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

Kaposi sarcoma (KS) is an AIDS-defining angio-proliferative malignancy, with the Kaposi sarcoma-associated herpes virus (KSHV) as its etiologic agent. Upon treatment with chemotherapy, a proportion of HIV-associated KS patients experience disease recurrence within a few months of completing treatment. We aimed at determining whether KSHV-specific adaptive immune responses were associated with KS recurrence upon complete remission.

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Introduction: Multiplathogen home-based self-sampling offers an opportunity to increase access to screening and treatment in endemic settings with high coinfection prevalence of sexually transmitted (HIV, human papillomavirus (HPV)) and non-sexually transmitted pathogens ()). Chronic coinfections may lead to disability (female genital schistosomiasis) and death (cervical cancer). The Zipime-Weka-Schista (Do self-testing sister!) study aims to evaluate the validity, acceptability, uptake, impact and cost-effectiveness of multipathogen self-sampling for genital infections among women in Zambia.

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Background: Helicobacter pylori (H. pylori) is a common bacterial infection which predominately drives upper gastrointestinal pathology. We carried out a nationwide serological survey in response to the deficiency of robust African data on H.

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High rates of placental inflammation among samples collected by the Multi-Omics for Mothers and Infants consortium.

Am J Obstet Gynecol

April 2024

Department of Obstetrics, Gynecology, and Reproductive Sciences, Center for Reproductive Sciences, University of California, San Francisco, CA; Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California, San Francisco, CA; Sandler-Moore Mass Spectrometry Core Facility, University of California, San Francisco, San Francisco, CA. Electronic address:

Article Synopsis
  • The Multi-Omics for Mothers and Infants consortium focuses on enhancing birth outcomes, particularly addressing the challenges of preterm birth, which poses serious health risks for infants and children globally.
  • Researchers collected and analyzed placental samples from 166 preterm births and 175 term births across five sites in Bangladesh, Pakistan, Tanzania, and Zambia, looking at the morphology and gene expression differences.
  • Results indicated a significant level of inflammation in the placental samples, particularly in chorionic villi, with a correlation between inflammation and preterm births; additionally, 267 genes were found to be differentially expressed between preterm and term placentas.
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Background: Environmental enteric dysfunction (EED), a chronic inflammatory condition of the small intestine, is an important driver of childhood malnutrition globally. Quantifying intestinal morphology in EED allows for exploration of its association with functional and disease outcomes.

Objectives: We sought to define morphometric characteristics of childhood EED and determine whether morphology features were associated with disease pathophysiology.

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Children who are HIV-exposed but uninfected have increased infectious mortality compared to HIV-unexposed children, raising the possibility of immune abnormalities following exposure to maternal viraemia, immune dysfunction, and co-infections during pregnancy. In a secondary analysis of the SHINE trial in rural Zimbabwe we explored biological pathways underlying infant mortality, and maternal factors shaping immune development in HIV-exposed uninfected infants. Maternal inflammation and cytomegalovirus viraemia were independently associated with infant deaths: mortality doubled for each log rise in maternal C-reactive protein (adjusted hazard ratio (aHR) 2.

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Article Synopsis
  • Malnutrition is a major cause of child deaths globally, with Severe Acute Malnutrition (SAM) leading to high mortality rates, especially when compounded by infections or medical complications.
  • A clinical trial conducted in Zambia and Zimbabwe evaluated four potential treatments for malnutrition-related enteropathy in 125 hospitalized children aged 6-59 months with SAM, comparing bovine colostrum, N-acetyl glucosamine, teduglutide, budesonide, and standard care over 14 days.
  • Results indicated that teduglutide significantly reduced mucosal damage biomarkers, suggesting it may be a beneficial treatment for enteropathy in children with complicated malnutrition, with all interventions deemed safe.
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Endoscopic diagnosis of gastric and oesophageal cancer in Lusaka, Zambia: a retrospective analysis.

BMC Gastroenterol

April 2024

Tropical Gastroenterology and Nutrition Group, University of Zambia School of Medicine, Nationalist Road, PO Box 50398, Lusaka, Zambia.

Introduction: There are uncertainties surrounding the spectrum of upper gastrointestinal (UGI) diseases in sub-Saharan Africa. This is mainly due to the limitations of data collection and recording. We previously reported an audit of UGI endoscopic diagnoses in Zambia spanning from 1977 to 2014.

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Seasonal coronaviruses (HCoVs) are known to contribute to cross-reactive antibody (Ab) responses against SARS-CoV-2. While these responses are predictable due to the high homology between SARS-CoV-2 and other CoVs, the impact of these responses on susceptibility to SARS-CoV-2 infection in cancer patients is unclear. To investigate the influence of prior HCoV infection on anti-SARS-CoV-2 Ab responses among COVID-19 asymptomatic individuals with cancer and controls without cancers, we utilized the VirScan technology in which phage immunoprecipitation and sequencing (PhIP-seq) of longitudinal plasma samples was performed to investigate high-resolution (i.

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Primary headache disorders among people living with HIV in Lusaka, Zambia.

J Neurol Sci

April 2024

Department of Medicine, University Teaching Hospital, Lusaka, Zambia; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address:

Objective: We completed a cross-sectional survey study to determine headache prevalence and its association with HIV characteristics among people living with HIV (PLHIV) in Lusaka, Zambia.

Background: Headaches are common but their association with HIV status is unknown.

Methods: The HARDSHIP survey, a headache epidemiology questionnaire previously validated in Zambia, was distributed during a 3-month period to 3666 consecutive adult PLHIV attending routine clinic appointments at the Adult Infectious Diseases Centre at the University Teaching Hospital in Lusaka, Zambia.

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Background: Helicobacter pylori (H. pylori) infection is the most prevalent type of bacterial infection. Current guidelines from different regions of the world neglect specific African conditions and requirements.

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Significance: The integrity of the intestinal barrier is gaining recognition as a significant contributor to various pathophysiological conditions, including inflammatory bowel disease, celiac disease, environmental enteric dysfunction (EED), and malnutrition. EED, for example, manifests as complex structural and functional changes in the small intestine leading to increased intestinal permeability, inflammation, and reduced absorption of nutrients. Despite the importance of gut function, current techniques to assess intestinal permeability (such as endoscopic biopsies or dual sugar assays) are either highly invasive, unreliable, and/or difficult to perform in certain patient populations (e.

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Perspectives on development and advancement of new tuberculosis vaccines.

Int J Infect Dis

April 2024

University College London, Center for Clinical Microbiology, Division of Infection and Immunity, and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK.

Tuberculosis (TB) remains a leading cause of death worldwide and is estimated to have caused 1.3 million deaths worldwide in 2022. Approximately one quarter of the world's population are infected with Mycobacterium tuberculosis, of whom up to 10% will progress to developing active TB disease.

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Protein-level immunodominance patterns against Kaposi sarcoma-associated herpesvirus (KSHV), the aetiologic agent of Kaposi sarcoma (KS), have been revealed from serological probing of whole protein arrays, however, the epitopes that underlie these patterns have not been defined. We recently demonstrated the utility of phage display in high-resolution linear epitope mapping of the KSHV latency-associated nuclear antigen (LANA/ORF73). Here, a VirScan phage immunoprecipitation and sequencing approach, employing a library of 1,988 KSHV proteome-derived peptides, was used to quantify the breadth and magnitude of responses of 59 sub-Saharan African KS patients and 22 KSHV-infected asymptomatic individuals (ASY), and ultimately to support an application of machine-learning-based predictive modeling using the peptide-level responses.

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Introduction: The HPTN071 (PopART) for Youth (P-ART-Y) study evaluated the acceptability and uptake of a community-level combination HIV prevention package including universal testing and treatment (UTT) among young people in Zambia and South Africa. We determined whether a four-question primary care level screening tool, validated for use in clinical settings, could enhance community (door-to-door) identification of undiagnosed HIV-positive younger adolescents (aged 10-14) who are frequently left out of HIV interventions.

Method: Community HIV-care Providers (CHiPs) contacted and consented adolescents in their homes and offered them participation in the PopART intervention.

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Postpartum depression (PPD) affects nearly 20% of postpartum women in Sub-Saharan Africa (SSA), where HIV prevalence is high. Depression is associated with worse HIV outcomes in non-pregnant adults and mental health disorders may worsen HIV outcomes for postpartum women and their infants. PPD is effectively treated with psychosocial or pharmacologic interventions; however, few studies have evaluated the acceptability of treatment modalities in SSA.

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Background: Human immunodeficiency virus 1 (HIV-1) tissue reservoirs remain the main obstacle against an HIV cure. Limited information exists regarding cannabis's effects on HIV-1 infections in vivo, and the impact of cannabis use on HIV-1 parenchymal tissue reservoirs is unexplored.

Methods: To investigate whether cannabis use alters HIV-1 tissue reservoirs, we systematically collected 21 postmortem brain and peripheral tissues from 20 men with subtype C HIV-1 and with suppressed viral load enrolled in Zambia, 10 of whom tested positive for cannabis use.

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Introduction: Helicobacter pylori (H. pylori) is one of the most important infections globally, affecting more than 50% of the human population. Clarithromycin (CLA)-containing regimens are recommended for empirical eradication of H.

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Environmental enteric dysfunction (EED) is a diffuse small bowel disorder associated with poor growth, inadequate responses to oral vaccines, and nutrient malabsorption in millions of children worldwide. We identify loss of the small intestinal Paneth and goblet cells that are critical for innate immunity, reduced villous height, increased bile acids, and dysregulated nicotinamide adenine dinucleotide (NAD) synthesis signaling as potential mechanisms underlying EED and which also correlated with diminished length-for-age score. Isocaloric low-protein diet (LPD) consumption in mice recapitulated EED histopathology and transcriptomic changes in a microbiota-independent manner, as well as increases in serum and fecal bile acids.

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Comorbidity in the multiple sclerosis and neuromyelitis optica spectrum disorders population: findings from an underserved, low income country, Zambia.

Mult Scler Relat Disord

January 2024

University Teaching Hospital, University of Zambia School of Medicine, Lusaka, Zambia; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address:

Article Synopsis
  • Comorbidities are frequent in patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD), but there is limited data, especially in low-income regions like Zambia.
  • A study analyzed comorbidities among 33 patients (17 with MS and 16 with NMOSD), finding that 46% had at least one comorbidity, with higher rates in MS patients compared to NMOSD.
  • The results revealed that over 40% of MS/NMOSD patients had physical comorbidities, and the odds of physical comorbidity were significantly higher in MS patients compared to those with NMOSD.
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Background: Seizures are relatively common among children with HIV in low- and middle-income countries and are associated with significant morbidity and mortality. Early treatment with antiretroviral therapy (ART) may reduce this risk by decreasing rates of central nervous system infections and HIV encephalopathy.

Methods: We conducted a prospective, unmatched case-control study.

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Objective: To evaluate the accuracy of two portable ultrasound machines (PUM) in assessing fetal biometry and estimated gestational age (EGA).

Methods: This was a secondary analysis of data from the Fetal Age Machine Learning Initiative, an observational study of pregnant women in the USA and Zambia. Each participant underwent ultrasound assessment by an experienced sonographer using both a high-specification ultrasound machine (HSUM) and a PUM (Butterfly iQ or Clarius C3) to measure fetal biometry and calculate EGA at each visit.

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Protein status in relation to linear growth faltering and environmental enteropathy.

Curr Opin Clin Nutr Metab Care

January 2024

Tropical Gastroenterology and Nutrition Group, University of Zambia School of Medicine, Lusaka, Zambia.

Purpose Of Review: Children with linear growth faltering refractory to nutritional management show evidence of environmental enteropathy, which may compromise nutrient availability. Protein could be particularly affected, due to the possibility of sub-optimal digestibility and/or increase in requirement for immune response. This increase in protein requirement along with poor intake could potentially lead to increased breakdown of body protein sources and in turn a depleted protein state.

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Article Synopsis
  • * Severe wasting in SAM patients negatively impacts cytokine secretion, and children with HIV exhibit even lower monocyte activation rates, particularly among younger children.
  • * The altered immune function observed in SAM patients may prioritize bacterial containment over proinflammatory responses, leading to ongoing health risks and increased mortality after discharge.
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