Cockroaches as carriers of human medically important parasites.

Cockroaches have been identified as mechanical carriers of pathogens capable of infesting humans. The primary objective of this research was to detect and separate medically significant parasites found within the collected cockroaches. A total of 185 cockroaches were captured. In the laboratory, cockroaches underwent a series of steps. Initially, they were washed in a saturated salt solution and rinsed with 70% alcohol, dried, and subsequently dissected to examine endoparasites. In this study, a transport rate of 29.729% was documented, and four types of helminths were identified, which included Ascaris lumbricoides (47.27%), Enterobius vermicularis (30.91%), Trichuris spp. (7.27%), and Hymenolepis nana (14.55%). The parasites were more frequently found on the external surface of cockroaches (38/69.09%), compared to the internal surface (17/30.91%). Cockroaches captured in toilets were found to carry a higher percentage of parasites (31/16.75%) compared to those from kitchens (11/5.94%) and houses (13/7.02%). These findings suggest that cockroaches can serve as carriers for intestinal parasites and potentially act as mechanical agents in the dissemination of these parasites.

Auditing the quality of epidemic decision-making in Somalia: a pilot evaluation.

OBJECTIVE: To assess decision-making quality through piloting an audit tool among decision-makers responding to the COVID-19 epidemic in Somalia. DESIGN AND SETTING: We utilised a mixed-methods programme evaluation design comprising quantitative and qualitative methods. Decision-makers in Somalia piloted the audit tool generating a scorecard for decision-making in epidemic response. They also participated in key informant interviews discussing their experience with the audit process and results. PARTICIPANTS: A total of 18 decision-makers from two humanitarian agencies responding to COVID-19 in Somalia were recruited to pilot the audit tool. OUTCOME MEASURES AND ANALYSIS: We used thematic analysis to assess the feasibility and perceived utility of the audit tool by intended users (decision-makers). We also calculated Fleiss' Kappa to assess inter-rater agreement in the audit scorecard. RESULTS: The audit highlighted areas of improvement in decision-making among both organisations including in the dimensions of accountability and transparency. Despite the audit occurring in a highly complex operating environment, decision-makers found the process to be feasible and of high utility. The flexibility of the audit approach allowed for organisations to adapt the audit to their needs. As a result, organisation reported a high level of acceptance of the findings. CONCLUSION: Strengthening decision-making processes is key to realising the objectives of epidemic response. This pilot evaluation contributes towards this goal by the testing what, to our knowledge, may be the first tool designed specifically to assess quality of decision-making processes in epidemic response. The tool has proven feasible and acceptable in assessing decision-making quality in an ongoing response and has potential applicability in assessing decision-making in broader humanitarian response.

Health research prioritization in Somalia: setting the agenda for context specific knowledge to advance universal health coverage.

Introduction: Despite recognition that health research is an imperative to progress toward universal health coverage, resources for health research are limited. Yet, especially in sub-Saharan Africa, more than 85% of the resources available for health research are spent on answering less relevant research questions. This misalignment is partially due to absence of locally determined health research priorities. In this study, we identified health research priorities which, if implemented, can inform local interventions required to accelerate progress toward universal health coverage in Somalia. Methods: We adapted the child health and nutrition research initiative method for research priority setting and applied it in 4 major phases: (1) establishment of an exercise management team, (2) a web-based survey among 84 respondents to identify health research questions; (3) categorization of identified health research questions; and (4) a workshop with 42 participants to score and rank the identified health research questions. Ethical approval was received from ethics review committee of the London School of Hygiene and Tropical Medicine (Ref:26524) and the Somali Research and Development Institute (Ref: EA0143). Results: Two hundred and thirty-one unique health research questions were identified and categorized under health systems, services and social determinants (77), communicable diseases (54), non-communicable diseases (41) and reproductive, maternal, new-born, child, adolescent health and nutrition (59). A priority score ranging from 1 to 9 was assigned to each of the questions. For each category, a list of 10 questions with the highest priority scores was developed. Across the four categories, an overall list of 10 questions with the highest priority scores was also developed. These related to bottlenecks to accessing essential health services, use of evidence in decision making, antimicrobial resistance, distribution and risk factors for non-communicable diseases, post-traumatic stress disorder and factors associated with low antenatal care attendance among others. Conclusion and recommendations: The developed priority research questions can be used to focus health research and to inform appropriation of health research resources to questions that contribute to generation of local health system knowledge which is required to accelerate progress toward universal health coverage in Somalia. The Somalia national institute of health should set up a consortium for provision of technical and financial support for research addressing the identified priority research questions, establish a mechanism to continuously monitor the extent to which new health interventions in Somalia are informed by knowledge generated through conducting prioritized health research and prioritize interventions aimed at strengthening the broader national health research system for Somalia.

Two haplotype clusters of Echinococcus granulosus sensu stricto in northern Iraq (Kurdistan region) support the hypothesis of a parasite cradle in the Middle East.

Human cystic echinococcosis (CE) caused by Echinococcus granulosus s.s. is a major public health problem in Iraqi Kurdistan with a reported surgical incidence of 6.3 per 100,000 Arbil inhabitants. A total of 125 Echinococcus isolates retrieved from sheep, goats and cattle were used in this study. Our aim was to determine species/genotypes infecting livestock in Iraqi Kurdistan and examine intraspecific variation and population structure of Echinococcus granulosus s.s. in this region and relate it to that of other regions worldwide. Using nucleotide sequences of the mitochondrial cytochrome c oxidase subunit 1 (cox 1) we identified E. granulosus s.s. as the cause of hydatidosis in all examined animals. The haplotype network displayed a double-clustered topology with two main E. granulosus s.s. haplotypes, (KU05) and (KU33). The 'founder' haplotype (KU05) confirmed the presence of a common lineage of non-genetically differentiated populations as inferred by the low non-significant fixation index values. Overall diversity and neutrality indices indicated demographic expansion. We used E. granulosus s.s. nucleotide sequences from GenBank to draw haplotype networks for the Middle East (Iran, Jordan and Turkey), Europe (Albania, Greece, Italy, Romania and Spain), China, Mongolia, Russia, South America (Argentina, Brazil, Chile and Mexico) and Tunisia. Networks with two haplotype clusters like that reported here for Iraqi Kurdistan were seen for the Middle East, Europe, Mongolia, Russia and Tunisia using both 827bp and 1609bp cox1 nucleotide sequences, whereas a star-like network was observed for China and South America. We hypothesize that the double clustering seen at what is generally assumed to be the cradle of domestication may have emerged independently and dispersed from the Middle East to other regions and that haplotype (KU33) may be the main haplotype within a second cluster in the Middle East from where it has spread into Europe, Mongolia, Russia and North Africa. Further studies using metacestodes of human origin are required to investigate the biological importance of E. granulosus s.s. haplotypes/clusters and their association, if any with clinical manifestations of CE infection.