A5079957177- Tuberculosis Research and Epidemiology
- Pneumonia and Respiratory Infections
- Mycobacterium research and diagnosis
- Diagnosis and treatment of tuberculosis
- Pneumocystis jirovecii pneumonia detection and treatment
- Chronic Obstructive Pulmonary Disease (COPD) Research
- HIV/AIDS Research and Interventions
- HIV Research and Treatment
- Global Health and Surgery
- HIV/AIDS drug development and treatment
- Respiratory viral infections research
- Infectious Diseases and Tuberculosis
- Vitamin D Research Studies
- COVID-19 diagnosis using AI
- Vitamin C and Antioxidants Research
- COVID-19 epidemiological studies
- COVID-19 Clinical Research Studies
- Viral Infections and Outbreaks Research
- Global Health Workforce Issues
- Respiratory Support and Mechanisms
- Pharmacological Effects and Toxicity Studies
- HIV, Drug Use, Sexual Risk
- COVID-19 Pandemic Impacts
- Maternal Mental Health During Pregnancy and Postpartum
- Clinical Reasoning and Diagnostic Skills
London School of Hygiene & Tropical Medicine
2020-2024
MRC Unit the Gambia
2012-2024
Medical Research Council
2007-2023
University of London
2022
Hospital for Tropical Diseases
2020
McGill University
2016-2019
McGill University Health Centre
2018
The University of Texas Health Science Center at Houston
2018
New biomarkers of tuberculosis (TB) risk and disease are critical for the urgently needed control ongoing TB pandemic. In a prospective multisite study across Subsaharan Africa, we analyzed metabolic profiles in serum plasma from HIV-negative, TB-exposed individuals who either progressed to 3-24 months post-exposure (progressors) or remained healthy (controls). We generated trans-African biosignature TB, which identifies future progressors both on blinded test samples external data sets...
Background Post-tuberculosis (post-TB) lung disease is an under-recognised consequence of pulmonary tuberculosis (pTB). We aimed to estimate the prevalence residual function impairment and reduced health-related quality life (HRQoL) in children after pTB treatment completion. Methods conducted a cross-sectional comparative study aged less than 15 years at TB diagnosis who had completed for least 6 months previously with comparator group age-matched without history pTB. Symptoms, spirometry...
Identification of basic prognostic indicators HIV infection is essential before widespread antiretroviral therapy can be implemented in low-technology settings. This study assessed how well body mass index (BMI:kg/m2) predicts survival.BMI within 3 months diagnosis was obtained from 1657 patients aged > or = 15 years, recruited a seroprevalent clinical cohort The Gambia since 1992 and followed up at least once. Baseline CD4+ counts assessment time were done.The mortality hazard ratio (HR)...
Abstract Unlike HIV-1-infected people, most HIV-2-infected subjects maintain a healthy CD4+ T cell count and strong HIV-specific response. To define the cellular immunological correlates of good prognosis in HIV-2 infection, we conducted cross-sectional study HIV Gag-specific function HIV-1- Gambians. Using cytokine flow cytometry lymphoproliferation assays, show that cells from individuals maintained proliferative capacity, were not terminally differentiated (CD57−), more frequently...
Although AIDS is less frequent following HIV-2 than HIV-1 infection, it unclear whether the clinical picture and course of are similar in two infections.To compare pattern AIDS-defining events, CD4 cell count at time diagnosis, survival from AIDS, near death HIV-2-infected patients.Adult patients with who attended clinics MRC The Gambia were enrolled. was diagnosed according to expanded World Health Organization case definition for surveillance (1994).Three hundred forty-one 87 infection...
We investigated host-derived biomarkers that were previously identified in QuantiFERON supernatants, a large pan-African study. recruited individuals presenting with symptoms of pulmonary TB at seven peripheral healthcare facilities six African countries, prior to assessment for disease. then evaluated the concentrations 12 stored supernatants using Luminex platform. Based on laboratory, clinical and radiological findings pre-established algorithm, participants classified as disease or other...
Recognition of the relevance colonial history to contemporary practice global health is not new, but recent increase in visibility and prominence given it by institutions flagship journals welcome when accompanied meaningful reflection action.1Hirsch LA Is possible decolonise institutions?.Lancet. 2021; 397: 189-190Summary Full Text PDF PubMed Scopus (13) Google Scholar The goal decolonising critically reflect on its history, identify hierarchies culturally Eurocentric conceptions, overcome...
Abstract Background Although post‐tuberculosis lung disease (PTLD) is a known consequence of pulmonary tuberculosis (pTB), few studies have reported the prevalence and spectrum PTLD in children adolescents. Methods Children adolescent (≤19 years) survivors pTB Western Regions The Gambia underwent respiratory symptom screening, chest X‐ray (CXR) spirometry at TB treatment completion. Variables associated with function impairment were identified through logistic regression models. Results...
Setting: Greater Banjul area of The Gambia. Objectives: To evaluate uptake, adherence and completion treatment among tuberculosis (TB) exposed children in Gambia when isoniazid preventive (IPT) is delivered at home Design: Child (age <5 years) contacts adults with smear-positive TB were prospectively enrolled. Following symptom screening, tuberculin skin testing clinical evaluation where indicated, those without disease placed on daily isoniazid, provided monthly home. Adherence was assessed...
To investigate the pattern of tuberculosis (TB) care initiation and risk factors for TB diagnostic delay in The Gambia.In this cross-sectional study, adult patients diagnosed with pulmonary (pTB) public facilities Greater Banjul Area Gambia were consecutively recruited from October 2016 to March 2017. Diagnostic was defined as >21 days onset at least one symptom suggestive pTB diagnosis. Logistic regression analyses used delay.Overall, 216 included study; median (Interquartile Range (IQR))...
Background: In sub-Saharan Africa, tuberculosis (TB) is the most frequently diagnosed opportunistic infection and cause of death among HIV-infected patients. HIV-2 has been associated with less immune suppression, slower disease progression longer survival. Objective: To examine whether incidence TB survival after are CD4 cell count rather than HIV type. Methods: Clinical immunological data were retrospectively evaluated an open clinic-based cohort HIV-1- HIV-2-infected patients to determine...
High early mortality rate among HIV infected patients following initiation of antiretroviral therapy (ART) in resource limited settings may indicate high pre-treatment ART-eligible patients. There is dearth data on ART programmes sub-Sahara Africa. This study aims to determine and predictors adult a West Africa clinic-based cohort.All HIV-infected aged 15 years or older eligible for between June 2004 September 2009 were included the analysis. Assessment eligibility was based Gambia...
Greater Banjul Area of the Gambia.To identify co-prevalent tuberculosis (TB) among child contacts adults with smear-positive TB.Child aged <15 years in immediate household and compound were prospectively enrolled evaluated for TB disease using screening questionnaires tuberculin skin test (TST). Symptomatic and/or TST-positive (10 mm) further investigated.Of 4042 who underwent symptom TST, 3339 (82.6%) diagnosed as TB-exposed but not infected, 639 (15.8%) latently infected 64 (1.6%) had TB....
HIV infection among children, particularly those under 24 months of age, is often rapidly progressive; as a result guidelines recommend earlier access to combination antiretroviral therapy (cART) for infected children. Losses follow-up (LTFU) and death in the interval between diagnosis initiation ART profoundly limit this strategy. This study explores correlates LTFU prior children.The based on 337 HIV-infected children enrolled into care at an urban centre The Gambia, including alive when...
Greater Banjul Area, The Gambia.To conduct a pragmatic evaluation of the Xpert(®) MTB/RIF assay in diagnosis tuberculosis (TB) among child contacts.In this prospective study, one induced sputum sample was obtained from TB contacts aged <15 years and tested using fluorescent microscopy, culture Xpert. diagnostic accuracy microbiological tests evaluated against 'all treatment' as separate reference standards.Using standard, Xpert positive for Mycobacterium 6/14 culture-positive 6/473...
Tuberculosis is one of the leading causes morbidity and mortality in developing countries. Analysis host immune response may help with generating point-of-care tests for personalised monitoring. Thus, aim this study was to assess relationship between activation markers: C-reactive protein (CRP), Beta2 microglobulin (B2M) Neopterin, disease severity prior treatment therapy adult pulmonary TB patients. HIV negative index cases (n = 91) were recruited from clinic at MRC, The Gambia. Plasma...
Vitamin D is essential in the host defence against tuberculosis (TB) as an immune modulator. The aim of this study was to determine level 25-hydroxyvitamin (25 (OH) D) from adult TB index cases before and after treatment their exposed household contacts (HHC) Gambia.Serum TB-exposed analysed for 25(OH) binding protein (VDBP) concentrations. Tuberculin skin test (TST) status used a measure Mycobacterium (Mtb) infectivity HHC. In addition, HHC who later progressed active (incident cases) were...
BackgroundOur study aimed to identify a host cytokine biosignature that could distinguish childhood tuberculosis (TB) from other respiratory diseases (OD).MethodsCytokine responses in prospectively recruited children with symptoms suggestive of TB were measured whole blood assay supernatants, harvested after overnight incubation, using Luminex platform. We used logistic regression models Least Absolute Shrinkage and Selection Operator (LASSO) penalty the optimal associated confirmed disease...