Tropical Diseases Research Articles

The Burden of Neglected Tropical Diseases in Sub-Saharan Africa

Health is a fundamental human right. However, a large population of the world is dogged with ill health which adversely affects the economy and development of nations. Although neglected tropical diseases (NTDs) cause enormous suffering, rob individuals of social and economic opportunities, and set-back countries’ development efforts, they receive only 0.6% health fund of official development assistance. Globally, more than one billion people suffer from one or more NTDs, and unfortunately, 500,000 die yearly. Despite remarkable progress in the effort against NTDs globally, they still persist in SSA. The objective of this study was to determine the burden of NTDs and suggest ways of reducing the burden. A scoping review of literature was conducted through Google Scholar according to Arksey and O’Malley (2005) methodology using the search terms “Burden” and “Neglected Tropical Diseases” or “NTDs” and “Sub-Saharan Africa” or “SSA”. Eligible studies were those addressing NTDs in SSA, published in English, for which the full text were available, and published between 2021 and 2023 in peer-reviewed scientific journals. Out of 20,800 identified studies, only 36 fully met the inclusion criteria. The study concluded that: SSA has a high burden of NTDs; communities in the region, including healthcare workers, have inadequate knowledge on NTDs; lack of community participation and engagement, and offering of fragmented care to people affected by NTDs; and lack of a robust clinical, public health, laboratory, pharmaceutical, and research capacity. The study recommends educating communities, as well as healthcare workers, on NTDs; ensuring community participation and engagement, and provision of holistic care to people affected by NTDs; and ensuring a robust clinical, public health, laboratory, pharmaceutical, and research capacity in SSA.

Expression profile analysis of the transient receptor potential (TRPM) channel, a possible target of praziquantel in Schistosoma japonicum

The WHO considers schistosomiasis, which is controlled by the mass administration of the drug praziquantel (PZQ), to be a neglected tropical disease. Despite its clinical use for over four decades, PZQ remains the only choice of chemotherapy against this disease. Regarding the previous studies that demonstrated that PZQ activates the transient receptor potential (TRP) channel in Schistosoma mansoni (Sm.TRPMPZQ), the expression profile of the ortholog of this channel gene (Smp_246790.5) in S. japonicum (EWB00_008853) (Sj.TRPMPZQ) was analyzed. The relative expression of this gene in various stages of the parasite lifecycle was analyzed by quantitative real-time reverse transcription-PCR (qRT-PCR), and the expression of Sj.TRPMPZQ was observed by immunohistochemical staining using anti-serum against the recombinant Sj.TRPMPZQ protein. qRT-PCR revealed the significantly lower mRNA expression in the snail stage in comparison to other stages (p < 0.01). The relative quantity of the Sj.TRPMPZQ expression for paired females, unpaired males, and eggs was 60%, 56%, and 68%, respectively, in comparison to paired males that showed the highest expression (p < 0.05). Interestingly, immunostaining demonstrated that Sj.TRPMPZQ is expressed in the parenchyma which contains muscle cells, neuronal cells and tegument cells in adult worms. This may support the two major effects of PZQ—worm paralysis and tegument disruption—induced by channel activation. Moreover, the channel was expressed in both the eggshell and the miracidia inside, but could not be observed in sporocyst. These results suggest that the expression of Sj.TRPMPQZ corresponds to the known sensitivity of S. japonicum to PZQ.

Identification of Discrete Typing Units of Trypanosoma cruzi Isolated from Domestic Environments in Southeastern Mexico.

Background: The Trypanosoma cruzi parasite is the causal agent of Chagas disease, recognized by the World Health Organization as a neglected tropical disease. Currently there are seven discrete typing units (DTUs) of T. cruzi distributed in America, but there are still gaps about its distribution in some endemic regions. Materials and Methods: Seventeen units isolated from Chiapas and Oaxaca in Mexico were identified by amplification of the C-5 sterol desaturase gene. Results: Three DTUs of T. cruzi, TcI (6), TcII (10), and TcIV (1) were detected by comparing polymorphic sites in specific regions. Conclusions: New DTUs are reported for both states, where TcII was the most common DTU. The genetic characterization of the isolates can help to understand the epidemiology of Chagas disease.

Severe Malaria and Risk Factors for Death in the Infectious Diseases Department of the University Hospital of Fann in Dakar, Senegal

Aim: The aim of this study was to describe the epidemiological, clinical, paraclinical and outcome aspects of severe malaria and to determine the risk factors for death.&#x0D; Methodology: This was a retrospective descriptive and analytical study of patients treated for severe malaria at the infectious and tropical diseases department of the University Hospital center of Fann between January 1, 2019 and December 31, 2021. Multivariate logistic regression was used to identify risk factors for death &#x0D; Results: During our study, 138 patients were hospitalized for severe malaria over a period of 3 years, with a peak in the months of october and november. They were mostly from urban areas (68.11%). The average consultation time was 6.7 days ± 7.1 days. There was a clear male predominance, with a sex ratio of 3.18. The average age of patients was 33.96 ± 17 years. The main signs of clinical severity were coma (44.2%), prostration (36.95%) and jaundice (61.5%). Biological signs included anaemia (14.49%) and renal failure (9.42%). Severe malaria was associated with SARS Cov 2 infection in 4 patients. All patients were treated with injectable artesunate. The average length of hospitalization was 6 ± 6 days. Case fatality was 10.7. In multivariate analysis, coma (ORa =12.29 IC95%: 2.0 - 73.22 P=0.006) and severe anaemia (ORa=27.16 IC95%: 3.4 - 217.18 P=0.006) were risk factors associated with death.&#x0D; Conclusion: Early recognition of the signs of seriousness and their early management thanks to improved technical facilities in intensive care units can improve the prognosis of patients.

FioSchisto's expert perspective on implementing WHO guidelines for schistosomiasis control and transmission elimination in Brazil.

The World Health Organization (WHO) recognizes schistosomiasis as one of the Neglected Tropical Diseases targeted for global elimination in the 2030 Agenda of the Sustainable Development Goals. In Brazil, schistosomiasis mansoni is considered a public health problem, particularly prevalent among vulnerable populations living in areas with poor environmental and sanitary conditions. In 2022, the WHO published a Guideline encompassing recommendations to assist national programs in endemic countries in achieving morbidity control, eliminating schistosomiasis as a public health problem, and advancing towards interrupting transmission. The perspectives presented here, collectively prepared by members of the Oswaldo Cruz Foundation's (Fiocruz) Schistosomiasis Translational Program (FioSchisto), along with invited experts, examine the feasibility of the WHO recommendations for the Brazilian settings, providing appropriate recommendations for public health policies applicable to the epidemiological reality of Brazil, and suggests future research to address relevant issues. In Brazil, the provision of safe water and sanitation should be the key action to achieve schistosomiasis elimination goals. The agencies involved in measures implementation should act together with the Primary Care teams for planning, executing, monitoring, and evaluating actions in priority municipalities based on their epidemiological indicators. Host snails control should prioritize judicious ecological interventions at breeding sites. The Information, Education, and Communication (IEC) strategy should be associated with water and sanitation and other control actions, actively involving school community. To identify infected carriers, FioSchisto recommends a two-stage approach of immunological and molecular tests to verify transmission interruption during the intervention and beyond. Praziquantel administration should be done under medical supervision at the Primary Care level. MDA should be considered in exceptional settings, as a measure of initial attack strategy in locations presenting high endemicity, always integrated with water and sanitation, IEC, and snail control. To assist decision-making, as well as the monitoring and evaluation of strategic actions, there is a need for an Information System. FioSchisto considers this systematization essential to make investments in strategic research to support the improvement of schistosomiasis control actions. Efforts toward schistosomiasis elimination in Brazil will succeed with a paradigm shift from the vertical prescriptive framework to a community-centered approach involving intersectoral and interdisciplinary collaboration.

Effects of temperature on the life history traits of intermediate host snails of fascioliasis: A systematic review.

The impact of climate change has led to variations in various biological processes, leading to altered transmission dynamics of infectious diseases, including snail-borne diseases (SBDs). Fascioliasis is one of the neglected zoonotic tropical snail-borne diseases caused by the trematode of the genus Fasciola. This review focused on laboratory experimental and model studies that evaluate the potential effect of temperature change on the ecology and biology of the intermediate host snails (IHS) of Fasciola. A literature search was conducted on Google Scholar, EBSCOhost, and PubMed databases using predefined medical subject heading terms, Boolean operators, and truncation symbols in combination with direct keywords: Fasciolosis AND Temperature, Lymnaea OR Austropeplea OR Radix OR Galba OR Fossaria OR Pseudosuccinea AND growth, fecundity, AND survival at the global scale. Other search terms used were (Fascioliasis AND Temperature), (Lymnaea AND Temperature), (Austropeplea AND Temperature), (Fossaria AND Temperature), (Galba AND Temperature), (Pseudosuccinea AND Temperature), and (Radix AND Temperature). The final synthesis included thirty-five published articles. The studies reviewed indicated that temperature rise may alter the distribution, and optimal conditions for breeding, growth, and survival of IHS, ultimately resulting in changing the transmission dynamics of fascioliasis. The literature also confirmed that the life history traits of IHS and their interaction with the liver fluke parasites are driven by temperature, and hence climate change may have profound outcomes on the population size of snails, parasite density, and disease epidemiology. We concluded that understanding the impact of temperature on the growth, fecundity, and survival of IHS may broaden our knowledge of the possible effects of climate change and hence inform fascioliasis control programs.

Synthesis and evaluation of hybrid sulfonamide-chalcones with potential antileishmanial activity.

Leishmaniasis is an emerging tropical infectious disease caused by a protozoan parasite of the genus Leishmania. In this work, the molecular hybridization between a trimethoxy chalcone and a sulfonamide group was used to generate a series of sulfonamide-chalcones. A series of eight sulfonamide-chalcone hybrids were made with good yields (up to 95%). These sulfonamide-chalcones were tested against promastigotes of Leishmania amazonensis and cytotoxicity against mouse macrophages, which showed good antileishmanial activity with IC50 = 1.72-3.19 µM. Three of them (10c, 10g, and 10h) were also highly active against intracellular amastigotes and had a good selectivity index (SI > 9). Thus, those three compounds were docked in the cytosolic tryparedoxin peroxidase (cTXNPx) enzyme of the parasite, and molecular dynamics simulations were carried out. This enzyme was selected as a target protein for the sulfonamide-chalcones due to the fact of the anterior report, which identified a strong and stable interaction between the chalcone NAT22 (6) and the cTXNPx. In addition, a prediction of the drug-likeness, and the pharmacokinetic profile of all compounds were made, demonstrating a good profile of those chalcones.

Molecular and functional characterization of Schistosoma japonicum annexin A13

Schistosomiasis is a neglected tropical disease that affects humans and animals in tropical and subtropical regions worldwide. Schistosome eggs are responsible for the pathogenesis and transmission of schistosomiasis, thus reducing egg production is vital for prevention and control of schistosomiasis. However, the mechanisms underlying schistosome reproduction remain unclear. Annexin proteins (ANXs) are involved in the physiological and pathological functions of schistosomes, but the specific regulatory mechanisms and roles of ANX A13 in the development of Schistosoma japonicum and host–parasite interactions remain poorly understood. Therefore, in this study, the expression profiles of SjANX A13 at different life cycle stages of S. japonicum were assessed using quantitative PCR. In addition, the expression profiles of the homolog in S. mansoni were analyzed in reference to public datasets. The results of RNA interference showed that knockdown of SjANX A13 significantly affected the development and egg production of female worms in vivo. The results of an immune protection assay showed that recombinant SjANX A13 increased production of immunoglobulin G-specific antibodies. Finally, co-culture of S. japonicum exosomes with LX-2 cells using a transwell system demonstrated that SjANX A13 is involved in host–parasite interactions via exosomes. Collectively, these results will help to clarify the roles of SjANX A13 in the development of S. japonicum and host–parasite interactions as a potential vaccine candidate.

Synthesis of findings from the literature and a qualitative research study on the impacts of gender, disability, and ethnicity in Neglected Tropical Diseases programs.

Act to End NTDs | West, a USAID-funded program that supports national governments to eliminate or control five neglected tropical diseases (NTDs) in West Africa including trachoma, lymphatic filariasis (LF), onchocerciasis, schistosomiasis and soil-transmitted helminthiasis, conducted a gender and social inclusion analysis to determine how NTDs differentially impact various populations and how gender and social norms impact NTD programs to inform future programming. The study used a mixed methods approach including a literature review; primary qualitative data collection; and monitoring data in Côte d'Ivoire, Sierra Leone, and Ghana. Women and girls face additional health risks from many NTDs compared to men and boys. In addition to differential health burden, the social and economic impacts of NTD-related disability or infertility can be particularly dire for women and girls. Men were somewhat less likely to participate in mass drug administration (MDAs) due to: lack of information about campaigns, lack of access due to work, and higher levels of mistrust of the government and concerns about side effects of the medicines. Pregnant and breastfeeding women were sometimes excluded by community drug distributors (CDDs) from certain types of MDAs for which they are eligible. Training participation rates for CDDs and supervisors were universally higher for men than women, even though feedback on the effectiveness of female CDDs was overwhelmingly positive, and female CDDs often have more access to other women in conservative households. The role of a CDD can lead to career and social opportunities for women. However, challenges faced by CDDs were seen as a greater barrier for women, including transportation, safety, household responsibilities, lower education levels, and low or lack of wages. Programs to address NTDs can promote equity and improve programming by increasing women's participation as CDDs and providing financial compensation. Additionally, programs should prioritize inclusive training for CDDs, and inclusive messaging about MDA for communities.

Migration in French Guiana: Implications in health and infectious diseases

In French Guiana, more than a third of the population, and nearly half of the adults, are of foreign origin. This immigration is explained by the French standard of living, which is attractive to nationals of surrounding countries. Infectious diseases remain in the top 10 causes of premature death, often in the most precarious populations. In this context we aimed to synthesize the state of the knowledge regarding immigration and infectious diseases in French Guiana and the general implications that follow this diagnosis.For HIV, although the majority of patients are of foreign origin, estimates of the presumed date of infection based on CD4 erosion modelling and from molecular analyses suggest that the majority of transmissions in foreign-born individuals occur in French Guiana and that the Guiana shield has been a crossroad between Latin America and the Caribbean. Among key populations bridging these regions illegal gold miners are very mobile and have the greatest proportion B Caribbean HIV viruses. Gold miners have been a key vulnerable population for falciparum malaria and other tropical diseases such as leishmaniasis, leprosy, or leptospirosis. The complex history of migrations in French Guiana and on the Guiana Shield is also reflected in the fingerprinting of mycobacterium tuberculosis and the high incidence of tuberculosis in French Guiana, notably in immigrants, reflects the incidences in the countries of origin of patients. The high burden of infectious diseases in immigrants in French Guiana is first and foremost a reflection of the precarious living conditions within French Guiana and suggests that community-based proactive interventions are crucial to reduce transmission, morbidity, and mortality from infectious diseases.

Effect of Azadirachta indica Leaf Extract on Some Biochemical Parameters in Wistar Albino Mice Infected with Plasmodium berghei

The use of medicinal plants in combating many tropical diseases including malaria is gaining wide acceptance owing to their many bioactive compounds. Malaria, which is caused by a Plasmodium parasite, and transmitted by the bite of infected mosquitoes is endemic in developing countries especially in Africa where it pose serious health challenge to the populace. This study evaluates the effect of Azadirachta indica leaf extract on some biochemical parameters in Wistar Albino mice infected with Plasmodiumberghei. A total of ninety (90) mature male swiss albino mice (free from infection and weighing between 25-35g) were used for the study. The animals were grouped into six classes (A-F) of fifteen (15) mice per group, per cage. Groups A to C served as the control groups [normal (uninfected plus distilled water), standard (infected plus Lonart (4mg/kg) and negative (infected plus distilled water)] respectively while groups D, E and F served as the treatment groups and were orally administered 100 mg/kg, 200 mg/kg and 400 mg/kg doses of leaf extract of Azadirachta indica for five (5) days consecutively. Malaria parasites (Plasmodium berghei, Anka strain) were inoculated using standard methods. At the end of the experimental periods, the animals were sacrificed and blood collected through cardiac puncture for bioassay studies. Activities of ALT, AST, ALP were determined using standard assay kits and concentrations of bilirubin (total and direct) as well as urea, creatinine, sodium, potassium, chloride and bicarbonate levels were carried out using standard methods. Results showed a significant increase (p&lt;0.05) in serum activities of ALT and AST in extract treated animals when compared with the untreated control while there was significant decrease (p&gt;0.05) in the serum activities of ALP in extract treated animals when compared with the untreated control. Results further showed an increase in the bilirubin (total and direct) levels of the extract treated groups as compared with the untreated control. Similar trends were observed for the levels of urea, creatinine, sodium, potassium and chloride. It could therefore be concluded that administration of Azadirachta indica leaf extract, though potent in fighting against malarial infection, could pose a threat to the liver and other organs of the body if not properly monitored.

DIAGNOSTIC MODEL OF TALAROMYCOSIS IN HIV/AIDS PATIENTS

Introduction: Talaromycosis (formerly penicilliosis), one of the most important opportunistic infections in Southeast Asia, is a common cause of HIV-AIDS-associated death. The current diagnosis of Talaromyces marneffei relies on culture. As microbiological results are often late, taking up to 14 days for pathogens isolation, the mortality rate is high. Serum Mp1p ELISA test was used to determine an earlier diagnosis of Talaromycosis. The research objectives were: (1) to determine the cut-off value, sensitivity, and specificity of the Mp1p ELISA test in AIDS patients; (2) to develop diagnostic models (with and without Mp1p ELISA test) of talaromycosis in AIDS patients. Methods: A descriptive cross-sectional study. HIV-infected patients aged ≥18 years with TCD4 &lt;100 cells/mm3 admitted to Ward E, Hospital for Tropical Diseases from June 2017 to July 2019 were recruited. Data analysis using SPSS 25.0 software. A receiver operating characteristic (ROC) curve and Youden index on the ROC curve was used to determine the cut-off value. The area under the ROC curve (AUC) and the 95% confidence intervals (CIs) were used to determine the discrimination power between cases and controls. Chi-square test, odds ratio (OR), and 95% confidence interval were used to find associations among variables. After multivariate analysis, the model of talaromycosis diagnosis was built by Monogram in R.3.6.3 software. Results: 533 patients meeting the inclusion criteria were enrolled. 78.4% were male; the median age was 34 years (IQR: 29-40), and 77.5% were &lt;40 years-old groups. 70 patients diagnosed with Talaromycosis were compared with other opportunistic infected participants (OIs).. The maximum Youden index=0,856 in correlation with the 0,22 OD cut-off value of serum Mp1p presents the highest sensitivity and specificity, with SEN = 88.6% and SPE = 97.0%, respectively. Two models (with and without serum Mp1p) were built based on the adjusted OR of risk factors. Two models based on living areas, skin lesions, low platelet, and Mp1p result. The two models have high accuracy in diagnostic talaromycosis. The SEN and SPEC of the model without Mp1p were 68.6% and 98.1%, and the SEN and SPEC of the model with Mp1p were 85.7% and 98.7%. Recommendation: Serum Mp1p ELISA as well as Diagnostic models of talaromycosis are considered as novel tools for early diagnosis of Talaromycosis in AIDS patients.

HSD84 Financial Hardship from Neglected Tropical Diseases: A Systematic Literature Review and Meta-Analysis

HSD84 Financial Hardship from Neglected Tropical Diseases: A Systematic Literature Review and Meta-Analysis

The Detection of Circulating Cell-Free DNA for the Diagnosis of Schistosoma in Immigrants from African Countries in Italy

The rising migration and travel from and towards endemic areas has brought renewed concerns about many parasitic infections, including neglected tropical diseases, such as schistosomiasis. Although serology is the most widely used method for the screening of schistosomiasis in non-endemic countries, this technique lacks sensitivity, especially to distinguish between past and ongoing infections. More recently, a molecular test based on the detection of Schistosoma cell-free DNA in the serum has been proposed as a diagnostic procedure for parasitosis. To test the performance of a blood PCR assay, this work investigated 102 serum samples collected from migrants coming from endemic areas by using primers specific to genomic regions of S. mansoni and S. haematobium patients. The results were then compared with the detection of specific IgG Abs with serological tests. Molecular analysis detected Schistosoma DNA in 32 patients. Among them, we characterized nine S. haematobium, 20 S. mansoni, and three coinfections. Compared with molecular assay, serological analysis detected specific antibodies against Schistosoma antigens in 52 out of 102 patients. Concordance between the two tests was found in 76 out of 102 patients (74.51%): in particular, both diagnostic tests were positive in 29 patients (28.43%) and negative in 47 (46.08%). The specificity of the molecular test was 94%. Overall, our data suggest that serological diagnosis could be combined with the molecular approach, providing the clinician with the serotyping of the parasite and useful information about the infection as well as the required further diagnostic procedures.

The anthelmintic meclonazepam activates a schistosome transient receptor potential channel

Parasitic flatworms cause various clinical and veterinary infections that impart a huge burden worldwide. The most clinically impactful infection is schistosomiasis, a neglected tropical disease caused by parasitic blood flukes. Schistosomiasis is treated with praziquantel (PZQ), an old drug introduced over 40 years ago. New drugs are urgently needed, as while PZQ is broadly effective it suffers from several limitations including poor efficacy against juvenile worms which may prevent it from being completely curative. An old compound that retains efficacy against juvenile worms is the benzodiazepine meclonazepam (MCLZ). However, host side effects caused by benzodiazepines preclude development of MCLZ as a drug, and MCLZ lacks an identified parasite target to catalyze rational drug design for engineering out human host activity. Here, we identify a transient receptor potential ion channel of the melastatin subfamily, named TRPMMCLZ, as a parasite target of MCLZ. MCLZ potently activates Schistosoma mansoni TRPMMCLZ through engagement of a binding pocket within the voltage-sensor like domain of the ion channel to cause worm paralysis, tissue depolarization and surface damage. TRPMMCLZ reproduces all known features of MCLZ action on schistosomes, including a lower activity versus Schistosoma japonicum which is explained by a polymorphism within this VSLD binding pocket. TRPMMCLZ is distinct from the TRP channel targeted by PZQ (TRPMPZQ), with both anthelmintic chemotypes targeting unique parasite TRPM paralogs. This advances TRPMMCLZ as a novel druggable target that could circumvent target-based resistance emerging in response to current mass drug administration campaigns centered around PZQ.

Chagas Disease in Europe.

Chagas disease is currently present in many non-endemic countries and remains a neglected tropical disease globally. A review of the literature identified significant gaps and scarcity of updated information from European countries, with most studies reporting data from Spain and Italy. The index of underdiagnosis may be as high as 70%, affecting mainly females of child-bearing age. Standardized screening of fertile, non-pregnant, women from endemic countries and subsequent treatment is considered an essential strategy to control transmission and prevent new cases, yet no uniform legislation for screening risk groups exists. There is heterogeneity in Europe in terms of preventive strategies to avoid transfusion-related transmission of Chagas disease, not necessarily in line with the European directives, with some countries conducting systematic screening for T. cruzi infection in blood donors, whilst others rely on pre-transfusion questionnaires. The growing burden of the infection in resource-rich areas may provide an opportunity for progress in certain aspects of control and prevention. Options for improving screening strategies, management and linkage to care are reviewed.

Quality of Life Among People with Leprosy-Related Disability In Tamil Nadu: A Cross-Sectional Study

Background: Leprosy is one among the 20 conditions termed as Neglected Tropical Disease. Early diagnosis and treatment with multidrug therapy has made leprosy a curable disease these days. Even after all the improvements in managing the disease, the quality of life of affected individuals is still uncertain. Materials and methods: A cross-sectional study was conducted among people with leprosy related disability residing in Chengalpattu district using a semi-structured questionnaire to access the quality of life and its association with socio-demographic variables. Simple random sampling technique was used to select 223 study participants. Data were analysed using IBM SPSS v 21. Fishers exact test and chi-square test were employed and statistical significance was set at p &lt;0.05. Results: Out of the 223 participants, 40.4% had poor quality of life score. Class V socio-economic status, lesser duration of disability and positive surgery history for deformity had a significant association with overall quality of life. Conclusion: To conclude the findings of the current study, a huge prevalence of poor quality of life was noted that reflects the affected individual’s deprived physical and mental health status. Early prevention of disabilities by rightful intervention at the right time and appropriate self- care should be ensured to improve the quality of life.

Fish and Food-Fatale: Food-borne Trematode Opisthorchis viverrini and Cholangiocarcinoma.

Neglected Tropical Diseases (NTDs) are a group of communicable diseases with a long history with human beings. NTDs are the proxy of poverty since they affect those in low-income and extreme-poverty populations, as those populations lack access to proper health care, clean water, sanitary conditions, and hygiene. NTDs create losses for a nation that come from the health and the economic sectors as well since the costs of diagnosis, prevention, and treatment strain the national purse strings. One of the 20 different forms of NTDs on the list is food-borne trematodes, comprises of Fasciola, Paragonimus, Clonorchis, and Opisthorchis. Currently, it is estimated that food-borne trematodes can cause a devastating effect on mortality and morbidity. All of them are zoonotic, as humans become infected by ingestion of a second intermediate host, such as freshwater snails, fish, or water vegetables. Opisthorchis viverrini, one of the food-borne trematodes that can be found mostly in South East Asia regions, especially in the Mekong basin, is regarded as a group 1 carcinogen leading to cholangiocarcinoma (CCA). This study aims to present the updated review of Opisthorchis viverrini and CCA.

Prevalence of and factors associated with scrub typhus exposure among the hill tribe population living in high incidence areas in Thailand: a cross-sectional study

BackgroundScrub typhus is a significant tropical disease, occurring in rural settings and therefore usually afflicting remote agricultural populations who have lower socioeconomic status and limited access to medical care. A large proportion of the hill tribe people in Thailand are financially poor, have limited education, and do not have adequate health care access. This study aimed to estimate the prevalence of and determine factors associated with scrub typhus exposure among the hill tribe population living in high-incidence areas in northern Thailand.MethodsA cross-sectional study design was used to gather information from hill tribe people aged 18 years and over living in ten hill tribe villages in Mae Fah Luang, Chiang Rai Province, Thailand. Participants who met the inclusion criteria were invited to participate in the study. A validated questionnaire was used as the research instrument, and 5 mL blood samples were taken. Orientia tsutsugamushi IgM and IgG antibodies were detected by enzyme-linked immunosorbent assay (ELISA) and then confirmed by immunofluorescence assay (IFA). Logistic regression was used to detect associations between variables at a significance level of α = 0.05.ResultsA total of 485 hill tribe people participated in the study; 57.1% were female, 29.9% were over 60 years of age, 46.4% were from the Akha tribe, and 74.2% had never attended school. The overall prevalence of scrub typhus exposure was 48.0%. In the multivariate model, five variables were found to be associated with scrub typhus exposure. Participants aged over 60 years had a 4.31-fold increased risk (95% CI = 1.73–10.72) of scrub typhus exposure compared to those who were younger than 30 years. Those who were illiterate had a 3.46-fold increased risk (95% CI = 1.93–6.21) of scrub typhus exposure than those who had at least a primary education level. Participants from the Akha tribe had a 2.20-fold increased risk (95% CI = 1.31–3.72) of scrub typhus exposure than those from the Lahu tribe. Subjects who had a history of cutting grass had a 1.85-fold increased risk (95% CI = 1.20–2.84) of scrub typhus exposure. Those who never wore gloves for farming had a 2.12-fold increased risk (95% CI = 1.28–3.49) of scrub typhus exposure than those who wore gloves daily.ConclusionsThere is a high prevalence of scrub typhus exposure among the hill tribe in Thailand. Effective public health interventions to promote scrub typhus awareness and prevention are urgently needed in these populations.

Plastic Surgeons Critical to Surgical Care and Rehabilitation of Patients with Neglected Tropical Diseases

Plastic Surgeons Critical to Surgical Care and Rehabilitation of Patients with Neglected Tropical Diseases