Community-based symptom reporting among agro-pastoralists and their livestock in Chad in a One Health approach.

One Health Syndromic Surveillance has a high potential for detecting early epidemiological events in remote and hard-to-reach populations. Chadian pastoralists living close to their animals and being socio-economically unprivileged have an increased risk for zoonosis exposure. Engaging communities in disease surveillance could also strengthen preparedness capacities for outbreaks in rural Chad. This study describes a retrospective cross-sectional survey that collected data on clinical symptoms reported in people and livestock in Chadian agro-pastoral communities. In January-February 2018, interviews were conducted in rural households living in nomadic camps or settled villages in the Yao and Danamadji health districts. The questionnaire covered demographic data and symptoms reported in humans and animals for the hot, wet, and cold seasons over the last 12 months. Incidence rates of human and animal symptoms were comparatively analyzed at the household level. Ninety-two households with a homogeneous socio-demographic distribution were included. We observed cough and diarrhea as the most frequent symptoms reported simultaneously in humans and animals. In all species, the incidence rate of cough was significantly higher during the cold season, and diarrhea tended to occur more frequently during the wet season. However, the incidence rate of cough and diarrhea in animals did not predict the incidence rate of these symptoms in humans. Overall, the variations in reported symptoms were consistent with known seasonal, regional, and sociological influences on endemic diseases. Our retrospective study demonstrated the feasibility of collecting relevant health data in humans and animals in remote regions with low access to health services by actively involving community members. This encourages establishing real-time community-based syndromic surveillance in areas such as rural Chad.

Clinical efficacy and pharmacokinetics of antimony in cutaneous leishmaniasis patients treated with sodium stibogluconate.

The efficacy and pharmacokinetics of antimony were explored in 12 young male patients with cutaneous leishmaniasis following intramuscular administration of sodium stibogluconate equivalent to 600 mg of antimony (Sb). Patients' cure rate was evaluated up to 6 weeks after treatment. Blood samples were collected at different time periods on the first and last days of a 3-week treatment. Twenty-four-hour urine samples were also collected on both occasions for the estimation of renal clearance (CL(r)). The blood concentrations of the Sb time profile were best described by a 2-compartment model with a first-order absorption rate. The mean absorption half-life was 0.21 ± 0.023 and 0.36 ± 0.18 hours for the first and last doses, respectively. A rapid distribution phase was followed by a slower elimination phase of a half-life of 9.4 ± 1.9 and 9.69 ± 2.3 hours for both days, respectively. An accumulation index of 2.33 was calculated. The fraction of dose excreted in urine was 0.386 ± 0.11 and 0.326 ± 0.05 on both occasions, respectively. The mean CL(r) was 4.88 ± 1.13 and 4.58 ± 1.05 L/h. In the current study, all of the patients were completely healed by week 6 after the end of treatment, as judged by the treating physician. In conclusion, the blood profile of antimony seems to be multicompartmental in nature.