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Article: Food and waterborne protozoan parasites: The African perspective

Siwila, Joyce / Mwaba, Florence / Chidumayo, Nozyechi / Mubanga, Chishimba

Food and Waterborne Parasitology. 2020 Sept., v. 20

2020

Abstract: Parasitic food-borne diseases, particularly those caused by the protozoan parasites Cryptosporidium, Giardia, Cyclospora cayetanensis and Entamoeba are increasingly becoming common and have received considerable attention in the last two decades. The ... ...

Abstract	Parasitic food-borne diseases, particularly those caused by the protozoan parasites Cryptosporidium, Giardia, Cyclospora cayetanensis and Entamoeba are increasingly becoming common and have received considerable attention in the last two decades. The ability of the transmission stages of the parasites to survive in the environment for prolonged periods, globalization of the food industry and changes in eating habits have contributed to the numbers of human infections. This systematic scoping review highlights these important water- and foodborne parasites in the African context, detailing the burden in African water sources, wastewater/effluents and fresh produce. A scoping review search targeting African countries was conducted in Medline, Web of science and African journals online as well as back referencing from included studies covering the period 1990 to January 2020. Out of 1134 studies, 68 were included in the review. The articles covered 17 out of 54 African countries. There were 39/68 studies reporting on water sources while the rest reported on fresh produce. Cryptosporidium prevalence ranged from 6 to 100% in surface water, 4 to 100% in tap water and up to 100% in wastewater and sludge. In fresh produce, Cryptosporidium was reported from five countries with prevalence of 0.8–75%. Giardia was reported in 47 out of 68 articles; prevalence ranged from 2.4% in surface water; 1% to over 70% in tap water; 28–100% in wastewater and 2% - 99% in fresh produce. Prevalence of Cyclospora cayetanensis was lower. Prevalence of Entamoeba was 78% in surface water; 100% in wastewater and up to 99% in fresh produce. This study finds that Africa is no exception to the risk presented by the subject parasites from water and/or food sources. Routine screening for these parasites particularly at household level and provision of adequate and safe drinking water would help to control the parasites.
Keywords	Cryptosporidium ; Cyclospora cayetanensis ; Entamoeba ; Giardia ; food industry ; fresh produce ; globalization ; humans ; parasitology ; risk ; sludge ; surface water ; tap water ; wastewater ; Africa
Language	English
Dates of publication	2020-09
Publishing place	Elsevier Inc.
Document type	Article
Note	NAL-AP-2-clean
ISSN	2405-6766
DOI	10.1016/j.fawpar.2020.e00088
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Food and waterborne protozoan parasites: The African perspective.

Siwila, Joyce / Mwaba, Florence / Chidumayo, Nozyechi / Mubanga, Chishimba

Food and waterborne parasitology

2020 Volume 20, Page(s) e00088

Abstract: Parasitic food-borne diseases, particularly those caused by the protozoan ... ...

Abstract	Parasitic food-borne diseases, particularly those caused by the protozoan parasites
Language	English
Publishing date	2020-09-09
Publishing country	Netherlands
Document type	Journal Article
ISSN	2405-6766
ISSN (online)	2405-6766
DOI	10.1016/j.fawpar.2020.e00088
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Gaps in treatment of epileptic seizures in a Zambian rural area.

Mambo, Richard / Phiri, Andrew M / Trevisan, Chiara / Zulu, Gideon / Mubanga, Chishimba M / Mwelwa, Chembensofu / Phiri, Isaac K / Schmidt, Veronika / Magnussen, Pascal / Dorny, Pierre / Gabriël, Sarah / Winkler, Andrea S / Mwape, Kabemba E

Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

2024

Abstract: Background: Epilepsy is a multifactorial neurological disorder, including parasitic infections of the brain such as neurocysticercosis (NCC). People with epileptic seizures (PWES) in low and middle-income countries often do not receive appropriate ... ...

Abstract	Background: Epilepsy is a multifactorial neurological disorder, including parasitic infections of the brain such as neurocysticercosis (NCC). People with epileptic seizures (PWES) in low and middle-income countries often do not receive appropriate treatment, which besides epileptic seizures, may also lead to reduced quality of life and possibly death. The objective of this study was to describe gaps in treatment of epileptic seizures in a Zambian rural area. Methods: A cross-sectional study was conducted in Sinda district of Zambia between August and October 2018. PWES identified from clinic records and with the help of community healthcare workers were recruited. Two questionnaires, one to PWES and the other to local healthcare workers, were administered to describe the treatment gap. Results: A total of 146 PWES and 43 healthcare workers were interviewed. Of the 146 PWES, 131 had taken anti-seizure medication (ASM) at some point since their seizure onset, of which 49.6% were on current treatment. Only 18.3% were on continuous ASM, an overall treatment gap of 83.6%. Over 55% of healthcare workers did not know the relationship between epilepsy and NCC. The risk factors associated with lack of appropriate treatment were stock-outs of ASMs, lack of diagnostic equipment, poor patient follow-up, and PWES opting for traditional medicine. Conclusion: The treatment gap is substantial in Sinda district. The causes are multifactorial, involving shortcomings at the level of healthcare facilities, communities, and individuals. Directed training of healthcare workers and significant improvements in the supply and dispensing of ASMs will be key in substantially reducing the gap.
Language	English
Publishing date	2024-03-28
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2016546-8
ISSN	1590-3478 ; 1590-1874
ISSN (online)	1590-3478
ISSN	1590-1874
DOI	10.1007/s10072-024-07456-1
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Article ; Online: Effects of 'The Vicious Worm' educational software on Taenia solium knowledge among key pork supply chain workers in Zambia.

Vaernewyck, Victor / Mwape, Kabemba Evans / Mubanga, Chishimba / Devleesschauwer, Brecht / Gabriël, Sarah / Trevisan, Chiara

PLoS neglected tropical diseases

2020 Volume 14, Issue 10, Page(s) e0008790

Abstract: The neglected zoonotic cestode Taenia solium is endemic in many low- and middle-income countries, including Zambia. The parasite infects humans and pigs, inflicting high socioeconomic and disease burdens in endemic areas. Health education is regarded as ... ...

Abstract	The neglected zoonotic cestode Taenia solium is endemic in many low- and middle-income countries, including Zambia. The parasite infects humans and pigs, inflicting high socioeconomic and disease burdens in endemic areas. Health education is regarded as an important component in T. solium control and previous studies indicate that 'The Vicious Worm' may be an effective T. solium health education tool for Tanzanian medical and agricultural professionals and Zambian primary school students. This study aimed to assess the effects of health education using 'The Vicious Worm' among Zambian pork supply chain workers, because the pork supply chain greatly influences food safety and security in Zambia. Half-day educational workshops using 'The Vicious Worm' and subsequent follow-up sessions were organized in the Lusaka and Katete districts of Zambia in March and April 2019. Questionnaires were administered before, after, and three weeks after the use of 'The Vicious Worm' to assess the program's impact on knowledge uptake and short-term retention. Focus group discussions were conducted to assess the program's user experience and the participants' beliefs, attitudes, and insights. In total, 47 pork supply chain workers participated: 25 from Lusaka and 22 from Katete. Overall, knowledge about T. solium was significantly higher (p<0.001) both immediately after, and three weeks after the use of 'The Vicious Worm' compared to baseline knowledge. Focus group discussions indicated incipient attitudinal and behavioral change, as well as a positive reception of the software; with participants describing the software as simple, educative, and useful to share knowledge. The study results indicate that workshops using 'The Vicious Worm' may be effective for short-term T. solium health education among key pork supply chain workers. Follow-up studies are required to assess long-term effects, transfer of knowledge and behavioral change. However, educational interventions with 'The Vicious Worm' could be considered for integrated T. solium control programs in sub-Saharan Africa, especially if the educational content is further simplified and clarified.
MeSH term(s)	Adult ; Animals ; Female ; Food Industry/education ; Food Supply ; Health Education ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Software ; Surveys and Questionnaires ; Swine ; Swine Diseases/parasitology ; Swine Diseases/psychology ; Swine Diseases/transmission ; Taenia solium/physiology ; Taeniasis/parasitology ; Taeniasis/psychology ; Taeniasis/transmission ; Taeniasis/veterinary ; Young Adult ; Zambia
Language	English
Publishing date	2020-10-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2429704-5
ISSN	1935-2735 ; 1935-2727
ISSN (online)	1935-2735
ISSN	1935-2727
DOI	10.1371/journal.pntd.0008790
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The epidemiology of human Taenia solium infections: A systematic review of the distribution in Eastern and Southern Africa.

Zulu, Gideon / Stelzle, Dominik / Mwape, Kabemba E / Welte, Tamara M / Strømme, Hilde / Mubanga, Chishimba / Mutale, Wilbroad / Abraham, Annette / Hachangu, Alex / Schmidt, Veronika / Sikasunge, Chummy S / Phiri, Isaac K / Winkler, Andrea S

PLoS neglected tropical diseases

2023 Volume 17, Issue 3, Page(s) e0011042

Abstract: Background: Taenia solium is a tapeworm that causes taeniosis in humans and cysticercosis in humans and pigs. Within Eastern and Southern Africa (ESA), information on the presence of human taeniosis and cysticercosis seems scarce. This systematic review ...

Abstract	Background: Taenia solium is a tapeworm that causes taeniosis in humans and cysticercosis in humans and pigs. Within Eastern and Southern Africa (ESA), information on the presence of human taeniosis and cysticercosis seems scarce. This systematic review aimed to describe the current information available and gaps in the epidemiology of human T. solium infections in ESA. Methods/principle findings: Scientific literature published between 1st January 2000 and 20th June 2022 in international databases [MEDLINE (Ovid), Embase (Ovid), Global Health (Ovid), Scopus (Elsevier), African Index Medicus (via WHO Global Index Medicus), and Open Grey] was systematically reviewed for ESA. The study area included 27 countries that make up the ESA region. Information on either taeniosis, cysticercosis or NCC was available for 16 of 27 countries within the region and a total of 113 reports were retained for the review. Most case reports for cysticercosis and NCC were from South Africa, while Tanzania had the most aggregated cysticercosis reports. Eleven countries reported on NCC with seven countries reporting data on NCC and epilepsy. Unconfirmed human T. solium taeniosis cases were reported in nine countries while two countries (Madagascar and Zambia) reported confirmed T. solium cases. The cysticercosis seroprevalence ranged between 0.7-40.8% on antigen (Ag) ELISA and between 13.1-45.3% on antibody (Ab) ELISA. Based on immunoblot tests the Ab seroprevalence was between 1.7-39.3%, while the proportion of NCC-suggestive lesions on brain CT scans was between 1.0-76% depending on the study population. The human taeniosis prevalence based on microscopy ranged between 0.1-14.7%. Based on Copro Ag-ELISA studies conducted in Kenya, Rwanda, Tanzania, and Zambia, the highest prevalence of 19.7% was reported in Kenya. Conclusions: Despite the public health and economic impact of T. solium in ESA, there are still large gaps in knowledge about the occurrence of the parasite, and the resulting One Health disease complex, and monitoring of T. solium taeniosis and cysticercosis is mostly not in place.
MeSH term(s)	Humans ; Swine ; Animals ; Seroepidemiologic Studies ; Taeniasis/epidemiology ; Taeniasis/parasitology ; Cysticercosis/epidemiology ; Cysticercosis/parasitology ; Taenia solium ; Africa, Southern/epidemiology ; Tanzania/epidemiology ; Prevalence ; Swine Diseases/parasitology
Language	English
Publishing date	2023-03-31
Publishing country	United States
Document type	Systematic Review ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2429704-5
ISSN	1935-2735 ; 1935-2735
ISSN (online)	1935-2735
ISSN	1935-2735
DOI	10.1371/journal.pntd.0011042
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Movements of free-range pigs in rural communities in Zambia: an explorative study towards future ring interventions for the control of Taenia solium

Van Damme, Inge / Pray, Ian / Mwape, Kabemba E. / Trevisan, Chiara / Coudenys, Fien / Mubanga, Chishimba / Mwelwa, Chembesofu / Vaernewyck, Victor / Dorny, Pierre / O’Neal, Seth E. / Gabriël, Sarah

Parasites & vectors. 2022 Dec., v. 15, no. 1

2022

Abstract: BACKGROUND: Taenia solium typically affects resource-poor communities where pigs are allowed to roam freely, and sanitation and hygiene levels are suboptimal. Sustainable, long-term strategies are urgently needed to control the disease. Geographically ... ...

Abstract	BACKGROUND: Taenia solium typically affects resource-poor communities where pigs are allowed to roam freely, and sanitation and hygiene levels are suboptimal. Sustainable, long-term strategies are urgently needed to control the disease. Geographically targeted interventions, i.e. screening or treatment of taeniosis among people living near infected pigs (defined as ring screening and ring treatment, respectively), have been shown to be effective control options in Peru. However, these results might not be directly generalizable to sub-Saharan African settings. Pig movements play a vital role in the transmission and, consequently, the success of ring interventions against T. solium. The aim of the present study was to explore roaming patterns of pigs in T. solium endemic communities in Zambia as a first step toward evaluating whether ring interventions should be considered as a treatment option in Zambia. METHODS: In total, 48 free-roaming pigs in two rural neighborhoods in the Eastern Province of Zambia were tracked using a Global Positioning System (GPS) receiver. Tracking took place in April (end of the rainy season) 2019 and October (end of the dry season) 2019. The number of revisitations and the time spent within rings of different radii (50, 100 and 250 m) around the coordinates of each pig owner’s household were calculated for each pig. RESULTS: The total tracking time for 43 pigs in the final analysis set ranged between 43 and 94 h. Pigs spent a median of 31% and 13% of the tracked time outside the 50- and 100-m radius, respectively, although large variations were observed between pigs. Overall, 25 pigs (58%) went outside the 250-m ring at least once, and individual excursions lasting up to 16 h were observed. In the dry season, 17 out of 23 pigs went outside the 250-m radius compared to only eight out of 20 pigs in the rainy season (P = 0.014). CONCLUSIONS: In our study sites in Zambia, the majority of pigs spent most of their time within 50 or 100 m of their owner’s home, and these results are comparable with those on Peruvian pigs. Both radii could therefore be considered reasonable options in future ring interventions.
Keywords	Taenia solium ; dry season ; hygiene ; people ; sanitation ; swine ; taeniasis ; wet season ; Peru ; Zambia
Language	English
Dates of publication	2022-12
Size	p. 150.
Publishing place	BioMed Central
Document type	Article
ZDB-ID	2409480-8
ISSN	1756-3305
ISSN	1756-3305
DOI	10.1186/s13071-022-05264-0
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Movements of free-range pigs in rural communities in Zambia: an explorative study towards future ring interventions for the control of Taenia solium.

Van Damme, Inge / Pray, Ian / Mwape, Kabemba E / Trevisan, Chiara / Coudenys, Fien / Mubanga, Chishimba / Mwelwa, Chembesofu / Vaernewyck, Victor / Dorny, Pierre / O'Neal, Seth E / Gabriël, Sarah

Parasites & vectors

2022 Volume 15, Issue 1, Page(s) 150

Abstract: Background: Taenia solium typically affects resource-poor communities where pigs are allowed to roam freely, and sanitation and hygiene levels are suboptimal. Sustainable, long-term strategies are urgently needed to control the disease. Geographically ... ...

Abstract	Background: Taenia solium typically affects resource-poor communities where pigs are allowed to roam freely, and sanitation and hygiene levels are suboptimal. Sustainable, long-term strategies are urgently needed to control the disease. Geographically targeted interventions, i.e. screening or treatment of taeniosis among people living near infected pigs (defined as ring screening and ring treatment, respectively), have been shown to be effective control options in Peru. However, these results might not be directly generalizable to sub-Saharan African settings. Pig movements play a vital role in the transmission and, consequently, the success of ring interventions against T. solium. The aim of the present study was to explore roaming patterns of pigs in T. solium endemic communities in Zambia as a first step toward evaluating whether ring interventions should be considered as a treatment option in Zambia. Methods: In total, 48 free-roaming pigs in two rural neighborhoods in the Eastern Province of Zambia were tracked using a Global Positioning System (GPS) receiver. Tracking took place in April (end of the rainy season) 2019 and October (end of the dry season) 2019. The number of revisitations and the time spent within rings of different radii (50, 100 and 250 m) around the coordinates of each pig owner's household were calculated for each pig. Results: The total tracking time for 43 pigs in the final analysis set ranged between 43 and 94 h. Pigs spent a median of 31% and 13% of the tracked time outside the 50- and 100-m radius, respectively, although large variations were observed between pigs. Overall, 25 pigs (58%) went outside the 250-m ring at least once, and individual excursions lasting up to 16 h were observed. In the dry season, 17 out of 23 pigs went outside the 250-m radius compared to only eight out of 20 pigs in the rainy season (P = 0.014). Conclusions: In our study sites in Zambia, the majority of pigs spent most of their time within 50 or 100 m of their owner's home, and these results are comparable with those on Peruvian pigs. Both radii could therefore be considered reasonable options in future ring interventions.
MeSH term(s)	Animals ; Cysticercosis/epidemiology ; Humans ; Rural Population ; Swine ; Swine Diseases/epidemiology ; Swine Diseases/prevention & control ; Taenia solium ; Zambia/epidemiology
Language	English
Publishing date	2022-04-27
Publishing country	England
Document type	Journal Article
ZDB-ID	2409480-8
ISSN	1756-3305 ; 1756-3305
ISSN (online)	1756-3305
ISSN	1756-3305
DOI	10.1186/s13071-022-05264-0
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Operational characteristics of an antibody detecting point of care test for Taenia solium infections in a community and hospital setting.

Mubanga, Chishimba / Mwape, Kabemba E / Phiri, Isaac K / Trevisan, Chiara / Kabululu, Mwemezi / Zulu, Gideon / Van Damme, Inge / Schmidt, Veronika / Dorny, Pierre / Gabriël, Sarah

BMC infectious diseases

2021 Volume 21, Issue 1, Page(s) 607

Abstract: Background: Diagnostic test evaluation includes measures of performance and assessment of operational characteristics. The latter focuses on end-user understanding of instructions to perform the test, ease of use, test turnaround time and ease of result ...

Abstract	Background: Diagnostic test evaluation includes measures of performance and assessment of operational characteristics. The latter focuses on end-user understanding of instructions to perform the test, ease of use, test turnaround time and ease of result interpretation. This study aimed to assess user comprehension of training for and ease of use of a Taenia solium point of care test (TS POC) evaluated in a community and hospital setting in Zambia and Tanzania, respectively. Methods: The TS POC is a three-step in-house-produced rapid diagnostic test (RDT) for the simultaneous detection of taeniosis (TST) and cysticercosis (TSCC) antibodies. Data collected by administering questionnaires to 29 end-users and from the main evaluation database was analyzed quantitatively. Results: End-users (28/29, 97%) perceived that the training they received for performing the test was sufficient. They performed 4080 tests, of which 80 were invalid. The community-based study and TST tests had higher invalid rates. The overall result interpretation was within the acceptable range of RDTs with an overall disagreement between readers of 3.3%. The Kappa coefficient of agreement was 85 and 82% for TSCC and TST, respectively. There was more disagreement among readers in the community-based study. Conclusion: End-users rated the TS POC kit moderate in terms of ease of use citing long test turnaround time and difficulties in using the blood transfer device. Overall, the operational performance of the TS POC kit and end-users was within the established acceptable performance range.
MeSH term(s)	Adult ; Animals ; Antibodies, Helminth/blood ; Community Health Services ; Cysticercosis/diagnosis ; Female ; Hospitals ; Humans ; Male ; Middle Aged ; Point-of-Care Testing ; Taenia solium ; Taeniasis/diagnosis ; Tanzania ; Young Adult ; Zambia
Chemical Substances	Antibodies, Helminth
Language	English
Publishing date	2021-06-25
Publishing country	England
Document type	Evaluation Study ; Journal Article
ISSN	1471-2334
ISSN (online)	1471-2334
DOI	10.1186/s12879-021-06320-3
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Progress on the development of rapid diagnostic tests for foodborne neglected zoonotic helminthiases: A systematic review

Mubanga, Chishimba / Chabala, Chishala / Dorny, Pierre / Gabriël, Sarah / Mwape, Kabemba E / Phiri, Isaac K / Schmidt, Veronika / Trevisan, Chiara / van Damme, Inge / Zulu, Gideon

Acta tropica. 2019 June, v. 194

2019

Abstract: Foodborne Neglected Zoonotic Helminths (FNZH) are parasites of both economic and public health importance. They include Taenia solium, Echinococcus granulosus sensu lato, Echinococcus multilocularis and Foodborne trematodes (FBT). FNZH are earmarked for ... ...

Abstract	Foodborne Neglected Zoonotic Helminths (FNZH) are parasites of both economic and public health importance. They include Taenia solium, Echinococcus granulosus sensu lato, Echinococcus multilocularis and Foodborne trematodes (FBT). FNZH are earmarked for major interventions for control, elimination and eradication. This systematic review highlights the progress towards development of rapid tests for the diagnosis of FNZH since 2010 when they were listed as neglected tropical diseases.A systematic search was conducted in three databases, World of Science, Embase and PubMed using the same search phrase. The search produced 480 hits. Three studies from back referencing were included. Only 22 of these met the inclusion criteria. Data was extracted from these and presented qualitatively.Twenty-five rapid diagnostic tests were found to have been developed since 2010, eight for diagnosis of T. solium infections, eight for echinococcosis and nine for FBT infections. The rapid tests for diagnosing T. solium infections included six antibody detecting and two antigen detecting tests. They constitute a combination among them, with some tests providing qualitative, others quantitative results. Similarly, seven out of the eight rapid tests developed for Echinococcus infections were antibody detecting tests save for one loop mediated isothermal amplification test. All of them were qualitative tests. For FBT infections, nine rapid tests were described; two antibody and one nucleic acid detecting test for diagnosis of Fascioliasis; three nucleic acid detecting tests for Opisthorchiasis; one antibody detecting test for Paragonimiasis; and for Clonorchiasis, one antibody and one nucleic acid detecting test. The FBT infection rapid tests were all qualitative in nature.Most of these tests have not undergone field evaluation in endemic areas where they will be used most.This review describes the development and evaluation of rapid diagnostic tests, while highlighting the need for in depth validations of the tools to determine how well they can perform in endemic areas.
Keywords	antibodies ; antibody detection ; antigens ; clonorchiasis ; databases ; diagnostic techniques ; echinococcosis ; Echinococcus granulosus ; Echinococcus multilocularis ; fascioliasis ; helminths ; nucleic acids ; opisthorchiasis ; paragonimiasis ; public health ; systematic review ; Taenia solium ; Trematoda
Language	English
Dates of publication	2019-06
Size	p. 135-147.
Publishing place	Elsevier B.V.
Document type	Article
ZDB-ID	210415-5
ISSN	1873-6254 ; 0001-706X
ISSN (online)	1873-6254
ISSN	0001-706X
DOI	10.1016/j.actatropica.2019.03.030
Database	NAL-Catalogue (AGRICOLA)

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Article: Challenges Encountered When Evaluating an Antibody-Detecting Point-of-Care Test for Taeniosis in an Endemic Community in Zambia: A Prospective Diagnostic Accuracy Study.

Mubanga, Chishimba / Trevisan, Chiara / Van Damme, Inge / Schmidt, Veronika / Phiri, Isaac K / Zulu, Gideon / Noh, John / Handali, Sukwan / Mambo, Richard / Chembensofu, Mwelwa / Masuku, Maxwell / Reynders, Dries / Jansen, Famke / Bottieau, Emmanuel / Magnussen, Pascal / Winkler, Andrea S / Dorny, Pierre / Mwape, Kabemba E / Gabriel, Sarah

Diagnostics (Basel, Switzerland)

2021 Volume 11, Issue 11

Abstract: ... Taenia ... ...

Abstract	Taenia solium
Language	English
Publishing date	2021-11-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics11112039
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