scholarly journals Tungiasis: a highly neglected disease among neglected diseases. Case series from Nduta refugee camp (Tanzania)

2019 ◽  
Vol 2019 (6) ◽  
Author(s):  
Sandra Montserrat Nájera Villagrana ◽  
Alejandra García Naranjo Santisteban
Keyword(s):  
Case Series ◽  
Refugee Camp ◽  
Sub Saharan Africa ◽  
Neglected Diseases ◽  
Refugee Camps ◽  
Neglected Disease ◽  
Surgical Extraction ◽  
Immunodeficiency Virus ◽  
Risk Areas ◽  
Sub Saharan

Abstract Tungiasis is a highly prevalent yet neglected disease of populations affected by extreme poverty. It causes great discomfort and pain, leads to social stigmatization and, when left untreated, can cause serious complications. Although natural repellents have been shown to be effective, too little is being done in terms of systematic prevention and treatment. In addition, self-treatment (usually extraction of fleas with non-sterile sharp instruments) comports high risks of infection, notably with viral hepatitis and human immunodeficiency virus. In this article, we report seven severe cases of tungiasis in children living in a refugee camp in Tanzania, all of whom were treated with surgical extraction of the fleas because the topical treatment (dimethicone) was not available. Refugee camps—particularly in sub-Saharan Africa where tungiasis is endemic—should be considered high-risk areas for the condition. Aid organizations should engage in active case searching, and health promotion should be systematically carried out.

scholarly journals Methylome-wide analysis reveals epigenetic marks associated with resistance to tuberculosis in HIV-infected individuals from East Africa

2020 ◽  
Author(s):  
Catherine Stein ◽  
Penelope Bencheck ◽  
Jacquelaine Bartlett ◽  
Robert P Igo ◽  
Rafal S Sobota ◽  
...  
Keyword(s):  
Genome Wide Association Study ◽  
Sub Saharan Africa ◽  
Chromosome 1 ◽  
Chromosome 2 ◽  
Chromosome 5 ◽  
Epigenetic Marks ◽  
Genome Wide ◽  
A Genome ◽  
Immunodeficiency Virus ◽  
Sub Saharan

Background: Tuberculosis (TB) is the most deadly infectious disease globally and highly prevalent in the developing world, especially sub-Saharan Africa. Even though a third of humans are exposed to Myocbacterium tuberculosis (Mtb), most infected immunocompetent individuals do not develop active TB. In contrast, for individuals infected with both TB and the human immunodeficiency virus (HIV), the risk of active disease is 10% or more per year. Previously, we identified in a genome-wide association study a region on chromosome 5 that was associated with resistance to TB. This region included epigenetic marks that could influence gene regulation so we hypothesized that HIV-infected individuals exposed to Mtb, who remain disease free, carry epigenetic changes that strongly protect them from active TB. To test this hypothesis, we conducted a methylome-wide study in HIV-infected, TB-exposed cohorts from Uganda and Tanzania. Results: In 221 HIV-infected adults from Uganda and Tanzania, we identified 3 regions of interest that included markers that were differentially methylated between TB cases and LTBI controls, that also included methylation QTLs and associated SNPs: chromosome 1 (RNF220, p=4x10-5), chromosome 2 (between COPS8 and COL6A3 genes, p=2.7x10-5), and chromosome 5 (CEP72, p=1.3x10-5). These methylation results colocalized with associated SNPs, methylation QTLs, and methylation x SNP interaction effects. These markers were in regions with regulatory markers for cells involved in TB immunity and/or lung. Conclusion: Epigenetic regulation is a potential biologic factor underlying resistance to TB in immunocompromised individuals that can act in conjunction with genetic variants.

scholarly journals The recent evolution of the HIV rates in Sub-Saharan Africa: Do differences still persist?

2019 ◽  
Author(s):  
antonio montañés bernal ◽  
Cristina Martínez
Keyword(s):  
Null Hypothesis ◽  
Incidence Rates ◽  
Sub Saharan Africa ◽  
Female Education ◽  
Prevalence Rates ◽  
African Countries ◽  
Total Incidence ◽  
Immunodeficiency Virus ◽  
Patterns Of Behavior ◽  
Sub Saharan

Abstract Background This paper studies the evolution of the human immunodeficiency virus (HIV) prevalence and incidence rates in Sub-Saharan African countries, paying special attention to the possible presence of a unique pattern of behavior of these variables across the mentioned countries during the 1990-2016 period. Methods We employ time series methods designed to analyze the hypothesis of convergence. We apply these tests to prevalence and incidence rates of the Sub-Saharan African countries for the 1990-2016 period. Results We cannot reject the null hypothesis of convergence for male prevalence rates and total incidence rates. By contrast, we can observe divergence in female prevalence rates, Conclusion The evolution of the male prevalence rates and incidence rates is quite similar for the Sub-Saharan countries. But, we can still find different patterns of behavior for female prevalence rates. Therefore, the recent HIV-oriented policies have not been able to control its transmission yet. We can also appreciate that some socioeconomic variables play a crucial role to explain the different behaviors of female prevalence rates, especially the level of female education. So, focusing on this variable is crucial to control this pandemia.

scholarly journals A Randomized Switch From Nevirapine-Based Antiretroviral Therapy to Single Tablet Rilpivirine/Emtricitabine/Tenofovir Disoproxil Fumarate in Virologically Suppressed Human Immunodeficiency Virus-1-Infected Rwandans

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Sean E. Collins ◽  
Philip M. Grant ◽  
Francois Uwinkindi ◽  
Annie Talbot ◽  
Eric Seruyange ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Tenofovir Disoproxil Fumarate ◽  
Sub Saharan Africa ◽  
Current Therapy ◽  
Virologic Suppression ◽  
Open Label ◽  
Immunodeficiency Virus ◽  
Sub Saharan ◽  
Hiv 1

Abstract Background.  Many human immunodeficiency virus (HIV)-infected patients remain on nevirapine-based antiretroviral therapy (ART) despite safety and efficacy concerns. Switching to a rilpivirine-based regimen is an alternative, but there is little experience with rilpivirine in sub-Saharan Africa where induction of rilpivirine metabolism by nevirapine, HIV subtype, and dietary differences could potentially impact efficacy. Methods.  We conducted an open-label noninferiority study of virologically suppressed (HIV-1 ribonucleic acid [RNA] < 50 copies/mL) HIV-1-infected Rwandan adults taking nevirapine plus 2 nucleos(t)ide reverse-transcriptase inhibitors. One hundred fifty participants were randomized 2:1 to switch to coformulated rilpivirine-emtricitabine-tenofovir disoproxil fumarate (referenced as the Switch Arm) or continue current therapy. The primary efficacy endpoint was HIV-1 RNA < 200 copies/mL at week 24 assessed by the US Food and Drug Administration Snapshot algorithm with a noninferiority margin of 12%. Results.  Between April and September 2014, 184 patients were screened, and 150 patients were enrolled; 99 patients switched to rilpivirine-emtricitabine-tenofovir, and 51 patients continued their nevirapine-based ART. The mean age was 42 years and 43% of participants were women. At week 24, virologic suppression (HIV-1 RNA level <200 copies/mL) was maintained in 93% and 92% in the Switch Arm versus the continuation arm, respectively. The Switch Arm was noninferior to continued nevirapine-based ART (efficacy difference 0.8%; 95% confidence interval, −7.5% to +12.0%). Both regimens were generally safe and well tolerated, although 2 deaths, neither attributed to study medications, occurred in participants in the Switch Arm. Conclusions.  A switch from nevirapine-based ART to rilpivirine-emtricitabine-tenofovir disoproxil fumarate had similar virologic efficacy to continued nevirapine-based ART after 24 weeks with few adverse events.

Introduction

ESC CardioMed ◽  
2018 ◽  
pp. 1185-1186
Author(s):  
Nombulelo P. Magula ◽  
Akira Singh
Keyword(s):  
Black Women ◽  
Hiv Infection ◽  
The United States ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
High Burden ◽  
Immunodeficiency Virus ◽  
Widespread Availability ◽  
Sub Saharan ◽  
Young Black Women

Life expectancy has increased significantly with the widespread availability of antiretroviral therapy. Despite this, new human immunodeficiency virus (HIV) infection rates in low- to middle-income, high-burden countries remain a cause for concern. The greatest impact of infection remains in sub-Saharan Africa, among young black women. However, the majority of studies investigating cardiovascular disease associated with HIV infection have been conducted in the United States and Europe, in predominantly male cohorts.

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