Publications by authors named "Garges E"

Background: There is concern about the risk of cholangiocarcinoma mortality (CCA) among U.S. veterans who deployed to the Vietnam War theater.

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The rapid emergence of antimicrobial-resistant strains of Neisseria gonorrhoeae threatens treatment options and control efforts. The Uniformed Services University Gonococcal Reference Laboratory and Repository of the Global Emerging Infections Surveillance Program receives isolates from several geographically distinct regions worldwide. We analyzed 962 isolates collected during 2014-2022 for genomic and phenotypic antimicrobial resistance.

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  • The West Nile virus (WNV) Koutango lineage (WN-KOUTV) has been isolated from phlebotomine sandflies in Kenya, expanding understanding of this virus found primarily in mosquitoes.
  • This study involved sampling sandflies, identifying species, isolating the virus, and analyzing its genetic sequences to understand its evolutionary relationships and variations.
  • Results indicated WN-KOUTV shows unique genetic traits and replicated effectively in both mammalian and mosquito cell lines, which could imply the sandflies might play a role as potential vectors for the virus.
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Background: We characterized the antimicrobial resistance (AMR) profiles of (NG) isolated from symptomatic men at a sexually transmitted infection clinic in Kisumu, Kenya.

Methods: Two urethral swabs were obtained from symptomatic men between 2020 and 2022, one for Gram's stain and the other inoculated directly onto modified Thayer-Martin media containing 1% VCNT and 1% IsoVitaleX enrichment. Culture results were confirmed by colony morphology, Gram's stain and oxidase test.

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Phleboviruses are an emerging threat to public health. Recent surveillance efforts in Kenya have unveiled novel phleboviruses. Despite these efforts, there remain knowledge gaps.

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  • Ticks are significant ectoparasites that transmit various human diseases, including Lyme disease and anaplasmosis, making them the second most important vector after mosquitoes.
  • This study analyzed the bacterial content of ticks collected from different regions in Kenya, using advanced genomic techniques to classify the bacterial species present.
  • Key findings included the dominance of Rickettsia and Coxiella species in the tick samples, along with the identification of bacteria linked to several human infections, highlighting the need for further research on tick-borne diseases in Kenya.
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The molecular mechanism underlying persistence in the asymptomatic phase of infection remains largely unknown. However, large-scale shifts in the parasites' gene expression during asymptomatic infections may enhance phenotypic plasticity, maximizing their fitness and leading to the persistence of the asymptomatic infections. To uncover these mechanisms, we aimed to identify parasite genetic factors implicated in asymptomatic infections through whole transcriptome analysis.

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Gonorrhea, a sexually transmitted disease caused by , poses a significant global public health threat. Infection in women can be asymptomatic and may result in severe reproductive complications. Escalating antibiotic resistance underscores the need for an effective vaccine.

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We report the sequencing of two viruses, Phasi Charoen-like phasivirus (PCLV) and Fako virus (FAKV), which were detected in a pool of from Kenya. Analysis showed a high similarity of PCLV to publicly available PCLV genomes from Kenya. FAKV showed a high genetic divergence from publicly available FAKV genomes.

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Objectives: This study examined the treatment response of mixed vs single-species Plasmodium falciparum infections to artemisinin-based combination therapies (ACTs).

Methods: A total of 1211 blood samples collected on days 0, 7, 14, 21, 28, 35, and 42 from 173 individuals enrolled in two randomized ACT efficacy studies were tested for malaria using 18s ribosomal RNA-based real-time polymerase chain reaction. All recurrent parasitemia were characterized for Plasmodium species composition and time to reinfection during 42-day follow-up compared across ACTs.

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Background: Reporting systems are commonly used for chlamydia and gonorrhea surveillance and community burden assessments. Estimates are conservative given high proportions of asymptomatic cases and underreporting. The military's unified health system, which includes laboratory and medical encounter data, could offer insight into surveillance gaps and improve burden analyses.

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  • - The study examines how different clinicians and travelers affect medical outcomes related to travelers' diarrhea within the U.S. Military Health System, highlighting the importance of self-treatment for traveler health.
  • - Researchers analyzed data from over 80,000 adult travelers, assessing prescribing patterns of medications for travelers' diarrhea, and found low prescription rates, especially among civilian and nonspecialist military providers.
  • - The findings suggest that increasing healthcare providers' knowledge about diarrhea treatment guidelines and improving access to travel medicine services could enhance care quality for both service members and beneficiaries.
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To address the ongoing epidemic of sexually transmitted infections (STIs) in the United States, the National Academies of Sciences, Engineering, and Medicine (National Academies) conducted a consensus study on STI control and prevention in the United States to provide recommendations to the Centers for Disease Control and Prevention and the National Association of County and City Health Officials. The culminating report identified military personnel as one of the priority groups that require special consideration given the high prevalence of STIs and their associated behaviors (e.g.

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Health events emerge from host, community, environment, and pathogen factors-forecasting epidemics is a complex task. We describe an exploratory analysis to identify economic risk factors that could aid epidemic risk assessment. A line list was constructed using the World Health Organization Disease Outbreak News (2016-2018) and economic indicators from the World Bank.

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  • - Chlamydia and gonorrhea rates in the US Army are higher than in the general population, particularly among younger Army women, with chlamydia rates nearly twice those of US adults in 2019.
  • - An analysis from 2015 to 2019 shows that while Army soldiers have elevated rates of chlamydia, gonorrhea rates are lower among them compared to certain age groups in the general US population.
  • - Factors such as age, sex, and race-ethnicity significantly influence infection rates in Army personnel, with possible explanations for these trends including differences in sexual behavior, screening access, and the demographics of high-risk groups.
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There is a pressing need for a gonorrhea vaccine due to the high disease burden associated with gonococcal infections globally and the rapid evolution of antibiotic resistance in Neisseria gonorrhoeae (Ng). Current gonorrhea vaccine research is in the stages of antigen discovery and the identification of protective immune responses, and no vaccine has been tested in clinical trials in over 30 years. Recently, however, it was reported in a retrospective case-control study that vaccination of humans with a serogroup B Neisseria meningitidis (Nm) outer membrane vesicle (OMV) vaccine (MeNZB) was associated with reduced rates of gonorrhea.

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Introduction: Sexually transmitted infections (STIs) continue to plague militaries and defense forces. While the historical recognition of the impact of STIs on operations is evident, contemporary surveillance and research activities are limited. As Neisseria gonorrhoeae and other sexually transmitted pathogens become increasingly resistant to antibiotics, the role of the Department of Defense (DoD) in disease surveillance and clinical research is essential to military Force Health Protection.

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Background: Understanding the underlying epidemiology that shapes Neisseria gonorrhoeae (GC), and Chlamydia trachomatis (CT) infections can contribute to data driven policies directed towards curbing the proliferation of these pathogens in Ghana. Information on the symptoms and risk factors for STIs will help to identify high-risk individuals which will in turn inform STI syndromic management and tailor the use of public health resources.

Methods: Participants were from 4 military clinics and 1 civilian STI clinic in Ghana and eligible if they had symptoms suggestive of STI.

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Background: Pharyngeal and anorectal reservoirs of gonorrhea (GC) and chlamydia (CT) are increasingly recognized among heterosexual women. While a number of studies performed at sexually transmitted disease (STD) clinics have found a high prevalence of extragenital GC/CT infection, such screening is typically not offered during routine primary care visits for women. We sought to define the prevalence of and factors associated with extragenital GC/CT among women in the U.

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Antimicrobial resistance in is a global health problem. Enhanced international collaborative surveillance and disease control are needed to reduce the global burden of this important pathogen. Currently the antimicrobial resistance properties and molecular mechanisms of multidrug-resistant in the Republic of Georgia represent a significant knowledge gap.

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Human immunodeficiency virus (HIV) infection is a substantial health concern for the U.S. Department of Defense (DoD) and for service members stationed throughout the world.

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Background: Since 2006, the Division of Tropical Public Health at the Uniformed Services University (USU) has sponsored the Tropical Medicine Training Program (TMTP). Despite practice guidelines stating that global health education should include the collection and evaluation of data on the impact of the training experiences, no quantitative evaluation of program outcomes had previously occurred. The objective of this report was to evaluate TMTP outcomes to guide program improvement.

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