American Journal of Tropical Medicine and Hygiene最新文献_第6页

Relationship between Prices and Quality of Essential Medicines from Different Manufacturers Collected in Cameroon, the Democratic Republic of the Congo, and Nigeria. 在喀麦隆、刚果民主共和国和尼日利亚收集的不同制造商生产的基本药物的价格与质量之间的关系。

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-10-08 DOI: 10.4269/ajtmh.24-0309

Julia Gabel, Peter Martus, Lutz Heide

{"title":"Relationship between Prices and Quality of Essential Medicines from Different Manufacturers Collected in Cameroon, the Democratic Republic of the Congo, and Nigeria.","authors":"Julia Gabel, Peter Martus, Lutz Heide","doi":"10.4269/ajtmh.24-0309","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0309","url":null,"abstract":"Achieving universal access to affordable medicines and at the same time ensuring the quality of medicines presents a challenge, especially in low- and middle-income countries. Here, the relationship between medicine prices and medicine quality was investigated in three African countries. From different types of health facilities and medicine vendors, 711 samples of 18 different essential medicines were purchased and analyzed for quality (assay and dissolution) according to the United States Pharmacopeia. Without exception, all originator brand medicines and all SRA generics (generic medicines manufactured in countries with stringent regulatory authorities [SRAs]) complied with pharmacopeial specifications. In contrast, 21.1% of the non-SRA generics (manufactured in countries without SRAs) were substandard. The median prices of originator brands and SRA generics were three times and two times higher than those of non-SRA generics, respectively. Within the non-SRA generics, no positive correlation was observed between medicine quality and medicine price. Medicines manufactured in India, China, or African countries showed similar quality and similar prices. Only a single WHO-prequalified medicine sample was found among the 711 samples. Non-SRA generic medicines produced by manufacturers for which WHO had published Public Inspection Reports showed a significantly lower rate of substandard medicines (7.3%) and, at the same time, significantly lower prices (by 33%) than other non-SRA generics. Falsified medicines (total 2.0%) were found among all categories of medicines and had prices similar to those of non-SRA generics. Our findings indicate that adequate quality assurance does not necessarily imply an increase in medicine prices.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Electronic Clinical Decision Support Tools: Strategies to Improve the Management of Lower Respiratory Tract Infections in Low-Resource Settings. 电子临床决策支持工具：电子临床决策支持工具：改善资源匮乏地区下呼吸道感染管理的策略》（Electronic Clinical Decision Support Tools: Strategies to Improve the Management of Lower Respiratory Tract Infections in Low-Resource Settings）。

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-10-08 DOI: 10.4269/ajtmh.24-0126

L Gayani Tillekeratne, Warsha De Soyza, Maria D Iglesias-Ussel, Stefany Olague, Dhammika Palangasinghe, Ajith Nagahawatte, Thilini Wickramatunga, Jayani Gamage, Ruvini Kurukulasooriya, Madureka Premamali, James Ngocho, Armstrong Obale, Kate Sanborn, John Gallis, Christopher W Woods, Susanna Naggie, Truls Ostbye, Hrishikesh Chakraborty, Eric Laber, Evan Myers, Melissa Watt, Champica K Bodinayake

{"title":"Electronic Clinical Decision Support Tools: Strategies to Improve the Management of Lower Respiratory Tract Infections in Low-Resource Settings.","authors":"L Gayani Tillekeratne, Warsha De Soyza, Maria D Iglesias-Ussel, Stefany Olague, Dhammika Palangasinghe, Ajith Nagahawatte, Thilini Wickramatunga, Jayani Gamage, Ruvini Kurukulasooriya, Madureka Premamali, James Ngocho, Armstrong Obale, Kate Sanborn, John Gallis, Christopher W Woods, Susanna Naggie, Truls Ostbye, Hrishikesh Chakraborty, Eric Laber, Evan Myers, Melissa Watt, Champica K Bodinayake","doi":"10.4269/ajtmh.24-0126","DOIUrl":"10.4269/ajtmh.24-0126","url":null,"abstract":"Lower respiratory tract infection (LRTI) is a common reason for hospitalization and antibacterial use globally. There is considerable overlap in the clinical presentation of bacterial and viral LRTIs. Low- or middle-income countries (LMICs) face the dual challenge of appropriately targeting antibacterials for bacterial LRTI while reducing inappropriate antibacterials for viral LRTI. We propose a framework by which an electronic clinical decision support tool (eCDST) for diagnosing LRTI and reducing unnecessary antibacterial use may be developed, validated, and prospectively evaluated in an LMIC. The developed tool would be data driven, low-cost, feasible in the local setting, adaptable based on resource availability, and updated in real time, with prospective assessment to identify its clinical impact. We draw upon our team's recent experience developing an eCDST for LRTI management in Sri Lanka. Publicly sharing such processes and data is valuable, such that we can collectively improve clinical care in LMICs and other settings.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Routine Immunization Status and Factors Associated with Immunization Coverage among Children Aged 12-23 Months in Tanzania. 坦桑尼亚 12-23 个月大儿童的常规免疫接种状况以及与免疫接种覆盖率相关的因素。

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-10-08 DOI: 10.4269/ajtmh.23-0563

Gumi Abdallah, Hajirani M Msuya, Sally Mtenga, Charles Festo, Grace Mhalu, Josephine Shabani, Robert Tillya, William Mwengee, Honorati Masanja, Abdallah Mkopi

{"title":"Routine Immunization Status and Factors Associated with Immunization Coverage among Children Aged 12-23 Months in Tanzania.","authors":"Gumi Abdallah, Hajirani M Msuya, Sally Mtenga, Charles Festo, Grace Mhalu, Josephine Shabani, Robert Tillya, William Mwengee, Honorati Masanja, Abdallah Mkopi","doi":"10.4269/ajtmh.23-0563","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0563","url":null,"abstract":"Immunization has saved millions of lives globally from vaccine-preventable diseases. Childhood immunization is an effective public health strategy for decreasing morbidity and mortality among children in developing countries. Tanzania has one of the highest rates of coverage of routine child immunization among sub-Saharan African countries. However, obstacles to universal immunization still exist, particularly in rural areas of the country. Assessing routine immunization coverage is essential to inform vaccine policies and program implementation. This study aimed to assess routine immunization status and factors associated with its coverage among children aged 12-23 months. We conducted a cross-sectional, quantitative household survey in 31 regions with caretakers of children in Tanzania, where a total of 4,560 households were visited. Nationally, 85.5% of children aged 12-23 months had completed the full recommended course of vaccines. Overall, 14.5% of children aged 12-23 months did not complete routine immunization schedules in 2019. We found that factors associated with immunization coverage included having one to six family members, higher household wealth, the family's head engaging in subsistence farming, caretakers' age, children's age, educational level, children with clinic cards, and children receiving the diphtheria, pertussis, tetanus-3 vaccine. The country is about to reach the vaccination coverage target set by the WHO and the United Nations Children Fund. Improving existing vaccination coverage and optimizing the use of recommended interventions are required. We strongly advise using the periodic micro-planning tool and satellite image technology, particularly in areas where immunization coverage is less than 80%.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multiple Organ Dysfunction Syndrome in Malawian Children with Cerebral Malaria. 马拉维脑疟疾患儿的多器官功能障碍综合征。

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-10-08 DOI: 10.4269/ajtmh.24-0303

Hunter J Wynkoop, Alistair Bevan, Xochilt Galeano, Madiha Raees, Md Rejuan Haque, Terrie Taylor, Nicole F O'Brien

{"title":"Multiple Organ Dysfunction Syndrome in Malawian Children with Cerebral Malaria.","authors":"Hunter J Wynkoop, Alistair Bevan, Xochilt Galeano, Madiha Raees, Md Rejuan Haque, Terrie Taylor, Nicole F O'Brien","doi":"10.4269/ajtmh.24-0303","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0303","url":null,"abstract":"More than 1,000 children under 5 years of age die every day from malaria. Cerebral malaria (CM) is the most severe and deadly manifestation of the disease. The occurrence of multiple organ dysfunction syndrome (MODS) has been associated with increased mortality in adult patients with CM. However, little is known about the frequency and severity of MODS in children with CM. This was a retrospective study of 199 pediatric patients with CM admitted to a referral hospital in Blantyre, Malawi, between January 2019 and May 2023. Data were abstracted from charts to calculate scores using four established scoring systems: Pediatric Logistic Organ Dysfunction-2 (PELOD-2), Pediatric Sequential Organ Failure Assessment (pSOFA), Signs of Inflammation in Children that Can Kill (SICK), and Lambaréné Organ Dysfunction Score (LODS). Mortality was 16% (n = 32). All four scoring systems were predictive of mortality, but the PELOD-2 and pSOFA scores outperformed the others with area under the curve values of 0.75 and 0.67, respectively. Multiple organ dysfunction syndrome was diagnosed in 182 patients (91%) using the PELOD-2 score, 172 patients (86%) using the pSOFA score, 99 patients (50%) using the SICK score, and 30 patients (15%) using the LODS. The PELOD-2 and pSOFA identify MODS in children with CM but require laboratory-based testing that is often unavailable in malaria-endemic areas. Furthermore, these scoring systems may identify primary malarial disease pathology rather than true organ dysfunction. Simplified scoring systems designed to recognize and quantify MODS in this patient population may provide opportunities for improved resource allocation and timely, organ-specific treatment.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment Outcomes of Single-Dose Liposomal Amphotericin B-Treated Visceral Leishmaniasis Patients and Factors Affecting Outcome in Bihar, India. 印度比哈尔邦单剂量脂质体两性霉素 B 治疗内脏利什曼病患者的疗效及影响疗效的因素。

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-10-08 DOI: 10.4269/ajtmh.23-0640

Niyamat Ali Siddiqui, Mohd Zahid Ansari, Sanjay Kumar Sinha, Biplab Pal, Ashish Kumar Singh, Subhankar Kumar Singh, Roshan Kamal Topno, Vidya Nand Rabi Das, Krishna Pandey

{"title":"Treatment Outcomes of Single-Dose Liposomal Amphotericin B-Treated Visceral Leishmaniasis Patients and Factors Affecting Outcome in Bihar, India.","authors":"Niyamat Ali Siddiqui, Mohd Zahid Ansari, Sanjay Kumar Sinha, Biplab Pal, Ashish Kumar Singh, Subhankar Kumar Singh, Roshan Kamal Topno, Vidya Nand Rabi Das, Krishna Pandey","doi":"10.4269/ajtmh.23-0640","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0640","url":null,"abstract":"An assessment of the treatment outcomes of single-dose liposomal amphotericin B, implemented in 2010, had not been conducted until this study. This prospective cross-sectional study encompassed 527 cases, comprising 470 (89%) cases of visceral leishmaniasis (VL) and 57 (11%) cases of post-kala-azar dermal leishmaniasis (PKDL). The male proportion was higher (55% for VL), and the mean (±SD) age was 39.2 (±33.9) years. Among VL cases (426) treated with single-dose liposomal amphotericin B, 402 cases were cured at the 6-month follow-up, resulting in a cure rate of 95%, whereas fewer than 1% (0.9%) experienced unsuccessful outcomes and 4.1% faced relapse. A statistically highly significant difference in treatment outcomes (successful versus unsuccessful) was observed between males and females (P = 0.0005). Males had higher odds of successful outcomes compared with females, with an odds ratio of 5.03 (95% CI: 1.84-13.74). Those aged ≤23 years had higher odds of successful outcomes than unsuccessful outcomes, with an odds ratio of 6.82 (95% CI: 2.29-20.33). Patients with PKDL had a mean (±SD) age of 28.5 (±10.6) years, with 63% being male. Among the 57 PKDL cases, 21 (37%) had been treated with single-dose liposomal amphotericin B, whereas others had received alternative drugs. The median duration of PKDL development for single-dose liposomal amphotericin B was significantly shorter (14.5 months), with a statistically significant difference (P <0.001) compared with other drugs. The current treatment strategy necessitates continuous close monitoring and reviews to ensure consistent and improved outcomes.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Scorpion Envenoming as an Emerging Public Health Problem in Paraguay, Bolivia, and Midwest Brazil: Involvement of Tityus confluens and the Need for a Panregional Evaluation of Available Antivenoms. 蝎子传染是巴拉圭、玻利维亚和巴西中西部地区新出现的公共卫生问题：Tityus confluens 的参与以及对现有抗毒血清进行泛区域评估的必要性。

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-10-08 DOI: 10.4269/ajtmh.24-0424

Adolfo Borges, Antonieta Rojas de Arias, Ana María Montaño, Cláudio Mauricio V de Souza

{"title":"Scorpion Envenoming as an Emerging Public Health Problem in Paraguay, Bolivia, and Midwest Brazil: Involvement of Tityus confluens and the Need for a Panregional Evaluation of Available Antivenoms.","authors":"Adolfo Borges, Antonieta Rojas de Arias, Ana María Montaño, Cláudio Mauricio V de Souza","doi":"10.4269/ajtmh.24-0424","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0424","url":null,"abstract":"This contribution highlights the emergence of a newly endemic region for scorpion envenoming in South America, covering eastern Bolivia, Paraguay, and the midwestern Brazilian states of Mato Grosso and Mato Grosso do Sul. These areas have not historically been known to harbor life-threatening scorpion species. Tityus confluens, a parthenogenetic species of medical significance in Argentina, has been identified in severe and lethal human cases in Bolivia and Paraguay. Given that the clinical use of scorpion antivenom preparations in the region has often lacked preclinical data and considering the significant burden of scorpion envenoming, we propose a panregional evaluation of available anti-Tityus antivenoms. This evaluation, along with interdisciplinary efforts at a multinational scale to control scorpionism, aims to determine their true neutralization capacity and potential clinical efficacy against known culprits in the Southern Cone of South America and other regions endemic for scorpion envenoming on the continent.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Myocardial Ischemia after Severe Scorpion Envenomation: A Narrative Review. 严重蝎子咬伤后心肌缺血：叙述性综述。

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-10-08 DOI: 10.4269/ajtmh.24-0163

Mabrouk Bahloul, Karama Bouchaala, Kamilia Chtara, Sana Kharrat, Mounir Bouaziz

{"title":"Myocardial Ischemia after Severe Scorpion Envenomation: A Narrative Review.","authors":"Mabrouk Bahloul, Karama Bouchaala, Kamilia Chtara, Sana Kharrat, Mounir Bouaziz","doi":"10.4269/ajtmh.24-0163","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0163","url":null,"abstract":"Myocardial ischemia after severe scorpion envenomation is rarely reported. The aim of this review was to elaborate on a review of myocardial ischemia after severe scorpion envenomation and to detail the mechanism of this myocardial hypoperfusion. We used the PubMed database and entered the following keywords in MeSH research: scorpion envenomation, myocardial ischemia, myocardial perfusion scintigraphy, echocardiography, and troponins. The literature analysis confirmed that severe scorpion envenomation can be complicated by temporary myocardial ischemia, based on electrocardiographic, histopathologic, echocardiographic, myocardial perfusion scintigraphy, and biological studies. The correlation between clinical manifestations, laboratory and electrocardiographic evidence of myocardial damage, echocardiographic studies, perfusion scintigraphy abnormalities, and histopathologic findings are suggestive of lesions of cardiac fibers secondary to myocardial ischemia. Myocardial hypoperfusion may be due to multiple factors. First, catecholamine storms can induce microvascular constriction. On the other hand, the release of catecholamines through a complex neurohormonal interaction with other neuropeptides and cytokine release can produce/induce major coronary microvascular constriction and/or microvascular injury, leading to microvascular acute coronary syndrome with Takotsubo cardiomyopathy. The management of severe scorpion envenomation with severe myocardial failure and pulmonary edema is based on oxygen with invasive or noninvasive ventilator support. Dobutamine improves cardiac function after scorpion envenomation. Antiplatelet therapy is not recommended. In conclusion, severe scorpion envenomation can be complicated by temporary myocardial ischemia, which can be due to multiple factors.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diary of Dhaka Dengue Days. 达卡登革热日记本。

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-10-01 DOI: 10.4269/ajtmh.23-0822

Labannya Das Puja

引用次数: 0

Navigating the Deluge: Unraveling the Impact of Floods in Kano Plains, Kenya. 在洪水中航行：了解洪水对肯尼亚卡诺平原的影响》（Navigating the Deluges: Unraveling of Impacts in Kano Plains, Kenya）。

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-10-01 DOI: 10.4269/ajtmh.24-0216

Stellah A Chumbe, Bartholomew N Ondigo

引用次数: 0

Efficacy and Safety of Adding 6 Weeks of Doxycycline to the Essential Package of Care to Treat Filarial Lymphedema: A Double-Blind, Randomized, Controlled Trial in Southern India. 在治疗丝虫性淋巴水肿的基本护理方案中添加 6 周多西环素的有效性和安全性：印度南部的双盲随机对照试验。

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-10-01 DOI: 10.4269/ajtmh.24-0337

Suma Krishnasastry, Anuja Ashok, Ammu Devidas, Sarah Sullivan, Mariana Stephens, Jayla Norman, Elianna Paljug, Andrew Deathe, Andrew Majewski, John Horton, Joseph P Shott, Ute Klarmann-Schulz, Achim Hoerauf, Eric Ottesen, Charles D Mackenzie

{"title":"Efficacy and Safety of Adding 6 Weeks of Doxycycline to the Essential Package of Care to Treat Filarial Lymphedema: A Double-Blind, Randomized, Controlled Trial in Southern India.","authors":"Suma Krishnasastry, Anuja Ashok, Ammu Devidas, Sarah Sullivan, Mariana Stephens, Jayla Norman, Elianna Paljug, Andrew Deathe, Andrew Majewski, John Horton, Joseph P Shott, Ute Klarmann-Schulz, Achim Hoerauf, Eric Ottesen, Charles D Mackenzie","doi":"10.4269/ajtmh.24-0337","DOIUrl":"10.4269/ajtmh.24-0337","url":null,"abstract":"Finding additional ways to manage lymphedema due to lymphatic filariasis (LF) is a primary concern for the Global Program to Eliminate Lymphatic Filariasis. The WHO-recommended Essential Package of Care (EPC) consists of skin hygiene, elevation of affected limbs, exercise, protective shoe ware, wound care, and supportive therapy for acute phases. The care program has been successful but often hard to maintain. A double-blind study reexamined previous findings that doxycycline treatment could improve the lymphedematous changes in LF patients. The present study was carried out in a semi-urban location of Kerala, southern India, where Brugia sp. is the predominant parasite, and LF mass drug administration had ceased in many areas. Two hundred individuals (aged 14-65 years; 142 females and 58 males) with lymphedema of stages 1-3 were instructed in the EPC and were randomly administered either 200 mg doxycycline or an identical-appearing placebo daily for 6 weeks. Data were collected at 0, 3, 6, 12, 18, and 24 months and included the state of the lymphedema (size, cleanliness, skin thickness and changes), occurrence of adenolymphangitis (ADL) attacks, and patients' quality of life (QOL). The results demonstrated no difference over time between the two arms of the study; virtually all patients of both groups showed either improvement or \"no worsening\" in the parameters during the 2-year study period. Importantly, this rigorous trial confirmed that the EPC is of substantial benefit to lymphedema patients by reducing acute ADL and improving their QOL and clinical condition.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0