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John Andrew Crump

Adjunct Professor in the Department of Medicine
Medicine, Infectious Diseases
Box 90519, Duke Global Health Institute, Durham, NC 27708
Trent Hall, Room 115, Durham, NC 27708

Selected Publications


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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 Antimicrobial agents and chemotherapy · 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 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

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

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

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