Passage of Meloidogyne eggs in human stool : forgotten, but not gone

The authors were involved in a project to train staff from the Atoifi Adventist Hospital (AAH) in East Kwaio, Malaita, Solomon Islands in applied research and laboratory methods. The project, run by AAH, included the performance of a cross-sectional survey for soil-transmitted helminths in two remote villages

Testing for Hendra virus: Difficulties experienced by veterinarians in Queensland prior to 2011

To identify the perceived barriers to Hendra virus (HeV) management by private equine veterinarians in Queensland. Design: An exploratory qualitative study of private equine veterinarians registered and working in coastal Queensland. Methods: A questionnaire that included eight open-ended questions about the management of HeV was used in face-to-face in-depth interviews with 21 veterinary personnel working in equine or mixed private practice between Far North and South-East Queensland in 2009-10. The qualitative data was entered and analysed thematically using QSR's International's Nvivo 9 qualitative data analysis software. Results: This study revealed key issues associated with HeV testing: (1) inadequate knowledge of testing procedures and laboratory diagnostic pathways; (2) difficulty in accessing laboratory services; (3) responsibility for cost of collection and transport of specimen; and (4) the role of government. Participants perceived these issues as reducing potential HeV case management efficiency. Conclusion: Although HeV management plans have been modified in part since 2009-10, this study highlights the importance of considering the perspectives of private veterinary practitioners in any biosecurity protocols. © 2013 Australian Veterinary Association

A case of Ancylostoma ceylanicum infection occurring in an Australian soldier returned from Solomon Islands

A 26-year-old male member of the Australian Defense Force presented with a history of central abdominal pain of 4 weeks duration and peripheral eosinophilia consistent with eosinophilic enteritis. Acute hookworm disease was diagnosed as the cause. Adult worms recovered from feces after therapy with albendazole were morphologically consistent with Ancylostoma ceylanicum. As the patient had been deployed with the Regional Assistance Mission to Solomon Islands for 6 months prior to this presentation, it is very likely that the A. ceylanicum was acquired in Solomon Islands. Until now, it has been assumed that any Ancylostoma spp. recovered from humans in Solomon Islands is A. duodenale. However, this case demonstrates that human hookworm infection acquired in the Solomon Islands could be caused by A. ceylanicum

Unexpected result of Hendra virus outbreaks for veterinarians, Queensland, Australia

A qualitative study of equine veterinarians and allied staff from Queensland, Australia, showed that veterinarians are ceasing equine practice because of fears related to Hendra virus. Their decisions were motivated by personal safety and legal liability concerns

Strongyloides stercoralis: Systematic review of barriers to controlling Strongyloidiasis for Australian Indigenous communities

© 2014 Miller et al.Strongyloides stercoralis infects human hosts mainly through skin contact with contaminated soil. The result is strongyloidiasis, a parasitic disease, with a unique cycle of auto-infection causing a variety of symptoms and signs, with possible fatality from hyper-infection. Australian Indigenous community members, often living in rural and remote settings, are exposed to and infected with S. stercoralis. The aim of this review is to determine barriers to control of strongyloidiasis. The purpose is to contribute to the development of initiatives for prevention, early detection and effective treatment of strongyloidiasis. Systematic search reviewing research published 2012 and earlier was conducted. Research articles discussing aspects of strongyloidiasis, context of infection and overall health in Indigenous Australians were reviewed. Based on the PRISMA statement, the systematic search of health databases, Academic Search Premier, Informit, Medline, PubMed, AMED, CINAHL, Health Source Nursing and Academic was conducted. Key search terms included strongyloidiasis, Indigenous, Australia, health, and community. 340 articles were retrieved with 16 original research articles published between 1969 and 2006 meeting criteria. Review found barriers to control defined across three key themes, (1) health status, (2) socioeconomic status, and (3) health care literacy and procedures. This study identifies five points of intervention: (1) develop reporting protocols between health care system and communities; (2) test all Indigenous Australian patients, immunocompromised patients and those exposed to areas with S. stercoralis; (3) health professionals require detailed information on strongyloidiasis and potential for exposure to Indigenous Australian people; (4) to establish testing and treatment initiatives within communities; and (5) to measure and report prevalence rates specific to communities and to act with initiatives based on these results. By defining barriers to control of strongyloidiasis in Australian Indigenous people, improved outcomes of prevention, treatment of strongyloidiasis and increased health overall are attainable

Policy implications for controlling communicable diseases in Indigenous communities: Case for Strongyloidiasis in Australia

The objective of this paper is to document the knowledge and experiences of healthcare professionals and researchers in Australia about the barriers to controlling Strongyloides stercoralis in Australian Indigenous communities. Qualitative research methods were used to conduct in-depth semi-structured interviews, which were digitally recorded, transcribed, and participant-checked. Data were thematically analysed to identify significant themes. Five major themes were identified: 1. Barriers to health/treatment; 2. Access to healthcare; 3. Policy; 4. Learning opportunity; and 5. Ideas for intervention. The findings suggest that Australian Indigenous communities will continue to suffer increased morbidity and mortality due to a lack of control or prevention of Strongyloides stercoralis. Issues such as institutional racism, improvements to health promotion, education, socioeconomic determinants, and health care system policy and procedures need to be addressed. This study identifies several direct implications for Indigenous health: • The need for increased knowledge and understanding of the risks to health for Indigenous community members; • The need for prevention policy development for neglected tropical diseases in Indigenous communities; • The need for increased knowledge and understanding of the treatment, diagnosis, and healthcare access concerning Strongyloides stercoralis for health professionals and policymakers who work within Indigenous health; • The need to raise awareness of systematic institutional racism in the control and prevention of neglected tropical diseases in Indigenous communities; and Policy Implications for Controlling Communicable Diseases in Indigenous Communities: Case of Strongyloidiasis in Australia • The need for a health promotion framework that can provide the basis for multiple-level interventions to control and prevent Strongyloides in Indigenous communities

Ancylostoma ceylanicum Hookworm in the Solomon Islands

Although hookworm is highly prevalent in the Solomon Islands, the species involved are unknown. We initiated this study in response to finding Ancylostoma ceylanicum hookworm in a peacekeeper in Australia who had returned from the Solomon Islands. Kato-Katz fecal surveys performed in 2013 and 2014 in 2 village groups in East Malaita, Solomon Islands, identified hookworm-positive samples. These specimens were tested by cytochrome oxidase 1 (cox-1) gene multiplex PCR and sequenced. Of 66 positive specimens, 54 (81.8%) contained only Necator americanus, 11 (16.7%) contained only A. ceylanicum, and 1 (1.5%) contained both species. A. duodenale was not found. Haplotype analysis of cox-1 sequences placed all human isolates (99% bootstrap support) of A. ceylanicum within the zoonotic clade rather than the human-specific clade. This study confirms that A. ceylanicum is endemic in the East Malaita region of this Pacific Island nation. The strain of the A. ceylanicum in this region can be shared among humans, dogs, and cats

Strongyloidiasis in Oceania

Strongyloidiasis is a potentially fatal disease caused by species of Strongyloides (Nematoda). In Oceania, two species infect humans: S. stercoralis and S. kellyi. S. stercoralis is widespread throughout Oceania and causes serious disease in any age group. S. kellyi is localised to Papua New Guinea and causes serious disease in infants. Infective larvae enter the body through the skin and migrate through the tissues. Adult females live in the mucosa of the proximal small intestine. The life cycle of S. stercoralis includes autoinfection, unusual in parasitic worms, whereby some of the offspring of the parasitic adults become infective in the lower intestine and complete the life cycle in the same person. This ensures that the infection persists, and the population of the worms can increase out of control, usually when the person is immunodefi cient or immunosuppressed. The worms can be eliminated by oral ivermectin, and the person is probably cured if their serology is negative 6 months after treatment. This chapter contains details of the life cycles, transmission, clinical manifestations, diagnostic tests and how to interpret them, most effective treatment options, how to ensure that treatment has been effective and what to consider when developing effective prevention and control strategies

Willingness to consult a veterinarian on physician's advice for zoonotic diseases: A formal role for veterinarians in medicine?

© 2015 Speare et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Physicians appear to find zoonotic diseases a challenge and consider that this topic belongs more to the veterinary profession. However, veterinarians have no formal role in clinical medicine. Data were collected as part of the Queensland Social Survey 2014 to determine the willingness of the public, if diagnosed with a zoonotic disease, to consult a veterinarian on the advice of a physician. Self-reported willingness to consult with a veterinarian at the respondent's own expense was 79.8%(95% CI: 81.96%-77.46%) (976/1223). If the cost was funded by Medicare, the Australian public health insurance scheme, 90.7% (95% CI: 92.18%-88.92%) (1109/1223) would be willing to consult a veterinarian. Therefore, a large majority of Australian residents would be willing to consult with a veterinarian on the advice of their physician if they had a zoonotic disease. Does this indicate a possible new role for veterinarians under Clinical One Health

Implications of male circumcision for women in Papua New Guinea: A transformational grounded theory study

BACKGROUND: Male circumcision reduces the risk of female-to-male transmission of human immunodeficiency virus (HIV) and is being explored for HIV prevention in Papua New Guinea (PNG). PNG has a concentrated HIV epidemic which is largely heterosexually transmitted. There are a diverse range of male circumcision and penile modification practices across PNG. Exploring the implications of male circumcision for women in PNG is important to inform evidence-based health policy that will result in positive, intended consequences. METHODS: The transformational grounded theory study incorporated participatory action research and decolonizing methodologies. In Phase One, an existing data set from a male circumcision study of 861 male and 519 female participants was theoretically sampled and analyzed for women's understanding and experience of male circumcision. In Phase Two of the study, primary data were co-generated with 64 women in seven interpretive focus group discussions and 11 semi-structured interviews to develop a theoretical model of the processes used by women to manage the outcomes of male circumcision. In Phase Three participants assisted to refine the developing transformational grounded theory and identify actions required to improve health. RESULTS: Many women know a lot about male circumcision and penile modification and the consequences for themselves, their families and communities. Their ability to act on this knowledge is determined by numerous social, cultural and economic factors. A transformational grounded theory was developed with connecting categories of: Women Know a Lot, Increasing Knowledge; Increasing Options; and Acting on Choices. Properties and dimensions of each category are represented in the model, along with the intervening condition of Safety. The condition of Safety contextualises the overarching lived realty for women in PNG, enables the inclusion of men in the transformational grounded theory model, and helps to explain relationships between men and women. The theory presents the core category as Power of Choice. CONCLUSIONS: This transformational grounded theory provides a means to explore how women experience male circumcision and penile modification in PNG, including for HIV prevention. Women who have had opportunities for education have a greater range of choices and an increased opportunity to act upon these choices. However, women can only exercise their power of choice in the context of safety. The concept of Peace drawn from the Social Determinants of Health is applied in order to extend the explanatory power of the transformational grounded theory. This study shows that women's ambivalence about male circumcision is often related to lack of safety, a consequence of gender inequality in PNG