Centro Nacional de Medicina Tropical (CNMT)

Permanent URI for this collectionhttps://hdl.handle.net/20.500.12105/19611

El Centro Nacional de Medicina Tropical se crea por orden del 27 de diciembre de 2001 (publicado en BOE del 11 de enero de 2002) para responder a la creciente movilidad internacional (inmigración y viajeros) y también por la mayor presencia española en programas de cooperación internacional, con el objetivo de reforzar la asistencia, investigación y docencia en enfermedades tropicales y establecer programas de cooperación científico-técnica, con países donde existen estas patologías.

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Inhibiting and protective factors of exclusive breastfeeding in an Island population in Spain: a longitudinal study.
(Springer, 2025-12-24) Llorente-Pulido, Seila; Custodio, Estefania; Otero Garcia, Laura
Abstract Background: Breastfeeding provides important health benefits for both mothers and infants. In Spain, the rate of exclusive breastfeeding (EBF) at 6 months is 47%, which remains below the 60% target proposed by the World Health Organization for 2030. The objective of this study was to identify the protective and inhibiting factors associated with EBF in a population of pregnant women in Tenerife (Canary Islands, Spain). Methods: We conducted a longitudinal, prospective study among women attending midwife consultations for pregnancy check-ups at a primary healthcare center between November 2018 and January 2021. We followed 83 women, collecting data at different time points during pregnancy and postpartum (hospital stay, 15 days, 1 month, 4 months, and 6 months). Descriptive statistics and univariable and multivariable logistic regression analyses were performed. Results: The inhibiting factors for EBF were pacifier use during the hospital stay, on EBF after birth (OR: 0.06, 95% CI: 0.02, 0.23), pacifier use at 15 days (OR: 0.13, 95% CI: 0.04, 0.42) and at 4 months (OR: 0.23, 95% CI: 0.07, 0.79), gynecological problems of the woman (OR: 0.14, 95% CI: 0.03, 0.61), the presence of nipple pain at 15 days affecting EBF at 4 months (OR: 0.18, 95% CI: 0.06, 0.56) and at 6 months (OR: 0.21, 95% CI: 0.07, 0.68), perception of insufficient milk at 15 days (OR: 0.15, 95% CI: 0.05, 0.49) and at 1 month (OR: 0.06, 95% CI: 0.02, 0.20), and giving birth in a privately managed hospital without Baby-Friendly Hospital Initiative (BFHI) accreditation (OR: 0.17, 95% CI: 0.05, 0.66). Protective factors for EBF were the woman’s prior knowledge of the benefits of breastfeeding for her child (OR: 5.25, 95% CI: 1.03, 26.80) and for herself (OR: 3.98, 95% CI: 1.31, 12.02), as well as having a foreign nationality (OR: 3.04, 95% CI: 1.05, 8.80). Conclusions: The factors impacting EBF can be addressed with improved care practices for women during pregnancy, childbirth, and the early postpartum period. It is essential to train healthcare professionals and implement the BFHI in Spain, where it is primarily carried out in public hospitals, but not in private ones.
Usefulness of the rK39-immunochromatographic test, direct agglutination test, and leishmanin skin test for detecting asymptomatic Leishmania infection in children in a new visceral leishmaniasis focus in Amhara State, Ethiopia.
(American Society of Tropical Medicine and Hygiene (ASTMH), 2012-05) Gadisa, Endalamaw; Custodio, Estefania; Cañavate, Carmen; Sordo, Luis; Chicharro, Carmen; Abebe, Zelalem; Nieto Martinez, Francisco Javier; Chicharro, Carmen; Aseffa, Abraham; Yamuah, Lawrence; Engers, Howard; Moreno, Javier; Cruz, Israel
In areas where visceral leishmaniasis is anthroponotic, asymptomatically infected patients may play a role in transmission. Additionally, the number of asymptomatic patients in a disease-endemic area will also provide information on transmission dynamics. Libo Kemkem and Fogera districts (Amhara State, Ethiopia) are now considered newly established areas to which visceral leishmaniasis is endemic. In selected villages in these districts, we conducted a study to assess the usefulness of different approaches to estimate the asymptomatic infection rate. Of 605 participants, the rK39 immunochromatographic test was able to detect asymptomatic infection in 1.5% (9 of 605), direct agglutination test in 5.3% (32 of 605), and leishmanin skin test in 5.6% (33 of 589); the combined use of serologic methods and leishmanin skin test enabled detecting asymptomatic infection in 10.1% (61 of 605). We conclude that the best option to detect asymptomatic infection in this new visceral leishmaniasis-endemic focus is the combined use of the direct agglutination test and the leishmanin skin test.
Malaria diagnosis challenges and and gene deletions using pregnant women as sentinel population in Nanoro region, Burkina Faso.
(Taylor & Francis, 2024-09) Molina-de la Fuente, Irene; Tahita, Marc Christian; Bérenger, Kabore; Ta Tang, Thuy Huong; Garcia, Luz; Gonzalez-Mora, Vicenta; Benito, Agustin; Hübschen, Judith M; Tinto, Halidou; Berzosa, Pedro
Malaria in pregnancy causes adverse consequences and prompt and accurate diagnosis is essential for case management. In malaria endemic countries, diagnosis is mainly based on rapid diagnostic tests (RDT) and microscopy. However, increasing reports of false negatives caused by low parasitemia and deletions raise concerns about HRP2-based RDT usefulness. This study aimed to assess RDT and microscopy performance and to describe deletions in a cohort of 418 pregnant women in Burkina Faso. Malaria was diagnosed using RDT and microscopy and blood samples were collected during antenatal care visits. Diagnostic results were compared to PCR as gold standard. and deletions were characterized for patients with confirmed infection. RDT had better sensitivity (76%) but lower specificity (83%) than microscopy (sensitivity = 57%; specificity = 98%). Low parasitemia (<150 parasites/µL), especially in multigravidae, was the principal factor causing false negatives by both methods. Moreover, deletion frequency among overall false negatives by RDT was 21.43%. Higher frequency of deletions was found among all samples, independently of RDT result, for example around 2% of samples had double deletions meaning that the majority of deletions had no effect on RDT testing. Finally, it was found higher deletion in women with lower uterine height during the first trimester. Wider and National surveillance study of deletions is recommended among pregnant women and in Burkina Faso.
Plasmodium falciparum pfhrp2 and pfhrp3 Gene Deletions in Malaria-Hyperendemic Region, South Sudan.
(Centers for Disease Control and Prevention (CDC), 2023-01) Molina-de la Fuente, Irene; Benito, María José Sagrado; Flevaud, Laurence; Ousley, Janet; Pasquale, Harriet Akello; Julla, Ahmed; Abdi, Abdirashid M; Chol, Buai Tut; Abubakr, Bakri; Benito, Agustín; Casademont, Cristian; Nanclares, Carolina; Berzosa, Pedro
Pfhrp2 and pfhrp3 gene deletions threaten the use of Plasmodium falciparum malaria rapid diagnostic tests globally. In South Sudan, deletion frequencies were 15.6% for pfhrp2, 20.0% for pfhrp3, and 7.5% for double deletions. Deletions were approximately twice as prevalent in monoclonal infections than in polyclonal infections.
Nigeria Nutrient Conversion Table (Nigeria_NCT)
(Instituto de Salud Carlos III, 2025-06-25) Cockx, Lara; Custodio, Estefania; Unión Europea. Centro Común de Investigación (JRC)
It includes the nutrients composition of food items reported in the food composition module of the 2018/2019 NLSS and GHS.
Equatorial Guinea Nutrient Conversion Table (EquatorialGuinea_NCT)
(Instituto de Salud Carlos III (ISCIII). Centro Nacional de Medicina Tropical (CNMT), 2022-06) Custodio, Estefania; Prieto Bercianos, Marina; Instituto de Salud Carlos III
It includes the nutrients composition of food items reported in the dataset of the Equatorial Guinea National Malaria and Nutrition Survey 2004. Component values, including for beverages and other liquids, are presented per 100 g edible portion.
Mutational profile of pfdhfr, pfdhps, pfmdr1, pfcrt and pfk13 genes of P. falciparum associated with resistance to different antimalarial drugs in Osun state, southwestern Nigeria
(BioMed Central (BMC), 2025-04-08) Martin-Ramirez, Alexandra; Akindele, Akeem Abiodun; Gonzalez-Mora, Vicenta; Garcia, Luz; Lara, Nicole; de la Torre-Capitán Matías, Eva; Molina-de la Fuente, Irene; Nassar, Sulaiman Adebayo; Ta Tang, Thuy-Huong; Benito, Agustin; Berzosa, Pedro; Centro de Investigación Biomédica en Red - CIBERINFEC (Enfermedades Infecciosas); Instituto de Salud Carlos III; Ministerio de Ciencia, Innovación y Universidades (España)
Background: Nigeria accounts for the greatest burden of malaria disease globally. Malaria control requires an effective treatment after diagnosis. The efficacy of antimalarial drugs can be assessed through the analysis of genetic changes associated with reduced drug sensitivity. Methods: This study includes the analysis of the markers associated with artemisinin (pfk13), sulfadoxine-pyrimethamine (pfdhfr and pfdhps), and chloroquine and its derivatives (pfmdr1 and pfcrt) resistances, in blood samples collected from asymptomatic children in south-western Nigeria. Results: The 25.95% of samples showed a number of mutations in pfk13 gene. Among those, the validated, C580Y, and the candidate, R515K, mutations by WHO were detected. Twenty-seven pfdhps different haplotypes were observed, with the haplotype ISGKAA as the most prevalent (18.80%), followed by IFGKAA (12.78%) and IAGKAA (11.28%). The VAGKGS was the most common haplotype carrying the I431V mutation (10.53%). Combinations of alleles in pfdhfr and pfdhps genes provided a 40.98% of samples with the partially resistant haplotype (IRNG). No samples exhibited the 'fully resistant' or 'super resistant' pfdhprf-pfdhps combinations, but one sample contained mutations at pfdhfr 51I, 59R, and 108N with pfdhps 431V, 436A, A437G and 540E. The analysis of pfcrt 72-76 variants disclosed a 12.12% of samples with the mutant-type (CVIET). No double mutant pfmdr1 haplotypes 86Y/1246Y (YY) were detected, nor was the haplotype formed by the alleles 86Y pfmdr1 + pfcrt 76 T (YT). Conclusions: There was no evidence of parasite genomes harbouring multilocus mutations conferring multidrug resistance, although evidence of a validated (C580Y) and a candidate (R515K) mutation in pfk13 gene, high frequency pfdhfr mutant alleles and high variability of pfdhps haplotypes were found in this study, which provides a baseline information essential in monitoring P. falciparum resistances.
Diet quality rather than caloric intake associated with labour wages in Kenya
(Springer, 2025-03-12) Custodio, Estefania; Jiménez, Sofía; Ramos, María Priscila; Sartori, Martina; Ferrari, Emanuele
Malnutrition, in all its forms, poses a significant threat to human development and economic growth. Consequently, enhancing food security and consumption is a moral and social imperative for fostering development. Despite the substantial evidence on the relationship between caloric intake and labour productivity, research on the connection between labour productivity and diet quality, measured by micronutrient intake, is scarce. This paper, focusing on Kenya, estimates the linkages between micronutrient intake and labour productivity, measured by household labour income. The daily intakes of energy and micronutrients per adult male equivalent at the household level is computed employing food consumption data collected in the 2015–2016 Kenya Integrated Household Budget Survey. Econometric results show that daily micronutrient (haem iron, zinc, folate, calcium, vitamins B2 and A) intakes are significantly and positively correlated with labour productivity. The quality of diets, reflected by micronutrient intakes, has a bigger impact on labour productivity than the daily energy consumed, measured by caloric intake. This paper contributes to the nutrition–productivity literature and provides a basis for designing policies to improve the nutritional quality of diets.
Comoros Nutrient Conversion Table (Comoros_NCT)
(Instituto de Salud Carlos III (ISCIII). Centro Nacional de Medicina Tropical (CNMT), 2024-09-18) Custodio, Estefania; Jiménez, Sofía; Ramos, María Priscila; World Bank Group
In order to estimate the nutrients intake from the food consumption module (Section 7B) of the Comoros 2018/2019 Harmonized Survey on Household Living Conditions, known as EHCVM by its French acronym (Enquête Harmoniser sur les Conditions de Vie de Ménage), each of the food items reported in that module is matched with a food item in the Food Composition Table (FCT) or Food Database (FDB) of choice, and nutrients composition are then compiled in what is called the nutrition conversion table (NCT).
Evolution of Spanish population well-being during the COVID-19 pandemic: Results from the COSMO-Spain study
(Elsevier, 2025-02-15) Santos-Ribeiro, Catarina; Rodriguez-Blazquez, Carmen; Ayala, Alba; Romay-Barja, Maria; Falcón, María; Forjaz, Maria João; Instituto de Salud Carlos III
Introduction: The COVID-19 pandemic affected mental health worldwide. The COSMO-Spain study analyses risk perceptions, behaviours, knowledge and other pandemic related variables, such as well-being. This work aimed to assess the evolution of self-reported well-being in Spain from May 2021 to September 2022 and its association with demographic and COVID-19 related factors. Methods: An online, nationwide cross-sectional panel survey was applied in seven rounds with 1000+ participants each, with a total sample of 7266 participants, representative of the Spanish adult general population. The main variable was well-being, measured with the World Health Organization Well-Being Index (WHO-5) total score, an index with a total score from 0 to 100 (0 = worst well-being, 100 = best well-being). Other variables included in the survey were: sociodemographic data, concern about COVID-19, feelings of depression and fear, COVID-19-related worries, risk perception, self-efficacy, preventive behaviours, pandemic fatigue, health literacy, information search behaviours, and trust in several institutions. A multiple linear regression was run to analyse the associated factors with the WHO-5 total score. Results: The WHO-5 total score showed a significant increase from rounds 6 (May-June 2021) to 8 (September-October 2021). Women (standardized b coefficient (b) = -0.10), youth or people with lower socioeconomic status (worsened financial situation (b = -0.10) or unemployed/furloughs (b = -0.04)) reported lower well-being levels, whereas having a university-level education showed the opposite (b = 0.11). Feeling less depressed was associated with higher well-being (b = 0.31). Conclusions: This study shows rising levels of well-being until a plateau was reached in October 2021. Vulnerable groups may be at higher risk of worsened mental health and should be addressed by policymakers. Further longitudinal studies should evaluate causality and evolution patterns of well-being throughout the COVID-19 pandemic.
Evolution of pfhrp2 and pfhrp3 deletions in Equatorial Guinea between the pre- and post-RDT introduction
(BioMed Central (BMC), 2024-07-18) Molina-de la Fuente, Irene; Pacheco, M Andreína; Garcia, Luz; Gonzalez-Mora, Vicenta; Riloha, Matilde; Oki, Consuelo; Benito, Agustin; Escalante, Ananias A; Berzosa, Pedro; Instituto de Salud Carlos III; University of Alcalá (España)
Background: Pfhrp2 and pfhrp3 deletions are threatening Plasmodium falciparum malaria diagnosis by rapid diagnostic tests (RDT) due to false negatives. This study assesses the changes in the frequencies of pfhrp2 and pfhrp3 deletions (pfhrp2Del and pfhrp3Del, respectively) and the genes in their flaking regions, before and after RDT introduction in Equatorial Guinea. Methods: A total of 566 P. falciparum samples were genotyped to assess the presence of pfhrp2 and pfhrp3 deletions and their flanking genes. The specimens were collected 18 years apart from two provinces of Equatorial Guinea, North Bioko (Insular Region) and Litoral Province (Continental Region). Orthologs of pfhrp2 and pfhrp3 genes from other closely related species were used to compare sequencing data to assess pfhrp2 and pfhrp3 evolution. Additionally, population structure was studied using seven neutral microsatellites. Results: This study found that pfhrp2Del and pfhrp3Del were present before the introduction of RDT; however, they increased in frequency after their use, reaching more than 15%. Haplotype networks suggested that pfhrp2Del and pfhrp3Del emerged multiple times. Exon 2 of pfhrp2 and pfhrp3 genes had high variability, but there were no significant changes in amino acid sequences. Conclusions: Baseline sampling before deploying interventions provides a valuable context to interpret changes in genetic markers linked to their efficacy, such as the dynamic of deletions affecting RDT efficacy.
Geographical distribution and species identification of human filariasis and onchocerciasis in Bioko Island, Equatorial Guinea
(Elsevier, 2018-04) Ta Tang, Thuy-Huong; Moya-Alonso, Laura; Nguema, Justino; Aparicio, Pilar; Miguel-Oteo, María; Cenzual, Gema; Canorea, Isabel; Lanza-Suarez, Marta; Benito, Agustin; Crainey, James Lee; Rubio Muñoz, Jose Miguel; Instituto de Salud Carlos III
Human filariae are vector-borne parasites and the causative agents of various diseases, including human onchocerciasis and lymphatic filariasis. Onchocerciasis causes a spectrum of cutaneous and ophthalmologic manifestations (including blindness) and has long been a major public health problem in Bioko Island (Equatorial Guinea). Bioko Island has been included in the WHO's Onchocerciasis Control Program since 1987. In Bioko Island, the specificity and sensitivity of clinical Onchocerca volvulus diagnosis is key. The objective of this work was to update onchocerciasis elimination progress in Bioko Island, after 18 years of mass ivermectin intervention, and the general filariasis situation through a rapid and accurate molecular method. A cross-sectional study was conducted in Bioko Island from mid-January to mid-February 2014. A total of 543 subjects were included in the study. Whole blood and one skin snip (from lumbar regions) were analysed with a real time PCR assay. Two other skin biopsies were analysed by an expert microscopist. All positive samples were confirmed by sequencing. Traditional microscopic examination of the skin biopsies failed to detect any microfilariae. However, 11 (2.03%) infections were detected using PCR assay, including one O. volvulus, two Mansonella streptocerca, seven Mansonella perstans and one Loa loa infections. PCR assays in blood detected 52 filariae-positive individuals (9.6%) which harboured M. perstans or L. loa. The low prevalence of O. volvulus confirms the success of the Onchocerciasis Control Programme and suggests that Mass Drug Administration in Bioko Island can be interrupted in the near future. The very high prevalence of M. perstans found in skin snips assays raises doubts about the reliability of microscope-based diagnosis of O. volvulus infections.
Trends in COVID-19 Vaccine Acceptance in Spain, September 2020‒May 2021
(American Public Health Association (APHA), 2022-11) Beca-Martínez, María Teresa; Romay-Barja, Maria; Ayala, Alba; Falcón-Romero, María; Rodriguez-Blazquez, Carmen; Benito, Agustin; Forjaz, Maria João; Instituto de Salud Carlos III
Objectives. To analyze factors associated with COVID-19 vaccine acceptance in Spain, over time. Methods. We used data from a national study that included 5 online surveys carried out every 2 months from September 2020 to May 2021. Each round recruited a sample of 1000 participants aged 18 years or older. We performed a multivariable logistic regression with vaccination acceptance as the dependent variable. We evaluated time trends through the interaction terms of each of the explanatory variables and the time. Results. Vaccination acceptance increased from 43.1% in September 2020 to 84.5% in May 2021. Sex, age, concerns about disease severity, health services overload, and people not wearing a face mask, together with adherence to preventive behavior, health literacy, and confidence in scientists, health care professionals' information, and adequacy of governmental decisions, were variables associated with vaccination acceptance. Conclusions. In a changing situation, vaccine acceptance factors and time trends could help in the design of contextualized public health messages. It is important to strengthen the population's trust in institutions, health care professionals, and scientists to increase vaccination rates, as well as to ensure easy access to accurate information for those who are more reluctant.
Food security and nutritional vulnerability in Comoros: The impact of Russia-Ukraine conflict.
(Public Library of Science (PLOS), 2024-11-12) Custodio, Estefania; Ramos, María Priscila; Jiménez, Sofía; Mulangu, Francis; Depetris-Chauvin, Nicolas
The Sustainable Development Goal 2 aims to eradicate hunger. However, many small island developing states (SIDS) face challenges in achieving this goal due to their reliance on the global market and susceptibility to crises. This paper focuses on Comoros, one of the least studied SIDS located in the Indian Ocean, to examine its food security and nutritional vulnerability. The findings reveal that Comoros experiences limited access to sufficient and nutritious diets, which are excessive in fat and deficient in key micronutrients. This situation is similar to other SIDS in the Pacific and the Caribbean, which also exhibit the convergence of the malnutrition triple burden. This paper further assesses the impact of changing food prices during the initial year of the Russia-Ukraine conflict on food security and nutrition in Comoros, serving as a case study for SIDS. Using microsimulations, we estimate the effects on food access, sufficiency, and adequacy at the household level. The results indicate a decline in food access and purchasing power for all households, particularly the poorer and rural. Additionally, food sufficiency has markedly decreased, leading to an additional 5,000 households (3.3% of all households) experiencing inadequate daily calorie intake. The study also highlights a reduction in the consumption of organ meats, fruits, and vegetables, resulting in decreased daily iron and folate intakes. This is particularly concerning given the high prevalence of anemia among women in Comoros and other SIDS. To address these challenges, policies promoting the consumption of fresh, nutrient-rich foods with low fat content are crucial to mitigate the malnutrition triple burden and curb the increasing trend of non-communicable diseases in these countries.
Kenya Nutrient Conversion Table (Kenya_NCT)
(Instituto de Salud Carlos III (ISCIII). Centro Nacional de Medicina Tropical (CNMT), 2024-09-18) Custodio, Estefania; Jiménez, Sofía; Ramos, María Priscila; Unión Europea. Centro Común de Investigación (JRC)
In order to estimate the nutrients intake from the food consumption module of the 2015/2016 Kenya Integrated Household Budget Survey (KIHBS), each of the food items reported in that module is matched with a food item in the Food Composition Table (FCT) or Food Database (FDB) of choice, and nutrients composition are then compiled in what is called the nutrition conversion table (NCT).
Approaching onchocerciasis elimination in Equatorial Guinea: Near zero transmission and public health implication
(BioMed Central (BMC), 2024-11-14) Ncogo, Policarpo; Hernandez-Gonzalez, Ana; Ta Tang, Thuy-Huong; Redondo-Bravo, Lidia; Alvarez‑Fernandez, Ana; Perteguer-Prieto, Maria Jesus; Rubio Muñoz, Jose Miguel; Nguema, Rufino; Nguema, Justino; García, Marta; Reguero, Laura; Valverde, Teresa; Lanza-Suarez, Marta; Cerrada-Gálvez, Laura; Rebollo, Maria; Cano, Jorge; Benito, Agustin; Herrador, Zaida; Instituto de Salud Carlos III; Agencia Estatal de Investigación (España); Centro de Investigación Biomédica en Red - CIBERINFEC (Enfermedades Infecciosas); World Health Organization (WHO/OMS)
Background: Onchocerciasis and lymphatic filariasis (LF) are endemic in Equatorial Guinea with notable variations in disease incidence between island and mainland regions. Historically, efforts to control and map these diseases were concentrated in Bioko Island, where loiasis is absent, allowing for targeted onchocerciasis interruption strategies. With the cessation of onchocerciasis transmission on Bioko and no reported cases on Annobon island, assessing the transmission status in the previously unaddressed mainland region has become imperative. Mapping efforts in mainland Equatorial Guinea have proven low to moderate level of transmission for LF and onchocerciasis, although the results so far have not been very conclusive. The current study aims to update the prevalence estimates for onchocerciasis and LF in mainland Equatorial Guinea using various diagnostic techniques. Methods: This is the first cross-sectional study carried out to estimate the prevalence of onchocerciasis and LF in the mainland area of Equatorial Guinea, from September to December 2019, based on the combination of skin snip biopsies, thick blood smears, laboratory serological tests (ELISA tests for the detection of IgG4 antibodies against Onchocerca volvulus recombinant antigen Ov16 and Wuchereria bancrofti recombinant antigen Wb123) and molecular laboratory tests. Frequencies and prevalence rates, along with 95% confidence intervals for interval estimation of a binomial proportion, were computed. Results: The overall onchocerciasis seroprevalence calculated for the study was 0.3% (95% CI: 0.1 to 0.5%). Microscopic examination of skin biopsies from the eight individuals seropositive for Ov16, out of the 3951 individuals initially tested, revealed no O. volvulus microfilariae. However, DNA extracted from one skin snip was successfully amplified, with subsequent sequencing confirming the presence of O. volvulus. Among the 3951 individuals, 182 were found to have anti-Wb123 antibodies, suggesting exposure to W. bancrofti, with an estimated seroprevalence of 4.6% (95% CI: 4.0 to 5.3%). Microscopy and Filaria-real time-PCR (F-RT-PCR) analysis for W. bancrofti were negative across all samples. Conclusions: The findings indicate that onchocerciasis may no longer constitutes a public health problem in Equatorial Guinea, positioning the country on the verge of achieving elimination. Additionally, the mapped prevalence of LF will facilitate the formulation of national strategies aimed at eradicating filariases countrywide.
Real-time PCR for malaria diagnosis and identification of Plasmodium species in febrile patients in Cubal, Angola
(BioMed Central (BMC), 2024-09-11) Mediavilla, Alejandro; Silgado, Aroa; Febrer-Sendra, Begoña; Crego-Vicente, Beatriz; Martínez-Vallejo, Patricia; Maturana, Carles Rubio; Goterris, Lidia; Nindia, Arlette; Martínez-Campreciós, Joan; Aixut, Sandra; Aznar-Ruiz-de-Alegría, María Luisa; Fernández-Soto, Pedro; Muro, Antonio; Salvador, Fernando; Molina, Israel; Berzosa, Pedro; Oliveira-Souto, Inés; Sulleiro, Elena
Background: Malaria is the parasitic disease with the highest morbimortality worldwide. The World Health Organization (WHO) estimates that there were approximately 249 million cases in 2022, of which 3.4% were in Angola. Diagnosis is based on parasite identification by microscopy examination, antigen detection, and/or molecular tests, such as polymerase chain reaction (PCR). This study aimed to evaluate the usefulness of real-time PCR as a diagnostic method for malaria in an endemic area (Cubal, Angola). Methods: A cross-sectional study was carried out at the Hospital Nossa Senhora da Paz in Cubal, Angola, including 200 patients who consulted for febrile syndrome between May and July 2022. From each patient, a capillary blood sample was obtained by finger prick for malaria field diagnosis [microscopy and rapid diagnostic test (RDT)] and venous blood sample for real-time PCR performed at the Hospital Universitario Vall d'Hebron in Barcelona, Spain. Any participant with a positive result from at least one of these three methods was diagnosed with malaria. Results: Of the 200 participants included, 54% were female and the median age was 7 years. Malaria was diagnosed by at least one of the three techniques (microscopy, RDT, and/or real-time PCR) in 58% of the participants, with RDT having the highest percentage of positivity (49%), followed by real-time PCR (39.5%) and microscopy (33.5%). Of the 61 discordant samples, 4 were only positive by microscopy, 13 by real-time PCR, and 26 by RDT. Plasmodium falciparum was the most frequent species detected (90.63%), followed by P. malariae (17.19%) and P. ovale (9.38%). Coinfections were detected in ten participants (15.63%): six (60%) were caused by P. falciparum and P. malariae, three (30%) by P. falciparum and P. ovale, and one (10%) triple infection with these three species. In addition, it was observed that P. falciparum and P. malariae coinfection significantly increased the parasite density of the latter. Conclusions: RDT was the technique with the highest positivity rate, followed by real-time PCR and microscopy. The results of the real-time PCR may have been underestimated due to suboptimal storage conditions during the transportation of the DNA eluates. However, real-time PCR techniques have an important role in the surveillance of circulating Plasmodium species, given the epidemiological importance of the increase in non-falciparum species in the country, and can provide an estimate of the intensity of infection.
Increased food crop diversification and gathering of wild plants associated with women's dietary diversity in Chad
(Wiley, 2025) Mascareñas-García, Marta; Custodio, Estefania; Issa, Mahamat Garba; Bechir, M; Kayitakire, Francois; Unión Europea. EU Joint Programme-Neurodegenerative Disease Research
Women of reproductive age are particularly vulnerable to low-quality diets due to their higher micronutrients needs. The minimum dietary diversity for women (MDDW) is a proxy for micronutrient adequacy in this group of women. Its relationship with other aspects that lead to malnutrition is not fully elucidated and depends on the context. In this study, we assessed the prevalence of MDDW among women of a rural area in Chad and its association with socioeconomical, agricultural, dietary and food security data. A cross-sectional study was conducted. Following a multistage cluster sampling, 984 women of reproductive age were randomly selected and interviewed in March 2019. We obtained food consumption data through unquantified 24 h recalls and computed MDDW as consuming at least five out of 10 predefined food groups. We constructed a Food Production Diversity Score (FPDS) with crop and livestock information. We obtained multivariable logistic regression models including different covariates. MDDW was achieved by only 33% of women in the sample. In our final model, we identified a significant association of MDDW with the FPDS and gathering of wild plants. Women in households with the highest FPDS had 70% more chances of achieving MDDW than those with the lowest FPDS. Gathering wild plants doubled these chances. Areas of cultivated land, Water, Sanitation and Hygiene resources, and a high level of food security, measured with the Household Food Insecurity Access Scale, were also significantly related to the achievement of MDDW. This illustrates the importance of nutrition-sensitive policies, also considering biodiversity and food production diversification.
Meeting statement: Call to action for step-change in health behaviours
(Elsevier, 2024-06) Bach Habersaat, Katrine; Koylyu, Anastasia; Likki, Tiina; Fietje, Nils; Scherzer, Martha; Snijders, Vee; Mazhnaia, Alona; Roy, Svenja; Berisha, Merita; Basholli, Florie Miftari; Catic, Sabina; Nagyova, Iveta; Sivelä, Jonas; Cirulli, Francesca; Van der Biest, Lien; Baros, Sladjana; Lagarija, Šeila Cilović; Schilling, Mathilde; Nohlen, Hannah U; Forjaz, Maria João; Romay-Barja, Maria; Üçüncü, İlayda; Flaschberger, Edith; Nikolić, Tatjana Krajnc; Nesterova, Olena; Lukmine, Igne; Rivero-Montesdeoca, Yaiza; Loss, Julika; Andreasyan, Diana; Oikonomou, Milena Carmina; Godoy-Ramirez, Karina; Karregård, Susanne; Murphy, Robert; Niskanovic, Jelena; Van Brussel, Leen; Telo de Arriaga, Miguel; Wojtyniak, Bogdan; Price, Cortney; Altymysheva, Nurila; Jost, Karin Stein; Berjaoui, Roxane; Saaristo, Panu; Glazewska, Joanna; Topuridze, Marina; Craig, Brett; Mukhtarova, Parvina; Duishenkulova, Marina; Pace, Sarah; MacLennan, Mary; Bachanovikj, Marina; Jakubowski, Elke; Zeroug-Vial, Halima; Gould, Ashley; Cutler, Adam; Leurs, Mariken; Silitrari, Natalia; Bratu, Eugenia Claudia; Young, Jenny; Bianco, Viviane Melo; Butler, Robb
Background: Enabling, supporting and promoting positive health-related behaviours is critical in addressing the major public health challenges of our time, and the multifaceted nature of behaviours requires an evidence-based approach. This statement seeks to suggest how a much-needed enhanced use of behavioural and cultural science and insights for health could be advanced. Study design and methods: and methods: Public health authorities of Europe and Central Asia and international partner organizations in September 2023 met in Copenhagen, Denmark, to discuss the way forward. Drawing on 1) country reporting to WHO, 2) interview study with public health authorities and 3) the meeting deliberations, this meeting statement was developed. Results: The meeting statement presents a joint call for step-change accelerated use of evidence-based approaches for health behaviours. Actionable next steps for public health authorities and international and regional development partners in health are presented. Conclusions: The way forward involves increased resource allocation, integration of behavioural insights into health strategies, advocacy through case and cost-effectiveness examples and capacity building.
Characteristics of adults who reported not having had COVID-19 in Spain after the first two years of the pandemic and associated factors
(Elsevier, 2024-03) Beca-Martínez, María Teresa; Ayala, Alba; Falcón-Romero, María; Rodriguez-Blazquez, Carmen; Benito, Agustin; Forjaz, Maria João; Romay-Barja, Maria; Instituto de Salud Carlos III
Background: There is little evidence regarding the characteristics of adults who self-reported not having had COVID-19 after two years of the pandemic. This study aimed to analyse the characteristics of no-COVID-19 respondents and the associated factors to better understand which may have conditioned not having had the disease as guidance to help in the design of better public health strategies. Methods: This cross-sectional, observational study was conducted in the Spanish general population in a representative sample of 1051 adults who completed an online survey in September 2022. Multivariable logistic regression was performed to assess which factors were related to reporting not having had COVID-19. Results: Almost half of the respondents (47.8%) reported not having ever had COVID-19. Significant differences were found between people who reported having had and not having had COVID-19 according to sex, age, education level, employment and living with children. No-COVID-19 respondents had greater concern and less fear of the disease and were more worried about the new variants. After the multivariable analysis, factors associated with no-COVID-19 respondents were male sex (OR)=1.40; 95% (CI=1.07-1.82), older age (OR=1.01; 95% CI=1.01-1.03), having a greater perception of disease severity if infected (OR=4.71; 95% CI=2.97-7.47), greater adherence to preventive measures (OR=1.02; 95% CI=1.01-1.03), and having received a complete vaccination schedule and booster dose (OR=1.56; 95% CI=1.03-2.36). Conclusions: Analysing the characteristics of people reporting not having had COVID-19 can support public health decision-makers in designing better interventions and facilitating the implementation of effective prevention and control measures to prepare for and respond to a possible future pandemic.

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