Pub Date : 2024-07-16Print Date: 2024-09-04DOI: 10.4269/ajtmh.24-0113
Delin Ran, Fangfang Bao, Donghong Du
{"title":"Unique Scabies Presentation in a Patient with Bullous Pemphigoid.","authors":"Delin Ran, Fangfang Bao, Donghong Du","doi":"10.4269/ajtmh.24-0113","DOIUrl":"10.4269/ajtmh.24-0113","url":null,"abstract":"","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-16Print Date: 2024-09-04DOI: 10.4269/ajtmh.24-0016
Mamadou Bountogo, Lucienne Ouermi, Clarisse Dah, Ali Sié, Boubacar Coulibaly, Alphonse Zakane, Thierry Ouedraogo, Mamadou Ouattara, Elodie Lebas, Ian Fetterman, Aimée Kimfuema, Thuy Doan, Thomas M Lietman, Catherine E Oldenburg
Single-dose azithromycin is being considered by the WHO as an intervention for prevention of child mortality. However, concerns have emerged related to longer term unintended consequences of early life antibiotic use, particularly among infants. We conducted a long-term follow-up in a random sample of children who had been enrolled in a trial of neonatal azithromycin versus placebo for prevention of mortality to assess whether neonatal azithromycin exposure led to differences in child growth up to 4 years of age. We found no evidence of a difference in any anthropometric outcome among children who had received a single oral dose of azithromycin compared with placebo during the neonatal period. These results do not support long-term growth-promoting or deleterious effects of early life azithromycin exposure.
{"title":"Neonatal Azithromycin Exposure and Childhood Growth: Long-Term Follow-Up of a Randomized Controlled Trial.","authors":"Mamadou Bountogo, Lucienne Ouermi, Clarisse Dah, Ali Sié, Boubacar Coulibaly, Alphonse Zakane, Thierry Ouedraogo, Mamadou Ouattara, Elodie Lebas, Ian Fetterman, Aimée Kimfuema, Thuy Doan, Thomas M Lietman, Catherine E Oldenburg","doi":"10.4269/ajtmh.24-0016","DOIUrl":"10.4269/ajtmh.24-0016","url":null,"abstract":"<p><p>Single-dose azithromycin is being considered by the WHO as an intervention for prevention of child mortality. However, concerns have emerged related to longer term unintended consequences of early life antibiotic use, particularly among infants. We conducted a long-term follow-up in a random sample of children who had been enrolled in a trial of neonatal azithromycin versus placebo for prevention of mortality to assess whether neonatal azithromycin exposure led to differences in child growth up to 4 years of age. We found no evidence of a difference in any anthropometric outcome among children who had received a single oral dose of azithromycin compared with placebo during the neonatal period. These results do not support long-term growth-promoting or deleterious effects of early life azithromycin exposure.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-16Print Date: 2024-09-04DOI: 10.4269/ajtmh.24-0149
Khumbo Kalua, Esther S Misanjo, Thomas M Lietman, Kevin Ruder, Lina Zhong, Cindi Chen, YuHeng Liu, Danny Yu, Thomas Abraham, Nathaniel Wu, Daisy Yan, Armin Hinterwirth, Thuy Doan, Gerami D Seitzman
Infectious keratitis is a leading cause of corneal blindness worldwide with little information known about causative etiologies in Malawi, Africa. This area is resource-limited with ophthalmologist and microbiology services. The Department of Ophthalmology at the Kamuzu College of Health Sciences in Blantyre, Malawi, is a participating site of an international corneal ulcer consortium, capriCORN (Comprehensive Analysis of Pathogens, Resistomes, and Inflammatory-markers in the CORNea). In this study, 50 patients with corneal ulcers were swabbed for pathogen identification using RNA-sequencing. Corneal trauma was reported in 41% and 19% of the patients worked in agriculture. A pathogen was identified in 58% of the cases. Fungal pathogens predominated, followed by viruses and bacteria. Aspergillus, Fusarium, HSV-1, and Gardnerella were the most common pathogens detected. 50% of patients reported treatment with an antibiotic before presentation. Pathogens unusual for infectious keratitis, such as Subramaniula asteroids, Aureobasidium pullulans, and Gardnerella vaginalis, were also detected.
{"title":"Etiologies of Infectious Keratitis in Malawi.","authors":"Khumbo Kalua, Esther S Misanjo, Thomas M Lietman, Kevin Ruder, Lina Zhong, Cindi Chen, YuHeng Liu, Danny Yu, Thomas Abraham, Nathaniel Wu, Daisy Yan, Armin Hinterwirth, Thuy Doan, Gerami D Seitzman","doi":"10.4269/ajtmh.24-0149","DOIUrl":"10.4269/ajtmh.24-0149","url":null,"abstract":"<p><p>Infectious keratitis is a leading cause of corneal blindness worldwide with little information known about causative etiologies in Malawi, Africa. This area is resource-limited with ophthalmologist and microbiology services. The Department of Ophthalmology at the Kamuzu College of Health Sciences in Blantyre, Malawi, is a participating site of an international corneal ulcer consortium, capriCORN (Comprehensive Analysis of Pathogens, Resistomes, and Inflammatory-markers in the CORNea). In this study, 50 patients with corneal ulcers were swabbed for pathogen identification using RNA-sequencing. Corneal trauma was reported in 41% and 19% of the patients worked in agriculture. A pathogen was identified in 58% of the cases. Fungal pathogens predominated, followed by viruses and bacteria. Aspergillus, Fusarium, HSV-1, and Gardnerella were the most common pathogens detected. 50% of patients reported treatment with an antibiotic before presentation. Pathogens unusual for infectious keratitis, such as Subramaniula asteroids, Aureobasidium pullulans, and Gardnerella vaginalis, were also detected.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dengue fever is an important arboviral disease that significantly impacts the disease burden among populations residing in tropical regions. Dengue infection is known to have a broad spectrum of clinical manifestations, which range from fatal, life-threatening shock, encephalitis, and myocarditis to asymptomatic illness. Mild hepatic dysfunction with deranged hepatic laboratory parameters is a known entity with dengue fever. However, dengue presenting as acute liver failure associated with hepatic encephalopathy without shock or signs of plasma leakage is rare. Therefore, we are reporting the case of a young male with dengue fever presented as acute liver failure from a tertiary care center in central India to spread awareness among healthcare professionals worldwide regarding unusual presentations of dengue fever and consideration of dengue fever as a differential diagnosis in patients presenting with acute liver failure, especially in endemic regions.
{"title":"Case Report: Dengue Fever Progressing to Acute Liver Failure and Hepatic Encephalopathy.","authors":"Vaibhav Yadav, Akash Pawar, Mahadev Meena, Tarini Prasad Dandasena, Prachi Singh","doi":"10.4269/ajtmh.23-0516","DOIUrl":"10.4269/ajtmh.23-0516","url":null,"abstract":"<p><p>Dengue fever is an important arboviral disease that significantly impacts the disease burden among populations residing in tropical regions. Dengue infection is known to have a broad spectrum of clinical manifestations, which range from fatal, life-threatening shock, encephalitis, and myocarditis to asymptomatic illness. Mild hepatic dysfunction with deranged hepatic laboratory parameters is a known entity with dengue fever. However, dengue presenting as acute liver failure associated with hepatic encephalopathy without shock or signs of plasma leakage is rare. Therefore, we are reporting the case of a young male with dengue fever presented as acute liver failure from a tertiary care center in central India to spread awareness among healthcare professionals worldwide regarding unusual presentations of dengue fever and consideration of dengue fever as a differential diagnosis in patients presenting with acute liver failure, especially in endemic regions.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-16Print Date: 2024-09-04DOI: 10.4269/ajtmh.23-0884
William S Probert, Alexa C Quintana, Anne M Kjemtrup, Jill K Hacker
Flea-borne spotted fever and flea-borne (murine) typhus are rickettsioses caused by Rickettsia felis and Rickettsia typhi, respectively, and typically present as undifferentiated febrile illnesses. The relative contribution of these agents to flea-borne rickettsioses in California is unclear. We have developed a duplex reverse transcription real-time polymerase chain reaction (RT-rtPCR) assay targeting R. felis- and R. typhi-specific 23S ribosomal RNA single nucleotide polymorphisms to better understand the respective roles of these agents in causing flea-borne rickettsioses in California. This assay was compared with an established duplex R. felis- and R. typhi-ompB rt-PCR assay and was shown to have 1,000-fold and 10-fold greater analytical sensitivity for the detection of R. felis and R. typhi, respectively. Retrospective testing of clinical specimens with both assays established R. typhi as the major etiologic agent of flea-borne rickettsioses in California.
{"title":"Duplex Reverse-Transcription Real-Time Polymerase Chain Reaction Assay Targeting 23S rRNA Single Nucleotide Polymorphisms for the Detection of Flea-Borne Rickettsioses.","authors":"William S Probert, Alexa C Quintana, Anne M Kjemtrup, Jill K Hacker","doi":"10.4269/ajtmh.23-0884","DOIUrl":"10.4269/ajtmh.23-0884","url":null,"abstract":"<p><p>Flea-borne spotted fever and flea-borne (murine) typhus are rickettsioses caused by Rickettsia felis and Rickettsia typhi, respectively, and typically present as undifferentiated febrile illnesses. The relative contribution of these agents to flea-borne rickettsioses in California is unclear. We have developed a duplex reverse transcription real-time polymerase chain reaction (RT-rtPCR) assay targeting R. felis- and R. typhi-specific 23S ribosomal RNA single nucleotide polymorphisms to better understand the respective roles of these agents in causing flea-borne rickettsioses in California. This assay was compared with an established duplex R. felis- and R. typhi-ompB rt-PCR assay and was shown to have 1,000-fold and 10-fold greater analytical sensitivity for the detection of R. felis and R. typhi, respectively. Retrospective testing of clinical specimens with both assays established R. typhi as the major etiologic agent of flea-borne rickettsioses in California.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-16Print Date: 2024-09-04DOI: 10.4269/ajtmh.23-0789
Anna M Stadelman-Behar, Nicki Tiffin, Jayne Ellis, Fiona V Creswell, Kenneth Ssebambulidde, Edwin Nuwagira, Lauren Richards, Vittoria Lutje, Adriana Hristea, Raluca Elena Jipa, José E Vidal, Renata G S Azevedo, Sérgio Monteiro de Almeida, Gislene Botão Kussen, Keite Nogueira, Felipe Augusto Souza Gualberto, Tatiana Metcalf, Anna Dorothee Heemskerk, Tarek Dendane, Abidi Khalid, Amine Ali Zeggwagh, Kathleen Bateman, Uwe Siebert, Ursula Rochau, Arjan van Laarhoven, Reinout van Crevel, Ahmad Rizal Ganiem, Sofiati Dian, Joseph Jarvis, Joseph Donovan, Thuong Nguyen Thuy Thuong, Guy E Thwaites, Nathan C Bahr, David B Meya, David R Boulware, Tom H Boyles
No accurate and rapid diagnostic test exists for tuberculous meningitis (TBM), leading to delayed diagnosis. We leveraged data from multiple studies to improve the predictive performance of diagnostic models across different populations, settings, and subgroups to develop a new predictive tool for TBM diagnosis. We conducted a systematic review to analyze eligible datasets with individual-level participant data (IPD). We imputed missing data and explored three approaches: stepwise logistic regression, classification and regression tree (CART), and random forest regression. We evaluated performance using calibration plots and C-statistics via internal-external cross-validation. We included 3,761 individual participants from 14 studies and nine countries. A total of 1,240 (33%) participants had "definite" (30%) or "probable" (3%) TBM by case definition. Important predictive variables included cerebrospinal fluid (CSF) glucose, blood glucose, CSF white cell count, CSF differential, cryptococcal antigen, HIV status, and fever presence. Internal validation showed that performance varied considerably between IPD datasets with C-statistic values between 0.60 and 0.89. In external validation, CART performed the worst (C = 0.82), and logistic regression and random forest had the same accuracy (C = 0.91). We developed a mobile app for TBM clinical prediction that accounted for heterogeneity and improved diagnostic performance (https://tbmcalc.github.io/tbmcalc). Further external validation is needed.
{"title":"Diagnostic Prediction Model for Tuberculous Meningitis: An Individual Participant Data Meta-Analysis.","authors":"Anna M Stadelman-Behar, Nicki Tiffin, Jayne Ellis, Fiona V Creswell, Kenneth Ssebambulidde, Edwin Nuwagira, Lauren Richards, Vittoria Lutje, Adriana Hristea, Raluca Elena Jipa, José E Vidal, Renata G S Azevedo, Sérgio Monteiro de Almeida, Gislene Botão Kussen, Keite Nogueira, Felipe Augusto Souza Gualberto, Tatiana Metcalf, Anna Dorothee Heemskerk, Tarek Dendane, Abidi Khalid, Amine Ali Zeggwagh, Kathleen Bateman, Uwe Siebert, Ursula Rochau, Arjan van Laarhoven, Reinout van Crevel, Ahmad Rizal Ganiem, Sofiati Dian, Joseph Jarvis, Joseph Donovan, Thuong Nguyen Thuy Thuong, Guy E Thwaites, Nathan C Bahr, David B Meya, David R Boulware, Tom H Boyles","doi":"10.4269/ajtmh.23-0789","DOIUrl":"10.4269/ajtmh.23-0789","url":null,"abstract":"<p><p>No accurate and rapid diagnostic test exists for tuberculous meningitis (TBM), leading to delayed diagnosis. We leveraged data from multiple studies to improve the predictive performance of diagnostic models across different populations, settings, and subgroups to develop a new predictive tool for TBM diagnosis. We conducted a systematic review to analyze eligible datasets with individual-level participant data (IPD). We imputed missing data and explored three approaches: stepwise logistic regression, classification and regression tree (CART), and random forest regression. We evaluated performance using calibration plots and C-statistics via internal-external cross-validation. We included 3,761 individual participants from 14 studies and nine countries. A total of 1,240 (33%) participants had \"definite\" (30%) or \"probable\" (3%) TBM by case definition. Important predictive variables included cerebrospinal fluid (CSF) glucose, blood glucose, CSF white cell count, CSF differential, cryptococcal antigen, HIV status, and fever presence. Internal validation showed that performance varied considerably between IPD datasets with C-statistic values between 0.60 and 0.89. In external validation, CART performed the worst (C = 0.82), and logistic regression and random forest had the same accuracy (C = 0.91). We developed a mobile app for TBM clinical prediction that accounted for heterogeneity and improved diagnostic performance (https://tbmcalc.github.io/tbmcalc). Further external validation is needed.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yaya I Coulibaly, Abdoul F Diabate, Moussa Sangare, Sekou O Thera, Housseini Dolo, Salif S Doumbia, Siaka Y Coulibaly, Ayouba Diarra, Lamine Diarra, Diadje Tanapo, Michel E Coulibaly, Lamine Soumaoro, Abdallah A Diallo, Amatigue Zeguime, Yacouba Sanogo, Adama Berthe, Fatoumata Dite Nene Konipo, Charles Mackenzie, Mariana Stephens, Joseph P Shott, Jayla Norman, Ute Klarmann-Schulz, Achim Hoerauf, Andrew Majewski, John Horton, Sarah Sullivan, Eric A Ottesen, Thomas B Nutman
Lymphedema (LE) is one the most disfiguring chronic manifestations of lymphatic filariasis. Its management relies primarily on limb hygiene and local care. A previous study in Ghana demonstrating a beneficial effect of doxycycline on LE led to the current multicenter trial on the efficacy of doxycycline in filarial LE. A randomized placebo-controlled trial was initiated in two rural health districts in Mali. Patients with LE stages 1-3 were randomized to receive either doxycycline (200 mg/day) or placebo over a 6-week monitored treatment period and were then followed every 6 months for 2 years. Both groups received materials for limb hygiene that was carried out daily for the entire 2-year study. The primary endpoint was lack of progression in LE stage at 24 months. One hundred patients were enrolled in each study arm. The baseline sociodemographic characteristics of each group were largely similar. There was no significant difference at month 24 after treatment initiation in the number of subjects showing progression in LE stage between the two treatment arms (P = 0.5921). Importantly, however, the number of attacks of acute adenolymphangitis (ADLA) was reduced in both arms, but there was no significant difference between the two groups at any follow-up time point (all P >0.23). Doxycycline was well tolerated in those receiving the drug. When added to daily self-administered limb hygiene, a 6-week course of doxycycline (200 mg) was not superior to placebo in increasing the improvement associated with hygiene alone in LE volume, stage, or frequency of ADLA attacks over a 24-month period.
淋巴水肿(LE)是淋巴丝虫病最难看的慢性表现之一。其治疗主要依靠肢体卫生和当地护理。此前在加纳进行的一项研究表明,多西环素对淋巴水肿有一定的疗效,因此目前正在进行一项多中心试验,研究多西环素对丝虫性淋巴水肿的疗效。马里的两个农村医疗区启动了一项随机安慰剂对照试验。1-3期丝虫病患者被随机分配接受强力霉素(200毫克/天)或安慰剂治疗,接受为期6周的监测治疗,然后每6个月随访一次,为期2年。两组患者都收到了肢体卫生材料,在整个两年的研究过程中,每天都要进行肢体卫生。主要终点是 24 个月时 LE 阶段没有进展。每个研究组均招募了 100 名患者。各组的基线社会人口学特征基本相似。在开始治疗后的第24个月,两个治疗组中出现LE阶段进展的受试者人数没有明显差异(P = 0.5921)。但重要的是,两组的急性腺淋巴管炎(ADLA)发作次数均有所减少,但在任何随访时间点,两组之间均无明显差异(P均大于0.23)。接受多西环素治疗的患者耐受性良好。在24个月的时间里,在每天自我管理肢体卫生的基础上加用强力霉素(200毫克)6周疗程,在改善LE体积、阶段或ADLA发作频率方面并不优于安慰剂。
{"title":"Effect of Adding a Six-Week Course of Doxycycline to Intensive Hygiene-Based Care for Improving Lymphedema in a Rural Setting of Mali: A Double-Blind, Randomized Controlled 24-Month Trial.","authors":"Yaya I Coulibaly, Abdoul F Diabate, Moussa Sangare, Sekou O Thera, Housseini Dolo, Salif S Doumbia, Siaka Y Coulibaly, Ayouba Diarra, Lamine Diarra, Diadje Tanapo, Michel E Coulibaly, Lamine Soumaoro, Abdallah A Diallo, Amatigue Zeguime, Yacouba Sanogo, Adama Berthe, Fatoumata Dite Nene Konipo, Charles Mackenzie, Mariana Stephens, Joseph P Shott, Jayla Norman, Ute Klarmann-Schulz, Achim Hoerauf, Andrew Majewski, John Horton, Sarah Sullivan, Eric A Ottesen, Thomas B Nutman","doi":"10.4269/ajtmh.23-0908","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0908","url":null,"abstract":"<p><p>Lymphedema (LE) is one the most disfiguring chronic manifestations of lymphatic filariasis. Its management relies primarily on limb hygiene and local care. A previous study in Ghana demonstrating a beneficial effect of doxycycline on LE led to the current multicenter trial on the efficacy of doxycycline in filarial LE. A randomized placebo-controlled trial was initiated in two rural health districts in Mali. Patients with LE stages 1-3 were randomized to receive either doxycycline (200 mg/day) or placebo over a 6-week monitored treatment period and were then followed every 6 months for 2 years. Both groups received materials for limb hygiene that was carried out daily for the entire 2-year study. The primary endpoint was lack of progression in LE stage at 24 months. One hundred patients were enrolled in each study arm. The baseline sociodemographic characteristics of each group were largely similar. There was no significant difference at month 24 after treatment initiation in the number of subjects showing progression in LE stage between the two treatment arms (P = 0.5921). Importantly, however, the number of attacks of acute adenolymphangitis (ADLA) was reduced in both arms, but there was no significant difference between the two groups at any follow-up time point (all P >0.23). Doxycycline was well tolerated in those receiving the drug. When added to daily self-administered limb hygiene, a 6-week course of doxycycline (200 mg) was not superior to placebo in increasing the improvement associated with hygiene alone in LE volume, stage, or frequency of ADLA attacks over a 24-month period.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-16Print Date: 2024-09-03DOI: 10.4269/ajtmh.23-0885
Shanze Sadiq, Ursula A Kajani, Anyess R Travers, Donald R Hopkins, Frank Richards, Kashef Ijaz
The International Task Force for Disease Eradication (ITFDE) was formed at The Carter Center in 1988. Its primary purpose is to review activities and provide recommendations related to programs focused on eradication. The ITFDE also considers opportunities for disease elimination and improved control. Over the last two decades, the ITFDE has held 33 meetings, discussed 22 diseases, and made 244 recommendations. This report aims to analyze the patterns in recommendations made by the ITFDE between 2001 and 2022 and assess the ITFDE's role, impacts, and successes in advancing elimination and eradication efforts for selected diseases. Using a thematic analysis, recommendation categories were crafted, followed by a scoping review to determine evidence of implementation for each recommendation. Categories of recommendations included research (24%), leadership (20%), medical (17%), advocacy (11%), collaboration (13%), development (8%), and financial (8%). We determined that 123 (50.4%) ITFDE recommendations were implemented in some form. Notably, the ITFDE has helped raise the profile of neglected tropical diseases. Four salient outcomes include 1) the identification of the potential eradicability of lymphatic filariasis (1993), 2) the recognition of the critical need for improved treatments of human African trypanosomiasis (2002), 3) a recommendation for the elimination of lymphatic filariasis and malaria from Hispaniola (2006), and 4) recommendations for effective and safe ways to avoid disruption of elimination and eradication programs during the COVID-19 pandemic (2020). This review of the ITFDE will help to devise new approaches to monitor its impact in the future.
{"title":"Evaluation of the International Task Force for Disease Eradication: A Review of Past Deliberations.","authors":"Shanze Sadiq, Ursula A Kajani, Anyess R Travers, Donald R Hopkins, Frank Richards, Kashef Ijaz","doi":"10.4269/ajtmh.23-0885","DOIUrl":"10.4269/ajtmh.23-0885","url":null,"abstract":"<p><p>The International Task Force for Disease Eradication (ITFDE) was formed at The Carter Center in 1988. Its primary purpose is to review activities and provide recommendations related to programs focused on eradication. The ITFDE also considers opportunities for disease elimination and improved control. Over the last two decades, the ITFDE has held 33 meetings, discussed 22 diseases, and made 244 recommendations. This report aims to analyze the patterns in recommendations made by the ITFDE between 2001 and 2022 and assess the ITFDE's role, impacts, and successes in advancing elimination and eradication efforts for selected diseases. Using a thematic analysis, recommendation categories were crafted, followed by a scoping review to determine evidence of implementation for each recommendation. Categories of recommendations included research (24%), leadership (20%), medical (17%), advocacy (11%), collaboration (13%), development (8%), and financial (8%). We determined that 123 (50.4%) ITFDE recommendations were implemented in some form. Notably, the ITFDE has helped raise the profile of neglected tropical diseases. Four salient outcomes include 1) the identification of the potential eradicability of lymphatic filariasis (1993), 2) the recognition of the critical need for improved treatments of human African trypanosomiasis (2002), 3) a recommendation for the elimination of lymphatic filariasis and malaria from Hispaniola (2006), and 4) recommendations for effective and safe ways to avoid disruption of elimination and eradication programs during the COVID-19 pandemic (2020). This review of the ITFDE will help to devise new approaches to monitor its impact in the future.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-16Print Date: 2024-09-04DOI: 10.4269/ajtmh.24-0190
Oscar H Del Brutto, Denisse A Rumbea, Emilio E Arias, Robertino M Mera
Calcified cysticerci are often associated with hippocampal atrophy (HA). While most studies suggest that repetitive seizures cause HA in these patients, others have demonstrated that HA may also occur in persons without epilepsy. Little is known about mechanisms triggering HA in seizure-free individuals with calcified cysticerci. Here, we aimed to assess whether the size of the calcification is associated with HA. Using a population-based design, we selected apparently seizure-free individuals with a single calcified cysticercus in whom interictal paroxysmal activity and other causes of HA have been discarded. A total of 55 individuals (mean age, 58.3 ± 13 years, 62% women) fulfilled inclusion criteria. Unadjusted and multivariate models were fitted to assess the association between the size of the calcification dichotomized into <3 mm and ≥3 mm (exposure) and the presence of HA (outcome). Sixteen participants (29%) had HA, which was asymmetric in eight (50%) cases. Hippocampal atrophy was noted in 11/20 (55%) participants with large calcifications and in 5/35 (14%) with small calcifications (P = 0.001). A multivariate logistic regression model showed a significant association between the presence of large calcifications and HA, after adjustment for relevant confounders (odds ratio: 7.78; 95% CI: 1.72-35.1). Participants with calcifications ≥3 mm in diameter were 7.8 times more likely to have HA than those with smaller ones. Study results open avenues of research for the use of agents to prevent HA progression.
钙化囊尾蚴通常与海马萎缩(HA)有关。大多数研究表明,癫痫反复发作会导致这些患者出现海马体萎缩,但也有研究表明,没有癫痫的人也可能出现海马体萎缩。人们对钙化囊尾蚴患者在无癫痫发作的情况下引发海马体萎缩的机制知之甚少。在此,我们旨在评估钙化的大小是否与 HA 有关。通过基于人群的设计,我们选择了明显无癫痫发作且有单个钙化囊尾蚴的患者,这些患者的发作间期阵发性活动和其他原因导致的 HA 已被剔除。共有 55 人(平均年龄为 58.3 ± 13 岁,62% 为女性)符合纳入标准。为评估钙化大小与下列因素之间的关系,拟合了未调整模型和多变量模型
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