bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of a large dam on malaria risk: the Koka reservoir in Ethiopia
Authors: Lautze Jonathan , McCartney Matthew , Kirshen Paul , Olana Dereje , Jayasinghe Gayathree , Spielman Andrew 
Published: August 2010

SummaryObjective  To determine whether the Koka water reservoir in the Rift Valley of Ethiopia contributes to the malaria burden in its vicinity.Methods  Frequency of malaria diagnosis in fever clinics was correlated with distance of residence from the margin of the Koka reservoir. Annual as well as seasonal malaria case rates were determined in cohorts residing < 3, 3–6 and 6–9 km from the reservoir. Plasmodium falciparum risk was compared with that of Plasmodium vivax. A multiple variable regression model was used to explore associations between malaria case rates and proximity to the reservoir, controlling for other suspected influences on malaria transmission.Results  Malaria case rates among people living within 3 km of the reservoir are about 1.5 times as great as for those living between 3 and 6 km from the reservoir and 2.3 times as great for those living 6–9 km from the reservoir. Proximity to the reservoir is associated with greater malaria case rates in periods of more intense transmission. Plasmodium falciparum is most prevalent in communities located close to the reservoir and P. vivax in more distant villages. The presence of the reservoir, coupled with inter‐annual climatic variations, explains more than half of the region's variability in malaria case rates.Conclusion  Large water impoundments are likely to exacerbate malaria transmission in malaria‐endemic parts of sub‐Saharan Africa.
A serological study of Cryptosporidium transmission in a periurban area of a Brazilian Northeastern city
Authors: Teixeira M. C. A. , Barreto M. L. , Melo C. , Silva L. R. , Moraes L. R. S. , Alcântara‐Neves N. M. 
Published: August 2010

SummaryObjectives  To study the prevalence of Cryptosporidium infection by measuring the levels of anti‐Cryptosporidium IgG antibodies among people inhabiting three neighbourhoods of a periurban area of Salvador, Northeast of Brazil; and to investigate the effects of environmental sanitation measures, hygienic habits and household water supply, storage and handling on the frequency of these antibodies in sera of the studied population.Methods  Cryptosporidium inter‐household transmission was studied by comparing the frequency of anti‐Cryptosporidium IgG antibodies among people inhabiting areas with or without different environmental sanitation measures and intra‐household transmission by comparing the presence of these antibodies in families with or without cases of diarrhoea, associated with the presence of Cryptosporidium oocysts in their stools. Children or family members with diarrhoeal episodes were evaluated parasitologically for Cryptosporidium infection by testing stool specimens with the Ritchie‐modified formol‐ether concentration and the acid‐fast staining methods. All groups were serologically evaluated for parasite exposure by an indirect enzyme‐linked immunosorbent assay.Results  A statistically significant difference was detected in the prevalence of Cryptosporidium infection between area 1 which had no environmental sanitation measures and area 3 which had improved environmental sanitation measures (P = 0.044). Most of the hygienic habits investigated did not correlate with the presence of anti‐Cryptosporidium antibody in sera of the population studied. However, positive associations were found between both poor household water supply (OD = 0.17; 90% CI = 0.09–0.32; P = 0.0001) and drinking unboiled/unfiltered water (OD = 0.40; 90% CI = 0.24–0.67; P = 0.0002) with high levels of anti‐Cryptosporidium antibodies in sera.Conclusions  These data suggest that although uncorrected household water supply, storage and handling play an important role on Cryptosporidium transmission in periurban areas of developing country cities, like Salvador, Brazil, inadequate environmental conditions may also contribute to the spread of this parasite.
Immune responses after single‐dose sulphadoxine–pyrimethamine indicate underestimation of protective efficacy of intermittent preventive treatment in infants
Authors: Schreiber Nadine , Kobbe Robin , Adjei Samuel , Adjei Ohene , Klinkert Mo‐Quen , May Jürgen 
Published: August 2010

SummaryObjective  To assess how intermittent preventive treatment in infants (IPTi) with sulphadoxine–pyrimethamine (SP) affects Immunoglobulin (IgG) immune responses against Plasmodium falciparum in infants from rural Ghana.Methods  Randomized, placebo‐controlled and double‐blinded clinical trial with participants randomized in blocks of 10 to receive either 250 mg sulphadoxine/2.5 mg pyrimethamine or placebo at the age of 3 (IPTi‐1), 9 (IPTi‐2) and 15 (IPTi‐3) months and followed‐up for 21 months. (i) Anti‐P. falciparum IgG levels were measured in 180 children at the age of 9 months. (ii) Longitudinal study of the relationship between IgG levels and P. falciparum infections and/or clinical malaria in 17 naive children until they reached the age of 2 years.Results  IgG antibody levels against crude P. falciparum lysate were dependent on the frequency of preceding infections and significantly lower in children treated with SP.Conclusion  Placebo‐treated children had an indifferentially higher incidence of P. falciparum infections than clinically observed, which implicates an underestimation of the protective efficacy of IPTi. IgG profiles in 17 children followed up until the age of 2 years provided no evidence for impaired immune responses after a single dose of SP within the framework of IPTi.
Scaling up clinical audits of obstetric cases in Morocco
Authors: Muffler Nathalie , Trabelssi Mohammed El Hassane , De Brouwere Vincent 
Published: August 2010

SummaryObjectives  To follow‐up on the process of implementing clinical audits of obstetric cases in Morocco as recommended by the Ministry of Health (2001) and to explore both the barriers to and factors facilitating sustainability of clinical audits.Method  Questionnaires were sent to heads of all 61 Moroccan health provinces (response rate 69%) to ask if their maternity units had implemented clinical audits between 1998 and 2003. Twenty of the 42 public maternities which responded had performed so. Thirteen of these 20 hospitals were visited and 56 semi‐structured interviews held with administrators and health professionals. Locally available audit registers were consulted to triangulate data.Results  Eleven of 13 maternities visited conducted an average of 6.8 case reviews per year with a total average of 16.7 cases per hospital (range 4–38). Although interviewees confirmed that audits resulted in better quality of care, five hospitals had ceased performing audits altogether and the remainder did them less frequently, because of audit teams encountering staff resistance, insufficient understanding of the audit concept, difficulties in organizing sessions, and lack of administrative support. Insufficient training and external assistance hindered the implementation of complete audit loops, resulting in a loss of staff motivation.Conclusion  Implementing clinical audits as a means to improving quality of care requires a significant investment in training and various kinds of on‐going assistance – factors which decision‐makers should be aware of.
Detection of mutant P2 adenosine transporter (TbAT1) gene in Trypanosoma brucei gambiense isolates from northwest Uganda using allele‐specific polymerase chain reaction
Authors: Nerima Barbara , Matovu Enock , Lubega George W. , Enyaru John C. K. 
Published: August 2010

SummaryObjective  To assess the application of allele‐specific PCR (AS‐PCR) as a fast, cheap and reliable method for detecting mutant TbAT1 associated with melarsoprol relapse in Trypanosoma brucei gambiense isolates from northwest Uganda.Methods  A total of 105 trypanosome isolates were analysed using SfaN1 restriction fragment length polymorphism (RFLP) and AS‐PCR, the former used as the gold standard. Sensitivity, specificity, positive and negative predictive values of AS‐PCR as well as agreement between the tests were determined.Results  Eleven trypanosome isolates had mutant TbAT1 while 94 exhibited the wild‐type TbAT1 genes. There was a highly significant agreement between SfaN1 RFLP and AS‐PCR with kappa and intra‐class correlation values of 1.0. The sensitivity and specificity of AS‐PCR were both 100%, while the positive and negative predictive values were found to be equal to 1.0. Cost and time analyses were performed and AS‐PCR was 4.3 times cheaper than SfaN1 RFLP, in addition to the less time required for its execution.Conclusion  AS‐PCR should be the test of choice for screening for mutant TbAT1 in the ever‐increasing numbers of field trypanosome isolates.
Influence of larval density or food variation on the geometry of the wing of Aedes (Stegomyia) aegypti
Authors: Jirakanjanakit N. , Leemingsawat S. , Thongrungkiat S. , Apiwathnasorn C. , Singhaniyom S. , Bellec C. , Dujardin J. P. 
Published: August 2010

SummaryBackground and Method  Variation in wing length among natural populations of Aedes (Stegomyia) aegypti (L.) (Diptera: Culicidae) is associated with different vectorial capacities. Geometric morphometrics allowed us to use a more powerful estimator of wing size (‘centroid size’), as well as to visualize the variation of wing shape, to describe the effects of density or food variation at larval stage on 20 anatomical landmarks of the wing of A. aegypti.Results  Almost perfect correlations between (centroid) size and larval density or size and larval food were observed in both sexes: a negative correlation with increasing density and a positive one with increasing amount of food. The allometric component of shape change was always highly significant, with stronger contribution of size to shape under food effects. Within each experiment, either food or density effects, and excluding extreme conditions, allometric trends were similar among replicates and sexes. However, they differed between the two experiments, suggesting different axes of wing growth.Conclusion  Aedes aegypti size is highly sensible to food concentration or population density acting at larval stages. As larger individuals could be better vectors, and because of the stronger effect of food concentration on size, vector control activities should pay more attention in eliminating containers with rich organic matter. Furthermore, as a simple reduction in larval density could significantly increase the size of the survivors, turning them into potentially better vectors, the control activities should try to obtain a complete elimination of the domestic populations.
Healthcare‐seeking behaviour and use of traditional healers after snakebite in Hlabisa sub‐district, KwaZulu Natal
Authors: Sloan Derek J. , Dedicoat Martin J. , Lalloo David G. 
Published: August 2010

SummaryObjetive  To quantify snakebite incidence in Hlabisa sub‐district and examine healthcare seeking behaviour, focussing on the use of traditional healers and medications.Methods  Snakebite incidence was calculated by retrospective register review at Hlabisa Hospital for the period 2000–2005 and at associated primary health care clinics for 2005. Fifty consecutive in‐patient snakebite victims were interviewed. Treatment‐seeking pathways, bite‐to‐admission times and factors associated with delay or use of traditional therapy were analysed.Results  The annual hospital snakebite incidence was 53 bites per 100 000 population. In 2005, combined hospital and community incidence was 58 per 100 000. Eighty per cent of admitted snakebite victims used traditional medicine and 62.5% of these consulted a traditional health practitioner (THP). The median time until admission was 7 h 15 min (interquartile range: 4–14.25 h). The median time until THP consultation was 15 min (interquartile range 5–50 min). THP consultation was associated with bite‐to‐hospital admission delays of more than 6 h [relative risk: 1.82, 95% confidence interval (CI): 1.09–3.03, P = 0.0016). Non‐statistically significant trends towards THP use were observed if hospital access was poor or if patients were younger than 9 years.
Duration and associated factors of patient delay during tuberculosis screening in rural Cameroon
Authors: Cambanis Alexis , Ramsay Andy , Yassin Mohammed A. , Cuevas Luis E. 
Published: August 2010

SummaryObjectives  (i) To determine patient delay – the time from the onset of symptoms to presentation at a health facility – and its causes in patients undergoing sputum smear examination in Cameroon; and (ii) to compare the results with those of a previous study in Ethiopia.Methods  A cross‐sectional study of 243 consecutive patients using a structured questionnaire.Results  Median (interquartile range) patient delay in Cameroon was 2.0 (1–4) weeks, shorter than the 4.3 (2–13) week delay in Ethiopia. Significantly fewer patients delayed more than 1, 2 and 3 months in Cameroon than in Ethiopia (P < 0.001). Delays in Cameroon were significantly associated with being the main income earner, the belief that TB is stigmatizing, and the use of traditional medicine – the latter being the only factor significant in both studies.Conclusion  Engaging traditional healers in TB control programs and reducing stigma through education could help to reduce patient delays, accelerate diagnosis, improve clinical outcomes and reduce disease transmission. These results, when placed in context of national human development indices, suggest that economic development, investment in health care and literacy may all be involved in improving access to TB services in sub‐Saharan Africa.
Do exemptions from user fees mean free access to health services? A case study from a rural Cambodian hospital
Authors: Jacobs Bart , Price Neil Lewis , Oeun Sam 
Published: August 2010

SummaryObjectives  To assess the effects of a user fee scheme, and related fee exemption system, on the health care seeking behaviour, the out‐of‐pocket expenditure and the coping mechanisms of fee‐exempted patients (FEP) at Kirivong Referral Hospital in Cambodia.Methods  A pre‐coded structured questionnaire administered to pre‐identified FEP and fee‐paying patients (PP) of the same age group and with the same medical condition, who were paired for comparison. Survey data were supplemented with unstructured in‐depth interviews.Results  199 pairs of patients were compared. The timing of the start of health care seeking was equal for FEP and PP, although significantly more FEP consulted first‐line public health providers than PP. Only a third of interviewees who visited public health facilities prior to hospitalization were referred. The direct costs of health care seeking were US$4.3 for FEP and US$15.3 for PP. FEP borrowed at a ratio of 3.4:1 to direct costs incurred, vs. 0.74:1 for PP. Hospitalization rates were 32.5/1000 population and 18.4/1000 population for FEP and PP, respectively.Conclusions  User fee exemption schemes can be pro‐poor provided that the fee exemption system is based on effective pre‐identification of intended beneficiaries, that these beneficiaries are informed of their right to free health care and that health care providers are reimbursed for the revenue foregone due to exemptions. To be effective in the Cambodian context, exemption schemes need to be underpinned by a range of additional interventions.
Short communication: Impact of climate variability on the incidence of dengue in Mexico
Authors: Hurtado‐Díaz M. , Riojas‐Rodríguez H. , Rothenberg S. J. , Gomez‐Dantés H. , Cifuentes E. 
Published: August 2010

SummaryWe evaluated the impact of weather variables and climatic indicators associated with the incidence of dengue in two municipalities of the state of Veracruz, Mexico, from 1995 to 2003. A retrospective ecological study was conducted, using time‐series analysis in which we compiled the weekly reported cases of dengue and the weather and climatic parameters: temperature, rainfall and sea‐surface temperature (SST), the latter as an El Niño Southern Oscillation indicator. We statistically evaluated the data with autogressive models. The models’ predictive abilities were evaluated using data collected from 1995 to 2002 and were validated with those observed for 2003. Each degree Centigrade increase in SST was followed by an increase in the number of dengue cases: 46% in San Andrés Tuxtla (P = 0.001) 16 weeks later and 42% in Veracruz 20 weeks later (P = 0.002). Increases in weekly minimum temperature and rainfall were also significant factors in the increase in the reported cases of dengue. We recommend future studies using the same method, involving larger populations with different geographic location, climate and weather. We also recommend strengthening environmental, health and entomological surveillance systems to improve preparedness and emergency responses.
Reducing microbial contamination on wastewater‐irrigated lettuce by cessation of irrigation before harvesting
Authors: Keraita Bernard , Konradsen Flemming , Drechsel Pay , Abaidoo Robert C. 
Published: August 2010

SummaryObjective  To assess the effectiveness of cessation of irrigation before harvesting in reducing microbial contamination of lettuce irrigated with wastewater in urban vegetable farming in Ghana.Methods  Assessment was done under actual field conditions with urban vegetable farmers in Ghana. Trials were arranged in completely randomized block design and done both in the dry and wet seasons. Seven hundred and twenty‐six lettuce samples and 36 water samples were analysed for thermotolerant coliforms and helminth eggs.Results  On average, 0.65 log units for indicator thermotolerant coliforms and 0.4 helminth eggs per 100 g of lettuce were removed on each non‐irrigated day from lettuce in the dry season. This corresponded to a daily loss of 1.4 tonnes / ha of fresh weight of lettuce. As an input for exposure analysis to make risk estimates, the decay coefficient, k, for thermotolerant coliforms was 0.66 / day for the wet season and 1.49 / day for the dry season.Conclusion  In combination with other measures for improving water quality, the measure can significantly reduce faecal contamination of lettuce during the dry season. However, it is not suitable for the wet season due to unfavourable conditions for pathogen die‐off and re‐contamination by splashes from contaminated soils. The results provide a good basis for risk assessments and for devising more appropriate measures for risk reduction, especially in sub‐Saharan Africa.
Dermatitis among farmers engaged in peri‐urban aquatic food production in Hanoi, Vietnam
Authors: Anh Vuong Tuan , Van Der Hoek Wim , Ersbøll Annette Kjær , Thuong Nguyen Van , Tuan Nguyen Dang , Cam Phung Dac , Dalsgaard Anders 
Published: August 2010

SummaryObjective  To assess whether exposure to wastewater is a risk factor for dermatitis (eczema) among farmers engaged in peri‐urban aquatic food production in Hanoi, Vietnam.Methods  A cross‐sectional study with two follow‐ups was conducted from April to December 2005 in two peri‐urban communes in Hanoi, one using wastewater and another using river, rain and well water for aquatic food production. In each commune, 100 households were randomly selected and adult household members engaged in farming field work were interviewed in three surveys. Farmers who reported skin problems at the time of interviews were examined and treated by a dermatologist. Data were analysed for one farmer per household.Results  The overall prevalence of dermatitis from 592 interviews was 6.3%. The commune which used wastewater had a much higher overall prevalence of dermatitis (10.4%) than the commune that did not (2.1%; P‐value < 0.001). Multivariable logistic regression analyses showed that occupational wastewater contact was an important risk factor for dermatitis (odds ratio [OR] 3.0; 95% confidence interval [CI] 1.1–7.7). Duration of daily wastewater contact was not significantly associated with dermatitis. Aquaculture work in the wet season carried an increased risk of dermatitis in both communes (OR 2.8; 95% CI 1.02–7.6). The use of personal protective measures during field work and washing hands and feet after work did not reduce the risk for dermatitis. However, observations showed that these practices were applied in such a way that they were unlikely to provide effective protection against wastewater contact.Conclusion  Contact with wastewater is an important risk factor for dermatitis among farmers engaged in wastewater‐fed peri‐urban aquatic food production. Additional studies should test preventive and mitigating measures such as improved personal protection and hygiene.
Faecal and protozoan parasite contamination of water spinach (Ipomoea aquatica) cultivated in urban wastewater in Phnom Penh, Cambodia
Authors: Anh Vuong Tuan , Tram Nguyen Thuy , Klank Lise Tønner , Cam Phung Dac , Dalsgaard Anders 
Published: August 2010

SummaryObjective  To identify the level of contamination with thermotolerant coliforms (ThC), intestinal helminth eggs and protozoan parasites in water spinach (Ipomoea aquatica) cultivated in a wastewater‐fed lake in Phnom Penh, Cambodia.Methods  The investigation was carried out from July 2004 to May 2005 in Boeng Cheung Ek lake, a main recipient of wastewater from the city of Phnom Penh. Water spinach samples were collected near two wastewater entry points in the northern part of the lake and near a wastewater exit point in the southern part of the lake, where water is discharged from the lake into a stream. Water spinach samples were harvested at each of the three locations with and without wastewater contact according to the normal practices of farmers, and analysed for ThC, protozoan parasites (Giardia, Cryptosporidium and Cyclospora), and helminth eggs (Ascaris lumbricoides, Trichuris trichura and hookworm) using standard methods. Wastewater samples were also collected at each of the three locations and analysed for ThC and helminth eggs.Results  High concentrations of ThC (approximately 105–107/g) were found in water spinach samples. ThC mean counts did not differ significantly, neither between sample types at each location, nor between locations. ThC mean concentration of water spinach samples collected in the rainy season of 2005 was higher than that in the dry season of 2004. Protozoan parasites were detected in the samples from all three locations and in water spinach harvested with and without wastewater contact. Giardia spp. were present in 56% (20) of samples with an average cyst concentration of 6.6/g. Mean counts of Giardia were not significantly associated with wastewater contact status of water spinach. Cryptosporidium oocysts were found in 17% (six) of samples with an average concentration of 0.5 oocyst per gram of water spinach. Cyclospora oocysts were detected in 8% (three) of samples. Four (11%) water spinach samples contained helminth eggs (average concentration: 0.1 egg per gram). Water samples contained approximately 104–107 ThC per 100 ml and a mean of 27.4 helminth eggs per litre. There was a 2–3 log reduction of ThC between the water samples collected at the wastewater entry and exit point(s) of the lake.Conclusions  Water spinach cultivated in the lake was highly contaminated with feces, as indicated by high ThC concentrations and the presence of protozoan parasites. A reduction in ThC numbers almost to WHO guideline levels for irrigation water occurred through natural biological and physical processes in the lake, as shown by differences in ThC counts at wastewater entry and exit points.