Abbasi, Kamran; Ali, Parveen; Barbour, Virginia; Benfield, Thomas; Bibbins-Domingo, Kirsten; Hancocks, Stephen; Horton, Richard; Laybourn-Langton, Laurie; Mash, Robert; Sahni, Peush; Sharief, Wadeia Mohammad; Yonga, Paul; Zielinski, Chris
doi: 10.1093/trstmh/trad075pmid: 37880156
de Freitas, Beatriz Sales; Fernandes, Gabriel Haiek; Pereira, Ana Carolina Esteves da Silva; Peixoto, Henry Maia
doi: 10.1093/trstmh/trad069pmid: 37772768
To provide a continuous update on the safety and efficacy of artesunate-mefloquine (ASMQ) compared with other artemisinin combination therapy (ACT) schemes used in the treatment of uncomplicated malaria caused by Plasmodium falciparum, this study updated and expanded the results of the systematic literature review published in 2016. Only randomised controlled clinical trials published from 1 January 2001 to 12 June 2023 from five databases were included in this study. The results related to efficacy, expressed through RR, were summarized in meta-analyses, performed according to the compared ACTs and with the intention-to-treat and per-protocol analyses. The results related to safety were synthesized in a descriptive manner. Thirty-two studies were included, of which 24 had been analysed in the 2016 review and eight new ones were added. Although the methodological quality of most studies was considered moderate, the body of evidence gathered indicates that ASMQ continues to be safe and effective for the treatment of uncomplicated infections caused by P. falciparum compared with other ACTs. However, the inclusion of two new studies, which identified failure rates exceeding 10%, suggests a possible reduction in the efficacy of ASMQ in the analysed locations. The incidence of serious adverse effects, such as seizure, encephalopathy and cardiac arrhythmia, was infrequent in both the ASMQ group and the comparison groups. After including new evidence, ASMQ is still recommended as a first-line treatment of uncomplicated malaria caused by P. falciparum, although local aspects need to be considered.
Assoni, Letícia Carolina Paraboli; Nakashima, Fabiana; de Sousa, Valquíria Pardo; Paduan, Natália Juliana; Andreasse, Isabela Rufino; Anghinoni, Thelma Helena; de Faria Junior, Geraldo Magela; Ricci Junior, Octávio; Castiglioni, Lilian; Brandão, Cinara Cássia; de Mattos, Luiz Carlos; Ayo, Christiane Maria
Yirgu, Robel; Middleton, Jo; Fekadu, Abebaw; Davey, Gail; Bremner, Stephen; Jones, Christopher Iain; Cassell, Jackie A
doi: 10.1093/trstmh/trad061pmid: 37665766
ABSTRACTBackgroundMass drug administration (MDA) is among the five major strategies that are currently in use to control, eliminate or eradicate Neglected Tropical Diseases (NTDs). Optimising MDA to control multiple NTDs maximises impact. The objective of this study is to estimate the secondary impact of ivermectin MDA for onchocerciasis on the prevalence of scabies.MethodsThis quasi-experimental study was conducted in Ayu Guagusa district, northwestern Ethiopia. Scabies prevalence was estimated in surveys before the MDA, at 6 and 12 months afterwards. The sample size was 1437 people from a panel of 381 randomly selected study households. Multistage sampling was employed in randomly selecting six kebeles (the lowest administrative unit) with respective gotes (small villages) and households. All members of the selected households were invited to participate in the study and participants who were available in all three surveys formed a cohort.ResultsScabies prevalence was similar prior to the MDA (13.4%, 95% CI 11.7 to 15.2%) and 6 months after (11.7%, 95% CI 10.1 to 13.2%) but was substantially greater at 12 months (22.1%, 95% CI 20.1 to 24.1%). The 6-month incidence and disappearance rates were 10.8% (95% CI 8.8 to 13.2%) and 82.6% (95% CI 75.0 to 88.6%), respectively.ConclusionsIvermectin MDA for onchocerciasis was not observed to have a secondary impact on the prevalence of scabies over the follow-up period of 12 months.
Méndez-Molina, Ricardo; Villela-Oriza, Ailed Karola; Espinosa-Couoh, Andrea Ariadne; Huchim-Lara, Oswaldo
doi: 10.1093/trstmh/trad070pmid: 37746875
ABSTRACTBackgroundGlobally, snakebites have a significant impact on public health and represent substantial costs for health services. Their severity is particularly relevant in developing countries due to the lack of resources and accessibility to health facilities. Additionally, the number of cases may be underestimated, highlighting the urgent need for improved prevention measures.MethodsAn observational ecological study was undertaken using the records identified with X200–X209 codes registered in the Ministry of Health injuries database during 2010–2022. Variables included information related to the patient, the snakebite and the healthcare provided. Statistical analysis was carried out with STATA 16 and Microsoft Excel 2020.ResultsA total of 10 420 snakebites were registered. The average number of cases per year was 788 (IQR 615, 875) and 82.74% occurred during the rainy season. The median age was 35 (IQR 19, 52) y and early adulthood was the most affected age group; bites were most common on the hand and in the living place. The Eastern region of Mexico registered the highest number of cases, with 3496 (33.71%) of snakebites. The lethality rate was 18.23 per 10 000.ConclusionsSnakebites are a significant health problem in Mexico. Most injuries occur among men in early adulthood, in households and in the upper extremities.
Boté-Casamitjana, Anna; Faye-Joof, Tisbeh; Bah, Ousman; Jallow, Sira; Camara, Alagie; Jallow, Olimatou; Mohammed, Nuredin; Forrest, Karen; Nadjm, Behzad
doi: 10.1093/trstmh/trad071pmid: 37818849
ABSTRACTBackgroundHuman immunodeficiency virus (HIV) rapid diagnostic tests (RDTs) are widely used. However, buffer stockouts commonly lead to utilising non-approved liquids, resulting in errors. Our aim was to evaluate the diagnostic accuracy of an alternative buffer.MethodsPaired Determine HIV-1/2 rapid tests with commercial buffer and locally produced 0.01M phosphate-buffered saline (PBS) were performed on consecutive consenting individuals requiring HIV testing. Serum samples were sent for confirmation through the local gold-standard algorithm (Murex HIV Ag/Ab, Hexagon HIV with/without Geenius HIV 1/2). Test accuracy, κ and exact McNemar's test were also carried out.ResultsOf 167 participants, 137 had confirmatory testing. The sensitivity of the Determine HIV-1/2 test using PBS compared with the gold standard was 100% (95% confidence interval [CI] 90.5 to 100) with a specificity of 98% (95% CI 92.9 to 99.8). The κ value was 0.94 compared with the gold standard and 0.92 compared with the Determine HIV-1/2 test using the commercial buffer. McNemar's test showed no evidence of differing sensitivities. Due to operational constraints, the study included 37 of the 49 positive cases as determined by the sample size calculation, resulting in an attained power of 80% instead of the intended 90%.ConclusionsThese results suggest that 0.01M PBS is an alternative solution for Determine HIV-1/2 when buffer stockouts occur.
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ABSTRACTBackgroundDengue (DENV), Zika (ZIKV) and chikungunya (CHIKV) viruses are transmitted mainly by Aedes mosquitoes and are responsible for a significant global healthcare burden. The current study aimed to detect arboviruses in the Aedes mosquitoes in close proximity of patients during the transmission season.MethodsBoth immature and adult mosquitoes were collected from in and around the patients’ houses. Mosquito pools were homogenized and extracted RNA was subjected to reverse transcription polymerase chain reaction for arboviral detection. Transovarian transmission (TOT) was assessed by screening F0 adults. Mosquito positivity was correlated with the aetiological agents identified in patients.ResultsOf 46 pools, 19 consisted of wild Aedes, with arboviral positivity in 53% (10/19) of pools. Among wild A. aegypti pools, positivity of DENV mono-infection, CHIKV mono-infection and DENV+CHIKV co-infection was noted in four, two and three pools, respectively. One wild pool of Aedes albopictus was positive for DENV-1. Similarly, A. aegypti F0 (adult Aedes developed from immatures) pools showed 59.2% (16/27) positivity for arboviruses. F0 Aedes showed positivity in three, six and seven pools for DENV-2, CHIKV and DENV+CHIKV, respectively, suggestive of TOT. DENV serotypes and CHIKV from 24 patients’ serum samples were matched with strains isolated from Aedes and correlation was observed in four instances.ConclusionsThe study detected DENV and CHIKV from wild-caught Aedes and found evidence of DENV and CHIKV TOT in F0 adults.
doi: 10.1093/trstmh/trad060pmid: 37647457
ABSTRACTBackgroundToxoplasmosis is one of the most common parasitic infections worldwide with varying prevalence between human populations. These variations are mainly associated with human exposure to risk factors. In this article, the seroprevalence of Toxoplasma gondii infection and the risk factors associated with infection in 1729 blood donors from São José do Rio Preto, São Paulo, Brazil were analysed.MethodsThe serological tests for detecting immunoglobulin M (IgM) and immunoglobulin G (IgG) anti-T. gondii were used. The risk factors associated with the infection were identified through the application of an epidemiological questionnaire.ResultsThe prevalence of T. gondii infection was 48.0%. The following factors were identified in the final model after multiple logistic regression analysis: drinking raw milk (p=0.003; odds ratio [OR] 1.364 [confidence interval {CI} 1.1 to 1.7]), residing in a rural area (p<0.0001; OR 2.764 [CI 1.7 to 4.6]) and receiving a blood transfusion (p=0.015; OR 1.856 [CI 1.1 to 3.0]).ConclusionsThe data obtained in this study showed that the blood donor population is exposed to risk factors related to infection by T. gondii. These data allow the establishment of control programs to contribute to public health in northwestern São Paulo state.