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  1. Article ; Online: Seasonal influence of tuberculosis diagnosis in Rwanda

    Doris Uwamahoro / Aly Beeman / Vinay K. Sharma / Michael B. Henry / Stephanie Chow Garbern / Joseph Becker / Fairuz Despujos Harfouche / Alexis Perez Rogers / Kayla Kendric / Mindi Guptill

    Tropical Medicine and Health, Vol 49, Iss 1, Pp 1-

    2021  Volume 7

    Abstract: Abstract Background Tuberculosis (TB) remains a major global health concern. Previous research reveals that TB may have a seasonal peak during the spring and summer seasons in temperate climates; however, few studies have been conducted in tropical ... ...

    Abstract Abstract Background Tuberculosis (TB) remains a major global health concern. Previous research reveals that TB may have a seasonal peak during the spring and summer seasons in temperate climates; however, few studies have been conducted in tropical climates. This study evaluates the influence of seasonality on laboratory-confirmed TB diagnosis in Rwanda, a tropical country with two rainy and two dry seasons. Methods A retrospective chart review was performed at the University Teaching Hospital-Kigali (CHUK). From January 2016 to December 2017, 2717 CHUK patients with TB laboratory data were included. Data abstracted included patient demographics, season, HIV status, and TB laboratory results (microscopy, GeneXpert, culture). Univariate and multivariable logistic regression (adjusted for age, gender, and HIV status) analyses were performed to assess the association between season and laboratory-confirmed TB diagnoses. Results Patients presenting during rainy season periods had a lower odds of laboratory-confirmed TB diagnosis compared to the dry season (aOR=0.78, 95% CI 0.63–0.97, p=0.026) when controlling for age group, gender, and HIV status. Males, adults, and people living with HIV were more likely to have laboratory-confirmed TB diagnosis. On average, more people were tested for TB during the rainy season per month compared to the dry season (120.3 vs. 103.3), although this difference was not statistically significant. Conclusion In Rwanda, laboratory-confirmed TB case detection shows a seasonal variation with patients having higher odds of TB diagnosis occurring in the dry season. Further research is required to further elucidate this relationship and to delineate the mechanism of season influence on TB diagnosis.
    Keywords Tuberculosis ; Rwanda ; Seasonal influence ; Seasonality ; Arctic medicine. Tropical medicine ; RC955-962
    Subject code 610
    Language English
    Publishing date 2021-05-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Perceptions toward Ebola vaccination and correlates of vaccine uptake among high-risk community members in North Kivu, Democratic Republic of the Congo

    Shiromi M. Perera / Stephanie Chow Garbern / Eta Ngole Mbong / Monica K. Fleming / Rigobert Fraterne Muhayangabo / Arsene Baleke Ombeni / Shibani Kulkarni / Dieula Delissaint Tchoualeu / Ruth Kallay / Elizabeth Song / Jasmine Powell / Monique Gainey / Bailey Glenn / Ruffin Mitume Mutumwa / Stephane Hans Bateyi Mustafa / Giulia Earle-Richardson / Rena Fukunaga / Neetu Abad / Gnakub Norbert Soke /
    Dimitri Prybylski / David L. Fitter / Adam C. Levine / Reena H. Doshi

    PLOS Global Public Health, Vol 4, Iss

    2024  Volume 1

    Keywords Public aspects of medicine ; RA1-1270
    Language English
    Publishing date 2024-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: External validation of a mobile clinical decision support system for diarrhea etiology prediction in children

    Stephanie Chow Garbern / Eric J Nelson / Sabiha Nasrin / Adama Mamby Keita / Ben J Brintz / Monique Gainey / Henry Badji / Dilruba Nasrin / Joel Howard / Mami Taniuchi / James A Platts-Mills / Karen L Kotloff / Rashidul Haque / Adam C Levine / Samba O Sow / Nur Haque Alam / Daniel T Leung

    eLife, Vol

    A multicenter study in Bangladesh and Mali

    2022  Volume 11

    Abstract: Background: Diarrheal illness is a leading cause of antibiotic use for children in low- and middle-income countries. Determination of diarrhea etiology at the point-of-care without reliance on laboratory testing has the potential to reduce inappropriate ... ...

    Abstract Background: Diarrheal illness is a leading cause of antibiotic use for children in low- and middle-income countries. Determination of diarrhea etiology at the point-of-care without reliance on laboratory testing has the potential to reduce inappropriate antibiotic use. Methods: This prospective observational study aimed to develop and externally validate the accuracy of a mobile software application (‘App’) for the prediction of viral-only etiology of acute diarrhea in children 0–59 months in Bangladesh and Mali. The App used a previously derived and internally validated model consisting of patient-specific (‘present patient’) clinical variables (age, blood in stool, vomiting, breastfeeding status, and mid-upper arm circumference) as well as location-specific viral diarrhea seasonality curves. The performance of additional models using the ‘present patient’ data combined with other external data sources including location-specific climate, data, recent patient data, and historical population-based prevalence were also evaluated in secondary analysis. Diarrhea etiology was determined with TaqMan Array Card using episode-specific attributable fraction (AFe) >0.5. Results: Of 302 children with acute diarrhea enrolled, 199 had etiologies above the AFe threshold. Viral-only pathogens were detected in 22% of patients in Mali and 63% in Bangladesh. Rotavirus was the most common pathogen detected (16% Mali; 60% Bangladesh). The present patient+ viral seasonality model had an AUC of 0.754 (0.665–0.843) for the sites combined, with calibration-in-the-large α = −0.393 (−0.455––0.331) and calibration slope β = 1.287 (1.207–1.367). By site, the present patient+ recent patient model performed best in Mali with an AUC of 0.783 (0.705–0.86); the present patient+ viral seasonality model performed best in Bangladesh with AUC 0.710 (0.595–0.825). Conclusions: The App accurately identified children with high likelihood of viral-only diarrhea etiology. Further studies to evaluate the App’s potential use in diagnostic and ...
    Keywords diarrhea ; global health ; antimicrobial resistance ; enteropathogens ; mobile health ; clinical decision support ; Medicine ; R ; Science ; Q ; Biology (General) ; QH301-705.5
    Subject code 360
    Language English
    Publishing date 2022-02-01T00:00:00Z
    Publisher eLife Sciences Publications Ltd
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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    Inter-library loan at ZB MED

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