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1.
Parasitol Res ; 119(7): 2237-2244, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32451718

RESUMEN

Ecological data on marine mammal parasites represent an excellent opportunity to expand our understanding of host-parasite systems. In this study, we used a dataset of intestinal helminth parasites on 167 long-finned pilot whales Globicephala melas (Traill, 1809) from seven localities in the Faroe Islands to evaluate the extent to which the host's age and sex influence the occurrence, richness, and nested pattern of helminth parasites and the importance of individual hosts to the helminth community. We found positive effects of age on both the occurrence and richness of helminths. Older host individuals showed an ordered accumulation of parasites, as evidenced by the nested pattern in their composition. Males had a higher occurrence of parasites than females, but the richness of helminths did not differ between sexes. Our findings suggest that differences in host-parasite interactions in long-finned pilot whales result mainly from age-structured variations in biological and behavioral characteristics.


Asunto(s)
Helmintiasis/epidemiología , Helmintos/aislamiento & purificación , Interacciones Huésped-Parásitos/fisiología , Calderón/parasitología , Distribución por Edad , Factores de Edad , Animales , Dinamarca/epidemiología , Femenino , Humanos , Intestinos/parasitología , Masculino , Factores Sexuales
2.
PLoS Pathog ; 16(5): e1008508, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32407385

RESUMEN

Parasitic helminths have coevolved with humans over millennia, intricately refining and developing an array of mechanisms to suppress or skew the host's immune system, thereby promoting their long-term survival. Some helminths, such as hookworms, cause little to no overt pathology when present in modest numbers and may even confer benefits to their human host. To exploit this evolutionary phenomenon, clinical trials of human helminth infection have been established and assessed for safety and efficacy for a range of immune dysfunction diseases and have yielded mixed outcomes. Studies of live helminth therapy in mice and larger animals have convincingly shown that helminths and their excretory/secretory products possess anti-inflammatory drug-like properties and represent an untapped pharmacopeia. These anti-inflammatory moieties include extracellular vesicles, proteins, glycans, post-translational modifications, and various metabolites. Although the concept of helminth-inspired therapies holds promise, it also presents a challenge to the drug development community, which is generally unfamiliar with foreign biologics that do not behave like antibodies. Identification and characterization of helminth molecules and vesicles and the molecular pathways they target in the host present a unique opportunity to develop tailored drugs inspired by nature that are efficacious, safe, and have minimal immunogenicity. Even so, much work remains to mine and assess this out-of-the-box therapeutic modality. Industry-based organizations need to consider long-haul investments aimed at unraveling and exploiting unique and differentiated mechanisms of action as opposed to toe-dipping entries with an eye on rapid and profitable turnarounds.


Asunto(s)
Proteínas del Helminto/inmunología , Helmintiasis/inmunología , Helmintos/inmunología , Inmunomodulación , Animales , Helmintiasis/patología , Helmintiasis/terapia , Helmintos/patogenicidad , Humanos
3.
BMC Infect Dis ; 20(1): 350, 2020 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-32414337

RESUMEN

BACKGROUND: Pediatric diarrhea caused by a range of pathogens, including intestinal parasites, is one of main causes of death among children under 5 years of age. The distribution of these parasitic infections overlaps in many environmental, socioeconomic and epidemiological settings. Their distribution and prevalence varies from region to region. In the current study, we assess the prevalence of intestinal parasites among pediatric patients with syndromic diarrheal disease living in Franceville, Gabon. METHODS: A cross-sectional study conducted in the Amissa Bongo Regional Hospital and Chinese-Gabonese Friendship Hospital in Franceville, between November 2016 and August 2017, enrolled a total of 100 diarrheic children between 0 and 180 months of age. Parasite detection in stool samples was performed using molecular diagnostic by PCR. Difference in means were tested by Student's t test and ANOVA while principal component analysis was used to determine the correlation between parasite distributions and age groups. RESULTS: The overall prevalence of intestinal parasite infection was 61% (61/100). Hymenolepis sp and Cryptosporidium hominis/parvum were the most common parasites (31 and 19%, respectively), followed by Encephalitozoon intestinalis (15%), Trichuris trichiura (4%), Dientamoeba fragilis (4%), and Enterocytozoon bieneusi (2%). The polyparasitism rate was 19.7%, with 83.3% double and 16.7% triple infections. Protozoan infections (66.7%) were more prevalent than helminths infections (33.3%). Seasonal association of the circulation of intestinal parasite was statistically significant (p = 0.03). Correlations between different parasites was also observed. CONCLUSION: The prevalence of intestinal parasitic infections is highest in diarrheic pediatric children. The prevalence of parasitic infections indicates that protozoa and helminths are the most common parasites in the Franceville environment. This study reinforces the importance of routine examination of diarrheic stool samples for the diagnostic of intestinal parasites. Further analyses are required to better understand the local epidemiology and risk factors associated with the transmission of intestinal parasites in Franceville, Gabon. KEYSWORDS: diarrhea, children, intestinal parasitic infections, molecular diagnostic, Franceville, Gabon.


Asunto(s)
Diarrea/parasitología , Helmintiasis/epidemiología , Parasitosis Intestinales/epidemiología , Infecciones por Protozoos/epidemiología , Animales , Preescolar , Estudios Transversales , Criptosporidiosis/epidemiología , Criptosporidiosis/parasitología , Cryptosporidium/genética , Diarrea/epidemiología , Heces/parasitología , Femenino , Gabón/epidemiología , Humanos , Lactante , Masculino , Reacción en Cadena de la Polimerasa , Prevalencia , Infecciones por Protozoos/parasitología , Factores de Riesgo
4.
PLoS One ; 15(5): e0226586, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32421720

RESUMEN

It is vital to share details of concrete experiences of conducting a nationwide disease survey. By doing so, the global health community could adapt previous experiences to expand geographic mapping programs, eventually contributing to the development of disease control and elimination strategies. A nationwide survey of schistosomiasis and intestinal helminthiases was conducted from December 2016 to March 2017 in Sudan. We aimed to describe details of the key activities and cost components required for the nationwide survey. We investigated which activities were necessary to prepare and conduct a nationwide survey of schistosomiasis and intestinal helminthiases, and the types and amounts of transportation, personnel, survey equipment, and consumables that were required. In addition, we estimated financial and economic costs from the perspectives of the donor and the Ministry of Health. Cash expenditures incurred to implement the survey were defined as financial costs. For economic costs, we considered the true value for society as a whole, and this category therefore accounted for the costs of all goods and services used for the project, including those that were not sold in the market and therefore had no market price (e.g., time spent by head teachers and teachers). We organized costs into capital and recurrent items. We ran one-way sensitivity and probabilistic analyses using Monte-Carlo methods with 10,000 draws to examine the robustness of the primary analysis results. A total of USD 1,465,902 and USD 1,516,238 was incurred for the financial and economic costs, respectively. The key cost drivers of the nationwide survey were personnel and transportation, for both financial and economic costs. Personnel and transportation accounted for around 64% and 18% of financial costs, respectively. If a government finds a way to mobilize existing government officials with no additional payments using the health system already in place, the cost of a nationwide survey could be remarkably reduced.


Asunto(s)
Tracto Gastrointestinal/patología , Helmintiasis/economía , Parasitosis Intestinales/economía , Esquistosomiasis/economía , Femenino , Tracto Gastrointestinal/parasitología , Programas de Gobierno , Helmintiasis/epidemiología , Helmintiasis/parasitología , Humanos , Parasitosis Intestinales/epidemiología , Parasitosis Intestinales/parasitología , Masculino , Esquistosomiasis/epidemiología , Esquistosomiasis/parasitología , Sudán/epidemiología , Encuestas y Cuestionarios
6.
PLoS Negl Trop Dis ; 14(4): e0008087, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32330127

RESUMEN

There is growing interest in local elimination of soil-transmitted helminth (STH) infection in endemic settings. In such settings, highly sensitive diagnostics are needed to detect STH infection. We compared double-slide Kato-Katz, the most commonly used copromicroscopic detection method, to multi-parallel quantitative polymerase chain reaction (qPCR) in 2,799 stool samples from children aged 2-12 years in a setting in rural Bangladesh with predominantly low STH infection intensity. We estimated the sensitivity and specificity of each diagnostic using Bayesian latent class analysis. Compared to double-slide Kato-Katz, STH prevalence using qPCR was almost 3-fold higher for hookworm species and nearly 2-fold higher for Trichuris trichiura. Ascaris lumbricoides prevalence was lower using qPCR, and 26% of samples classified as A. lumbricoides positive by Kato-Katz were negative by qPCR. Amplicon sequencing of the 18S rDNA from 10 samples confirmed that A. lumbricoides was absent in samples classified as positive by Kato-Katz and negative by qPCR. The sensitivity of Kato-Katz was 49% for A. lumbricoides, 32% for hookworm, and 52% for T. trichiura; the sensitivity of qPCR was 79% for A. lumbricoides, 93% for hookworm, and 90% for T. trichiura. Specificity was ≥ 97% for both tests for all STH except for Kato-Katz for A. lumbricoides (specificity = 68%). There were moderate negative, monotonic correlations between qPCR cycle quantification values and eggs per gram quantified by Kato-Katz. While it is widely assumed that double-slide Kato-Katz has few false positives, our results indicate otherwise and highlight inherent limitations of the Kato-Katz technique. qPCR had higher sensitivity than Kato-Katz in this low intensity infection setting.


Asunto(s)
Helmintiasis/diagnóstico , Parasitosis Intestinales/diagnóstico , Técnicas Microbiológicas/métodos , Técnicas de Diagnóstico Molecular/métodos , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Ancylostomatoidea/aislamiento & purificación , Animales , Ascaris lumbricoides/aislamiento & purificación , Bangladesh , Niño , Preescolar , ADN de Helmintos/genética , ADN Ribosómico/genética , Heces/parasitología , Femenino , Humanos , Lactante , Masculino , ARN Ribosómico 18S/genética , Población Rural , Sensibilidad y Especificidad , Trichuris/aislamiento & purificación
7.
Adv Parasitol ; 108: 47-131, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32291086

RESUMEN

Intestinal helminths are extremely widespread and highly prevalent infections of humans, particularly in rural and poor urban areas of low and middle-income countries. These parasites have chronic and often insidious effects on human health and child development including abdominal problems, anaemia, stunting and wasting. Certain animals play a fundamental role in the transmission of many intestinal helminths to humans. However, the contribution of zoonotic transmission to the overall burden of human intestinal helminth infection and the relative importance of different animal reservoirs remains incomplete. Moreover, control programmes and transmission models for intestinal helminths often do not consider the role of zoonotic reservoirs of infection. Such reservoirs will become increasingly important as control is scaled up and there is a move towards interruption and even elimination of parasite transmission. With a focus on southeast Asia, and the Philippines in particular, this review summarises the major zoonotic intestinal helminths, risk factors for infection and highlights knowledge gaps related to their epidemiology and transmission. Various methodologies are discussed, including parasite genomics, mathematical modelling and socio-economic analysis, that could be employed to improve understanding of intestinal helminth spread, reservoir attribution and the burden associated with infection, as well as assess effectiveness of interventions. For sustainable control and ultimately elimination of intestinal helminths, there is a need to move beyond scheduled mass deworming and to consider animal and environmental reservoirs. A One Health approach to control of intestinal helminths is proposed, integrating interventions targeting humans, animals and the environment, including improved access to water, hygiene and sanitation. This will require coordination and collaboration across different sectors to achieve best health outcomes for all.


Asunto(s)
Helmintiasis/prevención & control , Helmintiasis/transmisión , Parasitosis Intestinales/prevención & control , Parasitosis Intestinales/transmisión , Zoonosis/prevención & control , Zoonosis/transmisión , Animales , Asia Sudoriental , Helmintiasis/parasitología , Helmintos/fisiología , Humanos , Parasitosis Intestinales/parasitología , Factores de Riesgo , Zoonosis/parasitología
8.
PLoS Negl Trop Dis ; 14(4): e0008258, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32310966

RESUMEN

Soil-transmitted helminthiases (STH) are one of 17 neglected tropical diseases (NTDs) earmarked for control or elimination by 2020 in the WHO's Roadmap on NTDs. Deworming programs for STH have thus far been focused on treating pre-school and school-aged children; however, there is a growing consensus that to achieve elimination of STH transmission, programs must also target adults, potentially through community-wide mass drug administration (MDA). There is currently a gap in the literature on what components are required to deliver community-wide MDA for STH in order to achieve high intervention reach and uptake. Nested within the TUMIKIA Project, a cluster randomized trial in Kenya evaluating the effectiveness of school-based deworming versus community-wide MDA, we collected qualitative data from program implementers and recipients in eight clusters where community-wide MDA was delivered. Data collection included semi-structured in-depth interviews (n = 72) and focus group discussions (n = 32). A conceptual framework for drug distribution was constructed to help build an analysis codebook. Case memos were developed for each top-level theme. Community-wide MDA for STH was perceived as a complex intervention with key administrative and social mobilization domains. Key actionable themes included: (1) developing an efficient strategy to allocate reasonable workload for implementers to cover all targeted households; (2) maximizing community drug distributors' motivation through promoting belief in the effectiveness of the intervention and providing sufficient financial incentives; (3) developing effective capacity building strategies for implementers; and (4) implementing a context-adapted community engagement strategy that leverages existing community structures and takes into consideration past community experiences of MDAs. Transitioning from STH control to elimination goals requires significant planning and action to ensure community-wide MDA is delivered with sufficient reach and uptake. We present findings that can inform national deworming programs to increase intervention delivery capacity.


Asunto(s)
Antihelmínticos/uso terapéutico , Control de Enfermedades Transmisibles/organización & administración , Transmisión de Enfermedad Infecciosa/prevención & control , Helmintiasis/tratamiento farmacológico , Helmintiasis/prevención & control , Administración Masiva de Medicamentos/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Erradicación de la Enfermedad/organización & administración , Femenino , Humanos , Entrevistas como Asunto , Kenia , Masculino , Persona de Mediana Edad , Enfermedades Desatendidas/tratamiento farmacológico , Enfermedades Desatendidas/prevención & control , Resultado del Tratamiento , Adulto Joven
9.
PLoS Negl Trop Dis ; 14(4): e0008185, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32267856

RESUMEN

Animal and human helminth infections are highly prevalent around the world, with only few anthelminthic drugs available. The anthelminthic drug performance is expressed by the cure rate and the egg reduction rate. However, which kind of mean should be used to calculate the egg reduction rate remains a controversial issue. We visualized the distributions of egg counts of different helminth species in 7 randomized controlled trials and asked a panel of experts about their opinion on the egg burden and drug efficacy of two different treatments. Simultaneously, we calculated infection intensities and egg reduction rates using different types of means: arithmetic, geometric, trimmed, winsorized and Hölder means. Finally, we calculated the agreement between expert opinion and the different means. We generated 23 different trial arm pairs, which were judged by 49 experts. Among all investigated means, the arithmetic mean showed poorest performance with only 64% agreement with expert opinion (bootstrap confidence interval [CI]: 60-68). Highest agreement of 94% (CI: 86-96) was reached by the Hölder mean M0.2, followed by the geometric mean (91%, CI: 85-94). Winsorized and trimmed means showed a rather poor performance (e.g. winsorization with 0.1 cut-off showed 85% agreement, CI: 78-87), but they performed reasonably well after excluding treatment arms with a small number of patients. In clinical trials with moderate sample size, the currently recommended arithmetic mean does not necessarily rank anthelminthic efficacies in the same order as might be obtained from expert evaluation of the same data. Estimates based on the arithmetic mean should always be reported together with an estimate, which is more robust to outliers, e.g. the geometric mean.


Asunto(s)
Antihelmínticos/uso terapéutico , Helmintiasis/tratamiento farmacológico , Helmintos/efectos de los fármacos , Recuento de Huevos de Parásitos/métodos , Estadística como Asunto , Animales , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento
10.
PLoS Negl Trop Dis ; 14(4): e0008198, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32294081

RESUMEN

INTRODUCTION: Praziquantel has been in use by helminthiasis and schistosomiasis control programs for about 30 years. Although deemed to be safe with regard to its adverse drug reaction profile in reference to the product information of Biltricide, the Eritrean Pharmacovigilance Center received reports of visual abnormalities related to the drug. This is a case series assessment of unusual cases of visual abnormalities associated with praziquantel. METHODS: Search was made in VigiBase by setting praziquantel as a drug substance, Eritrea as the reporting country and all eye disorders, high level term (HLT) to capture all visual disorders associated with Praziquantel. The retrieved dataset was exported into an Excel spreadsheet for descriptive analysis and causality was assessed using Austin Bradford-Hill criteria. RESULTS: There are a total of 2579 Individual Case Safety Reports (ICSRs) of various Adverse Drug Reactions (ADRs) of praziquantel reported from Eritrea in VigiBase. The 61 reports of visual abnormalities that arose within the first 24 hours of praziquantel administration are of note. With a strong association as evidenced by the positive IC025 value, the association of praziquantel and blurred vision was consistently reported from different health facilities over a period of three years. It is a specific association in terms of both the exposure (only praziquantel) and the outcome (blurred vision) as reported in majority of the cases. However, experimental evidences for the association are lacking, the underweight profile of the Eritrean population suggests overdosing as a possible risk factor for the occurrence of these reactions. CONCLUSION: The strength, temporal plausibility, consistency and specificity of the association are suggestive of a causal association between praziquantel and visual disorders.


Asunto(s)
Antihelmínticos/efectos adversos , Praziquantel/efectos adversos , Trastornos de la Visión/inducido químicamente , Trastornos de la Visión/epidemiología , Adolescente , Adulto , Sistemas de Registro de Reacción Adversa a Medicamentos , Anciano , Niño , Bases de Datos Factuales , Eritrea/epidemiología , Femenino , Helmintiasis/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Farmacovigilancia , Factores de Riesgo , Adulto Joven
11.
PLoS Negl Trop Dis ; 14(4): e0008153, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32302298

RESUMEN

The World Health Organization's Neglected Tropical Disease Roadmap has accelerated progress towards eliminating select neglected tropical diseases (NTDs). This momentum has catalyzed research to determine the feasibility of interrupting transmission of soil-transmitted helminths (STH) using community-wide mass drug administration (MDA). This study aims to identify potential gender-specific facilitators and barriers to accessing and participating in community-wide STH MDA, with the goal of ensuring programs are equitable and maximize the probability of interrupting STH transmission. This research was conducted prior to the launch of community-wide MDA for STH in Comé, Benin. A total of 10 focus group discussions (FGDs) were conducted separately among 40 men, 38 women, and 15 community drug distributors (CDDs). Salient themes included: both men and women believe that community-wide MDA would reduce the financial burden associated with self-treatment, particularly for low income adults. Community members believe MDA should be packaged alongside water, sanitation, and other health services. Women feel past community-wide programs have been disorganized and are concerned these distributions will be similar. Women also expressed interest in increased engagement in the implementation of future community-based public health programs. Men often did not perceive themselves to be at great risk for STH infection and did not express a high demand for treatment. Finally, the barriers discussed by CDDs generally did not align with gender-specific concerns, but rather represented concerns shared by both genders. A door-to-door distribution strategy for STH MDA is preferred by women in this study, as this platform empowers women to participate as health decision makers for their family. In addition, involving women in planning and implementation of community-wide programs may help to increase treatment coverage and compliance.


Asunto(s)
Helmintiasis/tratamiento farmacológico , Helmintiasis/prevención & control , Helmintiasis/transmisión , Administración Masiva de Medicamentos/métodos , Benin/epidemiología , Femenino , Grupos Focales , Helmintiasis/epidemiología , Humanos , Masculino , Servicios Preventivos de Salud , Salud Pública/métodos , Saneamiento , Factores Socioeconómicos , Suelo/parasitología , Agua/parasitología
12.
PLoS Negl Trop Dis ; 14(3): e0008106, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32176703

RESUMEN

Lymphatic filariasis has remained endemic in Fiji despite repeated mass drug administration using the well-established and safe combination of diethylcarbamazine and albendazole (DA) since 2002. In certain settings the addition of ivermectin to this combination (IDA) remains a safe strategy and is more efficacious. However, the safety has yet to be described in scabies and soil-transmitted helminth endemic settings like Fiji. Villages of Rotuma and Gau islands were randomised to either DA or IDA. Residents received weight-based treatment unblinded with standard exclusions. Participants were actively found and asked by a nurse about their health daily for the first two days and then asked to seek review for the next five days if unwell. Anyone with severe symptoms were reviewed by a doctor and any serious adverse event was reported to the Medical Monitor and Data Safety Monitoring Board. Of 3612 enrolled and eligible participants, 1216 were randomised to DA and 2396 to IDA. Age and sex in both groups were representative of the population. Over 99% (3598) of participants completed 7 days follow-up. Adverse events were reported by 600 participants (16.7%), distributed equally between treatment groups, with most graded as mild (93.2%). There were three serious adverse events, all judged not attributable to treatment by an independent medical monitor. Fatigue was the most common symptom reported by 8.5%, with headache, dizziness, nausea and arthralgia being the next four most common symptoms. Adverse events were more likely in participants with microfilaremia (43.2% versus 15.7%), but adverse event frequency was not related to the presence of scabies or soil-transmitted helminth infection. IDA has comparable safety to DA with the same frequency of adverse events experienced following community mass drug administration. The presence of co-endemic infections did not increase adverse events. IDA can be used in community programs where preventative chemotherapy is needed for control of lymphatic filariasis and other neglected tropical diseases.


Asunto(s)
Albendazol/efectos adversos , Antiparasitarios/efectos adversos , Dietilcarbamazina/efectos adversos , Insecticidas/efectos adversos , Ivermectina/efectos adversos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Albendazol/administración & dosificación , Antiparasitarios/administración & dosificación , Niño , Preescolar , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Dietilcarbamazina/administración & dosificación , Quimioterapia Combinada/efectos adversos , Quimioterapia Combinada/métodos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/patología , Filariasis Linfática/tratamiento farmacológico , Femenino , Fiji , Helmintiasis/tratamiento farmacológico , Humanos , Lactante , Insecticidas/administración & dosificación , Ivermectina/administración & dosificación , Masculino , Persona de Mediana Edad , Enfermedades Desatendidas/tratamiento farmacológico , Población Rural , Escabiosis/tratamiento farmacológico , Resultado del Tratamiento , Adulto Joven
13.
Lancet Infect Dis ; 20(2): e27-e37, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32006517

RESUMEN

Fever is one of the most common reasons for seeking health care globally and most human pathogens are zoonotic. We conducted a systematic review to describe the occurrence and distribution of zoonotic causes of human febrile illness reported in malaria endemic countries. We included data from 53 (48·2%) of 110 malaria endemic countries and 244 articles that described diagnosis of 30 zoonoses in febrile people. The majority (17) of zoonoses were bacterial, with nine viruses, three protozoa, and one helminth also identified. Leptospira species and non-typhoidal salmonella serovars were the most frequently reported pathogens. Despite evidence of profound data gaps, this Review reveals widespread distribution of multiple zoonoses that cause febrile illness. Greater understanding of the epidemiology of zoonoses in different settings is needed to improve awareness about these pathogens and the management of febrile illness.


Asunto(s)
Enfermedades Endémicas , Fiebre/epidemiología , Fiebre/etiología , Zoonosis/epidemiología , Zoonosis/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Infecciones Bacterianas/epidemiología , Infecciones Bacterianas/patología , Niño , Preescolar , Femenino , Helmintiasis/epidemiología , Helmintiasis/patología , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Infecciones por Protozoos/epidemiología , Infecciones por Protozoos/patología , Virosis/epidemiología , Virosis/patología , Adulto Joven
14.
PLoS One ; 15(2): e0229235, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32069318

RESUMEN

Life Cycle Assessment typically focuses on the footprint of products and services, expressed on three Areas of Protection (AoP): Human Health, Ecosystems and Resources. While the handprint is often expressed qualitatively, quantified handprints have recently been compared directly to the footprint concerning one AoP: Human Health. We propose to take this one step further by simultaneously comparing the quantified handprint and footprint on all AoPs through normalization and weighting of the results towards a single score. We discuss two example cases of a pharmaceutical treatment: mebendazole to treat soil-transmitted helminthiases and paliperidone palmitate to treat schizophrenia. Each time, treatment is compared to 'no treatment'. The footprint of health care is compared to the handprint of improved patient health. The handprint and footprint were normalized separately. To include sensitivity in the normalization step we applied four sets of external normalization factors for both handprint (Global Burden of Disease) and footprint (ReCiPe and PROSUITE). At the weighting step we applied 26 sets of panel weighting factors from three sources. We propose the Relative Sustainability Benefit Rate (RSBR) as a new metric to quantify the relative difference in combined handprint and footprint single score between two alternatives. When only considering the footprint, the first case study is associated with an increased single score burden of treatment compared to 'no treatment', while in the second case study treatment reduces the single score burden by 41.1% compared to 'no treatment'. Also including the handprint provided new insights for the first case study, now showing a decrease of 56.4% in single score burden for treatment compared to 'no treatment'. For the second case study the reduction of single score burden was confirmed as the handprint burden was also decreased because of treatment by 9.9%, reinforcing the findings.


Asunto(s)
Prestación de Atención de Salud/normas , Sector de Atención de Salud/normas , Necesidades y Demandas de Servicios de Salud/normas , Helmintiasis/tratamiento farmacológico , Modelos Estadísticos , Preparaciones Farmacéuticas/administración & dosificación , Esquizofrenia/tratamiento farmacológico , Estado de Salud , Helmintiasis/epidemiología , Humanos , Esquizofrenia/epidemiología
15.
Am J Trop Med Hyg ; 102(4): 851-856, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32043453

RESUMEN

In tropical areas of developing countries, the interactions among parasitic diseases such as soil-transmitted helminths (STHs) and malaria, and glucose-6-phosphate dehydrogenase deficiency (G6PDd), are complex. Here, we investigated their interactions and impact on anemia in school students residing in a conflict zone of northeast Myanmar. A cross-sectional survey was conducted between July and December 2015 in two schools located along the China-Myanmar border. Stool samples from the schoolchildren were analyzed for STH infections, whereas finger-prick blood samples were analyzed for G6PDd, hemoglobin concentrations, and Plasmodium infections. Among 988 enrolled children, Plasmodium vivax, Plasmodium falciparum, hookworm, Ascaris lumbricoides, and Trichuris trichiura infections occurred in 3.3%, 0.8%, 31.5%, 1.2%, and 0.3%, respectively. Glucose-6-phosphate dehydrogenase deficiency was present in 16.9% of the children, and there was a very high prevalence of anemia (73%). Anthropometric measures performed on all children showed that 50% of the children were stunted and 25% wasted. Moderate to severe anemia was associated with STH infections, stunting, and wasting. In addition, children had increasing odds of anemia with increasing burden of infections. This study revealed a high prevalence of G6PDd, STHs, and anemia in schools located in a conflict zone. In areas where malnutrition and STH infections are rampant, testing for both glucose-6-phosphate dehydrogenase and anemia should be considered before treating vivax malaria with 8-aminoquinolines.


Asunto(s)
Anemia/epidemiología , Conflictos Armados , Deficiencia de Glucosafosfato Deshidrogenasa/genética , Helmintiasis/epidemiología , Malaria/sangre , Suelo/parasitología , Adolescente , Niño , Femenino , Helmintiasis/sangre , Helmintiasis/parasitología , Humanos , Malaria/epidemiología , Malaria/parasitología , Masculino , Mianmar/epidemiología
17.
PLoS Negl Trop Dis ; 14(2): e0008000, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32040473

RESUMEN

BACKGROUND: Soil-transmitted helminths (STHs) comprise a group of helminth parasites that are included in the list of Neglected Tropical Diseases and require a passage through the soil to become infective. Several studies have detected that infection with STHs are associated with certain socioeconomic, environmental and soil characteristics. In Argentina, the presence of these parasites has been detected through a few point studies conducted in localities from 11 of the 23 provinces that comprise the country. METHODS/PRINCIPAL FINDINGS: The most important characteristics previously associated with the presence of STHs were identified and ranked through the use of an expert survey and the Analytical Hierarchy Process (AHP) in order to construct a risk map of STHs specific for Argentina. Prevalence data from previous studies was used to validate the generated risk map. The map shows that half of Argentina, from the Central provinces to the North, contains localities with the characteristics necessary for the development of these parasites. CONCLUSIONS/SIGNIFICANCE: The predicted map should serve as a useful tool for guiding the identification of survey areas for the generation of baseline data, detecting hotspots of infection, planning and prioritizing areas for control interventions, and eventually performing post-implementation surveillance activities.


Asunto(s)
Helmintiasis/epidemiología , Helmintiasis/transmisión , Suelo/parasitología , Argentina/epidemiología , Humanos , Prevalencia , Factores de Riesgo
18.
Annu Rev Pathol ; 15: 179-209, 2020 01 24.
Artículo en Inglés | MEDLINE | ID: mdl-31977298

RESUMEN

The human eosinophil has long been thought to favorably influence innate mucosal immunity but at times has also been incriminated in disease pathophysiology. Research into eosinophil biology has uncovered a number of interesting contributions by eosinophils to health and disease. However, it appears that not all eosinophils from all species are created equal. It remains unclear, for example, exactly how having eosinophils benefits the human host when helminth infections in the developed world have become scarce. This review focuses on our current state of knowledge as it relates to human eosinophils. When information is lacking, we discuss lessons learned from mouse studies that may or may not directly apply to human biology and disease. It is an exciting time to be an "eosinophilosopher" because the use of biologic agents that selectively target eosinophils provides an unprecedented opportunity to define the contribution of this cell to eosinophil-associated human diseases.


Asunto(s)
Enfermedad/etiología , Eosinófilos/fisiología , Inmunidad Innata/fisiología , Animales , Helmintiasis/inmunología , Humanos , Recuento de Leucocitos , Ratones
19.
Am J Trop Med Hyg ; 102(4): 847-850, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31989919

RESUMEN

In the Bolivian Chaco, recent surveys documented a dramatic decrease in the prevalence of soil-transmitted helminth (STH) infections as compared with the 1980s after thirty years of preventive chemotherapy (PC). Concomitant immunological rearrangements are expected. Because nematode infections are associated with increased levels of circulating IgE and glycoprotein CD30 soluble form (sCD30), this study aims to evaluate changes in serological markers of T helper (Th)2-cells activity between 1987 (high STH prevalence) and 2013 (low STH prevalence) in rural communities in the Bolivian Chaco area. We collected 151 sera during two different surveys in 1987 (n = 65) and 2013 (n = 86) and measured the concentration of total IgE and sCD30 by immunoassays. We found a statistically significant age-independent decrease in the total IgE (P < 0.0001) and sCD30 (P < 0.0001) from 1987 to 2013. The significant decrease in serological Th2 markers (IgE and sCD30) between 1987 and 2013 is consistent with the drop in STH prevalence in this geographical area during the same period of time. Further studies might elucidate the clinical and epidemiological impact of these serological rearrangements.


Asunto(s)
Anticuerpos Antihelmínticos/sangre , Helmintiasis/epidemiología , Inmunoglobulina E/sangre , Antígeno Ki-1/sangre , Suelo/parasitología , Adulto , Bolivia/epidemiología , Femenino , Helmintiasis/transmisión , Humanos , Masculino
20.
PLoS One ; 15(1): e0227273, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31899772

RESUMEN

Soil Transmitted Helminth (STH) infections affect over 1.5 billion people worldwide. Although prevalent in all age groups, school aged children are a high-risk groups for STH infections. In Bhutan, epidemiological data on STH were collected from western Bhutan in 2003, which found a prevalence of 16.5%. However, little evidence is available on the prevalence of infection at national level. Therefore, this study was conducted with the aim to assess the prevalence and intensity of STH infections, and identify significant correlates of STH among students. A school-based survey was conducted in three regions of Bhutan. Two-stage cluster sampling was adopted to select a sample of 1500 students from 24 schools, in equal proportion from three regions of the country. A total of 1456 (97%) students were interviewed and their stool sample examined for the presence of parasites. Mini-FLOTAC technique was used to detect the parasite eggs/ova. The prevalence of any STH infection was 1.4%, with 0.8% Ascaris lumbricoides, 0.5% Trichuris trichiura and 0.2% hookworms. The eastern region had the highest prevalence at 2.3%. Except for one student who had moderate intensity of A. lumbricoides, the rest had light infection. Any STH presence was significantly associated with father's occupation, father's education level, type of house and the flooring of the house in which students reported to live. No significant associations were observed between water, sanitation and hygiene (WASH) variables measured and presence of any STH infection. The prevalence of STH was found to be very low with primarily light intensity in this study. Nonetheless, it was also found that the sanitation situation is not ideal in the country, with several students reporting constant or partial open defecation leading to environmental contamination. Based on this prevalence and in line with the WHO guideline, it is recommended that deworming be reduced to once a year in combination with concerted health education on proper hygiene and sanitation practice.


Asunto(s)
Antihelmínticos/administración & dosificación , Conocimientos, Actitudes y Práctica en Salud/etnología , Helmintiasis/epidemiología , Suelo/parasitología , Adolescente , Albendazol/administración & dosificación , Animales , Bután/epidemiología , Niño , Estudios Transversales , Defecación , Agua Potable/parasitología , Heces/parasitología , Femenino , Helmintiasis/parasitología , Helmintiasis/prevención & control , Helmintiasis/transmisión , Humanos , Higiene , Masculino , Prevalencia , Saneamiento/métodos , Saneamiento/estadística & datos numéricos , Instituciones Académicas/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Adulto Joven
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