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Muturi M, Bitek A, Mwatondo A, Osoro E, Marwanga D, Gura Z, Ngere P, Nganga Z, Thumbi SM, Njenga K. Risk factors for human brucellosis among a pastoralist community in South-West Kenya, 2015. BMC Res Notes 2018; 11:865. [PMID: 30518420 PMCID: PMC6282298 DOI: 10.1186/s13104-018-3961-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 11/29/2018] [Indexed: 12/31/2022] Open
Abstract
Objective Brucellosis is one of the top five priority zoonosis in Kenya because of the socio-economic burden of the disease, especially among traditional, livestock keeping communities. We conducted a 1 year, hospital based, unmatched case–control study to determine risk factors for brucellosis among Maasai pastoralists of Kajiado County in 2016. A case was defined by a clinical criteria; fever or history of fever and two clinical signs suggestive of brucellosis and a positive competitive enzyme-linked immunosorbent assay test (c-ELISA). A control was defined as patients visiting the study facility with negative c-ELISA. Unconditional logistic regression was used to study association between exposure variables and brucellosis using odds ratios (OR) and 95% confidence intervals (CI). Results Forty-three cases and 86 controls were recruited from a population of 4792 individuals in 801 households. The mean age for the cases was 48.7 years while that of the controls was 37.6 years. The dominant gender for both cases (62.7%) and controls (58.1%) groups was female. Regular consumption of un-boiled raw milk and assisting animals in delivery were significantly associated with brucellosis by OR 7.7 (95% CI 1.5–40.1) and OR 3.7 (95% CI 1.1–13.5), respectively.
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Affiliation(s)
- Mathew Muturi
- Kenya Zoonotic Disease Unit-Ministry of Agriculture, Livestock and Fisheries and Ministry of Health, P.O. Box 20811-00202, Nairobi, Kenya.
| | - Austine Bitek
- Food and Agriculture Organization of the United Nations, Nairobi, Kenya
| | - Athman Mwatondo
- Kenya Zoonotic Disease Unit-Ministry of Agriculture, Livestock and Fisheries and Ministry of Health, P.O. Box 20811-00202, Nairobi, Kenya
| | - Eric Osoro
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, USA
| | | | - Zeinab Gura
- Kenya Field Epidemiology and Laboratory Training Program, Nairobi, Kenya
| | | | - Zipporah Nganga
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - S M Thumbi
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, USA.,Kenya Field Epidemiology and Laboratory Training Program, Nairobi, Kenya
| | - Kariuki Njenga
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, USA
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Oluoch P, Orwa J, Lugalia F, Mutinda D, Gichangi A, Oundo J, Karama M, Nganga Z, Galbraith J. Application of psychosocial models to Home-Based Testing and Counseling (HBTC) for increased uptake and household coverage in a large informal urban settlement in Kenya. Pan Afr Med J 2017; 27:285. [PMID: 29187954 PMCID: PMC5660906 DOI: 10.11604/pamj.2017.27.285.10104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 08/04/2017] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Home Based Testing and Counselling (HBTC) aims at reaching individuals who have low HIV risk perception and experience barriers which prevent them from seeking HIV testing and counseling (HTC) services. Saturating the community with HTC is needed to achieve the ambitious 90-90-90 targets of knowledge of HIV status, ARV treatment and viral suppression. This paper describes the use of health belief model and community participation principles in HBTC to achieve increased household coverage and HTC uptake. METHODS This cross sectional survey was done between August 2009 and April 2011 in Kibera slums, Nairobi city. Using three community participation principles; defining and mobilizing the community, involving the community, overcoming barriers and respect to cultural differences and four constructs of the health belief model; risk perception, perceived severity, perceived benefits of changed behavior and perceived barriers; we offered HTC services to the participants. Descriptive statistics were used to describe socio-demographic characteristics, calculate uptake and HIV prevalence. RESULTS There were 72,577 individuals enumerated at the start of the program; 75,141 residents were found during service delivery. Of those, 71,925 (95.7%) consented to participate, out of which 71,720 (99.7%) took the HIV test. First time testers were (39%). The HIV prevalence was higher (6.4%) among repeat testers than first time testers (4.0%) with more women (7.4%) testing positive than men (3.6%) and an overall 5.5% slum prevalence. CONCLUSION This methodology demonstrates that the use of community participation principles combined with a psychosocial model achieved high HTC uptake, coverage and diagnosed HIV in individuals who believed they are HIV free. This novel approach provides baseline for measuring HTC coverage in a community.
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Affiliation(s)
- Patricia Oluoch
- Division of Global HIV/AIDS and Tuberculosis (DGHT), Centers for Disease Control and Prevention (CDC), Nairobi, Kenya
| | - James Orwa
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Fillet Lugalia
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - David Mutinda
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Anthony Gichangi
- Division of Global HIV/AIDS and Tuberculosis (DGHT), Centers for Disease Control and Prevention (CDC), Nairobi, Kenya
| | - Joseph Oundo
- United States Army Medical Research Unit (USAMRU) Kericho, Kenya
| | - Mohamed Karama
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Zipporah Nganga
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Jennifer Galbraith
- Division of Global HIV/AIDS and Tuberculosis (DGHT), Centers for Disease Control and Prevention (CDC), Nairobi, Kenya
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Mwangi J, Nganga Z, Mpoke S, Lihana R, Kinyua J, Lagat N, Muriuki J, Lel R, Kageha S, Osman S, Ichimura H. Hepatitis C virus genotypes in Kenya. Arch Virol 2015; 161:95-101. [PMID: 26497178 DOI: 10.1007/s00705-015-2623-8] [Citation(s) in RCA: 6] [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] [Received: 11/14/2013] [Accepted: 09/21/2015] [Indexed: 12/25/2022]
Abstract
Hepatitis C virus is a great public-health concern worldwide. Phylogenetic analysis of the HCV genome has identified six different genotypes that have generally been divided into several subtypes. There is very little information on HCV seroprevalence and genotypes in Kenya. To determine the genotypes of HCV circulating in Kenya, blood donor samples were serologically tested and confirmed by polymerase chain reaction (PCR). Positive samples were cloned and sequenced, and phylogenetic analysis conducted to determine the HCV genotypes. One hundred Murex-seropositive samples were re-tested using a passive hemagglutination test, and 16 of these were identified as seropositive. Further testing of all of the samples by PCR identified only 10 of the 16 samples as positive. Thus, only 10 % (10/100) of the samples were viremic. Six were from females (60 %), and four were from males (40 %). The mean age of the positive donors was considerably low, at 25 +/- 9 years. Genotypic testing indicated the presence of genotype 1a (10 %) and genotype 2b (90 %). This study reports on HCV genotypes in a blood donor population in Kenya where little had been done to provide information on HCV genotypes.
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Affiliation(s)
- Joseph Mwangi
- Center for Virus Research, Kenya Medical Research Institute, P.O. Box 54628, Nairobi, Kenya. .,Institute of Tropical Medicine and Infectious Disease, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
| | - Zipporah Nganga
- Institute of Tropical Medicine and Infectious Disease, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | | | - Raphael Lihana
- Center for Virus Research, Kenya Medical Research Institute, P.O. Box 54628, Nairobi, Kenya
| | - Joyceline Kinyua
- Center for Virus Research, Kenya Medical Research Institute, P.O. Box 54628, Nairobi, Kenya
| | - Nancy Lagat
- Center for Virus Research, Kenya Medical Research Institute, P.O. Box 54628, Nairobi, Kenya
| | - Joseph Muriuki
- Center for Virus Research, Kenya Medical Research Institute, P.O. Box 54628, Nairobi, Kenya
| | - Rency Lel
- Center for Virus Research, Kenya Medical Research Institute, P.O. Box 54628, Nairobi, Kenya
| | - Sheila Kageha
- Center for Virus Research, Kenya Medical Research Institute, P.O. Box 54628, Nairobi, Kenya
| | - Saida Osman
- Center for Virus Research, Kenya Medical Research Institute, P.O. Box 54628, Nairobi, Kenya
| | - Hiroshi Ichimura
- Department of Viral Infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
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Ndegwa LK, Katz MA, McCormick K, Nganga Z, Mungai A, Emukule G, Kollmann MKHM, Mayieka L, Otieno J, Breiman RF, Mott JA, Ellingson K. Surveillance for respiratory health care-associated infections among inpatients in 3 Kenyan hospitals, 2010-2012. Am J Infect Control 2014; 42:985-90. [PMID: 25179331 DOI: 10.1016/j.ajic.2014.05.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 05/23/2014] [Accepted: 05/23/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Although health care-associated infections are an important cause of morbidity and mortality worldwide, the epidemiology and etiology of respiratory health care-associated infections (rHAIs) have not been documented in Kenya. In 2010, the Ministry of Health, Kenya Medical Research Institute, and Centers for Disease Control and Prevention initiated surveillance for rHAIs at 3 hospitals. METHODS At each hospital, we surveyed intensive care units (ICUs), pediatric wards, and medical wards to identify patients with rHAIs, defined as any hospital-onset (≥3 days after admission) fever (≥38°C) or hypothermia (<35°C) with concurrent signs or symptoms of acute respiratory infection. Nasopharyngeal and oropharyngeal specimens were collected from these patients and tested by real-time reverse transcription polymerase chain reaction for influenza and 7 other viruses. RESULTS From April 2010-September 2012, of the 379 rHAI cases, 60.7% were men and 57.3% were children <18 years old. The overall incidence of rHAIs was 9.2 per 10,000 patient days, with the highest incidence in the ICUs. Of all specimens analyzed, 45.7% had at least 1 respiratory virus detected; 92.2% of all positive viral specimens were identified in patients <18 years old. CONCLUSION We identified rHAIs in all ward types under surveillance in Kenyan hospitals. Viruses may have a substantial role in these infections, particularly among pediatric populations. Further research is needed to refine case definitions and understand rHAIs in ICUs.
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Affiliation(s)
- Linus K Ndegwa
- Centers for Disease Control and Prevention-Nairobi, Kenya; Jomo Kenyatta University, Nairobi, Kenya.
| | - Mark A Katz
- Centers for Disease Control and Prevention-Nairobi, Kenya
| | - Kelly McCormick
- Centers for Disease Control and Prevention-Atlanta, Atlanta, GA
| | - Z Nganga
- Centers for Disease Control and Prevention-Atlanta, Atlanta, GA
| | - Ann Mungai
- Kenyatta National Hospital, Nairobi, Kenya
| | - Gideon Emukule
- Centers for Disease Control and Prevention-Nairobi, Kenya
| | | | - Lilian Mayieka
- Diagnostics and Laboratory Systems Program, Kenya Medical Research Institute/Centers for Disease Control, Kisumu, Kenya
| | - J Otieno
- Kenya Ministry of Medical Services, Nairobi, Kenya; New Nyanza Provincial Hospital, Nairobi, Kenya
| | | | - Joshua A Mott
- Centers for Disease Control and Prevention-Nairobi, Kenya
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Nyamache AK, Muigai AW, Nganga Z, Khamadi SA. HIV Type 1 genetic diversity and naturally occurring polymorphisms in HIV type 1 Kenyan isolates: implications for integrase inhibitors. AIDS Res Hum Retroviruses 2012; 28:933-6. [PMID: 21919802 DOI: 10.1089/aid.2011.0122] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Little is known about the extent and predictors of polymorphisms potentially influencing susceptibility to HIV integrase inhibitors. HIV-1 genetic diversity and drug resistance are major challenges in patient management globally. To evaluate HIV genetic diversity and drug resistance-associated mutations within a Nairobi cohort, genetic analysis of the HIV-1 pol-integrase gene regions was performed on samples collected from 42 subjects and 113 Kenyan intergrase sequences deposited in the Los Alamos HIV database. From the partial pol-integrase sequences analyzed phylogenetically, it was shown that 26 (61.9%) were subtype A1, 9 (21.4%) were subtype D, 5 (11.9%) were subtype C, 1 (2.4%) was subtype A2 and 1 (2.4%) was subtype CRF. Integrase-associated mutations were found in 12 patients, and in all 113 sequences already deposited in GenBank. One sample from this study and five from previous Kenyan integrase sequences had mutations at T97A, which is associated with reduced susceptibility to raltegravir.
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Affiliation(s)
- Anthony Kebira Nyamache
- Department of Plant and Microbial Sciences, Kenyatta University, Nairobi, Kenya
- Department of Medical Laboratory Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Anne W.T. Muigai
- Department of Medical Laboratory Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Zipporah Nganga
- Department of Medical Laboratory Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Samoel A. Khamadi
- Kenya Medical Research Institute, Centre for Virus Research, Nairobi, Kenya
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Mwangi J, Nganga Z, Lihana R, Lagat N, Kinyua J, Muriuki J, Maiyo A, Kinyua F, Okoth F, Mpoke S. Switch from 200 to 350 CD4 baseline count: what it means to HIV care and treatment programs in Kenya. Pan Afr Med J 2012; 12:80. [PMID: 23077701 PMCID: PMC3473966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Accepted: 06/06/2012] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION With the increasing population of infected individuals in Africa and constrained resources for care and treatment, antiretroviral management continues to be an important public health challenge. Since the announcement of World Health Organization recommendation and guidelines for initiation of antiretroviral Treatment at CD4 count below 350, many developing countries are adopting this strategy in their country specific guidelines to care and treatment of HIV and AIDS. Despite the benefits to these recommendations, what does this switch from 200 to 350 CD4 count mean in antiretroviral treatment demand? METHODS A Multi-centre study involving 1376 patients in health care settings in Kenya. CD4 count was carried out by flow cytometry among the HIV infected individuals in Kenya and results analyzed in view of the In-country and the new CD4 recommendation for initiation of antiretroviral treatment. RESULTS Across sites, 32% of the individual required antiretroviral at <200 CD4 Baseline, 40% at <250 baseline count and 58% based on the new criteria of <350 CD4 Count. There were more female (68%) than Male (32%).Different from <200 and <250 CD4 baseline criteria, over 50% of all age groups required antiretroviral at 350 CD4 baseline. Age groups between 41-62 led in demand for ART. CONCLUSION With the new guidelines, demand for ARVs has more than doubled with variations noted within regions and age groups. As A result, HIV Care and Treatment Programs should prepare for this expansion for the benefits to be realized.
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Affiliation(s)
- Joseph Mwangi
- Centre for Virus Research (CVR), Kenya Medical research Institute (KEMRI), Nairobi Kenya,Institute of Tropical Medicine and Infectious Diseases (ITROMID), Jomo Kenyatta University of Agriculture and Technology (JKUAT),Corresponding author: Joseph Mwangi, Centre for Virus Research (CVR), Kenya Medical Research Institute, PO BOX 54628-00200, Nairobi, Kenya
| | - Zipporah Nganga
- Institute of Tropical Medicine and Infectious Diseases (ITROMID), Jomo Kenyatta University of Agriculture and Technology (JKUAT)
| | - Raphael Lihana
- Centre for Virus Research (CVR), Kenya Medical research Institute (KEMRI), Nairobi Kenya,Department of Viral Infections and International Health, Graduate school OF Medical Sciences, Kanazawa University, Japan
| | - Nancy Lagat
- Centre for Virus Research (CVR), Kenya Medical research Institute (KEMRI), Nairobi Kenya
| | - Joyceline Kinyua
- Centre for Virus Research (CVR), Kenya Medical research Institute (KEMRI), Nairobi Kenya
| | - Joseph Muriuki
- Centre for Virus Research (CVR), Kenya Medical research Institute (KEMRI), Nairobi Kenya
| | - Alex Maiyo
- Centre for Virus Research (CVR), Kenya Medical research Institute (KEMRI), Nairobi Kenya
| | - Florence Kinyua
- Institute of Tropical Medicine and Infectious Diseases (ITROMID), Jomo Kenyatta University of Agriculture and Technology (JKUAT)
| | - Fredrick Okoth
- Centre for Virus Research (CVR), Kenya Medical research Institute (KEMRI), Nairobi Kenya
| | - Solomon Mpoke
- Kenya Medical Research Institute, Nairobi Kenya (KEMRI)
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Nderitu L, Lee JS, Omolo J, Omulo S, O'Guinn ML, Hightower A, Mosha F, Mohamed M, Munyua P, Nganga Z, Hiett K, Seal B, Feikin DR, Breiman RF, Njenga MK. Sequential Rift Valley fever outbreaks in eastern Africa caused by multiple lineages of the virus. J Infect Dis 2010; 203:655-65. [PMID: 21282193 DOI: 10.1093/infdis/jiq004] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND During the Rift Valley fever (RVF) epidemic of 2006-2007 in eastern Africa, spatial mapping of the outbreaks across Kenya, Somalia, and Tanzania was performed and the RVF viruses were isolated and genetically characterized. METHODS Following confirmation of the RVF epidemic in Kenya on 19 December 2006 and in Tanzania on 2 February 2007, teams were sent to the field for case finding. Human, livestock, and mosquito specimens were collected and viruses isolated. The World Health Organization response team in Kenya worked with the WHO's polio surveillance team inside Somalia to collect information and specimens from Somalia. RESULTS Seven geographical foci that reported hundreds of livestock and >25 cases in humans between December 2006 and June 2007 were identified. The onset of RVF cases in each epidemic focus was preceded by heavy rainfall and flooding for at least 10 days. Full-length genome analysis of 16 RVF virus isolates recovered from humans, livestock, and mosquitoes in 5 of the 7 outbreak foci revealed 3 distinct lineages of the viruses within and across outbreak foci. CONCLUSION The findings indicate that the sequential RVF epidemics in the region were caused by multiple lineages of the RVF virus, sometimes independently activated or introduced in distinct outbreak foci.
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Affiliation(s)
- Leonard Nderitu
- Global Disease Detection Division, United States Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya
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Mwangi J, Nganga Z, Songok E, Kinyua J, Lagat N, Muriuki J, Lihana R, Khamadi S, Osman S, Lwembe R, Kiptoo M, Mwau M, Chirchir R, Mpoke S, Nyamongo J, Okoth F, Yamada R, Kageyama S, Ichimura H. Molecular genetic diversity of hepatitis B virus in Kenya. Intervirology 2009; 51:417-21. [PMID: 19258721 DOI: 10.1159/000205526] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2008] [Accepted: 01/19/2009] [Indexed: 11/19/2022] Open
Abstract
Eight genotypes of hepatitis B virus (A-H) and subgenotypes have been recognized worldwide. However, there is limited information on prevalent genotypes in many countries in Africa. This study was undertaken to determine the hepatitis B virus (HBV) genotypes in Kenya. Seropositive HBV blood samples from a blood donor setting were used in the study. HBV genotypes were determined in 52 nucleic acid-positive samples using specific primer in a nested PCR and sequencing employed in the HBV genotyping. This study shows presence of HBV variants with genotypes A (88%), E (8%) and D (4%). In conclusion, we found that HBV genotype A is the most predominant genotype in Kenya with both subgenotype A1 and A2 present. Genotype D and E are also present in our population. This demonstrates that there could be a high genetic diversity of HBV in Kenya.
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Affiliation(s)
- Joseph Mwangi
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya.
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Nganga Z. Prevalence of Concomitant Infections of Plasmodium falciparum and Wuchereria bancrofti in Mosquito and Human Populations in Malindi, Kenya. Int J Infect Dis 2008. [DOI: 10.1016/j.ijid.2008.05.844] [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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