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Challenges and Opportunities for Global Eradication of Paste des Petits Ruminants (PPR) 全球消灭小反刍兽疫的挑战与机遇
Pub Date : 2020-01-01 DOI: 10.35248/2329-891X.20.8.349
H. S. Nour
Sheep and goat provide valuable products such as meat, milk, particularly for women and children. Sheep and goat can be raised in arid and semi-arid and around the house, because of less investment and less feed required. Also, high short period for output and income saving, On the other hand, diseases such as Paste Des Petits Ruminants (PPR) cause mortality and high economic loss in the world particularly in Asia and Africa that has negative impact in many rural and urban lives. The disease caused many outbreaks in Asia and Africa, characterized by huge mortality and morbidity. Recently, the Food and Agricultural Organization (FAO) and the world animal health organization declared global eradication of paste des petits ruminants subsequently reduce poverty. This review dealt with challenges and opportunities that affect the global eradication of paste des petits ruminants. Information on its economic importance, the taxonomy of the virus, transmission and pathogenesis and methods of diagnosis are briefly dealt with.
绵羊和山羊提供有价值的产品,如肉、奶,特别是对妇女和儿童。绵羊和山羊可以在干旱和半干旱地区以及房屋周围饲养,因为投资较少,所需饲料较少。另一方面,小反刍兽疫等疾病在世界上造成死亡率和巨大的经济损失,特别是在亚洲和非洲,对许多农村和城市生活产生负面影响。这种疾病在亚洲和非洲多次爆发,其特点是死亡率和发病率都很高。最近,粮食及农业组织(粮农组织)和世界动物卫生组织宣布全球消灭小反刍兽类继而减少贫困。本文综述了影响全球消灭小反刍兽类的挑战和机遇。简要介绍了其经济重要性、病毒分类、传播和发病机制以及诊断方法等信息。
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引用次数: 3
Intestinal Parasites Isolated in Vegetables Sold in most Important Marketswithin Ilorin Metropolis 伊洛林市主要市场蔬菜中肠道寄生虫的分离分析
Pub Date : 2020-01-01 DOI: 10.35248/2329-891X.19.8.342
Akinseye Janet Fumilayo, Oladejo Janet Mosunmola, Adewuyi Isaac Kayode, Agunlejika RichardAdedokun, Hosea Thomas Zagi, Ayuba Sunday Buru
The aim of the study was to determine the parasite prevalence of vegetables at three selected major markets in Ilorin metropolis for parasitic incidence. 150 vegetables of different kinds were randomly selected from the three selected markets and processed through both sedimentation and floatation methods. Of the 150 vegetable sampled, 63 (42%) of these vegetables were positive for parasites ranging from Ascaris to Amoeba and hookworm, etc. more parasites were recovered from sedimentation 44 (74.6%) than floatation 15 (25.4%). Spinach “Tete” (Amaranthus spinosus L), and Jute mallow “Ewedu” (Corchorus olitorius) had the highest parasitic contamination while tomatoes recorded the lowest parasitic contamination, detected were ova of Ascaris lumbricoides 19 (42.2%), ova of Hookworm 2 (4.4%), ova of Trichuris trichiura 1 (2.2%), cyst of Entamoeba histolytica 8 (17.8%), cyst of Entamoeba coli 7 (15.5%), cyst of Balantidium coli 5 (11.1%), cyst of Giardia lamblia and trophozoite of Trichomonas hominis. This study identified that vegetables can aids transmission of parasitic infection, avoidance of the use of feaces as manure should be encouraged, whilst vegetables should be properly cooked before consumption to reduce the risk of infection. Keywords: Selected market; Ilorin; Vegetables; Parasites
本研究的目的是确定伊洛林市三个主要市场蔬菜的寄生虫流行情况。从三个选定的市场中随机抽取150种不同种类的蔬菜,采用沉降法和浮法进行加工。其中63种(42%)蔬菜检出蛔虫、变形虫、钩虫等多种寄生虫,沉降法检出的寄生虫数为74.6%,浮法检出的寄生虫数为25.4%。其中,菠菜“Tete”(Amaranthus spinosus L)和黄麻锦花“Ewedu”(Corchorus olitorius)的寄生污染程度最高,番茄的寄生污染程度最低,分别为类蚓蛔虫虫卵19(42.2%)、钩虫虫卵2(4.4%)、毛滴虫虫卵1(2.2%)、溶组织内阿米巴8(17.8%)、大肠内阿米巴7(15.5%)、大肠Balantidium 5(11.1%)、兰第鞭毛虫虫卵和人毛滴虫滋养体。这项研究发现,蔬菜可以帮助寄生虫感染的传播,应鼓励避免使用粪便,而蔬菜在食用前应适当煮熟,以减少感染的风险。关键词:精选市场;台;蔬菜;寄生虫
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引用次数: 2
The Effect of Oral Cholera Vaccine in Response to an Outbreak of Cholera in aComplex Emergency, Borno State, Northeast Nigeria. 口服霍乱疫苗在应对尼日利亚东北部博尔诺州复杂紧急情况下霍乱疫情中的效果
Pub Date : 2020-01-01 DOI: 10.35248/2329-891X.20.8.344
Kumshida Yakubu Balami, Uzoma Ugochukwu, A. Malgwi, S. Thliza, AhmedNjidda, Lawi Auta Mshelia, Chima E Onuekwe, Womi-Etang Oboma Eteng, I. Kida, Isaac A. Boateng, Chikwe Ihekwaezu, Collins Owili
Background: Cholera Outbreak remains a global health threat amongst Internally Displaced Persons (IDPs) and areas facing complex emergencies. The insurgency in Northeast Nigeria disrupted social services and displaced thousands into IDPs camps which are overcrowded with sub-optimal water, sanitation, and hygiene. We confirmed, characterized the outbreak and instituted control measures which include the first-ever use of Oral Cholera Vaccine (OCV) in Nigeria. Methods: We defined a suspected cholera case-patient as any person above two (≥ 2) years of age presenting with Acute Watery Diarrhea (AWD) and severe dehydration or dying from AWD, with or without vomiting between 14th August to 21st December 2017. We conducted a descriptive and analytic study. Using the Polio vaccination structure, we launched an OCV campaign in two phases (rounds) targeting all people above one (≥ 1) year of age in the affected communities and IDP camps. Results: We identified 6,430 case-patients with 61 deaths in seven (7) Local Government Areas (LGAs) of Borno State which include 3,512 (54.62%) in Jere, 1,870 (29.08%) Monguno, 845 (13.14%) Dikwa, 115 (1.79%) Guzamala, 63 (0.98%) Maiduguri, 23 (0.36%) Mafa and 2 (0.03%) in Gubio. Most of the case-patients 6,109 (95%) were IDPs living in camps. The median age was nine (9) years (Range: 2-80). Females 2,780 (43%) were most affected than males. We targeted a total of 855,492 individuals above one year of age in the affected LGAs for an OCV. We vaccinated 896,919 individuals using 914,565 doses of OCV, giving a coverage rate of 105%. The wastage rate was 0.4%. We did not report any Adverse Events Following Immunization (AEFI). On OCV day four, 122 was the highest number of daily reported case-patients after which the daily case count began to decline until the end of the outbreak. The overall case fatality rate (CFR:0.95%) was 0.95%. Conclusion: The protracted cholera outbreak increased in magnitude and strength, and affected mostly children living in IDPs camps. The cholera outbreak was rapidly detected, and the response was timely, which might have been a possible reason for the low CFR. The reactive OCV might have influenced the ending of the outbreak. Despite the complex and challenging context, we were able to contain the outbreak within four months with a low CFR.
背景:霍乱疫情仍然是国内流离失所者和面临复杂紧急情况地区的全球健康威胁。尼日利亚东北部的叛乱破坏了社会服务,并使数千人流离失所,进入过度拥挤的国内流离失所者营地,这些营地的水、环境卫生和个人卫生都不理想。我们确认了疫情的特点,并制定了控制措施,其中包括在尼日利亚首次使用口服霍乱疫苗。方法:我们将疑似霍乱病例定义为2017年8月14日至12月21日期间出现急性水样腹泻(AWD)和严重脱水或死于AWD的任何2岁以上(≥2岁)患者,伴有或不伴有呕吐。我们进行了描述性和分析性研究。利用脊髓灰质炎疫苗接种结构,我们分两阶段(轮)针对受影响社区和国内流离失所者营地中1岁以上(≥1岁)的所有人发起了OCV运动。结果:在博尔诺州7个地方行政区(lga)共发现6430例病例,61例死亡,其中杰雷区3512例(54.62%),蒙古诺区1,870例(29.08%),迪夸区845例(13.14%),古扎马拉区115例(1.79%),迈杜古里区63例(0.98%),马法区23例(0.36%),古比奥区2例(0.03%)。大多数病例患者(6109例)(95%)是居住在难民营的国内流离失所者。中位年龄为9岁(范围:2-80)。女性2780人(43%)比男性受影响最大。我们针对受影响的lga中年龄在1岁以上的855,492人进行了OCV。我们使用914,565剂OCV为896,919人接种了疫苗,覆盖率为105%。流失率为0.4%。我们没有报告任何免疫后不良事件(AEFI)。在OCV第四天,122是每日报告病例-患者的最高数字,此后每日病例数开始下降,直到疫情结束。总病死率(CFR:0.95%)为0.95%。结论:持续的霍乱疫情在规模和强度上都有所增加,主要影响生活在国内流离失所者营地的儿童。霍乱疫情被迅速发现,反应及时,这可能是病死率低的一个可能原因。反应性OCV可能影响了爆发的结束。尽管环境复杂而具有挑战性,但我们能够在4个月内以较低的病死率控制疫情。
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引用次数: 0
Poultry Farm and Poultry Products as Sources of Multiple Antimicrobial-Resistant Salmonella and S. aureus 作为多重抗微生物沙门氏菌和金黄色葡萄球菌来源的家禽养殖场和家禽产品
Pub Date : 2019-03-01 DOI: 10.35248/2329-891X.19.7.308
M. Ugwu, Chinedu Omanukwue, Collins Chimezie Izuchukwu, U. Okezie, C. Ejikeugwu, Ezinne Nnnabuife-Iloh, C. Esimone
Background: Poultry production is a key interface for the spread of novel zoonotic and antibiotic-resistant foodborne pathogens. Salmonella spp. and S. aureus isolates from 2 poultry production were tested for resistance to clinical antibiotics. Methods: One hundred 100 anal swab samples were aseptically collected from 2 small scale poultry farms located within Agulu, during the period of February 2016 to May 2016. The swab sticks were carefully transferred into the buffered peptone water and incubated at 37°C for 24hours and pre-enriched in sterile nutrient broth at 37°C for 24hours. After which, the culture was streaked on selective media Salmonella-shigella Agar and Mannitol Salt Agar using a sterile wire loop and further incubated at 37°C for 24 hours. S. aureus and Salmonella isolates were identified using standard microbiological identification techniques. The isolates were evaluated for antibiotic susceptibility, and for the expression of extended spectrum β-lactamase as well as vancomycin sensitivity. Results: One hundred bacterial isolates (44 S. aureus and 56 Salmonella spp.) were bacteriologically obtained from the poultry samples. Resistance pattern of the isolates to antibiotics was in the order of ceftazidime>cefuroxime>cloxacillin>augmentin®>ceftriaxone>erythromycin>gentamicin>ofloxacin for S. aureus while the Salmonella spp. had augmentin®>cefuroxime~ofloxacin>gentamicin>ceftazidime>ceftriaxone. Only 5.3% (3/56) Salmonella spp. was ESBL producers while 27.3% S. aureus were Vancomycin resistant. Conclusion: Our findings demonstrated that the poultry farm and poultry products could be a source of multiple antimicrobial-resistant Salmonella and S. aureus and may constitute a public health concern considering the circulation and consumption of livestock and their products, especially chickens and eggs.
背景:家禽生产是新型人畜共患和抗生素耐药性食源性病原体传播的关键接口。对来自2个家禽生产的沙门氏菌和金黄色葡萄球菌分离株进行了临床抗生素耐药性测试。方法:在2016年2月至2016年5月期间,从阿古卢的2个小型家禽养殖场无菌采集了100份肛门拭子样本。将拭子棒小心地转移到缓冲的蛋白胨水中,在37°C下孵育24小时,并在37℃的无菌营养肉汤中预富集24小时。之后,使用无菌线环将培养物在选择性培养基志贺氏菌琼脂和甘露醇盐琼脂上划线,并在37°C下进一步孵育24小时。使用标准微生物鉴定技术鉴定金黄色葡萄球菌和沙门氏菌分离株。评估分离株的抗生素敏感性、超广谱β-内酰胺酶的表达以及万古霉素的敏感性。结果:从家禽样品中分离得到100株细菌,其中金黄色葡萄球菌44株,沙门氏菌56株。分离株对金黄色葡萄球菌的耐药模式依次为:头孢他啶>头孢呋辛>氯唑西林>奥格汀®>头孢曲松>红霉素>庆大霉素>氧氟沙星;而沙门氏菌的耐药模式为奥格汀®;>头孢呋辛~氧氟沙星>庆大霉素>头孢他啶>头孢曲松。只有5.3%(3/56)的沙门氏菌产生ESBL,而27.3%的金黄色葡萄球菌具有万古霉素耐药性。结论:我们的研究结果表明,家禽养殖场和家禽产品可能是多种抗微生物沙门氏菌和金黄色葡萄球菌的来源,考虑到牲畜及其产品,特别是鸡和蛋的流通和消费,可能构成公共卫生问题。
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引用次数: 8
Infection Prevalence of Intestinal Parasitic Protozoans in Atat Hospital, Gurage Zone, Ethiopia: A Retrospective Study 埃塞俄比亚古拉格区Atat医院肠道寄生原虫感染流行情况的回顾性研究
Pub Date : 2019-02-28 DOI: 10.35248/2329-891X.19.7.307
Kabeta Legese
Intestinal parasitic protozoan infections remain as the major public health concerns in many developing countries like Ethiopia. A retrospective analysis was conducted to determine the prevalence of intestinal parasitic protozoan infection in patients admitted at Atat Hospital from September 2014 to August 2016. Stool samples collected from the patients were examined using direct wet mount and formal-Ether concentration techniques by experienced laboratory technologists of the hospital. Out of 15, 731 examined stool samples, 7062 (45%) were infected by intestinal protozoan parasites. Most of the infected individuals were infected by Entamoeba histolytica (60.0%) and the least was infected by Cryptosporidium parvum (3.6%). Higher infection was observed among males, 5-9 year age group, and during wet seasons. This study showed a yearly fluctuation of intestinal parasitic protozoan infections. Therefore, strategic, integrated and community participatory prevention and control program needs to be implemented in the study area.
在埃塞俄比亚等许多发展中国家,肠道寄生原生动物感染仍然是主要的公共卫生问题。回顾性分析2014年9月至2016年8月Atat医院住院患者肠道寄生原虫感染的流行情况。收集的患者粪便样本由医院经验丰富的实验室技术人员使用直接湿垫和正规乙醚浓度技术进行检测。在检查的15731份粪便样本中,7062份(45%)感染了肠道原生动物寄生虫。感染人数以溶组织内阿米巴最多(60.0%),小隐孢子虫最少(3.6%)。男性、5-9岁年龄组和雨季感染率较高。该研究显示肠道寄生原生动物感染的年度波动。因此,需要在研究区实施战略性、综合性、社区参与性的防治方案。
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引用次数: 1
Campylobacteriosis: Emphasis on its Status as Foodborne Zoonosis in Ethiopia 弯曲杆菌病:强调其在埃塞俄比亚作为食源性人畜共患病的地位
Pub Date : 2019-01-01 DOI: 10.35248/2329-891X.19.7.317
Y. Hagos, Mebrahtu Berhe, Getachew Gugsa
Campylobacter is one of the major causes of gastroenteritis in humans. The bacteria is a common component of the intestinal microbiota of numerous wild bird and mammals’ species, and cause disease in human typically due to ingestion of contaminated food like that of chicken, drinking untreated water or unpasteurized milk and contact with farm animals. Most cases are sporadic with a seasonal peak during the summer. Usually, the disease manifested by fever, abdominal pain, and diarrhea, which usually diagnosed based on the patient’s history and the symptoms. The case campylobacteriosis was rarely investigated and under-reported in Ethiopia. Therefore, the aims of this paper are to review the nature of Campylobacter spp. and overview its status as a foodborne zoonosis in Ethiopia. Based on the published report from different parts of Ethiopia, thermophilic Campylobacter spp. were isolated from raw meats and feces samples of different domestic animals and human. The highest prevalence reported from chicken meats, and C. jejuni and C. coli were the most prevalence Campylobacter spp. isolated from both the foods of animal origin and human beings. The disease has significantly reported from different parts of the country, though researches do not seem to cover wider geographic areas. Campylobacteriosis control and prevention strategies should focus on prevention of transmission to human beings by implementing strict hygienic control measures along the food chain to improve the hygienic conditions during handling, slaughtering, storage and commercialization of foods.
弯曲杆菌是引起人类肠胃炎的主要原因之一。这种细菌是许多野生鸟类和哺乳动物肠道微生物群的常见组成部分,通常由于摄入受污染的食物(如鸡肉)、饮用未经处理的水或未经巴氏消毒的牛奶以及与农场动物接触而导致人类患病。大多数病例是散发的,夏季为季节性高峰。该病多表现为发热、腹痛、腹泻,多根据患者的病史及症状诊断。在埃塞俄比亚,弯曲杆菌病病例很少调查和报告不足。因此,本文的目的是回顾弯曲杆菌的性质和概述其作为食源性人畜共患病在埃塞俄比亚的地位。根据来自埃塞俄比亚不同地区的已发表报告,从不同家畜和人类的生肉和粪便样本中分离出嗜热弯曲杆菌。从动物源性食品和人源性食品中分离出的弯曲杆菌感染率最高的是鸡肉,最高的是空肠C.和大肠C.。尽管研究似乎没有覆盖更广泛的地理区域,但该国不同地区都有大量关于该病的报道。弯曲杆菌病的控制和预防战略应侧重于通过在食品链上实施严格的卫生控制措施来预防向人类传播,以改善食品处理、屠宰、储存和商业化过程中的卫生条件。
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引用次数: 3
Seroreactivity of Populations Living in Endemic Area of Burkina Faso to Plasmodium falciparum Alpha-Helical Coiled Coil Proteins Motifs by Protein Microarray 蛋白质芯片技术测定布基纳法索流行区人群对恶性疟原虫α -螺旋盘绕蛋白基序的血清反应性
Pub Date : 2019-01-01 DOI: 10.35248/2329-891x.19.7.320
O. Ouédraogo, Luisa Nunziangeli, Edith C. Bougouma, Y. Kaboré, A. Diarra, B. Kote, A. Tiono, G. Corradin, V. Mangano, D. Modiano, Y. Traoré, S. Sirima, R. Spaccapelo, I. Nebie’
The naturally acquired immunity is one of the models of immunity that is exploited for malaria antigens discovery. We have used multiplex protein microarrays of 92 P. falciparum alpha-helical coiled coil protein motifs to screen plasma samples obtained from 1113 children and adults belonging to three sympatric ethnic groups from malaria endemic area of Burkina Faso. We have investigated the influence of some factors such as age, ethnicity, hemoglobin genotype and sex on the antigens reactivity and the IgG antibody level. We also investigated specifically, the influence of the factors mentioned above on the 36 antigens with the highest antibody prevalence and intensity. As expected, the findings of the study confirmed the positive correlation between age, antigens reactivity and IgG antibody level. Except for three antigens (MSP2_3D7, MR260, and As182.20), the IgG level was higher in adults compared to children. The Fulani ethnic group recognized more antigens with the highest IgG values compared to the sympatric groups of Mossi and Rimaibe, except for six antigens (LR166, LR146, AS182.15, MR214, MR236A, and MSP3). In General, the hemoglobin type and sex did not have any influence on the IgG antibody reactivity and intensity. Except for four antigens (MR232, MR261A, MSP2_3D7, and NANP) 10), there was statistically no IgG intensity difference between people with normal hemoglobin genotype (AA) and the non-(AA) volunteers. Our study has demonstrated that protein microarrays of alpha-helical coiled-coil proteins motifs are suitable to screen the naturally acquired immunity. The findings of the study should be considered in any strategy for new antigen related to alpha-helical coiled coil protein segments discovery for a potential vaccine clinical development.
自然获得性免疫是用于发现疟疾抗原的免疫模型之一。我们采用92种恶性疟原虫α -螺旋盘曲蛋白基序的多重蛋白微阵列技术,对来自布基纳法索疟疾流行区3个同域族群的1113名儿童和成人的血浆样本进行了筛选。我们研究了年龄、种族、血红蛋白基因型和性别等因素对抗原反应性和IgG抗体水平的影响。我们还具体考察了上述因素对抗体流行率和抗体强度最高的36种抗原的影响。正如预期的那样,研究结果证实了年龄、抗原反应性和IgG抗体水平之间的正相关。除3种抗原(MSP2_3D7、MR260、As182.20)外,成人IgG水平均高于儿童。富拉尼族除LR166、LR146、AS182.15、MR214、MR236A和MSP3 6种抗原外,其余抗原的IgG值均高于莫西族和Rimaibe族。总的来说,血红蛋白类型和性别对IgG抗体反应性和强度没有影响。除4种抗原(MR232、MR261A、MSP2_3D7、NANP) 10)外,正常血红蛋白基因型(AA)与非正常血红蛋白基因型(AA)志愿者的IgG强度无统计学差异。我们的研究表明,α -螺旋螺旋蛋白基序的蛋白质微阵列适合筛选自然获得性免疫。该研究结果应被考虑在任何与α -螺旋螺旋蛋白片段相关的新抗原发现策略中,以用于潜在的疫苗临床开发。
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引用次数: 1
Primary Adrenal Tumors in Adults Single Institute 10 Years andrsquo; Experience 成人原发性肾上腺肿瘤的研究进展经验
Pub Date : 2019-01-01 DOI: 10.35248/2329-891X.19.7.314
A. Salem, Mahmoud Hussein Alshoeiby, Badawy M. Ahmed, Mona M. Sayed
Introduction: The study aims to describe the clinico-pathological data of adult patients with different types of primary adrenal masses admitted to SECI and their outcome. Patients and Methods: This is a retrospective study conducted at surgical oncology department, South Egypt cancer institute, Assiut University, from January 2006 till December of 2015. Ninety-six patients with proved primary suprarenal tumor were included in the study and their data were retrospectively collected. We tried to perform an epidemiological study and to evaluate the surgical outcome after adrenalectomy for either benign or malignant suprarenal tumors in term of intraoperative morbidity and short postoperative complications and long term follow up. Results: A total of 96 adult patients diagnosed with primary suprarenal tumors (36 males and 60 females). Overall, 24 patients had benign lesions and 72 had malignant tumors (64 of cases had tumor size ≥ 6 cm). Hormonal evaluation was performed in all cases, which revealed hypersecretion in 10 cases, seventy-six patients underwent adrenalectomy, pathology was Adrenocortical carcinoma in 43 cases, Pheochromocytoma 22 cases, Adrenocortical hyperplasia 8 cases, paraganglioma 7 cases, Myelolipoma and adenoma 6 cases each, splenecule and suprarenal cyst 2 cases each. The mean of overall survival for malignant cases was 73.63 months. Conclusion: The rarity of primary suprarenal tumours should not disprove their clinical significance because of their particular location and endocrine effects, and must be dealt with a multidisciplinary team to achieve cure and give the best survival values.
前言:本研究旨在描述不同类型原发性肾上腺肿块的成人SECI患者的临床病理资料及其转归。患者和方法:这是一项回顾性研究,于2006年1月至2015年12月在Assiut大学南埃及癌症研究所外科肿瘤科进行。96例确诊为原发性肾上肿瘤的患者被纳入研究,并对他们的资料进行回顾性收集。我们试图进行一项流行病学研究,并从术中发病率、术后短期并发症和长期随访的角度评估肾上腺切除术后良性或恶性肾上肿瘤的手术结果。结果:96例确诊为原发性肾上肿瘤的成人患者(男性36例,女性60例)。良性病变24例,恶性肿瘤72例(肿瘤大小≥6cm 64例)。所有病例均行激素检查,10例肾上腺分泌亢进,76例行肾上腺切除术,病理为肾上腺皮质癌43例,嗜铬细胞瘤22例,肾上腺皮质增生8例,副神经节瘤7例,骨髓脂肪瘤和腺瘤各6例,脾及肾上囊肿各2例。恶性病例的平均总生存期为73.63个月。结论:原发性肾上肿瘤的罕见性不应因其特殊的位置和内分泌作用而否定其临床意义,必须多学科联合治疗,以达到治愈和给予最佳生存价值。
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引用次数: 0
Primary Health Care System Readiness for Diabetes Mellitus and Tuberculosis Service Integration in South Africa 南非初级卫生保健系统对糖尿病和结核病服务整合的准备情况
Pub Date : 2019-01-01 DOI: 10.35248/2329-891X.19.7.329
H. Almossawi, R. Matji, Y. Pillay, H. Singh, L. Mvusi, B. Mbambo, Aida Olkkonen, N. Kak
Background: In recognition of the convergence of high levels of Tuberculosis (TB) and increasing Diabetes Mellitus (DM) in South Africa, the country has prioritized integrated clinical service management for acute diseases and chronic conditions at the primary health care level. The shift toward collaborative activities requires changes in all areas of the health system. Objective: To assess the readiness of the primary health care system to provide integrated tuberculosis and diabetes services, this case study assessed leadership/governance, the health workforce, health information systems, access to medicines, and service delivery. Methods: The mixed-method study included interviews with health facility managers, facility checklist of TB and DM supplies and commodities, review of health records, a patient survey, and focus group discussions with health managers in three districts in KwaZulu Natal Province, Eastern Cape Province, and Free State Province. Results: Performance in bi-directional screening and co-management of TB and DM was weak: TB patients sometimes received DM screening, and the results were sometimes reported. Whether DM patients were routinely being screened for TB was unclear due to the lack of systematic reporting on DM patients. Two potential factors undermining service delivery were the overburdened health workforce and the poor health information system, particularly for DM data recording and reporting. The availability of supplies and commodities for integrated service delivery was good. Conclusion: South Africa has exhibited a strong policy-level commitment to the integrated management of chronic and acute diseases at all levels. The challenge is on operationalizing the guidelines at the primary health care level. Investments need to focus particularly on strengthening the capacity of the health workforce at the primary health care level and establishing an integrated strategy for data collection and analysis.
背景:认识到南非结核病(TB)和糖尿病(DM)的高水平趋同,该国已优先考虑在初级卫生保健一级对急性疾病和慢性疾病进行综合临床服务管理。向协作活动的转变需要在卫生系统的所有领域进行变革。目的:为了评估初级卫生保健系统提供结核病和糖尿病综合服务的准备情况,本案例研究评估了领导/治理、卫生人力、卫生信息系统、药物获取和服务提供。方法:混合方法研究包括对卫生设施管理人员的访谈,结核病和糖尿病用品和商品的设施清单,健康记录的审查,患者调查,以及与夸祖鲁-纳塔尔省、东开普省和自由邦省三个地区的卫生管理人员的焦点小组讨论。结果:结核病与糖尿病的双向筛查和联合管理效果较差,结核病患者有时接受糖尿病筛查,结果有时被报道。由于缺乏对糖尿病患者的系统报道,目前尚不清楚糖尿病患者是否常规接受结核病筛查。破坏服务提供的两个潜在因素是卫生人力负担过重和卫生信息系统不完善,特别是DM数据记录和报告。提供综合服务所需的用品和商品情况良好。结论:南非在各级对慢性和急性疾病的综合管理表现出强有力的政策层面承诺。挑战在于如何在初级保健一级实施这些准则。投资需要特别侧重于加强初级卫生保健一级卫生工作人员的能力,并制定数据收集和分析的综合战略。
{"title":"Primary Health Care System Readiness for Diabetes Mellitus and Tuberculosis Service Integration in South Africa","authors":"H. Almossawi, R. Matji, Y. Pillay, H. Singh, L. Mvusi, B. Mbambo, Aida Olkkonen, N. Kak","doi":"10.35248/2329-891X.19.7.329","DOIUrl":"https://doi.org/10.35248/2329-891X.19.7.329","url":null,"abstract":"Background: In recognition of the convergence of high levels of Tuberculosis (TB) and increasing Diabetes Mellitus (DM) in South Africa, the country has prioritized integrated clinical service management for acute diseases and chronic conditions at the primary health care level. The shift toward collaborative activities requires changes in all areas of the health system. Objective: To assess the readiness of the primary health care system to provide integrated tuberculosis and diabetes services, this case study assessed leadership/governance, the health workforce, health information systems, access to medicines, and service delivery. Methods: The mixed-method study included interviews with health facility managers, facility checklist of TB and DM supplies and commodities, review of health records, a patient survey, and focus group discussions with health managers in three districts in KwaZulu Natal Province, Eastern Cape Province, and Free State Province. Results: Performance in bi-directional screening and co-management of TB and DM was weak: TB patients sometimes received DM screening, and the results were sometimes reported. Whether DM patients were routinely being screened for TB was unclear due to the lack of systematic reporting on DM patients. Two potential factors undermining service delivery were the overburdened health workforce and the poor health information system, particularly for DM data recording and reporting. The availability of supplies and commodities for integrated service delivery was good. Conclusion: South Africa has exhibited a strong policy-level commitment to the integrated management of chronic and acute diseases at all levels. The challenge is on operationalizing the guidelines at the primary health care level. Investments need to focus particularly on strengthening the capacity of the health workforce at the primary health care level and establishing an integrated strategy for data collection and analysis.","PeriodicalId":74002,"journal":{"name":"Journal of tropical diseases & public health","volume":"7 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70009312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Therapeutic Efficacy of Coartem® in Treatment of Simple Plasmodium falciparum Malaria in Woreta, South Gonder Zone, Ethiopia 复方蒿甲醚®治疗埃塞俄比亚南贡德地区Woreta地区单纯性恶性疟原虫疟疾的疗效
Pub Date : 2019-01-01 DOI: 10.35248/2329-891X.19.7.330
Sintayehu Tsegaye Tseha
Background: The aim of the study was to investigate the therapeutic efficacy of Coartem® in the treatment of simple P. falciparum malaria in Woreta Town, South Gonder Zone, Ethiopia. Methods: 2240 febrile patients attending the health center were screened and capillary blood was obtained by finger prick. Giemsa stained thick and thin blood smears were prepared and used for parasite density and species identification. Of the 2240 patients tested, 88 with confirmed falciparum malaria were enrolled and treated with Coartem®. Haemoglobin concentration of the study participants was measured on day 0, 14 and 28. Of the 88 patients enrolled, five were lost to follow and five were excluded from treatment response analysis due to protocol violation. As a result, 78 patients were evaluated for treatment outcomes. Results: The adequate clinical and parasitological response was 100% at day 28. Fever clearance was fast with only 1.7% being febrile at day three. Parasite clearance was rapid with almost all patients (98.9%) being free of parasitmia on day 2. A significant increase in haemoglobin level was observed on day 28. Conclusion: Thus, these findings further support the use of Coartem as an effective treatment of simple P. falciparum malaria in the infectious disease area.
背景:本研究旨在探讨复方蒿甲醚®治疗埃塞俄比亚南贡德区Woreta镇单纯性恶性疟原虫疟疾的疗效。方法:对2240例在卫生院就诊的发热患者进行筛查,采用刺指法采集毛细血管血。制备姬姆萨染色厚、薄血涂片,用于寄生虫密度和种类鉴定。在接受检测的2240名患者中,88名确诊为恶性疟疾的患者接受了复方蒿甲醚治疗。在第0、14和28天测量研究参与者的血红蛋白浓度。在入组的88例患者中,5例因违反方案而未能随访,5例因治疗反应分析而被排除。结果,78名患者接受了治疗结果评估。结果:28 d临床和寄生虫学反应均为100%。退热很快,第三天只有1.7%的人发烧。寄生虫清除迅速,几乎所有患者(98.9%)在第2天无寄生虫。第28天血红蛋白水平显著升高。结论:本研究结果进一步支持复方蒿甲醚作为传染病区单纯性恶性疟原虫疟疾的有效治疗方法。
{"title":"Therapeutic Efficacy of Coartem® in Treatment of Simple Plasmodium falciparum Malaria in Woreta, South Gonder Zone, Ethiopia","authors":"Sintayehu Tsegaye Tseha","doi":"10.35248/2329-891X.19.7.330","DOIUrl":"https://doi.org/10.35248/2329-891X.19.7.330","url":null,"abstract":"Background: The aim of the study was to investigate the therapeutic efficacy of Coartem® in the treatment of simple P. falciparum malaria in Woreta Town, South Gonder Zone, Ethiopia. Methods: 2240 febrile patients attending the health center were screened and capillary blood was obtained by finger prick. Giemsa stained thick and thin blood smears were prepared and used for parasite density and species identification. Of the 2240 patients tested, 88 with confirmed falciparum malaria were enrolled and treated with Coartem®. Haemoglobin concentration of the study participants was measured on day 0, 14 and 28. Of the 88 patients enrolled, five were lost to follow and five were excluded from treatment response analysis due to protocol violation. As a result, 78 patients were evaluated for treatment outcomes. Results: The adequate clinical and parasitological response was 100% at day 28. Fever clearance was fast with only 1.7% being febrile at day three. Parasite clearance was rapid with almost all patients (98.9%) being free of parasitmia on day 2. A significant increase in haemoglobin level was observed on day 28. Conclusion: Thus, these findings further support the use of Coartem as an effective treatment of simple P. falciparum malaria in the infectious disease area.","PeriodicalId":74002,"journal":{"name":"Journal of tropical diseases & public health","volume":"7 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70009375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Journal of tropical diseases & public health
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