bluuebunny/crossref_metadata_2025_split huggingface dataset:
ParaSight‐F test to diagnose malaria in hypo‐endemic and epidemic prone regions of Vietnam
Authors: Verlé P. , Binh L. N. , Lieu T. T. , Yen P. T. , Coosemans M. 
Published: August 2010

SummaryThe antigen capture Para Sight‐F test was evaluated during a drug sensitivity survey in a hypoendemic region of northern Vietnam. When only asexual blood forms of P. falciparum were considered, sensitivity of ParaSight‐F was 100%, specificity 88% (95% CI 95–80%), positive predictive value 68% (95% CI 85–50%) and negative predictive value 100%. ParaSight‐F proved very convenient for rapid screening and selection of patients to enrol in a drug sensitivity study. In northern Vietnam, the introduction of the test as a routine diagnostic tool is not justified, considering its high cost, the necessity to carry out the treatment of presumptive Plasmodium vivax cases and the persistence of positive reactions following treatment. However, the test will be a valuable tool in remote areas in emergency situations, where rapid confirmation of a P. falciparum outbreak is required.
A comparative study of the efficacies of chloroquine and a pyrimethamine‐dapsone combination in clearing Plasmodium falciparum parasitaemia in school children in Tanzania
Authors: Mshinda H. , Font F. , Hirt R. , Mashaka M. , Ascaso C. , Menendez C. 
Published: August 2010

SummaryA randomized study on the in vivo efficacies of chloroquine and a pyrimethamine‐dapsone combination (Maloprim) in clearing P. falciparum parasitaemia was carried out in 77 asymptomatic semi‐immune schoolchildren in the Kilombero District of Tanzania. Children were randomized to receive either chloroquine at a dose of 25 mg/kg over three days, or Maloprim (6·25 mg pyrimethamine+50 mg dapsone for children under 10 years, and 12.5 mg pyrimethamine+100 mg dapsone for children TO or more years old) as a single dose. Children were followed‐up for malaria parasitaemia at days 2, 7 and 14 after screening, randomization and treatment. The slide positivity rate was lower in the Maloprim group at all cross‐sectional surveys (23 vs 37% at day 2; 9 vs 20% at day 7; 21 vs 32% at day 14) but none of these differences reached statistical significance. No cases in the Maloprim group showed RII resistance, whereas in the chloroquine group, 2 cases showed RII resistance and a further 2 cases RIII resistance (6%). No major side‐effects were reported. The combination of pyrimethamine‐dapsone appears to be a better choice than chloroquine as a chemoprophylactic regimen for malaria in this area. Although they need to be confirmed in a larger study, these results may be of interest to the policy‐makers as well as researchers.
Chloroquine resistance of Plasmodium falciparum malaria in Ethiopia and Eritrea
Authors: Alene Getu D. , Bennett Steve 
Published: August 2010

SummaryWe report on the first 2 years of operation of a new strategy for treatment for P. falciparum malaria patients who were not cured by a standard course of chloroquine. Any such patient who returned to a malaria treatment and detection post within 2 weeks was treated daily under supervision with chloroquine. Patients whose parasitaemia had not decreased below 25% of the initial level by day 3 or cleared completely by day 7 were given sulphadoxine/pyrimethamine (Fansidar). Of 39 824 patients treated initially with chloroquine, 4% returned to the malaria post within 2 weeks of treatment; 87% of these were chloroquine resistant and treated with Fansidar and 28% of the returning patients were RIII resistant.Resistance was associated with geographical area, initial parasite density and age. Earlier studies had shown resistance to be confined to border areas, but we found that it was highest in the centre of the region, notably in the lowlands of the Shewa and Arsi provinces, and lowest in the west. Although imported cases have been held responsible for the development of resistance in border areas, other factors are likely to be important in the middle of the region. The implications of these findings for a treatment policy of P. falciparum malaria in the region are discussed.
Chloroquine resistant Plasmodium vivax malaria in India
Authors: Dua V. K. , Kar P. K. , Sharma V. P. 
Published: August 2010

SummaryIn India, 1·2‐1·5 million new cases of Plasmodium vivax occur each year. These cases are successfully treated with 600 mg chloroquine (adult dose). We report the results of malaria treatment of a 13‐year‐old girl from the Indian Oil Corporation (IOC), Mathura, India who contracted P. vivax infection. The infection failed to respond to 2 cycles of standard chloroquine therapy. The concentrations of chloroquine were monitored with high performance liquid chromatography (HPLC). The plasma and whole blood chloroquine concentrations were 260 and 106 ug/1 respectively, while a 15 µg/1 plasma concentration is considered lethal to P. vivax. Resistance in P. vivax to chloroquine was found at the IOC, Mathura.
Isolation of Vibrio cholerae O139 from the drinking water supply during an epidemic of cholera
Authors: Ramakrishna B. S. , Kang G. , Rajan D. P. , Mathan M. , Mathna V. I. 
Published: August 2010

SummaryIn mid 1994, the public water supply was investigated in a medium‐sized town in south India during an epidemic of cholera due to Vibrio cholerae O139. Vibrio cholerae O139 was isolated from the public water supply including one of the wells supplying the town, the central overhead tank, and domestic taps connected to the public supply. Following chlorination, the organism was no longer isolated from the water supply and the epidemic subsided. This demonstration of V. cholerae O139 in the drinking water supply of a town underlines the need for adequate treatment of the water supply.
Assessment of vector microfilarial uptake as a comparatively non‐invasive technique for monitoring onchocerciasis treatment campaigns in the Americas
Authors: Davies John B. , Luján Ricardo , López‐Martinez Luis A. , Paniagua‐Alvarez Aura J. , Morales‐Hernández Byron E. , Sherlock K. 
Published: August 2010

Summary Since 1992, efforts have been made to combat onchocerciasis in Guatemala through mass distribution of ivermectin. The impact of the campaign is assessed by taking skin‐snips from sentinel groups within selected communities. This method gives an estimate of the prevalence and intensity of infection, and thus the efficacy of the treatment. In some communities people are becoming reluctant to volunteer for skin‐snipping, and so there is a need for an alternative technique that will give quantitative results. In most hyperendemic communities in Guatemala, biting blackflies are so ubiquitous that few people object to allowing 10 to 20 flies to engorge upon them. We examined data on the quantitative uptake of microfilariae by Simulium ochraceum before and after ivermectin distribution to see whether results similar to skin‐snip data could be obtained. Counts of microfilariae ingested by S. ochraceum are compared to the numbers found in skin‐snips from the same volunteers.In a group of 31 untreated infected persons, a skin‐snip survey detected 64.5% positive, while feeding flies (vector microfilarial uptake, VmfU) detected 96.8%. Post‐treatment, in a sample of 58 of whom 52 (89.7%) had a history of infection, both skin‐snips and VmfU detected 54.2%. Vector blood meals contained more microfilariae than a mg of skin before treatment, but both recorded about equal numbers after treatment. When the data set was subdivided to compare samples taken at 2–3, 6–8 and 14–17 months post‐treatment, the effect of ivermectin was still apparent at 6–8 months, but had virtually disappeared by 14 months post‐treatment. A surprising observation was that the flies ingested fewer microfilariae from treated persons than was expected from the skin densities as estimated by skin‐snip. This effect lasted for over 8 months, and could indicate that ivermectin has a greater effect on transmission than previously suspected. We conclude that VmfU could be used as an alternative to skin‐snipping, and discuss the ethical implications.
Can source reduction of mosquito larval habitat reduce malaria transmission in Tigray, Ethiopia?
Authors: Yohannes Mekonnen , Haile Mituku , Ghebreyesus Tedros A. , Witten Karen H. , Getachew Asefaw , Byass Peter , Lindsay Steve W. 
Published: August 2010

SummaryThe development of irrigation schemes by dam construction has led to an increased risk of malaria in Tigray, Ethiopia. We carried out a pilot study near a microdam to assess whether environmental management could reduce malaria transmission by Anopheles arabiensis, the main vector in Ethiopia. The study took place in Deba village, close to a dam; Maisheru village, situated 3–4 km away from the dam, acted as a control. Baseline entomological and clinical data were collected in both villages during the first 12 months. Source reduction, involving filling, draining and shading of potential mosquito‐breeding habitats was carried out by the community of Deba in the second year and routine surveillance continued in both villages during the second year. Anopheles arabiensis was highly anthropophilic (Human Blood Index = 0.73), biting early in the night before people went to bed. The major breeding habitats associated with the dam were areas of seepage at the dam base (28%), leaking irrigation canals (16%), pools that formed along the bed of streams from the dam (13%), and man‐made pools (12%). In the pre‐intervention year, 5.9–7.2 times more adult vectors were found in the dam village compared with the control village. There was a 3.1% higher prevalence of an enlarged spleen in children under 10 years in the dam village than in the control village during the pre‐intervention period, but no statistically significant difference was found in the incidence of falciparum malaria between the two villages during the same period. Source reduction was associated with a 49% (95% CI = 46.6–50.0) relative reduction in An. arabiensis adults in the dam village compared with the pre‐intervention period. There were very few cases of malaria during the intervention period in both villages making it impossible to judge whether malaria incidence had been reduced. These preliminary findings suggest that in areas of low intensity transmission community‐led larval control may be a cheap and effective method of controlling malaria. Further, large‐scale studies are needed to confirm these findings.
Risk factors for mortality in Paraguayan children with pneumococcal bacterial meningitis
Authors: Lovera Dolores , Arbo Antonio 
Published: August 2010

SummaryBackground  Over the last decade Streptococcus pneumoniae has emerged as the most common bacterial pathogen for meningitis in all age groups, beyond the neonatal period.Objective  To determine the epidemiological and clinical characteristics; and risk factors for mortality of pneumoccocal meningitis in children in a developing transitional country.Materials and methods  A retrospective study that included patients <15 years of age admitted at the Instituto de Medicina Tropical of Paraguay, from January 1990 until December 2003 with the diagnosis of bacterial meningitis caused by S. pneumoniae. Clinical and laboratory data were collected and analysed in order to identify risk factors associated with morbidity and mortality outcomes of this infection.Results  Seventy‐two patients (between the ages of 35 days and 14 years) were identified. Forty‐two per cent of patients had seizures prior to or at the time of admission, 36% were admitted in a comatose state, and 19% with shock. Mortality was 33% (24/72), and 18% of the survivors (11/60) developed severe sequelae. Upon admission, the following variables were strongly correlated with mortality: age <12 months (P = 0.007), the presence of seizures (P = 0.0001) or development of seizures 48 h after admission (P = 0.01), a cerebrospinal fluid (CSF) glucose level of <10 mg/dl (P = 0.01), CSF albumin >200 mg/dl (P = 0.0003), an absolute blood neutrophil count <2000/mm3 (P = 0.006) and a haemoglobin value of <9 g/dl (P = 0.0001).Conclusions  This study confirms the high morbidity and mortality associated with S. pneumoniae meningitis in Paraguay. Certain clinical parameters and laboratory findings in blood and CSF at the time of admission could be used as predictors for mortality or severe sequelae among survivors.
A multi‐country cluster randomized controlled effectiveness evaluation to accelerate the introduction of Vi polysaccharide typhoid vaccine in developing countries in Asia: rationale and design
Authors: Acosta Camilo J. , Galindo Claudia M. , Ali Mohammad , Elyazeed Remon Abu , Leon Ochiai R. , Carolina Danovaro‐Holliday M. , Page Anne‐Laure , Thiem Vu Dinh , Jin Yang , Park Jin Kyung , Lee Hyejon , Puri Mahesh K. , Ivanoff Bernard , Agtini Magdarina D , Soeharno Rooswanti , Simanjuntak Cyrus H. , Punjabi Narain H. , Canh Do Gia , Sur Dipika , Nizami Qamaruddin , Manna Byomkesh , Bai‐qing Dong , Anh Dang Duc , Honghui Yang , Bhattacharya Sujit Kumar , Bhutta Zulfikar , Trach Dang Duc , Xu Zhi‐Yi , Pang Tikki , Donner Allan , Clemens John D. 
Published: August 2010

SummaryPhase‐III vaccine efficacy trials typically employ individually randomized designs intended to ensure that measurements of vaccine protective efficacy reflect only direct vaccine effects. As a result, decisions about introducing newly licensed vaccines into public health programmes often fail to consider the substantially greater protection that may occur when a vaccine is deployed in public health programmes, due to the combination of direct plus indirect vaccine protective effects. Vaccine total protection can be better evaluated with cluster randomized trials. Such a design was considered to generate policy relevant data to accelerate the rationale introduction of the licensed typhoid fever Vi polysaccharide (PS) vaccine in Asia by the Diseases of the Most Impoverished (DOMI) typhoid fever programme. The DOMI's programme multi‐country study is one of the largest cluster randomized vaccine trials ever mounted in Asia, which includes approximately 200 000 individuals. Its main objective is to determine the effectiveness of a licensed Vi PS vaccine. The rationale and design of this study are discussed. Preliminary results are presented that determined the final planning of the trial before immunization. Important methodological and practical issues regarding vaccine cluster randomized designs are illustrated.
Factors associated with functional limitations and subsequent employment or schooling in Buruli ulcer patients
Authors: Stienstra Ymkje , van Roest Margijske H. G. , van Wezel Marieke J. , Wiersma Irene C. , Hospers Ilona C. , Dijkstra Pieter U. , Christian Johnson R. , Ampadu Edwin O. , Gbovi Jules , Zinsou Claude , Etuaful Samuel , Klutse Erasmus Y. , van der Graaf Winette T. A. , van der Werf Tjip S. 
Published: August 2010

SummaryObjectives  To evaluate former Buruli ulcer disease (BUD) patients to assess the factors associated with functional limitations and subsequent employment or schooling.Methods  The previously validated Buruli ulcer functional limitation score (BUFLS) questionnaire and interviews about educational and professional consequences incurred by BUD.Results  Of 638 participants, 362 (57%) had a functional limitation after a median period of almost 4 years after treatment for BUD. A lesion on a joint, older age, female gender, a lesion on a distal part of an extremity and a persistent wound were found to be independent risk factors for stopping work or education. The same risk factors applied to the development of a functional limitation. Both functional limitations and financial difficulties due to BUD disease often led to job loss and school dropout.Conclusions  Rehabilitation programmes are urgently needed to diminish the suffering from the functional limitations and employment or schooling problems caused by BUD.
Rapid diagnostic tests for dengue and leptospirosis: antibody detection is insensitive at presentation
Authors: Cohen Adam L. , Dowell Scott F. , Nisalak Ananda , Mammen Mammen P. , Petkanchanapong Wimol , Fisk Tamara L. 
Published: August 2010

SummaryObjective  To determine the performance of rapid diagnostic tests for dengue and leptospirosis that rely on detecting antibodies that may not be produced when patients present for medical treatment.Methods  We prospectively enrolled 723 patients with undifferentiated febrile illness presenting to rural hospitals in northern and northeastern Thailand over a 1‐year period. We evaluated rapid antibody detection diagnostic tests for dengue and leptospirosis on these patients.Results  Sensitivity of the tests was low at the acute visit (7.6–21.5%). Sensitivity at the convalescent visit ranged from 25.8% to 81.5% and was significantly higher than at the acute visit for all tests (χ2, P < 0.001).Conclusions  Low sensitivity of the rapid tests at presentation suggests that their utility in the acute phase of dengue and leptospirosis is limited.
A model to simulate the impact of timing, coverage and transmission intensity on the effectiveness of indoor residual spraying (IRS) for malaria control
Authors: Worrall E. , Connor S. J. , Thomson M. C. 
Published: August 2010

SummaryObjective  (i) To develop a temperature‐ and rainfall‐driven model of malaria transmission capable of prediction. (ii) To use the model to examine the relationship between the intervention timing and transmission intensity on the effectiveness of indoor residual spraying (IRS).Methods  A dynamic model of malaria transmission was developed from existing models of malaria transmission dynamics. The model was used to retrospectively predict actual malaria cases from Hwange district in Zimbabwe using actual meteorological and IRS timing and coverage data. Simulations of alternative intervention scenarios (timing and coverage) examined the effectiveness of earlier and later interventions, at higher and lower coverage levels in epidemic and non‐epidemic years.Findings  The model was able to predict actual malaria cases in Hwange over a four‐and‐a‐half‐year period with a lead time of 4 months (e.g. January rainfall and temperature predicts April malaria) and a correlation coefficient of 0.825 (r2 = 0.6814). The IRS simulations show that the marginal benefits of increasing IRS coverage are higher in high‐transmission (HT) years relative to lower transmission years. This implies that over a period of years, maximum impact could be achieved with a given quantity of insecticide by increasing coverage in HT years. However, the model also shows that earlier spraying is more effective in all years, especially so in epidemic years, and that IRS has limited impact if it is carried out too late in relation to peak transmission.Conclusion  Temperature‐ and rainfall‐driven models of malaria transmission have the potential to predict malaria epidemics. Early intervention based on prior knowledge of the magnitude of the malaria season can be more effective and efficient than carrying out routine activities every year. Malaria control planners need improved access to the technology that would allow them to better predict malaria epidemics and develop Malaria Early Warning Systems (MEWS). MEWS can then be linked to intervention planning to reduce the devastating impact of malaria epidemics on populations.
Vitamin A deficiency in a Kenyan prison
Authors: Mathenge Wanjiku , Kuper Hannah , Myatt Mark , Foster Allen , Gilbert Clare 
Published: August 2010

SummaryObjective  To estimate the prevalence and causes of vitamin A deficiency disorders (VADD) in adult male prisoners in Nakuru, Kenya.Methods  A total of 1048 male prisoners aged ≥16 years in Nakuru Government of Kenya prison in Nakuru, Kenya were examined by an ophthalmologist for signs of xerophthalmia. Two hundred and forty‐one cases with xerophthalmia and 448 controls randomly selected from the remaining prison population were interviewed about risk factors for xerophthalmia and blood samples were taken to measure serum retinol and haemoglobin.Results  23.6% (95% CI = 21.1–26.3%) of examined inmates showed at least one sign of xerophthalmia, mostly night blindness (98.8% of cases). In the case–control study, the age‐adjusted analyses showed that xerophthalmia was associated with age, length of imprisonment and previous imprisonment. Men with xerophthalmia were significantly more likely be in poor health characterised by significant illness, recent hospital admission, persistent cough, diarrhoea, fever or chronic illness. After multivariate adjustment, duration of imprisonment remained strongly associated with xerophthalmia (OR comparing >4 years with <6 months = 20.1, 95% CI = 8.3–48.8). Previous imprisonment, fever, diarrhoea, hospital admission and chronic illness were also significant predictors. Serum retinol levels were significantly lower in cases than controls, while there was no difference in haemoglobin levels.Conclusion  Vitamin A deficiency was a significant public health problem among these Kenyan male prisoners, indicating that it may be important in vulnerable groups other than young children and pregnant or lactating women.
HIV/AIDS and TB: contextual issues and policy choice in programme relationships
Authors: Wang Yan , Collins Charles , Vergis Mercy , Gerein Nancy , Macq Jean 
Published: August 2010

SummaryTuberculosis (TB) and HIV/AIDS affect each other closely. Given the rapid spread of the HIV‐driven TB epidemic worldwide, the case for establishing some form of relationship between control activities for HIV/AIDS and TB is clear. However, the question ‘how’ has not been resolved satisfactorily. TB and HIV/AIDS programmes have traditionally maintained their own management, supervision, funding flows and specialist boundaries. This article explores opportunities and challenges for collaboration between the two, through drawing on the expertise in organization and management, policy analysis and disease control of both TB and HIV/AIDS. Based on an extensive literature review, the article investigates how contextual issues affect the design of a collaboration; what the organizational options are; and what impact a collaboration would have. A universal model for organizational change is unlikely and changes may present as both solutions and contradictions. Careful planning and consultation are required before implementing the changes, in order to avoid jeopardizing the function and effectiveness of both disease control programmes and the health service system.
A randomized open study to assess the efficacy and tolerability of dihydroartemisinin–piperaquine for the treatment of uncomplicated falciparum malaria in Cambodia
Authors: Janssens B. , Van Herp M. , Goubert L. , Chan S. , Uong S. , Nong S. , Socheat D. , Brockman A. , Ashley E. A. , Van Damme W. 
Published: August 2010

SummaryObjectives  To compare the efficacy and tolerability of dihydroartemisinin–piperaquine (DHA–PQP) with that of a 3‐day regimen of mefloquine and artesunate (MAS3) for the treatment of uncomplicated falciparum malaria in Cambodia.Method  Randomized open‐label non‐inferiority study over 64 days.Results  Four hundred and sixty‐four patients were included in the study. The polymerase chain reaction genotyping‐adjusted cure rates on day 63 were 97.5% (95% confidence interval, CI, 93.8–99.3) for DHA–PQP and 97.5% (95% CI, 93.8–99.3) for MAS3, P = 1. There were no serious adverse events, but significantly more episodes of vomiting (P = 0.03), dizziness (P = 0.002), palpitations (P = 0.04), and sleep disorders (P = 0.03) reported in the MAS3 treatment group, consistent with the side‐effect profile of mefloquine.Conclusions  DHA–PQP was as efficacious as MAS3, but much better tolerated, making it more appropriate for use in a routine programme setting. This highly efficacious, safe and more affordable fixed‐dose combination could become the treatment of choice for Plasmodium falciparum malaria in Cambodia.