المؤلفون: Bwire, Godfrey, Sartorius, Benn, Guerin, Philippe, Tegegne, Merawi Aragaw, Okware, Sam I., Talisuna, Ambrose O.

المصدر: BMC Medicine ; volume 21, issue 1 ; ISSN 1741-7015

مصطلحات موضوعية: General Medicine

الإتاحة: https://doi.org/10.1186/s12916-023-02847-1Test

المؤلفون: Mansoor, Rashid, Commons, Robert J., Douglas, Nicholas M., Abuaku, Benjamin, Achan, Jane, Adam, Ishag, Adjei, George O., Adjuik, Martin, Alemayehu, Bereket H., Allan, Richard, Allen, Elizabeth N., Anvikar, Anupkumar R., Arinaitwe, Emmanuel, Ashley, Elizabeth A., Ashurst, Hazel, Asih, Puji B. S., Bakyaita, Nathan, Barennes, Hubert, Barnes, Karen, I, Basco, Leonardo, Bassat, Quique, Baudin, Elisabeth, Bell, David J., Bethell, Delia, Bjorkman, Anders, Boulton, Caroline, Bousema, Teun, Brasseur, Philippe, Bukirwa, Hasifa, Burrow, Rebekah, Carrara, Verena, I, Cot, Michel, D'Alessandro, Umberto, Das, Debashish, Das, Sabyasachi, Davis, Timothy M. E., Desai, Meghna, Djimde, Abdoulaye A., Dondorp, Arjen M., Dorsey, Grant, Drakeley, Chris J., Duparc, Stephan, Espie, Emmanuelle, Etard, Jean-Francois, Falade, Catherine, Faucher, Jean Francois, Filler, Scott, Fogg, Carole, Fukuda, Mark, Gaye, Oumar, Genton, Blaise, Rahim, Awab Ghulam, Gilayeneh, Julius, Gonzalez, Raquel, Grais, Rebecca F., Grandesso, Francesco, Greenwood, Brian, Grivoyannis, Anastasia, Hatz, Christoph, Hodel, Eva Maria, Humphreys, Georgina S., Hwang, Jimee, Ishengoma, Deus, Juma, Elizabeth, Kachur, S. Patrick, Kager, Piet A., Kamugisha, Erasmus, Kamya, Moses R., Karema, Corine, Kayentao, Kassoum, Kazienga, Adama, Kiechel, Jean-Rene, Kofoed, Poul-Erik, Koram, Kwadwo, Kremsner, Peter G., Lalloo, David G., Laman, Moses, Lee, Sue J., Lell, Bertrand, Maiga, Amelia W., Mårtensson, Andreas, 1963, Mayxay, Mayfong, Mbacham, Wilfred, McGready, Rose, Menan, Herve, Menard, Didier, Mockenhaupt, Frank, Moore, Brioni R., Muller, Olaf, Nahum, Alain, Ndiaye, Jean-Louis, Newton, Paul N., Ngasala, Billy E., Nikiema, Frederic, Nji, Akindeh M., Noedl, Harald, Nosten, Francois, Ogutu, Bernhards R., Ojurongbe, Olusola, Osorio, Lyda, Ouedraogo, Jean-Bosco, Owusu-Agyei, Seth, Pareek, Anil, Penali, Louis K., Piola, Patrice, Plucinski, Mateusz, Premji, Zul, Ramharter, Michael, Richmond, Caitlin L., Rombo, Lars, Rosenthal, Philip J., Salman, Sam, Same-Ekobo, Albert, Sibley, Carol, Sirima, Sodiomon B., Smithuis, Frank M., Some, Fabrice A., Staedke, Sarah G., Starzengruber, Peter, Strub-Wourgaft, Nathalie, Sutanto, Inge, Swarthout, Todd D., Syafruddin, Din, Talisuna, Ambrose O., Taylor, Walter R., Temu, Emmanuel A., Thwing, Julie, I, Tinto, Halidou, Tjitra, Emiliana, Toure, Offianan A., Tran, T. Hien, Ursing, Johan, Valea, Innocent, Valentini, Giovanni, van Vugt, Michele, von Seidlein, Lorenz, Ward, Stephen A., Were, Vincent, White, Nicholas J., Woodrow, Charles J., Yavo, William, Yeka, Adoke, Zongo, Issaka, Simpson, Julie A., Guerin, Philippe J., Stepniewska, Kasia, Price, Ric N., Roper, Cally

المصدر: BMC Medicine. 20(1)

مصطلحات موضوعية: Plasmodium falciparum, Artemisinin-based therapy, Non-artemisinin-based therapy, Antimalarials, Haemoglobin, Severe anaemia, Pooled analysis of individual patient data

الوصف: BackgroundPlasmodium falciparum malaria is associated with anaemia-related morbidity, attributable to host, parasite and drug factors. We quantified the haematological response following treatment of uncomplicated P. falciparum malaria to identify the factors associated with malarial anaemia.MethodsIndividual patient data from eligible antimalarial efficacy studies of uncomplicated P. falciparum malaria, available through the WorldWide Antimalarial Resistance Network data repository prior to August 2015, were pooled using standardised methodology. The haematological response over time was quantified using a multivariable linear mixed effects model with nonlinear terms for time, and the model was then used to estimate the mean haemoglobin at day of nadir and day 7. Multivariable logistic regression quantified risk factors for moderately severe anaemia (haemoglobin < 7 g/dL) at day 0, day 3 and day 7 as well as a fractional fall >= 25% at day 3 and day 7.ResultsA total of 70,226 patients, recruited into 200 studies between 1991 and 2013, were included in the analysis: 50,859 (72.4%) enrolled in Africa, 18,451 (26.3%) in Asia and 916 (1.3%) in South America. The median haemoglobin concentration at presentation was 9.9 g/dL (range 5.0-19.7 g/dL) in Africa, 11.6 g/dL (range 5.0-20.0 g/dL) in Asia and 12.3 g/dL (range 6.9-17.9 g/dL) in South America. Moderately severe anaemia (Hb < 7g/dl) was present in 8.4% (4284/50,859) of patients from Africa, 3.3% (606/18,451) from Asia and 0.1% (1/916) from South America. The nadir haemoglobin occurred on day 2 post treatment with a mean fall from baseline of 0.57 g/dL in Africa and 1.13 g/dL in Asia. Independent risk factors for moderately severe anaemia on day 7, in both Africa and Asia, included moderately severe anaemia at baseline (adjusted odds ratio (AOR) = 16.10 and AOR = 23.00, respectively), young age (age < 1 compared to >= 12 years AOR = 12.81 and AOR = 6.79, respectively), high parasitaemia (AOR = 1.78 and AOR = 1.58, respectively) and delayed parasite clearance (AOR = 2.44 and AOR = 2.59, respectively). In Asia, patients treated with an artemisinin-based regimen were at significantly greater risk of moderately severe anaemia on day 7 compared to those treated with a non-artemisinin-based regimen (AOR = 2.06 [95%CI 1.39-3.05], p < 0.001).ConclusionsIn patients with uncomplicated P. falciparum malaria, the nadir haemoglobin occurs 2 days after starting treatment. Although artemisinin-based treatments increase the rate of parasite clearance, in Asia they are associated with a greater risk of anaemia during recovery.

وصف الملف: electronic

الوصول الحر: https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-470679Test
https://doi.org/10.1186/s12916-022-02265-9Test
https://uu.diva-portal.org/smash/get/diva2:1647895/FULLTEXT01.pdfTest

المؤلفون: Bwire, Godfrey, Ario, Alex Riolexus, Eyu, Patricia, Ocom, Felix, Wamala, Joseph F, Kusi, Kwadwo A, Ndeketa, Latif, Jambo, Kondwani, Wanyenze, Rhoda K, Talisuna, Ambrose O

المصدر: BMC Medicine, Vol 20, Issue 1, e167.

مصطلحات موضوعية: WA 105 Epidemiology, WC 20 Research (General), WC 506 COVID-19

الوصف: In December 2019, a new coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and associated disease, coronavirus disease 2019 (COVID-19), was identified in China. This virus spread quickly and in March, 2020, it was declared a pandemic. Scientists predicted the worst scenario to occur in Africa since it was the least developed of the continents in terms of human development index, lagged behind others in achievement of the United Nations sustainable development goals (SDGs), has inadequate resources for provision of social services, and has many fragile states. In addition, there were relatively few research reporting findings on COVID-19 in Africa. On the contrary, the more developed countries reported higher disease incidences and mortality rates. However, for Africa, the earlier predictions and modelling into COVID-19 incidence and mortality did not fit into the reality. Therefore, the main objective of this forum is to bring together infectious diseases and public health experts to give an overview of COVID-19 in Africa and share their thoughts and opinions on why Africa behaved the way it did. Furthermore, the experts highlight what needs to be done to support Africa to consolidate the status quo and overcome the negative effects of COVID-19 so as to accelerate attainment of the SDGs.

وصف الملف: text

العلاقة: https://archive.lstmed.ac.uk/20531/1/PMC9059455.pdfTest; Bwire, Godfrey, Ario, Alex Riolexus, Eyu, Patricia, Ocom, Felix, Wamala, Joseph F, Kusi, Kwadwo A, Ndeketa, Latif, Jambo, Kondwani orcid:0000-0002-3195-2210 , Wanyenze, Rhoda K and Talisuna, Ambrose O (2022) 'The COVID-19 pandemic in the African continent.'. BMC Medicine, Vol 20, Issue 1, e167.

الإتاحة: https://doi.org/10.1186/s12916-022-02367-4Test
https://archive.lstmed.ac.uk/20531Test/
https://archive.lstmed.ac.uk/20531/1/PMC9059455.pdfTest

المؤلفون: WWARN Artemisinin based Combination Therapy (ACT) Africa Baseline Study Group, Dahal, Prabin, d'Alessandro, Umberto, Dorsey, Grant, Guerin, Philippe J, Nsanzabana, Christian, Price, Ric N, Sibley, Carol H, Stepniewska, Kasia, Talisuna, Ambrose O

المصدر: BMC medicine. 13(1)

مصطلحات موضوعية: WWARN Artemisinin based Combination Therapy (ACT) Africa Baseline Study Group, Humans, Plasmodium falciparum, Malaria, Falciparum, Artemisinins, Quinolines, Amodiaquine, Drug Combinations, Antimalarials, Drug Therapy, Combination, Prospective Studies, Middle Aged, Infant, Africa, Africa South of the Sahara, Male, Vector-Borne Diseases, Clinical Research, Prevention, Rare Diseases, Infectious Diseases, Clinical Trials and Supportive Activities, Malaria, 2.2 Factors relating to the physical environment, Infection, General & Internal Medicine, Medical and Health Sciences

الوصف: BackgroundArtemisinin-resistant Plasmodium falciparum has emerged in the Greater Mekong sub-region and poses a major global public health threat. Slow parasite clearance is a key clinical manifestation of reduced susceptibility to artemisinin. This study was designed to establish the baseline values for clearance in patients from Sub-Saharan African countries with uncomplicated malaria treated with artemisinin-based combination therapies (ACTs).MethodsA literature review in PubMed was conducted in March 2013 to identify all prospective clinical trials (uncontrolled trials, controlled trials and randomized controlled trials), including ACTs conducted in Sub-Saharan Africa, between 1960 and 2012. Individual patient data from these studies were shared with the WorldWide Antimalarial Resistance Network (WWARN) and pooled using an a priori statistical analytical plan. Factors affecting early parasitological response were investigated using logistic regression with study sites fitted as a random effect. The risk of bias in included studies was evaluated based on study design, methodology and missing data.ResultsIn total, 29,493 patients from 84 clinical trials were included in the analysis, treated with artemether-lumefantrine (n = 13,664), artesunate-amodiaquine (n = 11,337) and dihydroartemisinin-piperaquine (n = 4,492). The overall parasite clearance rate was rapid. The parasite positivity rate (PPR) decreased from 59.7 % (95 % CI: 54.5-64.9) on day 1 to 6.7 % (95 % CI: 4.8-8.7) on day 2 and 0.9 % (95 % CI: 0.5-1.2) on day 3. The 95th percentile of observed day 3 PPR was 5.3 %. Independent risk factors predictive of day 3 positivity were: high baseline parasitaemia (adjusted odds ratio (AOR) = 1.16 (95 % CI: 1.08-1.25); per 2-fold increase in parasite density, P 37.5 °C) (AOR = 1.50 (95 % CI: 1.06-2.13), P = 0.022); severe anaemia (AOR = 2.04 (95 % CI: 1.21-3.44), P = 0.008); areas of low/moderate transmission setting (AOR = 2.71 (95 % CI: 1.38-5.36), P = 0.004); and treatment with the loose formulation of artesunate-amodiaquine (AOR = 2.27 (95 % CI: 1.14-4.51), P = 0.020, compared to dihydroartemisinin-piperaquine).ConclusionsThe three ACTs assessed in this analysis continue to achieve rapid early parasitological clearance across the sites assessed in Sub-Saharan Africa. A threshold of 5 % day 3 parasite positivity from a minimum sample size of 50 patients provides a more sensitive benchmark in Sub-Saharan Africa compared to the current recommended threshold of 10 % to trigger further investigation of artemisinin susceptibility.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/3kh75914Test

المؤلفون: WorldWide Antimalarial Resistance Network (WWARN) AS-AQ Study Group, Adjuik, Martin A, Allan, Richard, Anvikar, Anupkumar R, Ashley, Elizabeth A, Ba, Mamadou S, Barennes, Hubert, Barnes, Karen I, Bassat, Quique, Baudin, Elisabeth, Björkman, Anders, Bompart, François, Bonnet, Maryline, Borrmann, Steffen, Brasseur, Philippe, Bukirwa, Hasifa, Checchi, Francesco, Cot, Michel, Dahal, Prabin, D'Alessandro, Umberto, Deloron, Philippe, Desai, Meghna, Diap, Graciela, Djimde, Abdoulaye A, Dorsey, Grant, Doumbo, Ogobara K, Espié, Emmanuelle, Etard, Jean-Francois, Fanello, Caterina I, Faucher, Jean-François, Faye, Babacar, Flegg, Jennifer A, Gaye, Oumar, Gething, Peter W, González, Raquel, Grandesso, Francesco, Guerin, Philippe J, Guthmann, Jean-Paul, Hamour, Sally, Hasugian, Armedy Ronny, Hay, Simon I, Humphreys, Georgina S, Jullien, Vincent, Juma, Elizabeth, Kamya, Moses R, Karema, Corine, Kiechel, Jean R, Kremsner, Peter G, Krishna, Sanjeev, Lameyre, Valérie, Ibrahim, Laminou M, Lee, Sue J, Lell, Bertrand, Mårtensson, Andreas, Massougbodji, Achille, Menan, Hervé, Ménard, Didier, Menéndez, Clara, Meremikwu, Martin, Moreira, Clarissa, Nabasumba, Carolyn, Nambozi, Michael, Ndiaye, Jean-Louis, Nikiema, Frederic, Nsanzabana, Christian, Ntoumi, Francine, Ogutu, Bernhards R, Olliaro, Piero, Osorio, Lyda, Ouédraogo, Jean-Bosco, Penali, Louis K, Pene, Mbaye, Pinoges, Loretxu, Piola, Patrice, Price, Ric N, Roper, Cally, Rosenthal, Philip J, Rwagacondo, Claude Emile, Same-Ekobo, Albert, Schramm, Birgit, Seck, Amadou, Sharma, Bhawna, Sibley, Carol Hopkins, Sinou, Véronique, Sirima, Sodiomon B, Smith, Jeffery J, Smithuis, Frank, Somé, Fabrice A, Sow, Doudou, Staedke, Sarah G, Stepniewska, Kasia, Swarthout, Todd D, Sylla, Khadime, Talisuna, Ambrose O, Tarning, Joel, Taylor, Walter RJ, Temu, Emmanuel A, Thwing, Julie I, Tjitra, Emiliana, Tine, Roger CK

المصدر: BMC medicine. 13(1)

مصطلحات موضوعية: WorldWide Antimalarial Resistance Network (WWARN) AS-AQ Study Group, Humans, Malaria, Falciparum, Recurrence, Artemisinins, Amodiaquine, Drug Combinations, Antimalarials, Treatment Outcome, Risk Factors, Dose-Response Relationship, Drug, Middle Aged, Africa, Female, Male, Malaria, Plasmodium falciparum, Drug resistance, Artesunate, Dosing, Efficacy, Falciparum, Dose-Response Relationship, Drug, Medical and Health Sciences, General & Internal Medicine

الوصف: BackgroundArtesunate-amodiaquine (AS-AQ) is one of the most widely used artemisinin-based combination therapies (ACTs) to treat uncomplicated Plasmodium falciparum malaria in Africa. We investigated the impact of different dosing strategies on the efficacy of this combination for the treatment of falciparum malaria.MethodsIndividual patient data from AS-AQ clinical trials were pooled using the WorldWide Antimalarial Resistance Network (WWARN) standardised methodology. Risk factors for treatment failure were identified using a Cox regression model with shared frailty across study sites.ResultsForty-three studies representing 9,106 treatments from 1999-2012 were included in the analysis; 4,138 (45.4%) treatments were with a fixed dose combination with an AQ target dose of 30 mg/kg (FDC), 1,293 (14.2%) with a non-fixed dose combination with an AQ target dose of 25 mg/kg (loose NFDC-25), 2,418 (26.6%) with a non-fixed dose combination with an AQ target dose of 30 mg/kg (loose NFDC-30), and the remaining 1,257 (13.8%) with a co-blistered non-fixed dose combination with an AQ target dose of 30 mg/kg (co-blistered NFDC). The median dose of AQ administered was 32.1 mg/kg [IQR: 25.9-38.2], the highest dose being administered to patients treated with co-blistered NFDC (median = 35.3 mg/kg [IQR: 30.6-43.7]) and the lowest to those treated with loose NFDC-25 (median = 25.0 mg/kg [IQR: 22.7-25.0]). Patients treated with FDC received a median dose of 32.4 mg/kg [IQR: 27-39.0]. After adjusting for reinfections, the corrected antimalarial efficacy on day 28 after treatment was similar for co-blistered NFDC (97.9% [95% confidence interval (CI): 97.0-98.8%]) and FDC (98.1% [95% CI: 97.6%-98.5%]; P = 0.799), but significantly lower for the loose NFDC-25 (93.4% [95% CI: 91.9%-94.9%]), and loose NFDC-30 (95.0% [95% CI: 94.1%-95.9%]) (P

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/9q25z891Test

المؤلفون: Achan, Jane, Talisuna, Ambrose O, Erhart, Annette, Yeka, Adoke, Tibenderana, James K, Baliraine, Frederick N, Rosenthal, Philip J, D'Alessandro, Umberto

المصدر: Malaria Journal. 10(1)

الوصف: Abstract Quinine remains an important anti-malarial drug almost 400 years after its effectiveness was first documented. However, its continued use is challenged by its poor tolerability, poor compliance with complex dosing regimens, and the availability of more efficacious anti-malarial drugs. This article reviews the historical role of quinine, considers its current usage and provides insight into its appropriate future use in the treatment of malaria. In light of recent research findings intravenous artesunate should be the first-line drug for severe malaria, with quinine as an alternative. The role of rectal quinine as pre-referral treatment for severe malaria has not been fully explored, but it remains a promising intervention. In pregnancy, quinine continues to play a critical role in the management of malaria, especially in the first trimester, and it will remain a mainstay of treatment until safer alternatives become available. For uncomplicated malaria, artemisinin-based combination therapy (ACT) offers a better option than quinine though the difficulty of maintaining a steady supply of ACT in resource-limited settings renders the rapid withdrawal of quinine for uncomplicated malaria cases risky. The best approach would be to identify solutions to ACT stock-outs, maintain quinine in case of ACT stock-outs, and evaluate strategies for improving quinine treatment outcomes by combining it with antibiotics. In HIV and TB infected populations, concerns about potential interactions between quinine and antiretroviral and anti-tuberculosis drugs exist, and these will need further research and pharmacovigilance.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/6979c2xsTest

المؤلفون: Aceng, Jane Ruth, Ario, Alex R, Muruta, Allan N, Makumbi, Issa, Nanyunja, Miriam, Komakech, Innocent, Bakainaga, Andrew N, Talisuna, Ambrose O, Mwesigye, Collins, Mpairwe, Allan M, Tusiime, Jayne B, Lali, William Z, Katushabe, Edson, Ocom, Felix, Kaggwa, Mugagga, Bongomin, Bodo, Kasule, Hafisa, Mwoga, Joseph N, Sensasi, Benjamin, Mwebembezi, Edmund, Katureebe, Charles, Sentumbwe, Olive, Nalwadda, Rita, Mbaka, Paul, Fatunmbi, Bayo S, Nakiire, Lydia, Lamorde, Mohammed, Walwema, Richard, Kambugu, Andrew, Nanyondo, Judith, Okware, Solome, Ahabwe, Peter B, Nabukenya, Immaculate, Kayiwa, Joshua, Wetaka, Milton M, Kyazze, Simon, Kwesiga, Benon, Kadobera, Daniel, Bulage, Lilian, Nanziri, Carol, Monje, Fred, Aliddeki, Dativa M, Ntono, Vivian, Gonahasa, Doreen, Nabatanzi, Sandra, Nsereko, Godfrey, Nakinsige, Anne, Mabumba, Eldard, Lubwama, Bernard, Sekamatte, Musa, Kibuule, Michael, Muwanguzi, David, Amone, Jackson, Upenytho, George D, Driwale, Alfred, Seru, Morries, Sebisubi, Fred, Akello, Harriet, Kabanda, Richard, Mutengeki, David K, Bakyaita, Tabley, Serwanjja, Vivian N, Okwi, Richard, Okiria, Jude, Ainebyoona, Emmanuel, Opar, Bernard T, Mimbe, Derrick, Kyabaggu, Denis, Ayebazibwe, Chrisostom, Sentumbwe, Juliet, Mwanja, Moses, Ndumu, Deo B, Bwogi, Josephine, Balinandi, Stephen, Nyakarahuka, Luke, Tumusiime, Alex, Kyondo, Jackson, Mulei, Sophia, Lutwama, Julius, Kaleebu, Pontiano, Kagirita, Atek, Nabadda, Susan, Oumo, Peter, Lukwago, Robinah, Kasozi, Julius, Masylukov, Oleh, Kyobe, Henry Bosa, Berdaga, Viorica, Lwanga, Miriam, Opio, Joe C, Matseketse, David, Eyul, James, Oteba, Martin O, Bukirwa, Hasifa, Bulya, Nulu, Masiira, Ben, Kihembo, Christine, Ohuabunwo, Chima, Antara, Simon N, Owembabazi, Wilberforce, Okot, Paul B, Okwera, Josephine, Amoros, Isabelle, Kajja, Victoria, Mukunda, Basnet S, Sorela, Isabel, Adams, Gregory, Shoemaker, Trevor, Klena, John D, Taboy, Celine H, Ward, Sarah E, Merrill, Rebecca D, Carter, Rosalind J, Harris, Julie R, Banage, Flora, Nsibambi, Thomas, Ojwang, Joseph, Kasule, Juliet N, Stowell, Dan F, Brown, Vance R, Zhu, Bao-Ping, Homsy, Jaco, Nelson, Lisa J, Tusiime, Patrick K, Olaro, Charles, Mwebesa, Henry G, Woldemariam, Yonas Tegegn

الوصف: BACKGROUND: Since the declaration of the 10th Ebola Virus Disease (EVD) outbreak in DRC on 1st Aug 2018, several neighboring countries have been developing and implementing preparedness efforts to prevent EVD cross-border transmission to enable timely detection, investigation, and response in the event of a confirmed EVD outbreak in the country. We describe Uganda's experience in EVD preparedness. RESULTS: On 4 August 2018, the Uganda Ministry of Health (MoH) activated the Public Health Emergency Operations Centre (PHEOC) and the National Task Force (NTF) for public health emergencies to plan, guide, and coordinate EVD preparedness in the country. The NTF selected an Incident Management Team (IMT), constituting a National Rapid Response Team (NRRT) that supported activation of the District Task Forces (DTFs) and District Rapid Response Teams (DRRTs) that jointly assessed levels of preparedness in 30 designated high-risk districts representing category 1 (20 districts) and category 2 (10 districts). The MoH, with technical guidance from the World Health Organisation (WHO), led EVD preparedness activities and worked together with other ministries and partner organisations to enhance community-based surveillance systems, develop and disseminate risk communication messages, engage communities, reinforce EVD screening and infection prevention measures at Points of Entry (PoEs) and in high-risk health facilities, construct and equip EVD isolation and treatment units, and establish coordination and procurement mechanisms. CONCLUSION: As of 31 May 2019, there was no confirmed case of EVD as Uganda has continued to make significant and verifiable progress in EVD preparedness. There is a need to sustain these efforts, not only in EVD preparedness but also across the entire spectrum of a multi-hazard framework. These efforts strengthen country capacity and compel the country to avail resources for preparedness and management of incidents at the source while effectively cutting costs of using a "fire-fighting" approach ...

وصف الملف: text

العلاقة: https://researchonline.lshtm.ac.uk/id/eprint/4657337/1/Ugandas%20experience%20in%20Ebola%20virus%20disease%20outbreak%20preparedness,%202018-2019.pdfTest; Aceng, Jane Ruth; Ario, Alex R; Muruta, Allan N; Makumbi, Issa; Nanyunja, Miriam; Komakech, Innocent; Bakainaga, Andrew N; Talisuna, Ambrose O; Mwesigye, Collins; Mpairwe, Allan M; +117 more. Tusiime, Jayne B; Lali, William Z; Katushabe, Edson; Ocom, Felix; Kaggwa, Mugagga; Bongomin, Bodo; Kasule, Hafisa; Mwoga, Joseph N; Sensasi, Benjamin; Mwebembezi, Edmund; Katureebe, Charles; Sentumbwe, Olive; Nalwadda, Rita; Mbaka, Paul; Fatunmbi, Bayo S; Nakiire, Lydia; Lamorde, Mohammed; Walwema, Richard; Kambugu, Andrew; Nanyondo, Judith; Okware, Solome; Ahabwe, Peter B; Nabukenya, Immaculate; Kayiwa, Joshua; Wetaka, Milton M; Kyazze, Simon; Kwesiga, Benon; Kadobera, Daniel; Bulage, Lilian; Nanziri, Carol; Monje, Fred; Aliddeki, Dativa M; Ntono, Vivian; Gonahasa, Doreen; Nabatanzi, Sandra; Nsereko, Godfrey; Nakinsige, Anne; Mabumba, Eldard; Lubwama, Bernard; Sekamatte, Musa; Kibuule, Michael; Muwanguzi, David; Amone, Jackson; Upenytho, George D; Driwale, Alfred; Seru, Morries; Sebisubi, Fred; Akello, Harriet; Kabanda, Richard; Mutengeki, David K; Bakyaita, Tabley; Serwanjja, Vivian N; Okwi, Richard; Okiria, Jude; Ainebyoona, Emmanuel; Opar, Bernard T; Mimbe, Derrick; Kyabaggu, Denis; Ayebazibwe, Chrisostom; Sentumbwe, Juliet; Mwanja, Moses; Ndumu, Deo B; Bwogi, Josephine; Balinandi, Stephen; Nyakarahuka, Luke; Tumusiime, Alex; Kyondo, Jackson; Mulei, Sophia; Lutwama, Julius; Kaleebu, Pontiano ; Kagirita, Atek; Nabadda, Susan; Oumo, Peter; Lukwago, Robinah; Kasozi, Julius; Masylukov, Oleh; Kyobe, Henry Bosa; Berdaga, Viorica; Lwanga, Miriam; Opio, Joe C; Matseketse, David; Eyul, James; Oteba, Martin O; Bukirwa, Hasifa; Bulya, Nulu; Masiira, Ben; Kihembo, Christine; Ohuabunwo, Chima; Antara, Simon N; Owembabazi, Wilberforce; Okot, Paul B; Okwera, Josephine; Amoros, Isabelle; Kajja, Victoria; Mukunda, Basnet S; Sorela, Isabel; Adams, Gregory; Shoemaker, Trevor; Klena, John D; Taboy, Celine H; Ward, Sarah E; Merrill, Rebecca D; Carter, Rosalind J; Harris, Julie R; Banage, Flora; Nsibambi, Thomas; Ojwang, Joseph; Kasule, Juliet N; Stowell, Dan F; Brown, Vance R; Zhu, Bao-Ping; Homsy, Jaco; Nelson, Lisa J; Tusiime, Patrick K; Olaro, Charles; Mwebesa, Henry G; Woldemariam, Yonas Tegegn; (2020) Uganda's experience in Ebola virus disease outbreak preparedness, 2018-2019. Globalization and health, 16 (1). 24-. ISSN 1744-8603 DOI: https://doi.org/10.1186/s12992-020-00548-5Test

الإتاحة: https://doi.org/10.1186/s12992-020-00548-5Test
https://researchonline.lshtm.ac.uk/id/eprint/4657337Test/
https://researchonline.lshtm.ac.uk/id/eprint/4657337/1/Ugandas%20experience%20in%20Ebola%20virus%20disease%20outbreak%20preparedness,%202018-2019.pdfTest

المؤلفون: Wendler, David, Pace, Christine, Talisuna, Ambrose O., Maiso, Faustine, Grady, Christine, Emanuel, Ezekiel

المصدر: IRB: Ethics & Human Research, 2005 Mar 01. 27(2), 1-5.

الوصول الحر: https://www.jstor.org/stable/3564479Test

المؤلفون: Staedke, Sarah G, Jagannathan, Prasanna, Yeka, Adoke, Bukirwa, Hasifa, Banek, Kristin, Maiteki-Sebuguzi, Catherine, Clark, Tamara D, Nzarubara, Bridget, Njama-Meya, Denise, Mpimbaza, Arthur, Rosenthal, Philip J, Kamya, Moses R, Wabwire-Mangen, Fred, Dorsey, Grant, Talisuna, Ambrose O

المصدر: Malaria Journal. 7(1)

مصطلحات موضوعية: Medical Microbiology, Biomedical and Clinical Sciences, Clinical Sciences, Malaria, Vector-Borne Diseases, Infectious Diseases, Orphan Drug, Clinical Trials and Supportive Activities, Rare Diseases, Clinical Research, Patient Safety, 8.4 Research design and methodologies (health services), Evaluation of treatments and therapeutic interventions, Health and social care services research, 6.1 Pharmaceuticals, Infection, Good Health and Well Being, Adverse Drug Reaction Reporting Systems, Antimalarials, Artemisinins, Child, Child, Preschool, Drug Therapy, Combination, Humans, Infant, Randomized Controlled Trials as Topic, Treatment Outcome, Uganda, Microbiology, Public Health and Health Services, Tropical Medicine, Medical microbiology, Public health

الوصف: BackgroundNew antimalarial regimens, including artemisinin-based combination therapies (ACTs), have been adopted widely as first-line treatment for uncomplicated malaria. Although these drugs appear to be safe and well-tolerated, experience with their use in Africa is limited and continued assessment of safety is a priority. However, no standardized guidelines for evaluating drug safety and tolerability in malaria studies exist. A system for monitoring adverse events in antimalarial trials conducted in Uganda was developed. Here the reporting system is described, and difficulties faced in analysing and interpreting the safety results are illustrated, using data from the trials.Case descriptionBetween 2002 and 2007, eleven randomized, controlled clinical trials were conducted to compare the efficacy, safety, and tolerability of different antimalarial regimens for treatment of uncomplicated malaria in Uganda. The approach to adverse event monitoring was similar in all studies. A total of 5,614 treatments were evaluated in 4,876 patients. Differences in baseline characteristics and patterns of adverse event reporting were noted between the sites, which limited the ability to pool and analyse data. Clinical failure following antimalarial treatment confounded associations between treatment and adverse events that were also common symptoms of malaria, particularly in areas of lower transmission intensity.Discussion and evaluationDespite prospectively evaluating for adverse events, limitations in the monitoring system were identified. New standardized guidelines for monitoring safety and tolerability in antimalarial trials are needed, which should address how to detect events of greatest importance, including serious events, those with a causal relationship to the treatment, those which impact on adherence, and events not previously reported.ConclusionAlthough the World Health Organization has supported the development of pharmacovigilance systems in African countries deploying ACTs, additional guidance on adverse events monitoring in antimalarial clinical trials is needed, similar to the standardized recommendations available for assessment of drug efficacy.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/63w6v4v6Test

المؤلفون: Kamya, Moses R, Yeka, Adoke, Bukirwa, Hasifa, Lugemwa, Myers, Rwakimari, John B, Staedke, Sarah G, Talisuna, Ambrose O, Greenhouse, Bryan, Nosten, François, Rosenthal, Philip J, Wabwire-Mangen, Fred, Dorsey, Grant

المصدر: PLoS clinical trials. 2(5)

مصطلحات موضوعية: Clinical Sciences

الوصف: ObjectivesTo compare the efficacy and safety of artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP) for treating uncomplicated falciparum malaria in Uganda.DesignRandomized single-blinded clinical trial.SettingApac, Uganda, an area of very high malaria transmission intensity.ParticipantsChildren aged 6 mo to 10 y with uncomplicated falciparum malaria.InterventionTreatment of malaria with AL or DP, each following standard 3-d dosing regimens.Outcome measuresRisks of recurrent parasitemia at 28 and 42 d, unadjusted and adjusted by genotyping to distinguish recrudescences and new infections.ResultsOf 421 enrolled participants, 417 (99%) completed follow-up. The unadjusted risk of recurrent falciparum parasitemia was significantly lower for participants treated with DP than for those treated with AL after 28 d (11% versus 29%; risk difference [RD] 18%, 95% confidence interval [CI] 11%-26%) and 42 d (43% versus 53%; RD 9.6%, 95% CI 0%-19%) of follow-up. Similarly, the risk of recurrent parasitemia due to possible recrudescence (adjusted by genotyping) was significantly lower for participants treated with DP than for those treated with AL after 28 d (1.9% versus 8.9%; RD 7.0%, 95% CI 2.5%-12%) and 42 d (6.9% versus 16%; RD 9.5%, 95% CI 2.8%-16%). Patients treated with DP had a lower risk of recurrent parasitemia due to non-falciparum species, development of gametocytemia, and higher mean increase in hemoglobin compared to patients treated with AL. Both drugs were well tolerated; serious adverse events were uncommon and unrelated to study drugs.ConclusionDP was superior to AL for reducing the risk of recurrent parasitemia and gametocytemia, and provided improved hemoglobin recovery. DP thus appears to be a good alternative to AL as first-line treatment of uncomplicated malaria in Uganda. To maximize the benefit of artemisinin-based combination therapy in Africa, treatment should be integrated with aggressive strategies to reduce malaria transmission intensity.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/7f8673j3Test