Recent publications from TDC authors

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NCBI: db=pubmed; Term=(Yansouni C[Author]) OR (Iqbal A[Author] parasitology) OR (Ndao M[Author]) OR (Ward BJ[Author]) OR (Semret M[Author]) OR (Libman M[Author]) OR (Greenaway C[author]) OR (Barkati S[Author])
Updated: 16 hours 38 min ago

Rabies post-exposure prophylaxis started during or after travel: A GeoSentinel analysis.

Thu, 11/15/2018 - 00:50
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Rabies post-exposure prophylaxis started during or after travel: A GeoSentinel analysis.

PLoS Negl Trop Dis. 2018 Nov 13;12(11):e0006951

Authors: Gautret P, Angelo KM, Asgeirsson H, Lalloo DG, Shaw M, Schwartz E, Libman M, Kain KC, Piyaphanee W, Murphy H, Leder K, Vincelette J, Jensenius M, Waggoner J, Leung D, Borwein S, Blumberg L, Schlagenhauf P, Barnett ED, Hamer DH, GeoSentinel Global Surveillance Network

Abstract
BACKGROUND: Recent studies demonstrate that rabies post-exposure prophylaxis (RPEP) in international travelers is suboptimal, with only 5-20% of travelers receiving rabies immune globulin (RIG) in the country of exposure when indicated. We hypothesized that travelers may not be receiving RIG appropriately, and practices may vary between countries. We aim to describe the characteristics of travelers who received RIG and/or RPEP during travel.
METHODOLOGY/PRINCIPAL FINDINGS: We conducted a multi-center review of international travelers exposed to potentially rabid animals, collecting information on RPEP administration. Travelers who started RPEP before (Group A) and at (Group B) presentation to a GeoSentinel clinic during September 2014-July 2017 were included. We included 920 travelers who started RPEP. About two-thirds of Group A travelers with an indication for rabies immunoglobulin (RIG) did not receive it. Travelers exposed in Indonesia were less likely to receive RIG in the country of exposure (relative risk: 0.30; 95% confidence interval: 0.12-0.73; P = 0.01). Travelers exposed in Thailand [Relative risk (RR) 1.38, 95% Confidence Interval (95% CI): 1.0-1.8; P = 0.02], Sri Lanka (RR 3.99, 95% CI: 3.99-11.9; P = 0.013), and the Philippines (RR 19.95, 95% CI: 2.5-157.2; P = 0.01), were more likely to receive RIG in the country of exposure.
CONCLUSIONS/SIGNIFICANCE: This analysis highlights gaps in early delivery of RIG to travelers and identifies specific countries where travelers may be more or less likely to receive RIG. More detailed country-level information helps inform risk education of international travelers regarding appropriate rabies prevention.

PMID: 30422981 [PubMed - as supplied by publisher]

[Epidemiology of primary lung cancer among non-smokers in Senegal].

Mon, 11/12/2018 - 00:39
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[Epidemiology of primary lung cancer among non-smokers in Senegal].

Rev Mal Respir. 2018 Nov 06;:

Authors: Thiam K, Touré NO, Ndiaye EM, Baddredine H, Ndiaye M, Diop M, Niang A, Ba O, Dia Kane Y, Diatta A, Cissé MF, Mbaye FBR, Wayzani M, Niang S, Sagne JMAN, Dia S, Ndao M, Ka W

Abstract
INTRODUCTION: According to global data for 2002, one quarter of new cases of primary bronchopulmonary cancer were non-smokers. We undertook this study with the aim of describing the epidemiological characteristics of non-smokers with primary bronchopulmonary cancer in the Dakar region of Senegal.
METHODS: A multicenter descriptive study that included all non-smokers who presented with primary bronchopulmonary cancer between January 1st 2014 and December 31st 2015. The data were captured on an Excel file and then transferred to Epi InfoTM 7 software for analysis.
RESULTS: The rate of diagnosis for primary bronchopulmonary cancers was 72.1 %. The prevalence of non-smokers was 33.3 %. The sex ratio was 1.27. The average age was 54.6 years. More than a third of the sample were housewives. Carpenters and craftsmen exposed to metals predominated. Exposure to cooking oils was reported in one case. Three patients presented sequelae of pulmonary tuberculosis. Adenocarcinoma was the most common histological type and predominated in young subjects.
CONCLUSION: The proportion of primary bronchopulmonary cancers diagnosed among non-smokers is increasing in Dakar. An analytical study of suspected risk factors would be helpful for prevention.

PMID: 30413327 [PubMed - as supplied by publisher]

Validation of Apolipoprotein A-1 and Fibronectin Fragments as Markers of Parasitological Cure for Congenital Chagas Disease in Children Treated With Benznidazole.

Thu, 11/08/2018 - 00:14
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Validation of Apolipoprotein A-1 and Fibronectin Fragments as Markers of Parasitological Cure for Congenital Chagas Disease in Children Treated With Benznidazole.

Open Forum Infect Dis. 2018 Nov;5(11):ofy236

Authors: Ruiz-Lancheros E, Rasoolizadeh A, Chatelain E, Garcia-Bournissen F, Moroni S, Moscatelli G, Altcheh J, Ndao M

Abstract
Background: No reliable tests or validated biomarkers exist to ensure parasitological cure following treatment of Chagas disease (CD) patients chronically infected with Trypanosoma cruzi. As seroreversion, the only marker of cure, happens more quickly in children, we investigated the correlation between previously identified biomarkers and seroreversion in children.
Methods: Thirty CD children (age 1 month to 10 years) diagnosed as T. cruzi positive (time point S0) were treated with benznidazole (BZ) 5-8 mg/kg/d for 60 days. At least 2 serological tests were used to evaluate treatment efficacy from the end of treatment (S1) until seroreversion (S2). Thirty children (age 1 month to 10 years) and 15 adults were used as healthy controls (HCs). Immunoblot and a proteomic-based assay were used to validate previously identified fragments of apolipoprotein A-1 (ApoA1) and fibronectin (FBN) as CD biomarkers.
Results: Correlation between seroreversion and absence of ApoA1 and FBN fragments by immunoblot was observed in 30/30 (100%) and 29/30 (96.6%) CD children, respectively. ApoA1 and FBN fragments were absent at the end of BZ treatment in 20/30 (66.6%) and 16/30 (53.3%) children, respectively. Absence of fragments in serum profiles was confirmed by mass spectrometry. Using intact protein analysis, a 28 109-Da protein identified as full-length ApoA1 by tandem mass spectrometry was detected in HC serum samples.
Conclusions: These data confirm that ApoA1 and FBN fragments can discriminate between healthy and T. cruzi-infected samples. Correlation with seroreversion was shown for the first time; results suggest predictive capacity potentially superior to serology, making them potentially useful as surrogate biomarkers.

PMID: 30397621 [PubMed]

Spectrum of Illness in Migrants to Canada: Sentinel Surveillance through CanTravNet.

Wed, 11/07/2018 - 00:35
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Spectrum of Illness in Migrants to Canada: Sentinel Surveillance through CanTravNet.

J Travel Med. 2018 Nov 03;:

Authors: Boggild AK, Geduld J, Libman M, Yansouni CP, McCarthy AE, Hajek J, Ghesquiere W, Mirzanejad Y, Vincelette J, Kuhn S, Plourde PJ, Chakrabarti S, Greenaway C, Hamer DH, Kain KC

PMID: 30395252 [PubMed - as supplied by publisher]

Methods to reliably estimate faecal sludge quantities and qualities for the design of treatment technologies and management solutions.

Wed, 11/07/2018 - 00:35
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Methods to reliably estimate faecal sludge quantities and qualities for the design of treatment technologies and management solutions.

J Environ Manage. 2018 Oct 01;223:898-907

Authors: Strande L, Schoebitz L, Bischoff F, Ddiba D, Okello F, Englund M, Ward BJ, Niwagaba CB

Abstract
Sanitation access in urban areas of low-income countries is provided through unstandardized onsite technologies containing accumulated faecal sludge. The demand for infrastructure to manage faecal sludge is increasing, however, no reliable method exists to estimate total accumulated quantities and qualities (Q&Q) This proposed approach averages out complexities to estimate conditions at a centralized to semi-centralized scale required for management and treatment technology solutions, as opposed to previous approaches evaluating what happens in individual containments. Empirical data, demographic data, and questionnaires were used in Kampala, Uganda to estimate total faecal sludge accumulation in the city, resulting in 270 L/cap∙year for pit latrines and 280 L/cap∙year for septic tanks. Septic tank sludge was more dilute than pit latrine sludge, however, public toilet was not a distinguishing factor. Non-household sources of sludge represent a significant fraction of the total and have different characteristics than household-level sludge. Income level, water connection, black water only, solid waste, number of users, containment volume, emptying frequency, and truck size were predictors of sludge quality. Empirical relationships such as a COD:TS of 1.09 ± 0.56 could be used for more resource efficient sampling campaigns. Based on this approach, spatially available demographic, technical and environmental (SPA-DET) data and statistical relationships between parameters could be used to predict Q&Q of faecal sludge.

PMID: 30005415 [PubMed - indexed for MEDLINE]

Fever in the tropics: the ultimate clinical challenge?

Wed, 11/07/2018 - 00:35
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Fever in the tropics: the ultimate clinical challenge?

Clin Microbiol Infect. 2018 Aug;24(8):806-807

Authors: Bottieau E, Yansouni CP

PMID: 29940346 [PubMed - indexed for MEDLINE]

Point-of-care and point-of-'can': leveraging reference-laboratory capacity for integrated diagnosis of fever syndromes in the tropics.

Fri, 11/02/2018 - 00:28
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Point-of-care and point-of-'can': leveraging reference-laboratory capacity for integrated diagnosis of fever syndromes in the tropics.

Clin Microbiol Infect. 2018 Aug;24(8):836-844

Authors: Semret M, Ndao M, Jacobs J, Yansouni CP

Abstract
BACKGROUND: There is an urgent need for integrated diagnosis of febrile syndromes able to account for multiple pathogens and to inform decisions for clinical care and public health.
AIMS: To reflect on the evolving roles of laboratory-based testing for non-malarial febrile illnesses (NMFIs) in low-resource settings, and to consider how advances in diagnostics, in connectivity and transport, and in implementation of quality systems may substantially enhance the capacity of reference laboratories to bridge the current gap between remote passive surveillance and clinically meaningful integrated fever diagnosis.
SOURCES: Iterative search of PubMed databases, organizational reports, and expert consultation.
CONTENT: Implementation of new technologies-such as very broad molecular panels for surveillance and mass spectrometry-may considerably diminish capability gaps in reference laboratories in low-resource settings. Although the need for clinical bacteriology diagnostics is now recognized, the lack of new simple and rapid phenotypic tests for antimicrobial resistance remains a key deficiency. Several initiatives to strengthen diagnostic preparedness for infectious disease outbreaks have highlighted the need for functional tiered laboratory networks. Recently, dramatic headway in connectivity-such as combining automated readers with the image processing and data transmission capabilities of smartphones-now allows for more complex testing and interfacing with distant laboratory information systems while reducing workload and errors. Together with connectivity to transmit and receive results, new approaches to specimen collection and transport-such as the validation of rectal swabs and the use of aerial drones to transport specimens to distant laboratories-now make remote testing feasible. The above innovations also open up the possibility of implementing quality systems through community-level diagnostic stewardship. Finally, strengthened laboratory networks actively support the feasibility of implementing quality-assured point-of-care testing where it is needed.
IMPLICATIONS: Recent advances offer the present-day possibility of innovations to re-invent the relationship between distant reference laboratories and end-users for integrated diagnosis of NMFIs.

PMID: 29649602 [PubMed - indexed for MEDLINE]

Foxes (Vulpes vulpes) as sentinels for parasitic zoonoses, Toxoplasma gondii and Trichinella nativa, in the northeastern Canadian Arctic.

Wed, 10/31/2018 - 01:53
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Foxes (Vulpes vulpes) as sentinels for parasitic zoonoses, Toxoplasma gondii and Trichinella nativa, in the northeastern Canadian Arctic.

Int J Parasitol Parasites Wildl. 2018 Dec;7(3):391-397

Authors: Nicholas B, Ravel A, Leighton P, Stephen C, Iqbal A, Ndao M, Konecsni K, Fernando C, Jenkins E

Abstract
Outbreaks of Toxoplasma gondii and Trichinella spp. have been recurring for decades among Inuit of Nunavik, northeastern Canada. Contact with wildlife has been identified as a risk factor for Inuit exposure to T. gondii, but reservoirs have yet to be confirmed based on direct detection of DNA or organism. Similarly, little is known about the occurrence of Trichinella spp. in wildlife species of Nunavik other than walrus (Odobenus rosmarus) and bears (Ursus americanus, Ursus maritimus). Foxes (Vulpes vulpes) were targeted as possible sentinels for T. gondii and Trichinella spp. because of their high trophic position within the Arctic food chain as carnivorous scavengers. A total of 39 red foxes were sampled from four communities in southern and western Nunavik between November 2015 and September 2016. For the first time in wildlife, a novel magnetic capture DNA extraction and real-time PCR technique was used to isolate and detect T. gondii DNA from the heart and brain of foxes. A double separatory funnel digestion method followed by multiplex PCR was used to recover and genotype larvae of Trichinella spp. from tongues of foxes. Seroprevalence based on detection of antibodies to T. gondii was 41% (95% CI: 27-57%) using a commercially available modified agglutination test (MAT). Detection of DNA of T. gondii and larvae of Trichinella nativa (T2) occurred in 44% (95% CI: 28-60%) and 36% (95% CI: 21-51%) of foxes, respectively. Coinfection with both T. nativa and T. gondii occurred among 23% (95%CI: 13-38%) of foxes which can be attributed to co-transmission from prey and scavenged species in their diet. There was only moderate agreement between T. gondii serology and direct detection of T. gondii DNA using the MC-PCR technique (Kappa test statistic: 0.321), suggesting that using both methods in tandem can increase the sensitivity of detection for this parasite. These findings show that foxes are good sentinels for circulation of parasitic zoonoses in terrestrial northern ecosystems since they are highly exposed, show measurable indicators of infection and do not serve as exposure sources for humans.

PMID: 30370219 [PubMed]

Accessibility and Acceptability of Infectious Disease Interventions Among Migrants in the EU/EEA: A CERQual Systematic Review.

Sun, 10/28/2018 - 00:34
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Accessibility and Acceptability of Infectious Disease Interventions Among Migrants in the EU/EEA: A CERQual Systematic Review.

Int J Environ Res Public Health. 2018 Oct 23;15(11):

Authors: Driedger M, Mayhew A, Welch V, Agbata E, Gruner D, Greenaway C, Noori T, Sandu M, Sangou T, Mathew C, Kaur H, Pareek M, Pottie K

Abstract
In the EU/EEA, subgroups of international migrants have an increased prevalence of certain infectious diseases. The objective of this study was to examine migrants' acceptability, value placed on outcomes, and accessibility of infectious disease interventions. We conducted a systematic review of qualitative reviews adhering to the PRISMA reporting guidelines. We searched MEDLINE, EMBASE, CINAHL, DARE, and CDSR, and assessed review quality using AMSTAR. We conducted a framework analysis based on the Health Beliefs Model, which was used to organize our preliminary findings with respect to the beliefs that underlie preventive health behavior, including knowledge of risk factors, perceived susceptibility, severity and barriers, and cues to action. We assessed confidence in findings using an adapted GRADE CERQual tool. We included 11 qualitative systematic reviews from 2111 articles. In these studies, migrants report several facilitators to public health interventions. Acceptability depended on migrants' relationship with healthcare practitioners, knowledge of the disease, and degree of disease-related stigma. Facilitators to public health interventions relevant for migrant populations may provide clues for implementation. Trust, cultural sensitivity, and communication skills also have implications for linkage to care and public health practitioner education. Recommendations from practitioners continue to play a key role in the acceptance of infectious disease interventions.

PMID: 30360472 [PubMed - in process]

Fractional dosing of yellow fever vaccine during shortages: perspective from Canada.

Wed, 10/24/2018 - 00:25
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Fractional dosing of yellow fever vaccine during shortages: perspective from Canada.

J Travel Med. 2018 Oct 22;:

Authors: Teitelbaum P, Bui YG, Libman M, McCarthy A

PMID: 30346564 [PubMed - as supplied by publisher]

Review of synthetic human faeces and faecal sludge for sanitation and wastewater research.

Wed, 10/17/2018 - 00:59
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Review of synthetic human faeces and faecal sludge for sanitation and wastewater research.

Water Res. 2018 04 01;132:222-240

Authors: Penn R, Ward BJ, Strande L, Maurer M

Abstract
Investigations involving human faeces and faecal sludge are of great importance for urban sanitation, such as operation and maintenance of sewer systems, or implementation of faecal sludge management. However, working with real faecal matter is difficult as it not only involves working with a pathogenic, malodorous material but also individual faeces and faecal sludge samples are highly variable, making it difficult to execute repeatable experiments. Synthetic faeces and faecal sludge can provide consistently reproducible substrate and alleviate these challenges. A critical literature review of simulants developed for various wastewater and faecal sludge related research is provided. Most individual studies sought to develop a simulant representative of specific physical, chemical, or thermal properties depending on their research objectives. Based on the review, a suitable simulant can be chosen and used or further developed according to the research needs. As an example, the authors present such a modification for the development of a simulant that can be used for investigating the motion (movement, settling and sedimentation) of faeces and their physical and biological disintegration in sewers and in on-site sanitation systems.

PMID: 29331910 [PubMed - indexed for MEDLINE]

Development of a sandwich ELISA to detect Leishmania 40S ribosomal protein S12 antigen from blood samples of visceral leishmaniasis patients.

Sat, 10/06/2018 - 00:18
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Development of a sandwich ELISA to detect Leishmania 40S ribosomal protein S12 antigen from blood samples of visceral leishmaniasis patients.

BMC Infect Dis. 2018 Oct 03;18(1):500

Authors: Zhang WW, Ghosh AK, Mohamath R, Whittle J, Picone A, Lypaczewski P, Ndao M, Howard RF, Das P, Reed SG, Matlashewski G

Abstract
BACKGROUND: Visceral leishmaniasis (VL), caused by Leishmania donovani complex parasites, is a neglected parasitic disease that is generally fatal if untreated. Despite decades of research to develop a sensitive VL diagnostic test, definitive diagnosis of VL still mainly relies on the visualization of the parasite in aspirates from the spleen, liver or bone marrow, an invasive and dangerous process with variable sensitivity. A sensitive assay that can detect Leishmania antigen from blood samples will help confirm cause, cure or recurrence of VL.
METHODS: In this study, rabbit polyclonal antibodies were raised against eight recombinant Leishmania proteins that are highly abundant in Leishmania. The antibodies were purified and labeled with biotin for developing a prototype sandwich enzyme-linked immunosorbent assay (ELISA).
RESULTS: The ELISA for the Leishmania 40S ribosomal protein S12 detected target antigen with the highest sensitivity and specificity and could detect 1 pg of purified protein or as few as 60 L. donovani parasites. The 40S ribosomal protein S12 sandwich ELISA could detect the target antigen from Peripheral Blood Mononuclear Cell (PBMC) samples in 68% of VL patients and post-kala-azar dermal leishmaniasis (PKDL) patients, providing an estimation of parasitemia ranging from 15 to 80 amastigotes per ml of blood.
CONCLUSION: These results indicate that the 40S ribosomal protein S12 sandwich ELISA warrants further tests with more clinical samples of VL patients and other parasitic diseases. It is hopeful that this ELISA could become a useful tool for confirming VL diagnosis, monitoring treatment progress, disease recurrence and possibly detecting asymptomatic Leishmania infections with a high parasite load.

PMID: 30285653 [PubMed - in process]

Interventions to Improve Vaccination Uptake and Cost Effectiveness of Vaccination Strategies in Newly Arrived Migrants in the EU/EEA: A Systematic Review.

Mon, 09/24/2018 - 01:23
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Interventions to Improve Vaccination Uptake and Cost Effectiveness of Vaccination Strategies in Newly Arrived Migrants in the EU/EEA: A Systematic Review.

Int J Environ Res Public Health. 2018 Sep 20;15(10):

Authors: Hui C, Dunn J, Morton R, Staub LP, Tran A, Hargreaves S, Greenaway C, Biggs BA, Christensen R, Pottie K

Abstract
Newly arrived migrants to the EU/EEA (arrival within the past five years), as well as other migrant groups in the region, might be under-immunised and lack documentation of previous vaccinations, putting them at increased risk of vaccine-preventable diseases circulating in Europe. We therefore performed a systematic review conforming to PRISMA guidelines (PROSPERO CRD42016045798) to explore: (i) interventions that improve vaccine uptake among migrants; and (ii) cost-effectiveness of vaccination strategies among this population. We searched MEDLINE, Embase, CINAHL, and Cochrane Database of Systematic Reviews (CDSR) between 1 January 2006 to 18 June 2018. We included three primary intervention studies performed in the EU/EEA or high-income countries and one cost effectiveness study relevant to vaccinations in migrants. Intervention studies showed small but promising impact only on vaccine uptake with social mobilization/community outreach, planned vaccination programs and education campaigns. Targeting migrants for catch-up vaccination is cost effective for presumptive vaccination for diphtheria, tetanus, and polio, and there was no evidence of benefit of carrying out pre-vaccination serological testing. The cost-effectiveness is sensitive to the seroprevalence and adherence to vaccinations of the migrant. We conclude that scarce but direct EU/EEA data suggest social mobilization, vaccine programs, and education campaigns are promising strategies for migrants, but more research is needed. Research should also study cost effectiveness of strategies. Vaccination of migrants should continue to be a public heath priority in EU/EEA.

PMID: 30241320 [PubMed - in process]

Sequencing of high-efficacy disease-modifying therapies in multiple sclerosis: perspectives and approaches.

Sat, 09/22/2018 - 02:05
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Sequencing of high-efficacy disease-modifying therapies in multiple sclerosis: perspectives and approaches.

Neural Regen Res. 2018 Nov;13(11):1871-1874

Authors: Grand'Maison F, Yeung M, Morrow SA, Lee L, Emond F, Ward BJ, Laneuville P, Schecter R

Abstract
Multiple sclerosis (MS) is characterized by chronic inflammation in conjunction with neurodegeneration within the central nervous system. Most individuals with MS begin with a relapsing remitting course that later transitions to secondary progressive MS. Currently available disease-modifying therapies (DMTs) for relapsing MS have been demonstrated to reduce disease activity, however most patients require a change in therapy over the course of their disease. Treatment goals include the prevention of relapses and disability accumulation and to achieve this objective requires careful planning. Sequencing of DMTs for individual patients should be designed in such a way to maximize disease control and minimize risk based on the mechanism of action, pharmacokinetic and pharmacodynamic properties of each therapy. This includes the DMT patients are being switched from to those they are being switched to. The reversibility of immune system effects should be a key consideration for DMT sequence selection. This feature varies across DMTs and should factor more prominently in decision making as newer treatments become available for the prevention of disability accumulation in patients with progressive MS. In this short review, we discuss the landscape of existing therapies with an eye to the future when planning for optimal DMT sequencing. While no cure exists for MS, efforts are being directed toward research in neuroregeneration with the hope for positive outcomes.

PMID: 30233054 [PubMed]

Case Report: Ivermectin and Albendazole Plasma Concentrations in a Patient with Disseminated Strongyloidiasis on Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy.

Thu, 09/20/2018 - 01:10
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Case Report: Ivermectin and Albendazole Plasma Concentrations in a Patient with Disseminated Strongyloidiasis on Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy.

Am J Trop Med Hyg. 2018 Sep 17;:

Authors: Boodman C, Chhonker YS, Murry DJ, Mah A, Grant J, Steiner T, Libman M, Nishi C, Charles M

Abstract
Disseminated strongyloidiasis is often fatal, despite treatment with oral albendazole and parenteral ivermectin (IVM). Here, we report elevated plasma IVM and albendazole sulfoxide concentrations in the context of extracorporeal membrane oxygenation and continuous renal replacement therapy in a patient with disseminated strongyloidiasis treated with subcutaneous IVM and nasogastric albenzadole. Despite elevated drug plasma concentrations, live filariform larvae were detected in endotracheal aspirates after 2 weeks of treatment.

PMID: 30226142 [PubMed - as supplied by publisher]

The Effectiveness and Cost-Effectiveness of Hepatitis C Screening for Migrants in the EU/EEA: A Systematic Review.

Thu, 09/20/2018 - 01:10
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The Effectiveness and Cost-Effectiveness of Hepatitis C Screening for Migrants in the EU/EEA: A Systematic Review.

Int J Environ Res Public Health. 2018 Sep 14;15(9):

Authors: Greenaway C, Makarenko I, Chakra CNA, Alabdulkarim B, Christensen R, Palayew A, Tran A, Staub L, Pareek M, Meerpohl JJ, Noori T, Veldhuijzen I, Pottie K, Castelli F, Morton RL

Abstract
Chronic hepatitis C (HCV) is a public health priority in the European Union/European Economic Area (EU/EEA) and is a leading cause of chronic liver disease and liver cancer. Migrants account for a disproportionate number of HCV cases in the EU/EEA (mean 14% of cases and >50% of cases in some countries). We conducted two systematic reviews (SR) to estimate the effectiveness and cost-effectiveness of HCV screening for migrants living in the EU/EEA. We found that screening tests for HCV are highly sensitive and specific. Clinical trials report direct acting antiviral (DAA) therapies are well-tolerated in a wide range of populations and cure almost all cases (>95%) and lead to an 85% lower risk of developing hepatocellular carcinoma and an 80% lower risk of all-cause mortality. At 2015 costs, DAA based regimens were only moderately cost-effective and as a result less than 30% of people with HCV had been screened and less 5% of all HCV cases had been treated in the EU/EEA in 2015. Migrants face additional barriers in linkage to care and treatment due to several patient, practitioner, and health system barriers. Although decreasing HCV costs have made treatment more accessible in the EU/EEA, HCV elimination will only be possible in the region if health systems include and treat migrants for HCV.

PMID: 30223539 [PubMed - in process]

First Human Case of Metacestode Infection Caused by Versteria sp. in a Kidney Transplant Recipient.

Sat, 09/15/2018 - 00:10
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First Human Case of Metacestode Infection Caused by Versteria sp. in a Kidney Transplant Recipient.

Clin Infect Dis. 2018 Sep 13;:

Authors: Barkati S, Gottstein B, Mu Ller N, Sheitoyan-Pesant C, Metrakos P, Chen T, Garceau R, Libman MD, Ndao M, Yansouni CP

Abstract
Cestodes are emerging agents of severe opportunistic infections among immunocompromised patients. We describe the first case of human infection, with the recently-proposed genus Versteria causing an invasive, tumor-like hepatic infection with regional and distant extension in a 53-year-old female kidney transplant recipient from Atlantic Canada.

PMID: 30212859 [PubMed - as supplied by publisher]

Morphological characterization of a plant-made virus-like particle vaccine bearing influenza virus hemagglutinins by electron microscopy.

Thu, 09/13/2018 - 01:08
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Morphological characterization of a plant-made virus-like particle vaccine bearing influenza virus hemagglutinins by electron microscopy.

Vaccine. 2018 04 12;36(16):2147-2154

Authors: Lindsay BJ, Bonar MM, Costas-Cancelas IN, Hunt K, Makarkov AI, Chierzi S, Krawczyk CM, Landry N, Ward BJ, Rouiller I

Abstract
Plant-made virus-like particle (VLP) vaccines that display wild-type influenza hemagglutinin (HA) are rapidly advancing through clinical trials. Produced by transient transfection of Nicotiana benthamiana, these novel vaccines are unusually immunogenic, eliciting both humoral and cellular responses. Here, we directly visualized VLPs bearing either HA trimers derived from strains A/California/7/2009 or A/Indonesia/5/05 using cryo-electron microscopy and determined the 3D organization of the VLPs using cryo-electron tomography. More than 99.9% of the HA trimers in the vaccine preparations were found on discoid and ovoid-shaped particles. The discoid-shaped VLPs presented HA trimers on their outer diameter. The ovoid-shaped VLPs contained HA trimers evenly distributed at their surface. The VLPs were stable for 12 months at 4 °C. Early interactions of the VLPs with mouse dendritic and human monocytoid (U-937) cells were visualized by electron microscopy after resin-embedding and sectioning. The VLP particles were observed bound to plasma membranes as well as inside vesicles. Mouse dendritic cells exposed to VLPs displayed classic morphological changes associated with activation including the extensive formation of dendrites. Our findings demonstrate that plant-made VLPs bearing influenza HA trimers are morphologically stable over time and raise the possibility that these VLPs may interact with and activate antigen-presenting cells in a manner similar to the intact virus.

PMID: 29550194 [PubMed - indexed for MEDLINE]

Influenza vaccine effectiveness to prevent influenza-related hospitalizations and serious outcomes in Canadian adults over the 2011/12 through 2013/14 influenza seasons: A pooled analysis from the Canadian Immunization Research Network (CIRN) Serious...

Thu, 09/13/2018 - 01:08
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Influenza vaccine effectiveness to prevent influenza-related hospitalizations and serious outcomes in Canadian adults over the 2011/12 through 2013/14 influenza seasons: A pooled analysis from the Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS Network).

Vaccine. 2018 04 12;36(16):2166-2175

Authors: Nichols MK, Andrew MK, Hatchette TF, Ambrose A, Boivin G, Bowie W, Chit A, Dos Santos G, ElSherif M, Green K, Haguinet F, Halperin SA, Ibarguchi B, Johnstone J, Katz K, Lagacé-Wiens P, Langley JM, LeBlanc J, Loeb M, MacKinnon-Cameron D, McCarthy A, McElhaney JE, McGeer A, Poirier A, Powis J, Richardson D, Schuind A, Semret M, Shinde V, Smith S, Smyth D, Stiver G, Taylor G, Trottier S, Valiquette L, Webster D, Ye L, McNeil SA, Serious Outcomes Surveillance Network of the Canadian Immunization Research Network (CIRN), the Toronto Invasive Bacterial Diseases Network (TIBDN)

Abstract
BACKGROUND: Ongoing assessment of influenza vaccine effectiveness (VE) is critical to inform public health policy. This study aimed to determine the VE of trivalent influenza vaccine (TIV) for preventing influenza-related hospitalizations and other serious outcomes over three consecutive influenza seasons.
METHODS: The Serious Outcomes Surveillance (SOS) Network of the Canadian Immunization Research Network (CIRN) conducted active surveillance for influenza in adults ≥16 years (y) of age during the 2011/2012, 2012/2013 and 2013/2014 seasons in hospitals across Canada. A test-negative design was employed: cases were polymerase chain reaction (PCR)-positive for influenza; controls were PCR-negative for influenza and were matched to cases by date, admission site, and age (≥65 y or <65 y). All cases and controls had demographic and clinical characteristics (including influenza immunization status) obtained from the medical record. VE was estimated as 1-OR (odds ratio) in vaccinated vs. unvaccinated patients × 100%. The primary outcome was VE of TIV for preventing laboratory-confirmed influenza-related hospitalization; secondary outcomes included VE of TIV for preventing influenza-related intensive care unit (ICU) admission/mechanical ventilation, and influenza-related death.
RESULTS: Overall, 3394 cases and 4560 controls were enrolled; 2078 (61.2%) cases and 2939 (64.5%) controls were ≥65 y. Overall matched, adjusted VE was 41.7% (95% Confidence Interval (CI): 34.4-48.3%); corresponding VE in adults ≥65 y was 39.3% (95% CI: 29.4-47.8%) and 48.0% (95% CI: 37.5-56.7%) in adults <65 y, respectively. VE for preventing influenza-related ICU admission/mechanical ventilation in all ages was 54.1% (95% CI: 39.8-65.0%); in adults ≥65 y, VE for preventing influenza-related death was 74.5% (95% CI: 44.0-88.4%).
CONCLUSIONS: While effectiveness of TIV to prevent serious outcomes varies year to year, we demonstrate a statistically significant and clinically important TIV VE for preventing hospitalization and other serious outcomes over three seasons. Public health messaging should highlight the overall benefit of influenza vaccines over time while acknowledging year to year variability. ClinicalTrials.gov Identifier: NCT01517191.

PMID: 29548608 [PubMed - indexed for MEDLINE]

Low levels of detectable pertussis antibody among a large cohort of pregnant women in Canada.

Fri, 09/07/2018 - 00:26
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Low levels of detectable pertussis antibody among a large cohort of pregnant women in Canada.

Vaccine. 2018 Sep 01;:

Authors: Brooks JI, Bell CA, Rotondo J, Gilbert NL, Tunis M, Ward BJ, Desai S

Abstract
Newborns and infants less than 6 months of age continue to be at highest risk of severe outcomes from pertussis infection. Pertussis vaccination during the last trimester of pregnancy can confer protection to newborns as a result of trans-placental transfer of pertussis antibodies. In several countries, pertussis vaccination in pregnancy is recommended routinely and Canada's National Advisory Committee on Immunization issued similar routine recommendations in February 2018. Using second trimester biobanked plasma samples (n = 1752) collected between 2008 and 2011, we measured the pre-existing anti-pertussis toxin (PT) levels in a large cohort of second-trimester pregnant women using a commercial ELISA test. We found that 97.5% of these women had anti-PT IgG titres below 35 IU/mL. Women with higher incomes had slightly higher anti-PT levels but 96% still had titres <35 IU/ml. In conclusion, almost all of the pregnant women in this large cohort had anti-PT levels low enough to suggest susceptibility to pertussis infection in both the mothers and their newborn infants.

PMID: 30181046 [PubMed - as supplied by publisher]

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