Infectious Diseases of Poverty最新文献

{"title":"Mitigating host microRNA interference to enhance mRNA vaccine efficacy in public health interventions.","authors":"Tielong Xu, Ziqi Lin, Yicheng Yu, Muhammad Irfan, Munir Ahmed, Maya Septriana, Twinky Zebrina Cysta Sumantri, Anindini Winda Amalia, Bin Zheng","doi":"10.1186/s40249-025-01308-6","DOIUrl":"10.1186/s40249-025-01308-6","url":null,"abstract":"<p><strong>Background: </strong>While mRNA vaccines represent a transformative platform for infectious disease control, their efficacy in antigen-presenting cells (APCs) remains vulnerable to endogenous regulatory networks, particularly microRNA (miR)-mediated translational suppression. This study addresses a critical gap in current vaccine design paradigms by systematically investigating host miR interference - an understudied barrier to robust antigen production.</p><p><strong>Main text: </strong>APCs express cell-type-specific miR repertoires capable of binding vaccine mRNAs through conserved seed sequences, as evidenced by synthesis of experimental data from 67 studies demonstrating miR-mediated repression of exogenous transcripts. To decode these inhibitory interactions, the commentary proposes an integrated multi-omics framework combining Argonaute immunoprecipitation with crosslinking-based miR-mRNA interactome sequencing, enabling precise mapping of miR-vaccine mRNA binding events in vaccine-transfected APCs. Furthermore, the commentary suggests two actionable strategies for evading miR interference: (1) Synonymous codon optimization at seed-match regions, achieving binding energy reduction while preserving antigenicity through degeneracy of genetic coding; (2) Targeted co-delivery of miR inhibitors. By bridging host RNA biology and vaccine engineering, this work provides a blueprint for developing miR-resistant mRNA vaccines for public health interventions.</p><p><strong>Conclusions: </strong>miRs may inhibit mRNA vaccine translation in APCs, potentially reducing antigen production and weakening the resulting immune response. To address this, next-generation mRNA vaccines should incorporate \"miR-proofing\" strategies during design to avoid miR interference.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"32"},"PeriodicalIF":8.1,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of urbanization-related factors with tuberculosis incidence among 1992 counties in China from 2005 to 2019: a nationwide observational study.","authors":"Yaping Wang, Xiaoqiu Liu, Yuhong Li, Min Liu, Yiheng Wang, Hongliang Zhang, Jue Liu, Yanlin Zhao","doi":"10.1186/s40249-025-01299-4","DOIUrl":"10.1186/s40249-025-01299-4","url":null,"abstract":"<p><strong>Background: </strong>Most high tuberculosis (TB) burden countries are in low- and middle-income regions undergoing rapid urbanization. We aimed to assess the association between urbanization factors and TB incidence in China.</p><p><strong>Methods: </strong>We evaluated urbanization at the county level in China from 2005 to 2019 using a composite index integrating population density, gross domestic product (GDP, per capita), hospital beds per 1000 population, nighttime light (NTL), and normalized difference vegetation index (NDVI). The annual incidence rate and number of TB cases were obtained from the national Tuberculosis Information Management System, maintained by the Chinese Center for Disease Control and Prevention. Fixed-effects models were used to examine the association between urbanization factors and TB incidence. A subgroup analysis was performed by dividing counties into four regions: northeast, eastern, central, and western.</p><p><strong>Results: </strong>A total of 1992 counties in China were included in this study. Overall, urbanization scores were associated with reduced TB incidence (β = - 0.0114, P < 0.001), corresponding to a 1.1% reduction in TB incidence per unit score. Quadratic models presented a U-shaped relationship between urbanization and TB incidence with an inflection point at 52.94 urbanization units. For each indicator of urbanization, population density and the number of hospital beds were positively associated with TB incidence, with incidence rate ratios of 11.384 [95% confidence interval (CI): 9.337 to 13.881], and 1.015 (95% CI: 1.011 to 1.019), respectively, while GDP, NTL, and NDVI exhibited protective effects. Central China displayed an increase trend that urbanization score was linked to a 1.8% rise in TB incidence.</p><p><strong>Conclusions: </strong>Urbanization-related factors, including GDP, NTL and NDVI, were inversely associated with TB incidence. Central China's contrasting results highlighted region-specific challenges. Therefore, governments in developing countries should adopt integrated approaches that promote both economic growth and sustainable development of environment during urbanization to optimize TB control efforts.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"30"},"PeriodicalIF":8.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The research contribution of the Schistosomiasis Collection at the Natural History Museum (SCAN): highlights, challenges and future directions.","authors":"Aidan M Emery, Muriel Rabone, Toby Landeryou, Fiona Allan, David Rollinson","doi":"10.1186/s40249-025-01302-y","DOIUrl":"https://doi.org/10.1186/s40249-025-01302-y","url":null,"abstract":"<p><strong>Background: </strong>The Schistosomiasis Collection at the Natural History Museum (SCAN) is a repository of schistosomiasis-related specimens, the development of which was funded by the Wellcome Trust between 2011 and 2021. With a view to facilitating research by improving access to genetically diverse material, SCAN was built from legacy research collections of schistosomiasis-related specimens amassed over decades, with more recent collections made through partnership with large field-based projects.</p><p><strong>Methods: </strong>We identified the literature associated with SCAN from 2012 until 2024, using both database searches (search terms: SCAN, the schistosomiasis collection at the NHM and schistosomiasis) and citations of the publication which originally laid out the scope of the SCAN Collection. Studies were included if the SCAN publication was cited, and/or if the SCAN Collection was utilised in the work. Data extracted included year of publication, authors, whether and how SCAN was used in the work, and type of specimens used.</p><p><strong>Results: </strong>The literature includes 88 published works, demonstrating the utility of large field-based collections in supporting research. The collection comprises around half a million larval schistosomes originating from the field, with approximately 3000 specimen lots of lab-passaged adult parasites stored in liquid nitrogen. The Collection includes 11 schistosome species, the majority being the human pathogens Schistosoma haematobium and S. mansoni, while also including many livestock-associated species. Genome analysis of S. haematobium and S. guineensis samples indicate historical introgression or ongoing hybridisation. In order of representation, the collection includes S. haematobium (> 19,000 larval forms and eggs, and 550 specimen lots of laboratory passaged adult worms), S. mansoni, S. japonicum, S. bovis, S. curassoni, S. mattheei, S. rodhaini and S. guineensis, with S. intercalatum, S. margrebowiei and S. spindale represented only by laboratory-passaged isolates in liquid nitrogen. SCAN also includes around 210,000 snails, with the collection as a whole encompassing 27 countries.</p><p><strong>Conclusions: </strong>Improvements in DNA sequencing techniques have allowed genome-level data to be accessed from archived larval schistosomes and allowed retrospective analysis of samples collected decades ago. SCAN has been of use in exploring schistosome diversity, particularly with reference to hybridisation and drug resistance. Multiple author nationalities demonstrate the collaborative nature of research using the Collection, although more may need to be done in future, both to promote work led by developing countries and to ensure effective collaboration and sample sharing.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"29"},"PeriodicalIF":8.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-morbidity of malaria and soil-transmitted helminths in Nigeria: a joint Bayesian modelling approach.","authors":"Faith Eshofonie, Olatunji Johnson, Ezra Gayawan","doi":"10.1186/s40249-025-01276-x","DOIUrl":"10.1186/s40249-025-01276-x","url":null,"abstract":"<p><strong>Background: </strong>Malaria and soil-transmitted helminths (STH) represent significant public health challenges in tropical regions, particularly affecting children and impeding development. This study investigates the co-morbidity of malaria, caused by Plasmodium spp., and STH infections, including Ascaris lumbricoides(roundworm), Ancylostoma duodenale and Necator americanus (hookworm), and Trichuris trichiura(whipworm), in Nigeria.</p><p><strong>Methods: </strong>We utilized malaria prevalence data from the Nigeria Malaria Indicators Survey (NMIS) for the years 2010 and 2015 and STH prevalence data from the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) portal, covering the years 1978-2014. A Bayesian coregionalization model was employed to analyze the prevalence and incidence of malaria and STH, linking these data to climatic factors such as temperature and precipitation. The study's findings highlight significant co-morbidity between malaria and STH, particularly in the southsouth and southeast regions.</p><p><strong>Results: </strong>Our analysis reveals notable regional disparities: malaria prevalence is highest in the northwest and north-central regions, while Ascaris lumbricoides is widespread in both northern and southern states. Ancylostoma duodenale and Necator americanus(Hookworm) are predominantly found in the southwest, and Trichuris trichiura, though less prevalent, is significant in specific areas. Substantial co-morbidity between malaria and STH was observed, particularly in the South-South and southeast regions, indicating a compounded health burden. Furthermore, climatic factors significantly influence disease distribution; higher temperatures correlate with increased malaria prevalence, although temperature has a minimal effect on STH prevalence and incidence. In contrast, precipitation is positively associated with both malaria and STH incidence.</p><p><strong>Conclusions: </strong>These findings enhance our understanding of the spatial distribution and risk factors associated with malaria and STH in Nigeria, providing vital insights for the development of public health policies and targeted intervention strategies.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"28"},"PeriodicalIF":8.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with clinical antimicrobial resistance in China: a nationwide analysis.","authors":"Wenyong Zhou, Zexuan Wen, Wenlong Zhu, Jiali Gu, Jing Wei, Haiyan Xiong, Weibing Wang","doi":"10.1186/s40249-025-01289-6","DOIUrl":"10.1186/s40249-025-01289-6","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) represents a critical global health threat, necessitating the identification of factors that contribute to its emergence and proliferation. We used a \"One Health\" perspective to evaluate the association of human and veterinary antibiotic usage, environmental factors, socio-economic factors, and health care factors with clinical AMR in China.</p><p><strong>Methods: </strong>We analyzed data from 31 provincial-level administrative divisions in China, encompassing 20,762,383 bacterial isolates sourced from the China Antimicrobial Resistance Surveillance System dataset between 2014 and 2022. A <math><mi>β</mi></math> regression model was used to explore the relationship of AMR with multiple variables. We also estimated the contribution of factors associated with AMR, and evaluated the avoidable risk of AMR under six different measures during 2019 according to available guidelines.</p><p><strong>Results: </strong>AMR had positive associations with human antibiotic usage, veterinary antibiotic usage, particulate matter smaller than 2.5 µm (PM_2.5) level, population density, gross domestic product per capita, and length of hospital stay, and a 1 unit increase in the level of above independent variables were associated with a percentage change in the aggregate AMR of 1.8% (95% CI: 1.1, 2.5), 2.0% (95% CI: 0.6, 3.4), 0.9% (95% CI: 0.4, 1.4), 0.02% (95% CI: 0.01, 0.03), 0.5% (95% CI: 0.1, 0.8), and 8.0% (95% CI: 1.2, 15.3), respectively. AMR had negative associations with city water popularity, city greenery area per capita, and health expenditure per capita, and a 1 unit increase in the level of above independent variables were associated with a percentage change in the aggregate AMR of -4.2% (95% CI: -6.4, -1.9), -0.4% (95% CI: -0.8, -0.07), and -0.02% (95% CI: -0.04, -0.01), respectively. PM_2.5 might be a major influencing factor of AMR, accounting for 13.7% of variation in aggregate AMR. During 2019, there was estimated 5.1% aggregate AMR could be attributed to PM_2.5, corresponding to 25.7 thousand premature deaths, 691.8 thousand years of life lost, and 63.9 billion Chinese yuan in the whole country. Human antibiotic usage halved, veterinary antibiotic usage halved, city water popularity improved, city greenery area improved, and comprehensive measures could decrease nationwide aggregate AMR by 8.5, 0.5, 1.3, 4.4, and 17.2%, respectively.</p><p><strong>Conclusions: </strong>The study highlights the complex and multi-dimensional nature of AMR in China and finds PM_2.5 as a possible major influencing factor. Despite improvements in decreasing AMR, future initiatives should consider integrated strategies to control PM_2.5 and other factors simultaneously to decrease AMR.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"27"},"PeriodicalIF":8.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recognising the neurological burden of onchocerciasis: the need to include onchocerciasis-associated epilepsy in onchocerciasis global health metrics.","authors":"Luís-Jorge Amaral, Robert Colebunders","doi":"10.1186/s40249-025-01297-6","DOIUrl":"10.1186/s40249-025-01297-6","url":null,"abstract":"<p><strong>Background: </strong>Historically, onchocerciasis has been recognised for its dermatological and ophthalmological manifestations, such as blindness. However, growing epidemiological evidence indicates that onchocerciasis is also associated with neurological complications, particularly onchocerciasis-associated epilepsy (OAE). These complications are not currently reflected in disease burden estimates and associated disability-adjusted life years (DALYs) for onchocerciasis.</p><p><strong>Main text: </strong>The most recent global burden of disease estimates for onchocerciasis in 2019 reported 1.23 million DALYs without accounting for OAE. Yet, a preliminary study suggested that 128,000 years of life lost to disability (YLD, a key component of DALYs) may be attributable to epilepsy in onchocerciasis-endemic areas of East and Central Africa. This figure, which would represent over 13% of the total onchocerciasis morbidity burden and 10% of the global epilepsy morbidity burden, is likely still an underestimation. Current disability weights for epilepsy YLD estimation may not fully capture the spectrum of OAE, which often involves nodding syndrome, developmental delays, motor disabilities, cognitive impairments and stigma. In regions where access to antiseizure medication treatment is sparse, poorly controlled seizures can exacerbate disability and lead to premature mortality. Targeted integrated strategies-combining onchocerciasis control measures with improved epilepsy care-could help address these critical gaps.</p><p><strong>Conclusions: </strong>Recognising OAE as part of the disease burden associated with onchocerciasis may encourage global health stakeholders to allocate resources for targeted interventions, thereby refining disease burden estimates, reducing disability, averting premature deaths and improving overall health outcomes.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"26"},"PeriodicalIF":8.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collateral benefits of ivermectin mass drug administration designed for malaria against headlice in Mopeia, Mozambique: a cluster randomised controlled trial.","authors":"Joanna Furnival-Adams, Amelia Houana, Patricia Nicolas, Julia Montaña, Samuel Martinho, Aina Casellas, Hansel Mundaca, Jenisse Mbanze, Arlindo Soares, Saimado Imputiua, Paula Ruiz-Castillo, Marta Ribes, Almudena Sanz, Mussa Mamudo Salé, Antonio Macucha, Eldo Elobolobo, Vegovito Vegove, Victor Mutepa, Humberto Munguambe, Aida Xerinda, Felisbela Materula, Regina Rabinovich, Francisco Saute, Carlos Chaccour","doi":"10.1186/s40249-025-01290-z","DOIUrl":"10.1186/s40249-025-01290-z","url":null,"abstract":"<p><strong>Background: </strong>Headlice are prevalent worldwide, with a higher burden in rural, lower-middle income settings. They can cause intense itchiness, discomfort, and secondary bacterial infections with potentially serious consequences. Ivermectin is efficacious against headlice, and is also being evaluated as a malaria vector control tool. In this study, we explored risk factors for headlice, and assessed the efficacy of ivermectin mass drug administration (MDA) designed for malaria against headlice.</p><p><strong>Methods: </strong>We conducted an open-label, assessor-blind, cluster-randomized controlled trial in Mopeia, Mozambique. A single dose of ivermectin was given monthly to eligible humans or humans and livestock (humans: 400 μg/kg, livestock: 1% injectable 200 μg/kg) in 3 consecutive months during the rainy season. The control group received albendazole (humans only). Thirty-nine clusters (13 per arm) were randomly selected for the nested assessment of headlice prevalence. 1341 treated participants were followed up at least once, 1, 2 and 3 months and 382 untreated (ineligible) participants at 3 and 6 months after the first MDA round. Headlice diagnosis was determined by scalp examination. Logistic regression was used to identify risk factors for headlice at baseline, and to estimate the treatment effect at each time point.</p><p><strong>Results: </strong>A total of 1309 participants were included in the main analysis assessing ivermectin MDA efficacy, and 1332 in the risk factor analysis. The baseline headlice prevalence was 11%. Risk factors included living with a household member with head itch [adjusted odds ratio (aOR) = 48.63, 95% confidence interval (CI): 28.7-82.3, P-value < 0.0001], being female (aOR = 2.25, 95% CI: 1.33-3.80, P-value < 0.01), and using surface water as the main water (aOR = 2.37, 95% CI: 1.12-5.33, P-value = 0.04). The treated population receiving ivermectin had significantly lower odds of having headlice at 3 months compared to those receiving albendazole (aOR = 0.19, 95% CI: 0.04-0.91, P-value = 0.04). There was no indirect effect on headlice among children ineligible for treatment.</p><p><strong>Conclusions: </strong>In a highly endemic setting, mass drug administration with ivermectin significantly reduces headlice infestation prevalence among those who receive the drug for three sequential months. The lack of effect among untreated, ineligible children implies that additional interventions would be needed to interrupt local transmission.</p><p><strong>Trial registration: </strong>This study is registered with ClinicalTrials.gov (NCT04966702).</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"25"},"PeriodicalIF":8.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reassessing Schistosoma worms: the overlooked role in host pathology and disease elimination.","authors":"Haoran Zhong, Zhiqiang Fu, Jinming Liu, Yamei Jin","doi":"10.1186/s40249-025-01298-5","DOIUrl":"10.1186/s40249-025-01298-5","url":null,"abstract":"<p><strong>Background: </strong>Schistosomiasis, a neglected tropical disease, remains a pressing global health challenge, hindering progress toward achievement of the Sustainable Development Goals (SDGs) in endemic regions. Despite advances in control strategies, including preventive chemotherapy and integrated measures, the elimination of schistosomiasis remains an elusive goal. Current understanding of schistosomiasis pathogenesis has largely focused on egg-induced pathology, while the contributions of schistosome worms to disease progression are relatively underexplored. The objective of this article is to highlight the critical, yet overlooked, role of schistosome worms in disease progression and to advocate for a broader research focus on their direct impact on host pathology and efforts towards disease elimination.</p><p><strong>Main text: </strong>Single-sex schistosome infections, which may occur in low-transmission areas, deserve greater attention as they evade traditional egg-based diagnostics. These infections also provide a valuable model to explore the direct contributions of worms to host pathology. Recent studies suggest that schistosome worms, via their excretory-secretory products (ESPs), contribute to liver inflammation, fibrosis, and immune modulation independent of egg deposition. Understanding the interactions between worms and hosts is essential for elucidating their role in disease progression. Furthermore, the potential similarities between schistosome ESPs and those of carcinogenic trematodes highlight the need for further investigation into their long-term impact on host health and schistosomiasis pathology.</p><p><strong>Conclusions: </strong>Expanding the focus of schistosomiasis research to include the role of schistosome worms is essential for advancing diagnostic and therapeutic strategies. By incorporating single-sex infection models and targeting worm-derived molecules, it is possible to uncover the overlooked aspects of schistosomiasis pathogenesis, improve diagnostic accuracy, and support global elimination efforts, thereby contributing to the realization of the SDGs.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"24"},"PeriodicalIF":8.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building climate-resilient health systems in Sierra Leone: addressing the dual burden of infectious and climate-related diseases.","authors":"Umaru Sesay, Augustus Osborne","doi":"10.1186/s40249-025-01294-9","DOIUrl":"10.1186/s40249-025-01294-9","url":null,"abstract":"<p><p>Climate change presents a profound challenge to global health, disproportionately affecting low-income countries like Sierra Leone. This opinion examines the dual burden of infectious and climate-related diseases and their implications for Sierra Leone's health systems. Rising temperatures and changing rainfall patterns intensify vector-borne diseases such as malaria and Lassa fever, while flooding exacerbates waterborne diseases in overcrowded urban areas. Concurrently, climate-driven food insecurity worsens malnutrition, particularly among children, and heat stress contributes to the growing prevalence of non-communicable diseases. These overlapping health crises strain Sierra Leone's fragile health system, characterized by inadequate infrastructure, workforce shortages, weak surveillance systems, and limited financial resources. The dual disease burden not only increases morbidity and mortality but also deepens existing health inequities and inequalities. To address these challenges, this opinion underscores the need for climate-resilient health policies and systems. Key recommendations include strengthening healthcare infrastructure, building workforce capacity through targeted training, fostering community-based adaptation strategies, and enhancing international collaboration and financing. Establishing robust research and data systems is also critical to monitor and mitigate climate-related health impacts. By prioritizing response to dual burden of infectious and climate-related diseases within health policy frameworks, Sierra Leone can build a resilient health system that safeguards public health and promotes sustainable development.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"23"},"PeriodicalIF":8.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal control strategies supported by system dynamics modelling: a study on hookworm disease in China.","authors":"Huihui Zhu, Jinxin Zheng, Jilei Huang, Mizhen Zhang, Changhai Zhou, Tingjun Zhu, Hongchun Tian, Xiaohong Wu, Yang Liu, Bo Zhong, Hong Xie, Liping Zhang, Lei Tie, Jingwen Luo, Xiaoqin Mao, Bin Zhang, Xiu Deng, Suping Zhang, Menbao Qian, Shizhu Li, Xiaonong Zhou","doi":"10.1186/s40249-025-01293-w","DOIUrl":"10.1186/s40249-025-01293-w","url":null,"abstract":"<p><strong>Background: </strong>Hookworm disease remains a global health issue. In China, it persists with a 0.67% infection rate and uneven distribution in 2021. Optimized control strategies are needed. This study aims to optimize intervention strategies for hookworm disease in China.</p><p><strong>Methods: </strong>Structural analysis and parameter estimation were conducted using system dynamics theory. Key variables were identified via the Delphi method, leading to the creation of a causal loop diagram (CLD) and stock flow chart (SFC). Based on the SFC, parameter estimation and quantitative relationships were established and the model was validated. A cost-effectiveness model was then integrated into the intervention mechanism model. Various intervention measures were tested in the model to determine their cost-effectiveness ratio (CER) and effectiveness. Generalized linear models were constructed from simulation data, accounting for the impact of survey sites. The results were used to develop an optimized strategy for hookworm disease control.</p><p><strong>Results: </strong>In comparing drug treatment methods, whole population deworming (WPD) and key population deworming (KPD) showed lower CERs than examination and voluntarily deworming (EVD), saving 384.79-504.64 CNY and 354.35-506.21 CNY per infection reduced, respectively (P < 0.001). For WPD or KPD alone, CER decreased with increased drug coverage. For examination and deworming (ED) and EVD, CER was highest at 30% coverage for a 1-year intervention, but at 90% coverage for 2-5 years (P < 0.05). WPD, ED, and EVD had higher infection reduction rates than KPD, with ratios of 0.14-0.25, 0.10-0.19, and 0.08-0.17, respectively, over 1-5 years (P < 0.001). Continuous health education over 1-5 years showed that increasing coverage from a 10% baseline led to enhancing cost-effectiveness and intervention outcomes.</p><p><strong>Conclusions: </strong>In high-endemic areas (infection rate ≥ 20%) in China, prioritize WPD for better cost-effectiveness and outcomes. In medium-endemic areas (5% ≤ infection rate < 20%) where WPD isn't feasible, use ED for cost-effectiveness and KPD for infection reduction, based on local needs. In low-endemic areas (infection rate < 5%), encourage voluntary examination and treatment due to limited cost-effectiveness of mass treatment. Combining drug treatment with extensive health education can enhance long-term control effect. This strategy can guide control efforts for hookworm diseases in China.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"22"},"PeriodicalIF":8.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}