National Control Program Research Articles

Pattern and trend of cancer in Saurashtra region in Gujarat state of India, a hospital-based study.

Cancer is growing concern for every country. Reliable data is a source to define the magnitude of the problem, which then helps to plan for necessary action. This epidemiological study involves the collection and analysis of hospital registry data to assess the quantum of the problem of cancer over a five-year period from 2012-16 and to plan priority action. Hospital-based data for five years from 2012-2016 was retrieved from the department of radiotherapy at M. P. Shah Government Medical College, Jamnagar, Gujarat, India, and analysed to define the magnitude of the problem. All data was studied using Microsoft Excel 2016. A total of 7355 patients were registered between 2012 and 2016, out of which 62 percent were male. Cancers of the cervix and uterus were discernibly less common in the Saurashtra region and accounted for only 12.37% of all cancers in females. Lung cancer was the leading cancer as a single site in males (24.13% of all cancers in males) and breast cancer in females (37.36% of all cancers in females). Head and neck cancer, all sites clubbed, was most common in males (42%). Jamnagar taluka represented around 50% of all cases at the study center. Tobacco-related cancers were most common in the male population, and stringent implementation of a national tobacco control program is the most appropriate measure to curtail incidences and hence mortality in this male population. Non-modifiable risk factors like gender-related cancer were more common in the female population, and resource-appropriate screening is a suitable option for these diseases. A population-based cancer registry is required to further define the pattern pertinently, or an epidemiological study is required to find causes of the noticeably lower incidence of cancer of the cervix,.

Bovine Tuberculosis: Ethiopian Perspective

Bovine tuberculosis is a significant zoonotic disease affecting livestock and humans worldwide, causing substantial economic losses and posing serious public health risks. This review aims to provide an overview of bovine tuberculosis in Ethiopia, highlighting its prevalence, risk factors, transmission routes, clinical manifestations, and diagnostic methods. Mycobacterium bovis primarily causes bovine tuberculosis, which is characterized by granulomatous lesions in various organs. Transmission occurs through inhalation, ingestion of contaminated materials, and direct contact with infected animals. The age, breed, herd size, and management practices are some of the risk factors for bovine tuberculosis. In Ethiopia, the disease is prevalent but poorly controlled, lacking a national control program. Effective diagnosis relies on methods such as the tuberculin skin test, culture, and PCR. Control measures include test-and-slaughter programs, movement restrictions, biosecurity protocols, and public health education. This review underscores the urgent need for a comprehensive national control strategy, enhanced surveillance, public awareness campaigns, and investment in research to mitigate the impact of bovine tuberculosis in Ethiopia, thereby safeguarding both animal and human health.

School and community driven dengue vector control and monitoring in Myanmar: Study protocol for a cluster randomized controlled trial.

Dengue is the most common and widespread mosquito-borne arboviral disease globally estimated to cause >390 million infections and >20,000 deaths annually. There are no effective preventive drugs and the newly introduced vaccines are not yet available. Control of dengue transmission still relies primarily on mosquito vector control. Although most vector control methods currently used by national dengue control programs may temporarily reduce mosquito populations, there is little evidence that they affect transmission. There is an urgent need for innovative, participatory, effective, and locally adapted approaches for sustainable vector control and monitoring in which students can be particularly relevant contributors and to demonstrate a clear link between vector reduction and dengue transmission reduction, using tools that are inexpensive and easy to use by local communities in a sustainable manner. Here we describe a cluster randomized controlled trial to be conducted in 46 school catchment areas in two townships in Yangon, Myanmar. The outcome measures are dengue cases confirmed by rapid diagnostic test in the townships, dengue incidence in schools, entomological indices, knowledge, attitudes and practice, behavior, and engagement. The trial involves middle school students that positions them to become actors in dengue knowledge transfer to their communities and take a leadership role in the delivery of vector control interventions and monitoring methods. Following this rationale, we believe that students can become change agents of decentralized vector surveillance and sustainable disease control in line with recent new paradigms in integrated and participatory vector surveillance and control. This provides an opportunity to operationalize transdisciplinary research towards sustainable health development. Due to the COVID-19 pandemic and political instability in Myanmar the project has been terminated by the donor, but the protocol will be helpful for potential future implementation of the project in Myanmar and/or elsewhere.Registration: This trial was registered in the ISRCTN Registry on 31 May 2022 ( https://doi.org/10.1186/ISRCTN78254298).

Preventing malaria in pregnancy: knowledge and practices of pregnant women in an urban hospital in Kumasi, Ghana

Background: Malaria in pregnancy (MiP) is a public health concern in Ghana. The current national control program seeks to have 85% of pregnant women sleeping under insecticide treated nets (ITNs). It also seeks to achieve 100% intake of at least 2 doses of Sulfadoxine-Pyrimethamine (SP). In order to achieve these aims, it is important that pregnant women have good knowledge of malaria and subscribe to good preventive practices. This cross-sectional study sought to evaluate the knowledge and practices on malaria prevention among pregnant women in an urban setting of Ghana. Methods: This was a hospital-based study which involved 185 pregnant women visiting an urban hospital for antenatal care in Kumasi, Ghana. Data was collected via structured interviewer administered questionnaires. Univariate and bivariate analyses were conducted to assess the participants’ knowledge and practices on malaria prevention. Results: The women demonstrated good knowledge of MiP, with 76% of them having an excellent knowledge score. Familiarity with ITNs (99.5%) was higher than IPTp-SP (86.5%). There was a statistically significant association between tertiary education and high total knowledge score (X2 =31.912, df = 18, p = 0.023). ITN usage was poor (55.1%), with common challenges being difficulty in hanging nets, nets being deemed too hot, and unpleasant smell of the nets. 66.5% of the women had taken at least 2 SP doses. Conclusion: Although there was good knowledge, ITN use and SP coverage were below national targets. More studies should be conducted to explore the factors underlying poor ITN use and SP intake.

Psychosocial distress and associated factors among adult cancer patients at oncology: a case of Ethiopia.

Psychosocial distress is a chronic burden for cancer survivors, which impacts both their quality of life and their oncologic prognosis. Although the national cancer prevention and control program in Ethiopia has made efforts in cancer prevention, control, and management by implementing the national cancer control plan 2016-2020, there was no enough evidence about psychosocial distress among adult cancer patients. So, it is critical to understand the magnitude of psychosocial distress and the factors that contribute to it. The purpose of this study was to assess the prevalence of psychosocial distress and associated factors among adult cancer patients at oncology units in the Amhara regional state, Ethiopia. 2022. A multicenter institution-based cross-sectional study was conducted among a sample of 605 adult cancer patients from 30 April to 22 June 2022. A systematic random sampling technique was employed to select the study units. In addition, data were collected through interviewers administered questionnaires by using the validated and pretested tools. Distress was assessed using the Questionnaire on Stress in Cancer Patients Revised 10. Both bivariable and multivariable logistic regression was used to describe the association between dependent and independent variables. Independent variable with p < 0.25 in the bivariable logistic regression analyses were entered into multivariable logistic regression model. Variables with p < 0.05 in the multivariable logistic regression analyses were considered as statistically significant associated factors of psychosocial distress. A total of 593 adult cancer patients took part in this study with mean age of 46.86 ± 14.5 years. The overall prevalence of psychosocial distress was 63.74%. Variables such as being female [AOR = 1.98, 95% confidence interval (CI): 1.24-3.17], patients who lives in rural areas (AOR = 2.3, 95% CI: 1.49-3.54), community-based health insurance utilization (AOR = 0.34, 95% CI: 0.23-0.51), patients on chemotherapy treatment (AOR = 2.72, 95% CI: 1.38-5.39), patients with comorbidity (AOR = 3.2, 95% CI: 1.67-6.10), and symptom burdens such as severe fatigue (AOR = 1.65, 95% CI:1.09-2.39) and severe nausea (AOR = 2.07, 95% CI: 1.43-3.00) were statistically associated with psychosocial distress. In general, the findings of this study showed a relatively high magnitude in which around two-thirds of patients experienced psychosocial distress. It is better to establish and enforce the integration and coordination of psychosocial oncology service programs at national level with parallel guidelines and policies.

Effectiveness of targeted intervention program under the national AIDS control program among Hijra and transgender population: Evidence from Integrated Biological and Behavioral Surveillance, 2014-15.

The hijra and transgender (H/TG) population in India is vulnerable to HIV/AIDS. India had instituted a targeted intervention (TI) program to reduce this vulnerability. We aimed to measure the effectiveness of the TI program for H/TG. The National Integrated Behavioral and Biological Survey (IBBS) was carried out in 2014-15. H/TG data from IBBS was analyzed. Bivariate and multivariate logistic regression were used to calculate the unadjusted and adjusted odds ratios with 95% confidence interval. Condom use during the last sexual intercourse, and the consistent condom use in the last onemonth were considered as indicators of program effectiveness. The Propensity Score Matching (PSM) method was used to assess the effectiveness. We found that the participants who had received condoms from peer educator/outreach worker were 1.74 and 1.40 times more likely to use condoms in the last sexual intercourse (aOR: 1.74, CI: 1.35 - 2.26) and consistent condom use in the last onemonth (aOR: 1.40, CI: 1.12 - 1.74) respectively compared to the participants who did not receive the condom. The matched-samples estimate (i.e., average treatment effect on treated) for the condom use during the last sexual intercourse increased by 13.0%, i.e., 0.13 (CI; 0.08 - 0.18) and consistent condom use in the last onemonth increased by 5.0%, i.e., 0.05 (CI; 0.00 - 0.10) among those who had received condoms from the peer educator/outreach worker compared with those who had not received condom, respectively. The TI program intervention for H/TG was effective in reducing HIV risk behavior as evidenced by increase in use of condom during last sexual intercourse, and consistent condom use in the last onemonth.

Assessment of community pharmacies readiness to dispense antiretroviral medicines in Rwanda.

Since the introduction of the 'Test and treat' approach in the Human Immunodeficiency Virus (HIV) management, various strategies have been devised and implemented by countries to relieve public health facilities of the large numbers of people coming for medicine refills and clinical follow-up. One of the strategies is the dispensing of antiretroviral medicines through community pharmacies. In Rwanda, community pharmacies are not yet involved in antiretrovirals (ARVs) dispensing, and no study has assessed their readiness to provide this service. This study aimed to assess the readiness of community pharmacy staff and infrastructure to implement a decentralised model of antiretroviral medicines dispensing. This cross-sectional study included data from 262 community pharmacies sampled across all districts of Rwanda. Primary data were collected using a structured questionnaire, from February to March 2023. Responses were received for 262 community pharmacies, representing the total sample size. Data analysis was done using quantitative descriptive and inferential statistical approaches. Frequency tables and graphs were produced using STATA15 and the outputs were exported to MS Excel as well as MS Word to allow document framing and designing. The research has shown a high proportion of community pharmacy staff trained in HIV prevention (82.4% trained on HIV testing), but a low level of training in treatment (30.5%) and psychosocial support of people living with HIV (29.8%). Infrastructure and storage conditions were found to be adequate, with 99.6% of surveyed Pharmacies having sufficient storage space. Majority (93.9%) expressed their willingness to dispense ARVs in the pharmacy premises. A large number of respondents (92.4%) felt that dispensing of antiretroviral medicines through community pharmacies would lead to an increase in sales of over the counter and other non-HIV related medicines. The main anticipated challenge that should be addressed to ensure effective implementation is the lack of interoperability between reporting systems used by community pharmacies and those used by health facilities providing HIV services (76.7% of respondents). Community pharmacies in Rwanda have majority of staff trained in various areas of HIV prevention, but a small proportion have been trained in HIV care and treatment. Community pharmacies have the necessary infrastructure to dispense ARVs, and those with shortcomings, such as the lack of a separate room for individual patient counselling, are willing to obtain such a room if they are authorised to dispense ARVs. Staffs are willing to dispense ARVs in community pharmacies if the model is recommended by policymakers. The model could have several benefits for community pharmacies and the public health system in general, but there are also challenges that should be mitigated to ensure effective implementation. The staff willingness and expected benefits constitute enabling factors that the Ministry of Health and the national HIV control programme may leverage to prepare for introducing the model of ARVs distribution through community pharmacies.

Temephos resistance levels in populations of Aedes aegypti (Diptera: Culicidae) from Havana, Cuba

Aedes aegypti chemical control remains an indispensable alternative to prevent dengue, Zika, and Chikungunya outbreaks. Havana City requires constant surveillance due to its bioecological characteristics favor the proliferation of mosquito vectors of these diseases, which constitutes a high risk to the health of its inhabitants. The goal of this study was to determine temephos resistance levels in the populations of Ae. aegypti from five municipalities of Havana. The susceptibility of the larvae was evaluated by bioassays described by the World Health Organization. Aedes aegypti populations evaluated showed high resistance to temephos, with values that oscillated for the FR50 between 26,8 and 82,5 and for the FR90 between 16,6 and 42,5 respectively. The National Control Program of Aedes aegypti in Cuba must promote insecticide rotation policies to avoid or prevent the evolution of temephos resistance in Havana. In addition, an evaluation of the Abate doses applied by the operators in the municipalities studied must be carried out, since this could be influencing resistance development due to operational factors.

Lumpy Skin Disease (LSD) in Yak (Bos grunniens): An Evidence of Species Spillover from Cattle in India.

Lumpy skin disease (LSD), caused by the lumpy skin disease virus (LSDV), is a global concern that affects cattle and buffalo. Recently, the disease has been reported in new species such as the Indian Gazelle, Camel, Banteng, Gaur, and Giraffe from various parts of the world. This report provides an insight into the occurrence of LSD in Yak from Sikkim, a North-Eastern state of India. During the investigation, both cattle and yak exhibited typical clinical signs of LSD, including skin nodular lesions. The morbidity, mortality, and case fatality rates for cattle were 9.08%, 1.84%, and 20.24%, respectively. Similarly, the morbidity, mortality, and case fatality rates in yak were 7.57%, 1.24%, and 16.33%, respectively. The virus isolation and amplification of LSDV-specific genes confirmed the presence of LSDV in cattle, yak, and vectors. Further, demonstrated antibodies in randomly collected sera from naïve and unvaccinated cattle and yak using indirect Enzyme Linked Immuno-sorbent Assay (iELISA) and Serum Neutralisation test (SNT) from this region. Sequencing and phylogenetic analysis of P32, GPCR, and RPO30 genes revealed that the virus isolated from both species was 100% identical to each other and also closely related to the field LSDV isolates circulating in the Indian subcontinent. The study highlighted the emergence of LSDV in unconventional hosts and underscored the need to include other bovine species in national disease control programs, encompassing disease surveillance initiatives.

Field validation of an antibiotic-free hoof spray to effectively treat ovine footrot by eliminating virulent Dichelobacter nodosus

Ovine footrot caused by Dichelobacter nodosus is a highly contagious hoof disease negatively impacting animal welfare and causing major economic losses to the sheep industry. Bactericidal footbaths have shown to be an efficient treatment option and will be used in the national footrot control program in Switzerland. However, the application of footbaths is laborious and economically not sound for small flock holders. We therefore tested in a field study the Intra Repiderma spray for its applicability and efficacy to treat ovine footrot. Ten independent flocks fulfilling defined parameters (e.g. clinical signs, positive for D. nodosus, flock size) could be identified and were included in the study. Farms were visited weekly to fortnightly and clinical scores and swabs for D. nodosus real-time (rt)PCR were taken. Treatment with the Intra Repiderma spray was started after initial claw trimming at the very first visit and was carried out three times within a week. Clearly visible clinical improvement was evident after one week of treatment. Virulent D. nodosus amounts on feet declined constantly during treatment which was continued until all sheep of a flock tested rtPCR-negative (1–10 weeks). Results indicate that a highly effective improvement of clinical signs and complete elimination of virulent D. nodosus can be achieved with the spray treatment. Therefore, it is a valuable alternative to cumbersome footbaths especially for small flocks. A sustainable control of footrot and its pathogen in a successfully treated flock can be maintained by strict biosecurity measures and continued treatment as far as necessary.

Prevalence and pattern of refractive errors among school-going children in district Baramulla, Kashmir: A cross sectional study.

Uncorrected refractive error is one of the most important causes of visual impairment worldwide. Addressing childhood vision impairment (VI) is one of the main goals of the World Health Organization (WHO) to combat blindness strategies. To ascertain the prevalence and pattern of refractive errors among children aged 10 to 16 years in Baramulla district, Kashmir. A cross-sectional study was carried out among 680 school children during an eye camp under the school health program of the national program for control of blindness. The screening was conducted in four schools in Baramulla district, Kashmir. The schools were selected using the non-probability convenient sampling technique. A total of 680 school children from classes sixth to tenth aged 10-16 years participated in the study. Out of 680 students, 545 (80%) had normal vision, 97 (14%) had impaired visual acuity ranging between 6/9 and 6/24, and 38 (6%) had severe VI ranging from 6/36 to 6/60. Among the various types of refractive errors, myopia was the most prevalent affecting 54 children. Age distribution of refractive errors showed myopia to be more prevalent in the age group 13-14 years (16, 14 cases), hypermetropia was more prevalent in the age group 14-15 years (10, 8 cases), and astigmatism 5 cases in the age group 14-15 years. The study provides useful and baseline data about the refractive error amongst the school children of the Baramulla district. A larger study needs to be conducted in all schools of the state to get a clear picture of RE and other eye-related problems to detect vision problems earlier.

Strength in struggle: unravelling the journey of national vector borne disease control programme India: a comprehensive SWOT analysis

India, like many other regions, faces the substantial burden of vector-borne diseases. Initially confined to tropical and sub-tropical regions, vector-borne diseases are now spreading to new geographies due to increasing unplanned urbanization, changes in land use, growing international travel, and the impact of climate and environmental dynamics. To address these challenges, India implemented the National Vector Borne Disease Control Program (NVBDCP) in 2003-04, which targets the prevention and control of the six vector-borne diseases. Over the years, numerous initiatives have been undertaken to combat the challenges posed by vector-borne diseases in India. The successes, such as streamlined resource utilization and the introduction of effective tools, have led to substantial reductions in disease burden. Nevertheless, issues like manpower shortages, logistical hurdles, and a lack of research resources remain as challenges. Moreover, the program must confront emerging threats posed by urbanization, climate change, and resistance to treatments. NVBDCP's roadmap for the future includes embracing opportunities like vaccine development, and research, as well as fostering collaborations with partners. By addressing its weaknesses and effectively managing the threats at hand, the program can continue its vital mission of combatting vector-borne diseases in India. The implementation of these strategies is essential to ensure the sustained success of disease control and prevention efforts in the country.

Challenging Stereotypes: Cases of Breast Cancer in Men

Breast cancer is the most common malignant tumor in women, internationally, and the leading cause of death from cancer. However, breast cancer in men is an uncommon pathology, corresponding to less than 1% of neoplasms in men. The lifetime risk of breast cancer in a man is approximately 1:1000, compared to 1:8 for a woman. Currently, an increase in timely diagnosis has been demonstrated thanks to the programs that are carried out for the early detection of breast cancer worldwide. Although, unfortunately, early diagnosis is still difficult due to the lack of information that a large part of the population has regarding self-examination, not only in our country, but also around the world, and in the case of breast cancer in men, being such an uncommon condition, its diagnosis is more difficult. The incidence of breast cancer is increasing in the developing world, due to longer life expectancy, increased urbanization and the adoption of Western lifestyles. Among the risk factors that have been seen to increase the risk of breast cancer in men, with scientifically proven evidence, are mainly hormonal disorders, family history and mutations of certain genes that predispose to the disease. The hormonal disorders mentioned above refer to an increase in circulating estrogen levels and a deficiency in the synthesis or action of testosterone. These alterations can be caused by disorders at the level of testicular testosterone synthesis, such as: orchitis, orchiectomy, undescended testicle, congenital inguinal hernia and others. Patients who voluntarily consume exogenous estrogens as part of the treatment of prostate cancer or transsexuals should also be taken into account. Another risk factor that has been found to be implicated in the presentation of this type of neoplasia are medications; many frequently used medications are testosterone antagonists. Alcohol is also implicated, since it decreases testosterone synthesis and the number of testicular receptors for gonadotropin. A higher prevalence has also been seen in patients with obesity, in whom there is a double risk, because as they have a higher peripheral aromatization of androgens, they synthesize a greater amount of circulating estrogens. Approximately 20% of men with breast cancer have a first-line family history, which indicates a two to three times higher risk of developing the disease at some point in their lives and that this risk doubles exponentially with the number of affected family members. Currently there are many programs and organizations that promote the fight against breast cancer, such as the World Health Organization, where there are comprehensive national cancer control programs that are integrated with non-communicable diseases and other related problems. Comprehensive cancer control encompasses prevention, early detection, diagnosis and treatment, rehabilitation and palliative care. Raising awareness of the general public about the problem of breast cancer and control mechanisms, as well as promoting appropriate policies and programs, are key strategies for population-based breast cancer control. Based on what has been mentioned above, the work will be carried out in order to have a better approach to breast cancer in men, due to the little information we have about it, as well as to raise awareness among the general population about the risk factors, prognostic factors, timely diagnosis and treatment of patients with this type of pathology.

Serological and Molecular Survey of Brucella Species in Owners and Their Dogs Living on Island and Mainland Seashore Areas of Brazil.

Background: Although Brucella abortus, Brucella suis, and Brucella canis may infect humans and dogs worldwide, no study to date has assessed and compared owners and their dogs between island and mainland seashore areas. Materials and Methods: Accordingly, the study herein has applied serological tests, including Microplate Agglutination Test with 2-Mercaptoethanol, immunochromatographic assay, and Rose Bengal Test, and a Brucella genus-specific PCR assay to 195 owners and their 148 dogs living on 1 mainland seashore area and three nearby oceanic islands of southern Brazil. Results: No seropositivity to B. abortus and B. suis was detected in owner or dog sera. Anti-B. canis seropositivity was observed in 3/148 (2.0%) dogs, but no owner sample was seropositive to B. canis. In addition, all blood samples from both owners and dogs were negative on Brucella genus-specific PCR assay. Conclusions: The seropositive dogs were not related and lived on the seashore mainland area of Guaraqueçaba city. The absence of seropositivity on the islands and the low seropositivity on the seashore mainland could be attributed to geographic isolation, and suggest the low impact of the disease in the region. Despite being a zoonotic disease, brucellosis by B. canis is not included in the National Program for Control and Eradication of Brucellosis, and its diagnosis and notification are not mandatory. The presence of seropositive dogs highlights the risk to human health and the importance of epidemiological surveillance actions in the region, as well as the need for the implantation of preventive measures to avoid the transmission of the pathogen.

Detection and management of tuberculosis in Tunisia: challenges and outcomes

Abstract Introduction Tuberculosis (TB) is a major cause of morbidity and mortality worldwide. In Tunisia, where TB remains endemic, the national control program ensures free vaccination, free outpatient TB treatment in addition to early detection of cases and directly observed treatment short course. However, available data on these activities and outcomes are limited. The objective of this study was to describe the evolution of TB detection and management indicators and outcomes from 2018 to 2021. Methods We analyzed data collected part of the epidemiological investigations of notified cases and active search for cases over a period of 4 years (2018-2021). In each governorate, dedicated teams collect samples from cases’ contacts for microscopic sputum examination for screening and ensure patients’ follow-up. All data related to contact tracing, treatment and outcomes were collected, entered and analyzed using SPSS-21. Results The number of screened cases decreased from 30337 in 2018 to 16045 in 2021. The number of investigations of reported cases also decreased; from 2408 in 2018 to 1295 in 2021 (proportion of 74.6% to 48.9% respectively). However, the percentage of positives increased from 1.4% to 2.1%. In 2021, therapeutic success was recorded among 81% of cases (compared to 86% in 2018). From 2018 to 2021, there was an increase in three indicators: fatality rate (1.55 to 2.53%), discontinuation of treatment (from 2.5% to 3.2%) and the proportion of multidrug-resistant TB cases (0.45 to 0.69%). Conclusions Despite free care and treatment, our study showed challenges in the prevention and management of TB. Several activities of the national tuberculosis program have decreased, probably due to the pandemic, as noted in general preventive and care activities worldwide. More education and awareness efforts should be made, not only for patients and their contacts, but also for health care professionals, to be more vigilant in early case detection and continued treatment. Key messages • Several activities of the national tuberculosis program have decreased from 2018 to 2021, probably due to the pandemic. • From 2018 to 2021, there was an increase in the fatality rate, discontinuation of treatment and multidrug-resistant TB cases.

Depressive Symptoms among People Living with HIV Attending ART Centers of Lumbini Province, Nepal: A Cross-Sectional Study.

Depression is a common mental disorder and is a leading cause of disability globally. Depressive symptoms among people living with HIV can be a significant barrier to ART initiation and thus lead to poor ART adherence. Global studies have found the prevalence of depressive symptoms among people living with HIV ranges from 12 to 63%. The real scenario of Nepal still needs to be explored. Thus, this study aimed to identify the prevalence and predictors of depression in individuals with HIV. An institutional-based cross-sectional study was carried out from August to December 2020 among 406 people living with HIV attending ART centers in Lumbini province. Participants were selected using a systematic random sampling technique and surveyed with a structured questionnaire consisting of sociodemographic variables, HIV AIDS-related variables, and 21 items Beck Depression Inventory tool. The odds ratio was used as the ultimate measure of association, with a 95% confidence interval computed to establish statistical significance. A multivariate regression analysis was carried out to identify the final predictors of depressive symptoms. The study found that 26.8% of the respondents had depressive symptoms. Those who were literate (AOR = 0.24, 95% CI: 0.10-0.61), in the poorest wealth quintile (AOR = 7.28, 95% CI: 2.22-23.87), initiated ART within 12 months (AOR = 1.88, 95% CI: 1.03-3.42), had CD4 cell counts below 200 (AOR = 2.50, 95% CI: 1.54-4.06), and had a time difference of 3 months or less between HIV diagnosis and ART initiation (AOR = 0.50, 95% CI: 0.29-0.86) were independently associated with depressive symptoms. Routine screening for depressive symptoms should be integrated into national HIV prevention and control programs for people living with HIV. An enabling environment should be created to facilitate the rapid enrollment of individuals newly diagnosed with HIV in ART services, thereby reducing the time gap between HIV diagnosis and ART initiation.

Abundance, diversity and richness of natural enemies of the fall armyworm, Spodoptera frugiperda (J.E. Smith) (Lepidoptera: Noctuidae), in Zambia.

The fall armyworm (FAW), Spodoptera frugiperda, an invasive pest originating from the Americas is a serious pest threatening cereal production and food security in Zambia. We studied the prevalence and abundance of natural enemies of FAW in three Agroecological regions (AERs I, II, and III) to identify those that could potentially serve as bio-control agents. Sampling of FAW parasitoids and predators was done along trunk roads at intervals of 10 km. Molecular sequence analysis and morphological characterization were used to identify natural enemies. Over 11 species of FAW natural enemies, including egg, egg-larval, and larval parasitoids, and predators, were identified in Zambia. The mean number of natural enemies and species richness was higher in AER I and IIa. Consequently, egg parasitism was highest in those two regions, at 24.5% and 12.2%, respectively. Larvae parasitism was highest in AER I (4.8%) and AER III (1.9), although no significant differences were observed. The most abundant and widely distributed parasitoid was Drino sp. (Diptera: Tachinidae), while Rhynocoris segmentarius (Germar) (Hemiptera: Reduviidae) and Belanogaster sp. (Hymenoptera: Vespidae) were the most prevalent predators. Our study reveals the presence of two natural enemies belonging to the genus Tiphia and Micromeriella, uncommon to FAW. Significant differences in the number of parasitoids were observed in polycropping, with the highest recovery of 12 ± 10% from maize + cowpeas + pumpkin and watermelon mixed cropping. The higher the rainfall, the lower the number of natural enemies recorded. Variations in rainfall patterns which affect FAW availability, cropping systems and the three AERs may explain natural enemies' species diversity in Zambia. The information provided in this study can aid the development of a national biological control programme for sustainable management of fall armyworm.

Baseline soil-transmitted helminth and schistosome infection in the Geshiyaro project, Ethiopia: A unique transmission interruption project using biometric fingerprinting for longitudinal individual analysis.

The Geshiyaro project aims to assess the feasibility of interrupting transmission of soil-transmitted helminths (STH) and schistosome (SCH) infection in the Wolaita zone of southern Ethiopia through high coverage community-wide mass drug administration (MDA), in combination with improved water, sanitation, and hygiene services and behaviour change communication delivered through the existing health care infrastructure. To accurately measure treatment coverage a population census was conducted enrolling individuals with biometric fingerprinting and barcoded ID cards. This paper details the baseline census and parasitology surveys conducted before the start of any interventions. The census was conducted in five of the 15 Wolaita districts between October 2018 and December 2019, enrolling all consenting participants from every household. Simultaneously, a cross-sectional parasitology survey was conducted in 130 out of 361 randomly selected communities from all 15 districts, with 100 individuals across all age groups (infant to adult) per community providing stool and urine for analysis by duplicate Kato-Katz and a point-of-care circulating cathodic antigen (POC-CCA) to test for Schistosoma mansoni and STH, and microhaematuria and urine filtration for Schistosoma haematobium. Of the 130 communities, 30 were randomly selected for annual, longitudinal parasitological monitoring, with 150 randomly selected individuals from infant to adult providing two days of stool and urine samples for analysis by the same diagnostic tests per community. In total 97,919 households participated in the baseline census enrolling 466,071 individuals, with parasitological data obtained from 10,785 people. At baseline, 15.5% were infected with at least one STH species, with Ascaris lumbricoides (9.5%), followed by hookworm (7.2%) and Trichuris trichiura (1.8%). Substantial heterogeneity in STH prevalence was observed between communities ranging from 0% to 61% where most infections were low intensity. Schistosoma mansoni infection was the dominant schistosome infection (0.85% by Kato-Katz and 13.3% by POC-CCA trace negative and 21.5% trace positive), with few Schistosoma haematobium infections identified (2.77% haematuria positive and 0.13% positive by urine filtration). While the national control program in Ethiopia has made good progress in reducing prevalence of STH and SCH in Wolaita since it was launched in 2015, there remain areas of persistent infection suggesting the existence of environmental or behavioural risk factors that contribute to ongoing transmission. This project aims to identify the most efficient intervention strategies to reduce community burden and reach interruption of transmission.

The OECD report on the evaluation of the national tobacco control programme in France

The OECD report on the evaluation of the national tobacco control programme in France

Risk Factors for Salmonella Detection in Commercial Layer Flocks in Spain.

Trends in Salmonella human infections are assumed to be related to the distribution of the pathogen in the animal reservoir/food products, and cases in humans are most often linked to poultry and poultry products (eggs, meat). Therefore, ongoing Salmonella national control programs (NCPs) in European Union Member States have the objective of monitoring and reducing its prevalence in commercial poultry flocks. Results from NCPs have shown certain factors (housing systems, season of sampling and if sampling is conducted by food business operators (FBOps) or competent authorities (CAs), among others) can influence detection rates, but associations are often not consistent. Here, we analyzed data from the Spanish NCP on 7216 laying hen flocks subjected to 36,193 sampling events over a six-year period to characterize its performance and identify variables influencing detection rates. Overall, 1205 sampling events were positive for Salmonella spp. (any serovar) and 132 for S. Enteritidis-S. Typhimurium/monophasic. Bayesian multivariable models adjusting for multiple covariates concluded that sampling events later in the year, in caged flocks with older animals and conducted by CAs had increased odds of positivity for Salmonella spp., revealing aspects linked with a differential estimation of Salmonella levels in laying hen flocks.