RESUMEN
Peste des petits ruminants virus (PPRV) is a multi-host pathogen with sheep and goats as main hosts. To investigate the role of cattle in the epidemiology of PPR, we simulated conditions similar to East African zero-grazing husbandry practices in a series of trials with local Zebu cattle (Bos taurus indicus) co-housed with goats (Capra aegagrus hircus). Furthermore, we developed a mathematical model to assess the impact of PPRV-transmission from cattle to goats. Of the 32 cattle intranasally infected with the locally endemic lineage IV strain PPRV/Ethiopia/Habru/2014 none transmitted PPRV to 32 co-housed goats. However, these cattle or cattle co-housed with PPRV-infected goats seroconverted. The results confirm previous studies that cattle currently play a negligible role in PPRV-transmission and small ruminant vaccination is sufficient for eradication. However, the possible emergence of PPRV strains more virulent for cattle may impact eradication. Therefore, continued monitoring of PPRV circulation and evolution is recommended.
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Enfermedades de las Cabras , Cabras , Peste de los Pequeños Rumiantes , Virus de la Peste de los Pequeños Rumiantes , Animales , Peste de los Pequeños Rumiantes/transmisión , Peste de los Pequeños Rumiantes/virología , Peste de los Pequeños Rumiantes/epidemiología , Bovinos , Virus de la Peste de los Pequeños Rumiantes/inmunología , Virus de la Peste de los Pequeños Rumiantes/fisiología , Cabras/virología , Enfermedades de las Cabras/virología , Enfermedades de las Cabras/transmisión , Enfermedades de los Bovinos/transmisión , Enfermedades de los Bovinos/virología , Enfermedades de los Bovinos/epidemiología , Erradicación de la Enfermedad/métodosRESUMEN
INTRODUCTION: Sri Lanka implemented the National Programme for Elimination of Lymphatic Filariasis (NPELF) in its endemic regions in 2002. Five annual rounds of mass drug administration using the two-drug combination diethylcarbamazine (DEC) and albendazole led to sustained reductions in infection rates below threshold levels. In 2016, WHO validated that Sri Lanka eliminated lymphatic filariasis as a public health problem. OBJECTIVE: To explore the impact of the NPELF on lymphatic filariasis morbidity in Sri Lanka. METHODS: Passive Case Detection (PCD) data maintained in filaria clinic registries from 2006-2022 for lymphoedema and hospital admission data for managing hydroceles/spermatoceles from 2007-2022 were analyzed. The morbidity status in 2022 and trends in overall and district-wise PCD rates were assessed. Poisson log-linear models were used to assess the trends in PCD for endemic regions, including district-wise trends and hospital admissions for the management of hydroceles/spermatoceles. RESULTS: In 2022, there were 566 new lymphoedema case visits. The mean (SD) age was 53.9 (16.0) years. The staging was done for 94% of cases, of which 79% were in the early stages (57.3% and 21.4% in stages two and one, respectively). Western Province had the highest caseload (52%), followed by the Southern (32%) and Northwestern (16%) Provinces, respectively. The reported lymphoedema PCD rate in 2022 was 0.61 per 10,000 endemic population. The overall PCD rate showed a decline of 7.6% (95%CI: 4.9% - 10.3%) per year (P < 0.0001) from 2007 to 2022. A steady decline was observed in Colombo, Gampaha and Kurunegala districts, while Kalutara remained static and other districts showed a decline in recent years. Further, admissions for inpatient management of hydroceles/spermatoceles showed a declining trend after 2015. CONCLUSIONS: The PCD rates of lymphoedema and hydroceles/spermatoceles showed a declining trend in Sri Lanka after the implementation of the NPELF.
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Dietilcarbamazina , Filariasis Linfática , Filaricidas , Filariasis Linfática/epidemiología , Filariasis Linfática/prevención & control , Filariasis Linfática/tratamiento farmacológico , Humanos , Sri Lanka/epidemiología , Masculino , Estudios Retrospectivos , Femenino , Dietilcarbamazina/uso terapéutico , Dietilcarbamazina/administración & dosificación , Adulto , Persona de Mediana Edad , Filaricidas/uso terapéutico , Albendazol/uso terapéutico , Albendazol/administración & dosificación , Salud Pública , Anciano , Hidrocele Testicular/epidemiología , Erradicación de la Enfermedad/métodos , Adolescente , Adulto Joven , Administración Masiva de Medicamentos , Linfedema/epidemiología , Morbilidad/tendencias , Niño , Programas Nacionales de SaludRESUMEN
INTRODUCTION: Food insecurity and undernutrition both contribute to the large tuberculosis burden in India. Indian government rolled out the direct benefit transfer (DBT) programme "Nikshay Poshan Yojana" on a national scale on April 1, 2018 largely to provide nutritional support. Hence, it was proposed to take up this study in Western Maharashtra (Pune district) to study the coverage, delays and implementation challenges of 'Direct Benefit Transfer' in the National Tuberculosis Elimination Programme as there have only been a limited number of studies conducted regarding the same. METHODOLOGY: This mixed methods study was conducted at Tuberculosis Units (TUs) under District Tuberculosis Officer (DTO) in Western Maharashtra (Pune district) for the duration August 2020 to September 2022. A total of 3373 participants were included for the quantitative component. For qualitative component In-depth interviews of key informants (healthcare providers involved in the implementation of Direct Benefit Transfer) and Focus Group Discussion (FGD) for patients and care givers was done and explored using thematic analysis. RESULTS: The total coverage was found to be 76.81%. The health providers reported staff related challenges (overburden and non-cooperative staff), bank related issues (local and cooperate banks not involved in the Public Financial Management System (PFMS) loop and lack of bank account), patient related issues (fear of being scammed), the DBT process (lengthy and complex) and software related issues as major hurdles involved in the scheme's implementation. The challenges to the implementation of DBT reported by the beneficiaries (TB patients) were lack of awareness and disbelief about the scheme, bank related issues (lack of bank account and necessary documents to open account), financial challenges (job insecurity, loans), physical challenges (weakness) and delays in delivering the benefit due to software errors. CONCLUSION: In the present study the DBT coverage was very encouraging. The common challenges identified by the staff members and patients in the implementation of the scheme were lack of awareness about the scheme, bank related issues and software issues. To increase the coverage of DBT, it is vital that these issues be resolved.
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Tuberculosis , Humanos , India/epidemiología , Tuberculosis/prevención & control , Programas Nacionales de Salud , Inseguridad Alimentaria , Femenino , Erradicación de la Enfermedad/métodos , Masculino , Desnutrición/prevención & control , Personal de Salud , Grupos FocalesRESUMEN
Mammoth study in Chinese villages shows antibiotics that kill Helicobacter pylori reduced cancer risk.
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Antibacterianos , Erradicación de la Enfermedad , Tracto Gastrointestinal , Infecciones por Helicobacter , Helicobacter pylori , Neoplasias Gástricas , Femenino , Humanos , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , China/epidemiología , Tracto Gastrointestinal/efectos de los fármacos , Tracto Gastrointestinal/microbiología , Infecciones por Helicobacter/microbiología , Infecciones por Helicobacter/tratamiento farmacológico , Infecciones por Helicobacter/complicaciones , Helicobacter pylori/efectos de los fármacos , Neoplasias Gástricas/microbiología , Neoplasias Gástricas/prevención & control , Erradicación de la Enfermedad/métodosRESUMEN
Despite a half-century-long global eradication effort, polio continues to have a devastating impact on individuals and communities worldwide, especially in low-income countries affected by conflict or geographic barriers to immunization programs. In response, the World Health Organization (WHO) Global Polio Eradication Initiative (GPEI) employs disease surveillance and vaccination campaigns coordinated through the WHO Regional Office for Africa (AFRO) Geographic Information System (GIS) Centre. Established in 2017, the AFRO GIS Centre played a key role in the eradication of wild-type polioviruses (WPVs) in 2020, but the COVID-19 pandemic, emergence of circulating vaccine-derived polioviruses, and transmission of WPV1 from Central Asia have led to a resurgence of polio in Sub-Saharan Africa. The AFRO GIS comprises a set of mobile device or cloud-based tools for geospatial data collection, analysis, and visualization. Using tools such as Auto-Visual Acute Flaccid Paralysis Detection and Reporting, electronic surveillance, and Integrated Supportive Supervision, GIS personnel collect polio case numbers and locations, track field worker activities, follow the movements of nomadic populations vulnerable to polio and other diseases, and determine needs for further healthcare deployments. The system is location specific and operates in real time, enabling the AFRO GIS to promptly target its responses to polio, COVID-19, Ebola virus disease, and other public health crises and natural disasters. The present review describes the components of the AFRO GIS and how the AFRO GIS Centre coordinated on-the-ground polio eradication efforts to help secure Africa's certification as WPV free. It also examines current and prospective challenges regarding other disease outbreaks in the COVID-19 era and how the AFRO GIS Centre is addressing these ongoing public health needs.
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COVID-19 , Erradicación de la Enfermedad , Sistemas de Información Geográfica , Poliomielitis , Organización Mundial de la Salud , Poliomielitis/epidemiología , Poliomielitis/prevención & control , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Erradicación de la Enfermedad/métodos , Erradicación de la Enfermedad/organización & administración , África/epidemiología , Creación de Capacidad , SARS-CoV-2/aislamiento & purificación , Programas de Inmunización , Pandemias/prevención & controlRESUMEN
The World Health Organization (WHO) endorsed the use of triple-drug mass drug administration (MDA) regimen with ivermectin, diethylcarbamazine (DEC) and albendazole (commonly abbreviated as IDA) to accelerate the elimination of lymphatic filariasis (LF) as a public health problem in settings where onchocerciasis is not co-endemic. The National Programme for Elimination of LF (NPELF) in Kenya was among the first adopters of the IDA-MDA and two annual rounds were provided in 2018 and 2019 to the residents of Lamu County and Jomvu sub-County in the coast region. This study documented the feasibility of successfully delivering the two rounds of IDA-MDA. An operational research study was undertaken to determine efficient sampling strategies, indicators, and the appropriate population groups that could be used for the monitoring and evaluation of LF programs using IDA-MDA for the elimination of the disease as a public health problem. Two cross-sectional surveys were conducted at baseline in 2018 before IDA-MDA and an impact assessment 17 months after the second round of IDA-MDA. The reported epidemiological treatment coverage was at least 80% in all implementation units during each round of IDA-MDA. Blood samples were tested for filarial antigenemia using commercial Filariasis Test Strips (FTS) and any individual found to be positive was tested again at night for the presence of microfilariae in finger prick blood smears using microscopy. The overall prevalence of circulating filarial antigen (CFA) was relatively low at the baseline survey with Jomvu having 1.39% (95% CI: 0.91, 2.11) and Lamu having 0.48% (95% CI: 0.21, 1.13). Significant reduction in CFA prevalence was observed during the impact assessment after the two annual rounds of mass treatment. The overall relative reduction (%) in CFA prevalence following the two rounds of MDA with IDA was significant in both Jomvu (52.45%, Z = -2.46, P < 0.02) and Lamu (52.71%, Z = -1.97, P < 0.05). Heterogeneity, however, was observed in the CFA prevalence reduction between random and purposive clusters, as well as between adult and child populations. The results of the impact assessment survey offered strong evidence that it was safe to stop the IDA-MDA in the two EUs because transmission appears to have been interrupted. It is also important to implement a post-treatment surveillance system which would enable efficient detection of any recrudescence of LF transmission at a sub-evaluation unit level. Our findings show that IDA-MDA may be considered for acceleration of LF elimination in other settings where onchocerciasis is not co-endemic.
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Albendazol , Dietilcarbamazina , Erradicación de la Enfermedad , Quimioterapia Combinada , Filariasis Linfática , Filaricidas , Ivermectina , Administración Masiva de Medicamentos , Filariasis Linfática/tratamiento farmacológico , Filariasis Linfática/epidemiología , Filariasis Linfática/prevención & control , Humanos , Albendazol/uso terapéutico , Albendazol/administración & dosificación , Dietilcarbamazina/administración & dosificación , Dietilcarbamazina/uso terapéutico , Kenia/epidemiología , Ivermectina/uso terapéutico , Ivermectina/administración & dosificación , Femenino , Masculino , Adulto , Adolescente , Adulto Joven , Filaricidas/uso terapéutico , Filaricidas/administración & dosificación , Persona de Mediana Edad , Niño , Erradicación de la Enfermedad/métodos , Estudios Transversales , Animales , Prevalencia , Anciano , Preescolar , Wuchereria bancrofti/efectos de los fármacos , Wuchereria bancrofti/aislamiento & purificaciónRESUMEN
BACKGROUND: After decades of praziquantel mass drug administration (MDA), several countries approach schistosomiasis elimination. Continuing MDA in largely uninfected populations no longer seems justified. Alternative interventions to maintain the gains or accelerate interruption of transmission are needed. We report results, strengths, and shortcomings of novel test-treat-track-test-treat (5T) interventions in low Schistosoma haematobium prevalence areas on Pemba, Tanzania. METHODS: School- and household-based surveys were conducted in 2021 and 2022 to monitor the S. haematobium and microhematuria prevalence and assess the impact of interventions. In 2021, 5T interventions were implemented in 15 low-prevalence areas and included: (i) testing schoolchildren in primary and Islamic schools for microhematuria as a proxy for S. haematobium, (ii) treating positive children, (iii) tracking them to their households and to water bodies they frequented, (iv) testing individuals at households and water bodies, and (v) treating positive individuals. Additionally, test-and-treat interventions were implemented in the 22 health facilities of the study area. RESULTS: The S. haematobium prevalence in the school-based survey in 15 low-prevalence implementation units was 0.5% (7/1560) in 2021 and 0.4% (6/1645) in 2022. In the household-based survey, 0.5% (14/2975) and 0.7% (19/2920) of participants were infected with S. haematobium in 2021 and 2022, respectively. The microhematuria prevalence, excluding trace results, in the school-based survey was 1.4% (21/1560) in 2021 and 1.5% (24/1645) in 2022. In the household-based survey, it was 3.3% (98/2975) in 2021 and 5.4% (159/2920) in 2022. During the 5T interventions, the microhaematuria prevalence was 3.8% (140/3700) and 5.8% (34/594) in children in primary and Islamic schools, respectively, 17.1% (44/258) in household members, and 16.7% (10/60) in people at water bodies. In health facilities, 19.8% (70/354) of patients tested microhematuria-positive. CONCLUSIONS: The targeted 5T interventions maintained the very low S. haematobium prevalence and proved straightforward and feasible to identify and treat many of the few S. haematobium-infected individuals. Future research will show whether 5T interventions can maintain gains in the longer-term and expedite elimination. TRIAL REGISTRATION: ISRCTN, ISCRCTN91431493. Registered 11 February 2020, https://www.isrctn.com/ISRCTN91431493 .
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Antihelmínticos , Administración Masiva de Medicamentos , Praziquantel , Schistosoma haematobium , Esquistosomiasis Urinaria , Tanzanía/epidemiología , Esquistosomiasis Urinaria/tratamiento farmacológico , Esquistosomiasis Urinaria/epidemiología , Esquistosomiasis Urinaria/prevención & control , Humanos , Niño , Animales , Schistosoma haematobium/efectos de los fármacos , Adolescente , Masculino , Praziquantel/uso terapéutico , Praziquantel/administración & dosificación , Femenino , Prevalencia , Administración Masiva de Medicamentos/métodos , Antihelmínticos/uso terapéutico , Antihelmínticos/administración & dosificación , Erradicación de la Enfermedad/métodos , Instituciones Académicas , Adulto , Composición Familiar , Hematuria , Adulto JovenRESUMEN
Malaria is an infectious disease that seriously threatens human health. Currently, malaria control mainly depends on antimalarial chemotherapy. However, antimalarial drug resistance is becoming increasingly severe, which poses a great challenge to malaria control, notably treatment of Plasmodium falciparum malaria. To address this challenge, there is a need to facilitate development of novel antimalarial drugs and innovation of treatment strategies, as well as reinforce surveillance and research on antimalarial drug resistance. This article reviews the main categories and use guidelines of current antimalarial agents, summarizes the current status and monitoring methods of antimalarial drug resistance, and proposes the response to antimalarial drug resistance, so as to provide insights into the use of antimalarial drugs and response to antimalarial drug resistance, and contribute to global malaria elimination.
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Antimaláricos , Resistencia a Medicamentos , Malaria , Antimaláricos/uso terapéutico , Antimaláricos/farmacología , Humanos , Malaria/tratamiento farmacológico , Malaria/prevención & control , Erradicación de la Enfermedad/métodosRESUMEN
Driven by international exchanges and climate changes, the invasion and spread of vector Anopheles mosquitoes posed a new challenge to achieving global malaria elimination. Taking the invasion of An. stephensi to exacerbate the malaria epidemic in Africa as an example, this article summarizes the current situation of global Anopheles invasion, and estimates the potential risk of vector Anopheles mosquitoes to unravel the difficulties and challenges in the global malaria elimination program, so as to provide insights into improved early earning and precision control of vector Anopheles mosquito invasion across the world.
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Anopheles , Especies Introducidas , Malaria , Mosquitos Vectores , Malaria/prevención & control , Malaria/transmisión , Animales , Anopheles/parasitología , Anopheles/fisiología , Humanos , Mosquitos Vectores/parasitología , Mosquitos Vectores/fisiología , Erradicación de la Enfermedad/métodosRESUMEN
Geospatial data reporting from surveillance and immunization efforts is a key aspect of the World Health Organization (WHO) Global Polio Eradication Initiative in Africa. These activities are coordinated through the WHO Regional Office for Africa Geographic Information Systems Centre. To ensure the accuracy of field-collected data, the WHO Regional Office for Africa Geographic Information Systems Centre has developed mobile phone apps such as electronic surveillance (eSURV) and integrated supportive supervision (ISS) geospatial data collection programs. While eSURV and ISS have played a vital role in efforts to eradicate polio and control other communicable diseases in Africa, disease surveillance efforts have been hampered by incomplete and inaccurate listings of health care sites throughout the continent. To address this shortcoming, data compiled from eSURV and ISS are being used to develop, update, and validate a Health Facility master list for the WHO African region that contains comprehensive listings of the names, locations, and types of health facilities in each member state. The WHO and Ministry of Health field officers are responsible for documenting and transmitting the relevant geospatial location information regarding health facilities and traditional medicine sites using the eSURV and ISS form; this information is then used to update the Health Facility master list and is also made available to national ministries of health to update their respective health facility lists. This consolidation of health facility information into a single registry is expected to improve disease surveillance and facilitate epidemiologic research for the Global Polio Eradication Initiative, as well as aid public health efforts directed at other diseases across the African continent. This review examines active surveillance using eSURV at the district, country, and regional levels, highlighting its role in supporting polio surveillance and immunization efforts, as well as its potential to serve as a fundamental basis for broader public health initiatives and research throughout Africa.
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Instituciones de Salud , Poliomielitis , Organización Mundial de la Salud , Humanos , Poliomielitis/epidemiología , Poliomielitis/prevención & control , África/epidemiología , Instituciones de Salud/estadística & datos numéricos , Vigilancia de la Población/métodos , Sistemas de Información Geográfica , Erradicación de la Enfermedad/métodosRESUMEN
There are still multiple challenges in China during the malaria post-elimination phase, including a large number of imported malaria cases with widespread distribution, low awareness of timely healthcare seeking, insufficient malaria diagnosis and treatment capacity of medical institutions and insufficient malaria surveillance and response capability of disease control and prevention institutions. As the core technical institutions for preventing the re-establishment of malaria transmission, both medical institutions and disease control and prevention institutions are required to enhance the collaboration between clinical and public health services, improve the malaria diagnosis and quality management system, intensify case identification and epidemiological investigations, and improve the management mechanism of antimalarial drug reserves. In addition, doctors are encouraged to become the main force in the health education and promotion of malaria prevention to improve the public health literacy. These approaches are recommended to improve the overall capability of timely identification, standardized treatment and effective response of imported malaria cases, so as to continuously consolidate the malaria elimination achievements in China.
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Erradicación de la Enfermedad , Malaria , Salud Pública , Malaria/prevención & control , Humanos , China/epidemiología , Erradicación de la Enfermedad/métodosRESUMEN
We describe the computation of metrics to inform the selection of areas for a regionalised approach to bovine tuberculosis eradication in Ireland. Our aim was not to recommend suitable regions but to elucidate the criteria used in metric selection and comment on the diversity of metric values amongst regions. The 26 counties of Ireland were compared using 20 metrics, grouped into five categories: region size and cattle population, herd fragmentation, cattle movement, bovine TB testing, badger population and control. Fragmentation metrics, measuring the proportion of herds with land in at least two counties, varied considerably by county, from 1% to 24 %. Between 25 % and 92 % of moves into herds came from a different county, illustrating the likely disruption in trade that a regionalized approach could entail. Cattle movement networks were combined with a risk model to calculate the proportion of moves which would be deemed risky under a risk-based trading regime and these results were compared to a more traditional approach based on the herd type and test history of each herd, with many fewer moves potentially restricted using the latter approach. We show how correlation between region size and some of the metrics complicates their interpretation.
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Erradicación de la Enfermedad , Tuberculosis Bovina , Animales , Tuberculosis Bovina/prevención & control , Tuberculosis Bovina/epidemiología , Bovinos , Irlanda , Erradicación de la Enfermedad/métodos , Erradicación de la Enfermedad/estadística & datos numéricosRESUMEN
To eliminate malaria, all populations must be included. For those who are not reached by the health care system, specific interventions must be tailor-made. An innovative Malakit strategy, based on the distribution of self-diagnosis and self-treatment kits, has been evaluated in the Suriname-French Guiana- Amapá (Brazil) region. The results showed effectiveness and good acceptability. The Malakit intervention is complex and has many components. Its transferability requires adaptation to other populations and regions, while retaining the main features of the intervention. This article provides the keys to adapting, implementing and evaluating it in other contexts facing residual malaria in hard-to-reach and/or mobile populations. The process of transferring this intervention includes: diagnosis of the situation (malaria epidemiology, characteristics of the population affected) to define the relevance of the strategy; determination of the stakeholders and the framework of the intervention (research project or public health intervention); adaptation modalities (adaptation of the kit, training, distribution strategy); the role of community health workers and their need for training and supervision. Finally, evaluation needs are specified in relation to prospects for geographical or temporal extension. Malaria elimination is likely to increasingly involve marginalized people due to climate change and displacement of populations. Evaluation of the transferability and effectiveness of the Malakit strategy in new contexts will be essential to increase and refine the evidence of its value, and to decide whether it could be an additional tool in the arsenal recommended in future WHO guidelines.
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Malaria , Malaria/prevención & control , Humanos , Brasil , Suriname , Guyana Francesa , Erradicación de la Enfermedad/métodosRESUMEN
BACKGROUND OBJECTIVES: Despite significant progress in malaria control throughout India, Chhattisgarh state continues to be a significant contributor to both malaria morbidity and mortality. This study aims to identify key factors associated with malaria endemicity, with a goal of focusing on these factors for malaria elimination by 2030. METHODS: We employed an analysis and narrative review methodology to summarize the existing evidence on malaria epidemiology in Chhattisgarh. Data encompassing environmental conditions, dominant malaria vectors and their distribution, and the impact of previous interventions on malaria control, were extracted from published literature using PubMed and Google Scholar. This information was subsequently correlated with malaria incidence data using appropriate statistical and geographical methods. RESULTS: Much of the malaria burden in Chhattisgarh state is concentrated in a few specific districts. The primary malaria vectors in these regions are Anopheles culicifacies and An. fluviatilis. High transmission areas are found in tribal belts which are challenging to access and are characterized by densely forested areas that provide a conducive habitat for malaria vectors. INTERPRETATION CONCLUSION: Conducive environmental conditions characterized by high forest cover, community behavior, and insurgency, contribute to high malaria endemicity in the area. Challenges include insecticide resistance in malaria vectors and asymptomatic malaria. Allocating additional resources to high-endemic districts is crucial. Innovative and focused malaria control programs of the country, such as DAMAN and Malaria Mukt Abhiyan, hold immense importance.
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Anopheles , Malaria , Mosquitos Vectores , India/epidemiología , Humanos , Malaria/prevención & control , Malaria/epidemiología , Animales , Anopheles/parasitología , Anopheles/fisiología , Mosquitos Vectores/parasitología , Control de Mosquitos/métodos , Erradicación de la Enfermedad/métodos , Incidencia , Resistencia a los InsecticidasRESUMEN
OBJECTIVE: The objective of the study was to understand the role of self-reported drinking behavior on liver health after achieving sustained viral response (SVR) among HCV patients. RESULTS: The study was conducted in HCV treatment provider clinics in three cities in Georgia: Tbilisi, Batumi, and Telavi. Face-to-face interviews were conducted using a questionnaire developed specifically for this study. 9.5% considered themselves heavy drinkers, while 94.2% were aware that heavy alcohol consumption can progress liver fibrosis. During treatment, 97.8% abstained from alcohol, while 76.6% reported resuming drinking after achieving SVR. Additionally, 52.1% believed that moderate alcohol intake is normal for individuals with low fibrosis scores. Liver fibrosis improvement was more prevalent among individuals who abstained from alcohol after HCV diagnosis (85.4% vs. 71.4%, p < 0.01) and after achieving SVR (87.5% vs. 74.7% of those who resumed drinking after achieving SVR, p < 0.02). In conclusion, the majority of HCV patients abstain from alcohol during treatment but resume drinking after achieving SVR. Those who abstain from alcohol intake after HCV cure have a higher chance of liver fibrosis improvement.
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Consumo de Bebidas Alcohólicas , Humanos , Masculino , Femenino , Persona de Mediana Edad , Consumo de Bebidas Alcohólicas/epidemiología , Georgia (República)/epidemiología , Adulto , Hepatitis C/epidemiología , Hepatitis C/psicología , Hepatitis C/tratamiento farmacológico , Cirrosis Hepática/epidemiología , Cirrosis Hepática/virología , Encuestas y Cuestionarios , Anciano , Respuesta Virológica Sostenida , Erradicación de la Enfermedad/métodos , Hepatitis C Crónica/tratamiento farmacológico , Hepatitis C Crónica/epidemiología , Hepatitis C Crónica/psicología , Hepacivirus , Antivirales/uso terapéuticoRESUMEN
Cooperation and networking are powerful tools in the combating against tropical diseases. Cooperation on a global scale is essential due to the transboundary nature of tropical diseases. Networking plays a pivotal role in facilitating such cooperation. Both cooperation and networking can foster innovation in disease control programmes. Collaborative research can lead to the development of new drugs and vaccines, while shared surveillance data can enable the early detection and control of disease epidemics. Therefore, consensus of cooperation and networking has been reached during the 7th Symposium on Surveillance-Response Systems Leading to Tropical Diseases Elimination, which reflected in the two documents, i.e., Consensus for Transboundary Tropical Diseases Control, and Action Consensus of the Network of WHO Collaborating Centres Related to NTDs. These documents will improve the efforts in the fighting against tropical diseases through collective actions to achieve the United Nations' Sustainable Development Goals (SDGs).
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Erradicación de la Enfermedad , Salud Global , Cooperación Internacional , Medicina Tropical , Humanos , Medicina Tropical/métodos , Erradicación de la Enfermedad/métodos , Organización Mundial de la Salud , Enfermedades Desatendidas/prevención & controlRESUMEN
OBJECTIVES: Hepatitis B (HBV) and hepatitis C (HCV) viruses are significant causes of primary liver cancer, responsible for over a million deaths annually. We aimed to develop a screening strategy for viral hepatitis elimination in Spain, aligned with WHO's 2030 objectives. DESIGN: The CRIVALVIR-FOCUS program, conducted at the Consortium General University Hospital of Valencia, aimed to identify individuals with active blood-borne viral infections through opportunistic population screening. The hospital's Health Department serves more than 280,000 adults. RESULTS: Of the 31,995 adults screened (52% women; 15% immigrants), HBV prevalence was 0.44%, with higher rates in men (0.57%) than women (0.32%), and notably higher in migrants (1.27%) compared to Spanish nationals (0.30%). The 45-64 age group had the highest HBV prevalence (0.65%). HCV prevalence was 0.35%, again higher in men than women (0.51% vs 0.20%) and in migrants compared to Spanish nationals (0.58% vs 0.31%), with the 45-64 age group showing the highest HCV prevalence (0.76%). From the positive tests, 78.0% (110/141) of HBV cases and 71.4% (80/112) of HCV cases were patients previously unaware of their infections. CONCLUSION: Opportunistic screening effectively identifies early cases, potentially enhancing prevention of new infections. Our study highlights the need for targeted interventions for individuals aged 45-64 and migrants. Designing specific screening programs, in collaboration with social workers and cultural mediators, is critical to improve access to care. Training and involving primary care professionals are vital actions for the program's success.
Asunto(s)
Hepatitis B , Hepatitis C , Tamizaje Masivo , Humanos , Masculino , Femenino , Persona de Mediana Edad , España/epidemiología , Adulto , Tamizaje Masivo/métodos , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Hepatitis B/diagnóstico , Prevalencia , Hepatitis C/epidemiología , Hepatitis C/prevención & control , Hepatitis C/diagnóstico , Anciano , Adulto Joven , Adolescente , Erradicación de la Enfermedad/métodosRESUMEN
India has targeted malaria elimination by 2030. The national malaria control program has positioned its strategies in this direction. Substantial support in the form of dynamic research inputs leading to policy formulation and change is needed to steer the country towards malaria elimination. Indian Council of Medical Research (ICMR), India's nodal research body, has been generating evidence and helping to frame several policies ranging from malaria management to vector control operations. Since the country is preparing for malaria elimination, the connection between the programmatic needs and the research agenda needs further strengthening. Typically, the national malaria control program handles the implementation of programmatic activities, while the national research body, ICMR, conducts research studies to generate evidence. We propose a virtual integration of the activities conducted by these two entities to maximize the potential for translating research findings into programmatic policies. Joint monitoring of drug and insecticide resistance, codevelopment and utilization of more innovative surveillance systems, data-backed mitigation responses, and overcoming last-mile challenges are reasons for the virtual amalgamation of the two bodies. Timely translation of research outputs into policy, co-opting of workforce and material resources, joint capacity building, and synergistic advocacy are benefits of the proposed new alliance for more efficient operations. The close functioning will provide impetus to narrow down current gaps and disrupt traditional barriers, galvanizing the country toward malaria elimination.
Asunto(s)
Erradicación de la Enfermedad , Malaria , India/epidemiología , Humanos , Malaria/prevención & control , Malaria/epidemiología , Erradicación de la Enfermedad/organización & administración , Erradicación de la Enfermedad/métodos , Control de Mosquitos/métodos , Animales , Política de Salud , Investigación BiomédicaRESUMEN
The hepatitis C virus (HCV) continues to pose a significant public health challenge in Iran, mirroring a worldwide concern. This situation calls for a cohesive strategy that aligns with the World Health Organization's (WHO) goals for HCV elimination by 2030. Central to this strategy is targeting high-risk groups, notably people who inject drugs and prisoners, with prevention, screening and treatment. The deployment of point-of-care testing and treatments in prisons and harm reduction facilities is vital. The adoption of cost-effective generic direct-acting antivirals represents a major step forward. Furthermore, innovative educational initiatives for healthcare providers and awareness campaigns for the public are critical. Additionally, tackling stigma, ensuring treatment affordability and upholding strict surveillance and data management, coupled with ongoing policy reviews, are vital components. This comprehensive and integrated approach is designed to drive Iran towards eliminating HCV and can serve as a blueprint for other countries with similar challenges.
Asunto(s)
Erradicación de la Enfermedad , Hepatitis C , Humanos , Irán/epidemiología , Erradicación de la Enfermedad/métodos , Erradicación de la Enfermedad/organización & administración , Hepatitis C/prevención & control , Hepatitis C/epidemiología , Antivirales/uso terapéutico , Hepacivirus , Tamizaje MasivoRESUMEN
BACKGROUND: The biological characteristics of mosquito vectors vary, impacting their response to control measures. Thus, having up-to-date information on vector bionomics is essential to maintain the effectiveness of existing control strategies and tools, particularly as India aims for malaria elimination by 2030. OBJECTIVE: This study aims to assess the proportions of vector species resting indoors and outdoors, determine their preference for host biting/feeding, identify transmission sites, and evaluate the susceptibility of vectors to insecticides used in public health programs. METHODS: Mosquito collections were conducted in 13 districts across 8 Indian states from 2017 to 2020 using various methods to estimate their densities. Following morphological identification in the field, sibling species of Anopheles mosquitoes were identified molecularly using polymerase chain reaction (PCR)-specific alleles. Plasmodium falciparum and Plasmodium vivax infections in the vectors were detected using enzyme-linked immunosorbent assay (ELISA) and PCR assays. In addition, we assessed the insecticide susceptibility status of primary malaria vectors following the World Health Organization (WHO) protocol. RESULTS: Anopheles culicifacies, a primary malaria vector, was collected (with a man-hour density ranging from 3.1 to 15.9) from all states of India except those in the northeastern region. Anopheles fluviatilis, another primary vector, was collected from the states of Madhya Pradesh, Maharashtra, Karnataka, and Odisha. In Haryana and Karnataka, An. culicifacies sibling species A predominated, whereas species C and E were predominant in Madhya Pradesh and Maharashtra. An. culicifacies displayed mainly endophilic behavior across all states, except in Madhya Pradesh, where the proportion of semigravid and gravid mosquitoes was nearly half of that of unfed mosquitoes. The human blood index of An. culicifacies ranged from 0.001 to 0.220 across all study sites. The sporozoite rate of An. culicifacies ranged from 0.06 to 4.24, except in Madhya Pradesh, where none of the vector mosquitoes were found to be infected with the Plasmodium parasite. In the study area, An. culicifacies exhibited resistance to DDT (dichlorodiphenyltrichloroethane; with <39% mortality). Moreover, it showed resistance to malathion (with mortality rates ranging from 49% to 78%) in all districts except Angul in Odisha and Palwal in Haryana. In addition, resistance to deltamethrin was observed in districts of Maharashtra, Gujarat, Haryana, and Karnataka. CONCLUSIONS: Our study offers vital insights into the prevalence, resting behavior, and sibling species composition of malaria vectors in India. It is evident from our findings that resistance development in An. culicifacies, the primary vector, to synthetic pyrethroids is on the rise in the country. Furthermore, the results of our study suggest a potential change in the resting behavior of An. culicifacies in Madhya Pradesh, although further studies are required to confirm this shift definitively. These findings are essential for the development of effective vector control strategies in India, aligning with the goal of malaria elimination by 2030.