- Lusaka Apex Medical School, Directorate of Research, and Post Graduate Studies. Plot No. 12681/M, Hill view Park, P.O. Box 31909, Lusaka, Zambia
- +260975214550
- Lusaka Apex Medical University, Medical Microbiology, Faculty MemberUniversity of Zambia, Pathology and Microbiology, Department Memberadd
- 2020 to Date: Professor of Medical Microbiology, and Director of Research and Post Graduate Studies at Lusaka Apex Me... more2020 to Date: Professor of Medical Microbiology, and Director of Research and Post Graduate Studies at Lusaka Apex Medical University
2016 -2020Head of Department of Medical Microbiology and Senior Lecturer•Dr. James Mwansa PhD in Medical Microbiology (Manchester UK 1986), a long-time consultant Medical microbiologist, •1986-1989 Head of Laboratory Services at Tropical Diseases Research Centre, Ndola, Zambia.•1995-2009 Dr. Mwansa was the Head of the Zambia Country’s National Referal and reference Microbiology Laboratory at the University Teaching Hospital, Lusaka and advisor to the Government of Zambia •1995-2009 consultant Medical Microbiologist at UTH in clinical diagnosis and management of opportunistic (HIV) infections and Chairman of Hospital Infection control committee. •Honorary lecturer, research supervisor and Examiner and External Examiner for undergraduate, and post graduate Biomedical Science and Medical students, Doctors and researcher within the School of Medicine and the University teaching hospital, Zambia 1991-to date. •Since 1995 Member of the National Epidemic Prevention and Control Committee- Zambia•2014 WHO consultant on enhancing NTD Laboratory support in the WHO African Region•Since 1987- Has been consultant to the Ministry of Heath Zambia with vast experience in investigation , identification, and emergency response of epidemic infectious diseases (Integrated Disease Surveillance and Response- IDSR) • Leading field teams in investigating outbreaks of Plague , Diarrhoeal disease ( cholera, typhoid, dysentery) , epidemic meningitis, and Anthrax in various parts of Zambia country .•Trainer of Trainers in Intergrated Diseases Surveillance and Response in Zambia•2009 trained consultant on International Health Regulations (IHR) core Capacity Country Assessment.•Has been a WHO Temporary advisor to assess Core capacities for IHR in Eritrea, Zimbabwe, Kenya,and Zambia•1989 to date worked on Neglected Tropical diseases and was Chairman instrumental in introducing the NTD control programme in Zambia in particular Mass drug administration (MDA) for Schistosomiasis and Soil transmitted helminths in conjunction with School Health and Nutrition Programme•Since 2010 Dr. Mwansa has been a WHO Temporal advisor for developing Neglected Tropical Disease (NTD) National Master Plans and Mapping of NTDs for Kenya, Malawi, Zimbabwe, and Zambia.•1996 to date working closely in collaboration with the School of Verterinary Medicine to define the epidemiology and biology of the epidemic infectious and zoonotic disease.• 2010-2014 Dr. Mwansa Co investigator for an International Multi-Centre Prospective Project in the School of Medicine, in conjunction with Boston’s University’s Centre for Infectious Diseases and International Health in Zambia (CIDHZ). The Pneumonia Etiology Research for Child Health (PERCH) Project is a rigorous International Multi-Centre Prospective Project case control study of hospitalized paediatric patients with severe lower respiratory illnesses to determine the etiology and risk factors associated with the syndrome. •2014 to date,Member of WHO (AFRO) Regional Programme Review Group for NTD(2020 to Date: Professor of Medical Microbiology, and Director of Research and Post Graduate Studies at Lusaka Apex Medical University<br />2016 -2020Head of Department of Medical Microbiology and Senior Lecturer•Dr. James Mwansa PhD in Medical Microbiology (Manchester UK 1986), a long-time consultant Medical microbiologist, •1986-1989 Head of Laboratory Services at Tropical Diseases Research Centre, Ndola, Zambia.•1995-2009 Dr. Mwansa was the Head of the Zambia Country’s National Referal and reference Microbiology Laboratory at the University Teaching Hospital, Lusaka and advisor to the Government of Zambia •1995-2009 consultant Medical Microbiologist at UTH in clinical diagnosis and management of opportunistic (HIV) infections and Chairman of Hospital Infection control committee. •Honorary lecturer, research supervisor and Examiner and External Examiner for undergraduate, and post graduate Biomedical Science and Medical students, Doctors and researcher within the School of Medicine and the University teaching hospital, Zambia 1991-to date. •Since 1995 Member of the National Epidemic Prevention and Control Committee- Zambia•2014 WHO consultant on enhancing NTD Laboratory support in the WHO African Region•Since 1987- Has been consultant to the Ministry of Heath Zambia with vast experience in investigation , identification, and emergency response of epidemic infectious diseases (Integrated Disease Surveillance and Response- IDSR) • Leading field teams in investigating outbreaks of Plague , Diarrhoeal disease ( cholera, typhoid, dysentery) , epidemic meningitis, and Anthrax in various parts of Zambia country .•Trainer of Trainers in Intergrated Diseases Surveillance and Response in Zambia•2009 trained consultant on International Health Regulations (IHR) core Capacity Country Assessment.•Has been a WHO Temporary advisor to assess Core capacities for IHR in Eritrea, Zimbabwe, Kenya,and Zambia•1989 to date worked on Neglected Tropical diseases and was Chairman instrumental in introducing the NTD control programme in Zambia in particular Mass drug administration (MDA) for Schistosomiasis and Soil transmitted helminths in conjunction with School Health and Nutrition Programme•Since 2010 Dr. Mwansa has been a WHO Temporal advisor for developing Neglected Tropical Disease (NTD) National Master Plans and Mapping of NTDs for Kenya, Malawi, Zimbabwe, and Zambia.•1996 to date working closely in collaboration with the School of Verterinary Medicine to define the epidemiology and biology of the epidemic infectious and zoonotic disease.• 2010-2014 Dr. Mwansa Co investigator for an International Multi-Centre Prospective Project in the School of Medicine, in conjunction with Boston’s University’s Centre for Infectious Diseases and International Health in Zambia (CIDHZ). The Pneumonia Etiology Research for Child Health (PERCH) Project is a rigorous International Multi-Centre Prospective Project case control study of hospitalized paediatric patients with severe lower respiratory illnesses to determine the etiology and risk factors associated with the syndrome. •2014 to date,Member of WHO (AFRO) Regional Programme Review Group for NTD)edit - Vice Chancellor, Lusaka Apex Medical Universityedit
Diagnosis for intestinal Schistosoma mansoni lacks sensitivity and is arduous to conduct. The standard diagnostic tests, Kato-Katz (KK) and circulating cathodic antigen (CCA) both lack sensitivity and with KK, require obtaining,... more
Diagnosis for intestinal Schistosoma mansoni lacks sensitivity and is arduous to conduct. The standard diagnostic tests, Kato-Katz (KK) and circulating cathodic antigen (CCA) both lack sensitivity and with KK, require obtaining, transporting, and examining fresh stool. We compared diagnostic efficacy of KK, CCA, and polymerase chain reaction (PCR) to detect S. mansoni infection (species-specific DNA) from 89 filtered urine samples collected in Zambia. The PCR was the strongest indicator of positive cases with sensitivity and specificity of 100% in comparison to CCA (67% and 60%) and KK (50% and 100%). High positive and negative predictive values (100%) were also indicative of robustness of PCR. The same pattern was observed when stratified for sex and age group-specific analysis. Diagnosis of S. mansoni from filtered urine samples by PCR is an effective means to detect low intensity infection and would enhance the effectiveness of surveillance and control programs of schistosomiasis
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Research Interests: Zambia, Medicine, Hospital Acquired infection, Molecular Epidemiology, Antimicrobial drug resistance, and 15 moreMolecular typing, Humans, Bacterial Toxins, Staphylococcus aureus, TYPING, Clinical Sciences, Optometry and Ophthalmology, Public health systems and services research, Food Sciences, Cross Sectional Studies, Pvl Leukocidine, Methicillin Resistant Staphylococcus Aureus, Biochemistry and cell biology, Referral, and Staphylococcal infections(Molecular typing, Humans, Bacterial Toxins, Staphylococcus aureus, TYPING, Clinical Sciences, Optometry and Ophthalmology, Public health systems and services research, Food Sciences, Cross Sectional Studies, Pvl Leukocidine, Methicillin Resistant Staphylococcus Aureus, Biochemistry and cell biology, Referral, and Staphylococcal infections)
(Molecular typing, Humans, Bacterial Toxins, Staphylococcus aureus, TYPING, Clinical Sciences, Optometry and Ophthalmology, Public health systems and services research, Food Sciences, Cross Sectional Studies, Pvl Leukocidine, Methicillin Resistant Staphylococcus Aureus, Biochemistry and cell biology, Referral, and Staphylococcal infections)
Research Interests: Microbiology, Immunology, Genomics, Medical Microbiology, Biology, and 15 moreInfectious Diseases, Medicine, Clinical Microbiology, Biological Sciences, Disease Outbreaks, Humans, Child, Haplotypes, Female, Male, Gene Order, Antibody, Microbial Sensitivity Tests, Child preschool, and Medical and Health Sciences
The Two Weeks in the World research project has resulted in a dataset of 3087 clinically relevant bacterial genomes with pertaining metadata, collected from 59 diagnostic units in 35 countries around the world during 2020. A relational... more
The Two Weeks in the World research project has resulted in a dataset of 3087 clinically relevant bacterial genomes with pertaining metadata, collected from 59 diagnostic units in 35 countries around the world during 2020. A relational database is available with metadata and summary data from selected bioinformatic analysis, such as species prediction and identification of acquired resistance genes.
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Background Primary, basic, secondary, and high school teachers are constantly faced with increased work stressors that can result in psychological health challenges such as burnout, anxiety, and depression, and in some cases, physical... more
Background Primary, basic, secondary, and high school teachers are constantly faced with increased work stressors that can result in psychological health challenges such as burnout, anxiety, and depression, and in some cases, physical health problems. It is presently unknown what the mental health literacy levels are or the prevalence and correlates of psychological issues among teachers in Zambia. It is also unknown if an email mental messaging program (Wellness4Teachers) would effectively reduce burnout and associated psychological problems and improve mental health literacy among teachers. Objective The primary objectives of this study are to determine if daily supportive email messages plus weekly mental health literacy information delivered via email can help improve mental health literacy and reduce the prevalence of moderate to high stress symptoms, burnout, moderate to high anxiety symptoms, moderate to high depression symptoms, and low resilience among school teachers in Za...
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Background Moraxella catarrhalis is one of the bacterial pathogens associated with childhood pneumonia, but its clinical importance is not clearly defined. Objective This study aimed to investigate the microbiologic and virulence... more
Background Moraxella catarrhalis is one of the bacterial pathogens associated with childhood pneumonia, but its clinical importance is not clearly defined. Objective This study aimed to investigate the microbiologic and virulence characteristics of M. catarrhalis isolates obtained from children with pneumonia in Lusaka, Zambia. Methods This retrospective, cross-sectional study analyzed 91 M. catarrhalis isolates from induced sputum samples of children less than 5 years of age with pneumonia enrolled in the Pneumonia Etiology Research for Child Health study in Lusaka, Zambia between 2011 and 2014. Bacteria identification and virulence genes detection were performed by PCR and DNA sequencing, while antimicrobial susceptibility testing was determined by the Kirby–Bauer method. Results All the M. catarrhalis isolates were obtained from good-quality sputum samples and were the predominant bacteria. These isolates harbored virulence genes copB (100%), ompE (69.2%), ompCD (71.4%), uspA1 (92.3%), and uspA2 (69.2%) and were all β-lactamase producers. They showed resistance to ampicillin (100%), amoxicillin (100%), trimethoprim-sulfamethoxazole (92.3%), ciprofloxacin (46.2%), chloramphenicol (45.1%), erythromycin (36.3%), tetracycline (25.3%), cefuroxime (11.0%), and amoxicillin-clavulanate (2.2%), with 71.4% displaying multi-drug resistant phenotype but all susceptible to imipenem (100%). Conclusion This study showed that M. catarrhalis isolates were the predominant or only bacterial isolates from the sputum samples analyzed. The findings provide supportive evidence for the pathogenic potential role of this bacterium in pediatric pneumonia. High multidrug resistance was also observed amongst the isolates, which can result in affected patients not responding to standard treatment, leading to prolonged illness, increased healthcare costs, and risk of death.
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Background Sepsis is a leading cause of neonatal mortality in low-resource settings. As facility-based births become more common, the proportion of neonatal deaths due to hospital-onset sepsis has increased. Methods We conducted a... more
Background Sepsis is a leading cause of neonatal mortality in low-resource settings. As facility-based births become more common, the proportion of neonatal deaths due to hospital-onset sepsis has increased. Methods We conducted a prospective cohort study in a neonatal intensive care unit in Zambia where we implemented a multifaceted infection prevention and control (IPC) bundle consisting of IPC training, text message reminders, alcohol hand rub, enhanced environmental cleaning, and weekly bathing of babies ≥1.5 kg with 2% chlorhexidine gluconate. Hospital-associated sepsis, bloodstream infection (BSI), and mortality (>3 days after admission) outcome data were collected for 6 months prior to and 11 months after bundle implementation. Results Most enrolled neonates had a birth weight ≥1.5 kg (2131/2669 [79.8%]). Hospital-associated mortality was lower during the intervention than baseline period (18.0% vs 23.6%, respectively). Total mortality was lower in the intervention than pr...
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Many pneumonia etiology case-control studies exclude controls with respiratory illness from enrollment or analyses. Herein we argue that selecting controls regardless of respiratory symptoms provides the least biased estimates of... more
Many pneumonia etiology case-control studies exclude controls with respiratory illness from enrollment or analyses. Herein we argue that selecting controls regardless of respiratory symptoms provides the least biased estimates of pneumonia etiology. We review 3 reasons investigators may choose to exclude controls with respiratory symptoms in light of epidemiologic principles of control selection and present data from the Pneumonia Etiology Research for Child Health (PERCH) study where relevant to assess their validity. We conclude that exclusion of controls with respiratory symptoms will result in biased estimates of etiology. Randomly selected community controls, with or without respiratory symptoms, as long as they do not meet the criteria for case-defining pneumonia, are most representative of the general population from which cases arose and the least subject to selection bias.
Research Interests: Research Design, Medicine, Biological Sciences, Humans, Child, and 13 moreRespiratory Disease, Female, Pneumonia, Male, Etiology, Risk factors, Respiratory System, Respiratory Tract Infections, Risk Factors, Selection Bias, Clinical Infectious Diseases, Multicenter Studies as Topic, and Medical and Health Sciences
Variable adherence to standardized case definitions, clinical procedures, specimen collection techniques, and laboratory methods has complicated the interpretation of previous multicenter pneumonia etiology studies. To circumvent these... more
Variable adherence to standardized case definitions, clinical procedures, specimen collection techniques, and laboratory methods has complicated the interpretation of previous multicenter pneumonia etiology studies. To circumvent these problems, a program of clinical standardization was embedded in the Pneumonia Etiology Research for Child Health (PERCH) study. Between March 2011 and August 2013, standardized training on the PERCH case definition, clinical procedures, and collection of laboratory specimens was delivered to 331 clinical staff at 9 study sites in 7 countries (The Gambia, Kenya, Mali, South Africa, Zambia, Thailand, and Bangladesh), through 32 on-site courses and a training website. Staff competency was assessed throughout 24 months of enrollment with multiple-choice question (MCQ) examinations, a video quiz, and checklist evaluations of practical skills. MCQ evaluation was confined to 158 clinical staff members who enrolled PERCH cases and controls, with scores obtain...
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Lack of a gold standard for identifying bacterial and viral etiologies of pneumonia has limited evaluation of C-reactive protein (CRP) for identifying bacterial pneumonia. We evaluated the sensitivity and specificity of CRP for... more
Lack of a gold standard for identifying bacterial and viral etiologies of pneumonia has limited evaluation of C-reactive protein (CRP) for identifying bacterial pneumonia. We evaluated the sensitivity and specificity of CRP for identifying bacterial vs respiratory syncytial virus (RSV) pneumonia in the Pneumonia Etiology Research for Child Health (PERCH) multicenter case-control study. We measured serum CRP levels in cases with World Health Organization-defined severe or very severe pneumonia and a subset of community controls. We evaluated the sensitivity and specificity of elevated CRP for "confirmed" bacterial pneumonia (positive blood culture or positive lung aspirate or pleural fluid culture or polymerase chain reaction [PCR]) compared to "RSV pneumonia" (nasopharyngeal/oropharyngeal or induced sputum PCR-positive without confirmed/suspected bacterial pneumonia). Receiver operating characteristic (ROC) curves were constructed to assess the performance of ele...
Research Interests: Biomarkers, Medicine, Biological Sciences, Humans, Female, and 15 morePneumonia, Male, Bacteria, Polymerase Chain Reaction, Infant, Newborn Infant, C reactive protein, Clinical Infectious Diseases, Respiratory Syncytial Virus Infections Industry, Case Control Studies, Child preschool, Bacterial Pneumonia, Nasopharynx, Medical and Health Sciences, and Oropharynx
Previous studies suggested an association between upper airway pneumococcal colonization density and pneumococcal pneumonia, but data in children are limited. Using data from the Pneumonia Etiology Research for Child Health (PERCH) study,... more
Previous studies suggested an association between upper airway pneumococcal colonization density and pneumococcal pneumonia, but data in children are limited. Using data from the Pneumonia Etiology Research for Child Health (PERCH) study, we assessed this potential association. PERCH is a case-control study in 7 countries: Bangladesh, The Gambia, Kenya, Mali, South Africa, Thailand, and Zambia. Cases were children aged 1-59 months hospitalized with World Health Organization-defined severe or very severe pneumonia. Controls were randomly selected from the community. Microbiologically confirmed pneumococcal pneumonia (MCPP) was confirmed by detection of pneumococcus in a relevant normally sterile body fluid. Colonization density was calculated with quantitative polymerase chain reaction analysis of nasopharyngeal/oropharyngeal specimens. Median colonization density among 56 cases with MCPP (MCPP cases; 17.28 × 106 copies/mL) exceeded that of cases without MCPP (non-MCPP cases; 0.75 × ...
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Induced sputum (IS) may provide diagnostic information about the etiology of pneumonia. The safety of this procedure across a heterogeneous population with severe pneumonia in low- and middle-income countries has not been described. IS... more
Induced sputum (IS) may provide diagnostic information about the etiology of pneumonia. The safety of this procedure across a heterogeneous population with severe pneumonia in low- and middle-income countries has not been described. IS specimens were obtained as part a 7-country study of the etiology of severe and very severe pneumonia in hospitalized children <5 years of age. Rigorous clinical monitoring was done before, during, and after the procedure to record oxygen requirement, oxygen saturation, respiratory rate, consciousness level, and other evidence of clinical deterioration. Criteria for IS contraindications were predefined and serious adverse events (SAEs) were reported to ethics committees and a central safety monitor. A total of 4653 IS procedures were done among 3802 children. Thirteen SAEs were reported in relation to collection of IS, or 0.34% of children with at least 1 IS specimen collected (95% confidence interval, 0.15%-0.53%). A drop in oxygen saturation that...
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Sputum examination can be useful in diagnosing the cause of pneumonia in adults but is less well established in children. We sought to assess the diagnostic utility of polymerase chain reaction (PCR) for detection of respiratory viruses... more
Sputum examination can be useful in diagnosing the cause of pneumonia in adults but is less well established in children. We sought to assess the diagnostic utility of polymerase chain reaction (PCR) for detection of respiratory viruses and bacteria in induced sputum (IS) specimens from children hospitalized with severe or very severe pneumonia. Among children aged 1-59 months, we compared organism detection by multiplex PCR in IS and nasopharyngeal/oropharyngeal (NP/OP) specimens. To assess whether organism presence or density in IS specimens was associated with chest radiographic evidence of pneumonia (radiographic pneumonia), we compared prevalence and density in IS specimens from children with radiographic pneumonia and children with suspected pneumonia but without chest radiographic changes or clinical or laboratory findings suggestive of pneumonia (nonpneumonia group). Among 4232 cases with World Health Organization-defined severe or very severe pneumonia, we identified 1935 (...
Research Interests: Child health, Medicine, Biological Sciences, Humans, Female, and 15 morePneumonia, Male, Bacteria, Infant, Etiology, Lung, Newborn Infant, Respiratory System, Molecular Diagnostic Techniques, Clinical Infectious Diseases, Child preschool, Health Resources, real time polymerase chain reaction, Nasopharynx, and Medical and Health Sciences
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It is standard practice for laboratories to assess the cellular quality of expectorated sputum specimens to check that they originated from the lower respiratory tract. The presence of low numbers of squamous epithelial cells (SECs) and... more
It is standard practice for laboratories to assess the cellular quality of expectorated sputum specimens to check that they originated from the lower respiratory tract. The presence of low numbers of squamous epithelial cells (SECs) and high numbers of polymorphonuclear (PMN) cells are regarded as indicative of a lower respiratory tract specimen. However, these quality ratings have never been evaluated for induced sputum specimens from children with suspected pneumonia. We evaluated induced sputum Gram stain smears and cultures from hospitalized children aged 1-59 months enrolled in a large study of community-acquired pneumonia. We hypothesized that a specimen representative of the lower respiratory tract will contain smaller quantities of oropharyngeal flora and be more likely to have a predominance of potential pathogens compared to a specimen containing mainly saliva. The prevalence of potential pathogens cultured from induced sputum specimens and quantity of oropharyngeal flora ...
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We investigated the performance of polymerase chain reaction (PCR) on blood in the diagnosis of pneumococcal pneumonia among children from 7 low- and middle-income countries. We tested blood by PCR for the pneumococcal autolysin gene in... more
We investigated the performance of polymerase chain reaction (PCR) on blood in the diagnosis of pneumococcal pneumonia among children from 7 low- and middle-income countries. We tested blood by PCR for the pneumococcal autolysin gene in children aged 1-59 months in the Pneumonia Etiology Research for Child Health (PERCH) study. Children had World Health Organization-defined severe or very severe pneumonia or were age-frequency-matched community controls. Additionally, we tested blood from general pediatric admissions in Kilifi, Kenya, a PERCH site. The proportion PCR-positive was compared among cases with microbiologically confirmed pneumococcal pneumonia (MCPP), cases without a confirmed bacterial infection (nonconfirmed), cases confirmed for nonpneumococcal bacteria, and controls. In PERCH, 7.3% (n = 291/3995) of cases and 5.5% (n = 273/4987) of controls were blood pneumococcal PCR-positive (P < .001), compared with 64.3% (n = 36/56) of MCPP cases and 6.3% (n = 243/3832) of non...
Research Interests: Epidemiology, Poverty, Biostatistics, Medicine, Streptococcus pneumoniae, and 13 moreBiological Sciences, Humans, Female, Pneumonia, Male, Polymerase Chain Reaction, Infant, Newborn Infant, Internationality, Sensitivity and Specificity, Clinical Infectious Diseases, Child preschool, and Medical and Health Sciences
Schistosomiasis is a blood parasitic disease caused by trematode parasites of the genus Schistosoma. Schistosoma mansoni is one of the main contributors of the disease and 90% of the global burden of schistosomiasis is in Africa. Mass... more
Schistosomiasis is a blood parasitic disease caused by trematode parasites of the genus Schistosoma. Schistosoma mansoni is one of the main contributors of the disease and 90% of the global burden of schistosomiasis is in Africa. Mass drug administration (MDA) has been implemented to reduce the disease burden in endemic areas. Because of MDA, the diagnostic sensitivity and specificity for classical diagnostic tests are reduced. In any disease situation, diagnosis is vital in determining asymptomatic, concurrent, current, new, and reinfection cases to evaluate the efficacy of any control program. We have evaluated the positive infection for S. mansoni from filtered urine samples collected from Zambian school children after MDA using loop-mediated isothermal amplification (LAMP) and compared its sensitivity and specificity with polymerase chain reaction (PCR). One hundred eleven urine samples collected from school children aged between 7 and 15 years from Siavonga district in southern...
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Klebsiella pneumoniae is one of the major causes of blood-stream infections in neonatal intensive care units. Treatment has been a challenge due to the development of multidrug resistant strains, which are mainly attributed to the ability... more
Klebsiella pneumoniae is one of the major causes of blood-stream infections in neonatal intensive care units. Treatment has been a challenge due to the development of multidrug resistant strains, which are mainly attributed to the ability of the organism to produce extended spectrum β-lactamases that confer resistance to second and third generation cephalosporins. This laboratory-based cross-sectional study was aimed at determining the extent of extended spectrum β-lactamase production among invasive K. pneumoniae isolates from blood culture specimens at the University Teaching Hospital in Lusaka. The production of the extended spectrum β-lactamases was detected using the combination disc method, and by detecting genes encoding extended spectrum β-lactamases using Polymerase Chain Reaction. The drug resistance profile was determined using the Kirby-Bauer disc diffusion method against tetracycline, chloramphenicol, amikacin, gentamicin, co-trimoxazole, ciprofloxacin, cefotaxime, ceft...
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Background Despite the availability of vaccines, invasive bacterial diseases remain a public health concern and cause childhood morbidity and mortality. We investigated the characteristics of etiological agents causing bacterial... more
Background Despite the availability of vaccines, invasive bacterial diseases remain a public health concern and cause childhood morbidity and mortality. We investigated the characteristics of etiological agents causing bacterial meningitis in children <5 years in the years pre- (2010–2012) and post- (2014–2019) 10-valent pneumococcal conjugate vaccine (PCV10) introduction in Zambia. Methods Streptococcus pneumoniae (Spn), Haemophilus influenzae (Hi), and Neisseria meningitidis (Nm) from cerebrospinal fluid (CSF) were identified by microbiological culture and/or real-time polymerase chain reaction. Results During the surveillance period, a total of 3811 children were admitted with suspected meningitis, 16% (598 of 3811) of which were probable cases. Bacterial meningitis was confirmed in 37% (221 of 598) of the probable cases. Spn pneumoniae, Hi, and Nm accounted for 67% (148 of 221), 14% (31 of 221), and 19% (42 of 221) of confirmed cases, respectively. Thirty-six percent of pneum...
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Diagnosis for intestinal Schistosoma mansoni lacks sensitivity and is arduous to conduct. The standard diagnostic tests, Kato-Katz (KK) and circulating cathodic antigen (CCA) both lack sensitivity and with KK, require obtaining,... more
Diagnosis for intestinal Schistosoma mansoni lacks sensitivity and is arduous to conduct. The standard diagnostic tests, Kato-Katz (KK) and circulating cathodic antigen (CCA) both lack sensitivity and with KK, require obtaining, transporting, and examining fresh stool. We compared diagnostic efficacy of KK, CCA, and polymerase chain reaction (PCR) to detect S. mansoni infection (species-specific DNA) from 89 filtered urine samples collected in Zambia. The PCR was the strongest indicator of positive cases with sensitivity and specificity of 100% in comparison to CCA (67% and 60%) and KK (50% and 100%). High positive and negative predictive values (100%) were also indicative of robustness of PCR. The same pattern was observed when stratified for sex and age group-specific analysis. Diagnosis of S. mansoni from filtered urine samples by PCR is an effective means to detect low intensity infection and would enhance the effectiveness of surveillance and control programs of schistosomiasis.
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Poultry meat is considered to be one of the major vehicles of Salmonella infections in humans en implicated in outbreaks of Salmonellosis in humans.
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Background An improved understanding of childhood pneumonia aetiology is required to inform prevention and treatment strategies. Lung aspiration is the gold standard specimen for pneumonia diagnostics. We report findings from analyses of... more
Background An improved understanding of childhood pneumonia aetiology is required to inform prevention and treatment strategies. Lung aspiration is the gold standard specimen for pneumonia diagnostics. We report findings from analyses of lung and pleural aspirates collected in the Pneumonia Etiology Research for Child Health (PERCH) study. Methods The PERCH study enrolled children aged 1–59 months hospitalized with World Health Organization defined severe or very severe pneumonia in 7 countries in Africa and Asia. Percutaneous trans-thoracic lung (LA) and pleural fluid (PF) aspiration was performed on a sample of pneumonia cases with radiological consolidation and/or pleural fluid in 4 countries. Venous blood and nasopharyngeal/oropharyngeal swabs were collected from all cases. Multiplex quantitative PCR and routine microbiologic culture were applied to clinical specimens. Results Of 44 LAs performed within 3 days of admission on 622 eligible cases, 13 (30%) had a pathogen identifie...
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Several studies have attributed the etiopathogenesis of chronic related hepatic fibrosis to unregulated immune responses against trapped parasite ova in the host. However, there is limited data on immune profiles associated with varying... more
Several studies have attributed the etiopathogenesis of chronic related hepatic fibrosis to unregulated immune responses against trapped parasite ova in the host. However, there is limited data on immune profiles associated with varying degrees of the disease in a population under chronic exposure to the parasite. We therefore investigated the role of selected T-helper (Th)1, Th2, and Th17 cytokines in relation to hepatic fibrosis severity among individuals resident in a hyper- endemic region of Western Zambia. Two hundred and forty-four infected individuals with and without fibrosis were analysed for cytokine profiles. Based on hepatic fibrosis stage as determined by ultrasound, participants were categorized into Group 0, Group I, Group II, and Group III. Cytokines were measured in egg stimulated whole blood culture supernatants using the BD Cytometric Bead Array kits. Compared to the nonfibrotic group, participants in the severe hepatic fibrotic group produced less interleukin- (I...
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Schistosomiasis is one of the major Neglected Tropical Diseases (NTDs) in sub-Saharan Africa. In sub-Saharan Africa, two major human schistosome species namely Schistosoma mansoni and S. haematobium often occur sympatrically largely... more
Schistosomiasis is one of the major Neglected Tropical Diseases (NTDs) in sub-Saharan Africa. In sub-Saharan Africa, two major human schistosome species namely Schistosoma mansoni and S. haematobium often occur sympatrically largely affecting children. Recognizing the public health impact of Schistosomiasis, the World Health Organization (WHO) is urging member states to regularly treat at least 75% and up to 100%, of all school-aged children at risk of morbidity. For control strategies based on targeted mass drug administration (MDA) to succeed it is essential to have a simple and sensitive test for monitoring the success of these interventions. Current available diagnostic tests, such as egg detection in stool by Kato-Katz (KK) for S. mansoni and detection of eggs or blood (hematuria) in urine for S. haematobium have reduced sensitivity in low intensity settings. The objective of the study was to evaluate active single or duo schistosome infections in school children following MDA ...
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The Pneumonia Etiology Research for Child Health study was conducted across 7 diverse research sites and relied on standardized clinical and laboratory methods for the accurate and meaningful interpretation of pneumonia etiology data.... more
The Pneumonia Etiology Research for Child Health study was conducted across 7 diverse research sites and relied on standardized clinical and laboratory methods for the accurate and meaningful interpretation of pneumonia etiology data. Blood, respiratory specimens, and urine were collected from children aged 1-59 months hospitalized with severe or very severe pneumonia and community controls of the same age without severe pneumonia and were tested with an extensive array of laboratory diagnostic tests. A standardized testing algorithm and standard operating procedures were applied across all study sites. Site laboratories received uniform training, equipment, and reagents for core testing methods. Standardization was further assured by routine teleconferences, in-person meetings, site monitoring visits, and internal and external quality assurance testing. Targeted confirmatory testing and testing by specialized assays were done at a central reference laboratory.
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We investigated the performance of polymerase chain reaction (PCR) on blood in the diagnosis of pneumococcal pneumonia among children from 7 low- and middle-income countries. We tested blood by PCR for the pneumococcal autolysin gene in... more
We investigated the performance of polymerase chain reaction (PCR) on blood in the diagnosis of pneumococcal pneumonia among children from 7 low- and middle-income countries. We tested blood by PCR for the pneumococcal autolysin gene in children aged 1-59 months in the Pneumonia Etiology Research for Child Health (PERCH) study. Children had World Health Organization-defined severe or very severe pneumonia or were age-frequency-matched community controls. Additionally, we tested blood from general pediatric admissions in Kilifi, Kenya, a PERCH site. The proportion PCR-positive was compared among cases with microbiologically confirmed pneumococcal pneumonia (MCPP), cases without a confirmed bacterial infection (nonconfirmed), cases confirmed for nonpneumococcal bacteria, and controls. In PERCH, 7.3% (n = 291/3995) of cases and 5.5% (n = 273/4987) of controls were blood pneumococcal PCR-positive (P < .001), compared with 64.3% (n = 36/56) of MCPP cases and 6.3% (n = 243/3832) of non...
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The etiologic inference of identifying a pathogen in the upper respiratory tract (URT) of children with pneumonia is unclear. To determine if viral load could provide evidence of causality of pneumonia, we compared viral load in the URT... more
The etiologic inference of identifying a pathogen in the upper respiratory tract (URT) of children with pneumonia is unclear. To determine if viral load could provide evidence of causality of pneumonia, we compared viral load in the URT of children with World Health Organization-defined severe and very severe pneumonia and age-matched community controls. In the 9 developing country sites, nasopharyngeal/oropharyngeal swabs from children with and without pneumonia were tested using quantitative real-time polymerase chain reaction for 17 viruses. The association of viral load with case status was evaluated using logistic regression. Receiver operating characteristic (ROC) curves were constructed to determine optimal discriminatory viral load cutoffs. Viral load density distributions were plotted. The mean viral load was higher in cases than controls for 7 viruses. However, there was substantial overlap in viral load distribution of cases and controls for all viruses. ROC curves to det...
Research Interests: Biological Sciences, Humans, Female, Male, Viruses, and 15 moreInfant, ROC Curve, Newborn Infant, Human Respiratory Syncytial Viruses, Internationality, Respiratory Tract Infections, World Health Organization, Logistic Models, Clinical Infectious Diseases, Respiratory Syncytial Virus Infections Industry, Case Control Studies, Viral Load, Child preschool, Nasopharynx, and Medical and Health Sciences(Infant, ROC Curve, Newborn Infant, Human Respiratory Syncytial Viruses, Internationality, Respiratory Tract Infections, World Health Organization, Logistic Models, Clinical Infectious Diseases, Respiratory Syncytial Virus Infections Industry, Case Control Studies, Viral Load, Child preschool, Nasopharynx, and Medical and Health Sciences)
(Infant, ROC Curve, Newborn Infant, Human Respiratory Syncytial Viruses, Internationality, Respiratory Tract Infections, World Health Organization, Logistic Models, Clinical Infectious Diseases, Respiratory Syncytial Virus Infections Industry, Case Control Studies, Viral Load, Child preschool, Nasopharynx, and Medical and Health Sciences)
Detection of pneumococcus by lytA polymerase chain reaction (PCR) in blood had poor diagnostic accuracy for diagnosing pneumococcal pneumonia in children in 9 African and Asian sites. We assessed the value of blood lytA quantification in... more
Detection of pneumococcus by lytA polymerase chain reaction (PCR) in blood had poor diagnostic accuracy for diagnosing pneumococcal pneumonia in children in 9 African and Asian sites. We assessed the value of blood lytA quantification in diagnosing pneumococcal pneumonia. The Pneumonia Etiology Research for Child Health (PERCH) case-control study tested whole blood by PCR for pneumococcus in children aged 1-59 months hospitalized with signs of pneumonia and in age-frequency matched community controls. The distribution of load among PCR-positive participants was compared between microbiologically confirmed pneumococcal pneumonia (MCPP) cases, cases confirmed for nonpneumococcal pathogens, nonconfirmed cases, and controls. Receiver operating characteristic analyses determined the "optimal threshold" that distinguished MCPP cases from controls. Load was available for 290 of 291 cases with pneumococcal PCR detected in blood and 273 of 273 controls. Load was higher in MCPP case...