In the past decade,there has been extensive global surveillance for highly pathogenic avian influenza(HPAI)infection in both animals and humans,however,few studies on epidemiology of avian influenza in Democratic Peo...In the past decade,there has been extensive global surveillance for highly pathogenic avian influenza(HPAI)infection in both animals and humans,however,few studies on epidemiology of avian influenza in Democratic People’s Republic of Korea(DPRK)were published.During the period 2013–2014,HPAI H5N1 viruses were detected with outbreaks in domestic poultry in DPRK.Phylogenetic analysis revealed that the hemagglutinin gene of all samples belonged to clade 2.3.2.1c with high homology.The HPAI H5N1 virus found in ducks at the Tudan Duck Farm in 2013 was might introduced by migratory birds and then led to the outbreaks on neighboring chicken farms in 2014.These data provide direct evidence for the transmission of avian influenza viruses from wild birds to waterfowl to terrestrial birds.Therefore,the monitoring and control of influenza virus in ducks must be given top priority,which are essential components to prevent and control HPAI.展开更多
Background:Prevalence of Opisthorchis viverrini,Schistosoma mekongi and soil-transmitted helminths(STH)remains high in Lao People’s Democratic Republic(Lao PDR),despite control efforts including mass-drug administrat...Background:Prevalence of Opisthorchis viverrini,Schistosoma mekongi and soil-transmitted helminths(STH)remains high in Lao People’s Democratic Republic(Lao PDR),despite control efforts including mass-drug administration,education and communication campaigns.New approaches are required to advance helminth control.Methods:An ecohealth study was conducted on two Mekong islands in Southern Laos.Demographic and behavioural data were collected by questionnaire.Human and animal reservoir stools were examined.Bithynia spp.and Neotricula aperta snails were examined using shedding.Fresh water fish were examined using digestion technique.Multivariate random-effects analysis was used to find risk factors associated with helminth infections.Results:Human infection rates with O.viverrini,hookworm,S.mekongi,Trichuris trichiura,Ascaris lumbricoides and Taenia spp.were 60.7%,44.1%,22.2%,4.1%,0.6%and 0.1%,respectively.Heavy intensity infections were 4.2%,3.6%and 1.8%for O.viverrini,S.mekongi and hookworm,respectively.O.viverrini and S.mekongi infection rates among dogs and cats were 25.0%and 14.7%,respectively.Of the cats tested,53.1%were infected with O.viverrini.Prevalence of O.viverrini and S.mekongi in snails was 0.3%and 0.01%,respectively.Overall prevalence of O.viverrini infection in fresh water fish was 26.9%,with the highest infection rates occurring in Hampala dispa(87.1%),Cyclocheilichthys apogon(85.7%)and Puntius brevis(40.0%).Illiteracy and lower socioeconomic status increased the risk of O.viverrini infection,while those aged 10-16 years and possessing latrines at home were less likely to be infected.Household dogs and cats that consumed raw fish were significantly and positively associated with O.viverrini infection of the household members.For S.mekongi,children under 9 years old were exposed significantly to this infection,compared to older age groups.Conclusions:There is a pressing need to design and implement an integrated helminth control intervention on the Mekong Islands in southern Lao PDR.Given the highly dynamic transmission of O.viverrini,S.mekongi,STH and extended multiparasitism,annual mass-drug administration is warranted along with environmental modifications,health education and improved access to clean water and adequate sanitation to consolidate morbidity control and move towards elimination.Trail registration number:Our findings presented here are from a cross-sectional study,therefore,it has not been registered.展开更多
Background:The point-of-care circulating cathodic antigen(POC-CCA)test is increasingly used as a rapid diagnostic method for Schistosoma mansoni infection.The test has good sensitivity,although false positive results ...Background:The point-of-care circulating cathodic antigen(POC-CCA)test is increasingly used as a rapid diagnostic method for Schistosoma mansoni infection.The test has good sensitivity,although false positive results have been reported among pregnant women and patients with urine infections and hematuria.We validated the POC-CCA test's ability to diagnose Schistosoma mekongi infection in Lao People's Democratic Republic(Lao PDR),where S.mekongi is endemic.Of particular interest was the test's specificity and possible cross-reactivity with other helminth infections.Methods:We conducted a cross-sectional study of children and adults in the provinces of Champasack(Schistosoma mekongi and Opisthorchis viverrini endemic),Savannakhet(O.viverrini endemic)and Luang Prabang(soil-transmitted helminths endemic)between October 2018 and April 2019.POC-CCA and urine dipstick tests were administered to all study participants,while an additional pregnancy test was offered to women.Two stool samples were collected from participants and examined with a Kato-Katz test(two smears per stool).Logistic regression was used to associate potential confounding factors(predictors)with POC-CCA test results(outcome).Results:In S.mekongi-endemic Champasack,11.5%(n=366)and 0.5%(n=2)of study participants had positive POC-CCA and Kato-Katz test results,respectively.Only one of the two Kato-Katz positive patients was also POC-CCA positive.In Champasack and Luang Prabang,where S.rnekongi is not endemic,the POC-CCA test yielded(presumably)false positive results for 6.0%(n=22)and 2.5%(n=9)of study participants,respectively,while all of the Kato-Katz tests were negative.POC-CCA positive test results were significantly associated with O.viverrini infection(1.69,95%confidence interval(CI):1.02-2.77,P=0.042),increased leukocytes(adjusted Odds Ratio(aOR)=1.58,95%CI:1.15-2.17,P=0.005)and hematuria(aOR=1.50,95%CI:1.07-2.10,P=0.019)if the observed trace was counted as a positive test result.Two pregnant women from Champasack province had POC-CCA positive tests.Conclusions:We observed a cross-reaction between the POC-CCA test and O.viverrini infection.To some extent,we can confirm previous observations asserting that POC-CCA provides false positive results among patients with urinary tract infections and hematuria.In S.mekongi-endemic areas,POC-CCA can be applied cautiously for surveillance purposes,keeping in mind the considerable risk of false positive results and its unknown sensitivity.展开更多
Schistosoma mekongi and other intestinal helminth infections remain public health concerns in Lao People's Democratic Republic, especially in remote areas where access to sanitation is limited.We performed an expe...Schistosoma mekongi and other intestinal helminth infections remain public health concerns in Lao People's Democratic Republic, especially in remote areas where access to sanitation is limited.We performed an experimental study in four villages where latrine construction was coupled with two rounds of mass drug administration (MDA) with praziquantel and albendazole, and compared with two control villages that only received two rounds of MDA. The prevalence of helminth infections before (baseline) and after (follow-up) intervention were compared. Additionally, the prevalence in intervention and control villages were compared 12 months post-intervention. Kato–Katz, formalin-ethyl acetate concentration and Baermann techniques were employed to assess helminth infections.We found infection prevalence of S. mekongi in the intervention and control villages was 28.6% and 1.8%, respectively. The prevalences of other helminth infections were as follows: Opisthorchis viverrini, 79.5% and 71.8%;hookworm, 48.8% and 65.6%;and Strongyloides stercoralis, 43.1% and 38.3%. Other helminth species were detected in less than 5% of the study participants. Latrine intervention coupled with two rounds of MDA in the intervention villages reduced the prevalence of S. mekongi infection by 6.0% (from 28.6% to 22.6%;P < 0.001), O. viverrini infection by 11.3% (from 79.5% to 68.2%;P < 0.001), hookworm infection by 22.6% (from 48.8% to 26.2%;P < 0.001), and S. stercoralis infection by 12.0% (from 43.1% to 31.1%;P < 0.001). The observed reductions were not significantly different when compared to the control villages, where only two rounds of MDA were implemented (P > 0.05). Study participants in both groups commonly engaged in behaviours such as open defecation, bathing in the Mekong River, consuming raw or undercooked fish dishes and walking barefoot. These practices and behaviours are associated with helminth infections. Concluding, this study showed only a marginal impact associated with latrine use in intervention communities. There is a need for longer term studies with integrated interventions, such as effective health education to foster behavioural changes related to open defecation, raw or undercooked food consumption, wearing protected footwear outdoors, and personal hygiene.展开更多
基金supported by the China Agriculture Research System of MOF and MARA(CARS-41)。
文摘In the past decade,there has been extensive global surveillance for highly pathogenic avian influenza(HPAI)infection in both animals and humans,however,few studies on epidemiology of avian influenza in Democratic People’s Republic of Korea(DPRK)were published.During the period 2013–2014,HPAI H5N1 viruses were detected with outbreaks in domestic poultry in DPRK.Phylogenetic analysis revealed that the hemagglutinin gene of all samples belonged to clade 2.3.2.1c with high homology.The HPAI H5N1 virus found in ducks at the Tudan Duck Farm in 2013 was might introduced by migratory birds and then led to the outbreaks on neighboring chicken farms in 2014.These data provide direct evidence for the transmission of avian influenza viruses from wild birds to waterfowl to terrestrial birds.Therefore,the monitoring and control of influenza virus in ducks must be given top priority,which are essential components to prevent and control HPAI.
基金We are grateful to the International Development Research CentreForeign Affairs,Trade and Development Canada(through the Global Health Research Initiative)the Australian Agency for International Development for funding support。
文摘Background:Prevalence of Opisthorchis viverrini,Schistosoma mekongi and soil-transmitted helminths(STH)remains high in Lao People’s Democratic Republic(Lao PDR),despite control efforts including mass-drug administration,education and communication campaigns.New approaches are required to advance helminth control.Methods:An ecohealth study was conducted on two Mekong islands in Southern Laos.Demographic and behavioural data were collected by questionnaire.Human and animal reservoir stools were examined.Bithynia spp.and Neotricula aperta snails were examined using shedding.Fresh water fish were examined using digestion technique.Multivariate random-effects analysis was used to find risk factors associated with helminth infections.Results:Human infection rates with O.viverrini,hookworm,S.mekongi,Trichuris trichiura,Ascaris lumbricoides and Taenia spp.were 60.7%,44.1%,22.2%,4.1%,0.6%and 0.1%,respectively.Heavy intensity infections were 4.2%,3.6%and 1.8%for O.viverrini,S.mekongi and hookworm,respectively.O.viverrini and S.mekongi infection rates among dogs and cats were 25.0%and 14.7%,respectively.Of the cats tested,53.1%were infected with O.viverrini.Prevalence of O.viverrini and S.mekongi in snails was 0.3%and 0.01%,respectively.Overall prevalence of O.viverrini infection in fresh water fish was 26.9%,with the highest infection rates occurring in Hampala dispa(87.1%),Cyclocheilichthys apogon(85.7%)and Puntius brevis(40.0%).Illiteracy and lower socioeconomic status increased the risk of O.viverrini infection,while those aged 10-16 years and possessing latrines at home were less likely to be infected.Household dogs and cats that consumed raw fish were significantly and positively associated with O.viverrini infection of the household members.For S.mekongi,children under 9 years old were exposed significantly to this infection,compared to older age groups.Conclusions:There is a pressing need to design and implement an integrated helminth control intervention on the Mekong Islands in southern Lao PDR.Given the highly dynamic transmission of O.viverrini,S.mekongi,STH and extended multiparasitism,annual mass-drug administration is warranted along with environmental modifications,health education and improved access to clean water and adequate sanitation to consolidate morbidity control and move towards elimination.Trail registration number:Our findings presented here are from a cross-sectional study,therefore,it has not been registered.
基金The World Health Organization,Western Pacific Region,International Development Research Centre,Phase 2 has funded our study,along with the Swiss Agency for Development and Cooperation and the Swiss National Science Foundation(project No.IZ07Z0-160930,R4D).
文摘Background:The point-of-care circulating cathodic antigen(POC-CCA)test is increasingly used as a rapid diagnostic method for Schistosoma mansoni infection.The test has good sensitivity,although false positive results have been reported among pregnant women and patients with urine infections and hematuria.We validated the POC-CCA test's ability to diagnose Schistosoma mekongi infection in Lao People's Democratic Republic(Lao PDR),where S.mekongi is endemic.Of particular interest was the test's specificity and possible cross-reactivity with other helminth infections.Methods:We conducted a cross-sectional study of children and adults in the provinces of Champasack(Schistosoma mekongi and Opisthorchis viverrini endemic),Savannakhet(O.viverrini endemic)and Luang Prabang(soil-transmitted helminths endemic)between October 2018 and April 2019.POC-CCA and urine dipstick tests were administered to all study participants,while an additional pregnancy test was offered to women.Two stool samples were collected from participants and examined with a Kato-Katz test(two smears per stool).Logistic regression was used to associate potential confounding factors(predictors)with POC-CCA test results(outcome).Results:In S.mekongi-endemic Champasack,11.5%(n=366)and 0.5%(n=2)of study participants had positive POC-CCA and Kato-Katz test results,respectively.Only one of the two Kato-Katz positive patients was also POC-CCA positive.In Champasack and Luang Prabang,where S.rnekongi is not endemic,the POC-CCA test yielded(presumably)false positive results for 6.0%(n=22)and 2.5%(n=9)of study participants,respectively,while all of the Kato-Katz tests were negative.POC-CCA positive test results were significantly associated with O.viverrini infection(1.69,95%confidence interval(CI):1.02-2.77,P=0.042),increased leukocytes(adjusted Odds Ratio(aOR)=1.58,95%CI:1.15-2.17,P=0.005)and hematuria(aOR=1.50,95%CI:1.07-2.10,P=0.019)if the observed trace was counted as a positive test result.Two pregnant women from Champasack province had POC-CCA positive tests.Conclusions:We observed a cross-reaction between the POC-CCA test and O.viverrini infection.To some extent,we can confirm previous observations asserting that POC-CCA provides false positive results among patients with urinary tract infections and hematuria.In S.mekongi-endemic areas,POC-CCA can be applied cautiously for surveillance purposes,keeping in mind the considerable risk of false positive results and its unknown sensitivity.
基金funded by the World Health Organization,National Centres of Competence in Research,North-South and the Forlen Foundation.The project was also partially supported by the International Joint Laboratory on Tropical Diseases Control in Greater Mekong Subregion(no.21410750200)from Shanghai Municipality Government.
文摘Schistosoma mekongi and other intestinal helminth infections remain public health concerns in Lao People's Democratic Republic, especially in remote areas where access to sanitation is limited.We performed an experimental study in four villages where latrine construction was coupled with two rounds of mass drug administration (MDA) with praziquantel and albendazole, and compared with two control villages that only received two rounds of MDA. The prevalence of helminth infections before (baseline) and after (follow-up) intervention were compared. Additionally, the prevalence in intervention and control villages were compared 12 months post-intervention. Kato–Katz, formalin-ethyl acetate concentration and Baermann techniques were employed to assess helminth infections.We found infection prevalence of S. mekongi in the intervention and control villages was 28.6% and 1.8%, respectively. The prevalences of other helminth infections were as follows: Opisthorchis viverrini, 79.5% and 71.8%;hookworm, 48.8% and 65.6%;and Strongyloides stercoralis, 43.1% and 38.3%. Other helminth species were detected in less than 5% of the study participants. Latrine intervention coupled with two rounds of MDA in the intervention villages reduced the prevalence of S. mekongi infection by 6.0% (from 28.6% to 22.6%;P < 0.001), O. viverrini infection by 11.3% (from 79.5% to 68.2%;P < 0.001), hookworm infection by 22.6% (from 48.8% to 26.2%;P < 0.001), and S. stercoralis infection by 12.0% (from 43.1% to 31.1%;P < 0.001). The observed reductions were not significantly different when compared to the control villages, where only two rounds of MDA were implemented (P > 0.05). Study participants in both groups commonly engaged in behaviours such as open defecation, bathing in the Mekong River, consuming raw or undercooked fish dishes and walking barefoot. These practices and behaviours are associated with helminth infections. Concluding, this study showed only a marginal impact associated with latrine use in intervention communities. There is a need for longer term studies with integrated interventions, such as effective health education to foster behavioural changes related to open defecation, raw or undercooked food consumption, wearing protected footwear outdoors, and personal hygiene.
