Development of a telehealth monitoring service after colorectal surgery:A feasibility study

AIM To evaluate the feasibility of a text-messaging system to remotely monitor and support patients after discharge following elective colorectal surgery,within an enhanced recovery protocol.METHODS Florence(FLO) is a National Health Service telehealth solution utilised for monitoring chronic health conditions,such as hypertension,using text-messaging.Newalgorithms were designed to monitor the well-being,basic physiological observations and any patient-reported symptoms,and provide support messages to patients undergoing colorectal surgery within an enhanced recovery after surgery protocol for 30 d after discharge.All interactions with FLO and physiological readings were recorded and patients were invited to provide feedback.RESULTS Over a four-week period,16 out of 17 patients used the FLO telehealth service at home.These patients did not receive telephone follow-up at three days,as per our standard protocol,unless they reported being unwell or did not make use of the technology.Three patients were readmitted within 30 d,and two of these were identified as being unwell by FLO prior to readmission.No adverse events attributable to the use of the technology were encountered.CONCLUSION The utilisation of telehealth in the early follow-up of patients who have undergone major colorectal surgery after discharge is feasible.The use of this technology may assist in the early recognition and management of complications after discharge.

Impact of mechanical bowel preparation in elective colorectal surgery:A meta-analysis

AIM To analyse the effect of mechanical bowel preparation vs no mechanical bowel preparation on outcome in patients undergoing elective colorectal surgery.METHODS Meta-analysis of randomised controlled trials and observational studies comparing adult patients receiving mechanical bowel preparation with those receiving no mechanical bowel preparation, subdivided into those receiving a single rectal enema and those who received no preparation at all prior to elective colorectal surgery. RESULTS A total of 36 studies(23 randomised controlled trials and 13 observational studies) including 21568 patients undergoing elective colorectal surgery were included. When all studies were considered, mechanical bowel preparation was not associated with any significant difference in anastomotic leak rates(OR = 0.90, 95%CI: 0.74 to 1.10, P = 0.32), surgical site infection(OR = 0.99, 95%CI: 0.80 to 1.24, P = 0.96), intraabdominal collection(OR = 0.86, 95%CI: 0.63 to 1.17, P = 0.34), mortality(OR = 0.85, 95%CI: 0.57 to 1.27, P = 0.43), reoperation(OR = 0.91, 95%CI: 0.75 to 1.12, P = 0.38) or hospital length of stay(overall mean difference 0.11 d, 95%CI:-0.51 to 0.73, P = 0.72), when compared with no mechanical bowel preparation, nor when evidence from just randomized controlledtrials was analysed. A sub-analysis of mechanical bowel preparation vs absolutely no preparation or a single rectal enema similarly revealed no differences in clinical outcome measures. CONCLUSION In the most comprehensive meta-analysis of mechanical bowel preparation in elective colorectal surgery to date, this study has suggested that the use of mechanical bowel preparation does not affect the incidence of postoperative complications when compared with no preparation. Hence, mechanical bowel preparation should not be administered routinely prior to elective colorectal surgery.

Demonstration of malaria situation analysis,stratification and planning in Minab District,southern Iran

Objective:To demonstrate malaria situation analysis,stratification and planning for an endemic area in southern Iran.Methods:Data on health system,population,meteorological parameters, malaria cases,anopheline vectors,and control activities during 2005-2007 was obtained from Minab Health Center,Minab Meteorological Station and published documents about malaria elements in the study area.A datasheet was created in excel 2003 for analysis.Results:There were 644 health staff working in Minab District including 99 health staff in malaria control program.The health facilities are distributed as follow:1 hospital with 96 beds,23 health centers including private centers(10 in Minab city and 13 in rural area of Minab District) and 119 health houses in rural areas of Minab District.Anopheles stephensi was the dominant species in Minab District,however,Anopheles dthali,Anopheles superpictus,Anopheles fluviatilis,Anopheles multicolor,Anopheles pulcherrimus and Anopheles turkhudi can also be found in the area. Anopheles stephensi was reported susceptible to malathion,propoxur,primphos-methyl,lambdacyhalothrin permethrin and deltamethrin,and resistant to DDT and dieldrin in the area.During the study period a total of 10 665 positive cases were reported,mainly due to local transmission (99.6%).Plasmodium vivax was the main causative agent followed by Plasmodium falciparum. There were reports about drug resistance of Plasmodium falciparum in the area.Conclusions: Using different parameters,Minab was classified into 3 strata.A plan was designed based on described goal,objectives and targets.The approaches of this plan were categorized into:health education,early detection and correct treatment,and vector control.Main constraints of these approaches are population movement between Iran,Pakistan and Afghanistan;vector control challenges at district,inadequate skilled medical staff in malaria case management and weak inter-sectorial coordination for malaria control,especially in urban areas.

Environmental characteristics of anopheline mosquito larval habitats in a malaria endemic area in Iran

Objective:To determine the effects of environmental parameters of lanal habitats on distribution and abundance of anopheline mosquitoes in Rudan county of Iran.Methods:This cross-sectional study was conducted during the mosquito breeding season from February 2010 to October 2011. The anopheline larvae were collected using the standard dipping method,the specimens were identified using a morphological-based key.Simultaneously with larvay collection,environmental parameters of the larval habitats including water current and turbidity,sunlight situation,and substrate type of habitats were recorded.Water samples were taken from breeding sites during lanal collection.Before collection of samples,the water temperature was measured.The water samples were analysed for turbidity,conductivity,total alkalinity,total dissolved solid.pH and ions including chloride,sulphate,calcium,and magnesium.Statistical correlation analysis and ANOVA test were used to analyze the association between environmental parameters and larval mosquito abundance.Results:In total 2 973 lanae of the genus Anopheles were collected from 25 larval habitats and identified using morphological characters.They comprised of six species: An.dthali(53.21%),An.stephensi(24.22%),An.culicifacies(14.06%),An.superpictus(4.07%),An. turkhudi(3.30%),and An.apoci(1.14%).The most abundant species was An.dthali which were collected from all of the study areas.Larvae of two malaria vectors.An.dthali and An.stephensi, co-existed and collected in a wide range of habitats with different physico-chemical parameters. The most common larval habitats were man-made sites such as sand mining pools with clean and still water.The anopheline mosquitoes also preferred permanent habitats in sunlight with sandy substrates.The results indicated that there was a significant relationship between mean physicochemical parameters such as water temperature,conductivity,total alkalinity,sulphate,chloride, and mosquito distribution and abundance.Conclusions:The results of this study showed a correlation between certain environmental parameters and mosquito lanae abundance,and these parameters should be considered in planning and implementing larval control programs.

Visceral leishmaniasis among children in an endemic area of northwestern Iran between 2016 and 2017: An epidemiological study

Objective: To clarify the epidemiological aspects of visceral leishmaniasis in Kaleybar and Khoda-Afarin districts, north-west of Iran.Methods: A total of 1 420 human(children under 12 years) samples, 101 domestic dogs samples(Canis familiaris), and 577 female sand fly samples were collected. Sera of human and dogs were tested using the direct agglutination test, and sand flies were identified at species level using the microscopic method. Furthermore, a structured questionnaire was applied to evaluate the correlation between the potential risk factors and the related clinical signs/symptoms with the human and dogs’ seropositivity.Results: Totally, 2.18% of human samples were positive at titers≥1: 800;among them, 13 cases(41.94%) were above 1:3 200, and clinical symptoms were observed in all of them except for an 11-year old girl. Anti-Leishmania infantum antibodies were found at titer≥1: 320 in 9.90% of dogs’ samples, half of them had at least one sign of canine visceral leishmaniasis. Moreover, 10 Phlebotomus species were identified in the study areas, and Phlebotomus(Larroussius) major group was the predominant species. There are significant correlations between the presence of anti-Leishmania infantum antibodies and the fever(P<0.001), anemia(P=0.001) and weight loss(P=0.016) in children. On the other hand, significant correlations were revealed between the Leishmania infection and the shelter(P=0.039), cutaneous lesion(P=0.005), lymphadenopathy(P=0.001) and weight loss(P<0.001) in the infected dogs.Conclusions: Visceral Leishmania infection is prevalent in rural areas of Kaleybar and KhodaAfar districts located in East-Azerbaijan province, therefore active detection and treatment of visceral leishmaniasis cases should not be neglected.

Molecular characterization of sandflies and Leishmania detection in main vector of zoonotic cutaneous leishmaniasis in Abarkouh district of Yazd province,Iran

Ohjective:To assess molecular characterization,distribution,seasonal activities of sandfly species and Leishmania parasites infecting them for this zoonotic cutaneous leishmaniasis focus.Methods:The collections were carried out in 2009-2011 using CDC traps,Sticky Papers and manual aspirator in and around the villages in Abarkouh district.Individual sandflies were characterized by PCR amplification and sequencing of fragments of their mitochondrial cytochrome b gene.Leishmania parasite infections within sandflies were performed by targeting Cyt b,ITS-rDNA,k-DNA and microsatellite genes.Results:The PCR assays detected only Leishmania major(L.major).All infections(30)were found in the abundant and widespread vector Phlebolomus papalasi(P.papatasi).Small numbers of other sandfly species were also screened for infections,but none was found.Sergentomyia sinloni and P.papalasi were the predominant members in all locations of this district and in all habitats throughout the trapping season.Only five other sandfly species were found,namely Phlebolomus ansari,Phlebotomus caucasicus,Phlebotomus sergenti,Sergentomyia dentata and Sergentomyia merviney.Conclusions:In the current survey,the only infections detected are of L.major in females of P.papatasi(30 out of190).The rates of infection of P.papalasi by L.major are not significantly different in compare with other locations in Iran with no diversity of parasite strains.Zoonotic cutaneous leishmaniasis may have emerged only recently in Abarkouh district,and the reason may well be the instability of the transmission cycles there.

Pharmacological aspects of fisetin

Over the past decades,epidemiological studies have concluded that a diet rich in plant-derived products plays a pivotal role in human health.Fisetin(3,3’,4’,7-tetrahydroxyflavone)is a hydrophobic polyphenolic compound primarily found in edible plants(e.g.strawberry,blueberry,apple,grape,persimmon,kiwi,and cucumber).Various preclinical studies have revealed that fisetin exhibits a wide range of pharmacological effects such as antioxidant,antiinflammatory,anti-carcinogenic,anti-osteoporotic,antimicrobial,and anti-diabetic properties.Therefore,the pharmacological in vitro and in vivo studies on fisetin are discussed in this review.Additionally,this review would be useful for further study regarding the potential of natural products,notably fisetin,and its therapeutic potential for the prevention and treatment of diseases.

Bioassay evaluation on the efficacy of a-cypermethrin impregnated into long lasting insecticide treated nets using Anopheles stephensi

Objective:To evaluate the bioefficacy ofα-cypermethrin impregnated into long lasting insecticide treated nets(LLITNs- INTERCEPTOR?) against main malaria vector,Anopheles stephensi（An.stephensi）.Methods:The effectiveness of bed net impregnated withα-cypermethrin(INTERCEPTOR?) with washing was evaluated.The washing procedure and bioassay tests were carried out according to the WHO-recommended methods.Malaria vector, An.stephensi was exposed to impregnated bed net for three minutes and then mortality measured after 24 h recovery period.Knockdown was also measured according to the logarithmic times. Results:Result of cone bioassay method showed that bioefficacy ofα-cypermethrin decreased from 100%in unwashed to 15%in 20 washes.KT50 was measure as one minute in one wash and increased to 40 min in 20 washes.Discussion:Findings of this study provide guideline for malaria vector control authorities and people using pyrethroid-impregnated bed nets.

Removal of Reactive Red 198 from aqueous solution by combined method multi-walled carbon nanotubes and zero-valent iron:Equilibrium,kinetics,and thermodynamic

Dyes often include toxic,carcinogenic compounds and are harmful to humans' health.Therefore,removal of dyes from textile industry wastewater is essential.The present study aimed to evaluate the efficiency of the combination of zero valent iron(ZVI) powder and multi-walled carbon nanotubes(MWCNTs) in the removal of Reactive Red 198(RR198) dye from aqueous solution.This applied research was performed in a batch system in the laboratory scale.This study investigated the effect of various factors influencing dye removal,including contact time,p H,adsorbent dose,iron powder dose,initial dye concentration,and temperature.The equilibrium adsorption data were analyzed using three common adsorption models:Langmuir,Freundlich and Temkin.Besides,kinetic and thermodynamic parameters were used to establish the adsorption mechanism.The results showed,in pH =3,contact time = 100 min,ZVI dose = 5000 mg·L^(-1),and MWCNTs dose = 600 mg·L^(-1)in 100 mg·L^(-1)dye concentration,the adsorption efficiency increased to 99.16%.Also,adsorption kinetics was best described by the pseudo-second-order model.Equilibrium data fitted well with the Freundlich isotherm(R2= 0.99).The negative values of ΔG0and the positive value of ΔH0(91.76) indicate that the RR198 adsorption process is spontaneous and endothermic.According to the results,the combination of MWCNTs and ZVI was highly efficient in the removal of azo dyes.

人神经黑色素过度激活小胶质细胞：多巴胺能神经细胞进行性变性的新机制

目的探讨小胶质细胞在中脑黑质致密带(SNpc)人神经黑色素(HNM)导致多巴胺(DA)能神经细胞变性中的作用和机制。方法(1)采用HNM处理中脑胶质细胞重组培养体系,检测DA能神经细胞摄取能力,探讨小胶质细胞对HNM损伤作用的影响。(2)采用小胶质细胞培养体系,通过免疫细胞化学染色、检测免疫炎性及神经毒性因子,从功能及形态上研究HNM对小胶质细胞的激活作用。结果(1)经5.0μg/mL HNM干预后10%、20%和30%小胶质细胞重组培养体系DA能神经细胞摄取能力分别为纯神经细胞培养体系(对照组)的58%、51%和35%,与对照组比较差异有统计学意义(P<0.05);40%、50%和60%星形胶质细胞重组培养体系中DA能神经细胞摄取能力分别为对照组的97%、92%和93%,与对照组比较差异无统计学意义(P>0.05)。(2)经5.0μg/mLHNM干预后中脑神经-胶质细胞混合培养体系中激活的小胶质细胞数为对照组的5.77倍(P<0.05),小胶质细胞体积明显增大,形状不规则,呈棒状和/或阿米巴样,胞浆深染。(3)经5.0μg/mLHNM干预后小胶质细胞产生大量的细胞内活性氧类物质、一氧化氮、肿瘤坏死因子α、白细胞介素1β和前列腺素E2,与对照组比较差异均具有统计学意义(P<0.05)。结论HNM从功能及形态上激活小胶质细胞,促进了DA能神经细胞的进行性变性,为抑制小胶质细胞过度激活成为治疗PD的新靶点提供了一定理论依据。

Effectiveness and Safety of Chinese Medicine at Shenque(CV 8)for Primary Dysmenorrhea:A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background:Primary dysmenorrhea(PD)is the most common complaint associated with menstruation and affects up to three-quarters of women at some stage of their reproductive life.In Chinese medicine,navel therapy,treatment provided at Shenque(CV 8),is used as a treatment option for PD.Objective:To evaluate the effect of navel therapy on pain relief and quality of life in women with PD,compared with Western medicine(WM).Methods:China National Knowledge Infrastructure(CNKI),Chinese Scientific Journal Database(VIP),Sino Med and Wanfang Database,MEDLINE,the Cochrane Library,Embase,Web of Science,and the International Clinical Trial Registry of the U.S.National Institutes of Health were searched from their inceptions to April 1,2021.Randomized controlled trials(RCTs)assessing therapeutic effects of navel therapy on PD were eligible for inclusion.Rev Man 5.4 software was used for data analyses.The certainty of the evidence was assessed using the online GRADEpro tool.Results:Totally 24 RCTs involving 2,614 participants were identified.Interventions applied to acupuncture point CV 8 included:herbal patching,moxibustion or combined navel therapy(using at least 2 types of stimulation).Compared to placebo,there was a significant effect in favor of navel therapy on reducing overall menstrual symptom scores at the end of treatment[mean difference:-0.82,95%confidence interval(CI):-1.00 to-0.64,n=90;1 RCT].As compared with Western medicine,navel therapy had a superior effect on pain intensity as assessed by Visual Analogue Scale at the end of treatment[standardized mean difference(SMD):-0.64,95%CI:-1.22 to-0.06,I^(2)=80%,n=262;3 RCTs];on symptom resolution rate at 3-month follow-up(risk ratio:1.94,95%CI:1.47 to 2.56,n=1527,I^(2)=38%;13 RCTs);and on global menstrual symptoms score at the end of treatment(SMD:-0.67,95%CI:-0.90 to-0.45,I^(2)=63%,n=990;12 RCTs).Subgroup analyses showed either a better or an equivalent effect comparing navel therapy with Western medicine.No major adverse events were reported.The methodological quality of included trials was poor overall.Conclusions:Navel therapy appears to be more effective than Western medicine in decreasing menstrual pain and improving overall symptoms of PD.However,these findings need to be confirmed by well-designed clinical trials with adequate sample size(Systematic review registration at PROSPERO,No.CRD42021240350).

用荧光剂Fura-2连续测定大鼠泪腺细胞胞浆内Ca^(2+)浓度的变化

普遍认为，激素及神经递质对细胞作用的机理涉及到胞内CA^(2+)浓度的改变。

Malaria stratification in a malarious area,a field exercise

Objective:To conducted a spatial analysis for stratification of priority malaria control areas in Kahnuj County,as part of field exercise.Methods:Information of Health Centers of Kahnuj County has been used for stratification retrospectively.A knowledge,attitudes and practices(KAP) study was arranged to provide preliminary information about the knowledge,attitude and practice related to malaria in the area.Results:Numbers of malaria cases has been decreased in year 2008.There were five important vectors of malaria in this region including:Anopheles stephensi (An.stephensi),Anopheles dthali(An.dthali).Anopheles superpictus(An.superpictus),Anophels culicifacies(An.culicifacies),and Anopheles Jluviatilis(An.Jluviatilis),but majority of malaria cases in this county was related to Plasmodium vivax(P.vivax).Educational levels of community were 38% ,20% ,10% and 32% for illiterate,primary,secondary and university levels,respectively. KAP study revealed that about 37% of people have got malaria at least once and only 27% of people knew that mosquito is the vector of malaria.Conclusions:Malaria in Kahnuj represents a real threat.Transmission occurs in city center.An.stephensi can be suspected for the first peak of malaria cases in late spring in Kahnuj city.An.jluviatilis has a relatively high density in autumn while two malaria cases due to P.falciparum were reported in 2008.Based on KAP study,the knowledge of respondents seems good but the attitude and practice is low.According to the data such as API,main malaria vector,transmission rate,and foreign migrants,the Kahnuj County has been spatially divided into three strata based on various characteristics.The authorities should implement all the interventions based on stratification.

Measures of intracranial compartments in acute intracerebral haemorrhage:data from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke-2 Trial(RIGHT-2)

Background and purpose Intracerebral haemorrhage volume(ICHV)is prognostically important but does not account for intracranial volume(ICV)and cerebral parenchymal volume(CPV).We assessed measures of intracranial compartments in acute ICH using computerised tomography scans and whether ICHV/ICV and ICHV/CPV predict functional outcomes.We also assessed if cistern effacement,midline shift,old infarcts,leukoaraiosis and brain atrophy were associated with outcomes.Methods Data from 133 participants from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke-2 Trial trial were analysed.Measures included ICHV(using ABC/2)and ICV(XYZ/2)(by independent observers);ICHV,ICV and CPV(semiautomated segmentation,SAS);atrophy(intercaudate distance,ICD,Sylvian fissure ratio,SFR);midline shift;leukoaraiosis and cistern effacement(visual assessment).The effects of these measures on death at day 4 and poor functional outcome at day 90(modified Rankin scale,mRS of>3)was assessed.Results ICV was significantly different between XYZ and SAS:mean(SD)of 1357(219)vs 1420(196),mean difference(MD)62 mL(p<0.001).There was no significant difference in ICHV between ABC/2 and SAS.There was very good agreement for ICV measured by SAS,CPV,ICD,SFR,leukoaraiosis and cistern score(all interclass correlations,n=10:interobserver 0.72-0.99,intraobserver 0.73-1.00).ICHV/ICV and ICHV/CPV were significantly associated with mRS at day 90,death at day 4 and acute neurological deterioration(all p<0.05),similar to ICHV.Midline shift and cistern effacement at baseline were associated with poor functional outcome but old infarcts,leukoaraiosis and brain atrophy were not.Conclusions Intracranial compartment measures and visual estimates are reproducible.ICHV adjusted for ICH and CPV could be useful to prognosticate in acute stroke.The presence of midline shift and cistern effacement may predict outcome but the mechanisms need validation in larger studies.

An improved protocol for the treatment of fulminant myocarditis

Fulminant myocarditis is a rare form of severe myocarditis that is most commonly caused by viral infection.Fulminant myocarditis is often pathophysiologically indistinguishable from milder forms of acute myocarditis but is categorically defined based on clinical disease progression.Patients may initially present with mild symptoms,such as fever,shortness of breath or heart palpitations,but rapidly progress to severe respiratory distress,arrhythmias,and cardiogenic shock.

Epidemiological shift and geographical heterogeneity in the burden of leptospirosis in China

Background:Leptospirosis morbidity and mortality rates in China have decreased since the 2000s.Further analyses of the spatiotemporal and demographic changes occurring in the last decade and its implication on estimates of disease burden are required to inform intervention strategies.In this study,we quantified the epidemiological shift and geographical heterogeneity in the burden of leptospirosis during 2005-2015 in China.Methods:We used reported leptospirosis case data from 1st January 2005 to 31st of December 2015 that routinely collected by the China Information System for Disease Control and Prevention(CISDCP)to analyze the epidemiological trend and estimate the burden in terms of disability-adjusted life-years(DALYs)over space,time,and demographical groups.Results:A total of 7763 cases were reported during 2005-2015.Of which,2403(31%)cases were the laboratoryconfirmed case.Since 2005,the notified incidence rate was gradually decreased(P<0.05)and it was relatively stable during 2011-2015(P>0.05).During 2005-2015,we estimated a total of 10313 DALYs were lost due to leptospirosis comprising a total of 1804 years-lived with disability(YLDs)and 8509 years-life lost(YLLs).Males had the highest burden of disease(7149 DALYs)compared to females(3164 DALYs).The highest burden estimate was attributed to younger individuals aged 10-19 years who lived in southern provinces of China.During 2005-2015,this age group contributed to approximately 3078 DALYs corresponding to 30%of the total DALYs lost in China.Yet,our analysis indicated a declining trend in burden estimates(P<0.001)since 2005 and remained relatively low during 2011-2015.Low burden estimates have been identified in the endemic regions where infections principally distributed.Most of the changes in DALY estimates were driven by changes in YLLs.Conclusions:In the last 11-years,the burden estimates of leptospirosis have shown a declining trend across the country;however,leptospirosis should not be neglected as it remains an important zoonotic disease and potentially affecting the young and productive population in economically less-developed provinces in southern of China.In addition,while in the last five years the incidence has been reported at very low-level,this might not reflect the true incidence of leptospirosis.Strengthened surveillance in the endemic regions is,hence,substantially required to capture the actual prevalence to better control leptospirosis in China.

Differential Effects of Strategies to Improve the Transduction Efficiency of Lentiviral Vector that Conveys an Anti-HIV Protein,Nullbasic,in Human T Cells

Nullbasic is a mutant form of HIV-1 Tat that has strong ability to protect cells from HIV-1 replication by inhibiting three different steps of viral replication: reverse transcription, Rev export of viral m RNA from the nucleus to the cytoplasm and transcription of viral m RNA by RNA polymerase II. We previously showed that Nullbasic inhibits transduction of human cells including T cells by HIV-1-based lentiviral vectors. Here we investigated whether the Nullbasic antagonists huTat2(a Tat targeting intrabody), HIV-1 Tat or Rev proteins or cellular DDX1 protein could improve transduction by a HIV-1 lentiviral vector conveying Nullbasic-Zs Green1 to human T cells. We show that overexpression of huTat2, Tat-FLAG and DDX1-HA in virus-like particle(VLP) producer cells significantly improved transduction efficiency of VLPs that convey Nullbasic in Jurkat cells. Specifically, co-expression of Tat-FLAG and DDX1-HA in the VLP producer cell improved transduction efficiency better than if used individually. Transduction efficiencies could be further improved by including a spinoculation step. However, the same optimised protocol and using the same VLPs failed to transduce primary human CD4^+T cells. The results imply that the effects of Nullbasic on VLPs on early HIV-1 replication are robust in human CD4^+T cells. Given this significant block to lentiviral vector transduction by Nullbasic in primary CD4^+T cells, our data indicate that gammaretroviral, but not lentiviral, vectors are suitable for delivering Nullbasic to primary human T cells.

Reinfection of urogenital schistosomiasis in pre-school children in a highly endemic district in Northern Zimbabwe:a 12 months compliance study

Background:In light of the shift to aiming for schistosomiasis elimination,the following are needed:data on reinfection patterns,participation,and sample submission adherence of all high-risk age groups to intervention strategies.This study was conducted to assess prevalence,reinfections along with consecutive participation,sample submission adherence,and effect of treatment on schistosomiasis prevalence in children aged five years and below in an endemic district in Zimbabwe,over one year.Methods:The study was conducted from February 2016-February 2017 in Madziwa area,Shamva district.Following community mobilisation,mothers brought their children aged 5 years and below for recruitment at baseline and also urine sample collection at baseline,3,6,9 and 12 months follow up surveys.At each time point,urine was tested for urogenital schistosomiasis by urine filtration and children found positive received treatment.Schistosoma haematobium prevalence,reinfections as well as children participation,and urine sample submission at each visit were assessed at each time point for one year.Results:Of the 535 children recruited from the five communities,169(31.6%)participated consecutively at all survey points.The highest mean number of samples submitted was 2.9 among communities and survey points.S.haematobium prevalence significantly reduced from 13.3%at baseline to 2.8%at 12 months for all participants and from 24.9%at baseline to 1.8%at 12 months(P<0.001)for participants coming at all-time points.Among the communities,the highest baseline prevalence was found in Chihuri for both the participants coming consecutively(38.5%,10/26)and all participants(20.4%,21/103).Reinfections were significantly high at 9 months follow up survey(P=0.021)and in Mupfure(P=0.003).New infections significantly decreased over time(P<0.001).Logistic regression analysis showed that the risk of acquiring schistosomiasis was high in some communities(P<0.05).Conclusions:S.haematobium infections and reinfections are seasonal and depend on micro-geographical settings.The risk of being infected with schistosomes in pre-school aged children increases with increasing age.Sustained treatment of infected individuals in a community reduces prevalence overtime.Participation compliance at consecutive visits and sample submission adherence are important for effective operational control interventions.

Insecticide resistance in malaria-transmitting mosquitoes in Zimbabwe: a review

Malaria is a global public health problem,with about 3.2 billion people at risk of infection.The populations at risk mainly reside in Africa,Asia and America,with African populations accounting for the largest burden of the disease.In 2013,close to 198 million malaria cases were reported,leading to 584,000 deaths.Much(90%)of the mortality rates were recorded from the World Health Organization(WHO)database in the African region and 78%of these occurred in children under the age of five.In Zimbabwe,approximately half of the population is at risk of infection with malaria.Insecticide residual spraying(IRS)has been documented as an effective way to control malaria and has been adopted globally by the WHO and national governments.However,both insecticide resistance and climate change threaten to reverse the progress made by IRS in malaria control.Resistance has been reported in all four classes of insecticides approved by the WHO for vector control intervention.Variability of environmental temperature is suspected to complicate the situation through alteration in the genetic structure,and enzyme and protein profiles of mosquitoes.In Zimbabwe,little research has been done on the interaction between climate change,temperature variability and insecticide resistance in malarial mosquitoes over time.Such information is important for informing policies on insecticide selection for IRS.We reviewed literature on insecticide sensitivity among malarial mosquitoes in Zimbabwe from 1972 to 2014.International peer-reviewed articles on insecticide sensitivity in Zimbabwe,published in English in this time period,were searched using MEDLINE®(PubMed),Google Scholar,Google and grey literature.Eight publications were eligible for the present study,with one of the articles being a review paper.Six articles covered insecticide resistance,while the other two articles,published in 2000,were about the absence of resistance.Contradicting resistance results were reported in 2014.The insecticide sensitivity status and distribution of insecticide resistance in mosquitoes are still under debate in Zimbabwe,as studies report differing results.The resistance trend in Zimbabwe is characterised by fluctuations in the status of the sensitivity of existing insecticides.Inconsistencies in data collection methods may be responsible for the inconsistencies in the results.None of the studies have determined a link between climate/temperature variability and insecticide resistance as yet.The current insecticide sensitivity status of mosquitoes still needs to be verified.