PLoS Neglected Tropical Diseases最新文献

{"title":"People-centered strategies to mobilize people living with disabilities due to Neglected Tropical Diseases (PD-NTDs) to influence policy and programs: A mixed-methods study in Côte d'Ivoire.","authors":"Julien Aké, Eunheh Koh, Tiembre Issiaka, Boko-Koiadia Adjoua N'Groma Nadège, Lorou Bi Maxime, Maneesh Phillip, Konan Anne Cécille, Rie Yotsu","doi":"10.1371/journal.pntd.0013485","DOIUrl":"10.1371/journal.pntd.0013485","url":null,"abstract":"<p><strong>Introduction: </strong>Neglected tropical diseases (NTDs) are a priority in the public health agenda for Côte d'Ivoire, with persons living with disabilities due to NTDs (PD-NTDs) experiencing many challenges in their daily lives. Current policies do not sufficiently support PD-NTDs, thereby highlighting the need to identify opportunities for policy improvement.</p><p><strong>Methods: </strong>This study was carried out in two phases: first to identify the current needs (formative phase) and then to develop a pilot strategy (implementation phase). In the formative phase, pertinent current legislation was reviewed. Then, interviews of PD-NTDs and their caregivers were conducted and analyzed quantitatively. Thematic analysis of focus groups with key community stakeholders was also completed. In the implementation phase, a pilot strategy was developed to address the identified issues.</p><p><strong>Results: </strong>172 PD-NTDs and their caregivers were surveyed through this study. 99% of PD-NTDs expressed a need for rehabilitation, healthcare and psychosocial support. More than 80% endorsed the need for healthcare services and free medications, 92% expressed the need for educational services, and 83% reported economic difficulties. Furthermore, 30% of PD-NTDs reported limited awareness of specialized care services available in the community, 25% endorsed limited knowledge of current legislation that protects the rights of people living with disabilities, and 38% faced significant stigma and discrimination within the past 12 months. Fifty-six interviews with key informants further echoed these gaps. A pilot strategy was developed with four pillars to (1) increase community advocacy, (2) combat stigma, (3) promote mutual support among PD-NTDs, and (4) improve the sustainability of the effort. Forty-one out of 49 activities were completed.</p><p><strong>Discussion: </strong>This project represents a comprehensive effort to identify policy opportunities to effectively support PD-NTDs. This approach may be used by other organizations that plan to develop initiatives to target the needs of PD-NTDs in their local communities.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0013485"},"PeriodicalIF":3.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024518","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":"Interstitial pneumonia via the oropharyngeal route of infection with Encephalitozoon cuniculi.","authors":"Mariana Souza Santos, Rodrigo A da Silva, Lucas Nunes de Souza, Nicolli R Victorino, Rayane C B Pereira, José Guilherme Xavier, Ronalda da Silva Araújo, Elizabeth C Pérez, Anuska M Alvares-Saraiva, Maria Anete Lallo","doi":"10.1371/journal.pntd.0012130","DOIUrl":"10.1371/journal.pntd.0012130","url":null,"abstract":"<p><p>Microsporidia causes opportunistic infections in immunosuppressed individuals. Mammals shed these spores of fungi in feces, urine, or respiratory secretions, which could contaminate water and food, thereby reaching the human body and causing infection. The oral route is the most common route of infection, although experiments have demonstrated that intraperitoneal and intravenous routes may also spread infection. Respiratory tract infection, although considered to be possible, has not been reported to date. The present study, therefore, aimed to demonstrate infection with the microsporidia of Encephalitozoon cuniculi via the oropharyngeal route as a model for opportunistic pneumonia. The objectives were the study of opportunistic pneumonia in general while also confirming transmission via the respiratory route to expand the understanding of the epidemiology of zoonoses. C57BL mice, both male and female, up to 12 weeks of age, and free of specific pathogens (SPF) were inoculated (Infected group) or not infected (Uninfected group) with 1 × 107 spores of E. cuniculi via the oropharyngeal route. The animals immunosuppressed with cyclophosphamide (Cy) were infected (Cy-Infected group) or not infected (Cy-Uninfected group), and then assessed for the influence of immunosuppression on infection. In both groups, animals inoculated with 0.9% saline solution via the oropharyngeal route served as controls (Sham and Cy-Sham groups, respectively). After 14 days of infection, the lungs of all animals were retrieved for histopathological analysis, phenotyping of lung inflammatory cells using flow cytometry, measurement of fungal load using qPCR, and measurement of the serum levels of Th1, Th2, and Th17 cytokines. The results revealed that the infected animals developed interstitial pneumonia characterized by perialveolar inflammatory infiltrative lesions with a predominance of lymphocytes and plasma cells. However, the fungal load and the extent of the inflammatory infiltrate were relatively lower in the Cy-Infected group, with a predominance of the CD8+ T lymphocyte population in the lungs compared to Infected group. In the Infected group not treated with Cy, an increase in the population of alveolar macrophages (F4/80+CD11b-SiglecF+) was noted, along with higher fungal load and inflammatory infiltrate in the lungs, indicating a further pronounced Encephalitozoon pneumonia compared to the immunosuppressed animals. The infected groups presented Th1 cytokine profiles, with the Cy-Infected group exhibiting increased Th17 levels. Collectively, these results demonstrated that oropharyngeal infection promoted pneumonia caused by E. cuniculi in mice treated or not with cyclophosphamide, with greater severity occurring in the non-immunosuppressed mice, thereby establishing this model as a suitable one for interstitial pneumonia via aspiration.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0012130"},"PeriodicalIF":3.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024595","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":"Territorial and gender-linked risk factors for Buruli ulcer in Southern Benin: A case-control study using geographic and behavioral surveying.","authors":"Harvey Johnson, Alexandra Boccarossa, Esai Anagonou, Télésphore Brou, Perin Catraye, Sébastien Fleuret, Estelle Marion, Matthieu Eveillard","doi":"10.1371/journal.pntd.0013509","DOIUrl":"10.1371/journal.pntd.0013509","url":null,"abstract":"<p><strong>Objectives: </strong>The manuscript examines the risk factors associated with Buruli ulcer in endemic regions of Benin, focusing on community practices, agricultural activities, and age and gender disparities.</p><p><strong>Methods: </strong>The study, conducted from November 2021 to June 2024, used a prospective case-control approach combined with a geographic health survey. The study involved home interviews followed by guided tours of areas frequented by participants, allowing the precise identification of practices at risk of Buruli ulcer. Univariate analysis and stepwise backward stepwise logistic regression were carried out.</p><p><strong>Results: </strong>Overall, 117 patients and 234 controls were included. Multivariate analysis showed that activities such as bathing (OR = 3.2, p = .04), farming in flooded areas (OR = 3.8, p = .02), and frequenting irrigation canals (OR = 5.0, p = .003) were independent risk factors for Buruli ulcer. The originality of this study was that these risks were not distributed in the same way across territory and depended on age and gender.</p><p><strong>Conclusion: </strong>The findings suggest that public health interventions need to consider gender, age, territorial features, and local agricultural practices. Furthermore, integrating geographical and spatial data into epidemiological studies offers valuable insights helping to prevent the spread of this neglected tropical disease.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0013509"},"PeriodicalIF":3.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024561","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":"Geostatistical analysis to guide treatment decisions for soil-transmitted helminthiasis control in Uganda.","authors":"Bryan O Nyawanda, Kristin M Sullivan, Benjamin Tinkitina, Prudence Beinamaryo, Betty Nabatte, Hilda Kyarisiima, Alfred Mubangizi, Paul M Emerson, Jürg Utzinger, Penelope Vounatsou","doi":"10.1371/journal.pntd.0013467","DOIUrl":"10.1371/journal.pntd.0013467","url":null,"abstract":"<p><strong>Background: </strong>Soil-transmitted helminth (STH) infections remain a public health problem in Uganda despite biannual national deworming campaigns implemented since the early 2000s. Recent surveys have indicated a heterogeneous STH infection prevalence, suggesting that the current blanket deworming strategy may no longer be cost-effective. This study identified infection predictors, estimated the geographic distribution of STH infection prevalence by species, and calculated deworming needs for school-age children (SAC).</p><p><strong>Methodology: </strong>Bayesian geostatistical models were applied to STH survey data (2021-2023) for each species (i.e., Ascaris lumbricoides, hookworm, and Trichuris trichiura). Climatic, environmental, and socioeconomic predictors were obtained from remote sensing sources, model-based databases, and demographic and health surveys. Prevalence was predicted on a 1 × 1 km2 grid across Uganda, and district-level estimates were used to classify each district into treatment frequency categories and to determine its deworming tablet requirements.</p><p><strong>Principal findings: </strong>The national prevalence of A. lumbricoides, T. trichiura, and hookworm was estimated at 5.0% (95% Bayesian credible interval [BCI]: 0.8-11.8%), 3.5% (0.7-9.3%), and 7.2% (5.7-11.1%), respectively. The overall prevalence of any STH infection was 14.3% (9.6-21.8%). High intra-district variation in prevalence was observed. Of 146 implementation units (136 districts and 10 cities), 49 require twice-year treatment, 34 once-yearly treatment, 61 every other year treatment, and 2 had a prevalence <2%, indicating treatment suspension or event-based treatment. Approximately 17 million tablets will be needed for preventive chemotherapy aimed at SAC in 2025.</p><p><strong>Conclusions/significance: </strong>The prevalence of STH infection has declined considerably across Uganda compared to the early 2000s. However, deworming needs remain heterogeneous across districts. Through geostatistical modeling, districts were classified according to the latest World Health Organization's (WHO) treatment guidelines. This approach optimizes treatment distribution and allows for prioritization of populations with the greatest needs. We estimated that tablet requirements are approximately 40% lower compared to the current twice-a-year deworming regimen, which contributes towards WHO's goal of halving the number of tablets required for preventive chemotherapy by 2030.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0013467"},"PeriodicalIF":3.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024575","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":"The prevalence of trachoma, ocular Chlamydia trachomatis infection and anti-Pgp3 antibodies in Choiseul Province, Solomon Islands.","authors":"Clare E F Dyer, Carleigh S Cowling, Oliver Sokana, Lazarus Neko, Nemia Bainivalu, Freda Pitakaka, Anasaini Cama, Mitchel Starr, Emma M Harding-Esch, Cristina Jimenez, Ana Bakhtiari, Sarah Boyd, Sara Webster, Anthony W Solomon, John M Kaldor, Susana Vaz Nery","doi":"10.1371/journal.pntd.0013381","DOIUrl":"10.1371/journal.pntd.0013381","url":null,"abstract":"<p><p>Trachoma, caused by repeated ocular infection with Chlamydia trachomatis, remains a leading infectious cause of blindness globally, with significant implications for public health. The World Health Organization and partners aim to eliminate trachoma as a public health problem by 2030, targeting specific prevalence thresholds for trachomatous trichiasis (TT) and trachomatous inflammation-follicular (TF). Diagnosis is primarily clinical. Studies have shown discrepancies between prevalence estimates of TF and C. trachomatis infection. This study, undertaken in Choiseul, Solomon Islands, evaluated TF, evidence of current C. trachomatis infection (by polymerase chain reaction (PCR) on conjunctival swabs), and evidence of past exposure to that bacterium (using anti-Pgp3 serology on dried blood spots). Among 645 1-9-year-old children, TF prevalence was 17.5% and C. trachomatis prevalence was 8.5%. These findings suggest transmission of sufficient intensity to pose a public health problem. Notably, 59% of children with TF had evidence of neither current nor previous C. trachomatis infection. Increasing age was associated with TF and evidence of past infection, but not current infection. The community had poor water, sanitation, and hygiene conditions. This study highlights the benefit of integrating laboratory testing for guiding effective trachoma elimination as a public health problem. Although our work was limited by imperfect enrolment of resident children and the logistical challenges of collecting samples in a remote region, we believe our data justify continued public health interventions against trachoma in Choiseul.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0013381"},"PeriodicalIF":3.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024536","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":"Clinical, virological, and antibody profiles of overlapping dengue and chikungunya virus infections in children from southern Colombia.","authors":"Daniela Polanía-Espinosa, Sebastián Castro-Trujillo, Carlos F Narváez","doi":"10.1371/journal.pntd.0013260","DOIUrl":"10.1371/journal.pntd.0013260","url":null,"abstract":"<p><strong>Background: </strong>Dengue and chikungunya are arboviral diseases with overlapping clinical characteristics. Dengue virus (DENV) is endemic in Colombia, and in 2014/2015, the chikungunya virus (CHIKV) caused an epidemic that resulted in over 350,000 cases. Since then, both viruses have been actively co-circulating. The early and accurate identification of pediatric infection caused by DENV or CHIKV is essential for proper medical management. Given that subsequent infections and co-infections with DENV and CHIKV have been reported, virological and immunological factors may influence their clinical outcomes. Here, we analyzed the viremia, antigenemia, and virus-specific antibody responses in hospitalized children suspected of having dengue during the peak of CHIKV infections in Colombia.</p><p><strong>Methods: </strong>Ninety-one children with a clinical diagnosis of dengue were included in the peak of the CHIKV epidemic (December 2014 to May 2015) at a reference healthcare center in Huila, south of Colombia. Multiplexed RT-qPCR for DENV, CHIKV, and ZIKV was performed, and DENV antigenemia was evaluated using an ELISA for the NS1 antigen. Commercial capture or in-house indirect NS1-based ELISAs were used to assess circulating DENV and CHIKV-IgM and IgG. Clinical and laboratory characteristics were analyzed during hospitalization, and convalescent follow-up was conducted for a fraction of children.</p><p><strong>Results: </strong>DENV and CHIKV monoinfections were confirmed in 54% and 12% of children, respectively, with the expected virus-specific seroconversion in recovery. Overlapping infections occurred in 22% of the children, while 12% showed no detectable DENV or CHIKV infections. Abdominal pain, vomiting, hepatomegaly, and thrombocytopenia were common findings associated with DENV, while arthralgia and rash characterized CHIKV monoinfections. One fatal secondary DENV-3 monoinfection was registered, and DENV infection dominated the symptoms of overlapping infections without producing different clinical outcomes compared to monoinfections. Thirty-eight percent of children were seropositive for CHIKV-IgG, indicating a significant burden of CHIKV infection in the pediatric population shortly after its introduction in Colombia. The previous virus-specific IgG serostatus did not impact the clinical outcome of the current heterotypic arboviral infection.</p><p><strong>Conclusion: </strong>The pediatric population in southern Colombia was rapidly exposed to CHIKV infections during the first months following its arrival, with up to 12% of hospitalized children suspected of having dengue experiencing CHIKV monoinfection, supporting that complex and dynamic epidemiological patterns may lead to delayed or missed diagnoses. The overlapping infections of DENV and CHIKV were frequent and did not lead to worse clinical or fatal outcomes.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0013260"},"PeriodicalIF":3.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024582","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":"Factors associated with health worker adoption of facial and environmental hygiene promotion in the 'SAFE strategy' for trachoma elimination in Western Province, Zambia.","authors":"Martha Kasongo, Choolwe Jacobs, Adam Silumbwe, Patricia Maritim, Joseph Mumba Zulu, Hikabasa Halwindi","doi":"10.1371/journal.pntd.0013483","DOIUrl":"10.1371/journal.pntd.0013483","url":null,"abstract":"<p><strong>Background: </strong>Trachoma is responsible for the blindness or visual impairment of about 1.9 million people and causes about 1.4% of all blindness worldwide. In Zambia, trachoma is endemic and Western Province is one of the most affected provinces. The SAFE (surgery, antibiotics, facial cleanliness and environmental improvement) strategy is recommended for elimination of trachoma. In many settings, interventions particularly for facial cleanliness and environmental improvement are sub-optimally adopted due to lack of prioritization and inadequate funding of intervention activities. This study sought to establish the level of, and factors associated with adoption of facial and environmental hygiene promotion in the SAFE strategy among health workers in Western Province, Zambia.</p><p><strong>Methodology/principal findings: </strong>This was a cross-sectional study involving 24 health facilities selected from three districts using stratified random sampling. A total of 388 health workers comprising environmental health officers, community health assistants and community health workers were randomly selected. Adoption of facial and environmental hygiene promotion was self-reported, defined as participation in community distribution of information, education and communication (IEC) materials or community demonstrations of correct hand and face washing methods or both, within the past six months. Multiple logistic regression was used to identify the factors associated with adoption using STATA Version 15. The study was conducted in March and April 2023. Adoption of facial and environmental hygiene promotion was low at 47.68%. Having readily available transport (AOR = 3.06. 95% CI = [1.38, 6.80]), perceiving the intervention as relevant for trachoma prevention (AOR = 7.78, 95% CI = [4.38, 13.82]), having been trained in F and E (AOR = 2.17, 95% CI = [1.24, 3.78]) and availability of information, education and communication materials (AOR = 3.04, 95% CI = [1.69, 5.46]) were associated with higher odds of adoption of facial and environmental hygiene promotion among health workers.</p><p><strong>Conclusion/significance: </strong>There was low adoption of facial and environmental hygiene promotion among health workers influenced by training, transport availability, IEC material availability and perceived relevance and complexity of the intervention. To increase adoption of facial and environmental hygiene promotion, program implementers must ensure that they consider the identified factors in the planning of the intervention activities.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0013483"},"PeriodicalIF":3.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024570","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":"Impact of diabetes mellitus on adenolymphangitis episodes in patients with filarial lymphedema-Towards an integrated care approach.","authors":"Nikita Kubal, Sowmiya Manavalan, Vijayakumar Balakrishnan, Nileshkumar Elangovan, Danapriyaa Dharmalingam, Vijesh Sreedhar Kuttiatt","doi":"10.1371/journal.pntd.0013486","DOIUrl":"10.1371/journal.pntd.0013486","url":null,"abstract":"<p><strong>Background: </strong>Filarial lymphedema, caused by lymphatic filariasis, is characterized by chronic swelling and recurrent skin infections. Acute adenolymphangitis (ADL) episodes significantly exacerbate morbidity. Diabetes mellitus (DM) increases susceptibility to infections; however, the relationship between diabetes and ADL frequency and severity in filarial lymphedema patients remains unclear. This study investigated the influence of diabetes on ADL attacks and identified predictors influencing ADL episodes in patients with filarial lymphedema.</p><p><strong>Methodology/principal findings: </strong>This case-control study analyzed data from 166 patients (79 diabetic, 87 non-diabetic) attending a filariasis management clinic in Puducherry, India. Sociodemographic data, clinical characteristics, ADL frequency, severity, and adherence to morbidity management and disability prevention (MMDP) practices were collected. Univariate and multivariate logistic regression analyses examined the association between diabetes mellitus and ADL episodes. Diabetes status did not significantly influence ADL frequency or severity. However, lymphedema severity and intertrigo presence emerged as significant predictors of increased ADL attack risk. Home-based care was associated with increased ADL frequency, suggesting potential inadequacies in current self-care practices. Integration of filarial lymphedema care into existing non-communicable disease (NCD) clinics at primary healthcare centers (PHCs) and subcenters could streamline care delivery, enhance patient management, and optimize healthcare resource utilization.</p><p><strong>Conclusions: </strong>This study emphasizes the importance of integrated care approaches addressing both diabetes and lymphedema management. Lymphedema severity and intertrigo management should be prioritized in patient care to mitigate ADL risks. Strengthening home-care education and protocols is essential for improving ADL outcomes. Future research should explore structured community-based and prospective studies to clarify diabetes management's potential protective role and further enhance the quality of care for affected individuals.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0013486"},"PeriodicalIF":3.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024578","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":"Assessing the impact of tungiasis on children's quality of life in Kenya.","authors":"Lynne Elson, Berrick Otieno, Abneel K Matharu, Naomi Riithi, Esther Jebor Chongwo, Francis Mutebi, Hermann Feldmeier, Jürgen Krücken, Ulrike Fillinger, Amina Abubakar","doi":"10.1371/journal.pntd.0012606","DOIUrl":"10.1371/journal.pntd.0012606","url":null,"abstract":"<p><p>Tungiasis is a neglected tropical skin disease caused by the sand flea, Tunga penetrans which penetrates the skin causing considerable pain and itching. In this cross-sectional study we aimed to assess its impact on the quality of life of school children in Kenya. School pupils (198) aged 8-14 years with tungiasis were randomly selected and interviewed using a tungiasis-specific quality of life instrument (TLQI). The caregivers of each infected pupil and 199 randomly selected caregivers of uninfected pupils were interviewed using the proxy KIDscreen52 to assess their child's general health-related quality of life (HR-QoL). Generalized linear models were used to assess associations between quality-of-life variables, children's tungiasis status and other covariables. Among infected children, 62.4% had TLQI scores reflecting a moderate to very high impact, with no significant difference between mild and severe cases. Severe cases had a lower proxy-HR-QoL than uninfected pupils (β -21.15, 95% CI -39.63 - -2.68, p = 0.025), but this was not significant in multivariable models. For the first time, this study demonstrated for children whose caregivers were depressed, tungiasis had a higher impact on their quality of life (TLQI adjusted β 0.28, 95% CI 0.08 - 0.49, p = 0.006) and had a lower general HR-QoL (adjusted β -40.34, 95%CI -55.91 - -24.76, p < 0.001). Conversely, if their caregiver showed them affection, tungiasis had a lower impact on their quality of life (TLQI, adjusted β -0.45, 95% CI -0.70 - -0.20, p < 0.001). Further studies are needed to investigate the interaction of tungiasis with parenting styles, the mental health of children and their caregivers and their effect on children's well-being. However, this evidence indicates programs aiming to control tungiasis should include activities targeting the mental health and parenting style of caregivers.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0012606"},"PeriodicalIF":3.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024530","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":"Community-directed treatment with ivermectin in Maridi, South Sudan: Impact of an onchocerciasis awareness campaign and bi-annual treatment on therapeutic coverage.","authors":"Joseph Nelson Siewe Fodjo, Moses Okwii, Stephen Raimon Jada, Amber Hadermann, Jacopo Rovarini, Luis-Jorge Amaral, Rogers Nditanchou, Yak Yak Bol, Makoy Y Logora, Jane Y Carter, Johan Willems, Robert Colebunders","doi":"10.1371/journal.pntd.0013493","DOIUrl":"10.1371/journal.pntd.0013493","url":null,"abstract":"<p><strong>Background: </strong>A high onchocerciasis disease burden and a low coverage of community-directed treatment with ivermectin (CDTI) have been observed in many parts of South Sudan. In the Maridi County, CDTI was re-introduced in 2017 and various interventions implemented to improve coverage.</p><p><strong>Methods: </strong>Through successive community-based surveys, we investigated whether an onchocerciasis awareness campaign and a switch from annual to bi-annual distribution of ivermectin in Maridi County increased CDTI coverage. We also reviewed the evolution of ivermectin distribution in Maridi since 2017 and identified the determinants for ivermectin uptake.</p><p><strong>Results: </strong>For past years in Maridi, CDTI programme performance has been highly variable due to security concerns, limited funding, misconceptions about ivermectin, and poor organisation of mass treatment campaigns. Community-based surveys conducted between 2018 and 2024 in Maridi found that upon switching from annual CDTI (2017-2019) to bi-annual CDTI (2021 onward), therapeutic coverage significantly increased from 40.8% in 2017 to 70.3% in 2023. Lower age, male gender, more CDTI information sources, and awareness of a link between onchocerciasis and epilepsy were all associated with increased uptake of ivermectin.</p><p><strong>Conclusion: </strong>This study showed that with reinforced awareness raising accompanying biannual CDTI, a higher ivermectin treatment coverage is achievable. The findings present an opportunity for the health system to advance its onchocerciasis elimination scheme in remote, conflict-stricken communities in South Sudan.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0013493"},"PeriodicalIF":3.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024609","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}