Pub Date : 2024-04-01Epub Date: 2024-02-29DOI: 10.2471/BLT.23.290755
Alexander Thomas Schade, Maureen Sabawo, Zahra Jaffry, Nohakhelha Nyamulani, Chikumbutso Clara Mpanga, Leonard Banza Ngoie, Andrew John Metcalfe, David Graham Lalloo, William James Harrison, Andrew Leather, Peter MacPherson
Objective: To assess the impact of an open fracture intervention bundle on clinical management and patient outcomes of adults in Malawi with open tibia fractures.
Methods: We conducted a before-and-after implementation study in Malawi in 2021 and 2022 to assess the impact of an open fracture intervention bundle, including a national education course for clinical officers and management guidelines for open fractures. We recruited 287 patients with open tibia fractures. The primary outcome was a before-and-after comparison of the self-reported short musculoskeletal function assessment score, a measure of patient function. Secondary outcomes included clinical management; and clinician knowledge and implementation evaluation outcomes of 57 health-care providers attending the course. We also constructed multilevel regression models to investigate associations between clinical knowledge, patient function, and implementation evaluation before and after the intervention.
Findings: The median patient function score at 1 year was 6.8 (interquartile range, IQR: 1.5 to 14.5) before intervention and 8.4 (IQR: 3.8 to 23.2) after intervention. Compared with baseline scores, we found clinicians' open fracture knowledge scores improved 1 year after the intervention was implemented (mean posterior difference: 1.6, 95% highest density interval: 0.9 to 2.4). However, we found no difference in most aspects of clinicians' open fracture management practice.
Conclusion: Despite possible improvement in clinician knowledge and positive evaluation of the intervention implementation, our study showed that there was no overall improvement in clinical management, and weak evidence of worsening patient function 1 year after injury, after implementation of the open fracture intervention bundle.
{"title":"Improving the management of open tibia fractures, Malawi.","authors":"Alexander Thomas Schade, Maureen Sabawo, Zahra Jaffry, Nohakhelha Nyamulani, Chikumbutso Clara Mpanga, Leonard Banza Ngoie, Andrew John Metcalfe, David Graham Lalloo, William James Harrison, Andrew Leather, Peter MacPherson","doi":"10.2471/BLT.23.290755","DOIUrl":"10.2471/BLT.23.290755","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of an open fracture intervention bundle on clinical management and patient outcomes of adults in Malawi with open tibia fractures.</p><p><strong>Methods: </strong>We conducted a before-and-after implementation study in Malawi in 2021 and 2022 to assess the impact of an open fracture intervention bundle, including a national education course for clinical officers and management guidelines for open fractures. We recruited 287 patients with open tibia fractures. The primary outcome was a before-and-after comparison of the self-reported short musculoskeletal function assessment score, a measure of patient function. Secondary outcomes included clinical management; and clinician knowledge and implementation evaluation outcomes of 57 health-care providers attending the course. We also constructed multilevel regression models to investigate associations between clinical knowledge, patient function, and implementation evaluation before and after the intervention.</p><p><strong>Findings: </strong>The median patient function score at 1 year was 6.8 (interquartile range, IQR: 1.5 to 14.5) before intervention and 8.4 (IQR: 3.8 to 23.2) after intervention. Compared with baseline scores, we found clinicians' open fracture knowledge scores improved 1 year after the intervention was implemented (mean posterior difference: 1.6, 95% highest density interval: 0.9 to 2.4). However, we found no difference in most aspects of clinicians' open fracture management practice.</p><p><strong>Conclusion: </strong>Despite possible improvement in clinician knowledge and positive evaluation of the intervention implementation, our study showed that there was no overall improvement in clinical management, and weak evidence of worsening patient function 1 year after injury, after implementation of the open fracture intervention bundle.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":null,"pages":null},"PeriodicalIF":11.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10976873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Public health round-up.","authors":"","doi":"10.2471/BLT.24.010424","DOIUrl":"10.2471/BLT.24.010424","url":null,"abstract":"","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":null,"pages":null},"PeriodicalIF":11.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10976871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
[This corrects the article on p. 152 in vol. 102, PMID: 38434183.].
[此处更正了第 102 卷第 152 页的文章,PMID:38434183]。
{"title":"Corrigendum.","authors":"","doi":"10.2471/BLT.24.110424","DOIUrl":"https://doi.org/10.2471/BLT.24.110424","url":null,"abstract":"<p><p>[This corrects the article on p. 152 in vol. 102, PMID: 38434183.].</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":null,"pages":null},"PeriodicalIF":11.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10976874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
317 Bull World Health Organ 2011;89:317 | doi:10.2471/BLT.11.000511 In an editorial, Tim Nguyen et al. (318) announce an upcoming Bulletin theme issue on influenza and call for submissions. In a second editorial, Andreas Kalk (319) discusses the hidden costs of performance-based financing. Emily Leung et al. (390–392) discuss antimicrobial resistance and the actions needed to tackle this growing threat. Gary Humphreys (324–325) reports on the need for improving vaccine distribution systems. In an interview, psychiatrist Mustafa Elmasri (326–327) challenges the way the international community handles mental health emergency relief.
317 Bull World Health Organ 2011;89:317 | doi:10.2471/BLT.11.000511 在一篇社论中,Tim Nguyen 等人(318) 宣布了即将出版的《公报》流感主题专刊,并征集稿件。在第二篇社论中,Andreas Kalk(319)讨论了基于绩效的融资的隐性成本。Emily Leung 等人(390-392)讨论了抗菌药耐药性以及应对这一日益严重威胁所需的行动。Gary Humphreys (324-325) 报告了改善疫苗配送系统的必要性。精神病学家 Mustafa Elmasri(326-327)在一次采访中对国际社会处理心理健康紧急救援的方式提出了质疑。
{"title":"In this month’s Bulletin","authors":"Tim Nguyen, Andreas Kalk, Emily Leung","doi":"10.2471/BLT.24.000424","DOIUrl":"https://doi.org/10.2471/BLT.24.000424","url":null,"abstract":"317 Bull World Health Organ 2011;89:317 | doi:10.2471/BLT.11.000511 In an editorial, Tim Nguyen et al. (318) announce an upcoming Bulletin theme issue on influenza and call for submissions. In a second editorial, Andreas Kalk (319) discusses the hidden costs of performance-based financing. Emily Leung et al. (390–392) discuss antimicrobial resistance and the actions needed to tackle this growing threat. Gary Humphreys (324–325) reports on the need for improving vaccine distribution systems. In an interview, psychiatrist Mustafa Elmasri (326–327) challenges the way the international community handles mental health emergency relief.","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":null,"pages":null},"PeriodicalIF":11.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140355943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
[This corrects the article on p. 786 in vol. 101, PMID: 38024247.].
[此处更正了第 101 卷第 786 页的文章,PMID:38024247]。
{"title":"Corrigendum.","authors":"","doi":"10.2471/BLT.24.100424","DOIUrl":"https://doi.org/10.2471/BLT.24.100424","url":null,"abstract":"<p><p>[This corrects the article on p. 786 in vol. 101, PMID: 38024247.].</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":null,"pages":null},"PeriodicalIF":11.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10976875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-01-31DOI: 10.2471/BLT.23.289736
Qin Li, Rui Yang, Zehong Zhou, Weiping Qian, Jian Zhang, Ze Wu, Lei Jin, Xueqing Wu, Cuilian Zhang, Beihong Zheng, Jichun Tan, Guimin Hao, Shangwei Li, Yongxiu Hao, Danni Zheng, Yuanyuan Wang, Rong Li, Ping Liu, Jie Qiao
Objective: To estimate the proportion of married women in China who intend to become pregnant given the country's pronatalist population policy and to investigate fecundity, with an emphasis on the influence of socioeconomic factors.
Methods: A nationally representative survey of 12 815 married women aged 20 to 49 years (mean: 36.8 years) was conducted during 2019 and 2020. All completed questionnaires, 10 115 gave blood samples and 11 710 underwent pelvic ultrasound examination. Fertility intention was the desire or intent to become pregnant combined with engagement in unprotected sexual intercourse. We defined infertility as the failure to achieve pregnancy after 12 months or more of unprotected intercourse. We considered an anti-Müllerian hormone level < 1.1 ng/mL and an antral follicular count < 7 as indicating an abnormal ovarian reserve.
Findings: Fertility intentions were reported by 11.9% of women overall but by only 6.1% of current mothers (weighted percentages). Fertility intention was significantly less likely among women in metropolises (odds ratio, OR: 0.38; 95% confidence interval, CI: 0.31-0.45) and those with a higher educational level (OR: 0.74; 95% CI: 0.62-0.88). Overall, 18.0% had experienced infertility at any time and almost 30% had an abnormal ovarian reserve on assessment. An abnormal ovarian reserve and infertility were less likely in women in metropolises (P < 0.05) but more likely in obese women (P < 0.05).
Conclusion: The willingness of Chinese married women to give birth remained low, even with relaxation of the one-child policy.
{"title":"Fertility history and intentions of married women, China.","authors":"Qin Li, Rui Yang, Zehong Zhou, Weiping Qian, Jian Zhang, Ze Wu, Lei Jin, Xueqing Wu, Cuilian Zhang, Beihong Zheng, Jichun Tan, Guimin Hao, Shangwei Li, Yongxiu Hao, Danni Zheng, Yuanyuan Wang, Rong Li, Ping Liu, Jie Qiao","doi":"10.2471/BLT.23.289736","DOIUrl":"10.2471/BLT.23.289736","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the proportion of married women in China who intend to become pregnant given the country's pronatalist population policy and to investigate fecundity, with an emphasis on the influence of socioeconomic factors.</p><p><strong>Methods: </strong>A nationally representative survey of 12 815 married women aged 20 to 49 years (mean: 36.8 years) was conducted during 2019 and 2020. All completed questionnaires, 10 115 gave blood samples and 11 710 underwent pelvic ultrasound examination. Fertility intention was the desire or intent to become pregnant combined with engagement in unprotected sexual intercourse. We defined infertility as the failure to achieve pregnancy after 12 months or more of unprotected intercourse. We considered an anti-Müllerian hormone level < 1.1 ng/mL and an antral follicular count < 7 as indicating an abnormal ovarian reserve.</p><p><strong>Findings: </strong>Fertility intentions were reported by 11.9% of women overall but by only 6.1% of current mothers (weighted percentages). Fertility intention was significantly less likely among women in metropolises (odds ratio, OR: 0.38; 95% confidence interval, CI: 0.31-0.45) and those with a higher educational level (OR: 0.74; 95% CI: 0.62-0.88). Overall, 18.0% had experienced infertility at any time and almost 30% had an abnormal ovarian reserve on assessment. An abnormal ovarian reserve and infertility were less likely in women in metropolises (<i>P</i> < 0.05) but more likely in obese women (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The willingness of Chinese married women to give birth remained low, even with relaxation of the one-child policy.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":null,"pages":null},"PeriodicalIF":11.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10976870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-02-29DOI: 10.2471/BLT.23.290129
Haijun Zhang, Bryan Patenaude, Haonan Zhang, Mark Jit, Hai Fang
Objective: To quantify the association between reduction in child mortality and routine immunization across 204 countries and territories from 1990 to 2019.
Methods: We used child mortality and vaccine coverage data from the Global Burden of Disease Study. We used a modified child survival framework and applied a mixed-effects regression model to estimate the reduction in deaths in children younger than 5 years associated with eight vaccines.
Findings: Between 1990 and 2019, the diphtheria-tetanus-pertussis (DTP), measles, rotavirus and Haemophilus influenzae type b vaccines were significantly associated with an estimated 86.9 (95% confidence interval, CI: 57.2 to 132.4) million fewer deaths in children younger than 5 years worldwide. This decrease represented a 24.2% (95% CI: 19.8 to 28.9) reduction in deaths relative to a scenario without vaccines. The DTP and measles vaccines averted 46.7 (95% CI: 30.0 to 72.7) million and 37.9 (95% CI: 25.4 to 56.8) million deaths, respectively. Of the total reduction in child mortality associated with vaccines, 84.2% (95% CI: 83.0 to 85.1) occurred in 73 countries supported by Gavi, the Vaccine Alliance, with an estimated 45.4 (95% CI: 29.8 to 69.2) million fewer deaths from 2000 to 2019. The largest reductions in deaths associated with these four vaccines were in India, China, Ethiopia, Pakistan and Bangladesh (in order of the size of reduction).
Conclusion: Vaccines continue to reduce childhood mortality significantly, especially in Gavi-supported countries, emphasizing the need for increased investment in routine immunization programmes.
{"title":"Global vaccine coverage and childhood survival estimates: 1990-2019.","authors":"Haijun Zhang, Bryan Patenaude, Haonan Zhang, Mark Jit, Hai Fang","doi":"10.2471/BLT.23.290129","DOIUrl":"10.2471/BLT.23.290129","url":null,"abstract":"<p><strong>Objective: </strong>To quantify the association between reduction in child mortality and routine immunization across 204 countries and territories from 1990 to 2019.</p><p><strong>Methods: </strong>We used child mortality and vaccine coverage data from the Global Burden of Disease Study. We used a modified child survival framework and applied a mixed-effects regression model to estimate the reduction in deaths in children younger than 5 years associated with eight vaccines.</p><p><strong>Findings: </strong>Between 1990 and 2019, the diphtheria-tetanus-pertussis (DTP), measles, rotavirus and <i>Haemophilus influenzae</i> type b vaccines were significantly associated with an estimated 86.9 (95% confidence interval, CI: 57.2 to 132.4) million fewer deaths in children younger than 5 years worldwide. This decrease represented a 24.2% (95% CI: 19.8 to 28.9) reduction in deaths relative to a scenario without vaccines. The DTP and measles vaccines averted 46.7 (95% CI: 30.0 to 72.7) million and 37.9 (95% CI: 25.4 to 56.8) million deaths, respectively. Of the total reduction in child mortality associated with vaccines, 84.2% (95% CI: 83.0 to 85.1) occurred in 73 countries supported by Gavi, the Vaccine Alliance, with an estimated 45.4 (95% CI: 29.8 to 69.2) million fewer deaths from 2000 to 2019. The largest reductions in deaths associated with these four vaccines were in India, China, Ethiopia, Pakistan and Bangladesh (in order of the size of reduction).</p><p><strong>Conclusion: </strong>Vaccines continue to reduce childhood mortality significantly, especially in Gavi-supported countries, emphasizing the need for increased investment in routine immunization programmes.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":null,"pages":null},"PeriodicalIF":11.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10976869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tobacco advertising regulations need to adapt if they are to meet the challenges posed by a rapidly evolving social media and tobacco product landscape. Gary Humphreys reports.
{"title":"Countering the influence of tobacco.","authors":"","doi":"10.2471/BLT.24.020424","DOIUrl":"10.2471/BLT.24.020424","url":null,"abstract":"<p><p>Tobacco advertising regulations need to adapt if they are to meet the challenges posed by a rapidly evolving social media and tobacco product landscape. Gary Humphreys reports.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":null,"pages":null},"PeriodicalIF":11.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10976864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To assess knowledge and practices related to snakebite prevention among Chinese residents.
Methods: By using a multistage random sampling approach augmented by snowball sampling, we surveyed residents from 10 provinces, one municipality and one autonomous region south of the Yangtze River Basin between May 2022 and February 2023. We supplemented the data with a national online survey. We used a χ2-test to identify differences in knowledge and behaviour across various demographic characteristics. We conducted multifactor logistic regression analyses to evaluate factors potentially influencing snakebite knowledge and practices.
Findings: We obtained 55 775 valid survey responses, 16 200 respondents from the face-to-face survey and 39 575 respondents from the online survey. Only 25.7% (14 325) respondents demonstrated adequate knowledge about snakebites whereas 25.6% (14 295) respondents knew basic first-aid practices or preventive behaviours. Age, marital status, educational attainment, occupation, type of residence and frequency of exposure to nature are significant independent variables affecting snakebite knowledge (P-values: < 0.05). On the other hand, gender, age, marital status, educational attainment, occupation and type of residence were significant independent variables affecting the behaviour of snakebite prevention and first aid (P-values: < 0.05).
Conclusion: There is a notable shortfall in knowledge, first aid and preventive behaviours among Chinese residents regarding snakebites. Misguided first aid practices can severely compromise the effectiveness of evidence-based therapeutic interventions. Consequently, improving health education concerning snakes and snakebites in this population is needed.
{"title":"Knowledge and practices related to snakebite prevention, China: a cross-sectional study.","authors":"Lanfen He, Chuanzhu Lv, Xingyue Song, Wenjie Hao, Juntao Wang, Yanlan Hu, Yu Chen, Yong Gan, Xiaotong Han, Shijiao Yan","doi":"10.2471/BLT.23.290169","DOIUrl":"10.2471/BLT.23.290169","url":null,"abstract":"<p><strong>Objective: </strong>To assess knowledge and practices related to snakebite prevention among Chinese residents.</p><p><strong>Methods: </strong>By using a multistage random sampling approach augmented by snowball sampling, we surveyed residents from 10 provinces, one municipality and one autonomous region south of the Yangtze River Basin between May 2022 and February 2023. We supplemented the data with a national online survey. We used a <i>χ</i><sup>2</sup>-test to identify differences in knowledge and behaviour across various demographic characteristics. We conducted multifactor logistic regression analyses to evaluate factors potentially influencing snakebite knowledge and practices.</p><p><strong>Findings: </strong>We obtained 55 775 valid survey responses, 16 200 respondents from the face-to-face survey and 39 575 respondents from the online survey. Only 25.7% (14 325) respondents demonstrated adequate knowledge about snakebites whereas 25.6% (14 295) respondents knew basic first-aid practices or preventive behaviours. Age, marital status, educational attainment, occupation, type of residence and frequency of exposure to nature are significant independent variables affecting snakebite knowledge (<i>P</i>-values: < 0.05). On the other hand, gender, age, marital status, educational attainment, occupation and type of residence were significant independent variables affecting the behaviour of snakebite prevention and first aid (<i>P</i>-values: < 0.05).</p><p><strong>Conclusion: </strong>There is a notable shortfall in knowledge, first aid and preventive behaviours among Chinese residents regarding snakebites. Misguided first aid practices can severely compromise the effectiveness of evidence-based therapeutic interventions. Consequently, improving health education concerning snakes and snakebites in this population is needed.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":null,"pages":null},"PeriodicalIF":11.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10976863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-02-29DOI: 10.2471/BLT.23.289843
Ryan E Wiegand, Maurice R Odiere, Safari Kinung'hi, Eliézer K N'Goran, Pauline Mwinzi, W Evan Secor
Objective: To determine if the prevalence of schistosomiasis in children aged 9-12 years is associated with the prevalence in 5-8-year-olds and adults after preventive chemotherapy in schools or the community.
Methods: We combined data from four community-randomized, preventive chemotherapy trials in treatment-naïve populations in Côte d'Ivoire, Kenya and the United Republic of Tanzania during 2010-2016 according to the number of praziquantel treatments and the delivery method. Schistosoma mansoni infection was sought on two slides prepared from each participant's first stool using the Kato-Katz technique. We assessed associations between S. mansoni prevalence in 9-12-year-olds and 5-8-year-olds and adults in the community before and after treatment using Bayesian regression models.
Findings: Stool samples from 47 985 5-8-year-olds, 81 077 9-12-year-olds and 20 492 adults were analysed. We found associations between the prevalence in 9-12-year-olds and that in 5-8-year-olds and adults after preventive treatment, even when only school-age children were treated. When the prevalence in 9-12-year-olds was under 10%, the prevalence in 5-8-year-olds was consistently under 10%. When the prevalence in 9-12-year-olds was under 50%, the prevalence in adults after two or four rounds of preventive chemotherapy was 10%-15% lower than before chemotherapy. Post-chemotherapy age-group associations were consistent with pre-chemotherapy associations in this analysis and previous studies.
Conclusion: The prevalence of S. mansoni infection in 9-12-year-olds was associated with the prevalence in other age groups and could be used to guide community treatment decisions.
{"title":"Age-group associations of schistosomiasis prevalence from trial data, Côte d'Ivoire, Kenya and the United Republic of Tanzania.","authors":"Ryan E Wiegand, Maurice R Odiere, Safari Kinung'hi, Eliézer K N'Goran, Pauline Mwinzi, W Evan Secor","doi":"10.2471/BLT.23.289843","DOIUrl":"10.2471/BLT.23.289843","url":null,"abstract":"<p><strong>Objective: </strong>To determine if the prevalence of schistosomiasis in children aged 9-12 years is associated with the prevalence in 5-8-year-olds and adults after preventive chemotherapy in schools or the community.</p><p><strong>Methods: </strong>We combined data from four community-randomized, preventive chemotherapy trials in treatment-naïve populations in Côte d'Ivoire, Kenya and the United Republic of Tanzania during 2010-2016 according to the number of praziquantel treatments and the delivery method. <i>Schistosoma mansoni</i> infection was sought on two slides prepared from each participant's first stool using the Kato-Katz technique. We assessed associations between <i>S. mansoni</i> prevalence in 9-12-year-olds and 5-8-year-olds and adults in the community before and after treatment using Bayesian regression models.</p><p><strong>Findings: </strong>Stool samples from 47 985 5-8-year-olds, 81 077 9-12-year-olds and 20 492 adults were analysed. We found associations between the prevalence in 9-12-year-olds and that in 5-8-year-olds and adults after preventive treatment, even when only school-age children were treated. When the prevalence in 9-12-year-olds was under 10%, the prevalence in 5-8-year-olds was consistently under 10%. When the prevalence in 9-12-year-olds was under 50%, the prevalence in adults after two or four rounds of preventive chemotherapy was 10%-15% lower than before chemotherapy. Post-chemotherapy age-group associations were consistent with pre-chemotherapy associations in this analysis and previous studies.</p><p><strong>Conclusion: </strong>The prevalence of <i>S. mansoni</i> infection in 9-12-year-olds was associated with the prevalence in other age groups and could be used to guide community treatment decisions.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":null,"pages":null},"PeriodicalIF":11.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10976868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140338542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}