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Hertz JT Munishi OM Ooi EE Howe S Lim WY Chow A Morrissey AB Bartlett JA Onyango JJ Maro VP Kinabo GD Saganda W Gubler DJ Crump JA 《The American journal of tropical medicine and hygiene》2012,86(1):171-177
Consecutive febrile admissions were enrolled at two hospitals in Moshi, Tanzania. Confirmed acute Chikungunya virus (CHIKV), Dengue virus (DENV), and flavivirus infection were defined as a positive polymerase chain reaction (PCR) result. Presumptive acute DENV infection was defined as a positive anti-DENV immunoglobulin M (IgM) enzyme-linked immunsorbent assay (ELISA) result, and prior flavivirus exposure was defined as a positive anti-DENV IgG ELISA result. Among 870 participants, PCR testing was performed on 700 (80.5%). Of these, 55 (7.9%) had confirmed acute CHIKV infection, whereas no participants had confirmed acute DENV or flavivirus infection. Anti-DENV IgM serologic testing was performed for 747 (85.9%) participants, and of these 71 (9.5%) had presumptive acute DENV infection. Anti-DENV IgG serologic testing was performed for 751 (86.3%) participants, and of these 80 (10.7%) had prior flavivirus exposure. CHIKV infection was more common among infants and children than adults and adolescents (odds ratio [OR] 1.9, P = 0.026) and among HIV-infected patients with severe immunosuppression (OR 10.5, P = 0.007). CHIKV infection is an important but unrecognized cause of febrile illness in northern Tanzania. DENV or other closely related flaviviruses are likely also circulating. 相似文献
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Andrew J. Bouley Holly M. Biggs Robyn A. Stoddard Anne B. Morrissey John A. Bartlett Isaac A. Afwamba Venance P. Maro Grace D. Kinabo Wilbrod Saganda Sarah Cleaveland John A. Crump 《The American journal of tropical medicine and hygiene》2012,87(6):1105-1111
Acute and convalescent serum samples were collected from febrile inpatients identified at two hospitals in Moshi, Tanzania. Confirmed brucellosis was defined as a positive blood culture or a ≥ 4-fold increase in microagglutination test titer, and probable brucellosis was defined as a single reciprocal titer ≥ 160. Among 870 participants enrolled in the study, 455 (52.3%) had paired sera available. Of these, 16 (3.5%) met criteria for confirmed brucellosis. Of 830 participants with ≥ 1 serum sample, 4 (0.5%) met criteria for probable brucellosis. Brucellosis was associated with increased median age (P = 0.024), leukopenia (odds ratio [OR] 7.8, P = 0.005), thrombocytopenia (OR 3.9, P = 0.018), and evidence of other zoonoses (OR 3.2, P = 0.026). Brucellosis was never diagnosed clinically, and although all participants with brucellosis received antibacterials or antimalarials in the hospital, no participant received standard brucellosis treatment. Brucellosis is an underdiagnosed and untreated cause of febrile disease among hospitalized adult and pediatric patients in northern Tanzania. 相似文献
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Wilbrod Bonin 《Canadian Medical Association journal》1958,78(7):510-511
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Biggs HM Bui DM Galloway RL Stoddard RA Shadomy SV Morrissey AB Bartlett JA Onyango JJ Maro VP Kinabo GD Saganda W Crump JA 《The American journal of tropical medicine and hygiene》2011,85(2):275-281
We enrolled consecutive febrile admissions to two hospitals in Moshi, Tanzania. Confirmed leptospirosis was defined as a ≥ 4-fold increase in microscopic agglutination test (MAT) titer; probable leptospirosis as reciprocal MAT titer ≥ 800; and exposure to pathogenic leptospires as titer ≥ 100. Among 870 patients enrolled in the study, 453 (52.1%) had paired sera available, and 40 (8.8%) of these met the definition for confirmed leptospirosis. Of 832 patients with ≥ 1 serum sample available, 30 (3.6%) had probable leptospirosis and an additional 277 (33.3%) had evidence of exposure to pathogenic leptospires. Among those with leptospirosis the most common clinical diagnoses were malaria in 31 (44.3%) and pneumonia in 18 (25.7%). Leptospirosis was associated with living in a rural area (odds ratio [OR] 3.4, P < 0.001). Among those with confirmed leptospirosis, the predominant reactive serogroups were Mini and Australis. Leptospirosis is a major yet underdiagnosed cause of febrile illness in northern Tanzania, where it appears to be endemic. 相似文献
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Wilbrod Bonin 《Canadian Medical Association journal》1962,86(14):650-651
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Lofgren SM Kirsch EJ Maro VP Morrissey AB Msuya LJ Kinabo GD Saganda W Diefenthal HC Ramadhani HO Wheat LJ Crump JA 《Transactions of the Royal Society of Tropical Medicine and Hygiene》2012,106(8):504-507
Histoplasmosis may be common in East Africa but the diagnosis is rarely confirmed. We report 9 (0.9%) cases of probable histoplasmosis retrospectively identified among 970 febrile inpatients studied in northern Tanzania. Median (range) age was 31 (6, 44) years, 6 (67%) were female, 6 (67%) HIV-infected; 7 (78%) were clinically diagnosed with tuberculosis or bacterial pneumonia. Histoplasmosis is an important cause of febrile illness in Tanzania but is rarely considered in the differential diagnosis. Increased clinician awareness and availability of reliable diagnostic tests may improve patient outcomes. 相似文献
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Michael J. Maze Mindy Glass Elrod Holly M. Biggs John Bonnewell Manuela Carugati Alex R. Hoffmaster Bingileki F. Lwezaula Deng B. Madut Venance P. Maro Blandina T. Mmbaga Anne B. Morrissey Wilbrod Saganda Philoteus Sakasaka Matthew P. Rubach John A. Crump 《The American journal of tropical medicine and hygiene》2020,103(6):2510