bluuebunny/crossref_metadata_2025_split huggingface dataset:
PO 8503 EPIDEMIOLOGY, CO-INFECTIONS AND HAEMATOLOGICAL FEATURES OF SCHISTOSOMIASIS IN SCHOOL-AGED CHILDREN LIVING IN LAMBARÉNÉ, GABON
Authors: Claude Dejon Agobe Jean , J Honkpehedji Yabo , Fréjus Zinsou Jeannot , Edoa Jean-Ronald , R Adegbite Bayodé , Duali Mohamed , L Mougeni Fabrice , Lell Bertrand , G Kremsner Peter , P Grobusch Martin , Akim Adegnika Ayola 
Published: April 2019

BackgroundSchistosomiasis is a highly prevalent parasitic infection in Central Africa, where co-endemicity with other parasitic infections is common, and schistosomiasis outcomes can be affected by those other infections. Therefore, proper schistosomiasis control needs epidemiological data accounting for co-infections, too. In this present study, our objective was to determine the epidemiological situation around schistosomiasis in Lambaréné.MethodsA cross-sectional study was conducted among school-aged children living in Lambaréné. Urine filtration exam was performed for the detection ofSchistosomaeggs. Kato-Katz and stool culture (Coproculture and Harada-Mori) techniques were used for the detection of soil-transmitted helminths. Detection ofPlasmodiumspp. and blood microfilariae was performed applying light microscopy. Risk factors for schistosomiasis and factors associated with schistosomiasis were investigated; haematology parameters evaluated.ResultsA total of 614 school children with available schistosomiasis status were included in the analysis. Mean age was 10.9 (SD=2.7) years, with a 0.95 boy-to-girl sex ratio. The prevalence of schistosomiasis was 26%. No risk factors except human-water contact were associated with schistosomiasis. OnlyTrichuris trichiuraco-infection was associated with an increased odd (aOR=2.3,p-value=0.048) to be infected with schistosomiasis. Full blood counts showed a decrease of haemoglobin level and increase of WBC and platelet levels among the schistosoma-infected children. Haematuria was found associated with schistosomiasis (aOR=14.5,p-value<0.001) and was suitable to predict the disease.ConclusionThe prevalence of schistosomiasis is moderate in Lambaréné where human-water contact remains the main risk factor and praziquantel is available for treatment. Trichuriasis is associated with increased risk to be infected. Children with schistosomiasis exhibit a distinct full blood count profile and haematuria is found to be more suitable to predict infection. However, it is desirable to implement comprehensive approaches beyond chemotherapy for schistosomiasis control in this area as recommended by WHO.
PO 8544 USE OF XPERT MTB/RIF ASSAY AND FDA MICROSCOPY RELATIVE TO MONTHLY CULTURES IN MONITORING MULTIDRUG-RESISTANT TUBERCULOSIS PATIENTS IN BAMAKO, MALI
Authors: Diarra Bassirou , Aissata B , Decroo Tom , Keita Marie L , Degoga Boureima , Diallo Fatimata , Fane Bintou , Coulibaly Gagni , Baya Bocar , Somboro Amadou , Dit Sadio Sarro Yeya , Orsega Suzanne , Van Deun Armand , Dissou Affolabi , Rigouts Leen , L Murphy Robert , Doumbia Seydou , Diallo Souleymane , De Jong Bouke 
Published: April 2019

IntroductionXpert MTB/RIF assay is used extensively for the detection of rifampicin-resistant TB (RR-TB). RR-TB treatment monitoring is culture-based, although, in resource-limited settings, access to TB culture is poor. Alternative methods are needed. We therefore conducted a pilot study to determine the performance of fluorescein di-acetate FDA vital staining, a microscopy-based test that shows viable bacilli, and Xpert threshold cycle value (Ct) changes when assessing culture conversion at the end of the intensive phase of RR-TB treatment.MethodsBetween December 2015 and April 2018, we prospectively followed patients with RR-TB during the 6-month intensive phase of a 21-month standardised WHO treatment regimen. Sputum was collected and tested monthly with Auramine, FDA, Xpert MTB/RIF, and culture (Manual MGIT). Culture was considered to have converted to negative when two consecutive cultures, taken at least 30 days apart, were negative, including at least one culture between 4–6 months of treatment.ResultsForty-one patients were included in this study, 80% were male and 7% were HIV-co-infected. Conversion could not be assessed in 12 (29%) patients. Among the remaining 29 patients, 9 (31%) converted, and 11 (38%) did not convert. All 9 who converted on culture had a negative FDA, and most (6) had a Ct trend that showed a reduction of excreted DNA (increasing Ct trend). Three of these were still positive on Auramine (excretion of dead bacilli?). Of 11 patients with positive cultures, 8 tested negative on FDA, 5 tested ‘MTB not detected’ on Xpert MTB/RIF, and another 2 showed a reduction of excreted DNA.ConclusionResults from culture, FDA, and Xpert MTB/RIF provide similar results among converters but contrasting results among non-converters. Longer follow-up time is needed to assess the value of these tests to predict treatment outcome.
PO 8567 ASSOCIATION OF POLYMORPHISM RS 73885319 OF THE APOL1 GENE AND RESISTANCE/SUSCEPTIBILITY TOTRYPANOSOMA BRUCEI GAMBIENSE
Authors: Erick Mwamba Miaka , Lejon Veerle , Ilboudou Hamidou , Solano Philippe 
Published: April 2019

BackgroundIn Central Africa, human African trypanosomiasis (HAT) or sleeping sickness is caused byTrypanosoma brucei gambiense(T.b gambiense). Classically, the disease is characterised by an early haemolymphatic phase (stage 1) followed by a meningo-encephalitic phase (stage 2) leading to neurological disorders and death if left untreated. However, field observations suggest that infection byT.b gambiensemay result in a great diversity of clinical outcomes ranging from rapid progressions into stage 2, to asymptomatic infections that can last for years or even spontaneous cure in the absence of treatment.The determinants of this clinical diversity are not known but might have their origin both in the parasite (genetic variability) and in the host (individual susceptibility to disease). This study in the Democratic Republic of the Congo aimed at examining the association between the rs73885319 polymorphism of the APOL1 gene and resistance/susceptibility toT. b gambiense. We genotyped the APOL1 gene polymorphism in a total of 257 people comprised of 90 patients, 119 endemic controls and 48 seropositives. The analysis of the results has not shown any significant differences between HAT patients, controls and seropositives. Our results seem to suggest that the G allele of the rs 73885319 polymorphism of the APOL1 gene is not associated to resistance or susceptibility to infection.
OC 8459 ASSESSMENT OF PARASITE CLEARANCE AFTER REPEATED TREATMENT WITH ARTESUNATE AMODIAQUINE, DIHYDROARTEMISININ-PIPERAQUINE, PYRONARIDINE-ARTESUNATE IN MALARIA PATIENTS IN BURKINA FASO
Authors: Soulama Issiaka , Sirima Sodiomon B 
Published: April 2019

BackgroundReports from Southeast Asia showed delayed parasite clearance after treatment with known artemisinin-based combination therapies (ACTs), the first-line treatment for malaria. We then carried out a study in the framework of the WANECAM clinical trial to assess comparatively the parasite clearance time and rate fromP. falciparummalaria patients repeatedly treated with the artesunate-amodiaquine (ASAQ), dihydroartemisinin-piperaquine (DHA-PQ) and artesunate-pyronaridine (PYR).MethodsA randomised, phase III/IV comparative, multicentre, open-label, parallel 3-arms trial was conducted in Banfora Health District area comparing the efficacy of a three-day regimen of DHA-PQ, PYR with ASAQ for the treatment of children (above 6 months) and adults with uncomplicated falciparum malaria. From August 2012 to December 2013, each randomised patient was followed up for 42 days over a period of two years. Treatment was directly observed, and blood smear samples were collected twice daily (12 hour±2 hour) until parasite clearance.The endpoints of the present sub-study were parasite clearance rate and time. The secondary endpoints included PCR-corrected and uncorrected cure rates.ResultsOut of 2843 screened patients, 763 were recruited for parasite clearance endpoint analyses. The median parasite clearance time (PCT) was 24.1 hour (2-sided 95% CI, 24.0 to 24.2 hour), 23.9 hour (2-sided 95% CI, 23.8 to 24.0 hour) and 24.2 hour (2-sided 95% CI, 24.1 to 24.5 hour), in PYR and DHA-PQ, respectively. The PCR-corrected efficacy rates were estimated at 99.8%; 99.7%; 99.9%, at day 28% and 99.3%; 99.7%–99.9% in PYR, ASAQ and DHA-PQ, respectively.ConclusionThe parasite clearance times were comparable among the three ACT arms of treatment and their efficacy was comparable and higher than 99%. There was no delay in parasite clearance time (PCT ≥72 hour).
OC 8489 CLINICAL DEVELOPMENT OF A THERAPEUTIC VACCINE FOR PREVENTION OF POST KALA AZAR DERMAL LEISHMANIASIS
Authors: Kaye Paul , Musa Ahmed , Olobo Joseph , Mbuchi Margaret , Mekuria Asrat Hailu , D’Alessio Flavia , Houard Sophie , Leroy Odile 
Published: April 2019

BackgroundThe leishmaniases represent a complex of human diseases, with 350 million people at risk of infection worldwide. Although the potential benefits of vaccination have been well-recognised, no human vaccine is registered. Post-kala azar dermal leishmaniasis (PKDL) is a chronic skin disease often following treatment for visceral leishmaniasis (VL). In addition to affecting quality of life, evidence suggests that PKDL patients may also act as reservoirs for VL transmission. Hence, PKDL vaccines may have a significant impact on disease burden. We recently developed a third-generation adenoviral vaccine for leishmaniasis (ChAd63-KH) that has been evaluated for safety and immunogenicity in healthy volunteers (Osman et al,2017). ChAd63-KH is currently being evaluated for safety as a therapeutic in Sudanese PKDL patients, with a phase IIb RCT starting in late 2018. With EDCTP funding, we are initiating a new phase IIa/IIb study (PREV_PKDL) todetermine whether ChAd63-KH can prevent PKDL development.MethodsIn PREV_PKDL, we will conduct an open-label phase IIa safety study, followed by a placebo blinded, phase IIb RCT. Safety and clinical response represent primary outcome measures, and immunogenicity is a secondary outcome measure. In addition, working across the four countries of Leishmaniasis East Africa Platform (LEAP), we will use deep phenotyping methods to study the immune status of patients before and after treatment for VL to understand why PKDL development is limited to specific geographic regions. This work, and other research in the region, will be supported by the creation of a new flow cytometry ‘centre of excellence’ within LEAP.ResultsAn update on the progress of our current therapeutic trial in PKDL patients will be provided.ConclusionPREV_PKDL represents an important step in the clinical development of ChAd63-KH and will help develop capacity to support future vaccine and drug trials for leishmaniasis in the East Africa Region.
OC 8546 SAFETY AND IMMUNOGENICITY OF THE MALARIA VACCINE CANDIDATE BK-SE36 IN YOUNG CHILDREN LIVING IN BURKINA FASO
Authors: Sirima Sodiomon , Tiono Alfred B , Houard Sophie , Bougouma Edith C , Coulibaly Sam A , Leroy Odile , Palacpac Nirianne , Horii Toshihiro , Ouedraogo Issa N 
Published: April 2019

BackgroundThe malaria blood stage vaccine candidate SE-36 is based on the serine repeat antigen ofPlasmodium falciparum. Epidemiological studies have shown that antibodies against SE36 correlate with lower parasitaemia in Solomon Island residents. In a phase I b trial conducted in Uganda, the BK-SE36 vaccine, SE36 formulated with aluminium hydroxide gel, was found safe and immunogenic. Interestingly, highest levels of IgG anti-SE36 protein associated with protection against severe malaria were found in the youngest Ugandan trial participants.ObjectivesTo assess the safety and immunogenicity of the BK-SE36 vaccine in a randomised controlled double-blind age de-escalating phase Ib clinical trial in younger (≤5 years) malaria-exposed children living in Burkina Faso.MethodsHealthy participants (108) were included in two age cohorts, one consisting of 54 children aged 25–60 months and the other of 54 children aged 12–24 months. Trial participants received 3 intramuscular or subcutaneous injections of the BK-SE36 vaccine at Day 0, Week 4 and 26. Participants allocated to the control group received the control Synflorix vaccine via intramuscular route at Day 0 and Week 26 and saline at Week 4. The participants were followed for one year. Immune responses were evaluated by ELISA, ELISpot and parasite carriage by microscopy and PCR.ResultsPreliminary data from an interim analysis (data collected one month after the last immunisation) indicated that the vaccine was safe, well-tolerated and induced an IgG anti-SE36 response in these younger populations. The trial’s latest safety, immunogenicity and preliminary efficacy results will be presented.
OC 8561 RAPAED TB: AN INNOVATIVE CHILD TB DIAGNOSTIC VALIDATION STUDY
Authors: Olbrich Laura , Zar Heather , Graham Steve , Sabi Issa , Ntinginya Nyanda E , Bhatt Nilesh , Nliwasa Marriott , Corbett Elizabeth , Song Rinn , Denkinger Claudia , Hölscher Michael , Heinrich Norbert 
Published: April 2019

BackgroundChildren account for an estimated 1 million new cases of TB every year, representing roughly 7% of the total disease burden. Every year, around 2 09 000 children die from TB, half of those cases are in Africa. The main issue continues to be timely and accurate diagnosis, as treatment outcomes – even in the case of drug resistance – are significantly better than in adults.Clinical diagnosis in the absence of laboratory confirmation is hampered by non-specificity of symptoms. Diagnostics validation studies in children are difficult – in most studies, very few of the symptomatic children achieved microbiological disease confirmation, resulting in imprecise estimates for test sensitivity.Design/methodsWith the RaPaed TB study funded by EDCTP, we are preparing an improved diagnostic validation study design to improve on the traditional approach of a single-gate, double diagnostic study in the target population. The project will evaluate multiple new tests on the same patients, to determine algorithms of screening and confirmatory tests. Most novel tests in this study use non-sputum samples and are therefore more suitable for children.Allocation of patients to standardised groups will follow the recommendations of the NIH-convened consensus panel on case definitions of paediatric TB diagnostic studies. Using an endpoint review committee will allow blinded review of those new-positive cases, plus matched controls, and determine their likelihood of disease based on clinical data including follow-up, and X-ray. This will improve the quality of evaluation of false positive vs. true positive results of new tests and therefore improve the assessment of specificity.To improve on sensitivity assessment, the study includes partners with a high number of confirmed cases in past studies and plans to draw in cases of confirmed disease from other diagnostic facilities.ConclusionThis improved methodology will lead to more meaningful and applicable results of diagnostic validation studies.
OC 8244 QUANTITATIVE LATERAL FLOW ASSAY FOR DETECTION OFM. LEPRAEINFECTION USING FINGERSTICK BLOOD
Authors: Geluk Annemieke , Hooij Anouk Van , El Fat Elisa Tjon , Alam Kosrhed , Dlamini Sipho , Batista Da Silva Moises , Spencer John , Salgado Claudio , Richardus Jan Hendrik , Corstjens Paul 
Published: April 2019

BackgroundLeprosy is a debilitating, infectious disease caused byMycobacterium lepraeleading to skin and nerve damage and often lifelong handicaps. The unabated rate of new leprosy case detection indicates that transmission ofM. lepraeis persistent and that current measures for prevention and multidrug therapy (MDT) are insufficient. Contact withM. leprae-infected individuals is a risk factor for development of leprosy. Thus, detection ofM. leprae-infected individuals without clinical symptoms, allowing informed decision making on who needs treatment at a preclinical stage, is vital to interrupt transmission and can help prevent leprosy.Immunoprophylaxis by vaccination or post-exposure prophylaxis (PEP) with antibiotics provide effective strategies for the prevention of leprosy. To target individuals unknowingly spreading leprosy bacilli, methods allowing objective measurement ofM. lepraeinfection are needed. Besides antibody (Ab) levels that correspond with bacterial load and higher risk of progression to leprosy, detection of cytokine profiles can provide significant added value to identify infection.MethodsQuantitative detection of anti-PGL-I IgM antibodies, and cytokines such as IP-10 was performed on lateral flow (LF) test strips utilising the luminescent up-converting particle (UCP) technology. Precise amounts of fingerstick (FS)-blood samples were collected using disposable heparinised capillaries. Ab and cytokine levels in both FS-blood and serum from leprosy patients in South-Africa, Brazil, Bangladesh and the Netherlands and (their) contacts were measured using a portable reader.ResultsExcellent correlation was demonstrated between data for anti-PGL-I IgM Ab and cytokines obtained with serum and FS blood from the same individuals.ConclusionThe quantitative UCP-LF test strips detecting anti-PGL-I IgM Ab and cytokines for the detection ofM. lepraeinfection is compatible with fingerstick blood allowing near-patient testing and immediate appropriate follow-up counselling.
OC 8716 ENHANCING RESEARCH ETHICS REVIEW CAPACITY IN SUDAN
Authors: Abass Shaza , Brair Sara-Lavinia , Osman Shahd , Silverman Henry 
Published: April 2019

BackgroundIn Sudan, there is an increase in health research in a situation of scarce resources and limited counteractive quality assurance in research ethics. The aim of this project was to enhance the ethical review system in Sudan.MethodsOur framework for enhancing the ethical review capacity was based on the context of Sudan with emphasis on governance, coordination, feasibility, efficiency and sustainability. Activities conducted to achieve our goals included reviewing the guidelines that govern human subjects research, enhancing the governance of national authorities (National Health Research Ethics Committee and National Medicine and Poisons Board), improving coordination between the national authorities by developing a consensus clarifying their roles and functions, capacity building for the oversight bodies and institutional ethical review committees (RECs) as well as establishing a network of research ethics committees.ResultsThe guidelines that govern human subjects research in Sudan were reviewed and updated. In addition, a consensus document was endorsed to clarify the roles of the national regulatory authorities creating channels of coordination and cooperation between them and institutional RECs. Thirty-nine RECs from different parts of Sudan have been trained and the results of the pre/post test have shown an increase in the knowledge score among trainees (p<0.05). The project has also provided a platform for sharing experiences and maintaining partnerships with regional and international institutes in addition to provision of technical support for newly established RECs.ConclusionWe believe that the array of activities conducted through this project had enhanced the governance, coordination, feasibility and, efficiency of the ethical review system in Sudan.
PO 7139 CONDITIONAL ECONOMIC INCENTIVES AND MOTIVATIONAL INTERVIEWING TO IMPROVE ADOLESCENTS’ RETENTION AND ADHERENCE TO ANTIRETROVIRAL THERAPY IN NIGERIA: ARA TRIAL
Authors: Ekwunife Obinna , Anetoh Maureen , Kalu Stephen , Eleje George 
Published: April 2019

BackgroundAdolescent HIV patients have worse treatment outcomes compared to other age groups given their vulnerability to risk-taking behaviour. Limited evidence exists on the effectiveness of service delivery interventions to support adolescents’ retention in care and adherence to antiretroviral therapy (ART). The ARA trial tackles this challenge by evaluating the impact of conditional economic incentives coupled with motivational interviewing on adolescents’ retention in care and adherence to ART in Anambra State, Nigeria.MethodsThe study will be a cluster-randomised, controlled trial conducted in 12 HIV treatment hospitals in Anambra State, Nigeria. Six (6) hospitals each will be randomised to either intervention or control arm. A structured adherence support scheme, termed the Incentive Scheme, will be applied to the intervention hospitals while the control hospitals will receive routine HIV care. Additionally, patients in the intervention arm will receive motivational interviewing at baseline and following initiation of ART, they will receive a gift voucher of Nigerian Naira (NGN) 2000 when viral load (VL) is <20 copies/mL at 12 weeks, gift voucher of NGN 1000 if the VL remains suppressed for the next 3 months, and the next 6 months, and finally gift voucher of NGN 2000 if the VL remains <20 copies/mL at 1 year. All gift vouchers will be conditional not only on VL results but also on attending for motivational interviewing. The primary outcome for the trial will be the difference between groups in the proportion to HIV viral load suppression (≤20 copies/mL) by 12 months and then 24 months after withdrawal of the Incentive Scheme.ResultsThe protocol for ARA trial and planned activities is finalised. Application for approval for the trial is on-going.ConclusionThe proposed trial will provide evidence on the feasibility of applying the Incentive Scheme to improve retention and adherence to ART of adolescents living with HIV.
PO 8171 PREDICTORS OF LOSS TO FOLLOW-UP IN ART-COMMENCED PATIENTS IN NIGERIA: A 13-YEAR REVIEW (2004–2017)
Authors: Aliyu Ahmad , Adelekan Babatunde , Andrew Nifarta , Ekong Eunice , Dapiap Stephen , Murtala-Ibrahim Fati , Ndembi Nicaise , Nta Iboro , Mensah Charles , Dakum Patrick 
Published: April 2019

BackgroundExpanded access to antiretroviral therapy (ART) has improved HIV outcomes in Nigeria. However, increasing rates of patients lost to follow-up (LTFU) is threatening the achievement of the UNAIDS treatment targets to treat 90% of HIV-diagnosed patients and attain 90% viral suppression amongst those on treatment. Therefore, this retrospective cross-sectional study is aimed at identifying correlates and predictors of loss to follow-up in ART-commenced patients in a large HIV programme in Nigeria.MethodsRecords of all patients who started ART from 2004 to 2017 of 432 PEPFAR-supported facilities across 10 states in Nigeria were used for this study. Univariate, bivariate and multivariate analysis using frequencies, percentages, chi-square and logistic regression was conducted using STATA version 14 to determine occurrence, correlates and predictors of LTFU.ResultsAmong all 2 45 257 ever-enrolled-on-ART patients within the review period, 1 50 191 patients (61.2%) remained on treatment while 75 041 (30.6%) were LTFU. Patients were significantly more likely to be LTFU when non-pregnant female (OR: 4.55,p<0.001); on ≥3 monthly ARV refills (OR: 1.32, p<0.001); with unsuppressed viral loads on ART (OR: 4.52, p<0.001); adult on second-line regimen (OR: 1.23 p<0.001); paediatric on first-line regimen (OR: 1.70, p<0.001); 10–14 years (OR: 2.99, p<0.001); and ≥65 years (OR: 1622.84, p<0.001).ConclusionDespite increasing access to ART, LTFU is still a challenge in the HIV programme in Nigeria with gender, type of regimen, age, unsuppressed viral load, duration of ARV refill, and duration of ART amongst others as significant predictors of LTFU. Differentiated care is advocated to prevent LTFU and improve retention of people living with HIV on treatment while further research to unravel the gender and social dimensions of LTFU is encouraged.