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American Journal of Tropical Medicine and Hygiene

Jennifer Boss, David A B Dance, Anisone Chanthongthip, Paul N Newton, Vanaporn Wuthiekanun, Matthew T Robinson
Leptospirosis is a global zoonotic disease caused by pathogenic bacteria of the Leptospira genus, which are fastidious, slow-growing organisms. Antimicrobial susceptibility data are limited; traditionally, the organisms have not been culturable on solid media. The recent development of Leptospira Vanaporn Wuthiekanun (LVW) agar, which facilitates rapid growth of Leptospira spp., provides the opportunity for antimicrobial susceptibility testing. Eighty-three Leptospira spp. clinical isolates originating from patients in Laos between 2006 and 2016 were tested against six antimicrobials (azithromycin, ceftriaxone, ciprofloxacin, doxycycline, gentamicin, and penicillin G) using disk diffusion on LVW agar...
March 18, 2019: American Journal of Tropical Medicine and Hygiene
Fernando S Flores, Camila Zanluca, Alberto A Guglielmone, Claudia N Duarte Dos Santos, Marcelo B Labruna, Adrián Diaz
Many species of Amblyomma ticks are commonly found infesting wild birds in South America, where birds are important hosts for several arboviruses, such as West Nile virus (WNV) and Saint Louis encephalitis virus (SLEV). In this study, WNV and SLEV transmission experiments were performed to evaluate the vector competence of three South American tick species: Amblyomma ovale , Amblyomma tigrinum , and Amblyomma tonelliae . Larval and nymphal ticks of each species were allowed to feed on chicks needle inoculated with WNV or SLEV...
March 18, 2019: American Journal of Tropical Medicine and Hygiene
David S Fedson
Brett-Major and others remind us that pathogen lists for emerging infectious diseases aid in the development of tools that target specific pathogens (e.g., vaccines) and help attract financial support. These lists tell us what we need to have, not what we need to do. The authors call for more research on ways to prevent these diseases (e.g., platform technologies for vaccines) and mitigate disease impact. Vaccines and new treatments that target individual pathogens have many limitations. However, we might save lives by treating patients with inexpensive generic drugs that target common features of the host response to infection...
March 18, 2019: American Journal of Tropical Medicine and Hygiene
Jonathan D Berman
Malaria chemoprophylaxis has become increasingly prominent now that it is used for vulnerable populations in endemic regions in addition to nonimmune travelers to those regions. The objective would be a drug with > 95% efficacy and that is easily tolerated, including in children and pregnant women. For individuals who prefer weekly rather than daily drug administration, a further objective is a product that is administered weekly. The deficiencies of present agents are parasite resistance to chloroquine, neuropsychiatric liability of mefloquine, the need for daily dosing for atovaquone-proguanil, and daily dosing plus adverse reactions for doxycycline...
March 18, 2019: American Journal of Tropical Medicine and Hygiene
Mellisa Roskosky, Bhim Acharya, Geeta Shakya, Kshitij Karki, Kazutaka Sekine, Deepak Bajracharya, Lorenz von Seidlein, Isabelle Devaux, Anna Lena Lopez, Jacqueline Deen, David A Sack
A comprehensive targeted intervention (CTI) was designed and deployed in the neighborhoods of cholera cases in the Kathmandu Valley with the intent of reducing rates among the neighbors of the case. This was a feasibility study to determine whether clinical centers, laboratories, and field teams were able to mount a rapid, community-based response to a case within 2 days of hospital admission. Daily line listings were requested from 15 participating hospitals during the monsoon season, and a single case initiated the CTI...
March 18, 2019: American Journal of Tropical Medicine and Hygiene
Philippa Kirby, Simon Smith, Linda Ward, Josh Hanson, Bart J Currie
Thromobocytopenia predicts mortality in patients with melioidosis in Thailand. We analyzed platelet counts in two large cohorts of melioidosis patients in tropical northern Australia to assess utility in a different clinical setting. Admission platelet counts were compared between subgroups of patients with different clinical outcomes. Patients with more severe disease (indicated by bacteremia, septic shock, and death) had significantly lower platelet counts than those with less severe disease. Logistic regression analysis was carried out for potential predictors of mortality among various clinical parameters, and platelet count was shown to be an independent predictor of mortality...
March 18, 2019: American Journal of Tropical Medicine and Hygiene
Lina María Gómez, Lizeth Andrea Paniagua-Saldarriaga, Quinlan Richert, Yoav Keynan, Fernando Montes, Lucelly López, Zulma Vanessa Rueda
Antioquia Department is the state with the highest burden of tuberculosis (TB) in Colombia. Our aim was to determine the risk factors associated with unsuccessful TB treatment in HIV-seropositive and homeless persons, compared with non-HIV-infected and non-homeless persons with TB. We conducted a retrospective cohort study using observational, routinely collected health data from all drug-susceptible TB cases in homeless and/or HIV-seropositive individuals in Antioquia from 2014 to 2016. Unsuccessful TB treatment was defined as individuals having been lost to follow-up, having died, or treatment failure occurrence during the study period...
March 11, 2019: American Journal of Tropical Medicine and Hygiene
Meghna Phanichkrivalkosil, Ampai Tanganuchitcharnchai, Suthatip Jintaworn, Pacharee Kantipong, Achara Laongnualpanich, Wirongrong Chierakul, Daniel H Paris, Allen L Richards, Tri Wangrangsimakul, Nicholas P J Day, Stuart D Blacksell
In this diagnostic accuracy study, we evaluated data from 135 febrile patients from Chiang Rai, to determine the optimal optical density (OD) cutoffs for an in-house scrub typhus IgM ELISA. Receiver operating characteristic curves were generated using a panel of reference assays, including an IgM immunofluorescence assay (IFA), PCR, in vitro isolation, presence of an eschar, or a combination of these. Altogether, 33 patients (24.4%) were diagnosed as having scrub typhus. Correlation between positivity by IFA and increasing OD values peaked at a cutoff of 2...
March 11, 2019: American Journal of Tropical Medicine and Hygiene
Melanie Bannister-Tyrrell, Charlotte Gryseels, Suon Sokha, Lim Dara, Noan Sereiboth, Nicola James, Boukheng Thavrin, Po Ly, Kheang Soy Ty, Koen Peeters Grietens, Siv Sovannaroth, Shunmay Yeung
Multidrug-resistant Plasmodium falciparum malaria on the Cambodia-Thailand border is associated with working in forested areas. Beyond broad recognition of "forest-going" as a risk factor for malaria, little is known about different forest-going populations in this region. In Oddar Meanchey Province in northwestern Cambodia, qualitative ethnographic research was conducted to gain an in-depth understanding of how different populations, mobility and livelihood patterns, and activities within the forest intersect with potentiate malaria risk and impact on the effectiveness of malaria control and elimination strategies...
March 11, 2019: American Journal of Tropical Medicine and Hygiene
Xiao Cai, Huixia Cai, Qing Gan, Wenxu Chang, Fang Yuan, Wei Luo, Jie Sun, Jing An
Cystic echinococcosis (CE) is a common, chronic, and endemic zoonotic disease usually localized in a single organ; multivisceral cases are rare, especially outside the liver or lung. Here, we describe an unusual case of a 43-year-old Tibetan man with echinococcosis of the infratemporal fossa, heart, liver, pancreas, abdomen, and pelvic cavity. He only presented with diminished vision of the left eye, especially when chewing. Computed tomography and magnetic resonance imaging revealed multivisceral CE. The patient underwent surgery for the excision of a cyst in the infratemporal fossa, as well as chemotherapy, and the diagnosis was confirmed by histopathological examination...
March 11, 2019: American Journal of Tropical Medicine and Hygiene
Mumbere Hangi, Jane Achan, Aimé Saruti, Jacklyn Quinlan, Richard Idro
Despite recent large-scale investments, malaria remains a major public health concern. Few studies have examined congenital malaria, defined as the presence of malaria parasitemia within the first 7 days of life, in endemic areas. This study aimed to determine the prevalence, to describe the clinical presentation, and to examine factors associated with congenital malaria in newborns aged up to 7 days attending Tororo General Hospital in Uganda. A total of 261 mother/baby pairs were recruited in this cross-sectional study...
March 11, 2019: American Journal of Tropical Medicine and Hygiene
Friederike Feldmann, W Lesley Shupert, Elaine Haddock, Barri Twardoski, Heinz Feldmann
Gamma irradiation using a cobalt-60 source is a commonly used method for the inactivation of infectious specimens to be handled safely in subsequent laboratory procedures. Here, we determined irradiation doses to safely inactivate liquid proteinaceous specimens harboring different emerging/reemerging viral pathogens known to cause neglected tropical and other diseases of regional or global public health importance. By using a representative arenavirus, bunyavirus, coronavirus, filovirus, flavivirus, orthomyxovirus, and paramyxovirus, we found that these enveloped viruses differed in their susceptibility to irradiation treatment with adsorbed doses for inactivation of a target dose of 1 × 106 50% tissue culture infectious dose (TCID50 )/mL ranging from 1 to 5 MRads...
March 11, 2019: American Journal of Tropical Medicine and Hygiene
Joe Brown, Jeff Albert, Dale Whittington
Community-Led Total Sanitation Moves the Needle on Ending Open Defecation in Zambia.
March 11, 2019: American Journal of Tropical Medicine and Hygiene
Gaurvika M L Nayyar, Joel G Breman, Tim K Mackey, John P Clark, Mustapha Hajjou, Megan Littrell, James E Herrington
Falsified and substandard medicines are associated with tens of thousands of deaths, mainly in young children in poor countries. Poor-quality drugs exact an annual economic toll of up to US$200 billion and contribute to the increasing peril of antimicrobial resistance. The WHO has emerged recently as the global leader in the battle against poor-quality drugs, and pharmaceutical companies have increased their roles in assuring the integrity of drug supply chains. Despite advances in drug quality surveillance and detection technology, more efforts are urgently required in research, policy, and field monitoring to halt the pandemic of bad drugs...
March 11, 2019: American Journal of Tropical Medicine and Hygiene
Francesco G Genderini, Cecile Haeseleer, Brigitte Cantinieaux, Charlotte Martin
Hyperreactive malarial splenomegaly syndrome (HMSS) is a rare cause of splenomegaly in the Western world. Hyperreactive malarial splenomegaly syndrome is caused by an aberrant immunological response to chronic malaria exposure in endemic areas. Revised Fakunle's criteria may be helpful for diagnosis: persistent splenomegaly (> 10 cm below the costal margin), increased anti- Plasmodium antibodies, increased IgM levels, exclusion of other causes of splenomegaly or malignancy, and a favorable response to antimalarial treatment...
March 11, 2019: American Journal of Tropical Medicine and Hygiene
Lea A Heberlein-Larson, Yi Tan, Lillian M Stark, Andrew C Cannons, Meghan H Shilts, Thomas R Unnasch, Suman R Das
Eastern equine encephalitis virus (EEEV) infection results in high mortality in infected horses and humans. Florida has been identified as an important source of EEEV epidemics to other states in the United States. In this study, we further characterized the epidemiological and evolutionary dynamics of EEEV in Florida. Epidemiological analysis of sentinel chicken seroconversion rates to EEEV infections during 2005-2016 suggested significant seasonality of EEEV activity in Florida. We observed significant annual activity of EEEV in the North and North Central regions, with little significant seasonality in the Panhandle region...
March 11, 2019: American Journal of Tropical Medicine and Hygiene
Richard Mwaiswelo, Billy Ngasala, Irina Jovel, Weiping Xu, Erik Larson, Maja Malmberg, Jose Pedro Gil, Zul Premji, Bruno P Mmbando, Andreas Mårtensson
Prevalence of and risk factors associated with polymerase chain reaction (PCR)-determined Plasmodium falciparum positivity were assessed on day 3 after initiation of treatment, pre-implementation and up to 8 years post-deployment of artemether-lumefantrine as first-line treatment for uncomplicated malaria in Bagamoyo district, Tanzania. Samples originated from previously reported trials conducted between 2006 and 2014. Cytochrome b-nested PCR was used to detect malaria parasites from blood samples collected on a filter paper on day 3...
March 11, 2019: American Journal of Tropical Medicine and Hygiene
Kengo Inagaki, Brian Kirmse, Richard S Bradbury, Ramana S Moorthy, Irene Arguello, Charles D Mcguffey, Brian Tieu, Charlotte V Hobbs
Ocular toxocariasis can be vision threatening, and is commonly reported from tropical or subtropical regions. Knowledge of clinical manifestations from the United States, particularly in underserved areas such as the American South, is lacking. We report three cases of ocular toxocariasis in individuals from the Mississippi Delta, a rural community with prevalent poverty. Visual acuity was severely affected in two of the three cases. Increased awareness of ocular toxocariasis, which may have under-recognized frequency, will contribute to prompt diagnosis and treatment, which will ultimately improve patient health in the region...
March 11, 2019: American Journal of Tropical Medicine and Hygiene
Asaf Biber, Eyal Nof, Eli Schwartz
Data regarding cardiac involvement in enteric fever among travelers are scarce. In this retrospective study, 59 patients were hospitalized with enteric fever during 2004-2017 and 28 had cardiac workups. Among those, four had evidence of cardiac involvement, including clinical myocarditis, electrocardiogram changes, or troponin elevation. Cardiac involvement was higher among patients infected with Salmonella Typhi than with Salmonella Paratyphi A ( P = 0.08), with a significant relative risk of 6 (95% CI: 1...
March 11, 2019: American Journal of Tropical Medicine and Hygiene
Irina Maljkovic Berry, Fredrick Eyase, Simon Pollett, Samson Limbaso Konongoi, M Gordon Joyce, Katherine Figueroa, Victor Ofula, Helen Koka, Edith Koskei, Albert Nyunja, James D Mancuso, Richard G Jarman, Rosemary Sang
In 2016, a chikungunya virus (CHIKV) outbreak was reported in Mandera, Kenya. This was the first major CHIKV outbreak in the country since the global reemergence of this virus in Kenya in 2004. We collected samples and sequenced viral genomes from this outbreak. All Kenyan genomes contained two mutations, E1:K211E and E2:V264A, recently reported to have an association with increased infectivity, dissemination, and transmission in the Aedes aegypti vector. Phylogeographic inference of temporal and spatial virus relationships showed that this variant emerged within the East, Central, and South African lineage between 2005 and 2008, most probably in India...
March 11, 2019: American Journal of Tropical Medicine and Hygiene
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