Valencia J Lambert, Anna Samson, Dunstan J Matungwa, Agnes L. Kosia, Rhoda Ndubani, Marriam Hussein, K. Kalua, Amaya Bustinduy, Bonnie Webster, Virginia A. Bond, H. Mazigo
{"title":"Female genital schistosomiasis is a women’s issue, but men should not be left out: involving men in promoting care for female genital schistosomiasis in mainland Tanzania","authors":"Valencia J Lambert, Anna Samson, Dunstan J Matungwa, Agnes L. Kosia, Rhoda Ndubani, Marriam Hussein, K. Kalua, Amaya Bustinduy, Bonnie Webster, Virginia A. Bond, H. Mazigo","doi":"10.3389/fitd.2024.1333862","DOIUrl":"https://doi.org/10.3389/fitd.2024.1333862","url":null,"abstract":"Female Genital Schistosomiasis (FGS) causes gynecologic symptoms among women and girls living in sub-Saharan Africa. Despite continued efforts to raise awareness in communities about schistosomiasis, FGS remains poorly recognized. This study aimed to understand men’s knowledge and perceptions of FGS in northwestern Tanzania, and how this affects or can promote women’s uptake of FGS services.We conducted a qualitative, formative survey called “Broad Brush Survey” (BBS) using 30 focus group discussions (FGDs) and 29 key informant interviews in five (5) districts across three regions in northwestern Tanzania. Participants were purposively selected in collaboration with village leaders and provided a written consent and/or assent to participate and be voice recorded. They included adolescent girls and boys (15-20 years), adult women and men (21-45 years), older women and men (≥46 years), village leaders (village chairpersons and executive officers), community health workers (CHWs), traditional healers, retail drug sellers, religious leaders, and opinion leaders (influential women and men). This analysis focuses and draws on 18 FGDs and 19 KIIs in which participants discussed or explained the importance and potential role of men in promoting FGS care.Most participants were not aware of FGS. Despite having adequate knowledge about urogenital schistosomiasis, they perceived FGS to be a sexually transmitted infection (STI). Three main themes emerged during analysis. First, most men reported perceiving women suffering from FGS as “promiscuous” or “unfaithful” due to misperceiving FGS as an STI. Such misperception could result in men ending a relationship. Second, participants reported that their engagement in FGS interventions would be critical to the interventions’ effectiveness because men often regulate women’s access to healthcare. Third, participants argued that men could be empowered through education to promote women’s uptake of FGS services. Finally, they argued that if men are educated about FGS like women, they can both work together in seeking care for FGSEngaging men to address FGS holds potential to transform their negative perceptions of FGS. Further, participants described men’s potential to support and even advocate for women’s healthcare seeking when women experience symptoms that could be consistent with FGS. Including men more explicitly in FGS community education efforts could facilitate the provision of high-quality sexual and reproductive health care for women living in many communities where FGS is endemic but access to care is limited. We propose that public health interventions in such communities, which are often highly patriarchal, should leverage men’s positions within society by engaging them in promoting women’s health interventions. While we only interviewed participants from five (5) districts across three (3) regions, we are confident that their perceptions are reflective of many similar communities in Tanzania and beyond.","PeriodicalId":73112,"journal":{"name":"Frontiers in tropical diseases","volume":"128 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140751753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The role of protists, nematodes and mites as natural control agents of sandfly populations","authors":"Slavica Vaselek","doi":"10.3389/fitd.2024.1369007","DOIUrl":"https://doi.org/10.3389/fitd.2024.1369007","url":null,"abstract":"The Phlebotomine sandflies (Diptera, Psychodidae) are hematophagous insects of immense medical and veterinary importance. Since World War II, the intensive use of chemicals to suppress and control sandfly populations resulted in development of insecticide resistance and resurgence among the sandfly populations worldwide. The use of chemicals also negatively impacted diverse non-target organisms, overall agroecosystem, crop productivity, human health etc. Due to the multiple adverse effects of the chemical compounds, more eco-friendly approaches have been evaluated. The application of entomopathogenic organisms such as nematodes, protists or mites as biocontrol agents has been vastly explored and applied in the field of forestry and agriculture. In comparison, only a little attention was given to blood-sucking insects such as sandflies. This review summarizes the findings related to the detection and use of entomopathogenic protists, nematodes, and mites in the field of biological control of sandflies. It highlights the potential of these organisms to be further explored and used for biocontrol of immature and adult stages of sandflies.","PeriodicalId":73112,"journal":{"name":"Frontiers in tropical diseases","volume":"59 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140368957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Catherine Swedberg, Katrin Bote, Luke Gamble, N. Fénélon, A. King, Ryan M. Wallace
{"title":"Eliminating invisible deaths: the woeful state of global rabies data and its impact on progress towards 2030 sustainable development goals for neglected tropical diseases","authors":"Catherine Swedberg, Katrin Bote, Luke Gamble, N. Fénélon, A. King, Ryan M. Wallace","doi":"10.3389/fitd.2024.1303359","DOIUrl":"https://doi.org/10.3389/fitd.2024.1303359","url":null,"abstract":"Like other neglected diseases, surveillance data for rabies is insufficient and incompatible with the need to accurately describe the burden of disease. Multiple modeling studies central to estimating global human rabies deaths have been conducted in the last two decades, with results ranging from 14,000 to 74,000 deaths annually. Yet, uncertainty in model parameters, inconsistency in modeling approaches, and discrepancies in data quality per country included in global burden studies have led to recent skepticism about the magnitude of rabies mortality. Lack of data not only limits the efficiency and monitoring of rabies elimination strategies but also severely diminishes abilities to advocate for support from international funding agencies. Meanwhile, the most vulnerable communities continue to suffer from deaths that could have been prevented through more robust reporting. The Zero by 30 global strategy to eliminate dog-mediated human rabies by 2030 recommends endemic countries adopt the intersectoral approach, Integrated Bite Case Management (IBCM), as a cost-effective method to enhance surveillance. However, effective implementation of IBCM is impeded by challenges such as limited capacity, resources, knowledge, skills, and attitudes toward compliance. To address this, the World Health Organization and United Against Rabies Forum have developed several open-access tools to guide national control programs in strong data collection practices, and online data repositories to pragmatically streamline reporting and encourage data sharing. Here, we discuss how current and future initiatives can be best employed to improve the implementation of existing surveillance tools and prioritization of effective data reporting/sharing to optimize progress toward 2030 elimination.","PeriodicalId":73112,"journal":{"name":"Frontiers in tropical diseases","volume":"84 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140378057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Silvio Wallemacq, Ahalieyah Anantharajah, Pamela Baldin, J. Yombi, J. de Greef, L. Belkhir
{"title":"Case report: Imported asymptomatic schistosomiasis among Belgian school travelers to Rwanda","authors":"Silvio Wallemacq, Ahalieyah Anantharajah, Pamela Baldin, J. Yombi, J. de Greef, L. Belkhir","doi":"10.3389/fitd.2024.1354031","DOIUrl":"https://doi.org/10.3389/fitd.2024.1354031","url":null,"abstract":"Schistosomiasis is common in many tropical regions and poses a risk for the local population and travelers. In travelers, most of schistosomiasis are described as acute. We report the epidemiological, clinical, and laboratory characteristics associated with an outbreak of asymptomatic schistosomiasis among nonimmune Belgian school travelers in Rwanda. Schistosomiasis was diagnosed by serology in 12 out of the 15 (80%) travelers who swam in the lake nearly 2 years after a single exposure to freshwater at Kivu Lake, Rwanda. None showed signs of acute or chronic schistosomiasis. Eosinophilia was present in only 1 of them. Schistosoma mansoni eggs were not found in any infected patient. This report of an outbreak of asymptomatic schistosomiasis imported from Lake Kivu highlights the risk for travelers of acquiring the infection with only a short and single exposure, and provides strong arguments for routine serological screening for schistosomiasis in all individuals who have had any freshwater contact in endemic areas, irrespective of symptoms or laboratory findings.","PeriodicalId":73112,"journal":{"name":"Frontiers in tropical diseases","volume":"105 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140224879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Overview of microbial studies in sandflies and their progress toward development of paratransgenic approach for the control of Leishmania sp.","authors":"Slavica Vaselek","doi":"10.3389/fitd.2024.1369077","DOIUrl":"https://doi.org/10.3389/fitd.2024.1369077","url":null,"abstract":"During their whole life insects are exposed to the impact of different microbes from various sources. The role of microbes in the life of insects is of immense importance, and there is an ample of evidence showing that microbes can affect different aspects of insect physiology, behaviors as well as their potential and capacity to transmit pathogens. Sandflies are main vectors of Leishmania parasites – causative agent of leishmaniasis. Leishmaniasis is a difficult, disfiguring and if not treated deadly disease ranked among the top 10 neglected tropical diseases. In comparison to other medically and veterinary important insect vectors where microbial investigations already progressed toward field studies and practical application of paratransgenic approach, in the field of sandflies and leishmaniasis control microbial investigations are at their beginning. This mini review provides a summary of the key moments in the overall microbial studies in sandflies and highlights the urgency of detailed microbial investigations to progress toward the development of paratransgenic approach.","PeriodicalId":73112,"journal":{"name":"Frontiers in tropical diseases","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140228719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bacteria associated with Parthenium hysterophorus root exudate influence olfactory oviposition responses of Anopheles gambiae","authors":"T. Milugo, B. Torto, D. Tchouassi","doi":"10.3389/fitd.2024.1359774","DOIUrl":"https://doi.org/10.3389/fitd.2024.1359774","url":null,"abstract":"Previously, we documented that the malaria vector Anopheles gambiae responds to volatile emissions from the root exudate water of the invasive plant, Parthenium hysterophorus. However, the origin of the volatiles remains to be investigated. Here, we isolated bacteria from the root exudate water of the plant, test the influence of their volatiles in gravid An. gambiae oviposition, and examined relationships between volatile profiles and oviposition.Bacteria from root exudate water of P. hysterophorus were isolated using culture on Luria Bertani medium and identified by sequencing the 16S rRNA gene. Cultures of individual isolates were evaluated for egg laying response by gravid An. gambiae and number of eggs laid compared using generalized linear models relative to those in crude bacteria-mixture. Headspace volatile emissions of the bacterial isolates were analyzed by gas chromatography coupled to mass spectrometry (GC-MS) and relationships between volatile organic compound (VOC) profiles and gravid mosquito oviposition examined using Random Forest Analysis. Proximate analysis was performed to assess the difference in volatile chemistry among the different isolates.Three isolates were identified as Gram-negative bacteria belonging to two families: Enterobacteriaceae (Enterobacter sp. and Enterobacter mori) and Alcaligenaceae (Alcaligens aquatilis). An. gambiae laid 3-fold more eggs in cultures of A. aquatilis than in those of Enterobacter sp. In turn, approx. 4-fold more eggs were laid in cultures of E. mori than A. aquatilis. Overall, 16 VOCs were identified in the headspace of the isolates belonging to the chemical classes benzenoids, pyrazines, aldehydes, terpenes, alcohols, alkanes, and indoles. Random Forest Analysis identified 10 compounds contributing the most to the attraction of odors of the bacteria isolates to oviposition. Specifically, dodecane and indole were emitted in higher amounts in odors of Enterobacter sp than the other two species. Proximate analysis revealed differential attraction of the isolates on the gravid mosquito to be associated with their volatile profiles.Our results provide first report of E. mori or A. aquatilis mediating attractive oviposition responses in An. gambiae in support of the important role microbes play in insect oviposition. The potential use of the microbes and associated volatiles in malaria vector management needs further investigation.","PeriodicalId":73112,"journal":{"name":"Frontiers in tropical diseases","volume":"43 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140231500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Nwane, Michael Piameu, Yannick Niamsi Emalio, W. Ekoko, S. Mandeng, L. R. Mbakop, Salomon Patchoké, J. Toto, L. D. Alenou, Elisabeth Ngo Bikoi, Hugues Onguina, Narcisse Nvondo, R. Mimpfoundi, R. Tabue, J. Bigoga, E. Fondjo, P. Awono-ambene, J. Etang
{"title":"Assessing the performance of five adult mosquito sampling methods for malaria vector surveillance in various ecosystems in Cameroon","authors":"P. Nwane, Michael Piameu, Yannick Niamsi Emalio, W. Ekoko, S. Mandeng, L. R. Mbakop, Salomon Patchoké, J. Toto, L. D. Alenou, Elisabeth Ngo Bikoi, Hugues Onguina, Narcisse Nvondo, R. Mimpfoundi, R. Tabue, J. Bigoga, E. Fondjo, P. Awono-ambene, J. Etang","doi":"10.3389/fitd.2024.1235146","DOIUrl":"https://doi.org/10.3389/fitd.2024.1235146","url":null,"abstract":"Many sampling methods are used for entomological surveillance of vector borne diseases. This paper, evaluated the performance of five methods with regard to various ecosystems encountered in Cameroon. Two entomological databases generated during two study periods were examined: 2011-2014 in the North Region, and 2018-2019 in the Centre Region. Mosquitoes were collected using the (Human Landing Catches) (HLC) and four alternative methods including Clay Pots (CPs), Pyrethroid Spray Catches (PSCs), Window Exit Traps (WETs) and Centers for Disease Control-Light Traps (CDC-LTs) for which the performance was assessed in this study.A total of 29 anopheline species were identified from samples collected during the two study periods. All these anopheline species were found in North Region, with 5 species being the most abundant and prévalent, i.e. An. gambiae s.l, An. funestus, An. rufipes, An. paludis and An. pharoensis. In the Centre Region, only five species including An. gambiae s.l, An. funestus, An. coustani, An. ziemanni and An. paludis were recorded. Among these, An. gambiae s.l was the most abundant and prevalent species. Data confirmed HLC as the best in sampling outdoor and indoor mosquitoes in the surveyed HDs. The alternative methods showed variable records regarding the species richness. Based on the number of mosquitoes collected, CP was an alternative to HLC for outdoor collections in Garoua and Pitoa HDs, while WET was an alternative in Mayo Oulo HD. In the Centre Region, CDC-LT was an alternative to HLC for indoor collections in Ekié and Nkolbisson HDs, while PSC proved to be the best alternative in Nkolondom HD. Regarding the species richness WET appeared as an alternative to HLC in sampling outdoor mosquitoes in Garoua and Mayo Oulo HDs, while CP was the best alternative in Pitoa HD. In the Centre Region, CDC-LT was an alternative for outdoor and indoor collections in Nkolbisson HD, and the best alternative for outdoor collections in Ekie HD. The current study revealed variable performance of the five tested adult mosquito collection methods across the prospected HDs in North and Centre Regions of Cameroon. Further investigations will be conducted on other collection methods, e.g., aspiration, mosquito electrocuting grid trap, ovitraps and human-baited double net trap.","PeriodicalId":73112,"journal":{"name":"Frontiers in tropical diseases","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140245471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Saboyá-Díaz, A. N. S. Maia-Elkhoury, A. Luciañez, Samantha Y. O. B. Valadas, Ronaldo Guilherme Carvaho-Scholte, R. Nicholls, Marco A Vigilato, Luis Gerardo Castellanos, Marcos A. Espinal
{"title":"Neglected infectious diseases in the Americas: current situation and perspectives for the control and elimination by 2030","authors":"M. Saboyá-Díaz, A. N. S. Maia-Elkhoury, A. Luciañez, Samantha Y. O. B. Valadas, Ronaldo Guilherme Carvaho-Scholte, R. Nicholls, Marco A Vigilato, Luis Gerardo Castellanos, Marcos A. Espinal","doi":"10.3389/fitd.2024.1326512","DOIUrl":"https://doi.org/10.3389/fitd.2024.1326512","url":null,"abstract":"Neglected infectious diseases (NID) are a diverse group of conditions including more than 20 parasitic, bacterial, and fungal diseases, and envenoming by poisonous animals. Their risk factors include poverty, income inequality, lack of access to safe drinking water and proper sanitation, and barriers to education and health services, among other social determinants of health. They impose a large burden on marginalized populations globally and in the region of the Americas, including women and ethnic minorities. The region of the Americas has a track record of elimination of communicable diseases and countries have made significant progress in the elimination of NID in recent years. Between 2011 and 2020, one country eliminated trachoma, four eliminated onchocerciasis, one eliminated human rabies transmitted by dogs, and three were declared free of lymphatic filariasis. The COVID-19 pandemic impacted the continuity of actions to eliminate NID and there are challenges in controlling and eliminating NID, particularly in vulnerable and hard-to-reach populations with issues in accessing health services. There are still difficulties in the coordination between health and other sectors to work together on the socioeconomic and environmental determinants of NID. Forwarding the elimination of NID in the Americas involves continuous advocacy and resource mobilization at various levels (international, regional, national, and subnational), ensuring sufficient allocation of human and financial resources, access to essential health supplies, and implementing people-centered services. It also entails engaging and empowering civil society, communities, local governments, and public-private partnerships, while collaborating with stakeholders and donors for effective action.","PeriodicalId":73112,"journal":{"name":"Frontiers in tropical diseases","volume":"18 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140247537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ram Das, K. Vashisht, Lokesh Kori, Kuldeep Singh, Gaurav Kumar, Izazul Hasan, Jugal Gam, K. Pandey
{"title":"Detection of the infective Plasmodium falciparum gametocytes by RT-qPCR assay from a malaria-endemic region of Northeastern India","authors":"Ram Das, K. Vashisht, Lokesh Kori, Kuldeep Singh, Gaurav Kumar, Izazul Hasan, Jugal Gam, K. Pandey","doi":"10.3389/fitd.2024.1366462","DOIUrl":"https://doi.org/10.3389/fitd.2024.1366462","url":null,"abstract":"The diagnosis of infectious reservoirs in malaria (gametocytes) is necessary, especially in low-density infections and asymptomatic malaria patients. The gametocyte stage is a surrogate marker for infection of P. falciparum malaria in healthy individuals. The early detection of infectious gametocytes and treatment will strengthen our efforts in curbing transmission. The nested PCR and real-time quantitative PCR (RT-qPCR) methods have been demonstrated for the diagnosis of infectious gametocyte reservoirs. In this study, RDT, blood smear microscopy, and nested-PCR were used for the detection of P. falciparum and P. vivax, and compared with RT-qPCR detection of Pfg27 gametocyte biomarker gene.In the present cross-sectional study, 356 human blood samples were collected from endemic areas of Kokrajhar Assam (asymptomatic and symptomatic malaria patients) for malaria diagnosis.A total of 8.42%(30/356) incidence of malaria was observed. Malaria patients were observed to be both symptomatic, 80%(24/30; 13Pf+11Pv), and asymptomatic, 20%(6 (4Pf +2Pv)). More than 64%(11/17) of Pf and 92.3%(12/13) of Pv infections were observed in children and the adolescent population (age <20 years) by RDT, microscopy, nested PCR, and RT-qPCR methods. The prevalence of Pf infection was 4.77%(17/356) by RT-qPCR method. Of 16 the Pf positive samples 81.25%(13/16) were symptomatic and 18.75%(3/16) were asymptomatic. One asymptomatic individual was found positive for Pf infection by the RT-qPCR method.The findings from this research study revealed that the routine microscopy and RDT methods are insufficient for detecting all asymptomatic malaria and gametocyte infectious reservoirs. The early detection of infectious P. falciparum gametocytes and the treatment of patients will be helpful in preventing the transmission of malaria.","PeriodicalId":73112,"journal":{"name":"Frontiers in tropical diseases","volume":"13 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140258152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}