Annals of Tropical Medicine & Parasitology最新文献

{"title":"Implementing community-directed treatment with ivermectin for the control of onchocerciasis in Uganda (1997–2000): an evaluation","authors":"M. Katabarwa, P. Habomugisha, F. Richards","doi":"10.1179/000349802125000529","DOIUrl":"https://doi.org/10.1179/000349802125000529","url":null,"abstract":"Abstract Over the period 1997-2000, an evaluation was made, in 10 districts of Uganda, of the onchocerciasis-control programme based on community-directed treatment with ivermectin (CDTI). This programme is supported by the Ministry of Health, the African Progamme for Onchocerciasis Control (APOC) and The Carter Center Global 2000 River Blindness Programme. The data analysed came from: (1) monthly and annual reports; (2) annual interviews, in randomly-selected communities in selected districts, with heads of household, community leaders and ivermectin distributors; (3) participatory evaluation meetings (PEM); (4) participant observation studies; and (5) key informants. The percentage of treated communities in the 10 study districts achieving satisfactory treatment coverage [i.e. ≥ 90% of the annual treatment objective (ATO)] rose from 46.0 in 1997 to 86.8 in 2000. This improvement was largely attributable to the adoption of collective CDTI decision-making by community members, avoidance of paying monetary incentives to the ivermectin distributors, and the satisfaction with the programme of those who had been treated. Coverage improved as the numbers of community members who were involved in choosing the method of distribution and in selecting their own community-directed health workers (CDHW) increased. Health education was also critical in improving individual members' involvement in decision-making, and in mobilizing other community members to take part in CDTI. Involvement of kinship groups, as well as educated community members as supervisors of CDHW, also helped to increase coverage. In a regression model, satisfaction with the programme was revealed as a significant predictor of the achievement of the target coverage (P<0.001). Cost per person, as an indicator for sustainability, varied with the size of the population under treatment, from at least U.S.$0.40 when the district ATO was <15,000 people, to U.S.$0.26 with an ATO of 15,000-40,000 and less than U.S.$0.10 when the district ATO exceeded 40,000 people. These results cast doubt on the validity of the current APOC indicator for sustainability, of a cost of no more than U.S.$0.20/person for all CDTI projects, whatever the size of the population to be treated. Although some women were involved in decision-making, their current involvement as supervisors or CDHW was minimal. Most of the present data were obtained through monitoring and operational-research activities that have been carried out, in an integrated fashion, within the Ugandan CDTI programme since its launch. It is recommended that assessment, monitoring and evaluation be widely used within all CDTI efforts. Operational research should remain focused and appropriate and directly involve the personnel who are executing the programme.","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88613268","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":"A case-control study of the risk factors for cystic echinococcosis among the children of Río Negro province, Argentina","authors":"E. Larrieu, Costa Mt, M. Carpio, S. Moguillansky, G. Bianchi, Z. Yadón","doi":"10.1179/000349802125000501","DOIUrl":"https://doi.org/10.1179/000349802125000501","url":null,"abstract":"Abstract In 1984 the prevalence of cystic echinococcosis (CE) in Río Negro province in central Argentina reached alarming levels, with almost 6% of children aged 7-13 years infected with the causative agent, Echinococcus granulosus . Although the control activities developed between 1980-2000 have now lowered the prevalence of infection in this age-group to 1.1%, transmission of E. granulosus has clearly not ceased. The aim of the present study was to identify possible flaws in the control programme and the risk factors associated with CE. The 24 cases and 66 controls used were identified during a survey of the 1070 schoolchildren attending 12 schools in Ingeniero Jacobacci, Río Negro province. In interviews based around a standardized questionnaire, the adult female with responsibility for each subject (usually the mother but sometimes a grandmother or guardian) was asked 70 questions about the child and his or her immediate family, their contact with dogs and relevant environmentmental factors, and their level of contact with the control programme. Univariate and multivariate analyses were used to determine odds ratios (OR) and their 95% confidence intervals (CI). The main risk factors found to be significantly associated with CE were having a family member with the disease (OR=3.11; CI=0.92-10.47), spending the first years of life surrounded by a large number of dogs (OR=2.11; CI=1.2-3.5), and having a father who slaughtered sheep at his workplace (OR=1.14; CI=1.04-1.24). Obtaining drinking water from a tap (OR=0.28; CI=0.08-1.01) also remained in the final model, as a protective factor.","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76113479","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":"Inter-observer concordance in grading retinopathy in cerebral malaria","authors":"N. Beare, C. Southern, J. Lochhead, M. Molyneux, S. Lewallen, S. Harding","doi":"10.1179/000349802125000565","DOIUrl":"https://doi.org/10.1179/000349802125000565","url":null,"abstract":"In children severe Plasmodium falciparum malaria causes a unique set of retinal signs (Lewallen et al. 1993; Hero et al. 1997). Some of these changes are entirely specific to severe malaria and have been associated with fatal outcome in cerebral malaria (Lewallen et al. 1996; unpubl. obs.). Observations of these retinopathies therefore have a contribution to continuing studies on the patho-physiological processes in cerebral malaria (CM). Lewallen et al. (1999) described these opthalmic changes in detail and proposed a system for grading them. In an attempt to validate and standardize this grading system the level of agreement between two independent observers who used the system to grade retinopathy in CM and then recorded their findings on standardized charts was investigated in a prospective study. The patients investigated were the consecutive children with CM who were admitted to the Malaria Projects research ward at the Queen Elizabeth Central Hospital in Blantyre Malawi during one malaria season. For the purposes of this study CM was defined as a Blantyre coma score of 2 or less in the presence of P. falciparum parasitaemia with no other explanation of coma (Molyneux et al. 1989). The Malawi College of Medicines Research Committee gave ethical approval for the study and patients were included only after permission from their parents or guardians was obtained. The tenets of the Declaration of Helsinki were also followed. (excerpt)","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77878741","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":"Dynamics of the malaria-vector populations in coastal Lagos, south–western Nigeria","authors":"T. S. Awolola, O. Okwa, R. Hunt, A. Ogunrinade, Maureen Coetzee","doi":"10.1179/000349802125000538","DOIUrl":"https://doi.org/10.1179/000349802125000538","url":null,"abstract":"Abstract An entomological study was carried out in coastal Lagos, south-western Nigeria, to explore the role of Anopheles gambiae s.l. and An. moucheti in the transmission of Plasmodium falciparum in this holo-endemic area. Mosquitoes were caught, on human bait at night and by pyrethrum-spray catches during the day, twice a month throughout 2000. Of the 1812 Anopheles mosquitoes collected, An. gambiae s.l., the predominant vector species, represented 78.7% while the other 21.3% were An. moucheti. The results of a PCR-based test identified 56.8% of the mosquitoes of the An. gambiae complex collected as An. gambiae s.s. , 36.9% as An. melas and 6.3% as An. arabiensis. Anopheles gambiae s.s. was predominantly recorded in the wet season, biting females being collected from May to October, with a peak in July. Anopheles melas and An. moucheti were present throughout the yearlong study whereas An. arabiensis was mainly found in the dry season. The results of ELISA-based analyses of bloodmeals indicated that An. gambiae s.s., An. melas and An. moucheti were predominantly anthropophagic whereas An. arabiensis was largely zoophagic. Among all of the females investigated, 3.6% of the An. gambiae s.s., 1.9% of the An. melas , 1.8% of the An. moucheti and 0% of the An. arabiensis were found to be infected with P. falciparum (i.e. carrying the parasite's circumsporozoite antigen). The corresponding proportions for the females collected during the dry season were 1.3%, 2.3%, 2.7% and 0%. The entomological inoculation rates for An. melas and An. moucheti were significantly higher during the dry season than at other times of the year. Taken together, these results indicate that An. melas and An. moucheti maintain transmission of P. falciparum during the dry season, while the biting population of An. gambiae s.s. is relatively small.","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85190892","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":"Factors influencing participation in national immunization days in Kumasi, Ghana","authors":"E. Browne, A. A. Bonney, F. Agyapong, K. Nkrumah","doi":"10.1179/000349802125000556","DOIUrl":"https://doi.org/10.1179/000349802125000556","url":null,"abstract":"Abstract A study of the factors influencing participation in national immunization days (NID) in Kumasi, Ghana was carried out between the April and June of 1999. Polio-immunization coverage during NID was assessed among children aged <5 years; >90% of these children had received polio vaccinations on both of the two previous NID. The mothers who participated most in the NID tended to be those who were better educated and Ghanaian. Mothers who were salaried workers participated fully in NID. Radio and television played a major role in public education about NID, whereas the attitude of health workers was a strong factor that prevented many mothers/caregivers from bringing their children to be immunized. The coverage of the Expanded Programme on Immunization (EPI) was assessed in children aged 12-23 months; nearly 70% of these children were fully immunized. BCG had the highest coverage (97.0%) and measles the lowest (79.1%). Again, full coverage of the children of mothers who had been educated beyond primary level was higher than that of the other children (75.9% v. 65.2%), and coverage of the children of Ghanaian women was higher than that of the others (70.8% v. 50.0%). Although the mothers/caregivers raised concerns about the costs of the routine immunizations, these charges apparently did not prevent them from taking their children to be immunized. NID complement the routine EPI-associated work in Ghana, increasing overall polio-immunization coverage. The results of this study will be used to improve the overall performance of immunization programmes, especially in the Kumasi metropolis. Hopefully, sustained, increased polio-immunization coverage will contribute positively towards polio eradication in Ghana.","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87022753","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":"DNA extraction and amplification of Leishmania from archived, Giemsa-stained slides, for the diagnosis of cutaneous leishmaniasis by PCR","authors":"H. Motazedian, M. Karamian, H. Noyes, S. Ardehali","doi":"10.1179/000349802125000484","DOIUrl":"https://doi.org/10.1179/000349802125000484","url":null,"abstract":"Abstract DNA was isolated from 92 Giemsa-stained smears of lesions from suspected cases of cutaneous leishmaniasis and used for PCR-based diagnosis of Leishmania infection. Each smear had been examined under a light microscope at ∈1000 and scored for amastigote numbers. Although the smears had been stored for up to 4 years, all the microscopy-positive slides were also positive by PCR and four of the 14 smears that were negative by microscopy (although of lesions that were clinically consistent with leishmaniasis) were also PCR-positive. PCR-based investigations therefore appear to offer an effective method to confirm suspected cases of cutaneous leishmaniasis using (even archived) samples that have been collected, from humans (and reservoir hosts) in the field, by simple methods.","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81357320","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":"Using ivermectin-treatment coverage among schoolchildren monitored by schoolteachers as a proxy of population coverage in areas of Uganda where onchocerciasis is endemic","authors":"R. Ndyomugyenyi, J. Remmé","doi":"10.1179/000349802125000510","DOIUrl":"https://doi.org/10.1179/000349802125000510","url":null,"abstract":"Abstract In the control of onchocerciasis using mass treatment with ivermectin, coverage needs to be monitored regularly so that communities with poor or insufficient coverage can be identified and timely and appropriate interventions then instituted. The aim of the present study was to assess whether ivermectin-treatment coverage in schoolchildren, as monitored by schoolteachers, could be used as a proxy of population coverage. Although the coverages estimated in schoolchildren were found to be significantly correlated with estimates based on household surveys (P=0.01), there was poor correlation between either school and household-survey coverage and the values recorded in community registers. Although the community-register figures are the ones which the district health services normally use to report treatment coverage, they may be unreliable. Ivermectin-treatment coverage in schoolchildren monitored by schoolteachers could give a good and more accurate approximation of total population coverage. Further, large-scale studies, that take into consideration the cost-effectiveness of the various methods available to validate reported treatment coverage, are recommended.","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89362591","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":"Modulation of host immunity by haematophagous arthropods","authors":"G. Schoeler, S. Wikel","doi":"10.1080/00034983.2001.11813695","DOIUrl":"https://doi.org/10.1080/00034983.2001.11813695","url":null,"abstract":"The medical and veterinary public-health importance of haematophagous arthropods is immense and continuing to increase because of the emergence of new vector-borne infectious agents and the resurgence of well known ones. Control of blood-feeding arthropods and the pathogens they transmit is compounded by drug, insecticide and acaricide resistance. Novel control strategies are needed. Immunological control is one very promising approach to these problems. In order to develop anti-arthropod vaccines that block pathogen transmission and establishment, the immunological interactions occurring at the interface of the blood-feeding arthropod and host must be characterized. An important component of these interactions is arthropod modulation of the host's innate and acquired, specific immune defences. This review discusses current knowledge regarding the ability of haematophagous arthropods to alter their hosts' immune defences, the impact of those changes on pathogen transmission, the molecular bases for the immunomodulation, and strategies for identification of the molecules in arthropod saliva that are responsible for the immunomodulation.","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76686791","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":"Malaria-attributable morbidity in Assam, north-eastern India","authors":"V. Dev, C. Hira, M. Rajkhowa","doi":"10.1080/00034983.2001.11813698","DOIUrl":"https://doi.org/10.1080/00034983.2001.11813698","url":null,"abstract":"Malaria is endemic in the Indian state of Assam and transmission of the causative parasites is perennial and persistent. The available data on malaria-related morbidity and mortality in the state for the years 1991–1999 have been reviewed. Over this period, Plasmodium falciparum was the predominant parasite, causing 58%–68% of the malaria cases; all other cases were attributed to P. vivax. All malaria-related deaths were attributed to P. falciparum infection, and the numbers of such deaths were correlated with the numbers of cases of P. falciparum malaria. The deaths occurred mostly in the rainy season (April-September) and among all age-groups of both sexes. The factors responsible for focal outbreaks of malaria across the state are discussed in relation to the existing health infrastructure.","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86786090","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":"Mixed leishmanial infections in Rhombomys opimus: a key to the persistence of Leishmania major from one transmission season to the next","authors":"M. Strelkova, L. N. Eliseev, E. Ponirovsky, T. I. Dergacheva, D. Annacharyeva, P. Erokhin, D. Evans","doi":"10.1080/00034983.2001.11813700","DOIUrl":"https://doi.org/10.1080/00034983.2001.11813700","url":null,"abstract":"An important feature of the foci of zoonotic cutaneous leishmaniasis (ZCL) in Turkmenistan and Uzbekistan is a 6–10-month break in transmission when Leishmania parasites persist in great gerbils (Rhombomys opimus)—the main host for three species (L. major, L. turanica and L. gerbilli). Almost all (95%) of the laboratory-maintained R. opimus experimentally infected with L. major cured their infections within 6 months, a situation which, if mirrored in field conditions, cannot provide reliable persistence of the infection to the next transmission season. However, infections with L. turanica alone persisted for a mean of 15 months, and mixed infections of L. major and L. turanica persisted even longer (mean = 25 months), parasites of both species remaining detectable in the skin for at least 18 months. Isoenzyme identification of 664 isolates obtained from wild-caught R. opimus, and of 58 cloned strains developed from them, showed that L. turanica, which is non-pathogenic for humans, tends to predominate in the gerbils from all types of natural ZCL foci, including those which are hyper-endemic; in June, L. turanica may be present in 80%–100% of the R. opimus in the foci. In contrast, infections with L. major alone occur far less commonly, and are especially hard to find at the beginning of the transmission season. However, 5%–25% of great gerbils in these foci are each infected with a mixture of L. major and L. turanica. In hyper- and meso-endemic foci, the proportion of L. major within mixed infections of Leishmania increases significantly towards the end of transmission season (August-September). It would appear, therefore, that mixed L. major/L. turanica infections in R. opimus promote the persistence of L. major between transmission seasons.","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77154715","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}