scholarly journals A combined field study of Buruli ulcer disease in southeast Benin proposing preventive strategies based on epidemiological, geographic, behavioural and environmental analyses

2022 ◽  
Vol 2 (1) ◽  
pp. e0000095
Author(s):  
Alexandra Boccarossa ◽  
Horace Degnonvi ◽  
Télesphore Yao Brou ◽  
Marie Robbe-Saule ◽  
Lucille Esnault ◽  
...  
Keyword(s):  
Risk Factor ◽  
Rural Areas ◽  
Buruli Ulcer ◽  
Central Africa ◽  
Incidence Rates ◽  
Preventive Strategy ◽  
Human Environment ◽  
Effective Prevention ◽  
Ulcer Disease ◽  
Frequency Of Contact

Buruli ulcer is a neglected tropical disease caused by M. ulcerans, an environmental mycobacterium. This cutaneous infectious disease affects populations with poor access to sanitation, safe water and healthcare living in rural areas of West and Central Africa. Stagnant open bodies of surface water and slow-running streams are the only risk factor identified in Africa, and there is no human-to-human transmission. Appropriate and effective prevention strategies are required for populations living in endemic areas. Based on a multidisciplinary approach in an area in which Buruli ulcer is endemic in South Benin, we investigated the link between all human-environment interactions relating to unprotected water and behaviors associated with Buruli ulcer risk likely to affect incidence rates. We characterised the sources of water as well as water bodies and streams used by communities, by conducting a prospective case-control study directly coupled with geographic field observations, spatial analysis, and the detection of M. ulcerans in the environment. A full list of the free surface waters used for domestic activities was generated for a set of 34 villages, and several types of human behaviour associated with a higher risk of transmission were identified: (i) prolonged walking in water to reach cultivated fields, (ii) collecting water, (iii) and swimming. Combining the results of the different analyses identified the risk factor most strongly associated with Buruli ulcer was the frequency of contact with unprotected and natural water, particularly in regularly flooded or irrigated lowlands. We confirm that the use of clean water from drilled wells confers protection against Buruli ulcer. These specific and refined results provide a broader scope for the design of an appropriate preventive strategy including certain practices or infrastructures observed during our field investigations. This strategy could be improved by the addition of knowledge about irrigation practices and agricultural work in low-lying areas.

scholarly journals 1535. Impact of Defunding Family Planning Health Centers on Gonorrhea and Chlamydia Cases in Iowa: A Spatiotemporal Analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S768-S768
Author(s):  
Megan L Srinivas ◽  
Eileen Yang ◽  
Weiming Tang ◽  
Joseph Tucker
Keyword(s):  
Family Planning ◽  
Low Income ◽  
Rural Areas ◽  
Spatiotemporal Analysis ◽  
Incidence Rates ◽  
Health Centers ◽  
Transmitted Infection ◽  
Missed Opportunities ◽  
Linear Regression Modeling ◽  
The Impact

Abstract Background Fifteen states have defunded family planning health centers (FPHCs), causing thousands to be left without health services. This has accelerated in the COVID-19 era. FPHCs provide low-income individuals in rural areas with essential primary care services, including sexually transmitted infection prevention, testing, and treatment. The purpose of this analysis is to use spatiotemporal methods to examine the impact of FPHC closures in Iowa on the reported number of gonorrhea and chlamydia cases at the county level. Methods This analysis investigates the association between FPHC closures and changes in the number of gonorrhea and chlamydia cases between 2016 and 2018. Iowa implemented defunding policies for family planning clinics, resulting in four FPHC closures in June 2017. 2016 pre-closure STI incidence rates were compared to 2018 post-closure rates. Gonorrhea and chlamydia rates in the four Iowa counties with clinic closures were compared to the 95 Iowa counties without closures. T tests were used to compare changes in reported gonorrhea and chlamydia rates in the two settings. Linear regression modeling was used to determine the relationship between clinic closures and changes in gonorrhea and chlamydia cases. Results The gonorrhea burden in Iowa increased from 83 cases per 100,000 people in 2016 to 153.8 cases per 100,000 people in 2018. The four counties with clinic closures experienced a significantly larger increase (absolute 217 cases per 100,000 population) in their gonorrhea rate compared to counties without FPHC closures (absolute 121 cases per 100,000 population). There was also a significant relationship between clinic closures and increasing gonorrhea rates (p = 0.0015). Over the three-year period, there was no change in chlamydia rates (p = 0.1182). However, there was a trend towards counties with more FPHC closures having a higher number of chlamydia cases (p = 0.057). Conclusion Despite the fact that many STI diagnoses are made and reported by FPHCs, our data suggest that clinic closures may have contributed to an increase in gonorrhea and chlamydia cases. This is consistent with delayed diagnoses and missed opportunities for providing essential STI services to vulnerable and under-served rural residents. Legislative action is urgently needed to curtail this trend. Disclosures All Authors: No reported disclosures

scholarly journals Urban–rural disparity in cancer incidence in China, 2008–2012: a cross-sectional analysis of data from 36 cancer registers

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042762
Author(s):  
Shuai Yuan ◽  
Shao-Hua Xie
Keyword(s):  
Cancer Incidence ◽  
Rural Areas ◽  
Urban Areas ◽  
Incidence Rates ◽  
Cancer Type ◽  
Anatomic Site ◽  
Cross Sectional ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Urban Rural

ObjectiveThe substantial differences in socioeconomic and lifestyle exposures between urban and rural areas in China may lead to urban–rural disparity in cancer risk. This study aimed to assess the urban–rural disparity in cancer incidence in China.MethodsUsing data from 36 regional cancer registries in China in 2008–2012, we compared the age-standardised incidence rates of cancer by sex and anatomic site between rural and urban areas. We calculated the rate difference and rate ratio comparing rates in rural versus urban areas by sex and cancer type.ResultsThe incidence rate of all cancers in women was slightly lower in rural areas than in urban areas, but the total cancer rate in men was higher in rural areas than in urban areas. The incidence rates in women were higher in rural areas than in urban areas for cancers of the oesophagus, stomach, and liver and biliary passages, but lower for cancers of thyroid and breast. Men residing in rural areas had higher incidence rates for cancers of the oesophagus, stomach, and liver and biliary passages, but lower rates for prostate cancer, lip, oral cavity and pharynx cancer, and colorectal cancer.ConclusionsOur findings suggest substantial urban–rural disparity in cancer incidence in China, which varies across cancer types and the sexes. Cancer prevention strategies should be tailored for common cancers in rural and urban areas.

scholarly journals Aquatic Invertebrates as Unlikely Vectors of Buruli Ulcer Disease

2008 ◽  
Vol 14 (8) ◽  
pp. 1247-1254 ◽  
Author(s):  
M. Eric Benbow ◽  
Heather Williamson ◽  
Ryan Kimbirauskas ◽  
Mollie D. McIntosh ◽  
Rebecca Kolar ◽  
...  
Keyword(s):  
Aquatic Invertebrates ◽  
Buruli Ulcer ◽  
Ulcer Disease

scholarly journals Do Economic Reforms Spur Bancarisation Rate in the CEMAC Region? Empirical Analysis

2016 ◽  
Vol 8 (4) ◽  
pp. 123
Author(s):  
Gérard Tchouassi
Keyword(s):  
Rural Areas ◽  
Central Africa ◽  
Economic Reforms ◽  
Method Of Moment ◽  
Institutional Reforms ◽  
Modeling Framework ◽  
Public And Private ◽  
Financial Reforms ◽  
Bank Accounts ◽  
Generalized Method Of Moment

<p>The aim of this paper is to empirically analyze the effect of the economic reforms on the bancarisation rate in the Central Africa Economic and Monetary Community (CEMAC). Data of six countries from the sub-region from 2001 to 2011 was used in a generalized method of moment (GMM) modeling framework. The following results are obtained: Financial liberalization has facilitated the opening of bank accounts. The opening of bank accounts demand is an increasing function of Gross Domestic Product per capita. The literacy rate contributes to the improvement of financial and banking services. Public and private infrastructures promote decentralization and delocalization of the banking network to smaller cities and rural areas. Institutional reforms work best for increasing the bancarisation rate where financial and banking activities are weak. So, the economic policy to be implemented is to continue the economic and financial reforms and ameliorate the quality of the institutions in the CEMAC region.</p>

The Causal Role for Genital Ulcer Disease as a Risk Factor for Transmission of Human Immunodeficiency Virus

1996 ◽  
Vol 23 (5) ◽  
pp. 429-440 ◽  
Author(s):  
MARY C. DICKERSON ◽  
JEFF JOHNSTON ◽  
THOMAS E. DELEA ◽  
ALICE WHITE ◽  
ELIZABETH ANDREWS
Keyword(s):  
Human Immunodeficiency Virus ◽  
Risk Factor ◽  
Causal Role ◽  
Genital Ulcer ◽  
Ulcer Disease ◽  
Genital Ulcer Disease ◽  
Immunodeficiency Virus

scholarly journals Buruli-Ulcer Induced Disability in Ghana: A Study at Apromase in the Ashanti Region

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Pius Agbenorku ◽  
Anthony Edusei ◽  
Margaret Agbenorku ◽  
Thomas Diby ◽  
Esenam Nyador ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Buruli Ulcer ◽  
Lower Limbs ◽  
Daily Activities ◽  
Ulcer Disease ◽  
Mission Hospital ◽  
Ankle Joints ◽  
Proportional Increase ◽  
Using Data ◽  
Set Up

Objectives. To describe trends and category of disabilities caused by Buruli ulcer disease. Design. This retrospective study was set up to quantify information on the disability trends caused by Buruli ulcer (BU) using data on patients attending BU and chronic ulcer clinics from 2004 to 2009, at Global Evangelical Mission Hospital, Apromase. Methods. Data was retrieved from the WHO BU1 form, case registry book, surgical theatre register, and BU patients' records book of the hospital. Disability was measured as the incapability of patients to perform one or more daily activities due to his/her state of BU disease before treatment. Results. A total of 336 positive BU cases comprising 181 males (53.9%) were recorded of which 113 (33.6%) cases of disabilities were identified. A mean age of 52.5 (±1.32) years was recorded. For the trend of disabilities, the year 2009 recorded the highest (N = 34, 31.0%). The lesions were mostly located at the lower limbs (N = 65, 57.5%) region of the patients. Lesions with diameter >15 cm were the major (59.3%) category of lesions. Conclusion. Trend of disability reveals proportional increase over the years from 2004 to 2009. Contracture at the knee and ankle joints was the commonest disability recorded.

scholarly journals Evaluation of primitive ground water supplies as a risk factor for the development of major waterborne zoonosis in Egyptian children living in rural areas

2018 ◽  
Vol 11 (2) ◽  
pp. 203-208 ◽  
Author(s):  
Hassan A. Elfadaly ◽  
Nawal A. Hassanain ◽  
Mohey A. Hassanain ◽  
Ashraf M. Barakat ◽  
Raafat M. Shaapan
Keyword(s):  
Risk Factor ◽  
Ground Water ◽  
Rural Areas ◽  
Water Supplies ◽  
Egyptian Children ◽  
Waterborne Zoonosis

scholarly journals Molecular Mechanisms Underpinning the Circulation and Cellular Uptake of Mycobacterium ulcerans Toxin Mycolactone

2021 ◽  
Vol 12 ◽  
Author(s):  
Bruno Tello Rubio ◽  
Florence Bugault ◽  
Blandine Baudon ◽  
Bertrand Raynal ◽  
Sébastien Brûlé ◽  
...  
Keyword(s):  
Cellular Uptake ◽  
Molecular Mechanisms ◽  
Scavenger Receptor ◽  
Buruli Ulcer ◽  
Systemic Circulation ◽  
Mycobacterium Ulcerans ◽  
Host Cells ◽  
Ulcer Disease ◽  
Major Mechanism ◽  
Specific Association

Mycolactone is a diffusible lipid toxin produced by Mycobacterium ulcerans, the causative agent of Buruli ulcer disease. Altough bacterially derived mycolactone has been shown to traffic from cutaneous foci of infection to the bloodstream, the mechanisms underpinning its access to systemic circulation and import by host cells remain largely unknown. Using biophysical and cell-based approaches, we demonstrate that mycolactone specific association to serum albumin and lipoproteins is necessary for its solubilization and is a major mechanism to regulate its bioavailability. We also demonstrate that Scavenger Receptor (SR)-B1 contributes to the cellular uptake of mycolactone. Overall, we suggest a new mechanism of transport and cell entry, challenging the dogma that the toxin enters host cells via passive diffusion.

scholarly journals Spatial and temporal patterns of Ross River virus in South East Queensland, Australia: identification of hot spots at the rural-urban interface

2020 ◽  
Author(s):  
Amanda K. Murphy ◽  
Julie A. Clennon ◽  
Gonzalo Vazquez-Prokopec ◽  
Cassie C. Jansen ◽  
Francesca D. Frentiu ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Rural Areas ◽  
Hot Spots ◽  
Incidence Rates ◽  
Capital City ◽  
Health Concern ◽  
Ross River Virus ◽  
Urban Landscapes ◽  
Spatial And Temporal Patterns ◽  
Disease Patterns

Abstract Background: Ross River virus (RRV) is responsible for the most common vector-borne disease of humans reported in Australia. The virus circulates in enzootic cycles between multiple species of mosquitoes, wildlife reservoir hosts and humans. Public health concern about RRV is increasing due to rising incidence rates in Australian urban centres, along with increased circulation in Pacific Island countries. Australia experienced its largest recorded outbreak of 9,544 cases in 2015, with the majority reported from South East Queensland (SEQ). This study examined potential links between disease patterns and transmission pathways of RRV. Methods: The spatial and temporal distribution of notified RRV cases, and associated epidemiological features in SEQ, were analysed for the period 2001-2016. This included fine-scale analysis of disease patterns across the suburbs of the capital city of Brisbane, and those of 8 adjacent Local Government Areas, and host spot analyses to identify locations with significantly high incidence. Results: The mean annual incidence rate for the region was 41/100,000 with a consistent seasonal peak in cases between February and May. The highest RRV incidence was in adults aged from 30-64 years (mean incidence rate: 59/100,000), and females had higher incidence rates than males (mean incidence rates: 44/100,000 and 34/100,000, respectively). Spatial patterns of disease were heterogeneous between years, and there was a wide distribution of disease across both urban and rural areas of SEQ. Overall, the highest incidence rates were reported from predominantly rural suburbs to the north of Brisbane City, with significant hot spots located in peri-urban suburbs where residential, agricultural and conserved natural land use types intersect. Conclusions: Although RRV is endemic across all of SEQ, transmission is most concentrated in areas where urban and peri-urban environments intersect. The drivers of RRV transmission across rural-urban landscapes should be prioritised for further investigation, including identification of specific vectors and hosts that mediate human spillover.

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