Rastreio etnobotânico nas comunas de Caxito, Mabubas e Úcua (Província do Bengo): resultados preliminares

Objectivos do estudo: documentar e valorizar os conhecimentos tradicionais, relativamente a utilização de plantas medicinais; orientar estudos de recolha, classificação e identificação de espécies; potenciar a elaboração de perfis fitoquímicos e ensaios de bioactividade em espécies com potencial farmacológico; avaliar a biodiversidade vegetal na área de estudo potenciando a valorização da flora da região; potenciar a integração de estágios e capacitação de recursos humanos no âmbito do projecto CISA

Differential impact of mass and targeted praziquantel delivery on schistosomiasis control in school-aged children: A systematic review and meta-analysis.

Schistosomiasis is a widespread public health concern in the poorest regions of the world. The principal control strategy is regular praziquantel administration to school-aged children in endemic areas. With calls for the elimination of schistosomiasis as a public health problem, expanding praziquantel delivery to all community members has been advocated. This systematic review and meta-analysis compares the impact of community-wide and child-targeted praziquantel distribution on schistosomiasis prevalence and intensity in school-aged children. We searched MEDLINE, Embase and Web of Science to identify papers that reported schistosome prevalence before and after praziquantel administration, either to children only or to all community members. Extracted data included Schistosoma species, drug administration strategy, number of treatment rounds, follow-up interval and prevalence and intensity before and after treatment. We used inverse variance weighted generalised linear models to examine the impact of mass versus targeted drug administration on prevalence reduction, and weighted boxplots to examine the impact on infection intensity reduction. This study is registered with PROSPERO, number CRD42018095377. In total, 34 articles were eligible for systematic review and 28 for meta-analysis. Schistosoma mansoni was reported in 20 studies; Schistosoma haematobium in 19 studies, and Schistosoma japonicum in two studies. Results of generalised linear models showed no detectable difference between mass and targeted treatment strategies on prevalence reduction in school-aged children for S. mansoni (odds ratio 0.47, 95%CI 0.13-1.68, p = 0.227) and S. haematobium (0.41, 95%CI 0.06-3.03, p = 0.358). Box plots also showed no apparent differences in intensity reduction between the two treatment strategies. The results of this meta-analysis do not support the hypothesis that community-wide treatment is more effective than targeted treatment at reducing schistosomiasis infections in children. This may be due to the relatively small number of included studies, insufficient treatment coverage, persistent infection hotspots and unmeasured confounders. Further field-based studies comparing mass and targeted treatment are required

Spatial and temporal patterns of dengue infections in Timor-Leste, 2005-2013

Background: Dengue remains an important public health problem in Timor-Leste, with several major epidemics occurring over the last 10 years. The aim of this study was to identify dengue clusters at high geographical resolution and to determine the association between local environmental characteristics and the distribution and transmission of the disease. Methods: Notifications of dengue cases that occurred from January 2005 to December 2013 were obtained from the Ministry of Health, Timor-Leste. The population of each suco (the third-level administrative subdivision) was obtained from the Population and Housing Census 2010. Spatial autocorrelation in dengue incidence was explored using Moran’s I statistic, Local Indicators of Spatial Association (LISA), and the Getis-Ord statistics. A multivariate, Zero-Inflated, Poisson (ZIP) regression model was developed with a conditional autoregressive (CAR) prior structure, and with posterior parameters estimated using Bayesian Markov chain Monte Carlo (MCMC) simulation with Gibbs sampling. Results: The analysis used data from 3206 cases. Dengue incidence was highly seasonal with a large peak in January. Patients ≥ 14 years were found to be 74% [95% credible interval (CrI): 72–76%] less likely to be infected than those < 14 years, and females were 12% (95% CrI: 4–21%) more likely to suffer from dengue as compared to males. Dengue incidence increased by 0.7% (95% CrI: 0.6–0.8%) for a 1 °C increase in mean temperature; and 47% (95% CrI: 29–59%) for a 1 mm increase in precipitation. There was no significant residual spatial clustering after accounting for climate and demographic variables. Conclusions: Dengue incidence was highly seasonal and spatially clustered, with positive associations with temperature, precipitation and demographic factors. These factors explained the observed spatial heterogeneity of infection

Setting up a Demographic Surveillance System in Northern Angola

Abstract As in many regions of the developing world, the lack of accurate and up to date demographic information in Angola is a handicap to demographic and health research. To overcome this gap, a Health and Demographic Surveillance System (HDSS) was designed to support the research activities of CISA Project, a health research centre created in 2007 and located within Dande municipality in northern Angola. Here we report the methodology for setting up the HDSS-Dande as well as the adjustments made to improve the data collection process since the conclusion of the baseline census in April 2010. The HDSS data is instrumental for the support of epidemiological and other health studies.Resumé Comme dans de nombreuses régions du monde en développement, en Angola le manque d'informations démographiques exactes et à jour est un handicap pour la recherché démographique et de santé. Pour surmonter cette lacune un système de surveillance démographique et de santé (SSDS) a été conçu pour soutenir les activités de recherche de CISA Project, qui est un centre de recherche médicale, créé en 2007 et situé dans la municipalité du Dande, dans le nord del'Angola. Nous rapportons ici la méthodologie choisie pour la mise en place de la SSDSDande ainsi que les ajustements effectués pour améliorer le processos de collecte des données depuis le recensement de base conclu en avril 2010. Les données du SSDS sont instrumentales pour le soutien des études épidémiologiques et d'autres études de santé

Performance of microscopy and RDTs in the context of a malaria prevalence survey in Angola: A comparison using PCR as the gold standard

Background: Accurate identification of Plasmodium infections in community surveys is essential to successful malaria control. Microscopy and rapid diagnostic tests (RDTs) are the main techniques used to diagnose malaria in field-based surveys. While microscopy is still considered the gold standard, RDTs are growing in popularity as they allow for rapid and inexpensive diagnosis. Using data from a prevalence survey conducted in north-western Angola in 2010, the authors aimed to compare the performance of microscopy and RDTs in identifying Plasmodium falciparum infections, using polymerase chain reaction (PCR) as the gold standard. Methods. Results from 3,307 subjects (1,225 preschool-aged children (zero to five year olds), 1,134 school-aged children (six to 15 year olds) and 948 mothers/caregivers (>15 years of age)), tested for P. falciparum infections, were utilized. The sensitivity, specificity, positive, and negative predictive values (PPV and NPV) of microscopy and Paracheck-Pf® were compared using the McNemar's test and the weighted generalized score Chi-squared test for paired data. Results: The prevalence of P. falciparum infections determined by PCR and microscopy was 15.9% and by Paracheck- Pf® was 16.3%. Compared to microscopy, Paracheck-Pf® had significantly higher sensitivity (72.8% versus 60%), specificity (94.3% versus 92.5%), PPV (70.7% versus 60%) and NPV (94.8% versus 92.5%). Both tests had significantly lower sensitivity in mothers (36.8% for microscopy and 43.7% for Paracheck-Pf®) than in their children (68.4% in zero to five years-old and 60.6% in six to 15 years-old for microscopy and 80.4% in zero to five year-olds and 76.5% in six to 15 year-olds for Paracheck-Pf®). Conclusion: Both microscopy and RDTs performed suboptimally when compared to PCR. False negativity could be associated with the low parasite density profile of the samples. False positivity may be related to the well-described limitations of those techniques such as level of expertise of microscopists or persistent antigenicity from previous infections in the case of RDTs. Nevertheless, RDTs had enhanced performance comparatively to microscopy in detecting malaria infections, favouring their use in community cross-sectional malaria surveys, where expert performance of microscopy is hard to accomplish

Various pfcrt and pfmdr1 Genotypes of Plasmodium falciparum Cocirculate with P. malariae, P. ovale spp., and P. vivax in Northern Angola

Artemisinin-based combination therapy for malaria has become widely available across Africa. Populations of Plasmodium falciparum that were previously dominated by chloroquine (CQ)-resistant genotypes are now under different drug selection pressures. P. malariae, P. ovale curtisi, and P. ovale wallikeri are sympatric with P. falciparum across the continent and are frequently present as coinfections. The prevalence of human Plasmodium species was determined by PCR using DNA from blood spots collected during a cross-sectional survey in northern Angola. P. falciparum was genotyped at resistance-associated loci in pfcrt and pfmdr1 by real-time PCR or by direct sequencing of amplicons. Of the 3,316 samples collected, 541 (16.3%) contained Plasmodium species infections; 477 (88.2%) of these were P. falciparum alone, 6.5% were P. falciparum and P. malariae together, and 1.1% were P. vivax alone. The majority of the remainder (3.7%) harbored P. ovale curtisi or P. ovale wallikeri alone or in combination with other species. Of 430 P. falciparum isolates genotyped for pfcrt, 61.6% carried the wild-type allele CVMNK at codons 72 to 76, either alone or in combination with the resistant allele CVIET. No other pfcrt allele was found. Wild-type alleles dominated at codons 86, 184, 1034, 1042, and 1246 of the pfmdr1 locus among the sequenced isolates. In contrast to previous studies, P. falciparum in the study area comprises an approximately equal mix of genotypes associated with CQ sensitivity and with CQ resistance, suggesting either lower drug pressure due to poor access to treatment in rural areas or a rapid impact of the policy change away from the use of standard monotherapies

Aetiology of diahrroea in children under five at the Bengo General Hospital, Angola

Diarrhoea is the second leading cause of death in children under five years being responsible for 760.000 deaths, corresponding to 9% of the total deaths in this age group. Africa is the region with more deaths due to diarrhoea (46%), followed by South Asia (38%). Three quarters of the total of deaths occurs within only 15 countries and Angola is in the 15th position with a record of 20,000 annual childhood deaths. Diarrhoeal disease can be caused by bacterial, viral and parasitic infectious agents and can be transmited through contaminated food or drinking water, or directly from person to person. Rotavirus and Escherichia coli were shown the most frequent pathogenic agents in developing countries. This study aims to identify the most frequent pathogenic agents of diarrhoea in children under five atttending the Bengo General Hospital (BGH).

Osservazioni sul concetto di oggetto della psicologia

[English]:Remarks on the concept of object of psychology is Richard Avenarius last work and it represents his attempt to establish the fledgling scientific, physiological, experimental psychology on rigorous philosophical basis. With this work the founder of the so-called Empiriocriticism participates to the wide debate on the definition of psychology, along with notable personalities of the time, such as Wilhelm Wundt, Ernst Mach, Oswald Külpe, Hermann Ebbinghaus, Hugo Münsterberg and Edward B. Titchener./ [Italiano]: Le Osservazioni sul concetto di oggetto della psicologia costituiscono l’ultima opera di Richard Avenarius, in cui il fondatore dell’empiriocriticismo presenta il suo tentativo di fondare su basi filosoficamente rigorose la neonata psicologia scientifica di stampo fisiologico-sperimentale. Questo scritto si colloca così all’incrocio di quell’ampio dibattito sulla definizione di psicologia, che sul finire del diciannovesimo secolo vide coinvolte personalità del calibro di Wilhelm Wundt, Ernst Mach, Oswald Külpe, Hermann Ebbinghaus, Hugo Münsterberg ed Edward B. Titchener

Schistosomiasis and soil-transmitted helminthiasis preventive chemotherapy: adverse events in children from 2 to 15 years in Bengo province, Angola

This work was supported by the promoters of the CISA as follows: Camões, Institute of Cooperation and Language, Portugal (www.instituto-camoes.pt/en/); Calouste Gulbenkian Foundation, Portugal (https:// gulbenkian.pt/en/); Government of Bengo Province; Angolan Ministry of Health (www.minsa.gov.ao).Preventive chemotherapy campaigns with praziquantel and albendazole are being implemented in Angola, as a high priority public health intervention. However, there are no published data regarding adverse events associated with these medications. In this context, we analyzed adverse events due to co-administration of praziquantel and albendazole in endemic areas of schistosomiasis and soil-transmitted helminths in Bengo, Angola. In the context of a targeted drug administration, between December 2012 and September 2013, we conducted two surveys after co-administrating single oral doses of praziquantel and albendazole tablets to children 2 to 15 years of age. About 24 hours after each treatment, participants answered a questionnaire about adverse events. At baseline, 605 children (55.0% male; mean age: 9.7 years) were treated; 460 were interviewed and 257 (55.9%) reported at least one adverse event, 62.3% (160/257) of children being infected with Schistosoma haematobium. After six months of treatment, among 339 children surveyed, 184 (54.3%) reported adverse events, with 49.5% (91/184) of infected children. Adverse events were most common in preschool-aged children, with no significant difference between genders. The most frequent adverse events in the two surveys were abdominal pain (18.5%, 25.7%), headache (20.9%, 23.0%) and dizziness (15.7%, 19.8%). Children aged 12 to 15 years (adjusted OR = 0.40, p = 0.040) and those with mixed infection (adjusted OR = 0.04, p = 0.011) had lower odds of adverse events. After the second treatment, those with heavy infection (adjusted OR = 2.72, p = 0.018) and aged 9-11 years (adjusted OR = 2.01, p = 0.049) had significantly fewer adverse events. About 2.0% of children experienced severe adverse events. This study adds evidence that preventive chemotherapy for schistosomiasis and soil-transmitted helminths control is safe, but cases of adverse events are expected. Standardized methodologies to discriminate drug-related adverse events from the clinical manifestations of the infections are needed.info:eu-repo/semantics/publishedVersio

Various pfcrt and pfmdr1 genotypes of Plasmodium falciparum cocirculate with P. malariae, P. ovale spp., and P. vivax in Northern Angola

Artemisinin-based combination therapy for malaria has become widely available across Africa. Populations of Plasmodium falciparum that were previously dominated by chloroquine (CQ)-resistant genotypes are now under different drug selection pressures. P. malariae, P. ovale curtisi, and P. ovale wallikeri are sympatric with P. falciparum across the continent and are frequently present as coinfections. The prevalence of human Plasmodium species was determined by PCR using DNA from blood spots collected during a cross-sectional survey in northern Angola. P. falciparum was genotyped at resistance-associated loci in pfcrt and pfmdr1 by real-time PCR or by direct sequencing of amplicons. Of the 3,316 samples collected, 541 (16.3%) contained Plasmodium species infections; 477 (88.2%) of these were P. falciparum alone, 6.5% were P. falciparum and P. malariae together, and 1.1% were P. vivax alone. The majority of the remainder (3.7%) harbored P. ovale curtisi or P. ovale wallikeri alone or in combination with other species. Of 430 P. falciparum isolates genotyped for pfcrt, 61.6% carried the wild-type allele CVMNK at codons 72 to 76, either alone or in combination with the resistant allele CVIET. No other pfcrt allele was found. Wild-type alleles dominated at codons 86, 184, 1034, 1042, and 1246 of the pfmdr1 locus among the sequenced isolates. In contrast to previous studies, P. falciparum in the study area comprises an approximately equal mix of genotypes associated with CQ sensitivity and with CQ resistance, suggesting either lower drug pressure due to poor access to treatment in rural areas or a rapid impact of the policy change away from the use of standard monotherapies