ORCID Profile
0000-0002-8181-6321
Current Organisation
James Cook University
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Public Library of Science (PLoS)
Date: 22-01-2021
DOI: 10.1371/JOURNAL.PONE.0245328
Abstract: One principle of tuberculosis control is to prevent the development of tuberculosis disease by treating in iduals with latent tuberculosis infection. The diagnosis of latent infection using the tuberculin skin test is not straightforward because of concerns about immunologic cross reactivity with the Bacille Calmette-Guerin (BCG) vaccine and environmental mycobacteria. To parse the effects of BCG vaccine and environmental mycobacteria on the tuberculin skin test, we estimated the frequency distribution of skin test results in two isions of K ala, Uganda, ten years apart. We then used mixture models to estimate parameters for underlying distributions and defined clinically meaningful criteria for latent infection, including an indeterminate category. Using percentiles of two underlying normal distributions, we defined two skin test readings to demarcate three ranges. Values of 10 mm or greater contained 90% of in iduals with latent infection values less than 7.2 mm contained 80% of in iduals without infection. Contacts with values between 7.2 and 10 mm fell into an indeterminate zone where it was not possible to assign infection. We conclude that systematic tuberculin skin test surveys within populations at risk, combined with mixture model analysis, may be a reproducible, evidence-based approach to define meaningful criteria for latent tuberculosis infection.
Publisher: Public Library of Science (PLoS)
Date: 04-05-2020
Publisher: SAGE Publications
Date: 2023
Publisher: American Society of Tropical Medicine and Hygiene
Date: 06-04-2022
Abstract: There is little information about the amount of recent tuberculosis transmission in low-income settings. Genetic clustering can help identify ongoing transmission events. A retrospective observational study was performed on Mycobacterium tuberculosis isolates from persons living with HIV (PLHIV) and HIV-seronegative participants who submitted s les to a referral tuberculosis laboratory in Guatemala City, Guatemala from 2010 to 2014. Genotyping results were classified according to the international spoligotyping database, SITVIT2. Spoligotype patterns were categorized as clustered or nonclustered depending on their genotype. The proportion of clustering and the index of recent transmission index (RTI n-1 ) were estimated. In the RTI n-1 method, clustered cases represent recent transmission, whereas nonclustered cases represent reactivation of older tuberculosis infections. As a secondary aim, the potential risk factors associated with clustering in isolates from the subset of participants living with HIV were explored. From 2010 to 2014, a total of 479 study participants were confirmed as culture-positive tuberculosis cases. Among the 400 available isolates, 71 spoligotype patterns were identified. Overall, the most frequent spoligotyping families were Latin American-Mediterranean (LAM) (39%), followed by T (22%) and Haarlem (14%). Out of the 400 isolates, 365 were grouped in 36 clusters (range of cluster size: 2–92). Thus, the proportion of clustering was 91% and the RTI n-1 was 82%. Among PLHIV, pulmonary tuberculosis was associated with clustering (OR = 4.3, 95% CI 1.0–17.7). Our findings suggest high levels of ongoing transmission of M. tuberculosis in Guatemala as revealed by the high proportion of isolates falling into genomic clusters.
Publisher: Research Square Platform LLC
Date: 03-08-2020
DOI: 10.21203/RS.3.RS-51415/V1
Abstract: Background. Insecticide-treated bednets (ITNs) are widely used for the prevention and control of malaria. In Guatemala, since 2006, ITNs have been distributed free of charge in the highest risk malaria-endemic areas and constitute one of the primary vector control measures in the country. Despite relying on ITNs for almost 15 years, there is a lack of data to inform the timely replacement of ITNs whose effectiveness becomes diminished by routine use. Methods. We assessed the survivorship, physical integrity, insecticide content and bio-efficacy of ITNs through cross-sectional surveys conducted at 18, 24 and 32 months after a 2012 distribution of PermaNet® 2.0 in a malaria focus in Guatemala. A total of 988 ITNs were analyzed (290 at 18 months, 349 at 24 months and 349 at 32 months). Results. The functional survivorship of bednets decreased over time, from 92% at 18 months, to 81% at 24 months and 69% at 32 months. Independent of the time of the survey, less than 80% of the bednets that were still present in the household were reported to have been used the night before. Most of the bednets had been washed at least once (88% at 18 months, 92% at 24 months and 96% at 32 months). The proportion of bednets categorized as “in good condition” per WHO guidelines of the total hole surface area, diminished from 77% at 18 months to 58% at 32 months. The portion of ITNs with deltamethrin concentration less than 10mg/m 2 increased over time (14% at 18 months, 23% at 24 months, and 35% at 32 months). Among the bednets for which bioassays were conducted, the percentage that met WHO criteria for efficacy dropped from 90% at 18 months to 52% at 32 months. Conclusion. While our assessment demonstrated that nets were in relatively good physical condition over time, the combination of declining bio-efficacy over time and low use rates limited the overall effectiveness of the LLINs. Efforts to encourage the community to retain, use, and properly care for the LLINs may improve their impact. Durability assessments should be included in future c aigns.
Publisher: Public Library of Science (PLoS)
Date: 06-10-2201
Publisher: Oxford University Press (OUP)
Date: 20-10-2017
DOI: 10.1093/CID/CIX632
Publisher: Oxford University Press (OUP)
Date: 08-08-2021
DOI: 10.1093/CID/CIAA1146
Abstract: There are large knowledge gaps on the transmission dynamics of Mycobacterium tuberculosis in settings where both tuberculosis and human immunodeficiency virus (HIV) are endemic. We aimed to assess the infectiousness of tuberculosis patients coinfected with HIV. We systematically searched for studies of contacts of both HIV-positive and HIV-negative tuberculosis index cases. Our primary outcome was Mycobacterium tuberculosis infection in contacts. Data on sputum smear and lung cavitation status of index cases were extracted from each study to assess effect modification. Secondary outcomes included prevalent tuberculosis and HIV in contacts of HIV-positive and HIV-negative index cases. Of 5255 original citations identified, 32 studies met inclusion criteria, including 25 studies investigating M. tuberculosis infection (Nparticipants = 36 893), 13 on tuberculosis (Nparticipants = 18 853), and 12 on HIV positivity (Nparticipants = 18 424). Risk of M. tuberculosis infection was lower in contacts of HIV-positive index cases (odds ratio [OR], 0.67, 95% confidence interval [CI], .58–.77) but was heterogeneous (I2 = 75.1%). Two factors modified this relationship: the lung cavitary status of the index case and immunosuppression (measured through CD4 counts or HIV or acquired immunodeficiency syndrome diagnoses) among index people living with HIV. Rates of HIV were consistently higher in contacts of coinfected index cases (OR, 4.9 95% CI, 3.0–8.0). This was modified by whether the study was in sub-Saharan Africa (OR, 2.8 95% CI, 1.6–4.9) or in another global region (OR, 9.8 95% CI, 5.9–16.3). Tuberculosis patients coinfected with HIV are less infectious than HIV-uninfected cases when they have severe immunosuppression or paucibacillary disease. Contacts of coinfected index cases are almost 5 times more likely to also have HIV.
Publisher: Elsevier BV
Date: 07-2023
Publisher: International Union Against Tuberculosis and Lung Disease
Date: 09-2018
Publisher: Springer Science and Business Media LLC
Date: 15-02-2015
Publisher: Public Library of Science (PLoS)
Date: 02-02-2023
DOI: 10.1371/JOURNAL.PONE.0280732
Abstract: Patient satisfaction is an important predictor of health outcomes among patients in HIV/AIDS treatment and care, yet it is rarely measured in routine clinic settings in most of Africa. The aims of our study were to evaluate the internal validity and reliability of the Consumer Assessment of Healthcare Providers and Systems instrument for measuring satisfaction, assess the general level of patient satisfaction, and identify the factors associated with the level of satisfaction among patients receiving antiretroviral therapy in Uganda. We conducted a cross-sectional study of 475 HIV/AIDS-infected patients from July to August 2015 in K ala, Uganda. Eligible participants were 18 years or older, consented to the study and receiving antiretroviral therapy and outpatient care at the selected public health clinic. This study used a modified version of the validated Consumer Assessment of Healthcare Providers and Systems (CAHPS) instrument to assess the level of satisfaction among HIV/AIDS patients receiving outpatient care. We collected data on socio-demographics, clinical variables and 18-items adapted from the CAHPS instrument rating satisfaction with aspects of health services. We conducted an exploratory factor analysis to assess the internal validity of the 18 items and multiple linear regression analysis of factors associated with patient satisfaction with care. Majority of the respondents were females (76.8%), and the mean age was 37 years (SD = 10). The modified CAHPS instrument had high internal consistency (Cronbach’s α = 0.94) for measuring satisfaction with HIV/AIDS care. Female sex (p = 0.016), perceived providers’ technical and interpersonal skills (p = 0.022), emotional health (p = 0.032), and quality of reception services (p .001) were significantly associated with satisfaction in this urban HIV/AIDS public clinic. The reliability of the CAHPS instrument was high for measuring satisfaction. Providers’ technical and interpersonal skills, and the quality of reception services are key to achieving patient satisfaction. Health system interventions to address the gaps identified will enhance the quality of patient-centered HIV/AIDS care in the Ugandan setting.
Publisher: Public Library of Science (PLoS)
Date: 12-06-2101
Publisher: American Thoracic Society
Date: 15-02-2017
Publisher: Cold Spring Harbor Laboratory
Date: 26-03-2020
DOI: 10.1101/2020.03.23.20033878
Abstract: There is little information about the proportion of clustering of tuberculosis cases from low-income settings, which can represent ongoing transmission events. We investigated for the first time the proportion of clustered tuberculosis cases based on genotypic matching in Guatemala City, Guatemala between 2010 and 2014 and potential risk factors associated with these clustered cases in HIV-infected subjects. Moreover, the genetic ersity of M. tuberculosis isolates in this country is presented. This study was a retrospective observational study conducted on Mycobacterium tuberculosis isolates from HIV-infected and non-HIV infected tuberculosis cases that submitted s les to a referral tuberculosis laboratory in Guatemala City, Guatemala from 2010-2014. Genotyping results were compared with the international spoligotyping database, SITVIT2 and classified accordingly. We generated a spoligoforest using the MERCAT program. We categorized spoligotype patterns as clustered or non-clustered depending of their genotype and estimated the proportion of clustering and the recent transmission index (RTI n-1 ). We analyzed the crude association between demographic, clinical and behavioral variables and clustering in the HIV-population. From 2010 to 2014, a total of 479 patients were confirmed as tuberculosis cases by culture at the study site. Spoligotype patterns were available from 391 patients (82%), nine of them with two isolates included in the study. We detected 71 spoligotype patterns and overall, the most frequent spoligotyping families were LAM (39%), followed by T (22%), Haarlem (14%), X (13%), Unknown (6%) and Beijing (3%), representing 97% of the isolates. Out of the 400 isolates, 365 (91%) were grouped in 36 clusters (range: 2-92). The recent transmission index (RTI n-1 ) was 82%. Pulmonary tuberculosis was strongly associated with clustering in the 113 HIV-infected group with available data (OR=4.3, 95% CI 1.0-17.7). There might be high levels of ongoing transmission of M. tuberculosis in Guatemala City, Guatemala as indicated by clustering in a convenience s le. Among HIV-infected patients, clustering was more likely in pulmonary disease.
Publisher: Elsevier BV
Date: 2021
DOI: 10.2139/SSRN.3781645
Publisher: Public Library of Science (PLoS)
Date: 23-05-2019
Publisher: Springer Science and Business Media LLC
Date: 25-08-2013
DOI: 10.1038/NG.2742
Publisher: MDPI AG
Date: 13-06-2022
DOI: 10.3390/V14061283
Abstract: Several neglected infectious pathogens, such as the monkeypox virus (MPXV), have re-emerged in the last few decades, becoming a global health burden. Despite the incipient vaccine against MPXV infection, the global incidence of travel-related outbreaks continues to rise. About 472 confirmed cases have been reported in 27 countries as of 31 May 2022, the largest recorded number of cases outside Africa since the disease was discovered in the early 1970s.
Publisher: Springer Science and Business Media LLC
Date: 18-09-2013
Abstract: Anopheles albimanus is a key malaria vector in the northern neotropics. Current vector control measures in the region are based on mass distributions of long-lasting insecticidal nets (LLINs) and focal indoor residual spraying (IRS) with pyrethroids. Resistance to pyrethroid insecticides can be mediated by increased esterase and/or multi-function oxidase activity and/or mutations in the voltage-gated sodium channel gene. The aim of this work was to characterize the homologous kdr region of the voltage-gated sodium channel gene in An. albimanus and to conduct a preliminary retrospective analysis of field s les collected in the 1990’s, coinciding with a time of intense pyrethroid application related to agricultural and public health insect control in the region. Degenerate primers were designed to lify the homologous kdr region in a pyrethroid-susceptible laboratory strain (Sanarate) of An. albimanus . Subsequently, a more specific primer pair was used to lify and sequence the region that contains the 1014 codon associated with pyrethroid resistance in other Anopheles spp. (L1014F, L1014S or L1014C). Direct sequencing of the PCR products confirmed the presence of the susceptible kdr allele in the Sanarate strain (L1014) and the presence of homozygous-resistant kdr alleles in field-collected in iduals from Mexico (L1014F), Nicaragua (L1014C) and Costa Rica (L1014C). For the first time, the kdr region in An. albimanus is described. Furthermore, molecular evidence suggests the presence of kdr -type resistance in field-collected An. albimanus in Mesoamerica in the 1990s. Further research is needed to conclusively determine an association between the genotypes and resistant phenotypes, and to what extent they may compromise current vector control efforts.
Publisher: Springer Science and Business Media LLC
Date: 12-2012
Abstract: This is a report of the first Plasmodium vivax congenital malaria case in Guatemala and the first case in Latin America with genotypical, histological and clinical characterization. The findings show that maternal P . vivax infection still occurs in areas that are in the pathway towards malaria elimination, and can be associated with detrimental health effects for the neonate. It also highlights the need in very low transmission areas of not only maintaining, but increasing awareness of the problem and developing surveillance strategies, based on population risk, to detect the infection especially in this vulnerable group of the population.
Publisher: Cold Spring Harbor Laboratory
Date: 02-08-2020
DOI: 10.1101/2020.07.30.20165316
Abstract: Insecticide-treated bednets (ITNs) are widely used for the prevention and control of malaria. In Guatemala, since 2006, ITNs have been distributed free of charge in the highest risk malaria-endemic areas and constitute one of the primary vector control measures in the country. Despite relying on ITNs for almost 15 years, there is a lack of data to inform the timely replacement of ITNs whose effectiveness becomes diminished by routine use. We assessed the survivorship, physical integrity, insecticide content and bio-efficacy of ITNs through cross-sectional surveys conducted at 18, 24 and 32 months after a 2012 distribution of PermaNet® 2.0 in a malaria focus in Guatemala. A total of 988 ITNs were analyzed (290 at 18 months, 349 at 24 months and 349 at 32 months). The functional survivorship of bednets decreased over time, from 92% at 18 months, to 81% at 24 months and 69% at 32 months. Independent of the time of the survey, less than 80% of the bednets that were still present in the household were reported to have been used the night before. Most of the bednets had been washed at least once (88% at 18 months, 92% at 24 months and 96% at 32 months). The proportion of bednets categorized as “in good condition” per WHO guidelines of the total hole surface area, diminished from 77% at 18 months to 58% at 32 months. The portion of ITNs with deltamethrin concentration less than 10mg/m 2 increased over time (14% at 18 months, 23% at 24 months, and 35% at 32 months). Among the bednets for which bioassays were conducted, the percentage that met WHO criteria for efficacy dropped from 90% at 18 months to 52% at 32 months. While our assessment demonstrated that nets were in relatively good physical condition over time, the combination of declining bio-efficacy over time and low use rates limited the overall effectiveness of the LLINs. Efforts to encourage the community to retain, use, and properly care for the LLINs may improve their impact. Durability assessments should be included in future c aigns.
Publisher: Springer Science and Business Media LLC
Date: 14-05-2021
DOI: 10.1186/S12936-021-03722-1
Abstract: Insecticide-treated bed nets (ITNs) are widely used for the prevention and control of malaria. In Guatemala, since 2006, ITNs have been distributed free of charge in the highest risk malaria-endemic areas and constitute one of the primary vector control measures in the country. Despite relying on ITNs for almost 15 years, there is a lack of data to inform the timely replacement of ITNs whose effectiveness becomes diminished by routine use. The survivorship, physical integrity, insecticide content and bio-efficacy of ITNs were assessed through cross-sectional surveys conducted at 18, 24 and 32 months after a 2012 distribution of PermaNet® 2.0 in a malaria focus in Guatemala. A working definition of ‘LLIN providing adequate protection’ was developed based on the combination of the previous parameters and usage of the net. A total of 988 ITNs were analysed (290 at 18 months, 349 at 24 months and 349 at 32 months). The functional survivorship of bed nets decreased over time, from 92% at 18 months, to 81% at 24 months and 69% at 32 months. Independent of the time of the survey, less than 80% of the bed nets that were still present in the household were reported to have been used the night before. The proportion of bed nets categorized as “in good condition” per World Health Organization (WHO) guidelines of the total hole surface area, diminished from 77% to 18 months to 58% at 32 months. The portion of ITNs with deltamethrin concentration less than 10 mg/m 2 increased over time. Among the bed nets for which bioassays were conducted, the percentage that met WHO criteria for efficacy dropped from 90% to 18 months to 52% at 32 months. The proportion of long-lasting insecticidal nets (LLINs) providing adequate protection was 38% at 24 months and 21% at 32 months. At 32 months, only one in five of the LLINs distributed in the c aign provided adequate protection in terms of survivorship, physical integrity, bio-efficacy and usage. Efforts to encourage the community to retain, use, and properly care for the LLINs may improve their impact. Durability assessments should be included in future c aigns.
Publisher: Oxford University Press (OUP)
Date: 16-10-2020
DOI: 10.1093/CID/CIAA1556
Abstract: Although households of tuberculosis (TB) cases represent a setting for intense transmission of Mycobacterium tuberculosis, household exposure accounts for & % of transmission within a community. The aim of this study was to estimate excess risk of M. tuberculosis infection among household and extra-household contacts of index cases. We performed a cross-sectional study in K ala, Uganda, to delineate social networks of TB cases and matched controls without TB. We estimated the age-stratified prevalence difference of TB infection between case and control networks, partitioned as household and extra-household contacts. We enrolled 123 index cases, 124 index controls, and 2415 first-degree network contacts. The prevalence of infection was highest among household contacts of cases (61.5%), lowest among household contacts of controls (25.2%), and intermediary among extra-household TB contacts (44.9%) and extra-household control contacts (41.2%). The age-adjusted prevalence difference between extra-household contacts of cases and their controls was 5.4%. The prevalence of infection was similar among the majority of extra-household case contacts and corresponding controls (47%). Most first-degree social network members of TB cases do not have adequate contact with the index case to experience additional risk for infection, but appear instead to acquire infection through unrecognized exposures with infectious cases in the community.
Publisher: Springer Science and Business Media LLC
Date: 22-06-2018
DOI: 10.1007/S40615-017-0394-5
Abstract: Safety climate involves worker perception about the relative importance where they work and safety climate and has been shown to be a reliable predictor of safety-related outcomes. The primary objective of this study is to investigate ethnic differences in perceived safety climate among construction workers. Surveys (n = 179) that included a 10-item safety climate scale were administered in Athens, Georgia (GA), at local construction sites and home improvement stores during June-August, 2015. The majority of respondents were carpenters or roofers (39%), followed by laborers (22%), painters and dry wall workers (14%), other skilled trades (14%), and supervisors (11%) 32% were Hispanic. Hispanic ethnicity (p < 0.0001), drinking two or more alcoholic beverages per day (p < 0.0001), working for a company that does not provide health insurance (p = 0.0022), and working for a company with fewer than ten employees (p < 0.0001) were significantly associated with lower perceived safety climate scores. The lower perceived safety climate scores among Hispanic workers indicate that the perception of the importance of safety on the job site is lower among Hispanics construction workers than non-Hispanics construction workers.
Publisher: Research Square Platform LLC
Date: 28-03-2020
DOI: 10.21203/RS.3.RS-19461/V1
Abstract: Background. The risk of infection from respiratory pathogens increases according to the contact rate between the infectious case and susceptible contact, but the definition of adequate contact for transmission is not standard. In this study we aimed to identify factors that can explain the level of contact between tuberculosis cases and their social networks in an African urban environment. Methods. This was a cross-sectional study conducted in K ala, Uganda from 2012-2016. We carried out an exploratory factor analysis (EFA) in social network data from tuberculosis cases and their contacts. We evaluated the factorability of the data to EFA using the Kaiser-Meyer-Olkin Measure of S ling Adequacy (KMO). We used principal axis factoring with oblique rotation to extract and rotate the factors, then we calculated factor scores for each using the weighted sum scores method. We assessed construct validity of the factors by associating the factors with other variables related to social mixing. Results. Tuberculosis cases (N = 120) listed their encounters with 1,154 members of their social networks. Thirteen variables displayed high inter-correlation (KMO=0.72) and were included for EFA. Two factors were identified, which captured 82% of the variance. The first factor, named ‘Setting’, involves the type, frequency, duration and ventilation of the usual place of meeting as well the physical proximity among tuberculosis cases and contacts, represented by the sleeping and eating patterns. The second factor, named ‘Relationship’, was explained by the relationship, its duration, and the level of intimacy among cases and contacts, represented by the strength of knowledge of each other, provision of healthcare, and whether they were travel partners. Setting and Relationship scores varied according to the age, gender and nature of the relationship among tuberculosis cases and their contacts. Conclusions. In this large cross-sectional study from an urban African setting, we identified two factors that can assess adequate contact between tuberculosis cases and their social network members. These findings also confirm the complexity and heterogeneity of social mixing.
Publisher: Springer Science and Business Media LLC
Date: 09-06-2020
DOI: 10.1186/S12889-020-08998-7
Abstract: The risk of infection from respiratory pathogens increases according to the contact rate between the infectious case and susceptible contact, but the definition of adequate contact for transmission is not standard. In this study we aimed to identify factors that can explain the level of contact between tuberculosis cases and their social networks in an African urban environment. This was a cross-sectional study conducted in K ala, Uganda from 2013 to 2017. We carried out an exploratory factor analysis (EFA) in social network data from tuberculosis cases and their contacts. We evaluated the factorability of the data to EFA using the Kaiser-Meyer-Olkin Measure of S ling Adequacy (KMO). We used principal axis factoring with oblique rotation to extract and rotate the factors, then we calculated factor scores for each using the weighted sum scores method. We assessed construct validity of the factors by associating the factors with other variables related to social mixing. Tuberculosis cases (N = 120) listed their encounters with 1154 members of their social networks. Two factors were identified, the first named “Setting” captured 61% of the variance whereas the second, named ‘Relationship’ captured 21%. Median scores for the setting and relationship factors were 10.2 (IQR 7.0, 13.6) and 7.7 (IQR 6.4, 10.1) respectively. Setting and Relationship scores varied according to the age, gender, and nature of the relationship among tuberculosis cases and their contacts. Family members had a higher median setting score (13.8, IQR 11.6, 15.7) than non-family members (7.2, IQR 6.2, 9.4). The median relationship score in family members (9.9, IQR 7.6, 11.5) was also higher than in non-family members (6.9, IQR 5.6, 8.1). For both factors, household contacts had higher scores than extra-household contacts ( p .0001). Contacts of male cases had a lower setting score as opposed to contacts of female cases. In contrast, contacts of male and female cases had similar relationship scores. In this large cross-sectional study from an urban African setting, we identified two factors that can assess adequate contact between tuberculosis cases and their social network members. These findings also confirm the complexity and heterogeneity of social mixing.
Publisher: Public Library of Science (PLoS)
Date: 24-03-2016
Publisher: Research Square Platform LLC
Date: 04-02-2021
DOI: 10.21203/RS.3.RS-152862/V1
Abstract: Background. Exposure to an in idual with tuberculosis is necessary for transmission to occur. Previously, we developed a score that measures contact between tuberculosis cases and their social networks in an African urban context. This score was built using exploratory factor analysis and identified contact as the conjunction of two domains – setting and relationship. Now, our aim is to determine whether this score covaries with the presence of tuberculous infection among social contacts of tuberculosis cases.Methods. This was a large cross-sectional study conducted in K ala, Uganda from 2012-2016. Tuberculous infection was assessed in social contacts of adult tuberculosis cases. We estimated the prevalence of tuberculous infection in this population, overall and according to the setting and relationship domains. We calculated the prevalence ratio (PR) for the association between increasing scores in the setting and relationship domains and tuberculous infection, adjusted by other covariates, using modified Poisson regression models. Results. We enrolled 955 household and community contacts from 119 tuberculosis cases. The overall prevalence of tuberculous infection in the social networks was 52% (95% confidence interval [CI], 48-55). The prevalence of tuberculous infection in very low, low, medium, and high setting-contact quartiles was 44%, 40%, 53%, and 70% respectively (P trend .0001). By the relationship score, the prevalence of tuberculous infection in very low, low, moderate and high-contact groups was 41%, 47%, 53% and 66% respectively (P trend .0001). The effect of the setting score in the prevalence of tuberculous infection was higher among children between 5-14 years (PR=1.26 95% CI 1.15-1.39) whereas the relationship score was associated with tuberculous infection in children of 0-4 years (PR=1.42 95% CI 1.10-1.82)Conclusion. In this large observational study from an urban African setting, participants, especially children, with higher setting and relationship scores were more likely infected with Mycobacterium tuberculosis among contacts of a tuberculosis case.
Publisher: Frontiers Media SA
Date: 17-02-2017
Publisher: International Union Against Tuberculosis and Lung Disease
Date: 06-2019
Publisher: American Thoracic Society
Date: 11-2016
Publisher: Elsevier BV
Date: 2020
DOI: 10.1016/J.CYTO.2019.154818
Abstract: The immune status of women changes during and after pregnancy, differs between blood compartments at delivery and is affected by environmental factors particularly in tropical areas endemic for multiple infections. We quantified the plasma concentration of a set of thirty-one T
No related grants have been discovered for Maria Eugenia Castellanos.