RESUMEN
Schistosomiasis remains a formidable challenge to global public health. This study aims to predict the spatial distribution of schistosomiasis seropositive rates in Hunan Province, pinpointing high-risk transmission areas and advocating for tailored control measures in low-endemic regions. Six machine learning models and their corresponding hybrid machine learning-Kriging models were employed to predict the seropositive rate. The optimal model was selected through internal and external validations to simulate the spatial distribution of seropositive rates. Our results showed that the hybrid machine learning-Kriging model demonstrated superior predictive performance compared to basic machine learning model and the Cubist-Kriging model emerged as the most optimal model for this study. The predictive map revealed elevated seropositive rates around Dongting Lake and its waterways with significant clustering, notably in the central and northern regions of Yiyang City and the northeastern areas of Changde City. The model identified gross domestic product, annual average wind speed and the nearest distance from the river as the top three predictors of seropositive rates, with annual average daytime surface temperature contributing the least. In conclusion, our research has revealed that integrating the Kriging method significantly enhances the predictive performance of machine learning models. We developed a Cubist-Kriging model with high predictive performance to forecast the spatial distribution of schistosomiasis seropositive rates. These findings provide valuable guidance for the precise prevention and control of schistosomiasis.
Asunto(s)
Aprendizaje Automático , Esquistosomiasis , China/epidemiología , Humanos , Esquistosomiasis/epidemiología , Esquistosomiasis/prevención & control , Estudios Seroepidemiológicos , Análisis Espacial , Modelos Estadísticos , AnimalesRESUMEN
Schistosomiasis, also known as bilharzia or snail fever, is a tropical parasitic disease resulting from flatworms of the Schistosoma genus. This often overlooked disease has significant impacts in affected regions, causing enduring morbidity, hindering child development, reducing productivity, and creating economic burdens. Praziquantel (PZQ) is currently the only treatment option for schistosomiasis. Given the potential rise of drug resistance and the limited treatment choices available, there is a need to develop more effective inhibitors for this neglected tropical disease (NTD). In view of this, quantitative structure-activity relationship studies (QSAR), molecular docking, molecular dynamics simulations, drug-likeness, and ADMET predictions were applied to 31 inhibitors of Schistosoma mansoni Dihydroorotate dehydrogenase (SmDHODH). The designed QSAR model demonstrated robust statistical parameters including an R2 of 0.911, R2adj of 0.890, Q2cv of 0.686, R2pred of 0.807, and cR2p of 0.825, confirming its robustness. Compound 26, identified as the most active derivative, emerged as a lead candidate for new potential inhibitors through ligand-based drug design. Subsequently, 12 novel compounds (26A-26L) were designed with enhanced inhibition activity and binding affinity. Molecular docking studies revealed strong and stable interactions, including hydrogen bonding and hydrophobic interactions, between the designed compounds and the target receptor. Molecular dynamics simulations over 100 nanoseconds and MM-PBSA free binding energy (ΔGbind) calculations validated the stability of the two best-designed molecules (26A and 26L). Furthermore, drug-likeness and ADMET prediction analyses affirmed the potential of these designed compounds, suggesting their promise as innovative agents for treating schistosomiasis.
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Dihidroorotato Deshidrogenasa , Diseño de Fármacos , Simulación del Acoplamiento Molecular , Simulación de Dinámica Molecular , Oxidorreductasas actuantes sobre Donantes de Grupo CH-CH , Relación Estructura-Actividad Cuantitativa , Schistosoma mansoni , Schistosoma mansoni/efectos de los fármacos , Schistosoma mansoni/enzimología , Oxidorreductasas actuantes sobre Donantes de Grupo CH-CH/antagonistas & inhibidores , Oxidorreductasas actuantes sobre Donantes de Grupo CH-CH/química , Animales , Esquistosomiasis/tratamiento farmacológico , Ligandos , Inhibidores Enzimáticos/química , Inhibidores Enzimáticos/farmacología , Humanos , Antihelmínticos/farmacología , Antihelmínticos/química , Descubrimiento de Drogas , Esquistosomiasis mansoni/tratamiento farmacológicoRESUMEN
BACKGROUND: Schistosomiasis is a parasitic infection that can cause pulmonary hypertension (PH). Th2 CD4 T cells are necessary for experimental Schistosoma-PH. However, if T cells migrate to the lung to initiate, the localized inflammation that drives vascular remodeling and PH is unknown. METHODS: Mice were sensitized to Schistosoma mansoni eggs intraperitoneally and then challenged using tail vein injection. FTY720 was administered, which blocks lymphocyte egress from lymph nodes. T cells were quantified using flow cytometry, PH severity via heart catheterization, and cytokine concentration through ELISA. RESULTS: FTY720 decreased T cells in the peripheral blood, and increased T cells in the mediastinal lymph nodes. However, FTY720 treatment resulted in no change in PH or type 2 inflammation severity in mice sensitized and challenged with S. mansoni eggs, and the number of memory and effector CD4 T cells in the lung parenchyma was also unchanged. Notably, intraperitoneal Schistosoma egg sensitization alone resulted in a significant increase in intravascular lymphocytes and T cells, including memory T cells, although there was no significant change in parenchymal cell density, IL-4 or IL-13 expression, or PH. CONCLUSION: Blocking T cell migration did not suppress PH following Schistosoma egg challenge. Memory CD4 T cells, located in the lung intravascular space following egg sensitization, appear sufficient to cause type 2 inflammation and PH.
Asunto(s)
Hipertensión Pulmonar , Pulmón , Schistosoma mansoni , Animales , Ratones , Hipertensión Pulmonar/etiología , Hipertensión Pulmonar/parasitología , Hipertensión Pulmonar/inmunología , Pulmón/parasitología , Pulmón/inmunología , Pulmón/patología , Schistosoma mansoni/inmunología , Clorhidrato de Fingolimod/farmacología , Femenino , Linfocitos T CD4-Positivos/inmunología , Esquistosomiasis mansoni/inmunología , Esquistosomiasis mansoni/complicaciones , Esquistosomiasis mansoni/patología , Modelos Animales de Enfermedad , Interleucina-4/metabolismo , Citocinas/metabolismo , Ratones Endogámicos C57BL , Linfocitos T/inmunología , Linfocitos T/metabolismo , Células Th2/inmunología , Células Th2/metabolismo , Esquistosomiasis/complicaciones , Esquistosomiasis/inmunología , Esquistosomiasis/parasitologíaRESUMEN
PURPOSE OF REVIEW: This opinion piece aims to explore the transformative potential of integrating artificial intelligence with digital microscopy to enhance diagnostics for soil-transmitted helminthiasis (STH) and schistosomiasis (SCH), two pervasive neglected tropical diseases (NTDs). By aligning innovative artificial intelligence-driven solutions with WHO's strategic objectives and calls for better, more accessible, and more integrated diagnostics, we highlight the latest advancements that may support improved health outcomes in affected communities. RECENT FINDINGS: The review covers recent advancements in artificial intelligence-based diagnostic technologies, emphasizing automated egg detection and quantification. These technologies promise to mitigate challenges such as human error and the need for skilled technicians. SUMMARY: The findings have significant implications for public health, ethical considerations and regulatory pathways, particularly in resource-limited settings. The authors advocate for interdisciplinary collaboration and a strategic focus on meeting WHO target product profiles to ensure uptake, ultimately to support reaching WHO NTD targets.
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Inteligencia Artificial , Helmintiasis , Microscopía , Esquistosomiasis , Suelo , Humanos , Esquistosomiasis/diagnóstico , Helmintiasis/diagnóstico , Microscopía/métodos , Suelo/parasitología , Animales , Enfermedades Desatendidas/diagnósticoRESUMEN
Schistosomiasis is a significant public health threat, and Oncomelania hupensis is the only intermediate host for schistosoma japonicum. We conducted 12-year monthly repeated surveys to explore the interactive and lag effects of environmental factors on snail density and to monitor their long-term and seasonal trends in a bottomland around the Dongting Lake region in China. Relevant environmental data were obtained from multiple sources. A Bayesian kernel machine regression model and a Bayesian temporal model combined with a distributed lag model were constructed to analyze interactive and lag effects of environmental factors on snail density. The results indicated the average annual snail density in the study site exhibited an increasing and then decreasing trend, peaking in 2013. Snail densities were the highest in October and the lowest in January in a year. Normalized Difference Vegetation Index (NDVI) and water level were the most effective predictors of snail density, with potential interactions among temperature, precipitation, and NDVI. The mean minimum temperature in January, water level, precipitation and NDVI were positively correlated with snail density at lags ranging from 1 to 4 months. These findings could serve as references for relevant authorities to monitor the changing trend of snail density and implement control measures, thereby reducing the occurrence of schistosomiasis.
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Estaciones del Año , Caracoles , Animales , China/epidemiología , Caracoles/parasitología , Schistosoma japonicum/fisiología , Densidad de Población , Lagos/parasitología , Esquistosomiasis Japónica/epidemiología , Esquistosomiasis Japónica/parasitología , Esquistosomiasis Japónica/transmisión , Temperatura , Teorema de Bayes , Esquistosomiasis/epidemiología , Esquistosomiasis/transmisión , Esquistosomiasis/parasitología , AmbienteRESUMEN
BACKGROUND: Infections with soil-transmitted helminths (STH) and schistosomiasis (SCH) result in a significant global health burden, particularly in rural communities in low and middle-income countries. While microscopy remains the primary diagnostic method for STH and SCH in resource-limited settings, nucleic acid amplification tests (NAATs) are gaining prominence as tools for evaluation of public health control programs in endemic countries, and individual diagnosis in high-income countries. Despite the high sensitivity and specificity of NAATs, previous research has highlighted inter-laboratory variations, both in technical and clinical performance, justifying the need for continuous proficiency testing. METHODOLOGY: Results from 5 rounds over a 5-year period of the so far only longitudinal international Helminth External Molecular Quality Assessment Scheme (HEMQAS), coordinated by the Dutch Foundation for Quality Assessment in Medical Laboratories (SKML), were examined in order to (i) assess the diagnostic proficiency of laboratories in detecting helminths in stool and (ii) identify potential factors contributing to variations in performance. OUTCOME AND CONCLUSIONS: Thirty-six laboratories, from 18 countries and 5 continents, participated in HEMQAS. The overall diagnostic performances were satisfying, with remarkably low numbers (<2%) of false-positive results. False-negative results were more often reported for stool (15%) than for DNA (5%) samples. False-negative results varied largely between targets (the highest number (29%) for Trichuris trichiura). Twenty-five laboratories provided a sufficient number of results for a robust comparison between participating laboratories, which confirmed substantial inter-laboratory variability in quantitative NAAT results (Cq-values). This variability likely arises from differences in pre-treatment, DNA isolation and DNA-target amplification procedures. This study emphasizes the complexity of molecular diagnosis for STH and SCH, highlighting the critical role of proper stool preparation and DNA isolation methods. The results underscore the necessity for laboratory professionals and public health decision-makers to recognize these complexities and continuously undertake external quality assessment schemes to ensure accurate and reliable performance in molecular diagnosis.
Asunto(s)
Heces , Helmintiasis , Helmintos , Técnicas de Amplificación de Ácido Nucleico , Schistosoma , Esquistosomiasis , Suelo , Técnicas de Amplificación de Ácido Nucleico/métodos , Técnicas de Amplificación de Ácido Nucleico/normas , Humanos , Animales , Helmintiasis/diagnóstico , Helmintiasis/parasitología , Heces/parasitología , Suelo/parasitología , Esquistosomiasis/diagnóstico , Schistosoma/genética , Schistosoma/aislamiento & purificación , Helmintos/aislamiento & purificación , Helmintos/genética , Helmintos/clasificación , Sensibilidad y Especificidad , Técnicas de Diagnóstico Molecular/métodos , Técnicas de Diagnóstico Molecular/normasRESUMEN
BACKGROUND: Despite the gradual decline of schistosomiasis due to the efforts of the WHO and various countries, with the WHO setting a goal to eliminate schistosomiasis by 2030, a comprehensive global assessment of the current status of schistosomiasis has not been conducted. OBJECTIVES: To provide a detailed description of the changes in schistosomiasis from 1990 to 2019 by using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 database. METHODS: We obtained all relevant data on schistosomiasis worldwide from the Global Burden of Diseases (GBD) database from 1990 to 2019. The mortality, prevalence, disability-adjusted life-years (DALYs), Years of Life Lost (YLLs), Years Lived with Disability (YLDs) of schistosomiasis were examined by Socio-demographic Index (SDI), age, sex, and year at the global, region and national level. RESULTS: From 1990 to 2019, the age-standardized rate(ASR)-prevalence of schistosomiasis has decreased from 2600.9 per 100,000(95% uncertainty interval (UI) 2191.2 to 3059.3) to 1805.0 per 100,000(95% UI 1503.4 to 2146.9). The estimated annual percentage change (EAPC) from 1990 to 2019 was 1.28 (95% UI 1.22 to 1.33) in high SDI regions and -2.45 (95% UI -3.03 to -1.86) in low SDI regions. In North Africa and the Middle East, the most substantial reduction in DALYs occurred, with an observed EAPC of -5.36. CONCLUSION: The burden of schistosomiasis has decreased over the past three decades worldwide. However, the high SDI regions have shown the increasing burden of schistosomiasis. Besides, Multiple countries in Africa still bear a significant burden of schistosomiasis, necessitating robust prevention and control efforts.
Asunto(s)
Carga Global de Enfermedades , Salud Global , Esquistosomiasis , Humanos , Esquistosomiasis/epidemiología , Prevalencia , Masculino , Salud Global/estadística & datos numéricos , Femenino , Años de Vida Ajustados por Discapacidad , Adulto , Persona de Mediana Edad , Factores de Riesgo , Adolescente , Anciano , Niño , Costo de Enfermedad , Adulto Joven , Años de Vida Ajustados por Calidad de Vida , PreescolarRESUMEN
Schistosomiasis, a freshwater-borne neglected tropical disease, disproportionately affects impoverished communities mainly in the tropical regions. Transmission involves humans and intermediate host (IH) snails. This manuscript introduces a mathematical model to probe schistosomiasis dynamics and the role of non-host snail competitors and predators as biological control agents for IH snails. The numerical analyses include investigations into steady-state conditions and reproduction numbers associated with uncontrolled scenarios, as well as scenarios involving non-host snail competitors and/or predators. Sensitivity analysis reveals that increasing snail mortality rates is a key to reducing the IH snail population and control of the transmission. Results show that specific snail competitors and/or predators with strong competition/predation abilities reduce IH snails and the subsequent infectious cercaria populations, reduce the transmission, and possibly eradicate the disease, while those with weaker abilities allow disease persistence. Hence our findings advocate for the effectiveness of snail competitors with suitable competitive pressures and/or predators with appropriate predatory abilities as nature-based solutions for combating schistosomiasis, all while preserving IH snail biodiversity. However, if these strategies are implemented at insignificant levels, IH snails can dominate, and disease persistence may pose challenges. Thus, experimental screening of potential (native) snail competitors and/or predators is crucial to assess the likely behavior of biological agents and determine the optimal biological control measures for IH snails.
Asunto(s)
Modelos Biológicos , Esquistosomiasis , Caracoles , Animales , Esquistosomiasis/transmisión , Esquistosomiasis/prevención & control , Humanos , Caracoles/parasitología , Conducta Predatoria , Conceptos MatemáticosRESUMEN
This cross-sectional study aimed to assess the levels of health literacy and the associated factors among the general population living in 2 schistosomiasis-endemic villages in Jiangxi Province, China. Multistage stratified random sampling was used to select participants, and a face-to-face survey was conducted from July to August 2021 to collect participants' socio-demographic characteristics and levels of overall health literacy (HL) and its 3 subscales: health literacy of basic knowledge and concepts (HL-BKC), health literacy of behavior and lifestyle (HL-BAL), and health literacy of health-related skills (HL-HRS). The Chi-square test and logistic regression models were used to assess the association between socio-demographic characteristics and low HL levels. The prevalence rates of low overall HL, HL-BKC, HL-BAL, and HL-HRS were 84.3%, 61.8%, 82.6%, and 86%, respectively. In addition, no significant differences (Pâ >â .05) were noted between the 2 villages regarding overall HL scores and the 3 subscales of health literacy scores. Older age (Pâ <â .001), occupation (Pâ <â .001), lower educational level (Pâ <â .001), and lower annual household income (Pâ <â .05) were associated with an increased risk of low HL. Multivariate logistic regression revealed that occupation as a student (ORâ =â 32.289, 95% CI:1.965-530.462, Pâ <â .05) and fishermen (ORâ =â 27.902, 95%CI:1.91-407.642, Pâ <â .05), lower education level (ORâ =â 0.384, 95%CI:0.149-0.99, Pâ <â .05), older age (ORâ =â 5.228, 95%CI:1.458-18.75, Pâ <â .001), and lower annual household income (ORâ =â 0.452, 95%CI:0.24-0.851, Pâ <â .05) were independently associated with low HL. The prevalence of low HL is high among the population in the schistosomiasis-endemic villages of Jiangxi Province, China. Age, education level, occupation, and annual household income were all independent factors associated with HL levels. Health educational interventions to improve HL should be simultaneously conducted in health promotion work to reduce risky habits.
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Alfabetización en Salud , Esquistosomiasis , Humanos , China/epidemiología , Masculino , Femenino , Alfabetización en Salud/estadística & datos numéricos , Persona de Mediana Edad , Estudios Transversales , Adulto , Esquistosomiasis/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Anciano , Factores Socioeconómicos , Adulto Joven , Adolescente , Población Rural/estadística & datos numéricos , Modelos Logísticos , Prevalencia , Escolaridad , Factores de Edad , Enfermedades Endémicas/estadística & datos numéricosRESUMEN
BACKGROUND: Helminth infections, including Opisthorchis viverrini, hookworm, and Trichuris trichiura, are prevalent in Khong district, Champasack province, southern Lao People's Democratic Republic (PDR). Schistosomiasis caused by Schistosoma mekongi is of public health concern on the islands of the Khong district. This study aimed to assess the impact of an Eco-Health/One-Health approach in combination with mass drug administration (MDA) to reduce these helminth infections. METHODS: We conducted a community intervention using a stepped-wedge trial approach on two endemic islands (Donsom and Donkhone) of the Khong district, Champasack province, Lao PDR, between April 2012 and March 2013. In each study village, 30-40 households were randomly selected. All members of selected households, who were at home during the study period were invited to participate in the study. A baseline study was conducted to assess helminth infections, knowledge attitudes and practices toward Schistosoma mekongi infection, behavior of open defecation and availability of latrine at home. After the baseline (T0), the Eco-Health/One-Health approach was implemented on Donsom (intervention) and Donkhone island (control). An assessment was conducted in 2014 (T1), one year after the completion of intervention implementation, to assess the short-term impact of the Eco-Health/One-Health approach on helminth infections and compare intervention and control islands. Later in 2015, the Eco-Health/One-Health approach was implemented on control island (Donkhone). After the implementation of intervention, the parasitological assessments were conducted annually in humans in 2015 (T2), in 2016 (T3) and in 2017 (T4), and in dogs in 2017 (T4) to evaluate the long-term impact of the intervention on helminth infections. Frequency was used to describe the prevalence of helminth infections. Logistic regression was applied to associate the KAP (knowledge, attitudes, and practices and open defecation behavior) and the reduction of helminth infections between intervention and control islands. The reduction in prevalence pre- and post-intervention was associated using a McNemar test. A two-independent sample t-test was applied to compare the mean eggs per gram (EPG) of helminth infections between control and intervention islands. A paired t-test test was used to compare the mean EPG of stool samples before (baseline) and after (follow-up) interventions for the two islands separately. A P-value lower than 0.05 was considered statistically significant. RESULTS: Eco-Health/One-Health approach appears to be associated with reduction in prevalence of S. mekongi by 9.0% [odds ratio (OR) = 0.49, P = 0.003] compared to the use of mass drug administration alone (control island). Additionally, this intervention package significantly reduced O. viverrini infection by 20.3% (OR = 1.92, P < 0.001) and hookworm by 17.9% (OR = 0.71, P = 0.045), respectively. Annual parasitological assessments between 2012 and 2017 showed that the Eco-Health/One-Health approach, coupled with MDA, steadily reduced the prevalence of S. mekongi on the intervention island from 29.1% to 1.8% and on the control island from 28.4% to 3.1%, respectively. CONCLUSIONS: The study findings suggest that the Eco-Health/One-Health approach appears to be associated with a significant reduction in prevalence of S. mekongi and helminth co-infections, particularly hookworm and T. trichiura. Therefore, implementing the Eco-Health/One-Health approach in schistosomiasis-endemic areas could accelerate the achievement of national goals for transmission interruption by 2025 and elimination by 2030.
Asunto(s)
Helmintiasis , Islas , Administración Masiva de Medicamentos , Schistosoma , Humanos , Animales , Masculino , Femenino , Laos/epidemiología , Adulto , Schistosoma/fisiología , Helmintiasis/epidemiología , Helmintiasis/prevención & control , Persona de Mediana Edad , Adolescente , Adulto Joven , Niño , Islas/epidemiología , Administración Masiva de Medicamentos/métodos , Antihelmínticos/uso terapéutico , Esquistosomiasis/prevención & control , Esquistosomiasis/epidemiología , Preescolar , Anciano , Prevalencia , Salud ÚnicaRESUMEN
Human schistosomiasis is a parasitic disease caused by an infection with trematodes of the genus Schistosoma. The disease mainly affects impoverished populations. Around 800 million people are exposed to the infection, which is a public health problem in the tropical and subtropical regions of Africa, Asia, the Caribbean and South America. In Brazil, Schistosoma mansoni is the only species that causes schistosomiasis and the disease is widely distributed. Conventional diagnosis of the disease is carried out by detecting eggs using parasitological methods, such as the Kato-Katz test. Schistosomiasis has been reported in all regions of Brazil and is characterized as endemic in seven states in the Northeast Region and two states in the Southeast Region. In 2015, 78,7% of all cases reported in Brazil occurred in the Northeast Region. It is estimated that 1,5 million people is infected with this disease in Brazil and more than 25 millions live in areas with a high risk of transmission. Despite the reduction in mortality and morbidity, schistosomiasis was responsible for 8,756 deaths between 2000 and 2011 and 2,517 deaths between 2015 and 2019 in Brazil and it remains an important public health problem. In the state of Rio de Janeiro, some areas have low endemicity or isolated foci of Schistosoma mansoni and the majority of infected individuals have mild infections. The last survey of the disease in the state of Rio de Janeiro was carried out between 2010 and 2015 in students aged 7 to 17.Schistosomiasis was reported in 10 of the 21 municipalities studied. Of the 5,111 school children screened for S. mansoni infection, 46 (1,65%) were tested positive. Studies carried out in areas of low endemicity in Rio de Janeiro showed that among the 205 patients infected by S. mansoni in Sumidouro, around 84% were aged 14 or over and all, except one individual, had the intestinal form (91,2%) or hepato-intestinal (8,3%) of schistosomiasis. Another study carried out in Sumidouro showed that with tests based on patent Schistosoma egg infection determined by the Kato-Katz test, active infections were diagnosed in eight (8/108) individuals. The intensity of infection expressed by parasite loads ranged from 6 to 72 eggs per gram of feces/individual. The results showed DNA amplification in 32 of the 100 individuals tested by real-time PCR. All individuals with patent ovo infection showed positive DNA amplification. These studies showed that if we only analyzed school-age children using the Kato-Katz test, the majority of the infected population would never be diagnosed with S. mansoni infection. In situations of low endemicity, with low intensities of infection, with low severity in the population and in the most affected age groups, schistosomiasis requires a more sensitive diagnostic approach (e.g. screening by PCR rather than Kato test), otherwise many infected individuals will remain invisible to the healthcare system.
A esquistossomose humana é uma doença parasitária causada por uma infecçâo por vermes sanguíneos do gènero Schistosoma. A doença afeta principalmente populaçoes empobrecidas. Cerca de 800 milhoes de pessoas estâo expostas à infecçâo, sendo um problema de saúde pública nas regioes tropicais e subtropicais de África, Ásia, Caribe e América do Sul. No Brasil, o Schistosoma mansoni é a única espécie causadora da esquistossomose e a doença é amplamente distribuida. O diagnóstico convencional da doença é realizado pela detecçâo dos ovos através de métodos parasitológicos, como o teste de Kato-Katz. A esquistossomose foi notificada em todas as regioes do Brasil, e é caracterizada como endèmica em sete estados da Regiâo Nordeste e dois estados da Regiâo Sudeste. Em 2015, 78,7% de todos os casos notificados no Brasil ocorreram na Regiâo Nordeste. Estima-se que 1,5 milhâo de pessoas estejam infectadas com esta doença no Brasil e mais de 25 milhoes vivam em áreas com alto risco de transmissâo. Apesar da reduçâo da mortalidade e morbidade, a esquistossomose foi relatada em 8.756 mortes entre 2000 e 2011 e em 2.517 mortes entre 2015 e 2019 no Brasil e continua sendo um importante problema de saúde pública. No Estado do Rio de Janeiro, algumas áreas apresentam baixa endemicidade ou focos isolados de Schistosoma mansoni e a maioria dos individuos infectados apresenta infecçoes leves. O último levantamento da doença no Estado do Rio de Janeiro foi realizado entre 2010 e 2015 em estudantes de 7 a 17 anos. A esquistossomose foi relatada em 10 dos 21 municipios estudados. Das 5.111 crianças escolares triadas para infecçâo por S. mansoni, 46 (1,65%) testaram positivo. Estudos realizados em áreas de baixa endemicidade no Rio de Janeiro mostraram que dentre os 205 pacientes infectados por S. mansoni em Sumidouro, cerca de 84% tinham 14 anos ou mais e todos, exceto um individuo, tinham a forma intestinal (91,2%) ou hepato-intestinal (8,3%) da esquistossomose. Outro estudo realizado em Sumidouro, mostrou que testes baseados em infecçâo patente de ovo de Schistosoma determinada pelo teste de Kato-Katz, infecçoes ativas foram diagnosticadas em oito (8/108) individuos. A intensidade de infecçâo expressa pelas cargas parasitárias variou de 6 a 72 ovos por grama de fezes/individuo. Os resultados mostraram amplificaçâo do DNA em 32 dos 100 individuos testados por PCR em tempo real. Todos os indivíduos com infecçâo ovo-patente apresentaram amplificaçâo de DNA positiva. Tais estudos mostraram que se analisarmos apenas crianças em idade escolar pelo teste de Kato-Katz, a maioria da populaçâo infectada nunca seria diagnosticada com infecçâo pelo S. mansoni. Em situaçoes de baixa endemicidade, com baixas intensidades de infecçâo, com baixa gravidade na populaçâo e nas faixas etárias mais afetadas, a esquistossomose requer uma abordagem diagnóstica mais sensivel (por exemplo, triagem por PCR em vez do teste de Kato), caso contràrio, muitos individuos infectados permanecerâo invisiveis para o sistema de saúde.
Asunto(s)
Enfermedades Endémicas , Enfermedades Desatendidas , Schistosoma mansoni , Esquistosomiasis mansoni , Humanos , Brasil/epidemiología , Animales , Schistosoma mansoni/aislamiento & purificación , Esquistosomiasis mansoni/epidemiología , Esquistosomiasis mansoni/transmisión , Esquistosomiasis mansoni/diagnóstico , Esquistosomiasis mansoni/parasitología , Enfermedades Endémicas/estadística & datos numéricos , Enfermedades Desatendidas/epidemiología , Enfermedades Desatendidas/parasitología , Enfermedades Desatendidas/diagnóstico , Esquistosomiasis/epidemiología , Esquistosomiasis/parasitología , Esquistosomiasis/diagnóstico , Esquistosomiasis/transmisiónRESUMEN
An experiment was carried out in 1985-87 against schistosomiasis using products neutralizing the intermediate stages of schistosomes. In the laboratory, it had been shown that lauryl betaines, amphoteric substances, used for children's shampoos, quickly immobilized miracidiums and cercariae. Studies in Niger in field conditions with water laden with organic matter gave similar results. This surfactant can be incorporated into ordinary soaps at a dose of 5% without changing their characteristics. Betaine soaps were put on sale in ordinary commercial channels in Niger then in Côte d'Ivoire, in hyperendemic villages for Schistosoma haematobium. Betaines diffused without external intervention into the water used by populations for washing. The soaps were well accepted by these populations. However, after one year, the results in tested villages compared to control ones were unclear on the dynamics of urinary schistosomiasis in terms of prevalence and oviuria. Anti-schistosome treatment seems necessary at the start of the procedure. The use of soap by populations needed to be measured. In conclusion, this promising laboratory action deserves to be evaluated again in the field, in addition to health education and systematic treatment actions.
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Esquistosomiasis , Jabones , Humanos , Esquistosomiasis/prevención & control , Esquistosomiasis/epidemiología , Esquistosomiasis/tratamiento farmacológico , Côte d'Ivoire/epidemiología , Niger/epidemiología , Animales , Esquistosomiasis Urinaria/prevención & control , Esquistosomiasis Urinaria/tratamiento farmacológico , Esquistosomiasis Urinaria/epidemiologíaRESUMEN
BACKGROUND: In countries where malaria is endemic, the use of rapid diagnostic tests(RDTs) has become routine, especially in rural settings. Such regions are characterised by often having other co-endemic infectious diseases, at high levels of prevalence. AIM: To illustrate the potential added-value of "sentinel" screening for patients presenting for a routine diagnostic test for malaria, at healthcare facilities in Uganda. METHODS: We developed an economic model by combining two decision trees, one for malaria and a second for the co-endemic disease schistosomiasis. The integrated model was designed to inform policy strategies for the co-endemic disease in addition to malaria (i.e., whether to test opportunistically for schistosomiasis or use mass drug administration(MDA) as per usual practice).We performed the analysis on three comparators varying testing accuracy and costs. RESULTS: Sentinel screening can provide added value to the testing of patients compared with the status quo: when schistosomiasis prevalence is high then MDA is preferential; if low prevalence, treating no one is preferred. If the disease has average levels of prevalence, then a strategy involving testing is preferred. Prevalence thresholds driving the dominant strategy are dependent upon the model parameters, which are highly context specific. At average levels of prevalence for schistosomiasis and malaria for Uganda, adding a sentinel screening was cost-effective when the accuracy of test was higher than current diagnostics and when economies of scope were generated(Expected value clinical Information = 0.65$ per DALY averted, 137.91$ per correct diagnoses).Protocols using diagnostics with current accuracy levels were preferred only for levels of MDA coverage below 75%. CONCLUSION: The importance of the epidemiological setting is crucial in determining the best cost-effective strategy for detecting endemic disease. Economies of scope can make sentinel screenings cost-effective strategies in specific contexts. Blanket thresholds recommended for MDA may not always be the preferred option for endemic diseases.
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Análisis Costo-Beneficio , Enfermedades Endémicas , Malaria , Esquistosomiasis , Humanos , Esquistosomiasis/diagnóstico , Esquistosomiasis/epidemiología , Esquistosomiasis/economía , Malaria/diagnóstico , Malaria/epidemiología , Uganda/epidemiología , Femenino , Masculino , Adulto , Niño , Adolescente , Pruebas Diagnósticas de Rutina/economía , Pruebas Diagnósticas de Rutina/métodos , Persona de Mediana Edad , Preescolar , Adulto Joven , Prevalencia , Tamizaje Masivo/economía , Tamizaje Masivo/métodos , Vigilancia de Guardia , Modelos Económicos , AncianoRESUMEN
BACKGROUND: Acute schistosomiasis occurs most often in travelers to endemic regions. The aim of the study is to describe the epidemiological, clinical and parasitological characteristics of patients with schistosomiasis acquired during an international travel. METHODS: Observational retrospective study including all travel-related schistosomiasis cases seen at the International Health Unit Vall d'Hebron-Drassanes (Barcelona, Spain) from 2009 to 2022. Diagnosis of schistosomiasis was defined by the presence of Schistosoma eggs in stools or urine or the positivity of a serological test. We collected demographic, epidemiological, clinical, parasitological, and therapeutic information. RESULTS: 917 cases of schistosomiasis were diagnosed, from whom 96 (10.5 %) were travel-related. Mean age of the patients was 34.9 years, and 53.1 % were women. Median duration of the travel was 72 days, and geographical areas where travelers had contact with fresh water were Africa (82.3 %), Asia (12.5 %), and South America (5.2 %). Twenty (20.8 %) patients reported having had some clinical symptom, being gastrointestinal symptoms the most frequent. Two patients developed the classical Katayama syndrome. In eleven (11.5 %) cases eggs were observed in urine or feces samples, and 85 (88.5 %) cases were diagnosed by a positive serology. Ninety-one (94.8 %) patients received treatment with praziquantel with different therapeutic schemes. The two patients with Katayama syndrome received concomitant treatment with corticosteroids. CONCLUSIONS: Schistosomiasis in travelers represented 10 % of the overall schistosomiasis cases in our center. Increasing the awareness in the pre-travel advice and implementing specific screening in those travelers at risk (long travelers, contact with fresh water) could reduce the incidence and associated morbidity in this group.
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Esquistosomiasis , Viaje , Medicina Tropical , Humanos , España/epidemiología , Femenino , Masculino , Estudios Retrospectivos , Adulto , Esquistosomiasis/epidemiología , Esquistosomiasis/diagnóstico , Esquistosomiasis/tratamiento farmacológico , Persona de Mediana Edad , Praziquantel/uso terapéutico , Enfermedades Transmisibles Importadas/epidemiología , Enfermedades Transmisibles Importadas/parasitología , Enfermedades Transmisibles Importadas/diagnóstico , Enfermedades Transmisibles Importadas/tratamiento farmacológico , Heces/parasitología , Animales , Antihelmínticos/uso terapéutico , Adulto Joven , AdolescenteRESUMEN
BACKGROUND: Species hybridization represents a real concern in terms of parasite transmission, epidemiology and morbidity of schistosomiasis. It is greatly important to better understand the impact of species hybridization for the clinical management. METHODS: A prospective observational study was carried out in sub-Saharan migrants who were diagnosed with confirmed genitourinary schistosomiasis. A tailored protocol was applied, including Schistosoma serology, a specific urine LAMP tests for schistosomiasis and an ultrasound examination before treatment with praziquantel. A scheduled follow-up was performed at 3, 6 and 12 months to monitor treatment response, comparing patients carriers of Schistosoma hybrids with carriers of only genetically pure forms. RESULTS: A total of 31 male patients from West Africa were included in the study with a mean age of 26.5 years. Twelve (38.7 %) of the patients were carriers of Schistosoma hybrids. As compared with patients infected with S. haematobium alone, hybrid carriers had lower haemoglobin levels (13.8 g/dL [SD 1.8] vs 14.8 g/dL [SD 1.4], p = 0.04), a greater frequency of hematuria (100 % vs 52.6 %, p = 0.005), a higher ultrasound score (2.64, SD 2.20 vs 0.89, SD 0.99; p = 0.02). However, the presence of hybrids did not result in differences in clinical and analytical responses after treatment. CONCLUSIONS: The presence of Schistosoma hybrids seems to cause increased morbidity in infected individuals. However, it does not appear to result in differences in diagnostic tests or in clinical and analytical responses after treatment.
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Hibridación Genética , Praziquantel , Humanos , Masculino , Estudios Prospectivos , Adulto , Animales , Praziquantel/uso terapéutico , Esquistosomiasis Urinaria/tratamiento farmacológico , Esquistosomiasis Urinaria/diagnóstico , Esquistosomiasis Urinaria/epidemiología , Adulto Joven , Antihelmínticos/uso terapéutico , Schistosoma haematobium/genética , Schistosoma haematobium/aislamiento & purificación , Schistosoma/genética , Schistosoma/aislamiento & purificación , Adolescente , Esquistosomiasis/tratamiento farmacológico , Esquistosomiasis/epidemiología , Esquistosomiasis/diagnóstico , África Occidental/epidemiología , Persona de Mediana Edad , Migrantes/estadística & datos numéricosRESUMEN
A woman from sub-Saharan Africa living in the Middle East, presented with acute abdominal pain and COVID-19 infection. She underwent a laparotomy and left salpingectomy for a left tubal ruptured ectopic pregnancy. The histopathology report revealed the presence of tubal schistosomiasis in addition to the ectopic sac. The report emphasises the importance of considering female genital schistosomiasis as a potential cause of ectopic pregnancy and the need for collaboration between obstetricians and infectious disease physicians in the definitive treatment of the disease to reduce reproductive morbidity. This case report highlights the possibility of female genital schistosomiasis as a cause of ectopic pregnancy in women from endemic regions.
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COVID-19 , Humanos , Femenino , Embarazo , Adulto , COVID-19/complicaciones , COVID-19/diagnóstico , Salpingectomía , Rotura Espontánea/cirugía , Embarazo Tubario/cirugía , Embarazo Tubario/diagnóstico , Esquistosomiasis/diagnóstico , Esquistosomiasis/complicaciones , SARS-CoV-2 , Diagnóstico Diferencial , Embarazo Ectópico/diagnóstico , Embarazo Ectópico/cirugíaRESUMEN
The World Health Organization recommends the use of the Kato-Katz method in the procedures of schistosomiasis control programs. Studies show the importance of a fast reading of the slides due to the decline of their viability, with the appearance of fungi or desiccation of the sample, which hinders diagnosis. It is necessary to establish a procedure to improve the long-term preservation of these Kato-Katz slides in order to accomplish the following: (1) preserve the slides for future quality control procedures and readings; (2) allow for the production of durable materials for training; and (3) train health professionals involved in diagnosing schistosomiasis. Therefore, this study aims to test a slide preservation methodology for these purposes. The results showed that the modifications made to the experimental slides demonstrated that egg loss was within the expected range and the limit accepted by quality control standards, as well as improved the diagnostic durability of the slides during the preservation times tested. We concluded that the application of the preservation technique to the slides promoted stabilization and permanence for long-term storage.
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Heces , Recuento de Huevos de Parásitos , Manejo de Especímenes , Animales , Humanos , Recuento de Huevos de Parásitos/métodos , Heces/parasitología , Manejo de Especímenes/métodos , Manejo de Especímenes/normas , Esquistosomiasis/prevención & control , Preservación Biológica/métodosRESUMEN
Introduction: Schistosomiasis (SM) is a parasitic disease caused by Schistosoma mansoni. SM causes chronic inflammation induced by parasitic eggs, with collagen/fibrosis deposition in the granuloma process in the liver, spleen, central nervous system, kidneys, and lungs. Pulmonary arterial hypertension (PAH) is a clinical manifestation characterized by high pressure in the pulmonary circulation and right ventricular overload. This study investigated the production of functional autoantibodies (fAABs) against the second loop of the G-protein-coupled receptor (GPCR) in the presence of hepatic and PAH forms of human SM. Methods: Uninfected and infected individuals presenting acute and chronic manifestations (e.g., hepatointestinal, hepato-splenic without PAH, and hepato-splenic with PAH) of SM were clinically evaluated and their blood was collected to identify fAABs/GPCRs capable of recognizing endothelin 1, angiotensin II, and a-1 adrenergic receptor. Human serum was analyzed in rat cardiomyocytes cultured in the presence of the receptor antagonists urapidil, losartan, and BQ123. Results: The fAABs/GPCRs from chronic hepatic and PAH SM individuals, but not from acute SM individuals, recognized the three receptors. In the presence of the antagonists, there was a reduction in beating rate changes in cultured cardiomyocytes. In addition, binding sites on the extracellular domain functionality of fAABs were identified, and IgG1 and/or IgG3 antibodies were found to be related to fAABs. Conclusion: Our data suggest that fAABs against GPCR play an essential role in vascular activity in chronic SM (hepatic and PAH) and might be involved in the development of hypertensive forms of SM.
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Autoanticuerpos , Receptores Acoplados a Proteínas G , Autoanticuerpos/inmunología , Autoanticuerpos/sangre , Humanos , Animales , Receptores Acoplados a Proteínas G/inmunología , Receptores Acoplados a Proteínas G/metabolismo , Ratas , Masculino , Femenino , Adulto , Hipertensión Pulmonar/inmunología , Hipertensión Pulmonar/etiología , Persona de Mediana Edad , Miocitos Cardíacos/inmunología , Miocitos Cardíacos/metabolismo , Miocitos Cardíacos/parasitología , Esquistosomiasis mansoni/inmunología , Schistosoma mansoni/inmunología , Esquistosomiasis/inmunologíaRESUMEN
Schistosomiasis is an infection caused by contact with Schistosoma-contaminated water and affects more than 230 million people worldwide with varying morbidity. The roles of T helper 2 (TH2) cells and regulatory immune responses in chronic infection are well documented, but less is known about human immune responses during acute infection. Here, we comprehensively map immune responses during controlled human Schistosoma mansoni infection using male or female cercariae. Immune responses to male or female parasite single-sex infection were comparable. An early TH1-biased inflammatory response was observed at week 4 after infection, which was particularly apparent in individuals experiencing symptoms of acute schistosomiasis. By week 8 after infection, inflammatory responses were followed by an expansion of TH2 and regulatory cell subsets. This study demonstrates the shift from TH1 to both TH2 and regulatory responses, typical of chronic schistosomiasis, in the absence of egg production and provides immunological insight into the clinical manifestations of acute schistosomiasis.
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Schistosoma mansoni , Esquistosomiasis mansoni , Células Th2 , Humanos , Femenino , Animales , Masculino , Células Th2/inmunología , Esquistosomiasis mansoni/inmunología , Schistosoma mansoni/inmunología , Inflamación/inmunología , Adulto , Células TH1/inmunología , Adulto Joven , Adolescente , Citocinas/inmunología , Esquistosomiasis/inmunología , Esquistosomiasis/parasitologíaRESUMEN
Schistosomiasis is of medical and veterinary importance. Despite the critical situation of schistosomiasis in sub-Saharan Africa, few molecular epidemiological studies have been carried out to determine the role of animals in its transmission. In Mali, it has been over three decades since the last molecular study of animal schistosomes was carried out. It is now urgent to identify circulating strains of the parasite because of potential interactions with other schistosome species, which could complicate disease control. The aim of our work was to study the composition and genetic structure of schistosome populations collected from cattle. The prevalence of schistosome was 23.9%, with the prevalences of Schistosoma bovis (Sb) and S. curassoni (Sc) estimated at 12.6% and 9.8%, respectively. No hybrid strains or S. haematobium were found. The parasites displayed distinct geographical distribution with Sb dominant in Bamako (78.8% and 98% in Central Bamako Slaughterhouse and Sabalibougou Slaughterhouses, respectively) and Sc dominant in Kayes (95.3%). Of the 476 parasites with a complete genetic profile, 60.4% were pure Sc, and were mainly from Kayes. We identified two clusters at the site level (Fst of 0.057 and 0.042 for Sb and Sc, respectively). Cluster 1 was predominantly composed of pure Sb parasites and cluster 2 was mainly composed of pure Sc parasites, from Bamako and Kayes, respectively. Our study shows that cattle schistosomiasis remains endemic in Mali with S. bovis and S. curassoni. A robust genetic structure between the different schistosome populations was identified, which included two clusters based on the geographical distribution of the parasites.
Title: Structure génétique des populations de Schistosoma bovis et S. curassoni collectées chez des bovins au Mali. Abstract: La schistosomiase revêt une grande importance médicale et vétérinaire. Malgré la situation critique de la schistosomiase en Afrique subsaharienne, peu d'études épidémiologiques moléculaires ont été réalisées pour déterminer le rôle des animaux dans sa transmission. Au Mali, cela fait plus de trois décennies que la dernière étude moléculaire des schistosomes animaux a été réalisée. Il est désormais urgent d'identifier les souches circulantes du parasite en raison des interactions potentielles avec d'autres espèces de schistosomes, ce qui pourrait compliquer la lutte contre la maladie. Le but de notre travail était d'étudier la composition et la structure génétique des populations de schistosomes collectées chez des bovins. La prévalence des schistosomes était de 23,9 %, celles de Schistosoma bovis (Sb) et de S. curassoni (Sc) étant respectivement estimées à 12,6 % et 9,8 %. Aucune souche hybride ni S. haematobium n'ont été trouvés. Les parasites présentaient une répartition géographique distincte avec Sb dominant à Bamako (respectivement 78,8 % et 98 % aux Abattoirs Centraux de Bamako et aux Abattoirs de Sabalibougou) et Sc dominant à Kayes (95,3 %). Sur les 476 parasites ayant un profil génétique complet, 60,4 % étaient des Sc purs, et provenaient principalement de Kayes. Nous avons identifié deux clusters au niveau du site (Fst de 0,057 et 0,042 pour Sb et Sc, respectivement). Le groupe 1 était principalement composé de parasites Sb purs et le groupe 2 était principalement composé de parasites Sc purs, provenant respectivement de Bamako et de Kayes. Notre étude montre que la schistosomiase bovine reste endémique au Mali, avec S. bovis and S. curassoni. Une structure génétique robuste entre les différentes populations de schistosomes a été identifiée, comprenant deux groupes basés sur la répartition géographique des parasites.