ABSTRACT
Preventive chemotherapy is one of the pivotal interventions for the control and elimination of schistosomiasis, which is effective to reduce the morbidity and prevalence of schistosomiasis. In order to promote the United Nations' sustainable development goals and the targets set for schistosomiasis control in the Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021-2030, WHO released the guideline on control and elimination of human schistosomiasis in 2022, with major evidence-based updates of the current preventive chemotherapy strategy for schistosomiasis. In China where great success has been achieved in schistosomiasis control, the preventive chemotherapy strategy for schistosomiasis has been updated several times during the past seven decades. This article reviews the evolution of the WHO guidelines on preventive chemotherapy and Chinese national preventive chemotherapy schemes, compares the current Chinese national preventive chemotherapy scheme and the recommendations for preventive chemotherapy proposed in the 2022 WHO guideline on control and elimination of human schistosomiasis, and proposes recommendations for preventive chemotherapy during the future implementation of the 2022 WHO guideline, so as to provide insights into schistosomiasis control among public health professionals engaging in healthcare foreign aid.
Subject(s)
Humans , China/epidemiology , Prevalence , Public Health , Schistosomiasis/prevention & control , World Health OrganizationABSTRACT
Background: To investigate importance of INH preventivechemotherapy among the children age above 5 years whowere contacted with adults having open pulmonarytuberculosis, as well as the effectiveness of INH prophylaxisamong the children age under 5 years regarding Bangladeshicontext.Objectives: This prospective observational study was carriedout to detect the frequency of tuberculosis and also effect ofisoniazid preventive chemotherapy in children contact withadult open pulmonary tuberculosis.Methods: This study was conducted in the department ofPediatrics, Shaheed Suhrawardy Medical College andHospital, Dhaka for duration of three (3) years, from July 2015to July 2018. About 384 population under 12 years childrenwho were close contacted with adult open pulmonarytuberculosis patients, were taken as study sample. Thereprospectively document adherence to six months of INHchemoprophylaxis and outcome in children with householdexposure to an adult open pulmonary tuberculosis index caseon purposive sampling technique. All the children werefollowed up and evaluated after 6 and12 months with monthlymonitoring. Ethical issues were maintained accordingly.Results: In current study subjects, the mean age was6.27±3.08 years and gender distribution were near about equal(Male: 49.5% vs. Female: 50.5%).Among the ≤5 yearschildren, only 52.7% of them received INH prophylaxis andnobody developed TB. But TB was noticeably found in 21.3%of children aged ≤5 years those who didn’t take INHprophylaxis. The majority of tuberculosis patients was foundstayed in urban slum in comparison to LTBI and healthycontact (81.25% vs. 30.77% vs. 39.26%). More than 90% oftuberculosis patients were severe underweight in this study.Conclusion: INH preventive chemotherapy is an importantfactor in children contact of adult tuberculosis. It isrecommended to provide INH chemoprophylaxis in children upto 12 years age. So it should be consider in national policymaking of Bangladesh to reduce tubercular burden inchildhood age.
ABSTRACT
Objective To investigate the effects of preventive chemotherapy for hepatocellular carcinoma (HCC) exceeding Milan criteria after liver transplantation. Methods The clinical data of 243 patients who had undergone orthotopic liver transplantation for HCC exceeding Milan criteria from April 2001 to July 2007 were retrospectively analyzed. Of all patients, 162 received preventive chemotherapy after transplantation. Results The 1- and 3-year survival rates and disease-free survival rates were not statistically different between patients who had received chemotherapy (78.5%, 63.7% ; 76.8%, 52.5% ) and those without chemotherapy (56.6%, 39.1%; 69.3%, 64.7% ) (X2 = 3.084, 0.444, P > 0.05). Cox regression analysis demonstrated that postoperative chemotherapy was not an independent factor affecting the survival rates of HCC patients without vascular invasion, but an independent factor affecting the survival rates of HCC patients with vascular invasion. Conclusions Early preventive chemotherapy could obviously increase the survival rate and delay the tumor recurrence of patients with HCC exceeding Milan criteria, especially for HCC patients with vascular invasion.
ABSTRACT
BACKGROUND: Korean national guidelines for examining contacts with active pulmonary tuberculosis (TB) are a tuberculin skin test (TST) and chest radiographs. The treatment of a latent TB infection as performed only in those younger than six years of age who test positive for TST. Although there is a high incidence of active TB in young Korean soldiers, the current national guidelines for controlling contacts with active TB in soldiers are insufficient. This study highlights the problems with the Korean guidelines for controlling a TB outbreak in a small military unit. MATERIAL AND METHODS: In December of 2005, there was a tuberculosis outbreak in a military unit with a total of 464 soldiers in Kyung Gi province. The chest radiographs were taken of all the soldiers, and TST were carried out on 408 candidates. RESULTS: In the first screening of the chest radiographs, two active TB patients were detected. By August of 2006, four additional cases were detected, making a total of six cases after the outbreak. All the patients showed active pulmonary TB or TB pleuritis. When the results of TST in the close contacts and non-close contacts were compared, there was a significant difference in the absolute size of the induration(9.70 +/-7.50mm vs. 6.26 +/-7.02mm, p 10mm (50.0% vs. 32.0%, p<0.001) and 15mm (33.2% vs. 20.9%, p= 0.005). CONCLUSION: Although the national guidelines for managing a TB outbreak in a military unit were followed, there were continuous instances of new active TB cases. This highlights the need for new guidelines to prevent the spread of TB.