A5087427036- Global Maternal and Child Health
- Hemoglobinopathies and Related Disorders
- Iron Metabolism and Disorders
- SARS-CoV-2 detection and testing
- SARS-CoV-2 and COVID-19 Research
- Respiratory viral infections research
- Antibiotic Use and Resistance
- HIV Research and Treatment
- Pneumonia and Respiratory Infections
- COVID-19 epidemiological studies
- Immune Cell Function and Interaction
- Emergency and Acute Care Studies
- Mosquito-borne diseases and control
- Child Nutrition and Water Access
- Malaria Research and Control
- Immunodeficiency and Autoimmune Disorders
- COVID-19 and Mental Health
- Animal Virus Infections Studies
- Folate and B Vitamins Research
- HIV/AIDS drug development and treatment
- Infection Control and Ventilation
- COVID-19 Clinical Research Studies
- Food Security and Health in Diverse Populations
- Sepsis Diagnosis and Treatment
- Antimicrobial Resistance in Staphylococcus
University of North Carolina at Chapel Hill
2016-2024
Office of Infectious Diseases
2022
University of North Carolina Health Care
2019
University of North Carolina at Charlotte
2019
National Institute of Allergy and Infectious Diseases
2009-2011
National Institutes of Health
2007-2011
University of L'Aquila
2007
Universidade de São Paulo
2005-2006
Grinnell College
2005
The Wistar Institute
1993
During acute human immunodeficiency virus (HIV) infection, there is a massive depletion of CD4(+) T cells in the gut mucosa that can be reversed to various degrees with antiretroviral therapy. Th17 have been implicated mucosal immunity extracellular bacteria, and preservation this subset may support immune recovery. However, possibility has not yet evaluated HIV-1-infected long-term nonprogressors (LTNPs), who maintain high cell counts suppress viral replication absence In study, we...
We analyzed the recently defined ability of CD3-CD16+ cells to specifically recognize and lyse normal allogeneic target (PHA-induced blasts). The susceptibility lysis by a given alloreactive natural killer (NK) clone ("1 anti-A") was expressed PHA blasts derived from 9 38 random donors analyzed. In all instances, specific "susceptible" greater than 35% while that "nonsusceptible" targets less 6% at an E/T cell ratio 5:1. addition 1 anti-A, A anti-1 clones could also be isolated reverse MLC...
Mortality rates associated with C. gattii infections are estimated to be between 13% and 33%, depending on an individual’s predisposition, has caused at least 39 deaths in the PNW region. There have been four other international travel cases reported patients from Europe Asia history PNW, but this report describes first North American traveler who acquired deuterogattii infection presenting within United States case of a outbreak anti-GM-CSF autoantibodies. Early accurate diagnoses important...
Translocation of microbial products has been described in chronic human immunodeficiency virus (HIV) infection and correlates with activation the immune system. We investigated potential translocation idiopathic CD4 lymphocytopenia (ICL), a rare disorder characterized by low T cell counts absence HIV infection. Plasma lipopolysaccharide (LPS) levels were measured cross-sectional cohort study patients ICL healthy control subjects. Increases proliferation but not CD8 observed ICL. LPS...
Background The pathogenesis of immunodeficiency due to human virus (HIV)-1 is incompletely understood, but immune activation believed play a central role. Immunomodulatory agents that decrease may be useful in the treatment HIV-1 infection. Methodology A randomized, double blind, placebo-controlled pilot study leflunomide for 28 days was performed participants with infection who were not receiving antiretroviral therapy. Participants randomized subsequently treated cholestyramine until...
Death audits have been used to describe pediatric mortality in under-resourced settings, where record keeping is often a challenge. This information provides the cornerstone for foundation of quality improvement initiatives. Malawi, located sub-Saharan Africa, currently has an Under-5 rate 64/1000. Kamuzu Central Hospital, capital city Lilongwe, busy government referral hospital, which admits up 3000 children per month. A study published 2013 reported rates as high 9%. first known audit...
The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to evolve as a global health crisis. Although highly effective vaccines have been developed, non-pharmaceutical interventions remain critical controlling disease transmission. One such intervention-rapid, at-home antigen self-testing-can ease burden associated with facility-based testing programs and improve access in high-risk communities. However, its impact on SARS-CoV-2 community...
Few studies have described changes in SARS-CoV-2 antibody levels response to infection and vaccination at frequent intervals over extended follow-up periods. The purpose of this study was assess SARS-CoV-2-specific responses among a prospective cohort health care personnel 18 months with up 22 samples per person. Antibody live virus neutralization were measured before after mRNA-based results stratified by (1) status prior initial (2) any point during follow-up. We found that the first dose...
Acute respiratory illness (ARI) is one of the most common reasons children receive antibiotic treatment. Measurement C-reaction protein (CRP) has been shown to reduce unnecessary use among with ARI in a range clinical settings. In many resource-constrained contexts, patients seek care outside formal health sector, often from lay community workers (CHW). This study's objective was determine impact CRP measurement on presenting febrile CHW Uganda.
Using culture-based screening of stool specimens, 80.3% 188 children hospitalized for severe acute malnutrition in Malawi carried extended spectrum cephalosporin resistant Enterobacterales (ESCR-E) at admission. 38.3% were colonized with multiple ESCR-E species. Over half the did not have recent antibiotic exposure or prior hospitalization.
Natural killer (NK) cells lyse autologous and allogeneic target even in the absence of major histocompatibility complex (MHC) class I antigens on cells. Recently, however, human allospecific NK cell clones have been generated that recognize at least five distinct specificities inherited recessively controlled by genes linked to MHC. Because genetic specificity these alloreactive vitro appears analogous vivo cell-mediated murine hybrid resistance, i.e., rejection parental bone marrow...
Severe acute malnutrition (SAM) is a major cause of childhood mortality in resource-limited settings. The relationship between clinical factors and adherence to the 'WHO 10 Steps' children with SAM not fully understood.Data from an ongoing prospective observational cohort study assessing admission characteristics, management patterns outcome aged 6-36 months admitted tertiary hospital Malawi September 2018 2019 were analysed. Data clerks independently collected data patients' charts....
Summary Although renin‐angiotensin‐aldosterone system ( RAAS ) blocking agents decrease albuminuria in short‐term studies, there is no evidence confirming their long‐term efficacy sickle cell disease SCD ). In a single‐centre, retrospective study, we evaluated the effect of on proteinuria and declining estimated glomerular filtration rates eGFR Eighty‐six patients for proteinuria, followed median 2·28 years, were compared with 68 2·24 years who not receiving such treatment. The log odds...
Antimicrobial resistance (AMR) is a global threat, including in sub-Saharan Africa. However, little known about the genetics of resistant bacteria region. In Malawi, there growing concern increasing rates antimicrobial to most empirically used antimicrobials. The highly drug Escherichia coli sequence type (ST) 131, which associated with extended spectrum β-lactamase blaCTX-M-15, has been prevalence globally. Previous data from isolates collected between 2006 and 2013 southern Malawi have...
Summary We evaluated the prevalence of rapid decline in kidney function, its potential risk factors and influence upon mortality sickle cell disease (SCD) a retrospective single‐center study. Rapid function was defined as estimated glomerular filtration rate (eGFR) loss >3·0 ml/min/1·73 m 2 per year. A multivariable logistic regression model for eGFR constructed after evaluating individual covariates. multivariate Cox‐regression models mortality. Among 331 SCD patients (median age 29...
Abstract The effect of SARS-CoV-2 infection on response to mRNA-based vaccines is not well-described. We assessed longitudinal SARS-CoV-2-specific antibody responses pre- and post-vaccination among individuals with without prior infection. the first vaccine dose was almost two-fold higher in who were seropositive before vaccination compared those seronegative, suggesting that primes immune vaccine.
In Uganda, children with febrile illness are often treated antibiotics even though most have self-limiting, likely viral, infections. C-reactive protein (CRP) measurement can help identify those who more to a bacterial infection and therefore need antibiotic treatment. Implementation of CRP rapid diagnostic test (RDT) at the point-of-care in resource-constrained settings minimal laboratory infrastructure could reduce unnecessary use. this study, we evaluated performance three...
Abstract Glomerular hyperfiltration is common in young sickle cell anemia patients and precedes development of overt kidney disease. In this multicenter pooled cohort, we characterized its decline to normal range adult patients. filtration rate (GFR) was estimated using the creatinine-based 2009 CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation omitting race adjustment 2021 equation. Using CKD-EPI–2009, 506 had baseline GFR (eGFR) ≥90 mL/min per 1.73 m2, median age 24...
Background Health care personnel (HCP) are at high risk for exposure to the SARS-CoV-2 virus. While personal protective equipment (PPE) may mitigate this risk, prospective data collection on its use and other factors seroconversion in population is needed. Objective The primary objectives of study (1) determine incidence of, for, infection among HCP a tertiary medical center (2) actively monitor PPE use, interactions between participants via electronic sensors, secondary cases households,...
Background In children in sub-Saharan Africa, severe anaemia (SA) is an important cause of mortality, and malaria a primary cause. The World Health Organization (WHO) recommends blood transfusion for all with haemoglobin (Hb) <4 g/dL those Hb 4–6 signs instability. evidence the effect on mortality SA without mixed.Aim To determine whether receipt was associated lower at WHO thresholds.Methods This retrospective cohort study 1761 (Hb ≤6 g/dL) admitted to Kamuzu Central Hospital Malawi. whose...