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1.
Lancet Reg Health Am ; 16: 100390, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36408529

RESUMO

Background: Population-level SARS-CoV-2 immunological protection is poorly understood but can guide vaccination and non-pharmaceutical intervention priorities. Our objective was to characterise cumulative infections and immunological protection in the Dominican Republic. Methods: Household members ≥5 years were enrolled in a three-stage national household cluster serosurvey in the Dominican Republic. We measured pan-immunoglobulin antibodies against the SARS-CoV-2 spike (anti-S) and nucleocapsid glycoproteins, and pseudovirus neutralising activity against the ancestral and B.1.617.2 (Delta) strains. Seroprevalence and cumulative prior infections were weighted and adjusted for assay performance and seroreversion. Binary classification machine learning methods and pseudovirus neutralising correlates of protection were used to estimate 50% and 80% protection against symptomatic infection. Findings: Between 30 Jun and 12 Oct 2021 we enrolled 6683 individuals from 3832 households. We estimate that 85.0% (CI 82.1-88.0) of the ≥5 years population had been immunologically exposed and 77.5% (CI 71.3-83) had been previously infected. Protective immunity sufficient to provide at least 50% protection against symptomatic SARS-CoV-2 infection was estimated in 78.1% (CI 74.3-82) and 66.3% (CI 62.8-70) of the population for the ancestral and Delta strains respectively. Younger (5-14 years, OR 0.47 [CI 0.36-0.61]) and older (≥75-years, 0.40 [CI 0.28-0.56]) age, working outdoors (0.53 [0.39-0.73]), smoking (0.66 [0.52-0.84]), urban setting (1.30 [1.14-1.49]), and three vs no vaccine doses (18.41 [10.69-35.04]) were associated with 50% protection against the ancestral strain. Interpretation: Cumulative infections substantially exceeded prior estimates and overall immunological exposure was high. After controlling for confounders, markedly lower immunological protection was observed to the ancestral and Delta strains across certain subgroups, findings that can guide public health interventions and may be generalisable to other settings and viral strains. Funding: This study was funded by the US CDC.

2.
Epidemiol Infect ; 150: e178, 2022 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-36285816

RESUMO

The dissemination of Escherichia coli producing extended-spectrum beta-lactamase (ESBL-Ec) is evident in the community. A population-based spatial analysis is necessary to investigate community risk factors for ESBL-Ec occurrence. The study population was defined as individuals with ESBL-Ec isolated in Queensland, Australia, from 2010 to 2019. Choropleth maps, global Moran's index and Getis-Ord Gi* were used to describe ESBL-Ec distribution and identify hot spots. Multivariable Poisson regression models with or without spatially structured random effects were performed. A total of 12 786 individuals with ESBL-Ec isolate were identified. The crude incidence rate increased annually from 9.1 per 100 000 residents in 2010 to 49.8 per 100 000 residents in 2019. The geographical distribution of ESBL-Ec changed from random to clustered after 2014, suggesting presence of community-specific factors that can enhance occurrence. Hot spots were more frequently identified in Outback and Far North Queensland, future public health measures to reduce transmission should prioritise these communities. Communities with higher socioeconomic status (RR = 0.66, 95% CI 0.55-0.79, per 100 units increase) and higher proportion of residents employed in the agricultural industry (RR = 0.79, 95% CI 0.67-0.95, per 10% increase) had lower ESBL-Ec incidence. Risk factors for occurrence appear differential between remote and city settings and this should be further investigated.


Assuntos
Infecções por Escherichia coli , Humanos , beta-Lactamases , Escherichia coli , Incidência , Queensland/epidemiologia , Antibacterianos/uso terapêutico , Análise Espacial
3.
Trop Med Infect Dis ; 7(10)2022 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-36288036

RESUMO

Under the Global Program to Eliminate Lymphatic Filariasis (LF) American Samoa conducted seven rounds of mass drug administration (MDA) between 2000 and 2006. Subsequently, the territory passed the WHO recommended school-based transmission assessment survey (TAS) in 2011/2012 (TAS-1) and 2015 (TAS-2) but failed in 2016, when both TAS-3 and a community survey found LF antigen prevalence above what it had been in previous surveys. This study aimed to identify potential environmental drivers of LF to refine future surveillance efforts to detect re-emergence and recurrence. Data on five LF infection markers: antigen, Wb123, Bm14 and Bm33 antibodies and microfilaraemia, were obtained from a population-wide serosurvey conducted in American Samoa in 2016. Spatially explicit data on environmental factors were derived from freely available sources. Separate multivariable Poisson regression models were developed for each infection marker to assess and quantify the associations between LF infection markers and environmental variables. Rangeland, tree cover and urban cover were consistently associated with a higher seroprevalence of LF-infection markers, but to varying magnitudes between landcover classes. High slope gradient, population density and crop cover had a negative association with the seroprevalence of LF infection markers. No association between rainfall and LF infection markers was detected, potentially due to the limited variation in rainfall across the island. This study demonstrated that seroprevalence of LF infection markers were more consistently associated with topographical environmental variables, such as gradient of the slope, rather than climatic variables, such as rainfall. These results provide the initial groundwork to support the detection of areas where LF transmission is more likely to occur, and inform LF elimination efforts through better understanding of the environmental drivers.

4.
Int J Infect Dis ; 117: 378-386, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35150913

RESUMO

BACKGROUND: Under the Global Programme to Eliminate Lymphatic Filariasis (LF), American Samoa conducted 7 rounds of mass drug administration (MDA) between 2000 and 2006. The territory passed transmission assessment surveys (TASs) in 2011 (TAS-1) and 2015 (TAS-2). In 2016, the territory failed TAS-3, indicating resurgence. This study aims to determine if antibodies (Abs) may have provided a timelier indication of LF resurgence in American Samoa. METHODS: We examined school-level antigen (Ag) and Ab status (presence/absence of Ag- and Ab-positive children) and prevalence of single and combined Ab responses to Wb123, Bm14, and Bm33 Ags at each TAS. Pearson chi-square test and logistic regression were used to examine associations between school-level Ab prevalence in TAS-1 and TAS-2 and school-level Ag status in TAS-3. RESULTS: Schools with higher prevalence of Wb123 Ab in TAS-2 had higher odds of being Ag-positive in TAS-3 (odds ratio [OR] 24.5, 95% confidence interval [CI] 1.2-512.7). Schools that were Ab-positive for WB123 plus Bm14, Bm33, or both Bm14 and Bm33 in TAS-2 had higher odds of being Ag-positive in TAS-3 (OR 16.0-24.5). CONCLUSION: Abs could provide earlier signals of resurgence and enable a timelier response. The promising role of Abs in surveillance after MDA and decision making should be further investigated in other settings.


Assuntos
Filariose Linfática , Samoa Americana/epidemiologia , Animais , Anticorpos Anti-Helmínticos , Antígenos de Helmintos , Criança , Filariose Linfática/tratamento farmacológico , Filariose Linfática/epidemiologia , Filariose Linfática/prevenção & controle , Humanos , Preparações Farmacêuticas , Wuchereria bancrofti/fisiologia
6.
Acta Trop ; 223: 106079, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34363777

RESUMO

Parasitic infections caused by Opisthorchis viverrini and Strongyloides stercoralis remain a major public health threat in the Greater Mekong Sub-region. An understanding of climate and other environmental influences on the geographical distribution and emergence of parasitic diseases is a crucial step to guide targeted control and prevention programs. A parasitological survey was conducted from 2008 to 2013 and included 12,554 individuals (age between 20 and 60 years) from 142 villages in five districts in Khon Kaen Province, Thailand. Geographical information systems, remote sensing technologies and a Bayesian geostatistical framework were used to develop models for O. viverrini and S. stercoralis mono- and co-infections in areas where both parasites are known to co-occur. The results indicate that male sex, increased age, altitude, precipitation, and land surface temperature have influenced the infection rate and geographical distribution of mono- and co-infections of O. viverrini and S. stercoralis in this area. Males were 6.69 times (95% CrI: 5.26-8.58) more likely to have O. viverrini - S. stercoralis co-infection. We observed that O. viverrini and S. stercoralis mono-infections display distinct spatial pattern, while co-infection is predicted in the center and southeast of the study area. The observed spatial clustering of O. viverrini and S. stercoralis provides valuable information for the spatial targeting of prevention interventions in this area.


Assuntos
Coinfecção , Opistorquíase , Estrongiloidíase , Adulto , Animais , Teorema de Bayes , Coinfecção/epidemiologia , Coinfecção/parasitologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Opistorquíase/complicações , Opistorquíase/epidemiologia , Opisthorchis , Prevalência , Strongyloides stercoralis , Estrongiloidíase/complicações , Estrongiloidíase/epidemiologia , Tailândia/epidemiologia , Adulto Jovem
7.
BMJ Open ; 11(8): e046206, 2021 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-34385235

RESUMO

INTRODUCTION: The increase in international travel brought about by globalisation has enabled the rapid spread of emerging pathogens with epidemic and pandemic potential. While travel connectivity-based assessments may help understand patterns of travel network-mediated epidemics, such approaches are rarely carried out in sufficient detail for Oceania where air travel is the dominant method of transportation between countries. DESIGN: Travel data from the Australian Bureau of Statistics, Stats NZ and the United Nations World Tourism Organization websites were used to calculate travel volumes in 2018 within Oceania and between Oceania and the rest of the world. The Infectious Disease Vulnerability Index (IDVI) was incorporated into the analysis as an indicator of each country's capacity to contain an outbreak. Travel networks were developed to assess the spread of infectious diseases (1) into and from Oceania, (2) within Oceania and (3) between each of the Pacific Island Countries and Territories (PICTs) and their most connected countries. RESULTS: Oceania was highly connected to countries in Asia, Europe and North America. Australia, New Zealand and several PICTs were highly connected to the USA and the UK (least vulnerable countries for outbreaks based on the IDVI), and to China (intermediate low vulnerable country). High variability was also observed between the PICTs in the geographical distribution of their international connections. The PICTs with the highest number of international connections were Fiji, French Polynesia, Guam and Papua New Guinea. CONCLUSION: Travel connectivity assessments may help to accurately stratify the risk of infectious disease importation and outbreaks in countries depending on disease transmission in other parts of the world. This information is essential to track future requirements for scaling up and targeting outbreak surveillance and control strategies in Oceania.


Assuntos
Viagem Aérea , Doenças Transmissíveis , Austrália/epidemiologia , Doenças Transmissíveis/epidemiologia , Surtos de Doenças/prevenção & controle , Humanos , Pandemias , Viagem
8.
J Educ Health Promot ; 10: 149, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34222524

RESUMO

BACKGROUND: Little is known about the inference that physical activity (PA) may have on academic performance and learning styles of Latin American dental students. MATERIALS AND METHODS: In this cross-sectional study, an administrative dataset and a voluntary university characterization provided information about PA and academic performance. Moreover, 218 dental students of the University of Antioquia in Colombia completed a structured questionnaire to identify their learning styles. To analyze the information obtained a Pearson correlation, and logistic and linear regression models were implemented. RESULTS: A total of 131 (60%) students informed being physically active (PA group), and 87 (40%) did not report PA (non-PA group). The results showed a high-grade point average (GPA) in the PA group (P = 0.01). The PA group showed a preference for the theorist and pragmatist learning styles with statistically significant differences between the groups (P = 0.004 and P < 0.0001, respectively). It was also observed a statistically significant Pearson positive correlation between the theorist style and higher GPA (r = 0.15; P = 0.04). The multivariate regression model showed that PA protects against lower means of GPA (odds ratio = 0.3; 95% confidence interval [CI]: 0.09-0.7, P = 0.01). Furthermore, the adjusted linear regression models also showed that PA protects against lower means of the theorist (ß= -0.15; 95% CI: -0.02 to - 0.002, P = 0.002) and pragmatist styles (ß= -0.18; 95% CI: -0.03 to - 0.006, P = 0.0006). Interestingly, men were statistically significant in all multivariable models. DISCUSSION: This study suggests that PA is associated with higher academic performance and the theorist and pragmatist styles. Male students were also more physically active; therefore, it is relevant to establish strategies to stimulate physical activities in dental students, especially in women, including extracurricular activities.

9.
CES odontol ; 34(1): 25-34, ene.-jun. 2021. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1360258

RESUMO

Abstract Introduction and objective: Little is known about the learning styles of ethnic minorities in Latin American universities. The objective of this research was to identify the learning styles of the ethnic minorities attending a dental school. Moreover, their grade point averages were explored. Materials and methods: A total of 30 ethnic minority students were matched with 30 non-minority students. All the students took a systematized questionnaire to categorize their learning styles. Results: A strong association between ethnic minority students and low reflector style was observed in the multivariate model after adjusting for age, sex, and the current semester (OR=11; 95% CI=1.2-99; p=0.03). In addition, a relevant association between minority ethnic group and low theorist style was observed in the multivariate model after controlling for the same variables (OR= 4; 95% CI=1.2-11; p=0.02). Finally, a statistically significant difference was observed in the grade point averages of non-minority and minority groups, with the minority group having the lower averages (p=0.014). Conclusions: Ethnic minority students presented lower means for all learning styles compared to the control group. Similarly, their grade point averages were significantly inferior. These findings represent relevant precedents for creating educational strategies to improve the learning of ethnic minority groups in higher education in Latin America.


Resumen Introducción y objetivo: Poco se sabe sobre los estilos de aprendizaje de las minorías étnicas en las universidades latinoamericanas. El objetivo de esta investigación fue identificar los estilos de aprendizaje en las minorías étnicas de una facultad de odontología. Además, se exploró su promedio de calificaciones. Materiales y métodos: treinta estudiantes de minorías étnicas se parearon con treinta estudiantes de minorías no étnicas. Todos los estudiantes completaron un cuestionario sistematizado para clasificar sus estilos de aprendizaje. Resultados: En el modelo multivariado después de ajustar por las variables edad, sexo y semestre actual, se observó una fuerte asociación entre los estudiantes de minorías étnicas y un nivel bajo en el estilo reflector (OR= 11; 1.2-99, IC 95%; p= 0.03). Igualmente, después de controlar las mismas variables, se encontró una asociación relevante entre el grupo étnico minoritario y un nivel bajo en el estilo teórico (OR= 4; 1.2-11; IC 95%; p = 0.02). Además, se observaron diferencias estadísticamente significativas en el promedio de calificaciones entre los grupos, el cual fue menor en el grupo minoritario (p = 0.014). Conclusion: los estudiantes de minorías étnicas presentaron promedios más bajos para todos los estilos de aprendizaje en comparación con el grupo control. Del mismo modo, su promedio de calificaciones fue significativamente inferior. Estos hallazgos representan precedentes relevantes para crear estrategias educativas que favorezcan el aprendizaje de los grupos étnicos minoritarios en la educación superior en América Latina.


Resumo Introdução e objetivo: Pouco se sabe sobre os estilos de aprendizagem das minorias étnicas nas universidades latino-americanas. O objetivo desta pesquisa foi identificar os estilos de aprendizagem em minorias étnicas de uma faculdade de odontologia. Além disso, sua média de notas foi explorada. Materiais e métodos: Um total de trinta estudantes de minorias étnicas corresponde a trinta estudantes de minorias não étnicas. Todos os alunos preencheram um questionário sistematizado para classificar seus estilos de aprendizagem. Resultados: Observou-se forte associação entre os estudantes de minorias étnicas e o baixo estilo reflexivo no modelo multivariado após o ajuste para as variáveis idade, sexo e semestre atuais (OR = 11; 1,2-99, IC95%; p = 0,03) De maneira comparável, foi observada associação relevante entre o grupo étnico minoritário e o baixo estilo teórico no modelo multivariado, após o controle das mesmas variáveis (OR = 4; 1,2-11; IC95%; p = 0,02). Além disso, foram observadas diferenças estatisticamente significantes nas pontuações médias entre os grupos, sendo menor no grupo minoritário (p = 0,014). Conclusões: os estudantes das minorias étnicas apresentaram médias mais baixas para todos os estilos de aprendizagem em comparação ao grupo controle. Da mesma forma, a média de notas foi significativamente menor. Esses achados representam precedentes relevantes para a criação de estratégias educacionais que favoreçam a aprendizagem de grupos étnicos minoritários no ensino superior na América Latina.

10.
J Educ Health Promot ; 9: 138, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32766323

RESUMO

BACKGROUND: Ethnic minorities are underrepresented in health sciences programs in various nations. Furthermore, there is no known research studying the occurrence of physical inactivity (PI) and insufficient sleep (IS), and their effects on academic achievement (AA) in ethnic minority students (EMS) in higher education. OBJECTIVE: The objective of this study is to explore the occurrence of PI and IS, and their independent and mixed effects on AA in EMS of a dental school. MATERIALS AND METHODS: Thirty EMS and sixty non-EMSs were matched (1:2) in this case-control study. It was utilized as an administrative dataset that stores register related to the students. Moreover, the grade point average was considered an indicator of AA. Logistic regressions models were run, expressed in odds ratios, complemented by confidence intervals (CIs) of 95%. RESULTS: A total of 73% and 60% EMS were PI and slept insufficiently, respectively. The groups presented statistically significant differences (P < 0.0001) in physical activity, sleep, and AA, with inferior values for EMS. All unadjusted models showed that PS, IS, and low AA were strongly associated with EMS, demonstrating their independent effect. After controlling for PI and IS, the multivariate model for AA and EMS increased odds by 6.5 times (95%CI: 1.8-23;), indicating that EMS is strongly associated with low AA. Besides, PI and IS were also statistically significant higher (< 0.0001) in the model, demonstrating their mixed effect. CONCLUSIONS: This study found a higher occurrence of PI and IS in EMS. Besides, independent and mixed effects of these variables on low AA in EMS were very significant.

11.
Eur J Dent Educ ; 24(4): 660-665, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32542942

RESUMO

INTRODUCTION: There is no recognised investigation examining the influence of some lifestyle comportments on academic performance (AP) in forcibly displaced students in higher education. Thus, the frequency of physical inactivity (PI), insufficient sleep (IS), alcohol consumption (AC), drug consumption (DC) and cigarette smoking (CS) and the independent and combined consequences of these habits on AP in forcibly displaced dental students were investigated. MATERIALS AND METHODS: A sample of 185 students was studied (thirty-seven forcibly displaced and 148 non-displaced students). This cross-sectional study used an institutional administrative database that included students' demographic features and lifestyle behaviours. Multivariate analyses were performed to evaluate the independent and combined effects of lifestyle behaviours on AP. RESULTS: PI, IS, AC, DC and CS were observed in 51%, 43%, 83%, 27% and 16% of forcibly displaced students, respectively. Compared with non-displaced students, forcibly displaced students presented higher frequencies for all of these behaviours (P < .05), lower AP (P < .0001) and lower socio-economic status (P = .003). Unadjusted regression models showed independent and significant associations between forcibly displaced students and PI (P = .01), IS (P = .01), AC (P = .01), DC (P < .0001), CS (P = .02) and low AP (P = .006). The multivariate model for AP and forcibly displaced students increased odds by 4.6 times (1.5-11; 95% CI). Moreover, the lifestyle comportments studied were also statistically significant, showing combined effects. The variables of gender and age were not statistically significant in the adjusted model. CONCLUSIONS: This research observed high frequencies of the behaviours analysed in forcibly displaced students. Furthermore, independent and combined effects of them on AP were detected.


Assuntos
Educação em Odontologia , Estilo de Vida , Estudos Transversais , Odontologia , Hábitos , Humanos , Instituições Acadêmicas , Estudantes , Inquéritos e Questionários
12.
J Fungi (Basel) ; 6(1)2020 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-32244949

RESUMO

Invasive fungal diseases (IFD) contribute significantly to worldwide morbidity and mortality, but their frequency is not well-described in some countries. The present work describes the frequency of IFD in a specialized laboratory in Colombia. A retrospective, descriptive study was implemented between March 2009 and December 2015. Results: 13,071 patients with clinical suspicion of IFD were referred during the study period, from which 33,516 biological samples were processed and analyzed using 14 laboratory methods. Diagnosis was confirmed in 1425 patients (11%), distributed according to the mycoses of interest analyzed here: histoplasmosis in 641/11,756 patients (6%), aspergillosis in 331/10,985 patients (3%), cryptococcosis in 239/8172 patients (3%), pneumocystosis in 111/1651 patients (7%), paracoccidioidomycosis in 60/10,178 patients (0.6%), and invasive candidiasis in 48/7525 patients (0.6%). From the first year of the study period to the last year, there was a 53% increase in the number of cases of IFD diagnosed. Our laboratory experienced a high frequency of IFD diagnosis, possibly attributable to the availability of a greater range of diagnostic tools. Frequency of IFD in this study was atypical compared with other studies, probably as a result of the single laboratory-site analysis. This demonstrates that implementing educational strategies helps to create a high index of clinical suspicion, while the availability and utilization of appropriate diagnostic assays assure greater reliability in identification of these cases.

13.
J Fungi (Basel) ; 5(2)2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31212897

RESUMO

Disseminated histoplasmosis is a major opportunistic infection of HIV-infected patients, killing thousands in Latin America each year. Yet, it remains a neglected disease that is often confused with tuberculosis, for lack of simple, affordable, and rapid diagnostic tools. There is great heterogeneity in the level of histoplasmosis awareness. The purpose of this report was to describe how the historical "awakening" to the threat of histoplasmosis came to be in four different centers that have actively described this disease: In Brazil, the Sao José hospital in Fortaleza; in Colombia, the Corporación para Investigaciones Biológicas in Medellin; in French Guiana, Cayenne Hospital; and in Guatemala, the Association de Salud Integral in Guatemala city. In Brazil and French Guiana, the search for leishmaniasis on the buffy coat or skin smears, respectively, led to the rapid realization that HIV patients were suffering from disseminated histoplasmosis. With time and progress in fungal culture, the magnitude of this problem turned it into a local priority. In Colombia and Guatemala, the story is different because for these mycology centers, it was no surprise to find histoplasmosis in HIV patients. In addition, collaborations with the CDC to evaluate antigen-detection tests resulted in researchers and clinicians developing the capacity to rapidly screen most patients and to demonstrate the very high burden of disease in these countries. While the lack of awareness is still a major problem, it is instructive to review the ways through which different centers became histoplasmosis-aware. Nevertheless, as new rapid diagnostic tools are becoming available, their implementation throughout Latin America should rapidly raise the level of awareness in order to reduce the burden of histoplasmosis deaths.

14.
Infect Dis Poverty ; 7(1): 77, 2018 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-30089510

RESUMO

BACKGROUND: Cystic echinococcosis (CE) and alveolar echinococcosis (AE) are highly endemic in Xiji County of Ningxia Hui Autonomous Region (NHAR) in China where the control campaign based on dog de-worming with praziquantel has been undertaken over preceding decades. This study is to determine the current prevalence of Echinococcus granulosus and E. multilocularis in domestic dogs and monitor the echinococcosis transmission dynamics. METHODS: Study villages were selected using landscape patterns (Geographic Information System, GIS) for Echinococcus transmission "hot spots", combined with hospital records identifying risk areas for AE and CE. A survey of 750 domestic dogs, including copro-sampling and owner questionnaires, from 25 selected villages, was undertaken in 2012. A copro-multiplex PCR assay was used for the specific diagnosis of E. granulosus and E. multilocularis in the dogs. Data analysis, using IBM SPSS Statistics, was undertaken, to compare the prevalence of the two Echinococcus spp. in dogs between four geographical areas of Xiji by the χ2 test. Univariate analysis of the combinations of outcomes from the questionnaire and copro-PCR assay data was carried out to determine the significant risk factors for dog infection. RESULTS: The highest de-worming rate of 84.0% was found in the northwest area of Xiji County, and significant differences (P <  0.05) in the de-worming rates among dogs from the four geographical areas of Xiji were detected. The highest prevalence (19.7%, 59/300) of E. multilocularis occurred in northwest Xiji, though the highest prevalence (18.1%, 38/210) of E. granulosus occurred in southwest Xiji. There was no significant difference (P >  0.05) in the prevalence of E. granulosus in dogs from the northwest, southwest, northeast, and southeast of Xiji, but there were significant differences (P <  0.05) between dogs infected with E. multilocularis from the four areas. None of the other independent variables was statistically significant. CONCLUSIONS: The results from this study indicate a high prevalence of both E. granulosus and E. muiltilocularis in dogs in Xiji County, NHAR. Transmission of E. multilocularis was more impacted by geographical risk-factors in Xiji County than that of E. granulosus. Dogs have the potential to maintain the transmission of both species of Echinococcus within local Xiji communities, and the current praziquantel dosing of dogs appears to be ineffective or poorly implemented in this area.


Assuntos
Doenças do Cão/epidemiologia , Equinococose/veterinária , Doenças Endêmicas , Animais , Anti-Helmínticos/farmacologia , China/epidemiologia , Doenças do Cão/tratamento farmacológico , Doenças do Cão/parasitologia , Doenças do Cão/transmissão , Cães , Equinococose/tratamento farmacológico , Equinococose/epidemiologia , Equinococose/transmissão , Echinococcus granulosus/efeitos dos fármacos , Echinococcus granulosus/fisiologia , Echinococcus multilocularis/efeitos dos fármacos , Echinococcus multilocularis/fisiologia , Fezes/parasitologia , Feminino , Masculino , Praziquantel/farmacologia , Prevalência , População Rural
15.
Geospat Health ; 13(1): 644, 2018 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-29772887

RESUMO

The geographical distribution of Echinococcus spp. infections in Ningxia Hui Autonomous Region (NHAR) has been reported to be expanding in response to environmental change. The aim of the present study was to predict and compare the spatial distribution of human seropositivity for Echinococcus granulosus and Echinococcus multilocularis and infections with these parasites in dogs in four counties in the south of NHAR to identify communities where targeted prevention and control efforts are required. Predicted seroprevalence of E. granulosus in schoolchildren and E. granulosus infections in dogs concurred spatially, whereas predicted seroprevalence of E. multilocularis in schoolchildren and E. multilocularis infections in dogs differed spatially. Enhanced vegetation index was significantly associated with E. multilocularis seropositivity among schoolchildren, and infections with E. granulosus and E. multilocularis in dogs. A positive association was also found between dog infection with E. granulosus and cultivated land, and a negative association between human seropositivity for E. granulosus and bare-land/artificial surfaces. The findings of this study support the importance of land cover and climatic variables in determining habitat suitability for Echinococcus spp. infections, and suggest that definitive hosts other than dogs (e.g. foxes) are important in defining the geographical risk of human seropositivity for E. multilocularis in NHAR.


Assuntos
Doenças do Cão/parasitologia , Equinococose/epidemiologia , Echinococcus granulosus/isolamento & purificação , Análise Espacial , Adolescente , Animais , Criança , China/epidemiologia , Doenças do Cão/epidemiologia , Cães , Fezes/parasitologia , Inquéritos Epidemiológicos , Humanos , Medição de Risco , Estudos Soroepidemiológicos
16.
J Clin Microbiol ; 56(6)2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29563205

RESUMO

Histoplasmosis is an important cause of mortality in patients with AIDS, especially in countries with limited access to antiretroviral therapies and diagnostic tests. However, many disseminated infections in Latin America go undiagnosed. A simple, rapid method to detect Histoplasma capsulatum infection in regions where histoplasmosis is endemic would dramatically decrease the time to diagnosis and treatment, reducing morbidity and mortality. The aim of this study was to validate a commercial monoclonal Histoplasma galactomannan (HGM) enzyme-linked immunosorbent assay (Immuno-Mycologics [IMMY], Norman, OK, USA) in two cohorts of people living with HIV/AIDS (PLHIV). We analyzed urine samples from 589 people (466 from Guatemala and 123 from Colombia), including 546 from PLHIV and 43 from non-PLHIV controls. Sixty-three of these people (35 from Guatemala and 28 from Colombia) had confirmed histoplasmosis by isolation of H. capsulatum Using the standard curve provided by the quantitative commercial test, the sensitivity was 98% (95% confidence interval [CI], 95 to 100%) and the specificity was 97% (95% CI, 96 to 99%) (cutoff = 0.5 ng/ml). Semiquantitative results, using a calibrator of 12.5 ng/ml of Histoplasma galactomannan to calculate an enzyme immunoassay index value (EIV) for the samples, showed a sensitivity of 95% (95% CI, 89 to 100%) and a specificity of 98% (95% CI, 96 to 99%) (cutoff ≥ 2.6 EIV). This relatively simple-to-perform commercial antigenuria test showed a high performance with reproducible results in both countries, suggesting that it can be used to detect progressive disseminated histoplasmosis in PLHIV in a wide range of clinical laboratories in countries where histoplasmosis is endemic.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Antígenos de Fungos/urina , Histoplasmose/diagnóstico , Histoplasmose/urina , Kit de Reagentes para Diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/complicações , Antígenos de Fungos/imunologia , Estudos de Coortes , Coinfecção/microbiologia , Coinfecção/virologia , Colômbia , Ensaio de Imunoadsorção Enzimática , Galactose/análogos & derivados , Guatemala , Histoplasma/isolamento & purificação , Histoplasmose/complicações , Mananas/urina , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade
17.
Parasit Vectors ; 11(1): 159, 2018 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-29523176

RESUMO

BACKGROUND: Human echinococcoses are parasitic helminth infections that constitute a serious public health concern in several regions across the world. Cystic (CE) and alveolar echinococcosis (AE) in China represent a high proportion of the total global burden of these infections. This study was conducted to predict the spatial distribution of human seropositivity for Echinococcus species in Xiji County, Ningxia Hui Autonomous Region (NHAR), with the aim of identifying communities where targeted prevention and control efforts are required. METHODS: Bayesian geostatistical models with environmental and demographic covariates were developed to predict spatial variation in the risk of human seropositivity for Echinococcus granulosus (the cause of CE) and E. multilocularis (the cause of AE). Data were collected from three cross-sectional surveys of school children conducted in Xiji County in 2002-2003, 2006-2007 and 2012-2013. Environmental data were derived from high-resolution satellite images and meteorological data. RESULTS: The overall seroprevalence of E. granulosus and E. multilocularis was 33.4 and 12.2%, respectively, across the three surveys. Seropositivity for E. granulosus was significantly associated with summer and winter precipitation, landscape fragmentation variables and the extent of areas covered by forest, shrubland, water and bareland/artificial surfaces. Seropositivity for E. multilocularis was significantly associated with summer and winter precipitations, landscape fragmentation variables and the extent of shrubland and water bodies. Spatial correlation occurred over greater distances for E. granulosus than for E. multilocularis. The predictive maps showed that the risk of seropositivity for E. granulosus expanded across Xiji during the three surveys, while the risk of seropositivity for E. multilocularis became more confined in communities located in the south. CONCLUSIONS: The identification of high-risk areas for seropositivity for these parasites, and a better understanding of the role of the environment in determining the transmission dynamics of Echinococcus spp. may help to guide and monitor improvements in human echinococcosis control strategies by allowing targeted allocation of resources.


Assuntos
Anticorpos Anti-Helmínticos/sangue , Equinococose/epidemiologia , Echinococcus granulosus/imunologia , Echinococcus multilocularis/imunologia , Exposição Ambiental , Topografia Médica , Adolescente , Animais , Criança , China/epidemiologia , Estudos Transversais , Equinococose/parasitologia , Feminino , Humanos , Masculino , Modelos Estatísticos , Fatores de Risco , Estudos Soroepidemiológicos , Análise Espacial
18.
Parasit Vectors ; 11(1): 108, 2018 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-29471844

RESUMO

BACKGROUND: Human cystic (CE) and alveolar (AE) echinococcoses are zoonotic parasitic diseases that can be influenced by environmental variability and change through effects on the parasites, animal intermediate and definitive hosts, and human populations. We aimed to assess and quantify the spatiotemporal patterns of human echinococcoses in Ningxia Hui Autonomous Region (NHAR), China between January 1994 and December 2013, and examine associations between these infections and indicators of environmental variability and change, including large-scale landscape regeneration undertaken by the Chinese authorities. METHODS: Data on the number of human echinococcosis cases were obtained from a hospital-based retrospective survey conducted in NHAR for the period 1 January 1994 through 31 December 2013. High-resolution imagery from Landsat 4/5-TM and 8-OLI was used to create single date land cover maps. Meteorological data were also collected for the period January 1980 to December 2013 to derive time series of bioclimatic variables. A Bayesian spatio-temporal conditional autoregressive model was used to quantify the relationship between annual cases of CE and AE and environmental variables. RESULTS: Annual CE incidence demonstrated a negative temporal trend and was positively associated with winter mean temperature at a 10-year lag. There was also a significant, nonlinear effect of annual mean temperature at 13-year lag. The findings also revealed a negative association between AE incidence with temporal moving averages of bareland/artificial surface coverage and annual mean temperature calculated for the period 11-15 years before diagnosis and winter mean temperature for the period 0-4 years. Unlike CE risk, the selected environmental covariates accounted for some of the spatial variation in the risk of AE. CONCLUSIONS: The present study contributes towards efforts to understand the role of environmental factors in determining the spatial heterogeneity of human echinococcoses. The identification of areas with high incidence of CE and AE may assist in the development and refinement of interventions for these diseases, and enhanced environmental change risk assessment.


Assuntos
Equinococose Hepática/epidemiologia , Equinococose Pulmonar/epidemiologia , Animais , China/epidemiologia , Monitoramento Epidemiológico , Hospitais , Humanos , Incidência , Tecnologia de Sensoriamento Remoto , Estudos Retrospectivos , Risco , Análise Espaço-Temporal
19.
Med Mycol Case Rep ; 19: 41-44, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29379705

RESUMO

A total of 23/45 (51%) patients with AIDS and histoplasmosis from Medellín, Colombia had other infections. Tuberculosis was the most common (n = 16/23, 70%). Pneumocystosis and cryptococcosis were found in three patients each (13%), bacterial infection and cytomegalovirus occurred each in two patients (9%) while toxoplasmosis, herpes virus and esophageal candidiasis were recorded in one patient each (4%). Of all co-infected patients, 18/23 (78%) had one, four (17%) had two and one (4%) had three additional opportunistic infections.

20.
Sci Total Environ ; 598: 669-679, 2017 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-28454039

RESUMO

Environmental change has been a topic of great interest over the last century due to its potential impact on ecosystem services that are fundamental for sustainable development and human well-being. Here, we assess and quantify the spatial and temporal variation in land cover in Ningxia Hui Autonomous Region (NHAR), China. With high-resolution (30m) imagery from Landsat 4/5-TM and 8-OLI for the entire region, land cover maps of the region were created to explore local land cover changes in a spatially explicit way. The results suggest that land cover changes observed in NHAR from 1991 to 2015 reflect the main goals of a national policy implemented there to recover degraded landscapes. Forest, herbaceous vegetation and cultivated land increased by approximately 410,200ha, 708,600ha and 164,300ha, respectively. The largest relative land cover change over the entire study period was the increase in forestland. Forest growth resulted mainly from the conversion of herbaceous vegetation (53.8%) and cultivated land (30.8%). Accurate information on the local patterns of land cover in NHAR may contribute to the future establishment of better landscape policies for ecosystem management and protection. Spatially explicit information on land cover change may also help decision makers to understand and respond appropriately to emerging environmental risks for the local population.

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