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Alabi AS, Traoré AN, Loembe MM, Ateba-Ngoa U, Frank M, Adegnika AA, Lell B, Mahoumbou J, Köhler C, Kremsner PG, Grobusch MP. Enhanced laboratory capacity development: a boost for effective tuberculosis control in resource-limited settings. Int J Infect Dis 2016; 56:81-84. [PMID: 27888000 DOI: 10.1016/j.ijid.2016.11.404] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 11/14/2016] [Accepted: 11/15/2016] [Indexed: 12/31/2022] Open
Abstract
Both routine and research tuberculosis (TB) laboratory capacity urgently need to be expanded in large parts of Sub-Saharan Africa. In 2009, the Centre de Recherches Médicales de Lambaréné (CERMEL) took a strategic decision to expand its activities by building TB laboratory capacity to address research questions and to improve routine diagnostic and treatment capacity. Over the past 7 years, a standard laboratory has been developed that is contributing significantly to TB diagnosis, treatment, and control in Gabon; training has also been provided for TB research staff in Central Africa. CERMEL has a cordial relationship with the Gabon National TB Control Programme (PNLT), which has culminated in a successful Global Fund joint application. This endeavour is considered a model for similar developments needed in areas of high TB prevalence and where TB control remains poor to date.
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Affiliation(s)
- Abraham Sunday Alabi
- Centre des Recherches Médicales de Lambaréné (CERMEL), PB 118, Lambaréné, Gabon; Eberhard Karls Universität, Institut für Tropenmedizin, Tübingen, Germany.
| | - Afsatou Ndama Traoré
- Centre des Recherches Médicales de Lambaréné (CERMEL), PB 118, Lambaréné, Gabon; Microbiology Department, University of Venda, Thohoyandou, South Africa
| | - Marguerite Massinga Loembe
- Centre des Recherches Médicales de Lambaréné (CERMEL), PB 118, Lambaréné, Gabon; Eberhard Karls Universität, Institut für Tropenmedizin, Tübingen, Germany; Departement de Bacteriologie Virologie, Faculte de medicine, Universite des Sciences de la Sante, Libreville, Gabon
| | - Ulysse Ateba-Ngoa
- Centre des Recherches Médicales de Lambaréné (CERMEL), PB 118, Lambaréné, Gabon; Eberhard Karls Universität, Institut für Tropenmedizin, Tübingen, Germany
| | - Matthias Frank
- Eberhard Karls Universität, Institut für Tropenmedizin, Tübingen, Germany
| | - Ayola Akim Adegnika
- Centre des Recherches Médicales de Lambaréné (CERMEL), PB 118, Lambaréné, Gabon; Eberhard Karls Universität, Institut für Tropenmedizin, Tübingen, Germany
| | - Bertrand Lell
- Centre des Recherches Médicales de Lambaréné (CERMEL), PB 118, Lambaréné, Gabon; Eberhard Karls Universität, Institut für Tropenmedizin, Tübingen, Germany
| | - Jocelyn Mahoumbou
- Programme National de Lutte Contre la Tuberculose (PNLT), Ministry of Health, Libreville, Gabon
| | - Carsten Köhler
- Eberhard Karls Universität, Institut für Tropenmedizin, Tübingen, Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany
| | - Peter Gottfried Kremsner
- Centre des Recherches Médicales de Lambaréné (CERMEL), PB 118, Lambaréné, Gabon; Eberhard Karls Universität, Institut für Tropenmedizin, Tübingen, Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany
| | - Martin Peter Grobusch
- Centre des Recherches Médicales de Lambaréné (CERMEL), PB 118, Lambaréné, Gabon; Eberhard Karls Universität, Institut für Tropenmedizin, Tübingen, Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany; Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam Medical Centre, University of Amsterdam, The Netherlands
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Randomized, controlled, assessor-blind clinical trial to assess the efficacy of single- versus repeated-dose albendazole to treat ascaris lumbricoides, trichuris trichiura, and hookworm infection. Antimicrob Agents Chemother 2014; 58:2535-40. [PMID: 24550339 DOI: 10.1128/aac.01317-13] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
In many regions where soil-transmitted helminth infections are endemic, single-dose albendazole is used in mass drug administration programs to control infections. There are little data on the efficacy of the standard single-dose administration compared to that of alternative regimens. We conducted a randomized, controlled, assessor-blinded clinical trial to determine the efficacies of standard and extended albendazole treatment against soil-transmitted helminth infection in Gabon. A total of 175 children were included. Adequate cure rates and egg reduction rates above 85% were found with a single dose of albendazole for Ascaris infection, 85% (95% confidence interval [CI], 73, 96) and 93.8% (CI, 87.6, 100), respectively, while two doses were necessary for hookworm infestation (92% [CI, 78, 100] and 92% [CI, 78, 100], respectively). However, while a 3-day regimen was not sufficient to cure Trichuris (cure rate, 83% [CI, 73, 93]), this regimen reduced the number of eggs up to 90.6% (CI, 83.1, 100). The rate ratios of two- and three-dose regimens compared to a single-dose treatment were 1.7 (CI, 1.1, 2.5) and 2.1 (CI, 1.5, 2.9) for Trichuris and 1.7 (CI, 1.0, 2.9) and 1.7 (CI, 1.0, 2.9) for hookworm. Albendazole was safe and well tolerated in all regimens. A single-dose albendazole treatment considerably reduces Ascaris infection but has only a moderate effect on hookworm and Trichuris infections. The single-dose option may still be the preferred regimen because it balances efficacy, safety, and compliance during mass drug administration, keeping in mind that asymptomatic low-level helminth carriage may also have beneficial effects. (This study has been registered at ClinicalTrials.gov under registration number NCT01192802.).
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