Journal Article > ResearchFull Text
Emerg Infect Dis. 2016 January 1; Volume 22 (Issue 1); DOI:10.3201/eid2201.151078
Schillberg EBL, Ariti C, Bryson LHM, Delva-Senat R, Price DJ, et al.
Emerg Infect Dis. 2016 January 1; Volume 22 (Issue 1); DOI:10.3201/eid2201.151078
We assessed risk factors for fetal death during cholera infection and effect of treatment changes on these deaths. Third trimester gestation, younger maternal age, severe dehydration, and vomiting were risk factors. Changes in treatment had limited effects on fetal death, highlighting the need for prevention and evidence-based treatment.
Journal Article > ResearchFull Text
Emerg Infect Dis. 2012 January 1; Volume 68 (Issue 1); DOI:10.1111/j.1365-2648.2011.05934.x
Sanchez-Padilla E, Dlamini T, Ascorra A, Rusch-Gerdes S, Tefera ZD, et al.
Emerg Infect Dis. 2012 January 1; Volume 68 (Issue 1); DOI:10.1111/j.1365-2648.2011.05934.x
In Africa, although emergence of multidrug-resistant (MDR) tuberculosis (TB) represents a serious threat in countries severely affected by the HIV epidemic, most countries lack drug-resistant TB data. This finding was particularly true in the Kingdom of Swaziland, which has the world's highest HIV and TB prevalences. Therefore, we conducted a national survey in 2009-2010 to measure prevalence of drug-resistant TB. Of 988 patients screened, 420 new case-patients and 420 previously treated case-patients met the study criteria. Among culture-positive patients, 15.3% new case-patients and 49.5% previously treated case-patients harbored drug-resistant strains. MDR TB prevalence was 7.7% and 33.8% among new case-patients and previously treated case-patients, respectively. HIV infection and past TB treatment were independently associated with MDR TB. The findings assert the need for wide-scale intervention in resource-limited contexts such as Swaziland, where diagnostic and treatment facilities and health personnel are lacking.
Journal Article > ResearchFull Text
Emerg Infect Dis. 2013 February 1; Volume 19 (Issue 2); DOI:10.3201/eid1902.120301
Minetti A, Kagoli M, Katsulukuta A, Huerga H, Featherstone A, et al.
Emerg Infect Dis. 2013 February 1; Volume 19 (Issue 2); DOI:10.3201/eid1902.120301
Despite high reported coverage for routine and supplementary immunization, in 2010 in Malawi, a large measles outbreak occurred that comprised 134,000 cases and 304 deaths. Although the highest attack rates were for young children (2.3%, 7.6%, and 4.5% for children <6, 6-8, and 9-11 months, respectively), persons >15 years of age were highly affected (1.0% and 0.4% for persons 15-19 and >19 years, respectively; 28% of all cases). A survey in 8 districts showed routine coverage of 95.0% for children 12-23 months; 57.9% for children 9-11 months; and 60.7% for children covered during the last supplementary immunization activities in 2008. Vaccine effectiveness was 83.9% for 1 dose and 90.5% for 2 doses. A continuous accumulation of susceptible persons during the past decade probably accounts for this outbreak. Countries en route to measles elimination, such as Malawi, should improve outbreak preparedness. Timeliness and the population chosen are crucial elements for reactive campaigns.
Journal Article > LetterFull Text
Emerg Infect Dis. 2023 February 1; Volume 29 (Issue 2); DOI:10.3201/eid2902.221495
Azman AS, Gignoux E, Nesbitt R, Rumunu J, Aggarwal R, et al.
Emerg Infect Dis. 2023 February 1; Volume 29 (Issue 2); DOI:10.3201/eid2902.221495
Journal Article > ResearchFull Text
Emerg Infect Dis. 2016 September 1; Volume 22 (Issue 9); DOI:10.3201/eid2209.160354
Nanclares C, Kapetshi J, Lionetto F, de la Rosa O, Muyembe Tamfun JJ, et al.
Emerg Infect Dis. 2016 September 1; Volume 22 (Issue 9); DOI:10.3201/eid2209.160354
During July-November 2014, the Democratic Republic of the Congo underwent its seventh Ebola virus disease (EVD) outbreak. The etiologic agent was Zaire Ebola virus; 66 cases were reported (overall case-fatality rate 74.2%). Through a retrospective observational study of confirmed EVD in 25 patients admitted to either of 2 Ebola treatment centers, we described clinical features and investigated correlates associated with death. Clinical features were mainly generic. At admission, 76% of patients had >1 gastrointestinal symptom and 28% >1 hemorrhagic symptom. The case-fatality rate in this group was 48% and was higher for female patients (67%). Cox regression analysis correlated death with initial low cycle threshold, indicating high viral load. Cycle threshold was a robust predictor of death, as were fever, hiccups, diarrhea, dyspnea, dehydration, disorientation, hematemesis, bloody feces during hospitalization, and anorexia in recent medical history. Differences from other outbreaks could suggest guidance for optimizing clinical management and disease control.
Journal Article > LetterFull Text
Emerg Infect Dis. 2008 April 1; Volume 14 (Issue 4); 681-683.; DOI:10.3201/eid1404.070833
Escribà JM, Nakoune E, Recio C, Massamba PM, Matsika-Claquin MD, et al.
Emerg Infect Dis. 2008 April 1; Volume 14 (Issue 4); 681-683.; DOI:10.3201/eid1404.070833
Journal Article > ResearchFull Text
Emerg Infect Dis. 2016 December 1; Volume 22 (Issue 12); 2120-2127.; DOI:10.3201/eid2212.161136
van Griensven J, Bah EI, Haba N, Delamou A, Camara BS, et al.
Emerg Infect Dis. 2016 December 1; Volume 22 (Issue 12); 2120-2127.; DOI:10.3201/eid2212.161136
By using data from a 2015 clinical trial on Ebola convalescent-phase plasma in Guinea, we assessed the prevalence of electrolyte and metabolic abnormalities at admission and their predictive value to stratify patients into risk groups. Patients underwent testing with a point-of-care device. We used logistic regression to construct a prognostic model and summarized the predictive value with the area under the receiver operating curve. Abnormalities were common among patients, particularly hypokalemia, hypocalcemia, hyponatremia, raised creatinine, high anion gap, and anemia. Besides age and PCR cycle threshold value, renal dysfunction, low calcium levels, and low hemoglobin levels were independently associated with increased risk for death. A prognostic model using all 5 factors was highly discriminatory (area under the receiver operating curve 0.95; 95% CI 0.90-0.99) and enabled the definition of risk criteria to guide targeted care. Most patients had a very low (<5%) or very high (>80%) risk for death.
Journal Article > Short ReportFull Text
Emerg Infect Dis. 2024 August 1; Volume 30 (Issue 8); 1677-1682.; DOI:10.3201/eid3008.231137
Ratnayake R, Knee J, Cumming O, Saidi JM, Rumedeka BB, et al.
Emerg Infect Dis. 2024 August 1; Volume 30 (Issue 8); 1677-1682.; DOI:10.3201/eid3008.231137
We evaluated the spatiotemporal clustering of rapid diagnostic test−positive cholera cases in Uvira, eastern Democratic Republic of the Congo. We detected spatiotemporal clusters that consistently overlapped with major rivers, and we outlined the extent of zones of increased risk that are compatible with the radii currently used for targeted interventions.
Journal Article > ResearchFull Text
Emerg Infect Dis. 2014 April 1; Volume 20 (Issue 4); DOI:10.3201/eid2004.131328
Page AL, Jusot V, Mamaty AA, Adamou L, Kaplon J, et al.
Emerg Infect Dis. 2014 April 1; Volume 20 (Issue 4); DOI:10.3201/eid2004.131328
Knowledge of rotavirus epidemiology is necessary to make informed decisions about vaccine introduction and to evaluate vaccine impact. During April 2010–March 2012, rotavirus surveillance was conducted among 9,745 children <5 years of age in 14 hospitals/health centers in Niger, where rotavirus vaccine has not been introduced. Study participants had acute watery diarrhea and moderate to severe dehydration, and 20% of the children were enrolled in a nutrition program. Of the 9,745 children, 30.6% were rotavirus positive. Genotyping of a subset of positive samples showed a variety of genotypes during the first year, although G2P[4] predominated. G12 genotypes, including G12P[8], which has emerged as a predominant strain in western Africa, represented >80% of isolates during the second year. Hospitalization and death rates and severe dehydration among rotavirus case-patients did not differ during the 2 years. The emergence of G12P[8] warrants close attention to the characteristics of associated epidemics and possible prevention measures.
Journal Article > ResearchFull Text
Emerg Infect Dis. 2015 March 1; Volume 21 (Issue 3); 393-399.; DOI:10.3201/eid2103.141892
Kucharski AJ, Camacho A, Checchi F, Waldman RJ, Grais RF, et al.
Emerg Infect Dis. 2015 March 1; Volume 21 (Issue 3); 393-399.; DOI:10.3201/eid2103.141892
In some parts of western Africa, Ebola treatment centers (ETCs) have reached capacity. Unless capacity is rapidly scaled up, the chance to avoid a generalized Ebola epidemic will soon diminish. The World Health Organization and partners are considering additional Ebola patient care options, including community care centers (CCCs), small, lightly staffed units that could be used to isolate patients outside the home and get them into care sooner than otherwise possible. Using a transmission model, we evaluated the benefits and risks of introducing CCCs into Sierra Leone's Western Area, where most ETCs are at capacity. We found that use of CCCs could lead to a decline in cases, even if virus transmission occurs between CCC patients and the community. However, to prevent CCC amplification of the epidemic, the risk of Ebola virus-negative persons being exposed to virus within CCCs would have to be offset by a reduction in community transmission resulting from CCC use.