Jader Oliveira, Carlos Fernando Rocha, Jociel Klleyton Santos Santana, André Luiz Rodrigues Menezes, Cleber Galvão, João Aristeu da Rosa, Kaio Cesar Chaboli Alevi
Panstrongylus geniculatus is the most widely distributed species of Panstrongylus in Brazil and merits attention from vector control programs due to its potential for domiciliation. Specimens infected with Trypanosoma cruzi have already been reported in both peridomiciliary and domiciliary environments. Building on these findings, we report, for the first time, the presence of P. geniculatus in the state of Alagoas and provide an updated dichotomous key (based on cytogenetic data) for species in Alagoas. Panstrongylus geniculatus has been identified in Boca da Mata, Joaquim Gomes, and Novo Lino. In light of the recent notification of Rhodnius domesticus and this record of P. geniculatus, we present an updated identification key enabling the differentiation of all species in Alagoas. Emphasis is placed on the importance of correctly identifying triatomine species because it is crucial for the development of effective control measures, thereby aiding in the mitigation of Chagas disease.
Geniculatus 盘尾丝虫是巴西分布最广的盘尾丝虫种类,由于它有可能寄居,因此值得病媒控制计划关注。已经有报告称,在周边环境和寄居环境中都有感染克氏锥虫的标本。在这些研究结果的基础上,我们首次报告了阿拉戈斯州出现的 geniculatus 盘尾丝虫,并提供了阿拉戈斯州盘尾丝虫物种的最新二分法(基于细胞遗传学数据)。在 Boca da Mata、Joaquim Gomes 和 Novo Lino 发现了 geniculatus 盘尾丝虫。鉴于最近发现了Rhodnius domesticus,并记录了P. geniculatus,我们提出了一个最新的识别码,以区分阿拉戈斯州的所有物种。我们强调了正确识别三蠹物种的重要性,因为这对于制定有效的控制措施至关重要,从而有助于减轻南美锥虫病的危害。
{"title":"Chagas Disease Vectors of Alagoas, Brazil: First Report of Panstrongylus geniculatus (Latreille, 1811) (Hemiptera, Triatominae) in the Brazilian State and Update of the Dichotomous Key Based on Cytogenetic Data.","authors":"Jader Oliveira, Carlos Fernando Rocha, Jociel Klleyton Santos Santana, André Luiz Rodrigues Menezes, Cleber Galvão, João Aristeu da Rosa, Kaio Cesar Chaboli Alevi","doi":"10.4269/ajtmh.23-0433","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0433","url":null,"abstract":"<p><p>Panstrongylus geniculatus is the most widely distributed species of Panstrongylus in Brazil and merits attention from vector control programs due to its potential for domiciliation. Specimens infected with Trypanosoma cruzi have already been reported in both peridomiciliary and domiciliary environments. Building on these findings, we report, for the first time, the presence of P. geniculatus in the state of Alagoas and provide an updated dichotomous key (based on cytogenetic data) for species in Alagoas. Panstrongylus geniculatus has been identified in Boca da Mata, Joaquim Gomes, and Novo Lino. In light of the recent notification of Rhodnius domesticus and this record of P. geniculatus, we present an updated identification key enabling the differentiation of all species in Alagoas. Emphasis is placed on the importance of correctly identifying triatomine species because it is crucial for the development of effective control measures, thereby aiding in the mitigation of Chagas disease.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mario Songane, Sushant Mukherjee, Rachel Chamanga, Thulani Maphosa, Barry Longwe, Joseph Namathanga, Allan Ahimbisibwe, Rebecca Bailey, Appolinaire Tiam
Antimicrobial prophylaxis and treatment of opportunistic infections immediately before or at the start of antiretroviral therapy (ART) improves prognosis and decreases death rates among patients with advanced HIV disease (AHD). In this study, we estimated the average cost per patient receiving AHD services (PP) and per client retained (PR) at 12 months. The study population included children, adolescents, and adults enrolled in the AHD program at 13 hub and 19 spoke sites in Malawi. To evaluate the cost PP and PR, we divided the cost of providing AHD services at 12 months by the total number of patients who received these services and who were retained in AHD services care at 12 months, respectively. We enrolled 246 AHD patients, with 137 retained at 12 months. The cost of providing AHD services to 246 patients at 12 months was $59,063; cost PP was $240, and cost PR was $431. Drugs were the largest expenditure (30%), followed by travel for supportive supervision (24%), clinic visit costs (19%), site support personnel (8%), laboratory tests (7%), annualized training costs (6%), consumables (3%), and meetings (3%). The cost of ART was $11,754; however, ART would be provided regardless of whether the AHD package was in place. Any reduction in overall costs of AHD care will require coordination among procurement partners and negotiations with manufacturers to help reduce the prices of drugs and laboratory consumables. This calls for further improvement of efficiency and capacity of site-level staff to reduce costs related to supportive supervision.
{"title":"Cost of Providing Advanced HIV Disease Treatment Services through Malawi's Hub-and-Spoke Model.","authors":"Mario Songane, Sushant Mukherjee, Rachel Chamanga, Thulani Maphosa, Barry Longwe, Joseph Namathanga, Allan Ahimbisibwe, Rebecca Bailey, Appolinaire Tiam","doi":"10.4269/ajtmh.23-0880","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0880","url":null,"abstract":"<p><p>Antimicrobial prophylaxis and treatment of opportunistic infections immediately before or at the start of antiretroviral therapy (ART) improves prognosis and decreases death rates among patients with advanced HIV disease (AHD). In this study, we estimated the average cost per patient receiving AHD services (PP) and per client retained (PR) at 12 months. The study population included children, adolescents, and adults enrolled in the AHD program at 13 hub and 19 spoke sites in Malawi. To evaluate the cost PP and PR, we divided the cost of providing AHD services at 12 months by the total number of patients who received these services and who were retained in AHD services care at 12 months, respectively. We enrolled 246 AHD patients, with 137 retained at 12 months. The cost of providing AHD services to 246 patients at 12 months was $59,063; cost PP was $240, and cost PR was $431. Drugs were the largest expenditure (30%), followed by travel for supportive supervision (24%), clinic visit costs (19%), site support personnel (8%), laboratory tests (7%), annualized training costs (6%), consumables (3%), and meetings (3%). The cost of ART was $11,754; however, ART would be provided regardless of whether the AHD package was in place. Any reduction in overall costs of AHD care will require coordination among procurement partners and negotiations with manufacturers to help reduce the prices of drugs and laboratory consumables. This calls for further improvement of efficiency and capacity of site-level staff to reduce costs related to supportive supervision.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hridesh Mishra, Michelle Ngai, Valerie M Crowley, Vanessa Tran, Maria Salome Siose Painaga, James Yared Gaite, Patrick Hamilton, Kevin C Kain, Michael T Hawkes
Dengue virus (DENV) infection is associated with plasma leakage, which may progress to shock. The angiopoietin (Ang)-tyrosine kinase with immunoglobulin and epidermal growth factor homology domain 2 (Tie-2) axis regulates endothelial permeability. We examined the clinical utility of Ang-1, Ang-2, and the Ang-2-to-Ang-1 ratio for prediction of progression to severe DENV in a prospective cohort study of children and young adults (age 1 to <26 years) with DENV infection. Ang-1, Ang-2, Tie-2 were measured at presentation to an outpatient clinic in the Philippines from stored plasma by multiplex Luminex® assay. Patients were followed prospectively to document the clinical course (hospitalization, length of stay, intravenous fluid resuscitation, and transfer to a higher level facility). We included 244 patients (median age 9 years, 40% female). At presentation, 63 patients (26%) had uncomplicated dengue, 179 (73%) had dengue with warning signs, and 2 (0.82%) had severe dengue. One hundred eighty-one patients (74%) were hospitalized. Ang-1 levels were lower and Ang-2 higher in patients who required hospitalization. Ang-2-to-Ang-1 ratio >1 was associated with a relative risk of hospitalization of 1.20 (95% CI: 1.03-1.36, P = 0.016). A higher Ang-2-to-Ang-1 ratio was associated with longer length of hospital stay, higher frequency of transfer to a higher level facility, larger intravenous fluid requirement, hemoconcentration, and thrombocytopenia. Angiopoietin-2 was correlated with procalcitonin (Kendall's τ = 0.17, P = 0.00012), a marker of systemic inflammation, as well as soluble vascular cell adhesion molecule-1 (τ = 0.22, P <0.0001) and Endoglin (τ = 0.14, P = 0.0017), markers of endothelial activation. In conclusion, altered Ang-2-to-Ang-1 ratio can be detected early in the course of DENV infection and predicts clinically meaningful events (hospitalization, length of stay, and fluid resuscitation).
{"title":"The Angiopoietin-Tie-2 Axis in Children and Young Adults with Dengue Virus Infection in the Philippines.","authors":"Hridesh Mishra, Michelle Ngai, Valerie M Crowley, Vanessa Tran, Maria Salome Siose Painaga, James Yared Gaite, Patrick Hamilton, Kevin C Kain, Michael T Hawkes","doi":"10.4269/ajtmh.24-0115","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0115","url":null,"abstract":"<p><p>Dengue virus (DENV) infection is associated with plasma leakage, which may progress to shock. The angiopoietin (Ang)-tyrosine kinase with immunoglobulin and epidermal growth factor homology domain 2 (Tie-2) axis regulates endothelial permeability. We examined the clinical utility of Ang-1, Ang-2, and the Ang-2-to-Ang-1 ratio for prediction of progression to severe DENV in a prospective cohort study of children and young adults (age 1 to <26 years) with DENV infection. Ang-1, Ang-2, Tie-2 were measured at presentation to an outpatient clinic in the Philippines from stored plasma by multiplex Luminex® assay. Patients were followed prospectively to document the clinical course (hospitalization, length of stay, intravenous fluid resuscitation, and transfer to a higher level facility). We included 244 patients (median age 9 years, 40% female). At presentation, 63 patients (26%) had uncomplicated dengue, 179 (73%) had dengue with warning signs, and 2 (0.82%) had severe dengue. One hundred eighty-one patients (74%) were hospitalized. Ang-1 levels were lower and Ang-2 higher in patients who required hospitalization. Ang-2-to-Ang-1 ratio >1 was associated with a relative risk of hospitalization of 1.20 (95% CI: 1.03-1.36, P = 0.016). A higher Ang-2-to-Ang-1 ratio was associated with longer length of hospital stay, higher frequency of transfer to a higher level facility, larger intravenous fluid requirement, hemoconcentration, and thrombocytopenia. Angiopoietin-2 was correlated with procalcitonin (Kendall's τ = 0.17, P = 0.00012), a marker of systemic inflammation, as well as soluble vascular cell adhesion molecule-1 (τ = 0.22, P <0.0001) and Endoglin (τ = 0.14, P = 0.0017), markers of endothelial activation. In conclusion, altered Ang-2-to-Ang-1 ratio can be detected early in the course of DENV infection and predicts clinically meaningful events (hospitalization, length of stay, and fluid resuscitation).</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dinie Adila Zainol, Nor Suhada Anuar, Nur Shuhaidatul Sarmiza Abdul Halim, Mansheender Kaur, Rahmah Noordin, Anizah Rahumatullah
Accurate diagnosis of strongyloidiasis is crucial for effective treatment and prevention of complications. We reviewed the current landscape of diagnostic assays used in detecting Strongyloides infection in Southeast Asia. A literature search was performed using Scopus, PubMed, and Web of Science databases spanning the last three decades. Based on the exclusion and inclusion criteria, 52 papers were included in this review. We outlined the diagnostic methods used and their advantages and drawbacks. Insensitive parasitological methods were commonly used, thus underscoring the underestimation of Strongyloides infection rates in Southeast Asia. A combination of diagnostic methods (i.e., microscopy, molecular techniques, and serology) is preferred because it leads to more effective detection and higher prevalence rates. New approaches have been developed, including urine ELISAs and rapid lateral flow tests. Improving and standardizing diagnostics and making them more accessible can improve Strongyloides prevalence estimates and facilitate control efforts.
准确诊断强直丝虫病对于有效治疗和预防并发症至关重要。我们回顾了东南亚地区目前用于检测强直丝虫感染的诊断方法。我们使用 Scopus、PubMed 和 Web of Science 数据库对过去三十年的文献进行了检索。根据排除和纳入标准,本综述共纳入了 52 篇论文。我们概述了所使用的诊断方法及其优缺点。我们普遍采用了不敏感的寄生虫学方法,这凸显了东南亚地区对斯龙线虫感染率的低估。将多种诊断方法(即显微镜检查、分子技术和血清学)结合使用更受欢迎,因为这样能更有效地检测并提高感染率。目前已开发出新的方法,包括尿液酶联免疫吸附试验和快速侧流试验。改进诊断方法并使之标准化,使之更容易获得,可以提高对斯龙线虫病流行率的估计,促进控制工作。
{"title":"Systematic Review of Strongyloides stercoralis Infection Diagnosis in Southeast Asia: Insights from Parasitological, Molecular, and Serological Approaches.","authors":"Dinie Adila Zainol, Nor Suhada Anuar, Nur Shuhaidatul Sarmiza Abdul Halim, Mansheender Kaur, Rahmah Noordin, Anizah Rahumatullah","doi":"10.4269/ajtmh.23-0599","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0599","url":null,"abstract":"<p><p>Accurate diagnosis of strongyloidiasis is crucial for effective treatment and prevention of complications. We reviewed the current landscape of diagnostic assays used in detecting Strongyloides infection in Southeast Asia. A literature search was performed using Scopus, PubMed, and Web of Science databases spanning the last three decades. Based on the exclusion and inclusion criteria, 52 papers were included in this review. We outlined the diagnostic methods used and their advantages and drawbacks. Insensitive parasitological methods were commonly used, thus underscoring the underestimation of Strongyloides infection rates in Southeast Asia. A combination of diagnostic methods (i.e., microscopy, molecular techniques, and serology) is preferred because it leads to more effective detection and higher prevalence rates. New approaches have been developed, including urine ELISAs and rapid lateral flow tests. Improving and standardizing diagnostics and making them more accessible can improve Strongyloides prevalence estimates and facilitate control efforts.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sevgi Aslan Tuncay, Gulsen Akkoc, Seyhan Yilmaz, Burcu Parlak, Pinar Canizci Erdemli, Aylin Dizi Isik, Eda Kepenekli
Neurobrucellosis is rare in children, presenting with a variety of clinical manifestations, including meningitis, meningoencephalitis, cranial neuropathies, and intracranial mass-like lesions. We present a case of a 17-year-old girl admitted to the hospital in Istanbul for headache. Lumbar puncture showed elevated intracranial pressure, monocytic pleocytosis, elevated total protein, and hypoglycorrhachia. Brucella melitensis grew from the cerebrospinal fluid. The patient was treated with doxycycline, rifampin, amikacin, and ceftriaxone and showed persistent sensorineural hearing loss. It is essential to consider brucellosis in the differential diagnosis of infectious neurological disease in areas where the disease is endemic. Serologic tests and cultures are needed for diagnosis, and efforts need to be made to identify the infecting organism to the species level to guide zoonotic source control efforts.
{"title":"Case Report: Brucellosis Mimicking Tuberculous Meningitis in a Child.","authors":"Sevgi Aslan Tuncay, Gulsen Akkoc, Seyhan Yilmaz, Burcu Parlak, Pinar Canizci Erdemli, Aylin Dizi Isik, Eda Kepenekli","doi":"10.4269/ajtmh.23-0715","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0715","url":null,"abstract":"<p><p>Neurobrucellosis is rare in children, presenting with a variety of clinical manifestations, including meningitis, meningoencephalitis, cranial neuropathies, and intracranial mass-like lesions. We present a case of a 17-year-old girl admitted to the hospital in Istanbul for headache. Lumbar puncture showed elevated intracranial pressure, monocytic pleocytosis, elevated total protein, and hypoglycorrhachia. Brucella melitensis grew from the cerebrospinal fluid. The patient was treated with doxycycline, rifampin, amikacin, and ceftriaxone and showed persistent sensorineural hearing loss. It is essential to consider brucellosis in the differential diagnosis of infectious neurological disease in areas where the disease is endemic. Serologic tests and cultures are needed for diagnosis, and efforts need to be made to identify the infecting organism to the species level to guide zoonotic source control efforts.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tuberculosis (TB) is an airborne infectious disease caused by Mycobacterium tuberculosis that most commonly affects the lungs. Ocular involvement as part of extrapulmonary TB is noted in around 2-18% of cases of extrapulmonary TB. Any part of the eyes can be affected by the tubercular disease process, and a high index of suspicion is required for accurate diagnosis. Because the location is extrapulmonary, obtaining a proper sample is difficult, and the paucibacillary nature of the disease also makes microbiological detection a diagnostic challenge. Response to antitubercular therapy is usually good, and resolution of clinical features is observed in most cases. Here, we present a case report of a patient presenting with a chalazion-like lesion in the left eyelid that recurred after surgical intervention and did not respond to medical therapy. No history of past TB infection or contact was noted in the patient. An active tubercular lung infection was excluded. On further evaluation, the lesion was microbiologically proven to be of tubercular origin, and the signs and symptoms of the patient completely resolved with proper antitubercular therapy.
{"title":"Case Report: Unveiling the Unseen - Ocular Tuberculosis Presenting as Chalazion.","authors":"Rucha Karad, Vasireddy Teja, Hardik Patel, Boudhayan Bhattacharjee, Agnibho Mondal, Soumendra Nath Haldar, Bibhuti Saha","doi":"10.4269/ajtmh.24-0271","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0271","url":null,"abstract":"<p><p>Tuberculosis (TB) is an airborne infectious disease caused by Mycobacterium tuberculosis that most commonly affects the lungs. Ocular involvement as part of extrapulmonary TB is noted in around 2-18% of cases of extrapulmonary TB. Any part of the eyes can be affected by the tubercular disease process, and a high index of suspicion is required for accurate diagnosis. Because the location is extrapulmonary, obtaining a proper sample is difficult, and the paucibacillary nature of the disease also makes microbiological detection a diagnostic challenge. Response to antitubercular therapy is usually good, and resolution of clinical features is observed in most cases. Here, we present a case report of a patient presenting with a chalazion-like lesion in the left eyelid that recurred after surgical intervention and did not respond to medical therapy. No history of past TB infection or contact was noted in the patient. An active tubercular lung infection was excluded. On further evaluation, the lesion was microbiologically proven to be of tubercular origin, and the signs and symptoms of the patient completely resolved with proper antitubercular therapy.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lili B Steel, Prakash Babu Narasimhan, Megha Chaudhari, Madolyn R Dauphinais, Samantha Huang, Kaley Beall, Madeline E Carwile, Chelsie Cintron, Xinyi Du, Scott K Heysell, Subitha Lakshminarayanan, Urvashi B Singh, Pranay Sinha
The burden of tuberculosis (TB) is disproportionate in tropical and subtropical regions, where parasitic coinfections are common. Given the significant geographical overlap between TB and intestinal parasitic infections, it is important to consider the implications of intestinal parasitic infections for the TB pandemic. Intestinal parasitic infections have been theorized to increase vulnerability to TB by altering the inflammatory milieu, inducing undernutrition that blunts the immune response, and affecting drug pharmacokinetics. In this perspective piece, we provide a background of the epidemiological and immunological evidence that links parasitic infections to increased risk of TB progression and worse treatment outcomes. We also identify gaps in our knowledge and call for increased research on TB-parasitic coinfections to ensure action on a potentially widespread TB comorbidity.
{"title":"Intestinal Parasitic Infections May Be Overlooked Drivers of the Tuberculosis Pandemic.","authors":"Lili B Steel, Prakash Babu Narasimhan, Megha Chaudhari, Madolyn R Dauphinais, Samantha Huang, Kaley Beall, Madeline E Carwile, Chelsie Cintron, Xinyi Du, Scott K Heysell, Subitha Lakshminarayanan, Urvashi B Singh, Pranay Sinha","doi":"10.4269/ajtmh.23-0637","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0637","url":null,"abstract":"<p><p>The burden of tuberculosis (TB) is disproportionate in tropical and subtropical regions, where parasitic coinfections are common. Given the significant geographical overlap between TB and intestinal parasitic infections, it is important to consider the implications of intestinal parasitic infections for the TB pandemic. Intestinal parasitic infections have been theorized to increase vulnerability to TB by altering the inflammatory milieu, inducing undernutrition that blunts the immune response, and affecting drug pharmacokinetics. In this perspective piece, we provide a background of the epidemiological and immunological evidence that links parasitic infections to increased risk of TB progression and worse treatment outcomes. We also identify gaps in our knowledge and call for increased research on TB-parasitic coinfections to ensure action on a potentially widespread TB comorbidity.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karen E S Hamre, Amber M Dismer, Nishant Kishore, Anyess Travers, Kathleen McGee, Bernadette Fouché, Luccène Désir, Kathleen Holmes, Gregory S Noland, Jean Frantz Lemoine, Michelle A Chang
The Ministry of Public Health and Population in Haiti is committed to malaria elimination. In 2017, we used novel methods to conduct a census, monitor progress, and return to sampled households (HH) before a cross-sectional survey in La Chapelle and Verrettes communes in Artibonite department ("the 2017 Artibonite HH census"). Geospatial PDFs with digitized structures and basemaps were loaded onto tablets. Enumerators captured GPS coordinates and details of each HH and points of interest. The census used 1 km2 enumeration areas (EAs) to draw a representative sample. Three remote sampling frames were compared with the 2017 Artibonite HH census. First, 2003 census EAs with 2012 population estimates from the Haitian Institute of Statistics and Informatics were standardized to the study EAs. The second sampling frame used the 2016 LandScanTM population estimates and study EAs. The third sampling frame used structures ≥3 m2 manually digitized using Maxar satellite images. In each study EA, 70% of structures were estimated to be inhabited with 4.5 persons/HH. The census identified 33,060 inhabited HHs with an estimated population of 121,593 and 6,126 points of interest. Using daily coverage maps and including digitized structures were novel methods that improved the census quality. Manual digitization was closest to the census sampling frame results with 30,514 digitized structures in the study area. The LandScanTM method performed better in urban areas; however, it produced the highest number of HHs to sample. If a census is not possible, when feasible, remotely digitizing structures and estimating occupancy may provide a close estimate.
{"title":"Evaluating Geospatial Sampling Frames with a Novel Field Census for a Malaria Household Survey in Artibonite, Haiti.","authors":"Karen E S Hamre, Amber M Dismer, Nishant Kishore, Anyess Travers, Kathleen McGee, Bernadette Fouché, Luccène Désir, Kathleen Holmes, Gregory S Noland, Jean Frantz Lemoine, Michelle A Chang","doi":"10.4269/ajtmh.23-0891","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0891","url":null,"abstract":"<p><p>The Ministry of Public Health and Population in Haiti is committed to malaria elimination. In 2017, we used novel methods to conduct a census, monitor progress, and return to sampled households (HH) before a cross-sectional survey in La Chapelle and Verrettes communes in Artibonite department (\"the 2017 Artibonite HH census\"). Geospatial PDFs with digitized structures and basemaps were loaded onto tablets. Enumerators captured GPS coordinates and details of each HH and points of interest. The census used 1 km2 enumeration areas (EAs) to draw a representative sample. Three remote sampling frames were compared with the 2017 Artibonite HH census. First, 2003 census EAs with 2012 population estimates from the Haitian Institute of Statistics and Informatics were standardized to the study EAs. The second sampling frame used the 2016 LandScanTM population estimates and study EAs. The third sampling frame used structures ≥3 m2 manually digitized using Maxar satellite images. In each study EA, 70% of structures were estimated to be inhabited with 4.5 persons/HH. The census identified 33,060 inhabited HHs with an estimated population of 121,593 and 6,126 points of interest. Using daily coverage maps and including digitized structures were novel methods that improved the census quality. Manual digitization was closest to the census sampling frame results with 30,514 digitized structures in the study area. The LandScanTM method performed better in urban areas; however, it produced the highest number of HHs to sample. If a census is not possible, when feasible, remotely digitizing structures and estimating occupancy may provide a close estimate.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Siobhan M Mor, Grace Ndeezi, Luke R Ascolillo, Hannington B Tasimwa, Charalampos Attipa, Jerlyn Sponseller, David Mukunya, Ritah Nakato, Lilian N Kayondo, Saul Tzipori, James K Tumwine, Jeffrey K Griffiths
Respiratory cryptosporidiosis is considered an occasional, late-stage complication of HIV/AIDS. This study aimed to assess the clinical importance of respiratory cryptosporidiosis in children with diarrhea and respiratory symptoms at Mulago Hospital, Kampala, Uganda. Children aged 9 to 36 months presenting with diarrhea and cough or unexplained tachypnea (N = 1,918) were screened for fecal Cryptosporidium using polymerase chain reaction (PCR). Children with positive stool samples were eligible for further diagnostic tests, including sputum induction. Sputum samples were subjected to PCR for Cryptosporidium, as well as routine microbiology (culture and gram stain) and auramine stain for tuberculosis. Regression analyses were used to investigate 1) factors associated with respiratory cryptosporidiosis and 2) whether respiratory cryptosporidiosis was independently associated with hospitalization. Prevalence of enteric cryptosporidiosis was 260/1,918 (13.6%) (>80% Cryptosporidium hominis). Of the 236 children who had sputum available for analysis, 62 (26.3%) had Cryptosporidium in the sputum, only two of whom had HIV infection. Children with Cryptosporidium in the sputum were more likely to have abnormal oxygen saturation at presentation (SpO2 <96%; P = 0.053); no other differences in frequency or severity of respiratory signs were noted. No alternative bacterial cause of respiratory symptoms was identified in 37.7% of children with respiratory cryptosporidiosis, compared with 23.6% of children without (P = 0.04). Sputum-positive children had twice the odds of hospitalization compared with children without Cryptosporidium infection at this site (adjusted odds ratio = 2.08, 95% confidence interval: 1.02-4.22; P = 0.043). Respiratory tract involvement is common in children with intestinal cryptosporidiosis who are experiencing respiratory symptoms. Such children may experience some degree of respiratory compromise and may be at increased risk for hospitalization.
{"title":"Clinical Significance of Respiratory Involvement in Cryptosporidiosis: Cross-Sectional Study of Children with Diarrhea and Respiratory Symptoms in Uganda.","authors":"Siobhan M Mor, Grace Ndeezi, Luke R Ascolillo, Hannington B Tasimwa, Charalampos Attipa, Jerlyn Sponseller, David Mukunya, Ritah Nakato, Lilian N Kayondo, Saul Tzipori, James K Tumwine, Jeffrey K Griffiths","doi":"10.4269/ajtmh.24-0112","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0112","url":null,"abstract":"<p><p>Respiratory cryptosporidiosis is considered an occasional, late-stage complication of HIV/AIDS. This study aimed to assess the clinical importance of respiratory cryptosporidiosis in children with diarrhea and respiratory symptoms at Mulago Hospital, Kampala, Uganda. Children aged 9 to 36 months presenting with diarrhea and cough or unexplained tachypnea (N = 1,918) were screened for fecal Cryptosporidium using polymerase chain reaction (PCR). Children with positive stool samples were eligible for further diagnostic tests, including sputum induction. Sputum samples were subjected to PCR for Cryptosporidium, as well as routine microbiology (culture and gram stain) and auramine stain for tuberculosis. Regression analyses were used to investigate 1) factors associated with respiratory cryptosporidiosis and 2) whether respiratory cryptosporidiosis was independently associated with hospitalization. Prevalence of enteric cryptosporidiosis was 260/1,918 (13.6%) (>80% Cryptosporidium hominis). Of the 236 children who had sputum available for analysis, 62 (26.3%) had Cryptosporidium in the sputum, only two of whom had HIV infection. Children with Cryptosporidium in the sputum were more likely to have abnormal oxygen saturation at presentation (SpO2 <96%; P = 0.053); no other differences in frequency or severity of respiratory signs were noted. No alternative bacterial cause of respiratory symptoms was identified in 37.7% of children with respiratory cryptosporidiosis, compared with 23.6% of children without (P = 0.04). Sputum-positive children had twice the odds of hospitalization compared with children without Cryptosporidium infection at this site (adjusted odds ratio = 2.08, 95% confidence interval: 1.02-4.22; P = 0.043). Respiratory tract involvement is common in children with intestinal cryptosporidiosis who are experiencing respiratory symptoms. Such children may experience some degree of respiratory compromise and may be at increased risk for hospitalization.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cerebral malaria (CM) is a devastating disease globally. Transcranial Doppler ultrasound (TCD) has identified five different phenotypes of deranged cerebrovascular hemodynamics in children with CM, each associated with different outcomes. For TCD to be used as a point of care neurodiagnostic and neuromonitoring tool in CM patients, proper interpretation of examinations is paramount. Comparison of measured cerebral blood flow velocities (CBFVs) to age-matched normative values is needed to interpret any pediatric TCD study. Until recently, normative values in African children did not exist, so previous work reported the frequency of CM phenotypes by classifying studies compared with normative values of European children. Now that normative TCD values in healthy African children have been established, we performed this retrospective analysis of prospectively collected data to determine phenotype frequency and associated outcomes in children with CM by comparing CBFV values to these contemporary controls.
脑疟疾(CM)是一种全球性的毁灭性疾病。经颅多普勒超声(TCD)发现了五种不同的脑血管血流动力学表型,每种表型都与不同的结果有关。要将 TCD 用作 CM 患者的护理点神经诊断和神经监测工具,正确解释检查结果至关重要。要解释任何儿科 TCD 研究,都需要将测得的脑血流速度(CBFV)与年龄匹配的标准值进行比较。直到最近,非洲儿童的标准值还不存在,因此以前的工作通过与欧洲儿童的标准值进行分类研究来报告 CM 表型的频率。现在,健康非洲儿童的 TCD 标准值已经确定,我们对前瞻性收集的数据进行了回顾性分析,通过将 CBFV 值与这些当代对照进行比较,确定 CM 儿童的表型频率和相关结果。
{"title":"Revising the Interpretation of Transcranial Doppler Ultrasound Examinations in Pediatric Cerebral Malaria.","authors":"Nicole F O'Brien, Taty Tshimanga","doi":"10.4269/ajtmh.24-0332","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0332","url":null,"abstract":"<p><p>Cerebral malaria (CM) is a devastating disease globally. Transcranial Doppler ultrasound (TCD) has identified five different phenotypes of deranged cerebrovascular hemodynamics in children with CM, each associated with different outcomes. For TCD to be used as a point of care neurodiagnostic and neuromonitoring tool in CM patients, proper interpretation of examinations is paramount. Comparison of measured cerebral blood flow velocities (CBFVs) to age-matched normative values is needed to interpret any pediatric TCD study. Until recently, normative values in African children did not exist, so previous work reported the frequency of CM phenotypes by classifying studies compared with normative values of European children. Now that normative TCD values in healthy African children have been established, we performed this retrospective analysis of prospectively collected data to determine phenotype frequency and associated outcomes in children with CM by comparing CBFV values to these contemporary controls.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}