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[PMID]:27773873
[Au] Autor:Rourk AR; Nolte FS; Litwin CM
[Ti] Título:Performance Characteristics of the Reverse Syphilis Screening Algorithm in a Population With a Moderately High Prevalence of Syphilis.
[So] Source:Am J Clin Pathol;146(5):572-577, 2016 Nov 01.
[Is] ISSN:1943-7722
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: With the recent introduction of automated treponemal tests, a new reverse syphilis algorithm has been proposed and now used by many clinical laboratories. We analyzed the impact of instituting the reverse screening syphilis algorithm in a laboratory that serves a geographic area with a moderately high prevalence of syphilis infection. Methods: Serum samples sent for syphilis testing were tested using a treponemal enzyme immunoassay (EIA) as the screening assay. EIA reactive samples were tested by rapid plasma reagin (RPR) and titered to end point if reactive. RPR nonreactive samples were analyzed by the Treponema pallidum particle agglutination test (TP-PA). Pertinent medical records were reviewed for false-reactive screens and samples with evidence of past syphilis infection. Results: Among 10,060 patients tested, 502 (5%) were reactive on the initial EIA screen. The RPR was reactive in 150 (1.5%). TP-PA testing determined that 103 (1.0%) were falsely reactive on initial EIA screen. The reverse screening algorithm, however, identified 242 (2.4%) with evidence of latent, secondary, or past syphilis, 21 of whom had no or unknown prior treatment with antibiotics. Conclusions: Despite a 1.0% false-reactive rate, the reverse syphilis algorithm detected 21 patients with possible latent syphilis that may have gone undetected by traditional syphilis screening.
[Mh] Termos MeSH primário: Algoritmos
Anticorpos Antibacterianos/sangue
Antígenos de Bactérias/imunologia
Sífilis/diagnóstico
Treponema pallidum/imunologia
[Mh] Termos MeSH secundário: Reações Falso-Negativas
Seres Humanos
Técnicas Imunoenzimáticas
Imunoglobulina G/sangue
Prevalência
Sífilis/epidemiologia
Sífilis/microbiologia
Sorodiagnóstico da Sífilis
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Bacterial); 0 (Antigens, Bacterial); 0 (Immunoglobulin G)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1093/ajcp/aqw182


  2 / 3172 MEDLINE  
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[PMID]:29326237
[Au] Autor:Qiao J; Zhou S; Fang H
[Ad] Endereço:Department of Dermatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China.
[Ti] Título:An ulcer on the nipple.
[So] Source:BMJ;360:j5850, 2018 01 11.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Doenças Mamárias/diagnóstico
Mamilos/microbiologia
Sífilis/diagnóstico
Treponema pallidum
Úlcera/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Doenças Mamárias/microbiologia
Diagnóstico Diferencial
Feminino
Seres Humanos
Sífilis/microbiologia
Úlcera/microbiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5850


  3 / 3172 MEDLINE  
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[PMID]:29281641
[Au] Autor:Godornes C; Giacani L; Barry AE; Mitja O; Lukehart SA
[Ad] Endereço:Department of Medicine, University of Washington, Seattle, Washington, United States of America.
[Ti] Título:Development of a Multilocus Sequence Typing (MLST) scheme for Treponema pallidum subsp. pertenue: Application to yaws in Lihir Island, Papua New Guinea.
[So] Source:PLoS Negl Trop Dis;11(12):e0006113, 2017 12.
[Is] ISSN:1935-2735
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Yaws is a neglected tropical disease, caused by Treponema pallidum subsp. pertenue. The disease causes chronic lesions, primarily in young children living in remote villages in tropical climates. As part of a global yaws eradication campaign initiated by the World Health Organization, we sought to develop and evaluate a molecular typing method to distinguish different strains of T. pallidum subsp. pertenue for disease control and epidemiological purposes. METHODS AND PRINCIPAL FINDINGS: Published genome sequences of strains of T. pallidum subsp. pertenue and pallidum were compared to identify polymorphic genetic loci among the strains. DNA from a number of existing historical Treponema isolates, as well as a subset of samples from yaws patients collected in Lihir Island, Papua New Guinea, were analyzed using these targets. From these data, three genes (tp0548, tp0136 and tp0326) were ultimately selected to give a high discriminating capability among the T. pallidum subsp. pertenue samples tested. Intragenic regions of these three target genes were then selected to enhance the discriminating capability of the typing scheme using short readily amplifiable loci. This 3-gene multilocus sequence typing (MLST) method was applied to existing historical human yaws strains, the Fribourg-Blanc simian isolate, and DNA from 194 lesion swabs from yaws patients on Lihir Island, Papua New Guinea. Among all samples tested, fourteen molecular types were identified, seven of which were found in patient samples and seven among historical isolates or DNA. Three types (JG8, TD6, and SE7) were predominant on Lihir Island. CONCLUSIONS: This MLST approach allows molecular typing and differentiation of yaws strains. This method could be a useful tool to complement epidemiological studies in regions where T. pallidum subsp. pertenue is prevalent with the overall goals of improving our understanding of yaws transmission dynamics and helping the yaws eradication campaign to succeed.
[Mh] Termos MeSH primário: Tipagem de Sequências Multilocus/métodos
Treponema pallidum/classificação
Treponema pallidum/genética
Bouba/virologia
[Mh] Termos MeSH secundário: Sequência de Bases
Criança
DNA Bacteriano/genética
Países em Desenvolvimento
Seres Humanos
Papua Nova Guiné
Alinhamento de Sequência
Análise de Sequência de DNA
Treponema pallidum/isolamento & purificação
Bouba/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (DNA, Bacterial)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180130
[Lr] Data última revisão:
180130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0006113


  4 / 3172 MEDLINE  
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[PMID]:29073145
[Au] Autor:Fitzpatrick C; Asiedu K; Sands A; Gonzalez Pena T; Marks M; Mitja O; Meheus F; Van der Stuyft P
[Ad] Endereço:Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.
[Ti] Título:The cost and cost-effectiveness of rapid testing strategies for yaws diagnosis and surveillance.
[So] Source:PLoS Negl Trop Dis;11(10):e0005985, 2017 Oct.
[Is] ISSN:1935-2735
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Yaws is a non-venereal treponemal infection caused by Treponema pallidum subspecies pertenue. The disease is targeted by WHO for eradication by 2020. Rapid diagnostic tests (RDTs) are envisaged for confirmation of clinical cases during treatment campaigns and for certification of the interruption of transmission. Yaws testing requires both treponemal (trep) and non-treponemal (non-trep) assays for diagnosis of current infection. We evaluate a sequential testing strategy (using a treponemal RDT before a trep/non-trep RDT) in terms of cost and cost-effectiveness, relative to a single-assay combined testing strategy (using the trep/non-trep RDT alone), for two use cases: individual diagnosis and community surveillance. METHODS: We use cohort decision analysis to examine the diagnostic and cost outcomes. We estimate cost and cost-effectiveness of the alternative testing strategies at different levels of prevalence of past/current infection and current infection under each use case. We take the perspective of the global yaws eradication programme. We calculate the total number of correct diagnoses for each strategy over a range of plausible prevalences. We employ probabilistic sensitivity analysis (PSA) to account for uncertainty and report 95% intervals. RESULTS: At current prices of the treponemal and trep/non-trep RDTs, the sequential strategy is cost-saving for individual diagnosis at prevalence of past/current infection less than 85% (81-90); it is cost-saving for surveillance at less than 100%. The threshold price of the trep/non-trep RDT (below which the sequential strategy would no longer be cost-saving) is US$ 1.08 (1.02-1.14) for individual diagnosis at high prevalence of past/current infection (51%) and US$ 0.54 (0.52-0.56) for community surveillance at low prevalence (15%). DISCUSSION: We find that the sequential strategy is cost-saving for both diagnosis and surveillance in most relevant settings. In the absence of evidence assessing relative performance (sensitivity and specificity), cost-effectiveness is uncertain. However, the conditions under which the combined test only strategy might be more cost-effective than the sequential strategy are limited. A cheaper trep/non-trep RDT is needed, costing no more than US$ 0.50-1.00, depending on the use case. Our results will help enhance the cost-effectiveness of yaws programmes in the 13 countries known to be currently endemic. It will also inform efforts in the much larger group of 71 countries with a history of yaws, many of which will have to undertake surveillance to confirm the interruption of transmission.
[Mh] Termos MeSH primário: Técnicas e Procedimentos Diagnósticos/economia
Bouba/diagnóstico
Bouba/economia
[Mh] Termos MeSH secundário: Estudos de Coortes
Análise Custo-Benefício
Técnicas e Procedimentos Diagnósticos/instrumentação
Técnicas e Procedimentos Diagnósticos/estatística & dados numéricos
Erradicação de Doenças/economia
Monitoramento Epidemiológico
Seres Humanos
Prevalência
Sensibilidade e Especificidade
Treponema pallidum/isolamento & purificação
Bouba/epidemiologia
Bouba/microbiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171110
[Lr] Data última revisão:
171110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171027
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0005985


  5 / 3172 MEDLINE  
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[PMID]:28931218
[Au] Autor:Yu Q; Cheng Y; Wang Y; Wang C; Lu H; Guan Z; Huang J; Gong W; Shi M; Ni L; Wu J; Peng R; Zhou P
[Ad] Endereço:Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University.
[Ti] Título:Aberrant Humoral Immune Responses in Neurosyphilis: CXCL13/CXCR5 Play a Pivotal Role for B-Cell Recruitment to the Cerebrospinal Fluid.
[So] Source:J Infect Dis;216(5):534-544, 2017 Sep 01.
[Is] ISSN:1537-6613
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: Previous studies documented that humoral immune responses participated in neurological damage in neurosyphilis patients. However, the mechanisms that trigger and maintain humoral immunity involved in neurosyphilis remain unknown. Methods: Using flow cytometry, expression of B cells was measured in neurosyphilis and non-neurosyphilis. Expression of immunoglobulin indices and chemokine ligand CXCL13 was detected by enzyme-linked immunosorbent assay. The migration and inhibition assays were evaluated by modified chamber assays. The presence of CXCL13+ cells, cluster of differentiation (CD)20+ B cells, CD3+ T cells, CD138+ plasma cells and CD35+ follicular dendritic cells was studied by immunohistochemistry. Results: Enrichment of B cells was observed and activated in the cerebrospinal fluid (CSF) of neurosyphilis patients. Immunoglobulin indices were increased and associated with the progress to neurosyphilis. High expression of CSF CXCL13 mediated B cell migration both in vitro and in vivo. There was a positive correlation among the CSF B cells, immunoglobulin indices, and CSF CXCL13 levels. Ectopic germinal centers (EGCs), important structures for humoral immunity, were observed in the intracranial syphilitic gumma. Conclusions: CXCL13/CXCR5 mediated the aggregation of B cells, that directed the aberrant humoral immune responses via the formation of EGCs, which suggests a molecular mechanism of neurological damage in neurosyphilis.
[Mh] Termos MeSH primário: Linfócitos B/metabolismo
Quimiocina CXCL13/líquido cefalorraquidiano
Imunidade Humoral
Neurossífilis/líquido cefalorraquidiano
Receptores CXCR5/metabolismo
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Formação de Anticorpos
Biomarcadores/líquido cefalorraquidiano
Estudos de Casos e Controles
Diferenciação Celular
Feminino
Citometria de Fluxo
Seguimentos
Seres Humanos
Imunoglobulina A/sangue
Imunoglobulina G/sangue
Imunoglobulina M/sangue
Masculino
Meia-Idade
Neurossífilis/diagnóstico
Plasmócitos/metabolismo
Linfócitos T/metabolismo
Treponema pallidum
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (CXCL13 protein, human); 0 (CXCR5 protein, human); 0 (Chemokine CXCL13); 0 (Immunoglobulin A); 0 (Immunoglobulin G); 0 (Immunoglobulin M); 0 (Receptors, CXCR5)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170922
[St] Status:MEDLINE
[do] DOI:10.1093/infdis/jix233


  6 / 3172 MEDLINE  
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[PMID]:28886021
[Au] Autor:Strouhal M; Mikalová L; Havlícková P; Tenti P; Cejková D; Rychlík I; Bruisten S; Smajs D
[Ad] Endereço:Department of Biology, Faculty of Medicine, Masaryk University, Kamenice 5, Brno, Czech Republic.
[Ti] Título:Complete genome sequences of two strains of Treponema pallidum subsp. pertenue from Ghana, Africa: Identical genome sequences in samples isolated more than 7 years apart.
[So] Source:PLoS Negl Trop Dis;11(9):e0005894, 2017 Sep.
[Is] ISSN:1935-2735
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Treponema pallidum subsp. pertenue (TPE) is the causative agent of yaws, a multi-stage disease, endemic in tropical regions of Africa, Asia, Oceania, and South America. To date, four TPE strains have been completely sequenced including three TPE strains of human origin (Samoa D, CDC-2, and Gauthier) and one TPE strain (Fribourg-Blanc) isolated from a baboon. All TPE strains are highly similar to T. pallidum subsp. pallidum (TPA) strains. The mutation rate in syphilis and related treponemes has not been experimentally determined yet. METHODOLOGY/PRINCIPAL FINDINGS: Complete genomes of two TPE strains, CDC 2575 and Ghana-051, that infected patients in Ghana and were isolated in 1980 and 1988, respectively, were sequenced and analyzed. Both strains had identical consensus genome nucleotide sequences raising the question whether TPE CDC 2575 and Ghana-051 represent two different strains. Several lines of evidence support the fact that both strains represent independent samples including regions showing intrastrain heterogeneity (13 and 5 intrastrain heterogeneous sites in TPE Ghana-051 and TPE CDC 2575, respectively). Four of these heterogeneous sites were found in both genomes but the frequency of alternative alleles differed. The identical consensus genome sequences were used to estimate the upper limit of the yaws treponeme evolution rate, which was 4.1 x 10-10 nucleotide changes per site per generation. CONCLUSIONS/SIGNIFICANCE: The estimated upper limit for the mutation rate of TPE was slightly lower than the mutation rate of E. coli, which was determined during a long-term experiment. Given the known diversity between TPA and TPE genomes and the assumption that both TPA and TPE have a similar mutation rate, the most recent common ancestor of syphilis and yaws treponemes appears to be more than ten thousand years old and likely even older.
[Mh] Termos MeSH primário: Genoma Bacteriano
Treponema pallidum/genética
Treponema pallidum/isolamento & purificação
Bouba/microbiologia
[Mh] Termos MeSH secundário: Animais
Ásia/epidemiologia
Mapeamento Cromossômico
Escherichia coli/genética
Gana/epidemiologia
Seres Humanos
Mutação
Papio/microbiologia
Análise de Sequência de DNA
América do Sul/epidemiologia
Fatores de Tempo
Treponema pallidum/classificação
Bouba/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170909
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0005894


  7 / 3172 MEDLINE  
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[PMID]:28820706
[Au] Autor:Correa ME; Croda J; Coimbra Motta de Castro AR; Maria do Valle Leone de Oliveira S; Pompilio MA; Omizolo de Souza R; Ferreira de Sá Queiroz JH; Esther da Silva K; Ko AI; Simionatto S
[Ad] Endereço:Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados (UFGD), Dourados, Mato Grosso do Sul, Brazil.
[Ti] Título:High Prevalence of Infection in Brazilian Prisoners.
[So] Source:Am J Trop Med Hyg;97(4):1078-1084, 2017 Oct.
[Is] ISSN:1476-1645
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The number of new syphilis cases in Brazil has risen alarmingly in recent years. However, there is limited data regarding syphilis prevalence in the Brazilian prison population. To facilitate the development of effective interventions, a cross-sectional study was undertaken to determine the prevalence of infection, active syphilis, and associated risk factors among Brazilian prisoners. We administered a questionnaire to a population-based sample of prisoners from 12 prisons in Central-West Brazil and collected sera for syphilis testing, from January to December 2013. Univariable and multivariable regression analyses were performed to assess associations with active syphilis. We recruited 3,363 prisoners (men: 84.6%; women: 15.4%). The overall lifetime and active syphilis prevalences were 10.5% (9.4% among men; 17% among women, < 0.001) and 3.8% (2% among men; 9% among women, < 0.001), respectively. The variables associated with active syphilis in men prisoners were homosexual preference, history of sexually transmitted infections, and human immunodeficiency virus status. Among women, the factors were sex with intravenous drug users, genital ulcer disease, and previous incarceration. Despite the high prevalence of active syphilis, 88.5% reported unawareness of their serological status and 67% reported unprotected sexual practices. Women had the highest rates of infection, including them in a high-risk group for the development of syphilis during pregnancy. Thus, implementing screening programs to enable continuous measures of control and prevention of infection in the prison environment, mainly in women institutions, is important to prevent severe forms of this disease and congenital infections.
[Mh] Termos MeSH primário: Prisioneiros/estatística & dados numéricos
Doenças Sexualmente Transmissíveis/epidemiologia
Sífilis/epidemiologia
Treponema pallidum/isolamento & purificação
[Mh] Termos MeSH secundário: Adulto
Idoso
Brasil/epidemiologia
Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Prevalência
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170819
[St] Status:MEDLINE
[do] DOI:10.4269/ajtmh.17-0098


  8 / 3172 MEDLINE  
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[PMID]:28787460
[Au] Autor:Tong ML; Zhao Q; Liu LL; Zhu XZ; Gao K; Zhang HL; Lin LR; Niu JJ; Ji ZL; Yang TC
[Ad] Endereço:Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China.
[Ti] Título:Whole genome sequence of the Treponema pallidum subsp. pallidum strain Amoy: An Asian isolate highly similar to SS14.
[So] Source:PLoS One;12(8):e0182768, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Treponema pallidum ssp. pallidum (T. pallidum), the causative agent of the sexually transmitted disease syphilis, is an uncultivatable human pathogen. The geographical differences in T. pallidum genomes leading to differences in pathogenicity are not yet understood. Presently, twelve T. pallidum genomes are available to the public, all of which are American in origin and often co-infect patients with human immunodeficiency virus (HIV). In this study, we examined the T. pallidum subsp. pallidum strain Amoy, a syphilis pathogen found in Xiamen, China. We sequenced its genome using Illumina next-generation sequencing technology and obtained a nearly (98.83%) complete genome of approximately 1.12 Mbps. The new genome shows good synteny with its five T. pallidum sibling strains (Nichols, SS14, Mexico A, DAL-1, and Chicago), among which SS14 is the strain closest to the Amoy strain. Compared with strain SS14, the Amoy strain possesses four uncharacterized strain-specific genes and is likely missing six genes, including a gene encoding the TPR domain protein, which may partially account for the comparatively low virulence and toxicity of the Amoy strain in animal infection. Notably, we did not detect the 23S rRNA A2058G/A2059G mutation in the Amoy strain, which likely explains the sensitivity of Amoy strain to macrolides. The results of this study will lead to a better understanding of the pathogenesis of syphilis and the geographical distribution of T. pallidum genotypes.
[Mh] Termos MeSH primário: Genômica
Treponema pallidum/genética
[Mh] Termos MeSH secundário: Farmacorresistência Bacteriana/genética
Genoma Bacteriano/genética
Macrolídeos/farmacologia
Anotação de Sequência Molecular
Especificidade da Espécie
Treponema pallidum/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Macrolides)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170809
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0182768


  9 / 3172 MEDLINE  
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[PMID]:28759580
[Au] Autor:Marks M; Kwakye-Maclean C; Doherty R; Adwere P; Aziz Abdulai A; Duah F; Ohene SA; Mitja O; Oguti B; Solomon AW; Mabey DCW; Adu-Sarkodie Y; Asiedu K; Ackumey MM
[Ad] Endereço:Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
[Ti] Título:Knowledge, attitudes and practices towards yaws and yaws-like skin disease in Ghana.
[So] Source:PLoS Negl Trop Dis;11(7):e0005820, 2017 Jul.
[Is] ISSN:1935-2735
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Yaws is endemic in Ghana. The World Health Organization (WHO) has launched a new global eradication campaign based on total community mass treatment with azithromycin. Achieving high coverage of mass treatment will be fundamental to the success of this new strategy; coverage is dependent, in part, on appropriate community mobilisation. An understanding of community knowledge, attitudes and practices related to yaws in Ghana and other endemic countries will be vital in designing effective community engagement strategies. METHODS: A verbally administered questionnaire was administered to residents in 3 districts in the Eastern region of Ghana where a randomised trial on the treatment of yaws was being conducted. The questionnaire combined both quantitative and qualitative questions covering perceptions of the cause and mechanisms of transmission of yaws-like lesions, the providers from which individuals would seek healthcare for yaws-like lesions, and what factors were important in reaching decisions on where to seek care. Chi-square tests and logistic regression were used to assess relationships between reported knowledge, attitudes and practices, and demographic variables. Thematic analysis of qualitative data was used to identify common themes. RESULTS: A total of 1,162 individuals participated. The majority of individuals (n = 895, 77%) reported that "germs" were the cause of yaws lesions. Overall 13% (n = 161) of respondents believed that the disease was caused by supernatural forces. Participants frequently mentioned lack of personal hygiene, irregular and inefficient bathing, and washing with dirty water as fundamental to both the cause and the prevention of yaws. A majority of individuals reported that they would want to take an antibiotic to prevent the development of yaws if they were asymptomatic (n = 689, 61.2%), but a substantial minority reported they would not want to do so. A majority of individuals (n = 839, 72.7%) reported that if they had a yaws-like skin lesion they would seek care from a doctor or nurse. Both direct and indirect costs of treatment were reported as key factors affecting where participants reported they would seek care. DISCUSSION: This is the first study that has explored community knowledge, attitudes and practices in relation to yaws in any endemic population. The belief that 'germs' are in some way related to disease through a variety of transmission routes including both contact and dirty water are similar to those reported for other skin diseases in Ghana. The prominent role of private healthcare providers is an important finding of this study and suggests engagement with this sector will be important in yaws eradication efforts. Strategies to address the substantial minority of individuals who reported they would not take treatment for yaws if they were currently asymptomatic will be needed to ensure the success of yaws eradication efforts. The data collected will be of value to the Ghana Health Service and also to WHO and other partners, who are currently developing community mobilisation tools to support yaws eradication efforts worldwide.
[Mh] Termos MeSH primário: Conhecimentos, Atitudes e Prática em Saúde
Bouba/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Antibacterianos/administração & dosagem
Feminino
Gana
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Aceitação pelo Paciente de Cuidados de Saúde
Inquéritos e Questionários
Treponema pallidum
Bouba/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170801
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0005820


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[PMID]:28727773
[Au] Autor:Chen B; Peng X; Xie T; Jin C; Liu F; Wu N
[Ad] Endereço:State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
[Ti] Título:The tradition algorithm approach underestimates the prevalence of serodiagnosis of syphilis in HIV-infected individuals.
[So] Source:PLoS Negl Trop Dis;11(7):e0005758, 2017 Jul.
[Is] ISSN:1935-2735
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Currently, there are three algorithms for screening of syphilis: traditional algorithm, reverse algorithm and European Centre for Disease Prevention and Control (ECDC) algorithm. To date, there is not a generally recognized diagnostic algorithm. When syphilis meets HIV, the situation is even more complex. To evaluate their screening performance and impact on the seroprevalence of syphilis in HIV-infected individuals, we conducted a cross-sectional study included 865 serum samples from HIV-infected patients in a tertiary hospital. Every sample (one per patient) was tested with toluidine red unheated serum test (TRUST), T. pallidum particle agglutination assay (TPPA), and Treponema pallidum enzyme immunoassay (TP-EIA) according to the manufacturer's instructions. The results of syphilis serological testing were interpreted following different algorithms respectively. We directly compared the traditional syphilis screening algorithm with the reverse syphilis screening algorithm in this unique population. The reverse algorithm achieved remarkable higher seroprevalence of syphilis than the traditional algorithm (24.9% vs. 14.2%, p < 0.0001). Compared to the reverse algorithm, the traditional algorithm also had a missed serodiagnosis rate of 42.8%. The total percentages of agreement and corresponding kappa values of tradition and ECDC algorithm compared with those of reverse algorithm were as follows: 89.4%,0.668; 99.8%, 0.994. There was a very good strength of agreement between the reverse and the ECDC algorithm. Our results supported the reverse (or ECDC) algorithm in screening of syphilis in HIV-infected populations. In addition, our study demonstrated that screening of HIV-populations using different algorithms may result in a statistically different seroprevalence of syphilis.
[Mh] Termos MeSH primário: Algoritmos
Infecções por HIV/complicações
Programas de Rastreamento/métodos
Testes Sorológicos/métodos
Sífilis/diagnóstico
Sífilis/epidemiologia
Treponema pallidum/imunologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Estudos Transversais
Seres Humanos
Masculino
Meia-Idade
Estudos Soroepidemiológicos
Centros de Atenção Terciária
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0005758



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