Infectious Diseases of Poverty

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ISSN / EISSN : 2049-9957 / 2049-9957
Published by: Springer Nature (10.1186)
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Infectious Diseases of Poverty, Volume 11, pp 1-9; https://doi.org/10.1186/s40249-022-00997-7

Abstract:
Background: Antibiotics are a key part of modern healthcare, but their use has downsides, including selecting for antibiotic resistance, both in the individuals treated with antibiotics and in the community at large. When evaluating the benefits and costs of mass administration of azithromycin to reduce childhood mortality, effects of antibiotic use on antibiotic resistance are important but difficult to measure, especially when evaluating resistance that “spills over” from antibiotic-treated individuals to other members of their community. The aim of this scoping review was to identify how the existing literature on antibiotic resistance modeling could be better leveraged to understand the effect of mass drug administration (MDA) on antibiotic resistance. Main text: Mathematical models of antibiotic use and resistance may be useful for estimating the expected effects of different MDA implementations on different populations, as well as aiding interpretation of existing data and guiding future experimental design. Here, strengths and limitations of models of antibiotic resistance are reviewed, and possible applications of those models in the context of mass drug administration with azithromycin are discussed. Conclusions: Statistical models of antibiotic use and resistance may provide robust and relevant estimates of the possible effects of MDA on resistance. Mechanistic models of resistance, while able to more precisely estimate the effects of different implementations of MDA on resistance, may require more data from MDA trials to be accurately parameterized. Graphical
Infectious Diseases of Poverty, Volume 11, pp 1-20; https://doi.org/10.1186/s40249-022-00999-5

Abstract:
Antibiotics have become a mainstay of healthcare in the past century due to their activity against pathogens. This manuscript reviews the impact of antibiotic use on the intestinal microbiota in the context of mass drug administration (MDA). The importance of the gut microbiota to human metabolism and physiology is now well established, and antibiotic exposure may impact host health via collateral effects on the microbiota and its functions. To gain further insight into how gut microbiota respond to antibiotic perturbation and the implications for public health, factors that influence the impact of antibiotic exposure on the microbiota, potential health outcomes of antibiotic-induced microbiota alterations, and strategies that have the potential to ameliorate these wider antibiotic-associated microbiota perturbations are also reviewed. Graphical Abstract
Robert J. Rolfe, Hassaan Shaikh,
Infectious Diseases of Poverty, Volume 11, pp 1-17; https://doi.org/10.1186/s40249-022-00998-6

Abstract:
Background: Mass drug administration (MDA) is a strategy to improve health at the population level through widespread delivery of medicine in a community. We surveyed the literature to summarize the benefits and potential risks associated with MDA of antibacterials, focusing predominantly on azithromycin as it has the greatest evidence base. Main body: High-quality evidence from randomized controlled trials (RCTs) indicate that MDA-azithromycin is effective in reducing the prevalence of infection due to yaws and trachoma. In addition, RCTs suggest that MDA-azithromycin reduces under-five mortality in certain low-resource settings that have high childhood mortality rates at baseline. This reduction in mortality appears to be sustained over time with twice-yearly MDA-azithromycin, with the greatest effect observed in children < 1 year of age. In addition, observational data suggest that infections such as skin and soft tissue infections, rheumatic heart disease, acute respiratory illness, diarrheal illness, and malaria may all be treated by azithromycin and thus incidentally impacted by MDA-azithromycin. However, the mechanism by which MDA-azithromycin reduces childhood mortality remains unclear. Verbal autopsies performed in MDA-azithromycin childhood mortality studies have produced conflicting data and are underpowered to answer this question. In addition to benefits, there are several important risks associated with MDA-azithromycin. Direct adverse effects potentially resulting from MDA-azithromycin include gastrointestinal side effects, idiopathic hypertrophic pyloric stenosis, cardiovascular side effects, and increase in chronic diseases such as asthma and obesity. Antibacterial resistance is also a risk associated with MDA-azithromycin and has been reported for both gram-positive and enteric organisms. Further, there is the risk for cross-resistance with other antibacterial agents, especially clindamycin. Conclusions: Evidence shows that MDA-azithromycin programs may be beneficial for reducing trachoma, yaws, and mortality in children < 5 years of age in certain under-resourced settings. However, there are significant potential risks that need to be considered when deciding how, when, and where to implement these programs. Robust systems to monitor benefits as well as adverse effects and antibacterial resistance are warranted in communities where MDA-azithromycin programs are implemented. Graphical
, Pranab Chatterjee, Connor LaMontagne, Joe Brown
Infectious Diseases of Poverty, Volume 11, pp 1-14; https://doi.org/10.1186/s40249-022-01000-z

Abstract:
Mass drug administration (MDA) of antimicrobials has shown promise in the reduction and potential elimination of a variety of neglected tropical diseases (NTDs). However, with antimicrobial resistance (AMR) becoming a global crisis, the risks posed by widespread antimicrobial use need to be evaluated. As the role of the environment in AMR emergence and dissemination has become increasingly recognized, it is likewise crucial to establish the role of MDA in environmental AMR pollution, along with the potential impacts of such pollution. This review presents the current state of knowledge on the antimicrobial compounds, resistant organisms, and antimicrobial resistance genes in MDA trials, routes of these determinants into the environment, and their persistence and ecological impacts, particularly in low and middle-income countries where these trials are most common. From the few studies directly evaluating AMR outcomes in azithromycin MDA trials, it is becoming apparent that MDA efforts can increase carriage and excretion of resistant pathogens in a lasting way. However, research on these outcomes for other antimicrobials used in MDA trials is sorely needed. Furthermore, while paths of AMR determinants from human waste to the environment and their persistence thereafter are supported by the literature, quantitative information on the scope and likelihood of this is largely absent. We recommend some mitigative approaches that would be valuable to consider in future MDA efforts. This review stands to be a valuable resource for researchers and policymakers seeking to evaluate the impacts of MDA. Graphical Abstract
Adam W. Bartlett, Jose C. Sousa-Figueiredo, Roelofje C. van Goor, Paul Monaghan, Warren Lancaster, Rukaaka Mugizi, Elsa P. Mendes, Susana Vaz Nery,
Infectious Diseases of Poverty, Volume 11, pp 1-15; https://doi.org/10.1186/s40249-022-00975-z

Abstract:
Background: Schistosomiasis and soil-transmitted helminths (STHs) contribute high disease burdens amongst the neglected tropical diseases (NTDs) and are public health problems in Angola. This study reports the prevalence, intensity and risk factors for schistosomiasis and STH infection in Huambo, Uige and Zaire provinces, Angola, to inform a school-based preventive chemotherapy program. Methods: A two-stage cluster design was used to select schools and schoolchildren to participate in parasitological and water, sanitation and hygiene (WASH) surveys across Huambo, Uige, and Zaire provinces. Point-of-care circulating cathodic antigen and urinalysis rapid diagnostic tests (RDTs) were used to determine the prevalence of Schistosoma mansoni and S. haematobium, respectively. Kato-Katz was used to identify and quantify STH species and quantify and compare with RDTs for S. mansoni. Urine filtration was used to quantify and compare with RDTs for S. haematobium. Descriptive statistics were used for prevalence and infection intensity of schistosomiasis and STH infection. Performance of RDTs was assessed through specificity and Cohen’s Kappa agreement with microscopy. A multivariate regression analysis was used to determine demographic and WASH factors associated with schistosomiasis and STH infection. Results: A total 575 schools and 17,093 schoolchildren participated in the schistosomiasis survey, of which 121 schools and 3649 schoolchildren participated in the STH survey. Overall prevalence of S. mansoni was 21.2% (municipality range 0.9–74.8%) and S. haematobium 13.6% (range 0–31.2%), with an overall prevalence of schistosomiasis of 31.4% (range 5.9–77.3%). Overall prevalence of Ascaris lumbricoides was 25.1% (range 0–89.7%), hookworm 5.2% (range 0–42.6%), and Trichuris trichiura 3.6% (range 0–24.2%), with an overall prevalence of STH infection of 29.5% (range 0.8–89.7%). Ecological zone and ethnicity were factors associated with schistosomiasis and STH infection, with older age and female sex additional risk factors for S. haematobium. Conclusions: Most municipalities met World Health Organization defined prevalence thresholds for a schistosomiasis preventive chemotherapy program. A STH preventive chemotherapy program is indicated for nearly all municipalities in Uige and select municipalities in Huambo and Zaire. The association between ecological zone and ethnicity with schistosomiasis and STH infection necessitates further evaluation of home and school environmental, sociodemographic and behavioural factors to inform targeted control strategies to complement preventive chemotherapy programs.
Lingcai Kong, Mengwei Duan, Jin Shi, Jie Hong, Zhaorui Chang, Zhijie Zhang
Infectious Diseases of Poverty, Volume 11, pp 1-9; https://doi.org/10.1186/s40249-022-01001-y

Abstract:
Background: The coronavirus disease 2019 (COVID-19) epidemic, considered as the worst global public health event in nearly a century, has severely affected more than 200 countries and regions around the world. To effectively prevent and control the epidemic, researchers have widely employed dynamic models to predict and simulate the epidemic’s development, understand the spread rule, evaluate the effects of intervention measures, inform vaccination strategies, and assist in the formulation of prevention and control measures. In this review, we aimed to sort out the compartmental structures used in COVID-19 dynamic models and provide reference for the dynamic modeling for COVID-19 and other infectious diseases in the future. Main text: A scoping review on the compartmental structures used in modeling COVID-19 was conducted. In this scoping review, 241 research articles published before May 14, 2021 were analyzed to better understand the model types and compartmental structures used in modeling COVID-19. Three types of dynamics models were analyzed: compartment models expanded based on susceptible-exposed-infected-recovered (SEIR) model, meta-population models, and agent-based models. The expanded compartments based on SEIR model are mainly according to the COVID-19 transmission characteristics, public health interventions, and age structure. The meta-population models and the agent-based models, as a trade-off for more complex model structures, basic susceptible-exposed-infected-recovered or simply expanded compartmental structures were generally adopted. Conclusion: There has been a great deal of models to understand the spread of COVID-19, and to help prevention and control strategies. Researchers build compartments according to actual situation, research objectives and complexity of models used. As the COVID-19 epidemic remains uncertain and poses a major challenge to humans, researchers still need dynamic models as the main tool to predict dynamics, evaluate intervention effects, and provide scientific evidence for the development of prevention and control strategies. The compartmental structures reviewed in this study provide guidance for future modeling for COVID-19, and also offer recommendations for the dynamic modeling of other infectious diseases. Graphical "Image missing"<!-- image only, no MathML or LaTex -->
Jiahui Wu, Xia Zhou, Qiaoqiao Chen, Zhiqiang Chen, Jinyu Zhang, Lele Yang, Yuxuan Sun, Guohui Wang, , Tingting Feng
Infectious Diseases of Poverty, Volume 11, pp 1-13; https://doi.org/10.1186/s40249-022-00996-8

Abstract:
Background: Ticks are hematophagous parasites that transmit an extensive range of pathogens to their vertebrate hosts. Ticks can destroy invading microorganisms or alleviate infection via their rudimentary but orchestrated innate immune system. Antimicrobial peptides (AMPs) are important components of tick innate immunity. Among these humoral effector molecules, defensins are well-studied and widely identified in various species of Ixodidae (hard ticks) and Argasidae (soft ticks). This review was aimed at presenting the characterization of tick defensins from structure-based taxonomic status to antimicrobial function. Main text: All published papers written in English from 2001 to May 2022 were searched through PubMed and Web of Science databases with the combination of relevant terms on tick defensins. Reports on identification and characterization of tick defensins were included. Of the 329 entries retrieved, 57 articles were finally eligible for our scoping review. Tick defensins mainly belong to the antibacterial ancient invertebrate-type defensins of the cis-defensins superfamily. They are generally small, cationic, and amphipathic, with six cysteine residues forming three intra-molecular disulfide bonds. Tick defensins primarily target membranes of a variety of pathogens, including Gram-positive and Gram-negative bacteria, fungi, viruses, and protozoa. Since tick defensins have a high degree of variability, we summarize their common biological properties and enumerate representative peptides. Along with the various and potent antimicrobial activities, the role of tick defensins in determining vector competence is discussed. Conclusions: Due to their broad-spectrum antimicrobial activities, tick defensins are considered novel candidates or targets for controlling infectious diseases. Graphical
Bo Zheng, Wenlong Zhu, Jinhua Pan,
Infectious Diseases of Poverty, Volume 11, pp 1-14; https://doi.org/10.1186/s40249-022-00988-8

Abstract:
Background: The pandemic of coronavirus disease 2019 (COVID-19) has changed human behavior in areas such as contact patterns and mask-wearing frequency. Exploring human–human contact patterns and mask-wearing habits in high-risk groups is an essential step in fully understanding the transmission of respiratory infection-based diseases. This study had aims to quantify local human–human (H–H) contacts in high-risk groups in representative provinces of China and to explore the occupation-specific assortativity and heterogeneity of social contacts. Methods: Delivery workers, medical workers, preschoolers, and students from Qinghai, Shanghai, and Zhejiang were recruited to complete an online questionnaire that queried general information, logged contacts, and assessed the willingness to wear a mask in different settings. The “group contact” was defined as contact with a group at least 20 individuals. The numbers of contacts across different characteristics were assessed and age-specific contact matrices were established. A generalized additive mixed model was used to analyze the associations between the number of individual contacts and several characteristics. The factors influencing the frequency of mask wearing were evaluated with a logistic regression model. Results: A total of 611,287 contacts were reported by 15,635 participants. The frequency of daily individual contacts averaged 3.14 (95% confidence interval: 3.13–3.15) people per day, while that of group contacts was 37.90 (95% CI: 37.20–38.70). Skin-to-skin contact and long-duration contact were more likely to occur at home or among family members. Contact matrices of students were the most assortative (all contacts q-index = 0.899, 95% CI: 0.894–0.904). Participants with larger household sizes reported having more contacts. Higher household income per capita was significantly associated with a greater number of contacts among preschoolers (P50,000–99,999 = 0.033) and students (P10,000–29,999 = 0.017). In each of the public places, the frequency of mask wearing was highest for delivery workers. For preschoolers and students with more contacts, the proportion of those who reported always wearing masks was lower (P < 0.05) in schools/workplaces and public transportation than preschoolers and students with fewer contacts. Conclusions: Contact screening efforts should be concentrated in the home, school, and workplace after an outbreak of an epidemic, as more than 75% of all contacts, on average, will be found in such places. Efforts should be made to improve the mask-wearing rate and age-specific health promotion measures aimed at reducing transmission for the younger demographic. Age-stratified and occupation-specific social contact research in high-risk groups could help inform policy-making decisions during the post-relaxation period of the COVID-19 pandemic. Graphical
Yin-Long Li, Hui Dang, Su-Ying Guo, Li-Juan Zhang, Yun Feng, Song-Jun Ding, Xiao-Wei Shan, Guang-Ping Li, Min Yuan, , et al.
Infectious Diseases of Poverty, Volume 11, pp 1-9; https://doi.org/10.1186/s40249-022-00995-9

Abstract:
Background: Due to sustained control activities, the prevalence of Schistosoma japonicum infection in humans, livestock and snails has decreased significantly in P. R. China, and the target has shifted from control to elimination according to the Outline of Healthy China 2030 Plan. Applying highly sensitive methods to explore the presence of S. japonicum infection in its intermediate host will benefit to assess the endemicity or verify the transmission interruption of schistosomiasis accurately. The aim of this study was to access the presence of S. japonicum infection by a loop-mediated isothermal amplification (LAMP) method through a 5-year longitudinal study in five lake provinces along the Yangtze River. Methods: Based on previous epidemiological data, about 260 villages with potential transmission risk of schistosomiasis were selected from endemic counties in five lake provinces along the Yangtze River annually from 2015 to 2019. Snail surveys were conducted in selected villages by systematic sampling method and/or environmental sampling method each year. All live snails collected from field were detected by microscopic dissection method, and then about one third of them were detected by LAMP method to assess the presence of S. japonicum infection with a single blind manner. The infection rate and nucleic acid positive rate of schistosomes in snails, as well as the indicators reflecting the snails’ distribution were calculated and analyzed. Fisher's exact test was used to examine any change of positive rate of schistosomes in snails over time. Results: The 5-year survey covered 94,241 ha of environment with 33,897 ha of snail habitats detected accumulatively. Totally 145.3 ha new snail habitats and 524.4 ha re-emergent snail habitats were found during 2015–2019. The percentage of frames with snails decreased from 5.93% [45,152/761,492, 95% confidence intervals (CI): 5.88–5.98%] in 2015 to 5.25% (30,947/589,583, 95% CI: 5.19–5.31%) in 2019, while the mean density of living snails fluctuated but presented a downward trend generally from 0.20 snails/frame (155,622/761,492, 95% CI: 0.17–0.37) in 2015 to 0.13 snails/frame (76,144/589,583, 95% CI: 0.11–0.39) in 2019. A total of 555,393 live snails were collected, none of them was positive by dissection method. Totally 17 pooling snail samples were determined as positives by LAMP method among 8716 pooling samples with 174,822 of living snails, distributed in 12 villages of Hubei, Hunan, Jiangxi and Anhui provinces. The annual average positive rate was 0.41% (95% CI: 0.13–0.69%) in 2015, 0% in 2016, 0.36% (95% CI: 0.09–0.63%) in 2017, 0.05% (95% CI: 0–0.16%) in 2018, 0.05% (95% CI: 0–0.15%) in 2019, respectively, presenting a downward trend from 2015 to 2019 with statistical significance (χ2 = 11.64, P < 0.05). Conclusions: The results suggest that S. japonicum infection still persisted in nature along the Yangtze River and traditional techniques might underestimate the prevalence of schistosomiasis in its intermediate hosts. Exploring and integrating molecular techniques into national surveillance programme could improve the sensitivity of surveillance system and provide guidance on taking actions against schistosomiasis. Graphical
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