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1. High prevalence of late presentation with advanced HIV disease and its predictors among newly diagnosed patients in Kumasi, Ghana

Author

Sakyi, Samuel Asamoah, Kwarteng, Samuel, Senu, Ebenezer, Effah, Alfred, Opoku, Stephen, Oppong, Success Acheampomaa, Yeboah, Kingsley Takyi, Abutiate, Solomon, Lamptey, Augustina, Arafat, Mohammed, Afari-Gyan, Festus Nana, Agordzo, Samuel Kekeli, Mensah, Oscar Simon Olympio, Owusu, Emmauel, Buckman, Tonnies Abeku, Amoani, Benjamin, and Enimil, Anthony Kwame

Published
2024
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2. Caring for Adolescents and Young Adults With Tuberculosis or at Risk of Tuberculosis: Consensus Statement From an International Expert Panel

Author

Chiang, Silvia S., Waterous, Patricia M., Atieno, Vivian Faith, Bernays, Sarah, Bondarenko, Yaroslava, Cruz, Andrea T., de Oliveira, Márcia C.B., Del Castillo Barrientos, Hernán, Enimil, Anthony, Ferlazzo, Gabriella, Ferrand, Rashida Abbas, Furin, Jennifer, Hoddinott, Graeme, Isaakidis, Petros, Kranzer, Katharina, Maleche-Obimbo, Elizabeth, Mansoor, Homa, Marais, Ben J., Mohr-Holland, Erika, Morales, Mabel, Nguyen, Anh Phuong, Oliyo, Joshua Ochieng, Sant’Anna, Clemax Couto, Sawyer, Susan M., Schaaf, H. Simon, Seddon, James A., Sharma, Sangeeta, Skrahina, Alena, Starke, Jeffrey R., Triasih, Rina, Tsogt, Bazarragchaa, Welch, Henry, and Enane, Leslie A.

Published
2023
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4. Factors associated with anti-retroviral therapy (ART) adherence among adult people living with HIV (PLWH): A 5-year retrospective multi-centre study in Kumasi, Ghana

Author

Senu, Ebenezer, Sakyi, Samuel Asamoah, Ayisi-Boateng, Nana Kwame, Enimil, Anthony Kwame, Opoku, Stephen, Ansah, Richard Owusu, Aning, Bismark Dankwah, Ojuang, Diana Atsieno, Wekesa, Doreen Nafula, Ahmed, Fatima Osman, Okeke, Chidinma B., Sarfo, Ama Darkoaa, Kwofie, Gabriel Sakyi, and Amoani, Benjamin

Published
2022
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6. HIV symptom severity and associated factors among young people with HIV in Ghana.

Author

Tarantino, Nicholas, Norman, Betty, Enimil, Anthony, Osei Asibey, Shadrack, Martyn-Dickens, Charles, Guthrie, Kate, Kwara, Awewura, Bock, Beth, Mimiaga, Matthew J., and Brown, Larry

Subjects
FEAR, HEALTH services accessibility, VIRAL load, PSYCHOLOGICAL distress, RESEARCH funding, HIV-positive persons, FATIGUE (Physiology), HEADACHE, SEVERITY of illness index, MULTIVARIATE analysis, DESCRIPTIVE statistics, PSYCHOLOGY of HIV-positive persons, MUSCLE weakness, TELEMEDICINE, STATISTICS, SYMPTOMS
Abstract

Adolescents and young adults (young people) with HIV (YPWH) often struggle with treatment self-management. Many have symptoms due to HIV disease, medication side-effects, or comorbid conditions. Our study investigated the severity of HIV-related symptoms among YPWH aged 18–24 with detectable viral loads from an HIV clinic in Ghana (N = 60) and potential correlates of severity across a range of factors. Results indicated that YPWH currently experienced, on average, 13 symptoms (SD = 12.33). Six of the 10 most common symptoms were from two domains: fatigue and psychological. The most common symptoms were headaches (62%), weakness (53%), and fear/worries (52%). No differences were observed in number or severity of symptoms between youth based on HIV transmission status. Bivariate correlates of symptom severity were found with six that remained significant or approached significance in a multivariate model predicting severity: living with a parent/guardian, higher perceived access to HIV care, and higher treatment readiness were associated with lower severity while greater travel time to the HIV clinic, psychological distress, and more missed clinic appointments were associated with higher severity. Our findings suggest that interventions to address symptoms among YPWH should be multilevel and include strategies (e.g., telehealth, home care) to increase access to care. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Social constructs, late recognition and decision making for managing fast breathing in children

Author

Agyei-Baffour, Peter, Ansong, Daniel, Osei, Francis Adjei, Appiah, Seth Christopher Yaw, Kwarteng, Sandra Owusu, Nyanor, Isaac, Bonney, Joseph, Enimil, Anthony, Odai Laryea, Dennis, Dapaah, Jonathan Mensah, Mensah, Nicholas, Osei-Peprah, Ida, Owusu, Alfred, Addo-Yobo, Emmanuel, Osei-Akoto, Alex, Owusu, Osei Asibey, Ampiah, Victoria, Saahene, Joana Osei, Amuzu, Evans Xorse, and Sylverken, Justice

Published
2020
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10. Use of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries

Author

Irwin, Adam, Akula, Akhila, Bamford, Alasdair, Chang, Amanda, da Silva, Andre, Whitelaw, Andrew, Dramowski, Angela, Vasudevan, Anil Kumar, Sharma, Anita, Justicia, Antonio, Chikkappa, Ashok, Slowinska-Jarzabek, Barbara, Rippberger, Bianca, Zhao, Changan, Tersigni, Chiara, Cheng, Chinglan, Harkensee, Christian, Jing, Chuamei, Zhu, Chunmei, Li, Chunyan, Tagliabue, Claudia, Epalza, Cristina, Jacqueline, Daglish, Tian, Daiyin, Jinka, Dasaratha, Gkentzi, Despoina, Dharmapalan, Dhanya, Benadof, Dona, Papadimitriou, Eleni, Iosifidis, Elias, Roilides, Emmanuel, Yarci, Erbu, Majda-Stanisławska, Ewa, Gowin, Ewelina, Chappell, Faye, Torres, Federico Martinon, Collett-White, Francis, Liu, Gang, Lu, Gen, Syrogiannopoulos, George, Pitsava, Georgia, Alvarez-Uria, Gerardo, Renk, Hana, Mahmood, Hana, Saxen, Harri, Finlayson, Heather, Green, Helen, Rabie, Helena, Kandraju, Hemasree, Zhang, Hong, Okokon, Ita, Cross, Jack, Herberg, Jethro, Li, Jianping, Zhang, Jiaosheng, Deng, Jikui, Liu, Jing, Qian, Jing, Yang, Jinhong, Sicińska, Joanna, Hübner, Johannes, Fukuoka, Kahoru, Yao, Kaihu, Cheung, Kaman, Ojeda, Karla, Kaffe, Katerina, Kreitmeyer, Katharina, Doerholt, Katja, Grimwood, Keith, Ledoare, Kirsty, Vazouras, Konstantinos, Shen, Kunling, Tang, Lanfang, Zhang, Lehai, Lin, Li, Ashkenazi-Hoffnung, Liat, Wu, Lijuan, Wang, Lijun, Teston, Lilian, Galli, Luisa, Speirs, Lynne, Tsolia, Maria, Hufnagel, Markus, Knuf, Markus, Duse, Marzia, Ding, Mingjie, Rozic, Mojca, Premru, Mueller, O'Connell, Natasha, Rieber, Nikolaus, Spyridis, Nikos, Tunga, Onkaraiah, Conejo, Pablo Rojo, McMaster, Paddy, Lumbiganon, Pagakrong, Pansa, Paola, D'Argenio, Patrizia, Moriarty, Paul, Nikolic, Petra, Wang, Ping, Paopongsawan, Pongsatorn, Cao, Qing, Deng, Qiulian, Laxminarayan, Ramanan, Kanithi, Ravishankar, Jimenez, Rodolfo, Cao, Sancheng, Singh, Sanjeev, Rees, Sarah, Praveen, Saroey, Kekomaki, Satu, Hackett, Scott, Ashkenazi, Shai, Chang, Si Min, Drysdale, Simon, Koning, Sonia, Subramanian, Sreeram, Murki, Srinivas, Vergnano, Stefania, Gandra, Sumanth, Esposito, Susanna, Anugulruengkitt, Suvaporn, Puthanakit, Thanyawee, Behrends, Uta, Papaevangelous, Vana, Jian, Victoria, Li, Wei, Zhao, Wei, Wang, Wei, Zhang, Wenshuang, Mu, Xiaoping, Dong, Xiaoyie, Jiang, Xiyuan, Chen, Xu, Wang, Yi, Zheng, Yuejie, Horikoshi, Yuho, Aboderin, Aaron, Olayinka, Adebola, Dedeic-Ljubovic, Amela, McCorry, Ann, Enimil, Anthony, Neubert, Antje, solano, antonio, Pignatari, Antonio, Poojary, Aruna, Kambaralieva, Baktygul, McCullagh, Bernadette, Carevi, Biljana, Van Herendael, Bruno, Gormley, Cairine, Carvajal, Camila, Ramírez, Carlos, Fitzgerald, David, Sabuda, Deana, Konopnicki, Deborah, Lacej, Denada, Pierard, Denis, Rios, Edgar, Marshall, Emily, Firre, Eric, van Elzakker, Erika, Shaqiri, Erjona, Darwish Elhajji, Feras, Gawrys, Gerard, Markovic, Goran, Kunsihima, Hiroyuki, Chen, Hui Hiong, Sviestina, Inese, Pristas, Irina, Hoxha, Iris, Korinteli, Irma, Mareković, Ivana, Soltani, Jafar, Labarca, Jaime, AlSalman, Jameela, Horvatic, Jasminka, Frimpong, Juliet Ampomah, Pagava, Karaman, Kei, Kasahara, Okinaka, Keiji, Iregbu, Kenneth, Ghazaryan, Lilit, Raka, Lul, Gessner-Wharton, Mallory, Aldeyab, Mamoon, Cooper, Mandelin, del Castillo, Marcelo, Hojman, Martin, Hudson, Melissa, Alshehri, Mohamed, Ling, Moi Lin, Greer, Nickie, Oduyebo, Oyinlola, Buijtels, Patricia, TEROL BARRERO, PEDRO, Zarb, Peter, Schelstraete, PEtra, Nwajiobi-Princewill, Princewill Ifeanyi Philip, Khanna, Priya, Quiros, Rodolfo, Simovic, Sanja, Thompson, Sarah, Chan, Si Min, Burokiene, Sigita, Rachina, Svetlana, Usonis, Vytautas, Cornistein, Wanda, Holemans, Xavier, Gu, Yoshiaki, Brothers, Adam, Hersh, Adam, Fernandez, Alfred, Tribble, Alison, Hurst, Amanda, Green, Andrea, Hammer, Benjamin, Lee, Betty P, Kuzmic, Brenik, Shapiro, Craig, Boge, Craig, Haslam, David, Berman, David, Naeem, Fouzia, Johnson, George, Schwenk, Hayden, Orr, Hillary, Maples, Holly, Olsen, Jared, Gerber, Jeffrey, Girotto, Jennifer, Zweiner, Jennifer, Goldman, Jennifer, Gillon, Jessica, Tansmore, Jessica, Manaloor, John, Courter, Joshua, Mongkolrattanothai, Kanokporn, Patel, Karisma, Merkel, Kathryn, Namtu, Katie, Flett, Kelly, Lee, Kelly, Nichols, Kristen, Klein, Kristin, Handy, Lori, Castagnini, Luis, Mazade, Marc, Heger, Margaret, Fernandez, Marisol, Chang, Michael, Crawford, Michelle, Nelson, Miranda, Bennett, Nicholas, Jaggi, Preeti, Hamdy, Rana, Banerjee, Ritu, Olivero, Rosemary, Patel, Sameer, Arnold, Sandra, Ogrin, Sara, Jones, Sarah, Parker, Sarah, Kubes, Sarah, Hymes, Saul, Weissman, Scott, Chan, Shannon, Henderson, Sheryl, Metjian, Talene, Hsia, Yingfen, Lee, Brian R, Versporten, Ann, Yang, Yonghong, Bielicki, Julia, Jackson, Charlotte, Newland, Jason, Goossens, Herman, Magrini, Nicola, and Sharland, Mike

Published
2019
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11. Aetiological agents of pneumonia among HIV and non-HIV infected children in Ghana: A case-control study.

Author

Owusu, Michael, Adu, Eric, Kalu, Lotenna Elsie, Martey, Eugene, Acheampong, Godfred, Enimil, Anthony, Appiah, John Adabie, Badu-Peprah, Augustina, Sylverken, Justice, Sylverken, Augustina Angelina, Nguah, Samuel Blay, Westeel, Emilie, Pouzol, Stephane, Drosten, Christian, and Adu-Sarkodie, Yaw

Abstract

Pneumonia is the leading cause of death in children, however, the microbial aetiology of pneumonia is not well elucidated in low- and middle-income countries. Our study was aimed at determining the microbial aetiologies of childhood pneumonia and associated risk factors in HIV and non-HIV infected children. We conducted a case-control study that enrolled children with pneumonia as cases and non-pneumonia as controls from July 2017 to May 2020. Induced sputum and blood samples were investigated for microbial organisms using standard microbiological techniques. DNA/RNA was extracted from sputum samples and tested for viral and bacterial agents. Four hundred and four (404) subjects consisting of 231 (57.2%) cases and 173 (42.8%) controls were enrolled. We identified a significant (p = 0.011) proportion of viruses in cases (125; 54.1%, 95%CI: 47.4–60.7) than controls (71; 33.6%, 95%CI: 33.6–48.8) and these were mostly contributed to by Respiratory Syncytial Virus. Staphylococcus aureus (16; 4.0%), Klebsiella spp. (15, 3.7%) and Streptococcus pneumoniae (8, 2.0%) were the main bacterial agents identified in sputum or induced sputum samples. HIV infected children with viral-bacterial co-detection were found to have very severe pneumonia compared to those with only viral or bacterial infection. Indoor cooking (OR = 2.36; 95%CI:1.41–3.96) was found to be associated with pneumonia risk in patients. This study demonstrates the importance of various microbial pathogens, particularly RSV, in contributing to pneumonia in HIV and non-HIV paediatric populations. There is a need to accelerate clinical trials of RSV vaccines in African populations to support improvement of patient care. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Human candidate gene polymorphisms and risk of severe malaria in children in Kilifi, Kenya: a case-control association study

Author

Abathina, Amadou, Abubakar, Ismaela, Achidi, Eric, Agbenyega, Tsiri, Aiyegbo, Mohammed, Akoto, Alex, Allen, Angela, Allen, Stephen, Amenga-Etego, Lucas, Amodu, Folakemi, Amodu, Olukemi, Anchang-Kimbi, Judith, Ansah, Nana, Ansah, Patrick, Ansong, Daniel, Antwi, Sampson, Anyorigiya, Thomas, Apinjoh, Tobias, Asafo-Agyei, Emmanuel, Asoala, Victor, Atuguba, Frank, Auburn, Sarah, Bah, Abdou, Bamba, Kariatou, Bancone, Germana, Band, Gavin, Barnwell, David, Barry, Abdoulaye, Bauni, Evasius, Besingi, Richard, Bojang, Kalifa, Bougouma, Edith, Bull, Susan, Busby, George, Camara, Abdoulie, Camara, Landing, Campino, Susana, Carter, Richard, Carucci, Dan, Casals-Pascual, Climent, Ceesay, Ndey, Ceesay, Pa, Chau, Tran, Chuong, Ly, Clark, Taane, Clarke, Geraldine, Cole-Ceesay, Ramou, Conway, David, Cook, Katharine, Cook, Olivia, Cornelius, Victoria, Corran, Patrick, Correa, Simon, Cox, Sharon, Craik, Rachel, Danso, Bakary, Davis, Timothy, Day, Nicholas, Deloukas, Panos, Dembele, Awa, deVries, Jantina, Dewasurendra, Rajika, Diakite, Mahamadou, Diarra, Elizabeth, Dibba, Yaya, Diss, Andrea, Djimdé, Abdoulaye, Dolo, Amagana, Doumbo, Ogobara, Doyle, Alan, Drakeley, Chris, Drury, Eleanor, Duffy, Patrick, Dunstan, Sarah, Ebonyi, Augustine, Elhassan, Ahmed, Elhassan, Ibrahim, Elzein, Abier, Enimil, Anthony, Esangbedo, Pamela, Evans, Jennifer, Evans, Julie, Farrar, Jeremy, Fernando, Deepika, Fitzpatrick, Kathryn, Fullah, Janet, Garcia, Jacob, Ghansah, Anita, Gottleib, Michael, Green, Angie, Hart, Lee, Hennsman, Meike, Hien, Tran, Hieu, Nguyen, Hilton, Eliza, Hodgson, Abraham, Horstmann, Rolf, Hubbart, Christina, Hughes, Catherine, Hussein, Ayman, Hutton, Robert, Ibrahim, Muntaser, Ishengoma, Deus, Jaiteh, Jula, Jallow, Mariatou, Jallow, Muminatou, Jammeh, Kebba, Jasseh, Momodou, Jeffreys, Anna, Jobarteh, Amie, Johnson, Kimberly, Joseph, Sarah, Jyothi, Dushyanth, Kachala, David, Kamuya, Dorcas, Kanyi, Haddy, Karunajeewa, Harin, Karunaweera, Nadira, Keita, Momodou, Kerasidou, Angeliki, Khan, Aja, Kivinen, Katja, Kokwaro, Gilbert, Konate, Amadou, Konate, Salimata, Koram, Kwadwo, Kwiatkowski, Dominic, Laman, Moses, Le, Si, Leffler, Ellen, Lemnge, Martha, Lin, Enmoore, Ly, Alioune, Macharia, Alexander, MacInnis, Bronwyn, Mai, Nguyen, Makani, Julie, Malangone, Cinzia, Mangano, Valentina, Manjurano, Alphaxard, Manneh, Lamin, Manning, Laurens, Manske, Magnus, Marsh, Kevin, Marsh, Vicki, Maslen, Gareth, Maxwell, Caroline, Mbunwe, Eric, McCreight, Marilyn, Mead, Daniel, Mendy, Alieu, Mendy, Anthony, Mensah, Nathan, Michon, Pascal, Miles, Alistair, Miotto, Olivo, Modiano, David, Mohamed, Hiba, Molloy, Sile, Molyneux, Malcolm, Molyneux, Sassy, Moore, Mike, Moyes, Catherine, Mtei, Frank, Mtove, George, Mueller, Ivo, Mugri, Regina, Munthali, Annie, Mutabingwa, Theonest, Nadjm, Behzad, Ndi, Andre, Ndila, Carolyne, Newton, Charles, Niangaly, Amadou, Njie, Haddy, Njie, Jalimory, Njie, Madi, Njie, Malick, Njie, Sophie, Njiragoma, Labes, Nkrumah, Francis, Ntunthama, Neema, Nyika, Aceme, Nyirongo, Vysaul, O'Brien, John, Obu, Herbert, Oduro, Abraham, Ofori, Alex, Olaniyan, Subulade, Olaosebikan, Rasaq, Oluoch, Tom, Omotade, Olayemi, Oni, Olajumoke, Onykwelu, Emmanuel, Opi, Daniel, Orimadegun, Adebola, O'Riordan, Sean, Ouedraogo, Issa, Oyola, Samuel, Parker, Michael, Pearson, Richard, Pensulo, Paul, Peshu, Norbert, Phiri, Ajib, Phu, Nguyen, Pinder, Margaret, Pirinen, Matti, Plowe, Chris, Potter, Claire, Poudiougou, Belco, Puijalon, Odile, Quyen, Nguyen, Ragoussis, Ioannis, Ragoussis, Jiannis, Rasheed, Oba, Reeder, John, Reyburn, Hugh, Riley, Eleanor, Risley, Paul, Rockett, Kirk, Rodford, Joanne, Rogers, Jane, Rogers, William, Rowlands, Kate, Ruano-Rubio, Valentín, Sabally-Ceesay, Kumba, Sadiq, Abubacar, Saidy-Khan, Momodou, Saine, Horeja, Sakuntabhai, Anavaj, Sall, Abdourahmane, Sambian, David, Sambou, Idrissa, SanJoaquin, Miguel, Sepúlveda, Nuno, Shah, Shivang, Shelton, Jennifer, Siba, Peter, Silva, Nilupa, Simmons, Cameron, Simpore, Jaques, Singhasivanon, Pratap, Sinh, Dinh, Sirima, Sodiomon, Sirugo, Giorgio, Sisay-Joof, Fatoumatta, Sissoko, Sibiry, Small, Kerrin, Somaskantharajah, Elilan, Spencer, Chris, Stalker, Jim, Stevens, Marryat, Suriyaphol, Prapat, Sylverken, Justice, Taal, Bintou, Tall, Adama, Taylor, Terrie, Teo, Yik, Thai, Cao, Thera, Mahamadou, Titanji, Vincent, Toure, Ousmane, Troye-Blomberg, Marita, Usen, Stanley, Uyoga, Sophie, Vanderwal, Aaron, Wangai, Hannah, Watson, Renee, Williams, Thomas, Wilson, Michael, Wrigley, Rebecca, Yafi, Clarisse, Yamoah, Lawrence, Ndila, Carolyne M, Macharia, Alexander W, Nyutu, Gideon, Ojal, John, Shebe, Mohammed, Awuondo, Kennedy O, Mturi, Neema, Tsofa, Benjamin, Clark, Taane G, Kariuki, Silvia, Mackinnon, Margaret, Maitland, Kathryn, Kwiatkowski, Dominic P, Rockett, Kirk A, and Williams, Thomas N

Published
2018
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13. Antimicrobial consumption and resistance in adult hospital inpatients in 53 countries: results of an internet-based global point prevalence survey

Author

Koraqi, Andi, Hoxha, Iris, Tafaj, Silva, Lacej, Denada, Hojman, Martin, Quiros, Rodolfo Ernesto, Ghazaryan, Lilit, Cairns, Kelly A, Cheng, Allen, Horne, Kylie C, Doukas, Fiona F, Gottlieb, Thomas, Alsalman, Jameela, Magerman, Koen, Marielle, Gounongbe YT, Ljubovic, Amela Dedeic, Coelho, André Afonso Machado, Gales, Ana Cristina, Keuleyan, Emma, Sabuda, Deana, Boswell, Jennifer Lee, Conly, John M, Rojas, Alvaro, Carvajal, Camila, Labarca, Jaime, Solano, Antonio, Valverde, Carlos Ramírez, Villalobos-Vindas, Juan M, Pristas, Irina, Plecko, Vanda, Paphitou, Niki, Shaqiri, Erjona, Rummukainen, Maija-Liisa, Pagava, Karaman, Korinteli, Irma, Brandt, Tobias, Messler, Sabine, Enimil, Anthony, Iosifidis, Elias, Roilides, Emmanuel, Sow, Mamadou Saliou, Sengupta, Sharmila, George, Joby V, Poojary, Aruna, Patil, Priyanka, Soltani, Jafar, Jafarpour, Zahra, Ameen, Hadi, Fitzgerald, David, Maor, Yasmin, Chowers, Michal, Temkin, Elizabeth, Esposito, Susanna, Arnoldo, Luca, Brusaferro, Silvio, Gu, Yoshiaki, El-Hajji, Feras Darwish, Kim, Nam Joong, Kambaralieva, Baktygul, Pavare, Jana, Zarakauska, Lelde, Usonis, Vytautas, Burokiene, Sigita, Ivaskeviciene, Inga, Mijovic, Gordana, Duborija-Kovacevic, Natasa, Bondesio, Kristen, Iregbu, Kenneth, Oduyebo, Oyinlola, Raka, Denis, Raka, Lul, Rachina, Svetlana, Enani, Mushira Abdulaziz, Al Shehri, Mohamed, Carevic, Biljana, Dragovac, Gorana, Obradovic, Dusanka, Stojadinovic, Aleksandra, Radulovic, Lili, Wu, Jia EN, Wei Teng Chung, Gladys, Chen, Hui Hiong, Tambyah, Paul Anantharajah, Lye, David, Tan, Sock Hoon, Ng, Tat Ming, Tay, Hui Lin, Ling, Moi Lin, Chlebicki, Maciej Piotr, Kwa, Andrea L, Lee, Winnie, Beović, Bojana, Dramowski, Angela, Finlayson, Heather, Taljaard, Jantjie, Ojeda-Burgos, Guillermo, Retamar, Pilar, Lucas, Johan, Pot, Wolter, Verduin, Cees, Kluytmans, Jan, Scott, Michael, Aldeyab, Mamoon A, McCullagh, Bernadette, Gormley, Cairine, Sharpe, David, Gilchrist, Mark, Whitney, Laura, Laundy, Matthew, Lockwood, Debbie, Drysdale, Simon B, Boudreaux, Jennifer, Septimus, Edward J, Greer, Nickie, Gawrys, Gerard, Rios, Edgar, May, Suzanne, Versporten, Ann, Zarb, Peter, Caniaux, Isabelle, Gros, Marie-Françoise, Drapier, Nico, Miller, Mark, Jarlier, Vincent, Nathwani, Dilip, and Goossens, Herman

Published
2018
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14. Pharmacokinetics and pharmacodynamics of adult dolutegravir tablets in treatment-experienced children with HIV weighing at least 20 kg

Author

Martyn-Dickens, Charles, primary, Ojewale, Oluwayemisi, additional, Sly-Moore, Eugenia, additional, Dompreh, Albert, additional, Enimil, Anthony, additional, Amissah, Aikins Kofi, additional, Bosomtwe, Dennis, additional, Appiah, Augustina Frimpong, additional, Sarfo, Ama D., additional, Opoku, Theresah, additional, Asiedu, Priscilla, additional, Dong, Stephen K., additional, Kusi-Amponsah, Isaac, additional, Maranchick, Nicole, additional, Peloquin, Charles A., additional, Antwi, Sampson, additional, and Kwara, Awewura, additional

Published
2023
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15. Frailty syndrome and associated factors among patients with hypertension: A cross‐sectional study in Kumasi, Ghana.

Author

Sakyi, Samuel A., Tawiah, Phyllis, Senu, Ebenezer, Ampofo, Ransford O., Enimil, Anthony K., Amoani, Benjamin, Anto, Enoch O., Opoku, Stephen, Effah, Alfred, Abban, Elizabeth, Frimpong, Joseph, Frimpong, Emmaunel, Bannor, Lydia Oppong, Kwayie, Afia A., Naturinda, Emmanuel, Ansah, Eugene A., Baidoo, Bright T., Kodzo, Kini E., and Ayisi‐Boateng, Nana K.

Abstract

Background and Aim: Frailty is a condition marked by accumulation of biological deficits and dysfunctions that come with aging and it is correlated with high morbidity and mortality in patients with cardiovascular diseases, particularly hypertension. Hypertension continues to be a leading cause of cardiovascular diseases and premature death globally. However, there is dearth of literature in sub‐Saharan Africa on frailty syndrome among hypertensives on medication. This study evaluated frailty syndrome and its associated factors among Ghanaian hypertensives. Methods: This cross‐sectional study recruited 303 patients with hypertension from the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana. Data on sociodemographic, lifestyle and clinical factors were collected using a well‐structured questionnaire. Medication adherence was measured using Adherence in Chronic Disease Scale, and frailty was assessed by Tilburg Frailty Indicator. Statistical analyses were performed using SPSS Version 26.0 and GraphPad prism 8.0. p‐value of < 0.05 and 95% confidence interval (CI) were considered statistically significant. Results: The prevalence of frailty was 59.7%. The proportion of high, medium and low medication adherence was 23.4%, 64.4% and 12.2%, respectively. Being ≥ 70years (adjusted odds ratio [aOR]: 8.33, 95% CI [3.72–18.67], p < 0.0001), unmarried (aOR: 2.59, 95% CI [1.37–4.89], p = 0.0030), having confirmed hypertension complications (aOR: 3.21, 95% CI [1.36–7.53], p = 0.0080), medium (aOR: 1.99, 95% CI [1.05–3.82], p = 0.0360) and low antihypertensive drug adherence (aOR: 27.69, 95% CI [7.05–108.69], p < 0.0001) were independent predictors of increased odds of developing frailty syndrome. Conclusion: Approximately 6 out of 10 Ghanaian adult patients with hypertension experience frailty syndrome. Hypertension complications, older age, being unmarried, and low antihypertensive drug adherence increased the chances of developing frailty syndrome. These should be considered in intervention programmes to prevent frailty among patients with hypertension. [ABSTRACT FROM AUTHOR]

Published
2023
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16. The Economic Burden Of Households With Children Less Than Five Years Presenting With Pneumonia At Komfo Anokye Teaching Hospital, Kumasi, Ghana

Author

Francis Adjei Osei, Francis Adjei Osei, primary, Ansong, Daniel Ansong, additional, Mensah, Kofi Akohene Mensah, additional, Amuzu, Evans Xorse Amuzu, additional, Owusu, Kwame Alfred Owusu, additional, Sarpong, Phans Oduro Sarpong, additional, Osei-Peprah, Ida Osei-Peprah, additional, Kobina, Timothy Ofori Kobina, additional, Bonney, Joseph Bonney, additional, Enimil, Anthony Enimil, additional, Dankwah, Bright Atta Dankwah, additional, and Agyei-Baffour, Peter Agyei-Baffour, additional

Published
2022
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22. Hospital antibiotic prescribing patterns in adult patients according to the WHO Access, Watch and Reserve classification (AWaRe): results from a worldwide point prevalence survey in 69 countries

Author

Pauwels, Ines, Versporten, Ann, Drapier, Nico, Vlieghe, Erika, Goossens, Herman, Koraqi, Andi, Hoxha, Iris, Tafaj, Silva, Cornistein, Wanda, Quiros, Rodolfo, Hojman, Martin, Ghazaryan, Lilit, Horne, Kylie, Cairns, Kelly, Doukas, Fiona, Gottlieb, Thomas, Sermijn, Erica, Verhamme, Katia, Brands, Christiane, Van Herendael, Bruno, Filippin, Lorenzo, Vandewal, Wouter, Konopnicki, Deborah, Maillart, Evelyne, Teixeira Lopes, Liliana, Papin, Pauline, Smits, Ilse, Jansens, Hilde, Bartholomeus, Sofie, Van den Abeele, Anne-Marie, Steyaert, Sophia, Piette, Anne, Buyle, Franky, Cartuyvels, Reinoud, Jonckheere, Stijn, Wybo, Ingrid, Vanneste, Lorenz, Mathieu, Delphine, Firre, Eric, Westelinck, Veerle, Gadisseux, Philippe, Dugernier, Thierry, Bafort, Kristof, Gonissen, Viviane, Vanderper, Vanessa, Gabriels, Patrick, Weekers, Frank, Michel, Philippe, Van Liedekerke, Ann, Costers, Michiel, Catry, Boudewijn, Dedeic-Ljubovic, Amela, Gales, Ana C., Matos Porto, Ana Paula, Figueiredo Costa, Silvia, Keuleyan, Emma, Beidi, Apollinaire, Cissohko, Youssouph, Blakwe, Habsatou, Batchaya Basile, Ngassa, German, Greg J., Lutes, Sarah, Boswell, Jennifer, Mertz, Dominik, Nguyen, Tuyen, MacLaggan, Timothy, Landry, Daniel, Ang, Anita, Thirion, Daniel J.G., Frenette, Charles, Émond, Yannick, Roberts, Jacqueline, Chang, Sandra, Kosar, Justin, Valiquette, Louis, Dutrisac, Ginette, Afra, Kevin, McGeer, Allison, Carrier, Marie, Grant, Jennifer, Labarca, Jaime, Carvajal, Camila, Lin, HongYi, Wang, Qiang, Yang, Jing, Yang, Wenjie, Cortes, Jorge A., Villalobos-Vindas, Juan, Ramírez-Valverde, Carlos, Horvatic, Jasminka, Pristas, Irina, Paphitou, Niki, Rummukainen, Maija-Liisa, Froissart, Antoine, Vanhems, Philippe, Pagava, Karaman, Korinteli, Irma, Brandt, Tobias, Gaertner, Johannes, Enimil, Anthony, Roilides, Emmanuel, Hajdú, Edit, Sengupta, Sharmila, Singh, Sanjeev, Patil, Priyanka, Poojary, Aruna, Soltani, Jafar, Pouladfar, Gholamreza, Jafarpour, Zahra, Alinia, Cyrus, Ameen, Hadi, Fitzgerald, David, Paul, Mical, Maor, Yasmin, Strahilevitz, Jacob, Chowers, Michal, Temkin, Elizabeth, Luca, Arnoldo, Ishibashi, Noriomi, Gu, Yoshiaki, Darwish Elhajji, Feras, Karabukayeva, Aizhan, Raka, Denis, Kambaralieva, Baktygul, Zarakauska, Lelde, Zarb, Peter, Hernandez Chena, Blanca Estela, Gonzalez-Diaz, Esteban, Corona-Meléndez, JuanCarlos, Torres Erazo, Darwin Stalin, Loza-Jalil, Suria Elizabeth, Molina, Julio, Candelas, Jose Antonio, Mijovic, Gordana, Duborija-Kovacevic, Natasa, Jong, Eefje, Kluytmans, Jan, van Elzakker, Erika, Schweitzer, Valentijn, Davies, Nicola, Iregbu, Kenneth, Nwajiobi-Princewill, Philip, Nwafia, Ifeyinwa, Fasuyi, Temitayo, Aboderin, Aaron, Elikwu, Charles John, Fadeyi, Abayomi, Ola-Bello, Olafoyekemi, Oduyebo, Oyinlola, Adedosu, Akin Nelson, Ekuma, Agantem, Shaqiri, Erjona, Saleem, Zikria, De Los Reyes, Mari Rose, Tavares, Luis, Kim, Nam Joong, Rachina, Svetlana, Alharthi, Alwaleed R., Enani, Mushira, Faried, Osama, Mirghani, Mohamed, Carevic, Biljana, Radulovic, Lili, Dragovac, Gorana, Tan, Sock Hoon, Taljaard, Jantjie, Chibabhai, Vindana, Joiner, Jennifer, Caston, Juan Jose, Núñez-Núñez, María, Martínez-Marcos, Francisco Javier, Ojeda-Burgos, Guillermo, Menendez, Maria Dolores, Retamar, Pilar, Corzo, Juan E., Rattanaumpawan, Pinyo, Salou, Mounerou, Mnif, Basma, Oncul, Ahsen, Babigumira, Peter Ahabwe, Olweny, James, Marshall, Emily, McCorry, Ann, Aldeyab, Mamoon, Khanna, Priya, Gormley, Cairine, Maloney, Sara, Cooper, Mandelin, Blackburn, Laura, Gessner-Wharton, Mallory, Vu, Lam, Greer, Nickie, Gawrys, Gerard, Kronmann, Lisha, Rios, Edgar, Hudson, Melissa, Lindholm, David A., The Global-PPS network, Vriendenkring VUB, Clinical sciences, Microbiology and Infection Control, and Clinical Biology

Subjects
Adult, Microbiology (medical), Point prevalence survey, Latin Americans, education, Population, MEDLINE, World Health Organization, Essential medicines, Antibiotic prescribing, Anti-Infective Agents, Environmental health, Prevalence, Humans, AcademicSubjects/MED00740, Medicine, Pharmacology (medical), Medical prescription, Biology, Original Research, Pharmacology, education.field_of_study, Adult patients, business.industry, Pharmacology. Therapy, Hospitals, Anti-Bacterial Agents, Anti-Bacterial Agents/therapeutic use, AcademicSubjects/MED00290, Infectious Diseases, Human medicine, AcademicSubjects/MED00230, business
Abstract

ObjectivesThe WHO Access, Watch and Reserve (AWaRe) classification has been developed to support countries and hospitals in promoting rational use of antibiotics while improving access to these essential medicines. We aimed to describe patterns of worldwide antibiotic use according to the AWaRe classification in the adult inpatient population.MethodsThe Global Point Prevalence Survey on Antimicrobial Consumption and Resistance (Global-PPS) collects hospital antibiotic use data using a standardized PPS methodology. Global-PPS 2015, 2017 and 2018 data, collected by 664 hospitals in 69 countries, were categorized into AWaRe groups to calculate proportional AWaRe use, Access-to-Watch ratios and the most common indications for treatment with selected Watch antibiotics. Only prescriptions for systemic antibiotics on adult inpatient wards were analysed.ResultsRegional Access use ranged from 28.4% in West and Central Asia to 57.7% in Oceania, whereas Watch use was lowest in Oceania (41.3%) and highest in West and Central Asia (66.1%). Reserve use ranged from 0.03% in sub-Saharan Africa to 4.7% in Latin America. There were large differences in AWaRe prescribing at country level. Watch antibiotics were prescribed for a range of very different indications worldwide, both for therapeutic and prophylactic use.ConclusionsWe observed considerable variations in AWaRe prescribing and high use of Watch antibiotics, particularly in lower- and upper-middle-income countries, followed by high-income countries. The WHO AWaRe classification has an instrumental role to play in local and national stewardship activities to assess prescribing patterns and to inform and evaluate stewardship activities.

Published
2021

24. Xpert MTB/RIF Ultra and mycobacterial culture in routine clinical practice at a Tertiary Paediatric Hospital

Author

Enimil, Anthony Kwame, Eley, Brian, and Nuttall, James

Subjects
unconfirmed, confirmed, tuberculosis, Diagnosis, childhood
Abstract

Introduction World Health Organization approved the use of Xpert MTB/RIF Ultra (Ultra) in children due to quick turn-around time, improved yield over smear microscopy, and ability to detect rifampicin resistance despite culture being the “gold standard”. This study reviewed published literature on current childhood tuberculosis diagnostic modalities. It also retrospectively compared demographic, clinical, and radiological features of children with confirmed and unconfirmed PTB, reviewed criteria for microbiologically unconfirmed PTB, and assessed incremental microbiological yield on second and third Ultra and/or mycobacterial culture results in routine clinical care at a tertiary paediatric hospital. Method For the review on childhood TB diagnostic modalities, PubMed was searched using Boolean terms OR/AND between childhood tuberculosis and words such as diagnosis, polymerase chain reaction, molecular, histology, imaging, and cultures. All abstracts were read after which selected articles that met the objectives of the thesis were fully reviewed and referenced appropriately. The retrospective study was conducted in children (0 to 13 years) treated for Pulmonary TB (PTB) between 1 February 2018 and 31 January 2019 and who had at least one respiratory specimen investigated by Ultra and/or mycobacterial culture before TB treatment was commenced. Relevant demographic, clinical information, tuberculin skin test results and laboratory results were abstracted from paper-based medical records and electronic database. Baseline chest radiographic findings were obtained from the radiology digital imaging database. All data was entered anonymously into a Microsoft Excel spreadsheet and exported to R-statistical software for statistical analysis. Descriptive and inferential statistics were used in the analysis. Incremental yield of Ultra and/or mycobacterial cultures on sequential respiratory specimens was determined. Results Ultra is an important diagnostic method for confirming TB in children even though mycobacterial culture, molecular, and histology tests are also available. Other modalities such as imaging and immunologic tests support the diagnosis of microbiologically unconfirmed TB. 174 children with PTB ± EPTB were included in the retrospective study. The median age was 2.5 years. Tuberculosis was microbiologically confirmed in 93 (53.4%). Yield on Ultra in first respiratory specimens was 39.1%. When the results of Ultra and mycobacterial culture on first respiratory specimens were combined, 47.1% (82/174) had microbiologically confirmed TB. Microcytic anaemia and pulmonary pathology were more common in confirmed TB. Of 81 children with microbiologically unconfirmed TB, 31 (38.3%) met a consensus definition of unconfirmed intrathoracic TB formulated by an international expert committee. In the subset of children (n=70) who were screened by Ultra on two sequential respiratory specimens, the incremental yield was 30.3%. When the results of Ultra and mycobacterial culture were combined the incremental yield in children who had 2 sequential respiratory specimens tested was 24.4% and 3.1% on Ultra and mycobacterial culture, respectively. Conclusion Ultra and/or mycobacterial culture on single respiratory specimens resulted in high microbiological yield. Ultra on second sequential respiratory specimens increased microbiological confirmation. The value of additional Ultra and/or mycobacterial culture testing in routine clinical practice requires further study.

Published
2022

25. Assessment of Clinical Outcomes Among Children and Adolescents Hospitalized With COVID-19 in 6 Sub-Saharan African Countries

Author

Nachega, Jean B, Sam-Agudu, Nadia A, Machekano, Rhoderick N, Rabie, Helena, van der Zalm, Marieke M, Redfern, Andrew, Dramowski, Angela, O'Connell, Natasha, Pipo, Michel Tshiasuma, Tshilanda, Marc B, Byamungu, Liliane Nsuli, Masekela, Refiloe, Jeena, Prakash Mohan, Pillay, Ashendri, Gachuno, Onesmus W, Kinuthia, John, Ishoso, Daniel Katuashi, Amoako, Emmanuella, Agyare, Elizabeth, Agbeno, Evans K, Martyn-Dickens, Charles, Sylverken, Justice, Enimil, Anthony, Jibril, Aishatu Mohammed, Abdullahi, Asara M, Amadi, Oma, Umar, Umar Mohammed, Sigwadhi, Lovemore Nyasha, Hermans, Michel, Otokoye, John Otshudiema, Mbala-Kingebeni, Placide, Muyembe-Tamfum, Jean-Jacques, Zumla, Alimuddin, Sewankambo, Nelson K, Aanyu, Hellen Tukamuhebwa, Musoke, Philippa, Suleman, Fatima, Adejumo, Prisca, Noormahomed, Emilia V, Deckelbaum, Richard J, Fowler, Mary Glenn, Tshilolo, Léon, Smith, Gerald, Mills, Edward J, Umar, Lawal W, Siedner, Mark J, Kruger, Mariana, Rosenthal, Philip J, Mellors, John W, Mofenson, Lynne M, African Forum for Research and Education in Health (AFREhealth) COVID-19 Research Collaboration on Children and Adolescents, UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - (SLuc) Centre de pathologie sexuelle masculine, and UCL - (SLuc) Service d'endocrinologie et de nutrition

Subjects
Male, Adolescent, SARS-CoV-2, Pneumonia, Viral, Oxygen Inhalation Therapy, COVID-19, Infant, Length of Stay, Respiration, Artificial, Child, Preschool, Pediatrics, Perinatology and Child Health, Outcome Assessment, Health Care, Humans, Female, Child, Child, Hospitalized, Pandemics, Africa South of the Sahara
Abstract

IMPORTANCE: Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. OBJECTIVE: To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. DESIGN, SETTING, AND PARTICIPANTS: This cohort study was a retrospective record review of data from 25 hospitals in the Democratic Republic of the Congo, Ghana, Kenya, Nigeria, South Africa, and Uganda from March 1 to December 31, 2020, and included 469 hospitalized patients aged 0 to 19 years with SARS-CoV-2 infection. EXPOSURES: Age, sex, preexisting comorbidities, and region of residence. MAIN OUTCOMES AND MEASURES: An ordinal primary outcome scale was used comprising 5 categories: (1) hospitalization without oxygen supplementation, (2) hospitalization with oxygen supplementation, (3) ICU admission, (4) invasive mechanical ventilation, and (5) death. The secondary outcome was length of hospital stay. RESULTS: Among 469 hospitalized children and adolescents, the median age was 5.9 years (IQR, 1.6-11.1 years); 245 patients (52.4%) were male, and 115 (24.5%) had comorbidities. A total of 39 patients (8.3%) were from central Africa, 172 (36.7%) from eastern Africa, 208 (44.3%) from southern Africa, and 50 (10.7%) from western Africa. Eighteen patients had suspected (n = 6) or confirmed (n = 12) multisystem inflammatory syndrome in children. Thirty-nine patients (8.3%) died, including 22 of 69 patients (31.9%) who required intensive care unit admission and 4 of 18 patients (22.2%) with suspected or confirmed multisystem inflammatory syndrome in children. Among 468 patients, 418 (89.3%) were discharged, and 16 (3.4%) remained hospitalized. The likelihood of outcomes with higher vs lower severity among children younger than 1 year expressed as adjusted odds ratio (aOR) was 4.89 (95% CI, 1.44-16.61) times higher than that of adolescents aged 15 to 19 years. The presence of hypertension (aOR, 5.91; 95% CI, 1.89-18.50), chronic lung disease (aOR, 2.97; 95% CI, 1.65-5.37), or a hematological disorder (aOR, 3.10; 95% CI, 1.04-9.24) was associated with severe outcomes. Age younger than 1 year (adjusted subdistribution hazard ratio [asHR], 0.48; 95% CI, 0.27-0.87), the presence of 1 comorbidity (asHR, 0.54; 95% CI, 0.40-0.72), and the presence of 2 or more comorbidities (asHR, 0.26; 95% CI, 0.18-0.38) were associated with reduced rates of hospital discharge. CONCLUSIONS AND RELEVANCE: In this cohort study of children and adolescents hospitalized with COVID-19 in sub-Saharan Africa, high rates of morbidity and mortality were observed among infants and patients with noncommunicable disease comorbidities, suggesting that COVID-19 vaccination and therapeutic interventions are needed for young populations in this region.

Published
2022

31. Factors Associated With Viral Suppression and Rebound Among HIV Patients On Treatment: A Retrospective Study in Ghana

Author

Opoku, Stephen, primary, Sakyi, Samuel Asamoah, additional, Ayisi-Boateng, Nana Kwame, additional, Enimil, Anthony Kwame, additional, Senu, Ebenezer, additional, Ansah, Richard Owusu, additional, Aning, Bismark Dankwah, additional, Ojuang, Diana Atsieno, additional, Wekesa, Doreen Nafula, additional, Ahmed, Fatima Osman, additional, Okeke, Chidinma B., additional, and Sarfo, Ama Darkoaa, additional

Published
2021
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32. The Worldwide Antibiotic Resistance and Prescribing in European Children (ARPEC) point prevalence survey: developing hospital-quality indicators of antibiotic prescribing for children

Author

Versporten, Ann, Bielicki, Julia, Drapier, Nico, Sharland, Mike, Goossens, Herman, Calle, Graciela Maria, Garrahan, Juan P., Clark, Julia, Cooper, Celia, Blyth, Christopher C., Francis, Joshua Reginald, Alsalman, Jameela, Jansens, Hilde, Mahieu, Ludo, Van Rossom, Paul, Vandewal, Wouter, Lepage, Philippe, Blumental, Sophie, Briquet, Caroline, de Louvain, Catholique, Robbrecht, Dirk, Maton, Pierre, Gabriels, Patrick, Rubic, Zana, Kovacevic, Tanja, Nielsen, Jens Peter, Petersen, Jes Reinholdt, Poorisrisak, Porntiva, Jensen, Lise Heilmann, Laan, Mari, Tamm, Eda, Matsinen, Maire, Rummukainen, Maija-Liisa, Gajdos, Vincent, Olivier, Romain, Le Maréchal, Flore, Martinot, Alain, Prot-Labarthe, Sonia, Lorrot, Mathie, Orbach, Daniel, Pagava, Karaman, Hufnagel, Markus, Knuf, Markus, Schlag, Stephanie A. A., Liese, Johannes, Renner, Lorna, Enimil, Anthony, Awunyo, Marah, Syridou, Garyfallia, Spyridis, Nikos, Critselis, Elena, Kouni, Sofia, Mougkou, Katerina, Ladomenou, Fani, Gkentzi, Despoina, Iosifidis, Elias, Roilides, Emmanuel, Sahu, Suneeta, Murki, Srinivas, Malviya, Manoj, Kalavalapalli, Durga Bhavani, Singh, Sanjeev, Singhal, Tanu, Garg, Garima, Garg, Pankaj, Kler, Neelam, Soltani, Jafar, Jafarpour, Zahra, Pouladfar, Gholamreza, Nicolini, Giangiacomo, Montagnani, Carlotta, Galli, Luisa, Esposito, Susanna, Donaʼ, Daniele, Giaquinto, Carlo, Borgia, Eleonora, DʼArgenio, Patrizia, De Luca, Maia, Centenari, Chiara, Raka, Lul, Omar, Abeer, Al-Mousa, Haifaa, Mozgis, Dzintars, Sviestina, Inese, Burokiene, Sigita, Usonis, Vytautas, Tavchioska, Gabriela, Hargadon-Lowe, Antonia, Zarb, Peter, Borg, Michael A., González Lozano, Carlos Agustín, Zárate Castañon, Patricia, Cancino, Martha E., McCullagh, Bernadette, McCorry, Ann, Gormley, Cairine, Al Maskari, Zaina, Al-Jardani, Amina, Pluta, Magdalena, Rodrigues, Fernanda, Brett, Ana, Esteves, Isabel, Marques, Laura, Ali AlAjmi, Jameela, Claudia Cambrea, Simona, Rashed, Asia N., Mubarak Al Azmi, Aeshah Abdu, Chan, Si Min, Isa, Mas Suhaila, Najdenov, Peter, Čižman, Milan, Unuk, Sibila, Finlayson, Heather, Dramowski, Angela, Maté-Cano, Irene, Soto, Beatriz, Calvo, Cristina, Santiago, Begoña, Saavedra-Lozano, Jesus, Bustinza, Amaya, Escosa-García, Luis, Ureta, Noelia, Tagarro, Alfredo, Barrero, Pedro Terol, Rincon-Lopez, Elena Maria, Abubakar, Ismaela, Aston, Jeff, Heginbothom, Maggie, Satodia, Prakash, Garbash, Mehdi, Johnson, Alison, Sharpe, David, Barton, Christopher, Menson, Esse, Arenas-Lopez, Sara, Luck, Suzanne, Doerholt, Katja, McMaster, Paddy, Caldwell, Neil A., Lunn, Andrew, Drysdale, Simon B., Howe, Rachel, Scorrer, Tim, Gahleitner, Florian, Gupta, Richa, Nash, Clare, Alexander, John, Raman, Mala, Bell, Emily, Rajagopal, Veena, Kohlhoff, Stephan, Cox, Elaine, and Zaoutis, Theoklis

Published
2016
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33. A novel locus of resistance to severe malaria in a region of ancient balancing selection

Author

Band, Gavin, Rockett, Kirk A., Spencer, Chris C.A., Kwiatkowski, Dominic P., Le, Quang Si, Clarke, Geraldine M., Kivinen, Katja, Leffler, Ellen M., Cornelius, Victoria, Conway, David J., Williams, Thomas N., Taylor, Terrie, Bojang, Kalifa A., Doumbo, Ogobara, Thera, Mahamadou A., Modiano, David, Sirima, Sodiomon B., Wilson, Michael D., Koram, Kwadwo A., Agbenyega, Tsiri, Achidi, Eric, Marsh, Kevin, Reyburn, Hugh, Drakeley, Chris, Riley, Eleanor, Molyneux, Malcolm, Jallow, Muminatou, Pinder, Margaret, Toure, Ousmane B., Konate, Salimata, Sissoko, Sibiri, Bougouma, Edith C., Mangano, Valentina D., Amenga-Etego, Lucas N., Ghansah, Anita K., Hodgson, Abraham V.O., Ansong, Daniel, Enimil, Anthony, Evans, Jennifer, Apinjoh, Tobias O., Macharia, Alexander, Ndila, Carolyne M., Newton, Charles, Peshu, Norbert, Uyoga, Sophie, Manjurano, Alphaxard, Kachala, David, Nyirongo, Vysaul, Mead, Daniel, Drury, Eleanor, Auburn, Sarah, Campino, Susana G., MacInnis, Bronwyn, Stalker, Jim, Gray, Emma, Hubbart, Christina, Jeffreys, Anna E., Rowlands, Kate, Mendy, Alieu, Craik, Rachel, Fitzpatrick, Kathryn, Molloy, Sile, Hart, Lee, Hutton, Robert, Kerasidou, Angeliki, and Johnson, Kimberly J.

Published
2015
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34. Pharmacogenetic predictors of nevirapine pharmacokinetics in Ghanaian children living with HIV with or without TB coinfection

Author

Langaee, Taimour, primary, Al-Shaer, Mohammad H., additional, Gong, Yan, additional, Lima, Elizabeth, additional, Antwi, Sampson, additional, Enimil, Anthony, additional, Dompreh, Albert, additional, Yang, Hongmei, additional, Alghamdi, Wael A., additional, Wiesner, Lubbe, additional, Peloquin, Charles A., additional, and Kwara, Awewura, additional

Published
2021
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38. Family APGAR and treatment outcomes among HIV patients at two ART Centres in Kumasi, Ghana.

Author

Ayisi-Boateng, Nana K., Enimil, Anthony, Essuman, Akye, Lawson, Henry, Mohammed, Aliyu, Aninng, Douglas O., Fordjour, Emmanuel A., and Spangenberg, Kathryn

Subjects
*TREATMENT effectiveness, *HIV-positive persons, *FISHER exact test, *VIRAL load, *CHI-squared test
Abstract

Objectives: This study aimed to examine the association between Family Adaptability, Partnership, Growth, Affection and Resolve (Family APGAR) and HIV treatment outcomes. Design: A cross-sectional study using the Family APGAR questionnaire Setting: The study was conducted in Kumasi, Ghana, at the Komfo Anokye Teaching Hospital and the Kwame Nkrumah University of Science and Technology Hospital Participants: Consenting HIV-positive patients who had been on treatment for at least 12 months were recruited. Main outcome measures: The Family APGAR questionnaire was administered, and relevant data were extracted from hospital records and analysed using STATA® software. The relationship between Family APGAR and treatment outcomes was determined using Chi-squared tests or Fisher's exact test. Results: Approximately 70.1% of 304 participants were females with a mean age of 41.8 years (±9.9). At treatment initiation, 47.4% of the patients presented at World Health Organisation (WHO) clinical stages I and II and had a CD4 count = 200 cells/mm3. Females were less likely (Odds Ratio= 0.52; 95% CI=0.31 - 0.90, p = 0.018) to report late for treatment compared with the males. After 12 months of treatment, approximately 70% recorded undetectable viral load. Patients with functional families constituted 70.4%, which had a statistically significant relationship with viral load (p = 0.041). Conclusion: HIV care providers should incorporate family functionality evaluation into clinical practice and provide early essential support to enhance treatment outcomes. [ABSTRACT FROM AUTHOR]

Published
2022
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39. Insights into malaria susceptibility using genome - wide data on 17,000 individuals from Africa, Asia and Oceania

Author

Band, Gavin, Le, Quang Si, Clarke, Geraldine M., Kivinen, Katja, Hubbart, Christina, Jeffreys, Anna E., Rowlands, Kate, Leffler, Ellen M., Jallow, Muminatou, Conway, David J., Sisay-Joof, Fatoumatta, Sirugo, Giorgio, d’Alessandro, Umberto, Toure, Ousmane B., Thera, Mahamadou A., Konate, Salimata, Sissoko, Sibiri, Mangano, Valentina D., Bougouma, Edith C., Sirima, Sodiomon B., Amenga-Etego, Lucas N., Ghansah, Anita K., Hodgson, Abraham V. O., Wilson, Michael D., Enimil, Anthony, Ansong, Daniel, Evans, Jennifer, Ademola, Subulade A., Apinjoh, Tobias O., Ndila, Carolyne M., Manjurano, Alphaxard, Drakeley, Chris, Reyburn, Hugh, Phu, Nguyen Hoan, Ngoc Quyen, Nguyen Thi, Thai, Cao Quang, Hien, Tran Tinh, Teo, Yik Ying, Manning, Laurens, Laman, Moses, Michon, Pascal, Karunajeewa, Harin, Siba, Peter, Allen, Steve, Allen, Angela, Bahlo, Melanie, Davis, Timothy M. E., Cornelius, Victoria, Shelton, Jennifer, Spencer, Chris C.A., Busby, George B.J., Kerasidou, Angeliki, Drury, Eleanor, Stalker, Jim, Dilthey, Alexander, Mentzer, Alexander J., McVean, Gil, Bojang, Kalifa A., Doumbo, Ogobara, Modiano, David, Koram, Kwadwo A., Agbenyega, Tsiri, Amodu, Olukemi K., Achidi, Eric, Williams, Thomas N., Marsh, Kevin, Riley, Eleanor M., Molyneux, Malcolm, Taylor, Terrie, Dunstan, Sarah J., Farrar, Jeremy, Mueller, Ivo, Rockett, Kirk A., Kwiatkowski, Dominic P., HUS Gynecology and Obstetrics, and Wellcome Trust

Subjects
0301 basic medicine, Male, RESISTANCE LOCI, General Physics and Astronomy, Datasets as Topic, Genome-wide association study, Disease, Genome-wide association studies, DISEASE, 0302 clinical medicine, HLA Antigens, BLOOD-GROUP, Prevalence, qu_460, Malaria, Falciparum, Child, lcsh:Science, GENE-EXPRESSION, 11832 Microbiology and virology, Genetics, Multidisciplinary, PLASMODIUM-FALCIPARUM, biology, GENOTYPE, 3. Good health, ALLELE, Cerebral Malaria, Chromosomes, Human, Pair 6, Female, Malaria Genomic Epidemiology Network, Medical genomics, Adult, Asia, Science, Oceania, wa_395, Polymorphism, Single Nucleotide, General Biochemistry, Genetics and Molecular Biology, Article, malaria genomic epidemiology, plasmodium-falciparum, genotype, 03 medical and health sciences, Plasma Membrane Calcium-Transporting ATPases, parasitic diseases, medicine, Immunogenetics, Humans, Genetic Predisposition to Disease, Genetic association, TRANSCRIPTOME ANALYSES, IDENTIFICATION, Case-control study, Plasmodium falciparum, wc_755, General Chemistry, biology.organism_classification, medicine.disease, wc_750, Malaria, ASSOCIATION ANALYSIS, 030104 developmental biology, Infectious disease (medical specialty), Genetic Loci, Case-Control Studies, Africa, lcsh:Q, 3111 Biomedicine, 030217 neurology & neurosurgery, Genome-Wide Association Study
Abstract

The human genetic factors that affect resistance to infectious disease are poorly understood. Here we report a genome-wide association study in 17,000 severe malaria cases and population controls from 11 countries, informed by sequencing of family trios and by direct typing of candidate loci in an additional 15,000 samples. We identify five replicable associations with genome-wide levels of evidence including a newly implicated variant on chromosome 6. Jointly, these variants account for around one-tenth of the heritability of severe malaria, which we estimate as ~23% using genome-wide genotypes. We interrogate available functional data and discover an erythroid-specific transcription start site underlying the known association in ATP2B4, but are unable to identify a likely causal mechanism at the chromosome 6 locus. Previously reported HLA associations do not replicate in these samples. This large dataset will provide a foundation for further research on the genetic determinants of malaria resistance in diverse populations., Four genome-wide associated loci are currently known for malaria susceptibility. Here, the authors expand on earlier work by combining data from 11 malaria-endemic countries and additional population sequencing informing an African-enriched imputation reference panel, with findings including a previously unreported association on chromosome 6.

Published
2019

44. Effect of First-Line Antituberculosis Therapy on Nevirapine Pharmacokinetics in Children Younger than Three Years Old

Author

Enimil, Anthony, primary, Antwi, Sampson, additional, Yang, Hongmei, additional, Dompreh, Albert, additional, Alghamdi, Wael A., additional, Gillani, Fizza S., additional, Orstin, Antoinette, additional, Bosomtwe, Dennis, additional, Opoku, Theresa, additional, Norman, Jennifer, additional, Wiesner, Lubbe, additional, Langaee, Taimour, additional, Peloquin, Charles A., additional, Court, Michael H., additional, Greenblatt, David J., additional, and Kwara, Awewura, additional

Published
2019
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45. PS-003: EVIDENCE-INFORMED POLICY MAKING: CHALLENGES AND OPPORTUNITIES

Author

Makanga, Michael, Beattie, Pauline, Breugelmans, Gabrielle, Nyirenda, Thomas, Bockarie, Moses, Tanner, Marcel, Volmink, Jimmy, Hankins, Catherine, Walzl, Gerhard, Chegou, Novel, Malherbe, Stephanus, Hatherill, Mark, Scriba, Thomas J., Zak, Daniel E., Barry, Clifton E., Kaufmann, Stefan H.E., Noor, Abdisalan, Strub-Wourgaft, Nathalie, Phillips, Patrick, Munguambe, Khátia, Ravinetto, Raffaella, Tinto, Halidou, Diro, Ermias, Mahendrahata, Yodi, Okebe, Joseph, Rijal, Suman, Garcia, Coralith, Sundar, Shyam, Ndayisaba, Gilles, Sopheak, Thai, Ngoduc, Thang, Loen, Harry Van, Jacobs, Jan, D'Alessandro, Umberto, Boelaert, Marleen, Buvé, Anne, Kamalo, Patrick, Manda-Taylor, Lucinda, Rennie, Stuart, Mokgatla, Boitumelo, Bahati, Prince, Ijsselmuiden, Carel, Afolabi, Muhammed, Mcgrath, Nuala, Kampmann, Beate, Imoukhuede, Egeruan, Alexander, Neal, Larson, Heidi, Chandramohan, Daniel, Bojang, Kalifa, Kasaro, Margaret Phiri, Muluka, Brenda, Kaunda, Kaunda, Morse, Jill, Westfall, Andrew, Kapata, Nathan, Kruuner, Annika, Henostroza, German, Reid, Stewart, Alabi, Abraham, Foguim, Francis, Sankarganesh, Jeyaraj, Bruske, Ellen, Mfoumbi, Arnault, Mevyann, Chester, Adegnika, Ayola, Lell, Bertrand, Kranzer, Katharina, Kremsner, Peter, Grobusch, Martin, Sabiiti, Wilber, Ntinginya, Nyanda, Kuchaka, Davis, Azam, Khalide, Kampira, Elizabeth, Mtafya, Bariki, Bowness, Ruth, Bhatt, Nilesh, Davies, Gerry, Kibiki, Gibson, Gillespie, Stephen, Lejon, Veerle, Ilboudo, Hamidou, Mumba, Dieudonné, Camara, Mamady, Kaba, Dramane, Lumbala, Crispin, Fèvre, Eric, Jamonneau, Vincent, Bucheton, Bruno, Büscher, Philippe, Chisenga, Caroline, Sinkala, Edford, Chilengi, Roma, Chitundu, Hellen, Zyambo, Zude, Wandeler, Gilles, Vinikoor, Michael, Emilie, Dama, Camara, Oumou, Mathurin, Koffi, Guiguigbaza-Kossigan, Dayo, Philippe, Büscher, Regassa, Fikru, Hassane, Sakande, Bienvenu, Somda Martin, Fabrice, Courtin, Ouédraogo, Elie, Kouakou, Lingue, Owusu, Michael, Mensah, Eric, Enimil, Anthony, Mutocheluh, Mohamed, Ndongo, Francis Ateba, Tejiokem, Mathurin Cyrille, Texier, Gaetan, Penda, Calixte, Ndiang, Suzie, Ndongo, Jean-Audrey, Guemkam, Georgette, Sofeu, Casimir Ledoux, Afumbom, Kfutwa, Faye, Albert, Msellati, Philippe, Warszawski, Josiane, Vos, Alinda, Devillé, Walter, Barth, Roos, Klipstein-Grobusch, Kerstin, Tempelman, Hugo, Venter, François, Coutinho, Roel, Grobbee, Diederick, Ssemwanga, Deogratius, Lyagoba, Frederick, Magambo, Brian, Kapaata, Anne, Kirangwa, Joseph, Nannyonjo, Maria, Nassolo, Faridah, Nsubuga, Rebecca, Yebra, Gonzalo, Brown, Andrew, Kaleebu, Pontiano, Nylén, Hanna, Habtewold, Abiy, Makonnen, Eyasu, Yimer, Getnet, Burhenne, Jürgen, Diczfalusy, Ulf, Aklillu, Eleni, Steele, Duncan, Walker, Richard, Simuyandi, Michelo, Beres, Laura, Bosomprah, Samuel, Ansumana, Rashid, Taitt, C., Lamin, J.M., Jacobsen, K.H., Mulvaney, S.P., Leski, T., Bangura, U., Stenger, D., Vries, Sophie De, Zinsou, Frejus Jeannot, Honkpehedji, J, Dejon, Jean Claude, Loembe, Marguerite Massinga, Bache, Bache, Pakker, Nadine, Leeuwen, Remko Van, Hounkpatin, Aurore Bouyoukou, Yazdanbakhsh, Maria, Bethony, Jeffrey, Hotez, Peter, Diemert, David, Bache, Bache Emmanuel, Fernandes, José F., Mba, Régis M Obiang, Kabwende, Anita L., Grobusch, Martin P., Krishna, Sanjeev, Kremsner, Peter G., Todagbe, Agnandji Selidji, Nambozi, Michael, Kabuya, Jean-Bertin, Hachizovu, Sebastian, Mwakazanga, David, Kasongo, Webster, Buyze, Jozefien, Mulenga, Modest, Geertruyden, Jean-Pierre, Gitaka, Jesse, Chan, Chim, Kongere, James, Kagaya, Wataru, Kaneko, Akira, Kabore, Naomie, Barry, Nouhoun, Kabre, Zachari, Werme, Karidia, Fofana, Aminata, Compaore, Daniel, Nikiema, Frederic, Some, Fabrice, Djimde, Abdoulaye, Zongo, Issaka, Ouedraogo, Bosco, Kone, Aminatou, Sagara, Issaka, Björkman, Anders, Gil, Jose Pedro, Nchinda, Godwin, Bopda, Alain, Nji, Nadesh, Ambada, Georgia, Ngu, Loveline, Tchadji, Jules, Sake, Carol, Magagoum, Suzanne, Njambe, Ghislain D., Lisom, Abel, Park, Chae Gyu, Tait, Dereck, Sibusiso, Hlatjwako, Manda, Olga, Croucher, Kristin, Westhuizen, Anja Van Der, Mshanga, Isaac, Levin, Jonathan, Nanvubya, Annet, Kibengo, Freddie, Jaoko, Walter, Pala, Pietro, Perreau, Matthieu, Namuniina, Annemarie, Kitandwe, Paul, Tapia, Gonzalo, Serwanga, Jennifer, Yates, Nicole, Fast, Pat, Mayer, Bryan, Montefiori, David, Tomaras, Georgia, Robb, Merlin, Lee, Carter, Wagner, Ralf, Sanders, Edward, Kilembe, William, Kiwanuka, Noah, Gilmour, Jill, Kuipers, Hester, Vooij, Dani, Chinyenze, Kundai, Priddy, Frances, Ding, Song, Hanke, Tom, Pantaleo, Giuseppe, Ngasala, Billy, Jovel, Irina, Malmberg, Maja, Mmbando, Bruno, Premji, Zul, Mårtensson, Andreas, Mwaiswelo, Richard, Agbor, Lenshina, Apinjoh, Tobias, Mwanza, Sydney, Chileshe, Justin, Joshi, Sudhaunshu, Malunga, Phidelis, Manyando, Christine, Laufer, Miriam, Dara, Antoine, Niangaly, Amadou, Sinha, Indranil, Brodin, David, Fofana, Bakary, Dama, Souleymane, Dembele, Demba, Sidibe, Bakary, Diallo, Nouhoum, Thera, Mahamadou, Wright, Karin, Gil, Jose, Doumbo, Ogobara, Baraka, Vito, Nabasumba, Carolyn, Francis, Filbert, Lutumba, Pascal, Mavoko, Hypolite, Alifrangis, Michael, Geertruyden, Jean-Pierre Van, Sissoko, Sekou, Sangaré, Cheick, Toure, Sekou, Sanogo, Kassim, Diakite, Hamadoun, Toure, Siaka, Doumbia, Diagassan, Haidara, Kadiatou, Julé, Amélie, Ashurst, Hazel, Merson, Laura, Olliaro, Piero, Marsh, Vicki, Lang, Trudie, Guérin, Philippe, Awuondo, Kennedy, Njenga, Daniel, Nyakarungu, Elizabeth, Titus, Pauline, Sutamihardja, Awalludin, Lowe, Brett, Ogutu, Bernhards, Billingsley, Peter, Soulama, Issiaka, Kaboré, Moïse, Coulibaly, Aboubacar, Ouattara, Maurice, Sanon, Souleymane, Diarra, Amidou, Bougouma, Edith, Ouedraogo, Alphonse, Sombie, Benjamin, Ouedraogo, Amidou, Kargougou, Désiré, Ouattara, Daouda, Issa, Nebie, Tiono, Alfred, Sirima, Sodiomon, Chaponda, Mike, Dabira, Edgard, Dao, François, Dara, Nianwalou, Sidibe, Bouran, Coulibaly, Moctar, Tolo, Allaye, Maiga, Hamma, Ouologuem, Nouhoum, Niangaly, Hamidou, Botchway, Felix, Wilson, Nana, Dickinson-Copeland, Carmen M, Adjei, Andrew A., Wilson, Michael, Stiles, Jonathan K., Hamid, Muzamil Abdel, Awad-Elgeid, Mona, Nasr, Awad, Netongo, Palmer, Kamdem, Séverin, Velavan, Thirumalaisamy, Lasry, Estrella, Diarra, Modibo, Bamadio, Amadou, Traore, Aliou, Coumare, Samba, Soma, Bahonan, Dicko, Yeyia, Sangare, Boubou, Tembely, Aly, Traore, Djibril, Haidara, Aboubecrin, Dicko, Alassane, Diawara, Elisabeth, Beavogui, Abdoul, Camara, Daouda, Sylla, Malick, Yattara, Mohamed, Sow, Amadou, Camara, Gnèpou Camara, Diallo, Saliou, Mombo-Ngoma, Ghyslain, Remppis, Jonathan, Sievers, Moritz, Manego, Rella Zoleko, Endamne, Lilian, Hutchinson, David, Held, Jana, Supan, Christian, Salazar, Carmen L. Ospina, Bonkian, Léa Nadège, Nahum, Alain, Sié, Ali, Abdulla, Salim, Cantalloube, Cathy, Djeriou, Elhadj, Bouyou-Akotet, Marielle, Mordmüller, Benjamin, Siribie, Mohamadou, Sirima, Sodiomon B., Ouattara, San Maurice, Coulibaly, Sam, Kabore, Jean Moïse, Amidou, Diarra, Tekete, Mamadou, Burhenne, Juergen, Traore, Oumar, Haefeli, Walter, Borrmann, Steffen, Kaboré, Naomie, Kabré, Zachari, Nikèma, Fréderic, Compaoré, Daniel, Somé, Fabrice, Djimdé, Abdoulaye, Ouédraogo, Jean, Chalwe, Victor, Miller, John, Diakité, Hamadoun, Greco, Beatrice, Spangenberg, Thomas, Kourany-Lefoll, Elly, Oeuvray, Claude, Mulry, Jim, Tyagarajan, Kamala, Magsaam, Bettina, Barnes, Karen, Hodel, Eva Maria, Humphreys, Georgina, Pace, Cheryl, Banda, C.G, Denti, Paulo, Allen, Elizabeth, Lalloo, David, Mwapasa, Victor, Terlouw, Anja, Mwesigwa, Julia, Achan, Jane, Jawara, Musa, Ditanna, Gian, Worwui, Archibald, Affara, Muna, Koukouikila-Koussounda, Félix, Kombo, Michael, Vouvoungui, Christevy, Ntoumi, Francine, Etoka-Beka, Mandingha Kosso, Deibert, Julia, Poulain, Pierre, Kobawila, Simon, Gueye, Nerly Gampio, Koukouikila-Koussounda, Felix, Seda, Brian, Kwambai, Titus, Jangu, Phelix, Samuels, Aaron, ter Kuile, Feike, Kariuki, Simon, Barry, Aissata, Bousema, Teun, Okech, Brenda, Egwang, Thomas, Corran, Patrick, Riley, Eleanor, Ezennia, Ifeoma, Ekwunife, Obinna, Muleba, Mbanga, Stevenson, Jennifer, Mbata, Keith, Coetzee, Maureen, Norris, Douglas, Moneke-Anyanwoke, Ngozi, Momodou, Jasseh, Clarke, Ed, Scott, Susana, Tijani, Adelani, Djimde, Moussa, Vaillant, Michel, Samouda, Hanen, Mensah, Victorine, Roetynck, Sophie, Kanteh, Ebrima, Bowyer, Georgina, Ndaw, Amy, Oko, Francis, Bliss, Carly, Jagne, Ya Jankey, Cortese, Riccardo, Nicosia, Alfredo, Roberts, Rachel, D'Alessio, Flavia, Leroy, Odile, Faye, Babacar, Cisse, Badara, Gerry, Stephen, Viebig, Nicola, Lawrie, Alison, Ewer, Katie, Hill, Adrian, Nebie, Issa, Tiono, Alfred B, Sanou, Guillaume, Konate, Amadou T, Yaro, Baptiste J, Sodiomon, Sirima, Honkpehedji, Yabo, Agobe, Jean Claude Dejon, Zinsou, Frejus, Mengue, Juliana, Richie, Thomas, Hoffman, Stephen, Nouatin, Odilon, Ngoa, Ulysse Ateba, Edoa, Jean R, Homoet, Andreas, Engelhon, Julie Englhon, Massinga-Louembe, Marguerite, Esen, Meral, Theisen, Michael, Sim, Kim Lee, Luty, Adrian Jf, Moutairou, Kabirou, Dinko, Bismarck, King, Elizabeth, Targett, Geoffrey, Sutherland, Colin, Likhovole, Clement, Ouma, Collins, Vulule, John, Musau, Susan, Khayumbi, Jeremiah, Okumu, Albert, Murithi, Wilfred, Otu, Jacob, Gehre, Florian, Zingue, Dezemon, Kudzawu, Samuel, Forson, Audrey, Mane, Morto, Rabna, Paulo, Diarra, Bassirou, Kayede, Salako, Adebiyi, Emmanuel, Kehinde, Aderemi, Onyejepu, Nneka, Onubogu, Catherine, Idigbe, Emmanuel, Ba, Awa, Diallo, Aissatou, Mboup, Souleymane, Disse, Kodjo, Kadanga, Gerard, Dagnra, Yaotse, Baldeh, Ignatius, Corrah, Tumani, Jong, Bouke De, Antonio, Martin, Musanabaganwa, Clarisse, Musabyimana, Jean Pierre, Karita, Etienne, Diop, Blondin, Nambajimana, Abidan, Dushimiyimana, Valentine, Karame, Prosper, Russell, Jim, Ndoli, Jules, Hategekimana, Theobald, Sendegeya, Augustin, Condo, Jeannine, Binagwaho, Agnes, Okonko, Iheanyi, Okerentugba, Phillip, Opaleye, Oluyinka, Awujo, Ezinwanne, Frank-Peterside, Nnenna, Moyo, Sikhulile, Kotokwe, Kenanao, Mohammed, Terence, Boleo, Coretah, Mupfumi, Lucy, Chishala, Samuel, Gaseitsiwe, Simani, Tsalaile, Lesedi, Bussmann, Herman, Makhema, Joseph, Baum, Marianna, Marlink, Richard, Engelbretch, Susan, Essex, Max, Novitsky, Vladimir, Saka, Emmanuel, Kalipalire, Zex, Bhairavabhotla, Ravikiran, Midiani, Dalitso, Sherman, Judith, Mgode, Georgies, Cox, Christophe, Bwana, Dickens, Mtui, Leah, Magesa, Daniel, Kahwa, Amos, Mfinanga, Godfrey, Mulder, Christiaan, Borain, Nick, Petersen, Lizette, Plessis, Julianne Du, Theron, Grant, Holm-Hansen, Carol, Tekwu, Emmanuel Mouafo, Sidze, Larissa Kamgue, Assam, Jean Paul Assam, Eyangoh, Sarah, Niemann, Stefan, Beng, Veronique Penlap, Frank, Matthias, Atiadeve, Samuel, Hilmann, Doris, Awoniyi, Dolapo, Baumann, Ralf, Kriel, Belinda, Jacobs, Ruschca, Kidd, Martin, Loxton, Andre, Kaempfer, Susanne, Singh, Mahavir, Mwanza, Winnie, Milimo, Deborah, Moyo, Maureen, Kasese, Nkatya, Cheeba-Lengwe, Maina, Munkondya, Stembiso, Ayles, Helen, Haas, Petra De, Muyoyeta, Monde, Namuganga, Anna Ritah, Kizza, Harriet Mayanja, Mendy, Alieu, Tientcheu, Leopold, Ayorinde, Abigail, Coker, Edward, Egere, Uzochukwu, Coussens, Anna, Naude, Celeste, Chaplin, George, Noursadeghi, Mahdad, Martineau, Adrian, Jablonski, Nina, Wilkinson, Robert, Ouedraogo, Henri Gautier, Matteelli, Alberto, Regazzi, Mario, Tarnagda, Grissoum, Villani, Paola, Sulis, Giorgia, Diagbouga, Serge, Roggi, Alberto, Giorgetti, Francesco, Kouanda, Seni, Bidias, Amel, Ndjonka, Dieudonné, Olemba, Clémence, Souleymanou, Arabo, Mukonzo, Jackson, Kuteesa, Ronald, Ogwal-Okeng, Jasper, Gustafsson, Lars L., Owen, Joel, Bassi, Peter, Gashau, Wadzani, Olaf, Klungel, Dodoo, Alexander, Okonkwo, Prosper, Kanki, Phyllis, Maruapula, Dorcas, Seraise, Boitumelo, Einkauf, Kevin, Reilly, Amanda, Rowley, Christopher, Musonda, Rosemary, Framhein, Anna, Mpagama, Stella, Semvua, Hadija, Maboko, Leonard, Hoelscher, Michael, Heinrich, Norbert, Mulenga, Lloyd, Kaayunga, Callistus, Davies, Mary-Ann, Egger, Matthias, Musukuma, Kalo, Dambe, Rosalia, Usadi, Benjamin, Ngari, Moses, Thitiri, Johnstone, Mwalekwa, Laura, Fegan, Greg, Berkley, James, Nsagha, Dickson, Munamunungu, Virginia, Bolton, Carolyn, Siyunda, Alice, Shilimi, Jacinta, Bucciardini, Raffaella, Fragola, Vincenzo, Abegaz, Teshome, Lucattini, Stefano, Halifom, Atakilt, Tadesse, Eskedar, Berhe, Micheal, Pugliese, Katherina, Castro, Paola De, Terlizzi, Roberta, Fucili, Luca, Gregorio, Massimiliano Di, Mirra, Marco, Zegeye, Teame, Binelli, Andrea, Vella, Stefano, Abraham, Loko, Godefay, Hagos, Rakotoarivelo, Rivo, Raberahona, Mihaja, Randriamampionona, Njary, Andriamihaja, Rabezanahary, Rasamoelina, Tahinamandranto, Cornet, Muriel, Randria, Mamy Jean De Dieu, Benet, Thomas, Vanhems, Philippe, Andrianarivelo, Mala Rakoto, Chirwa, Uchizi, Michelo, Charles, Hamoonga, Raymond, Wandiga, Steve, Oduor, Patience, Agaya, Janet, Sharma, Aditya, Cavanaugh, Sean, Cain, Kevin, Mukisa, John, Mupere, Ezekiel, Worodria, William, Ngom, Justice Trésor, Koro, Francioli, Godwe, Celestin, Adande, Clemence, Ateugieu, Romaric, Onana, Tatiana, Ngono, Annie, Kamdem, Yannick, Ngo-Niobe, Sara, Etoa, François-Xavier, Kanengoni, Muchineripi, Ruzario, Sithembile, Ndebele, Paul, Shana, Melody, Tarumbiswa, Fadzai, Musesengwa, Rosemary, Gutsire, Rutendo, Fisher, Kevin, Thyagarajan, Bargavi, Akanbi, Olusola, Binuyo, Michael, Ssengooba, Willy, Respeito, Durval, Mambuque, Edson, Blanco, Silvia, Mandomando, Inacio, Cobelens, Frank, Garcia-Basteiro, Alberto, Tamene, Ayele, Topp, Stephanie, Mwamba, Chanda, Padian, Nancy, Sikazwe, Izukanji, Geng, Elvin, Holmes, Charles, Sikombe, Kombatende, Hantuba, Cardinal, Czaicki, Nancy, Simbeza, Sandra, Somwe, Paul, Umulisa, Michele, Ilo, Jennifer, Kestelyn, Evelyne, Uwineza, Mireille, Agaba, Stephen, Delvaux, Therese, Wijgert, Janneke, Gethi, Dickson, Odeny, Lazarus, Tamandjou, Cynthia, Kaindjee-Tjituka, Francina, Brandt, Laura, Cotton, Mark, Nel, Etienne, Preiser, Wolfgang, Andersson, Monique, Adepoju, Abiola, Magana, Musa, Etsetowaghan, Andrew, Chilikwazi, Mutinta, Sutcliffe, Catherine, Thuma, Philip, Sinywimaanzi, Kathy, Matakala, Hellen, Munachoonga, Passwell, Moss, William, Masenza, Issa Sabi, Geisenberger, Otto, Agrea, Peter, Rwegoshora, France, Mahiga, Hellen, Olomi, Willyhelmina, Kroidl, Arne, Kayode, Gbenga, Amoakoh-Coleman, Mary, Ansah, Evelyn, Uthman, Olalekan, Fokam, Joseph, Santoro, Maria-Mercedes, Musolo, Chrissie, Chimbiri, Isabel, Chikwenga, Gloria, Deula, Ruth, Massari, Riccardo, Lungu, Agness, Perno, Carlo-Federico, Ndzengue, Georgia, Loveline, Ngu, Lissom, Abel, Flaurent, Tchouangueu, Sosso, Samuel, Essomba, Claudine, Kpeli, Grace, Otchere, Isaac, Lamelas, Araceli, Buultjens, Andrew, Bulach, Dieter, Baines, Sarah, Seemann, Torsten, Giulieri, Stefano, Nakobu, Zuliehatu, Aboagye, Samuel, Owusu-Mireku, Evelyn, Danso, Emelia, Hauser, Julia, Hinic, Vladimira, Pluschke, Gerd, Stinear, Timothy, Yeboah-Manu, Dorothy, Elshayeb, Ayman, Siddig, Marmar El, Ahmed, Abdel Azim, Hussien, Adil El, Kabwe, Mwila, Tembo, John, Chilukutu, Lophina, Chilufya, Moses, Ngulube, Francis, Lukwesa, Chileshe, Enne, Virve, Wexner, Hannah, Mwananyanda, Lawrence, Hamer, Davidson, Sinyangwe, Sylvester, Ahmed, Yusuf, Klein, Nigel, Maeurer, Markus, Zumla, Ali, Bates, Matthew, Beyala, Landry, Etienne, Guenou, Anthony, Njimbia, Benjamin, Azike, Ateudjieu, Jerome, Chibwe, Bertha, Ojok, David, Tarr, Christine Attia, Perez, Guillermo Martinez, Omeonga, Senga, Kibungu, Fanta, Meyer, Ana, Lansana, Peter, Mayor, Alfredo, Onyango, Peter, Loggerenberg, François Van, Furtado, Tamzin, Boggs, Liam, Segrt, Alexis, Dochez, Carine, Burnett, Rosemary, Mphahlele, M. Jeffrey, Miiro, George, Mbidde, Edward, Peshu, Norbert, Kivaya, Esther, Ngowi, Bernard, Kavishe, Reginald, Maowia, Mukhtar, Sandstrom, Eric, Ayuo, Elizabeth, Mmbaga, Blandina, Leisegang, Cordelia, Thorpe, Marie, Batchilly, Elizabeth, N'Guessan, Jean-Pierre, Kanteh, Dembo, Søfteland, Solrun, Sebitloane, Motshedisi, Vwalika, Bellington, Taylor, Myra, Galappaththi-Arachchige, Hashini, Holmen, Sigve, Gundersen, Svein Gunnar, Ndhlovu, Patricia, Kjetland, Eyrun Floerecke, Kombe, Francis, Toohey, Jacintha, Pienaar, Elizabeth, Kredo, Tamara, Cham, Pa Modou, Abubakar, Ismaela, Dondeh, Bai Lamin, Vischer, Nerina, Pfeiffer, Constanze, Burri, Christian, Musukwa, Kalo, Zürcher, Samuel, Mwandu, Temwani, Bauer, Sophie, Adriko, Moses, Mwaura, Peter, Omolloh, Kevin, Jones, Clarer, Malecela, Mwelecele, Hamidu, Buhari Adamu, Jenner, Tettevi Edward, Asiedu, Larbi John, Osei-Atweneboana, Mike, Afeke, Innocent, Addo, Phyllis, Newman, Mercy, Durnez, Lies, Eddyani, Miriam, Ammisah, Nana, Abas, Mona, Quartey, Maxwell, Ablordey, Anthony, Akinwale, Olaoluwa, Adeneye, Adeniyi, Ezeugwu, Sylvanus, Olukosi, Yetunde, Adewale, Babatunde, Sulyman, Medinat, Mafe, Margaret, Okwuzu, Jane, Gyang, Pam, Nwafor, Timothy, Henry, Uzoma, Musa, Bilkisu, Ujah, Innocent, Agobé, Jean Claude Dejon, Grau-Pujol, Berta, Sacoor, Charfudin, Nhabomba, Augusto, Casellas, Aina, Quintó, Llorenç, Subirà, Carme, Giné, Ricard, Valentín, Antònia, Muñoz, Jose, Nikiema, Marguerite, Ky-Ba, Absatou, Comapore, Kiswendsida Abdou Muller, Traore, Alfred, Sangare, Lassana, Oluremi, Adeolu, Michel, Mandro, Camara, Yaya, Sanneh, Bakary, Cuamba, Inocencia, Gutiérrez, Jose, Lázaro, Carlota, Mejia, Rojelio, Adedeji, Abimbola, Folorunsho, Sola, Demehin, Pelumi, Akinsanya, Bamidele, Cowley, Giovanna, Silva, Eunice Teixeira Da, Nabicassa, Meno, Barros, Pedrozinho Duarte Pereira De, Blif, Milena Mbote, Bailey, Robin, Last, Anna, Mahendradhata, Yodi, Gotuzzo, Eduardo, Nys, Kateljine De, Casteels, Minnes, Nona, Sylvie Kwedi, Lumeka, Kabwende, Todagbe, Agnandji, Djima, Mariam Mama, Ukpong, Morenike, Sagay, Atiene, Khamofu, Hadiza, Torpey, Kwasi, Afiadigwe, Evaristus, Anenih, James, Ezechi, Oliver, Nweneka, Chidi, Idoko, John, Muhumuza, Simon, Katahoire, Anne, Nuwaha, Fred, Olsen, Annette, Okeyo, Seth, Omollo, Raymond, Kimutai, Robert, Ochieng, Michael, Egondi, Thaddaeus, Moonga, Clement, Chileshe, Chisele, Magwende, George, Anumudu, Chiaka, Onile, Olugbenga, Oladele, Victoria, Adebayo, Adewale, Awobode, Henrietta, Oyeyemi, Oyetunde, Odaibo, Alexander, Kabuye, Emily, Lutalo, Tom, Njua-Yafi, Clarisse, Nkuo-Akenji, Theresa, Anchang-Kimbi, Judith, Mugri, Regina, Chi, Hanesh, Tata, Rolland, Njumkeng, Charles, Dodoo, Daniel, Achidi, Eric, Fernandes, José, Bache, Emmanuel B., Matakala, Kalumbu, Searle, Kelly, Greenman, Michelle, and Rainwater-Lovett, Kaitlin

Subjects
Abstracts of Poster Presentations, Abstracts of Oral Presentations, Author Index, Abstracts of Presentations in Plenary Sessions, Article, Abstracts of the Eighth Edctp Forum, 6–9 November 2016
Published
2017

46. A global network for investigating the genomic epidemiology of malaria

Author

Achidi, Eric Akum, Agbenyega, Tsiri, Allen, Stephen, Amodu, Olukemi, Bojang, Kalifa, Conway, David, Corran, Patrick, Deloukas, Panos, Djimde, Abdoulaye, Dolo, Amagana, Doumbo, Ogobara, Drakeley, Chris, Duffy, Patrick, Dunstan, Sarah, Evans, Jennifer, Farrar, Jeremy, Fernando, Deepika, Hien, Tran Tinh, Horstmann, Rolf, Ibrahim, Muntaser, Karunaweera, Nadira, Kokwaro, Gilbert, Koram, Kojo, Kwiatkowski, Dominic, Lemnge, Martha, Makani, Julie, Marsh, Kevin, Michon, Pascal, Modiano, David, Molyneux, Malcolm E., Mueller, Ivo, Mutabingwa, Theonest, Peshu, Norbert, Plowe, Chris, Puijalon, Odile, Ragoussis, Jiannis, Reeder, John, Reyburn, Hugh, Riley, Eleanor, Rogers, Jane, Sakuntabhai, Anavaj, Singhasivanon, Pratap, Sirima, Sodiomon, Sirugo, Giorgio, Tall, Adama, Taylor, Terrie, Thera, Mahamadou, Troye-Blomberg, Marita, Williams, Tom, Wilson, Michael, Amenga-Etego, Lucas, Apinjoh, Tobias O., Bougouma, Edith, Dewasurendra, Rajika, Diakite, Mahamadou, Enimil, Anthony, Hussein, Ayman, Ishengoma, Deus, Jallow, Muminatou, Lin, Enmoore, Ly, Alioune, Mangano, Valentina D., Manjurano, Alphaxard, Manning, Laurens, Ndila, Carolyne M., Nyirongo, Vysaul, Oluoch, Tom, Quyen, Nguyen T. N., Suriyaphol, Prapat, Toure, Ousman, Kwiatkowski, Dominic, Alcock, Daniel, Auburn, Sarah, Barnwell, David, Bull, Susan, Campino, Susana, deVries, Jantina, Elzein, Abier, Evans, Julie, Fitzpatrick, Kathryn, Ghansah, Anita, Green, Angie, Hart, Lee, Hilton, Eliza, Hubbart, Christina, Hughes, Catherine, Jeffreys, Anna E., Kivinen, Katja, MacInnis, Bronwyn, Manske, Magnus, Maslen, Gareth, McCreight, Marilyn, Mendy, Alieu, Moyes, Catherine, Nyika, Aceme, Potter, Claire, Risley, Paul, Rowlands, Kate, SanJoaquin, Miguel, Small, Kerrin, Somaskantharajah, Elilan, Stevens, Marryat, Teo, YikYing, Watson, Renee, Carucci, Dan, Cook, Katharine, Doyle, Alan, Duombo, Ogobara, Gottlieb, Michael, Kwiatkowski, Dominic, Rockett, Kirk A., Vanderwal, Aaron, Clark, Taane, Parker, Michael, and Wrigley, Rebecca

Published
2008
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47. Use of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries

Author

Hsia, Yingfen, Lee, Brian R, Versporten, Ann, Yang, Yonghong, Bielicki, Julia, Jackson, Charlotte, Newland, Jason, Goossens, Herman, Magrini, Nicola, Sharland, Mike, Irwin, Adam, Akula, Akhila, Bamford, Alasdair, Chang, Amanda, da Silva, Andre, Whitelaw, Andrew, Dramowski, Angela, Vasudevan, Anil Kumar, Sharma, Anita, Justicia, Antonio, Chikkappa, Ashok, Slowinska-Jarzabek, Barbara, Rippberger, Bianca, Zhao, Changan, Tersigni, Chiara, Cheng, Chinglan, Harkensee, Christian, Jing, Chuamei, Zhu, Chunmei, Li, Chunyan, Tagliabue, Claudia, Epalza, Cristina, Jacqueline, Daglish, Tian, Daiyin, Jinka, Dasaratha, Gkentzi, Despoina, Dharmapalan, Dhanya, Benadof, Dona, Papadimitriou, Eleni, Iosifidis, Elias, Roilides, Emmanuel, Yarci, Erbu, Majda-Stanisławska, Ewa, Gowin, Ewelina, Chappell, Faye, Torres, Federico Martinon, Collett-White, Francis, Liu, Gang, Lu, Gen, Syrogiannopoulos, George, Pitsava, Georgia, Alvarez-Uria, Gerardo, Renk, Hana, Mahmood, Hana, Saxen, Harri, Finlayson, Heather, Green, Helen, Rabie, Helena, Kandraju, Hemasree, Zhang, Hong, Okokon, Ita, Cross, Jack, Herberg, Jethro, Li, Jianping, Zhang, Jiaosheng, Deng, Jikui, Liu, Jing, Qian, Jing, Yang, Jinhong, Sicińska, Joanna, Hübner, Johannes, Fukuoka, Kahoru, Yao, Kaihu, Cheung, Kaman, Ojeda, Karla, Kaffe, Katerina, Kreitmeyer, Katharina, Doerholt, Katja, Grimwood, Keith, Ledoare, Kirsty, Vazouras, Konstantinos, Shen, Kunling, Tang, Lanfang, Zhang, Lehai, Lin, Li, Ashkenazi-Hoffnung, Liat, Wu, Lijuan, Wang, Lijun, Teston, Lilian, Galli, Luisa, Speirs, Lynne, Tsolia, Maria, Hufnagel, Markus, Knuf, Markus, Duse, Marzia, Ding, Mingjie, Rozic, Mojca, Premru, Mueller, O'Connell, Natasha, Rieber, Nikolaus, Spyridis, Nikos, Tunga, Onkaraiah, Conejo, Pablo Rojo, McMaster, Paddy, Lumbiganon, Pagakrong, Pansa, Paola, D'Argenio, Patrizia, Moriarty, Paul, Nikolic, Petra, Wang, Ping, Paopongsawan, Pongsatorn, Cao, Qing, Deng, Qiulian, Laxminarayan, Ramanan, Kanithi, Ravishankar, Jimenez, Rodolfo, Cao, Sancheng, Singh, Sanjeev, Rees, Sarah, Praveen, Saroey, Kekomaki, Satu, Hackett, Scott, Ashkenazi, Shai, Chang, Si Min, Drysdale, Simon, Koning, Sonia, Subramanian, Sreeram, Murki, Srinivas, Vergnano, Stefania, Gandra, Sumanth, Esposito, Susanna, Anugulruengkitt, Suvaporn, Puthanakit, Thanyawee, Behrends, Uta, Papaevangelous, Vana, Jian, Victoria, Li, Wei, Zhao, Wei, Wang, Wei, Zhang, Wenshuang, Mu, Xiaoping, Dong, Xiaoyie, Jiang, Xiyuan, Chen, Xu, Wang, Yi, Zheng, Yuejie, Horikoshi, Yuho, Aboderin, Aaron, Olayinka, Adebola, Dedeic-Ljubovic, Amela, McCorry, Ann, Enimil, Anthony, Neubert, Antje, solano, antonio, Pignatari, Antonio, Poojary, Aruna, Kambaralieva, Baktygul, McCullagh, Bernadette, Carevi, Biljana, Van Herendael, Bruno, Gormley, Cairine, Carvajal, Camila, Ramírez, Carlos, Fitzgerald, David, Sabuda, Deana, Konopnicki, Deborah, Lacej, Denada, Pierard, Denis, Rios, Edgar, Marshall, Emily, Firre, Eric, van Elzakker, Erika, Shaqiri, Erjona, Darwish Elhajji, Feras, Gawrys, Gerard, Markovic, Goran, Kunsihima, Hiroyuki, Chen, Hui Hiong, Sviestina, Inese, Pristas, Irina, Hoxha, Iris, Korinteli, Irma, Mareković, Ivana, Soltani, Jafar, Labarca, Jaime, AlSalman, Jameela, Horvatic, Jasminka, Frimpong, Juliet Ampomah, Pagava, Karaman, Kei, Kasahara, Okinaka, Keiji, Iregbu, Kenneth, Ghazaryan, Lilit, Raka, Lul, Gessner-Wharton, Mallory, Aldeyab, Mamoon, Cooper, Mandelin, del Castillo, Marcelo, Hojman, Martin, Hudson, Melissa, Alshehri, Mohamed, Ling, Moi Lin, Greer, Nickie, Oduyebo, Oyinlola, Buijtels, Patricia, TEROL BARRERO, PEDRO, Zarb, Peter, Schelstraete, Petra, Nwajiobi-Princewill, Princewill Ifeanyi Philip, Khanna, Priya, Quiros, Rodolfo, Simovic, Sanja, Thompson, Sarah, Chan, Si Min, Burokiene, Sigita, Rachina, Svetlana, Usonis, Vytautas, Cornistein, Wanda, Holemans, Xavier, Gu, Yoshiaki, Brothers, Adam, Hersh, Adam, Fernandez, Alfred, Tribble, Alison, Hurst, Amanda, Green, Andrea, Hammer, Benjamin, Lee, Betty P, Kuzmic, Brenik, Shapiro, Craig, Boge, Craig, Haslam, David, Berman, David, Naeem, Fouzia, Johnson, George, Schwenk, Hayden, Orr, Hillary, Maples, Holly, Olsen, Jared, Gerber, Jeffrey, Girotto, Jennifer, Zweiner, Jennifer, Goldman, Jennifer, Gillon, Jessica, Tansmore, Jessica, Manaloor, John, Courter, Joshua, Mongkolrattanothai, Kanokporn, Patel, Karisma, Merkel, Kathryn, Namtu, Katie, Flett, Kelly, Lee, Kelly, Nichols, Kristen, Klein, Kristin, Handy, Lori, Castagnini, Luis, Mazade, Marc, Heger, Margaret, Fernandez, Marisol, Chang, Michael, Crawford, Michelle, Nelson, Miranda, Bennett, Nicholas, Jaggi, Preeti, Hamdy, Rana, Banerjee, Ritu, Olivero, Rosemary, Patel, Sameer, Arnold, Sandra, Ogrin, Sara, Jones, Sarah, Parker, Sarah, Kubes, Sarah, Hymes, Saul, Weissman, Scott, Chan, Shannon, Henderson, Sheryl, Metjian, Talene, GARPEC and Global-PPS networks, on behalf of the, GARPEC Network, Global-PPS Network, Children's Hospital, HUS Children and Adolescents, and Clinicum

Subjects
medicine.medical_specialty, Adolescent, medicine.drug_class, 030231 tropical medicine, Antibiotics, MEDLINE, Psychological intervention, CHILDREN, World Health Organization, Pediatrics, Essential medicines, 03 medical and health sciences, Antimicrobial Stewardship, 0302 clinical medicine, Antibiotic resistance, POINT PREVALENCE SURVEY, SURVEILLANCE, Medicine and Health Sciences, Medicine, Antimicrobial stewardship, Humans, 030212 general & internal medicine, Medical prescription, Child, Neonatal sepsis, business.industry, lcsh:Public aspects of medicine, STEWARDSHIP, Infant, Newborn, Infant, lcsh:RA1-1270, General Medicine, medicine.disease, 3142 Public health care science, environmental and occupational health, Drug Utilization, 3. Good health, Anti-Bacterial Agents, QUALITY INDICATORS, Family medicine, Child, Preschool, Health Care Surveys, Human medicine, business, Pharmacy Service, Hospital
Abstract

Summary: Background: Improving the quality of hospital antibiotic use is a major goal of WHO's global action plan to combat antimicrobial resistance. The WHO Essential Medicines List Access, Watch, and Reserve (AWaRe) classification could facilitate simple stewardship interventions that are widely applicable globally. We aimed to present data on patterns of paediatric AWaRe antibiotic use that could be used for local and national stewardship interventions. Methods: 1-day point prevalence survey antibiotic prescription data were combined from two independent global networks: the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children and the Global Point Prevalence Survey on Antimicrobial Consumption and Resistance networks. We included hospital inpatients aged younger than 19 years receiving at least one antibiotic on the day of the survey. The WHO AWaRe classification was used to describe overall antibiotic use as assessed by the variation between use of Access, Watch, and Reserve antibiotics, for neonates and children and for the commonest clinical indications. Findings: Of the 23 572 patients included from 56 countries, 18 305 were children (77·7%) and 5267 were neonates (22·3%). Access antibiotic use in children ranged from 7·8% (China) to 61·2% (Slovenia) of all antibiotic prescriptions. The use of Watch antibiotics in children was highest in Iran (77·3%) and lowest in Finland (23·0%). In neonates, Access antibiotic use was highest in Singapore (100·0%) and lowest in China (24·2%). Reserve antibiotic use was low in all countries. Major differences in clinical syndrome-specific patterns of AWaRe antibiotic use in lower respiratory tract infection and neonatal sepsis were observed between WHO regions and countries. Interpretation: There is substantial global variation in the proportion of AWaRe antibiotics used in hospitalised neonates and children. The AWaRe classification could potentially be used as a simple traffic light metric of appropriate antibiotic use. Future efforts should focus on developing and evaluating paediatric antibiotic stewardship programmes on the basis of the AWaRe index. Funding: GARPEC was funded by the PENTA Foundation. GARPEC-China data collection was funded by the Sanming Project of Medicine in Shenzhen (SZSM2015120330). bioMérieux provided unrestricted funding support for the Global-PPS.

Published
2019

48. High Rates of Prescribing Antimicrobials for Prophylaxis in Children and Neonates: Results From the Antibiotic Resistance and Prescribing in European Children Point Prevalence Survey

Author

Hufnagel, Markus Versporten, Ann Bielicki, Julia Drapier, Nico Sherland, Mike Goossens, Herman Maria Calle, Graciela and Clark, Julia Cooper, Celia Blyth, Christopher C. and Francis, Joshua Reginald Alsalman, Jameela Jansen, Hilde and Mahieu, Ludo Van Rossom, Paul Vandewal, Wouter Lepage, Philippe Blumental, Sophie Briquet, Caroline Robbrecht, Dirk and Maton, Pierre Gabriels, Patrick Rubic, Zana Kovacevic, Tanja Nielsen, Jens Peter Petersen, Jes Reinholdt and Poorisrisak, Porntiva Jensen, Lise Heilmann Laan, Mari Tamm, Eda Matsinen, Maire Rummukainen, Maija-Liisa Gajdos, Vincent and Olivier, Romain Le Marechal, Flore Martinot, Alain and Dubos, Francois Lagree, Marion Prot-Labarthe, Sonia Lorrot, Mathie Orbach, Daniel Pagava, Karaman Knuf, Markus and Schlag, Stephanie A. A. Liese, Johannes Renner, Lorna and Enimil, Anthony Awunyo, Marah Syridou, Garyfallia Spyridis, Nikos Critselis, Elena Kouni, Sofia Mougkou, Katerina and Ladomenou, Fani Gkentzi, Despoina Iosifidis, Elias Roilides, Emmanuel Sahu, Suneeta Murki, Srinivas Malviya, Manoj and Kalavalapalli, Durga Bhavani Singh, Sanjeev Singhal, Tanu and Garg, Garima Garg, Pankaj Kler, Neelam Soltani, Jafar and Jafarpour, Zahra Pouladfar, Gholamreza Nicolini, Giangiacomo and Montagnani, Carlotta Galli, Luisa Esposito, Susanna Tenconi, Rossana Lo Vecchio, Andrea Dona, Daniele Giaquinto, Carlo and Borgia, Eleonora D'Argenio, Patrizia De Luca, Maia and Centenari, Chiara Raka, Lul Raka, Denis Omar, Abeer and Al-Mousa, Haifaa Mozgis, Dzintars Sviestina, Inese and Burokiene, Sigita Usonis, Vytautas Tavchioska, Gabriela and Hargadon-Lowe, Antonia Zarb, Peter Borg, Michael A. Gonzalez Lozano, Carlos Agustin Zarate Castanon, Patricia Cancino, Martha E. McCullagh, Bernadette McCorry, Ann Gormley, Cairine and Al Maskari, Zaina Al-Jardani, Amina Pluta, Magdalena and Rodrigues, Fernanda Brett, Ana Esteves, Isabel Marques, Laura AlAjmi, Jameela Ali Cambrea, Simona Claudia Rashed, Asia N. Al Azmi, Aeshah Abdu Mubarak Chan, Si Min Isa, Mas Suhaila Najdenov, Peter Cizman, Milan Unuk, Sibila and Finlayson, Heather Dramowski, Angela Mate-Cano, Irene Soto, Beatriz Calvo, Cristina Santiago, Begona Saavedra-Lozano, Jesus Bustinza, Amaya Escosa-Garcia, Luis Ureta, Noelia and Lopez-Varela, Elisa Rojo, Pablo Tagarro, Alfredo Terol Barrero, Pedro Maria Rincon-Lopez, Elena Abubakar, Ismaela and Aston, Jeff Patel, Mitul Russell, Alison Bedford and Heginbothom, Maggie Satodia, Prakash Garbash, Mehdi Johnson, Alison Sharpe, David Barton, Christopher Menson, Esse and Arenas-Lopez, Sara Luck, Suzanne Doerholt, Katja McMaster, Paddy Caldwell, Neil A. Lunn, Andrew Drysdale, Simon B. and Howe, Rachel Scorrer, Tim Gahleitner, Florian Gupta, Richa and Nash, Clare Alexander, John Raman, Mala Bell, Emily and Rajagopal, Veena Kohlhoff, Stephan Cox, Elaine Nichols, Kristen Zaoutis, Theoklis ARPEC Project Grp

Abstract

Background. This study was conducted to assess the variation in prescription practices for systemic antimicrobial agents used for prophylaxis among pediatric patients hospitalized in 41 countries worldwide. Methods. Using the standardized Antibiotic Resistance and Prescribing in European Children Point Prevalence Survey protocol, a cross-sectional point-prevalence survey was conducted at 226 pediatric hospitals in 41 countries from October 1 to November 30, 2012. Results. Overall, 17 693 pediatric patients were surveyed and 36.7% of them received antibiotics (n = 6499). Of 6818 inpatient children, 2242 (32.9%) received at least 1 antimicrobial for prophylactic use. Of 11 899 prescriptions for antimicrobials, 3400 (28.6%) were provided for prophylactic use. Prophylaxis for medical diseases was the indication in 73.4% of cases (2495 of 3400), whereas 26.6% of prescriptions were for surgical diseases (905 of 3400). In approximately half the cases (48.7% [1656 of 3400]), a combination of 2 or more antimicrobials was prescribed. The use of broad-spectrum antibiotics (BSAs), which included tetracyclines, macrolides, lincosamides, and sulfonamides/trimethoprim, was high (51.8% [1761 of 3400]). Broad-spectrum antibiotic use for medical prophylaxis was more common in Asia (risk ratio [RR], 1.322; 95% confidence interval [CI], 1.202-1.653) and more restricted in Australia (RR, 0.619; 95% CI, 0.521-0.736). Prescription of BSA for surgical prophylaxis also varied according to United Nations region. Finally, a high percentage of surgical patients (79.7% [721 of 905]) received their prophylaxis for longer than 1 day. Conclusions. A high proportion of hospitalized children received prophylactic BSAs. This represents a clear target for quality improvement. Collectively speaking, it is critical to reduce total prophylactic prescribing, BSA use, and prolonged prescription.

Published
2019

49. High rates of prescribing antimicrobials for prophylaxis in children and neonates : results from the antibiotic resistance and prescribing in European children point prevalence survey

Author

Hufnagel, Markus, Versporten, Ann, Bielicki, Julia, Drapier, Nico, Sharland, Mike, Goossens, Herman, Sherland, Mike, Maria Calle, Graciela, Clark, Julia, Cooper, Celia, Blyth, Christopher C., Francis, Joshua Reginald, Alsalman, Jameela, Jansen, Hilde, Mahieu, Ludo, Van Rossom, Paul, Vandewal, Wouter, Lepage, Philippe, Blumental, Sophie, Briquet, Caroline, Robbrecht, Dirk, Maton, Pierre, Gabriels, Patrick, Rubic, Zana, Kovacevic, Tanja, Nielsen, Jens Peter, Petersen, Jes Reinholdt, Poorisrisak, Porntiva, Jensen, Lise Heilmann, Laan, Mari, Tamm, Eda, Matsinen, Maire, Rummukainen, Maija-Liisa, Gajdos, Vincent, Olivier, Romain, Le Marechal, Flore, Martinot, Alain, Dubos, Francois, Lagree, Marion, Prot-Labarthe, Sonia, Lorrot, Mathie, Orbach, Daniel, Pagava, Karaman, Knuf, Markus, Schlag, Stephanie A. A., Liese, Johannes, Renner, Lorna, Enimil, Anthony, Awunyo, Marah, Syridou, Garyfallia, Spyridis, Nikos, Critselis, Elena, Kouni, Sofia, Mougkou, Katerina, Ladomenou, Fani, Gkentzi, Despoina, Iosifidis, Elias, Roilides, Emmanuel, Sahu, Suneeta, Murki, Srinivas, Malviya, Manoj, Kalavalapalli, Durga Bhavani, Singh, Sanjeev, Singhal, Tanu, Garg, Garima, Garg, Pankaj, Kler, Neelam, Soltani, Jafar, Jafarpour, Zahra, Pouladfar, Gholamreza, Nicolini, Giangiacomo, Montagnani, Carlotta, Galli, Luisa, Esposito, Susanna, Tenconi, Rossana, Lo Vecchio, Andrea, Dona, Daniele, Giaquinto, Carlo, Borgia, Eleonora, D'Argenio, Patrizia, De Luca, Maia, Centenari, Chiara, Raka, Lul, Raka, Denis, Omar, Abeer, Al-Mousa, Haifaa, Mozgis, Dzintars, Sviestina, Inese, Burokiene, Sigita, Usonis, Vytautas, Tavchioska, Gabriela, Hargadon-Lowe, Antonia, Zarb, Peter, Borg, Michael A., Gonzalez Lozano, Carlos Agustin, Zarate Castanon, Patricia, Cancino, Martha E., McCullagh, Bernadette, McCorry, Ann, Gormley, Cairine, Al Maskari, Zaina, Al-Jardani, Amina, Pluta, Magdalena, Rodrigues, Fernanda, Brett, Ana, Esteves, Isabel, Marques, Laura, AlAjmi, Jameela Ali, Cambrea, Simona Claudia, Rashed, Asia N., Al Azmi, Aeshah Abdu Mubarak, Chan, Si Min, Isa, Mas Suhaila, Najdenov, Peter, Cizman, Milan, Unuk, Sibila, Finlayson, Heather, Dramowski, Angela, Mate-Cano, Irene, Soto, Beatriz, Calvo, Cristina, Santiago, Begona, Saavedra-Lozano, Jesus, Bustinza, Amaya, Escosa-Garcia, Luis, Ureta, Noelia, Lopez-Varela, Elisa, Rojo, Pablo, Tagarro, Alfredo, Terol Barrero, Pedro, Maria Rincon-Lopez, Elena, Abubakar, Ismaela, Aston, Jeff, Patel, Mitul, Russell, Alison Bedford, Heginbothom, Maggie, Satodia, Prakash, Garbash, Mehdi, Johnson, Alison, Sharpe, David, Barton, Christopher, Menson, Esse, Arenas-Lopez, Sara, Luck, Suzanne, Doerholt, Katja, McMaster, Paddy, Caldwell, Neil A., Lunn, Andrew, Drysdale, Simon B., Howe, Rachel, Scorrer, Tim, Gahleitner, Florian, Gupta, Richa, Nash, Clare, Alexander, John, Raman, Mala, Bell, Emily, Rajagopal, Veena, Kohlhoff, Stephan, Cox, Elaine, Nichols, Kristen, Zaoutis, Theoklis, Mahieu, Ludo, and ARPEC Project Grp

Subjects
antimicrobials, inpatients, pediatrics, point-prevalence survey, prophylactic prescribing, Point-prevalence survey, Male, medicine.medical_specialty, medicine.drug_class, Antibiotics, Pediatrics, Drug Prescriptions, 03 medical and health sciences, Surgical prophylaxis, 0302 clinical medicine, Pharmacotherapy, Antibiotic resistance, Anti-Infective Agents, 030225 pediatrics, Internal medicine, medicine, Prevalence, Humans, Medical prescription, Antimicrobials, Inpatients, Prophylactic prescribing, 0303 health sciences, 030306 microbiology, business.industry, Pharmacology. Therapy, Infant, Newborn, Drug Resistance, Microbial, General Medicine, Antibiotic Prophylaxis, Hospitals, Pediatric, Prophylactic Surgery, Drug Utilization, Anti-Bacterial Agents, Hospitalization, Infectious Diseases, Cross-Sectional Studies, Relative risk, Health Care Surveys, Pediatrics, Perinatology and Child Health, Chemoprophylaxis, Drug Therapy, Combination, Female, Human medicine, business, Child, Hospitalized
Abstract

Background: This study was conducted to assess the variation in prescription practices for systemic antimicrobial agents used for prophylaxis among pediatric patients hospitalized in 41 countries worldwide.Methods: Using the standardized Antibiotic Resistance and Prescribing in European Children Point Prevalence Survey protocol, a cross-sectional point-prevalence survey was conducted at 226 pediatric hospitals in 41 countries from October 1 to November 30, 2012.Results: Overall, 17693 pediatric patients were surveyed and 36.7% of them received antibiotics (n = 6499). Of 6818 inpatient children, 2242 (32.9%) received at least 1 antimicrobial for prophylactic use. Of 11899 prescriptions for antimicrobials, 3400 (28.6%) were provided for prophylactic use. Prophylaxis for medical diseases was the indication in 73.4% of cases (2495 of 3400), whereas 26.6% of prescriptions were for surgical diseases (905 of 3400). In approximately half the cases (48.7% [1656 of 3400]), a combination of 2 or more antimicrobials was prescribed. The use of broad-spectrum antibiotics (BSAs), which included tetracyclines, macrolides, lincosamides, and sulfonamides/trimethoprim, was high (51.8% [1761 of 3400]). Broad-spectrum antibiotic use for medical prophylaxis was more common in Asia (risk ratio [RR], 1.322; 95% confidence interval [CI], 1.202-1.653) and more restricted in Australia (RR, 0.619; 95% CI, 0.521-0.736). Prescription of BSA for surgical prophylaxis also varied according to United Nations region. Finally, a high percentage of surgical patients (79.7% [721 of 905]) received their prophylaxis for longer than 1 day.Conclusions: A high proportion of hospitalized children received prophylactic BSAs. This represents a clear target for quality improvement. Collectively speaking, it is critical to reduce total prophylactic prescribing, BSA use, and prolonged prescription.

Published
2019

50. Human candidate gene polymorphisms and risk of severe malaria in children in Kilifi, Kenya: a case-control association study

Author

Ndila, Carolyne M, Uyoga, Sophie, Macharia, Alexander W, Nyutu, Gideon, Peshu, Norbert, Ojal, John, Shebe, Mohammed, Awuondo, Kennedy O, Mturi, Neema, Tsofa, Benjamin, Sepúlveda, Nuno, Clark, Taane G, Band, Gavin, Clarke, Geraldine, Rowlands, Kate, Hubbart, Christina, Jeffreys, Anna, Kariuki, Silvia, Marsh, Kevin, Mackinnon, Margaret, Maitland, Kathryn, Kwiatkowski, Dominic P, Rockett, Kirk A, Williams, Thomas N, Abathina, Amadou, Abubakar, Ismaela, Achidi, Eric, Agbenyega, Tsiri, Aiyegbo, Mohammed, Akoto, Alex, Allen, Angela, Allen, Stephen, Amenga-Etego, Lucas, Amodu, Folakemi, Amodu, Olukemi, Anchang-Kimbi, Judith, Ansah, Nana, Ansah, Patrick, Ansong, Daniel, Antwi, Sampson, Anyorigiya, Thomas, Apinjoh, Tobias, Asafo-Agyei, Emmanuel, Asoala, Victor, Atuguba, Frank, Auburn, Sarah, Bah, Abdou, Bamba, Kariatou, Bancone, Germana, Barnwell, David, Barry, Abdoulaye, Bauni, Evasius, Besingi, Richard, Bojang, Kalifa, Bougouma, Edith, Bull, Susan, Busby, George, Camara, Abdoulie, Camara, Landing, Campino, Susana, Carter, Richard, Carucci, Dan, Casals-Pascual, Climent, Ceesay, Ndey, Ceesay, Pa, Chau, Tran, Chuong, Ly, Clark, Taane, Cole-Ceesay, Ramou, Conway, David, Cook, Katharine, Cook, Olivia, Cornelius, Victoria, Corran, Patrick, Correa, Simon, Cox, Sharon, Craik, Rachel, Danso, Bakary, Davis, Timothy, Day, Nicholas, Deloukas, Panos, Dembele, Awa, Devries, Jantina, Dewasurendra, Rajika, Diakite, Mahamadou, Diarra, Elizabeth, Dibba, Yaya, Diss, Andrea, Djimdé, Abdoulaye, Dolo, Amagana, Doumbo, Ogobara, Doyle, Alan, Drakeley, Chris, Drury, Eleanor, Duffy, Patrick, Dunstan, Sarah, Ebonyi, Augustine, Elhassan, Ahmed, Elhassan, Ibrahim, Elzein, Abier, Enimil, Anthony, Esangbedo, Pamela, Evans, Jennifer, Evans, Julie, Farrar, Jeremy, Fernando, Deepika, Fitzpatrick, Kathryn, Fullah, Janet, Garcia, Jacob, Ghansah, Anita, Gottleib, Michael, Green, Angie, Hart, Lee, Hennsman, Meike, Hien, Tran, Hieu, Nguyen, Hilton, Eliza, Hodgson, Abraham, Horstmann, Rolf, Hughes, Catherine, Hussein, Ayman, Hutton, Robert, Ibrahim, Muntaser, Ishengoma, Deus, Jaiteh, Jula, Jallow, Mariatou, Jallow, Muminatou, Jammeh, Kebba, Jasseh, Momodou, Jobarteh, Amie, Johnson, Kimberly, Joseph, Sarah, Jyothi, Dushyanth, Kachala, David, Kamuya, Dorcas, Kanyi, Haddy, Karunajeewa, Harin, Karunaweera, Nadira, Keita, Momodou, Kerasidou, Angeliki, Khan, Aja, Kivinen, Katja, Kokwaro, Gilbert, Konate, Amadou, Konate, Salimata, Koram, Kwadwo, Kwiatkowski, Dominic, Laman, Moses, Si, Le, Leffler, Ellen, Lemnge, Martha, Lin, Enmoore, Alioune, Ly, Macharia, Alexander, Macinnis, Bronwyn, Mai, Nguyen, Makani, Julie, Malangone, Cinzia, Mangano, Valentina, Manjurano, Alphaxard, Manneh, Lamin, Manning, Laurens, Manske, Magnus, Marsh, Vicki, Maslen, Gareth, Maxwell, Caroline, Mbunwe, Eric, Mccreight, Marilyn, Mead, Daniel, Mendy, Alieu, Mendy, Anthony, Mensah, Nathan, Michon, Pascal, Miles, Alistair, Miotto, Olivo, Modiano, David, Mohamed, Hiba, Molloy, Sile, Molyneux, Malcolm, Molyneux, Sassy, Moore, Mike, Moyes, Catherine, Mtei, Frank, Mtove, George, Mueller, Ivo, Mugri, Regina, Munthali, Annie, Mutabingwa, Theonest, Nadjm, Behzad, Ndi, Andre, Ndila, Carolyne, Newton, Charles, Niangaly, Amadou, Njie, Haddy, Njie, Jalimory, Njie, Madi, Njie, Malick, Njie, Sophie, Njiragoma, Labes, Nkrumah, Francis, Ntunthama, Neema, Nyika, Aceme, Nyirongo, Vysaul, O'Brien, John, Obu, Herbert, Oduro, Abraham, Ofori, Alex, Olaniyan, Subulade, Olaosebikan, Rasaq, Oluoch, Tom, Omotade, Olayemi, Oni, Olajumoke, Onykwelu, Emmanuel, Opi, Daniel, Orimadegun, Adebola, O'Riordan, Sean, Ouedraogo, Issa, Oyola, Samuel, Parker, Michael, Pearson, Richard, Pensulo, Paul, Phiri, Ajib, Phu, Nguyen, Pinder, Margaret, Pirinen, Matti, Plowe, Chris, Potter, Claire, Poudiougou, Belco, Puijalon, Odile, Quyen, Nguyen, Ragoussis, Ioannis, Ragoussis, Jiannis, Rasheed, Oba, Reeder, John, Reyburn, Hugh, Riley, Eleanor, Risley, Paul, Rockett, Kirk, Rodford, Joanne, Rogers, Jane, Rogers, William, Ruano-Rubio, Valentín, Sabally-Ceesay, Kumba, Sadiq, Abubacar, Saidy-Khan, Momodou, Saine, Horeja, Sakuntabhai, Anavaj, Sall, Abdourahmane, Sambian, David, Sambou, Idrissa, Sanjoaquin, Miguel, Shah, Shivang, Shelton, Jennifer, Siba, Peter, Silva, Nilupa, Simmons, Cameron, Simpore, Jaques, Singhasivanon, Pratap, Sinh, Dinh, Sirima, Sodiomon, Sirugo, Giorgio, Sisay-Joof, Fatoumatta, Sissoko, Sibiry, Small, Kerrin, Somaskantharajah, Elilan, Spencer, Chris, Stalker, Jim, Stevens, Marryat, Suriyaphol, Prapat, Sylverken, Justice, Taal, Bintou, Tall, Adama, Taylor, Terrie, Teo, Yik, Thai, Cao, Thera, Mahamadou, Titanji, Vincent, Toure, Ousmane, Troye-Blomberg, Marita, Usen, Stanley, Vanderwal, Aaron, Wangai, Hannah, Watson, Renee, Williams, Thomas, Wilson, Michael, Wrigley, Rebecca, Yafi, Clarisse, Yamoah, Lawrence, The Wellcome Trust Centre for Human Genetics [Oxford], University of Oxford, London School of Hygiene and Tropical Medicine (LSHTM), The Wellcome Trust Sanger Institute [Cambridge], St Mary's Hospital, Imperial College, TNW and MM are funded through awards from the Wellcome Trust (grants 091758 and 202800 [to TNW] and grant 088634 [to MM]) and DPK and TGC receive support from the Medical Research Council (grant G19/9 [to DPK] and grants MR/K000551/1, MR/M01360X/1, MR/N010469/1, and MC_PC_15103 [to TGC]). The research leading to these results received funding from the European Community's Seventh Framework Programme (FP7/2007-2013, under grant agreement 242095) and from the Medical Research Council (grant G0600718). MalariaGEN is supported by the Wellcome Trust (WT077383/Z/05/Z) and by the Foundation for the National Institutes of Health (grant 566) as part of the Bill & Melinda Gates' Grand Challenges in Global Health Initiative. The Resource Centre for Genomic Epidemiology of Malaria is supported by the Wellcome Trust (grant 090770/Z/09/Z). Support was also provided by the Medical Research Council (grant G0600718). The Wellcome Trust also provides core awards to the Wellcome Trust Centre for Human Genetics (grant 090532/Z/09/Z) and to the Wellcome Trust Sanger Institute (grant 098051). This work forms part of a larger collaboration with the MalariaGEN Consortium, whose members are listed at http://www.malariagen.net/projects/host/consortium-members. This paper is published with permission from the Director of the Kenya Medical Research Institute (KEMRI)., MalariaGEN Consortium (Anavaj Sakuntabhai), and European Project: 242095,EC:FP7:HEALTH,FP7-HEALTH-2009-single-stage,EVIMALAR(2009)

Subjects
Case-Control Studies, Child, Child, Preschool, Female, Gene Frequency, Genetic Predisposition to Disease, Humans, Kenya, Malaria, Male, Polymorphism, Genetic, Hematology, macromolecular substances, [SDV.BIBS]Life Sciences [q-bio]/Quantitative Methods [q-bio.QM], Article, Genetic, [SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics, parasitic diseases, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Polymorphism, Preschool
Abstract

Summary Background Human genetic factors are important determinants of malaria risk. We investigated associations between multiple candidate polymorphisms—many related to the structure or function of red blood cells—and risk for severe Plasmodium falciparum malaria and its specific phenotypes, including cerebral malaria, severe malaria anaemia, and respiratory distress. Methods We did a case-control study in Kilifi County, Kenya. We recruited as cases children presenting with severe malaria to the high-dependency ward of Kilifi County Hospital. We included as controls infants born in the local community between Aug 1, 2006, and Sept 30, 2010, who were part of a genetics study. We tested for associations between a range of candidate malaria-protective genes and risk for severe malaria and its specific phenotypes. We used a permutation approach to account for multiple comparisons between polymorphisms and severe malaria. We judged p values less than 0·005 significant for the primary analysis of the association between candidate genes and severe malaria. Findings Between June 11, 1995, and June 12, 2008, 2244 children with severe malaria were recruited to the study, and 3949 infants were included as controls. Overall, 263 (12%) of 2244 children with severe malaria died in hospital, including 196 (16%) of 1233 with cerebral malaria. We investigated 121 polymorphisms in 70 candidate severe malaria-associated genes. We found significant associations between risk for severe malaria overall and polymorphisms in 15 genes or locations, of which most were related to red blood cells: ABO, ATP2B4, ARL14, CD40LG, FREM3, INPP4B, G6PD, HBA (both HBA1 and HBA2), HBB, IL10, LPHN2 (also known as ADGRL2), LOC727982, RPS6KL1, CAND1, and GNAS. Combined, these genetic associations accounted for 5·2% of the variance in risk for developing severe malaria among individuals in the general population. We confirmed established associations between severe malaria and sickle-cell trait (odds ratio [OR] 0·15, 95% CI 0·11–0·20; p=2·61 × 10−58), blood group O (0·74, 0·66–0·82; p=6·26 × 10−8), and –α3·7-thalassaemia (0·83, 0·76–0·90; p=2·06 × 10−6). We also found strong associations between overall risk of severe malaria and polymorphisms in both ATP2B4 (OR 0·76, 95% CI 0·63–0·92; p=0·001) and FREM3 (0·64, 0·53–0·79; p=3·18 × 10−14). The association with FREM3 could be accounted for by linkage disequilibrium with a complex structural mutation within the glycophorin gene region (comprising GYPA, GYPB, and GYPE) that encodes for the rare Dantu blood group antigen. Heterozygosity for Dantu was associated with risk for severe malaria (OR 0·57, 95% CI 0·49–0·68; p=3·22 × 10−11), as was homozygosity (0·26, 0·11–0·62; p=0·002). Interpretation Both ATP2B4 and the Dantu blood group antigen are associated with the structure and function of red blood cells. ATP2B4 codes for plasma membrane calcium-transporting ATPase 4 (the major calcium pump on red blood cells) and the glycophorins are ligands for parasites to invade red blood cells. Future work should aim at uncovering the mechanisms by which these polymorphisms can result in severe malaria protection and investigate the implications of these associations for wider health. Funding Wellcome Trust, UK Medical Research Council, European Union, and Foundation for the National Institutes of Health as part of the Bill & Melinda Gates Grand Challenges in Global Health Initiative.

Published
2018

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