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van Doren TP. Biocultural perspectives of infectious diseases and demographic evolution: Tuberculosis and its comorbidities through history. Evol Anthropol 2022; 32:100-117. [PMID: 36436141 DOI: 10.1002/evan.21970] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 06/09/2022] [Accepted: 11/11/2022] [Indexed: 11/28/2022]
Abstract
Anthropologists recognize the importance of conceptualizing health in the context of the mutually evolving nature of biology and culture through the biocultural approach, but biocultural anthropological perspectives of infectious diseases and their impacts on humans (and vice versa) through time are relatively underrepresented. Tuberculosis (TB) has been a constant companion of humans for thousands of years and has heavily influenced population health in almost every phase of cultural and demographic evolution. TB in human populations has been dramatically influenced by behavior, demographic and epidemiological shifts, and other comorbidities through history. This paper critically discusses TB and some of its major comorbidities through history within a biocultural framework to show how transitions in human demography and culture affected the disease-scape of TB. In doing so, I address the potential synthesis of biocultural and epidemiological transition theory to better comprehend the mutual evolution of infectious diseases and humans.
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2
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Baindara P, Agrawal S, Franco OL. Host-directed therapies for malaria and tuberculosis: common infection strategies and repurposed drugs. Expert Rev Anti Infect Ther 2022; 20:849-869. [DOI: 10.1080/14787210.2022.2044794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Piyush Baindara
- Department of Molecular Microbiology & Immunology, School of Medicine, University of Missouri, Missouri, Columbia, MO, USA
| | - Sonali Agrawal
- Immunology Division, ICMR-National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, Uttar Pradesh, India
| | - O. L. Franco
- Proteomics Analysis and Biochemical Center, Catholic University of Brasilia, Brasilia, Brazil; S-Inova Biotech, Catholic University Dom Bosco, Campo Grande, MS, Brazil
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3
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Pan Y, Sun X, Li D, Zhao Y, Jin F, Cao Y. PD-1 blockade promotes immune memory following Plasmodium berghei ANKA reinfection. Int Immunopharmacol 2020; 80:106186. [PMID: 31931371 DOI: 10.1016/j.intimp.2020.106186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 12/27/2019] [Accepted: 01/01/2020] [Indexed: 01/22/2023]
Abstract
The establishment of malaria immune memory is slow, incomplete, and short-lived. The mechanisms underpinning the generation and maintenance of anti-malarial immune memory remain unclear. This study evaluated the possible role of programmed cell death-1 (PD-1) in the establishment of malaria immune memory. Following infection by Plasmodium berghei ANKA (Pb ANKA) we compared natural immunity, acquired immunity, and immune memory between WT and mice lacking PD-1 via monoclonal antibody treatment. We found that parasitemia levels were significantly lower in the PD-1 knockdown group. After PD-1 elimination, dendritic cells, Th1, and T-follicular helper cells increased significantly. In addition, memory T, long-lived plasma cells, and serum antibody production also increased significantly. Therefore, PD-1 elimination induced stronger natural and acquired immune responses and enhanced immune memory against the parasite.
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Affiliation(s)
- Yanyan Pan
- Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang 110013, China; Department of Central Laboratory, Dalian Municipal Central Hospital, Dalian 116033, China
| | - Xiaodan Sun
- Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang 110013, China
| | - Danni Li
- Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang 110013, China
| | - Yan Zhao
- Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang 110013, China
| | - Feng Jin
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang 110001,China
| | - Yaming Cao
- Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang 110013, China.
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4
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Teixeira R, Rodrigues MGA, Ferreira MD, Borges MC, Safe I, Melo GC, Spener R, Garrido MS, Monteiro WM, Siqueira AM, Lacerda MVG, Cordeiro-Santos M, de Souza Sampaio V. Tuberculosis and malaria walk side by side in the Brazilian Amazon: an ecological approach. Trop Med Int Health 2019; 24:1003-1010. [PMID: 31233671 DOI: 10.1111/tmi.13282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the spatial distribution of TB and malaria incidence, as well as their spatial association with each other, regardless of environmental and socio-economic factors commonly reported as determinants of both disease rates among the municipalities of Amazonas State, Brazil between 2012 and 2015. METHODS Through an ecological approach considering municipalities of Amazonas, Brazil, as unit of analysis, a negative binomial regression model was used to assess association between malaria and TB rates, in which the dependent variable was the average municipal tuberculosis incidence rate. RESULTS Positive associations of overall malaria (β = 0.100 [CI = 0.032, 0.168], P = 0.004), P. vivax malaria (β = 0.115 [CI = 0.036, 0.195], P = 0.005), and P. falciparum malaria (β = 0.389 [CI = -0.0124, 0.791], P = 0.057) with TB rates were found, regardless of the sociodemographic factors included in the study. CONCLUSION In the Brazilian Amazon, TB and malaria are spatially associated. Therefore, it is very likely that co-infections also occur in this region, regardless of the HIV status.
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Affiliation(s)
- Rahyja Teixeira
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
| | | | - Marcia Danielle Ferreira
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Maria Cecília Borges
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Izabella Safe
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Gisely Cardoso Melo
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Programa de Pós-graduação em Ciências Aplicadas à Hematologia Universidade do Estado do Amazonas, Rio de Janeiro, Brazil
| | - Renata Spener
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
| | | | - Wuelton Marcelo Monteiro
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - André Machado Siqueira
- Institutto Nacional de Infectologia Evandro Chagas, Fiocruz Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcus Vinícius Guimarães Lacerda
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Programa de Pós-graduação em Ciências Aplicadas à Hematologia Universidade do Estado do Amazonas, Rio de Janeiro, Brazil.,Instituto Leônidas e Maria Deane Manaus Brazil, Fiocruz Amazônia, Manaus, Brazil
| | - Marcelo Cordeiro-Santos
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Universidade Nilton Lins, Manaus, Brazil
| | - Vanderson de Souza Sampaio
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Fundação de Vigilância em Saúde do Estado do Amazonas, FVS-AM, Manaus, Brazil
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5
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Whittaker E, López-Varela E, Broderick C, Seddon JA. Examining the Complex Relationship Between Tuberculosis and Other Infectious Diseases in Children. Front Pediatr 2019; 7:233. [PMID: 31294001 PMCID: PMC6603259 DOI: 10.3389/fped.2019.00233] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 05/22/2019] [Indexed: 12/21/2022] Open
Abstract
Millions of children are exposed to tuberculosis (TB) each year, many of which become infected with Mycobacterium tuberculosis. Most children can immunologically contain or eradicate the organism without pathology developing. However, in a minority, the organism overcomes the immunological constraints, proliferates and causes TB disease. Each year a million children develop TB disease, with a quarter dying. While it is known that young children and those with immunodeficiencies are at increased risk of progression from TB infection to TB disease, our understanding of risk factors for this transition is limited. The most immunologically disruptive process that can happen during childhood is infection with another pathogen and yet the impact of co-infections on TB risk is poorly investigated. Many diseases have overlapping geographical distributions to TB and affect similar patient populations. It is therefore likely that infection with viruses, bacteria, fungi and protozoa may impact on the risk of developing TB disease following exposure and infection, although disentangling correlation and causation is challenging. As vaccinations also disrupt immunological pathways, these may also impact on TB risk. In this article we describe the pediatric immune response to M. tuberculosis and then review the existing evidence of the impact of co-infection with other pathogens, as well as vaccination, on the host response to M. tuberculosis. We focus on the impact of other organisms on the risk of TB disease in children, in particularly evaluating if co-infections drive host immune responses in an age-dependent way. We finally propose priorities for future research in this field. An improved understanding of the impact of co-infections on TB could assist in TB control strategies, vaccine development (for TB vaccines or vaccines for other organisms), TB treatment approaches and TB diagnostics.
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Affiliation(s)
- Elizabeth Whittaker
- Department of Paediatrics, Imperial College London, London, United Kingdom
- Department of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, St. Mary's Campus, London, United Kingdom
| | - Elisa López-Varela
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Claire Broderick
- Department of Paediatrics, Imperial College London, London, United Kingdom
| | - James A. Seddon
- Department of Paediatrics, Imperial College London, London, United Kingdom
- Department of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, St. Mary's Campus, London, United Kingdom
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Seddon JA, Chiang SS, Esmail H, Coussens AK. The Wonder Years: What Can Primary School Children Teach Us About Immunity to Mycobacterium tuberculosis? Front Immunol 2018; 9:2946. [PMID: 30619306 PMCID: PMC6300506 DOI: 10.3389/fimmu.2018.02946] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 11/30/2018] [Indexed: 12/22/2022] Open
Abstract
In high burden settings, the risk of infection with Mycobacterium tuberculosis increases throughout childhood due to cumulative exposure. However, the risk of progressing from tuberculosis (TB) infection to disease varies by age. Young children (<5 years) have high risk of disease progression following infection. The risk falls in primary school children (5 to <10 years), but rises again during puberty. TB disease phenotype also varies by age: generally, young children have intrathoracic lymph node disease or disseminated disease, while adolescents (10 to <20 years) have adult-type pulmonary disease. TB risk also exhibits a gender difference: compared to adolescent boys, adolescent girls have an earlier rise in disease progression risk and higher TB incidence until early adulthood. Understanding why primary school children, during what we term the "Wonder Years," have low TB risk has implications for vaccine development, therapeutic interventions, and diagnostics. To understand why this group is at low risk, we need a better comprehension of why younger children and adolescents have higher risks, and why risk varies by gender. Immunological response to M. tuberculosis is central to these issues. Host response at key stages in the immunopathological interaction with M. tuberculosis influences risk and disease phenotype. Cell numbers and function change dramatically with age and sexual maturation. Young children have poorly functioning innate cells and a Th2 skew. During the "Wonder Years," there is a lymphocyte predominance and a Th1 skew. During puberty, neutrophils become more central to host response, and CD4+ T cells increase in number. Sex hormones (dehydroepiandrosterone, adiponectin, leptin, oestradiol, progesterone, and testosterone) profoundly affect immunity. Compared to girls, boys have a stronger Th1 profile and increased numbers of CD8+ T cells and NK cells. Girls are more Th2-skewed and elicit more enhanced inflammatory responses. Non-immunological factors (including exposure intensity, behavior, and co-infections) may impact disease. However, given the consistent patterns seen across time and geography, these factors likely are less central. Strategies to protect children and adolescents from TB may need to differ by age and sex. Further work is required to better understand the contribution of age and sex to M. tuberculosis immunity.
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Affiliation(s)
- James A. Seddon
- Department of Paediatrics, Imperial College London, London, United Kingdom
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Silvia S. Chiang
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, United States
- Center for International Health Research, Rhode Island Hospital, Providence, RI, United States
| | - Hanif Esmail
- Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
- Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Anna K. Coussens
- Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Infection and Immunity Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Division of Medical Biology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
- Division of Medical Microbiology, Department of Pathology, University of Cape Town, Cape Town, South Africa
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Djiba B, Kane BS, Diallo MA, Diongue K, Diack ND, Deme H, Dieng M, Sow M, Ndiaye D, Pouye A. Tuberculosis arthritis of the sternoclavicular joint after uncomplicated falciparum malaria: a case report. Ann Clin Microbiol Antimicrob 2017; 16:44. [PMID: 28583115 PMCID: PMC5460410 DOI: 10.1186/s12941-017-0219-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 05/31/2017] [Indexed: 11/10/2022] Open
Abstract
Background Malaria and tuberculosis are co-endemic in many developing countries. However their associations are rarely reported. Yet, it has been suggested that a pathological process may link the two diseases. Case presentation A 20-year-old female patient was admitted in the internal medicine service of Aristide Le Dantec Hospital for uncomplicated malaria. She was previously treated for autoimmune hemolytic anaemia using prednisone at 5 mg per day. Clinical examination showed swelling in front of the sternoclavicular joint. She presented with fever and headache. Thick smear from blood revealed trophozoites of P. falciparum at parasite density of 52,300 parasites/μl. The Ziehl–Neelsen stained smear showed the presence of acid-fast bacilli from the fluid puncture of the swelling. Mycobacterium tuberculosis was further isolated in culture. The diagnosis of falciparum malaria co-infection with sternoclavicular tuberculosis was posed. The patient was treated successfully using antimalarial drugs subsequently followed by multidrug antitubercular therapy. Conclusion Interactions between malaria and tuberculosis need to be largely and prospectively investigated and appropriate treatment should be undertaken.
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Affiliation(s)
- Boundia Djiba
- Service de Médecine Interne, Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Avenue Cheikh Anta Diop, Fann, BP 5005, Dakar, Senegal
| | - Baidy Sy Kane
- Service de Médecine Interne, Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Avenue Cheikh Anta Diop, Fann, BP 5005, Dakar, Senegal
| | - Mamadou Alpha Diallo
- Laboratoire de Parasitologie-Mycologie, Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Avenue Cheikh Anta Diop, Fann, BP 5005, Dakar, Senegal.
| | - Khadim Diongue
- Laboratoire de Parasitologie-Mycologie, Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Avenue Cheikh Anta Diop, Fann, BP 5005, Dakar, Senegal
| | - Ngoné Diaba Diack
- Service de Médecine Interne, Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Avenue Cheikh Anta Diop, Fann, BP 5005, Dakar, Senegal
| | - Hamidou Deme
- Service d'Imagerie Medicale, Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Avenue Cheikh Anta Diop, Fann, BP 5005, Dakar, Senegal
| | - Mouhamed Dieng
- Service de Médecine Interne, Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Avenue Cheikh Anta Diop, Fann, BP 5005, Dakar, Senegal
| | - Maimouna Sow
- Service de Médecine Interne, Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Avenue Cheikh Anta Diop, Fann, BP 5005, Dakar, Senegal
| | - Daouda Ndiaye
- Laboratoire de Parasitologie-Mycologie, Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Avenue Cheikh Anta Diop, Fann, BP 5005, Dakar, Senegal
| | - Abdoulaye Pouye
- Service de Médecine Interne, Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Avenue Cheikh Anta Diop, Fann, BP 5005, Dakar, Senegal
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Rodriguez-Fernandez R, Ng N, Susilo D, Prawira J, Bangs MJ, Amiya RM. The double burden of disease among mining workers in Papua, Indonesia: at the crossroads between Old and New health paradigms. BMC Public Health 2016; 16:951. [PMID: 27609056 PMCID: PMC5016925 DOI: 10.1186/s12889-016-3630-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 09/02/2016] [Indexed: 12/21/2022] Open
Abstract
Background As the global shift toward non-communicable diseases overlaps with the unfinished agenda of confronting infectious diseases in low- and middle-income countries, epidemiological links across both burdens must be recognized. This study examined the non-communicable disease-infectious disease overlap in the specific comorbidity rates for key diseases in an occupational cohort in Papua, Indonesia. Methods Diagnosed cases of ischaemic heart disease, stroke, hypertension, diabetes (types 1 and 2), chronic obstructive pulmonary disease, asthma, cancer, HIV and AIDS, tuberculosis, and malaria were extracted from 22,550 patient records (21,513 men, 1037 women) stored in identical electronic health information systems from two clinic sites in Papua, Indonesia. Data were collected as International Classification of Diseases, 10th Revision, entries from records spanning January-December 2013. A novel application of Circos software was used to visualize the interconnectedness between the disease burdens as overlapping prevalence estimates representing comorbidities. Results Overall, NCDs represented 38 % of all disease cases, primarily in the form of type 2 diabetes (n = 1440) and hypertension (n = 1398). Malaria cases represented the largest single portion of the disease burden with 5310 recorded cases, followed by type 2 diabetes with 1400 cases. Tuberculosis occurred most frequently alongside malaria (29 %), followed by chronic obstructive pulmonary disease (19 %), asthma (17 %), and stroke (12 %). Hypertension-tuberculosis (4 %), tuberculosis-cancer (4 %), and asthma-tuberculosis (2 %) comorbidities were also observed. Conclusions The high prevalence of multimorbidity, preponderance of non-communicable diseases, and extensive interweaving of non-communicable and infectious disease comorbidities highlighted in this cohort of mining workers in Papua, Indonesia reflect the markedly double disease burden increasingly plaguing Indonesia and other similar low- and middle-income countries – a challenge with which their over-stretched, under-resourced health systems are ill-equipped to cope. Integrated, person-centered treatment and control strategies rooted in the primary healthcare sector will be critical to reverse this trend.
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Affiliation(s)
| | - Nawi Ng
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Dwidjo Susilo
- Center for Health Policy and Management, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
| | - John Prawira
- Center for Health Policy and Management, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
| | | | - Rachel M Amiya
- Freeport Public Health and Malaria Control, International SOS, Papua, Indonesia.,Department of Family Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.,NCD Asia Pacific Alliance, Tokyo, Japan
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9
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Drabe CH, Vestergaard LS, Helleberg M, Nyagonde N, Rose MV, Francis F, Theilgaard OP, Asbjørn J, Amos B, Bygbjerg IC, Ruhwald M, Ravn P. Performance of Interferon-Gamma and IP-10 Release Assays for Diagnosing Latent Tuberculosis Infections in Patients with Concurrent Malaria in Tanzania. Am J Trop Med Hyg 2016; 94:728-35. [PMID: 26834199 DOI: 10.4269/ajtmh.15-0633] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 12/14/2015] [Indexed: 01/14/2023] Open
Abstract
Interferon-gamma (IFN-γ) release assays (IGRAs) are used to detect cellular immune recognition of Mycobacterium tuberculosis The chemokine IFN-γ-inducible protein 10 (IP-10) is an alternative diagnostic biomarker to IFN-γ. Several conditions interfere with IGRA test performance. We aimed to assess the possible influence of Plasmodium falciparum infection on the IGRA test QuantiFERON-TB GOLD® In-Tube (QFT) test and an in-house IP-10 release assay. In total, 241 Tanzanian adults were included; 184 patients with uncomplicated malaria (88 human immunodeficiency virus [HIV] coinfected) and 57 HIV-infected patients without malaria infection. Malaria was treated with artemether-lumefantrine (Coartem®). QFT testing was performed before initiation of malaria treatment and at days 7 and 42. In total, 172 patients completed follow-up. IFN-γ and IP-10 was measured in QFT supernatants. We found that during malaria infection IFN-γ and IP-10 levels in the unstimulated samples were elevated, mitogen responsiveness was impaired, and CD4 cell counts were decreased. These alterations reverted after malaria treatment. Concurrent malaria infection did not affect QFT test results, whereas there were more indeterminate IP-10 results during acute malaria infection. We suggest that IGRA and IP-10 release assay results of malaria patients should be interpreted with caution and that testing preferably should be postponed until after malaria treatment.
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Affiliation(s)
- Camilla H Drabe
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Lasse S Vestergaard
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Marie Helleberg
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Nyagonde Nyagonde
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Michala V Rose
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Filbert Francis
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Ola P Theilgaard
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Jens Asbjørn
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Ben Amos
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Ib Christian Bygbjerg
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Morten Ruhwald
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Pernille Ravn
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
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Banfield S, Pascoe E, Thambiran A, Siafarikas A, Burgner D. Factors associated with the performance of a blood-based interferon-γ release assay in diagnosing tuberculosis. PLoS One 2012; 7:e38556. [PMID: 22701664 PMCID: PMC3373489 DOI: 10.1371/journal.pone.0038556] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Accepted: 05/11/2012] [Indexed: 11/18/2022] Open
Abstract
Background Indeterminate results are a recognised limitation of interferon-γ release assays (IGRA) in the diagnosis of latent tuberculosis (TB) infection (LTBI) and TB disease, especially in children. We investigated whether age and common co-morbidities were associated with IGRA performance in an unselected cohort of resettled refugees. Methods A retrospective cross-sectional study of refugees presenting for their post-resettlement health assessment during 2006 and 2007. Refugees were investigated for prevalent infectious diseases, including TB, and for common nutritional deficiencies and haematological abnormalities as part of standard clinical screening protocols. Tuberculosis screening was performed by IGRA; QuantiFERON-TB Gold in 2006 and QuantiFERON-TBGold In-Tube in 2007. Results Complete data were available on 1130 refugees, of whom 573 (51%) were children less than 17 years and 1041 (92%) were from sub-Saharan Africa. All individuals were HIV negative. A definitive IGRA result was obtained in 1004 (89%) refugees, 264 (26%) of which were positive; 256 (97%) had LTBI and 8 (3%) had TB disease. An indeterminate IGRA result was obtained in 126 (11%) refugees (all failed positive mitogen control). In multivariate analysis, younger age (linear OR = 0.93 [95% CI 0.91–0.95], P<0.001), iron deficiency anaemia (2.69 [1.51–4.80], P = 0.001), malaria infection (3.04 [1.51–6.09], P = 0.002), and helminth infection (2.26 [1.48–3.46], P<0.001), but not vitamin D deficiency or insufficiency, were associated with an indeterminate IGRA result. Conclusions Younger age and a number of common co-morbidities are significantly and independently associated with indeterminate IGRA results in resettled predominantly African refugees.
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Affiliation(s)
- Sally Banfield
- School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
| | - Elaine Pascoe
- School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
- School of Medicine, University of Queensland, Queensland, Australia
| | - Aesen Thambiran
- The Migrant Health Unit, Perth, Western Australia, Australia
| | - Aris Siafarikas
- School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
- Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- The Institute of Health and Rehabilitation Research, University of Notre Dame, Fremantle, Western Australia, Australia
| | - David Burgner
- School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
- Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- * E-mail:
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Schrenzel MD, Maalouf GA, Keener LL, Gaffney PM. MOLECULAR CHARACTERIZATION OF MALARIAL PARASITES IN CAPTIVE PASSERINE BIRDS. J Parasitol 2003; 89:1025-33. [PMID: 14627151 DOI: 10.1645/ge-3163] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Seven of 28 passerine birds that died in captivity were positive for malarial parasites by polymerase chain reaction targeting the mitochondrial cytochrome b (cytB) and apicoplast ribosomal RNA (rRNA) genes. Each bird was infected with a single parasite lineage having a unique genotype. Apicoplast rRNA sequences were present both in Haemoproteus spp. and Plasmodium spp. and had typically high adenosine + thymidine content. Phylogenies for cytB and apicoplast rRNA sequences were largely congruent and supported previous studies that suggest that Plasmodium-Haemoproteus spp. underwent synchronous speciation with their avian hosts, interrupted by sporadic episodes of host switching. Apicoplast phylogeny further indicated that Haemoproteus spp. are ancestral to Plasmodium spp. All the 7 infected passerine birds had histologic lesions of malaria, and malarial parasites may have contributed to the death of at least 4 animals. These findings provide new genetic data on passerine hematozoa, including initial sequences of apicoplast DNA, and emphasize the relevance of parasite prevalence, evolutionary relationships, and host switching to modern management and husbandry practices of captive birds.
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Affiliation(s)
- Mark D Schrenzel
- Zoological Society of San Diego, Center for Reproduction of Endangered Species, Department of Pathology, Molecular Diagnostics Laboratory, P.O. Box 120-551, San Diego, California 92112, USA.
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Odida M, Schmauz R, Lwanga SK. Grade of malignancy of cervical cancer in regions of Uganda with varying malarial endemicity. Int J Cancer 2002; 99:737-41. [PMID: 12115509 DOI: 10.1002/ijc.10384] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
As in a prior study on malignant lymphomas, 3 and 6 areas of Uganda showing low and high malarial endemicity, respectively, were selected for analysis and the data retrieved from the Kampala Cancer Registry, which in the 1960s and 1970s collected cases of cancer through a widely used free biopsy service from the whole country. Overall incidence rates were derived from 924 cases from the 12-year period 1964-1975. For reasons of economy, grade of tumour was determined only in cases pertaining to the 6-year period 1968-1973. Of 457 cases, 304 could be reviewed histologically. Only the group of squamous cell carcinomas (84.9%, 258 cases) was large enough for subsequent geographic analysis. High incidence rates of CC were found in areas with high malarial endemicity, whereas low incidence rates occurred where malaria was either frequent or rare. A correlate to malarial infection was the proportion of high-grade carcinomas irrespective of the overall incidence of CC. With high prevalence of malaria and high CPRs of 35-74%, the relative share of high-grade cancer amounted to 50-67%. Where malaria was rare with low CPRs of 8-11%, these values were lower and varied only from 25-39% with a similar range of 14%. Geographic agreement between malarial endemicity and the PI of high-grade cancer was high in the 9 study areas and only slightly lower than for BL, for which the association with malaria is beyond doubt. Compared to areas with little malaria, the RR for the incidence of high-grade carcinomas in areas with severe malaria was increased. The value was 2.04 with a 95% confidence interval of 1.37-3.04. Attributable to secondary immunodeficiency, lifelong exposure to malaria may result in excess frequency of high-grade malignant tumours not only in the group of malignant lymphomas but also in CC.
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Affiliation(s)
- Michael Odida
- Department of Pathology, Makerere University, Kampala, Uganda
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