Endemic regions

  • 文章类型: Journal Article
    人类弓形虫病(HT)是全球范围内广泛存在的人畜共患传染病,特别是在热带地区流行。增强我们对弓形虫病的了解可以引起人们对这种被忽视的人畜共患病的社会经济影响和控制的更多关注。我们对有关伊朗弓形虫病的所有可用文章和官方文件进行了全面审查,以确定研究差距和控制其关键需求。这篇综述强调,尽管有许多研究探索了确定性和性腺宿主中弓形虫病的各个方面,以及人类和环境污染,该国不同地区仍然存在显著的数据缺陷和差距。这些差距涉及调查确定宿主的蠕虫负担和再感染率,开发更灵敏的方法来检测和区分弓形虫物种,并了解确定宿主动物的行为。此外,确定HT的潜在paratenic宿主并探索这些宿主中弓形虫幼虫的器官特异性亲和力和存活时间是探索的重要领域。还必须理解寄生虫在副科宿主中的sylvatic和domestic周期。此外,评估环境中的鸡蛋密度,探索潜在的新来源,如水,和确定具有弓形虫卵生存和发育的最佳气候条件的区域对于制定有效的预防和控制策略至关重要。确定风险群体,发展早期诊断技术,采用成像方法,识别人类的长期并发症也至关重要。社区卫生组织应优先对公众和专业人员进行健康教育。此外,准确估计确定的宿主种群,监视和防止他们在公共场所的活动,对宠物和流浪寄主实施定期驱虫做法,认识到感染作为健康优先事项的重要性至关重要。这种全面的理解倡导了一种整体的“一种健康”方法来控制HT。
    Human toxocariasis (HT) is a widespread zoonotic infection globally, notably prevalent in tropical areas. Enhancing our understanding of toxocariasis can lead to increased attention towards the socioeconomic impact and control of this neglected zoonosis. We conducted a comprehensive review of all available articles and official documents on toxocariasis in Iran to identify research gaps and critical needs for its control. This review highlights that despite numerous studies exploring various aspects of toxocariasis in definitive and paratenic hosts, as well as humans and environmental contamination, significant data deficiencies and gaps persist across different regions in the country. These gaps involve investigating the worm burden and reinfection rates in definitive hosts, developing more sensitive methods to detect and differentiate of Toxocara species, and understanding the behavior of definitive host animals. Additionally, identifying potential paratenic hosts for HT and exploring the organ-specific affinity and survival duration of Toxocara larvae within these hosts are essential areas for exploration. It\'s also imperative to comprehend the sylvatic and domestic cycles of the parasite in paratenic hosts. Furthermore, assessing egg density in the environment, exploring potential new sources such as water, and identifying regions with optimal climatic conditions for the survival and development of Toxocara eggs are crucial for the formulation of effective prevention and control strategies. Identifying at-risk groups, developing early diagnosis techniques, employing imaging methods, and identifying long-term complications in humans are also crucial. Community health organizations should prioritize health education for the public and professionals. Furthermore, accurately estimating definitive host populations, monitoring and preventing their movements in public places, implementing regular deworming practices for pets and stray hosts, and recognizing the infection\'s significance as a health priority are critical. This comprehensive understanding advocates for a holistic \"one health\" approach to control of HT.
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  • 文章类型: Journal Article
    在低收入和中等收入国家,伤寒的疾病负担最高。主要位于亚洲和撒哈拉以南非洲。以前的伤寒疫苗如活的减毒伤寒(Ty21a)疫苗和Vi(毒力)荚膜多糖疫苗的局限性在于它们不能与其他标准的儿童免疫接种一起施用,并且在两岁以下的儿童中无效。为了解决以前疫苗的这些缺点,伤寒结合疫苗(TCV)是由世界卫生组织开发和资格预审。交叉反应材料和破伤风类毒素广泛用作TCV中的载体蛋白。根据各种研究,TCV具有更高的疗效,有更长的保护期,并且在6个月大的婴儿中具有安全性和免疫原性。这篇综述文章旨在全面评估现有的TCV疗效数据,保护期限,安全,和地方性地区的免疫原性。
    Typhoid fever has the highest disease burden in countries in low- and middle-income countries, primarily located in Asia and Sub-Saharan Africa. Previous typhoid vaccines such as the live attenuated typhoid (Ty21a) vaccine and Vi (virulence) capsular polysaccharide vaccine had the limitation that they could not be administered with other standard childhood immunizations and were ineffective in children under two years of age. To address these shortcomings of the previous vaccines, typhoid conjugate vaccines (TCVs) were developed and prequalified by the World Health Organization. Cross-reacting material and tetanus toxoid are widely used as carrier proteins in TCVs. According to various studies, TCV has higher efficacy, has a more extended protection period, and is safe and immunogenic in infants as young as six months. This review article aims to comprehensively appraise the data available on TCVs\' efficacy, duration of protection, safety, and immunogenicity in endemic regions.
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  • 文章类型: Case Reports
    Tuberculosis remains a global health threat, notably with a considerable burden of extrapulmonary cases. Prostate tuberculosis stands out as a rare and challenging diagnosis, often resulting in substantial management delays. In this report, we present the case of a 55-year-old man in whom initial suspicion of prostate cancer resulted in the diagnosis of prostate tuberculosis. The diagnostic methods, progressive features, and therapeutic tools of this rare condition are discussed.
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  • 文章类型: Journal Article
    球孢子菌病是人类和动物的一种潜在致命的真菌病。环境中的关节分生孢子。狗的疾病类似于人的疾病,因为狗由于靠近地面和挖掘行为而暴露的风险增加,它们是人类疾病的宝贵模型。狗已成为确定华盛顿和德克萨斯州新的地方性地区的哨兵。犬血清监测也已用于预测与球藻属的环境存在相关的变量。随着气候变化,球孢子菌病流行区的扩张以及美国西南部预计的人口增长和发展增加,到2090年可能会导致4540万人面临感染风险。在这里,我们概述了狗作为该病哨兵的价值,并鼓励向公共卫生机构常规报告狗中的球孢子菌病病例。我们还强调了狗作为研究新的治疗选择和预防措施的自然发生模型的价值。例如一种新型的无毒活球孢子菌病疫苗。
    球孢子菌病(“山谷热”)是美洲半干旱至干旱地区的人类和动物的新兴真菌疾病。该疾病的地理分布可能会随着气候变化而扩大。在这里,我们重点介绍了犬中球孢子菌病的研究如何具有增强我们对人类球孢子菌病的认识的潜力。
    Coccidioidomycosis is a potentially fatal fungal disease of humans and animals that follows inhalation of Coccidioides spp. arthroconidia in the environment. The disease in dogs resembles that in people, and because dogs may be at increased risk of exposure due to their proximity to the ground and digging behavior, they are valuable models for the disease in humans. Dogs have been sentinels for identification of new regions of endemicity in Washington and Texas. Canine serosurveillance has also been used to predict variables associated with environmental presence of Coccidioides spp. Expansion of the endemic region of coccidioidomycosis with climate change-along with predicted population increases and increased development in the southwest United States-may result in 45.4 million additional people at risk of infection by 2090. Here we provide an overview of the value of dogs as sentinels for the disease and encourage the routine reporting of coccidioidomycosis cases in dogs to public health agencies. We also highlight the value of dogs as naturally occurring models for studying novel treatment options and preventatives, such as a novel live avirulent coccidioidomycosis vaccine.
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  • 文章类型: Journal Article
    BACKGROUND: SARS-CoV-2 infection spatial and temporal distribution overlaps with endemic areas of vector-borne diseases (VBD), whose surveillance in Mexico has substantially changed since the first COVID-19 confirmed case.
    OBJECTIVE: To estimate and compare the incidence rates of VBDs before and after the introduction of SARS-CoV-2 in Mexico.
    METHODS: Retrospective study of VBD cases from 2014 to 2021. The incidence rates of each VBD in the period before (2014-2019) and after (2020-2021) the introduction of SARS-CoV-2 in Mexico were calculated and compared.
    RESULTS: Before the introduction of SARS-CoV-2, the incidence rates of VBDs were high and after the introduction of coronavirus there was a decrease in epidemiological indices; however, there was only statistically significant difference in the incidence rate of malaria (p ≤ 0.05) and other rickettsiae (p ≤ 0.05).
    CONCLUSIONS: Some measures to reduce COVID-19 cases, such as social distancing, home confinement, reductions in public transport and working at home (home office), probably temporarily decreased the number of VBD cases; however, there may be a resurgence of VBDs in the near future.
    UNASSIGNED: La distribución espacial y temporal de la infección por SARS-CoV-2 sobrepasa las áreas endémicas de enfermedades transmitidas por vector (ETV), cuya vigilancia en México ha cambiado sustancialmente a partir del primer caso confirmado de COVID-19.
    OBJECTIVE: Estimar y comparar las tasas de incidencia de las ETV antes y después de la introducción del SARS-CoV-2 en México.
    UNASSIGNED: Estudio retrospectivo de casos de ETV de 2014 a 2021. Las tasas de incidencia de cada ETV en el periodo previo (2014-2019) y posterior (2020-2021) a la introducción del SARS-CoV-2 en México fueron calculadas y comparadas.
    RESULTS: Antes de la introducción del SARS-CoV-2, las tasas de incidencia de las ETV fueron altas y posterior a la introducción del coronavirus hubo un descenso en los índices epidemiológicos; sin embargo, solo se identificó diferencia estadística significativa en la tasa de incidencia de la malaria (p ≤ 0.05) y otras rickettsias (p ≤ 0.05).
    CONCLUSIONS: Algunas medidas para reducir los casos de COVID-19, como el distanciamiento social, el confinamiento domiciliario, la reducción en el aforo en el transporte público y el trabajo en casa, probablemente contribuyeron a disminuir temporalmente el número de casos de las ETV; sin embargo, puede haber rebrote de las ETV en el futuro cercano.
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  • 文章类型: Case Reports
    脑囊虫病在不发达国家和发展中国家的许多地方都很流行,由于来自疾病流行地区的移民涌入,在发达国家持续存在。神经影像学,解剖病理学技术,免疫诊断试验,临床检查和流行病学考虑将很容易提供诊断。然而,发达国家的医生可能正在逐渐错过诊断,并且需要重新熟悉条件并获得很高的怀疑指数。作者提出了一个法医学案例,其中法医小组得出了神经囊虫病的结论(以及其他诊断),在对大部分骨骼和木乃伊的人类遗骸进行尸检后。尸检时在死者的颅骨中观察到特征性变化。对死前医疗记录的审查显示,计算机断层扫描(CT)扫描早在12年前,西班牙裔移民的诊断特征,但是主治医生没有考虑到这种情况的可能性。医师应注意暗示性的临床发现,尤其是在参加来自世界流行地区的个人时。囊虫病仍然是地方性的,误诊可能会引起医疗事故诉讼。法医病理学家还应考虑罕见临床疾病的可能性,即使在骨骼化的遗骸中。也许早期的诊断可能改变了死者的结果。
    Neurocysticercosis is endemic in many parts of the underdeveloped and developing countries, with continuous presence in developed countries due to the influx of migrants from regions where the diseases are endemic. Neuroimaging, anatomic pathological techniques, immunodiagnostic tests, clinical examination and epidemiologic considerations will easily provide the diagnosis. However, physicians in developed countries are perhaps progressively missing the diagnosis, and need to re-acquaint themselves with the condition and acquire a high suspicion index. The authors present a medicolegal case where the forensic team made a conclusion of neurocysticercosis (among other diagnoses), following post mortem examination of a largely skeletonized and mummified human remains. Characteristic changes were observed in the calvarium of the decedent at autopsy. Review of the antemortem medical records revealed that Computed Tomography (CT) scan had 12 years earlier, suggested diagnostic features in a Hispanic migrant, but the attending surgeons failed to consider the possibility of the condition. Physicians should pay attention to suggestive clinical findings especially when attending to individuals coming from endemic parts of the world. Cysticercosis remains endemic and a misdiagnosis can potentially attract medical malpractice suits. Forensic pathologists should also consider the possibility of uncommon clinical disorders, even in skeletonized remains. Perhaps an earlier diagnosis might have altered the outcome in the decedent.
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  • 文章类型: Journal Article
    背景:登革热已成为主要的媒介传播疾病之一,这是一个重要的公共卫生问题。我们旨在估算1990年至2019年主要流行地区登革热的疾病负担,并基于全球疾病负担探讨社会经济因素对登革热负担的影响模式。受伤,和2019年风险因素研究(GBD2019)。
    方法:使用来自GBD2019的分析策略和数据,我们描述了1990年至2019年主要流行地区登革热的发病率和残疾调整寿命年(DALYs)。此外,我们估计了登革热负担和社会经济因素之间的相关性,然后建立了自回归综合移动平均(ARIMA)模型来预测登革热流行地区的流行趋势。所有估计数均以每100,000人口的数量和年龄标准化率(ASR)提出,具有不确定性区间(UI)。在地理上比较了登革热发病率的ASR,并通过社会人口统计学指数(SDI)对五个地区进行了分层。
    结果:在1990年至2019年期间,全球范围内观察到显着上升,总体年龄标准化率(ASR)从557.15(95%UI243.32-1212.53)增加到1990年的每100,000到2019年的740.4(95%UI478.2-1323.1)。2019年,大洋洲地区每10万人口的年龄标准化发病率最高(3173.48(95%UI762.33-6161.18)),其次是南亚地区(1740.79(95%UI660.93-4287.12)),然后是东南亚地区(1153.57(95%UI1049.49-1281.59))。在大洋洲,南亚,东南亚,通过DALY的ASR测量的登革热负担有增加趋势,这与国家一级登革热发病率的ASR一致。大多数登革热负担最重的国家都发生在低和中SDI地区。然而,中、高SDI国家的负担相对较低,尤其是大洋洲的所罗门群岛和汤加,南亚的马尔代夫和东南亚的印度尼西亚。主要流行地区登革热发病率和疾病负担的年龄分布结果显示,登革热发病风险和疾病负担较高的人群主要集中在14岁以下或70岁以上人群。ARIMA的预测表明,南亚和东南亚的登革热风险正在上升,有必要进一步预防和控制。
    结论:鉴于许多登革热流行国家的人口快速增长和城市化,我们的研究结果对未来登革热的发展趋势具有重要意义。建议决策者特别关注城市化对登革热发病率的负面影响,并将更多资源分配给低SDI地区和14岁以下或70岁以上的人群,以减轻登革热负担。
    BACKGROUND: Dengue has become one of the major vector-borne diseases, which has been an important public health concern. We aimed to estimate the disease burden of dengue in major endemic regions from 1990 to 2019, and explore the impact pattern of the socioeconomic factors on the burden of dengue based on the global burden of diseases, injuries, and risk factors study 2019 (GBD 2019).
    METHODS: Using the analytical strategies and data from the GBD 2019, we described the incidence and disability-adjusted life years (DALYs) of dengue in major endemic regions from 1990 to 2019. Furthermore, we estimated the correlation between dengue burden and socioeconomic factors, and then established an autoregressive integrated moving average (ARIMA) model to predict the epidemic trends of dengue in endemic regions. All estimates were proposed as numbers and age-standardized rates (ASR) per 100,000 population, with uncertainty intervals (UIs). The ASRs of dengue incidence were compared geographically and five regions were stratified by a sociodemographic index (SDI).
    RESULTS: A significant rise was observed on a global scale between 1990 and 2019, with the overall age-standardized rate (ASR) increasing from 557.15 (95% UI 243.32-1212.53) per 100,000 in 1990 to 740.4 (95% UI 478.2-1323.1) per 100,000 in 2019. In 2019, the Oceania region had the highest age-standardized incidence rates per 100,000 population (3173.48 (95% UI 762.33-6161.18)), followed by the South Asia region (1740.79 (95% UI 660.93-4287.12)), and then the Southeast Asia region (1153.57 (95% UI 1049.49-1281.59)). In Oceania, South Asia, and Southeast Asia, increase trends were found in the burden of dengue fever measured by ASRs of DALY which were consistent with ASRs of dengue incidence at the national level. Most of the countries with the heaviest burden of dengue fever occurred in areas with low and medium SDI regions. However, the burden in high-middle and high-SDI countries is relatively low, especially the Solomon Islands and Tonga in Oceania, the Maldives in South Asia and Indonesia in Southeast Asia. The age distribution results of the incidence rate and disease burden of dengue fever of major endemic regions showed that the higher risk and disease burden are mainly concentrated in people under 14 or over 70 years old. The prediction by ARIMA showed that the risk of dengue fever in South and Southeast Asia is on the rise, and further prevention and control is warranted.
    CONCLUSIONS: In view of the rapid population growth and urbanization in many dengue-endemic countries, our research results are of great significance for presenting the future trend in dengue fever. It is recommended to policy makers that specific attention needs to be paid to the negative impact of urbanization on dengue incidence and allocate more resources to the low-SDI areas and people under 14 or over 70 years old to reduce the burden of dengue fever.
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  • 文章类型: Journal Article
    自1942年首例病例报告以来,小反刍动物病毒(PPRV)已在多种易感宿主中引起感染,特别是在疾病流行地区。在过去的40年里,各种报告强调了来自9个不同家庭的大约46种动物的疾病和病毒基因组的证据,包括牛科,子宫颈,骆驼科,Suidae,犬科,费里达,Muridae,和Elephantidae.这种临床和/或亚临床感染的证据以及病毒在更广泛的易感宿主中的存在强调了跨物种传播,这仍然是有效控制的重大障碍,特别是在疾病流行地区。因此,更好地了解病毒传播,宿主易感性,该疾病的流行病学调查对于实现由世界动物卫生组织和粮农组织在各种疾病流行地区发起的有效疾病控制和根除计划的目标至关重要。然而,就涉及异常或新宿主的新爆发而言,PPRV间传和间传的倾向可能是疾病控制策略中的一个制约因素.考虑到这方面,我们试图将PPR的分散数据总结为有关各种野生物种易感性的可用信息,大型反刍动物,骆驼,和不寻常的主机。
    Since the first case report in 1942, the peste-des-petits-ruminants virus (PPRV) has been causing infection in a wide range of susceptible hosts, particularly in disease-endemic regions. In the last 40 years, various reports highlighted the evidence of disease and viral genome in around 46 animal species from nine diverse families, including Bovidae, Cervidae, Camelidae, Suidae, Canidae, Felidae, Muridae, and Elephantidae. This evidence of clinical and/ or subclinical infection and the presence of the virus in an extended range of susceptible hosts emphasizes the cross-species transmission that remains a significant obstacle to effective control, particularly in disease-endemic regions. Therefore, a better understanding of virus transmission, host susceptibility, and epidemiological investigation of the disease is crucial to achieving the goals of efficient disease control and eradication programs initiated by OIE and FAO in various diseases-endemic regions. Nevertheless, the propensity of PPRV to inter- and intra-transmission may be a possible constraint in disease control strategies in terms of the new outbreak with the involvement of unusual or novel hosts. Considering this aspect, we tried to summarize the scattered data on PPR in available information about the susceptibility of a wide range of wildlife species, large ruminants, camels, and unusual hosts.
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  • 文章类型: Case Reports
    Intestinal amoebiasis and sequelae such as amoebic liver abscess are rarely reported in the era of modern medicine. Atypical presentation of amoebic liver abscess with high false-positive results on serology in endemic regions poses major diagnostic issues in the developing nations of the world. We report a case of amoebic liver abscess and describe the imaging appearances in a 59-year-old female. A detailed medical history was elicited to determine the etiology of amoebic liver abscess. Furthermore, the diagnosis was confirmed based on serological tests. Percutaneous aspiration of the amoebic liver abscess was performed, and treatment was initiated with intravenous metronidazole followed by diloxanide furoate. The patient has been on follow-up since three months with a negative stool examination and with no complaints of recurrence.
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  • 文章类型: Journal Article
    Behçet病(BD),慢性系统性血管炎,具有明显的地理和种族差异。有关美国BD患者流行病学的数据有限;因此,我们试图描述美国的BD患者特征和药物使用情况,并将它们与流行地区患者的数据进行比较。
    我们使用RISE注册中心(2014-2018)的数据进行了横断面研究。纳入年龄≥18岁的BD患者。提取社会人口统计学和治疗信息。我们将RISE注册的患者与其他已发表的地方性地区BD患者研究的数据进行了比较。
    包括来自RISE注册表的一千三百二十三名患有BD的受试者。平均年龄为48.7±16.3岁,男女比例为3.8:1,白人占66.7%。最常用的药物包括糖皮质激素(67.6%)和秋水仙碱(55.0%)。英夫利昔单抗和阿达木单抗是最常用的生物制剂(14.5%和14.1%,分别);3.2%的患者使用阿普瑞司特。RISE登记处有更多的女性(79.3%),与以前发表的来自流行地区的BD研究相比,患者年龄更大。与埃及和土耳其的研究相比,甲氨蝶呤和TNFi在RISE中更常见(21.8%和29.4%)。秋水仙碱,环孢菌素,环磷酰胺更常用于来自埃及的队列中,土耳其,和伊朗。
    来自美国最大的BD数据集的研究结果表明,BD患者主要是女性。需要进一步的研究来探索美国女性中BD患病率较高的原因及其对疾病严重程度和管理的可能影响。
    Behçet\'s disease (BD), a chronic systemic vasculitis, has distinct geographical and ethnic variation. Data regarding the epidemiology of patients with BD in the U.S. are limited; therefore, we sought to describe BD patient characteristics and medication use in the U.S., and compared them with data from patients from endemic regions.
    We conducted a cross-sectional study using data from the RISE registry (2014-2018). Patients aged ≥ 18 years with BD were included. Sociodemographic and treatment information was extracted. We compared patients from the RISE registry to data from other published studies of patients with BD from endemic areas.
    One thousand three hundred twenty-three subjects with BD from the RISE registry were included. Mean age was 48.7 ± 16.3 years, female to male ratio was 3.8:1, and 66.7% were White. The most frequently used medications included glucocorticoids (67.6%) and colchicine (55.0%). Infliximab and adalimumab were the most used biologics (14.5% and 14.1%, respectively); 3.2% of patients used apremilast. The RISE registry had more women (79.3%), and patients were older compared to previously published BD studies from endemic areas. Methotrexate and TNFi were more commonly reported in RISE (21.8% and 29.4%) compared to studies from Egypt and Turkey. Colchicine, cyclosporine, and cyclophosphamide were more commonly used in cohorts from Egypt, Turkey, and Iran.
    Findings from the largest BD dataset in the U.S. suggest that BD patients are predominantly female. Further research is needed to explore the reasons for the higher prevalence of BD among women in the U.S. and its possible impact on disease severity and management.
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