“Author Archive”
Stories written by Tropical Med and Intl Health
By Tropical Med and Intl Health
Objective Until 2010, no Japanese encephalitis (JE) had been reported from Delhi. Upon report of four confirmed cases of JE in September 2011, detailed investigations were carried out to determine whether the cases were imported or indigenous. Methods Entomological surveys were carried out and all mosquito pools were tested for the detection of JE virus by ELISA method using specific monoclonal antibody. Human blood samples from contacts of the patients were tested by IgM-captured ELISA method. Pig’s blood samples were also tested for the detection of JE virus.
May 20th, 2013 | Posted in Journal Watch | Read More »
By Tropical Med and Intl Health
A meningococcal serogroup A polysaccharide/tetanus toxoid conjugate vaccine (PsA-TT) (MenAfriVac™) is being deployed in countries of the African meningitis belt. Experience with other polysaccharide/protein conjugate vaccines has shown that an important part of their success has been their ability to prevent the acquisition of pharyngeal carriage and hence to stop transmission and induce herd immunity. If PsA-TT is to achieve the goal of preventing epidemics, it must be able to prevent the acquisition of pharyngeal carriage as well as invasive meningococcal disease and whether PsA-TT can prevent pharyngeal carriage needs to be determined. To address this issue, a consortium (the African Meningococcal Carriage (MenAfriCar) consortium) was established in 2009 to investigate the pattern of meningococcal carriage in countries of the African meningitis belt prior to and after the introduction of PsA-TT. This article describes how the consortium was established, its objectives and the standardised field and laboratory methods that were used to achieve these objectives
May 18th, 2013 | Posted in Journal Watch | Read More »
By Tropical Med and Intl Health
Objectives In 2006, Mdecins sans Frontires (MSF) established an emergency obstetric and neonatal care (EmONC) referral facility linked to an ambulance referral system for the transfer of women with obstetric complications from peripheral maternity units in Kabezi district, rural Burundi. This study aimed to (i) describe the communication and ambulance service together with the cost; (ii) examine the association between referral times and maternal and early neonatal deaths; and (iii) assess the impact of the referral service on coverage of complicated obstetric cases and caesarean sections. Methods Data were collected for the period January to December 2011, using ambulance log books, patient registers and logistics records. Results In 2011, there were 1478 ambulance call-outs.
May 18th, 2013 | Posted in Journal Watch | Read More »
By Tropical Med and Intl Health
Objectives To determine whether medical staff at PHC level would have the time to take up additional activities such as 1-day fever camps for active VL case detection. Methods This article assessed the workload of health staff of different professional categories working at health facilities in Bangladesh, India and Nepal. Data were collected from different sites in high endemic VL areas. The study population was the health staff of government health facilities at all levels. Workload indicators of staffing need (WISN) software were adopted to carry out the analysis of staff workload and their availability in the selected health facility.
May 8th, 2013 | Posted in Journal Watch | Read More »
By Tropical Med and Intl Health
Objective To assess progress in improving use of medicines in developing and transitional countries by reviewing empirical evidence, 1990–2009, concerning patterns of primary care medicine use and intervention effects. Methods We extracted data on medicines use, study setting, methodology and interventions from published and unpublished studies on primary care medicine use. We calculated the medians of six medicines use indicators by study year, country income level, geographic region, facility ownership and prescriber type. To estimate intervention impacts, we calculated greatest positive (GES) and median effect sizes (MES) from studies meeting accepted design criteria. Results Our review comprises 900 studies conducted in 104 countries, reporting data on 1033 study groups from public (62%), and private (mostly for profit) facilities (26%), and households
May 7th, 2013 | Posted in Journal Watch | Read More »
By Tropical Med and Intl Health
Objective Strong evidence suggests diabetes may be associated with tuberculosis (TB) and could influence TB treatment outcomes. We assessed the role of diabetes on sputum culture conversion and mortality among patients undergoing TB treatment. Methods A total of 1250 Tanzanian TB patients were followed prospectively during TB treatment with sputum culture after 2 and 5 months. Survival status was assessed at least 1 year after initiation of treatment.
May 6th, 2013 | Posted in Journal Watch | Read More »
By Tropical Med and Intl Health
Objective To characterise the epidemiology of Plasmodium falciparum gametocytemia and determine the prevalence, age structure and the viability of a predictive model for detection. Methods We collected data from 21 therapeutic efficacy trials conducted in India during 2009–2010 and estimated the contribution of each age group to the reservoir of transmission. We built a predictive model for gametocytemia and calculated the diagnostic utility of different score cut-offs from our risk score. Results Gametocytemia was present in 18% (248/1 335) of patients and decreased with age.
April 30th, 2013 | Posted in Journal Watch | Read More »
By Tropical Med and Intl Health
Objective To identify the Anopheles culicifacies sibling species complex and study their vectorial role in malaria endemic regions of Odisha. Methods Mosquitoes were collected from 6 malaria endemic districts using standard entomological collection methods. An. culicifacies sibling species were identified by multiplex polymerase chain reaction (PCR) using cytochrome oxidase subunit II (COII) region of mitochondrial DNA. Plasmodium falciparum (Pf) sporozoite rate and human blood fed percentage (HBF) were estimated by PCR using Pf- and human-specific primers. Sequencing and phylogenetic analysis were performed to confirm the type of sibling species of An. culicifacies found in Odisha.
April 27th, 2013 | Posted in Journal Watch | Read More »
By Tropical Med and Intl Health
Amplification of the pfmdr1 gene is associated with clinical failures and reduced in vivo and in vitro sensitivity to both mefloquine and artemether–lumefantrine in South-East Asia. Several African countries have reported the absence or very low prevalence of increased copy number, whilst South American reports are limited to Peru without and Venezuela with increased pfmdr1 multiplication. The relative pfmdr1 copy numbers were assessed in 68 isolates from Suriname collected from different endemic villages (2005) and from mining areas (2009). 11% of the isolates harbour multiple copies of the pfmdr1 gene.
April 27th, 2013 | Posted in Journal Watch | Read More »
By Tropical Med and Intl Health
Objectives To identify the meteorological drivers of dengue vector density and determine high- and low-risk transmission zones for dengue prevention and control in Cairns, Australia. Methods Weekly adult female Ae. aegypti data were obtained from 79 double sticky ovitraps (SOs) located in Cairns for the period September 2007–May 2012. Maximum temperature, total rainfall and average relative humidity data were obtained from the Australian Bureau of Meteorology for the study period. Time series–distributed lag nonlinear models were used to assess the relationship between meteorological variables and vector density. Spatial autocorrelation was assessed via semivariography, and ordinary kriging was undertaken to predict vector density in Cairns.
April 26th, 2013 | Posted in Journal Watch | Read More »
By Tropical Med and Intl Health
Objective To evaluate a large, ongoing effort to improve urban primary health care (PHC) in Bangladesh through expansion of publicly funded urban health facilities and contracting with partner non-governmental organisations (NGOs). Methods A part of Chittagong was assigned to a contracted NGO while the other parts of the city were contracted to the local government. Performance was assessed by baseline and follow-on household surveys, an endline health facility survey and routinely collected data. Results The results of a health facility survey indicated that overall quality of care was better in the NGO area, and routinely collected data showed that the NGO provided many more services per capita. Based on household survey data, the NGO area of Chittagong was poorer and had lower coverage at baseline
April 24th, 2013 | Posted in Journal Watch | Read More »
By Tropical Med and Intl Health
Objective We aimed to improve paediatric inpatient surveillance at a busy referral hospital in Malawi with two new programmes: (i) the provision of vital sign equipment and implementation of an inpatient triage programme (ITAT) that includes a simplified paediatric severity-of-illness score, and (ii) task shifting ITAT to a new cadre of healthcare workers called vital sign assistants’ (VSAs). Methods This study, conducted on the paediatric inpatient ward of a large referral hospital in Malawi, was divided into three phases, each lasting 4 weeks. In Phase A, we collected baseline data. In Phase B, we provided three new automated vital sign poles and implemented ITAT with current hospital staff. In Phase C, VSAs were introduced and performed ITAT
April 22nd, 2013 | Posted in Journal Watch | Read More »
By Tropical Med and Intl Health
Objective To estimate the prevalence of antibodies against Coxiella burnetii (Q fever) among children in eight villages in The Gambia, West Africa. Methods Sera of 796 children aged 1–15 years were tested for presence of antibodies against phase II of C. burnetii by ELISA. Results IgG and/or IgM phase II antibodies against C. burnetii were detectable in 8.3% (66/796) of all serum samples analysed with significant differences in seroprevalence between villages. Highest prevalence was found in the age group 1–4 years.
April 19th, 2013 | Posted in Journal Watch | Read More »
By Tropical Med and Intl Health
Objective To provide information on the effect of timing of antiretroviral therapy (ART) initiation on outcomes of TB infection in real-life, non-clinical trial, rural settings in sub-Saharan Africa. Methods We conducted an observational cohort study of all HIV-infected TB patients presenting to a rural hospital in Kenya between 2005 and 2009. We analysed the association between timing of initiation of ART and mortality, using a Cox regression survival analysis, adjusted for measured confounders. Results A total of 404 antiretroviral-nave HIV/TB coinfected patients were included in the study. Initiation of ART during the first 8 weeks of TB treatment (early group) was not associated with changes in mortality at 1 year compared with initiation of ART after 8 weeks (late group) [Hazard Ratio (HR) = 0.74 (Confidence Interval (CI), 0.33–1.64, P = 0.46].
April 17th, 2013 | Posted in Journal Watch | Read More »
