scholarly journals Developing and validating a clinical algorithm for the diagnosis of podoconiosis

2020 ◽  
Vol 114 (12) ◽  
pp. 916-925
Author(s):  
Kebede Deribe ◽  
Lyndsey Florence ◽  
Abebe Kelemework ◽  
Tigist Getaneh ◽  
Girmay Tsegay ◽  
...  
Keyword(s):  
Kidney Diseases ◽  
Scale Up ◽  
Wuchereria Bancrofti ◽  
Signs And Symptoms ◽  
Clinical History ◽  
World Health ◽  
Northern Ethiopia ◽  
Immunoglobulin G4 ◽  
Clinical Algorithm ◽  
Health Organization

Abstract Background Difficulties in reliably diagnosing podoconiosis have severely limited the scale-up and uptake of the World Health Organization–recommended morbidity management and disability prevention interventions for affected people. We aimed to identify a set of clinical features that, combined into an algorithm, allow for diagnosis of podoconiosis. Methods We identified 372 people with lymphoedema and administered a structured questionnaire on signs and symptoms associated with podoconiosis and other potential causes of lymphoedema in northern Ethiopia. All individuals were tested for Wuchereria bancrofti–specific immunoglobulin G4 in the field using Wb123. Results Based on expert diagnosis, 344 (92.5%) of the 372 participants had podoconiosis. The rest had lymphoedema due to other aetiologies. The best-performing set of symptoms and signs was the presence of moss on the lower legs and a family history of leg swelling, plus the absence of current or previous leprosy, plus the absence of swelling in the groin, plus the absence of chronic illness (such as diabetes mellitus or heart or kidney diseases). The overall sensitivity of the algorithm was 91% (95% confidence interval [CI] 87.6 to 94.4) and specificity was 95% (95% CI 85.45 to 100). Conclusions We developed a clinical algorithm of clinical history and physical examination that could be used in areas suspected or endemic for podoconiosis. Use of this algorithm should enable earlier identification of podoconiosis cases and scale-up of interventions.

scholarly journals Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania

2020 ◽  
Vol 6 (1) ◽  
pp. 1
Author(s):  
Boushab Mohamed Boushab ◽  
Mohamed Salem Ould Ahmedou Salem ◽  
Ali Ould Mohamed Salem Boukhary ◽  
Philippe Parola ◽  
Leonardo Basco
Keyword(s):  
Renal Failure ◽  
Respiratory Distress ◽  
Severe Malaria ◽  
Falciparum Malaria ◽  
Clinical Features ◽  
Signs And Symptoms ◽  
Plasmodium Falciparum Malaria ◽  
Severe Anaemia ◽  
World Health ◽  
Health Organization

Severe malaria in adults is not well-studied in Sahelian Africa. Clinical features and mortality associated with severe Plasmodium falciparum malaria in adult patients hospitalized in Kiffa, southern Mauritania, were analysed. Patients over 15 years old admitted for severe malaria between August 2016 and December 2019 were included in the present retrospective study. The World Health Organization (WHO) criteria were used to define severe malaria. The presenting clinical characteristics and outcome were compared. Of 4266 patients hospitalized during the study period, 573 (13.4%) had a positive rapid diagnostic test for malaria, and 99 (17.3%; mean age, 37.5 years; range 15–79 years; sex-ratio M/F, 2.1) satisfied the criteria for severe malaria. On admission, the following signs and symptoms were observed in more than one-fourth of the patients: fever (98%), impairment of consciousness (81.8%), multiple convulsions (70.7%), cardiovascular collapse (61.6%), respiratory distress (43.4%), severe anaemia ≤ 80 g/L (36.4%), haemoglobinuria (27.3%), and renal failure (25.3%). Patients were treated with parenteral quinine or artemether. Fourteen (14.1%) patients died. Multiple convulsions, respiratory distress, severe anaemia, haemoglobinuria, acute renal failure, jaundice, and abnormal bleeding occurred more frequently (p < 0.05) in deceased patients. Mortality due to severe falciparum malaria is high among adults in southern Mauritania. An adoption of the WHO-recommended first-line treatment for severe malaria, such as parenteral artesunate, is required to lower the mortality rate associated with severe malaria.

scholarly journals Progress towards elimination of lymphatic filariasis in the Americas region

2020 ◽  
Vol 13 (Supplement_1) ◽  
pp. S33-S38
Author(s):  
Gilberto Fontes ◽  
Eliana Maria Mauricio da Rocha ◽  
Ronaldo Guilherme Carvalho Scholte ◽  
Rubén Santiago Nicholls
Keyword(s):  
Dominican Republic ◽  
Lymphatic Filariasis ◽  
Wuchereria Bancrofti ◽  
World Health ◽  
Vector Species ◽  
Effective Coverage ◽  
The Third ◽  
Assessment Survey ◽  
Health Organization ◽  
Important Progress

Abstract In South and Central America, lymphatic filariasis (LF) is caused by Wuchereria bancrofti, which is transmitted by Culex quinquefasciatus, the only vector species in this region. Of the seven countries considered endemic for LF in the Americas in the last decade, Costa Rica, Suriname and Trinidad and Tobago were removed from the World Health Organization list in 2011. The remaining countries, Brazil, Dominican Republic, Guyana and Haiti, have achieved important progress in recent years. Brazil was the first country in the Americas to stop mass drug administration (MDA) and to establish post-MDA surveillance. Dominican Republic stopped MDA in all LF-endemic foci: La Ciénaga and Southwest passed the third Transmission Assessment Survey (TAS) and the Eastern focus passed TAS-1 in 2018. Haiti passed the TAS and interrupted transmission in &gt;80% of endemic communes, achieving effective drug coverage. Guyana implemented effective coverage in MDAs in 2017 and 2018 and in 2019 scaled up the treatment for 100% of the geographical region, introducing ivermectin in the MDA in order to achieve LF elimination by the year 2026. The Americas region is on its way to eliminating LF transmission. However, efforts should be made to improve morbidity management to prevent disability of the already affected populations.

scholarly journals COVID-19 Pandemic: A Global Disaster

2021 ◽  
Vol 1 (1) ◽  
pp. 7-8
Author(s):  
Solomon Arigwe Joseph ◽  
Abuhuraira Ado Musa ◽  
Faisal Muhammad ◽  
Tijjani Muhammad Ahmad
Keyword(s):  
Public Health ◽  
World Health Organization ◽  
Signs And Symptoms ◽  
Viral Disease ◽  
Hubei Province ◽  
Public Health Emergency ◽  
World Health ◽  
Novel Coronavirus ◽  
Health Organization

People began to become ill in late December 2019 in Wuhan, Hubei Province, China, and the illness was revealed to be a kind of pneumonia with unusual signs and symptoms. It was eventually discovered as a novel coronavirus, a virus that causes widespread sickness in animals and birds. World Health Organization (WHO) named this new viral disease coronavirus disease 2019 (COVID-19) and declared a Public Health Emergency of International Concern in January 2020.

scholarly journals Phosphodiesterase Inhibitors: Could They Be Beneficial for the Treatment of COVID-19?

2020 ◽  
Vol 21 (15) ◽  
pp. 5338 ◽  
Author(s):  
Mauro Giorgi ◽  
Silvia Cardarelli ◽  
Federica Ragusa ◽  
Michele Saliola ◽  
Stefano Biagioni ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Clinical Manifestations ◽  
Phosphodiesterase Inhibitors ◽  
Signs And Symptoms ◽  
World Health ◽  
Pde Inhibitors ◽  
Clinical Signs And Symptoms ◽  
Hydrolyzing Enzymes ◽  
Health Organization ◽  
Restrictive Measures

In March 2020, the World Health Organization declared the severe acute respiratory syndrome corona virus 2 (SARS-CoV2) infection to be a pandemic disease. SARS-CoV2 was first identified in China and, despite the restrictive measures adopted, the epidemic has spread globally, becoming a pandemic in a very short time. Though there is growing knowledge of the SARS-CoV2 infection and its clinical manifestations, an effective cure to limit its acute symptoms and its severe complications has not yet been found. Given the worldwide health and economic emergency issues accompanying this pandemic, there is an absolute urgency to identify effective treatments and reduce the post infection outcomes. In this context, phosphodiesterases (PDEs), evolutionarily conserved cyclic nucleotide (cAMP/cGMP) hydrolyzing enzymes, could emerge as new potential targets. Given their extended distribution and modulating role in nearly all organs and cellular environments, a large number of drugs (PDE inhibitors) have been developed to control the specific functions of each PDE family. These PDE inhibitors have already been used in the treatment of pathologies that show clinical signs and symptoms completely or partially overlapping with post-COVID-19 conditions (e.g., thrombosis, inflammation, fibrosis), while new PDE-selective or pan-selective inhibitors are currently under study. This review discusses the state of the art of the different pathologies currently treated with phosphodiesterase inhibitors, highlighting the numerous similarities with the disorders linked to SARS-CoV2 infection, to support the hypothesis that PDE inhibitors, alone or in combination with other drugs, could be beneficial for the treatment of COVID-19.

scholarly journals Fatal Rattlesnake Envenomation in Northernmost Brazilian Amazon: A Case Report and Literature Overview

Reports ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. 9 ◽  
Author(s):  
Jilvando M. Medeiros ◽  
Isadora S. Oliveira ◽  
Isabela G. Ferreira ◽  
Gabriel Melo Alexandre-Silva ◽  
Felipe A. Cerni ◽  
...  
Keyword(s):  
Neglected Tropical Diseases ◽  
Fatal Case ◽  
Signs And Symptoms ◽  
Hemodynamic Instability ◽  
World Health ◽  
Amazon Forest ◽  
Patient Death ◽  
Macroscopic Hematuria ◽  
Health Organization ◽  
Crotalus Durissus

Snakebite envenomations are classified as Category A Neglected Tropical Diseases by the World Health Organization. In Brazil, 405 snake species are distributed among 11 families, with the genera Bothrops and Crotalus being the most studied and main responsible for severe and lethal envenomations. In the country, Crotalus genus (i.e., rattlesnakes) is represented by Crotalus durissus species, showing seven different subspecies distributed along the country, including Crotalus durissus ruruima, which inhabits Roraima, the Brazilian nothermost state from Amazon forest. Here, we report a fatal case of a severe envenomation following a rattlesnake bite. The patient presented classic crotalic neurological signs and symptoms such as ptosis, drooling of saliva, sluggishness, macroscopic hematuria, and oliguria, which evolved to acute kidney failure (AKF) and hemodynamic instability. Although the patient was treated with the specific antivenom therapy, the severe envenomation resulted in three cardiac arrests and death of the victim in less than 38 h. This study discusses the causes of the patient death, the features of rattlesnake venom-induced AKF, and shows evidences that the Brazilian crotalic antivenom should be improved to treat rattlesnake envenomations caused by C. d. ruruima venom in Roraima state.

scholarly journals Detecting tuberculosis: rapid tools but slow progress

2019 ◽  
Vol 9 (3) ◽  
pp. 80-83
Author(s):  
K. England ◽  
T. Masini ◽  
E. Fajardo
Keyword(s):  
Point Of Care ◽  
Scale Up ◽  
Critical Issue ◽  
World Health ◽  
High Turnover ◽  
Low Resource Settings ◽  
Laboratory Staff ◽  
Low Resource ◽  
Point Of Care Test ◽  
Health Organization

The World Health Organization (WHO) currently recommends Xpert® MTB/RIF as the initial test for all people with presumptive tuberculosis (TB). A number of challenges have been reported, however, in using this technology, particularly in low-resource settings. Here we examine these challenges, and provide our perspective of the barriers to Xpert scale-up as assessed through a survey in 16 TB burden countries in which the Médecins Sans Frontières is present. We observed that the key barriers to scale-up include a lack of policy adoption and implementation of WHO recommendations for the use of Xpert, resulting from high costs, poor sensitisation of clinical staff and a high turnover of trained laboratory staff; insufficient service and maintenance provision provided by the manufacturer; and inadequate resources for sustainability and expansion. Funding is a critical issue as countries begin to transition out of support from the Global Fund. While it is clear that there is still an urgent need for research into and development of a rapid, affordable point-of-care test for TB that is truly adapted for use in low-resource settings, countries in the meantime need to develop functional and sustainable Xpert networks in order to close the existing diagnostic gap.

PREDICTORS OF MALE CIRCUMCISION AMONG MEN AGED 15–35 YEARS IN HARARE, ZIMBABWE

2017 ◽  
Vol 50 (2) ◽  
pp. 193-211
Author(s):  
Kudzaishe Mangombe ◽  
Ishumael Kalule-Sabiti
Keyword(s):  
Hiv Prevention ◽  
Male Circumcision ◽  
Employment Status ◽  
Scale Up ◽  
World Health ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Male Circumcision ◽  
Sub Saharan ◽  
Health Organization

SummaryMedical male circumcision has been recommended by the World Health Organization as part of a comprehensive approach to HIV prevention. Zimbabwe is one of the fourteen sub-Saharan countries that embarked on the Medical Male Circumcision (MMC) programme. However, the country has not yet met male circumcision targets. This paper examines the predictors of male circumcision in Zimbabwe. A cross-sectional survey was conducted on 784 men aged 15–35 years in Harare, Zimbabwe. Negative log-log logistic regression analysis was used to determine the predictors of male circumcision. The main predictors of circumcision were age, employment status, ever tested for HIV, approval of HIV testing prior to circumcision, knowledge about male circumcision and attitudes towards male circumcision. By and large, participants had good knowledge about male circumcision and viewed HIV prevention with a reasonably positive attitude. The identification of these predictors can be used to scale up the demand for male circumcision in Zimbabwe.

scholarly journals Quarantine for Zika Virus? Where is the Science?

2016 ◽  
Vol 10 (5) ◽  
pp. 704-706 ◽  
Author(s):  
Kristi L. Koenig
Keyword(s):  
Public Health ◽  
Zika Virus ◽  
Ebola Virus ◽  
Virus Disease ◽  
Rapid Test ◽  
Signs And Symptoms ◽  
World Health ◽  
Virus Infections ◽  
Health Organization ◽  
Spread Of Infection

AbstractIn January 2016, the World Health Organization warned that Zika virus is “spreading explosively” in the Americas and that up to 4 million infections could be present worldwide within a year. Soon thereafter, some politicians and authors publicly advocated for quarantine of travelers returning from regions where mosquitoes carrying Zika virus are prevalent. The public health tool of quarantine can be used to prevent the spread of infection by restricting the movement of persons who have been exposed to a deadly disease that can be transmitted from person to person before symptom onset. With 80% of Zika virus infections being asymptomatic, no rapid test being available to detect the virus, and primary transmission being via the bites of certain mosquitoes, application of quarantine in this setting is not scientifically sound or practically feasible. Rather, public health interventions should focus on preventing bites from infected mosquitoes, counseling pregnant women on the risks of fetal microcephaly and other birth defects, and identifying patients with signs and symptoms of Guillain-Barré syndrome. As was seen in the Ebola virus disease outbreak of 2014, non-evidence-based factors can influence policy decisions. Public health experts must ensure that policy makers are informed that quarantine is not a scientifically sound approach for the control of Zika virus. (Disaster Med Public Health Preparedness. 2016;0:1–3)

scholarly journals Prevalence and characteristics of postpartum thyroid dysfunction in Tehran

2001 ◽  
pp. 397-401 ◽  
Author(s):  
HB Shahbazian ◽  
F Sarvghadi ◽  
F Azizi
Keyword(s):  
World Health Organization ◽  
Previous History ◽  
Low Frequency ◽  
Signs And Symptoms ◽  
Iodine Intake ◽  
World Health ◽  
Control Group ◽  
World Health Organization Classification ◽  
Serum T3 ◽  
Health Organization

OBJECTIVE: To determine the prevalence of postpartum thyroiditis (PPT), one of the autoimmune disorders of the thyroid which usually occurs in women in the first year after parturition. PPT presents with periods of transient thyrotoxicosis and hypothyroidism, in many cases resulting in permanent hypothyroidism. DESIGN: The study involved 1040 mothers who had contacted five health centers in Tehran for vaccination of their children. METHODS: Signs and symptoms of hypothyroidism and thyrotoxicosis, and the presence of goiter (using the World Health Organization classification), were sought. Serum T3, T4, TSH, anti-TPO and anti-Tg antibodies were measured at 3, 4.5, 6 and 9 months after parturition. In those with hypothyroidism or thyrotoxicosis and a matched group of normal women, thyroid sonography was performed. RESULTS: The prevalence of thyroiditis was 11.4%. Hypothyroidism and thyrotoxicosis occurred in 68 and 42 mothers respectively. Nine had thyrotoxicosis followed by hypothyroidism. There was one case of Graves' disease. Out of 68 hypothyroid patients, 33 women underwent treatment with levothyroxine (because of the severity of symptoms) for 12 months. Six women showed increased TSH at 6 weeks after discontinuation of thyroxine. Stage II goiter (World Health Organization classification) were observed in 21.8% of patients and in 6.7% of pospartum euthyroid women (P<0.001). Positive anti-TPO was found in 61.5% of patients and in 19% of the control group; positive anti-Tg was found in 58% of patients and in 6% of the control group (P<0.001). Sonographic changes were observed in 96% of the patients and in 7% of the control group (P<0.001). There was no significant correlation between the occurrence of thyroiditis and parity, the age of the mother, a previous history of thyroid disease in the patient or family, breast-feeding, or the gender of the child. CONCLUSION: The results of this study show a high prevalence of PPT in Tehranian women. This may be due to the length and frequency of follow-up and/or the transition from low to adequate iodine intake. The major difference with respect to other studies is the low frequency of the biphasic form of PPT.

scholarly journals Interruption of lymphatic filariasis transmission in Manaus, a former focus of Wuchereria bancrofti in the Western Brazilian Amazon

2021 ◽  
Vol 45 ◽  
pp. 1
Author(s):  
Marilaine Martins ◽  
Rebeca Cristina Souza Guimarães ◽  
Gilberto Fontes
Keyword(s):  
Lymphatic Filariasis ◽  
Urban Areas ◽  
Wuchereria Bancrofti ◽  
Brazilian Amazon ◽  
World Health ◽  
Circulating Filarial Antigens ◽  
Adolescents And Adults ◽  
Rapid Tests ◽  
Health Organization ◽  
The City

Objective. To confirm the absence of Wuchereria bancrofti autochthonous cases in Manaus, a former focus of lymphatic filariasis in the Western Brazilian Amazon. Methods. A field survey was carried out in 2016 using immunochromatographic rapid tests (ICT card) for the detection of circulating filarial antigens in blood. The sample included a group of 3 000 schoolchildren aged 6 to 10 years enrolled in schools from different urban areas of Manaus (including the former lymphatic filariasis focus in the city) and a group of 709 adolescents and adults, between the ages of 11 and 85 years, born and raised in different areas of Manaus. Results. All of the individuals tested negative for W. bancrofti antigen. Conclusions. Although Manaus was once considered endemic, this focus no longer seems to be active for lymphatic filariasis transmission. The results of this study could support the certification by the World Health Organization of the lymphatic filariasis transmission elimination exercise in Brazil.

Sign in / Sign up

Export Citation Format

Share Document