PLoS Neglected Tropical Diseases最新文献

{"title":"Revisiting the Loa loa microfilaremia thresholds above which serious adverse events may occur with ivermectin treatment.","authors":"Charlotte Boullé, Sébastien D Pion, Jacques Gardon, Nathalie Gardon-Wendel, Joël Fokom Domgue, Joseph Kamgno, Cédric B Chesnais, Michel Boussinesq","doi":"10.1371/journal.pntd.0012957","DOIUrl":"10.1371/journal.pntd.0012957","url":null,"abstract":"<p><strong>Background: </strong>Loiasis was long deemed to be a benign condition, but individuals with high Loa loa microfilarial densities (MFD) are at risk of serious adverse events (SAEs) including encephalopathy following ivermectin (IVM) administration. The risk of marked AE or SAE is usually considered when MFD exceeds 8000 microfilariae (mf)/mL or 30,000 mf/mL, respectively. There are no international guidelines on the treatment of loiasis, resulting in a variety of practices worldwide for the treatment of infected individuals outside endemic areas. Our objective was to determine the probabilities of SAEs after IVM administration at the usual thresholds, and to refine those thresholds using individual characteristics such as age and sex.</p><p><strong>Methods: </strong>We used data from two clinical trials conducted in Cameroon where L. loa MFD were determined before IVM administration. The risk of SAE was modeled as a logistic function of age, sex, and MFD transformed as a first-order fractional polynomial.</p><p><strong>Principal findings: </strong>SAEs probabilities were found to be <104 for MFD<2000 mf/mL, > 1‰ for MFD >8000 mf/mL, >1% for MFD>20,000 mf/mL, and >2.5% for MFD>30,000 mf/mL. We showed that specific categories may be at a higher risk of SAE than expected. Specifically, in order not to exceed 1% risk, the corresponding thresholds would be 18,000 mf/mL for females in the 31-40 age group; 16,000 mf/mL for males in the 21-30 age group; 12,000 mf/mL for males in the 31-40 age group; and 19,000 mf/mL for males in the 41-50 age group.</p><p><strong>Conclusions: </strong>Our study suggests that IVM should be used with caution for males or individuals in specific age categories with a high L. loa MFD. For these high risk groups, lowering the thresholds to 8000 mf/mL should be considered. The increased risk in males requires further investigation to understand the pathophysiological phenomena involved that are crucial to prevent and manage SAEs.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 3","pages":"e0012957"},"PeriodicalIF":3.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated rapid risk assessment for dengue fever in settings with limited diagnostic capacity and uncertain exposure: Development of a methodological framework for Tanzania.","authors":"Matthias Hans Belau, Juliane Boenecke, Jonathan Ströbele, Mirko Himmel, Daria Dretvić, Ummul-Khair Mustafa, Katharina Sophia Kreppel, Elingarami Sauli, Johanna Brinkel, Ulfia Annette Clemen, Thomas Clemen, Wolfgang Streit, Jürgen May, Amena Almes Ahmad, Ralf Reintjes, Heiko Becher","doi":"10.1371/journal.pntd.0012946","DOIUrl":"10.1371/journal.pntd.0012946","url":null,"abstract":"<p><strong>Background: </strong>Dengue fever is one of the world's most important re-emerging but neglected infectious diseases. We aimed to develop and evaluate an integrated risk assessment framework to enhance early detection and risk assessment of potential dengue outbreaks in settings with limited routine surveillance and diagnostic capacity.</p><p><strong>Methods: </strong>Our risk assessment framework utilizes the combination of various methodological components: We first focused on (I) identifying relevant clinical signals based on a case definition for suspected dengue, (II) refining the signal for potential dengue diagnosis using contextual data, and (III) determining the public health risk associated with a verified dengue signal across various hazard, exposure, and contextual indicators. We then evaluated our framework using (i) historical clinical signals with syndromic and laboratory-confirmed disease information derived from WHO's Epidemic Intelligence from Open Sources (EIOS) technology using decision tree analyses, and (ii) historical dengue outbreak data from Tanzania at the regional level from 2019 (6,795 confirmed cases) using negative binomial regression analyses adjusted for month and region. Finally, we evaluated a test signal across all steps of our integrated framework to demonstrate the implementation of our multi-method approach.</p><p><strong>Results: </strong>The result of the suspected case refinement algorithm for clinically defined syndromic cases was consistent with the laboratory-confirmed diagnosis (dengue yes or no). Regression between confirmed dengue fever cases in 2019 as the dependent variable and a site-specific public health risk score as the independent variable showed strong evidence of an increase in dengue fever cases with higher site-specific risk (rate ratio = 2.51 (95% CI = [1.76, 3.58])).</p><p><strong>Conclusions: </strong>The framework can be used to rapidly determine the public health risk of dengue outbreaks, which is useful for planning and prioritizing interventions or for epidemic preparedness. It further allows for flexibility in its adaptation to target diseases and geographical contexts.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 3","pages":"e0012946"},"PeriodicalIF":3.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parasitaemia and fever in uncomplicated Plasmodium vivax malaria: A systematic review and individual patient data meta-analysis.","authors":"Emily S Groves, Julie A Simpson, Peta Edler, André Daher, Ayodhia P Pasaribu, Dhelio B Pereira, Kavitha Saravu, Lorenz von Seidlein, Megha Rajasekhar, Ric N Price, Robert J Commons","doi":"10.1371/journal.pntd.0012951","DOIUrl":"10.1371/journal.pntd.0012951","url":null,"abstract":"<p><strong>Background: </strong>Parasite density thresholds used for diagnosing symptomatic malaria are defined by the relationship between parasitaemia and fever. This relationship can inform the design and development of novel diagnostic tests but appropriate parasitaemia thresholds for Plasmodium vivax malaria remain poorly defined.</p><p><strong>Methodology/principal findings: </strong>We undertook an individual patient data meta-analysis of P. vivax clinical trials mapped to the WorldWide Antimalarial Resistance Network (WWARN) repository and used parasitaemia centiles of febrile patients at enrolment to derive proportions of patients who would have been diagnosed at different parasite densities. Febrile and afebrile patients with recurrent infections were selected to estimate pyrogenic densities using receiver operating characteristic curve analysis. In total 13,263 patients from 50 studies were included in the analysis. In 27 studies (8,378 febrile patients) in which a parasitaemia threshold was not applied as an inclusion criterion, the median parasitaemia at enrolment was 3,280/µL (interquartile range, 968 - 8,320); 90% of patients had a parasitaemia above 278/µL (10th centile), and 95% above 120/µL (5th centile). The 10th centile was higher in children <5 years old (368/µL) compared to adults ≥15 years (240/µL). In high relapse periodicity regions (Southeast Asia and Oceania) febrile patients presented with lower parasitaemias (10th centile 185/µL vs. 504/µL) and a wider range of parasitaemias compared to those from low relapse periodicity regions (interquartile range 760/µL - 8,774/µL vs. 1,204/µL - 8,000/µL). In total 2,270 patients from 41 studies had at least one episode of recurrent P. vivax parasitaemia, of whom 43% (849/1,983) were febrile at their first recurrence. The P. vivax pyrogenic density at first recurrence was 1,063/µL, defining fever with 74% sensitivity and 65% specificity. The pyrogenic density was lower in young children compared to adults ≥15 years (935/µL vs. 1,179/µL).</p><p><strong>Conclusions/significance: </strong>The derived parasitaemia centiles will inform the use of current and the design of novel point-of-care tests to diagnose patients with symptomatic vivax malaria. Variation by age and location should be considered when selecting diagnostic thresholds and interpreting results.</p><p><strong>Trial registration: </strong>This trial was registered with PROSPERO: CRD42021254905. The date of the first registration was 17th May 2021.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 3","pages":"e0012951"},"PeriodicalIF":3.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of dengue patients in Vietnam: Clinical, virological, and IL-10 profiles during 2021- 2022 outbreaks.","authors":"Do Duc Anh, Lara Vugrek, Nguyen Trong The, Nourhane Hafza, Truong Nhat My, Le Thi Kieu Linh, Do Huy Loc, Jonas Schmidt-Chanasit, Nguyen Linh Toan, Peter G Kremsner, Le Huu Song, Thirumalaisamy P Velavan","doi":"10.1371/journal.pntd.0012954","DOIUrl":"10.1371/journal.pntd.0012954","url":null,"abstract":"<p><strong>Background: </strong>The pathogenesis of dengue is attributed to a complex interaction between the dengue virus (DENV) and the host immune system. The aim of this study is to investigate the clinical, virological, and Interleukin-10 (IL-10) profiles of dengue patients in Vietnam from two consecutive outbreaks in 2021 and 2022.</p><p><strong>Methods: </strong>A total of n=306 dengue patients were examined, who were clinically stratified according to dengue without warning signs (DF; n=178), dengue with warning signs (DWS; n=115) and severe dengue (SD; n=13). Patients were screened for dengue, Zika and chikungunya viruses. DENV were subjected to serotype specific real-time RT-PCR. Interleukin-10 (IL-10) levels were measured by ELISA, and IL-10 promoter variants (-1082G/A; -819C/T; -592C/A) were genotyped by direct Sanger sequencing to determine a possible association with susceptibility to dengue and disease severity.</p><p><strong>Results: </strong>No chikungunya or Zika viruses were detected. Patients were infected by one of the three different DENV serotypes (DENV-1, -2, -4). Plasma IL-10 levels were significantly elevated in patients (DF vs. DWS, p=0.004; DF vs. SD, p=0.001; DWS vs. SD, p=0.015). While the IL-10 allele -819C contributed to an increased risk of dengue (OR = 1.5, 95% CI = 1.1-2.0, p=0.04), genotype -1082GA showed a protective role against the disease (OR = 0.45, 95% CI = 0.27-0.72, p=0.009), and allele -1082G showed a protective role against DWS (OR = 0.44, 95% CI = 0.22-0.81, p=0.049). Also, the IL-10 GTA (-1082G/-819T/-592A) haplotype was observed to confer protection (OR = 0.31, 95% CI = 0.14-0.67, p< 0.003).</p><p><strong>Conclusion: </strong>While DENV-1 and DENV-2 were the predominant serotypes in circulation, plasma IL-10 levels and IL-10 promoter variants were also significantly associated with dengue and its severity.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 3","pages":"e0012954"},"PeriodicalIF":3.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a rapid lateral flow assay for the detection of taeniosis and cysticercosis at district hospital level in Tanzania: A prospective multicentre diagnostic accuracy study.","authors":"Inge Van Damme, Chiara Trevisan, Mwemezi Kabululu, Dominik Stelzle, Charles E Makasi, Veronika Schmidt-Urbaneja, Kabemba E Mwape, Chishimba Mubanga, Gideon Zulu, Karen Shou Møller, Famke Jansen, Dries Reynders, John Noh, Sukwan Handali, Emmanuel Bottieau, Andrea S Winkler, Pierre Dorny, Pascal Magnussen, Sarah Gabriël, Bernard Ngowi","doi":"10.1371/journal.pntd.0012310","DOIUrl":"10.1371/journal.pntd.0012310","url":null,"abstract":"<p><p>The TS POC test, Taenia solium point-of-care test, is a two-strip lateral flow assay using the recombinant antigen rES33 on the TS POC T test strip, and rT24H on the TS POC CC test strip, to detect antibodies against T. solium taeniosis and cysticercosis, respectively. The objective of this study was to assess the diagnostic performance of the TS POC test for the detection of T. solium taeniosis and cysticercosis in individuals attending district hospitals in Tanzania. In this prospective two-phase diagnostic accuracy study, we recruited participants aged 10 and above, excluding pregnant women and those with acute severe illness. Participants were consecutively recruited in three cohorts according to their signs/symptoms: compatible with neurocysticercosis (cohort 1), intestinal worm infections (cohort 2), and other signs/symptoms (cohort 3). Lacking a gold standard test for both infections, diagnostic accuracy was evaluated using results of two coprological and two serological tests for taeniosis, and three serological tests for cysticercosis, in a Bayesian Latent Class Model approach. The TS POC test was conducted on 601 participants in cohort 1, 1661 participants in cohort 2, and 662 participants in cohort 3. Most individuals tested negative on both TS POC test strips, with proportions of 83% (n = 496), 97% (n = 1613) and 97% (n = 641) in cohorts 1, 2 and 3, respectively. Complete case data were available for 120, 114, and 53 participants for taeniosis, and 126, 122, and 55 participants for cysticercosis. Sensitivity values for the TS POC T test strip were 50.2% [95% credible interval 4.9 - 96.4], 40.8% [2.2 - 95.2], and 40.4% [2.3 - 95.0], while specificity values were 98.6% [97.1 - 99.6], 99.3% [98.7 - 99.7] and 99.4% [98.5 - 99.9], respectively. For the TS POC CC test strip, the sensitivity was 77.5% [37.8 - 99.2], 24.9% [95% CI 6.4 - 52.7] and 44.2% [6.6 - 91.5], and the specificity 92.3% [86.5 - 98.8], 99.1% [97.8 - 100], and 98.1% [96.1 - 99.7] across the respective cohorts. Although the TS POC test has a low sensitivity, it demonstrates a high specificity, which may have clinical utility to guide treatment and diagnostic decisions, or in epidemiological studies. An important strength of this study lies in its assessment of the TS POC test under real-world conditions, revealing divergent estimates across distinct cohorts. The study underscores the suboptimal performance of existing tests under field conditions, emphasizing the need to enhance and validate these tests for better performance in practical real-world settings. Registration number: PACTR201712002788898.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 3","pages":"e0012310"},"PeriodicalIF":3.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using iDNA to determine impacts of Amazonian deforestation on Leishmania hosts, vectors, and their interactions.","authors":"Aimee L Massey, David José Ferreira da Silva, Carla Julia da Silva Pessoa Vieira, Jennifer M Allen, Gustavo Rodrigues Canale, Christine Steiner São Bernardo, Roberta Vieira de Morais Bronzoni, Carlos A Peres, Taal Levi","doi":"10.1371/journal.pntd.0012925","DOIUrl":"10.1371/journal.pntd.0012925","url":null,"abstract":"<p><strong>Background: </strong>There is debate concerning whether there exists a generalizable effect of land-use change on zoonotic disease risk. Strong data informing this debate are sparse because it is challenging to establish direct links between hosts, vectors, and pathogens. However, molecular methods using invertebrate-derived DNA (iDNA) can now measure species composition and interactions from vector samples at landscape scales, which has the potential to improve mechanistic understanding of the effects of land-use change on zoonotic disease risk.</p><p><strong>Methodology/principal findings: </strong>We used iDNA metabarcoding of sandflies to disentangle the relationships between Leishmania parasites, sandfly vectors, and vertebrate hosts. We paired these samples with iDNA metabarcoding of carrion flies to survey vertebrates independent of sandfly feeding preferences. We collected sandflies and carrion flies at forest sites across a deforestation gradient in the southern Amazon 'Arc of Deforestation', which exemplifies global patterns of deforestation due to agricultural expansion. We used a series of models to test whether sandflies and the vertebrate they feed upon were influenced by deforestation, which we measured using percent forest cover, percent pasture cover, and distance to the major urban center. We found that vectors were encountered less frequently in forests surrounded by pasture. We also found that the probability of a Leishmania host/reservoir being detected in sandfly bloodmeals was quadratically related to local forest cover, with the highest probability found at sites with intermediate levels of deforestation. Hosts were also detected most often with carrion flies at sites with intermediate forest cover, suggesting that increased host availability rather than feeding preferences was responsible for this result. Domestic dogs and the nine-banded armadillo, Dasypus novemcinctus, were the most prevalent hosts found in the sandfly iDNA data.</p><p><strong>Conclusions/significance: </strong>Our results did not support the generality of the 'dilution effect' hypothesis. However, important vectors and hosts showed consistent responses to deforestation and our findings suggest that interactions between domestic dogs and sylvatic hosts are a pathway for zoonotic disease transmission in human impacted tropical forests.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 3","pages":"e0012925"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Itraconazole resistance in Madurella fahalii linked to a distinct homolog of the gene encoding cytochrome P450 14-α sterol demethylase (CYP51).","authors":"Isato Yoshioka, Ahmed Hassan Fahal, Satoshi Kaneko, Wei Cao, Takashi Yaguchi","doi":"10.1371/journal.pntd.0012623","DOIUrl":"10.1371/journal.pntd.0012623","url":null,"abstract":"<p><strong>Background: </strong>Mycetoma is a deep fungal infection caused by several microorganisms, with Madurella mycetomatis being the most common causative agent. Another related species, Madurella fahalii, is also known to cause eumycetoma. However, unlike M. mycetomatis, M. fahalii exhibits resistance to itraconazole, the standard treatment for eumycetoma, and the underlying cause of this resistance remains unknown. Therefore, understanding the mechanism of this resistance is critical for developing more effective therapies.</p><p><strong>Principal findings: </strong>Using the high-quality draft genome sequence of Madurella fahalii IFM 68171, we identified two copies of the gene encoding cytochrome P450 14-α sterol demethylase (CYP51), the target enzyme of itraconazole. These include a gene conserved among Madurella species (Mfcyp51A1) and a M. fahalii-specific gene (Mfcyp51A2). Both genes are actively transcribed in M. fahalii and are upregulated in response to itraconazole. Furthermore, heterologous expression in Saccharomyces cerevisiae revealed that transformants carrying the Mfcyp51A2 gene exhibited reduced susceptibility to itraconazole compared to those with Mfcyp51A1.</p><p><strong>Conclusion: </strong>We demonstrated that itraconazole resistance in M. fahalii may be attributed to the presence of an additional CYP51 gene. This study represents the first report on the physiological characteristics of Madurella species using genetic engineering techniques.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 3","pages":"e0012623"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Park entrances, commonly contaminated with infective Toxocara canis eggs, present a risk of zoonotic infection and an opportunity for focused intervention.","authors":"Jason D Keegan, Paul M Airs, Claire Brown, Anya Rishi Dingley, Conor Courtney, Eric R Morgan, Celia V Holland","doi":"10.1371/journal.pntd.0012917","DOIUrl":"10.1371/journal.pntd.0012917","url":null,"abstract":"<p><p>Toxocara canis and Toxocara cati, the common roundworms of dogs and cats respectively are commonly found in the soil of public parks. This zoonotic parasite can also infect humans causing difficult to diagnose diseases. Direct contact with contaminated soil is considered one of the primary routes of transmission from animals to humans with the contamination of public places common around the world. In this study we aimed to employ an easily repeatable soil sampling methodology to identify differences in contamination levels between and within parks. Egg density was found to differ significantly between parks and park entrances were the most heavily contaminated locations within parks, followed by playgrounds. Species confirmation by polymerase chain reaction was conducted on a proportion of the recovered eggs and identified most as T. canis (n=36) while three eggs were identified as T. cati. These results indicate that dogs are responsible for the majority of environmental contamination in Dublin City parks, with the highest levels of contamination found around park entrances. Concentration of preventive efforts on dog fouling at these sites is recommended to reduce risks of zoonotic disease transmission.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 3","pages":"e0012917"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, common helminthes, and factors associated with helminthes among pregnant women attending antenatal clinic at a tertiary hospital in Uganda.","authors":"Fowsia Ali Said, Emmanuel Okurut, Naima Bashir Mohamed, Simon Byonanuwe, Richard Mulumba, Isaac Kusolo","doi":"10.1371/journal.pntd.0012926","DOIUrl":"10.1371/journal.pntd.0012926","url":null,"abstract":"<p><strong>Background: </strong>Helminthes in pregnant women is among the neglected tropical diseases. The Uganda ministry of health adopted the WHO recommendation of routine biannual deworming for girls and women of reproductive age and twice in pregnancy during the second and third trimesters. Despite the measures put in place, the prevalence of Helminthes among pregnant women in Uganda is still high which has implications for both the mother and to the developing fetus.</p><p><strong>Methods: </strong>This was a hospital-based cross-sectional study carried out from January to April, 2024. Using Consecutive sampling method, 334 pregnant women were enrolled. Data was collected using pre-tested questionnaires, and a single stool specimen was collected from each woman and freshly voided stool specimens was directly examined microscopically. The data was analyzed using STATA Version 14.2. A bivariate and multivariate analysis were used to show the association between the dependent and independent variables, considering P < 0.05 as the level of significance and the 95% confidence interval.</p><p><strong>Results: </strong>The overall prevalence of Helminthes was 27.54%. Among all pregnant women who tested positive, common helminth was Hook worm (83.7%), followed by Ascaris lumbricoides (31.5%), and Trichuris triciuria (21.7%). Age, rural residence, having no toilet facility, no hand washing after toilet use, walking bare footed, no hand washing before meals were significantly associated with Helminthes with (aOR = 0.2; 95% CI = [0.085-0.588]; P = 0.002), (aOR = 9.0; 95% CI = [1.684-48.325]; P =0.010), (aOR = 3.6; 95% CI = [1.788-7.101]; P = 0.001), (aOR = 4.7; 95% CI = [1.359-16.419]; P = 0.015), (aOR = 1.9; 95% CI = [1.014-3.674]; P = 0.045), (aOR = 13.1; 95% CI = [5.146-33..578]; P = 0.001), respectively.</p><p><strong>Conclusion: </strong>In this study, the overall prevalence of Helminthes was low in pregnancy compared to the global prevalence. The common helminthes among pregnant women was Hook worm infestation. The infection was independently associated with respect to Age, rural residence, having no toilet facility, no hand washing after toilet use, walking bare footed, no hand washing before meals.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 3","pages":"e0012926"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of quantitative point-of-care tests to measure G6PD activity: An individual participant data meta-analysis.","authors":"Arkasha Sadhewa, Ari Winasti Satyagraha, Mohammad Shafiul Alam, Wondimagegn Adissu, Anup Anvikar, Germana Bancone, Praveen K Bharti, Vinod K Bhutani, Santasabuj Das, Muzamil Mahdi Abdel Hamid, Mohammad Sharif Hossain, Nitika Nitika, Bernard A Okech, Lydia Visita Panggalo, Arunansu Talukdar, Michael E von Fricken, Ronald J Wong, Daniel Yilma, Ric N Price, Kamala Thriemer, Benedikt Ley","doi":"10.1371/journal.pntd.0012864","DOIUrl":"10.1371/journal.pntd.0012864","url":null,"abstract":"<p><strong>Background: </strong>Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the main risk factor for severe haemolysis following treatment with 8-aminoquinolines (8AQ). The World Health Organization recommends G6PD testing prior to 8AQ-based hypnozoitocidal treatment.</p><p><strong>Methods: </strong>We undertook an individual level meta-analysis of the performance of commercially available quantitative point-of-care diagnostics (PoCs) compared with reference spectrophotometry. A systematic literature search (PROSPERO: CRD42022330733) identified 595 articles of which 16 (2.7%) fulfilled pre-defined inclusion criteria and were included in the analysis, plus an additional 4 datasets. In total there were 12,678 paired measurements analyzed, 10,446 (82.4%) by STANDARD G6PD Test (SD Biosensor, RoK, [SDB]), 2,042 (16.1%) by CareStart G6PD Biosensor (AccessBio, USA, [CSA]), 150 (1.2%) by CareStart Biosensor (WellsBio, RoK [CSW]), and 40 (0.3%) by FINDER (Baebies, USA, [FBA]).</p><p><strong>Findings: </strong>The pooled sensitivities of the SDB when measuring G6PD activity <30% of normal were 0.82 (95% confidence interval [CI]: 0.72-0.89) for capillary and 0.93 (95% CI: 0.75-0.99) for venous blood samples. The corresponding values for measuring <70% G6PD activity were 0.93 (95% CI: 0.67-0.99) and 0.89 (95% CI: 0.73-0.96), respectively. The pooled specificity of the SDB was high (>96%) for all blood samples and G6PD activity thresholds. Irrespective of the blood samples and thresholds applied, sensitivity of the CSA did not exceed 62%, although specificity remained high at both 30% and 70% thresholds (>88%). Only one study each for CSW and FBA was included. Sensitivities of the CSW were 0.04 (95% CI: 0.01-0.14) and 0.81 (95% CI: 0.71-0.89) at the 30% and 70% thresholds, respectively (venous blood samples). Sensitivities of the FBA were 1.00 (95% CI: 0.29-1.00) and 0.75 (95% CI: 0.19-0.99) at the 30% and 70% thresholds (venous blood samples). Specificities of the CSW and FBA were consistently high (>90%) at both thresholds. Accuracy of the SDB was higher in females at the 30% cut-off (OR: 3.49, p=0.002) and lower in malaria patients at the 70% cut-off (OR: 0.59, p = 0.005).</p><p><strong>Conclusions: </strong>The SDB performed better than other PoCs. More evidence was available for the performance of the SDB compared to other PoCs, giving higher confidence in its utility in diagnosing G6PD deficiency.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 3","pages":"e0012864"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}