A5091453196- Malaria Research and Control
- Mosquito-borne diseases and control
- Global Maternal and Child Health
- Hemoglobinopathies and Related Disorders
- Sepsis Diagnosis and Treatment
- Viral Infections and Vectors
- Child Nutrition and Water Access
- Parasites and Host Interactions
- Emergency and Acute Care Studies
- Salmonella and Campylobacter epidemiology
- Pneumonia and Respiratory Infections
- Drug-Induced Hepatotoxicity and Protection
- Cardiac Arrest and Resuscitation
- Vibrio bacteria research studies
- Respiratory viral infections research
- Complement system in diseases
- Pneumocystis jirovecii pneumonia detection and treatment
- Pregnancy and preeclampsia studies
- Hepatitis Viruses Studies and Epidemiology
- Neonatal Health and Biochemistry
- Insect Pest Control Strategies
- Viral gastroenteritis research and epidemiology
- Vector-borne infectious diseases
- HIV Research and Treatment
- COVID-19 Impact on Reproduction
National Institute for Medical Research
2014-2024
Rajabu St Augustine's, Hospitali Teule
2009-2019
Kilimanjaro Christian Medical Centre
2008-2018
Christian Medical College & Hospital
2015-2018
The Francis Crick Institute
2011-2015
Christian Medical College
2015
African Malaria Network Trust
2010
The role of fluid resuscitation in the treatment children with shock and life-threatening infections who live resource-limited settings is not established.We randomly assigned severe febrile illness impaired perfusion to receive boluses 20 40 ml 5% albumin solution (albumin-bolus group) or 0.9% saline (saline-bolus per kilogram body weight no bolus (control at time admission a hospital Uganda, Kenya, Tanzania (stratum A); hypotension were one groups only B). All received appropriate...
Early rapid fluid resuscitation (boluses) in African children with severe febrileillnesses increases the 48-hour mortality by 3.3% compared controls (nobolus). We explored effect of boluses on all-cause byclinical presentation at enrolment, hemodynamic changes over first hour, andon different modes death, according to terminal clinical events. hypothesizethat may cause excess deaths from neurological or respiratory eventsrelating overload. Pre-defined syndromes (PS; acidosis...
Background. Data from the largest randomized, controlled trial for treatment of children hospitalized with severe malaria were used to identify such predictors a poor outcome malaria. Methods. African (<15 years) participated in randomized comparison parenteral artesunate and quinine 9 countries. Detailed clinical assessment was performed on admission. Parasite densities assessed reference laboratory. Predictors death examined using multivariate logistic regression model. Results. Twenty...
To assess the performance of WHO's "Guidelines for care at first-referral level in developing countries" an area intense malaria transmission and identify bacterial infections children with without malaria.Prospective study.District hospital Muheza, northeast Tanzania.Children aged 2 months to 13 years admitted febrile illness.Sensitivity specificity WHO guidelines diagnosing invasive disease; susceptibility isolated organisms recommended antimicrobials.Over one year, 3639 were enrolled 184...
In African children, distinguishing severe falciparum malaria from other febrile illnesses with coincidental Plasmodium parasitaemia is a major challenge. P. histidine-rich protein 2 (PfHRP2) released by mature sequestered parasites and can be used to estimate the total parasite burden. We investigated prognostic significance of plasma PfHRP2 it malaria-attributable fraction in children diagnosed malaria.Admission was measured prospectively (from Mozambique, The Gambia, Kenya, Tanzania,...
Severe anaemia in children is a leading cause of hospital admission and major mortality sub-Saharan Africa, yet there are limited published data on blood transfusion this vulnerable group. We present from large controlled trial fluid resuscitation (Fluid Expansion As Supportive Therapy (FEAST) trial) the prevalence, clinical features, management presenting to hospitals three East African countries with serious febrile illness (predominantly malaria and/or sepsis) impaired peripheral...
Understanding the factors which determine a household's or individual's risk of malaria infection is important for targeting control interventions at all intensities transmission. Malaria ecology in Tanzania appears to have reduced over recent years. This study investigated potential and clustering face changing dynamics. Household survey data were collected villages rural Muheza district. Children aged between six months thirteen years tested presence parasites using microscopy. A...
Background The importance of invasive salmonellosis in African children is well recognized but there inadequate information on these infections. We conducted a fever surveillance study Tanzanian rural hospital to estimate the case fraction among pediatric admissions, examine associations with common co-morbidities and describe its clinical features. compared our main findings those from previous studies sub-Saharan Africa. Methodology/Principal Findings From 1 March 2008 28 Feb 2009, 1,502...
Background. The epidemiology of Salmonella Typhi and invasive nontyphoidal (NTS) differs, prevalence these pathogens among children in sub-Saharan Africa may vary relation to malaria transmission intensity.
Background. In malaria-endemic settings, asymptomatic parasitemia complicates the diagnosis of malaria. Histidine-rich protein 2 (HRP2) is produced by Plasmodium falciparum, and its plasma concentration reflects total body parasite burden. We aimed to define malaria-attributable fraction severe febrile illness, using distributions P. falciparum HRP2 (PfHRP2) concentrations from parasitemic children with different clinical presentations.
ABSTRACT Bats carry a variety of paramyxoviruses that impact human and domestic animal health when spillover occurs. Recent studies have shown great diversity in an urban-roosting population straw-colored fruit bats Ghana. Here, we investigate this further through virus isolation describe two novel rubulaviruses: Achimota 1 (AchPV1) 2 (AchPV2). The viruses form phylogenetic cluster with each other bat-derived rubulaviruses, such as Tuhoko viruses, Menangle virus, Tioman virus. We developed...
X-linked Glucose-6-phosphate dehydrogenase (G6PD) A- deficiency is prevalent in sub-Saharan Africa populations, and has been associated with protection from severe malaria. Whether females and/or males are protected by G6PD uncertain, due part to malaria phenotypic complexity misclassification. Almost all large association studies have genotyped a limited number of SNPs (e.g. G6PD202 / G6PD376), this approach too blunt capture the complete epidemiological picture. Here we identified 68...
Mortality in paediatric emergency care units Africa often occurs within the first 24 h of admission and remains high. Alongside effective triage systems, a practical clinical bedside risk score to identify those at greatest could contribute reducing mortality. Data collected during Fluid As Expansive Supportive Therapy (FEAST) trial, multi-centre trial involving 3,170 severely ill African children, were analysed laboratory prognostic factors for Multivariable Cox regression was used build...
Significant selection pressure has been exerted on the genomes of human populations exposed to Plasmodium falciparum infection, resulting in acquisition mechanisms resistance against severe malarial disease. Many host genetic factors, including sickle cell trait, have associated with reduced risk developing malaria, but do not account for all observed phenotypic variation. Identification novel inherited factors relies upon high-resolution genome-wide association studies (GWAS). We present...
The relationship between community prevalence of
Abstract Background The annual incidence and temporal trend of severe malaria community-acquired bacteraemia during a four-year period in Muheza, Tanzania was assessed. Methods Data on severely ill febrile children aged 2 months to 14 years from three prospective studies conducted at Muheza District Hospital 2006 2010 pooled analysed. On admission, each enrolled child had thin thick blood film least one rapid diagnostic test for falciparum malaria, as well culture. among coming calculated...
In the Fluid Expansion as a Supportive Treatment (FEAST) trial, an unexpectedly high proportion of participants from eastern Uganda presented with blackwater fever (BWF).
In high transmission settings, most school-aged children harbour malaria parasites without showing symptoms, often leading to anaemia and possibly impaired psychomotor cognitive abilities. We aimed assess the effectiveness safety of intermittent preventive treatment for in (IPTsc) living highly endemic areas.We did an open-label randomised controlled trial seven primary schools northeastern Tanzania. Schoolchildren aged 5-15 years were individually randomly assigned (1:1:1) receive...
WHO guidelines for the treatment of young children with suspected malaria have recently changed from presumptive to anti-malarial guided by a blood slide or rapid diagnostic test (RDT). However, there is limited evidence safety this policy in routine outpatient settings Africa.Children 3-59 months age non-severe febrile illness and no obvious cause were enrolled over period one year endemic area Tanzania. Treatment was determined results clinical examination RDT result, culture serum lactate...
Background. Rapid diagnostic tests (RDTs) now play an important role in the diagnosis of falciparum malaria many countries where disease is endemic. Although these have been extensively evaluated uncomplicated malaria, reliable data on their performance for diagnosing potentially lethal severe lacking.
Abstract Background There is no clear consensus on the most sustainable and effective distribution strategy for insecticide treated bed nets (ITNs). Tanzania has been a leader in social marketing but it still not if this can result high equitable levels of coverage. Methods A cluster-randomized survey ITN net ownership use was conducted rural area exposed to intense Plasmodium falciparum transmission NE where had subject routine delivery national strategies episodic free through local...
The diagnosis of typhoid fever is confirmed by culture Salmonella enterica serotype Typhi (S. typhi). However, a more rapid, simpler, and cheaper diagnostic method would be very useful especially in developing countries. Widal test widely used Africa but little information exists about its reliability. We assessed the performance tube agglutination among febrile hospitalized Tanzanian children. calculated sensitivity, specificity, positive predictive value (PPV), negative (NPV) various...