Serological diagnosis of soil-transmitted helminth (Ascaris, Trichuris and hookworm) infections: A scoping review.

BACKGROUND: The World Health Organization emphasizes the importance of integrated monitoring and evaluation in neglected tropical disease (NTD) control programs. Serological assays offer a potential solution for integrated diagnosis of NTDs, particularly for those requiring mass drug administration (MDA) as primary control and elimination strategy. This scoping review aims (i) to provide an overview of assays using serum or plasma to detect infections with soil-transmitted helminths (STHs) in both humans and animals, (ii) to examine the methodologies used in this research field and (iii) to discuss advancements in serological diagnosis of STHs to guide prevention and control programs in veterinary and human medicine. METHODOLOGY: We conducted a systematic search in the Ovid MEDLINE, Embase and Cochrane Library databases, supplemented by a Google search using predefined keywords to identify commercially available serological assays. Additionally, we performed a patent search through Espacenet. PRINCIPAL FINDINGS: We identified 85 relevant literature records spanning over 50 years, with a notable increased interest in serological assay development in recent years. Most of the research efforts concentrated on diagnosing Ascaris infections in both humans and pigs, primarily using ELISA and western blot technologies. Almost all records targeted antibodies as analytes, employing proteins and peptides as analyte detection agents. Approximately 60% of sample sets described pertained to human samples. No commercially available tests for Trichuris or hookworms were identified, while for Ascaris, there are at least seven different ELISAs on the market. CONCLUSIONS: While a substantial number of assays are employed in epidemiological research, the current state of serological diagnosis for guiding STH prevention and control programs is limited. Only two assays designed for pigs are used to inform efficient deworming practices in pig populations. Regarding human diagnosis, none of the existing assays has undergone extensive large-scale validation or integration into routine diagnostics for MDA programs.

An integrated human behavioral model for mosquito-borne disease control: A scoping review of behavior change theories used to identify key behavioral determinants.

Mosquito-borne disease (MBD) control depends largely on a range of public health measures aimed at reducing the spread of infected mosquitoes and human-mosquito contact. These public health measures are generally driven by voluntary, though in few occasions obligatory (e.g., indoor residual spraying), self-protective behaviors by individuals and communities. To develop effective interventions that promote public health measures, the underlying mechanisms that contribute to self-protective behaviors should be well understood. The present scoping review aims to provide a timely overview of how behavior change theories have been applied in the context of MBD control. In addition, the review proposes an integrated model that includes identified key determinants in MBD control behavior, and identifies knowledge gaps to inform future research. A comprehensive search was performed in several databases: MEDLINE, PsycINFO, Embase (Ovid), Web of Science Core Collection, CINAHL, ERIC, and Econ.Lit (EBSCO), as well as registered trials and reviews in CENTRAL and PROSPERO to identify ongoing or unpublished studies. References of included studies and literature reviews were screened, as well as citation tracking in Web of Science, Google Scholar and the malaria database of Behavior Change Impact. This scoping review identified a total of 28 studies. Most studies targeted personal-protective behavioral measures such as adopting, using, or maintaining insecticide-treated bed nets, and were most frequently informed by risk-related behavioral theories. Knowledge and perceived susceptibility of the risk, and related perceived efficacy were identified as key behavioral determinants in the conceptual, integrated human behavior model for MBD control. Numerous studies related to MBD control behavior, especially those focusing on knowledge-attitudes-practices (KAP), often lack a solid theoretical framework, which risks depicting an incomplete understanding of behaviors. In addition, by incorporating various behavioral disciplines into the domain of MBD control, a more comprehensive understanding of key behavioral determinants may be developed and applied in future research and MBD control efforts.

Understanding the uptake of diagnostics for sustainable gastrointestinal nematode control by European dairy cattle farmers: a multi-country cross-sectional study.

To mitigate emerging anthelmintic resistance (AR) in cattle, sustainable gastrointestinal nematode control strategies should be adopted. A multi-centre study was set up to understand the factors affecting European dairy cattle farmers' adoption of diagnostics and to gauge for differences between regions. The data were collected through a multi-lingual survey by participating countries of the European Co-operation in Science and Technology (COST) action COMbatting Anthelmintic Resistance in ruminants (COMBAR). Four countries provided sufficient data to be included in the data analysis: Norway, Italy, Germany and Austria. Three models were estimated and validated through structural equation modelling. Norway, along with Germany and Austria (pooled dataset) showed similar trends that align with previous studies. AR risk perception had no influence on the adoption intention of diagnostics, a positive influence was found for attitude towards diagnostics and subjective norms (i.e., perceived opinion of others), and a negative influence of attitudes towards anthelminthics. Additionally, routine (i.e., perception of the current treatment) had an indirect effect on adoption intention through attitudes. Italy's data deviated from these findings, presenting a positive effect of the perceived severity of AR, and perceived behavioural control (i.e., perceived ability to perform a specific behaviour) on adoption intention of diagnostics. Finally, Norway's data set allowed for inclusion of a measurement of current behaviour in the model, identifying a direct positive effect of the perceived actual behaviour of other farmers on their own behaviour.

Title: Comprendre l'adoption des diagnostics pour le contrôle durable des nématodes gastro-intestinaux par les producteurs laitiers européens : une étude transversale multi-pays. Abstract: Pour atténuer la résistance émergente aux anthelminthiques (RA) chez les bovins, des stratégies durables de contrôle des nématodes gastro-intestinaux devraient être adoptées. Une étude multicentrique a été réalisée pour comprendre les facteurs affectant l'adoption des diagnostics par les éleveurs de bovins laitiers européens, et pour évaluer les différences entre les régions. Les données ont été recueillies au moyen d'une enquête multilingue menée par les pays participants à l'action de European Co-operation in Science and Technology (COST) COMbatting Anthelmintic Resistance in ruminants (COMBAR). Quatre pays ont collecté suffisamment de données pour être inclus dans l'analyse statistique : la Norvège, l'Italie, l'Allemagne et l'Autriche. Trois modèles ont été estimés et validés par modélisation d'équations structurelles. La Norvège, et d'autre part l'Allemagne et l'Autriche (données regroupées) ont montré des tendances similaires qui correspondent aux études précédentes. La perception de la RA n'avait aucune influence sur l'intention d'adoption des diagnostics, une influence positive a été trouvée pour l'attitude envers les diagnostics et les normes subjectives (c'est-à-dire l'opinion perçue des autres), et une influence négative des attitudes envers les anthelminthiques. De plus, la routine (c'est-à-dire la perception du traitement actuel) a eu un effet indirect sur l'intention d'adoption par le biais des attitudes. Les données de l'Italie s'écartaient des résultats précédents, présentant un effet positif de la gravité perçue du risque de la RA, et du contrôle comportemental perçu (c'est-à-dire la capacité perçue à adopter un comportement spécifique) sur l'intention d'adoption de diagnostic. Enfin, l'ensemble de données de la Norvège a permis d'inclure une mesure du comportement actuel dans le modèle, identifiant un effet positif direct du comportement réel perçu des autres agriculteurs sur son propre comportement.

School and community driven dengue vector control and monitoring in Myanmar: Study protocol for a cluster randomized controlled trial.

Background: Dengue is the most common and widespread mosquito-borne arboviral disease globally estimated to cause >390 million infections and >20,000 deaths annually. There are no effective preventive drugs and the newly introduced vaccines are not yet available. Control of dengue transmission still relies primarily on mosquito vector control. Although most vector control methods currently used by national dengue control programs may temporarily reduce mosquito populations, there is little evidence that they affect transmission. There is an urgent need for innovative, participatory, effective, and locally adapted approaches for sustainable vector control and monitoring in which students can be particularly relevant contributors and to demonstrate a clear link between vector reduction and dengue transmission reduction, using tools that are inexpensive and easy to use by local communities in a sustainable manner. Methods: Here we describe a cluster randomized controlled trial to be conducted in 46 school catchment areas in two townships in Yangon, Myanmar. The outcome measures are dengue cases confirmed by rapid diagnostic test in the townships, dengue incidence in schools, entomological indices, knowledge, attitudes and practice, behavior, and engagement. Conclusions: The trial involves middle school students that positions them to become actors in dengue knowledge transfer to their communities and take a leadership role in the delivery of vector control interventions and monitoring methods. Following this rationale, we believe that students can become change agents of decentralized vector surveillance and sustainable disease control in line with recent new paradigms in integrated and participatory vector surveillance and control. This provides an opportunity to operationalize transdisciplinary research towards sustainable health development. Due to the COVID-19 pandemic and political instability in Myanmar the project has been terminated by the donor, but the protocol will be helpful for potential future implementation of the project in Myanmar and/or elsewhere.Registration: This trial was registered in the ISRCTN Registry on 31 May 2022 ( https://doi.org/10.1186/ISRCTN78254298).

Dengue is a mosquito-borne disease, causing millions of infections and thousands of deaths annually. Current control efforts focus on reducing mosquito numbers, but there's little evidence of their impact on disease transmission. New innovative and locally adapted approaches are needed to sustain vector control. We describe a trial protocol for Yangon, Myanmar, involving 46 schools, for reducing the number of dengue cases and mosquitoes in schools and communities though various interventions. Middle school students will play a central role, becoming agents in transferring dengue knowledge to their communities, leading vector control efforts. The idea is that students can drive decentralized vector surveillance, aligning with modern disease control approaches. This initiative offers a chance to integrate diverse research disciplines for sustainable health development. Unfortunately, due to the COVID-19 pandemic and political instability in Myanmar, the project could not be realized. Despite this setback, the outlined protocol remains valuable for potential future implementation in Myanmar or elsewhere, emphasizing the importance of student involvement in community-based disease control efforts.

Nudge strategies for behavior-based prevention and control of neglected tropical diseases: A scoping review and ethical assessment.

BACKGROUND: Nudging, a strategy that uses subtle stimuli to direct people's behavior, has recently been included as an effective and low-cost behavior change strategy in low- and middle- income countries (LMIC), targeting behavior-based prevention and control of neglected tropical diseases (NTDs). The present scoping review aims to provide a timely overview of how nudge interventions have been applied within this field. In addition, the review proposes a framework for the ethical consideration of nudges for NTD prevention and control, or more broadly global health promotion. METHODS: A comprehensive search was performed in several databases: MEDLINE, PsycINFO, and Embase (Ovid), Web of Science Core Collection, CINAHL, ERIC and Econ.Lit (EBSCO), as well as registered trials and reviews in CENTRAL and PROSPERO to identify ongoing or unpublished studies. Additionally, studies were included through a handpicked search on websites of governmental nudge units and global health or development organizations. RESULTS: This scoping review identified 33 relevant studies, with only two studies targeting NTDs in particular, resulting in a total of 67 nudge strategies. Most nudges targeted handwashing behavior and were focused on general health practices rather than targeting a specific disease. The most common nudge strategies were those targeting decision assistance, such as facilitating commitment and reminder actions. The majority of nudges were of moderate to high ethical standards, with the highest standards being those that had the most immediate and significant health benefits, and those implemented by agents in a trust relationship with the target audience. CONCLUSION: Three key recommendations should inform research investigating nudge strategies in global health promotion in general. Firstly, future efforts should investigate the different opportunities that nudges present for targeting NTDs in particular, rather than relying solely on integrated health promotion approaches. Secondly, to apply robust study designs including rigorous process and impact evaluation which allow for a better understanding of 'what works' and 'how it works'. Finally, to consider the ethical implications of implementing nudge strategies, specifically in LMIC.

Assessing Student Perceptions of a Norwegian University's COVID-19 Response Strategy: A Cross-Sectional Study.

Aim: This study aims to investigate Norwegian students' perceptions toward a higher education institution (HEI)'s COVID-19 response strategy, differentiating between three behavioral techniques: informing (i. e., email updates about COVID-19), nudging (i.e., visual cues as reminders), and creating novel opportunities (i.e., provision of antibacterial dispensers). In addition, the study assesses to what extent these perceptions are influenced by COVID-19 related psychological factors: risk perception; attitudes toward infection prevention and control (IPC) behaviors; perceived behavior control; institutional trust. Methods: A cross-sectional online survey was conducted among a student population. The survey was developed to evaluate the HEI's response strategy, and distinct perceptions of COVID-19 and related practices. Structural equation modeling (SEM) was applied to estimate the effect of the psychological factors on the attitude toward different behavioral techniques. Results: Creating novel opportunities was perceived most positively from the students, secondly, informing the students through email updates about COVID-19, finally, reminders through visual cues. Institutional trust presented the largest positive effect on informing the students through email updates, while no effect was measured for reminders. Attitudes toward IPC behaviors showed the strongest effect on students' perceptions of new opportunities and reminders, whereas providing email updates about COVID-19 is less affected by pre-existing perceptions. Conclusions: A host of factors such as institutional trust, and perceptions concerning IPC measures and risk severity, influence students' perceptions of different behavior change techniques. This type of knowledge can contribute to understanding how perceptions can impact acceptance and adoption of specific preventive measures within a pandemic response. An assessment as such may result in more ethical and relevant future efforts.

Identifying nudge strategies for behavior-based prevention and control of neglected tropical diseases: a scoping review protocol.

OBJECTIVE: The aim of this scoping review is to synthesize the existing body of studies that use nudge strategy and focus on behavioral practices suitable for prevention and control of neglected tropical diseases. The review will map the existing literature, identify gaps in knowledge, and provide a series of recommendations for future research. INTRODUCTION: There is a well-established body of knowledge related to "nudging," a strategy that uses subtle stimuli to direct people's behavior within public health interventions, with the aim of changing behaviors to reduce the prevalence of non-communicable diseases. Recently, interventions to promote prevention and control of neglected tropical diseases have included nudging as a strategy for altering behavior. However, these interventions not been synthesized and present the opportunity for a scoping review. INCLUSION CRITERIA: Eligible studies are those that include nudge strategies aimed at changing behavior to prevent and control neglected tropical diseases. All types of behavioral practices suitable for targeting neglected tropical diseases (e.g. handwashing behaviors) will be considered, not exclusively focusing on a specific type or group of neglected tropical diseases. The nudge strategy must be described in full, without restrictions to the study design. The context or population will be limited to low- and middle-income countries. METHODS: A comprehensive search will be performed in the following databases: MEDLINE, PsycINFO, and Embase (Ovid), Web of Science Core Collection, CINAHL, ERIC, and EconLit (EBSCO), as well as registered trials and reviews in CENTRAL and PROSPERO to identify ongoing or unpublished studies. Titles will be screened by one reviewer, and non-eligible studies excluded. Two reviewers (SB and FVV) will screen abstracts independently. Eligible studies will be selected through a questionnaire that specifies the inclusion criteria. Papers selected for inclusion will be subject to data extraction using a tool designed by one review author and agreed upon by the other review authors. Data will be presented in a table and other conceptual styles.

Farmer Behavior and Gastrointestinal Nematodes in Ruminant Livestock-Uptake of Sustainable Control Approaches.

Gastrointestinal nematode (GIN) infections are a common constraint in pasture-based herds and cause a decrease in animal health, productivity and farm profitability. Current control practices to prevent production losses of GIN infections in livestock depend largely on the use of anthelmintic drugs. However, due to the continued use of these drugs over more than three decades, the industry is now increasingly confronted with nematode populations resistant to the available anthelmintics. This emerging anthelmintic resistance (AR) in cattle nematodes emphasizes the need for a change toward more sustainable control approaches that limit, prevent or reverse the development of AR. The uptake of diagnostic methods for sustainable control could enable more informed treatment decisions and reduce excessive anthelmintic use. Different diagnostic and targeted or targeted selective anthelmintic control approaches that slow down the selection pressure for anthelmintic resistance have been developed and evaluated recently. Now it is time to transform these insights into guidelines for sustainable control and communicate them across the farmer community. This article reviews the current uptake of such sustainable practices with a focus on farmer's socio-psychological factors affecting this uptake. We investigate communication as a possible tool to change current behavior and successfully implement more sustainable anthelmintic treatment strategies.

Decision making on helminths in cattle: diagnostics, economics and human behaviour.

Helminth infections of cattle affect productivity in all classes of stock, and are amongst the most important production-limiting diseases of grazing ruminants. Over the last decade, there has been a shift in focus in the diagnosis of these infections from merely detecting presence/absence of infection towards detecting its impact on production. This has been facilitated by studies observing consistent negative correlations between helminth diagnostic test results and measures of productivity. Veterinarians are increasingly challenged to consider the economic aspects of their work, and the use of these tests should now be integrated in economic evaluation frameworks for improved decision making. In this paper, we review recent insights in the farm-specific economic impact of helminth infections on dairy cattle farms as well as in farmer attitudes and behaviour regarding helminth control. Combining better economic impact assessments of helminth infections together with a deeper understanding of the non-economic factors that drive a farmer's animal health decisions should result in more effective control strategies and increased farmer satisfaction.