Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 704
Filtrar
1.
Exp Parasitol ; 210: 107847, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32004535

RESUMO

Leishmaniasis is an infectious disease that has high endemicity and is among the six parasitic diseases of higher occurrence in the world. The current treatments are limited due to their toxicity, treatment resistance and high cost which have increased the search for new substances of natural origin for its therapy. Based on this, an in vitro biological and chemical investigation was carried out to evaluate the potential of Piper marginatum against Leishmania amazonesis. P. marginatum leaves were collected to obtain the essential oil (EO) and the ethanolic extract (CE). The chemical profile of the CE and fractions was obtained by 1H NMR. The analysis of the EO chemical composition was performed by GC-MS. EO, CE and fractions were submitted to antileishmanial and cytotoxicity assays against macrophages. The chromatographic profiles of EO, CE and fractions showed the presence of phenolic compounds and terpenoids, having 3,4-Methylenedioxypropiophenone as a major compound. All P. marginatum samples showed low toxicity to macrophages. The CE and the methanolic, hexane and ethyl acetate fractions had low cytotoxicity when compared to Pentamidine. All tested samples inhibited growth of L. amazonensis promastigotes. The antileishmanial activity of EO, CE and fractions were evaluated in macrophages infected with L. (L.) amazonensis and treated with the concentrations 1, 10 and 100 µg/mL for 48 h. All samples were active, but EO and CE showed superior activity against amastigote forms when compared to the promastigote forms of L. amazonensis. This work describes for the first time the antileishmanial activity of the species P. marginatum and its cytotoxicity against macrophages, suggesting that it can be an alternative source of natural products in the phytotherapeutic treatment of leishmaniasis.


Assuntos
Leishmania mexicana/efeitos dos fármacos , Leishmaniose Cutânea/tratamento farmacológico , Óleos Voláteis/farmacologia , Piper/química , Extratos Vegetais/farmacologia , Animais , Brasil/epidemiologia , Doenças Endêmicas , Cromatografia Gasosa-Espectrometria de Massas , Concentração Inibidora 50 , Leishmaniose Cutânea/epidemiologia , Leishmaniose Cutânea/parasitologia , Macrófagos/efeitos dos fármacos , Macrófagos/parasitologia , Espectroscopia de Ressonância Magnética , Camundongos , Camundongos Endogâmicos BALB C , Doenças Negligenciadas/tratamento farmacológico , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/parasitologia , Óleos Voláteis/química , Óleos Voláteis/isolamento & purificação , Extratos Vegetais/química , Extratos Vegetais/isolamento & purificação , Folhas de Planta/química , Óleos Vegetais/química , Óleos Vegetais/isolamento & purificação , Óleos Vegetais/farmacologia
4.
PLoS One ; 14(12): e0224422, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31856176

RESUMO

BACKGROUND: Preventive chemotherapy was administered to 3.2 million Sierra Leoneans in 13 health districts for lymphatic filariasis, onchocerciasis, and soil transmitted helminthes from October 2008 to February 2009. This paper aims to report the findings of a coverage survey conducted in 2009, compare the coverage survey findings with two reported rates for lymphatic filariasis coverage obtained using pre-mass drug administration (MDA) registration and national census projections, and use the comparison to understand the best source of population estimates in calculating coverage for NTD programming in Sierra Leone. METHODOLOGY/PRINCIPAL FINDINGS: Community drug distributors (CDDs) conducted a pre- MDA registration of the population. Two coverage rates for MDA for lymphatic filariasis were subsequently calculated using the reported number treated divided by the total population from: 1) the pre-MDA register and 2) national census projections. A survey was conducted to validate reported coverage data. 11,602 persons participated (response rate of 76.8%). Overall, reported coverage data aggregated to the national level were not significantly different from surveyed coverage (z-test >0.05). However, estimates based on pre-MDA registration have higher agreement with surveyed coverage (mean Kendall's W = 0.68) than coverage calculated with census data (mean Kendall's = 0.59), especially in districts with known large-scale migration, except in a highly urban district where it was more challenging to conduct a pre-MDA registration appropriately. There was no significant difference between coverage among males versus females when the analyses were performed excluding those women who were pregnant at the time of MDA. The surveyed coverage estimate was near or below the minimum 65% epidemiological coverage target for lymphatic filariasis MDA in all districts. CONCLUSION/SIGNIFICANCE: These results from Sierra Leone illustrate the importance of choosing the right denominator for calculating treatment coverage for NTD programs. While routinely reported coverage results using national census data are often good enough for programmatic decision making, census projections can quickly become outdated where there is substantial migration, e.g. due to the impact of civil war, with changing economic opportunities, in urban settings, and where there are large migratory populations. In districts where this is known to be the case, well implemented pre-MDA registration can provide better population estimates. Pre-MDA registration should, however, be implemented correctly to reduce the risk of missing pockets of the population, especially in urban settings.


Assuntos
Filariose Linfática/prevenção & controle , Helmintíase/prevenção & controle , Oncocercose/prevenção & controle , Adulto , Albendazol/uso terapêutico , Censos , Quimioprevenção/métodos , Filariose Linfática/epidemiologia , Feminino , Filaricidas/uso terapêutico , Helmintíase/epidemiologia , Humanos , Ivermectina/uso terapêutico , Masculino , Administração Massiva de Medicamentos/métodos , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/prevenção & controle , Oncocercose/epidemiologia , Serra Leoa/epidemiologia , Inquéritos e Questionários
5.
Z Gastroenterol ; 57(11): 1281-1290, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31739373

RESUMO

INTRODUCTION: The prevalence of alveolar echinococcosis (AE) and cystic echinococcosis (CE) in Germany is increasing. The number of cases in northern and eastern regions is low, so there is little experience with regard to diagnosis and therapy. OBJECTIVES: The objective of this paper was to evaluate the management of suspected and/or diagnosed echinococcosis at a university center in a low-prevalence region. METHODS: All the patients at the Leipzig University Hospital between 2004 and 2018 who had been serologically examined for echinococci were included in a retrospective cohort study. Clinical course, imaging, histology, therapeutic characteristics, relevant comorbidities and risk factors for AE and CE were evaluated. A time-staggered prevalence estimation, as well as sensitivity and specificity calculations for the serological tests, were performed. RESULTS: A total of 382 patients were enrolled, with 11 AE and 7 CE cases identified. The mean prevalence rate of AE in this cohort was 2.9 % and that of CE was 1.8 %. Among the patients, 56 % had known risk factors for AE and CE. The serological tests showed a sensitivity of 86 % and a specificity of 91 %. Two patients with false-negative serology were diagnosed by biopsy. All CE and 5 AE patients (45 %) were operated on. Six AE patients received long-term treatment with albendazole. CONCLUSIONS: AE and CE are rare diseases in the greater Leipzig region; however, case numbers are on the rise. Due to favorable factors such as the escalation of migration, a further increase is expected. Diagnosis and therapy are challenging and should be supported by specialists (experienced infectiologists, imaging experts and skilled hepatobiliary surgeons) who should be integrated in a German network.


Assuntos
Equinococose Pulmonar/epidemiologia , Equinococose/epidemiologia , Echinococcus/isolamento & purificação , Albendazol/uso terapêutico , Animais , Anti-Helmínticos/uso terapêutico , Equinococose/diagnóstico , Equinococose/tratamento farmacológico , Equinococose/parasitologia , Equinococose Hepática/diagnóstico , Equinococose Hepática/tratamento farmacológico , Equinococose Hepática/epidemiologia , Equinococose Pulmonar/parasitologia , Alemanha/epidemiologia , Humanos , Doenças Negligenciadas/diagnóstico , Doenças Negligenciadas/tratamento farmacológico , Doenças Negligenciadas/epidemiologia , Prevalência , Estudos Retrospectivos
6.
PLoS Negl Trop Dis ; 13(11): e0007847, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31751336

RESUMO

INTRODUCTION: Individuals and communities affected by NTDs are often the poorest and most marginalised; ensuring a gender and equity lens is centre stage will be critical for the NTD community to reach elimination goals and inform Universal Health Coverage (UHC). NTDs amenable to preventive chemotherapy have been described as a 'litmus test' for UHC due to the high mass drug administration (MDA) coverage rates needed to be effective and their model of community engagement. However, until now highly aggregated coverage data may have masked inequities in availability, accessibility and acceptability of medicines, slowing down the equitable achievement of elimination goals. METHODS: We conducted qualitative programmatic analysis across different country contexts through the novel application of the Tanahashi Coverage Framework enhanced by gendered intersectional theory to interrogate different components of programme coverage: availability, accessibility, acceptability, contact and effective. Drawing on communities and health implementers perspectives (using focus groups, interviews, and participatory methods) from varying levels of the health system, across four African country contexts (Cameroon, Ghana, Liberia and Nigeria), we show who is left behind and provide recommendations for programmes to respond. FINDINGS: We have unmasked inequities in programme delivery that repeatedly leave vulnerable populations underserved in relation to the prevention and treatment of PC NTDs across all components of coverage explored within the Tanahashi framework. Inequities are influenced by health systems challenges and limitations, due to lack of consideration of gender, power and equity issues. Effective treatment for individuals and communities is shaped by individual identities and the intersecting axes of inequity that converge to shape these positions including gender, age, disability, and geography. Health systems are inherently social and gendered thus they become mediators in managing the impact that social and structural processes have on individual health outcomes. SIGNIFICANCE: To our knowledge this is the only paper which has combined a comprehensive equity framework with intersectional feminist theory, to establish a fuller understanding of who is left behind and why in MDA across countries and contexts. Ensuring the most vulnerable have continued access to future treatment options will contribute to the progressive realisation of UHC, allowing the NTD community to continue to support their vision of being a true 'litmus test'.


Assuntos
Anti-Infecciosos/uso terapêutico , Doenças Transmissíveis/tratamento farmacológico , Doenças Transmissíveis/epidemiologia , Disparidades em Assistência à Saúde/estatística & dados numéricos , Administração Massiva de Medicamentos/métodos , Doenças Negligenciadas/tratamento farmacológico , Doenças Negligenciadas/epidemiologia , África , Feminino , Humanos , Masculino
7.
Rev Bras Parasitol Vet ; 29(1): e014319, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31576975

RESUMO

The role of rodents as reservoirs of helminths of public health importance is not well known. The zoonotic potential of Syphacia spp. has been confirmed; therefore, the study aimed to estimate the occurrence of oxyurid nematodes in small rodents from pet shops and breeding clubs in Slovakia. Fecal samples of 586 pet rodents kept in 133 cages were collected between 2016 and 2018 and examined by Faust´s flotation method. Four species of oxyurid nematodes, Syphacia muris, S. obvelata, Aspiculuris tetraptera and Paraspidodera uncinata were detected. A. tetraptera was found in the faecal samples of all rodent species included in this survey. The number of positive boxes varied from 5.4% in hamsters to 70.0% with mice. The prevalence of Syphacia muris was highest in Mongolian gerbils where up to 75.0% boxes were positive; S. obvelata was found in 26.7% of boxes with mice, 25.0% of boxes with Mongolian gerbils and 3.2% of boxes with rats. The high prevalence of Syphacia spp. in all animal species points out the infection risk for humans. Animals offered for sale are often in close contact with human beings; therefore they should be regularly tested for parasites and then effectively dewormed.


Assuntos
Fezes/parasitologia , Doenças Negligenciadas/veterinária , Oxiuríase/veterinária , Oxyuroidea/isolamento & purificação , Animais de Estimação/parasitologia , Doenças dos Roedores/parasitologia , Animais , Cricetinae/parasitologia , Gerbillinae/parasitologia , Cobaias/parasitologia , Camundongos/parasitologia , Doenças Negligenciadas/diagnóstico , Doenças Negligenciadas/epidemiologia , Oxiuríase/diagnóstico , Oxiuríase/epidemiologia , Oxyuroidea/classificação , Animais de Estimação/classificação , Prevalência , Ratos/parasitologia , Doenças dos Roedores/diagnóstico , Doenças dos Roedores/epidemiologia , Eslováquia/epidemiologia
8.
BMC Infect Dis ; 19(1): 855, 2019 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-31619180

RESUMO

BACKGROUND: Cutaneous leishmaniasis is one of the neglected tropical diseases in the Ethiopian highlands and studies on assessment of knowledge, attitude and practice of the community in endemic areas are scanty. The study aimed to assess the knowledge, attitude towards cutaneous leishmaniasis and treatment seeking practices in people living in the endemic highlands areas in the Northwest, Ethiopia and to provide evidence-based information to guide development of appropriate interventions to reduce the impact of cutaneous leishmaniasis on communities. METHODS: Quantitative cross-sectional study was conducted in cutaneous leishmaniasis endemic districts (woredas) using a semi structured questionnaire. Households were randomly selected according to probability proportional to size of households in each enumeration area. Systematic random sampling of eligible households was based on the number of households recorded during listing of households. Descriptive statistics was used to describe numerical data, organise and summarise the data in a manner that gave meaning to the numerical form. Frequency tables were used to show descriptive analysis and regression analysis was used to determine correlation between variables. RESULTS: Majority of respondents 321(78.7%) lived in rural areas, age ranged between 18 and 85 years and most were farmers. Illiteracy was high (47.6%) among respondents and majority 358(87.8%) had seen patients with CL. Less than quarter (21.6%) had heard about sand flies and knowledge on the peak transmission period was low (46.3%). About 192 (47.1%) of the respondents indicated disfiguring lesions were the major clinical presentations, less than half 55(27.5%) of urban residents believed CL was treatable compared to 145(72.5%) of rural residents (P < 0.001). Traditional medicines were indicated as best treatment option by 209(51.2%) compared to 114(27.9%) for modern treatment. Major factors influencing treatment options included accessibility to treatment facilities, distance and short duration of treatment. Participants expressed negative experiential attitude and perceived control towards modern treatment because of inaccessibility and distance from where modern treatment is provided. CONCLUSION: Priority should be given to primary prevention and appropriate awareness campaigns on lesion recognition. Information on modern treatment should be intensified.


Assuntos
Doenças Endêmicas , Conhecimentos, Atitudes e Prática em Saúde , Leishmaniose Cutânea/epidemiologia , Doenças Negligenciadas/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Etiópia/epidemiologia , Humanos , Pessoa de Meia-Idade , Adulto Jovem
9.
Parasit Vectors ; 12(1): 466, 2019 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-31597558

RESUMO

BACKGROUND: Tsetse-transmitted trypanosomosis is a deadly, neglected tropical disease and a major challenge for mixed crop-livestock agriculture in sub-Saharan Africa. It is caused by several species of the genus Trypanosoma. Information on the occurrence of tsetse flies and African animal trypanosomosis (AAT) is available for different areas of Mali. However, these data have never been harmonized and centralized, which prevents the development of comprehensive epidemiological maps and constrains an evidence-based planning of control actions. To address this challenge, we created a dynamic geo-spatial database of tsetse and AAT distribution in Mali. METHODS: A digital repository containing epidemiological data collected between 2000 and 2018 was assembled. In addition to scientific publications, the repository includes field datasheets, technical reports and other grey literature. The data were verified, harmonized, georeferenced and integrated into a single spatially-explicit database. RESULTS: For the tsetse component, approximately 19,000 trapping records, corresponding to 6000 distinct trapping locations and 38,000 flies were included in the database. Glossina palpalis gambiensis was the most widespread and abundant species, and it was found in the southern, southern-central and western parts of the country. Glossina tachinoides was only found in the South. Only a few specimens of Glossina morsitans submorsitans were detected. For the AAT component, approximately 1000 survey records were included, corresponding to 450 distinct survey sites and 37,000 tested bovines. AAT was found in all surveyed regions, although data for the tsetse-free North and North-East are lacking. Trypanosoma vivax and Trypanosoma congolense were the dominant species, while Trypanosoma brucei infections were much less numerous. CONCLUSIONS: The atlas of tsetse and AAT in Mali provides a synoptic view of the vector and disease situation at the national level. Still, major geographical gaps affect the North, the North-East and the West, and there is also a severe lack of data over the past five years. Trypanosomosis remains a major animal health problem in Mali. However, despite its prevalence and distribution, monitoring and control activities are presently very limited. Efforts should be made to strengthen the progressive control of AAT in Mali, and the atlas provides a new tool to identify priority areas for intervention.


Assuntos
Insetos Vetores/classificação , Tripanossomíase Africana/veterinária , Moscas Tsé-Tsé/classificação , Animais , Bovinos , Bases de Dados Factuais , Feminino , Insetos Vetores/parasitologia , Masculino , Mali/epidemiologia , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/parasitologia , Doenças Negligenciadas/veterinária , Prevalência , Trypanosoma brucei brucei/isolamento & purificação , Trypanosoma brucei brucei/fisiologia , Trypanosoma congolense/isolamento & purificação , Trypanosoma congolense/fisiologia , Trypanosoma vivax/isolamento & purificação , Trypanosoma vivax/fisiologia , Tripanossomíase Africana/epidemiologia , Tripanossomíase Africana/transmissão , Tripanossomíase Bovina/epidemiologia , Tripanossomíase Bovina/transmissão , Moscas Tsé-Tsé/parasitologia
11.
Indian J Med Res ; 149(6): 706-714, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31496523

RESUMO

Onchocerciasis and lymphatic filariasis (LF) are human filarial diseases belonging to the group of neglected tropical diseases, leading to permanent and long-term disability in infected individuals in the endemic countries such as Africa and India. Microfilaricidal drugs such as ivermectin and albendazole have been used as the standard therapy in filariasis, although their efficacy in eliminating the diseases is not fully established. Anti-Wolbachia therapy employs antibiotics and is a promising approach showing potent macrofilaricidal activity and also prevents embryogenesis. This has translated to clinical benefits resulting in successful eradication of microfilarial burden, thus averting the risk of adverse events from target species as well as those due to co-infection with loiasis. Doxycycline shows potential as an anti-Wolbachia treatment, leading to the death of adult parasitic worms. It is readily available, cheap and safe to use in adult non-pregnant patients. Besides doxycycline, several other potential antibiotics are also being investigated for the treatment of LF and onchocerciasis. This review aims to discuss and summarise recent developments in the use of anti-Wolbachia drugs to treat onchocerciasis and LF.


Assuntos
Filariose Linfática/tratamento farmacológico , Doenças Negligenciadas/tratamento farmacológico , Oncocercose/tratamento farmacológico , Wolbachia/patogenicidade , Adulto , Albendazol/uso terapêutico , Animais , Antibacterianos/uso terapêutico , Doxiciclina/uso terapêutico , Quimioterapia Combinada , Filariose Linfática/epidemiologia , Filariose Linfática/microbiologia , Humanos , Índia/epidemiologia , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/microbiologia , Oncocercose/epidemiologia , Oncocercose/microbiologia , Medicina Tropical , Wolbachia/efeitos dos fármacos
12.
Rev Saude Publica ; 53: 61, 2019 Aug 01.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31390430

RESUMO

OBJECTIVE: To analyze the temporal trend of leprosy indicators in a hyperendemic state of Brazil, from 2001-2015. METHODS: This is a time-series study of leprosy indicators in the state of Maranhão, Northeastern region of Brazil. The study used data from the Brazilian National System of Reportable Diseases, for the period between 2001 and 2015. The following indicators were evaluated: (i) detection coefficient in the general population; (ii) detection coefficient in people under 15 years old; (iii) rate of cases with grade 2 physical disability in the diagnosis; (iv) rate of examined contacts, and (v) proportion of healing . The Prais-Winsten regression model was used for trend analysis. Analyses were performed for the state and by each health region. RESULTS: 77,697 leprosy cases were analyzed in the general population and 7,599 in individuals under 15 years old. The detection coefficient in the general population ranged from 80.7/100 thousand inhabitants in 2001 to 51.2/100 thousand inhabitants in 2015. The coefficient in the general population presented a downward trend (annual percentage variation [APV] = -2.98; 95%CI -4.15- -1.79). For the population under 15 years old, the rate was 24.9/100 thousand inhabitants in 2001, and 19.9/100 thousand inhabitants in 2015, with downward trend (APV = -3.07; 95%CI -4.95- -1.15). It was observed upward trend in rate of contacts examined (APV = 2.35; 95%CI 0.58-4.15) and rate of cases with grade 2 disability (APV = 2.19; 95%CI 0.23-4.19). Stationary trend was observed in the proportion of healing (APV = -0.10; 95%CI -0.50-0.30). Regional differences were found in the performance of the indicators. CONCLUSIONS: A downward trend for the detection coefficients in the general population and in individuals under 15 years old was found in Maranhão. Despite this result, the rates are still very high, demanding efforts from all spheres of public administration and health professionals to reduce the burden of the disease in the state.


Assuntos
Doenças Endêmicas/estatística & dados numéricos , Indicadores Básicos de Saúde , Hanseníase/epidemiologia , Doenças Negligenciadas/epidemiologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Feminino , Geografia , Humanos , Hanseníase/diagnóstico , Hanseníase/prevenção & controle , Hanseníase/transmissão , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Vigilância da População , Fatores de Tempo , Adulto Jovem
13.
Prev Vet Med ; 170: 104729, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31421490

RESUMO

Snakebite is a Neglected Tropical Disease estimated to cause more than 100,000 human deaths and disable more than 400,000 victims each year. It primarily affects poor agricultural workers, farmers, and cattle herders living in rural areas of developing countries. It is thus an occupational disease. However, the impact of snakebite on these rural communities could be even higher if a One Health approach is taken to consider the direct impact on domestic animals and indirect impact on the livelihood of affected communities. To explore this hypothesis we developed the first scoping review to identify and characterize the global literature on snakebite in domestic animals. Three bibliographic databases (PubMed, Web of Science and Agricola) were searched using terms related to snake, snakebite and domestic animals for publications up to December 31st, 2016. Two independent reviewers screened publications applying inclusion/exclusion criteria to select relevant material. Relevant information was then extracted from the selected literature. The global literature on snakebite in domestic animals (n = 143 observational studies, reviews and letters) mainly represented North America, Europe and Australia (69%) with less information from Central and South America, Asia and Africa (31%). Observational studies (n = 119) mostly concerned pets (78%) and to a lesser extent livestock (22%). Thirty-four snake species were reported as responsible for bites in domestic animals. WHO's Medically Important Venomous Snakes were more frequently involved. The social-ecological determinants of snakebite were poorly documented but the reviewed literature suggested a strong seasonality and a diversity of habitat. Snakebite in animals caused neurotoxic, cytotoxic and hemotoxic envenomation syndromes similar to humans and death. Half of publications on envenomed livestock reported a fatality rate above 47%. There was no literature on the indirect impact of snakebite on livelihood caused by animal morbidity and mortality. The results of this scoping review suggest a high and under-reported burden in terms of mortality in animals and a potential economic impact of snakebite in terms of losses in livelihood of affected communities. However, major knowledge gaps with respect to impact of snakebite on livestock and livelihood were identified. Filling these gaps is necessary for a full understanding of the impact of snakebite and to raise scientific, political and public awareness on this neglected issue.


Assuntos
Animais Domésticos , Doenças Negligenciadas/veterinária , Mordeduras de Serpentes/veterinária , Animais , Bibliometria , Doenças Negligenciadas/economia , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/mortalidade , População Rural/estatística & dados numéricos , Mordeduras de Serpentes/economia , Mordeduras de Serpentes/epidemiologia , Mordeduras de Serpentes/mortalidade
15.
PLoS Negl Trop Dis ; 13(7): e0007337, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31276494

RESUMO

Lymphatic filariasis (LF) elimination as a public health problem requires the interruption of transmission by administration of preventive mass drug administration (MDA) to the eligible population living in endemic districts. Suboptimal MDA coverage leads to persistent parasite transmission with consequential infection, disease and disability, and the need for continuing MDA rounds, requiring considerable investment. Routine coverage reports must be verified in each MDA implementation unit (IU) due to incorrect denominators and numerators used to calculate coverage estimates with administrative data. IU are usually the health districts. Coverage is verified so IU teams can evaluate their outreach and take appropriate action to improve performance. Mozambique and the Democratic Republic of Congo (DRC) have conducted MDA campaigns for LF since 2009 and 2014, respectively. To verify district reports and assess the declared achievement using administrative data of the minimum 80% coverage of eligible people (or 65% of the total population), both countries conducted rapid probability surveys using Lot Quality Assurance Sampling (LQAS)(n = 1102) in 2015 and 2016 in 58 IU in 49 districts. The surveys identified IU with suboptimal coverage, reasons residents did not take the medication, place where the medication was received, information sources, and knowledge about diseases prevented by the MDA. LQAS identified four inadequately covered IU triggering district team performance reviews with provincial and national teams and district retreatment. Provincial estimates using probability samples (weighted by populations sizes) were 10 and 17 percentage points lower than reported coverage in DRC and Mozambique. The surveys identified: absence from home during annual MDA rounds as the main reason for low performance and provided valuable information about pre-campaign and campaign activities resulting in improved strategies and continued progress towards elimination of LF and co-endemic Neglected Tropical Diseases.


Assuntos
Erradicação de Doenças/normas , Filariose Linfática/prevenção & controle , Filaricidas/administração & dosagem , Administração Massiva de Medicamentos/normas , Garantia da Qualidade dos Cuidados de Saúde , Animais , República Democrática do Congo/epidemiologia , Erradicação de Doenças/métodos , Doenças Endêmicas/prevenção & controle , Humanos , Moçambique/epidemiologia , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/prevenção & controle , Saúde Pública , Wuchereria bancrofti/efeitos dos fármacos
19.
J Neurol ; 266(9): 2334-2337, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31209574

RESUMO

Human African trypanosomiasis (HAT), also known as sleeping sickness, is one of the Africa's 'neglected diseases' and is caused by infection with protozoan parasites of the Trypanosoma genus. Transmitted by the bite of the tsetse fly, it puts 70 million people at risk throughout sub-Saharan Africa and is usually fatal if untreated or inadequately treated. In this brief overview, some important recent developments in this disease are outlined. These cover various aspects including a reduction in disease incidence, newly recognised parasite reservoir sites in humans, disease outcome, novel diagnostic methods, new and improved treatment, and disease neuropathogenesis.


Assuntos
Trypanosoma brucei gambiense/isolamento & purificação , Trypanosoma brucei rhodesiense/isolamento & purificação , Tripanossomíase Africana/diagnóstico , Tripanossomíase Africana/terapia , Animais , Benzamidas/uso terapêutico , Compostos de Boro/uso terapêutico , Humanos , Doenças Negligenciadas/diagnóstico , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/terapia , Tripanossomíase Africana/epidemiologia
20.
PLoS One ; 14(6): e0217420, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31166983

RESUMO

BACKGROUND: Despite Taenia solium taeniosis/cysticercosis (TSTC) having been put high on the global agenda of neglected tropical diseases (NTDs), which over the last years has received a lot of attention, there has been no control programmes in place in sub-Saharan Africa, a highly endemic region. This could be attributed to lack of awareness of many stakeholders on the burden and impact of T. solium. This information is essential in guiding TSTC policies, practices and research agendas as well as encouraging cross-sectoral collaboration in the control of this important zoonotic parasite using a One Health approach. National elimination of the parasite is the foundation for global eradication. This will require that substantial country-level information is provided to all key stakeholders. We have mapped out TSTC research evidence in Tanzania to inform on disease burden and potential for integrated control measures. METHODOLOGY/PRINCIPAL FINDINGS: A scoping review of all TSTC studies undertaken in Tanzania and published up to December 2018 was conducted. The articles were searched from PUBMED, AJOL, Google Scholar and Google in general. Fifty-one (51) articles met the inclusion criteria and were reviewed. Prevalence of taeniosis of 2.3% - 5.2% was estimated based on copro-antigen ELISA while human cysticercosis of >16% was estimated based on serum antigen ELISA (Ag-ELISA) or IgG Western Blot. Neurocysticercosis (NCC) contributed significantly to epilepsy in adults. Farm prevalence of porcine cysticercosis were 6.0% - 17.4% (lingual examination) and 1.5% - 33.3% (Ag-ELISA). Slaughter-slab prevalence were 0% - 18.2% (routine meat inspection). Lacking latrines, watering pigs with river or pond water, and feeding pigs with potato peels were associated with porcine cysticercosis prevalence. Washing hands by dipping method increased the risk of human cysticercosis. In 2012, the number of DALYs/1000 person-years for NCC-associated epilepsy was 0.7 (95% UI, 0.2-1.6), around 5 million USD (95% UI, 797,535-16,933,477) were spent due to NCC-associated epilepsy and nearly 3 million USD (95% UI, 1,095,960-5,366,038) were potentially lost due to porcine cysticercosis. Three rounds of annual treatment of school-age children with praziquantel significantly reduced prevalence of taeniosis and porcine cysticercosis. Health education was efficacious in improving knowledge and attitudes favourable for control of TSTC while a single dose of oxfendazole 30 mg/kg body weight was efficacious in eliminating T. solium cysticerci from pig musculature. CONCLUSIONS/SIGNIFICANCE: The observed high burden of TSTC and the significant contribution of NCC to epilepsy in Tanzania warrant urgent interventions. Evaluation of best control options should make use of disease transmission dynamics models such as cystiSim, taking into account findings from the field based intervention studies. In addition, locally adapted management guidelines for people suffering from NCC are urgently needed.


Assuntos
Cisticercose , Doenças Negligenciadas , Taenia solium , Animais , Efeitos Psicossociais da Doença , Cisticercose/epidemiologia , Cisticercose/prevenção & controle , Humanos , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/prevenção & controle , Tanzânia/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA