High prevalence of epilepsy in onchocerciasis endemic health areas in Democratic Republic of the Congo

Background:A high prevalence of epilepsy has been observed in many onchocerciasis endemic regions.This study is to estimate the prevalence of active epilepsy and exposure to Onchocerca volvulus infection in a rural population in Ituri province,Democratic Republic of Congo.Methods:In August 2016,a community-based cross-sectional study was conducted in an onchocerciasis endemic area in the rural health zone of Logo,Ituri Province.Households within two neighbouring health areas were randomly sampled.To identify persons with epilepsy,a three-stage approach was used.In the first stage,all individuals of the selected households were screened for epilepsy by non-medical field workers using a validated 5-item questionnaire.In the second and third stage,suspected cases of epilepsy were examined by non-specialist medical doctors,and by a neurologist,respectively.A case of epilepsy was defined according to the 2014 International League Against Epilepsy(ILAE)guidelines.Exposure to O.volvulus was assessed by testing for IgG4 antibodies to an O.volvulus antigen(OV16 Rapid Test,)in individuals aged 3 years and older.Results:Out of 1389 participants included in the survey,64 were considered to have active epilepsy(prevalence 4.6%)(95%confidence interval[CI]:3.6-5.8).The highest age-specific epilepsy prevalence estimate was observed in those aged 20 to 29 years(8.2%).Median age of epilepsy onset was 10 years,with a peak incidence of epilepsy in the 10 to 15 year-old age group.OV16 test results were available for 912 participants,of whom 30.5%(95%CI,27.6-33.6)tested positive.The prevalence of OV16 positivity in a village ranged from 8.6 to 68.0%.After adjusting for age,gender and ivermectin use,a significant association between exposure to onchocerciasis and epilepsy was observed(adjusted odds ratio=3.19,95%CI:1.63-5.64)(P<0.001).Conclusions:A high prevalence of epilepsy and a significant association between epilepsy and exposure to O.volvulus were observed in the population in Ituri province,Democratic Republic of Congo.There is an urgent need to implement a CDTI programme and to scale up an epilepsy treatment and care programme.

Human-animal interactions and bat coronavirus spillover potential among rural residents in Southern China

Human interaction with animals has been implicated as a primary risk factor for several high impact zoonoses,including many bat-origin viral diseases.However the animal-to-human spillover events that lead to emerging diseases are rarely observed or clinically examined,and the link between specific interactions and spillover risk is poorly understood.To investigate this phenomenon,we conducted biological-behavioral surveillance among rural residents in Yunnan,Guangxi,and Guangdong districts of Southern China,where we have identified a number of SARS-related coronaviruses in bats.Serum samples were tested for four bat-borne coronaviruses using newly developed enzyme-linked immunosorbent assays(ELISA).Survey data were used to characterize associations between human-animal contact and bat coronavirus spillover risk.A total of 1,596 residents were enrolled in the study from 2015 to 2017.Nine participants(0.6%)tested positive for bat coronaviruses.265(17%)participants reported severe acute respiratory infections(SARI)and/or influenza-like illness(ILI)symptoms in the past year,which were associated with poultry,carnivore,rodent/shrew,or bat contact,with variability by family income and district of residence.This study provides serological evidence of bat coronavirus spillover in rural communities in Southern China.The low seroprevalence observed in this study suggests that bat coronavirus spillover is a rare event.Nonetheless,this study highlights associations between human-animal interaction and zoonotic spillover risk.These findings can be used to support targeted biological behavioral surveillance in high-risk geographic areas in order to reduce the risk of zoonotic disease emergence.

Lessons from COVID-19 to Help Prevent Future Pandemics

In just over 12 months since it was first discovered,coronavirus disease 2019(COVID-19)has caused over 100 million confirmed cases and more than 2.2 million deaths.Its impact on our global economy has been staggering and likely to be in the tens of trillions of dollars by the time vaccines are fully deployed(1).COVID-19 has caused significant hardship,mortality,and morbidity across the world,from the lockdowns experienced by the citizens of Wuhan in early 2020.

Spatiotemporal patterns and trends of community transmission of the pandemic COVID-19 in South Asia: Bangladesh as a case study

South Asian(SA)countries have been fighting with the pandemic novel coronavirus disease 2019(COVID-19)since January 2020.Earlier,the country-specific descriptive study has been done.Nevertheless,as transboundary infection,the border sharing,shared cultural and behavioral practice,effects on the temporal and spatial distribution of COVID-19 in SA is still unveiled.Therefore,this study has been revealed the spatial hotspot along with descriptive output on different parameters of COVID-19 infection.We extracted data from theWHO and the worldometer database from the onset of the outbreak up to 15 May,2020.Europe has the highest case fatality rate(CFR,9.22%),whereas Oceania has the highest(91.15%)recovery rate from COVID-19.Among SA countries,India has the highest number of cases(85,790),followed by Pakistan(38,799)and Bangladesh(20,065).However,the number of tests conducted was minimum in this region in comparison with other areas.The highest CFR was recorded in India(3.21%)among SA countries,whereas Nepal and Bhutan had no death record due to COVID-19 so far.The recovery rate varies from 4.75%in the Maldives to 51.02%in Sri Lanka.In Bangladesh,community transmission has been recorded,and the highest number of cases were detected in Dhaka,followed by Narayanganj and Chattogram.We detected Dhaka and its surrounding six districts,namely Gazipur,Narsingdi,Narayanganj,Munshiganj,Manikganj,and Shariatpur,as the 99%confidence-based hotspot where Faridpur and Madaripur district as the 95%confidence-based spatial hotspots of COVID-19 in Bangladesh.However,we did not find any cold spots in Bangladesh.We identified three hotspots and three cold spots at different confidence levels in India.Findings from this study suggested the“Test,Trace,and Isolation”approach for earlier detection of infection to prevent further community transmission of COVID-19.

Onchocerca volvulus as a risk factor for developing epilepsy in onchocerciasis endemic regions in the Democratic Republic of Congo:a case control study

Background:A high prevalence of epilepsy has been observed in onchocerciasis endemic areas in the Democratic Republic of Congo(DRC).With this study we aimed to investigate whether Onchocerca volvulus infection is a risk factor for developing epilepsy in onchocerciasis endemic regions in the DRC.Methods:Between October and December 2015,a multi-centre case control study was performed in onchocerciasis endemic health zones(HZ)in the DRC:one study site was situated in Tshopo Province in the HZ of Wanierukula(village of Salambongo)where there had been 13 annual community distributions of treatment with ivermectin(CDTI),a second was situated in Ituri Province in the HZ of Logo(village of Draju)where ivermectin had never been distributed and in the HZ of Rethy(village of Rassia)where there had been THREE CDTI annual campaigns before the study.Individuals with unprovoked convulsive epilepsy of unknown etiology were enrolled as cases(n=175).Randomly selected healthy members of families without epilepsy cases from the same village and age-groups and were recruited as controls(n=170).Results:Onchocerciasis associated symptoms(e.g.,itching and abnormal skin)were more often present in cases compared to controls(respectively,OR=2.63,95%CI:1.63-4.23,P<0.0001 and OR=3.23,95%CI:1.48-7.09,P=0.0034).A higher number of cases was found to present with microfilariae in skin snips and with O.volvulus IgG4 antibodies in the blood compared to controls.Moreover,the microfilariae load in skin snips was 3-10 times higher in cases than controls.Conclusions:This case control study confirms that O.volvulus is a risk factor for developing epilepsy in onchocerciasis endemic regions in the DRC.

新型冠状病毒引发全球卫生危机,需要科学解决方案和地方行动

根据《国际卫生条例(2005)》(IHR),世界卫生组织(WHO)宣布将新型冠状病毒肺炎(COVID-19)列为国际关注的突发公共卫生事件。系统性问题导致此次病毒暴发,该疫情全世界大流行对全球政治和社会系统产生了重大影响。虽然过去15年间科学界在提高了公众对于疾病大流行的警觉方面做了大量的工作,但此次疫情依然暴发并已威胁全球人们的健康,影响经济发展。为了更好地应对这一事件,降低风险,有哪些做法可以改进?对政府、学术组织和个人有哪些科学建议?本文探讨在如何保障人民健康安全的同时,降低经济和社会成本,并号召世界科学家参加"未来地球健康领域知识行动网络"计划。