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Article ; Online: Faecal carriage of extended-spectrum β-lactamase-producing Escherichia coli in a remote region of Niger.

Jacquier, Hervé / Assao, Bachir / Chau, Françoise / Guindo, Ousmane / Condamine, Bénédicte / Magnan, Mélanie / Bridier-Nahmias, Antoine / Sayingoza-Makombe, Nathan / Moumouni, Aissatou / Page, Anne-Laure / Langendorf, Céline / Coldiron, Matthew E / Denamur, Erick / de Lastours, Victoire

The Journal of infection

2023 Volume 87, Issue 3, Page(s) 199–209

Abstract: ... Escherichia coli (ESBL-E. coli) in developing countries is lacking. Here we describe the population structure and ... molecular characteristics of ESBL-E. coli faecal isolates in rural Southern Niger.: Methods: Stools ... A subset of 90 ESBL-E. coli containing stools (109 ESBL-E. coli isolates) were further analysed by WGS ...

Abstract	Objective: Whole genome sequencing (WGS) of extended-spectrum β-lactamase-producing Escherichia coli (ESBL-E. coli) in developing countries is lacking. Here we describe the population structure and molecular characteristics of ESBL-E. coli faecal isolates in rural Southern Niger. Methods: Stools of 383 healthy participants were collected among which 92.4% were ESBL-Enterobacterales carriers. A subset of 90 ESBL-E. coli containing stools (109 ESBL-E. coli isolates) were further analysed by WGS, using short- and long-reads. Results: Most isolates belonged to the commensalism-adapted phylogroup A (83.5%), with high clonal diversity. The bla Conclusions: Massive prevalence of community faecal carriage of CTX-M-15-producing E. coli was observed in a rural region of Niger due to the spread of highly diverse A phylogroup commensalism-adapted clones, with frequent chromosomal integration of bla
MeSH term(s)	Humans ; Escherichia coli/genetics ; Escherichia coli Infections/epidemiology ; Niger/epidemiology ; Anti-Bacterial Agents ; beta-Lactamases/genetics ; Plasmids/genetics
Chemical Substances	Anti-Bacterial Agents ; beta-Lactamases (EC 3.5.2.6)
Language	English
Publishing date	2023-06-25
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	424417-5
ISSN	1532-2742 ; 0163-4453
ISSN (online)	1532-2742
ISSN	0163-4453
DOI	10.1016/j.jinf.2023.06.015
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Article: Authors' response to "Evaluation of Treatments for HIV-Associated Kaposi Sarcoma in Africa".

Coldiron, Matthew E / Gutierrez Zamudio, Ana Gabriela / Manuel, Rolanda / Ciglenecki, Iza / Trellu, Laurence Toutous / Molfino, Lucas

Infectious agents and cancer

2021 Volume 16, Issue 1, Page(s) 27

Language	English
Publishing date	2021-05-05
Publishing country	England
Document type	Letter
ISSN	1750-9378
ISSN	1750-9378
DOI	10.1186/s13027-021-00372-5
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Article ; Online: Analysis of a meningococcal meningitis outbreak in Niger - potential effectiveness of reactive prophylaxis.

Hitchings, Matt D T / Coldiron, Matthew E / Grais, Rebecca F / Lipsitch, Marc

PLoS neglected tropical diseases

2019 Volume 13, Issue 3, Page(s) e0007077

Abstract: Background: Seasonal epidemics of bacterial meningitis in the African Meningitis Belt carry a high burden of disease and mortality. Reactive mass vaccination is used as a control measure during epidemics, but the time taken to gain immunity from the ... ...

Abstract	Background: Seasonal epidemics of bacterial meningitis in the African Meningitis Belt carry a high burden of disease and mortality. Reactive mass vaccination is used as a control measure during epidemics, but the time taken to gain immunity from the vaccine reduces the flexibility and effectiveness of these campaigns. Targeted reactive antibiotic prophylaxis could be used to supplement reactive mass vaccination and further reduce the incidence of meningitis, and the potential effectiveness and efficiency of these strategies should be explored. Methods and findings: Data from an outbreak of meningococcal meningitis in Niger, caused primarily by Neisseria meningitidis serogroup C, is used to estimate clustering of meningitis cases at the household and village level. In addition, reactive antibiotic prophylaxis and reactive vaccination strategies are simulated to estimate their potential effectiveness and efficiency, with a focus on the threshold and spatial unit used to declare an epidemic and initiate the intervention. There is village-level clustering of suspected meningitis cases after an epidemic has been declared in a health area. Risk of suspected meningitis among household contacts of a suspected meningitis case is no higher than among members of the same village. Village-wide antibiotic prophylaxis can target subsequent cases in villages: across of range of parameters pertaining to how the intervention is performed, up to 220/672 suspected cases during the season are potentially preventable. On the other hand, household prophylaxis targets very few cases. In general, the village-wide strategy is not very sensitive to the method used to declare an epidemic. Finally, village-wide antibiotic prophylaxis is potentially more efficient than mass vaccination of all individuals at the beginning of the season, and than the equivalent reactive vaccination strategy. Conclusions: Village-wide antibiotic prophylaxis should be considered and tested further as a response against outbreaks of meningococcal meningitis in the Meningitis Belt, as a supplement to reactive mass vaccination.
MeSH term(s)	Adolescent ; Adult ; Anti-Bacterial Agents/administration & dosage ; Chemoprevention/methods ; Child ; Child, Preschool ; Computer Simulation ; Disease Outbreaks ; Disease Transmission, Infectious/prevention & control ; Female ; Health Services Administration ; Humans ; Male ; Mass Drug Administration/methods ; Mass Vaccination/methods ; Meningitis, Meningococcal/epidemiology ; Meningitis, Meningococcal/microbiology ; Meningitis, Meningococcal/prevention & control ; Meningococcal Vaccines/administration & dosage ; Neisseria meningitidis, Serogroup C/isolation & purification ; Niger/epidemiology ; Rural Population ; Young Adult
Chemical Substances	Anti-Bacterial Agents ; Meningococcal Vaccines
Language	English
Publishing date	2019-03-11
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2429704-5
ISSN	1935-2735 ; 1935-2727
ISSN (online)	1935-2735
ISSN	1935-2727
DOI	10.1371/journal.pntd.0007077
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Article ; Online: Seasonal malaria chemoprevention: successes and missed opportunities.

Coldiron, Matthew E / Von Seidlein, Lorenz / Grais, Rebecca F

Malaria journal

2017 Volume 16, Issue 1, Page(s) 481

Abstract: Seasonal malaria chemoprevention (SMC) was recommended in 2012 for young children in the Sahel during the peak malaria transmission season. Children are given a single dose of sulfadoxine/pyrimethamine combined with a 3-day course of amodiaquine, once a ... ...

Abstract	Seasonal malaria chemoprevention (SMC) was recommended in 2012 for young children in the Sahel during the peak malaria transmission season. Children are given a single dose of sulfadoxine/pyrimethamine combined with a 3-day course of amodiaquine, once a month for up to 4 months. Roll-out and scale-up of SMC has been impressive, with 12 million children receiving the intervention in 2016. There is evidence of its overall benefit in routine implementation settings, and a meta-analysis of clinical trial data showed a 75% decrease in clinical malaria compared to placebo. SMC is not free of shortcomings. Its target zone includes many hard-to-reach areas, both because of poor infrastructure and because of political instability. Treatment adherence to a 3-day course of preventive treatment has not been fully documented, and could prove challenging. As SMC is scaled up, integration into a broader, community-based paradigm which includes other preventive and curative activities may prove beneficial, both for health systems and for recipients.
MeSH term(s)	Africa South of the Sahara ; Amodiaquine/therapeutic use ; Antimalarials/therapeutic use ; Chemoprevention/methods ; Child, Preschool ; Drug Combinations ; Humans ; Infant ; Malaria/prevention & control ; Pyrimethamine/therapeutic use ; Seasons ; Sulfadoxine/therapeutic use
Chemical Substances	Antimalarials ; Drug Combinations ; Amodiaquine (220236ED28) ; fanasil, pyrimethamine drug combination (37338-39-9) ; Sulfadoxine (88463U4SM5) ; Pyrimethamine (Z3614QOX8W)
Language	English
Publishing date	2017-11-28
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1475-2875
ISSN (online)	1475-2875
DOI	10.1186/s12936-017-2132-1
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Article ; Online: Corrigendum to: Pneumococcal Meningitis Outbreaks in Africa, 2000-2018: Systematic Literature Review and Meningitis Surveillance Database Analyses.

Franklin, Kat / Kwambana-Adams, Brenda / Lessa, Fernanda C / Soeters, Heidi M / Cooper, Laura / Coldiron, Matthew E / Mwenda, Jason M / Antonio, Martin / Nakamura, Tomoka / Novak, Ryan / Cohen, Adam L

The Journal of infectious diseases

2022 Volume 227, Issue 10, Page(s) 1220

Language	English
Publishing date	2022-02-04
Publishing country	United States
Document type	Published Erratum
ZDB-ID	3019-3
ISSN	1537-6613 ; 0022-1899
ISSN (online)	1537-6613
ISSN	0022-1899
DOI	10.1093/infdis/jiac002
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Article ; Online: Evaluation of HRP2 and pLDH-based rapid diagnostic tests for malaria and prevalence of pfhrp2/3 deletions in Aweil, South Sudan.

Lynch, Emily / Jensen, Tomas O / Assao, Bachir / Chihana, Menard / Turuho, Thadeous / Nyehangane, Dan / Manyok, John B / Pasquale, Harriet / Khim, Nimol / Witkowski, Benoit / Coldiron, Matthew E

Malaria journal

2022 Volume 21, Issue 1, Page(s) 261

Abstract: Background: Rapid diagnostic tests (RDT) for malaria are the primary tool for malaria diagnosis in sub-Saharan Africa but the utility of the most commonly used histidine-rich protein 2 (HRP2) antigen-based tests is limited in high transmission settings ... ...

Abstract	Background: Rapid diagnostic tests (RDT) for malaria are the primary tool for malaria diagnosis in sub-Saharan Africa but the utility of the most commonly used histidine-rich protein 2 (HRP2) antigen-based tests is limited in high transmission settings due to the long duration of positivity after successful malaria treatment. HRP2 tests are also threatened by the emergence of Plasmodium that do not carry pfhrp2 or pfhrp 3 genes. Plasmodium lactate dehydrogenase (pLDH)-based tests are promising alternatives, but less available. This study assessed the performances of HRP2 and pLDH(pan) tests under field conditions. Methods: The study performed a prospective facility-based diagnostic evaluation of two malaria RDTs in Aweil, South Sudan, during the high transmission season. Capillary blood by fingerprick was collected from 800 children under 15 years of age with fever and no signs of severity. SD Bioline HRP2 and CareStart pLDH(pan) RDTs were performed in parallel, thick and thin smears for microscopy were examined, and dried blood was used for PCR testing. Results: Using microscopy as the gold standard, the sensitivity of both tests was estimated at > 99%, but the specificity of each was lower: 55.0% for the pLDH test and 61.7% for the HRP2 test. When using PCR as the gold standard, the sensitivity of both tests was lower than the values assessed using microscopy (97.0% for pLDH and 96.5% for HRP2), but the specificity increased (65.1% for pLDH and 72.9% for HRP2). Performance was similar across different production lots, sex, and age. Specificity of both the pLDH and HRP2 tests was significantly lower in children who reported taking a therapeutic course of anti-malarials in the 2 months prior to enrollment. The prevalence of pfhrp2/3 deletions in the study population was 0.6%. Conclusions: The low specificity of the pLDH RDT in this setting confirms previous results and suggests a problem with this specific test. The prevalence of pfhrp2/3 deletions in the study area warrants continued monitoring and underscores the relevance of assessing deletion prevalence nationally. Improved malaria RDTs for high-transmission environments are needed.
MeSH term(s)	Child ; Diagnostic Tests, Routine ; Histidine ; Humans ; L-Lactate Dehydrogenase ; Malaria ; Plasmodium ; Prevalence ; Prospective Studies ; South Sudan
Chemical Substances	Histidine (4QD397987E) ; L-Lactate Dehydrogenase (EC 1.1.1.27)
Language	English
Publishing date	2022-09-09
Publishing country	England
Document type	Journal Article
ZDB-ID	2091229-8
ISSN	1475-2875 ; 1475-2875
ISSN (online)	1475-2875
ISSN	1475-2875
DOI	10.1186/s12936-022-04280-w
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Article ; Online: Outbreak of Pneumococcal Meningitis, Paoua Subprefecture, Central African Republic, 2016-2017.

Coldiron, Matthew E / Touré, Oumar / Frank, Thierry / Bouygues, Nathalie / Grais, Rebecca F

Emerging infectious diseases

2018 Volume 24, Issue 9, Page(s) 1720–1722

Abstract: We report a pneumococcal meningitis outbreak in the Central African Republic (251 suspected cases; 60 confirmed by latex agglutination test) in 2016-2017. Case-fatality rates (10% for confirmed case-patients) were low. In areas where a recent ... ...

Abstract	We report a pneumococcal meningitis outbreak in the Central African Republic (251 suspected cases; 60 confirmed by latex agglutination test) in 2016-2017. Case-fatality rates (10% for confirmed case-patients) were low. In areas where a recent pneumococcal conjugate vaccine campaign was conducted, a smaller proportion of cases was seen in youngest children.
MeSH term(s)	Adolescent ; Adult ; Central African Republic/epidemiology ; Child ; Child, Preschool ; Disease Outbreaks/prevention & control ; Female ; Humans ; Incidence ; Infant ; Male ; Meningitis, Pneumococcal/epidemiology ; Meningitis, Pneumococcal/mortality ; Meningitis, Pneumococcal/prevention & control ; Middle Aged ; Pneumococcal Vaccines/administration & dosage ; Streptococcus pneumoniae/immunology ; Streptococcus pneumoniae/isolation & purification ; Vaccination ; Vaccines, Conjugate/administration & dosage ; Young Adult
Chemical Substances	Pneumococcal Vaccines ; Vaccines, Conjugate
Language	English
Publishing date	2018-08-20
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1380686-5
ISSN	1080-6059 ; 1080-6040
ISSN (online)	1080-6059
ISSN	1080-6040
DOI	10.3201/eid2409.171058
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Article ; Online: Analysis of a meningococcal meningitis outbreak in Niger - potential effectiveness of reactive prophylaxis.

Matt D T Hitchings / Matthew E Coldiron / Rebecca F Grais / Marc Lipsitch

PLoS Neglected Tropical Diseases, Vol 13, Iss 3, p e

2019 Volume 0007077

Abstract: Background Seasonal epidemics of bacterial meningitis in the African Meningitis Belt carry a high burden of disease and mortality. Reactive mass vaccination is used as a control measure during epidemics, but the time taken to gain immunity from the ... ...

Abstract	Background Seasonal epidemics of bacterial meningitis in the African Meningitis Belt carry a high burden of disease and mortality. Reactive mass vaccination is used as a control measure during epidemics, but the time taken to gain immunity from the vaccine reduces the flexibility and effectiveness of these campaigns. Targeted reactive antibiotic prophylaxis could be used to supplement reactive mass vaccination and further reduce the incidence of meningitis, and the potential effectiveness and efficiency of these strategies should be explored. Methods and findings Data from an outbreak of meningococcal meningitis in Niger, caused primarily by Neisseria meningitidis serogroup C, is used to estimate clustering of meningitis cases at the household and village level. In addition, reactive antibiotic prophylaxis and reactive vaccination strategies are simulated to estimate their potential effectiveness and efficiency, with a focus on the threshold and spatial unit used to declare an epidemic and initiate the intervention. There is village-level clustering of suspected meningitis cases after an epidemic has been declared in a health area. Risk of suspected meningitis among household contacts of a suspected meningitis case is no higher than among members of the same village. Village-wide antibiotic prophylaxis can target subsequent cases in villages: across of range of parameters pertaining to how the intervention is performed, up to 220/672 suspected cases during the season are potentially preventable. On the other hand, household prophylaxis targets very few cases. In general, the village-wide strategy is not very sensitive to the method used to declare an epidemic. Finally, village-wide antibiotic prophylaxis is potentially more efficient than mass vaccination of all individuals at the beginning of the season, and than the equivalent reactive vaccination strategy. Conclusions Village-wide antibiotic prophylaxis should be considered and tested further as a response against outbreaks of meningococcal meningitis in the ...
Keywords	Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Subject code	390
Language	English
Publishing date	2019-03-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Prevalence of malaria in an area receiving seasonal malaria chemoprevention in Niger.

Coldiron, Matthew E / Assao, Bachir / Guindo, Ousmane / Sayinzoga-Makombe, Nathan / Koscalova, Alena / Sterk, Esther / Quere, Michel / Ciglenecki, Iza / Mumina, Ann / Atti, Salifou / Langendorf, Céline / Grais, Rebecca F

Malaria journal

2021 Volume 20, Issue 1, Page(s) 419

Abstract: Background: Malaria transmission is highly seasonal in Niger. Despite the introduction of seasonal malaria chemoprevention (SMC) in the Magaria District, malaria incidence remains high, and the epidemiology of malaria in the community is not well- ... ...

Abstract	Background: Malaria transmission is highly seasonal in Niger. Despite the introduction of seasonal malaria chemoprevention (SMC) in the Magaria District, malaria incidence remains high, and the epidemiology of malaria in the community is not well-understood. Methods: Four cross-sectional, household-based malaria prevalence surveys were performed in the Magaria District of Niger between October 2016 and February 2018. Two occurred during the peak malaria season and two during the low malaria season. Individuals in each of three age strata (3-59 months, 5-9 years, and 10 years and above) were sampled in randomly-selected households. Capillary blood was collected by fingerprick, thick and thin blood films were examined. Microscopy was performed at Epicentre, Maradi, Niger, with external quality control. The target sample size was 396 households during the high-season surveys and 266 households during the low-season surveys. Results: Prevalence of parasitaemia was highest in children aged 5-9 years during all four surveys, ranging between 53.6% (95%CI 48.8-63.6) in February 2018 and 73.2% (66.2-79.2) in September 2017. Prevalence of parasitaemia among children aged 3-59 months ranged between 39.6% (33.2-46.4) in February 2018 and 51.9% (45.1-58.6) in October 2016. Parasite density was highest in children aged 3-59 months during all four surveys, and was higher in high season surveys than in low season surveys among all participants. The prevalence of gametocytaemia in children aged 3-59 months ranged between 9.9% (6.5-14.8) in February 2018 and 19.3% (14.6-25.2) in October 2016. The prevalence of gametocytaemia in children aged 5-9 years ranged between 6.3% (3.5-11.1) in February 2018 and 18.5% (12.7-26.1) in October 2016. Conclusions: Asymptomatic malaria infection is highly prevalent in this area, even during the season with low incidence of clinical malaria. The high prevalence of parasitaemia in children aged 5-9 years warrants considering their inclusion in SMC programmes in this context.
MeSH term(s)	Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Antimalarials/administration & dosage ; Chemoprevention/statistics & numerical data ; Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Humans ; Infant ; Malaria/epidemiology ; Malaria/prevention & control ; Male ; Middle Aged ; Niger/epidemiology ; Prevalence ; Seasons ; Young Adult
Chemical Substances	Antimalarials
Language	English
Publishing date	2021-10-24
Publishing country	England
Document type	Journal Article
ISSN	1475-2875
ISSN (online)	1475-2875
DOI	10.1186/s12936-021-03953-2
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Article: Outcomes of AIDS-associated Kaposi sarcoma in Mozambique after treatment with pegylated liposomal doxorubicin.

Coldiron, Matthew E / Gutierrez Zamudio, Ana Gabriela / Manuel, Rolanda / Luciano, Gilda / Rusch, Barbara / Ciglenecki, Iza / Telnov, Alex / Grais, Rebecca F / Trellu, Laurence Toutous / Molfino, Lucas

Infectious agents and cancer

2021 Volume 16, Issue 1, Page(s) 2

Abstract: Background: Kaposi's sarcoma (KS) is a common HIV-associated malignancy frequently associated with poor outcomes. It is the most frequently diagnosed cancer in major cities of Mozambique. Antiretroviral therapy is the cornerstone of KS treatment, but ... ...

Abstract	Background: Kaposi's sarcoma (KS) is a common HIV-associated malignancy frequently associated with poor outcomes. It is the most frequently diagnosed cancer in major cities of Mozambique. Antiretroviral therapy is the cornerstone of KS treatment, but many patients require cytotoxic chemotherapy. The traditional regimen in Mozambique includes conventional doxorubicin, bleomycin and vincristine, which is poorly tolerated. In 2016, pegylated liposomal doxorubicin was introduced at a specialized outpatient center in Maputo, Mozambique. Methods: We performed a prospective, single-arm, open-label observational study to demonstrate the feasibility, safety, and outcomes of treatment with pegylated liposomal doxorubicin (PLD) in patients with AIDS-associated Kaposi sarcoma (KS) in a low-resource setting. Chemotherapy-naïve adults with AIDS-associated KS (T1 or T0 not responding to 6 months of antiretroviral therapy) were eligible if they were willing to follow up for 2 years. Patients with Karnofsky scores < 50 or contraindications to PLD were excluded. One hundred eighty-three patients were screened and 116 participants were enrolled. Patients received PLD on three-week cycles until meeting clinical stopping criteria. Follow-up visits monitored HIV status, KS disease, side effects of chemotherapy, mental health (PHQ-9) and quality of life (SF-12). Primary outcome measures included vital status and disease status at 6, 12, and 24 months after enrollment. Results: At 24 months, 23 participants (20%) had died and 15 (13%) were lost to follow-up. Baseline CD4 < 100 was associated with death (HR 2.7, 95%CI [1.2-6.2], p = 0.016), as was T1S1 disease compared to T1S0 disease (HR 2.7, 95%CI [1.1-6.4], p = 0.023). Ninety-two participants achieved complete or partial remission at any point (overall response rate 80%), including 15 (13%) who achieved complete remission. PLD was well-tolerated, and the most common AEs were neutropenia and anemia. Quality of life improved rapidly after beginning PLD. Discussion: PLD was safe, well-tolerated and effective as first-line treatment of KS in Mozambique. High mortality was likely due to advanced immunosuppression at presentation, underscoring the importance of earlier screening and referral for KS.
Language	English
Publishing date	2021-01-07
Publishing country	England
Document type	Journal Article
ISSN	1750-9378
ISSN	1750-9378
DOI	10.1186/s13027-020-00341-4
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