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2.
Med Anthropol ; 39(6): 457-473, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31852244

RESUMO

Programs for neglected tropical diseases (NTDs) such as sleeping sickness increasingly involve patients and community workers in syndromic case detection with little exploration of patient understandings of symptoms. Drawing on concepts from sensorial anthropology, I investigate peoples' experiences of sleeping sickness in South Sudan. People here sense the disease through discourses about four symptoms (pain, sleepiness, confusion and hunger) using biomedical and ethnophysiological concepts and sensations of risk in the post-conflict environment. When identified together, the symptoms interlock as a complete disease, prompting people to seek hospital-based care. Such local forms of sense-making enable diagnosis and help control programs function.


Assuntos
Tripanossomíase Africana , Adolescente , Adulto , Idoso , Antropologia Médica , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Negligenciadas/diagnóstico , Doenças Negligenciadas/etnologia , Sudão do Sul , Tripanossomíase Africana/diagnóstico , Tripanossomíase Africana/etnologia , Adulto Jovem
3.
Artigo em Inglês | MEDLINE | ID: mdl-30235817

RESUMO

'Rama and the Worm' is a shadow puppet production targeting neglected diseases in Central Java. It is an entertainment-based intervention study to promote health by reducing the impact of parasitic diseases such as soil-transmitted helminths (STH). The study uses traditional Javanese shadow puppetry (wayang kulit) as a vehicle in village communities to disseminate health messages and promote behaviour change to prevent diseases caused, primarily, by inadequate sanitation and poor hygiene. The health education messages contained in the play, although using traditional characters and themes, required the creation of a completely new narrative script, using characters and plot lines familiar to the wayang kulit repertoire, but placing them in new situations that relate specifically to health promotion objectives. The intervention was piloted in a village in Central Java, Indonesia using a pre/post design with both qualitative and quantitative analysis. A total of 96 male and female villagers, aged between 7 and 87 years, provided both baseline and follow up data. Participant knowledge and behaviours related to gastrointestinal and helminth-related disease were assessed before and after the intervention through a questionnaire administered by interview. Results revealed statistically significant improvements in both knowledge (48.6% pre-intervention score vs. 62.8% post-intervention score, p < 0.001) and behaviour (77.4% vs. 80.6%, p = 0.004) related to gastrointestinal and helminth disease. Findings of the study indicate the wayang kulit performance is an effective health education tool. The results provide proof of concept with scaling up the next step forward. The wayang kulit production provides a significant additional component for an integrated, comprehensive approach to reduction and elimination of STH infection.


Assuntos
Drama , Promoção da Saúde/métodos , Helmintíase/prevenção & controle , Enteropatias Parasitárias/prevenção & controle , Doenças Negligenciadas/prevenção & controle , Jogos e Brinquedos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Helmintíase/etnologia , Humanos , Higiene , Indonésia/epidemiologia , Enteropatias Parasitárias/etnologia , Masculino , Pessoa de Meia-Idade , Doenças Negligenciadas/etnologia , População Rural/estatística & dados numéricos , Solo , Inquéritos e Questionários , Adulto Jovem
4.
PLoS Negl Trop Dis ; 11(10): e0005979, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29077717

RESUMO

BACKGROUND: Human African Trypanosomiasis (HAT) is a neglected disease targeted for elimination as a public health problem by 2020. Elimination requires a better understanding of the epidemiology and clinical evolution of HAT. In addition to the classical clinical evolution of HAT, asymptomatic carriers and spontaneous cure have been reported in West Africa. A genetic component to human susceptibility to HAT has been suggested to explain these newly observed responses to infection. In order to test for genetic associations with infection response, genetic polymorphism in 17 genes were tested (APOL1, IL1B, IL4, IL4R, IL6, IL8, IL12B, IL12RB1, IL10, TNFA, INFG, MIF, HLA-G, HLA-A, HP, HPR and CFH). METHODOLOGY: A case-control study was performed on 180 blood samples collected from 56 cases and 124 controls from Cameroon. DNA was extracted from blood samples. After quality control, 25 samples (24 controls and 1 case) were eliminated. The genotyping undertaken on 155 individuals including 55 cases and 100 controls were investigated at 96 loci (88 SNPs and 8 indels) located on 17 genes. Associations between these loci and HAT were estimated via a case-control association test. RESULTS: Analyses of 64 SNPs and 4 indels out of 96 identified in the selected genes reveal that the minor allele (T) of rs8062041 in haptoglobin (HP) appeared to be protective against HAT (p = 0.0002395, OR 0.359 (CI95 [0.204-0.6319])); indicating higher frequency in cases compared to controls. This minor allele with adjusted p value of 0.0163 is associated with a lower risk (protective effect) of developing sleeping sickness. CONCLUSION: The haptoglobin related protein HPR and HP are tightly linked and both are duplicated in some people and may lead to higher activity. This increased production could be responsible of the protection associated with rs8062041 even though this SNP is within HP.


Assuntos
Antígenos de Neoplasias/genética , Predisposição Genética para Doença , Haptoglobinas/genética , Polimorfismo de Nucleotídeo Único , Tripanossomíase Africana/etnologia , Tripanossomíase Africana/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Alelos , Doenças Assintomáticas/epidemiologia , Camarões/epidemiologia , Estudos de Casos e Controles , Criança , Feminino , Frequência do Gene , Estudos de Associação Genética , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/etnologia , Doenças Negligenciadas/genética , Doenças Negligenciadas/parasitologia , Fatores de Risco , Trypanosoma brucei gambiense/isolamento & purificação , Tripanossomíase Africana/sangue , Tripanossomíase Africana/epidemiologia , Adulto Jovem
5.
Acute Med ; 15(2): 79-83, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27441309

RESUMO

A 62 year old Nepalese gentleman presented with left sided weakness and sensory loss. Initial brain CT scanning was suggestive of acute infarction but a subsequent MRI scan showed cysts with oedema. Cysticercosis serology was positive and a diagnosis of neurocysticercosis was made. The patient made almost a complete recovery after treatment with albendazole, praziquantel and steroids. Neurocysticercosis should be considered in the diffierential diagnosis when patients originating from endemic areas present with focal neurological deficit.


Assuntos
Albendazol/administração & dosagem , Glucocorticoides/administração & dosagem , Neurocisticercose , Paresia , Praziquantel/administração & dosagem , Acidente Vascular Cerebral/diagnóstico , Anticestoides/administração & dosagem , Encéfalo/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Doenças Negligenciadas/diagnóstico , Doenças Negligenciadas/etnologia , Nepal , Neurocisticercose/complicações , Neurocisticercose/diagnóstico , Neurocisticercose/tratamento farmacológico , Neurocisticercose/fisiopatologia , Paresia/diagnóstico , Paresia/etiologia , Paresia/fisiopatologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
7.
PLoS One ; 9(9): e107980, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25248116

RESUMO

Soil-transmitted helminth (STH) infections have been documented among these minority groups since 1938. However the prevalence of STH is still high among these communities. Most studies tend to consider the Orang Asli (indigenous) as a homogenous group. In contrary, different subtribes have their own cultural practices. To understand this variation better, we studied the prevalence and associated factors of STH and other gut parasitic infections among two common subtribes (i.e. Temuan and Temiar). Results showed that the prevalence of the overall STH infections was higher in the Temuan subtribe (53.2% of 171) compared to the Temiar subtribe (52.7% of 98). Trichuris trichiura (46.2%) was the most prevalent parasite in the Temuan subtribe, followed by Ascaris spp. (25.7%) and hookworm (4.1%). In contrast, Ascaris spp. (39.8%) was more prevalent among the Temiar subtribe, preceded by T. trichiura (35.7%) and finally hookworm (8.3%). There were also co-infections of helminthiasis and intestinal protozoa among both Temuan and Temiar subtribes with rates being three times higher among the Temiar compared to Temuan. The most common co-infection was with Entamoeba histolytica/dispar/moshkovskii (n = 24; 24.5%, 16.0-33.0), followed by Giardia spp. (n = 3; 3.1%, -0.3-6.5). In Temuan, STH infection individuals were also infected with Entamoeba histolytica/dispar/moshkovskii (n = 11; 6.4%, 5.0-13.8), Cryptosporidium spp. (n = 3, 1.8%, -0.2-3.8) and Giardia spp. (n = 2, 1.2%, -0.4-2.8). In comparison, there was no Cryptosporidium spp. detected among the Temiar. However, it was interesting to note that there was an occurrence of co-infection of intestinal helminthiasis and sarcocystosis (intestinal) in a Temiar individual. The last report of sarcocystosis (muscular) among the Orang Asli was in 1978. The present study highlighted the importance of understanding the variation of infections amongst the different Orang Asli subtribes. It is vital to note these differences and use this knowledge to customise effective control measures for the various subtribes.


Assuntos
Helmintíase/epidemiologia , Helmintos/classificação , Enteropatias Parasitárias/epidemiologia , Doenças Negligenciadas/etnologia , Sarcocystis/classificação , Sarcocistose/epidemiologia , Adolescente , Adulto , Idoso , Animais , Povo Asiático/etnologia , Criança , Pré-Escolar , Coinfecção , Estudos Transversais , Feminino , Helmintíase/etnologia , Helmintíase/parasitologia , Helmintos/isolamento & purificação , Humanos , Lactente , Enteropatias Parasitárias/etnologia , Enteropatias Parasitárias/parasitologia , Malásia/epidemiologia , Malásia/etnologia , Masculino , Pessoa de Meia-Idade , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/parasitologia , Sarcocystis/isolamento & purificação , Sarcocistose/etnologia , Sarcocistose/parasitologia , Adulto Jovem
8.
Indian J Pediatr ; 80 Suppl 1: S77-86, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22941214

RESUMO

Rheumatic heart disease, a neglected disease, continues to be a burden in India and other developing countries. It is a result of an autoimmune sequalae in response to group A beta hemolytic streptococcus (GAS) infection of the pharynx. Acute rheumatic fever (RF), a multisystem inflammatory disease, is followed by rheumatic heart disease (RHD) and has manifestations of joints, skin and central nervous system involvement. A review of epidemiological studies indicates unchanged GAS pharyngitis and carrier rates in India. The apparent decline in RHD rates in India as indicated by the epidemiological studies has to be taken with caution as methodological differences exist among studies. Use of echocardiography increases case detection rates of RHD in population surveys. However, the significance of echo based diagnosis of carditis needs further evaluation to establish the significance. Research in this area through prospective follow up studies will have to be undertaken by the developing countries as the interest of developed countries in the disease has waned due the declined burden in their populations. Prevention of RHD is possible through treatment of GAS pharyngitis (primary prophylaxis) and continued antibiotic treatment for number of years in patients with history of RF to prevent recurrences (secondary prophylaxis). The cost effectiveness and practicality of secondary prophylaxis is well documented. The challenge to any secondary prophylaxis program for prevention of RF in India will be the availability of benzathine penicillin G and dissipation of fears of allergic reactions to penicillin among practitioners, general public and policy makers. The authors review here the progress and challenges in epidemiology, diagnosis and primary and secondary prevention of RF and RHD.


Assuntos
Países em Desenvolvimento , Doenças Negligenciadas/epidemiologia , Cardiopatia Reumática/epidemiologia , Antibacterianos/uso terapêutico , Criança , Diagnóstico Precoce , Humanos , Índia , Assistência de Longa Duração , Doenças Negligenciadas/diagnóstico , Doenças Negligenciadas/etnologia , Doenças Negligenciadas/prevenção & controle , Penicilina G Benzatina/uso terapêutico , Faringite/complicações , Faringite/diagnóstico , Faringite/epidemiologia , Faringite/prevenção & controle , Guias de Prática Clínica como Assunto , Febre Reumática/complicações , Febre Reumática/epidemiologia , Febre Reumática/prevenção & controle , Cardiopatia Reumática/diagnóstico , Cardiopatia Reumática/etiologia , Cardiopatia Reumática/prevenção & controle , Prevenção Secundária , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/prevenção & controle , Streptococcus pyogenes
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