• Asymptomatic Plasmodium Infections in Children in Low Malaria Transmission Setting, Southwestern Uganda

      Roh, M E; Oyet, C; Orikiriza, P; Wade, M; Kiwanuka, G N; Mwanga-Amumpaire, J; Parikh, S; Boum, Y (Center for Disease Control, 2016-08-01)
      A survey of asymptomatic children in Uganda showed Plasmodium malariae and P. falciparum parasites in 45% and 55% of microscopy-positive samples, respectively. Although 36% of microscopy-positive samples were negative by rapid diagnostic test, 75% showed P. malariae or P. ovale parasites by PCR, indicating that routine diagnostic testing misses many non–P. falciparum malarial infections.
    • Case-Fatality Rates and Sequelae Resulting from Neisseria Meningitidis Serogroup C Epidemic, Niger, 2015

      Coldiron, ME; Salou, H; Sidikou, F; Goumbi, K; Djibo, A; Lechevalier, P; Compaoré, I; Grais, RFF (Center for Disease Control, 2016-10-01)
      We describe clinical symptoms, case-fatality rates, and prevalence of sequelae during an outbreak of Neisseria meningitidis serogroup C infection in a rural district of Niger. During home visits, we established that household contacts of reported case-patients were at higher risk for developing meningitis than the general population.
    • Case-Fatality Rates and Sequelae Resulting from Neisseria Meningitidis Serogroup C Epidemic, Niger, 2015

      Coldiron, ME; Salou, H; Sidikou, F; Goumbi, K; Djibo, A; Lechevalier, P; Compaore, I; Grais, RFF (Center for Disease Control, 2016-10-01)
      We describe clinical symptoms, case-fatality rates, and prevalence of sequelae during an outbreak of Neisseria meningitidis serogroup C infection in a rural district of Niger. During home visits, we established that household contacts of reported case-patients were at higher risk for developing meningitis than the general population.
    • Cholera Epidemic in South Sudan and Uganda and Need for International Collaboration in Cholera Control

      Abubakar, A; Bwire, G; Azman, AS; Bouhenia, M; Deng, LL; Wamala, JF; Rumunu, J; Kagirita, A; Rauzier, J; Grout, L; et al. (Center for Disease Control, 2018-05-01)
    • Continuing effectiveness of serogroup a meningococcal conjugate vaccine, Chad, 2013

      Gamougam, K; Daugla, D M; Toralta, J; Ngadoua, C; Fermon, F; Page, A-L; Djingarey, M H; Caugant, D A; Manigart, O; Trotter, C L; et al. (Center for Disease Control, 2015-01-01)
      In 2011, vaccination with a serogroup A meningococcal polysaccharide conjugate vaccine was implemented in 3 of 23 regions in Chad. Cases of meningitis declined dramatically in vaccinated areas, but an epidemic continued in the rest of Chad. In 2012, the remaining Chad population was vaccinated, and the epidemic was halted.
    • Ebola Virus Disease, Democratic Republic of the Congo, 2014

      Nanclares, C; Kapetshi, J; Lionetto, F; de la Rosa, O; Tamfun, JJ; Alia, M; Kobinger, G; Bernasconi, A (Center for Disease Control, 2016-09)
      During July-November 2014, the Democratic Republic of the Congo underwent its seventh Ebola virus disease (EVD) outbreak. The etiologic agent was Zaire Ebola virus; 66 cases were reported (overall case-fatality rate 74.2%). Through a retrospective observational study of confirmed EVD in 25 patients admitted to either of 2 Ebola treatment centers, we described clinical features and investigated correlates associated with death. Clinical features were mainly generic. At admission, 76% of patients had >1 gastrointestinal symptom and 28% >1 hemorrhagic symptom. The case-fatality rate in this group was 48% and was higher for female patients (67%). Cox regression analysis correlated death with initial low cycle threshold, indicating high viral load. Cycle threshold was a robust predictor of death, as were fever, hiccups, diarrhea, dyspnea, dehydration, disorientation, hematemesis, bloody feces during hospitalization, and anorexia in recent medical history. Differences from other outbreaks could suggest guidance for optimizing clinical management and disease control.
    • Factors Related to Fetal Death in Pregnant Women with Cholera, Haiti, 2011-2014

      Schillberg, E; Ariti, C; Bryson, L; Delva-Senat, R; Price, D; GrandPierre, R; Lenglet, A (Center for Disease Control, 2016-01-01)
      We assessed risk factors for fetal death during cholera infection and effect of treatment changes on these deaths. Third trimester gestation, younger maternal age, severe dehydration, and vomiting were risk factors. Changes in treatment had limited effects on fetal death, highlighting the need for prevention and evidence-based treatment.
    • High prevalence of multidrug-resistant tuberculosis, Swaziland, 2009-2010

      Sanchez-Padilla, E; Dlamini, T; Ascorra, A; Rüsch-Gerdes, S; Tefera, Z D; Calain, P; de la Tour, R; Jochims, F; Richter, E; Bonnet, M; et al. (Center for Disease Control, 2012-01)
      In Africa, although emergence of multidrug-resistant (MDR) tuberculosis (TB) represents a serious threat in countries severely affected by the HIV epidemic, most countries lack drug-resistant TB data. This finding was particularly true in the Kingdom of Swaziland, which has the world's highest HIV and TB prevalences. Therefore, we conducted a national survey in 2009-2010 to measure prevalence of drug-resistant TB. Of 988 patients screened, 420 new case-patients and 420 previously treated case-patients met the study criteria. Among culture-positive patients, 15.3% new case-patients and 49.5% previously treated case-patients harbored drug-resistant strains. MDR TB prevalence was 7.7% and 33.8% among new case-patients and previously treated case-patients, respectively. HIV infection and past TB treatment were independently associated with MDR TB. The findings assert the need for wide-scale intervention in resource-limited contexts such as Swaziland, where diagnostic and treatment facilities and health personnel are lacking.
    • Population-Level Effect of Cholera Vaccine on Displaced Populations, South Sudan, 2014

      Azman, AS; Rumunu, J; Abubakar, A; West, H; Ciglenecki, I; Helderman, T; Wamala, JF; Vázquez, OR; Perea, W; Sack, DA; et al. (Center for Disease Control, 2016-06-01)
      Following mass population displacements in South Sudan, preventive cholera vaccination campaigns were conducted in displaced persons camps before a 2014 cholera outbreak. We compare cholera transmission in vaccinated and unvaccinated areas and show vaccination likely halted transmission within vaccinated areas, illustrating the potential for oral cholera vaccine to stop cholera transmission in vulnerable populations.
    • Prognostic Indicators for Ebola Patient Survival

      Crowe, SJ; Maenner, MJ; Kuah, S; Erickson, BR; Coffee, M; Knust, B; Klena, J; Foday, J; Hertz, D; Hermans, V; et al. (Center for Disease Control, 2016-02-01)
      To determine whether 2 readily available indicators predicted survival among patients with Ebola virus disease in Sierra Leone, we evaluated information for 216 of the 227 patients in Bo District during a 4-month period. The indicators were time from symptom onset to healthcare facility admission and quantitative real-time reverse transcription PCR cycle threshold (Ct), a surrogate for viral load, in first Ebola virus-positive blood sample tested. Of these patients, 151 were alive when detected and had reported healthcare facility admission dates and Ct values available. Time from symptom onset to healthcare facility admission was not associated with survival, but viral load in the first Ebola virus-positive blood sample was inversely associated with survival: 52 (87%) of 60 patients with a Ct of >24 survived and 20 (22%) of 91 with a Ct of <24 survived. Ct values may be useful for clinicians making treatment decisions or managing patient or family expectations.