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From river blindness control to elimination:bridge over troubled water

Infectious diseases of poverty 2018年第1期7卷 215-229页

作者： Robert Colebunders Maria-Gloria Basanez Katja Siling Rory J.Post Anke Rotsaert Bruno Mmbando Patrick Suykerbuyk Adrian Hopkins Global Health Institute University of AntwerpAntwerpBelgium London Centre for neglected Tropical Disease Research Imperial College LondonLondonUK Institute of Tropical Medicine AntwerpBelgium London School of Hygiene&Tropical Medicine LondonUK Liverpool John Moores University LiverpoolUK National Institute for Medical Research TangaTanzania neglected and disabling diseases of poverty consultant GravesendKentUK

Background:An estimated 25 million people are currently infected with onchocerciasis(a parasitic infection caused by the filarial nematode Onchocerca volvulus and transmitted by Simulium vectors),and 99%of these are in sub-Saharan *** African Programme for Onchocerciasis Control closed in December 2015 and the World Health Organization has established a new structure,the Expanded Special Project for the Elimination of neglected Tropical diseases for the coordination of technical support for activities focused on five neglected tropical diseases in Africa,including onchocerciasis ***:In this paper we argue that despite the delineation of a reasonably well-defined elimination strategy,its implementation will present particular difficulties in *** aim to highlight these in an attempt to ensure that they are well understood and that effective plans can be laid to solve them by the countries concerned and their international ***:A specific concern is the burden of disease caused by onchocerciasis-associated epilepsy in hyperendemic zones situated in countries experiencing difficulties in strengthening their onchocerciasis control *** difficulties should be identified and programmes supported during the transition from morbidity control to interruption of transmission and elimination.

关键词： Onchocerciasis Control Elimination Monitoring&evaluation Community drug distributors Epilepsy Prevalence Incidence

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Report of the first international workshop on onchocerciasis-associated epilepsy

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Infectious diseases of poverty 2018年第1期7卷 238-242页

作者： Robert Colebunders Michel Mandro Alfred K.Njamnshi Michel Boussinesq An Hotterbeekx Joseph Kamgno Sarah O’Neill Adrian Hopkins Patrick Suykerbuyk Maria-Gloria Basanez Rory J.Post Belen Pedrique Pierre-Marie Preux Wilma A.Stolk Thomas B.Nutman Richard Idro Global Health Institute University of AntwerpAntwerpBelgium Provincial Health Division of Ituri BuniaDemocratic Republic of the Congo Department of Neurology Yaounde Central Hospital/University of Yaounde 1Brain Research Africa Initiative(BRAIN)YaoundeCameroon Institut de Recherche pour le Developpement(IRD) MontpellierFrance Centre for Research on Filariasis and other Tropical diseases(CRFilMT) and Faculty of Medicine and Biomedical SciencesUniversity of Yaounde 1YaoundeCameroon Department of Public Health Institute of Tropical MedicineAntwerpBelgium neglected and disabling diseases of poverty consultant KentUK London Centre for neglected Tropical Disease Research Imperial College LondonLondonUK London School of Hygiene&Tropical Medicine and Liverpool John Moores University LondonUK Drugs for neglected diseases initiative GenevaSwitzerland Preux Pierre-Marie INSERMUniversity LimogesCHU LimogesUMR_S 1094Tropical NeuroepidemiologyInstitute of Neuroepidemiology and Tropical NeurologyCNRS FR 3503 GEIST87000 LimogesFrance Department of Public Health Erasmus MCUniversity Medical Centre RotterdamRotterdamThe Netherlands Laboratory of Parasitic diseases National Institutes of HealthBethesdaMarylandUSA Makerere University College of Health SciencesKampalaUganda

Background:Recently,several epidemiological studies performed in Onchocerca volvulus-endemic regions have suggested that onchocerciasis-associated epilepsy(OAE)may constitute an important but neglected public health problem in many countries where onchocerciasis is still *** text:On October 12-14th 2017,the first international workshop on onchocerciasis-associated epilepsy(OAE)was held in Antwerp,*** workshop was attended by 79 participants from 20 different *** research findings strongly suggest that *** is an important contributor to epilepsy,particularly in meso-and hyperendemic areas for *** with *** is associated with a spectrum of epileptic seizures,mainly generalised tonic-clonic seizures but also atonic neck seizures(nodding),and stunted *** is characterised by an onset of seizures between the ages of 3-18 *** working groups discussed topics such as how to 1)strengthen the evidence for an association between onchocerciasis and epilepsy,2)determine the burden of disease caused by OAE,3)prevent OAE,4)improve the treatment/care for persons with OAE and affected families,5)identify the pathophysiological mechanism of OAE,and 6)deal with misconceptions,stigma,discrimination and gender violence associated with *** OAE Alliance was created to increase awareness about OAE and its public health importance,stimulate research and disseminate research findings,and create partnerships between OAE researchers,communities,advocacy groups,ministries of health,non-governmental organisations,the pharmaceutical industry and funding ***:Although the exact pathophysiological mechanism underlying OAE remains unknown,there is increasing evidence that by controlling and eliminating onchocerciasis,OAE will also ***,OAE constitutes an additional argument for strengthening onchocerciasis elimination *** the high numbers of people with epilepsy

关键词： Onchocerciasis Epilepsy Nodding syndrome Nakalanga syndrome Prevalence Burden of disease Africa

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Management of psoriasis patients with hepatitis B or hepatitis C virus infection

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World Journal of Gastroenterology 2016年第28期22卷 6444-6455页

作者： Claudio Bonifati Viviana Lora Dario Graceffa Lorenzo Nosotti Center for the Study and Treatment of Psoriasis San Gallicano Dermatologic Institute IRCCS Gastrointestinal and Liver Department National Institute for Health Migration and Poverty

The systemic therapies available for the management of Psoriasis (PsO) patients who cannot be treated with more conservative options, such as topical agents and/or phototherapy, with the exception of acitretin, can worsen or reactivate a chronic infection. Therefore, before administering immunosuppressive therapies with either conventional disease-modifying drugs (cDMARDs) or biological ones (bDMARDs) it is mandatory to screen patients for some infections, including hepatitis B virus (HBV) and hepatitis C virus (HCV). In particular, the patients eligible to receive an immunosuppressive drug must be screened for the following markers: antibody to hepatitis B core, antibody to hepatitis B surface antigen (anti-HBsAg), HBsAg, and antibody to HCV (anti-HCV). In case HBV or HCV infection is diagnosed, a close collaboration with a consultant hepatologist is needed before and during an immunosuppressive therapy. Concerning therapy with immunosuppressive drugs in PsO patients with HBV or HCV infection, data exist mainly for cyclosporine a (CyA) or bDMARDs (etanercept, adalimumab, infliximab, ustekinumab). The natural history of HBV and HCV infection differs significantly as well as the effect of immunosuppression on the aforementioned infectious diseases. As a rule, in the case of active HBV infection, systemic immunosuppressive antipsoriatic therapies must be deferred until the infection is controlled with an adequate antiviral treatment. Inactive carriers need to receive antiviral prophylaxis 2-4 wk before starting immunosuppressive therapy, to be continued after 6-12 mo from its suspension. Due to the risk of HBV reactivation, these patients should be monitored monthly for the first 3 mo and then every 3 mo for HBV DNA load together with transaminases levels. Concerning the patients who are occult HBV carriers, the risk of HBV reactivation is very low. Therefore, these patients generally do not need antiviral prophylaxis and the sera HBsAg and transaminases dosing can be

关键词： Psoriasis Therapy Conventional disease-modifying drugs Biological disease-modifying drugs Hepatitis B virus infection Hepatitis C virus infection

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Establishing a child and adolescent mental health center in Herat,Afghanistan:a project description

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Global Health Journal 2023年第4期7卷 194-199页

作者： Abdul Fattah Najm Aziz-ur-Rahman Niazi Mina Alekozay Emily B.Allan Kaaren Mathias Technical Director International Assistance MissionHerat 3001Afghanistan Department of Public Health and Infectious diseases Faculty of MedicineHerat 3001Afghanistan Independent consultant RedcarNorth YorkshireTS103JAUK Faculty of Health University of CanterburyChristchurch 8140New Zealand

Objective:Afghanistan has witnessed a long-lasting 4-decade armed conflict,which together with high levels of poverty and interpersonal violence,resulted in high incidence and prevalence of mental disorders in general population,including children and *** mid-2018,there was neither mental health care facility nor a child psychiatrist in ***,we report the establishment of the first children and adolescents'mental health center(CAMHC)in Herat province of ***:In July 2018,CAMHC was initiated at Mental Health Training *** was initially planned by the International Assistance Mission(IAM)and Herat Public Health Directorate;and financially supported by the Tearfund UK,the United Methodist Committee on Relief and Tearfund *** target population of CAMHC was children and adolescents in Herat and neighboring provinces,healthcare professionals,staff of government and non-governmental organizations,school teachers and community ***:A group of eight mental health professionals were trained and made the interdisciplinary board for diagnosis and management of mental disorders in children and *** the initial three-year period,2448 patients,including 1264(51.6%)boys and 1184(48.4%)girls,presented with mental disorders to *** and management of mental disorders were performed according to standard international *** awareness-raising seminars were held;2000 leaflets,10000 posters,and 30000 brochures were prepared and distributed;and two short video clips were produced and broadcast via IAM website,social media and local TV channels.A database was developed to house for project data,assessment of outcomes and reporting to ***:Establishment of CAMHC resulted in significant achievements in diagnosis and management of mental disorders among children and adolescents,healthcare staff capacity building,and awareness-raising about mental *** o

关键词： Child and adolescent Mental health Herat Afghanistan

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Ex Ante Inequality and Under-Nutrition Vulnerability Dynamics: Case Study of the Sundarbans Delta Region, West Bengal, India

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Food and Nutrition Sciences 2014年第20期5卷 1951-1963页

作者： Moumita Mukherjee Independent Research consultant Atlanta USA

In this paper ex ante inequality measure is used to estimate inequality in childhood chronic under-nutrition among different vulnerable subgroups. Ex ante inequality in nutritional achievement is determined by estimating Concentration Index by ranking the sample population as per different contextual absolute and predicted vulnerabilities. Such vulnerabilities include climatic shock induced asset loss, livelihood insecurity, physical accessibility and consumption sacrifice after treatment seeking of children for under-nutrition related morbidities and perception of care givers regarding quality and effectiveness of care provided by unqualified providers. Results found that vulnerability to consumption poverty aggravated chronic under-nutrition among less vulnerable groups mainly among those who perceived that unqualified providers provided quality service and were very effective during crisis. Whereas, vulnerability to investment poverty due to asset loss aggravates chronic under-nutrition among more vulnerable groups as their low economic resilience against any safety net results in no treatment seeking but rely on home remedies to cure the child. Though due to good social cohesion, traditional knowledge and beliefs for treatment are shared among each other but this is not sufficient to break the under-nutrition morbidity vicious circle, especially when the under-nutrition is chronic in nature. So the paper finally suggests several policy suggestions for different vulnerable segments.

关键词： Vulnerability Concentration Index

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poverty Reduction and Pattern of Chronic Childhood Under-Nutrition in India: How Far Does the Link Exist?

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Food and Nutrition Sciences 2014年第20期5卷 1964-1977页

作者： Moumita Mukherjee Independent Research consultant Atlanta USA

In spite of an established link between poverty and under-nutrition in India, fall in under-nutrition is sluggish with fall in poverty. This research paper aims to seek answer on the effect of poverty decline on child under-nutrition in India over a period of one and a half decades. After examining the extent of association between poverty reduction and reciprocal changes in child under-nutrition, the paper found that although there was a definite influence of poverty levels on child under-nutrition at the state-level, the strength of the impact was not very high. This possibly explains why improvements in nutritional status among children have failed to keep up pace with steady reduction in mass poverty across the states in the last couple of decades. The results also strongly reiterate the magnificent role of child’s healthcare utilization and higher public spending which can help to capitalize on the increase in economic capabilities at the household level, resulting from robust economic growth and alleviation of endemic poverty.

关键词： Absolute poverty Chronic Under-Nutrition India

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Emerging HIV Epidemic in the North-Eastern State of Assam, India: An Exploratory Study Using Mixed-Methods Approach

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World Journal of AIDS 2018年第1期8卷 21-36页

作者： Chiranjeev Bhattacharjya Giridhar Pathak Tulika Goswami Mahanta Y. Manihar Singh Ranjanjyoti Deka Mitali Sen Alok Kr. Deb Assam State AIDS Control Society (SACS) Guwahati India Silchar Medical College & Hospital Silchar India Assam Medical College & Hospital Dibrugarh India Regional Institute of Medical Sciences Imphal India Part-Time Project consultant Kolkata India ICMR-National Institute of Cholera & Enteric diseases Kolkata India

Background: The national HIV scenario in India has improved impressively during past two decades. Contrastingly, the State-level HIV sentinel surveil-lance and routine programme data from various testing facilities indicated an increasing HIV prevalence among antenatal clinic attendees and female sex workers (FSWs) in three districts of Assam. Objectives: 1) To explore the reasons behind increasing adult HIV prevalence and 2) To understand the role of FSW and Migrants/long distance truckers as drivers of the HIV epi-demic in these districts. Methodology: Three sources of data were utilized in this concurrent mixed methods study—1) existing programme data for past three years;2) questionnaire-based data for a case-control study, where dur-ing past six months at designated testing facilities HIV(+) married women were “cases” and age-matched HIV(?) women from the same district were “controls”. Spouses of these women were also interviewed separately;and 3) a qualitative study, where focus group discussions were conducted among FSWs, outgoing male migrant labourers and long-distance truckers. Results: The study revealed high levels of unsafe sexual practices among the FSWs. Sometimes in poverty-struck areas, women, not identifying themselves as sex workers, sold sex on a part-time basis to earn extra money for financial sup-port and often remained invisible to the programme. The clients of the sex workers, male migrants and truckers also revealed various risk behaviours for contracting and transmitting HIV infection. Conclusion: Population and context specific programme strategies are required to halt the rising trend of HIV infection in the general population in Assam.

关键词： HIV Assam Mixed Methods

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Defining an evidence base for treatment and treatment modalities in patients with Acromegaly

Defining an evidence base for treatment and treatment modali...

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2008内分泌代谢性疾病系列研讨会暨中青年英文论坛

作者： Paul M Stewart University of Birmingham and consultant Physician Queen Elizabeth HospitalBirminghamUK MD FRCP FMedSci Professor of Medicine

Acromegaly is invariably caused by a GH secreting pituitary tumour and results in significant patient morbidity and premature cardiovascular *** options first and foremost should reverse the disabling symptoms(headache,sweating,tiredness,paraesthesia,arthralgia, snoring)and address the pituitary tumour itself,ideally with total excision and prevention of *** last 10 years has also seen an evidence base for the biochemical follow-up and"cure"of patients with Acromegaly,with a series of retrospective follow-up studies showing normalization of mortality rates if GH can be reduced to<5 mU/L(2.5 ?g/L).

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Establishment of a Qualitative Cancer Care Centre in a Rural Set-up at Mirpur-India

Establishment of a Qualitative Cancer Care Centre in a Rural...

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第四届中国肿瘤学术大会暨第五届海峡两岸肿瘤学术会议

作者： S. S. Yadav Chairman of consultant Orthopedic Surgeon Ram-Bhagwan Charitable Medical Institute of Cancer Management ＆ Research MIRPURDistt.: RewariHaryanaIndia

＜正＞India lives in villages. The statistics reveal that 77 % of population of our country dwell in villages and the remaining 23% in Urban areas. It is a fact that Health problems in Rural population is profoundly different from Urban. poverty and malnutrition dramatically exacerbates the incidents of chronic diseases including TB and Cancer. Cancer has been considered as Road to Death. However, if detected early a cure is possible. Once a diagnosis is made, the

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Early detection of neuropathy in leprosy:a comparison of five tests for field settings

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Infectious diseases of poverty 2017年第1期6卷 1034-1042页

作者： Inge Wagenaar Erik Post Wim Brandsma Dan Ziegler Moshiur Rahman Khorshed Alam Jan Hendrik Richardus Department of Public Health Erasmus MCRotterdamThe Netherlands KIT Health Royal Tropical InstituteAmsterdamThe Netherlands Independent leprosy consultant AmsterdamThe Netherlands Institute for Clinical Diabetology German Diabetes Center at Heinrich Heine UniversityLeibniz Center for Diabetes ResearchDusseldorfGermany Department of Endocrinology and Diabetology Medical FacultyHeinrich Heine UniversityDüsseldorfGermany Rural Health Program The Leprosy Mission International-BangladeshNilphamariBangladesh

Background:Early detection and treatment of neuropathy in leprosy is important to prevent disabilities.A recent study showed that the Nerve Conduction Studies(NCS)and Warm Detection Thresholds(WDT)tests can detect leprosy neuropathy the *** two tests are not practical under field conditions,however,because they require climate-controlled rooms and highly trained staff and are *** assessed the usefulness of alternative test methods and their sensitivity and specificity to detect neuropathy at an early ***:Through a literature search we identified five alternative devices that appeared user-friendly,more affordable,portable and/or battery-operated:the Neuropad^(■),Vibratip^(TM),NC-Stat^(■)DPNCheck^(TM),NeuroQuick and the Thermal Sensibility Tester(TST),assessing respectively sweat function,vibration sensation,nerve conduction,cold sensation and warm *** leprosy patients in Bangladesh,the posterior tibial and sural nerves that tested normal for the monofilament test and voluntary muscle test were assessed with the NCS and WDT as reference standard *** alternative devices were then tested on 94 nerves with abnormal WDT and/or NCS results and on 94 unaffected *** and specificity were the main ***:The NeuroQuick and the TST showed very good sensitivity and *** the sural nerve,the NeuroQuick had both a sensitivity and a specificity of 86%.The TST had a sensitivity of 83%and a specificity of 82%.Both the NC-Stat^(■)DPNCheck^(TM)and Vibratip^(TM)had a high specificity(88%and 100%),but a low sensitivity(16%and 0%).On the posterior tibial nerve,the NeuroQuick and the TST also showed good sensitivity,but the sensitivity was lower than for the sural *** Neuropad^(■)had a sensitivity of 56%and a specificity of 61%.Conclusions:The NeuroQuick and TST are good candidates for further field-testing for reliability and *** feasibility of production on a larger scale should be exami

关键词： Leprosy Neuropathy Detection Subclinical Field use

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