Hugh Reyburn
A5103024456- Malaria Research and Control
- Mosquito-borne diseases and control
- Global Maternal and Child Health
- Hemoglobinopathies and Related Disorders
- Complement system in diseases
- Parasites and Host Interactions
- Child Nutrition and Water Access
- Viral Infections and Vectors
- Pneumonia and Respiratory Infections
- Sepsis Diagnosis and Treatment
- Emergency and Acute Care Studies
- HIV Research and Treatment
- Salmonella and Campylobacter epidemiology
- Respiratory viral infections research
- HIV/AIDS Research and Interventions
- Pneumocystis jirovecii pneumonia detection and treatment
- Vibrio bacteria research studies
- Health Policy Implementation Science
- Hepatitis Viruses Studies and Epidemiology
- Healthcare Systems and Reforms
- Immune Cell Function and Interaction
- Drug Transport and Resistance Mechanisms
- Cardiac Arrest and Resuscitation
- Child and Adolescent Health
- Neonatal Health and Biochemistry
London School of Hygiene & Tropical Medicine
2013-2022
University of London
2008-2020
Kilimanjaro Christian Medical Centre
2008-2018
Christian Medical College & Hospital
2008-2018
Rajabu St Augustine's, Hospitali Teule
2011-2015
Tumaini University
2015
African Malaria Network Trust
2004-2014
Mayo Clinic in Arizona
2014
Mayo Clinic
2014
National Institute for Medical Research
2013
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...
<h3>Abstract</h3> <b>Objective</b> To study the diagnosis and outcomes in people admitted to hospital with a of severe malaria areas differing intensities transmission. <b>Design</b> Prospective observational children adults over course year. <b>Setting</b> 10 hospitals north east Tanzania. <b>Participants</b> 17 313 patients were hospital; these 4474 (2851 aged under 5 years) fulfilled criteria for disease. <b>Main outcome measure</b> Details treatment given outcome. Altitudes residence (a...
<h3>Background</h3> Leukoaraiosis (LA) is a risk factor for stroke and dementia, but the mechanism uncertain. Further studies are required, there no consensus about imaging requirements. MR has greater sensitivity to LA than CT, specificity of CT may have some advantages. <h3>Methods</h3> We did systematic review factors using Medline Embase via OVID interface search reference lists. determined pooled estimates associations between presence LA, stratified by modality. <h3>Results</h3> Of 74...
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...
The malaria parasite Plasmodium falciparum invades human red blood cells by a series of interactions between host and surface proteins. By analyzing genome sequence data from populations, including 1269 individuals sub-Saharan Africa, we identify diverse array large copy-number variants affecting the invasion receptor genes GYPA GYPB We find that nearby association with severe is explained complex structural rearrangement involving loss gain two GYPB-A hybrid genes, which encode...
Abstract The human genetic factors that affect resistance to infectious disease are poorly understood. Here we report a genome-wide association study in 17,000 severe malaria cases and population controls from 11 countries, informed by sequencing of family trios direct typing candidate loci an additional 15,000 samples. We identify five replicable associations with levels evidence including newly implicated variant on chromosome 6. Jointly, these variants account for around one-tenth the...
Malaria over-diagnosis in Africa is widespread and costly both financially terms of morbidity mortality from missed diagnoses. An understanding the reasons behind malaria urgently needed to inform strategies for better targeting antimalarials.In an ethnographic study clinical practice two hospitals Tanzania, 2,082 patient consultations with 34 clinicians were observed over a period three months at each hospital. All also interviewed individually as well being during routine working...
<h3>Abstract</h3> <b>Objectives</b>: To explore general practitioners9 reasons for recent changes in their prescribing behaviour. <b>Design</b>: Qualitative analysis of semistructured interviews. <b>Setting</b>: General practice south east London. <b>Subjects</b>: A heterogeneous sample 18 practitioners. <b>Results</b>: Interviewees were able to identify between two and five specific that had occurred the preceding six months. The most frequently mentioned related fluoxetine, angiotensin...
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...
Rapid diagnostic tests for malaria seem cost effective in standard analyses, but these do not take account of clinicians' response to test results. This study tested the impact rapid or microscopy results on costs and benefits testing at different levels transmission age groups.Cost-benefit analysis using a decision tree model clinical data effectiveness malaria, their costs, results.Tanzania.Data were obtained from trial 2425 patients carried out three settings varying transmission.At...
Background. Few studies describe patterns of human immunodeficiency virus (HIV) co-infections in African hospitals the antiretroviral therapy (ART) era.
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,...
<b>Objectives</b> To examine the impact of use rapid diagnostic tests for malaria on prescribing antimicrobials, specifically antibiotics, acute febrile illness in Africa and Asia. <b>Design</b> Analysis<b></b>of nine preselected linked codesigned observational randomised studies (eight cluster or individually trials one study). <b>Setting</b> Public private healthcare settings, 2007-13, Afghanistan, Cameroon, Ghana, Nigeria, Tanzania, Uganda. <b>Participants</b> 522 480 children adults with...
Previous analyses have suggested that immunity to non-cerebral severe malaria due Plasmodium falciparum is acquired after only a few infections, whereas longitudinal studies show some children experience multiple episodes of disease, suggesting may not be so quickly. We fitted mathematical model for the acquisition and loss disease age distribution cases stratified by symptoms from range transmission settings in Tanzania, combined with data several African countries on overall incidence...
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...
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.