Infant oral mutilation: data collection, clinical management and public health guidelines.

Infant oral mutilation (IOM) is a traditional practice involving extraction of an infant's unerupted primary tooth buds. IOM has implications for oral and overall health due to blood loss, infection or transmission of bloodborne diseases, such as human immunodeficiency virus. IOM also leads to long-term dental complications, such as malformation of the child's permanent dentition. IOM is practised primarily in East Africa but can also be seen among immigrant populations in other countries. Currently, there are no tools for a comparative IOM diagnosis and reporting. The aim of this paper is to describe a data collection tool for healthcare practitioners, which was created based on the existing literature and a clinical consultation with senior clinical and public health physicians working in the field.The tool can be used to record IOM-related data for appropriate diagnosis, management and treatment, as well as for monitoring preventive interventions on a community level. Furthermore, this article also summarises clinical guidelines to support practitioners with the management of acute IOM cases. The article concludes by providing recommendations and examples of community education and engagement programmes that could guide the development of interventions to eradicate IOM globally.

Diet-Induced Obesity Does Not Alter Tigecycline Treatment Efficacy in Murine Lyme Disease.

Obese individuals more frequently suffer from infections, as a result of increased susceptibility to a number of bacterial pathogens. Furthermore, obesity can alter antibiotic treatment efficacy due to changes in drug pharmacokinetics which can result in under-dosing. However, studies on the treatment of bacterial infections in the context of obesity are scarce. To address this research gap, we assessed efficacy of antibiotic treatment in diet-induced obese mice infected with the Lyme disease pathogen, Borrelia burgdorferi. Diet-induced obese C3H/HeN mice and normal-weight controls were infected with B. burgdorferi, and treated during the acute phase of infection with two doses of tigecycline, adjusted to the weights of diet-induced obese and normal-weight mice. Antibiotic treatment efficacy was assessed 1 month after the treatment by cultivating bacteria from tissues, measuring severity of Lyme carditis, and quantifying bacterial DNA clearance in ten tissues. In addition, B. burgdorferi-specific IgG production was monitored throughout the experiment. Tigecycline treatment was ineffective in reducing B. burgdorferi DNA copies in brain. However, diet-induced obesity did not affect antibiotic-dependent bacterial DNA clearance in any tissues, regardless of the tigecycline dose used for treatment. Production of B. burgdorferi-specific IgGs was delayed and attenuated in mock-treated diet-induced obese mice compared to mock-treated normal-weight animals, but did not differ among experimental groups following antibiotic treatment. No carditis or cultivatable B. burgdorferi were detected in any antibiotic-treated group. In conclusion, obesity was associated with attenuated and delayed humoral immune responses to B. burgdorferi, but did not affect efficacy of antibiotic treatment.