Interaction between Biochar and Algae on Problem Soil

An in-vitro experiment was conducted to assess the interaction between biochar and algae on a problem soil. Experiments were performed with and without algae to observe the effectiveness of algae for overcoming the challenges posed by problem soils. At the end of incubation periods, the adsorption and desorption of phosphorus (P) on a problem soil vis-á-vis algal inoculation were determined. Our results showed that different types of biochars adsorbed different amounts of P suggesting that the source of biochar played a crucial role in determining its behavior towards P. Tannery waste biochar significantly adsorbed 147% and 35% more P compared to that of the chicken litter and orange peel biochars respectively. Significant reductions in adsorption were observed when the biochar was used in combination with the algae which could be due to the beneficial effects of algae leading to the amelioration of the problem soil. Adsorption was reduced to 34%, 24% and 20% for the orange peel biochar + algae, chicken litter biochar + algae and tannery waste biochar + algae, respectively compared to the corresponding biochars present as a single solid. Phosphorus (P) desorption was also reduced significantly in presence of algal inoculation. Overall our findings suggest that the application of algae along with biochar in the problem soil could reduce the adsorption of P which would influence the availability of P.

融合多种特征的实体链接技术研究

实体消歧是自然语言理解的重要研究内容,旨在解决文本信息中普遍存在的命名实体歧义问题,在信息抽取、知识工程和语义网络等领域有广泛的应用价值。实体链接是实体消歧的一种重要方法,该方法将具有歧义的实体指称项链接到给定的知识库中从而实现实体歧义的消除[1]。传统的实体链接方法主要利用上下文的词语匹配等表层特征,缺乏深层语义信息,针对这一问题,该文提出的实体链接方法利用了多种特征,从不同的维度捕获语义信息。为了更好地融合各个维度的特征,该文利用了基于排序学习框架的实体链接方法,与传统的方法相比,节省了人工对大量的模型参数选择和调节的工作,与基于分类的方法相比,能更好地利用到候选之间的关系信息。在TAC-KBP-2009的实体链接评测数据上的实验表明,该文提出的特征和方法表现出良好的性能,在评测指标上高出参赛队伍最好水平2.21%,达到84.38%。

Transition of an acronym from nonalcoholic fatty liver disease to metabolic dysfunction-associated fatty liver disease

Nonalcoholic fatty liver disease(NAFLD)is a global public health concern owing to its substantial contribution to chronic liver diseases.The disease is closely linked to metabolic syndrome(MS),suggesting a common biological pathway and shared disease mechanism for both ailments.Previous studies revealed a close relationship of NAFLD with the components of MS including abdominal obesity,dyslipidemia,hypertension,and hyperglycemia.Hence,a group of experts recently renamed NAFLD as metabolic dysfunction-associated fatty liver disease(MAFLD)in order to encompass a more appropriate pathogenesis of the disease.NAFLD was first named to describe a condition similar to alcoholic hepatitis in absence of significant alcohol consumption.However,knowledge pertaining to the etiopathogenesis of the disease has evolved over the past four decades.Recent evidence endorses NAFLD as a terminology of exclusion and suggests that it may often leads to misdiagnosis or inappropriate management of patients,particularly in clinical practice.On the other hand,the new definition is useful in addressing hepatic steatosis with metabolic dysfunction,which ultimately covers most of the patients with such illness.Therefore,it seems to be helpful in improving clinical diagnosis and managing high-risk patients with fatty liver disease.However,it is imperative to validate the new terminology at the population level to ensure a holistic approach to reduce the global burden of this heterogeneous disease condition.

Predictors of Death in Under-Five Children with Sepsis Attending an Urban Diarrheal Treatment Centre in Bangladesh

SETTING: Special Care Ward (SCW) of the Dhaka Hospital of icddr,b, Bangladesh. OBJECTIVE: To evaluate the clinical and laboratory predictors of death in under-five children with clinically defined sepsis presenting with diarrhea. METHODS: We prospectively enrolled all the diarrheal children (n = 151) aged 0 to 59 months with clinical sepsis admitted in the SCW during September’2007 through December’2007. Comparison was made between deaths (n = 23) and survivors (n = 128). Sepsis is defined as presence of inflammation [abnormal WBC count (>11 × 109/L or, 9/L or, band and neutrophil ratio ≤0.10] plus presence or presumed presence of infection with thermo-instability [hypo (≤35.0℃) or hyperthermia (≥38.5℃)], tachycardia, tachypnea, and/or the indications of altered organ function (altered mental status and bounding pulse) in the absence of clinical dehydration or after correction of dehydration. RESULTS: The median (inter-quartile range) age (months) of the children who survived and died was comparable [4.0 (2.0, 12.0) vs. 1.5 (0.8, 10.0);p = 0.703]. In the logistic regression analysis, after adjusting for potential confounders, such as abnormal WBC count, use of intravenous fluid, patient with fatal outcome more often presented with hypernatremia (odds ratio = 16.48, 95% confidence interval = 2.21 -?123.12;p = 0.006), lobar consolidation (odds ratio = 19.9, 95% confidence interval = 2.99 - 132.80;p = 0.002), hypoxemia (odds ratio = 14.78, 95% confidence interval = 1.38 157.90;p = 0.026) and severe under-nutrition (odds ratio = 7.57, 95% confidence interval = 1.24 - 46.11;p = 0.028). CONCLUSIONS: Our data suggest that children under-five with clinical sepsis who present with lobar pneumonia, hypoxaemia, severe acute malnutrition and hyperntaemia are at higher risk of death and identification of these simple factors may help clinicians to take prompt initiative for the aggressive management of such children especially in a resource-limited setting like Bangladesh.

Health and Nutritional Status of Young Foster Children Attending a Diarrhea Treatment Hospital in Bangladesh

There is scarcity of evidence-based information about socio-demographic as well as ailment factors associated with foster children in Bangladesh. Thus the aim of the present study was to determine the socio-economic, health and nutritional status of young foster children in urban Dhaka. A total of 208 (1%;n = 208/28,948) under-5 foster children were enrolled in the Diarrheal Disease Surveillance System of icddr,b between 1993-2012. Randomly selected under-5 children (n = 624) with a ratio of 1:3 were extracted and constituted as comparison group. Forty-three percent (n = 90) foster children were male. Lack of formal schooling of mother was higher among foster children compared to non-foster children (52% vs. 35%;p < 0.001). Higher proportion of foster children suffered from some or severe dehy-dration (60% vs. 47%;p = 0.001) and often received intravenous saline (12% vs. 5%;p = 0.002) in comparison to non-foster children. Significantly lower proportion of foster children had rotavirus diarrhea (26% vs. 43%;p < 0.001). In multivariate analysis, foster children were 2 times (95% CI: 1.31-4.32) more likely to be stunted and 194 times (95% CI: 82.25-457.76) more likely to be non-breastfed. Infants aged 6-11 months were 8 times (95% CI: 3.70-15.50) more likely to be foster compared to older children and probability of fostering was 7 times (95% CI: 3.96-13.33) higher among mothers with a median age of 25 years. The findings of our study clearly demonstrate the existing health and nutritional problems of foster children. Therefore, appropriate health and nutrition interventions are critical for foster children in Bangladesh.

Weight Gain in Malnourished Children after 5 Months Food Supplementation in a Slum Setting in Bangladesh

We examined the rate of weight gain and absolute weight gain of underweight children (weight- for-age Z score < -2) aged between 6 - 24 months living in a slum of Dhaka city, in response to two different regimens of supplementary feeding. Comparison was also made with the weight gain of a healthy group of children from the same locality. In total 161 children, including 68 healthy children representing the control group, were enrolled for the 5 months supplementation. The two regimens of feeding were either ready-to-use therapeutic food (RUTF, Plumpy’Nut) or locally made cereal-based supplementary food Pushti packet which was recommended in the National Nutritional Program. No food supplementation was provided to control children. All children received vitamin A as part of the six-monthly national program, albendazole for deworming, immunization, and health and nutrition education. Multiple micronutrient powder (MNP) was provided only to Pushti packet and control children. The rate of weight gain on RUTF was 1.69 g/kg/day during the first month and gradually declined to 0.9 g/kg/day at the final month of the trial, whereas, the rate of weight gain on Pushti packet was 0.77 g/kg/day during the first month declining to 0.70 g/kg/day at the end of the trial. Rate of weight gain in the control group was steady between 0.47 - 0.50 g/kg/day. Absolute weight gains of 1085 g, 790 g and 730 g were observed in the RUTF, Pushti packet and the control groups, respectively which were significantly higher in the RUTF group. There was no statistically significant difference between the RUTF and Pushti packet groups in terms of rate of weight gain. Overall, weight gain was unsatisfactory for both supplementation groups. Better absolute weight gain was observed with RUTF supplementation compared to Pushti packet which prevented further deterioration in weight among the malnourished children.

Socio-demographic, host and clinical characteristics of people with typhoidal and non-typhiodal<i>Salmonella</i>gastroenteritis in urban Bangladesh

Typhoidal (Salmonella enterica serover Typhi and Para-typhi A and B) (TS) and non-typhiodal Salmonella (NTS) gastroenteritis are less reported in Bangladesh. There is also a lack of report on socio-demographic and clinical characteristics of Bangladeshi people with typhoid fever and those with non-typhoidal Salmonella (NTS) gastroenteritis. Thus, the present study aimed to compare the socio-demographic, host and clinical characteristics, and seasonal variations between TS and NTS infections among patients attending at a large diarrheal disease hospital in urban Bangladesh. Information were extracted from the database of icddr,b in two different age stratums (0-14 years, and 15 years and above) as 54 with TS and 199 with NTS;and 65 with TS and 239 with NTS respectively after excluding all other pathogens. Randomly selected individuals with diarrhea but without any pathogen in stool constituted the control group (n = 253 and n = 304 respectively). Among 0-14 years, fever [aOR-4.35 (95% CI-1.45-13.06)] and drink unboiled water [aOR-0.22 (95% CI-0.06-0.83)] significantly differed between TS and NTS. Significant associations were observed with lower socio-economic context [aOR-10.02 (95% CI-3.79-26.45)], unbolied drinking water [aOR-2.16 (95% CI-1.05-4.43)], fever [aOR-4.54 (95% CI-1.71-12.03)], pneumonia [aOR-21.57 (95% CI-1.90-245.01)], wasting [aOR-2.60 (95% CI-1.21-5.57)], presence of RBC [aOR-0.09 (95% CI-0.02-0.33], leucocytes [aOR-3.97 (95% CI-1.76-8.99)] and macrophage [aOR-10.71 (95% CI-2.80-41.06)] in stool and alkaline pH [aOR-2.07 (95% CI-1.08-3.97)] when compared with control group. Among ≥15 years, TS was more frequently isolated from individuals with poor socio-economic background [aOR-2.09 (95% CI-1.0-4.33)] and use non-tap drinking water [aOR-0.29 (95% CI-0.13-0.66] compared to their NTS counterparts. Reported lack of formal schooling [aOR-0.65 (95% CI-0.44-0.96)], fever [aOR-2.10 (95% CI-1.03-4.31)], hospital stay (>24 hours) [aOR-1.66 (95% CI-1.05-2.62)], use of intravenous saline [aOR-0.50 (95% CI-0.34-0.76)] and RBC [aOR-2.34 (95% CI-1.23-4.45)] were associated with TS and NTS compared to control group. Socio-demographic, host and clinical characteristics between TS and NTS gastroenteritis were identical;however, findings significantly differed when compared with individuals presented with diarrhea but without any common enteric pathogen in stool.

Association of Television Watching Practices of Mothers on Overweight and Obesity of Their Under-5 Offspring in Urban Bangladesh

Childhood overweight and obesity, is an emerging public health concern in developing countries like Bangladesh. However, regular television watching by child’s mother and its impact on excess weight gain or overweight and obesity to their offspring is not reported elsewhere. The aim of the present analysis was to determine the socio-demographic characteristics among overweight and obese children based on those mothers who watch television regularly and compare this finding with malnourished and well-nourished under-5 children. A total of 20,800 under-5 children were enrolled during 1996 to 2012 in the Diarrheal Disease Surveillance System (DDSS) of Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). Mean weight-for-age z-score (–1.61 vs. –2.30;mean difference: ?0.69;p < 0.001), height-for-age z-score (–1.42 vs. –1.99;–0.57;<0.001), weight-for-height z-score (–1.59 vs. –1.07;–0.53;<0.001), BMI-for-age z-score (–1.09 vs. –1.61, –0.52;<0.001) differed significantly between the children whose mother did and did not watch television regularly. Under-5 children whose mother watched television regularly (2%) compared to those who did not (1%), had 2.28 [(95% CI-1.61 - 3.24) p < 0.001] times increased odds of being overweight and obese. Television watching of mothers is associated with childhood overweight and obesity and is one of the most public health concerns in Bangladesh. These changes may be in part of better socio-economic condition, changes in life style behaviour and dietary pattern.

Predictive Factors of Hyponatremia in Under-Five Severely Malnourished Children with Pneumonia Admitted to a Large Urban Hospital in Dhaka, Bangladesh: A Nested Case-Control Design

Background: Hyponatremia is the most common electrolyte imbalance encountered in the management of diarrheal children. Common ramifications include cerebral edema and fatal outcomes. However, pediatric data remain lacking, particularly in developmental contexts where resources are limited and associated conditions like malnutrition and pneumonia are common. Aim: This study aimed to evaluate predicting factors associated with hyponatremia in children under five years of age with severe acute malnutrition (SAM) in Bangladesh. Methods: Using a nested case-control design, we compared clinical and laboratory characteristics of children with (n = 61) and without hyponatremia (n = 183) taken from a parent population of all children under five with SAM and clinical or radiological pneumonia admitted to Dhaka Hospital of icddr,b between April 2011 and June 2012 (n = 407). Results: Logistic regression analysis adjusting for potential confounders such as lack of breast feeding, duration of vomiting (days), and severe wasting revealed that older age (OR 1.05, 95%CI 1.02 - 1.07, p = 0.001) (5% increase in the relative odds of hyponatremia for each additional month of age), presence of diarrhea (OR 2.43, 95%CI 1.0 - 6.0, p = 0.05), and difficulty breathing (OR 1.52, 95%CI 1.0 - 2.05, p = 0.05) were significantly associated with hyponatremia. Conclusion: Our data suggest that older age, presence of diarrhea, and difficulty breathing in under-five children with SAM is independent predictors of hyponatremia. These findings underscore the importance of detecting simple clinical predictors early in order to facilitate appropriate management and to prevent potential ramifications of hyponatremia in SAM children, especially in resource-poor settings.

Prolonged acute diarrhea in adults: Decades of observation from epidemiological perspective in urban Bangladesh

The study aimed to determine the epidemiological, clinical characteristics, and etiology of adults aged ≥20 years presented with prolonged acute diarrhea (≥7 days). A total of 18,210 adults aged ≥20 years were enrolled in the Diarrheal Disease Surveillance System of icddr,b between 1993-2012 and included into the analysis. Of these, 17,631 (97%) had duration of diarrhea ≤6 days, 418 (2%) diarrhea presented with a duration of 7 - 13 days and rest 161 (1%) had history of diarrhea ≥14 days. A higher proportion of adult individuals who had duration of diarrhea ≥14 days (70% vs. 56%;p male. At least 73% of all patients used oral rehydration solution;but proportion was lower among prolonged acute diarrhea groups. Use of antimicrobials was higher among those with duration 7 - 13 days (81%) and ≥14 days (81%). Diarrhea lasting ≥14 days, 47% were suffering from chronic energy deficiency and 30% had history of smoking. Individuals with diarrhea ≥7 days less frequently presented with vomiting, watery stool, frequency of stool >10 times/24 hours, drowsy or lethargy, fast breathing, some or severe dehydration, received intravenous saline for initial corrections of dehydration and stayed for longer duration in hospital (≥24 hours) but more often presented with abdominal pain. Stool microscopic examination showed less frequent presence of red blood cells (36% vs. 44%;p = 0.043) and fecal leucocytes (50% vs. 59%;p = 0.029) among individuals with diarrhea ≥14 days compared to those with ≤6 days. None was infected with Vibrio cholerae (≥14 days) (3% for 7 - 13 days);however, isolation rate of Aeromonas was higher among adults with duration for ≥14 days (11%). Only 15% with ≥14 days were positive for Shigella contrary to 19% (7 - 13 days) and 56% (≤6 days). Differences in sociodemographic, clinical presentation and etiology varied with duration of diarrhea among adults.

Probabilistic Prediction for Earthquake in Bangladesh: Just How Big Does the Earthquake Have to Be Next Years?

Earthquakes are more deadly than any other form of natural hazard. Because of this, scientists have been searching for accurate ways to predict earthquakes so that lives can be saved. Statistical analysis is useful methods of predicting earthquakes. They provide additional insights to the seismic hazard. In this work, the statistical analysis has been described through the study of “Region of Bangladesh”. A sample result from the statistical analysis which gives intermediate term prediction of earthquakes is given. At the end of the study, the prediction of near future earth-quakes is also investigated through the pictorial and tabular behaviors.

单次剂量环丙沙星与12次剂量红霉素治疗儿童霍乱的比较:一项随机、对照试验

Background: Single- dose ciprofloxacin is effective for the treatment of severe cholera in adults. We assessed whether single- dose ciprofloxacin would be as effective as 3- day, 12- dose erythromycin in achieving clinical cure in children with severe cholera. Methods: We did a randomised, open label, controlled trial in children age 2- 15 years with V cholerae O1 or O139 present in stool on dark- field microscopy. Children received either a single 20 mg/kg dose of ciprofloxacin (n = 90) or 12.5 mg/kg of erythromycin (n = 90) every 6 h for 3 days, and remained in hospital for 5 days. The primary outcome was clinical success of treatment, defined as cessation of watery stools within 48 h of start of drug treatment. Analysis was per protocol. This study is registered as an International Standard Randomised Controlled Trial, number ISRCTN00142272. Findings: Of 10 children randomised 162 completed the study. Treatment was clinically successful in 60% (47/78) of children treated with ciprofloxacin and in 55% (46/84) of those treated with erythromycin (difference 5% 95% CI - 10 to 21). Children receiving ciprofloxacin vomited less often (58% vs 74% ; difference 16% 2 to 30), had fewer stools (15 vs 21; 6 0 to 9), and less stool volume (152 vs 196 mL/kg; 43 mL/kg 13 to 87) than those receiving erythromycin. Bacteriological failure was more common in ciprofloxacin- treated patients (58% vs 30% ; 28% 13 to 43) than erythromycin- treated patients. Interpretation: Single- dose ciprofloxacin achieves clinical outcomes similar to, or better than, those achieved with 12- dose erythromycin treatment in childhood cholera, but is less effective in eradicating V cholerae from stool.

单剂量阿奇霉素治疗成人霍乱

BACKGROUND: Single-dose azithromycin is effective in the treatment of severe cholera in children, but its effectiveness in adults has not been evaluated. METHODS: We conducted a double-blind, randomized trial comparing the equivalence of azithromycin and ciprof loxacin (each given in a single 1-g dose of two 500-mg tablets) among 195 men with severe cholera caused by Vibrio cholerae O1 or O139. Patients were hospitalized for five days. A stool culture was performed daily. Primary outcome measures were clinical success (the cessation of watery stools within 48 hours after drug administration) and bacteriologic success (the inability to isolate V. cholerae after 48 hours). RESULTS: Therapy was clinically successful in 71 of 97 patients receiving azithromycin (73 percent) and in 26 of 98 patients receiving ciprofloxacin (27 percent) (P < 0.001) and bacteriologically successful in 76 of 97 patients receiving azithromycin (78 percent) and in 10 of 98 patients receiving ciprofloxacin (10 percent) (P< 0.001). Patients who were treated with azithromycin had a shorter duration of diarrhea than did patients treated with ciprofloxacin (median, 30 vs. 78 hours); a lower frequency of vomiting (43 percent vs. 67 percent); fewer stools (median, 36 vs. 52); and a lower stool volume (median, 114 vs. 322 ml per kilogram of body weight). The median minimal inhibitory concentration of ciprofloxacin for the 177 isolates of V. cholerae O1 was 0.25 μg per milliliter, which was 11 to 83 times as high as that in previous studies at this site. CONCLUSIONS: Single-dose azithromycin was effective in the treatment of severe cholera in adults. The lack of efficacy of ciprofloxacin may result from its diminished activity against V. cholerae O1 strains currently circulating in Bangladesh.

Effective antimicrobial therapies of urinary tract infections among children in low-and middle-income countries:A systematic review

Importance:Urinary tract infection(UTI)is one of the most common infections encountered in infancy and childhood.Despite the emerging problem of antibiotic resistance in recent years,the use of antibiotics for better management of UTIs is inevitable.Objective:This study aims to explore the efficacy and adverse effects of the available antimicrobial agents that are used in pediatric UTIs in low-and middle-income countries(LMICs).Methods:Five electronic databases were searched to identify relevant articles.Two reviewers independently performed screening,data extraction,and quality assessment of the available literature.Randomized controlled trials providing antimicrobial interventions in both male and female participants within the age range of 3 months to 17 years in LMICs were included.Results:Six randomized controlled trials from 13 LMICs were included in this review(four trials explored the efficacy).Due to high heterogeneity across the studies,a meta-analysis was not performed.Other than attrition and reporting bias,the risk of bias was moderate to high due to poor study designs.The differences in the efficacy and adverse events of different antimicrobials were not found to be statistically significant.Interpretation:This review indicates the necessity for additional clinical trials on children from LMICs with more significant sample numbers,adequate intervention periods,and study design.

Toxin(s), Other Than Cholera Toxin, Produced by Environmental Non O1 Non O139 Vibrio cholerae

A total of 39 Vibrio cholerae non O1 non O139 strains were isolated from surface waters of different parts of Dhaka City, Bangladesh. All these strains showed lack of ctx or zot gene, as demonstrated by the PCR analysis. Eighteen representative strains were tested for enterotoxin production using a rabbit ileal loop model, of which live cells of 8 strains and culture filtrates of 6 strains produced fluid accumulation in ileal loops. However, none of them produced heat stable toxin （ST）, as detected by suckling mouse assay. On the other hand, 15% of isolates produced cytotoxin as detected by the Chinese Hamster Ovary （CHO） cell assay. Fifty times concentrated culture filtrates of the representative strains did not give any precipitin band against the anti-cholera toxin, suggesting the strains produced an enterotoxin, which is antigenically different from known cholera toxin （CT）. Eighty percent of the total isolates were found to be positive for heat labile haemolysin detected by tube method, whereas, 39% were found positive by the Christie-Atkins-Munch-Petersen （CAMP） method. However, 87% of the isolates were positive for haemagglutinin/protease and all of the strains were positive for mannose-sensitive-haemagglutinin assay.

An update to monoclonal antibody as therapeutic option against COVID-19

With the number of Coronavirus Disease 2019(COVID-19)cases soaring worldwide and limited vaccine availability for the general population in most countries,the monoclonal antibody(mAb)remains a viable therapeutic option to treat COVID-19 disease and its complications,especially in the elderly individuals.More than 50 monoclonal antibody-related clinical trials are being conducted in different countries around the world,with few of them nearing the completion of the third and fourth phase clinical trial.In view of recent emergency use authorization(EUA)from the FDA(Food and Drug Administration)of casirivimab and imdevimab,it is of importance thatmAbs,already used to treat diseases such as Ebola and respiratory syncytial virus(RSV)infection,are discussed in scientific communities.This brief review discusses the mechanism of action and updates to clinical trials of different monoclonal antibodies used to treat COVID-19,with special attention paid to SARS-CoV-2 immune response in host cells,target viral structures,and justification of developing mAbs following the approval and administration of potential effective vaccine among vulnerable populations in different countries.

必须对野鸡杂志采取有力措施——它们对中低收入国家的研究者伤害最大，但人人都应起来坚决回击

野鸡杂志迅速增长，令有些人称之为“创造了学术诈骗时代”。这些杂志索要高额费用，但不提供编辑和出版方面的服务。它们通过肆无忌惮的营销手段和铺天盖地的垃圾邮件到处拉稿，许诺只要缴纳费用，即可快速审稿，开放获取（openaccess，OA）发表。

Using focused pharmacovigilance for ensuring patient safety against antileishmanial drugs in Bangladesh’s National Kala-azar Elimination Programme

Background:Adverse effects of antileishmanial drugs can affect patients’quality of life and adherence to therapy for visceral leishmaniasis(VL)and post-kala-azar dermal leishmaniasis(PKDL).In Bangladesh,there are 26 treatment centers that manage leishmaniasis cases coming from 100 endemic upazilas(subdistricts)of 26 districts(these include VL,PKDL,treatment failure,and relapse VL and cutaneous leishmaniasis cases).This study aimed to investigate the feasibility of using focused pharmacovigilance for VL(VLPV)in Bangladesh’s National Kala-azar Elimination Programme for the early detection and prevention of expected and unexpected adverse drug reactions(ADRs).Methods:This activity has been going on since December 2014.Activity area includes secondary public hospital or Upazila health complex(UHC)in hundred sub districts and Surya Kanta Kala-azar Research Center(SKKRC)in Mymensingh District,a specialized center for management of complicated VL and PKDL cases.Communicable Disease Control(CDC)of the Directorate General of Health Services(DGHS)assigned twenty five of hundred UHCs and SKKRC(total 26)as treatment centers depending on their suitable geographical location.This was implemented for better management of VL cases with Liposomal Amphotericin B(AmBisome®)to ensure patient convenience and proper utilization of this expensive donated drug.A VLPV expert committee and a UHC VLPV team were established,an operational manual and pharmacovigilance report forms were developed,training and refresher training of health personnel took place at UHCs and at the central level,collected information such as patient data including demographics,treatment history and response,adverse events were analyzed.This report includes information for the period from December 2014 to December 2016.Results:From December 2014 to December 2016,1327 leishmaniasis patients were treated and 1066(80%)were available for VLPV.Out of these,57,33,9,and 1%were new VL,PKDL,VL relapse,and other cases,respectively.Liposomal amphotericin B was mostly used(82%)for case management,followed by miltefosine(20%)and paromomycin(3%).Out of the 1066 patients,26%experienced ADRs.The most frequent ADR was fever(17%,176/1066),followed by vomiting(5%,51/1066).Thirteen serious adverse events(SAEs)(eight deaths and five unexpected SAEs)were observed.The expert committee assessed that three of the deaths and all unexpected SAEs were possibly related to treatment.Out of the five unexpected SAEs,four were miltefosine-induced ophthalmic complications and the other was an AmBisome^(■)-induced avascular necrosis of the nasal alae.The Directorate General of the Drug Administration entered the ADRs into the World Health Organization Uppsala Monitoring Centre(WHO-UMC)VigiFlow database.Conclusions:This study found that VLPV through NKEP is feasible and should be continued as a routine activity into the public health system of Bangladesh to ensure patient safety against anti-leishmanial drugs.

Performance of the point-of-care circulating cathodic antigen test in the diagnosis of schistosomiasis japonica in a human cohort from Northern Samar, the Philippines

Background:Zoonotic schistosomiasis,caused by Schistosoma japonicum,remains a major public health problem in the Philippines.This study aimed to evaluate the commercially available rapid diagnostic point-of-care circulating cathodic antigen(POC-CCA)test in detecting individuals infected with S.japonicum in a human cohort from an endemic area for schistosomiasis japonica in the Philippines.Methods:Clinical samples were collectedin 18 barangays endemic for S.japonicum infection in Laoang and Palapag municipalities,Northern Samar,the Philippines,in 2015.The presence of CCA in flter-concentrated urine samples(n=412)was evaluated using the commercial kits and the results were converted to images,which were further analyzed by ImageJ software to calculate R values.The diagnostic performance of the immunochromatographic POCCCA test was compared using the Kato-Katz(KK)procedure,in-house enzyme-linked immunosorbent assays(ELISAs)and droplet digital(dd)PCR assays as reference.Results:The POC-CCA test was able to detect S.japonicum-infected individuals in the cohort with an eggs per gram of faeces(EPG)more than or equal to 10 with sensitivity/specifcity values of 63.3%/93.3%.However,the assay showed an inability to diagnose schistosomiasis japonica infections in all cohort KK-positive individuals,of which the majority had an extremely low egg burden(EPG:1–9).The prevalence of S.japonicum infection in the total cohort determined by the POC-CCA test was 12.4%,only half of that determined by the KK method(26.2%).When compared with the ELISAs and ddPCR assays as a reference,the POC-CCA assay was further shown to be a test with low sensitivity.Nevertheless,the assay exhibited signifcant positive correlations with egg burden determined by the KK technique and the target gene copy number index values determined by the ddPCR assays within the entire cohort.Conclusions:By using in silico image analysis,the POC-CCA cassette test could be converted to a quantitative assay to avoid reader-variability.Because of its low sensitivity,the commercially available POC-CCA assay had limited potential for determining the status of a S.japonicum infection in the target cohort.The assay should be applied with caution in populations where schistosome parasites(especially S.japonicum)are present at low infection intensity.