Journal ArticleAnn Am Thorac Soc · August 2024
Rationale: Data on risk factors for chronic hypoxemia in low- and middle-income countries are lacking. Objectives: We aimed to quantify the association between potential risk factors and chronic hypoxemia among adults hospitalized in Kenya. Methods: A hosp ...
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Journal ArticleAIDS · June 1, 2024
People with HIV are at increased risk of cardiac dysfunction; however, limited tools are available to identify patients at highest risk for future cardiac disease. We performed proteomic profiling using plasma samples from children and young adults with pe ...
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Journal ArticleJMIR Res Protoc · May 30, 2024
BACKGROUND: Critical to efforts to end the HIV epidemic is the identification of persons living with HIV who have yet to be diagnosed and engaged in care. Expanded HIV testing outreach efforts need to be both efficient and ambitious, targeting the social n ...
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Journal ArticleBMC Health Serv Res · March 28, 2024
BACKGROUND: Evidence-based care for acute myocardial infarction (AMI) reduces morbidity and mortality. Prior studies in Tanzania identified substantial gaps in the uptake of evidence-based AMI care. Implementation science has been used to improve uptake of ...
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Journal ArticleAIDS Res Ther · March 4, 2024
BACKGROUND: Cardiovascular disease (CVD) remains a leading cause of death in people living with HIV. Myocardial fibrosis is well-described in HIV infection acquired in adulthood. We evaluate the burden of fibrosis by cardiac magnetic resonance in people wi ...
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Journal ArticleJMIR Res Protoc · January 12, 2024
BACKGROUND: Tanzania is 1 of 20 countries where the majority of unvaccinated and undervaccinated children reside. Prior research identified substantial rural-urban disparities in the coverage and timeliness of childhood vaccinations in Tanzania, with child ...
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Journal ArticleInt J STD AIDS · January 2024
INTRODUCTION: People with HIV (PLWH) have an increased risk myocardial infarction (MI), and evidence suggests that MI is under-diagnosed in Tanzania. However, little is known about barriers to MI care among PLWH in the region. METHODS: In this qualitative ...
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Journal ArticlePLOS Glob Public Health · 2024
Community-based HIV testing offers an alternative approach to encourage HIV testing among men in sub-Saharan Africa. In this study, we evaluated a community-based HIV testing strategy targeting male bar patrons in northern Tanzania to assess factors predic ...
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Journal ArticleAnn Glob Health · 2024
BACKGROUND: Uptake of evidence-based care for acute myocardial infarction (AMI) is suboptimal in Tanzania, but there are currently no published interventions to improve AMI care in sub-Saharan Africa. OBJECTIVES: Co-design a quality improvement interventio ...
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Journal ArticlePLOS Glob Public Health · 2024
INTRODUCTION: Myocardial Infarction (MI) is a leading cause of death worldwide. In high income countries, quality improvement strategies have played an important role in increasing uptake of evidence-based MI care and improving MI outcomes. The incidence o ...
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Journal ArticleBMC Nephrol · November 12, 2023
BACKGROUND: CKD of unknown etiology (CKDu) disproportionately affects young people in Central America who lack traditional CKD risk factors (diabetes and hypertension) and has instead been variably linked to heat stress, occupational and environmental expo ...
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Journal ArticlePsychiatr Serv · October 1, 2023
OBJECTIVE: Evidence shows that Black individuals have higher rates of coercive emergency psychiatric interventions than other racialized groups, yet no studies have elevated the voices of Black patients undergoing emergency psychiatric evaluation. This qua ...
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Journal ArticleBMJ Open · September 18, 2023
OBJECTIVE: Global medical oxygen security is limited by knowledge gaps in hypoxaemia burden and oxygen access in low-income and middle-income countries. We examined the prevalence and phenotypic trajectories of hypoxaemia among hospitalised adults in Kenya ...
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Journal ArticleAIDS Care · September 2023
To achieve the UNAIDS target of diagnosing 95% of all persons living with HIV, enhanced HIV testing services with greater attractional value need to be developed and implemented. We conducted a discrete choice experiment (DCE) to quantify preferences for e ...
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Journal ArticleGlob Health Sci Pract · April 28, 2023
BACKGROUND: Asset-based indices of living standards, or wealth indices, are widely used proxies for economic status; however, such indices are not readily available for small and nonrepresentative samples. METHODS: We describe a simple out-of-sample predic ...
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Journal ArticlePLoS One · 2023
BACKGROUND: People with HIV in sub-Saharan Africa are increasingly developing age-related comorbidities. The purpose of this prospective observational study was to describe 6-month outcomes among Tanzanians with HIV and elevated blood pressure or hyperglyc ...
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Journal ArticleAnn Am Thorac Soc · August 2024
Rationale: Data on risk factors for chronic hypoxemia in low- and middle-income countries are lacking. Objectives: We aimed to quantify the association between potential risk factors and chronic hypoxemia among adults hospitalized in Kenya. Methods: A hosp ...
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Journal ArticleAIDS · June 1, 2024
People with HIV are at increased risk of cardiac dysfunction; however, limited tools are available to identify patients at highest risk for future cardiac disease. We performed proteomic profiling using plasma samples from children and young adults with pe ...
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Journal ArticleJMIR Res Protoc · May 30, 2024
BACKGROUND: Critical to efforts to end the HIV epidemic is the identification of persons living with HIV who have yet to be diagnosed and engaged in care. Expanded HIV testing outreach efforts need to be both efficient and ambitious, targeting the social n ...
Full textLink to itemCite
Journal ArticleBMC Health Serv Res · March 28, 2024
BACKGROUND: Evidence-based care for acute myocardial infarction (AMI) reduces morbidity and mortality. Prior studies in Tanzania identified substantial gaps in the uptake of evidence-based AMI care. Implementation science has been used to improve uptake of ...
Full textOpen AccessLink to itemCite
Journal ArticleAIDS Res Ther · March 4, 2024
BACKGROUND: Cardiovascular disease (CVD) remains a leading cause of death in people living with HIV. Myocardial fibrosis is well-described in HIV infection acquired in adulthood. We evaluate the burden of fibrosis by cardiac magnetic resonance in people wi ...
Full textLink to itemCite
Journal ArticleJMIR Res Protoc · January 12, 2024
BACKGROUND: Tanzania is 1 of 20 countries where the majority of unvaccinated and undervaccinated children reside. Prior research identified substantial rural-urban disparities in the coverage and timeliness of childhood vaccinations in Tanzania, with child ...
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Journal ArticleInt J STD AIDS · January 2024
INTRODUCTION: People with HIV (PLWH) have an increased risk myocardial infarction (MI), and evidence suggests that MI is under-diagnosed in Tanzania. However, little is known about barriers to MI care among PLWH in the region. METHODS: In this qualitative ...
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Journal ArticlePLOS Glob Public Health · 2024
Community-based HIV testing offers an alternative approach to encourage HIV testing among men in sub-Saharan Africa. In this study, we evaluated a community-based HIV testing strategy targeting male bar patrons in northern Tanzania to assess factors predic ...
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Journal ArticleAnn Glob Health · 2024
BACKGROUND: Uptake of evidence-based care for acute myocardial infarction (AMI) is suboptimal in Tanzania, but there are currently no published interventions to improve AMI care in sub-Saharan Africa. OBJECTIVES: Co-design a quality improvement interventio ...
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Journal ArticlePLOS Glob Public Health · 2024
INTRODUCTION: Myocardial Infarction (MI) is a leading cause of death worldwide. In high income countries, quality improvement strategies have played an important role in increasing uptake of evidence-based MI care and improving MI outcomes. The incidence o ...
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Journal ArticleBMC Nephrol · November 12, 2023
BACKGROUND: CKD of unknown etiology (CKDu) disproportionately affects young people in Central America who lack traditional CKD risk factors (diabetes and hypertension) and has instead been variably linked to heat stress, occupational and environmental expo ...
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Journal ArticlePsychiatr Serv · October 1, 2023
OBJECTIVE: Evidence shows that Black individuals have higher rates of coercive emergency psychiatric interventions than other racialized groups, yet no studies have elevated the voices of Black patients undergoing emergency psychiatric evaluation. This qua ...
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Journal ArticleBMJ Open · September 18, 2023
OBJECTIVE: Global medical oxygen security is limited by knowledge gaps in hypoxaemia burden and oxygen access in low-income and middle-income countries. We examined the prevalence and phenotypic trajectories of hypoxaemia among hospitalised adults in Kenya ...
Full textOpen AccessLink to itemCite
Journal ArticleAIDS Care · September 2023
To achieve the UNAIDS target of diagnosing 95% of all persons living with HIV, enhanced HIV testing services with greater attractional value need to be developed and implemented. We conducted a discrete choice experiment (DCE) to quantify preferences for e ...
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Journal ArticleGlob Health Sci Pract · April 28, 2023
BACKGROUND: Asset-based indices of living standards, or wealth indices, are widely used proxies for economic status; however, such indices are not readily available for small and nonrepresentative samples. METHODS: We describe a simple out-of-sample predic ...
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Journal ArticlePLoS One · 2023
BACKGROUND: People with HIV in sub-Saharan Africa are increasingly developing age-related comorbidities. The purpose of this prospective observational study was to describe 6-month outcomes among Tanzanians with HIV and elevated blood pressure or hyperglyc ...
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Journal ArticlePLOS Glob Public Health · 2023
Data describing the incidence of hypertension and diabetes among people with HIV in sub-Saharan Africa remain sparse. In this study, adults with HIV were enrolled from a public clinic in Moshi, Tanzania (September 2020-March 2021). At enrollment, a survey ...
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Journal ArticleInt J Public Health · 2023
Objectives: Determine the prevalence of airway disease (e.g., asthma, airflow obstruction, and eosinophilic airway inflammation) in Kenya, as well as related correlates of airway disease and health-related quality of life. Methods: A three-stage, cluster-r ...
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Journal ArticleGlob Public Health · December 2022
HIV is associated with increased risk of cardiovascular disease, but there has been less study of cardiovascular comorbidities among people with HIV in sub-Saharan Africa. In a cross-sectional observational study, Tanzanian adults presenting for outpatient ...
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Journal ArticleSex Transm Dis · November 1, 2022
Among 145 individuals surveyed in Tanzania, 42% indicated willingness to test for human immunodeficiency virus in response to a confidential, phone-based text message. On average, participants were likely to provide contact information for 1.5 members of t ...
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Journal ArticleJ Clin Hypertens (Greenwich) · August 2022
Current care models are inadequate to address the dual epidemic of hypertension and HIV in sub-Saharan Africa. We developed a community health worker (CHW)-delivered educational intervention, integrated into existing HIV care to address hypertension in per ...
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Journal ArticleInt Health · July 1, 2022
BACKGROUND: Little is known about healthcare-seeking behaviour and barriers to care for cardiovascular disease (CVD) in sub-Saharan Africa. METHODS: Emergency department patients in Tanzania with acute CVD were prospectively enrolled. Questionnaires were a ...
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Journal ArticlePsychiatr Serv · July 2022
OBJECTIVE: Few studies have examined the disproportionate use of restraints for Black adults receiving emergency psychiatric care. This study sought to determine whether the odds of physical and chemical restraint use were higher for Black patients undergo ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · April 2022
BACKGROUND: Little is known about long-term outcomes and uptake of secondary preventative therapies following acute myocardial infarction (AMI) in sub-Saharan Africa. METHODS: Consecutive patients presenting with AMI (as defined by the Fourth Universal Def ...
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Journal ArticleAnn Glob Health · 2022
BACKGROUND: Heart failure (HF), is a leading cause of cardiovascular morbidity and mortality in Sub-Saharan Africa. Cardiac rehabilitation (CR) is known to improve functional capacity and reduce morbidity associated with HF. Although CR is a low-cost inter ...
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Journal ArticlePan Afr Med J · 2022
CITE THIS ARTICLE: Preeti Manavalan et al. Hypertension among adults enrolled in HIV care in northern Tanzania: comorbidities, cardiovascular risk, and knowledge, attitudes and practices. Pan African Medical Journal. 2022;41(285). 10.11604/pamj.2022.41.285 ...
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Journal ArticleTrop Med Int Health · December 2021
OBJECTIVES: To describe knowledge, attitudes, and practices (KAP) regarding ischemic heart disease (IHD) among adults with HIV in Tanzania. METHODS: Adults presenting for routine HIV care at a clinic in northern Tanzania were consecutively enrolled and wer ...
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Journal ArticleInt J Cardiol · November 1, 2021
OBJECTIVE: There is a rising burden of myocardial infarction (MI) within sub-Saharan Africa. Prospective studies of detailed MI outcomes in the region are lacking. METHODS: Adult patients with confirmed MI from a prospective surveillance study in northern ...
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Journal ArticleJ Choice Model · September 2021
Efforts to eliminate the HIV epidemic will require increased HIV testing rates among high-risk populations. To inform the design of HIV testing interventions, a discrete choice experiment (DCE) with six policy-relevant attributes of HIV testing options eli ...
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Journal ArticleJ Am Heart Assoc · August 3, 2021
Background Rigorous incidence data for acute myocardial infarction (AMI) in sub-Saharan Africa are lacking. Consequently, modeling studies based on limited data have suggested that the burden of AMI and AMI-associated mortality in sub-Saharan Africa is low ...
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Journal ArticleAIDS Behav · July 2021
We investigated a novel community-based HIV testing and counseling (HTC) strategy by recruiting men from bars in northern Tanzania in order to identify new HIV infections. All bars in the town of Boma Ng'ombe were identified and male patrons were systemati ...
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Journal ArticleJ Glob Health · May 8, 2021
BACKGROUND: Respiratory diseases are the leading cause of death and disability worldwide. Oxygen is an essential medicine used to treat hypoxemia from respiratory diseases. However, the availability and utilization of oxygen delivery systems for adults in ...
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Journal ArticleNature · February 2021
Neutralizing antibody function provides a foundation for the efficacy of vaccines and therapies1-3. Here, using a robust in vitro Ebola virus (EBOV) pseudo-particle infection assay and a well-defined set of solid-phase assays, we describe a wide spectrum o ...
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Journal ArticlePLoS One · 2021
BACKGROUND: The burden of heart failure is growing in sub-Saharan Africa, but there is a dearth of data characterizing care and outcomes of heart failure patients in the region, particularly in emergency department settings. METHODS: In a prospective obser ...
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Journal ArticleJ Int Assoc Provid AIDS Care · 2021
One in three people with HIV (PWH) has hypertension. However, most hypertensive PWH in sub-Saharan Africa are unaware of their hypertension diagnosis and are not on treatment. To better understand barriers to hypertension care faced by PWH, we interviewed ...
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Journal ArticleInt J Public Health · 2021
Objectives: Many orphaned children in low- and middle-income countries live with family. Yet, their household composition and its stability are not well-characterized, nor is impact of stability on longer-term outcomes. Methods: We used the longitudinal, m ...
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Journal ArticleNorth Carolina Medical Journal · January 1, 2021
Background This study explored the health needs, trends of health care utilization, and barriers to care of a diverse population of refugee children resettled in Durham County, North Carolina. Methods Researchers conducted a retrospective chart review of 3 ...
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Journal ArticleBMJ Open · November 6, 2020
INTRODUCTION: Approximately one million undiagnosed persons living with HIV in Southern and Eastern Africa need to test for HIV. Novel approaches are necessary to identify HIV testing options that match the heterogeneous testing preferences of high-risk po ...
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Journal ArticleJ Am Heart Assoc · August 18, 2020
Background Evidence suggests that acute coronary syndrome (ACS) is underdiagnosed in sub-Saharan Africa. Triage-based interventions have improved ACS diagnosis and management in high-income settings but have not been evaluated in sub-Saharan African emerge ...
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Journal ArticleAm Heart J · August 2020
BACKGROUND: Growing evidence suggests that under-diagnosis of acute myocardial infarction (AMI) may be common in sub-Saharan Africa. Prospective studies of routine AMI screening among patients presenting to emergency departments in sub-Saharan Africa are l ...
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Journal ArticleJ Clin Hypertens (Greenwich) · August 2020
Failure to address hypertension among people living with HIV (PLWH) may undermine the significant progress made toward reducing mortality among this high-risk population in sub-Saharan Africa (SSA). Here, the authors report hypertension prevalence, diagnos ...
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Journal ArticleValue Health · July 2020
OBJECTIVE: Limited data describe patient preferences for the growing number of antiretroviral therapies (ARTs). We quantified preferences for key characteristics of modern ART deemed relevant to shared decision making. METHODS: A discrete choice experiment ...
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Journal ArticleAIDS · March 15, 2020
OBJECTIVE: To define the prevalence of early cardiac dysfunction in children and young adults with perinatally acquired HIV and predictors of cardiac function. DESIGN: Cross-sectional design. METHODS: Early cardiac dysfunction was defined as left ventricul ...
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Journal ArticlePLoS One · 2020
BACKGROUND: While factors that drive early mortality among people living with HIV (PLWH) initiating antiretroviral therapy (ART) in sub-Saharan Africa (SSA) have been described, less is known about the predictors of long-term mortality for those with ART e ...
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Journal ArticleN C Med J · 2020
BACKGROUND Resettled refugees are at increased risk of poor health outcomes due to acculturation challenges, logistical barriers, experiences of trauma, and other barriers to care that are poorly understood. Refugee children may be particularly vulnerable ...
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Journal ArticlePLoS One · 2020
BACKGROUND: Hypertension, a leading risk for cardiovascular mortality, is an important co-morbidity among people living with HIV (PLHIV). In Tanzania, hypertension prevalence among PLHIV approaches 20 to 30%. However, most patients are unaware of their dia ...
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Journal ArticlePublic Health · October 2019
OBJECTIVES: The objective of this study is to increase understanding of knowledge, attitudes, and preventative practices regarding ischemic heart disease (IHD) in sub-Saharan Africa in order to develop patient-centered interventions to improve care and out ...
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ConferenceCirculation · March 5, 2019
Background:
Heart failure (HF) is a growing driver of morbidity and mortality worldwide. Cardiac rehabilitation in HF improves functional status, quality of life, and depression. Global access to card ...
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Journal ArticleBMC Pregnancy Childbirth · February 13, 2019
BACKGROUND: Hypoxia during labor contributes to 2.2 million intrapartum and early neonatal deaths each year. An additional 0.6-1.0 million cases of life-long disability occur because of fetal hypoxia during labor. It is known that fetal heart rate changes ...
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Journal ArticlePLoS One · 2019
OBJECTIVES: Globally, hypertension affects one billion people and disproportionately burdens low-and middle-income countries. Despite the high disease burden in sub-Saharan Africa, optimal care models for diagnosing and treating hypertension have not been ...
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Journal ArticleEthn Dis · 2019
INTRODUCTION: Little is known about the burden of hypertension and diabetes on emergency department (ED) utilization and hospitalizations in sub-Saharan Africa. METHODS: A retrospective review of adult ED patients in northern Tanzania was performed from Se ...
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ConferenceBlood · November 29, 2018
AbstractBACKGROUND: Thalassemia syndromes are inherited hemoglobin (Hb) disorders that most severely affect Southeast Asia (SEA). As a result of population migration, thalassemia has grown into a global heal ...
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Journal ArticleInt J Health Policy Manag · November 1, 2018
BACKGROUND: The Rwanda Human Resources for Health Program (HRH Program) is a 7-year (2012-2019) health professional training initiative led by the Government of Rwanda with the goals of training a large, diverse, and competent health workforce and strength ...
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Journal ArticleOpen Forum Infect Dis · October 2018
Study participants were asked about their interest in switching to novel drug delivery systems that reduce the dosing frequency of antiretroviral regimens. Across a diverse, treatment-experienced cohort, we describe greatest interest in switching to an ora ...
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Journal ArticleAIDS Patient Care STDS · September 2018
As the number of effective antiretroviral therapy (ART) options increases, there is greater opportunity to involve HIV patients in ART selection. To establish the parameters for a shared ART decision-making process, we sought to identify ART characteristic ...
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Journal ArticleBMC Infect Dis · July 18, 2018
BACKGROUND: Blastomycosis is an endemic mycosis in North America that is caused by the dimorphic fungus Blastomyces dermatitidis. The illness is a systemic disease with a wide variety of pulmonary and extra-pulmonary manifestations. The initial presentatio ...
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Journal ArticleJ Infect Dis · July 13, 2018
BACKGROUND: Ebola virus (EBOV) neutralizing antibody in plasma may reduce viral load following administration of plasma to patients with Ebola virus disease (EVD), but measurement of these antibodies is complex. METHODS: Anti-EBOV antibody was measured by ...
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Journal ArticleAIDS Care · November 2017
Stressful and traumatic life events (STLEs) are common among HIV-infected individuals and may affect health behaviors such as adherence to antiretroviral (ARV) therapy, with important implications for treatment outcomes. We examined the association between ...
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Journal ArticleJ Clin Apher · June 2017
PURPOSE: This report describes initiation of apheresis capability in Liberia, Africa to support a clinical trial of convalescent plasma therapy for Ebola Virus Disease. METHODS: A bloodmobile was outfitted in the United States as a four-bed apheresis unit ...
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Journal ArticleWorld Neurosurg · June 2017
OBJECTIVE: Traumatic brain injury (TBI) is a leading cause of death and disability. Patients with TBI in low and middle-income countries have worse outcomes than patients in high-income countries. We evaluated important clinical indicators associated with ...
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Journal ArticlePediatr Rheumatol Online J · February 23, 2017
BACKGROUND: Systemic Lupus Erythematosus (SLE) is a serious multisystem autoimmune disease, which is more aggressive in children and people of African descent. In South Africa, pediatric SLE (pSLE) patients are at high risk for severe disease. Similar to p ...
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Journal ArticleLupus · February 2017
Background Systemic lupus erythematosus (SLE) is a life-threatening multisystem autoimmune disease that is more severe in patients of African ancestry and children, yet pediatric SLE on the African continent has been understudied. This study describes a co ...
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Journal ArticleGlobal Health · October 11, 2016
BACKGROUND: Communities and nations seeking to foster social responsibility in their youth are interested in understanding factors that predict and promote youth involvement in public activities. Orphans and separated children (OSC) are a vulnerable popula ...
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Journal ArticleBMC Infect Dis · September 20, 2016
BACKGROUND: Linkage to HIV care is crucial to the success of antiretroviral therapy (ART) programs worldwide, loss to follow up at all stages of the care continuum is frequent, and long-term prospective studies of care linkage are currently lacking. METHOD ...
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Journal ArticleAIDS Care · July 2016
Orphans and separated children (OSC) are a vulnerable population whose numbers are increasing, particularly in sub-Saharan Africa and Asia. Over 153 million children worldwide have lost one or both parents, including 17 million orphaned by AIDS, and millio ...
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Journal ArticleBMC Public Health · March 5, 2016
BACKGROUND: In order to begin to address the burden of non-communicable diseases (NCDs) in sub-Saharan Africa, high quality community-based epidemiological studies from the region are urgently needed. Cluster-designed sampling methods may be most efficient ...
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Journal ArticleAIDS Behav · February 2016
Fatigue and depression are common co-morbid conditions among people with HIV infection. We analyzed a population of HIV-infected adults with depression, who were enrolled in a depression treatment trial, to examine the extent to which improvements in depre ...
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Journal ArticleClin Trials · February 2016
The outbreak of Ebola virus disease in West Africa is the largest ever recorded. Numerous treatment alternatives for Ebola have been considered, including widely available repurposed drugs, but initiation of enrollment into clinical trials has been limited ...
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Journal ArticleClin Trials · February 2016
BACKGROUND: Little progress was made in advancing Ebola-specific therapies during the epidemic that began in West Africa in late 2013. Throughout the last quarter of 2014, which saw the greatest numbers of cases, only a handful of clinical trials were unde ...
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Journal ArticleJ Affect Disord · January 15, 2016
BACKGROUND: Suicidal ideation is the most proximal risk factor for suicide and can indicate extreme psychological distress; identification of its predictors is important for possible intervention. Depression and stressful or traumatic life events (STLEs), ...
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Journal ArticleOpen Forum Infect Dis · January 2016
Background.  Due to the unintended potential misclassifications of the World Health Organization (WHO) immunological failure criteria in predicting virological failure, limited availability of treatment options, poor laboratory infrastructure, and healthca ...
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Journal ArticlePLoS One · 2016
BACKGROUND: Non-communicable diseases (NCDs) are a leading cause of death among adults in sub-Saharan Africa, and chronic kidney disease (CKD) is a growing public health threat. Understanding knowledge, attitudes, and practices associated with NCDs is vita ...
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Journal ArticleAm J Epidemiol · December 15, 2015
In randomized trials of provider-focused clinical interventions, treatment allocation often cannot be blinded to participants, study staff, or providers. The choice of unit of randomization (patient, provider, or clinic) entails tradeoffs in cost, power, a ...
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Journal ArticleHealth Econ Rev · December 2015
OBJECTIVES: Despite substantial public health efforts to increase HIV testing, testing rates have plateaued in many countries and rates of repeat testing for those with ongoing risk are low. To inform policies aimed at increasing uptake of HIV testing, we ...
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Journal ArticleAIDS · September 24, 2015
BACKGROUND: Depression is a major barrier to HIV treatment outcomes. OBJECTIVE: To test whether antidepressant management decision support integrated into HIV care improves antiretroviral adherence and depression morbidity. DESIGN: Pseudo-cluster randomize ...
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Journal ArticleGlob Health Sci Pract · August 25, 2015
BACKGROUND: Policy makers struggling to protect the 153 million orphaned and separated children (OSC) worldwide need evidence-based research on the burden of potentially traumatic events (PTEs) and the relative risk of PTEs across different types of care s ...
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Journal ArticlePsychiatr Serv · March 1, 2015
OBJECTIVE: Depression is common among patients in HIV care and is associated with worse HIV-related health behaviors and outcomes. Effective depression treatment is available, yet depression remains widely underdiagnosed and undertreated in HIV care. METHO ...
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Journal ArticleAIDS Care · 2015
Improving quality of life (QOL) for HIV-infected individuals is an important objective of HIV care, given the considerable physical and emotional burden associated with living with HIV. Although worse QOL has been associated with depression, no research ha ...
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Journal ArticleAIDS Care · 2015
In order to maximize the effectiveness of "Seek, Test, and Treat" strategies for curbing the HIV epidemic, new approaches are needed to increase the uptake of HIV testing services, particularly among high-risk groups. Low HIV testing rates among such group ...
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Journal ArticlePLoS One · 2015
INTRODUCTION: Traditional medicines are an important part of healthcare in sub-Saharan Africa, and building successful disease treatment programs that are sensitive to traditional medicine practices will require an understanding of their current use and ro ...
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Journal ArticlePLoS One · 2015
BACKGROUND: In sub-Saharan Africa, kidney failure has a high morbidity and mortality. Despite this, population-based estimates of prevalence, potential etiologies, and awareness are not available. METHODS: Between January and June 2014, we conducted a hous ...
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Journal ArticleGlob Ment Health (Camb) · January 2015
BACKGROUND: Approximately 153 million children worldwide are orphaned and vulnerable to potentially traumatic events (PTEs). Gender differences in PTEs in low- and middle-income countries (LMIC) are not well-understood, although support services and preven ...
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Journal ArticleAIDS Care · 2015
HIV serostatus disclosure plays an important role in HIV transmission risk reduction and is positively associated with HIV medication adherence and treatment outcomes. However, to date, no study has quantified the role of disclosure across the HIV treatmen ...
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Journal ArticleCurr HIV/AIDS Rep · December 2014
Given the widespread availability of effective antiretroviral therapy, engagement of HIV-infected persons in care is a global priority. We reviewed 51 studies, published in the past decade, assessing strategies for improving linkage to and retention in HIV ...
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Journal ArticleInjury · November 2014
INTRODUCTION: Deaths due to road traffic injuries, particularly motorcycle crashes, have increased rapidly in many African nations and context-specific strategies to improve preventative behaviours are needed. Although adhering to conspicuity measures by w ...
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Journal ArticleOpen Forum Infect Dis · September 2014
BACKGROUND: Adherence to first-line antiretroviral therapy (ART) may be an important indicator of adherence to second-line ART. Evaluating this relationship may be critical to identify patients at high risk for second-line failure, thereby exhausting their ...
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Journal ArticleBMC Public Health · August 12, 2014
BACKGROUND: HIV counseling and testing (HCT), an effective preventive strategy and an entry point for care, remains under-utilized in Tanzania. Limited uptake of HCT, despite the widespread availability of varied testing options, suggests that existing opt ...
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Journal ArticleJ Acquir Immune Defic Syndr · March 1, 2014
: The predictors for seeking alternative therapies for HIV-infection in sub-Saharan Africa are unknown. Among a prospective cohort of 442 HIV-infected patients in Moshi, Tanzania, 249 (56%) sought cure from a newly popularized religious healer in Loliondo ...
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Journal ArticleBMC Infect Dis · February 20, 2014
BACKGROUND: Routine tuberculosis culture remains unavailable in many high-burden areas, including Tanzania. This study sought to determine the impact of providing mycobacterial culture results over standard of care [unconcentrated acid-fast (AFB) smears] o ...
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Journal ArticleBMC Infectious Diseases · February 20, 2014
Background: Routine tuberculosis culture remains unavailable in many high-burden areas, including Tanzania. This study sought to determine the impact of providing mycobacterial culture results over standard of care [unconcentrated acid-fast (AFB) smears] o ...
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Journal ArticleAIDS Care · 2014
Decentralization of HIV care is promoted to improve access to antiretroviral therapy in sub-Saharan Africa. This study describes care transitions among HIV-infected persons in Northern Tanzania during a period of rapid decentralization of HIV care and trea ...
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Journal ArticlePLoS One · 2014
BACKGROUND: Efforts to reduce Human Immunodeficiency Virus (HIV) transmission through treatment rely on HIV testing programs that are acceptable to broad populations. Yet, testing preferences among diverse at-risk populations in Sub-Saharan Africa are poor ...
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Journal ArticlePLoS One · 2014
BACKGROUND: With more than 2 million children living in group homes, or "institutions", worldwide, the extent to which institution-based caregiving negatively affects development and wellbeing is a central question for international policymakers. METHODS: ...
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Journal ArticleJ Contin Educ Health Prof · 2014
INTRODUCTION: VISION (HIV Integrated Learning ModuleS: Achieving Performance Improvement through CollaboratiON) was a regional performance improvement (PI) continuing medical education (CME) initiative designed to increase guideline-conforming practice of ...
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Journal ArticleAIDS Care · 2014
Children in low- and middle-income countries (LMIC) are the least touched by recent successes in the diagnosis and treatment of HIV/AIDS globally. Early treatment is essential for a child's longer and higher quality of life; however, by 2011, only a small ...
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Journal ArticlePrehosp Disaster Med · December 2013
INTRODUCTION: Large earthquakes can cause population displacement, critical sanitation infrastructure damage, and increased threats to water resources, potentially predisposing populations to waterborne disease epidemics such as cholera. Problem The risk o ...
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Journal ArticlePLoS ONE · October 4, 2013
Background:As antiretroviral therapy (ART) for HIV becomes increasingly available in low and middle income countries (LMICs), understanding reasons for lack of adherence is critical to stemming the tide of infections and improving health. Understanding the ...
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Journal ArticleAIDS Patient Care STDS · March 2013
Depression is highly prevalent among HIV-infected patients, yet little is known about the quality of HIV providers' depression treatment practices. We assessed depression treatment practices of 72 HIV providers at three academic medical centers in 2010-201 ...
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Journal ArticleInt J Gynaecol Obstet · February 2013
OBJECTIVE: To describe rates of improved knowledge following a structured 2-day emergency obstetrics training course. METHODS: Quantitative assessments to evaluate emergency obstetrics knowledge and practical skills were administered before, immediately af ...
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Journal ArticlePLoS One · 2013
BACKGROUND: The reduction of HIV transmission risk behaviors among those infected with HIV remains a major global health priority. Psychosocial characteristics have proven to be important correlates of sexual transmission risk behaviors in high-income coun ...
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Journal ArticlePLoS One · 2013
BACKGROUND: As antiretroviral therapy (ART) for HIV becomes increasingly available in low and middle income countries (LMICs), understanding reasons for lack of adherence is critical to stemming the tide of infections and improving health. Understanding th ...
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Journal ArticleBMC Public Health · December 5, 2012
BACKGROUND: The proportion of births attended by skilled health personnel is one of two indicators used to measure progress towards Millennium Development Goal 5, which aims for a 75% reduction in global maternal mortality ratios by 2015. Rwanda has one of ...
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Journal ArticleContemp Clin Trials · July 2012
Depression affects 20-30% of people living with HIV/AIDS (PLWHA) in the U.S. and predicts greater sexual risk behaviors, lower antiretroviral (ARV) medication adherence, and worse clinical outcomes. Yet little experimental evidence addresses the critical c ...
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Journal ArticleInt J Emerg Med · June 8, 2012
BACKGROUND: Injuries represent a significant and growing public health concern in the developing world, yet their impact on patients and the emergency health-care system in the countries of East Africa has received limited attention. This study evaluates t ...
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Journal ArticleJ Acquir Immune Defic Syndr · April 1, 2012
OBJECTIVE: Traumatic life histories are highly prevalent in people living with HIV/AIDS and predict sexual risk behaviors, medication adherence, and all-cause mortality. Yet the causal pathways explaining these relationships remain poorly understood. We so ...
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Journal ArticleInt J Gynaecol Obstet · February 2012
OBJECTIVE: To determine the knowledge, attitudes, and practices of obstetric care providers (OCPs) in Bugesera District, Rwanda, crucial to the delivery of safe motherhood services. METHODS: A quantitative descriptive survey in Kinyarwanda targeting all OC ...
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Journal ArticleAIDS Behav · February 2012
Assessment of children's learning and performance in low and middle income countries has been critiqued as lacking a gold standard, an appropriate norm reference group, and demonstrated applicability of assessment tasks to the context. This study was desig ...
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Journal ArticleAIDS Care · 2012
While HIV counseling and testing (HCT) has been considered an HIV preventive measure in Africa, data are limited describing behavior changes following HCT. This study evaluated behavior changes and estimated HIV seroincidence rate among returning HCT clien ...
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Journal ArticlePLoS One · 2012
BACKGROUND: More than 153 million children worldwide have been orphaned by the loss of one or both parents, and millions more have been abandoned. We investigated relationships between the health of orphaned and abandoned children (OAC) and child, caregive ...
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Journal ArticleJ Acquir Immune Defic Syndr · April 15, 2011
BACKGROUND: Guidelines in sub-Saharan Africa on when HIV-seronegative persons should retest range from never to annually for lower-risk populations and from annually to every 3 months for high-risk populations. METHODS: We designed a mathematical model to ...
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Journal ArticleInt J Gynaecol Obstet · April 2011
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OBJECTIVE: To investigate the prevalence and correlates of intimate partner violence (IPV) among women at an HIV voluntary counseling and testing (VCT) center in northern Tanzania. METHODS: In a cross-sectional study, the lifetime history of IPV experience ...
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Journal ArticleJ Trauma Stress · April 2011
This study examines rates of potentially traumatic events and associated anxiety and emotional/behavioral difficulties among 1,258 orphaned and abandoned children in 5 low- and middle-income countries. The study quantifies the types of events the children ...
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Journal ArticleAIDS Care · February 2011
A history of traumatic and/or stressful experiences is prevalent among HIV-infected individuals and has been consistently associated with poorer health outcomes. However, little is known about incident stressful experiences and the factors that predict the ...
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Journal ArticlePLoS One · January 31, 2011
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BACKGROUND: Optimally, expanded HIV testing programs should reduce barriers to testing while attracting new and high-risk testers. We assessed barriers to testing and HIV risk among clients participating in mobile voluntary counseling and testing (MVCT) ca ...
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Journal ArticleBMC Int Health Hum Rights · January 13, 2011
BACKGROUND: The care and protection of the estimated 143,000,000 orphaned and abandoned children (OAC) worldwide is of great importance to global policy makers and child service providers in low and middle income countries (LMICs), yet little is known abou ...
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Journal ArticleCell Immunol · 2011
CD8(+) T-lymphocytes can utilize noncytolytic mechanisms to suppress HIV-1 replication through the secretion of soluble factors. The secretion of MIP-1β, MIP-1α, IP-10, MIG, IL-1α, and interferon gamma correlated most strongly with soluble noncytolytic sup ...
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Journal ArticleGlob Public Health · 2011
The success of antiretroviral therapy (ART) programmes requires high adherence and retention in care. In light of healthcare shortages, group interventions may be optimal ways to deliver information and provide support to ART patients. This study assessed ...
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Journal ArticlePsychosom Med · September 2010
OBJECTIVE: To assess the association between incident stressful life events (e.g., sexual and physical assault; housing instability; and major financial, employment, and legal difficulties) and unprotected anal or vaginal sexual intercourse (unprotected se ...
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Journal ArticleBMC Public Health · August 19, 2010
BACKGROUND: In the face of the HIV/AIDS epidemic that has contributed to the dramatic increase in orphans and abandoned children (OAC) worldwide, caregiver attitudes about HIV, and HIV-related stigma, are two attributes that may affect caregiving. Little r ...
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Journal ArticleJ Infect Dis · June 1, 2010
BACKGROUND: To our knowledge, the antiviral activity of pegylated interferon alfa-2a has not been studied in participants with untreated human immunodeficiency virus type 1 (HIV-1) infection but without chronic hepatitis C virus (HCV) infection. METHODS: U ...
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Journal ArticleBMC Public Health · 2010
BACKGROUND: In the face of the HIV/AIDS epidemic that has contributed to the dramatic increase in orphans and abandoned children (OAC) worldwide, caregiver attitudes about HIV, and HIV-related stigma, are two attributes that may affect caregiving. Little r ...
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Journal ArticlePLoS One · December 18, 2009
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BACKGROUND: Leaders are struggling to care for the estimated 143,000,000 orphans and millions more abandoned children worldwide. Global policy makers are advocating that institution-living orphans and abandoned children (OAC) be moved as quickly as possibl ...
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Journal ArticleAIDS Res Hum Retroviruses · December 2009
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Fixed dose combination abacavir/lamivudine/zidovudine (ABC/3TC/ZDV) among HIV-1 and tuberculosis (TB)-coinfected patients was evaluated and outcomes between early vs. delayed initiation were compared. In a randomized, pilot study conducted in the Kilimanja ...
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Journal ArticleJ Acquir Immune Defic Syndr · December 2009
OBJECTIVES: We evaluated changes in characteristics of clients presenting for voluntary counseling and testing (VCT) before and during care and treatment center (CTC) scale-up activities in Moshi, Tanzania, between November 2003 and December 2007. METHODS: ...
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Journal ArticlePsychosom Med · November 2009
OBJECTIVE: To examine the influence of incident stressful experiences on antiretroviral medication adherence and treatment outcomes. Past trauma history predicts poorer medication adherence and health outcomes. Human immunodeficiency virus (HIV)-infected i ...
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Journal ArticleInt J Tuberc Lung Dis · October 2009
SETTING: A community-based voluntary counseling and testing (VCT) center in Moshi, Tanzania. OBJECTIVE: To compare rates of prior human immunodeficiency virus (HIV) testing among clients with and without previous tuberculosis (TB) treatment, and HIV seropo ...
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Journal ArticleAnn Trop Med Parasitol · April 2009
Community home-based care (CHBC) plays an integral role in the care of HIV-infected patients living in resource-limited regions. A longitudinal cohort study has recently been conducted, in the Kilimanjaro Region of northern Tanzania, in order to identify t ...
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Journal ArticleBMC Public Health · March 4, 2009
BACKGROUND: Religion shapes everyday beliefs and activities, but few studies have examined its associations with attitudes about HIV. This exploratory study in Tanzania probed associations between religious beliefs and HIV stigma, disclosure, and attitudes ...
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Journal ArticleEmerg Infect Dis · January 2009
Data on nontuberculous mycobacterial (NTM) disease in sub-Saharan Africa are limited. During 2006-2008, we identified 3 HIV-infected patients in northern Tanzania who had invasive NTM; 2 were infected with "Mycobacterium sherrisii" and 1 with M. avium comp ...
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Journal ArticleJ Clin Microbiol · December 2008
Rapid human immunodeficiency virus (HIV) antibody tests support the effort to expand access to HIV testing and counseling services in remote, rural, and poor parts of the world. We validated the Capillus HIV-1/HIV-2 (Trinity Biotech PLC, Bray, County Wickl ...
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Journal ArticleAIDS Patient Care STDS · November 2008
Alcohol and drug use are common among HIV-infected patients and are important determinants of secondary transmission risk and medication adherence. As part of the Coping with HIV/AIDS in the Southeast (CHASE) Study, 611 HIV-infected patients were consecuti ...
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Journal ArticleEast Afr Med J · September 2008
OBJECTIVE: To evaluate the performance of QuantiFERON-TB GOLD (QFTG) in a resource-poor setting among patients with and without HIV infection. DESIGN: Cross-sectional study. SETTING: Two hospitals in Northern Tanzania. SUBJECTS: Eighty three adult male and ...
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Journal ArticlePLoS One · August 27, 2008
BACKGROUND: Monogamy, together with abstinence, partner reduction, and condom use, is widely advocated as a key behavioral strategy to prevent HIV infection in sub-Saharan Africa. We examined the association between the number of sexual partners and the ri ...
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Journal ArticleJ Acquir Immune Defic Syndr · April 15, 2008
BACKGROUND: Trimethoprim-sulfamethoxazole (SXT) reduces morbidity and mortality among HIV-infected persons in Africa, but its impact on antimicrobial resistance is of concern. METHODS: HIV-uninfected (group A), HIV-infected but not requiring SXT (group B), ...
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Journal ArticleJ Acquir Immune Defic Syndr · February 1, 2008
BACKGROUND: Expanded access to antiretroviral therapy (ART) has produced dramatic reductions in HIV-associated morbidity and mortality. Disparities in access to and benefit from ART have been observed by race, gender, and mental health status, however. MET ...
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Journal ArticleClin Infect Dis · December 1, 2007
BACKGROUND: Access to antiretroviral therapy is rapidly expanding in sub-Saharan Africa. Identifying the predictors of incomplete adherence, virologic failure, and antiviral drug resistance is essential to achieving long-term success. METHODS: A total of 1 ...
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Journal ArticleAm J Psychiatry · November 2007
OBJECTIVE: In an era of highly active antiretroviral therapies, the authors needed to confirm previous findings showing that stress and depression have an impact on HIV disease progression. The goal of the current study was to examine the effects of lifeti ...
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Journal ArticleSouth Med J · November 2007
BACKGROUND: The HIV/AIDS epidemic in the U.S. South is undergoing a marked shift toward a greater proportion of new HIV/AIDS cases in women, African-Americans, and through heterosexual transmission. METHODS: Using consecutive sampling, 611 participants wer ...
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Journal ArticleAIDS Care · October 2007
An alarmingly high prevalence of childhood sexual and physical abuse has been observed in HIV-infected men and women, with rates several times higher than observed in the general population. Childhood abuse history has been associated with worse antiretrov ...
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Journal ArticleAIDS research and human retroviruses · October 2007
Clinical criteria are recommended to select HIV-infected patients for initiation of antiretroviral therapy when CD4 lymphocyte testing is unavailable. We evaluated the performance characteristics of WHO staging criteria, anthropometrics, and simple laborat ...
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Journal ArticleAIDS Res Hum Retroviruses · October 2007
Clinical criteria are recommended to select HIV-infected patients for initiation of antiretroviral therapy when CD4 lymphocyte testing is unavailable. We evaluated the performance characteristics of WHO staging criteria, anthropometrics, and simple laborat ...
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Journal ArticleAIDS Patient Care STDS · September 2007
Advances in the treatment of HIV and associated opportunistic infections (OIs) have led to dramatic reductions in HIV-related morbidity and mortality in the United States, but not all patients have benefited equally. A longitudinal analysis of the Coping w ...
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Journal ArticleSouth Med J · August 2007
BACKGROUND: Women and minorities continue to account for a higher proportion of AIDS incidence and mortality than their male and white counterparts. This study examined whether race and gender were associated with antiretroviral use among HIV-infected indi ...
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Journal ArticleJ Infect Dis · May 15, 2007
BACKGROUND: We sought to determine the safety of treatment interruption (TI) and to identify parameters that would define patients with human immunodeficiency virus (HIV) for whom TI is safer. METHODS: AIDS Clinical Trials Group 5170 was a multicenter, 96- ...
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Journal ArticleCurr HIV/AIDS Rep · May 2007
To date, a minority of persons living with HIV worldwide has benefited from the advances in HIV therapeutics fueled by the scientific community, policy-makers, advocates, and the pharmaceutical industry in the global North. A growing body of evidence demon ...
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Journal ArticleJ Int Assoc Physicians AIDS Care (Chic) · March 2007
Antiretroviral treatment literacy leads to greater HIV testing and treatment and antiretroviral treatment adherence. Among northern Tanzanian subjects, antiretroviral treatment awareness was only 17%. Factors associated with low antiretroviral treatment li ...
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Journal ArticleEast Afr Med J · December 2006
Hookworm infection and peptic ulcer disease are common in subtropical and tropical countries. While hookworm infection is endemic where sanitary conditions are poor, peptic ulcer disease is associated with a high prevalence of Helicobacter pylori infection ...
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Journal ArticleAm J Public Health · June 2006
We examined prevalence and predictors of trauma among HIV-infected persons in the Deep South using data from the Coping with HIV/AIDS in the Southeast (CHASE) study. Over 50% of CHASE participants were abused during their lives, with approximately 30% expe ...
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Journal ArticleAIDS Patient Care STDS · June 2006
Among HIV-infected persons, high-level adherence to antiretroviral medications (>90%-95%) is associated with improved immunologic, virologic, and clinical outcomes, and is necessary to prevent the emergence of viral resistance. This study examines whether ...
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Journal ArticleAm J Public Health · April 2006
OBJECTIVES: We examined associations between trust of health care providers and the government and health service use and outcomes. METHODS: Interviews with a sample of 611 HIV-positive individuals included an attitudinal assessment measuring beliefs conce ...
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Journal ArticleCurr Treat Options Gastroenterol · February 2006
Diarrhea in patients with AIDS is a worldwide problem that can have a devastating impact on quality of life for the patient. Chronic diarrhea, usually defined as at least 4 weeks' duration, is more common in patients with low CD4-positive T-lymphocyte coun ...
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Journal ArticleAm 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 ...
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Journal ArticleAIDS Care · 2006
Providing behavioral treatment for mental health and substance use disorders among HIV-infected individuals is critical because these disorders have been associated with negative outcomes such as poorer medication adherence. This study examines the effecti ...
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Journal ArticleJ Clin Gastroenterol · October 2005
Diarrhea from gastrointestinal infection remains a common problem. In industrialized countries, management is aimed at reducing morbidity and defining groups that may benefit from further investigation. Most infectious diarrhea is self-limiting and only re ...
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Journal ArticleInt J STD AIDS · October 2005
HIV voluntary counselling and testing (VCT) reduces high-risk sexual behaviour. Factors associated with HIV infection in VCT clients have not been well characterized in northern Tanzania. We prospectively surveyed 813 VCT clients in Moshi, Tanzania. Client ...
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Journal ArticleSouth Med J · January 2005
OBJECTIVES: Mental illness and substance abuse have been consistently associated with poor HIV-medication adherence and other negative health outcomes. METHODS: A brief mental health and substance use screening instrument was administered to 1,362 HIV-infe ...
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Journal ArticlePsychosom Med · 2005
OBJECTIVE: In addition to biological markers of human immunodeficiency virus (HIV) disease progression, physical functioning, and utilization of health care may also be important indicators of health status in HIV-infected patients. There is insufficient u ...
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Journal ArticleAnn Trop Med Parasitol · March 2004
Hospitalized patients with HIV infection are among the most likely to benefit from the expanding availability of anti-retroviral therapy in sub-Saharan Africa. Between 1990 and 2000, 3667 people known to be HIV-infected were admitted to Kilimanjaro Christi ...
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Journal ArticleBraz J Infect Dis · February 2003
Advanced HIV infection is frequently complicated by diarrhea, disruption of bowel structure and function, and malnutrition. Resulting malabsorption of or pharmacokinetic changes in antiretroviral agents might lead to subtherapeutic drug dosing and treatmen ...
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Journal ArticleDig Dis Sci · July 2002
Clinical trials evaluating HIV-related diarrhea have used varied unidimensional end points to assess diarrhea severity. We hypothesized that a self-reported measure of diarrhea that assesses stool form, stool frequency, and diarrhea morbidity would accurat ...
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Journal ArticleCurr Infect Dis Rep · February 2002
Diarrhea is one of the most common health problems among travelers. Although enterotoxigenic Escherichia coli is implicated most commonly, enteroaggregative E. coli has recently been described as a major pathogen. Shigella, Campylobacter, and Salmonella or ...
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Journal ArticleJ Infect · October 2001
Results of in vitro susceptibility studies and one clinical trial have led to recommendations of clarithromycin monotherapy for the treatment of disseminated cutaneous Mycobacterium chelonae infections. We describe the case of a 65-year-old woman, immunoco ...
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Journal ArticleInfect Dis Clin North Am · June 1998
In conclusion, the causes of chronic diarrhea in the returned traveler are protean. Careful evaluation requires an understanding of where the traveler has been, when they were there, the type of diarrheal illness, medications taken, and knowledge of the pa ...
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Journal ArticleJ Clin Invest · April 15, 1997
Cholera toxin (CT)-induced intestinal secretion and Chinese hamster ovary cell (CHO) elongation involves cyclic adenosine monophosphate and protein synthesis-dependent prostaglandin formation. We previously reported inhibition of CT-induced intestinal secr ...
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Journal ArticleAnnu Rev Med · 1997
Safe and efficient treatment of drinking water has been one of the major public health advances of the twentieth century. People in developed countries generally take for granted that their water is safe to drink, a luxury the majority of the world's popul ...
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Journal ArticleJ Acquir Immune Defic Syndr Hum Retrovirol · July 1996
Delayed-type hypersensitivity (DTH) testing and total lymphocyte counts as measures of cell-mediated immune function were assessed for medical patients in Dar es Salaam, Tanzania. DTH testing was performed with the Multitest CMI device which simultaneously ...
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Journal ArticleJ Acquir Immune Defic Syndr Hum Retrovirol · August 1, 1995
The clinical utility of the World Health Organization (WHO) clinical case definition (CCD) of acquired immune deficiency syndrome (AIDS) in Africa, several proposed modifications of the WHO CCD, and two proposed screening algorithms for human immunodeficie ...
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Journal ArticleJ Lipid Mediat Cell Signal · March 1995
Clostridium difficile is a major recognized cause of antibiotic-associated diarrhea, an effect mediated through its toxin A. Toxin A has been reported to disrupt epithelial tight junctions, attract neutrophils, and cause striking intestinal inflammation an ...
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Journal ArticleCurrent Opinion in Infectious Diseases · November 4, 1994
Versatile pathogenic mechanisms, define at least six categories of Escherichia coli that cause diarrheal illnesses worldwide. Recent advances have uncovered new potential structure-function relationships among the toxins of enterotoxigenic E. coli, which c ...
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Journal ArticleProc Natl Acad Sci U S A · September 27, 1994
With the recent heightened concern about cholera around the world come new questions about the mechanism by which cholera toxin causes diarrhea. Peterson and Ochoa have suggested that prostaglandin synthesis is key to both the intestinal epithelial secreto ...
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