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  1. Article ; Online: The urgent need to scale-up fungal diagnostics in Africa.

    Osaigbovo, Iriagbonse Iyabo / Rajasingham, Radha

    The Lancet. Infectious diseases

    2022  Volume 23, Issue 5, Page(s) 517–519

    MeSH term(s) Humans ; Africa/epidemiology ; Mycoses/diagnosis
    Language English
    Publishing date 2022-12-21
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 2061641-7
    ISSN 1474-4457 ; 1473-3099
    ISSN (online) 1474-4457
    ISSN 1473-3099
    DOI 10.1016/S1473-3099(22)00682-X
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  2. Article ; Online: Female Contributions to Infectious Diseases Society of America Guideline Publications.

    Rajasingham, Radha

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2018  Volume 68, Issue 5, Page(s) 893–894

    MeSH term(s) Female ; Humans ; Periodicals as Topic ; Physicians, Women ; Publications ; Societies, Scientific/standards
    Language English
    Publishing date 2018-09-07
    Publishing country United States
    Document type Letter ; Research Support, N.I.H., Extramural
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciy772
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  3. Article ; Online: Faecal microbiota transplantation for first and second episodes of Clostridioides difficile infection.

    Aby, Elizabeth S / Rajasingham, Radha / Enns, Eva A / Vaughn, Byron P

    The lancet. Gastroenterology & hepatology

    2023  Volume 8, Issue 2, Page(s) 110–111

    MeSH term(s) Humans ; Fecal Microbiota Transplantation ; Clostridium Infections/therapy ; Clostridioides difficile
    Language English
    Publishing date 2023-01-05
    Publishing country Netherlands
    Document type Letter ; Comment
    ISSN 2468-1253
    ISSN (online) 2468-1253
    DOI 10.1016/S2468-1253(22)00353-3
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  4. Article ; Online: Progress toward realizing the promise of decentralized clinical trials.

    McCarthy, Matthew W / Lindsell, Christopher J / Rajasingham, Radha / Stewart, Thomas G / Boulware, David R / Naggie, Susanna

    Journal of clinical and translational science

    2024  Volume 8, Issue 1, Page(s) e19

    Language English
    Publishing date 2024-01-14
    Publishing country England
    Document type Editorial
    ISSN 2059-8661
    ISSN (online) 2059-8661
    DOI 10.1017/cts.2023.706
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  5. Article ; Online: Cryptococcal Antigen Screening and Preemptive Treatment-How Can We Improve Survival?

    Rajasingham, Radha / Boulware, David R

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2019  Volume 70, Issue 8, Page(s) 1691–1694

    MeSH term(s) Antigens, Fungal ; Cryptococcus/immunology ; Fluconazole ; Humans
    Chemical Substances Antigens, Fungal ; Fluconazole (8VZV102JFY)
    Language English
    Publishing date 2019-06-08
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Comment
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciz488
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  6. Article ; Online: Reply to Author.

    Rajasingham, Radha / Enns, Eva A / Vaughn, Byron P

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2020  Volume 74, Issue 3, Page(s) 563

    Language English
    Publishing date 2020-04-10
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciaa740
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  7. Article ; Online: New US Food and Drug Administration Approvals Decrease Generic Flucytosine Costs.

    Rajasingham, Radha / Boulware, David R

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2019  Volume 69, Issue 4, Page(s) 732

    MeSH term(s) Drug Approval/economics ; Drugs, Generic/administration & dosage ; Drugs, Generic/economics ; Drugs, Generic/therapeutic use ; Flucytosine/administration & dosage ; Flucytosine/economics ; Flucytosine/therapeutic use ; Health Services Accessibility/economics ; Humans ; Meningitis, Cryptococcal/drug therapy ; United States ; United States Food and Drug Administration
    Chemical Substances Drugs, Generic ; Flucytosine (D83282DT06)
    Language English
    Publishing date 2019-02-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciz037
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  8. Article ; Online: Reply to Neves.

    Nicol, Melanie R / Boulware, David R / Rajasingham, Radha

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2020  Volume 73, Issue 7, Page(s) e1772–e1774

    Language English
    Publishing date 2020-11-30
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciaa1809
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Cost-effectiveness of Fecal Microbiota Transplantation for First Recurrent Clostridioides difficile Infection.

    Aby, Elizabeth S / Vaughn, Byron P / Enns, Eva A / Rajasingham, Radha

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2022  Volume 75, Issue 9, Page(s) 1602–1609

    Abstract: Background: Both the American College of Gastroenterology and the Infectious Diseases Society of America (IDSA)/Society for Healthcare Epidemiology of America 2021 Clostridioides difficile infection (CDI) guidelines recommend fecal microbiota ... ...

    Abstract Background: Both the American College of Gastroenterology and the Infectious Diseases Society of America (IDSA)/Society for Healthcare Epidemiology of America 2021 Clostridioides difficile infection (CDI) guidelines recommend fecal microbiota transplantation (FMT) for persons with multiple recurrent CDI. Emerging data suggest that FMT may have high cure rates when used for first recurrent CDI. The aim of this study was to assess the cost-effectiveness of FMT for first recurrent CDI.
    Methods: We developed a Markov model to simulate a cohort of patients presenting with initial CDI infection. The model estimated the costs, effectiveness, and cost-effectiveness of different CDI treatment regimens recommended in the 2021 IDSA guidelines, with the additional option of FMT for first recurrent CDI. The model includes stratification by the severity of initial infection, estimates of cure, recurrence, and mortality. Data sources were taken from IDSA guidelines and published literature on treatment outcomes. Outcome measures were quality-adjusted life-years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs).
    Results: When FMT is available for first recurrent CDI, the optimal cost-effective treatment strategy is fidaxomicin for initial nonsevere CDI, vancomycin for initial severe CDI, and FMT for first and subsequent recurrent CDI, with an ICER of $27 135/QALY. In probabilistic sensitivity analysis at a $100 000 cost-effectiveness threshold, FMT for first and subsequent CDI recurrence was cost-effective 90% of the time given parameter uncertainty.
    Conclusions: FMT is a cost-effective strategy for first recurrent CDI. Prospective evaluation of FMT for first recurrent CDI is warranted to determine the efficacy and risk of recurrence.
    MeSH term(s) Humans ; Fecal Microbiota Transplantation ; Cost-Benefit Analysis ; Clostridioides difficile ; Anti-Bacterial Agents/therapeutic use ; Clostridium Infections/drug therapy ; Treatment Outcome ; Recurrence
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2022-03-11
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciac207
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  10. Article ; Online: Advanced HIV disease: A review of diagnostic and prophylactic strategies.

    Lehman, Alice / Ellis, Jayne / Nalintya, Elizabeth / Bahr, Nathan C / Loyse, Angela / Rajasingham, Radha

    HIV medicine

    2023  Volume 24, Issue 8, Page(s) 859–876

    Abstract: Background: Despite expanded access to antiretroviral therapy (ART) and the rollout of the World Health Organization's (WHO) 'test-and-treat' strategy, the proportion of people with HIV (PWH) presenting with advanced HIV disease (AHD) remains unchanged ... ...

    Abstract Background: Despite expanded access to antiretroviral therapy (ART) and the rollout of the World Health Organization's (WHO) 'test-and-treat' strategy, the proportion of people with HIV (PWH) presenting with advanced HIV disease (AHD) remains unchanged at approximately 30%. Fifty percent of persons with AHD report prior engagement to care. ART failure and insufficient retention in HIV care are major causes of AHD. People living with AHD are at high risk for opportunistic infections and death. In 2017, the WHO published guidelines for the management of AHD that included a comprehensive package of care for screening and prophylaxis of major opportunistic infections (OIs). In the interim, ART regimens have evolved: integrase inhibitors are first-line therapy globally, and the diagnostic landscape is evolving. The objective of this review is to highlight novel point-of-care (POC) diagnostics and treatment strategies that can facilitate OI screening and prophylaxis for persons with AHD.
    Methods: We reviewed the WHO guidelines for recommendations for persons with AHD. We summarized the scientific literature on current and emerging diagnostics, along with emerging treatment strategies for persons with AHD. We also highlight the key research and implementation gaps together with potential solutions.
    Results: While POC CD4 testing is being rolled out in order to identify persons with AHD, this alone is insufficient; implementation of the Visitect CD4 platform has been challenging given operational and test interpretation issues. Numerous non-sputum POC TB diagnostics are being evaluated, many with limited sensitivity. Though imperfect, these tests are designed to provide rapid results (within hours) and are relatively affordable for resource-poor settings. While novel POC diagnostics are being developed for cryptococcal infection, histoplasmosis and talaromycosis, implementation science studies are urgently needed to understand the clinical benefit of these tests in the routine care.
    Conclusions: Despite progress with HIV treatment and prevention, a persistent 20%-30% of PWH present to care with AHD. Unfortunately, these persons with AHD continue to carry the burden of HIV-related morbidity and mortality. Investment in the development of additional POC or near-bedside CD4 platforms is urgently needed. Implementation of POC diagnostics theoretically could improve HIV retention in care and thereby reduce mortality by overcoming delays in laboratory testing and providing patients and healthcare workers with timely same-day results. However, in real-world scenarios, people with AHD have multiple comorbidities and imperfect follow-up. Pragmatic clinical trials are needed to understand whether these POC diagnostics can facilitate timely diagnosis and treatment, thereby improving clinical outcomes such as HIV retention in care.
    MeSH term(s) Humans ; HIV Infections/diagnosis ; HIV Infections/drug therapy ; Point-of-Care Testing ; Health Services Accessibility ; Anti-Retroviral Agents/therapeutic use ; Opportunistic Infections/drug therapy
    Chemical Substances Anti-Retroviral Agents
    Language English
    Publishing date 2023-04-11
    Publishing country England
    Document type Journal Article ; Review ; Research Support, N.I.H., Extramural
    ZDB-ID 2001932-4
    ISSN 1468-1293 ; 1464-2662
    ISSN (online) 1468-1293
    ISSN 1464-2662
    DOI 10.1111/hiv.13487
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