Publications by authors named "Gail M Williams"

274 Publications

"The Magic Glasses Philippines": a cluster randomised controlled trial of a health education package for the prevention of intestinal worm infections in schoolchildren.

Lancet Reg Health West Pac 2022 Jan 3;18:100312. Epub 2021 Nov 3.

Research School of Population Heath, The Australian National University, Canberra, Australia.

Background: Soil-transmitted helminths (STH) cause substantial disease and disability globally. Health education has proven complementary to school-based drug administration programs for STH control. We determined the generalizability of the impact of "The Magic Glasses" health education package for STH prevention in schoolchildren in Laguna province, the Philippines, having previously shown its positive impact in China.

Methods: We conducted a cluster-randomised controlled trial, in schoolchildren, aged 9-10 years, across 40 schools over one year. Schools were randomly assigned either to the "Magic Glasses Philippines" health education intervention package (consisting of a cartoon video, classroom discussions, drawing and essay competition) complementing the standard health education activities of the Philippines Departments of Health and Education, or to a control group, which involved only the standard health education activities. The primary trial outcomes were the proportion of STH infected schoolchildren and their knowledge, attitude and behaviour of STH assessed in both groups at baseline and through two follow-up surveys undertaken immediately prior to the semi-annual national mass administration of albendazole. The outcomes between the study arms were compared using generalized estimating equation models, accounting for clustering at the school level. The trial is registered with Australian New Zealand Clinical Trials Registry number: ACTRN12616000508471.

Findings: At follow-up assessments, the mean knowledge and behaviour scores in the intervention group were, respectively, 5·3 (95% confidence interval [CI]:4·2-6·5; p=<0.001) and 1·1 (95% CI: 0·4-1·7; p=0.002) percentage points higher than the control group. There was no overall effect on helminth infections (any STH; adjusted odds ratio [aOR]:1·0; 95% CI: 0·8-1·3; p=0·856), aOR:1·0; 95% CI: 0·7-1·6; p=0·894, or aOR:1·7; 95% CI: 0·9-1·6; p=0·315) but sub-group analysis showed a 60% reduction in the odds of any STH infection resulting from the "Magic Glasses" intervention in schools with a baseline prevalence ≤15% (aOR: 0·4; 95% CI: 0·2-0·7; p=0·001).

Interpretation: The health-education package demonstrated a modest but statistically significant impact on the students' overall STH knowledge and changes in their behaviour but was only effective in preventing STH infections in intervention schools where the baseline prevalence was ≤15%.

Funding: National Health and Medical Research Council, Australia, and the UBS-Optimus Foundation, Switzerland.
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http://dx.doi.org/10.1016/j.lanwpc.2021.100312DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8671727PMC
January 2022

Soil-transmitted helminth infections and nutritional indices among Filipino schoolchildren.

PLoS Negl Trop Dis 2021 Dec 22;15(12):e0010008. Epub 2021 Dec 22.

Research School of Population Heath, The Australian National University, Canberra, Australia.

Background: Soil-transmitted helminth (STH) infections are still prevalent among schoolchildren in the Philippines. We evaluated the risk factors associated with STH and the relationship between STH and nutritional indices among schoolchildren aged 9-10 years in Laguna province, the Philippines.

Methods: We used the baseline data from 40 schools enrolled in a randomised controlled trial of the Magic Glasses Philippines health education package. Data on demographic and socio-economic variables, and STH related knowledge, attitudes and practices, were obtained through a questionnaire. Stool samples were collected and assessed for STH egg presence using the Kato-Katz technique. Haemoglobin levels and height and weight of study participants were also determined. The generalized estimating equations approach was used to construct logistic regression models to assess STH-associated risk factors, and the association between any STH infection and anaemia, child stunting, wasting and being underweight. The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616000508471).

Findings: Among 1,689 schoolchildren, the prevalence of any STH was 23%. The prevalence of anaemia, stunting, being underweight and wasting was 13%, 20.2%, 19% and 9.5%, respectively. Age, socio-economic status, rural/urban classification of schools and knowledge of STH were significant risk factors for acquiring a STH infection. Moreover, infections with any STH were significantly associated with stunting (P = <0.001) and being underweight (P = <0.003), but not wasting (P = 0.375) or anaemia (P = 0.462) after controlling for confounding covariates.

Conclusion: The study findings emphasise the need for sustainable deworming in tandem with other measures such as the provision of health education, improvements in sanitation and hygiene, and nutritional programs in order to control STH infections and improve morbidity outcomes in schoolchildren.

Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN12616000508471).
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http://dx.doi.org/10.1371/journal.pntd.0010008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8694453PMC
December 2021

Lifestyle correlates of dietary patterns among young adults: evidence from an Australian birth cohort.

Public Health Nutr 2021 Sep 6:1-12. Epub 2021 Sep 6.

School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia.

Objective: Previous studies of sociodemographic and lifestyle correlates of dietary patterns among young adults have primarily focused on physical activity and smoking, with inconclusive results. This study aims to examine the associations between a broader range of lifestyles of young adults and their patterns of food consumption.

Design: Cross-sectional.

Setting: Brisbane, Australia.

Participants: The data set are from a long running birth cohort study which commenced in 1981. Details of dietary intake and sociodemographic and lifestyle factors were from the 21-year follow-up of the Mater-University of Queensland Study of Pregnancy (MUSP) birth cohort. The effective cohort (n 2665, 57 % women) is of young adult offspring. Usual dietary intake was assessed using a Food Frequency Questionnaire (FFQ). Data on sociodemographic and lifestyle variables were obtained from self-reports.

Results: Western and prudent dietary patterns were identified for the combined cohort of women and men using principal components analysis. Multivariable linear regression models were used to examine the associations between lifestyle variables and dietary patterns adjusting for potential confounders. Results from multivariable adjusted models showed that physical activity, watching TV and smoking were strongly associated with each dietary pattern; alcohol consumption and BMI showed weaker associations (P < 0·05 for all).

Conclusions: Our study describes a clustering of unhealthy lifestyles in young adults. Young adults with unhealthy lifestyles less often adhere to a healthy prudent dietary pattern and more often an unhealthy Western pattern. Dietary preferences are enmeshed in a lifestyle matrix which includes physical activity, sedentary activity, smoking and alcohol consumption of young adults.
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http://dx.doi.org/10.1017/S1368980021003864DOI Listing
September 2021

Genetic association study of childhood aggression across raters, instruments, and age.

Transl Psychiatry 2021 07 30;11(1):413. Epub 2021 Jul 30.

Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Childhood aggressive behavior (AGG) has a substantial heritability of around 50%. Here we present a genome-wide association meta-analysis (GWAMA) of childhood AGG, in which all phenotype measures across childhood ages from multiple assessors were included. We analyzed phenotype assessments for a total of 328 935 observations from 87 485 children aged between 1.5 and 18 years, while accounting for sample overlap. We also meta-analyzed within subsets of the data, i.e., within rater, instrument and age. SNP-heritability for the overall meta-analysis (AGG) was 3.31% (SE = 0.0038). We found no genome-wide significant SNPs for AGG. The gene-based analysis returned three significant genes: ST3GAL3 (P = 1.6E-06), PCDH7 (P = 2.0E-06), and IPO13 (P = 2.5E-06). All three genes have previously been associated with educational traits. Polygenic scores based on our GWAMA significantly predicted aggression in a holdout sample of children (variance explained = 0.44%) and in retrospectively assessed childhood aggression (variance explained = 0.20%). Genetic correlations (r) among rater-specific assessment of AGG ranged from r = 0.46 between self- and teacher-assessment to r = 0.81 between mother- and teacher-assessment. We obtained moderate-to-strong rs with selected phenotypes from multiple domains, but hardly with any of the classical biomarkers thought to be associated with AGG. Significant genetic correlations were observed with most psychiatric and psychological traits (range [Formula: see text]: 0.19-1.00), except for obsessive-compulsive disorder. Aggression had a negative genetic correlation (r = ~-0.5) with cognitive traits and age at first birth. Aggression was strongly genetically correlated with smoking phenotypes (range [Formula: see text]: 0.46-0.60). The genetic correlations between aggression and psychiatric disorders were weaker for teacher-reported AGG than for mother- and self-reported AGG. The current GWAMA of childhood aggression provides a powerful tool to interrogate the rater-specific genetic etiology of AGG.
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http://dx.doi.org/10.1038/s41398-021-01480-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8324785PMC
July 2021

Does the millennial generation of women experience more mental illness than their mothers?

BMC Psychiatry 2021 07 17;21(1):359. Epub 2021 Jul 17.

Mental Health Research Programme, QIMR Berghofer Medical Research Institute, Herston, Australia.

Background: There is concern that rates of mental disorders may be increasing although findings disagree. Using an innovative design with a daughter-mother data set we assess whether there has been a generational increase in lifetime ever rates of major depressive disorder, generalised anxiety disorder, panic disorder, and post-traumatic stress disorder (PTSD) experienced prior to 30 years of age.

Methods: Pregnant women were recruited during 1981-1983 and administered the Composite International Diagnostic Interview (CIDI) at the 27-year follow-up (2008-11). Offspring were administered the CIDI at the 30-year follow-up (2010-2014). Comparisons for onset of diagnosis are restricted to daughter and mother dyads up to 30 years of age. To address recall bias, disorders were stratified into more (≥12 months duration) and less persistent episodes (< 12 months duration) for the purposes of comparison. Sensitivity analyses with inflation were used to account for possible maternal failure to differentially recall past episodes.

Results: When comparing life time ever diagnoses before 30 years, daughters had higher rates of persistent generalised anxiety disorder, and less persistent major depressive disorder, generalised anxiety disorder and PTSD.

Conclusions: In the context of conflicting findings concerning generational changes in mental disorders we find an increase in generational rates of persistent generalised anxiety disorders and a range of less persistent disorders. It is not clear whether this finding reflects actual changes in symptom levels over a generation or whether there has been a generational change in recognition of and willingness to report symptoms of mental illness.
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http://dx.doi.org/10.1186/s12888-021-03361-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8285825PMC
July 2021

The control of soil-transmitted helminthiases in the Philippines: the story continues.

Infect Dis Poverty 2021 Jun 12;10(1):85. Epub 2021 Jun 12.

Department of Global Health, Research School of Population Health, The Australian National University, Building 62 Mills Rd, Acton ACT, Canberra, 2601, Australia.

Background: Soil-transmitted helminth (STH) infections have long been an important public health concern in the Philippines. In this review, we describe the current status of STH infections there and highlight the control efforts undertaken to reduce STH burden.

Main Text: A nationwide STH mass drug administration (MDA) programme was started in 2006 but the overall STH prevalence remains stubbornly high across the Philippines, ranging from 24.9% to 97.4%. The continued increase in the prevalence may have been due to the challenges related to MDA implementation which include the lack of people's awareness about the importance of regular treatment, misconceptions about the MDA strategy, lack of confidence on the drugs used, fear of adverse events and general distrust of government programs. There are existing water, sanitation and hygiene (WASH) programmes implemented in communities [e.g., Community-Led Total Sanitation (CLTS) program and providing toilet bowls and provision of subsidy for latrine construction] and schools [e.g., WASH in School (WINS) program], but sustained implementation is required to achieve expected outcomes. Although WASH in general is being taught in schools, integration of STH as a disease and community problem in the current public elementary school curriculum is still inadequate. The Integrated Helminth Control Program (IHCP) currently implemented in the country, which is focused on improved sanitation and personal hygiene, health education and preventive chemotherapy, will require continuous appraisal. The sustainability of this programme still continues to be a challenge.

Conclusions: Despite the major efforts to control STH infections for almost two decades in the Philippines, persistently high STH prevalence has been reported across the country, which is likely due to suboptimal MDA coverage and limitations in WASH and health education programs. Sustainable delivery of integrated control approaches will continue to play a pivotal role in the control and elimination of STH in the Philippines.
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http://dx.doi.org/10.1186/s40249-021-00870-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8196932PMC
June 2021

Increased melanoma recurrence in patients with multiple primary invasive melanomas.

J Am Acad Dermatol 2021 May 27. Epub 2021 May 27.

Queensland Melanoma Project, Princess Alexandra Hospital, The University of Queensland, Brisbane, Australia.

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http://dx.doi.org/10.1016/j.jaad.2021.05.025DOI Listing
May 2021

Predicting Child Maltreatment over the Early Life Course: A Prospective Study.

Child Psychiatry Hum Dev 2021 Mar 31. Epub 2021 Mar 31.

School of Criminology and Criminal Justice, Griffith University, 176 Messines Ridge Road, Mount Gravatt, QLD, 4122, Australia.

A large number of early life exposures predict child maltreatment. Using data from a 30-year birth cohort study we examine 12 early life course risk factors of four types of self-reported childhood maltreatment recalled at the 30-year follow-up. Of the 7223 children in the sample at birth, 2425 responded to the Child Trauma Questionnaire at the 30-year follow-up. On adjusted analysis being a teenage mother predicts childhood physical and sexual abuse, as well as child neglect. More numerous maternal marital partner changes in the 5 years after the birth predict offspring experiences of emotional abuse, sexual abuse and childhood neglect. Policy responses should focus on the broad social context in which children are reared as the most effective approach to reducing the high level of childhood abuse and neglect.
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http://dx.doi.org/10.1007/s10578-021-01164-zDOI Listing
March 2021

COVID-19, children and schools: overlooked and at risk.

Med J Aust 2021 03;214(4):188-188.e1

QIMR Berghofer Medical Research Institute, Brisbane, QLD.

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http://dx.doi.org/10.5694/mja2.50937DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8013432PMC
March 2021

A national cross-sectional study of exposure to outdoor nitrogen dioxide and aeroallergen sensitization in Australian children aged 7-11 years.

Environ Pollut 2021 Feb 16;271:116330. Epub 2020 Dec 16.

Faculty of Medicine, School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia; Centre for Air Pollution, Energy and Health Research, Glebe, NSW, 2037, Australia. Electronic address:

The prevalence of allergic diseases in Australian children is high, but few studies have assessed the potential role of outdoor air pollution in allergic sensitization. We investigated the association between outdoor air pollution and the prevalence of aeroallergen sensitization in a national cross-sectional study of Australian children aged 7-11 years. Children were recruited from 55 participating schools in 12 Australian cities during 2007-2008. Parents completed a detailed (70-item) questionnaire. Outdoor nitrogen dioxide (NO), as a proxy for exposure to traffic-related emissions, was estimated using measurements from regulatory monitors near each school and a national land-use regression (LUR) model. Three averaging periods were assessed, using information on duration of residence at the address, including lifetime, previous (lifetime, excluding the last year), and recent (the last year only). The LUR model was used as an additional source of recent exposure estimates at school and home addresses. Skin prick tests (SPTs) were performed to measure sensitization to eight common aeroallergens. Multilevel logistic regression estimated the association between NO and sensitization (by individual allergens, indoor and outdoor allergens, and all allergens combined), after adjustment for individual- and area-level covariates. In total, 2226 children had a completed questionnaire and SPT. The prevalence of sensitization to any allergen was 44.4%. Sensitization to house dust mites (HDMs) was the most common (36.1%), while sensitization to Aspergillus was the least common (3.4%). Measured mean (±s.d.) NO exposure was between 9 (±2.9) ppb and 9.5 (±3.2) ppb, depending on the averaging period. An IQR (4 ppb) increase in measured previous NO exposure was associated with greater odds of sensitization to HDMs (OR: 1.21, 95% CI: 1.01-1.43, P = 0.035). We found evidence of an association between relatively low outdoor NO concentrations and sensitization to HDMs, but not other aeroallergens, in Australian children aged 7-11 years.
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http://dx.doi.org/10.1016/j.envpol.2020.116330DOI Listing
February 2021

Current Status of Schistosomiasis Control and Prospects for Elimination in the Dongting Lake Region of the People's Republic of China.

Front Immunol 2020 9;11:574136. Epub 2020 Oct 9.

Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.

Schistosomiasis japonica is an ancient parasitic disease that has severely impacted human health causing a substantial disease burden not only to the Chinese people but also residents of other countries such as the Philippines, Indonesia and, before the 1970s, Japan. Since the founding of the new People's Republic of China (P. R. China), effective control strategies have been implemented with the result that the prevalence of schistosomiasis japonica has decreased markedly in the past 70 years. Historically, the Dongting Lake region in Hunan province is recognised as one of the most highly endemic for schistosomiasis in the P.R. China. The area is characterized by vast marshlands outside the lake embankments and, until recently, the presence of large numbers of domestic animals such as bovines, goats and sheep that can act as reservoir hosts for . Considerable social, economic and environmental changes have expanded the intermediate snail host areas in the Dongting lake region increasing the potential for both the emergence of new hot spots for schistosomiasis transmission, and for its re-emergence in areas where infection is currently under control. In this paper, we review the history, the current endemic status of schistosomiasis and the control strategies in operation in the Dongting Lake region. We also explore epidemiological factors contributing to transmission and highlight key research findings from studies undertaken on schistosomiasis mainly in Hunan but also other endemic Chinese provinces over the past 10 years. We also consider the implications of these research findings on current and future approaches that can lead to the sustainable integrated control and final elimination of schistosomiasis from the P. R. China and other countries in the region where this unyielding disease persists.
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http://dx.doi.org/10.3389/fimmu.2020.574136DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7583462PMC
June 2021

Agency notification and retrospective self-reports of childhood maltreatment in a 30-Year cohort: Estimating population prevalence from different data sources.

Child Abuse Negl 2020 11 1;109:104744. Epub 2020 Oct 1.

Clinical Psychological Science Department, Faculty of Psychology and Neuroscience, Maastricht University, Univesiteitssingel 40, 6229 ER, Maastrichts, Netherlands.

Background: There is little known about how two sources of child maltreatment reports correspond, specifically for emotional, physical, sexual abuse and emotional or physical neglect.

Objective: To compare agency and self-reports of child maltreatment and determine whether they are predicted by similar early life course adverse experiences. Participants Data are taken from a long running birth cohort study (Mater-University of Queensland Study of Pregnancy - MUSP). Mothers (N=7223) were recruited in 1981-83 and their children were followed-up 30 years later (2010-14). In 2000 data from the relevant child protection agency were accessed and linked to the survey data. Setting Consecutive women giving birth to a live singleton baby at a major obstetrical service in Brisbane, Australia were recruited and both mother and child were repeatedly follow-up over a 30 year period. Methods Birth cohort study with data linkage of child protection agency records and self-report survey data (using the Childhood Trauma Questionnaire - CTQ) of childhood maltreatment experiences. We compare reports of emotional, physical and sexual abuse and neglect using agency and self-reports (Cramer's V and kappa).

Results: Most children who are notified cases of maltreatment subsequently self-report they experienced little or no maltreatment in childhood. Most children who report experiencing severe maltreatment have not previously been notified to the protection agency. Teenage mothers have children who are notified 2.89 (1.52, 5.52) times, self-report 2.01 (1.31, 3.09) times and both notified and self-report 3.61 (2.26, 6.10) times more than their older comparison mothers.

Conclusions: Different methods of assessing maltreatment identify different subsets of those children who have experienced maltreatment.
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http://dx.doi.org/10.1016/j.chiabu.2020.104744DOI Listing
November 2020

Dietary Antioxidant Capacity and Skin Photoaging: A 15-Year Longitudinal Study.

J Invest Dermatol 2021 04 16;141(4S):1111-1118.e2. Epub 2020 Jul 16.

Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia; Cancer Research UK Manchester Institute and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.

The long-term effect of diet on skin aging is largely unknown, but evidence suggests that the antioxidants from foods may mitigate the main component of skin aging caused by sun exposure. We assessed the association between the total antioxidant capacity of foods people eat and the photoaging of their skin. In a community-based, prospective study among 777 Australian adults aged <55 years at baseline, we estimated the total dietary antioxidant capacity of participants' diets in 1992, 1994, and 1996 and graded photoaging severity using microtopography in 1992, 1996, and 2007. We used ordinal logistic regression and applied generalized estimating equations to estimate change in the degree of photoaging associated with increasing total antioxidant capacity compared with the group with the lowest antioxidant capacity, separately in younger (≤45 years) and older (>45 years) adults. In the 15-year study period, the overall prevalence of severe skin photoaging increased from 42% at baseline to 88%. Adults aged >45 years who consumed foods with high antioxidant capacity experienced approximately 10% less photoaging over 15 years than those who ate foods with low antioxidant capacity. No association was found among adults aged ≤45 years. Foods rich in antioxidants as measured by antioxidant capacity may retard skin aging among healthy men and women aged >45 years.
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http://dx.doi.org/10.1016/j.jid.2020.06.026DOI Listing
April 2021

Poverty over the early life course and young adult cardio-metabolic risk.

Int J Public Health 2020 Jul 15;65(6):759-768. Epub 2020 Jul 15.

School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Australia.

Objectives: There is little known about whether exposure to family poverty at specific periods of the early life course independently contributes to coronary heart disease risk beyond the contribution of concurrent poverty.

Methods: Children were recruited in early pregnancy and additional survey data obtained during the pregnancy and at the 5-, 14- and 30-year follow-ups. Fasting blood samples were also obtained at the 30-year follow-up. Analyses are multinominal logistic regressions stratified by gender and with adjustments for confounding.

Results: For male offspring, family poverty at different stages of the early life course was not associated with measures of cardio-metabolic risk. For females early life course, poverty predicted obesity, homeostatic model assessment of insulin resistance (HOMA-IR) and total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C), as well as concurrent family poverty associated with obesity, HOMA-IR, TC/HDL-C, HDL-C and increased systolic and diastolic blood pressure.

Conclusions: Family poverty in the early life course independently predicts increased levels of cardio-metabolic risk of females. The primary finding, however, is that concurrent poverty is independently and strongly associated with increased cardio-metabolic risk levels in young adulthood.
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http://dx.doi.org/10.1007/s00038-020-01423-1DOI Listing
July 2020

Health-education to prevent COVID-19 in schoolchildren: a call to action.

Infect Dis Poverty 2020 Jul 1;9(1):81. Epub 2020 Jul 1.

Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia.

Background: There is currently considerable international debate around school closures/openings and the role of children in the transmission of coronavirus disease 2019 (COVID-19). Whilst evidence suggests that children are not impacted by COVID-19 as severely as adults, little is still known about their transmission potential, and with a lot of asymptomatic cases they may be silent transmitters (i.e. infectious without showing clinical signs of disease), albeit at a lower level than adults. In relation to this, it is somewhat concerning that in many countries children are cared for, or are often in close contact with, older individuals such as grandparents ─ the age group most at risk of acquiring serious respiratory complications resulting in death.

Main Text: We emphasise that in the absence of a vaccine or an effective therapeutic drug, preventive measures such as good hygiene practices ─ hand washing, cough etiquette, disinfection of surfaces and social distancing represent the major (in fact only) weapons that we have against COVID-19. Accordingly, we stress that there is a pressing need to develop specific COVID-19 prevention messages for schoolchildren.

Conclusion: An entertainment education intervention for schoolchildren systematically implemented in schools would be highly effective and fill this need. With such measures in place there would be greater confidence around the opening of schools.
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http://dx.doi.org/10.1186/s40249-020-00695-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327200PMC
July 2020

Determining the Impact of a School-Based Health Education Package for Prevention of Intestinal Worm Infections in the Philippines: Protocol for a Cluster Randomized Intervention Trial.

JMIR Res Protoc 2020 Jun 25;9(6):e18419. Epub 2020 Jun 25.

Research School of Population Heath, The Australian National University, Canberra, Australia.

Background: Repeated mass drug administration (MDA) of antihelminthics to at-risk populations is still the main strategy for the control of soil-transmitted helminth (STH) infections. However, MDA, as a stand-alone intervention, does not prevent reinfection. Accordingly, complementary measures to prevent STH reinfection, such as health education and improved sanitation, as part of an integrated control approach, are required to augment the effectiveness of MDA for optimal efficiency and sustainability.

Objective: The aim of this study is to determine the impact and generalizability of a school-based health education package entitled The Magic Glasses for STH prevention in the Philippines.

Methods: We conducted a cluster randomized controlled intervention trial, involving 2020 schoolchildren aged 9-10 years, in 40 schools in Laguna Province, Philippines, to evaluate the impact of the school-based health education package for the prevention of STHs. The trial was conducted over the course of 1 year (June 2016 to July 2017). A total of 20 schools were randomly assigned to the intervention arm, in which The Magic Glasses Philippines health education package was delivered with the standard health education activities endorsed by the Philippines Department of Health (DOH) and the Department of Education (DepEd). The other 20 schools comprised the control arm of the study, where the DOH/DepEd's standard health education activities were done. At baseline, parasitological assessments and a knowledge, attitude, and practice survey were carried out in all schools. In addition, height, weight, and hemoglobin levels were obtained from each child (after parental consent), and their school attendance and academic performance in English and mathematics were accessed from the school records. The baseline and 2 follow-up surveys were completed using the same study measurements and quality-control assessments.

Results: Key results from this cluster randomized intervention trial will shed light on the impact that The Magic Glasses health education package will have against STH infections in schoolchildren in the province of Laguna, located on the Island of Luzon, in the Calabarzon Region of the Philippines.

Conclusions: The results of the trial will be used to assess the generalizability of the impact of The Magic Glasses health education package in different epidemiological and cultural settings, providing evidence for translation of this health education package into public health policy and practice in the Asian region and beyond.

Trial Registration: Australian New Zealand Clinical Trials Registry number ACTRN12616000508471; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368849.

International Registered Report Identifier (irrid): DERR1-10.2196/18419.
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http://dx.doi.org/10.2196/18419DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7381005PMC
June 2020

Illicit drug use by mothers and their daughters in Australia: A comparison of two generations.

Addict Behav 2020 07 20;106:106321. Epub 2020 Jan 20.

Institute for Social Science Research, University of Queensland, 80 Meiers Road, Indooroopilly, Qld 4068, Australia.

Background: While recent decades have witnessed an increase in the use of illicit drugs in Australia, the extent to which the types of drugs used has changed over a generation of young women has not been documented.

Methods: Data are from a prospective birth cohort study. Mothers were recruited in early pregnancy (1981-83) and then they and their child were followed up, with mothers interviewed 27 years (2008-2011), and daughters 30 years (2010-14), after the birth. At these most recent interviews both mothers and daughters were administered the Composite International Diagnostic Interview (CIDI III). Comparisons are for mothers and daughters separated by a 25 year period. For this study, we compare levels of lifetime use of a range of illicit drugs and drug use disorders reported by mothers and their daughters (N = 998 mother/daughter pairs) with adjustment for family income, marital status, education and occupation.

Results: There has been a generational increase in the use of illicit substances and prevalence of substance use disorders experienced by Australian women. Mothers' use of illicit drugs was generally restricted to cannabis. By contrast the majority of daughters report lifetime use of an illicit drug with cannabis, club drugs and stimulants the most common. Compared to the mothers, daughters used club drugs 50 times, cocaine 19 times and inhalants 20 times more often. Daughters report experiencing 12 times the rate of cocaine use disorders, 9 times the rate of stimulant disorders and 7 times the rate of cannabis use disorders compared to their mothers.

Conclusions: Mothers of the current generation of 30 year old Australian women rarely used illicit drugs and few experienced a drug use disorder. The current generation of young women report commonly using one or more illicit drugs with a substantial minority experiencing a drug use disorder. It is unlikely that the use of illicit drugs by young women in Australia will be reversed in the foreseeable future. Government policies and treatment practices need to be calibrated to the reality of the much greater contact with illicit drugs being exhibited by younger women.
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http://dx.doi.org/10.1016/j.addbeh.2020.106321DOI Listing
July 2020

Generational changes in young adults' sleep duration: a prospective analysis of mother-offspring dyads.

Sleep Health 2020 04 8;6(2):240-245. Epub 2020 Jan 8.

Institute for Social Science Research, The University of Queensland, Brisbane, Australia; Centre for Rural & Remote Health (Mount Isa), James Cook University, Mount Isa, Australia. Electronic address:

Objective: To quantify the changes in sleep duration over two generations of young adults.

Methods: We used data from the Mater-University of Queensland Study of Pregnancy cohort to compare sleep duration in mother and offspring. The analyses were restricted to 1,731 mothers who were young adults (mean age 21.96 years; SD±1.90) at the baseline measurement, and their offspring who were about the same age (mean age 20.6 years; SD±0.86) when assessed 21 years later. Maternal sleep was explored by asking the mother, during the first trimester, about her typical sleep duration prior to pregnancy, while offspring participants were asked about the sleep duration in the last month at the time assessed. Multinomial logistic regression for correlated responses was used to assess generational changes.

Results: We found that offspring had 3.2 (2.7, 3.9) times the odds of sleeping for short duration (≤6 hours/night) and 1.7 (1.5, 1.9) times the odds of sleeping for a longer duration (≥9 hours/night) compared with their mothers. Gender-based analysis found that daughters had 3.0 (2.3, 5.0) times the odds of sleeping for a short duration, while sons had 3.4 (2.6, 6.4) times the odds of sleeping for a short duration compared with their mothers.

Conclusions: There is a significant decline in sleep duration below recommendations as well as a substantial increase in long-duration above the recommendations over two generations of young adults. Therefore, the focus of sleep health should not be limited to short sleep, but on the need for achieving optimal sleep recommended for the age.
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http://dx.doi.org/10.1016/j.sleh.2019.12.007DOI Listing
April 2020

Intimate partner violence and subsequent depression and anxiety disorders.

Soc Psychiatry Psychiatr Epidemiol 2020 May 7;55(5):611-620. Epub 2020 Jan 7.

Institute for Social Science Research, The University of Queensland, Indooroopilly, QLD, 4068, Australia.

Purpose: The current longitudinal study examines the temporal association between different types of intimate partner violence (IPV) at early adulthood (21 years) and subsequent depression and anxiety disorders in young adulthood (30 years).

Methods: Participants were from the Mater-University of Queensland Study of Pregnancy. A cohort of 1529 was available for analysis. IPV was measured using the Composite Abuse Scale at 21 years. At the 21 and 30-year follow-ups, major depression disorder and anxiety disorders were measured using the Composite International Diagnostic Interview.

Results: We found a temporal relationship between almost all forms of IPV at 21 years and females' new cases of major depression disorder at 30 years. This association was not found for females who had previously been diagnosed with depression disorder. IPV did not predict the onset of new anxiety disorders, but it had a robust association with anxiety disorders in females with a previous anxiety diagnosis. We observed no significant link between IPV and males' subsequent major depression disorder. Interestingly, the experience of emotional abuse was a robust predictor of new cases of anxiety disorders but only for males.

Conclusion: Our results suggest the need for sex-specific and integrated interventions addressing both IPV and mental health problems simultaneously. IPV interventions should be informed by the extend to which pre-existing anxiety and depression may lead to different psychological responses to the IPV experience. Increased risk of anxiety disorders predicted by emotional abuse experienced by males challenges beliefs about invulnerability of men in the abusive relationships and demands further attention.
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http://dx.doi.org/10.1007/s00127-019-01828-1DOI Listing
May 2020

Complement receptor C3aR1 controls neutrophil mobilization following spinal cord injury through physiological antagonism of CXCR2.

JCI Insight 2019 05 2;4(9). Epub 2019 May 2.

School of Biomedical Sciences, Faculty of Medicine.

Traumatic spinal cord injury (SCI) triggers an acute-phase response that leads to systemic inflammation and rapid mobilization of bone marrow (BM) neutrophils into the blood. These mobilized neutrophils then accumulate in visceral organs and the injured spinal cord where they cause inflammatory tissue damage. The receptor for complement activation product 3a, C3aR1, has been implicated in negatively regulating the BM neutrophil response to tissue injury. However, the mechanism via which C3aR1 controls BM neutrophil mobilization, and also its influence over SCI outcomes, are unknown. Here, we show that the C3a/C3aR1 axis exerts neuroprotection in SCI by acting as a physiological antagonist against neutrophil chemotactic signals. We show that C3aR1 engages phosphatase and tensin homolog (PTEN), a negative regulator of the phosphatidylinositol 3-kinase (PI3K)/AKT pathway, to restrain C-X-C chemokine receptor type 2-driven BM neutrophil mobilization following trauma. These findings are of direct clinical significance as lower circulating neutrophil numbers at presentation were identified as a marker for improved recovery in human SCI. Our work thus identifies C3aR1 and its downstream intermediary, PTEN, as therapeutic targets to broadly inhibit neutrophil mobilization/recruitment following tissue injury and reduce inflammatory pathology.
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http://dx.doi.org/10.1172/jci.insight.98254DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6538362PMC
May 2019

Field Testing Integrated Interventions for Schistosomiasis Elimination in the People's Republic of China: Outcomes of a Multifactorial Cluster-Randomized Controlled Trial.

Front Immunol 2019 3;10:645. Epub 2019 Apr 3.

Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.

Despite significant progress, China faces the challenge of re-emerging schistosomiasis transmission in currently controlled areas due, in part, to the presence of a range of animal reservoirs, notably water buffalo and cattle, which can harbor infections. Environmental, ecological and social-demographic changes in China, shown to affect the distribution of oncomelanid snails, can also impact future schistosomiasis transmission. In light of their importance in the , lifecycle, vaccination has been proposed as a means to reduce the excretion of egg from cattle and buffalo, thereby interrupting transmission from these reservoir hosts to snails. A DNA-based vaccine (SjCTPI) our team developed showed encouraging efficacy against in Chinese water buffaloes. Here we report the results of a double-blind cluster randomized trial aimed at determining the impact of a combination of the SjCTPI bovine vaccine (given as a prime-boost regimen), human mass chemotherapy and snail control on the transmission of in 12 selected administrative villages around the Dongting Lake in Hunan province. The trial confirmed human praziquantel treatment is an effective intervention at the population level. Further, mollusciciding had an indirect ~50% efficacy in reducing human infection rates. Serology showed that the SjCTPI vaccine produced an effective antibody response in vaccinated bovines, resulting in a negative correlation with bovine egg counts observed at all post-vaccination time points. Despite these encouraging outcomes, the effect of the vaccine in preventing human infection was inconclusive. This was likely due to activities undertaken by the China National Schistosomiasis Control Program, notably the treatment, sacrifice or removal of bovines from trial villages, over which we had no control; as a result, the trial design was compromised, reducing power and contaminating outcome measures. This highlights the difficulties in undertaking field trials of this nature and magnitude, particularly over a long period, and emphasizes the importance of mathematical modeling in predicting the potential impact of control intervention measures. A transmission blocking vaccine targeting bovines for the prevention of with the required protective efficacy would be invaluable in tandem with other preventive intervention measures if the goal of eliminating schistosomiasis from China is to become a reality.
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http://dx.doi.org/10.3389/fimmu.2019.00645DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6456715PMC
June 2020

Regular Sunscreen Use and Risk of Mortality: Long-Term Follow-up of a Skin Cancer Prevention Trial.

Am J Prev Med 2019 05 16;56(5):742-746. Epub 2019 Mar 16.

School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia. Electronic address:

Introduction: Sunscreen is widely used to protect the skin from harmful effects of sun exposure. However, there are concerns that sunscreens may negatively affect overall health. Evidence of the general safety of long-term regular sunscreen use is therefore needed.

Methods: The effect of long-term sunscreen use on mortality was assessed over a 21-year period (1993-2014) among 1,621 Australian adults who had participated in a randomized skin cancer prevention trial of regular versus discretionary sunscreen use (1992-1996). In 2018, an intention-to-treat analysis was conducted using Cox proportional hazards regression to compare death rates in people who were randomized to apply sunscreen daily for 4.5years, versus randomized to use sunscreen at their usual, discretionary level. All-cause mortality and deaths resulting from cardiovascular disease, cancer, and other causes were considered.

Results: In total, 160 deaths occurred in the daily sunscreen group compared with 170 deaths in the discretionary sunscreen group (hazard ratio=0.94, 95% CI=0.76, 1.17); 59vs 76 cardiovascular disease deaths (hazard ratio=0.77, 95% CI=0.55, 1.08), 63vs 58 cancer deaths (hazard ratio=1.09, 95% CI=0.76, 1.57), and 45vs 44 deaths resulting from other causes (hazard ratio=1.02, 95% CI=0.67, 1.54) occurred respectively.

Conclusions: Regular use of a sun protection factor 16 sunscreen on head, neck, arms, and hands for 4.5years did not increase mortality.
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http://dx.doi.org/10.1016/j.amepre.2018.11.025DOI Listing
May 2019

Response to letter to the editor: When does selection generate bias in clinical samples?

J Psychiatr Res 2019 09 22;116:191-192. Epub 2019 Feb 22.

School of Public Health, The University of Queensland, Herston, 4006, Australia.

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http://dx.doi.org/10.1016/j.jpsychires.2019.02.011DOI Listing
September 2019

Asian Schistosomiasis: Current Status and Prospects for Control Leading to Elimination.

Trop Med Infect Dis 2019 Feb 26;4(1). Epub 2019 Feb 26.

Department of Global Health, Research School of Population Health, Australian National University, Acton, ACT 2601, Australia.

Schistosomiasis is an infectious disease caused by helminth parasites of the genus Worldwide, an estimated 250 million people are infected with these parasites with the majority of cases occurring in sub-Saharan Africa. Within Asia, three species of cause disease. is the most prevalent, followed by and . All three species are zoonotic, which causes concern for their control, as successful elimination not only requires management of the human definitive host, but also the animal reservoir hosts. With regard to Asian schistosomiasis, most of the published research has focused on with comparatively little attention paid to and even less focus on . In this review, we examine the three Asian schistosomes and their current status in their endemic countries: Cambodia, Lao People's Democratic Republic, Myanmar, and Thailand (); Malaysia (); and Indonesia, People's Republic of China, and the Philippines (). Prospects for control that could potentially lead to elimination are highlighted as these can inform researchers and disease control managers in other schistosomiasis-endemic areas, particularly in Africa and the Americas.
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http://dx.doi.org/10.3390/tropicalmed4010040DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6473711PMC
February 2019

Risk factors for infection with soil-transmitted helminths during an integrated community level water, sanitation, and hygiene and deworming intervention in Timor-Leste.

Int J Parasitol 2019 04 22;49(5):389-396. Epub 2019 Feb 22.

Research School of Population Health, Australian National University, Canberra ACT 0200, Australia.

Water, sanitation and hygiene interventions have been advocated as important complements to deworming programs to improve soil-transmitted helminth control. Evidence for the impact of water, sanitation and hygiene on soil-transmitted helminth infections is mixed, and based mainly on cross-sectional studies. In this study, we assessed associations between individual- and household-level water, sanitation and hygiene variables and soil-transmitted helminth infections, using data collected during the 2 year follow-up study period of the WASH for WORMS randomised controlled trial in Timor-Leste. Data were collected across four surveys, conducted at 6 monthly intervals in 23 communities. We analysed water, sanitation and hygiene and sociodemographic variables as risk factors for infection with Necator americanus, Ascaris spp., and undifferentiated soil-transmitted helminth infection, using generalised linear mixed models to account for clustering at community, household and participant levels. Water, sanitation and hygiene risk factors were examined both concurrently and with a 6 month lag period that coincided with the most recent deworming. The analysis included 2333 participants. Factors associated with N. americanus infection included age group, male sex (adjusted odds ratio (aOR) 3.1, 95% confidence interval (CI) 2.4-4.2), working as a farmer (aOR 1.7, 95% CI 1.2-2.4), and completing secondary school or higher (aOR 0.29, 95% CI 0.16-0.53). Risk factors for Ascaris spp. infection included age group, living in a dwelling with more than six people (aOR 1.6, 95% CI 1.1-2.3), having a tube well or borehole as the household water source (aOR 3.7, 95% CI 1.3-10.8), and using a latrine shared between households 6 months previously (aOR 2.3, 95% CI 1.2-4.3). Handwashing before eating was protective against infection with any soil-transmitted helminth (aOR 0.79, 95% CI 0.65-0.95). In the context of regular deworming, few water, sanitation and hygiene-related factors were associated with soil-transmitted helminth infections. Future research examining the role of water, sanitation and hygiene in soil-transmitted helminth transmission is required, particularly in low transmission settings after cessation of deworming. Identifying improved indicators for measuring water, sanitation and hygiene behaviours is also a key priority.
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http://dx.doi.org/10.1016/j.ijpara.2018.12.006DOI Listing
April 2019

Intimate partner violence in emerging adulthood and subsequent substance use disorders: findings from a longitudinal study.

Addiction 2019 07 19;114(7):1264-1273. Epub 2019 Mar 19.

School of Public Health, The University of Queensland, Herston, Queensland, Australia.

Aims: To examine the temporal association between the experience of different types of intimate partner violence (IPV) in early adulthood (21 years) and substance use disorders in young adulthood (30 years).

Design: Prospective birth cohort study using data from the Mater-University of Queensland Study of Pregnancy (MUSP).

Setting: Brisbane, Australia.

Participants: A total of 1353 people (822 females and 531 males).

Measurements: IPV was measured using the Composite Abuse Scale (CAS) and alcohol, substance and nicotine use disorders were assessed using the Composite International Diagnostic Interview (CIDI).

Findings: In females, the experience of different forms of IPV at 21 years remained a robust risk factor for subsequent alcohol use disorder [adjusted odds ratios (aORs) ranged from 1.6 to 2.6 (all P < 0.05)], substance use disorder [aORs ranged from 2.1 to 4.0 (all P < 0.001)] and nicotine use disorder [aORs ranged from 2.0 to 2.4 (all P < 0.05)] at 30 years, even after controlling for antecedent substance disorders. However, in males only physical and emotional abuse (but not harassment) were significant in predicting alcohol use disorder [aORs ranged from 1.4 to 1.8 (all P < 0.05)] and drug use disorder [aORs ranged from 1.6 to 2.0 (all P < 0.05)] in the fully adjusted model.

Conclusion: Intimate partner violence (IPV) in early adulthood is robustly associated with alcohol, substance and nicotine use disorders in women, whereas in men the association is clear for only some forms of IPV and types of disorder.
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http://dx.doi.org/10.1111/add.14592DOI Listing
July 2019

On the estimation of population cause-specific mortality fractions from in-hospital deaths.

BMC Med 2019 02 8;17(1):29. Epub 2019 Feb 8.

School of Population and Global Health, University of Melbourne, Parkville, Australia.

Background: Almost all countries without complete vital registration systems have data on deaths collected by hospitals. However, these data have not been widely used to estimate cause of death (COD) patterns in populations because only a non-representative fraction of people in these countries die in health facilities. Methods that can exploit hospital mortality statistics to reliably estimate community COD patterns are required to strengthen the evidence base for disease and injury control programs. We propose a method that weights hospital-certified causes by the probability of death to estimate population cause-specific mortality fractions (CSMFs).

Methods: We used an established verbal autopsy instrument (VAI) to collect data from hospital catchment areas in Chandpur and Comilla Districts, Bangladesh, and Bohol province, the Philippines, between 2011 and 2014, along with demographic covariates for each death. Hospital medical certificates of cause of death (death certificates) were collected and mapped to the corresponding cause categories of the VAI. Tariff 2.0 was used to assign a COD for community deaths. Logistic regression models were created for broad causes in each country to calculate the probability of in-hospital death, given a set of covariate values. The reweighted CSMFs for deaths in the hospital catchment population, represented by each hospital death, were calculated from the corresponding regression models.

Results: We collected data on 4228 adult deaths in the Philippines and 3725 deaths in Bangladesh. Short time to hospital and education were consistently associated with in-hospital death in the Philippines and absence of a disability was consistently associated with in-hospital death in Bangladesh. Non-communicable diseases (excluding stroke) and stroke were the leading causes of death in both the Philippines (33.9%, 19.1%) and Bangladesh (46.1%, 21.1%) according to the reweighted method. The reweighted method generally estimated CSMFs that fell between those derived from hospitals and those diagnosed by Tariff 2.0.

Conclusions: Statistical methods can be used to derive estimates of cause-specific probability of death in-hospital for Bangladesh and the Philippines to generate population CSMFs. In regions where hospital death certification is of reasonable quality and routine verbal autopsy is not applied, these estimates could be applied to generate cost-effective and robust CSMFs for the population.
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http://dx.doi.org/10.1186/s12916-019-1267-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367755PMC
February 2019

WASH for WORMS: A Cluster-Randomized Controlled Trial of the Impact of a Community Integrated Water, Sanitation, and Hygiene and Deworming Intervention on Soil-Transmitted Helminth Infections.

Am J Trop Med Hyg 2019 03;100(3):750-761

Faculty of Health Sciences, Curtin University, Perth, Australia.

Water, sanitation, and hygiene (WASH) interventions have been proposed as an important complement to deworming programs for sustainable control of soil-transmitted helminth (STH) infections. We aimed to determine whether a community-based WASH program had additional benefits in reducing STH infections compared with community deworming alone. We conducted the WASH for WORMS cluster-randomized controlled trial in 18 rural communities in Timor-Leste. Intervention communities received a WASH intervention that provided access to an improved water source, promoted improved household sanitation, and encouraged handwashing with soap. All eligible community members in intervention and control arms received albendazole every 6 months for 2 years. The primary outcomes were infection with each STH, measured using multiplex real-time quantitative polymerase chain reaction. We compared outcomes between study arms using generalized linear mixed models, accounting for clustering at community, household, and individual levels. At study completion, the integrated WASH and deworming intervention did not have an effect on infection with spp. (relative risk [RR] 2.87, 95% confidence interval [CI]: 0.66-12.48, = 0.159) or (RR 0.99, 95% CI: 0.52-1.89, = 0.987), compared with deworming alone. At the last follow-up, open defecation was practiced by 66.1% (95% CI: 54.2-80.2) of respondents in the control arm versus 40.2% (95% CI: 25.3-52.6) of respondents in the intervention arm ( = 0.005). We found no evidence that the WASH intervention resulted in additional reductions in STH infections beyond that achieved with deworming alone over the 2-year trial period. The role of WASH on STH infections over a longer period of time and in the absence of deworming remains to be determined.
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http://dx.doi.org/10.4269/ajtmh.18-0705DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402916PMC
March 2019

The association between the longitudinal course of common mental disorders and subsequent physical activity status in young adults: A 30-year birth cohort study.

J Psychiatr Res 2019 02 6;109:173-177. Epub 2018 Dec 6.

Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Australia; School of Public Health, The University of Queensland, Herston, Australia; Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, Australia.

Low physical activity is a major public health concern. There has been extensive research examining the role of physical activity as a potentially modifiable risk factor for the onset of mental illness. However, fewer studies have reported how mental disorders affect future physical activity. Using data from a large birth cohort, the current study explored the association between the longitudinal course of common mental disorders (affective disorders, anxiety disorders, and substance use disorders, as well as any common mental disorder) and subsequent physical activity status among young adults living in Australia. Prospective data from the Mater-University of Queensland Study of Pregnancy, consisting of 1611 young adults, were analyzed. The longitudinal course of mental disorder diagnoses between ages 21 and 30 was derived from the Composite International Diagnostic Interview. Physical activity status at age 30 was estimated using International Physical Activity Questionnaire long form. Logistic regression was used to examine the association between the longitudinal course of common mental disorders between 21 and 30 years and subsequent physical activity status at age 30. After adjusting for confounding factors, there was no association between the longitudinal course of affective disorders, anxiety disorders, substance use disorders, or any common mental disorder at ages 21 and 30 and physical activity status at age 30. Our findings suggest that there is no longitudinal association between the common mental disorder diagnoses and physical activity status among young adults living in Australia.
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http://dx.doi.org/10.1016/j.jpsychires.2018.12.003DOI Listing
February 2019

Co-parasitism of intestinal protozoa and Schistosoma japonicum in a rural community in the Philippines.

Infect Dis Poverty 2018 Dec 10;7(1):121. Epub 2018 Dec 10.

Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, 4006, Australia.

Background: Co-parasitism is a frequent occurrence in impoverished communities in the tropics resulting in a considerable disease burden. While there are extensive reports of intestinal helminthiases, including schistosomiasis japonica, the occurrence and extent of diseases caused by intestinal protozoa (IP) have yet to be investigated in depth in the Philippines. We present a detailed analysis of polyparasitism in a rural community of Northern Samar, focusing on co-infections of IP with Schistosoma japonicum.

Methods: A descriptive cross sectional study was carried out in 2015 across 18 barangays (villages) endemic for S. japonicum in Northern Samar, the Philippines to assess the burden of human schistosomiasis and IP infections. Faecal samples collected from 412 participants from the 18 barangays were included in the final molecular analysis. A multiplex quantitative PCR assay was developed and used for the detection of Blastocystis spp., Entamoeba histolytica, Cryptosporidium spp. and Giardia duodenalis in stool samples. The findings were combined with previous results of droplet digital PCR diagnosis of individuals from the same 18 barangays infected with S. japonicum determined using the same stool samples for analysis.

Results: Mean age of the study participants was 40.3 years (95% CI: 38.8-41.8) with 53% (n = 218) being males. Prevalence of S. japonicum (74.5%) and Blastocystis spp. (58.7%) was significantly higher compared to other infections, with E. histolytica having the lowest prevalence (12.1%). A majority of individuals were infected with more than one parasite with two infections being most common (n = 175, 42.5%). The prevalence of individuals with two parasites was significantly higher than all others with 27.9% (n = 115) subjects harbouring a single parasite species. Of individuals with two infections, S. japonicum and Blastocystis spp. were the most common combination (n = 110, 62.9%). Examining age within the population, 58.5% (n = 38) of school-aged children and 60.1% (n = 14) of women of child bearing age harboured at least two parasite species.

Conclusions: The study revealed that polyparasitism with IP infections and schistosomiasis japonica is highly prevalent in individuals in Northern Samar which likely contributes to the significant public health and socio-economic burden suffered by this population. More generally, the findings are of relevance when considering implementation of integrated control strategies for intestinal parasites.
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http://dx.doi.org/10.1186/s40249-018-0504-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6287361PMC
December 2018
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