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Pediatric malaria

Vanessa A Thomas, Heather L Crouse, Kristy O Murray, Deborah C Hsu, Elizabeth A Camp, Andrea T Cruz
OBJECTIVE: The aim of this study was to perform a needs assessment of pediatric (PEM) and general emergency medicine (EM) provider knowledge, comfort, and current practice patterns in the evaluation of pediatric tropical infectious diseases. METHODS: An online survey was developed based on educational priorities identified by an expert panel via modified Delphi methodology. The survey included assessment of providers' typical evaluation, diagnosis, and treatment of tropical diseases and was distributed to PEM and EM providers in 2 large professional organizations...
March 12, 2018: Pediatric Emergency Care
Taty Tshimangani, Jean Pongo, Joseph Bodi Mabiala, Marcel Yotebieng, Nicole F O'Brien
Empirical knowledge suggests that acute neurologic disorders are common in sub-Saharan Africa, but studies examining the true burden of these diseases in children are scarce. We performed this prospective, observational study to evaluate the prevalence, clinical characteristics, treatment approaches, and outcomes of children suffering acute neurologic illness or injury (ANI) in an urban and rural site in the Democratic Republic of the Congo. Over 12 months, 471 out of 6,563 children admitted met diagnostic criteria for ANI, giving a hospital-based prevalence of 72/1,000 admissions...
March 5, 2018: American Journal of Tropical Medicine and Hygiene
Elizabeth Fitzgerald, Rachel Mlotha-Mitole, Emily J Ciccone, Alyssa E Tilly, Jennie M Montijo, Hans-Joerg Lang, Michelle Eckerle
BACKGROUND: 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 the foundation of quality improvement initiatives. Malawi, located in sub-Saharan Africa, currently has an Under-5 mortality rate of 64/1000. Kamuzu Central Hospital, in the capital city Lilongwe, is a busy government referral hospital, which admits up to 3000 children per month. A study published in 2013 reported mortality rates as high as 9%...
February 21, 2018: BMC Pediatrics
Katherine Finn, Jody Lori, Maurgan Lee, Bruno Giordani
PURPOSE: Severe malaria (SM) is the leading cause of pediatric cognitive impairment in sub-Saharan Africa. Computerized Cognitive Rehabilitation Therapy (CCRT), a promising intervention for children suffering from SM related cognitive delay, targets areas impacted by the disease (memory, attention, and executive function), but has yet to be implemented for daily use. This paper explores the perspectives of Ugandan professionals regarding CCRT implementation in the academic setting of Uganda...
February 2018: Applied Nursing Research: ANR
Benedikt Hogan, Daniel Eibach, Ralf Krumkamp, Nimako Sarpong, Denise Dekker, Benno Kreuels, Oumou Maiga-Ascofaré, Kennedy Gyau Boahen, Charity Wiafe Akenten, Yaw Adu-Sarkodie, Ellis Owusu-Dabo, Jürgen May
Background: The epidemiology of pediatric febrile illness is shifting in sub-Saharan Africa, but malaria remains a major cause of childhood morbidity and mortality. The present study describes causes of febrile illness in hospitalized children in Ghana and aims to determine the burden of malaria coinfections and their association with parasite densities. Methods: In a prospective study, children (aged ≥30 days and ≤15 years) with fever ≥38.0°C were recruited after admission to the pediatric ward of a primary hospital in Ghana...
February 2, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Teresa Bleakly Kortz, Alden Blair, Ellen Scarr, Andrew Masozi Mguntha, Gama Bandawe, Ellen Schell, Sally Rankin, Kimberly Baltzell
Objective. To characterize children with non-malarial fever at risk of nonrecovery or worsening in rural Malawi. Methods. This is a subgroup analysis of patients ≤14 years of age from a prospective cohort study in non-malarial fever subjects (temperature ≥37.5°C, or fever within 48 hours, and malaria negative) in southern Malawi cared for at a mobile clinic during the 2016 dry (August to September) or wet (November to December) season. Data collection included chart review and questionnaires; 14-day follow-up was conducted...
2018: Global Pediatric Health
Paul Bangirana, Andrea L Conroy, Robert O Opoka, Michael T Hawkes, Laura Hermann, Christopher Miller, Sophie Namasopo, W Conrad Liles, Chandy C John, Kevin C Kain
BACKGROUND: Severe malaria is a leading cause of acquired neurodisability in Africa and is associated with reduced nitric oxide (NO) bioavailability. A neuroprotective role for inhaled NO has been reported in animal studies, and administration of inhaled NO in preterm neonates with respiratory distress syndrome is associated with a 47% reduced risk of cognitive impairment at two years of age. METHODS: A randomized double-blind placebo-controlled trial of inhaled NO versus placebo as an adjunctive therapy for severe malaria was conducted in Uganda between 2011 and 2013...
2018: PloS One
Michael J Potchen, Samuel D Kampondeni, Karl B Seydel, E Mark Haacke, Sylvester S Sinyangwe, Musaku Mwenechanya, Simon J Glover, Danny A Milner, Eric Zeli, Colleen A Hammond, David Utriainen, Kennedy Lishimpi, Terrie E Taylor, Gretchen L Birbeck
The hallmark of pediatric cerebral malaria (CM) is sequestration of parasitized red blood cells in the cerebral microvasculature. Malawi-based research using 0.35 Tesla (T) magnetic resonance imaging (MRI) established that severe brain swelling is associated with fatal CM, but swelling etiology remains unclear. Autopsy and clinical studies suggest several potential etiologies, but limitations of 0.35 T MRI precluded optimal investigations into swelling pathophysiology. A 1.5 T MRI in Zambia allowed for further investigations including susceptibility-weighted imaging (SWI)...
January 8, 2018: American Journal of Tropical Medicine and Hygiene
E B Brickley, E Kabyemela, J D Kurtis, M Fried, A M Wood, P E Duffy
As a pilot study to investigate whether personalized medicine approaches could have value for the reduction of malaria-related mortality in young children, we evaluated questionnaire and biomarker data collected from the Mother Offspring Malaria Study Project birth cohort (Muheza, Tanzania, 2002-2006) at the time of delivery as potential prognostic markers for pediatric severe malarial anemia. Severe malarial anemia, defined here as a Plasmodium falciparum infection accompanied by hemoglobin levels below 50 g/L, is a key manifestation of life-threatening malaria in high transmission regions...
2017: Glob Health Epidemiol Genom
Ravell Juan, Isaac Otim, Hadijah Nabalende, Ismail D Legason, Steven J Reynolds, Martin D Ogwang, Christopher M Ndugwa, Vickie Marshall, Denise Whitby, James J Goedert, Eric A Engels, Kishor Bhatia, Michael J Lenardo, Sam M Mbulaiteye
BACKGROUND: Epstein-Barr virus (EBV) causes endemic Burkitt lymphoma (eBL). EBV control was improved by magnesium (Mg2+) supplementation in XMEN, an X-linked genetic disease associated with Mg2+ deficiency, high circulating EBV levels (viral loads), and EBV-related lymphomas. We, therefore, investigated the relationship between Mg2+ levels and EBV levels and eBL in Uganda. METHODS: Plasma Mg2+ was measured in 45 women with low or high circulating EBV levels, 40 pediatric eBL cases, and 79 healthy children...
December 14, 2017: Cancer Epidemiology
Victorine A Mensah, Sophie Roetynck, Ebrima K Kanteh, Georgina Bowyer, Amy Ndaw, Francis Oko, Carly M Bliss, Ya Jankey Jagne, Riccardo Cortese, Alfredo Nicosia, Rachel Roberts, Flavia D'Alessio, Odile Leroy, Babacar Faye, Beate Kampmann, Badara Cisse, Kalifa Bojang, Stephen Gerry, Nicola K Viebig, Alison M Lawrie, Ed Clarke, Egeruan B Imoukhuede, Katie J Ewer, Adrian V S Hill, Muhammed O Afolabi
Background: Heterologous prime-boost vaccination with chimpanzee adenovirus 63 (ChAd63) and modified vaccinia virus Ankara (MVA) encoding multiple epitope string thrombospondin-related adhesion protein (ME-TRAP) has shown acceptable safety and promising immunogenicity in African adult and pediatric populations. If licensed, this vaccine could be given to infants receiving routine childhood immunizations. We therefore evaluated responses to ChAd63 MVA ME-TRAP when co-administered with routine Expanded Program on Immunization (EPI) vaccines...
2017: Frontiers in Immunology
Marie Patrice Halle, Carine Tsou Lapsap, Esther Barla, Hermine Fouda, Hilaire Djantio, Beatrice Kaptue Moudze, Christophe Adjahoung Akazong, Eugene Belley Priso
BACKGROUND: Pediatric nephrology is challenging in developing countries and data on the burden of kidney disease in children is difficult to estimate due to absence of renal registries. We aimed to describe the epidemiology and outcomes of children with renal failure in Cameroon. METHODS: We retrospectively reviewed 103 medical records of children from 0 to 17 years with renal failure admitted in the Pediatric ward of the Douala General Hospital from 2004 to 2013...
December 6, 2017: BMC Pediatrics
Claire Leonie Ward, David Shaw, Evelyn Anane-Sarpong, Osman Sankoh, Marcel Tanner, Bernice Elger
This study explores ethical issues raised in providing medical care to participants and communities of low-resource settings involved in a Phase II/III pediatric malaria vaccine trial (PMVT). We conducted 52 key informant interviews with major stakeholders of an international multi-center PMVT (GSK/PATH-MVI RTS,S) (NCT00866619) in Ghana and Tanzania. Based on their stakeholder experiences, the responses fell into three main themes: (a) undue inducement, (b) community disparities, and (c) broad therapeutic misconceptions...
February 2018: Journal of Empirical Research on Human Research Ethics: JERHRE
Charlotte V Hobbs, Erin E Gabriel, Portia Kamthunzi, Gerald Tegha, Jean Tauzie, Yonghua Li, Tiina Ilmet, Elena Artimovich, Jillian Neal, Ted Hall, Sunil Parikh, Brian Kirmse, Patrick Jean-Philippe, Jingyang Chen, William R Prescott, Paul Palumbo, Patrick E Duffy, William Borkowsky, For The P S Study Team
Laboratory data and prior pediatric reports indicate that HIV protease inhibitor (PI)-based antiretroviral therapy (ARV) kills gametocytes and reduces rates of gametocytemia, but not asymptomatic parasitemia, in a high malaria-transmission area. To determine whether ARV regimen impacts these rates in areas with less-intense malaria transmission, we compared asymptomatic parasitemia and gametocytemia rates in HIV-infected children by ARV regimen in Lilongwe, Malawi, an area of low-to-moderate transmission intensity...
November 20, 2017: American Journal of Tropical Medicine and Hygiene
Anne Kessler, Selasi Dankwa, Maria Bernabeu, Visopo Harawa, Samuel A Danziger, Fergal Duffy, Sam D Kampondeni, Michael J Potchen, Nicholas Dambrauskas, Vladimir Vigdorovich, Brian G Oliver, Sarah E Hochman, Wenzhu B Mowrey, Ian J C MacCormick, Wilson L Mandala, Stephen J Rogerson, D Noah Sather, John D Aitchison, Terrie E Taylor, Karl B Seydel, Joseph D Smith, Kami Kim
Brain swelling is a major predictor of mortality in pediatric cerebral malaria (CM). However, the mechanisms leading to swelling remain poorly defined. Here, we combined neuroimaging, parasite transcript profiling, and laboratory blood profiles to develop machine-learning models of malarial retinopathy and brain swelling. We found that parasite var transcripts encoding endothelial protein C receptor (EPCR)-binding domains, in combination with high parasite biomass and low platelet levels, are strong indicators of CM cases with malarial retinopathy...
November 8, 2017: Cell Host & Microbe
(no author information available yet)
No abstract text is available yet for this article.
November 2017: Pediatrics
Offianan Andre Toure, Victor Mwapasa, Issaka Sagara, Oumar Gaye, Ricardo Thompson, Aishwarya V Maheshwar, Pitabas Mishra, Narendra Behra, Antoinette K Tshefu, Rashmi R Das, Anupkumar R Anvikar, Pradeep Sharma, Arjun Roy, Sanjay K Sharma, Amit Nasa, Rajinder K Jalali, Neena Valecha
Background: Administration of artemisinin-based combination therapy (ACT) to infant and young children can be challenging. A formulation with accurate dose and ease of administration will improve adherence and compliance in children. The fixed-dose combination dispersible tablet of arterolane maleate (AM) 37.5 mg and piperaquine phosphate (PQP) 187.5 mg can make dosing convenient in children. Methods: This multicenter (India and Africa), comparative, parallel-group trial enrolled 859 patients aged 6 months to 12 years with Plasmodium falciparum malaria...
October 30, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Katherine R Dobbs, Paula Embury, John Vulule, Peter S Odada, Bruce A Rosa, Makedonka Mitreva, James W Kazura, Arlene E Dent
BACKGROUND: Inflammation and monocytes are thought to be important to human malaria pathogenesis. However, the relationship of inflammation and various monocyte functions to acute malaria, recovery from acute malaria, and asymptomatic parasitemia in endemic populations is poorly understood. METHODS: We evaluated plasma cytokine levels, monocyte subsets, monocyte functional responses, and monocyte inflammatory transcriptional profiles of 1- to 10-year-old Kenyan children at the time of presentation with acute uncomplicated malaria and at recovery 6 weeks later; these results were compared with analogous data from asymptomatic children and adults in the same community...
September 21, 2017: JCI Insight
Gemma Moncunill, Stephen C De Rosa, Aintzane Ayestaran, Augusto J Nhabomba, Maximillian Mpina, Kristen W Cohen, Chenjerai Jairoce, Tobias Rutishauser, Joseph J Campo, Jaroslaw Harezlak, Héctor Sanz, Núria Díez-Padrisa, Nana Aba Williams, Daryl Morris, John J Aponte, Clarissa Valim, Claudia Daubenberger, Carlota Dobaño, M Juliana McElrath
Comprehensive assessment of cellular responses to the RTS,S/AS01E vaccine is needed to understand potential correlates and ultimately mechanisms of protection against malaria disease. Cellular responses recognizing the RTS,S/AS01E-containing circumsporozoite protein (CSP) and Hepatitis B surface antigen (HBsAg) were assessed before and 1 month after primary vaccination by intracellular cytokine staining and 16-color flow cytometry in 105 RTS,S/AS01-vaccinated and 74 rabies-vaccinated participants (controls) in a pediatric phase III trial in Africa...
2017: Frontiers in Immunology
Nicaise Tuikue Ndam, Azizath Moussiliou, Thomas Lavstsen, Claire Kamaliddin, Anja T R Jensen, Atikatou Mama, Rachida Tahar, Christian W Wang, Jakob S Jespersen, Jules M Alao, Benoit Gamain, Thor G Theander, Philippe Deloron
Background: Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) mediates the binding and accumulation of infected erythrocytes (IE) to blood vessels and tissues. Specific interactions have been described between PfEMP1 and human endothelial proteins CD36, intercellular adhesion molecule-1 (ICAM-1), and endothelial protein C receptor (EPCR); however, cytoadhesion patterns typical for pediatric malaria syndromes and the associated PfEMP1 members are still undefined. Methods: In a cohort of 94 hospitalized children with malaria, we characterized the binding properties of IE collected on admission, and var gene transcription using quantitative polymerase chain reaction...
June 15, 2017: Journal of Infectious Diseases
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