Health Systems Strengthening to Tackle the Global Burden of Pediatric and Congenital Heart Disease: A Diagonal Approach

1 Background Congenital heart disease(CHD)is the most common major congenital anomaly,affecting approximately one in every 100 live births[1].Among congenital anomalies,66%of preventable deaths are due to CHD,and 58%of the avertable morbidity and mortality due to congenital anomalies would result from scaling congenital heart surgery services[2].Every year,nearly 300,000 children and adults die from CHD,the majority of whom live in low-and middle-income countries(LMICs)[3].Approximately 49%of all individuals with CHD will require surgical or interventional care at some point in their lifetime[4];as a result of advances in access to and the delivery of such services,over 95%of children born with CHD in high-income countries now live into adulthood[3].Here,adults have surpassed children in the number of CHD cases at a ratio of 2:1[5].

Evaluation of the Care of Children Aged 0 to 10 Years Hospitalized for Severe Malaria at the Tambacounda Health Center, Senegal

Introduction: Malaria remains a public health priority in Senegal, particularly in Tambacounda, where it is one of the main causes of child mortality. The objective of this work was to evaluate the care of children under 10 years of age hospitalized at the Tambacounda Health Center and the factors associated with recovery. Methods: An analytical, retrospective, and descriptive cross-sectional study with exhaustive recruitment of children 0 to 120 months hospitalized at the Tambacounda reference health center for severe malaria (according to WHO criteria) between 1 January 2018 and 31 December 2021 was performed. Data collection was done through a questionnaire. Records, hospitalization records, and treatment records were the sources of collection. Data entry and analysis were performed on Epi Info 7.2 and R. Results: A total of 481 children hospitalized with severe malaria were recruited. The highest number of cases was recorded in 2018 (33.05%). In the four years of the study, peaks were always observed between October and November and the highest peak in November 2020 with 95 cases. The mean age was 65.64 months with a standard deviation of 29.28 months and a predominance of male (53.43%). The majority of people were admitted from the outpatient clinic (57.79%) and the rest (42.21%) on the recommendation of a peripheral health post. All hospitalized patients had a positive RDT and/or a positive thick drop. However, the sharp decline at admission or during hospitalization was positive in 93.80% of patients in our series, negative in 5.20% and not achieved in 1.00%. Seizures and severe anemia topped the list of signs of severity with 45.94% and 8.11%, respectively. In terms of evolution, for all hospitalized patients, there were 81.29% recovery, 10.19% referral to the Tambacounda regional hospital center for hospitalization, 4.99% death, 0.83% discharge and 2.70% unknown evolution. There was a statistically significant association between recovery without referral from a health post (OR = 1.85), absence of 2 or more signs of severity (OR = 1.82), absence of seizures (OR = 1.51), prostration (OR = 2.78), cardiovascular shock (OR = 6.67), coma (OR = 7.69), lack of evidence of biological severity (OR = 3.70), and hypoglycemia with blood glucose less than 0.4 g/L (OR = 5.88). Conclusion: In addition to the routine malaria prevention and management strategies implemented in Tambacounda, and the early referral of cases of severe malaria from health posts to the health center, all children hospitalized for severe malaria with certain symptomatology such as coma, prostration, cardiovascular shock, etc. Seizures and/or hypoglycemia should be systematically referred to the regional hospital to increase their chance of recovery.

Impact of phytoconstituents on oral health practices:a post COVID-19 observation

Appropriate oral hygiene significantly reduces the possibility of oral infections.However,dental caries and periodontal diseases are major oral health issues causing chronic diseases due to poor oral health.Recently,herbal compounds have gained interest in maintaining oral health.Extracts of burdock root(Arctium),noni fruit(Morinda citrifolia),and neem leaf(Azadirachta indica)are now used as intracanal medicaments in endodontics and periodontics.Plectranthus amboinicus species and other plants produces essential oil likeβ-caryophyllene,p-cymene,andγ-terpinene can exhibit antibacterial activity;highlighting phytoconstituents plays a vital role in oral health.The COVID-19 pandemic highlighted the importance of hygiene and sanitization,to curb SARS-CoV-2.Oral cavity is among the gateways for virus entry into saliva.Saliva is a potential reservoir of SARS-CoV-2,and there is an increased risk of infection if there is any fissure in the mouth.This enables entry of virus into the vascular system through gingival or periodontal pocket,possibly reaching lung periphery then to lung vessels by interacting with endothelial surface receptors triggering pulmonary vasoconstriction and lung damage due to endothelial dysfunction.This review aims to draw attention to the possible route of SARS-CoV-2 infection via the oral cavity and the importance of oral hygiene against COVID-19.

Analysis of the Effect of Family-Centered Empowerment Model(FCEM)Health Education Through WeChat on Medication Compliance and Blood Pressure of Elderly Hypertensive Patients in Rural Areas

Objective: To validate the effectiveness of a Family-Centered Empowerment Model (FCEM) health education through WeChat on medication compliance and blood pressure among elderly hypertensive patients in rural areas. Methods: One hundred and two rural elderly hypertensive patients aged 65-80 years were selected and randomly divided into an experimental and control group of 51 each. The control group implemented conventional health education, and the experimental group implemented FCEM health education through WeChat platform for 4 consecutive weeks. The Therapeutic Adherence Scale for Hypertensive Patients (TASHP) scores and blood pressure measurements were compared between and within the two groups. Results: After the intervention, there were significant differences in medication compliance and blood pressure between the two groups (P < 0.001). In the control group, before and after the intervention, there was a significant difference in medication compliance (P < 0.001), but no significant difference in blood pressure (P > 0.05). In the experimental group, there were significant differences in medication compliance and blood pressure before and after the intervention (P < 0.001). Conclusion: The FCEM health education through an online social platform significantly improved medication compliance and led to effective blood pressure control in rural elderly hypertensive patients. Therefore, as an effective, safe, and economical model, it is also necessary to explore its effectiveness in improving health problems in other chronic diseases and other age groups.

Predictors of antenatal health service utilization among left-behind wives of male outmigrants:Evidence from Patna District,India

Objective:To analyze the sociological support system available for left-behind wives of male outmigrants and develop a model that predicts the antenatal care(ANC)services utilization.Methods:A cross-sectional survey was conducted in rural regions of the Patna district,India.The sample size(n=328)was estimated using Cochran’s formula.Five parameters of the social support system were identified(autonomy,spousal support,family support,social circle support,and government support).The score for each was calculated as a composite score using multiple variables;these served as independent variables.The respondents were categorized as efficient and non-efficient users of ANC service based on established criteria.Results:The regression results showed that four out of five social parameters had a significant effect on ANC behavior.Spousal support was the strongest predictor(standardized regression coefficient β=0.57,OR 1.16,95%CI 1.08-1.79,P=0.007).Government support was found to be the second strongest predictor(β=0.40,OR 1.49,95%CI 1.04-2.14,P=0.027),followed by family support(β=0.31,OR 1.36,95%CI 1.23-2.57,P=0.034)and autonomy(β=0.11,OR 1.32,95%CI 1.11-2.26,P=0.030).The social circle support was found to be non-significant in predicting ANC behavior(P>0.05).Conclusions:The policymakers could focus on the identified predictors to strengthen and modify the existing policies for leftbehind wives of male outmigrants.The need of the hour is a strategic intervention for behavioral modification of not only the left-behind wives but also their family members along with reinforcement of the existing social-security net.One strategy we suggest is to launch an awareness campaign focusing on husbands(male outmigrants)and family members.

Burden of gallstone disease in the United States population:Prepandemic rates and trends

BACKGROUND Gallstone disease is one of the most common digestive disorders in the United States and leads to significant morbidity,mortality,and health care utilization.AIM To expand on earlier findings and investigate prepandemic rates and trends in the gallstone disease burden in the United States using national survey and claims databases.METHODS The National Ambulatory Medical Care Survey,National Inpatient Sample,Nationwide Emergency Department Sample,Nationwide Ambulatory Surgery Sample,Vital Statistics of the United States,Optum Clinformatics®Data Mart,and Centers for Medicare and Medicaid Services Medicare 5%Sample and Medicaid files were used to estimate claims-based prevalence,medical care including cholecystectomy,and mortality with a primary or other gallstone diagnosis.Rates were age-adjusted(for national databases)and shown per 100000 population.RESULTS Gallstone disease prevalence(claims-based,2019)was 0.70%among commercial insurance enrollees,1.03%among Medicaid beneficiaries,and 2.09%among Medicare beneficiaries and rose over the previous decade.Recently,in the United States population,gallstone disease contributed to approximately 2.2 million ambulatory care visits,1.2 million emergency department visits,625000 hospital discharges,and 2000 deaths annually.Women had higher medical care rates with a gallstone disease diagnosis,but mortality rates were higher among men.Hispanics had higher ambulatory care visit and hospital discharge rates compared with Whites,but not mortality rates.Blacks had lower ambulatory care visit and mortality rates,but similar hospital discharge rates compared with whites.During the study period,ambulatory care and emergency department visit rates with a gallstone disease diagnosis rose,while hospital discharge and mortality rates declined.Among commercial insurance enrollees,rates were higher compared with national data for ambulatory care visits and hospitalizations,but lower for emergency department visits.Cholecystectomies performed in the United States included 605000 ambulatory laparoscopic,280000 inpatient laparoscopic,and 49000 inpatient open procedures annually.Among commercial insurance enrollees,rates were higher compared with national data for laparoscopic procedures.CONCLUSION The gallstone disease burden in the United States is substantial and increasing,particularly among women,Hispanics,and older adults with laparoscopic cholecystectomy as the mainstay treatment.Current practice patterns should be monitored for better health care access.

Association between Serum Uric Acid and the Early Marker of Kidney Function Decline among Chinese Middle-Aged and Older Population:Evidence from the China Health and Retirement Longitudinal Study

Objective To evaluate the association between serum uric acid(SUA)and kidney function decline.Methods Data was obtained from the China Health and Retirement Longitudinal Study on the Chinese middle-aged and older population for analysis.The kidney function decline was defined as an annual estimated glomerular filtration rate(e GFR)decrease by>3 mL/min per 1.73 m^(2).Multivariable logistic regression was applied to determine the association between SUA and kidney function decline.The shape of the association was investigated by restricted cubic splines.Results A total of 7,346 participants were included,of which 1,004 individuals(13.67%)developed kidney function decline during the follow-up of 4 years.A significant dose-response relation was recorded between SUA and the kidney function decline(OR 1.14,95%CI 1.03-1.27),as the risk of kidney function decline increased by 14%per 1 mg/d L increase in SUA.In the subgroup analyses,such a relation was only recorded among women(OR 1.22,95%CI 1.03-1.45),those aged<60 years(OR 1.22,95%CI 1.05-1.42),and those without hypertension and without diabetes(OR 1.22,95%CI 1.06-1.41).Although the dose-response relation was not observed in men,the high level of SUA was related to kidney function decline(OR 1.83,95%CI 1.05-3.17).The restricted cubic spline analysis indicated that SUA>5 mg/dL was associated with a significantly higher risk of kidney function decline.Conclusion The SUA level was associated with kidney function decline.An elevation of SUA should therefore be addressed to prevent possible kidney impairment and dysfunction.

Evaluation of Attitudes of Family Physicians toward Occupational Health and Occupational Diseases in Türkiye

Background/Aim: This study evaluated family physicians’ attitudes toward occupational health and disease in Türkiye. Materials and Methods: The study is cross-sectional and descriptive in a quantitative research design. The “Attitude Scale for Physicians toward Occupational Health and Occupational Diseases” developed by Kolcu et al. was used in the study (Cronbach’s α 0.94). Our study aimed to sample the entire country using the stratified sample selection based on geographical region. 349 family physicians were included in the study according to sample size (n: 349). Results: The mean age of the participants in the study was 37.77 ± 8.96 (min: 27, max: 65 years). Of the participants, 65.2% were male. Of the physicians, 33.8% were family medicine specialists, and 38.8% had occupational physician certificates. It was determined that the level of attitude of family physicians toward occupational diseases was insufficient. It was also found that awareness increased as age increased, and awareness and attitude levels did not change according to gender. No significant difference was found in the scale total scores and subdimensions of family physicians’ occupational health and occupational disease attitudes according to the regions they worked in Türkiye. Conclusion: It has been concluded that there is no difference in awareness among family physicians in regions where it is much more important to diagnose an occupational disease, especially in industrial regions. The number of family physicians with occupational physician certificates was very insufficient, and a significant number of those who had occupational physician certificates did not practice occupational medicine.

Surveillance of Surgical Site Infections: A Public Health Emergency in a Regional Hospital of Northern Benin. A Prospective Observational Pilot Study

Background: Surgical site infections (SSIs) are considered as result of the healthcare quality in hospitals. Objective: to study SSI at Saint Jean de Dieu Hospital Tanguieta (SJDHT), prior to the implementation of a permanent monitoring system. Method: transversal, and descriptive study with prospective data collection was performed from 1 July to 31 janvier 2017 in the department of general surgery of SJDHT. The hospital lacks in a microbiology unit. All patients who underwent surgery during this period were included and the monitoring lasted one month. SSIs diagnostic was carried out according to WHO criteria as described in the Practical Guide for the Prevention of Nosocomial Infections published in 2002. Statistical tests (χ-square and Student’s t-test) were applied and p 0.05 were statistically significant. Results: Of 343 patients recorded, 105 (30.6%) had SSI. Their age averaged 40.3 years and the sex-ratio (men/women) was 2.8. The emergency surgery resulted in a 50.0% rate of SSI (p = 0.00). The SSI rate for clean and clean-contaminated surgery was 6.3% against 94.6% for infected surgery (p = 0.00). The SSI rates were 100% and 66.7% for NNISS = 2 and NNISS = 1 (p = 0.00), respectively. Superficial SSI rate was 13.3%, while deep SSI and organ/space SSI were 46.7% and 40%, respectively. The hospital stay of patients with SSI was three times longer than the length of patients without SSI (p = 0.00). Conclusion: SSIs are real burden at SJDHT. Appropriate measures must be adopted to reduce its prevalence.

Role of lysosomal trafficking regulator in autophagic lysosome reformation in neurons:a disease perspective

Lysosomes are discrete organelles that act as recycling centers for extracellular and intracellular materials,playing a pivotal role in maintaining cellular homeostasis.Their acidic environment,maintained by numerous hydrolytic enzymes,facilitates substrate degradation.Dysfunction in lysosomal processes can lead to abnormal substrate degradation,significantly impacting cellular homeostasis.High energy-demanding cells,such as post-mitotic neurons,are especially vulnerable to these changes,often resulting in neurological diseases.Autophagy,a conserved catabolic process,requires extensive lysosomal utilization.It plays a key role in removing unnecessary intracellular components,ensuring cellular homeostasis,and promoting cell survival during stress conditions such as starvation,infection,or cellular damage.

Coupling Analysis of Multiple Machine Learning Models for Human Activity Recognition

Artificial intelligence(AI)technology has become integral in the realm of medicine and healthcare,particularly in human activity recognition(HAR)applications such as fitness and rehabilitation tracking.This study introduces a robust coupling analysis framework that integrates four AI-enabled models,combining both machine learning(ML)and deep learning(DL)approaches to evaluate their effectiveness in HAR.The analytical dataset comprises 561 features sourced from the UCI-HAR database,forming the foundation for training the models.Additionally,the MHEALTH database is employed to replicate the modeling process for comparative purposes,while inclusion of the WISDM database,renowned for its challenging features,supports the framework’s resilience and adaptability.The ML-based models employ the methodologies including adaptive neuro-fuzzy inference system(ANFIS),support vector machine(SVM),and random forest(RF),for data training.In contrast,a DL-based model utilizes one-dimensional convolution neural network(1dCNN)to automate feature extraction.Furthermore,the recursive feature elimination(RFE)algorithm,which drives an ML-based estimator to eliminate low-participation features,helps identify the optimal features for enhancing model performance.The best accuracies of the ANFIS,SVM,RF,and 1dCNN models with meticulous featuring process achieve around 90%,96%,91%,and 93%,respectively.Comparative analysis using the MHEALTH dataset showcases the 1dCNN model’s remarkable perfect accuracy(100%),while the RF,SVM,and ANFIS models equipped with selected features achieve accuracies of 99.8%,99.7%,and 96.5%,respectively.Finally,when applied to the WISDM dataset,the DL-based and ML-based models attain accuracies of 91.4%and 87.3%,respectively,aligning with prior research findings.In conclusion,the proposed framework yields HAR models with commendable performance metrics,exhibiting its suitability for integration into the healthcare services system through AI-driven applications.

Global collaboration of eye research--personal experience

On December 9,2023,I was privileged to be honored and participate in the Dr.Chi Chao Chan Symposium on Global Collaboration of Eye Research as the Global Eye Genetic Consortium(GEGC)session,which was held in the 16th Congress of the Asia-Pacific Vitreo-Retina Society(APVRS)in Hong Kong.Along with my talk on“Global collaboration of eye research:personal experience”,other prominent international speakers provided their own perspectives on opportunities for networking,collaboration,and exchange of ideas with global leaders and experts in ophthalmic practice,research,and education.

New glucocerebrosidase antibodies can advance research in the field of neurodegenerative disorders

In medical research,there are times when the introduction of a new tool can launch scientific discovery in new directions.While antibody development may be considered mundane,in the field of glucocerebrosidase(GCase)research,the dearth of validated antibodies for different applications has impeded progress in studies of disease pathogenesis and therapeutic development.The recent introduction of new,rigorously evaluated antibodies can now propel research into the link between glucocerebrosidase and Parkinson’s disease(PD)as well as aspects of the pathobiology of Gaucher disease(Jong et al.,2024).

Promotion of structural plasticity in area V2 of visual cortex prevents against object recognition memory deficits in aging and Alzheimer's disease rodents

Memory deficit,which is often associated with aging and many psychiatric,neurological,and neurodegenerative diseases,has been a challenging issue for treatment.Up till now,all potential drug candidates have failed to produce satisfa ctory effects.Therefore,in the search for a solution,we found that a treatment with the gene corresponding to the RGS14414protein in visual area V2,a brain area connected with brain circuits of the ventral stream and the medial temporal lobe,which is crucial for object recognition memory(ORM),can induce enhancement of ORM.In this study,we demonstrated that the same treatment with RGS14414in visual area V2,which is relatively unaffected in neurodegenerative diseases such as Alzheimer s disease,produced longlasting enhancement of ORM in young animals and prevent ORM deficits in rodent models of aging and Alzheimer’s disease.Furthermore,we found that the prevention of memory deficits was mediated through the upregulation of neuronal arbo rization and spine density,as well as an increase in brain-derived neurotrophic factor(BDNF).A knockdown of BDNF gene in RGS14414-treated aging rats and Alzheimer s disease model mice caused complete loss in the upregulation of neuronal structural plasticity and in the prevention of ORM deficits.These findings suggest that BDNF-mediated neuronal structural plasticity in area V2 is crucial in the prevention of memory deficits in RGS14414-treated rodent models of aging and Alzheimer’s disease.Therefore,our findings of RGS14414gene-mediated activation of neuronal circuits in visual area V2 have therapeutic relevance in the treatment of memory deficits.

Nanocarrier-mediated siRNA delivery:a new approach for the treatment of traumatic brain injury-related Alzheimer's disease

Traumatic brain injury and Alzheimer's disease share pathological similarities,including neuronal loss,amyloid-βdeposition,tau hyperphosphorylation,blood-brain barrier dysfunction,neuroinflammation,and cognitive deficits.Furthermore,traumatic brain injury can exacerbate Alzheimer's disease-like pathologies,potentially leading to the development of Alzheimer's disease.Nanocarriers offer a potential solution by facilitating the delive ry of small interfering RNAs across the blood-brain barrier for the targeted silencing of key pathological genes implicated in traumatic brain injury and Alzheimer's disease.U nlike traditional approaches to neuro regeneration,this is a molecula r-targeted strategy,thus avoiding non-specific drug actions.This review focuses on the use of nanocarrier systems for the efficient and precise delive ry of siRNAs,discussing the advantages,challenges,and future directions.In principle,siRNAs have the potential to target all genes and non-targetable protein s,holding significant promise for treating various diseases.Among the various therapeutic approaches currently available for neurological diseases,siRNA gene silencing can precisely"turn off"the expression of any gene at the genetic level,thus radically inhibiting disease progression;however,a significant challenge lies in delivering siRNAs across the blood-brain barrier.Nanoparticles have received increasing attention as an innovative drug delive ry tool fo r the treatment of brain diseases.They are considered a potential therapeutic strategy with the advantages of being able to cross the blood-brain barrier,targeted drug delivery,enhanced drug stability,and multifunctional therapy.The use of nanoparticles to deliver specific modified siRNAs to the injured brain is gradually being recognized as a feasible and effective approach.Although this strategy is still in the preclinical exploration stage,it is expected to achieve clinical translation in the future,creating a new field of molecular targeted therapy and precision medicine for the treatment of Alzheimer's disease associated with traumatic brain injury.

Prevention of ventilator-associated pneumonia with inhaled antibiotics

The direct delivery of inhaled antibiotics to the respiratory tract has been a subject of enduring interest among medical practitioners and researchers due to the associated favorable pharmacokinetics.This interest has been particularly pronounced in the context of critically illpatients,wherehealthcare-associatedpulmonary infections represent a significant challenge,driving continued exploration of inhaled antibiotics for intubated patients.Recent high-level evidence has shown a very promising application in the field of ventilator-associated pneumonia (VAP) prevention.^([1]).

Effects of Curcumin on Neuroinflammation and the Nrf2/HO-1 Pathway in Rat Brains Following Gas Explosion

Gas explosions,a major occupational hazard in China’s coal industry,endanger the lives and health of miners.These explosions cause a specific type of traumatic brain injury with complex mechanisms,leading to disability and death.A study by Zhao et al.using magnetic resonance imaging on 49 gas explosion survivors revealed significant damage to brain regions like the hippocampus and cerebral cortex.

Changes in structural plasticity of hippocampal neurons in an animal model of multiple sclerosis

Structural plasticity is critical for the functional diversity of neurons in the brain.Experimental autoimmune encephalomyelitis(EAE)is the most commonly used model for multiple sclerosis(MS),successfully mimicking its key pathological features(inflammation,demyelination,axonal loss,and gliosis)and clinical symptoms(motor and non-motordysfunctions).Recentstudieshave demonstrated the importance of synaptic plasticity in EAE pathogenesis.In the present study,we investigated the features of behavioral alteration and hippocampal structural plasticity in EAE-affected mice in the early phase(11 days post-immunization,DPI)and chronic phase(28DPI).EAE-affected mice exhibited hippocampus-related behavioral dysfunction in the open field test during both early and chronic phases.Dendritic complexity was largely affected in the cornu ammonis 1(CA1)and CA3 apical and dentate gyrus(DG)subregions of the hippocampus during the chronic phase,while this effect was only noted in the CA1 apical subregion in the early phase.Moreover,dendritic spine density was reduced in the hippocampal CA1 and CA3 apical/basal and DG subregions in the early phase of EAE,but only reduced in the DG subregion during the chronic phase.Furthermore,mRNA levels of proinflammatory cytokines(Il1β,Tnfα,and Ifnγ)and glial cell markers(Gfap and Cd68)were significantly increased,whereas the expression of activity-regulated cytoskeletonassociated protein(ARC)was reduced during the chronic phase.Similarly,exposure to the aforementioned cytokines in primary cultures of hippocampal neurons reduced dendritic complexity and ARC expression.Primary cultures of hippocampal neurons also showed significantly reduced extracellular signal-regulated kinase(ERK)phosphorylation upon treatment with proinflammatory cytokines.Collectively,these results suggest that autoimmune neuroinflammation alters structural plasticity in the hippocampus,possibly through the ERK-ARC pathway,indicating that this alteration may be associated with hippocampal dysfunctions in EAE.

Navigating the labyrinth of long non-coding RNAs in colorectal cancer:From chemoresistance to autophagy

Long non-coding RNAs(lncRNAs),with transcript lengths exceeding 200 nucleotides and little or no protein-coding capacity,have been found to impact colorectal cancer(CRC)through various biological processes.LncRNA expression can regulate autophagy,which plays dual roles in the initiation and progression of cancers,including CRC.Abnormal expression of lncRNAs is associated with the emergence of chemoresistance.Moreover,it has been confirmed that targeting autophagy through lncRNA regulation could be a viable approach for combating chemoresistance.Two recent studies titled“Human β-defensin-1 affects the mammalian target of rapamycin pathway and autophagy in colon cancer cells through long non-coding RNA TCONS_00014506”and“Upregulated lncRNA PRNT promotes progression and oxaliplatin resistance of colorectal cancer cells by regulating HIPK2 transcription”revealed novel insights into lncRNAs associated with autophagy and oxaliplatin resistance in CRC,respectively.In this editorial,we particularly focus on the regulatory role of lncRNAs in CRC-related autophagy and chemoresistance since the regulation of chemotherapeutic sensitivity by intervening with the lncRNAs involved in the autophagy process has become a promising new approach for cancer treatment.

Prevalence and intensity of urinary schistosomiasis and soil-transmitted helminths among women of reproductive age in Mwaluphamba,Kwale

Objective:To assess the epidemiology of urinary schistosomiasis and soil-transmitted helminthiasis among women of reproductive age in Mwaluphamba,Kwale County,Kenya.Methods:A community-based cross-sectional study design was employed to randomly sample 422 women of reproductive age(15-<50 years)from four villages in Mwaluphamba location.Stool specimens were collected and examined using the Kato-Katz method,while filtration technique was used to analyze urine specimens.Participants’sociodemographic details were obtained using a standardized questionnaire.Results:Urinary schistosomiasis prevalence was at 4.7%(20/422,95%CI 2.8%-6.9%)while the prevalence of soil-transmitted helminthiasis infection was 4.5%(19/422,95%CI 2.6%-6.7%).The infection intensities of urinary schistosomiasis among the study participants ranged from 1 to 120 eggs/10 mL of urine with median egg count of 18.45 eggs/10 mL.The patients were diagnosed with light infection,of 56.16 egg/gram and 48.48 egg/gram for Trichuris trichiura and hookworms,respectively.Women without latrines had 15.7 times higher risk of having urinary schistosomiasis compared to those with a latrine.Similarly,use of surface water(aOR=1.0,95%CI 0.2-1.4,P=0.010)and crossing the river to go to a place(aOR=1.1,95%CI 0.3-1.6,P=0.009)were statistically significant risk factors for getting urinary schistosomiasis.In bivariable regression analysis,defecating around the water source(OR=4.3,95%CI 1.5-12.9)had a statistically significant association with the prevalence of soil-transmitted helminthiasis(P=0.008).Conclusions:This study has given an insight on the prevalence and intensity of urinary schistosomiasis and soil-transmitted helminthiasis in Mwaluphamba location that form a basis for strengthening the control and elimination programmes for these neglected tropical diseases.