The impact of co-morbid conditions on family history of venous thromboembolism in Whites and Blacks.
Mili FD , Hooper WC , Lally C , Austin H . Thromb Res 2011 127 (4) 309-16 INTRODUCTION: Our objectives were to compare the magnitude of family history as a risk factor for venous thromboembolism (VTE) risk between Blacks and Whites, and to assess the impact of co-morbid conditions on familial risk for VTE. MATERIALS AND METHODS: We used data from the Genetic Attributes Thrombosis Epidemiology (GATE) study, a matched case-control study which enrolled Blacks and Whites aged 18-70years in Atlanta, Georgia. A total of 1,094 case patients with a deep vein thrombosis (DVT) or pulmonary embolism (PE) and 1,264 control patients were interviewed about their family history. RESULTS: Family history of VTE was a statistically significant risk factor for VTE among Blacks (odds ratio (OR)=2.9, 95% confidence interval (CI) 2.0-4.1; P value<0.0001) and among Whites (OR=2.7, 95% CI 1.9-3.7; P value<0.0001); among Blacks and Whites who were obese or had hypertension; among Blacks who had diabetes mellitus or cancer; as well as among males and females, and across all age categories. Family history of VTE increased the risk of VTE among Blacks with cancer by about 6-fold, whereas among Blacks without cancer the increased risk due to a positive family history was about 3-fold; a 2-fold relative difference. In addition, family history was a risk factor for VTE among case patients with DVT only or with PE only. The effect of family history generally was stronger among those with recurrent episodes of VTE compared with a first episode of VTE. For example, family history of any VTE was a strong risk factor among Black females with recurrent VTE compared with Black females with first VTE (OR=3.9, 95% CI 2.0-7.5; P value<0.0001). CONCLUSION: Our study indicated that the adjusted attributable fraction for VTE was 16.9% among Blacks vs. 18.3% among Whites, and certain co-morbid conditions could further increase the risk of VTE associated with a positive family history of VTE. |
Prevalence of age-related macular degeneration in the US population
Klein R , Chou CF , Klein BE , Zhang X , Meuer SM , Saaddine JB . Arch Ophthalmol 2011 129 (1) 75-80 OBJECTIVE: To examine the prevalence of age-related macular degeneration (AMD) in non-Hispanic white, non-Hispanic black, Mexican American, and other racial/ethnic groups. DESIGN: A US nationally representative, population-based, cross-sectional study involving a total of 5553 persons aged 40 years and older from the 2005-2008 National Health and Nutrition Examination Survey. The main outcome measure was AMD determined by the grading of 45 degrees digital images from both eyes using a standardized protocol. RESULTS: In the civilian, noninstitutionalized, US population aged 40 years and older, the estimated prevalence of any AMD was 6.5% (95% confidence interval, 5.5-7.6) and the estimated prevalence of late AMD was 0.8% (95% confidence interval, 0.5-1.3). Non-Hispanic black persons aged 60 years and older had a statistically significantly lower prevalence of any AMD than non-Hispanic white persons aged 60 years and older (odds ratio = 0.37; 95% confidence interval, 0.21-0.67). CONCLUSIONS: Overall, the prevalence of any AMD in the 2005-2008 National Health and Nutrition Examination Survey was 6.5%, which is lower than the 9.4% prevalence reported in the 1988-1994 Third National Health and Nutrition Examination Survey. While this finding might be explained in part by possible methodological differences, these estimates are consistent with a decreasing incidence of AMD and suggest important public health care implications. |
Prevalence and correlates of herpes simplex virus type-2 infection among men who have sex with men, San Francisco, 2008
Bohl DD , Katz KA , Bernstein K , Wong E , Raymond HF , Klausner JD , McFarland W . Sex Transm Dis 2011 38 (7) 617-21 BACKGROUND: Most herpes simplex virus type 2 (HSV-2) infections are asymptomatic or unrecognized, so periodic serological surveys are necessary in order to measure the true prevalence of infection, track trends over time, and identify correlates of infection, including coinfection with human immunodeficiency virus (HIV). METHODS: We conducted a community-based, cross-sectional, serological survey among 500 men who have sex with men (MSM) in San Francisco during 2008. RESULTS: The seroprevalence of HSV-2 infection was 26.1% (95% confidence interval [CI], 18.3-33.9), of HIV infection was 18.6% (95% CI, 13.0-24.4), and of HSV-2/HIV coinfection was 12.0% (95% CI, 7.3-16.8; categories not mutually exclusive). HSV-2 prevalence was 3.7 (95% CI, 2.3-5.9) times as high among HIV-infected MSM as among HIV-uninfected MSM. Strong predictors of HSV-2 infection among both HIV-infected and HIV-uninfected MSM were older age and black race. CONCLUSIONS: The prevalence of HSV-2 infection among MSM in San Francisco is similar to that among MSM nationwide and is higher than that among all men nationwide. Prevalence rates are highly disparate among subpopulations of MSM in San Francisco, with the strongest predictors of infection being HIV-positive serostatus, older age, and black race. Primary prevention of HSV-2, particularly among populations at the highest risk for infection with HSV-2 or HIV, should remain a major public health goal to reduce the substantial morbidity caused by both of these infections. |
Gordonia bronchialis bacteremia and pleural infection: case report and review of the literature
Johnson JA , Onderdonk AB , Cosimi LA , Yawetz S , Lasker BA , Bolcen SJ , Brown JM , Marty FM . J Clin Microbiol 2011 49 (4) 1662-6 Gordonia species are aerobic actinomycetes recently recognized as causing human disease, often in the setting of intravascular catheter-related infections. We describe a case of Gordonia bronchialis bacteremia and pleural space infection in the absence of an indwelling intravascular catheter, and review the breadth of reported infections with this emerging pathogen. |
Follow-up assessment of health consequences after a chlorine release from a train derailment - Graniteville, SC, 2005
Duncan MA , Drociuk D , Belflower-Thomas A , Van Sickle D , Gibson JJ , Youngblood C , Daley WR . J Med Toxicol 2011 7 (1) 85-91 INTRODUCTION: After a train derailment released chlorine gas in Graniteville, South Carolina, in 2005, a multiagency team performed an epidemiologic assessment of chlorine exposure and resulting health effects. Five months later, participants were resurveyed to determine their health status and needs and to assist in planning additional interventions in the community. METHODS: Questionnaires were mailed to 279 patients interviewed in the initial assessment; follow-up telephone calls were made to nonresponders. The questionnaire included questions regarding duration of symptoms experienced after exposure and a posttraumatic stress disorder (PTSD) assessment tool. RESULTS: Ninety-four questionnaires were returned. Seventy-six persons reported chronic symptoms related to the chlorine exposure, 47 were still under a doctor's care, and 49 were still taking medication for chlorine-related problems. Agreement was poor between the first and second questionnaires regarding symptoms experienced after exposure to the chlorine (kappa = 0.30). Forty-four respondents screened positive for PTSD. PTSD was associated with post-exposure hospitalization for three or more nights [relative risk (RR) = 1.7; 95% confidence interval (CI) = 1.1-2.6] and chronic symptoms (RR = 9.1; 95% CI = 1.3-61.2), but not with a moderate-to-extreme level of chlorine exposure (RR = 1.2; 95% CI = 0.8-1.8). CONCLUSIONS: Some victims of this chlorine exposure event continued to experience physical symptoms and continued to require medical care 5 months later. Chronic mental health symptoms were prevalent, especially among persons experiencing the most severe or persistent physical health effects. Patients should be interviewed as soon as possible after an incident because recall of acute symptoms experienced can diminish within months. |
Importance of including all pregnancy outcomes to reduce bias in epidemiologic studies of neural tube defects-Texas, 1999 to 2005
Parks SE , Canfield MA , Ramadhani TA . Birth Defects Res A Clin Mol Teratol 2011 91 (3) 185-91 BACKGROUND: Neural tube defects (NTDs) often result in fetal death or elective termination; therefore, not all cases are captured in typical hospital-based surveillance. We examined sociodemographic differences among pregnancy outcomes to assess sources of bias in NTD surveillance and research. METHODS: We used 1999 to 2005 Texas Birth Defects Registry data, a population-based active surveillance system, and calculated crude and adjusted prevalence ratios (aPRs). We then assessed the association of anencephaly and spina bifida with the selected characteristics, stratified by pregnancy outcomes (fetal death, elective termination, or live birth). RESULTS: Data were available for 1852 NTD cases (anencephaly, 677; spina bifida, 954; and encephalocele, 221), resulting in 1211 live births, 236 fetal deaths, and 405 elective terminations. For both anencephaly and spina bifida, a significant excess of Hispanic mothers was observed among live-birth cases (aPRs = 1.2-2.4), but not among mothers experiencing other pregnancy outcomes. Mothers of anencephaly cases resulting in a non-live birth were more likely to be adolescents (aPRs = 2.4-2.7 for ages <20 years old vs. ages 25-29 years old), but this pattern was not observed for live-birth cases. A trend of increasing anencephaly risk with increasing parity was demonstrated only among fetal-death cases. For spina bifida, mothers of fetal-death (but not live-birth) cases were less likely to live along the Texas-Mexico border (aPR = 0.30). CONCLUSIONS: Demographic differences across NTD pregnancy outcomes exist and are a potential source of bias. Inclusion of all pregnancy outcomes in NTD surveillance is vital in NTD monitoring and research. Birth Defects Research (Part A), 2011. (c) 2011 Wiley-Liss, Inc. |
Selective sweeps and genetic lineages of Plasmodium falciparum drug -resistant alleles in Ghana.
Alam MT , de Souza DK , Vinayak S , Griffing SM , Poe AC , Duah NO , Ghansah A , Asamoa K , Slutsker L , Wilson MD , Barnwell JW , Udhayakumar V , Koram KA . J Infect Dis 2011 203 (2) 220-7 BACKGROUND: In 2005, Ghana adopted artemisinin-based combination therapy (ACT) for primary treatment of falciparum malaria. A comprehensive study of the drug-resistance-associated mutations and their genetic lineages will lead to a better understanding of the evolution of antimalarial drug resistance in this region. METHODS: The pfcrt, pfmdr1, dhps, and dhfr mutations associated with chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) resistance and the microsatellite loci flanking these genes were genotyped in Plasmodium falciparum isolates from Ghana. RESULTS: The prevalence of mutations associated with both CQ and SP resistance was high in Ghana. However, we observed a decrease in prevalence of the pfcrt K76T mutation in northern Ghana after the change in drug policy from CQ to ACT. Analysis of genetic diversity and differentiation at microsatellite loci flanking all 4 genes indicated that they have been under strong selection, because of CQ and SP use. The triple-mutant pfcrt and dhfr alleles in Ghana were derived from Southeast Asia, whereas the double-mutant dhfr, dhps, and pfmdr1 alleles were of African lineage. CONCLUSION: Because of the possible role of pfmdr1 in amodiaquine and mefloquine resistance, demonstrating selection on pfmdr1 and defining lineages of resistant alleles in an African population holds great importance. |
'Never testing for HIV' among men who have sex with men recruited from a sexual networking website, United States
Margolis AD , Joseph H , Belcher L , Hirshfield S , Chiasson MA . AIDS Behav 2011 16 (1) 23-9 HIV testing was assessed online among men accessing a sexual networking website for men who have sex with men. Most of the 8,040 participants reported HIV testing (58.2% ≤ 1 year; 33.1% > 1 year) and 17.1% were HIV-positive. Overall, 8.6% of men including 24% of those 18-24 years of age had never been tested. Among never testers, 25% did not know where to get tested. Predictors of never being tested included younger age (18-24), bisexual or heterosexual orientation, living outside of large metropolitan areas, and not having a healthcare provider. Increasing access to and knowledge of HIV testing sites is needed. |
National Standards for diabetes self-management education
Funnell MM , Brown TL , Childs BP , Haas LB , Hosey GM , Jensen B , Maryniuk M , Peyrot M , Piette JD , Reader D , Siminerio LM , Weinger K , Weiss MA . Diabetes Care 2011 34 Suppl 1 S89-96 Diabetes self-management education (DSME) is a critical element of care for all people with diabetes and is necessary in order to improve patient outcomes. The National Standards for DSME are designed to define quality diabetes self-management education and to assist diabetes educators in a variety of settings to provide evidence-based education. Because of the dynamic nature of health care and diabetes-related research, these Standards are reviewed and revised approximately every 5 years by key organizations and federal agencies within the diabetes education community. | A Task Force was jointly convened by the American Association of Diabetes Educators and the American Diabetes Association in the summer of 2006. Additional organizations that were represented included the American Dietetic Association, the Veteran's Health Administration, the Centers for Disease Control and Prevention, the Indian Health Service, and the American Pharmaceutical Association. Members of the Task Force included a person with diabetes; several health services researchers/behaviorists, registered nurses, and registered dietitians; and a pharmacist. | The Task Force was charged with reviewing the current DSME standards for their appropriateness, relevance, and scientific basis. The Standards were then reviewed and revised based on the available evidence and expert consensus. The committee convened on 31 March 2006 and 9 September 2006, and the Standards were approved 25 March 2007. |
Recommended adult immunization schedule: United States, 2011
Advisory Committee on Immunization Practices , Pickering LK , Friedman C . Ann Intern Med 2011 154 (3) 168-73 The Advisory Committee on Immunization Practices (ACIP) annually reviews the recommended Adult Immunization Schedule (Figure) to ensure that the schedule reflects current recommendations for the licensed vaccines. In October 2010, ACIP approved the Adult Immunization Schedule for 2011, which includes several changes. The notation for seasonal influenza vaccine in the figure and footnotes was changed to reflect the expanded recommendation for annual influenza vaccination for everyone 6 months of age or older, which was approved by ACIP in February 2010. In October 2010, ACIP issued a permissive recommendation for use of the tetanus, diphtheria, pertussis (Tdap) vaccine in adults aged 65 years or older; approved the recommendation that Tdap can be administered regardless of how much time has elapsed since the last tetanus and diphtheria (Td)–containing vaccine; and approved a recommendation for a 2-dose series of meningococcal vaccine in adults with certain high-risk medical conditions. The vaccines listed in the Figure have been reordered to keep all universally recommended vaccines together (for example, influenza, Td/Tdap, varicella, human papillomavirus [HPV], and zoster). |
Projected impact and cost-effectiveness of a rotavirus vaccination program in India, 2008
Esposito DH , Tate JE , Kang G , Parashar UD . Clin Infect Dis 2011 52 (2) 171-7 BACKGROUND: To assess the value of rotavirus vaccination in India, we determined the potential impact and cost-effectiveness of a national rotavirus vaccination program. METHODS: We compared the national rotavirus disease and cost burden with and without a vaccination program and assessed the cost-effectiveness of vaccination. Model inputs included measures of disease and cost burden, vaccine performance, and vaccination coverage and cost. We measured the annual number of health-related events and treatment costs averted, as well as the cost-effectiveness in US dollars per disability-adjusted life-year (DALY) and cost per death averted. One-way sensitivity analyses were performed by individually varying each model input. RESULTS: With use of a vaccine that has an estimated effectiveness of 50%, a rotavirus vaccination program in India would prevent approximately 44,000 deaths, approximately 293,000 hospitalizations, and approximately 328,000 outpatient visits annually, which would avert $20.6 million in medical treatment costs. Vaccination would be cost-saving at the GAVI Alliance price of $0.15 per dose. At $1.00 per dose, a vaccination program would cost $49.8 million, which would result in an expenditure of $21.41 per DALY averted or $662.94 per life saved. Even at $7.00 per dose, vaccination would be highly cost-effective. In sensitivity analyses, varying efficacy against severe rotavirus disease and vaccine price had the greatest impact on cost-effectiveness. CONCLUSIONS: A national rotavirus vaccination program in India would prevent substantial rotavirus morbidity and mortality and would be highly cost-effective at a range of vaccine prices. Public health officials can use this locally derived data to evaluate how this highly cost-effective intervention might fit into India's long-term health care goals. (See the editorial commentary by Nelson et al, on pages 178-179.). |
Getting under the hood: exploring issues that affect provider-based recall using an immunization information system
Saville AW , Albright K , Nowels C , Barnard J , Daley MF , Stokley S , Irby K , Kempe A . Acad Pediatr 2011 11 (1) 44-49 OBJECTIVE: To assess 1) pediatric practices' use of provider-based recall using an immunization information system 8 months after training on the recall process; 2) initiation and sustainability barriers to provider-based recall using an immunization information system; 3) strategies that facilitated recall initiation; and 4) recommendations for alternative approaches for conducting recall. METHODS: In 2008, 11 practices received training on the automatic recall function in the Colorado Immunization Information System (CIIS) for both infants and adolescents. The 2-hour computer-based training provided an opportunity for attendees to run real-time recall reports with CIIS staff assistance. Eight months later, key informant interviews were conducted with 24 providers and staff from these practices. RESULTS: Eight months after training, only 4 of 11 practices had implemented recall using CIIS: 3 practices recalled children ≤2 years of age, and 1 practice recalled adolescent girls for human papillomavirus vaccine. Initiation barriers included lack of awareness of baseline immunization rates, distrust in the accuracy of CIIS-generated data, and perceived difficulties recalling adolescents. Having unrealistic expectations about recall effectiveness was a barrier to sustainability. Strategies that facilitated recall included having a dedicated staff person for recall efforts and recalling children ≤2 years of age. Most key informants viewed population-based recall conducted by public health departments or schools as an acceptable alternative to provider-based recall. CONCLUSIONS: Even with a promising tool to assist pediatric offices, implementing provider-based recall is challenging for pediatric practices. Given existing barriers, providers expressed support for alternative recall methods. |
Influenza, hepatitis B, and tetanus vaccination coverage among health care personnel in the United States
Lu PJ , Euler GL . Am J Infect Control 2011 39 (6) 488-94 BACKGROUND: Health care personnel (HCP) are at risk for exposure to and possible transmission of vaccine-preventable diseases. Maintenance of immunity is an essential prevention practice for HCP. We assessed the recent influenza, hepatitis B, and tetanus vaccination coverage among HCP in the United States. METHODS: We analyzed data from the 2007 National Immunization Survey-Adult restricted to survey respondents aged 18 to 64 years. Influenza, hepatitis B, and tetanus vaccination coverage levels among HCP were assessed. Multivariable logistic regression was conducted to assess factors independently associated with receipt of vaccination among HCP. RESULTS: Among HCP aged 18 to 64 years, 46.7% (95% confidence interval [CI]: 39.6%-53.8%) had received influenza vaccination for the 2006-2007 season, and 70.4% (95% CI: 63.9%-76.1%) received tetanus vaccination in the past 10 years; 61.7% (95% CI: 52.5%-70.2%) had received 3 or more doses of hepatitis B vaccination among HCP aged 18 to 49 years. Multiple logistic regression analysis showed that being married was associated with influenza vaccination coverage, higher education level was associated with hepatitis B vaccination coverage, and younger age was significantly associated with tetanus vaccination among HCP. Among those HCP who did not receive influenza vaccination, the most common reason reported was respondent concerns about vaccine safety and adverse effects. CONCLUSION: By 2007, influenza and hepatitis B vaccination coverage among HCP remained well below the Healthy People 2010 objectives. Tetanus vaccination level was 70%, and this study provided a baseline data for tetanus vaccination among HCP. Innovative strategies are needed to further increase vaccination coverage among HCP. |
Considerations for human papillomavirus (HPV) vaccination of mid-adult women in the United States
Grant LA , Dunne EF , Chesson H , Markowitz LE . Vaccine 2011 29 (13) 2365-70 In the United States, human papillomavirus (HPV) vaccination is recommended for 11 or 12 year old girls, with catch-up vaccination through age 26 years. Data are available for women over the age of 26 years on immunogenicity for both quadrivalent and bivalent HPV vaccines and on efficacy for the quadrivalent HPV vaccine. If HPV vaccines are licensed for use in women over 26 years of age (mid-adult women), recommendations for this age group will need to be considered. This review summarizes vaccine efficacy and immunogenicity data in mid-adult women, and addresses epidemiologic data related to key questions for consideration of vaccine recommendations for women over age 26 years. |
Fatalities in swimming pools with lifeguards: USA, 2000-2008
Pelletier AR , Gilchrist J . Inj Prev 2011 17 (4) 250-3 BACKGROUND: Pools with lifeguards are often perceived to represent a safe environment for swimming. OBJECTIVES: To examine how often fatalities occurred in pools with lifeguards and what factors were common in these incidents. DESIGN: Case series. SETTING: USA. SUBJECTS: A case was defined as a death in a swimming pool with at least one lifeguard that occurred in the USA from 2000 to 2008. Potential cases were identified from media accounts using Lexis-Nexis and ProQuest databases. Supplemental information was obtained through internet based searches and review of death certificates. RESULTS: A total of 140 deaths from 37 states were identified. Of decedents, 109 (78%) were children and 93 (66%) were males. African Americans accounted for 44% of deaths among those of known race. 104 (74%) fatalities occurred during May through August; 85 (61%) deaths occurred in outdoor pools. Sites for fatal incidents included 53 (38%) municipal pools, 21 (15%) community organisations, and 20 (14%) schools. The median swimmer to lifeguard ratio was 13:1. Decedents were initially identified in the pool twice as often by non-lifeguards (eg, other swimmers or bystanders) as by lifeguards. CONCLUSIONS: Deaths in pools with lifeguards are uncommon, but do occur. Groups most affected include children, males, and African Americans. While lifeguards provide an important layer of protection at swimming pools, they alone cannot prevent all drownings. Additional safety measures are needed. |
Detection of bacterial pathogens in Mongolia meningitis surveillance with a new real-time PCR assay to detect Haemophilus influenzae.
Wang X , Mair R , Hatcher C , Theodore MJ , Edmond K , Wu HM , Harcourt BH , Carvalho MD , Pimenta F , Nymadawa P , Altantsetseg D , Kirsch M , Satola SW , Cohn A , Messonnier NE , Mayer LW . Int J Med Microbiol 2011 301 (4) 303-9 Since the implementation of Haemophilus influenzae (Hi) serotype b vaccine, other serotypes and non-typeable strains have taken on greater importance as a cause of Hi diseases. A rapid and accurate method is needed to detect all Hi regardless of the encapsulation status. We developed 2 real-time PCR (rt-PCR) assays to detect specific regions of the protein D gene (hpd). Both hpd assays are very specific and sensitive for detection of Hi. Of the 63 non-Hi isolates representing 21 bacterial species, none was detected by the hpd #1 assay, and only one of 2 H. aphrophilus isolates was detected by the hpd #3 assay. The hpd #1 and #3 assays detected 97% (229/237) and 99% (234/237) of Hi isolates, respectively, and were superior for detection of both typeable and non-typeable Hi isolates, as compared to previously developed rt-PCR targeting ompP2 or bexA. The diagnostic sensitivity and specificity of these rt-PCR assays were assessed on cerebrospinal fluid specimens collected as part of meningitis surveillance in Ulaanbaatar, Mongolia. The etiology (Neisseria meningitidis, Hi, and Streptococcus pneumoniae) of 111 suspected meningitis cases was determined by conventional methods (culture and latex agglutination), previously developed rt-PCR assays, and the new hpd assays. The rt-PCR assays were more sensitive for detection of meningitis pathogens than other classical methods and improved detection from 50% (56/111) to 75% (83/111). The hpd #3 assay identified a non-b Hi that was missed by the bexA assay and other methods. A sensitive rt-PCR assay to detect both typeable and non-typeable Hi is a useful tool for improving Hi disease surveillance especially after Hib vaccine introduction. |
Scardovia wiggsiae sp. nov., isolated from the human oral cavity and clinical material, and emended descriptions of the genus Scardovia and Scardovia inopinata.
Downes J , Mantzourani M , Beighton D , Hooper S , Wilson MJ , Nicholson A , Wade WG . Int J Syst Evol Microbiol 2011 61 25-9 Six strains of anaerobic, pleomorphic Gram-positive bacilli, isolated from the human oral cavity and an infected arm wound, were subjected to a comprehensive range of phenotypic and genotypic tests and were found to comprise a homogeneous group. 16S rRNA gene sequence analysis revealed that the isolates were most closely related to Scardovia inopinata CCUG 35729(T) (94.8-94.9 % 16S rRNA gene sequence similarity). The isolates were saccharolytic and produced acetic and lactic acids as end products of fermentation. The major fatty acids were C(16 : 0) (49.8 %) and C(18 : 1)omega9c (35.8 %). Polar lipid analysis revealed a variety of glycolipids, diphosphatidylglycerol, an unidentified phospholipid and an unidentified phosphoglycolipid. No respiratory quinones were detected. The peptidoglycan was of the type A4alpha L-Lys-Thr-Glu, with L-lysine partially replaced by L-ornithine. The DNA G+C content of one of the strains, C1A_55(T)(,) was 55 mol%. A novel species, Scardovia wiggsiae sp. nov., is proposed to accommodate the six isolates, with the type strain C1A_55(T) (=DSM 22547(T)=CCUG 58090(T)). |
Multi-laboratory testing of two-drug combinations of antifungals against Candida albicans, Candida glabrata, and Candida parapsilosis
Chaturvedi V , Ramani R , Andes D , Diekema DJ , Pfaller MA , Ghannoum MA , Knapp C , Lockhart SR , Ostrosky-Zeichner L , Walsh TJ , Marchillo K , Messer S , Welshenbaugh AR , Bastulli C , Iqbal N , Paetznick VL , Rodriguez J , Sein T . Antimicrob Agents Chemother 2011 55 (4) 1543-8 There are few multilaboratory studies on antifungal combinations testing to suggest a format for use in clinical laboratories. In the present study, eight laboratories tested quality control (QC) strain Candida parapsilosis ATCC 22019 and clinical isolates Candida albicans 20533.043, C. albicans 20464.007, Candida glabrata 20205.075, and C. parapsilosis 20580.070. The clinical isolates had relatively high azole and echinocandin MICs. A modified CLSI M-27A3 protocol was used, with 96-well custom-made plates containing checkerboard pair-wise combinations of amphotericin B (AMB), anidulafungin (AND), caspofungin (CSP), micafungin (MFC), posaconazole (PSC), and voriconazole (VRC). The end points were scored visually and on a spectrophotometer or ELISA reader for 50% growth reduction (IC50). Combination IC50 were used to calculate summation FICIs (SigmaFIC, fractional inhibitory concentration indices) based on the Lowe additivity formula. Results revealed that IC50 values of all drug combinations were lower or equal to the IC50 of individual drugs in the combination. A majority of the SigmaFIC values were indifferent (SigmaFIC = 0.51 -2.0), but no antagonism was observed (SigmaFIC ≥ 4). Synergistic combinations (SigmaFIC ≤ 0.5) were found from both visual and spectrophotometric readings for AMB-PSC against C. glabrata and for AMB-AND and AMB-CSP against C. parapsilosis. Additional synergistic interactions were revealed by either of the two end points for AMB-AND, AMB-CSP, AMB-MCF, AMB-PSC, AMB-VRC, AND-PSC, CSP-MCF, and CSP-PSC. The percent agreements among participating laboratories ranged from 37.5 % (lowest) for AND-CAS and POS-VOR and 87.5% (highest) for AB-MF and AND-CAS. Median SigmaFIC values showed wide dispersion, and inter-laboratory agreements were less than 85% in most instances. Additional studies are needed to improve inter-laboratory reproducibility of antifungal combination testing. |
Novel virulence gene and CRISPR multilocus sequence typing scheme for subtyping the major serovars of Salmonella enterica subspecies enterica
Liu F , Barrangou R , Gerner-Smidt P , Ribot EM , Knabel SJ , Dudley EG . Appl Environ Microbiol 2011 77 (6) 1946-56 Salmonella enterica subsp. enterica is the leading cause of bacterial foodborne disease in the United States. Molecular subtyping methods are powerful tools for tracking the farm-to-fork spread of foodborne pathogens during outbreaks. In order to develop a novel multilocus sequence typing (MLST) scheme for subtyping the major serovars of S. enterica subspecies enterica, the virulence genes sseL and fimH and Clustered Regularly Interspaced Short Palindromic Repeat (CRISPR) loci were sequenced from 171 clinical isolates from serovars Typhimurium, Enteritidis, Newport, Heidelberg, Javiana, I 4, [5], 12: i: -, Montevideo, Muenchen and Saintpaul. The MLST scheme using only virulence genes was congruent with serotyping and identified epidemic clones, but could not differentiate outbreaks. The addition of CRISPR sequences dramatically improved discriminatory power by differentiating individual outbreak strains/clones. Of particular note, the present MLST scheme provided better discrimination of ser. Enteritidis strains than PFGE. This method showed high epidemiologic concordance for all serovars screened except for ser. Muenchen. In conclusion, the novel MLST scheme described in the present study accurately differentiated outbreak strains/clones of the major serovars of Salmonella, and therefore shows promise for subtyping this important foodborne pathogen during outbreak investigations. |
Evaluation of the performance characteristics of 6 rapid HIV antibody tests
Delaney KP , Branson BM , Uniyal A , Phillips S , Candal D , Owen SM , Kerndt PR . Clin Infect Dis 2011 52 (2) 257-63 BACKGROUND: Since 2002, the US Food and Drug Administration has approved 6 rapid human immunodeficiency virus (HIV) tests for use in the United States. To date, there has been no direct comparison of the performance of all 6 tests. METHODS: Persons known to be HIV-infected and persons who sought HIV testing at 2 clinical sites in Los Angeles, California, were recruited for evaluation of 6 rapid HIV tests with whole blood, oral fluid, serum, and plasma specimens. Sensitivity and specificity of the rapid tests were compared with viral lysate and immunoglobulin (Ig) M-sensitive peptide HIV enzyme immunoassays (EIAs). RESULTS: A total of 6282 specimens were tested. Sensitivity was >95% and specificity was >99% for all rapid tests. Compared with the IgM-sensitive EIA, rapid tests gave false-negative results with an additional 2-5 specimens. All rapid tests had statistically equivalent performance characteristics, based on overlapping confidence intervals for sensitivity and specificity, compared with either conventional EIA. CONCLUSIONS: All 6 rapid tests have high sensitivity and specificity, compared with that of conventional EIAs. Because performance was similar for all tests and specimen types, other characteristics, such as convenience, time to result, shelf life, and cost will likely be determining factors for selection of a rapid HIV screening test for a specific application. |
Evaluation of urine CCA assays for detection of Schistosoma mansoni infection in western Kenya
Shane HL , Verani JR , Abudho B , Montgomery SP , Blackstock AJ , Mwinzi PN , Butler SE , Karanja DM , Secor WE . PLoS Negl Trop Dis 2011 5 (1) e951 Although accurate assessment of the prevalence of Schistosoma mansoni is important for the design and evaluation of control programs, the most widely used tools for diagnosis are limited by suboptimal sensitivity, slow turn-around-time, or inability to distinguish current from former infections. Recently, two tests that detect circulating cathodic antigen (CCA) in urine of patients with schistosomiasis became commercially available. As part of a larger study on schistosomiasis prevalence in young children, we evaluated the performance and diagnostic accuracy of these tests-the carbon test strip designed for use in the laboratory and the cassette format test intended for field use. In comparison to 6 Kato-Katz exams, the carbon and cassette CCA tests had sensitivities of 88.4% and 94.2% and specificities of 70.9% and 59.4%, respectively. However, because of the known limitations of the Kato-Katz assay, we also utilized latent class analysis (LCA) incorporating the CCA, Kato-Katz, and schistosome-specific antibody results to determine their sensitivities and specificities. The laboratory-based CCA test had a sensitivity of 91.7% and a specificity of 89.4% by LCA while the cassette test had a sensitivity of 96.3% and a specificity of 74.7%. The intensity of the reaction in both urine CCA tests reflected stool egg burden and their performance was not affected by the presence of soil transmitted helminth infections. Our results suggest that urine-based assays for CCA may be valuable in screening for S. mansoni infections. |
Improved detection of Botulinum neurotoxin type A in stool by mass spectrometry
Wang D , Baudys J , Kalb SR , Barr JR . Anal Biochem 2011 412 (1) 67-73 Botulinum neurotoxins (BoNTs) are the most toxic substances known to mankind. Rapid and sensitive detection of BoNTs is necessary for timely clinical confirmation of the disease state in botulism. BoNTs cleave proteins and peptide mimics at specific sites. A mass spectrometry (MS)-based method, Endopep-MS, can detect these cleavages and has detection limits of 0.05-0.5 mouse LD(50) (U) in serum, depending on the BoNT serotypes. In this method, the products generated from cleavage of peptide substrates using antibody affinity-purified toxins are detected by MS. Nonspecific bound endogenous proteases or peptidases in stool can co-extract with the toxin, cleaving the peptide substrates and reducing the sensitivity of the method. Here we report a method to reduce nonspecific substrate cleavage by reducing stool protease co-extraction in the Endopep-MS assay. |
Alterations in welding process voltage affect the generation of ultrafine particles, fume composition, and pulmonary toxicity
Antonini JM , Keane M , Chen BT , Stone S , Roberts JR , Schwegler-Berry D , Andrews RN , Frazer DG , Sriram K . Nanotoxicology 2011 5 (4) 700-10 The goal was to determine if increasing welding voltage changes the physico-chemical properties of the fume and influences lung responses. Rats inhaled 40 mg/m(3) (3 h/day x 3 days) of stainless steel (SS) welding fume generated at a standard voltage setting of 25 V (regular SS) or at a higher voltage (high voltage SS) of 30 V. Particle morphology, size and composition were characterized. Bronchoalveolar lavage was performed at different times after exposures to assess lung injury. Fumes collected from either of the welding conditions appeared as chain-like agglomerates of nanometer-sized primary particles. High voltage SS welding produced a greater number of ultrafine-sized particles. Fume generated by high voltage SS welding was higher in manganese. Pulmonary toxicity was more substantial and persisted longer after exposure to the regular SS fume. In summary, a modest raise in welding voltage affected fume size and elemental composition and altered the temporal lung toxicity profile. |
Combining culture techniques for Bartonella: the best of both worlds
Lynch T , Iverson J , Kosoy M . J Clin Microbiol 2011 49 (4) 1363-8 In this study we compared some common Bartonella culturing methodologies using four diverse species causing human illnesses. Based on a review of the literature, we focused on three major inconsistencies between protocols: base media, cell co-culture and temperature. Our data showed that B. tamiae demonstrated temperature-dependent growth limitations between common culturing conditions only 2 degrees C apart. Additionally, growth of B. quintana was significantly enhanced by the presence of mammalian cell co-culture within mammalian culture conditions, however when the media was modified to incorporate insect culture-based media, co-culturing with mammalian cells was no longer needed. In this study, we were able to overcome these temperature and cell dependent limitations and accommodate all of the strains tested by combining mammalian culture-based media with insect culture-based media. |
Attribution of congenital cytomegalovirus infection to primary versus non-primary maternal infection
Wang C , Zhang X , Bialek S , Cannon MJ . Clin Infect Dis 2011 52 (2) e11-3 Congenital cytomegalovirus (CMV) infection is a leading cause of developmental disabilities. In the United States during the period 1988-1994, approximately one-quarter of congenital CMV infections were attributable to primary maternal infection (n = 8772), and three-quarters were attributable to non-primary maternal infection (n = 29,918). Effective prevention strategies need to be developed for both primary and non-primary maternal infections. |
Associations between concentrations of vitamin D and concentrations of insulin, glucose, and HbA1c among adolescents in the United States
Ford ES , Zhao G , Tsai J , Li C . Diabetes Care 2011 34 (3) 646-8 OBJECTIVE: Our objective was to examine the associations between concentrations of vitamin D and concentrations of insulin, glucose, and HbA(1c) in a nationally representative sample of adolescents in the U.S. RESEARCH DESIGN AND METHODS: We used data for 1,941 adolescents, aged 12-17 years, who participated in the National Health and Nutrition Examination Survey between 2001 and 2006. RESULTS: Adjusted concentrations of insulin were ~24% lower among male subjects with a concentration of vitamin D ≥75 nmol/L than among male subjects with a concentration of vitamin D <50 nmol/L (P = 0.003). Concentrations of vitamin D were inversely associated with concentrations of glucose only among Mexican American male subjects (P = 0.007). No significant associations between concentrations of vitamin D and HbA(1c) were detected. CONCLUSIONS: Our results support an inverse association between concentrations of vitamin D and insulin primarily in adolescent male subjects. |
Trends in work-related musculoskeletal disorders: a comparison of risk factors for symptoms using Quality of Work Life data from the 2002 and 2006 general social survey
Waters TR , Dick RB , Krieg EF . J Occup Environ Med 2011 53 (9) 1013-24 OBJECTIVE: To assess trends in risk factors for work-related musculoskeletal disorders (MSDs). METHODS: Results from two similar national surveys (2002 and 2006) examined trends in relationships between individual, psychosocial, and physical factors and MSDs. RESULTS: Findings between years were similar, but important differences included a stronger effect of "Work Stress" on "Pain in Arms," and a stronger combined effect of "Hand Movement" and "Work Stress" on "Pain in Arms." Also, two interactions were statistically significant in the 2006 data, but not in the 2002 data, revealing potentially increased risks. These were "Hand Movement" and "Work Stress" on "Back Pain," and "Heavy Lifting" and "Work Stress" on "Pain in Arms." CONCLUSION: New strategies for preventing both low back and upper extremity MSDs should focus on work stress, heavy lifting, and hand movement, individually and in combination. |
Mortality in the Agricultural Health Study, 1993-2007
Waggoner JK , Kullman GJ , Henneberger PK , Umbach DM , Blair A , Alavanja MC , Kamel F , Lynch CF , Knott C , London SJ , Hines CJ , Thomas KW , Sandler DP , Lubin JH , Beane Freeman LE , Hoppin JA . Am J Epidemiol 2011 173 (1) 71-83 Comparing agricultural cohorts with the general population is challenging because the general healthiness of farmers may mask potential adverse health effects of farming. Using data from the Agricultural Health Study, a cohort of 89,656 pesticide applicators and their spouses (N = 89, 656) in North Carolina and Iowa, the authors computed standardized mortality ratios (SMRs) comparing deaths from time of the enrollment (1993-1997) through 2007 to state-specific rates. To compensate for the cohort's overall healthiness, relative SMRs were estimated by calculating the SMR for each cause relative to the SMR for all other causes. In 1,198,129 person-years of follow-up, 6,419 deaths were observed. The all-cause mortality rate was less than expected (SMR(applicators) = 0.54, 95% confidence interval (CI): 0.52, 0.55; SMR(spouses) = 0.52, 95% CI: 0.50, 0.55). SMRs for all cancers, heart disease, and diabetes were significantly below 1.0. In contrast, applicators experienced elevated numbers of machine-related deaths (SMR = 4.15, 95% CI: 3.18, 5.31), motor vehicle nontraffic accidents (SMR = 2.80, 95% CI: 1.81, 4.14), and collisions with objects (SMR = 2.12, 95% CI: 1.25, 3.34). In the relative SMR analysis for applicators, the relative mortality ratio was elevated for lymphohematopoietic cancers, melanoma, and digestive system, prostate, kidney, and brain cancers. Among spouses, relative SMRs exceeded 1.0 for lymphohematopoietic cancers and malignancies of the digestive system, brain, breast, and ovary. Unintentional fatal injuries remain an important risk for farmers; mortality ratios from several cancers were elevated relative to other causes. |
Assessing the risk to firefighters from chemical vapors and gases during vehicle fire suppression
Fent KW , Evans DE . J Environ Monit 2011 13 (3) 536-43 Despite the frequent occurrence of vehicle fires, very few studies investigating firefighters' potential inhalation exposures during vehicle fire suppression have been conducted. In this paper, we present an assessment of firefighters' health risk from vehicle fire suppression that accounts for the mixture of gases and vapors likely to be found in these fires. Summa canisters were used to collect emissions from the engine and cabin fires of a single vehicle and were analyzed for 75 volatile organic compounds (VOCs). Firefighters' breathing zone concentrations (BZCs) of aromatic hydrocarbons, aldehydes, isocyanates, and carbon monoxide were measured during the suppression of three vehicle fires. The Summa canister and BZC data were used to develop a simple model for predicting BZCs for the compounds that were not measured in the firefighters' breathing zones. Hazard quotients (HQs) were calculated by dividing the predicted and measured BZCs by the most conservative short-term exposure limits (STELs) or ceiling limits. Hazard indices (HIs) were determined by adding HQs for compounds grouped by the target organ for acute health effects. Any HIs above unity represented unacceptable risks. According to this mixture analysis, the estimated 95(th) percentile of the exposure distribution for the study population represents ≥9.2 times the acceptable level of risk to the respiratory tract and eyes. Furthermore, chemicals known or reasonably anticipated to be human carcinogens contributed to >45% of these HIs. While STELs are not usually based on carcinogenicity, maintaining exposures below STELs may protect individuals from the biological stress that could result from short-term exposures to carcinogens over time. Although vehicle fires are suppressed quickly (<10 min), this assessment suggests that firefighters have the potential to be overexposed to acute toxins during vehicle fire suppression and should therefore wear self-contained breathing apparatus at all times during vehicle fire response. |
Pillar strength in underground stone mines in the United States
Esterhuizen GS , Dolinar DR , Ellenberger JL . Int J Rock Mech Min Sci 2011 48 (1) 42-50 Stone mines in the Eastern and Midwestern United States make use of the room-and-pillar method of mining to extract relatively flat-laying sedimentary formations. A survey of pillar performance was carried out to identify potential modes of instability. Pillars were found to have been successful in providing support to the overburden, but a small number of individual failed pillars were observed. Failure of the pillars was observed to be related to spalling of the hard brittle rocks, shearing along pre-existing angular discontinuities or progressive extrusion of soft infill materials on bedding planes. A method of estimating the pillar strength and selecting a safety factor for design was developed based on observations of stable and failed pillars, supplemented by numerical models. The developed pillar strength equation can be used to design stable stone mine pillars provided the rock conditions are similar to those included in the study. Published by Elsevier Ltd. |
Probabilistic modeling using bivariate normal distributions for identification of flow and displacement intervals in longwall overburden
Karacan CO , Goodman GVR . Int J Rock Mech Min Sci 2011 48 (1) 27-41 Gob gas ventholes (GGV) are used to control methane emissions in longwall mines by capturing it within the overlying fractured strata before it enters the work environment. In order for GGVs to effectively capture more methane and less mine air, the length of the slotted sections and their proximity to top of the coal bed should be designed based on the potential gas sources and their locations, as well as the displacements in the overburden that will create potential flow paths for the gas. In this paper, an approach to determine the conditional probabilities of depth-displacement, depth-flow percentage, depth-formation and depth-gas content of the formations was developed using bivariate normal distributions. The flow percentage, displacement and formation data as a function of distance from coal bed used in this study were obtained from a series of borehole experiments contracted by the former US Bureau of Mines as part of a research project. Each of these parameters was tested for normality and was modeled using bivariate normal distributions to determine all tail probabilities. In addition, the probability of coal bed gas content as a function of depth was determined using the same techniques. The tail probabilities at various depths were used to calculate conditional probabilities for each of the parameters. The conditional probabilities predicted for various values of the critical parameters can be used with the measurements of flow and methane percentage at gob gas ventholes to optimize their performance. Published by Elsevier Ltd. |
Malaria control in pregnancy: still a long way to go
Gutman J , Slutsker L . Lancet Infect Dis 2011 11 (3) 157-9 Pregnant women, especially those pregnant for the first time, are at increased risk of more frequent and more severe malaria infections than are non-pregnant women.1–3 In endemic areas, malaria in pregnancy is a major preventable cause of maternal morbidity and poor birth outcomes. Use of insecticide-treated nets can decrease maternal anaemia and parasitaemia, resulting in improved pregnancy outcomes.4,5 Furthermore, the use of intermittent preventive treatment with sulfadoxine–pyrimethemine during pregnancy can reduce maternal anaemia, placental malaria, and the number of infants born with low birthweight.6,7 | In the Lancet Infectious Diseases today, Anna Maria van Eijk and colleagues8 report the progress of coverage with malaria control interventions in pregnant women in sub-Saharan Africa. The report is a substantial effort on the part of the investigators to compile data from all the countries in the sub-Saharan region. The findings emphasise that, although progress has been made in the scaling up of malaria-control interventions, the goals set by the Roll Back Malaria Partnership (80% population coverage of insecticide-treated nets in at-risk areas and 100% coverage of intermittent preventive treatment in pregnancy by 2010) have not been reached.9 On the basis of available data, the investigators estimated an overall coverage of treated nets among pregnant women of only 17%. The biggest impediment to use of nets is ownership.10,11 Between 2000 and 2004, distribution of nets occurred mainly through social marketing with subsidies to susceptible groups, leading to slow uptake, especially in poor, rural households.12 Subsequently, several studies showed that free distribution of nets increases coverage and use,12–14 and multiple mass-distribution campaigns have improved coverage. Because nearly half of the data in van Eijk and colleagues’ report8 were derived from surveys done before 2007, and because production and procurement of insecticide-treated nets increased strikingly from 2004 to 2007,9 present coverage in women probably exceeds 17%. Nonetheless, countries fell far short of stated goals. Provision of free nets via mass distribution campaigns and through distribution at antenatal clinics will help to move countries towards the targeted goals. |
Sexually transmitted diseases program performance measures: how are they performing?
Peterman TA , Newman DR , Collins DE , Doshi SR , Berman SM . Sex Transm Dis 2011 38 (7) 610-6 BACKGROUND: Performance measures were developed in order to improve the performance of sexually transmitted disease (STD) prevention programs. METHODS: A consultant worked with persons from STD programs and Centers for Disease Control and Prevention to identify possible measures. Measures were pilot tested for feasibility and relevance in several programs, then implemented nationwide in 2004. Data were collated and shared with programs and presented at national meetings. Site visits, webinars, and technical assistance focused on program improvement related to the measures. Reported data were analyzed to see if national performance improved on the activities measured. RESULTS: Some measures were dropped or revised, and quality of reported data improved over time. There was little evidence that overall program performance improved. CONCLUSIONS: Performance measures are one way to monitor performance, and might contribute to program improvement, but additional efforts are needed to improve performance. |
Assessing male condom failure and incorrect use
Duerr A , Gallo MF , Warner L , Jamieson DJ , Kulczycki A , Macaluso M . Sex Transm Dis 2011 38 (7) 580-6 BACKGROUND: It has not been well established whether common indices of male condom failure are valid predictors of biologically meaningful exposure during condom use. METHODS: To address this gap, the authors compared self-reported condom malfunctions (i.e., breakage and slippage) and incorrect condom practices to 2 following objective measures of failure: prostate-specific antigen (PSA) detected in vaginal swabs collected after condom use and structural integrity of used condoms. The study, conducted in 2000-2001, evaluated 635 male condoms used by 77 women attending an outpatient, reproductive-health clinic in Birmingham, AL. RESULTS: Women reported breakage or slippage for 7.9% of condoms; 3.5% of postcoital swabs had moderate or high levels of PSA; and laboratory testing of used condoms revealed breaks (1.1%) and leaks (2.0%). Self-reported breakage and slippage was associated with moderate/high PSA concentrations in postcoital swabs only when the malfunctions were not accompanied by reports of corrective actions to reduce exposure (adjusted odds ratio [aOR], 6.9; 95% confidence interval [CI], 1.8-26.2). Defects observed in postcoital laboratory testing were related to PSA detection (aOR, 8.0; 95% CI, 1.5-42.6). Incorrect practices defined on the condom label were frequent, but not all types were associated with semen exposure. Furthermore, other practices not currently label-defined were associated with semen exposure: touching the tip of the penis with his hands (aOR, 6.2; 95% CI, 2.3-17.0) or with her hands (aOR, 2.8; 95% CI, 1.1-72) before donning the condom. CONCLUSIONS: Used correctly, male condoms afforded good protection based on objective measures of failure. |
Power of tests for comparing trend curves with application to National Immunization Survey (NIS)
Zhao Z . Stat Med 2011 30 (5) 531-40 To develop statistical tests for comparing trend curves of study outcomes between two socio-demographic strata across consecutive time points, and compare statistical power of the proposed tests under different trend curves data, three statistical tests were proposed. For large sample size with independent normal assumption among strata and across consecutive time points, the Z and Chi-square test statistics were developed, which are functions of outcome estimates and the standard errors at each of the study time points for the two strata. For small sample size with independent normal assumption, the F-test statistic was generated, which is a function of sample size of the two strata and estimated parameters across study period. If two trend curves are approximately parallel, the power of Z-test is consistently higher than that of both Chi-square and F-test. If two trend curves cross at low interaction, the power of Z-test is higher than or equal to the power of both Chi-square and F-test; however, at high interaction, the powers of Chi-square and F-test are higher than that of Z-test. The measurement of interaction of two trend curves was defined. These tests were applied to the comparison of trend curves of vaccination coverage estimates of standard vaccine series with National Immunization Survey (NIS) 2000-2007 data. Copyright (c) 2011 John Wiley & Sons, Ltd. |
Molecular characterization of Cryptosporidium spp. in native breeds of cattle in Kaduna State, Nigeria
Maikai BV , Umoh JU , Kwaga JK , Lawal IA , Maikai VA , Cama V , Xiao L . Vet Parasitol 2011 178 241-5 Despite numerous molecular epidemiologic studies of cryptosporidiosis in dairy cattle in industrialized countries, there are very few studies on the diversity and public health significance of Cryptosporidium species in native cattle in developing countries. In this study, a polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) analysis of the small-subunit (SSU) rRNA gene was used to detect and identify Cryptosporidium spp. in 194 fecal specimens from 2 to 365 days old calves in 20 White Fulani and Sokoto Gudali herds in Nigeria. Thirty one (16.0%) of the specimens were positive for Cryptosporidium. Restriction digestion of the PCR products showed the presence of Cryptosporidium bovis (7.2%), Cryptosporidium ryanae (4.1%), Cryptosporidium andersoni (2.5%), and concurrent occurrence of C. bovis and C. ryanae (1.5%), and C. bovis and C. andersoni (0.5%). There were no significant differences (p>0.05) in Cryptosporidium infection rates by sex, herd location, management system, breed of calves, or fecal consistency. However, calves 180 days or younger had a higher infection rate of Cryptosporidium than older calves (p=0.034). Likewise, younger calves also had higher occurrence of C. bovis and C. ryanae (p=0.022). The absence of zoonotic Cryptosporidium parvum in the calves studied suggests that native breeds of cattle may not be important in the transmission of human cryptosporidiosis in Kaduna State, Nigeria. |
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