Sample records for clinical african trypanosomiasis

  1. Expression and role of CXCL10 during the encephalitic stage of experimental and clinical African trypanosomiasis

    Amin, Daniel N; Rottenberg, Martin E; Thomsen, Allan R; Mumba, Dieudonné; Fenger, Christina; Kristensson, Krister; Büscher, Philippe; Finsen, Bente; Masocha, Willias


    BACKGROUND: Human African trypanosomiasis, caused by Trypanosoma brucei, involves an early hemolymphatic stage followed by a late encephalitic stage. METHODS: We studied the expression of chemokines with use of microarray and enzyme-linked immunosorbent assay in T. brucei brucei-infected mice and...... in patients with human African trypanosomiasis and examined their role in controlling brain accumulation of T cells and parasites. RESULTS: The messenger RNAs (mRNAs) encoding CXCR3 ligands CXCL9 and CXCL10 demonstrated the greatest increases among chemokines in brain specimens of infected mice, as...... reduced accumulation of trypanosomes and T cells in the brain parenchyma but similar parasitemia levels, compared with wild-type mice. CXCL10 and IFN-gamma levels were increased in the cerebrospinal fluid of patients with late stage but not early stage human African trypanosomiasis. Levels of CXCL10 in...

  2. African Trypanosomiasis Detection using Dempster-Shafer Theory


    World Health Organization reports that African Trypanosomiasis affects mostly poor populations living in remote rural areas of Africa that can be fatal if properly not treated. This paper presents Dempster-Shafer Theory for the detection of African trypanosomiasis. Sustainable elimination of African trypanosomiasis as a public-health problem is feasible and requires continuous efforts and innovative approaches. In this research, we implement Dempster-Shafer theory for detecting African trypan...

  3. Orchitis as an unusual manifestation of human African trypanosomiasis.

    Ehrhardt, Stephan; Lippert, Ute; Burchard, Gerd D; Sudeck, Hinrich


    African trypanosomiasis is a re-emerging disease. We report the case of an African patient whose predominant symptom was infertility due to a granulomatous orchitis. The patient was afebrile and had not been in Africa for years. Lymphadenopathy and splenomegaly led us eventually to the diagnosis of sleeping sickness. After treatment with suramin his spermiogram returned to normal. Sleeping sickness evolves through clinically different stages and leads to death if left untreated. The disease may, however, present clinically extremely variable and may thus be difficult to diagnose. PMID:15936085

  4. Human African Trypanosomiasis Transmission, Kinshasa, Democratic Republic of Congo

    Diabakana, Philemon Mansinsa; Mesu, Victor Kande Betu Ku; Manzambi, Emile Zola; Ollivier, Gaelle; Asonganyi, Tazoacha; Cuny, Gerard; Grébaut, Pascal


    To investigate the epidemiology of human African trypanosomiasis (sleeping sickness) in Kinshasa, Democratic Republic of Congo, 2 entomologic surveys were conducted in 2005. Trypanosoma brucei gambiense and human-blood meals were found in tsetse fly midguts, which suggested active disease transmission. Vector control should be used to improve human African trypanosomiasis control efforts. PMID:17326955

  5. African Trypanosomiasis Detection using Dempster-Shafer Theory

    Maseleno, Andino


    World Health Organization reports that African Trypanosomiasis affects mostly poor populations living in remote rural areas of Africa that can be fatal if properly not treated. This paper presents Dempster-Shafer Theory for the detection of African trypanosomiasis. Sustainable elimination of African trypanosomiasis as a public-health problem is feasible and requires continuous efforts and innovative approaches. In this research, we implement Dempster-Shafer theory for detecting African trypanosomiasis and displaying the result of detection process. We describe eleven symptoms as major symptoms which include fever, red urine, skin rash, paralysis, headache, bleeding around the bite, joint the paint, swollen lymph nodes, sleep disturbances, meningitis and arthritis. Dempster-Shafer theory to quantify the degree of belief, our approach uses Dempster-Shafer theory to combine beliefs under conditions of uncertainty and ignorance, and allows quantitative measurement of the belief and plausibility in our identificat...

  6. Research priorities for Chagas disease, human African trypanosomiasis and leishmaniasis.


    This report provides a review and analysis of the research landscape for three diseases - Chagas disease, human African trypanosomiasis and leishmaniasis - that disproportionately afflict poor and remote populations with limited access to health services. It represents the work of the disease reference group on Chagas Disease, Human African Trypanosomiasis and Leishmaniasis (DRG3) which was established to identify key research priorities through review of research evidence and input from stakeholders' consultations. The diseases, which are caused by related protozoan parasites, are described in terms of their epidemiology and diseases burden, clinical forms and pathogenesis, HIV coinfection, diagnosis, drugs and drug resistance, vaccines, vector control, and health-care interventions. Priority areas for research are identified based on criteria such as public health relevance, benefit and impact on poor populations and equity, and feasibility. The priorities are found in the areas of diagnostics, drugs, vector control, asymptomatic infection, economic analysis of treatment and vector control methods, and in some specific issues such as surveillance methods or transmission-blocking vaccines for particular diseases. This report will be useful to researchers, policy and decision-makers, funding bodies, implementation organizations, and civil society. This is one of ten disease and thematic reference group reports that have come out of the TDR Think Tank, all of which have contributed to the development of the Global Report for Research on Infectious Diseases of Poverty, available at: PMID:23484340

  7. Immunology and immunopathology of African trypanosomiasis

    Philippe Vincendeau


    Full Text Available Major modifications of immune system have been observed in African trypanosomiasis. These immune reactions do not lead to protection and are also involved in immunopathology disorders. The major surface component (variable surface glycoprotein,VSG is associated with escape to immune reactions, cytokine network dysfunctions and autoantibody production. Most of our knowledge result from experimental trypanosomiasis. Innate resistance elements have been characterised. In infected mice, VSG preferentially stimulates a Th 1-cell subset. A response of gd and CD8 T cells to trypanosome antigens was observed in trypanotolerant cattle. An increase in CD5 B cells, responsible for most serum IgM and production of autoantibodies has been noted in infected cattle. Macrophages play important roles in trypanosomiasis, in synergy with antibodies (phagocytosis and by secreting various molecules (radicals, cytokines, prostaglandins,.... Trypanosomes are highly sensitive to TNF-alpha, reactive oxygen and nitrogen intermediates. TNF-alpha is also involved in cachexia. IFN-gamma acts as a parasite growth factor. These various elements contribute to immunosuppression. Trypanosomes have learnt to use immune mechanisms to its own profit. Recent data show the importance of alternative macrophage activation, including arginase induction. L-ornithine produced by host arginase is essential to parasite growth. All these data reflect the deep insight into the immune system realised by trypanosomes and might suggest interference therapeutic approaches.Modificações importantes no sistema imune são observadas na tripanosomíase Africana. Essas reações imunológicas não protegem e estão envolvidas em distúrbios imunopatológicos. O principal componente de superfície (glicoproteína variante de superfície, VSG está associado à evasão das respostas imune, às disfunções da rede de citocinas e à produção de autoanticorpos. Muitos de nossos conhecimentos resultam

  8. The detection and treatment of human African trypanosomiasis

    Bouteille B


    Full Text Available Bernard Bouteille,1 Alain Buguet21Laboratory of Parasitology, Dupuytren University Hospital of Limoges, France; 2Polyclinic Marie-Louise Poto-Djembo, Pointe-Noire, CongoAbstract: Human African trypanosomiasis (HAT is caused by the injection of Trypanosoma brucei (T. b. gambiense or T. b. rhodesiense by Glossina, the tsetse fly. Three historical eras followed the exclusive clinical approach of the 19th century. At the turn of the century, the “initial research” era was initiated because of the dramatic spread of HAT throughout intertropical Africa, and scientists discovered the agent and its vector. Two entities, recurrent fever and sleeping sickness, were then considered a continuum between hemolymphatic stage 1 and meningoencephalitic stage 2. Treatments were developed. Soon after World War I, specific services and mobile teams were created, initiating the “epidemiological” era, during which populations were visited, screened, and treated. As a result, by 1960, annual new cases were rare. New mass screening and staging tools were then developed in a third, “modern” era, especially to counter a new epidemic wave. Currently, diagnosis still relies on microscopic detection of trypanosomes without (wet and thick blood films or with concentration techniques (capillary tube centrifugation, miniature anion-exchange centrifugation technique. Staging is a vital step.Stage 1 patients are treated on site with pentamidine or suramin. However, stage 2 patients are treated in specialized facilities, using drugs that are highly toxic and/or that require complex administration procedures (melarsoprol, eflornithine, or nifurtimox-eflornithine combination therapy. Suramin and melarsoprol are the only medications active against Rhodesian HAT. Staging still relies on cerebrospinal fluid examination for trypanosome detection and white blood cell counts: stage 1, absence of trypanosomes, white blood cell counts ≤ 5/µL; stage 2, presence of

  9. Bioluminescence Imaging to Detect Late Stage Infection of African Trypanosomiasis.

    Burrell-Saward, Hollie; Ward, Theresa H


    Human African trypanosomiasis (HAT) is a multi-stage disease that manifests in two stages; an early blood stage and a late stage when the parasite invades the central nervous system (CNS). In vivo study of the late stage has been limited as traditional methodologies require the removal of the brain to determine the presence of the parasites. Bioluminescence imaging is a non-invasive, highly sensitive form of optical imaging that enables the visualization of a luciferase-transfected pathogen in real-time. By using a transfected trypanosome strain that has the ability to produce late stage disease in mice we are able to study the kinetics of a CNS infection in a single animal throughout the course of infection, as well as observe the movement and dissemination of a systemic infection. Here we describe a robust protocol to study CNS infections using a bioluminescence model of African trypanosomiasis, providing real time non-invasive observations which can be further analyzed with optional downstream approaches. PMID:27284970

  10. Determinants of Human African Trypanosomiasis Elimination via Paratransgenesis.

    Jennifer A Gilbert


    Full Text Available Human African trypanosomiasis (HAT, transmitted by tsetse flies, has historically infected hundreds of thousands of individuals annually in sub-Saharan Africa. Over the last decade, concerted control efforts have reduced reported cases to below 10,000 annually, bringing complete elimination within reach. A potential technology to eliminate HAT involves rendering the flies resistant to trypanosome infection. This approach can be achieved through the introduction of transgenic Sodalis symbiotic bacteria that have been modified to produce a trypanocide, and propagated via Wolbachia symbionts, which confer a reproductive advantage to the paratransgenic tsetse. However, the population dynamics of these symbionts within tsetse flies have not yet been evaluated. Specifically, the key factors that determine the effectiveness of paratransgenesis have yet to be quantified. To identify the impact of these determinants on T.b. gambiense and T.b. rhodesiense transmission, we developed a mathematical model of trypanosome transmission that incorporates tsetse and symbiont population dynamics. We found that fecundity and mortality penalties associated with Wolbachia or recombinant Sodalis colonization, probabilities of vertical transmission, and tsetse migration rates are fundamental to the feasibility of HAT elimination. For example, we determined that HAT elimination could be sustained over 25 years when Wolbachia colonization minimally impacted fecundity or mortality, and when the probability of recombinant Sodalis vertical transmission exceeded 99.9%. We also found that for a narrow range of recombinant Sodalis vertical transmission probability (99.9-90.6% for T.b. gambiense and 99.9-85.8% for T.b. rhodesiense, cumulative HAT incidence was reduced between 30% and 1% for T.b. gambiense and between 21% and 3% for T.b. rhodesiense, although elimination was not predicted. Our findings indicate that fitness and mortality penalties associated with paratransgenic

  11. Challenges in Diagnosing Human African Trypanosomiasis: Evaluation of the MSF OCG project in Dingila, DRC

    Van Nieuwenhove, Simon


    Between late 2010 and the end of 2014 and under extremely difficult conditions, Médecins sans Frontières (MSF) carried out a project to combat Human African Trypanosomiasis (HAT), also known as sleeping sickness, in the Dingila, Ango and Zobia regions of Orientale Province in the Democratic Republic of Congo (DRC). HAT in DRC is caused by Trypanosoma brucei gambiense and is transmitted by the tsetse fly (Glossina genus) of the Palpalis group. Without effective treatment, virtually all f...

  12. The FAO programme for the control of African animal trypanosomiasis and related development

    The FAO proposal for a long-term Programme for the Control of African Animal Trypanosomiasis and Related Development was presented to the World Food Conference in November 1974. A recommendation was adopted that the programme should be implemented as a matter of urgency and should receive high priority in the FAO programme of work and budget. Following recommendations of support by FAO statutory bodies the preparatory phase, which led to implementation of a large-scale programme, was launched in 1980

  13. Syndromic algorithms for detection of gambiense human african trypanosomiasis in South Sudan.

    Palmer, JJ; Surur, EI; Goch, GW; Mayen, MA; Lindner, AK; Pittet, A.; Kasparian, S; Checchi, F.; Whitty, CJ


    BACKGROUND Active screening by mobile teams is considered the best method for detecting human African trypanosomiasis (HAT) caused by Trypanosoma brucei gambiense but the current funding context in many post-conflict countries limits this approach. As an alternative, non-specialist health care workers (HCWs) in peripheral health facilities could be trained to identify potential cases who need testing based on their symptoms. We explored the predictive value of syndromic referral algorithms to...

  14. Human African Trypanosomiasis in South Sudan: How Can We Prevent a New Epidemic?

    Ruiz-Postigo, José A; José R Franco; Mounir Lado; Pere P Simarro


    Human African trypanosomiasis (HAT) has been a major public health problem in South Sudan for the last century. Recurrent outbreaks with a repetitive pattern of responding-scaling down activities have been observed. Control measures for outbreak response were reduced when the prevalence decreased and/or socio-political crisis erupted, leading to a new increase in the number of cases. This paper aims to raise international awareness of the threat of another outbreak of sleeping sickness in Sou...

  15. Human African Trypanosomiasis in a Traveler: Diagnostic Pitfalls

    Meltzer, Eyal; Leshem, Eyal; Steinlauf, Shmuel; MICHAELI, SHULAMIT; Sidi, Yechezkel; Schwartz, Eli


    An Israeli traveler returning from Tanzania presented with a relapsing febrile illness. A diagnosis of Trypanosoma brucei rhodesiense infection was established by blood smear after nearly a month. Blood polymerase chain reaction failed to provide an early diagnosis of human African trypanososmiasis. Recognition of suggestive signs should prompt physicians to perform repeated tests before ruling out human African trypanososmiasis.

  16. Genome sequence of the tsetse fly (Glossina morsitans ): Vector of African trypanosomiasis

    Watanabe, Junichi


    Tsetse flies are the sole vectors of human African trypanosomiasis throughout sub-Saharan Africa. Both sexes of adult tsetse feed exclusively on blood and contribute to disease transmission. Notable differences between tsetse and other disease vectors include obligate microbial symbioses, viviparous reproduction, and lactation. Here, we describe the sequence and annotation of the 366-megabase Glossina morsitans morsitans genome. Analysis of the genome and the 12,308 predicted protein-encoding genes led to multiple discoveries, including chromosomal integrations of bacterial (Wolbachia) genome sequences, a family of lactation-specific proteins, reduced complement of host pathogen recognition proteins, and reduced olfaction/chemosensory associated genes. These genome data provide a foundation for research into trypanosomiasis prevention and yield important insights with broad implications for multiple aspects of tsetse biology.

  17. The changing epidemiology of human African trypanosomiasis among patients from nonendemic countries--1902-2012.

    Ami Neuberger

    Full Text Available BACKGROUND: Although human African trypanosomiasis (HAT is uncommon among patients from non-endemic countries (NEC, there has been an increase in the number of cases reported in recent years. METHODS: A systematic review of the literature was performed. The number of incoming tourists to HAT endemic countries was obtained from the United Nations World Tourism Organization. All HAT cases diagnosed in patients from NEC were included. Immigrants and refugees were excluded. We compared patients during and after the colonial period, and analyzed the relationship between the number of incoming travellers and the number of HAT cases. RESULTS: Between 1902 and 2012, HAT was reported in 244 patients. Most HAT cases were reported before 1920, and after the year 2000. In the colonial era the average age of patients was lower (32.5±7.8 vs. 43.0±16.1 years, P<0.001, the proportion of females was lower (10.0% vs. 23.9%, P<0.01], most cases were diagnosed in expatriates, missionaries and soldiers (74.3%, and Gambian trypanosomiasis accounted for 86/110, (78% of cases. In the post-colonial era most patients 91/125 (72.8% were short-term tourists to game parks in Eastern and South-Eastern Africa (mainly in Tanzania; Rhodesian trypanosomiasis accounted for 94/123 (76.4% of cases. Between 1995 and 2010 there has been a constant linear increase in the number of incoming tourists to Tanzania, and HAT cases occurred in small outbreaks rather than following a similar linear pattern. CONCLUSIONS: In recent decades HAT patients from NEC are older, and more likely to be tourists who acquired the disease while visiting game-parks in Eastern and South-Eastern Africa. While Rhodesian trypanosomiasis is relatively uncommon among Africans, it now accounts for most cases reported among patients from NEC. Returning febrile travellers without an alternative diagnosis should be evaluated for HAT. Cases among travellers may serve as sentinels for Rhodesian trypanosomiasis "hot

  18. Therapeutic evaluation of Acacia nilotica (Linn stem bark extract in experimental African trypanosomiasis

    E O Ogbadoyi


    Full Text Available Summary: Chemotherapy of African trypanosomiasis still remains far from being satisfactory, being severely limited by a number of factors including unacceptable toxicity, increasing parasite resistance, high cost and unavailability. There is an urgent need for therapeutic agents that are effective, affordable and accessible to the rural poor in Africa who bear most of the disease burden. The objective of this study was to evaluate the therapeutic effects of Acacia nilotica in experimental Trypanosoma brucei brucei infection in mice.  Methanol extract of stem bark of the plant was investigated for its therapeutic effects in experimental African trypanosomiasis. Acute toxicity studies were also conducted. Crude extract of 70% v/v (Methanol/Water at a dose of 400mg kg-1 body weight per day completely cured the experimental T.b. brucei infection in mice, while doses of 50, 100, 200, 300, and 400mgkg-1 body weight per day of the partially purified extract completely cured the experimental infection in mice within two days.  Sub inoculation of blood and cerebrospinal fluid drawn from the cured mice into healthy mice failed to produce any infection within 28 days of post inoculation. Phytochemical analysis showed the presence of carbohydrates, saponin, tannin and cardiac glycoside. LD50 of the partially purified extract was found to be 2000mg/kg body weight, the extract being acutely toxic at a dose of 1600mgkg-1 body weight. It is concluded that methanol extract of stem bark of A. nilotica cures experimental T. b. brucei infection in mice.   Industrial relevance: The findings in this study provide very useful clue for biopharmaceutical industries and drug manufacturers for the development of phytotherapeutic agents from this plant, not only for therapeutic intervention in the control of African trypanosomiasis but also for the treatment of cancer. This is because of the strong link between Chemotherapy of human African trypanosomiasis (sleeping

  19. LAMP for human African trypanosomiasis: a comparative study of detection formats.

    Sally L Wastling

    Full Text Available Loop-mediated isothermal amplification (LAMP is at the forefront of the search for innovative diagnostics for human African trypanosomiasis (HAT. Several simple endpoint detection methods have been developed for LAMP and here we compare four of these: (i visualization of turbidity; (ii addition of hydroxynaphthol blue before incubation; (iii addition of calcein with MnCl₂ before incubation and (iv addition of Quant-iT PicoGreen after incubation. These four methods were applied to four LAMP assays for the detection of human African trypanosomiasis, including two Trypanozoon specific and two Trypanosoma brucei rhodesiense specific reactions using DNA extracted from cryo-preserved procyclic form T. b. rhodesiense. A multi-observer study was performed to assess inter-observer reliability of two of these methods: hydroxynapthol blue and calcein with MnCl₂, using DNA prepared from blood samples stored on Whatman FTA cards. Results showed that hydroxynaphthol blue was the best of the compared methods for easy, inexpensive, accurate and reliable interpretation of LAMP assays for HAT. Hydroxynapthol blue generates a violet to sky blue colour change that was easy to see and was consistently interpreted by independent observers. Visible turbidity detection is not possible for all currently available HAT LAMP reactions; Quant-iT PicoGreen is expensive and addition of calcein with MnCl₂ adversely affects reaction sensitivity and was unpopular with several observers.

  20. Improving the diagnosis and control of trypanosomiasis and other vector-borne diseases of African livestock using immunoassay methods

    This publication contains the results presented by the participants of the Co-ordinated Research Programme (CRP) on improving the diagnosis and control of trypanosomiasis and other vector-borne diseases of African livestock using immunoassay methods. The CRP lasted from 1987 until 1992. The individual contributions have been indexed separately. Refs, figs and tabs

  1. Human African trypanosomiasis prevention, treatment and control costs: a systematic review.

    Keating, Joseph; Yukich, Joshua O; Sutherland, C Simone; Woods, Geordie; Tediosi, Fabrizio


    The control and eventual elimination of human African trypanosomiasis (HAT) requires the expansion of current control and surveillance activities. A systematic review of the published literature on the costs of HAT prevention, treatment, and control, in addition to the economic burden, was conducted. All studies that contained primary or secondary data on costs of prevention, treatment and control were considered, resulting in the inclusion of 42 papers. The geographically focal nature of the disease and a lack of standardization in the cost data limit the usefulness of the available information for making generalizations across diverse settings. More recent information on the costs of treatment and control interventions for HAT is needed to provide accurate information for analyses and planning. The cost information contained herein can be used to inform rational decision making in control and elimination programs, and to assess potential synergies with existing vector-borne disease control programs, but programs would benefit significantly from new cost data collection. PMID:26056739

  2. Evaluation of the diagnostic accuracy of prototype rapid tests for human African trypanosomiasis.

    Jeremy M Sternberg


    Full Text Available Diagnosis of human African trypanosomiasis (HAT remains a challenge both for active screening, which is critical in control of the disease, and in the point-of-care scenario where early and accurate diagnosis is essential. Recently, the first field deployment of a lateral flow rapid diagnostic test (RDT for HAT, "SD BIOLINE HAT" has taken place. In this study, we evaluated the performance of "SD BIOLINE HAT" and two new prototype RDTs.The performance of "SD BIOLINE HAT" and 2 prototype RDTs was tested using archived plasma from 250 Trypanosoma brucei gambiense patients, and 250 endemic controls. As well as comparison of the sensitivity and specificity of each device, the performance of individual antigens was assessed and the hypothetical performance of novel antigen combinations extrapolated. Neither of the prototype devices were inferior in sensitivity or specificity to "SD BIOLINE HAT" (sensitivity 0.82±0.01, specificity 0.97±0.01, 95% CI at the 5% margins, while one of the devices (BBI had significantly superior sensitivity (0.88±0.03. Analysis of the performance of individual antigens was used to model new antigen combinations to be explored in development of the next generation of HAT RDTs. The modelling showed that an RDT using two recombinant antigens (rLiTat1.5 and rISG65 would give a performance similar to the best devices in this study, and would also offer the most robust performance under deteriorating field conditions.Both "SD BIOLINE HAT" and the prototype devices performed comparably well to one another and also to the published performance range of the card agglutination test for trypanosomiasis in sensitivity and specificity. The performance of individual antigens enabled us to predict that an all-recombinant antigen RDT can be developed with an accuracy equivalent to " SD BIOLINE HAT." Such an RDT would have advantages in simplified manufacture, lower unit cost and assured reproducibility.

  3. Trypanosomiasis in Red Sokoto and West African Dwarf Goats at Ikpa Abattoir, Nsukka, Enugu State, Nigeria

    Okafor Obioma Juliet


    Full Text Available Goat serves as a major investment to most homes in Nigeria, mainly for provision of animal protein and income. The output of this animal is disturbed by Tsetse infestation which is the primary vector of Trypanosome. A survey of Trypanosomiasis of goat in Ikpa abattoir Nsukka, Enugu State, Nigeria was carried out between September and October 2010. This was aimed at determining the species of Trypanosome prevalent in the area and their infection rates among breeds of goat. 106 goats were sampled, among which 15(14.1% were positive for Trypanosome infection. The infection rates among the goat breeds were; Sokoto red (10.4% and West African Dwarf Goat (50.0%. The species of Trypanosome encountered were Trypanosoma vivax(66.7% and Trypanosoma brucei (33.3%. In the infection by sex, this was common among female goats in the various breeds examined and this stood as follows; 9.4% in Sokoto red and 4.7% in West African Dwarf goat. Considering the overall infection rate of Trypanosome in the breeds of goat in the study area, this was relatively high when compared with similar results in related areas; chemo prophylactic and insect control measures should be put in place to rescue the area.

  4. Identifying Transmission Cycles at the Human-Animal Interface: The Role of Animal Reservoirs in Maintaining Gambiense Human African Trypanosomiasis

    Sebastian Funk; Hiroshi Nishiura; Hans Heesterbeek; W. John Edmunds; Francesco Checchi


    Many infections can be transmitted between animals and humans. The epidemiological roles of different species can vary from important reservoirs to dead-end hosts. Here, we present a method to identify transmission cycles in different combinations of species from field data. We used this method to synthesise epidemiological and ecological data from Bipindi, Cameroon, a historical focus of gambiense Human African Trypanosomiasis (HAT, sleeping sickness), a disease that has often been considere...

  5. Cattle owners' perceptions of African bovine trypanosomiasis and its control in Busia and Kwale Districts of Kenya.

    Machila, Noreen; Wanyangu, Samuel W; McDermott, John; Welburn, Susan C; Maudlin, Ian; Eisler, Mark C


    A study using a structured questionnaire was conducted in Busia District, Western Kenya and Kwale District, Coastal Kenya to obtain qualitative and quantitative information from 256 cattle owners about their production systems, their perceptions of the diseases encountered in their cattle, the drugs used, and other measures adopted to control trypanosomiasis in cattle. The predominant production system was mixed crop-livestock with farmers owning 2-11 local cattle on holdings between 2 and 5 ha. Approximately 15% of disease episodes in cattle were perceived to be trypanosomiasis, although the farmers' ability to make diagnoses was limited in that over half of the diagnoses were inconsistent with the clinical signs described. Drugs were generally obtained from agro-veterinary shops, and the farmers themselves administered slightly more than half of these. One third of drug treatments given to sick cattle were trypanocides, but over half of these trypanocidal treatments were given to cattle believed to have diseases other than trypanosomiasis. PMID:12711100

  6. Human African trypanosomiasis in South Sudan: how can we prevent a new epidemic?

    José A Ruiz-Postigo

    Full Text Available Human African trypanosomiasis (HAT has been a major public health problem in South Sudan for the last century. Recurrent outbreaks with a repetitive pattern of responding-scaling down activities have been observed. Control measures for outbreak response were reduced when the prevalence decreased and/or socio-political crisis erupted, leading to a new increase in the number of cases. This paper aims to raise international awareness of the threat of another outbreak of sleeping sickness in South Sudan. It is a review of the available data, interventions over time, and current reports on the status of HAT in South Sudan. Since 2006, control interventions and treatments providing services for sleeping sickness have been reduced. Access to HAT diagnosis and treatment has been considerably diminished. The current status of control activities for HAT in South Sudan could lead to a new outbreak of the disease unless 1 the remaining competent personnel are used to train younger staff to resume surveillance and treatment in the centers where HAT activities have stopped, and 2 control of HAT continues to be given priority even when the number of cases has been substantially reduced. Failure to implement an effective and sustainable system for HAT control and surveillance will increase the risk of a new epidemic. That would cause considerable suffering for the affected population and would be an impediment to the socioeconomic development of South Sudan.

  7. Spatial distribution of African Animal Trypanosomiasis in Suba and Teso districts in Western Kenya

    Jung'a Joseph O


    Full Text Available Abstract Background Studies on the epidemiology of African Animal Trypanosomiasis (AAT rarely consider the spatial dimension of disease prevalence. This problem is confounded by use of parasitological diagnostic methods of low sensitivity in field surveys. Here we report a study combining highly sensitive and species specific molecular diagnostic methods, and Geographical information system (GIS for spatial analysis of trypanosome infection patterns, to better understand its epidemiology. Blood samples from 44 and 59 animals randomly selected from Teso and Suba districts respectively were screened for trypanosomes using PCR diagnostic assays. Spatial distribution of the positive cases was mapped and average nearest neighbour analysis used to determine the spatial pattern of trypanosome cases detected. Findings Trypanosome prevalence of 41% and 29% in Suba and Teso districts respectively was observed. T. vivax infections were most prevalent in both areas. Higher proportions of T. brucei infections (12% were observed in Suba, a known sleeping sickness foci compared with 2% in Teso. Average nearest neighbour analysis showed the pattern of trypanosome infections as random. An overlay with tsetse maps showed cases lying outside the tsetse infested areas, mostly being cases of T. vivax which is known to be transmitted both biologically by tsetse and mechanically by biting flies. Conclusion These findings suggest a need to design control strategies that target not just the biological vector tsetse, but also the parasite in cattle in order to clear the possibly mechanically transmitted T. vivax infections. There is need to also review the accuracy of available tsetse maps.

  8. Development of multiplex serological assay for the detection of human African trypanosomiasis.

    Nzou, Samson Muuo; Fujii, Yoshito; Miura, Masashi; Mwau, Matilu; Mwangi, Anne Wanjiru; Itoh, Makoto; Salam, Md Abdus; Hamano, Shinjiro; Hirayama, Kenji; Kaneko, Satoshi


    Human African trypanosomiasis (HAT) is a disease caused by Kinetoplastid infection. Serological tests are useful for epidemiological surveillance. The aim of this study was to develop a multiplex serological assay for HAT to assess the diagnostic value of selected HAT antigens for sero-epidemiological surveillance. We cloned loci encoding eight antigens from Trypanosoma brucei gambiense, expressed the genes in bacterial systems, and purified the resulting proteins. Antigens were subjected to Luminex multiplex assays using sera from HAT and VL patients to assess the antigens' immunodiagnostic potential. Among T. b. gambiense antigens, the 64-kDa and 65-kDa invariant surface glycoproteins (ISGs) and flagellar calcium binding protein (FCaBP) had high sensitivity for sera from T. b. gambiense patients, yielding AUC values of 0.871, 0.737 and 0.858 respectively in receiver operating characteristics (ROC) analysis. The ISG64, ISG65, and FCaBP antigens were partially cross-reactive to sera from Trypanosoma brucei rhodesiense patients. The GM6 antigen was cross-reactive to sera from T. b. rhodesiense patients as well as to sera from VL patients. Furthermore, heterogeneous antibody responses to each individual HAT antigen were observed. Testing for multiple HAT antigens in the same panel allowed specific and sensitive detection. Our results demonstrate the utility of applying multiplex assays for development and evaluation of HAT antigens for use in sero-epidemiological surveillance. PMID:26519611

  9. Development of a nanoparticulate formulation of diminazene to treat African trypanosomiasis

    Kroubi, Maya; Betbeder, Didier [EA 4483, IFR 114 IMPRT, Faculte de Medecine, Pole recherche, Departement de Physiologie, 1 place de Verdun, 59045 Lille Cedex (France); Daulouede, Sylvie; Mossalayi, Djavad; Vincendeau, Philippe [Laboratoire de Parasitologie, Universite Victor Segalen Bordeaux 2, 146 rue Leo Saignat, 33076 Bordeaux Cedex (France); Karembe, Hamadi [CEVA Sante Animale, ZI la Ballastiere, BP 126, 33501 Libourne (France); Jallouli, Youssef [Faculte de Pharmacie, Universite de Lille 2, 3 rue du Professeur Laguesse, 59006 Lille (France); Howsam, Mike, E-mail: [Centre Universitaire de Mesure et d' Analyse, Faculte de Pharmacie, Universite de Lille 2, 3 rue du Professeur Laguesse, 59006 Lille (France)


    There is a real need to develop new therapeutic strategies for African trypanosomiasis infections. In our study, we developed a new drug delivery system of diminazene (DMZ), a trypanocidal drug registered for veterinary use. This drug candidate presents a limited efficacy, a poor affinity for brain tissue and instability. The development of colloidal formulations based on a porous cationic nanoparticle with an oily core ({sub 70}DGNP{sup +}), has potentially two advantages: stabilization of the drug and potential targeting of the parasite. We analyzed two processes of drug loading: in process (DMZ was added during the preparation of {sub 70}DGNP{sup +} at 80 deg. C) and post-loading (DMZ was mixed with a {sub 70}DGNP{sup +} solution at room temperature). Poor stability of the drug was observed using the in process technique. When using the post-loading technique over 80% drug entrapment efficiency was obtained at a ratio of DMZ:phospholipids (wt:wt) < 5%. Moreover, DMZ loaded into {sub 70}DGNP{sup +} was found to be protected against oxidation and was stable for at least six months at 4 deg. C. Finally, in vitro tests on T.b. brucei showed an increased efficacy of DMZ loaded in {sub 70}DGNP{sup +}.

  10. Syndromic algorithms for detection of gambiense human African trypanosomiasis in South Sudan.

    Jennifer J Palmer

    Full Text Available BACKGROUND: Active screening by mobile teams is considered the best method for detecting human African trypanosomiasis (HAT caused by Trypanosoma brucei gambiense but the current funding context in many post-conflict countries limits this approach. As an alternative, non-specialist health care workers (HCWs in peripheral health facilities could be trained to identify potential cases who need testing based on their symptoms. We explored the predictive value of syndromic referral algorithms to identify symptomatic cases of HAT among a treatment-seeking population in Nimule, South Sudan. METHODOLOGY/PRINCIPAL FINDINGS: Symptom data from 462 patients (27 cases presenting for a HAT test via passive screening over a 7 month period were collected to construct and evaluate over 14,000 four item syndromic algorithms considered simple enough to be used by peripheral HCWs. For comparison, algorithms developed in other settings were also tested on our data, and a panel of expert HAT clinicians were asked to make referral decisions based on the symptom dataset. The best performing algorithms consisted of three core symptoms (sleep problems, neurological problems and weight loss, with or without a history of oedema, cervical adenopathy or proximity to livestock. They had a sensitivity of 88.9-92.6%, a negative predictive value of up to 98.8% and a positive predictive value in this context of 8.4-8.7%. In terms of sensitivity, these out-performed more complex algorithms identified in other studies, as well as the expert panel. The best-performing algorithm is predicted to identify about 9/10 treatment-seeking HAT cases, though only 1/10 patients referred would test positive. CONCLUSIONS/SIGNIFICANCE: In the absence of regular active screening, improving referrals of HAT patients through other means is essential. Systematic use of syndromic algorithms by peripheral HCWs has the potential to increase case detection and would increase their participation in HAT

  11. Spatial predictions of Rhodesian Human African Trypanosomiasis (sleeping sickness prevalence in Kaberamaido and Dokolo, two newly affected districts of Uganda.

    Nicola A Batchelor

    Full Text Available The continued northwards spread of Rhodesian sleeping sickness or Human African Trypanosomiasis (HAT within Uganda is raising concerns of overlap with the Gambian form of the disease. Disease convergence would result in compromised diagnosis and treatment for HAT. Spatial determinants for HAT are poorly understood across small areas. This study examines the relationships between Rhodesian HAT and several environmental, climatic and social factors in two newly affected districts, Kaberamaido and Dokolo. A one-step logistic regression analysis of HAT prevalence and a two-step logistic regression method permitted separate analysis of both HAT occurrence and HAT prevalence. Both the occurrence and prevalence of HAT were negatively correlated with distance to the closest livestock market in all models. The significance of distance to the closest livestock market strongly indicates that HAT may have been introduced to this previously unaffected area via the movement of infected, untreated livestock from endemic areas. This illustrates the importance of the animal reservoir in disease transmission, and highlights the need for trypanosomiasis control in livestock and the stringent implementation of regulations requiring the treatment of cattle prior to sale at livestock markets to prevent any further spread of Rhodesian HAT within Uganda.

  12. Monitoring the use of nifurtimox-eflornithine combination therapy (NECT in the treatment of second stage gambiense human African trypanosomiasis

    Franco JR


    Full Text Available Jose R Franco,1 Pere P Simarro,1 Abdoulaye Diarra,2 Jose A Ruiz-Postigo,3 Mireille Samo,1 Jean G Jannin11World Health Organization, Control of Neglected Tropical Diseases, Innovative and Intensified Disease Management, Geneva, Switzerland; 2World Health Organization, Regional Office for Africa, Brazzaville, Congo; 3World Health Organization, Communicable Disease Control, Control of Tropical Diseases and Zoonoses Regional Office for the Eastern Mediterranean, Cairo, EgyptAbstract: After inclusion of the nifurtimox-eflornithine combination therapy (NECT in the Model List of Essential Medicines for the treatment of second-stage gambiense human African trypanosomiasis (HAT, the World Health Organization, in collaboration with National Sleeping Sickness Control Programs and nongovernmental organizations set up a pharmacovigilance system to assess the safety and efficacy of NECT during its routine use. Data were collected for 1735 patients treated with NECT in nine disease endemic countries during 2010–2011. At least one adverse event (AE was described in 1043 patients (60.1% and a total of 3060 AE were reported. Serious adverse events (SAE were reported for 19 patients (1.1% of treated, leading to nine deaths (case fatality rate of 0.5%. The most frequent AE were gastrointestinal disorders (vomiting/nausea and abdominal pain, followed by headache, musculoskeletal pains, and vertigo. The most frequent SAE and cause of death were convulsions, fever, and coma that were considered as reactive encephalopathy. Two hundred and sixty-two children below 15 years old were treated. The characteristics of AE were similar to adults, but the major AE were less frequent in children with only one SAE and no deaths registered in this group. Gastrointestinal problems (vomiting and abdominal pain were more frequent than in adults, but musculoskeletal pains, vertigo, asthenia, neuropsychiatric troubles (headaches, seizures, tremors, hallucinations, insomnia were less

  13. The molecular basis of livestock disease as illustrated by African trypanosomiasis

    African trypanosomes are protozoan parasites, most species of which are transmitted by tsetse flies. They reside in the mammalian bloodstream and evade the immune system by periodically switching the major protein on their surface - a phenomenon called antigenic variation, mediated by gene rearrangements in the trypanosome genome. The trypanosomes eventually enter the central nervous system and cause a fatal disease, commonly called ngana in domestic cattle and sleeping sickness in humans. Two sub-species of Trypanosoma brucei infect humans (T. b. rhodesiense and T. b. gambiense) and one sub-species does not survive in humans (T. b. brucei) because it is lysed by the human-specific serum protein, apolipoprotein L-I. Wild animals in Africa have other (less well understood) molecular mechanisms of suppressing the number of African trypanosomes in the blood, and some indigenous breeds of African cattle also display a partial 'trypanotolerance' whose genetic loci have recently been mapped. (author)

  14. Molecular Evidence of a Trypanosoma brucei gambiense Sylvatic Cycle in the Human African Trypanosomiasis Foci of Equatorial Guinea

    Carlos eCordon-Obras


    Full Text Available Gambiense trypanosomiasis is considered an anthroponotic disease. Consequently, control programs are generally aimed at stopping transmission of Trypanosoma brucei gambiense (T. b. gambiense by detecting and treating human cases. However, the persistence of numerous foci despite efforts to eliminate this disease questions this strategy as unique tool to pursue the eradication. The role of animals as a reservoir of T. b. gambiense is still controversial, but could partly explain maintenance of the infection at hypo-endemic levels. In the present study, we evaluated the presence of T. b. gambiense in wild animals in Equatorial Guinea. The infection rate ranged from 0.8% in the insular focus of Luba to more than 12% in Mbini, a focus with a constant trickle of human cases. The parasite was detected in a wide range of animal species including four species never described previously as putative reservoirs. Our study comes to reinforce the hypothesis that animals may play a role in the persistence of T. b. gambiense transmission, being particularly relevant in low transmission settings. Under these conditions the integration of sustained vector control and medical interventions should be considered to achieve the elimination of Gambiense trypanosomiasis.

  15. Genetically Distinct Glossina fuscipes fuscipes Populations in the Lake Kyoga Region of Uganda and Its Relevance for Human African Trypanosomiasis

    Richard Echodu


    Full Text Available Tsetse flies (Glossina spp. are the sole vectors of Trypanosoma brucei—the agent of human (HAT and animal (AAT trypanosomiasis. Glossina fuscipes fuscipes (Gff is the main vector species in Uganda—the only country where the two forms of HAT disease (rhodesiense and gambiense occur, with gambiense limited to the northwest. Gff populations cluster in three genetically distinct groups in northern, southern, and western Uganda, respectively, with a contact zone present in central Uganda. Understanding the dynamics of this contact zone is epidemiologically important as the merger of the two diseases is a major health concern. We used mitochondrial and microsatellite DNA data from Gff samples in the contact zone to understand its spatial extent and temporal stability. We show that this zone is relatively narrow, extending through central Uganda along major rivers with south to north introgression but displaying no sex-biased dispersal. Lack of obvious vicariant barriers suggests that either environmental conditions or reciprocal competitive exclusion could explain the patterns of genetic differentiation observed. Lack of admixture between northern and southern populations may prevent the sympatry of the two forms of HAT disease, although continued control efforts are needed to prevent the recolonization of tsetse-free regions by neighboring populations.

  16. Clinical and diagnostic study of trypanosomiasis of cattle in mosul, Iraq

    M. S. H. Rhaymah; B. A. AL-Badrani


    This study reported the occurrence of Trypanosoma vivax in cattle in Mosul, Iraq and its effect on their haemotology. The main clinical sings were anemia, lethargy, weakness, general weight loss and, loss of appetite. Blood samples from infected cattle were collected which showed decrease of hemoglobin concentration, packed cell volume and total erythrocytes count with leucopenia especially neutropenia and esonopenia. Blood smears showed short form of trypanos...

  17. Clinical and diagnostic study of trypanosomiasis of cattle in mosul, Iraq

    M. S. H. Rhaymah; B. A. AL-Badrani


    Full Text Available This study reported the occurrence of Trypanosoma vivax in cattle in Mosul, Iraq and its effect on their haemotology. The main clinical sings were anemia, lethargy, weakness, general weight loss and, loss of appetite. Blood samples from infected cattle were collected which showed decrease of hemoglobin concentration, packed cell volume and total erythrocytes count with leucopenia especially neutropenia and esonopenia. Blood smears showed short form of trypanosome in acute cases and long forms in chronic cases. Morphological changes of erythrocytes showed the presence of anisocytosis, poikelocytosis, target cells, macrocytes, punctuate basophile and sometimes monocytes. Anemia was basically normocytic normochromic. This study provides the baseline data for further studies on this parasite.

  18. Constraints in the Control of African Trypanosomiasis the Prevailing Factors in Kurmin Kaduna, Northern, Nigeria (Review Article

    Attahir Abubakar


    Full Text Available The aim of this review is to further highlight the prevailing factors in the control of African trypanosomosis in Nigeria. The effectiveness of trypanocides as a means of control is being curtailed by, wide spread drug resistance, lack of alternative drugs, multiple resistance, fake drugs,insufficient veterinary services, proliferation of quacks, high cost of trypanocides and the ability of the parasite to survive in cryptic foci poorly accessible to drugs. Trypanotolerance is a relative rather than absolute trait, severely affected by heavy challenge, malnutrition, stress, breed, age, season, and concurrent disease, Trypanotolerant breeds are poorly utilized and accepted because of their size, productivity and traction power compared with the large zebu breeds. Use of insecticide has been the most effective and reliable method of control but fear of emergence of resistance, cross resistance, environmental damage, accumulation in food chains with damaging effect on fertility etc constitute a major drawback on its use. Poor policies formulation and enforcement, human beliefs and behaviors, tsetse redistribution, mechanical transmitters and reservoire host has hindered effective control. The scanty inform ation on distribution, prevalence and economic impact of trypanosomosis in Nigeria, coupled with corruption, lack of community participation, inability to implement cost effective control strategies, these has resulted in the negative attitude of national governments and international funding organizations towards control of the disease, leading to collapse of many control projects. There is no control method that can be used alone; rather a combination of different control methods has proven effective due to the social, economical and cultural behaviors of Nigerians.

  19. A mixed methods study of a health worker training intervention to increase syndromic referral for gambiense human African trypanosomiasis in South Sudan.

    Jennifer J Palmer


    Full Text Available BACKGROUND: Active screening by mobile teams is considered the most effective method for detecting gambiense-type human African trypanosomiasis (HAT but constrained funding in many post-conflict countries limits this approach. Non-specialist health care workers (HCWs in peripheral health facilities could be trained to identify potential cases for testing based on symptoms. We tested a training intervention for HCWs in peripheral facilities in Nimule, South Sudan to increase knowledge of HAT symptomatology and the rate of syndromic referrals to a central screening and treatment centre. METHODOLOGY/PRINCIPAL FINDINGS: We trained 108 HCWs from 61/74 of the public, private and military peripheral health facilities in the county during six one-day workshops and assessed behaviour change using quantitative and qualitative methods. In four months prior to training, only 2/562 people passively screened for HAT were referred from a peripheral HCW (0 cases detected compared to 13/352 (2 cases detected in the four months after, a 6.5-fold increase in the referral rate observed by the hospital. Modest increases in absolute referrals received, however, concealed higher levels of referral activity in the periphery. HCWs in 71.4% of facilities followed-up had made referrals, incorporating new and pre-existing ideas about HAT case detection into referral practice. HCW knowledge scores of HAT symptoms improved across all demographic sub-groups. Of 71 HAT referrals made, two-thirds were from new referrers. Only 11 patients completed the referral, largely because of difficulties patients in remote areas faced accessing transportation. CONCLUSIONS/SIGNIFICANCE: The training increased knowledge and this led to more widespread appropriate HAT referrals from a low base. Many referrals were not completed, however. Increasing access to screening and/or diagnostic tests in the periphery will be needed for greater impact on case-detection in this context. These data

  20. Influence of Pastoralists' Sociocultural Activities on Tsetse-Trypanosome-Cattle Reservoir Interface: The Risk of Human African Trypanosomiasis in North-Central Nigeria.

    Alhaji, N B; Kabir, J


    The study investigated socio-cultural characteristics of pastoralists that influenced on the tsetse-trypanosome-cattle reservoir interface thereby predisposing them to HAT in Niger State, North-central Nigeria. It was a cross-sectional survey of adult pastoral herders, aged 30 years and above, and conducted between October 2012 and February 2013. A face-to-face structured questionnaire was administered on the pastoralists nested in 96 cattle herds with questions focused on pastoralists' socio-cultural activities and behavioral practices related to HAT risk. Descriptive and analytic statistics were used to describe the obtained data. A total of 384 pastoralists participated, with mean age of 49.6  ± 10.76 SD years. Male respondents constituted 86.7% of gender, while pastoralists of age group 40-49 years constituted 35.4% of respondents. About 59.4% of the pastoralists had knowledge about HAT and its symptoms and only 33.9% of them believed that cattle served as reservoir of HAT trypanosome. Knowledge/belief levels of the pastoralists about African trypanosomiasis occurrence in humans and animals were statistically significant. Males were four times more likely to be exposed to HAT (OR = 3.67; 95% CI: 1.42, 9.52); age group 60-69 was also four times more likely to be exposed (OR = 3.59; 95% CI: 1.56, 8.28); and nomadic pastoralists were two times more likely to be exposed to HAT (OR = 2.07; 95% CI: 1.37, 3.14). All cultural practices significantly influenced exposure to HAT with extensive husbandry system three times more likely to predisposed pastoralists to HAT (OR = 3.21; 95% CI: 1.65, 6.24). Socio-cultural characteristics of pastoralists influenced exposure to HAT risk and, therefore, there is a need to sensitize them to bring changes to their socio-cultural practices and perceptions to achieve effective and long term sustainable HAT control. Elimination strategies of parasites in animals and vectors should be considered to avoid reintroduction

  1. Overview of the Diagnostic Methods Used in the Field for Human African Trypanosomiasis: What Could Change in the Next Years?

    Julien Bonnet


    Full Text Available Sleeping sickness is a parasitic infection caused by two species of trypanosomes (Trypanosoma brucei gambiense and rhodesiense, transmitted by the tsetse fly. The disease eventually affects the central nervous system, resulting in severe neurological symptoms. Without treatment, death is inevitable. During the first stage of the disease, infected patients are mildly symptomatic and early detection of infection allows safer treatment (administered on an outpatient basis which can avoid death; routine screening of the exposed population is necessary, especially in areas of high endemicity. The current therapeutic treatment of this disease, especially in stage 2, can cause complications and requires a clinical surveillance for several days. A good stage diagnosis of the disease is the cornerstone for delivering the adequate treatment. The task faced by the medical personnel is further complicated by the lack of support from local health infrastructure, which is at best weak, but often nonexistent. Therefore it is crucial to look for new more efficient technics for the diagnosis of stage which are also best suited to use in the field, in areas not possessing high-level health facilities. This review, after an overview of the disease, summarizes the current diagnosis procedures and presents the advances in the field.

  2. Cerebral trypanosomiasis and AIDS

    Antunes Apio Claudio Martins


    Full Text Available A 36 year-old black female, complaining of headache of one month's duration presented with nausea, vomiting, somnolence, short memory problems, loss of weight, and no fever history. Smoker, intravenous drugs abuser, promiscuous lifestyle. Physical examination: left homonimous hemianopsia, left hemiparesis, no papilledema, diffuse hyperreflexia, slowness of movements. Brain CT scan: tumor-like lesion in the splenium of the corpus calosum, measuring 3.5 x 1.4 cm, with heterogeneous enhancing pattern, sugesting a primary CNS tumor. Due to the possibility of CNS infection, a lumbar puncture disclosed an opening pressure of 380 mmH(20; 11 white cells (lymphocytes; glucose 18 mg/dl (serum glucose 73 mg/dl; proteins 139 mg/dl; presence of Trypanosoma parasites. Serum Elisa-HIV tests turned out to be positive. Treatment with benznidazole dramatically improved clinical and radiographic picture, but the patient died 6 weeks later because of respiratory failure. T. cruzi infection of the CNS is a rare disease, but we have an increasing number of cases in HIV immunecompromised patients. Diagnosis by direct observation of CSF is uncommon, and most of the cases are diagnosed by pathological examination. It is a highly lethal disease, even when properly diagnosed and treated. This article intends to include cerebral trypanosomiasis in the differential diagnosis of intracranial space-occupying lesions, especially in immunecompromised patients from endemic regions.

  3. Improving the Quality of Host Country Ethical Oversight of International Research: The Use of a Collaborative 'Pre-Review' Mechanism for a Study of Fexinidazole for Human African Trypanosomiasis.

    Coleman, Carl H; Ardiot, Chantal; Blesson, Séverine; Bonnin, Yves; Bompart, Francois; Colonna, Pierre; Dhai, Ames; Ecuru, Julius; Edielu, Andrew; Hervé, Christian; Hirsch, François; Kouyaté, Bocar; Mamzer-Bruneel, Marie-France; Maoundé, Dionko; Martinent, Eric; Ntsiba, Honoré; Pelé, Gérard; Quéva, Gilles; Reinmund, Marie-Christine; Sarr, Samba Cor; Sepou, Abdoulaye; Tarral, Antoine; Tetimian, Djetodjide; Valverde, Olaf; Van Nieuwenhove, Simon; Strub-Wourgaft, Nathalie


    Developing countries face numerous barriers to conducting effective and efficient ethics reviews of international collaborative research. In addition to potentially overlooking important scientific and ethical considerations, inadequate or insufficiently trained ethics committees may insist on unwarranted changes to protocols that can impair a study's scientific or ethical validity. Moreover, poorly functioning review systems can impose substantial delays on the commencement of research, which needlessly undermine the development of new interventions for urgent medical needs. In response to these concerns, the Drugs for Neglected Diseases Initiative (DNDi), an independent nonprofit organization founded by a coalition of public sector and international organizations, developed a mechanism to facilitate more effective and efficient host country ethics review for a study of the use of fexinidazole for the treatment of late stage African Trypanosomiasis (HAT). The project involved the implementation of a novel 'pre-review' process of ethical oversight, conducted by an ad hoc committee of ethics committee representatives from African and European countries, in collaboration with internationally recognized scientific experts. This article examines the process and outcomes of this collaborative process. PMID:25039421

  4. Diagnosis of human trypanosomiasis, due to Trypanosoma brucei gambiense in central Africa, by the polymerase chain reaction

    Penchenier, Laurent; Simo, G.; Grébaut, Pascal; Nkinin, S.; Laveissière, Claude; Herder, Stéphane


    During a mass screening of sleeping sickness conducted in 1998 and 1999, and involving 27,932 persons in Cameroon and the Central African Republic, we tested the polymerase chain reaction (PCR) on whole blood for the diagnosis of human African trypanosomiasis due to #Trypanosoma brucei gambiense$. The 1858 samples obtained were from 4 groups : 155 infected patients, 1432 serological suspects detected by the card agglutination test for trypanosomiasis (CATT), 222 negative controls living in th...

  5. Clinical photography among African cleft caregivers

    Peter Babatunde Olaitan


    Full Text Available Objective: The aim of this paper is to document the practice of photography among clinicians whose daily work depends and is influenced so much by medical photography. Materials and Methods: Questionnaires documenting the bio data, place of practice, and experience of cleft caregivers with clinical photography were distributed. Knowledge of rules guiding clinical photography and adherence to them were also asked. Types of camera used were documented and knowledge of the value of clinical photographs were also inquired. Results: Plastic surgeons constitute the highest proportion of 27 (38.6%, followed by Oral and Maxillofacial surgeons with 14 (20.0%. Twenty one (30.0% of the respondents always, 21 (30.0% often, 12 (17.1% frequently, while 9 respondents sometimes took photographs of their patients. Suggested uses of clinical photographs included training, 52 (74.3%, education, 51 (72.9%, medicolegal, 44 (62.9% and advertisement, 44 (62.9% among others. Twenty two (31.4% did not know that there were standard guidelines for taking clinical photographs. Twenty three (32.9% of them did not seek the consent of the patients before taking clinical photographs. Conclusion: While the practice of clinical photography is high among African cleft caregivers, there is a need for further education on the issues of standard rules and obtaining consent from patients.

  6. African American women's perceptions of cancer clinical trials

    Haynes-Maslow, Lindsey; Godley, Paul; DiMartino, Lisa; White, Brandolyn; Odom, Janice; Richmond, Alan; Carpenter, William


    Cancer clinical trials are important for resolving cancer health disparities for several reasons; however, clinical trial participation among African Americans is significantly lower than Caucasians. This study engaged focus groups of 82 female African American cancer survivors or cancer caregivers, including those in better resourced, more urban areas and less resourced, more rural areas. Informed by an integrated conceptual model, the focus groups examined perceptions of cancer clinical tri...

  7. Clinical malaria in African pregnant women

    Aponte John


    Full Text Available Abstract Background There is a widespread notion, based on limited information, that in areas of stable malaria transmission most pregnant women with Plasmodium falciparum infection are asymptomatic. This study aim to characterize the clinical presentation of malaria in African pregnant women and to evaluate the adequacy of case management based on clinical complaints. Methods A hospital-based descriptive study between August 2003 and November 2005 was conducted at the maternity clinic of a rural hospital in Mozambique. All women attending the maternity clinic were invited to participate. A total of 2,330 women made 3,437 eligible visits, 3129 were analysed, the remainder were excluded because diagnostic results were unavailable or they were repeat visits. Women gave a standardized clinical history and had a medical exam. Malaria parasitaemia and haematocrit in capillary blood was determined for all women with signs or symptoms compatible with malaria including: presence and history of fever, arthromyalgias, headache, history of convulsions and pallor. Outcome measure was association of malaria symptoms or signs with positive blood slide for malaria parasitaemia. Results In 77.4% of visits pregnant women had symptoms suggestive of malaria; 23% (708/3129 were in the first trimester. Malaria parasitaemia was confirmed in 26.9% (842/3129 of visits. Headache, arthromyalgias and history of fever were the most common symptoms (86.5%, 74.8% and 65.4% presented, but their positive predictive values for malaria parasitaemia were low [28% (27–30, 29% (28–31, and 33% (31–35, respectively]. Conclusion Symptoms suggestive of malaria were very frequent among pregnant women attending a rural maternity clinic in an area of stable malaria transmission. However, less than a third of them were parasitaemic. In the absence of microscopy or rapid diagnostic tests, a large proportion of women, including those in the first trimester of gestation, would be

  8. Animal trypanosomiasis control in Uganda

    Uganda, with a population of about 17 million people, depends largely on the Agricultural Sector both for subsistence and export. Uganda livestock stands at 4 million cattle, 2.5 million goats, 0.7 million sheep and 0.5 million pigs. The life of these animals is being threatened by various tropical diseases. Animal trypanosomiasis is endemic in all the 34 districts of Uganda except the highland areas of the country. These are correspondingly areas of high tsetse fly infestation. For effective control of this disease, therefore, an integrated approach is adopted. The country has been divided into three zones of disease incidence, namely the high, medium and low risk zones. Each zone has a slightly different treatment regime with curative and prophylactic trypanocidals as short term control measures. The long term aim is to eradicate the tsetse fly, and therefore, the disease

  9. Transverse myelitis due to trypanosomiasis in a middle aged Tanzanian man

    Kibiki, G S; Murphy, D K


    We report the case of a middle aged Tanzanian man who developed a spinal cord syndrome over 6 weeks, along with a mild encephalopathy. Investigations ruled out the usual major causes of such a syndrome in our setting in northern Tanzania. Examination of his cerebrospinal fluid revealed trypanosomes, and he made a slow but dramatic improvement after a full course of suramine and melarsoprol. We postulate that he had a transverse myelitis due to African trypanosomiasis, a rare and barely recogn...

  10. Challenges facing the elimination of sleeping sickness in west and central Africa: sustainable control of animal trypanosomiasis as an indispensable approach to achieve the goal.

    Simo, Gustave; Rayaisse, Jean Baptiste


    African trypanosomiases are infectious diseases caused by trypanosomes. African animal trypanosomiasis (AAT) remains an important threat for livestock production in some affected areas whereas human African trypanosomiasis (HAT) is targeted for elimination in 2020. In West and Central Africa, it has been shown that the parasites causing these diseases can coexist in the same tsetse fly or the same animal. In such complex settings, the control of these diseases must be put in the general context of trypanosomiasis control or "one health" concept where the coordination of control operations will be beneficial for both diseases. In this context, implementing control activities on AAT will help to sustain HAT control. It will also have a positive impact on animal health and economic development of the regions. The training of inhabitants on how to implement and sustain vector control tools will enable a long-term sustainability of control operations that will lead to the elimination of HAT and AAT. PMID:26671582

  11. Social factors affecting seasonal variation in bovine trypanosomiasis on the Jos Plateau, Nigeria


    Background African Animal Trypanosomiasis (AAT) is a widespread disease of livestock in Nigeria and presents a major constraint to rural economic development. The Jos Plateau was considered free from tsetse flies and the trypanosomes they transmit due to its high altitude and this trypanosomiasis free status attracted large numbers of cattle-keeping pastoralists to the area. The Jos Plateau now plays a major role in the national cattle industry in Nigeria, accommodating approximately 7% of the national herd, supporting 300,000 pastoralists and over one million cattle. During the past two decades tsetse flies have invaded the Jos Plateau and animal trypanosomiasis has become a significant problem for livestock keepers. Here we investigate the epidemiology of trypanosomiasis as a re-emerging disease on the Plateau, examining the social factors that influence prevalence and seasonal variation of bovine trypanosomiasis. Methods In 2008 a longitudinal two-stage cluster survey was undertaken on the Jos Plateau. Cattle were sampled in the dry, early wet and late wet seasons. Parasite identification was undertaken using species-specific polymerase chain reactions to determine the prevalence and distribution of bovine trypanosomiasis. Participatory rural appraisal was also conducted to determine knowledge, attitudes and practices concerning animal husbandry and disease control. Results Significant seasonal variation between the dry season and late wet season was recorded across the Jos Plateau, consistent with expected variation in tsetse populations. However, marked seasonal variations were also observed at village level to create 3 distinct groups: Group 1 in which 50% of villages followed the general pattern of low prevalence in the dry season and high prevalence in the wet season; Group 2 in which 16.7% of villages showed no seasonal variation and Group 3 in which 33.3% of villages showed greater disease prevalence in the dry season than in the wet season. Conclusions

  12. Barriers to Clinical Trial Participation: Comparing Perceptions and Knowledge of African American and White South Carolinians.

    Kim, Sei-Hill; Tanner, Andrea; Friedman, Daniela B; Foster, Caroline; Bergeron, Caroline


    Analyzing data from a survey of African American and White residents in South Carolina, this study attempts to understand how to better promote clinical trial participation specifically within the African American population. To explore why participation is lower in the African American population, the authors examined two sets of potential barriers: structural/procedural (limited accessibility, lack of awareness, doctors not discussing clinical trial options, lack of health insurance) and cognitive/psychological (lack of subjective and factual knowledge, misperceptions, distrust, fear, perceived risk). Findings revealed that African Americans were significantly less willing than Whites to participate in a clinical trial. African Americans also had lower subjective and factual knowledge about clinical trials and perceived greater risk involved in participating in a clinical trial. The authors found that lack of subjective knowledge and perceived risk were significant predictors of African Americans' willingness to participate in a clinical trial. Implications of the findings are discussed in detail. PMID:26042496

  13. Tsetse and trypanosomiasis control in Zimbabwe

    Trypanosomiasis, a disease transmitted by tsetse flies, is a major constraint on Agricultural Production in Tropical Africa. In Zimbabwe where agriculture, and particularly stock raising, is of major economic and social significance, the control of the tsetse fly leading to its eradication is a task of national importance. Zimbabwe has achieved significant progress in tsetse and trypanosomiasis control with a total of 48,000 km2 being cleared of tsetse since 1980. The cleared areas have been consolidated by planned human settlement whose agricultural production has increased following introduction of cattle which provide much needed traction power. Tsetse flies are now confined to an area of 25,000 km2 along the Zambezi Valley. Several strategies are being used to control tsetse flies with the latest technique being the use of odour-baited insecticide-impregnated targets. When used at a density of 4/km2, targets have been found to be extremely effective against the species of tsetse flies found in Zimbabwe. The work undertaken in Zimbabwe as well as prospects for the future within the EEC-funded Regional Tsetse and Trypanosomiasis Control Programme will be discussed. (author)

  14. International assistance to intervention policies and implementation of area-wide tsetse and animal trypanosomiasis programmes

    Full text: Tsetse-transmitted trypanosomiasis is a human and animal disease problem that directly and indirectly affects African livestock and agricultural output, rural socio-economic development, human health and welfare. The overall economic impact of African animal trypanosomiasis (AAT) is estimated at USD 4.75 billion per annum in benefits than could otherwise have been obtained in the agriculture and livestock sector. With regards to human African trypanosomiasis (HAT), an effective active surveillance programme would need to cover 70 percent of the people at risk, for which some USD 35 million per year would be needed, not including the cost of drugs needed for treating all detected cases. Efforts against the AAT problem require a prioritised approach as part of sustainable agriculture and rural development (SARD). As the spread of HAT over the past decades, was furthered by many socio-economic factors, such as political instability, wars and poverty, effective and sustainable intervention efforts against HAT require to be established as part of overall public health initiatives. A removal of the tsetse and trypanosomiasis (T and T) problem is expected to have a catalysing effect on rural development, on public health and on reducing poverty and food insecurity. A variety of agro-ecological settings (geo-climatic factors and trends, land-use patterns, livestock systems and crop agriculture practices) prevail in tsetse-infested sub-Saharan Africa and result in heterogeneous landscape scenarios in terms of HAT foci, AAT prevalence, farming, poverty and food security. Consequently, priority areas, where T and T intervention is most urgently needed and is expected to produce tangible and sustainable benefits, are to be selected not merely on the basis of the technical feasibility to alleviate or eliminate disease, but also and perhaps foremost on the need for emergency assistance - particularly regarding HAT - and the potential for sustainable public health and

  15. Bites, stings, and rigors: clinical considerations in African operations.

    Lynch, James H; Verlo, April R; Givens, Melissa L; Munoz, Cesar E


    The natural health threats in Africa pose daunting clinical challenges for any provider, as evidenced by the current Ebola epidemic in West Africa, but the threat is multiplied for the Special Operations provider on the continent who faces these challenges with limited resources and the tyranny of distance. The majority of operationally significant health risks can be mitigated by strict adherence to a comprehensive force health protection plan. The simplest, yet most effective, technique for preventing mosquito-borne diseases is the prevention of mosquito bites with repellent, bed nets, and appropriate clothing in addition to chemoprophylaxis. Some of the more likely or lethal infectious diseases encountered on the continent include malaria, Chikungunya, dengue, human immunodeficiency virus, and Ebola. Venomous snakes pose a particular challenge since the treatment can be as deadly as the injury. Providers supporting African operations should educate themselves on the clinical characteristics of possible envenomations in their area while promoting snake avoidance as the primary mitigation measure. To succeed in Africa, the Special Operations provider must consider how to meet these challenges in an environment where there may not be reliable evacuation, hospitalization, or logistics channels. PMID:25399379

  16. Interim strategies to control animal trypanosomiasis in two selected villages along the white volta river in the onchocerciasis free zone of Northern Ghana

    The onchocerciasis eradication campaign in the west African subregion was a remarkable success which made formally deserted lands now suitable for settlement. Recent tsetse and trypanosomiasis surveys along the White Volta river indicate that livestock development would virtually be impossible in these areas without some form of intervention to contain animal trypanosomiasis. Apparent fly densities are in the order of 5-10 flies/trap/day (biconica traps) with fly infection rate being in the order of 1-8.0%. Trypanosomiasis is particularly prevalent in small ruminants (12-30%) with several reported cases of abortion. In view of the sparse human population in some of these areas, large scale control programmes would not be advisable unless there is a clear land-use plan. In the interim, however, efforts could be made to control the disease at the village level. This paper outlines some village-based strategies that could be adopted by settlers in these areas. (author)

  17. The "Bantu Clinic": a genealogy of the African patient as object and effect of South African clinical medicine, 1930-1990.

    Butchart, A


    This paper is about power, medicine and the identity of the African as a patient of western medicine. From a conventional perspective and as encoded in the current "quest for wholeness" that characterises South African biomedical discourse, the African patient--like any other patient--has always existed as an authentic and subjectified being, whose true attributes and experiences have been denied by the "mechanistic," "reductionistic" and "ethnocentric" practices of clinical medicine. Against this liberal humanist perspective on the body as ontologically independent of power, this paper offers a Foucaultian reading of the African patient as-like any other patient--contingent upon the force relations immanent within and relayed through the clinical practices of biomedicine. A quintessential form of disciplinary micro-power, these fabricate the most intimate recesses of the human body as manageable objects of medical knowledge and social consciousness to make possible the great control strategies of repression, segmentation and liberation that are the usual focus of conventional investigations into the place and function of medicine in society. Since the 1930s when the African body first emerged as a discrete object of a secular clinical knowledge, these have repeatedly transformed the attributes and identity of the African patient, and the paper traces this archaeology of South African clinical perception from then until the 1990s to show how its "quest for wholeness" is not an end point of "discovery" or "liberation," but merely another ephemeral crystallization of socio-medical knowledge in a constantly changing force field of disciplinary power. PMID:9492973

  18. Treatment disparities among African American men with depression: implications for clinical practice.

    Hankerson, Sidney H; Suite, Derek; Bailey, Rahn K


    A decade has passed since the National Institute of Mental Health initiated its landmark Real Men Real Depression public education campaign. Despite increased awareness, depressed African American men continue to underutilize mental health treatment and have the highest all-cause mortality rates of any racial/ethnic group in the United States. We review a complex array of socio-cultural factors, including racism and discrimination, cultural mistrust, misdiagnosis and clinician bias, and informal support networks that contribute to treatment disparities. We identify clinical and community entry points to engage African American men. We provide specific recommendations for frontline mental health workers to increase depression treatment utilization for African American men. Providers who present treatment options within a frame of holistic health promotion may enhance treatment adherence. We encourage the use of multidisciplinary, community-based participatory research approaches to test our hypotheses and engage African American men in clinical research. PMID:25702724

  19. Unequal Burden of Disease, Unequal Participation in Clinical Trials: Solutions from African American and Latino Community Members

    Ford, Marvella E.; Siminoff, Laura A.; Pickelsimer, Elisabeth; Mainous, Arch G.; Smith, Daniel W.; Diaz, Vanessa A.; Soderstrom, Lea H.; Jefferson, Melanie S.; Tilley, Barbara C.


    African Americans and Latinos are underrepresented in clinical trials. The purpose of this study was to elicit solutions to participation barriers from African Americans and Latinos. Fifty-seven adults (32 African Americans, 25 Latinos) ages 50 years and older participated. The Institute of Medicine's "Unequal Treatment" conceptual framework was…

  20. Gousiekte in African buffalo (Syncerus caffer : clinical communication

    J.A. Lawrence


    Full Text Available Three African buffalo (Syncerus caffer that died after capture and translocation from Mutirikwe Recreational Park in southern Zimbabwe showed macroscopic and microscopic lesions of cardiomyopathy compatible with a diagnosis of gousiekte. The buffalo had had access to Pavetta schumanniana, a plant that is known to cause gousiekte. Death was attributed to cardiac failure as a result of previous consumption of the plant, exacerbated by the stress of translocation.

  1. Report of the workshop on strategic planning of area-wide tsetse and trypanosomiasis control in West Africa

    Tsetse-transmitted trypanosomiasis is a disease unique to Africa affecting both humans and animals. This disease occurs in about 10 million km2 in 37 sub-Saharan countries corresponding approximately to one-third of Africa's total land area, and threatens an estimated 50 million people, 48 million cattle and a countless population of other domestic animal species. Trypanosomiasis has a severe impact on African agriculture; estimated annual losses in cattle production alone are in the range of 1.0-1.2 billion dollars. To this, we have to add the indirect negative effects engendered by trypanosomiasis on total crop production. The disease influences where people decide to live, how they manage their livestock and the intensity of crop agriculture. The combined effects result in changes in land use, environment and affect human welfare and increase the vulnerability of agricultural activity. FAO has identified the reinforcement of agriculture as a key element in the fight against poverty and the improvement of food security in developing countries. The need to reduce poverty is particularly felt in tsetse infested areas of sub-Saharan Africa. In this region half of the population suffers from food insecurity. Approximately 85% of the poor are located in rural areas and more than 80% of the population depends on agricultural production for their livelihood. In order to respond to the need in the fight against tsetse and trypanosomiasis (T and T) in people as well as livestock, the Programme Against African Trypanosomiasis (PAAT) was endorsed in November 1997 by the FAO Conference. The Programme seeks to combine the forces of FAO, IAEA, OAU/IBAR and WHO in order to: promote and co-ordinate international alliances and efforts assisting in harmonised interventions against T and T; effectively combat the disease in Africa; and delineate the polity framework, strategies and guiding pest management principles. This workshop was primarily concerned with the development of

  2. Tsetse and trypanosomiasis at the Ngulia Rhino sanctuary

    The conservation of black rhinoceros (Diceros bicornis) in Kenya involves the translocation of rhinoceros to protected sanctuaries, e.g. the recently enlarged 69 km2 sanctuary at Ngulia in Tsavo West National Park. As the black rhinoceros is known to be particularly susceptible to infection with Trypanosoma brucei, there is a strong possibility that the stress of translocation will induce health problems that would not normally occur in resident populations. Similarly, the movement of animals born in tsetse-free areas to tsetse-infested areas may result in trypanosomiasis problems because of loss of immune protection in the absence of challenge in early life. Finally, there is some concern over the possibility of facilitating genetic exchange in T. brucei through the artificial movement of animals over long distances into novel environments. To aid in the development of prudent management practices, we initiated baseline studies on tsetse distribution and trypanosomiasis at the Ngulia sanctuary. To date, we have completed a dry season survey of tsetse distribution over a 125 km2 area centred on the sanctuary and have characterized the nature of the trypanosomiasis challenge in different areas. Trypanosomiasis challenge at Ngulia involves a variety of Trypanosoma spp. Nevertheless, an unusual finding is the lack of diversity in Nannomonas parasites, with most belonging to the savannah group of T. congolense

  3. Using clinical signs to diagnose anaemia in African children.

    Luby, S. P.; Kazembe, P.N.; Redd, S. C.; Ziba, C.; Nwanyanwu, O. C.; Hightower, A. W.; C. Franco; Chitsulo, L.; Wirima, J J; Olivar, M. A.


    Anaemia is a serious and common problem among young children in sub-Saharan Africa. As a first step towards developing guidelines for its recognition and treatment, we conducted a study to evaluate the ability of health workers to use clinical findings to identify children with anaemia. Health care workers examined a total of 1104 children under 5 years of age at two hospital-based outpatient clinics in rural Malawi. Blood samples were taken to determine haemoglobin concentrations. Pallor of ...

  4. Prevalence and Clinical Characteristics Associated with Pulmonary Hypertension in African-Americans

    Choudhary, Gaurav; Jankowich, Matthew; Wu, Wen-Chih


    Background Pulmonary hypertension (PH) is associated with increased mortality and morbidity. It is frequently associated with cardiopulmonary diseases that are prevalent in African Americans (AAs). However, the prevalence or determinants of PH in the AA population is not known. Methods We conducted a cross-sectional study to estimate the prevalence of PH (defined as trans-tricuspid gradient ≥ 35 mm Hg) and associated clinical characteristics in AAs using the Jackson Heart Study cohort (n=3,28...

  5. African American Participation in Oncology Clinical Trials-Focus on Prostate Cancer: Implications, Barriers, and Potential Solutions.

    Ahaghotu, Chiledum; Tyler, Robert; Sartor, Oliver


    In the United States, the incidence and mortality rates of many cancers, especially prostate cancer, are disproportionately high among African American men compared with Caucasian men. Recently, mortality rates for prostate cancer have declined more rapidly in African American versus Caucasian men, but prostate cancer is still the most common cancer and the second leading cause of cancer deaths in African American men in the United States. Compared with Caucasian men, prostate cancer occurs at younger ages, has a higher stage at diagnosis, and is more likely to progress after definitive treatments in African American men. Reasons for racial discrepancies in cancer are multifactorial and potentially include socioeconomic, cultural, nutritional, and biologic elements. In addition to improving access to novel therapies, clinical trial participation is essential to adequately establish the risks and benefits of treatments in African American populations. Considering the disproportionately high mortality rates noted in these groups, our understanding of the natural history and responses to therapies is limited. This review will explore African American underrepresentation in clinical trials with a focus on prostate cancer, and potentially effective strategies to engage African American communities in prostate cancer research. Solutions targeting physicians, investigators, the community, and health care systems are identified. Improvement of African American participation in prostate cancer clinical trials will benefit all stakeholders. PMID:26786562

  6. Suicidal ideation among attendees of a West African HIV clinic.

    Ogundipe, Olasimbo A; Olagunju, Andrew T; Adeyemi, Joseph D


    The paucity of information on suicide and its related issues among people living with HIV/AIDS (PLWHA) can impair evidence guided intervention. This study was set to determine the prevalence of suicidal ideation and the associated risk factors among PLWHA. A total of 295 participants made up of HIV positive individuals were subjected to a sociodemographic/clinical profile questionnaire. This was followed by the 28-item General Health Questionnaire (GHQ-28), suicidal intention item from the Beck Depression Inventory (BDI) and World Health Organisation Quality of Life (WHOQOL)--Bref scale to assess emotional distress, suicidal ideation, and quality of life respectively. The prevalence of suicidal ideation among PLWHA was 13.6%; and being unmarried, poor medication adherence, and poorer quality of life were significantly associated (p unemployment (odds ratio [OR] = 0.200; 95% Confidence Interval [CI] = 0.084-0.476; P emotional distress (OR = 5.734; 95% CI = 2.119-15.519; P--0.001), religion (OR = 4.829; 95% CI = 1.639-14.231; P--0.004), HIV status non-disclosure (OR = 2.630; 95% CI = 1.015-6.809; P--0.046) and previous suicidal attempt (OR = 0.172, 95% CI = 0.042-0.705; P--0.014) were not only associated but predictive of suicidal ideation in PLWHA. These findings indicate a significant burden of suicidal ideation, and psychosocial with clinical factors constitute identifiable risk factors among PLWHA. The development of evidence guided preventive and treatment measures against suicide among PLWHA are implied. PMID:25058473

  7. Fate of trypanocidal drugs in cattle (chemotherapy of trypanosomiasis). Kenya

    This document is the final report of a project to determine the fate of tryponocidal drugs in cattle. Drugs are still the primary agent in the struggle against trypanosomiasis although there is little data on their pharmacokinetics, residue levels, bioavailability rates, etc. This project aimed to provide such information for the three drugs Diminazene aceturate (Berenil), Isometamidium chloride (Samorin) and Homidium bromide (Ethidium). Figs and tabs

  8. Communicating Effectively About Clinical Trials With African American Communities: A Comparison of African American and White Information Sources and Needs.

    Tanner, Andrea; Bergeron, Caroline D; Zheng, Yue; Friedman, Daniela B; Kim, Sei-Hill; Foster, Caroline B


    Clinical trial (CT) participation is low among African Americans (AAs). To better communicate with AAs about the importance of CTs, the purpose of this study was to explore the communication sources and perceived effective communication channels and strategies through which the general public, AAs, and White individuals receive CT information. A quantitative telephone survey was conducted with AAs and Whites in one Southern state (N = 511). The measures assessed CT sources of information, perceived effectiveness of communication channels and strategies, CT understanding, and CT participation. Descriptive and bivariate analyses were used to compare responses overall and by race. AAs reported being exposed to more CT information than Whites. AAs received CT information most often through television, social media, and doctors compared to Whites. Perceived effectiveness of communication strategies and channels varied by race. AAs preferred simple and easy-to-understand CT information distributed through faith-based organizations. Whites preferred to receive CT information through a trustworthy source (e.g., doctor). There were no significant differences between AAs and Whites in their perceived effectiveness of media sources (e.g., Internet). Recommendations are provided to help health promotion practitioners and CT recruiters tailor information and communicate it effectively to potential AA and White CT participants. PMID:26715695

  9. Immunodiagnosis of bovine trypanosomiasis in Anambra and Imo states, Nigeria, using enzyme-linked immunosorbent assay: zoonotic implications to human health

    M.C. Ezeani


    Full Text Available Background & objectives: The prevalence of trypanosomiasis was studied in cattle, being a major source of animal protein in Nigeria, thus, a very likely means of spread of Human African Trypano-somosis (HAT. Methods: Enzyme-linked immunosorbent assay (ELISA was used to diagnose bovine trypanosomiasis in 264 samples collected from adult cattle of mixed breeds, age and sex, in Anambra and Imo states, Nigeria. Results: Out of 264 samples analysed, 21 (7.96% were seropositive for Trypanosoma congolense while 20 (7.58% were seropositive for T. vivax and 8 (3.03% were seropositive for T. brucei infections in both the states. Interpretation & conclusion: The predominant species was found to be T. congolense. Mixed infection of three species, T. vivax, T. congolense and T. brucei was found to dominate other mixed infections in both the states. ELISA detected the infection of the three species of trypanosomes in the same group of animals. The usefulness of antigen capture ELISA in the diagnosis of human or animal trypanosomiasis was established, and the possibility of the spread of HAT caused by T. brucei gambiense and T.b. rhodesiense through cattle was expressed.

  10. Familial aggregation of Trypanosoma brucei gambiense trypanosomiasis in a very high incidence community in Zaire.

    Khonde, N; Pépin, J; Niyonsenga, T; De Wals, P


    Familial aggregation of Trypanosoma brucei gambiense human African trypanosomiasis (HAT) was investigated in 3 adjacent villages of central Zaire where 318/1431 inhabitants had previously suffered from HAT. Neither spatial nor familial aggregation was detected when analysing the distribution of cases in the whole community using Poisson, negative binomial and pairwise odds ratio models. However, clustering of cases was observed when specific familial relationships were examined. The risk of HAT for a child was significantly increased if the mother had also had HAT, but it was not influenced by a past history of HAT in the father. Sisters and brothers of cases of HAT had a higher risk of HAT than siblings of individuals who had never had HAT, but no such association was documented for half-sisters and half-brothers. Among married couples, a past history of HAT in one spouse had no impact on the other spouse's risk of HAT. Indirect arguments suggested that familial clustering was a consequence of shared exposure, either sequential or simultaneous, rather than of genetic susceptibility. The existence of familial clustering should be kept in mind when implementing passive or active case-finding activities. PMID:9463655

  11. Burkitt's lymphoma between African and American types in Turkish children: clinical, viral (EBV), and molecular studies.

    Cavdar, A O; Gözdaşoğlu, S; Yavuz, G; Babacan, E; Unal, E; Uluoğlu, O; Yücesan, S; Magrath, I T; Akar, N


    Seventy-two Turkish children with Burkitt's lymphoma (BL) observed during a period of 22 years (1968-1990) have been analysed retrospectively. The diagnosis was established histologically according to WHO criteria. BL represented 50% of NHL in this series. The patients were staged according to Ziegler's system. The median age of patients was 5.5 years with a sex (M/F) ratio of 2.1/1. The most common primary site of tumor involvement was the abdomen (69.4%), which was followed by facial tumors, in particular the jaw and orbit (49.9%). There were 21 cases with jaw (29.1%) and 15 cases with orbital involvement (20.8%) at initial presentation. The majority of the patients (84.4%) were in advanced stages (C and D) at initial diagnosis. Facial tumors observed in Turkish children with BL were more similar to African Burkitt's lymphoma than American or European cases. High titers of antibodies against VCA and EA of EBV were also seen in our recent cases of BL. Two main treatment regimens, namely, single agent chemotherapy with cyclophosphamide (CYX) (1968-1974) and three drug (COM) combination chemotherapy, were used consecutively (1974-1988). COM has been shown to produce better results than single agent therapy. The clinical presentation, mean age, and high antibodies (IgG) to EBV and preliminary molecular studies revealed that BL appears to be in between African and non-African types in Turkish children. This will be further elucidated by direct examination of tumor cells for EBV and investigation of the molecular characteristics of Turkish tumors. Such studies are presently under way. PMID:8381202

  12. The counseling african americans to control hypertension (caatch trial: baseline demographic, clinical, psychosocial, and behavioral characteristics

    Diaz-Gloster Marleny


    Full Text Available Abstract Background Effectiveness of combined physician and patient-level interventions for blood pressure (BP control in low-income, hypertensive African Americans with multiple co-morbid conditions remains largely untested in community-based primary care practices. Demographic, clinical, psychosocial, and behavioral characteristics of participants in the Counseling African American to Control Hypertension (CAATCH Trial are described. CAATCH evaluates the effectiveness of a multi-level, multi-component, evidence-based intervention compared with usual care (UC in improving BP control among poorly controlled hypertensive African Americans who receive primary care in Community Health Centers (CHCs. Methods Participants included 1,039 hypertensive African Americans receiving care in 30 CHCs in the New York Metropolitan area. Baseline data on participant demographic, clinical (e.g., BP, anti-hypertensive medications, psychosocial (e.g., depression, medication adherence, self-efficacy, and behavioral (e.g., exercise, diet characteristics were gathered through direct observation, chart review, and interview. Results The sample was primarily female (71.6%, middle-aged (mean age = 56.9 ± 12.1 years, high school educated (62.4%, low-income (72.4% reporting less than $20,000/year income, and received Medicaid (35.9% or Medicare (12.6%. Mean systolic and diastolic BP were 150.7 ± 16.7 mm Hg and 91.0 ± 10.6 mm Hg, respectively. Participants were prescribed an average of 2.5 ± 1.9 antihypertensive medications; 54.8% were on a diuretic; 33.8% were on a beta blocker; 41.9% were on calcium channel blockers; 64.8% were on angiotensin converting enzyme (ACE inhibitors/angiotensin receptor blockers (ARBs. One-quarter (25.6% of the sample had resistant hypertension; one-half (55.7% reported medication non-adherence. Most (79.7% reported one or more co-morbid medical conditions. The majority of the patients had a Charlson Co-morbidity score ≥ 2. Diabetes

  13. Adaptation of a Cancer Clinical Trials Education Program for African American and Latina/o Community Members

    Pelto, Debra J.; Sadler, Georgia Robins; Njoku, Ogo; Rodriguez, Maria Carina; Villagra, Cristina; Malcarne, Vanessa L.; Riley, Natasha E.; Behar, Alma I.; Jandorf, Lina


    The pilot study reported in this article culturally and linguistically adapted an educational intervention to promote cancer clinical trials (CCTs) participation among Latinas/os and African Americans. The single-session slide presentation with embedded videos, originally developed through a campus-community partnership in Southern California, was…

  14. Unequal burden of disease, unequal participation in clinical trials: solutions from African American and Latino community members.

    Ford, Marvella E; Siminoff, Laura A; Pickelsimer, Elisabeth; Mainous, Arch G; Smith, Daniel W; Diaz, Vanessa A; Soderstrom, Lea H; Jefferson, Melanie S; Tilley, Barbara C


    African Americans and Latinos are underrepresented in clinical trials. The purpose of this study was to elicit solutions to participation barriers from African Americans and Latinos. Fifty-seven adults (32 African Americans, 25 Latinos) ages 50 years and older participated. The Institute of Medicine's Unequal Treatment conceptual framework was used. Six racially/ ethnically homogenous focus groups were conducted at five sites in three counties. Themes within groups and cross-cutting themes were identified. The NVIVO program was used for data classification. The data were reviewed for final coding and consensus. Shared solutions included addressing costs, recruiting in community contexts, conducting community and individualized patient education, and sharing patient safety information. Participants were unanimously in favor of clinical trials navigation recruitment interventions. Solutions specific to African Americans included diversifying research teams, recognizing past research abuses, and increasing community trust. Solutions specific to Latinos included providing low-literacy materials, providing Spanish-speaking clinicians and advocates, and clarifying that immigration status would neither be documented nor prevent participation. Solutions from African Americans and Latinos reflect their cultural backgrounds and historical experiences. The results suggest the importance of developing a tailored, barriers-focused navigation intervention to improve participation among diverse racial and ethnic populations. PMID:23539894

  15. Clinical outcome of skin yaws lesions after treatment with benzathinebenzylpenicillin in a pygmy population in Lobaye, Central African Republic

    Manirakiza Alexandre


    Full Text Available Abstract Background Yaws is a bacterial skin and bone infectious disease caused by Treponema pallidum pertenue. It is endemic, particularly among pygmies in Central African Republic. To assess the clinical cure rate after treatment with benzathinepenicillin in this population, we conducted a cohort survey of 243 patients in the Lobaye region. Findings and conclusion The rate of healing of lesions after 5 months was 95.9%. This relatively satisfactory level of therapeutic response implies that yaws could be controlled in the Central African Republic. Thus, reinforcement of the management of new cases and of contacts is suggested.

  16. Seroprevalence of CANINE LEISHMANIASIS AND American trypanosomiasis in dogs from Grenada, West Indies

    Canine leishmaniasis and American trypanosomiasis (AT) are caused by related hemoflagellated parasites, Leishmania spp. and Trypanosoma cruzi, which share several common host species. Dogs are reservoirs for human infections with both pathogens. We determined the prevalence of antibodies to Leishman...

  17. Validation of the antigen ELISA in comparison with parasitological techniques for the diagnosis of bovine trypanosomiasis in Zimbabwe

    The antigen ELISA (Ag-ELISA) for the detection of trypanosomal infections was used to test sera from naturally infected cattle and the results were correlated with those obtained by buffy coat technique (BCT). Sera were obtained from cattle kept in a tsetse free area to determine test sensitivity and from a second tsetse free area to obtain baseline values for a group of animals which were later to be moved to an area of high tsetse challenge. The Ag-ELISA was apparently 98.4% specific. In the area of high tsetse challenge the buffy coat technique detected 75 (26.6%) infections while the antigen ELISA detected 110 (39.0%) infections. The ELISA failed to detect antigens in some parasitologically positive animals, but the two were complementary for the diagnosis of trypanosomiasis in individual animals. An unexpectedly high proportion of antigen positive animals (25.0%) was found in the second tsetse free area but these infections could be due to non cyclical transmission indicating that although tsetse eradication may remove the vector, sub-clinical trypanosomiasis may persist in the cattle population unless measures are taken to provide adequate trypanocidal drug therapy. (author). 2 refs, 6 figs, 1 tab

  18. Neglected diseases in the news: a content analysis of recent international media coverage focussing on leishmaniasis and trypanosomiasis.

    Mangai Balasegaram

    Full Text Available BACKGROUND: Although the pharmaceutical industry's "neglect" of neglected tropical diseases (NTDs has been investigated, no study evaluating media coverage of NTDs has been published. Poor media coverage exacerbates the neglect. This study aimed to investigate, describe, and analyse international media coverage of "neglected diseases" in general and three specific NTDs--African trypanosomiasis, leishmaniasis, and Chagas disease--from 1 January 2003 to 1 June 2007. METHODS: Archives of 11 leading international, English-language media were searched. A content analysis was done, coding for media organisation, date, author, type of report, slant, themes, and "frames". Semi-structured interviews with journalists and key informants were conducted for further insight. PRINCIPAL FINDINGS: Only 113 articles in a 53-month time period met the inclusion criteria, with no strong trends or increases in coverage. Overall, the BBC had the highest coverage with 20 results, followed by the Financial Times and Agence France Presse. CNN had the least coverage with one result. The term "neglected diseases" had good media currency and "sleeping sickness" was far more widely used than trypanosomiasis. The disease most covered was leishmaniasis and the least covered was Chagas. Academic researchers were most commonly quoted as a main source, while the World Health Organization (WHO and pharmaceutical industry were the least quoted. Journalists generally agreed NTDs had not been adequately covered, but said a lack of real news development and the need to cater to domestic audiences were major obstacles for NTD reporting. All journalists said health agencies, particularly WHO, were not communicating adequately about the burden of NTDs. CONCLUSIONS: Public health agencies need to raise priority for NTD advocacy. Innovative strategies, such as reporting grants or creating a network of voices, may be needed.

  19. Cryptic Diversity within the Major Trypanosomiasis Vector Glossina fuscipes Revealed by Molecular Markers

    Choi, Kwang-Shik; Darby, Alistair C.; Causse, Sandrine; Kapitano, Berisha; Hall, Martin J. R.; Steen, Keith; Lutumba, Pascal; Madinga, Joules; Torr, Steve J.; Okedi, Loyce M.; Lehane, Michael J.; Donnelly, Martin J.


    Background The tsetse fly Glossina fuscipes s.l. is responsible for the transmission of approximately 90% of cases of human African trypanosomiasis (HAT) or sleeping sickness. Three G. fuscipes subspecies have been described, primarily based upon subtle differences in the morphology of their genitalia. Here we describe a study conducted across the range of this important vector to determine whether molecular evidence generated from nuclear DNA (microsatellites and gene sequence information), mitochondrial DNA and symbiont DNA support the existence of these taxa as discrete taxonomic units. Principal Findings The nuclear ribosomal Internal transcribed spacer 1 (ITS1) provided support for the three subspecies. However nuclear and mitochondrial sequence data did not support the monophyly of the morphological subspecies G. f. fuscipes or G. f. quanzensis. Instead, the most strongly supported monophyletic group was comprised of flies sampled from Ethiopia. Maternally inherited loci (mtDNA and symbiont) also suggested monophyly of a group from Lake Victoria basin and Tanzania, but this group was not supported by nuclear loci, suggesting different histories of these markers. Microsatellite data confirmed strong structuring across the range of G. fuscipes s.l., and was useful for deriving the interrelationship of closely related populations. Conclusion/Significance We propose that the morphological classification alone is not used to classify populations of G. fuscipes for control purposes. The Ethiopian population, which is scheduled to be the target of a sterile insect release (SIT) programme, was notably discrete. From a programmatic perspective this may be both positive, given that it may reflect limited migration into the area or negative if the high levels of differentiation are also reflected in reproductive isolation between this population and the flies to be used in the release programme. PMID:21858237

  20. Practical applications of geographical information systems in tsetse and trypanosomiasis control

    Three aspects of geographical information systems (GISs) in tsetse and trypanosomiasis control are addressed. First is their use in planning and managing control operations, second is the use of appropriate data management systems to capture data from the field and process them in a format that facilitates their geographical analysis, and third is the use of GISs to predict some of the data layers required for planning tsetse and trypanosomiasis control activities. In planning and managing trypanosomiasis interventions, GISs are applied at a range of levels. At the policy level, it can be used to integrate data such as tsetse and trypanosomiasis distributions, livestock densities and percentage cultivation to assist in allocating resources to tsetse and trypanosomiasis control. At the management level, it can be used to combine the same sorts of data in decision support models to help prioritize areas for control. At the operational level, it can be used to help plan, manage and monitor field operations. Much of the data required for these applications come directly from the field, particularly the distributions of livestock, vector and disease. The use of bespoke software such as the disease and vector integrated database (DAVID) greatly facilitates entry, display and analysis of field data, and their integration with other data within GISs. Collecting field data relevant to planning and managing tsetse and trypanosomiasis control operations is often very expensive and time consuming, therefore preventing exhaustive ground coverage. The use of GISs to combine environmental predictor variables, using multivariate statistical models, and to predict the distribution and abundance of tsetse, trypanosomiasis, cultivation and livestock is reviewed. Finally, opportunities are discussed for developing these applications in the future. It is recommended that stronger links be forged between the research workers and those in operational programmes. (author)

  1. Clinical outcome of skin yaws lesions after treatment with benzathinebenzylpenicillin in a pygmy population in Lobaye, Central African Republic.

    Manirakiza Alexandre; Boas Susana; Beyam Narcisse; Zadanga Germain; Konamna François; Njuimo Siméon P; Laganier Rémi


    Abstract Background Yaws is a bacterial skin and bone infectious disease caused by Treponema pallidum pertenue. It is endemic, particularly among pygmies in Central African Republic. To assess the clinical cure rate after treatment with benzathinepenicillin in this population, we conducted a cohort survey of 243 patients in the Lobaye region. Findings and conclusion The rate of healing of lesions after 5 months was 95.9%. This relatively satisfactory level of therapeutic response implies that...

  2. Prevalence and clinical characteristics associated with pulmonary hypertension in African-Americans.

    Gaurav Choudhary

    Full Text Available BACKGROUND: Pulmonary hypertension (PH is associated with increased mortality and morbidity. It is frequently associated with cardiopulmonary diseases that are prevalent in African Americans (AAs. However, the prevalence or determinants of PH in the AA population is not known. METHODS: We conducted a cross-sectional study to estimate the prevalence of PH (defined as trans-tricuspid gradient ≥ 35 mm Hg and associated clinical characteristics in AAs using the Jackson Heart Study cohort (n=3,282 who underwent echocardiography and had a measurable trans-tricuspid regurgitant jet. Echocardiography is frequently used for screening for PH despite its limitations in estimating accurate PA systolic pressures. Overall and age-adjusted gender-specific prevalence were estimated and modified Poisson regression was used to identify independent clinical, spirometric, and echocardiographic characteristics associated with PH. RESULTS: The mean age of the study population was 56.1 ± 12.6 years with 67.5% female. The prevalence of PH was 6.8%, with higher prevalence in female AAs (age-adjusted prevalence: Men 4.9%, 95% CI 3.6-6.2%; Women 7.7%, 95% CI 6.6-8.8%. Pulmonary hypertension prevalence increased with age (Prevalence Ratio: 10.0, 95%CI 4.0-25.1, >65 versus <45 years old, presence of obesity, higher pulse pressure, diabetes, obstructive or restrictive spirometry pattern, and severe left heart valvular disease. Also, PH was significantly associated with left atrial size and left ventricular ejection fraction. CONCLUSIONS: Pulmonary hypertension is prevalent in AAs, more in women than in men. The identified cardiopulmonary risk factors that increase the prevalence of PH may assist in diagnosis and management of these at-risk subjects in the AA population.

  3. Comparative Clinical Observations on Trypanosoma vivax Infected Pregnant Yankasa and West African Dwarf Ewes

    S.A.S. Olorunju


    Full Text Available Three groups of pregnant Yankasa (YK and West African Dwarf (WAD ewes, made up of 6pregnant YK and 6 pregnant WAD ewes in each group, were assigned at random to first, second and third trimester of pregnancy, to study the clinical manifestation of. T. vivax infection at each trimester of pregnancy. A fourth group made up of 3 pregnant YK and 3 pregnant WAD ewes served as the non-infected controls for the study. Pre- infection mean rectal temperatures of the YK and WAD ewes were 38.6 Co and 38.7 Crespectively, while post-infection temperatures were as high as 41.5 C and 41.6 C for the YK and WAD ewes respectively. The infection was severe in the infected YK and WAD ewes in the second and third trimesters of pregnancy and most severe in YK than in the WAD ewes. The infected YK and WAD ewes exhibited pyrexia, signs of anaemia shown by pale mucus membrane, decrease in packed cell volume (PCV values, decrease in total plasma protein (TP values, weight loss, lethargy, dullness, abortions and death of ewes. The severity of the infection increased as the pregnancy advanced in the ewes. WAD ewes in the first trimester were least susceptible to the infection and self-cure was observed in one WAD ewe. The infected WAD ewes controlled the effects of the infection on abortions and mortality more than the YK ewes. It was concluded from the study that the trimester of pregnancy and breed of ewe influenced the clinical manifestation of T. vivax infection on pregnant YK and WAD ewes.

  4. Glycolysis in the African Trypanosome: Targeting Enzymes and Their Subcellular Compartments for Therapeutic Development

    James C. Morris; Morris, Meredith T.; Dodson, Heidi C.; Coley, April F.


    Subspecies of the African trypanosome, Trypanosoma brucei, which cause human African trypanosomiasis, are transmitted by the tsetse fly, with transmission-essential lifecycle stages occurring in both the insect vector and human host. During infection of the human host, the parasite is limited to using glycolysis of host sugar for ATP production. This dependence on glucose breakdown presents a series of targets for potential therapeutic development, many of which have been explored and validat...

  5. Pre-clinical assays predict pan-African Echis viper efficacy for a species-specific antivenom.

    Nicholas R Casewell

    Full Text Available BACKGROUND: Snakebite is a significant cause of death and disability in subsistent farming populations of sub-Saharan Africa. Antivenom is the most effective treatment of envenoming and is manufactured from IgG of venom-immunised horses/sheep but, because of complex fiscal reasons, there is a paucity of antivenom in sub-Saharan Africa. To address the plight of thousands of snakebite victims in savannah Nigeria, the EchiTAb Study Group organised the production, testing and delivery of antivenoms designed to treat envenoming by the most medically-important snakes in the region. The Echis saw-scaled vipers have a wide African distribution and medical importance. In an effort to maximise the clinical utility of scarce antivenom resources in Africa, we aimed to ascertain, at the pre-clinical level, to what extent the E. ocellatus-specific EchiTAbG antivenom, which was designed specifically for Nigeria, neutralised the lethal activity of venom from two other African species, E. pyramidum leakeyi and E. coloratus. METHODOLOGY/PRINCIPAL FINDINGS: Despite apparently quite distinctive venom protein profiles, we observed extensive cross-species similarity in the immuno-reactivity profiles of Echis species-specific antisera. Using WHO standard pre-clinical in vivo tests, we determined that the monospecific EchiTAbG antivenom was as effective at neutralising the venom-induced lethal effects of E. pyramidum leakeyi and E. coloratus as it was against E. ocellatus venom. Under the restricted conditions of this assay, the antivenom was ineffective against the lethal effects of venom from the non-African Echis species, E. carinatus sochureki. CONCLUSIONS/SIGNIFICANCE: Using WHO-recommended pre-clinical tests we have demonstrated that the new anti-E. ocellatus monospecific antivenom EchiTAbG, developed in response to the considerable snakebite-induced mortality and morbidity in Nigeria, neutralised the lethal effects of venoms from Echis species representing each

  6. Application of ELISA for diagnosing and investigating the epidemiology of trypanosomiasis in buffaloes in north Vietnam

    An antigen-detection enzyme immunoassay (Ag-ELISA) based on a Trypanosoma evansi specific monoclonal antibody was used for the detection of circulating antigens in experimentally infected buffaloes and in buffaloes kept in different geographical regions of Vietnam. In experimental infections, circulating antigens were detected around 7 to 14 days after infection but the levels detected were considerably lower than those in sera collected from the field, suggesting that the parasite isolate used became highly adapted to mice thorough passage. In a study of field sera the agreement between the Ag-ELISA and parasitological methods for detecting infected cases was 80% and the apparent specificity of the test was 90%. In these and other studies the Ag-ELISA consistently detected many more infected cases than did the conventional parasitological methods. In most cases animals whose sera reacted in the Ag-ELISA also had trypanosome specific antibodies in their circulation. Treatment of infected animals with a trypanocidal drug in most cases resulted in a significant drop in trypanosome antigen levels but their status with respect to trypanosomal antibodies remained unchanged. Seroepidemiological surveys using Ag-ELISA and Ab-ELISA and base on an analysis of around 1000 sera collected from different regions of Vietnam demonstrated prevalence ranging between 17% and 50% with no apparent relationship to geographical region. However, prevalence of infection was generally higher in summer (rainy season), when fly activity is highest. It is concluded that serological methods based on Ag-ELISA and Ab-ELISA are valuable adjuncts to clinical and parasitological methods for diagnosing trypanosomiasis, studying the epidemiology of the disease and monitoring the effectiveness of control programmes. (author). 12 refs, 2 figs, 3 tabs

  7. African trypanosomiasis in the rat alters melatonin secretion and melatonin receptor binding in the suprachiasmatic nucleus

    Kristensson, Krister; Claustrat, Bruno; Mhlanga, Jama D.M.;


    Neurobiology, cytokines, circadian rhythm, infection, nervous system, pineal gland, trypanosoma brucei......Neurobiology, cytokines, circadian rhythm, infection, nervous system, pineal gland, trypanosoma brucei...

  8. Diabetes in African Americans

    Marshall, M.


    African Americans have a high risk for type 2 diabetes. Genetic traits, the prevalence of obesity, and insulin resistance all contribute to the risk of diabetes in the African American community. African Americans have a high rate of diabetic complications, because of poor glycaemic control and racial disparities in health care in the USA. African Americans with diabetes may have an atypical presentation that simulates type 1 diabetes, but then their subsequent clinical course is typical of t...

  9. Treatment Disparities among African American Men with Depression: Implications for Clinical Practice

    Hankerson, Sidney H.; Suite, Derek; Bailey, Rahn K.


    A decade has passed since the National Institute of Mental Health initiated its landmark Real Men Real Depression public education campaign. Despite increased awareness, depressed African American men continue to underutilize mental health treatment and have the highest all-cause mortality rates of any racial/ethnic group in the United States. We review a complex array of socio-cultural factors, including racism and discrimination, cultural mistrust, misdiagnosis and clinician bias, and infor...

  10. Idiosyncratic sound systems of the South African Bantu languages: Research and clinical implications for speech-language pathologists and audiologists

    Anita van der Merwe


    Full Text Available The objective of this article is to create awareness amongst speech-language pathologists and audiologists in South Africa regarding the difference between the sound systems of Germanic languages and the sound systems of South African Bantu languages. A brief overview of the sound systems of two Bantu languages, namely isiZulu and Setswana, is provided. These two languages are representative of the Nguni language group and the Sotho group respectively.Consideration is given to the notion of language-specific symptoms of speech, language and hearing disorders in addition to universal symptoms. The possible impact of speech production, language and hearing disorders on the ability to produce and perceive speech in these languages, and the challenges that this holds for research and clinical practice, are pointed out.

  11. The sterile insect technique and its role in integrated Trypanosomiasis control programmes

    In the paper an attempt is made to define the rationale for using the sterile insect technique (SIT) for tsetse fly eradication within the global concept of trypanosomiasis control. Against the background of past and present research and development, and particularly the success of integrated tsetse fly control campaigns in Burkina Faso and Nigeria, the paper identifies problems to be overcome before further major action programmes with an SIT component are undertaken. (author). 33 refs

  12. Visual Representation of Body Shape in African-American and European American Women: Clinical Considerations

    Capers, Patrice L.; Kinsey, Amber W.; Miskell, Edrika L.; Affuso, Olivia


    BACKGROUND Body mass index (BMI) has been used widely among clinicians to assess obesity in their patients due to its ease and availability. However, BMI has some diagnostic limitations and other measures related to health risks; in particular, body shape may be of greater relevance to health outcomes. OBJECTIVE The objective of this study was to illustrate the importance of body shape assessments above and beyond BMI and its relationship to health risk among a sample of African-American and European American women. METHODS African-American and European American women aged 19–78 years (n = 552) in Birmingham, Alabama, were recruited and stratified by menopausal status (ie, pre- or postmenopausal). Pictorial body shapes were derived from digital photographs, while body fat distribution defined by android–gynoid ratio (AGR) and body composition were obtained from dual-energy X-ray absorptiometry. RESULTS Images of BMI and age-matched women illustrate variability in fat distribution. Among both menopausal status groups, more than 50% of women had a pear body shape (AGR < 1). An apple body shape was associated with higher odds of having diabetes (unadjusted odds ratio [OR]: 4.1, 95% confidence interval [CI]: 1.9–9.3), hypertension (unadjusted OR: 3.1, 95% CI: 2.0–4.7), and high cholesterol (unadjusted OR: 3.0, 95% CI: 1.8–5.1). CONCLUSION Use of visual cues alongside traditional methods of weight status assessment may help to facilitate weight management conversations between physicians and female patients. However, next steps should include the validation of visual assessments of body shape in women for use by physicians. PMID:27478392

  13. Adaptation of a Cancer Clinical Trials Education Program for African American and Latina/o Community Members.

    Pelto, Debra J; Sadler, Georgia Robins; Njoku, Ogo; Rodriguez, Maria Carina; Villagra, Cristina; Malcarne, Vanessa L; Riley, Natasha E; Behar, Alma I; Jandorf, Lina


    The pilot study reported in this article culturally and linguistically adapted an educational intervention to promote cancer clinical trials (CCTs) participation among Latinas/os and African Americans. The single-session slide presentation with embedded videos, originally developed through a campus-community partnership in Southern California, was chosen for adaptation because it was perceived to fit the CORRECT model of innovation (credible, observable, relevant, relatively advantageous, easy to understand, compatible, and testable) and because of the potential to customize any components not identified as core, allowing them to be revised for cultural and linguistic alignment in New York City. Most of the 143 community participants (76.2%) were female; most (54.6%) were older than 59 years. More than half (78.3%) preferred to speak English or were bilingual in English and Spanish. A large proportion (41.3%) had not completed high school. Knowledge and perceived benefits and barriers regarding CCT showed small, though statistically significant, increases. There were no statistically significant group differences for changes in mean knowledge, perceived benefits, or perceived barriers when examined by ethnicity, education level, language, or other included sociodemographic variables. However, a small, but statistically significant difference in perceived barriers was observed when examined by country of origin, with the foreign born score worsening 0.08 points (SD = 0.47, p = .007) on the 5-point Likert-type scale administered posteducation compared to preeducation. Participants' open-ended comments demonstrated the acceptability of the topic and intervention. This adaptation resulted in an intervention with the potential to educate African American and Latina/o general community members in a new geographic region about the purpose, methods, and benefits of CCTs. PMID:26493870

  14. Genome Sequence of Vibrio cholerae G4222, a South African Clinical Isolate

    le Roux, Wouter J.; Chan, Wai Yin; De Maayer, Pieter; Venter, Stephanus N.


    Vibrio cholerae, a Gram-negative pathogen autochthonous to the aquatic environment, is the causative agent of cholera. Here, we report the complete genome sequence of V. cholerae G4222, a clinical isolate from South Africa.

  15. The South African Military Nursing College Pupil Enrolled Nurses’ experiences of the clinical learning environment

    Ernestina M. Caka; Sebi Lekalakala-Mokgele


    The study focused on the clinical learning experiences of Pupil Enrolled Nurses (PENs) within the military health service. The purpose of the research was to explore and describe the learning experiences of PENs within the Military health clinical learning environment. An explorative, descriptive, contextual design which is qualitative in nature was used to guide the study. The military as a training institution prides itself on preparing nurses both as soldiers and nurses, this could be both...

  16. Male, mobile, and moneyed: loss to follow-up vs. transfer of care in an urban African antiretroviral treatment clinic.

    Kara G Marson

    Full Text Available The purpose of this study was to analyze characteristics, reasons for transferring, and reasons for discontinuing care among patients defined as lost to follow-up (LTFU from an antiretroviral therapy (ART clinic in Nairobi, Kenya.The study used a prospective cohort of patients who participated in a randomized, controlled ART adherence trial between 2006 and 2008.Participants were followed from pre-ART clinic enrollment to 18 months after ART initiation, and were defined as LTFU if they failed to return to clinic 4 weeks after their last scheduled visit. Reasons for loss were captured through phone call or home visit. Characteristics of LTFU who transferred care and LTFU who did not transfer were compared to those who remained in clinic using log-binomial regression to estimate risk ratios.Of 393 enrolled participants, total attrition was 83 (21%, of whom 75 (90% were successfully traced. Thirty-seven (49% were alive at tracing and 22 (59% of these reported having transferred their antiretroviral care. In the final model, transfers were more likely to have salaried employment [Risk Ratio (RR, 2.7; 95% confidence interval (CI, 1.2-6.1; p=0.020] and pay a higher monthly rent (RR, 5.8; 95% CI, 1.3-25.0; p=0.018 compared to those retained in clinic. LTFU who did not transfer care were three times as likely to be men (RR, 3.1; 95% CI, 1.1-8.1; p=0.028 and nearly 4 times as likely to have a primary education or less (RR, 3.8; 95% CI, 1.3-10.6; p=0.013. Overall, the most common reason for LTFU was moving residence, predominantly due to job loss or change in employment.A broad definition of LTFU may include those who have transferred their antiretroviral care and thereby overestimate negative effects on ART continuation. Interventions targeting men and considering mobility due to employment may improve retention in urban African ART clinics.The study's identifier is NCT00273780.

  17. The South African Military Nursing College Pupil Enrolled Nurses’ experiences of the clinical learning environment

    Ernestina M. Caka


    Full Text Available The study focused on the clinical learning experiences of Pupil Enrolled Nurses (PENs within the military health service. The purpose of the research was to explore and describe the learning experiences of PENs within the Military health clinical learning environment. An explorative, descriptive, contextual design which is qualitative in nature was used to guide the study. The military as a training institution prides itself on preparing nurses both as soldiers and nurses, this could be both challenging and exasperating for students, as the scopes are diverse. Being notably very hierarchical, the military’s rules constantly take precedence over nursing rules. For the duration of nursing training, students are allocated in the clinical learning area to acquire competencies such as problem solving, cognitive and psychomotor skills (Kuiper & Pesut 2003:383. Students learn how to merge theory and practice and apply theories in the practical sense. This is however, not done in isolation from the military codes, as they are intertwined. Attendance of military parades and drills are incorporated during this phase. This could create missed opportunities from the clinical learning as students are expected to leave the clinical setting for this purpose. Three focus group sessions were conducted and the experiences of the students, as narrated by themselves, yielded valuable insights. The researcher wrote field notes and assisted with the management of the audio tapes for easy retrieval of information. Data was analysed by the researcher, independent of the cocoder. Two themes relating to the PENs’ learning experiences emerged from the data analysed: (1 facilitators of clinical learning, (2 and barriers to clinical learning. The findings obtained depicted those factors which facilitated and obstructed student learning. These findings made it possible for the researcher to make recommendations concerning positive interventions which could be taken to

  18. Social franchising primary healthcare clinics--a model for South African National Health Insurance?

    Robinson, Andrew Ken Lacey


    This article describes the first government social franchise initiative in the world to deliver a 'brand' of quality primary healthcare (PHC) clinic services. Quality and standards of care are not uniformly and reliably delivered across government PHC clinics in North West Province, South Africa, despite government support, numerous policies, guidelines and in-service training sessions provided to staff. Currently the strongest predictor of good-quality service is the skill and dedication of the facility manager. A project utilising the social franchising business model, harvesting best practices, has been implemented with the aim of developing a system to ensure reliably excellent healthcare service provision in every facility in North West. The services of social franchising consultants have been procured to develop the business model to drive this initiative. Best practices have been benchmarked, and policies, guidelines and clinic support systems have been reviewed, evaluated and assessed, and incorporated into the business plan. A pilot clinic has been selected to refine and develop a working social franchise model. This will then be replicated in one clinic to confirm proof of concept before further scale-up. The social franchise business model can provide solutions to a reliable and recognisable 'brand' of quality universal coverage of healthcare services. PMID:26428744

  19. In Vitro Activities of 15 Antimicrobial Agents against Clinical Isolates of South African Enterococci

    Struwig, M. C.; Botha, P. L.; Chalkley, L. J.


    The activities of a panel of currently available antibiotics and the investigational agents LY 333328, linezolid, CL 331,002, CL 329,998, moxifloxacin (BAY 12-8039), trovafloxacin, and quinupristin-dalfopristin against 274 clinical isolates of enterococci were determined. No vancomycin resistance or β-lactamase production was observed. Except for 12 isolates (all non-Enterococcus faecalis) showing reduced susceptibility to quinupristin-dalfopristin (MIC, ≥4 μg/ml), the new agents exhibited pr...

  20. The validation of an Ag-ELISA for the diagnosis of trypanosomiasis in cattle in Uganda and its use in assessing the efficacy of a control programme

    An antigen detection ELISA (Ag-ELISA) for the diagnosis of trypanosomiasis was established in UTRO. The Ag-ELISA was used to assess the efficacy on an integrated tsetse and trypanosomiasis control programme which started in June 1991. Cattle were screened for trypanosomiasis using parasitologial tests and the Ag-ELISA. Cattle in Masafu where no control was implemented were screened for comparison with areas where control had been applied. Six months from the onset of control there was a reduction in the prevalence of trypanosomiasis throughout the control area. Six months from the onset of control there was a reduction in the prevalence of trypanosomiasis through the control area. Six months later, prevalence of trypanosomiasis had started rising throughout the control area with the exception of Buteba, where 1% Deltamethrin (Spot-on) had been applied to cattle. In Buteba the presence of trypanosomiasis was only detectable by Ag-ELISA. In Masafu where there was no control, prevalence of trypanosomiasis remained high. The Ag-ELISA consistently showed the presence of greater levels of infection than was revealed by microscopic methods and its usefulness was confirmed both as a means of monitoring the effectiveness of the control campaign and in identifying individual animals with non-patent active infections. 6 refs, 7 figs, 1 tab

  1. Associated syndromes and other genetic variations at a South African cleft lip and palate clinic

    H.J.S. van den Berg


    Full Text Available A retrospective study was done of data on all patients registered at one of the largest cleft lip and palate clinics in South Africa (n = 3174. The associated syndromes and other genetic variations [(abbreviation: ASGV] found in the population of persons suffering from facial cleft deformities (FCD were analysed. 832 (26.2% cleft lip and/ or palate patients presented with ASGV. Fifty-seven different types of syndromes were recorded of which the Fairbaim-Robin appearance (FRA (or Pierre Robin sequence 169 (5.3%, the Demarque-van der Woude syndrome 40 (1.3%, and the holoprosencephaly sequence cases 32 (1.0% were the three most common ones. The three most common genetic variations found in the non-syndromic patients, were heart involvement 53(1.7%, club foot 42 (1.3% and various eye problems 39 (1.2%. The main facial cleft deformity, namely the cleft lip, alveolus and palate (CLAP, was found in 26.2% of the ASGV-group. This particular cleft deformity was recorded at 39.7% in the FCD clinic. On the other hand, the hard and soft palate cleft (hPsP group was found in 32.9% of patients who also had ASGV; in the total group of patients registered at the clinic, it accounted for only 16.6%. This means that ASGV occur less commonly in the CLAP group of patients, than in the hPsP group of patients.

  2. Clinical determinants of early parasitological response to ACTs in African patients with uncomplicated falciparum malaria

    Abdulla, S.; Adam, I.; Adjei, G. O.;


    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. Results: In total, 29,493 patients from 84 clinical trials were included.......020, compared to dihydroartemisinin-piperaquine). Conclusions: The 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...

  3. Clinical and epidemiological aspects of a hepatitis E outbreak in Bangui, Central African Republic

    Komas Narcisse P


    Full Text Available Abstract Background Outbreaks of hepatitis E frequently occur in tropical developing countries during the rainy season due to overflowing drains, short-circuiting of networks of clean water and use of contaminated water from wells. Hepatitis E virus (HEV infections are usually accompanied by general symptoms of acute liver disease. This study was conducted to define the clinical and epidemiological aspects of the HEV outbreak that occurred in May 2004 in Bangui. Methods Blood samples were collected from 411 patients aged 1-87 years, most of whom presented with jaundice, asthenia or signs of uncomplicated malaria, for a transversal study from June 2004 to September 2005. Patients were recruited at 11 health care centres, including two referral hospitals, after they had given informed consent. The diagnosis of HEV was made with a commercial ELISA test to detect IgM and/or IgG antibodies. HEV RNA was amplified by RT-PCR to confirm the presence of the viral genome. Results The most frequent clinical signs found were jaundice (93.4%, vomiting (50.7%, hepatalgia (47.4%, hepatomegaly (30.9% and asthenia (26.8%, which are the general clinical signs of hepatic disease. Acute hepatitis E was found in 213 patients (51.8% who were positive for HEV IgM antibodies. The IgG anti-HEV seroprevalence during this outbreak was high (79.5%. The age group 18-34 years was more frequently infected (91.2% than those aged 1-17 (78.0% or over 34 (64.9% (p -6. RT-PCR performed on 127 sera from the 213 IgM-HEV-positive patients was amplified, and the presence of the viral genome was found in 65 samples. Conclusion Although no specific clinical signs exist for hepatitis E infection, people presenting with jaundice, vomiting, hepatalgia, asthenia, hepatomegaly or distended abdomen with no signs of uncomplicated malaria in tropical developing countries should be sent to a laboratory for testing for hepatitis E.

  4. The significance of migrant Fulani and human trypanosomiasis in Kainji Lake area of Nigeria.

    Adekolu-John, E O


    The transhumance-route followed by the Fulani around Lake Kainji area of Nigeria is presented. Between January and February 1977 130 Fulanis were interviewed at different locations. Most respondents were between 20-60 years of age. In addition to cattle rearing, farming is practised among the Fulanis interviewed at Kaiama and Olli. Those interviewed at Faku practised pastoral transhumance. Less than 15% of the respondents had previous knowledge of human sleeping sickness. Although examination of blood films (thin and thick) did not reveal any blood trypanosome, the transhumance pastoral mobility will be an important factor in any outbreak of human trypanosomiasis around Kainji Lake area in future. PMID:734753

  5. Immunization against East Coast fever: Effect of chronic trypanosomiasis on the development of immunity

    Two experiments were carried out in which clean cattle, or cattle chronically infected with Trypanosoma congolense, were immunized by the infection and treatment method against East Coast fever (ECF, Theileria parva infection). Chronic trypanosomiasis did not prevent cattle from mounting and effective immunological response to ECF immunization and resisting subsequent lethal challenge. There appeared to be no difference in the level or quality of immunity between clean cattle and trypanosome infected cattle. Thus, T. congolense infection on its own does not appear to provide a constraint to ECF immunization in the field. (author). 17 refs, 2 tabs

  6. Stakeholder Narratives on Trypanosomiasis, Their Effect on Policy and the Scope for One Health

    Grant, Catherine; Anderson, Neil; Machila, Noreen


    Background This paper explores the framings of trypanosomiasis, a widespread and potentially fatal zoonotic disease transmitted by tsetse flies (Glossina species) affecting both humans and livestock. This is a country case study focusing on the political economy of knowledge in Zambia. It is a pertinent time to examine this issue as human population growth and other factors have led to migration into tsetse-inhabited areas with little historical influence from livestock. Disease transmission in new human-wildlife interfaces such as these is a greater risk, and opinions on the best way to manage this are deeply divided. Methods A qualitative case study method was used to examine the narratives on trypanosomiasis in the Zambian policy context through a series of key informant interviews. Interviewees included key actors from international organisations, research organisations and local activists from a variety of perspectives acknowledging the need to explore the relationships between the human, animal and environmental sectors. Principal Findings Diverse framings are held by key actors looking from, variously, the perspectives of wildlife and environmental protection, agricultural development, poverty alleviation, and veterinary and public health. From these viewpoints, four narratives about trypanosomiasis policy were identified, focused around four different beliefs: that trypanosomiasis is protecting the environment, is causing poverty, is not a major problem, and finally, that it is a Zambian rather than international issue to contend with. Within these narratives there are also conflicting views on the best control methods to use and different reasoning behind the pathways of response. These are based on apparently incompatible priorities of people, land, animals, the economy and the environment. The extent to which a One Health approach has been embraced and the potential usefulness of this as a way of reconciling the aims of these framings and narratives is

  7. Spontaneous intracerebral hemorrhage: Clinical and computed tomography findings in predicting in-hospital mortality in Central Africans

    Michel Lelo Tshikwela


    Full Text Available Background and Purpose: Intracerebral hemorrhage (ICH constitutes now 52% of all strokes. Despite of its deadly pattern, locally there is no clinical grading scale for ICH-related mortality prediction. The first objective of this study was to develop a risk stratification scale (Kinshasa ICH score by assessing the strength of independent predictors and their association with in-hospital 30-day mortality. The second objective of the study was to create a specific local and African model for ICH prognosis. Materials and Methods: Age, sex, hypertension, type 2 diabetes mellitus (T2DM, smoking, alcohol intake, and neuroimaging data from CT scan (ICH volume, Midline shift of patients admitted with primary ICH and follow-upped in 33 hospitals of Kinshasa, DR Congo, from 2005 to 2008, were analyzed using logistic regression models. Results: A total of 185 adults and known hypertensive patients (140 men and 45 women were examined. 30-day mortality rate was 35% (n=65. ICH volume>25 mL (OR=8 95% CI: 3.1-20.2; P 7 mm, a consequence of ICH volume, was also a significant predictor of mortality. The Kinshasa ICH score was the sum of individual points assigned as follows: Presence of coma coded 2 (2 × 2 = 4, absence of coma coded 1 (1 × 2 = 2, ICH volume>25 mL coded 2 (2 × 2=4, ICH volume of ≤25 mL coded 1(1 × 2=2, left hemispheric site of ICH coded 2 (2 × 1=2, and right hemispheric site of hemorrhage coded 1(1 × 1 = 1. All patients with Kinshasa ICH score ≤7 survived and the patients with a score >7 died. In considering sex influence (Model 3, points were allowed as follows: Presence of coma (2 × 3 = 6, absence of coma (1 × 3 = 3, men (2 × 2 = 4, women (1 × 2 = 2, midline shift ≤7 mm (1 × 3 = 3, and midline shift >7 mm (2 × 3 = 6. Patients who died had the Kinshasa ICH score ≥16. Conclusion: In this study, the Kinshasa ICH score seems to be an accurate method for distinguishing those ICH patients who need continuous and special management

  8. Racial differences in DSM diagnosis using a semi-structured instrument: the importance of clinical judgment in the diagnosis of African Americans.

    Neighbors, Harold W; Trierweiler, Steven J; Ford, Briggett C; Muroff, Jordana R


    Schizophrenia is diagnosed more frequently among African Americans while mood disorders are identified more often among whites. Such findings have raised serious questions about the accuracy of clinical judgment. This article analyzes data on 665 African American and white psychiatric inpatients using a semi-structured diagnostic instrument. The paper explores the relationship of patient race to schizophrenia, schizoaffective disorder, major depression, and bipolar disorder. The paper also explores the extent to which patient race is related to the manner in which clinicians link individual symptoms to diagnoses. Results indicate some significant race differences in diagnosis remain even when a semi-structured instrument and DSM criteria are used, whites, were more likely than African Americans to receive a diagnosis of bipolar disorder and less likely to be diagnosed with schizophrenia. There were no race differences in major depression. Some patterns of symptom attribution differed by race. The results are consistent with previous sociological research showing that patient race is related to diagnosis even when standardized diagnostic criteria are used. These findings underscore the importance of clinical judgment within the context of cross-race and cross-ethnic diagnosis. Clinical training programs must reduce ethnocentric bias by teaching the appropriate use of the socio-cultural information necessary to employ DSM-IV's Cultural Formulation. PMID:14582306

  9. A Comparison Between Caucasians and African Americans in Willingness to Participate in Cancer Clinical Trials: The Roles of Knowledge, Distrust, Information Sources, and Religiosity.

    Meng, Jingbo; McLaughlin, Margaret; Pariera, Katrina; Murphy, Sheila


    This study aims to (a) examine the roles of knowledge, distrust in medical professionals, information sources, and 2 dimensions of religiosity (i.e., religious activity and religious belief) in influencing willingness to participate (WTP) in cancer clinical trials and to (b) compare the results for Caucasians and African Americans in order to inform future recruitment. An online survey was fielded via a Knowledge Networks panel with a nationally representative sample including 478 Caucasians and 173 African Americans. The results showed that distrust in medical professionals was a strong barrier to WTP for both ethnic groups, whereas factual knowledge about trial procedures was not associated with WTP for either ethnic group. Seeking trial information from doctors was positively associated with WTP for Caucasians; seeking trial information from hospitals was positively associated with WTP for African Americans. More interestingly, levels of religious activity negatively predicted WTP for Caucasians but positively predicted WTP for African Americans. Self-reported religious belief was not associated with WTP for either ethnic group. In sum, although distrust is a common barrier to WTP, the influence of preferred information sources and religious activity on WTP varies as a function of ethnicity. PMID:27175604

  10. Baseline morbidity in 2,990 adult African volunteers recruited to characterize laboratory reference intervals for future HIV vaccine clinical trials.

    Wendy Stevens

    Full Text Available BACKGROUND: An understanding of the health of potential volunteers in Africa is essential for the safe and efficient conduct of clinical trials, particularly for trials of preventive technologies such as vaccines that enroll healthy individuals. Clinical safety laboratory values used for screening, enrolment and follow-up of African clinical trial volunteers have largely been based on values derived from industrialized countries in Europe and North America. This report describes baseline morbidity during recruitment for a multi-center, African laboratory reference intervals study. METHODS: Asymptomatic persons, aged 18-60 years, were invited to participate in a cross-sectional study at seven sites (Kigali, Rwanda; Masaka and Entebbe, Uganda; Kangemi, Kenyatta National Hospital and Kilifi, Kenya; and Lusaka, Zambia. Gender equivalency was by design. Individuals who were acutely ill, pregnant, menstruating, or had significant clinical findings were not enrolled. Each volunteer provided blood for hematology, immunology, and biochemistry parameters and urine for urinalysis. Enrolled volunteers were excluded if found to be positive for HIV, syphilis or Hepatitis B and C. Laboratory assays were conducted under Good Clinical Laboratory Practices (GCLP. RESULTS AND CONCLUSIONS: Of the 2990 volunteers who were screened, 2387 (80% were enrolled, and 2107 (71% were included in the analysis (52% men, 48% women. Major reasons for screening out volunteers included abnormal findings on physical examination (228/603, 38%, significant medical history (76, 13% and inability to complete the informed consent process (73, 13%. Once enrolled, principle reasons for exclusion from analysis included detection of Hepatitis B surface antigen (106/280, 38% and antibodies against Hepatitis C (95, 34%. This is the first large scale, multi-site study conducted to the standards of GCLP to describe African laboratory reference intervals applicable to potential volunteers in

  11. A South African family with oculopharyngeal muscular dystrophy: Clinical and molecular genetic characteristics.

    Schutte, Clara Maria; Dorfling, Cecelia M; van Coller, Riaan; Honey, Engela M; van Rensburg, Elizabeth Jansen


    Autosomal dominantly inherited oculopharyngeal muscular dystrophy (OPMD) is caused by a trinucleotide repeat expansion in exon 1 of the polyadenylate binding protein nuclear 1 (PABPN1) gene on chromosome 14q. A large family with OPMD was recently identified in Pretoria, South Africa (SA). Molecular studies revealed a (GCG)11(GCA)3GCG or (GCN)15 mutant allele. The (GCN)15 mutation detected in this family has been described previously in families from Uruguay and Mexico as a founder effect. To our knowledge, this is the first report of an SA Afrikaner family with molecularly confirmed OPMD. The proband, a 64-year-old woman, presented to the neurology outpatient department at Steve Biko Academic Hospital, Pretoria. A sibship of 18 individuals was identified, of whom eight had OPMD. Four patients were interviewed and examined clinically, and electromyographic studies were performed. Molecular analysis of the PABPN1 gene was performed by polymerase chain reaction amplification and direct sequencing of exon 1 in three of the patients. Patients presented with ptosis, external ophthalmoplegia, dysphagia, dysarthria and mild proximal weakness. High foot arches and absent ankle reflexes raised the possibility of peripheral neuropathy, but electromyography showed only mildly low sensory amplitudes, and myopathic units in two patients. PMID:26428746

  12. South African Guidelines Excellence (SAGE): Efficient, effective and unbiased clinical practice guideline teams.

    Grimmer, Karen; Dizon, Janine Margarita; Louw, Quinette; Kredo, Tamara; Young, Taryn; Machingaidze, Shingai


    A range of different evidence-based methods for clinical practice guideline activities have been established, and there is common agreement in these that poorly conceived CPG team composition and management can jeopardise CPG integrity.  Recognised CPG initiatives therefore provide guidance on CPG team construction and management. In this editorial, we outline steps for effective, efficient and outcome-focused CPG team membership, roles and management: (i) determine responsibilities and tasks; (ii) identify 'experts' and their 'voices'; (iii) identify a CPG team leader; (iv) determine and declare conflicts of interest; (v) determine CPG team terms of reference; (vi) establish CPG timeframes and tailored capacity development; and (vii) establish consensus. Writing CPGs can be time-consuming and expensive.Efforts therefore need to be underpinned by efficient, respectful and agreed processes. Justifying CPG team membership, declaring conflicts of interest, identifying efficient ways of hearing constituent 'voices', defining and time-lining team tasks and roles, providing necessary training, and respecting individuals' efforts and time should ensure that CPG team members enjoy their experiences. This will contribute to growing CPG expertise in South Africa and beyond. PMID:27138656

  13. The Molecular Dynamics of Trypanosoma brucei UDP-Galactose 4′-Epimerase: A Drug Target for African Sleeping Sickness

    Friedman, Aaron J; Durrant, Jacob D.; Pierce, Levi C. T.; McCorvie, Thomas J; Timson, David J; McCammon, J. Andrew


    During the past century, several epidemics of human African trypanosomiasis, a deadly disease caused by the protist Trypanosoma brucei, have afflicted sub-Saharan Africa. Over 10 000 new victims are reported each year, with hundreds of thousands more at risk. As current drug treatments are either highly toxic or ineffective, novel trypanocides are urgently needed. The T. brucei galactose synthesis pathway is one potential therapeutic target. Although galactose is essential for T. brucei survi...

  14. Observational monitoring of clinical signs during the last stage of habituation in a wild western gorilla group at Bai Hokou, Central African Republic.

    Morton, F Blake; Todd, Angelique F; Lee, Phyllis; Masi, Shelly


    Anthropozoonotic disease transmission to great apes is a critical conservation concern, and has raised ethical doubts regarding ape habituation. We monitored over a 3-year period clinical signs within a group of wild western gorillas (G. gorilla) undergoing habituation at Bai Hokou, Central African Republic. The majority of observations consisted of singular coughs and sneezes among the gorillas. These were the only clinical signs that significantly and positively increased over the years. No changes in the demography of the study group were observed. While clinical signs are not necessarily indicative of 'disease' or other health-related problems, we discuss how long-term records of clinical signs provide useful information when health monitoring, and the importance of the rigid application of preventive disease transmission protocols. PMID:23736676

  15. 77 FR 37886 - Notice of Intent To Obtain Information Regarding Organizations Who Are Assisting African...


    ... African Governments To Increase Healthcare Institution Capacity To Maintain Complex Medical Equipment..., which are currently helping African government hospitals, clinics, laboratories, and other African... involved in enhancing the long term ability of African government health institutions to maintain...

  16. Computer-Aided Drug Discovery Approaches against the Tropical Infectious Diseases Malaria, Tuberculosis, Trypanosomiasis, and Leishmaniasis.

    Njogu, Peter M; Guantai, Eric M; Pavadai, Elumalai; Chibale, Kelly


    Despite the tremendous improvement in overall global health heralded by the adoption of the Millennium Declaration in the year 2000, tropical infections remain a major health problem in the developing world. Recent estimates indicate that the major tropical infectious diseases, namely, malaria, tuberculosis, trypanosomiasis, and leishmaniasis, account for more than 2.2 million deaths and a loss of approximately 85 million disability-adjusted life years annually. The crucial role of chemotherapy in curtailing the deleterious health and economic impacts of these infections has invigorated the search for new drugs against tropical infectious diseases. The research efforts have involved increased application of computational technologies in mainstream drug discovery programs at the hit identification, hit-to-lead, and lead optimization stages. This review highlights various computer-aided drug discovery approaches that have been utilized in efforts to identify novel antimalarial, antitubercular, antitrypanosomal, and antileishmanial agents. The focus is largely on developments over the past 5 years (2010-2014). PMID:27622945

  17. Hematology and Clinical Chemistry Measures During and After Pregnancy and Age- and Sex-Specific Reference Intervals in African Green Monkeys (Chlorocebus aethiops sabaeus).

    Chichester, Lee; Gee, Melaney K; Jorgensen, Matthew J; Kaplan, Jay R


    Clinical decisions and experimental analyses often involve the assessment of hematology and clinical chemistry. Using clinical pathology to assess the health status of NHP in breeding colonies or data from studies than involve pregnancy can often be complicated by pregnancy status. This study had 2 objectives regarding the hematology and clinical chemistry of African green monkeys (AGM, Chlorocebus aethiops sabaeus): 1) to compare pregnant or recently postpartum animals with nonpregnant, nonlactating animals and 2) to create age- and sex-specific reference intervals. Subjects in this study were 491 AGM from the Vervet Research Colony of the Wake Forest University Primate Center. Results indicated that changes in BUN, serum total protein, albumin, ALP, GGT, calcium, phosphorus, sodium, potassium, cholesterol, total CO2, globulins, lipase, amylase, WBC, neutrophils, lymphocytes, platelets, RBC, Hgb, and Hct occur during pregnancy and the postpartum period. Age- and sex-specific reference intervals consistent with guidelines from the American Society for Veterinary Clinical Pathology were established and further expand the understanding of how to define health in AGM on the basis of clinical pathology. The combination of understanding the changes that occur in pregnancy and postpartum and expansive reference intervals will help guide clinical and experimental decisions. PMID:26224434

  18. The molecular dynamics of Trypanosoma brucei UDP-galactose 4'-epimerase:a drug target for African sleeping sickness

    Friedman, Aaron J; Durrant, Jacob D.; Pierce, Levi C. T.; McCorvie, Thomas J; Timson, David J; McCammon, J. Andrew


    During the past century, several epidemics of human African trypanosomiasis, a deadly disease caused by the protist Trypanosoma brucei, have afflicted sub-Saharan Africa. Over 10 000 new victims are reported each year, with hundreds of thousands more at risk. As current drug treatments are either highly toxic or ineffective, novel trypanocides are urgently needed. The T. brucei galactose synthesis pathway is one potential therapeutic target. Although galactose is essential for T. brucei survi...

  19. Idiosyncratic sound systems of the South African Bantu languages: Research and clinical implications for speech-language pathologists and audiologists

    Anita Van der Merwe; Mia le Roux


    The objective of this article is to create awareness amongst speech-language pathologists and audiologists in South Africa regarding the difference between the sound systems of Germanic languages and the sound systems of South African Bantu languages. A brief overview of the sound systems of two Bantu languages, namely isiZulu and Setswana, is provided. These two languages are representative of the Nguni language group and the Sotho group respectively.Consideration is given to the notion of l...

  20. Benefiting Africans



    Along with thriving Sino-African economic and trade ties,Chinese companies have attached greater importance to their social responsibility to Africans.More than 2,000 sweaters woven by Chinese mothers were sent to orphans and disabled children in Kenya and four other African countries in September.This activity was launched by Hengyuanxiang,a leading Chinese wool manufacturer.

  1. Benefiting Africans


    Along with thriving Sino-African economic and trade ties,Chinese companies have attached greater importance to their social responsibility to Africans.More than 2,000 sweaters woven by Chinese mothers were sent to orphans and disabled children in Kenya and four other African countries in September. This activity was launched by Hengyuanxiang,aleading Chinese wool manufacturer.

  2. Pharmacokinetic studies on 14C-labelled phenanthridine and aromatic diamidine drugs used to control African trypanosomiasis in domestic animals

    For many years ethidium (homidium) bromide (3, 8-diamino-6-phenyl-5-ethyl phenanthridinium bromide) has been used curatively and for limited prophylaxis against Trypanosoma congolense and Trypanosoma vivax infections in ruminants in Africa and aromatic diamidine berenil (diminazeneaceturate, 4, 4'-(diazoamino) benzamidine) has been used as a curative drug against these parasites, but there is little published information about the pharmacokinetics of either drug. Reviewed here is the present knowledge and report results of recent experiments using 14C-labelled drugs to measure blood and tissue fluid levels and tissue residues of ethidium in uninfected and T. congolense-infected laboratory animals and bovines and berenil in laboratory animals. In the case of 14C-ethidium levels of radioactivity in blood and tissue fluids reached a maximum within 1 h of intramuscular injection (1 mg/kg) and then fell rapidly; after 96 h 80-90% of the radioactivity injected had been excreted, approximately one-third in urine and two-thirds in faeces. It is estimated that ca 3-4% of the radioactivity injected is present in tissues of animals sacrificed 9-10 d after administration of drug, the highest residues/unit wet weight of tissue being present in liver and kidney. In similar experiments with 14C-berenil (3.5 mg/kg) radioactivity in blood reached a peak within 30 min, fell rapidly over the next 5 h, but remained at a significant level for 4-6 d. Radioactivity in tissue fluids did not rise as rapidly or to such a high peak level as in blood, but after 2 h remained at approximately twice the level detected in blood for up to 7 d. At 7 d, in marked contrast to ethidium, only 65% of the administered radioactivity had been excreted (44% in urine and 21% in faeces), and in animals sacrificed at that time it was found that the majority (95%) of the residual drug was present in the liver. (author)

  3. Challenges towards the elimination of Human African Trypanosomiasis in the sleeping sickness focus of Campo in southern Cameroon.

    Simo, Gustave; Mbida Mbida, Jean Arthur; Ebo'o Eyenga, Vincent; Asonganyi, Tazoacha; Njiokou, Flobert; Grébaut, Pascal


    The sleeping sickness focus of Campo lies along the Atlantic coast and extends along the Ntem River, which constitutes the Cameroonian and Equatorial Guinean border. It is a hypo-endemic focus with the disease prevalence varying from 0.3 to 0.86% during the last few decades. Investigations on animal reservoirs revealed a prevalence of Trypanosoma brucei gambiense of 0.6% in wild animals and 4.83% in domestic animals of this focus. From 2001 to 2012, about 19 931 tsetse were collected in this focus and five tsetse species including Glossina palpalis palpalis, G. pallicera, G. nigrofusca, G. tabaniformis and G. caliginea were identified. The analysis of blood meals of these flies showed that they feed on human, pig, goat, sheep, and wild animals such as antelope, duiker, wild pig, turtle and snake. The percentage of blood meals taken on these hosts varies according to sampling periods. For instance, 6.8% of blood meals from pig were reported in 2004 and 22% in 2008. This variation is subjected to considerable evolutions because the Campo HAT focus is submitted to socio-economic mutations including the reopening of a new wood company, the construction of autonomous port at "Kribi" as well as the dam at "Memve ele". These activities will bring more that 3000 inhabitants around Campo and induce the deforestation for the implementation of farmlands as well as breeding of domestic animals. Such mutations have impacts on the transmission and the epidemiology of sleeping sickness due to the modification of the fauna composition, the nutritional behavior of tsetse, the zoophilic/anthropophilic index. To achieve the elimination goal in the sleeping sickness focus of Campo, we report in this paper the current epidemiological situation of the disease, the research findings of the last decades notably on the population genetics of trypanosomes, the modifications of nutritional behavior of tsetse, the prevalence of T. b. gambiense in humans, domestic and wild animals. An overview on the types of mutations occurring in the region has been raised and a discussion on the strategies that can be implemented to achieve the elimination of the disease has been made. PMID:25129168

  4. A practice-based trial of blood pressure control in African Americans (TLC-Clinic: study protocol for a randomized controlled trial

    Schoenthaler Antoinette


    Full Text Available Abstract Background Poorly controlled hypertension (HTN remains one of the most significant public health problems in the United States, in terms of morbidity, mortality, and economic burden. Despite compelling evidence supporting the beneficial effects of therapeutic lifestyle changes (TLC for blood pressure (BP reduction, the effectiveness of these approaches in primary care practices remains untested, especially among African Americans, who share a disproportionately greater burden of HTN-related outcomes. Methods/Design This randomized controlled trial tests the effectiveness of a practice-based comprehensive therapeutic lifestyle intervention, delivered through group-based counseling and motivational interviewing (MINT-TLC versus Usual Care (UC in 200 low-income, African Americans with uncontrolled hypertension. MINT-TLC is designed to help patients make appropriate lifestyle changes and develop skills to maintain these changes long-term. Patients in the MINT-TLC group attend 10 weekly group classes focused on healthy lifestyle changes (intensive phase; followed by 3 monthly individual motivational interviewing (MINT sessions (maintenance phase. The intervention is delivered by trained research personnel with appropriate treatment fidelity procedures. Patients in the UC condition receive a single individual counseling session on healthy lifestyle changes and print versions of the intervention materials. The primary outcome is within-patient change in both systolic and diastolic BP from baseline to 6 months. In addition to BP control at 6 months, other secondary outcomes include changes in the following lifestyle behaviors from baseline to 6 months: a physical activity, b weight loss, c number of daily servings of fruits and vegetables and d 24-hour urinary sodium excretion. Discussion This vanguard trial will provide information on how to refine MINT-TLC and integrate it into a standard treatment protocol for hypertensive African Americans

  5. Impact of comorbidities and drug therapy on development of renal impairment in a predominantly African American and Hispanic HIV clinic population

    M Keith Rawlings


    Full Text Available M Keith Rawlings1, Jennifer Klein1, Edna P Toubes Klingler1, Ejeanée Queen1, Lauren Rogers1, Linda H Yau2, Keith A Pappa2, Gary E Pakes21AIDS Arms Peabody Health Clinic, Dallas, Texas; 2GlaxoSmithKline, Research Triangle Park, North Carolina, USAPurpose: Renal impairment in human immunodeficiency virus (HIV-infected patients could potentially be caused by many factors. HIV-related renal impairment risks have been little studied in African Americans and Hispanics. We investigated the impact of HIV itself, highly active antiretroviral therapy (HAART, comorbidities, and non-HIV-related drug treatment on glomerular filtration rate in a predominantly African American/Hispanic HIV-infected population who had received HAART for at least one year. This study was a retrospective electronic medical record database evaluation of renal impairment risks in a largely African American/Hispanic HIV population obtaining medical care at an HIV clinic in Dallas, Texas.Methods: Proportional hazards models were used to investigate an association between an estimated glomerular filtration rate decrease >25% from baseline (ie, renal impairment and demographics, antiretroviral/nonantiretroviral medications, comorbidities (hypertension, diabetes mellitus, hepatitis C virus [HCV] infection, hepatitis B virus [HBV] infection, CD4+ counts, viral load, and duration patients were monitored at the clinic (time on study.Results: In total, 323 patients were evaluated: 82% males; 61% African American/12% Hispanic/19% Caucasian; mean age 37.9 years (standard deviation [SD] 8.5; 6% HBV-positive; 34% HCV-positive; 29% hypertensive; 3% diabetic; 52% tenofovir-treated; mean weight 75.4 kg (SD, 15.4; mean estimated glomerular filtration 114.5 mL/min/1.73 m2 (SD, 36.7 using the Modification of Diet in Renal Disease (MDRD calculation method; mean creatinine clearance (from which estimated glomerular filtration was extrapolated by the Cockcroft-Gault calculation method 120.6 mL/min/1

  6. Estudios sobre Trypanosomiasis americana en el Perú. Observaciones en el departamento de Ica

    Víctor M Ayulo Robles


    Full Text Available Hemos comprobado la presencia de Triatomas en las ciudades de Ica y Nazca. Los Triatomas encontrados en esas localidades son de la especie del Triatoma Infestans. Las observaciones del contenido intestinal de los Triatomas capturados en ambas ciudades reveló que ellos no se encuentran infestados; lo que hace sospechar que estos insectos procedan de la Ciudad de Arequipa. Los exámenes de sangre en fresco, gota gruesa y frotis coloreados por el método de Giemsa en 174 personas y 32 animales, así como las pruebas de Desviación del Complemento (Reacción de GUERREIRO Y MACHADO e intradermo-reacción en las 174 personas, fueron negativas; lo que demuestra que actualmente no existe la Enfermedad de Chagas en el Departamento de Ica. Dada la presencia de Triatomas en Ica y Nazca y la existencia de la Enfermedad de Chagas en Vitor, Sihuas y Quishuarani del Departamento de Arequipa no se excluye la posibilidad de que posteriormente se haga presente la Trypanosomiasis americana, también, en esas zonas.

  7. Animal trypanosomiasis in South America. Current status, partnership, and information technology.

    Dávila, A M; Silva, R A


    Animal trypanosome species of economical importance in South America include T. vivax and T. evansi. Both species are described in Brazil, Bolivia, Colombia, French Guyana, Peru, Suriname, and Venezuela. In Argentina and Guyana, only T. evansi and T. vivax are found, respectively. Our studies on T. vivax indicated that the parasite was spreading around 1.3 km per day in Bolivia. We found severe leukopenia in bovines from Pantanal (Brazil) and the Department of Santa Cruz (Bolivia). Because it can cause immunosuppression, the importance of trypanosomiasis control in ensuring success of vaccination campaigns against foot and mouth disease (FMD) in the Pantanal and Bolivia should be considered. The use of one needle for several animals during FMD campaigns in Brazil and Bolivia could also contribute to the spread of T. vivax. The anticipated losses due to T. vivax could exceed $160 million, assuming there are 11 million head of cattle in the Brazilian Pantanal and Bolivian lowlands. International collaboration among research institutes is needed to deal with these diseases and parasites. Previous efforts using information technologies resulted in the creation of two discussion lists (Tryplink and Trypan), the edition of the on-line version of Trypnews and Internet conferences. PMID:11193622

  8. Tsetse and trypanosomiasis control for the rural development of Buvuma island, Lake Victoria, Uganda

    Historically, the potentially highly agricultural productive areas of Uganda, bordering the shores of Lake Victoria, have been plagued by the presence of tsetse flies. While Glossina pallidipes was reported to be main vector in the area, evidence has accrued indicating that G. fuscipes fuscipes is in fact the main vector on the island. There is also evidence that the species has adopted a peridomestic behaviour in this, predominantly, farming and fishing community. Since 1987/88, intensive surveys were conducted and current monitoring work concentrates on strategic sites such as water collection points, fishing camps, ports of call and selected villages on the island (Bulopa-Walwanda, Lwenyanga, Kyanamu, Tome, Isiriba and Kachanga). Making use of 20-25 pyramidal traps impregnated with deltamethrin (400 mg/trap) for 20-22 days/month, the G. f. fuscipes population around reference villages was considerably reduced (90-95% after 7-9 months). Arrangements are underway to evaluate insecticides treatments of domestic livestock host animals and monitor trends in the transmission of trypanosomiasis. In collaboration with UTRO, Tororo, experimental rearing of G. F. fuscipes will be undertaken aiming at producing flies for mark-release-recapture studies and trials with sterile flies

  9. A Pre-clinical Animal Model of Trypanosoma brucei Infection Demonstrating Cardiac Dysfunction

    McCarroll, Charlotte S; Rossor, Charlotte L.; Linda R Morrison; Morrison, Liam J.; Loughrey, Christopher M.


    Author Summary African trypanosomiasis (AT) is a disease caused by the single-celled protozoan parasite Trypanosoma brucei. In humans, AT causes neurological problems including sleep disturbances, which give the disease its colloquial name of “sleeping sickness”. Much of the focus of AT research has been on the neurological deficits, but other major organs are also affected, including the heart. Previous studies in humans and animals with AT have identified heart abnormalities such as contrac...

  10. Consultants' Group Meeting on Tsetse Genetics in Relation to Tsetse/Trypanosomiasis Control/Eradication

    The FAO and IAEA have long recognized the need for methods for insect and pest control based upon approaches other than simply the widespread use of insecticides. Through the past several years the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture has expended a considerable amount of effort in the development of a SIT programme applicable to tsetse. Such programmes have proved to be a highly successful component of the integrated control of tsetse flies. However, the pilot programmes undertaken to date have been applied to areas of limited size and future integrated control programmes for tsetse must cover much larger regions. The Consultants' Group was cognisant of the continued need for improvements in the cost effectiveness in the mass production of tsetse, particularly for SIT programmes. The Consultants' Goup recognized also that FAO/IAEA plays an important leadership role in the development of new technologies for the control of insect pest populations, and in the transfer of such technologies to assist in the improvement of agricultural production, particularly in developing countries. In addition to research on the development of methods for insect control (emphasizing application of the Sterile Insect Technique), the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture has established and implemented five 'Co-ordinated Research Programmes' on tsetse and has, from time to time, convened groups of consultants to discuss and make recommendations on specific subjects. At least two such meetings (in July 1975 and November 1987) focused on genetic methods of insect control. The recent, rapid developments in molecular biology have stimulated interest in the application of genetic techniques to the problem of tsetse and trypanosomiasis control in Africa.

  11. Male, Mobile, and Moneyed: Loss to Follow-Up vs. Transfer of Care in an Urban African Antiretroviral Treatment Clinic

    Marson, Kara G.; Tapia, Kenneth; Kohler, Pamela; McGrath, Christine J.; John-Stewart, Grace C.; Richardson, Barbra A.; Njoroge, Julia W.; Kiarie, James N.; Sakr, Samah R.; Michael H Chung


    Objectives The purpose of this study was to analyze characteristics, reasons for transferring, and reasons for discontinuing care among patients defined as lost to follow-up (LTFU) from an antiretroviral therapy (ART) clinic in Nairobi, Kenya. Design The study used a prospective cohort of patients who participated in a randomized, controlled ART adherence trial between 2006 and 2008. Methods Participants were followed from pre-ART clinic enrollment to 18 months after ART initiation, and were ...

  12. Differences in Clinical Manifestations of Acute and Early HIV-1 Infection between HIV-1 Subtypes in African Women

    Lemonovich, Tracy L.; Watkins, Richard R.; Morrison, Charles S.; Kwok, Cynthia; Chipato, Tsungai; Musoke, Robert; Arts, Eric J; Nankya, Immaculate; Salata, Robert A.


    Little is known about the differences in clinical manifestations between women with various HIV-1 subtypes during acute (AI) and early (EI) HIV infection. In a longitudinal cohort study, clinical signs and symptoms among Uganda and Zimbabwe women with AI and EI were compared with HIV-negative controls; symptoms were assessed quarterly for 15 to 24 months. Early HIV infection was defined as the first visit during which a woman tested HIV antibody positive. Women who were HIV negative serologic...

  13. Experimental exposure of African catfish Clarias Gariepinus (Burchell, 1822 to phenol: Clinical evaluation, tissue alterations and residue assessment

    Mai D. Ibrahem


    Full Text Available There is lack of information regarding; the toxicological and pathological consequences of phenol stressed Clarias gariepinus; as well as; the susceptibility of the stressed fish to disease occurrence. Static renewal bioassay was experimentally conducted to evaluate the toxic effects of phenol on the African catfish C. gariepinus. Ninety-six-hour acute toxicity tests revealed that the median lethal concentration of phenol (LC50 is 35 mg/L by immersion. Four experimental fish groups were assigned for 3 weeks exposure test; three were exposed 20%, 50% and 70% LC50, the fourth control fish group received a vehicle of dechlorinated water. Abnormal signs including cessation of feeding, nervous manifestations; skin expressed perfuses mucous, black patches with skin erosion and ulcerations in the later stages. All observations were correlated to the time and dose of exposure. Post mortem examination revealed adhesion of the internal organs. For tissue alterations; Skin, gills, brain, liver and kidney showed variable degrees of degenerative changes and necrosis. Muscle residues shown in mean ± SE were 4.3 ± 0.05 and 6.65 ± 0.05 ppm in groups that received 20 and 50% LD50, respectively. Infection with Aeromonas hydrophila resulted in high percent of mortalities with a non significant difference between the challenged fish groups. The study cleared that phenol is toxic to C. gariepinus under experimental conditions.

  14. Complete Genome Sequences of Three African Foot-and-Mouth Disease Viruses from Clinical Samples Isolated in 2009 and 2010

    Rosseel, Toon; Haegeman, Andy; Fana, Mpolokang Elliot; Seoke, Latoa; Hyera, Joseph; Matlho, George; Vandenbussche, Frank; De Clercq, Kris


    The complete genome sequences of three foot-and-mouth disease viruses (one virus of each serotype SAT1, SAT2 and O) were directly sequenced from RNA extracted from clinical bovine samples, demonstrating the feasibility of full-genome sequencing from strong positive samples taken from symptomatic animals. PMID:27151795

  15. Complete Genome Sequences of Three African Foot-and-Mouth Disease Viruses from Clinical Samples Isolated in 2009 and 2010

    Van Borm, Steven; Rosseel, Toon; Haegeman, Andy; Fana, Mpolokang Elliot; Seoke, Latoa; Hyera, Joseph; Matlho, George; Vandenbussche, Frank; De Clercq, Kris


    The complete genome sequences of three foot-and-mouth disease viruses (one virus of each serotype SAT1, SAT2 and O) were directly sequenced from RNA extracted from clinical bovine samples, demonstrating the feasibility of full-genome sequencing from strong positive samples taken from symptomatic animals.

  16. Complete Genome Sequences of Three African Foot-and-Mouth Disease Viruses from Clinical Samples Isolated in 2009 and 2010.

    Van Borm, Steven; Rosseel, Toon; Haegeman, Andy; Fana, Mpolokang Elliot; Seoke, Latoa; Hyera, Joseph; Matlho, George; Vandenbussche, Frank; De Clercq, Kris


    The complete genome sequences of three foot-and-mouth disease viruses (one virus of each serotype SAT1, SAT2 and O) were directly sequenced from RNA extracted from clinical bovine samples, demonstrating the feasibility of full-genome sequencing from strong positive samples taken from symptomatic animals. PMID:27151795

  17. Frequency of glucose-6-phosphate dehydrogenase deficiency in malaria patients from six African countries enrolled in two randomized anti-malarial clinical trials

    Duparc Stephan


    Full Text Available Abstract Background Glucose-6-phosphate dehydrogenase (G6PD deficiency is common in populations living in malaria endemic areas. G6PD genotype and phenotype were determined for malaria patients enrolled in the chlorproguanil-dapsone-artesunate (CDA phase III clinical trial programme. Methods Study participants, aged > 1 year, with microscopically confirmed uncomplicated Plasmodium falciparum malaria, and haemoglobin ≥ 70 g/L or haematocrit ≥ 25%, were recruited into two clinical trials conducted in six African countries (Burkina Faso, Ghana, Kenya, Nigeria, Tanzania, Mali. G6PD genotype of the three most common African forms, G6PD*B, G6PD*A (A376G, and G6PD*A- (G202A, A542T, G680T and T968C, were determined and used for frequency estimation. G6PD phenotype was assessed qualitatively using the NADPH fluorescence test. Exploratory analyses investigated the effect of G6PD status on baseline haemoglobin concentration, temperature, asexual parasitaemia and anti-malarial efficacy after treatment with CDA 2/2.5/4 mg/kg or chlorproguanil-dapsone 2/2.5 mg/kg (both given once daily for three days or six-dose artemether-lumefantrine. Results Of 2264 malaria patients enrolled, 2045 had G6PD genotype available and comprised the primary analysis population (1018 males, 1027 females. G6PD deficiency prevalence was 9.0% (184/2045; 7.2% [N = 147] male hemizygous plus 1.8% [N = 37] female homozygous, 13.3% (273/2045 of patients were heterozygous females, 77.7% (1588/2045 were G6PD normal. All deficient G6PD*A- genotypes were A376G/G202A. G6PD phenotype was available for 64.5% (1319/2045 of patients: 10.2% (134/1319 were G6PD deficient, 9.6% (127/1319 intermediate, and 80.2% (1058/1319 normal. Phenotype test specificity in detecting hemizygous males was 70.7% (70/99 and 48.0% (12/25 for homozygous females. Logistic regression found no significant effect of G6PD genotype on adjusted mean baseline haemoglobin (p = 0.154, adjusted mean baseline temperature (p = 0

  18. Assessment of Common Anaesthetic and Clinical Indices of Multimodal Therapy of Propofol, Xylazine, and Ketamine in Total Intravenous Anaesthesia in West African Dwarf Goat

    Ukwueze Celestine Okwudili


    Full Text Available The assessment of anaesthetic and clinical indices of multimodal therapy of propofol, xylazine, and ketamine was done in West African Dwarf (WAD goat. Sixteen healthy male WAD goats were assigned into four treatment groups, namely, control (group A (ketamine 5 mg/kg + xylazine 0.05 mg/kg, group B (propofol 5 mg/kg + xylazine 0.05 mg/kg, group C (propofol 5 mg/kg + ketamine 5 mg/kg, and group D (propofol 2.5 mg/kg + ketamine 2.5 mg/kg + xylazine 0.05 mg/kg. All drugs were administered intravenously. The multimodal therapy decreased significantly (P<0.05 the heart rate in groups A, B, and D. Also respiratory rate significantly (P<0.05 decreased in groups A, B, and D but significantly (P<0.05 increased at 20 min after induction in group C. However, temperature significantly (P<0.05 decreased in groups A, B, and C. The induction was good and smooth in groups B and D. Surgical anaesthetic time was longer in groups B and D and shorter in group C. The quality of recovery was good in groups B and D. Side effects such as salivation and apnoea were observed in all groups. In conclusion, the multimodal therapy could be used successfully. However, group D could be the best combination considering the parameters measured.

  19. Individual and Partner-Level Factors Associated with Condom Non-Use Among African American STI Clinic Attendees in the Deep South: An Event-Level Analysis.

    Marshall, Brandon D L; Perez-Brumer, Amaya G; MacCarthy, Sarah; Mena, Leandro; Chan, Philip A; Towey, Caitlin; Barnett, Nancy; Parker, Sharon; Barnes, Arti; Brinkley-Rubinstein, Lauren; Rose, Jennifer S; Nunn, Amy S


    The US HIV/AIDS epidemic is concentrated in the Deep South, yet factors contributing to HIV transmission are not fully understood. We examined relationships between substance use, sexual partnership characteristics, and condom non-use in an African American sample of STI clinic attendees in Jackson, Mississippi. We assessed condom non-use at last intercourse with up to three recent sexual partners reported by participants between January and June 2011. Participant- and partner-level correlates of condom non-use were examined using generalized estimating equations. The 1295 participants reported 2880 intercourse events, of which 1490 (51.7 %) involved condom non-use. Older age, lower educational attainment, reporting financial or material dependence on a sex partner, sex with a primary partner, and higher frequency of sex were associated with increased odds of condomless sex. HIV prevention efforts in the South should address underlying socioeconomic disparities and structural determinants that result in partner dependency and sexual risk behavior. PMID:26683032

  20. Filarial-specific antibody response in East African bancroftian filariasis: effects of host infection, clinical disease, and filarial endemicity

    Jaoko, Walter G; Simonsen, Paul E; Meyrowitsch, Dan W;


    The effect of host infection, chronic clinical disease, and transmission intensity on the patterns of specific antibody responses in Bancroftian filariasis was assessed by analyzing specific IgG1, IgG2, IgG3, IgG4, and IgE profiles among adults from two communities with high and low Wuchereria...... bancrofti endemicity. In the high endemicity community, intensities of the measured antibodies were significantly associated with infection status. IgG1, IgG2, and IgE were negatively associated with microfilaria (MF) status, IgG3 was negatively associated with circulating filarial antigen (CFA) status...

  1. Plagiarism in the article Emphysematous cystitis and emphysematous pyelitis: a clinically misleading association. Mustapha Ahsaini et al. The Pan African Medical Journal. 2013;16:18. (doi:10.11604/pamj.2013.16.18.2505).


    This retracts article Emphysematous cystitis and emphysematous pyelitis: a clinically misleading association. Mustapha Ahsaini, Amadou Kassogue, Mohammed Fadl Tazi, Anas Zaougui, Jalal Edine Elammari, Abdelhak Khallouk, Mohammed Jamal El Fassi, My Hassan Farih. The Pan African Medical Journal. 2013;16:18. (doi:10.11604/pamj.2013.16.18.2505).[This retracts the article DOI: 10.11604/pamj.2013.16.18.2505.]. PMID:26328003

  2. Challenges of Diagnosing Acute HIV-1 Subtype C Infection in African Women: Performance of a Clinical Algorithm and the Need for Point-of-Care Nucleic-Acid Based Testing

    Mlisana, Koleka; Sobieszczyk, Magdalena; Werner, Lise; Feinstein, Addi; van Loggerenberg, Francois; NAICKER, Nivashnee; Williamson, Carolyn; Garrett, Nigel


    Background Prompt diagnosis of acute HIV infection (AHI) benefits the individual and provides opportunities for public health intervention. The aim of this study was to describe most common signs and symptoms of AHI, correlate these with early disease progression and develop a clinical algorithm to identify acute HIV cases in resource limited setting. Methods 245 South African women at high-risk of HIV-1 were assessed for AHI and received monthly HIV-1 antibody and RNA testing. Signs and symp...

  3. Clinical versus Rapid Molecular HIV Diagnosis in Hospitalized African Infants: A Randomized Controlled Trial Simulating Point-of-Care Infant Testing

    McCollum, Eric D.; Preidis, Geoffrey A.; Maliwichi, Madalitso; Olson, Dan; McCrary, L. Madeline; Kazembe, Peter N.; van der Horst, Charles; Hoffman, Irving; Hosseinipour, Mina C.


    Objective Many African infants fail to receive their diagnostic HIV molecular test results and subsequently, antiretroviral therapy (ART). To determine whether a point-of-care molecular HIV test increases ART access for hospitalized Malawian infants, we simulated a point-of-care test using rapid HIV RNA polymerase chain reaction (Rapid PCR) and compared patient outcomes to an optimized standard care that included assessment with the World Health Organization (WHO) clinical algorithm for HIV infection plus a DNA PCR with a turnaround time of several weeks (standard care). Design Randomized controlled trial. Methods Hospitalized HIV-exposed Malawian infants <12 months old were randomized into Rapid PCR or standard care. Rapid PCR infants obtained molecular test results within 48 hours to facilitate immediate ART, similar to a point-of-care test. Standard care infants meeting clinical criteria were also offered inpatient ART. The primary outcome was appropriate in-hospital ART for DNA or RNA PCR-confirmed HIV-infected infants. Results 300 infants were enrolled. A greater proportion of HIV-infected infants receiving Rapid PCR, versus standard care, started inpatient ART (72.3% vs 47.8%, p=0.016). Among molecular test-negative infants, 26.9% receiving standard care unnecessarily initiated inpatient ART, versus 0.0% receiving Rapid PCR (p<0.001). Rapid PCR modestly reduced the median days to ART (3.0 vs 6.5, p=0.001) but did not influence outpatient follow-up for HIV-infected infants (78.1% vs 82.4%, P = 0.418). Conclusions Rapid PCR, versus an optimized standard care, increased the proportion of hospitalized HIV-infected infants initiating ART and reduced ART exposure in molecular test-negative infants, without meaningfully impacting time to ART initiation or follow-up rates. PMID:24326604

  4. Cancer and African Americans

    ... Population Profiles > Black/African American > Cancer Cancer and African Americans African Americans have the highest mortality rate ... 65MB] At a glance – Top Cancer Sites for African Americans (2008-2012) Cancer Incidence Rates per 100, ...

  5. Clinical Characteristics and 30-Day Outcomes of Intermittent Hemodialysis for Acute Kidney Injury in an African Intensive Care Unit

    Tumukunde, Janat; Ssemogerere, Lameck; Ayebale, Emmanuel; Agaba, Peter; Yakubu, Jamali; Lubikire, Aggrey; Nabukenya, Mary


    Introduction. Acute kidney injury (AKI) is a common occurrence in the intensive care unit (ICU). Studies have looked at outcomes of renal replacement therapy using intermittent haemodialysis (IHD) in ICUs with varying results. Little is known about the outcomes of using IHD in resource-limited settings where continuous renal replacement therapy (CRRT) is limited. We sought to determine outcomes of IHD among critically ill patients admitted to a low-income country ICU. Methods. A retrospective review of patient records was conducted. Patients admitted to the ICU who underwent IHD for AKI were included in the study. Patients' demographic and clinical characteristics, cause of AKI, laboratory parameters, haemodialysis characteristics, and survival were interpreted and analyzed. Primary outcome was mortality. Results. Of 62 patients, 40 had complete records. Median age of patients was 38.5 years. Etiologic diagnoses associated with AKI included sepsis, malaria, and ARDS. Mortality was 52.5%. APACHE II (OR 4.550; 95% CI 1.2–17.5, p = 0.028), mechanical ventilation (OR 13.063; 95% CI 2.3–72, p = 0.003), and need for vasopressors (OR 16.8; 95% CI 3.4–82.6, p = 0.001) had statistically significant association with mortality. Conclusion. IHD may be a feasible alternative for RRT in critically ill haemodynamically stable patients in low resource settings where CRRT may not be available. PMID:27042657

  6. “Mama just won’t accept this”: Adult Perspectives on Engaging Depressed African American Teens in Clinical Research and Treatment

    BRELAND-NOBLE, ALFIEE M.; Bell, Carl C.; Burriss, Antoinette


    This manuscript focuses on qualitative data collected for AAKOMA Project, a 2-phase treatment engagement intervention trial for depressed African American adolescents and families. Data are presented from our phase I study of adult perspectives on African American adolescent depression, depression treatment, and research engagement. The research team conducted four focus groups (N = 24) and generated major themes from the data including ideas regarding the manifestations of depression in Afri...

  7. Impact of comorbidities and drug therapy on development of renal impairment in a predominantly African American and Hispanic HIV clinic population

    Rawlings, M Keith; Klein, Jennifer; Klingler, Edna P Toubes; Queen, Ejeanée; Rogers, Lauren; Yau, Linda H; Pappa, Keith A; Gary E. Pakes


    Purpose Renal impairment in human immunodeficiency virus (HIV)-infected patients could potentially be caused by many factors. HIV-related renal impairment risks have been little studied in African Americans and Hispanics. We investigated the impact of HIV itself, highly active antiretroviral therapy (HAART), comorbidities, and non-HIV-related drug treatment on glomerular filtration rate in a predominantly African American/Hispanic HIV-infected population who had received HAART for at least on...

  8. Couples' voluntary counselling and testing and nevirapine use in antenatal clinics in two African capitals: a prospective cohort study

    Conkling Martha


    Full Text Available Abstract Background With the accessibility of prevention of mother to child transmission (PMTCT services in sub-Saharan Africa, more women are being tested for HIV in antenatal care settings. Involving partners in the counselling and testing process could help prevent horizontal and vertical transmission of HIV. This study was conducted to assess the feasibility of couples' voluntary counseling and testing (CVCT in antenatal care and to measure compliance with PMTCT. Methods A prospective cohort study was conducted over eight months at two public antenatal clinics in Kigali, Rwanda, and Lusaka, Zambia. A convenience sample of 3625 pregnant women was enrolled. Of these, 1054 women were lost to follow up. The intervention consisted of same-day individual voluntary counselling and testing (VCT and weekend CVCT; HIV-positive participants received nevirapine tablets. In Kigali, nevirapine syrup was provided in the labour and delivery ward; in Lusaka, nevirapine syrup was supplied in pre-measured single-dose syringes. The main outcome measures were nurse midwife-recorded deliveries and reported nevirapine use. Results In eight months, 1940 women enrolled in Kigali (984 VCT, 956 CVCT and 1685 women enrolled in Lusaka (1022 VCT, 663 CVCT. HIV prevalence was 14% in Kigali, and 27% in Lusaka. Loss to follow up was more common in Kigali than Lusaka (33% vs. 24%, p = 0.000. In Lusaka, HIV-positive and HIV-negative women had significantly different loss-to-follow-up rates (30% vs. 22%, p = 0.002. CVCT was associated with reduced loss to follow up: in Kigali, 31% of couples versus 36% of women testing alone (p = 0.011; and in Lusaka, 22% of couples versus 25% of women testing alone (p = 0.137. Among HIV-positive women with follow up, CVCT had no impact on nevirapine use (86-89% in Kigali; 78-79% in Lusaka. Conclusions Weekend CVCT, though new, was feasible in both capital cities. The beneficial impact of CVCT on loss to follow up was significant, while

  9. African dance

    Mumberson, Stephen


    The RE Open will be shown at the Mall Gallery London and the international section was judged by major practitioners and educators, print dealers and collectors, President of RE and Keeper of the Ashmolean Museum Dr Bren Unwin, John Purcell, Deborah Roslund, Colin Harrison, Dave Ferry, and Mark Hampson. Piece selected "African Dance" print.

  10. A Review of Ecological Factors Associated with the Epidemiology of Wildlife Trypanosomiasis in the Luangwa and Zambezi Valley Ecosystems of Zambia

    King Shimumbo Nalubamba; Musso Munyeme; Hetron Mweemba Munang’andu; Victor Siamudaala


    Trypanosomiasis has been endemic in wildlife in Zambia for more than a century. The disease has been associated with neurological disorders in humans. Current conservation strategies by the Zambian government of turning all game reserves into state-protected National Parks (NPs) and game management areas (GMAs) have led to the expansion of the wildlife and tsetse population in the Luangwa and Zambezi valley ecosystem. This ecological niche lies in the common tsetse fly belt that harbors the h...

  11. Obesity and African Americans

    ... Data > Minority Population Profiles > Black/African American > Obesity Obesity and African Americans African American women have the ... ss6304.pdf [PDF | 3.38MB] HEALTH IMPACT OF OBESITY More than 80 percent of people with type ...

  12. Environments and trypanosomiasis risks for early herders in the later Holocene of the Lake Victoria basin, Kenya.

    Chritz, Kendra L; Marshall, Fiona B; Zagal, M Esperanza; Kirera, Francis; Cerling, Thure E


    Specialized pastoralism developed ∼3 kya among Pastoral Neolithic Elmenteitan herders in eastern Africa. During this time, a mosaic of hunters and herders using diverse economic strategies flourished in southern Kenya. It has been argued that the risk for trypanosomiasis (sleeping sickness), carried by tsetse flies in bushy environments, had a significant influence on pastoral diversification and migration out of eastern Africa toward southern Africa ∼2 kya. Elmenteitan levels at Gogo Falls (ca. 1.9-1.6 kya) preserve a unique faunal record, including wild mammalian herbivores, domestic cattle and caprines, fish, and birds. It has been suggested that a bushy/woodland habitat that harbored tsetse fly constrained production of domestic herds and resulted in subsistence diversification. Stable isotope analysis of herbivore tooth enamel (n = 86) from this site reveals, instead, extensive C4 grazing by both domesticates and the majority of wild herbivores. Integrated with other ecological proxies (pollen and leaf wax biomarkers), these data imply an abundance of C4 grasses in the Lake Victoria basin at this time, and thus little risk for tsetse-related barriers to specialized pastoralism. These data provide empirical evidence for the existence of a grassy corridor through which small groups of herders could have passed to reach southern Africa. PMID:25775535

  13. A Virtual World Versus Face-to-Face Intervention Format to Promote Diabetes Self-Management Among African American Women: A Pilot Randomized Clinical Trial

    Rosal, Milagros C.; Heyden, Robin; Mejilla, Roanne; Capelson, Roberta; Chalmers, Karen A; Rizzo DePaoli, Maria; Veerappa, Chetty; Wiecha, John M


    Background Virtual world environments have the potential to increase access to diabetes self-management interventions and may lower cost. Objective We tested the feasibility and comparative effectiveness of a virtual world versus a face-to-face diabetes self-management group intervention. Methods We recruited African American women with type 2 diabetes to participate in an 8-week diabetes self-management program adapted from Power to Prevent, a behavior-change in-person group program for Afri...

  14. Fertility of the Small East African goat following pre-pubertal infection with Trypanosoma congolense

    Pre-pubertal male and female Small East African goats were infected with Trypanosoma congolense at 4-5 months of age. Changes in body weight and haemogram were monitored weekly. Progesterone and testosterone measurements were made three times weekly until the goats either reached puberty or 18 months of age. Onset of puberty was determined from observation of oestrus behaviour, mating or increase in libidio; this was confirmed by elevation in plasma progesterone or testosterone levels. Trypanosomiasis affected pre-pubertal goats by reducing body weight gain and delaying onset of puberty. Histological examination of the gonads showed pronounced pathological changes. These effects were reversed by treatment with isometamidium chloride (Samorin, May and Baker). It was concluded that early treatment of infected goats before serious gonadal damage could occur allowed full restoration of reproductive function. (author). 6 refs, 4 figs, 1 tab

  15. Contribution to the Analysis Cost/Benefit of Scenarios to Control Tsetse and Trypanosomiasis in West Africa (Data Study Area in Benin)

    Trypanosomiasis and animal sleeping sickness is a major constraint for Africa south of Sahara. Nearly a century of struggle was not enough to contain tsetse infestations or reduce the impact of Trypanosomiasis in Africa. So that the socioeconomic development of third of the continent is severely compromised by the consequences of this debilitating often fatal disease that affects humans and animals. It is painful to note that the country's poorest continent through a crisis period (armed conflict, population movements) are most severely affected by the sleeping sickness making interventions of medical teams difficult and dangerous. Sixty (60) million men, women and children in 22 of 36 countries in sub-Saharan Africa live under the threat of sleeping sickness. About half a million men are affected by sleeping sickness. 45,000 new cases were recorded according to WHO in 1999. Forty four (44) million cattle besides other domestic animals are in infested areas of tsetse flies. The disease causes a loss of 3 million cattle a year, a loss of 26% milk yield, a 50% reduction in the number of herds in areas with high agricultural potential (PLTA, 1999). This report has been prepared to provide the International Atomic Energy Agency (IAEA) data on the various study area in Benin for a cost / benefit analysis of any program against tsetse flies and trypanosomiasis in Sudanian and Sudanian Sahel of West Africa. The study area located in Benin covers the departments of Alibori and Borgou. After presenting general information on Benin, this report focuses on: - The evolution of the human population in the study area, - The health situation, - The size and productivity of livestock, - The development achievements of major crops - Natural resources and soil quality. In conclusion, it was noted the positive impact of a regional program to fight against Tsetse and Trypanosomiasis based on the integrated use of different control methods non pollutant to the environment (traps and

  16. Options for Tsetse Eradication in the Moist Savannah Zone of West Africa: Technical and Economic Feasibility, Phase 1 - GIS-Based Study. Programme Against African Trypanosomiasis

    This desk study was initiated with two objectives: - To examine the economic costs and benefits of a range of different sized tsetse eradication projects in the Moist Savannah Zone of West Africa (MSZ), and; - To test the hypothesis that larger tsetse control projects are more economically efficient than smaller projects in that region. The limited nature of the study precluded detailed examination of the socio-cultural and environmental issues relating to controlling trypanosomosis although these are briefly considered; nor did it aim to compare vector control with other methods of combating trypanosomosis such as the therapeutic or prophylactic use of drugs. However, by computing benefits over just 10 years an indirect comparison is made with the strategy that maintains that eradicating tsetse flies is not justified as, sooner or later, rapidly increasing population pressure will autonomously eradicate tsetse flies and hence trypanosomosis. This analysis suggests that such a strategy is not justified economically. As the basis of the economic evaluation was a study of projects in defined areas it was first necessary to iteratively examine the technical and economic issues relating to project selection and design. In this respect, the re-invasion issue was considered to be the major influence as it threatens both the sustainability and economic performance of tsetse eradication. Consequently, it was considered that the river basin was the smallest size of project that would optimise economic performance. This particular observation relates uniquely to the MSZ and may not apply to more southerly areas where fly distribution is more ubiquitous or to other parts of Africa. By basing the economic analysis on an evaluation of projects, albeit hypothetical, it was possible to use real data as the baseline database and the projects could be designed in response to actual tsetse and trypanosomosis scenarios. The group of study areas were chosen to be representative of the whole of the MSZ and not in response to any project that is being planned by any organisation or government. Consequently the studies must be regarded as hypothetical and are termed 'shadow' projects in the report. It was considered that the level 4 river basins were the most appropriate level in the MSZ and five study areas throughout the zone ranging from 13,000 sq km to 22,000 sq km were selected as the small shadow project areas. Adjacent pairs of small project areas formed the basis of two mediumsized project areas (170,000 and 187,000 sq km) and the whole zone (669,000 sq km) formed the large project. By examining these different project sizes it was hoped to test the hypothesis that larger projects are more economically efficient than smaller projects. (author)

  17. Heart Disease and African Americans

    ... Minority Population Profiles > Black/African American > Heart Disease Heart Disease and African Americans Although African American adults are ... were 30 percent more likely to die from heart disease than non-Hispanic whites. African American women are ...

  18. Infant Mortality and African Americans

    ... African American > Infant Heath & Mortality Infant Mortality and African Americans African Americans have 2.2 times the infant mortality rate ... birthweight as compared to non-Hispanic white infants. African Americans had almost twice the sudden infant death syndrome ...

  19. African Americans and Glaucoma

    ... Involved News About Us Donate In This Section African Americans and Glaucoma email Send this article to ... glaucoma is the leading cause of blindness in African Americans. Half of those with glaucoma don't ...

  20. African American Suicide

    African American Suicide Fact Sheet Based on 2012 Data (2014) Overview • In 2012, 2,357 African Americans completed suicide in the U.S. Of these, ... 46 per 100,000. • The suicide rate for African Americans ages 10-19 was 2.98 per ...

  1. Cardiac assessment of African hedgehogs (Atelerix albiventris).

    Black, Peter A; Marshall, Cecilia; Seyfried, Alice W; Bartin, Anne M


    Cardiomyopathy is a common finding in captive African hedgehogs (Atelerix albiventris) at postmortem exam. To date, treatment attempts have been mostly empirical and unrewarding. The objective of this study was to determine reference cardiac values for captive African hedgehogs based on echocardiogram, electrocardiogram (ECG), and radiographs. Adult African hedgehogs with no clinical signs of cardiac disease (n = 13) were selected. Each animal was anesthetized with isoflurane via facemask and an echocardiogram, ECG, and radiographs were performed. Standard measurements were taken and the descriptive statistics performed. Values were comparable to limited data available in other hedgehog species and other similar-sized exotic species. Two animals were removed from consideration of reference values due to valvular defects that were considered significant. These data are the first establishing cardiac parameters in normal African hedgehogs using radiographic cardiac measurement, echocardiogram, and ECG. Evaluating animals with possible cardiomyopathy may allow for earlier diagnosis and more successful treatment. PMID:22946370

  2. Frequency of glucose-6-phosphate dehydrogenase deficiency in malaria patients from six African countries enrolled in two randomized anti-malarial clinical trials

    Duparc Stephan; Pamba Allan; Carter Nick; Waitumbi John N


    Abstract Background Glucose-6-phosphate dehydrogenase (G6PD) deficiency is common in populations living in malaria endemic areas. G6PD genotype and phenotype were determined for malaria patients enrolled in the chlorproguanil-dapsone-artesunate (CDA) phase III clinical trial programme. Methods Study participants, aged > 1 year, with microscopically confirmed uncomplicated Plasmodium falciparum malaria, and haemoglobin ≥ 70 g/L or haematocrit ≥ 25%, were recruited into two clinical trials cond...

  3. Random blood glucose may be used to assess long-term glycaemic control among patients with type 2 diabetes mellitus in a rural African clinical setting

    Rasmussen, Jon B; Nordin, Lovisa S; Rasmussen, Niclas S;


    OBJECTIVES: To investigate the diagnostic accuracy of random blood glucose (RBG) on good glycaemic control among patients with diabetes mellitus (DM) in a rural African setting. METHODS: Cross-sectional study at St. Francis' Hospital in eastern Zambia. RBG and HbA1c were measured during one.......7%; specificity = 70.8%; positive predictive value = 62.2%; negative predictive value = 82.9%). CONCLUSIONS: Random blood glucose could possibly be used to assess glycaemic control among patients with type 2 DM in rural settings of sub-Saharan Africa........24-0.32, P < 0.001) was significantly associated with HbA1c among the patients with type 2 DM. Based on ROC analysis (AUC = 0.80, SE = 0.05), RBG ≤7.5 mmol/l was determined as the optimal cut-off value for good glycaemic control (HbA1c <7.0% [53 mmol/mol]) among patients with type 2 DM (sensitivity = 76...

  4. Inhibition of adaptive immune responses leads to a fatal clinical outcome in SIV-infected pigtailed macaques but not vervet African green monkeys.

    Jörn E Schmitz


    Full Text Available African green monkeys (AGM and other natural hosts for simian immunodeficiency virus (SIV do not develop an AIDS-like disease following SIV infection. To evaluate differences in the role of SIV-specific adaptive immune responses between natural and nonnatural hosts, we used SIV(agmVer90 to infect vervet AGM and pigtailed macaques (PTM. This infection results in robust viral replication in both vervet AGM and pigtailed macaques (PTM but only induces AIDS in the latter species. We delayed the development of adaptive immune responses through combined administration of anti-CD8 and anti-CD20 lymphocyte-depleting antibodies during primary infection of PTM (n = 4 and AGM (n = 4, and compared these animals to historical controls infected with the same virus. Lymphocyte depletion resulted in a 1-log increase in primary viremia and a 4-log increase in post-acute viremia in PTM. Three of the four PTM had to be euthanized within 6 weeks of inoculation due to massive CMV reactivation and disease. In contrast, all four lymphocyte-depleted AGM remained healthy. The lymphocyte-depleted AGM showed only a trend toward a prolongation in peak viremia but the groups were indistinguishable during chronic infection. These data show that adaptive immune responses are critical for controlling disease progression in pathogenic SIV infection in PTM. However, the maintenance of a disease-free course of SIV infection in AGM likely depends on a number of mechanisms including non-adaptive immune mechanisms.

  5. 'They can't report abuse, they can't move out. They are at the mercy of these men': exploring connections between intimate partner violence, gender and HIV in South African clinical settings.

    Sprague, Courtenay; Hatcher, Abigail M; Woollett, Nataly; Sommers, Theresa; Black, Vivian


    This qualitative study captured South African female health provider perspectives of intimate partner violence in female patients, gender norms and consequences for patients' health. Findings indicated female patients' health behaviours were predicated on sociocultural norms of submission to men's authority and economic dependence on their partners. Respondents described how men's preferences and health decision-making in clinics affected their patients' health. Adverse gender norms and gender inequalities affected women's opportunities to be healthy, contributing to HIV risk and undermining effective HIV management in this context. Some providers, seeking to deliver a standard of quality healthcare to their female patients, demonstrated a willingness to challenge patriarchal gender relations. Findings enhance understanding of how socially-sanctioned gender norms, intimate partner violence and HIV are synergistic, also reaffirming the need for integrated HIV-intimate partner violence responses in multi-sector national strategic plans. Health providers' intimate knowledge of the lived experiences of female patients with intimate partner violence and/or HIV deepens understanding of how adverse gender norms generate health risks for women in ways that may inform policy and clinical practice in South Africa and other high-HIV prevalence settings. PMID:26505136

  6. Language Learning and Use by African American Children.

    Battle, Dolores E.


    This article reviews recent investigations of the development of phonology, morphology, semantics, and pragmatics in the development of speech and language by African American children. Clinical implications are offered to aid the distinction between normal language development using features of African American English and language disorders.…

  7. Low prevalence of liver disease but regional differences in HBV treatment characteristics mark HIV/HBV co-infection in a South African HIV clinical trial.

    Prudence Ive

    Full Text Available BACKGROUND: Hepatitis B virus (HBV infection is endemic in South Africa however, there is limited data on the degree of liver disease and geographic variation in HIV/HBV coinfected individuals. In this study, we analysed data from the CIPRA-SA 'Safeguard the household study' in order to assess baseline HBV characteristics in HIV/HBV co-infection participants prior to antiretroviral therapy (ART initiation. METHODS: 812 participants from two South African townships Soweto and Masiphumelele were enrolled in a randomized trial of ART (CIPRA-SA. Participants were tested for hepatitis B surface antigen (HBsAg, hepatitis B e antigen (HBeAg, and HBV DNA. FIB-4 scores were calculated at baseline. RESULTS: Forty-eight (5.9% were HBsAg positive, of whom 28 (58.3% were HBeAg positive. Of those with HBV, 29.8% had an HBV DNA<2000 IU/ml and ALT<40 IU/ml ; 83.0% had a FIB-4 score <1.45, consistent with absent or minimal liver disease. HBV prevalence was 8.5% in Masiphumelele compared to 3.8% in Soweto (relative risk 2.3; 95% CI: 1.3-4.0. More participants in Masiphumelele had HBeAg-negative disease (58% vs. 12%, p = 0.002 and HBV DNA levels ≤2000 IU/ml, (43% vs. 6% p<0.007. CONCLUSION: One third of HIV/HBV co-infected subjects had low HBV DNA levels and ALT while the majority had indicators of only mild liver disease. There were substantial regional differences in HBsAg and HbeAg prevalence in HIV/HBV co-infection between two regions in South Africa. This study highlights the absence of severe liver disease and the marked regional differences in HIV/HBV co-infection in South Africa and will inform treatment decisions in these populations.

  8. Three-year changes of prothrombotic factors in a cohort of South Africans with a high clinical suspicion of obstructive sleep apnea.

    von Känel, Roland; Malan, Nico T; Hamer, Mark; Lambert, Gavin W; Schlaich, Markus; Reimann, Manja; Malan, Leoné


    A hypercoagulable state might be one important mechanism linking obstructive sleep apnea (OSA) with incident myocardial infarction and stroke. However, previous studies on prothrombotic factors in OSA are not uniform and cross-sectional. We longitudinally studied prothrombotic factors in relation to OSA risk, adjusting for baseline levels of prothrombotic factors, demographics, metabolic parameters, aspirin use, and life style factors. The Berlin Questionnaire and/or neck circumference were used to define high OSA risk in 329 South African teachers (48.0% male, 44.6% black) at baseline and at three-year follow-up. Von Willebrand factor (VWF), fibrinogen, D-dimer, plasminogen activator inhibitor-1, clot lysis time (CLT), and soluble urokinase-type plasminogen activator receptor (suPAR) were measured in plasma. At baseline 35.7% of participants had a high risk of OSA. At follow-up, persistently high OSA risk, persistently low OSA risk, OSA risk remission, and new-onset OSA risk were present in 26.1%, 53.2%, 9.4%, and 11.3% of participants, respectively. New-onset OSA risk was associated with a significant and longitudinal increase in VWF, fibrinogen, CLT, and suPAR relative to persistently low OSA risk; in VWF, fibrinogen, and suPAR relative to remitted OSA risk; and in VWF relative to persistently high OSA risk. Persistently high OSA risk was associated with an increase in CLT and suPAR relative to persistently low OSA risk and in D-dimer relative to remitted OSA risk. Remitted OSA risk was associated with D-dimer decrease relative to persistently low OSA risk. In OSA, hypercoagulability is a dynamic process with a most prominent three-year increase in individuals with new-onset OSA risk. PMID:26335891

  9. MRI determination of the vertebral termination of the dural sac tip in a South African population: clinical significance during spinal irradiation and caudal anaesthesia

    A Cilliers


    Full Text Available Abstract Knowing where the dural sac (DS ends is important, especially when placing the portal fields during craniospinal irradiation (CSI and performing caudal anesthesia. The purpose of this investigation was to determine the level of termination of the DS in relation to the spine in a group of South African patients using magnetic resonance imaging (MRI. We retrospectively reviewed the lumbosacral MR Imaging of 309 patients in each case identifying the tip of the DS. This level was recorded in relation to the adjacent vertebral body i.e. upper-, middle- and lower third and adjacent intervertebral disc. The overall mean of the DS position was at the middle third of S2. A notable percentage (13.9% of patients had a DS level lower than the lower third of S2 and (15.2% patients had a DS level higher than the S1-S2 intervertebral disc. This study failed to demonstrate a difference in the DS termination level, compared to the levels reported in various international studies; nor is there a statistical difference between gender, race and age. Our study shows that routine placement of the portal field at the lower border of S2 adequately treats the majority of CSI patients. However some patients (13.9% will be undertreated and some patients (15.2% will be overradiated. Using spinal MRI to establish the lower border of the CSI portal field will however benefit patients by ensuring adequate coverage of the entire neuroaxis as well as minimizing late gonadal toxicity due to overradiation.

  10. Young African American Men Having Sex with Multiple Partners Are More Likely to Use Condoms Incorrectly: A Clinic-Based Study

    Crosby, Richard; DiClemente, Ralph J.; Yarber, William L.; Snow, Gregory; Troutman, Adewale


    This study tested the research hypothesis that men’s errors using condoms would be associated with having multiple sex partners. Specifically, men engaging in sex with three or more women were compared to those having sex with two or fewer women. Recruitment (N=271) occurred in a publicly-funded STD clinic located in a metropolitan area of the Southern U.S. All men were clinically diagnosed with a STD. Men completed a self-reported questionnaire (using a three-month recall period). Those repo...

  11. Comprehensive Characterization of Reference Standard Lots of HIV-1 Subtype C Gp120 Proteins for Clinical Trials in Southern African Regions.

    Wang, Zihao; Lorin, Clarisse; Koutsoukos, Marguerite; Franco, David; Bayat, Babak; Zhang, Ying; Carfi, Andrea; Barnett, Susan W; Porter, Frederick


    Two HIV-1 subtype C gp120 protein candidates were the selected antigens for several experimental vaccine regimens now under evaluation in HVTN 100 Phase I/II clinical trial aiming to support the start of the HVTN 702 Phase IIb/III trial in southern Africa, which is designed to confirm and extend the partial protection seen against HIV-1 infection in the RV144 Thai trial. Here, we report the comprehensive physicochemical characterization of the gp120 reference materials that are representative of the clinical trial materials. Gp120 proteins were stably expressed in Chinese Hamster Ovary (CHO) cells and subsequently purified and formulated. A panel of analytical techniques was used to characterize the physicochemical properties of the two protein molecules. When formulated in the AS01 Adjuvant System, the bivalent subtype C gp120 antigens elicited 1086.C- and TV1.C-specific binding antibody and CD4+ T cell responses in mice. All the characteristics were highly representative of the Clinical Trial Materials (CTM). Data from this report demonstrate the immunogenicity of the gp120 antigens, provide comprehensive characterization of the molecules, set the benchmark for assessment of current and future CTM lots, and lay the physicochemical groundwork for interpretation of future clinical trial data. PMID:27187483

  12. Comprehensive Characterization of Reference Standard Lots of HIV-1 Subtype C Gp120 Proteins for Clinical Trials in Southern African Regions

    Zihao Wang


    Full Text Available Two HIV-1 subtype C gp120 protein candidates were the selected antigens for several experimental vaccine regimens now under evaluation in HVTN 100 Phase I/II clinical trial aiming to support the start of the HVTN 702 Phase IIb/III trial in southern Africa, which is designed to confirm and extend the partial protection seen against HIV-1 infection in the RV144 Thai trial. Here, we report the comprehensive physicochemical characterization of the gp120 reference materials that are representative of the clinical trial materials. Gp120 proteins were stably expressed in Chinese Hamster Ovary (CHO cells and subsequently purified and formulated. A panel of analytical techniques was used to characterize the physicochemical properties of the two protein molecules. When formulated in the AS01 Adjuvant System, the bivalent subtype C gp120 antigens elicited 1086.C- and TV1.C-specific binding antibody and CD4+ T cell responses in mice. All the characteristics were highly representative of the Clinical Trial Materials (CTM. Data from this report demonstrate the immunogenicity of the gp120 antigens, provide comprehensive characterization of the molecules, set the benchmark for assessment of current and future CTM lots, and lay the physicochemical groundwork for interpretation of future clinical trial data.

  13. Clinical epidemiology of bocavirus, rhinovirus, two polyomaviruses and four coronaviruses in HIV-infected and HIV-uninfected South African children

    Nunes, Marta C.; Kuschner, Zachary; Rabede, Zelda; Madimabe, Richard; Van Niekerk, Nadia; Moloi, Jackie; Kuwanda, Locadiah; Rossen, John W.; Klugman, Keith P.; Adrian, Peter V.; Madhi, Shabir A.


    Background: Advances in molecular diagnostics have implicated newly-discovered respiratory viruses in the pathogenesis of pneumonia. We aimed to determine the prevalence and clinical characteristics of human bocavirus (hBoV), human rhinovirus (hRV), polyomavirus-WU (WUPyV) and -KI (KIPyV) and human

  14. Clinical, legal and ethical implications of the intra-ocular (off-label) use of bevacizumab (avastin)--a South African perspective.

    Jansen, Rita-Marié; Gouws, Chris


    therefore cannot be considered careless, imprudent or unprofessional. We submit that an ophthalmologist who omits to inform a patient of the availability of Avastin for this form of treatment may be found to be negligent. Protocols developed by the South African Vitreoretinal Society and endorsed by the Ophthalmological Society of South Africa for administering Avastin and other intra-ocular medication intravitreally should be strictly adhered to. PMID:19736847

  15. Design of a trial to evaluate the impact of clinical pharmacists and community health promoters working with African-Americans and Latinos with Diabetes

    Gerber Ben S


    Full Text Available Abstract Background Given the increasing prevalence of diabetes and the lack of patients reaching recommended therapeutic goals, novel models of team-based care are emerging. These teams typically include a combination of physicians, nurses, case managers, pharmacists, and community-based peer health promoters (HPs. Recent evidence supports the role of pharmacists in diabetes management to improve glycemic control, as they offer expertise in medication management with the ability to collaboratively intensify therapy. However, few studies of pharmacy-based models of care have focused on low income, minority populations that are most in need of intervention. Alternatively, HP interventions have focused largely upon low income minority groups, addressing their unique psychosocial and environmental challenges in diabetes self-care. This study will evaluate the impact of HPs as a complement to pharmacist management in a randomized controlled trial. Methods/Design The primary aim of this randomized trial is to evaluate the effectiveness of clinical pharmacists and HPs on diabetes behaviors (including healthy eating, physical activity, and medication adherence, hemoglobin A1c, blood pressure, and LDL-cholesterol levels. A total of 300 minority patients with uncontrolled diabetes from the University of Illinois Medical Center ambulatory network in Chicago will be randomized to either pharmacist management alone, or pharmacist management plus HP support. After one year, the pharmacist-only group will be intensified by the addition of HP support and maintenance will be assessed by phasing out HP support from the pharmacist plus HP group (crossover design. Outcomes will be evaluated at baseline, 6, 12, and 24 months. In addition, program and healthcare utilization data will be incorporated into cost and cost-effectiveness evaluations of pharmacist management with and without HP support. Discussion The study will evaluate an innovative, integrated

  16. Implementation and Operational Research: What Happens After a Negative Test for Tuberculosis? Evaluating Adherence to TB Diagnostic Algorithms in South African Primary Health Clinics

    McCarthy, K. M.; Grant, A. D.; Chihota, V.; Ginindza, S; Mvusi, L.; Churchyard, G.J.; Fielding, K.L.


    Introduction and Background: Diagnostic tests for tuberculosis (TB) using sputum have suboptimal sensitivity among HIV-positive persons. We assessed health care worker adherence to TB diagnostic algorithms after negative sputum test results. Methods: The XTEND (Xpert for TB—Evaluating a New Diagnostic) trial compared outcomes among people tested for TB in primary care clinics using Xpert MTB/RIF vs. smear microscopy as the initial test. We analyzed data from XTEND participants who were HIV po...

  17. African Americans,hypertension and the renin angiotensin system

    Sandra; F; Williams; Susanne; B; Nicholas; Nosratola; D; Vaziri; Keith; C; Norris


    African Americans have exceptionally high rates of hypertension and hypertension related complications. It is commonly reported that the blood pressure lowering efficacy of renin angiotensin system(RAS) inhibitors is attenuated in African Americans due to a greater likelihood of having a low renin profile. Therefore these agents are often not recommended as initial therapy in African Americans with hypertension. However, the high prevalence of comorbid conditions, such as diabetes, cardiovascular and chronic kidney disease makes treatment with RAS inhibitors more compelling. Despite lower circulating renin levels and a less significant fall in blood pressure in response to RAS inhibitors in African Americans, numerous clinical trials support the efficacy of RAS inhibitors to improve clinical outcomes in this population, especially in those with hypertension and risk factors for cardiovascular and related diseases. Here, we discuss the rationale of RAS blockade as part of a comprehensive approach to attenuate the high rates of premature morbidity and mortality associated with hypertension among African Americans.

  18. African Otter Workshop

    Jan Reed-Smith; Hughes Akpona; Grace Yoxon


    All concerned thought this was an excellent workshop with important progress made towards creating a viable beginning of an African Otter Network. There is a long road ahead but the 2015 African Otter Workshop is a start on developing range country partners, activists and researchers as well as collaborating on issue identification and resolution which will assist in preserving at least some refugia for Africa’s otters. A list of actions was agreed on, including the creation of an African Ott...

  19. African and non-African admixture components in African Americans and an African Caribbean population.

    Murray, Tanda; Beaty, Terri H; Mathias, Rasika A; Rafaels, Nicholas; Grant, Audrey Virginia; Faruque, Mezbah U; Watson, Harold R; Ruczinski, Ingo; Dunston, Georgia M; Barnes, Kathleen C


    Admixture is a potential source of confounding in genetic association studies, so it becomes important to detect and estimate admixture in a sample of unrelated individuals. Populations of African descent in the US and the Caribbean share similar historical backgrounds but the distributions of African admixture may differ. We selected 416 ancestry informative markers (AIMs) to estimate and compare admixture proportions using STRUCTURE in 906 unrelated African Americans (AAs) and 294 Barbadians (ACs) from a study of asthma. This analysis showed AAs on average were 72.5% African, 19.6% European and 8% Asian, while ACs were 77.4% African, 15.9% European, and 6.7% Asian which were significantly different. A principal components analysis based on these AIMs yielded one primary eigenvector that explained 54.04% of the variation and captured a gradient from West African to European admixture. This principal component was highly correlated with African vs. European ancestry as estimated by STRUCTURE (r(2)=0.992, r(2)=0.912, respectively). To investigate other African contributions to African American and Barbadian admixture, we performed PCA on approximately 14,000 (14k) genome-wide SNPs in AAs, ACs, Yorubans, Luhya and Maasai African groups, and estimated genetic distances (F(ST)). We found AAs and ACs were closest genetically (F(ST)=0.008), and both were closer to the Yorubans than the other East African populations. In our sample of individuals of African descent, approximately 400 well-defined AIMs were just as good for detecting substructure as approximately 14,000 random SNPs drawn from a genome-wide panel of markers. PMID:20717976

  20. Proteomic-coupled-network analysis of T877A-androgen receptor interactomes can predict clinical prostate cancer outcomes between White (non-Hispanic and African-American groups.

    Naif Zaman

    Full Text Available The androgen receptor (AR remains an important contributor to the neoplastic evolution of prostate cancer (CaP. CaP progression is linked to several somatic AR mutational changes that endow upon the AR dramatic gain-of-function properties. One of the most common somatic mutations identified is Thr877-to-Ala (T877A, located in the ligand-binding domain, that results in a receptor capable of promiscuous binding and activation by a variety of steroid hormones and ligands including estrogens, progestins, glucocorticoids, and several anti-androgens. In an attempt to further define somatic mutated AR gain-of-function properties, as a consequence of its promiscuous ligand binding, we undertook a proteomic/network analysis approach to characterize the protein interactome of the mutant T877A-AR in LNCaP cells under eight different ligand-specific treatments (dihydrotestosterone, mibolerone, R1881, testosterone, estradiol, progesterone, dexamethasone, and cyproterone acetate. In extending the analysis of our multi-ligand complexes of the mutant T877A-AR we observed significant enrichment of specific complexes between normal and primary prostatic tumors, which were furthermore correlated with known clinical outcomes. Further analysis of certain mutant T877A-AR complexes showed specific population preferences distinguishing primary prostatic disease between white (non-Hispanic vs. African-American males. Moreover, these cancer-related AR-protein complexes demonstrated predictive survival outcomes specific to CaP, and not for breast, lung, lymphoma or medulloblastoma cancers. Our study, by coupling data generated by our proteomics to network analysis of clinical samples, has helped to define real and novel biological pathways in complicated gain-of-function AR complex systems.

  1. Identification of trans-sialidases as a common mediator of endothelial cell activation by African trypanosomes.

    Zeinab Ammar

    Full Text Available Understanding African Trypanosomiasis (AT host-pathogen interaction is the key to an "anti-disease vaccine", a novel strategy to control AT. Here we provide a better insight into this poorly described interaction by characterizing the activation of a panel of endothelial cells by bloodstream forms of four African trypanosome species, known to interact with host endothelium. T. congolense, T. vivax, and T. b. gambiense activated the endothelial NF-κB pathway, but interestingly, not T. b. brucei. The parasitic TS (trans-sialidases mediated this NF-κB activation, remarkably via their lectin-like domain and induced production of pro-inflammatory molecules not only in vitro but also in vivo, suggesting a considerable impact on pathogenesis. For the first time, TS activity was identified in T. b. gambiense BSF which distinguishes it from the subspecies T. b. brucei. The corresponding TS were characterized and shown to activate endothelial cells, suggesting that TS represent a common mediator of endothelium activation among trypanosome species with divergent physiopathologies.

  2. Keeping African Masks Real

    Waddington, Susan


    Art is a good place to learn about our multicultural planet, and African masks are prized throughout the world as powerfully expressive artistic images. Unfortunately, multicultural education, especially for young children, can perpetuate stereotypes. Masks taken out of context lose their meaning and the term "African masks" suggests that there is…

  3. Empowering African States


    China helps bring lasting peace and stability to Africa African think tanks expressed a high opinion of China’s role in helping build African peace and security at the first meeting of the China-Africa Think Tanks Forum. The

  4. African Literature as Celebration.

    Achebe, Chinua


    Describes the Igbo tradition of "Mbari," a communal creative enterprise that celebrates the world and the life lived in it through art. Contrasts the cooperative, social dimension of pre-colonial African culture with the exclusion and denial of European colonialism, and sees new African literature again celebrating human presence and dignity. (AF)

  5. Laboratory-based clinical audit as a tool for continual improvement: an example from CSF chemistry turnaround time audit in a South-African teaching hospital

    Imoh, Lucius C; Mutale, Mubanga; Parker, Christopher T; Erasmus, Rajiv T; Zemlin, Annalise E


    Introduction Timeliness of laboratory results is crucial to patient care and outcome. Monitoring turnaround times (TAT), especially for emergency tests, is important to measure the effectiveness and efficiency of laboratory services. Laboratory-based clinical audits reveal opportunities for improving quality. Our aim was to identify the most critical steps causing a high TAT for cerebrospinal fluid (CSF) chemistry analysis in our laboratory. Materials and methods A 6-month retrospective audit was performed. The duration of each operational phase across the laboratory work flow was examined. A process-mapping audit trail of 60 randomly selected requests with a high TAT was conducted and reasons for high TAT were tested for significance. Results A total of 1505 CSF chemistry requests were analysed. Transport of samples to the laboratory was primarily responsible for the high average TAT (median TAT = 170 minutes). Labelling accounted for most delays within the laboratory (median TAT = 71 minutes) with most delays occurring after regular work hours (P < 0.05). CSF chemistry requests without the appropriate number of CSF sample tubes were significantly associated with delays in movement of samples from the labelling area to the technologist’s work station (caused by a preference for microbiological testing prior to CSF chemistry). Conclusion A laboratory-based clinical audit identified sample transportation, work shift periods and use of inappropriate CSF sample tubes as drivers of high TAT for CSF chemistry in our laboratory. The results of this audit will be used to change pre-analytical practices in our laboratory with the aim of improving TAT and customer satisfaction. PMID:27346964

  6. Clinical epidemiology of bocavirus, rhinovirus, two polyomaviruses and four coronaviruses in HIV-infected and HIV-uninfected South African children.

    Marta C Nunes

    Full Text Available BACKGROUND: Advances in molecular diagnostics have implicated newly-discovered respiratory viruses in the pathogenesis of pneumonia. We aimed to determine the prevalence and clinical characteristics of human bocavirus (hBoV, human rhinovirus (hRV, polyomavirus-WU (WUPyV and -KI (KIPyV and human coronaviruses (CoV-OC43, -NL63, -HKU1 and -229E among children hospitalized with lower respiratory tract infections (LRTI. METHODS: Multiplex real-time reverse-transcriptase polymerase chain reaction was undertaken on archived nasopharyngeal aspirates from HIV-infected and -uninfected children (<2 years age hospitalized for LRTI, who had been previously investigated for respiratory syncytial virus, human metapneumovirus, parainfluenza I-III, adenovirus and influenza A/B. RESULTS: At least one of these viruses were identified in 274 (53.0% of 517 and in 509 (54.0% of 943 LRTI-episodes in HIV-infected and -uninfected children, respectively. Human rhinovirus was the most prevalent in HIV-infected (31.7% and -uninfected children (32.0%, followed by CoV-OC43 (12.2% and hBoV (9.5% in HIV-infected; and by hBoV (13.3% and WUPyV (11.9% in HIV-uninfected children. Polyomavirus-KI (8.9% vs. 4.8%; p = 0.002 and CoV-OC43 (12.2% vs. 3.6%; p<0.001 were more prevalent in HIV-infected than -uninfected children. Combined with previously-tested viruses, respiratory viruses were identified in 60.9% of HIV-infected and 78.3% of HIV-uninfected children. The newly tested viruses were detected at high frequency in association with other respiratory viruses, including previously-investigated viruses (22.8% in HIV-infected and 28.5% in HIV-uninfected children. CONCLUSIONS: We established that combined with previously-investigated viruses, at least one respiratory virus was identified in the majority of HIV-infected and HIV-uninfected children hospitalized for LRTI. The high frequency of viral co-infections illustrates the complexities in attributing causality to specific viruses

  7. African Peacekeepers in Africa

    Emmanuel, Nikolas G.


    peacekeeping operations in the region. It is important to add that the international community has frequently tried to facilitate the deployment of African armed forces with aid and training. From this reality, the following study goes beyond the current literature by focusing on the international factors...... behind African participation in United Nations (UN) peacekeeping operations in Africa. In doing so, this research focuses on US military aid and foreign troop training from 2002 to 2012, and its impact on African deployments into UN peacekeeping missions in Africa. As can be expected, such third...

  8. Reading the African context

    Musonda Bwalya


    There is so much alienation, pain and suffering in our today�s world. In this vein, African Christianity, a voice amongst many voices, should seek to be a transformational religion for the whole of life, affecting all facets of human life towards a fuller life of all in Africa. This article sought to highlight and point to some of the major societal challenges in the African context which African Christianity, as a life-affirming religion, should continue to embrace, re-embrace and engag...

  9. Capitalism and African business cultures

    Taylor, Scott D.


    Scholars and practitioners once commonly linked 'African culture' to a distinctive 'African capitalism', at odds with genuine capitalism and the demands of modern business. Yet contemporary African business cultures reveal that a capitalist ethos has taken hold within both state and society. The success and visibility of an emergent, and celebrated, class of African big business reveals that business and profit are culturally acceptable. Existing theories of African capitalism are ill-equippe...

  10. Knowledge of causes, clinical features and diagnosis of common zoonoses among medical practitioners in Tanzania

    Mfinanga Godfrey S


    Full Text Available Abstract Background Many factors have been mentioned as contributing to under-diagnosis and under-reporting of zoonotic diseases particularly in the sub-Sahara African region. These include poor disease surveillance coverage, poor diagnostic capacity, the geographical distribution of those most affected and lack of clear strategies to address the plight of zoonotic diseases. The current study investigates the knowledge of medical practitioners of zoonotic diseases as a potential contributing factor to their under-diagnosis and hence under-reporting. Methods The study was designed as a cross-sectional survey. Semi-structured open-ended questionnaire was administered to medical practitioners to establish the knowledge of anthrax, rabies, brucellosis, trypanosomiasis, echinococcosis and bovine tuberculosis in selected health facilities within urban and rural settings in Tanzania between April and May 2005. Frequency data were analyzed using likelihood ratio chi-square in Minitab version 14 to compare practitioners' knowledge of transmission, clinical features and diagnosis of the zoonoses in the two settings. For each analysis, likelihood ratio chi-square p-value of less than 0.05 was considered to be significant. Fisher's exact test was used where expected results were less than five. Results Medical practitioners in rural health facilities had poor knowledge of transmission of sleeping sickness and clinical features of anthrax and rabies in humans compared to their urban counterparts. In both areas the practitioners had poor knowledge of how echinococcosis is transmitted to humans, clinical features of echinococcosis in humans, and diagnosis of bovine tuberculosis in humans. Conclusion Knowledge of medical practitioners of zoonotic diseases could be a contributing factor to their under-diagnosis and under-reporting in Tanzania. Refresher courses on zoonotic diseases should be conducted particularly to practitioners in rural areas. More emphasis

  11. Challenges of diagnosing acute HIV-1 subtype C infection in African women: performance of a clinical algorithm and the need for point-of-care nucleic-acid based testing.

    Koleka Mlisana

    Full Text Available BACKGROUND: Prompt diagnosis of acute HIV infection (AHI benefits the individual and provides opportunities for public health intervention. The aim of this study was to describe most common signs and symptoms of AHI, correlate these with early disease progression and develop a clinical algorithm to identify acute HIV cases in resource limited setting. METHODS: 245 South African women at high-risk of HIV-1 were assessed for AHI and received monthly HIV-1 antibody and RNA testing. Signs and symptoms at first HIV-positive visit were compared to HIV-negative visits. Logistic regression identified clinical predictors of AHI. A model-based score was assigned to each predictor to create a risk score for every woman. RESULTS: Twenty-eight women seroconverted after a total of 390 person-years of follow-up with an HIV incidence of 7.2/100 person-years (95%CI 4.5-9.8. Fifty-seven percent reported ≥1 sign or symptom at the AHI visit. Factors predictive of AHI included age <25 years (OR = 3.2; 1.4-7.1, rash (OR = 6.1; 2.4-15.4, sore throat (OR = 2.7; 1.0-7.6, weight loss (OR = 4.4; 1.5-13.4, genital ulcers (OR = 8.0; 1.6-39.5 and vaginal discharge (OR = 5.4; 1.6-18.4. A risk score of 2 correctly predicted AHI in 50.0% of cases. The number of signs and symptoms correlated with higher HIV-1 RNA at diagnosis (r = 0.63; p<0.001. CONCLUSIONS: Accurate recognition of signs and symptoms of AHI is critical for early diagnosis of HIV infection. Our algorithm may assist in risk-stratifying individuals for AHI, especially in resource-limited settings where there is no routine testing for AHI. Independent validation of the algorithm on another cohort is needed to assess its utility further. Point-of-care antigen or viral load technology is required, however, to detect asymptomatic, antibody negative cases enabling early interventions and prevention of transmission.

  12. Clinical Legal Education Models: Recommended Assessment Regimes

    Riette (MA) du Plessis


    Clinical legal education (CLE) forms part of the LLB curriculum at most South African Universities. There are many similarities in the approach to CLE, but often also many differences. The clinical models of four South African university law clinics are reviewed in an effort to find suitable models. It is indicated that formulating a mission for the law clinic will have a direct impact on the clinical model chosen. The integration of CLE courses into the core curriculum of the law school will...

  13. Disease: H00357 [KEGG MEDICUS

    Full Text Available H00357 African trypanosomiasis; Sleeping sickness African trypanosomiasis is a parasitic conditi ... rucei [GN:tbr] Vector: Glossina pallidipes (tsetse fly ) ICD-10: B56 MeSH: D014353 MedlinePlus: 001362 ...

  14. An iron-superoxide dismutase antigen-based serological screening of dogs indicates their potential role in the transmission of cutaneous leishmaniasis and trypanosomiasis in Yucatan, Mexico.

    Longoni, Silvia S; Marín, Clotilde; Sauri-Arceo, Carlos H; López-Cespedes, Angeles; Rodríguez-Vivas, Roger I; Villegas, Noelia; Escobedo-Ortegón, Javier; Barrera-Pérez, Mario A; Bolio-Gonzalez, Manuel E; Sánchez-Moreno, Manuel


    An increasing number of studies have reported high infection rates for American cutaneous leishmaniasis in dogs, which have thus been proposed as the reservoir host. Canine leishmaniasis is widespread in different states in Mexico, where a number of Leishmania species have been isolated from dogs. In the present study, the detection of different Leishmania species is described in stray dogs from two localities, namely Tulum and Celestún on the Yucatan Peninsula (Mexico). The use of iron-superoxide dismutase excreted by the parasites as the antigen fraction and enzyme-linked immunosorbent assay and western blot tests allowed us to confirm the presence of at least three species of Leishmania (Le. mexicana, Le. braziliensis, and Le. panamensis), some of which are reported for the first time in this species. In addition to a high prevalence of Le. mexicana and Le. braziliensis, and to a lesser degree, Le. panamensis, there is a significant prevalence of Trypanosoma cruzi, suggesting that the dog may be a source of transmission of trypanosomiasis. However, a more thorough epidemiological study on the dog population, both wild as well as urban, of the Yucatan Peninsula will be required to design a control strategy for these diseases, paying particular attention to the population affected and even broadening the study to other Mexican states as well as neighboring countries. These results again confirm that iron-superoxide dismutase excreted by the different trypanosomatid species constitutes a good source of antigen for serodiagnosis in epidemiological studies. PMID:21323424

  15. South African AIDS plan criticised.

    Sidley, P


    In a television broadcast, Deputy President Mbeki of South Africa announced a campaign against HIV/AIDS that would involve coordination between various government departments and nongovernmental organizations. Mbeki, who is associated with Virodene (a drug treatment for AIDS that is considered a scam), replaced President Mandela at the last minute in the broadcast. Two days after the broadcast, the government refused to support treatment of pregnant women infected with HIV with zidovudine to prevent transmission of the virus to the baby. The treatment is considered cost-effective by AIDS workers and public health officials. According to Mark Heywood of the AIDS law project at Witwatersrand University, 16% of pregnant women attending antenatal clinics were HIV-positive in 1997; this means that about 3 million South Africans (8% of the population) were living with HIV. Heywood said that the government believes there are 1500 new cases daily. By the end of 1998, 3.5 million South Africans will be living with HIV. Although the government is asking other sectors to join in the campaign, what the government is doing is unclear. Mother-to-child transmission of HIV is second only to transmission of the virus through heterosexual sex in South Africa. PMID:9841037

  16. An African-American family with dystonia.

    Puschmann, Andreas; Xiao, Jianfeng; Bastian, Robert W; Searcy, Jill A; LeDoux, Mark S; Wszolek, Zbigniew K


    The genetic cause of late-onset focal and segmental dystonia remains unknown in most individuals. Recently, mutations in Thanatos-associated protein domain containing, apoptosis associated protein 1 (THAP1) have been described in DYT6 dystonia and associated with some cases of familial and sporadic late-onset dystonia in Caucasians. We are not aware of any previous descriptions of familial dystonia in African-Americans or reports of THAP1 mutations in African-Americans. Herein, we characterize an African-American (AA) kindred with late-onset primary dystonia, clinically and genetically. The clinical phenotype included cervical, laryngeal and hand-forearm dystonia. Symptoms were severe and disabling for several family members, whereas others only displayed mild signs. There were no accompanying motor or cognitive signs. In this kindred, age of onset ranged from 45 to 50 years and onset was frequently sudden, with symptoms developing within weeks or months. DYT1 was excluded as the cause of dystonia in this kindred. The entire genomic region of THAP1, including non-coding regions, was sequenced. We identified 13 sequence variants in THAP1, although none co-segregated with dystonia. A novel THAP1 variant (c.-237-3G>T/A) was found in 3/84 AA dystonia patient alleles and 3/212 AA control alleles, but not in 5870 Caucasian alleles. In summary, although previously unreported, familial primary dystonia does occur in African-Americans. Genetic analysis of the entire genomic region of THAP1 revealed a novel variant that was specific for African-Americans. Therefore, genetic testing for dystonia and future studies of candidate genes must take genetic background into consideration. PMID:21601506

  17. Characterizing the admixed African ancestry of African Americans

    Zakharia, Fouad; Basu, Analabha; Absher, Devin; Assimes, Themistocles L.; Go, Alan S.; Hlatky, Mark A.; Iribarren, Carlos; Knowles, Joshua W.; Li, Jun; Narasimhan, Balasubramanian; Sidney, Steven; Southwick, Audrey; Myers, Richard M.; Quertermous, Thomas; Risch, Neil


    Abstract Background Accurate, high-throughput genotyping allows the fine characterization of genetic ancestry. Here we applied recently developed statistical and computational techniques to the question of African ancestry in African Americans by using data on more than 450,000 single-nucleotide polymorphisms (SNPs) genotyped in 94 Africans of diverse geographic origins included in the...

  18. African-Americans and Alzheimer's

    ... Share Plus on Google Plus African-Americans and Alzheimer's | IHaveAlz Introduction 10 Warning Signs Brain ... African-Americans are at a higher risk for Alzheimer's disease. Many Americans dismiss the warning signs of ...

  19. African Cultural Astronomy

    Holbrook, Jarita C; Medupe, R. Thebe; Current Archaeoastronomy and Ethnoastronomy research in Africa


    Astronomy is the science of studying the sky using telescopes and light collectors such as photographic plates or CCD detectors. However, people have always studied the sky and continue to study the sky without the aid of instruments this is the realm of cultural astronomy. This is the first scholarly collection of articles focused on the cultural astronomy of Africans. It weaves together astronomy, anthropology, and Africa. The volume includes African myths and legends about the sky, alignments to celestial bodies found at archaeological sites and at places of worship, rock art with celestial imagery, and scientific thinking revealed in local astronomy traditions including ethnomathematics and the creation of calendars. Authors include astronomers Kim Malville, Johnson Urama, and Thebe Medupe; archaeologist Felix Chami, and geographer Michael Bonine, and many new authors. As an emerging subfield of cultural astronomy, African cultural astronomy researchers are focused on training students specifically for do...

  20. Stakeholder Perspectives on Barriers for Healthy Living for Low-Income African American Families

    Jones, Veronnie Faye; Rowland, Michael L.; Young, Linda; Atwood, Katherine; Thompson, Kirsten; Sterrett, Emma; Honaker, Sarah Morsbach; Joel E. Williams; Johnson, Knowlton; Davis, Deborah Winders


    Background: Childhood obesity is a growing problem for children in the United States, especially for children from low-income, African American families. Objective: The purpose of this qualitative study was to understand facilitators and barriers to engaging in healthy lifestyles faced by low-income African American children and their families. Methods: This qualitative study used semi-structured focus group interviews with eight African American children clinically identified as overwe...

  1. Isolation and identification of African horsesickness virus from naturally infected dogs in Upper Egypt.

    Salama, S.A.; Dardiri, A. H.; Awad, F. I.; A. M. Soliman; M.M Amin


    African horsesickness virus was isolated from blood samples of street dogs in Aswan Province in Arab Republic of Egypt. Of six isolated "dog strain" African horsesickness viruses, three viruses designated D2, D6 and D10 have been identified as type 9 African horsesickness virus. Methods of isolation, tissue culture adaptation, serological indentification and typing are described. Horses experimentally infected with dog viruses showed febrile reaction and characteristic clinical and pathologic...

  2. Enhancing the African bioethics initiative

    Ogundiran Temidayo O


    Full Text Available Abstract Background Medical ethics has existed since the time of Hippocrates. However, formal training in bioethics did not become established until a few decades ago. Bioethics has gained a strong foothold in health sciences in the developed world, especially in Europe and North America. The situation is quite different in many developing countries. In most African countries, bioethics – as established and practiced today in the west- is either non-existent or is rudimentary. Discussion Though bioethics has come of age in the developed and some developing countries, it is still largely "foreign" to most African countries. In some parts of Africa, some bioethics conferences have been held in the past decade to create research ethics awareness and ensure conformity to international guidelines for research with human participants. This idea has arisen in recognition of the genuine need to develop capacity for reviewing the ethics of research in Africa. It is also a condition required by external sponsors of collaborative research in Africa. The awareness and interest that these conferences have aroused need to be further strengthened and extended beyond research ethics to clinical practice. By and large, bioethics education in schools that train doctors and other health care providers is the hook that anchors both research ethics and clinical ethics. Summary This communication reviews the current situation of bioethics in Africa as it applies to research ethics workshops and proposes that in spite of the present efforts to integrate ethics into biomedical research in Africa, much still needs to be done to accomplish this. A more comprehensive approach to bioethics with an all-inclusive benefit is to incorporate formal ethics education into health training institutions in Africa.

  3. African names for American plants

    Andel, van T.R.


    African slaves brought plant knowledge to the New World, sometimes applying it to related plants they found there and sometimes bringing Old World plants with them. By tracing the linguistic parallels between names for plants in African languages and in communities descended from African slaves, pie

  4. The Struggles over African Languages

    Maseko, Pam; Vale, Peter


    In this interview, African Language expert Pam Maseko speaks of her own background and her first encounter with culture outside of her mother tongue, isiXhosa. A statistical breakdown of South African languages is provided as background. She discusses Western (originally missionary) codification of African languages and suggests that this approach…

  5. African agricultural trade

    Jensen, Hans Grinsted; Sandrey, Ron


    This article starts with a profile of African agricultural trade. Using the pre-release version 9.2 of the GTAP database, we then show that the results for tariff elimination on intra-African trade are promising, but these tariff barriers are not as significant as the various trade-related barriers...... elimination, non-tariff barrier reductions and time in transit cost reductions are likely to be cumulative and would generate very large gains to Africa. The policy implications are clear: while cooperation will enhance the gains, much of the benefits will result from unilateral actions and regional...

  6. Gene fusion analysis in the battle against the African endemic sleeping sickness.

    Philip Trimpalis

    Full Text Available The protozoan Trypanosoma brucei causes African Trypanosomiasis or sleeping sickness in humans, which can be lethal if untreated. Most available pharmacological treatments for the disease have severe side-effects. The purpose of this analysis was to detect novel protein-protein interactions (PPIs, vital for the parasite, which could lead to the development of drugs against this disease to block the specific interactions. In this work, the Domain Fusion Analysis (Rosetta Stone method was used to identify novel PPIs, by comparing T. brucei to 19 organisms covering all major lineages of the tree of life. Overall, 49 possible protein-protein interactions were detected, and classified based on (a statistical significance (BLAST e-value, domain length etc., (b their involvement in crucial metabolic pathways, and (c their evolutionary history, particularly focusing on whether a protein pair is split in T. brucei and fused in the human host. We also evaluated fusion events including hypothetical proteins, and suggest a possible molecular function or involvement in a certain biological process. This work has produced valuable results which could be further studied through structural biology or other experimental approaches so as to validate the protein-protein interactions proposed here. The evolutionary analysis of the proteins involved showed that, gene fusion or gene fission events can happen in all organisms, while some protein domains are more prone to fusion and fission events and present complex evolutionary patterns.

  7. Deepening African Ties


    Chinese President Hu Jintao has just embarked on his state visits to eight African countries that will take him to both the northern and southern tips of the continent. This is his first trip abroad this year, and also his third visit to Africa

  8. East African institutions

    Nordby, Johannes Riber; Jacobsen, Katja

    For the past decade security in East Africa has gained focus internationally. However there is a growing ambition among African states to handle such issues by themselves, sometimes through regional institutions. This has been supported by many Western states but potential risks are often forgotten....

  9. African Women Writing Resistance

    Jennifer Browdy de Hernandez; Pauline Dongala; Omotayo; Jolaosho; Anne Serafin


    AFRICAN Women Writing Resistance is the first transnational anthology to focus on women's strategies of resistance to the challenges they face in Africa today.The anthology brings together personal narratives,testimony,interviews,short stories,poetry,performance scripts,folktales and lyrics.

  10. African Women Writing Resistance

    Jennifer; Browdy; de; Hernandez; Pauline; Dongala; Omotayo; Jolaosho; Anne; Serafin


    An Anthology of Contemporary Voices AFRICAN Women Writing Resistance is the first transnational anthology to focus on women’s strategies of resistance to the challenges they face in Africa today.The anthology brings together personal narratives,testimony,interviews, short stories,po-

  11. West African Antislavery Movements

    Hahonou, Eric Komlavi; Pelckmans, Lotte


    In the context of liberalization of West African political regimes, the upsurge of audacious political entrepreneurs who want to end chattel slavery in their nation-state, resulted in the legal criminalisation of slavery in both Mauritania (2007) and Niger (2003) and in a proposal to revise the...... cultures (or ‘mentalities’) go hand in hand....

  12. Immunizations and African Americans

    ... Program Grants Other Grants Planning and Evaluation Grantee Best Practices Black/African American Asthma Cancer Chronic Liver Disease ... 13 to 17 years who ever received the human papillomavirus (HPV) vaccination, 2014 - Males # doses ... 240-453-2882 Office of Minority Health Resource Center Toll Free: 1-800-444-6472 / Fax: ...

  13. The African Union

    Mandrup, Thomas; Mandrup, Bjørn


    . Moreover, the ‘African Security Architecture’, of which it is the central component, also includes sub-regional organisations to which responsibility is to be devolved for dealing with armed confl ict and other matters. These so-called Regional Economic Communities (RECs) are, likewise, constantly changing...

  14. African tick bite fever

    Johansen, Jakob Aaquist; Thybo, Søren


    The incident of spotted fever imported to Denmark is unknown. We present a classic case of African Tick Bite Fever (ATBF) to highlight a disease, which frequently infects wildlife enthusiasts and hunters on vacation in South Africa. ATBF has a good prognosis and is easily treated with doxycyclin...

  15. Female genital mutilation in African and African American women's literature

    Darja Marinšek


    Full Text Available The article builds on the existing dispute between African and African American women writers on the competence of writing about female genital mutilation (FGM, and tries to determine the existence and nature of the differences between the writings of these two groups. The author uses comparative analysis of two popular African and African American novels, comparing their ways of describing FGM, its causes and consequences, the level ob objectivity and the style of the narrations.This is followed by a discussion on the reasons for such differences, incorporating a larger circle of both African and African American women authors, at the same time analysing the deviance within the two groups. While the differences between African American writers are not that great, as they mostly fail to present the issue from different points of view, which is often the result of their lack of direct knowledge of the topic, African authors' writing is in itself discovered to be ambivalent and not at all invariable. The reasons for such ambivalence are then discussed in greater context, focusing on the effect of the authors' personal contact with circumcision as well as their knowledge and acceptance of Western values. The author concludes by establishing the African ambivalent attitude towards FGM, which includes different aspects of the issue, as the most significant difference between their and African American writers' description of this practice.

  16. Experiences of undergraduate African health sciences students: A hermeneutic inquiry.

    Inyama, Davis; Williams, Allison; McCauley, Kay


    While efforts have been made to understand the experiences of African students in predominantly white environments, the experiences of African students in clinical placement areas have rarely been explored. This paper is a report on a study designed to address the gap in educational research on the experiences of African health sciences students in clinical placements in predominantly white environments. Interviews adopting an open approach to conversations were conducted with nine African students from three health disciplines at one metropolitan university in Australia between 2012 and 2013. Interview transcripts were analyzed using philosophical hermeneutics, where shared meanings were arrived at by employing key Gadamerian hermeneutic components. Findings revealed a number of factors that had a direct effect on the meaning students derived from their clinical placement experiences. These, as revealed in the interlinked domains of body, space, relationships, and time included difference, acceptance, resilience, and cultural sensitivity. Insights from this study may lead to the adoption of strategies designed to improve the experiences of African students studying health sciences in predominantly white environments. PMID:24942056

  17. One Health: past successes and future challenges in three African contexts.

    Anna L Okello


    Full Text Available The recent emergence of zoonotic diseases such as Highly Pathogenic Avian Influenza (HPAI and Severe Acute Respiratory Syndrome (SARS have contributed to dominant Global Health narratives around health securitisation and pandemic preparedness, calling for greater co-operation between the health, veterinary and environmental sectors in the ever-evolving One Health movement. A decade later, One Health advocates face increasing pressure to translate the approach from theory into action.A qualitative case study methodology was used to examine the emerging relationships between international One Health dialogue and its practical implementation in the African health policy context. A series of Key Informant Interviews (n = 32 with policy makers, government officials and academics in Nigeria, Tanzania and Uganda are presented as three separate case studies. Each case examines a significant aspect of One Health operationalisation, framed around the control of both emerging and Neglected Zoonotic Diseases including HPAI, Human African Trypanosomiasis and rabies. The research found that while there is general enthusiasm and a strong affirmative argument for adoption of One Health approaches in Africa, identifying alternative contexts away from a narrow focus on pandemics will help broaden its appeal, particularly for national or regionally significant endemic and neglected diseases not usually addressed under a "global" remit.There is no 'one size fits all' approach to achieving the intersectoral collaboration, significant resource mobilisation and political co-operation required to realise a One Health approach. Individual country requirements cannot be underestimated, dismissed or prescribed in a top down manner. This article contributes to the growing discussion regarding not whether One Health should be operationalised, but how this may be achieved.

  18. Leadership in the African context

    M. Masango


    Full Text Available The Western world has always viewed the African continent as plagued by corruption; dictatorship; military coups; rebellious leaders; greediness; misuse of power; and incompetent, politically unstable leaders - in effect, suspicious leaders who undermine their own democracies. This paper analyzes African leadership and its impact by concentrating on three historical eras, namely; the African Religious era; the Christian era, and the era of Globalization. These affected African leadership. In addition, many brilliant minds left the continent in search of greener pastures. A review of these three eras will help us understand how leadership shifted from African values into Western concepts. The role of missionaries lead African people to live with both an African and a Western concept of life. In spite of the above problems, our past leaders did their best in addressing the difficulties they faced during the three eras. African concepts of leadership were often regarded as barbaric and uncultured. Structures were evaluated by Western standards. Due to globalisation, African leaders, through programmes like NEPAD, are going back to basics, drawing on African concepts of unity among its leadership. Effectiveness or life-giving leadership is emerging and empowering villagers/communities in the continent. This type of leadership is innovative and has brought new hope for the continent.

  19. The genetic structure and history of Africans and African Americans

    Tishkoff, Sarah A; Reed, Floyd A; Friedlaender, Françoise R; Ehret, Christopher; Ranciaro, Alessia; Froment, Alain; Hirbo, Jibril B.; Awomoyi, Agnes A; Bodo, Jean-Marie; Doumbo, Ogobara; Ibrahim, Muntaser; Juma, Abdalla T; Kotze, Maritha J.; Lema, Godfrey; Moore, Jason H.


    Africa is the source of all modern humans, but characterization of genetic variation and of relationships among populations across the continent has been enigmatic. We studied 121 African populations, four African American populations, and 60 non-African populations for patterns of variation at 1327 nuclear microsatellite and insertion/deletion markers. We identified 14 ancestral population clusters in Africa that correlate with self-described ethnicity and shared cultural and/or linguistic p...

  20. Steps to African Development


    The development of Africa is vital to the world’s sustainable development.However,African countries still face key challenges in achieving the meaningful expansion of their economies.At the High-Level Symposium on China-Africa Investment Cooperation in Xiamen,southeast China’s Fujian Province,held from September 8 to 10,Chen Deming,Minister of Commerce of China,elaborates on these challenges and sees

  1. Biofuels: The African experience

    Carrillo, L.A.; Nkolo, M. [German Agency for Technical Cooperation GTZ, Delegation Regionale des Eaux et Forets, Bertoua (Cameroon)


    In July 2006, the African Non-Petroleum Producers Association was formed in Senegal, Africa to develop alternative energy sources. It involved 13 of Africa's poorest nations, who joined forces to become global suppliers of biofuels, and some have set mandatory mixing of ethanol into gasoline. Although several biofuel production projects have been launched in western Africa, many of the new projects and plantations have not yet reached maturity due to the time lag between plantation and full-scale production, which is about 6 years. Major projects that could be producing significant quantities of biofuels in the next few years are not yet reflected in production statistics. Although ethanol is not yet being produced in large quantities in Africa, short-term opportunities exist. Countries in the South African Development Community are using molasses from the sugar can industry to produce ethanol. Biodiesel is also not currently produced on a significant scale in western Africa, but several other countries are gaining experience with cotton and palm oil resources, and Jatropha. Biomass residue also represents a large potential for all African countries involved in timber production. Unlike biodiesel production, land use conflicts are not an issue with biomass residue production.

  2. Diversity among African pygmies.

    Fernando V Ramírez Rozzi

    Full Text Available Although dissimilarities in cranial and post-cranial morphology among African pygmies groups have been recognized, comparative studies on skull morphology usually pull all pygmies together assuming that morphological characters are similar among them and different with respect to other populations. The main aim of this study is to compare cranial morphology between African pygmies and non-pygmies populations from Equatorial Africa derived from both the Eastern and the Western regions in order to test if the greatest morphological difference is obtained in the comparison between pygmies and non-pygmies. Thirty three-dimensional (3D landmarks registered with Microscribe in four cranial samples (Western and Eastern pygmies and non-pygmies were obtained. Multivariate analysis (generalized Procrustes analysis, Mahalanobis distances, multivariate regression and complementary dimensions of size were evaluated with ANOVA and post hoc LSD. Results suggest that important cranial shape differentiation does occur between pygmies and non-pygmies but also between Eastern and Western populations and that size changes and allometries do not affect similarly Eastern and Western pygmies. Therefore, our findings raise serious doubt about the fact to consider African pygmies as a homogenous group in studies on skull morphology. Differences in cranial morphology among pygmies would suggest differentiation after divergence. Although not directly related to skull differentiation, the diversity among pygmies would probably suggest that the process responsible for reduced stature occurred after the split of the ancestors of modern Eastern and Western pygmies.

  3. Institution Building for African Regionalism

    Khadiagala, Gilbert M.


    Since the 1960s, African states have embraced regional integration as a vital mechanism for political cooperation and for pooling resources to overcome problems of small and fragmented economies. In building meaningful institutions for regionalism, however, Africans have faced the challenges of reconciling the diversities of culture, geography, and politics. As a result, African regional institutions are characterized by multiple and competing mandates and weak institutionalization. This stud...

  4. African-Americans and Heart Disease, Stroke

    ... Pressure High Blood Pressure Tools & Resources Stroke More African-Americans and Heart Disease, Stroke Updated:Apr 18, ... of getting those diseases are even higher for African-Americans. The good news is, African-Americans can ...

  5. Chronic Liver Disease and African Americans

    ... American > Chronic Liver Disease Chronic Liver Disease and African Americans Among African Americans, chronic liver disease is a ... white women. At a glance – Cancer Rates for African Americans (2008-2012) Cancer Incidence Rates per 100,000 – ...

  6. The Diabetic Health of African American Grandmothers Raising their Grandchildren

    Carthron, Dana L.; Busam, Maria Rivera


    PURPOSE The purpose of this study is to compare the health of primary caregiving African American grandmothers with diabetes with African American women with diabetes who were not primary caregivers. DESIGN Using a comparative, descriptive, cross-sectional design, 34 African American primary caregiving grandmothers were compared with 34 non-caregiving women with diabetes mellitus; women aged 55–75 years were recruited for this study throughout the central Arkansas. METHODS To measure the overall health, data on blood pressure, body mass index measurements, HbA1c levels, total cholesterol, and urine protein and creatinine levels were collected from all the participants. RESULTS Statistically significant differences between the caregivers and non-caregivers groups in systolic pressure (t = −3.42, P = 0.001) and diastolic pressure (t = −3.790, P = 0.000) and urine protein (W = 294.00, P = 0.000) were noted. Additionally, a clinically significant difference in HbA1c was noted between groups. CONCLUSION Differences in systolic and diastolic pressures, urine protein, and clinically significant differences in HbA1c suggest that African American primary caregiving grandmothers with diabetes mellitus may have more difficulty in maintaining their diabetic health than non-caregiving African American women. PMID:27398044

  7. Cystic fibrosis on the African continent.

    Stewart, Cheryl; Pepper, Michael S


    Cystic fibrosis (CF; OMIM 219700) is a life-shortening and costly autosomal recessive disease that has been most extensively studied in individuals of Caucasian descent. There is ample evidence, however, that it also affects other ethnicities. In Africa there have been several reports of CF, but there has been no concerted effort toward establishing the molecular epidemiology of this disease on the continent, which is the first step toward outlining a public health strategy to effectively address the needs of these patients. A literature search revealed reports from only 12 of the 54 African states on the molecular analysis of the mutations present in suspected CF patients, resulting in the identification of 79 mutations. Based on previous functional investigations, 39 of these cause CF, 10 are of varying clinical consequence, 4 have no associated evidence regarding whether they cause CF, 4 are synonymous, 5 are novel, and 21 are unique to Africa. We propose that CF be more thoroughly investigated on the continent to ensure that the public health needs of African CF patients-both those in Africa and those of African descent living elsewhere-are met.Genet Med 18 7, 653-662. PMID:26656651

  8. The African Diaspora, Civil Society and African Integration

    Opoku-Mensah, Paul Yaw

    This paper, a work-in-progress, makes a contribution to the discussions on the appropriate modalities for incorporating the African diaspora in the African integration project.  It argues that the most appropriate entry points for incorporating the African diaspora into the integration project...... might not, necessarily, be in the formal political structures, although this is important. To the contrary, the most effective and sustainable might be within civil society---that is the links between the peoples and organizations of Africa and the diaspora. Using the case of the African academy-- as an...... institution of civil society--- the paper outlines a conceptual framework for incorporating the diaspora into the African integration project....

  9. Pseudoachondroplasia: Report on a South African family

    Shahida Moosa


    Full Text Available Pseudoachondroplasia is an autosomal dominant skeletal dysplasia that results in disproportionately short stature, severe brachydactyly with strikingly lax small joints, malalignments of the lower limbs, and characteristic radiological features. Although named ‘false achondroplasia’, the entity is a distinct condition, in which affected individuals are born with normal length and have a normal facies, but is often only recognised after the age of 2 years, when the disproportion and waddling gait become evident. We report on an affected South African father and daughter, and highlight their clinical and radiographic features.

  10. Phytogeography of African Commelinaceae

    R. B. Faden


    Full Text Available Africa (including Madagascar has nearly twice as many species of Commelinaceae as any other continent (approximately 270 species, or about 40% of the total in the family. Of the 17 genera which are native, seven (Anthericopsis, Coleotrype, Palisota, Polyspatha, Pseudoparis, Stanfieldiella and  Triceratella are endemic, the highest percentage generic endemism of any continent. Within Africa gcneric diversity is slightly higher in western than in eastern tropical floras. Species richness, however, is greatest in eastern Africa, mainly due to a high diversity of species of Commelina and Aneilema. Africa shares more genera with Asia (nine than with any other continent. Only one African genus, Buforrestia, is neither endemic nor shared with Asia. Its western African/northeastern South American distribution is unique in the family. Besides Buforrestia, only five other genera of Commelinaceae (out of a total of 50 in the family, occur in both the Old and New Worlds. These genera.  Aneilema, Commelina, Floscopa, Murdannia and  Pollia are all very widespread in the Old World, occurring in Australia and Asia in addition to Africa (both continental and Madagascar. Madagascar is relatively poor in species (31. but these include the endemic Madagascan genus Pseudoparis, the sole African species of Rhopalephora, and the largest number of species of the Afro-Malagasy endemic genus Coleotrype. The high rate of generic endemism of Commelinaceae in Africa probably indicates that Africa was one of the ancient centres of diversity for the family. The high species diversity is more likely due to relatively recent radiations by genera pre-adapted to survival in non-forest habitats. The occurrence of only a small number of genera on both sides of the Atlantic suggests that the Commelinaceae have been evolving independently in the eastern and western hemispheres for a long period.

  11. Booster for African Economy


    China’s investment is fueling African growth SINCE 2000,driven by the Forum on China-Africa Cooperation,China’s foreign direct investment(FDI) in Africa has been growing rapidly.In the face of the global financial crisis,which led to global FDI flows falling,China’s investment in Africa has been on a steady, upbeat rise without any interruption.In 2009,China’s direct investment in Africa reached $1.44 billion,of which nonfinancial direct investment soared by 55.4 percent from the previous year.Africa

  12. African Conservation Tillage Network Website

    African Conservation Tillage Network (ACT)


    Metadata only record Maintained by the African Conservation Tillage Network (ACT), this website provides information on Conservation Agriculture in an African context and gathered by stakeholders (NGOs) native to the continent. Resources on projects, practices, reports, and training courses are provided.

  13. A Call to African Unity

    Muchie, Mammo

    This month's paper, written by Professor Mammo Muchie, examines the necessity for a pan-African monetary union.  Professor Muchie argues for the "the creation of a unified African strategy and unified approach to dealing with the outside donor world by neutralising the poison of money as honey th...

  14. African Diaspora Associations in Denmark

    Vammen, Ida Marie; Trans, Lars Ove


    Since the early 1990s, an increasing number of African migrants have come to Denmark, where they have formed a large number of migrant associations. This chapter presents selected findings from a comprehensive survey of African diaspora associations in Denmark and focuses specifically on their...

  15. Establishment of baseline haematology and biochemistry parameters in wild adult African penguins (Spheniscus demersus)

    Parsons, Nola J.; Schaefer, Adam M.; Stephen D. van der Spuy; Gous, Tertius A


    There are few publications on the clinical haematology and biochemistry of African penguins (Spheniscus demersus) and these are based on captive populations. Baseline haematology and serum biochemistry parameters were analysed from 108 blood samples from wild, adult African penguins. Samples were collected from the breeding range of the African penguin in South Africa and the results were compared between breeding region and sex. The haematological parameters that were measured were: haematoc...

  16. Bioenergy and African transformation.

    Lynd, Lee R; Sow, Mariam; Chimphango, Annie Fa; Cortez, Luis Ab; Brito Cruz, Carlos H; Elmissiry, Mosad; Laser, Mark; Mayaki, Ibrahim A; Moraes, Marcia Afd; Nogueira, Luiz Ah; Wolfaardt, Gideon M; Woods, Jeremy; van Zyl, Willem H


    Among the world's continents, Africa has the highest incidence of food insecurity and poverty and the highest rates of population growth. Yet Africa also has the most arable land, the lowest crop yields, and by far the most plentiful land resources relative to energy demand. It is thus of interest to examine the potential of expanded modern bioenergy production in Africa. Here we consider bioenergy as an enabler for development, and provide an overview of modern bioenergy technologies with a comment on application in an Africa context. Experience with bioenergy in Africa offers evidence of social benefits and also some important lessons. In Brazil, social development, agricultural development and food security, and bioenergy development have been synergistic rather than antagonistic. Realizing similar success in African countries will require clear vision, good governance, and adaptation of technologies, knowledge, and business models to myriad local circumstances. Strategies for integrated production of food crops, livestock, and bioenergy are potentially attractive and offer an alternative to an agricultural model featuring specialized land use. If done thoughtfully, there is considerable evidence that food security and economic development in Africa can be addressed more effectively with modern bioenergy than without it. Modern bioenergy can be an agent of African transformation, with potential social benefits accruing to multiple sectors and extending well beyond energy supply per se. Potential negative impacts also cut across sectors. Thus, institutionally inclusive multi-sector legislative structures will be more effective at maximizing the social benefits of bioenergy compared to institutionally exclusive, single-sector structures. PMID:25709714

  17. Nota sobre caso autóctone de tripanossomíase americana no litoral sul do Estado de São Paulo, Brasil A case of American Trypanosomiasis in the southern coastal region of S. Paulo State, Brazil

    Oswaldo Paulo Forattini


    Full Text Available Descreve-se em caso autóctone de tripanossomíase americana no litoral sul do Estado de São Paulo, Brasil. As evidências sugerem a hipótese de a transmissão ter ocorrido graças à contaminação durante o manuseio de carcaças de animais silvestres utilizados na alimentação.An indigenous case of American Trypanosomiasis in the southern coastal region of the State of S. Paulo is reported on. There are no synanthropic triatominae vectors in the area; therefore the transmission mechanism may have been the handling of wild mammal carcasses while they were being prepared for consumption.

  18. Court stories in selected African short narratives

    E. Yewah


    This article attempts to cross-examine African Literature and African costumary, Islamic and inherited colonial laws. It opens a new topic in the study of African literature by showing how legal discourses are inscribed in certain African narratives and how these discourses link the narratives to the overall context of their production.

  19. 2002 Sino-African SHP Training Workshop


    The 2002 Sino-African SHP Training Workshop was held from 10 May to 18 June 2002 at Hangzhou Regional Center for Small Hydro Power(HRC). Attended altogether 9 participants from 5 African countries, i.e. Burundi, Nigeria, South African, Tanzania and Tunisia. This is the second training workshop on SHP that HRC conducted for African countries.

  20. Assimilation Differences among Africans in America.

    Dodoo, F. Nii-Amoo


    Census data (1990) indicate that male African immigrants earn more than their Caribbean-born counterparts or native-born African Americans, but controlling for relevant earnings-related endowments erases the African advantage and elevates Caribbean earnings above those of the other groups. Also, African (but not Caribbean) university degree…

  1. Facteurs socioculturels et contrôle de la Trypanosomiase Humaine Africaine en République Démocratique du Congo / Sociocultural factors and control of human African trypanosomiasis in the Democratic Republic of Congo

    Mpanya Kabeya, Alain


    RESUMELa Trypanosomiase Humaine Africaine (THA) appelée également « maladie du sommeil» est une maladie parasitaire provoquée par un protozoaire du genre Trypanosoma dont deux sous-espèces (T. brucei gambiense et T. brucei rhodesiense) sont pathogènes à l’homme. La stratégie de lutte contre cette maladie est essentiellement basée sur le dépistage précoce et le traitement des malades, complété avec le contrôle du vecteur. Cependant, l’utilisation du service de dépistage de la THA par les commu...

  2. Cardiomyopathy in captive African hedgehogs (Atelerix albiventris).

    Raymond, J T; Garner, M M


    From 1994 to 1999, 16 captive African hedgehogs (Atelerix albiventris), from among 42 necropsy cases, were diagnosed with cardiomyopathy. The incidence of cardiomyopathy in this study population was 38%. Fourteen of 16 hedgehogs with cardiomyopathy were males and all hedgehogs were adult (>1 year old). Nine hedgehogs exhibited 1 or more of the following clinical signs before death: heart murmur, lethargy, icterus, moist rales, anorexia, dyspnea, dehydration, and weight loss. The remaining 7 hedgehogs died without premonitory clinical signs. Gross findings were cardiomegaly (6 cases), hepatomegaly (5 cases), pulmonary edema (5 cases), pulmonary congestion (4 cases), hydrothorax (3 cases), pulmonary infarct (1 case), renal infarcts (1 case), ascites (1 case), and 5 cases showed no changes. Histologic lesions were found mainly within the left ventricular myocardium and consisted primarily of myodegeneration, myonecrosis, atrophy, hypertrophy, and disarray of myofibers. All hedgehogs with cardiomyopathy had myocardial fibrosis, myocardial edema, or both. Other common histopathologic findings were acute and chronic passive congestion of the lungs, acute passive congestion of the liver, renal tubular necrosis, vascular thrombosis, splenic extramedullary hematopoiesis, and hepatic lipidosis. This is the first report of cardiomyopathy in African hedgehogs. PMID:11021439

  3. Infant-feeding practices among African American women: social-ecological analysis and implications for practice.

    Reeves, Elizabeth A; Woods-Giscombé, Cheryl L


    Despite extensive evidence supporting the health benefits of breastfeeding, significant disparities exist between rates of breastfeeding among African American women and women of other races. Increasing rates of breastfeeding among African American women can contribute to the improved health of the African American population by decreasing rates of infant mortality and disease and by enhancing cognitive development. Additionally, higher rates of breastfeeding among African American women could foster maternal-child bonding and could contribute to stronger families, healthier relationships, and emotionally healthier adults. The purpose of this article is twofold: (a) to use the social-ecological model to explore the personal, socioeconomic, psychosocial, and cultural factors that affect the infant feeding decision-making processes of African American women and (b) to discuss the implications of these findings for clinical practice and research to eliminate current disparities in rates of breastfeeding. PMID:24810518

  4. Investigating the influence of African American and African Caribbean race on primary care doctors' decision making about depression.

    Adams, A; Vail, L; Buckingham, C D; Kidd, J; Weich, S; Roter, D


    This paper explores differences in how primary care doctors process the clinical presentation of depression by African American and African-Caribbean patients compared with white patients in the US and the UK. The aim is to gain a better understanding of possible pathways by which racial disparities arise in depression care. One hundred and eight doctors described their thought processes after viewing video recorded simulated patients presenting with identical symptoms strongly suggestive of depression. These descriptions were analysed using the CliniClass system, which captures information about micro-components of clinical decision making and permits a systematic, structured and detailed analysis of how doctors arrive at diagnostic, intervention and management decisions. Video recordings of actors portraying black (both African American and African-Caribbean) and white (both White American and White British) male and female patients (aged 55 years and 75 years) were presented to doctors randomly selected from the Massachusetts Medical Society list and from Surrey/South West London and West Midlands National Health Service lists, stratified by country (US v.UK), gender, and years of clinical experience (less v. very experienced). Findings demonstrated little evidence of bias affecting doctors' decision making processes, with the exception of less attention being paid to the potential outcomes associated with different treatment options for African American compared with White American patients in the US. Instead, findings suggest greater clinical uncertainty in diagnosing depression amongst black compared with white patients, particularly in the UK. This was evident in more potential diagnoses. There was also a tendency for doctors in both countries to focus more on black patients' physical rather than psychological symptoms and to identify endocrine problems, most often diabetes, as a presenting complaint for them. This suggests that doctors in both countries

  5. How student teachers understand African philosophy

    Matsephe M. Letseka; Elza Venter


    The question ‘What constitutes African philosophy?’ was first raised with the publication of Placide Tempels’s seminal work Bantu philosophy in 1959. Tempels’s book inevitably elicited considerable critical response from African philosophers, which culminated in a wide range of publications such as Wiredu’s (1980) Philosophy and an African culture, Hountondji’s (1983) African philosophy: Myth and reality, Oruka’s (1990) Sage philosophy: Indigenous thinkers and modern debate on African philoso...

  6. Junctophilin 3 (JPH3) expansion mutations causing Huntington disease like 2 (HDL2) are common in South African patients with African ancestry and a Huntington disease phenotype.

    Krause, Amanda; Mitchell, Claire; Essop, Fahmida; Tager, Susan; Temlett, James; Stevanin, Giovanni; Ross, Christopher; Rudnicki, Dobrila; Margolis, Russell


    Huntington disease (HD) is a progressive autosomal dominant neurodegenerative disorder, characterized by abnormal movements, cognitive decline, and psychiatric symptoms, caused by a CAG repeat expansion in the huntingtin (HTT) gene on chromosome 4p. A CAG/CTG repeat expansion in the junctophilin-3 (JPH3) gene on chromosome 16q24.2 causes a Huntington disease-like phenotype (HDL2). All patients to date with HDL2 have some African ancestry. The present study aimed to characterize the genetic basis of the Huntington disease phenotype in South Africans and to investigate the possible origin of the JPH3 mutation. In a sample of unrelated South African individuals referred for diagnostic HD testing, 62% (106/171) of white patients compared to only 36% (47/130) of black patients had an expansion in HTT. However, 15% (20/130) of black South African patients and no white patients (0/171) had an expansion in JPH3, confirming the diagnosis of Huntington disease like 2 (HDL2). Individuals with HDL2 share many clinical features with individuals with HD and are clinically indistinguishable in many cases, although the average age of onset and diagnosis in HDL2 is 5 years later than HD and individual clinical features may be more prominent. HDL2 mutations contribute significantly to the HD phenotype in South Africans with African ancestry. JPH3 haplotype studies in 31 families, mainly from South Africa and North America, provide evidence for a founder mutation and support a common African origin for all HDL2 patients. Molecular testing in individuals with an HD phenotype and African ancestry should include testing routinely for JPH3 mutations. PMID:26079385

  7. African Ethnobotany in the Americas

    Zent, Egleé L


    Review of African Ethnobotany in the Americas. Edited by Robert Voeks and John Rashford. 2013. Springer. Pp. 429, 105 illustrations, 69 color illustrations. $49.95 (paperback). ISBN 978‐1461408352.

  8. Mental Health and African Americans

    ... Program Grants Other Grants Planning and Evaluation Grantee Best Practices Black/African American Asthma Cancer Chronic Liver Disease Diabetes Heart Disease Hepatitis HIV/AIDS Immunizations Infant Heath & Mortality Mental Health Obesity Organ and Tissue Donation Stroke Stay Connected ...

  9. African Ethnobotany in the Americas

    Egleé L. Zent


    Full Text Available Review of African Ethnobotany in the Americas. Edited by Robert Voeks and John Rashford. 2013. Springer. Pp. 429, 105 illustrations, 69 color illustrations. $49.95 (paperback. ISBN 978‐1461408352.

  10. Bromodomain Proteins Contribute to Maintenance of Bloodstream Form Stage Identity in the African Trypanosome.

    Schulz, Danae; Mugnier, Monica R; Paulsen, Eda-Margaret; Kim, Hee-Sook; Chung, Chun-wa W; Tough, David F; Rioja, Inmaculada; Prinjha, Rab K; Papavasiliou, F Nina; Debler, Erik W


    Trypanosoma brucei, the causative agent of African sleeping sickness, is transmitted to its mammalian host by the tsetse. In the fly, the parasite's surface is covered with invariant procyclin, while in the mammal it resides extracellularly in its bloodstream form (BF) and is densely covered with highly immunogenic Variant Surface Glycoprotein (VSG). In the BF, the parasite varies this highly immunogenic surface VSG using a repertoire of ~2500 distinct VSG genes. Recent reports in mammalian systems point to a role for histone acetyl-lysine recognizing bromodomain proteins in the maintenance of stem cell fate, leading us to hypothesize that bromodomain proteins may maintain the BF cell fate in trypanosomes. Using small-molecule inhibitors and genetic mutants for individual bromodomain proteins, we performed RNA-seq experiments that revealed changes in the transcriptome similar to those seen in cells differentiating from the BF to the insect stage. This was recapitulated at the protein level by the appearance of insect-stage proteins on the cell surface. Furthermore, bromodomain inhibition disrupts two major BF-specific immune evasion mechanisms that trypanosomes harness to evade mammalian host antibody responses. First, monoallelic expression of the antigenically varied VSG is disrupted. Second, rapid internalization of antibodies bound to VSG on the surface of the trypanosome is blocked. Thus, our studies reveal a role for trypanosome bromodomain proteins in maintaining bloodstream stage identity and immune evasion. Importantly, bromodomain inhibition leads to a decrease in virulence in a mouse model of infection, establishing these proteins as potential therapeutic drug targets for trypanosomiasis. Our 1.25Å resolution crystal structure of a trypanosome bromodomain in complex with I-BET151 reveals a novel binding mode of the inhibitor, which serves as a promising starting point for rational drug design. PMID:26646171