Tropical Medicine & International Health最新文献

{"title":"Progress towards the elimination of trachoma as a public health problem in four counties of Eastern Equatoria State, Republic of South Sudan.","authors":"Stephen Ohidor, Nicholas A Presley, Angelia M Sanders, Andrew W Nute, Tania A Gonzalez, Yak Yak Bol, Albino W Nyibong, Paul Weiss, James Niquette, E Kelly Callahan, Scott D Nash","doi":"10.1111/tmi.14078","DOIUrl":"10.1111/tmi.14078","url":null,"abstract":"<p><strong>Background: </strong>Trachoma is targeted by the World Health Organization (WHO) for elimination as a public health problem by 2030. Trachoma impact surveys using standardised methodology are recommended to monitor progress towards elimination and to determine eligibility for continued surgery, antibiotics, facial cleanliness, and environmental improvement (SAFE) interventions. From 2007 to 2015, four counties of Eastern Equatoria State, South Sudan, received three to five rounds of mass drug administration with antibiotics. A trachoma impact survey in 2015 indicated all four counties had trachomatous-inflammation follicular prevalence among children ages 1-9 years above the WHO elimination threshold (range 17.4%-47.6%). Based on these results, the recommended number of years of SAFE interventions were implemented and the counties were subsequently resurveyed.</p><p><strong>Methods: </strong>Between 2021 and 2023, trachoma impact surveys were conducted in Budi, Kapoeta East, Kapoeta North, and Kapoeta South counties using a two-stage cluster sample design. Trained and certified graders examined participants for trachoma clinical signs using the WHO simplified grading system to estimate county-level prevalence.</p><p><strong>Results: </strong>A total of 12,570 individuals from 3286 households in 116 survey clusters were examined for trachoma. Prevalence of trachomatous-inflammation follicular among children ages 1-9 years was 5.6% (95% confidence interval [CI]:3.7%-8.3%) in Kapoeta South, 7.4% (CI:5.1%-10.7%) in Budi, 12.3% (CI:7.8%-18.9%) in Kapoeta East, and 18.1% (CI:13.5%-24.0%) in Kapoeta North. Trachomatous inflammation-intense prevalence among children ages 1-9 years ranged from 0.4% (CI:0.2%-1.0%) in Kapoeta East to 2.1% (CI:1.4%-3.2%) in Kapoeta North, and trachomatous trichiasis in individuals ages ≥15 years ranged from 1.0% (CI:0.5%-2.1%) in Kapoeta North to 1.9% (CI:1.3%-2.8%) in Budi.</p><p><strong>Conclusions: </strong>As no county reached the WHO elimination thresholds of trachomatous-inflammation follicular <5% or trachomatous trichiasis <0.2%, SAFE interventions should continue. Furthermore, these districts are classified as having persistent trachoma, based on trachomatous-inflammation follicular levels remaining >5% after two impact surveys. Compared to results from 2015, the prevalence of trachomatous-inflammation follicular, trachomatous inflammation-intense, and trachomatous trichiasis in all counties decreased, indicating that the Republic of South Sudan Ministry of Health's Trachoma Control Program is advancing towards its elimination goal.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"159-169"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of sensory deficits in fine nerve fibres in leprosy diagnosis.","authors":"Ismael Alves Rodrigues Júnior, Ana Thereza Chaves, Luciana Cardoso de Andrade, Sandra Lyon, Maria Aparecida de Faria Grossi, Ramayana Morais de Medeiros Brito, Ana Laura Grossi de Oliveira, Manoel de Figueiredo Villarroel, Manoel Otávio da Costa Rocha","doi":"10.1111/tmi.14079","DOIUrl":"10.1111/tmi.14079","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to determine reference points for thermal perception in cutaneous lesions of leprosy, a disease caused by Mycobacterium leprae characterised by hypoesthesia in skin lesions due to nerve and Schwann cell infection. Early diagnosis is essential to control transmission and effectively treat the disease.</p><p><strong>Methods: </strong>Quantitative thermal testing (QTT) has been proposed as a valuable tool for early detection of the disease, initiation of treatment, and monitoring of nerve damage. A thermal analyser was used to determine warm and cold perception thresholds (WPT and CPT, respectively) in skin lesions of 42 leprosy patients and 22 healthy controls.</p><p><strong>Results: </strong>The thresholds were determined using a 0.25 cm² thermal stimulator, the method of limits, and the receiver operating characteristic (ROC) curve. Thermal thresholds were higher in patients' skin lesions compared to unaffected areas and controls. The reference points calculated for the WPT and CPT were 36.55 and 26.35°C, respectively, with high sensitivity and specificity.</p><p><strong>Conclusion: </strong>The nerve fibres affected by leprosy caused altered thermal sensitivity in the patients' lesions, especially in warm sensation. A smaller thermal stimulator and the method of limits were effective in detecting early sensory deficits in nerve fibres, demonstrating the potential for early detection of the disease.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"170-180"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life in Chagas cardiomyopathy: Development of a theoretical model.","authors":"Whesley Tanor Silva, Mauro Felippe Felix Mediano, Lucas Frois Fernandes de Oliveira, Keity Lamary Souza Silva, Matheus Ribeiro Ávila, Thaís Souza Azevedo, Marcus Alessandro de Alcantara, Alessandra de Carvalho Bastone, Renato Guilherme Trede Filho, Vanessa Pereira Lima, Ana Cristina Rodrigues Lacerda, Vanessa Amaral Mendonça, Sanny Cristina de Castro Faria, Daniel Menezes Souza, Luciano Fonseca Lemos de Oliveira, Pedro Henrique Scheidt Figueiredo, Henrique Silveira Costa","doi":"10.1111/tmi.14087","DOIUrl":"10.1111/tmi.14087","url":null,"abstract":"<p><strong>Objective: </strong>Chagas disease can cause several complications, such as Chagas cardiomyopathy, the most severe clinical form of the disease. Chagas cardiomyopathy is complex and involves biological and psychosocial factors that can compromise health-related quality of life. However, it is necessary to establish interactions that significantly impact the health-related quality of life of this population. Therefore, we aimed to develop and present a theoretical model on the impact of Chagas cardiomyopathy on the health-related quality of life of patients.</p><p><strong>Methods: </strong>This is a cross-sectional study with a multi-methodology approach. The model's development process relied on the findings of a systematic review of qualitative studies, as well as a qualitative study involving participants from original communities, conventional rural areas and urban centres. Patients diagnosed with Chagas cardiomyopathy were interviewed using a semistructured research script, and the sample size was determined by theoretical saturation. Ultimately, the model underwent evaluation and received approval from three specialists in Chagas cardiomyopathy.</p><p><strong>Results: </strong>Patients experience many emotional conflicts, manifested by feelings of sadness, existential emptiness and anxiety. They have fears related to the course of the disease, the inability to care for the people they love, their suffering and that of the family caregivers, as well as the fear of invasive treatments and death. The model based on social determinants of health was created and presented three different levels of factors that impact patients' health-related quality of life. At the first and most external level are social, cultural and environmental conditions: absence from work, difficulties in accessing healthcare services, limited resources for specialised care and geographical barriers to accessing healthcare services. At a more internally committed level, there are social factors and community networks encompassing social isolation, family conflicts, social stigma, emotional aspects, fears and disabilities. The innermost layer of factors represents personal and behavioural complaints, such as physical ailments and poor sleep quality.</p><p><strong>Conclusion: </strong>The factors that affect the health-related quality of life of patients with Chagas cardiomyopathy are diverse in their biopsychosocial nature.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"219-230"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotypic and genotypic landscape of antibiotic resistance through One Health approach in Sri Lanka: A systematic review.","authors":"Thilini Nisansala, Yasodhara Deepachandi Gunasekara, Nadisha Sewwandi Piyarathne","doi":"10.1111/tmi.14084","DOIUrl":"10.1111/tmi.14084","url":null,"abstract":"<p><strong>Objectives: </strong>Antibiotic resistance (ABR) constitutes a significant burden to economies in developing countries. In the 'One-Health' concept, ABR in human, animals, and environment is interconnected. The aim of this study was to critically appraise literature on ABR in all three domains in One Health, within the Sri Lankan geographical context.</p><p><strong>Methods: </strong>The protocol was registered with PROSPERO and followed PRISMA 2020 guidelines. A comprehensive electronic literature search was conducted in PubMed, Scopus, Web of Science databases and grey literature via Google Scholar. Out of 298 abstracts, 37 articles were selected following screening. A risk of bias assessment was conducted using Joanna Briggs Institute tools. Following blinded data extraction, descriptive data analysis and narrative synthesis were performed.</p><p><strong>Results: </strong>This review included studies published between 2016-2023. Of the included studies, 17 (45.9%) reported data on samples obtained from humans, 9 (24.3%) from animals, and 6 (16.2%) from environmental sources, two studies (5.4%) from humans and animals, one study on animal and environment; whereas two studies including all three domains. ABR of 32 different bacteria (Gram negative⸺17, Gram positive⸺14) was retrieved; E. coli was the most frequently studied bacteria followed by MRSA and ESBL. For E. coli, a median resistance over 50% was reported for sulfamethoxazole (88.8%), trimethoprim (79.1%), ampicillin (60%) and tetracycline (50.3%) with the highest resistance for erythromycin (98%). Of a total of 21 antibiotic-resistance genes in E. coli, the highest genotypic resistance was for tet-A (48.5%).</p><p><strong>Conclusions: </strong>A comprehensive description of ABR for a total of 32 bacteria, 62 antibiotics and 46 ABR genes is presented. This review discusses the contemporary ABR landscape in Sri Lanka through the One Health lens, highlighting key methodological and empirical research gaps.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":"30 3","pages":"143-158"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cost of the production and release of male Aedes aegypti mosquitoes sterilised by irradiation.","authors":"A Baly, R Gato, Z Garcia, M Rodriguez, P Van der Stuyft","doi":"10.1111/tmi.14086","DOIUrl":"10.1111/tmi.14086","url":null,"abstract":"<p><strong>Introduction: </strong>Classic vector control tools do not sustainably reduce Aedes populations or prevent the surge of arboviruses. The sterile insect technique (SIT) by irradiation relies on mass-rearing and release of male insects that will not produce viable offspring. It has been successfully integrated into controlling agricultural and livestock pests. Experiments are conducted to determine the effectiveness of the approach for suppressing Aedes aegypti and curbing dengue transmission. Detailed implementation cycle costs have not been reported yet.</p><p><strong>Objective: </strong>To detail the costs of producing and releasing male A. aegypti mosquitoes sterilised by irradiation.</p><p><strong>Method: </strong>We carried out a cost analysis during a SIT pilot trial in Havana. We took a provider perspective and used microcosting. From the cost function, we subsequently calculated costs for base case variations in production volume and mosquito release rate per hectare.</p><p><strong>Results: </strong>The setup expenses to establish the capacity to produce and release 450,000 mosquitoes weekly amounted to 155,452.00 and 2456.40 USD in capital means and training, respectively. The average number of sterile mosquitoes released per hectare per week during the trial was 1500, utilising 17% of the installed capacity. Including capital depreciation, the average cost per 10,000 sterile male mosquitoes released was 110.12 USD. When producing at 85% capacity, this reduces nearly threefold, to 41.06 USD. At that production level, releasing 500 or 4500 sterile male mosquitoes per hectare costs on average 2.70 or 16.54 USD per hectare covered. In densely populated areas with 500 inhabitants per hectare, this corresponds to 0.28 or 1.72 USD per inhabitant per year.</p><p><strong>Conclusion: </strong>Our cost estimates for SIT by irradiation are within the range of estimates reported for alternative mass-rearing and release methods to control Aedes populations, and the approach appears competitive with insecticide-based interventions. The cost-effectiveness in different contexts remains to be investigated.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"210-218"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TaqMan Array Card real-time polymerase chain reaction panel to detect pathogens in whole blood of febrile inpatients in northern Tanzania, 2016-2019.","authors":"James S Ngocho, Jie Liu, Nathaniel H Kalengo, Asia H Kipengele, Athanasia Maro, Buliga Mujage, Ndealilia Senyael, Jean Gratz, Kajiru G Kilonzo, Grace Kinabo, Bingileki F Lwezaula, Furaha Lyamuya, Annette Marandu, Ronald Mbwasi, Blandina T Mmbaga, Calvin Mosha, Manuela Carugati, Deng B Madut, John P Bonnewell, Michael J Maze, Venance P Maro, John A Crump, Eric R Houpt, Matthew P Rubach","doi":"10.1111/tmi.14083","DOIUrl":"10.1111/tmi.14083","url":null,"abstract":"<p><strong>Background: </strong>Acute febrile illness is a common reason for seeking healthcare in low- and middle-income countries. We describe the diagnostic utility of a TaqMan Array Card (TAC) real-time polymerase chain reaction (PCR) panel for pathogen detection in paediatric and adult inpatients admitted with febrile illness.</p><p><strong>Methods: </strong>In this prospective cohort study, we screened medical admissions for a tympanic temperature ≥38.0°C or reported fever within 72 h and used a PCR panel to detect pathogens, including bacteria, viruses, fungi and protozoa, in 697 participants. We compared PCR results to conventional diagnostic methods and considered PCR detections as the cause of fever, except for Plasmodium spp. and Schistosoma spp. Participants for PCR testing was consecutively selected from the end of enrolment.</p><p><strong>Results: </strong>Of 1132 participants enrolled in the cohort, 697 (61.6%) were tested by PCR. Median (IQR) age was 29.6 (4.6-46.4) years. Three hundred seventy-eight (54.2%) were male. The PCR method improved illness identification, increasing diagnostic yield from 73 (10.5%) by conventional methods to 124 (17.8%) of 697 participants. PCR detections included four viral pathogens: dengue (n = 1), enterovirus (n = 7), measles (n = 1) and Rift Valley Fever Virus (RVFV) (n = 3). Forty-six bacterial pathogens were detected in 44 (6.3%) participants, including fastidious bacteria such as Bartonella spp. (n = 2), Brucella spp. (n = 3), Coxiella burnetii (n = 2), Leptospira spp. (n = 1), M. tuberculosis (n = 7) and Rickettsia spp. (n = 9).</p><p><strong>Conclusion: </strong>The PCR panel improved pathogen detection in febrile inpatients, providing clinically actionable results for fastidious bacteria and epidemiologically relevant findings like RVFV detections, when combined with conventional methods.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"201-209"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seroprevalence and risk factors for Crimean-Congo hemorrhagic fever virus exposure among febrile patients in northern Tanzania.","authors":"Elichilia R Shao, Chee Wah Tan, Shailendra Mani, Danielle E Anderson, Bingileki F Lwezaula, Blandina T Mmbaga, Venance P Maro, Shu Shen, Fei Deng, Jo E B Halliday, Ângelo J Mendes, Deng B Madut, Sarah Cleaveland, John A Crump, Matthew P Rubach, Lin-Fa Wang","doi":"10.1111/tmi.14082","DOIUrl":"10.1111/tmi.14082","url":null,"abstract":"<p><strong>Background: </strong>Crimean-Congo hemorrhagic fever is a tick-borne zoonotic disease that may be severe and is present in many African countries. We aimed to understand the seroprevalence and risk for Crimean-Congo hemorrhagic fever virus in Tanzania by testing archived serum samples from patients enrolled in a prospective cohort study.</p><p><strong>Methods: </strong>We prospectively enrolled febrile inpatients and outpatients from 2012 through 2014 at two referral hospitals in northern Tanzania. Archived serum samples were tested for Crimean-Congo hemorrhagic fever virus antibodies initially by a Luminex assay screen followed by confirmation with immunofluorescence assay. Evidence of exposure to Crimean-Congo hemorrhagic fever virus was defined as antibody detection by Luminex and confirmed by immunofluorescence assay. Questionnaire data were used to construct logistic regression models to understand factors associated with prior exposure to Crimean-Congo hemorrhagic fever virus. Domains of predictor variables included sociodemographics, livestock-rearing activities, and environmental factors.</p><p><strong>Results: </strong>Of 735 participants included, antibodies to Crimean-Congo hemorrhagic fever virus nucleocapsid protein were detected by Luminex assay in 23 (3.1%) and confirmed by immunofluorescence assay in 13 (1.8%). In multivariable logistic regression, prior exposure to Crimean-Congo hemorrhagic fever virus was associated with self-report of milking livestock in the past month (adjusted OR [aOR]: 12.6, 95% CI 1.6-99.8) and natural log increase in goat density (head/km²; aOR: 1.7, 95% CI: 1.1-2.7).</p><p><strong>Conclusions: </strong>We show serologic evidence of prior exposure to Crimean-Congo hemorrhagic fever virus among humans in northern Tanzania. Similar to other settings, our results suggest that exposure is closely linked to livestock activities. Additional research is warranted to understand reservoirs and modes of transmission of Crimean-Congo hemorrhagic fever virus to humans in northern Tanzania.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"193-200"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying the ADAPT guidance to implement a telemedicine and medication delivery service in a malaria-endemic setting: A prospective cohort study.","authors":"Katelyn E Flaherty, Mohammed-Najeeb Mahama, Molly B Klarman, Nana A Anane-Binfoh, Mayur D Patel, Nathanael J Smith, Maxwell Osei-Ampofo, Michael Mathelier, Eric J Nelson, Ahmed N Zakariah, Taiba J Afaa, Torben K Becker","doi":"10.1111/tmi.14081","DOIUrl":"10.1111/tmi.14081","url":null,"abstract":"<p><strong>Background: </strong>The ADAPT guidance proposes a process model for adapting evidence-informed interventions to novel contexts. Herein, we leveraged this guidance to adapt a paediatric nighttime telemedicine and medication delivery service from Haiti, a setting with low malaria prevalence, to Ghana, where malaria is a leading cause of paediatric mortality.</p><p><strong>Methods: </strong>Core components of the intervention were defined and conserved. Discretionary components were identified and considered for adaptation. The service was defined by a workflow involving a call from a guardian of a sick child, a telemedicine assessment, referral of severe cases, and medication delivery/in-person assessments for non-severe cases. Key adaptations related to partner organisation (private to public/government), clinician type (nurse to emergency medical technician), user fees (sliding scale to none), and point-of-care testing (none to malaria rapid diagnostic testing). The adapted model was implemented in Jamestown and Usshertown, Ghana, on 16 November 2022 as part of a 12-month study to evaluate implementation outcomes and the role of the telemedicine assessment. Empiric thresholds for safety and feasibility were set a priori and served as benchmarks for this study and points of iteration for future studies.</p><p><strong>Results: </strong>In the first year of implementation, 517 cases were enrolled; 492 were included in the analysis, 96% of which were reached at 10-day follow-up. Safety and feasibility thresholds were met. 98% of febrile cases received rapid diagnostic testing for malaria; 4% tested positive. At 10 days, 97% of cases were improving/well, and no severe adverse events were reported. The median lengths of the telemedicine assessment, time to delivery, and in-person assessments were 9, 49, and 43 min, respectively. 99% of participants expressed interest in using the service again. There was fair congruence between paired telemedicine and in-person assessments for vital sign assessments and mild/moderate triage decisions.</p><p><strong>Conclusions: </strong>A nighttime paediatric telemedicine and medication delivery service adapted and implemented per the ADAPT Guidance met a priori-defined safety and feasibility metrics in the malaria-endemic country of Ghana. The role of telemedicine in assessing vital signs and informing mild versus moderate triage decisions may be limited.</p><p><strong>Trial registration: </strong>This study was registered on Clinicaltrials.gov on 8/17/2022 (NCT05506683).</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"181-192"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological models to estimate the burden of snakebite envenoming: A systematic review.","authors":"Ahmed Adamu Gololo, Sajesh K Veettil, Puree Anantachoti, Suthira Taychakhoonavudh, Chanthawat Patikorn","doi":"10.1111/tmi.14080","DOIUrl":"10.1111/tmi.14080","url":null,"abstract":"<p><strong>Background: </strong>Epidemiological modelling studies in snakebite envenoming research are evolving. Their techniques can be essential in filling the knowledge gap needed to attain the World Health Organization's (WHO) goal of halving the burden of snakebite envenoming by complementing the current data scarcity. Hence, there is a need for a systematic review to summarise epidemiological models used in estimating the burden of snakebite envenoming.</p><p><strong>Methods: </strong>We conducted a systematic review by searching PubMed, EMBASE, and Scopus to identify articles reporting epidemiological models in snakebite envenoming from database inception to 31st December 2023. A narrative synthesis was performed to summarise types of models, methodologies, input parameters, model outputs, and associating factors.</p><p><strong>Results: </strong>Thirty-nine modelling studies were included from 2426 retrieved articles, comprising statistical models (76.9%) and mathematical models (23.1%). Most of the studies were conducted in South Asia, (35.9%) and Latin America (35.9%), and only a few (5.1%) were a global burden estimation. The eligible studies constructed 42 epidemiological models, of which 33 were statistical models that included regression, (60.6%) geostatistical (21.2%), and time series, (18.2%) while 9 mathematical models comprised compartmental, (44.4%) agent-based, (22.2%) transmission dynamics, (11.1%) network, (11.1%) and a simple mathematical model (11.1%). The outputs of the models varied across the study objectives. Statistical models analysed the relationship between incidence, (83.3%) mortality, (33.3%) morbidity (16.7%) and prevalence (10.0%) and their associating factors (environmental, [80%] socio-demographic [33.3%] and therapeutic [10.0%]). Mathematical models estimated incidence, (100%) mortality (33.3%), and morbidity (22.2%). Five mathematical modelling studies considered associating factors, including environmental (60%) and socio-demographic factors (40%).</p><p><strong>Conclusion: </strong>Mathematical and statistical models are crucial for estimating the burden of snakebite envenoming, offering insights into risk prediction and resource allocation. Current challenges include low-quality data and methodological heterogeneity. Modelling studies are needed, and their continued improvement is vital for meeting WHO goals. Future research should emphasise standardised methodologies, high-quality community data, and stakeholder engagement to create accurate, applicable models for prevention and resource optimization in high-burden regions, including Africa and Asia.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"71-83"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of isoniazid preventive therapy among children living with diagnosed pulmonary tuberculosis patients: A mixed methods study from Mumbai, India.","authors":"P A Sreevidya, Shrikala Acharya, Mayuri Umesh Raul, Aparna Prakash","doi":"10.1111/tmi.14072","DOIUrl":"10.1111/tmi.14072","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis remains a significant public health issue, particularly among children who are in close contact with tuberculosis patients. India accounts for a large proportion of global tuberculosis cases. Despite global recommendations for Isoniazid Preventive Therapy to prevent latent tuberculosis infection from progressing to active disease, the initiation and adherence to Isoniazid Preventive Therapy remain suboptimal, especially in high-burden settings. Understanding the barriers to Isoniazid Preventive Therapy implementation is crucial to improving treatment outcomes and achieving tuberculosis elimination goals.</p><p><strong>Objectives: </strong>This study aimed to quantify the uptake of isoniazid among children under 6 years who were started on Isoniazid Preventive Therapy and to identify the challenges from the perspectives of caregivers and healthcare providers.</p><p><strong>Methods: </strong>The study was conducted in a slum in Mumbai, India, from June to December 2023, using a mixed-methods design. The quantitative phase involved a house-to-house survey, covering all 96 contacts started on Isoniazid Preventive Therapy in 2022, using a semi-structured questionnaire. The qualitative phase included key informant interviews with healthcare providers and in-depth interviews with caregivers. Quantitative data were analysed using Fisher's exact test and chi-square test, while qualitative data were analysed thematically.</p><p><strong>Results: </strong>Of the 96 children, 11 (11.45%) completed therapy, with an average treatment duration of 2.5 months. Quantitative findings highlighted fear of side effects and family migration as major reasons for discontinuation. Completion of chemoprophylaxis was significantly associated with factors like male gender, support from extended family, home visits by tuberculosis health staff, and shorter travel time (under 30 min) to the tuberculosis unit. Qualitative data revealed challenges across themes of supply, staff, training, services, and adherence. Key challenges included lack of awareness, unavailability of isoniazid in syrup form, inadequate training for health workers, weak program monitoring, insufficient staffing, and fears related to tuberculosis exposure during outpatient department visits.</p><p><strong>Conclusion: </strong>Effective counselling, regular follow-ups, availability of medications in syrup form, increasing staffing based on case burden, timely training of staff, strengthening program monitoring, and ensuring infection control in tuberculosis outpatient departments are critical to achieving successful completion of isoniazid preventive therapy.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"93-98"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}