COVID-19 fatality and DALYs, and associated metabolic disorders and ambient air pollutants in pre-Omicron era of the pandemic: an international comparative study.

BACKGROUND: Air pollution and a number of metabolic disorders have been reported to increase the risk of severe COVID-19 outcomes. This study explored the association between severe COVID-19 outcomes, metabolic disorders and environmental air pollutants, at regional level, across 38 countries. METHODS: We conducted an ecological study using COVID-19 data related to countries of the Organization for Economic Cooperation and Development (OECD), with an estimated population of 1.4 billion. They were divided into 3 regions: 1. Europe & Middle east; 2. Americas (north, central & south America); 3. East-Asia & West Pacific. The outcome variables were: COVID-19 case-fatality rate (CFR) and disability-adjusted life years (DALYs) at regional level. Freely accessible datasets related to regional DALYs, demographics and other environmental pollutants were obtained from OECD, WHO and the World in Data websites. Generalized linear model (GLM) was performed to determine the regional determinants of COVID-19 CFR and DALYs using the aggregate epidemiologic data (Dec. 2019-Dec. 2021). RESULTS: Overall cumulative deaths were 65,000 per million, for mean CFR and DALYs of 1.31 (1.2)% and 17.35 (2.3) years, respectively. Globally, GLM analysis with adjustment for elderly population rate, showed that COVID-19 CFR was positively associated with atmospheric PM2.5 level (beta = 0.64(0.0), 95%CI: 0.06-1.35; p < 0.05), diabetes prevalence (beta = 0.26(0.1), 95%CI: 0.12-0.41; p < 0.001). For COVID-19 DALYs, positive associations were observed with atmospheric NOx level (beta = 0.06(0.0), 95%CI: 0.02-0.82; p < 0.05) and diabetes prevalence (beta = 0.32(0.2), 95%CI: 0.04-0.69; p < 0.05). At regional level, adjusted GLM analysis showed that COVID-19 CFR was associated with atmospheric PM2.5 level in the Americas and East-Asia & Western Pacific region; it was associated with diabetes prevalence for countries of Europe & Middle east and East-Asia & Western Pacific region. Furthermore, COVID-19 DALYs were positively associated with atmospheric PM2.5 and diabetes prevalence for countries of the Americas only. CONCLUSION: These findings confirm that diabetes and air pollution increase the risk of disability and fatality due to COVID-19, with disparities in terms of their impact. They suggest that efficient preventive and management programs for diabetes and air pollution countermeasures would have curtailed severe COVID-19 outcome rates.

Rapid diagnostic tests versus RT-PCR for Ebola virus infections: a systematic review and meta-analysis.

Objective: To evaluate the clinical accuracy of rapid diagnostic tests for the detection of Ebola virus. Methods: We searched MEDLINE®, Embase® and Web of Science for articles published between 1976 and October 2021 reporting on clinical studies assessing the performance of Ebola virus rapid diagnostic tests compared with reverse transcription polymerase chain reaction (RT-PCR). We assessed study quality using the QUADAS-2 criteria. To estimate the pooled sensitivity and specificity of these rapid diagnostic tests, we used a bivariate random-effects meta-analysis. Findings: Our search identified 113 unique studies, of which nine met the inclusion criteria. The studies were conducted in the Democratic Republic of the Congo, Guinea, Liberia and Sierra Leone and they evaluated 12 rapid diagnostic tests. We included eight studies in the meta-analysis. The pooled sensitivity and specificity of the rapid tests were 86% (95% confidence interval, CI: 80-91) and 95% (95% CI: 91-97), respectively. However, pooled sensitivity decreased to 83% (95% CI: 77-88) after removing outliers. Pooled sensitivity increased to 90% (95% CI: 82-94) when analysis was restricted to studies using the RT-PCR from altona Diagnostics as gold standard. Pooled sensitivity increased to 99% (95% CI: 67-100) when the analysis was restricted to studies using whole or capillary blood specimens. Conclusion: The included rapid diagnostic tests did not detect all the Ebola virus disease cases. While the sensitivity and specificity of these tests are moderate, they are still valuable tools, especially useful for triage and detecting Ebola virus in remote areas.

Country-level and regional COVID-19 burden and determinants across OECD member states and partner countries.

BACKGROUND: COVID-19 pandemic is tremendously impacted by socioeconomic and health determinants worldwide. This study aimed to determine factors associated with COVID-19 fatality among member states and partner countries of the Organization for Economic Cooperation and Development (OECD). METHODS: An ecological study was conducted using COVID-19 data of 48 countries for the period between 31 December 2019-31 December 2021. The outcome variables were COVID-19 case fatality rate (CFR) and years of life lost to COVID-19 (YLLs). Countries' sociodemographics and COVID-19-related data were extracted from OECD website, Our World in Data, John Hopkins Coronavirus Resource Center, Economist Intelligence Unit (EIU) and WHO. RESULTS: In the first year of the pandemic (December 2019-January 2021), highest CFR was observed in Mexico, 8.51%, followed by China, 5.17% and Bulgaria, 4.12%), and highest YLLs was observed in Mexico, 2,055 per 100,000. At regional level, highest CFR was observed in North & central America, 4.25 (3.71) %, followed by South America (2.5 (0.1) %); whereas highest YLLs was observed in South America region 1457.5 (274.8) per 100,000, followed by North & central America, 1207.3 (908.1) per 100,000. As of 31 December 2021, Mexico (7.52%) and Bulgaria (4.78%) had highest CFR; on the other hand, highest YLLs was observed in England, 26.5 per 1,000, followed by the United States, 25.9 per 1,000. At regional level, highest CFR (3.37(3.19) %) and YLLs (16.7 (13) per 1,000) were both observed in North & central America. Globally, the analysis of the 2-year cumulative data showed inverse correlation between CFR and nurse per 10,000 (R = -0.48; p < 0.05) and GDP per capita (R = -0.54; p < 0.001), whereas positive correlation was observed between YLLs and elderly population rate (R = 0.66; p < 0.05) and overweight/obese population rates (R = 0.55; p < 0.05). CONCLUSION: This study provides insights on COVID-19 burden among OECD states and partner countries. GDP per capita, overweight/obesity and the rate of elderly population emerged as major social and health determinants of COVID-19 related burden and fatality. Findings suggest that a robust economy and interventions designed to promote healthy longevity and prevent weight gain in at-risk individuals might reduce COVID-19 burden and fatality among OECD states and partner countries.

Malaria rapid diagnostic test (HRP2/pLDH) positivity, incidence, care accessibility and impact of community WASH Action programme in DR Congo: mixed method study involving 625 households.

BACKGROUND: Malaria is one of the most prevalent and deadliest illnesses in sub-Saharan Africa. Despite recent gains made towards its control, many African countries still have endemic malaria transmission. This study aimed to assess malaria burden at household level in Kongo central province, Democratic Republic of Congo (DRC), and the impact of community participatory Water, Sanitation and Hygiene (WASH) Action programme. METHODS: Mixed method research was conducted in two semi-rural towns, Mbanza-Ngungu (a WASH action site) and Kasangulu (a WASH control site) in DRC between 1 January 2017 through March 2018, involving 625 households (3,712 household members). Baseline and post-intervention malaria surveys were conducted with the use of World Bank/WHO Malaria Indicator Questionnaire. An action research consisting of a six-month study was carried out which comprised two interventions: a community participatory WASH action programme aiming at eliminating mosquito breeding areas in the residential environment and a community anti-malaria education campaign. The latter was implemented at both study sites. In addition, baseline and post-intervention malaria rapid diagnostic test (RDT) was performed among the respondents. Furthermore, a six-month hospital-based epidemiological study was conducted at selected referral hospitals at each site from 1 January through June 2017 to determine malaria trend. RESULTS: Long-lasting insecticide-treated net (LLIN) was the most commonly used preventive measure (55%); 24% of households did not use any measures. Baseline malaria survey showed that 96% of respondents (heads of households) reported at least one episode occurring in the previous six months; of them only 66.5% received malaria care at a health setting. In the Action Research, mean incident household malaria cases decreased significantly at WASH action site (2.3 ± 2.2 cases vs. 1.2 ± 0.7 cases, respectively; p < 0.05), whereas it remained unchanged at the Control site. Similar findings were observed with RDT results. Data collected from referral hospitals showed high malaria incidence rate, 67.4%. Low household income (ORa = 2.37; 95%CI: 1.05-3.12; p < 0.05), proximity to high risk area for malaria (ORa = 5.13; 95%CI: 2-29-8.07; p < 0.001), poor WASH (ORa = 4.10; 95%CI: 2.11-7.08; p < 0.001) were predictors of household malaria. CONCLUSION: This research showed high prevalence of positive malaria RDT among the responders and high household malaria incidence, which were reduced by a 6-month WASH intervention. DRC government should scale up malaria control strategy by integrating efficient indoor and outdoor preventive measures and improve malaria care accessibility.

Environmental and sociodemographic factors associated with household malaria burden in the Congo.

BACKGROUND: Malaria is one of the most severe public health issues that result in massive morbidity and mortality in most countries of the sub-Saharan Africa (SSA). This study aimed to determine the scope of household, accessibility to malaria care and factors associated with household malaria in the Democratic Republic of Congo (DRC). METHODS: This was a community-based cross-sectional study conducted in an urban and a rural sites in which 152 households participated, including 82 urban and 70 rural households (1029 members in total). The 'malaria indicator questionnaire' (MIQ) was anonymously answered by household heads (respondents), reporting on malaria status of household members in the last 12 months. RESULTS: There were 67.8% of households using insecticide-treated bed nets (ITN) only, 14.0% used indoor residual spraying (IRS) only, 7.3% used ordinary bed nets (without insecticide treatment), 1.4% used mosquito repelling cream, 2.2% combined ITN and IRS, whereas 7.3% of households did not employ any preventive measure; p < 0.01). In addition, 96.7% of households were affected by malaria (at least one malaria case), and malaria frequency per household was relatively high (mean: 4.5 ± 3.1 cases reported) in the last 12 months. The mean individual malaria care expenditure was relatively high (101.6 ± 10.6 USD) in the previous 12 months; however, the majority of households (74.5%) earned less than 50 USD monthly. In addition, of the responders who suffered from malaria, 24.1% did not have access to malaria care at a health setting. Furthermore, a multivariate analysis with adjustment for age, education level and occupation showed that household size (OR = 1.43 ± 0.13; 95% CI 1.18-1.73; p < 0.001), inappropriate water source (OR = 2.41 ± 0.18; 95% CI 1.17-2.96; p < 0.05) absence of periodic water, sanitation and hygiene (WASH) intervention in residential area (OR = 1.63 ± 1.15; 95% CI 1.10-2.54; p < 0.05), and rural residence (OR = 4.52 ± 2.47; 95% CI 1.54-13.21; p < 0.01) were associated with household malaria. CONCLUSION: This study showed that household size, income, WASH status and rural site were malaria-associated factors. Scaling up malaria prevention through improving WASH status in the residential environment may contribute to reducing the disease burden.

Respiratory health of dust-exposed Congolese coltan miners.

PURPOSE: In Democratic Republic of the Congo (DRC), informal coltan mining has been expanding amidst increased insecurity due to armed conflicts. We investigated the impact of occupational dust-exposure on the respiratory health of Congolese coltan miners. METHODS: In total, 441 Congolese workers participated in this study, including 199 informal coltan miners and 242 office workers (controls). Information on respiratory complaints was collected using two standardized questionnaires. Physical examination (vital signs, auscultation) and lung function test (Peak Flow meter) were performed. In addition, workplace airborne PM2.5 and volatile organic compounds (VOC) concentrations were measured. RESULTS: Higher airborne PM2.5 (range 180-210 µg/m3) and VOC (range 1.4-2.3 µg/m3) levels were detected at coltan mining work stations as compared with control sites (19-44 and 0.5-0.8 µg/m3, respectively). All respiratory complaints and disorders were more prevalent in informal coltan miners than in controls. Additionally, a markedly lower mean PEFR was observed in coltan miners than in controls (347.93 ± 6.88 vs. 493.23 ± 67.38 L/min, respectively). Moreover, positive associations between informal coltan mining and almost all respiratory complaints were observed, except wheezing at effort and night cough. On the other hand, an inverse association was observed between lung function (PEFR) and PM2.5 exposure, between PEFR and VOC exposure, and also between PEFR and current smoking. CONCLUSIONS: This study showed high prevalence of respiratory complaints in Congolese informal coltan miners, suggesting the necessity to implement efficient occupational safety measures and regulate this informal mining business.

Rubella Seroprevalence and real-time PCR detection of RUBV among Congolese pregnant women.

BACKGROUND: Rubella is an acute infectious disease caused by Rubella virus (RUBV). RUBV remains an important pathogen worldwide, causing approximately 100 000 cases of congenital rubella syndrome (CRS) every year; and the most severe consequence of rubella is teratogenicity. The aim of this study was to estimate the prevalence of RUBV IgG antibodies and determine RUBV genotypes in Congolese pregnant women in Kongo central province, Democratic Republic of Congo (DRC). METHODS: This was a prospective cross-sectional study that consisted of a laboratory analysis of blood samples from 78 pregnant women to check for the presence of RUBV IgG antibodies, and also determine RUBV genotypes in seropositive samples (using primers targeting RUBV nucleoprotein), with the use of serological and molecular methods, respectively. Participants were pregnant women attending antenatal care clinics (ANC) at two health zones of Kisantu town in DRC. They were followed-up from the first to third trimester. Those who were negative for RUBV antibodies at the initial assay (first trimester) were tested in the second and, eventually, the third trimester. RESULTS: An overall rubella seroprevalence of 58.97% was observed, whereas RUBV nucleoprotein was detected in 60% of randomly selected 30 blood samples among the 46 RUBV seropositive pregnant women. Five (27.77%) of positive samples were positive for both RUBV genotypes (RV8633/9112 and RV8945/9577), whereas 11 (61.11%) of them were positive for RV8633/9112 and two (11.11%) were positive for RV8945/9577 only. Regarding rubella clinical signs and complications, two subjects (2.56%) presented with fever, whereas five pregnant women (6.41%) had experienced abortion. None (0%) of the participants has been vaccinated against RUBV. CONCLUSIONS: Findings from this study suggest that RUBV is prevalent in Congolese pregnant women. Further research is required to elucidate the molecular epidemiology of RUBV in order to design a rational rubella surveillance and control program in DRC.

Epidemiology of ebolavirus disease (EVD) and occupational EVD in health care workers in Sub-Saharan Africa: Need for strengthened public health preparedness.

Ebolavirus disease (EVD) is a severe contagious disease in humans, and health care workers (HCW) are at risk of infection when caring for EVD patients. This paper highlights the epidemiologic profile of EVD and its impact on the health care workforce in Africa. A documentary study was conducted which consisted of a review of available literature regarding the epidemiology of EVD, occupational EVD (OEVD), and work safety issues in Sub-Saharan Africa; the literature findings are enriched by field experiences from the authors. EVD outbreaks have already caused 30,500 cases in humans of whom 12,933 died (as of September 9, 2015), and the number of infected HCW has dramatically increased. All eight HCW infected during the 2014 outbreak in Democratic Republic of the Congo died, whereas during the recent West African EVD epidemic more than 890 HCW were infected, with a case fatality rate of 57%. Occupational exposure to blood and other body fluids due to inadequate use of personal protective equipment and needle stick or sharp injuries are among factors that contribute to the occurrence of OEVD. Prevention of OEVD should be one of the top priorities in EVD outbreak preparedness and management, and research should be conducted to elucidate occupational and other factors that expose HCW to EVD. In addition to regularly training HCW to be adequately prepared to care for patients with EVD, it is critical to strengthen the general health care system and improve occupational safety in medical settings of countries at risk.

Uncovering Adiponectin Replenishing Property of Sujiaonori Algal Biomaterial in Humans.

The replenishment of adiponectin-an adipocyte-derived hormone with salutary health effects-has recently been proposed as a new approach to treat hypertension, also ameliorate cardiovascular and metabolic risks. We conducted a prospective placebo-controlled, non-randomized and investigator-blinded dietary intervention study to evaluate the health effects of dietary intake of Sujiaonori (Ulva/Enteromorpha prolifera Müller) algal biomaterial (SBM), especially on adiponectin production, blood pressure (BP), and body mass index (BMI) in human subjects. Participants (N = 32) were divided into two equally sized groups (n = 16 for each group): SBM group (subjects supplemented with 3 g SBM powder twice a day during meal) and the control group (subjects who took 3 g of a supplement made of 70% corn starch powder and 30% spinach twice a day) for four weeks. Two health survey questionnaires (dietary and current health questionnaires) were completed anonymously, saliva sampling was done for adiponectin measurement by ELISA, and blood pressure (BP) and anthropometric parameters were measured at baseline and four weeks later. Student paired t-test was performed to compare baseline and post-intervention data on outcome variables between the two study groups. Results showed a 2.24-fold increase in adiponectin level in SBM group (2.81 and 6.26 ng/mL at baseline and at the end of study, respectively) (p < 0.01); whereas no significant change was observed in controls (3.58 and 3.51 ng/mL, respectively) (p > 0.05). In SBM subjects, an improvement of BP profile was noted with a significant decrease in systolic BP (p < 0.01). A positive correlation was found between SBM supplementation and adiponectin level, whereas an inverse correlation was noted between SBM supplementation and blood pressure, and also BMI. These findings suggest that SBM-increased adiponectin level and improved BP in a sample of Japanese young adults, and has the potential to improve blood pressure in humans.

Frequency, causes and human impact of motor vehicle-related road traffic accident (RTA) in Lubumbashi, Democratic Republic of Congo.

OBJECTIVES: Road traffic accident (RTA)-related trauma remains a public health issue. The aim of this study was to determine the frequency, causes and human impact of motor vehicle-related RTA in Lubumbashi, Democratic Republic of Congo. METHODS: A prospective cross-sectional study was conducted in the first semester of the year 2015 in which 288 drivers (144 RTA-causing drivers and 144 control drivers who have been declared not guilty by road safety agents) involved in 144 motor vehicle-related RTA were interviewed, and only data on all RTA involving two motor vehicles with at least four wheels were recorded and analyzed. RESULTS: Results showed a total of 144 RTA that involved two motor vehicles with four wheels occurring during the study period which affected 104 people, including 93 injury and 11 fatality cases. The mean age of RTA-causing drivers was 33.8 ± 7.4, whereas it was 35 ± 8.8 for control drivers. The majority of RTA-causing drivers (53.4 %) did not attend a driving school. Over speeding (32 %), distracted driving (22 %), overtaking (16 %) and careless driving/risky maneuver (15 %) and driving under the influence of alcohol (9 %) were the main causes of RTA occurrence. In addition, the absence of a valid driving license [aOR = 12.74 (±2.71); 95 % CI 3.877-41.916; p = 0.015], unfastened seat belt for the RTA-causing driver [aOR = 1.85 (±0.62); 95 % CI 1.306-6.661; p = 0.048] and presence of damages on RTA-causing vehicle [aOR = 33.56 (24.01); 95 % CI 1.429-78.352; p = 0.029] were associated with the occurrence of RTA-related fatality. CONCLUSION: This study showed a relatively high frequency of RTA occurring in Lubumbashi and suggests the necessity to reinforce road traffic regulation.

A cross-sectional assessment of oxidative DNA damage and muscle strength among elderly people living in the community.

OBJECTIVES: The mechanism by which muscle weakness leads to an increased risk of death remains a subject of interest. In this context, the aim of this study is to assess the relationship between urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) and muscle strength, and other risk factors contributing to poor muscle strength in older persons. METHODS: This was a cross-sectional study in which a total of 86 participants, both men and women, aged 65 years or above were screened for urinary 8-OHdG, and muscle strength as measured by handgrip strength. RESULTS: Handgrip strength was lower in participants who had history of acute or chronic disease. Urinary 8-OHdG level was negatively associated with muscle strength, and the association remained after adjusting for confounding factors. CONCLUSIONS: Urinary 8-OHdG is associated with muscle strength. These findings may be clinically relevant as there is a possibility of controlling oxidative DNA damage by healthy behaviors related to lifestyle.

The basic reproduction number (R0) of ebola virus disease: A systematic review and meta-analysis.

BACKGROUND: Ebola virus disease (Ebola) is highly pathogenic, transmissible, and often deadly, with debilitating consequences. Superspreading within a cluster is also possible. In this study, we aim to document Ebola basic reproduction number (R0): the average number of new cases associated with an Ebola case in a completely susceptible population. METHODS: We undertook a systematic review and meta-analysis. We searched PubMed, EMBASE, and Web of Science for studies published between 1976 and February 27, 2023. We also manually searched the reference lists of the reviewed studies to identify additional studies. We included studies that reported R0 during Ebola outbreaks in Africa. We excluded studies that reported only the effective reproduction number (Rt). Abstracting data from included studies was performed using a pilot-tested standard form. Two investigators reviewed the studies, extracted the data, and assessed quality. The pooled R0 was determined by a random-effects meta-analysis. R0 was stratified by country. We also estimated the theoretically required immunization coverage to reach herd-immunity using the formula of (1-1/R0) × 100 %. RESULTS: The search yielded 2042 studies. We included 53 studies from six African countries in the systematic review providing 97 Ebola mean R0 estimates. 27 (with 46 data points) studies were included in the meta-analysis. The overall pooled mean Ebola R0 was 1.95 (95 % CI 1.74-2.15), with high heterogeneity (I2 = 99.99 %; τ2 = 0.38; and p < 0.001) and evidence of small-study effects (Egger's statistics: Z = 4.67; p < 0.001). Mean Ebola R0 values ranged from 1.2 to 10.0 in Nigeria, 1.1 to 7 in Guinea, 1.14 to 8.33 in Sierra Leone, 1.13 to 5 in Liberia, 1.2 to 5.2 in DR Congo, 1.34 to 2.7 in Uganda, and from 1.40 to 2.55 for all West African countries combined. Pooled mean Ebola R0 was 9.38 (95 % CI 4.16-14.59) in Nigeria, 3.31 (95 % CI 2.30-4.32) in DR Congo, 2.0 (95 % CI 1.25-2.76) in Uganda, 1.83 (95 % CI 1.61-2.05) in Liberia, 1.73 (95 % CI 1.47-2.0) in Sierra Leonne, and 1.44 (95 % CI 1.29-1.60) in Guinea. In theory, 50 % of the population needs to be vaccinated to achieve herd immunity, assuming that Ebola vaccine would be 100 % effective. CONCLUSIONS: Ebola R0 varies widely across countries. Ebola has a much wider R0 range than is often claimed (1.3-2.0). It is possible for an Ebola index case to infect more than two susceptible individuals.

Anti-inflammatory effects of sacran, a novel polysaccharide from Aphanothece sacrum, on 2,4,6-trinitrochlorobenzene-induced allergic dermatitis in vivo.

BACKGROUND: Sacran is a newly discovered sulfated polysaccharide extracted from an algae, Aphanothece sacrum, grown in a river of the Kyushu region in Japan. OBJECTIVE: To evaluate sacran's inhibitory effect in 2,4,6-trinitrochlorobenzene (TNCB)-induced allergic dermatitis in NC/Nga mice. METHODS: Sacran was extracted by acid and alkaline treatment of A sacrum cyanobacterial biomaterials. To sensitize mice, 150 µL of 5% TNCB was applied epicutaneously on the abdomen of each mouse on day 1 and challenged with 15 µL of 1% TNCB applied on the ear skin of mice on day 8 and then every other day to induce skin lesions. Serum levels of inflammatory markers were measured and histopathologic examination of ear skin specimens performed. On the other hand, sacran's transepidermal water loss was evaluated in 11 volunteer women with dry skin. RESULTS: Epicutaneous application of sacran in mice has significantly inhibited the development of allergic dermatitis skin lesions and reduced the number of scratching behavior episodes (P < .01). In addition, sacran efficiently inhibited IgE (P < .001), tumor necrosis factor α (P = .02), interleukin 4, interleukin 5, and interferon γ (P < .01; vs buffer in the TNCB group) production and eosinophilic infiltration in the chemical allergen-exposed ear skin. In addition, sacran-treated body regions of human volunteers with dry skin significantly reduced transepidermal water loss levels compared with exogenous hyaluronic acid (P < .01), which is known to improve skin moisture and exert skin barrier repair activity. CONCLUSIONS: This study suggests that sacran exerts anti-inflammatory effects by improving skin barrier function and reducing T(H)2 cytokine production.

Limonene inhalation reduces allergic airway inflammation in Dermatophagoides farinae-treated mice.

Limonene is one of the main flavonoids which is reported to inhibit the inflammatory response by suppressing the production of reactive oxygen species. The aim of this study was to evaluate whether limonene can inhibit Dermatophagoides farinae-induced airway hyperresponsiveness (AHR), eosinophilic infiltration and other histological changes in the lung, T helper (Th) 2 cytokine production and airway remodeling in a mice model of asthma. Treatment with limonene significantly reduced the levels of IL-5, IL-13, eotaxin, MCP-1, and TGF-ß1 in bronchoalveolar lavage fluid. The goblet cell metaplasia, thickness of airway smooth muscle, and airway fibrosis were markedly decreased in limonene-treated mice. Furthermore, AHR to acetylcholine was significantly abrogated in limonene-treated mice. These results indicate that limonene has a potential to reduce airway remodeling and AHR in asthma model.

Anti-allergic effects of Vernonia amygdalina leaf extracts in hapten-induced atopic dermatitis-like disease in mice.

BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by pruritic and eczematous skin lesions. In this study, AD-like disease was induced in NC/Nga mice so as to evaluate the anti-allergic effects of Vernonia amygdalina leaf extracts (VAM). METHODS: Forty NC/Nga mice were purchased for each of the two protocols (prophylactic and curative) of the study. Mice were randomly divided in groups of five or six after sensitization with 5% trinitrochlorobenzene (TNCB): aqueous extracts (VAM1), methanolic extracts (VAM2), hydrocortisone (HCT), buffer for the control (TNCB) and the normal mice (NORM) groups. RESULTS: As for HCT, VAM1 and VAM2-pretreated mice showed significantly lower number of scratching behavior episodes (p < 0.01; vs. TNCB) following TNCB challenge. In addition, VAM1, VAM2 exerted a significant inhibitory effect on the development of AD skin symptoms (vs. TNCB group; p < 0.001), the production of IgE, TNF-alpha (p < 0.05), IL-5 and IFN-gamma (p < 0.01) (vs. TNCB group) and on the increase in ear thickness (p < 0.05) in prophylactic protocol. In the AD curative protocol, topical VAM1, VAM2 markedly improved skin lesions such as erythema/hemorrhage (p < 0.05), scaling/dryness, erosion/excoriation (p < 0.01) (vs. TNCB mice). Furthermore, a significant decrease in ear thickness was noted in VAM1, VAM2, HCT groups (vs. TNCB group; p < 0.05) as well as the serum total IgE, MCP-1 (p < 0.01) and eotaxin (p < 0.05). VAM2 also improved chronic eczema dermatitis skin symptoms in a patient. CONCLUSIONS: Results from this report suggest that VAM extracts, known as ERK pathway inhibitor, prevent and improve atopic/eczema dermatitis syndrome.

Perception of the risk of sexual transmission of HIV among Congolese and Japanese university students.

OBJECTIVE: Sub-Saharan Africa remains the region most heavily affected by HIV infection. This study aimed to evaluate the knowledge, attitudes, and practices of Congolese students of risk behaviors for sexual transmission of HIV in comparison with their Japanese counterparts. METHODS: Of the 1,747 undergraduate students who participated in the survey, there were 1,326 respondents (752 Japanese, 574 Congolese) who voluntarily and fully filled out the auto-administered questionnaire. RESULTS: The proportion of Congolese respondents who do not always use condoms with an occasional sex partner was significantly higher, 57%, as compared with their Japanese counterparts (15%; p < 0.001). Fewer than 40% (9.9-39.7%) of Congolese respondents had accurate knowledge about multiple sex partnership (MSP), men sex with men (MSM), precocious sex, and commercial sex work (CSW) being high-risk behaviors (p < 0.001) for the sexual transmission of HIV infection. However, the proportion of Congolese tested or willing to get tested for HIV was significantly higher (97.2%) than that in the Japanese group (72.4%, p < 0.001). In Congolese students, we observed an absence of adherence to preventive measures such as condom use with an occasional sex partner, and a greater proportion of students having inaccurate knowledge of major risk behaviors such as MSM, precocious sex, and MSP, compared with their Japanese counterparts. CONCLUSIONS: This study showed that, though sexual contact remains the main mode of HIV transmission in the region, Congolese students tend to have inaccurate knowledge of risk behaviors that expose people to the sexual transmission of HIV. This suggests that continuous education targeting those risk behaviors is of great importance to reduce the spread of the HIV epidemic.

Modulatory Effects of NBF1, an Algal Fiber-Rich Bioformula, on Adiponectin and C-Reactive Protein Levels, and Its Therapeutic Prospects for Metabolic Syndrome and Type-2 Diabetes Patients.

An unhealthy diet can lead to the development of metabolic disorders. C-reactive protein (CRP) has been reported to be an inflammatory component of metabolic disorders. Additionally, reduced adiponectin (APN) levels is known as a predictor of metabolic disorders. We report on the beneficial effects of NBF1, an algal fiber-rich formula, on CRP, APN, and diabetes markers. Additionally, associations between dietary nutrients, CRP, and APN were investigated. A dietary survey that used a brief self-administered diet history questionnaire, a validated 58-item fixed-portion-type questionnaire, and a 4-week placebo-controlled dietary intervention were carried out. The latter consisted of a twice daily intake of 3 g of sujiaonori alga-based powder as a supplement (NBF1, n = 16), whereas the placebo group received the same amount of corn starch powder (n = 15). CRP and APN levels were assayed by ELISA. Clinical cases comprising three subjects with metabolic disorders treated with NBF1, including two type 2 diabetes mellitus patients and one subject with hypercholesterolemia, are also reported. They received 2.1g NBF1 once daily for 12 weeks. Intakes of algal fiber and n-3 PUFA were positively associated with the increase of APN, and n-3PUFA intake was inversely associated with CRP. All cases had improved metabolic health profile.

Trends in per Capita Food and Protein Availability at the National Level of the Southeast Asian Countries: An Analysis of the FAO's Food Balance Sheet Data from 1961 to 2018.

We aimed to analyze the temporal trends in the per capita food (kcal/day/person) and protein (g/day/person) availability at the national level in the Southeast Asian (SEA) countries from 1961 to 2018. To avoid intercountry variations and errors, we used a dataset derived from the FAO's old and new food balance sheets. We used the joinpoint model and the jump model to analyze the temporal trends. The annual percentage change (APC) was computed for each segment of the trends. Per capita food and protein availability in the SEA countries increased significantly by 0.8% per year (54.0%) and 1.1% per year (85.1%), respectively, from 1961 to 2018. During the 1960s, 1970s, and 1980s the per capita food availability in mainland SEA did not change significantly and was less than 2200 kcal/person/day. Since the early 1990s, food availability increased appreciably in the mainland SEA countries, except for Cambodia, which has experienced the increasing trend from the late 1990s. Distinct from the mainland, maritime SEA countries showed an up-down-up growth trend in their per-capita food availability from 1961 to 2018. Food-availability growth slowed down for Brunei (since the mid-1980s) and Malaysia (since mid-the 1990s) whereas it increased for Indonesia (1.5% per year), Timor-Leste (0.9% per year), and the Philippines (0.8% per year). Per capita protein availability trends in the mainland SEA countries were similar to the countries' per capita food availability trends. Since the late 1980s, Thailand and since the late 1990s, other mainland SEA countries experienced a significant growth in their per capita protein availability. Since the late 1990s, per capita protein availability in Vietnam increased markedly and reached the highest available amount in the SEA region, following Brunei and Myanmar. Per capita protein availability increased almost continuously among the maritime SEA countries, except for Timor-Leste. Marked inequality did exist between maritime and mainland SEA countries in per capita food-availability growth till the mid-1990s. Considerable increases in per capita food availability have occurred in most of the SEA countries, but growth is inadequate for Timor-Leste and Cambodia.

Misconceptions and Rumors about Ebola Virus Disease in Sub-Saharan Africa: A Systematic Review.

We sought to summarize knowledge, misconceptions, beliefs, and practices about Ebola that might impede the control of Ebola outbreaks in Africa. We searched Medline, EMBASE, CINAHL, and Google Scholar (through May 2019) for publications reporting on knowledge, attitudes, and practices (KAP) related to Ebola in Africa. In total, 14 of 433 articles were included. Knowledge was evaluated in all 14 articles, and they all highlighted that there are misconceptions and risk behaviors during an Ebola outbreak. Some communities believed that Ebola spreads through the air, mosquito bites, malice from foreign doctors, witchcraft, and houseflies. Because patients believe that Ebola was caused by witchcraft, they sought help from traditional healers. Some people believed that Ebola could be prevented by bathing with salt or hot water. Burial practices where people touch Ebola-infected corpses were common, especially among Muslims. Discriminatory attitudes towards Ebola survivors or their families were also prevalent. Some Ebola survivors were not accepted back in their communities; the possibility of being ostracized from their neighborhoods was high and Ebola survivors had to lead a difficult social life. Most communities affected by Ebola need more comprehensive knowledge on Ebola. Efforts are needed to address misconceptions and risk behaviors surrounding Ebola for future outbreak preparedness in Africa.