A scientometric evaluation of the Chagas disease implementation research programme of the PAHO and TDR

The End Justifies the Means: Chagas Disease from a Perspective of the Host-Trypanosoma cruzi Interaction

The neglected Chagas disease (CD) is caused by the protozoan parasite Trypanosoma cruzi. Despite CD dispersion throughout the world, it prevails in tropical areas affecting mainly poor communities, causing devastating health, social and economic consequences. Clinically, CD is marked by a mildly symptomatic acute phase, and a chronic phase characterized by cardiac and/or digestive complications. Current treatment for CD relies on medications with strong side effects and reduced effectiveness. The complex interaction between the parasite and the host outlines the etiology and progression of CD. The unique characteristics and high adaptability of T. cruzi, its mechanisms of persistence, and evasion of the immune system seem to influence the course of the disease. Despite the efforts to uncover the pathology of CD, there are many gaps in understanding how it is established and reaches chronicity. Also, the lack of effective treatments and protective vaccines constitute challenges for public health. Here, we explain the background in which CD is established, from the peculiarities of T. cruzi molecular biology to the development of the host's immune response leading to the pathophysiology of CD. We also discuss the state of the art of treatments for CD and current challenges in basic and applied science.

Chagas disease

Chagas disease persists as a global public health problem due to the high morbidity and mortality burden. Despite the possibility of a cure and advances in transmission control, epidemiological transformations, such as urbanisation and globalisation, and the emerging importance of oral and vertical transmission mean that Chagas disease should be considered an emerging disease, with new cases occurring worldwide. Important barriers to diagnosis, treatment, and care remain, resulting in repressed numbers of reported cases, which in turn leads to inadequate public policies. The validation of new diagnostic tools and treatment options is needed, as existing tools pose serious limitations to access to health care. Integrated models of surveillance, with community and intersectional participation, embedded in the concept of One Health, are essential for control. In addition, mitigation strategies for the main social determinants of health, including difficulties imposed by migration, are important to improve access to comprehensive health care in a globalised scenario.

India’s Contribution in Neglected tropical diseases: A Scientometrics Study.. [DOI: 10.32388/wrjp0g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Neglected Tropical Diseases (NTDs) are a group of parasitic and bacterial infections that are prevalent in tropical and subtropical regions. These diseases mainly affect improvised people of developing countries living in abject poverty. These are called "neglected" because they are often overlooked by the mainstream healthcare systems, despite their significant impact on public health. India has a large burden of NTDs and has made significant progress in developing and implementing interventions to control and eliminate these diseases. It is important to note that Indian researchers and institutions contribute to global research efforts in various fields, including neglected tropical diseases (NTDs). In this context, this paper is a scientometric assessment of Indian authors’ contribution in NTDs. For this purpose, scholarly publication data was downloaded form the Scopus® database of Elsevier science. The study observed developed countries particularly the US and UK are predominant in research on NTDs. Among the ‘Global South’ Brazil and India ranked third and fourth respectively. Indian scholarly output contributes about 6 percent of global contribution. For some diseases, Indian researchers contributes significantly. For example, in Leprosy research India is at the top with 18 percent of publication. For some diseases Indian contributions are comparatively less. This is due to the variation in disease conditions and also in local or regional focus in research. Hence a south-south cooperation is required for a detail investigation and preventions of NTDs.

Analysis of Chagas disease vectors occurrence data: the Argentinean triatomine species database

Background

Chagas disease is a neglected tropical disease and Trypanosomacruzi (its etiological agent) is mainly transmitted by triatomines (Hemiptera: Reduviidae). All triatomine species are considered as potential vectors; thus, their geographic distribution and habitat information should be a fundamental guide for the surveillance and control of Chagas disease. Currently, of the 137 species distributed in the Americas (Justi and Galvão 2017), 17 species are cited for Argentina: Panstrongylusgeniculatus, P.guentheri, P.megistus, P.rufotuberculatus, Psammolestescoreodes, Triatomabreyeri, T.delpontei, T.eratyrusiformis, T.garciabesi, T.guasayana, T.infestans, T.limai, T.patagonica, T.platensis, T.rubrofasciata, T.rubrovaria and T.sordida. Almost 20 years have passed since the publication of the “Atlas of the Triatominae” by Carcavallo et al. (1998) and no work has been done to provide an updated complete integration and analysis of the existing information for Argentinean triatomine species. Here we provide a detailed temporal, spatial and ecological analysis of updated occurrence data for triatomines present in Argentina.

New information

This is the first database of the 17 triatomine species present in Argentina (15917 records), with a critical analysis of the temporal, spatial and ecological characteristics of 9788 records. The information spans the last 100 years (1918–2019) and it was mostly obtained from the DataTri database and from the Argentinean Vector Reference Center. As 70% of the occurrences corresponded to the last 20 years, the information was split into two broad periods (pre-2000 and post-2000). Occurrence data for most species show distribution range contractions, which, from the pre-2000 to post-2000 period, became restricted mainly to the dry and humid Chaco ecoregions. Concurrently, the highest species richness foci occurred within those ecoregions. The species T.infestans, T.sordida, T.garciabesi and T.guasayana mostly colonise human dwelling habitats. This study provides the most comprehensive picture available for Argentinean triatomine species and we hope that any knowledge gaps will encourage others to keep this information updated to assist health policy-makers to make decisions based on the best evidence.

Scientometrics analysis of research activity and collaboration patterns in Chagas cardiomyopathy

Background

Chagas cardiomyopathy is a serious and common complication of Chagas disease.

Methods

Through bibliometric and Social Network Analysis, we examined patterns of research on Chagas cardiomyopathy, identifying the main countries, authors, research clusters, and topics addressed; and measuring the contribution of different countries.

Results

We found 1932 documents on Chagas cardiomyopathy in the MEDLINE database. The most common document type was ‘journal article’, accounting for 79.6% of the total (n = 1538), followed by ‘review’ (n = 217, 11.2%). The number of published records increased from 156 in 1980–1984 to 311 in 2010–2014. Only 2.5% were clinical trials. Brazil and the USA dominated the research, participating in 53.1% and 25.7%, respectively, of the documents. Other Latin American countries where Chagas is endemic contributed less, with Bolivia, where Chagas disease is most prevalent, producing only 1.8% of the papers. We observed a high rate of domestic collaboration (83.1% of the documents published in 2010–2016) and a lower but significant rate of international collaboration (32.5% in the same time period). Although clinical research dominated overall, the USA, Mexico and several countries in Europe produced a considerable body of basic research on animal models. We identified four main research clusters, focused on heart failure and dysfunction (physical symptoms, imaging techniques, treatment), and on myocarditis and parasitemia in animal models.

Conclusions

Research on Chagas cardiomyopathy increased over the study period. There were more clinical than basic studies, though very few of the documents were clinical trials. Brazil and the USA are currently leading the research on this subject, while some highly endemic countries, such as Bolivia, have contributed very little. Different approaches could help to redress this imbalance: encouraging researchers to conduct more clinical trials, launching international collaborations to help endemic countries contribute more, and strengthening links between basic and clinical research.

Scientific production on Chagas cardiomyopathy has grown considerably since the turn of the 21st century, probably reflecting the increased incidence of Chagas disease in non-endemic areas like the USA and Europe. Brazil and the USA dominate the research, but we found a very small proportion of clinical trials on Chagas cardiomyopathy and a low scientific production in several endemic countries with a high prevalence of the disease such as Colombia, Chile, Mexico and Bolivia. We observed a polarity between endemic and non-endemic countries where clinical research and basic research predominate, respectively. Different approaches could help to redress the observed imbalance of research on Chagas cardiomyopathy: encouraging researchers to conduct more clinical trials, launching international collaborations to help endemic countries contribute more, and strengthening links between basic and clinical research. It is crucial to foster translational research in order to link basic knowledge on the physiology of the disease with clinical applications in diagnosis and treatment.

Spatial and temporal distribution of house infestation by Triatoma infestans in the Toro Toro municipality, Potosi, Bolivia

BACKGROUND

Triatoma infestans is the main vector of Trypanosoma cruzi in Bolivia. The species is present both in domestic and peridomestic structures of rural areas, and in wild ecotopes of the Andean valleys and the Great Chaco. The identification of areas persistently showing low and high house infestation by the vector is important for the management of vector control programs. This study aimed at analyzing the temporal and spatial distribution of house infestation by T. infestans in the Toro Toro municipality (Potosi, Bolivia) between 2009 and 2014, and its association with environmental variables.

METHODS

House infestation and T. infestans density were calculated from entomological surveys of houses in the study area, using a fixed-time effort sampling technique. The spatial heterogeneity of house infestation was evaluated using the SatScan statistic. Association between house infestation with Bioclim variables (Worldclim database) and altitude was analyzed using a generalized linear model (GLM) with a logit link. Model selection was based on the Akaike information criteria after eliminating collinearity between variables using the variable inflation factor. The final model was used to create a probability map of house infestation for the Toro Toro municipality.

RESULTS

A total of 73 communities and 16,489 house evaluation events were analyzed. Presence of T. infestans was recorded on 480 house evaluation events, giving an overall annual infestation of 2.9% during the studied period (range 1.5-5.4% in 2009 and 2012). Vector density remained at about 1.25 insects/ house. Infestation was highly aggregated in five clusters, including 11 communities. Relative risk of infestation within these clusters was 1.7-3.9 times the value for the regional average. Four environmental variables were identified as good descriptors of house infestation, explaining 57% of house infestation variability. The model allowed the estimation of a house infestation surface for the Toro Toro municipality.

CONCLUSION

This study shows that residual and persistent populations of T. infestans maintain low house infestation, representing a potential risk for the transmission of T. cruzi in these communities, and it is possible to stratify house infestation using EV, and produce a risk map to guide the activities of vector control interventions in the municipality of Toro Toro (Potosi, Bolivia).

Snakebite Envenoming - A Combined Density Equalizing Mapping and Scientometric Analysis of the Publication History

Estimates suggest that more than 25,000 to 125,000 people die annually from snakebite envenomation worldwide. In contrast to this major disease burden, thorough bibliometric studies do not exist so far that illustrate the overall research activity over a long time span. Therefore, the NewQIS-platform conducted an analysis on snakebite envenoming using the Thomson Reuters database Web of Science. To determine and assess changes regarding the scientific activities and to specifically address the more recent situation we analyzed two time intervals (t). During the first time interval from 1900 to 2007 (t1) 13,015 publications (p) were identified. In the following period (2008-2016 = t2) 4,982 publications were identified by the same search strategy. They originate from 114 (t1) respectively 121 countries (t2), with the USA (p = 3518), Brazil (p = 1100) and Japan (p = 961) being most productive in the first period, and the USA (p = 1087), Brazil (p = 991) and China (p = 378) in the second period, respectively. Setting the publication numbers in relation to GDP/capita, Brazil leads with 92 publications per 10,000 Int$GDP/capita, followed by India with 79 publications per 10000 Int$GDP/capita (t1). Comparing the country's publication activity with the Human Development Index level indicates that the majority of the publications is published by highly developed countries. When calculating the average citation rates (citations per published item = CR) mainly European countries show the highest ranks: From 1900-2007 Sweden ranks first with a CR = 27, followed by the Netherlands (CR = 24.8), Switzerland (CR = 23), Spain, Austria and the USA (CR = 22). From 2008 to 2016 the highest rate achieves Switzerland with a value of 24.6, followed by Belgium (CR = 18.1), Spain (CR = 16.7), Costa Rica (CR = 14.9) and Netherlands (CR = 14). Compared with this, the USA was placed at rank 13 (CR = 9,5). In summary, the present study represents the first density-equalizing map projection and in-depth scientometric analysis of the global research output on snakebites and its venoms. So it draws a sketch of the worldwide publication architecture and indicates that countries with a high incidence of snakebites and a low economical level still need to be empowered in carrying out research in this area.