Snakebites in the Global Health Agenda of the Twenty First Century: A South to South Collaborative Effort

Snakebite envenomation constitutes to be a major public health problem in the most resource poor, tropical areas of the world, resulting in death or severe sequelae. Snakebites were officially included in the Neglected Tropical Disease portfolio of the World Health Organization in 2018, after the World Health Assembly acknowledged it as a Global Health problem. This study details the journey of snakebites from obscurity to its inclusion in Global Health agenda over the course of the twentieth and twenty first century and argues that the main thrust of the movement came from South-to-South partnerships between academic and public-private research institutions. It explores how Latin American countries, such as Costa Rica and Brazil, played crucial roles in promoting the international movement of snakebites, challenging the paradigm that scientific and pharmacological knowledge and objects only emerge from the Global North and flow to the Global South, and provides evidence of scientific excellence at the periphery

Whose Feces Matter? Household Fecal Contamination and Drug-Resistant Campylobacteriosis in the Peruvian Amazon

Household fecal contamination is regularly targeted outcome in community-wide interventions, yet the origin of fecal contamination remains unexplored. This research gap is critical given the high attributable fraction of zoonotic enteric pathogens related to enteric disease among pediatric populations living in resource constraint settings. Of these, Campylobacter spp., a poultry-associated bacterium, is the most prevalent among epidemiologic and geographic contexts. As a result, this body of work 1) validated a molecular tool to attribute household surface fecal contamination to a specific source, 2) measured specie-specific fecal contamination on household surfaces and 3) characterized the population structure and antimicrobial resistance of Campylobacter spp. isolated from industrially raise and household-raised poultry. Of the eight microbial source tracking markers validated, avian fecal markers Av4143, and swine fecal marker Pig2Bac showed excellent performance parameters, while human fecal markers BacHum and HF183-Taqman, as well as avian exposure markers CytB and ND5 showed moderate performance. Household surfaces were more frequently contaminated with animal fecal material, specifically avian fecal material), in comparison to human fecal material. Floors were more contaminated than tables, and unfinished floors and wooden tables were more contaminated than their counterparts. A higher burden of avian fecal contamination was associated with lower age of the primary caregiver and shorter household tenancy. Detecting Campylobacter spp. in household surfaces was highly associated with the presence of the avian fecal marker Av4143. Campylobacter spp. isolates from industrially raised chickens had a distinct population structure form its household-raised counterparts, as determined by three independent genomic assessments. Moreover, higher prevalence of antimicrobial resistance genes associated with macrolides, fluoroquinolones and aminoglycosides antibiotics were found among Campylobacter spp. isolates from industrially raised poultry. However, Campylobacter spp. from household-raised poultry had a lipooligosacharide class associated with post-infection neuropathies such as Guillan-Barre Syndrome. Based on this research, we propose that future interventions that seek to reduce household fecal contamination should target both human and animal sources of feces, as well as household infrastructure characteristics. Finally, household prevention measures to reduce Campylobacter spp. transmission events at the human-poultry interphase should be prioritized, as well as the implementation of legislative measures that aim to reduce sub-therapeutic use of antimicrobials at the industry level for growth promotion of prophylactic measures

Poluição do ar interior provocada pelo fumo do cigarro em locais públicos de Portugal

OBJETIVO: Poucos têm sido os estudos para conhecer o grau de poluição pelo fumo do tabaco a que estão sujeitas as pessoas em vários lugares públicos e privados. O objectivo do estudo foi quantificar o nível de poluição do ar provocada pelo fumo do cigarro em locais de trabalho e de lazer. MÉTODOS: O estudo foi realizado no concelho de Braga, Portugal, em 2005. A medição dos teores de nicotina no ar interior foi realizada com monitores passivos contendo um filtro de 37 mm de diâmetro tratado com bissulfato sódico no seu interior. Os monitores foram colocados em lugares públicos, de trabalho e de lazer, pré-definidos. Para cada um dos locais, calculou-se a mediana da nicotina. RESULTADOS: A presença de nicotina foi detectada em 85% das amostras. Foram encontrados valores elevados de contaminação do ar nas discotecas, com mediana de 82,26 µg/m³, variando entre os 5,79 e os 106,31 µg/m³.Os locais de trabalho da administração pública e da universidade apresentaram os valores mais baixos de nicotina. CONCLUSÕES: Os dados confirmam a necessidade de reforçar a implemen-tação e sobretudo, o cumprimento de políticas sem fumo nos locais de trabalho e de lazer, em benefício da saúde dos trabalhadores e como medida reforçadora de um ambiente que facilite aos fumadores o abandono do fumo do tabaco.OBJECTIVE: There have been few studies investigating the level of cigarette smoke pollution to which people in several public and private places are exposed. The purpose of this study was to quantify the level of air pollution produced by cigarette smoking in workplaces and leisure settings. METHODS: The study was carried out in Braga, Portugal, in 2005. Nicotine content in indoor air was measured using passive monitors containing a 37-mm diameter filter inside treated with sodium bisulphate. The monitors were installed in predefined public workplaces and leisure settings. Median nicotine content was estimated for each place studied. RESULTS: Nicotine was detected in 85% of the samples. Extremely high air contamination levels were found in discos with a median of 82.26 µg/m³, ranging between 5.79 and 106.31 µg/m³. Workplaces of public administration and university buildings showed the lowest nicotine content. CONCLUSIONS: The study findings confirm the need to promote the implementation of smoke-free policies in workplaces and leisure settings to protect workers' health and as a reinforcing measure of an environment which facilitates smokers to quit smoking

MRI versus mammography plus ultrasound in women at intermediate breast cancer risk: study design and protocol of the MRIB multicenter, randomized, controlled trial

In women at high/intermediate lifetime risk of breast cancer (BC-LTR), contrast-enhanced magnetic resonance imaging (MRI) added to mammography ± ultrasound (MX ± US) increases sensitivity but decreases specificity. Screening with MRI alone is an alternative and potentially more cost-effective strategy. Here, we describe the study protocol and the characteristics of enrolled patients for MRIB feasibility, multicenter, randomized, controlled trial, which aims to compare MRI alone versus MX+US in women at intermediate breast cancer risk (aged 40-59, with a 15-30% BC-LTR and/or extremely dense breasts). Two screening rounds per woman were planned in ten centers experienced in MRI screening, the primary endpoint being the rate of cancers detected in the 2 arms after 5 years of follow-up. From July 2013 to November 2015, 1254 women (mean age 47 years) were enrolled: 624 were assigned to MX+US and 630 to MRI. Most of them were aged below 50 (72%) and premenopausal (45%), and 52% used oral contraceptives. Among postmenopausal women, 15% had used hormone replacement therapy. Breast and/or ovarian cancer in mothers and/or sisters were reported by 37% of enrolled women, 79% had extremely dense breasts, and 41% had a 15-30% BC-LTR. The distribution of the major determinants of breast cancer risk profiles (breast density and family history of breast and ovarian cancer) of enrolled women varied across centers

Indoor air pollution caused by cigarette smoke in public places in Portugal

OBJETIVO: Poucos têm sido os estudos para conhecer o grau de poluição pelo fumo do tabaco a que estão sujeitas as pessoas em vários lugares públicos e privados. O objectivo do estudo foi quantificar o nível de poluição do ar provocada pelo fumo do cigarro em locais de trabalho e de lazer. MÉTODOS: O estudo foi realizado no concelho de Braga, Portugal, em 2005. A medição dos teores de nicotina no ar interior foi realizada com monitores passivos contendo um filtro de 37 mm de diâmetro tratado com bissulfato sódico no seu interior. Os monitores foram colocados em lugares públicos, de trabalho e de lazer, pré-definidos. Para cada um dos locais, calculou-se a mediana da nicotina. RESULTADOS: A presença de nicotina foi detectada em 85% das amostras. Foram encontrados valores elevados de contaminação do ar nas discotecas, com mediana de 82,26 µg/m3, variando entre os 5,79 e os 106,31 µg/m3.Os locais de trabalho da administração pública e da universidade apresentaram os valores mais baixos de nicotina. CONCLUSÕES: Os dados confirmam a necessidade de reforçar a implemen-tação e sobretudo, o cumprimento de políticas sem fumo nos locais de trabalho e de lazer, em benefício da saúde dos trabalhadores e como medida reforçadora de um ambiente que facilite aos fumadores o abandono do fumo do tabaco.OBJECTIVE: There have been few studies investigating the level of cigarette smoke pollution to which people in several public and private places are exposed. The purpose of this study was to quantify the level of air pollution produced by cigarette smoking in workplaces and leisure settings. METHODS: The study was carried out in Braga, Portugal, in 2005. Nicotine content in indoor air was measured using passive monitors containing a 37-mm diameter filter inside treated with sodium bisulphate. The monitors were installed in predefined public workplaces and leisure settings. Median nicotine content was estimated for each place studied. RESULTS: Nicotine was detected in 85% of the samples. Extremely high air contamination levels were found in discos with a median of 82.26 µg/m3, ranging between 5.79 and 106.31 µg/m3. Workplaces of public administration and university buildings showed the lowest nicotine content. CONCLUSIONS: The study findings confirm the need to promote the implementation of smoke-free policies in workplaces and leisure settings to protect workers' health and as a reinforcing measure of an environment which facilitates smokers to quit smoking.info:eu-repo/semantics/publishedVersio

Data Management in Multicountry Consortium Studies: The Enterics For Global Health (EFGH) Shigella Surveillance Study Example

Background: Rigorous data management systems and planning are essential to successful research projects, especially for large, multicountry consortium studies involving partnerships across multiple institutions. Here we describe the development and implementation of data management systems and procedures for the Enterics For Global Health (EFGH) Shigella surveillance study—a 7-country diarrhea surveillance study that will conduct facility-based surveillance concurrent with population-based enumeration and a health care utilization survey to estimate the incidence of Shigella­-associated diarrhea in children 6 to 35 months old. Methods: The goals of EFGH data management are to utilize the knowledge and experience of consortium members to collect high-quality data and ensure equity in access and decision-making. During the planning phase before study initiation, a working group of representatives from each EFGH country site, the coordination team, and other partners met regularly to develop the data management systems for the study. Results: This resulted in the Data Management Plan, which included selecting REDCap and SurveyCTO as the primary database systems. Consequently, we laid out procedures for data processing and storage, study monitoring and reporting, data quality control and assurance activities, and data access. The data management system and associated real-time visualizations allow for rapid data cleaning activities and progress monitoring and will enable quicker time to analysis. Conclusions: Experiences from this study will contribute toward enriching the sparse landscape of data management methods publications and serve as a case study for future studies seeking to collect and manage data consistently and rigorously while maintaining equitable access to and control of data