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BMC Complement Altern Med ; 18(1): 327, 2018 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-30526582


BACKGROUND: Soil transmitted helminths (STHs) are among the world's neglected tropical diseases. Morbidity due to STHs is greatest in school-age children who typically have the highest burden of infection. In 2001, WHO passed a resolution for the use of large-scale mass drug administration (MDA) to deworm vulnerable children through school based programs. Though effective, there is concern that MDA might not be sustainable over extended periods. Additionally the current MDA strategy does not consider child malnutrition, a very common malady in resource limited countries. We report a pilot evaluation of an innovation that bundles school feeding and deworming. METHODS: We designed a maize (corn) flour fortified with grounded dried papaya (Carica papaya) seeds and used it to prepare porridge as per the usual school meal recipe Children from three primary schools from Nandi County in Kenya were randomized into three arms: One school received 300 ml papaya fortified porridge daily (papaya group), the second school received similar serving of plain porridge without the pawpaw ingredient (control group) and the third school received plain porridge and the conventional MDA approach of one time 400 mg dosage of albendazole (albendazole arm). Prior to the randomization, an initial baseline stool microscopy analysis was done to determine presence and intensity of intestinal worms. Core indicators of nutrition-height, weight and hemoglobin counts were also assessed. The children were monitored daily for two months and final stool sample analysis and clinical monitoring done at the end of the study. Baseline and follow-up data were analyzed and compared through SAS version 9.1 statistical package. RESULTS: A total of 326 children participated in the trial. The overall prevalence of Ascaris lumbricoides was 29.4% (96), Trichuris Trichura 5.2% (17) and hookworm 1 (0.3%). Papaya seed fortified porridge reduced the Ascaris lumbricoides egg count by 63.9% after the two month period (mean 209.7epg to 75.7 p < 0.002) as compared to the albendazole arm 78.8% (129.5 epg to 27.5, p value 0.006). The control group showed an increase in egg count (42.epg to 56.3) though it was not statistically significant. Hemoglobin counts in the papaya group increased from a mean of 2 g/dL (11.5 g/dL to 13.5 g/dL, p < 0.001), as compared to the albendazole arm that increased by 1 g/dL (12.8-13.9, p < 0.001). No significant change was observed in the placebo arm (13.2 to 13.1). Interestingly the papaya group showed a significant reduction of children with Tinea capitis (ringworms) (54.4 to 34%, p < 0.002) as compared to the albendazole arm that showed an increase in ringworm infestation though not statistically significant (39.7 to 64.7% p = 0.608). CONCLUSION: Papaya seed fortified porridge had a significant effect on reduction of Ascaris lumbricoides burden. It had a better nutritional outcome and effect on child fungal infections than albendazole. Its application as a routine school meal may aid current national school based nutrition and deworming programs in Africa. TRIAL REGISTRATION: This study was retrospectively registered at Ref. NCT02725255 on 31st March 2016.

Anti-Helmínticos , Carica , Alimentos Fortificados , Helmintíase/tratamento farmacológico , Enteropatias Parasitárias/tratamento farmacológico , Albendazol/administração & dosagem , Albendazol/uso terapêutico , Anti-Helmínticos/administração & dosagem , Anti-Helmínticos/uso terapêutico , Criança , Fezes/parasitologia , Feminino , Frutas , Helmintíase/epidemiologia , Humanos , Enteropatias Parasitárias/epidemiologia , Quênia , Masculino , Administração Massiva de Medicamentos , Preparações de Plantas/administração & dosagem , Preparações de Plantas/uso terapêutico , Prevalência , Sementes , Estudantes , Zea mays
Int J Drug Policy ; 34: 20-6, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27450319


BACKGROUND: Estimations of drug use are mostly based on population surveys that can suffer from response biases. The current study evaluates using wastewater-based epidemiology (WBE) for assessing illicit drug use by comparing wastewater data with that from a population survey. METHODS: Introductory letters (29,083) were sent to inhabitants of Lier, Belgium, asking them to participate in an online survey study. Participants were asked to indicate their drug use in the past week for a 12-week period (September-November 2014). Concomitant wastewater samples were collected from the associated wastewater treatment plant in four bi-weekly periods. Samples were analyzed using solid-phase extraction and liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). RESULTS: On average, 263 (1%) inhabitants filled out the questionnaire each week. According to the survey results, cannabis was the most used drug, followed by amphetamine, cocaine and methylenedioxymethamphetamine (MDMA). Wastewater data corroborated these results. Cocaine, amphetamine and MDMA showed a significant difference between days of the week. The four sampling periods differed significantly from each other for cocaine, amphetamine and methadone. CONCLUSION: Observed drug consumption patterns from survey and wastewater data match national and international data. Wastewater analyses confirm that WBE can be reliably used to confirm patterns and trends in drug use. Future studies should focus on identifying the most opportune sampling period giving the most reliable estimates of drug use and use smaller, contained communities such as festivals or prisons if methodology allows.

Detecção do Abuso de Substâncias/métodos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Águas Residuárias/análise , Adulto , Bélgica/epidemiologia , Cromatografia Líquida , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Extração em Fase Sólida , Inquéritos e Questionários , Espectrometria de Massas em Tandem
Drug Alcohol Depend ; 162: 170-5, 2016 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-26980372


BACKGROUND/AIMS: Alcohol and nicotine are the two most used substances world-wide and associated with increased burden of disease. Since surveys on substance use may be difficult due to response biases, wastewater-based epidemiology (WBE) was developed as a more objective measure of nicotine and alcohol use. This study compares estimates of nicotine and alcohol use from a wastewater sampling campaign in a medium-sized Belgian city with a concurrently executed population survey. METHODS: 29,083 letters about participation in an online survey study on weekly alcohol and tobacco use were sent to the inhabitants of Lier, Belgium. Wastewater samples were collected from the associated treatment plant in four bi-weekly periods. Samples were analyzed using liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). Ethylsulfate was used as alcohol biomarker and cotinine and trans-3'-hydroxycotinine as nicotine biomarker. RESULTS: 263 (1%) surveys were filled out on average per week. According to survey data, alcohol and nicotine were used less than in the rest of Belgium and this was matched by the wastewater data. Nicotine use, but not alcohol use, showed a significant variation over the sampling periods. Both nicotine and alcohol showed increase use during the weekend while only alcohol showed a different use pattern throughout the week. CONCLUSION: No correlation between WBE and survey data could be demonstrated, possibly due to small sample sizes. However, this study shows that weekly trends in alcohol and nicotine use can be quickly detected from wastewater analysis and the occurrence of major events such as festivals can be identified.

Consumo de Bebidas Alcoólicas/epidemiologia , Etanol/análise , Nicotina/análise , Fumar/epidemiologia , Águas Residuárias/análise , Adolescente , Adulto , Idoso , Bélgica/epidemiologia , Biomarcadores/análise , Cromatografia Líquida/métodos , Cidades/epidemiologia , Cotinina/análogos & derivados , Cotinina/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Características de Residência , Ésteres do Ácido Sulfúrico/análise , Inquéritos e Questionários , Espectrometria de Massas em Tandem , Adulto Jovem
Exp Appl Acarol ; 26(1-2): 101-13, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12475080


Separation of midgut membrane proteins from the tick, Ambylomma variegatum, using a nonionic detergent (Triton X-114), resulted in two protein fractions, namely DET (detergent) and AQ (aqueous). In immunoblotting analysis with polyclonal antibodies against these fractions, 4 proteins (Mr approximately 27,000, 67,000, 86,000 and 95,000,) and 2 proteins (M, approximately 54,000 and 67,000) were detected in the DET and AQ fractions, respectively. Three of the DET fraction proteins Mr approximately 27,000, 67,000 and 95,000 were glycosylated since they bound to the lectin, concanavalin A. In 2-dimensional gel electrophoresis, the AQ and DET fraction proteins were found to be acidic in nature. In a series of bioassay experiments, rabbits were first immunised with both DET and AQ fractions and then infested with ticks. The egg batch weights of these ticks were reduced by 50% compared to control ticks. Furthermore, there was a significant reduction in the hatchability of eggs laid by ticks fed on rabbits previously immunised with both DET (14%) and AQ (33%) fractions. Based on the egg hatchability, the reproductive capacity of ticks was reduced by 77 and 48% by DET and AQ fractions, respectively.

Antígenos/análise , Ixodidae/imunologia , Animais , Antígenos/imunologia , Fracionamento Químico , Sistema Digestório/imunologia , Glicosilação , Polietilenoglicóis , Coelhos