Background: In 2017, 900 million people in the world did not have sustainable access to safe drinking water (SDW). In addition, between 2016 and 2020, the global population with safely managed drinking water at home i...Background: In 2017, 900 million people in the world did not have sustainable access to safe drinking water (SDW). In addition, between 2016 and 2020, the global population with safely managed drinking water at home increased from 70 percent to 74 percent. Drinking water insecurity is the daily situation of people in developing countries. The lack of SDW supply is at the root of many diseases, including diarrheal diseases. Kassouala is a village in the municipality of Tchaourou without access to SDW, but having benefited from the drilling of a well in September 2018. The objective of this study was to study the effect of access to safe drinking water on the frequency of diarrheal diseases in Kassouala between January 2018 and July 2019. Methods: We conducted a quasi-experimental study in Kassouala using the natural experiments of the village of Bérétou as a control group for estimating the effect of a causal nature. There were double temporal (January 2018-July 2019) and geographical (Kassouala-Bérétou) comparisons based on data collected from health care registers. A population-based comparability survey of the two villages was conducted among 170 households in each village (experimental village, control village). A two-stage cluster sampling procedure was used to select the survey participants. Data were collected from heads of household by semi-structured questionnaire. We used Pearson or Mantel-Haenszel chi-square tests, as appropriate, and the “difference-in-difference” method to assess the effect. Results: In Kassouala, the proportion of households with access to safe drinking water had increased to 78.88%, whereas it was nil in 2018 before the well drilling, and the frequency of diarrheal diseases decreased significantly from January 2018 before drilling to July 2019 after drilling (57.11% to 44.64%;p Conclusion: Access to safe drinking water in Kassouala has a causal effect on the reduction of diarrheal diseases. However, for the supply of drinking water to be integrated into the community development plan of Tchaourou, it is necessary to support the scaling up of this intervention, which would be considered as a pilot, of a community participation program.展开更多
Sub-Saharan Africa(SSA)has a rapidly growing urban population,with water,sanitation,and hygiene(WASH)services representing the central needs for this population.Incidentally,this region has the lowest global WASH cove...Sub-Saharan Africa(SSA)has a rapidly growing urban population,with water,sanitation,and hygiene(WASH)services representing the central needs for this population.Incidentally,this region has the lowest global WASH coverage.Data from the‘WHO/UNICEF Joint Monitoring Programme for Water supply,Sanitation and Hygiene’and the‘Global Burden of Disease’study from the Institute for Health Metrics and Evaluation were used to assess WASH coverage and related health burden in SSA,its subregions,and rural and urban areas in SSA.WASH coverage in the SSA region appears to be low,but urban coverage is better than that in rural areas;however,there is unequal access to urban WASH and poor urban areas are underserved.In addition,7.75%(5.99–9.7%)of total deaths due to diarrheal diseases across SSA are attributed to unsafe WASH with a risk factor attribution(RFA)percentage of 95.93%(91.94–98.24%).Therefore,a correlation between WASH coverage and mortality due to diarrheal diseases could be established.There is a lack of data on WASH coverage in poor urban areas,although these areas have high incidence of WASH-related diseases including diarrhea.Disaggregated urban WASH data are needed to better understand the WASH service needs of poor urban areas,which would be helpful in ensuring a more inclusive implementation of WASH services.展开更多
Objective This study aimed to understand the epidemic status and phylogenetic relationships of rotavirus group A(RVA)in the Pearl River Delta region of Guangdong Province,China.Methods This study included individuals ...Objective This study aimed to understand the epidemic status and phylogenetic relationships of rotavirus group A(RVA)in the Pearl River Delta region of Guangdong Province,China.Methods This study included individuals aged 28 days–85 years.A total of 706 stool samples from patients with acute gastroenteritis collected between January 2019 and January 2020 were analyzed for 17 causative pathogens,including RVA,using a Gastrointestinal Pathogen Panel,followed by genotyping,virus isolation,and complete sequencing to assess the genetic diversity of RVA.Results The overall RVA infection rate was 14.59%(103/706),with an irregular epidemiological pattern.The proportion of co-infection with RVA and other pathogens was 39.81%(41/103).Acute gastroenteritis is highly prevalent in young children aged 0–1 year,and RVA is the key pathogen circulating in patients 6–10 months of age with diarrhea.G9P[8](58.25%,60/103)was found to be the predominant genotype in the RVA strains,and the 41 RVA-positive strains that were successfully sequenced belonged to three different RVA genotypes in the phylogenetic analysis.Recombination analysis showed that gene reassortment events,selection pressure,codon usage bias,gene polymorphism,and post-translational modifications(PTMs)occurred in the G9P[8]and G3P[8]strains.Conclusion This study provides molecular evidence of RVA prevalence in the Pearl River Delta region of China,further enriching the existing information on its genetics and evolutionary characteristics and suggesting the emergence of genetic diversity.Strengthening the surveillance of genotypic changes and gene reassortment in RVA strains is essential for further research and a better understanding of strain variations for further vaccine development.展开更多
Introduction: Diarrheagenic Escherichia coli (DEC) is a relevant cause of diarrhea, particularly among infants and young children in developing countries. Methodology: We compared the frequency, antimicrobial resistan...Introduction: Diarrheagenic Escherichia coli (DEC) is a relevant cause of diarrhea, particularly among infants and young children in developing countries. Methodology: We compared the frequency, antimicrobial resistance, adherence, enterovirulence and genetic diversity of DEC isolates from Guarani indigenous population under five living in distinct villages in Brazil. Results: Of the 314 E. coli isolates from 57 children, with and without diarrhea, 15% (48/314) were classified in DEC categories: aEPEC (56%, 27/48), EAEC (35%, 17/48) and ETEC (8%, 4/48). ETEC belonged to plylogroup A, EAEC to groups A, B1, B2 and D, and aEPEC to phylogroups A, B1, and B2. EAEC exhibited the aggregative adherence phenotype while ETEC and aEPEC the aggregative and undefined patterns. Multidrug-resistance was detected in aEPEC, ETEC and EAEC while extensive drug-resistance was found in EAEC and aEPEC. RAPD typing revealed a genetically diverse bacterial population. Conclusion: This is the first report regarding aspects of DEC in an indigenous Brazilian population, showing that Guarani children are DEC carriers and that antimicrobial resistance at high levels is widely disseminated among these enteropathogens.展开更多
文摘Background: In 2017, 900 million people in the world did not have sustainable access to safe drinking water (SDW). In addition, between 2016 and 2020, the global population with safely managed drinking water at home increased from 70 percent to 74 percent. Drinking water insecurity is the daily situation of people in developing countries. The lack of SDW supply is at the root of many diseases, including diarrheal diseases. Kassouala is a village in the municipality of Tchaourou without access to SDW, but having benefited from the drilling of a well in September 2018. The objective of this study was to study the effect of access to safe drinking water on the frequency of diarrheal diseases in Kassouala between January 2018 and July 2019. Methods: We conducted a quasi-experimental study in Kassouala using the natural experiments of the village of Bérétou as a control group for estimating the effect of a causal nature. There were double temporal (January 2018-July 2019) and geographical (Kassouala-Bérétou) comparisons based on data collected from health care registers. A population-based comparability survey of the two villages was conducted among 170 households in each village (experimental village, control village). A two-stage cluster sampling procedure was used to select the survey participants. Data were collected from heads of household by semi-structured questionnaire. We used Pearson or Mantel-Haenszel chi-square tests, as appropriate, and the “difference-in-difference” method to assess the effect. Results: In Kassouala, the proportion of households with access to safe drinking water had increased to 78.88%, whereas it was nil in 2018 before the well drilling, and the frequency of diarrheal diseases decreased significantly from January 2018 before drilling to July 2019 after drilling (57.11% to 44.64%;p Conclusion: Access to safe drinking water in Kassouala has a causal effect on the reduction of diarrheal diseases. However, for the supply of drinking water to be integrated into the community development plan of Tchaourou, it is necessary to support the scaling up of this intervention, which would be considered as a pilot, of a community participation program.
文摘Sub-Saharan Africa(SSA)has a rapidly growing urban population,with water,sanitation,and hygiene(WASH)services representing the central needs for this population.Incidentally,this region has the lowest global WASH coverage.Data from the‘WHO/UNICEF Joint Monitoring Programme for Water supply,Sanitation and Hygiene’and the‘Global Burden of Disease’study from the Institute for Health Metrics and Evaluation were used to assess WASH coverage and related health burden in SSA,its subregions,and rural and urban areas in SSA.WASH coverage in the SSA region appears to be low,but urban coverage is better than that in rural areas;however,there is unequal access to urban WASH and poor urban areas are underserved.In addition,7.75%(5.99–9.7%)of total deaths due to diarrheal diseases across SSA are attributed to unsafe WASH with a risk factor attribution(RFA)percentage of 95.93%(91.94–98.24%).Therefore,a correlation between WASH coverage and mortality due to diarrheal diseases could be established.There is a lack of data on WASH coverage in poor urban areas,although these areas have high incidence of WASH-related diseases including diarrhea.Disaggregated urban WASH data are needed to better understand the WASH service needs of poor urban areas,which would be helpful in ensuring a more inclusive implementation of WASH services.
基金funded by the grant National Key R&D Program of China(2017ZX10103011-004 and 2018YFC1603804)the Science and Technology Program of Guangdong Province(2018B020207013 and 2019B030316013).
文摘Objective This study aimed to understand the epidemic status and phylogenetic relationships of rotavirus group A(RVA)in the Pearl River Delta region of Guangdong Province,China.Methods This study included individuals aged 28 days–85 years.A total of 706 stool samples from patients with acute gastroenteritis collected between January 2019 and January 2020 were analyzed for 17 causative pathogens,including RVA,using a Gastrointestinal Pathogen Panel,followed by genotyping,virus isolation,and complete sequencing to assess the genetic diversity of RVA.Results The overall RVA infection rate was 14.59%(103/706),with an irregular epidemiological pattern.The proportion of co-infection with RVA and other pathogens was 39.81%(41/103).Acute gastroenteritis is highly prevalent in young children aged 0–1 year,and RVA is the key pathogen circulating in patients 6–10 months of age with diarrhea.G9P[8](58.25%,60/103)was found to be the predominant genotype in the RVA strains,and the 41 RVA-positive strains that were successfully sequenced belonged to three different RVA genotypes in the phylogenetic analysis.Recombination analysis showed that gene reassortment events,selection pressure,codon usage bias,gene polymorphism,and post-translational modifications(PTMs)occurred in the G9P[8]and G3P[8]strains.Conclusion This study provides molecular evidence of RVA prevalence in the Pearl River Delta region of China,further enriching the existing information on its genetics and evolutionary characteristics and suggesting the emergence of genetic diversity.Strengthening the surveillance of genotypic changes and gene reassortment in RVA strains is essential for further research and a better understanding of strain variations for further vaccine development.
文摘Introduction: Diarrheagenic Escherichia coli (DEC) is a relevant cause of diarrhea, particularly among infants and young children in developing countries. Methodology: We compared the frequency, antimicrobial resistance, adherence, enterovirulence and genetic diversity of DEC isolates from Guarani indigenous population under five living in distinct villages in Brazil. Results: Of the 314 E. coli isolates from 57 children, with and without diarrhea, 15% (48/314) were classified in DEC categories: aEPEC (56%, 27/48), EAEC (35%, 17/48) and ETEC (8%, 4/48). ETEC belonged to plylogroup A, EAEC to groups A, B1, B2 and D, and aEPEC to phylogroups A, B1, and B2. EAEC exhibited the aggregative adherence phenotype while ETEC and aEPEC the aggregative and undefined patterns. Multidrug-resistance was detected in aEPEC, ETEC and EAEC while extensive drug-resistance was found in EAEC and aEPEC. RAPD typing revealed a genetically diverse bacterial population. Conclusion: This is the first report regarding aspects of DEC in an indigenous Brazilian population, showing that Guarani children are DEC carriers and that antimicrobial resistance at high levels is widely disseminated among these enteropathogens.
