bluuebunny/crossref_metadata_2025_split huggingface dataset:
MODIFIABLE RISK FACTORS OF BURULI ULCER IN COMMUNITIES OF TWO ENDEMIC LOCAL GOVERNMENT AREAS OF OGUN STATE, NIGERIA
Authors: Akinwale Olaoluwa , Adeneye Adeniyi , Ezeugwu Sylvanus , Olukosi Yetunde , Adewale Babatunde , Sulyman Medinat , Mafe Margaret , Okwuzu Jane , Gyang Pam , Nwafor Timothy , Henry Uzoma , Musa Bilkisu , Ujah Innocent 
Published: February 2017

BackgroundBuruli ulcer (BU) remains a neglected tropical disease globally including in Nigeria despite its severe health and socio-economic consequences. This study was conducted as there is a paucity of data on community knowledge and risk factors of BU in Nigeria.MethodsThe study was conducted in the BU-endemic Yewa North and Yewa South local government areas (LGAs) of Ogun State, Nigeria. Study population included community members selected using multi-stage sampling techniques. Household survey using a semi-structured questionnaire was used for data collection. Data were analysed using SPSS (version 20) software.ResultsA total of 236 consented respondents were interviewed (Yewa North 76.7%vsYewa South 23.3%; males 48.7%vsfemales 51.3%) with an average age of 33.1 years. Only 39.0% had a minimum of secondary education. A little over half (128; 54.2%) reported having knowledge of BU in their communities. However, only 35.6% adjudged BU a common disease in their communities while 56.0% perceived it as a serious health challenge. Few (14.0%) respondents had an average of one household member who had or have BU. Most (64.8%) did not know the cause of BU while 9.7% attributed it to witchcraft/Olobutu, bacteria (4.2%), water contact (3.0%) and poor hygiene (3.0%). 53.4% visit riverbanks for activities that were predominantly: washing (37.3%); swimming (35.7%); fetching water (19.8%); and agricultural activities (4.0%). Gender and age had no significant influence on respondents' knowledge of the cause of BU (p>0.05). Swimming and other activities on the riverbanks associated with BU had significant correlation with report of BU cases in the household (p< 0.05).ConclusionsPervasive knowledge of BU cases and high-perceived seriousness of the disease in the study communities exist. Nonetheless, there is need for more public health education emphasising common modifiable risk factors and actual cause of BU. Overall, these results provide insights for BU programme planning and optimisation.
IS TRACHOMA ON TRACK FOR ELIMINATION BY 2020? MONITORING AND SURVEILLANCE AFTER MASS DRUG ADMINISTRATION WITH AZITHROMYCIN FOR ACTIVE TRACHOMA IN GUINEA BISSAU
Authors: Cowley Giovanna , Silva Eunice Teixeira Da , Nabicassa Meno , Barros Pedrozinho Duarte Pereira De , Blif Milena Mbote , Bailey Robin , Last Anna 
Published: February 2017

BackgroundGuinea Bissau is a trachoma-endemic country that has pledged to eliminate blinding trachoma by 2020 by implementation of the SAFE strategy. Evidence for elimination is to be presented in a dossier to WHO. Mass drug administration (MDA) with azithromycin for active trachoma has been carried out in the Bijagos and Cacheu regions. Through collaboration with government and non-government agencies, we conducted coverage and impact surveys to evaluate success of MDA and build capacity in monitoring and surveillance activities within the Programa Nacional de Saude de Bissau. Our surveys demonstrate the feasibility of compiling the elimination dossier and show promising results.Methods(1) Coverage survey (Bijagos): Seven households were randomly selected from 17 villages on five islands which had received MDA 1 month previously. Household members reported whether they had taken azithromycin and population coverage was calculated. (2) Impact survey (Cacheu): 15 households were randomly selected from 20 clusters. Trained ophthalmic nurses recorded cases of follicular trachoma (TF) amongst 1–9 year-olds and of trachomatous trichiasis (TT) amongst people aged 15 and above. Prevalence estimates of TF and TT were calculated.Results(1) MDA Coverage (Bijagos): Estimated MDA coverage was 90.9% overall (n=518) and 94.4% amongst children aged 1–9. (2) Impact survey (Cacheu): 701 1–9 year-olds and 1557 >14 year-olds were examined. The estimated prevalence of TF1–9 was 0.3% and that of unoperated TT>14 was between 0.1 and 0.4%.ConclusionsThese surveys provide evidence that MDA can achieve very high levels of coverage in remote and poorly accessible areas and can reduce TF to below the WHO elimination threshold. Successful TF elimination can allow focus to shift to operating TT, which remains a significant public health problem after MDA. These surveys demonstrate how sound epidemiological methods can be used in programmatic settings to evaluate elimination campaigns, guide future programme activities and contribute to global data collection.
ESTABLISHMENT OF A SUB-REGIONAL ETHICS COMMITTEE IN CENTRAL AFRICA TO ADDRESS THE NEEDS OF MULTICOUNTRY PROJECTS: AN OCEAC INITIATIVE
Authors: Nona Sylvie Kwedi 
Published: February 2017

BackgroundThe Universal Declaration on Bioethics and Human Rights, adopted by UNESCO, requires that governments establish National Ethics Committees (NECs) capable of reviewing ethical and scientific aspects on research involving human beings. These NECs are government gatekeepers tasked with ensuring that research conducted in their territories is in compliance with national and international ethics requirements. In Central Africa, NECs are lacking in some countries, barely functional in others either crippled by lack of expertise, scarce opportunities for training or by an environment not conducive to quality and ethical research. To remedy this shortcoming, OCEAC was awarded an EDCTP grant to put in place a common Ethics Committee for Central Africa.MethodsSix designated representatives of Ministries of Health, with appropriate background and skills, from Cameroon, Chad, Equatorial Guinea, Gabon, Republic of Congo, and the Central African Republic were selected to be members of the sub-regional Ethics Commitee. In order to ensure the proper composition of this committee, ethics experts originating from central Africa were selected through a call for candidates widely published in various ethics and research networks in the sub-region.ResultsCERSAC (Comité d'Ethique de la Recherche et de la Santé en Afrique Centrale) is the designation of the resulting sub-regional Ethics Committee, assembling fifteen members from the six CEMAC countries and the Democratic Republic of Congo. Since 2014, CERSAC has provided streamlined reviews of health research projects conducted in more than one Central Africa country. A total of 37 local emerging-career researchers and ethics committee members were trained.ConclusionsCERSAC enhances the ethical conduct and social value of research and optimises the protection of human research participants for communities in dire need. The committee also provides a harmonised platform to address ethical challenges related to the conduct and output of health research in Central Africa.
INVOLVEMENT OF STAKEHOLDERS IN THE REPORTING PROCESS OF SERIOUS ADVERSE EVENTS DURING CLINICAL TRIALS IN A SUB-SAHARAN RESEARCH CENTER, LAMBARÉNÉ, GABON
Authors: Lumeka Kabwende , Todagbe Agnandji 
Published: February 2017

BackgroundThe pharmacovigilance of medical products for human use should start during the clinical development and continues after licensure. In developed countries, regulatory agencies are actively involved in all steps of pharmacovigilance. In sub-Saharan African countries, the lack and weaknesses of national regulatory authorities are being addressed through regional regulatory authorities like AVAREF 2 which aims to oversee pharmacovigilance duties across countries. Informing such initiative about the current practices for the reporting of serious adverse events is needed.MethodsWe reviewed the reporting of clinical trials performed in CERMEL from 2006–2016. The methods of serious adverse events (SAE) reporting and handling was the main objective of the review.ResultsThe most frequent methods used to reporting SAE for the clinical trials reviewed in Lambarene were: 31% (5/16) paper Case Report Forms (CRF) only, 25% (4/16) electronic case report form (eCRF) without alert, 13% ( 2/16) paper CRF+phone call and 13% (2/16) phone +email or fax+ paper CRF and 6% (1/16) electronic SAE reporting system with alert. Generally, all studies reported SAEs directly to the sponsors who reacted according to their guidelines. Only 2 of 16 studies could involve the Institutional Review Board (IRB), Ethics Committees, and the Data Safety Monitoring Committee (DSMC) and eventually reported to the Regulatory Authorities in the country. The Local Safety Monitoring was involved only in one study which used the eCRF with alert.ConclusionsIt appears that in the current practices, the reporting and handling of SAEs are mainly done by investigators and sponsors. Although both are the key stakeholders to do so, more active involvement of regulatory authorities is an essential step towards establishment of a pharmacovigilance system and would improve the community engagement towards clinical trials. Electronic reporting with alert system could be one of the methods suitable to involve all partners.
PILOTING DHIS2 SYSTEM IN VISCERAL LEISHMANIASIS SURVEILLANCE
Authors: Okeyo Seth , Omollo Raymond , Kimutai Robert , Ochieng Michael , Egondi Thaddaeus 
Published: February 2017

BackgroundThe District Health Information System 2 (DHIS2) is a tool for collection, validation, analysis and presentation of both individual (tracker) and aggregated data tailored to integrated health information management activities. DHIS2, developed by the Health Information Systems Programme (HISP) in collaboration with University of Oslo, is a modular web-based software package built with open source Java frameworks. Visceral leishmaniasis (VL) is not captured in the DHIS2 regional database, and therefore coming up with the modalities of aggregating available data from clinical trials and general patient records into the DHIS2 national database is crucial for surveillance.MethodsDHIS2 runs on Tomcat Server and PostgreSQL. We set up the VL surveillance program with different stages: enrolment and demographics, initial treatment outcome and follow-up visits. In this system, a patient is enrolled into the system and data is collected in individual data elements; data Indicators are built to help aggregate the data and thereafter used for report generation. It is programmed to visualise data and display reports in the system dashboard which can then be used to present data.ResultsPiloting DHIS2 has enabled us to set up a system that uses the set indicators programmed to aggregate data, thus able to produce reports on the data and the user is also able to select the type of report in the form of pivot tables, charts and graphs and also in GIS mapped data.ConclusionsDHIS2 system is an open source that can be customised and expanded to capture detailed individual surveillance data and shared in reports. This data is useful for tracking neglected tropical diseases such as VL. Data can be handled in the following modalities: i) use of off-line data synchronisation. ii) remote data collection using mobile devices iii) data aggregation and organisation iv) data visualisation and presentation through charts, graphs and pivot tables.
MATERNAL UROGENITAL SCHISTOSOMIASIS, MONITORING DISEASE MORBIDITY BY SIMPLE REAGENT STRIPS
Authors: Oyeyemi Oyetunde , Odaibo Alexander 
Published: February 2017

BackgroundUrine analysis is one of the recommended antenatal guidelines for early diagnosis of pregnancy-associated complications. While urine analysis by dipstick had been used in practice to provide useful information on other urinary tract infections, its application for early detection of urogenital schistosomiasis in pregnant women is often downplayed in most endemic areas. Our study therefore assessed the performance of some common urinalysis parameters in the diagnosis of maternal urogenital schistosomiasis in endemic rural communities of Nigeria.MethodsThe cross-sectional epidemiological survey of urogenital schistosomiasis was conducted among pregnant women in Yewa North Local Government, Ogun State, Nigeria. The women were examined for infection withSchistosoma haematobiummicroscopically and screened for macrohaematuria, microhaematuria and proteinuria using standard urine chemical reagent strips.ResultsOf 261 volunteer participants, 19.9% tested positive forS. haematobiuminfection. The proportion of microhaematuria (23.8%) was significantly higher than that of macrohaematuria (3.8%) and proteinuria (16.8%) (p<0.05). Microhaematuria with sensitivity (82.7%) and specificity (89.0%) was the best diagnostic indicator of urogenital schistosomiasis.Macrohaematuria with the least sensitivity (11.8%) was however the most specific (98.1%) for diagnosing urogenital schistosomiasis in pregnant women. Maximum microhaematuria sensitivity (100.0%) was observed in women between 15–19 years but sensitivity was consistently low in other older age groups. Maximum sensitivity, specificity and predictive values (100.0%) were recorded for microhaematuria in first trimester women. Diagnostic efficiency of proteinuria and macrohaematuria was also better in first trimester women except the 25.0% specificity recorded for proteinuria. The overall diagnostic performance of microhaematuria and proteinuria was best in secundigravidae.ConclusionsMicrohaematuria can be used for early detection of urogenital schistosomiasis in endemic areas especially in younger and first trimester women. Treatment with praziquantel is recommended for the women in their late trimester in order to avert associated adverse pregnancy outcomes.
THE EFFECT OF HELMINTH CO-INFECTION ON MALARIA-SPECIFIC IMMUNOGLOBULIN G RESPONSES
Authors: Njua-Yafi Clarisse , Nkuo-Akenji Theresa , Anchang-Kimbi Judith , Apinjoh Tobias , Mugri Regina , Chi Hanesh , Tata Rolland , Njumkeng Charles , Dodoo Daniel , Theisen Michael , Achidi Eric 
Published: February 2017

BackgroundMalaria and helminthiases overlap extensively in their epidemiological distributions, and co-infections are common. Helminth infection has a profound effect on the immune system such as the induction of immuno-regulatory mechanisms such as potent regulatory T cell responses known to suppress cellular effector mechanisms.MethodsThe prevalence of malaria parasitaemia, intestinal helminths, co-infection and anaemia was determined in a cross-sectional study (March 2011) of 372 children aged 6 months to 10 years resident in Mutengene in south-western Cameroon. Plasma total IgG and IgG1–4 subclass antibody levels toP. falciparumapical membrane antigen 1 (AMA1), the N-terminal non-repeat region (GLURP R0) and the C-terminal repeat region of glutamate rich protein (GLURP R2) and merozoite surface protein 3 (MSP3) were measured by standardised ELISA.ResultsPrevalence was as follows: malaria parasitaemia (mp) 18%, pyrexia 25.4%, helminths 19.7%, and anaemia 71.5%. Amongst those who were mp-positive, 25.4% were symptomatic (4.5% overall). Almost all helminth infections were the soil-transmitted helminthsAscaris,Trichurisand hookworm (96.4%) with a few cases ofHymenolepisandEnterobius. Haemoglobin concentration (g/dl) correlated positively with age and negatively with mp density (p≤0.001). The mean haemoglobin (g/dl) level of participants co-infected with both parasites (3.4%) was higher compared to participants infected with eitherPlasmodium(15.8%) or helminths (16.1%) alone (p< 0.01). IgG and IgG1–4 subclass antibody levels to all recombinant antigens correlated positively with age (p< 0.01). Total IgG, IgG1, 2 & 3 levels to all the antigens tested were significantly (except MSP3 IgG2, p=0.08) higher in participants infected withPlasmodiumalone, compared to the co-infection, helminths only and no infection groups. Decreased levels of AMA1 IgG associated significantly with co-infection (OR=0.27, 95% CI:0.11–0.68). Increased MSP3 IgG and IgG1–4 levels were significantly associated with children infected withPlasmodiumalone compared to children co-infected with both parasites.ConclusionsInfection with intestinal helminths stifles protective anti-plasmodial antibody responses.
THE IMMUNE TRYPANOLYSIS TEST: AN ACCURATE SEROLOGICAL MARKER TO MANAGE ELIMINATION OFT.B. GAMBIENSEHUMAN AFRICAN TRYPANOSOMIASIS
Authors: Emilie Dama , Camara Oumou , Mathurin Koffi , Guiguigbaza-Kossigan Dayo , Philippe Büscher , Regassa Fikru , Hassane Sakande , Bienvenu Somda Martin , Ilboudo Hamidou , Fabrice Courtin , Ouédraogo Elie , Kouakou Lingue , Kaba Dramane , Camara Mamady , Bucheton Bruno , Lejon Veerle , Jamonneau Vincent 
Published: February 2017

BackgroundContinued post-elimination monitoring is required to ensure sustainability of zero transmission of human African trypanosomosis (HAT) and to avoid re-emergence caused by potential remainingTrypanosoma brucei gambiensereservoirs (animal and/or human). Until now, no tool is able to attest or validate elimination. Increasingly, the serological immune trypanolysis test is being implemented in the decision algorithms to characterise parasitological unconfirmed CATT or RDT seropositive subjects. Therefore, we wanted to assess further the high specificity of immune trypanolysis.MethodsWe first tested samples from domestic animals from a tsetse-infested area in Ethiopia, a country where noT. b. gambienseexists, but where bovine trypanosomosis is prevalent. Then, we tested cattle and human samples from the south-west of Burkina Faso, a historical focus ofgambienseHAT that still shelters tsetse flies populations and animal trypanosomosis. Lastly, we were interested in testing human samples from active foci in Côte d'Ivoire and Guinea.ResultsOur results showed zero trypanolysis-positive animals from Ethiopia while in the historical HAT foci in Burkina Faso, 4.89% (14/286) of cattle were trypanolysis-positive. In humans, zero samples over 729 were trypanolysis-positive in Burkina Faso, while the percentage of positives was 3.77% (44/1166) in Guinea, including 7 new cases diagnosed during the sampling and 1.3% in Côte d'Ivoire (8/598).ConclusionsConsidering results from this study, we think that trypanolysis test, confirmed to be a very specific test in human, can be a tool able to certify HAT elimination in a given area. It also suggests that the risk of the reintroduction ofT. b. gambiensein Burkina Faso is real, especially in the south-west which shelters a high density of tsetse populations, in addition to the possible presence ofT. b. gambiense in domestic animals. However, further studies on the specificity of the trypanolysis test regardingT. b. gambiensein animals should be conducted.
HIV INFECTION AND CARDIOVASCULAR RISK PROFILE IN A RURAL SOUTH AFRICAN POPULATION: THE NDLOVU COHORT STUDY
Authors: Vos Alinda , Devillé Walter , Barth Roos , Klipstein-Grobusch Kerstin , Tempelman Hugo , Venter François , Coutinho Roel , Grobbee Diederick 
Published: February 2017

BackgroundLife expectancy increased in HIV-infected populations due to antiretroviral treatment (ART). Whether HIV-infection and/or ART increase cardiovascular risk against a background of increasing prevalence of obesity, hypertension and diabetes in low- and middle-income countries is not yet clear. To answer this question in a rural South-African population, the Ndlovu Cohort Study was designed. We describe the baseline distribution of cardiovascular risk factors in relation to HIV and ART.MethodsThe Ndlovu Cohort Study is a prospective cohort study of 1000 HIV-positive and 1000 HIV-negative adults from the Moutse area, Limpopo, South Africa with an intended follow-up duration of ten years. Information is collected on demographics, anthropometrics, life-style, kidney and liver function, CRP, glucose and proteinuria. Carotid intima-media thickness (CIMT) and pulse wave velocity (PWV) measurements are used to assess subclinical atherosclerosis, respectively arterial stiffness. Cardiovascular risk factors were compared between HIV-negative and HIV – positive participants, whether or not on ART. Data were adjusted for gender and age.ResultsBy December 2015, 1053 participants were included, 66% women; 345 (32.8%) women were HIV-positive of whom 235 (68.1%) received ART. HIV-infected participants were significantly older (40.0 versus 37.3 years), and mainly women (73%). HIV was associated with a lower body mass index, lower total – and LDL cholesterol and a lower prevalence of hypertension and diabetes. ART was associated with increased HDL and triglyceride levels. Current smoking did not differ between groups (23.6%), HIV and ART were associated with higher CRP values. Framingham risk scores (FRS) did not differ between HIV+/HIV- and/or ART use.ConclusionsHIV infection is accompanied by a lower prevalence of cardiovascular risk factors, although the level of inflammation is increased. So far, we found no evidence that the 10-year cardiovascular disease risk according to FRS is influenced by HIV infection or HIV treatment.
POINT-OF-NEED DIAGNOSTICS: BIOSURVEILLANCE WITH A DEVICE2CLOUD CAPABILITY IN SIERRA LEONE
Authors: Ansumana Rashid , Taitt C. , Lamin J.M. , Jacobsen K.H. , Mulvaney S.P. , Leski T. , Bangura U. , Stenger D. 
Published: February 2017

BackgroundInfectious diseases contribute to a high burden of diseases globally. Surveillance using low-cost technology, combined with cutting edge platforms offers a path for understanding the disease ecology of locations of interest in resource-poor countries. Our goal was to pilot a bio surveillance system comprising of rapid lateral flow immunoassays, rapid PCR and a cloud database.MethodsThe study was carried out in Bo, Sierra Leone at the Mercy Hospital. We recruited 1570 subjects over a period of two years. Inclusion criteria for the study were being febrile, being at least five years of age, living within the city of Bo or its neighbouring villages and agreeing to participate in the study. The assays used included a DPP multiplex lateral flow assay for dengue,Burkholderia pseudomallei,Yersinia pestis, malaria Pf/Pan, a Film Array PCR platform with multiplex Biothreat and SASFI panels that together detect over 30 pathogen targets. We used a Deki Reader to upload lateral flow images to the cloud database. The Deki reader quantitates test results, such that scores at ≥1.75 are considered positive. A special computer program was designed to upload pdf images of PCR results to the cloud database. The cloud database was designed for automated quality assessment and remote monitoring.ResultsPreliminary results show that out of 1570 samples processed by DPP, 30(1.9%) were positive for Burkholderia, 41(2.6%) were positive for Dengue NS1 antigen, 22(1.4%) were positive forYesinia pestisfraction 1 antigen, and 340(21.7%) were positive for malaria. When a cross-section of results obtained by eye was compared with results automatically detected by the D2C platform, there was 95.2% concordance between results obtained by eye and those obtained automatically by the Deki reader to the cloud database.ConclusionsActive disease surveillance and the ability to remotely monitor activities in peripheral health units are critical needs in many poor countries. Our results provide additional perspectives on the twin problem of surveillance and remote quality assessment.