Alweer een jaar geleden diende Kamerlid Pieter Omtzigt, samen met een aantal andere Kamerleden een motie in om de Commissie van Venetië om advies te vragen. De Europese Commissie voor Democratie... Show moreAlweer een jaar geleden diende Kamerlid Pieter Omtzigt, samen met een aantal andere Kamerleden een motie in om de Commissie van Venetië om advies te vragen. De Europese Commissie voor Democratie door Recht, ook wel de Commissie van Venetië, is een adviserend orgaan van de Raad van Europa dat zich richt op het bevorderen van het constitutioneel recht en de democratische orde in Europa. Dit verzoek tot advies kwam niet uit de lucht vallen: drie jaar eerder, in 2018, kwam de toeslagenaffaire aan het licht. Deze affaire richtte de schijnwerpers op de mazen in de Nederlandse wet en rechtsstaat. Na het aannemen van de motie op 25 februari 2021 kwam 18 oktober 2021 eindelijk de reactie van de Commissie. Op welke vlakken zijn onze democratie en rechten beschermd en waar liggen de verbeterpunten? Wat is de volgende stap voor een door affaire-aangetaste rechtsstaat? Show less
Pierneef, L.; Hooij, A. van; Taal, A.; Rumbaut, R.; Nobre, M.L.; Brakel, W. van; Geluk, A. 2021
Background Leprosy elimination primarily targets transmission of Mycobacterium leprae which is not restricted to patients' households. As interruption of transmission is imminent in many countries,... Show moreBackground Leprosy elimination primarily targets transmission of Mycobacterium leprae which is not restricted to patients' households. As interruption of transmission is imminent in many countries, a test to detect infected asymptomatic individuals who can perpetuate transmission is required. Antibodies directed against M. leprae antigens are indicative of M. leprae infection but cannot discriminate between active and past infection. Seroprevalence in young children, however, reflects recent M. leprae infection and may thus be used to monitor transmission in an area. Therefore, this literature review aimed to evaluate what has been reported on serological tests measuring anti-M. leprae antibodies in children without leprosy below the age of 15 in leprosy-endemic areas. Methods and findings A literature search was performed in the databases Pubmed, Infolep, Web of Science and The Virtual Health Library. From the 724 articles identified through the search criteria, 28 full-text articles fulfilled all inclusion criteria. Two additional papers were identified through snowballing, resulting in a total of 30 articles reporting data from ten countries. All serological tests measured antibodies against phenolic glycolipid-I or synthetic derivatives thereof, either quantitatively (ELISA or UCP-LFA) or qualitatively (ML-flow or NDO-LID rapid test). The median seroprevalence in children in endemic areas was 14.9% and was stable over time if disease incidence remained unchanged. Importantly, seroprevalence decreased with age, indicating that children are a suitable group for sensitive assessment of recent M. leprae infection. However, direct comparison between areas, solely based on the data reported in these studies, was impeded by the use of different tests and variable cut-off levels. Conclusions Quantitative anti-PGL-I serology in young children holds promise as a screening test to assess M. leprae infection and may be applied as a proxy for transmission and thereby as a means to monitor the effect of (prophylactic) interventions on the route to leprosy elimination.Author summary Leprosy, a chronic infectious disease caused by Mycobacterium leprae (M. leprae), targets the skin and nerves and often results in irreversible disabilities as well as social exclusion. Though the disease can be efficiently treated, leprosy elimination is hampered by ongoing transmission of M. leprae. Currently, elimination is monitored by the number of new cases. Since only a small percentage of individuals infected with M. leprae develops disease, this does not accommodate monitoring of transmission. Previous studies have shown that antibody levels against M. leprae in blood correspond to the bacterial load in an individual and can be used as a proxy for infection, although antibodies cannot distinguish between past and present infection. In young children, infection is recent by definition, which allows assessment of more current state of transmission in an area. Thus, this literature review investigated studies on leprosy serology in children without leprosy. Our findings underscore that young children are a fitting group for up-to-date monitoring of M. leprae transmission in an area as seropositivity is inversely related with age. Importantly, a standardized, field-friendly test quantitatively measuring anti-M. leprae antibodies should be applied for population screening to monitor the status of transmission and thereby elimination in an area. Show less
