Comparison of the estimated incidence of acute leptospirosis in the Kilimanjaro Region of Tanzania between 2007-08 and 2012-14

Background: The sole report of annual leptospirosis incidence in continental Africa of 75–102 cases per 100,000 population is from a study performed in August 2007 through September 2008 in the Kilimanjaro Region of Tanzania. To evaluate the stability of this estimate over time, we estimated the incidence of acute leptospirosis in Kilimanjaro Region, northern Tanzania for the time period 2012–2014. Methodology and Principal Findings: Leptospirosis cases were identified among febrile patients at two sentinel hospitals in the Kilimanjaro Region. Leptospirosis was diagnosed by serum microscopic agglutination testing using a panel of 20 Leptospira serovars belonging to 17 separate serogroups. Serum was taken at enrolment and patients were asked to return 4–6 weeks later to provide convalescent serum. Confirmed cases required a 4-fold rise in titre and probable cases required a single titre of ≥800. Findings from a healthcare utilisation survey were used to estimate multipliers to adjust for cases not seen at sentinel hospitals. We identified 19 (1.7%) confirmed or probable cases among 1,115 patients who presented with a febrile illness. Of cases, the predominant reactive serogroups were Australis 8 (42.1%), Sejroe 3 (15.8%), Grippotyphosa 2 (10.5%), Icterohaemorrhagiae 2 (10.5%), Pyrogenes 2 (10.5%), Djasiman 1 (5.3%), Tarassovi 1 (5.3%). We estimated that the annual incidence of leptospirosis was 11–18 cases per 100,000 population. This was a significantly lower incidence than 2007–08 (p<0.001). Conclusions: We estimated a much lower incidence of acute leptospirosis than previously, with a notable absence of cases due to the previously predominant serogroup Mini. Our findings indicate a dynamic epidemiology of leptospirosis in this area and highlight the value of multi-year surveillance to understand leptospirosis epidemiology

Scaling approach to itinerant quantum critical points

Based on phase space arguments, we develop a simple approach to metallic quantum critical points, designed to study the problem without integrating the fermions out of the partition function. The method is applied to the spin-fermion model of a T=0 ferromagnetic transition. Stability criteria for the conduction and the spin fluids are derived by scaling at the tree level. We conclude that anomalous exponents may be generated for the fermion self-energy and the spin-spin correlation functions below $d=3$, in spite of the spin fluid being above its upper critical dimension.Comment: 3 pages, 2 figures; discussion of the phase space restriction modified and, for illustrative purposes, restricted to the tree-level analysis of the ferromagnetic transitio

Interplay of disorder and spin fluctuations in the resistivity near a quantum critical point

The resistivity in metals near an antiferromagnetic quantum critical point (QCP) is strongly affected by small amounts of disorder. In a quasi-classical treatment, we show that an interplay of strongly anisotropic scattering due to spin fluctuations and isotropic impurity scattering leads to a large regime where the resistivity varies as T^alpha, with an anomalous exponent, alpha, 1 <= alpha <= 1.5, depending on the amount of disorder. I argue that this mechanism explains in some detail the anomalous temperature dependence of the resistivity observed in CePd_2Si_2, CeNi_2Ge_2 and CeIn_3 near the QCP.Comment: 4 pages, 4 eps figures, published version, only small change

Incidence of human brucellosis in the Kilimanjaro Region of Tanzania in the periods 2007-2008 and 2012-2014

Background: Brucellosis causes substantial morbidity among humans and their livestock. There are few robust estimates of the incidence of brucellosis in sub-Saharan Africa. Using cases identified through sentinel hospital surveillance and health care utilization data, we estimated the incidence of brucellosis in Moshi Urban and Moshi Rural Districts, Kilimanjaro Region, Tanzania, for the periods 2007–2008 and 2012–2014. Methods: Cases were identified among febrile patients at two sentinel hospitals and were defined as having either a 4-fold increase in Brucella microscopic agglutination test titres between acute and convalescent serum or a blood culture positive for Brucella spp. Findings from a health care utilization survey were used to estimate multipliers to account for cases not seen at sentinel hospitals. Results: Of 585 patients enrolled in the period 2007–2008, 13 (2.2%) had brucellosis. Among 1095 patients enrolled in the period 2012–2014, 32 (2.9%) had brucellosis. We estimated an incidence (range based on sensitivity analysis) of brucellosis of 35 (range 32–93) cases per 100 000 persons annually in the period 2007–2008 and 33 (range 30–89) cases per 100 000 persons annually in the period 2012–2014. Conclusions: We found a moderate incidence of brucellosis in northern Tanzania, suggesting that the disease is endemic and an important human health problem in this area

Superconductivity on the threshold of magnetism in CePd2Si2 and CeIn3

The magnetic ordering temperature of some rare earth based heavy fermion compounds is strongly pressure-dependent and can be completely suppressed at a critical pressure, p$_c$, making way for novel correlated electron states close to this quantum critical point. We have studied the clean heavy fermion antiferromagnets CePd$_2$Si$_2$ and CeIn$_3$ in a series of resistivity measurements at high pressures up to 3.2 GPa and down to temperatures in the mK region. In both materials, superconductivity appears in a small window of a few tenths of a GPa on either side of p$_c$. We present detailed measurements of the superconducting and magnetic temperature-pressure phase diagram, which indicate that superconductivity in these materials is enhanced, rather than suppressed, by the closeness to magnetic order.Comment: 11 pages, including 9 figure

Metamagnetic Quantum Criticality in Sr3Ru2O7

We consider the metamagnetic transition in the bilayer ruthenate, ${\rm Sr_3Ru_2O_7}$, and use this to motivate a renormalization group treatment of a zero-temperature quantum-critical end-point. We summarize the results of mean field theory and give a pedagogical derivation of the renormalization-group equations. These are then solved to yield numerical results for the susceptibility, the specific heat and the resistivity exponent which can be compared with measured data on ${\rm Sr_3Ru_2O_7}$ to provide a powerful test for the standard framework of metallic quantum criticality. The observed approach to the critical point is well-described by our theory explaining a number of unusual features of experimental data. The puzzling behaviour very near to the critical point itself, though, is not accounted for by this, or any other theory with a Fermi surface

Estimating leptospirosis incidence using hospital-based surveillance and a population-based health care utilization survey in Tanzania.

BACKGROUND: The incidence of leptospirosis, a neglected zoonotic disease, is uncertain in Tanzania and much of sub-Saharan Africa, resulting in scarce data on which to prioritize resources for public health interventions and disease control. In this study, we estimate the incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a population-based household health care utilization survey in two districts in the Kilimanjaro Region of Tanzania and identified leptospirosis cases at two hospital-based fever sentinel surveillance sites in the Kilimanjaro Region. We used multipliers derived from the health care utilization survey and case numbers from hospital-based surveillance to calculate the incidence of leptospirosis. A total of 810 households were enrolled in the health care utilization survey and multipliers were derived based on responses to questions about health care seeking in the event of febrile illness. Of patients enrolled in fever surveillance over a 1 year period and residing in the 2 districts, 42 (7.14%) of 588 met the case definition for confirmed or probable leptospirosis. After applying multipliers to account for hospital selection, test sensitivity, and study enrollment, we estimated the overall incidence of leptospirosis ranges from 75-102 cases per 100,000 persons annually. CONCLUSIONS/SIGNIFICANCE: We calculated a high incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania, where leptospirosis incidence was previously unknown. Multiplier methods, such as used in this study, may be a feasible method of improving availability of incidence estimates for neglected diseases, such as leptospirosis, in resource constrained settings

Spin fluctuations in nearly magnetic metals from ab-initio dynamical spin susceptibility calculations:application to Pd and Cr95V5

We describe our theoretical formalism and computational scheme for making ab-initio calculations of the dynamic paramagnetic spin susceptibilities of metals and alloys at finite temperatures. Its basis is Time-Dependent Density Functional Theory within an electronic multiple scattering, imaginary time Green function formalism. Results receive a natural interpretation in terms of overdamped oscillator systems making them suitable for incorporation into spin fluctuation theories. For illustration we apply our method to the nearly ferromagnetic metal Pd and the nearly antiferromagnetic chromium alloy Cr95V5. We compare and contrast the spin dynamics of these two metals and in each case identify those fluctuations with relaxation times much longer than typical electronic `hopping times'Comment: 21 pages, 9 figures. To appear in Physical Review B (July 2000

Plasmodium knowlesi Genome Sequences from Clinical Isolates Reveal Extensive Genomic Dimorphism.

Plasmodium knowlesi is a newly described zoonosis that causes malaria in the human population that can be severe and fatal. The study of P. knowlesi parasites from human clinical isolates is relatively new and, in order to obtain maximum information from patient sample collections, we explored the possibility of generating P. knowlesi genome sequences from archived clinical isolates. Our patient sample collection consisted of frozen whole blood samples that contained excessive human DNA contamination and, in that form, were not suitable for parasite genome sequencing. We developed a method to reduce the amount of human DNA in the thawed blood samples in preparation for high throughput parasite genome sequencing using Illumina HiSeq and MiSeq sequencing platforms. Seven of fifteen samples processed had sufficiently pure P. knowlesi DNA for whole genome sequencing. The reads were mapped to the P. knowlesi H strain reference genome and an average mapping of 90% was obtained. Genes with low coverage were removed leaving 4623 genes for subsequent analyses. Previously we identified a DNA sequence dimorphism on a small fragment of the P. knowlesi normocyte binding protein xa gene on chromosome 14. We used the genome data to assemble full-length Pknbpxa sequences and discovered that the dimorphism extended along the gene. An in-house algorithm was developed to detect SNP sites co-associating with the dimorphism. More than half of the P. knowlesi genome was dimorphic, involving genes on all chromosomes and suggesting that two distinct types of P. knowlesi infect the human population in Sarawak, Malaysian Borneo. We use P. knowlesi clinical samples to demonstrate that Plasmodium DNA from archived patient samples can produce high quality genome data. We show that analyses, of even small numbers of difficult clinical malaria isolates, can generate comprehensive genomic information that will improve our understanding of malaria parasite diversity and pathobiology