Elimination Program Research Articles

Evaluation of the International Task Force for Disease Eradication: A Review of Past Deliberations.

The International Task Force for Disease Eradication (ITFDE) was formed at The Carter Center in 1988. Its primary purpose is to review activities and provide recommendations related to programs focused on eradication. The ITFDE also considers opportunities for disease elimination and improved control. Over the last two decades, the ITFDE has held 33 meetings, discussed 22 diseases, and made 244 recommendations. This report aims to analyze the patterns in recommendations made by the ITFDE between 2001 and 2022 and assess the ITFDE's role, impacts, and successes in advancing elimination and eradication efforts for selected diseases. Using a thematic analysis, recommendation categories were crafted, followed by a scoping review to determine evidence of implementation for each recommendation. Categories of recommendations included research (24%), leadership (20%), medical (17%), advocacy (11%), collaboration (13%), development (8%), and financial (8%). We determined that 123 (50.4%) ITFDE recommendations were implemented in some form. Notably, the ITFDE has helped raise the profile of neglected tropical diseases. Four salient outcomes include 1) the identification of the potential eradicability of lymphatic filariasis (1993), 2) the recognition of the critical need for improved treatments of human African trypanosomiasis (2002), 3) a recommendation for the elimination of lymphatic filariasis and malaria from Hispaniola (2006), and 4) recommendations for effective and safe ways to avoid disruption of elimination and eradication programs during the COVID-19 pandemic (2020). This review of the ITFDE will help to devise new approaches to monitor its impact in the future.

Drugs resistance and new strategies of prevention against Malaria: An ongoing battle.

From ancient times until 21st century, Malaria has remained a fatal disease. It causes death in many poor and developing countries. Excluding vector control, Antimalarial drugs are the most reliable and effective weapon to tackle this severe disease. The emergence of antimalarial drug resistance in Plasmodium spp. becomes a barrier in Malaria elimination program as there has been no effective antimalarial vaccine till today. Apart from artemisinin, most of the antimalarial drugs have become resistant against malaria at present. Although, reduced efficacy of artemisinin-based combination therapy (ACT) has also been reported from southeast regions of Asia. Mutation of some genes within the parasite play a vital role in this drug resistance. Therefore, malaria is still a prime threat to human death and an unsolved problem. Newly emerging approaches like, vaccine development, plants based antimalarial drugs, nanoparticles, next generation antimalarial drugs should be taken & supported. In addition to that, public awareness is much needed for understanding the fatality of the disease and for encouraging self-protection and early treatment.

Paving a Way for “TB Mukt Bharat”: A Snapshot of India's TB Elimination Program

AbstractTuberculosis (TB) remains a significant global health challenge, particularly in countries like India, where it is a leading cause of mortality. This article provides an overview of India's efforts to combat TB through its national TB programs, tracing their evolution from the National TB Program in 1962 to the current National TB Elimination Program (NTEP) launched in 2020. The NTEP aims to eliminate TB by ensuring universal access to high-quality diagnosis and treatment services. The program emphasizes prevention, detection, treatment, and capacity building, aligning with global initiatives like the World Health Organization's End TB Strategy. Key components of the NTEP include free diagnostic services, treatment regimens for drug-sensitive and drug-resistant TB, and TB preventive therapy. The program also includes robust patient support systems, such as incentive schemes and transport support, to improve treatment outcomes. Through these comprehensive strategies, India seeks to achieve its goal of a TB-free nation by 2025, aligning with global Sustainable Development Goals.

The State of Immunity of the Population of the Russian Federation to Rubella during the Elimination of Infection

Relevance. Serological monitoring of the state of the population's immunity to the rubella virus is one of the key elements of epidemiological surveillance of the infection, which makes it possible to assess the effectiveness of vaccine prevention, including the level of protection of the population from this infection. This article presents a comprehensive analysis of the results of this event in Russia for the period from 2015 to 2022 in individuals vaccinated against this infection, based on data from reports from regional centers and existing statistical models. The aim. To carry out a comprehensive analysis of data on serological monitoring of immunity among indicator groups of the population to rubella virus in the Russian Federation for the period from 2015 to 2022, taking into account the incidence and peculiarities of immunization tactics. Materials and Methods. Serological monitoring was carried out using standardized test systems and techniques, which ensured comparability of data throughout the entire study period (2015-2022). The contingent for the examination was selected with documentary confirmation of the fact of vaccination in the age groups 3–4 years, 9–10, 15–17, 25–29, 30–35 years. Only persons aged 40 years and older were examined without taking into account the vaccination history Results and Discussion. The conducted study confirmed a sufficient, stable level of immunity to the rubella virus in most age groups and regions of the country, which indicates the effectiveness of vaccination and the preservation (stabilization) of the infection elimination process. The slight increase in the average proportion of seronegatives among adults 30–35 and 40 years and older, revealed in the analysis, compared with other groups, requires further observation and clarification of the causes. Conclusions. The study confirmed the high level of immunity to rubella virus among the population of the Russian Federation, which indicates the effectiveness of the current program of vaccination against rubella infection and the infection elimination program. However, groups of the population have been identified, among which there is a slight decrease in the level of immunity, which requires additional attention from health authorities to maintain a stable rubella elimination status in the country. The results of the study will be used as additions to national and regional strategies aimed at maintaining the rubella elimination status.

Assessing LLIN distribution implementation using evidence-informed intervention core elements: a qualitative study in a resource-constrained setting

BackgroundThe National Malaria Elimination Programme implements the mass LLIN Distribution Campaigns in Ghana. Implementation science promotes the systematic study of social contexts, individual experiences, real-world environments, partnerships, and stakeholder consultations regarding the implementation of evidence-informed interventions. In this paper, we assess the core elements of the mass LLIN distribution campaign in a resource constrained setting to learn best implementation practices. Three core domains were assessed through the application of Galbraith’s taxonomy (i.e., implementation, content, and pedagogy) for evidence-informed intervention implementation.MethodsSix districts in two regions (Eastern and Volta) in Ghana participated in this study. Fourteen Focus Group Discussions (FGDs) were conducted across these communities. Eligible participants were purposively sampled considering age, occupation, gender, and care giving for children under 5 years and household head roles. All audio-recorded FGDs were transcribed verbatim, data was assessed and coded through deductive and inductive processes. NVivo software version 13 was used for the coding process. Themes were refined, legitimized, and the most compelling extracts selected to produce the results.ResultsSixty-nine (69) caregivers of children under 5 years and sixty (60) household heads participated in the FGDs. All caregivers were females (69), whilst household heads included more males (41). Core elements identified under implementation domain of the LLIN distribution campaign in Ghana include the registration and distribution processes, preceded by engagement with traditional authorities and continuous involvement of community health volunteers during implementation. For pedagogy domain, core elements include delivery of intervention through outreaches, illustrations, demonstrations, and the use of multiple communication channels. Core elements realized within the content domain include information on effective malaria prevention, and provision of information to enhance their self-efficacy. Yet, participants noted gaps (e.g., misuse) in the desired behavioural outcome of LLIN use and a heavy campaign focus on women.Conclusion and recommendationsAlthough the implementation of the mass LLIN distribution campaigns exhibit components of core elements of evidence informed interventions (implementation, content and pedagogy), it has not achieved its desired behavioural change intentions (i.e. continuous LLIN use). Future campaigns may consider use of continuous innovative pedagogical approaches at the community level and lessons learnt from this study to strengthen the implementation process of evidence-based health interventions. There is also the need for standardization of core elements to identify the number of core elements required within each domain to achieve efficacy.Ethical approvalEthical clearance was obtained from the Ghana Health Service Ethics Review Committee (GHS-ERC: 002/06/21) before the commencement of all data collection.

Triple-drug therapy with ivermectin, diethylcarbamazine and albendazole for the acceleration of lymphatic filariasis elimination in Kenya: Programmatic implementation and results of the first impact assessment.

The World Health Organization (WHO) endorsed the use of triple-drug mass drug administration (MDA) regimen with ivermectin, diethylcarbamazine (DEC) and albendazole (commonly abbreviated as IDA) to accelerate the elimination of lymphatic filariasis (LF) as a public health problem in settings where onchocerciasis is not co-endemic. The National Programme for Elimination of LF (NPELF) in Kenya was among the first adopters of the IDA-MDA and two annual rounds were provided in 2018 and 2019 to the residents of Lamu County and Jomvu sub-County in the coast region. This study documented the feasibility of successfully delivering the two rounds of IDA-MDA. An operational research study was undertaken to determine efficient sampling strategies, indicators, and the appropriate population groups that could be used for the monitoring and evaluation of LF programs using IDA-MDA for the elimination of the disease as a public health problem. Two cross-sectional surveys were conducted at baseline in 2018 before IDA-MDA and an impact assessment 17 months after the second round of IDA-MDA. The reported epidemiological treatment coverage was at least 80% in all implementation units during each round of IDA-MDA. Blood samples were tested for filarial antigenemia using commercial Filariasis Test Strips (FTS) and any individual found to be positive was tested again at night for the presence of microfilariae in finger prick blood smears using microscopy. The overall prevalence of circulating filarial antigen (CFA) was relatively low at the baseline survey with Jomvu having 1.39% (95% CI: 0.91, 2.11) and Lamu having 0.48% (95% CI: 0.21, 1.13). Significant reduction in CFA prevalence was observed during the impact assessment after the two annual rounds of mass treatment. The overall relative reduction (%) in CFA prevalence following the two rounds of MDA with IDA was significant in both Jomvu (52.45%, Z = -2.46, P < 0.02) and Lamu (52.71%, Z = -1.97, P < 0.05). Heterogeneity, however, was observed in the CFA prevalence reduction between random and purposive clusters, as well as between adult and child populations. The results of the impact assessment survey offered strong evidence that it was safe to stop the IDA-MDA in the two EUs because transmission appears to have been interrupted. It is also important to implement a post-treatment surveillance system which would enable efficient detection of any recrudescence of LF transmission at a sub-evaluation unit level. Our findings show that IDA-MDA may be considered for acceleration of LF elimination in other settings where onchocerciasis is not co-endemic.

Assessment of the influence of levees along Yangtze River on Oncomelania hupensis, the intermediate host of Schistosoma japonicum

BackgroundOncomelania hupensis is the exclusive intermediate host of Schistosoma japonicum in China. Snail control is an essential component of schistosomiasis elimination programme. With 70 years of continuous efforts, the range of O. hupensis had reduced significantly, but slowed down in last decades. A large number of levees against flooding were constructed along Yangtze River and its affiliated lakes in the middle and lower reaches, which influenced the hydrology and ecology in the alluvial plains. The purpose of this study was to assess the impact of levees on the distribution of O. hupensis in the middle and lower reaches of the Yangtze River.MethodsThe snail habitats were digitalised by hand-held GPS system. The years for discovery and elimination of snail habitats were extracted from historical records. The accumulated snail-infested range for each habitat was calculated on the basis of annual reports. The current distribution of O. hupensis was determined by systematic and environmental sampling. The geographical distribution of levees was obtained from satellite imagery. To assess the impact of levees, the data pertaining to O. hupensis were divided into two parts: inside and outside the Yangtze River. Joinpoint regression was utilised to divide the study time span and further characterise the regression in each period. The 5-year-period moving averages of eliminated area infested by snails were calculated for the habitats inside and outside Yangtze River. The moving routes of corresponding geographical median centres were simulated in ArcGIS. Hotspot analysis was used to determine the areas with statistical significance clustering of O. hupensis density.ResultsThree periods were identified according to Joinpoint regression both inside and outside Yangtze River. The area infested by O. hupensis increased in the first two periods. It decreased rapidly outside Yangtze River year over year after 1970, while that inside the Yangtze River did not change significantly. Furthermore, the latter was significantly higher than the former. It was observed that the present density of O. hupensis inside Yangtze River was lower than outside the Yangtze River. The median centre for eliminated ranges inside Yangtze River wavered between the east (lower reach) and the west (middle reach). In contrast, the median centre for eliminated ranges continuously moved from the east to the west.ConclusionsOur findings indicated that the levees had a considerable negative impact on the distribution of O. hupensis outside Yangtze River. Some hotspots observed in the irrigation areas need a sluice system at the inlet of branch for snail control. The major distribution of O. hupensis located in Hubei might be caused by severe waterlogging. The intensive surveillance should be implemented there. The biggest two freshwater lakes, the major endemic regions historically, were identified as cold spots. The long-term impact of Three Gorges Dam on the distribution of O. hupensis in the lakes should be monitored and evaluated.Graphical

An Update on Viral Hepatitis B and C in Mexico: Advances and Pitfalls in Eradication Strategies.

In Mexico, hepatitis B and C infections are a significant burden on the health system. The aim of this narrative review was to analyze the state of the art on hepatitis B and C in Mexico by searching and studying available data in academic articles and government reports and statements on epidemiology, prevention, treatment, and elimination strategies undertaken by the Mexican government. Even where the government has implemented a hepatitis B vaccination strategy to reduce its incidence, a very low proportion of people complete the vaccination schedule. Regarding hepatitis C, there is a National Elimination Program that emphasizes the importance of screening, diagnosis, and treatment focused on the population at risk. With the implementation of this program, more than a million fast tests have been carried out and the positive cases have been verified by viral load. Infected patients are tested to determine liver function, fibrosis stage, and coinfection with HBV and/or HIV. Patients without cirrhosis and/or coinfections are treated in first-level care centers, while those with cirrhosis and/or comorbidities are referred to specialists. The possibility of hepatitis C eradication in Mexico seems more likely than eradication of hepatitis B; however, major challenges remain to be overcome to reach both infections' elimination.

Qualitative protocol to support detection of the early presentation and diagnosis of mycetoma in Sudan

The neglected tropical disease (NTD) mycetoma is a chronic and progressively destructive infectious disease endemic in Sudan. There is a growing body of scientific research on mycetoma -causes, transmission, treatment, and impact from a clinical and biomedical perspective. However, there is further need for in-depth medical anthropology research on the disease to successfully translate biomedical advances into elimination and control programmes. Given this background the NIHR Global Health Research Unit on NTDs at Brighton and Sussex Medical School is leading multidisciplinary research on skin NTDs, including mycetoma, with a medical anthropology research component exploring how community engagement can lead to earlier presentation of mycetoma in Sudan. This protocol paper sets out the research aims and methods to generate new knowledge on mycetoma in Sudan once the political situation becomes stable and it is safe to carry out global health research once again. We continue to develop appropriate community engagement intervention strategies, while activities like training and capacity strengthening get underway remotely. In what follows we situate this study in the NIHR Research Unit on NTDs and alongside social science research on mycetoma. This study is part of the programme of research conducted by the NIHR Research Unit on NTDs at Brighton and Sussex Medical School (BSMS). Phase I of the Unit was conducted from 2018–2021. Below we detail key findings from Phase I that have informed our more recent work in Phase II (2021)(2022)(2023)(2024)(2025)(2026). It also sits alongside the Social Sciences for Severe Stigmatising Skin Conditions (5-S) Foundation also at BSMS (‘NIHR 5S Foundation -BSMS’ n.d., 5). The 5-S foundation examines the cultural, social, economic, and policy contexts of podoconiosis, mycetoma, and scabies in relation to the dynamics and dimensions of stigma. This study differs from the aims of the 5S Foundation in that it specifically focuses on the role community engagement can have in the early presentation and diagnosis of mycetoma in Sudan.

Competency Mapping of Key Stakeholders in Procurement and Contracting of the National Tuberculosis Elimination Program Goods and Services in an Eastern Indian State

Abstract Background: The National Tuberculosis Elimination Program is a complex program, and the program officers are involved in the procurement and contracting of goods and services under it. A competency mapping was conducted to highlight the current capacity gaps in contract management at state and district levels under the program. Materials and Methods: A descriptive cross-sectional design was adopted with 15 participants involved in procurement and contracting in two districts of the state using a semi-structured questionnaire, and results were presented using the descriptive statistical analysis. Results: A total of 15 different stakeholders from the National Health Mission, State and District Tuberculosis (TB) Cell, State TB Training and Demonstration Centre, and State Medical Corporation participated in the study. The participants had an average of 10.3 years of experience in contracting, and 20% of them had received some training on contracting. The capacity of these respondents varied based on their involvement, previous training (s) received, and technical background. It was further observed that most of the respondents suggested an in-person physical training instead of virtual training. Most of the respondents requested to issue training certificate. Some of the topics that the participants requested for further training include Digital Signature Certification, Government e-Marketplace, General Financial Rule, Public Financial Management System, monitoring of performance indicators, and bid evaluation techniques. Moreover, 92% of the respondents felt that there is a training need on procurement and contracting. Conclusions: Many a time, the program officers come from a technical background not relevant to the contracting and procurement of goods and services and require regular on-the-job support and training to aid in effective program delivery.

Plasmodium gametocyte carriage in humans and sporozoite rate in anopheline mosquitoes in Gondar zuria district, Northwest Ethiopia.

Although the overall burden of malaria is decreasing in Ethiopia, a recent report of an unpredictable increased incidence may be related to the presence of community-wide gametocyte-carrier individuals and a high proportion of infected vectors. This study aimed to reveal the current prevalence of gametocyte-carriage and the sporozoite infectivity rate of Anopheles vectors for Plasmodium parasites. A community-based cross-sectional study was conducted from May 01 to June 30/2019. A total of 53 households were selected using systematic random sampling and a 242 study participants were recruited. Additionally,515 adult female Anopheles mosquitoes were collected using Center for Diseases Control and Prevention (CDC) light traps and mouth aspirators. Parasite gametocytemia was determined using giemsa stain microscopy, while sporozoite infection was determined by giemsa staining microscopy and enzyme linked immunosorbent assay (ELISA). Among the total 242 study participants, 5.4% (95%, CI = 2.9-8.3) of them were positive for any of the Plasmodium species gametocyte. Furthermore, being female [AOR = 15.5(95%, CI = 1.71-140.39)], age group between 15-29 years old [AOR = 16.914 (95%, CI = 1.781-160.63)], no ITNs utilization [AOR = 16.7(95%, CI = 1.902 -146.727)], and high asexual parasite density [(95%, CI = 0.057-0.176, P = 0.001, F = 18.402)] were identified as statistically significant factors for gametocyte carriage. Whereas sporozoite infection rate was 11.6% (95%, CI = 8.2-15.5) and 12.7% (95%, CI = 9.6-16.3) by microscopy and ELISA, respectively. Overall, this study indicated that malaria remains to be an important public health problem in Gondar Zuria district where high gametocyte carriage rate and sporozoite infection rate could sustain its transmission and burden. Therefore, in Ethiopia, where malaria elimination program is underway, frequent, and active community-based surveillance of gametocytemia and sporozoite infection rate is important.

Prevalence of hepatitis B and C virus infections among visceral leishmaniasis patients: a systematic review and meta-analysis.

Visceral leishmaniasis (VL) patients are at high risk of acquiring hepatitis B virus (HBV) and hepatitis C virus (HCV) infections during multiple injections and the anti-leishmanial treatment possesses a potential hepatotoxic effect. This systematic review and meta-analysis determined the pooled prevalence of HBV and HCV infections in VL patients. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO), with the assigned number CRD42024516889, and conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was performed using PubMed, Medline, EMBASE, Google Scholar, Web of Science, and Science Direct databases. Data were extracted using Microsoft Excel and analyzed using STATA version 11.0 software. A random-effects model was used to estimate the pooled effect size of outcome variables across studies with a 95% confidence interval and was displayed in a forest plot. The I 2 statistic was used to check for heterogeneity. The presence of publication bias was determined using a funnel plot and Egger's test with a p value <0.05 evidence of statistically significant bias. Among 216 retrieved records, seven studies were eligible for systematic review and meta-analysis. A total of 937 VL patients were examined, revealing that 105 and 93 were infected with HBV and HCV, respectively. The pooled prevalence of HBV was 16.15% (95% CI: -4.10 to 36.39), with a significant heterogeneity (I 2 = 91.4%, p < 0.001). The combined prevalence of HCV was 13.74% (95% CI: 1.32-26.16, I 2 = 71.6%, p = 0.003). The funnel plot (symmetry), and Egger's test in both HBV (p value = 0.650) and HCV (p value = 0.841) revealed no publication bias. In subgroup analysis, high HBV and HCV prevalence was detected in Sudan; 20.64% (95% CI: -13.60 to 54.88) and India; 18.26% (95% CI: -0.40 to 36.92%), respectively. This study revealed a high prevalence of both HBV and HCV infections in VL patients. In subgroup analysis, the prevalence of HBV and HCV was high in Sudan and India, respectively. Therefore, screening of VL patients for HBV and HCV, vaccination of VL patients in endemic regions, and collaboration between kala-azar and hepatitis elimination programs are required. https://www.crd.york.ac.uk/prospero/export_details_pdf.php#page=1.00&gsr=0, identifier: CRD42024516889.

Knowledge and practices on lymphatic filariasis in patients with filarial morbidity in an endemic area in Northeastern Brazil

BackgroundLymphatic filariasis (LF) is a stigmatizing and debilitating disease that represents a significant global public health challenge. Information regarding the knowledge and practices of individuals with filarial morbidities is limited, and this understanding is crucial for the implementation of effective control strategies. This study aimed to investigate the knowledge and practices of individuals with filarial morbidity residing in two intervention areas of the Elimination Program in the city of Olinda, Brazil.MethodsA cross-sectional study was carried out with residents who reported filarial morbidity in 2010, four years after the start of mass drug administration, in the intervention areas of the LF Elimination Program in the city of Olinda, Brazil. The knowledge and practices of patients with reported filarial morbidity in an endemic area were scrutinized using a semi-structured questionnaire to collect pertinent information. Data were analyzed utilizing the R language version 3.6.1.ResultsFilarial morbidity was reported in 338 patients. Dermatolymphangioadenitis emerged as the most frequently reported clinical form (50.9%). Mosquito bites were the most commonly cited form of transmission, accounting for 296 cases (87.6%). Approximately 80% (266) confirmed the adoption of prevention measures. Participants reported that the treatment involved the administration of medication. The existence of a cure for parasitosis was indicated by 212 subjects (62.7%).ConclusionsIndividuals with reported filarial morbidity exhibit varying levels of conceptions, knowledge, and practices regarding the disease, despite residing in an endemic area and receiving consistent visits from family health teams. Health services must identify shortcomings in this approach to minimize disparities, thereby enabling health education to effectively contribute to disease control and elimination in the municipality.

Factors associated with hookworm and Schistosoma mansoni infections among school-aged children in Mayuge district, Uganda

BackgroundHookworm infection and schistosomiasis are two of sub-Saharan Africa's most common neglected tropical diseases. An annual mass drug administration (MDA) program against schistosomiasis and soil-transmitted helminths (STHs), including hookworm, has been implemented in Mayuge district, Uganda, since 2003 to date. However, hookworm and schistosomiasis remain prevalent in Mayuge district. Understanding the factors that predispose children to these infections in the context of MDA could inform interventions to reduce prevalence in Uganda and similar settings.MethodThis cross-sectional study took place in 33 randomly selected primary schools in the Mayuge district from January to February 2022. Children in primary classes 4 or 5, in the selected schools provided single stool samples and completed questionnaires. Stool specimens were examined using the Kato-Katz method to determine the prevalence of hookworm and schistosomiasis. We performed univariable and multivariable logistic regression to assess the associations of each infection with potential risk factors.ResultA total of 1,617 students (mean age 12.1 years, 50.1% male) were enrolled. The prevalence of hookworm infection and schistosomiasis was 21.8% (95% confidence interval (CI): 19.8–23.9%) and 18.7% (95% CI: 16.8–20.7%), respectively. In multivariable analysis, longer water fetching time (over 30 min versus less than 30 min) and working daily in the soil were associated with increased odds of hookworm infection (adjusted odds ratio (AOR): 1.49, 95% CI: 1.13–1.96 and 1.37, 95% CI: 1.03–1.82, respectively). Higher odds of schistosomiasis were linked to proximity to water bodies within a one-hour walking distance (AOR: 1.84, 95% CI: 1.35–2.50), and not always washing hands before eating (AOR: 2.00, 95% CI: 1.50–2.67). Swimming, bathing, or washing in water bodies twice a week, compared to never, also increased schistosomiasis odds (AOR: 2.91, 95% CI: 1.66–5.13).ConclusionConsistent with the mechanisms of acquisition, hookworm infection increased with exposure to soil, and schistosomiasis increased with exposure to unclean water. Our findings highlight the importance of Water, Sanitation, and Hygiene programs and strategies aimed at reducing exposure within the framework of Neglected Tropical Disease elimination programs.

Active Community-Based Case Finding of Endemic Leishmaniasis in West Bengal, India

IntroductionThe ongoing visceral leishmaniasis (VL) elimination programme in India is targeting the elimination of the disease VL but not the pathogen. The persistence of hidden parasite pool may initiate a resurgence in suitable conditions. This study dealt with a novel approach to unearth such pathogen pool and their proper management to prevent the resurgence of VL.Materials and MethodsWe deployed a new approach for detection of pathogen pool by following up the VL and post kala-azar dermal leishmaniasis patients treated during the last 10 years along with mass sero-surveillance within a radius of 500 m of recently treated individuals.ResultsWe followed up 72.6% (3026/4168) previously treated VL and post kala-azar dermal leishmaniasis patients and diagnosed 42 (1.4%) new and 38 (1.3%) recurrent post kala-azar dermal leishmaniasis. We detected 93 asymptomatic leishmanial infection, 8 VL and 1 post kala-azar dermal leishmaniasis by mass sero-surveillance.ConclusionOur three-step process including mapping and follow-up of previously treated cases, mass surveillance within 500 m of radius of known cases, and 6 monthly follow-on clinical and serological screening of asymptomatic cases, enabled detection of previously undetected cases of post kala-azar dermal leishmaniasis and VL. Recurrent post kala-azar dermal leishmaniasis deserves special attention regarding their treatment guideline. Early diagnosis and effective treatment of all leishmaniasis cases will hasten pathogen elimination and prevent resurgence of VL. This may help the policymakers to develop appropriate strategy for elimination of pathogen to prevent resurgence of VL.

The Increasing Occurrence of Infectious Diseases in Childhood: Is It Linked with Declining Vaccination Rates Across Society?

Introduction. Childhood infectious diseases have been a significant medical problem, with a global increase in recent years. Modern diagnostic methods and new vaccinations are available. Poland is part of the WHO-coordinated global measles and rubella elimination program. Controversy surrounds mandatory and recommended vaccinations in Poland. There has been a concerning increase in the abandonment of vaccinating children, leading to a resurgence of infectious diseases. In 2024, the WHO reported a significant increase in measles cases in the European region, including in Poland. It's crucial to remind people of these diseases and warn them about the complications they bring. Aim of study. The aim of this study is to investigate the increasing occurrence of infectious diseases in childhood and examine the correlation with declining vaccination rates across society. Materials and methods. An unsystematic review of scientific literature was conducted, employing specific keywords such as „measles,” „pertussis,” „rubella,” „infectious diseases,” „vaccination,” and „hib.” The review was executed on the PubMed database, analyzing a total of 59 sources published until the conclusion of 2024. Conclusions. To control and eliminate infectious diseases, it is vital to maintain and improve vaccination rates. Policymakers and healthcare providers should prioritize immunization programs and address barriers to vaccine access. Further research is crucial to develop comprehensive strategies for increasing vaccination coverage and understanding vaccine-preventable diseases in modern public health challenges.

Dietary Assessment of Tuberculosis Patients Receiving Treatment at a Tertiary Care Center in New Delhi

Introduction: Undernutrition and tuberculosis (TB) are interrelated, with a bidirectional relationship. Despite its potential impact on nutritional status and TB patient outcomes, there is limited information available on the dietary patterns of TB patients in the Indian TB program. This study aims to address this knowledge gap by evaluating dietary patterns and factors associated with reduced dietary intake among TB patients in a tertiary care center. Methodology: This was a cross-sectional study conducted in a directly observed treatment short center working under the National Tuberculosis Elimination Program. A semi-structured, pretested interviewer-administered questionnaire was used to collect data related to the demographic profile and dietary patterns of 49 patients. Results: The mean calorie intake among the patients was 1525.2 (±897) kcal, whereas the required mean calorie intake was 2231.6 (±409.2) kcal. The mean protein requirement was 66.9 (±15.2) g, whereas the mean protein intake was only 39.2 (±15.4) g. Conclusion: To strive toward the goal of TB elimination in India, the nutritional care of the patient cannot be undermined. The need of the hour is to enforce the nutritional supplementation as well as support program by the government at the national level.

Evaluation of alcohol use behavior among patients cured through HCV elimination program in Georgia

ObjectiveThe objective of the study was to understand the role of self-reported drinking behavior on liver health after achieving sustained viral response (SVR) among HCV patients.ResultsThe study was conducted in HCV treatment provider clinics in three cities in Georgia: Tbilisi, Batumi, and Telavi. Face-to-face interviews were conducted using a questionnaire developed specifically for this study. 9.5% considered themselves heavy drinkers, while 94.2% were aware that heavy alcohol consumption can progress liver fibrosis. During treatment, 97.8% abstained from alcohol, while 76.6% reported resuming drinking after achieving SVR. Additionally, 52.1% believed that moderate alcohol intake is normal for individuals with low fibrosis scores. Liver fibrosis improvement was more prevalent among individuals who abstained from alcohol after HCV diagnosis (85.4% vs. 71.4%, p < 0.01) and after achieving SVR (87.5% vs. 74.7% of those who resumed drinking after achieving SVR, p < 0.02). In conclusion, the majority of HCV patients abstain from alcohol during treatment but resume drinking after achieving SVR. Those who abstain from alcohol intake after HCV cure have a higher chance of liver fibrosis improvement.

Progress Toward Tuberculosis Elimination and Tuberculosis Program Performance - National Tuberculosis Indicators Project, 2016-2022.

Elimination of tuberculosis (TB) is defined as reducing TB disease incidence in the United States to less than 1 case per million persons per year. In 2022, TB incidence in the United States was 2.5 TB cases per 100,000 persons. CDC's TB program developed a set of national TB indicators to evaluate progress toward TB elimination through monitoring performance of state and city TB program activities. Examining TB indicator data enables state- and city-level TB programs to identify areas for program evaluation and improvement activities. These data also help CDC identify states and cities that might benefit from technical assistance. The 5-year period for which the most recent data were available for each of five indicators: 1) overall TB incidence (2018-2022), 2) TB incidence among non-U.S.-born persons (2018-2022), 3) percentage of persons with drug susceptibility results reported (2018-2022), 4) percentage of contacts to sputum acid-fast bacillus (AFB) smear-positive TB patients with newly diagnosed latent TB infection (LTBI) who completed treatment (2017-2021), and 5) percentage of patients with completion of TB therapy within 12 months (2016-2020). The National TB Indicators Project (NTIP) is a web-based performance monitoring tool that uses national TB surveillance data reported through the National TB Surveillance System and the Aggregate Reports for TB Program Evaluation. NTIP was developed to facilitate the use of existing data to help TB program staff members prioritize activities, monitor progress, and focus program improvement efforts. The following five indicators were selected for this report because of their importance in Federal TB funding allocation and in accelerating the decline in TB cases: 1) overall TB incidence in the United States, 2) TB incidence among non-U.S.-born persons, 3) percentage of persons with drug susceptibility results reported, 4) percentage of contacts to sputum AFB smear-positive TB cases who completed treatment for LTBI, and 5) percentage of patients with completion of TB therapy within 12 months. For this report, 52 TB programs (50 states, the District of Columbia, and New York City) were categorized into terciles based on the 5-year average number of TB cases reported to National TB Surveillance System. This grouping allows comparison of TB programs that have similar numbers of TB cases and allocates a similar number of TB programs to each category. The following formula was used to calculate the relative change by TB program for each indicator: [(% from year 5 - % from year 1 ÷ % from year 1) × 100]. During the 5-year period for which the most recent data were available, most TB programs had improvements in reducing overall TB incidence (71.2%) and increasing the percentage of contacts receiving a diagnosis of LTBI who completed LTBI treatment (55.8%); the majority of programs (51.0%) also had improvements in reducing incidence among non-U.S.-born persons. The average percentage of persons with drug susceptibility results reported in most jurisdictions (28 of 52, [53.9%]) met or exceeded the 5-year national average of 97% (2018-2022). The percentage of contacts to sputum acid-fast bacillus (AFB) smear-positive TB patients with newly diagnosed latent TB infection (LTBI) who completed treatment increased in 29 of 52 (55.8%) jurisdictions from 2017 to 2021, signifying that, for most jurisdictions, steps have been taken to enhance performance in this area. The average percentage of patients with completion of TB therapy within 12 months was at or above the national average of 89.7% in approximately two-thirds (32 of 52 [61.5%]) of jurisdictions. This report is the first to describe a 5-year relative change for TB program performance. These results suggest that TB programs are making improvements in activities that help identify persons with TB and LTBI and ensure patients complete treatment in a timely manner. Use of NTIP data from individual TB programs enables a more detailed examination of trends in program performance and identification of areas for program improvement. Assessing indicator trends by TB program provides an opportunity to gain a better understanding of program performance in comparison to other programs. It can also facilitate communication between programs regarding successes and challenges in program improvement. This information is valuable for TB programs to allocate resources effectively and provide additional context on TB control for public health policymakers.

"Healthcare providers' perspectives on Tuberculosis control in a district of Southern India – Insights from 2022 sub-national TB free certification"

BackgroundIn response to the persistent TB challenge, the National Tuberculosis Elimination Programme (NTEP) of India, formerly known as the Revised National Tuberculosis Control Programme (RNTCP), set a strategic goal to eliminate the nation's TB burden by 2025, five years ahead of the Sustainable Development Goals. In recognition of this challenge, the Indian Government launched the Sub-national Certification initiative in 2021, fostering competition among states and districts to attain TB-free status and offering recognition and incentives to the best-performing entities. Leveraging verification methods such as TB scores, treatment data, and community-level incidence estimation, this study seeks to provide a comprehensive view of the landscape. Materials & methodsThe study targeted healthcare providers encompassing doctors and chemists employed in both public and private sectors. A non-probability sampling technique, specifically, the convenient sampling method, was utilized. Two Nominal Group Technique (NGT) sessions were conducted. The first NGT comprised 8 healthcare providers, while the second NGT included 10 healthcare providers, while 14 participants were interviewed for KII. ResultsUtilizing the nominal group technique, the following results were derived: approximately 20 % of patients opt for treatment in the private sector, and pharmacies notifying TB cases comprise around 70 % of the cases. Additionally, most participants concurred that there has been a reduction in TB cases over recent years. ConclusionStudy's findings shed light on healthcare providers' perspectives on various facets of TB control, including incidence trends, patient preferences, drug choices, and compliance.