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1. Identification, Prevalence and Susceptibility Profile of Candida Isolates at the Pasteur Institute in Côte D'ivoire from 2017 to 2019

Author

Bonouman Ira A.V., Mboh R., Roger F., Krasteva D., Bellet V., Koffi D., Noell J., Pottier C., Drakulovski P., Menan H., Toure O., Dosso M., Ranque S., and Bertout S.

Subjects
Marketing, Pharmacology, Organizational Behavior and Human Resource Management, Strategy and Management, Drug Discovery, Pharmaceutical Science
Abstract

This study was conducted in Côte d’Ivoire to determine the respective prevalence of Candida species and to study their susceptibility profile to antifungal agents to identify the emergence of resistance.This retrospective study was conducted from 2017 to 2019 at the Institute Pasteur of Côte d’Ivoire on patients with fungal disease. The yeasts isolated and identified in Côte d’Ivoire were subcultured on a chromogenic medium and identified with MALDI-TOF-MS. Sensitivity tests were performed using the CLSI method and evaluated by the M27. In total, 227 Candida spp. were isolated from 1941 patients. Most of the samples were vaginal swabs (120/228). Using the conventional method, C. albicans was prevalent (52.6%). There were mixtures of 2 to 4 species in 36.8% of the samples. Thus MALDI-TOF-MS identified in 315 isolates 13 distinct species, C. tropicalis was prevalent at 35.2%, and the species in both C. albicans and C. parapsilosis complexes were differentiated. This study highlights the hurdle of correct yeast identification in developing countries. The transition from conventional to modern MALDI-TOF based identification of these life-threatening opportunistic pathogens is mandatory and should be emphasised as a public health priority.

Published
2023
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3. Temporal distribution of Plasmodium falciparum recrudescence following artemisinin-based combination therapy: an individual participant data meta-analysis

Author

Dahal, P, Simpson, JA, Abdulla, S, Achan, J, Adam, I, Agarwal, A, Allan, R, Anvikar, AR, Ashley, EA, Bassat, Q, Borrmann, S, Bousema, T, Bukirwa, H, Carrara, V, Corsi, M, D'Alessandro, U, Davis, TME, Deloron, P, Desai, M, Dimbu, PR, Djalle, D, Djimde, A, Dorsey, G, Drakeley, CJ, Duparc, S, Edstein, MD, Espie, E, Abul, F, Falade, C, Fanello, C, Faucher, J-F, Faye, B, Fortes, FDJ, Gadalla, NB, Gaye, O, Gil, JP, Gilayeneh, J, Greenwood, B, Grivoyannis, A, Hien, TT, Hwang, J, Janssens, B, Juma, E, Kamugisha, E, Karema, C, Karunajeewa, HA, Kiechel, JR, Kironde, F, Kofoed, P-E, Kremsner, PG, Lee, SJ, Marsh, K, Martensson, A, Mayxay, M, Menan, H, Mens, P, Mutabingwa, TK, Ndiaye, J-L, Ngasala, BE, Noedl, H, Nosten, F, Offianan, AT, Ogutu, BR, Olliaro, PL, Ouedraogo, JB, Piola, P, Plowe, C, Plucinski, MM, Pratt, OJ, Premji, Z, Ramharter, M, Rogier, C, Vitare, P, Rombo, L, Rosenthal, PJ, Sibley, C, Sirima, S, Smithuis, F, Staedke, SG, Sutanto, I, Talisuna, AO, Tarning, J, Taylor, WRJ, Temu, E, Thriemer, K, Thuy-Nhien, N, Udhayakumar, V, Ursing, JD, van Herp, M, van Lenthe, M, van Vugt, M, William, Y, Winnips, C, Zaloumis, S, Zongo, I, White, NJ, Guerin, PJ, Stepniewska, K, Price, RN, Arinaitwe, E, Dahal, P, Simpson, JA, Abdulla, S, Achan, J, Adam, I, Agarwal, A, Allan, R, Anvikar, AR, Ashley, EA, Bassat, Q, Borrmann, S, Bousema, T, Bukirwa, H, Carrara, V, Corsi, M, D'Alessandro, U, Davis, TME, Deloron, P, Desai, M, Dimbu, PR, Djalle, D, Djimde, A, Dorsey, G, Drakeley, CJ, Duparc, S, Edstein, MD, Espie, E, Abul, F, Falade, C, Fanello, C, Faucher, J-F, Faye, B, Fortes, FDJ, Gadalla, NB, Gaye, O, Gil, JP, Gilayeneh, J, Greenwood, B, Grivoyannis, A, Hien, TT, Hwang, J, Janssens, B, Juma, E, Kamugisha, E, Karema, C, Karunajeewa, HA, Kiechel, JR, Kironde, F, Kofoed, P-E, Kremsner, PG, Lee, SJ, Marsh, K, Martensson, A, Mayxay, M, Menan, H, Mens, P, Mutabingwa, TK, Ndiaye, J-L, Ngasala, BE, Noedl, H, Nosten, F, Offianan, AT, Ogutu, BR, Olliaro, PL, Ouedraogo, JB, Piola, P, Plowe, C, Plucinski, MM, Pratt, OJ, Premji, Z, Ramharter, M, Rogier, C, Vitare, P, Rombo, L, Rosenthal, PJ, Sibley, C, Sirima, S, Smithuis, F, Staedke, SG, Sutanto, I, Talisuna, AO, Tarning, J, Taylor, WRJ, Temu, E, Thriemer, K, Thuy-Nhien, N, Udhayakumar, V, Ursing, JD, van Herp, M, van Lenthe, M, van Vugt, M, William, Y, Winnips, C, Zaloumis, S, Zongo, I, White, NJ, Guerin, PJ, Stepniewska, K, Price, RN, and Arinaitwe, E

Abstract

BACKGROUND: The duration of trial follow-up affects the ability to detect recrudescent infections following anti-malarial treatment. The aim of this study was to explore the proportions of recrudescent parasitaemia as ascribed by genotyping captured at various follow-up time-points in treatment efficacy trials for uncomplicated Plasmodium falciparum malaria. METHODS: Individual patient data from 83 anti-malarial efficacy studies collated in the WorldWide Antimalarial Resistance Network (WWARN) repository with at least 28 days follow-up were available. The temporal and cumulative distributions of recrudescence were characterized using a Cox regression model with shared frailty on study-sites. Fractional polynomials were used to capture non-linear instantaneous hazard. The area under the density curve (AUC) of the constructed distribution was used to estimate the optimal follow-up period for capturing a P. falciparum malaria recrudescence. Simulation studies were conducted based on the constructed distributions to quantify the absolute overestimation in efficacy due to sub-optimal follow-up. RESULTS: Overall, 3703 recurrent infections were detected in 60 studies conducted in Africa (15,512 children aged < 5 years) and 23 studies conducted in Asia and South America (5272 patients of all ages). Using molecular genotyping, 519 (14.0%) recurrences were ascribed as recrudescent infections. A 28 day artemether-lumefantrine (AL) efficacy trial would not have detected 58% [95% confidence interval (CI) 47-74%] of recrudescences in African children and 32% [95% CI 15-45%] in patients of all ages in Asia/South America. The corresponding estimate following a 42 day dihydroartemisinin-piperaquine (DP) efficacy trial in Africa was 47% [95% CI 19-90%] in children under 5 years old treated with > 48 mg/kg total piperaquine (PIP) dose and 9% [95% CI 0-22%] in those treated with ≤ 48 mg/kg PIP dose. In absolute terms, the simulation study found that trials limited to 28 days follow-up

Published
2022

4. Haematological consequences of acute uncomplicated falciparum malaria: a WorldWide Antimalarial Resistance Network pooled analysis of individual patient data

Author

Mansoor, R, Commons, RJ, Douglas, NM, Abuaku, B, Achan, J, Adam, I, Adjei, GO, Adjuik, M, Alemayehu, BH, Allan, R, Allen, EN, Anvikar, AR, Arinaitwe, E, Ashley, EA, Ashurst, H, Asih, PBS, Bakyaita, N, Barennes, H, Barnes, K, Basco, L, Bassat, Q, Baudin, E, Bell, DJ, Bethell, D, Bjorkman, A, Boulton, C, Bousema, T, Brasseur, P, Bukirwa, H, Burrow, R, Carrara, V, Cot, M, D'Alessandro, U, Das, D, Das, S, Davis, TME, Desai, M, Djimde, AA, Dondorp, AM, Dorsey, G, Drakeley, CJ, Duparc, S, Espie, E, Etard, J-F, Falade, C, Faucher, JF, Filler, S, Fogg, C, Fukuda, M, Gaye, O, Genton, B, Rahim, AG, Gilayeneh, J, Gonzalez, R, Grais, RF, Grandesso, F, Greenwood, B, Grivoyannis, A, Hatz, C, Hodel, EM, Humphreys, GS, Hwang, J, Ishengoma, D, Juma, E, Kachur, SP, Kager, PA, Kamugisha, E, Kamya, MR, Karema, C, Kayentao, K, Kazienga, A, Kiechel, J-R, Kofoed, P-E, Koram, K, Kremsner, PG, Lalloo, DG, Laman, M, Lee, SJ, Lell, B, Maiga, AW, Martensson, A, Mayxay, M, Mbacham, W, McGready, R, Menan, H, Menard, D, Mockenhaupt, F, Moore, BR, Muller, O, Nahum, A, Ndiaye, J-L, Newton, PN, Ngasala, BE, Nikiema, F, Nji, AM, Noedl, H, Nosten, F, Ogutu, BR, Ojurongbe, O, Osorio, L, Ouedraogo, J-B, Owusu-Agyei, S, Pareek, A, Penali, LK, Piola, P, Plucinski, M, Premji, Z, Ramharter, M, Richmond, CL, Rombo, L, Rosenthal, PJ, Salman, S, Same-Ekobo, A, Sibley, C, Sirima, SB, Smithuis, FM, Some, FA, Staedke, SG, Starzengruber, P, Strub-Wourgaft, N, Sutanto, I, Swarthout, TD, Syafruddin, D, Talisuna, AO, Taylor, WR, Temu, EA, Thwing, J, Tinto, H, Tjitra, E, Toure, OA, Tran, TH, Ursing, J, Valea, I, Valentini, G, van Vugt, M, von Seidlein, L, Ward, SA, Were, V, White, NJ, Woodrow, CJ, Yavo, W, Yeka, A, Zongo, I, Simpson, JA, Guerin, PJ, Stepniewska, K, Price, RN, Roper, C, Mansoor, R, Commons, RJ, Douglas, NM, Abuaku, B, Achan, J, Adam, I, Adjei, GO, Adjuik, M, Alemayehu, BH, Allan, R, Allen, EN, Anvikar, AR, Arinaitwe, E, Ashley, EA, Ashurst, H, Asih, PBS, Bakyaita, N, Barennes, H, Barnes, K, Basco, L, Bassat, Q, Baudin, E, Bell, DJ, Bethell, D, Bjorkman, A, Boulton, C, Bousema, T, Brasseur, P, Bukirwa, H, Burrow, R, Carrara, V, Cot, M, D'Alessandro, U, Das, D, Das, S, Davis, TME, Desai, M, Djimde, AA, Dondorp, AM, Dorsey, G, Drakeley, CJ, Duparc, S, Espie, E, Etard, J-F, Falade, C, Faucher, JF, Filler, S, Fogg, C, Fukuda, M, Gaye, O, Genton, B, Rahim, AG, Gilayeneh, J, Gonzalez, R, Grais, RF, Grandesso, F, Greenwood, B, Grivoyannis, A, Hatz, C, Hodel, EM, Humphreys, GS, Hwang, J, Ishengoma, D, Juma, E, Kachur, SP, Kager, PA, Kamugisha, E, Kamya, MR, Karema, C, Kayentao, K, Kazienga, A, Kiechel, J-R, Kofoed, P-E, Koram, K, Kremsner, PG, Lalloo, DG, Laman, M, Lee, SJ, Lell, B, Maiga, AW, Martensson, A, Mayxay, M, Mbacham, W, McGready, R, Menan, H, Menard, D, Mockenhaupt, F, Moore, BR, Muller, O, Nahum, A, Ndiaye, J-L, Newton, PN, Ngasala, BE, Nikiema, F, Nji, AM, Noedl, H, Nosten, F, Ogutu, BR, Ojurongbe, O, Osorio, L, Ouedraogo, J-B, Owusu-Agyei, S, Pareek, A, Penali, LK, Piola, P, Plucinski, M, Premji, Z, Ramharter, M, Richmond, CL, Rombo, L, Rosenthal, PJ, Salman, S, Same-Ekobo, A, Sibley, C, Sirima, SB, Smithuis, FM, Some, FA, Staedke, SG, Starzengruber, P, Strub-Wourgaft, N, Sutanto, I, Swarthout, TD, Syafruddin, D, Talisuna, AO, Taylor, WR, Temu, EA, Thwing, J, Tinto, H, Tjitra, E, Toure, OA, Tran, TH, Ursing, J, Valea, I, Valentini, G, van Vugt, M, von Seidlein, L, Ward, SA, Were, V, White, NJ, Woodrow, CJ, Yavo, W, Yeka, A, Zongo, I, Simpson, JA, Guerin, PJ, Stepniewska, K, Price, RN, and Roper, C

Abstract

BACKGROUND: Plasmodium falciparum malaria is associated with anaemia-related morbidity, attributable to host, parasite and drug factors. We quantified the haematological response following treatment of uncomplicated P. falciparum malaria to identify the factors associated with malarial anaemia. METHODS: Individual patient data from eligible antimalarial efficacy studies of uncomplicated P. falciparum malaria, available through the WorldWide Antimalarial Resistance Network data repository prior to August 2015, were pooled using standardised methodology. The haematological response over time was quantified using a multivariable linear mixed effects model with nonlinear terms for time, and the model was then used to estimate the mean haemoglobin at day of nadir and day 7. Multivariable logistic regression quantified risk factors for moderately severe anaemia (haemoglobin < 7 g/dL) at day 0, day 3 and day 7 as well as a fractional fall ≥ 25% at day 3 and day 7. RESULTS: A total of 70,226 patients, recruited into 200 studies between 1991 and 2013, were included in the analysis: 50,859 (72.4%) enrolled in Africa, 18,451 (26.3%) in Asia and 916 (1.3%) in South America. The median haemoglobin concentration at presentation was 9.9 g/dL (range 5.0-19.7 g/dL) in Africa, 11.6 g/dL (range 5.0-20.0 g/dL) in Asia and 12.3 g/dL (range 6.9-17.9 g/dL) in South America. Moderately severe anaemia (Hb < 7g/dl) was present in 8.4% (4284/50,859) of patients from Africa, 3.3% (606/18,451) from Asia and 0.1% (1/916) from South America. The nadir haemoglobin occurred on day 2 post treatment with a mean fall from baseline of 0.57 g/dL in Africa and 1.13 g/dL in Asia. Independent risk factors for moderately severe anaemia on day 7, in both Africa and Asia, included moderately severe anaemia at baseline (adjusted odds ratio (AOR) = 16.10 and AOR = 23.00, respectively), young age (age < 1 compared to ≥ 12 years AOR = 12.81 and AOR = 6.79, respectively), high parasitaemia (AOR = 1.78 and AOR = 1.

Published
2022

5. Effect of systematic tuberculosis detection on mortality in young children with severe pneumonia in countries with high incidence of tuberculosis: a stepped-wedge cluster-randomised trial

Author

Marcy, O, Wobudeya, E, Font, H, Vessière, A, Chabala, C, Khosa, C, Taguebue, J-V, Moh, R, Mwanga-Amumpaire, J, Lounnas, M, Mulenga, V, Mavale, S, Chilundo, J, Rego, D, Nduna, B, Shankalala, P, Chirwa, U, De Lauzanne, A, Dim, B, Tiogouo Ngouana, E, Folquet Amorrissani, M, Cisse, L, Amon Tanoh Dick, F, Komena, EA, Kwedi Nolna, S, Businge, G, Natukunda, N, Cumbe, S, Mbekeka, P, Kim, A, Kheang, C, Pol, S, Maleche-Obimbo, E, Seddon, JA, Mao, TE, Graham, SM, Delacourt, C, Borand, L, Bonnet, M, Serre, A, Badrichani, A, Razafimanantsoa, M, Poublan, J, Roucher, C, Occelli, E, Beuscart, A, Charpin, A, Habiyambere, G, Mesnier, S, Balestre, E, Bhatta, B, Maillard, A-L, Orne-Gliemann, J, Baillet, E, Koskas, N, D'Elbée, M, Gabillard, D, Huyen, M, Espérou, H, Couffin-Cadiergues, S, Kuppers, A, Hamze, B, BORAND, L, de LAUZANNE, A, DIM, B, Keang, C, PRING, L, YIN, S, SARITH, C, PHAN, C, NHEUONG, S, LY, S, KAING, S, SRENG, V, LUN, E, SAY, L, SUOM, S, FERHY, R, SO, D, BORN, S, PAL, S, NANG, B, MAO, TE, KIM, A, Srey, V, Kan, P, Hout, L, Ith, S, Oum, S, Sau, S, Ho, KH, Kith, D, Nuch, N, Horm, CL, Sophon, C, Roeungdeth, B, MENG, C, RITH, R, PHY, S, SOR, C, SAO, V, KHAT, S, MAK, B, UY, A, KHAY, S, SOM, K, HACH, R, SOK, H, KUON, S, HENG, S, SENG, A, NIM, S, PAN, R, KIM, S, SREY LEAP, K, NET, B, NOUN, V, LAY, D, MANY, C, Seng, S, Ly, V, So, S, Oun, S, CHEY, S, CHHEA, R, BAONG, L, THOUNG, V, KHEANG, C, BY, B, Nguon, V, MEACH, E, Tek, S, Ngeav, S, Lun, T, HEM, D, CHUT, N, SARIK, S, NANG, H, MEACH, M, SRENG, S, SAR, D, KIN, R, ROS, P, DORN, C, KAK, C, Sambath, SL, Son, L, Bin, L, Pengong, E, Khutsorn, S, Seang, S, Soun, V, Vong, V, Khoeung, C, Um, P, Bou, S, Song Pich, S, Nim, P, Khat, S, Ban Si, N, Ream, S, Ing, S, Chann, P, Ngeth, S, Sun, M, Chhoeung, S, Sean, S, Prak, R, Amboua Schouame Onambele, A, Hycenth, N, Melingui, B, Nkembe Medounmga, A, Hougnang Tatmi, L, Etemgoua, N, Kouesso, V, Bugin, J, Nzedjom, C, Ngoya, R, Eyike, J, Loudjom, E, Lonsti, R, Dang, L, Bintar, E, Njayong, C, Ngonsoa O, C, Ndzeukap, I, Dzoyem, P, Dzokou, C, Dindo, B, Aka Bony, R, Kouadio, C, Danho, S, Goli, M, Folquet, M, Itchy, MV, Sidibé, A, Cissé, L, Ouattara, J, Konaté, M, Amon-Tanoh Dick, F, Cardena, M, Adonis-Koffi, L, Eugenie, D, Kouamé, F, Menan, H, Inwoley, A, Ouassa, T, Nguessan, MS, Manhiça, E, Zitha, A, Chiúle, V, Muxanga, E, Gune, I, Lima, Y, Ribeiro, J, Maxanguana, F, Morais, N, Manhiça, J, Give, J, Atumane, J, Lucas, G, Thai, A, Chave, A, Guambe, L, Issa, F, Carneiro, R, Pene, N, Florindo, N, Machel, D, Cumbane, C, Mendes, H, Kitungwa, M, Muianga, V, Tamele, H, Sulude, A, Mabota, R, Comandante, H, Massangaie, A, Businge, GB, Namulinda, F, Sserunjogi, R, Nassozi, R, Barungi, C, Aanyu, H, Muwonge, D, Kagoya, E, Aciparu, S, Chemutai, S, Ntambi, S, Wasswa, A, Nangozi, J, Tagoola, A, Kenneth, S, Lubega, JP, Nassali, A, Tagobera, J, Agwang, C, Kalembe, F, Ajambo, A, Aguti, E, Kasibante, S, Matende, H, Odongo, IO, Mwanga Amumpaire, J, Ngabirano, G, Kakwenza, P, Nuwamanya, S, Nyangoma, M, Nabbuto, J, Abok, F, Arinaitwe, R, Birungi, D, Mwesigwa, E, Atwine, D, Mbega, H, Orikiriza, P, Taremwa, I, Turyashemererwa, E, Derrick, H, Nyehangane, D, Kaitano, R, Logoose, S, Businge, S, Ntambi, C, Mugabi, J, Mzee, J, Besigye, J, Kanzira, S, Turyatemba, P, Twebaze, F, Hambulo, C, Kapotwe, V, Ngambi, M, Kasakwa, K, Kapula, C, Zulu, S, Nawakwi, G, Siasulingana, T, Chilonga, J, Chimbini, M, Chilanga, M, Inambao, M, Mwambazi, M, Halende, B, Mumba, W, Mankunshe, E, Silavwe, M, Chakopo, M, Moono, R, Marcy, O, Wobudeya, E, Font, H, Vessière, A, Chabala, C, Khosa, C, Taguebue, J-V, Moh, R, Mwanga-Amumpaire, J, Lounnas, M, Mulenga, V, Mavale, S, Chilundo, J, Rego, D, Nduna, B, Shankalala, P, Chirwa, U, De Lauzanne, A, Dim, B, Tiogouo Ngouana, E, Folquet Amorrissani, M, Cisse, L, Amon Tanoh Dick, F, Komena, EA, Kwedi Nolna, S, Businge, G, Natukunda, N, Cumbe, S, Mbekeka, P, Kim, A, Kheang, C, Pol, S, Maleche-Obimbo, E, Seddon, JA, Mao, TE, Graham, SM, Delacourt, C, Borand, L, Bonnet, M, Serre, A, Badrichani, A, Razafimanantsoa, M, Poublan, J, Roucher, C, Occelli, E, Beuscart, A, Charpin, A, Habiyambere, G, Mesnier, S, Balestre, E, Bhatta, B, Maillard, A-L, Orne-Gliemann, J, Baillet, E, Koskas, N, D'Elbée, M, Gabillard, D, Huyen, M, Espérou, H, Couffin-Cadiergues, S, Kuppers, A, Hamze, B, BORAND, L, de LAUZANNE, A, DIM, B, Keang, C, PRING, L, YIN, S, SARITH, C, PHAN, C, NHEUONG, S, LY, S, KAING, S, SRENG, V, LUN, E, SAY, L, SUOM, S, FERHY, R, SO, D, BORN, S, PAL, S, NANG, B, MAO, TE, KIM, A, Srey, V, Kan, P, Hout, L, Ith, S, Oum, S, Sau, S, Ho, KH, Kith, D, Nuch, N, Horm, CL, Sophon, C, Roeungdeth, B, MENG, C, RITH, R, PHY, S, SOR, C, SAO, V, KHAT, S, MAK, B, UY, A, KHAY, S, SOM, K, HACH, R, SOK, H, KUON, S, HENG, S, SENG, A, NIM, S, PAN, R, KIM, S, SREY LEAP, K, NET, B, NOUN, V, LAY, D, MANY, C, Seng, S, Ly, V, So, S, Oun, S, CHEY, S, CHHEA, R, BAONG, L, THOUNG, V, KHEANG, C, BY, B, Nguon, V, MEACH, E, Tek, S, Ngeav, S, Lun, T, HEM, D, CHUT, N, SARIK, S, NANG, H, MEACH, M, SRENG, S, SAR, D, KIN, R, ROS, P, DORN, C, KAK, C, Sambath, SL, Son, L, Bin, L, Pengong, E, Khutsorn, S, Seang, S, Soun, V, Vong, V, Khoeung, C, Um, P, Bou, S, Song Pich, S, Nim, P, Khat, S, Ban Si, N, Ream, S, Ing, S, Chann, P, Ngeth, S, Sun, M, Chhoeung, S, Sean, S, Prak, R, Amboua Schouame Onambele, A, Hycenth, N, Melingui, B, Nkembe Medounmga, A, Hougnang Tatmi, L, Etemgoua, N, Kouesso, V, Bugin, J, Nzedjom, C, Ngoya, R, Eyike, J, Loudjom, E, Lonsti, R, Dang, L, Bintar, E, Njayong, C, Ngonsoa O, C, Ndzeukap, I, Dzoyem, P, Dzokou, C, Dindo, B, Aka Bony, R, Kouadio, C, Danho, S, Goli, M, Folquet, M, Itchy, MV, Sidibé, A, Cissé, L, Ouattara, J, Konaté, M, Amon-Tanoh Dick, F, Cardena, M, Adonis-Koffi, L, Eugenie, D, Kouamé, F, Menan, H, Inwoley, A, Ouassa, T, Nguessan, MS, Manhiça, E, Zitha, A, Chiúle, V, Muxanga, E, Gune, I, Lima, Y, Ribeiro, J, Maxanguana, F, Morais, N, Manhiça, J, Give, J, Atumane, J, Lucas, G, Thai, A, Chave, A, Guambe, L, Issa, F, Carneiro, R, Pene, N, Florindo, N, Machel, D, Cumbane, C, Mendes, H, Kitungwa, M, Muianga, V, Tamele, H, Sulude, A, Mabota, R, Comandante, H, Massangaie, A, Businge, GB, Namulinda, F, Sserunjogi, R, Nassozi, R, Barungi, C, Aanyu, H, Muwonge, D, Kagoya, E, Aciparu, S, Chemutai, S, Ntambi, S, Wasswa, A, Nangozi, J, Tagoola, A, Kenneth, S, Lubega, JP, Nassali, A, Tagobera, J, Agwang, C, Kalembe, F, Ajambo, A, Aguti, E, Kasibante, S, Matende, H, Odongo, IO, Mwanga Amumpaire, J, Ngabirano, G, Kakwenza, P, Nuwamanya, S, Nyangoma, M, Nabbuto, J, Abok, F, Arinaitwe, R, Birungi, D, Mwesigwa, E, Atwine, D, Mbega, H, Orikiriza, P, Taremwa, I, Turyashemererwa, E, Derrick, H, Nyehangane, D, Kaitano, R, Logoose, S, Businge, S, Ntambi, C, Mugabi, J, Mzee, J, Besigye, J, Kanzira, S, Turyatemba, P, Twebaze, F, Hambulo, C, Kapotwe, V, Ngambi, M, Kasakwa, K, Kapula, C, Zulu, S, Nawakwi, G, Siasulingana, T, Chilonga, J, Chimbini, M, Chilanga, M, Inambao, M, Mwambazi, M, Halende, B, Mumba, W, Mankunshe, E, Silavwe, M, Chakopo, M, and Moono, R

Abstract

Background: Tuberculosis diagnosis might be delayed or missed in children with severe pneumonia because this diagnosis is usually only considered in cases of prolonged symptoms or antibiotic failure. Systematic tuberculosis detection at hospital admission could increase case detection and reduce mortality. Methods: We did a stepped-wedge cluster-randomised trial in 16 hospitals from six countries (Cambodia, Cameroon, Côte d'Ivoire, Mozambique, Uganda, and Zambia) with high incidence of tuberculosis. Children younger than 5 years with WHO-defined severe pneumonia received either the standard of care (control group) or standard of care plus Xpert MTB/RIF Ultra (Xpert Ultra; Cepheid, Sunnyvale, CA, USA) on nasopharyngeal aspirate and stool samples (intervention group). Clusters (hospitals) were progressively switched from control to intervention at 5-week intervals, using a computer-generated random sequence, stratified on incidence rate of tuberculosis at country level, and masked to teams until 5 weeks before switch. We assessed the effect of the intervention on primary (12-week all-cause mortality) and secondary (including tuberculosis diagnosis) outcomes, using generalised linear mixed models. The primary analysis was by intention to treat. We described outcomes in children with severe acute malnutrition in a post hoc analysis. This study is registered with ClinicalTrials.gov (NCT03831906) and the Pan African Clinical Trial Registry (PACTR202101615120643). Findings: From March 21, 2019, to March 30, 2021, we enrolled 1401 children in the control group and 1169 children in the intervention group. In the intervention group, 1140 (97·5%) children had nasopharyngeal aspirates and 942 (80·6%) had their stool collected; 24 (2·1%) had positive Xpert Ultra. At 12 weeks, 110 (7·9%) children in the control group and 91 (7·8%) children in the intervention group had died (adjusted odds ratio [OR] 0·986, 95% CI 0·597–1·630, p=0·957), and 74 (5·3%) children in the control group

Published
2022

6. Genotyping Canadian Cyclospora cayetanensis Isolates to Supplement Cyclosporiasis Outbreak Investigations.

Author

Yanta CA, Barta JR, Corbeil A, Menan H, Thivierge K, Needle R, Morshed M, Dixon BR, Wasmuth JD, and Guy RA

Abstract

Cyclospora cayetanensis is an emerging foodborne parasite that causes cyclosporiasis, an enteric disease of humans. Domestically acquired outbreaks have been reported in Canada every spring or summer since 2013. To date, investigations into the potential sources of infection have relied solely on epidemiological data. To supplement the epidemiological data with genetic information, we genotyped 169 Canadian cyclosporiasis cases from stool specimens collected from 2010 to 2021 using an existing eight-marker targeted amplicon deep (TADS) scheme specific to C. cayetanensis as previously described by the US Centers for Disease Control and Prevention (CDC). This is the first study to genotype Canadian Cyclospora cayetanensis isolates, and it focuses on evaluating the genotyping performance and genetic clustering. Genotyping information was successfully collected with at least part of one of the markers in the TADS assay for 97.9% of specimens, and 81.1% of cyclosporiasis cases met the minimum requirements to genetically cluster into 20 groups. The performance of the scheme suggests that examining cyclosporiasis cases genetically will be a valuable tool for supplementing epidemiological outbreak investigations and to minimize further infections. Further research is required to expand the number of discriminatory markers to improve genetic clustering.

Published
2022
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7. Population genetic structure of Schistosoma haematobium and Schistosoma haematobium × Schistosoma bovis hybrids among school-aged children in Côte d'Ivoire.

Author

Angora EK, Vangraefschepe A, Allienne JF, Menan H, Coulibaly JT, Meïté A, Raso G, Winkler MS, Yavo W, Touré AO, N'Goran EK, Zinsstag J, Utzinger J, Balmer O, and Boissier J

Subjects
Animals, Cattle, Child, Cote d'Ivoire epidemiology, Genetic Structures, Humans, Polymorphism, Restriction Fragment Length, Parasites genetics, Schistosoma haematobium genetics
Abstract

While population genetics of Schistosoma haematobium have been investigated in West Africa, only scant data are available from Côte d'Ivoire. The purpose of this study was to analyze both genetic variability and genetic structure among S. haematobium populations and to quantify the frequency of S. haematobium × S. bovis hybrids in school-aged children in different parts of Côte d'Ivoire. Urine samples were subjected to a filtration method and examined microscopically for Schistosoma eggs in four sites in the western and southern parts of Côte d'Ivoire. A total of 2692 miracidia were collected individually and stored on Whatman ® FTA cards. Of these, 2561 miracidia were successfully genotyped for species and hybrid identification using rapid diagnostic multiplex mitochondrial cox1 PCR and PCR Restriction Fragment Length Polymorphism (PCR-RFLP) analysis of the nuclear ITS2 region. From 2164 miracidia, 1966 (90.9%) were successfully genotyped using at least 10 nuclear microsatellite loci to investigate genetic diversity and population structure. Significant differences were found between sites in all genetic diversity indices and genotypic differentiation was observed between the site in the West and the three sites in the East. Analysis at the infrapopulation level revealed clustering of parasite genotypes within individual children, particularly in Duekoué (West) and Sikensi (East). Of the six possible cox1-ITS2 genetic profiles obtained from miracidia, S. bovis cox1 × S. haematobium ITS2 (42.0%) was the most commonly observed in the populations. We identified only 15 miracidia (0.7%) with an S. bovis cox1 × S. bovis ITS2 genotype. Our study provides new insights into the population genetics of S. haematobium and S. haematobium × S. bovis hybrids in humans in Côte d'Ivoire and we advocate for researching hybrid schistosomes in animals such as rodents and cattle in Côte d'Ivoire., (© E.K. Angora et al., published by EDP Sciences, 2022.)

Published
2022
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