bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular markers as indicators of antimalarial drug failure rates
Authors: Hastings Ian M. 
Published: August 2010

SummarySeveral mutations have been identified in Plasmodium falciparum that cause, or contribute to, drug resistance. It is relatively easy to measure their prevalence in human blood samples, so they are often used to infer drug failure rates, clinical and parasitological, that will occur in the human population. One current method of making this inference is through the use of genotypic resistance and genotypic failure indices. These indices are rather sensitive to background drug failures rates (i.e. failures not caused by the mutation), to mutation prevalence, and to the genetic background in which the marker occurs. Extreme care should therefore be taken in the construction and interpretation of these indices.
Epidemiology of congenital malaria in Nigeria: a multi‐centre study
Authors: Falade Catherine , Mokuolu Olugbenga , Okafor Henrietta , Orogade Adeola , Falade Adegoke , Adedoyin Olanrewaju , Oguonu Tagbo , Aisha Maman , Hamer Davidson H. , Callahan Michael V. 
Published: August 2010

SummaryObjective  To determine the burden of congenital malaria in newborns in Nigeria.Methods  In a prospective multi‐centre study, 1875 consecutive mother–baby pairs were enrolled over a continuous 12‐month period. Blood smears were prepared from mothers, neonates, placental aspirates and cord blood within 4 h of delivery. Outcome variables were patent parasitaemia in the mother, placenta, cord and neonate in addition to maternal and neonatal haematocrit.Results  Patent parasitaemia was detected in 95 neonates (5.1%). The occurrence varied between study centres, but was found year round in all sites. The mean parasite density among infected neonates was low (48 asexual forms per μl, range 8–200/μl). Maternal and placental parasitaemia were the most important risk factors for patent neonatal parasitaemia (P < 0.0001). Spontaneous clearance of parasitaemia occurred in 62.1% of neonates before day 2. 33.7% were symptomatic within 3 days of birth.Conclusion  Congenital malaria is often asymptomatic, clears spontaneously and may not warrant treatment. However, newborns with unexplained fever and refusal to feed in malaria endemic areas should be tested for malaria.
Effect of low‐cost irrigation methods on microbial contamination of lettuce irrigated with untreated wastewater
Authors: Keraita Bernard , Konradsen Flemming , Drechsel Pay , Abaidoo Robert C. 
Published: August 2010

SummaryObjective  To assess the effectiveness of simple irrigation methods such as drip irrigation kits, furrow irrigation and use of watering cans in reducing contamination of lettuce irrigated with polluted water in urban farming in Ghana.Methods  Trials on drip kits, furrow irrigation and watering cans were conducted with urban vegetable farmers. Trials were arranged in a completely randomised block design with each plot having all three irrigation methods tested. This was conducted in both dry and wet seasons. Three hundred and ninety‐six lettuce, 72 soil, 15 poultry manure and 32 water samples were analysed for thermotolerant coliforms and helminth eggs.Results  Lettuce irrigated with drip kits had the lowest levels of contamination, with, on average, 4 log units per 100 g, fewer thermotolerant coliforms than that irrigated with watering cans. However, drip kits often got clogged, required lower crop densities and restricted other routine farm activities. Watering cans were the most popular method. Using watering cans with caps on outlets from a height <0.5 m reduced thermotolerant coliforms by 2.5 log units and helminthes by 2.3 eggs per 100 g of lettuce compared with using watering cans without caps from a height >1 m.Conclusion  Simple, cheap and easily adoptable irrigation methods have great potential to reduce crop contamination in low‐income areas. When used in combination with other on‐farm and post‐harvest risk reduction measures, these will help to comprehensively reduce public health risks from using polluted water in vegetable farming.
Occurrence and species distribution of fishborne zoonotic trematodes in wastewater‐fed aquaculture in northern Vietnam
Authors: Hop Nguyen Thi , De Nguyen Van , Murrell Darwin , Dalsgaard Anders 
Published: August 2010

SummaryObjectives  To assess the risk of fishborne zoonotic trematode (FZT) infection in fish reared in wastewater‐fed ponds in peri‐urban areas of northern Vietnam.Methods  We collected 1200 fish from aquaculture systems receiving wastewater from the cities of Hanoi and Nam Dinh in northern Vietnam and examined them for zoonotic metacercariae. Collection periods were fall (October–November 2005) and spring (April–June 2006). The fish were digested in pepsin and metacecariae, recovered and identified by light microscopy. Data were expressed as both prevalence and intensity of infection.Results  FZT metacercariae were recovered from fish samples at both sites and during both sampling periods. The overall prevalence of FZT was 5% (2.0% in fall and 6.5% in spring) in fish from Hanoi and 4.6% (2.4% in fall and 5.7% in spring) in fish from Nam Dinh. The higher prevalence in the warmer months was likely due to ecological factors such as temperatures and population dynamics of the snail vectors. All metacercariae recovered were zoonotic intestinal trematodes of the family Heterophyidae. The infected fish included tilapia (Oreochromis niloticus) and three species of carps, including silver carp (Hypophthalmichthys molitrix), which is commonly used for the preparation of raw fish dishes. Intensities of infection were relatively low.Conclusion  Fish raised in peri‐urban wastewater‐fed aquaculture systems are at risk of infection with trematode parasites, which can be transmitted to humans through consumption of raw or improperly prepared fish. However, the prevalence was low as compared to previous findings of FZT in non‐wastewater fish elsewhere in Vietnam. Studies are needed to assess the relative importance of different risk factors for transmission and control of FZT in wastewater‐fed aquaculture.
Hepatosplenomegaly in Kenyan schoolchildren: exacerbation by concurrent chronic exposure to malaria and Schistosoma mansoni infection
Authors: Wilson Shona , Vennervald Birgitte J. , Kadzo Hilda , Ireri Edmund , Amaganga Clifford , Booth Mark , Kariuki H. Curtis , Mwatha Joseph K. , Kimani Gachuhi , Ouma John H. , Muchiri Eric , Dunne David W. 
Published: August 2010

SummaryObjectives  Chronic exposure to malaria exacerbates Schistosoma mansoni‐associated hepatosplenomegaly in school‐aged children. However, residual hepatosplenomegaly after treatment of S. mansoni with concurrent mollusciciding suggests malaria could be an underlying cause of hepatosplenomegaly. We investigated the role of chronic malaria in childhood hepatosplenomegaly in the presence and absence of concurrent S. mansoni infection.Methods  Cross‐sectional study of children in an study area where transmission of S. mansoni, but not malaria, is restricted to the eastern end. Clinical and ultrasound examinations were conducted, and parasitological and serological tests used to determine S. mansoni infection intensities and comparative exposure levels to malaria.Results  Chronic exposure to malaria, as determined by Pfs‐IgG3 levels, was associated with hepatosplenomegaly even in the absence of S. mansoni infection. Children infected with S. mansoni mostly had light to moderate infection intensities but greater enlargement of the liver and spleen than children who did not have schistosomiasis, and for the left liver lobe this was S. mansoni infection intensity dependent.Conclusions  Children chronically exposed to malaria but without S. mansoni infection can have hepatosplenomegaly, which even light S. mansoni infections can exacerbate in an intensity‐dependent manner. Thus, concurrent chronic exposure to S. mansoni and Plasmodium falciparum can have an additive or synergistic effect on childhood morbidity.
Short communication: CD4 counts of HIV‐infected pregnant women and their infected children – implications for PMTCT and treatment programmes
Authors: Lebon Ankie , Bland Ruth M , Rollins Nigel C , Coutsoudis Anna , Coovadia Hoosen , Newell Marie‐Louise 
Published: August 2010

SummaryA considerable proportion of pregnant women and their infected children are likely to be eligible for anti‐retroviral treatment. The antenatal–postnatal divide needs to be bridged with respect to the follow‐up of both HIV‐infected women and their exposed infants.
Determinants of HIV counselling and testing participation in a Prevention of Mother‐to‐Child Transmission programme in rural Burkina Faso
Authors: Sarker M. , Sanou A. , Snow R. , Ganame J. , Gondos A. 
Published: August 2010

SummaryObjectives  To analyse the factors associated with the uptake of HIV counselling, HIV testing and returning for test results in a rural hospital setting in Nouna, Burkina Faso.Methods  Cross sectional survey of 435 pregnant women who visited the district hospital for antenatal care, from July to December 2004. Separate multivariate logistic regression analyses including analysis of reported reasons were performed to identify the factors associated with accepting HIV counselling and testing.Results  HIV testing participation was related to discussing HIV screening with the partner (OR 8.36), and the number of antenatal care (ANC) visits already accomplished (OR 2.23). The quality of pre‐test counselling was very poor as 42% did not understand the process. The absence of doctors and mismanagement of time for post‐test counselling were the main reasons why women did not receive test results. Analysis of participants by discussion status, counselling and test participation revealed that fewer women dropped out at every stage who discussed HIV testing with their partner.Conclusion  Communication with the partner plays a vital role in the uptake of HIV testing. Encouraging women to engage in a discussion about testing with their partners may be a viable intervention to improve participation. Quality of service needs to be better.
Infant mortality among twins and triplets in rural Bangladesh in 1975–2002
Authors: Alam Nurul , Van Ginneken Jeroen K. , Bosch Alinda M. 
Published: August 2010

SummaryTo examine trends in incidence of multiple births (MB) and their survival in infancy, we used population‐based, longitudinal data derived from the Health and Demographic Surveillance System in Matlab, Bangladesh, from 1975 to 2002. Logistic regression was applied to determine the impact of a number of variables on mortality among MB in the first year of life. MB averaged 2% of all live births, but contributed 10% to all infant deaths. Infant mortality among MB was more than five times higher than among singletons. Mortality among MB declined by 27% in 1975–2002, considerably less than the 51% mortality decline among singletons in the same period. Infant mortality among twins and triplets was particularly high among children who were born to young mothers (<20 years), who were the first live birth, who were born after a short birth interval (<24 months) and whose mothers were unschooled. Mortality of MB was lower in the area with easy access to high‐quality maternal and child‐care services. Thus, good maternity and newborn care will improve the survival of MB.
Tuberculous meningitis: does lowering the treatment threshold result in many more treated patients?
Authors: Moreira Juan , Alarcon Fernando , Bisoffi Zeno , Rivera José , Salinas Robert , Menten Joris , Dueñas Gonzalo , Van den Ende Jef 
Published: August 2010

SummaryObjective  To determine how many more patients would be treated when lowering the treatment threshold for tuberculous meningitis.Methods  From 1989 to 2004 findings of patients with symptoms lasting more than 1 week and inflammatory changes of cerebrospinal fluid (CSF) were collected. Several models of latent class analysis were tested. Cumulative numbers of cases were plotted against different cut‐offs for post‐test probability.Results  In a cohort of 232 patients the prevalence of tuberculous meningitis (TBM) was estimated at 79.8% (95% CI. 67,0–88,1); probabilities above 80% were reached in 73% of patients. Lowering this threshold from 80% to 20% would add 14% more patients to be treated, for a total of 87%. A further lowering of the threshold to 5% would imply 5% more patients to be treated, bringing the cumulative number to 92%. The difference of lowering the threshold from 80% to 5% was 19%.Conclusion  In this setting, at least 75% of patients showing suggestive symptoms for more than a week and CSF changes very probably had TBM. The number of patients that should be treated does not increase linearly when lowering the threshold.
Plasmodium vivax resistance to chloroquine in Dawei, southern Myanmar
Authors: Guthmann Jean‐Paul , Pittet Anne , Lesage Alexandre , Imwong Mallika , Lindegardh Niklas , Min Lwin Myo , Zaw Than , Annerberg Anna , De Radiguès Xavier , Nosten François 
Published: August 2010

SummaryObjective  To assess the efficacy of chloroquine in the treatment of Plasmodium vivax malaria in in Dawei District, southern Myanmar.Methods  Enrolled patients at Sonsinphya clinic >6 months of age were assessed clinically and parasitologically every week for 28 days. To differentiate new infections from recrudescence, we genotyped pre‐ and post‐treatment parasitaemia. Blood chloroquine was measured to confirm resistant strains.Results  Between December 2002 and April 2003, 2661 patients were screened, of whom 252 were included and 235 analysed. Thirty‐four per cent (95% CI: 28.1–40.6) of patients had recurrent parasitaemia and were considered treatment failures. 59.4% of these recurrences were with a different parasite strain. Two (0.8%) patients with recurrences on day 14 had chloroquine concentrations above the threshold of 100 ng/ml and were considered infected with chloroquine resistant parasites. 21% of failures occurred during the first 3 weeks of follow‐up: early recurrence and median levels of blood chloroquine comparable to those of controls suggested P. vivax resistance.Conclusions  Plasmodium vivax resistance to chloroquine seems to be emerging in Dawei, near the Thai‐Burmese border. While chloroquine remains the first‐line drug for P. vivax infections in this area of Myanmar, regular monitoring is needed to detect further development of parasite resistance.
Household burden of malaria in South Africa and Mozambique: is there a catastrophic impact?
Authors: Castillo‐Riquelme Marianela , McIntyre Diane , Barnes Karen 
Published: August 2010

SummaryObjectives  To evaluate treatment‐seeking behaviour, financial impact and time lost due to malaria events, in southern Mozambique and eastern South Africa.Methods  In‐depth household surveys (828 in Mozambique and 827 in South Africa) were analysed. An asset index was calculated using principal component analysis to allow comparison across socio‐economic groups. Direct costs of seeking care and the time lost due to malaria were determined. The extent of catastrophic payments was assessed using as thresholds the traditional 10% of household income and 40% of non‐food income, as recently recommended by WHO.Results  Poverty was highly prevalent: 70% of the South African and 95% of Mozambican households studied lived on less than $1 per capita per day. Around 97% of those with recent malaria sought healthcare, mainly in public facilities. Out‐of‐pocket household expenditure per malaria episode averaged $2.30 in South Africa and $6.50 in Mozambique. Analysis at the individual household level found that 32–34% of households in Mozambique, compared with 9–13% of households in South Africa, incurred catastrophic payments for malaria episodes. Results based on mean values underestimated the prevalence of catastrophic payments. Days off work/school were higher in Mozambique.Conclusions  The high rate of health seeking in public health facilities seems unusual in the African context, which bodes well for high coverage with artemisinin‐based combinations, even if only deployed within the public sector. However, despite no or modest charges for public sector primary healthcare, households frequently incur catastrophic expenditure on a single malaria episode.
Beyond symptom recognition: care‐seeking for ill newborns in rural Ghana
Authors: Bazzano Alessandra N. , Kirkwood Betty R. , Tawiah‐Agyemang Charlotte , Owusu‐Agyei Seth , Adongo Philip Baba 
Published: August 2010

SummaryObjectives  To assess newborn care‐seeking practices in a rural area of Ghana where most births take place at home in order to inform potential strategies for reducing newborn mortality.Methods  Qualitative, ethnographic study with quantitative data from a birth cohort collected as part of the surveillance system of an ongoing randomized controlled trial. Data collected comprised 84 h of participant observation (including following an ill newborn through a hospital visit), 14 in‐depth interviews with key informants (older mothers and grandmothers), 45 semistructured interviews with mothers, 28 case histories from women who had recently given birth and 32 expert interviews with local health providers. Thirteen focus groups were held with men and women, and narrative histories of newborn deaths were taken from eight women. Birth cohort data came from 2878 singletons born alive in the study district within the year July 2003–June 2004.Results  Significant delays in care seeking for ill newborns occur in Kintampo District, Ghana. 2.1% of 2878 newborns in the birth cohort had a serious illness during the first 4 weeks of life, but care was only sought outside the home for 61% of those and from a doctor or hospital for 39%. Barriers to prompt allopathic care seeking include sequential care‐seeking practices, with often exclusive use of traditional medicine as first‐line treatment for 7 days, previous negative experiences with health service facilities, financial constraints and remoteness from health facilities.Conclusions  Improvements in care seeking are urgently needed. Families should be urged to seek medical care for any symptom of illness in a newborn; financial and socio‐cultural barriers to care seeking for newborns must be addressed in order to improve neonatal survival.
The impact of HIV infection on adult mortality in some communities in Zambia: a cohort study
Authors: Dzekedzeke Kumbutso , Siziya Seter , Fylkesnes Knut 
Published: August 2010

SummaryObjective  To examine the contribution of human immunodeficiency virus (HIV) to adult death rates between 1995/1996 and 1998/1999 in some urban and rural populations in Zambia.Method  A cohort of 2592 out of 3013 adults aged 15–49 years enrolled in a baseline survey in 1995/1996 in areas of Chelston Township (HIV prevalence 26.2%) and Kapiri Mposhi district (HIV prevalence 15.6%) were followed up in 1998/1999. Person years of observation (PYO) were calculated for those known to have been alive, dead and migrated between the surveys. Fixed covariates Cox proportional hazard models were fitted to assess survival prospects.Results  Death rates per 1000 PYO in the rural cohort were 38.1 among those with HIV, 4.8 among those without HIV and 9.8 for all; the population attributable fraction of deaths among those with HIV was 52.3%. Respective estimates in the urban cohort were 53.8, 4.6, 17.2 and 73.6%. The hazard rate (HR) ratio of death for persons infected with HIV was 8.7 times [HR 8.65; 95% confidence interval (CI) 5.28–14.15] higher than for the uninfected after adjusting for age, area of residence, marital status, self‐rated health and years spent on education. HR among those who rated their health good/excellent was 40% less, i.e. HR 0.60 (95% CI: 0.40–0.91) than those who rated it to be poor/fair.Conclusions  HIV infection was the most important factor accounting for adult deaths in the communities.
Antenatal clinic HIV data found to underestimate actual prevalence declines: evidence from Zambia
Authors: Michelo Charles , Sandøy Ingvild , Fylkesnes Knut 
Published: August 2010

SummaryObjective  To determine to what extent antenatal clinic (ANC)‐based estimates reflect HIV prevalence trends among men and women in a high prevalence urban population.Methods  Examination of data from serial population‐based HIV surveys in 1995 (n = 2115), 1999 (n = 1962) and 2003 (n = 2692), and ANC‐based surveillance in 1994 (n = 450), 1998 (n = 810) and 2002 (n = 786) in the same site in Lusaka, Zambia. The population‐based surveys recorded refusal rates between 6% and 10% during the three rounds.Results  Among ANC attendees, prevalence declined by 20% (25.0% to 19.9%; P = 0.101) in the age group 15–24 years and was stable overall. In the general population, the prevalence declined by 49% (P < 0.001) and by 32% (P < 0.001) in age group 15–24 and 15–49, respectively. Among women only, HIV prevalence declined by 44% (22.5% to 12.5%; P < 0.001) and by 27% (29.6% to 21.7%; P < 0.001) in age group 15–24 and 15–49 years, respectively. In addition, prevalence substantially declined in higher educated women aged 15–24 years (20.7% to 8.5%, P < 0.001).Conclusion  ANC‐based estimates substantially underestimated declines in HIV prevalence in the general population. This seemed to be partially explained by a combination of marked differentials in prevalence change by educational attainment and changes in fertility‐related behaviours among young women. These results have important implications for the interpretation of ANC‐based HIV estimates and underscore the importance of population‐based surveys.
Effects of grinding surgical tissue specimens and smear staining methods on Buruli ulcer microscopic diagnosis
Authors: Affolabi Dissou , Bankolé Honoré , Ablordey Anthony , Hounnouga Julie , Koutchakpo Pierre , Sopoh Ghislain , Aguiar Julia , Dossou Ange , Johnson Roch Christian , Anagonou Séverin , Portaels Françoise 
Published: August 2010

SummaryTo optimize Buruli ulcer (BU) microscopic diagnosis, we compared two smear preparation methods from tissue specimens: smears made with tissue suspension after grinding and smears made directly with unground tissue. We also compared two smear staining methods: auramine and Ziehl–Neelsen (ZN). IS 2404‐PCR was used as reference method. One hundred and thirty‐one surgical tissue specimens from patients suspected of having BU were analyzed. Both smear preparation methods and both staining methods were equivalent in any combination. Thus we recommend ZN stained smears of unground tissue for peripheral treatment centres.