Detection of drug resistant Mycobacterium tuberculosis by high-throughput sequencing of DNA isolated from acid fast bacilli smears.

Background: Drug susceptibility testing for Mycobacterium tuberculosis (MTB) is difficult to perform in resource-limited settings where Acid Fast Bacilli (AFB) smears are commonly used for disease diagnosis and monitoring. We developed a simple method for extraction of MTB DNA from AFB smears for sequencing-based detection of mutations associated with resistance to all first and several second-line anti-tuberculosis drugs.

Methods: We isolated MTB DNA by boiling smear content in a Chelex solution, followed by column purification.

Progress made towards enhancement of rheumatology education and practice in Zambia: review of an ILAR-supported project.

The burden of non-communicable diseases such as musculoskeletal diseases in the developing world is often overshadowed by the more prevalent infectious diseases. Generally, there is gross underestimation of the burden of rheumatologic disease in the backdrop of scanty or indeed non-existent rheumatology services in these countries. Local studies conducted in the last two decades in Zambia have documented the increasing burden of rheumatologic conditions in the country.

Spondyloarthritis in sub-Saharan Africa.

Spondyloarthritis (SpA) is generally uncommon in sub-Saharan Africa, in part because of the rarity of HLA-B27 in this region. However, the relationship between HLA-B27 and SpA, particularly ankylosing spondylitis (AS), is complex. Despite the HLA-B 27:05 risk allele occurring in some West African populations, associated AS is not seen.

Clinical patterns of juvenile idiopathic arthritis in Zambia.

Background: Juvenile idiopathic arthritis (JIA) is a heterogeneous group of disorders with different disease manifestations among various populations. There are few reports of JIA among indigenous Africans especially sub-Saharan Africa. We present herein the clinical patterns of JIA encountered at a tertiary hospital in Lusaka, Zambia.

Improving performance of Zambia Defence Force antiretroviral therapy providers: evaluation of a standards-based approach.

Background: The Zambia Defence Force (ZDF) has applied the Standards-Based Management and Recognition (SBM-R®) approach, which uses detailed performance standards, at some health facilities to improve HIV-related services offered to military personnel and surrounding civilian communities. This study examines the effectiveness of the SBM-R approach in improving facility readiness and provider performance at ZDF facilities.

Methods: We collected data on facility readiness and provider performance before and after the 2010-2012 intervention at 4 intervention sites selected for their relatively poor performance and 4 comparison sites.

Influence of HLA-B*5703 and HLA-B*1403 on susceptibility to spondyloarthropathies in the Zambian population.

Objective: To analyze the distribution of HLA-B alleles and to investigate their contribution in the susceptibility to spondyloarthropathies (SpA) in a sample population from Zambia, in order to determine a relationship between some HLA-B alleles and development of ankylosing spondylitis (AS), reactive arthritis (ReA), or undifferentiated SpA (uSpA).

Methods: . We selected 72 patients with SpA and found that 46 had uSpA, 23 ReA, and 3 AS.

Soft tissue rheumatic lesions and HIV infection in Zambians.

Objective: To explore the relationship between human immunodeficiency virus (HIV) infection and soft tissue rheumatic lesions in HIV-positive black Zambians.

Methods: We performed a prospective study of all patients over 18 years of age attending a rheumatic clinic in a teaching hospital. All patients underwent routine blood tests, and radiographs were performed when indicated.

Sexual risk-taking and HIV testing among health workers in Zambia.

Health workers (N=692) in five Zambian hospitals were interviewed to assess HIV/AIDS risk-taking and status awareness. They comprised of physicians, nurses, clinical officers and paramedics. Only 33% had been tested for HIV and only 24% said their partner had been tested.

Human immunodeficiency virus related reactive arthritis in Zambia.

Objective: To characterize the clinical, radiological, and diagnostic features of reactive arthritis (ReA) in indigenous Black Zambians with human immunodeficiency virus (HIV) infection.

Methods: Consecutive patients attending an arthritis clinic over a 5-year period were studied prospectively. Those who satisfied diagnostic criteria for ReA were analyzed.

Interaction between KIR3DL1 and HLA-B*57 supertype alleles influences the progression of HIV-1 infection in a Zambian population.

KIR and HLA loci are both highly polymorphic, and some HLA class 1 products bind and trigger cell-surface receptors specified by KIR genes. We examined whether KIR genes act in concert with HLA-B locus to control HIV-1 infection in a sample of Zambian patients. DNA samples from 88 Zambian patients with HIV-1 were examined.

The HLA-B*5703 allele confers susceptibility to the development of spondylarthropathies in Zambian human immunodeficiency virus-infected patients with slow progression to acquired immunodeficiency syndrome.

Objective: To analyze the HLA distribution in a population of individuals from Zambia in order to establish a possible relationship between the progression of human immunodeficiency virus (HIV) infection and the development of spondylarthropathy (SpA).

Methods: A large epidemiologic analysis of rheumatology patients living in Zambia was performed in order to identify those who had SpA. We selected 64 patients with SpA and found that 54 also had HIV type 1 (HIV-1) infection; only 10 were HIV negative.

Psoriatic arthritis and human immunodeficiency virus infection in Zambia.

Objective: To characterize the clinical features of psoriatic arthritis (PsA) in black Zambians and the association of PsA with human immunodeficiency virus (HIV) infection.

Methods: Patients attending an arthritis clinic in a 40 month period who exhibited psoriasiform lesions were assessed clinically and tested for the presence of antibodies to HIV.

Results: Of 702 new attendees with inflammatory arthritis 28 were designated as PsA and 27 of these were HIV+.

Spondyloarthropathy and human immunodeficiency virus infection in Zambia.

Objective: To explore the relationship between spondyloarthropathy (SpA) and infection with the human immunodeficiency virus (HIV) in black Zambians.

Methods: Consecutive patients attending an arthritis clinic in a 30 month period were assessed clinically and tested for the presence of antibodies to HIV. HLA-B27 gene was investigated by polymerase chain reaction and T cell subsets were tested in selected subgroups.