1
|
Doras C, Özcelik R, Abakar MF, Issa R, Kimala P, Youssouf S, Bolon I, Dürr S. Community-based symptom reporting among agro-pastoralists and their livestock in Chad in a One Health approach. Acta Trop 2024; 253:107167. [PMID: 38458407 DOI: 10.1016/j.actatropica.2024.107167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/02/2024] [Accepted: 02/28/2024] [Indexed: 03/10/2024]
Abstract
One Health Syndromic Surveillance has a high potential for detecting early epidemiological events in remote and hard-to-reach populations. Chadian pastoralists living close to their animals and being socio-economically unprivileged have an increased risk for zoonosis exposure. Engaging communities in disease surveillance could also strengthen preparedness capacities for outbreaks in rural Chad. This study describes a retrospective cross-sectional survey that collected data on clinical symptoms reported in people and livestock in Chadian agro-pastoral communities. In January-February 2018, interviews were conducted in rural households living in nomadic camps or settled villages in the Yao and Danamadji health districts. The questionnaire covered demographic data and symptoms reported in humans and animals for the hot, wet, and cold seasons over the last 12 months. Incidence rates of human and animal symptoms were comparatively analyzed at the household level. Ninety-two households with a homogeneous socio-demographic distribution were included. We observed cough and diarrhea as the most frequent symptoms reported simultaneously in humans and animals. In all species, the incidence rate of cough was significantly higher during the cold season, and diarrhea tended to occur more frequently during the wet season. However, the incidence rate of cough and diarrhea in animals did not predict the incidence rate of these symptoms in humans. Overall, the variations in reported symptoms were consistent with known seasonal, regional, and sociological influences on endemic diseases. Our retrospective study demonstrated the feasibility of collecting relevant health data in humans and animals in remote regions with low access to health services by actively involving community members. This encourages establishing real-time community-based syndromic surveillance in areas such as rural Chad.
Collapse
Affiliation(s)
- Camille Doras
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Veterinary Public Health Institute, Vetsuisse Faculty Bern, University of Bern, Bern, Switzerland
| | - Ranya Özcelik
- Veterinary Public Health Institute, Vetsuisse Faculty Bern, University of Bern, Bern, Switzerland
| | | | - Ramadan Issa
- Institut de Recherche en Elevage pour le Développement (IRED), N'Djamena, Chad
| | - Pidou Kimala
- Institut de Recherche en Elevage pour le Développement (IRED), N'Djamena, Chad
| | - Soumaya Youssouf
- Institut de Recherche en Elevage pour le Développement (IRED), N'Djamena, Chad
| | - Isabelle Bolon
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Salome Dürr
- Veterinary Public Health Institute, Vetsuisse Faculty Bern, University of Bern, Bern, Switzerland.
| |
Collapse
|
2
|
Zavala E, Adler S, Wabyona E, Ahimbisibwe M, Doocy S. Trends and determinants of anemia in children 6-59 months and women of reproductive age in Chad from 2016 to 2021. BMC Nutr 2023; 9:117. [PMID: 37872637 PMCID: PMC10594667 DOI: 10.1186/s40795-023-00777-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 10/10/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Hemoglobin assessments in children and women have been conducted annually in Chad since 2016 through the Standardized Monitoring and Assessment of Relief and Transitions (SMART) cross-sectional surveys. This analysis aims to characterize national and sub-national trends in anemia among children under five and women of reproductive age from 2016 to 2021 and to compare risk factors for anemia before and during the COVID-19 pandemic. METHODS Hemoglobin concentrations were measured in approximately half of the 12,000 to 15,000 included households each year, except for 2020 when hemoglobin tests were omitted. For children 6 to 59 months of age, anemia was defined as hemoglobin less than 11.0 g/dL. Anemia was defined as hemoglobin less than 11.0 g/dL and 12.0 g/dL for pregnant women and non-pregnant women, respectively. Trends were stratified by agroecological zone, and tests of proportions were used to assess statistical significance. Simple and multivariate logistic regression models were conducted for 2019 and 2021 to identify risk factors for anemia. RESULTS Reductions in anemia over the 6-year period were significant among women (47.6-30.8%, p = 0.000) and children (68.6-59.6%, p = 0.000). The Sudanian zone had consistently higher rates, particularly in children, compared to the Sahelian and Saharan zones. Significant declines in women's anemia were observed in all zones from 2019 to 2021, but this global decline was not observed among children, where rates in the Saharan zone significantly increased. In 2019, only minimum dietary diversity significantly reduced the odds of anemia in children (AOR: 0.65, 95%CI: 0.46-0.92), whereas in 2021, improvements in all diet indicators were associated with lower odds of anemia. Improved household socio-economic factors, including head of household literacy, were associated with lower odds of anemia in children (2019 AOR: 0.76, 95%CI: 0.67, 0.88) and women (2019 AOR: 0.75, 95%CI: 0.65, 0.87; 2021 AOR: 0.81, 95%CI: 0.70, 0.93). CONCLUSIONS Anemia declined significantly in Chad among women of reproductive age and children from 2016 to 2021, but the national prevalence of 60% among children remains unacceptably high. Sub-national differences in anemia rates underline the need to identify and address regional causes of anemia while strengthening national level programs.
Collapse
Affiliation(s)
- Eleonor Zavala
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA.
| | - Sarah Adler
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA
| | | | | | - Shannon Doocy
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA
| |
Collapse
|
3
|
Lanker KC, Muhummed AM, Cissé G, Zinsstag J, Hattendorf J, Yusuf RB, Hassen SB, Tschopp R, Vonaesch P. Prevalence and associated risk factors of intestinal parasitic infections among children in pastoralist and agro-pastoralist communities in the Adadle woreda of the Somali Regional State of Ethiopia. PLoS Negl Trop Dis 2023; 17:e0011448. [PMID: 37399193 DOI: 10.1371/journal.pntd.0011448] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 06/08/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Intestinal parasitic infections (IPIs) can cause illness, morbidity, and occasional mortality in children. Agro-pastoralist and pastoralist children in the Somali Regional State of Ethiopia (ESRS) are especially at risk for IPIs, as access to safe water, sanitation, and health services is lacking. Minimal data on the prevalence of IPIs and associated risk factors exists in this region. METHODOLOGY We assessed the prevalence of IPIs and associated risk factors during the wet season from May-June 2021 in 366 children aged 2 to 5 years in four agro-pastoralist and four pastoralist kebeles (wards) in Adadle woreda (district) of the Shebelle zone, ESRS. Household information, anthropometric measurements, and stool samples were obtained from included children. Parasites were identified microscopically using Kato-Katz and direct smear methods. Risk factors were assessed using general estimating equation models accounting for clustering. PRINCIPAL FINDINGS Overall prevalence of IPIs was 35%: 30.6% for single infections and 4.4% for poly-parasitic infections. Intestinal protozoan prevalence was 24.9%: 21.9% Giardia intestinalis, and 3.0% Entamoeba spp.. Intestinal helminth prevalence was 14.5%: 12.8% Ascaris lumbricoides, 1.4% hookworm (Ancylostoma duodenale /Necator americanus.), and 0.3% Hymenolepis nana. G. intestinalis infection was associated with drinking water sourced from the river (aOR 15.6, 95%CI 6.84, 35.4) and from collected rainwater (aOR 9.48, 95%CI 3.39, 26.5), with toilet sharing (aOR 2.93, 95%CI 1.36, 6.31) and with household ownership of cattle (1-5 cattle: aOR 1.65, 95%CI 1.13, 2.41; 6+ cattle: aOR 2.07, 95%CI 1.33, 3.21) and chickens (aOR 3.80, 95%CI 1.77, 8.17). A. lumbricoides infection was associated with children 36 to 47 months old (aOR 1.92, 95%CI 1.03, 3.58). CONCLUSIONS/SIGNIFICANCE Improving access to safe water, sanitation, and hygiene services in Adadle and employing a One Health approach would likely improve the health of children living in (agro-) pastoralist communities in Adadle and the ESRS; however, further studies are required.
Collapse
Affiliation(s)
- Kayla C Lanker
- Human and Animal Health Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Faculty of Science, University of Basel, Basel, Switzerland
| | - Abdifatah M Muhummed
- Human and Animal Health Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Faculty of Science, University of Basel, Basel, Switzerland
- Jigjiga University One Health Initiative, Jigjiga University, Jigjiga, Ethiopia
| | - Guéladio Cissé
- Faculty of Science, University of Basel, Basel, Switzerland
- Ecosystem Health Sciences Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Jakob Zinsstag
- Human and Animal Health Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Faculty of Science, University of Basel, Basel, Switzerland
| | - Jan Hattendorf
- Human and Animal Health Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Faculty of Science, University of Basel, Basel, Switzerland
| | - Ramadan Budul Yusuf
- Jigjiga University One Health Initiative, Jigjiga University, Jigjiga, Ethiopia
| | | | - Rea Tschopp
- Human and Animal Health Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Faculty of Science, University of Basel, Basel, Switzerland
- One Health Unit, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Pascale Vonaesch
- Department of Fundamental Microbiology, University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
4
|
Aliyo A, Geleto A. Trends of intestinal parasites among the patients attended at Yabelo General Hospital, Borena Zone, Southern Ethiopia. SAGE Open Med 2022; 10:20503121221143644. [PMID: 36568344 PMCID: PMC9772975 DOI: 10.1177/20503121221143644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/18/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives Intestinal parasitic infections (IPIs) still cause a major public health problem in developing countries. The most affected populations are those with low socioeconomic status, lack of latrines, inadequate water supply, and poor hygiene like in pastoralist community areas in Ethiopia. Therefore, the study assessed the trends of intestinal parasites among the patients attended at Yabelo General Hospital, Southern Ethiopia, from 2019 to 2021. Methods This retrospective study was conducted on 6108 patients and recorded data from Yabelo General Hospital, which were extracted using a checklist. The complete data of sex, age, and laboratory stool examination result in the record book were included in the study. The data were double-entered using EpiData version 3 and exported to the Statistical Package for Social Sciences version 16 for analysis. The associated factors were analyzed using chi-square and a p-value <0.05 was considered statistically significant. The results were presented in tables, pie charts, and graphs. Results The overall prevalence of intestinal parasites among the patients who attended Yabelo General Hospital was 48%. Of these, 37.8% (2310) were intestinal protozoa, and 10.2% (624) were intestinal helminths. The study indicates that 59% of patients aged above 45 years were seen infected with intestinal parasites. Of the total suspected patients, 2% (123) were found to have mixed parasite infections. The most reported parasites were Entamoeba histolytica/Entamoeba Dispar 22.6%, Giardia lamblia 15.3%, and Ascaris lumbricoides 1.8%. The trend analysis of intestinal parasites revealed that the overall prevalence declined from 55% in 2019 to 42.3% in 2021. Conclusion The prevalence of IPI was high among patients seen at Yabelo General Hospital. The analysis showed that the prevalence declined from 2019 to 2021. To sustain the decrease in prevalence, all intestinal parasite prevention measures should be continuously exercised in the area.
Collapse
Affiliation(s)
- Alqeer Aliyo
- Alqeer Aliyo, Department of Medical Laboratory Science, Institute of Health, Bule Hora University, P.O. Box 144, Bule Hora, Ethiopia.
| | | |
Collapse
|
5
|
Nasrallah J, Akhoundi M, Haouchine D, Marteau A, Mantelet S, Wind P, Benamouzig R, Bouchaud O, Dhote R, Izri A. Updates on the worldwide burden of amoebiasis: A case series and literature review. J Infect Public Health 2022; 15:1134-1141. [PMID: 36155852 DOI: 10.1016/j.jiph.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Amoebiasis is an intestinal and tissue parasitic infection caused by the protozoan Entamoeba histolytica. Despite significant medical importance and worldwide dispersion, little is known about the epidemiology and distinct geographical distribution of various clinical forms of amoebiasis in the world. In this study, we present an amoebiasis case series referred to Avicenne Hospital (Bobigny, France) from 2010 to 2022 followed by an overview of the released literature to explore diverse clinico-pathology of amoebiasis and to update the actual epidemiological situation of this parasitosis worldwide. METHODS The referred patients underwent a combination of clinical and parasitological examinations and imaging. The study was followed by an overview of released literature performed based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline. RESULTS A total of 15 patients with amoebiasis were diagnosed with an average age of 48.5 years old at the occurrence time of infection. Men (78%) were the most affected patients. Most of the cases were reported following a trip to endemic regions, such as Mali, India, Nepal, Algeria, Cameroon or Congo. All of the processed patients exhibited a hepatic amoebiasis. Amoebic abscess was observed in all cases with an average size of 6.3 cm. Of these patients, seven cases (46.7%) benefited from drainage following a risk of rupture or superinfection of the abscess. A compilation of findings extracted from 390 scientific publications via seven major medical databases, allowed us to update the main epidemiological and clinical events that has led to the current worldwide expansion of amoebiasis. We presented a clinical and epidemiological overview of the amoebiasis accompanied with a worldwide illustrative map displaying the current distribution of known amoebiasis foci in each geographical ecozone of Asia, Europe, Africa, Americas, and Australia. CONCLUSIONS Although Metropolitan France is not known as an endemic region of amoebiasis, amoebic liver abscess was the most frequent clinical form observed among our 15 patients processed. Most of infected patients had a history of travel to or lived-in endemic areas before arriving in France.
Collapse
Affiliation(s)
- Jade Nasrallah
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France
| | - Mohammad Akhoundi
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France.
| | - Djamel Haouchine
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France
| | - Anthony Marteau
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France
| | - Stéphane Mantelet
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France
| | - Philippe Wind
- Digestive Surgery and Surgical Oncology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France
| | - Robert Benamouzig
- Hepato-gastroenterology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France
| | - Olivier Bouchaud
- Infectious diseases Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord, Bobigny, France
| | - Robin Dhote
- Internal Medicine Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France
| | - Arezki Izri
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France; Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection), Marseille, France
| |
Collapse
|
6
|
Li X, Li Y, Xing X, Liu Y, Zhou Z, Liu S, Tian Y, Nima Q, Yin L, Yu B. Urban-rural disparities in the association between long-term exposure to high altitude and malnutrition among children under 5 years old: evidence from a cross-sectional study in Tibet. Public Health Nutr 2022; 26:1-10. [PMID: 36098091 PMCID: PMC10131156 DOI: 10.1017/s1368980022001999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 08/05/2022] [Accepted: 08/18/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess urban-rural disparities in the association between long-term exposure to high altitude and malnutrition among children under 5 years old. DESIGN A three-stage, stratified, cluster sampling was used to randomly select eligible individuals from July to October 2020. The data of participants, including demographic characteristics, altitude of residence, and nutritional status, were collected via questionnaire and physical examination. SETTING Tibet, China. PARTICIPANTS Children under 5 years old in Tibet. RESULTS Totally, 1975 children under 5 years old were included in this study. We found that an additional 1000 m increase in altitude was associated with decreased Z-scores of height-for-age (β = -0·23, 95 % CI: -0·38, -0·08), Z-scores of weight-for-age (β = -0·24, 95 % CI: -0·39, -0·10). The OR for stunting and underweight were 2·03 (95 % CI: 1·51 to 2·73) and 2·04 (95 % CI: 1·38 to 3·02) per 1000 m increase in altitude, respectively; and OR increased rapidly at an altitude above 3500 m. The effects of long-term exposure to high altitudes on the prevalence of underweight in rural children were higher than that in urban children (P < 0·05). CONCLUSIONS High-altitude exposure is tightly associated with malnutrition among children under 5 years old. Improving children's nutrition is urgently needed in areas above 3500 m, especially in rural ones.
Collapse
Affiliation(s)
- Xianzhi Li
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, People’s Republic of China
- Clinical Research Center, Panzhihua Central Hospital, Panzhihua, People’s Republic of China
| | - Yajie Li
- Tibet Center for Disease Control and Prevention, Lhasa, People’s Republic of China
| | - Xiangyi Xing
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, People’s Republic of China
- Department of Pharmacy, Panzhihua Central Hospital, Panzhihua, People’s Republic of China
| | - Yu Liu
- Chongqing Center for Disease Control and Prevention, Chongqing, People’s Republic of China
| | - Zonglei Zhou
- Department of Epidemiology, School of Public Health, Fudan University, People’s Republic of China
| | - Shunjin Liu
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, People’s Republic of China
- Clinical Research Center, Panzhihua Central Hospital, Panzhihua, People’s Republic of China
| | - Yunyun Tian
- Clinical Research Center, Panzhihua Central Hospital, Panzhihua, People’s Republic of China
| | - Qucuo Nima
- Tibet Center for Disease Control and Prevention, Lhasa, People’s Republic of China
| | - Li Yin
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, People’s Republic of China
- Clinical Research Center, Panzhihua Central Hospital, Panzhihua, People’s Republic of China
| | - Bin Yu
- Institute for Disaster Management and Reconstruction, Sichuan University – Hong Kong Polytechnic University, Chengdu, People’s Republic of China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People’s Republic of China
| |
Collapse
|
7
|
Nathem Rashed R. Effect biological life factors on pregnant woman. BIONATURA 2022. [DOI: 10.21931/rb/2022.07.02.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Define anemia is the low concentration in the amount of hemoglobin according to age, sex and trimester pregnancy. The pregnant has three trimesters and has an exceptional hemoglobin range in every trimester. The pregnant has 124-135 g/dl in the 1st trimester, 110-117 g/dl in the 2nd trimester and 106-109 g/dl in the 3rd trimester. Many pregnant females had been found with anemia because of a low level of Iron. This leads to megaloblastic anemia because of iron deficiency anemia and B12 Vitamin, diet, gastrectomy, malabsorption, blood loss and physiological demand (pregnancy infancy and adolescence). The blood consists of Hemoglobin (Heam + globin) Heam and Iron protoporphyrin ring. Globin is the type of protein with a specific length of amino acid and a specific type of A, maybe 2 Alpha 2 Beta called A1 or 2 Alpha and 2 Bata called A2 or 2Alpha and Gamma called F Fetal. The production of hemoglobin depends on the previously mentioned factors. In this study, we focused on some factors associated with the amount of blood and how these factors affected anemia, which is the most important in Iron treatments, with considering other factors such as food, diversity, Economic situation, social status, number of the fetus, and number of pregnancies. Statistical analysis was used to detect the effect factors of anemia in pregnant. This study refers to 23.2% of anemia because of Iron deficiency during pregnancy. So, treatment of Iron deficiency reduces anemia during pregnancy time.
Keywords. Anemia; Hemoglobin; Pregnant Woman
Collapse
Affiliation(s)
- Rawya Nathem Rashed
- Umm Al-rabeein High School for Outstanding Students _Directorate General of Education Nineveh. Mosul - Iraq
| |
Collapse
|
8
|
Moukénet A, Richardson S, Moundiné K, Laoukolé J, Ngarasta N, Seck I. Knowledge and practices surrounding malaria and LLIN use among Arab, Dazagada and Fulani pastoral nomads in Chad. PLoS One 2022; 17:e0266900. [PMID: 35421160 PMCID: PMC9009653 DOI: 10.1371/journal.pone.0266900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/29/2022] [Indexed: 12/04/2022] Open
Abstract
Background Chadian pastoral nomads are highly exposed to malaria due to their lifestyle and their mobility between various endemic areas. To inform strategies to reduce nomads’ risk of malaria and associated morbidity and mortality, it is important to understand the factors associated to their knowledge of malaria transmission and prevention practices. Methods A cross–sectional study among Arab, Dazagada and Fulani pastoral nomadic groups was conducted in February and October 2021. A validated structured electronic questionnaire was administered to assess knowledge of malaria. Attitudes and malaria prevention practices were assessed on the basis of perception of the causes of malaria and the use of a long-lasting insecticide-treated net (LLIN) the day before the survey. Data were analyzed using Chi—square tests and multivariate logistic regression with covariates adjustment. Results A total of 278 nomads aged 20 to 65 years were included in the study. Overall, 90.7% of participants surveyed had a good knowledge of malaria. Fulani respondents were more likely to have a good knowledge of malaria than Arab respondents (Adjusted Odd ratio (AOR): 5.00, 95% CI: 1.04–24.03) and households possessing a LLIN were more likely to have a good knowledge of malaria (AOR: 9.66, 95% CI: 1.24–75.36). Most nomad households surveyed reported sleeping under a mosquito net the night before the survey (87.1%) while 98.9% owned a LLIN. Daza respondents (AOR: 0.23, 95% CI: 0.09–0.56) were less likely to use LLINs than Arab respondents. The middle (AOR: 2.78, 95% CI: 1.17–6.62) and wealthier households (AOR: 6.68, 95% CI: 3.19–14.01) were more likely to use LLINs. Knowledge of malaria was associated with the use of LLIN (AOR: 12.77, 95% CI: 1.58–102.99). Conclusion There remains a need to improve nomads’ understanding of Plasmodium falciparum-carrying mosquitoes as the vector for malaria transmission and the quality of information provided. Knowledge of malaria and its prevention strategies in nomadic setting lead to the use of LLINs. Further reductions in malaria morbidity can be achieved by improving nomads’ access to LLINs. This study can inform on the design policies to improve nomadic communities’ knowledge of malaria prevention and promoting LLIN use as requested by the national policy against malaria.
Collapse
Affiliation(s)
- Azoukalné Moukénet
- Cheikh Anta Diop University, Dakar, Senegal
- University of Ndjamena, Ndjamena, Chad
- * E-mail:
| | - Sol Richardson
- Malaria Consortium, London, United Kingdom
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Kebféné Moundiné
- StraDEC Training, Research & Innovation Department, Ndjamena, Chad
| | | | | | | |
Collapse
|
9
|
Parasitic Infections in Internationally Adopted Children: A Twelve-Year Retrospective Study. Pathogens 2022; 11:pathogens11030354. [PMID: 35335678 PMCID: PMC8949827 DOI: 10.3390/pathogens11030354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/19/2022] [Accepted: 03/11/2022] [Indexed: 01/25/2023] Open
Abstract
Parasitic infections (PIs) are among the most frequent infectious diseases globally. Previous studies reported discrepant results regarding the prevalence of PIs in internationally adopted children (IAC). Data from IAC referred to our paediatric university hospital in 2009–2021 were collected to evaluate the frequency of PIs by the use of stool microscopic examination, antigen assays for Giardia lamblia and Cryptosporidium parvum, and serological tests for Toxocara canis, Strongyloides stercoralis, Schistosoma mansoni, Echinococcus spp., Taenia solium, and Trypanosoma cruzi. Uni- and multivariate logistic regression analyses were performed to evaluate risk factors for PIs and eosinophilia. The proportion of IAC with at least one positive test was 26.83% (640/2385); 2.13% (n = 51) had positive tests for 2 or 3 parasites. A positive assay for helminthic infection was retrieved in 11.07% of children (n = 264), and 17.86% (n = 426) presented with eosinophilia. The most common positive tests were anti-Toxocara canis antibodies (n = 312; 13.8%), followed by positive stool antigen for Giardia lamblia (n = 290; 12.16%), and positive microscopic stool examination for Blastocystis hominis (n = 76; 3.19%). A statistically significant association was found between PIs and region of origin (children from Latin America and Africa were more likely to present PIs than children from Eastern Europe), age 5–14 years, and eosinophilia. No significant association was observed between PIs and gender, vitamin D deficiency, or anemia. In conclusion, PIs are relevant in IAC and an accurate protocol is needed to evaluate IAC once they arrive in their adoptive country.
Collapse
|
10
|
Nava-Castro KE, Pavón L, Becerril-Villanueva LE, Ponce-Regalado MD, Aguilar-Díaz H, Segovia-Mendoza M, Morales-Montor J. Sexual Dimorphism of the Neuroimmunoendocrine Response in the Spleen during a Helminth Infection: A New Role for an Old Player? Pathogens 2022; 11:pathogens11030308. [PMID: 35335632 PMCID: PMC8955289 DOI: 10.3390/pathogens11030308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 02/05/2023] Open
Abstract
The interaction of the nervous, immune, and endocrine systems is crucial in maintaining homeostasis in vertebrates, and vital in mammals. The spleen is a key organ that regulates the neuroimmunoendocrine system. The Taenia crassiceps mouse system is an excellent experimental model to study the complex host–parasite relationship, particularly sex-associated susceptibility to infection. The present study aimed to determine the changes in neurotransmitters, cytokines, sex steroids, and sex-steroid receptors in the spleen of cysticercus-infected male and female mice and whole parasite counts. We found that parasite load was higher in females in comparison to male mice. The levels of the neurotransmitter epinephrine were significantly decreased in infected male animals. The expression of IL-2 and IL-4 in the spleen was markedly increased in infected mice; however, the expression of Interleukin (IL)-10 and interferon (IFN)-γ decreased. We also observed sex-associated differences between non-infected and infected mice. Interestingly, the data show that estradiol levels increased in infected males but decreased in females. Our studies provide evidence that infection leads to changes in neuroimmunoendocrine molecules in the spleen, and these changes are dimorphic and impact the establishment, growth, and reproduction of T. crassiceps. Our findings support the critical role of the neuroimmunoendocrine network in determining sex-associated susceptibility to the helminth parasite.
Collapse
Affiliation(s)
- Karen Elizabeth Nava-Castro
- Laboratorio de Biología y Química Atmosférica, Departamento de Ciencias Ambientales, Instituto de Ciencias de la Atmósfera y Cambio Climático, Universidad Nacional Autónoma de México, Ciudad de Mexico 04510, Mexico;
| | - Lenin Pavón
- Laboratory of Psychoimmunology, National Institute of Psychiatry “Ramón de la Fuente Muñiz”, Mexico City 14370, Mexico; (L.P.); (L.E.B.-V.)
| | - Luis Enrique Becerril-Villanueva
- Laboratory of Psychoimmunology, National Institute of Psychiatry “Ramón de la Fuente Muñiz”, Mexico City 14370, Mexico; (L.P.); (L.E.B.-V.)
| | - María Dolores Ponce-Regalado
- Centro Universitario de los Altos, Departamento de Ciencias de la Salud, Universidad de Guadalajara, Jalisco 47610, Mexico;
| | - Hugo Aguilar-Díaz
- Centro Nacional de Investigaciones Disciplinarias en Salud Animal e Inocuidad, Instituto Nacional de Investigaciones Forestales Agrícolas y Pecuarias (INIFAP), Morelos 50550, Mexico;
| | - Mariana Segovia-Mendoza
- Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de Mexico 00810, Mexico;
| | - Jorge Morales-Montor
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de Mexico 04510, Mexico
- Correspondence: ; Tel.: +52-55-5622-3854 or +52-55-5622-3732; Fax: +52-55-5622-3369
| |
Collapse
|
11
|
Moukénet A, Honoré B, Smith H, Moundiné K, Djonkamla WM, Richardson S, Dormbaye M, Ngarasta N, Seck I. Knowledge and social beliefs of malaria and prevention strategies among itinerant Nomadic Arabs, Fulanis and Dagazada groups in Chad: a mixed method study. Malar J 2022; 21:56. [PMID: 35183185 PMCID: PMC8858476 DOI: 10.1186/s12936-022-04074-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 02/06/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Nomadic populations in Chad are at increased risk of contracting malaria because of their lifestyle. Being highly mobile they are often excluded from disease control programmes, and access to preventive measures and treatment is more difficult. Effective malaria control interventions take account of local modes of transmission, patterns of care-seeking behaviour and community perceptions of cause and prevention practices. There is currently little information about malaria knowledge and perceptions among nomadic groups in Chad, or their awareness of malaria control interventions and this study sought to address this knowledge gap.
Methods
A mixed methods study, including a cross-sectional survey with men and women (n = 78) to determine the level of knowledge and use of malaria prevention strategies among Arabs, Peuls and Dagazada nomadic groups. Three focus group discussions were conducted with women to explore their representation of malaria and knowledge of preventive methods. Key informant interviews were held with leaders of nomadic groups (n = 6) to understand perception of malaria risk among itinerant communities.
Results
Nomads are aware of the risk of malaria, recognize the symptoms and have local explanations for the disease. Reported use of preventive interventions such as Seasonal Malaria Chemoprevention (SMC) for children and Intermittent Preventive Treatment (IPT) of malaria in pregnancy was very low. However, 42.3% of respondents reported owning at least one LLIN and 60% said they slept under an LLIN the night before the survey. In case of a malaria episode, nomads seek clinicians, informal drug sellers in the street or market for self-medication, or traditional medicine depending on their financial means. Interviews with nomad leaders and discussions with women provide key themes on: (i) social representation of malaria risk and (ii) social representation of malaria and (iii) perspectives on malaria prevention and (iv) malaria treatment practices.
Conclusion
The nomadic groups included in this study are aware of risk of malaria and their level of exposure. Local interpretations of the cause of malaria could be addressed through tailored and appropriate health education. Except for LLINs, malaria prevention interventions are not well known or used. Financial barriers lowered access to both mosquito nets and malaria treatment. Reducing the barriers highlighted in this study will improve access to the healthcare system for nomadic groups, and increase the opportunity to create awareness of and improve uptake of SMC and IPT among women and children.
Collapse
|
12
|
Gaston RT, Habyarimana F, Ramroop S. Joint modelling of anaemia and stunting in children less than five years of age in Lesotho: a cross-sectional case study. BMC Public Health 2022; 22:285. [PMID: 35148690 PMCID: PMC8840695 DOI: 10.1186/s12889-022-12690-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 01/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anaemia and stunting remain jointly a serious health issue worldwide especially in developing countries. In Lesotho, their prevalence is high, particularly among children less than 5 years of age. OBJECTIVES The primary objective was to determine the association between anaemia and stunting, and identify factors relating to both conditions among children younger than 5 years in Lesotho. METHODS This cross-sectional study used secondary data from 3112 children collected during the 2014 Lesotho Demographic Health Survey (LDHS). Haemoglobin (Hb) levels were adjusted for altitude and a level less than 11 g per deciliters (11 g/dl) was determined as the cutoff for being anaemic. A child with the height-for-age z score (HAZ) below minus two standard deviations (SD) was considered to have stunting. We linked factors relating to anaemia and stunting using a multivariate joint model under the scope of the generalized linear mixed model (GLMM). RESULTS The prevalence of anaemia and stunting in children younger than 5 years were 51% and 43% respectively. The multivariate results revealed a strong association between anaemia and stunting. In addition, maternal education, urban vs. rural residence, wealth index and childbirth weight significantly impacted childhood stunting or malnutrition, while having fever and/or diarrhoea was linked to anaemia. Lastly, age was shown to have a significant effect on both stunting and anaemia. CONCLUSION Anaemia and stunting or malnutrition showed linked longitudinal trajectories, suggesting both conditions could lead to synergetic improvements in overall child health. Demographic, socio-economic, and geographical characteristics were also important drivers of stunting and anaemia in children younger than 5 years. Thus, children living in similar resources settings as Lesotho could benefit from coordinated programs designed to address both malnutrition and anaemia.
Collapse
Affiliation(s)
- Rugiranka Tony Gaston
- School of Mathematics, Statistics and Computer Sciences, University of KwaZulu-Natal, Private Bag X01, Pietermaritzburg CampusScottsville, 3209, South Africa. .,Health Economics and HIV/AIDS Research Division (HEARD), University of KwaZulu-Natal, Westville Campus, Private Bag X01, Westville, 3629, South Africa.
| | - Faustin Habyarimana
- School of Mathematics, Statistics and Computer Sciences, University of KwaZulu-Natal, Private Bag X01, Pietermaritzburg CampusScottsville, 3209, South Africa
| | - Shaun Ramroop
- School of Mathematics, Statistics and Computer Sciences, University of KwaZulu-Natal, Private Bag X01, Pietermaritzburg CampusScottsville, 3209, South Africa
| |
Collapse
|
13
|
Endris BS, Dinant GJ, Gebreyesus SH, Spigt M. Risk factors of anemia among preschool children in Ethiopia: a Bayesian geo-statistical model. BMC Nutr 2022; 8:2. [PMID: 34996515 PMCID: PMC8740428 DOI: 10.1186/s40795-021-00495-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 12/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The etiology and risk factors of anemia are multifactorial and varies across context. Due to the geospatial clustering of anemia, identifying risk factors for anemia should account for the geographic variability. Failure to adjust for spatial dependence whilst identifying risk factors of anemia could give spurious association. We aimed to identify risk factors of anemia using a Bayesian geo-statistical model. METHODS We analyzed the Ethiopian Demographic and Health Survey (EDHS) 2016 data. The sample was selected using a stratified, two- stage cluster sampling design. In this survey, 9268 children had undergone anemia testing. Hemoglobin level was measured using a HemoCue photometer and the results were recorded onsite. Based on the World Health Organization's cut-off points, a child was considered anaemic if their altitude adjusted haemoglobin (Hb) level was less than 11 g/dL. Risk factors for anemia were identified using a Bayesian geo-statistical model, which accounted for spatial dependency structure in the data. Posterior means and 95% credible interval (BCI) were used to report our findings. We used a statistically significant level at 0.05. RESULT The 9267 children in our study were between 6 and 59 months old. Fifty two percent (52%) of children were males. Thirteen percent (13%) of children were from the highest wealth quintile whereas 23% from the lowest wealth quintile. Most of them lived in rural areas (90%). The overall prevalence of anemia among preschool children was 57% (95% CI: 54.4-59.4). We found that child stunting (OR = 1.26, 95% BCI (1.14-1.39), wasting (OR = 1.35, 95% BCI (1.15-1.57), maternal anemia (OR = 1.61, 95% BCI (1.44-1.79), mothers having two under five children (OR = 1.2, 95% BCI (1.08-1.33) were risk factors associated with anemia among preschool children. Children from wealthy households had lower risk of anemia (AOR = 0.73, 95% BCI (0.62-0.85). CONCLUSION Using the Bayesian geospatial statistical modeling, we were able to account for spatial dependent structure in the data, which minimize spurious association. Childhood Malnutrition, maternal anemia, increased fertility, and poor wealth status were risk factors of anemia among preschool children in Ethiopia. The existing anaemia control programs such as IFA supplementation during pregnancy should be strengthened to halt intergenerational effect of anaemia. Furthermore, routine childhood anaemia screening and intervention program should be part of the Primary health care in Ethiopia.
Collapse
Affiliation(s)
- Bilal Shikur Endris
- School of Public Health, Department of Nutrition and Dietetics, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Geert-Jan Dinant
- School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Seifu H Gebreyesus
- School of Public Health, Department of Nutrition and Dietetics, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mark Spigt
- School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- General Practice Research Unit, Department of Community Medicine, The Arctic University of Tromsø, Tromsø, Norway
| |
Collapse
|
14
|
Geletaw A, Egata G, Weldegebreal F, Kibr G, Semaw M. Nutritional Status and Associated Factors among Primary Schoolchildren from Pastoral Communities, Mieso-Mulu District, Sitti Zone, Somali Regional State, Eastern Ethiopia: Institution-Based Cross-Sectional Study. J Nutr Metab 2021; 2021:6630620. [PMID: 34603774 PMCID: PMC8483933 DOI: 10.1155/2021/6630620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 07/12/2021] [Accepted: 08/29/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Child undernourishment is the disturbance of body function arising from a dietary imbalance between body demand and supply, which is the most serious public health problem in developing countries. OBJECTIVE This study aimed to assess the magnitude of nutritional status and associated factors among full-cycle primary schoolchildren in pastoral communities in the Mieso-Mulu district, Sitti Zone, Somali Regional State of Ethiopia. METHODS An institution-based cross-sectional study design was used. Study participants were selected using two-stage sampling procedures. Data were collected using structured, translated, pretested, and interviewer-administered questionnaires. The weight and height were measured using a calibrated digital scale and a Seca Rod stadiometer, respectively. Microscopic identification of intestinal parasites was done. Multicollinearity was checked for independent variables. Height for age z scores (HAZ) and body mass index for age z scores (BAZ) were used to determine the nutritional status of children. Logistic regression with both bivariate analysis and multivariate analysis was applied to identify associated factors with the nutritional status of children. Adjusted odds ratios were reported and the level of statistical significance was declared at a P value <0.05. RESULTS The magnitudes of thinness and stunting were 13.1% [95% CI: 10.6%, 15.7%] and 24.6% [95% CI: 21.3%, 27.9%], respectively. Being male, not using a bed net, and the presence of intestinal parasitic infection were among the factors associated with thinness. Family size of less than five, household food insecurity, and unavailability of the latrine were among the factors associated with stunting. CONCLUSION This study revealed that stunting and thinness are major health problems among schoolchildren. Household food insecurity, intestinal parasitic infection, bed net utilization, and the availability of latrine were some of the major factors significantly associated with undernutrition. Local policymakers, health programmers, nutritionists, health practitioners, and nongovernmental organizations should enhance the nutritional status of schoolchildren by using information dissemination interventions, particularly in improving waste disposal, sanitation/hygiene, latrine facilities, and school-based deworming. Furthermore, awareness creation using nutrition promotion and encouraging communities to attempt to diversify locally available and low-cost nutritionally effective food items to improve food consumption and distribution within a household is recommended to reduce the prevalence of undernutrition among schoolchildren.
Collapse
Affiliation(s)
- Alayou Geletaw
- Somalia Regional Health Bureau, Jigjiga, Ethiopia
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gudina Egata
- Department of Public Health Nutrition and Dietetics, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Fitsum Weldegebreal
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gesessew Kibr
- Department of Food and Nutritional Sciences, Faculty of Agriculture, Shambu Campus, Wollega University, Shambu, Ethiopia
| | - Mohammed Semaw
- Department of Food and Nutritional Sciences, Faculty of Agriculture, Shambu Campus, Wollega University, Shambu, Ethiopia
| |
Collapse
|
15
|
Abakar MF, Seli D, Lechthaler F, Crump L, Mancus A, Tran N, Zinsstag J, Muñoz DC. Evaluation of the feasibility and sustainability of the joint human and animal vaccination and its integration to the public health system in the Danamadji health district, Chad. Health Res Policy Syst 2021; 19:44. [PMID: 34380491 PMCID: PMC8356365 DOI: 10.1186/s12961-021-00688-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND One Health approaches such as the Joint human and animal vaccination programmes (JHAVP) are shown to be feasible and to increase health care access to hard-to-reach communities such as mobile pastoralists. However, the financial sustainability and the integration into the public health systems at the district level of such programmes are still challenging. The main objective of the present study was to give insight to the feasibility and financial sustainability of JHAVP integrated as part of the public health system in Chad. METHODS We conducted a mixed methods study using semi-structured key informant interviews, focus group discussions and budget impact analysis. Strengths, weaknesses, opportunities, and threats were analysed regarding the feasibility and sustainability of the implementation of JHAVP in Danamadji health district in Chad. Feasibility was further analysed using three dimensions: acceptability, implementation, and adaptation. Financial sustainability of JHAVP was analysed through budget impact analysis of implementation of the programme at district level. RESULTS The acceptability of this approach was regularly assessed by immunization campaign teams through evaluation meetings which included pastoralists. The presence of authorities in the meetings and workshops of the programme had an incentive effect since they represent a mark of consideration these populations generally declared to be lacking. The coordination between the public health and veterinary services at central and decentralized level seemed to be a key element in the success of the implementation of the programme. Regarding financial sustainability, the total incremental budget impact was 27% slightly decreasing to 26% after five years, which accounts for up to one third of the total budget of the district health office. Also, given that most of the costs for each round are recurrent costs, efficiency gains from scale effects over time are limited. CONCLUSION Based on these findings, we conclude that for JHAVP to be routinely delivered at the district health level, a considerable increase in financial resources would be required. The district could benefit from joint immunization to maintain contact with mobile pastoralists to promote the use of available immunization services at district level.
Collapse
Affiliation(s)
- Mahamat Fayiz Abakar
- Institut de Recherche en Elevage pour le Développement, P.O Box 433, N'Djamena, Chad.
- Swiss Tropical and Public Health Institute (Swiss TPH), CH-4002, Basel, Switzerland.
- University of Basel, Petersplatz 1, CH 4001, Basel, Switzerland.
| | - Djimet Seli
- Centre de Recherche en Anthropologie et Sciences Humaines, P.O. Box 6542, N'Djamena, Chad
| | - Filippo Lechthaler
- School of Agricultural, Forest and Food Sciences, Bern University of Applied Sciences, P.O. Box 3052, Zollikofen, Switzerland
| | - Lisa Crump
- Swiss Tropical and Public Health Institute (Swiss TPH), CH-4002, Basel, Switzerland
- University of Basel, Petersplatz 1, CH 4001, Basel, Switzerland
| | | | - Nhan Tran
- World Health Organization, Geneva, Switzerland
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute (Swiss TPH), CH-4002, Basel, Switzerland
- University of Basel, Petersplatz 1, CH 4001, Basel, Switzerland
| | - Daniel Cobos Muñoz
- Swiss Tropical and Public Health Institute (Swiss TPH), CH-4002, Basel, Switzerland
- University of Basel, Petersplatz 1, CH 4001, Basel, Switzerland
| |
Collapse
|
16
|
Calegar DA, Bacelar PA, Monteiro KJL, dos Santos JP, Gonçalves AB, Boia MN, Jaeger LH, Coronato-Nunes B, Carvalho-Costa FA. A community-based, cross-sectional study to assess interactions between income, nutritional status and enteric parasitism in two Brazilian cities: are we moving positively towards 2030? JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2021; 40:26. [PMID: 34099052 PMCID: PMC8186086 DOI: 10.1186/s41043-021-00252-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 05/27/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND This study assessed the interactions between income, nutritional status and intestinal parasitism in children in Brazil. METHODS A cross-sectional study (n = 421 children aged 1 to 14 years living in the states of Piauí (rural communities in the city of Teresina) and Rio de Janeiro (rural and periurban communities in the city of Cachoeiras de Macacu) was performed in order to obtain income and anthropometric data, as well as fecal samples for parasitological analyses through the Ritchie technique. RESULTS Children infected with Ascaris lumbricoides had significantly lower means of height-for-age z scores (- 1.36 ± 0.75 vs. - 0.11 ± 1.02; p < 0.001), weight-for-age z scores (- 1.23 ± 0.74 vs. 0.09 ± 1.15; p = 0.001), and weight-for-height z scores (- 0.68 ± 0.44 vs. 0.23 ± 1.25; p = 0.006) when compared with uninfected children. Infection with hookworm was also associated with lower means of height-for-age z scores (- 1.08 ± 1.17 vs. - 0.12 ± 1.02; p = 0.015) and weight-for-age z scores (- 1.03 ± 1.13 vs. 0.08 ± 1.15; p = 0.012). Children infected with Entamoeba coli presented significantly lower means of height-for-age z scores (- 0.54 ± 1.02 vs. - 0.09 ± 1.02; p = 0.005) and weight-for-age z scores (- 0.44 ± 1.15 vs. 0.12 ± 1.15; p = 0.002). The multivariate multiple linear regression analysis showed that height-for-age z scores are independently influenced by monthly per capita family income (β = 0.145; p = 0.003), female gender (β = 0.117; p = 0.015), and infections with A. lumbricoides (β = - 0.141; p = 0.006) and Entamoeba coli (β = - 0.100; p = 0.043). Weight-for-age z scores are influenced by monthly per capita family income (β = 0.175; p < 0.001), female gender (β = 0.123; p = 0.010), and infections with A. lumbricoides (β = - 0.127; p = 0.012), and Entamoeba coli (β = - 0.101; p = 0.039). Monthly per capita family income (β = 0.102; p = 0.039) and female gender (β = 0.134; p = 0.007) positively influences mid upper arm circumpherence. CONCLUSIONS Intestinal parasitism and low family income negatively influence the physical development of children in low-income communities in different Brazilian regions.
Collapse
Affiliation(s)
- Deiviane A. Calegar
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro Brazil
| | - Polyanna A. Bacelar
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro Brazil
- Escritório Técnico Regional - Fundação Oswaldo Cruz, Piauí, Rua Magalhães Filho, 519, Centro/Norte, Teresina, Piauí Brazil
| | - Kerla J. L. Monteiro
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro Brazil
- Escritório Técnico Regional - Fundação Oswaldo Cruz, Piauí, Rua Magalhães Filho, 519, Centro/Norte, Teresina, Piauí Brazil
| | - Jessica P. dos Santos
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro Brazil
- Escritório Técnico Regional - Fundação Oswaldo Cruz, Piauí, Rua Magalhães Filho, 519, Centro/Norte, Teresina, Piauí Brazil
| | - Andressa B. Gonçalves
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro Brazil
| | - Márcio N. Boia
- Laboratório de Biologia e Parasitologia de Mamíferos Silvestres Reservatórios, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro Brazil
| | - Lauren H. Jaeger
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro Brazil
- Faculdade de Farmácia, Universidade Federal de Juiz de Fora, Rua José Lourenço Kelmer, s/n – Campus Universitário Bairro São Pedro, Juiz de Fora, Minas Gerais Brazil
| | - Beatriz Coronato-Nunes
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro Brazil
- Faculdade de Medicina de Petrópolis (FMP)/ Centro Universitário Arthur Sá Earp Neto (UNIFASE), Rua Machado Fagundes, 326, Cascatinha, Petrópolis, Rio de Janeiro, Brazil
| | - Filipe A. Carvalho-Costa
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro Brazil
| |
Collapse
|
17
|
Westgard CM, Orrego-Ferreyros LA, Calderón LF, Rogers AM. Dietary intake, intestinal infection, and safe drinking water among children with anemia in Peru: a cross-sectional analysis. BMC Nutr 2021; 7:11. [PMID: 34078476 PMCID: PMC8173807 DOI: 10.1186/s40795-021-00417-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 03/04/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Anemia is a major public health concern that is present in 41.7% of children under 5 worldwide. The prevalence of anemia in Peru was 43.6% in 2017, a decrease by only 6.8% in 8 years. Despite great efforts made by the government to reduce anemia by distributing free multi-micronutrient supplements and promote the consumption of iron rich foods, progress has been slow. The current study sought to better understand why the prevalence remains high by analyzing the dietary intake, incidence of intestinal infectious disease, and access to safe drinking water by children with anemia in Peru. METHODS A cross-sectional analysis was conducted using data from two national surveys that were combined by child ID. Descriptive statistics was analyzed to understand the experience of children with anemia in comparison to child without anemia. Logistic multivariate regression analyses were conducted to test the associations between anemia and dietary intake, intestinal infection, and access to safe drinking water. RESULTS The sample included 586 children between 6 and 35 months. The prevalence of anemia in this population was 53%. The portion of children that consumed sufficient iron to meet the recommendation for their age was 62%. Of the children with anemia, 52% consumed sufficient iron to meet their recommendation, vs. 72% of children without anemia (p < 0.001). The children with anemia were more likely to have an intestinal infection during the previous year (35% vs. 26%, p = 0.057) and less likely to have access to safe drinking water (77% vs. 86%, p = 0.002) than those without anemia. The logistic analysis revealed that having an intestinal infection increased the odds of having anemia (OR = 1.64, CI 95% [1.041-2.584]), and having access to safe drinking waters decreased the odds of having anemia (OR = 0.578, [0.334-0.998]). CONCLUSIONS More than half of the children with anemia in Peru already consume sufficient iron to meet their daily requirement. However, they continue to have anemia, likely due to intestinal infection, such as diarrhea and parasites, from a lack of access to safe drinking water and hygienic practices.
Collapse
Affiliation(s)
- Christopher M Westgard
- Department of Research and Innovation, Elementos, Lima, Peru.
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Luis A Orrego-Ferreyros
- Department of Research and Innovation, Elementos, Lima, Peru
- Faculty of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Alexandra M Rogers
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
18
|
An R, Huang Y, Man Y, Valentine RW, Kucukal E, Goreke U, Sekyonda Z, Piccone C, Owusu-Ansah A, Ahuja S, Little JA, Gurkan UA. Emerging point-of-care technologies for anemia detection. LAB ON A CHIP 2021; 21:1843-1865. [PMID: 33881041 PMCID: PMC8875318 DOI: 10.1039/d0lc01235a] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Anemia, characterized by low blood hemoglobin level, affects about 25% of the world's population with the heaviest burden borne by women and children. Anemia leads to impaired cognitive development in children, as well as high morbidity and early mortality among sufferers. Anemia can be caused by nutritional deficiencies, oncologic treatments and diseases, and infections such as malaria, as well as inherited hemoglobin or red cell disorders. Effective treatments are available for anemia upon early detection and the treatment method is highly dependent on the cause of anemia. There is a need for point-of-care (POC) screening, early diagnosis, and monitoring of anemia, which is currently not widely accessible due to technical challenges and cost, especially in low- and middle-income countries where anemia is most prevalent. This review first introduces the evolution of anemia detection methods followed by their implementation in current commercially available POC anemia diagnostic devices. Then, emerging POC anemia detection technologies leveraging new methods are reviewed. Finally, we highlight the future trends of integrating anemia detection with the diagnosis of relevant underlying disorders to accurately identify specific root causes and to facilitate personalized treatment and care.
Collapse
Affiliation(s)
- Ran An
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA.
| | - Yuning Huang
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA.
| | - Yuncheng Man
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA.
| | - Russell W Valentine
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA.
| | - Erdem Kucukal
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA.
| | - Utku Goreke
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA.
| | - Zoe Sekyonda
- Biomedical Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Connie Piccone
- Department of Pediatric Hematology, Carle Foundation Hospital, Urbana, IL, USA
| | - Amma Owusu-Ansah
- Department of Pediatrics, Division of Hematology and Oncology, University Hospitals Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Sanjay Ahuja
- Department of Pediatrics, Division of Hematology and Oncology, University Hospitals Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Jane A Little
- Division of Hematology & UNC Blood Research Center, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Umut A Gurkan
- Mechanical and Aerospace Engineering Department, Case Western Reserve University, 10900 Euclid Ave., Glennan Building, Cleveland, OH 44106, USA. and Biomedical Engineering Department, Case Western Reserve University, Cleveland, OH, USA and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
19
|
Muleta A, Hailu D, Belachew T. Camel milk consumption was associated with lower prevalence of anemia among preschool children in rural pastoral districts of Somali, eastern Ethiopia. Nutrition 2021; 86:111170. [PMID: 33601123 DOI: 10.1016/j.nut.2021.111170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 01/09/2021] [Accepted: 01/16/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to investigate association between consumption of camel milk (CaM) and childhood anemia. METHODS A community-based cross-sectional study was conducted with 388 preschool children (24-59 mo of age) in rural pastoral districts of Somali, eastern Ethiopia. We sampled 185 consumers of CaM and 203 who consumed bovine milk (BM). Children were selected from random households with lactating camels or cattle. Hemoglobin (Hb) was measured in the field using a HemoCue instrument. A multivariable logistic regressions model was used in SPSS version 20 to examine association between type of milk consumption and anemia. RESULTS Anemia (Hb <11 g/dL) was found in 59.8% of the overall sample, whereas it was 42.7% and 75.4% among CaM and BM consumers, respectively. The odds of anemia among BM consumers (adjusted odds ratio [aOR], 3.12; 95% confidence interval [CI], 1.27-7.66) and children with intestinal parasites (aOR: 3.32; 95% CI, 1.39-7.91) was compared with CaM consumers and children without intestinal parasites, respectively. Increasing age and height-for-age z-score of children were associated with decreased childhood anemia (P < 0.001). Children with anemia consumed a higher volume of BM compared with non-anemic and CaM consumers, too but the consumption was not statistically significant. CONCLUSION CaM consumption was associated with lower prevalence of anemia compared with consumption of BM. Promoting use of CaM as complementary food for preschool children in pastoralist areas might be considered an intervention toward reducing anemia.
Collapse
Affiliation(s)
- Anbissa Muleta
- Hawassa University, School of Nutrition, Food Science and Technology, Hawassa, Ethiopia; Jigjiga University, Department of Food Science and Nutrition, Jigjiga, Ethiopia.
| | - Dejene Hailu
- Hawassa University, Department of Public and Environmental Health, College of Health Sciences, Hawassa, Ethiopia
| | - Tefera Belachew
- Jimma University, Department of Nutrition and Dietetics, Jimma, Ethiopia
| |
Collapse
|
20
|
Abaka-Yawson A, Senoo D, Aboagye EA, Hotorvi C, Tawiah PA, Sosu SQ, Kwadzokpui PK. High prevalence of intestinal helminthic infection among children under 5 years in a rural Ghanaian community: an urgent call for attention. J Parasit Dis 2020; 44:625-632. [PMID: 32801516 DOI: 10.1007/s12639-020-01239-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 06/29/2020] [Indexed: 11/26/2022] Open
Abstract
Intestinal parasitic infections presents a significant public health concern in developing countries. The study determined the prevalence of intestinal parasitic infection of children under 5 years. A cross-sectional prospective study was conducted at Dodi Papase, a town in the Kadjebi district of the Oti region of Ghana. Stool samples were collected from 152 children under 5 years and examined for the presence of intestinal parasites using Kato-Katz technique. Additionally, venous blood samples were collected from participants into EDTA tubes and analyzed for their hemoglobin concentration using the Sysmex XS-500i automated hematology analyzer All laboratory analyses were done at the Ho Teaching Hospital Laboratory. Overall prevalence of intestinal helminthic infections was 44.08% (67/152). Ascaris lumbricoides, Trichuris trichiura and Hookworm recorded 20.39%, 10.53% and 13.16% prevalence respectively. Children aged 4 years recorded the highest prevalence of intestinal parasitic infections vis-à-vis 50.00% A. lumbricoides and 37.50% Hookworm while children below age 2 years recorded the lowest. T. trichiura infection was highest among children below age 2 years (44.44%) and lowest among children aged 4 years. This study recorded an overall parasitic infections of 44.08%. This therefore calls for periodic screening, anti-helminthic treatment of these children as well as intensified education on attitudinal/behavioral change on improved personal and environmental hygiene in order to help control the menace of intestinal parasitic infections.
Collapse
Affiliation(s)
- Albert Abaka-Yawson
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Daniel Senoo
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Esther Akoto Aboagye
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Christian Hotorvi
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Philip Apraku Tawiah
- Department of Pharmacognosy and Herbal Medicine, School of Pharmacy, University of Health and Allied Sciences, Ho, Ghana
| | - Solomon Quarshie Sosu
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Precious Kwablah Kwadzokpui
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| |
Collapse
|
21
|
de Macedo Couto R, Brandespim DF. A review of the One Health concept and its application as a tool for policy-makers. INTERNATIONAL JOURNAL OF ONE HEALTH 2020. [DOI: 10.14202/ijoh.2020.83-89] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The One Health concept represents the inseparability of human, animal, and environmental health through a unified view of health care. This article addressed the topic of public health policies from the One Health perspective, demonstrating its inclusion in various health agendas such as emerging and reemerging infectious diseases, basic sanitation, mental health, chronic non-communicable diseases, interpersonal violence, and food safety. The results showed that the application of the One Health concept to the development and implementation of policies is associated with a growing need to involve transdisciplinary teams for solving complex problems to improve communication and to ensure the relevance and acceptability of public policies, thus guaranteeing governance. According to the principle of efficiency, the government must be aware of the evolution of technical knowledge and should use the One Health approach to improve the efficacy of already existing systems. We, therefore, conducted this review to contextualize current knowledge in this topic which is becoming an essential tool for public health policy-makers and practitioners around the world promoting a reflection on the importance of multiprofessional articulation in the implementation of intersectoral public health policies.
Collapse
Affiliation(s)
- Rodrigo de Macedo Couto
- Department of Epidemiology, Faculdade de Saúde Pública, Universidade de São Paulo (USP), São Paulo/SP, 04024-002, Brazil
| | | |
Collapse
|
22
|
Osman KA, Zinsstag J, Tschopp R, Schelling E, Hattendorf J, Umer A, Ali S, Cercamondi CI. Nutritional status and intestinal parasites among young children from pastoralist communities of the Ethiopian Somali region. MATERNAL AND CHILD NUTRITION 2020; 16:e12955. [PMID: 32026575 PMCID: PMC7296781 DOI: 10.1111/mcn.12955] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 12/13/2019] [Accepted: 01/06/2020] [Indexed: 11/30/2022]
Abstract
Pastoralist children in the Ethiopian Somali Regional State (ESRS) are at high risk for undernutrition and intestinal parasitic infections (IPIs). We assessed the nutritional status and its association with IPIs in 500 children <5 years of age in a clustered cross‐sectional study in Adadle district, ESRS. Stool samples were microscopically examined for IPIs and biomarkers for iron and vitamin A status, anthropometry, and food variety score (FVS) were assessed. Median (interquartile range [IQR]) FVS was 2.0 (2.0, 4.0), and 35% of children were exclusively breastfed up to age 6 months. Prevalence of stunting, wasting, underweight and mid‐upper arm circumference (MUAC) <12.5 cm was 30, 34, 40, and 16%, respectively. Median (IQR) haemoglobin, ferritin, and retinol‐binding protein concentrations were 9.5 g dL‐1 (8.2, 10.9), 6.2 μg L‐1 (4.0, 10.2), and 0.8 μmol L−1 (0.67, 0.91), respectively. Prevalence of anaemia, iron, and vitamin A deficiency was 75, 91, and 30%, respectively. IPIs' prevalence was 47%; the most prevalent IPIs were Giardia lamblia (22%) and Ascaris lumbricoides (15%). Giardial infections but not A. lumbricoides increased the risk for MUAC <12.5 cm (adjusted odds ratio [aOR]: 3.50, 95% confidence interval [CI] [2.21, 5.54]). The odds for anaemia were 97% (aOR: 0.03, 95% CI [0.03, 0.07]) and 89% (aOR: 0.11, 95% CI [0.11, 0.23]) less for children with FVS >2 or with exclusive breastfeeding up to 6 months, respectively. Undernutrition and IPIs are alarmingly high in <5 years of age children in ESRS. Giardial infections and low nutritional adequacy of the diet seem to be major contributing factors to the precarious nutritional status and should be addressed by appropriate interventions.
Collapse
Affiliation(s)
- Kadra A Osman
- Jigjiga University One Health Initiative, Jigjiga University, Jigjiga, Ethiopia.,Human and Animal Health Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Jakob Zinsstag
- Human and Animal Health Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Rea Tschopp
- Human and Animal Health Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Esther Schelling
- Human and Animal Health Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Jan Hattendorf
- Human and Animal Health Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Abdurezak Umer
- Jigjiga University One Health Initiative, Jigjiga University, Jigjiga, Ethiopia.,Human and Animal Health Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Seid Ali
- Jigjiga University One Health Initiative, Jigjiga University, Jigjiga, Ethiopia.,Human and Animal Health Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Colin I Cercamondi
- Human Nutrition Laboratory, Swiss Federal Institute of Technology, Zürich, Switzerland
| |
Collapse
|
23
|
Guan M, Han B. Association between intestinal worm infection and malnutrition among rural children aged 9-11 years old in Guizhou Province, China. BMC Public Health 2019; 19:1204. [PMID: 31477069 PMCID: PMC6719348 DOI: 10.1186/s12889-019-7538-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intestinal worm infection adversely impacted child health and was one of the China's largest health burdens. However, yet little was known about associations between intestinal worm infection and malnutrition in school-aged children in rural China. This study aimed to fill into the gap. METHODS Data were from a survey of children aged 9-11 years old in Guizhou Province, China conducted in June 2013. Considering anemia and low intelligent quotient (IQ) as mediating factors, binomial logistic regression was used to estimate the associations of intestinal worm infection with thinness, underweight, and stunting. Moreover, the associations between socio-demographic factors and malnutrition were also explored. RESULTS Among 2179 children, part of children was infected by intestinal worm (41.85%). Stunting (28%), low memory IQ (87.52%), and low process IQ (62.59%) were highly prevalent in the sample. Socio-demographic factors were associated with thinness, underweight, stunting, low memory IQ, low process IQ, anaemia, and intestinal worm infection. Intestinal worm infection was associated with low IQ, anemia, and stunting. In addition, anemia and low IQ could not confound the other expected associations. CONCLUSION This study demonstrated the association between intestinal worm infections and stunting appeared to be largely mediated via low IQ. The study highlighted the importance of deworming and improving nutrition in the surveyed areas.
Collapse
Affiliation(s)
- Ming Guan
- Family Issues Center, Xuchang University, Road Bayi, Xuchang, 88, Henan, China.,School of Business, Xuchang University, Road Bayi, Xuchang, 88, Henan, China
| | - Bingxue Han
- Family Issues Center, Xuchang University, Road Bayi, Xuchang, 88, Henan, China. .,College of Urban and Rural Planning and Gardening, Xuchang University, Road Bayi, Xuchang, 88, Henan, China.
| |
Collapse
|
24
|
Lambrecht NJ, Wilson ML, Jones AD. Assessing the Impact of Animal Husbandry and Capture on Anemia among Women and Children in Low- and Middle-Income Countries: A Systematic Review. Adv Nutr 2019; 10:331-344. [PMID: 30854553 PMCID: PMC6416043 DOI: 10.1093/advances/nmy080] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Animal husbandry and capture (AHC) may mitigate anemia among women and children by supplying a source of micronutrient-rich animal source foods (ASF), yet may concurrently increase exposure to anemia-inducing pathogens such as Plasmodium spp., helminths, and enteropathogens. We conducted a systematic literature review to assess the relation between AHC and anemia among women of reproductive age, school-aged children, and children aged <5 y in low- and middle-income countries (LMICs). We used a 2-stage screening process, in which 1 reviewer searched 4 databases (PubMed, Web of Science, EMBASE, and Global Health) with predetermined search terms for relevant articles. Two reviewers then independently screened studies using a priori exclusion criteria, yielding a total of 23 articles included in the final review. We evaluated evidence from observational studies assessing animal-dependent livelihoods and livestock ownership, and interventions that promoted livestock and fish production. We found little consistency in anemia outcomes across the several AHC exposures and population groups. Poultry production interventions had modest benefits on anemia among women and children, although whether these improvements were a result of increased ASF consumption, or a result of the combined treatment study design could not be determined. Observational studies identified chicken ownership, and no other livestock species, as a risk factor for anemia among young children. However, there was limited evidence to evaluate pathways underlying these associations. Studies tended to rely on self-reported fever and diarrhea to assess illness, and no study directly assessed linkages between AHC, pathogen burden, and anemia. Thus, there is insufficient evidence to conclude whether AHC improves or worsens anemia among women and children in LMICs. Given the current interest in promoting animal production among low-income households, future studies with robust measures of livestock ownership, ASF consumption, pathogen burden, and anemia status are needed to understand the nuances of this complex and potentially contradictory relation.
Collapse
Affiliation(s)
| | - Mark L Wilson
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Andrew D Jones
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI,Address correspondence to ADJ (e-mail: )
| |
Collapse
|
25
|
Altmann M, Altare C, van der Spek N, Barbiche JC, Dodos J, Bechir M, Ait Aissa M, Kolsteren P. Effectiveness of a Household Water, Sanitation and Hygiene Package on an Outpatient Program for Severe Acute Malnutrition: A Pragmatic Cluster-Randomized Controlled Trial in Chad. Am J Trop Med Hyg 2018; 98:1005-1012. [PMID: 29488461 PMCID: PMC5928824 DOI: 10.4269/ajtmh.17-0699] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 01/10/2018] [Indexed: 11/25/2022] Open
Abstract
Water, sanitation and hygiene (WASH) interventions have a small but measurable benefit on stunting, but not on wasting. Our objective was to assess the effectiveness of a household WASH package on the performance of an Outpatient Therapeutic feeding Program (OTP) for severe acute malnutrition (SAM). We conducted a cluster-randomized controlled trial embedded in a routine OTP. The study population included 20 health centers (clusters) from Mao and Mondo districts in Chad. Both arms received the OTP. The intervention arm received an additional household WASH package (chlorine, soap, water storage container, and promotion on its use). The primary objective measures were the relapse rates to SAM at 2 and 6 months post-recovery. The secondary objectives included the recovery rate from SAM, the time-to-recovery, the weight gain, and the diarrhea longitudinal prevalence in OTP. The study lasted from April 2015 to May 2016. Among the 1,603 recruited children, 845 were in the intervention arm and 758 in the control arm. No differences in the relapse rates were noticed at 2 (-0.4%; P = 0.911) and 6 (-1.0%; P = 0.532) months. The intervention decreased the time-to-recovery (-4.4 days; P = 0.038), improved the recovery rate (10.5%; P = 0.034), and the absolute weight gain (3.0 g/d; P = 0.014). No statistical differences were noticed for the diarrhea longitudinal prevalence (-1.7%; P = 0.223) and the weight gain velocity (0.4 g/kg/d; P = 0.086). Our results showed that adding a household WASH package did not decrease post-recovery relapse rates but increased the recovery rate among children admitted in OTP. We recommend further robust trials in other settings to confirm our results.
Collapse
Affiliation(s)
| | | | | | | | | | - Mahamat Bechir
- Alliance Sahélienne de Recherches Appliquées pour le Développement Durable, Quartier Klemat, N’Djamena, Chad
| | | | | |
Collapse
|
26
|
Barnes AN, Davaasuren A, Baasandagva U, Gray GC. A systematic review of zoonotic enteric parasitic diseases among nomadic and pastoral people. PLoS One 2017; 12:e0188809. [PMID: 29190664 PMCID: PMC5708844 DOI: 10.1371/journal.pone.0188809] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 10/25/2017] [Indexed: 12/31/2022] Open
Abstract
Introduction Zoonotic enteric parasites are ubiquitous and remain a public health threat to humans due to our close relationship with domestic animals and wildlife, inadequate water, sanitation, and hygiene practices and diet. While most communities are now sedentary, nomadic and pastoral populations still exist and experience unique exposure risks for acquiring zoonotic enteric parasites. Through this systematic review we sought to summarize published research regarding pathogens present in nomadic populations and to identify the risk factors for their infection. Methods Using systematic review guidelines set forth by PRISMA, research articles were identified, screened and summarized based on exclusion criteria for the documented presence of zoonotic enteric parasites within nomadic or pastoral human populations. A total of 54 articles published between 1956 and 2016 were reviewed to determine the pathogens and exposure risks associated with the global transhumance lifestyle. Results The included articles reported more than twenty different zoonotic enteric parasite species and illustrated several risk factors for nomadic and pastoralist populations to acquire infection including; a) animal contact, b) food preparation and diet, and c) household characteristics. The most common parasite studied was Echinococcosis spp. and contact with dogs was recognized as a leading risk factor for zoonotic enteric parasites followed by contact with livestock and/or wildlife, water, sanitation, and hygiene barriers, home slaughter of animals, environmental water exposures, household member age and sex, and consumption of unwashed produce or raw, unprocessed, or undercooked milk or meat. Conclusion Nomadic and pastoral communities are at risk of infection with a variety of zoonotic enteric parasites due to their living environment, cultural and dietary traditions, and close relationship to animals. Global health efforts aimed at reducing the transmission of these animal-to-human pathogens must incorporate a One Health approach to support water, sanitation, and hygiene development, provide education on safe food handling and preparation, and improve the health of domestic animals associated with these groups, particularly dogs.
Collapse
Affiliation(s)
- Amber N. Barnes
- Institute of Veterinary Medicine, Ulaanbaatar, Mongolia
- Division of Infectious Diseases, School of Medicine, Duke University, Durham, NC, United States of America
- * E-mail:
| | - Anu Davaasuren
- Institute of Veterinary Medicine, Ulaanbaatar, Mongolia
- National Center for Communicable Disease, Ulaanbaatar, Mongolia
| | - Uyanga Baasandagva
- Institute of Veterinary Medicine, Ulaanbaatar, Mongolia
- National Center for Zoonotic Disease, Ulaanbaatar, Mongolia
| | - Gregory C. Gray
- Division of Infectious Diseases, School of Medicine, Duke University, Durham, NC, United States of America
- Global Health Institute, Duke University, Durham, NC, United States of America
| |
Collapse
|
27
|
Spina A, Lenglet A, Beversluis D, de Jong M, Vernier L, Spencer C, Andayi F, Kamau C, Vollmer S, Hogema B, Irwin A, Ngueremi Yary R, Mahamat Ali A, Moussa A, Alfani P, Sang S. A large outbreak of Hepatitis E virus genotype 1 infection in an urban setting in Chad likely linked to household level transmission factors, 2016-2017. PLoS One 2017; 12:e0188240. [PMID: 29176816 PMCID: PMC5703542 DOI: 10.1371/journal.pone.0188240] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 11/05/2017] [Indexed: 12/27/2022] Open
Abstract
Background In September 2016, three acutely jaundiced (AJS) pregnant women were admitted to Am Timan Hospital, eastern Chad. We described the outbreak and conducted a case test-negative study to identify risk factors for this genotype of HEV in an acute outbreak setting. Methods Active case finding using a community based surveillance network identified suspected AJS cases. Pregnant or visibly ill AJS cases presenting at hospital were tested with Assure® IgM HEV rapid diagnostic tests (RDTs) and some with Polymerase Chain Reaction (PCR) in Amsterdam; confirmed cases were RDT-positive and controls were RDT-negative. All answered questions around: demographics, household makeup, area of residence, handwashing practices, water collection behaviour and clinical presentation. We calculated unadjusted odds ratios (ORs) and 95% confidence intervals (95% CI). Results Between September and April 2017, 1443 AJS cases (1293 confirmed) were detected in the town(attack rate: 2%; estimated 65,000 population). PCR testing confirmed HEV genotype 1e. HEV RDTs were used for 250 AJS cases; 100 (40%) were confirmed. Risk factors for HEV infection, included: having at least two children under the age of 5 years (OR 2.1, 95%CI 1.1–4.3), having another household member with jaundice (OR 2.4, 95%CI 0.90–6.3) and, with borderline significance, living in the neighbourhoods of Riad (OR 3.8, 95%CI 1.0–1.8) or Ridina (OR 3.3, 95%CI 1.0–12.6). Cases were more likely to present with vomiting (OR 3.2, 9%CI 1.4–7.9) than controls; possibly due to selection bias. Cases were non-significantly less likely to report always washing hands before meals compared with controls (OR 0.33, 95%CI 0.1–1.1). Discussion Our study suggests household factors and area of residence (possibly linked to access to water and sanitation) play a role in HEV transmission; which could inform future outbreak responses. Ongoing sero-prevalence studies will elucidate more aspects of transmission dynamics of this virus with genotype 1e.
Collapse
Affiliation(s)
- Alexander Spina
- Médecins Sans Frontières, Operational Center Amsterdam (OCA), Ndjamena, Chad
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC), Stockholm, Sweden
- Department for Infectious Disease Epidemiology and Surveillance, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Annick Lenglet
- Médecins Sans Frontières, Operational Center Amsterdam (OCA), Amsterdam, The Netherlands
- * E-mail:
| | - David Beversluis
- Médecins Sans Frontières, Operational Center Amsterdam (OCA), Ndjamena, Chad
| | - Marja de Jong
- Médecins Sans Frontières, Operational Center Amsterdam (OCA), Ndjamena, Chad
| | - Larissa Vernier
- Médecins Sans Frontières, Operational Center Amsterdam (OCA), Ndjamena, Chad
| | - Craig Spencer
- Médecins Sans Frontières, Operational Center Amsterdam (OCA), Ndjamena, Chad
| | - Fred Andayi
- Médecins Sans Frontières, Operational Center Amsterdam (OCA), Ndjamena, Chad
| | - Charity Kamau
- Médecins Sans Frontières, Operational Center Amsterdam (OCA), Amsterdam, The Netherlands
| | - Simone Vollmer
- Médecins Sans Frontières, Operational Center Amsterdam (OCA), Ndjamena, Chad
| | - Boris Hogema
- Department of Virology, Sanquin Blood Supply, Amsterdam, the Netherlands
| | - Andrea Irwin
- Médecins Sans Frontières, Operational Center Amsterdam (OCA), Ndjamena, Chad
| | - Roger Ngueremi Yary
- Médecins Sans Frontières, Operational Center Amsterdam (OCA), Ndjamena, Chad
| | | | - Ali Moussa
- Ministère de la Santé Publique, N’djamena, Chad
| | - Prince Alfani
- Médecins Sans Frontières, Operational Center Amsterdam (OCA), Ndjamena, Chad
| | - Sibylle Sang
- Médecins Sans Frontières, Operational Center Amsterdam (OCA), Amsterdam, The Netherlands
| |
Collapse
|
28
|
Abstract
Studies of prévalence in iron deficiency separate iron depletion (defined as decreased blood ferritin) and iron deficiency anemia (defined as blood decrease in both ferritin and hemoglobin). In Europe, most studies are outdated. Prevalence of iron depletion varies from 7 to 18 % and 24 to 36% in toddlers and adolescents, respectively. Prevalence of iron deficiency anemia varies from 2 to 8.5% and 7 to 10% in toddlers and adolescents. In French speaking African countries, Demography Health Surveys show that 80% of children aged 0 to 2 years are anemic, severely for 5 to 9% of them.
Collapse
Affiliation(s)
- C Dupont
- Service d'explorations fonctionnelles digestives, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75015 Paris, France.
| |
Collapse
|
29
|
Makuuchi R, Jere S, Hasejima N, Chigeda T, Gausi J. The correlation between malaria RDT (Paracheck pf.®) faint test bands and microscopy in the diagnosis of malaria in Malawi. BMC Infect Dis 2017; 17:317. [PMID: 28464837 PMCID: PMC5414284 DOI: 10.1186/s12879-017-2413-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Accepted: 04/21/2017] [Indexed: 11/25/2022] Open
Abstract
Background Faint test bands of Paracheck Pf.® are interpreted as malaria positive according to world health organization (WHO) guideline. However if there are conspicuous number of faint test bands, a performance of Paracheck Pf.® could be influenced depending on whether interpreting faint test bands as malaria positive or negative. Finding out the frequency and accurate interpretation of faint test bands are important to prevent the overdiagnosis and drug resistance. Methods A cross-sectional, descriptive study was conducted to find out the frequency of faint test bands and evaluate the performance of Paracheck Pf.® by sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of diagnosis of Paracheck Pf.® using microscopy as the gold standard. 388 suspected patients with malaria in Malawi were recruited in this study. Malaria rapid diagnostic tests (RDTs) and microscopy were used and patients’ information which includes age, sex, body temperature and signs or symptoms of malaria were recorded. Results Among all patients involved in the study, 29.1% (113/388) were found malaria positive by RDT. Overall 5.4% (21/388) of all Paracheck Pf.® tests resulted in a “faint test band” and 85.7% (18/21) corresponded with malaria negative by microscopy. Faint test bands which corresponded with malaria positive by microscopy were lower parasite density and there are no patients who showed definitive symptom of malaria, such as fever. When Paracheck Pf.® “faint test bands” were classified as positive, accuracy of diagnosis was 76.5% (95% CI 72%–80.7%) as compared to 80.4% (95% CI 76.1%–84.2%) when Paracheck Pf.® “faint test bands” were classified as negative. Conclusions This study shows that frequency of faint test bands is 5.4% in all malaria RDTs. The accuracy of diagnosis was improved when faint test bands were interpreted as malaria negative. However information and data obtained in this study may not be enough and more intensive research including a frequency and property of faint test bands is needed for significant interpretation of faint test bands.
Collapse
Affiliation(s)
- Ryoko Makuuchi
- Nippon International Cooperation for Community Development, 101 Nishi-rokkaku-cho, Nakagyo-ku, Kyoto, 604-8217, Japan.
| | - Sandy Jere
- Ministry of health, Community Health Science Unit, PO Box 30377, Lilongwe, Malawi
| | - Nobuchika Hasejima
- Nippon International Cooperation for Community Development, 101 Nishi-rokkaku-cho, Nakagyo-ku, Kyoto, 604-8217, Japan
| | - Thoms Chigeda
- Lilongwe District Health Office, PO Box 1274, Lilongwe, Malawi
| | - January Gausi
- Lilongwe District Health Office, PO Box 1274, Lilongwe, Malawi
| |
Collapse
|
30
|
Amato KR. Incorporating the gut microbiota into models of human and non-human primate ecology and evolution. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2016; 159:S196-215. [PMID: 26808106 DOI: 10.1002/ajpa.22908] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The mammalian gut is home to a diverse community of microbes. Advances in technology over the past two decades have allowed us to examine this community, the gut microbiota, in more detail, revealing a wide range of influences on host nutrition, health, and behavior. These host-gut microbe interactions appear to shape host plasticity and fitness in a variety of contexts, and therefore represent a key factor missing from existing models of human and non-human primate ecology and evolution. However, current studies of the gut microbiota tend to include limited contextual data or are clinical, making it difficult to directly test broad anthropological hypotheses. Here, I review what is known about the animal gut microbiota and provide examples of how gut microbiota research can be integrated into the study of human and non-human primate ecology and evolution with targeted data collection. Specifically, I examine how the gut microbiota may impact primate diet, energetics, disease resistance, and cognition. While gut microbiota research is proliferating rapidly, especially in the context of humans, there remain important gaps in our understanding of host-gut microbe interactions that will require an anthropological perspective to fill. Likewise, gut microbiota research will be an important tool for filling remaining gaps in anthropological research.
Collapse
|
31
|
Diouf S, Folquet M, Mbofung K, Ndiaye O, Brou K, Dupont C, N'dri D, Vuillerod M, Azaïs-Braesco V, Tetanye E. [Prevalence and determinants of anemia in young children in French-speaking Africa. Role of iron deficiency]. Arch Pediatr 2015; 22:1188-97. [PMID: 26433575 DOI: 10.1016/j.arcped.2015.08.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 05/22/2015] [Accepted: 08/21/2015] [Indexed: 02/05/2023]
Abstract
Anemia and iron deficiency are major public health issues worldwide and particularly in Africa. Reliable information about their prevalence and associated factors is required to allow for effective actions. In this study, we used data from recent (2006-2012) large population health surveys, carried out in 11 French-speaking African countries (Benin, Burkina Faso, Cameroon, Congo Brazzaville, Ivory Coast, Gabon, Guinea, Mali, Niger, Democratic Republic of Congo, and Senegal). Hemoglobin (Hb) was assessed and demographic and health-related parameters were obtained from nation-representative samples of children aged 6-59 months. Anemia (Hb<11g/dL) was found in 72.4% of the children (60.2-87.8%), with no gender difference but a slightly lower incidence in older children (62% at age 4-5 years versus 85% at age 9 months), especially for the more severe forms (2.1% versus 8.7%, respectively). Anemia was only slightly but significantly affected by location (75.5% in rural areas versus 67.3% in towns), income (79.8% in lower quintile of income versus 62.3% in higher quintile), or maternal education (74.1% in children from non-educated mothers versus 62.4% in children whose mothers had secondary education). Nearly 50% of women of child-bearing age had anemia. In the countries that report this information, less than 50% (17-65%) of children consumed iron-rich foods regularly and only 12% (7.4-20.5%) received iron supplementation. Infection and parasitism are known to affect some markers of iron status, because of the inflammatory reaction, thereby making the diagnosis of iron deficiency difficult. In the study countries, acute respiratory diseases and diarrhea affected 6.2 and 15.6% of children aged between 6 and 59 months, respectively; their distribution according to age and location is very different from the one of anemia, which is also the case for the distribution of malaria. It is thus likely that a large part of the anemia observed in young children is due to iron deficiency, although further research is needed to confirm this. This fully justifies the nationwide programs of iron fortification of flour, currently undergoing in most countries of French-speaking Africa. Their formal evaluation is still pending but the initial data suggest some efficacy, although far from optimal. It is thus likely that a more holistic approach, including iron fortification, actions against undernutrition and parasitism in children, and actions in favor of improving young women's iron and nutritional status, together with appropriate communication and education objectives, would be more effective.
Collapse
Affiliation(s)
- S Diouf
- Institut de pédiatrie, université Cheikh Anta Diop, BP 5593, Dakar, Sénégal
| | - M Folquet
- Service de pédiatrie, CHU Cocody, université Houphouet Boigny, 25 BP 567, Abidjan 25, Côte d'Ivoire
| | - K Mbofung
- Biochimie et nutrition humaine, université de Bamenda, BP 516, Bamenda, Cameroun
| | - O Ndiaye
- Service de pédiatrie et néonatologie, CHU Abass Ndao, université Cheikh Anta Diop, BP 15872, Dakar, Sénégal
| | - K Brou
- Laboratoire de nutrition et sécurité alimentaire, université Nangui Abrogoua, 02 BP 801, Abidjan 02, Côte d'Ivoire
| | - C Dupont
- Service des explorations digestives et fonctionnelles, hôpital Necker, 149, rue de Sèvres, 75015 Paris, France
| | - D N'dri
- Recherche et développement, Danone Nutricia Africa & Overseas - Cocody, 2, plateaux Valllons, 28 BP 651, Abidjan, Côte d'Ivoire
| | - M Vuillerod
- Danone Nutricia Africa & Overseas, 383, rue Philippe-Héron, 69653 Villefranche-sur-Saône cedex, France
| | - V Azaïs-Braesco
- VAB-nutrition, 1, rue Claude-Danziger, 63100 Clermont-Ferrand, France.
| | - E Tetanye
- Université de Yaoundé, BP 2036, Yaoundé, Cameroun
| |
Collapse
|
32
|
Tyburski EA, Gillespie SE, Stoy WA, Mannino RG, Weiss AJ, Siu AF, Bulloch RH, Thota K, Cardenas A, Session W, Khoury HJ, O'Connor S, Bunting ST, Boudreaux J, Forest CR, Gaddh M, Leong T, Lyon LA, Lam WA. Disposable platform provides visual and color-based point-of-care anemia self-testing. J Clin Invest 2014; 124:4387-94. [PMID: 25157824 DOI: 10.1172/jci76666] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 07/24/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Anemia, or low blood hemoglobin (Hgb) levels, afflicts 2 billion people worldwide. Currently, Hgb levels are typically measured from blood samples using hematology analyzers, which are housed in hospitals, clinics, or commercial laboratories and require skilled technicians to operate. A reliable, inexpensive point-of-care (POC) Hgb test would enable cost-effective anemia screening and chronically anemic patients to self-monitor their disease. We present a rapid, stand-alone, and disposable POC anemia test that, via a single drop of blood, outputs color-based visual results that correlate with Hgb levels. METHODS We tested blood from 238 pediatric and adult patients with anemia of varying degrees and etiologies and compared hematology analyzer Hgb levels with POC Hgb levels, which were estimated via visual interpretation using a color scale and an optional smartphone app for automated analysis. RESULTS POC Hgb levels correlated with hematology analyzer Hgb levels (r = 0.864 and r = 0.856 for visual interpretation and smartphone app, respectively), and both POC test methods yielded comparable sensitivity and specificity for detecting any anemia (n = 178) (<11 g/dl) (sensitivity: 90.2% and 91.1%, specificity: 83.7% and 79.2%, respectively) and severe anemia (n = 10) (<7 g/dl) (sensitivity: 90.0% and 100%, specificity: 94.6% and 93.9%, respectively). CONCLUSIONS These results demonstrate the feasibility of this POC color-based diagnostic test for self-screening/self-monitoring of anemia. TRIAL REGISTRATION Not applicable. FUNDING This work was funded by the FDA-funded Atlantic Pediatric Device Consortium, the Georgia Research Alliance, Children's Healthcare of Atlanta, the Georgia Center of Innovation for Manufacturing, and the InVenture Prize and Ideas to Serve competitions at the Georgia Institute of Technology.
Collapse
|
33
|
The association of parasitic infections in pregnancy and maternal and fetal anemia: a cohort study in coastal Kenya. PLoS Negl Trop Dis 2014; 8:e2724. [PMID: 24587473 PMCID: PMC3937317 DOI: 10.1371/journal.pntd.0002724] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 01/17/2014] [Indexed: 11/19/2022] Open
Abstract
Background Relative contribution of these infections on anemia in pregnancy is not certain. While measures to protect pregnant women against malaria have been scaling up, interventions against helminthes have received much less attention. In this study, we determine the relative impact of helminthes and malaria on maternal anemia. Methods A prospective observational study was conducted in coastal Kenya among a cohort of pregnant women who were recruited at their first antenatal care (ANC) visit and tested for malaria, hookworm, and other parasitic infections and anemia at enrollment. All women enrolled in the study received presumptive treatment with sulfadoxine-pyrimethamine, iron and multi-vitamins and women diagnosed with helminthic infections were treated with albendazole. Women delivering a live, term birth, were also tested for maternal anemia, fetal anemia and presence of infection at delivery. Principal Findings Of the 706 women studied, at the first ANC visit, 27% had moderate/severe anemia and 71% of women were anemic overall. The infections with highest prevalence were hookworm (24%), urogenital schistosomiasis (17%), trichuria (10%), and malaria (9%). In adjusted and unadjusted analyses, moderate/severe anemia at first ANC visit was associated with the higher intensities of hookworm and P. falciparum microscopy-malaria infections. At delivery, 34% of women had moderate/severe anemia and 18% of infants' cord hemoglobin was consistent with fetal anemia. While none of the maternal infections were significantly associated with fetal anemia, moderate/severe maternal anemia was associated with fetal anemia. Conclusions More than one quarter of women receiving standard ANC with IPTp for malaria had moderate/severe anemia in pregnancy and high rates of parasitic infection. Thus, addressing the role of co-infections, such as hookworm, as well as under-nutrition, and their contribution to anemia is needed. International guidelines recommend routine prevention and treatments which are safe and effective during pregnancy to reduce hookworm, malaria and other infections among pregnant women living in geographic areas where these infections are prevalent. Despite their effectiveness, programs to address common infections such as hookworm, schistosomiasis and malaria during pregnancy have not been widely adopted. Hookworm, malaria and other infections have been associated with anemia in children, but the studies on the impact of these infections on anemia in pregnancy have not been as clear. This study was undertaken to evaluate the prevalence of parasitic infections among women attending antenatal care which provided the nationally recommended malaria preventive treatment program in coastal Kenya. At the first ANC visit, more than 70% of women were anemic, nearly one-fourth had hookworm and about 10% had malaria. Women with high levels of hookworm or malaria infections were at risk of anemia.
Collapse
|
34
|
Montavon A, Jean-Richard V, Bechir M, Daugla DM, Abdoulaye M, Bongo Naré RN, Diguimbaye-Djaibé C, Alfaroukh IO, Schelling E, Wyss K, Tanner M, Zinsstag J. La santé des pasteurs mobiles au Sahel - Bilan de 15 années de recherches et développement. Trop Med Int Health 2013; 18:E1-E10. [DOI: 10.1111/tmi.12148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- A. Montavon
- Swiss Tropical and Public Health Institute; Basel Switzerland
| | - V. Jean-Richard
- Swiss Tropical and Public Health Institute; Basel Switzerland
| | - M. Bechir
- Centre de Support en Santé Internationale; N'Djaména Tchad
| | - D. M. Daugla
- Centre de Support en Santé Internationale; N'Djaména Tchad
| | - M. Abdoulaye
- Centre de Support en Santé Internationale; N'Djaména Tchad
| | - R. N. Bongo Naré
- Institut de Recherche en Elevage pour le Développement ex Laboratoire de Recherches Vétérinaires et Zootechniques de Farcha; N'Djaména Tchad
| | - C. Diguimbaye-Djaibé
- Institut de Recherche en Elevage pour le Développement ex Laboratoire de Recherches Vétérinaires et Zootechniques de Farcha; N'Djaména Tchad
| | - I. O. Alfaroukh
- Institut de Recherche en Elevage pour le Développement ex Laboratoire de Recherches Vétérinaires et Zootechniques de Farcha; N'Djaména Tchad
| | - E. Schelling
- Swiss Tropical and Public Health Institute; Basel Switzerland
| | - K. Wyss
- Swiss Tropical and Public Health Institute; Basel Switzerland
| | - M. Tanner
- Swiss Tropical and Public Health Institute; Basel Switzerland
| | - J. Zinsstag
- Swiss Tropical and Public Health Institute; Basel Switzerland
| |
Collapse
|
35
|
Montavon A, Jean-Richard V, Bechir M, Daugla DM, Abdoulaye M, Bongo Naré RN, Diguimbaye-Djaibé C, Alfarouk IO, Schelling E, Wyss K, Tanner M, Zinsstag J. Health of mobile pastoralists in the Sahel - assessment of 15 years of research and development. Trop Med Int Health 2013; 18:1044-1052. [PMID: 23834073 DOI: 10.1111/tmi.12147] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
In the Sahel, between Mauritania and Somalia including Northern Kenya, about 20-30 million people live as mobile pastoralists. The rhythm of their migration follows the seasons and the availability of resources such as water, pasture and salt. Despite their high exposure to zoonoses and problems caused by extreme climatic conditions, mobile pastoralists are virtually excluded from health services because the provision of social services adapted to their way of life is challenging. In cooperation with various partners in the region, the Swiss Tropical and Public Health Institute has been active in research and development in the Sahel for 15 years. Based on the perceived needs of mobile pastoralists and the necessities of development, interdisciplinary research has considerably contributed to better understanding of their situation and their problems. Close contact between humans and livestock necessitates close cooperation between human and animal health specialists. Such useful approaches should be continued and extended.
Collapse
Affiliation(s)
- A Montavon
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - V Jean-Richard
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - M Bechir
- Centre de Support en Santé Internationale, N'Djaména, Tchad
| | - D M Daugla
- Centre de Support en Santé Internationale, N'Djaména, Tchad
| | - M Abdoulaye
- Centre de Support en Santé Internationale, N'Djaména, Tchad
| | - R N Bongo Naré
- Institut de Recherche en Elevage pour le Développement ex Laboratoire de Recherches Vétérinaires et Zootechniques de Farcha, N'Djaména, Tchad
| | - C Diguimbaye-Djaibé
- Institut de Recherche en Elevage pour le Développement ex Laboratoire de Recherches Vétérinaires et Zootechniques de Farcha, N'Djaména, Tchad
| | - I O Alfarouk
- Institut de Recherche en Elevage pour le Développement ex Laboratoire de Recherches Vétérinaires et Zootechniques de Farcha, N'Djaména, Tchad
| | - E Schelling
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - K Wyss
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - M Tanner
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - J Zinsstag
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| |
Collapse
|
36
|
Bechir M, Schelling E, Kraemer K, Schweigert F, Bonfoh B, Crump L, Tanner M, Zinsstag J. Retinol assessment among women and children in sahelian mobile pastoralists. ECOHEALTH 2012; 9:113-121. [PMID: 22825749 PMCID: PMC3415612 DOI: 10.1007/s10393-012-0781-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2011] [Revised: 05/22/2012] [Accepted: 06/15/2012] [Indexed: 06/01/2023]
Abstract
Micronutrient deficiencies are widespread in developing countries, particularly in remote communities such as mobile pastoralists. The nutritional and vitamin A status of this population is not well-documented in Chad. This study assessed serum retinol levels among women and children under five-year-old in nomadic and semi-nomadic pastoralist and rural-settled communities, who are similarly exposed to risk factors such as gastrointestinal parasitic infection, anaemia and emaciation. The novel method of portable fluorometry was used for the first time to measure β-carotene and retinol levels in a pastoral nomadic area. Moderate level blood retinol deficiency (<0.7 μmol/L) was observed in 5% (CI 1-11) of nomadic, 29% (CI 13-45) of semi-nomadic and 22% (CI 8-35) of sedentary women. In children, 1% (CI 0.1-4), 17% (CI 9-25) and 28% (CI 18-39), respectively, had moderate level blood retinol deficiency. In nomadic communities, women and children had blood retinol levels close to normal. Deficiency of retinol was strongly linked with lifestyle (nomadic, semi-nomadic and settled) among women and lifestyle and age among children. The results support an ecological linkage between human retinol levels and livestock milk retinol. This study shows the feasibility of portable retinol and β-carotene measurement in human blood as well as human and animal milk under remote field conditions, but the approach requires further validation.
Collapse
Affiliation(s)
- M. Bechir
- Centre National de Nutrition et de Technologie Alimentaire du Ministère de la Santé Publique au Tchad, BP 440, N’Djamena, Chad
- Swiss Tropical and Public Health Institute, The University of Basel, Socinstrasse 57, 4002 Basel, Switzerland
- The University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - E. Schelling
- Swiss Tropical and Public Health Institute, The University of Basel, Socinstrasse 57, 4002 Basel, Switzerland
- The University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - K. Kraemer
- Sight and Life, P.O. Box 2116, 4002 Basel, Switzerland
| | - F. Schweigert
- Institute of Nutritional Science, University of Potsdam, Arthur-Scheunert-Allee 114–116, 14558 Bergholz-Rehbrücke, Germany
| | - B. Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, P.O. Box 1303, Abidjan 01, Côte d’Ivoire
| | - L. Crump
- Swiss Tropical and Public Health Institute, The University of Basel, Socinstrasse 57, 4002 Basel, Switzerland
- The University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - M. Tanner
- Swiss Tropical and Public Health Institute, The University of Basel, Socinstrasse 57, 4002 Basel, Switzerland
- The University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - J. Zinsstag
- Swiss Tropical and Public Health Institute, The University of Basel, Socinstrasse 57, 4002 Basel, Switzerland
- The University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| |
Collapse
|