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Hobbs CV, Rhinewalt JM, Arguello I, Malloch L, Martin L, Poston WM, Byers P, Bradbury RS. Autochthonous Ascariasis, Mississippi, USA. Emerg Infect Dis 2024; 30:821-823. [PMID: 38526329 PMCID: PMC10977833 DOI: 10.3201/eid3004.240176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
We describe a case of a 2-year-old child who expelled a single adult female Ascaris lumbricoides worm. The patient is from a rural county in Mississippi, USA, with no reported travel outside of the United States. The caregivers in the home practice good sanitation. Exposure to domestic pigs is the likely source of infection.
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2
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Kryston A, Woods CG, Manga M. Social barriers to safe sanitation access among housed populations in the United States: A systematic review. Int J Hyg Environ Health 2024; 257:114326. [PMID: 38295493 DOI: 10.1016/j.ijheh.2024.114326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 01/16/2024] [Accepted: 01/25/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Nearly six million people residing in the United States do not have access to safely managed sanitation. Housed populations may lack access to centralized wastewater treatment systems or functioning onsite wastewater treatment systems, which subsequently places them at higher risk for adverse health outcomes associated with unsafe sanitation. OBJECTIVES We sought to understand the various social barriers that impact access to safe sanitation in the United States. METHODS We included peer-reviewed studies published between January 2000 and March 2023. The publication search was conducted using Scopus, ProQuest Social Science Database, and HeinOnline. We extracted data on social barriers and physical factors associated with access to sanitation. RESULTS Twenty publications met the inclusion criteria, and data relating to 11 social barriers and two physical factors were extracted. The social barriers to safe sanitation access mentioned most frequently were found to be socioeconomic status and race-based discrimination. Studies discussed sanitation in communities in five states. DISCUSSION Barriers pertained to lack of access to centralized wastewater treatment system, inadequate repair or replacement of septic systems, and lack of safely managed onsite sanitation systems. We discuss the intersectionality of the barriers, the underlying policy and history that leads to them, and make recommendations to address inequitable access to safe sanitation. Legislation and policy must be critically reviewed at national, state, and local levels to limit or eliminate ability for utilities to be extended on the basis of a community's income and property values or racial makeup. Policy recommendations also include additional community engagement, onsite sanitation system monitoring, and knowledge dissemination and education of septic system users. More geographically diverse research and research on sanitation in specific communities such as those of migrant farmworkers, undocumented persons, and tenants are recommended.
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Affiliation(s)
- Amy Kryston
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, 170 Rosenau Hall, CB #7400, 135 Dauer Drive, Chapel Hill, NC, 27599-7400, USA.
| | - Courtney G Woods
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, 170 Rosenau Hall, CB #7400, 135 Dauer Drive, Chapel Hill, NC, 27599-7400, USA.
| | - Musa Manga
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, 170 Rosenau Hall, CB #7400, 135 Dauer Drive, Chapel Hill, NC, 27599-7400, USA.
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Capone D, Bakare T, Barker T, Chatham AH, Clark R, Copperthwaite L, Flemister A, Geason R, Hoos E, Kim E, Manoj A, Pomper S, Samodal C, Smith S, Poole C, Brown J. Risk Factors for Enteric Pathogen Exposure among Children in Black Belt Region of Alabama, USA. Emerg Infect Dis 2023; 29. [PMID: 37987604 PMCID: PMC10683812 DOI: 10.3201/eid2912.230780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023] Open
Abstract
We collected stool from school-age children from 352 households living in the Black Belt region of Alabama, USA, where sanitation infrastructure is lacking. We used quantitative reverse transcription PCR to measure key pathogens in stool that may be associated with water and sanitation, as an indicator of exposure. We detected genes associated with > 1 targets in 26% of specimens, most frequently Clostridioides difficile (6.6%), atypical enteropathogenic Escherichia coli (6.1%), and enteroaggregative E. coli (3.9%). We used generalized estimating equations to assess reported risk factors for detecting > 1 pathogen in stool. We found no association between lack of sanitation and pathogen detection (adjusted risk ratio 0.95 [95% CI 0.55–1.7]) compared with specimens from children served by sewerage. However, we did observe an increased risk for pathogen detection among children living in homes with well water (adjusted risk ratio 1.7 [95% CI 1.1–2.5]) over those reporting water utility service.
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La Hoz RM. Minimizing the Risk of Donor-Derived Events and Maximizing Organ Utilization Through Education and Policy Development. Infect Dis Clin North Am 2023:S0891-5520(23)00044-2. [PMID: 37302913 DOI: 10.1016/j.idc.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Herein, we review the current knowledge of donor-derived disease and current US Organ Procurement and Transplantation Network policies to minimize the risk. During the process, we also consider actions to further mitigate the risk of donor-derived disease. The overarching goal is to provide an infectious disease perspective on the complex decision of organ acceptance for transplant programs and candidates.
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Affiliation(s)
- Ricardo M La Hoz
- Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9913, USA.
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5
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Adams SH, Endy TP, Larsen DA. Using Google Trends to Estimate the Geographic Distribution of Soil-Transmitted Helminthiasis in the United States from 2016 to 2021. Trop Med Infect Dis 2023; 8:tropicalmed8040212. [PMID: 37104338 PMCID: PMC10145709 DOI: 10.3390/tropicalmed8040212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
Soil-transmitted helminth infections are assumed to be uncommon in the US, despite numerous studies in the past few decades showing high burdens in Appalachia and the southern states. We assessed trends of interest in the Google search engine to gauge spatiotemporal patterns of potential soil-transmitted helminth transmission. We conducted a further ecological study comparing Google search trends to risk factors for soil-transmitted helminth transmission. Google search trends for terms related to soil-transmitted helminths were clustered in Appalachia and the south, with seasonal surges suggestive of endemic transmission for hookworm, roundworm (Ascaris), and threadworm. Furthermore, lower access to plumbing, increased septic tank use, and more rural environments were associated with increased soil-transmitted helminth-related Google search terms. Together, these results suggest that soil-transmitted helminthiasis remains endemic in parts of Appalachia and the south.
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Affiliation(s)
- Steven H. Adams
- Department of Pathology, Stony Brook University Hospital, Stony Brook, NY 11794, USA
| | - Timothy P. Endy
- Departments of Internal Medicine and Infectious Diseases, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - David A. Larsen
- Department of Public Health, Syracuse University, Syracuse, NY 13244, USA
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6
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Mendoza Cavazos C, Heredia MY, Owens LA, Knoll LJ. Using Entamoeba muris To Model Fecal-Oral Transmission of Entamoeba in Mice. mBio 2023; 14:e0300822. [PMID: 36744962 DOI: 10.1128/mbio.03008-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
There are several Entamoeba species that colonize humans, but only Entamoeba histolytica causes severe disease. E. histolytica is transmitted through the fecal-oral route to colonize the intestinal tract of 50 million people worldwide. The current mouse model to study E. histolytica intestinal infection directly delivers the parasite into the surgically exposed cecum, which circumvents the natural route of infection. To develop a fecal-oral mouse model, we screened our vivarium for a natural murine Entamoeba colonizer via a pan-Entamoeba PCR targeting the 18S ribosomal gene. We determined that C57BL/6 mice were chronically colonized by Entamoeba muris. This amoeba is closely related to E. histolytica, as determined by 18S sequencing and cross-reactivity with an E. histolytica-specific antibody. In contrast, outbred Swiss Webster (SW) mice were not chronically colonized by E. muris. We orally challenged SW mice with 1 × 105 E. muris cysts and discovered they were susceptible to infection, with peak cyst shedding occurring between 5 and 7 days postinfection. Most infected SW mice did not lose weight significantly but trended toward decreased weight gain throughout the experiment compared to mock-infected controls. Infected mice treated with paromomycin, an antibiotic used against noninvasive intestinal disease, do not become colonized by E. muris. Within the intestinal tract, E. muris localizes exclusively to the cecum and colon. Purified E. muris cysts treated with bovine bile in vitro excyst into mobile, pretrophozoite stages. Overall, this work describes a novel fecal-oral mouse model for the important global pathogen E. histolytica. IMPORTANCE Infection with parasites from the Entamoeba genus are significantly underreported causes of diarrheal disease that disproportionally impact tropical regions. There are several species of Entamoeba that infect humans to cause a range of symptoms from asymptomatic colonization of the intestinal tract to invasive disease with dissemination. All Entamoeba species are spread via the fecal-oral route in contaminated food and water. Studying the life cycle of Entamoeba, from host colonization to infectious fecal cyst production, can provide targets for vaccine and drug development. Because there is not an oral challenge rodent model, we screened for a mouse Entamoeba species and identified Entamoeba muris as a natural colonizer. We determine the peak of infection after an oral challenge, the efficacy of paromomycin treatment, the intestinal tract localization, and the cues that trigger excystation. This oral infection mouse model will be valuable for the development of novel therapeutic options for Entamoeba infections.
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Gildner TE, Cepon-Robins TJ. Rural Embodiment and Community Health: an Anthropological Case Study on Biocultural Determinants of Tropical Disease Infection and Immune System Development in the USA. Curr Trop Med Rep 2023; 10:26-39. [PMID: 36714157 DOI: 10.1007/s40475-023-00282-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 01/24/2023]
Abstract
Purpose of Review Biocultural methods are critically important for identifying environmental and socioeconomic factors linked with tropical disease risk and outcomes. For example, embodiment theory refers to the process by which lived experiences impact individual biology. Increased exposure to pathogens, chronic psychosocial stress, and unequal resource access are all outcomes linked with discrimination and poverty. Through lived experiences, race and socioeconomic inequality can literally become embodied-get under the skin and affect physiology-impacting immune responses and contributing to lifelong health disparities. Yet, few studies have investigated tropical disease patterns and associated immune function using embodiment theory to understand lasting physiological impacts associated with living in a high-pathogen environment. Recent Findings Here, we use preliminary data drawn from the Rural Embodiment and Community Health (REACH) study to assess whether pathogen exposure and immune stimulation within a sample of children from the Mississippi Delta are associated with household income. We also test whether immune marker levels-assessed with enzyme-linked immunosorbent assays using dried blood spot samples-vary between the REACH sample and a similarly aged nationally representative NHANES sample. Immune marker levels did not differ significantly between REACH participants living below vs. above the federal poverty line, yet immunoglobulin E levels-a marker of macroparasite infection-were higher among REACH study participants compared to the NHANES sample. Summary These results may suggest community-level pathogenic exposures (i.e., parasitic infections) are embodied by REACH participants with implications for long-term immune function, potentially resulting in immune aspects that differ from nationally representative samples. Supplementary Information The online version contains supplementary material available at 10.1007/s40475-023-00282-z.
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Mendez P, Walsh B, Hallem EA. Using newly optimized genetic tools to probe Strongyloides sensory behaviors. Mol Biochem Parasitol 2022; 250:111491. [PMID: 35697205 PMCID: PMC9339661 DOI: 10.1016/j.molbiopara.2022.111491] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/25/2022] [Accepted: 06/07/2022] [Indexed: 11/26/2022]
Abstract
The oft-neglected human-parasitic threadworm, Strongyloides stercoralis, infects roughly eight percent of the global population, placing disproportionate medical and economic burden upon marginalized communities. While current chemotherapies treat strongyloidiasis, disease recrudescence and the looming threat of anthelminthic resistance necessitate novel strategies for nematode control. Throughout its life cycle, S. stercoralis relies upon sensory cues to aid in environmental navigation and coordinate developmental progression. Odorants, tastants, gases, and temperature have been shown to shape parasite behaviors that drive host seeking and infectivity; however, many of these sensory behaviors remain poorly understood, and their underlying molecular and neural mechanisms are largely uncharacterized. Disruption of sensory circuits essential to parasitism presents a promising strategy for future interventions. In this review, we describe our current understanding of sensory behaviors - namely olfactory, gustatory, gas sensing, and thermosensory behaviors - in Strongyloides spp. We also highlight the ever-growing cache of genetic tools optimized for use in Strongyloides that have facilitated these findings, including transgenesis, CRISPR/Cas9-mediated mutagenesis, RNAi, chemogenetic neuronal silencing, and the use of fluorescent biosensors to measure neuronal activity. Bolstered by these tools, we are poised to enter an era of rapid discovery in Strongyloides sensory neurobiology, which has the potential to shape pioneering advances in the prevention and treatment of strongyloidiasis.
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Affiliation(s)
- Patricia Mendez
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA, USA; Molecular Biology Interdepartmental PhD Program, University of California Los Angeles, Los Angeles, CA, USA.
| | - Breanna Walsh
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA, USA; Molecular Biology Interdepartmental PhD Program, University of California Los Angeles, Los Angeles, CA, USA; Medical Scientist Training Program, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Elissa A Hallem
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA, USA; Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA, USA.
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9
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Bryant AS, Ruiz F, Lee JH, Hallem EA. The neural basis of heat seeking in a human-infective parasitic worm. Curr Biol 2022; 32:2206-2221.e6. [PMID: 35483361 PMCID: PMC9158753 DOI: 10.1016/j.cub.2022.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 03/21/2022] [Accepted: 04/05/2022] [Indexed: 02/06/2023]
Abstract
Soil-transmitted parasitic nematodes infect over one billion people and cause devastating morbidity worldwide. Many of these parasites have infective larvae that locate hosts using thermal cues. Here, we identify the thermosensory neurons of the human threadworm Strongyloides stercoralis and show that they display unique functional adaptations that enable the precise encoding of temperatures up to human body temperature. We demonstrate that experience-dependent thermal plasticity regulates the dynamic range of these neurons while preserving their ability to encode host-relevant temperatures. We describe a novel behavior in which infective larvae spontaneously reverse attraction to heat sources at sub-body temperatures and show that this behavior is mediated by rapid adaptation of the thermosensory neurons. Finally, we identify thermoreceptors that confer parasite-specific sensitivity to body heat. Our results pinpoint the parasite-specific neural adaptations that enable parasitic nematodes to target humans and provide the foundation for drug development to prevent human infection.
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Affiliation(s)
- Astra S Bryant
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Felicitas Ruiz
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Joon Ha Lee
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Elissa A Hallem
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA 90095, USA; Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA.
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11
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Kaplan J, Centeno FH, Hayon J, Bottazzi ME, Hotez PJ, Weatherhead JE, Clark E, Woc-Colburn L. Reviewing a Decade of Outpatient Tropical Medicine in Houston, Texas. Am J Trop Med Hyg 2022; 106:1049-1056. [PMID: 35226869 PMCID: PMC8991353 DOI: 10.4269/ajtmh.21-1059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/12/2021] [Indexed: 12/15/2022] Open
Abstract
Tropical diseases cause significant morbidity among the world's poorest populations. Although more common in low- and middle-income countries, tropical diseases are also found among underserved populations living in high-income countries such as the United States. The National School of Tropical Medicine at Baylor College of Medicine and the Harris Health System founded a tropical medicine clinic-the Harris Health Tropical Medicine Clinic (HHTMC)-in Houston in 2011 in response to tropical disease-related morbidity in Texas. We conducted a retrospective chart review of a sample of patients older than 18 years of age who were referred to the HHTMC between October 2011 and January 2020. Of the 523 patients reviewed, 185 (35.4%) had mycobacterial infections, 184 (35.2%) had parasitic infections, 38 (7.3%) had fungal infections, 16 (3.1%) had eosinophilia without a confirmed clinical diagnosis, 28 (5.4%) had bacterial infections, and 13 (2.5%) had viral infections. The most common infections overall were extrapulmonary and latent tuberculosis (n = 169), neurocysticercosis (n = 78), strongyloidiasis (n = 28), Chagas disease (n = 25), and schistosomiasis (n = 12). The epidemiology of tropical diseases in the United States is understudied at national and regional levels. This 10-year retrospective study contributes to bridging this knowledge gap by detailing the frequencies of tropical disease diagnoses made at the HHTMC in Houston, TX. These data highlight areas for advancement in the field of tropical medicine within the United States, such as improving front-line health-care provider education; establishing tropical medicine clinics in areas of high prevalence such as the Gulf Coast, Appalachia, and urban areas; and developing comprehensive, systematic national tropical disease screening programs and patient registries.
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Affiliation(s)
- Julika Kaplan
- Department of Internal Medicine, Baylor College of Medicine, Houston, Texas
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | | | - Jesica Hayon
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas
| | - Maria Elena Bottazzi
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas
| | - Peter J. Hotez
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas
| | - Jill E. Weatherhead
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas
| | - Eva Clark
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas
- Health Services Research, Michael E. DeBakey VA Health Services Research Center of Innovations, Houston, Texas
| | - Laila Woc-Colburn
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia
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12
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Shattuck EC. Networks, cultures, and institutions: Toward a social immunology. Brain Behav Immun Health 2021; 18:100367. [PMID: 34761241 PMCID: PMC8566934 DOI: 10.1016/j.bbih.2021.100367] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 10/08/2021] [Accepted: 10/08/2021] [Indexed: 12/26/2022] Open
Abstract
This paper calls for increased attention to the ways in which immune function – including its behavioral aspects – are responsive to social contexts at multiple levels. Psychoneuroimmunology has demonstrated that the quantity and quality of social connections can affect immune responses, while newer research is finding that sickness temporarily affects these same social networks and that some aspects of culture can potentially “get under the skin” to affect inflammatory responses. Social immunology, the research framework proposed here, unifies these findings and also considers the effects of structural factors – that is, a society's economic, political, and environmental landscape – on exposure to pathogens and subsequent immune responses. As the COVID-19 pandemic has highlighted, a holistic understanding of the effects of social contexts on the patterning of morbidity and mortality is critically important. Social immunology provides such a framework and can highlight important risk factors related to impaired immune function.
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Affiliation(s)
- Eric C Shattuck
- Institute for Health Disparities Research, University of Texas at San Antonio, San Antonio, TX, USA.,Department of Public Health, University of Texas at San Antonio, San Antonio, TX, USA
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13
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Kositz C, Bradley J, Hutchins H, Last A, D'Alessandro U, Marks M. Broadening the range of use cases for ivermectin - a review of the evidence. Trans R Soc Trop Med Hyg 2021; 116:201-212. [PMID: 34323283 DOI: 10.1093/trstmh/trab114] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/30/2021] [Accepted: 07/13/2021] [Indexed: 11/12/2022] Open
Abstract
Ivermectin is a broad-spectrum antiparasitic agent that interferes with glutamate-gated chloride channels found in invertebrates but not in vertebrate species. Mass drug administration (MDA) with ivermectin-based regimes has been a mainstay of elimination efforts targeting onchocerciasis and lymphatic filariasis for more than 3 decades. More recently, interest in the use of ivermectin to control other neglected tropical diseases (NTDs) such as soil-transmitted helminths and scabies has grown. Interest has been further stimulated by the fact that ivermectin displays endectocidal efficacy against various Anopheles species capable of transmitting malaria. Therefore there is growing interest in using ivermectin MDA as a tool that might aid in the control of both malaria and several NTDs. In this review we outline the evidence base to date on these emerging indications for ivermectin MDA with reference to clinical and public health data and discuss the rationale for evaluating the range of impacts of a malaria ivermectin MDA on other NTDs.
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Affiliation(s)
- Christian Kositz
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - John Bradley
- MRC International Statistics and Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - Harry Hutchins
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - Anna Last
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK.,Hospital for Tropical Diseases, Mortimer Market Capper Street, WC1E 6JB, London, UK
| | - Umberto D'Alessandro
- Disease Control and Elimination, Medical Research Council Unit Gambia at London School of Hygiene and Tropical Medicine, Atlantic Boulevard, Fajara, The Gambia
| | - Michael Marks
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK.,Hospital for Tropical Diseases, Mortimer Market Capper Street, WC1E 6JB, London, UK
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14
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Lynn MK, Morrissey JA, Conserve DF. Soil-Transmitted Helminths in the USA: a Review of Five Common Parasites and Future Directions for Avenues of Enhanced Epidemiologic Inquiry. Curr Trop Med Rep 2021; 8:32-42. [PMID: 33552843 PMCID: PMC7847297 DOI: 10.1007/s40475-020-00221-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2020] [Indexed: 12/01/2022]
Abstract
Purpose of Review The aim of this review is to present a comprehensive look at five intestinal soil-transmitted helminths (STHs) of global health importance that may continue to plague low-income and rural areas of the USA and argue the need for enhanced surveillance of these infections, which primarily affect the nation’s most vulnerable groups. Recent Findings Human STH infections in middle- and high-income countries are at particular risk for being undiagnosed; as common symptoms are non-specific, differentials require a high index of clinical suspicion, and cases are concentrated in areas of poverty where access to care is limited. Although autochthonous STHs are thought to be rare in the USA, infections were once common in the American South and Appalachia and robust epidemiologic surveillance is limited post 1980s. However, recent community studies and case reports from small-scale farms and areas of high rural or inner-city poverty reveal the potential for persisting helminth infections in distinct populations of the country. Summary STHs are among the most common neglected tropical diseases globally causing significant morbidity in underserved communities and contributing to the continuation of cycles of poverty within vulnerable populations. Due to possible severe disease sequalae and their ability to perpetuate poverty and poverty-associated health outcomes within already vulnerable groups, it is vital that surveillance for these infections is enhanced to bolster health equity in the USA.
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Affiliation(s)
- Mary K Lynn
- Laboratory of Vector-Borne and Zoonotic Diseases, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Josephine A Morrissey
- Laboratory of Vector-Borne and Zoonotic Diseases, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Donaldson F Conserve
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
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15
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Shirley DA, Moonah S. COVID-19 and Corticosteroids: Unfamiliar but Potentially Fatal Infections That Can Arise following Short-Course Steroid Treatment. Am J Trop Med Hyg 2021; 104:790-793. [PMID: 33410395 PMCID: PMC7941796 DOI: 10.4269/ajtmh.20-1471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/07/2020] [Indexed: 12/19/2022] Open
Abstract
Corticosteroid use is increasing worldwide as recent studies confer survival benefit of corticosteroids in the management of patients with severe COVID-19. Strongyloides and amebic infections are neglected diseases that can progress to catastrophic complications in patients exposed to corticosteroids, even with short treatment courses. To prevent lethal outcomes, clinicians should be aware of the threat these two parasitic infections pose to at-risk patients receiving corticosteroids, especially in the era of COVID-19.
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Affiliation(s)
- Debbie-Ann Shirley
- Division of Infectious Diseases and International Health, University of Virginia COVID-19 Clinic, University of Virginia Health System, Charlottesville, Virginia
| | - Shannon Moonah
- Division of Infectious Diseases and International Health, University of Virginia COVID-19 Clinic, University of Virginia Health System, Charlottesville, Virginia
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Rowles LS, Whittaker T, Ward PM, Araiza I, Kirisits MJ, Lawler DF, Saleh NB. A Structural Equation Model to Decipher Relationships among Water, Sanitation, and Health in Colonias-Type Unincorporated Communities. Environ Sci Technol 2020; 54:16017-16027. [PMID: 33259189 DOI: 10.1021/acs.est.0c05355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The colonias along the United States-Mexico border are generally self-built neighborhoods of low-income families that lack basic infrastructure. While some government assistance has provided roads and electricity, water and wastewater services are still lacking in many colonias. This research is the first to collect a comprehensive dataset on water, sanitation, health, and living conditions in these unincorporated neighborhoods through collection of water samples and surveys; 114 households in 23 colonias across three geographically diverse Texas counties are studied. Water quality is assessed via traditional microbial indicators, chlorine, and arsenic. This complex dataset requires an advanced statistical tool to disentangle relationships among diverse factors. Structural equation modeling is utilized to identify relationships among surveyed and measured variables. The model reveals that colonias residents with well/hauled water accurately predict their water quality, while those with treated+piped water tend to think that their water is worse than it actually is. Dwelling quality and connection to sanitary sewers influence perceived health risks and household health, respectively. Furthermore, these communities have an overwhelming need and desire for point-of-use water treatment. This model can inform decision making and may be adapted to probe other questions and social dynamics for water and sanitation in unincorporated communities elsewhere.
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Affiliation(s)
- Lewis Stetson Rowles
- Department of Civil, Architectural and Environmental Engineering, University of Texas at Austin, Austin, Texas 78712, United States
| | - Tiffany Whittaker
- Educational Psychology Department, University of Texas at Austin, Austin, Texas 78712, United States
| | - Peter M Ward
- The Lyndon B. Johnson School of Public Affairs, University of Texas at Austin, Austin, Texas 78712, United States
| | - Isabel Araiza
- Department of Psychology and Sociology, Texas A&M University-Corpus Christi, Corpus Christi, Texas 78412, United States
| | - Mary Jo Kirisits
- Department of Civil, Architectural and Environmental Engineering, University of Texas at Austin, Austin, Texas 78712, United States
| | - Desmond F Lawler
- Department of Civil, Architectural and Environmental Engineering, University of Texas at Austin, Austin, Texas 78712, United States
| | - Navid B Saleh
- Department of Civil, Architectural and Environmental Engineering, University of Texas at Austin, Austin, Texas 78712, United States
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Abstract
OBJECTIVES To provide a spatial risk assessment for the neglected disease strongyloidiasis in the United States by prioritizing areas with high probability of Strongyloides stercoralis presence and to offer recommendations for targeted screening and surveillance. METHODS The risk assessment was based on a species distribution model with parasite occurrence data and ecologically important environmental variables as input and local habitat suitability for the species as output. The model used a maximum entropy algorithm and occurrence records and environmental data from public sources. This ecological risk assessment was coupled to socioeconomic factors using multi-criteria analysis. RESULTS The model predicts suitable habitat for the parasite in ten states beyond the southeastern United States where it has been recorded including states in the south, east and northeast, and west coasts. CONCLUSIONS We recommend strongyloidiasis should be reportable in 16 states at high risk and uniform, near universal solid organ transplant screening should be implemented alongside approaches to heighten clinical suspicion.
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Affiliation(s)
- Rachael Singer
- Lyndon B. Johnson School of Public Affairs, University of Texas at Austin, PO Box Y, Austin, TX, 78713, United States.
| | - Sahotra Sarkar
- Departments of Integrative Biology, Philosophy, University of Texas at Austin, 2210 Speedway, Austin, TX, 78712, United States
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18
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Abstract
Purpose of Review In this commentary, we summarize and put into perspective the recent information that highlights the associations between coronavirus disease and poverty. We also bring attention to another dimension that will most likely exacerbate the severity and long-term sequelae of COVID-19 in impoverished populations, that is, the comorbidities and the presence of tropical infections. Recent Findings During this first half of 2020, the COVID-19 pandemic has emerged as a poverty-related neglected disease on at least two fronts. First, is its significant impact in low-income neighborhoods in the USA, the epicenter of the pandemic. Second, is its emergence in poor urban areas of South America, and now in Asia and Africa. In both fronts, the pandemic is contributing heavily towards the loss of public health gains that we managed to achieve globally during the last two decades. Specifically, any advances made as part of the United Nations Millennium Development Goals (United Nations, 2020) is eroding, and for the first time, the number of people entering extreme poverty is increasing. Adding to this descent into poverty are new disruptions in ongoing disease control programs, routine vaccination strategies, and a reduction of capacity building efforts globally. Therefore, and as highlighted by many others, we support the notion that a way forward to eliminate this coronavirus pandemic should include linking COVID-19 control to other tropical or poverty-related diseases. Summary COVID-19 is slowing or reversing global health and development gains. To be successful and achieve the global goals including the control of pandemics such as the one seen from the COVID-19, we must rely on strong leadership leading to impactful public policies and global collaborations, including global COVID-19 vaccinations, and potentially linking them to programs for childhood and adult vaccinations and programs for malaria, tuberculosis, HIV/AIDS, and neglected tropical disease treatments. Opportunities also include the creation of unique research opportunities and funding models and increase science engagement for international diplomacy. This can only be done with a better understanding of the relationships between coronavirus disease, poverty, and tropical diseases.
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Affiliation(s)
- Rojelio Mejia
- Department of Pediatrics and Medicine, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX USA
| | - Peter Hotez
- Department of Pediatrics and Medicine, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX USA.,Texas Children's Hospital Center for Vaccine Development, Houston, TX USA.,Departments of Pediatrics and Molecular Virology & Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX USA.,Department of Biology, Baylor University, Waco, TX USA.,Hagler Institute for Advanced Studies, Texas A&M University, College Station, TX USA.,Scowcroft Institute of International Studies, Bush School of Government and Public Service, Texas A&M University, College Station, TX USA.,James A Baker III Institute of Public Policy, Rice University, Houston, TX USA
| | - Maria Elena Bottazzi
- Department of Pediatrics and Medicine, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX USA.,Texas Children's Hospital Center for Vaccine Development, Houston, TX USA.,Departments of Pediatrics and Molecular Virology & Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX USA.,Department of Biology, Baylor University, Waco, TX USA
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