450 results match your criteria: "University of Zambia School of Medicine[Affiliation]"

The increased burden of non-communicable diseases (NCDs) is fueled by lifestyle factors including diet. This cross-sectional study explored among Tanzanian adults whether unhealthy dietary patterns are associated with intestinal and systemic inflammation which could increase the risk of NCDs. The study included 574 participants, with both diet and inflammatory markers data.

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Early Neuro-Deterioration and Mortality Among Neurology Inpatients in a Zambian Referral Hospital: A Prospective Cohort Study.

Neurology

January 2025

From the Department of Neurology (M.L.P.), Yale School of Medicine, New Haven, CT; University Teaching Hospital (K.K., M.K.), Lusaka, Zambia; Department of Neurology (V.S.), University of Maryland School of Medicine, Baltimore, MD; Department of Medicine (K.M., M.B., M. Chilando, M.L., D.N., D.M., C.N., J.M., F.S., L.Y., M.A., S.B., L.C., M. Chomba, S.Z., N.M., D.R.S.), University of Zambia School of Medicine, Lusaka; University of Miami School of Medicine (G.P., H.P.), FL; Queen's University (A.P.), Kingston, Ontario, Canada; and Department of Neurology (D.R.S.), Johns Hopkins University School of Medicine, Baltimore, MD.

Article Synopsis
  • Neurocritical illnesses often lead to increased mortality in low-resource countries, and early neurodeterioration (END) may help identify high-risk patients for better care.
  • A study conducted in Zambia monitored neurology inpatients to assess the impact of END, defined as a decline in the Glasgow Coma Scale (GCS) within three days of admission.
  • The results showed that 18% of patients experienced END, significantly increasing their risk of death (72% vs 11% mortality), with common causes of death being aspiration pneumonia and sepsis, indicating a need for targeted interventions.
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Purpose Of Review: Women in Africa bear the burden of the HIV epidemic, which has been associated with the high prevalence of bacterial vaginosis (BV) in the region. However, little progress has been made in finding an effective cure for BV. Drawing on advances in microbiome-directed therapies for gastrointestinal disorders, similar live-biotherapeutic based approaches for BV treatment are being evaluated.

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Background: Academic examination retakes are significant challenges in health professions education. With rigorous clinical assessments, limited training resources and high-stakes examinations, students struggle to meet academic requirements which cab result in retakes. This study aimed to assess the proportion of medical and nursing students with retakes across five Sub-Saharan African universities and to explore factors contributing to the retakes.

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In sub-Saharan Africa, children with severe malnutrition (SM) and HIV have substantially worse outcomes than children with SM alone, facing higher mortality risk and impaired nutritional recovery post-hospitalisation. Biological mechanisms underpinning this risk remain incompletely understood. This case-control study nested within the CHAIN cohort in Kenya, Uganda, Malawi, and Burkina Faso examined effect of HIV on six months post-discharge growth among children with SM and those at risk of malnutrition, assessed proteomic signatures associated with HIV in these children, and investigated how these systemic processes impact post-discharge growth in children with SM.

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Background: Although Helicobacter pylori infection (H. pylori) prevalence in Africa has declined in the last decade, it remains concerningly high. H.

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Background: Sickle cell disease (SCD) is a prevalent inherited blood disorder. Globally, approximately 515 000 babies are born with SCD annually, with 75% of these births occurring in Africa. Integrating newborn screening (NBS) for SCD into primary healthcare structures, such as immunisation programmes, holds significant promise, with dried blood spots (DBS)-point-of-care technologies (POCT) like HaemoTypeSC offering cost-effective screening solutions.

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A newly identified subtype of hereditary axonal motor neuropathy, characterized by early proximal limb involvement, has been discovered in a cohort of 34 individuals with biallelic variants in von Willebrand factor A domain-containing 1 (). This study further delineates the disease characteristics in a cohort of 20 individuals diagnosed through genome or exome sequencing, incorporating neurophysiological, laboratory and imaging data, along with data from previously reported cases across three different studies. Newly reported clinical features include hypermobility/hyperlaxity, axial weakness, dysmorphic signs, asymmetric presentation, dystonic features and, notably, upper motor neuron signs.

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Antenatal care (ANC) plays a crucial role in preventing and detecting pregnancy risks, facilitating prompt treatment, and disseminating essential information to expectant mothers. This role is particularly vital in developing countries, where a 4.65% rise in maternal mortality rate was observed in 2022, with over 800 maternal and 7,700 perinatal deaths reported.

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A cross-sectional study of associations between the C-sucrose breath test, the lactulose rhamnose assay, and growth in children at high risk of environmental enteropathy.

Am J Clin Nutr

December 2024

Rutgers Global Health Institute, Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, the State University of New Jersey, New Brunswick, NJ, United States. Electronic address:

Article Synopsis
  • Environmental enteropathy (EE) is a condition affecting children in low-resource settings due to exposure to enteric pathogens, and a new noninvasive breath test (C-SBT) to assess carbohydrate digestion was developed and validated.
  • The study aimed to link the C-SBT results to the lactulose/rhamnose ratio (LR) and identify their relationship with child growth, as well as investigate connections with socio-economic factors, dietary diversity, and other EE biomarkers.
  • Results indicated variability in C-SBT and LR measurements across different sites, with some associations found between child growth and test timing, but no significant links between C-SBT and LR or overall growth metrics were established.
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Article Synopsis
  • Assessing the digestive capabilities of the gastrointestinal tract in children, especially non-invasively, is challenging due to complex processes and variability in how functions are measured.
  • * Childhood environmental enteropathy (EE) plays a key role in issues like growth and nutrition, linking poor nutrient absorption to conditions like malnutrition and cognitive impairment.
  • * The review highlights mechanisms behind malabsorption in children, identifies promising non-invasive breath tests to evaluate this issue, and emphasizes the need for future research on its impact on growth and cognitive function.
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Introduction: Executive function (EF) may be impaired in people with human immunodeficiency virus (HIV) infection, and poor EF may affect medication adherence. However, there is little data on EF in children with HIV in sub-Saharan Africa.

Methods: 208 children/adolescents with perinatally acquired HIV and 208 HIV-exposed uninfected controls were recruited in Zambia for this prospective cohort study.

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Background: Environmental Enteric Dysfunction (EED) is an acquired disorder of asymptomatic altered gut function, the etiology of which is unknown. EED is postulated to be a major contributor to growth faltering in early childhood in regions where early-life enteropathogenic carriage is prevalent. Few studies have examined the critical organ (the upper small bowel) with enteropathogens in the evolution of small bowel disease.

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Background: Validated biomarkers could catalyze environmental enteric dysfunction (EED) research.

Objectives: Leveraging an EED histology scoring system, this multicountry analysis examined biomarker associations with duodenal histology features among children with EED. We also examined differences in 2-h compared with 1-h urine collections in the lactulose rhamnose (LR) dual sugar test.

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Background: Environmental enteric dysfunction (EED) is a precursor of growth faltering in children living in impoverished conditions who are frequently exposed to environmental toxins and enteropathogens, leading to small bowel inflammatory, malabsorptive, and permeability derangements and low-grade chronic systemic inflammation.

Objectives: We explored the association between anthropometrics and duodenal histologic features of EED among children from 3 lower middle-income country centers.

Methods: In this cross-sectional study, Pakistani children (n = 63) with wasting, Bangladesh children (n = 116) with stunting or at risk for stunting (height-for-age Z score [HAZ] <-1 but ≥-2), and Zambian children (n = 108) with wasting or stunting received nutritional intervention.

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Background: Environmental enteric dysfunction (EED) is an inflammatory condition of the small intestine that is prevalent in children residing in low- and middle-income countries. EED is accompanied by profound histopathologic changes in the small bowel, loss of absorptive capacity, increased intestinal permeability, increased microbial translocation, and nutrient loss.

Objectives: We sought to identify dysregulated genes and pathways that might underlie pediatric EED.

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Article Synopsis
  • - Environmental enteric dysfunction (EED) is a condition that leads to inflammation in the small intestine, impacting childhood growth and neurodevelopment, but has been overlooked until recently.
  • - The EEDBI Consortium was formed in 2016 to study EED through biopsy data from children in Bangladesh, Pakistan, and Zambia, while also comparing them to children in the U.S. undergoing endoscopy for other reasons.
  • - The initiative aims to coordinate research efforts, allowing researchers to analyze EED-related tissue and associated factors like histology and biomarkers across multiple studies, all with the goal of better understanding this debilitating condition.
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Background: Environmental enteric dysfunction (EED) is characterized by reduced absorptive capacity and barrier function of the small intestine, leading to poor ponderal and linear childhood growth.

Objectives: To further define gene expression patterns that are associated with EED to uncover new pathophysiology of this disorder.

Methods: Duodenal biopsies from cohorts of children with EED from Bangladesh, Pakistan and Zambia were analyzed by immunohistochemistry (IHC) to interrogate gene products that distinguished differentiation and various biochemical pathways in immune and epithelial cells, some identified by prior bulk RNA sequence analyses.

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Article Synopsis
  • Environmental enteric dysfunction (EED) is a silent intestinal disorder linked to various health issues in children, notably affecting growth and neurodevelopment.
  • Researchers aimed to create a scoring system based on duodenal biopsies from children with EED in Bangladesh, Pakistan, and Zambia, comparing them to healthy children and those with celiac disease.
  • The study revealed five key histopathological features that distinguished EED from normal biopsies, with a high accuracy in identifying EED (AUC: 0.992), highlighting geographical differences in goblet cell depletion among the affected populations.
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Utility of Cerebrospinal Fluid Unstimulated Interferon-Gamma (IRISA-TB) as a Same-Day Test for Tuberculous Meningitis in a Tuberculosis-Endemic, Resource-Poor Setting.

Open Forum Infect Dis

September 2024

Centre for Lung Infection and Immunity, Department of Medicine, University of Cape Town and Division of Pulmonology, University of Cape Town Lung Institute, Observatory, Cape Town, South Africa.

Background: Tuberculous meningitis (TBM) mortality is high and current diagnostics perform suboptimally. We evaluated the diagnostic performance of a DNA-based assay (GeneXpert Ultra) against a new same-day immunodiagnostic assay that detects unstimulated interferon-gamma (IRISA-TB).

Methods: In a stage 1 evaluation, IRISA-TB was evaluated in biobanked samples from Zambia (n = 82; tuberculosis [TB] and non-TBM), and specificity in a South African biobank (n = 291; non-TBM only).

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Inflammation and Elevated Osteopontin in Plasma and CSF in Cerebral Malaria Compared to -Negative Neurological Infections.

Int J Mol Sci

September 2024

University Teaching Hospital Malaria Research Unit (SMUTH-MRU), Department of Pediatrics and Child Health, University of Zambia School of Medicine, Lusaka P.O. Box 50110, Zambia.

Cerebral malaria in young African children is associated with high mortality, and persisting neurological deficits often remain in survivors. Sequestered -infected red blood cells lead to cerebrovascular inflammation and subsequent neuroinflammation. Brain inflammation can play a role in the pathogenesis of neurologic sequelae.

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Importance: Accurate assessment of gestational age (GA) is essential to good pregnancy care but often requires ultrasonography, which may not be available in low-resource settings. This study developed a deep learning artificial intelligence (AI) model to estimate GA from blind ultrasonography sweeps and incorporated it into the software of a low-cost, battery-powered device.

Objective: To evaluate GA estimation accuracy of an AI-enabled ultrasonography tool when used by novice users with no prior training in sonography.

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Rosai Dorfman disease (RDD) is a rare non-Langerhans histiocytic disorder, which belongs to the R group of the 2016 revised histiocytic classification. It's characterized by the accumulation of activated histiocytes in the sinusoids of lymph nodes and/or extranodal tissues. Herein, we report a 7-year-old female who was initially suspected to have a lymphoma but was later identified as having RDD.

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Although previous studies have suggested that subtype B HIV-1 proviruses in the brain are associated with physiological changes and immune activation accompanied with microgliosis and astrogliosis, and indicated that both HIV-1 subtype variation and geographical location might influence the neuropathogenicity of HIV-1 in the brain. The natural course of neuropathogenesis of the most widespread subtype C HIV-1 has not been adequately investigated, especially for people living with HIV (PLWH) in sub-Saharan Africa. To characterize the natural neuropathology of subtype C HIV-1, postmortem frontal lobe and basal ganglia tissues were collected from nine ART-naïve individuals who died of late-stage AIDS with subtype C HIV-1 infection, and eight uninfected deceased individuals as controls.

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