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Huddart S, Yadav V, Sieberts SK, Omberg L, Raberahona M, Rakotoarivelo R, Lyimo IN, Lweno O, Christopher DJ, Nhung NV, Theron G, Worodria W, Yu CY, Bachman CM, Burkot S, Dewan P, Kulhare S, Small PM, Cattamanchi A, Jaganath D, Lapierre SG. Solicited Cough Sound Analysis for Tuberculosis Triage Testing: The CODA TB DREAM Challenge Dataset. medRxiv 2024:2024.03.27.24304980. [PMID: 38585855 PMCID: PMC10996751 DOI: 10.1101/2024.03.27.24304980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Cough is a common and commonly ignored symptom of lung disease. Cough is often perceived as difficult to quantify, frequently self-limiting, and non-specific. However, cough has a central role in the clinical detection of many lung diseases including tuberculosis (TB), which remains the leading infectious disease killer worldwide. TB screening currently relies on self-reported cough which fails to meet the World Health Organization (WHO) accuracy targets for a TB triage test. Artificial intelligence (AI) models based on cough sound have been developed for several respiratory conditions, with limited work being done in TB. To support the development of an accurate, point-of-care cough-based triage tool for TB, we have compiled a large multi-country database of cough sounds from individuals being evaluated for TB. The dataset includes more than 700,000 cough sounds from 2,143 individuals with detailed demographic, clinical and microbiologic diagnostic information. We aim to empower researchers in the development of cough sound analysis models to improve TB diagnosis, where innovative approaches are critically needed to end this long-standing pandemic.
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Affiliation(s)
- Sophie Huddart
- University of California San Francisco, School of Medicine, 533 Parnassus Ave, San Francisco, CA 94143 USA
| | | | | | - Larson Omberg
- Sage Bionetworks, Seattle, WA 98103 USA
- Curently at Koneksa Health, One World Trade Center 285 Fulton St. 77th Floor New York, NY, 10007
| | - Mihaja Raberahona
- CHU Joseph Rasera Befelatanana, Antananarivo, 101, Analamanga, Madagascar
- Centre d’Infectiologie Charles Mérieux, Antananarivo, 101, Analamanga, Madagascar
| | - Rivo Rakotoarivelo
- CHU Tambohobe Fianarantsoa, 301, Haute-Matsiatra, Madagascar
- Université de Fianarantsoa, Fianarantsoa, 301, Haute-Matsiatra, Madagascar
| | - Issa N. Lyimo
- Ifakara Health Institute, Environmental and Ecological Sciences & Interventions and Clinical Trials Departments, Kiko Avenue, Plot 463, Mikocheni, Dar es Salaam, Tanzania
| | - Omar Lweno
- Ifakara Health Institute, Environmental and Ecological Sciences & Interventions and Clinical Trials Departments, Kiko Avenue, Plot 463, Mikocheni, Dar es Salaam, Tanzania
| | | | - Nguyen Viet Nhung
- National Tuberculosis Programme, 463 Hoang Hoa Tham, Ba Dinh District, Hanoi, Vietnam
| | - Grant Theron
- Stellenbosch University, Division of Molecular Biology and Human Genetics, Matieland, 7602 South Africa
| | | | - Charles Y. Yu
- De La Salle Medical and Health Sciences Institute, Governor D. Mangubat Avenue, Dasmarinas Cavite, Philippines 4114
| | | | - Stephen Burkot
- Global Health Labs, 14360 SE Eastgate Way, Bellevue, WA 98007 USA
| | - Puneet Dewan
- Global Health Labs, 14360 SE Eastgate Way, Bellevue, WA 98007 USA
| | - Sourabh Kulhare
- Global Health Labs, 14360 SE Eastgate Way, Bellevue, WA 98007 USA
| | - Peter M Small
- Global Health Labs, 14360 SE Eastgate Way, Bellevue, WA 98007 USA
| | - Adithya Cattamanchi
- University of California Irvine, School of Medicine, 333 City Blvd. W Suite 400, Orange CA 92868 USA
| | - Devan Jaganath
- University of California Irvine, School of Medicine, 333 City Blvd. W Suite 400, Orange CA 92868 USA
| | - Simon Grandjean Lapierre
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Immunopathology Axis, 900 St-Denis, Montréal, Québec, H2X 0A9 Canada
- Université de Montréal, Department of Microbiology, Infectious Diseases and Immunology, 2900 Edouard-Montpetit, Montréal, Québec, H3T 1J4 Canada
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Kassimu K, Milando F, Omolo J, Mdemu A, Nyaulingo G, Mbarak H, Mohamed L, Rashid R, Ahmed S, Rashid M, Msami H, Damiano D, Simon B, Mbaga T, Issa F, Lweno O, Balige N, Hassan O, Mwalimu B, Hamad A, Olotu A, Mårtensson A, Machumi F, Jongo S, Ngasala B, Abdulla S. Safety and Tolerability of an Antimalarial Herbal Remedy in Healthy Volunteers: An Open-Label, Single-Arm, Dose-Escalation Study on Maytenus senegalensis in Tanzania. Trop Med Infect Dis 2022; 7:tropicalmed7120396. [PMID: 36548651 PMCID: PMC9787516 DOI: 10.3390/tropicalmed7120396] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/15/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Though Maytenus senegalensis is one of the medicinal plants widely used in traditional medicine to treat infectious and inflammatory diseases in Africa, there is a lack of safety data regarding its use. Therefore, the study aimed to asselss the safety and tolerability of the antimalarial herbal remedy M. senegalensis. MATERIAL AND METHODS The study design was an open-label, single-arm, dose-escalation. Twelve eligible male healthy Tanzanians aged 18 to 45 years were enrolled in four study dose groups. Volunteers' safety and tolerability post-investigational-product administration were monitored on days 0 to 7,14, and 56. RESULTS There were no deaths or serious adverse events in any of the study groups, nor any adverse events that resulted in premature discontinuation. The significant mean changes observed in WBC (p = 0.003), Neutrophils (p = 0.02), Lymphocytes (p = 0.001), Eosinophils (p = 0.009), Alanine aminotransferase (p = 0.002), Creatinine (p = 0.03) and Total bilirubin (p = 0.004) laboratory parameters were not associated with any signs of toxicity or clinical symptoms. CONCLUSIONS M. senegalensis was demonstrated to be safe and tolerable when administered at a dose of 800 mg every eight hours a day for four days. This study design may be adapted to evaluate other herbal remedies.
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Affiliation(s)
- Kamaka Kassimu
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
- Correspondence: or ; Tel.: +255-713-488-238
| | - Florence Milando
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Justin Omolo
- Department of Traditional Medicine, National Institute for Medical Research, Dar es Salaam P.O. Box 9653, Tanzania
| | - Abel Mdemu
- Department of Traditional Medicine, National Institute for Medical Research, Dar es Salaam P.O. Box 9653, Tanzania
| | - Gloria Nyaulingo
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Hussein Mbarak
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Latipha Mohamed
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Ramla Rashid
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Saumu Ahmed
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Mohammed Rashid
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Hania Msami
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - David Damiano
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Beatus Simon
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Thabit Mbaga
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Fatuma Issa
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Omar Lweno
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Neema Balige
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Omary Hassan
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Bakari Mwalimu
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Ali Hamad
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Ally Olotu
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Andreas Mårtensson
- Department of Women’s and Children’s Health, International Maternal and Child Health (IMCH), Uppsala University, S-751 85 Uppsala, Sweden
| | - Francis Machumi
- Institute of Traditional Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
| | - Said Jongo
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Billy Ngasala
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
- Department of Women’s and Children’s Health, International Maternal and Child Health (IMCH), Uppsala University, S-751 85 Uppsala, Sweden
| | - Salim Abdulla
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
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Kassimu KR, Milando FA, Omolo JJ, Nyaulingo G, Mbarak H, Mohamed L, Rashid R, Ahmed S, Rashid M, Abdallah G, Mbaga T, Issa F, Lweno O, Balige N, Mwalimu B, Hamad A, Olotu A, Jongo S, Ngasala B, Abdulla S. Motivations and barriers for healthy participants to participate in herbal remedy clinical trial in Tanzania: A qualitative study based on the theory of planned behaviour. PLoS One 2022; 17:e0271828. [PMID: 35862395 PMCID: PMC9302811 DOI: 10.1371/journal.pone.0271828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 07/07/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The success of any randomized clinical trial relies on the willingness of people to be recruited in the trial. However, 90% of all clinical trials worldwide have been reported to have failed to recruit the required number of trial participants within the scheduled time. This study aimed to qualitatively explore the motivations and barriers for healthy participants to participate in herbal remedy clinical trials in Tanzania. MATERIALS AND METHODS This study used a qualitative descriptive research design based on the theory of planned behaviour. A total of five Focus Group Discussions (FGD) were conducted at Bagamoyo Clinical Trial Facility from 29 to 30 May 2021. Each group consisted of 5 to 10 participants. The participants of the study were 30 healthy males aged 18 to 45 male who participated in the clinical trial that evaluated the safety, tolerability, and efficacy of Maytenus Senegalensis. The focus group discussions were recorded audio-recorded. Verbatim transcription and thematic analysis were performed on the data. RESULTS The prominent motivations mentioned were the opportunity for self-development, altruism, flexible study visit schedule, and financial compensation. Furthermore, the Participants' mothers and friends were reported as those most likely to approve of participation in an herbal remedy. The most mentioned barriers were inconvenience related to time commitment requirements, possible side effects, inflexible study visit schedule, and having other commitments. Moreover, the participants' father was reported to be more likely to disapprove of participation in a clinical trial of herbal remedy clinical trial. CONCLUSIONS The results of this study showed that the motivations and barriers of healthy participants to participate in clinical trials of herbal remedies are varied and that participants are motivated by more than financial gains. The identified motivations and barriers can be used as a guideline to improve the design of recruitment and retention strategies for herbal remedy clinical trials.
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Affiliation(s)
- Kamaka R. Kassimu
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
- Department of Parasitology, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania
| | - Florence A. Milando
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Justin J. Omolo
- Department of traditional medicine, National Institute for Medical Research, Dar es salaam, Tanzania
| | - Gloria Nyaulingo
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Hussein Mbarak
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Latipha Mohamed
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Ramla Rashid
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Saumu Ahmed
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Mohammed Rashid
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Gumi Abdallah
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Thabit Mbaga
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Fatuma Issa
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Omar Lweno
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Neema Balige
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Bakari Mwalimu
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Ali Hamad
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Ally Olotu
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Said Jongo
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Billy Ngasala
- Department of Parasitology, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania
| | - Salim Abdulla
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
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Lweno O, Hertzmark E, Darling AM, Noor R, Bakari L, Sudfeld C, Manji K, Fawzi W. The High Burden and Predictors of Anemia Among Infants Aged 6 to 12 Months in Dar es Salaam, Tanzania. Food Nutr Bull 2021; 43:68-83. [PMID: 34615387 DOI: 10.1177/03795721211007009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite several interventions, the prevalence of anemia and related complications remains high among infants in Tanzania. OBJECTIVE We sought to determine the predictors of iron-deficiency anemia (IDA) among infants of HIV-negative women in Dar es Salaam, Tanzania. METHODS Cross-sectional analysis of 2826 mother-infant pairs who participated in a trial of vitamins and perinatal outcomes in Dar es Salaam, Tanzania. Hemoglobin and mean corpuscular volume were used to determine the prevalence of anemia among infants at 6 and 12 months. Multiple logistic regression was used to determine the maternal and infant risk factors for anemia during infancy. RESULTS We found high prevalence of anemia (90%) and IDA (44.2%) among infants. Higher maternal education (odds ratio [OR] = 0.52), maternal normal hemoglobin at enrollment (OR = 0.68) and during the early postpartum period reduced the odds of IDA at 6 months (OR = 0.56). The odds of IDA at 6 months were higher among males (OR = 1.65), wealth score below median (OR = 1.35), low birth weight (LBW; OR = 1.75), and small for gestational age (SGA) infants below the third centile (OR = 1.95) or third to less than fifth centile (OR = 2.29). Higher maternal education lowered the odds of IDA at 12 months (OR = 0.25). Wealth score below median (OR = 1.44), preterm delivery (OR = 1.94), SGA (less than third centile; OR = 2.40), and LBW (OR = 2.89) increased the odds of IDA during infancy in the study population. Dietary diversity was low for infants and women in the study sample. CONCLUSION Interventions to reduce the risk of infant IDA should address women's education, improvement of wealth status, and optimal care for premature, SGA, and LBW infants.
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Affiliation(s)
- Omar Lweno
- Ifakara Health Institute, Bagamoyo Research and Training Center, Bagamoyo, Tanzania
| | - Ellen Hertzmark
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Anne Marie Darling
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ramadhani Noor
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Leguma Bakari
- Ifakara Health Institute, Bagamoyo Research and Training Center, Bagamoyo, Tanzania
| | - Christopher Sudfeld
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Karim Manji
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Wafaie Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Salim N, Knopp S, Lweno O, Abdul U, Mohamed A, Schindler T, Rothen J, Masimba J, Kwaba D, Mohammed AS, Althaus F, Abdulla S, Tanner M, Daubenberger C, Genton B. Distribution and risk factors for Plasmodium and helminth co-infections: a cross-sectional survey among children in Bagamoyo district, coastal region of Tanzania. PLoS Negl Trop Dis 2015; 9:e0003660. [PMID: 25837022 PMCID: PMC4383605 DOI: 10.1371/journal.pntd.0003660] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 02/28/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Plasmodium and soil transmitted helminth infections (STH) are a major public health problem, particularly among children. There are conflicting findings on potential association between these two parasites. This study investigated the Plasmodium and helminth co-infections among children aged 2 months to 9 years living in Bagamoyo district, coastal region of Tanzania. METHODS A community-based cross-sectional survey was conducted among 1033 children. Stool, urine and blood samples were examined using a broad set of quality controlled diagnostic methods for common STH (Ascaris lumbricoides, hookworm, Strongyloides stercoralis, Enterobius vermicularis, Trichuris trichura), schistosoma species and Wuchereria bancrofti. Blood slides and malaria rapid diagnostic tests (mRDTs) were utilized for Plasmodium diagnosis. RESULTS Out of 992 children analyzed, the prevalence of Plasmodium infection was 13% (130/992), helminth 28.5% (283/992); 5% (50/992) had co-infection with Plasmodium and helminth. The prevalence rate of Plasmodium, specific STH and co-infections increased significantly with age (p < 0.001), with older children mostly affected except for S. stercoralis monoinfection and co-infections. Spatial variations of co-infection prevalence were observed between and within villages. There was a trend for STH infections to be associated with Plasmodium infection [OR adjusted for age group 1.4, 95% CI (1.0-2.1)], which was more marked for S. stercoralis (OR = 2.2, 95% CI (1.1-4.3). Age and not schooling were risk factors for Plasmodium and STH co-infection. CONCLUSION The findings suggest that STH and Plasmodium infections tend to occur in the same children, with increasing prevalence of co-infection with age. This calls for an integrated approach such as using mass chemotherapy with dual effect (e.g., ivermectin) coupled with improved housing, sanitation and hygiene for the control of both parasitic infections.
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Affiliation(s)
- Nahya Salim
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
- Department of Pediatrics and Child Health, Muhimbili University Health and Allied Sciences (MUHAS), Dar es Salaam, United Republic of Tanzania
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail: (NS)
| | - Stefanie Knopp
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, Natural History Museum, London, United Kingdom
| | - Omar Lweno
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
| | - Ummi Abdul
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
| | - Ali Mohamed
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
| | - Tobias Schindler
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
- University of Basel, Basel, Switzerland
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Julian Rothen
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
- University of Basel, Basel, Switzerland
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - John Masimba
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
| | - Denis Kwaba
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
| | - Alisa S. Mohammed
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
| | - Fabrice Althaus
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Salim Abdulla
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
| | - Marcel Tanner
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Claudia Daubenberger
- University of Basel, Basel, Switzerland
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Blaise Genton
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of Ambulatory Care and Community Medicine, Infectious Disease Service, Lausanne University Hospital, Lausanne, Switzerland
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Mwakasungula S, Schindler T, Jongo S, Moreno E, Kamaka K, Mohammed M, Joseph S, Rashid R, Athuman T, Tumbo AM, Hamad A, Lweno O, Tanner M, Shekalaghe S, Daubenberger CA. Red blood cell indices and prevalence of hemoglobinopathies and glucose 6 phosphate dehydrogenase deficiencies in male Tanzanian residents of Dar es Salaam. Int J Mol Epidemiol Genet 2014; 5:185-194. [PMID: 25755846 PMCID: PMC4348704] [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] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 11/12/2014] [Indexed: 06/04/2023]
Abstract
Hemoglobinopathies, disorders of hemoglobin structure and production, are one of the most common monogenic disorders in humans. Glucose 6 phosphate dehydrogenase deficiency (G6PD) is an inherited enzymopathy resulting in increased oxygen stress susceptibility of red blood cells. The distributions of these genetic traits in populations living in tropical and subtropical regions where malaria has been or is still present are thought to result from survival advantage against severe life threatening malaria disease. 384 male Tanzanian volunteers residing in Dar es Salaam were typed for G6PD, sickle cell disease and α-thalassemia. The most prominent red blood cell polymorphism was heterozygous α(+)-thalassemia (37.8%), followed by the G6PD(A) deficiency (16.4%), heterozygous sickle cell trait (15.9%), G6PD(A-) deficiency (13.5%) and homozygous α(+)-thalassemia (5.2%). 35%, 45%, 17% and 3% of these volunteers were carriers of wild type gene loci, one, two or three of these hemoglobinopathies, respectively. We find that using a cut off value of 28.6 pg. for mean corpuscular hemoglobin (MCH), heterozygous α(+)-thalassemia can be predicted with a sensitivity of 84% and specificity of 72% in this male population. All subjects carrying homozygous α(+)-thalassemia were identified based on their MCH value < 28.6 pg.
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Affiliation(s)
- Solomon Mwakasungula
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health InstituteSocinstrasse 57, 4002 Basel, Switzerland
- University of BaselBasel, Petersplatz 1, CH-4003 Basel, Switzerland
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Tobias Schindler
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health InstituteSocinstrasse 57, 4002 Basel, Switzerland
- University of BaselBasel, Petersplatz 1, CH-4003 Basel, Switzerland
| | - Said Jongo
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Elena Moreno
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Kasimu Kamaka
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Mgeni Mohammed
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Selina Joseph
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Ramla Rashid
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Thabit Athuman
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Anneth Mwasi Tumbo
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Ali Hamad
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Omar Lweno
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Marcel Tanner
- University of BaselBasel, Petersplatz 1, CH-4003 Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health InstituteSocinstrasse 57, 4002 Basel, Switzerland
| | - Seif Shekalaghe
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Claudia A Daubenberger
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health InstituteSocinstrasse 57, 4002 Basel, Switzerland
- University of BaselBasel, Petersplatz 1, CH-4003 Basel, Switzerland
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Salim N, Schindler T, Abdul U, Rothen J, Genton B, Lweno O, Mohammed AS, Masimba J, Kwaba D, Abdulla S, Tanner M, Daubenberger C, Knopp S. Enterobiasis and strongyloidiasis and associated co-infections and morbidity markers in infants, preschool- and school-aged children from rural coastal Tanzania: a cross-sectional study. BMC Infect Dis 2014; 14:644. [PMID: 25486986 PMCID: PMC4271451 DOI: 10.1186/s12879-014-0644-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 11/20/2014] [Indexed: 11/24/2022] Open
Abstract
Background There is a paucity of data pertaining to the epidemiology and public health impact of Enterobius vermicularis and Strongyloides stercoralis infections. We aimed to determine the extent of enterobiasis, strongyloidiasis, and other helminth infections and their association with asymptomatic Plasmodium parasitaemia, anaemia, nutritional status, and blood cell counts in infants, preschool-aged (PSAC), and school-aged children (SAC) from rural coastal Tanzania. Methods A total of 1,033 children were included in a cross-sectional study implemented in the Bagamoyo district in 2011/2012. Faecal samples were examined for intestinal helminth infections using a broad set of quality controlled methods. Finger-prick blood samples were subjected to filariasis and Plasmodium parasitaemia testing and full blood cell count examination. Weight, length/height, and/or mid-upper arm circumference were measured and the nutritional status determined in accordance with age. Results E. vermicularis infections were found in 4.2% of infants, 16.7%, of PSAC, and 26.3% of SAC. S. stercoralis infections were detected in 5.8%, 7.5%, and 7.1% of infants, PSAC, and SAC, respectively. Multivariable regression analyses revealed higher odds of enterobiasis in children of all age-groups with a reported anthelminthic treatment history over the past six months (odds ratio (OR): 2.15; 95% confidence interval (CI): 1.22 - 3.79) and in SAC with a higher temperature (OR: 2.21; CI: 1.13 - 4.33). Strongyloidiasis was associated with eosinophilia (OR: 2.04; CI: 1.20-3.48) and with Trichuris trichiura infections (OR: 4.13; CI: 1.04-16.52) in children of all age-groups, and with asymptomatic Plasmodium parasitaemia (OR: 13.03; CI: 1.34 - 127.23) in infants. None of the investigated helminthiases impacted significantly on the nutritional status and anaemia, but moderate asymptomatic Plasmodium parasitaemia was a strong predictor for anaemia in children aged older than two years (OR: 2.69; 95% CI: 1.23 – 5.86). Conclusions E. vermicularis and S. stercoralis infections were moderately prevalent in children from rural coastal Tanzania. Our data can contribute to inform yet missing global burden of disease and prevalence estimates for strongyloidiasis and enterobiasis. The association between S stercoralis and asymptomatic Plasmodium parasitaemia found here warrants further comprehensive investigations. Electronic supplementary material The online version of this article (doi:10.1186/s12879-014-0644-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nahya Salim
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania. .,Department of Pediatrics and Child Health, Muhimbili University Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania. .,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Tobias Schindler
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania. .,University of Basel, Basel, Switzerland. .,Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.
| | - Ummi Abdul
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
| | - Julian Rothen
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania. .,University of Basel, Basel, Switzerland. .,Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.
| | - Blaise Genton
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland. .,Department of Ambulatory Care and Community Medicine, Infectious Disease Service, Lausanne University Hospital, Lausanne, Switzerland.
| | - Omar Lweno
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
| | - Alisa S Mohammed
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
| | - John Masimba
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
| | - Denis Kwaba
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
| | - Salim Abdulla
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
| | - Marcel Tanner
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Claudia Daubenberger
- University of Basel, Basel, Switzerland. .,Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.
| | - Stefanie Knopp
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland. .,Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, Natural History Museum, London, United Kingdom.
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Shekalaghe S, Rutaihwa M, Billingsley PF, Chemba M, Daubenberger CA, James ER, Mpina M, Ali Juma O, Schindler T, Huber E, Gunasekera A, Manoj A, Simon B, Saverino E, Church LWP, Hermsen CC, Sauerwein RW, Plowe C, Venkatesan M, Sasi P, Lweno O, Mutani P, Hamad A, Mohammed A, Urassa A, Mzee T, Padilla D, Ruben A, Lee Sim BK, Tanner M, Abdulla S, Hoffman SL. Controlled human malaria infection of Tanzanians by intradermal injection of aseptic, purified, cryopreserved Plasmodium falciparum sporozoites. Am J Trop Med Hyg 2014; 91:471-480. [PMID: 25070995 PMCID: PMC4155546 DOI: 10.4269/ajtmh.14-0119] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Controlled human malaria infection (CHMI) by mosquito bite has been used to assess anti-malaria interventions in > 1,500 volunteers since development of methods for infecting mosquitoes by feeding on Plasmodium falciparum (Pf) gametocyte cultures. Such CHMIs have never been used in Africa. Aseptic, purified, cryopreserved Pf sporozoites, PfSPZ Challenge, were used to infect Dutch volunteers by intradermal injection. We conducted a double-blind, placebo-controlled trial to assess safety and infectivity of PfSPZ Challenge in adult male Tanzanians. Volunteers were injected intradermally with 10,000 (N = 12) or 25,000 (N = 12) PfSPZ or normal saline (N = 6). PfSPZ Challenge was well tolerated and safe. Eleven of 12 and 10 of 11 subjects, who received 10,000 and 25,000 PfSPZ respectively, developed parasitemia. In 10,000 versus 25,000 PfSPZ groups geometric mean days from injection to Pf positivity by thick blood film was 15.4 versus 13.5 (P = 0.023). Alpha-thalassemia heterozygosity had no apparent effect on infectivity. PfSPZ Challenge was safe, well tolerated, and infectious.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Stephen L. Hoffman
- *Address correspondence to Stephen L. Hoffman, Sanaria Inc., 9800 Medical Center Drive, Rockville, MD 20850. E-mail:
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Knopp S, Salim N, Schindler T, Karagiannis Voules DA, Rothen J, Lweno O, Mohammed AS, Singo R, Benninghoff M, Nsojo AA, Genton B, Daubenberger C. Diagnostic accuracy of Kato-Katz, FLOTAC, Baermann, and PCR methods for the detection of light-intensity hookworm and Strongyloides stercoralis infections in Tanzania. Am J Trop Med Hyg 2014; 90:535-545. [PMID: 24445211 PMCID: PMC3945701 DOI: 10.4269/ajtmh.13-0268] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Sensitive diagnostic tools are crucial for an accurate assessment of helminth infections in low-endemicity areas. We examined stool samples from Tanzanian individuals and compared the diagnostic accuracy of a real-time polymerase chain reaction (PCR) with the FLOTAC technique and the Kato-Katz method for hookworm and the Baermann method for Strongyloides stercoralis detection. Only FLOTAC had a higher sensitivity than the Kato-Katz method for hookworm diagnosis; the sensitivities of PCR and the Kato-Katz method were equal. PCR had a very low sensitivity for S. stercoralis detection. The cycle threshold values of the PCR were negatively correlated with the logarithm of hookworm egg and S. stercoralis larvae counts. The median larvae count was significantly lower in PCR false negatives than true positives. All methods failed to detect very low-intensity infections. New diagnostic approaches are needed for monitoring of progressing helminth control programs, confirmation of elimination, or surveillance of disease recrudescence.
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Affiliation(s)
- Stefanie Knopp
- *Address correspondence to Stefanie Knopp, Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland. E-mail:
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