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   2015| October-December  | Volume 7 | Issue 4  
    Online since November 25, 2015

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The Ebola outbreak of 2014-2015: From coordinated multilateral action to effective disease containment, vaccine development, and beyond
Thomas R Wojda, Pamela L Valenza, Kristine Cornejo, Thomas McGinley, Sagar C Galwankar, Dhanashree Kelkar, Richard P Sharpe, Thomas J Papadimos, Stanislaw P Stawicki
October-December 2015, 7(4):127-138
DOI:10.4103/0974-777X.170495  PMID:26752867
The Ebola outbreak of 2014-2015 exacted a terrible toll on major countries of West Africa. Latest estimates from the World Health Organization indicate that over 11,000 lives were lost to the deadly virus since the first documented case was officially recorded. However, significant progress in the fight against Ebola was made thanks to a combination of globally-supported containment efforts, dissemination of key information to the public, the use of modern information technology resources to better track the spread of the outbreak, as well as more effective use of active surveillance, targeted travel restrictions, and quarantine procedures. This article will outline the progress made by the global public health community toward containing and eventually extinguishing this latest outbreak of Ebola. Economic consequences of the outbreak will be discussed. The authors will emphasize policies and procedures thought to be effective in containing the outbreak. In addition, we will outline selected episodes that threatened inter-continental spread of the disease. The emerging topic of post-Ebola syndrome will also be presented. Finally, we will touch on some of the diagnostic (e.g., point-of-care [POC] testing) and therapeutic (e.g., new vaccines and pharmaceuticals) developments in the fight against Ebola, and how these developments may help the global public health community fight future epidemics.
  6,433 131 6
Tuberculous drug-induced liver injury and treatment re-challenge in Human Immunodeficiency Virus co-infection
Cecilia T Costiniuk, Bernadett I Gosnell, Thandekile C Manzini, Camille N Du Plessis, Mahomed Yunus S Moosa
October-December 2015, 7(4):151-156
DOI:10.4103/0974-777X.170499  PMID:26752869
Background: Tuberculosis drug-induced liver injury (TB-DILI) is the most common adverse event necessitating therapy interruption. The optimal re-challenge strategy for antituberculous therapy (ATT) remains unclear, especially in human immunodeficiency virus (HIV) co-infected individuals in high-prevalence settings such as South Africa. Objective: To determine the incidence of and risk factors for the recurrence of TB-DILI with different ATT re-challenge strategies. Materials and Methods: We conducted a retrospective chart review of patients managed for TB-DILI from 2005 to 2013 at King Edward VIII Hospital in Durban, South Africa. Relevant clinical and laboratory data at the presentation of TB-DILI, time to recovery of liver function, method of ATT re-challenge and outcome of re-challenge were documented. Results: 1016 charts were reviewed, and 53 individuals with TB-DILI (48 HIV-co-infected) were identified. Following discontinuation of ATT, the median time to alanine aminotransferase normalization was 28 days (interquartile range 13-43). Forty-two subjects were re-challenged (30 regimen re-challenges and 12 step-wise re-challenges). 5 (12%) cases of recurrent TB-DILI were noted. Recurrences were not associated with the method of re-challenge. Conclusion: Based on the data available, it appears that full ATT can be safely restarted in the majority of subjects with a recurrence of DILI occurring in about 12% of subjects. The method of re-challenge did not appear to impact on the risk of recurrence. Ideally, a prospective randomized trial is needed to determine the best method of re-challenge.
  4,825 73 1
Retrospective clinical study of eighty-one cases of intracranial mucormycosis
Jinjian Ma, Ruichao Jia, Jin Li, Yunyang Liu, Yuming Li, Peng Lin, Mingmu Zhang, Mu Li
October-December 2015, 7(4):143-150
DOI:10.4103/0974-777X.170497  PMID:26752868
Background: Fungal infections of the central nervous system, especially cerebral mucormycosis or brain abscess are very rare.Cerebral mucormycosis is a rare disease. It is not an independent disease, but a secondary opportunistic infectious disease. Materials and methods: This study has collected the data of 81 cases of intracranial mucormycosis from 28 Chinese hospitals, within 37 years, as well as reviewed the literatures and retrospectively analyzed and summarized this disease's background, clinical classifications, risk factors, pathology, clinical manifestations, diagnosis, treatment, and prognosis. Results: The 81 IM cases were aged between 15 days (the youngest) and 79 years (oldest), with a mean age of 41.6 years. Among them, 12 cases were <1 year old (the infant group), six cases were within one to 13 years old (the children group), and 63 cases were >14 years old (the adult group ). 45 cases were male and 36 were female, with a male/female ratio of 1.25:1.0. The shortest duration of the disease was three days, and the longest was 248 days. Conclusions: This study helped to realize an early diagnosis and treatment, improve the cure rate, and reduce mortality.
  4,270 80 8
Polymorphisms of transporter associated with antigen presentation, tumor necrosis factor-α and interleukin-10 and their implications for protection and susceptibility to severe forms of dengue fever in patients in Sri Lanka
Anira N Fernando, Gathsaurie Neelika Malavige, Kuda Liyanage Nandika Perera, Sunil Premawansa, Graham S Ogg, Aruna Dharshan De Silva
October-December 2015, 7(4):157-164
DOI:10.4103/0974-777X.170501  PMID:26752870
Context: To date, a clear understanding of dengue disease pathogenesis remains elusive. Some infected individuals display no symptoms while others develop severe life-threatening forms of the disease. It is widely believed that host genetic factors influence dengue severity. Aims: This study evaluates the relationship between certain polymorphisms and dengue severity in Sri Lankan patients. Settings and Design: Polymorphism studies are carried out on genes for; transporter associated with antigen presentation (TAP), promoter of tumor necrosis factor-α (TNF-α), and promoter of interleukin-10 (IL-10). In other populations, TAP1 (333), TAP2 (379), TNF-α (−308), and IL-10 (−1082, −819, −592) have been associated with dengue and a number of different diseases. Data have not been collected previously for these polymorphisms for dengue patients in Sri Lanka. Materials and Methods: The polymorphisms were typed by amplification refractory mutation system polymerase chain reaction in 107 dengue hemorrhagic fever (DHF) patients together with 62 healthy controls. Statistical Analysis Used: Pearson's Chi-square contingency table analysis with Yates' correction. Results: Neither the TAP nor the IL-10 polymorphisms considered individually can define dengue disease outcome with regard to severity. However, the genotype combination, IL-10 (−592/−819/−1082) CCA/ATA was significantly associated with development of severe dengue in these patients, suggesting a risk factor to developing DHF. Also, identified is the genotype combination IL-10 (−592/−819/−1082) ATA/ATG which suggested a possibility for protection from DHF. The TNF-α (−308) GG genotype was also significantly associated with severe dengue, suggesting a significant risk factor. Conclusions: The results reported here are specific to the Sri Lankan population. Comparisons with previous reports imply that data may vary from population to population.
  3,624 73 2
Identification of invasive Salmonella enterica serovar Typhimurium ST313 in ambulatory HIV-infected adults in Mozambique
Troy D Moon, Monika Johnson, Monique A Foster, Wilson P Silva, Manuel Buene, Emilio Valverde, Luνs Morais, John V Williams, Sten H Vermund, Paula E Brentlinger
October-December 2015, 7(4):139-142
DOI:10.4103/0974-777X.170496  PMID:26751031
Introduction: Despite evidence describing the burden of invasive non-typhoidal salmonella (iNTS) disease in sub-Saharan Africa, iNTS is not recognized as a priority within global health policy institutions. Recently, Salmonella enterica serovar Typhimurium, sequence type (ST) 313, has been identified as the predominant cause of iNTS disease in multiple sub-Saharan African countries. Materials and Methods: We conducted multilocus sequence typing (MLST) to determine the prevalence of the ST313 genotype in a sample of blood isolates from ambulatory HIV-infected Mozambican adults with iNTS disease. Results: Of the 29 samples of NTS obtained and analyzed by MLST, all (29/29) were assigned the ST313 sequence type based on the set of allele types derived from each of the seven loci. For quality control, five randomly selected strains taken from the original cultures were confirmed as ST313, and the positive control strain SL3261 (taken from the original culture) was categorized as S. Typhimurium ST19. Conclusion: S. Typhimurium ST313 is an important example of a widely distributed pathogen that lacks a coordinated strategy for control. The highly vulnerable populations at risk for ST313 infection in Mozambique, and within the region, would benefit greatly from the development of new policy and on-the-ground capacity to support increased surveillance, prevention, and treatment initiatives.
  3,628 59 2
Risk factors of delay proportional probability in diphtheria-tetanus-pertussis vaccination of Iranian children; Life table approach analysis
Mohsen Mokhtari, Masoomeh Rezaeimanesh, Abolfazl Mohammadbeigi, Seyed Mohsen Zahraei, Narges Mohammadsalehi, Hossein Ansari
October-December 2015, 7(4):165-169
DOI:10.4103/0974-777X.170503  PMID:26752871
Despite success in expanded program immunization for an increase in vaccination coverage in the children of world, timeliness and schedule of vaccination remains as one of the challenges in public health. This study purposed to demonstrate the related factors of delayed diphtheria-tetanus-pertussis (DTP) vaccination using life table approach. A historical cohort study conducted in the poor areas of five large Iran cities. Totally, 3610 children with 24-47 months old age who had documented vaccination card were enrolled. Time of vaccination for the third dose of DTP vaccine was calculated. Life table survival was used to calculate the proportional probability of vaccination in each time. Wilcoxon test was used for the comparison proportional probability of delayed vaccination based on studies factors. The overall median delayed time for DTP3 was 38.52 days. The Wilcoxon test showed that city, nationality, education level of parents, birth order and being in rural areas are related to the high probability of delay time for DTP3 vaccination (P < 0. 001). Moreover, child gender and parent's job were not significant factors (P > 0.05). Being away from the capital, a high concentration of immigrants in the city borders with a low socioeconomic class leads to prolonged delay in DTP vaccination time. Special attention to these areas is needed to increase the levels of parental knowledge and to facilitate access to the health services care.
  3,073 51 2
Enteric fistulous communication with an aortobifemoral graft permitting for Eggerthella lenta colonization
Waqas Jehangir, Federico Sanabria, Zorawar Singh, Souad Enakuaa, Kebir Hammed Bedran, Nazar Raoof, Abdalla Yousif
October-December 2015, 7(4):170-172
DOI:10.4103/0974-777X.170506  PMID:26752872
The presence of an aortoenteric fistula following aortobifemoral graft repair of an abdominal aortic aneurysm is associated with a high probability of infection leading to clinically significant bacteremia. We report a case of an aortoenteric fistula that developed two years after initial aortic grafting resulting in colonization with the anaerobe, Eggerthella lenta. This dangerous bacterium is difficult to culture, associated with high mortality and the patient may have mild symptoms on presentation.
  2,766 29 3
State of the globe: The rippling effect of multidrug-resistant gram-negative infections
Aliyah Baluch
October-December 2015, 7(4):125-126
DOI:10.4103/0974-777X.170494  PMID:26752866
  2,733 61 -
Infection control care bundles prevents emergence of multidrug resistant nosocomial pathogens in newborn care units: A perspective
Kalaivani Ramakrishnan, Soma Venkatesh, Gunasekaran Dhandapany, Soundararajan Palanisamy
October-December 2015, 7(4):173-174
DOI:10.4103/0974-777X.170507  PMID:26752873
  2,412 31 -
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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008