bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasmodium falciparum from Pará state (Brazil) shows satisfactory in vitro response to artemisinin derivatives and absence of the S769N mutation in the SERCA‐type PfATPase6
Authors: Ferreira Isabel D. , Martinelli Axel , Rodrigues Louise A. , Do Carmo Ediclei L. , Do Rosário Virgílio E. , Póvoa Marinete M. , Cravo Pedro 
Published: August 2010

SummaryObjective  To evaluate the in vitro efficacy of artesunate (ATN) and artemether (ATH) against Plasmodium falciparum isolates from the Brazilian Amazon state of Pará and to search for mutations and/or altered copy numbers in the putative resistance‐associated pfcrt, pfmdr1 and pfATPase6 genes.Methods  In vitro efficacy of ATN and ATH was successfully measured in 56 freshly collected P. falciparum isolates, using a conventional WHO microtest with minor modifications. Single nucleotide polymorphisms (SNPs) in the same isolates were inspected using DNA sequencing and/or PCR‐RFLP. We used real‐time quantitative PCR to assess gene copy numbers.Results  ATN and ATH geometric mean IC50s were 0.85 nm, 95% CI (0.55–1.15) and 3.0 nm, 95% CI (1.5–4.5), respectively. There was extremely limited diversity of pfcrt and pfmdr1 genotypes and three SNPs were identified in the pfATPase6 gene: one T to A synonymous mutation at nucleotide 2694 and two non‐synonymous (both G to A) mutations at nucleotides 110 and 1916, causing predicted aminoacid shifts of arginine to lysine and of glycine to aspartate, respectively. The previously reported S769N mutation was not detected in any of the isolates inspected. In addition, no gene amplifications were detected in a subset of eight isolates.Conclusion  Artemisinin derivatives display satisfactory in vitro activity locally and the pfATPase6 gene is distinct from that reported in French Guiana, suggesting that those haplotypes have not been introduced regionally.
Effectiveness of malaria control during changing climate conditions in Eritrea, 1998–2003
Authors: Graves Patricia M. , Osgood Daniel E. , Thomson Madeleine C. , Sereke Kiros , Araia Afwerki , Zerom Mehari , Ceccato Pietro , Bell Michael , Corral John del , Ghebreselassie Shashu , Brantly Eugene P , Ghebremeskel Tewolde 
Published: August 2010

SummaryObjective  To assess the effectiveness of impregnated mosquito nets, indoor residual spraying and larval control relative to the impacts of climate variability in the decline of malaria cases in Eritrea.Methods  Monthly data on clinical malaria cases by subzoba (district) in three zobas (zones) of Eritrea for 1998–2003 were used in Poisson regression models to determine whether there is statistical evidence for reduction in cases by DDT, malathion, impregnated nets and larval control used over the period, while analysing the effects of satellite‐derived climate variables in the same geographic areas.Results  Both indoor residual spraying (with DDT or malathion) and impregnated nets were independently and significantly negatively associated with reduction in cases, as was larval control in one zoba. Malaria cases were significantly positively related to differences in current and previous months’ vegetation (NDVI) anomalies. The relationship to rainfall differences 2 and 3 months previously was also significant, but the direction of the effect varied by zoba. Standardized regression coefficients indicated a greater effect of climate in the zoba with less intense malaria transmission.Conclusion  The results support the view that both indoor residual spraying and impregnated nets have been independently effective against malaria, and that larval control was also effective in one area. Thus climate, while significant, is not the only explanation for the recent decline in malaria cases in Eritrea. If appropriate statistical approaches are used, routine surveillance data from cases attending health facilities can be useful for assessing control programme success and providing estimates of the effectiveness of individual control measures. Effectiveness estimates suitable for use in cost‐effectiveness analysis have been obtained.
Future prevalence of WHO grade 2 impairment in relation to incidence trends in leprosy: an exploration
Authors: Meima Abraham , Van Veen Natasja H. J. , Richardus Jan H. 
Published: August 2010

SummaryObjectives  To explore the relationship between leprosy incidence trends and the future prevalence of World Health Organization (WHO) grade 2 impairment caused by leprosy.Methods  Three scenarios were defined to estimate incidences and prevalences of leprosy impairment beyond 2000, assuming 6%, 12% and 18% annual declines in case detection rate respectively, and 6% impairment among new patients. Case detection data from 1985 to 2000 were used for projecting leprosy incidences up to 2020. To estimate future prevalences of WHO grade 2 impairment, the survival of existing and new impaired individuals was calculated.Results  In the 6% scenario, 410 000 new patients will be detected in 2010 and 250 000 in 2020. The number of people living with WHO grade 2 impairment in these years will be 1.3 and 1.1 million, respectively. The 12% scenario predicts that 210 000 new patients will be detected in 2010 and 70 000 in 2020. The grade 2 prevalences will be 1.2 and 0.9 million, respectively. In the 18% scenario, the incidence will be 110 000 in 2010 and 20 000 in 2020, and the grade 2 prevalences will be 1.1 and 0.8 million, respectively.Conclusions  Declines in numbers of people living with grade 2 impairment lag behind trends in leprosy incidence. The prevalence of people with grade 2 decreases much slower than leprosy incidence and case detection in all three scenarios. This implies that a substantial number of people will live with impairment and will need support, training in self‐care and other prevention of disability interventions in the next decades.
Sleeping sickness in West Africa (1906–2006): changes in spatial repartition and lessons from the past
Authors: Courtin F. , Jamonneau V. , Duvallet G. , Garcia A. , Coulibaly B. , Doumenge J. P. , Cuny G. , Solano P. 
Published: August 2010

SummaryObjective  To review the geography and history of sleeping sickness (Human African trypanosomiasis; HAT) over the past 100 years in West Africa, to identify priority areas for sleeping sickness surveillance and areas where HAT no longer seems active.Method  History and geography of HAT were summarized based on a review of old reports and recent publications and on recent results obtained from medical surveys conducted in West Africa up to 2006.Results/conclusions  Active HAT foci seem to have moved from the North to the South. Endemic HAT presently appears to be limited to areas where annual rainfall exceeds 1200 mm, although the reasons for this remain unknown. There has also been a shift towards the south of the isohyets and of the northern distribution limit of tsetse. Currently, the most severely affected countries are Guinea and Ivory Coast, whereas the northern countries seem less affected. However, many parts of West Africa still lack information on HAT and remain to be investigated. Of particular interest are the consequences of the recent political crisis in Ivory Coast and the resulting massive population movements, given the possible consequences on HAT in neighbouring countries.
Setting up a national reference laboratory for Buruli ulcer: the case of Benin
Authors: Affolabi Dissou , Tanimomo‐Kledjo Blanche , Anyo Gladys , Johnson Roch C. , Anagonou Séverin Y. , Portaels Françoise 
Published: August 2010

SummaryObjective  To report the experience of Benin, where Buruli ulcer (BU) is endemic, in the implementation of diagnostic laboratory services.Methods and results  There has been a gradual introduction of biologic diagnostic activities for BU comprising (1) training of a laboratory technician in a highly experienced reference laboratory; (2) acquiring indispensable laboratory start‐up materials; (3) progressive development of diagnostic laboratory activities; (4) regular external quality assessment with an experienced reference laboratory and (5) decentralization of activities to various clinical diagnostic and treatment centres for BU in Benin.Conclusion  Setting up a reference laboratory for BU is a continuous process, which necessitates motivated personnel and the cooperation of an experienced external reference laboratory.
End‐user errors in applying two malaria rapid diagnostic tests in a remote area of Sudan
Authors: Seidahmed Osama M.E. , Mohamedein Muneir M.N. , Elsir Afrah A. , Ali Fayez T. , Malik El Fatih M. , Ahmed Eldirdieri S. 
Published: August 2010

SummaryWe assessed end‐user practice for numerous procedural steps of two types of RDTs: Core Malaria Pf™ (the cassette format) and OptiMAL IT™ (the dipstick format). Two types of errors occurred: generic errors common to both types of test and specific errors caused by the test design and manufacturer’s instructions. End‐user errors were more frequent with OptiMAL IT™ than Core Pf™ tests. To improve malaria diagnosis with rapid tests, users require training and better manufacturer’s instructions that take into account local conditions.
Antibiotic use and health‐seeking behaviour in an underprivileged area of Perú
Authors: Kristiansson C. , Reilly M. , Gotuzzo E. , Rodriguez H. , Bartoloni A. , Thorson A. , Falkenberg T. , Bartalesi F. , Tomson G. , Larsson M. 
Published: August 2010

SummaryObjective  To describe the health‐seeking behaviour and use of antibiotics in the urban community of Yurimaguas in the Amazonian area of Peru.Method  Cross‐sectional survey of caregivers of 798 children aged 6–72 months by interview using a semi‐structured questionnaire. Reported symptoms were classified as illnesses where antibiotics would or would not be recommended based on principles of the integrated management of childhood illnesses algorithm.Results  Forty‐one per cent of consultations were with health care professionals; 71% of antibiotics were obtained through the formal public health sector and prescribed mainly by medical doctors. All prescribed antibiotics were on the Peruvian essential drugs list. When prescribing, doctors and nurses hardly discriminated between illnesses where antibiotic treatment was or was not indicated; there was no significant difference in antibiotic prescribing rates between the two (doctors, P = 0.24; nurses, P = 0.32). Not all caregivers sought help for children with severe symptoms.Conclusion  Although most of the antibiotics were prescribed by doctors and nurses, they were commonly prescribed for illnesses where they were not indicated. The use of antibiotics needs to be rationalized, and barriers to health care must be overcome.
Age patterns in undernutrition and helminth infection in a rural area of Brazil: associations with ascariasis and hookworm
Authors: Jardim‐Botelho Anne , Brooker Simon , Geiger Stefan Michael , Fleming Fiona , Souza Lopes Aline Cristine , Diemert David Joseph , Corrêa‐Oliveira Rodrigo , Bethony Jeffrey Michael 
Published: August 2010

SummaryObjective To investigate the nutritional status of individuals from a rural area of Brazil, and associations with helminth infections in an age‐stratified sample.Method A total of 1113 individuals aged from 6 months to 83 years from the rural community of Americaninhas in Minas Gerais were investigated. Assessments comprised anthropometric measurements of weight, height and body composition, examining faecal samples for helminth eggs, and peripheral blood assays for albumin, haemoglobin and ferritin concentrations.Results Ten percent of the participants were underweight, 12.8% were overweight and 28.3% of the children and adolescents were stunted. 11.6% had low lean body mass and 28.8% had low fat body mass. Hypoalbuminaemia was seen in 5.5%, anaemia in 12.5% and iron deficiency in 13.1%, although the prevalence of these two indices increased with age. Multivariate analysis showed that, after controlling for age, sex and socio‐economic status, stunting was significantly associated withAscaris lumbricoidesinfection among children and adolescents, whereas low body mass was significantly associated with hookworm infection among adults and the elderly.Conclusions Helminth infections are associated with undernutrition in endemic populations, with important differences between the effects of hookworm andA. lumbricoideson age‐related nutritional status.
The use of artemether‐lumefantrine by febrile children following national implementation of a revised drug policy in Kenya
Authors: Gitonga Caroline W. , Amin Abdinasir A. , Ajanga Antony , Kangwana Beth B. , Noor Abdisalan M. , Snow Robert W. 
Published: August 2010

SummaryObjectives  To examine access to, timing and use of artemisinin‐based combination therapy among rural Kenyan febrile children before and following the introduction of artemether‐lumefantrine (AL) as first‐line antimalarial drug policy.Methods  In August 2006, a cohort was established within 72 rural clusters in four sentinel districts to monitor the period prevalence of fever and treatment in children aged 0–4 years through four repeat cross‐sectional surveys (one prior to introduction of AL and three post‐AL introduction: January–June 2007). Mothers/guardians of children were asked about fever in the last 14 days and related treatment actions including the timing, drugs used, dosing and adherence supported by visual aids of commonly available drug products.Results  A total of 2526 child‐observations were recorded during the four survey rounds. The period prevalence of fever was between 20% and 26% with little variation between survey rounds. The overall proportion of children with fever receiving antimalarial drugs for their fever was 31 % (95% CI, 26–36%) and the proportion of febrile children receiving antimalarial drugs within 48 h was 23.3% (95% CI, 18.6–28.0%). The proportion of febrile children who received first‐line recommended AL within 48 h was 10.2% (95% CI, 7.0–13.4%), compared to only 4.6% (95% CI, 3.8–5.4%) of children receiving sulphadoxine‐pyrimethamine first‐line therapy in 2001.Conclusions  Although Kenya was less than a year into the new policy implementation and AL is restricted to the public formal sector, access to antimalarial drugs among children within 48 h and to the first‐line therapy has improved. But it remains well below national and international targets. The continued use of amodiaquine and artemisinin monotherapies constrains effective implementation of artemisinin‐based combination therapy policy in Kenya.
Detection and modelling of case clusters for urban leptospirosis
Authors: Tassinari Wagner S. , Pellegrini Debora C. P. , Sá Claudio B. P. , Reis Renato B. , Ko Albert I. , Carvalho Marilia S. 
Published: August 2010

SummaryObjective  To analyse the epidemiological profile of 488 cases of leptospirosis in Rio de Janeiro, Brazil between 1997 and 2002, using a variety of methods of spatial epidemiology, to establish alert guidelines in general hospitals, which might be a tool to improve diagnosis and treatment of leptospirosis to reduce lethality rates.Methods  Scan statistics identified six space–time clusters, which comprised a range of 2 to 28 cases per cluster. Generalized linear mixed models were used to evaluate risk factors for a cluster case which incorporated individual characteristics and spatial information on environmental and climactic factors in a single model frame.Results  Cluster case events were associated with heavy rainfall (OR 3.71; 95% CI 1.83–7.51). The model did not identify socioeconomic or environmental covariates that significantly influence the risk of developing a cluster rather than non‐cluster case.Conclusion  Clustering of leptospirosis in this urban setting appears to be due to transmission during heavy rainfall.
Typhoid fever in children in Africa
Authors: Mweu Evanson , English Mike 
Published: August 2010

SummaryEstimates for the year 2000 suggested that there were approximately 21.5 million infections and 200,000 deaths from typhoid fever globally each year, making the disease one of the most serious infectious disease threats to public health on a global scale. However, these estimates were based on little data, especially from Africa. Global prominence and high‐profile outbreaks have created the perception in Kenya that typhoid is a common cause of febrile illness. The Widal test is used widely in diagnosis. We have reviewed recent literature, taking the perspective of a healthcare provider, to collate information on the prevalence of typhoid in children particularly, and to explore the role of clinical diagnosis and diagnosis based on a crude, but common, interpretation of the Widal test. Data suggest that typhoid in children in rural Africa is uncommon, perhaps 100 times or 250 times less common than invasive disease because of Haemophilus influenzae or Streptococcus pneumoniae, respectively. Frequent use of the Widal test may result in many hundreds of over‐treatment episodes for every true case treated and may perpetuate the perception that typhoid is common. Countries such as Kenya need better bacterial disease surveillance systems allied to better information for healthcare providers to promote appropriate decision‐making on prevention and treatment strategies.
Desiccated vector mosquitoes used for the surveillance of Japanese encephalitis virus activity in endemic southern India
Authors: Tewari S. C. , Thenmozhi V. , Arunachalam N. , Philip Samuel P. , Tyagi B. K. 
Published: August 2010

SummaryTo monitor Japanese encephalitis virus (JEV) activity in endemic areas of Tamil Nadu, southern India, desiccated vector mosquitoes were screened for JEV antigen using ELISA, from 1996. A total of 133 233 specimens from eight index villages comprising 2816 pools (mainly Culex vishnui subgroup) were tested. Of these, 59 pools (2.1%) were positive for JEV antigen. Control measures were undertaken in positive villages accordingly. The average annual minimum infection rate was 0.8 at the beginning of the study and remained lower for nearly 8 years. A declining trend in JE cases was recorded.
Effectiveness of interventions for the prevention of HIV and other sexually transmitted infections in female sex workers in resource poor setting: a systematic review
Authors: Shahmanesh Maryam , Patel Vikram , Mabey David , Cowan Frances 
Published: August 2010

SummaryObjective  To systematically review the evidence for effectiveness of HIV and sexually transmitted infection (STI) prevention interventions in female sex workers in resource poor settings.Method  Published and unpublished studies were identified through electronic databases (Cochrane database, Medline, Embase, and Web of Science), hand searching and contacting experts. Randomized‐controlled‐trials and quasi‐experimental studies were included if they were conducted in female sex workers from low and middle income settings; if the exposure was described; if the outcome was externally measurable, it was after the discovery of HIV, and if follow‐up was longer than 6 months. A priori criteria were used to extract data. Meta‐analysis was not performed due to the heterogeneity of studies.Results  Twenty‐eight interventions were included. Despite methodological limitations, the evidence suggested that combining sexual risk reduction, condom promotion and improved access to STI treatment reduces HIV and STI acquisition in sex workers receiving the intervention. Strong evidence that regular STI screening or periodic treatment of STIs confers additional protection against HIV was lacking. It appears that structural interventions, policy change or empowerment of sex workers, reduce the prevalence of STIs and HIV.Conclusion  Rigorous evaluation of HIV/STI prevention interventions in sex workers is challenging. There is some evidence for the efficacy of multi‐component interventions, and/or structural interventions. The effect of these interventions on the wider population has rarely been evaluated.
Timing of default from tuberculosis treatment: a systematic review
Authors: Kruk Margaret E. , Schwalbe Nina R. , Aguiar Christine A. 
Published: August 2010

SummaryObjectives  To provide a systematic assessment of the timing of default from tuberculosis (TB) treatment which could help to quantify the potential contribution of new shorter duration TB drugs to global TB control.Methods  We performed a systematic review following QUOROM guidelines. MEDLINE was searched from 1998 to the present using the terms TB and default or drop‐out or compliance or adherence and therapy. A total of 840 articles were returned. A further detailed manual review selected 15 randomized trials and observational studies that reported timing of drop‐out and focused on developing countries.Results  The selected studies comprised randomized controlled trials, retrospective record reviews, and qualitative assessments and spanned 10 countries. Both directly observed treatment (DOT) and non‐DOT programs were represented. Thus results were highly heterogeneous and not statistically aggregated. Data suggest, but do not conclude, that the majority of defaulters across the studies completed the 2‐month intensive phase of treatment.Conclusions  There is insufficient high‐quality comparable information on the timing of default from TB treatment to permit any firm conclusions on trends in default. However, a substantial proportion of defaulters appear to leave treatment in the later stages of the current 6‐month regimen, suggesting that new TB chemotherapeutic agents which can reduce the length of treatment have the potential to improve global TB treatment success rates.
Age and gender effects in self‐reported urinary schistosomiasis in Tanzania
Authors: Clements Archie C. A. , Barnett Adrian G. , Nyandindi Ursuline , Lwambo Nicholas J. S. , Kihamia Charles M. , Blair Lynsey 
Published: August 2010

SummaryObjectives  To characterize age–gender prevalence profiles of urinary schistosomiasis according to the questionnaire responses, compare the profiles to field survey data from selected regions, and determine if the profiles varied spatially throughout Tanzania.Methods  In 2004, a national school‐based questionnaire survey for self‐reported schistosomiasis and blood in urine (BIU) was conducted in all regions of mainland Tanzania, to assist targeted mass distribution of praziquantel. Field survey data were collected in six north‐western and five coastal regions using microscopic examination of urine samples for the presence of Schistosoma haematobium eggs and assessment of micro‐haematuria with chemical reagent strips. Bayesian logistic regression models were created to calculate age–gender profiles adjusted for demographic and ecological covariates and spatial correlation in the questionnaire data. Separate odds ratios (OR) for age–gender effects were calculated in each administrative area.Results  Data were obtained from > 2.5 million schoolchildren. Boys had higher prevalence of self‐reported schistosomiasis and BIU than girls. In boys, prevalence according to the questionnaire and field surveys followed similar age profiles. However, in girls, prevalence according to the field surveys increased in older age groups, but flattened out or decreased according to the questionnaire, indicating the latter underestimated prevalence in older girls. In the models, little spatial correlation was evident in the OR for the age–gender effects, suggesting that these did not vary spatially.Conclusion  Age–gender patterns of urinary schistosomiasis were consistent in different geographical areas of Tanzania. Because the questionnaire underestimated prevalence in older girls, we propose that upward calibration of observed prevalence is done for older females only.