Publications by authors named "Ymkje Stienstra"

Background: There is a dearth of information concerning the epidemiology of human scabies in prisons. Therefore, we aimed to assess the burden of scabies and ascertain if prevalence was high enough to warrant mass drug administration (MDA) with ivermectin in a medium security prison in central Ghana.

Methods: We conducted a cross-sectional study in December 2022 and recruited inmates at the Kumasi central prison in Ghana.

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Venom-induced consumption coagulopathy (VICC) is a common complication of snakebite that is associated with hypofibrinogenemia, bleeding, disability, and death. In remote tropical settings, where most snakebites occur, the 20-minute whole blood clotting test is used to diagnose VICC. Point-of-care (POC) coagulation devices could provide an accessible means of detecting VICC that is better standardized, quantifiable, and more accurate.

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Article Synopsis
  • Clarithromycin extended-release (CLA-ER) was tested alongside rifampicin (RIF) for treating Mycobacterium ulcerans in a WHO drug trial, but RIF can lower CLA serum levels due to its effect on metabolism.
  • The study involved 30 participants who provided dried blood samples over ten hours, with findings showing a non-significant decrease in CLA levels and a slight increase in systemic exposure compared to previous standard dosages.
  • Ultimately, CLA co-administration didn't impact RIF levels or effectiveness, leading to unclear benefits of CLA-ER over immediate release formulations.
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Background: Tuberculosis (TB), and especially its drug resistant forms, is responsible for not only significant mortality, but also considerable morbidity, still under-quantified. This study used four Patient-Reported Outcome Measures (PROMS) to assess the status of persons affected by drug-susceptible and drug-resistant TB during their TB treatment or after treatment completion, in Romania, the highest TB burden country in the EU.

Methods: People affected by TB in two different regions in Romania were included during and after treatment, following a cross-sectional design.

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Introduction: Scabies is an underdiagnosed skin infestation caused by the Sarcoptes scabiei mite. The infection causes severe itching and a skin rash but can be effectively treated using topical or systemic drugs. Scabies outbreaks are commonly reported in resource-poor countries, including Ghana.

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Article Synopsis
  • Skin diseases like impetigo and scabies are prevalent in Ghana, with a significant portion of the population affected, yet there's limited data on their prevalence.
  • A cross-sectional study involving 1,327 participants from various settings in Ghana found that 14% had impetigo, often mild, and 56.2% had scabies, with a notable overlap between the two conditions.
  • Key factors increasing the risk of impetigo included having an itch, presence of scabies, and being in preschool, highlighting the need for improved detection and control measures as part of health initiatives in the region.
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Introduction: Antivenom is a lifesaving medicine for treating snakebite envenoming, yet there has been a crisis in antivenom supply for many decades. Despite this, substantial quantities of antivenom stocks expire before use. This study has investigated whether expired antivenoms retain preclinical quality and efficacy, with the rationale that they could be used in emergency situations when in-date antivenom is unavailable.

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Introduction: Snakebite is an important public health concern, especially in tropical areas, but the true burden remains unclear due to sub-optimal reporting and over-reliance on health facility-based data.

Methods: A community-based cross-sectional survey was conducted in Samburu County, Kenya from December 2019 to March 2020. Geospatial techniques were used to create a sampling frame of all households in Samburu County and a multistage cluster sampling strategy to select households and recruit study participants.

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Introduction: Research on snakebite has mostly been conducted on settled populations and current risk factors and potential interventions are therefore most suited for these populations. There is limited epidemiological data on mobile and nomadic populations, who may have a higher risk of snakebite.

Methods And Results: We conducted a scoping review to gather evidence on survey methods used in nomadic populations and compared them with contemporary survey methods used for snakebite research.

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Snakebite envenoming is a debilitating neglected tropical disease disproportionately affecting the rural poor in low and middle-income countries in the tropics and sub-tropics. Critical questions and gaps in public health and policy need to be addressed if major progress is to be made towards reducing the negative impact of snakebite, particularly in the World Health Organisation (WHO) Africa region. We engaged key stakeholders to identify barriers to evidence-based snakebite decision making and to explore how development of research and policy hubs could help to overcome these barriers.

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The goal to reduce the burden of snakebite envenoming is challenged by the gaps in evidence for clinical care and public health. These evidence gaps and the absence of a strong network are illustrated by bibliometrics. The African Snakebite Alliance is a multidisciplinary group focusing on research themes which will generate evidence needed to shape policy and practice.

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Background: Halving snakebite morbidity and mortality by 2030 requires countries to develop both prevention and treatment strategies. The paucity of data on the global incidence and severity of snakebite envenoming causes challenges in prioritizing and mobilising resources for snakebite prevention and treatment. In line with the World Health Organisation's 2019 Snakebite Strategy, this study sought to investigate Eswatini's snakebite epidemiology and outcomes, and identify the socio-geographical factors associated with snakebite risk.

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Introduction: Snakebite is one of the most neglected tropical diseases. In Ghana, there has been a limited interest in snakebite envenoming research despite evidence of high human-snake conflicts. In an effort to meet the World Health Organisation's (WHO) 2030 snakebite targets, the need for research evidence to guide policy interventions is evident.

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Article Synopsis
  • Envenoming by Echis spp. snakes, common in West Africa, leads to serious blood clotting issues, and early diagnosis is essential for patient management.* -
  • A study at Kaltungo General Hospital tested the effectiveness of the 20-minute whole blood clotting test (20WBCT) in detecting venom-induced coagulopathy, finding it had a sensitivity of 87.2% but a lower specificity of 50%.* -
  • The 20WBCT is a practical and cost-effective bedside test for identifying VICC, though it can produce false positives, indicating the need for further testing.*
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Background: Scabies commonly affects poor populations in low-middle-income countries. The WHO has advocated for country-driven and country-owned control strategies. Knowledge of context specific issues will be important for design and implementation of scabies control interventions.

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Snakebite envenoming is an acute medical emergency which affects hundreds of thousands of people worldwide, primarily in remote rural areas of low-and middle income countries in the Global South. A considerable proportion of snakebite patients turn to traditional healers (THs) for help, driven by a number of push and pull factors. These include socio-cultural factors, geographical proximity, and the absence or inaccessibility of overstretched and often costly allopathic healthcare services.

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Background: Scabies is a global health concern disproportionately affecting vulnerable populations such as refugees and asylum seekers. Greece is a main point of entry in Europe for refugees, but epidemiological data on scabies in this population are scarce. We aimed to describe the epidemiology of scabies, including trends over the study period.

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Background: The estimated five million snakebites per year are an important health problem that mainly affect rural poor populations. The global goal is to halve both mortality and morbidity from this neglected tropical disease by 2030. Data on snakebite morbidity are sparse and mainly obtained from hospital records.

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BackgroundMigrants in low tuberculosis (TB) incidence countries in the European Union (EU)/European Economic Area (EEA) are an at-risk group for latent tuberculosis infection (LTBI) and are increasingly included in LTBI screening programmes.AimTo investigate current approaches and implement LTBI screening in recently arrived migrants in the EU/EEA and Switzerland.MethodsAt least one TB expert working at a national level from the EU/EEA and one TB expert from Switzerland completed an electronic questionnaire.

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Antiviral therapies are urgently needed to treat and limit the development of severe COVID-19 disease. Ivermectin, a broad-spectrum anti-parasitic agent, has been shown to have anti-SARS-CoV-2 activity in Vero cells at a concentration of 5 μM. These limited results triggered the investigation of ivermectin as a treatment option to alleviate COVID-19 disease.

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Background: Latent tuberculosis infection (LTBI) is one of the most prevalent infections globally and can lead to the development of active tuberculosis disease. In many low-burden countries, LTBI is concentrated within migrant populations often because of a higher disease burden in the migrant's country of origin. National programmes consequently focus on screening and treating LTBI in migrants to prevent future tuberculosis cases; however, how effective these programmes are is unclear.

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Background: Snakebite envenoming is a medical emergency which is common in many tropical lower- and middle-income countries. Traditional healers are frequently consulted as primary care-givers for snakebite victims in distress. Traditional healers therefore present a valuable source of information about how snakebite is perceived and handled at the community level, an understanding of which is critical to improve and extend snakebite-related healthcare.

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Background: Previous studies have reported that presence and severity of Buruli ulcer (BU) may reflect the underlying immunosuppression in HIV infected individuals by causing increased incidence of multiple, larger and ulcerated lesions. We report cases of BU-HIV coinfection and the accompanying programmatic challenges encountered in central Ghana.

Methods: Patients with PCR confirmed BU in central Ghana who were HIV positive were identified and their BU01 forms were retrieved and reviewed in further detail.

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Background: There is a dearth of data on scabies from Ghana. In September 2019, local health authorities in the East Mamprusi district of northern Ghana received reports of scabies from many parts of the district. Due to on-going reports of more cases, an assessment team visited the communities to assess the effect of the earlier individual treatment on the outbreak.

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