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  • Rye Broch posted an update 2 days, 16 hours ago

    7% in 2015 to 78.5% in 2018. In 2019, 23 of 31 countries requiring MDA achieved 100% geographic coverage. Although much remains to be done, morbidity management and disability prevention services have steadily increased in recent years. Vector control interventions conducted by other programmes, particularly malaria vector control, have had a profound effect in stopping transmission in some endemic countries in the region. In conclusion, significant progress has been made in the LF programme in the region while we identify the key remaining challenges in achieving an Africa free of LF.Lymphatic filariasis (LF), a neglected tropical disease, is targeted for global elimination as a public health problem. This article reviews the history of LF control and elimination activities in the countries of the World Health Organization’s (WHO) Eastern Mediterranean Region (EMR) over the last 2 decades. In 2000, the estimated at-risk population in EMR countries was 12.6 million people, accounting for approximately 1% of the global disease burden. Of the 22 EMR countries, 3 countries (Egypt, Sudan and Yemen) were LF endemic and the disease was suspected in 4 other countries (Djibouti, Oman, Somalia and Saudi Arabia). After almost 2 decades of implementing sustained control and prevention measures, Egypt and Yemen were successfully validated by the WHO as having achieved the elimination criteria in 2017 and 2019, respectively. In 2018, Sudan completed mapping of LF, reaching 26.2% geographical coverage where mass drug administration (MDA) is required and is scaling-up MDA. Extensive epidemiological assessment indicated the absence of LF transmission in the four suspected countries and no MDA required. Challenges faced during the elimination and post-elimination phases are described and discussed.

    The recent slowdown in life expectancy increase in Australia has occurred concurrently with widening socioeconomic and geographical inequalities in all-cause mortality risk. We analysed whether, and to what extent, mortality inequalities among specific non-communicable diseases (NCDs) in Australia at ages 35-74 years widened during 2006-16.

    Registered deaths that occurred during 2006-16 in Australia were analysed. Inequalities were measured by area socioeconomic quintile [ranging from Q1 (lowest) to Q5 (highest)] and remoteness (major cities, inner regional, outer regional/remote/very remote). Age-standardized death rates (ASDR) for 35-74 years were calculated and smoothed over time.

    NCD mortality inequalities by area socioeconomic quintile widened; the ratio of Q1 to Q5 ASDR for males increased from 1.96 [95% confidence interval (CI) 1.91-2.01] in 2011 to 2.08 (2.03-2.13) in 2016, and for females from 1.78 (1.73-1.84) to 1.96 (1.90-2.02). Moreover, Q1 NCD ASDRs did not clearly decline from 2011 to 2016ties are partly explained by major risk factors for CVDs and NCDs being overweight or obese, lack of exercise, poor diet and smoking. There is a need for urgent policy responses that consider socioeconomic disadvantage.

    Intermittent preventive treatment in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) is a key malaria prevention strategy in areas with moderate to high transmission. As part of the TIPTOP (Transforming IPT for Optimal Pregnancy) project, baseline information about IPTp coverage was collected in eight districts from four sub-Saharan countries Democratic Republic of Congo (DRC), Madagascar, Mozambique and Nigeria.

    Cross-sectional household surveys were conducted using a multistage cluster sampling design to estimate the coverage of IPTp and antenatal care attendance. Eligible participants were women of reproductive age who had ended a pregnancy in the 12 months preceding the interview and who had resided in the selected household during at least the past 4 months of pregnancy. Coverage was calculated using percentages and 95% confidence intervals.

    A total of 3911 women were interviewed from March to October 2018. Coverage of at least three doses of IPTp (IPTp3+) was 22% and 24% in DRC project distrther study.

    Sexual minority populations-particularly gay/lesbian and bisexual women-use tobacco at higher rates than their heterosexual peers. Evidence-based biopsychosocial interventions for tobacco cessation are available; however, research is lacking on the specific barriers to tobacco cessation in these populations. The purpose of this study is to describe the psychological, normative, and environmental barriers to cessation that disproportionally impact sexual minority tobacco users.

    Data from wave 1 of the Population Assessment of Tobacco and Health was used to explore differences by sexual identity across psychosocial barriers and facilitators of tobacco cessation. The analytic sample consisted of current tobacco users (including cigarettes, e-cigarettes, cigars, cigarillos, pipes, hookah, dissolvable snus, and smokeless products). TWS119 purchase Psychosocial barriers/facilitators were modeled using logistic regression analyses, controlling for age, race/ethnicity, poverty, education, census region, and urbanicity and were sn, as well as between gay and bisexual participants.

    To assess the pharmacokinetic of itraconazole capsule formulation and its active metabolite, hydroxyitraconazole, in adults with HIV diagnosed with talaromycosis in an endemic area, and to evaluate the drug-drug interaction between itraconazole/hydroxyitraconazole (ITC/OH-ITC) and efavirenz.

    Open-label, single arm, sequential pharmacokinetic study. Eligible subjects were adults with HIV, ≥18 years old, with confirmed talaromycosis, initiating itraconazole capsule as part of standard talaromycosis treatment, in whom efavirenz-based ART was anticipated. Steady-state pharmacokinetic assessments (pre-dose and at 1, 3, 4, 5, 6, 8 and 12 h post dose) were performed for itraconazole/hydroxyitraconazole without and with efavirenz use. Mid-dose efavirenz concentrations were also assessed. Pharmacokinetics parameters were calculated using non-compartmental analysis.

    Ten subjects (70% male) were enrolled. At entry, median (range) age was 29.5 years (22-64), and CD4 cell count was 18.0 (1-39) cells/mm3. Geometric mean (95% CI) of itraconazole and hydroxyitraconazole AUC0-12 without efavirenz were 9097 (6761-12 239) and 11 705 (8586-15 959) ng·h/mL, respectively, with a median metabolic ratio of OH-ITC  ITC of 1.