Drugs used in canines and felines for the treatment of giardia intestinalis.
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He published ten books or chapter books in national and international publishing houses and more than 140 papers in international and national journals and conferences proceedings.",coeditorOneBiosketch:"Prof. Dr. Daniel Tudor Cotfas received several awards - Gold medal at invention salon Euroinvent 2015; National Instruments Graphical System Design Achievement Awards 2013, USA, Austin: Education Winner, NI Community's Choice; Editor's Choice Award; Romania National Instruments NIDays Contest 2012 Romania, Bucharest. Prof. Dr. Cotfas published more than 65 papers in ISI journals or ISI conferences and over 50 papers in proceedings of international and national conferences.",coeditorTwoBiosketch:"Dr. Hedesiu authored over 100 papers in international journals, books, or communications to conferences. Horia Hedesiu is a co-author of two US patents in the field of embedded data acquisition systems. He is a managing director with National Instruments in Romania since 2005.",coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"460635",title:"Dr.",name:"Petru Adrian",middleName:null,surname:"Cotfas",slug:"petru-adrian-cotfas",fullName:"Petru Adrian Cotfas",profilePictureURL:"https://mts.intechopen.com/storage/users/460635/images/system/460635.jpg",biography:"Petru A COTFAS received his BSc degrees in mathematics and physics and also in computer science in 1997 and 2001 respectively, and MSc degree in mathematics and computer science at Transilvania University of Brasov, in 1998. He obtained the PhD degree in material science engineering at Transilvania University of Brasov, in 2007.\nHe is an Prof. Dr. at the Electronics and Computers Department, Transilvania University of Brasov, Romania. He has experience in several fields such as virtual instrumentation, PVs and hybrid systems characterization and testing, electronics circuit design, graphical programming and remote engineering. Dr. Cotfas published ten books or chapter books in national and international publishing houses and more than 140 papers in international and national journals and conferences proceedings (33 are in ISI journals and 30 are ISI conferences).\nORCID: https://orcid.org/0000-0002-6301-7841",institutionString:"Department of Electronics and Computer, Faculty of Electrical Engineering and Computer Science, Transilvania University of Brasov",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:null}],coeditorOne:{id:"465597",title:"Dr.",name:"Daniel Tudor",middleName:null,surname:"Cotfas",slug:"daniel-tudor-cotfas",fullName:"Daniel Tudor Cotfas",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003RJpNAQA1/Profile_Picture_2022-04-06T09:45:51",biography:"Prof. Dr. Daniel Tudor Cotfas is Professor in Electronics and Computers Department, at the Transilvania University of Brasov, Romania. His research interest is in the characterization of the hybrid PV components, virtual instrumentation, and remote systems control. During his career he received several awards - Gold medal at invention salon Euroinvent 2015; National Instruments Graphical System Design Achievement Awards 2013, USA, Austin: Education Winner, NI Community's Choice; Editor's Choice Award; Romania National Instruments NIDays Contest 2012 Romania, Bucharest. Prof. Dr. Cotfas published more than 65 papers in ISI journals or ISI conferences and over 50 papers in proceedings of international and national conferences and has reviewed more than 100 papers for ISI and BDI journals.",institutionString:"Transylvania University of Brașov",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Transylvania University of Brașov",institutionURL:null,country:{name:"Romania"}}},coeditorTwo:{id:"465599",title:"Dr.",name:"Horia",middleName:null,surname:"Hedesiu",slug:"horia-hedesiu",fullName:"Horia Hedesiu",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003RJpRxQAL/Profile_Picture_2022-04-06T09:45:18.596",biography:"Horia Hedesiu received his B.Sc. and a Ph.D. degree in Electrical Engineering from the Technical University of Cluj-Napoca, Romania (formerly Polytechnic Institute of Cluj) in 1991 and 1999 respectively. He is currently a Professor with the Electrical Machines and Drives Department at the TUCN. He has authored over 100 papers in international journals, books, or communications to conferences. Horia Hedesiu is a co-author for two US patents in the field of embedded data acquisition systems. His research interests are in the information systems area, real-time simulation systems, Hardware-in-the-Loop, and also dedicating resources to industrial application implementations that involve machinery, graphical programming technologies and computer-based measurement systems. 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Epidemiology has been considered a cosmopolitan parasite, which causes malabsorption syndrome in the host, causing gastroenteritis in these patients [1, 4], due to the presence of giardia in intestinal mucosa, producing ulcerative lesions and hemorrhagic, it should be made clear that, not being an agent considered cosmopolitan, it does not affect the species of cattle such as cattle, goats, sheep, and swine [1, 2, 4], it is a seriously pathogenic agent for animal species, that if it causes injuries that produce a consuming disease, considered as a zoonotic disease of global importance [2].
The prevalence is higher in areas with unhealthy conditions [3, 5], where the presence of excreta in the water, excreta management, overcrowding, and warm conditions has been described, favoring the presence of an agent [6]. Transmission is oro-fecal; humans, canines, and felines ingest the infecting cysts [2, 3], which hatch and develop into gastroenteritis later on. This route allows the outbreaks between dogs and humans frequently, especially in rural areas and shelter canines [7, 8].
It is important to introduce ourselves in the treatment, to comment on the typical clinical signs of the disease, these are due to gastroenteritis [2], due to damage of the villi of the intestine, leading to malabsorption syndrome [8–10], this type of gastroenteritis causes not only typical diarrhea with mucus, odor, and steatorrhea, but also abdominal discomfort, vomiting, nausea, regurgitation, and anorexia. This is why it is important to use drugs that are not only extremely effective (greater than 95% effectiveness) but also the least gastrolesive or irritant.
For the treatment of giardiasis, there are a number of drugs approved by the Food and Drug Administration (FDA), which are described in the Plumb and Papich therapeutic manuals [11, 12]. It is important that it is established which drugs have kinetic studies in animal species, because sometimes pharmacological products are used, which has few studies in domestic species and if we speak of a health picture, not only high morbidity but zoonotic, it should be clear that products can be formulated and what are their therapeutic indications, according to previous studies.
The drugs used for the curative treatment of
The prevalence of
This group of drugs is the most described for the treatment of giardiasis, in many countries of the world, both for dogs and for cats, and is one of the most described pharmacological products in the treatment of giardiasis in humans [13–15].
Nitroimidazole class drugs, which are considered to be anti-Giardia, have some limitations in domestic species, especially in small animals, where their toxic effects on the central nervous system (CNS) have been described when close doses have been used at 50 mg/kg [16], especially in felines; other authors suggest not exceeding the dose of 25 mg/kg in felines [11].
Within the nitroimidazole family of drugs, metronidazole, secnidazole, tinidazole, and dimetridazole are frequently used in the treatment of intestinal protozoa, such as
With regard to their pharmacological characteristics, the oral absorption of nitroimidazoles is almost complete by the oral route, but are somewhat gastrolesivos, especially in humans which cause anorexia and give a metallic taste to the mouth [20]; in horses, their bioavailability is of 75–100%, whereas in felines and canines, it is 60–100% [12] in dogs. This group of drugs has variable mean lives according to the species: 2–4 h in horses, 9–12 h in foals, 4–5 h in dogs, and 4.8 h in cats [12, 17, 21], given mainly in urine [18]. In cats, metronidazole benzoate salt has been used or suggested, which improves palatability.
As for the adverse effects of these drugs, CNS toxicity is described mainly by several authors; as mentioned previously, doses close to 50 mg/kg cause especially in feline states of lethargy, depression, ataxia, incoordination, tremors, vomiting, weakness, and clonic seizures. The explanation of this phenomenon of drug toxicity is mainly due to the fact that nitroimidazoles cause an inhibition of gamma butyric acid (GABA). Peripheral neuropathic lesions can also be frequent in doses higher than 25 mg/kg [11, 12, 16].
Due to their hepatic metabolism that is achieved by the action of cytochrome P450, by hydroxylation, and conjugation with glucuronic acid, they can cause toxic liver diseases after continuous use [18]. It is important to emphasize that by their oral presentation, these drugs have the property of causing states of inappetence, especially in dogs and cats [17, 18], so their use has been lost for the treatment of giardiasis in these species, because the agent of per se causes inappetence which can be potentiated, after the use of these drugs.
It is important to document that these drugs are mutagenic and teratogenic and therefore should not be used in pregnant females. It is also important to note that the addition of salts to improve the taste can also cause harmful effects especially in cats that are intolerant to acid derivatives, benzoic acid [12].
Regarding therapeutics, it has been described that metronidazole is 100% effective for the treatment of giardia enteritis; the explanation is based not only on its ability to eliminate other common agents such as amoebas and trichomonas, which may be parasitizing concomitantly, but also on its property of inhibiting the lymphocytic response behaving as an intestinal anti-inflammatory at the same time [16, 17].
The recommended dose for domestic species varies according to the drug, species and agent to be treated, as for metronidazole, 22 mg/kg every 12 h for 5 days [11, 21]; for canines, Papich suggests not exceeding 15 mg/kg every 12 h for 8 days; and in cats, it is suggested 10–25 mg/kg every 12 h for 8 days [11, 12, 21, 22]. Other authors recommend an effective dose of 100% for cats of 22–25 mg/kg every 12 h for 5–7 days [16, 23]. For the author, 20 mg/kg has been shown to be an effective dose for canines and felines every 12 h for 5 days [17].
Other nitroimidazoles such as tinidazole 44 mg/kg every 24 h for 3 days have also been used in small animals [21]; while Papich only indicates that 15 mg/kg every 12 h for 5 days is sufficient for dogs and cats [22], secnidazole 30 mg/kg single dose is recommended in a study conducted in a canine shelter and found effectiveness of 725 with a single dose [24].
Other nitroimidazoles, such as ipronidazole, ornidazole, and ronidazole, which have been used in the treatment of giardiasis in a small number of animals, some medicated in drinking water, have been suggested for use in birds than for canines and felines [17–19].
The benzimidazoles are a group of drugs that have frequently been used for the treatment of parasitic nematodes mainly, although their effectiveness in the control of cestodes and trematodes has been evident. Its capacity to eliminate not only the adult forms but also the ovoposición has been the treatment of gastrointestinal parasites in many animal species [17–19], including humans, where this group is of greater importance in the control of giardias [13, 15].
Nowadays, benzimidazoles and especially fenbendazole and its prodrug febantel are considered as the standard drugs for the control of canine and feline giardiasis [25], not only because of its effectiveness, which is 100% [26, 27], but also because they require fewer days of treatment as well as a longer half-life, which facilitates their administration especially in small animals.
Within this group of drugs, there are two that have been shown to be effective for the treatment of
It is important to document some of the pharmacodynamic properties of the benzimidazoles. Its mechanism of action is to produce the degeneration of the parasite microtubule and irreversibly block the uptake of glucose by the parasite; in this case,
Regarding their kinetic behavior, benzimidazoles are absorbed marginally after oral administration; blood levels in calves are 0.11 μg/ml and in horses are 0.07 μg/ml, whereas in canines and felines at levels of up to 0.2 μg/ml, allowing it to have a high volume of distribution [11, 21], reaching sites where the parasites are in a hypobiotic form, hence showing their great quality in eliminating larvae in the state of hypobiosis. This family of drugs has a hepatic metabolism, by the simple action of the cytochromes P450, being the excretion between 44–50% by feces and 1% by urine.
It is important to describe that febantel is a prodrug, which presents first-pass metabolism, which transforms it after the metabolism in fenbendazole and albendazole, which makes it a very potent anti-giardia, by sum synergism [11, 17].
With regard to the safety of the drugs in this family, it is important to note that they are very safe, with a high safety margin, but they may also have some digestive problems such as vomiting and diarrhea, especially when doses higher than those suggested are given or intervals increased, such as three to five times a day [11, 12, 22]. In terms of renal and hepatic safety, the author has found that benzimidazoles are very safe for both kidney and liver and are also very safe during gestation and lactation; no known contraindications for domestic species have been described and used at any age [11, 17, 22].
Benzimidazole treatment for the management of
In a study conducted by Molina, Salazar and Cabreraet (2016), it was found that fenbendazole was 60% effective for the control of
In cats, the treatment has been found to be effective with febantel 37.8 mg/kg, oral every 24 h for 5 days [23], whereas the dose in canines is equal, 100% effectiveness is achieved with only 3 days of treatment, in which the number of cysts in the proportion discussed above is eliminated [34].
The uses of other benzimidazoles such as albendazole at a dose of 25 mg/kg every 12 h for 4 days have been shown to be effective in killing infected animals [22]. However, therapy with albendazole may cause bone marrow suppression and therefore should be used with caution in canines and felines, in a case of acute giardiasis [22]. In sheep, the use of albendazole at doses of 20 mg/kg oral once daily is sufficient to control
Other benzimidazoles, such as mebendazole, have been found to be only 37% effective against giardiasis; thus their use is impractical [12].
Some authors have described the use of antibiotics for the treatment of
The study of the pharmacodynamics of this antibiotic will allow us to understand its giardicidal ability; furazolidone interferes with susceptible bacterial or parasitic enzymatic systems, within which we can indicate that it has activity against
As for pharmacokinetics, the information is somewhat contradictory regarding the absorption characteristics of furazolidone; it is absorbed orally and reaches in the different body fluids, with concentrations sufficient to exert an effective antibacterial action. Its absorption is fast in the small intestine, but prefers media with acid pH, with little water solubility. Its metabolism is hepatic with a half-life of 30 min, and its binding to plasma proteins is 60%, which causes most of it to be excreted in urine [17–19].
The suggested dose for the treatment of giardiasis in dogs and cats is 4 mg/kg, orally every 12 h for 7 days [12, 22]; in the case of cats, it has been recommended that the dose should be given per 10 days [11, 21].
This drug is currently one of the least used, basically because of its side effects that are sometimes annoying; this drug has properties and activities against a variety of protozoa and helminths. Its use against all except Giardia and Trichomonas has been replaced by agents safer or more effective [12, 21, 22], as we have already discussed.
In humans, quinacrine may be used for the treatment of mild-to-moderate discoid lupus erythromatosis (LE), transcervically as a sterilizing agent, or as a powder as an intrapleural sclerosing agent [11].
As for its mechanism of action, quinacrine has its antiprotozoal activity against Giardia not understood; however, it binds to DNA by intercalation at adjacent base pairs, thus inhibiting RNA transcription and translocation [11, 21, 22]. In addition, quinacrine interferes with electron transport and inhibits the oxidation of succinate and cholinesterase, which binds to nucleoproteins that (in humans at least) can suppress the lupus erythromatosis cell factor [11, 21].
To know its pharmacokinetics, this product is absorbed well from the gastrointestinal tract, after the oral administration. It is distributed throughout the body, but CSF levels are only 1–5% of those found in plasma [12, 22]. The drug is concentrated in the liver, spleen, lungs, and adrenals [21]. It is relatively highly limited to plasma proteins in humans (80–90%). This can pass through the placenta, but only small amounts enter the breast milk. The elimination is slow, with a half-life of 5 days, with a slow liver metabolism, being eliminated almost entirely by the kidney, causing acidification of the urine, which increases its excretion via this pathway [11, 21].
It is important to know that is contraindicated its use in behavioral alterations, psoriasis and porphyria, very described in humans, more studies are missing in animals; it is clear that it should be handled with care in patients with hepatic disorders, since jaundice appears in addition to digestive signs such as anorexia, nausea, vomiting, and diarrhea, abnormal behaviors (“biting with fly,” agitation), pruritus, and fever. In addition to hypersensitivity, liver disease, anemia, corneal edema, and retinopathy, it should not be used in pregnant females to cross the placental barrier and also has milk elimination. In humans, it is responsible for hydrocephalus, and in rats, the neonatal mortality rate is increased. According to the FDA, this drug is category C, so it should not be used during gestation [11, 22].
While its therapeutic safety is poor, an overdose can cause death; the signs of intoxication are neurological, giving convulsions, delirium, and excitement, in addition to what was described above with gastrointestinal symptoms.
The recommended dosage for canines is 6.6 mg/kg every 12 h for 5 days [36]; other authors recommend 9 mg/kg orally every 24 h for 6 days [21]. For cats, the dose is 9 mg/kg, oral every 24 h for 6 days [37].
It is an antibiotic of the aminoglycoside family, whose bactericidal effect is the irreversible inhibition of the 30 S subunit of bacterial chromosomes, preventing the formation of the initiation complex between mRNA and ribosome [17, 18, 38], thereby inhibiting protein synthesis.
This drug is considered as an amebicide and anthelmintic directly by contact, although its mechanism of action is unknown. In human medicine, it has been used for the treatment of mixed enteritis including giardiasis [13, 28]; in addition, it acts as an intestinal bactericide of digestive bacterial flora, including ammonia-producing bacteria [13, 15].
Paromomycin exhibits a broad spectrum of action, including bacteria, protozoa, and helminths. It is active mainly against amoebas such as
Regarding pharmacokinetics, after oral administration, absorption may increase in situations in which the permeability of the intestinal mucosa is altered, such as inflammation or erosion of the epithelium [13], and elimination is by feces and via the kidneys slowly [15].
The recommended dosage for canines is 125–160 mg/kg, every 12 h for 5 days [25].
Nitazoxanide is a synthetic derivative drug of salicylamide, used as a broad-spectrum antiparasitic agent with proven effectiveness in protozoal infections and worms [9, 39–41]. It is approved for infections by parasites such as
This drug, initially explored in the equine species, was indicated in horses for the treatment of equine protozoal myeloencephalitis (EPM) caused by
The mechanism of action is to inhibit the enzyme pyruvate ferredoxin oxidoreductase (PFOR), disrupting the metabolism of the parasite; in addition, this mechanism prevents the transference of electrons preventing energy metabolism by the parasite [17]. In helminths, it inhibits the polymerization of tubulin in the parasite.
As far as pharmacokinetic data are concerned, they are well known in equines, where after oral administration, it is absorbed and transformed into tizoxanide (deacetyl-nitazoxanide); the maximum level is reached at 2–3 h; in humans, it is reached at 4 h, 99% of which is bound to plasma proteins [39], excreted by urine and bile, in the form of glucuronic acid [11, 22].
This drug is a prodrug, followed by its rapidly hydrolyzed administration to its active metabolite, tizoxanide, 99% of which binds to blood plasma proteins [39]. Peak concentrations are observed for 1–4 h after administration. It is excreted in the urine, bile, and feces [12]. Its mechanism of action is by the inhibition of tubulin in helminths [11]. In the case of protozoa, electron and biochemical resonance studies have shown that pyruvate ferridoxin oxidoreductase (PFOR) and, to a lesser extent, hydrogenase reduce ferredoxin, which is oxidized by the nitro group in position 5 over the nitroheterocyclic compounds such as nitazoxanide [39]. In these organisms, nitazoxanide is reduced to a toxic radical in an organelle of carbohydrate metabolism and the hydrogenosome which contains hydrogenase PFOR and ferredoxin [13, 15, 43].
After oral administration in horses, nitazoxanide is absorbed and rapidly converted to tizoxanide (deacetyl-nitazoxanide). Nitazoxanide levels are reached within 2–3 h and are not detectable 24 h after dosing, which is 99% bound to proteins and is metabolized in the liver and is excreted in urine, bile, and feces; glucuronic acid is the conjugation of the compound [39, 44].
Adverse effects are commonly reported, such as fever, anorexia, reduced appetite, lethargy, and depression (Rodríguez García et al., 2004, Delgado et al.). However, the reproductive safety of nitazoxanide has not been determined in pregnant females; it is categorized as drug B by the FDA, not used during gestation or lactation, and it has been considered that the LD 50 is 10 g/kg [11, 22, 39].
The recommended dosage for canines is 10 mg/kg every 24 h for 3 days [26]; in a study published by Cabrera and Molina, effectiveness found at 8 days of treatment was 43.75%, which increased at 30 days of treatment with 87.5% [45]. This finding differs from those found by other authors such as Moron-Soto et al. and other authors consulted [42, 46, 47], and totally contradictory with respect to human pediatric patients, where the effectiveness is 80% [48, 49].
In humans, one of the drugs of choice for protozoal infections is teclozan, which is a derivative of dichloroacetamide; its trade name is known as Falmonox® (Sanofi-Aventis®, Paris, France) and its dose varies between 25 and 50 mg/kg, every 24 h, for 5 days [17]. It is a drug of high efficacy and is considered safe, since it does not present teratogenic effects and its few side effects include flatulence, nausea, meteorism, headache, rush cutaneous, and urticaria. This drug acts in the intestinal lumen being effective in treating
The mechanism of action of teclozan in humans has been described as intervening in the phospholipid metabolism preventing the formation of arachidonic acid in the parasite, which has a lethal protozoan effect and has not been determined in studies in animal species [15, 17]. This product shows an efficiency of 60% in the treatment of giardiasis in children, when oral 10 mg/kg is given every 24 h [50]. It is important to discuss that the treatment of intestinal infections caused by protozoa and treated with teclozan has shown cure rates between 80 and 93% and with very few side effects and minimal relapse.
There are vaccines for the control of Giardiasis of Fort Dodge© Animal Health for giardia, called Giardia-Vax® for dogs and Giardia Fel-O® for cats, their effectiveness being questionable [2, 51]. It has been considered that their application according to the commercial house, should be done after 4 months of life, and repetitions every 4–6 months, which makes its use in third world countries, is not very useful, if we consider epidemiological data on the prevalence of parasites in America Latin American countries, which can reach 27%, with high prevalences such as those in Brazil and Argentina that are above 20% (prevalence). This is why the use of the Giardia-Vax® vaccine in Latin America has had little impact on the control of the disease.
In human medicine, a combination of nutritional intervention and phytotherapy is the first line of approach for the treatment of giardiasis, whereas in veterinary medicine, dietary manipulation is often combined with antiprotozoal chemotherapy. Another point to consider is the use of probiotic therapy which could be useful in preventing infection or as an adjunct to the treatment of it; in this vein, the use of commensal bacteria can determine the vulnerability and the resistance to Giardia infection in mice. The use of probiotic lactobacilli releases a low molecular weight thermosensitive factor that inhibits the proliferation of Giardia trophozoites in in vitro culture. These modern therapeutic strategies justify further investigation which could prove to be more applicable and useful than drugs for the treatment in endemic regions [8, 52].
In any case, part of the control of the agent is to improve sanitary conditions, avoid contamination of water and food with cysts of the parasite, and control of more frequent parasites in hostile environments, that is, deworming programs every 3–4 months, especially for the canine species, with effective products such as benzimidazoles and especially fenbendazole and in particular the hygiene of pets with the use of baths with detergent products based on chlorhexidine, irgasan, and benzoyl peroxide (Table 1).
Drug | Dose canine | Dose feline |
---|---|---|
Metronidazole | 10–25 mg/kg BID for 5–8 days | 15–25 mg/kg BID for 8 days |
Secnidazole | 30 mg/kg SID for 1–3 days | |
Tinidazole | 10–44 mg/kg SID for 3 days | 15 mg/kg BID for 3 days |
Albendazole | 25 mg/kg BID for 4 days | 25 mg/kg BID for 4 days |
Fenbendazole | 50 mg/kg SID for 3 days | 50 mg/kg SID for 3 days |
Febantel | 37.8 mg/kg SID for 3 days | 37.8 mg/kg SID for 3 days |
Furazolidona | 4 mg/kg BID for 7 days | 4 mg/kg BID for 7 days |
Quinacrina | 6.6–9 mg/kg SID, BID for 5–6 days | 9 mg/kg BID for 6 days |
Paromomicina | 125–160 mg/kg BID for 5 days | |
Nitazoxanida | 10 mg/kg SID for 3 days | |
Teclozan | 10 mg/kg SID for 3 days |
Drugs used in canines and felines for the treatment of giardia intestinalis.
The World Health Organization (WHO) considers schistosomiasis the most important water-based disease in the world. The disease is caused by infection with trematodes of the genus
The life cycle of the most important human
The damage caused by schistosomiasis results from the movement of eggs through host tissue, which triggers an inflammatory response and acute, chronic disease. Schistosomes (as members of the genus
Due to increased human population growth, anthropogenic environmental changes, and global movements of humans and animals, there are increasing reports of hybridization events among
The two major
The number of deaths attributable to schistosomiasis is difficult to estimate because of hidden pathologies such as liver and kidney failure, bladder cancer and ectopic pregnancies; in addition, the death rate may have decreased over the past decade due to the implementation of large-scale preventive chemotherapy campaigns [3].
The most prevalent species in Africa,
Chronic disability is far more common than death. Intestinal schistosomiasis can result in abdominal pain, diarrhea, and blood in the stool. Liver enlargement is common in advanced cases, and is frequently associated with an accumulation of fluid in the peritoneal cavity and hypertension of the abdominal blood vessels. In such cases, there may also be enlargement of the spleen. Hematuria is the classic sign of urogenital schistosomiasis. Fibrosis of the bladder and ureter, bladder cancer, and kidney damage are sometimes diagnosed in advanced cases. In women, urogenital schistosomiasis may present with genital lesions, vaginal bleeding, pain during sexual intercourse, and nodules in the vulva. In men, urogenital schistosomiasis can induce pathology of the seminal vesicles, prostate, and other organs. This disease can also have other long-term irreversible consequences, including infertility. In children, schistosomiasis can cause anemia, stunting and a reduced ability to learn (although the effects are usually reversible with treatment). Praziquantel is the drug of choice for the treatment of schistosomiasis. The drug is recommended for the treatment of all forms of schistosomiasis. Despite that reinfection may occur after treatment, the risk of developing the severe disease is reduced after initiation of treatment [3].
The prevalence of human schistosomiasis in Africa is estimated to be 192 million, which is 93% of the total global prevalence of the disease. About 29 million people are infected by this disease in Nigeria, 19 million in Tanzania, and 15 million each in the Democratic Republic of Congo and Ghana, while Mozambique, with 13 million cases, completes the list of five countries with the greatest prevalence in Africa [5]. The heavy burden of schistosomiasis in Africa is attributed to limited access to clean water, poor sanitation and inadequate health services [2].
In Africa, animal schistosomiasis is a common parasitic infection among cattle, although it rarely infects other domestic animals such as goats and sheep; nor does it appear to trouble wild rodents and primates [6]. It is estimated that 165 million domestic cattle are affected by schistosomiasis worldwide. The disease is of veterinary and economic significance [7]. In China, 1.5 million cattle suffer from schistosomiasis, and more than 5 million are at risk of infection [8]. Schistosomiasis among livestock does not show clinical effects in most cases. However, if the infection persists for a long time, it can cause enteritis and anemia, as well as emaciation leading to significantly reduced productivity and growth, and even death [9]. Schistosomiasis in animals is caused by several
The three species with significant animal health impact in Africa are
The distribution of
Like a human, animals are treated for schistosomiasis through the administration of praziquantel. Effective treatment requires two rounds 3 to 5 weeks apart. However, unlike human schistosomiasis, which is frequently controlled by preventive praziquantel chemotherapy in areas where the infection is endemic [15], schistosomiasis in domestic animals is rarely treated in Africa, probably because little attention has been given by scientists to its zoonotic potential.
Environmental and ecological changes due to natural phenomena and anthropogenic activities break species isolation barriers and increase the possibility of acquiring new infections of both human and animal origin. This can lead to the occurrence of multiple infectious species and strains within a single host [4]. Multiple infections of two or more genetically distinct agent species may permit heterospecific (between-species or between-lineage) mate pairings, resulting in the production of a new offspring (species) that can be either infertile or fertile. This process is called , and control [4]. They are characterized by heterotic alterations, speciations, neo-functionalization, and adaptations, called hybrid vigor [16]. Hybrid vigor may increase parasite virulence, transmission potential, resistance, pathology, host use and can lead to the emergence of new diseases [17, 18]. Moreover, hybridization can influence parasite acquisition of novel genotypes, potentially expanding their geographical and host range and leading to novel ecological adaptations detrimental to human and animal populations [17, 20].
Trematode worms of the genus
Evidence of the potential occurrence of natural hybridization within and between human and animal
Typical morphologies of
It was not until 1980, after the invention of biochemical marker technology, that the detection of previously suspected
The number of reported
Several
There is geographic overlapping between different
Natural introgressive hybridization between
The natural hybridization events documented between animal (livestock)
The most important and interesting schistosome hybridization is that between human and animal schistosome species (e.g.,
Distribution of
Zoonotic diseases (also known as zoonoses) are those diseases caused by viruses, bacteria, fungi or parasites that are naturally transmitted between humans and other vertebrate animals [18, 34]. Currently, six main species of
Recent studies have reported evidence of some unique schistosomiasis transmission events in Africa. It had been believed that
The magnitude of
Schematic presentation of the causes and consequences of schistosome hybridization.
The ongoing emergence (or discovery) of potential zoonotic
Recent years have witnessed an increased interest in the control and, finally, elimination of Neglected Tropical Diseases (NTDs), and today the control of schistosomiasis has again become a priority on the agenda of many governments, donors, pharmaceutical companies and international agencies [40]. WHO has developed several road maps for NTDs, and many African countries have made significant progress by rolling out national action plans and programs targeting schistosomiasis control and elimination [41, 42]. Preventive chemotherapy is the main strategy for schistosomiasis control in Africa, supplemented with water, sanitation and hygiene (WASH) interventions in some regions [43].
Current control of human schistosomiasis in Africa is based on preventive chemotherapy, whereby populations are mass-treated with anthelminthic praziquantel administered in the standard single oral dose of 40 mg/kg body weight. Treatment with praziquantel is currently the strategy of choice and is endorsed by WHO [41, 43]. The ambitious goals of control and eventual elimination are underpinned by targets that require countries to reach at least 75% treatment coverage of school-age children and at-risk adults, with mass drug administration schedules and the designation of target groups depending on schistosomiasis endemicity [43]. This coverage goal is endorsed for schistosomiasis and soil-transmitted helminths in the 2012–2020 WHO road map for NTDs, in which preventive chemotherapy was identified as a key strategy for tackling NTDs [42, 44].
Over the past decade, significant progress has been made on large-scale treatments through integrated control of schistosomiasis and other NTDs. It is estimated that at least 236.6 million people required preventive treatment for schistosomiasis in 2019, of which more than 105.4 million (about 45%) were reported to have been treated [45]. In Africa, 17 countries out of the 40 that require preventive chemotherapy had not achieved the 75% treatment coverage target for school-age children during 2018, when a total of 69.1 million school-age children were treated, representing overall coverage of 62.9% [46]. In general, annual mass drug administration of preventive chemotherapy has had a significant effect on infection prevalence, intensity and associated morbidity among school-age children [47, 48, 49]. However, disease reoccurrence and persistent transmission suggest a need for more intense control measures to achieve the goal of schistosomiasis elimination.
Since the adoption of the World Health Assembly Resolution WHA 65.21 and NTDs road map 2021–2030, schistosomiasis control programs have shifted from morbidity control to disease elimination [41]. However, gaps continue to be observed in the implementation of control programs in Africa. Mass drug administration programs commonly overlook large numbers of preschool-age children, adolescents and adults, thus increasing health inequality and the risk of reinfections of previously treated groups [50]. Schistosomiasis cannot be eliminated in communities where mass drug administration is not ongoing. In the past, a key bottleneck to the implementation of preventive chemotherapy for control of schistosomiasis in Africa was the limited access to praziquantel [51]. Though there is now growing access to this medication for schistosomiasis control in Africa, it is not at the level that is projected to be necessary to reach all people who are at risk or who require treatment [52]. Analysis of data reported on treatment coverage for schistosomiasis shows that utilization of available praziquantel by NTD programs is not yet optimal in many countries [46, 52].
Praziquantel is the drug of choice for the treatment of schistosomiasis, as it is considered cost-effective, relatively safe, inexpensive and efficacious; also, donor organizations are willing to provide the drug [53]. Despite increased efforts to control schistosomiasis using preventive chemotherapy, several challenges still exist in reaching the target populations. Until recently, preschool-age children, as well as at-risk adults such as fishery workers, have not been included in many mass drug administration programs despite the evidence of schistosomiasis infection among these populations [54, 55]. This increases health inequality and the accumulation of potentially irreversible morbidities due to prolonged infection [56].
A major challenge now lies in the unavailability of a child-size formulation of praziquantel [56, 57]. The currently available formulation presents several limitations: (a) It is a large tablet, which is difficult for young children and infants to swallow and thus must be broken and crushed to allow for safe uptake. (b) It has a very bitter taste, and so is often mixed with a sweetener to make it palatable to young children. (c) The current formulation of 600 mg does not allow for flexible-dose adjustments for this age group.
Clean water provision, sanitation and hygiene are critical components of the global NTD roadmap [41]. For schistosomiasis, improved sanitation across the entire community to prevent contaminated feces and urine from reaching surface water can reduce or eliminate transmission, by stopping worm eggs in feces and urine from entering water sources, which are the snail habitat [58]. The aim of United Nations Sustainable Development Goal 6 (SDG 6) is to ensure the availability and sustainable management of water and sanitation for all by 2030. WASH interventions are among the most important measures used to control water-related diseases in Africa. However, sanitation, hygienic practices, and access to clean water are inadequate in large parts of Africa where schistosomiasis is endemic [59]. According to the United Nations Children’s Fund, in 2020 more than two-thirds of the African population did not have basic sanitation services and about 18% practiced open defecation. Ethiopia, Uganda, Kenya and Tanzania had the largest numbers of people in the continent without access to basic sanitation services, while Eritrea, South Sudan and Ethiopia had the largest proportions and numbers of people practicing open defecation [60]. Furthermore, in Eastern and Southern Africa, about 50 million (over 27%) of school-age children had no access to sanitation services, while 117 million (62%) had no access to hand-washing facilities at school [60]. It has also been reported that nearly half of Africans do not have access to clean water and two-thirds lack access to sewage infrastructure [61]. A systematic review and meta-analysis of the relationship between safe water, adequate sanitation, good hygiene and schistosomiasis found that people with access to safe water were significantly less likely to acquire a
The Centers for Disease Control and Prevention define One Health as a collaborative, multispectral transdisciplinary approach applied at the local, regional, national and global levels, with the goal of achieving optimal health outcomes that recognize the interconnection among people, animals, plants and their shared environment [63]. The One Health approach is a collaborative effort between the human health, animal health and environmental sectors to attain optimal health for people, animals and the environment. Over 60% of emerging, re-emerging and endemic human diseases have their origins in animals [64]. Humans are at increased risk of contracting diseases of animal origin because of a wide range of interconnected variables, including mass urbanization, large-scale livestock production and increased travel [64]. Therefore, efforts to unite the sectors working to protect humans and animals and the ecosystem are of paramount significance.
The recurrent hybridization between
Schematic presentation of the proposed one health framework for controlling zoonotic schistosomiasis in Africa.
Snail control can be attempted through snail habitat modifications such as altering flow rate and water levels so as to disturb snail habitat and disrupt snails’ food sources. Such modifications include constructing V-shaped banks in irrigation channels, removing vegetation and draining water sources that serve no special purpose for humans, wildlife or livestock [67]. Biological control of snails using nonsusceptible competitor snails has been reported to be successful in the Caribbean region [69], although it is important not to run the risk of importing potentially invasive snails. Snail control may also be accomplished through molluscicide application; however, since molluscicides have not been notably effective in past efforts, and may cause damage to other organisms [70], the application should be targeted, and carefully monitored rather than widespread [67].
As part of ongoing mass drug administration campaigns, other human interventions should be considered. Therefore, WASH providers must prioritize the reduction of inequality to align with the Sustainable Development Goals agenda, as developed in the recent WASH strategy to accelerate and sustain progress on NTDs [71]. Water scarcity can result in the sharing of water sources between people and animals, which can increase the risk of zoonotic diseases. Improving access to clean water by supplying tap water or wells at homes [65], accompanied by behavioral changes such as avoiding swimming, wading, washing or bathing in contaminated ponds, rivers and lakes, would help to prevent human contact with
The most effective way of controlling zoonotic schistosomiasis in livestock is also through keeping susceptible domestic animals from coming into contact with infested water. This can be achieved by preventing livestock grazing in infested wetlands, fencing infested water sources and supplying drinking water to the animals in troughs [73]. Apart from reducing the risk of infections to the animals, these measures will also prevent contaminated excreta from livestock from entering freshwater sources. Susceptible animals used in wetland areas for agriculture purposes should be replaced with nonsusceptible species or with farm machinery if the purpose of animals’ use is mechanical management. Periodic examination and treatment of susceptible livestock should be conducted. However, reinfection may occur quickly if the source of contamination is left uncontrolled. Regarding wild animals, high-density populations of susceptible wildlife increase the potential for disease transmission. Interaction between livestock and wildlife should be prevented wherever possible, and supplementary feeding of wild animals close to water sources should be avoided. Lastly, scientists and funders should invest in finding
Strong social, economic and political commitments are key elements in successful schistosomiasis control, which requires persistent efforts and a systematic step-by-step approach with increasingly ambitious targets to reach elimination [35]. The disease context is complex, with the interplay of social, economic, political and cultural factors [20, 27] that may affect the attainment of the goals of the NTD 2021–2030 road map [28]. Concurrent treatment of zoonotic
Given the potential impact of schistosomiasis on animal health and productivity, a One Health economic evaluation of extending treatment to animal hosts in Africa appears warranted, and requires data to be gathered on the costs and benefits to both the animal and human health sectors. To assess the economics of One Health interventions, the impacts on both sectors need to be integrated so that decision-makers in both sectors can assess and interpret outcomes in a way that is meaningful both to their sector and to society [74]. In light of these challenges, there is a need to revisit the current approach to schistosomiasis control among African countries irrespective of the level of endemicity.
Since the novel zoonotic
The authors declare that there are no conflicts of interest.
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',metaTitle:"Horizon 2020 Compliance",metaDescription:"General requirements for Open Access to Horizon 2020 research project outputs are found within Guidelines on Open Access to Scientific Publication and Research Data in Horizon 2020. The guidelines, in their simplest form, state that if you are a Horizon 2020 recipient, you must ensure open access to your scientific publications by enabling them to be downloaded, printed and read online. Additionally, said publications must be peer reviewed. ",metaKeywords:null,canonicalURL:null,contentRaw:'[{"type":"htmlEditorComponent","content":"Publishing with IntechOpen means that your scientific publications already meet these basic requirements. It also means that through our utilization of open licensing, our publications are also able to be copied, shared, searched, linked, crawled, and mined for text and data, optimizing our authors' compliance as suggested by the European Commission.
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From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. 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Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. 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Micro and Macro Perspectives"},signatures:"Janos Csapo",authors:[{id:"118766",title:"Dr.",name:"János",middleName:null,surname:"Csapó",slug:"janos-csapo",fullName:"János Csapó"}]},{id:"35712",doi:"10.5772/37101",title:"What Women Want: Hotel Characteristics Preferences of Women Travellers",slug:"what-women-want-hotel-characteristics-preferences-of-women-travellers",totalDownloads:7624,totalCrossrefCites:8,totalDimensionsCites:11,abstract:null,book:{id:"2298",slug:"strategies-for-tourism-industry-micro-and-macro-perspectives",title:"Strategies for Tourism Industry",fullTitle:"Strategies for Tourism Industry - Micro and Macro Perspectives"},signatures:"Azizan Marzuki, Tan Lay Chin and Arman Abdul Razak",authors:[{id:"111261",title:"Associate Prof.",name:"Azizan",middleName:null,surname:"Marzuki",slug:"azizan-marzuki",fullName:"Azizan Marzuki"},{id:"118609",title:"Ms.",name:"Lay Chin",middleName:null,surname:"Tan",slug:"lay-chin-tan",fullName:"Lay Chin Tan"},{id:"118610",title:"Mr.",name:"Arman",middleName:null,surname:"Abdul Razak",slug:"arman-abdul-razak",fullName:"Arman Abdul Razak"}]},{id:"35718",doi:"10.5772/37137",title:"The Bottom-Up Approach of Community-Based Ethnic Tourism: A Case Study in Chiang Rai",slug:"the-bottom-up-approach-of-community-based-ethnic-tourism-a-case-study-in-chiang-rai",totalDownloads:8423,totalCrossrefCites:6,totalDimensionsCites:11,abstract:null,book:{id:"2298",slug:"strategies-for-tourism-industry-micro-and-macro-perspectives",title:"Strategies for Tourism Industry",fullTitle:"Strategies for Tourism Industry - Micro and Macro Perspectives"},signatures:"Polladach Theerapappisit",authors:[{id:"111426",title:"Dr.",name:"Polladach",middleName:null,surname:"Theerapappisit",slug:"polladach-theerapappisit",fullName:"Polladach Theerapappisit"}]},{id:"35710",doi:"10.5772/38549",title:"A Model for Assessing the Level of Tourism Impacts and Sustainability of Coastal Cities",slug:"a-model-for-assessing-the-level-of-tourism-impacts-and-sustainability-of-coastal-cities",totalDownloads:8430,totalCrossrefCites:0,totalDimensionsCites:9,abstract:null,book:{id:"2298",slug:"strategies-for-tourism-industry-micro-and-macro-perspectives",title:"Strategies for Tourism Industry",fullTitle:"Strategies for Tourism Industry - Micro and Macro Perspectives"},signatures:"Beser Oktay Vehbi",authors:[{id:"117933",title:"Dr.",name:"Beser",middleName:null,surname:"Oktay Vehbi",slug:"beser-oktay-vehbi",fullName:"Beser Oktay Vehbi"}]},{id:"35713",doi:"10.5772/38798",title:"New Challenges for Tourism Destination Management in Romania",slug:"new-challenges-for-tourism-destination-management-in-romania",totalDownloads:10539,totalCrossrefCites:4,totalDimensionsCites:9,abstract:null,book:{id:"2298",slug:"strategies-for-tourism-industry-micro-and-macro-perspectives",title:"Strategies for Tourism Industry",fullTitle:"Strategies for Tourism Industry - Micro and Macro Perspectives"},signatures:"Gabriela Tigu",authors:[{id:"119493",title:"Dr.",name:"Gabriela",middleName:null,surname:"Tigu",slug:"gabriela-tigu",fullName:"Gabriela Tigu"}]}],mostDownloadedChaptersLast30Days:[{id:"35717",title:"Cultural Districts, Tourism and Sustainability",slug:"cultural-districts-tourism-and-sustainability",totalDownloads:2419,totalCrossrefCites:2,totalDimensionsCites:2,abstract:null,book:{id:"2298",slug:"strategies-for-tourism-industry-micro-and-macro-perspectives",title:"Strategies for Tourism Industry",fullTitle:"Strategies for Tourism Industry - Micro and Macro Perspectives"},signatures:"Giulio Maggiore and Immacolata Vellecco",authors:[{id:"118072",title:"Dr.",name:"Immacolata",middleName:null,surname:"Vellecco",slug:"immacolata-vellecco",fullName:"Immacolata Vellecco"},{id:"118597",title:"Dr.",name:"Giulio",middleName:null,surname:"Maggiore",slug:"giulio-maggiore",fullName:"Giulio Maggiore"}]},{id:"35715",title:"The Role and Importance of Cultural Tourism in Modern Tourism Industry",slug:"the-role-and-importance-of-cultural-tourism-in-modern-tourism-industry",totalDownloads:41028,totalCrossrefCites:29,totalDimensionsCites:56,abstract:null,book:{id:"2298",slug:"strategies-for-tourism-industry-micro-and-macro-perspectives",title:"Strategies for Tourism Industry",fullTitle:"Strategies for Tourism Industry - Micro and Macro Perspectives"},signatures:"Janos Csapo",authors:[{id:"118766",title:"Dr.",name:"János",middleName:null,surname:"Csapó",slug:"janos-csapo",fullName:"János Csapó"}]},{id:"71088",title:"Public Sector Organizational Culture: Experience from Frontline Bureaucracies",slug:"public-sector-organizational-culture-experience-from-frontline-bureaucracies",totalDownloads:868,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"This chapter discusses the practice of organizational culture by the frontline bureaucrats in Bangladesh. Culture scholars argue that organizational culture—commonly defined as the beliefs, values, attitudes, and practices of the members of an organization—is a powerful force in determining the health and well-being of an organization. Scholars also suggest the existence of different dimensions of organizational culture. Although they do not agree in naming these dimensions, commonalities are found in their understanding. How organizational culture is practiced by the frontline bureaucrats in Bangladesh has not been studied much. A study was designed to know how the frontline public bureaucrats practice organizational culture and how they differ in their practices along their service lines. Four dimensions of organizational culture—power distance, uncertainty avoidance tendency, participation, and team orientation—were considered. The chosen culture dimensions impact the overall management of any public sector organization. Three hundred and twenty-six frontline public bureaucrats were studied using a survey questionnaire. Both descriptive and inferential statistics have been used for analyzing the collected data. Findings from independent samples t-tests revealed that the frontline bureaucrats significantly differ along their service lines in practicing the culture dimensions.",book:{id:"7807",slug:"a-closer-look-at-organizational-culture-in-action",title:"A Closer Look at Organizational Culture in Action",fullTitle:"A Closer Look at Organizational Culture in Action"},signatures:"Md. Morshed Alom",authors:[{id:"314259",title:"Ph.D.",name:"Md. Morshed",middleName:null,surname:"Alom",slug:"md.-morshed-alom",fullName:"Md. Morshed Alom"}]},{id:"72449",title:"Communication and Organizational Culture",slug:"communication-and-organizational-culture",totalDownloads:756,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"When people in an organization understand themselves and their context of interaction from very different perspectives, there is an increased risk of poor organizational dialogue. The reason is not only that individuals’ social interpretations of others are influenced by their idiosyncratic perspectives. In interactions involving a significant diversity of individual perspectives, there is also a risk that communicators form radically different interpretations of goals and processes in the organization. It is therefore of crucial importance that people have a sufficiently similar understanding of action-guiding information, communicative acts and the workplace itself. The chapter focuses on the importance of creating shared organizational culture on the basis of four communication conditions from social interaction theory. (1) In communicative processes, senders need to secure the attention of audiences. (2) Senders and audiences need to have a sufficiently similar understanding of the language that is used. (3) Senders and audiences need to interpret communicative acts in a sufficiently similar way. (4) The attitudes and values that audiences ascribe to senders must correspond to the values and attitudes that senders actually have. After having clarified these conditions, the chapter applies them to analyse fundamental organizational challenges. The final part of the chapter argues that the conditions can, typically on management levels, constitute conceptual tools for creating unifying communicative cultures. Furthermore, using the conditions (1)–(4) actively as a means for securing communication across a diversity of individual perspectives can contribute to reaching organizational goals, no matter how they are defined.",book:{id:"7807",slug:"a-closer-look-at-organizational-culture-in-action",title:"A Closer Look at Organizational Culture in Action",fullTitle:"A Closer Look at Organizational Culture in Action"},signatures:"Halvor Nordby",authors:[{id:"212169",title:"Prof.",name:"Halvor",middleName:null,surname:"Nordby",slug:"halvor-nordby",fullName:"Halvor Nordby"}]},{id:"72534",title:"Effects of Information Technologies on Organizational Culture: A Discussion Based on the Key Role of Organizational Structure",slug:"effects-of-information-technologies-on-organizational-culture-a-discussion-based-on-the-key-role-of-",totalDownloads:1072,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"This chapter discusses the influences of information technologies on cultural features of organizations with an emphasis on the concept of “organizational structure” because research shows that organizational culture and organizational structure are in a very close relationship. In this regard, it argues that information technologies can have direct and indirect effects on organizational cultures based on the information technologies’ influences on organizational structures and the processes, activities, and human relations within these structures. Underlining different and controversial approaches and findings in the literature, this study makes some deductions by referring to important features of information technologies and organizational culture. 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He obtained a Master’s degree in Public Health and PhD in Public Health and Epidemiology. He has a background in Clinical Medicine and has taken courses at higher diploma levels in public health from University of Transkei, Republic of South Africa, and African Medical and Research Foundation (AMREF) in Nairobi, Kenya. Dr. Kasenga worked in different places in and outside Malawi, and has held various positions, such as Licensed Medical Officer, HIV/AIDS Programme Officer, HIV/AIDS resource person in the International Department of Diakonhjemet College, Oslo, Norway. He also managed an Integrated HIV/AIDS Prevention programme for over 5 years. He is currently working as a Director for the Health Ministries Department of Malawi Union of the Seventh Day Adventist Church. Dr. Kasenga has published over 5 articles on HIV/AIDS issues focusing on Prevention of Mother to Child Transmission of HIV (PMTCT), including a book chapter on HIV testing counseling (currently in press). 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