Last data update: Jan 27, 2025. (Total: 48650 publications since 2009)
Records 1-11 (of 11 Records) |
Query Trace: Woodhall D[original query] |
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Advancing the public health applications of Chlamydia trachomatis serology
Woodhall SC , Gorwitz RJ , Migchelsen SJ , Gottlieb SL , Horner PJ , Geisler WM , Winstanley C , Hufnagel K , Waterboer T , Martin DL , Huston WM , Gaydos CA , Deal C , Unemo M , Dunbar JK , Bernstein K . Lancet Infect Dis 2018 18 (12) e399-e407 Genital Chlamydia trachomatis infection is the most commonly diagnosed sexually transmitted infection. Trachoma is caused by ocular infection with C trachomatis and is the leading infectious cause of blindness worldwide. New serological assays for C trachomatis could facilitate improved understanding of C trachomatis epidemiology and prevention. C trachomatis serology offers a means of investigating the incidence of chlamydia infection and might be developed as a biomarker of scarring sequelae, such as pelvic inflammatory disease. Therefore, serological assays have potential as epidemiological tools to quantify unmet need, inform service planning, evaluate interventions including screening and treatment, and to assess new vaccine candidates. However, questions about the performance characteristics and interpretation of C trachomatis serological assays remain, which must be addressed to advance development within this field. In this Personal View, we explore the available information about C trachomatis serology and propose several priority actions. These actions involve development of target product profiles to guide assay selection and assessment across multiple applications and populations, establishment of a serum bank to facilitate assay development and evaluation, and development of technical and statistical methods for assay evaluation and analysis of serological findings. The field of C trachomatis serology will benefit from collaboration across the public health community to align technological developments with their potential applications. |
Assessment of U.S. pediatrician knowledge of toxocariasis
Woodhall DM , Garcia AP , Shapiro CA , Wray SL , Shane AL , Mani CS , Stimpert KK , Fox LM , Montgomery SP . Am J Trop Med Hyg 2017 97 (4) 1243-1246 Toxocariasis, one of a group of parasitic diseases known as neglected parasitic infections, is a disease caused by the larvae of two species of Toxocara roundworms, Toxocara canis, from dogs, and less commonly Toxocara cati, from cats. Although most infected individuals are asymptomatic, clinical manifestations may include fever, fatigue, coughing, wheezing, or abdominal pain (visceral toxocariasis) or vision loss, retina damage, or eye inflammation (ocular toxocariasis). To assess U.S. pediatrician knowledge of toxocariasis, we conducted an electronic survey of American Academy of Pediatrics members. Of the 2,684 respondents, 1,120 (47%) pediatricians correctly selected toxocariasis as the diagnosis in an unknown case presentation with findings typical for toxocariasis; overall 1,695 (85%) stated they were not confident that their knowledge of toxocariasis was current. This knowledge gap suggests a need for improved toxocariasis awareness and education for U.S. pediatricians, especially those caring for children at risk for infection. |
Baylisascaris procyonis roundworm seroprevalence among wildlife rehabilitators, United States and Canada, 2012-2015
Sapp SG , Rascoe LN , Wilkins PP , Handali S , Gray EB , Eberhard M , Woodhall DM , Montgomery SP , Bailey KL , Lankau EW , Yabsley MJ . Emerg Infect Dis 2016 22 (12) 2128-2131 Baylisascaris procyonis roundworms can cause potentially fatal neural larva migrans in many species, including humans. However, the clinical spectrum of baylisascariasis is not completely understood. We tested 347 asymptomatic adult wildlife rehabilitators for B. procyonis antibodies; 24 were positive, suggesting that subclinical baylisascariasis is occurring among this population. |
How do changes in the population tested for chlamydia over time affect observed trends in chlamydia positivity? Analysis of routinely collected data from young women tested for chlamydia in family planning clinics in the Pacific Northwest (USA), between 2003 and 2010
Woodhall SC , Torrone L , Fine D , Salomon SG , Nakatsukasa-Ono W , Soldan K , Weinstock H . Sex Health 2015 12 (6) 512-9 BACKGROUND: The proportion of chlamydia tests that are positive (positivity) is dependent on the population tested and the test technology used. The way in which changes in these variables might affect trends in positivity over time is investigated. METHODS: Data from 15- to 24-year-old women tested for chlamydia in family planning clinics participating in the Infertility Prevention Project in the Pacific Northwest, United States (USA Public Health Service Region X) during 2003-2010 (n = 590557) were analysed. Trends in positivity and in test, demographic and sexual behaviour variables were identified. Unadjusted and adjusted trends in chlamydia positivity were calculated using logistic regression. RESULTS: The proportion of tests carried out using nucleic acid amplification tests (NAATs) increased dramatically during the analysis period in two states. Smaller changes in demographic and behavioural characteristics were seen. Controlling for test technology used had the largest effect on the trend in testing positive per year, leading to a fall in the calculated odds ratio of testing positive from 1.06 to 1.02 in Oregon, and from 1.07 to 1.02 in Idaho. Controlling for other variables had minimal effect on chlamydia positivity trends. CONCLUSIONS: Changes in NAAT use had a large effect on observed trends in chlamydia positivity over time in the two states where NAATs were introduced during the analysis period. While trends in chlamydia positivity may be a useful metric for monitoring chlamydia burden, it is important to consider changes in test type when interpreting these data. |
Prevalence of Strongyloides stercoralis antibodies among a rural Appalachian population - Kentucky, 2013
Russell ES , Bosserman E , Marshall RE , Davis S , Beaudoin A , Handali S , McAuliffe I , Davis C , Woodhall D . Am J Trop Med Hyg 2014 91 (5) 1000-1 We investigated whether Strongyloides infection remains endemic in rural Kentucky's Appalachian regions; 7 of 378 (1.9%) participants tested positive for Strongyloides antibodies. We identified no statistically significant association between a positive test and travel to a known endemic country (P = 0.58), indicating that transmission in rural Kentucky might be ongoing. |
Toxocariasis: a review for pediatricians
Woodhall DM , Fiore AE . J Pediatric Infect Dis Soc 2014 3 (2) 154-159 Toxocariasis is a parasitic disease caused by roundworms of cats and dogs. The disease is endemic throughout the United States and causes significant morbidity in children, including damage to the lungs, liver, or central nervous system, especially the eyes. Two well established clinical syndromes of disease include visceral and ocular toxocariasis. Symptoms of visceral toxocariasis include abdominal pain, cough, or wheezing. Vision loss or strabismus are common symptoms of ocular toxocariasis. Serologic testing for presence of Toxocara antibody is available, although a positive test result does not necessarily correlate with active clinical infection. Albendazole or mebendazole is the recommended treatment for visceral toxocariasis. Treatment options for ocular toxocariasis include corticosteroids or ophthalmic surgery; anthelminthic medications also may be used. Risk for toxocariasis can be reduced by handwashing after soil contact, routine pets deworming, discouraging geophagia, and appropriate disposal of pet feces. |
Neglected parasitic infections: what every family physician needs to know
Woodhall D , Jones JL , Cantey PT , Wilkins PP , Montgomery SP . Am Fam Physician 2014 89 (10) 803-11 Neglected parasitic infections, including Chagas disease, toxocariasis, cysticercosis, and toxoplasmosis, affect millions of persons in the United States. Relatively few resources have been devoted to surveillance, prevention, and treatment of these diseases. Chagas disease primarily affects Latin American immigrants and can cause heart failure and death if not treated. Immediate antiparasitic treatment is indicated for most patients with acute Chagas disease. Treatment is recommended for patients younger than 18 years who have chronic Chagas disease and is generally recommended for adults younger than 50 years who do not have advanced cardiomyopathy; treatment decisions for other patients should be made on an individual basis. Toxocariasis primarily affects children and can cause gastrointestinal, respiratory, and ophthalmologic disease. Treatment options include albendazole and mebendazole. Patients with ocular infection require referral to an ophthalmologist. Neurocysticercosis, a form of cysticercosis, is the most common infectious cause of seizures in some parts of the United States. Initial treatment should focus on symptom control. Humans generally acquire toxoplasmosis by eating undercooked contaminated meat or ingesting things that have been contaminated with cat feces. Congenital infection can result in miscarriage or adverse fetal effects. Treatment is recommended for immunosuppressed persons, pregnant women, and immunocompetent persons with severe symptoms. |
Neglected parasitic infections in the United States: toxocariasis
Woodhall DM , Eberhard ML , Parise ME . Am J Trop Med Hyg 2014 90 (5) 810-3 Toxocariasis is a preventable parasitic disease that is caused by the dog and cat roundworms Toxocara cani and T. cati, respectively. Humans become infected when they accidently ingest infectious Toxocara eggs commonly found in contaminated soil; children are most often affected. Clinical manifestations of Toxocara infection in humans include ocular toxocariasis and visceral toxocariasis. Although infection with Toxocara can cause devastating disease, the burden of toxocariasis in the United States population remains unknown. In addition, risk factors for acquiring infection need to be better defined, and research needs to be conducted to better understand the pathophysiology and clinical course of toxocariasis. Development of diagnostic tests would enable clinicians to detect active infection, and determination of optimal drug regiments would ensure patients were appropriately treated. Addressing these public health gaps is necessary to understand and address the impact of toxocariasis in the United States. |
Exploring innovative ways to conduct coverage surveys for neglected tropical diseases in Malawi, Mali, and Uganda
Woodhall DM , Mkwanda S , Dembele M , Lwanga H , Drexler N , Dubray C , Harris J , Worrell C , Mathieu E . Acta Trop 2014 132 119-24 Currently, a 30-cluster survey to monitor drug coverage after mass drug administration for neglected tropical diseases is the most common methodology used by control programs. We investigated alternative survey methodologies that could potentially provide an estimation of drug coverage. Three alternative survey methods (market, village chief, and religious leader) were conducted and compared to the 30-cluster method in Malawi, Mali, and Uganda. In Malawi, drug coverage for the 30-cluster, market, village chief, and religious leader methods were 66.8% (95% CI 60.3-73.4), 74.3%, 76.3%, and 77.8%, respectively. In Mali, results for round 1 were 62.6% (95% CI 54.4-70.7), 56.1%, 74.8%, and 83.2%, and 57.2% (95% CI 49.0-65.4), 54.5%, 72.2%, and 73.3%, respectively, for round 2. Uganda survey results were 65.7% (59.4-72.0), 43.7%, 67.2%, and 77.6% respectively. Further research is needed to test different coverage survey methodologies to determine which survey methods are the most scientifically rigorous and resource efficient. |
First reported multistate human Q fever outbreak in the United States, 2011
Bjork A , Marsden-Haug N , Nett RJ , Kersh GJ , Nicholson W , Gibson D , Szymanski T , Emery M , Kohrs P , Woodhall D , Anderson AD . Vector Borne Zoonotic Dis 2013 14 (2) 111-7 In April, 2011, the Q fever bacterium Coxiella burnetii was identified at a Washington farm where an abortion storm took place among goats. Soon after, Q fever cases were reported among visitors to the farm from Washington and Montana. A cross-sectional investigation was conducted among humans and goats associated with the index farm or with 16 other farms that purchased goats from the index farm or housed goats at the index farm for breeding purposes. Questionnaire data were analyzed, along with human and goat specimens collected for evidence of C. burnetii infection. Twenty-one persons (19%) of the 109-person cohort from Washington and Montana met the outbreak case definition of an epidemiologic link to the index farm and a C. burnetii Phase II immunoglobulin G (IgG) titer ≥1:128 by immunofluorescence assay. Seventy-one percent of cases (15 of 21) were symptomatic, compared with approximately 50% during previous Q fever outbreaks. National Q fever surveillance reports increase in frequency with age, but 29% (6 of 21) of cases during this outbreak occurred in children aged <14 years. Goat-specific Q fever risk factors included direct contact with a newborn (prevalence ratio [PR] 10.7; confidence interval [CI] 1.5, 77.4), exposure to a newborn that died (PR 5.5; CI 1.7, 18.2), exposure to a weak newborn (PR 4.4; CI 1.7, 11.6), living on a property with goats (PR 4.2; CI 1.3, 13.9), and direct contact with birth/afterbirth products (PR 2.8; CI 1.1, 6.9). Evidence of C. burnetii infection was detected in all 17 goat herds sampled (13 Washington, 3 Montana, 1 Oregon) by PCR and/or enzyme-linked immunosorbent assay. Following this investigation, Washington and Montana implemented a herd management plan to encourage best-management practices among livestock owners, reduce the potential for future outbreaks, and promote continued communication between state public health and agricultural authorities. |
Ocular toxocariasis: epidemiologic, anatomic, and therapeutic variations based on a survey of ophthalmic subspecialists
Woodhall D , Starr MC , Montgomery SP , Jones JL , Lum F , Read RW , Moorthy RS . Ophthalmology 2012 119 (6) 1211-7 PURPOSE: To assess the current burden of ocular toxocariasis (OT) and to gain knowledge regarding the diagnostic and treatment practices used in the ophthalmologic community in the United States. DESIGN: Web-based, cross-sectional survey. PARTICIPANTS: Subspecialty ophthalmologists who are currently practicing in the United States. METHODS: An electronic survey was sent to 3020 ophthalmologic subspecialists belonging to the American Uveitis Society (AUS), the American Society of Retina Specialists (ASRS), or the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) to capture demographic, clinical, diagnostic, and treatment data on patients with OT seen in their practices between September 2009 and September 2010. MAIN OUTCOME MEASURES: The demographic, epidemiologic, and clinical characteristics of each reported patient with OT. RESULTS: A total of 159 patients with OT were reported by 559 respondents (19%). The median patient age was 11.5 years (range, 1-66 years). Seventy-two patients (45%) with OT lived in the Southern region of the United States. Thirty-one (69%) of 45 patients with OT owned a dog or cat. Vision loss was reported in 46 (85%) of 54 patients with OT; 32 (71%) of 45 patients had permanent vision loss, 13 patients (29%) had temporary vision loss, and duration of vision loss was unreported for 1 patient. Of the 32 patients with OT with permanent vision loss, 30 (94%) had a subretinal granulomatous mass/scar, peripheral granuloma with traction bands, or posterior pole granuloma noted on ophthalmologic examination. Subretinal granulomatous mass/scar, vitritis, and scotoma were the most common ophthalmologic signs found on examination of patients with OT. CONCLUSIONS: Ocular toxocariasis continues to occur in the United States, where it affects mainly children and causes permanent vision loss in many patients. Healthcare professionals should counsel patients and their family members about prevention strategies in an effort to decrease infection rates and morbidity due to Toxocara. Further improvement of diagnostic and treatment tools is needed to assist ophthalmologists in treating patients with OT. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article. |
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