1,688 research outputs found
When can antibiotic treatments for trachoma be discontinued? Graduating communities in three African countries.
No full textBACKGROUND: Repeated mass azithromycin distributions are effective in controlling the ocular strains of chlamydia that cause trachoma. However, it is unclear when treatments can be discontinued. Investigators have proposed graduating communities when the prevalence of infection identified in children decreases below a threshold. While this can be tested empirically, results will not be available for years. Here we use a mathematical model to predict results with different graduation strategies in three African countries. METHODS: A stochastic model of trachoma transmission was constructed, using the parameters with the maximum likelihood of obtaining results observed from studies in Tanzania (with 16% infection in children pre-treatment), The Gambia (9%), and Ethiopia (64%). The expected prevalence of infection at 3 years was obtained, given different thresholds for graduation and varying the characteristics of the diagnostic test. RESULTS: The model projects that three annual treatments at 80% coverage would reduce the mean prevalence of infection to 0.03% in Tanzanian, 2.4% in Gambian, and 12.9% in the Ethiopian communities. If communities graduate when the prevalence of infection falls below 5%, then the mean prevalence at 3 years with the new strategy would be 0.3%, 3.9%, and 14.4%, respectively. Graduations reduced antibiotic usage by 63% in Tanzania, 56% in The Gambia, and 11% in Ethiopia. CONCLUSION: Models suggest that graduating communities from a program when the infection is reduced to 5% is a reasonable strategy and could reduce the amount of antibiotic distributed in some areas by more than 2-fold
Emma Gelders Sterne papers, W.0099
No full textAbstract: Contracts and business correspondence related to the publication of books written by Alabama author Emma Gelders Sterne.Scope and Content Note: This collection contains contracts and business correspondence between Alabama author Emma Gelders Sterne and her publishers at Dodd, Mead, and Company. The correspondence and contracts are dated from 1934 to 1953 and mostly include republication agreements between Sterne and the publishers. The collection includes materials related to
The Calico Ball, Some Plant Olive Trees, and
Drums of Monmouth.Biographical/Historical Note: Emma Gelders Sterne was born on May 13, 1894, in Birmingham, Alabama. She graduated from Smith College in 1916, receiving a BA. After college, Sterne returned to Birmingham, where she was involved in a number of activist efforts, including the suffrage movement.In 1917, she married lawyer Roy M. Sterne; the couple had two daughters, Ann and Barbara. The family moved to New York, where Roy worked for the Liggett Drug Company and Emma became involved in a number of activist groups, including the National Association for the Advancement of Colored People and the American Civil Liberties Union.A prolific children's author, Sterne published a total of forty-four books during a literary career that spanned four decades. Several of her books, including
No Surrender,
Amarantha Gay, M.D., and
The Calico Ball are set in Birmingham; another work,
Some Plant Olive Trees, was inspired by the French settlement of Demopolis, Alabama.Sterne spent her final years in California; she died on August 29, 1971, in San Jose.Source:
Encyclopedia of Alabam
sj-pdf-2-ijq-10.1177_16094069221081377 – Supplemental Material for Developing Poetry as a Research Methodology with Rarer Forms of Dementia: Four Research Protocols
No full textSupplemental Material, sj-pdf-2-ijq-10.1177_16094069221081377 for Developing Poetry as a Research Methodology with Rarer Forms of Dementia: Four Research Protocols by Paul M. Camic, Emma Harding, Mary Pat Sullivan, Adetola Grillo, Roberta McKee-Jackson, Lawrence Wilson, Nikki Zimmermann and Emilie V. Brotherhood in International Journal of Qualitative Methods</p
sj-pdf-1-ijq-10.1177_16094069221081377 – Supplemental Material for Developing Poetry as a Research Methodology with Rarer Forms of Dementia: Four Research Protocols
No full textSupplemental Material, sj-pdf-1-ijq-10.1177_16094069221081377 for Developing Poetry as a Research Methodology with Rarer Forms of Dementia: Four Research Protocols by Paul M. Camic, Emma Harding, Mary Pat Sullivan, Adetola Grillo, Roberta McKee-Jackson, Lawrence Wilson, Nikki Zimmermann and Emilie V. Brotherhood in International Journal of Qualitative Methods</p
Supplemental Material - Talking Lines: A Research Protocol Integrating Verbal and Visual Narratives to Understand the Experiences of People Affected by Rarer Forms of Dementia
No full textSupplemental Material for Talking Lines: A Research Protocol Integrating Verbal and Visual Narratives to Understand the Experiences of People Affected by Rarer Forms of Dementia by Paul M. Camic, Sam Rossi-Harries, Emma Harding, Charlie Harrison, Mary Pat Sullivan, Adetola Grillo, Emilie V. Brotherhood, Sebastian J. Crutch in International Journal of Qualitative Methods.</p
Risk factors for active trachoma and ocular Chlamydia trachomatis infection in treatment-naïve trachoma-hyperendemic communities of the Bijagós Archipelago, Guinea Bissau.
No full textBACKGROUND: Trachoma, caused by ocular infection with Chlamydia trachomatis, is hyperendemic on the Bijagós Archipelago of Guinea Bissau. An understanding of the risk factors associated with active trachoma and infection on these remote and isolated islands, which are atypical of trachoma-endemic environments described elsewhere, is crucial to the implementation of trachoma elimination strategies. METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional population-based trachoma prevalence survey was conducted on four islands. We conducted a questionnaire-based risk factor survey, examined participants for trachoma using the World Health Organization (WHO) simplified grading system and collected conjunctival swab samples for 1507 participants from 293 randomly selected households. DNA extracted from conjunctival swabs was tested using the Roche Amplicor CT/NG PCR assay. The prevalence of active (follicular and/or inflammatory) trachoma was 11% (167/1508) overall and 22% (136/618) in 1-9 year olds. The prevalence of C. trachomatis infection was 18% overall and 25% in 1-9 year olds. There were strong independent associations of active trachoma with ocular and nasal discharge, C. trachomatis infection, young age, male gender and type of household water source. C. trachomatis infection was independently associated with young age, ocular discharge, type of household water source and the presence of flies around a latrine. CONCLUSIONS/SIGNIFICANCE: In this remote island environment, household-level risk factors relating to fly populations, hygiene behaviours and water usage are likely to be important in the transmission of ocular C. trachomatis infection and the prevalence of active trachoma. This may be important in the implementation of environmental measures in trachoma control
Diagnostic accuracy of a prototype point-of-care test for ocular Chlamydia trachomatis under field conditions in The Gambia and Senegal.
No full textBACKGROUND: The clinical signs of active trachoma are often present in the absence of ocular Chlamydia trachomatis infection in low prevalence and mass treated settings. Treatment decisions are currently based on the prevalence of clinical signs, and this may result in the unnecessary distribution of mass antibiotic treatment. We aimed to evaluate the diagnostic accuracy of a prototype point-of-care (POC) test, developed for field diagnosis of ocular C. trachomatis, in low prevalence settings of The Gambia and Senegal. METHODOLOGY/PRINCIPAL FINDINGS: Three studies were conducted, two in The Gambia and one in Senegal. Children under the age of 10 years were screened for the clinical signs of trachoma. Two ocular swabs were taken from the right eye. The first swab was tested by the POC test in the field and the result independently graded by two readers. The second swab was tested for the presence of C. trachomatis by Amplicor Polymerase Chain Reaction. In Senegal, measurements of humidity and temperature in the field were taken. A total of 3734 children were screened, 950 in the first and 1171 in the second Gambian study, and 1613 in Senegal. The sensitivity of the prototype POC test ranged between 33.3-67.9%, the specificity between 92.4-99.0%, the positive predictive value between 4.3-21.0%, and the negative predictive value between 98.0-99.8%. The rate of false-positives increased markedly at temperatures above 31.4°C and relative humidities below 11.4%. CONCLUSIONS/SIGNIFICANCE: In its present format, this prototype POC test is not suitable for field diagnosis of ocular C. trachomatis as its specificity decreases in hot and dry conditions: the environment in which trachoma is predominantly found. In the absence of a suitable test for infection, trachoma diagnosis remains dependent on clinical signs. Under current WHO recommendations, this is likely resulting in the continued mass treatment of non-infected communities
Costs of testing for ocular Chlamydia trachomatis infection compared to mass drug administration for trachoma in the Gambia: application of results from the PRET study.
No full textBACKGROUND: Mass drug administration (MDA) treatment of active trachoma with antibiotic is recommended to be initiated in any district where the prevalence of trachoma inflammation, follicular (TF) is ≥ 10% in children aged 1-9 years, and then to continue for at least three annual rounds before resurvey. In The Gambia the PRET study found that discontinuing MDA based on testing a sample of children for ocular Chlamydia trachomatis(Ct) infection after one MDA round had similar effects to continuing MDA for three rounds. Moreover, one round of MDA reduced disease below the 5% TF threshold. We compared the costs of examining a sample of children for TF, and of testing them for Ct, with those of MDA rounds. METHODS: The implementation unit in PRET The Gambia was a census enumeration area (EA) of 600-800 people. Personnel, fuel, equipment, consumables, data entry and supervision costs were collected for census and treatment of a sample of EAs and for the examination, sampling and testing for Ct infection of 100 individuals within them. Programme costs and resource savings from testing and treatment strategies were inferred for the 102 EAs in the study area, and compared. RESULTS: Census costs were 108.79. MDA with donated azithromycin cost 796.90 per EA, with Ct testing kits costing 1.38 per result. However stopping or deciding not to initiate treatment in the study area based on testing a sample of EAs for Ct infection (or examining children in a sample of EAs) creates savings relative to further unnecessary treatments. CONCLUSION: Resources may be saved by using tests for chlamydial infection or clinical examination to determine that initial or subsequent rounds of MDA for trachoma are unnecessary
Design and baseline data of a randomized trial to evaluate coverage and frequency of mass treatment with azithromycin: the Partnership for Rapid Elimination of Trachoma (PRET) in Tanzania and The Gambia.
No full textOBJECTIVES: Trachoma is the principal cause of infectious blindness. As part of its strategy to eliminate trachoma, the World Health Organization recommends annual mass antibiotic treatment for at least 3 years with an 80% population coverage target. However, to date, ideal population coverage and mass treatment duration have not been determined and further evaluation of treatment recommendations in areas of varying endemicity is warranted. The studies presented here evaluate the impact of coverage level and frequency of mass treatment with single dose azithromycin on trachoma and ocular C. trachomatis infection. METHODS: The Partnership for the Rapid Elimination of Trachoma supervises 2 randomized, community-based clinical trials in Tanzania and The Gambia. Although each trial is a stand-alone effort, protocols, data collection, and analytic approaches have been harmonized to permit generalizations. Communities in each site were randomized using a 2X2 factorial design to standard (80%-90.0%) versus high (over 90.0%) treatment coverage; communities were further randomized to annual treatment for 3 years versus a "graduation" rule where evidence indicates an absence of follicular trachoma or infection and annual treatment is halted. RESULTS: Average prevalence of follicular trachoma in children age less than 5 years was 32.2% in Tanzania and 5.96% in The Gambia. Randomization appeared to be effective, as prevalence was not statistically different between the arms within each country. CONCLUSIONS: There are challenges in harmonizing 2, large trials in Africa. Study outcomes will provide critical data to national trachoma control programs on treatment methodology and resource allocation toward elimination of the disease
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