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1.
Int J Mol Sci ; 22(13)2021 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-34281269

RESUMO

The host-parasite schistosome relationship relies heavily on the interplay between the strategies imposed by the schistosome worm and the defense mechanisms the host uses to counter the line of attack of the parasite. The ultimate goal of the schistosome parasite entails five important steps: evade elimination tactics, survive within the human host, develop into adult forms, propagate in large numbers, and transmit from one host to the next. The aim of the parasitized host on the other hand is either to cure or limit infection. Therefore, it is a battle between two conflicting aspirations. From the host's standpoint, infection accompanies a plethora of immunological consequences; some are set in place to defend the host, while most end up promoting chronic disease, which ultimately crosses paths with oxidative stress and cancer. Understanding these networks provides attractive opportunities for anti-schistosome therapeutic development. Hence, this review discusses the mechanisms by which schistosomes modulate the human immune response with ultimate links to oxidative stress and genetic instability.


Assuntos
Citocinas/metabolismo , Interações Hospedeiro-Parasita/imunologia , Esquistossomose/imunologia , Esquistossomose/metabolismo , Animais , Linfócitos B Reguladores/imunologia , Basófilos/imunologia , Células Dendríticas/imunologia , Eosinófilos/imunologia , Humanos , Macrófagos/imunologia , Mastócitos/imunologia , MicroRNAs/imunologia , Modelos Imunológicos , Estresse Oxidativo , Schistosoma/imunologia , Schistosoma/patogenicidade , Esquistossomose/parasitologia , Linfócitos T Auxiliares-Indutores/imunologia , Linfócitos T Reguladores/imunologia
2.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 33(3): 225-233, 2021 Jun 22.
Artigo em Chinês | MEDLINE | ID: mdl-34286522

RESUMO

This report presented the endemic status of schistosomiasis in the People's Republic of China at a national level in 2020, and analyzed the data collected from the national schistosomiasis prevention and control system and national schistosomiasis surveillance sites. Among the 12 provinces (municipality and autonomous region) endemic for schistosomiasis in China, Shanghai Municipality, Zhejiang Province, Fujian Province, Guangdong Province and Guangxi Zhuang Autonomous Region continued to consolidate the achievements of schistosomiasis elimination, and Sichuan and Jiangsu provinces maintained the criteria of transmission interruption, while Yunnan, Hubei, Anhui, Jiangxi and Hunan provinces maintained the criteria of transmission control by the end of 2020. A total of 450 counties (cites, districts) were found to be endemic for schistosomiasis in China, with 28 376 endemic villages covering 71 370 400 people at risk of infections. Among the 450 endemic counties (cities, districts), 74.89% (337/450), 21.87% (98/450) and 3.33% (15/450) achieved the criteria of elimination, transmission interruption and transmission control of schistosomiasis, respectively. By the end of 2020, 29 517 cases with advanced schistosomiasis were documented in China. In 2020, 11 117 655 individuals received inquiry examinations and 1 798 580 were positive; 5 263 082 individuals received serological tests and 83 179 were sero-positive. A total of 273 712 individuals received stool examinations and 3 were positive, including one case of acute schistosomiasis. In 2020, snail survey was performed in 19 733 endemic villages in China and Oncomelania snails were found in 7 309 villages, accounting for 37.04% of all surveyed villages, with 15 villages identified with emerging snail habitats. Snail survey covered an area of 736 984.13 hm2 and 206 125.22 hm2 snail habitats were found, including 1 174.67 hm2 emerging snail habitats and 1.96 hm2 habitats with infected snails. In 2020, 544 424 bovines were raised in the schistosomiasis-endemic areas of China, and 147 887 received serological examinations, with 326 positives detected, while 130 673 bovines received stool examinations, with no positives identified. In 2020, there were 19 214 patients with schistosomiasis receiving praziquantel chemotherapy, and 964 103 person-time individuals and 266 280 herd-time bovines were given expanded chemotherapy. In 2020, molluscicide treatment was performed in 136 141.92 hm2 snail habitats, and the actual area of chemical treatment was 71 980.22 hm2, while environmental improvements were performed in snail habitats covering an area of 1 464.03 hm2. Data from the national schistosomiasis surveillance sites of China showed that the mean prevalence of Schistosoma japonicum infections were both zero in humans and bovines in 2020, and no S. japonicum infection was detected in snails. The results demonstrate that the overall endemic status of schistosomiasis remains at a low level in China and the goal of the National Thirteenth Five-Year Plan for Schistosomiasis Control was achieved as scheduled; however, the endemic situation of schistosomiasis rebounded in local areas. Precision schistosomiasis control and intensified monitoring of the endemic situation and transmission risk of schistosomiasis are required to be performed to facilitate the progress towards elimination of schistosomiasis steadily.


Assuntos
Moluscocidas , Esquistossomose Japônica , Esquistossomose , Animais , Bovinos , China/epidemiologia , Cidades , Doenças Endêmicas , Humanos , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle , Esquistossomose Japônica/epidemiologia , Caramujos
3.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 33(3): 234-239, 2021 Jul 06.
Artigo em Chinês | MEDLINE | ID: mdl-34286523

RESUMO

OBJECTIVE: To investigate the epidemiological characteristics of current advanced schistosomiasis cases in China, so as to provide the scientific evidence for the precision management and medical care of advanced schistosomiasis. METHODS: The baseline data pertaining to the current advanced schistosomiasis cases in China were collected from the Epidemiological Dynamic Data Collection Platform (EDDC) operated by the Chinese Center for Disease Control and Prevention. The demographic characteristics, population and regional distribution and medical care of advanced schistosomiasis cases were analyzed with a descriptive method. RESULTS: A total of 31 889 cases with advanced schistosomiasis were reported in China by the end of June, 2019, and these cases were mainly identified in Hubei Province (7 737 cases) followed by in Jiangxi Province (7 256 cases), Hunan Province (5 615 cases), Anhui Province (5 236 cases) and Jiangsu Province (2 908 cases), accounting for 90.2% (28 752/31 889) of total cases in China. The current advanced schistosomiasis cases had a male/female ratio of 1.5∶1, and a mean age of (67.0 ± 11.2) years, with 92.6% (29 521/31 889) detected in individuals at ages of over 50 years. There were 97.6% (31 109/31 889) of the cases with an educational level of junior high school and lower, and 95.2% (30 359/31 889) with an occupation of farmers. Ascites (72.6%, 23 164/31 889) and splenomegaly types (26.3%, 8 386/31 889) were predominant in current advanced schistosomiasis cases in China, and there was a significant difference in the constituent ratio of disease types among current advanced schistosomiasis cases with different age groups (χ2 = 362.31, P < 0.01), with the ascites type as the predominant type of advanced schistosomiasis. Among the current advanced schistosomiasis cases, 88.9% (28 358/31 889) and 18.7% (5 973/31 889) had received medical treatment and surgical treatment, respectively. CONCLUSIONS: The current advanced schistosomiasis cases are predominantly reported in five marshland and lake endemic provinces of China where schistosomiasis is not eliminated, and are mostly categorized as the ascites and megalosplenia types, with minor differences seen in gender and disease-type distributions. Precision medical care should be reinforced according to the epidemiological features of the current advanced schistosomiasis cases, and early screening and standard management and follow-up is required.


Assuntos
Esquistossomose , Idoso , China/epidemiologia , Coleta de Dados , Feminino , Humanos , Lagos , Masculino , Pessoa de Meia-Idade , Esquistossomose/epidemiologia , Esplenomegalia
4.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 33(3): 240-247, 2021 Jun 21.
Artigo em Chinês | MEDLINE | ID: mdl-34286524

RESUMO

OBJECTIVE: To establish an indicator system for assessment of schistosomiasis transmission risk after transmission interruption in Hubei Province, so as to provide insights into the precise control of schistosomiasis. METHODS: The indicator system was preliminarily established based on data collection, literature review, expert interviews. Two rounds of expert consultation were performed. The indicator system was screened based on the importance, operability, sensitivity and comprehensive score of the indicators, and the weights of each indicator were calculated. The credibility of the Delphi method was evaluated by calculating the active coefficient of the experts, degree of expert authority and coordination levels of experts' opinions. RESULTS: An indicator system for assessment of schistosomiasis transmission risk was preliminarily established, including 3 primary indicators, 12 secondary indicators and 44 tertiary indicators. A Delphi consultation was performed among 17 experts participating in schistosomiasis control, management and research. Following two rounds of consultation, a risk assessment indicator system was finally constructed, including 3 primary indicators, 10 secondary indicators and 35 tertiary indicators. Among the primary indicators, the variable with the highest normalized weight was the current status of schistosomiasis (0.420 2), followed by social factors (0.397 3) and natural environments (0.182 5). Among the secondary indicators, those with high combined weights included risk monitoring (0.142 3), current snail status (0.140 1), and current prevalence of human and livestock infections (0.137 8). Among the tertiary indicators, those with high combined weights included the positive rate of wild feces (0.049 8), the prevalence of snail infections (0.047 4), and the area of snail habitats submerged by floods (0.046 8). During the two-round consultation, the active coefficients of the experts were 85.00% and 100.00%, the degree of expert authority was both 0.75 and greater, and the coordination levels of experts' opinions were 0.405 to 0.521 and 0.592 to 0.695 (all P values < 0.05). CONCLUSIONS: An indicator system for assessment of schistosomiasis transmission risk is successfully established after transmission interruption in Hubei Province based on the Delphi method, which provides insights into the identification of the schistosomiasis transmission risk and the targets for schistosomiasis control in Hubei Province.


Assuntos
Esquistossomose , China/epidemiologia , Ecossistema , Meio Ambiente , Inundações , Humanos , Medição de Risco , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle
5.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 33(3): 301-304, 2021 Jul 08.
Artigo em Chinês | MEDLINE | ID: mdl-34286534

RESUMO

The invalid patents associated with schistosomiasis control were retrieved in the Chinese Patent Database of China National Intellectual Property Administration, the Baiten database and the incoPat database, and the overall trends, legal status, types, patent indexing and technical fields of all retrieved invalid patents were analyzed. As of December 30, 2020, there were totally 859 patents relating to schistosomiasis control, and 512 were invalid patents, with an invalid rate of 59.6%. The number of patent applications and invalid patents peaked in 2018, including 71 patent applications and 53 invalid patents. Among the 511 schistosomiasis control-related invalid patents with complete records, there were 425 invention patents, 81 utility model patents and 5 design patents, and 219 patents (42.9%) were invalid due to the termination of the patented right and 292 (57.1%) due to loss of the right for patent applications. The major technical points included medicines (chemicals), basic research, devices and detections, and the specialized fields were mainly concentrated in A61P33, G01N33, C12N15, C07K14 and A01N65. Our data demonstrate a high invalid rate of patents relating to schistosomiasis control in China. Secondary development and mining of the invalid patents in relation to schistosomiasis are recommended to make use of their values in the national schistosomiasis elimination program of China.


Assuntos
Esquistossomose , China/epidemiologia , Humanos , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle
6.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 33(3): 311-316, 2021 Apr 14.
Artigo em Chinês | MEDLINE | ID: mdl-34286537

RESUMO

Due to the relative shortage of health resources, rational allocation and utilization of health resources is critical to achieving the maximum economic benefits in developing countries, which requires a health economic assessment to meet the needs to balance the competitive requirements of cost reduction and effectiveness enhancement. This review describes the advances in applications of health economic assessment techniques in four major infectious diseases, including AIDS, tuberculosis, hepatitis B and schistosomiasis. Currently, there is no standard economic assessment in the prevention and control of infectious diseases, and notably, the transparency of cost research is limited, which may affect the popularization of the study conclusions. Further health economic assessments of infectious diseases are required to improve the quality, standard and transparency of the economic evaluation through formulating strategies, to improve the standardization of studies, to improve the popularization of the study conclusions and to improve the applicability of the economic evaluation for policies.


Assuntos
Doenças Transmissíveis , Esquistossomose , Doenças Transmissíveis/epidemiologia , Análise Custo-Benefício , Humanos , Esquistossomose/prevenção & controle
7.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 33(3): 320-324, 2021 Apr 16.
Artigo em Chinês | MEDLINE | ID: mdl-34286539

RESUMO

With the deepening of the schistosomiasis research, risk assessment models have been widely used in schistosomiasis research and control. This paper reviews the theoretical basis and applications of common schistosomiasis risk assessment models and the Bayesian model, so as to provide insights into national schistosomiasis elimination program in China.


Assuntos
Esquistossomose , Teorema de Bayes , China/epidemiologia , Humanos , Medição de Risco , Esquistossomose/prevenção & controle
8.
Front Cell Infect Microbiol ; 11: 691757, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34277472

RESUMO

Schistosoma japonicum (S. japonicum) infection can induce serious organ damage and cause schistosomiasis japonica which is mainly prevalent in Asia and currently one of the most seriously neglected tropical diseases. Treatment of schistosomiasis largely depends on the drug praziquantel (PZQ). However, PZQ exhibits low killing efficacy on juvenile worms and the potential emergence of its drug resistance is a continual concern. Protein kinases (PKs) are enzymes that catalyze the phosphorylation of proteins and can participate in many signaling pathways in vivo. Recent studies confirmed the essential roles of PKs in the growth and development of S. japonicum, as well as in schistosome-host interactions, and researches have screened drug targets about PKs from S. japonicum (SjPKs), which provide new opportunities of developing new treatments on schistosomiasis. The aim of this review is to present the current progress on SjPKs from classification, different functions and their potential to become drug targets compared with other schistosomes. The efficiency of related protein kinase inhibitors on schistosomes is highlighted. Finally, the current challenges and problems in the study of SjPKs are proposed, which can provide future guidance for developing anti-schistosomiasis drugs and vaccines.


Assuntos
Preparações Farmacêuticas , Schistosoma japonicum , Esquistossomose , Animais , Ásia , Proteínas Quinases
9.
Artigo em Chinês | MEDLINE | ID: mdl-34218560

RESUMO

Objective: To assess the health-related quality of life in the agricultural workers with schistosomiasis liver fibrosis using Europe Health-Related Quality of Life Questionnaire 5 Dimensions (EQ-5D) . Methods: From January to December 2019, a cross sectional study was applied to 3507 agricultural workers at a township, Kaihua County, Zhejiang Province, of which 424 agricultural workers with schistosomiasis liver fibrosis as objective group and of which 3083 agricultural workers without schistosomiasis liver fibrosis as the control group whom were respectively evaluated by the EQ-5D scale. At the same time, aspartate aminotransferase (AST) and platelet (PLT) ratio index (APRI) was calculated, and B-type ultrasound was used to test the degree of liver fibrosis among two groups. Results: There were 424 patients in the objective group, aged (66.29±7.21) years, and 3083 person in the control group, aged (65.98±14.81) years. The APRI scores between the control group and the objective group were (0.74±0.51) points and (1.04±0.53) points, respectively (P<0.01) . The total score of 5 items of EQ-5D was (6.86±2.21) points and (7.88±2.71) points, respectively, in the objective group had 375 cases of liver fibrosis grade I and 49 cases of liver fibrosis grade Ⅱ, which were significantly higher than that of the control group[ (5.50±1.17) points] (P<0.01) . Among the respondents, EQ-VAS score was negative correlated with EQ-5D scores (r=-0.616, P<0.01) . Conclusion: The health-related quality of life of agricultural workers with schistosomiasis liver fibrosis at a township, Quzhou City Kaihua County decreased compared with the control group.


Assuntos
Qualidade de Vida , Esquistossomose , Estudos Transversais , Europa (Continente) , Fazendeiros , Humanos , Cirrose Hepática , Fatores Socioeconômicos , Inquéritos e Questionários
10.
BMC Public Health ; 21(1): 1064, 2021 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-34088297

RESUMO

BACKGROUND: Understanding the health behavior of the target population is crucial for sustainable schistosomiasis control. The aim of this study was to assess schistosomiasis related levels of knowledge, attitude, and practices of communities in lowland areas of western Ethiopia, where schistosomiasis is endemic. METHODS: A community-based multilevel triangulation mixed-methods design was conducted in three schistosomiasis endemic villages in the Abbey and Didessa valleys of the Benishangul Gumuz Region of Western Ethiopia, where mass drug administration (MDA) was done 30 years back and again the last 5 years. A structured survey questionnaire, in-depth interviews, focused group discussions, and observation was conducted to assess levels of knowledge, attitude, and practices related to schistosomiasis in the communities. RESULTS: Among the survey participants, 13% reported having heard of schistosomiasis, locally called Pecka (meaning worm). The majority of this 13% believe that schistosomiasis is caused by the biting of the worm Pecka, while others say drinking dirty water is the cause of infection, or they didn't know what the cause is. A majority of respondents answered "I don't know" to most of the questions about established knowledge of schistosomiasis. Male participants and students were more aware of schistosomiasis than their counterparts, and awareness increased with the educational level. Only one participant perceived that schistosomiasis was a serious disease. There were negative attitudes and misconceptions about the drug used in the mass treatment and many complaints were raised related to the size of the tablet and its side effects. There was no local budget and specific plan to prevent and control the disease. Local health personnel had insufficient knowledge about schistosomiasis, and the diagnosis and treatment capacities of local health institutions were poor. CONCLUSION: In the current research area, schistosomiasis prevention and control recommendations should be redesigned to change the knowledge, attitudes, and practices of the community and local health workers. It is also necessary to have the local budget and trained manpower in order to diagnose and treat schistosomiasis locally. There is a great need to have a safer Praziquantel pediatric formulation.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Esquistossomose , Criança , Estudos Transversais , Etiópia/epidemiologia , Humanos , Masculino , Administração Massiva de Medicamentos , Praziquantel , Esquistossomose/tratamento farmacológico , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle , Inquéritos e Questionários
11.
Artigo em Inglês | MEDLINE | ID: mdl-34069316

RESUMO

Schistosomiasis, a neglected tropical disease (NTD), causes morbidity and mortality in over 250 million people globally. And 700 million people are at risk of contracting it. It is caused by a parasite of the genus Schistosoma. Freshwater snails of the family Planorbidae are of public health significance as they are intermediate hosts of these highly infective flukes. Accurate diagnostic techniques to detect schistosome infections in intermediate host snails (IHS) and environmental surveillance are needed to institute measures for the interruption of transmission and eventual elimination. We carried out a systematic review of the literature to assess advantages and limitations of different diagnostic techniques for detecting schistosome infections in snails. Literature from Scopus, Web of Science, and PubMed databases from 2008 to 2020 were searched using combinations of predefined search terms with Boolean operators. The studies revealed that conventional diagnostics are widely used, although they are labor-intensive, have low specificity and sensitivity levels, and cannot detect prepatent infections. Whereas more advanced techniques such as immunological, nucleic-acid amplification, and eDNA diagnostics have high sensitivity and specificity levels, they are costly, hence, not suitable for field applications and large-scale surveys. Our review highlights the importance of designing and developing innovative diagnostics that are high in specificity and sensitivity as well as affordable and technically feasible for use in field laboratories and for large-scale surveys.


Assuntos
Esquistossomose , Animais , Água Doce , Humanos , Doenças Negligenciadas , Schistosoma , Esquistossomose/diagnóstico , Caramujos
12.
BMJ Open ; 11(6): e047147, 2021 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-34168029

RESUMO

INTRODUCTION: Alternative drugs and diagnostics are needed for the treatment and control of schistosomiasis. The exclusive use of praziquantel (PZQ) in mass drug administration programmes may result in the emergence of drug resistance. PZQ has little activity against Schistosoma larvae, thus reinfection remains a problem in high-risk communities. Furthermore, the insufficient sensitivity of conventional microscopy hinders therapeutic response assessment. Evaluation of artesunate-mefloquine (AM) as a Novel Alternative Treatment for Schistosomiasis in African Children (SchistoSAM) aims to evaluate the safety and efficacy of the antimalarial combination artesunate-mefloquine, re-purposed for the treatment of schistosomiasis, and to assess the performance of highly sensitive novel antigen-based and DNA-based assays as tools for monitoring treatment response. METHODS AND ANALYSIS: The SchistoSAM study is an open-label, two-arm, individually randomised controlled non-inferiority trial, with a follow-up of 48 weeks. Primary school-aged children from the Richard Toll district in northern Senegal, an area endemic for Schistosoma mansoni and Schistosoma haematobium, are allocated to the AM intervention arm (3-day courses at 6-week intervals) or the PZQ control arm (single dose of 40 mg/kg). The trial's primary endpoints are the efficacy (cure rate (CR), assessed by microscopy) and safety (frequency and pattern of drug-related adverse events) of one AM course versus PZQ at 4 weeks after treatment. Secondary endpoints include (1) cumulative CR, egg reduction rate and safety after each additional course of AM, and at weeks 24 and 48, (2) prevalence and severity of schistosomiasis-related morbidity and (3) malaria prevalence, incidence and morbidity, both after 24 and 48 weeks. CRs and intensity reduction rates are also assessed by antigen-based and DNA-based diagnostic assays, for which performance for treatment monitoring is evaluated. ETHICS AND DISSEMINATION: Ethics approval was obtained both in Belgium and Senegal. Oral assent from the children and signed informed consent from their legal representatives was obtained, prior to enrolment. The results will be disseminated in peer-reviewed journals and at international conferences. TRIAL REGISTRATION NUMBER: NCT03893097; pre-results.


Assuntos
Anti-Helmínticos , Esquistossomose , Anti-Helmínticos/uso terapêutico , Artesunato , Bélgica , Criança , Humanos , Mefloquina , Ensaios Clínicos Controlados Aleatórios como Assunto , Esquistossomose/tratamento farmacológico , Senegal , Resultado do Tratamento
13.
PLoS Negl Trop Dis ; 15(6): e0009478, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34166369

RESUMO

BACKGROUND: Globally, schistosomiasis affects at least 240 million people each year with a high proportion of cases in sub-Saharan Africa. The infection presents a wide range of symptoms mainly at the gastrointestinal and urogenital level. Cases of schistosomiasis-related appendicitis are seldom reported. The aim of the present study is to identify the prevalence of schistosomiasis-related appendicitis in Beira, Mozambique and compare to global prevalence. METHODS: We retrospectively reviewed all cases of appendicitis recorded from January 2017 to March 2020 at a single pathology department located in Beira in order to assess the prevalence of schistosomiasis. Moreover, we performed a systematic review on the prevalence of schistosomiasis-related appendicitis in all countries. FINDINGS: A total of 145 appendicitis cases in Beira showed a 13.1% prevalence of schistosomal-related appendicitis. The mean age of patients was 29.1 years, and 14 (73.7%) were male. The systematic review identified 20 studies with 34,790 inpatients with schistosomiasis-related appendicitis with a global prevalence of 1.31% (95% confidence interval (CI): 0.72 to 2.06); a high heterogeneity (I2 = 96.0%) was observed. Studies carried out in Africa reported a significantly higher prevalence of schistosomiasis-related appendicitis (2.75%; 95% CI: 1.28 to 4.68) than those in Middle East (0.49%; 95% CI: 0.18 to 0.95) (p for interaction < 0.0001). CONCLUSIONS: Schistosomiasis infection should be considered as possible cause of appendicitis not only in endemic areas but also in developed countries. Considering that prevention is the best way to control the infection, more efforts should be put in place in order to increase the prevention coverage and avoid the cascading implications for health. This is even more so important in this Coronavirus Disease 2019 (COVID-19) era where the majority of attention and funds are used to fight the pandemic.


Assuntos
Apendicite/etiologia , Esquistossomose/complicações , Adulto , Apendicite/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Estudos Retrospectivos
14.
Artigo em Inglês | MEDLINE | ID: mdl-34037157

RESUMO

Neglected tropical diseases (NTDs) are those affecting vulnerable people and causing additional social and economic burden. The aim of this study was to carry out a general overview of the health economic assessments involving the diagnosis and treatment of six NTDs: cutaneous leishmaniasis (CL), Chagas disease, cysticercosis, filariasis, schistosomiasis and visceral leishmaniasis (VL). The literature search was based on two of the main medical literature databases (Medline and SciELO) and identified 46 studies. Twenty-six studies (57%) addressed therapeutic strategies, while other 20 (43%) assessed diagnostic or both diagnostic and therapeutic approaches. The studies were published between 1994 and 2021, and 57% of them (26/46) were carried out in four countries. Cost-effectiveness analyses were conducted in 59% (27/46) of the studies. Economic studies of NTDs have timidly increased in recent years. Despite the improvement of analytical methods, completeness and accuracy of information, there are few new technologies applied to NTDs and public health systems. In addition, economic studies for NTDs are concentrated in a few countries. Thus, this review points out the need for investment in research, development and training of human resources dedicated to the economic analysis in health, especially on NTDs, as a strategy to reduce inequalities by optimizing the use of health resources.


Assuntos
Doença de Chagas , Esquistossomose , Medicina Tropical , Análise Custo-Benefício , Humanos , Doenças Negligenciadas/diagnóstico
15.
BMC Health Serv Res ; 21(1): 529, 2021 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-34053433

RESUMO

BACKGROUND: The World Health Organization (WHO) calls for schistosomiasis endemic countries to integrate schistosomiasis control measures into the primary health care (PHC) services; however, in Tanzania, little is known about the capacity of the primary health care system to assume this role. The objective of this study was to assess the capacity of the primary health care system to diagnose and treat schistosomiasis in endemic regions of north-western Tanzania. METHODS: A total of 80 randomly-selected primary health care facilities located in the Uyui, Geita and Ukerewe districts of North-western Tanzania participated in the study. At each facility, the in-charge clinician, or any other healthcare worker appointed by the in-charge clinician, participated in the questionnaire survey. A quantitative questionnaire installed in a Data Tool Kit software was used to collect data. Healthcare workers working at various stations (laboratory, pharmacy, data clerks, outpatient section) were interviewed. The questionnaire collected information related to healthcare workers' knowledge about urogenital and intestinal schistosomiasis symptoms, human and material resources, laboratory services, data capture, and anti-schistosomiasis treatment availability. RESULTS: A total of 80 healthcare workers were interviewed. Bloody stool (78.3 %) and haematuria (98.7 %) were the most common symptoms of intestinal and urogenital schistosomiasis mentioned by healthcare workers. Knowledge on the chronic symptoms such as hepatosplenomegaly and hematemesis for intestinal schistosomiasis, and oliguria and dysuria for urogenital schistosomiasis, were inadequate. Laboratory services were only available in 33.8 % (27/80) of the health facilities and direct wet preparation was the most common diagnostic technique used for both urine and stool samples. All healthcare workers knew that praziquantel was the drug of choice for the treatment of schistosomiasis and the drug was available in 91.3 % (73/80) of the health facilities. CONCLUSIONS: The capacity of the primary health care facilities included in the current study is inadequate in terms of diagnosis, treatment, reporting and healthcare workers' knowledge of schistosomiasis. Thus, the integration of schistosomiasis control activities into the primary healthcare system requires these gaps to be addressed.


Assuntos
Esquistossomose mansoni , Esquistossomose , Pessoal de Saúde , Humanos , Atenção Primária à Saúde , Esquistossomose/diagnóstico , Esquistossomose/tratamento farmacológico , Esquistossomose/epidemiologia , Esquistossomose mansoni/diagnóstico , Esquistossomose mansoni/tratamento farmacológico , Esquistossomose mansoni/epidemiologia , Tanzânia/epidemiologia
16.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 33(2): 107-109, 2021 Apr 16.
Artigo em Chinês | MEDLINE | ID: mdl-34008355

RESUMO

Surveillance is an important part of the national schistosomiasis control program of China, which play a critical role in facilitating the progress towards elimination of schistosomiasis in China. The coverage of schistosomiasis surveillance has shifted from the high-risk regions at the initial stage of the national schistosomiasis control program of China to the current all endemic counties (cities, districts), and the surveillance contents have extended from single surveillance of endemic status to comprehensive surveillance of endemic status, epidemic factors and transmission risks. With the continuous progress towards schistosomiasis elimination, the national schistosomiasis control program has shifted from "extensive control" to surveillance and early warning-based "precision control" in China, which proposes much higher requirements for schistosomiasis surveillance. Currently, the surveillance of schistosomiasis has been covered in all schistosomiasis-endemic counties (cities, districts) of China, and the development of rapid and early identification of Schistosoma japonicum cercariae and S. japonicum-infected Oncomelania hupensis snails will greatly improve the sensitivity of and the duration of responses to schistosomiasis surveillance, which will provide powerful tools for elimination of schistosomiasis in China.


Assuntos
Esquistossomose Japônica , Esquistossomose , Animais , China/epidemiologia , Cidades , Schistosoma , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle , Caramujos
17.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 33(2): 120-126, 2021 Apr 20.
Artigo em Chinês | MEDLINE | ID: mdl-34008357

RESUMO

OBJECTIVE: To understand the morbidity due to Schistosoma japonicum in national schistosomiasis surveillance sites of China from 2015 to 2019, so as to provide insights into schistosomiasis control and elimination and provide the scientific evidence for formulating the new scheme for schistosomiasis surveillance in China. METHODS: According to the requirements of National Scheme for Schistosomiasis Surveillance in China (2014 Edition), national schistosomiasis surveillance sites were assigned in all schistosomiasis-endemic counties (cities, districts) and the potential endemic counties (cities, districts) in the Three Gorges Reservoir areas, and S. japonicum infections were monitored in local residents, mobile populations and livestock according to different epidemic types. The sero-prevalence of S. japonicum infections, adjusted prevalence of human S. japonicum infections, characteristics of egg-positive individuals and prevalence of S. japonicum infections livestock were analyzed. RESULTS: S. japonicum infections were monitored in 453 schistosomiasis-endemic counties (cities, districts) from 13 provinces (municipalities, autonomous regions) and 4 potential endemic counties (cities, districts) from the Three Gorges Reservoir areas in China from 2015 to 2019. During the 5-year period from 2015 to 2019, the sero-prevalence of S. japonicum infections reduced from 3.35% to 1.63% among local residents and from 1.15% to 0.75% among mobile populations, while the adjusted prevalence of infections reduced from 0.05% to 0 among local residents and from 0.20% to 0.001 03% among mobile populations. There were significant differences in the sero-prevalence of S. japonicum infections among local residents and mobile populations in terms of province, occupation and age (all P values < 0.05). A total of 132 egg-positives were identified during the 5-year period, including 97 local residents (inter-quartile range for ages, 47 to 61 years), and 35 mobile populations (inter-quartile range for ages, 26 to 48 years), and there was a significant difference in the age distribution between local residents and mobile populations (P < 0.05). There were totally 6 bovines (5 in 2015 and 1 in 2016) identified with S. japonicum infections in national schistosomiasis surveillance sites of China, with no S. japonicum infections detected in bovines from 2017 to 2019. CONCLUSIONS: The prevalence of schistosomiasis is very low in China. Further surveillance including more mobile surveillance sites seems justified to identify the risk of schistosomiasis as soon as possible and interrupt the transmission route, so as to facilitate the elimination of schistosomiasis in China.


Assuntos
Esquistossomose Japônica , Esquistossomose , Adulto , Animais , Bovinos , China/epidemiologia , Cidades , Humanos , Gado , Pessoa de Meia-Idade , Esquistossomose/epidemiologia , Caramujos
18.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 33(2): 127-132, 2021 Apr 20.
Artigo em Chinês | MEDLINE | ID: mdl-34008358

RESUMO

OBJECTIVE: To analyze the monitoring data of Oncomelania hupensis in the national schistosomiasis surveillance sites of China from 2015 to 2019, so as to understand the changes of Oncomelania snail status in the schistosomiasis-endemic areas of China and to provide the scientific evidence for Oncomelania snail control. METHODS: According to the requirements of National Scheme for Schistosomiasis Surveillance in China (2014 Edition), national schistosomiasis surveillance sites were assigned in all schistosomiasis-endemic counties (cities, districts) and the potential endemic counties (cities, districts) in the Three Gorges Reservoir areas, and Oncomelania snail status was monitored according to different epidemic types. In endemic areas, Oncomelania snail survey was performed by means of systematic sampling and environmental sampling, and the occurrence of frames with Oncomelania snails and the prevalence of Schistosoma japonicum infections in Oncomelania snails were calculated, while in potential endemic areas, the risk of imported Oncomelania snails and Oncomelania snails in floating debris were monitored. RESULTS: Oncomelania snail survey was performed covering an area of 116 834.16 hm2 in the national schistosomiasis surveillance of China from 2015 to 2019, with 35 007.62 hm2 Oncomelania snail habitats identified. A total of 6 908 292 frames were surveyed during the 5-year period, and there were 364 555 frames detected with Oncomelania snails, with a 5.28% mean occurrence of frames with Oncomelania snails. Among 997 508 living Oncomelania snails captured, no S. japonicum infections were detected, and loop-mediated isothermal amplification (LAMP) assay detected 18 positive mixed Oncomelania snail samples. During the period from 2015 to 2019, 147.20 hm2 emerging Oncomelania snail habitats were identified, with an overall tendency towards a rise seen in the proportion of emerging Oncomelania snail habitats in plain regions with waterway networks (0.12% to 92.00%), a tendency towards a rise followed by decline seen in marshland and lake regions (0 to 96.72%), and a large fluctuation in hilly regions (0 to 88.49%). A total of 831.10 hm2 re-emerging Oncomelania snail habitats were found in the national schistosomiasis surveillance sites of China from 2015 to 2019, with an overall tendency towards a rise seen in the proportion of re-emerging Oncomelania snail habitats in marshland and lake regions (16.05% to 79.66%), an overall tendency towards a decline seen in hilly regions (19.25% to 81.00%), and a minor fluctuation in plain regions with waterway networks (1.10% to 10.14%). During the 5-year period from 2015 to 2019, a total of 48 656 kg floating debris were captured in 4 surveillance sites in the Three Gorges Reservoir areas, and 2 204 snails were found, with no Oncomelania snails identified. CONCLUSIONS: The areas of Oncomelania snail habitats tended to be stable in the national schistosomiasis surveillance sites of China during the period from 2015 to 2019, however, there was a gradual rise in the area of Oncomelania snail habitats year by year, and LAMP assay identified positive Oncomelania snail samples, suggesting Oncomelania snail control is far from optimistic in China.


Assuntos
Esquistossomose , Animais , China/epidemiologia , Cidades , Técnicas de Diagnóstico Molecular , Técnicas de Amplificação de Ácido Nucleico , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle , Caramujos
19.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 33(2): 133-137, 2021 Apr 16.
Artigo em Chinês | MEDLINE | ID: mdl-34008359

RESUMO

OBJECTIVE: To create a model based on meteorological data to predict the regions at risk of schistosomiasis during the flood season, so as to provide insights into the surveillance and forecast of schistosomiasis. METHODS: An interactive schistosomiasis forecast system was created using the open-access R software. The schistosomiasis risk index was used as a basic parameter, and the species distribution model of Oncomelania hupensis snails was generated according to the cumulative rainfall and temperature to predict the probability of O. hupensis snail distribution, so as to identify the regions at risk of schistosomiasis transmission during the flood season. RESULTS: The framework of the web page was built using the Shiny package in the R program, and an interactive and visualization system was successfully created to predict the distribution of O. hupensis snails, containing O. hupensis snail surveillance site database, meteorological and environmental data. In this system, the snail distribution area may be displayed and the regions at risk of schistosomiasis transmission may be predicted using the species distribution model. This predictive system may rapidly generate the schistosomiasis transmission risk map, which is simple and easy to perform. In addition, the regions at risk of schistosomiasis transmission were predicted to be concentrated in the middle and lower reaches of the Yangtze River during the flood period. CONCLUSIONS: A schistosomiasis forecast system is successfully created, which is accurate and rapid to utilize meteorological data to predict the regions at risk of schistosomiasis transmission during the flood period.


Assuntos
Inundações , Esquistossomose , Animais , China/epidemiologia , Rios , Esquistossomose/epidemiologia , Caramujos
20.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 33(2): 148-153, 2021 Apr 16.
Artigo em Chinês | MEDLINE | ID: mdl-34008361

RESUMO

OBJECTIVE: To investigate the expression and clinicopathological significance of Bcl-2 and Bax genes in colorectal cancer (CRC) patients complicated with schistosomiasis. METHODS: The CRC patients receiving surgical treatment in the First Affiliated Hospital of Dali University from June 2016 to June 2020 were recruited as the study subjects, and 30 subjects were randomly sampled from the CRC patients complicated with schistosomiasis (CRC-S group) and 30 subjects were randomly sampled from the CRC patients without schistosomiasis (CRC group) using a random number table method. The cancer specimens were sampled from subjects in the CRC-S and CRC groups, and the peri-cancer specimens were sampled from subjects in the CRC group. The Bcl-2 and Bax expression was quantified in cancer and peri-cancer specimens using a real-time fluorescent quantitative PCR (qPCR) assay and immunohistochemistry at transcriptional and translational levels, and the cell apoptosis was detected in cancer specimens using HE staining. RESULTS: A total of 60 subjects were enrolled, including 30 cases in the CRC group and 30 cases in the CRC-S group. There were no significant differences between the two groups in terms of gender distribution (χ2 = 0.271, P > 0.05), mean age (t = -0.596, P > 0.05), tumor growth pattern (χ2 = 0.275, P > 0.05), tumor location (χ2 = 4.008, P > 0.05), tumor invasion depth (χ2 = 0.608, P > 0.05), degree of tumor differentiation (χ2 = 0.364, P > 0.05), or presence of vascular metastasis (χ2 = 1.111, P > 0.05), while significant differences were seen between the two groups in terms of histological type, presence of lymph node metastasis and TMN staging (χ2 = 5.963, 8.297 and 5.711, all P values < 0.05). qPCR assay and immunohistochemistry quantified significantly higher Bcl-2 and Bax expression in cancer specimens from the CRC and CRC-S groups than in the peri-cancer specimens from the CRC group at both translational and transcriptional levels (all P values < 0.05), and higher Bcl-2 and lower Bax expression were seen in the cancer specimens from the CSC-S group than that from the CRC group (all P values < 0.05). In addition, the cell apoptotic rate was significantly greater in the cancer specimens in the CRC group than in the CRC-S group (42.00% vs. 23.35%; χ2 = 41.500, P = 0.000). CONCLUSION: Schistosomiasis may be involved in the development and progression of CRC through affecting Bcl-2 and Bax gene expression in the apoptosis signaling pathway.


Assuntos
Neoplasias Colorretais , Esquistossomose , Apoptose , Neoplasias Colorretais/complicações , Neoplasias Colorretais/genética , Humanos , Imuno-Histoquímica , Esquistossomose/complicações , Proteína X Associada a bcl-2/genética
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