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Miyazaki A, Tung R, Taing B, Matsui M, Iwamoto A, Cox SE. Frequent unregulated use of antibiotics in rural Cambodian infants. Trans R Soc Trop Med Hyg 2021; 114:401-407. [PMID: 32307551 PMCID: PMC7266683 DOI: 10.1093/trstmh/traa020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 10/25/2019] [Accepted: 03/17/2020] [Indexed: 01/26/2023] Open
Abstract
Background Despite a high prevalence of antibiotic resistance in Cambodia, few studies have assessed health-seeking behaviour and the use of antibiotics by caregivers of young children in Cambodia. Methods We conducted a cross-sectional survey of infants <12 months of age and their caregivers, assessing the frequency of reported illness, common symptoms and associated health-seeking behaviour through structured questionnaires administered by trained fieldworkers at a home visit. In a subset of these participants, ages 4–8 months with no acute malnutrition, we conducted a 3-month surveillance with fortnightly home visits. Results Of 149 infants (ages 1–11 months, 54.4% male) enrolled in the cross-sectional study, 76 (51.4%) reported symptoms of diarrhoea, fever or cough in the previous 14 d, with associated use of antibiotics reported in 22 (14.8%) infants. In 47 infants enrolled in the longitudinal surveillance, there were 141 reported episodes of illness in 44 (94%) infants with 21 infants (45%) reported to have received antibiotics in 32/141 (22.7%) episodes. Amoxicillin was the most commonly reported antibiotic in both surveys (68% [40/59 episodes reporting the use of antibiotics]). Conclusions Antibiotic usage is high in this population and appears to be occurring largely outside of the formal healthcare system.
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Affiliation(s)
- Asuka Miyazaki
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Rathavy Tung
- National Maternal and Child Health Centre, Ministry of Health, Phnom Penh, Cambodia
| | | | - Mitsuaki Matsui
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Azusa Iwamoto
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Sharon E Cox
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.,Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.,Dept of Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Chande AT, Rishishwar L, Ban D, Nagar SD, Conley AB, Rowell J, Valderrama-Aguirre AE, Medina-Rivas MA, Jordan IK. The Phenotypic Consequences of Genetic Divergence between Admixed Latin American Populations: Antioquia and Chocó, Colombia. Genome Biol Evol 2021; 12:1516-1527. [PMID: 32681795 PMCID: PMC7513793 DOI: 10.1093/gbe/evaa154] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2020] [Indexed: 12/11/2022] Open
Abstract
Genome-wide association studies have uncovered thousands of genetic variants that are associated with a wide variety of human traits. Knowledge of how trait-associated variants are distributed within and between populations can provide insight into the genetic basis of group-specific phenotypic differences, particularly for health-related traits. We analyzed the genetic divergence levels for 1) individual trait-associated variants and 2) collections of variants that function together to encode polygenic traits, between two neighboring populations in Colombia that have distinct demographic profiles: Antioquia (Mestizo) and Chocó (Afro-Colombian). Genetic ancestry analysis showed 62% European, 32% Native American, and 6% African ancestry for Antioquia compared with 76% African, 10% European, and 14% Native American ancestry for Chocó, consistent with demography and previous results. Ancestry differences can confound cross-population comparison of polygenic risk scores (PRS); however, we did not find any systematic bias in PRS distributions for the two populations studied here, and population-specific differences in PRS were, for the most part, small and symmetrically distributed around zero. Both genetic differentiation at individual trait-associated single nucleotide polymorphisms and population-specific PRS differences between Antioquia and Chocó largely reflected anthropometric phenotypic differences that can be readily observed between the populations along with reported disease prevalence differences. Cases where population-specific differences in genetic risk did not align with observed trait (disease) prevalence point to the importance of environmental contributions to phenotypic variance, for both infectious and complex, common disease. The results reported here are distributed via a web-based platform for searching trait-associated variants and PRS divergence levels at http://map.chocogen.com (last accessed August 12, 2020).
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Affiliation(s)
- Aroon T Chande
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia.,IHRC-Georgia Tech Applied Bioinformatics Laboratory, Atlanta, Georgia.,PanAmerican Bioinformatics Institute, Valle del Cauca, Cali, Colombia
| | - Lavanya Rishishwar
- IHRC-Georgia Tech Applied Bioinformatics Laboratory, Atlanta, Georgia.,PanAmerican Bioinformatics Institute, Valle del Cauca, Cali, Colombia
| | - Dongjo Ban
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia.,PanAmerican Bioinformatics Institute, Valle del Cauca, Cali, Colombia
| | - Shashwat D Nagar
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia.,PanAmerican Bioinformatics Institute, Valle del Cauca, Cali, Colombia
| | - Andrew B Conley
- IHRC-Georgia Tech Applied Bioinformatics Laboratory, Atlanta, Georgia.,PanAmerican Bioinformatics Institute, Valle del Cauca, Cali, Colombia
| | - Jessica Rowell
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia
| | - Augusto E Valderrama-Aguirre
- PanAmerican Bioinformatics Institute, Valle del Cauca, Cali, Colombia.,Biomedical Research Institute (COL0082529), Cali, Colombia.,Universidad Santiago de Cali, Colombia
| | - Miguel A Medina-Rivas
- PanAmerican Bioinformatics Institute, Valle del Cauca, Cali, Colombia.,Centro de Investigación en Biodiversidad y Hábitat, Universidad Tecnológica del Chocó, Quibdó, Colombia
| | - I King Jordan
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia.,IHRC-Georgia Tech Applied Bioinformatics Laboratory, Atlanta, Georgia.,PanAmerican Bioinformatics Institute, Valle del Cauca, Cali, Colombia
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