Tropical medicine & international health : TM & IH
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Trop. Med. Int. Health · Sep 2012
Procalcitonin and C-reactive protein as predictors of blood culture positivity among hospitalised children with severe pneumonia in Mozambique.
To evaluate the benefits of using procalcitonin (PCT) and C-reactive protein (CRP) as pre-screening tools to predict blood culture positivity among Mozambican children with clinical severe pneumonia (CSP). ⋯ Among hospitalised children with CSP and absence of concurrent malaria, PCT pre-screening could help reduce the number of blood cultures and diagnosis costs by specifically targeting patients more likely to yield positive results.
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Trop. Med. Int. Health · Sep 2012
Treatment outcomes for human African Trypanosomiasis in the Democratic Republic of the Congo: analysis of routine program data from the world's largest sleeping sickness control program.
To enable the human African trypanosomiasis (HAT) control program of the Democratic Republic of the Congo to generate data on treatment outcomes, an electronic database was developed. The database was piloted in two provinces, Bandundu and Kasai Oriental. In this study, we analysed routine data from the two provinces for the period 2006-2008. ⋯ High relapse rates in Kasai and poor compliance with post-treatment follow-up in both provinces are important problems that the HAT control program urgently needs to address. Moreover, in analogy to tuberculosis control programs, HAT control programs need to adopt a recording and reporting routine that includes reporting on treatment outcomes.
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Trop. Med. Int. Health · Aug 2012
Adult mortality and probable cause of death in rural northern Malawi in the era of HIV treatment.
Developing countries are undergoing demographic transition with a shift from high mortality caused by communicable diseases (CD) to lower mortality rates caused by non-communicable diseases (NCD). HIV/AIDS has disrupted this trend in sub-Saharan Africa. However, in recent years, HIV-associated mortality has been reduced with the introduction of widely available antiretroviral therapy (ART). Side effects of ART may lead to increased risk of cardiovascular diseases, raising the prospects of an accelerated transition towards NCD as the primary cause of death. We report population-based data to investigate changes in cause of death owing to NCD during the first 4 years after introduction of HIV treatment. ⋯ Our findings show that 4 years after the introduction of ART into HIV care in Karonga district, all-cause mortality has fallen dramatically, with no evidence of an increase in deaths owing to NCD.
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Trop. Med. Int. Health · Aug 2012
Randomized Controlled TrialDeterminants of low birthweight, small-for-gestational-age and preterm birth in Lombok, Indonesia: analyses of the birthweight cohort of the SUMMIT trial.
To examine the determinants of low birthweight (LBW), small-for-gestation (SGA) and preterm births in Lombok, Indonesia, an area of high infant mortality. ⋯ Women's education, maternal nutrition and household wealth and family planning are key factors to improving birth outcomes.
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Trop. Med. Int. Health · Aug 2012
Dengue in travellers: applicability of the 1975-1997 and the 2009 WHO classification system of dengue fever.
The aim of this study was to assess the applicability and benefits of the new WHO dengue fever guidelines in clinical practice, for returning travellers. ⋯ In our cohort of returned travellers, the new classification system did not differ in sensitivity and specificity from the old system to a clinically relevant degree. The guidelines did not improve identification of severe disease.