LF) in the Upper West region of Ghana. All lymphedema patients who were available at the time of data collection participated in the study before and after the training.The mean age of respondents was 54.67 years (SD ± 16.89 years) at baseline and 54.70 years (SD ± 15.80 years) at evaluation. The majority (i.e., 76.30% at baseline and 80.50% at evaluation) of the respondents were female. Most of the respondents had not completed primary school (83.82% at baseline and 85.40% at evaluation). We found an improvement in the quality of life among LF patients, that is, the proportion of respondents who reported having a high quality of life increased from 2.9% at baseline to 20.12% at evaluation (p < 0.001). The lymphedema management practice of “hygiene/washing and drying of affected limb” was reported by 73.17% of respondents at evaluation compared with only 32.95% of respondents at baseline (p < 0.001). The acute attack management technique of “cooling the affected limb in cool water/cold compress” was reported by 70.15% of respondents at evaluation compared with 23.70% of respondents at baseline (p < 0.001).The research confirmed that LF-related perceptions remained generally the same at baseline and evaluation among community members. The implementation of the LF-related morbidity management (MMDP) project has led to a significant improvement in the morbidity management practices among patients at evaluation compared with baseline. Our findings also showed that self-care led to an improvement in patients’ quality of life. This justifies the need for investment in morbidity management interventions in endemic communities.
加纳在降低淋巴丝虫病的传播率方面取得了重大进展。然而,在提供发病率管理和残疾预防(MMDP)服务方面进展甚微,而这是证明消灭这种具有公共卫生重要性的疾病的关键要求之一。本研究旨在比较干预前和干预后,以确定加纳卫生工作者能力加强梯级培训模式的可行性和有效性,使用世卫组织推荐的最低干预一揽子计划来改善获得MMDP服务的机会。本研究采用准实验设计来评估加纳上西部地区淋巴丝虫病(LF)患者循证培训的影响。所有在数据收集时可用的淋巴水肿患者在训练前后都参加了研究。调查对象基线时平均年龄为54.67岁(SD±16.89岁),评估时平均年龄为54.70岁(SD±15.80岁)。调查对象中女性居多,基线时76.30%,评估时80.50%。大多数受访者未完成小学教育(基线时为83.82%,评估时为85.40%)。我们发现LF患者的生活质量有所改善,即报告生活质量高的受访者比例从基线时的2.9%增加到评估时的20.12% (p < 0.001)。73.17%的应答者在评估时报告了“卫生/患肢清洗和干燥”的淋巴水肿管理做法,而基线时只有32.95%的应答者报告了这一做法(p < 0.001)。采用“冷水/冷敷冷却患肢”的急性发作管理技术的受访者在评估时为70.15%,而基线时为23.70% (p < 0.001)。研究证实,社区成员在基线和评估时,与lf相关的认知基本保持不变。与基线相比,lf相关发病率管理(MMDP)项目的实施使评估患者的发病率管理实践有了显著改善。我们的研究结果还表明,自我护理可以改善患者的生活质量。这证明有必要投资于流行社区的发病率管理干预措施。
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引用次数: 0
Challenges in drug discovery and description targeting Leishmania spp.: enzymes, structural proteins, and transporters 针对利什曼原虫的药物发现和描述面临的挑战:酶、结构蛋白和转运体
Pub Date : 2023-11-30 DOI: 10.3389/fitd.2023.1241044
A. Mendoza-León, María Luisa Serrano G., Alicia Ponte-Sucre
Leishmaniasis is a complex tropical disease caused by the protozoan parasite Leishmania spp. Classical chemotherapy includes pentavalent antimonial; however, pentamidine, amphotericin B, and miltefosine have been used. Chemo-resistance remains a risk for successful treatment; thus, target identification and development of selective drugs remain a priority in controlling this disease. Evidence indicates that 6-phosphogluconate dehydrogenase (6PGDH), β-tubulin protein, and ATP-dependent transporters (ABCs-T) are potential targets to be addressed. The pentose phosphate pathway key enzyme 6PGDH is essential for protecting kinetoplastid parasites from oxidative stress and differs from the mammalian host enzyme (<35% AA sequence identity). An optimized 3D model has been used to select high -affinity compounds toward the enzyme through virtual screening and subsequent evaluation in vivo. In kinetoplasts, tubulins are highly conserved proteins essential for microtubule formation. However, compared to other eukaryotic cells, there is a differential susceptibility of kinetoplastid proteins to antimicrotubular agents, e.g., colchicine resistance. A comparison of experimental models between bovine and Leishmania β-tubulin protein allowed us to identify structural modification products of various amino acid substitutions, which hinder the access of colchicine to the binding pocket of the Leishmania protein. Similar changes are found in the β-tubulin sequence of other kinetoplastids such as Trypanosoma cruzi, T. brucei, and T. evansi. The evaluation of the β-tubulin protein as a therapeutic target and the compounds that selectively interact with it was carried out using in silico approaches. The activities of ABC-Transporters are related to the main causes of drug resistance, and the collected evidence suggests that for the ABC-Transporter blocker glibenclamide, there is a: (1) differential susceptibility of Leishmania spp. vs. macrophages; (2) greater susceptibility of axenic amastigotes vs. promastigotes; and (3) glibenclamide-glucantime synergistic drug interaction in macrophage-infected cells. Herein, we discuss the potential value of designing ABC-Transporter blockers for combination therapy in the treatment of leishmaniasis. The examples mentioned above highlight the importance of the search for new therapeutic targets and pharmacophores for the design of alternative treatments for the disease.
利什曼病是由原生动物寄生虫利什曼属引起的一种复杂的热带疾病。经典的化疗方法包括五价抗锑剂,但也使用过喷他脒、两性霉素 B 和米替福新。化疗抗药性仍然是成功治疗的一个风险;因此,目标识别和选择性药物的开发仍然是控制这种疾病的当务之急。有证据表明,6-磷酸葡萄糖酸脱氢酶(6PGDH)、β-微管蛋白和 ATP 依赖性转运体(ABCs-T)是潜在的靶点。磷酸戊糖途径关键酶 6PGDH 对于保护动粒寄生虫免受氧化应激至关重要,它与哺乳动物宿主酶不同(AA 序列相同度小于 35%)。通过虚拟筛选和随后的体内评估,我们利用优化的三维模型筛选出了对该酶具有高亲和力的化合物。在动力体中,微管蛋白是高度保守的蛋白质,对微管的形成至关重要。然而,与其他真核细胞相比,动粒蛋白对抗菌微管药物的敏感性存在差异,如秋水仙碱抗性。通过对牛和利什曼尼亚β-管蛋白的实验模型进行比较,我们确定了各种氨基酸取代的结构修饰产物,它们阻碍了秋水仙碱进入利什曼尼亚蛋白的结合袋。在克鲁斯锥虫、布鲁西锥虫和埃文西锥虫等其他动植体的β-管蛋白序列中也发现了类似的变化。我们采用硅学方法评估了作为治疗靶点的β-微管蛋白以及与之发生选择性相互作用的化合物。ABC 转运体的活性与耐药性的主要原因有关,收集到的证据表明,对于 ABC 转运体阻断剂格列本脲,存在以下情况(1) 利什曼原虫对巨噬细胞的敏感性不同;(2) 轴生非主流原虫对原生原虫的敏感性更高;(3) 格列本脲-格列本脲在巨噬细胞感染细胞中的协同药物作用。在此,我们将讨论设计用于利什曼病联合疗法的 ABC 转运体阻断剂的潜在价值。上述例子凸显了寻找新的治疗靶点和药理机制对于设计治疗利什曼病的替代疗法的重要性。
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引用次数: 0
Presence of tissue schistosomiasis in KwaZulu-Natal, South Africa: a retrospective histopathologic review 南非夸祖鲁-纳塔尔省的组织血吸虫病:回顾性组织病理学研究
Pub Date : 2023-11-28 DOI: 10.3389/fitd.2023.1301485
A. Mwazha, G. Nhlonzi, Eyrun Floerecke Kjetland
Schistosomiasis affects many parts of the human body including those not usually accessible during routine clinical follow-up. We investigated the presence of schistosomiasis in routine tissue specimens sent to the only public histopathology laboratory in KwaZulu-Natal, South Africa.The catchment area for the Department of Anatomical Pathology constitutes 11 million people in 10 districts. We retrospectively reviewed all the histopathology reports for occurrence of schistosomiasis between 1 January 2015 and 30 June 2020.Schistosomiasis was identified in the appendix, uterine cervix, urinary bladder, lung, liver, fallopian tubes and prostate. During the study period, 725 cases had a diagnosis of schistosomiasis confirmed on histopathology, which equals 0.3% of the total number of specimens sent to the laboratory. Female genital schistosomiasis represented 49.1% (356/725) of the schistosomiasis cases of which 25.1% (182) were from the uterine cervix and 24% (174) from the fallopian tubes. The appendix had 39.7% (289) of all the cases of schistosomiasis. Other organs were urinary bladder (4.4%, 32), lung (3.2%, 23) and liver (2.6%, 19). There were two cases of schistosomiasis in the prostate and four cases in the anorectal region. The main three indications for taking biopsies were acute appendicitis, cervical intraepithelial neoplasia, and sterilization. Majority of the schistosomiasis cases (312) were from eThekwini/Durban metropolitan district, however this represented only 1.2% (312/25 111) of the specimens received from eThekwini/Durban. The districts with the highest percentage positive cases were uMkhanyakude (43/965, 4.5%), followed by Ugu (129/5 251, 2.6%), and King Cetshwayo districts (132/5 360, 2.5%).Clinicians in the KwaZulu-Natal public health sector hospitals did not suspect schistosomiasis when they submitted patient samples for histopathological investigations. The study indicates the prevalence and the diversity of the body organs affected by schistosomiasis.
血吸虫病影响人体的许多部位,包括常规临床随访通常无法触及的部位。我们调查了南非夸祖鲁-纳塔尔省唯一一家公共组织病理学实验室收到的常规组织标本中是否存在血吸虫病。我们回顾性地审查了2015年1月1日至2020年6月30日期间所有组织病理学报告中的血吸虫病病例。在研究期间,有 725 例病例经组织病理学确诊为血吸虫病,占送往实验室的标本总数的 0.3%。女性生殖器血吸虫病占血吸虫病病例的49.1%(356/725),其中25.1%(182例)来自子宫颈,24%(174例)来自输卵管。在所有血吸虫病病例中,阑尾占 39.7%(289 例)。其他器官包括膀胱(4.4%,32例)、肺(3.2%,23例)和肝脏(2.6%,19例)。前列腺血吸虫病有 2 例,肛门直肠血吸虫病有 4 例。活检的主要三个适应症是急性阑尾炎、宫颈上皮内瘤变和绝育。大多数血吸虫病病例(312 例)来自特克维尼/德班大都会区,但这只占特克维尼/德班大都会区收到的标本的 1.2%(312/25 111)。阳性病例比例最高的地区是uMkhanyakude(43/965,4.5%),其次是Ugu(129/5 251,2.6%)和King Cetshwayo地区(132/5 360,2.5%)。这项研究表明了血吸虫病的流行程度和受影响身体器官的多样性。
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引用次数: 0
A high-fat diet protects C57BL/6 mice from Plasmodium berghei ANKA infection in an experimental malaria study 在一项疟疾实验研究中,高脂饮食可保护 C57BL/6 小鼠免受伯格氏疟原虫 ANKA 感染
Pub Date : 2023-11-28 DOI: 10.3389/fitd.2023.1188902
S. M. Soares, Ana Gualberto, Augusto Cesar da Costa, D. A. Gonçalves, J. Gameiro
It is well known that dietary changes have a significant impact on the immune system, and modifications in lipid balance may contribute to disease progression in several cases. Malaria is still a major global health concern, and the development of the disease has already been linked to the host’s nutritional status, so it’s critical to understand how environmental factors, such as dietary variations, can influence the outcome of infection. We therefore investigated the effect of a short-term diet in a murine model of experimental cerebral malaria.For this, male C57BL/6 mice were fed a high fat diet containing 60% of the calories from lipids for 5 days. Following this period, the animals were infected with Plasmodium berghei ANKA, and parasitemia, survival, and neurological scores were compared. Considering that one of the first elimination routes of the intracellular parasite is oxidative stress, the antioxidant N-acetylcysteine was administered to assess whether the protection would be reversed.Animals fed a hyperlipidic diet reacted the same way to infection even after NAC administration. Unlike the control group, which died after eight days of infection with roughly 7% parasitized red blood cells, the hyperlipidic diet group was resistant to infection, with no clinical signs and no increase in blood parasitemia. Several proinflammatory cytokines such as TNF-α IFN-γ and IL-6 were increased in the spleen of both infected groups, regardless of their diet. The provision of a high-fat diet to mice for as little as 5 days completely prevents Plasmodium berghei ANKA infection in C57BL/6 mice, while the treatment of an antioxidant failed to reverse the parasite protection.
众所周知,饮食变化会对免疫系统产生重大影响,而血脂平衡的改变可能会在某些情况下导致疾病的恶化。疟疾仍然是全球关注的主要健康问题,而疾病的发展已经与宿主的营养状况有关,因此了解环境因素(如饮食变化)如何影响感染结果至关重要。为此,我们给雄性 C57BL/6 小鼠喂食高脂肪饮食 5 天,其中 60% 的热量来自脂类。之后,动物感染了伯格氏疟原虫 ANKA,并对寄生虫血症、存活率和神经系统评分进行了比较。考虑到细胞内寄生虫的首要清除途径之一是氧化应激,我们给动物注射了抗氧化剂 N-乙酰半胱氨酸,以评估这种保护是否会逆转。对照组在感染八天后死亡,寄生红细胞约占 7%,而高脂饮食组与对照组不同,它们对感染具有抵抗力,没有临床症状,血液中的寄生虫血症也没有增加。无论饮食如何,两个感染组的脾脏中一些促炎细胞因子(如 TNF-α IFN-γ 和 IL-6)都有所增加。为小鼠提供短短 5 天的高脂肪饮食可完全防止 C57BL/6 小鼠感染伯格希氏疟原虫 ANKA,而使用抗氧化剂则无法逆转对寄生虫的保护作用。
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引用次数: 0
Present drugs and future perspectives in treating soil-transmitted helminthiasis 治疗土壤传播蠕虫病的现有药物和未来展望
Pub Date : 2023-11-22 DOI: 10.3389/fitd.2023.1282725
Jennifer Keiser
Soil-transmitted helminthiases caused by Ascaris lumbricoides, Trichuris trichiura, and hookworm (Ancylostoma duodenale and Necator americanus) are responsible for the infection of approximately 1.5 billion people worldwide, mostly in tropical and subtropical regions. Preventive chemotherapy is the mainstay of control, which is the regular administration of anthelminthic drugs, mainly albendazole and mebendazole to at-risk populations. As benzimidazoles face a risk of developing drug resistance and have shortcomings in their therapeutic profile, efforts have been made to develop alternative anthelminthics. The aim of this review is to provide a state-of-the-art update on available treatments and ongoing efforts in Research and Development (R&D) for the three main soil-transmitted helminth infections. Recent findings on the use of drug combinations and advanced drug candidates such as oxantel pamoate and emodepside and how these drugs fulfill the target product profile will be reviewed. Lastly, progress in drug discovery will be summarized.
由蛔虫、毛滴虫和钩虫(十二指肠肛门蛔虫和美洲钩虫)引起的土壤传播蠕虫病导致全球约 15 亿人感染,其中大部分在热带和亚热带地区。预防性化疗是防治的主要手段,即定期向高危人群施用抗蠕虫药物,主要是阿苯达唑和甲苯咪唑。由于苯并咪唑类药物有产生抗药性的风险,而且在治疗方面存在缺陷,因此人们一直在努力开发替代性抗虫药。本综述旨在提供有关现有治疗方法的最新进展,以及针对三种主要土壤传播蠕虫感染正在进行的研发工作。此外,还将综述使用复方药物和先进候选药物(如帕莫酸奥康特和依莫地普赛)的最新研究成果,以及这些药物如何满足目标产品的要求。最后,将总结药物发现方面的进展。
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引用次数: 0
Origin and spread of leprosy in Suriname. A historical and biomedical study 苏里南麻风病的起源和传播。历史和生物医学研究
Pub Date : 2023-11-07 DOI: 10.3389/fitd.2023.1258006
William R. Faber, Karin Sewpersad, Henk Menke, Charlotte Avanzi, Annemieke Geluk, Els M. Verhard, Maria Tió Coma, Mike Chan, Toine Pieters
The new world was considered free of leprosy before the arrival of Europeans. In Suriname, historical migration routes suggest that leprosy could have been introduced from West Africa by the slave trade, from Asia by indentured workers, from Europe by the colonizers, and more recently by Brazilian gold miners. Previous molecular studies on environmental and ancient samples suggested a high variability of the strains circulating in the country, possibly resulting from the various migration waves. However, a current overview of such diversity in humans still needs to be explored. The origin and spread of leprosy in Suriname are investigated from a historical point of view and by strain genotyping of Mycobacterium leprae from skin biopsies of 26 patients with multibacillary leprosy using PCR-genotyping and whole-genome sequencing. Moreover, molecular signs of resistance to the commonly used anti-leprosy drugs i.e. dapsone, rifampicin and ofloxacin, were investigated. Molecular detection was positive for M. leprae in 25 out of 26 patient samples, while M. lepromatosis was not found in any of the samples. The predominant M. leprae strain in our sample set is genotype 4P (n=8) followed by genotype 1D-2 (n=3), 4N (n=2), and 4O/P (n=1). Genotypes 4P, 4N, 4O/P are predominant in West Africa and Brazil, and could have been introduced in Suriname by the slave trade from West Africa, and more recently by gold miners from Brazil. The presence of the Asian strains 1D-2 probably reflects an introduction by contract workers from India, China and Indonesia during the late 19th and early 20th century after the abolition of slavery. There is currently no definite evidence for the occurrence of the European strain 3 in the 26 patients. Geoplotting reflects internal migration, and also shows that most patients live in and around Paramaribo. A biopsy of one patient harbored two M. leprae genotypes, 1D-2 and 4P, suggesting co-infection. A mutation in the dapsone resistance determining region of folP1 was detected in two out of 13 strains for which molecular drug susceptibility was obtained, suggesting the circulation of dapsone resistant strains.
在欧洲人到来之前,新大陆被认为没有麻风病。在苏里南,历史上的移民路线表明,麻风病可能是通过奴隶贸易从西非传入的,通过契约工人从亚洲传入的,通过殖民者从欧洲传入的,最近则是由巴西的金矿工人传入的。先前对环境和古代样本的分子研究表明,在该国传播的菌株具有很高的可变性,可能是由于各种迁移浪潮造成的。然而,目前人类这种多样性的概况仍然需要探索。从历史的角度对苏里南麻风的起源和传播进行了调查,并利用pcr -基因分型和全基因组测序对26例多菌性麻风患者的皮肤活检进行了麻风分枝杆菌的菌株基因分型。此外,还调查了对常用抗麻风药物如氨苯砜、利福平和氧氟沙星的耐药分子迹象。在26个患者样本中有25个麻风分枝杆菌分子检测呈阳性,而在任何样本中均未发现麻风分枝杆菌病。本组样本中主要的麻风分枝杆菌菌株为4P基因型(n=8),其次为1D-2基因型(n=3)、4N基因型(n=2)和40o /P基因型(n=1)。基因型4P、4N、40o /P在西非和巴西占主导地位,可能是通过西非的奴隶贸易引入苏里南的,最近可能是由巴西的淘金者引入的。亚洲菌株1D-2的出现可能反映了在19世纪末和20世纪初废除奴隶制后,来自印度、中国和印度尼西亚的合同工引进了这种病毒。目前没有明确的证据表明这26名患者中出现了欧洲3型毒株。地理绘图反映了内部迁移,也表明大多数患者居住在帕拉马里博及其周边地区。一名患者的活组织检查发现两种麻风分枝杆菌基因型,1D-2和4P,提示合并感染。在13株获得分子药敏的菌株中,有2株检测到folP1基因耐药区突变,提示耐药菌株存在循环。
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引用次数: 0
Operationalizing One Health: strategic guidance for prevention and control of emerging and re-emerging vector-borne and zoonotic diseases in the Eastern Mediterranean Region 实施同一个健康:预防和控制东地中海区域新出现和再出现的病媒传播疾病和人畜共患疾病的战略指导
Pub Date : 2023-11-07 DOI: 10.3389/fitd.2023.1237688
Chiori Kodama, Amira S. El Rifay, Rebecca Badra, Rana Abu Salbi, Abdinasir Abubakar, Ghazi Kayali
Operationalizing global One Health strategies at the field level to prevent and control vector-borne and zoonotic diseases (VBZDs) is of significant public health importance. Such strategies should be coordinated at the human–animal–ecosystems interface and applied at the national, regional, and global levels through the enforcement of effective policies. We aimed to develop a regional framework that can aid countries of the World Health Organization Eastern Mediterranean region to better prevent, detect, and respond to VBZDs events. This strategic guidance is a twelve-element framework drafted using various guidance documents and peer-reviewed scientific literatures, incorporating recommendations made through expert consultations. The framework elements were then integrated within a logical framework designed for practical implementation of One Health at regional and country level.
在实地一级实施全球“同一个健康”战略,以预防和控制媒介传播疾病和人畜共患疾病,对公共卫生具有重要意义。这些战略应在人-动物-生态系统界面上进行协调,并通过执行有效政策在国家、区域和全球各级加以应用。我们的目标是建立一个区域框架,以帮助世界卫生组织东地中海区域的国家更好地预防、发现和应对VBZDs事件。该战略指导是一个十二要素框架,利用各种指导文件和同行评议的科学文献起草,并纳入通过专家协商提出的建议。然后将框架要素整合到一个逻辑框架内,为在区域和国家一级实际实施“同一个健康”而设计。
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引用次数: 0
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Frontiers in tropical diseases
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