bluuebunny/crossref_metadata_2025_split huggingface dataset:
In vitro assessment of artesunate, artemether and amodiaquine susceptibility and molecular analysis of putative resistance‐associated mutations of Plasmodium falciparum from São Tomé and Príncipe
Authors: Ferreira Isabel D. , Lopes Dinora , Martinelli Axel , Ferreira Conceição , Do Rosário Virgílio E. , Cravo Pedro 
Published: August 2010

SummaryObjective  To evaluate the basal in vitro responses of Plasmodium falciparum isolates collected in The Democratic Republic of São Tomé and Príncipe to artemether (ATH), artesunate (ATN) and amodiaquine (AMQ).Methods  The prevalence of given single nucleotide polymorphisms in the pfmdr1, pfcrt, pftctp and pfATPase6 genes was assessed by PCR‐RFLP or DNA sequencing, and gene copy numbers were estimated by real‐time PCR.Results  Mean IC50s to ATH and ATN were relatively low (1.12 nm and 0.58 nm, respectively). However, 10% of parasites displayed AMQ IC50 values above the accepted resistance threshold of 60 nm and there was a positive association between susceptibility to all three drugs (ATH vs. ATN: R = 0.84; ATH vs. AMQ: R = 0.68; ATN vs. AMQ: R = 0.72). Mutations in the pfcrt and pfmdr1 genes were highly prevalent, while only one synonymous polymorphism was detected in the pfATPase6 gene and no mutations were found in pftctp. All isolates harboured a single copy of the genes studied.Conclusions  Artemisinin combination treatment in the São Tomé and Príncipe should be efficacious, although a significant number of AMQ‐resistant parasites were detected and the susceptibility to each drug was positively associated with that of the other two. Mutations in the pfcrt and pfmdr1 genes are near fixation, most likely because of high levels of chloroquine resistance, whereas only one protein type of the artemisinin resistance candidate, PfATPase6, was identified.
Temporal trends and epidemiological aspects of ciguatera in French Polynesia: a 10‐year analysis
Authors: Chateau‐Degat Marie‐Ludivine , Dewailly Eric , Cerf Nicole , Nguyen Ngoc Lam , Huin‐Blondey Marie‐Odile , Hubert Bruno , Laudon François , Chansin René 
Published: August 2010

SummaryObjectives  The purpose of this study was to report the temporal trends of the incidence of ciguatera poisoning from 1992 to 2001 in French Polynesia.Methods  This retrospective study analysed 7842 cases of ciguatera disease recorded over a period of 10 years.Results  The annual incidence varied from 26.3 to 41.9 per 10 000 person‐years. An analysis of cases grouped by archipelago revealed differences in incidences (P < 0.0001) with the most remote archipelagos having the highest incidences. A detailed analysis on a sub‐sample of recorded cases for which clinical information was available (n = 1824) confirmed the neurological and gastrointestinal nature of this seafood poisoning.Conclusion  The incidence of ciguatera poisoning appeared relatively stable during the 10 years of the study period. However, the gradient of remoteness observed suggests an adaptation of management of ciguatera disease to each archipelago.
Thiamin deficiency and uncomplicated falciparum malaria in Laos
Authors: Mayxay Mayfong , Taylor Ann M. , Khanthavong Maniphone , Keola Siamphay , Pongvongsa Tiengkham , Phompida Samlane , Phetsouvanh Rattanaxay , White Nicholas J. , Newton Paul N. 
Published: August 2010

SummaryObjective  Thiamin deficiency complicates severe Plasmodium falciparum malaria in Thailand and may contribute to acidosis. We therefore estimated the frequency of biochemical thiamin deficiency in patients presenting with uncomplicated falciparum malaria in southern Laos.Methods  Red cell transketolase activation coefficients (α) were measured in 310 patients presenting with uncomplicated falciparum malaria and 42 days after starting treatment.Results  Twelve per cent of patients had biochemical evidence of severe deficiency (α values >1.31) at presentation, declining to 3% 42 days later.Conclusion  Thiamin deficiency was common in Lao patients admitted with uncomplicated P. falciparum infection and was reduced following treatment of malaria and multivitamin supplementation. The role of this preventable and treatable disorder in malaria and other acute infections, and the incidence of beriberi in rural Laos, needs further investigation.
The role of communication between clients and health care providers: implications for adherence to malaria treatment in rural Gambia
Authors: Conteh Lesong , Stevens Warren , Wiseman Virginia 
Published: August 2010

SummaryObjectives  One of the major barriers to the successful treatment of malaria is the non‐adherence to drug regimens. Work till now has often been based on the assumption that most patients begin their treatment having received adequate or at least similar instructions and information about both the disease itself and the content and course of their treatment. This paper questions such an assumption. We ask whether people do not adhere to treatment in part because they have not understood the diagnosis and subsequent treatment from the outset.Methods  This study was conducted in the North Bank district of The Gambia, West Africa where a convenience sample of 1337 caretakers with children under 10 years of age were interviewed immediately after their consultation about their recommended treatment.Results  Findings show a mismatch between caretakers and healthcare providers’ (HCP) interpretations of a child's clinic visit, both in terms of the diagnosis and drug regimen. Less than a third of the caretakers’ responses matched the diagnosis that the HCP had written on the child's medical card. Results also showed a delay in the first important antimalarial dose. A common response was ‘I'm not sure what is wrong with the child but I will start the medicine when I get home’.Conclusions  The findings from these exit interviews lend weight to the argument that the value of pre‐packaged blisters could potentially provide far greater benefits than their additional cost, especially when coupled with improved communication by HCP.
Clinical features and associated morbidity of scabies in a rural community in Alagoas, Brazil
Authors: Jackson Anne , Heukelbach Jörg , Filho Arthur Ferreira da Silva , Campelo Júnior Evônio de Barros , Feldmeier Hermann 
Published: August 2010

SummaryObjective  To describe the clinical characteristics of scabies and the associated morbidity in an impoverished rural community in northeast Brazil.Method  A door‐to‐door survey was made to examine twice the population of an endemic area; first at the end of the rainy season, and a second time in the dry season 4 months later.Results  In total, 2005 individuals were examined. The overall prevalence of scabies was 9.8% (95% CI 8.5–11.2). Predilection sites with similar relative frequencies in all age groups were the abdomen (83.7%) and the inguinal area/inner part of the thighs (66.3%). Hands, feet, genitals and the scalp/neck/face were significantly more often affected in children <7 years (all P < 0.03). Fifty‐five per cent of the patients showed scabies lesions simultaneously at ≥12 distinct topographic areas. Papular lesions were most commonly found, followed by papular‐crusted lesions. Vesicles were significantly more often observed in children (P = 0.04). Sixty‐four per cent of the patients had three or more types of lesions. Local lymphadenopathy was present in 53.6% and superinfection in 36.7% of the cases. The number of topographic areas affected, as well as the proportion of superinfected lesions, was inversely correlated with age (rho = −0.22, P = 0.002 and rho = −0.358, P < 0.05, respectively). The quantity of skin surface infested, the proportion of superinfected lesions and the presence of a superinfected lesion distal to an enlarged lymphnode were predictors of lymphadenopathy. Seventy‐two per cent of the patients suffered from sleep disorders, mainly because of itching.Conclusion  Scabies is associated with considerable morbidity in this endemic community. Predilection sites, clinical presentation, quantity of skin surface affected and proportion of secondary infected lesions show a dichotomy between children and adults.
Are mosquitoes diverted from repellent‐using individuals to non‐users? Results of a field study in Bolivia
Authors: Moore S. J. , Davies C. R. , Hill N. , Cameron M. M. 
Published: August 2010

SummaryOutside sub‐Saharan Africa, Anopheline mosquito exophagic and/or crepuscular behaviour patterns imply that insecticide‐treated nets may provide incomplete protection from malaria‐infective mosquito bites. Supplementary repellent treatment has been recommended in such circumstances, especially where vectors are exophilic and so are not susceptible to residual insecticide spraying. As maintaining complete usage of repellents in a community is unrealistic, the potential negative impact on non‐users of repellent usage by ‘neighbours’ in the same community needs to be addressed in the context of health policy promoting equity. This study quantifies diversion of host‐seeking mosquitoes, from repellent wearing to unprotected individuals, 1 m apart under field conditions in Bolivia. Each of the six volunteer‐pairs sat >20 m apart from other pairs. Volunteers were allocated di‐ethyl toluamide (DEET) or mineral oil in ethanol control. Treatments were rotated, so that during the trial, both pair‐members wore repellent on 72 occasions; both pair‐members wore control on 72 occasions; and on 36 occasions, one pair‐member wore repellent and the other control. Unprotected (control) pair‐members received 36.4% [95% confidence interval (CI): 8.1–72.0%] moreAnopheles darlingilandings (P = 0.0096) and 20.4% (95% CI: 0.6–44.0%) more mosquito landings (P = 0.044), when their ‘partner’ wore repellent than when their partner also wore control. A second, smaller Latin‐square trial using 30% lemongrass (Cymbopogon citratus) repellent, with control, obtained 26.0% (95% CI: 5.2–51.0%) more mosquito landings when controls sat with repellent‐wearers rather than other controls (P = 0.0159). With incomplete community repellent usage, non‐users could be put at an increased risk of malaria. The results also have implications for repellent‐efficacy assay design, as protection will appear magnified when mosquitoes are given a choice between repellent‐users and non‐users.
Molecular genotyping in a malaria treatment trial in Uganda – unexpected high rate of new infections within 2 weeks after treatment
Authors: Mugittu Kefas , Priotto Gerardo , Guthmann Jean‐Paul , Kiguli James , Adjuik Martin , Snounou Georges , Beck Hans‐Peter , Mshinda Hassan , Olliaro Piero L. , Taylor Walter R. J. 
Published: August 2010

SummaryPolymerase chain reaction (PCR) genotyping of malaria parasites in drug efficacy trials helps differentiate reinfections from recrudescences. A combination therapy trial of one (n = 115) or three (n = 117) days artesunate (1AS, 3AS 4 mg/kg/day) plus sulphadoxine–pyrimethamine (SP) vs. SP alone (n = 153) was conducted in Mbarara, a mesoendemic area of western Uganda. All paired recurrent Plasmodium falciparum parasitaemias on days 7, 14, 21 and 28 post‐treatment were genotyped by PCR amplification and analysis of glutamate‐rich protein (glurp) and merozoite surface proteins (msp) 1 and 2 genes to distinguish recrudescent from new infections. A total of 156 (1AS = 61, 3AS = 35, SP alone = 60) of 199 paired recurrent samples were successfully analysed and were resolved as 79 recrudescences (1AS = 32, 3AS = 8, SP = 39) and 77 as new infections (1AS = 29, 3AS = 27, SP = 21). The ratios of proportions of new to recrudescent infections were 0.2, 0.9, 1.4 and 1.9 on days 7, 14, 21 and 28, respectively (P < 0.001, χ2 test for linear trend). Unexpected high new infection rates were observed early in follow‐up on days 7 [5/26 (19.2%)] and 14 [24/51 (47.1%)]. These results impact significantly on resistance monitoring and point to the value of genotyping all recurrent infections in antimalarial trials.
Social and environmental determinants of Aedes aegypti infestation in Central Havana: results of a case–control study nested in an integrated dengue surveillance programme in Cuba
Authors: Spiegel Jerry M. , Bonet Mariano , Ibarra Ana‐Maria , Pagliccia Nino , Ouellette Veronic , Yassi Annalee 
Published: August 2010

SummaryObjective  To characterize the social and environmental risk factors associated with the presence of Aedes aegypti in order to improve community dengue control.Methods  A case–control study with ‘cases’ being households with entomologically confirmed A. aegypti infestation; personal interviews in Central Havana, a densely populated inner city area characterized by overcrowded housing and irregular water service. The participants were residents of 278 houses with infestation and 556 houses without infestation.Results  Greater risk of infestation was associated with lack of preventive measures, such as no larvicide in the water tanks (OR = 2.21) and use of flower vases for religious practice (1.93), not being economically active (1.64), vulnerable populations with higher risks in households with older people (1.52) and households with children (1.94).Conclusions  Efforts to reduce infestations should continue to focus on water tank sanitation and improving housing conditions, but also engage community religious leaders to help promote safe practices. Vulnerable populations should be especially targeted by prevention activities. A surveillance programme can produce evidence to guide interventions.
Exposure to mixed asymptomatic infections with Trypanosoma cruzi, Leishmania braziliensis and Leishmania chagasi in the human population of the greater Amazon
Authors: Mendes Daniella G. , Lauria‐Pires Liana , Nitz Nadjar , Lozzi Silene P. , Nascimento Rubens J. , Monteiro Pedro S. , Rebelo Manuel M. , Rosa Ana de Cássia , Santana Jaime M. , Teixeira Antonio R. L. 
Published: August 2010

SummaryLack of conservation of the Amazon tropical rainforest has imposed severe threats to its human population living in newly settled villages, resulting in outbreaks of some infectious diseases. We conducted a seroepidemiological survey of 1100 inhabitants of 15 villages of Paço do Lumiar County, Brazil. Thirty‐five (3%) individuals had been exposed to Trypanosoma cruzi (Tc), 41 (4%) to Leishmania braziliensis (Lb) and 50 (4.5%) to Leishmania chagasi (Lc) infections. Also, 35 cases had antibodies that were cross‐reactive against the heterologous kinetoplastid antigens. Amongst these, the Western blot assays revealed that 11 (1%) had Tc and Lb, that seven (0.6%) had Lc and Tc, and that 17 (1.6%) had Lb and Lc infections. All of these cases of exposures to mixed infections with Leishmania sp, and eight of 11 cases of Tc and Lb were confirmed by specific PCR assays and Southern hybridizations. Two cases had triple infections. We consider these asymptomatic cases showing phenotype and genotype markers consistent with mixed infections by two or more kinetoplastid flagellates a high risk factor for association with Psychodidae and Triatominae vectors blood feeding and transmitting these protozoa infections. This is the first publication showing human exposure to mixed asymptomatic kinetoplastid infections in the Amazon.
Poorer health and nutritional outcomes in orphans and vulnerable young children not explained by greater exposure to extreme poverty in Zimbabwe
Authors: Watts Helen , Gregson Simon , Saito Suzue , Lopman Ben , Beasley Michael , Monasch Roeland 
Published: August 2010

SummaryObjective  To describe patterns of association between different groups of young orphans and vulnerable children (OVC) and their nutritional and health outcomes; and to develop a theoretical framework to analyse the determinants of child malnutrition and ill‐health, and identify the different mechanisms which contribute to these outcomes in such children.Methods  We developed and tested a theoretical framework to explain why orphans and vulnerable children experience more ill‐health and malnutrition based on statistical analysis of data on 31 672 children aged 0–17 years (6753 aged under 5 years) selected from the Zimbabwe OVC Baseline Survey 2004.Results  28% of children aged 0–4 years at last birthday were either orphans or vulnerable children. They were more likely than non‐vulnerable children to have suffered recently from diarrhoeal illness (age‐ and sex–adjusted odds ratio, AOR, 1.27; 95% CI 1.09–1.48) and acute respiratory infection (1.27; 1.01–1.59) and to be stunted (1.24; 1.09–1.41) and underweight (1.18; 1.02–1.36). After further adjustment for exposure to extreme poverty, OVC remained at greater risk of diarrhoeal disease (AOR 1.25; 1.07–1.46) and chronic malnutrition (1.21; 1.07–1.38). In 0–17‐year‐olds, OVC with acute respiratory infection were more likely not to have received any treatment even after adjusting for poverty (AOR 1.29; 95% CI 1.16–1.43).Conclusion  Differences in exposure to extreme poverty among young children by OVC status were relatively small and did not explain the greater malnutrition and ill‐health seen in OVC.
Delayed cord clamping and haemoglobin levels in infancy: a randomised controlled trial in term babies
Authors: Van Rheenen Patrick , De Moor Lette , Eschbach Sanne , De Grooth Hannah , Brabin Bernard 
Published: August 2010

SummaryObjectives  This study was carried out to assess whether delaying umbilical cord clamping is effective in improving the haematological status of term infants living in a malaria‐endemic area, and whether this is associated with complications in infants and mothers.Methods  We randomly assigned women delivering term babies in Mpongwe Mission Hospital, Zambia, to delayed cord clamping (DCC, n = 46) or immediate cord clamping (controls, n = 45) and followed their infants on a bi‐monthly basis until the age of 6 months. We compared the haemoglobin (Hb) change from cord values and the proportion of anaemic infants. Secondary outcomes related to infant and maternal safety.Results  Throughout the observation period infant Hb levels in both groups declined, but more rapidly in controls than in the DCC group [difference in Hb change from baseline at 4 months 1.1 g/dl, 95% confidence interval (CI) 0.2; 2.1]. By 6 months, this difference had disappeared (0.0 g/dl, 95% CI −0.9; 0.8). The odds ratio for iron deficiency anaemia in the DCC group at 4 months was 0.3 (95% CI 0.1; 1.0), but no differences were found between the groups at 6 months. No adverse events were seen in infants and mothers.Conclusion  Our findings indicate that DCC could help improve the haematological status of term infants living in a malaria‐endemic region at 4 months of age. However, the beneficial haematological effect disappeared by 6 months. This simple, free and safe delivery procedure might offer a strategy to reduce early infant anaemia risk, when other interventions are not yet feasible.
Endogenous reactivation and true treatment failure as causes of recurrent tuberculosis in a high incidence setting with a low HIV infection
Authors: Shamputa Isdore Chola , Deun Armand Van , Salim Md Abdul Hamid , Hossain Md Anwar , Fissette Krista , Rijk Pim de , Rigouts Leen , Portaels Françoise 
Published: August 2010

SummaryObjective  To determine the relative frequencies of reinfection vs. reactivation or treatment failure in patients from a high tuberculosis incidence setting with a low prevalence of HIV infection.Method  We performed DNA fingerprinting on serial isolates from one and multiple TB episodes from 97 retreatment patients; 35 patients had been previously cured, whereas 62 had not.Results  DNA fingerprinting patterns of recurrence Mycobacterium tuberculosis isolates of 5 of the 35 previously cured patients did not match with those of the corresponding initial isolates, indicating reinfection. We did not document reinfection during treatment. Isolates from each of the remaining 30 previously cured patients had identical DNA fingerprinting results, indicating reactivation. DNA fingerprinting patterns of isolates from the 62 patients with persistently positive sputum smears were identical, suggesting treatment failure.Conclusion  These findings suggest that reinfection is not a common cause of relapse and treatment failure in this rural predominantly HIV‐free population despite the high incidence of TB.
Risk factors for Schistosoma mansoni and hookworm in urban farming communities in western Côte d'Ivoire
Authors: Matthys Barbara , Tschannen Andres B. , Tian‐Bi Norbert T. , Comoé Hermann , Diabaté Salia , Traoré Mahamadou , Vounatsou Penelope , Raso Giovanna , Gosoniu Laura , Tanner Marcel , Cissé Gueladio , N'Goran Eliézer K. , Utzinger Jürg 
Published: August 2010

SummaryObjectives  To identify risk factors for Schistosoma mansoni and hookworm infections in urban farming communities, and to investigate small‐scale spatial patterns of infection prevalence.Methods  A cross‐sectional survey was carried out in 113 farming households (586 individuals) and 21 non‐farming households (130 individuals) from six agricultural zones in the town of Man, western Côte d'Ivoire. Heads of households were interviewed on common agricultural activities, land and water use, education attainment, socioeconomic status and sanitation facilities. Household members provided stool specimens that were processed by the Kato‐Katz technique and a formol‐ether concentration method and diagnosed for S. mansoni, hookworms and other soil‐transmitted helminths and intestinal protozoa. Bayesian statistics were employed for spatial analyses.Results  The prevalences of S. mansoni and hookworm in farming households were 51.4% and 24.7%, respectively. Risk factors for a S. mansoni infection comprised living in close proximity to the Kô River, water contact with irrigation wells and ponds and low education attainment. Living in zones of smallholder irrigated rice plots or large rice perimeters, using water from domestic wells, and low socioeconomic status were risk factors for a hookworm infection. We found significant spatial heterogeneity between agricultural zones, with the highest infection prevalences of S. mansoni and hookworm in the zone where there was a large rice perimeter.Conclusions  In this urban setting, both S. mansoni and hookworm infections were related to specific agricultural activities. Health education and active participation of urban farmers for the control of schistosomiasis and soil‐transmitted helminthiasis is recommended.
Microgeographical and tribal variations in water contact and Schistosoma mansoni exposure within a Ugandan fishing community
Authors: De Moira Angela Pinot , Fulford Anthony J. C. , Kabatereine Narcis B. , Kazibwe Francis , Ouma John H. , Dunne David W. , Booth Mark 
Published: August 2010

SummaryObjective  To explore patterns of water contact and Schistosoma mansoni exposure by age, sex, tribe and space within a single village.Methods  For 10 months, we systematically observed water contacts made by the 800 inhabitants of a small Ugandan fishing village. In order to estimate cercarial exposure, times spent in water were weighted by snail infection levels, time of day and degree of immersion.Results  There were marked differences in water contact patterns between the two main tribes, which inhabited geographically distinct ends of the village resulting in geographically distinct spatial patterns of water contact. The distributions of the intermediate hosts, Biomphalaria sudanica and Biomphalaria stanleyi, also appeared to differ over small distances. This led to quite different exposure patterns between the two tribes, particularly amongst females.Conclusions  Schistosoma mansoni exposure can vary markedly within a single village. Such non‐homogenous patterns of exposure are likely to have wider implications for schistosomiasis control programmes and research studies.