The American journal of tropical medicine and hygiene
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Am. J. Trop. Med. Hyg. · Feb 2005
Case ReportsAtypical clinical presentation of strongyloidiasis in a patient co-infected with human T cell lymphotrophic virus type I.
Alterations in the immunologic response induced by human T cell lymphotrophic virus type I (HTLV-I) predispose the development of disseminated strongyloidiasis. We report a case of an atypical clinical presentation of strongyloidiasis in a patient co-infected with HTLV-I causing scrotal and perineal pain and infertility. Strongyloides stercoralis was found in the analysis of the sperm and specific therapy for strongyloidiasis was associated with disappearance of the symptoms.
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Am. J. Trop. Med. Hyg. · Nov 2004
Comparative StudyShort report: evaluation of a simple and inexpensive photometric device for the measurement of hemoglobin.
We have evaluated the accuracy of a simple and inexpensive photometric device (DHT) for the estimation of the blood concentration of hemoglobin by comparison with an automated, high-resolution, flow cytometry-based hematology analyzer (CellDyn 3000) and a centrifugal quantitative buffy coat hematology system (QBC I). We have analyzed the hemoglobin values of 163 individual blood samples. Bland-Altman analysis showed that the methods agreed only poorly: mean differences were 1.0 g/dL with limits of agreement (LOA) of -1.2 g/dL to 3.2 g/dL for the comparison of DHT and CellDyn measurements, 0.5 g/dL with LOA of -2.0 g/dL to 3.0 g/dL for the comparison of DHT with QBC measurements, and 0.5 g/dL with LOA of -1.1 g/dL to 2.1 g/dL for the comparison of QBC with CellDyn measurements. We conclude that the poor agreement of the DHT with the CellDyn does not permit the use of the DHT for critical hemoglobin measurements, particularly in transfusion services.
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Am. J. Trop. Med. Hyg. · Nov 2004
Trigger events: enviroclimatic coupling of Ebola hemorrhagic fever outbreaks.
We use spatially continuous satellite data as a correlate of precipitation within tropical Africa and show that the majority of documented Ebola hemorrhagic fever outbreaks were closely associated with sharply drier conditions at the end of the rainy season. We propose that these trigger events may enhance transmission of Ebola virus from its cryptic reservoir to humans. These findings suggest specific directions to help understand the sylvatic cycle of the virus and may provide early warning tools to detect possible future outbreaks of this enigmatic disease.
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Am. J. Trop. Med. Hyg. · Aug 2004
ReviewConquering the intolerable burden of malaria: what's new, what's needed: a summary.
Each year, up to three million deaths due to malaria and close to five billion episodes of clinical illness possibly meriting antimalarial therapy occur throughout the world, with Africa having more than 90% of this burden. Almost 3% of disability adjusted life years are due to malaria mortality globally, 10% in Africa. New information is presented in this supplement on malaria-related perinatal mortality, occurrence of human immunodeficiency virus in pregnancy, undernutrition, and neurologic, cognitive, and developmental sequelae. ⋯ Evidence over the past century is that successful control malaria programs have been linked to strong research activities. To ensure effective coordination and cooperation between the growing number of research and control coalitions forming in support of malaria activities, an umbrella group is needed. With continued support for scientists and control workers globally, particularly in low-income malarious countries, the long-deferred dream of malaria elimination can become a reality.
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Am. J. Trop. Med. Hyg. · Aug 2004
ReviewThe contribution of malaria in pregnancy to perinatal mortality.
The link between malaria and perinatal mortality was explored by systematically reviewing 117 studies published between 1948 and 2002. The mean perinatal mortality rate was higher in malaria endemic countries (61.1/1,000, 95% confidence interval [CI] = 52.1-70.1) than in non-endemic countries (25.8/1,000, 95% CI = 21.1-30.6). Similarly, the fetal mortality rate was higher in endemic countries (40.1/1,000, 95% CI = 32.1-48.0) than in non-endemic countries (20.0/1,000, 95% CI = 13.2-26.8) countries. ⋯ Placental malaria was significantly associated with a higher risk for stillbirth, regardless of parity (odds ratio = 2.19, 95% CI = 1.49-3.22, P < 0.001). Despite the limitations involved in this kind of review, all information found indicates that in endemic countries, malaria is an important determinant of perinatal mortality. Preventive measures such as intermittent preventive treatment or insecticide-treated bed nets could substantially reduce perinatal mortality and fetal wastage.