Background:Despite its low cure rates and possible resistance,praziquantel(PZQ)is the only drug available for schistosomiasis treatment.Hence,monitoring its efficacy is crucial.This study assessed the efficacy of PZQ,...Background:Despite its low cure rates and possible resistance,praziquantel(PZQ)is the only drug available for schistosomiasis treatment.Hence,monitoring its efficacy is crucial.This study assessed the efficacy of PZQ,determined re-infection and incidence rates of Schistosoma haematobium infection among school-going children in the Ndumo area,KwaZulu-Natal.Methods:A cohort of 320 school-going children(10-15 years)in 10 primary schools was screened for S.haematobium infection using the filtration technique.Infected children were treated at different times and hence were divided into two sub-cohorts;A1 and A2.Non-infected children constituted the sub-cohort B.Children who continued excreting viable eggs 4 weeks post-treatment received a second dose of PZQ.Re-infection rates were determined in sub-cohort A1 and A2 at 28 and 20 weeks post-treatment,respectively.Cure rates(CR)and egg reduction rates(ERR)were calculated.Incidence rate was assessed 28 weeks post baseline survey using children that were negative for schistosome eggs at that survey.Analysis of data was done using the Chi square and the Wilcoxon rank test.A 95%confidence interval with a P-value<0.05 determined significance.Results:At baseline,120(37.5%)of the 320 study participants were found infected with Schistosoma haematobium.Heavy infections accounted for 36.7%.The calculated cure rates were 88.07%and 82.92%for females and males,respectively.Egg Reduction Rates of 80%and 64%for females and males were observed 4 weeks after the initial treatment.After the second treatment,CR was 100%in females and 50%in males with an ERR of 100%in females and 70%in males.At 20 and 28 weeks post treatment,reinfection rates of 8.03%and 8.00%were observed,respectively,giving an overall rate of 8.1%.An incidence rate of 4.1%was observed 28 weeks after the baseline screening.Conclusions:The study indicated high CR while the ERR was low suggesting a reduced PZQ efficacy.The efficacy improved among females after the second dose.Re-infection rates at 20 and 28 weeks posttreatme展开更多
Background:High early morbidity and mortality following antiretroviral therapy(ART)initiation has been a distinguishing feature of ART programmes in resource limited settings(RLS)compared to high-income countries.This...Background:High early morbidity and mortality following antiretroviral therapy(ART)initiation has been a distinguishing feature of ART programmes in resource limited settings(RLS)compared to high-income countries.This study assessed how well body mass index(BMI:kg/m^(2))correlated with survival among HIV infected patients with and without TB co-infection.Methods:We retrospectively evaluated clinical data from 1000 HIV infected patients,among whom 389 were also co-infected with TB,between January 2008 and December 2010,in KwaZulu-Natal,South Africa.Results:Among 948 patients eligible for analysis,15.7%(149/948)were underweight(<18.50),55.9%(530/948)had normal BMI(≥18.50-24.90),18.7%(177/948)were overweight(25.00-29.00)and 9.7%(92/948)were obese(≥30.00).Irrespective of TB status,underweight patients,had significantly higher risk of death compared to those with normal BMI at baseline(aHR=2.9;95%CI:1.5-5.7;P=0.002).Conclusions:Irrespective of TB co-infection,low BMI correlated with mortality in HIV infected patients.Trial registration:UKZN Biomedical Research Ethics Committee Reference number E 248/05,23 September 2005.展开更多
Background:Despite efforts to control neglected tropical diseases(NTDs),schistosomiasis and soil-transmitted helminthiases remain widely prevalent in sub-Saharan Africa.Recent data suggest that these infections are pr...Background:Despite efforts to control neglected tropical diseases(NTDs),schistosomiasis and soil-transmitted helminthiases remain widely prevalent in sub-Saharan Africa.Recent data suggest that these infections are prevalent among preschool aged children(PSAC)in poor communities.Evidence of schistosomiasis and soil-transmitted helminths(STH)infection patterns and prevalence among PSAC is essential for effective treatment and control programmes.The aim of the study was to determine the prevalence,intensity and risk factors of schistosomiasis and STH infection among PSAC in the Ingwavuma area of uMkhanyakude District,South Africa.Methods:A cross-seaional study was conducted among 1143 PSAC aged 1-5 years in 34 preschools and early childhood development(ECD)centres.Data on risk factors was collected using a semi-struaured questionnaire.A Kruskal-Wallis test was used to compare the differences in infection intensity with age.Pearson Chi-square test and multivariate logistic regression were performed to assess the association between PSAC infection status,sociodemographic,household,water and sanitation variables and hygiene practices of PSAC and their caregivers.Results:We observed a low prevalence o f Schistosom a haem atobium(1.0%)and 5.m ansoni(0.9%).The prevalence of Ascaris lum bricoides(18.3%)was high compared to Trichuris trichiuro(1.2%),hookworms(1.6%)and Taenio(6.4%).The odds of schistosome infection were lowest among PSAC under younger(15-24 years)caregivers(0.1,95%CI:0.02-0.54)and those who used tap water(0.3,95%Cl:0.09-0.78)for domestic purposes.Schistosome infection was however higher among PSAC who bathed in river water(17.4,95%CI:5.96-51.04).STH infection on the other hand was lowest among PSAC who did not play in soil(0.1,95%CI:0.51-0.28),were from households that used tap water for domestic purposes(0.5,95%CI:0.27-0.80)and PSAC under the care of younger(25-35 years)caregivers(0.3,95%Cl:0.10-0.75).The risk of STH infeaion was highest among PSAC who did not wash their hands with soap(3.5,95%CI:1.04-11.6展开更多
基金The study received logistic supports from Malaria and Bilharzia in Southern Africa(MABISA)project under which the study was conducted,funded by Wold Health Organisation(WHO)Special Programme for Research and Training in Tropical Diseases(TDR)and the Canadian International Development Research Centre(IDRC)The study was also supported by the College of Health Sciences scholarship program at the University of KwaZulu-Natal.
文摘Background:Despite its low cure rates and possible resistance,praziquantel(PZQ)is the only drug available for schistosomiasis treatment.Hence,monitoring its efficacy is crucial.This study assessed the efficacy of PZQ,determined re-infection and incidence rates of Schistosoma haematobium infection among school-going children in the Ndumo area,KwaZulu-Natal.Methods:A cohort of 320 school-going children(10-15 years)in 10 primary schools was screened for S.haematobium infection using the filtration technique.Infected children were treated at different times and hence were divided into two sub-cohorts;A1 and A2.Non-infected children constituted the sub-cohort B.Children who continued excreting viable eggs 4 weeks post-treatment received a second dose of PZQ.Re-infection rates were determined in sub-cohort A1 and A2 at 28 and 20 weeks post-treatment,respectively.Cure rates(CR)and egg reduction rates(ERR)were calculated.Incidence rate was assessed 28 weeks post baseline survey using children that were negative for schistosome eggs at that survey.Analysis of data was done using the Chi square and the Wilcoxon rank test.A 95%confidence interval with a P-value<0.05 determined significance.Results:At baseline,120(37.5%)of the 320 study participants were found infected with Schistosoma haematobium.Heavy infections accounted for 36.7%.The calculated cure rates were 88.07%and 82.92%for females and males,respectively.Egg Reduction Rates of 80%and 64%for females and males were observed 4 weeks after the initial treatment.After the second treatment,CR was 100%in females and 50%in males with an ERR of 100%in females and 70%in males.At 20 and 28 weeks post treatment,reinfection rates of 8.03%and 8.00%were observed,respectively,giving an overall rate of 8.1%.An incidence rate of 4.1%was observed 28 weeks after the baseline screening.Conclusions:The study indicated high CR while the ERR was low suggesting a reduced PZQ efficacy.The efficacy improved among females after the second dose.Re-infection rates at 20 and 28 weeks posttreatme
基金Patient care in the CAPRISA AIDS Treatment project is supported by the KwaZulu-Natal Department of Health,the Global Fund to fight AIDSTuberculosis and Malaria and the U.S.President’s Emergency Plan for AIDS Relief(PEPFAR)+2 种基金The research infrastructure to conduct this trial,including the data management,laboratory and pharmacy cores were established through the US National Institutes for Health’s Comprehensive International Program of Research on AIDS grant(CIPRA,grant no.:AI51794)KN and SA was supported by the Columbia University-South Africa Fogarty AIDS International Training and Research Program(AITRP,grant no.:D43 TW000231)The funding sources listed here did not have any role in the analysis or preparation of the data in this manuscript,nor was。
文摘Background:High early morbidity and mortality following antiretroviral therapy(ART)initiation has been a distinguishing feature of ART programmes in resource limited settings(RLS)compared to high-income countries.This study assessed how well body mass index(BMI:kg/m^(2))correlated with survival among HIV infected patients with and without TB co-infection.Methods:We retrospectively evaluated clinical data from 1000 HIV infected patients,among whom 389 were also co-infected with TB,between January 2008 and December 2010,in KwaZulu-Natal,South Africa.Results:Among 948 patients eligible for analysis,15.7%(149/948)were underweight(<18.50),55.9%(530/948)had normal BMI(≥18.50-24.90),18.7%(177/948)were overweight(25.00-29.00)and 9.7%(92/948)were obese(≥30.00).Irrespective of TB status,underweight patients,had significantly higher risk of death compared to those with normal BMI at baseline(aHR=2.9;95%CI:1.5-5.7;P=0.002).Conclusions:Irrespective of TB co-infection,low BMI correlated with mortality in HIV infected patients.Trial registration:UKZN Biomedical Research Ethics Committee Reference number E 248/05,23 September 2005.
文摘Background:Despite efforts to control neglected tropical diseases(NTDs),schistosomiasis and soil-transmitted helminthiases remain widely prevalent in sub-Saharan Africa.Recent data suggest that these infections are prevalent among preschool aged children(PSAC)in poor communities.Evidence of schistosomiasis and soil-transmitted helminths(STH)infection patterns and prevalence among PSAC is essential for effective treatment and control programmes.The aim of the study was to determine the prevalence,intensity and risk factors of schistosomiasis and STH infection among PSAC in the Ingwavuma area of uMkhanyakude District,South Africa.Methods:A cross-seaional study was conducted among 1143 PSAC aged 1-5 years in 34 preschools and early childhood development(ECD)centres.Data on risk factors was collected using a semi-struaured questionnaire.A Kruskal-Wallis test was used to compare the differences in infection intensity with age.Pearson Chi-square test and multivariate logistic regression were performed to assess the association between PSAC infection status,sociodemographic,household,water and sanitation variables and hygiene practices of PSAC and their caregivers.Results:We observed a low prevalence o f Schistosom a haem atobium(1.0%)and 5.m ansoni(0.9%).The prevalence of Ascaris lum bricoides(18.3%)was high compared to Trichuris trichiuro(1.2%),hookworms(1.6%)and Taenio(6.4%).The odds of schistosome infection were lowest among PSAC under younger(15-24 years)caregivers(0.1,95%CI:0.02-0.54)and those who used tap water(0.3,95%Cl:0.09-0.78)for domestic purposes.Schistosome infection was however higher among PSAC who bathed in river water(17.4,95%CI:5.96-51.04).STH infection on the other hand was lowest among PSAC who did not play in soil(0.1,95%CI:0.51-0.28),were from households that used tap water for domestic purposes(0.5,95%CI:0.27-0.80)and PSAC under the care of younger(25-35 years)caregivers(0.3,95%Cl:0.10-0.75).The risk of STH infeaion was highest among PSAC who did not wash their hands with soap(3.5,95%CI:1.04-11.6
