Scholars@Duke
John Andrew Crump

John Andrew Crump

Adjunct Professor in the Department of Medicine
Medicine, Infectious Diseases
john.crump@duke.edu
Box 90519, Duke Global Health Institute, Durham, NC 27708
Trent Hall, Room 115, Durham, NC 27708

Selected Publications

Epidemiologic and genomic characterization of an outbreak of Rift Valley fever among humans and dairy cattle in northern Tanzania.

Journal Article J Infect Dis · November 13, 2024 BACKGROUND: A peri-urban 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 ... Full text Link to item Cite

Predicting mortality in febrile adults: comparative performance of the MEWS, qSOFA, and UVA scores using prospectively collected data among patients in four health-care sites in sub-Saharan Africa and South-Eastern Asia

Journal Article eClinicalMedicine · November 1, 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 ... Full text Cite

Population Structure and Antimicrobial Resistance in Campylobacter jejuni and C. coli Isolated from Humans with Diarrhea and from Poultry, East Africa.

Journal Article Emerg 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. ... Full text Link to item Cite

Metagenomic Detection of Bacterial Zoonotic Pathogens among Febrile Patients, Tanzania, 2007-20091.

Journal Article Emerg Infect Dis · 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 ... Full text Link to item Cite

Vaccine value profile for invasive non-typhoidal Salmonella disease.

Journal Article Vaccine · 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 ... Full text Link to item Cite

Molecular and clinical epidemiology of carbapenem resistant Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacterales in Fiji: a multicentre prospective observational study

Journal Article The Lancet 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 ... Full text Cite

Prevalence and risk factors for Q fever, spotted fever group rickettsioses, and typhus group rickettsioses in a pastoralist community of northern Tanzania, 2016-2017.

Journal Article Trop 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 ... Full text Link to item Cite

Incidence of typhoid fever in Burkina Faso, Democratic Republic of the Congo, Ethiopia, Ghana, Madagascar, and Nigeria (the Severe Typhoid in Africa programme): a population-based study.

Journal Article Lancet 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 ... Full text Link to item Cite

Examining geospatial and temporal distribution of invasive non-typhoidal Salmonella disease occurrence in sub-Saharan Africa: a systematic review and modelling study.

Journal Article BMJ 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 ... Full text Link to item Cite

Global distribution of Leptospira serovar isolations and detections from animal host species: A systematic review and online database.

Journal Article Trop 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 ... Full text Link to item Cite

Public opinion on global COVID-19 vaccine procurement and distribution policies: A nationally representative survey in Aotearoa New Zealand 2022.

Journal Article Vaccine · 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 ... Full text Link to item Cite

Diagnosis of human leptospirosis: systematic review and meta-analysis of the diagnostic accuracy of the Leptospira microscopic agglutination test, PCR targeting Lfb1, and IgM ELISA to Leptospira fainei serovar Hurstbridge.

Journal Article BMC 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 ... Full text Link to item Cite

Mapping the incidence rate of typhoid fever in sub-Saharan Africa.

Journal Article PLoS 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 ... Full text Link to item Cite

Oral antimicrobial therapy for cellulitis versus outpatient parenteral antimicrobial therapy: a single-centre audit of cellulitis outcomes.

Journal Article Intern 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 ... Full text Link to item Cite

Environmental contamination with carbapenem resistant Acinetobacter baumannii in healthcare settings in Fiji: a potential source of infection.

Journal Article Front 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 ... Full text Link to item Cite

Host-response transcriptional biomarkers accurately discriminate bacterial and viral infections of global relevance.

Journal Article Sci 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 ... Full text Link to item Cite

Typhoid fever.

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 ... Full text Link to item Cite

Prevalence and risk factors for human leptospirosis at a hospital serving a pastoralist community, Endulen, Tanzania.

Journal Article PLoS 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 ... Full text Open Access Link to item Cite

Molecular and clinical epidemiology of carbapenem resistant Acinetobacter baumannii ST2 in Oceania: a multicountry cohort study

Journal Article The Lancet 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 ... Full text Cite

Prevalence and distribution of non-typhoidal Salmonella enterica serogroups and serovars isolated from normally sterile sites: A global systematic review.

Journal Article Epidemiol 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 ... Full text Link to item Cite

Etiologic Investigation of Patients Diagnosed with Bacteriologically Unconfirmed Tuberculosis in Tanzania.

Journal Article Am 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 ... Full text Link to item Cite

Global distribution of Leptospira serovar isolations and detections from animal host species: a systematic review and online database.

Journal Article medRxiv · 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 ... Full text Open Access Link to item Cite

Global diversity and antimicrobial resistance of typhoid fever pathogens: Insights from a meta-analysis of 13,000 Salmonella Typhi genomes.

Journal Article Elife · 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 ... Full text Link to item Cite

Antibacterial Utilization for Febrile Illnesses and Laboratory-Confirmed Bloodstream Infections in Northern Tanzania.

Journal Article Open 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 ... Full text Open Access Link to item Cite

Evaluation of Ebola virus disease surveillance system capability to promptly detect a new outbreak in Liberia.

Journal Article BMJ 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 ... Full text Link to item Cite

Detection of dengue virus infection in children presenting with fever in Hawassa, southern Ethiopia.

Journal Article Sci 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 ... Full text Link to item Cite

Nontyphoidal Salmonella Invasive Disease: Challenges and Solutions.

Journal Article Open 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 ... Full text Link to item Cite

'One Health´ approach to end zoonotic TB.

Journal Article Int 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 ... Full text Open Access Link to item Cite

Differences in diagnosis, management, and outcomes of acute febrile illness by health facility level in southern Ethiopia.

Journal Article Sci 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 ... Full text Link to item Cite

An outbreak of Rift Valley fever among peri-urban dairy cattle in northern Tanzania.

Journal Article Trans 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 ... Full text Link to item Cite

Inter-epidemic Rift Valley fever virus infection incidence and risks for zoonotic spillover in northern Tanzania.

Journal Article PLoS 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 ... Full text Link to item Cite

Clinical evaluation of the BioFire Global Fever Panel for the identification of malaria, leptospirosis, chikungunya, and dengue from whole blood: a prospective, multicentre, cross-sectional diagnostic accuracy study.

Journal Article Lancet 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 ... Full text Link to item Cite

Antimicrobial resistance patterns in bacteria causing febrile illness in Africa, South Asia, and Southeast Asia: a systematic review of published etiological studies from 1980-2015.

Journal Article Int 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 ... Full text Link to item Cite

Performance of Xpert Ultra nasopharyngeal swab for identification of tuberculosis deaths in northern Tanzania.

Journal Article Clin 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 ... Full text Open Access Link to item Cite

Prospective cohort study reveals unexpected aetiologies of livestock abortion in northern Tanzania.

Journal Article Sci 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 ... Full text Link to item Cite

Facility-based disease surveillance and Bayesian hierarchical modeling to estimate endemic typhoid fever incidence, Kilimanjaro Region, Tanzania, 2007-2018.

Journal Article PLoS 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 ... Full text Open Access Link to item Cite

Genomic epidemiology of Salmonella Typhi in Central Division, Fiji, 2012 to 2016

Journal Article The Lancet 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 ... Full text Cite

Towards equitable scheduling of global health teleconferences: a spatial exploration of the world's population and health by time zone.

Journal Article BMJ 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 ... Full text Link to item Cite

Clinical management and outcomes of acute febrile illness in children attending a tertiary hospital in southern Ethiopia.

Journal Article BMC 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 ... Full text Link to item Cite

Spread of Nontyphoidal Salmonella in the Beef Supply Chain in Northern Tanzania: Sensitivity in a Probabilistic Model Integrating Microbiological Data and Data from Stakeholder Interviews.

Journal Article Risk 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 ... Full text Link to item Cite

Complications and mortality of non-typhoidal salmonella invasive disease: a global systematic review and meta-analysis.

Journal Article Lancet 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- ... Full text Link to item Cite

Point-prevalence surveys of antimicrobial consumption and resistance at a paediatric and an adult tertiary referral hospital in Yangon, Myanmar.

Journal Article Infect 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 ... Full text Link to item Cite

Timely health care seeking and first source of care for acute febrile illness in children in Hawassa, southern Ethiopia.

Journal Article PLoS 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 ... Full text Link to item Cite

Incidence Estimates of Acute Q Fever and Spotted Fever Group Rickettsioses, Kilimanjaro, Tanzania, from 2007 to 2008 and from 2012 to 2014.

Journal Article Am 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 ... Full text Open Access Link to item Cite

Trends in fever case management for febrile inpatients in a low malaria incidence setting of Tanzania.

Journal Article Trop Med Int Health · December 2021 OBJECTIVES: In 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: We compa ... Full text Open Access Link to item Cite

Performance Assessment of the Universal Vital Assessment Score vs Other Illness Severity Scores for Predicting Risk of In-Hospital Death Among Adult Febrile Inpatients in Northern Tanzania, 2016-2019.

Journal Article JAMA 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 ... Full text Open Access Link to item Cite

Assessment of Rapid Diagnostic Tests for Typhoid Diagnosis and Assessment of Febrile Illness Outbreaks in Fiji.

Journal Article Am 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 ... Full text Link to item Cite

Incidence of non-typhoidal Salmonella invasive disease: A systematic review and meta-analysis.

Journal Article J 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 ... Full text Link to item Cite

Investigating the Meat Pathway as a Source of Human Nontyphoidal Salmonella Bloodstream Infections and Diarrhea in East Africa.

Journal Article Clin 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 ... Full text Link to item Cite

On the robustness of latent class models for diagnostic testing with no gold standard.

Journal Article Stat 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 ... Full text Link to item Cite

Incidence of Acute Myocardial Infarction in Northern Tanzania: A Modeling Approach Within a Prospective Observational Study.

Journal Article J 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 ... Full text Open Access Link to item Cite

The genomic epidemiology of multi-drug resistant invasive non-typhoidal Salmonella in selected sub-Saharan African countries.

Journal Article BMJ 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 ... Full text Link to item Cite

Latent class evaluation of the performance of serological tests for exposure to Brucella spp. in cattle, sheep, and goats in Tanzania.

Journal Article PLoS 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 ... Full text Link to item Cite

"He Who Relies on His Brother's Property Dies Poor": The Complex Narratives of Livestock Care in Northern Tanzania.

Journal Article Front 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 ... Full text Link to item Cite

Investigation of Melioidosis Using Blood Culture and Indirect Hemagglutination Assay Serology among Patients with Fever, Northern Tanzania.

Journal Article Am 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 ... Full text Open Access Link to item Cite

A Systematic Review on Antimicrobial Resistance among Salmonella Typhi Worldwide.

Journal Article Am 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 ... Full text Link to item Cite

Complications and mortality of typhoid fever: A global systematic review and meta-analysis.

Journal Article J 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 ... Full text Link to item Cite

Aetiology of acute febrile illness among children attending a tertiary hospital in southern Ethiopia.

Journal Article BMC 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 ... Full text Link to item Cite

Molecular Detection and Typing of Pathogenic Leptospira in Febrile Patients and Phylogenetic Comparison with Leptospira Detected among Animals in Tanzania.

Journal Article Am 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 ... Full text Link to item Cite

An In-Depth Examination of Reasons for Autopsy Acceptance and Refusal in Northern Tanzania.

Journal Article Am 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 ... Full text Link to item Cite

Non-malarial febrile illness: a systematic review of published aetiological studies and case reports from Southern Asia and South-eastern Asia, 1980-2015.

Journal Article BMC 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 ... Full text Link to item Cite

Non-malarial febrile illness: a systematic review of published aetiological studies and case reports from Africa, 1980-2015.

Journal Article BMC 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 ... Full text Link to item Cite

Estimating acute human leptospirosis incidence in northern Tanzania using sentinel site and community behavioural surveillance.

Journal Article Zoonoses 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 ... Full text Link to item Cite

Assessing the Feasibility of Typhoid Elimination.

Journal Article Clin 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 ... Full text Link to item Cite

Tenacious Endemic Typhoid Fever in Samoa.

Journal Article Clin 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 ... Full text Link to item Cite

Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE): protocol for a multisite prospective observational study of the causes of fever in Africa and Asia.

Journal Article BMJ 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 ... Full text Link to item Cite

"If You Have No Money, You Might Die": A Qualitative Study of Sociocultural and Health System Barriers to Care for Decedent Febrile Inpatients in Northern Tanzania.

Journal Article Am 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 ... Full text Link to item Cite

Mycobacterium tuberculosis bloodstream infection prevalence, diagnosis, and mortality risk in seriously ill adults with HIV: a systematic review and meta-analysis of individual patient data.

Journal Article Lancet 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 ... Full text Link to item Cite

Typhoid Outbreaks, 1989-2018: Implications for Prevention and Control.

Conference The 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 ... Full text Cite

Child undernutrition in households with microbiologically safer drinking water and 'improved water' in Tanna, Vanuatu.

Journal Article J 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 ... Full text Link to item Cite

Risk factors for Staphylococcus capitis pulsotype NRCS-A colonisation among premature neonates in the neonatal intensive care unit of a tertiary-care hospital: a retrospective case-control study

Journal Article Infection 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 ... Full text Cite

A prospective study of Escherichia coli bloodstream infection among adolescents and adults in northern Tanzania.

Journal Article Trans 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 ... Full text Open Access Link to item Cite

Prevalence and speciation of brucellosis in febrile patients from a pastoralist community of Tanzania.

Journal Article Sci 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 ... Full text Link to item Cite

Meat Safety in Tanzania's Value Chain: Experiences, Explanations and Expectations in Butcheries and Eateries.

Journal Article Int 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 ... Full text Link to item Cite

A prospective study of bloodstream infections among febrile adolescents and adults attending Yangon General Hospital, Yangon, Myanmar.

Journal Article PLoS 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 ... Full text Link to item Cite

Estimation of Incidence of Typhoid and Paratyphoid Fever in Vientiane, Lao People's Democratic Republic.

Journal Article Am 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 ... Full text Link to item Cite

Sensitivity of C-reactive protein for the identification of patients with laboratory-confirmed bacterial infections in northern Tanzania.

Journal Article Trop 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 ... Full text Link to item Cite

Prevalence of Campylobacter and Salmonella in African food animals and meat: A systematic review and meta-analysis.

Journal Article Int 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 ... Full text Link to item Cite

Zoonotic causes of febrile illness in malaria endemic countries: a systematic review.

Journal Article Lancet 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 ... Full text Open Access Link to item Cite

Classification and characterisation of livestock production systems in northern Tanzania.

Journal Article PLoS 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 ... Full text Link to item Cite

Meat Safety in Northern Tanzania: Inspectors' and Slaughter Workers' Risk Perceptions and Management.

Journal Article Front 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 ... Full text Link to item Cite

A Systematic Review and Meta-analysis of the Prevalence of Community-Onset Bloodstream Infections among Hospitalized Patients in Africa and Asia.

Journal Article Antimicrob 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 ... Full text Link to item Cite

Using hospital-based studies of community-onset bloodstream infections to make inferences about typhoid fever incidence.

Journal Article Trop 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 ... Full text Link to item Cite

The global burden of non-typhoidal salmonella invasive disease: a systematic analysis for the Global Burden of Disease Study 2017.

Journal Article Lancet 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 ... Full text Link to item Cite

A retrospective study of patients with blood culture-confirmed typhoid fever in Fiji during 2014-2015: epidemiology, clinical features, treatment and outcome.

Journal Article Trans 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 ... Full text Link to item Cite

Global knowledge gaps in acute febrile illness etiologic investigations: A scoping review.

Journal Article PLoS 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 ... Full text Link to item Cite

Multicountry Distribution and Characterization of Extended-spectrum β-Lactamase-associated Gram-negative Bacteria From Bloodstream Infections in Sub-Saharan Africa.

Journal Article Clin 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 ... Full text Link to item Cite

The Severe Typhoid Fever in Africa Program: Study Design and Methodology to Assess Disease Severity, Host Immunity, and Carriage Associated With Invasive Salmonellosis.

Journal Article Clin 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 ... Full text Link to item Cite

Molecular mechanisms of antimicrobial resistance and phylogenetic relationships of Salmonella enterica isolates from febrile patients in Yangon, Myanmar.

Journal Article Trans 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 ... Full text Link to item Cite

Fever, bacterial zoonoses, and One Health in sub-Saharan Africa.

Journal Article Clin 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 ... Full text Open Access Link to item Cite

Environmental Foundations of Typhoid Fever in the Fijian Residential Setting.

Journal Article Int 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 ... Full text Link to item Cite

Street-level diplomacy and local enforcement for meat safety in northern Tanzania: knowledge, pragmatism and trust.

Journal Article BMC 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 ... Full text Link to item Cite

Diagnostic accuracy of leptospirosis whole-cell lateral flow assays: a systematic review and meta-analysis.

Journal Article Clin 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 ... Full text Link to item Cite

Self-medication with non-prescribed pharmaceutical agents in an area of low malaria transmission in northern Tanzania: a community-based survey.

Journal Article Trans 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 ... Full text Link to item Cite

Knowledge of myocardial infarction symptoms and perceptions of self-risk in Tanzania.

Journal Article Am 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 ... Full text Link to item Cite

The global burden of typhoid and paratyphoid fevers: a systematic analysis for the Global Burden of Disease Study 2017.

Journal Article Lancet 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 ... Full text Link to item Cite

Global Typhoid Fever Incidence: A Systematic Review and Meta-analysis.

Journal Article Clin 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 ... Full text Link to item Cite

Incidence of Typhoid and Paratyphoid Fevers Among Adolescents and Adults in Yangon, Myanmar.

Journal Article Clin 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 ... Full text Link to item Cite

Epidemiology and Antimicrobial Susceptibility of Salmonella enterica Bloodstream Isolates Among Febrile Children in a Rural District in Northeastern Tanzania: A Cross-sectional Study.

Journal Article Clin 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 ... Full text Link to item Cite

Increasing incidence of invasive nontyphoidal Salmonella infections in Queensland, Australia, 2007-2016.

Journal Article PLoS 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 ... Full text Link to item Cite

Progress in Typhoid Fever Epidemiology.

Journal Article Clin 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 ... Full text Link to item Cite

Perceptions of chest pain and healthcare seeking behavior for chest pain in northern Tanzania: A community-based survey.

Journal Article PLoS 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 ... Full text Link to item Cite

Perceptions of Stroke and Associated Health-Care-Seeking Behavior in Northern Tanzania: A Community-Based Study.

Journal Article Neuroepidemiology · 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 ... Full text Link to item Cite

The phylogeography and incidence of multi-drug resistant typhoid fever in sub-Saharan Africa.

Journal Article Nat 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 ... Full text Link to item Cite

Determining the Best Immunization Strategy for Protecting African Children Against Invasive Salmonella Disease.

Journal Article Clin 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 ... Full text Link to item Cite

Predicting Mortality for Adolescent and Adult Patients with Fever in Resource-Limited Settings.

Conference Am 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 ... Full text Link to item Cite

The epidemiology of febrile illness in sub-Saharan Africa: implications for diagnosis and management.

Journal Article Clin 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 ... Full text Link to item Cite

Febrile illness in Asia: gaps in epidemiology, diagnosis and management for informing health policy.

Journal Article Clin 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 ... Full text Link to item Cite

Health Outcomes from Multidrug-Resistant Salmonella Infections in High-Income Countries: A Systematic Review and Meta-Analysis.

Journal Article Foodborne 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 ... Full text Link to item Cite

Assessment of animal hosts of pathogenic Leptospira in northern Tanzania.

Journal Article PLoS 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 ... Full text Link to item Cite

Risk factors for human acute leptospirosis in northern Tanzania.

Journal Article PLoS 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 ... Full text Link to item Cite

Epidemiology and risk factors for typhoid fever in Central Division, Fiji, 2014-2017: A case-control study.

Journal Article PLoS 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 ... Full text Link to item Cite

Seasonal dynamics of typhoid and paratyphoid fever.

Journal Article Sci 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 ... Full text Link to item Cite

Incidence of human brucellosis in the Kilimanjaro Region of Tanzania in the periods 2007-2008 and 2012-2014.

Journal Article Trans 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 ... Full text Open Access Link to item Cite

Risk Factors for Human Brucellosis in Northern Tanzania.

Conference Am 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 ... Full text Link to item Cite

Sociocultural and health system factors associated with mortality among febrile inpatients in Tanzania: a prospective social biopsy cohort study.

Journal Article BMJ 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 ... Full text Link to item Cite

WHAT IS THE BEST IMMUNIZATION STRATEGY FOR PROTECTING AFRICAN CHILDREN AGAINST INVASIVE DISEASE?

Conference AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · 2018 Cite

2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.

Journal Article Clin 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 ... Full text Link to item Cite

2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.

Journal Article Clin 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 ... Full text Link to item Cite

Estimating the burden of scrub typhus: A systematic review.

Journal Article PLoS 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 ... Full text Link to item Cite

One Health contributions towards more effective and equitable approaches to health in low- and middle-income countries.

Journal Article Philos 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 ... Full text Link to item Cite

Child and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study.

Journal Article JAMA 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 ... Full text Link to item Cite

ESBL- and Carbapenemase-Producing Enterobacteriaceae in Patients with Bacteremia, Yangon, Myanmar, 2014.

Journal Article Emerg 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 ... Full text Link to item Cite

Incidence of invasive salmonella disease in sub-Saharan Africa: a multicentre population-based surveillance study.

Journal Article Lancet 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 ... Full text Link to item Cite

Derivation and validation of a universal vital assessment (UVA) score: a tool for predicting mortality in adult hospitalised patients in sub-Saharan Africa.

Journal Article BMJ 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 ... Full text Link to item Cite

EXAMINING PERCEPTIONS AND ACCEPTABILITY OF FULL DIAGNOSTIC AUTOPSY IN KILIMANJARO REGION, TANZANIA

Conference AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · January 1, 2017 Link to item Cite

Comparison of the Estimated Incidence of Acute Leptospirosis in the Kilimanjaro Region of Tanzania between 2007-08 and 2012-14.

Journal Article PLoS 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 ... Full text Link to item Cite

Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015.

Journal Article Lancet · 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 ... Full text Link to item Cite

Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.

Journal Article Lancet · 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 ... Full text Link to item Cite

Salmonella

Chapter · October 6, 2016 Salmonella enterica remains a major cause of morbidity and mortality worldwide. In industrialized countries, nontyphoidal serovars of S.enterica are important causes of diarrhea. In low-resource settings, particularly in sub-Saharan African countries, nont ... Full text Cite

An extended genotyping framework for Salmonella enterica serovar Typhi, the cause of human typhoid.

Journal Article Nat 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 ... Full text Link to item Cite

Molecular Surveillance Identifies Multiple Transmissions of Typhoid in West Africa

Journal Article PLoS 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 ... Full text Cite

Whole-genome sequencing of multidrug-resistant Mycobacterium tuberculosis isolates from Myanmar.

Journal Article J 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 ... Full text Link to item Cite

Challenges of Maintaining Good Clinical Laboratory Practices in Low-Resource Settings:  A Health Program Evaluation Framework Case Study From East Africa.

Journal Article Am 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 ... Full text Open Access Link to item Cite

Mycobacterium tuberculosis bacteremia in adults and children: a systematic review and meta-analysis.

Journal Article Int 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. ... Full text Link to item Cite

Distribution of Aedes mosquitoes in the Kilimanjaro Region of northern Tanzania.

Journal Article Pathog 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 ... Full text Open Access Link to item Cite

The Typhoid Fever Surveillance in Africa Program (TSAP): Clinical, Diagnostic, and Epidemiological Methodologies.

Journal Article Clin 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 ... Full text Open Access Link to item Cite

Validation and Identification of Invasive Salmonella Serotypes in Sub-Saharan Africa by Multiplex Polymerase Chain Reaction.

Journal Article Clin 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 ... Full text Open Access Link to item Cite

A Multicountry Molecular Analysis of Salmonella enterica Serovar Typhi With Reduced Susceptibility to Ciprofloxacin in Sub-Saharan Africa.

Journal Article Clin 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 ... Full text Open Access Link to item Cite

Utilization of Healthcare in the Typhoid Fever Surveillance in Africa Program.

Journal Article Clin 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 ... Full text Open Access Link to item Cite

The Relationship Between Invasive Nontyphoidal Salmonella Disease, Other Bacterial Bloodstream Infections, and Malaria in Sub-Saharan Africa.

Journal Article Clin 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 ... Full text Open Access Link to item Cite

Mixed Methods Survey of Zoonotic Disease Awareness and Practice among Animal and Human Healthcare Providers in Moshi, Tanzania.

Journal Article PLoS 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 ... Full text Open Access Link to item Cite

Global and National Burden of Diseases and Injuries Among Children and Adolescents Between 1990 and 2013: Findings From the Global Burden of Disease 2013 Study.

Journal Article JAMA 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 ... Full text Link to item Cite

Development of a TaqMan Array Card for Acute-Febrile-Illness Outbreak Investigation and Surveillance of Emerging Pathogens, Including Ebola Virus.

Journal Article J 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 ... Full text Open Access Link to item Cite

Differential Killing of Salmonella enterica Serovar Typhi by Antibodies Targeting Vi and Lipopolysaccharide O:9 Antigen.

Journal Article PLoS 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 ... Full text Open Access Link to item Cite

Target Product Profile for a Diagnostic Assay to Differentiate between Bacterial and Non-Bacterial Infections and Reduce Antimicrobial Overuse in Resource-Limited Settings: An Expert Consensus.

Journal Article PLoS 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 ... Full text Open Access Link to item Cite

Smartphone Microscopy of Parasite Eggs Accumulated into a Single Field of View.

Journal Article Am 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 ... Full text Link to item Cite

Draft genome sequences of two drug-resistant Mycobacterium tuberculosis isolates from Myanmar

Journal Article Genome 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 ... Full text Cite

World Health Organization Estimates of the Global and Regional Disease Burden of 22 Foodborne Bacterial, Protozoal, and Viral Diseases, 2010: A Data Synthesis.

Journal Article PLoS 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 ... Full text Link to item Cite

Estimating the Burden of Febrile Illnesses.

Journal Article PLoS Negl Trop Dis · December 2015 Full text Link to item Cite

World Health Organization Global Estimates and Regional Comparisons of the Burden of Foodborne Disease in 2010.

Journal Article PLoS 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 ... Full text Link to item Cite

Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition.

Journal Article Lancet · 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 ... Full text Link to item Cite

Establishment of biochemistry reference values for healthy Tanzanian infants, children and adolescents in Kilimanjaro Region.

Journal Article Trop 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 ... Full text Open Access Link to item Cite

Bloodstream Infections and Frequency of Pretreatment Associated With Age and Hospitalization Status in Sub-Saharan Africa.

Journal Article Clin 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 ... Full text Open Access Link to item Cite

A Perspective on Invasive Salmonella Disease in Africa.

Journal Article Clin 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 ... Full text Link to item Cite

Estimating the burden of fungal disease in Vietnam.

Journal Article Mycoses · 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 ... Full text Link to item Cite

Performance Requirements to Achieve Cost-Effectiveness of Point-of-Care Tests for Sepsis Among Patients with Febrile Illness in Low-Resource Settings.

Journal Article Am 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 ... Full text Link to item Cite

Cost-Effectiveness of Surveillance for Bloodstream Infections for Sepsis Management in Low-Resource Settings.

Journal Article Am 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 ... Full text Link to item Cite

Epidemiology, Clinical Presentation, Laboratory Diagnosis, Antimicrobial Resistance, and Antimicrobial Management of Invasive Salmonella Infections.

Journal Article Clin 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 ... Full text Link to item Cite

Community prevalence of fever and relationship with malaria among infants and children in low-resource areas.

Journal Article Am 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 ... Full text Link to item Cite

Building the case for wider use of typhoid vaccines.

Journal Article Vaccine · 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 ... Full text Link to item Cite

Phylogeographical analysis of the dominant multidrug-resistant H58 clade of Salmonella Typhi identifies inter- and intracontinental transmission events.

Journal Article Nat 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 ... Full text Link to item Cite

Global burden of invasive nontyphoidal Salmonella disease, 2010(1).

Journal Article Emerg 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 ... Full text Link to item Cite

Lopinavir/Ritonavir Monotherapy as Second-line Antiretroviral Treatment in Resource-Limited Settings: Week 104 Analysis of AIDS Clinical Trials Group (ACTG) A5230.

Journal Article Clin 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 ... Full text Open Access Link to item Cite

Endemic zoonoses in the tropics: a public health problem hiding in plain sight.

Journal Article Vet 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. ... Full text Link to item Cite

Etiologies of illness among patients meeting integrated management of adolescent and adult illness district clinician manual criteria for severe infections in northern Tanzania: implications for empiric antimicrobial therapy.

Journal Article Am 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 ... Full text Open Access Link to item Cite

Predictors and outcomes of Mycobacterium tuberculosis bacteremia among patients with HIV and tuberculosis co-infection enrolled in the ACTG A5221 STRIDE study.

Journal Article BMC 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 ... Full text Open Access Link to item Cite

Initiation of antiretroviral therapy in HIV-infected adults with skin complaints in northern Tanzania.

Journal Article Int 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 ... Full text Open Access Link to item Cite

Epidemiology of Leptospirosis in Africa: A Systematic Review of a Neglected Zoonosis and a Paradigm for 'One Health' in Africa.

Journal Article PLoS 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 ... Full text Open Access Link to item Cite

Etiology of Severe Febrile Illness in Low- and Middle-Income Countries: A Systematic Review.

Journal Article PLoS 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 ... Full text Link to item Cite

Bloodstream infections at a tertiary referral hospital in Yangon, Myanmar.

Journal Article Trans 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 ... Full text Link to item Cite

Typhoid fever in Fiji: a reversible plague?

Journal Article Trop 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 ... Full text Link to item Cite

A cloud-compatible bioinformatics pipeline for ultrarapid pathogen identification from next-generation sequencing of clinical samples.

Journal Article Genome 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 ... Full text Open Access Link to item Cite

Epidemiology of Coxiella burnetii infection in Africa: a OneHealth systematic review.

Journal Article PLoS 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 ... Full text Open Access Link to item Cite

Invasive Salmonella infections in areas of high and low malaria transmission intensity in Tanzania.

Journal Article Clin 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 ... Full text Open Access Link to item Cite

Fluoroquinolone susceptibility testing of Salmonella enterica: detection of acquired resistance and selection of zone diameter breakpoints for levofloxacin and ofloxacin.

Journal Article J 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 ... Full text Link to item Cite

A randomized controlled trial of standard versus intensified tuberculosis diagnostics on treatment decisions by physicians in Northern Tanzania.

Journal Article BMC 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 ... Full text Open Access Link to item Cite

A randomized controlled trial of standard versus intensified tuberculosis diagnostics on treatment decisions by physicians in Northern Tanzania

Journal Article BMC 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 ... Full text Cite

Evaluation of in-hospital management for febrile illness in Northern Tanzania before and after 2010 World Health Organization Guidelines for the treatment of malaria.

Journal Article PLoS 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 ... Full text Open Access Link to item Cite

The management of antimicrobial-resistant enteric fever.

Journal Article Expert Rev Anti Infect Ther · December 2013 Full text Link to item Cite

Comparing actual and perceived causes of fever among community members in a low malaria transmission setting in northern Tanzania.

Journal Article Trop 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 ... Full text Open Access Link to item Cite

Chest radiography for predicting the cause of febrile illness among inpatients in Moshi, Tanzania.

Journal Article Clin 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 ... Full text Link to item Cite

Brucellosis in low-income and middle-income countries.

Journal Article Curr 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 ... Full text Open Access Link to item Cite

Leptospirosis and human immunodeficiency virus co-infection among febrile inpatients in northern Tanzania.

Journal Article Vector 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 ... Full text Open Access Link to item Cite

Prevalence of mycobacteremia among HIV-infected infants and children in northern Tanzania.

Journal Article Pediatr 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 ... Full text Open Access Link to item Cite

Estimating leptospirosis incidence using hospital-based surveillance and a population-based health care utilization survey in Tanzania.

Journal Article PLoS 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, ... Full text Open Access Link to item Cite

Reflecting on short-term international service-learning trips

Journal Article Academic Medicine · January 1, 2013 Full text Cite

Etiology of severe non-malaria febrile illness in Northern Tanzania: a prospective cohort study.

Journal Article PLoS 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 ... Full text Open Access Link to item Cite

Brucellosis among hospitalized febrile patients in northern Tanzania.

Journal Article Am 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 ... Full text Open Access Link to item Cite

Utility of rapid antibody tests to exclude HIV-1 infection among infants and children aged <18 months in a low-resource setting.

Journal Article J 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 ... Full text Open Access Link to item Cite

Predicting mortality for paediatric inpatients where malaria is uncommon.

Journal Article Arch 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 ... Full text Open Access Link to item Cite

Reply to yansouni et al

Journal Article Clinical Infectious Diseases · August 15, 2012 Full text Cite

Histoplasmosis among hospitalized febrile patients in northern Tanzania.

Journal Article Trans 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 ... Full text Open Access Link to item Cite

Cross-platform analysis of HIV-1 RNA data generated by a multicenter assay validation study with wide geographic representation.

Journal Article J 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 ... Full text Open Access Link to item Cite

Lopinavir/ritonavir monotherapy after virologic failure of first-line antiretroviral therapy in resource-limited settings.

Journal Article AIDS · 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 ... Full text Open Access Link to item Cite

Bacteremic disseminated tuberculosis in sub-saharan Africa: a prospective cohort study.

Journal Article Clin 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 ... Full text Open Access Link to item Cite

Initial HIV-1 antigen-specific CD8+ T cells in acute HIV-1 infection inhibit transmitted/founder virus replication.

Journal Article J 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 ... Full text Open Access Link to item Cite

Two distinct broadly neutralizing antibody specificities of different clonal lineages in a single HIV-1-infected donor: implications for vaccine design.

Journal Article J 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 ... Full text Open Access Link to item Cite

Chikungunya and dengue fever among hospitalized febrile patients in northern Tanzania.

Journal Article Am 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 ... Full text Open Access Link to item Cite

Changes in HIV risk behavior and seroincidence among clients presenting for repeat HIV counseling and testing in Moshi, Tanzania.

Journal Article AIDS 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 ... Full text Open Access Link to item Cite

Performance of nucleic acid amplification following extraction of 5 milliliters of whole blood for diagnosis of Mycobacterium tuberculosis bacteremia.

Journal Article J 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 ... Full text Open Access Link to item Cite

Tb in a global health exchange program.

Journal Article J Gen Intern Med · January 2012 Full text Open Access Link to item Cite

Structure of HIV-1 gp120 V1/V2 domain with broadly neutralizing antibody PG9.

Journal Article Nature · 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 ... Full text Open Access Link to item Cite

Polyclonal B cell responses to conserved neutralization epitopes in a subset of HIV-1-infected individuals.

Journal Article J 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 ... Full text Link to item Cite

Analysis of a clonal lineage of HIV-1 envelope V2/V3 conformational epitope-specific broadly neutralizing antibodies and their inferred unmutated common ancestors.

Journal Article J 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 ... Full text Link to item Cite

Focused evolution of HIV-1 neutralizing antibodies revealed by structures and deep sequencing.

Journal Article Science · 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 ... Full text Link to item Cite

Antimicrobial susceptibility to azithromycin among Salmonella enterica isolates from the United States.

Journal Article Antimicrob 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 ... Full text Link to item Cite

Sensitivity and specificity of typhoid fever rapid antibody tests for laboratory diagnosis at two sub-Saharan African sites.

Journal Article Bull 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 ... Full text Link to item Cite

Leptospirosis among hospitalized febrile patients in northern Tanzania.

Journal Article Am 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 ... Full text Open Access Link to item Cite

Q fever, spotted fever group, and typhus group rickettsioses among hospitalized febrile patients in northern Tanzania.

Journal Article Clin 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 ... Full text Link to item Cite

Controlled comparison of BacT/Alert MB system, manual Myco/F lytic procedure, and isolator 10 system for diagnosis of Mycobacterium tuberculosis Bacteremia.

Journal Article J 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 ... Full text Link to item Cite

Invasive bacterial and fungal infections among hospitalized HIV-infected and HIV-uninfected children and infants in northern Tanzania.

Journal Article Trop 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 ... Full text Link to item Cite

Guidelines for global health training.

Journal Article Health Aff (Millwood) · June 2011 Full text Link to item Cite

Mycobacterium sherrisii sp. nov., a slow-growing non-chromogenic species.

Journal Article Int 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 ... Full text Link to item Cite

A cost-effectiveness analysis of alternative HIV retesting strategies in sub-saharan Africa.

Journal Article J 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 ... Full text Link to item Cite

Antimicrobial resistance among invasive nontyphoidal Salmonella enterica isolates in the United States: National Antimicrobial Resistance Monitoring System, 1996 to 2007.

Journal Article Antimicrob 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 ... Full text Link to item Cite

Abbott RealTime HIV-1 m2000rt viral load testing: manual extraction versus the automated m2000sp extraction.

Journal Article J 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 ... Full text Link to item Cite

In response

Journal Article American Journal of Tropical Medicine and Hygiene · March 1, 2011 Full text Cite

Invasive bacterial and fungal infections among hospitalized HIV-infected and HIV-uninfected adults and adolescents in northern Tanzania.

Journal Article Clin 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 ... Full text Link to item Cite

Who tests, who doesn't, and why? Uptake of mobile HIV counseling and testing in the Kilimanjaro Region of Tanzania.

Journal Article PLoS 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 ... Full text Open Access Link to item Cite

Ethics and best practice guidelines for training experiences in global health.

Journal Article Am 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 ... Full text Link to item Cite

Q FEVER AMONG HOSPITALIZED FEBRILE PATIENTS IN NORTHERN TANZANIA, 2007-2008

Conference AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · November 1, 2010 Link to item Cite

LEPTOSPIROSIS AMONG HOSPITALIZED PATIENTS WITH FEBRILE ILLNESS IN NORTHERN TANZANIA

Conference AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · November 1, 2010 Link to item Cite

Determinants of use of household-level water chlorination products in rural Kenya, 2003-2005.

Journal Article Int 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 ... Full text Open Access Link to item Cite

Establishment of haematological and immunological reference values for healthy Tanzanian children in Kilimanjaro Region.

Journal Article Trop 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 ... Full text Link to item Cite

Predicting virologic failure among HIV-1-infected children receiving antiretroviral therapy in Tanzania: a cross-sectional study.

Journal Article J 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. ... Full text Open Access Link to item Cite

Community-acquired bloodstream infections in Africa: a systematic review and meta-analysis.

Journal Article Lancet 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 ... Full text Link to item Cite

WHO guidelines for antimicrobial treatment in children admitted to hospital in an area of intense Plasmodium falciparum transmission: prospective study.

Journal Article BMJ · 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 ... Full text Open Access Link to item Cite

Global trends in typhoid and paratyphoid Fever.

Journal Article Clin 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 ... Full text Open Access Link to item Cite

Evaluation of the Abbott m2000rt RealTime HIV-1 assay with manual sample preparation compared with the ROCHE COBAS AmpliPrep/AMPLICOR HIV-1 MONITOR v1.5 using specimens from East Africa.

Journal Article J 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 ... Full text Link to item Cite

Early versus delayed fixed dose combination abacavir/lamivudine/zidovudine in patients with HIV and tuberculosis in Tanzania.

Journal Article AIDS 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 ... Full text Open Access Link to item Cite

Characteristics of HIV voluntary counseling and testing clients before and during care and treatment scale-up in Moshi, Tanzania.

Journal Article J 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: ... Full text Link to item Cite

Evaluation of a dried blood spot HIV-1 RNA program for early infant diagnosis and viral load monitoring at rural and remote healthcare facilities.

Journal Article AIDS · 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 ... Full text Link to item Cite

Identifying HIV-infected children who may benefit from early initiation of antiretrovirals

Journal Article Journal 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 ... Full text Cite

HIV DISEASE AND BLOODSTREAM INFECTIONS AMONG FEBRILE PEDIATRIC HOSPITAL ADMISSIONS IN NORTHERN TANZANIA

Conference AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · November 1, 2009 Link to item Cite

Missed opportunities for diagnosis of tuberculosis and human immunodeficiency virus co-infection in Moshi, Tanzania.

Journal Article Int 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 ... Link to item Cite

Invasive non-Typhi Salmonella disease in Africa.

Journal Article Clin Infect Dis · August 15, 2009 Featured Publication 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 ... Full text Link to item Cite

Total lymphocyte count and World Health Organization pediatric clinical stage as markers to assess need to initiate antiretroviral therapy among human immunodeficiency virus-infected children in Moshi, Northern Tanzania.

Journal Article Pediatr 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 ... Full text Link to item Cite

Morbidity and mortality among a cohort of HIV-infected adults in a programme for community home-based care, in the Kilimanjaro Region of Tanzania (2003-2005).

Journal Article Ann 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 ... Full text Link to item Cite

MORTALITY AMONG CHILDREN WITH MODERATE-TO-SEVERE DIARRHEA IN RURAL WESTERN KENYA, 2008

Conference AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · 2009 Cite

Invasive disease caused by nontuberculous mycobacteria, Tanzania.

Journal Article Emerg 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 ... Full text Link to item Cite

Validation, performance under field conditions, and cost-effectiveness of Capillus HIV-1/HIV-2 and determine HIV-1/2 rapid human immunodeficiency virus antibody assays using sequential and parallel testing algorithms in Tanzania.

Journal Article J 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 ... Full text Link to item Cite

Low sensitivity of T-cell based detection of tuberculosis among HIV co-infected Tanzanian in-patients.

Journal Article East 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 ... Full text Link to item Cite

Gender differences in the risk of HIV infection among persons reporting abstinence, monogamy, and multiple sexual partners in northern Tanzania.

Journal Article PLoS 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 ... Full text Open Access Link to item Cite

Part III. Analysis of data gaps pertaining to enterotoxigenic Escherichia coli infections in low and medium human development index countries, 1984-2005.

Journal Article Epidemiol 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 ... Full text Link to item Cite

Part II. Analysis of data gaps pertaining to Shigella infections in low and medium human development index countries, 1984-2005.

Journal Article Epidemiol 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 ... Full text Link to item Cite

Effect of trimethoprim-sulfamethoxazole prophylaxis on antimicrobial resistance of fecal Escherichia coli in HIV-infected patients in Tanzania.

Journal Article J Acquir Immune Defic Syndr · April 15, 2008 Featured Publication 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), ... Full text Link to item Cite

Clinical response and outcome of infection with Salmonella enterica serotype Typhi with decreased susceptibility to fluoroquinolones: a United States foodnet multicenter retrospective cohort study.

Journal Article Antimicrob Agents Chemother · April 2008 Featured Publication 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 ... Full text Link to item Cite

Part I. Analysis of data gaps pertaining to Salmonella enterica serotype Typhi infections in low and medium human development index countries, 1984-2005.

Journal Article Epidemiol 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 ... Full text Link to item Cite

Predictors of incomplete adherence, virologic failure, and antiviral drug resistance among HIV-infected adults receiving antiretroviral therapy in Tanzania.

Journal Article Clin Infect Dis · December 1, 2007 Featured Publication 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 ... Full text Link to item Cite

Predicting CD4 lymphocyte count

Journal Article AIDS 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 ... Cite

Predicting CD4 lymphocyte count <200 cells/mm(3) in an HIV type 1-infected African population.

Journal Article AIDS 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 ... Full text Link to item Cite

Part II. Analysis of data gaps pertaining to Shigella infections in low and medium human development index countries, 1984-2005.

Journal Article Epidemiol 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

Part III. Analysis of data gaps pertaining to enterotoxigenic Escherichia coli infections in low and medium human development index countries, 1984-2005.

Journal Article Epidemiol 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

Part I. Analysis of data gaps pertaining to Salmonella enterica serotype Typhi infections in low and medium human development index countries, 1984-2005.

Journal Article Epidemiol 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 ... Cite

Comparing serologic response against enteric pathogens with reported diarrhea to assess the impact of improved household drinking water quality.

Journal Article Am 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 ... Link to item Cite

Epidemiology and risk factors for endemic typhoid fever in Uzbekistan.

Journal Article Trop 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 ... Full text Link to item Cite

Antiretroviral treatment literacy among HIV voluntary counseling and testing clients in Moshi, Tanzania, 2003 to 2005.

Journal Article J 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 ... Full text Link to item Cite

Hookworm infection of the duodenum associated with dyspepsia and diagnosed by oesophagoduodenoscopy: case report.

Journal Article East 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 ... Full text Link to item Cite

Capacity of health-care facilities to deliver HIV treatment and care services, Northern Tanzania, 2004.

Journal Article Int 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 ... Full text Link to item Cite

What facets of openness and conscientiousness predict fluid intelligence score?

Journal Article Learning 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 ... Full text Cite

Population-based surveillance of typhoid fever in Egypt.

Journal Article Am 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 ... Link to item Cite

Cost-effectiveness of free HIV voluntary counseling and testing through a community-based AIDS service organization in Northern Tanzania.

Journal Article Am J Public Health · January 2006 Featured Publication 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 ... Full text Link to item Cite

Sociodemographic and clinical characteristics of clients presenting for HIV voluntary counselling and testing in Moshi, Tanzania.

Journal Article Int 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 ... Full text Link to item Cite

Household based treatment of drinking water with flocculant-disinfectant for preventing diarrhoea in areas with turbid source water in rural western Kenya: cluster randomised controlled trial.

Journal Article BMJ · September 3, 2005 Featured Publication 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 ... Full text Link to item Cite

Reduction of exit-site infections of tunnelled intravascular catheters among neutropenic patients by sustained-release chlorhexidine dressings: results from a prospective randomized controlled trial.

Journal Article J 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 ... Full text Link to item Cite

The global burden of typhoid fever.

Journal Article Bull World Health Organ · May 2004 Featured Publication 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 ... Link to item Cite

Salmonella enterica serotype Javiana infections associated with amphibian contact, Mississippi, 2001.

Journal Article Epidemiol 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 ... Full text Link to item Cite

Rapid diagnosis of typhoid fever by enzyme-linked immunosorbent assay detection of Salmonella serotype typhi antigens in urine.

Journal Article Am 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 ... Link to item Cite

HIV-associated morbidity, mortality and diagnostic testing opportunities among inpatients at a referral hospital in northern Tanzania.

Journal Article Ann 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 ... Full text Link to item Cite

Development, implementation, and impact of acceptability criteria for serologic tests for infectious diseases.

Journal Article J 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 ... Full text Link to item Cite

Effect of point-of-use disinfection, flocculation and combined flocculation-disinfection on drinking water quality in western Kenya.

Journal Article J 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 ... Full text Link to item Cite

Outbreaks of Escherichia coli O157 infections at multiple county agricultural fairs: a hazard of mixing cattle, concession stands and children.

Journal Article Epidemiol 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 ... Full text Link to item Cite

Two decades of disseminated tuberculosis at a university medical center: the expanding role of mycobacterial blood culture.

Journal Article Clin Infect Dis · October 15, 2003 Featured Publication 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 ... Full text Link to item Cite

Reevaluating fluoroquinolone breakpoints for Salmonella enterica serotype Typhi and for non-Typhi salmonellae.

Journal Article Clin 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 ... Full text Link to item Cite

Controlled comparison of BACTEC 13A, MYCO/F LYTIC, BacT/ALERT MB, and ISOLATOR 10 systems for detection of mycobacteremia.

Journal Article J 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 ... Full text Link to item Cite

Estimating the incidence of typhoid fever and other febrile illnesses in developing countries.

Journal Article Emerg 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 ... Full text Link to item Cite

Reply

Journal Article Clinical Infectious Diseases · April 2003 Full text Cite

Putting salmonella contamination in perspective.

Journal Article Clin Infect Dis · April 1, 2003 Full text Link to item Cite

Toxigenic Vibrio cholerae serogroup O141-associated cholera-like diarrhea and bloodstream infection in the United States.

Journal Article J 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 ... Full text Link to item Cite

Bacterial contamination of animal feed and its relationship to human foodborne illness.

Journal Article Clin 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 ... Full text Link to item Cite

An outbreak of Escherichia coli O157:H7 infections among visitors to a dairy farm.

Journal Article N 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 ... Full text Link to item Cite

Emerging infectious diseases in an island ecosystem: the New Zealand perspective.

Journal Article Emerg 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 ... Full text Link to item Cite

Intravascular catheter-associated infections.

Journal Article Eur 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 ... Full text Link to item Cite

Lyme disease. Pitfalls in diagnosis.

Journal Article N C Med J · 2000 Link to item Cite

Female genital schistosomiasis.

Journal Article J 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 ... Full text Link to item Cite

Ciguatera fish poisoning.

Journal Article Postgrad 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 ... Full text Link to item Cite

Ciguatera fish poisoning.

Journal Article N Z Med J · July 23, 1999 Link to item Cite

Knowledge, attitudes and behaviour towards HIV infection among family planning clinic attendees: changes between 1991 and 1997.

Journal Article N 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 ... Link to item Cite

Diagnosis and treatment of atypical pneumonia in critically-ill patients

Journal Article Current 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 ... Full text Cite

Molecular epidemiology and transmission dynamics of Mycobacterium tuberculosis in rural Africa.

Journal Article Trop 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 ... Full text Link to item Cite

TB or not TB?

Journal Article Trans 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 ... Full text Link to item Cite

Acute adrenal insufficiency: a new presentation of Castleman's disease.

Journal Article J 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 ... Full text Link to item Cite