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Arnaiz P, Bergman MM, Seelig H, Adams L, Dolley D, Gerber M, Joubert N, Nqweniso S, Steinmann P, Utzinger J, Randt RD, Walter C, Pühse U, Müller I. Acceptability and perceived feasibility of the KaziKidz health promotion intervention among educators and caregivers in schools from South Africa: a qualitative descriptive study. BMC Public Health 2024; 24:934. [PMID: 38561742 PMCID: PMC10985953 DOI: 10.1186/s12889-024-18456-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Despite the uncontested benefits of physical activity, its promotion lags behind in the public health agenda of low- and middle-income countries (LMICs). School-based interventions are promising strategies to foster health during childhood, but evidence of their effectiveness is limited and inconclusive for LMICs. Thus, further investigation is needed on contextual factors associated with intervention implementation in low-resource settings. We studied the acceptability and feasibility of the KaziKidz health promotion intervention and its implementation and make recommendations to improve future adoption and sustainability. METHODS KaziKidz was implemented in four primary schools from low-income communities in South Africa in 2019. Semi-structured interviews with four school principals, three focus group interviews with 16 educators, and another three with 16 caregivers were conducted between October and November 2021. Participants were purposively recruited. Interview transcripts were analyzed via thematic analysis using a deductive and reflexive approach. RESULTS Three main themes influencing intervention implementation and adoption were identified: (1) prioritizing teachers' needs (2), integrating the program into the school structure, and (3) creating opportunities in the community. Supporting recommendations included: (theme 1) adopting intervention approaches that are inclusive of educators' health and providing them with capacity development and external support; (theme 2) fostering a feeling of ownership and belonging among school stakeholders to adapt interventions to specific resources and needs; and (theme 3) raising community awareness to encourage individuals to claim power over and actively engage with the program. CONCLUSIONS Comprehensive interventions comprising health support, adequate training, and ongoing assistance for educators combined with school-wide and community outreach actions seeking to strengthen program ownership, accountability, and engagement can enhance uptake of school-based interventions and long-term maintenance. TRIAL REGISTRATION ISRCTN15648510, registered on 17/04/2020.
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Affiliation(s)
- Patricia Arnaiz
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
| | | | - Harald Seelig
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Larissa Adams
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Danielle Dolley
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Nandi Joubert
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Siphesihle Nqweniso
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Rosa du Randt
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Cheryl Walter
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Ivan Müller
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Vaillant MT, Philippy F, Neven A, Barré J, Bulaev D, Olliaro PL, Utzinger J, Keiser J, Garba AT. Diagnostic tests for human Schistosoma mansoni and Schistosoma haematobium infection: a systematic review and meta-analysis. Lancet Microbe 2024; 5:e366-e378. [PMID: 38467130 PMCID: PMC10990967 DOI: 10.1016/s2666-5247(23)00377-4] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 10/22/2023] [Accepted: 11/16/2023] [Indexed: 03/13/2024]
Abstract
BACKGROUND Accurate diagnosis is pivotal for implementing strategies for surveillance, control, and elimination of schistosomiasis. Despite their low sensitivity in low-endemicity areas, microscopy-based urine filtration and the Kato-Katz technique are considered as reference diagnostic tests for Schistosoma haematobium and Schistosoma mansoni infections, respectively. We aimed to collate all available evidence on the accuracy of other proposed diagnostic techniques. METHODS In this systematic review and meta-analysis, we searched PubMed, Embase, the Cochrane Library, and LILACS for studies published from database inception to Dec 31, 2022, investigating the sensitivity and specificity of diagnostic tests for S haematobium and S mansoni infections against Kato-Katz thick smears or urine microscopy (reference tests) involving adults (aged ≥18 years), school-aged children (aged 7 to 18 years), or preschool-aged children (aged 1 month to 7 years). We extracted raw data on true positives, true negatives, false positives, and false negatives for the diagnostic tests and data on the number of participants, study authors, publication year, journal, study design, participants' age and sex, prevalence of Schistosoma infection, and treatment status. To account for imperfect reference tests, we used a hierarchical Bayesian latent class meta-analysis to model test accuracy. FINDINGS Overall, we included 121 studies, assessing 28 different diagnostic techniques. Most studies (103 [85%] of 121) were done in Africa, 14 (12%) in South America, one (1%) in Asia, and one (1%) in an unknown country. Compared with the reference test, Kato-Katz thick smears, circulating cathodic antigen urine cassette assay version 1 (CCA1, 36 test comparisons) had excellent sensitivity (95% [95% credible interval 88-99]) and reasonable specificity (74% [63-83]) for S mansoni. ELISA-based tests had a performance comparable to circulating cathodic antigen, but there were few available test comparisons. For S haematobium, proteinuria (42 test comparisons, sensitivity 73% [62-82]; specificity 94% [89-98]) and haematuria (75 test comparisons, sensitivity 85% [80-90]; specificity 96% [92-99]) reagent strips showed high specificity, with haematuria reagent strips having better sensitivity. Despite limited data, nucleic acid amplification tests (NAATs; eg, PCR or loop-mediated isothermal amplification [LAMP]) showed promising results with sensitivity estimates above 90%. We found an unclear risk of bias of about 70% in the use of the reference or index tests and of 50% in patient selection. All analyses showed substantial heterogeneity (I2>80%). INTERPRETATION Although NAATs and immunological diagnostics show promise, the limited information available precludes drawing definitive conclusions. Additional research on diagnostic accuracy and cost-effectiveness is needed before the replacement of conventional tests can be considered. FUNDING WHO and Luxembourg Institute of Health.
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Affiliation(s)
- Michel T Vaillant
- Competence Center for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg.
| | - Fred Philippy
- Competence Center for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg; Zortify, Luxembourg City, Luxembourg
| | - Anouk Neven
- Competence Center for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Jessica Barré
- Competence Center for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg; Luxembourg National Office of Health, Luxembourg City, Luxembourg
| | - Dmitry Bulaev
- Competence Center for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Piero L Olliaro
- International Severe Acute Respiratory and Emerging Infection Consortium, Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute and Medical Parasitology and Infection Biology Department, University of Basel, Basel, Switzerland
| | - Amadou T Garba
- Department of Control of Neglected Tropical Diseases, WHO, Geneva, Switzerland
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Qian MB, Keiser J, Utzinger J, Zhou XN. Clonorchiasis and opisthorchiasis: epidemiology, transmission, clinical features, morbidity, diagnosis, treatment, and control. Clin Microbiol Rev 2024; 37:e0000923. [PMID: 38169283 PMCID: PMC10938900 DOI: 10.1128/cmr.00009-23] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/18/2023] [Indexed: 01/05/2024] Open
Abstract
Clonorchis sinensis, Opisthorchis viverrini, and Opisthorchis felineus are important liver flukes that cause a considerable public health burden in eastern Asia, southeastern Asia, and eastern Europe, respectively. The life cycles are complex, involving humans, animal reservoirs, and two kinds of intermediate hosts. An interplay of biological, cultural, ecological, economic, and social factors drives transmission. Chronic infections are associated with liver and biliary complications, most importantly cholangiocarcinoma. With regard to diagnosis, stool microscopy is widely used in epidemiologic surveys and for individual diagnosis. Immunologic techniques are employed for screening purposes, and molecular techniques facilitate species differentiation in reference laboratories. The mainstay of control is preventive chemotherapy with praziquantel, usually combined with behavioral change through information, education and communication, and environmental control. Tribendimidine, a drug registered in the People's Republic of China for soil-transmitted helminth infections, shows potential against both C. sinensis and O. viverrini and, hence, warrants further clinical development. Novel control approaches include fish vaccine and biological control. Considerable advances have been made using multi-omics which may trigger the development of new interventions. Pressing research needs include mapping the current distribution, disentangling the transmission, accurately estimating the disease burden, and developing new diagnostic and treatment tools, which would aid to optimize control and elimination measures.
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Affiliation(s)
- Men-Bao Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, People’s Republic of China
- NHC Key Laboratory of Parasite and Vector Biology, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, People’s Republic of China
- NHC Key Laboratory of Parasite and Vector Biology, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
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Giovanoli Evack J, Kouadio JN, Achi LY, Bonfoh B, N'Goran EK, Zinsstag J, Utzinger J, Balmer O. Genetic characterization of schistosome species from cattle in Côte d'Ivoire. Parasit Vectors 2024; 17:122. [PMID: 38475876 DOI: 10.1186/s13071-024-06221-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Schistosomiasis is a water-based parasitic disease that affects humans, livestock and wild animals. While considerable resources are dedicated to the surveillance, disease mapping, control and elimination of human schistosomiasis, this is not the case for livestock schistosomiasis. Indeed, there are important data and knowledge gaps concerning the species present, population genetic diversity, infection prevalence, morbidity and economic impact. This study aimed to identify circulating schistosome species in cattle across Côte d'Ivoire and to investigate their population diversity and structuring. METHODS Overall, 400 adult schistosomes were collected from slaughtered cattle at six sites across Côte d'Ivoire. Additionally, 114 miracidia were collected from live cattle at one site: Ferkessédougou, in the northern part of Côte d'Ivoire. DNA from all specimens was extracted and the cox1 and ITS1/2 regions amplified and analysed to confirm species. The genetic diversity and structuring of the schistosome populations were investigated using 12 microsatellite markers. RESULTS All adult schistosomes and miracidia presented Schistosoma bovis mitochondrial cox1 profile. Nuclear ITS1/2 data were obtained from 101 adult schistosomes and four miracidia, all of which presented an S. bovis profile. Genetic diversity indices revealed a deficiency of heterozygotes and signals of inbreeding across all sites, while structure analyses displayed little geographic structuring and differentiation. Cattle in Côte d'Ivoire thus appear to be mono-species infected with S. bovis. Hybrids of Schistosoma haematobium × S. bovis have not been identified in this study. Cattle schistosomes appear to be panmictic across the country. CONCLUSIONS Our results contribute to a deeper understanding of schistosome populations in Ivorian cattle and emphasize a One Health approach of joint human and animal surveillance and prevention and control programmes for schistosomiasis.
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Affiliation(s)
- Jennifer Giovanoli Evack
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
| | - Jules N Kouadio
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Louise Y Achi
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- École de Spécialisation en Elevage et Métiers de la Viande de Bingerville, Abidjan, Côte d'Ivoire
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Eliézer K N'Goran
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Oliver Balmer
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Traoré N, Singhal T, Millogo O, Sié A, Utzinger J, Vounatsou P. Relative effects of climate factors and malaria control interventions on changes of parasitaemia risk in Burkina Faso from 2014 to 2017/2018. BMC Infect Dis 2024; 24:166. [PMID: 38326750 PMCID: PMC10848559 DOI: 10.1186/s12879-024-08981-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 01/03/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND In Burkina Faso, the prevalence of malaria has decreased over the past two decades, following the scale-up of control interventions. The successful development of malaria parasites depends on several climatic factors. Intervention gains may be reversed by changes in climatic factors. In this study, we investigated the role of malaria control interventions and climatic factors in influencing changes in the risk of malaria parasitaemia. METHODS Bayesian logistic geostatistical models were fitted on Malaria Indicator Survey data from Burkina Faso obtained in 2014 and 2017/2018 to estimate the effects of malaria control interventions and climatic factors on the temporal changes of malaria parasite prevalence. Additionally, intervention effects were assessed at regional level, using a spatially varying coefficients model. RESULTS Temperature showed a statistically important negative association with the geographic distribution of parasitaemia prevalence in both surveys; however, the effects of insecticide-treated nets (ITNs) use was negative and statistically important only in 2017/2018. Overall, the estimated number of infected children under the age of 5 years decreased from 704,202 in 2014 to 290,189 in 2017/2018. The use of ITNs was related to the decline at national and regional level, but coverage with artemisinin-based combination therapy only at regional level. CONCLUSION Interventions contributed more than climatic factors to the observed change of parasitaemia risk in Burkina Faso during the period of 2014 to 2017/2018. Intervention effects varied in space. Longer time series analyses are warranted to determine the differential effect of a changing climate on malaria parasitaemia risk.
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Affiliation(s)
- Nafissatou Traoré
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland
- University of Basel, Petersplatz 1, CH-4001, Basel, Switzerland
- Nouna Health Research Centre, National Institute of Public Health, BP 02, Nouna, Burkina Faso
| | - Taru Singhal
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland
- University of Basel, Petersplatz 1, CH-4001, Basel, Switzerland
| | - Ourohiré Millogo
- Nouna Health Research Centre, National Institute of Public Health, BP 02, Nouna, Burkina Faso
- Institut de Recherche en Sciences de la Santé/Centre National de Recherche Scientifique et Technologique, 01 BP, 2779, Bobo-Dioulasso, Burkina Faso
| | - Ali Sié
- Nouna Health Research Centre, National Institute of Public Health, BP 02, Nouna, Burkina Faso
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland
- University of Basel, Petersplatz 1, CH-4001, Basel, Switzerland
| | - Penelope Vounatsou
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland.
- University of Basel, Petersplatz 1, CH-4001, Basel, Switzerland.
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Long KZ, Beckmann J, Lang C, Seelig H, Nqweniso S, Probst-Hensch N, Pühse U, Steinmann P, Randt RD, Walter C, Utzinger J, Gerber M. Randomized Trial to Improve Body Composition and Micronutrient Status Among South African Children. Am J Prev Med 2024:S0749-3797(24)00027-8. [PMID: 38309672 DOI: 10.1016/j.amepre.2024.01.017] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/05/2024]
Abstract
INTRODUCTION Physical activity (PA) promotion combined with multimicronutrient supplementation (MMNS) among school-age children may reduce fat mass accrual and increase muscle mass through different mechanisms and so benefit child health. This study determined the efficacy of combined interventions on body composition among South African schoolchildren and determined if micronutrients mediate these effects. STUDY DESIGN Longitudinal cluster randomized controlled trial of children followed from 2019 to 2021. Statistical analyses carried from 2022 to 2023. SETTING/PARTICIPANTS A total of 1,304 children 6-12 years of age recruited from public schools in Gqeberha, South Africa. INTERVENTION Children were randomized by classes to either: (a) a physical activity group (PA); (b) a MMNS group; (c) a physical activity + multimicronutrient supplementation group (PA + MMNS); and (d) a placebo control group. MAIN OUTCOME MEASURES Trajectories of overall and truncal fat free mass (FFM) and fat mass (FM) estimates in modeled at 9 and 21 months using latent growth curve models (LGCM). Changes in micronutrient concentrations at 9 months from baseline. RESULTS An increased FFM trajectory was found among children in the MMNS arm at 9 months (Beta 0.16, 95% CI = 0.12, 0.31). The PA and MMNS arms both had positive indirect effects on this trajectory at 9 months (Beta 0.66, 95% CI = 0.44, 0.88 and Beta 0.32 95% CI = 0.1 0.5, respectively) and similarly at 21 months when mediated by zinc concentration changes. A reduced FM trajectory was found among children in the PA promotion arm at 9 months when using this collection point as the referent intercept. This arm was inversely associated with the FM trajectory at 9 months when mediated by zinc changes. CONCLUSIONS PA and MMNS promotion in school-based interventions directly contributed to reductions in FM and increased FFM among South African children and indirectly through changes in micronutrient status. TRIAL REGISTRATION ISRCTN, ISRCTN29534081. Registered on August 9, 2018 Institutional review board: Ethikkommission Nordwest- und Zentralschweiz" (EKNZ, project number: Req-2018-00608). Date of approval: 2018.
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Affiliation(s)
- Kurt Z Long
- Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland.
| | - Johanna Beckmann
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Christin Lang
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Harald Seelig
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Siphesihle Nqweniso
- Department of Human Movement Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - Rosa du Randt
- Department of Human Movement Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Cheryl Walter
- Department of Human Movement Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Brummaier T, Rinchai D, Toufiq M, Karim MY, Habib T, Utzinger J, Paris DH, McGready R, Marr AK, Kino T, Terranegra A, Al Khodor S, Chaussabel D, Syed Ahamed Kabeer B. Design of a targeted blood transcriptional panel for monitoring immunological changes accompanying pregnancy. Front Immunol 2024; 15:1319949. [PMID: 38352867 PMCID: PMC10861739 DOI: 10.3389/fimmu.2024.1319949] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/11/2024] [Indexed: 02/16/2024] Open
Abstract
Background Immunomodulatory processes exert steering functions throughout pregnancy. Detecting diversions from this physiologic immune clock may help identify pregnant women at risk for pregnancy-associated complications. We present results from a data-driven selection process to develop a targeted panel of mRNAs that may prove effective in detecting pregnancies diverting from the norm. Methods Based on a de novo dataset from a resource-constrained setting and a dataset from a resource-rich area readily available in the public domain, whole blood gene expression profiles of uneventful pregnancies were captured at multiple time points during pregnancy. BloodGen3, a fixed blood transcriptional module repertoire, was employed to analyze and visualize gene expression patterns in the two datasets. Differentially expressed genes were identified by comparing their abundance to non-pregnant postpartum controls. The selection process for a targeted gene panel considered (i) transcript abundance in whole blood; (ii) degree of correlation with the BloodGen3 module; and (iii) pregnancy biology. Results We identified 176 transcripts that were complemented with eight housekeeping genes. Changes in transcript abundance were seen in the early stages of pregnancy and similar patterns were observed in both datasets. Functional gene annotation suggested significant changes in the lymphoid, prostaglandin and inflammation-associated compartments, when compared to the postpartum controls. Conclusion The gene panel presented here holds promise for the development of predictive, targeted, transcriptional profiling assays. Such assays might become useful for monitoring of pregnant women, specifically to detect potential adverse events early. Prospective validation of this targeted assay, in-depth investigation of functional annotations of differentially expressed genes, and assessment of common pregnancy-associated complications with the aim to identify these early in pregnancy to improve pregnancy outcomes are the next steps.
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Affiliation(s)
- Tobias Brummaier
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Darawan Rinchai
- Research Department, Sidra Medicine, Doha, Qatar
- Department of Infectious Diseases, St. Jude Children Research Hospital, Memphis, TN, United States
| | | | | | - Tanwir Habib
- Research Department, Sidra Medicine, Doha, Qatar
- Bioinformatics Core, Weill Cornell Medicine-Qatar, Education City, Doha, Qatar
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Daniel H. Paris
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Rose McGready
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | | | | | | | | | - Damien Chaussabel
- Research Department, Sidra Medicine, Doha, Qatar
- Computational Sciences Department, The Jackson Laboratory, Farmington, CT, United States
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Gordon CA, Utzinger J, Muhi S, Becker SL, Keiser J, Khieu V, Gray DJ. Strongyloidiasis. Nat Rev Dis Primers 2024; 10:6. [PMID: 38272922 DOI: 10.1038/s41572-023-00490-x] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 01/27/2024]
Abstract
Strongyloidiasis is a neglected tropical disease caused primarily by the roundworm Strongyloides stercoralis. Strongyloidiasis is most prevalent in Southeast Asia and the Western Pacific. Although cases have been documented worldwide, global prevalence is largely unknown due to limited surveillance. Infection of the definitive human host occurs via direct skin penetration of the infective filariform larvae. Parasitic females reside in the small intestine and reproduce via parthenogenesis, where eggs hatch inside the host before rhabditiform larvae are excreted in faeces to begin the single generation free-living life cycle. Rhabditiform larvae can also develop directly into infectious filariform larvae in the gut and cause autoinfection. Although many are asymptomatic, infected individuals may report a range of non-specific gastrointestinal, respiratory or skin symptoms. Autoinfection may cause hyperinfection and disseminated strongyloidiasis in immunocompromised individuals, which is often fatal. Diagnosis requires direct examination of larvae in clinical specimens, positive serology or nucleic acid detection. However, there is a lack of standardization of techniques for all diagnostic types. Ivermectin is the treatment of choice. Control and elimination of strongyloidiasis will require a multifaceted, integrated approach, including highly sensitive and standardized diagnostics, active surveillance, health information, education and communication strategies, improved water, sanitation and hygiene, access to efficacious treatment, vaccine development and better integration and acknowledgement in current helminth control programmes.
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Affiliation(s)
- Catherine A Gordon
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia.
- Faculty of Medicine, University of Queensland, St Lucia, Brisbane, Queensland, Australia.
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Stephen Muhi
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Parkville, Victoria, Australia
- The University of Melbourne, Department of Microbiology and Immunology, Parkville, Victoria, Australia
| | - Sören L Becker
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Virak Khieu
- National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | - Darren J Gray
- Population Health Program, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia
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Ekou FK, Eze IC, Aka J, Kwiatkowski M, Merten S, Acka FK, Fink G, Utzinger J, Probst-Hensch N. Randomised controlled trial on the effect of social support on disease control, mental health and health-related quality of life in people with diabetes from Côte d'Ivoire: the SoDDiCo study protocol. BMJ Open 2024; 14:e069934. [PMID: 38199625 PMCID: PMC10806827 DOI: 10.1136/bmjopen-2022-069934] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/21/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Diabetes mellitus (DM) and its severe complications contribute significantly to disability and, hence, burden of disease. Poor mental health, a frequent DM consequence, may hinder successful diabetes control in low-income and middle-income countries (LMICs). Evidence suggests social support as a cost-effective tool to improve diabetes self-management, behaviour and mental health. However, its real-world application in LMICs has rarely been tested. We aim to investigate the effect of a social support intervention on disease control, mental health and health-related quality of life in people with diabetes from Côte d'Ivoire (SoDDiCo) through a randomised controlled trial. METHODS AND ANALYSIS The trial will take place in the Centre Antidiabétique d'Abidjan, Institut National de Santé Publique, Abidjan, Côte d'Ivoire. We will prospectively randomise up to 1500 people with newly diagnosed diabetes into two parallel arms: intervention (routine care+family supporter accompanying clinical management) and control (routine care), using gender-stratified blocked randomisation with random block sizes of 10, 16, 20 and 24. Participants will undergo baseline, 3-month and 12-month postrandomisation assessments. The primary study outcome will be glycated haemoglobin (HbA1c). Secondary outcomes will include glycaemic control (HbA1c<7.0%), presence at follow-up visits, mental health and quality of life scores. Using intention-to-treat framework, we will assess the impact of the family support intervention on these endpoints over the course of the 1-year follow-up. Effect modification by baseline social capital will be assessed. ETHICS AND DISSEMINATION The SoDDiCo trial was approved by the Ethikkommission Nordwest- und Zentralschweiz (ref: AO_2021-00041; approved: 12 July 2021) and by Comité National d'Éthique des Sciences de la Vie et de la Santé (ref: 049-22/MSHPCMU/CNESVS-kp; approved: 20 April 2022). The randomised intervention trial will follow good clinical practice guidelines. All results will be made available to the public through abstracts at conferences as well as through peer-reviewed articles. International guidelines for authorship will be respected. TRIAL REGISTRATION NUMBER ISRCTN10901121, ISRCTN registry.
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Affiliation(s)
- Franck Kokora Ekou
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Institut National de Sante Publique, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche Sciences Médicales, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Ikenna C Eze
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Joseph Aka
- Institut National de Sante Publique, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche Sciences Médicales, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Marek Kwiatkowski
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Sonja Merten
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Felix Kouamé Acka
- Institut National de Sante Publique, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche Sciences Médicales, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Günther Fink
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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10
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Onyango S, Kitsao-Wekulo P, Langat N, Okelo K, Murdock DE, Utzinger J, Fink G. Maternal stimulation and early child development in sub-saharan Africa: evidence from Kenya and Zambia. BMC Public Health 2023; 23:2418. [PMID: 38053131 PMCID: PMC10696819 DOI: 10.1186/s12889-023-17235-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 11/15/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Despite major improvements in child survival over the past decade, many children in low and middle-income countries (LMICs) remain at risk of not reaching their developmental potential due to malnutrition, poor health, and a lack of stimulation. Maternal engagement and stimulation have been identified as some of the most critical inputs for healthy development of children. However, relatively little evidence exists on the links between maternal stimulation and child development exists in sub-Saharan Africa (SSA). This current paper aims to identify the associations between maternal stimulation and child development in Kenya and Zambia, as well as the activities that are most predictive of developmental outcomes in these settings. METHODS We conducted a descriptive study using data from a prospective study in Kenya and Zambia. The study included three rounds of data collection. Children were on average 10 months old in round one, 25 months old in round two, and 36 months old in round three. The primary exposure variable of interest was maternal stimulation activities, which we grouped into cognitive, language, motor, and socio-emotional activities. The outcome of interest was child development measured through the Third Edition of the Ages and Stages Questionnaire (ASQ-3). Linear regression models were used to estimate the associations between overall maternal stimulation and domain-specific maternal stimulation and child development across the three rounds of the survey. RESULTS Higher maternal stimulation scores were associated with higher ASQ scores (effect size = 0.25; 95% CI: 0.19, 0.31) after adjusting for other confounders. For domain specific and child development (ASQ scores), the largest effect size (ES) was found for language stimulation (ES = 0.15) while weakest associations were found for socio-emotional domain activities (ES= -0.05). Overall maternal stimulation was most strongly associated with gross motor development (ES = 0.21) and the least associated with problem-solving (ES = 0.16). CONCLUSION Our study findings suggest a strong positive link between maternal stimulation activities and children's developmental outcomes among communities in poor rural settings. TRIAL REGISTRATION NA (not a clinical trial).
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Affiliation(s)
- Silas Onyango
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, CH-4123, Switzerland.
- University of Basel, Petersplatz, Basel, CH-4051, Switzerland.
- Human Development Theme, African Population and Health Research Center, Nairobi, 10787-00100, Kenya.
| | - Patricia Kitsao-Wekulo
- Human Development Theme, African Population and Health Research Center, Nairobi, 10787-00100, Kenya
| | - Nelson Langat
- Human Development Theme, African Population and Health Research Center, Nairobi, 10787-00100, Kenya
| | - Kenneth Okelo
- Human Development Theme, African Population and Health Research Center, Nairobi, 10787-00100, Kenya
| | - Dawn E Murdock
- Episcopal Relief & Development, 815 Second Avenue, New York, NY, 10017, USA
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, CH-4123, Switzerland
- University of Basel, Petersplatz, Basel, CH-4051, Switzerland
| | - Günther Fink
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, CH-4123, Switzerland
- University of Basel, Petersplatz, Basel, CH-4051, Switzerland
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11
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Gerber DJF, Dhakal S, Islam MN, Al Kawsar A, Khair MA, Rahman MM, Karim MJ, Rahman MS, Aktaruzzaman MM, Tupps C, Stephens M, Emerson PM, Utzinger J, Vounatsou P. Distribution and treatment needs of soil-transmitted helminthiasis in Bangladesh: A Bayesian geostatistical analysis of 2017-2020 national survey data. PLoS Negl Trop Dis 2023; 17:e0011656. [PMID: 37930980 PMCID: PMC10662736 DOI: 10.1371/journal.pntd.0011656] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 11/21/2023] [Accepted: 09/11/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND In Bangladesh, preventive chemotherapy targeting soil-transmitted helminth (STH) infections in school-age children has been implemented since 2008. To evaluate the success of this strategy, surveys were conducted between 2017 and 2020 in 10 out of 64 districts. We estimate the geographic distribution of STH infections by species at high spatial resolution, identify risk factors, and estimate treatment needs at different population subgroups. METHODOLOGY Bayesian geostatistical models were fitted to prevalence data of each STH species. Climatic, environmental, and socioeconomic predictors were extracted from satellite images, open-access, model-based databases, and demographic household surveys, and used to predict the prevalence of infection over a gridded surface at 1 x 1 km spatial resolution across the country, via Bayesian kriging. These estimates were combined with gridded population data to estimate the number of required treatments for different risk groups. PRINCIPAL FINDINGS The population-adjusted prevalence of Ascaris lumbricoides, Trichuris trichiura, and hookworm across all ages is estimated at 9.9% (95% Bayesian credible interval: 8.0-13.0%), 4.3% (3.0-7.3%), and 0.6% (0.4-0.9%), respectively. There were 24 out of 64 districts with an estimated population-adjusted STH infection prevalence above 20%. The proportion of households with improved sanitation showed a statistically important, protective association for both, A. lumbricoides and T. trichiura prevalence. Precipitation in the driest month of the year was negatively associated with A. lumbricoides prevalence. High organic carbon concentration in the soil's fine earth fraction was related to a high hookworm prevalence. Furthermore, we estimated that 30.5 (27.2; 36.0) million dosages of anthelmintic treatments for school-age children were required per year in Bangladesh. CONCLUSIONS/SIGNIFICANCE For each of the STH species, the prevalence was reduced by at least 80% since treatment was scaled up more than a decade ago. The current number of deworming dosages could be reduced by up to 61% if the treatment strategy was adapted to the local prevalence.
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Affiliation(s)
- Daniel J. F. Gerber
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Sanjaya Dhakal
- Children Without Worms, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Md. Nazmul Islam
- Communicable Disease Control Unit, Directorate General of Health Services, Ministry of Health & Family Welfare, Dhaka, Bangladesh
| | - Abdullah Al Kawsar
- Communicable Disease Control Unit, Directorate General of Health Services, Ministry of Health & Family Welfare, Dhaka, Bangladesh
| | - Md. Abul Khair
- Communicable Disease Control Unit, Directorate General of Health Services, Ministry of Health & Family Welfare, Dhaka, Bangladesh
| | - Md. Mujibur Rahman
- Communicable Disease Control Unit, Directorate General of Health Services, Ministry of Health & Family Welfare, Dhaka, Bangladesh
| | - Md. Jahirul Karim
- Communicable Disease Control Unit, Directorate General of Health Services, Ministry of Health & Family Welfare, Dhaka, Bangladesh
| | - Md. Shafiqur Rahman
- Communicable Disease Control Unit, Directorate General of Health Services, Ministry of Health & Family Welfare, Dhaka, Bangladesh
| | - M. M. Aktaruzzaman
- Communicable Disease Control Unit, Directorate General of Health Services, Ministry of Health & Family Welfare, Dhaka, Bangladesh
| | - Cara Tupps
- Children Without Worms, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Mariana Stephens
- Children Without Worms, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Paul M. Emerson
- Children Without Worms, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Penelope Vounatsou
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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12
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Shrikhande S, Merten S, Cambaco O, Lee TT, Lakshmanasamy R, Röösli M, Dalvie MA, Utzinger J, Cissé G. Barriers to climate change and health research in India: a qualitative study. BMJ Open 2023; 13:e073381. [PMID: 37821134 PMCID: PMC10582851 DOI: 10.1136/bmjopen-2023-073381] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/04/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVES Almost a quarter of the global burden of disease and mortalities is attributable to environmental causes, the magnitude of which is projected to increase in the near future. However, in many low- and middle-income settings, there remains a large gap in the synthesis of evidence on climate-sensitive health outcomes. In India, now the world's most populous country, little remains known about the impacts of climate change on various health outcomes. The objective of this study is to better understand the challenges faced in conducting climate change and health research in Puducherry, India. DESIGN AND SETTING In this study, we employed key informant interviews to deepen the understanding of the perceived research barriers in Puducherry. The findings were analysed using data-driven qualitative thematic analysis to elaborate the major perceived barriers to conducting environmental health research. PARTICIPANTS This study was conducted among 16 public health professionals, including medical researchers, and professionals involved in environmental policies and planning in Puducherry. RESULTS We identify three key barriers faced by public health professionals as key stakeholders, namely: (1) political and institutional barriers; (2) education and awareness barriers; and (3) technical research barriers. We show there is a need, from the professionals' perspective, to improve community and political awareness on climate change and health; strengthen technical research capacity and collaboration among researchers; and strengthen health surveillance, resource allocation and access to health data for research. CONCLUSION Evidence informed policies and interventions are a key element in the adaptation response for countries. In the context of the paucity of data on environmental health from India, despite recognised climate change related health vulnerabilities, these findings could contribute to the development and improvement of relevant interventions conducive to a strong research environment.
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Affiliation(s)
- Shreya Shrikhande
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Sonja Merten
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Olga Cambaco
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Manhiça Health Research Centre, Maputo, Mozambique
| | - Tristan T Lee
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Ravivarman Lakshmanasamy
- Department of Health and Family Welfare Services, Goverment of Puducherry, Puducherry, India
- Non-communicable Diseases Team, World Health Organization Country Office for India, New Delhi, India
| | - Martin Röösli
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Mohammad Aqiel Dalvie
- Centre for Environmental and Occupational Health Research, School of Public Health, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Jürg Utzinger
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Guéladio Cissé
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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13
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Koffi DY, Konan AG, Koné VB, N'krumah RT, Coulibaly ID, Kaloga M, Kreppel K, Haydon D, Utzinger J, Bonfoh B. Accelerating the healing of hard-to-heal wounds with food supplements: nutritional analysis in the Côte d'Ivoire. J Wound Care 2023; 32:cci-ccx. [PMID: 37830803 DOI: 10.12968/jowc.2023.32.sup10.cci] [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] [Indexed: 10/14/2023]
Abstract
OBJECTIVE Hard-to-heal wounds are an important, yet often neglected, public health issue in low- and middle-income countries (LMICs). Malnutrition has been identified as a risk factor for prolonged healing times. However, nutritional supplements are not routinely provided for patients with hard-to-heal wounds, and so this study aimed to investigate their benefits. METHOD This 9-month study was conducted in the Taabo Health and Demographic Surveillance System in the south-central part of Côte d'Ivoire. Patients with wounds (≥30mm2) were recruited. Treatment was standardised for inpatients (72%) and outpatients (28%). There were three intervention groups: supplemented with soy; orange flesh sweet potato (OFSP); or both. Another group was included without supplement, serving as control. General linear models were employed to assess the effects of log initial wound size, type of wound, food treatment group, haemoglobin, sex, age, place of treatment and body mass index on the rate of wound closure. RESULTS The cohort consisted of 56 patients, 41 of whom were placed in intervention groups, and the remainder as controls. Within the cohort, 37 (66%) patients suffered from Buruli ulcer, 15 (27%) from traumatic wounds and four (7%) from erysipelas. We found a significant effect (p=0.004) of diet supplemented with OFSP on the wound healing rate. CONCLUSION OFSP is a nutritional rehabilitation supplement, characterised by a high content of beta-carotene and carbohydrates. It is associated with shortened wound healing times, reduced discomfort and reduced cost of wound care. Further research should investigate the effect of a diet rich in beta-carotene, in combination with standard medical care, on hard-to-heal wound healing in LMICs.
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Affiliation(s)
- Didier Y Koffi
- Unité de Formation et de Recherche en Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Programme National de Lutte contre l'Ulcère de Buruli, Abidjan, Côte d'Ivoire
| | - Amoin G Konan
- Unité de Formation et de Recherche en Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Valentin B Koné
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Raymond T N'krumah
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche en Biologie, Université Péléforo Gon Coulibaly, Korhogo, Côte d'Ivoire
| | - Ismael Dognimin Coulibaly
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche en Sociologie, Université Péléforo Gon Coulibaly, Korhogo, Côte d'Ivoire
| | - Mamadou Kaloga
- Programme National de Lutte contre l'Ulcère de Buruli, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche en Sciences Médicales, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Katharina Kreppel
- University of Glasgow, Institute of Biodiversity, Animal Health and Comparative Medicine, Glasgow, UK
- Ifakara Health Institute Environmental Health and Ecological Sciences, Bagamoyo, Tanzania
| | - Daniel Haydon
- Institute of Biodiversity Animal Health & Comparative Medicine, College of Veterinary Medical & Life Sciences, University of Glasgow, Glasgow, UK
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
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14
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Pessoa Colombo V, Chenal J, Koné B, Koffi JD, Utzinger J. Spatial Distributions of Diarrheal Cases in Relation to Housing Conditions in Informal Settlements: A Cross-Sectional Study in Abidjan, Côte d'Ivoire. J Urban Health 2023; 100:1074-1086. [PMID: 37801186 PMCID: PMC10618124 DOI: 10.1007/s11524-023-00786-z] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
In addition to individual practices and access to water, sanitation, and hygiene (WASH) facilities, housing conditions may also be associated with the risk of diarrhea. Our study embraced a broad approach to health determinants by looking at housing deprivation characteristics as exposures of interest and confronting the latter's spatial distribution to that of diarrheal cases. We tested the hypothesis that the risk of diarrhea in informal settlements is not only associated with WASH services, but also with inadequate dwelling characteristics, and that their spatial distributions follow similar patterns. We designed a cross-sectional study and collected primary data through georeferenced household surveys in two informal settlements in Abidjan, Côte d'Ivoire. We used local join count statistics to assess the spatial distribution of events and multiple logistic regressions to calculate adjusted odds ratios between diarrhea and exposures. A total of 567 households were enrolled. We found that constant access to basic WASH services, non-durable building materials, cooking outdoors, and water service discontinuity were associated with higher risks of diarrhea in the general population. The spatial distribution of diarrheal cases coincided with that of dwelling deprivation characteristics. We observed significant heterogeneity within the study sites regarding the spatial distribution of diarrheal cases and deprived dwellings. Along with WASH infrastructure, communities also need dignified housing to effectively prevent diarrhea. We recommend that decision-makers acknowledge a "spectrum" of deprivation within the heterogeneous universe of informal settlements, adopting a site-specific approach based on high-resolution data to address diarrhea and improve people's well-being.
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Affiliation(s)
| | - Jérôme Chenal
- École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
- Université Mohammed VI Polytechnique, Ben Guerir, Morocco
| | - Brama Koné
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Université Péléforo Gon Coulibaly, Korhogo, Côte d'Ivoire
| | - Jeanne d'Arc Koffi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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15
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Nqweniso S, Walter C, du Randt R, Adams L, Beckmann J, Coulibaly JT, Dolley D, Joubert N, Long KZ, Müller I, Nienaber M, Pühse U, Seelig H, Steinmann P, Utzinger J, Gerber M, Lang C. Associations between soil-transmitted helminth infections and physical activity, physical fitness, and cardiovascular disease risk in primary schoolchildren from Gqeberha, South Africa. PLoS Negl Trop Dis 2023; 17:e0011664. [PMID: 37831637 PMCID: PMC10575529 DOI: 10.1371/journal.pntd.0011664] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 09/15/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND/AIM School-aged children in low- and middle-income countries carry the highest burden of intestinal helminth infections, such as soil-transmitted helminths (STH). STH infections have been associated with negative consequences for child physical and cognitive development and wellbeing. With the epidemiological transition and rise in cardiovascular disease (CVD), studies have shown that helminth infections may influence glucose metabolism by preventing obesity. Thus, the aim of this study was to determine the association of STH infections in schoolchildren from Gqeberha, focusing on physical activity, physical fitness, and clustered CVD risk score. METHODS This cross-sectional study involved 680 schoolchildren (356 girls and 324 boys; mean age 8.19 years, SD±1.4) from disadvantaged communities in Gqeberha (formerly, Port Elizabeth), South Africa. Stool samples were collected and examined for STH infections using the Kato-Katz method. Physical activity (accelerometer) and physical fitness (grip strength, 20 m shuttle run) were measured using standard procedures. Furthermore, anthropometry, blood pressure, as well as glycated haemoglobin and lipid profile from capillary blood samples were assessed. We employed one-way ANOVAs to identify the associations of STH infections in terms of species and infection intensity with physical activity, physical fitness, and clustered CVD risk score. RESULTS We found a low STH infection prevalence (7.2%) in our study, with participants infected with at least one intestinal helminth species. In comparison to their non-infected peers, children infected with STH had lower mean grip strength scores, but higher mean VO2max estimation and higher levels of MVPA (p < .001). When considering type and intensity of infection, a positive association of A. lumbricoides infection and MVPA was found. In contrast, light T. trichiura-infected children had significantly lower grip strength scores compared to non and heavily-infected children. VO2max and MVPA were positively associated with light T. trichiura infection. No significant association between the clustered CVD risk score and infection with any STH species was evident. CONCLUSIONS STH-infected children had lower grip strength scores than their non-infected peers, yet, achieved higher VO2max and MVPA scores. Our study highlights that the type and intensity of STH infection is relevant in understanding the disease burden of STH infections on children's health. The findings of our study must be interpreted cautiously due to the low infection rate, and more research is needed in samples with higher prevalence rates or case-control designs.
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Affiliation(s)
- Siphesihle Nqweniso
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Cheryl Walter
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Rosa du Randt
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Larissa Adams
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Johanna Beckmann
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Jean T. Coulibaly
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
| | - Danielle Dolley
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Nandi Joubert
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Kurt Z. Long
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Ivan Müller
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Madeleine Nienaber
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Harald Seelig
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Christin Lang
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Utzinger J, Mäser P. Editorial : Swiss TPH: 30 Years of R&D Towards New Drugs for Tropical Diseases. Chimia (Aarau) 2023; 77:570-571. [PMID: 38047831 DOI: 10.2533/chimia.2023.570] [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: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 12/05/2023] Open
Abstract
The year 2023 marks the 80th anniversary of the Swiss Tropical and Public Health Institute (Swiss TPH). Associated with the University of Basel, Swiss TPH combines research, education and services, working across a value chain from innovation and validation to application to improve people's health and well-being. Around 700 staff and students work in Swiss TPH's new headquarters in an emerging life-science cluster in Allschwil, Switzerland, focusing on infectious and non-communicable diseases, environment, society and health as well as health systems and interventions. In this special issue of Chimia, we highlight 30 years of research and development (R&D) at Swiss TPH, deeply grounded in partnership, towards new drugs for tropical diseases.
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Affiliation(s)
- Jürg Utzinger
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland.
- University of Basel, CH-4001 Basel, Switzerland
| | - Pascal Mäser
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland.
- University of Basel, CH-4001 Basel, Switzerland
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Meier L, Antillon M, Burri C, Chitnis N, Endriss Y, Keiser J, Moore S, Müller P, Penny MA, Voss TS, Mäser P, Utzinger J. Repurposing Know-how for Drug Development: Case Studies from the Swiss Tropical and Public Health Institute. Chimia (Aarau) 2023; 77:582-592. [PMID: 38047834 DOI: 10.2533/chimia.2023.582] [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: 08/11/2023] [Accepted: 08/12/2023] [Indexed: 12/05/2023] Open
Abstract
In pursuing novel therapeutic solutions, drug discovery and development rely on efficiently utilising existing knowledge and resources. Repurposing know-how, a strategy that capitalises on previously acquired information and expertise, has emerged as a powerful approach to accelerate drug discovery and development processes, often at a fraction of the costs of de novo developments. For 80 years, collaborating within a network of partnerships, the Swiss Tropical and Public Health Institute (Swiss TPH) has been working along a value chain from innovation to validation and application to combat poverty-related diseases. This article presents an overview of selected know-how repurposing initiatives conducted at Swiss TPH with a particular emphasis on the exploration of drug development pathways in the context of neglected tropical diseases and other infectious diseases of poverty, such as schistosomiasis, malaria and human African trypanosomiasis.
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Affiliation(s)
- Lukas Meier
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland.
- University of Basel, CH-4001 Basel, Switzerland
| | - Marina Antillon
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4001 Basel, Switzerland
| | - Christian Burri
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4001 Basel, Switzerland
| | - Nakul Chitnis
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4001 Basel, Switzerland
| | - Yvette Endriss
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4001 Basel, Switzerland
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4001 Basel, Switzerland
| | - Sarah Moore
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4001 Basel, Switzerland
- Ifakara Health Institute, Bagamoyo Branch, Bagamoyo, Tanzania
| | - Pie Müller
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4001 Basel, Switzerland
| | - Melissa A Penny
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4001 Basel, Switzerland
| | - Till S Voss
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4001 Basel, Switzerland
| | - Pascal Mäser
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4001 Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4001 Basel, Switzerland
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Mäser P, Bernhard S, Brun R, Burri C, Gagneux S, Hetzel MW, Kaiser M, Lengeler C, Pluschke G, Reus E, Rottmann M, Utzinger J, Warryn L, Wittlin S, Keiser J. Key Contributions by the Swiss Tropical and Public Health Institute Towards New and Better Drugs for Tropical Diseases. Chimia (Aarau) 2023; 77:593-602. [PMID: 38047835 DOI: 10.2533/chimia.2023.593] [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: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 12/05/2023] Open
Abstract
Thanks to its expertise in clinical research, epidemiology, infectious diseases, microbiology, parasitology, public health, translational research and tropical medicine, coupled with deeply rooted partnerships with institutions in low- and middle-income countries (LMICs), the Swiss Tropical and Public Health Institute (Swiss TPH) has been a key contributor in many drug research and development consortia involving academia, pharma and product development partnerships. Our know-how of the maintenance of parasites and their life-cycles in the laboratory, plus our strong ties to research centres and disease control programme managers in LMICs with access to field sites and laboratories, have enabled systems for drug efficacy testing in vitro and in vivo, clinical research, and modelling to support the experimental approaches. Thus, Swiss TPH has made fundamental contributions towards the development of new drugs - and the better use of old drugs - for neglected tropical diseases and infectious diseases of poverty, such as Buruli ulcer, Chagas disease, food-borne trematodiasis (e.g. clonorchiasis, fascioliasis and opisthorchiasis), human African trypanosomiasis, leishmaniasis, malaria, schistosomiasis, soil-transmitted helminthiasis and tuberculosis. In this article, we show case the success stories of molecules to which Swiss TPH has made a substantial contribution regarding their use as anti-infective compounds with the ultimate aim to improve people's health and well-being.
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Affiliation(s)
- Pascal Mäser
- Dept. Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland.
- University of Basel, CH-4001 Basel, Switzerland
| | - Sonja Bernhard
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland.
- University of Basel, CH-4001 Basel, Switzerland
| | - Reto Brun
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland.
- University of Basel, CH-4001 Basel, Switzerland
| | - Christian Burri
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland.
- University of Basel, CH-4001 Basel, Switzerland
| | - Sébastien Gagneux
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland.
- University of Basel, CH-4001 Basel, Switzerland
| | - Manuel W Hetzel
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland.
- University of Basel, CH-4001 Basel, Switzerland
| | - Marcel Kaiser
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland.
- University of Basel, CH-4001 Basel, Switzerland
| | - Christian Lengeler
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland.
- University of Basel, CH-4001 Basel, Switzerland
| | - Gerd Pluschke
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland.
- University of Basel, CH-4001 Basel, Switzerland
| | - Elisabeth Reus
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland.
- University of Basel, CH-4001 Basel, Switzerland
| | - Matthias Rottmann
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland.
- University of Basel, CH-4001 Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland.
- University of Basel, CH-4001 Basel, Switzerland
| | - Louisa Warryn
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland.
- University of Basel, CH-4001 Basel, Switzerland
| | - Sergio Wittlin
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland.
- University of Basel, CH-4001 Basel, Switzerland
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland.
- University of Basel, CH-4001 Basel, Switzerland
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Flahault A, Choirat C, Utzinger J. La Suisse, acteur incontournable de la santé globale. Rev Med Suisse 2023; 19:1387-1388. [PMID: 37493112 DOI: 10.53738/revmed.2023.19.836.1387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Affiliation(s)
- Antoine Flahault
- Institut de santé globale, Faculté de médecine, Université de Genève
| | - Christine Choirat
- Swiss Data Science Center, École polytechnique fédérale de Lausanne et Eidgenössische Technische Hochschule Zurich, Professeure invitée, Université de Genève
| | - Jürg Utzinger
- Institut tropical et de santé publique suisse, Allschwil et Université de Bâle
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Kouadio JN, Giovanoli Evack J, Sékré JBK, Achi LY, Ouattara M, Hattendorf J, Balmer O, Bonfoh B, Zinsstag J, Utzinger J, N’Goran EK. Prevalence and risk factors of schistosomiasis and hookworm infection in seasonal transmission settings in northern Côte d'Ivoire: A cross-sectional study. PLoS Negl Trop Dis 2023; 17:e0011487. [PMID: 37459286 PMCID: PMC10351694 DOI: 10.1371/journal.pntd.0011487] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/29/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Schistosomiasis and hookworm infection remain public health problems in large parts of sub-Saharan Africa. The epidemiology of schistosomiasis and hookworm was studied in seasonal transmission settings in the northern part of Côte d'Ivoire. METHODOLOGY In August 2018, a cross-sectional study was conducted. Urine and stool samples were collected from 742 individuals aged 6-96 years in 16 localities from four departments in northern Côte d'Ivoire. Urine samples were examined by a filtration method for quantification of Schistosoma haematobium eggs. Stool samples were subjected to duplicate Kato-Katz thick smears and eggs of Schistosoma mansoni and soil-transmitted helminths (STHs) were counted. Additionally, a questionnaire was administered to determine demographic characteristics and to identify risk factors of schistosomiasis and STHs. Malacologic surveys were carried out at water points that are contacted by humans and animals. PRINCIPAL FINDINGS The prevalence of schistosomiasis was very low. Only two cases of S. mansoni were found (0.3%, 95% confidence interval [CI]: 0.1-1.0%). The distribution of S. haematobium was focal, with cases found only in two departments; Ferkessédougou (5.4%, 95% CI: 2.5-9.9%) and Ouangolodougou (2.7%, 95% CI: 0.9-6.3%). Hookworm was the only STH species observed with a prevalence of 1.5% (95% CI: 0.8-2.8%). A higher risk of S. haematobium infection was observed in males compared to females, but the difference was not statistically significant (2.3% versus 1.3%, odds ratio [OR]: 1.5, 95% CI: 0.8-2.7). Participants aged 16-20 years showed the highest prevalence of S. haematobium. A total of 111 human- and animal-water contact points were identified at 47 water sources. Three potential intermediate host snails of schistosomes were collected; namely, Bulinus forskalii (n = 761), Bulinus truncatus (n = 205), and Biomphalaria pfeifferi (n = 1). Yet, only one specimen of Bu. truncatus was found to be shedding schistosome cercariae. CONCLUSIONS/SIGNIFICANCE This study confirms very low transmission of schistosomiasis and hookworm in northern Côte d'Ivoire. The establishment and rigorous implementation of integrated surveillance-response systems could lead to the elimination of schistosomiasis and hookworm in this part of Côte d'Ivoire.
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Affiliation(s)
- Jules N. Kouadio
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Jennifer Giovanoli Evack
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Jean-Baptiste K. Sékré
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
| | - Louise Y. Achi
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Ecole de Spécialisation en Elevage et des Métiers de la Viande de Bingerville, Bingerville, Côte d’Ivoire
- Laboratoire National d’Appui au Développement Agricole, Abidjan, Côte d’Ivoire
| | - Mamadou Ouattara
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Jan Hattendorf
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Oliver Balmer
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Eliézer K. N’Goran
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
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Kulinkina AV, Farnham A, Biritwum NK, Utzinger J, Walz Y. How do disease control measures impact spatial predictions of schistosomiasis and hookworm? The example of predicting school-based prevalence before and after preventive chemotherapy in Ghana. PLoS Negl Trop Dis 2023; 17:e0011424. [PMID: 37327211 DOI: 10.1371/journal.pntd.0011424] [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: 11/21/2022] [Accepted: 05/28/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Schistosomiasis and soil-transmitted helminth infections are among the neglected tropical diseases (NTDs) affecting primarily marginalized communities in low- and middle-income countries. Surveillance data for NTDs are typically sparse, and hence, geospatial predictive modeling based on remotely sensed (RS) environmental data is widely used to characterize disease transmission and treatment needs. However, as large-scale preventive chemotherapy has become a widespread practice, resulting in reduced prevalence and intensity of infection, the validity and relevance of these models should be re-assessed. METHODOLOGY We employed two nationally representative school-based prevalence surveys of Schistosoma haematobium and hookworm infections from Ghana conducted before (2008) and after (2015) the introduction of large-scale preventive chemotherapy. We derived environmental variables from fine-resolution RS data (Landsat 8) and examined a variable distance radius (1-5 km) for aggregating these variables around point-prevalence locations in a non-parametric random forest modeling approach. We used partial dependence and individual conditional expectation plots to improve interpretability. PRINCIPAL FINDINGS The average school-level S. haematobium prevalence decreased from 23.8% to 3.6% and that of hookworm from 8.6% to 3.1% between 2008 and 2015. However, hotspots of high-prevalence locations persisted for both diseases. The models with environmental data extracted from a buffer radius of 2-3 km around the school location where prevalence was measured had the best performance. Model performance (according to the R2 value) was already low and declined further from approximately 0.4 in 2008 to 0.1 in 2015 for S. haematobium and from approximately 0.3 to 0.2 for hookworm. According to the 2008 models, land surface temperature (LST), modified normalized difference water index (MNDWI), elevation, slope, and streams variables were associated with S. haematobium prevalence. LST, slope, and improved water coverage were associated with hookworm prevalence. Associations with the environment in 2015 could not be evaluated due to low model performance. CONCLUSIONS/SIGNIFICANCE Our study showed that in the era of preventive chemotherapy, associations between S. haematobium and hookworm infections and the environment weakened, and thus predictive power of environmental models declined. In light of these observations, it is timely to develop new cost-effective passive surveillance methods for NTDs as an alternative to costly surveys, and to focus on persisting hotspots of infection with additional interventions to reduce reinfection. We further question the broad application of RS-based modeling for environmental diseases for which large-scale pharmaceutical interventions are in place.
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Affiliation(s)
- Alexandra V Kulinkina
- Tufts University - Friedman School of Nutrition Science and Policy, Boston, Illinois, United States of America
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Andrea Farnham
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Yvonne Walz
- United Nations University - Institute for Environment and Human Security, Bonn, Germany
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Wynberg E, Commons RJ, Humphreys G, Ashurst H, Burrow R, Adjei GO, Adjuik M, Anstey NM, Anvikar A, Baird KJ, Barber BE, Barennes H, Baudin E, Bell DJ, Bethell D, Binh TQ, Borghini-Fuhrer I, Chu CS, Daher A, D’Alessandro U, Das D, Davis TME, de Vries PJ, Djimde AA, Dondorp AM, Dorsey G, Faucher JFF, Fogg C, Gaye O, Grigg M, Hatz C, Kager PA, Lacerda M, Laman M, Mårtensson A, Menan HIE, Monteiro WM, Moore BR, Nosten F, Ogutu B, Osorio L, Penali LK, Pereira DB, Rahim AG, Ramharter M, Sagara I, Schramm B, Seidlein L, Siqueira AM, Sirima SB, Starzengruber P, Sutanto I, Taylor WR, Toure OA, Utzinger J, Valea I, Valentini G, White NJ, William T, Woodrow CJ, Richmond CL, Guerin PJ, Price RN, Stepniewska K. Variability in white blood cell count during uncomplicated malaria and implications for parasite density estimation: a WorldWide Antimalarial Resistance Network individual patient data meta-analysis. Malar J 2023; 22:174. [PMID: 37280686 DOI: 10.1186/s12936-023-04583-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/07/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND The World Health Organization (WHO) recommends that when peripheral malarial parasitaemia is quantified by thick film microscopy, an actual white blood cell (WBC) count from a concurrently collected blood sample is used in calculations. However, in resource-limited settings an assumed WBC count is often used instead. The aim of this study was to describe the variability in WBC count during acute uncomplicated malaria, and estimate the impact of using an assumed value of WBC on estimates of parasite density and clearance. METHODS Uncomplicated malaria drug efficacy studies that measured WBC count were selected from the WorldWide Antimalarial Resistance Network data repository for an individual patient data meta-analysis of WBC counts. Regression models with random intercepts for study-site were used to assess WBC count variability at presentation and during follow-up. Inflation factors for parasitaemia density, and clearance estimates were calculated for methods using assumed WBC counts (8000 cells/µL and age-stratified values) using estimates derived from the measured WBC value as reference. RESULTS Eighty-four studies enrolling 27,656 patients with clinically uncomplicated malaria were included. Geometric mean WBC counts (× 1000 cells/µL) in age groups < 1, 1-4, 5-14 and ≥ 15 years were 10.5, 8.3, 7.1, 5.7 and 7.5, 7.0, 6.5, 6.0 for individuals with falciparum (n = 24,978) and vivax (n = 2678) malaria, respectively. At presentation, higher WBC counts were seen among patients with higher parasitaemia, severe anaemia and, for individuals with vivax malaria, in regions with shorter regional relapse periodicity. Among falciparum malaria patients, using an assumed WBC count of 8000 cells/µL resulted in parasite density underestimation by a median (IQR) of 26% (4-41%) in infants < 1 year old but an overestimation by 50% (16-91%) in adults aged ≥ 15 years. Use of age-stratified assumed WBC values removed systematic bias but did not improve precision of parasitaemia estimation. Imprecision of parasite clearance estimates was only affected by the within-patient WBC variability over time, and remained < 10% for 79% of patients. CONCLUSIONS Using an assumed WBC value for parasite density estimation from a thick smear may lead to underdiagnosis of hyperparasitaemia and could adversely affect clinical management; but does not result in clinically consequential inaccuracies in the estimation of the prevalence of prolonged parasite clearance and artemisinin resistance.
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23
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Arnaiz P, Seelig H, Gerber M, Adams L, Degen J, Dolley D, Joubert N, Nienaber M, Nqweniso S, Steinmann P, Utzinger J, du Randt R, Walter C, Pühse U, Müller I. Intervention effects and long-term changes in physical activity and cardiometabolic outcomes among children at risk of noncommunicable diseases in South Africa: a cluster-randomized controlled trial and follow-up analysis. Front Public Health 2023; 11:1199381. [PMID: 37304085 PMCID: PMC10250595 DOI: 10.3389/fpubh.2023.1199381] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 05/12/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Risk factors for noncommunicable diseases such as insufficient physical activity (PA), overweight or hypertension are becoming increasingly predominant among children globally. While school-based interventions are promising preventive strategies, evidence of their long-term effectiveness, especially among vulnerable populations, is scarce. We aim to assess the short-term effects of the physical and health KaziKidz intervention on cardiometabolic risk factors and the long-term, pre-and post-COVID-19 pandemic changes thereof in high-risk children from marginalized communities. Methods The intervention was tested in a cluster-randomized controlled trial between January and October 2019 in eight primary schools near Gqeberha, South Africa. Children with overweight, elevated blood pressure, pre-diabetes, and/or borderline dyslipidemia were identified and re-assessed 2 years post-intervention. Study outcomes included accelerometry-measured PA (MVPA), body mass index (BMI), mean arterial pressure (MAP), glucose (HbA1c), and lipid levels (TC to HDL ratio). We conducted mixed regression analyses to assess intervention effects by cardiometabolic risk profile, and Wilcoxon signed-rank tests to evaluate longitudinal changes in the high-risk subpopulation. Results We found a significant intervention effect on MVPA during school hours for physically inactive children, and among active as well as inactive girls. In contrast, the intervention lowered HbA1c and TC to HDL ratio only in children with glucose or lipid values within the norm, respectively. At follow-up, the intervention effects were not maintained in at-risk children, who showed a decline in MVPA, and an increase in BMI-for-age, MAP, HbA1c and TC to HDL ratio. Conclusion We conclude that schools are key settings in which to promote PA and improve health; however, structural changes are necessary to ensure that effective interventions reach marginalized school populations and achieve sustainable impact.
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Affiliation(s)
- Patricia Arnaiz
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Harald Seelig
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Larissa Adams
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Jan Degen
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Danielle Dolley
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Nandi Joubert
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Madeleine Nienaber
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Siphesihle Nqweniso
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Rosa du Randt
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Cheryl Walter
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Ivan Müller
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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24
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Nooh F, Utzinger J, Paris DH, Probst-Hensch N, Chernet A. Association of Hypertension, Diabetes, and Cardiovascular Disease with COVID-19 in Africa: Scoping Review Protocol. Trop Med Infect Dis 2023; 8:293. [PMID: 37368711 DOI: 10.3390/tropicalmed8060293] [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] [Received: 05/02/2023] [Revised: 05/18/2023] [Accepted: 05/21/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND COVID-19 caused devastating effects on global healthcare systems. The elderly and people with chronic comorbidities were at a particularly high risk of mortality and morbidity. However, the evidence on the association of COVID-19 severity with noncommunicable diseases (NCDs) in the African population is scarce. OBJECTIVE The aim is to estimate COVID-19 severity among African patients with hypertension, diabetes, and cardiovascular diseases (CVDs) and its implications for case management. METHODS We will adhere to the extension for Scoping Reviews of PRISMA (PRISMA-ScR). The following electronic databases will be searched: PubMed, Scopus, Web of Science, Embase, CINAHL, and Joanna Briggs Institute. The search will be conducted after the publication of this protocol. Two reviewers will extract data from articles published after March 2020 without language restrictions. A descriptive analysis of the important findings and a narrative synthesis of the results will serve as the basis for interpretation. Expected results and conclusions: This scoping review is expected to determine the odds of patients with chronic comorbidities to progress to severe stages of COVID-19. The review will generate an evidence-based and set foundation for recommendations toward the establishment of surveillance systems and referral guidelines for the management of NCDs in the face of COVID-19 and future pandemics.
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Affiliation(s)
- Faisal Nooh
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
- College of Medicine & Health Sciences, University of Hargeisa, Hargeisa, Somalia
- College of Medicine & Health Sciences, Jigjiga University, 1020 Jigjiga, Ethiopia
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
| | - Daniel H Paris
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
| | - Afona Chernet
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
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Nooh F, Chernet A, Reither K, Okuma J, Brattig NW, Utzinger J, Probst-Hensch N, Paris DH, Dreyfus A. Prevalence of fever of unidentified aetiology in East African adolescents and adults: a systematic review and meta-analysis. Infect Dis Poverty 2023; 12:55. [PMID: 37231500 DOI: 10.1186/s40249-023-01105-z] [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] [Received: 01/17/2023] [Accepted: 05/16/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Primary health care settings and hospitals of low- and middle-income countries have few accessible diagnostic tools and limited laboratory and human resources capacity to identify multiple pathogens with high accuracy. In addition, there is a paucity of information on fever and its underlying aetiology in the adolescent and adult population in East Africa. The purpose of this study was to estimate the pooled prevalence of fever of unidentified aetiology among adolescent and adult febrile patients seeking health care in East Africa. METHODS We pursued a systematic review using readily available electronic databases (i.e. PubMed, Cumulative Index to Nursing & Allied Health Literature, Scopus, Cochrane Library and Web of Science) without language restriction from inception date of the respective databases to October 31, 2022. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Identified studies were screened for relevance. Further analyses based on pre-set eligibility criteria were carried out for final inclusion. Two reviewers independently screened and extracted data. Risk of study bias was assessed. Meta-analysis of the prevalence of fever of unidentified aetiology was performed. RESULTS We identified 14,029 articles of which 25 were eligible for inclusion, reporting data from 8538 participants. The pooled prevalence of febrile cases with unidentified aetiology was 64% [95% confidence interval (CI): 51-77%, I2 = 99.6%] among febrile adolescents and adults in East Africa. For the proportion of patients with identified aetiology, the studies documented bacterial pathogens (human bloodstream infections), bacterial zoonotic pathogens and arboviruses as the main non-malarial causative agents in East Africa. CONCLUSIONS Our study provides evidence that almost two-thirds of adolescent and adult febrile patients attending health care facilities in East Africa might receive inappropriate treatments due to unidentified potential life-threatening fever aetiology. Hence, we call for a comprehensive fever syndromic surveillance to broaden a consequential differential diagnosis of syndromic fever and to considerably improve the course of patients' disease and treatment outcomes.
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Affiliation(s)
- Faisal Nooh
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
- College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia.
- College of Medicine and Health Sciences, University of Hargeisa, Hargeisa, Somaliland.
| | - Afona Chernet
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Klaus Reither
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - James Okuma
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Norbert W Brattig
- Department Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Daniel H Paris
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Anou Dreyfus
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Section of Epidemiology, University of Zürich, Zurich, Switzerland
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Nooh F, Ali MI, Chernet A, Probst-Hensch N, Utzinger J. Prevalence and Risk Factors of Hypertension in Hargeisa, Somaliland: A Hospital-Based Cross-Sectional Study. Diseases 2023; 11:diseases11020062. [PMID: 37092444 PMCID: PMC10123622 DOI: 10.3390/diseases11020062] [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] [Received: 03/01/2023] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 04/25/2023] Open
Abstract
Hypertension is the leading risk factor for cardiovascular diseases and represents a major public health challenge worldwide. There is a paucity of information regarding the hypertension status of adults in Somaliland. We aimed to assess the magnitude of, and factors associated with, hypertension among adult patients seeking care at Hargeisa group hospital in Hargeisa city, Somaliland. We conducted a health facility-based cross-sectional study enrolling adult outpatients. We used the World Health Organization (WHO) STEPwise surveillance approach to obtain patient information. A total of 319 participants (54.2% males; mean age 40.4 ± 14.0 years) had complete data records. The prevalence of hypertension was 22.6% (95% confidence interval; 18.2-27.6%). The prevalence of hypertension increased with age and was higher in males (24.9%) than in females (19.9%). Age, cholesterolaemia and obesity were significantly associated with hypertension. Separate analyses for females and males revealed that obesity was significantly associated with hypertension in females but not in males. On the contrary, cholesterolaemia was significantly associated with hypertension in males but not in females. We found a high prevalence of hypertension and multiple risk factors for non-communicable diseases (NCDs) in outpatients seeking care in Hargeisa. Our findings emphasise the need for enhanced focus on the prevention and management of NCDs in Somaliland.
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Affiliation(s)
- Faisal Nooh
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
- College of Medicine & Health Sciences, University of Hargeisa, Hargeisa 25263, Somaliland
- College of Medicine & Health Sciences, Jigjiga University, Jigjiga 1020, Ethiopia
| | - Mohamed I Ali
- College of Medicine & Health Sciences, Jigjiga University, Jigjiga 1020, Ethiopia
| | - Afona Chernet
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
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Pessoa Colombo V, Chenal J, Orina F, Meme H, Koffi JDA, Koné B, Utzinger J. Environmental determinants of access to shared sanitation in informal settlements: a cross-sectional study in Abidjan and Nairobi. Infect Dis Poverty 2023; 12:34. [PMID: 37038238 PMCID: PMC10084626 DOI: 10.1186/s40249-023-01078-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 03/10/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Universal access to basic sanitation remains a global challenge, particularly in low- and middle-income countries. Efforts are underway to improve access to sanitation in informal settlements, often through shared facilities. However, access to these facilities and their potential health gains-notably, the prevention of diarrheal diseases-may be hampered by contextual aspects related to the physical environment. This study explored associations between the built environment and perceived safety to access toilets, and associations between the latter and diarrheal infections. METHODS A cross-sectional study was carried out between July 2021 and February 2022, including 1714 households in two informal settlements in Abidjan (Côte d'Ivoire) and two in Nairobi (Kenya). We employed adjusted odds ratios (aORs) obtained from multiple logistic regressions (MLRs) to test whether the location of the most frequently used toilet was associated with a perceived lack of safety to use the facility at any time, and whether this perceived insecurity was associated with a higher risk of diarrhea. The MLRs included several exposure and control variables, being stratified by city and age groups. We employed bivariate logistic regressions to test whether the perceived insecurity was associated with settlement morphology indicators derived from the built environment. RESULTS Using a toilet outside the premises was associated with a perceived insecurity both in Abidjan [aOR = 3.14, 95% confidence interval (CI): 1.13-8.70] and in Nairobi (aOR = 57.97, 95% CI: 35.93-93.53). Perceived insecurity to access toilets was associated with diarrheal infections in the general population (aOR = 1.90, 95% CI: 1.29-2.79 in Abidjan, aOR = 1.69, 95% CI: 1.22-2.34 in Nairobi), but not in children below the age of 5 years. Several settlement morphology features were associated with perceived insecurity, namely, buildings' compactness, the proportion of occupied land, and angular deviation between neighboring structures. CONCLUSIONS Toilet location was a critical determinant of perceived security, and hence, must be adequately addressed when building new facilities. The sole availability of facilities may be insufficient to prevent diarrheal infections. People must also be safe to use them. Further attention should be directed toward how the built environment affects safety.
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Affiliation(s)
| | - Jérôme Chenal
- École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
- Université Mohammed VI Polytechnique, Ben Guerir, Morocco
| | - Fred Orina
- Kenya Medical Research Institute, Nairobi, Kenya
| | - Hellen Meme
- Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Brama Koné
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Université Péléforo Gon Coulibaly, Korhogo, Côte d'Ivoire
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Koné S, Probst-Hensch N, Dao D, Utzinger J, Fink G. Improving coverage of antenatal iron and folic acid supplementation and malaria prophylaxis through targeted information and home deliveries in Côte d'Ivoire: a cluster randomised controlled trial. BMJ Glob Health 2023; 8:bmjgh-2022-010934. [PMID: 37076197 PMCID: PMC10124199 DOI: 10.1136/bmjgh-2022-010934] [Citation(s) in RCA: 2] [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: 10/10/2022] [Accepted: 12/20/2022] [Indexed: 04/21/2023] Open
Abstract
INTRODUCTION Coverage of antenatal iron and folic acid (IFA) supplementation and malaria chemoprophylaxis remains low in many low-income and middle-income settings. We assessed the effectiveness of personal information (INFO) sessions and personal information session plus home deliveries (INFO+DELIV) to increase coverage of IFA supplementation and intermittent preventive treatment in pregnancy (IPTp), and their effectiveness on postpartum anaemia and malaria infection. METHODS We included 118 clusters randomised to a control (39), INFO (39) and INFO+DELIV (40) arm, in a trial conducted between 2020 and 2021 with pregnant women (age ≥15 years) in their first or second trimester of pregnancy in Taabo, Côte d'Ivoire. We used generalised linear regression models to assess intervention impact in postpartum anaemia and malaria parasitaemia, and displayed resulting estimates as prevalence ratios. RESULTS Overall, 767 pregnant women were enrolled and 716 (93.3%) were followed up after delivery. Neither intervention had an impact on postpartum anaemia, with estimated adjusted prevalence ratios (aPRs) of 0.97 (95% CI 0.79 to 1.19, p=0.770) for INFO and 0.87 (95% CI 0.70 to 1.09, p=0.235) for INFO+DELIV. While INFO had no effect on malaria parasitaemia (aPR=0.95, 95% CI 0.39 to 2.31, p=0.915), INFO+DELIV reduced malaria parasitaemia by 83% (aPR=0.17, 95% CI 0.04 to 0.75, p=0.019). No improvements in antenatal care (ANC) coverage (aPR=1.05, 95% CI 0.81 to 1.36, p=0.692), IFA (aPR=2.00, 95% CI 0.89 to 4.46, p=0.093) and IPTp (aPR=1.03, 95% CI 0.87 to 1.21, p=0.728) compliance were found for INFO. INFO+DELIV increased ANC attendance (aPR=1.35, 95% CI 1.02 to 1.78, p=0.037) and compliance with IPTp (aPR=1.60, 95% CI 1.41 to 1.80, p<0.001) and IFA recommendations (aPR=7.06, 95% CI 3.68 to 13.51, p<0.001). CONCLUSIONS INFO+DELIV can substantially increase compliance with IFA supplementation and improve malaria prevention. However, the increases in IFA supplementation are likely insufficient to address the prevalence of often severe anaemia in this population. TRIAL REGISTRATION NUMBER NCT04250428.
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Affiliation(s)
- Siaka Koné
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoires, Abidjan, Côte d'Ivoire
- Swiss Tropical and Public Health Institute, allschwill, Switzerland
- University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, allschwill, Switzerland
- University of Basel, Basel, Switzerland
| | - Daouda Dao
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoires, Abidjan, Côte d'Ivoire
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, allschwill, Switzerland
- University of Basel, Basel, Switzerland
| | - Günther Fink
- Swiss Tropical and Public Health Institute, allschwill, Switzerland
- University of Basel, Basel, Switzerland
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29
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N'Dri BP, Wipf NC, Saric J, Fodjo BK, Raso G, Utzinger J, Müller P, Mouhamadou CS. Species composition and insecticide resistance in malaria vectors in Ellibou, southern Côte d'Ivoire and first finding of Anopheles arabiensis in Côte d'Ivoire. Malar J 2023; 22:93. [PMID: 36915098 PMCID: PMC10010045 DOI: 10.1186/s12936-023-04456-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/16/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Knowing the species composition and insecticide resistance status of the target vector population is important to guide malaria vector control. The aim of this study was to characterize the malaria vector population in terms of species composition, insecticide susceptibility status and potential underlying resistance mechanisms in Ellibou, southern Côte d'Ivoire. METHODS A 1-year longitudinal entomological survey was conducted using light traps and pyrethroid spray catches to sample adult mosquitoes in combination with larval sampling. The susceptibility status of Anopheles gambiae sensu lato (s.l.) to bendiocarb, deltamethrin, DDT and malathion was assessed using the World Health Organization insecticide susceptibility test. Additionally, An. gambiae specimens were screened for knockdown (kdr) and acetylcholineesterase (ace1) target site resistance alleles, and the expression levels of eight metabolic resistance genes, including seven cytochrome P450 monooxygenases (P450s) and one glutathione S-transferase (GST), measured with reverse transcription quantitative real-time polymerase chain reaction (qPCR). RESULTS Overall, 2383 adult mosquitoes from 12 different taxa were collected with Culex quinquefasciatus and An. gambiae being the predominant taxa. Molecular identification of An. gambiae s.l. revealed the presence of Anopheles arabiensis, Anopheles coluzzii, An. gambiae sensu stricto (s.s.) and Anopheles coluzzii/An. gambiae s.s. hybrids. Anopheles gambiae mosquitoes were resistant to all insecticides except malathion. PCR diagnostics revealed the presence of ace1-G280S and the kdr L995F, L995S and N1570Y target-site mutations. Additionally, several genes were upregulated, including five P450s (i.e., CYP6P3, CYP6M2, CYP9K1, CYP6Z1, CYP6P1) and GSTE2. CONCLUSION This is the first documented presence of An. arabiensis in Côte d'Ivoire. Its detection - together with a recent finding further north of the country - confirms its existence in the country, which is an early warning sign, as An. arabiensis shows a different biology than the currently documented malaria vectors. Because the local An. gambiae population was still susceptible to malathion, upregulation of P450s, conferring insecticide resistance to pyrethroids, together with the presence of ace1, suggest negative cross-resistance. Therefore, organophosphates could be an alternative insecticide class for indoor residual spraying in the Ellibou area, while additional tools against the outdoor biting An. arabiensis will have to be considered.
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Affiliation(s)
- Bédjou P N'Dri
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire. .,Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland. .,University of Basel, 4001, Basel, Switzerland.
| | - Nadja C Wipf
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland.,University of Basel, 4001, Basel, Switzerland
| | - Jasmina Saric
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland.,University of Basel, 4001, Basel, Switzerland
| | - Behi K Fodjo
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire
| | - Giovanna Raso
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland.,University of Basel, 4001, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland.,University of Basel, 4001, Basel, Switzerland
| | - Pie Müller
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland.,University of Basel, 4001, Basel, Switzerland
| | - Chouaïbou S Mouhamadou
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire.,North Carolina State University, Raleigh, NC, 27695-7508, USA
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Shrikhande SS, Merten S, Cambaco O, Lee T, Lakshmanasamy R, Röösli M, Dalvie MA, Utzinger J, Cissé G. "Climate Change and Health?": Knowledge and Perceptions among Key Stakeholders in Puducherry, India. Int J Environ Res Public Health 2023; 20:4703. [PMID: 36981615 PMCID: PMC10048771 DOI: 10.3390/ijerph20064703] [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] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
Climate change has far-reaching impacts on human health, with low- and middle-income countries, including India, being particularly vulnerable. While there have been several advances in the policy space with the development of adaptation plans, little remains known about how stakeholders who are central to the strengthening and implementation of these plans perceive this topic. We conducted a qualitative study employing key interviews with 16 medical doctors, researchers, environmentalists and government officials working on the climate change agenda from Puducherry, India. The findings were analysed using the framework method, with data-driven thematic analysis. We elucidated that despite elaborating the direct and indirect impacts of climate change on health, there remains a perceived gap in education and knowledge about the topic among participants. Knowledge of the public health burden and vulnerabilities influenced the perceived health risks from climate change, with some level of scepticism on the impacts on non-communicable diseases, such as cardiovascular diseases. There was also a felt need for multi-level awareness and intervention programmes targeting all societal levels along with stakeholder recommendations to fill these gaps. The findings of this study should be taken into consideration for strengthening the region's climate change and health adaptation policy. In light of limited research on this topic, our study provides an improved understanding of how key stakeholders perceive the impacts of climate change on health in India.
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Affiliation(s)
- Shreya S. Shrikhande
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Sonja Merten
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Olga Cambaco
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Tristan Lee
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Ravivarman Lakshmanasamy
- State Surveillance Officer, Department of Health and Family Welfare Services, Government of Puducherry, Puducherry 605001, India
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Mohammad Aqiel Dalvie
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Guéladio Cissé
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
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Nyawanda BO, Beloconi A, Khagayi S, Bigogo G, Obor D, Otieno NA, Lange S, Franke J, Sauerborn R, Utzinger J, Kariuki S, Munga S, Vounatsou P. The relative effect of climate variability on malaria incidence after scale-up of interventions in western Kenya: A time-series analysis of monthly incidence data from 2008 to 2019. Parasite Epidemiol Control 2023; 21:e00297. [PMID: 37021322 PMCID: PMC10068258 DOI: 10.1016/j.parepi.2023.e00297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 03/07/2023] [Accepted: 03/12/2023] [Indexed: 03/17/2023] Open
Abstract
Background Despite considerable progress made over the past 20 years in reducing the global burden of malaria, the disease remains a major public health problem and there is concern that climate change might expand suitable areas for transmission. This study investigated the relative effect of climate variability on malaria incidence after scale-up of interventions in western Kenya. Methods Bayesian negative binomial models were fitted to monthly malaria incidence data, extracted from records of patients with febrile illnesses visiting the Lwak Mission Hospital between 2008 and 2019. Data pertaining to bed net use and socio-economic status (SES) were obtained from household surveys. Climatic proxy variables obtained from remote sensing were included as covariates in the models. Bayesian variable selection was used to determine the elapsing time between climate suitability and malaria incidence. Results Malaria incidence increased by 50% from 2008 to 2010, then declined by 73% until 2015. There was a resurgence of cases after 2016, despite high bed net use. Increase in daytime land surface temperature was associated with a decline in malaria incidence (incidence rate ratio [IRR] = 0.70, 95% Bayesian credible interval [BCI]: 0.59-0.82), while rainfall was associated with increased incidence (IRR = 1.27, 95% BCI: 1.10-1.44). Bed net use was associated with a decline in malaria incidence in children aged 6-59 months (IRR = 0.78, 95% BCI: 0.70-0.87) but not in older age groups, whereas SES was not associated with malaria incidence in this population. Conclusions Variability in climatic factors showed a stronger effect on malaria incidence than bed net use. Bed net use was, however, associated with a reduction in malaria incidence, especially among children aged 6-59 months after adjusting for climate effects. To sustain the downward trend in malaria incidence, this study recommends continued distribution and use of bed nets and consideration of climate-based malaria early warning systems when planning for future control interventions.
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Shrikhande SS, Pedder H, Röösli M, Dalvie MA, Lakshmanasamy R, Gasparrini A, Utzinger J, Cissé G. Non-optimal apparent temperature and cardiovascular mortality: the association in Puducherry, India between 2011 and 2020. BMC Public Health 2023; 23:291. [PMID: 36755271 PMCID: PMC9909923 DOI: 10.1186/s12889-023-15128-6] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 01/24/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs), the leading cause of death worldwide, are sensitive to temperature. In light of the reported climate change trends, it is important to understand the burden of CVDs attributable to temperature, both hot and cold. The association between CVDs and temperature is region-specific, with relatively few studies focusing on low-and middle-income countries. This study investigates this association in Puducherry, a district in southern India lying on the Bay of Bengal, for the first time. METHODS Using in-hospital CVD mortality data and climate data from the Indian Meteorological Department, we analyzed the association between apparent temperature (Tapp) and in-hospital CVD mortalities in Puducherry between 2011 and 2020. We used a case-crossover model with a binomial likelihood distribution combined with a distributed lag non-linear model to capture the delayed and non-linear trends over a 21-day lag period to identify the optimal temperature range for Puducherry. The results are expressed as the fraction of CVD mortalities attributable to heat and cold, defined relative to the optimal temperature. We also performed stratified analyses to explore the associations between Tapp and age-and-sex, grouped and considered together, and different types of CVDs. Sensitivity analyses were performed, including using a quasi-Poisson time-series approach. RESULTS We found that the optimal temperature range for Puducherry is between 30°C and 36°C with respect to CVDs. Both cold and hot non-optimal Tapp were associated with an increased risk of overall in-hospital CVD mortalities, resulting in a U-shaped association curve. Cumulatively, up to 17% of the CVD deaths could be attributable to non-optimal temperatures, with a slightly higher burden attributable to heat (9.1%) than cold (8.3%). We also found that males were more vulnerable to colder temperature; females above 60 years were more vulnerable to heat while females below 60 years were affected by both heat and cold. Mortality with cerebrovascular accidents was associated more with heat compared to cold, while ischemic heart diseases did not seem to be affected by temperature. CONCLUSION Both heat and cold contribute to the burden of CVDs attributable to non-optimal temperatures in the tropical Puducherry. Our study also identified the age-and-sex and CVD type differences in temperature attributable CVD mortalities. Further studies from India could identify regional associations, inform our understanding of the health implications of climate change in India and enhance the development of regional and contextual climate-health action-plans.
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Affiliation(s)
- Shreya S Shrikhande
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Hugo Pedder
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Mohammad Aqiel Dalvie
- School of Public Health and Family Medicine, Centre for Environmental and Occupational Health Research, University of Cape Town, Cape Town, South Africa
| | - Ravivarman Lakshmanasamy
- State Surveillance Officer, Department of Health and Family Welfare Services, Govt. of Puducherry, Puducherry, India
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
- Centre On Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Guéladio Cissé
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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de Castañeda RR, Villers J, Guzmán CAF, Eslanloo T, de Paula N, Machalaba C, Zinsstag J, Utzinger J, Flahault A, Bolon I. One Health and planetary health research: leveraging differences to grow together. Lancet Planet Health 2023; 7:e109-e111. [PMID: 36754465 PMCID: PMC9901939 DOI: 10.1016/s2542-5196(23)00002-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/22/2022] [Indexed: 06/18/2023]
Affiliation(s)
- Rafael Ruiz de Castañeda
- Institute of Global Health, Department of Community Health and Medicine, Faculty of Medicine, University of Geneva, CH-1205 Geneva, Switzerland; Division of Tropical and Humanitarian Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Jennifer Villers
- Institute of Global Health, Department of Community Health and Medicine, Faculty of Medicine, University of Geneva, CH-1205 Geneva, Switzerland
| | - Carlos A Faerron Guzmán
- Planetary Health Alliance, Harvard University T H Chan School of Public Health, Boston, MA, USA
| | - Turan Eslanloo
- Institute of Global Health, Department of Community Health and Medicine, Faculty of Medicine, University of Geneva, CH-1205 Geneva, Switzerland
| | - Nicole de Paula
- Women Leaders for Planetary Health, Institute for Advanced Sustainability Studies, Potsdam, Germany
| | | | - Jakob Zinsstag
- Department of Epidemiology and Public Health, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Antoine Flahault
- Institute of Global Health, Department of Community Health and Medicine, Faculty of Medicine, University of Geneva, CH-1205 Geneva, Switzerland
| | - Isabelle Bolon
- Institute of Global Health, Department of Community Health and Medicine, Faculty of Medicine, University of Geneva, CH-1205 Geneva, Switzerland.
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Dolley D, Du Randt R, Pühse U, Gerber M, Bosma J, Aerts A, Adams L, Arnaiz P, Joubert N, Müller I, Nqweniso S, Seelig H, Steinmann P, Utzinger J, Walter C. Relationship between Body Mass Index and Physical Activity among Children from Low-Income Communities in Gqeberha, South Africa: A Cross-Sectional Study. Int J Environ Res Public Health 2023; 20:1428. [PMID: 36674182 PMCID: PMC9864586 DOI: 10.3390/ijerph20021428] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/07/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
This study aimed to establish the prevalence of underweight, overweight and obesity, the level of moderate-to-vigorous physical activity (MVPA) and the association thereof among vulnerable children from low-income communities in South Africa. Cross-sectional data were collected from 916 children (467 boys and 449 girls) aged 8-13 years (x̄ = 10.4 ± 1.2 years) attending eight low-income schools in Gqeberha, South Africa. Measured outcomes included accelerometery-measured physical activity (PA), weight, height and body mass index (BMI). Analysis of variance was used to determine the mean difference of total MVPA stratified by sex and BMI classification. Overall, 13% of the cohort were underweight, 19% were overweight/obese and 64% engaged in 60 min of MVPA per day. Girls presented nearly twice the odds of being overweight or obese than boys (95% CI: 1.40-2.77). Underweight to normal-weight children (boys: OR = 3.89, 95% CI: 2.18-6.93; girls: OR = 1.78, 95% CI: 1.13-2.80) were more likely to engage in 60 min/day of MVPA than overweight to obese children. There is an inverse association between BMI categories and theduration of MVPA achieved per day. Special attention should be aimed at increasing awareness of healthy nutrition and promoting a variety of PA, especially among girls and children with excess weight.
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Affiliation(s)
- Danielle Dolley
- Department of Human Movement Science, Nelson Mandela University, Gqeberha 77000, South Africa
| | - Rosa Du Randt
- Department of Human Movement Science, Nelson Mandela University, Gqeberha 77000, South Africa
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Jacob Bosma
- Department of Human Movement Science, Nelson Mandela University, Gqeberha 77000, South Africa
| | - Ann Aerts
- Novartis Foundation, 4056 Basel, Switzerland
| | - Larissa Adams
- Department of Human Movement Science, Nelson Mandela University, Gqeberha 77000, South Africa
| | - Patricia Arnaiz
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Nandi Joubert
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- University of Basel, 4052 Basel, Switzerland
| | - Ivan Müller
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Siphesihle Nqweniso
- Department of Human Movement Science, Nelson Mandela University, Gqeberha 77000, South Africa
| | - Harald Seelig
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- University of Basel, 4052 Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- University of Basel, 4052 Basel, Switzerland
| | - Cheryl Walter
- Department of Human Movement Science, Nelson Mandela University, Gqeberha 77000, South Africa
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van Zyl-Hermann D, Hammel T, Burri C, Chenal J, Fink G, Konou AA, Nébié E, Osei Afriyie D, Pessoa Colombo V, Utzinger J, Tischler J. Examining African contributions to global health: Reflections on knowledge circulation and innovation. Glob Public Health 2023; 18:2118343. [PMID: 36074862 DOI: 10.1080/17441692.2022.2118343] [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: 12/08/2021] [Accepted: 08/23/2022] [Indexed: 11/04/2022]
Abstract
This article unites different disciplinary debates on 'southern innovation', 'theory from the South', and 'decolonisation of knowledge' in order to discuss existing understandings around the role of Africa in the production of health-related knowledge, public health policy, and medical innovation. Arguing that high-income countries have much to learn from the global South when it comes to health-related knowledge and practices, we propose an interdisciplinary research approach to uncovering and examining African contributions to global health, drawing on an ongoing collaborative project funded by the Swiss National Science Foundation. We present four empirical case studies concerning drug development, healthcare systems, and urban planning to critically enquire into both historical and contemporary transcontinental knowledge circulation and learning potentials, as much as cases of forgetting and silencing. On this basis, we argue that 'learning from the South' must mean more than transplanting quick and cheap technological fixes to serve societies in the global North, but rather recognising the vast contributions that Africans have made to global epistemologies, without losing sight of the asymmetries inherent in South-North knowledge exchanges. Lessons learned might apply to fields other than those discussed here and go far beyond 'reverse innovation'.
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Affiliation(s)
| | | | - Christian Burri
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Jérôme Chenal
- School of Architecture, Civil and Environmental Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
- Center of Urban Systems, Université Mohammed VI Polytechnique, Ben Guerir, Morocco
| | - Günther Fink
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Akuto Akpedze Konou
- School of Architecture, Civil and Environmental Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Eric Nébié
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- Center of Urban Systems, Université Mohammed VI Polytechnique, Ben Guerir, Morocco
| | - Doris Osei Afriyie
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Vitor Pessoa Colombo
- School of Architecture, Civil and Environmental Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Jürg Utzinger
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
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Leuenberger A, Koné BV, N’krumah RTAS, Koffi DY, Bonfoh B, Utzinger J, Pluschke G. Perceived water-related risk factors of Buruli ulcer in two villages of south-central Côte d'Ivoire. PLoS Negl Trop Dis 2022; 16:e0010927. [PMID: 36516125 PMCID: PMC9750022 DOI: 10.1371/journal.pntd.0010927] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/01/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Buruli ulcer, caused by Mycobacterium ulcerans, is a neglected tropical skin disease that is primarily endemic in West and Central Africa, including Côte d'Ivoire. Studies indicate that M. ulcerans infections are caused by contact with an environmental reservoir of the bacteria, governed by specific human biological conditions. Yet, the nature of this reservoir and the exact mode of transmission remain unknown. METHODOLOGY To identify ecologic risk factors of Buruli ulcer in south-central Côte d'Ivoire, we pursued a qualitative study matched with geo-referencing inquiry. Embedded in a broader integrated wound management research project, we (i) mapped households and water sources of laboratory confirmed Buruli ulcer cases and (ii) interviewed 12 patients and four health care workers to assess exposure to surface water and to deepen the understanding of perceived transmission pathways. PRINCIPAL FINDINGS Water availability, accessibility, and affordability were reported as key determinants for choosing water resources. Furthermore, perceived risks were related to environmental, structural, and individual factors. Despite the presence of improved water sources (e.g., drilled wells), communities heavily relied on unprotected surface water for a multitude of activities. The nearby Bandama River and seasonal waterbodies were frequently used for washing, bathing, and collection of water for drinking and cooking. Many residents also reported to cross the river on a daily basis for agricultural chores, and hence, are exposed to stagnant water during farming activities. CONCLUSIONS/SIGNIFICANCE Our study in two Buruli ulcer endemic villages in south-central Côte d'Ivoire revealed a wide range of water-related domestic activities that might expose people to an increased risk of contracting the disease. Environmental, biological, social, and cultural risk factors are closely interlinked and should be considered in future investigations of Buruli ulcer transmission. Active participation of the communities is key to better understand their circumstances to advance research and fight against Buruli ulcer and other neglected tropical diseases.
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Affiliation(s)
- Andrea Leuenberger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
| | - Bognan V. Koné
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Raymond T. A. S. N’krumah
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Université Peleforo Gon Coulibaly de Korhogo, Korhogo, Côte d’Ivoire
| | - Didier Y. Koffi
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Programme National de Lutte contre l’Ulcère de Buruli, Abidjan, Côte d’Ivoire
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Gerd Pluschke
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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37
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Lo NC, Bezerra FSM, Colley DG, Fleming FM, Homeida M, Kabatereine N, Kabole FM, King CH, Mafe MA, Midzi N, Mutapi F, Mwanga JR, Ramzy RMR, Satrija F, Stothard JR, Traoré MS, Webster JP, Utzinger J, Zhou XN, Danso-Appiah A, Eusebi P, Loker ES, Obonyo CO, Quansah R, Liang S, Vaillant M, Murad MH, Hagan P, Garba A. Review of 2022 WHO guidelines on the control and elimination of schistosomiasis. Lancet Infect Dis 2022; 22:e327-e335. [PMID: 35594896 DOI: 10.1016/s1473-3099(22)00221-3] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/13/2022] [Accepted: 03/21/2022] [Indexed: 01/13/2023]
Abstract
Schistosomiasis is a helminthiasis infecting approximately 250 million people worldwide. In 2001, the World Health Assembly (WHA) 54.19 resolution defined a new global strategy for control of schistosomiasis through preventive chemotherapy programmes. This resolution culminated in the 2006 WHO guidelines that recommended empirical treatment by mass drug administration with praziquantel, predominately to school-aged children in endemic settings at regular intervals. Since then, school-based and community-based preventive chemotherapy programmes have been scaled-up, reducing schistosomiasis-associated morbidity. Over the past 15 years, new scientific evidence-combined with a more ambitious goal of eliminating schistosomiasis and an increase in the global donated supply of praziquantel-has highlighted the need to update public health guidance worldwide. In February, 2022, WHO published new guidelines with six recommendations to update the global public health strategy against schistosomiasis, including expansion of preventive chemotherapy eligibility from the predominant group of school-aged children to all age groups (2 years and older), lowering the prevalence threshold for annual preventive chemotherapy, and increasing the frequency of treatment. This Review, written by the 2018-2022 Schistosomiasis Guidelines Development Group and its international partners, presents a summary of the new WHO guideline recommendations for schistosomiasis along with their historical context, supporting evidence, implications for public health implementation, and future research needs.
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Affiliation(s)
- Nathan C Lo
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA.
| | | | - Daniel G Colley
- Department of Microbiology, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, USA
| | | | - Mamoun Homeida
- Academy of Medical Sciences and Technology, Khartoum, Sudan
| | - Narcis Kabatereine
- Accelerating Resilient, Innovative, and Sustainable Elimination of NTDs, Vector Control Division, Kampala, Uganda
| | | | - Charles H King
- Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Nicholas Midzi
- National Institute of Health Research, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Francisca Mutapi
- Institute of Immunology and Infection Research, Tackling Infections to Benefit Africa Partnership, University of Edinburgh, Edinburgh, UK
| | - Joseph R Mwanga
- Department of Epidemiology, Biostatistics and Behavioral Sciences, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Reda M R Ramzy
- National Nutrition Institute, General Organization for Teaching Hospitals and Institutes, Cairo, Egypt
| | - Fadjar Satrija
- School of Veterinary Medicine and Biomedicine, IPB University, Bogor, Indonesia
| | - J Russell Stothard
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Joanne P Webster
- Department of Pathobiology and Population Science, Royal Veterinary College, University of London, London, UK
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China; School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Paolo Eusebi
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Eric S Loker
- Department of Biology, University of New Mexico, Albuquerque, NM, USA
| | - Charles O Obonyo
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | | | - Song Liang
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Michel Vaillant
- Competence Centre for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - M Hassan Murad
- Evidence-based Practice Center, Mayo Clinic, Rochester, NY, USA
| | - Paul Hagan
- Faculty of Health Sciences, University of Hull, Hull, UK
| | - Amadou Garba
- Department of Control of Neglected Tropical Diseases, WHO, Geneva, Switzerland
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Engels D, Tang SL, Butler CD, Oduola AMJ, de Araujo-Jorge TC, Gao GF, Utzinger J, Zhou XN. A decade of innovation to deepen the understanding of infectious diseases of poverty and foster their control and elimination. Infect Dis Poverty 2022; 11:110. [PMID: 36274165 PMCID: PMC9589687 DOI: 10.1186/s40249-022-01037-0] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Dirk Engels
- grid.3575.40000000121633745World Health Organization (Retired), Geneva, Switzerland
| | - Sheng-lan Tang
- grid.26009.3d0000 0004 1936 7961Duke University, Durham, USA
| | - Colin D. Butler
- grid.1001.00000 0001 2180 7477Australia National University, Canberra, Australia
| | - Ayoade M. J. Oduola
- grid.9582.60000 0004 1794 5983University of Ibadan Research Foundation, University of Ibadan, Ibadan, Nigeria
| | - Tania C. de Araujo-Jorge
- grid.418068.30000 0001 0723 0931Institute Oswaldo Cruz, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - George F. Gao
- grid.9227.e0000000119573309Chinese Academy of Sciences, Beijing, People’s Republic of China
| | - Jürg Utzinger
- grid.416786.a0000 0004 0587 0574Swiss Tropical and Public Health Institute, Allschwil, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, Basel, Switzerland
| | - Xiao-Nong Zhou
- grid.508378.1National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Shanghai, People’s Republic of China ,grid.16821.3c0000 0004 0368 8293One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai, People’s Republic of China
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Shrikhande S, Pedder H, Roosli M, Dalvie MA, Ravivarman L, Gasparrini A, Utzinger J, Cisse G. Temperature and cardiovascular diseases: exploring associations in India and public health insights. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.157] [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] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Climate change has far-reaching consequences on human health globally. Cardiovascular diseases (CVDs), the global leading cause of death, are climate sensitive, mainly to temperature. The temperature-CVD association is region-specific, with several studies from Europe but relatively few from low-and-middle-income countries (LMICs).
Methods
We used a binomial regression model to analyze the association between apparent temperature and in-hospital CVD mortality in Puducherry city. A distributed lag non-linear model was used to capture the delayed and non-linear trends over a 21 day lag period to estimate the burden of in-hospital CVD mortalities attributable to non-optimal temperature between 2010 and 2020.
Results
Tapp in Puducherry ranges from 23°C to 40°C. We found that the optimal temperature range for Puducherry is between 33°C and 35°C with respect to CVDs. Temperatures both above and below the optimal temperature range were associated with an increased risk of overall in-hospital CVD mortalities, resulting in a U-shaped association curve. Up to 20% of the CVD deaths could be attributable to non-optimal temperatures, with a slightly higher burden attributable to cold (11.2%) than heat (9.12%). We also found that males above 60 years of age were more vulnerable to colder temperatures while females above 60 years were more vulnerable to the heat. Mortality with cerebrovascular accidents was associated more with heat compared to cold, and ischemic heart diseases did not seem to be affected by temperature.
Conclusions
Both cold and heat is associated with CVD mortality in Puducherry. The comparison of the results of this exploratory Indian study with those from European contexts show that the associations differ based on several factors. There are also age, gender and CVD type differences in Tapp attributable CVD mortalities. More region specific studies on Tapp- CVD mortality are needed from LMICs to better understand this association and build capacity.
Key messages
• The regional burden of cold attributable CVD deaths needs to be considered along with heat. Age and gender specific differences in the association need to be further studied globally.
• The development regional and contextual climate-health action plans, as seen in some European countries, could be enhanced by such studies and reduce the burden of temperature attributable CVD deaths.
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Affiliation(s)
- S Shrikhande
- Ecosystem Health Sciences, Swiss Tropical and Public Health Institute , Allschwil, Switzerland
- Faculty of Science, University of Basel , Basel, Switzerland
| | - H Pedder
- Population Health Sciences, University of Bristol , Bristol, UK
| | - M Roosli
- Ecosystem Health Sciences, Swiss Tropical and Public Health Institute , Allschwil, Switzerland
- Faculty of Science, University of Basel , Basel, Switzerland
| | - MA Dalvie
- Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town , Cape Town, South Africa
| | - L Ravivarman
- Department of Health and Family Welfare Services, Government of Puducherry , Puducherry, India
| | - A Gasparrini
- Centre for Statistical Methodology, LSHTM , London, UK
| | - J Utzinger
- Ecosystem Health Sciences, Swiss Tropical and Public Health Institute , Allschwil, Switzerland
- Faculty of Science, University of Basel , Basel, Switzerland
| | - G Cisse
- Ecosystem Health Sciences, Swiss Tropical and Public Health Institute , Allschwil, Switzerland
- Faculty of Science, University of Basel , Basel, Switzerland
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40
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Alene KA, Gordon CA, Clements ACA, Williams GM, Gray DJ, Zhou XN, Li Y, Utzinger J, Kurscheid J, Forsyth S, Zhou J, Li Z, Li G, Lin D, Lou Z, Li S, Ge J, Xu J, Yu X, Hu F, Xie S, McManus DP. Spatial Analysis of Schistosomiasis in Hunan and Jiangxi Provinces in the People's Republic of China. Diseases 2022; 10:93. [PMID: 36278592 PMCID: PMC9590053 DOI: 10.3390/diseases10040093] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/30/2022] [Accepted: 10/11/2022] [Indexed: 11/07/2023] Open
Abstract
Understanding the spatial distribution of schistosome infection is critical for tailoring preventive measures to control and eliminate schistosomiasis. This study used spatial analysis to determine risk factors that may impact Schistosoma japonicum infection and predict risk in Hunan and Jiangxi Provinces in the People's Republic of China. The study employed survey data collected in Hunan and Jiangxi in 2016. Independent variable data were obtained from publicly available sources. Bayesian-based geostatistics was used to build models with covariate fixed effects and spatial random effects to identify factors associated with the spatial distribution of infection. Prevalence of schistosomiasis was higher in Hunan (12.8%) than Jiangxi (2.6%). Spatial distribution of schistosomiasis varied at pixel level (0.1 × 0.1 km), and was significantly associated with distance to nearest waterbody (km, β = -1.158; 95% credible interval [CrI]: -2.104, -0.116) in Hunan and temperature (°C, β = -4.359; 95% CrI: -9.641, -0.055) in Jiangxi. The spatial distribution of schistosomiasis in Hunan and Jiangxi varied substantially and was significantly associated with distance to nearest waterbody. Prevalence of schistosomiasis decreased with increasing distance to nearest waterbody in Hunan, indicating that schistosomiasis control should target individuals in close proximity to open water sources as they are at highest risk of infection.
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Affiliation(s)
| | - Catherine A. Gordon
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia
| | | | - Gail M. Williams
- School of Population Health, University of Queensland, Brisbane 4072, Australia
| | - Darren J. Gray
- Department of Global Health, Australian National University, Canberra 0200, Australia
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Yuesheng Li
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia
- Hunan Institute of Schistosomiasis Control, Yueyang 414000, China
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, CH-4051 Allschwil, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
| | - Johanna Kurscheid
- School of Population Health, University of Queensland, Brisbane 4072, Australia
- Swiss Tropical and Public Health Institute, CH-4051 Allschwil, Switzerland
| | - Simon Forsyth
- School of Population Health, University of Queensland, Brisbane 4072, Australia
| | - Jie Zhou
- Hunan Institute of Schistosomiasis Control, Yueyang 414000, China
| | - Zhaojun Li
- Jiangxi Institute of Parasitic Diseases, Nanchang 330096, China
| | - Guangpin Li
- Hunan Institute of Schistosomiasis Control, Yueyang 414000, China
| | - Dandan Lin
- Jiangxi Institute of Parasitic Diseases, Nanchang 330096, China
| | - Zhihong Lou
- Hunan Institute of Schistosomiasis Control, Yueyang 414000, China
| | - Shengming Li
- Hunan Institute of Schistosomiasis Control, Yueyang 414000, China
| | - Jun Ge
- Jiangxi Institute of Parasitic Diseases, Nanchang 330096, China
| | - Jing Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Xinling Yu
- Hunan Institute of Schistosomiasis Control, Yueyang 414000, China
| | - Fei Hu
- Jiangxi Institute of Parasitic Diseases, Nanchang 330096, China
| | - Shuying Xie
- Jiangxi Institute of Parasitic Diseases, Nanchang 330096, China
| | - Donald P. McManus
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia
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Li Q, Xu J, Li SZ, Utzinger J, McManus DP, Zhou XN. Short-, Mid-, and Long-Term Epidemiological and Economic Effects of the World Bank Loan Project on Schistosomiasis Control in the People’s Republic of China. Diseases 2022; 10:diseases10040084. [PMID: 36278583 PMCID: PMC9624324 DOI: 10.3390/diseases10040084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/19/2022] [Accepted: 09/23/2022] [Indexed: 12/01/2022] Open
Abstract
It is widely acknowledged that the 10-year World Bank Loan Project (WBLP) on schistosomiasis control in the People’s Republic of China played an important role in raising the public and political profile of schistosomiasis, particularly regarding its prevention, control, and elimination. The WBLP adopted large-scale administration of praziquantel as the main control measure. At the end of the 10-year project in 2001, data from high-, medium-, and low-endemic areas suggested that the infection rates of both humans and domestic animals had fallen to the expected levels. However, major floods in the Yangtze River basin, coupled with reduced funding for schistosomiasis control, resulted in a rebound of the disease in endemic areas. Since 2005, a steady decline in infection rates was observed and it was hypothesized that the experiences and technological advances accumulated during the WBLP played a role. Nonetheless, relatively little is known about the long-term effects of the WBLP on schistosomiasis, particularly management mechanisms, technological innovations, epidemiological changes, and long-term economic impact. To fill these gaps, we systematically searched the literature for articles in English and Chinese on the WBLP on schistosomiasis from 1 January 1992 to 30 July 2022. Relevant studies were analyzed for short-, mid-, and long-term epidemiological and economic effects of the WBLP on schistosomiasis prevention, control, and elimination. Overall, 81 articles met our inclusion criteria, of which 17 were related to management mechanism reform, 20 pertained to technological innovation, and 44 examined epidemiological changes and economic effects. Most papers documented the WBLP as a positive contribution to schistosomiasis prevention and control in the People’s Republic of China. Regarding the long-term effects, there was a significant contribution to the national schistosomiasis control and elimination programme in terms of renewed management mechanisms, talent development, and technological innovation. In conclusion, the WBLP contributed to enhanced control of schistosomiasis and shaped the ultimate response towards schistosomiasis elimination in the People’s Republic of China. Experiences and lessons learned might guide schistosomiasis control and elimination elsewhere.
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Affiliation(s)
- Qin Li
- National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Jing Xu
- National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Shi-Zhu Li
- National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai 200025, China
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland
- University of Basel, CH-4001 Basel, Switzerland
| | - Donald P. McManus
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai 200025, China
- Correspondence:
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Grolimund CM, Bärenbold O, Utzinger J, Keiser J, Vounatsou P. Modeling the effect of different drugs and treatment regimen for hookworm on cure and egg reduction rates taking into account diagnostic error. PLoS Negl Trop Dis 2022; 16:e0010810. [PMID: 36194622 PMCID: PMC9595538 DOI: 10.1371/journal.pntd.0010810] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/25/2022] [Accepted: 09/12/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Hookworm infections, caused by Ancylostoma duodenale and Necator americanus, are of considerable public health importance. The World Health Organization recommends preventive chemotherapy as the key strategy for morbidity control. Meta-analyses have been conducted to estimate treatment efficacy of available drugs and drug combinations. However, in most studies, the relation between the diagnostic error and infection intensity have not been considered, resulting in an overestimation of cure rates (CRs). METHODOLOGY A Bayesian model was developed to compare the 'true' CR and egg reduction rate of different treatment regimens for hookworm infections taking into account the error of the recommended Kato-Katz thick smear diagnostic technique. It was fitted to the observed egg count data which was linked to the distribution of worms, considered the day-to-day variation of hookworm egg excretion and estimated the infection intensity-dependent sensitivity. The CR was obtained by defining the prevalence of infection at follow-up as the probability of having at least one fertilized female worm. The model was applied to individual-level egg count data available from 17 treatments and six clinical trials. PRINCIPAL FINDINGS Taking the diagnostic error into account resulted in considerably lower CRs than previously reported. Overall, of all treatments analyzed, mebendazole administered in six dosages of 100 mg each was the most efficacious treatment with a CR of 88% (95% Bayesian credible interval: 79-95%). Furthermore, diagnostic sensitivity varied with the infection intensity and sampling effort. For an infection intensity of 50 eggs per gram of stool, the sensitivity is close to 60%; for two Kato-Katz thick smears it increased to approximately 76%. CONCLUSIONS/SIGNIFICANCE Our model-based estimates provide the true efficacy of different treatment regimens against hookworm infection taking into account the diagnostic error of the Kato-Katz method. Estimates of the diagnostic sensitivity for different number of stool samples and thick smears are obtained. To accurately assess efficacy in clinical trials with the Kato-Katz method, at least two stool samples on consecutive days should be collected.
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Affiliation(s)
- Carla M. Grolimund
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Oliver Bärenbold
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Penelope Vounatsou
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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Matowo NS, Tanner M, Temba BA, Finda M, Mlacha YP, Utzinger J, Okumu FO. Participatory approaches for raising awareness among subsistence farmers in Tanzania about the spread of insecticide resistance in malaria vectors and the possible link to improper agricultural pesticide use. Malar J 2022; 21:277. [PMID: 36180865 PMCID: PMC9524312 DOI: 10.1186/s12936-022-04289-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
Background Insecticide resistance is a key barrier to long-term malaria control, and it may be exacerbated by poor agricultural pesticide use. Current practices, however, do not link public health and agricultural pesticide use. This study investigated the perspectives of farmers and other stakeholders regarding the integration of agricultural and public health measures to address resistance. Additionally, the feasibility of participatory workshops to increase the farmers’ understanding and participation in pesticide stewardship was assessed. Methods Four themes were investigated: pesticide awareness, practices, and opinions of; insecticide resistance in malaria vectors; the effectiveness of current malaria prevention tools; and the links between agricultural and public health pesticide usage. Participatory workshops and field training were held with entomologists, farmers, and agricultural specialists, focusing on agro-ecosystem practices related to pest control; and local farmers were involved in live-testing for insecticides resistance of local Anopheles mosquitoes. Results Most farmers (94%) considered pesticides effective, and nearly half of them (n = 198, 46.4%) could identify and name crop pests and diseases, mostly using local names. Three quarters were unaware of mosquito larvae in their fields, and only 7% considered their fields as potential sources of mosquitoes. Two thirds were uninformed of any effects that agricultural pesticides may have on mosquitoes, and three quarters had never heard of resistance in malaria mosquitoes. Experts from various sectors acknowledged that agricultural pesticides might impact malaria control through increasing resistance. They did, however, emphasize the importance of crop protection and advocated for the use of pesticides sparingly and non-chemical approaches. Farmers learnt how to discriminate between malaria vectors and non-vectors, identify agricultural pests and diseases, choose and use pesticides effectively, and conduct resistance tests during the participatory workshops. Conclusion This study emphasizes the significance of enhancing subsistence farmers’ awareness of mosquito ecology as well as merging public health and agricultural pest management measures. Participatory techniques have the potential to raise stakeholder awareness and engagement, resulting in more effective resistance management.
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Affiliation(s)
- Nancy Stephen Matowo
- Environmental and Ecological Sciences Department, Ifakara Health Institute, Ifakara, Tanzania. .,Swiss Tropical and Public Health Institute, Allschwil, Switzerland. .,University of Basel, Basel, Switzerland. .,Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
| | - Marcel Tanner
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.,University of Basel, Basel, Switzerland
| | - Benigni Alfred Temba
- Department of Veterinary Physiology, Pharmacology and Toxicology, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Marceline Finda
- Environmental and Ecological Sciences Department, Ifakara Health Institute, Ifakara, Tanzania
| | - Yeromin Paul Mlacha
- Environmental and Ecological Sciences Department, Ifakara Health Institute, Ifakara, Tanzania.,Swiss Tropical and Public Health Institute, Allschwil, Switzerland.,University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.,University of Basel, Basel, Switzerland
| | - Fredros Oketch Okumu
- Environmental and Ecological Sciences Department, Ifakara Health Institute, Ifakara, Tanzania.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
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Gerber M, Lang C, Beckmann J, du Randt R, Long KZ, Müller I, Nienaber M, Probst-Hensch N, Steinmann P, Pühse U, Utzinger J, Nqweniso S, Walter C. Physical Activity, Sedentary Behaviour, Weight Status, and Body Composition among South African Primary Schoolchildren. Int J Environ Res Public Health 2022; 19:ijerph191811836. [PMID: 36142108 PMCID: PMC9517541 DOI: 10.3390/ijerph191811836] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/05/2022] [Accepted: 09/14/2022] [Indexed: 05/17/2023]
Abstract
Background: Over the past decades, childhood overweight has increased in many African countries. We examined the relationship between sedentary behaviour, moderate-to-vigorous physical activity (MVPA), and body composition in South African primary schoolchildren living in peri-urban settings. Methods: MVPA was measured via 7-day accelerometry and body composition via bioelectrical impedance analysis in 1090 learners (49.2% girls, Mage = 8.3 ± 1.4 years). The relationships between MVPA and sedentary behaviour with the various body composition indicators (body fat and fat-free mass [total, truncal, arms, and legs], bone mass, muscle mass, and body water) were tested with mixed linear regressions. Results: The prevalence of overweight and obesity was 9.8% and 6.6%, respectively; 77.1% of the children engaged in ≥60 min of MVPA/day. Girls were more likely to be overweight/obese, to accumulate less than 60 min of MVPA/day, and had significantly higher relative body fat than boys (ps < 0.001). Lower MVPA was associated with a higher likelihood of being overweight/obese, higher relative body fat, and lower relative fat-free mass, bone mass, muscle mass, and body water (ps < 0.001). For lower sedentary behaviour, the associations with body composition pointed in the opposite direction. Conclusions: In this South African setting, girls are a particularly relevant target group for future physical activity interventions to prevent overweight/obesity-related non-communicable diseases in later life.
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Affiliation(s)
- Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, CH-4052 Basel, Switzerland
- Correspondence: ; Tel.: +41-61-207-4783
| | - Christin Lang
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, CH-4052 Basel, Switzerland
| | - Johanna Beckmann
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, CH-4052 Basel, Switzerland
| | - Rosa du Randt
- Human Movement Science, Nelson Mandela University, P.O. Box 7700, Gqeberha 6031, South Africa
| | - Kurt Z. Long
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland
- University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland
| | - Ivan Müller
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, CH-4052 Basel, Switzerland
| | - Madeleine Nienaber
- Human Movement Science, Nelson Mandela University, P.O. Box 7700, Gqeberha 6031, South Africa
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland
- University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland
- University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, CH-4052 Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland
- University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland
| | - Siphesihle Nqweniso
- Human Movement Science, Nelson Mandela University, P.O. Box 7700, Gqeberha 6031, South Africa
| | - Cheryl Walter
- Human Movement Science, Nelson Mandela University, P.O. Box 7700, Gqeberha 6031, South Africa
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Olliaro PL, Vaillant MT, Diawara A, Speich B, Albonico M, Utzinger J, Keiser J. Egg excretion indicators for the measurement of soil-transmitted helminth response to treatment. PLoS Negl Trop Dis 2022; 16:e0010593. [PMID: 35917364 PMCID: PMC9374261 DOI: 10.1371/journal.pntd.0010593] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 08/12/2022] [Accepted: 06/18/2022] [Indexed: 11/30/2022] Open
Abstract
Background Periodic administration of anthelmintic drugs is a cost-effective intervention for morbidity control of soil-transmitted helminth (STH) infections. However, with programs expanding, drug pressure potentially selecting for drug-resistant parasites increases. While monitoring anthelmintic drug efficacy is crucial to inform country control program strategies, different factors must be taken into consideration that influence drug efficacy and make it difficult to standardize treatment outcome measures. We aimed to identify suitable approaches to assess and compare the efficacy of different anthelmintic treatments. Methodology We built an individual participant-level database from 11 randomized controlled trials and two observational studies in which subjects received single-agent or combination therapy, or placebo. Eggs per gram of stool were calculated from egg counts at baseline and post-treatment. Egg reduction rates (ERR; based on mean group egg counts) and individual-patient ERR (iERR) were utilized to express drug efficacy and analyzed after log-transformation with a linear mixed effect model. The analyses were separated by follow-up duration (14–21 and 22–45 days) after drug administration. Principal findings The 13 studies enrolled 5,759 STH stool-positive individuals; 5,688 received active medication or placebo contributing a total of 11,103 STH infections (65% had two or three concurrent infections), of whom 3,904 (8,503 infections) and 1,784 (2,550 infections) had efficacy assessed at 14–21 days and 22–45 days post-treatment, respectively. Neither the number of helminth co-infections nor duration of follow-up affected ERR for any helminth species. The number of participants treated with single-dose albendazole was 689 (18%), with single-dose mebendazole 658 (17%), and with albendazole-based co-administrations 775 (23%). The overall mean ERR assessed by day 14–21 for albendazole and mebendazole was 94.5% and 87.4%, respectively on Ascaris lumbricoides, 86.8% and 40.8% on hookworm, and 44.9% and 23.8% on Trichuris trichiura. The World Health Organization (WHO) recommended criteria for efficacy were met in 50%, 62%, and 33% studies of albendazole for A. lumbricoides, T. trichiura, and hookworm, respectively and 25% of mebendazole studies. iERR analyses showed similar results, with cure achieved in 92% of A. lumbricoides-infected subjects treated with albendazole and 93% with mebendazole; corresponding figures for hookworm were 70% and 17%, and for T. trichiura 22% and 20%. Conclusions/significance Combining the traditional efficacy assessment using group averages with individual responses provides a more complete picture of how anthelmintic treatments perform. Most treatments analyzed fail to meet the WHO minimal criteria for efficacy based on group means. Drug combinations (i.e., albendazole-ivermectin and albendazole-oxantel pamoate) are promising treatments for STH infections. To reduce morbidity caused by parasitic worm infections, hundreds of million treatments are given to children every year through repeat cycles of single-dose deworming drugs. This strategy works, and is cost-effective. However, the downside is drug pressure that potentially selects for resistant parasites. Hence, there is a need to monitor treatment efficacy, and do so in a way that allows us to pick up early any deterioration in treatment effects. We analyzed data from 13 trials that enrolled 5,688 infected people who were given deworming drugs or a placebo, by calculating the reduction in worm egg counts in their stools from before to 14–21 and 22–45 days after treatment using different methods. We found that many people harbored more than one species of parasitic worms. Neither multiple infections, nor the intensity of infection, or whether effects were measured earlier or later, appeared to affect treatment efficacy. We also found that the most common treatments are only partially effective. The World Health Organization recommended criteria for efficacy were met in 50%, 62%, and 33% studies of albendazole for roundworm, whipworm, and hookworm, respectively and in 25% of mebendazole studies. In addition, we confirmed that combinations of albendazole-ivermectin and albendazole-oxantel pamoate are promising treatments.
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Affiliation(s)
- Piero L. Olliaro
- International Severe Acute Respiratory and Emerging Infection Consortium, Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom
| | - Michel T. Vaillant
- Centre of Competence for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
- * E-mail:
| | - Aïssatou Diawara
- Program in Biology, Division of Science and Mathematics, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- The Global Institute for Disease Elimination, Abu Dhabi, United Arab Emirates
| | - Benjamin Speich
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Qian MB, Patel C, Palmeirim MS, Wang X, Schindler C, Utzinger J, Zhou XN, Keiser J. Efficacy of drugs against clonorchiasis and opisthorchiasis: a systematic review and network meta-analysis. The Lancet Microbe 2022; 3:e616-e624. [DOI: 10.1016/s2666-5247(22)00026-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 12/21/2021] [Accepted: 01/20/2022] [Indexed: 10/18/2022] Open
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Pradyumna A, Mishra A, Utzinger J, Winkler MS. Health in Food Systems Policies in India: A Document Review. Int J Health Policy Manag 2022; 11:1158-1171. [PMID: 33904697 PMCID: PMC9808200 DOI: 10.34172/ijhpm.2021.18] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 02/23/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Food systems affect nutritional and other health outcomes. Recent literature from India has described policy aspects addressing nutritional implications of specific foods (eg, fruits, vegetables, and trans-fats), and identified opportunities to tackle the double burden of malnutrition. This paper attempts to deepen the understanding on how health concerns and the role of the health sector are addressed across food systems policies in India. METHODS This qualitative study used two approaches; namely (i) the framework method and (ii) manifest content analysis, to investigate national-level policy documents from relevant sectors (ie, food security, agriculture, biodiversity, food processing, trade, and waste management, besides health and nutrition). The documents were selected purposively. The textual data were coded and compared, from which themes were identified, described, and interpreted. Additionally, mentions of various health concerns and of the health ministry in the included documents were recorded and collated. RESULTS A total of 35 policy documents were included in the analysis. A variety of health concerns spanning nutritional, communicable and non-communicable diseases (NCDs) were mentioned. Undernutrition received specific attention even beyond nutrition policies. Only few policies mentioned NCDs, infectious diseases, and injuries. Governing and advisory bodies were instituted by 17 of the analysed policies (eg, food safety, agriculture, and food processing), and often included representation from the health ministry (9 of the 17 identified inter-ministerial bodies). CONCLUSION We found some evidence of concern for health, and inclusion of health ministry in food policy documents in India. The ongoing and planned intersectoral coordination to tackle undernutrition could inform actions to address other relevant but currently underappreciated concerns such as NCDs. Our study demonstrated a method for analysis of health consideration and intersectoral coordination in food policy documents, which could be applied to studies in other settings and policy domains.
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Affiliation(s)
- Adithya Pradyumna
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Azim Premji University, Bengaluru, India
| | | | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Mirko S. Winkler
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Dolley D, Walter C, du Randt R, Pühse U, Bosma J, Aerts A, Adams L, Arnaiz P, Degen J, Gall S, Joubert N, Müller I, Nienaber M, Nqweniso F, Seelig H, Steinmann P, Utzinger J, Gerber M. Clustered cardiovascular disease risk among children aged 8–13 years from lower socioeconomic schools in Gqeberha, South Africa. BMJ Open Sport Exerc Med 2022; 8:e001336. [PMID: 35813129 PMCID: PMC9234795 DOI: 10.1136/bmjsem-2022-001336] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2022] [Indexed: 11/04/2022] Open
Abstract
ObjectivesTo determine the prevalence of individual cardiovascular disease (CVD) risk factors and clustered CVD risk among children attending schools in periurban areas of Gqeberha and to investigate the independent association between clustered CVD risk, moderate to vigorous physical activity (MVPA) and cardiorespiratory fitness (CRF).MethodsBaseline data were collected in a cross-sectional analysis of 975 children aged 8–13 years. We measured the height, weight, waist circumference, blood pressure, fasting glucose, full lipid panel, 20 m shuttle run performance and accelerometry. The prevalence of individual risk factors was determined, and a clustered risk score (CRS) was constructed using principal component analysis. Children with an elevated CRS of 1 SD above the average CRS were considered ‘at-risk’.ResultsWe found 424 children (43.3%) having at least one elevated CVD risk factor: 27.7% elevated triglycerides, 20.7% depressed high-density lipoprotein cholesterol and 15.9% elevated total cholesterol. An elevated clustered risk was identified in 17% (n=104) of the sample; girls exhibited a significantly higher CRS >1 SD than boys (p=0.036). The estimated odds of an elevated clustered risk are doubled every 2 mL/kg/min decrease in VO2max (95% CI 1.66 to 3.12) or every 49 min reduction in MVPA (95% CI 27 to 224).ConclusionA relatively high prevalence of elevated individual and clustered CVD risk was identified. Our results have also confirmed the independent inverse association of the clustered CVD risk with physical activity and CRF. These indicate that increased levels of CRF or MVPA may aid in the prevention and reduction of elevated clustered CVD risk.
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Affiliation(s)
- Danielle Dolley
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, Eastern Cape, South Africa
| | - Cheryl Walter
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, Eastern Cape, South Africa
| | - Rosa du Randt
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, Eastern Cape, South Africa
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Jacob Bosma
- Nelson Mandela University, Gqeberha, South Africa
| | - Ann Aerts
- Novartis Foundation, Basel, Switzerland
| | - Larissa Adams
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, Eastern Cape, South Africa
| | - Patricia Arnaiz
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Jan Degen
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Stefanie Gall
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Nandi Joubert
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Ivan Müller
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Madeleine Nienaber
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, Eastern Cape, South Africa
| | - Felicitas Nqweniso
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, Eastern Cape, South Africa
| | - Harald Seelig
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Pessoa Colombo V, Chenal J, Koné B, Bosch M, Utzinger J. Using Open-Access Data to Explore Relations between Urban Landscapes and Diarrhoeal Diseases in Côte d’Ivoire. IJERPH 2022; 19:ijerph19137677. [PMID: 35805337 PMCID: PMC9265306 DOI: 10.3390/ijerph19137677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 02/01/2023]
Abstract
Unlike water and sanitation infrastructures or socio-economic indicators, landscape features are seldomly considered as predictors of diarrhoea. In contexts of rapid urbanisation and changes in the physical environment, urban planners and public health managers could benefit from a deeper understanding of the relationship between landscape patterns and health outcomes. We conducted an ecological analysis based on a large ensemble of open-access data to identify specific landscape features associated with diarrhoea. Designed as a proof-of-concept study, our research focused on Côte d’Ivoire. This analysis aimed to (i) build a framework strictly based on open-access data and open-source software to investigate diarrhoea risk factors originating from the physical environment and (ii) understand whether different types and forms of urban settlements are associated with different prevalence rates of diarrhoea. We advanced landscape patterns as variables of exposure and tested their association with the prevalence of diarrhoea among children under the age of five years through multiple regression models. A specific urban landscape pattern was significantly associated with diarrhoea. We conclude that, while the improvement of water, sanitation, and hygiene infrastructures is crucial to prevent diarrhoeal diseases, the health benefits of such improvements may be hampered if the overall physical environment remains precarious.
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Affiliation(s)
- Vitor Pessoa Colombo
- School of Architecture, Civil and Environmental Engineering, École Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland; (J.C.); (M.B.)
- Correspondence:
| | - Jérôme Chenal
- School of Architecture, Civil and Environmental Engineering, École Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland; (J.C.); (M.B.)
| | - Brama Koné
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan 01 BP 1303, Côte d’Ivoire;
| | - Martí Bosch
- School of Architecture, Civil and Environmental Engineering, École Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland; (J.C.); (M.B.)
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland;
- University of Basel, 4001 Basel, Switzerland
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Beckmann J, Nqweniso S, Ludyga S, du Randt R, Gresse A, Long KZ, Nienaber M, Seelig H, Pühse U, Steinmann P, Utzinger J, Walter C, Gerber M, Lang C. Evaluation of a Physical Activity and Multi-Micronutrient Intervention on Cognitive and Academic Performance in South African Primary Schoolchildren. Nutrients 2022; 14:nu14132609. [PMID: 35807790 PMCID: PMC9268611 DOI: 10.3390/nu14132609] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/08/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
Executive functions (EFs) are essential for optimal academic development. Appropriate nutrition and physical activity (PA) have been shown to facilitate optimal cognitive development. Therefore, this study examined whether a 12-week school-based PA and multi-micronutrient supplementation (MMNS) intervention would improve cognitive and academic performance. A cluster-randomized controlled trial (RCT) was conducted. Children from four schools located in a peri-urban area of South Africa were randomly assigned to (i) PA + MMNS, (ii) PA + placebo, (iii) MMNS or (iv) placebo. Information processing and inhibitory control were measured with a computerized Flanker task. End-of-year results provided insight into academic achievement. Anthropometric measures were used to determine nutritional status. Data were analyzed with linear mixed-models, adjusting for baseline scores, school classes and age; 932 children (458 girls (49.1%), Mage (mean age) = 8.42 ± 1.94 years) completed baseline and post-intervention assessments. Cognitive performance improved among all four groups, with no significant group × time effects. For academic achievement, there was no significant interaction effect between the combined intervention group and placebo. We encourage future studies in this neglected area in order to determine the most optimal design of school-based nutrition and PA programs to enhance overall cognitive performance.
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Affiliation(s)
- Johanna Beckmann
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland; (S.L.); (H.S.); (U.P.); (M.G.); (C.L.)
- Correspondence:
| | - Siphesihle Nqweniso
- Department of Human Movement Science, Nelson Mandela University, Gqeberha 6011, South Africa; (S.N.); (R.d.R.); (M.N.); (C.W.)
| | - Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland; (S.L.); (H.S.); (U.P.); (M.G.); (C.L.)
| | - Rosa du Randt
- Department of Human Movement Science, Nelson Mandela University, Gqeberha 6011, South Africa; (S.N.); (R.d.R.); (M.N.); (C.W.)
| | - Annelie Gresse
- Department of Human Nutrition and Dietetics, Nelson Mandela University, Gqeberha 6031, South Africa;
| | - Kurt Z. Long
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland; (K.Z.L.); (P.S.); (J.U.)
| | - Madeleine Nienaber
- Department of Human Movement Science, Nelson Mandela University, Gqeberha 6011, South Africa; (S.N.); (R.d.R.); (M.N.); (C.W.)
| | - Harald Seelig
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland; (S.L.); (H.S.); (U.P.); (M.G.); (C.L.)
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland; (S.L.); (H.S.); (U.P.); (M.G.); (C.L.)
| | - Peter Steinmann
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland; (K.Z.L.); (P.S.); (J.U.)
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland; (K.Z.L.); (P.S.); (J.U.)
| | - Cheryl Walter
- Department of Human Movement Science, Nelson Mandela University, Gqeberha 6011, South Africa; (S.N.); (R.d.R.); (M.N.); (C.W.)
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland; (S.L.); (H.S.); (U.P.); (M.G.); (C.L.)
| | - Christin Lang
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland; (S.L.); (H.S.); (U.P.); (M.G.); (C.L.)
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