bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of malaria on mortality in a cohort of HIV‐infected Ugandan adults
Authors: Quigley Maria A. , Hewitt Kirsten , Mayanja Billy , Morgan Dilys , Eotu Henry , Ojwiya Amato , Whitworth James A. G. 
Published: August 2005

SummaryObjectives  To investigate the effects of malaria parasitaemia and clinical malaria on mortality in HIV seropositive and seronegative adults.Methods  A cohort of adults in rural Uganda were followed from 1990 to 1998. Participants attended routine clinic visits every 3 months and also when sick (interim visits). Information was collected on HIV serostatus, history of fever, current fever and malaria parasite levels. Malaria was categorized as any parasitaemia, significant parasitaemia (≥1.25 × 106 parasites/ml at routine or ≥50 parasites per 200 white blood cells at interim visits) or clinical malaria. The effect of malaria on all‐cause mortality was assessed using Cox models.Results  The 222 HIV seropositive participants made 2762 routine visits and 1522 interim visits. During follow‐up, of the 211 participants with full records, 69% had at least one episode of parasitaemia, 51% experienced significant parasitaemia and 28% had clinical malaria. There were 90 deaths in 922 person‐years of observation. There were no significant associations between numbers of visits with any parasitaemia, significant parasitaemia or clinical malaria on mortality rates. The highest mortality rates were observed in those making four or more routine visits with significant parasitaemia [adjusted mortality rate ratio (RR) 3.27 compared with those making 0 such visits; P = 0.078] and those making two or more visits with clinical malaria (adjusted RR 2.23; P = 0.093). There was no significant interaction between any malaria category and HIV serostatus.Conclusion  We found no evidence of a strong detrimental effect of malaria on all‐cause mortality in HIV seropositive adults in this setting.
Towards empirical description of malaria seasonality in southern Africa: the example of Zimbabwe
Authors: Mabaso M. L. H. , Craig M. , Vounatsou P. , Smith T. 
Published: August 2005

SummaryBackground  Quantitative description and mapping of malaria seasonality is important for timely spatial targeting of interventions and for modelling malaria risk. There is a need for seasonality models that predict quantitative variation in transmission between months.Methods  We use Zimbabwe as an example for developing an empirical map of malaria seasonality. We describe the relationship between seasonality in malaria and environmental covariates for the period 1988–1999, by fitting a spatial‐temporal regression model within a Bayesian framework to provide smoothed maps of the seasonal trend. We adapt a seasonality concentration index used previously for rainfall to quantify malaria case load during the peak transmission season based on monthly values.Results  Combinations of mean monthly temperature (range 28–32 °C), maximum temperature (24–28 °C) and high rainfall provide suitable conditions for seasonal transmission. High monthly maximum and mean monthly minimum temperatures limit months of high transmission. The intensity of seasonal transmission was highest in the north western part of the country from February to May with the peak in April and lowest in the whole country from July to December. The north western lowlands had the highest concentration of malaria cases (>25%) followed by some districts in the north central and eastern part with a moderate concentration of cases (20–25%). The central highlands and south eastern part of the country had the lowest concentration of malaria cases (<20%). This pattern was closely associated to the geographic variation in the seasonality of climatic covariates particularly rainfall and temperature.Conclusions  Our modelling approach quantifies the geographical variation in seasonal trend and the concentration of cases during the peak transmission season and therefore has potential application in malaria control. The use of a covariate adjusted empirical model may prove useful for predicting the seasonal risk pattern across southern Africa.
The effect of micronutrient supplementation on treatment outcome in patients with pulmonary tuberculosis: a randomized controlled trial in Mwanza, Tanzania
Authors: Range Nyagosya , Andersen Åse B. , Magnussen Pascal , Mugomela Apolinary , Friis Henrik 
Published: August 2005

SummaryObjective  The aim of the study was to assess the effects of micronutrient supplementation on culture conversion in tuberculosis (TB) patients.Design  The study was a randomized, double‐blind placebo‐controlled 2 × 2 trial of zinc and multi‐micronutrient (MMN) supplementation in pulmonary TB patients in Tanzania.Results  A total of 499 pulmonary TB patients were included in the trial after being confirmed sputum‐positive by microscopy or culture. At 8 weeks, 25% were sputum‐smear positive but only 11% were culture‐positive (P < 0.0001). No significant differences were observed in culture conversion rate among those allocated to MMN or placebo (89.5 vs. 86.2%, P = 0.29) at 8 weeks, although at week 4 those allocated to MMN had a slightly reduced culture conversion rate (42.8 vs. 52.8%, P = 0.058). Zinc had no effects on culture conversion. MMN increased weight gain by 0.78 kg [95% confidence interval (CI): 0.12–1.43] at week 8, while zinc supplementation had no effect. The effects of MMN and zinc did not interact and neither MMN nor zinc interacted with human immunodeficiency virus status, sex and culture‐intensity at baseline.Conclusion  Neither zinc nor MMN supplementation had significant effects on culture conversion, but MMN supplementation increased weight gain in TB patients.
Distribution de l'infection à Mycobacterium ulcerans (Ulcère de Buruli) dans la commune de Lalo au Bénin
Authors: Johnson R. C. , Sopoh G. E. , Boko M. , Zinsou C. , Gbovi J. , Makoutode M. , Portaels F. 
Published: August 2005

RésuméLa présente étude, a pour principal objectif d’étudier la distribution de l‘Ulcère de Buruli dans la commune de Lalo, dans le département du Couffo au Bénin. Le recensement des cas d'Ulcère de Buruli hameau par hameau, a permis d'identifier 752 cas dont 160 patients porteurs de lésions évolutives et 592 formes inactives. Ainsi, la prévalence générale (toutes formes confondues) dans la commune de Lalo est de 86.6 pour 10.000 habitants. Cette prévalence peut varier de 0 à 249 cas pour 10.000 habitants d'un arrondissement à un autre de la commune. De même, à l’échelle village, la prèvalence peut varier de 0 à 561 cas pour 10.000 habitants confirmant ainsi le caractère très focalisé dans la distribution de l'Ulcère de Buruli. Les caractéristiques cliniques des formes évolutives recensées, objectivent à l'instar des données de la littérature, une prédominance des cas chez les enfants de moins de 15 ans. Notre étude permet aussi d'objectiver une association entre l’âge et la localisation des lésions. Des études épidémiologiques ultérieures ainsi que des études de l'environnement sont nécessaires en vue d’étudier d‘une part les facteurs de risques qui font que deux villages proches peuvent avoir des niveaux d'endémicité aussi différents, et d'autre part si ces variations géographiques s'accompagnent d'une variation temporelle d'une saison à une autre et d'une année à une autre.
Transmissibility of Trypanosoma brucei during its development in cattle
Authors: Van den Bossche P. , Ky‐Zerbo A. , Brandt J. , Marcotty T. , Geerts S. , De Deken R. 
Published: August 2005

SummaryRecent outbreaks of Trypanosoma brucei rhodesiense sleeping sickness in Soroti District of eastern Uganda have demonstrated the important role cattle can play as reservoirs of this parasite. To clarify the epidemiological importance of the cattle reservoir, experiments were conducted to determine the ease with which T. brucei is transmitted during the course of its development in Friesian cattle. The development of T. brucei in cattle is characterized by an acute phase with high levels of parasitaemia and a decline in PCV. The acute phase is followed by a chronic phase during which the PCV remains low but stable and the parasitaemia is low. Parasites are often difficult to detect using parasitological diagnostic tools during this chronic phase. Challenge of chronically infected cattle with T. congolense results in a sudden increase in the T. brucei parasitaemia. Despite significant differences in parasitaemia, the proportion of tsetse flies that developed metacyclic infections after a first bloodmeal on the infected cattle did not differ significantly between the acute and chronic phases or the phase of mixed T. b. brucei/T. congolense infection. This suggests that, throughout the observation period, the parasitaemia was above the threshold above which infection rates of tsetse are independent of the parasitaemia. The repercussions of the research findings for the understanding of the epidemiology, spread and the control of T. b. rhodesiense sleeping sickness are discussed.
Susceptibility of Grammomys surdaster thicket rats to Trypanosoma brucei gambiense infection
Authors: Büscher Philippe , Shamamba Stomy Kahremere Bin , Ngoyi Dieudonne Mumba , Pyana Pati , Baelmans Rudy , Magnus Eddy , Overmeir Chantal Van 
Published: August 2005

SummaryHuman African Trypanosomiasis is caused by Trypanosoma brucei gambiense and T. b. rhodesiense. Historically, a treatment relapse rate of about 5% is observed in patients treated with melarsoprol, an arsenical derivative used for treatment of both gambiense and rhodesiense second stage sleeping sickness. More recently, relapse rates up to 30% are noted in gambiense sleeping sickness foci in Angola, Sudan and Uganda. Therefore, WHO established a Network on Treatment Failure and Drug Resistance in Sleeping Sickness. One of its objectives is to improve isolation of T. b. gambiense from relapsing cases for research on drug resistance mechanisms. Trypanosoma b. gambiense isolation techniques suffer from low success rates and long periods needed to adapt the parasite to its new host. Usually, rodents are inoculated with patient's blood or cerebrospinal fluid and sub‐passaged until the strain becomes sufficiently adapted to yield high parasitaemia within few days after inoculation. Until now, the best recipient for T. b. gambiense is Mastomys natalensis, with a success rate of about 50%. In this study, Grammomys surdaster (former Thamnomys surdaster) was investigated as a potential recipient for isolation of T. b. gambiense. Comparative experimental infections of Swiss mice, Wistar rats and G. surdaster thicket rats with T. b. gambiense clearly show that this trypanosome grows faster in G. surdaster. Inoculation of the same rodent species with patient's blood and cerebrospinal fluid in Kinshasa (R.D. Congo) confirms the observation that the thicket rats are more susceptible to T. b. gambiense infection than typical laboratory rodents.
Antenatal syphilis screening in sub‐Saharan Africa: lessons learned from Tanzania
Authors: Watson‐Jones Deborah , Oliff Monique , Terris‐Prestholt Fern , Changalucha John , Gumodoka Balthazar , Mayaud Philippe , Semakafu Ave Maria , Kumaranayake Lilani , Gavyole Awene , Mabey David , Hayes Richard 
Published: August 2005

SummaryObjectives  To synthesise data from four recent studies in Tanzania examining maternal syphilis screening and its operational implementation in routine antenatal clinics (ANC), drawing lessons for strengthened antenatal services for the prevention of mother‐to‐child transmission (PMTCT) of HIV.Methods  The impact of untreated maternal syphilis was examined in a retrospective cohort of 380 Tanzanian women. Effectiveness and cost‐effectiveness of screening and single dose benzathine penicillin treatment were prospectively examined in 1688 pregnant women. Observation, interviews and facility audits were carried out in health facilities within nine districts to determine the operational reality of syphilis screening.Results  Overall, 49% of women with untreated high titre syphilis experienced an adverse pregnancy outcome compared with 11% of uninfected women. Stillbirth and low birthweight rates among those treated for high‐ or low‐titre syphilis were reduced to rates similar to those for uninfected women. The economic cost was $1.44 per woman screened and $10.56 per disability‐adjusted life year saved. In the operational study, only 43% of 2256 ANC attenders observed were screened and only 61% of seroreactive women and 37% of their partners were treated. Adequate training, continuity of supplies, supervision and quality control are critical elements for strengthened antenatal services, but are frequently overlooked.Conclusions  Maternal syphilis has a severe impact on pregnancy outcome. Same‐day screening and treatment strategies are clinically effective and highly cost‐effective, but there are significant challenges to implementing syphilis screening programmes in sub‐Saharan Africa. Current PMTCT interventions present an opportunity to reinforce and improve syphilis screening. Increasing PMTCT coverage will involve similar operational challenges to those faced by syphilis screening programmes.
Epidemiological assessment of mucocutaneous infections in patients with recurrent infection syndrome
Authors: Orrego Julio C. , Montoya Carlos J. , Gómez Rubén D. , Franco José L. , Patiño Pablo J. , Vargas María E. , García de O Diana , Wolff Juan C. 
Published: August 2005

AbstractBackground  Recurrent infection syndrome (RIS) results from repeated interactions between hosts and environmental infectious agents and is considered normal (NRIS) because of its benign evolution and positive effects in the development of normal immune responses. Abnormal RIS (ARIS) is characterized by the unusually high frequency of severe infections, either as a result of anatomical or functional abnormalities or due to primary or secondary immunodeficiencies (PIDs and SIDs, respectively). Recurrent mucocutaneous infections (MCIs) can be manifestations of RIS or ARIS and could be more frequent in primary immunodeficiencies. Similarly, etiologic agents might vary from what is observed in the general population.Methods  We carried out a descriptive study to determine the prevalence of aerobic bacterial and fungal mucocutaneous infections in 452 patients with recurrent infections, using clinical records to establish immunological status associated with the presence and characteristics of the infections. Microbiological analyses from mucocutaneous lesions were used to confirm the etiology.Results  We found mucocutaneous infections in 50 patients for a total of 62 episodes (bacterial or fungal infections in 38 vs. 12 patients, respectively). Mucocutaneous infections were more frequent (21.8% vs. 9.1%; OR = 2.8) and recurrent (8.7% vs. 0.2%; P= 0.000) in primary immunodeficient patients. Furthermore, those with defects in phagocytic cells presented more mucocutaneous infections (56.2%) than patients with other primary immunodeficiencies (11.3%; OR = 10.1).Conclusions  Bacterial and fungal mucocutaneous infections are more frequent and severe in primary immunodeficient patients, particularly those with defective phagocytosis. Early and adequate assessment of the nature of mucocutaneous infections in ARIS should impact the ability of physicians to treat promptly, avoid complications and reduce the costs of medical assistance.
Narrow‐band UVB311 nm vs. broad‐band UVB therapy in combination with topical calcipotriol vs. placebo in vitiligo
Authors: Hartmann Anke , Lurz Christa , Hamm Henning , Bröcker Eva‐B. , Hofmann Uta B. 
Published: August 2005

AbstractBackground  Recently, it has been shown that UVB phototherapy may be more effective than UVA in the treatment of vitiligo. Currently, however, no studies have compared the efficacy of UVB311 nm and broad‐band UVB therapy. Calcipotriol has recently been reported to be effective adjunctive treatment for vitiligo, enhancing the efficacy of 8‐methoxypsoralen plus UVA (PUVA) therapy.Methods  Ten patients were enrolled in the study; nine completed the 12 months of therapy. The upper part of the body was treated twice weekly with UVB311 nm and the lower part with broad‐band UVB. Calcipotriol was applied onto the vitiligo lesions of the right side of the body and placebo on the left side. Repigmentation was documented by photography, planimetry, and Vitiligo Disease Activity (VIDA) score. The quality of life was measured by the Dermatology Life Quality Index (DLQI).Results  After 7–16 weeks, six of the nine patients showed initial repigmentation on the side treated with UVB311 nm. After 6 months of treatment, none of the patients showed repigmentation on the areas treated with broad‐band UVB, which prompted us to apply UVB311 nm all over the body. At the end of 12 months, two patients showed > 75% repigmentation, two showed 51–75%, two showed 26–50%, and three showed 0–25%. In all patients with progressive vitiligo (seven of the nine patients), disease activity was stopped. Remarkably, vitiligo lesions treated with calcipotriol initially showed delayed repigmentation compared with control areas; however, there was no therapeutic difference between calcipotriol and placebo, both in combination with UVB311 nm, by the end of the study. The DLQI score improved significantly by an average of 28%.Conclusion  UVB311 nm therapy was effective in the treatment of vitiligo, whereas broad‐band UVB had no effect. Combination with calcipotriol ointment was not superior to UVB311 nm monotherapy. The quality of life significantly improved with narrow‐band UVB311 nm phototherapy.
The relationship between lichen planus and hepatitis C in dermatology outpatients in Kerman, Iran
Authors: Rahnama Zahra , Esfandiarpour Iraj , Farajzadeh Saideh 
Published: August 2005

AbstractBackground  Lichen planus (LP) is classified as a papulosquamous disease. It has been associated with liver disease, particularly hepatitis C virus (HCV) infection, in several studies. Most of these reports, especially the larger series, were conducted in Europe and Japan.Objective  We conducted a case–control study in Kerman, Iran to explore the association between LP and HCV.Methods  The study included 66 patients with LP (as cases; mean age = 39.7 ± 15.8 years; 31 female, 35 male) and 140 volunteer blood donors (as controls; mean age = 29.5 ± 8.4 years; 43 females, 97 males). An enzyme‐linked immunosorbent assay (ELISA) was used to determine the presence of anti‐HCV antibodies in all subjects in both groups. To confirm positive diagnoses, a second generation recombinant immunoblot assay (RIBA II) test was performed.Results  Lichen planus lesions were most frequently located on the trunk and extremities, and the most common clinical type was generalized LP (48.5%). One of the patients with LP (1.5%) and three of the controls (2.1%) were HCV‐Ab positive. No significant difference was observed in HCV‐Ab positive between the two groups (OR = 0.7; 95% CI = 0.1–6.9).Conclusion  The findings indicate that an investigation for HCV infection should not necessarily be performed in all patients with LP. It is recommended that further studies should focus on larger groups in other regions of Iran to determine whether testing for HCV infection is necessary in patients with LP.
Classic Kaposi's sarcoma in Sardinia: HLA positive and negative associations
Authors: Masala Maria Vittoria , Carcassi Carlo , Cottoni Francesca , Mulargia Marina , Contu Licinio , Cerimele Decio 
Published: August 2005

AbstractBackground  The incidence of classic Kaposi's sarcoma (CKS) in northern Sardinia is one of the highest in the world.Methods  Sixty‐two patients with CKS were typed for class I and class II antigens. All patients had been born and were living in northern Sardinia.Results  In the Sardinian patients, we observed a positive CKS association with Cw7, DRB1*1104, DRB1*1302, DQA1*0302, and DQB1*0604, and a negative CKS association with A30, B58, Cw5, DRB1*1601, and DQB1*0502.Conclusions  The strong positive CKS association with DRB1*1104 and DQB1*0604 and negative association with B58 are particularly significant and further support the notion of a genetic predisposition to CKS.
Finger pebbles in a diabetic patient: Huntley's papules
Authors: Guarneri Claudio , Guarneri Fabrizio , Borgia Francesco , Vaccaro Mario 
Published: August 2005

A 60‐year‐old obese man was referred to our department from the internal medicine unit. He had a 20‐year history of poorly controlled diabetes (no other cases in the family), and was admitted to hospital because of respiratory and consequent heart failure.Skin examination showed diffuse xerosis and a rough, sandpaper‐like appearance of the skin of the finger, of approximately 15 years’ duration, consisting of multiple, minute, hyperkeratotic papules grouped in a miniature “cobblestone” pattern on the dorsum of the distal phalanges (Fig. 1), more dense over the knuckles and the interphalangeal joints. No pruritus was present.Pebbly pattern of the skin on the dorsum of the second digitimageHe was a pensioner, who had been physically inactive for months previously, and this condition had occurred progressively in the absence of any known trauma. No other cutaneous manifestations were evident.Histologic examination was performed using hematoxylin and eosin staining of a biopsy specimen taken from the left second finger; it displayed a hyperorthokeratotic epidermis with enlarged dermal papillae, thickened and vertically oriented collagen bundles, few elastic fibers, and a mild perivascular inflammatory infiltrate (Fig. 2).Histologic view of a biopsy specimen of the skin of the finger: the epidermis is hyperkeratotic, the dermal papillae are enlarged and there are thickened vertical collagen bundles, elastic fibers, and a mild perivascular inflammatory infiltrate (hematoxylin and eosin stain; original magnification, ×100)image
Treatment of cutaneous leishmaniasis with cryosurgery
Authors: Panagiotopoulos Antonios , Stavropoulos Panagiotis G. , Hasapi Vassiliki , Papakonstantinou Anastasia‐Metaxia , Petridis Athanassios , Katsambas Andreas 
Published: August 2005

AbstractBackground  The management of cutaneous leishmaniasis with topical methods, if effective, can spare patients from long and costly inpatient treatments.Methods  Seventeen patients with cutaneous leishmaniasis were treated with cryosurgery using liquid nitrogen as the cryogen. Two cycles of 10–30 s freezing time were used and repeated at 3‐week intervals.Results  All patients responded well to therapy with excellent cosmetic results and no relapse in any case. Side‐effects were rare.Conclusions  Cutaneous leishmaniasis can be successfully treated with a simple protocol of cryosurgery with minor side‐effects.