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Estimated need for anthelminthic medicines to control soil-transmitted helminthiases in school-aged children,2020–2030

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Infectious Diseases of Poverty 2020年第3期9卷 74-83页

作者： chiara marocco Fabrizio Tediosi Mathieu Bangert Denise Mupfasoni Antonio Montresor Department of Control of Neglected Tropical Diseases World Health OrganizationGenevaSwitzerland Swiss Tropical and Public Health Institute BaselSwitzerland University of Basel BaselSwitzerland

Background:Soil-transmitted helminthiases(STH)are part of the group of neglected tropical diseases traditionally treated with preventive chemotherapy interventions.In recent years,drug donations have been essential to expanding preventive chemotherapy and achieving progressive control of morbidity from STH.This study aims to evaluate the need for anthelminthic medicines during 2020–2030.Methods:To estimate the need for anthelminthic medicines,we considered three different scenarios:(1)the control programmes continues to expand coverage and maintains the frequency of drug administration established at baseline;(2)the programmes continues to expand coverage but adapts the frequency of drug administration when the STH prevalence is reduced and(3)the STH programme becomes self-sustainable in some endemic countries.Results:We estimate that the number of anthelmintic medicines needed to treat school-aged children will increase by 40%by 2025 and by 52%by 2030 if countries do not change the frequency of preventive chemotherapy(scenario 1);that the number of tablets needed will reduce by 32.4%by 2025 and by 49.1%in 2030 if endemic countries reduce the frequency of preventive chemotherapy(scenario 2);and drug donations could be reduced by 54.4%by 2025 and 74.4%by 2030 if some endemic countries could become independent in drug procurement(scenario 3).Conclusions:The number of anthelmintic medicines needed to achieve elimination of morbidity due to STH in school-aged children will decline during 2020–2030.The decline will be substantial if a number of“upper-middle income”countries in which STH are endemic procure,as expected,anthelminthic medicines independently.

关键词： Preventive chemotherapy Soil-transmitted helminthiases Drug donations

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Sustained preventive chemotherapy for soil-transmitted helminthiases leads to Pdaes reduction in prevalence and anthelminthic tablets required

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Infectious Diseases of Poverty 2019年第5期8卷 30-39页

作者： Denise Mupfasoni Mathieu Bangert Alexei Mikhailov chiara marocco Antonio Montresor Department of Control of Neglected Tropical Diseases World Health OrganizationGenevaSwitzerland

Background:The goal of soil-transmitted helminthiases(STH)control programmes is to eliminate STH-associated morbidity in the target population by reducing the prevalence of moderate-and heavy-intensity infections and the overall STH infection prevalence mainly through preventive chemotherapy(PC)with either albendazole or mebendazole.Endemic countries should measure the success of their control programmes through regular epidemiological assessments.We evaluated changes in STH prevalence in countries that conducted effective PC coverage for STH to guide changes in the frequency of PC rounds and the number of tablets needed.Methods:We selected countries from World Health Organization(WHO)^Preventive Chemotherapy and Transmission control(PCT)databank that conducted≥5 years of PC with effective coverage for school-age children(SAC)and extracted STH baseline and impact assessment data using the WHO Epidemiological Data Reporting Form,Ministry of Health reports and/or peer-reviewed publications.We used pooled and weighted means to plot the prevalence of infection with any STH and with each STH species at baseline and after≥5 years of PC with effective coverage.Finally,using the WHO STH decision tree,we estimated the reduction in the number of tablets needed.Results:Fifteen countries in four WHO regions conducted annual or semi-annual rounds of PC for STH for 5 years or more and collected data before and after interventions.At baseline,the pooled prevalence was 48.9%(33.1-64.7%)for any STH,23.2%(13.7-32.7%)for Ascoris lumbricoides,21.01%(9.7-32.3%)for Trichuris trichiuro and 18.2%(10.9-25.5%)for hookworm infections,while after>5 years of PC for STH,the prevalence was 14.3%(7.3-21.3%)for any STH,6.9%(1.3-12.5%)for A.lumbricoides,5.3%(1.06-9.6%)for T.trichiura and 8.1%(4.0-12.2%)for hookworm infections.Conclusions:Countries endemic for STH have made tremendous progress in reducing STH-associated morbidity,but very few countries have data to demonstrate that progress.In this study,the data show that nine countries should ad

关键词： Soil-transmitted helminthiases Control morbidity Preventive chemotherapy Prevalence

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Negative association between trunk fat, insulin resistance and skeleton in obese women

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World Journal of Diabetes 2013年第2期4卷 31-39页

作者： Emanuela A Greco Davide Francomano Rachele Fornari chiara marocco Carla Lubrano Vincenza Papa Francesca Wannenes Luigi Di Luigi Lorenzo M Donini Andrea Lenzi Antonio Aversa Silvia Migliaccio Department of Experimental Medicine Section of Medical Pathophysiology Endocrinology and Nutrition University "Sapienza"of Rome Department of Experimental Medicine Section of Medical Pathophysiology Endocrinology and Nutrition University "Sapienza" of Rome Unit of Endocrinology Department of Health Sciences University "Foro Italico" of Rome

AIM: To evaluate the potential interference of trunk fat (TF) mass on metabolic and skeletal metabolism. METHODS: In this cross-sectional study, 340 obese women (mean age: 44.8 ± 14 years; body mass index: 36.0 ± 5.9 kg/m 2 ) were included. Patients were evaluated for serum vitamin D, osteocalcin (OSCA), inflammatory markers, lipids, glucose and insulin (homeostasis model assessment of insulin resistance, HOMA-IR) levels, and hormones profile. Moreover, all patients underwent measurements of bone mineral density (BMD;at lumbar and hip site) and body composition (lean mass, total and trunk fat mass) by dual-energy X-ray absorptiometry. RESULTS: Data showed that: (1) high TF mass was inversely correlated with low BMD both at lumbar (P < 0.001) and hip (P < 0.01) sites and with serum vitamin D (P < 0.0005), OSCA (P < 0.0001) and insulin-like growth factor-1 (IGF-1; P < 0.0001) levels; (2) a positive correlation was found between TF and HOMA-IR (P < 0.01), fibrinogen (P < 0.0001) and erythrocyte sedimentation rate (P < 0.0001); (3) vitamin D levels were directly correlated with IGF-1 (P < 0.0005), lumbar (P < 0.006) and hip (P < 0.01) BMD; and (4) inversely with HOMA-IR (P < 0.001) and fibrinogen (P < 0.0005). Multivariate analysis demonstrated that only vitamin D was independent of TF variable. CONCLUSION: In obese women, TF negatively correlates with BMD independently from vitamin D levels. Reduced IGF-1 and increased inflammatory markers might be some important determinants that account for this relationship.

关键词： Obesity Skeleton Vitamin D Osteocalcin Insulin resistance Trunk fat Inflammation

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