neglected tropical disease

被忽视的热带病
  • 文章类型: Journal Article
    背景:土壤传播的蠕虫(STH)是一组被认为是被忽视的热带病(NTD)的蠕虫,全球,每年影响超过150万至260万人。根据物种的不同,它们可以通过从污染物质中摄取含胚胎的卵或通过皮肤渗透来获得。大多数STH物种在热带地区发现,比如菲律宾。尽管有大众药物管理局(MDA),该国的STH感染病例继续上升。热带医学研究所(RITM)的调查表明,STH(A虫,TrichurisTrichiura,和Necatoramericanus)主要在该国各省观察到,例如在CamarinesSur.
    目的:将遥感协变量,例如归一化植被指数(NDVI)和归一化差异构造指数(NDBI)-与CamarinesSur的37个城市的STH感染病例相关联。
    方法:使用量子地理信息系统(QGIS)计算了2015年至2019年STH病例的可用公共卫生记录,并使用皮尔逊相关系数进行了关联。
    结果:结果显示,儿童的感染率高于成人,和A.lumbricoides引起60%的感染。在2015年和2017年期间,没有观察到指标与感染病例的相关性;然而,2019年的相关性表现出中等强度(p=0.037)。
    结论:这表明感染主要不依赖于植被和城市化,而是依赖于其他环境因素和非环境变量。
    BACKGROUND: Soil-transmitted helminth (STH) is a group of helminths that are considered to be neglected tropical diseases (NTDs) and, globally, affect more than 1.5 to 2.6 million people yearly. Depending on the species, they can be acquired by ingesting embryonated eggs from contaminated matter or by skin penetration. Most species of STH are found in the tropics, such as the Philippines. Despite the Mass Drug Administration (MDA), the cases of STH infection continue to rise in the country. Surveys from the Research Institute of Tropical Medicine (RITM) indicate that a high prevalence of STH (Ascaris lumbricoides, Trichuris trichiura, and Necator americanus) was primarily observed in the provinces of the country, such as in Camarines Sur.
    OBJECTIVE: To correlate remote sensing covariates such as Normalized Difference Vegetation Index (NDVI) and Normalized Difference Built-up Index (NDBI) - to STH-infected cases of the 37 municipalities of Camarines Sur.
    METHODS: The available public health record of STH cases from 2015 to 2019 were calculated using the Quantum Geographic Information System (QGIS)and correlated using Pearson Correlation Coefficient.
    RESULTS: The results showed that infection was higher in children than adults, and A. lumbricoides caused 60% of infection. No correlation of indices with infection cases during 2015 and 2017 was observed; however, 2019 showed a moderate strength (p = 0.037) in correlation.
    CONCLUSIONS: This indicates that infection relied not mainly on vegetation and urbanization but on additional environmental factors and non-environmental variables.
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  • 文章类型: Journal Article
    土壤传播的蠕虫(STH)是热带和亚热带地区贫困社区的重大公共卫生问题。改进的诊断方法对于被忽视的热带病计划至关重要,特别是对于S.stercoralis,因为传统方法是不够的。因此,确定最准确、最有效的STH诊断方法非常重要。我们进行了一项回顾性研究,分析了2010年至2019年Tropicales研究所的实验室数据。该研究包括来自萨尔塔省北部城市和农村社区的门诊患者的粪便分析和公共卫生干预措施的数据,阿根廷。如果通过沉降/浓缩处理,则将样品包括在此分析中。Baermann,原田森和麦克马斯特,亚组还包括琼脂平板培养法(APC)。相对于复合参考标准计算灵敏度。在收集的5625个样本中,944有资格进行此分析,A.lumbricoides的患病率为11.14%,钩虫8.16%,T.trichiura为1.38%,和6.36%。沉降/浓缩方法对A.lumbricoides最敏感(96%),与麦克马斯特方法相比,灵敏度为62%。同样,对于钩虫来说,沉降/浓度比麦克马斯特更敏感,Harada-Mori,Baermann的敏感度为87%,70%,43%,13%,分别。这些感染大多数是光强度的。对于S.stercoralis,Baermann和沉降/浓缩方法最敏感,分别为70%和62%,而原田森是最不敏感的。在APC也分析的389个样本的子集中,Baermann比APC对检测胸骨链球菌更敏感,两种方法都优于原田森。寄生虫学方法,主要是结合使用时,为临床和公共卫生实验室的STH诊断提供足够的机会。将S.stercoralis纳入世界卫生组织的控制策略需要重新考虑当前用于调查的诊断方法。沉降/浓缩和Baermann似乎是该物种最敏感的方法。进一步研究,包括执行情况评估,应有助于确定最充分和可行的全STH诊断方法。
    Soil-transmitted helminths (STH) are a significant public health problem in impoverished communities of tropical and subtropical areas. Improved diagnostic methods are crucial for Neglected Tropical Diseases programs, particularly for S. stercoralis, as traditional methods are inadequate. Thus, it is important to identify the most accurate and efficient methods for the diagnosis of STH. We performed a retrospective study analyzing laboratory data at the Instituto de Investigaciones de Enfermedades Tropicales from 2010 to 2019. The study included data from outpatients referred for stool analysis and public health interventions from urban and rural communities in northern Salta province, Argentina. Samples were included in this analysis if processed through sedimentation/concentration, Baermann, Harada-Mori and McMaster\'s, with a subgroup that also included Agar plate culture method (APC). Sensitivity was calculated against a composite reference standard. Of the 5625 samples collected, 944 qualified for this analysis, with a prevalence of 11.14% for A. lumbricoides, 8.16% for hookworm, 1.38% for T. trichiura, and 6.36% for S. stercoralis. The sedimentation/concentration method was the most sensitive for A. lumbricoides (96%), compared to the McMaster method, with a sensitivity of 62%. Similarly, for hookworms, sedimentation/concentration was more sensitive than McMaster\'s, Harada-Mori, and Baermann with sensitivities of 87%, 70%, 43%, and 13%, respectively. Most of these infections were of light intensity. For S. stercoralis, Baermann and sedimentation/concentration methods were the most sensitive, with 70% and 62% respectively, while Harada-Mori was the least sensitive. In a subset of 389 samples also analyzed by the APC, Baermann was more sensitive than APC for detecting S. stercoralis, and both methods were superior to Harada-Mori. Parasitological methods, mostly when used combined, offer adequate opportunities for the diagnosis of STH in clinical and public health laboratories. The incorporation of S. stercoralis into the control strategies of the World Health Organization requires rethinking the current diagnostic approach used for surveys. With sedimentation/concentration and Baermann appearing as the most sensitive methods for this species. Further studies, including implementation assessments, should help in identifying the most adequate and feasible all-STH diagnostic approach.
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  • 文章类型: Journal Article
    伊维菌素,一种有效的治疗疮的方法,体重<15公斤的儿童未获得许可。药代动力学模型显示,幼儿的剂量为3毫克(2-4岁,体重10-14kg)在≥5岁的儿童中达到200μg/kg剂量的可比药物暴露。该试验评估了3mg剂量的幼儿。
    多中心,在老挝人民民主共和国的五个卫生中心进行的第二阶段试验。2-4岁儿童,体重为10-14kg的sc疮患者接受3mg伊维菌素,并测定了两种血浆浓度(Clinicaltrials.govIDNCT05500326)。在第14天,评估临床结果和不良反应,并给予第二剂量以完成治疗。主要结果是首次给药后的平均血浆伊维菌素暴露(AUC0-∞)(与年龄≥5岁,体重≥15kg,接受200μg/kg的澳大利亚土著儿童的历史对照相比)。次要结果是临床改善和不良反应。
    总的来说,纳入100名中位年龄3.0岁(IQR2.6-3.9)、体重11.9kg(IQR11.0-13.1)的儿童。平均观察到的伊维菌素AUC0-∞与5-11岁的历史对照组相当(815μgh/Lvs953μgh/L,p=0.256)。到第14天时,90/99名儿童出现c疮完全消退。副作用轻微,发生在7/99
    3mg伊维菌素剂量用于2-4岁体重10-14kg的儿童,其平均血浆AUC0-∞与年龄较大的儿童相当,在治疗sc疮方面非常有效,并且耐受性良好。这项研究支持将伊维菌素治疗扩展到年幼儿童,以改善控制这种被忽视的疾病的全球努力。
    由Thrasher基金会早期职业研究奖提供的项目资金。
    UNASSIGNED: Ivermectin, an effective treatment for scabies, is not licensed for children weighing <15 kg. Pharmacokinetic modelling has shown a 3 mg dose in young children (2-4 years, weighing 10-14 kg) achieves comparable drug exposure to a 200 μg/kg dose in children aged ≥5 years. This trial evaluated a 3 mg dose in young children.
    UNASSIGNED: Multicentre, phase 2 trial in five health centres in Lao PDR. Children aged 2-4 years, weighing 10-14 kg with scabies received 3 mg ivermectin and had two plasma concentrations determined (Clinicaltrials.gov ID NCT05500326). On day 14, clinical outcomes and adverse effects were assessed, and a second dose given to complete treatment. The primary outcome was the mean plasma ivermectin exposure (AUC0-∞) after the first dose (compared to a historical control of Indigenous Australian children aged ≥5 years weighing ≥15 kg receiving 200 μg/kg). Secondary outcomes were clinical improvement and adverse effects.
    UNASSIGNED: Overall, 100 children with a median age of 3.0 years (IQR 2.6-3.9) and weight of 11.9 kg (IQR 11.0-13.1) were enrolled. The mean observed ivermectin AUC0-∞ was comparable to the historical control group aged 5-11 years (815 μg h/L vs 953 μg h/L, p = 0.256). Complete resolution of scabies occurred in 90/99 children by day 14. Adverse effects were mild, occurring in 7/99.
    UNASSIGNED: A 3 mg ivermectin dose in children aged 2-4 years and weighing 10-14 kg achieved a mean plasma AUC0-∞ comparable to older children, was highly effective in treating scabies and well tolerated. This study supports extending ivermectin treatment to younger children improving global efforts to control this neglected disease.
    UNASSIGNED: Project funding provided by a Thrasher Foundation Early Career Research Award.
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  • 文章类型: Journal Article
    目的:恰加斯病(CD)一种被忽视的热带病是一个重要的公共卫生问题,可持续发展目标(SDG)。传统上仅限于农村地区,从矢量到口腔的各种传播途径具有急性表现,但在慢性期更常见。这项调查的目的是描述知识,在哥伦比亚加勒比海地区的两个农村定居点中,与查加斯病(CD)有关的态度和做法(KAP),先前有该疾病和/或寄生虫的记录。
    方法:在哥伦比亚的两个农村居民区进行了横断面描述性研究,并开发了监视工具来测量知识,与查加斯病(CD)相关的态度和实践(KAP)。
    结果:在人口中,妇女占60%,获得社会保障的比例约为66.5%;81,6%的房主获得水和电的比例>90%,但只有9%的下水道。对CD的知识水平约为62%,但对传播途径的理解缺乏特异性(74,6%),并发现症状(85,3%);结论是,尽管在所研究的两个社区开展了预防运动,但接受调查的样本中有86%对该疾病的知识水平非常差。
    结论:尽管该加勒比地区的CD频率较低,载体的存在,危险因素加上对该疾病的知识水平不足,证明应长期实施和监测公共卫生干预策略,以维持对南美锥虫病的不间断监测.
    OBJECTIVE: Chagas disease (CD) a Neglected Tropical Diseases is an important public health issue in countries where is still endemic, included in the Sustainable Development Goals (SDG). Traditionally restricted to rural areas with diverse routes of transmissions from vectorial to oral with acute manifestations but being more common diagnosed in chronic stages. The aim of this investigation was to characterize the Knowledge, Attitudes and Practices (KAP) related to Chagas disease (CD) in two rural settlements of the Colombian Caribbean with previous records of the disease and/or the parasite.
    METHODS: A cross-sectional descriptive study was made in two rural settlements in Colombia and surveillance instrument was developed to measure Knowledge, Attitudes and Practices (KAP) related to Chagas disease (CD).
    RESULTS: In a population with > 60% women and access to social security around 66.5%; 81,6% were homeowners with access to water and electricity > 90% but only 9% of sewerage. The level of knowledge about CD was around 62% but lack of specificity about comprehension of transmission routes (74,6%), and symptoms (85,3%) were found; concluding that 86% of the surveyed sample had very poor level of knowledge about the disease despite preventive campaigns carried out in the two communities studied.
    CONCLUSIONS: Despite of a low frequency of CD in this Caribbean areas, the presence of vector, risk factors plus poor level of knowledge about the disease justify that public health intervention strategies should be implemented and monitored over time to maintain uninterrupted surveillance of Chagas Disease.
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  • 文章类型: Journal Article
    背景:Podosoniosis是一种由于长期暴露于刺激性火山土壤而引起的非传染性被忽视的热带病。它导致严重的身体,心理和财务后果。心脏和唯一的非洲(HASA)是一个非政府组织,以社区为基础的组织,为卢旺达的足孔病患者提供管理。我们试图分析他们的计划对患者生活的影响。
    方法:定量调查记录了参与者的人口统计学,遵守HASA的管理建议和生活质量(QOL)的变化。定性问题用于收集受访者对HASA编程的看法。
    结果:我们采访了来自HASA的Musanze(n=47)和Burera(n=80)诊所的127名患者。几乎所有参与者(98.4%)都报告了他们的生活质量有统计学意义(p<0.01)的改善,超过一半(51.2%)的患者的依从性得分>80%。定性反馈确定了在症状管理中坚持和认可计划成功的具体挑战。
    结论:我们的研究证明了以社区为基础的足节病计划在改善患者生活方面的价值。定期洗脚等做法,润肤剂的应用,穿鞋和抬高肢体可以显着降低发病率。我们的发现支持在卢旺达各地扩大这些管理实践的论点。
    BACKGROUND: Podoconiosis is a non-infectious neglected tropical disease caused by long-term exposure to irritant volcanic soils. It results in severe physical, psychological and financial consequences. Heart and Sole Africa (HASA) is a non-governmental, community-based organization providing management to podoconiosis patients in Rwanda. We sought to analyze the impact of their program on the lives of patients.
    METHODS: Quantitative surveys recorded the participants\' demographics, adherence to HASA\'s management recommendations and changes in quality of life (QOL). Qualitative questions were used to gather respondent perspectives on HASA programming.
    RESULTS: We interviewed 127 patients from HASA\'s Musanze (n=47) and Burera (n=80) clinics. Almost all participants (98.4%) reported statistically significant (p<0.01) improvements in their QOL, and more than one-half (51.2%) had a favorable adherence score of >80%. Qualitative feedback identified specific challenges to adherence and recognition of program success in symptom management.
    CONCLUSIONS: Our study demonstrated the value of community-based podoconiosis programming in improving the lives of patients. Practices such as regular feet washing, emollient application, shoe wearing and limb raising can result in a marked reduction of morbidity. Our findings support the argument for scaling up these management practices across Rwanda.
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  • 文章类型: Journal Article
    背景:Tungiasis,被忽视的热带寄生虫病,不成比例地影响儿童。很少有实证研究报道患有外寄生物皮肤病如冻结病的儿童的神经认知和心理健康结果。结肠病的病理生理学表明,它可能会对认知和行为产生不利影响。这项研究开创了对冻虫病儿童的神经认知和心理健康结果的调查。
    方法:这是一项多地点的横断面研究,包括来自肯尼亚两个县和乌干达一个地区的48所学校的454名8-14岁的准随机抽样学童。根据是否存在冻结病,将参与者分为感染和未感染。根据感染的强度,将感染者进一步分为轻度和重度感染组。适应,已验证,和认知和心理健康的标准化措施,如乌鸦矩阵和儿童行为清单被用来收集数据。包括多层次的统计检验,我们使用家庭联系设定为身份的广义混合效应线性模型比较未感染和感染儿童的评分,并确定神经认知和行为结局的其他潜在危险因素.
    结果:对协变量进行调整后,轻度感染与识字得分较低相关[调整后的β(aβ)=-8.9;95%置信区间(CI)-17.2,-0.6],语言(aβ=-1.7;95%CI-3.2,-0.3),认知灵活性(aβ=-6.1;95%CI-10.4,-1.7)和工作记忆(aβ=-0.3;95%CI-0.6,-0.1)。严重感染与识字得分较低相关(aβ=-11.0;95%CI-19.3,-2.8),反应抑制,(aβ=-2.2;95%CI-4.2,-0.2),精细运动控制(aβ=-0.7;95%CI-1.1,-0.4)和算术(aβ=-3;95%CI-5.5,-0.4)。
    结论:这项研究提供了初步证据,证明冻囊症与儿童不良的神经认知功能有关。由于苔藓病是一种慢性疾病,经常再感染,这种负面影响可能会损害他们的发展和生活成就。
    BACKGROUND: Tungiasis, a neglected tropical parasitosis, disproportionately affects children. Few empirical studies have reported neurocognitive and mental health outcomes of children with ectoparasitic skin diseases like tungiasis. Pathophysiology of tungiasis suggests it could detrimentally affect cognition and behaviour. This study pioneered the investigation of neurocognitive and mental health outcomes in children with tungiasis.
    METHODS: This was a multi-site cross-sectional study including 454 quasi-randomly sampled school-children aged 8-14 from 48 randomly selected schools in two counties in Kenya and a district in Uganda. The participants were stratified into infected and uninfected based on the presence of tungiasis. The infected were further classified into mild and severe infection groups based on the intensity of the infection. Adapted, validated, and standardized measures of cognition and mental health such as Raven Matrices and Child Behaviour Checklist were used to collect data. Statistical tests including a multilevel, generalized mixed-effects linear models with family link set to identity were used to compare the scores of uninfected and infected children and to identify other potential risk factors for neurocognitive and behavioural outcomes.
    RESULTS: When adjusted for covariates, mild infection was associated with lower scores in literacy [adjusted β(aβ) = - 8.9; 95% confidence interval (CI) - 17.2, - 0.6], language (aβ = - 1.7; 95% CI - 3.2, - 0.3), cognitive flexibility (aβ = - 6.1; 95% CI - 10.4, - 1.7) and working memory (aβ = - 0.3; 95% CI - 0.6, - 0.1). Severe infection was associated with lower scores in literacy (aβ = - 11.0; 95% CI - 19.3, - 2.8), response inhibition, (aβ = - 2.2; 95% CI - 4.2, - 0.2), fine motor control (aβ = - 0.7; 95% CI - 1.1, - 0.4) and numeracy (aβ = - 3; 95% CI - 5.5, - 0.4).
    CONCLUSIONS: This study provides first evidence that tungiasis is associated with poor neurocognitive functioning in children. Since tungiasis is a chronic disease with frequent reinfections, such negative effects may potentially impair their development and life achievements.
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  • 文章类型: Journal Article
    世界卫生组织承认各国有必要将被忽视的热带病护理纳入其日常医疗保健系统。然而,在流行国家已经观察到真菌瘤的低检出率和在医疗机构的晚期出现,包括乌干达。
    授权乌干达北部的社区卫生工作者(CHW)识别并将其转介给医疗机构。
    这将是一项基于Gulu和Pader地区的阶梯式楔形集群随机试验,为期9个月,在不同的时间点从干预阶段到控制阶段进行顺序交叉,直到两个地区都暴露于干预。
    该研究将利用乌干达北部医疗团与乌干达卫生部之间正在进行的伙伴关系,该伙伴关系已在古卢和帕德培训了300多名CHWs。研究评估将使用RE-AIM(达到,有效性,收养,实施,和维护)框架。该研究的预期结果是增加了对霉菌瘤嫌疑人的检测和转诊。将使用STATA17.0和Friedman统计或方差分析对数据进行分析,以确定病例识别和转介的增加。
    该研究获得了Mulago医院研究与伦理委员会(MHREC2406)的批准,并在泛非临床试验注册中心(PACTR202301534749787)注册。
    该试验的结果将发表在同行评审的期刊上。此外,调查结果将在会议上分享,与资助者,在其他研究会议上。
    UNASSIGNED: The World Health Organization acknowledges the need for countries to incorporate neglected tropical disease care into their routine health care system. However, low detection rates and late presentation of mycetoma to health facilities have been observed in endemic countries, including Uganda.
    UNASSIGNED: To empower community health workers (CHWs) in Northern Uganda to recognize and refer suspects of mycetoma to health facilities.
    UNASSIGNED: This will be a stepped-wedge cluster-randomized trial based in Gulu and Pader districts over a period of 9 months with sequential crossover from intervention phase to the control phase at different time points until both districts are exposed to the intervention.
    UNASSIGNED: The study will leverage on the ongoing partnership between Northern Uganda Medical Mission and the Uganda Ministry of Health that has trained over 300 CHWs in Gulu and Pader. The study evaluation will be done using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. The expected outcome of the study is increased detection and referral of suspects of mycetoma. Data will be analyzed using STATA 17.0 and Friedman statistics or Analysis of Variance to determine increase in case identifications and referrals.
    UNASSIGNED: The study was approved by Mulago Hospital Research and Ethics Committee (MHREC 2406) and registered with Pan African Clinical Trial Registry (PACTR202301534749787).
    UNASSIGNED: The results from this trial will be published in a peer-reviewed journal. In addition, the findings will be shared at conferences, with funders, and at other research meetings.
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  • 文章类型: Journal Article
    尽管通过世卫组织批准的多药疗法(MDT)有效治疗了麻风病,患者仍然患有衰弱的神经性后遗症,包括周围神经性疼痛(PNP),并继续发展并发病因(如糖尿病),和进行性现有的神经病变随着时间的推移。寻求改善生理和代谢健康的策略,包括那些减少全身性炎症和增强对神经毒性因子的免疫反应性的物质,可能会影响潜在的神经病变病因.一个完整的食品植物为基础的饮食(WFPBD)已被证明是有效的治疗神经性疼痛由于糖尿病,限制严重程度和相关症状学。糖尿病仍然是麻风病的重要后遗症,高达50%的患者需要皮质类固醇的反应,可能发展为生化糖尿病。由于营养干预可能会调节麻风病和糖尿病,对这些关系的具体探索仍然是相关的。
    (1)为了证明WFPBD生活方式干预的效果,关于麻风病的神经性疼痛变量;(2)通过评估耐受性和副作用来了解饮食在治疗麻风病慢性后遗症中的意义。
    预期,随机化,控制,单盲,描述了多中心介入试验。每周一小时的饮食咨询会议推广WFPBD强调蔬菜,水果,全谷物,坚果,和豆类,省略动物产品,并将实施在六个月内限制脂肪摄入量。参与者将是70名年龄和性别匹配的人,他们经历了活跃或治疗的“治愈”麻风病和PNP,随机分为干预组或对照组。主要结果测量包括通过视觉模拟量表进行的疗效,主观问卷和客观定量感官测试,以及安全,耐受性,WFPBD对麻风病PNP的危害。本研究将在所有参与研究中心的研究伦理委员会(REB)批准后启动。在研究开始之前,审判将在ClinicalTrials.gov注册。
    据推测,WFPBD将减轻PNP的进展和严重程度,并有可能减少与标准皮质类固醇治疗麻风病反应相关的不良事件,从而降低疾病的严重程度。通过检测WFPBDs对麻风病PNP的影响,我们希望阐明有助于加强这种被忽视的热带病治疗管理的数据。
    UNASSIGNED: Despite effective treatment of leprosy via WHO-approved multi-drug therapy (MDT), patients still suffer from debilitating neuropathic sequelae, including peripheral neuropathic pain (PNP), and continue to develop intercurrent etiologies (such as diabetes), and progressive existing neuropathy over time. Strategies seeking to improve physiological and metabolic wellness, including those that reduce systemic inflammation and enhance immune responsiveness to neurotoxic factors may influence underlying neuropathic etiologies. A whole food plant-based diet (WFPBD) has been shown to be effective in the management of neuropathic pain due to diabetes, limiting severity and relevant symptomology. Diabetes remains a significant sequela of leprosy, as up to 50% of patients in reaction requiring corticosteroids, may develop a biochemical diabetes. As nutritional interventions may modulate both leprosy and diabetes, a specific exploration of these relationships remains relevant.
    UNASSIGNED: (1) To demonstrate the effect of a WFPBD lifestyle intervention, on neuropathic pain variables in leprosy; and (2) To contextualize the significance of diet in the treatment of chronic sequelae in leprosy by evaluating tolerability and side effect profile.
    UNASSIGNED: A prospective, randomized, controlled, single-blind, multicentre interventional trial is described. Weekly one-hour dietary counseling sessions promoting a WFPBD emphasizing vegetables, fruits, whole-grains, nuts, and legumes, omitting animal products, and limiting fat intake over a six-month duration will be implemented. Participants will be 70 age and sex-matched individuals experiencing active or treated \"cured\" leprosy and PNP, randomized to either intervention or control groups. Primary outcome measures include efficacy via visual analog scale, subjective questionnaire and objective quantitative sensory testing, as well as safety, tolerability, and harms of a WFPBD on PNP in leprosy. This study will be initiated after Research Ethics Board (REB) approval at all participating sites, and in advance of study initiation, the trial will be registered at ClinicalTrials.gov.
    UNASSIGNED: It is hypothesized that WFPBDs will mitigate progression and severity of PNP and potentially reduce the adverse events related to standard corticosteroid treatment of leprosy reactions, thereby reducing disease severity. By examining the effects of WFPBDs on PNP in leprosy, we hope to illuminate data that will lead to the enhanced therapeutic management of this neglected tropical disease.
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  • 文章类型: Journal Article
    未经评估:社会和环境脆弱性导致血吸虫病的持续和增加,这在巴西和全世界都是一个公共卫生问题。在这项研究中,我们的目标是监控进入,安装,以及巴西沿海城市地区血吸虫病传播持续20年(2000-2010/2010-2020)。
    UNASSIGNED:这项基于人群的横断面研究是在加林尼亚斯港进行的,伯南布哥州,巴西,调查市区血吸虫病传播动态。通过3次疟疾和寄生虫学调查,并使用地质处理技术,血吸虫病传播灶(STF),以及该疾病的病例被识别和量化。统计和地理处理工具用于分析数据。
    未经评估:总的来说,STF的数量从15个(2000年)减少到11个(2010年),然后减少到9个(2020年)。尽管2000年蜗牛的感染率从16·1%下降到2010年的5·8%,但我们观察到到2020年增加到7·2%。此外,对6,499人进行了分析(2000年为2012年;2010年为2459人,2020年为2028人),人类感染的流行率多年来有所下降,从32·5%(2000年),16·6%(2010年)至8·8%(2020年)。无序城市化进程与STF和血吸虫病病例的空间分布直接相关,造成了一种新的情况,人们在未铺砌和被洪水淹没的街道上行走而被感染。
    UNASSIGNED:虽然我们观察到血吸虫病病例和STF减少,这个NTD成为与研究区域城市化相关的健康问题。克服这种新型传播的挑战将需要对无序迁移有更多的了解,空间占用,和环境的恶化。
    联合国:国家科学技术发展委员会(CNPq),科学部,技术,创新与沟通,巴西。
    UNASSIGNED: Social and environmental vulnerabilities contribute to the persistence and increase of Schistosomiasis, which has been a public health problem in Brazil and worldwide. In this study, we aimed to monitor the entry, installation, and maintenance of schistosomiasis transmission in an urban area on the Brazilian coast over two decades (2000-2010/2010-2020).
    UNASSIGNED: This population-based cross-sectional study was conducted in Porto de Galinhas, state of Pernambuco, Brazil, to investigate the dynamics of schistosomiasis transmission in the urban area. Through 3 malacological and parasitological surveys and using geoprocessing technologies, schistosomiasis transmission foci (STF), as well as cases of the disease were identified and quantified. Statistical and geoprocessing tools were used to analyse the data.
    UNASSIGNED: Overall, the number of STF decreased from 15 (2000) to 11 (2010) and then to 9 (2020). Although the infection ratio of snails in 2000 has decreased from 16·1% to 5·8% in 2010, we observed an increase to 7·2% in 2020. Additionally, 6,499 individuals were analysed (2012 in 2000; 2459 in 2010, and 2028 in 2020) and the prevalence of human infection has decreased over years, from 32·5% (2000), 16·6% (2010) to 8·8% (2020). The disorderly urbanization process was directly related to the spatial distribution of STF and schistosomiasis cases, causing a new scenario where people became infected by walking on unpaved and flooded streets.
    UNASSIGNED: Although we observed a decreasing in schistosomiasis cases and STF, this NTD became a health problem related to urbanization in the study area. The challenge to overcome this new sort of transmission will require a greater understanding of the disorderly migration, spatial occupation, and degradation of the environment.
    UNASSIGNED: National Council for Scientific and Technological Development (CNPq), Ministry of Science, Technology, Innovations and Communications, Brazil.
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  • 文章类型: Journal Article
    常见的皮肤感染,如脓疱疮和sc疮,在全球范围内构成了巨大的疾病负担。在热带和资源有限的环境中特别普遍。通过大规模药物管理解决这些感染的努力最近已被证明是有效和安全的。在萨摩亚,一个太平洋岛国,这些被忽视的热带病的流行病学数据明显缺乏,或欣赏他们的司机在这个设置。
    观测,Upolu岛农村地区4至15岁儿童就读于小学的横断面调查,对萨摩亚进行了评估,以评估居住在萨摩亚农村的学童中的脓疱病和sc疮的患病率,与描述性流行病学和微生物基因组数据相结合。对从萨摩亚学童中分离出的本地金黄色葡萄球菌进行了系统发育评估,以估计推定的社区传播。
    在这项调查中,在萨摩亚学童中观察到的脓疱病患病率是全球描述的最高患病率之一(57•1%,95%CI[53•8-60•5%],476/833)。注意到活动性脓疱病与年龄和性别之间的关联,年龄较小的儿童和男性更常见(aOR2•8[1•8-4•7]和aOR1•8[1•3-2•5],分别)。sc疮的患病率与其他南太平洋岛国相似(14•4%,95%CI[12•2-17•0%],120/833)。预测了金黄色葡萄球菌的传播,主要是在同一所学校的孩子之间。化脓性链球菌的运输明显较低,在不到2%的学童中观察到咽带,与萨摩亚早期的研究一致。
    这项研究描述了萨摩亚脓疱疮和sc疮引起的相当大的疾病负担。这些发现对于解决这些条件带来的公共卫生挑战将是有价值的。提供基线流行数据,并强调在这种情况下减少相关微生物和寄生虫传播的实用策略。
    Oa\'afiagaolepa\'uifa\'ama\'iolepo\'u(脓疱病)maleutuolepa\'u(sc疮),uatelenaualefanauuamauaaiilepasefika,马勒·拉洛拉吉·阿托阿。Ofuafuagavaaimamaomapopokalameefoinaaineifaafitauli,eaofiaaileinumagaofualaauetapeinaaineifa\'ama\'i,阿利阿里·迈艾·马法伊纳·法塔玛亚·内法·马·我。EleotelenitusitusigamafaamaumaugaitotonuoSamoa,体育塔\'阿特勒内法\'阿迈奥勒帕\'u体育丽。奥娜·勒法塔瓦伊娜·内法·阿玛·我,eleoiloafo\'inimafuagamanisitulagaefaateleinaaineifa\'ama\'iolepa\'ui萨摩亚。
    Olesuesuegafaasaenisiilefanauaogailevaole4male15tausagaolooao\'ogailetulagaluainisionunu\'uituaiUpolu,Nafaatinoinaaisuesuegalea,iasuesueinaaileaotelegamafainumeraolefanauuamauaifa\'ama\'Iolepo\'u(脓疱病)maleutuolepa\'u(sc疮)。列内福·苏苏埃加,nafiailoaaifo\'ipo\'aituaigasiamaeseeseoloomauailugaopa\'umatinoolefanauaoga,inaiailoaaifoiaualauapipissiaineisiamamaileisitamaitiitiileisi,奥娜·马法瓦·艾利·奥内法\“阿玛\”我奥勒帕\“你。
    Uafaailoamaiilesuesuega,leta\'ateleolefa\'ama\'iolepo\'u(脓疱病)uamauaailefanauaoga(57%),我AoganaFaiaaileSuesuega.Osefainumerauamaualugateleilelalolagiatoa.etoateleatunisiolefanaulaiti(年轻)matama(男性)emauailepo\'unailoisitamaiti.Olefainumeraoleutuolepa'u(sc疮)(14·4%)etutusa熔岩maisimotuolePasefika。Olefeaveainaolesiamafaapitoa(金黄色葡萄球菌)uatupuleailefanauuaao\'ogaileaogaetasi.Eletoatelefoinisiolefanau(2%)namauailesiamafaapitoaolefa\ai(链球菌化脓)eonamafuaailefivarumatika.奥列伊·法努玛·阿塔图萨·马苏苏埃加·法萨尼西娜·法伊·穆阿马·萨摩亚。
    Oleaotelegalaoleneisuesuegafaasaenisi,uafaailoainamaiailetelenauaolefa\'ama\'iolepa\'u,opo\'u(脓疱病)maleutuolepa\'u(sc疮)i萨摩亚nei。Oneifoisuesuegaoleaaogateleinipolokalamemanifuafuagamamaoefafoisiaaineifaafitaulilesoifuamalloinaolefanaui萨摩亚.Oleaaveafoineifainumeraefaamamaumainamolesilafiaeleatunuumalesoifuamaloloina,Leta\'ateleoneifa\'amaiolepa\'u,莫勒·塔佩纳娜·尼福福·塔拉菲盖伊·泰米·伊·卢马,我是faaitiitinaailepipissioneisiamiifanau\'ogaiSamoa.
    UNASSIGNED: Common infections of the skin such as impetigo and scabies represent a large burden of disease globally, being particularly prevalent in tropical and resource-limited settings. Efforts to address these infections through mass drug administrations have recently been shown as efficacious and safe. In Samoa, a Pacific Island nation, there is a marked lack of epidemiological data for these neglected tropical diseases, or appreciation of their drivers in this setting.
    UNASSIGNED: An observational, cross-sectional survey of children aged between 4 and 15 years attending primary schools in rural areas of Upolu Island, Samoa was carried out to assess the prevalence of impetigo and scabies in schoolchildren residing in rural Samoa, integrated with descriptive epidemiological and microbial genomic data. A phylogenetic assessment of local Staphylococcus aureus isolated from Samoan schoolchildren was performed to estimate putative community transmission.
    UNASSIGNED: In this survey, the prevalence of impetigo observed in Samoan schoolchildren was one of the highest described globally (57•1%, 95% CI [53•8-60•5%], 476/833). Associations between active impetigo and age and gender were noted, with younger children and males more commonly affected (aOR2•8 [1•8-4•7]and aOR1•8 [1•3-2•5], respectively). The prevalence of scabies was similar to that seen in other South Pacific island countries (14•4%, 95% CI [12•2-17•0%], 120/833). Transmission of S. aureus was predicted, primarily between those children attending the same school. Carriage of S. pyogenes was notably low, with pharyngeal carriage observed in less than 2% of schoolchildren, consistent with earlier studies from Samoa.
    UNASSIGNED: This study describes a considerable burden of disease attributed to impetigo and scabies in Samoa. These findings will be valuable in addressing the public health challenge posed by these conditions, providing baseline prevalence data and highlighting practical strategies to reduce transmission of relevant microbes and parasites in this setting.
    UNASSIGNED: O a\'afiaga o le pa\'u i fa\'ama\'i o le po\'u (impetigo) ma le utu o le pa\'u (scabies), ua tele naua le fanau ua maua ai i le pasefika, ma le lalolagi atoa. O fuafuaga vaai mamao ma polokalame e fofoina ai nei faafitauli, e aofia ai le inumaga o fualaau e tapeina ai nei fa\'ama\'i, ua aliali mai ai e mafai ona faatamaia nei fa\'ama\'i. E le o tele ni tusitusiga ma faamaumauga i totonu o Samoa, pe ta\'atele nei fa\'amai o le pa\'u pe leai. Ona o le le faatauaina o nei fa\'ama\'i, e le o iloa fo\'i ni mafuaga ma nisi tulaga e faateleina ai nei fa\'ama\'i o le pa\'u i Samoa.
    UNASSIGNED: O le suesuega faasaenisi i le fanau aoga i le va o le 4 ma le 15 tausaga o loo ao\'oga i le tulaga lua i nisi o nu\'u i tua i Upolu, na faatinoina ai suesuega lea, ia suesueina ai le aotelega ma fainumera o le fanau ua maua i fa\'ama\'I o le po\'u (impetigo) ma le utu o le pa\'u (scabies). O lenei foi suesuega, na fia iloa ai fo\'i po\'o a ituaiga siama eseese o loo maua i luga o pa\'u ma tino o le fanau aoga, ina ia iloa ai foi auala ua pipisi ai nei siama mai le isi tamaitiiti i le isi, ona mafua ai lea o nei fa\'ama\'i o le pa\'u.
    UNASSIGNED: Ua faailoa mai i le suesuega, le ta\'atele o le fa\'ama\'i o le po\'u (impetigo) ua maua ai le fanau aoga (57%), i aoga na faia ai le suesuega. O se fainumera ua maualuga tele i le lalolagi atoa. E toatele atu nisi o le fanau laiti (younger) ma tama (male) e maua i le po\'u nai lo isi tamaiti. O le fainumera o le utu o le pa\'u (scabies) (14·4%) e tai tutusa lava ma isi motu o le Pasefika. O le feaveaina o le siama faapitoa (staph aureus) ua tupu lea i le fanau ua ao\'oga i le aoga e tasi. E le toatele foi nisi o le fanau (2%) na maua i le siama faapitoa o le fa\'ai (strep pyogenes) e ona mafua ai le fiva rumatika. O lenei fainumera ua tai tutusa ma suesuega faasaenisi na fai muamua i Samoa.
    UNASSIGNED: O le aotelega la o lenei suesuega faasaenisi, ua faailoaina mai ai le tele naua o le fa\'ama\'i o le pa\'u, o po\'u (impetigo) ma le utu o le pa\'u (scabies) i Samoa nei. O nei foi suesuega o le a aoga tele ini polokalame ma ni fuafuaga mamao e fa\'afoisia ai nei faafitauli i le soifua maloloina o le fanau i Samoa. O le a avea foi nei fainumera e faamaumauina mo le silafia e le atunuu ma le soifua maloloina, le ta\'atele o nei fa\'amai o le pa\'u, mo le tapenaina o ni fofo talafeagai ise taimi o i luma, ina ia faaitiitina ai le pipisi o nei siami i fanau ao\'oga i Samoa.
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