American Journal of Tropical Medicine and Hygiene最新文献

{"title":"Exploring Barriers to Timely Diagnosis and Treatment of Tuberculosis in Selangor, Malaysia: A Qualitative Study.","authors":"Punitha Makeswaran, Shamsul Azhar Shah, Nazarudin Safian","doi":"10.4269/ajtmh.24-0224","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0224","url":null,"abstract":"<p><p>Tuberculosis (TB) occurs as one of the highest in the state of Selangor, Malaysia and its causes are currently underexplored especially from patients' perspectives of the disease. This study assesses perspectives from patients in relations to determinants of delayed presentation, diagnosis, and treatment of TB. The study utilises a qualitative methodology involving focus group discussions and in-depth interviews with patients selected based on specific inclusion and exclusion criteria. The research covered components which include social demographic, sociocultural factors, health-seeking behaviors, social support and resources, previous knowledge and experience as a TB patient, and treatment pathway. Thematic analysis was performed using NVivo 12 analysis software to interpret the data. This study aims to identify key barriers and facilitators of prompt presentation and diagnosis of TB patients. Results revealed that socioeconomic status, challenges faced during TB diagnosis and treatment, knowledge of TB, patient and healthcare-related factors, and health-seeking behaviours were the main emerging themes. Improvements are required in the areas of access to healthcare facilities, minimizing cost, providing specific clinics and proximity of health facilities to facilitate a prompt response, increasing capacity to isolate infected persons, and provision of adequate treatment. It is revealed that financial constraints, inaccessibility and long distance to healthcare facilities, poor knowledge of TB, and lack of family and social support contributed to delayed TB presentation and diagnosis. Findings from this study can be utilized to develop effective, locally tailored interventions to address delayed presentation and diagnosis of TB patients in the nation.</p>","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":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364022","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}

{"title":"On the Edge.","authors":"Madhusudan Samprathi","doi":"10.4269/ajtmh.24-0459","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0459","url":null,"abstract":"","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":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364026","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}

{"title":"A Comprehensive Assessment of Quality of Antimalarial Medicines in Mainland Tanzania: Insights from Five Years of Postmarket Surveillance.","authors":"Eulambius M Mlugu, Jacob Mhagama, Damas Matiko, Siya Agustine, Moses Nandonde, Emmanuel Masunga, Peter P Kunambi, Raphael Zozimus Sangeda, Yonah H Mwalwisi, Adam Fimbo","doi":"10.4269/ajtmh.24-0145","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0145","url":null,"abstract":"<p><p>Sustainable access to high-quality antimalarial medicines is pivotal to achieving universal and effective malaria control. Poor-quality antimalarial medicines are prevalent in sub-Saharan Africa, impeding malaria control initiatives and claiming the lives of many children. Regular monitoring of the quality of antimalarial medicines is crucial to ensure the quality of service to the community. A cross-sectional study using a postmarket surveillance (PMS) approach was conducted from 2019 to 2023. Samples were collected from the port of entry, local manufacturers, and various distribution outlets in 15 regions of mainland Tanzania. The samples were subjected to tier 1 evaluation, comprising a product information review (PIR) and identification using the Global Pharma Health Fund-Minilab® techniques. Samples that failed the identification tests and 10% of the samples from distribution outlets that passed the tests were subjected to confirmatory testing (tier 2), which included assays, related substances, dissolution, and sterility per the pharmacopeial monographs. During five annual PMSs, 2,032 antimalarial samples were collected and subjected to quality tests. All samples complied with the standard specifications for identity, dissolution, related substances, sterility, physical evaluation, disintegration, and assay. A total of 292 (55.5%) tested samples failed the PIR evaluation, with incomplete package information in leaflets contributing to 64.7% of all deviations. Antimalarial medicines circulating in the mainland Tanzanian market meet expected quality standards. Continuous monitoring of the quality of antimalarial medicines is recommended.</p>","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":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364006","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}

{"title":"Concurrence of Neurocysticercosis and Hemangioblastoma.","authors":"Oscar H Del Brutto, Juan Carlos Garcés, Denisse A Rumbea, Iván X Mena","doi":"10.4269/ajtmh.24-0457","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0457","url":null,"abstract":"","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":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364008","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}

{"title":"Optimizing the Delivery of Routine Malaria Data Quality Assessments: A Two-Level Logistic Regression Model to Inform an Institutionalized Approach in Mozambique.","authors":"Ann-Sophie Stratil, Maria Rodrigues, Sarmento Armando, Sergio Gomane, Kulssum Mussa, Baltazar Candrinho, Arantxa Roca-Feltrer","doi":"10.4269/ajtmh.23-0443","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0443","url":null,"abstract":"<p><p>Mozambique has implemented routine data quality assessments (DQAs) to improve accuracy of health facility (HF) malaria reporting since 2019. However, despite this being a resource-intensive exercise, the impact of operational factors on DQAs has not yet been systematically investigated. This analysis aimed to provide insights into optimizing the operational delivery of routine DQAs. A two-level logistic regression model based on 1,354 DQAs conducted across 195 HFs (16 districts, November 2019-December 2022) was used to estimate the impact of relevant operational factors, namely number of DQAs received, baseline reporting accuracy, HF setting, workload, malaria transmission intensity, and the shift to digital reporting, on accurate reporting by HFs. A report was considered accurate if the deviation between number of confirmed malaria cases in reports and register books was less than 10%. A statistically significant interaction was observed between baseline reporting accuracy and number of DQAs. For HFs with a baseline accuracy of ≤90%, each additional DQA increased the odds of accurate reporting by 102.8% (95% CI: 71.1-140.2%). For HFs with inaccurate data at baseline, the probability of accurate reporting increased to >80% after five DQAs, whereas HFs with accurate baseline data did not improve beyond the baseline visit. Other operational factors did not significantly affect reporting accuracy. Prioritizing HFs with low baseline accuracy for more frequent DQAs (every 6 months) with at least one visit to all HFs every 3 years might optimize resource allocation in Mozambique. Similar analytic approaches can be applied in other countries to optimize resource allocations for the delivery of routine DQAs.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339469","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}

{"title":"Intestinal Protozoa, Helminth Infection, and Associated Factors among Tuberculosis Patients and Nontuberculosis Persons in Bobo-Dioulasso City, Burkina Faso.","authors":"Diakourga Arthur Djibougou, Gloria Ivy Mensah, Mamoudou Cissé, Toé Inoussa, Leon Tinnoga Sawadogo, Adjima Combary, Adama Sanou, Bassirou Bonfoh, Kennedy Kwasi Addo, Adrien Marie Gaston Belem, Clément Ziemlé Meda, Roch Konbobr Dabiré, Achille Kaboré, Potiandi Serge Diagbouga","doi":"10.4269/ajtmh.23-0346","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0346","url":null,"abstract":"<p><p>We report the frequency and associated factors of tuberculosis (TB) and parasite coinfection from newly diagnosed pulmonary TB patients (TB+) and non-TB participants (TB-) from the Regional Tuberculosis Control Center, households, and health facilities in Bobo-Dioulasso from 2019 to 2021. Biological samples were examined for parasite infection using direct microscopy, concentration techniques, and the immunochromatographic rapid test. Data were analyzed using STATA 14. Of a total of 192 participants involved, 95 were TB+ and 97 were non-TB. There was no statistically significant difference in parasitic infections between the two groups, although it was higher in TB+ than TB- (69.5% [66/95] versus 55.7% [54/97]; P = 0.07). Protozoal infection prevalence was significantly higher in patients with TB+ than in those TB- (61.1% versus 37.1%; P = 0.001). Specifically, Entamoeba spp. and Cryptosporidium spp. followed this pattern with 35.8% versus 19.6% (P = 0.01) and 22.1% versus 8.3% (P = 0.007), respectively. Although higher in TB+ patients, helminthiasis frequency was not significantly different between the two groups (23.2% versus 15.5%; P = 0.2). Helminth species were Schistosomia mansoni (17.9% versus 12.4%), Dicrocoelium dendriticum (3.2% versus 1.0%), Enterobius vermicularis (2.1% versus 2.1%), Wuchereria bancrofti (1.1% versus 0.0%), and Hymenolepis nana (1.1% versus 0.0%). Illiteracy (adjusted odds ratio [aOR]: 2.5; 95% CI: 1.0-6.1), smoking (aOR: 2.4; 95% CI: 1.1-5.3), and handwashing after defecation (aOR: 2.4; 95% CI: 1.2-4.7) were associated with parasites. This study reported a high frequency of parasite coinfection in TB patients. These findings suggest the need for adequate health education for behavioral change and systematic diagnosing of parasites in TB patients for better coinfection management.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339468","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}

{"title":"Cause-Specific Mortality among Infants in a Randomized Controlled Trial of Azithromycin Compared to Placebo for Prevention of Mortality.","authors":"Mamadou Ouattara, Ali Sié, Mamadou Bountogo, Valentin Boudo, Thierry Ouedraogo, Clarisse Dah, Elodie Lebas, Huiyu Hu, Aimee Lansdale, Ian Fetterman, Benjamin F Arnold, Thomas M Lietman, Catherine E Oldenburg","doi":"10.4269/ajtmh.24-0186","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0186","url":null,"abstract":"<p><p>Although community randomized trials have found a reduction in all-cause child mortality in communities receiving mass azithromycin distribution compared with placebo, individually randomized trials have not found similar protective effects. If a direct effect of azithromycin for prevention of child mortality exists, it is likely due to reduction in infectious mortality. Here, we assessed cause-specific mortality in a large randomized controlled trial of azithromycin administered during well-infant visits in Burkina Faso for prevention of mortality. Among 32,877 enrolled infants, the most common causes of death by 6 months of age were malaria, acute respiratory infections, and diarrheal disease. We found no evidence of a difference in the distribution of cause of death by randomized treatment assignment (P = 0.42) or in any infectious-specific cause of death. The results of this analysis are consistent with no direct effect of azithromycin on infant mortality when administered during well-infant visits.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339466","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}

{"title":"Resurgence of Noma (Cancrum Oris) in Nigeria.","authors":"Oche Joseph Otorkpa, Chinenye Oche Otorkpa, Onifade Adefunmilola Adebola, Chinazom Anuniru","doi":"10.4269/ajtmh.24-0406","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0406","url":null,"abstract":"<p><p>Recent data from Médecins Sans Frontières and local health authorities highlight a concerning rise in noma cases across previously unaffected Nigerian states. Noma is a severe gangrenous disease affecting impoverished populations, causing severe facial disfigurement and high mortality rates, especially among children. Despite its eradication in developed regions, sub-Saharan Africa faces an escalating noma incidence. This communication highlights the urgent need for enhanced surveillance, awareness, regional treatment centers, and international support to mitigate its impact in Nigeria and avoid exacerbation of the condition across sub-Saharan Africa.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339470","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}

{"title":"Assessment of Risk Factors Associated with and Practices of Cattle Farmers in Kirehe District Rwanda with Respect to Vector-Borne and Zoonotic Pathogens.","authors":"M Fausta Dutuze, Analise Espino, Rebecca C Christofferson","doi":"10.4269/ajtmh.24-0099","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0099","url":null,"abstract":"<p><p>Rural Rwandan communities face health challenges for humans and animals, and the topography and climate of the Kirehe District of Rwanda put farmers at high risk for mosquito-borne diseases. Individuals from 92 Rwandan farms were surveyed about farm practices, as well as animal and human health histories between December 2017 and February 2018. Human, animal, and environmental factors were investigated to determine whether there is a pattern of risk for abortion incidence and/or history of malarial disease on the farm. Iterative, complementary logistic regression models were used to determine whether there was an association between variables and abortion history in animals. These factors were then used to investigate association with a reported history of malaria. Of the 92 farms in our study, 82 were family farms and 10 were commercial farms. On average, 88% of the farms had cattle, and 30% of farms had experienced a cattle abortion in the past 2 years. There was no observed statistical significance in the risk factors for history of abortion in cattle and the measured variables. Using One Health as a guiding framework, we sought to determine whether human, animal, and environmental factors were statistically associated with observed disease outcomes. From our study of the practices of the farmers with respect to biosafety and self-protection against disease, we have identified potential sources of risk that could be targeted to enhance education and protection on these farms.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279198","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}

{"title":"Narrowing the Gap in Managing the Lymphedema of Lymphatic Filariasis.","authors":"James W Kazura","doi":"10.4269/ajtmh.24-0565","DOIUrl":"10.4269/ajtmh.24-0565","url":null,"abstract":"","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370772","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}