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  1. Article ; Online: Concentrations of respirable crystalline silica and radon among tanzanite mining communities in Mererani, Tanzania.

    Mbuya, Alexander W / Mboya, Innocent B / Semvua, Hadija H / Msuya, Sia E / Howlett, Patrick J / Mamuya, Simon H

    Annals of work exposures and health

    2023  Volume 68, Issue 1, Page(s) 48–57

    Abstract: Background: Globally, the number of small-scale miners (SSM) is estimated to be more than 25 million, but it supports the livelihoods of around 100 million individuals. In Tanzania, the number of SSM has increased from an estimated 150,000 in 1987 to ~1. ...

    Abstract Background: Globally, the number of small-scale miners (SSM) is estimated to be more than 25 million, but it supports the livelihoods of around 100 million individuals. In Tanzania, the number of SSM has increased from an estimated 150,000 in 1987 to ~1.5 million in 2017. The miners are at a high risk of occupational-related health challenges. The study aimed to assess the concentrations of respirable crystalline silica (RCS) and radon among the tanzanite mining communities in Simanjiro District, Tanzania.
    Methods: We carried out a cross-sectional study involving the Mererani mines in Tanzania. These are underground mines comprised of informally employed miners, i.e. SSM. Concentrations of RCS and radon gas were measured in 44 study units, i.e. 22 mining pits and within 22 houses in the general community, e.g. shops in the peri-mining community. A total of 132 respirable personal dust exposure samples (PDS), 3 from each of the study units were taken, but only 66 PDS from the mining pits were analysed, as this was the main interest of this study. Radon concentration was measured by continuous monitoring throughout the working shift (and overnight for residences) using AlphaGuard monitor. The medians and comparison to the reference values, OSHA USA PEL and WHO/IARC references, were done for RCS and radon, respectively, using SPSS Ver. 27.0.0).
    Results: The median time-weighted average (TWA) concentration of the RCS in the mining pits was 1.23 mg/m3. Of all 66 personal dust samples from the mining pits, 65 (98.5%) had concentrations of RCS above the Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) of 0.05 mg/m3. Mining pits had a median radon concentration of 169.50 bq/m3, which is above the World Health Organization (WHO)/International Commission on Radiation Protection (ICRP) recommended reference of 100.00 bq/m3 but not above the upper reference of 300.00 bq/m3, while the community buildings had a median radon concentration of 88.00 bq/m3. Overall, 9 (20.5%) and 17 (38.6%) radon measurements were above 300.00 bq/m3 and between 100.00 and 300.00 bq/m3 references, respectively. Specifically, in the mining pits, 9 (40.9%) test results were above 300.00 bq/m3, while none of the test results in the community was above 300.00 bq/m3.
    Conclusion: The tanzanite SSM in Mererani we highly exposed to RCS, which increases the risk of pulmonary diseases, including silicosis, tuberculosis, and pulmonary malignancies. Immediate action by OSHA Tanzania should be enforcement of wearing respirators by all miners throughout the working hours. Health education programmes to the SSM must be strengthened and OSHA Tanzania should adopt the 0.05 mg/m3 PEL, and enforce other occupational health and safety measures, including regular use of dust suppression mechanisms (water spray and wet drilling) and monitoring of RCS exposures among SSM. Monitoring of radon exposure both in the mining pits and community buildings should be conducted, and mitigation measures should be implemented in areas that exceed the reference level of 100.00 bq/m3.
    MeSH term(s) Humans ; Occupational Exposure/analysis ; Radon/analysis ; Tanzania ; Cross-Sectional Studies ; Silicon Dioxide/analysis ; Dust/analysis
    Chemical Substances Radon (Q74S4N8N1G) ; Silicon Dioxide (7631-86-9) ; Dust
    Language English
    Publishing date 2023-10-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2885096-8
    ISSN 2398-7316 ; 2398-7308
    ISSN (online) 2398-7316
    ISSN 2398-7308
    DOI 10.1093/annweh/wxad062
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Neurological disorders in Northern Tanzania: A 6-year prospective hospital-based case series.

    Howlett, William P / Urasa, Sarah J / Maro, Venance P / Walker, Richard W / Kilonzo, Kajiru G / Howlett, Patrick J / Dekker, Marieke Cj

    African health sciences

    2022  Volume 22, Issue 1, Page(s) 269–284

    Abstract: Background: The burden of neurological disorders is large and altered by the HIV epidemic.: Objectives: We describe the pattern of neurological disorders and their association with HIV infection in adult patients attending a consultant hospital in ... ...

    Abstract Background: The burden of neurological disorders is large and altered by the HIV epidemic.
    Objectives: We describe the pattern of neurological disorders and their association with HIV infection in adult patients attending a consultant hospital in Northern Tanzania.
    Methods: In this prospective cross-sectional study, we collected data on adult neurological referrals over a 6-year period between 2007-13. The odds of HIV infection, across neurological categories adjusted for age and sex, was calculated.
    Results: Of 2037 participants, 54.8% were male and 45.2% were female. The median age of participants was 43 years. The results for HIV screening were available for 992/2037 (48.7%) patients, of whom 306 (30.8%) were seropositive. The most frequent neurological disorders were cerebrovascular disease (19.9%), paraplegia (13.6%), and peripheral neuropathies (8%). Taken together CNS infection accounted for 278/2037 (13.6%). The adjusted odds (aOR) of HIV infection was highest amongst infections; brain abscesses (aOR 107, 95% CI 35.1-470.4) and meningitis/encephalitis (aOR 40.1, 95% CI 13.6-172.9), but also raised in cerebrovascular disease, paraplegia, peripheral neuropathies, cranial nerve palsies, seizures, cerebllar disorders, movement disorders, motor neuron disease and headache.
    Conclusion: The main pattern of neurological disorders in Northern Tanzania is presented. The odds of HIV infection was highest in CNS infections and in a wide range of non-communicable neurological disorders.
    MeSH term(s) Adult ; Cerebrovascular Disorders ; Cross-Sectional Studies ; Female ; HIV Infections ; Hospitals ; Humans ; Male ; Nervous System Diseases ; Paraplegia ; Peripheral Nervous System Diseases ; Prevalence ; Prospective Studies ; Tanzania
    Language English
    Publishing date 2022-08-27
    Publishing country Uganda
    Document type Journal Article
    ZDB-ID 2240308-5
    ISSN 1729-0503 ; 1680-6905
    ISSN (online) 1729-0503
    ISSN 1680-6905
    DOI 10.4314/ahs.v22i1.34
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Recent progress in understanding immune activation in the pathogenesis in HIV-tuberculosis co-infection.

    du Bruyn, Elsa / Peton, Nashied / Esmail, Hanif / Howlett, Patrick J / Coussens, Anna K / Wilkinson, Robert J

    Current opinion in HIV and AIDS

    2018  Volume 13, Issue 6, Page(s) 455–461

    Abstract: Purpose of review: Tuberculosis is the leading infectious cause of death worldwide, and HIV-1 the best recognized risk factor for active TB. This review focuses on immune complex formation; the interplay of type I and II interferon signaling; and T-cell ...

    Abstract Purpose of review: Tuberculosis is the leading infectious cause of death worldwide, and HIV-1 the best recognized risk factor for active TB. This review focuses on immune complex formation; the interplay of type I and II interferon signaling; and T-cell activation in HIV-TB pathogenesis.
    Recent findings: Circulating immune complexes and complement, and Fcγ signaling in whole blood act as early markers of TB disease in HIV-1-infected persons. HIV-1 is associated with a type I interferon response in whole blood, reducing the specificity of TB biomarkers dependent on type I and II interferon genes. Type I and type II interferons are implicated in both protection and TB disease, a protective outcome may depend on modulating these pathways. Whilst M. tuberculosis-specific CD4 T cells are preferentially depleted during HIV-1 infection, activation markers on M. tuberculosis-specific CD4 T cells, in particular HLA-DR, reflect immune activation and have promise as biomarkers of M. tuberculosis disease activity in individuals with HIV-1.
    Summary: TB pathogenesis in HIV-1 involves a complex interaction of underlying activation of both the innate and adaptive immune systems. Further research is required to understand whether biomarkers of activation could be used to predict or quantify TB disease in the context of HIV-1 infection.
    MeSH term(s) Animals ; CD4-Positive T-Lymphocytes/immunology ; Coinfection/immunology ; Coinfection/microbiology ; Coinfection/virology ; HIV Infections/immunology ; HIV Infections/virology ; HIV-1/physiology ; Humans ; Mycobacterium tuberculosis/physiology ; Tuberculosis/immunology ; Tuberculosis/microbiology
    Language English
    Publishing date 2018-10-03
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2502511-9
    ISSN 1746-6318 ; 1746-630X
    ISSN (online) 1746-6318
    ISSN 1746-630X
    DOI 10.1097/COH.0000000000000501
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Case Series of Severe Neurologic Sequelae of Ebola Virus Disease during Epidemic, Sierra Leone.

    Howlett, Patrick J / Walder, Anna R / Lisk, Durodami R / Fitzgerald, Felicity / Sevalie, Stephen / Lado, Marta / N'jai, Abdul / Brown, Colin S / Sahr, Foday / Sesay, Foday / Read, Jonathon M / Steptoe, Paul J / Beare, Nicholas A V / Dwivedi, Reena / Solbrig, Marylou / Deen, Gibrilla F / Solomon, Tom / Semple, Malcolm G / Scott, Janet T

    Emerging infectious diseases

    2018  Volume 24, Issue 8, Page(s) 1412–1421

    Abstract: We describe a case series of 35 Ebola virus disease (EVD) survivors during the epidemic in West Africa who had neurologic and accompanying psychiatric sequelae. Survivors meeting neurologic criteria were invited from a cohort of 361 EVD survivors to ... ...

    Abstract We describe a case series of 35 Ebola virus disease (EVD) survivors during the epidemic in West Africa who had neurologic and accompanying psychiatric sequelae. Survivors meeting neurologic criteria were invited from a cohort of 361 EVD survivors to attend a preliminary clinic. Those whose severe neurologic features were documented in the preliminary clinic were referred for specialist neurologic evaluation, ophthalmologic examination, and psychiatric assessment. Of 35 survivors with neurologic sequelae, 13 had migraine headache, 2 stroke, 2 peripheral sensory neuropathy, and 2 peripheral nerve lesions. Of brain computed tomography scans of 17 patients, 3 showed cerebral and/or cerebellar atrophy and 2 confirmed strokes. Sixteen patients required mental health followup; psychiatric disorders were diagnosed in 5. The 10 patients who experienced greatest disability had co-existing physical and mental health conditions. EVD survivors may have ongoing central and peripheral nervous system disorders, including previously unrecognized migraine headaches and stroke.
    MeSH term(s) Adult ; Cohort Studies ; Epidemics ; Female ; Hemorrhagic Fever, Ebola/complications ; Hemorrhagic Fever, Ebola/epidemiology ; Humans ; Male ; Migraine Disorders/etiology ; Peripheral Nervous System Diseases/etiology ; Sierra Leone/epidemiology ; Stroke/etiology ; Young Adult
    Language English
    Publishing date 2018-07-16
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 1380686-5
    ISSN 1080-6059 ; 1080-6040
    ISSN (online) 1080-6059
    ISSN 1080-6040
    DOI 10.3201/eid2408.171367
    Database MEDical Literature Analysis and Retrieval System OnLINE

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