ABSTRACT
BACKGROUND: The effects of a diverse spectrum of malaria interventions were evaluated through a deterministic Plasmodium vivax transmission model. This approach aimed to provide theoretical evidence of the performance of these interventions once implemented for achieving malaria elimination. METHODS: An integrated intervention portfolio, including mass drug administration, insecticide treatment, and untreated bed nets, was analyzed through modeling. Additionally, data-driven calibration was implemented to infer coverages that effectively reproduced historical malaria patterns in China from 1971 to 1983. RESULTS: MDA utilizing primaquine emerged as the most effective single intervention, achieving a 70% reduction in malaria incidence when implemented at full coverage. Furthermore, a strategic combination of MDA with primaquine, chloroquine, untreated bed nets, and seasonal insecticide treatments effectively eradicated malaria, attaining elimination at a coverage level of 70%. It was conclusively demonstrated that an integrated approach combining MDA and vector control measures is essential for the successful elimination of malaria. CONCLUSION: High coverage of mass drug administration with primaquine and chloroquine before transmission was the key driver of the malaria decline in China from 1971 to 1983. The best-fit intervention coverage combinations derived from calibration are provided as a reference for malaria control in other countries.
Subject(s)
Antimalarials , Malaria, Vivax , Malaria, Vivax/prevention & control , Malaria, Vivax/epidemiology , China/epidemiology , Humans , Antimalarials/therapeutic use , Plasmodium vivax/drug effects , Primaquine/therapeutic use , Mass Drug Administration , Chloroquine/therapeutic use , Mosquito Control/methodsABSTRACT
Diabetic kidney disease is one of the most severe chronic microvascular complications of diabetes and a primary cause of end-stage renal disease. Clinical studies have shown that renal inflammation is a key factor determining kidney damage during diabetes. With the development of immunological technology, many studies have shown that diabetic nephropathy is an immune complex disease, and that most patients have immune dysfunction. However, the immune response associated with diabetic nephropathy and autoimmune kidney disease, or caused by ischemia or infection with acute renal injury, is different, and has a com-plicated pathological mechanism. In this review, we discuss the pathogenesis of diabetic nephropathy in immune disorders and the intervention mechanism, to provide guidance and advice for early intervention and treatment of diabetic nephropathy.
ABSTRACT
Although, from a therapeutic standpoint, breast cancer (BC) is considerably well-characterized, it still leaves puzzling spots. The Her-2+/PR+/ER+ BC can benefit from the mainstays of anticancer therapy and immunotherapy and overall have a better prognosis. Triple-negative BC, due to the concomitant absence of Her-2/PR/ER receptors, is more challenging and necessitates different strategies. It has been learned that the mainstay anti-BC therapies were initially designed to demolish as many cancer cells as they possibly could. However, the number of reports on the adverse effects of these mainstay therapies has recently been increasing. It underpins efforts to reshape such therapies into much better and safer forms over time. Moreover, some current findings on the molecular markers, which are target-potential, have also shifted the paradigm from radical-to-local-yet-precise-approach to meet the need for a therapy platform that is less cytotoxic to normal cells yet efficiently kills cancer cells.
Subject(s)
Breast Neoplasms , Humans , Female , Breast Neoplasms/therapy , Immunotherapy/methods , Receptor, ErbB-2/metabolism , Triple Negative Breast Neoplasms/therapy , Triple Negative Breast Neoplasms/drug therapy , Antineoplastic Agents/therapeutic useABSTRACT
Panic buying poses significant challenges for individuals and societies. This paper provides a literature review on the process by which a pandemic crisis evolves into panic buying behavior. The review offers a comprehensive perspective on studies related to panic buying and mitigation efforts, categorizing them based on their contributions in three stages: factors influencing panic buying, the process of transforming panic into increased demand and stockpiling, and applicable intervention strategies to mitigate panic situations. The paper introduces the Socio-Economic Framework of Panic (SEFP) to illustrate the interaction between demand and supply during a panic. The review identifies a lack of quantitative models explicitly correlating influencing factors with panic and estimating panic demand. Additionally, it reveals that suggested intervention strategies often lack practical implementation guidelines. Using the SEFP, the importance of considering interventions at various stages is highlighted, ranging from controlling influencing factors and panic demands to overseeing stockpiling and supply-related activities. The paper also identifies research gaps in both qualitative and quantitative modeling, policymaking, and governance.
ABSTRACT
With the improvement of living quality, people pay more and more attention to vitamin supplements. The vitamins in the daily diet can meet the needs of the body. Whether additional vitamin supplementation is necessary still needs to be further explored. Many studies have reported that vitamin deficiency and excessive vitamin supplementation could lead to abnormal development in the body or increase the risk of diseases. Here, we summarize the abnormal levels of vitamins can cause the homeostasis imbalance of hypothalamus-pituitary-adrenal (HPA) axis by affecting its development and function. It can lead to abnormal synthesis and secretion of glucocorticoid in the body, which mediates the occurrence and development of metabolic diseases and psychoneurotic diseases. In addition, vitamin has a strong antioxidant effect, which can eliminate oxygen free radicals. Thereby, vitamins can alter HPA axis function and homeostasis maintenance by combating oxidative stress. This review provides a theoretical basis for clarifying the role of abnormal levels of vitamin in the occurrence and development of multiple diseases and its intervention strategy, and also provides reference value and guiding significance for rational use of vitamins.
Subject(s)
Hypothalamo-Hypophyseal System , Vitamins , Humans , Hypothalamo-Hypophyseal System/metabolism , Pituitary-Adrenal System/metabolism , Antioxidants/metabolism , Vitamin A , HomeostasisABSTRACT
Sexual harassment in universities harms the physical and psychological health and development of students. Although Chinese universities are required to implement sexual harassment interventions, few studies have estimated how well interventions are perceived by students and the association with their perceptions and attitudes toward sexual harassment. This study aims to examine the perceptions and attitudes toward sexual harassment and perceived sexual harassment interventions among university students. Further, it evaluated the association between sexual harassment interventions and sexual harassment perceptions and attitudes among university students and explored potential gender differences in the observed associations. We categorized sexual harassment interventions into three types of strategies (informal education activities, prevention mechanisms, and multiformat publicity) and designed an 8-item scale for sexual harassment perception and a 10-item scale for sexual harassment attitude. A total of 872 students were recruited from six universities in Beijing, China. Association between intervention strategies and sexual harassment perceptions and attitudes was analyzed using multiple linear regression. The results showed that 78.56% of the university students recognized all sexual harassment behaviors, and 11.58% felt angry about all sexual harassment behaviors. Male students felt angrier at same-sex harassment than female students (p < .001). Overall, the students were aware of approximately 3 of the 13 sexual harassment interventions. None of the three intervention strategies was significantly associated with perceptions of sexual harassment (p > .050). The attitude toward sexual harassment was positively associated with informal education activities (coeff = 0.055, p = .015) and multiformat publicity (coeff = 0.077, p = .030) among female students, and negatively associated with prevention mechanisms (coeff = -0.123, p = .033) among male students. Our findings imply that sexual harassment interventions are not well known among university students. Universities should develop and propagate more sexual harassment informal education activities and multiformat publicity intervention strategies and pay more attention to gender differences in intervention strategies.
Subject(s)
Sexual Harassment , Humans , Male , Female , Sexual Harassment/psychology , Universities , Beijing , Surveys and Questionnaires , Attitude , Students , PerceptionABSTRACT
In this paper, the study presented is designed to gain a deeper insight into how adolescents describe, understand, and suggest dealing with Problematic Internet Use (PIU). Eight focus groups were activated with a total of 70 students from the 9th and 11th grades (Mean Age = 15.53 ± 1.202; Female = 44.4%) in four different schools in Southern Italy. A Thematic Analysis was applied to the verbatim transcripts, and seven macro-categories were identified throughout the discourses collected: definition of PIU, symptomatology, impact, determinants, intervention strategy, opportunities and limits of the digital world, and needs that adolescents try to satisfy by surfing the net and which the offline world does not fulfill. Participants converge in seeing PIU in terms of addiction but adopt heterogeneous viewpoints in talking about the reasons for problematic engagement and possible preventive intervention strategies. In the overall picture emerging from the responses, PIU appeared to be the outcome of a psychological dynamic emerging from the interaction of individual, interpersonal, and sociocultural dimensions.
Subject(s)
Adolescent Behavior , Behavior, Addictive , Humans , Adolescent , Female , Focus Groups , Internet Use , Adolescent Behavior/psychology , Students/psychology , Schools , Behavior, Addictive/psychology , InternetABSTRACT
BACKGROUND: Water, sanitation, and hygiene (WASH) play a pivotal role in controlling typhoid fever, as it is primarily transmitted through oral-fecal pathways. Given our constrained resources, staying current with the most recent research is crucial. This ensures we remain informed about practical insights regarding effective typhoid fever control strategies across various WASH components. We conducted a systematic review and meta-analysis of case-control studies to estimate the associations of water, sanitation, and hygiene exposures with typhoid fever. METHODS: We updated the previous review conducted by Brockett et al. We included new findings published between June 2018 and October 2022 in Web of Science, Embase, and PubMed. We used the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool for risk of bias (ROB) assessment. We classified WASH exposures according to the classification provided by the WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation, and Hygiene (JMP) update in 2015. We conducted the meta-analyses by only including studies that did not have a critical ROB in both Bayesian and frequentist random-effects models. RESULTS: We identified 8 new studies and analyzed 27 studies in total. Our analyses showed that while the general insights on the protective (or harmful) impact of improved (or unimproved) WASH remain the same, the pooled estimates of OR differed. Pooled estimates of limited hygiene (OR = 2.26, 95% CrI: 1.38 to 3.64), untreated water (OR = 1.96, 95% CrI: 1.28 to 3.27) and surface water (OR = 2.14, 95% CrI: 1.03 to 4.06) showed 3% increase, 18% decrease, and 16% increase, respectively, from the existing estimates. On the other hand, improved WASH reduced the odds of typhoid fever with pooled estimates for improved water source (OR = 0.54, 95% CrI: 0.31 to 1.08), basic hygiene (OR = 0.6, 95% CrI: 0.38 to 0.97) and treated water (OR = 0.54, 95% CrI: 0.36 to 0.8) showing 26% decrease, 15% increase, and 8% decrease, respectively, from the existing estimates. CONCLUSIONS: The updated pooled estimates of ORs for the association of WASH with typhoid fever showed clear changes from the existing estimates. Our study affirms that relatively low-cost WASH strategies such as basic hygiene or water treatment can be an effective tool to provide protection against typhoid fever in addition to other resource-intensive ways to improve WASH. TRIAL REGISTRATION: PROSPERO 2021 CRD42021271881.
Subject(s)
Sanitation , Typhoid Fever , Humans , Bayes Theorem , Typhoid Fever/epidemiology , Typhoid Fever/prevention & control , Case-Control Studies , HygieneABSTRACT
To maintain the body's regular immune system, CD4+ T cell homeostasis is crucial, particularly T helper (Th1, Th17) cells and T regulatory (Treg) cells. Abnormally differentiated peripheral CD4+ T cells are responsible for the occurrence and development of numerous diseases, including autoimmune diseases, transplantation rejection, and irritability. Searching for an effective interventional approach to control this abnormal differentiation is therefore especially important. As immunometabolism progressed, the inherent metabolic factors underlying the immune cell differentiation have gradually come to light. Mounting number of studies have revealed that glutaminolysis plays an indelible role in the differentiation of CD4+ T cells. Besides, alterations in the glutaminolysis can also lead to changes in the fate of peripheral CD4+ T cells. All of this indicate that the glutaminolysis pathway has excellent potential for interventional regulation of CD4+ T cells differentiation. Here, we summarized the process by which glutaminolysis regulates the fate of CD4+ T cells during differentiation and further investigated how to reshape abnormal CD4+ T cell differentiation by targeting glutaminolysis.
Subject(s)
Autoimmune Diseases , T-Lymphocytes, Regulatory , Humans , Cell Differentiation , Lymphocyte Activation , Graft RejectionABSTRACT
The developing world has been facing a significant health issue due to cholera as an endemic communicable disease. Lusaka was Zambia's worst affected province, with 5414 reported cases of cholera during the outbreak from late October 2017 to May 12, 2018. To explore the epidemiological characteristics associated with the outbreak, we fitted weekly reported cholera cases with a compartmental disease model that incorporates two transmission routes, namely environment-to-human and human-to-human. Estimates of the basic reproduction number show that both transmission modes contributed almost equally during the first wave. In contrast, the environment-to-human transmission appears to be mostly dominating factor for the second wave. Our study finds that a massive abundance of environmental vibrio's with a huge reduction in water sanitation efficacy triggered the secondary wave. To estimate the expected time to extinction (ETE) of cholera, we formulate the stochastic version of our model and find that cholera can last up to 6.5-7 years in Lusaka if any further outbreak occurs at a later time. Results indicate that a considerable amount of attention is to be paid to sanitation and vaccination programs in order to reduce the severity of the disease and to eradicate cholera from the community in Lusaka.
Subject(s)
Cholera , Humans , Cholera/epidemiology , Cholera/prevention & control , Zambia/epidemiology , Mathematical Concepts , Models, Biological , Disease OutbreaksABSTRACT
Frequent emergence of communicable diseases is a major concern worldwide. Lack of sufficient resources to mitigate the disease burden makes the situation even more challenging for lower-income countries. Hence, strategy development for disease eradication and optimal management of the social and economic burden has garnered a lot of attention in recent years. In this context, we quantify the optimal fraction of resources that can be allocated to two major intervention measures, namely reduction of disease transmission and improvement of healthcare infrastructure. Our results demonstrate that the effectiveness of each of the interventions has a significant impact on the optimal resource allocation in both long-term disease dynamics and outbreak scenarios. The optimal allocation strategy for long-term dynamics exhibits non-monotonic behaviour with respect to the effectiveness of interventions, which differs from the more intuitive strategy recommended in the case of outbreaks. Further, our results indicate that the relationship between investment in interventions and the corresponding increase in patient recovery rate or decrease in disease transmission rate plays a decisive role in determining optimal strategies. Intervention programmes with decreasing returns promote the necessity for resource sharing. Our study provides fundamental insights into determining the best response strategy when controlling epidemics in resource-constrained situations.
Subject(s)
Communicable Diseases , Epidemics , Humans , Epidemics/prevention & control , Communicable Diseases/epidemiology , Disease Outbreaks/prevention & control , Resource AllocationABSTRACT
The COVID-19 pandemic has threatened public health and caused substantial economic loss to most countries worldwide. A multigroup susceptible-exposed-asymptomatic-infectious-hospitalized-recovered-dead (SEAIHRD) compartment model is first constructed to model the spread of the disease by dividing the population into three age groups: young (aged 0-19), prime (aged 20-64), and elderly (aged 65 and over). Then, we develop a free terminal time, partially fixed terminal state optimal control problem to minimize deaths and costs associated with hospitalization and the implementation of different control strategies. And the optimal strategies are derived under different assumptions about medical resources and vaccination. Specifically, we explore optimal control strategies for reaching herd immunity in the COVID-19 outbreak in a free terminal time situation to evaluate the effect of nonpharmaceutical interventions (NPIs) and vaccination as control measures. The transmission rate of SARS-CoV-2 is calibrated by using real data in the United States at the early stage of the epidemic. Through numerical simulation, we conclude that the outbreak of COVID-19 can be contained by implementing appropriate control of the prime age population and relatively strict control measures for young and elderly populations. Within a specific period, strict control measures should be implemented before the vaccine is marketed.
Subject(s)
COVID-19 , Aged , Humans , SARS-CoV-2 , Pandemics/prevention & control , Computer Simulation , Public HealthABSTRACT
Havoc, brutality, economic breakdown, and vulnerability are the terms that can be rightly associated with COVID-19, for the kind of impact it is having on the whole world for the last two years. COVID-19 came as a nightmare and it is still not over yet, changing its form factor with each mutation. Moreover, each unpredictable mutation causes more severeness. In the present article, we outline a decision support algorithm using Generalized Trapezoidal Intuitionistic Fuzzy Numbers (GTrIFNs) to deal with various facets of COVID-19 problems. Intuitionistic fuzzy sets (IFSs) and their continuous counterparts, viz., the intuitionistic fuzzy numbers (IFNs), have the flexibility and effectiveness to handle the uncertainty and fuzziness associated with real-world problems. Although a meticulous amount of research works can be found in the literature, a wide majority of them are based mainly on normalized IFNs rather than the more generalized approach, and most of them had several limitations. Therefore, we have made a sincere attempt to devise a novel Similarity Measure (SM) which considers the evaluation of two prominent features of GTrIFNs, which are their expected values and variances. Then, to establish the superiority of our approach we present a comparative analysis of our method with several other established similarity methods considering ten different profiles of GTrIFNs. The proposed SM is then validated for feasibility and applicability, by elaborating a Fuzzy Multicriteria Group Decision Making (FMCGDM) algorithm and it is supportedby a suitable illustrative example. Finally, the proposed SM approach is applied to tackle some significant concerns due to COVID-19. For instance, problems like the selection of best medicine for COVID-19 infected patients; proper healthcare waste disposal technique; and topmost government intervention measures to prevent the COVID-19 spread, are some of the burning issues which are handled with our newly proposed SM approach.
ABSTRACT
BACKGROUND: Sexual dysfunction (SD) is a frequent non-motor symptom in Parkinson's disease (PD) that is rarely addressed, and sexual counseling is sporadic. OBJECTIVES: To investigate PD patients' SD and sexual counseling motivation and to propose an interventional strategy for movement disorder specialists. METHODS: All consecutive PD patients who presented to a movement disorder unit between 2018 and 2019 completed anonymous questionnaires containing the Female Sexual Function Index, the International Index of Erectile Function, and a questionnaire on sexual needs and motivation to receive sexual counseling. RESULTS: The age range of the 100 recruited patients (78 men) was 40-80 years, and the mean disease duration was 8.64 ± 6.84 years. SD appeared at all PD stages. The presence of SD pre-PD diagnosis significantly predicted SD post-diagnosis in men. Erectile dysfunction was the most common male SD (70%). Women reported frequent SD before PD diagnosis and currently. More than half of the responders (74% of the men and 40% of the women) were motivated to receive sexual counseling. Most of them (77.4%) were in a relationship. CONCLUSIONS: The findings of this analysis revealed that most PD patients had experienced SD before being diagnosed with PD and were interested in receiving sexual counseling. We propose a six-step intervention strategy for the management of SD in PD designed for application in a movement disorder unit. We also recommend that neurologists and other healthcare providers undergo training to provide basic sexual counseling tailored to the needs of PD patients.
Subject(s)
Mental Disorders , Parkinson Disease , Sexual Dysfunction, Physiological , Humans , Male , Female , Aged, 80 and over , Sexual Behavior , Sexual Dysfunction, Physiological/etiology , Sexual Dysfunction, Physiological/therapy , Motivation , Surveys and QuestionnairesABSTRACT
Objective:To investigate the influencing factors of anxiety and depression in patients with secondary lower extremity deep venous thrombosis (LEDVT) after radical cervical cancer surgery.Methods:Retrospective analysis method was used, a total of 92 patients with anxiety and/or depression secondary to LEDVT after radical cervical cancer surgery admitted to the People′s Hospital of Xinjiang Uygur Autonomous Region from June 2019 to June 2022 were included as the observation group, according to the presence of anxiety or depression, they were divided into anxiety group (65 cases) and depression group (58 cases) (some patients had both anxiety and depression). Another 90 patients who did not have anxiety or depression after radical cervical cancer surgery with secondary LEDVT were selected as the control group in the same period. The questionnaires of clinical data and disease cognition were designed to investigate the clinical data and disease cognition of patients, social support rating scale (SSRS) was used to assess the level of social support of patients, and univariate analysis was performed to identify the influencing factors of depression and anxiety in patients with secondary LEDVT after radical cervical cancer surgery.Results:The percentage of patients with self-pay, no children, unemployed or jobless, monthly family income <5 000 CNY, less social support, and disease awareness <80 scores in the anxiety group and depression group (36.92%, 67.69%, 69.23%, 66.15%, 46.15%, 70.77% and 34.48%, 68.97%, 72.41%, 65.52%, 44.83%, 68.97%) were higher than the control group (14.44%, 40.00%, 33.33%, 32.22%, 11.11%, 23.33%) (all P<0.01). The percentage of mixed thrombus, central thrombus, peripheral thrombus, bilateral thrombus, right thrombus, and left thrombus in the anxiety group and depression group (30.77%, 20.00%, 49.23%, 16.92%, 35.38%, 47.69% and 32.76%, 15.52%, 51.72%, 12.07%, 37.93%, 50.00%) were not significantly different from those in the control group (32.22%, 17.78%, 50.00%, 10.00%, 36.67%, 53.33%) (all P>0.05). Univariate analysis showed that self-pay, unemployed or jobless, no children, monthly family income <5 000 CNY, less social support, and disease awareness <80 scores were correlated with depression and anxiety status in patients with secondary LEDVT after radical cervical cancer surgery (all P<0.01). Conclusion:Depression and anxiety in patients with secondary LEDVT after radical cervical cancer surgery are related to self-pay, unemployed or jobless, no children, low monthly family income, less social support, and low disease awareness.
ABSTRACT
Objective:To explore the effect of patient engagement on medication safety for patients with chronic disease through a systematic review.Methods:Relevant randomized controlled trials of patient engagement on medication safety were searched from PubMed, EMBASE, The Cochrane Library, CNKI, Wanfang and VIP database. The literature was screened according to inclusion and exclusion criteria, and data extraction and literature quality evaluation was conducted on the selected literature.Results:A total of 15 eligible studies was included. Most of the studies occurred in outpatient and home settings, and the subjects were patients with chronic diseases. Patient engagement strategies can be divided into three categories: (1) patient engagement in medical decision-making; (2) patient engagement in medication adjustment; (3) patient engagement in medication management. The outcomes of medication safety included medication adherence, medication knowledge, medication beliefs, adverse events and medication errors. Intervention strategies for patients to actively engage in medication safety significantly improved patients′ medication knowledge and beliefs, but did not improve medication adherence of patients.Conclusion:Promoting patient active engagement is an effective intervention measure to improve patients ′ perception of medication safety. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
ABSTRACT
Lipid-based nanocarrier is a classic drug delivery system with great biocompatibility and biodegradability. It can effectively reduce the toxicity of anti-tumor and anti-infective drugs in clinical practice. However, it has not yet met the clinical demand for enhanced therapeutic efficacy, and the clinical application is still very limited. The complex in vivo delivery process of lipid-based nanomedicine and the reciprocal interactions with body lead to unexpected changes in in vivo performance of nanomedicine and seriously hinder clinical translation. Therefore, the in-depth study of the relationships among intrinsic properties of lipid-based nanomedicine, the in vivo delivery process, and the regulatory mechanisms will not only provide guidance for the rational design of nanocarriers, but also promote the clinical translation and precision medicine of new lipid-based nanomedicine. In this review, we summarize the in vivo delivery process, regulating factors and intervention strategies for the in vivo delivery of lipid-based nanomedicine.
ABSTRACT
Feasible interventions addressing unhealthy changes in energy balance-related behavior (EBRB) during pregnancy and early postpartum are needed. This study identified the needs and wishes of expecting and first-time parents concerning EBRB interventions during the transition to parenthood. Thirteen focus group discussions (n = 74) were conducted. Couples provided information about whether an intervention targeting unhealthy EBRB changes during pregnancy and postpartum would be acceptable, how such an intervention should look like, and in which way and during which period they needed support. Guided by the TiDIER checklist, all quotes were divided into five main categories (i.e., 'what', 'how', 'when and how much', 'where', 'for and from whom'). Interventions should aim for changes at the individual, social, environmental and policy levels. The accessibility and approach (indirect or face-to-face) together with communicational aspects should be taken into account. A focus should go to delivering reliable and personalized information and improving self-regulation skills. Interventions should be couple- or family-based. Authorities, healthcare professionals, the partner and peers are important sources for intervention delivery and support. In the prevention of unhealthy EBRB changes around childbirth, the involvement of both parents is needed, while health care professionals play an important role in providing personalized advice.
Subject(s)
Energy Metabolism , Parents , Female , Focus Groups , Humans , Peer Group , Postpartum Period , PregnancyABSTRACT
BACKGROUND: Tuberculosis (TB) has a serious impact on people's health. China is one of 30 countries that has a high TB burden. As the currently decreasing speed of the incidence of TB, the WHO's goal of "End TB Strategy" is hard to achieve by 2035. As a result, a SEIR model that determines the impact of different tuberculosis preventive treatments (TPTs) in different age groups, and the effect of different interventions on latent TB infections (LTBIs) in China is developed. METHODS: A Susceptible-Exposed-Infectious-Recovered (SEIR) model was established. Goodness-of-fit tests were used to assess model performance. Predictive analysis was used to assess the effect of different interventions on LTBIs and achieving the goals of the "End TB Strategy". RESULTS: The Chi-square test indicated the model provided a good statistical fit to previous data on the incidence of TB (χ2 = 0.3085, p > 0.999). The 1HP treatment regimen (daily rifapentine + isoniazid for 4 weeks) was most effective in reducing the number of TB cases by 2035. The model indicated that several strategies could achieve the 2035 target of the "End TB Strategy": completion of active case finding (ACF) for LTBI and TPT nation-wide within 5 years; completion of ACF for LTBIs and TPT within 2 years in high-incidence areas; completion of TPT in the elderly within 2 years; or introduction of a new vaccine in which the product of annual doses and vaccine efficiency in the three age groups above 14 years old reached 10.5 million. CONCLUSION: The incidence of TB in China declined gradually from 2005 to 2019. Implementation of ACF for LTBIs and TPT nation-wide or in areas with high incidence, in the elderly, or administration of a new and effective vaccine could greatly reduce the number of TB cases and achieve the 2035 target of the "End TB Strategy" in China.
Subject(s)
Latent Tuberculosis , Tuberculosis , Adolescent , Aged , Antitubercular Agents/therapeutic use , China/epidemiology , Humans , Incidence , Isoniazid/therapeutic use , Latent Tuberculosis/drug therapy , Latent Tuberculosis/epidemiology , Latent Tuberculosis/prevention & control , Tuberculosis/drug therapy , Tuberculosis/epidemiology , Tuberculosis/prevention & controlABSTRACT
Diminishing Campylobacter prevalence in poultry flocks has proven to be extremely challenging. To date, efficacious control measures to reduce Campylobacter prevalence are still missing. A potential approach to control Campylobacter in modern poultry productions is to occupy its niche in the mucosal layer by administering live intestinal microbiota from adult chickens to dayold-chicks (competitive exclusion (CE)). Therefore, this in vivo study investigates the efficacy of a complex CE culture to reduce Campylobacter (C.) jejuni colonization in broiler chickens. For this purpose, the complex CE culture was applied twice: once by spray application to day-old chicks immediately after hatching (on the 1st day of life) and subsequently by an additional application via drinking water on the 25th day of life. We observed a consistent and statistically significant reduction of C. jejuni counts in cloacal swabs throughout the entire fattening period. At the end of the trial after necropsy (at 33 days of age), C. jejuni cecal counts also showed a statistically significant decrease of 1 log10 MPN/g compared to the control group. Likewise, colon counts were reduced by 2.0 log10 MPN/g. These results suggest that CE cultures can be considered a practically relevant control strategy to reduce C. jejuni colonization in broiler chickens on poultry farms.