44 research outputs found
Susceptibility of murine induced pluripotent stem cell-derived cardiomyocytes to hypoxia and nutrient deprivation
Exploring health practitioners’ acceptability of a prospective semi-quantitative pfHRP2 device to define severe malaria in the Democratic Republic of Congo
Cerebrospinal fluid Plasmodium falciparum histidine-rich protein-2 in pediatric cerebral malaria
Abstract Background Cerebral malaria (CM) causes a rapidly developing coma, and remains a major contributor to morbidity and mortality in malaria-endemic regions. This study sought to determine the relationship between cerebrospinal fluid (CSF) Plasmodium falciparum histidine rich protein-2 (PfHRP-2) and clinical, laboratory and radiographic features in a cohort of children with retinopathy-positive CM. Methods Patients included in the study were admitted (2009–2013) to the Pediatric Research Ward (Queen Elizabeth Central Hospital, Blantyre, Malawi) meeting World Health Organization criteria for CM with findings of malarial retinopathy. Enzyme-linked immunosorbent assay was used to determine plasma and CSF PfHRP-2 levels. Wilcoxon rank-sum tests and multivariable logistic regression analysis assessed the association of clinical and radiographic characteristics with the primary outcome of death during hospitalization. Results In this cohort of 94 patients, median age was 44 (interquartile range 29–62) months, 53 (56.4%) patients were male, 6 (7%) were HIV-infected, and 10 (11%) died during hospitalization. Elevated concentrations of plasma lactate (p = 0.005) and CSF PfHRP-2 (p = 0.04) were significantly associated with death. On multivariable analysis, higher PfHRP-2 in the CSF was associated with death (odds ratio 9.00, 95% confidence interval 1.44–56.42) while plasma PfHRP-2 was not (odds ratio 2.05, 95% confidence interval 0.45–9.35). Conclusions Elevation of CSF, but not plasma PfHRP-2, is associated with death in this paediatric CM cohort. PfHRP-2 egress into the CSF may represent alteration of blood brain barrier permeability related to the sequestration of parasitized erythrocytes in the cerebral microvasculature
The influence of insecticide exposure and environmental stimuli on the movement behaviour and dispersal of a freshwater isopod
Performance characteristics and costs of serological tests for brucellosis in a pastoralist community of northern Tanzania
The control of brucellosis across sub-Saharan Africa is hampered by the lack of standardized testing
and the use of tests with poor performance. This study evaluated the performance and costs of
serological assays for human brucellosis in a pastoralist community in northern Tanzania. Serum
collected from 218 febrile hospital patients was used to evaluate the performance of seven index
tests, selected based on international recommendation or current use. We evaluated the Rose Bengal
test (RBT) using two protocols, four commercial agglutination tests and a competitive enzymelinked
immunosorbent assay (cELISA). The sensitivity, specificity, positive predictive value, negative
predictive value, Youden’s index, diagnostic accuracy, and per-sample cost of each index test were
estimated. The diagnostic accuracy estimates ranged from 95.9 to 97.7% for the RBT, 55.0 to 72.0%
for the commercial plate tests, and 89.4% for the cELISA. The per-sample cost range was 0.79
for the RBT, 1.14 for the commercial plate tests, and $2.51 for the cELISA. The widely used
commercial plate tests performed poorly and cost more than the RBT. These findings provide evidence
for the public health value of discontinuing the use of commercial agglutination tests for human
brucellosis in Tanzania.DELTAS Africa Initiative Afrique One-ASPIRE scholarship scheme
(Afrique One-ASPIRE/DEL-15-008, http://afriq ueone aspir e.org). Â.J.M is supported by The University of Glasgow’s
Lord Kelvin/Adam Smith (LKAS) PhD scholarship. R.F.B received scholarship support from the UK Biotechnology
and Biological Sciences Research Council (BBSRC), Department for International Development
(DFID), the Economic & Social Research Council, the Medical Research Council, the Natural Environment
Research Council and the Defence Science & Technology Laboratory, under the Zoonoses and Emerging Livestock
Systems – Associated Studentship (ZELS-AS) programme (grant number BB/N503563/1). This study was
also supported by the Zoonoses and Emerging Livestock Systems program grant numbers BB/L018845 and BB/
L017679 http://www.bbsrc .ac.uk/)