23 research outputs found
HIV/Malaria co-infection: Effect of HIV infection on antimalarial treatment outcomes in children in Zambia
No full textChildren co-infected with HIV-1 and malaria are more likely to suffer from malaria and may respond poorly to anti-malarial treatment due to immunosuppression resulting from HIV infection. This study provides results of antimalarial treatment outcomes in children co-infected with HIV and malaria. The study was a health facility based case control study and was conducted between December 2006 and October 2007. One hundred and twenty four children were recruited from five study sites with stable and unstable malaria transmission patterns. Among the 124 children recruited, 9 had HIV-1 and malaria co-infections (cases) while 113 were non-HIV-1 and malaria infected (controls). Treatment was according to the Zambian government malaria treatment policy guidelines; thus Quinine for complicated malaria and Artemether Lumefantrine (Coartem) for uncomplicated malaria. All the children recruited were followed-up for 28 days. Eighty children completed the day 28 follow-up. Clinical assessment and malaria parasite examination were done on each day of the visit while samples for PCR were collected on day 14 and any day thereafter if the patient was malaria positive by blood slide. Molecular genotyping was used to distinguish re-infection parasites from recrudescent parasites. Data was analyzed with SPSS version 11.0. Chi-square test was used to test for significant differences of baseline data among the two groups and the difference in means was measured with the unpaired t-test. Tests of significance could not be performed on treatment outcomes because of the low numbers of patients in the case group. Out of the 80 children who completed day 28 follow-up, 8 were cases and 72 were controls. The mean haemoglobin levels among children in the case and control groups at baseline was 6.62 ±2.71 and 9.55±2.40 respectively (p-value <0.05). The parasite count geometric means for the case and control groups were 11501 and 7550 respectively. The mean CD4 counts for the children in the case group 356± 138.47 while the control had 1171.86±445.18 (p-value <0.05). Fifty percent of the cases presented with complicated malaria upon recruitment as compared to 6.9% in the controls. A total of 16 post treatment positive samples were recorded of which 4 were positive by both microscopy and 12 were positive by PCR only. In order to distinguish re-infection parasites from recrudescent, all the 16 positive post treatment samples were genotyped. Out of the 16 post treatment malaria positive samples recorded, 5 (31.3%) were due to re-infections and 10 (62.5%) were recrudescents. Recrudescent parasites were seen in 6.2% and 62.5% of the cases and controls respectively. Treatment failure rates within the case and control groups were I (12.5%) and 10 (13.8%) respectively. Our study has documented higher parasitaemia and prevalence of severe malaria among HIV-1 malaria co-infected children. However, the study findings have shown that the risk of developing treatment failure is less likely among children with severe immunosuppression as seen in HIV malaria infected children. These results may not be significant and conclusive due to a number of factors including the low prevalence rates of HIV and malaria co-infections and small study sample size
HIV/Malaria co-infection: Effect of HIV infection on antimalarial treatment outcomes in children in Zambia
No full textChildren co-infected with HIV-1 and malaria are more likely to suffer from malaria and may respond poorly to anti-malarial treatment due to immunosuppression resulting from HIV infection. This study provides results of antimalarial treatment outcomes in children co-infected with HIV and malaria. The study was a health facility based case control study and was conducted between December 2006 and October 2007. One hundred and twenty four children were recruited from five study sites with stable and unstable malaria transmission patterns. Among the 124 children recruited, 9 had HIV-1 and malaria co-infections (cases) while 113 were non-HIV-1 and malaria infected (controls). Treatment was according to the Zambian government malaria treatment policy guidelines; thus Quinine for complicated malaria and Artemether Lumefantrine (Coartem) for uncomplicated malaria. All the children recruited were followed-up for 28 days. Eighty children completed the day 28 follow-up. Clinical assessment and malaria parasite examination were done on each day of the visit while samples for PCR were collected on day 14 and any day thereafter if the patient was malaria positive by blood slide. Molecular genotyping was used to distinguish re-infection parasites from recrudescent parasites. Data was analyzed with SPSS version 11.0. Chi-square test was used to test for significant differences of baseline data among the two groups and the difference in means was measured with the unpaired t-test. Tests of significance could not be performed on treatment outcomes because of the low numbers of patients in the case group. Out of the 80 children who completed day 28 follow-up, 8 were cases and 72 were controls. The mean haemoglobin levels among children in the case and control groups at baseline was 6.62 ±2.71 and 9.55±2.40 respectively (p-value <0.05). The parasite count geometric means for the case and control groups were 11501 and 7550 respectively. The mean CD4 counts for the children in the case group 356± 138.47 while the control had 1171.86±445.18 (p-value <0.05). Fifty percent of the cases presented with complicated malaria upon recruitment as compared to 6.9% in the controls. A total of 16 post treatment positive samples were recorded of which 4 were positive by both microscopy and 12 were positive by PCR only. In order to distinguish re-infection parasites from recrudescent, all the 16 positive post treatment samples were genotyped. Out of the 16 post treatment malaria positive samples recorded, 5 (31.3%) were due to re-infections and 10 (62.5%) were recrudescents. Recrudescent parasites were seen in 6.2% and 62.5% of the cases and controls respectively. Treatment failure rates within the case and control groups were I (12.5%) and 10 (13.8%) respectively. Our study has documented higher parasitaemia and prevalence of severe malaria among HIV-1 malaria co-infected children. However, the study findings have shown that the risk of developing treatment failure is less likely among children with severe immunosuppression as seen in HIV malaria infected children. These results may not be significant and conclusive due to a number of factors including the low prevalence rates of HIV and malaria co-infections and small study sample size
Emerg Infect Dis
No full textRickettsia asembonensis is a flea-related Rickettsia with unknown pathogenicity to humans. We detected R. asembonensis DNA in 2 of 1,153 human blood samples in Zambia. Our findings suggest the possibility of R. asembonensis infection in humans despite its unknown pathogenicity
Female Genital Schistosomiasis (FGS) Prevalence and Burden Across Endemic Countries, Timelines, and Age Groups: A Retrospective Study
No full textFemale Genital Schistosomiasis (FGS) is caused by Schistosoma haematobium, which causes chronic gynecological conditions that lead to substantial morbidity and infertility. This study’s objective is to determine the prevalence and burden of FGS based on the presence of S. haematobium-specific DNA in females across age groups using our previously field-acquired filtered human urine samples from Zambia, Tanzania, and Ghana, collected over multiple years. For Ghana (2013), 39 out of 90 samples were from females, of which 31 (79.5%) were positive and 8 (20.5%) were negative. In Zambia (2016), 80 out of 133 samples were from females, of which 46 (57.5%) tested positive and 34 (42.5%) were negative. For Zambia (2017), 60 out of 110 samples were from females, of which 45 (75%) tested positive and 15 (25%) tested negative. In Tanzania (2018), 70 out of 104 samples were from females, of which 43 (61.4%) tested positive and 27 (38.6%) tested negative. FGS prevalence ranged from 57.5% (Zambia in 2016) to 79.5% (Ghana in 2013) and was found predominantly among the 11–20 years age group. The analytical outcome highlights that FGS is predominant among females in different endemic countries and in the age range of pre-teen to young adult
A case report: primary amoebic meningoencephalitis in a young Zambian adult
No full textAbstract Background Primary amoebic meningoencephalitis (PAM) is a fulminant disease of the brain caused by Naegleria fowleri. Although the disease is rare, the case fatality rate is very high. In this report, we describe the first case of PAM in Zambia. Case presentation The patient presented with sudden onset of seizures and fever on admission. On physical examination he was febrile, comatose and with a stiff neck. Cerebral spinal fluid (CSF) collected on admission did not reveal any organism on microscopy or culture but showed elevated white cell count. A working diagnosis of severe septicemia with acute meningoencephalitis was then made and the patient was started on IV Cephtriaxone (2 g) twice daily. Despite receiving treatment, his condition deteriorated. A second CSF sample collected on day 3 was also negative for bacteria and other organisms. However, a repeat CSF sample collected on day 8 revealed numerous motile organisms that were identified as Naegleria on microscopy and confirmed to be N. fowleri on polymerase chain reaction. The patient died on day 8 of hospital admission after having received one dose of Amphotericin B (50 mg). Features consistent with PAM were detected on autopsy. Conclusion The isolation of N. fowleri in this patient calls for increased awareness among clinical and laboratory staff on suspected PAM cases to promptly diagnose and effectively manage the disease
Molecular characterization of
No full textCryptosporidium is a major etiological agent of diarrhoeal diseases among children and immune-compromised individuals in sub-Saharan African countries. We conducted a study to determine the prevalence and genetic characteristics of Cryptosporidium spp. in stool samples from patients with diarrhoea who presented at the University Teaching Hospital in Lusaka, Zambia. Cryptosporidium species and subtypes from 71 microscopically confirmed cryptosporidiosis stool samples collected between 2017 and 2019 were determined by polymerase chain reaction followed by partial sequencing of the small subunit rRNA and 60-kDa glycoprotein (gp60) gene. Additionally, data for the period between 2014 and 2019 were reviewed and analysed for cryptosporidiosis seasonal and age distribution. Cryptosporidium was more prevalent in the rainy season. The highest number of cases was reported among the 1–4 year age group. By sequence analysis of the 71 positive isolates, Cryptosporidium hominis (n = 42; 59.2%), C. parvum (n = 27; 38%), C. felis (n = 1; 1.4%), and C. meleagridis (n = 1; 1.4%) were identified. Four C. hominis subtype families (Ia, Ib, Id, and Ie) and three C. parvum subtype families (IIc, IIe, and IIs) were identified. The most frequent subtypes were IeA11G3T3 (n = 20; 28.2%), IIcA5G3 (n = 12; 16.9%), IIeA12G1 (n = 11; 15.5%) and IaA30R3 (n = 10; 14.1%). The observed species/subtypes of C. hominis and C. parvum indicated that the infection was mainly transmitted through the anthroponotic route. The identification of C. felis and C. meleagridis suggests that an atypical zoonotic transmission cycle also exists
Prevalence of schistosome antibodies with hepatosplenic signs and symptoms among patients from Kaoma, Western Province, Zambia
No full text
Escherichia coli Antimicrobial Susceptibility Reduction amongst HIV-Infected Individuals at the University Teaching Hospital, Lusaka, Zambia
No full textIncreased antimicrobial resistance among Human Immunodeficiency Virus (HIV)-infected individuals to commonly used antibiotics in the treatment of gastroenteritis is a public health concern, especially in resource-limited settings. We set out to compare the antimicrobial susceptibility pattern of Escherichia coli (E. coli) isolates from HIV-infected and HIV-uninfected individuals at a tertiary hospital in Lusaka, Zambia. An analytical cross-sectional study was conducted at the University Teaching Hospital from May 2019 to August 2019. Stool samples were screened, and 79 HIV-infected individuals matched by age and sex with 84 HIV-uninfected individuals that presented with E. coli associated gastroenteritis were studied. Demographics were collected from the Laboratory Information System (LIS) and stool samples were collected in a sterile leak-proof container. Samples were cultured and only those where E. coli was isolated were included in the study and tested for antimicrobial susceptibility by the Kirby–Bauer disk diffusion technique. HIV-positive individuals were 3 times (adjusted odds ratio (AOR) = 3.17; 95% CI (1.51, 6.66); p < 0.001) more likely to be resistant to quinolones compared with their HIV-negative counterparts. Similarly, HIV-positive individuals were almost 4 times (AOR = 3.97, 95% CI (1.37, 11.46); p = 0.011) more likely to have multidrug-resistant E. coli compared with those who were HIV-negative. HIV infection was associated with reduced E. coli susceptibility to commonly used antibiotics, and most cases showed resistance
