Echinococcosis Case Studies

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Cystic echinococcosis in the Eastern Mediterranean region: neglected and prevailing

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Since the concept of "neglected diseases of poverty" has been developed and explored. In the United States alone, there are at least 12 million people suffering from these neglected parasitic infections. In the United States, high rates of parasitic infection can be distributed along geographic, racial, and socio-economic lines. Within the African-American community, there may be up to 2. Rates of toxocariasis, trichomoniasis , and other neglected infections occur in the United States at the same rate as in Nigeria. Within the Hispanic community, neglected infections are concentrated near the US—Mexico border. Vector-borne illnesses are especially high, with some rates approaching those of Latin America.

Chagas disease was found in the US as early as the s. This may be due to lack of economic incentives and public policy failings. Here, a lack of awareness prevents effective policy generation and leaves health care services unequipped to address the issue. Additionally, there is little effort put into taking and maintaining large data sets on neglected disease in the United States and other developed nations. In Europe, a similar trend is seen. Neglected tropical diseases are concentrated in eastern and southern Europe, where poverty levels are the highest.

The most prevalent diseases in this region are ascariasis , trichuriasis , zoonotic helminth infections , and visceral leishmaniasis. Migration paths to Europe, most notably to Spain, have brought diseases to Europe as well. As many as 6, cases of Chagas disease have been introduced via this method. In response to a growing awareness to the burden on these populations, the European Centre for Disease Prevention and Control has laid out ten public health guidelines.

They cover a variety of topics, from health education and promotion to community partnerships and the development of a minority healthcare workforce. There is some debate among the WHO , CDC , and infectious disease experts over which diseases are classified as neglected tropical diseases. Feasey, a researcher in neglected tropical diseases, notes 13 neglected tropical diseases: ascariasis , Buruli ulcer , Chagas disease , dracunculiasis , hookworm infection, human African trypanosomiasis , Leishmaniasis , leprosy , lymphatic filariasis , onchocerciasis , schistosomiasis , trachoma , and trichuriasis. The World Health Organization recognizes the twenty diseases below as neglected tropical diseases. Buruli ulcer is caused by the bacterium Mycobacterium ulcerans.

Chagas disease is also known as American trypanosomiasis. There are approximately 15 million people infected with Chagas disease. It is caused by a vector-borne [38] protozoa [37] and spread by contact with Trypanosoma cruzi infected feces of the triatomine assassin bug. The protozoan can enter the body via the bug's bite, skin breaks, or mucous membranes. Infection can result from eating infected food and coming into contact with contaminated bodily fluids. The acute phase is usually asymptomatic. The first symptoms are usually skin chancres , unilateral purplish orbital oedema , local lymphoadenopathies, and fever accompanied by a variety of other symptoms depending on infection site. Chagas disease can be prevented by avoiding insect bites through insecticide spraying, home improvement, bed nets, hygienic food, medical care, laboratory practices, and testing.

There are 50— million dengue virus infections annually. Chikungunya is an arboviral disease transmitted by A. The virus was first isolated from an outbreak in Tanzania in Dracunculiasis is also known as Guinea-worm disease. In 53 cases were reported across four countries. Worms can be up to 1 m long. An eradication program has been able to reduce prevalence. The rates of echinococcosis is higher in rural areas, and there are more than one million people infected currently. Both versions involve an asymptomatic incubation period of several years. In the cystic version, liver cysts cause abdominal pain, nausea and vomiting while cysts in the lungs cause chronic cough, chest pain, and shortness of breath.

In alveolar echinococcosis, a primary cyst develops, usually in the liver, in addition to weight loss, abdominal pain, general feeling of ill health, and signs of liver failure. Surgery and drugs can both be used to treat echinococcosis. Alveolar echinococcosis is found in western and northern China, Russia, Europe, and northern North America. There are limited data available on the prevalence of yaws , although it primarily affects children.

The foodborne trematode infections include clonorchiasis , opisthorchiasis , fascioliasis , and paragonimiasis. These infections are all zoonotic, primarily affecting domestic or wild animals, but also transmitted to humans. They are acquired by eating food, such as raw fish, contaminated with the larval stages of the parasites. At least 40 million people are thought to be infected. African trypanosomiasis African sleeping sickness is a somewhat rare disease as there are fewer than 10, cases currently. The disease is always fatal if untreated. The current forms of treatment are highly toxic and ineffective as resistance is spreading. It is diagnosed through an inexpensive serological test. The three forms of leishmaniasis are visceral Kala-azar , cutaneous, and mucocutaneous.

Around 90 percent of mucocutaneous leishmaniasis occurs in Bolivia, Brazil, and Peru. The only method of prevention is a vaccine that is under development and prevention of sandfly bites. Diagnosis can be made by identifying clinical signs, serological tests, or parasitological tests. According to recent figures from the WHO, new cases of leprosy were reported in from countries. It is curable if treated early. Leprosy has a 5—20 year incubation period, and the symptoms are damage to the skin, nerves, eyes, and limbs. Lymphatic filariasis is also known as elephantiasis. There are approximately million individuals infected [61] and 40 million with deformities. Most people are asymptomatic, but have lymphatic damage. Up to 40 percent of infected individuals have kidney damage.

It can be treated with cost-effective antihelminthic treatments, [64] and washing skin can slow or even reverse damage. Onchocerciasis is also known as "river blindness". There are It can be treated with ivermectin. There are two forms of rabies : furious and paralytic. There are 60, deaths from rabies annually. Furious more common type rabies causes hyperactivity, hydrophobia, aerophobia, and death by cardio-respiratory arrest occurs within days. Paralytic rabies causes a slow progression from paralysis to coma to death. It can be prevented in dogs by vaccination, [70] and cleaning and disinfecting bite wounds post-exposure prophylaxis. It can be detected through tissue testing after symptoms develop. There are over million cases of schistosomiasis. Infection occurs when skin comes into contact with contaminated fresh water in which the snails that carry the parasite are living.

Symptoms for schistosomiasis are not caused by the worms but by the body's reaction to the eggs. The eggs that do not pass out of the body can become lodged in the intestine or bladder, causing inflammation or scarring. Children who are repeatedly infected can develop anemia, malnutrition and learning difficulties. Inexpensive praziquantel can be used to treat individuals with schistosomiasis, but cannot prevent reinfection. It can be diagnosed through a serological test, but it often produces false negatives. The three major worm species responsible for soil-transmitted helminthiasis are Ascaris roundworms , Trichuris whipworm , the hookworms Necator americanus and Ancylostoma duodenale , and Strongyloides stercoralis.

Parasitic worms are generally transmitted via exposure to infected human feces and soil that are spread in the environment, for example, due to open defecation. Cysticercosis is a tapeworm larvae infection, while taeniasis is infection with adult tapeworms. Cysticercosis is the most common preventable cause of epilepsy in the developing world. Taeniasis is not fatal. Taeniasis has mild symptoms, including abdominal pain, nausea, diarrhea, or constipation. Drugs are used to treat both diseases. It is treated with antibiotics. The only known prevention method is interpersonal hygiene. Snakebite was added to the list in , after years of criticism of the WHO by activists for not making it a priority. Globally, there are an estimated , envenomings each year about 1 in 4 snakebites and 20, deaths, but snakebites often go unreported.

Several NTDs, such as leprosy , cause severe deformities that result in social stigma. Stigma is considered to be the 'hidden burden' of neglected tropical diseases, and is not accounted for in measures such as disability-adjusted life years DALYs. Other NTDs that carry heavy social stigma include onchocerciasis , lymphatic filariasis , plague , Buruli ulcer , leishmaniasis , and Chagas disease. The social effects of neglected tropical diseases have been shown to affect men and women in different ways. Men are socially stigmatized in a way that detrimentally affects their economic prospects. Women are more likely to be affected in the areas of marriage and family.

A review found that infection with a neglected tropical disease predisposes individuals to poor mental health. This is partially due to the social stigma that surround NTDs, but is also likely caused by the subsequent lack of access to health and social services. Overall, being a member of the infected community was found to cut individuals off from multiple aspects of society via civic rights, educational opportunities, and employment. The authors suggest that more research be directed into the psychological aspects of neglected tropical diseases in order to fully untangle their co-effects.

NTDs disproportionately affect women and children. A study in Uganda found that women were more easily able to obtain treatment because they had fewer occupational responsibilities than men and were more trusting of treatment, but ignorance of the effects of medicines on pregnant women prevented adequate care. The paper concludes that gender should be considered when designing treatment programs in Uganda. The cost of treatment of some of these diseases, such as Buruli ulcer, can amount to over twice the yearly income of an average household in the lowest income quartile, while for the highest income quartile, the burden is slightly less than the average household income.

These enormous financial costs often cause deferral of treatment and financial ruin, but there is inequality between the wealthy and poor in terms of economic burden. These diseases also cost the government in terms of health care and lost worker productivity through morbidity and shortened life spans. In Kenya, for example, deworming is estimated to increase average adult income by 40 percent, which is a benefit-to-cost ratio of Each case of schistosomiasis causes a loss of Most of the diseases cost the economies of various developing countries millions of dollars. Large-scale prevention campaigns are predicted to increase agricultural output and education levels.

The low cost of treatment for NTDs can be attributed to the large scale of the programs, free provision of drugs by pharmaceutical companies, delivery modes of drugs, and the unpaid volunteers who distribute the drugs. The economic burden of NTDs is undervalued and therefore the corresponding economic effect and cost-effectiveness of decreased prevalence of NTDs is underestimated. Coinfection is a major concern with neglected tropical diseases, making NTDs more damaging than their mortality rates might portray.

Because the factors that support neglected tropical diseases poverty, inadequate healthcare, inadequate sanitation practices, etc. Helminth infections , as the most common infection of humans, are often found to be in multi-infection systems. For example, in Brazil, low socioeconomic status contributes to overcrowded housing. In these same areas, connection by Necator americanus and Schistosoma mansoni is common.

The effect of each worm weakens the immune system of those infected, making infection from the other easier and more severe. For this reason, coinfection carries a higher risk of mortality. Prevention and eradication are important because "of the appalling stigma, disfigurement, blindness and disabilities caused by NTDs. It was launched in January While the current era has had a noticeable uptick in biological research into neglected tropical diseases, prevention may be supplemented by social and development outreach. Spiegal and his coauthors advocated for this to take the form of "social offset. The simulation research results show that reasonable punishment strategies are more effective than reward ones.

Based on this, the author proposes countermeasures, such as establishing a reasonable reward and punishment mechanism, reasonably determining the reward and punishment intensity for polluting enterprises. A deep study of its internal mechanism is not only of great significance for pollution control but also of great significance for the development of a green economy. As a transitional economy, China has listed companies with different ownership and special regulatory rules.

We explore under the expectation of tax reduction whether there are differences in the way and degree of earnings management implemented by different types of companies. Our study shows that firms under the anticipation of tax reduction make use of earning management, including delaying sales, taking unusual income-decreasing discretionary accruals, and so on, which leads to lower income in higher tax rate period.

We find that private enterprises have more attention to reduce earning in the higher tax rate period than state-owned enterprises SOEs , indicating that the ownership has effect on the extent of earning management. Moreover, under the specific regulations in Chinese stock market, we find that for those listed companies with negative net profit in the previous year, the priority is how to reverse losses rather than tax saving. One of the main challenges in microgrid system energy management is dealing with uncertainties such as the power output from renewable energy sources. The classic two-stage robust optimization C-TSRO method was proposed to cope with these uncertainties. However, this method is oriented to the worst-case scenario and is therefore somewhat conservative.

In this study, focusing on the energy management of a typical islanded microgrid and considering uncertainties such as the power output of renewable energy sources and the power demand of loads, an expected-scenario-oriented two-stage robust optimization E-TSRO method is proposed to alleviate the conservative tendency of the C-TSRO method because the E-TSRO method chooses to optimize the system cost according to the expected scenario instead, while ensuring the feasibility of the first-stage variables for all possible scenarios, including the worst case.

Finally, the effectiveness of the E-TSRO model and the solution algorithm are analysed and validated through a series of experiments, thus obtaining some important conclusions, i. How are limited resources efficiently allocated among different innovation populations? The performances of different innovation populations are quite different with either synergy or competition between them. If the innovation population is kept under an appropriate scale, full use can be made of the allocated resources. The maximization of the development and performance for a certain scale of innovation population is a typical multichoice development problem.

Therefore, the scale optimization of the innovation population should be analyzed. According to the population dynamics, a resource constraint model for the growth of innovation population is developed, and the growth of innovation population under resource constraints is in equilibrium accordingly. With the help of a multichoice goal programming model, the scale optimization of innovation population performance can be obtained.

The results of the resource constraint model and multichoice goal programming model are used to determine the optimal scale of the innovation population. Based on these data, the scale optimization of the innovation population under resource constraints can be calculated. The results of the study show that, in the observation period, the enterprise innovation population is often in the appropriate scale state. The scale development of enterprise innovation population is often more suitable for innovation ecosystem than that of scientific research institutions.

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