Publications by authors named "Peter M Small"

Cough is a common and commonly ignored symptom of lung disease. Cough is often perceived as difficult to quantify, frequently self-limiting, and non-specific. However, cough has a central role in the clinical detection of many lung diseases including tuberculosis (TB), which remains the leading infectious disease killer worldwide.

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Cough is a common and commonly ignored symptom of lung disease. Cough is often perceived as difficult to quantify, frequently self-limiting, and non-specific. However, cough has a central role in the clinical detection of many lung diseases including tuberculosis (TB), which remains the leading infectious disease killer worldwide.

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Purpose: This study evaluated the feasibility and utility of longitudinal cough frequency monitoring with the Hyfe Cough Tracker, a mobile application equipped with cough-counting artificial intelligence algorithms, in real-world patients with chronic cough.

Methods: Patients with chronic cough (> 8-week duration) were monitored continuously for cough frequency with the Hyfe app for at least one week. Cough was also evaluated using the Leicester Cough Questionnaire (LCQ) and daily cough severity scoring (0-10).

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Background: Quality surveillance data used to build tuberculosis (TB) transmission models are frequently unavailable and may overlook community intrinsic dynamics that impact TB transmission. Social network analysis (SNA) generates data on hyperlocal social-demographic structures that contribute to disease transmission.

Methods: We collected social contact data in five villages and built SNA-informed village-specific stochastic TB transmission models in remote Madagascar.

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Purpose: Recent developments in the field of artificial intelligence and acoustics have made it possible to objectively monitor cough in clinical and ambulatory settings. We hypothesized that time patterns of objectively measured cough in COVID-19 patients could predict clinical prognosis and help rapidly identify patients at high risk of intubation or death.

Methods: One hundred and twenty-three patients hospitalized with COVID-19 were enrolled at University of Florida Health Shands and the Centre Hospitalier de l'Université de Montréal.

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Long coronavirus disease (COVID) refers to an array of variable and fluctuating symptoms experienced after acute illness, with signs and symptoms that persist for 8-12 weeks and are not otherwise explicable. Cough is the most common symptom of acute COVID-19, but cough may persist in some individuals for weeks or months after recovery from acute phase. Long-COVID cough patients may get stigmatised because of the public fear of contagion and reinfection.

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Article Synopsis
  • Taenia solium infections, including taeniosis and cysticercosis, are prevalent yet underdiagnosed in rural Madagascar, particularly around Ranomafana National Park, prompting a study to evaluate their prevalence and risk factors.
  • A cross-sectional survey conducted in June 2016 revealed that 10 out of 459 participants had Taenia spp. eggs in their stool, predominantly the Asian genotype of T. solium, while seroprevalence of cysticercosis showed 27.5% to 29.8% of participants had specific antibodies.
  • Key risk factors identified included open defecation, large household sizes, and age over 15 years, while females and reliance on river
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Article Synopsis
  • Affordable and portable ultrasound devices are increasing the interest in using point-of-care ultrasound (POCUS) for detecting pulmonary TB (PTB).
  • A systematic review analyzed the diagnostic accuracy of POCUS in PTB, reviewing 3,919 articles, but only six studies were included, with a total of 564 participants, mostly adults.
  • Findings showed high risks of bias and varying sensitivity and specificity across studies, indicating the need for improved study designs and protocols to better assess POCUS's diagnostic capability for PTB.
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Background: Understanding latent Mycobacterium tuberculosis infection (LTBI) prevalence is crucial for the design of TB control strategies. There are no data on LTBI in rural Madagascar.

Methods: Tuberculin skin tests were performed in 98 adults aged >15 y in five rural villages in the Ifanadiana district, Madagascar.

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Background: Continuing tuberculosis control with current approaches is unlikely to reach the World Health Organization's objective to eliminate TB by 2035. Innovative interventions such as unmanned aerial vehicles (or drones) and digital adherence monitoring technologies have the potential to enhance patient-centric quality tuberculosis care and help challenged National Tuberculosis Programs leapfrog over the impediments of conventional Directly Observed Therapy (DOTS) implementation. A bundle of innovative interventions referred to for its delivery technology as the Drone Observed Therapy System (DrOTS) was implemented in remote Madagascar.

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Drones are increasingly being used globally for the support of healthcare programmes. Madagascar, Malawi and Senegal are among a group of early adopters piloting the use of bi-directional transport drones for health systems in sub-Saharan Africa. This article presents the experiences as well as the strengths, weaknesses, opportunities and threats (SWOT analysis) of these country projects.

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Introduction: Poor road and communication infrastructure pose major challenges to tuberculosis (TB) control in many regions of the world. TB surveillance and patient support often fall to community health workers (CHWs) who may lack the time or knowledge needed for this work. To meet the End TB Strategy goal of reducing TB incidence by 90% by 2035, the WHO calls for intensified research and innovation including the rapid uptake of new tools, interventions and strategies.

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Background: worldwide, the frequency of tuberculosis among older people almost triples that observed among young adults.

Objective: to describe clinical and epidemiological consequences of pulmonary tuberculosis among older people.

Methods: we screened persons with a cough lasting more than 2 weeks in Southern Mexico from March 1995 to February 2007.

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The fragmentation of clinical and public health systems results in divergent information collection practices, presenting challenges to standardization and EHR certification efforts. Data forms employed in public health jurisdictions nationwide reflect these differences in patient treatment, monitoring and evaluation, and follow-up, presenting challenges for data integration. To study these variations, we surveyed tuberculosis contact investigation forms from all fifty states, three municipalities and two countries.

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Mycobacterium tuberculosis is an obligate human pathogen capable of persisting in individual hosts for decades. We sequenced the genomes of 21 strains representative of the global diversity and six major lineages of the M. tuberculosis complex (MTBC) at 40- to 90-fold coverage using Illumina next-generation DNA sequencing.

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Background: Indoor air pollution produced by biomass cooking fuels in developing countries has been associated with acute and chronic lower respiratory diseases, but has not been identified as an occupational exposure among women.

Objective: To examine the relationship between the use of biomass cooking fuels (mainly wood) and tuberculosis (TB) among women living in rural areas in Southern Mexico.

Methods: We conducted a population based case-control study in the health jurisdiction of Orizaba, Mexico.

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Tuberculosis is a global problem that we can't afford to keep ignoring. In 2006, tuberculosis killed 1.7 million people--almost twice as many people as malaria--and it is the leading cause of death among people living with HIV/AIDS.

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Article Synopsis
  • * Recent research indicates that human-adapted strains of M. tuberculosis are more genetically diverse than previously thought, influenced by human demographics and migrations.
  • * This genetic diversity, coupled with reduced purifying selection and genetic drift, may contribute to the rise of drug-resistant tuberculosis, especially amid increasing global population and travel.
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