Increasing women's engagement in vector control: a report from Accelerate To Equal project workshops.

Workshops with academic, national and local government, and community stakeholders were held in Kenya (2017) and Indonesia (2018) to understand the role and perceptions of women in vector control and to identify strategies for accelerating involvement of women in sustained support for vector control interventions at multiple levels/sectors.

Campylobacter and Ethnicity-A Case-Case Analysis to Determine Differences in Disease Presentation and Risk Factors.

BACKGROUND: Rates of Campylobacter infection in Arizona have historically been higher than the national average, with the highest rates in Hispanic populations. The purpose of this retrospective case-case analysis was to determine how risk factors and disease presentation differ by ethnicity (Hispanic vs. Non-Hispanic) in cases of campylobacteriosis from 2012 to 2015 in Maricopa County, Arizona. METHODS: Basic demographics and seasonality, including standardized morbidity ratios (SMRs), were analyzed to determine differences by ethnicity. To determine differences in risk factors, adjusted univariate and multivariable logistic regression was conducted. RESULTS: There were significant differences by ethnicity by age (1-14 years and >60 years), location of residence (urban vs. suburban), and testing methodology. Most months in the seasonality analysis showed higher than expected values of Hispanic cases based on population distributions (SMR Range: 0.91-1.78, annual mean: 1.23). Differences in disease presentation showed that Hispanics (adjusted for age and location of residence) were more likely to experience vomiting (OR = 1.41) and fever (OR = 1.08), as well as seek care through an urgent care or emergency department (OR = 1.50), than non-Hispanic cases. Hispanics had a higher odds of reporting consumption of tomatoes (OR = 1.45), salsa (OR = 2.35), cilantro (OR = 2.21), queso fresco (OR = 8.53), and sprouts (OR = 1.94) than non-Hispanic cases. Multivariable analyses found queso fresco (aOR = 6.58), cilantro (aOR = 3.93), and animal products (aOR = 0.38) all to be significant by ethnicity. CONCLUSIONS: Hispanics had a higher likelihood of consuming high risk foods, while non-Hispanics were more likely to have environmental exposures linked to Campylobacter infection. Focused questionnaires can reveal differences and contribute to improving public health action/education for specific populations.

Post-infectious sequelae after Campylobacter enteric infection: a pilot study in Maricopa County, Arizona, USA.

BACKGROUND: Campylobacter is a leading cause of gastroenteritis across the globe caused by the ingestion of contaminated food, water, or contact with animals carrying Campylobacter bacteria. The resulting disease, campylobacteriosis, is usually self-limiting, but cases may develop post-infectious sequelae (PIS) such as gastrointestinal disorders, neurological disorders, and joint disorders. The objective of this study was to estimate a crude incidence rate for PIS among Campylobacter cases in Maricopa County, Arizona, USA and to determine the feasibility of conducting a larger scale study to understand chronic outcomes from campylobacteriosis and salmonellosis. METHODS: The pilot study spanned from August 1, 2016, to August 31, 2017. During this time, cases of campylobacteriosis were reported to the Maricopa County Department of Public Health and interviewed by public health students at the University of Arizona. Initial interviews were conducted using a routine enteric surveillance questionnaire, and eligible cases were recruited and consented into the pilot study. Follow-up with a questionnaire occurred 4 to 6 weeks from the date of each case's initial interview. Data analysis was conducted using STATA SE 14 and included chi-squared tests to determine differences in demographics, symptoms, and exposures between those enrolled in the study and those eligible but not enrolled during the study period and feasibility metrics for the study including enrollment rates, response rates, time to interview, and reasons for non-enrollment. Crude rates with 95% confidence intervals were calculated to estimate PIS. RESULTS: Of the routine surveillance cases, 102 (36%) enrolled into the pilot study. Of enrolled participants, 68.6% completed the follow-up questionnaire. Most enrolled participants were non-Hispanic White, male, and aged 60 + years. Over half (52.8%, 95% CI 41.1%, 64.5%) of cases experienced PIS approximately 4 to 6 weeks after acute onset of campylobacteriosis. CONCLUSIONS: Results from this pilot study indicate that a larger study is feasible. The larger study will identify the true incidence of PIS and improve the management of patient health among ethnically diverse populations.

Barriers and Opportunities to Advancing Women in Leadership Roles in Vector Control: Perspectives from a Stakeholder Survey.

Increasing the active participation of professional women in vector control (VC) activities may help promote greater gender equity in the workplace and reduce the burden of vector-borne diseases. This stakeholder survey examined the current roles and perspective of professionals employed in the VC sector in Kenya, Indonesia, India, and other countries. The largest barriers that women face in pursuing leadership roles in the VC sector include lack of awareness of career opportunities, limitations based on cultural norms, and the belief that VC is men's work. These barriers could be addressed through improving education and recruitment campaigns, as well as supporting higher education and mentoring programs. Females were almost six times more likely to be encouraged to pursue leadership positions in their organization compared with male respondents (odds ratio = 5.9, P > 0.03, 95% confidence interval: 1.19, 29.42). These findings suggest that once women are recruited into the VC workforce, they face minimal discrimination and have increased leadership opportunities.

Regulation of Cigarette Smoke (CS)-Induced Autophagy by Nrf2.

Cigarette smoke (CS) has been reported to induce autophagy in airway epithelial cells. The subsequent autophagic cell death has been proposed to play an important pathogenic role in chronic obstructive pulmonary disease (COPD); however, the underlying molecular mechanism is not entirely clear. Using CS extract (CSE) as a surrogate for CS, we found that it markedly increased the expressions of both LC3B-I and LC3B-II as well as autophagosomes in airway epithelial cells. This is in contrast to the common autophagy inducer (i.e., starvation) that increases LC3B-II but reduces LC3B-I. Further studies indicate that CSE regulated LC3B at transcriptional and post-translational levels. In addition, CSE, but not starvation, activated Nrf2-mediated adaptive response. Increase of cellular Nrf2 by either Nrf2 overexpression or the knockdown of Keap1 (an Nrf2 inhibitor) significantly repressed CSE-induced LC3B-I and II as well as autophagosomes. Supplement of NAC (a GSH precursor) or GSH recapitulated the effect of Nrf2, suggesting the increase of cellular GSH level is responsible for Nrf2 effect on LC3B and autophagosome. Interestingly, neither Nrf2 activation nor GSH supplement could restore the repressed activities of mTOR or its downstream effctor-S6K. Thus, the Nrf2-dependent autophagy-suppression was not due to the re-activation of mTOR-the master repressor of autophagy. To search for the downstream effector of Nrf2 on LC3B and autophagosome, we tested Nrf2-dependent genes (i.e., NQO1 and P62) that are also increased by CSE treatment. We found that P62, but not NQO1, could mimic the effect of Nrf2 activation by repressing LC3B expression. Thus, Nrf2->P62 appears to play an important role in the regulation of CSE-induced LC3B and autophagosome.