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Background: Scabies is a common but neglected skin disease caused by the parasitic mite Sarcoptes scabiei var. hominis. Globally, the disease affects more than 400 million people. Although Ethiopia is a high-burden country for scabies, its epidemiology has not been well assessed. Therefore, this study aimed to determine the prevalence of scabies, clinical features, and associated risk factors in the communities of the Hawassa Zuria District of the Sidama Region, southern Ethiopia. Methods: A community-based cross-sectional study was conducted from September through November 2023 in the Hawassa Zuria District. A multistage random sampling technique was applied to enrol 511 participants. The International Alliance for Control of Scabies Diagnostic Criteria was used for examination. The data were collected electronically using the Open Data Kit application through a pretested interviewer-administered questionnaire. Analysis was performed using STATA software. The binary logistic regression analyses model was used to assess the association between each independent variable and scabies prevalence. During the bivariate logistic regression analyses a variable with a p-value of < 0.25 was a candidate for multivariable logistic regression analyses. In multivariable logistic regression analyses the odds ratios with a 95% confidence interval and a p-value less than 0.05 were used to describe the strength of the association and statistical significance. Results: The median age of the study participants was 19 years (interquartile range: 11–32 years), and 52.6% of the participants were females. The overall prevalence of scabies was 6.3% (95% CI 4.3–8.7%). The majority of individuals with scabies had a moderate degree of severity. The most frequent lesions were intensely itchy papules, vesicles, and pustules that appeared in the interdigital space, flexor wrist surfaces, and elbow. Males were more likely to have scabies [adjusted odds ratio (AOR) = 2.57; 95% CI: 1.10–6.00] than females were and it was not influenced by age. The risk of scabies was higher for households with low (AOR = 3.88; 95% CI: 1.01–14.91) and middle-class wealth index (AOR = 4.43; 95% CI: 1.13–17.33), as well as for individuals residing in households with an overcrowding index >1.5 (AOR = 2.64; 95% CI: 1.13–6.18), in those individuals who washed their hands with water only (AOR = 2.98; 95% CI: 1.23–7.24), in those who used an unimproved water source (AOR = 2.98; 95% CI: 1.25–7.06) and in those who slept on the floor (AOR = 2.70; 95% CI: 1.17–6.18). Conclusion: The observed moderate presence of scabies in the study area stresses the need to strengthen disease management efforts, improve wealth, reduce overcrowding, ensure clean water access, and promote better hygiene practices to reduce the spread of scabies. [ABSTRACT FROM AUTHOR]

Background: Following the COVID-19 pandemic declaration, the World Health Organization recommended suspending neglected tropical diseases (NTD) control activities as part of sweeping strategies to minimise COVID-19 transmission. Understanding how NTD programs were impacted and resumed operations will inform contingency planning for future emergencies. This is the first study that documents how South-East Asian and Pacific NTD programs addressed challenges experienced during the COVID-19 pandemic. Methodology/Principal findings: Data was collected through semi-structured interviews with 11 NTD Program Coordinators and related personnel from Fiji, Papua New Guinea, The Philippines, Timor-Leste, and Vanuatu. Constructivist grounded theory methods were drawn on to generate an explanation of factors that enabled or hindered NTD program operations during the COVID-19 pandemic. The COVID-19 pandemic disrupted NTD programs in all countries. Some programs implemented novel strategies by partnering with services deemed essential or used new communications technology to continue (albeit scaled-back) NTD activities. Strong relationships to initiate cross-program integration, sufficient resources to implement adapted activities, and dedicated administrative systems were key enabling factors for recommencement. As the COVID-19 pandemic continued, exacerbating health resources scarcity, programs faced funding shortages and participants needed to find efficiencies through greater integration and activity prioritisation within their NTD units. Emphasising community-led approaches to restore trust and engagement was critical after widespread social anxiety and disconnection. Conclusions/Significance: Sustaining effective NTD programs during a global emergency goes beyond managing immediate activity disruptions and requires attention to how NTD programs can be better ensconced within wider health programs, administrative, and social systems. This study underscores the importance of pre-emergency planning that reinforces NTD control programs as a critical service at all health systems levels, accompanied by governance arrangements that increase NTD staff control over their operations and strategies to maintain strong community relationships. Ensuring NTD units are supported via appropriate funding, personnel, and bureaucratic resources is also required. Author summary: Disruptions to health services during the COVID-19 pandemic may delay progress in neglected tropical diseases (NTDs) control by several years. Current studies of how NTD programs responded to the challenges arising from the COVID-19 pandemic are largely from African settings and focus on earlier periods during the pandemic when policy advice was most stringent. In contrast, this study documents how NTD staff and other related personnel in five South-East Asian and Pacific countries adapted to changing situations throughout the pandemic. We found a difference in the strategies NTD programs initially used to manage the immediate challenges of strict new public health measures compared to those used later in the pandemic's evolution when seeking to recommence usual programs. Initially, some NTD programs devised new ways of offering modified services, primarily though cross-program integration with other health services that were allowed to continue operating. When operations re-commenced, NTD programs faced financial challenges that meant human and resource efficiencies in these units needed to be found. The cumulative impact of pandemic-related restrictions and misinformation eroded community trust in health programs more broadly and required NTD staff to rebuild local relationships. The lessons learned in these settings may help NTD programs in these and other regions prepare for prolonged future emergencies. [ABSTRACT FROM AUTHOR]

Background: Strongyloides stercoralis is a neglected soil-transmitted helminth (STH) that leads to significant morbidity in endemic populations. Infection with this helminth has recently been recognised by the World Health Organization (WHO) as a major global health problem to be addressed with ivermectin preventive chemotherapy, and therefore, there is now, the need to develop guidelines for strongyloidiasis control that can be implemented by endemic countries. This study aimed to evaluate the impact of ivermectin preventive chemotherapy (PC) on S. stercoralis prevalence in endemic areas to generate evidence that can inform global health policy. Methodology/Principal findings: This study was a systematic review and meta-analysis. We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and LILACS for literature published between 1990 and 2022 and reporting prevalence of S. stercoralis before and after PC with ivermectin, administered either at school or at community level. The search strategy identified 933 records, eight of which were included in the meta-analysis. Data extraction and quality assessment were carried out by two authors. Meta-analysis of studies based on fecal testing demonstrated a significant reduction of S. stercoralis prevalence after PC: prevalence Risk Ratio (RR) 0.18 (95% CI 0.14–0.23), I2 = 0. A similar trend was observed in studies that used serology for diagnosis: RR 0.35 (95% CI 0.26–0.48), I2 = 4.25%. A sensitivity analysis was carried out for fecal tests where low quality studies were removed, confirming a post-intervention reduction in prevalence. The impact of PC could not be evaluated at different time points or comparing annual vs biannual administration due to insufficient data. Conclusions/Significance: Our findings demonstrate a significant decrease of S. stercoralis prevalence in areas where ivermectin PC has taken place, supporting the use of ivermectin PC in endemic areas. Author summary: Ivermectin is a broad-spectrum, anti-parasitic drug that has been administered for decades in the context of preventive chemotherapy programs for onchocerciasis and lymphatic filariasis elimination. Ivermectin is also effective against Strongyloides stercoralis, an intestinal worm causing significant morbidity in low-income countries in tropical and subtropical regions. The World Health Organization recently identified the need to develop guidelines to assist S. stercoralis control in endemic countries. We aimed to study the impact of ivermectin preventive chemotherapy on S. stercoralis prevalence to generate evidence that can inform global health policy. Therefore, we conducted a systematic review of the available literature, collecting data from studies where ivermectin was administered for control of S. stercoralis or other parasitic infections. The analysis demonstrated a reduction in the prevalence of S. stercoralis in areas where ivermectin was administered. These data may be useful for informing future public health policies. [ABSTRACT FROM AUTHOR]

Background: A school preventive chemotherapy (PC) program for soil-transmitted helminths (STHs) and schistosomiasis has operated in Huambo, Uige and Zaire provinces, Angola, since 2013 and 2014, respectively; complemented by a school water, sanitation and hygiene (WASH) program in a subset of schools from 2016. Conducted in 2021, this is the first impact assessment of the school program for the control of schistosomiasis and STHs. Methodology/Principal findings: A two-stage cluster design was used to select schools and schoolchildren for parasitological and WASH surveys. The rapid diagnostic tests (RDTs), point of care circulating cathodic antigen (POC-CCA) and Hemastix, were used to estimate Schistosoma mansoni and Schistosoma haematobium prevalence, respectively. Kato Katz was used to detect STHs, and quantify STH and S. mansoni infections. Urine filtration was used to quantify S. haematobium infections. Prevalence, infection intensity, relative prevalence reduction and egg reduction rates were calculated for schistosomiasis and STHs. Cohen's Kappa co-efficient was used to assess agreement between RDTs and microscopy. Chi-square or Fisher's exact test was used to compare WASH indicators in WASH-supported and WASH-unsupported schools. Overall, 17,880 schoolchildren (599 schools) and 6,461 schoolchildren (214 schools) participated in the schistosomiasis and STH surveys, respectively. Prevalence of any schistosomiasis in Huambo was 29.6%, Uige 35.4%, and Zaire 28.2%. Relative reduction in schistosomiasis prevalence from 2014 for Huambo was 18.8% (95% confidence interval (CI) 8.6, 29.0), Uige -92.3% (95%CI -162.2, -58.3), and Zaire -14.0% (95%CI -48.6, 20.6). Prevalence of any STH in Huambo was 16.3%, Uige 65.1%, and Zaire 28.2%. Relative reduction in STH prevalence for Huambo was -28.4% (95%CI -92.1, 35.2), Uige -10.7% (95%CI -30.2, 8.8), and Zaire -20.9% (95%CI -79.5, 37.8). A higher proportion of WASH-supported schools had improved water sources, and toilet and handwashing facilities compared to WASH-unsupported schools. Conclusions/Significance: The limited impact this school program has had in controlling schistosomiasis and STHs identifies the need for a comprehensive understanding of individual, community, and environmental factors associated with transmission, and consideration for a community-wide control program. Author summary: Schistosomiasis and soil-transmitted helminths (STHs) have long been recognized as public health problems in Angola, including Huambo, Uige and Zaire provinces. To address these neglected tropical diseases, the Angolan Ministry of Health, in conjunction with the MENTOR Initiative and END Fund have been implementing school preventive chemotherapy (PC) from 2013 for STHs and 2014 for schistosomiasis. Additionally, the school PC program has been complemented by a school WASH program in a subset of schools from 2016. To assess the impact of the school program on the prevalence and burden of schistosomiasis and STHs, parasitological surveys were conducted in 2021 that included 17,880 schoolchildren from 599 schools in the schistosomiasis survey and 6,461 schoolchildren from 214 schools in the STH survey. Access and use of WASH interventions was also assessed via questionnaires for each school participating in the parasitological surveys, and compared between WASH supported and unsupported schools. When compared to the results of the 2014 survey there has been limited reduction in the prevalence of schistosomiasis and STHs across the three provinces. A higher proportion of schools that received WASH support provided schoolchildren with better WASH conditions. [ABSTRACT FROM AUTHOR]

Preventive chemotherapy (PC), consisting of the regular distribution of anthelmintics to populations or groups of populations at risk, is the primary tool used to control soil-transmitted helminth (STH) infections. This strategy, whilst cost-effective, raises the concern of potential emergence of drug resistance. The efficacy of anthelmintics against STH infections is measured using cure rate (CR) and egg reduction rate (ERR), using microscopy-based techniques such as the Kato-Katz thick smear. However, Kato-Katz has low sensitivity, especially for low-intensity infections, and requires fresh samples that need to be processed quickly. Realtime quantitative PCR (qPCR), which is more sensitive, is emerging as a "gold standard" for STH diagnostics given its higher sensitivity (important in low prevalence settings) and ability to differentiate hookworm species, while sodium nitrate flotation (SNF) may provide a low-cost more sensitive and practical alternative to Kato-Katz in the field. In this study, we examined the efficacy of a locally manufactured brand of albendazole 400 mg ("Alzental") against hookworm in Đắk Lắk province, Vietnam, using both qPCR and SNF. For qPCR, formulae to convert qPCR cycle threshold (Ct) values into eggs per gram of faeces (EPG) were utilised to determine efficacy calculations, and these values directly compared with efficacy values generated using SNF. Factors associated with CR and ERR were examined, and Alzental tablet quality was assessed by comparing with an Australian TGA-approved equivalent "Eskazole" tablet. We observed a CR and ERR of 64.9% and 87.5% respectively using qPCR, and 68.4% and 67.6% respectively using SNF. The tablet composition of Alzental was comparable to Eskazole in terms of active albendazole drug concentration with no evidence of impurities. This study demonstrates that the efficacy of Alzental against hookworm is within the range of previously reported studies for albendazole 400 mg. The study also demonstrates the value of qPCR and SNF as alternatives to standard Kato-Katz methodology for assessment of anthelmintic efficacy. Author summary: Regular administration of deworming drugs to whole at-risk populations is the recommended strategy to control soil-transmitted helminth (STH) infections in humans. Repeated rounds of deworming drug administration could lead to emerging drug resistance. In this study, we examined the efficacy of the deworming drug albendazole 400 mg ("Alzental") against hookworm in Đắk Lắk province, Vietnam. Efficacy is measured by calculating cure rates and egg reduction rates after Alzental treatment. We also compared two different diagnostic methods for detecting and quantifying STH infections–a microscopy approach with sodium nitrate flotation, and a molecular approach with quantitative PCR. We show the efficacy of Alzental is within the range previously reported for albendazole and we found no evidence of emerging drug resistance. SNF and qPCR may provide more convenient, and more sensitive alternatives to the current standard diagnostic tool (the Kato Katz thick smear). [ABSTRACT FROM AUTHOR]

Background: Timely health care seeking with access to quality health care are crucial to improve child survival. We conducted a study which aimed to identify factors influencing timely health care seeking and choice of first source of health care in Ethiopia. Methods: A total of 535 caregivers who sought health care for febrile children aged under 5 years at a tertiary hospital, and one urban and two rural health centres in Hawassa, southern Ethiopia were recruited to participate in the study from August to November 2019. Caregivers were interviewed using pretested structured questionnaires on socio-demographic and clinical factors to identify associations with health care seeking practice and first source of care, and reasons for particular practices. Delayed care seeking was defined as seeking care from a health facility after 24 hours of onset of fever. Results: Of 535 caregivers who participated, 271 (50.7%) had sought timely health care; 400 (74.8%) utilized a primary health care (PHC) facility as first source; and 282 (52.7%) bypassed the nearest PHC facility. Rural residents (adjusted odds ratio (AOR) 1.85; 95% CI 1.11–3.09), and those who reported cough (AOR 1.87; 95% CI 1.20–2.93) as a reason for consultation were more likely to delay seeking health care. While caregivers were less likely delayed for children aged 24–35 months (AOR 0.50; 95% CI 0.28–0.87) compared to infants. Utilizing higher-level hospitals as the first source of care was less frequent among rural residents (AOR 0.15; 95% CI 0.06–0.39) and in those with no formal education (AOR 0.03; 95% CI 0.01–0.27). Those having a longer travel time to the provider (AOR 2.11; 95% CI 1.09–4.08) more likely utilized higher hospitals. Conclusion: We identified a need to improve timely health seeking among rural residents, infants, and those presenting with respiratory symptoms. Improvements may be achieved by educating communities on the need of early care seeking, and ensuring the communities members' expectations of services at each level consistent with the services capacity. [ABSTRACT FROM AUTHOR]

Background: The epidemiology of trachoma in several Pacific Islands differs from other endemic settings, in that there is a high prevalence of clinical signs of trachoma, particularly trachomatous inflammation—follicular (TF), but few cases of trichiasis and limited evidence of ocular chlamydial infection. This so-called "Pacific enigma" has led to uncertainty regarding the appropriate public health response. In 2019 alongside Nauru's national trachoma population survey, we performed bacteriological and serological assessments of children to better understand the typology of trachoma and to determine whether there is a need for trachoma interventions. Methods: We used two-stage cluster sampling, examining residents aged ≥1 year and collecting household-level water, sanitation, and hygiene (WASH) variables. Children aged 1–9 years provided conjunctival swabs and finger-prick dried blood spots to investigate the presence of Chlamydia trachomatis nucleic acid and anti-Pgp3 antibodies, respectively. Principal Findings: In 818 participants aged 1–9 years, the age-adjusted TF prevalence was 21.8% (95% CI 15.2–26.2%); ocular C. trachomatis prevalence was 34.5% (95% CI 30.6–38.9), and anti-Pgp3 antibody prevalence was 32.1% (95% CI 28.4%–36.3%). The age- and gender-adjusted prevalence of trichiasis in ≥15-year-olds was 0.3% (95% CI 0.00–0.85), but no individual with trichiasis had trachomatous scarring (TS). Multivariable analysis showed an association between age and both TF (OR per year of age 1.3 [95% CI 1.2–1.4]) and anti-Pgp3 positivity (OR 1.2 [95% CI 1.2–1.3]). There were high rates of access to water and sanitation and no WASH variable was associated with the presence of TF. Conclusions: TF, nucleic acid, and age-specific antibody prevalence collectively indicate that high levels of C. trachomatis transmission among children present a high risk of ocular damage due to trachoma. The absence of trichiasis with trachomatous scarring suggest a relatively recent increase in transmission intensity. Author summary: In contrast to several neighbouring Pacific Island nations, Nauruan children are heavily affected by active trachoma and the cause is ocular infection with C. trachomatis. Comprehensive public health intervention to control trachoma in Nauru is required. The use of laboratory markers for current and previous C. trachomatis infection should be considered in baseline trachoma prevalence surveys as we approach global elimination of trachoma, and in settings with inconsistent findings during previous screening exercises. [ABSTRACT FROM AUTHOR]

Background: Preventative chemotherapy and mass drug administration have been identified as effective strategies for the prevention, treatment, control and elimination of several NTDs in the Asia-Pacific region. Qualitative research can provide in-depth insight into the social dynamics and processes underlying effective implementation of and adherence to mass drug administration programs. This scoping review examines published qualitative literature to examine factors influencing community perceptions and acceptability of mass drug administration approaches to control NTDs in the Asia-Pacific region. Methodology: Twenty-four peer reviewed published papers reporting qualitative data from community members and stakeholders engaged in the implementation of mass drug administration programs were identified as eligible for inclusion. Findings: This systematic scoping review presents available data from studies focussing on lymphatic filariasis, soil-transmitted helminths and scabies in eight national settings (India, Indonesia, Philippines, Bangladesh, Laos, American Samoa, Papua New Guinea, Fiji). The review highlights the profoundly social nature of individual, interpersonal and institutional influences on community perceptions of willingness to participate in mass drug administration programs for control of neglected tropical diseases (NTD). Future NTD research and control efforts would benefit from a stronger qualitative social science lens to mass drug administration implementation, a commitment to understanding and addressing the social and structural determinants of NTDs and NTD control in complex settings, and efforts to engage local communities as equal partners and experts in the co-design of mass drug administration and other efforts to prevent, treat, control and eliminate NTDs. Conclusion: For many countries in the Asia-Pacific region, the "low hanging fruit has been picked" in terms of where mass drug administration has worked and transmission has been stopped. The settings that remain–such as remote areas of Fiji and Papua New Guinea, or large, highly populated, multi-cultural urban settings in India and Indonesia–present huge challenges going forward. Author summary: Qualitative research can provide in-depth insight into the social dynamics and processes underlying effective implementation of and adherence to mass drug administration programs. This scoping review examines published qualitative literature to examine factors influencing community perceptions and acceptability of mass drug administration approaches to control neglected tropical diseases (NTDs) in the Asia-Pacific region. Our analyses highlight the profoundly social nature of individual, interpersonal and institutional influences on community perceptions of willingness to participate in mass drug administration programs for control of NTDs. For many countries in the Asia-Pacific region, the "low hanging fruit has been picked" in terms of where mass drug administration has worked and transmission has been stopped. The settings that remain–e.g. remote areas of Fiji and Papua New Guinea, or large, highly populated, multi-cultural urban settings in India and Indonesia–present huge challenges going forward. Future NTD research and control efforts would benefit from a stronger qualitative social science lens to mass drug administration implementation, a commitment to understanding the socio-structural determinants of NTDs and NTD control in complex settings, and engaging local communities as equal partners and experts in the co-design of mass drug administration and other efforts to prevent, treat, control and eliminate NTDs. [ABSTRACT FROM AUTHOR]

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. Schistosomiasis is a neglected tropical disease, caused by parasitic worms, that affects more than 143 million people worldwide. Chronic infections can lead to significant morbidity including kidney damage, anaemia, malnutrition, infertility and growth impairment. School-aged children between six and 15 years are often targeted for regular treatment with praziquantel in large-scale drug delivery programs, because they suffer a disproportionate burden of morbidity. On the other hand, a mass drug delivery strategy that treats all members of the community has been suggested in a move towards elimination of schistosomiasis as a public health problem. In this systematic review, we assess the impact of community-wide versus children-only praziquantel distribution in reducing schistosomiasis infections in school-aged children. We did not detect a difference between mass and targeted treatment strategies, possibly due to factors including insufficient treatment coverage and persistent sources of reinfection. Addressing these factors may assist in optimising control programs. [ABSTRACT FROM AUTHOR]

Background: Regular preventive chemotherapy (PCT) targeting high-risk populations is an effective way to control STH in the short term, but sustainable long-term STH control is expected to require improved access to water, sanitation, and hygiene (WASH). However, experimental studies have not been able to conclusively demonstrate the benefit of WASH in preventing STH (re-)infections. We investigated the impact of WASH on STH infections during and after PCT using mathematical modelling. Methods and findings: We use the individual-based transmission model WORMSIM to predict the short and long-term impact of WASH on STH transmission in contexts with and without PCT. We distinguish two WASH modalities: sanitation, which reduces individuals’ contributions to environmental contamination; and hygiene, which reduces individuals’ exposure to infection. We simulate the impact of varying levels of uptake and effectiveness of each WASH modality, as well as their combined impact. Clearly, sanitation and hygiene interventions have little observable short-term impact on STH infections levels in the context of PCT. However, in the long term, both are pivotal to sustain control or eliminate infection levels after scaling down or stopping PCT. The impact of hygiene is determined more by the effectiveness of the intervention than its overall uptake, whereas the impact of sanitation depends more directly on the product of uptake and the effectiveness. Interpretation: The impact of WASH interventions on STH transmission highly depends on the worm species, WASH modality, and uptake and effectiveness of the intervention. Also, the impact of WASH is difficult to measure in the context of ongoing PCT programmes. Still, we show a clear added benefit of WASH to sustain the gains made by PCT in the long term, such that PCT may be scaled down or even stopped altogether. To safely stop or scale down PCT, policy for WASH and PCT should be integrated. [ABSTRACT FROM AUTHOR]

Background: Rotavirus group A (RVA) is considered the leading cause of pediatric diarrhea, responsible for the high burden of diarrheal diseases in sub-Saharan Africa. Despite recent studies, the existent data are scarce for some African countries like Angola, a country with one of the highest RVA-related death estimates. The aim of this study was to determine the RVA detection rate and circulating genotypes in children less than five years of age with acute gastroenteritis attended at the Bengo General Hospital in Caxito, Bengo province, Angola, before vaccine introduction. Methods: Between September 2012 and December 2013, 342 fecal specimens were collected from children enrolled. Positive samples for RVA by immunochromatographic rapid test were G and P-typed by hemi-nested type-specific multiplex PCR, and subgrouped for the VP6 gene. VP4 and VP7 genes from a subset of samples were sequenced for phylogenetic analysis. Results: During the study period, a high RVA detection rate was registered (25.1%, 86/342). The age group most affected by RVA infection includes children under 6 months of age (p<0.01). Vomiting was highly associated with RVA infection (72.1%; p<0.001). From the 86 RVA-positive samples, 72 (83.7%) were genotyped. The most prevalent genotype was G1P[8] (34/72; 47.2%), followed by the uncommon G1P[6] (21/72; 29.2%), and G2P[4] (9/72; 12.5%). Only two G-types were found: G1 (60/72; 83.3%) and G2 (11/72; 15.3%). Among the P-genotypes, P[8] was the most prevalent (34/72; 47.2%), followed by P[6] (22/72; 30.6%) and P[4] (9/72; 12.5%). In the phylogenetic trees, the identified G and P-types clustered tightly together and with reference sequences in specific monophyletic groups, with highly significant bootstrap values (≥92%). Conclusion: This pre-vaccination study revealed, for the first time for Bengo province (Angola), the RVA genotype profile, including phylogenetic relationships, and a high RVA detection rate, supporting the immediate introduction of a RVA vaccine in the national immunization programme. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) has recently updated guidelines for helminth control programs, focusing on soil-transmitted helminthiasis (STH) and schistosomiasis in school-age children. However, there are other helminth infections, such as hymenolepiasis, that are not included in these guidelines but can cause significant morbidity in children and can be treated with praziquantel (PZQ). Hymenolepiasis is caused by a tapeworm and is the most prevalent human cestodiasis in the world. This article analyzes data from a study in Angola to describe the epidemiology of H. nana infection and its impact on morbidity. The study suggests that PZQ delivery should be extended to communities at risk of hymenolepiasis, in addition to schistosomiasis, and that water, sanitation, and hygiene (WASH) improvements should be implemented alongside anthelminth therapy. [Extracted from the article]