Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-6 (of 6 Records) |
Query Trace: Dear N[original query] |
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Advanced HIV disease in East Africa and Nigeria, in The African Cohort Study (AFRICOS)
Oboho IK , Esber AL , Dear N , Paulin HN , Iroezindu M , Bahemana E , Kibuuka H , Owuoth J , Maswai J , Shah N , Crowell TA , Ake JA , Polyak CS . J Acquir Immune Defic Syndr 2024 BACKGROUND: Earlier antiretroviral therapy (ART) may decrease progression to advanced HIV disease (AHD) with CD4 <200 cells/mm3 or clinical sequelae. We assessed factors associated with AHD among people living with HIV (PLHIV) before and during the "test and treat" era. SETTING: The African Cohort Study (AFRICOS) prospectively enrolls adults with and without HIV from 12 clinics in Uganda, Kenya, Tanzania, and Nigeria. METHODS: Enrollment evaluations included clinical history, physical examination, and laboratory testing. Generalized estimating equations were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CI) for factors associated with CD4 <200 at study visits. RESULTS: From 2013-2021, 3059 PLHIV with available CD4 at enrollment were included; median age was 38 years [interquartile range: 30-46] and 41.3% were men. From 2013 to 2021, the prevalence of CD4 <200 decreased from 10.5% to 3.1% while the percentage on ART increased from 76.6% to 100% (p <0.001). Factors associated with higher odds of CD4 <200 were male sex (aOR 1.56 [CI 1.29-1.89]), being 30-39 years (1.42 [1.11-1.82]) or older (compared to <30), World Health Organization stage 2 disease (1.91 [1.48-2.49]) or higher (compared to stage 1), and HIV diagnosis eras 2013-2015 (2.19 [1.42-3.37]) or later (compared to <2006). Compared to ART naïve, unsuppressed participants, being viral load suppressed on ART, regardless of ART duration, was associated with lower odds of CD4 <200 (<6 months on ART: 0.45 [0.34-0.58]). CONCLUSION: With ART scale-up, AHD has declined. Efforts targeting timely initiation of suppressive ART may further reduce AHD risk. |
Identification of TB space-time clusters and hotspots in Ouest dpartement, Haiti, 2011-2016
Dismer AM , Charles M , Dear N , Louis-Jean JM , Barthelemy N , Richard M , Morose W , Fitter DL . Public Health Action 2021 11 (2) 101-107 BACKGROUND: Haiti has the highest incidence rate of TB in the Western Hemisphere, with an estimated 170 cases per 100,000 in 2019. Since 2010, control efforts have focused on targeted case-finding activities in urban areas, implementation of rapid molecular diagnostics at high-volume TB centers, and improved reporting. TB analyses are rarely focused on lower geographic units; thus, the major goal was to determine if there were focal areas of TB transmission from 2011 to 2016 at operational geographic levels useful for the National TB Control Program (PNLT). METHODS: We created a geocoder to locate TB cases at the smallest geographic level. Kulldorff's space-time permutation scan, Anselin Moran's I, and Getis-Ord Gi* statistics were used to determine the spatial distribution and clusters of TB. RESULTS: With 91% of cases linked using the geocoder, TB clusters were identified each year. Getis-Ord Gi* analysis revealed 14 distinct spatial clusters of high incidences in the Port-au-Prince metropolitan area. One hundred retrospective space-time clusters were detected. CONCLUSION: Our study confirms the presence of TB hotspots in the Ouest département, with most clusters in the Port-au-Prince metropolitan area. Results will help the PNLT and its partners better design case-finding strategies for these areas. |
Breastfeeding duration and cytomegalovirus seroprevalence among U.S. children aged 1-5 years: The National Health and Nutrition Examination Surveys, 2011-2012 and 2017-2018
Lanzieri TM , Kruszon-Moran D , Link-Gelles R , Wong P , Dollard SM . Clin Infect Dis 2020 73 (1) e275-e276 Dear Editor, Petersen et al reported that cytomegalovirus (CMV) seroprevalence among U.S. children aged 1–5 years in the National Health and Nutrition Examination Survey (NHANES) increased from 20.7% in 2011–2012 to 28.2% in 2017–2018, with significant increases among 1-year-olds, non-Hispanic White children, those living at or above the poverty level, and being the only child ≤5 years in the household [1]. As we previously reported, 2011–2012 NHANES results indicated that these groups had significantly lower CMV seroprevalence in comparison to children that were older, Hispanic, living below the poverty level, and living with another child ≤5 years in the household, respectively [2, 3]. |
Antibiotic prophylaxis in vaccinated eculizumab recipients who developed meningococcal disease: Antibiotic prophylaxis and eculizumab
Crew PE , McNamara L , Waldron PE , McCulley L , Jones SC , Bersoff-Matcha SJ . J Infect 2019 80 (3) 350-371 Dear Editor: | | We recently published a case series of typically commensal Neisseria spp. disease among eculizumab recipients[1]. Eculizumab is a terminal complement inhibitor indicated for treatment of paroxysmal nocturnal hemoglobinuria, atypical hemolytic uremic syndrome, and certain patients with generalized myasthenia gravis or neuromyelitis optica spectrum disorder[2]. Due to complement inhibition, many different Neisseria spp. can cause invasive disease in eculizumab recipients[1, 3, 4] and eculizumab recipients are at an estimated 2000-fold increased risk of meningococcal disease (caused by Neisseria meningitidis). All eculizumab recipients should receive meningococcal vaccinations prior to therapy; however, eculizumab recipients may develop meningococcal disease or other Neisseria infections despite vaccine receipt[4–6]. For patients who cannot receive meningococcal vaccinations ≥2 weeks before starting eculizumab, U.S. eculizumab labeling recommends 2 weeks of antibiotic prophylaxis[2]. In July 2017, the Centers for Disease Control and Prevention (CDC) advised that prescribers could consider antibiotic prophylaxis in eculizumab recipients for the duration of eculizumab therapy[4]. There are no published studies evaluating the efficacy or safety of antibiotic prophylaxis in eculizumab recipients. Here, we report on potential risks and benefits of antibiotic prophylaxis for the prevention of meningococcal disease in a case series of vaccinated eculizumab recipients who developed meningococcal disease. |
Genomic analysis of the causative agents of coccidiosis in domestic chickens.
Reid AJ , Blake DP , Ansari HR , Billington K , Browne HP , Bryant JM , Dunn M , Hung SS , Kawahara F , Miranda-Saavedra D , Malas T , Mourier T , Naghra H , Nair M , Otto TD , Rawlings ND , Rivailler P , Sanchez-Flores A , Sanders M , Subramaniam C , Tay YL , Woo Y , Wu X , Barrell B , Dear PH , Doerig C , Gruber A , Ivens AC , Parkinson J , Rajandream MA , Shirley MW , Wan KL , Berriman M , Tomley FM , Pain A . Genome Res 2014 24 (10) 1676-85 Global production of chickens has trebled in the past two decades and they are now the most important source of dietary animal protein worldwide. Chickens are subject to many infectious diseases that reduce their performance and productivity. Coccidiosis, caused by apicomplexan protozoa of the genus Eimeria, is one of the most important poultry diseases. Understanding the biology of Eimeria parasites underpins development of new drugs and vaccines needed to improve global food security. We have produced annotated genome sequences of all seven species of Eimeria that infect domestic chickens, which reveal the full extent of previously described repeat-rich and repeat-poor regions and show that these parasites possess the most repeat-rich proteomes ever described. Furthermore, while no other apicomplexan has been found to possess retrotransposons, Eimeria is home to a family of chromoviruses. Analysis of Eimeria genes involved in basic biology and host-parasite interaction highlights adaptations to a relatively simple developmental life cycle and a complex array of co-expressed surface proteins involved in host cell binding. |
CDC and FDA response to risk of confusion in dosing Tamiflu oral suspension
Budnitz DS , Lewis LL , Shehab N , Birnkrant D . N Engl J Med 2009 361 (19) 1913-4 On September 23, Parker et al.1 described a case in which Tamiflu (oseltamivir) for oral suspension was dispensed with pharmacy instructions to administer the drug in volume units (teaspoons), whereas the manufacturer's dosing syringe accompanying the product is calibrated in milligrams. Interest in the use of oseltamivir for young children has risen since the emergence of 2009 pandemic influenza A (H1N1) virus. We recognize that dosing instructions with units different from those given on the device included with the product create risks of confusion and dosing errors. | Together, the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) have acted promptly to provide information that emphasizes appropriate dosing and dispensing of Tamiflu for oral suspension. Communications regarding potential dosing errors were posted on the CDC and FDA Web sites, and Roche has published a “Dear Healthcare Professional” letter.2 All communications recommend that, when dispensing commercially manufactured Tamiflu for oral suspension, pharmacists should ensure that the units of measure on the dosing instructions match those on the device provided. If the dosing instructions specify volumetric measures (teaspoons or milliliters), the manufacturer's syringe should be removed and replaced with an appropriate device with matching units. When dispensing this suspension for children younger than 1 year of age, according to the Emergency Use Authorization, the syringe in the package should always be replaced with an appropriate measuring device, because doses for children younger than 1 year of age cannot be measured with the manufacturer's syringe.3 |
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