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Contexte & objectif : Les adultes fortement exposés par leurs activités professionnelles dans l'eau douce dans les régions d'endémicité de la schistosomiase, entretiennent la transmission de la maladie. Il est donc nécessaire d'investiguer sur leurs fréquences afin de lutter contre la pérennité de la schistosomiase. Méthodes : Il s'agissait d'une étude transversale, réalisée entre septembre et octobre 2019, chez creuseurs le long de la rivière N'djili. Les Schistoma étaient systématiquement recherchés à la fois dans les échantillons de selles et des urines. Résultats : Au total 224 creuseurs de sables ont été examinés. La fréquence de la Schistosomiase était de 28,6 % (IC : 22,8-35). Les S. mansoni (22,8 %), S. intercalatum (3,1 %) et S. haematobium (2,7 %) ont été détectés. Le revenu financier supérieur ou égal au SMIG (ORa= 1,8 ; IC 95% : 1,0 3,4), était associé à la schistosomiase. Conclusion : Les creuseurs s'exposent et entretiennent la schistosomiase. Parmi les espèces qui les affectent, nous comptons également le S. intercalatum à Kinshasa. Il faut donc une étude complémentaire de comparaison avec les autres catégories professionnelles
Context and objective. Adults who are highly exposed to schistosomiasis through their professional activities in freshwater in regions where the disease is endemic, maintain the transmission of the disease. It is therefore necessary to investigate their frequency in order to combat the perpetuation of schistosomiasis. Methods. This was a cross-sectional study, carried out from September to October 2019, among diggers along the N'djili River. Schistosoma were systematically tested both in the stools and urine. Results. A total of 224 sand diggers were included. The prevalence of Schistosomiasis was 28.6 % (95 % CI: 22.8-35). S. mansoni (22.8 %), S. intercalatum (3.1 %) and S. haematobium (2.7 %) were detected. Financial income greater than or equal to SMIG (ORa= 1.8; 95 % CI: 1.0 - 3.4), was associated with schistosomiasis. Conclusion: Diggers are exposed to and maintain schistosomiasis. S. intercalatum is found among the species that affect the diggers in Kinshasa. Therefore, there is need to carry out a further comparative study with other occupational categories.
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Humans , Male , Female , RiversABSTRACT
Objective To understand the current status of capacity building in schistosomiasis control institutes in schistosomiasis-endemic provinces (municipality, autonomous region) of China. Methods The responsibilities and construction requirements of various schistosomiasis control institutions were surveyed by expert discussions, and field interviews and visits during the period between May and June, 2023, and the questionnaire for capacity maintenance and consolidation in schistosomiasis control institutions was designed. An online questionnaire survey was conducted in county-, municipal-, and provincial-level institutions that undertook schistosomiasis control and surveillance activities through the Wenjuanxing program. The distribution of schistosomiasis control institutions, the status of institutions, departments and staff undertaking schistosomiasis control activities and the translation of scientific researches on schistosomiasis control in China were analyzed. The laboratories accredited by China National Accreditation Service for Conformity Assessment (CNAS) were considered to be capable for testing associated with schistosomiasis control, and the testing capability of schistosomiasis control institutions was analyzed. Results A total of 486 valid questionnaires were recovered from 486 schistosomiasis control institutions in 12 endemic provinces (municipality, autonomous region) of China, including 12 provincial-level institutions (2.5%), 77 municipal-level institutions (15.8%) and 397 county-level institutions (81.7%). Of all schistosomiasis control institutions, 376 (77.4%) were centers for disease control and prevention or public health centers, 102 (21.0%) were institutions for schistosomiasis, endemic disease and parasitic disease control, and 8 (1.6%) were hospitals, healthcare centers or others. There were 37 713 active employees in the 486 schistosomiasis control institutions, including 5 675 employees related to schistosomiasis control, and the proportions of employees associated with schistosomiasis control among all active employees were 5.9% (231/3 897), 5.5% (566/10 134), and 20.6% (4 878/23 682) in provincial-, municipal-, and county-level institutions, respectively. There were 3 826 full-time employees working in schistosomiasis control activities, with 30.5% (1 166/3 826), 34.6% (1 324) and 34.9% (1 336/3 826) at ages of 40 years and below, 41 to 50 years and over 50 years, and there were 1 571 (41.0%) full-time schistosomiasis control employees with duration of schistosomiasis control activities for over 25 years, and 1 358 (35.5%) employees with junior professional titles and 1 290 with intermediate professional titles (35.5%), while 712 (18.6%) full-time employees working in schistosomiasis control activities had no professional titles. The three core schistosomiasis control activities included snail control (26.3%, 374/1 420), epidemics surveillance and management (25.4%, 361/1 420) and health education (18.8%, 267/1 420) in schistosomiasis control institutions. The Kato-Katz method, miracidium hatching test with nylon gauzes, and indirect haemagglutination assay (IHA) were the most commonly used techniques for detection of schistosomiasis, and there were less than 50% laboratories that had capabilities or experimental conditions for performing enzyme-linked immunosorbent assay (ELISA), dipstick dye immunoassay (DDIA), dot immunogold filtration assay (DIG-FA), loop-mediated isothermal amplification (LAMP) and polymerase chain reaction (PCR) assays. During the period from 2018 to 2022, schistosomiasis control institutions had undertaken a total of 211 research projects for schistosomiasis control, with a total funding of 18.596 million RMB, published 619 articles, participated in formulation of 13 schistosomiasis control-related criteria, and applied for 113 schistosomiasis control-related patents, including 101 that were granted, and commercialized 4 scientific research outcomes. Conclusions The proportion of independent specialized schistosomiasis control institutions is low in schistosomiasis control institutions in China, which suffers from problems of unsatisfactory laboratory testing capabilities, aging of staff and a high proportion of low-level professional titles. More investment into and intensified schistosomiasis control activities and improved capability building and talent cultivation in schistosomiasis control institutions are recommended to provide a powerful support for high-quality elimination of schistosomiasis in China.
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On June 16, 2023, National Disease Control and Prevention Administration of the People’s Republic of China, in collaboration with other ministries, formulated and issued the Action Plan to Accelerate the Elimination of Schistosomiasis in China (2023—2030). The implementation of this plan provides an important basis for achieving the targets set in the “Healthy China 2030” action plan and the implementation of the rural revitalization strategy. This paper describes the background, principles, targets, control strategies, safeguard measures and effectiveness evaluation of the plan, in order to guide the scientific and standardized implementation of actions for schistosomiasis elimination at the grassroots level, and facilitate the progress towards elimination of schistosomiasis in China with a high quality.
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The goal of achieving elimination of schistosomiasis across all endemic counties in China by 2030 was proposed in the Outline of the Healthy China 2030 Plan. On June 16, 2023, the Action Plan to Accelerate the Elimination of Schistosomiasis in China (2023—2030) was jointly issued by National Disease Control and Prevention Administration and other 10 ministries, which deployed the targets and key tasks of the national schistosomiasis elimination programme in China. This article describes the progress of the national schistosomiasis control programme, analyzes the opportunities to eliminate schistosomiasis, and proposes targeted recommendations to tackle the challenges of schistosomiasis elimination, so as to accelerate the process towards schistosomiasis elimination and facilitate the building of a healthy China.
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Introducción: la esquistosomiasis es la infección por trematodos más importante a nivel global. El carcinoma de células escamosas constituye el 2 % de todos los tipos histológicos de cáncer vesical; sin embargo, la incidencia de esta variedad en países endémicos de esquistosomiasis es mayor. Objetivo: evaluar la relación entre la esquistosomiasis y el cáncer de vejiga en pacientes del Hospital Central de Nampula. Materiales y métodos: se realizó un estudio observacional, descriptivo y transversal en el período comprendido entre enero de 2014 y diciembre de 2020. Los pacientes se dividieron en grupos etarios, por intervalos de 10 años. Se tomaron muestras de biopsias de tumores de vejiga, clasificándose por tipo histológico, además de los hallazgos relacionados con infestación por esquistosomiasis y formas de presentación del cáncer de vejiga. El universo estuvo constituido por 184 pacientes, y la muestra se conformó por 135 casos. Resultados: se comprobó que el mayor número de pacientes con cáncer de vejiga es del sexo masculino; el tipo histológico más frecuente fue el carcinoma de células escamosas, representando un 84,3 % del total. La cistitis, la presencia de esquistosomas, y sus huevos estuvieron presentes en casi todas las biopsias realizadas. Sus formas de presentación más frecuente fueron la cistitis, la hematúrica y la dolorosa. Conclusiones: el cáncer de vejiga mostró una mayor incidencia en las edades comprendidas entre 30 y 69 años. El carcinoma de células escamosas fue el más frecuente, y su relación con la cistitis y la infección por esquistosomas estuvo presente en más del 90 % de las biopsias.
Introduction: schistosomiasis is the most important trematode infection globally. Squamous cell carcinoma constitutes 2% of all the histological types of bladder cancer; however, the incidence of this variety of cancer in squistosomiasis-endemic countries is higher. Objective: to evaluate the relationship between squistosomiasis and bladder cancer in patients from the Central Hospital of Nampula. Materials and methods: a cross-sectional descriptive observational study was carried in the period between January 2014 and December 2020. Patients were divided into age-groups, by 10-year intervals. Biopsy samples of bladder tumors were taken, classified by histological type, in addition to findings related to squistosomiasis infestations and bladder cancer presentation forms. The universe consisted of 184 patients and the sample of 135 cases. Results: it was found that the largest number of patients with bladder cancer is male; squamous cell carcinoma is the most frequent histological type, representing 84.3% of the total. Cystitis, schistosome and their eggs were present in almost all the biopsies performed. Its most frequent presentation forms were hematuric and painful cystitis. Conclusions: bladder cancer showed higher incidence at the ages between 30 and 69 years. The squamous cell carcinoma was the most frequent, and its relationship with cystitis and schistosome infection was present in more than 90% of biopsies.
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RESUMO Objetivo. Analisar a distribuição espaço-temporal e os fatores associados à mortalidade por doenças tropicais negligenciadas (DTNs) no Brasil de 2000 a 2019. MÉtodo. Estudo ecológico que analisou os óbitos por DTNs registrados no Sistema de Informação sobre Mortalidade (SIM). Para a análise temporal, utilizou-se o método joinpoint. A dependência espacial foi analisada pelos índices de Moran global e local e Getis-Ord Gi*. Quatro modelos de regressão não espacial e espacial foram usados para identificar fatores associados ao óbito. Resultados. A taxa média de mortalidade por DTNs no Brasil foi de 3,32 óbitos/100 000 habitantes no período considerado, com a maior taxa (8,68 óbitos/100 000 habitantes) observada no Centro-Oeste. As causas mais prevalentes de morte foram doença de Chagas (n = 94 781; 74,9%) e esquistossomose (n = 10 271; 8,1%). Houve redução de 1,24% (IC95% = -1,6; - 0,9; P < 0,001) ao ano da mortalidade por DTNs no Brasil. Observou-se padrão alto/alto de distribuição espacial e hotspots em municípios dos estados de Goiás, Minas Gerais, Bahia, Tocantins e Piauí. Os indicadores "população em domicílios com densidade > 2 habitantes por dormitório" (β = -0,07; P = 0,00) e "índice de desenvolvimento humano municipal" (β = -3,36; P = 0,08) associaram-se negativamente ao desfecho, enquanto o indicador "índice de vulnerabilidade social" (β = 2,74; P = 0,05) associou-se positivamente ao desfecho. Conclusão. Quanto menor o desenvolvimento humano e maior a vulnerabilidade social, maior é a mortalidade por DTNs, o que deve direcionar as ações de prevenção e controle das DTNs.
ABSTRACT Objective. To analyze the spatial-temporal distribution and factors associated with mortality from neglected tropical diseases (NTDs) in Brazil from 2000 to 2019. Method. We performed an ecological study to analyze NTD-related deaths recorded in the Ministry of Health Mortality Information System (SIM). For the temporal analysis, the joinpoint method was used. Spatial dependence was analyzed using global Moran and local Getis-Ord Gi* indices. Four non-spatial and spatial regression models were used to identify factors associated with mortality. Results. The mean mortality rate from NTDs in Brazil during the study period was 3.32 deaths per 100 000 inhabitants, with the highest rate (8.68 deaths per 100 000 inhabitants) recorded in the Midwest. The most prevalent causes of death were Chagas disease (n = 94 781; 74.9%) and schistosomiasis (n = 10 271; 8.1%). There was a 1.24% reduction (95%CI = -1.6; -0.9; P < 0.001) in NTD-related mortality in Brazil per year. A high/high spatial distribution pattern and hotspots were observed in municipalities in the states of Goiás, Minas Gerais, Bahia, Tocantins, and Piauí. The indicators "population in households with density > 2 people per bedroom" (β = -0.07; P = 0.00) and "municipal human development index" (β = -3.36; P = 0.08) were negatively associated with the outcome, while the "index of social vulnerability" (β = 2.74; P = 0.05) was positively associated with the outcome. Conclusion. Lower human development and higher social vulnerability are associated with higher mortality from NTDs, which should guide NTD prevention and control efforts.
RESUMEN Objetivo. Analizar la distribución espacial y temporal de la mortalidad por enfermedades tropicales desatendidas en Brasil en el período 2000-2019 y los factores asociados a ella. Método. Estudio ecológico centrado en el análisis de las muertes por enfermedades tropicales desatendidas registradas en el Sistema de Información sobre Mortalidad. Para el análisis temporal se utilizó el método de regresión de puntos de inflexión (joinpoint). La dependencia espacial se analizó mediante los índices de Moran global y local y Gi* de Getis-Ord. Se utilizaron cuatro modelos de regresión espacial y no espacial para detectar los factores relacionados con la mortalidad. Resultados. La tasa media de mortalidad por enfermedades tropicales desatendidas en Brasil fue de 3,32 muertes por 100 000 habitantes en el periodo del estudio, y la tasa más alta observada (8,68 muertes por 100 000 habitantes) fue la del Centro Oeste. Las causas de muerte más prevalentes fueron la enfermedad de Chagas (n = 94.781; 74,9%) y la esquistosomiasis (n = 10.271; 8,1%). Se registró una disminución de 1,24% (IC del 95% = -1,6; -0,9; p < 0,001) anual de la mortalidad por enfermedades tropicales desatendidas en el país. Se observó un patrón de distribución espacial alto/alto, con puntos calientes en municipios de los estados de Bahía, Goiás, Minas Gerais, Piauí y Tocantins. Los indicadores "población en hogares con densidad > 2 habitantes por dormitorio" (β = -0,07; P = 0,00) e "índice de desarrollo humano municipal" (β = -3,36; P = 0,08) mostraron una asociación negativa con el resultado, mientras que el indicador "índice de vulnerabilidad social" (β = 2,74; P = 0,05) arrojó una asociación positiva. Conclusiones. Cuanto menor es el grado de desarrollo humano y mayor la vulnerabilidad social, mayor es la mortalidad por enfermedades tropicales desatendidas, lo que debe orientar las medidas correspondientes de prevención y control.
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ABSTRACT BACKGROUND: Hepatosplenic schistosomiasis is an endemic disease prevalent in tropical countries and is associated with a high incidence of portal vein thrombosis. Inflammatory changes caused by both parasitic infection and portal thrombosis can lead to the development of chronic liver disease with potential carcinogenesis. AIMS: To assess the incidence of portal vein thrombosis and hepatocellular carcinoma in patients with schistosomiasis during long-term follow-up. METHODS: A retrospective study was conducted involving patients with schistosomiasis followed up at our institution between 1990 and 2021. RESULTS: A total of 126 patients with schistosomiasis were evaluated in the study. The mean follow-up time was 16 years (range 5-31). Of the total, 73 (57.9%) patients presented portal vein thrombosis during follow-up. Six (8.1%) of them were diagnosed with hepatocellular carcinoma, all with portal vein thrombosis diagnosed more than ten years before. CONCLUSIONS: The incidence of hepatocellular carcinoma in patients with schistosomiasis and chronic portal vein thrombosis highlights the importance of a systematic long-term follow-up in this group of patients.
RESUMO RACIONAL: A esquistossomose hepatoesplênica é uma doença endêmica prevalente em países tropicais e está associada a uma alta incidência de trombose da veia porta. Alterações inflamatórias causadas tanto pela infecção parasitária quanto pela trombose portal podem levar ao desenvolvimento de doença hepática crônica com potencial carcinogênico. OBJETIVOS: Avaliar a incidência de trombose da veia porta e carcinoma hepatocelular em pacientes com esquistossomose durante um seguimento de longo prazo. MÉTODOS: Foi realizado estudo retrospectivo envolvendo pacientes com esquistossomose acompanhados em nossa instituição entre 1990 e 2021. RESULTADOS: Um total de 126 pacientes com esquistossomose foram avaliados no estudo. O tempo médio de acompanhamento foi de 16 anos (variando de 5 a 31). Do total, 73 (57,9%) pacientes apresentaram trombose da veia porta durante o seguimento e seis (8,1%) deles foram diagnosticados com carcinoma hepatocelular, todos com trombose da veia porta diagnosticada há mais de 10 anos. CONCLUSÕES: A incidência de carcinoma hepatocelular em pacientes com esquistossomose e trombose da veia porta crônica destaca a importância de um acompanhamento sistemático de longo prazo nesse grupo de pacientes.
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The World Health Organization (WHO) roadmap and recommendations for elimination of schistosomiasis were recently updated. With significant reductions in the prevalence and intensity of schistosomiasis infections worldwide, there is a need for more sensitive diagnostic methods. There are a few remaining transmission hotspots in Brazil, although low endemicity settings comprise most of the endemic localities. For the latter, serology may represent a tool for population screening which could help eliminate transmission of schistosomiasis. Here, we review serology tests currently available in Brazil from both public health and private laboratories: immunofluorescent antibody tests (IFATs) on adult worm sections and enzyme-linked immunosorbent assays (ELISAs) with soluble egg and adult worm antigens. Both in-house and commercially available tests have received less than adequate performance evaluations. Our review of immediate basic and operational research goals may help identify local adjustments that can be made to improve control interventions aimed at elimination of schistosomiasis as a public health problem.
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ABSTRACT Schistosomiasis is a major health problem that affects over 200 million people worldwide. There are few reports of Schistosoma mansoni found in liver transplants as well as scarce information about the course of the disease and the long-term effects on the graft. Herein, we report two cases of schistosomiasis in liver transplant recipients who presented abnormal serum liver enzymes, with evidence of gradual improvement after antiparasitic treatment. Furthermore, we discuss the possible role of screening the parasite infection in potential liver transplant recipients from endemic areas.
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ABSTRACT Background: The long-term effects of schistosomiasis on the glomerulus may contribute to the development of chronic kidney disease. This study aimed to investigate baseline Schistosoma mansoni-Circulating Anodic Antigen (CAA) levels and their association with kidney biomarkers related to podocyte injury and inflammation in long-term follow-up after praziquantel (PZQ) treatment. Methods: Schistosoma infection was diagnosed by detecting CAA in urine using a quantitative assay based on lateral flow using luminescent up-converting phosphor reporter particles. A cutoff threshold of 0.1 pg/mL CAA was used to diagnose Schistosoma infection (baseline) in a low-prevalence area in Ceará, Northeast, Brazil. Two groups were included: CAA-positive and CAA-negative individuals, both of which received a single dose of PZQ at baseline. Urinary samples from 55 individuals were evaluated before (baseline) and at 1, 2, and 3 years after PZQ treatment. At all time points, kidney biomarkers were quantified in urine and adjusted for urinary creatinine levels. Results: CAA-positive patients had increased baseline albuminuria and proteinuria and showed greater associations between kidney biomarkers. CAA levels correlated only with Vascular Endothelial Growth Factor (VEGF) (podocyte injury) levels. Increasing trends were observed for malondialdehyde (oxidative stress), monocyte chemoattractant protein-1 (inflammation marker), and VEGF. In the follow-up analysis, no relevant differences were observed in kidney biomarkers between the groups and different periods. Conclusions: S. mansoni-infected individuals presented subclinical signs of glomerular damage that may reflect podocyte injury. However, no causal effect on long-term renal function was observed after PZQ treatment.
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RESUMO Objetivo: Verificar a concordância dos dados relacionados às formas graves e aos óbitos por esquistossomose registrados no Sistema de Informação de Agravos de Notificação e no Sistema de Informação Sobre Mortalidade, as variáveis sociodemográficas com a ocorrência das formas graves e óbitos e a tendência temporal da doença em Pernambuco. Métodos: Trata-se de um estudo ecológico, descritivo, de série temporal com dados referentes às formas graves e aos óbitos por esquistossomose em Pernambuco, de 2007 a 2017. Para o linkage entre as bases de dados, foi desenvolvida uma função em linguagem python de programação, utilizando o método soundex. Para identificar fatores sociodemográficos e sanitários que se correlacionaram com as variáveis dependentes, foi aplicado o teste de correlação de Pearson. Para a análise de tendência, aplicou-se a regressão linear. Resultados: Identificaram-se 9.085 casos graves, 1.956 óbitos e 186 casos no linkage. A correlação entre a taxa média de positividade com o abastecimento hídrico rede geral e coleta de lixo foi 0,22 e 0,26 respectivamente. Houve correlação da taxa média de mortalidade acumulada com abastecimento hídrico por poço ou nascente (r=0,27), abastecimento hídrico por rede geral (r=0,3), coleta de lixo (r=0,42), urbanização das vias (r=0,29). Ocorreram 3.153 formas graves em 2007, com tendência a redução, e 205 óbitos em 2010, sem um padrão de tendência. Conclusão: Há necessidade de maiores investimentos no controle da doença e na qualidade da informação, especialmente no registro das formas graves, pois, dada a fisiopatologia da doença, o óbito só ocorre quando o indivíduo desenvolve a forma crônica, sendo imperativo sua notificação no Sistema de Informação de Agravos de Notificação.
ABSTRACT Objective: To verify the agreement of data on severe forms and deaths from schistosomiasis recorded in the Brazilian Notifiable Diseases Information System and the Mortality Information System, sociodemographic variables with the occurrence of severe forms and deaths, and the temporal trend of the disease in the state of Pernambuco, Brazil. Methods: This is an ecological, descriptive, time series study with data on severe forms and deaths from schistosomiasis in Pernambuco, from 2007 to 2017. For the linkage between databases, a function was developed in python programming language, using the Soundex method. To identify sociodemographic and health factors that correlated with the dependent variables, Pearson's correlation test was applied. For trend analysis, linear regression was applied. Results: We identified 9,085 severe cases, 1,956 deaths, and 186 cases in the linkage. The correlation between the average positivity rate with the general water supply and waste collection was 0.22 and 0.26 respectively. We verified a correlation of the average cumulative mortality rate with water supply by well or spring (r=0.27), water supply by the general network (r=0.3), waste collection (r=0.42), and road urbanization (r=0.29). We found 3,153 severe forms in 2007 with a decrease trend and 205 deaths in 2010, without a trend pattern. Conclusion: There is a need for greater investments in disease control and in the quality of information, especially in the record of severe forms, considering that, due to the pathophysiology of the disease, death only occurs when the individual develops the chronic form, and its notification on the Notifiable Diseases Information System is imperative.
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RESUMO Objetivo. Investigar a relação entre prevalência de esquistossomose e geo-helmintíases e variáveis de acesso a água, esgotamento sanitário e resíduos sólidos em países da América Latina e Caribe (ALC). Métodos. Realizou-se uma revisão sistemática nas bases de dados LILACS, PubMed, Web of Science e SciELO. Foram incluídos estudos publicados entre 1950 e agosto de 2021, com desenho ecológico e foco em agregados populacionais (estados, municípios e/ou distritos), tendo como desfecho primário a prevalência da infecção por Schistosoma mansoni, Ancylostoma sp., Necator americanus, Ascaris lumbricoides ou Trichuris trichiura e como variável explicativa o acesso a água, esgotamento sanitário e/ou resíduos sólidos. Foram considerados artigos com disponibilidade de texto completo e acesso livre nos idiomas inglês, espanhol ou português. O risco de viés e a qualidade dos estudos foram avaliados conforme o manual do Instituto Joanna Briggs. Resultados. De 2 714 artigos, nove foram elegíveis, publicados entre 1994 e 2021 e cobrindo 22 países da ALC e 14 350 municípios. A qualidade metodológica de todos os artigos foi moderada. As variáveis ambientais apontaram associação de abastecimento de água e coleta de resíduos sólidos com esquistossomose; abastecimento de água com ascaridíase, tricuríase e ancilostomíase; e de esgotamento sanitário com ascaridíase e ancilostomíase. Exceto por um artigo com abrangência regional para ALC, todos os demais foram desenvolvidos no Brasil. Conclusão. Evidencia-se a necessidade de ampliar a pesquisa sobre a associação entre condições sanitárias domiciliares e coletivas e doenças parasitárias para todos os países endêmicos da ALC para embasar estratégias ambientais para controle dessas doenças.
ABSTRACT Objective. To investigate the relationship between the prevalence of schistosomiasis and soil-transmitted helminthiasis with variables related to access to water, sanitation and solid waste in Latin American and Caribbean (LAC) countries. Method. A systematic review was performed in the LILACS, PubMed, Web of Science, and SciELO databases. Studies published between 1950 and August 2021, with an ecological design and a focus on population groups (states, municipalities and/or districts), having the prevalence of infection by Schistosoma mansoni, Ancylostoma sp., Necator americanus, Ascaris lumbricoides or Trichuris trichiura as primary variable and access to water, sewage and/or solid waste as explanatory variables were included. Open access articles with full text available in English, Spanish, or Portuguese were considered. The risk of bias and the quality of the studies were assessed according to the Joanna Briggs Institute manual. Results. Of 2 714 articles, nine were eligible, published between 1994 and 2021 and covering 22 LAC countries and 14 350 municipalities. All articles had moderate methodological quality. Environmental variables indicated an association between water supply and solid waste collection with schistosomiasis; water supply with ascariasis, trichuriasis and hookworm; and sewage with ascariasis and hookworm. Except for one article, which had regional coverage for LAC, all the others were developed in Brazil. Conclusion. There is a clear need to expand research on the association between household and collective health conditions and parasitic diseases for all endemic countries in LAC to support environmental strategies to control these diseases.
RESUMEN Objetivo. Investigar la relación entre la prevalencia de esquistosomiasis y geohelmintiasis y las variables de acceso al agua, el saneamiento y el manejo de residuos sólidos en los países de América Latina y el Caribe. Métodos. Se realizó una revisión sistemática en las bases de datos LILACS, PubMed, Web of Science y SciELO. Todos los artículos fueron de calidad metodológica moderada. Se incluyeron estudios publicados entre 1950 y agosto del 2021, con diseño ecológico y atención en agregados demográficos (estados, municipios o distritos), que tuvieran como resultado principal la prevalencia de infección por Schistosoma mansoni, Ancylostoma spp., Necator americanus, Ascaris lumbricoides o Trichuris trichiura y como variable explicativa el acceso al agua, el saneamiento y el manejo de residuos sólidos. Se analizaron artículos de texto completo y acceso libre en español, inglés o portugués. El riesgo de sesgo y la calidad de los estudios se evaluaron según las normas del manual del Instituto Joanna Briggs. Resultados. De los 2 714 artículos, hubo 9 que cumplieron con los requisitos establecidos; estos se publicaron entre 1994 y el 2021 y abarcaron 22 países y 14 350 municipios de América Latina y el Caribe. Las variables ambientales indicaron una relación del abastecimiento de agua y la recolección de residuos sólidos con la esquistosomiasis; del abastecimiento de agua con la ascariasis, la tricuriasis y la anquilostomiasis; y del saneamiento con la ascariasis y la anquilostomiasis. Con excepción de un artículo que abarcó la Región de América Latina y el Caribe, todos los demás se realizaron en Brasil. Conclusiones. Es evidente la necesidad de ampliar las investigaciones sobre la relación entre las condiciones sanitarias domésticas y colectivas y las enfermedades parasitarias en todos los países de América Latina y el Caribe donde son endémicas, con el fin de formular estrategias centradas en el medio ambiente para controlar esas enfermedades.
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ABSTRACT The pancreatic form of tuberculosis (TB) is rare and its diagnosis is challenging, since it manifests itself with non-specific symptoms and non-pathognomonic radiological findings, mimicking a neoplasia of the pancreas. Here, we report the case of a patient who had previously undergone liver transplantation and sought care for abdominal pain, weight loss, anorexia, hematochezia and postprandial fullness. Following an exploratory laparotomy and nucleic acid amplification testing on a pancreatic sample that had been collected, the patient was diagnosed with pancreatic TB. The patient received anti-tubercular pharmacological therapy and required percutaneous biliary drainage. Awareness of the possibility of a pancreatic TB diagnosis is important for clinicians. This attention should be even greater in patients who have undergone transplants, who are immunodeficient or who are from endemic areas.
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@#Abstract: Objective To construct a mouse model of Schistosoma japonicum liver disease induced by direct injection of Schistosoma japonicum eggs through the portal vein and evaluate its effectiveness, in order to provide a new animal model for schistosomiasis liver disease research. Methods Fifteen 8-week-old C57BL/6 male mice were randomly divided into control group and egg injection group, with 5 in the control group and 10 in the egg injection group. On day -14, 5 000 live eggs were injected into the abdominal cavity of mice, and on day 0, the mice were anesthetized and the abdominal cavity was opened. 5 000 live eggs were injected through the portal vein, and the control group was injected with equal volume of phosphate buffer (PBS). 5 mice in the egg group were killed on day 10 and 30, respectively. The control group mice were killed on day 10, and their serum and liver tissue were collected. Hematoxylin eosin staining (HE) and Masson staining were performed, and alanine aminotransferase (ALT), aspartate aminotransferase (AST), and liver hydroxyproline (HYP) content were detected using a microplate spectrophotometer. Liver fibrosis-related genes, Th1 and Th2 type immune response-related genes were analyzed by real-time fluorescence quantitative PCR (qPCR). Liver injury, egg granuloma and fibrosis, and adaptive immune response were detected to evaluate the effect of portal vein injection of eggs while inducing mouse model of schistosomiasis liver disease. Results The results showed that significant egg granulomas appeared in the liver of mice after injection of eggs into the portal vein for 10 and 30 days. There was no statistically significant difference in the area of egg granulomas between the 10-day group and the 30-day group (t=0.975, P=0.332). Masson staining and liver hydroxyproline content detection showed significant fibrosis in the liver. The qPCR results showed that, compared with the control group, the expression levels of fibrosis marker genes, such as α⁃Sma (alpha smooth muscle actin), Col1a1 (collagen type Ⅰ alpha 1), and Tgfb1 (transforming growth factor beta 1), were significantly increased (t=6.380, 7.533, 5.314; P=0.002, 0.001, 0.007), and then decreased on the 30th day, with no statistical difference compared to the control group (t=0.940, 1.529, 1.746; P=0.778, 0.543, 0.457). At the same time, the expression levels of Th1 type immune response-related genes, such as tumor necrosis factor alpha (Tnf), interferon gamma (Ifng), and Th2 type immune response-related genes, such as interleukin-5 (Il5), interleukin-13 (Il13), significantly increased 10 days after eggs injection (t=6.163, 4.589, 5.651, 5.367; P=0.003, 0.018, 0.020, 0.009). In addition, there was no significant change in the levels of AST and ALT in the serum of each group of mice (t=0.982, 3.450; P=0.771, 0.074. t=1.164, 0.564; P=0.697, 0.917). Conclusions A mouse model of schistosomiasis liver disease induced by portal vein injection of worm eggs was constructed. The study provides a new modeling method for studying the mechanism of liver fibrosis in schistosomiasis..
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Schistosomiasis control is not only a disease control programme, but also a great social practice activity in China. During the evolution of national schistosomiasis control programmes, the special schistosomiasis control culture has been cultivated and developed, which contains the spiritual connotation of government-led, people-oriented, respect for science and integration of all efforts. The publication of Chairman Mao Zedong’s two poems entitled “Farewell to the God of Plague” and the post-script in 1958 was a sign for the formation and development of Chinese schistosomiasis control culture, which always lead the orientation of development and practice of schistosomiasis control culture building. The schistosomiasis control culture provides powerful spiritual motivation and supports to schistosomiasis control programmes in China, and improving the building of schistosomiasis control culture is of great significance to strengthen our belief in achieving the goal of schistosomiasis elimination, mobilize all social resources, accelerate the progress towards elimination of schistosomiasis and facilitate the high-quality development of healthcare services. Chinese schistosomiasis control spirit is the refinement from the cultural connotation of the long-term schistosomiasis control programmes in China, and is the most essential and concentrated embodiment of the schistosomiasis control culture. This article describes the great significance of two poems entitled “Farewell to the God of Plague”, summarizes the connotation and role of schistosomiasis control spirit, and introduces the practice, development and innovation of schistosomiasis control culture building in Jiangxi Province.
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To evaluate the implementation of Survey of oncomelanid snails (WS/T 563—2017) in schistosomiasis-endemic foci, two schistosomiasis-endemic counties were selected from two provinces of Sichuan and Anhui. Professional staff working in province-, city-, county- and township-level disease control and prevention institutions, parasitic disease control institutions or medical institutions were recruited, and the understanding, use and implementation of Survey of oncomelanid snails (WS/T 563—2017) were investigated using questionnaires and interviews. The awareness, use, proportion of propagation and implementation and correct rate of answering questions pertaining to Survey of oncomelanid snails (WS/T 563—2017) were analyzed. A total of 270 questionnaires were allocated, and 269 were recovered, including 254 valid questionnaires. The overall awareness of Survey of oncomelanid snails (WS/T 563—2017) was 84.64% (215/254), and propagation and implementation of Survey of oncomelanid snails (WS/T 563—2017) was not performed in 23.28% (17/73) of the survey institutions following implementation of Survey of oncomelanid snails (WS/T 563—2017), with meeting training and allocation of propagation materials as the main type of propagation and implementation. Among 254 respondents, 77.16% (196/254) were familiar with the standard, 66.14% (168/254) understood the conditions for use of the standard during snail surveys, and 96.85% (246/254) had the approach for identifying snails. In addition, there were 41.73% (106/254), 50.78% (129/254) and 7.48% (19/254) of respondents that considered the operability of Survey of oncomelanid snails (WS/T 563—2017) was very good, good and general, respectively. The findings demonstrate that the issue and implementation of Survey of oncomelanid snails (WS/T 563—2017) has filled the gap for the standardization of snail control techniques, and which plays an importang guiding role in the national schistosomiasis control program.
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Objective To analyze the epidemiological characteristics of newly reported advanced schistosomiasis cases in Sichuan Province, so as to provide the evidence for analyzing the causes and formulating targeted control measures of newly reported advanced schistosomiasis cases. Methods Individual case investigation forms for advanced schistosomiasis cases were collected from the Sichuan Provincial Epidemic Annual Report System from 2011 to 2022, and patients’ demographics, previous medical history and liver parenchymal grading were retrieved. All advanced schistosomiasis cases’ medical records were reviewed, and the subtypes of schistosomiasis-endemic villages where the cases’ household registration were, floating population, survival and death and time of death were collected. Results A total of 321 newly reported advanced schistosomiasis cases were found in Sichuan Province from 2011 to 2022, with a male to female ratio of 0.99 to 1. There were 274 cases at ages of over 50 years (85.4%), with the highest proportion seen at ages of 60 to 69 years (87 cases, 27.1%), and splenomegaly was the most common type (180 cases, 56.1%), with no dwarfism type detected. The highest number of cases was reported in 2011 (78 cases), followed by in 2022 (74 cases), and the highest number of cases were reported in Meishan City (199 cases, 62.0%), Dongpo District (131 cases, 40.8%), and hilly subtype areas (136 cases, 42.4%). As of the end of 2022, there were 111 deaths due to advanced schistosomiasis, with the highest number of deaths seen in 2018 (25 deaths), and the highest mortality was seen among patients with the ascites type (41.2%). There were 47 (37.3%), 40 (59.5%) and 4 (23.5%) cases with grade III liver parenchyma among patients with splenomegaly, ascites, and colonic proliferation types, respectively, and there was a significant difference in the grading of III liver parenchyma among three types of patients (H = 12.092, P < 0.05), with more severe liver parenchyma injuries seen among patients with the ascites type than among those with splenomegaly and colonic proliferation type (Z = 24.262 and 44.738, both Padjusted values < 0.05). Conclusions There have been newly reported advanced schistosomiasis cases in Sichuan Province during recent years, and patients with the ascites type should be given a high priority among advanced schistosomiasis cases in Sichuan Province. Intensified clue surveys are needed for early identification and treatment of advanced schistosomiasis cases, so as to increase the survival rate and improve the quality of life.
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An ambitious goal has been set for elimination of schistosomiasis in all endemic counties (districts) in Sichuan Province by 2023. To achieve this goal, and to continue to consolidate the control achievements, it is necessary to understand the current endemic status of schistosomiasis, identify the challenges and analyze the experiences and lessons from the schistosomiasis control program, and develop targeted control strategies and interventions in the province. This paper reviews the progress of schistosomiasis control in Sichuan Province since the 12th Five-Year Plan period, analyzes the challenges in the schistosomiasis elimination program, and proposes recommendations for future directions and priorities.
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Objective To investigate the publications and citations of Chinese Journal of Schistosomiasis Control from 2011 to 2020, so as to provide insights into improving the journal quality and impact.. Methods All publications were retrieved from 60 issues of 10 volumes of Chinese Journal of Schistosomiasis Control from 2011 to 2020, and publication and citation analyses were performed using a bibliometric method. Results A total of 1 867 articles were published in Chinese Journal of Schistosomiasis Control from 2011 to 2020, with the largest number in 2012 (220 publications) and the lowest in 2020 (135 publications), and original article (36.48%), control experience (17.14%) and control study (10.34%) were the three most common article type. The overall proportion of grant-supported articles was 59.08% (1 103/1 867), and the number of grant per article was (2.34±1.58) grants. The mean duration from submission to publication was (173.48±105.84) days per article, and there was a significant difference in the mean duration from submission to publication among years (F = 30.883, P < 0.01). Jiangsu Province (492 publications, 26.35%), Shanghai Municipality (264 publications, 14.14%) and Hubei Province (230 publications, 12.32%) were the three most productive provinces where the first author lived, and disease control and prevention institutions were the predominant affiliations of the first author (67.22%), with Jiangsu Institute of Schistosomiasis Control, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, and Wannan Medical College as the three most productive affiliations. The number of authors was 5.94 authors per publication, and the proportion of co-authored publications was 95.45% in Chinese Journal of Schistosomiasis Control from 2011 to 2020. Journal article was the predominant type of cited (89.97%), and the mean number of citations was (15.70±11.56) citations per publication, with a significant difference in the mean number of citations per publication among years (F = 2.205, P < 0.05). The impact factors of Chinese Journal of Schistosomiasis Control ranged from 0.877 to 1.676 during the period from 2011 to 2020, and the overall Price index was 47.59%. Conclusions Both the academic impact and national transmissibility of Chinese Journal of Schistosomiasis Control appeared a tendency towards a rise from 2011 to 2020. Seeking high-quality contributions, increasing interdisciplinary integration, shortening the duration from submission to publication, expanding the coverage of publication services and enhancing impact are the future priorities of the journal.
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Objective To analysize the temporal trends in the disease burden of major human parasitic diseases in China from 1990 to 2019, so as to provide the evidence for improving the parasitic disease control strategy in China.. Methods The disability-adjusted life years (DALYs) of malaria, intestinal nematode infections, schistosomiasis, food-borne trematodiases, cysticercosis and echinococcosis in China from 1990 to 2019 were captured from the Global Burden of Disease Study 2019 (GBD 2019), and age- and gender-specific DALYs of parasitic diseases were estimated. The temporal trends in DALYs of malaria, intestinal nematode infections, schistosomiasis, food-borne trematodiases, cysticercosis and echinococcosis were evaluated in China from 1990 to 2019 using average annual percent change (AAPC) with Joinpoint regression analysis. Results The DALYs were 643 836.42 person-years due to food-borne trematodiases, 156 853.03 person-years due to cysticercosis, 79 764.62 person-years due to schistosomiasis, 70 989.73 person-years due to intestinal nematode infections, 4 258.61 person-years due to echinococcosis and 264.86 person-years due to malaria in China in 2019, respectively. The overall DALYs of six parasitic diseases were higher among men (546 441.93 person-years) than among women (409 525.33 person-years), and were greater among adults at ages of 14 to 65 years (684 780.84 person-years) than among children at 14 years and lower (35 437.38 person-years) and the elderly at ages of 65 years and older (235 749.04 person-years). During the period from 1990 to 2019, food-borne trematodiases were the leading cause of DALYs among the six parasitic diseases, and cysticercosis shifted from the fourth leading cause in 1990 to the second leading cause of DALYs in China in 2019, while intestinal nematode infections shifted from the second leading cause in 1990 to the fourth leading cause of DALYs in 2019. The DALYs of major human parasitic diseases appeared an overall tendency towards a decline in China from 1990 to 2019, with the fastest drop seen in DALYs due to malaria (AAPC = −19.6%, P = 0.003), followed by due to intestinal nematode infections (AAPC = −8.2%, P < 0.001) and schistosomiasis (AAPC = −3.1%, P < 0.001), and a slow decline was seen in the DALYs of food-borne trematodiases (AAPC = −1.0%, P < 0.001), while there were no significant decrease in the DALYs of echinococcosis (AAPC = −0.5%, P = 0.264) and the DALYs of cysticercosis appeared a tendency towards a rise (AAPC = 0.7%, P < 0.001). Conclusions The disease burden of major human parasitic diseases appeared an overall tendency towards a decline in China from 1990 to 2019, with a high disease burden seen due to food-borne parasitic diseases, no remarkable reduction seen in echinococcosis, and a tendency towards a rise seen in cysticercosis. It is recommended to focus on echinococcosis control, and continue to consolidate the control achievements of other major human parasitic diseases in China; meanwhile, the surveillance and prevention of food-borne parasitic diseases should be reinforced.