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Ejo M, Van Deun A, Nunn A, Meredith S, Ahmed S, Dalai D, Tumenbayar O, Tsogt B, Dat PT, Ha DTM, Hang PT, Kokebu D, Teferi M, Mebrahtu T, Ngubane N, Moodliar R, Duckworth L, Conradie F, Enduwamahoro E, Keysers J, De Rijk P, Mulders W, Diro E, Rigouts L, de Jong BC, Torrea G. Effectiveness of GenoType MTBDR sl in excluding TB drug resistance in a clinical trial. Int J Tuberc Lung Dis 2021; 25:839-845. [PMID: 34615581 DOI: 10.5588/ijtld.21.0212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES: To assess the performance of the GenoType MTBDRsl v1, a line-probe assay (LPA), to exclude baseline resistance to fluoroquinolones (FQs) and second-line injectables (SLIs) in the Standard Treatment Regimen of Anti-tuberculosis Drugs for Patients With MDR-TB 1 (STREAM 1) trial.METHODS: Direct sputum MTBDRsl results in the site laboratories were compared to indirect phenotypic drug susceptibility testing (pDST) results in the central laboratory, with DNA sequencing as a reference standard.RESULTS: Of 413 multidrug-resistant TB (MDR-TB) patients tested using MTBDRsl and pDST, 389 (94.2%) were FQ-susceptible and 7 (1.7%) FQ-resistant, while 17 (4.1%) had an inconclusive MTBDRsl result. For SLI, 372 (90.1%) were susceptible, 5 (1.2%) resistant and 36 (8.7%) inconclusive. There were 9 (2.3%) FQ discordant pDST/MTBDRsl results, of which 3 revealed a mutation and 5 (1.3%) SLI discordant pDST/MTBDRsl results, none of which were mutants on sequencing. Among the 17 FQ- and SLI MTBDRsl-inconclusive samples, sequencing showed 1 FQ- and zero SLI-resistant results, similar to frequencies among the conclusive MTBDRsl. The majority of inconclusive MTBDRsl results were associated with low bacillary load samples (acid-fast bacilli smear-negative or scantily positive) compared to conclusive results (P < 0.001).CONCLUSION: MTBDRsl can facilitate the rapid exclusion of FQ and SLI resistances for enrolment in clinical trials.
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Affiliation(s)
- M Ejo
- Institute of Tropical Medicine, Antwerp, Belgium, University of Gondar, Gondar, Ethiopia, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - A Van Deun
- Institute of Tropical Medicine, Antwerp, Belgium, Independent Consultant, Leuven, Belgium
| | - A Nunn
- Medical Research Council Clinical Trials at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - S Meredith
- Medical Research Council Clinical Trials at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - S Ahmed
- Medical Research Council Clinical Trials at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - D Dalai
- National Centre of Infectious Diseases, National Tuberculosis Reference Laboratory, Ulaanbaatar, Mongolia
| | - O Tumenbayar
- National Centre of Infectious Diseases, National Tuberculosis Reference Laboratory, Ulaanbaatar, Mongolia
| | - B Tsogt
- Mongolian TB Coalition, Ulaanbaatar, Mongolia
| | - P T Dat
- Pham Ngoc Thach Hospital, Ho Chi Minh, Vietnam
| | - D T M Ha
- Pham Ngoc Thach Hospital, Ho Chi Minh, Vietnam
| | - P T Hang
- Pham Ngoc Thach Hospital, Ho Chi Minh, Vietnam
| | - D Kokebu
- Saint Peter´s TB Specialized Hospital, Addis Ababa, Ethiopia
| | - M Teferi
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - T Mebrahtu
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - N Ngubane
- Doris Goodwin Hospital, Pietermaritzburg, South Africa
| | - R Moodliar
- King Dinuzulu Hospital, Durban, South Africa
| | - L Duckworth
- King Dinuzulu Hospital, Durban, South Africa
| | - F Conradie
- Sizwe Tropical Disease, Johannesburg, South Africa
| | | | - J Keysers
- Institute of Tropical Medicine, Antwerp, Belgium
| | - P De Rijk
- Institute of Tropical Medicine, Antwerp, Belgium
| | - W Mulders
- Institute of Tropical Medicine, Antwerp, Belgium
| | - E Diro
- University of Gondar, Gondar, Ethiopia
| | - L Rigouts
- Institute of Tropical Medicine, Antwerp, Belgium, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - B C de Jong
- Institute of Tropical Medicine, Antwerp, Belgium
| | - G Torrea
- Institute of Tropical Medicine, Antwerp, Belgium
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Schulman H, Niward K, Abate E, Idh J, Axenram P, Bornefall A, Forsgren S, Jakobsson J, Öhrling C, Kron M, Brudin L, Diro E, Getachew Kebede A, Paues J, Bruchfeld J, Wejse C, Stendahl O, Schön T. Sedimentation rate and suPAR in relation to disease activity and mortality in patients with tuberculosis. Int J Tuberc Lung Dis 2020; 23:1155-1161. [PMID: 31718751 DOI: 10.5588/ijtld.18.0634] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE: To investigate how levels of the soluble urokinase plasminogen activator receptor (suPAR) and erythrocyte sedimentation rate (ESR) correlate with disease activity and prognosis in pulmonary tuberculosis (PTB).DESIGN: This was a retrospective analysis of patients with active PTB (n = 500) in Gondar, Ethiopia, for whom the suPAR (n = 301) and ESR (n = 330) were analysed at the start of treatment. Both biomarkers were available for 176 patients. Human immunodeficiency virus (HIV) status, chest X-ray (CXR) findings, classification according to the clinical TBscore and treatment outcome were all recorded.RESULTS: In a multivariable logistic regression analysis adjusted for age, sex and HIV status, surrogate markers of disease activity such as advanced CXR patterns correlated with increased levels of suPAR (adjusted OR [aOR] 8.24, P < 0.001) and of ESR (aOR 1.63, P = 0.030), whereas ESR only correlated significantly with a TBscore >6 points. Increased levels of both suPAR and ESR were associated with unsuccessful treatment outcomes (aOR 2.93, P = 0.013; aOR 2.52, P = 0.025). The highest quartile of suPAR (aOR 13.3, P = 0.029) but not ESR levels correlated independently with increased mortality.CONCLUSION: SuPAR and ESR levels correlate with disease activity in PTB; however, the clinical role of these potentially prognostic biomarkers needs to be verified in prospective studies.
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Affiliation(s)
- H Schulman
- Department of Infectious Diseases, Linköping University Hospital, Linköping
| | - K Niward
- Department of Infectious Diseases, Linköping University Hospital, Linköping, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - E Abate
- Department of Immunology and Molecular Biology, University of Gondar, Gondar, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - J Idh
- Department of Clinical and Experimental Medicine, Division of Microbiology, Infection and Inflammation, Linköping University
| | - P Axenram
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - A Bornefall
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - S Forsgren
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - J Jakobsson
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - C Öhrling
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - M Kron
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - L Brudin
- Department of Clinical Physiology, Kalmar County Hospital, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - E Diro
- Department of Internal Medicine, University of Gondar, Gondar
| | - A Getachew Kebede
- Department of Radiology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - J Paues
- Department of Infectious Diseases, Linköping University Hospital, Linköping, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - J Bruchfeld
- Division of Infectious Diseases, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - C Wejse
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau, Department of Infectious Diseases, Aarhus University Hospital, Aarhus, GloHAU, Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - O Stendahl
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden, Department of Clinical and Experimental Medicine, Division of Microbiology, Infection and Inflammation, Linköping University
| | - T Schön
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden, Department of Clinical and Experimental Medicine, Division of Microbiology, Infection and Inflammation, Linköping University, Department of Infectious Diseases and Clinical Microbiology, Kalmar County Hospital, Linköping University, Linköping, Sweden
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Camara BS, Delamou AM, Diro E, El Ayadi A, Béavogui AH, Sidibé S, Grovogui FM, Takarinda KC, Kolié D, Sandouno SD, Okumura J, Baldé MD, Van Griensven J, Zachariah R. Influence of the 2014-2015 Ebola outbreak on the vaccination of children in a rural district of Guinea. Public Health Action 2017; 7:161-167. [PMID: 28695091 DOI: 10.5588/pha.16.0120] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 03/24/2017] [Indexed: 12/24/2022] Open
Abstract
Setting: All health centres in Macenta District, rural Guinea. Objective: To compare stock-outs of vaccines, vaccine stock cards and the administration of various childhood vaccines across the pre-Ebola, Ebola and post-Ebola virus disease periods. Design: This was an ecological study. Results: Similar levels of stock-outs were observed for all vaccines (bacille Calmette-Guérin [BCG], pentavalent, polio, measles, yellow fever) in the pre-Ebola and Ebola periods (respectively 2760 and 2706 facility days of stock-outs), with some variation by vaccine. Post-Ebola, there was a 65-fold reduction in stock-outs compared to pre-Ebola. Overall, 24 facility-months of vaccine stock card stock-outs were observed during the pre-Ebola period, which increased to 65 facility-months of stock-outs during the Ebola outbreak period; no such stock-out occurred in the post-Ebola period. Apart from yellow fever and measles, vaccine administration declined universally during the peak outbreak period (August-November 2014). Complete cessation of vaccine administration for BCG and a prominent low for polio (86% decrease) were observed in April 2014, corresponding to vaccine stock-outs. Post-Ebola, overall vaccine administration did not recover to pre-Ebola levels, with the highest gaps seen in polio and pentavalent vaccines, which had shortages of respectively 40% and 38%. Conclusion: These findings highlight the need to sustain vaccination activities in Guinea so that they remain resilient and responsive, irrespective of disease outbreaks.
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Affiliation(s)
- B S Camara
- Department of Public Health, Gamal University of Conakry, Conakry, Guinea
| | - A M Delamou
- Department of Public Health, Gamal University of Conakry, Conakry, Guinea.,Woman and Child Health Research Centre, Institute of Tropical Medicine, Antwerp, Belgium
| | - E Diro
- University of Gondar, Gondar, Ethiopia
| | - A El Ayadi
- Bixby Center for Global Reproductive Health, University of California, San Francisco, California, USA
| | - A H Béavogui
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forecariah, Guinea
| | - S Sidibé
- Department of Public Health, Gamal University of Conakry, Conakry, Guinea
| | - F M Grovogui
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forecariah, Guinea
| | - K C Takarinda
- International Union Against Tuberculosis and Lung Disease, Paris, France
| | - D Kolié
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forecariah, Guinea
| | - S D Sandouno
- Department of Public Health, Gamal University of Conakry, Conakry, Guinea
| | - J Okumura
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - M D Baldé
- Department of Gynecology-Obstetrics, Gamal University of Conakry, Conakry, Guinea
| | - J Van Griensven
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - R Zachariah
- Médecins Sans Frontières, Brussels Operational Centre (LuxOR), Luxembourg
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Abate E, Elias D, Getachew A, Alemu S, Diro E, Britton S, Aseffa A, Stendahl O, Schön T. Effects of albendazole on the clinical outcome and immunological responses in helminth co-infected tuberculosis patients: a double blind randomised clinical trial. Int J Parasitol 2014; 45:133-40. [PMID: 25486494 DOI: 10.1016/j.ijpara.2014.09.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 09/15/2014] [Accepted: 09/19/2014] [Indexed: 11/25/2022]
Abstract
Despite several review papers and experimental studies concerning the impact of chronic helminth infection on tuberculosis in recent years, there is a scarcity of data from clinical field studies in highly endemic areas for these diseases. We believe this is the first randomised clinical trial investigating the impact of albendazole treatment on the clinical and immunological outcomes of helminth co-infected tuberculosis patients. A randomised, double-blind, placebo-controlled trial of albendazole (400mg per day for 3 days) in helminth-positive tuberculosis patients was conducted in Gondar, Ethiopia. The primary outcome was clinical improvement (ΔTB score) after 2 months. Among secondary outcomes were changes in the levels of eosinophils, CD4+ T cells, regulatory T cells, IFN-γ, IL-5 and IL-10 after 3 months. A total of 140 helminth co-infected tuberculosis patients were included with an HIV co-infection rate of 22.8%. There was no significant effect on the primary outcome (ΔTB score: 5.6±2.9 for albendazole versus 5.9±2.5 for placebo, P=0.59). The albendazole-treated group showed a decline in eosinophil cells (P=0.001) and IL-10 (P=0.017) after 3 months. In an exploratory analysis after 12 weeks, the albendazole treated group showed a trend towards weight gain compared with the placebo group (11.2±8.5 kg versus 8.2±8.7 kg, P=0.08)). The reductions in eosinophil counts and IL-10 show that asymptomatic helminth infection significantly affects host immunity during tuberculosis and can be effectively reversed by albendazole treatment. The clinical effects of helminth infection on chronic infectious diseases such as tuberculosis merit further characterisation.
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Affiliation(s)
- E Abate
- Department of Immunology and Molecular Biology, University of Gondar, Gondar, Ethiopia; Department of Medical Microbiology, Linköping University, Sweden.
| | - D Elias
- University of Southern Denmark, Institute of Molecular Medicine, Department of Cancer and Inflammation, Odense, Denmark
| | - A Getachew
- Department of Radiology, University of Gondar, Gondar, Ethiopia
| | - S Alemu
- Department of Internal Medicine, University of Gondar, Gondar, Ethiopia
| | - E Diro
- Department of Internal Medicine, University of Gondar, Gondar, Ethiopia
| | - S Britton
- Department of Infectious Diseases, Karolinska Hospital, Stockholm, Sweden
| | - A Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - O Stendahl
- Department of Medical Microbiology, Linköping University, Sweden
| | - T Schön
- Department of Medical Microbiology, Linköping University, Sweden; Department of Clinical Microbiology and Infectious Diseases, Kalmar County Hospital, Kalmar, Sweden
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Seid M, Teferi Y, Woldeyohannes D, Wube M, Mohammed R, Moges F, Lynen L, Jacobs J, van Griensven J, Diro E. Bacterial sepsis in patients with visceral leishmaniasis in Northwest Ethiopia. Int J Infect Dis 2014. [DOI: 10.1016/j.ijid.2014.03.417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Schön T, Idh J, Westman A, Elias D, Abate E, Diro E, Moges F, Kassu A, Ayele B, Forslund T, Getachew A, Britton S, Stendahl O, Sundqvist T. Effects of a food supplement rich in arginine in patients with smear positive pulmonary tuberculosis--a randomised trial. Tuberculosis (Edinb) 2011; 91:370-7. [PMID: 21813328 DOI: 10.1016/j.tube.2011.06.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Revised: 05/11/2011] [Accepted: 06/08/2011] [Indexed: 11/28/2022]
Abstract
In tuberculosis (TB), the production of nitric oxide (NO) is confirmed but its importance in host defense is debated. Our aim was to investigate whether a food supplement rich in arginine could enhance clinical improvement in TB patients by increased NO production. Smear positive TB patients from Gondar, Ethiopia (n = 180) were randomized to a food supplementation rich in arginine (peanuts, equivalent to 1 g of arginine/day) or with a low arginine content (wheat crackers, locally called daboqolo) during four weeks. The primary outcome was cure rate according to the WHO classification and secondary outcomes were sputum smear conversion, weight gain, sedimentation rate, reduction of cough and chest X-ray improvement as well as levels of NO in urine (uNO) or exhaled air (eNO) at two months. There was no effect of the intervention on the primary outcome (OR 1.44, 95% CI: 0.69-3.0, p = 0.39) or secondary outcomes. In the subgroup analysis according to HIV status, peanut supplemented HIV+/TB patients showed increased cure rate (83.8% (31/37) vs 53.1% (17/32), p < 0.01). A low baseline eNO (<10 ppb) in HIV+/TB patients was associated with a decreased cure rate. We conclude that nutritional supplementation with a food supplement rich in arginine did not have any overall clinical effect. In the subgroup of HIV positive TB patients, it significantly increased the cure rate and as an additional finding in this subgroup, low initial levels of NO in exhaled air were associated with a poor clinical outcome but this needs to be confirmed in further studies.
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Affiliation(s)
- T Schön
- Department of Medical Microbiology, Faculty of Health Sciences, Linköping University, 581 85 Linköping, Sweden.
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Mulu A, Diro E, Tekleselassie H, Belyhun Y, Anagaw B, Alemayehu M, Gelaw A, Biadglegne F, Desalegn K, Yifiru S, Tiruneh M, Kassu A, Nishikawa T, Isogai E. Effect of Ethiopian multiflora honey on fluconazole-resistant Candida species isolated from the oral cavity of AIDS patients. Int J STD AIDS 2010; 21:741-5. [DOI: 10.1258/ijsa.2010.010140] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study aimed to determine the antifungal effect of Ethiopian multiflora honey against Candida species isolated from the oral cavity of AIDS patients. Oral rinses were obtained from 13 AIDS patients and cultured on CHROMagar plates at 37°C for 48 hours. Candida species were identified by microbiological and molecular techniques. The antifungal effect of the honey sample on Candida was investigated by an agar dilution technique. Susceptibility of the Candida species to fluconazole was tested following a semi-modified microdilution method. Growth of both fluconazole-susceptible and -resistant Candida species was inhibited with a minimum fungicidal concentration (MFC) of 35–40% (v/v) honey. The MFC of different Candida species was not significantly different ( P > 0.05). From the total of 25 Candida isolates tested for susceptibility, 11 (44%), eight (32%) and six (24%) of the isolates were sensitive (minimum inhibitory concentrations [MICs] < 8 µg/mL), susceptible (dose-dependent: MICs 16–32 µg/mL) and resistant (MICs > 64 µg/mL) to fluconazole, respectively. Ethiopian multiflora honey has antifungal activity against fluconazole-resistant Candida species isolated from the oral cavity of AIDS patients. This supports the existing folkloric practice of using honey to treat oral lesions. Nevertheless, identification of the bioactive agents in honey, their clinical evaluation and pharmacological standardization are crucial.
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Affiliation(s)
- A Mulu
- Department of Microbiology and Parasitology
| | - E Diro
- Department of Internal Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar
| | - H Tekleselassie
- Department of Surgery, Facility of Medicine, Addis Ababa University, Addis Ababa
| | - Y Belyhun
- Department of Microbiology and Parasitology
| | - B Anagaw
- Department of Microbiology and Parasitology
| | | | - A Gelaw
- Department of Microbiology and Parasitology
| | | | | | - S Yifiru
- Department of Pediatrics and Child Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - M Tiruneh
- Department of Microbiology and Parasitology
| | - A Kassu
- Department of Microbiology and Parasitology
| | - T Nishikawa
- Hokkaido University of Education, Division of Medicine and Nursing, Sapporo
| | - E Isogai
- Department of Disease Control and Molecular Epidemiology, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
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Diro E, Feleke Y, Guteta S, Fekade D, Neway M. Assessment of risk behaviours and factors associated with oral and peri-oral lesions in adult HIV patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. ETHIOP J HEALTH DEV 2009. [DOI: 10.4314/ejhd.v22i2.10069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Diro E, Alemu S, Yohannes A. PP-067 Blood safety and prevalence of transfusion transmissible viral infections among donors at the Red Cross Blood Bank in Gondar. Int J Infect Dis 2008. [DOI: 10.1016/s1201-9712(09)60218-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Andualem B, Kassu A, Diro E, Moges F, Gedefaw M. The prevalence and antimicrobial responses of Shigella isolates in HIV-1 infected and uninfected adult diarrhoea patients in north west Ethiopia. ETHIOP J HEALTH DEV 2007. [DOI: 10.4314/ejhd.v20i2.10019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mengistu G, Diro E. Treatment outcome of severe malaria in adults with emphasis on neurological manifestations at Gondar University Hospital, north west Ethiopia. ETHIOP J HEALTH DEV 2007. [DOI: 10.4314/ejhd.v20i2.10020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kassu A, Yabutani T, Mahmud ZH, Mohammad A, Nguyen N, Huong BTM, Hailemariam G, Diro E, Ayele B, Wondmikun Y, Motonaka J, Ota F. Alterations in serum levels of trace elements in tuberculosis and HIV infections. Eur J Clin Nutr 2006; 60:580-6. [PMID: 16340948 DOI: 10.1038/sj.ejcn.1602352] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate serum concentrations of trace elements in tuberculosis (TB) patients with or with out human immunodeficiency virus (HIV) coinfection before and after anti-TB chemotherapy. SUBJECTS A total of 155 TB patients, 74 of which were coinfected with HIV, and 31 healthy controls from Gondar, Ethiopia. METHODS Serum levels of copper, zinc, selenium and iron were determined using an inductively coupled plasma mass spectrometer from all subjects at baseline and from 44 TB patients (22 with HIV coinfection) at the end of an intensive phase of anti-TB chemotherapy. RESULTS Compared with the control group, the concentrations of iron, zinc and selenium were significantly lower (P<0.05) while that of copper and copper/zinc ratio was significantly higher (P<0.05) in the serum of TB patients. TB patients with HIV coinfection had significantly lower serum zinc and selenium concentrations and significantly higher copper/zinc ratio compared to that in TB patients without HIV coinfection (P<0.05). The serum concentration of zinc had significantly increased at the end of intensive phase of anti-TB chemotherapy in patients without HIV coinfection (P<0.05). An increase in serum selenium level was observed in TB patients with or without HIV coinfection after therapy. On the contrary, serum copper concentration and copper/zinc ratio declined significantly after anti-TB chemotherapy irrespective of HIV serostatus (P<0.05). CONCLUSIONS The results indicate that TB patients have altered profile of trace elements in their sera. This warrants the need for further investigations so that strategies for trace elements supplementation can be planned in addition to their potential as diagnostic parameters in monitoring responses to anti-TB chemotherapy.
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Affiliation(s)
- A Kassu
- Department of Preventive Environment and Nutrition, Systems of Nutritional Sciences, Graduate School of Health Biosciences Research, The University of Tokushima, Tokushima, Japan
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Hailu A, Schoone GJ, Diro E, Tesfaye A, Techane Y, Tefera T, Assefa Y, Genetu A, Kebede Y, Kebede T, Schallig HDFH. Field evaluation of a fast anti-Leishmania antibody detection assay in Ethiopia. Trans R Soc Trop Med Hyg 2006; 100:48-52. [PMID: 16203020 DOI: 10.1016/j.trstmh.2005.07.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2005] [Revised: 07/01/2005] [Accepted: 07/06/2005] [Indexed: 10/25/2022] Open
Abstract
A fast agglutination screening test (FAST) for the detection of Leishmania antibodies in human serum samples was evaluated under harsh field conditions in northern Ethiopia. Test performance was compared with a standard serological test, namely the direct agglutination test (DAT), and with parasitology. In total, 103 suspected cases were recruited for the study. Based on parasitological examination, 49 patients were confirmed of having visceral leishmaniasis (VL) and the other 54 suspected cases were parasitologically negative. Field evaluation of FAST was possible in blood samples of 89 patients. FAST had 4 false negative results and 13 false positive results. DAT had 2 false negative results and 20 false positive results. A good degree of agreement (86.9%) was observed between FAST and DAT (kappa value 0.73). In this field-based evalauation, the sensitivity and specificity of FAST were found to be 91.1% (95% CI 77.9-97.1) and 70.5% (95% CI 54.6-82.8), respectively, compared with 95.3% (95% CI 82.9-99.2) and 62.3% (95% CI 47.9-74.9) for DAT. FAST had a high predictive value of a negative test, demonstrating that FAST could be utilised to exclude rapidly non-VL patients from a large population of suspects with fever and splenomegaly in endemic areas.
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Affiliation(s)
- A Hailu
- Institute for Pathobiology, Addis Ababa University, Jimma Road, Addis Ababa, Ethiopia
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