Andrea Sylvia Winkler

• MD Dr.med PhD Prof
• Senior Researcher at Technical University of Munich

The TS POC test, Taenia solium point-of-care test, is a two-strip lateral flow assay using the recombinant antigen rES33 on the TS POC T test strip, and rT24H on the TS POC CC test strip, to detect antibodies against T. solium taeniosis and cysticercosis, respectively. The objective of this study was to assess the diagnostic performance of the TS P...

Introduction The interplay between HIV and Taenia solium cysticercosis in co-endemic regions remains poorly understood, particularly regarding the immune responses but is relevant for an effective treatment strategy. This study aimed to investigate the relationship between peripheral cytokine profiles, CD4⁺ T-cell counts, and cysticercosis infectio...

Schistosomiasis is a serious public health problem in many African countries and beyond. Preventive chemotherapy with praziquantel is a successful public health intervention that is recommended for all communities at risk, commonly reached through large-scale mass drug administration campaigns. However, preschool-age children are currently not rout...

Introduction: Epilepsy is one of the most common neurological conditions worldwide, with large variation in prevalence across sub-Saharan African countries. Northern Uganda is one of the poorest areas of the country and has seen a high density of pigs and a prevalence of Taenia solium, a zoonotic tapeworm transmitted which causes neurocysticercosi...

Background Neurocysticercosis (NCC) and Acquired Human Immunodeficiency Syndrome (AIDS) are both highly prevalent in Africa. Clinical presentation of NCC ranges from asymptomatic to manifestations, including epileptic seizures, severe progressive headache, and focal neurological deficits. It is influenced by the number, size, location, and stage of...

Humanity is facing an important existential threat—irreversible climate change caused by human activity. Until recently, most of the proposals to address climate change have downplayed or ignored the adverse impact of food systems, especially intensive animal agriculture. This is in spite of the fact that up to a third of global greenhouse gas prod...

BACKGROUND Digital platforms play a vital role in improving the availability and access to health research outputs and enhancing the engagement of policymakers and practitioners in the research processes. Despite its potential, it needs to be explored how digital platforms are utilised to manage and share health research datasets and publications f...

Planet Earth is threatened by the human population. Energy and resource use are far beyond the planet’s carrying capacity. Planetary Health suggests an alternative idea of prosperity as the best possible human health for all within planetary boundaries. This implies giving priority to ecology because human health depends ultimately on the integrity...

Background Neurocysticercosis (NCC) is the main cause of epilepsy in Taenia solium endemic rural communities. NCC diagnosis is difficult due to unavailability and unaffordability of serologic assays and neuroimaging. This study aimed to assess the performance of a cheap, novel T. solium lateral-flow point-of-care (TS POC) test for the diagnosis of...

Background This systematic review analyzes the impact of COVID-19 on dementia patients' functional, cognitive, neuropsychiatric, and health related outcomes. It hypothesizes that dementia patients infected with SARS-CoV-2experience more pronounced deterioration compared to those who are uninfected. Methods Research from 01/03/2020 to 07/10/2023 wa...

Background The parasitic infection caused by Taenia solium represents a significant public health concern in developing countries. Larval invasion of body tissues leads to cysticercosis (CC), while central nervous system (CNS) involvement results in neurocysticercosis (NCC). Both conditions exhibit diverse clinical manifestations, and the potential...

Background This study aimed at describing the epidemiology of (neuro)cysticercosis as well as its clinical and radiological characteristics in a Taenia solium endemic district of Zambia. Methods This was part of a cross-sectional community-based study conducted in Sinda district to evaluate an antibody-detecting T. solium point-of-care (TS POC) te...

Background: We conducted this study to develop and rapidly assess a community-based health education package (CHEP) to serve as a guide to improving knowledge, attitude, and practices (KAP) for controlling T. solium cysticercosis Taeniasis (TSCT) in endemic areas in Tanzania. Methods: Data for the development of the (CHEP) was collected through a q...

The TS POC test, Taenia solium point-of-care test, is a two-strip lateral flow assay using the recombinant antigen rES33 on the TS POC T test strip, and rT24H on the TS POC CC test strip, to detect antibodies against T. solium taeniosis and cysticercosis, respectively. The objective of this study was to assess the diagnostic performance of the TS P...

Treating preschool age children (PSAC) for schistosomiasis has remained a challenge due to lack of a pediatric formulation. In response to this unmet need, the Paediatric Praziquantel Consortium has developed a potential novel paediatric treatment option. In advance to its roll-out to follow regulatory response, we conducted a social science study...

One Health (OH) has been recognized as an approach to enhance the health of the environment, plants, animals and humans and to promote global health security. However, implementing OH is difficult, since it requires effective and equitable collaboration, communication and sharing. The OH High-Level Expert Panel definition of OH sets principles of d...

Background: Taenia solium cysticercosis/taeniasis (TSCT) is reported to be endemic in pig producing areas around the world, causing significant disease burden and economic losses. Methods: This cross-sectional study aimed at assessing Knowledge, Attitudes and Practices (KAP) regarding TSCT in four districts, namely Mbulu, Mpwapwa, Mbinga, and Rungw...

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 obje...

Background Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditio...

Taenia solium Cysticercosis/Taeniasis (TSCT) is a neglected zoonotic disease with significant public health and socio-economic impacts. TSCT is endemic in areas with low socio-economic development. This study examined the influence of socio-demographic factors on community knowledge, attitude, and practices regarding TSCT control in Mbulu, Mpwapwa,...

Taenia solium cysticercosis and taeniosis (TSCT) are two forms of a zoonotic disease caused by T. solium tapeworm. Towards promotion of a One Health approach to the control of TSCT, we assessed TSCT reporting in the medical and veterinay sectors in Tanzania. We conducted a cross-sectional study between January and April 2020 in Babati and Mbulu dis...

Introduction The aim of this systematic review and meta-analysis was to evaluate the prevalence of thirteen neurological manifestations in people affected by COVID-19 during the acute phase and at three, six, nine and twelve-month follow-up time points. Methods The study protocol was registered with PROSPERO (CRD42022325505). MEDLINE (PubMed), Emba...

Background and purpose In 2016, we concluded a randomized controlled trial testing 1 mg rasagiline per day add‐on to standard therapy in 252 amyotrophic lateral sclerosis (ALS) patients. This article aims at better characterizing ALS patients who could possibly benefit from rasagiline by reporting new subgroup analysis and genetic data. Methods We...

The World Health Organization's Intersectoral Global Action Plan (IGAP) on Epilepsy and Other Neurological Diseases 2022–2031 is a holistic, interdisciplinary, and intersectoral plan with a strong focus on equity and human rights. The IGAP was unanimously approved by all World Health Organization Member States at the 75th World Health Assembly in M...

Introduction: Nodding Syndrome (NS) remains a poorly understood disorder. For a long time, it has been thought to be restricted to East Africa, however cases in Central Africa have been increasing over time. The objective of this systematic review (SR) was to provide a summary of the state of knowledge on NS to date. Methods: All original articles...

A BSTRACT Background Headache is the most common neurological side effect of coronavirus disease 2019 (COVID-19) vaccination. However, the underlying reason for COVID-19 postvaccine headache has not been fully understood. In this study, we addressed the potential association of vaccine-related headaches with a history of allergy, atopic diseases,...

Background Intestinal helminth infections are among the most common infections worldwide and have a negative impact on the health, education, nutrition and economic development of affected populations. This study aimed to estimate the prevalence of intestinal helminthiasis, including T. solium taeniasis, using a large-scale community-based study in...

Taenia solium porcine cysticercosis (PCC) is widespread in many low- and middle-income countries (LMICs) where free-range pig rearing is common and hygienic standards are subpar. A cross-sectional survey was conducted in 42 villages between June and September 2019 (14 in Songwe district, southwest Tanzania, and 28 in Kongwa district, central Tanzan...

Humanity is now facing what may be the biggest challenge to its existence: irreversible climate change brought about by human activity. Our planet is in a state of emergency, and we only have a short window of time (7–8 years) to enact meaningful change. The goal of this systematic literature review is to summarize the peer-reviewed literature on p...

Post-acute neurological sequelae of COVID-19 affect millions of people worldwide, yet little data is available to guide treatment strategies for the most common symptoms. We conducted a scoping review of PubMed/Medline from 1/1/2020–4/1/2023 to identify studies addressing diagnosis and treatment of the most common post-acute neurological sequelae o...

Background Pre-existing neurological diseases have been identified as risk factors for severe COVID-19 infection and death. There is a lack of comprehensive literature review assessing the relationship between pre-existing neurological conditions and COVID-19 outcomes. Identification of high risk groups is critical for optimal treatment and care....

Background Women’s empowerment is an important factor for HIV prevention, but the association with HIV-related indicators has never been quantified. In this study, we examined the association between women’s empowerment and selected HIV-related indicators. Methods We used the latest Demographic and Health Surveys that included HIV testing among ot...

Background Several studies on Taenia solium taeniosis / cysticercosis (TSTC) have been conducted in Zambia. However, none has assessed community knowledge, attitudes and practices related to TSTC and epilepsy. Methods A community-based cross-sectional study was conducted between November and December 2022. The design consisted of a questionnaire-b...

Background Intestinal helminth infections are among the most common infections worldwide and have a negative impact on the health, education, nutrition and economic development of affected populations. This study aimed to estimate the prevalence of intestinal helminthiasis, including T. solium taeniasis, using a large-scale community-based study in...

Previous studies have described the association of onchocerciasis (caused by Onchocerca volvulus) with epilepsy, including nodding syndrome, although a clear etiological link is still missing. Cases are found in different African countries (Tanzania, South Sudan, Uganda, Democratic Republic of the Congo, Central African Republic and Cameroon). In o...

Background Although meningitis is largely preventable, it still causes hundreds of thousands of deaths globally each year. WHO set ambitious goals to reduce meningitis cases by 2030, and assessing trends in the global meningitis burden can help track progress and identify gaps in achieving these goals. Using data from the Global Burden of Diseases,...

Background: Neurocysticercosis is a common cause of epilepsy in Taenia solium-endemic areas in sub-Saharan Africa but is often undiagnosed because of an absence of affordable diagnostic tools. This study evaluated the diagnostic accuracy of a T solium cysticercosis antibody-detecting lateral-flow point-of-care assay (TS POC test) for the neuroimag...

Background: Although meningitis is largely preventable, it still causes hundreds of thousands of deaths globally each year. WHO set ambitious goals to reduce meningitis cases by 2030, and assessing trends in the global meningitis burden can help track progress and identify gaps in achieving these goals. Using data from the Global Burden of Diseases...

Poor knowledge of human T. solium taeniasis/cysticercosis and insufficient sanitary and hygienic practices have been associated with the persistence of human T. solium infections in endemic areas. Community health education intervention measures were implemented in 42 villages of Kongwa and Songwe Districts to increase knowledge, improve good pract...

Background Neurocysticercosis (NCC) is common in eastern Africa, but disease presentation varies considerably. Most patients have single or few NCC-typical lesions in their brain but some present with a large number of lesions. We present three patients with positive antibody-based serology for Taenia solium cysticercosis screened at the Vwawa dist...

Taenia solium taeniasis/cysticercosis (TSTC) is a parasitic zoonotic disease that is endemic in several developing countries, causing serious public health and economic impacts. A cross-sectional study was conducted to assess knowledge, attitudes and practices (KAP) related to porcine cysticercosis (PCC) transmission, prevention and control among s...

Background Emerging and reemerging zoonotic diseases have become a global concern due to their frequent occurrence. Large delays between onset of emerging zoonotic disease outbreaks and their reporting and control are indicative of weak animal and human health systems. Objectives The objective of this paper is to tackle the time delay by suggestin...

For the first time since the foundation of the Global Health Hub Germany in 2019, the members voted on an overarching and crosscutting topic for 2022: mental Health and well-being. By choosing this topic, Community members aimed for a deeper understanding of the relevance of mental health for the work of various Hub Communities and to start a conve...

Background: Several studies on Taenia solium taeniosis / cysticercosis (TSTC) have been conducted in Zambia. However, none has assessed community knowledge, attitudes and practices related to TSTC and epilepsy. Methods: A community-based cross-sectional study was conducted between November and December 2022. The design consisted of a questionnaire-...

Abstract Burundi has one of the highest prevalence of stunting in the world. This study aimed to identify determinants of stunting among children under age five in Burundi. A total of 4993 children with anthropometric measurements from the 2016–2017 Burundi Demographic and Health Survey were included in the study. Stunting was assessed from the hei...

Introduction: Uniform case definitions are required to ensure harmonised reporting of neurological syndromes associated with SARS-CoV-2. Moreover, it is unclear how clinicians perceive the relative importance of SARS-CoV-2 in neurological syndromes, which risks under- or over-reporting. Methods: We invited clinicians through global networks, inc...

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. soli...

Purpose Neurocysticercosis is common in regions endemic for Taenia solium. Active-stage neurocysticercosis can be treated with antiparasitic medication, but so far no study on efficacy and safety has been conducted in Africa. Methods We conducted a prospective cohort study on treatment of neurocysticercosis in Tanzania between August 2018 and Janu...

Objective Taenia solium (T. solium) neurocysticercosis (NCC) affects the central nervous system and is associated with 30% of acquired epilepsy in some endemic areas. Epilepsy is a stigmatizing disease in many societies and people with epilepsy (PWE) and their families experience discrimination. This study aimed to explore the knowledge, perception...

Abstract Background Artificial Intelligence (AI) has great potential to transform health systems to improve the quality of healthcare services. However, AI is still new in Tanzania, and there is limited knowledge about the application of AI technology in the Tanzanian health sector. Objectives This study aims to explore the current status, challen...

Background The COVID-19 pandemic has led to a deepening of existing inequalities and a rollback of achievements made in gender equality. Women in Global Health (WGH) is a global movement that aims to achieve gender equality in health and increase female leadership in global health. Here, the aim was to understand how the pandemic affects the privat...

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Digital health is considered an opportunity to engage a wider community in disease control for public health. It has been used in healthcare consultation, in medical treatments and in reporting emergencies. The current study developed digital health literacy content for public health education and assessed its effects on porcine cysticercosis preva...

Background: Taenia solium is a tapeworm that causes taeniosis in humans and cysticercosis in humans and pigs. Within Eastern and Southern Africa (ESA), there are many countries in which information on the presence of human taeniosis and cysticercosis is missing. This systematic review aimed to describe the current information available and gaps in...

Background: With an estimated lifetime prevalence of epilepsy of 7.6 per 1,000 people, epilepsy represents one of the most common neurological disorders worldwide, with the majority of people with epilepsy (PWE) living in low-income and middle-income countries (LMICs). Adequately treated, up to 70 % of PWE will become seizure-free, however, as man...

Background Neurocysticercosis (NCC) is common among people with epilepsy in low-resource settings. Prevalence of NCC and radiological characteristics of patients with NCC vary considerably even within small areas but differences have been poorly characterized so far. Methods We conducted a cross-sectional study between August 2018 and April 2020 i...

Due to the high burden of mental health issues among students at higher education institutions world-wide, animal-assisted interventions (AAIs) are being used to relieve student stress. The objective of this study was to systematically review of the effects of AAIs on the mental, physiological, and cognitive outcomes of higher education students. R...

Background Neurocysticercosis (NCC), a zoonotic disease caused by the pork tapeworm T. solium, represents one of the most common causes of secondary epilepsy but remains often undiagnosed due to lack of awareness and diagnostic facilities. Methodology We pooled data from four cross-sectional studies on epilepsy and NCC in eastern Africa. Study sit...

Objectives Neurocysticercosis (NCC) is a parasitic disease caused by the larval stage of the tapeworm Taenia solium. NCC mainly occurs in Africa, Latin America and South-East Asia and can cause a variety of clinical signs/symptoms. Although it is a rare disease in Europe, it should nonetheless be considered as a differential diagnosis. The aim of t...

Porcine cysticercosis is endemic in Tanzania, especially in the Southern Highlands, Central areas and Northern Highlands regions of the country. It is a condition that reduces pork quality and suitability for human consumption and hence affecting public health and the pig industry. The prevalence and possible associated factors for porcine cysticer...

Background Epilepsy and neurocysticercosis (NCC) prevalence estimates in sub-Saharan Africa are still scarce but show important variation due to the population studied and different screening and diagnosis strategies used. The aims of this study were to estimate the prevalence of epileptic seizures and epilepsy in the sampled population, and the pr...

Background Epilepsy is one of the most common neurological disorders worldwide. Yet, its treatment gap is large in some areas and especially in sub-Saharan Africa data on clinical, radiological and semiological characteristics, as well as on treatment of persons with epilepsy (PWE) are still scarce. Methods We pooled data from four cross-sectional...

Background Community health education is one of the most effective measures to increase health literacy worldwide and can contribute to the achievement of specific targets of the Sustainable Development Goal 3. Digitalized health education materials can improve health knowledge as a dimension of health literacy and play an important role in disease...

Encephalopathy, a common condition among patients hospitalized with COVID-19, can be a challenge to manage and negatively affect prognosis. While encephalopathy may present clinically as delirium, subsyndromal delirium, or coma and may be a result of systemic causes such as hypoxia, COVID-19 has also been associated with more prolonged encephalopat...

Background Cysticercosis and Neurocysticercosis (NCC) can be studied using several animal species in experimental models which contributes to the understanding of the human form of the disease. Experimental infections of Taenia spp. are vital in explaining the modes of transmission of the parasite and helps the understanding of transmission of the...

Background Taenia solium (neuro-)cysticercosis, a neglected tropical disease, can be associated with epileptic seizures and other neuropsychiatric (= neurological and psychiatric) disorders. This study aimed to evaluate the association of T. solium cysticercosis with selected neuropsychiatric disorders and/or symptoms (chronic headache, epileptic s...

Background Geographical differences in health outcomes are reported in many countries. Norway has led an active policy aiming for regional balance since the 1970s. Using data from the Global Burden of Disease Study (GBD) 2019, we examined regional differences in development and current state of health across Norwegian counties. Methods Data for li...

Background: Taenia solium (neuro) cysticercosis/taeniosis (TSCT) is a zoonotic disease complex. There is a perceived inefficient diagnosis of infections by either form, the adult pork tapeworm (taeniosis) and the larval stage of it (cysticercosis), in low-income settings, including Tanzania. This study aimed at identifying potential gaps around TS...

Background Taenia solium cysticercosis/taeniasis (TSCT) is reported to be endemic in pig producing areas around the world, causing significant disease burden and economic losses. Methods This cross-sectional study aimed at assessing Knowledge, Attitudes and Practices (KAP) regarding TSCT in four districts, namely Mbulu, Mpwapwa, Mbinga, and Rungwe...

Introduction: Antimicrobial resistance (AMR) has a critical global impact, mostly affecting low- and middle-income countries. A major knowledge gap exists in understanding the transmission pathway of the gut colonisation with AMR bacteria between healthy humans and their animals in addition to the presence of those AMR bacteria in the surrounding...