Maternally Derived Anti-Dengue Antibodies and Risk of DHF in Infants: A Case-Control Study

This study proposes to directly test the hypothesis that antibody-dependent enhancement (ADE) is the critical factor in the development of dengue hemorrhagic fever (DHF) in infants. DHF occurs in two distinct clinical settings: a) in children and adults with secondary DENV infection, and b) in infants with primary DENV infection born to mothers with prior DENV infection. The ADE hypothesis proposes that pre-existing serotype-cross-reactive non-neutralizing anti-DENV antibodies bind the heterotypic DENV during secondary infection and enhance its uptake into immune cells, leading to increased viral load and DHF. This model suggests that DHF in DENV-infected infants is caused by the enhancing effect of waning maternal anti-DENV antibodies, thus causing a “physiologic secondary infection” during an infant’s primary infection and thereby increasing the infant’s risk for DHF. The effect of maternal immunity on DHF in infants has been studied exclusively in Southeast Asia. However, the maternal DENV seroprevalence approaches 100% in this part of the world. As a consequence, the ADE model of infant DHF cannot truly be tested in Southeast Asia, because all infants possess anti-DENV antibody at birth. In the Western Hemisphere, by contrast, women may have experienced either a single DENV infection, more than one DENV infection, or no DENV infection at all. The ability to include DENV-seronegative mothers as controls allows for the ADE hypothesis to be directly tested in a clinical study. To our knowledge, no such study has been previously conducted. This thesis presents a case-control study designed to evaluate the influence of positive maternal dengue seroprevalence on the risk of DHF in infants. As the MSCI program provides instruction in study design, this thesis does not present findings. The clinical trial described herein began in May 2010 and enrollment is expected to continue through May 2012 (see Table 4)

CNS Infections, Part 1 and Part 2

The goal of this presentation is to review the clinical presentation, diagnosis, treatment, and complications of the following viral causes of CNS infections: Bacterial meningitis, TB meningitis, Viral meningitis, Herpes Simplex Encephalitis, HIV and CNS infections, Rabies

Gram Negative Bacteria in Clinical Medicine

The goals of this presentation are to: define the molecular structure of Gram-negative organisms; highlight differences between Gram-negatives and Gram-positives; discuss the most important clinically-relevant Gram-negative bacteria; review treatments for Gram-negatives; and illustrate clinical scenarios involving Gram-negative infection

HIV Basics: common clinical scenarios

This is a lecture in the PEER Liberia Infectious Diseases Lecture Series. The goals of this presentation are to: review some (not all) clinical scenarios involving advanced HIV infection; consider some (not all) opportunistic infection (OI) scenarios; discuss OI prophylaxis; discuss alternative HIV regimens; and briefly review most pertinent data regarding TB/HIV coinfection

Skin and Soft-Tissue Infections

The goals of this presentation are to: review several major presentations of skin and soft tissue infection; and note importance of rapid diagnosis in specific diseases. This is not an exhaustive list

Bacteremia and Endocarditis

This presentation provides an overview of the pathogens that cause bacteremia and endocarditis. Manifestations, pathology and treatment are discussed. The goals of the presentation are: Consider major pathogens that cause bacteremia and endocarditis in both adults and children; Discuss pathogenesis; Review clinical manifestations; Discuss basic treatment strategies; and Highlight useful sources of information

COVID-19, Ebola, Spacesuits, and Infection Control: What PPE Does for HCWs

The goals of this presentation are to: explain the general concepts of infection control; highlight differences between infection control approaches, especially contact/droplet vs. airborne; explain the concept of Personal Protective Equipment (PPE); discuss particular instances of infection control/PPE use (Ebola); review N95 versus Surgical Mask protection in COVID; and emphasize the importance of handwashing in the COVID outbreak

Gram Positive Bacteria in Clinical Medicine

The goals of this presentation are to: define the molecular structure of Gram-positive organisms; highlight differences between Gram-positives and Gram-negatives; discuss the most important clinically-relevant Gram-positive bacteria; review treatments for Gram-positives; and illustrate clinical scenarios involving Gram-positive infection

Using Powerpoint in Medical Presentations: A User’s Guide

This presentation provides an overview of how to use PowerPoint to present medical information

HIV Basics: The History and Current State of the Epidemic

The goals of this presentation are to: briefly discuss the origin and history of HIV; illustrate life cycle of HIV and demonstrate effects of various drug classes on disruption of life cycle; discuss basic treatment strategies; and highlight useful sources of information