Journal ArticlePublic health ethics · November 2025
The COVID-19 pandemic has revealed the complex interplay between national self-interest and global cooperation. Media communication can contribute to the formation of national identity and promote nationalist themes, particularly in times of crisis. Media ...
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Journal ArticleJ Infect Dis · October 6, 2025
BACKGROUND: Timely and accurate diagnosis of spotted fever rickettsioses (SFR) is difficult due to non-specific symptoms and testing challenges. We evaluated serum antibodies to tick salivary proteins, AV422 and calreticulin, as potential markers of recent ...
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Journal ArticleThe Journal of infectious diseases · October 2025
BackgroundWe investigated the prevalence, diversity, and risk factors for acute leptospirosis in the Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE) study.MethodsFebrile patients aged ≥2 months in Laos, Malawi, Mozamb ...
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Journal ArticleTrop Med Int Health · September 2025
OBJECTIVES: To inform patient management and disease prevention, we sought to estimate the prevalence of, and identify risk factors for, scrub typhus, murine typhus, and spotted fever group rickettsioses (SFGR) among febrile patients presenting to hospital ...
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Journal ArticleTrop Med Int Health · September 2025
OBJECTIVES: Rickettsioses are frequent causes of treatable febrile illness in Southeast Asia, including Myanmar. Accurate estimates of the incidence of rickettsioses are needed to inform investments in disease prevention and control. We sought to estimate ...
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Journal ArticleJ Infect Dis · August 19, 2025
BACKGROUND: Extraintestinal pathogenic Escherichia coli (ExPEC) are a leading cause of human bloodstream infections (BSI) in sub-Saharan Africa, yet few studies have characterized African strains implicated in BSI or explored their potential reservoirs. ME ...
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Journal ArticleJ Infect Dis · August 14, 2025
BACKGROUND: A periurban outbreak of Rift Valley fever virus (RVFV) among dairy cattle from May through August 2018 in northern Tanzania was detected through testing samples from prospective livestock abortion surveillance. We sought to identify concurrent ...
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Journal ArticlebioRxiv · July 31, 2025
BACKGROUND: Typhoid fever results from systemic infection with Salmonella enterica serovar Typhi (Typhi) and causes 10 million illnesses annually. Disease control relies on prevention (water, sanitation, and hygiene interventions or vaccination) and effect ...
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Journal ArticleVaccine · May 22, 2025
Enteric fever caused by Salmonella enterica serovars Typhi and Paratyphi A and, to a lesser extent, S. Paratyphi B and C, remains a significant cause of mortality and morbidity in resource-constrained settings. Typhoid conjugate vaccines (TCVs) protect aga ...
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Journal ArticleGenome Med · May 9, 2025
BACKGROUND: Salmonella enterica subspecies enterica serovar Typhi (abbreviated as 'Typhi') is the bacterial agent of typhoid fever. Effective antimicrobial therapy reduces complications and mortality; however, antimicrobial resistance (AMR) is a major prob ...
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Journal ArticleBMJ Glob Health · March 6, 2025
BACKGROUND: We conducted a randomised population-based cluster survey in northern Tanzania to assess care-seeking behaviours in the context of a febrile illness. Our objectives were to determine the most effective points for intervention during initial fev ...
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Journal ArticleAm J Trop Med Hyg · March 5, 2025
Acute Q fever diagnosis via paired serology is problematic because it requires follow-up for convalescent sample collection; as such, it cannot provide a diagnosis to inform a treatment decision at the time of acute presentation. Real-time polymerase chain ...
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Journal ArticleTrop Med Int Health · March 2025
BACKGROUND: Crimean-Congo hemorrhagic fever is a tick-borne zoonotic disease that may be severe and is present in many African countries. We aimed to understand the seroprevalence and risk for Crimean-Congo hemorrhagic fever virus in Tanzania by testing ar ...
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Journal ArticleTrop Med Int Health · March 2025
BACKGROUND: Acute febrile illness is a common reason for seeking healthcare in low- and middle-income countries. We describe the diagnostic utility of a TaqMan Array Card (TAC) real-time polymerase chain reaction (PCR) panel for pathogen detection in paedi ...
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Journal ArticleOpen Forum Infect Dis · March 2025
Spotted fever group rickettsioses (SFGR) pose a global threat as emerging zoonotic infectious diseases; however, timely and cost-effective diagnostic tools are currently limited. We used data from 449 patients presenting to 2 hospitals in northern Tanzania ...
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Chapter · 2025
Salmonella is named after D. E. Salmon, an American bacteriologist, who first isolated the bacteria from a pig intestine in 1884. The Salmonella bacteria is a Gram-negative, motile, hydrogen sulfide producing, an acid-labile facultative intracellular micro ...
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Journal ArticleOpen Forum Infect Dis · January 2025
BACKGROUND: Despite a high burden of sepsis in Sub-Saharan Africa, clinical data for adolescent and adult sepsis in this setting are limited. We sought to describe clinical characteristics, management, and outcomes in adolescents and adults with sepsis in ...
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Journal ArticlePLoS One · 2025
Neonatal bloodstream infections (BSI) make a substantial contribution to morbidity and mortality in low- and middle-income countries (LMICs), but data on the epidemiology and antimicrobial resistance (AMR) in Tanzania are limited. We describe the prevalenc ...
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Journal ArticleJournal of Public Health · January 1, 2025
Background: The World Health Organization’s convention, agreement or other international instrument on pandemic prevention, preparedness, and response, often referred to as the ‘pandemic treaty’, was established with principles to guide implementation. The ...
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Journal ArticleLancet Infectious Diseases · January 1, 2025
Background: Contemporary evidence on the incidence of typhoid fever is essential to inform decision making for typhoid prevention by vaccine introduction and non-vaccine measures. We aimed to update our previous systematic review and meta-analysis on the g ...
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Journal ArticleGates Open Research · January 1, 2025
In 2021, Salmonella Paratyphi A caused >2 million illnesses, resulting in >14,000 deaths, most of which occurred among children under 5 years of age in socioeconomically deprived populations. Both typhoid fever and paratyphoid fever occur in such areas, bu ...
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Journal ArticleOpen Forum Infect Dis · December 2024
BACKGROUND: Knowledge gaps exist on risk factors for spotted fever group rickettsioses (SFGR) in sub-Saharan Africa. We sought to identify SFGR risk factors in Kilimanjaro Region, Tanzania. METHODS: We recruited febrile patients presenting at 2 hospitals i ...
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Journal ArticleEClinicalMedicine · November 2024
BACKGROUND: Clinical severity scores can identify patients at risk of severe disease and death, and improve patient management. The modified early warning score (MEWS), the quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA), and the Univers ...
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Journal ArticleEmerg Infect Dis · October 2024
Campylobacteriosis and antimicrobial resistance (AMR) are global public health concerns. Africa is estimated to have the world's highest incidence of campylobacteriosis and a relatively high prevalence of AMR in Campylobacter spp. from humans and animals. ...
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Journal ArticleEmerging infectious diseases · August 2024
Bacterial zoonoses are established causes of severe febrile illness in East Africa. Within a fever etiology study, we applied a high-throughput 16S rRNA metagenomic assay validated for detecting bacterial zoonotic pathogens. We enrolled febrile patients ad ...
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Journal ArticleVaccine · July 25, 2024
Invasive non-typhoidal Salmonella (iNTS) disease is an under-recognized high-burden disease causing major health and socioeconomic issues in sub-Saharan Africa (sSA), predominantly among immune-naïve infants and young children, including those with recogni ...
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Journal ArticleLancet Regional Health Western Pacific · June 1, 2024
Background: Carbapenem resistant organisms (CROs) such as Acinetobacter baumannii (CRAb), Pseudomonas aeruginosa (CRPa), Escherichia coli (CREc), and Klebsiella pneumoniae (CRKp) have been identified by the World Health Organization (WHO) as global priorit ...
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Journal ArticleTrop Med Int Health · May 2024
BACKGROUND: In northern Tanzania, Q fever, spotted fever group (SFG) rickettsioses, and typhus group (TG) rickettsioses are common causes of febrile illness. We sought to describe the prevalence and risk factors for these zoonoses in a pastoralist communit ...
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Journal ArticleLancet Glob Health · April 2024
BACKGROUND: Typhoid Fever remains a major cause of morbidity and mortality in low-income settings. The Severe Typhoid in Africa programme was designed to address regional gaps in typhoid burden data and identify populations eligible for interventions using ...
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Journal ArticleBMJ Open · March 14, 2024
BACKGROUND: Invasive non-typhoidal Salmonella (iNTS) disease is a significant health concern in sub-Saharan Africa. While our knowledge of a larger-scale variation is growing, understanding of the subnational variation in iNTS disease occurrence is lacking ...
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Journal ArticleTrop Med Int Health · March 2024
OBJECTIVES: Leptospira, the spirochaete causing leptospirosis, can be classified into >250 antigenically distinct serovars. Although knowledge of the animal host species and geographic distribution of Leptospira serovars is critical to understand the human ...
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Journal ArticleVaccine · February 27, 2024
The World Health Organisation and many health experts have regarded vaccine nationalism, a "my country first" approach to vaccines procurement, as a critical pandemic response failure. However, few studies have considered public opinion in this regard. Thi ...
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Journal ArticleBMC Infect Dis · February 7, 2024
BACKGROUND: Leptospirosis is an underdiagnosed infectious disease with non-specific clinical presentation that requires laboratory confirmation for diagnosis. The serologic reference standard remains the microscopic agglutination test (MAT) on paired serum ...
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Journal ArticlePLoS Negl Trop Dis · February 2024
BACKGROUND: With more than 1.2 million illnesses and 29,000 deaths in sub-Saharan Africa in 2017, typhoid fever continues to be a major public health problem. Effective control of the disease would benefit from an understanding of the subnational geospatia ...
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Journal ArticleIntern Med J · February 2024
BACKGROUND: Cellulitis is a common acute skin and soft tissue infection that causes substantial morbidity and healthcare costs. AIMS: To audit the impact on cellulitis management, regimen tolerability and outcomes of switching from outpatient parenteral an ...
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Journal ArticleFront Cell Infect Microbiol · 2024
INTRODUCTION: There are multiple ongoing outbreaks of carbapenem resistant Acinetobacter baumannii (CRAb) infection in Fiji's hospitals. CRAb is able to colonize and persist on various hospital surfaces for extended periods. We conducted a study to underst ...
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Journal ArticleSci Rep · December 18, 2023
Diagnostic limitations challenge management of clinically indistinguishable acute infectious illness globally. Gene expression classification models show great promise distinguishing causes of fever. We generated transcriptional data for a 294-participant ...
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Chapter · December 14, 2023
Typhoid fever is an invasive bacterial disease associated with bloodstream infection that causes a high burden of disease in Africa and Asia. Typhoid primarily affects individuals ranging from infants through to young adults. The causative organism, Salmon ...
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Journal ArticlePLoS Negl Trop Dis · December 2023
BACKGROUND: Leptospirosis is suspected to be a major cause of illness in rural Tanzania associated with close contact with livestock. We sought to determine leptospirosis prevalence, identify infecting Leptospira serogroups, and investigate risk factors fo ...
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Journal ArticleLancet Regional Health Western Pacific · November 1, 2023
Background: Carbapenem resistant Acinetobacter baumannii (CRAb) is categorised by the World Health Organization (WHO) as a pathogen of critical concern. However, little is known about CRAb transmission within the Oceania region. This study addresses this k ...
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Journal ArticleEpidemiol Infect · October 18, 2023
To inform coverage by potential vaccines, we aimed to systematically review evidence on the prevalence and distribution of non-typhoidal Salmonella enterica serogroups and serovars. We searched four databases from inception through 4 June 2021. Articles we ...
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Journal ArticleAm J Trop Med Hyg · October 4, 2023
Globally, half of patients with pulmonary tuberculosis (PTB) are diagnosed clinically without bacteriologic confirmation. In clinically diagnosed PTB patients, we assessed both the proportion in whom PTB could be bacteriologically confirmed by reference st ...
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Journal ArticlemedRxiv · October 3, 2023
OBJECTIVES: Leptospira, the spirochaete causing leptospirosis, can be classified into >250 antigenically distinct serovars. Although knowledge of the animal host species and geographic distribution of Leptospira serovars is critical to understand the human ...
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Journal ArticleElife · September 12, 2023
BACKGROUND: The Global Typhoid Genomics Consortium was established to bring together the typhoid research community to aggregate and analyse Salmonella enterica serovar Typhi (Typhi) genomic data to inform public health action. This analysis, which marks 2 ...
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Journal ArticleOpen Forum Infect Dis · August 2023
BACKGROUND: We describe antibacterial use in light of microbiology data and treatment guidelines for common febrile syndromes in Moshi, Tanzania. METHODS: We compared data from 2 hospital-based prospective cohort studies, cohort 1 (2011-2014) and cohort 2 ...
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Journal ArticleBMJ Glob Health · August 2023
INTRODUCTION: Liberia was heavily affected by the 2014-2016 Ebola virus disease (EVD) outbreak. With substantial investments in interventions to combat future outbreaks, it is hoped that Liberia is well prepared for a new incursion. We assessed the perform ...
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Journal ArticleSci Rep · May 17, 2023
Dengue fever is a mosquito-borne viral infection, with rising incidence globally. Eastern Ethiopia has had dengue fever outbreaks in recent years. However, the extent to which the infection contributes to hospital presentation among children with fever in ...
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Journal ArticleOpen Forum Infect Dis · May 2023
Nontyphoidal Salmonella are a leading cause of community-onset bacteremia and other serious infections in sub-Saharan African countries where large studies indicate that they are an uncommon cause of moderate-to-severe diarrhea. Approximately 535 000 nonty ...
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Journal ArticleInt J Tuberc Lung Dis · February 1, 2023
Mycobacterium bovis has a wide host range causing TB in animals, both in wildlife and cattle (bovine TB bTB), and in humans (zoonotic TB zTB). The real burden of bovine and zoonotic TB (b/zTB) remains unknown due to diagnostic challenges. Although progress ...
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Journal ArticleSci Rep · November 10, 2022
We assessed the diagnosis, management and outcomes of acute febrile illness in a cohort of febrile children aged under 5 years presenting at one urban and two rural health centres and one tertiary hospital between 11 August 2019 and 01 November 2019. Pneum ...
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Journal ArticleTrans R Soc Trop Med Hyg · November 1, 2022
BACKGROUND: Human and animal cases of Rift Valley fever (RVF) are typically only reported during large outbreaks. The occurrence of RVF cases that go undetected by national surveillance systems in the period between these outbreaks is considered likely. Th ...
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Journal ArticlePLoS Negl Trop Dis · October 2022
Rift Valley fever virus (RVFV) is a mosquito-borne pathogen that has caused epidemics involving people and animals across Africa and the Arabian Peninsula. A number of studies have found evidence for the circulation of RVFV among livestock between these ep ...
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Journal ArticleLancet Infect Dis · September 2022
BACKGROUND: Acute febrile illness is a common presentation for patients at hospitals globally. Assays that can diagnose a variety of common pathogens in blood could help to establish a diagnosis for targeted disease management. We aimed to evaluate the per ...
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Journal ArticleInt J Infect Dis · September 2022
OBJECTIVE: In this study, we aimed to conduct a systematic review to characterize antimicrobial resistance (AMR) patterns for bacterial causes of febrile illness in Africa and Asia. METHODS: We included published literature from 1980-2015 based on data ext ...
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Journal ArticleClin Microbiol Infect · August 2022
OBJECTIVE: Numerous tuberculosis (TB) deaths remain undetected in low-resource endemic settings. With autopsy-confirmed tuberculosis as our standard, we assessed the diagnostic performance of Xpert MTB/RIF Ultra (Ultra; Cepheid) on nasopharyngeal specimens ...
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Journal ArticleSci Rep · July 8, 2022
Livestock abortion is an important cause of productivity losses worldwide and many infectious causes of abortion are zoonotic pathogens that impact on human health. Little is known about the relative importance of infectious causes of livestock abortion in ...
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Journal ArticlePLoS Negl Trop Dis · July 2022
Growing evidence suggests considerable variation in endemic typhoid fever incidence at some locations over time, yet few settings have multi-year incidence estimates to inform typhoid control measures. We sought to describe a decade of typhoid fever incide ...
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Journal ArticleLancet Regional Health Western Pacific · July 1, 2022
Background: Typhoid fever is endemic in some Pacific Island Countries including Fiji and Samoa yet genomic surveillance is not routine in such settings. Previous studies suggested imports of the global H58 clade of Salmonella enterica var Typhi (Salmonella ...
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Journal ArticleBMJ Open · May 30, 2022
OBJECTIVES: To examine the world's population, development, and health by condensed Coordinated Universal Time (UTC) offset to support a normative position on how to most defensibly schedule global health teleconferences with the primary goal of advancing ...
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Journal ArticleBMC Infect Dis · May 4, 2022
BACKGROUND: The management of febrile illnesses is challenging in settings where diagnostic laboratory facilities are limited, and there are few published longitudinal data on children presenting with fever in such settings. We have previously conducted th ...
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Journal ArticleRisk Anal · May 2022
East Africa is a hotspot for foodborne diseases, including infection by nontyphoidal Salmonella (NTS), a zoonotic pathogen that may originate from livestock. Urbanization and increased demand for animal protein drive intensification of livestock production ...
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Journal ArticleLancet Infect Dis · May 2022
BACKGROUND: Non-typhoidal salmonella can cause serious, life-threatening invasive infections involving the bloodstream and other normally sterile sites. We aimed to systematically review the prevalence of complications and case-fatality ratio (CFR) of non- ...
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Journal ArticleInfect Prev Pract · March 2022
BACKGROUND: Antimicrobial resistance is increasingly prevalent worldwide. The inappropriate use of antimicrobials, including in the hospital setting, is considered a major driver of antimicrobial resistance. AIM: To inform improvements in antimicrobial ste ...
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Journal ArticlePLoS One · 2022
BACKGROUND: Timely health care seeking with access to quality health care are crucial to improve child survival. We conducted a study which aimed to identify factors influencing timely health care seeking and choice of first source of health care in Ethiop ...
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Journal ArticleAm J Trop Med Hyg · December 20, 2021
Q fever and spotted fever group rickettsioses (SFGR) are common causes of severe febrile illness in northern Tanzania. Incidence estimates are needed to characterize the disease burden. Using hybrid surveillance-coupling case-finding at two referral hospit ...
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Journal ArticleTropical medicine & international health : TM & IH · December 2021
ObjectivesIn 2010, WHO published guidelines emphasising parasitological confirmation of malaria before treatment. We present data on changes in fever case management in a low malaria transmission setting of northern Tanzania after 2010.Methods ...
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Journal ArticleJAMA Netw Open · December 1, 2021
IMPORTANCE: Severity scores are used to improve triage of hospitalized patients in high-income settings, but the scores may not translate well to low- and middle-income settings such as sub-Saharan Africa. OBJECTIVE: To assess the performance of the Univer ...
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Journal ArticleAm J Trop Med Hyg · November 29, 2021
Typhoid is an endemic in Fiji with increases observed since the early 2000s and frequent outbreaks reported. We assessed the diagnostic accuracy of currently available typhoid rapid diagnostic tests (RDTs) (TUBEX, Typhidot Rapid, and Test-It assay) to esta ...
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Journal ArticleJ Infect · November 2021
OBJECTIVES: We sought to collate and summarize high-quality data on non-typhoidal Salmonella invasive disease (iNTS) incidence to provide contemporary incidence estimates by location and year. METHODS: We systematically searched the databases Embase + MEDL ...
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Journal ArticleClin Infect Dis · October 5, 2021
BACKGROUND: Salmonella Enteritidis and Salmonella Typhimurium are major causes of bloodstream infection and diarrheal disease in East Africa. Sources of human infection, including the role of the meat pathway, are poorly understood. METHODS: We collected c ...
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Journal ArticleStat Med · September 30, 2021
It is difficult to estimate sensitivity and specificity of diagnostic tests when there is no gold standard. Latent class models have been proposed as a potential solution as they provide estimates without the need for a gold standard. Using a motivating ex ...
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Journal ArticleJ Am Heart Assoc · August 3, 2021
Background Rigorous incidence data for acute myocardial infarction (AMI) in sub-Saharan Africa are lacking. Consequently, modeling studies based on limited data have suggested that the burden of AMI and AMI-associated mortality in sub-Saharan Africa is low ...
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Journal ArticleBMJ Glob Health · August 2021
BACKGROUND: Invasive non-typhoidal Salmonella (iNTS) is one of the leading causes of bacteraemia in sub-Saharan Africa. We aimed to provide a better understanding of the genetic characteristics and transmission patterns associated with multi-drug resistant ...
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Journal ArticlePLoS Negl Trop Dis · August 2021
BACKGROUND: Brucellosis is a neglected zoonosis endemic in many countries, including regions of sub-Saharan Africa. Evaluated diagnostic tools for the detection of exposure to Brucella spp. are important for disease surveillance and guiding prevention and ...
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Journal ArticleFront Vet Sci · 2021
Background: Endemic zoonoses have important impacts for livestock-dependent households in East Africa. In these communities, people's health and livelihoods are severely affected by livestock disease losses. Understanding how livestock keepers undertake re ...
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Journal ArticleAm J Trop Med Hyg · December 2020
Prediction models indicate that melioidosis may be common in parts of East Africa, but there are few empiric data. We evaluated the prevalence of melioidosis among patients presenting with fever to hospitals in Tanzania. Patients with fever were enrolled a ...
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Journal ArticleAm J Trop Med Hyg · December 2020
Understanding patterns and trends of antimicrobial resistance (AMR) in Salmonella Typhi can guide empiric treatment recommendations and contribute to country decisions about typhoid conjugate vaccine (TCV) introduction. We systematically reviewed PubMed an ...
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Journal ArticleJ Infect · December 2020
OBJECTIVES: Updated estimates of the prevalence of complications and case fatality ratio (CFR) among typhoid fever patients are needed to understand disease burden. METHODS: Articles published in PubMed and Web of Science from 1 January 1980 through 29 Jan ...
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Journal ArticleBMC Infect Dis · November 30, 2020
BACKGROUND: The diagnosis of non-malarial aetiologies, which now represent the majority of febrile illnesses, has remained problematic in settings with limited laboratory capacity. We aimed to describe common aetiologies of acute febrile illness among chil ...
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Journal ArticleAm J Trop Med Hyg · October 2020
Molecular data are required to improve our understanding of the epidemiology of leptospirosis in Africa and to identify sources of human infection. We applied molecular methods to identify the infecting Leptospira species and genotypes among patients hospi ...
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Journal ArticleAm J Trop Med Hyg · October 2020
Uncertainty about the causes of death (COD) in low- and middle-income countries (LMICs) has been recognized as a constraint to global health and development. Although complete diagnostic autopsy (CDA) is the best way to assess COD, it is uncommon in LMICs ...
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Journal ArticleBMC Med · September 21, 2020
BACKGROUND: In the absence of definitive diagnosis, healthcare providers are likely to prescribe empirical antibacterials to those who test negative for malaria. This problem is of critical importance in Southern Asia (SA) and South-eastern Asia (SEA) wher ...
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Journal ArticleBMC Med · September 21, 2020
BACKGROUND: The availability of reliable point-of-care tests for malaria has heralded a paradigm shift in the management of febrile illnesses away from presumptive antimalarial therapy. In the absence of a definitive diagnosis, health care providers are mo ...
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Journal ArticleZoonoses Public Health · August 2020
Many infectious diseases lack robust estimates of incidence from endemic areas, and extrapolating incidence when there are few locations with data remains a major challenge in burden of disease estimation. We sought to combine sentinel surveillance with co ...
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Journal ArticleClin Infect Dis · July 29, 2020
In 1993, the International Task Force on Disease Eradication classified the political will for typhoid eradication as "none." Here we revisit the Task Force's assessment in light of developments in typhoid vaccines and increasing antimicrobial resistance i ...
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Journal ArticleClin Infect Dis · July 29, 2020
BACKGROUND: Typhoid fever has been endemic on the island nation of Samoa (2016 population, 195 979) since the 1960s and has persisted through 2019, despite economic development and improvements in water supply and sanitation. METHODS: Salmonella enterica s ...
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Journal ArticleBMJ Open · July 21, 2020
INTRODUCTION: Fever commonly leads to healthcare seeking and hospital admission in sub-Saharan Africa and Asia. There is only limited guidance for clinicians managing non-malarial fevers, which often results in inappropriate treatment for patients. Further ...
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Journal ArticleAm J Trop Med Hyg · July 2020
Infectious diseases are a leading cause of mortality in low- and middle-income countries (LMICs) despite effective treatments. To study the sociocultural and health system barriers to care, we conducted a qualitative social autopsy study of patients who di ...
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Journal ArticleLancet Infect Dis · June 2020
BACKGROUND: The clinical and epidemiological significance of HIV-associated Mycobacterium tuberculosis bloodstream infection (BSI) is incompletely understood. We hypothesised that M tuberculosis BSI prevalence has been underestimated, that it independently ...
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ConferenceThe American journal of tropical medicine and hygiene · June 2020
Typhoid fever remains an important public health problem in low- and middle-income countries, with large outbreaks reported from Africa and Asia. Although the WHO recommends typhoid vaccination for control of confirmed outbreaks, there are limited data on ...
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Journal ArticleJ Water Health · June 2020
The Sustainable Development Goal drinking water indicators include microbiological safety measures, whereas the Millennium Development Goal indicator 'improved water' may be microbiologically unsafe. In rural Vanuatu, we undertook household surveys, child ...
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Journal ArticleInfection Prevention in Practice · June 1, 2020
Background: A S. capitis strain called NRCS-A (S. capitis NRCS-A) has emerged as a cause of bloodstream infections and sepsis in neonatal intensive care units (NICUs) worldwide. Aim: To identify risk factors for S. capitis NRCS-A colonisation among neonate ...
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Journal ArticleTrans R Soc Trop Med Hyg · May 7, 2020
BACKGROUND: Characterization of the epidemiology of Escherichia coli bloodstream infection (BSI) in sub-Saharan Africa is lacking. We studied patients with E. coli BSI in northern Tanzania to describe host risk factors for infection and to describe the ant ...
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Journal ArticleSci Rep · April 27, 2020
Brucellosis is an endemic zoonosis in sub-Saharan Africa. Pastoralists are at high risk of infection but data on brucellosis from these communities are scarce. The study objectives were to: estimate the prevalence of human brucellosis, identify the Brucell ...
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Journal ArticleInt J Environ Res Public Health · April 20, 2020
Urbanisation is associated with changes in consumption patterns and food production processes. These patterns and processes can increase or decrease the risks of outbreaks of foodborne diseases and are generally accompanied by changes in food safety polici ...
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Journal ArticlePLoS Negl Trop Dis · April 2020
Data on causes of community-onset bloodstream infection in Myanmar are scarce. We aimed to identify etiological agents of bloodstream infections and patterns of antimicrobial resistance among febrile adolescents and adults attending Yangon General Hospital ...
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Journal ArticleAm J Trop Med Hyg · April 2020
Typhoid conjugate vaccines represent a new tool for typhoid control. However, incidence data are needed to inform decisions about introduction. We sought to estimate typhoid and paratyphoid fever incidence in Vientiane, the capital and largest city of the ...
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Journal ArticleTrop Med Int Health · March 2020
OBJECTIVE: Identifying febrile patients requiring antibacterial treatment is challenging, particularly in low-resource settings. In South-East Asia, C-reactive protein (CRP) has been demonstrated to be highly sensitive and moderately specific in detecting ...
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Journal ArticleInt J Food Microbiol · February 16, 2020
BACKGROUND: Campylobacter and Salmonella, particularly non-typhoidal Salmonella, are important bacterial enteric pathogens of humans which are often carried asymptomatically in animal reservoirs. Bacterial foodborne infections, including those derived from ...
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Journal ArticleLancet Infect Dis · February 2020
Fever is one of the most common reasons for seeking health care globally and most human pathogens are zoonotic. We conducted a systematic review to describe the occurrence and distribution of zoonotic causes of human febrile illness reported in malaria end ...
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Journal ArticlePLoS One · 2020
Livestock keepers in sub-Saharan Africa face a range of pressures, including climate change, land loss, restrictive policies, and population increase. Widespread adaptation in response can lead to the emergence of new, non-traditional typologies of livesto ...
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Journal ArticleFront Vet Sci · 2020
Through a social scientific lens, this paper considers the risk perceptions and "risk-based decision-making" of two key groups in a northern Tanzanian context: (1) frontline government meat inspectors and health officers charged with ensuring that red meat ...
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Journal ArticleAntimicrob Agents Chemother · December 20, 2019
Community-onset bloodstream infections (CO-BSI) are major causes of severe febrile illness and death worldwide. In light of new data and the growing problem of antimicrobial resistance (AMR) among pathogens causing BSI, we undertook a systematic review of ...
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Journal ArticleTrop Med Int Health · December 2019
OBJECTIVES: Hospital-based studies of community-onset bloodstream infections (CO-BSI) are less resource-intensive to carry out than population-based incidence studies. We examined several metrics capturing the potential role of Salmonella Typhi as a cause ...
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Journal ArticleLancet Infect Dis · December 2019
BACKGROUND: Non-typhoidal salmonella invasive disease is a major cause of global morbidity and mortality. Malnourished children, those with recent malaria or sickle-cell anaemia, and adults with HIV infection are at particularly high risk of disease. We so ...
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Journal ArticleTrans R Soc Trop Med Hyg · December 1, 2019
BACKGROUND: Typhoid fever is endemic in Fiji. We sought to describe the epidemiology, clinical features and case fatality risk of blood culture-confirmed typhoid fever from January 2014 through December 2015. METHODS: Blood culture-positive patients were i ...
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Journal ArticlePLoS Negl Trop Dis · November 2019
BACKGROUND: Acute febrile illness (AFI), a common reason for people seeking medical care globally, represents a spectrum of infectious disease etiologies with important variations geographically and by population. There is no standardized approach to condu ...
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Journal ArticleClin Infect Dis · October 30, 2019
BACKGROUND: Antimicrobial resistance (AMR) is a major global health concern, yet, there are noticeable gaps in AMR surveillance data in regions such as sub-Saharan Africa. We aimed to measure the prevalence of extended-spectrum β-lactamase (ESBL) producing ...
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Journal ArticleClin Infect Dis · October 30, 2019
BACKGROUND: Invasive salmonellosis is a common community-acquired bacteremia in persons residing in sub-Saharan Africa. However, there is a paucity of data on severe typhoid fever and its associated acute and chronic host immune response and carriage. The ...
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Journal ArticleTrans R Soc Trop Med Hyg · October 11, 2019
BACKGROUND: Enteric fever is common in southeast Asia. However, there is little information on the circulating Salmonella enterica strains causing enteric fever in Myanmar. METHODS: We performed antimicrobial susceptibility testing and whole genome sequenc ...
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Journal ArticleClin Med (Lond) · September 2019
Although often underappreciated, a number of bacterial zoonoses are endemic in Africa. Of these, brucellosis, leptospirosis, Q fever, and rickettsioses are responsible for a substantial proportion of febrile illness among patients seeking hospital care. In ...
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Journal ArticleInt J Environ Res Public Health · July 6, 2019
Proximal characteristics and conditions in the residential setting deserve greater attention for their potential to influence typhoid transmission. Using a case-control design in Central Division, Republic of Fiji, we examined bacterial (coliform and Esche ...
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Journal ArticleBMC Public Health · July 3, 2019
BACKGROUND: With increasing demand for red meat in Tanzania comes heightened potential for zoonotic infections in animals and humans that disproportionately affect poor communities. A range of frontline government employees work to protect public health, p ...
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Journal ArticleClin Microbiol Infect · April 2019
BACKGROUND: Leptospirosis is under-diagnosed by clinicians in many high-incidence countries, because reference diagnostic tests are largely unavailable. Lateral flow assays (LFA) that use antigen derived from heat-treated whole cell Leptospira biflexa sero ...
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Journal ArticleTrans R Soc Trop Med Hyg · April 1, 2019
BACKGROUND: Self-treatment with antimicrobials is common in sub-Saharan Africa. Little is known about the prevalence of this practice where malaria transmission intensity is low, and little is known about the prevalence of self-treatment with other medicat ...
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Journal ArticleAm Heart J · April 2019
BACKGROUND: Little is known about community knowledge of myocardial infarction symptoms and perceptions of self-risk in sub-Saharan Africa. METHODS: A community survey was conducted in northern Tanzania, where the prevalence of cardiovascular risk factors ...
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Journal ArticleLancet Infect Dis · April 2019
BACKGROUND: Efforts to quantify the global burden of enteric fever are valuable for understanding the health lost and the large-scale spatial distribution of the disease. We present the estimates of typhoid and paratyphoid fever burden from the Global Burd ...
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Journal ArticleClin Infect Dis · March 7, 2019
BACKGROUND: Contemporary incidence estimates of typhoid fever are needed to guide policy decisions and control measures and to improve future epidemiological studies. METHODS: We systematically reviewed 3 databases (Ovid Medline, PubMed, and Scopus) withou ...
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Journal ArticleClin Infect Dis · March 7, 2019
BACKGROUND: Accurate estimates of typhoid disease burden are needed to guide policy decisions, including on vaccine use. Data on the incidence of enteric fever in Myanmar are scarce. We estimated typhoid and paratyphoid fever incidence among adolescents an ...
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Journal ArticleClin Infect Dis · March 7, 2019
BACKGROUND: Salmonella enterica including Salmonella Typhi and nontyphoidal Salmonella (NTS) are the predominant cause of community-acquired bloodstream infections in sub-Saharan Africa (sSA). Multiple-drug resistance and emerging fluoroquinolone resistanc ...
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Journal ArticlePLoS Negl Trop Dis · March 2019
Nontyphoidal Salmonella is a major contributor to the global burden of foodborne disease, with invasive infections contributing substantially to illnesses and deaths. We analyzed notifiable disease surveillance data for invasive nontyphoidal Salmonella dis ...
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Journal ArticleClin Infect Dis · February 15, 2019
Salmonella enterica subspecies enterica serovar Typhi (Salmonella Typhi) is the cause of typhoid fever and a human host-restricted organism. Our understanding of the global burden of typhoid fever has improved in recent decades, with both an increase in th ...
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Journal ArticlePLoS One · 2019
BACKGROUND: Little is known about community perceptions of chest pain and healthcare seeking behavior for chest pain in sub-Saharan Africa. METHODS: A two-stage randomized population-based cluster survey with selection proportional to population size was p ...
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Journal ArticleNeuroepidemiology · 2019
BACKGROUND: Little is known about knowledge of stroke symptoms, perceptions of self-risk, and health-care-seeking behavior for stroke in East Africa. METHODS: A 2-stage randomized population-based cluster survey with selection proportional to population si ...
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Journal ArticleNat Commun · November 30, 2018
There is paucity of data regarding the geographical distribution, incidence, and phylogenetics of multi-drug resistant (MDR) Salmonella Typhi in sub-Saharan Africa. Here we present a phylogenetic reconstruction of whole genome sequenced 249 contemporaneous ...
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Journal ArticleClin Infect Dis · November 28, 2018
BACKGROUND: The World Health Organization recently prequalified a typhoid conjugate vaccine (TCV), recommending its use in persons ≥6 months to 45 years residing in typhoid fever (TF)-endemic areas. We now need to consider how TCVs can have the greatest im ...
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ConferenceAm J Trop Med Hyg · November 2018
Febrile illnesses are a major cause of mortality in sub-Saharan Africa. Early identification of patients at increased risk of death may avert adverse outcomes. We aimed to independently evaluate the performance of the Modified Early Warning Score, quick Se ...
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Journal ArticleClin Microbiol Infect · August 2018
BACKGROUND: Fever is among the most common symptoms of people living in Africa, and clinicians are challenged by the similar clinical features of a wide spectrum of potential aetiologies. AIM: To summarize recent studies of fever aetiology in sub-Saharan A ...
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Journal ArticleClin Microbiol Infect · August 2018
BACKGROUND: Increasing evidence is becoming available on the aetiology and management of fevers in Asia; the importance of these fevers has increased with the decline in the incidence of malaria. AIMS: To conduct a narrative review of the epidemiology and ...
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Journal ArticleFoodborne Pathog Dis · July 2018
BACKGROUND: Salmonella is a leading cause of foodborne enterocolitis worldwide. Antimicrobial use in food animals is the driving force for antimicrobial resistance among Salmonella particularly in high-income countries. Nontyphoidal Salmonella (NTS) infect ...
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Journal ArticlePLoS Negl Trop Dis · June 2018
Leptospirosis is a zoonotic bacterial disease that affects more than one million people worldwide each year. Human infection is acquired through direct or indirect contact with the urine of an infected animal. A wide range of animals including rodents and ...
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Journal ArticlePLoS Negl Trop Dis · June 2018
INTRODUCTION: Leptospirosis is a major cause of febrile illness in Africa but little is known about risk factors for human infection. We conducted a cross-sectional study to investigate risk factors for acute leptospirosis and Leptospira seropositivity amo ...
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Journal ArticlePLoS Negl Trop Dis · June 2018
BACKGROUND: Typhoid fever is endemic in Fiji, with high reported annual incidence. We sought to identify the sources and modes of transmission of typhoid fever in Fiji with the aim to inform disease control. METHODOLOGY/PRINCIPAL FINDINGS: We identified an ...
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Journal ArticleSci Rep · May 2, 2018
Typhoid and paratyphoid fever may follow a seasonal pattern, but this pattern is not well characterized. Moreover, the environmental drivers that influence seasonal dynamics are not fully understood, although increasing evidence suggests that rainfall and ...
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Journal ArticleTrans R Soc Trop Med Hyg · March 1, 2018
BACKGROUND: Brucellosis causes substantial morbidity among humans and their livestock. There are few robust estimates of the incidence of brucellosis in sub-Saharan Africa. Using cases identified through sentinel hospital surveillance and health care utili ...
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ConferenceAm J Trop Med Hyg · February 2018
Little is known about the epidemiology of human brucellosis in sub-Saharan Africa. This hampers prevention and control efforts at the individual and population levels. To evaluate risk factors for brucellosis in northern Tanzania, we conducted a study of p ...
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Journal ArticleBMJ Glob Health · 2018
INTRODUCTION: Communicable diseases are the leading causes of death in Tanzania despite the existence of effective treatment tools. We aimed to assess the sociocultural and health system factors associated with mortality from febrile illness in northern Ta ...
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Journal ArticleClin Infect Dis · November 29, 2017
These guidelines are intended for use by healthcare professionals who care for children and adults with suspected or confirmed infectious diarrhea. They are not intended to replace physician judgement regarding specific patients or clinical or public healt ...
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Journal ArticleClin Infect Dis · November 29, 2017
These guidelines are intended for use by healthcare professionals who care for children and adults with suspected or confirmed infectious diarrhea. They are not intended to replace physician judgement regarding specific patients or clinical or public healt ...
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Journal ArticlePLoS Negl Trop Dis · September 2017
BACKGROUND: Scrub typhus is a vector-borne zoonotic disease that can be life-threatening. There are no licensed vaccines, or vector control efforts in place. Despite increasing awareness in endemic regions, the public health burden and global distribution ...
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Journal ArticlePhilos Trans R Soc Lond B Biol Sci · July 19, 2017
Emerging zoonoses with pandemic potential are a stated priority for the global health security agenda, but endemic zoonoses also have a major societal impact in low-resource settings. Although many endemic zoonoses can be treated, timely diagnosis and appr ...
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Journal ArticleJAMA Pediatr · June 1, 2017
IMPORTANCE: Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health. OBJECTIVE: To quantify and describe levels and trends of mortality and nonfatal health ou ...
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Journal ArticleEmerg Infect Dis · May 2017
Among 42 gram-negative bloodstream isolates from inpatients in 3 hospitals in Yangon, Myanmar, admitted during July-December 2014, 16 (38%) were extended-spectrum β-lactamase-producing Enterobacteriaceae and 6 (14%) produced carbapenemase. The high prevale ...
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Journal ArticleLancet Glob Health · March 2017
BACKGROUND: Available incidence data for invasive salmonella disease in sub-Saharan Africa are scarce. Standardised, multicountry data are required to better understand the nature and burden of disease in Africa. We aimed to measure the adjusted incidence ...
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Journal ArticleBMJ Glob Health · 2017
BACKGROUND: Critical illness is a leading cause of morbidity and mortality in sub-Saharan Africa (SSA). Identifying patients with the highest risk of death could help with resource allocation and clinical decision making. Accordingly, we derived and valida ...
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Journal ArticlePLoS Negl Trop Dis · December 2016
BACKGROUND: The sole report of annual leptospirosis incidence in continental Africa of 75-102 cases per 100,000 population is from a study performed in August 2007 through September 2008 in the Kilimanjaro Region of Tanzania. To evaluate the stability of t ...
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Journal ArticleLancet · October 8, 2016
BACKGROUND: Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-caus ...
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Journal ArticleLancet · October 8, 2016
BACKGROUND: Non-fatal outcomes of disease and injury increasingly detract from the ability of the world's population to live in full health, a trend largely attributable to an epidemiological transition in many countries from causes affecting children, to ...
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Journal ArticleNat Commun · October 5, 2016
The population of Salmonella enterica serovar Typhi (S. Typhi), the causative agent of typhoid fever, exhibits limited DNA sequence variation, which complicates efforts to rationally discriminate individual isolates. Here we utilize data from whole-genome ...
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Journal ArticlePlos Neglected Tropical Diseases · September 22, 2016
Background: The burden of typhoid in sub-Saharan African (SSA) countries has been difficult to estimate, in part, due to suboptimal laboratory diagnostics. However, surveillance blood cultures at two sites in Nigeria have identified typhoid associated with ...
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Journal ArticleJ Glob Antimicrob Resist · September 2016
Drug-resistant tuberculosis (TB) is a major health threat in Myanmar. An initial study was conducted to explore the potential utility of whole-genome sequencing (WGS) for the diagnosis and management of drug-resistant TB in Myanmar. Fourteen multidrug-resi ...
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Journal ArticleAm J Clin Pathol · August 2016
OBJECTIVES: Using a clinical research laboratory as a case study, we sought to characterize barriers to maintaining Good Clinical Laboratory Practice (GCLP) services in a developing world setting. METHODS: Using a US Centers for Disease Control and Prevent ...
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Journal ArticleInt J Tuberc Lung Dis · July 2016
UNLABELLED: SETTINGp: Among human immunodeficiency virus (HIV) infected adults living in tuberculosis (TB) endemic settings, Mycobacterium tuberculosis is a common cause of bloodstream infections. Although young children have an increased propensity for M. ...
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Journal ArticlePathog Glob Health · May 2016
Little is known about the presence and distribution of Aedes mosquitoes in northern Tanzania despite the occurence of viruses transmitted by these mosquitoes such as Chikungunya virus (CHIKV) and Dengue virus (DENV) in the region. Adult and larval mosquito ...
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Journal ArticleClin Infect Dis · March 15, 2016
BACKGROUND: New immunization programs are dependent on data from surveillance networks and disease burden estimates to prioritize target areas and risk groups. Data regarding invasive Salmonella disease in sub-Saharan Africa are currently limited, thus hin ...
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Journal ArticleClin Infect Dis · March 15, 2016
Salmonella enterica serovar Typhi and nontyphoidal Salmonella (NTS) cause the majority of bloodstream infections in sub-Saharan Africa; however, serotyping is rarely performed. We validated a multiplex polymerase chain reaction (PCR) assay with the White-K ...
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Journal ArticleClin Infect Dis · March 15, 2016
BACKGROUND: Salmonella enterica serovar Typhi is a predominant cause of bloodstream infections in sub-Saharan Africa (SSA). Increasing numbers of S. Typhi with resistance to ciprofloxacin have been reported from different parts of the world. However, data ...
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Journal ArticleClin Infect Dis · March 15, 2016
BACKGROUND: Assessing healthcare utilization is important to identify weaknesses of healthcare systems, to outline action points for preventive measures and interventions, and to more accurately estimate the disease burden in a population. METHODS: A healt ...
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Journal ArticleClin Infect Dis · March 15, 2016
BACKGROUND: Country-specific studies in Africa have indicated that Plasmodium falciparum is associated with invasive nontyphoidal Salmonella (iNTS) disease. We conducted a multicenter study in 13 sites in Burkina Faso, Ethiopia, Ghana, Guinea-Bissau, Kenya ...
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Journal ArticlePLoS Negl Trop Dis · March 2016
BACKGROUND: Zoonoses are common causes of human and livestock illness in Tanzania. Previous studies have shown that brucellosis, leptospirosis, and Q fever account for a large proportion of human febrile illness in northern Tanzania, yet they are infrequen ...
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Journal ArticleJAMA Pediatr · March 2016
IMPORTANCE: The literature focuses on mortality among children younger than 5 years. Comparable information on nonfatal health outcomes among these children and the fatal and nonfatal burden of diseases and injuries among older children and adolescents is ...
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Journal ArticleJ Clin Microbiol · January 2016
Acute febrile illness (AFI) is associated with substantial morbidity and mortality worldwide, yet an etiologic agent is often not identified. Convalescent-phase serology is impractical, blood culture is slow, and many pathogens are fastidious or impossible ...
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Journal ArticlePLoS One · 2016
Salmonella enterica serovar Typhi expresses a capsule of Vi polysaccharide, while most Salmonella serovars, including S. Enteritidis and S. Typhimurium, do not. Both S. Typhi and S. Enteritidis express the lipopolysaccharide O:9 antigen, yet there is littl ...
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Journal ArticlePLoS One · 2016
Acute fever is one of the most common presenting symptoms globally. In order to reduce the empiric use of antimicrobial drugs and improve outcomes, it is essential to improve diagnostic capabilities. In the absence of microbiology facilities in low-income ...
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Journal ArticleAm J Trop Med Hyg · January 2016
A Nokia Lumia 1020 cellular phone (Microsoft Corp., Auckland, New Zealand) was configured to image the ova of Ascaris lumbricoides converged into a single field of view but on different focal planes. The phone was programmed to acquire images at different ...
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Journal ArticleGenome Announcements · January 1, 2016
Multidrug-resistant tuberculosis (MDR-TB) and lately, extensively drug-resistant TB (XDR-TB) are increasing global health concerns. Here, we present the genome sequences of two MDR-TB isolates from Myanmar, one of 27 countries with a high MDR-TB burden, an ...
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Journal ArticlePLoS Med · December 2015
BACKGROUND: Foodborne diseases are important worldwide, resulting in considerable morbidity and mortality. To our knowledge, we present the first global and regional estimates of the disease burden of the most important foodborne bacterial, protozoal, and ...
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Journal ArticlePLoS Med · December 2015
Illness and death from diseases caused by contaminated food are a constant threat to public health and a significant impediment to socio-economic development worldwide. To measure the global and regional burden of foodborne disease (FBD), the World Health ...
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Journal ArticleLancet · November 28, 2015
BACKGROUND: The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health l ...
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Journal ArticleTrop Med Int Health · November 2015
OBJECTIVE: To establish common biochemistry reference intervals for Tanzanian infants, children and adolescents living in the Kilimanjaro Region. METHODS: We recruited healthy, HIV-uninfected Tanzanian infants, children and youth between the ages of 1 mont ...
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Journal ArticleClin Infect Dis · November 1, 2015
BACKGROUND: The clinical diagnosis of bacterial bloodstream infections (BSIs) in sub-Saharan Africa is routinely confused with malaria due to overlapping symptoms. The Typhoid Surveillance in Africa Program (TSAP) recruited febrile inpatients and outpatien ...
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Journal ArticleClin Infect Dis · November 1, 2015
Salmonella enterica is a leading cause of community-acquired bloodstream infection in Africa. The contribution of typhoidal and nontyphoidal Salmonella serovars to invasive disease varies considerably in place and time, even within the same country. Noneth ...
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Journal ArticleMycoses · October 2015
Data regarding the prevalence of fungal infections in Vietnam are limited yet they are likely to occur more frequently as increasingly sophisticated healthcare creates more iatrogenic risk factors. In this study, we sought to estimate baseline incidence an ...
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Journal ArticleAm J Trop Med Hyg · October 2015
Bacterial sepsis is an important cause of mortality in low- and middle-income countries, yet distinguishing patients with sepsis from those with other illnesses remains a challenge. Currently, management decisions are based on clinical assessment using alg ...
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Journal ArticleAm J Trop Med Hyg · October 2015
Bacterial sepsis is a leading cause of mortality among febrile patients in low- and middle-income countries, but blood culture services are not widely available. Consequently, empiric antimicrobial management of suspected bloodstream infection is based on ...
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Journal ArticleClin Microbiol Rev · October 2015
Salmonella enterica infections are common causes of bloodstream infection in low-resource areas, where they may be difficult to distinguish from other febrile illnesses and may be associated with a high case fatality ratio. Microbiologic culture of blood o ...
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Journal ArticleAm J Trop Med Hyg · July 2015
We used Demographic and Health Survey data to describe the 2-week period prevalence of fever, cough, and diarrhea among children aged < 5 years in low-resources areas. We then explored the relationship between prevalence of isolated fever and national mala ...
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Journal ArticleVaccine · June 19, 2015
Efficacious typhoid fever vaccines have been available for decades. Typhoid fever burden of disease estimates indicate a substantial burden of illness and death in low-resource areas. The World Health Organization has recommended that countries consider th ...
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Journal ArticleNat Genet · June 2015
The emergence of multidrug-resistant (MDR) typhoid is a major global health threat affecting many countries where the disease is endemic. Here whole-genome sequence analysis of 1,832 Salmonella enterica serovar Typhi (S. Typhi) identifies a single dominant ...
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Journal ArticleEmerg Infect Dis · June 2015
Nontyphoidal Salmonella is a major cause of bloodstream infections worldwide, and HIV-infected persons and malaria-infected children are at increased risk for the disease. We conducted a systematic literature review to obtain age group-specific, population ...
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Journal ArticleClin Infect Dis · May 15, 2015
BACKGROUND: The AIDS Clinical Trials Group (ACTG) A5230 study evaluated lopinavir/ritonavir (LPV/r) monotherapy following virologic failure (VF) on first-line human immunodeficiency virus (HIV) regimens in Africa and Asia. METHODS: Eligible subjects had re ...
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Journal ArticleVet Rec · February 28, 2015
Zoonotic diseases are a significant burden on animal and human health, particularly in developing countries. Despite recognition of this fact, endemic zoonoses often remain undiagnosed in people, instead being mistaken for febrile diseases such as malaria. ...
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Journal ArticleAm J Trop Med Hyg · February 2015
We describe the laboratory-confirmed etiologies of illness among participants in a hospital-based febrile illness cohort study in northern Tanzania who retrospectively met Integrated Management of Adolescent and Adult Illness District Clinician Manual (IMA ...
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Journal ArticleBMC Infect Dis · January 13, 2015
BACKGROUND: We evaluated predictors and outcomes of Mycobacterium tuberculosis bacteremia among participants undergoing baseline mycobacterial blood culture in the ACTG A5221 STRIDE study, a randomized clinical trial comparing earlier with later ART among ...
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Journal ArticleInt J Dermatol · January 2015
Abnormal skin findings are identified in over 90% of human immunodeficiency virus (HIV)-infected persons globally. A prospective cohort study of HIV-infected patients with skin complaints commencing antiretroviral therapy (ART) in northern Tanzania was und ...
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Journal ArticlePLoS Negl Trop Dis · 2015
BACKGROUND: Leptospirosis is an important but neglected bacterial zoonosis that has been largely overlooked in Africa. In this systematic review, we aimed to summarise and compare current knowledge of: (1) the geographic distribution, prevalence, incidence ...
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Journal ArticlePLoS One · 2015
BACKGROUND: With apparent declines in malaria worldwide during the last decade and more widespread use of malaria rapid diagnostic tests, healthcare workers in low-resource areas face a growing proportion of febrile patients without malaria. We sought to d ...
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Journal ArticleTrans R Soc Trop Med Hyg · November 2014
BACKGROUND: Data regarding characteristics of bloodstream infections in Myanmar are limited. METHODS: Blood culture results from all outpatients and inpatients were extracted from records of the Clinical Microbiology Laboratory, Yangon General Hospital, fo ...
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Journal ArticleTrop Med Int Health · October 2014
The country of Fiji, with a population of approximately 870 000 people, faces a growing burden of several communicable diseases including the bacterial infection typhoid fever. Surveillance data suggest that typhoid has become increasingly common in rural ...
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Journal ArticleGenome Res · July 2014
Unbiased next-generation sequencing (NGS) approaches enable comprehensive pathogen detection in the clinical microbiology laboratory and have numerous applications for public health surveillance, outbreak investigation, and the diagnosis of infectious dise ...
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Journal ArticlePLoS Negl Trop Dis · April 2014
BACKGROUND: Q fever is a common cause of febrile illness and community-acquired pneumonia in resource-limited settings. Coxiella burnetii, the causative pathogen, is transmitted among varied host species, but the epidemiology of the organism in Africa is p ...
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Journal ArticleClin Infect Dis · March 2014
BACKGROUND: The epidemiology of Salmonella Typhi and invasive nontyphoidal Salmonella (NTS) differs, and prevalence of these pathogens among children in sub-Saharan Africa may vary in relation to malaria transmission intensity. METHODS: We compared the p ...
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Journal ArticleJ Clin Microbiol · March 2014
Fluoroquinolones (e.g., ciprofloxacin) have become a mainstay for treating severe Salmonella infections in adults. Fluoroquinolone resistance in Salmonella is mostly due to mutations in the topoisomerase genes, but plasmid-mediated quinolone resistance (PM ...
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Journal ArticleBMC Infect Dis · February 20, 2014
BACKGROUND: Routine tuberculosis culture remains unavailable in many high-burden areas, including Tanzania. This study sought to determine the impact of providing mycobacterial culture results over standard of care [unconcentrated acid-fast (AFB) smears] o ...
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Journal ArticleBMC Infectious Diseases · February 20, 2014
Background: Routine tuberculosis culture remains unavailable in many high-burden areas, including Tanzania. This study sought to determine the impact of providing mycobacterial culture results over standard of care [unconcentrated acid-fast (AFB) smears] o ...
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Journal ArticlePLoS One · 2014
OBJECTIVE: In 2010, the World Health Organization (WHO) published updated guidelines emphasizing and expanding recommendations for a parasitological confirmation of malaria before treating with antimalarials. This study aimed to assess differences in histo ...
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Journal ArticleTrop Med Int Health · November 2013
OBJECTIVE: To compare actual and perceived causes of fever in northern Tanzania. METHODS: In a standardised survey, heads of households in 30 wards in Moshi, Tanzania, were asked to identify the most common cause of fever for children and for adults. Respo ...
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Journal ArticleClin Radiol · October 2013
AIM: To describe chest radiographic abnormalities and assess their usefulness for predicting causes of fever in a resource-limited setting. MATERIALS AND METHODS: Febrile patients were enrolled in Moshi, Tanzania, and chest radiographs were evaluated by ra ...
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Journal ArticleCurr Opin Infect Dis · October 2013
PURPOSE OF REVIEW: Human brucellosis is a neglected, underrecognized infection of widespread geographic distribution. It causes acute febrile illness and a potentially debilitating chronic infection in humans, and livestock infection has substantial socioe ...
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Journal ArticleVector Borne Zoonotic Dis · August 2013
BACKGROUND: Leptospirosis and human immunodeficiency virus (HIV) infection are prevalent in many areas, including northern Tanzania, yet little is known about their interaction. METHODS: We enrolled febrile inpatients at two hospitals in Moshi, Tanzania, o ...
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Journal ArticlePediatr Infect Dis J · July 2013
Mycobacterium tuberculosis is a common cause of bloodstream infections among HIV-infected adults in sub-Saharan Africa, and is associated with high morbidity and mortality. We found no cases of mycobacteremia among 93 ill, HIV-infected children in northern ...
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Journal ArticlePLoS Negl Trop Dis · 2013
BACKGROUND: The incidence of leptospirosis, a neglected zoonotic disease, is uncertain in Tanzania and much of sub-Saharan Africa, resulting in scarce data on which to prioritize resources for public health interventions and disease control. In this study, ...
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Journal ArticlePLoS Negl Trop Dis · 2013
INTRODUCTION: The syndrome of fever is a commonly presenting complaint among persons seeking healthcare in low-resource areas, yet the public health community has not approached fever in a comprehensive manner. In many areas, malaria is over-diagnosed, and ...
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Journal ArticleAm J Trop Med Hyg · December 2012
Acute and convalescent serum samples were collected from febrile inpatients identified at two hospitals in Moshi, Tanzania. Confirmed brucellosis was defined as a positive blood culture or a ≥ 4-fold increase in microagglutination test titer, and probable ...
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Journal ArticleJ Clin Virol · November 2012
BACKGROUND: Excluding HIV infection among infants and young children in resource-poor settings where nucleic acid amplification tests (NAAT) are not routinely available remains a considerable challenge. OBJECTIVES: To assess the performance of two rapid HI ...
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Journal ArticleArch Dis Child · October 2012
OBJECTIVE: As the proportion of children living low malaria transmission areas in sub-Saharan Africa increases, approaches for identifying non-malarial severe illness need to be evaluated to improve child outcomes. DESIGN: As a prospective cohort study, we ...
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Journal ArticleTrans R Soc Trop Med Hyg · August 2012
Histoplasmosis may be common in East Africa but the diagnosis is rarely confirmed. We report 9 (0.9%) cases of probable histoplasmosis retrospectively identified among 970 febrile inpatients studied in northern Tanzania. Median (range) age was 31 (6, 44) y ...
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Journal ArticleJ Clin Microbiol · August 2012
HIV-1 RNA quantitation continues to be extremely important for monitoring patients infected with HIV-1, and a number of assays have been utilized for this purpose. Differences in assay performance with respect to log(10) recovery and HIV-1 subtype specific ...
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Journal ArticleAIDS · July 17, 2012
OBJECTIVE: To evaluate virologic response rates of lopinavir/ritonavir (LPV/r) monotherapy as second-line antiretroviral treatment (ART) among adults in resource-limited settings (RLSs). DESIGN: An open-label pilot study of LPV/r monotherapy in participant ...
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Journal ArticleClin Infect Dis · July 2012
BACKGROUND: Disseminated tuberculosis is a major health problem in countries where generalized human immunodeficiency virus (HIV) infection epidemics coincide with high tuberculosis incidence rates; data are limited on patient outcomes beyond the inpatient ...
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Journal ArticleJ Virol · June 2012
CD8-mediated virus inhibition can be detected in HIV-1-positive subjects who naturally control virus replication. Characterizing the inhibitory function of CD8(+) T cells during acute HIV-1 infection (AHI) can elucidate the nature of the CD8(+) responses t ...
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Journal ArticleJ Virol · April 2012
Plasma from a small subset of subjects chronically infected with HIV-1 shows remarkable magnitude and breadth of neutralizing activity. From one of these individuals (CH0219), we isolated two broadly neutralizing antibodies (bnAbs), CH01 and VRC-CH31, from ...
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Journal ArticleAm J Trop Med Hyg · January 2012
Consecutive febrile admissions were enrolled at two hospitals in Moshi, Tanzania. Confirmed acute Chikungunya virus (CHIKV), Dengue virus (DENV), and flavivirus infection were defined as a positive polymerase chain reaction (PCR) result. Presumptive acute ...
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Journal ArticleAIDS Care · 2012
While HIV counseling and testing (HCT) has been considered an HIV preventive measure in Africa, data are limited describing behavior changes following HCT. This study evaluated behavior changes and estimated HIV seroincidence rate among returning HCT clien ...
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Journal ArticleJ Clin Microbiol · January 2012
To investigate the performance of a nucleic acid amplification test (NAAT) for the diagnosis of Mycobacterium tuberculosis bacteremia, 5-ml aliquots of blood were inoculated into bioMérieux mycobacterial (MB) bottles and incubated, and 5-ml aliquots of blo ...
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Journal ArticleNature · November 23, 2011
Variable regions 1 and 2 (V1/V2) of human immunodeficiency virus-1 (HIV-1) gp120 envelope glycoprotein are critical for viral evasion of antibody neutralization, and are themselves protected by extraordinary sequence diversity and N-linked glycosylation. H ...
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Journal ArticleJ Virol · November 2011
A small proportion of HIV-infected individuals generate a neutralizing antibody (NAb) response of exceptional magnitude and breadth. A detailed analysis of the critical epitopes targeted by broadly neutralizing antibodies should help to define optimal targ ...
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Journal ArticleJ Virol · October 2011
V2/V3 conformational epitope antibodies that broadly neutralize HIV-1 (PG9 and PG16) have been recently described. Since an elicitation of previously known broadly neutralizing antibodies has proven elusive, the induction of antibodies with such specificit ...
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Journal ArticleScience · September 16, 2011
Antibody VRC01 is a human immunoglobulin that neutralizes about 90% of HIV-1 isolates. To understand how such broadly neutralizing antibodies develop, we used x-ray crystallography and 454 pyrosequencing to characterize additional VRC01-like antibodies fro ...
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Journal ArticleAntimicrob Agents Chemother · September 2011
Due to emerging resistance to traditional antimicrobial agents, such as ampicillin, trimethoprim-sulfamethoxazole, and chloramphenicol, azithromycin is increasingly used for the treatment of invasive Salmonella infections. In the present study, 696 isolate ...
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Journal ArticleBull World Health Organ · September 1, 2011
OBJECTIVE: To evaluate three commercial typhoid rapid antibody tests for Salmonella Typhi antibodies in patients suspected of having typhoid fever in Mpumalanga, South Africa, and Moshi, United Republic of Tanzania. METHODS: The diagnostic accuracy of Crom ...
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Journal ArticleAm J Trop Med Hyg · August 2011
We enrolled consecutive febrile admissions to two hospitals in Moshi, Tanzania. Confirmed leptospirosis was defined as a ≥ 4-fold increase in microscopic agglutination test (MAT) titer; probable leptospirosis as reciprocal MAT titer ≥ 800; and exposure to ...
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Journal ArticleClin Infect Dis · August 2011
BACKGROUND: The importance of Q fever, spotted fever group rickettsiosis (SFGR), and typhus group rickettsiosis (TGR) as causes of febrile illness in sub-Saharan Africa is unknown; the putative role of Q fever as a human immunodeficiency virus (HIV) coinfe ...
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Journal ArticleJ Clin Microbiol · August 2011
We compared the performance of the BacT/Alert MB system, that of the manual Bactec Myco/F Lytic procedure, and that of the Isolator 10 lysis-centrifugation system in the detection of Mycobacterium tuberculosis bacteremia. Mean times to detection were 16.4 ...
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Journal ArticleTrop Med Int Health · July 2011
OBJECTIVE: To describe the contribution of paediatric HIV and of HIV co-infections to admissions to a hospital in Moshi, Tanzania, using contemporary laboratory methods. METHODS: During 1 year, we enrolled consecutively admitted patients aged ≥2 months and ...
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Journal ArticleInt J Syst Evol Microbiol · June 2011
'Mycobacterium sherrisii' is an undescribed species that appears to be emerging, in particular, among HIV-positive patients originating from Africa. To describe 'M. sherrisii', to ensure that the species name is validly published and to define its phylogen ...
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Journal ArticleJ Acquir Immune Defic Syndr · April 15, 2011
BACKGROUND: Guidelines in sub-Saharan Africa on when HIV-seronegative persons should retest range from never to annually for lower-risk populations and from annually to every 3 months for high-risk populations. METHODS: We designed a mathematical model to ...
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Journal ArticleAntimicrob Agents Chemother · March 2011
Nontyphoidal salmonellae (NTS) are important causes of community-acquired bloodstream infection. We describe patterns of antimicrobial resistance among invasive NTS in the United States. We compared bloodstream NTS isolates with those from stool submitted ...
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Journal ArticleJ Virol Methods · March 2011
The Abbott RealTime HIV-1 assay is a real-time nucleic acid amplification assay available for HIV-1 viral load quantitation. The assay has a platform for automated extraction of viral RNA from plasma or dried blood spot samples, and an amplification platfo ...
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Journal ArticleClin Infect Dis · February 1, 2011
BACKGROUND: few studies describe patterns of human immunodeficiency virus (HIV) co-infections in African hospitals in the antiretroviral therapy (ART) era. METHODS: we enrolled consecutive admitted patients aged ≥ 13 years with oral temperature of ≥ 38.0°C ...
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Journal ArticlePLoS One · January 31, 2011
BACKGROUND: Optimally, expanded HIV testing programs should reduce barriers to testing while attracting new and high-risk testers. We assessed barriers to testing and HIV risk among clients participating in mobile voluntary counseling and testing (MVCT) ca ...
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Journal ArticleAm J Trop Med Hyg · December 2010
Academic global health programs are growing rapidly in scale and number. Students of many disciplines increasingly desire global health content in their curricula. Global health curricula often include field experiences that involve crossing international ...
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Journal ArticleInt J Environ Res Public Health · October 2010
Household-level water treatment products provide safe drinking water to at-risk populations, but relatively few people use them regularly; little is known about factors that influence uptake of this proven health intervention. We assessed uptake of these w ...
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Journal ArticleTrop Med Int Health · September 2010
OBJECTIVE: To determine the normal haematological and immunological reference intervals for healthy Tanzanian children. METHODS: We analysed data from 655 HIV-seronegative, healthy children from 1 month to 18 years of age from the Kilimanjaro Region of Tan ...
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Journal ArticleJ Acquir Immune Defic Syndr · August 2010
BACKGROUND: Many HIV care and treatment programs in resource-limited settings rely on clinical and immunologic monitoring of antiretroviral therapy (ART), but accuracy of this strategy to detect virologic failure (VF) among children has not been evaluated. ...
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Journal ArticleLancet Infect Dis · June 2010
Data on the prevalence and causes of community-acquired bloodstream infections in Africa are scarce. We searched three databases for studies that prospectively studied patients admitted to hospital with at least a blood culture, and found 22 eligible studi ...
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Journal ArticleBMJ · March 30, 2010
OBJECTIVES: To assess the performance of WHO's "Guidelines for care at the first-referral level in developing countries" in an area of intense malaria transmission and identify bacterial infections in children with and without malaria. DESIGN: Prospective ...
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Journal ArticleClin Infect Dis · January 15, 2010
Typhoid and paratyphoid fever continue to be important causes of illness and death, particularly among children and adolescents in south-central and Southeast Asia, where enteric fever is associated with poor sanitation and unsafe food and water. High-qual ...
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Journal ArticleJ Virol Methods · December 2009
The performance of the Abbott m2000rt RealTime HIV-1 assay (RealTime HIV-1) with manual sample preparation was compared against the ROCHE COBAS AmpliPrep/AMPLICOR HIV-1 MONITOR Test v1.5 (CAP/CA HIV-1) using samples collected from 100 donors infected with ...
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Journal ArticleAIDS Res Hum Retroviruses · December 2009
Fixed dose combination abacavir/lamivudine/zidovudine (ABC/3TC/ZDV) among HIV-1 and tuberculosis (TB)-coinfected patients was evaluated and outcomes between early vs. delayed initiation were compared. In a randomized, pilot study conducted in the Kilimanja ...
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Journal ArticleJ Acquir Immune Defic Syndr · December 2009
OBJECTIVES: We evaluated changes in characteristics of clients presenting for voluntary counseling and testing (VCT) before and during care and treatment center (CTC) scale-up activities in Moshi, Tanzania, between November 2003 and December 2007. METHODS: ...
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Journal ArticleAIDS · November 27, 2009
OBJECTIVE: To assess technical and operational performance of a dried blood spot (DBS)-based HIV-1 RNA service for remote healthcare facilities in a low-income country. DESIGN: A method comparison and operational evaluation of DBS RNA against conventional ...
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Journal ArticleJournal of Pediatric Infectious Diseases · November 11, 2009
In resource-limited settings lacking laboratory testing, clinical staging criteria may not identify all human immunodeficiency virus (HIV)-infected children who could benefit from antiretroviral therapy (ART). A retrospective analysis was conducted to iden ...
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Journal ArticleInt J Tuberc Lung Dis · October 2009
SETTING: A community-based voluntary counseling and testing (VCT) center in Moshi, Tanzania. OBJECTIVE: To compare rates of prior human immunodeficiency virus (HIV) testing among clients with and without previous tuberculosis (TB) treatment, and HIV seropo ...
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Journal ArticleClin Infect Dis · August 15, 2009
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Invasive non-Typhi Salmonella is endemic to sub-Saharan Africa, where it is a leading cause of bloodstream infection. Some host risk factors have been established, but little is known about environmental reservoirs and predominant modes of transmission, so ...
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Journal ArticlePediatr Infect Dis J · June 2009
BACKGROUND: The World Health Organization (WHO) has recommended the use of clinical staging alone and with total lymphocyte count to identify HIV infected children in need of antiretroviral therapy (ART) in resource-limited settings, when CD4 cell count is ...
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Journal ArticleAnn Trop Med Parasitol · April 2009
Community home-based care (CHBC) plays an integral role in the care of HIV-infected patients living in resource-limited regions. A longitudinal cohort study has recently been conducted, in the Kilimanjaro Region of northern Tanzania, in order to identify t ...
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Journal ArticleEmerg Infect Dis · January 2009
Data on nontuberculous mycobacterial (NTM) disease in sub-Saharan Africa are limited. During 2006-2008, we identified 3 HIV-infected patients in northern Tanzania who had invasive NTM; 2 were infected with "Mycobacterium sherrisii" and 1 with M. avium comp ...
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Journal ArticleJ Clin Microbiol · December 2008
Rapid human immunodeficiency virus (HIV) antibody tests support the effort to expand access to HIV testing and counseling services in remote, rural, and poor parts of the world. We validated the Capillus HIV-1/HIV-2 (Trinity Biotech PLC, Bray, County Wickl ...
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Journal ArticleEast Afr Med J · September 2008
OBJECTIVE: To evaluate the performance of QuantiFERON-TB GOLD (QFTG) in a resource-poor setting among patients with and without HIV infection. DESIGN: Cross-sectional study. SETTING: Two hospitals in Northern Tanzania. SUBJECTS: Eighty three adult male and ...
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Journal ArticlePLoS One · August 27, 2008
BACKGROUND: Monogamy, together with abstinence, partner reduction, and condom use, is widely advocated as a key behavioral strategy to prevent HIV infection in sub-Saharan Africa. We examined the association between the number of sexual partners and the ri ...
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Journal ArticleEpidemiol Infect · June 2008
Enterotoxigenic Escherichia coli (ETEC) is a common cause of profuse watery diarrhoea in the developing world, often leading to severe dehydration or death. We found only 15 population-based studies in low and medium human development index (HDI) countries ...
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Journal ArticleEpidemiol Infect · May 2008
The global incidence of Shigella infection has been estimated at 80-165 million episodes annually, with 99% of episodes occurring in the developing world. To identify contemporary gaps in the understanding of the global epidemiology of shigellosis, we cond ...
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Journal ArticleJ Acquir Immune Defic Syndr · April 15, 2008
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BACKGROUND: Trimethoprim-sulfamethoxazole (SXT) reduces morbidity and mortality among HIV-infected persons in Africa, but its impact on antimicrobial resistance is of concern. METHODS: HIV-uninfected (group A), HIV-infected but not requiring SXT (group B), ...
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Journal ArticleAntimicrob Agents Chemother · April 2008
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Patients with typhoid fever due to Salmonella enterica serotype Typhi strains for which fluoroquinolones MICs are elevated yet that are classified as susceptible by the current interpretive criteria of the Clinical and Laboratory Standards Institute may no ...
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Journal ArticleEpidemiol Infect · April 2008
There are only 10 contemporary, population-based studies of typhoid fever that evaluate disease incidence using blood culture for confirmation of cases. Reported incidence ranged from 13 to 976/100 000 persons per year. These studies are likely to have bee ...
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Journal ArticleClin Infect Dis · December 1, 2007
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BACKGROUND: Access to antiretroviral therapy is rapidly expanding in sub-Saharan Africa. Identifying the predictors of incomplete adherence, virologic failure, and antiviral drug resistance is essential to achieving long-term success. METHODS: A total of 1 ...
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Journal ArticleAIDS research and human retroviruses · October 2007
Clinical criteria are recommended to select HIV-infected patients for initiation of antiretroviral therapy when CD4 lymphocyte testing is unavailable. We evaluated the performance characteristics of WHO staging criteria, anthropometrics, and simple laborat ...
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Journal ArticleAIDS Res Hum Retroviruses · October 2007
Clinical criteria are recommended to select HIV-infected patients for initiation of antiretroviral therapy when CD4 lymphocyte testing is unavailable. We evaluated the performance characteristics of WHO staging criteria, anthropometrics, and simple laborat ...
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Journal ArticleEpidemiol Infect · August 2007
SUMMARYThe global incidence of Shigella infection has been estimated at 80-165 million episodes annually, with 99% of episodes occurring in the developing world. To identify contemporary gaps in the understanding of the global epidemiology of shigellosis, ...
Cite
Journal ArticleEpidemiol Infect · August 2007
SUMMARYEnterotoxigenic Escherichia coli (ETEC) is a common cause of profuse watery diarrhoea in the developing world, often leading to severe dehydration or death. We found only 15 population-based studies in low and medium human development index (HDI) co ...
Cite
Journal ArticleEpidemiol Infect · August 2007
SUMMARYThere are only 10 contemporary, population-based studies of typhoid fever that evaluate disease incidence using blood culture for confirmation of cases. Reported incidence ranged from 13 to 976/100 000 persons per year. These studies are likely to h ...
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Journal ArticleAm J Trop Med Hyg · July 2007
We evaluated enteric infection serology as an alternative outcome measure to diarrhea prevalence in a randomized controlled trial of household-based drinking water treatment; 492 households were randomly assigned to 5 household-based water treatment interv ...
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Journal ArticleTrop Med Int Health · July 2007
BACKGROUND: To investigate the risk factors for infection with endemic typhoid fever in the Samarkand region of Uzbekistan. METHODS: Case-control study of culture-confirmed bloodstream infection with Salmonella Typhi. Patients were compared to age-matched ...
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Journal ArticleJ Int Assoc Physicians AIDS Care (Chic) · March 2007
Antiretroviral treatment literacy leads to greater HIV testing and treatment and antiretroviral treatment adherence. Among northern Tanzanian subjects, antiretroviral treatment awareness was only 17%. Factors associated with low antiretroviral treatment li ...
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Journal ArticleEast Afr Med J · December 2006
Hookworm infection and peptic ulcer disease are common in subtropical and tropical countries. While hookworm infection is endemic where sanitary conditions are poor, peptic ulcer disease is associated with a high prevalence of Helicobacter pylori infection ...
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Journal ArticleInt J STD AIDS · July 2006
Few data exist on the current capacity of Tanzanian health-care facilities to deliver antiretroviral therapy (ART). We evaluated this capacity among Northern Zone facilities in 2004 using a questionnaire that addressed human resources, clinical facilities ...
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Journal ArticleLearning and Individual Differences · February 27, 2006
The aim of this study was to investigate the relationship of fluid intelligence (gf) with trait Openness and Conscientiousness. A total of 2658 participants completed the NEO PI-R [Costa Jr., P. T. & MCrae, R. (1985). Revised NEO Personality Inventory and ...
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Journal ArticleAm J Trop Med Hyg · January 2006
Credible measures of disease incidence are necessary to guide typhoid fever control efforts. In Egypt, incidence estimates have been derived from hospital-based syndromic surveillance, which may not represent the population with typhoid fever. To determine ...
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Journal ArticleAm J Public Health · January 2006
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OBJECTIVES: We evaluated the cost-effectiveness of fee-based and free testing strategies at an HIV voluntary counseling and testing (VCT) program integrated into a community-based AIDS service organization in Moshi, Tanzania. METHODS: We waived the usual f ...
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Journal ArticleInt J STD AIDS · October 2005
HIV voluntary counselling and testing (VCT) reduces high-risk sexual behaviour. Factors associated with HIV infection in VCT clients have not been well characterized in northern Tanzania. We prospectively surveyed 813 VCT clients in Moshi, Tanzania. Client ...
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Journal ArticleBMJ · September 3, 2005
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OBJECTIVE: To compare the effect on prevalence of diarrhoea and mortality of household based treatment of drinking water with flocculant-disinfectant, sodium hypochlorite, and standard practices in areas with turbid water source in Africa. DESIGN: Cluster ...
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Journal ArticleJ Hosp Infect · September 2005
Exit-site and tunnel infections of tunnelled central intravascular catheters are a frequent source of morbidity among neutropenic patients and may necessitate catheter removal. They require antimicrobial therapy that increases healthcare costs and is assoc ...
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Journal ArticleBull World Health Organ · May 2004
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OBJECTIVE: To use new data to make a revised estimate of the global burden of typhoid fever, an accurate understanding of which is necessary to guide public health decisions for disease control and prevention efforts. METHODS: Population-based studies usin ...
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Journal ArticleEpidemiol Infect · April 2004
Salmonella Javiana is a Salmonella serotype that is restricted geographically in the United States to the Southeast. During the summer of 2001, the number of reported S. Javiana infections in Mississippi increased sevenfold. To identify sources of infectio ...
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Journal ArticleAm J Trop Med Hyg · March 2004
We developed and evaluated an enzyme-linked immunosorbent assay (ELISA) using monoclonal antibodies to capture somatic antigen 9 (O9), flagellar antigen d (Hd), and the Vi capsular polysaccharide antigen (Vi) from the urine of persons with and without typh ...
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Journal ArticleAnn Trop Med Parasitol · March 2004
Hospitalized patients with HIV infection are among the most likely to benefit from the expanding availability of anti-retroviral therapy in sub-Saharan Africa. Between 1990 and 2000, 3667 people known to be HIV-infected were admitted to Kilimanjaro Christi ...
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Journal ArticleJ Clin Microbiol · February 2004
Serologic testing is essential for the diagnosis of some infectious diseases and yet is fraught with potential pitfalls. All parts of the diagnostic process must be optimized to ensure that serologic tests perform adequately. Recognizing that a lack of cli ...
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Journal ArticleJ Appl Microbiol · 2004
AIMS: Point-of-use drinking water disinfection with sodium hypochlorite has been shown to improve water quality and reduce diarrhoeal disease. However, the chlorine demand of highly turbid water may render sodium hypochlorite less effective. METHODS AND RE ...
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Journal ArticleEpidemiol Infect · December 2003
Escherichia coli O157 infections cause an estimated 60 deaths and 73 000 illnesses annually in the United States. A marked summer peak in incidence is largely unexplained. We investigated an outbreak of E. coli O157 infections at an agricultural fair in Oh ...
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Journal ArticleClin Infect Dis · October 15, 2003
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We describe the clinical presentation, predisposing conditions, diagnostic approach, and outcome for 52 patients with disseminated tuberculosis who presented at Duke University Medical Center (Durham, NC) from 1980 through 1999. The mean age of the patient ...
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Journal ArticleClin Infect Dis · July 1, 2003
Salmonella enterica infections cause considerable morbidity and mortality worldwide. Antimicrobial therapy may be life-saving for patients with extraintestinal infections with S. enterica serotype Typhi or non-Typhi salmonellae. Because antimicrobial resis ...
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Journal ArticleJ Clin Microbiol · May 2003
To compare the performance of the BACTEC 13A (Becton Dickinson, Sparks, Md.), BACTEC MYCO/F LYTIC (Becton Dickinson), BacT/ALERT MB (bioMérieux, Durham, N.C.), and ISOLATOR 10 lysis-centrifugation (Wampole Laboratories, Cranbury, N.J.) systems for detectio ...
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Journal ArticleEmerg Infect Dis · May 2003
To measure the incidence of typhoid fever and other febrile illnesses in Bilbeis District, Egypt, we conducted a household survey to determine patterns of health seeking among persons with fever. Then we established surveillance for 4 months among a repres ...
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Journal ArticleJ Infect Dis · March 1, 2003
Toxigenic Vibrio cholerae serogroup O141 has been associated with sporadic cholera-like diarrhea and bloodstream infection in the United States. Consumption of seafood and proximity to the coast may increase the risk of infection. All V. cholerae isolates ...
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Journal ArticleClin Infect Dis · October 1, 2002
Animal feed is at the beginning of the food safety chain in the "farm-to-fork" model. The emergence of variant Creutzfeldt-Jakob disease has raised awareness of the importance of contaminated animal feed, but less attention has been paid to the role of bac ...
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Journal ArticleN Engl J Med · August 22, 2002
BACKGROUND: Outbreaks of Escherichia coli O157:H7 infections have involved direct transmission from animals and their environment to humans. We describe an outbreak among visitors to a Pennsylvania dairy and petting farm that provides public access to anim ...
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Journal ArticleEmerg Infect Dis · 2001
Several unique features characterize infectious disease epidemiology in New Zealand. Historically, well-organized, government-run control programs have eliminated several zoonoses. More recently, however, communicable disease control has been mixed. Rates ...
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Journal ArticleEur J Clin Microbiol Infect Dis · January 2000
Serious infections associated with intravascular catheters are common. The available data suggests there are likely to be more than 500 000 cases of catheter-associated bloodstream infections occurring annually in Western Europe and the USA. These may be a ...
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Journal ArticleJ Travel Med · January 2000
Schistosoma haemtobium infection in travelers from endemic areas is usually asymptomatic, or presents with hematuria. Uncommon manifestations include neurological syndromes, genital dysaesthesias and watery or blood stained semen. This organism also causes ...
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Journal ArticlePostgrad Med J · November 1999
Ciguatera fish poisoning is one of a variety of non-bacterial forms of human seafood poisoning. Consuming large predatory fish from tropical reef ecosystems may be hazardous. We describe a case that is typical of the disease, and illustrates the persistenc ...
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Journal ArticleN Z Med J · April 9, 1999
AIM: To detect changes in knowledge, attitudes and behaviour towards HIV infection amongst Family Planning Clinic attendees in Christchurch, New Zealand, between 1991 and 1997. METHODS: A voluntary, anonymous, self-administered questionnaire was applied to ...
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Journal ArticleCurrent Anaesthesia and Critical Care · January 1, 1999
'Atypical' pneumonia can be defined as pneumonia that is caused by bacteria lacking a typical cell wall, and those resistant to β-lactam and cephalosporin antibiotics. Therefore, 'atypical' pneumonia caused by Mycoplasma pneumoniae, Chlamydia pneumoniae, C ...
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Journal ArticleTrop Med Int Health · August 1997
The relative contribution of reactivated and recently acquired tuberculosis to the disease burden in developing countries is unknown, as are the settings within which most transmission occurs. In an attempt to answer these questions, we combined molecular ...
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Journal ArticleTrans R Soc Trop Med Hyg · 1997
These 3 cases illustrate what we believe to be unusual presentations of tuberculosis. In no case was there conclusive proof of infection with Mycobacterium tuberculosis using histological, microbiological or radiological techniques. All were treated empiri ...
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Journal ArticleJ Intern Med · July 1995
We report the case of a 35-year-old patient who presented with acute adrenal insufficiency, then developed fever, hypoalbuminuria, anasarca, thrombocytopaenia and anaemia. Lymphadenopathy appeared later with microscopic features typical of Castleman's dise ...
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