• Characteristics of human encounters and social mixing patterns relevant to infectious diseases spread by close contact: a survey in Southwest Uganda

      le Polain de Waroux, O; Cohuet, S; Ndazima, D; Kucharski, AJ; Juan-Giner, A; Flasche, S; Tumwesigye, E; Arinaitwe, R; Mwanga-Amumpaire, J; Boum, Y; et al. (BioMed Central, 2018-04-11)
      Quantification of human interactions relevant to infectious disease transmission through social contact is central to predict disease dynamics, yet data from low-resource settings remain scarce.
    • CMV retinitis in China and SE Asia: the way forward

      Heiden, David; Saranchuk, Peter; Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA, USA; Seva Foundation, Berkeley, CA, USA; South African Medical Unit, Operational Centre Brussels, Medicines Sans Frontieres, Cape Town, South Africa (BioMed Central, 2011-11-24)
      AIDS-related CMV retinitis is a common clinical problem in patients with advanced HIV/AIDS in China and Southeast Asia. The disease is causing blindness, and current clinical management, commonly characterized by delayed diagnosis and inadequate treatment, results in poor clinical outcomes: 21% - 36% of eyes with CMV retinitis are already blind at the time the diagnosis is first established by an ophthalmologist. CMV retinitis also identifies a group of patients at extraordinary risk of mortality, and the direct or indirect contribution of extraocular CMV disease to AIDS-related morbidity and mortality is currently unmeasured and clinically often overlooked. The obvious way to improve clinical management of CMV retinitis is to screen all patients with CD4 counts < 100 cells/μL with indirect ophthalmoscopy at the time they first present for care, and to provide systemic treatment with oral valganciclovir when active CMV retinitis is detected. Treatment of opportunistic infections is an integral part of HIV management, and, with appropriate training and support, CMV retinitis screening and treatment can be managed by the HIV clinicians, like all other opportunistic infections. Access to ophthalmologist has been problematic for HIV patients in China, and although non-ophthalmologists can perform screening, sophisticated ophthalmological skills are required for the management of retinal detachment and immune recovery uveitis, the major complications of CMV retinitis. CMV retinitis has been clinically ignored, in part, because of the perceived complexity and expense of treatment, and this obstacle can be removed by making valganciclovir affordable and widely available. Valganciclovir is an essential drug for developing successful programs for management of CMV retinitis in China and throughout SE Asia.
    • Ebola haemorrhagic fever outbreak in Masindi District, Uganda: outbreak description and lessons learned

      Borchert, Matthias; Mutyaba, Imaam; Van Kerkhove, Maria D; Lutwama, Julius; Luwaga, Henry; Bisoborwa, Geoffrey; Turyagaruka, John; Pirard, Patricia; Ndayimirije, Nestor; Roddy, Paul; et al. (BioMed Central, 2011-12-28)
      ABSTRACT:
    • Hepatitis B virus in the Lao People's Democratic Republic: A Cross Sectional Serosurvey in Different Cohorts.

      Black, Antony P; Nouanthong, Phonethipsavanh; Nanthavong, Naphavan; Souvannaso, Chanthasone; Vilivong, Keooudomphone; Jutavijittum, Prapan; Samountry, Bounthome; Lütteke, Nina; Hübschen, Judith M; Goossens, Sylvie; et al. (BioMed Central (Springer Science), 2014-08-23)
      Despite hepatitis B vaccination at birth and at 6, 10 and 14 weeks of age, hepatitis B virus (HBV) infection continues to be endemic in the Lao People's Democratic Republic (PDR). We carried out a cross-sectional serological study in infants, pre-school children, school pupils and pregnant women to determine their burden of disease, risk of infection and vaccination status.
    • Incidence, clinical spectrum, diagnostic features, treatment and predictors of paradoxical reactions during antibiotic treatment of Mycobacterium ulcerans infections

      O Brien, Daniel P; Robson, Mike; Friedman, N Deborah; Walton, Aaron; McDonald, Anthony; Callan, Peter; Hughes, Andrew; Rahdon, Richard; Athan, Eugene (BioMed Central Ltd., 2013-09-05)
      Paradoxical reactions from antibiotic treatment of Mycobacterium ulcerans have recently been recognized. Data is lacking regarding their incidence, clinical and diagnostic features, treatment, outcomes and risk factors in an Australian population.
    • Increased Hepatitis C Virus Co-infection and Injection Drug Use in HIV-infected Fishermen in Myanmar

      Ousley, J; Nesbitt, R; Kyaw, NTT; Bermudez, E; Soe, KP; Anicete, R; Mon, PE; Le Shwe Sin Ei, W; Christofani, S; Fernandez, M; et al. (BioMed Central, 2018-12-14)
      In Southeast Asia, though fishermen are known to be a key population at high risk of HIV, little is known about their co-infection rates with Hepatitis C virus (HCV), or how illness and risk behaviors vary by occupation or type of fishermen. In Myanmar, this lack of knowledge is particularly acute, despite the fact that much of the country's border is coastline.
    • Ocular inflammatory disease and ocular tuberculosis in a cohort of patients co-infected with HIV and multidrug-resistant tuberculosis in Mumbai, India: a cross-sectional study.

      Mehta, Salil; Mansoor, Homa; Khan, Samsuddin; Saranchuk, Peter; Isaakidis, Petros; Médecins Sans Frontières, Mumbai, India. msfocb-asia-epidemio@brussels.msf.org. (2013-05)
      The prevalence and the patterns of ocular inflammatory disease and ocular tuberculosis (TB) are largely undocumented among Multidrug Resistant TB (MDR-TB) patients co-infected with Human Immunodeficiency Virus (HIV) and on antituberculosis and antiretroviral therapy (ART).
    • Prioritising pathogens for the management of severe febrile patients to improve clinical care in low- and middle-income countries

      Osborn, J; Roberts, T; Guillen, E; Bernal, O; Roddy, P; Ongarello, S; Sprecher, A; Page, AL; Ribeiro, I; Piriou, E; et al. (BioMed Central, 2020-02-10)
      BACKGROUND: Severe febrile illness without a known source (SFWS) is a challenge for clinicians when deciding how to manage a patient, particularly given the wide spectrum of potential aetiologies that contribute to fever. These infections are difficult to distinguish clinically, and accurate diagnosis requires a plethora of diagnostics including blood cultures, imaging techniques, molecular or serological tests, and more. When laboratory services are available, a limited test menu hinders clinical decision-making and antimicrobial stewardship, leading to empiric treatment and suboptimal patient outcomes. To specifically address SFWS, this work aimed to identify priority pathogens for a globally applicable panel for fever causing pathogens. METHOD: A pragmatic two-pronged approach combining currently available scientific data in an analytical hierarchy process and systematically gathered expert input, was designed to address the lack of comprehensive global aetiology data. The expert re-ranked list was then further adapted for a specific use case to focus on community acquired infections in whole blood specimens. The resulting list was further analysed to address different geographical regions (Asia, Africa, and Latin America), and Cohen kappa scores of agreement were calculated. RESULTS: The expert ranked prioritized pathogen list generated as part of this two-pronged approach included typhoidal Salmonella, Plasmodium species and Mycobacterium tuberculosis as the top 3 pathogens. This pathogen list was then further adapted for the SFWS use case to develop a final pathogen list to inform product development. Subsequent analysis comparing the relevance of the SFWS pathogen list to multiple populations and geographical regions showed that the SFWS prioritized list had considerable utility across Africa and Asia, but less so for Latin America. In addition, the list showed high levels of agreement across different patient sub-populations, but lower relevance for neonates and symptomatic HIV patients. CONCLUSION: This work highlighted once again the challenges of prioritising in global health, but it also shows that taking a two-pronged approach, combining available prevalence data with expert input, can result in a broadly applicable priority list. This comprehensive utility is particularly important in the context of product development, where a sufficient market size is essential to achieve a sustainable commercialized diagnostic product to address SFWS.
    • Serological evaluation for Chagas disease in migrants from Latin American countries resident in Rome, Italy

      Pane, S; Giancola, ML; Piselli, P; Corpolongo, A; Repetto, E; Bellagamba, R; Cimaglia, C; Carrara, S; Ghirga, P; Oliva, A; et al. (BioMed Central, 2018-05-08)
      Chagas disease (CD) is a systemic parasitic infection caused by the protozoan Trypanosoma cruzi, whose chronic phase may lead to cardiac and intestinal disorders. Endemic in Latin America where it is transmitted mainly by vectors, large-scale migrations to other countries have turned CD into a global health problem because of its alternative transmission routes through blood transfusion, tissue transplantation, or congenital. Aim of this study was to compare the performance of two commercially available tests for serological diagnosis of CD in a group of Latin American migrants living in a non-endemic setting (Rome, Italy). The study was based on a cross-sectional analysis of seroprevalence in this group. Epidemiological risk factors associated to CD were also evaluated in this study population.
    • Seroprevalence and risk factors of recent infection with hepatitis E virus during an acute outbreak in an urban setting in Chad, 2017

      Vernier, L; Lenglet, A; Hogema, BM; Moussa, AM; Ariti, C; Vollmer, S; Irwin, A; Alfani, P; Sang, S; Kamau, C (BioMed Central, 2018-06-26)
      From September 2016-April 2017, Am Timan, Chad, experienced a large HEV outbreak in an urban setting with a limited impact in terms of morbidity and mortality. To better understand HEV epidemiology in this context, we estimated the seroprevalence of anti-HEV antibodies (IgM and IgG) and assessed the risk factors for recent HEV infections (positive anti-HEV IgM) during this outbreak.