Development of a vaccine against gonorrhoea is a global priority, driven by the rise in antibiotic resistance. Although Neisseria gonorrhoeae (Ng) infection does not induce substantial protective immunity, highly exposed individuals may develop immunity against re-infection with the same strain. Retrospective epidemiological studies have shown that vaccines containing Neisseria meningitidis (Nm) outer membrane vesicles (OMVs) provide a degree of cross-protection against Ng infection.
View Article and Find Full Text PDFNeisseria meningitidis is a human-adapted pathogen that causes meningitis and sepsis worldwide. N. meningitidis factor H-binding protein (fHbp) provides a mechanism for immune evasion by binding human complement factor H (CFH) to protect it from complement-mediated killing.
View Article and Find Full Text PDFPretomanid is a new nitroimidazole with proven treatment-shortening efficacy in drug-resistant tuberculosis. Pretomanid-rifamycin-pyrazinamide combinations are potent in mice but have not been tested clinically. Rifampicin, but not rifabutin, reduces pretomanid exposures.
View Article and Find Full Text PDFJ Acquir Immune Defic Syndr
December 2022
Background: Tuberculosis preventive therapy (TPT) is recommended for people with HIV infection, including during pregnancy. The effect of TPT exposure at conception and during pregnancy is poorly documented.
Methods: We report pregnancy outcomes among South African women with HIV enrolled in a randomized trial of 4 TPT regimens (two 3-month regimens, rifapentine/isoniazid [3HP] or rifampin/isoniazid [3HR], isoniazid for 6 months, or isoniazid continuously).
Carbapenems are recommended for treatment of drug-resistant tuberculosis. Optimal dosing remains uncertain. To evaluate the 14-day bactericidal activity of meropenem, at different doses, with or without rifampin.
View Article and Find Full Text PDFMeropenem is being investigated for repurposing as an anti-tuberculosis drug. This study aimed to develop a meropenem population pharmacokinetics model in patients with pulmonary and identify covariates explaining inter-individual variability. Patients were randomized to one of four treatment groups: meropenem 2 g three times daily plus oral rifampicin 20 mg/kg once daily, meropenem 2 g three times daily, meropenem 1 g three times daily, and meropenem 3 g once daily.
View Article and Find Full Text PDFBackground: Tuberculosis is a top-10 cause of under-5 mortality, despite policies promoting tuberculosis preventive therapy (TPT). We previously conducted a cluster randomized trial to evaluate the effectiveness of symptom-based versus tuberculin skin-based screening on child TPT uptake. Symptom-based screening did not improve TPT uptake and nearly two-thirds of child contacts were not identified or not linked to care.
View Article and Find Full Text PDFShorter, more potent regimens are needed for tuberculosis. The nitroimidazole pretomanid was recently approved for extensively drug-resistant tuberculosis in combination with bedaquiline and linezolid. Pretomanid may also have benefit as a treatment-shortening agent for drug-sensitive tuberculosis.
View Article and Find Full Text PDFBackground: Current options for temperature measurement in children presenting to primary care include either electronic axillary or infrared tympanic thermometers. Non-contact infrared thermometers could reduce both the distress of the child and the risk of cross-infection.
Objectives: The objective of this study was to compare the use of non-contact thermometers with the use of electronic axillary and infrared tympanic thermometers in children presenting to primary care.
Background: Tuberculosis preventive therapy (TPT) is highly effective at preventing tuberculosis disease in household child contacts (<5 years), but is poorly implemented worldwide. In 2006, the World Health Organization recommended symptom-based screening as a replacement for tuberculin skin testing (TST) to simplify contact evaluation and improve implementation. We aimed to determine the effectiveness of this recommendation.
View Article and Find Full Text PDFBackground: Tuberculosis (TB) remains the leading cause of death among human immunodeficiency virus (HIV)-infected individuals globally. Screening for TB at the point of HIV diagnosis with a high-sensitivity assay presents an opportunity to reduce mortality.
Methods: We performed a cluster randomized trial of TB screening among adults newly diagnosed with HIV in 12 primary health clinics in rural Thyolo, Malawi.
Background And Objectives: This paper examines risk factors of gambling and problem gambling among racial subgroups in the U.S. population, namely Native Americans and blacks, for whom research data are lacking.
View Article and Find Full Text PDFIn this article we examine data from a national U.S. adult survey of gambling to determine correlates of problem gambling and discuss them in light of theories of the etiology of problem gambling.
View Article and Find Full Text PDFBackground: The combination of rifapentine and moxifloxacin administered daily with other anti-tuberculosis drugs is highly active in mouse models of tuberculosis chemotherapy. The objective of this phase 2 clinical trial was to determine the bactericidal activity, safety, and tolerability of a regimen comprised of rifapentine, moxifloxacin, isoniazid, and pyrazinamide administered daily during the first 8 weeks of pulmonary tuberculosis treatment.
Methods: Adults with sputum smear-positive pulmonary tuberculosis were randomized to receive either rifapentine (approximately 7.
In this article we examine the relationship between extent of gambling for U.S. adults and the distance from their residence to the nearest casino or track.
View Article and Find Full Text PDFIn this article, we examine the relationship between the total number of types of gambling that are legal in a state and the gambling involvement of state residents. Of particular interest is whether more types of legal gambling are associated with higher rates of problem gambling. Telephone surveys of U.
View Article and Find Full Text PDFTuberculosis is the leading cause of death among adults infected with human immunodeficiency virus (HIV), and rates of tuberculosis remain high even after preventive therapy. Among 908 HIV-infected adults in a trial of preventive treatment, we found self-reported alcohol consumption, low baseline CD4 count, high baseline viral load, and tuberculin skin test size >15 mm as independent risk factors for incident tuberculosis.
View Article and Find Full Text PDFThis study is an up-to-date examination of gambling behaviors as well as gambling problems and their relationships to substance use and abuse. Further, the co-occurrence between problem gambling and substance abuse is studied using a large-scale, representative sample of adults aged 18 years and older in the United States. This random-digit-dial national survey was carried out in 2011-2013 with completed interviews from 2,963 respondents.
View Article and Find Full Text PDFGambling opportunities on and near Native American lands have increased in recent decades; yet there is a lack of research examining the patterns of problem gambling and alcohol abuse among Native Americans in the US. Traditional Native American cultural identity may be a protective factor for problem gambling and alcohol abuse among Native Americans. Telephone interviews were conducted with 415 Native American adults aged 18 years and older across the US.
View Article and Find Full Text PDFJ Acquir Immune Defic Syndr
September 2014
Telephone surveys of US adults were conducted in 1999-2000 and again in 2011-2013. The same questions and methods were used so as to make the surveys comparable. There was a reduction in percentage of past-year gambling and in frequency of gambling.
View Article and Find Full Text PDFBackground: CD4 count is a proxy for the extent of immune deficiency and declines in CD4 count are a measure of disease progression. Decline in CD4 count is an important component: for estimating benefits of ARV treatment; for individual level counselling on the rapidity of untreated disease progression and prognosis; and can be used in planning demand for health services. Our objective is to report CD4 decline and changes in viral load (VL) in a group of HIV-infected adults enrolled in a randomized trial of preventive treatment for TB in South Africa where clade C infection predominates.
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