Background:Large numbers of Latin American immigrants recently arrived in Western Europe.Curative and preventive programmes need to take account of their risk of suffering and transmitting imported chronic infections ...Background:Large numbers of Latin American immigrants recently arrived in Western Europe.Curative and preventive programmes need to take account of their risk of suffering and transmitting imported chronic infections and of their susceptibility to cosmopolitan infections.We aimed to assess the prevalence and co-occurrence of imported chronic infections among Latin American immigrants,and their susceptibility to highly prevalent cosmopolitan infections.Methods:Adult participants were recruited in the community and in a primary health centre in Geneva in 2008.Serological tests were performed on stored sera for HIV,HBV,syphilis,Strongyloides stercoralis,Trypanosoma cruzi,varicella and measles.We considered only chronic active infections in the analysis.Results and discussion:The 1012 participants,aged 37.2(SD 11.3)years,were mostly female(82.5%)and Bolivians(48%).Overall,209(20.7%)had at least one and 27(2.7%)two or more chronic infections.T.cruzi(12.8%)and S.stercoralis(8.4%)were the most prevalent chronic active infections compared to syphilis(0.4%),HBV(0.4%)and HIV(1.4%).Concomitant infections affected 28.2 and 18.5%of T.cruzi and S.stercoralis infected cases.Bolivian origin(aOR:13.6;95%CI:3.2–57.9)was associated with risk of multiple infections.Susceptibilities for VZV and measles were 0.7 and 1.4%,respectively.Latin American immigrants are at risk of complications and possible reactivation of chronic parasitic infections but have overall low risks of chronic viral and syphilitic active infections.Conclusions:Systematic screening for chronic active parasitic infections is therefore necessary especially among Bolivians.The high protection rate against measles and VZV doesn’t require specific preventive interventions.展开更多
Background:Uganda has suffered from a series of epidemics of Human African Trypanosomiasis(HAT),a tsetse transmitted disease,also known as sleeping sickness.The area affected by acute Trypanosoma brucei rhodesiense HA...Background:Uganda has suffered from a series of epidemics of Human African Trypanosomiasis(HAT),a tsetse transmitted disease,also known as sleeping sickness.The area affected by acute Trypanosoma brucei rhodesiense HAT(rHAT)has been expanding,driven by importation of infected cattle into regions previously free of the disease.These regions are also affected by African Animal Trypanosomiasis(AAT)demanding a strategy for integrated disease control.Methods:In 2008,the Public Private Partnership,Stamp Out Sleeping Sickness(SOS)administered a single dose of trypanocide to 31486 head of cattle in 29 parishes in Dokolo and Kaberamaido districts.This study examines the impact of this intervention on the prevalence of rHAT and AAT trypanosomes in cattle from villages that had(HAT^(+ve))or had not(HAT^(-ve))experienced a recent case of rHAT.Cattle herds from 20 villages were sampled and screened by PCR,pre-intervention and 6-months post-intervention,for the presence or absence of:Trypanosoma brucei s.l.;human infective T.b.rhodesiense;Trypanosoma vivax;and Trypanosoma congolense savannah.Results:Post-intervention,there was a significant decrease in the prevalence of T.brucei s.l.and the human infective sub-species T.b.rhodesiense in village cattle across all 20 villages.The prevalence of T.b.rhodesiense was reduced from 2.4%to 0.74%(P<0.0001),with the intervention showing greater impact in HAT^(-ve) villages.The number of villages containing cattle harbouring human infective parasites decreased from 15/20 to 8/20,with T.b.rhodesiense infection mainly persisting within cattle in HAT^(+ve) villages(six/eight).The proportion of T.brucei s.l.infections identified as human infective T.b.rhodesiense decreased after the intervention from 8.3%(95%CI=11.1-5.9%)to 4.1%(95%CI=6.8-2.3%).Villages that had experienced a recent human case(HAT^(+ve) villages)showed a significantly higher prevalence for AAT both pre-and post-intervention.For AAT the prevalence of T.vivax was significantly reduced from 5.9%to 0.05%post-intervention while the prevalence of T.congolense increased from 8.0%to 12.2%.Conclusions:The intervention resulted in a significant decrease in the prevalence of T.brucei s.l.,human infective T.b.rhodesiense and T.vivax infection in village cattle herds.The proportion of T.brucei s.l.that were human infective,decreased from 1:12 T.brucei s.l.infections before the intervention to 1:33 post-intervention.It is clearly more difficult to eliminate T.b.rhodesiense from cattle in villages that have experienced a human case.Evidence of elevated levels of AAT in livestock within village herds is a useful indicator of risk for rHAT in Uganda.Integrated veterinary and medical surveillance is key to successful control of zoonotic rHAT.展开更多
文摘Background:Large numbers of Latin American immigrants recently arrived in Western Europe.Curative and preventive programmes need to take account of their risk of suffering and transmitting imported chronic infections and of their susceptibility to cosmopolitan infections.We aimed to assess the prevalence and co-occurrence of imported chronic infections among Latin American immigrants,and their susceptibility to highly prevalent cosmopolitan infections.Methods:Adult participants were recruited in the community and in a primary health centre in Geneva in 2008.Serological tests were performed on stored sera for HIV,HBV,syphilis,Strongyloides stercoralis,Trypanosoma cruzi,varicella and measles.We considered only chronic active infections in the analysis.Results and discussion:The 1012 participants,aged 37.2(SD 11.3)years,were mostly female(82.5%)and Bolivians(48%).Overall,209(20.7%)had at least one and 27(2.7%)two or more chronic infections.T.cruzi(12.8%)and S.stercoralis(8.4%)were the most prevalent chronic active infections compared to syphilis(0.4%),HBV(0.4%)and HIV(1.4%).Concomitant infections affected 28.2 and 18.5%of T.cruzi and S.stercoralis infected cases.Bolivian origin(aOR:13.6;95%CI:3.2–57.9)was associated with risk of multiple infections.Susceptibilities for VZV and measles were 0.7 and 1.4%,respectively.Latin American immigrants are at risk of complications and possible reactivation of chronic parasitic infections but have overall low risks of chronic viral and syphilitic active infections.Conclusions:Systematic screening for chronic active parasitic infections is therefore necessary especially among Bolivians.The high protection rate against measles and VZV doesn’t require specific preventive interventions.
基金This study was funded with UK aid from the UK government’under the DfID Research into Use Programme(SCW,LH,KP,KP,KLB,CW,JDK)and from the European Union’s Seventh Framework Program(FP7/2007-2014)under grant agreement n°221948 Integrated Control of Neglected Zoonoses(ICONZ)(SCW,KP,KLB,CW,JDK)Treatment of village cattle was undertaken under the Stamp Out Sleeping Sickness Programme supported by IKARE and Ceva Sante AnimaleThe funders had no role in study design,data collection and analysis,decision to publish,or preparation of the manuscript.
文摘Background:Uganda has suffered from a series of epidemics of Human African Trypanosomiasis(HAT),a tsetse transmitted disease,also known as sleeping sickness.The area affected by acute Trypanosoma brucei rhodesiense HAT(rHAT)has been expanding,driven by importation of infected cattle into regions previously free of the disease.These regions are also affected by African Animal Trypanosomiasis(AAT)demanding a strategy for integrated disease control.Methods:In 2008,the Public Private Partnership,Stamp Out Sleeping Sickness(SOS)administered a single dose of trypanocide to 31486 head of cattle in 29 parishes in Dokolo and Kaberamaido districts.This study examines the impact of this intervention on the prevalence of rHAT and AAT trypanosomes in cattle from villages that had(HAT^(+ve))or had not(HAT^(-ve))experienced a recent case of rHAT.Cattle herds from 20 villages were sampled and screened by PCR,pre-intervention and 6-months post-intervention,for the presence or absence of:Trypanosoma brucei s.l.;human infective T.b.rhodesiense;Trypanosoma vivax;and Trypanosoma congolense savannah.Results:Post-intervention,there was a significant decrease in the prevalence of T.brucei s.l.and the human infective sub-species T.b.rhodesiense in village cattle across all 20 villages.The prevalence of T.b.rhodesiense was reduced from 2.4%to 0.74%(P<0.0001),with the intervention showing greater impact in HAT^(-ve) villages.The number of villages containing cattle harbouring human infective parasites decreased from 15/20 to 8/20,with T.b.rhodesiense infection mainly persisting within cattle in HAT^(+ve) villages(six/eight).The proportion of T.brucei s.l.infections identified as human infective T.b.rhodesiense decreased after the intervention from 8.3%(95%CI=11.1-5.9%)to 4.1%(95%CI=6.8-2.3%).Villages that had experienced a recent human case(HAT^(+ve) villages)showed a significantly higher prevalence for AAT both pre-and post-intervention.For AAT the prevalence of T.vivax was significantly reduced from 5.9%to 0.05%post-intervention while the prevalence of T.congolense increased from 8.0%to 12.2%.Conclusions:The intervention resulted in a significant decrease in the prevalence of T.brucei s.l.,human infective T.b.rhodesiense and T.vivax infection in village cattle herds.The proportion of T.brucei s.l.that were human infective,decreased from 1:12 T.brucei s.l.infections before the intervention to 1:33 post-intervention.It is clearly more difficult to eliminate T.b.rhodesiense from cattle in villages that have experienced a human case.Evidence of elevated levels of AAT in livestock within village herds is a useful indicator of risk for rHAT in Uganda.Integrated veterinary and medical surveillance is key to successful control of zoonotic rHAT.
