Search Results (20)

The burden of mental health among individuals affected by skin-neglected tropical diseases (skin-NTDs) has increased significantly, prompting systemic measures to improve their mental health and well-being. Healthcare professionals have instrumental roles to play in this area in terms of integrating mental health into the existing primary and community healthcare services for skin-NTDs. The current study investigates the readiness of healthcare professionals for integrated healthcare, barriers to mental health service delivery and the professional development needs for mental health service delivery. A total of 252 healthcare professionals recruited from Nkwanta North and South Districts in the Oti Region of Ghana participated in the study by completing a set of questionnaires measuring the above variables, in addition to demographic factors. Descriptive statistics were used to summarize the study variables while Pearson Moment Product Correlation was used to investigate the relationship between continuous study variables. Confirmatory factor analysis (CFA) was conducted to elucidate the factorial validity of the study measures. Structural Equation Modeling (SEM) was used to examine the association between the variables and the mediating effects of professional development needs. The results showed that over 50% of the participants encountered several barriers in their attempt to provide mental health services to patients, and over 80% of them requested training and capacity building in mental health. CFA supports a two-factor structure of the readiness scale and one-factor structure of mental health barrier and professional development needs scales. SEM revealed a significant relationship between readiness for integrated healthcare, mental health barriers and professional development needs (p < 0.05). Further SEM analysis revealed that professional development needs significantly mediated the relationship between readiness for integrated healthcare and mental health barriers (p < 0.05). Addressing mental health professional development needs of healthcare professionals will help ensure their readiness for integrated healthcare for people with skin-NTDs. Full article

Background: The MVA-BN vaccine is considered effective for preventing mpox in key populations, based on observational studies, though no randomized trials have yet confirmed its effectiveness. Observational studies published to date rely on retrospective analyses of routine data, often missing information on relevant risk factors for mpox. Methods: Multi-country target trial emulation study with prospective data collection. Between 1 September 2022 and 15 June 2023, we recruited individuals eligible for mpox vaccination based on clinical history and exposure behaviors via healthcare centers and social venues in Spain, Peru, Panama, and Chile. Vaccinated individuals were paired with unvaccinated counterparts matched by mpox risk factors, country, recruitment date, and age. Follow-up continued via periodic surveys until 31 March 2024. The primary endpoint was symptomatic mpox occurrence ≥14 days post-vaccination. Results: The primary analysis included 1028 individuals (514 vaccinated, 514 unvaccinated) with a median follow-up time of 9.3 months (IQR 4.7–13.7). Mpox occurred in eight participants (0.8%): three vaccinated and five unvaccinated (HR 0.6; 95% CI 0.21–1.70). Adverse reactions were reported by 731 (49.6%) participants, predominantly skin reactions (703/1475; 47.7%), while systemic reactions occurred in 107 (7.3%). Long-lasting erythema at the injection site was reported in 450/1058 (42.5%) participants, persisting >6 months in 107 of them (23.8%). Conclusions: The low incidence of mpox during the study period resulted in a limited number of endpoint events, precluding robust conclusions on the efficacy of the MVA-BN vaccine as pre-exposure prevention for mpox. However, our analysis, which accounted for key confounders such as exposure behaviors, yielded results consistent with previous studies suggesting the effectiveness of the vaccine in the mpox setting. Full article

Scabies and tungiasis are skin-related neglected tropical diseases (NTDs) associated with poverty and poor living conditions. We performed an ecological study covering a state in northeast Brazil to identify socio-economic and environmental factors associated with the occurrence of severe scabies and severe tungiasis, respectively. Data on disease occurrence on the municipality level were derived from a previous study based on online questionnaires. A total of 47 (26.0%) of the 181 state’s municipalities reported severe tungiasis, and 113 (62.4%) severe scabies. Municipalities with occurrence of severe tungiasis were characterized by higher annual rainfalls (median = 883 mm vs. 741 mm; p = 0.037), higher minimum temperatures (median = 23.4 °C vs. 22.7 °C; p = 0.002), higher aridity indices indicating more humid climates (median = 45.1 vs. 50.6; p = 0.019), lower altitudes (median = 88.8 m vs. 201 m; p < 0.001), higher mean air humidity (66.5% vs. 63%; p = 0.018), and better socioeconomic indices (Municipal Human Development Index [MHDI]—median = 0.616 vs. 0.611; p = 0.048/MHDI Longevity—mean = 0.769 vs. 0.759; p = 0.007/Municipal Development Index [MDI]—median = 27.5 vs. 21.8; p < 0.001). Municipalities with predominant luvisol soil characteristics had a lower risk for severe tungiasis (RR = 0.46; 95% CI = 0.27–0.79; p = 0.003), whereas municipalities with predominant gleysols had a significantly higher risk (RR = 2.44; 95% CI = 1.43–4.15; p = 0.010). Municipalities with occurrence of severe scabies were characterized by significantly higher annual rainfalls (median = 804 mm vs. 708 mm; p = 0.001), higher minimum temperatures (23.1 °C vs. 22.3 °C; p < 0.001), higher aridity index (median = 48.2 vs. 41.9; p = 0.014), higher air humidity (65.9% vs. 61%; p = 0.001), lower altitudes (median = 153 m vs. 246 m; p = 0.003), and better socio-economic indicators (MHDI—median = 0.616 vs. 608; p= 0.012/MHDI Education—mean = 0.559 vs. 0.541; p = 0.014/MDI—median = 24.3 vs. 21.1; p = 0.005). In multivariate regression analysis, MDI remained significantly associated with the presence of severe tungiasis in the final model (RR = 1.04; 95% CI: 1.02–1.05; p < 0.001) and the presence of severe scabies with minimum temperature (RR = 1.13; 95% CI: 1.04–1.24; p = 0.003) and aridity index (RR = 1.01; 95% CI: 1.00–1.01; p = 0.004). Our study underscores the importance of environmental and socioeconomic factors for the occurrence of severe scabies and tungiasis in a semi-arid climatic context, offering a perspective for identification of high-risk areas, and providing evidence for the control of skin NTDs withina One Health approach. Full article

Background: Yaws is an infectious, neglected tropical disease that affects the skin of many children and adolescents who live in poor, rural, low-income communities in humid, tropical areas of Africa, Southeast Asia, and the Pacific Islands. Yaws is currently endemic in at least 15 countries, but adequate surveillance data are lacking. In line with the WHO’s effort to improve early detection, diagnosis, and proper management leading to the eventual eradication of yaws, this article reviews the existing literature on yaws in Africa to highlight the epidemiological pattern, genetic variability, diagnosis modalities, treatment, and control strategies, the challenges and prospects for yaws eradication. Methods: We searched PubMed and Scopus databases to identify published data in line with the review objectives. Results: One hundred and eighty-eight peer-reviewed articles were identified by PubMed and Scopus, out of which thirty were eligible. The studies covered 11 African countries, with the reported prevalence ranging from 0.50% to 43.0%. Conclusions: There is a great prospect for eradication if countries capitalize on the availability of simple, inexpensive, and well-tolerated oral treatment that has proven effective, validated point-of-care diagnostic tests and new molecular tests. Countries should embark on integrated disease control efforts to increase sustainability and improve the quality of life for people living with this NTD in poor communities. Full article

Neglected tropical diseases (NTDs) with skin manifestations present a significant health and societal problems challenge worldwide. This study aimed to analyzed factors associated with the knowledge, attitudes and practices (KAPs) of primary healthcare workers (HCW) concerning NTDs with skin manifestations in the Dakar region of Senegal. We conducted a cross-sectional study utilizing a semi-structured questionnaire which was administered to eligible HCW (general practitioners, nurses and midwives) working at the 24 health centers located in the Dakar region. Data were collected using the ODK Collect application (version 2022.3.6). KAPs measures were constructed from questionnaire responses, and bivariate analysis was used to identify associated factors. Of the 187 HCW surveyed, 75.9% were female, with a mean age of 35.1 years (SD: 8.56). The majority of HCWs had a bachelor’s degree (40.6%), were nurses (49.2%) and had between 1- and 10-years of professional experience (52.4%). Regarding their knowledge of NTDs with skin manifestations, only 43.3% of HCW had received initial training on NTDs. The most commonly reported NTDs with skin manifestations were leprosy (53.5%), lymphatic filariasis (51.3%), scabies (49.7%), onchocerciasis (45.5%) and schistosomiasis (42.8%). Television was the main source of information about these NTDs (38.5%). In term of practices, only 47.6% of HCW reported being able to diagnose NTDs with skin. Factors associated with good knowledge regarding NTDs with skin manifestations included having received training on NTDs (p = 0.0015) and more years of professional experience (p = 0.004). In summary, there is a need to strengthen and raise awareness about NTDs with skin manifestations among HCWs and promote quality management of patients in Senegal. Full article

Neglected Tropical Diseases (NTDs) are a group of chronic infectious diseases of poverty affecting over one billion people globally. Intersections of NTDs, disability, and mental ill-health are increasingly evidenced but are rarely studied from a mixed-methods perspective. Here, we advance syndemic understandings by further assessing and contextualising the syndemic relationship between NTDs (particularly their associated disability) and mental distress in Liberia. Participatory qualitative methods, including body mapping (56 participants), social mapping (28 participants), and in-depth interviews (12) provided space for persons affected by NTDs to narrate their experiences. Simultaneously, 201 surveys explored experiences of common mental health conditions among persons affected by skin NTDs. An intersectionality approach was applied within the analysis for both qualitative and quantitative methods informed by Meyer’s minority stress model, adapted for NTDs. Qualitative data was analysed thematically and gender-disaggregated, univariable and multivariable analyses were applied to survey data for the outcome measures depression (PHQ-9) and anxiety (GAD-7). Disability was associated with higher levels of depression and anxiety (p < 0.001). An interaction between disability and being a women increased incidence risk ratio of depression (p < 0.001). In alignment with qualitative findings, persons affected experienced additional generalised (financial concerns), external (experience of stigma) and internal (experience of pain and physical symptoms) minority stressors, to varying degrees, which contributed towards their mental distress, and mental health conditions. These findings were used to co-develop a syndemic-informed person-centred health system response to address the suffering associated with NTDs and mental distress, including a focus on strengthening relationships between formal and informal community health actors and the broader health system. Full article

We identified five distinct full-length human mineralocorticoid receptor (MR) genes containing either 984 amino acids (MR-984) or 988 amino acids (MR-988), which can be distinguished by the presence or absence of Lys, Cys, Ser, and Trp (KCSW) in their DNA-binding domain (DBD) and mutations at codons 180 and 241 in their amino-terminal domain (NTD). Two human MR-KCSW genes contain either (Val-180, Val-241) or (Ile-180, Val-241) in their NTD, and three human MR-984 genes contain either (Ile-180, Ala-241), (Val-180, Val-241), or (Ile-180, Val-241). Human MR-KCSW with (Ile-180, Ala-241) has not been cloned. In contrast, chimpanzees contain four MRs: two MR-988s with KCSW in their DBD, or two MR-984s without KCSW in their DBD. Chimpanzee MRs only contain (Ile180, Val-241) in their NTD. A chimpanzee MR with either (Val-180, Val-241) or (Ile-180, Ala-241) in the NTD has not been cloned. Gorillas and orangutans each contain one MR-988 with KCSW in the DBD and one MR-984 without KCSW, and these MRs only contain (Ile-180, Val-241) in their NTD. A gorilla MR or orangutan MR with either (Val-180, Val-241) or (Ile-180, Ala-241) in the NTD has not been cloned. Together, these data suggest that human MRs with (Val-180, Val-241) or (Ile-180, Ala-241) in the NTD evolved after humans and chimpanzees diverged from their common ancestor. Considering the multiple functions in human development of the MR in kidney, brain, heart, skin, and lungs, as well as MR activity in interaction with the glucocorticoid receptor, we suggest that the evolution of human MRs that are absent in chimpanzees may have been important in the evolution of humans from chimpanzees. Investigation of the physiological responses to corticosteroids mediated by the MR in humans, chimpanzees, gorillas, and orangutans may provide insights into the evolution of humans and their closest relatives. Full article

The most common association related to alpha-fetoprotein (AFP) is fetal neural tube defect (NTD), and indeed, this is where the international career of this protein began. In times when ultrasonography was not yet technically advanced, the detection of high levels of AFP in maternal serum (MS-AFP) and amniotic fluid was the basis for suspecting neural tube defects. In cases where there was no confirmation of NTD, other causes were sought. It has been established that high titers of MS-AFP could originate in other defects or diseases, such as (1) increased proteinuria in severe fetal kidney diseases; (2) pathological overproduction in liver diseases; (3) penetration through the membranes of gastrointestinal organs exposed to amniotic fluid; (4) passage through the walls of skin vessels; and as a side effect of (5) hepatic hematopoiesis and increased transfer through the edematous placenta in fetal anemia. This article provides a review of the current literature on congenital defects and genetic diseases in the fetus where an elevated level of MS-AFP may serve as the initial diagnostic clue for their detection. Full article

Background: The prevalence of skin diseases such as leprosy, and limited dermatological knowledge among frontline health workers (FHWs) in rural areas of Sub-Saharan Africa, led to the development of the NLR SkinApp: a mobile application (app) that supports FHWs to promptly diagnose and treat, or suspect and refer patients with skin diseases. The app includes common skin diseases, neglected tropical skin diseases (skin NTDs) such as leprosy, and HIV/AIDS-related skin conditions. This study aimed to test the supporting role of the NLR SkinApp by examining the diagnostic accuracy of its third edition. Methods: A cross-sectional study was conducted in East Hararghe, Ethiopia, as well as the Mwanza and Morogoro region, Tanzania, in 2018–2019. Diagnostic accuracy was measured against a diagnosis confirmed by two dermatologists/dermatological medical experts (reference standard) in terms of sensitivity, specificity, positive predictive value, and negative predictive value. The potential negative effect of an incorrect management recommendation was expressed on a scale of one to four. Results: A total of 443 patients with suspected skin conditions were included. The FHWs using the NLR SkinApp diagnosed 45% of the patients accurately. The values of the sensitivity of the FHWs using the NLR SkinApp in determining the correct diagnosis ranged from 23% for HIV/AIDS-related skin conditions to 76.9% for eczema, and the specificity from 69.6% for eczema to 99.3% for tinea capitis/corporis. The inter-rater reliability among the FHWs for the diagnoses made, expressed as the percent agreement, was 58% compared to 96% among the dermatologists. Of the management recommendations given on the basis of incorrect diagnoses, around one-third could have a potential negative effect. Conclusions: The results for diagnosing eczema are encouraging, demonstrating the potential contribution of the NLR SkinApp to dermatological and leprosy care by FHWs. Further studies with a bigger sample size and comparing FHWs with and without using the NLR SkinApp are needed to obtain a better understanding of the added value of the NLR SkinApp as a mobile health (mHealth) tool in supporting FHWs to diagnose and treat skin diseases. Full article

Cutaneous leishmaniasis (CL) is a common illness that causes skin lesions, principally ulcerations, on exposed regions of the body. Although neglected tropical diseases (NTDs) are typically found in tropical areas, they have recently become more common along Africa’s northern coast, particularly in Libya. The devastation of healthcare infrastructure during the 2011 war and the following conflicts, as well as governmental apathy, may be causal factors associated with this catastrophic event. The main objective of this study is to evaluate alternative diagnostic strategies for recognizing amastigotes of cutaneous leishmaniasis parasites at various stages using Convolutional Neural Networks (CNNs). The research is additionally aimed at testing different classification models employing a dataset of ultra-thin skin smear images of Leishmania parasite-infected people with cutaneous leishmaniasis. The pre-trained deep learning models including EfficientNetB0, DenseNet201, ResNet101, MobileNetv2, and Xception are used for the cutaneous leishmania parasite diagnosis task. To assess the models’ effectiveness, we employed a five-fold cross-validation approach to guarantee the consistency of the models’ outputs when applied to different portions of the full dataset. Following a thorough assessment and contrast of the various models, DenseNet-201 proved to be the most suitable choice. It attained a mean accuracy of 0.9914 along with outstanding results for sensitivity, specificity, positive predictive value, negative predictive value, F1-score, Matthew’s correlation coefficient, and Cohen’s Kappa coefficient. The DenseNet-201 model surpassed the other models based on a comprehensive evaluation of these key classification performance metrics. Full article

Novel approaches to geohealth data analysis offer major benefits to neglected tropical disease control by identifying how social, economic and environmental elements of place interact to influence disease outcomes. However, a lack of timely and accurate geohealth data poses substantial risks to the accuracy of risk identification and challenges to the development of suitably targeted disease control programs. Scabies is one of many skin-related NTDs that is nominated as a priority for global disease control by the World Health Organization, but for which there remains a lack of baseline geospatial data on disease distribution. In this opinion paper, we consider lessons on impediments to geohealth data availability for other skin-related NTDs before outlining challenges specific to the collection of scabies-related geohealth data. We illustrate the importance of a community-centred approach in this context using a recent initiative to develop a community-led model of scabies surveillance in remote Aboriginal communities in Australia. Full article

In recent years bioactive textiles have risen to the forefront of consumers perception due to their potential protection against virus, fungi and bacteria. However, traditional textile staining is an eco-damaging process that and current methods of textile functionalization are expensive, complicated and with great environmental impact. With that in mind, this work sought to show a possible solution for this problematic through the usage of a novel one step textile dyeing and functionalization method based upon nanoencapsulated textile dyes (NTDs). To do so navy blue everzol NTDs were produced with chitosan, cotton dyed, characterized through FTIR and SEM and biological potential evaluated through biocompatibility screening and antimicrobial activity against skin pathogens. The data obtained showed that NTDs effectively dyed the target textile through a coating of the cotton fibre and that NTDs formed hydrogen bonds with the cellulose fibre via electrostatic interactions of the chitosan amino groups with cotton sulphate groups. From a biocompatibility perspective NTDs dyed cotton had no deleterious effects upon a skin cell line, as it promoted cellular metabolism of HaCat cells, while traditionally died cotton reduced it by 10%. Last but not least, NTDs dyed cotton showed significant antimicrobial activity as it reduced viable counts of MRSA, MSSA and A. baumannii between 1 and 2 log of CFU while traditional dyed cotton had no antimicrobial activity. Considering these results the novel method proposed shows is a viable and ecological alternative for the development of antimicrobial textiles with potential biomedical applications. Full article

Introduction: Schistosomiasis, a neglected tropical disease (NTD), remains a public health problem in Ethiopia. Freshwater snails, acting as intermediate hosts, release cercariae, the infectious parasite, into the water, which penetrate human skin that encounters infested waters. The objective of this study was to map snail abundance along rivers and study its association with schistosomiasis infection in communities using these rivers. Materials and Methods: A cross-sectional study was carried out at 20 river sites in Mizan Aman city administration, Bench Sheko zone, South West Ethiopia Peoples (SWEP) region, Ethiopia, to study the distribution of host snails and transmission sites for intestinal schistosomiasis. This study used a quantitative database consisting of data on the prevalence of infected snails, the characteristics of rivers and riverbanks, and the prevalence of schistosomiasis in the community, based on stool samples collected from community members near the sampling sites. Results: Aquatic snails were found in 11 of the 20 sites sampled. A total of 598 snails was collected, including Biomphalaria pfeifferi, Biomphalaria sudanica, Radix natalensis and Bulinus globosus species; the most abundant species was Biomphalaria pfeifferi. Stool samples were collected from 206 community members from all 20 sites. Forty-one (19.9%) were positive for Schistosoma mansoni. A positive correlation was found between the presence of snails and positive stool samples (r = 0.60, p = 0.05) and between the presence of infected snails and the prevalence of infection (r = 0.64, p = 0.03). Locations with muddy riverbanks were associated with the presence of snails (r = 0.81, p < 0.001). Conclusions: These results emphasize the importance of mapping snails for the control of schistosomiasis by defining hotspots of infection and identifying factors associated with the presence of infected snails. The results support the need for a continuous mapping of snails and the introduction of snail control as a major element for the successful control of schistosomiasis in endemic communities. Full article

Lymphatic filariasis causes disfiguring and disabling lymphoedema, which is commonly and frequently exacerbated by acute dermatolymphangioadenitis (ADLA). Affected people require long-term care and monitoring but health workers lack objective assessment tools. We examine the use of an infrared thermal imaging camera as a novel non-invasive point-of-care tool for filarial lower-limb lymphoedema in 153 affected adults from a highly endemic area of Bangladesh. Temperature differences by lymphoedema stage (mild, moderate, severe) and ADLA history were visualised and quantified using descriptive statistics and regression models. Temperatures were found to increase by severity and captured subclinical differences between no lymphoedema and mild lymphoedema, and differences between moderate and severe stages. Toes and ankle temperatures detected significant differences between all stages other than between mild and moderate stages. Significantly higher temperatures, best captured by heel and calf measures, were found in participants with a history of ADLA, compared to participants who never had ADLA, regardless of the lymphoedema stage. This novel tool has great potential to be used by health workers to detect subclinical cases, predict progression of disease and ADLA status, and monitor pathological tissue changes and stage severity following enhanced care packages or other interventions in people affected by lymphoedema. Full article