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Insights Into The Availability And Distribution Of Oral Artemisinin Monotherapy In Myanmar: Evidence From A Nationally Representative Outlet Survey., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, ACTwatch Group, Si Thu Thein, Hnin Su Su Khin, Aung Thi 2017 ACTwatch Group

Insights Into The Availability And Distribution Of Oral Artemisinin Monotherapy In Myanmar: Evidence From A Nationally Representative Outlet Survey., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Si Thu Thein, Hnin Su Su Khin, Aung Thi

Collected Faculty and Staff Scholarship

BACKGROUND: The containment of artemisinin resistance in Myanmar, historically an important probable origin and route of anti-malarial resistance to the India sub-continent and beyond, is crucial to global malaria control and elimination. This paper describes what is currently known about the sale and distribution of oral artemisinin monotherapy (AMT) across Myanmar, where this medicine is commonly found.

METHODS: A nationally representative 2015 outlet survey was conducted in the private sector, and among community health workers across four geographical domains. A national sample of outlets was screened for availability of malaria testing and treatment, and an audit was completed for all ...


Evidence On Anti-Malarial And Diagnostic Markets In Cambodia To Guide Malaria Elimination Strategies And Policies, Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, ACTwatch Group, Sochea Phok, Dysoley Lek 2017 ACTwatch Group

Evidence On Anti-Malarial And Diagnostic Markets In Cambodia To Guide Malaria Elimination Strategies And Policies, Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Sochea Phok, Dysoley Lek

Collected Faculty and Staff Scholarship

BACKGROUND: Understanding Cambodia's anti-malarial and diagnostic landscape in 2015 is critical for informing and monitoring strategies and policies as Cambodia moves forward with national efforts to eliminate malaria. The aim of this paper is to present timely and key findings on the public and private sector anti-malarial and diagnostic landscape in Cambodia. This evidence can serve as a baseline benchmark for guiding implementation of national strategies as well as other regional initiatives to address malaria elimination activities.

METHODS: From August 17th to October 1st, 2015, a cross sectional, nationally-representative malaria outlet survey was conducted in Cambodia. A census of ...


Anti-Malarial Landscape In Myanmar: Results From A Nationally Representative Survey Among Community Health Workers And The Private Sector Outlets In 2015/2016., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, ACTwatch Group, Si Thu Thein, Hnin Su Su Khin, Aung Thi 2017 ACTwatch Group

Anti-Malarial Landscape In Myanmar: Results From A Nationally Representative Survey Among Community Health Workers And The Private Sector Outlets In 2015/2016., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Si Thu Thein, Hnin Su Su Khin, Aung Thi

Collected Faculty and Staff Scholarship

BACKGROUND: In 2015/2016, an ACTwatch outlet survey was implemented to assess the anti-malarial and malaria testing landscape in Myanmar across four domains (Eastern, Central, Coastal, Western regions). Indicators provide an important benchmark to guide Myanmar's new National Strategic Plan to eliminate malaria by 2030.

METHODS: This was a cross-sectional survey, which employed stratified cluster-random sampling across four regions in Myanmar. A census of community health workers (CHWs) and private outlets with potential to distribute malaria testing and/or treatment was conducted. An audit was completed for all anti-malarials, malaria rapid diagnostic tests.

RESULTS: A total of 28,664 ...


What Happened To Anti-Malarial Markets After The Affordable Medicines Facility-Malaria Pilot? Trends In Act Availability, Price And Market Share From Five African Countries Under Continuation Of The Private Sector Co-Payment Mechanism., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, ACTwatch Group, Sarah Tougher, Kara Hanson, Catherine Goodman 2017 ACTwatch Group

What Happened To Anti-Malarial Markets After The Affordable Medicines Facility-Malaria Pilot? Trends In Act Availability, Price And Market Share From Five African Countries Under Continuation Of The Private Sector Co-Payment Mechanism., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Sarah Tougher, Kara Hanson, Catherine Goodman

Collected Faculty and Staff Scholarship

BACKGROUND: The private sector supplies anti-malarial treatment for large proportions of patients in sub-Saharan Africa. Following the large-scale piloting of the Affordable Medicines Facility-malaria (AMFm) from 2010 to 2011, a private sector co-payment mechanism (CPM) provided continuation of private sector subsidies for quality-assured artemisinin combination therapies (QAACT). This article analyses for the first time the extent to which improvements in private sector QAACT supply and distribution observed during the AMFm were maintained or intensified during continuation of the CPM through 2015 in Kenya, Madagascar, Nigeria, Tanzania and Uganda using repeat cross-sectional outlet survey data.

RESULTS: QAACT market share in all ...


Ticked Off: An Analysis Of The Inadequate Diagnosis And Treatment Of Lyme Disease, Virginia P. Yoder 2017 Liberty University

Ticked Off: An Analysis Of The Inadequate Diagnosis And Treatment Of Lyme Disease, Virginia P. Yoder

Senior Honors Theses

Lyme disease is the most common vector-borne disease in the United States and has a high prevalence among people in the northeast. Lyme disease can be a debilitating illness if not diagnosed early, and can lead to long-term health problems for many patients. This thesis serves as a review of scientific literature on Lyme disease, with the prevalence, symptomology, the bacterial mechanism of infection, the diagnostic process, transmission, and treatment therapies. Further research and development could lead to better primary care for those suffering with Lyme disease.


The Malaria Testing And Treatment Landscape In Mainland Tanzania, 2016., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, ACTwatch Group, Daniel Michael, Sigsbert Patila Mkunde 2017 ACTwatch Group

The Malaria Testing And Treatment Landscape In Mainland Tanzania, 2016., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Daniel Michael, Sigsbert Patila Mkunde

Collected Faculty and Staff Scholarship

BACKGROUND: Understanding the key characteristics of malaria testing and treatment is essential to the control of a disease that continues to pose a major risk of morbidity and mortality in mainland Tanzania, with evidence of a resurgence of the disease in recent years. The introduction of artemisinin combination therapy (ACT) as the first-line treatment for malaria, alongside policies to promote rational case management following testing, highlights the need for evidence of anti-malarial and testing markets in the country. The results of the most recent mainland Tanzania ACTwatch outlet survey are presented here, including data on the availability, market share and ...


Development Of An Interleukin-4-Inducing Principle From Schistosoma Mansoni Eggs (Ipse)-Specific Pcr Assay As A Quantitative Predictor Of Schistosomiasis-Associated Morbidity, Dannah Farah, Evaristis Mbanefo, Michael H. Hsieh 2017 George Washington University

Development Of An Interleukin-4-Inducing Principle From Schistosoma Mansoni Eggs (Ipse)-Specific Pcr Assay As A Quantitative Predictor Of Schistosomiasis-Associated Morbidity, Dannah Farah, Evaristis Mbanefo, Michael H. Hsieh

GW Research Days 2016 - Present

Schistosomiasis is a neglected tropical disease affecting between 200-500 million people worldwide. The two species causing most human cases of schistosomiasis are Schistosoma mansoni and Schistosoma haematobium. The gold standard for diagnosis is parasitological detection of parasite eggs in stool using the Kato-Katz method. Counting eggs shed in stool is labor-intensive and inaccurate. Interleukin-4- inducing principle from Schistosoma mansoni eggs (IPSE) is the most abundant secreted protein from schistosome eggs. We hypothesized that the mRNA transcripts of the IPSE protein may be found in the liver tissue and stool of experimentally infected animals, and that these transcripts can be specifically ...


Quality Of Water In Relation To Diarrheal Disease Incidence In Obunga, Tianna Herman 2017 SIT Study Abroad

Quality Of Water In Relation To Diarrheal Disease Incidence In Obunga, Tianna Herman

Independent Study Project (ISP) Collection

Kenyan cities are experiencing a serious dilemma in dealing with the large influx of people from rural parts of the country to the cities. Most people come to the city in pursuit of better opportunities and jobs. Rapid urban growth with little planning and preparation by the national and county governments has led to the development of informal settlements. These informal settlements are characterized by poor environmental conditions that predispose their residents for poor health conditions. Because of their illegal status, most residents of informal settlements in Kenya do not receive government services such as water, drainage, sewerage, and rubbish ...


Dynamic Transcriptomes Identify Biogenic Amines And Insect-Like Hormonal Regulation For Mediating Reproduction In Schistosoma Japonicum., Jipeng Wang, Ying Yu, Haimo Shen, Tao Qing, Yuanting Zheng, Qing Li, Xiaojin Mo, Shuqi Wang, Nana Li, Riyi Chai, Bin Xu, Mu Liu, Paul J Brindley, Donald P McManus, Zheng Feng, Leming Shi, Wei Hu 2017 George Washington University

Dynamic Transcriptomes Identify Biogenic Amines And Insect-Like Hormonal Regulation For Mediating Reproduction In Schistosoma Japonicum., Jipeng Wang, Ying Yu, Haimo Shen, Tao Qing, Yuanting Zheng, Qing Li, Xiaojin Mo, Shuqi Wang, Nana Li, Riyi Chai, Bin Xu, Mu Liu, Paul J Brindley, Donald P Mcmanus, Zheng Feng, Leming Shi, Wei Hu

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Eggs produced by the mature female parasite are responsible for the pathogenesis and transmission of schistosomiasis. Female schistosomes rely on a unique male-induced strategy to accomplish reproductive development, a process that is incompletely understood. Here we map detailed transcriptomic profiles of male and female Schistosoma japonicum across eight time points throughout the sexual developmental process from pairing to maturation. The dynamic gene expression pattern data reveal clear sex-related characteristics, indicative of an unambiguous functional division between males and females during their interplay. Cluster analysis, in situ hybridization and RNAi assays indicate that males likely use biogenic amine neurotransmitters through the ...


Copyright And The Use Of Images As Biodiversity Data [Forum Paper], Willi Egloff, Donat Agosti, Puneet Kishor, David J. Patterson, Jeremy A. Miller 2017 Plazi

Copyright And The Use Of Images As Biodiversity Data [Forum Paper], Willi Egloff, Donat Agosti, Puneet Kishor, David J. Patterson, Jeremy A. Miller

Concepts in Animal Parasitology Textbook

Taxonomy is the discipline responsible for charting the world’s organismic diversity, understanding ancestor/descendant relationships, and organizing all species according to a unified taxonomic classification system. Taxonomists document the attributes (characters) of organisms, with emphasis on those can be used to distinguish species from each other. Character information is compiled in the scientific literature as text, tables, and images. The information is presented according to conventions that vary among taxonomic domains; such conventions facilitate comparison among similar species, even when descriptions are published by different authors.

There is considerable uncertainty within the taxonomic community as to how to re-use ...


Screening Of Tnfalpha, Il-10 And Tlr4 Single Nucleotide Polymorphisms In Individuals With Asymptomatic And Chronic Cutaneous Leishmaniasis In Colombia: A Pilot Study, Angelica Mera-Ramirez, Andres Castillo, Yenifer Orobio, Maria Adelaida. Gomez, Carolina Gallego-Marin 2017 Centro Internacional de Entrenamiento e Investigaciones Médicas-CIDEIM, Columbia

Screening Of Tnfalpha, Il-10 And Tlr4 Single Nucleotide Polymorphisms In Individuals With Asymptomatic And Chronic Cutaneous Leishmaniasis In Colombia: A Pilot Study, Angelica Mera-Ramirez, Andres Castillo, Yenifer Orobio, Maria Adelaida. Gomez, Carolina Gallego-Marin

Open Access Articles

BACKGROUND: Clinical manifestations of cutaneous leishmaniasis (CL) caused by Leishmania (Viannia) range from asymptomatic infection to self-limited, or chronic (non-healing) cutaneous lesions. Given the critical role of the immune response in the clinical outcome of CL, it is plausible that functional polymorphisms in immune-related genes contribute to define the clinical manifestations of human infection.

METHODS: DNA samples from a retrospective cohort of individuals from an endemic area of L. V. panamensis transmission in Colombia were used to determine the frequency of SNPs in TNFalpha, IL-10 and TLR4 genes. DNA samples were obtained from 74 adult participants: 38 patients presenting chronic ...


The Malaria Testing And Treatment Market In Kinshasa, Democratic Republic Of The Congo, 2013, Angela Alum, Andrew Andrada, Julie Archer, Erik Auko, Katie Bates, Paul Bouanchaud, Meghan Bruce, Angela Camilleri, Emily Carter, Steven Chapman, Nikki Charman, Desmond Chavasse, Kevin Duff, Keith Esch, Anna Fulton, Illah Evance, Anna Fulton, Helen Gataaka, Tarryn Haslam, Emily Harris, Catherine A. Hurley, Beth Kangwana, Esther Kabui, Gloria Kigo, Aliza Lailari, Megan Littrell, Erik Munroe Julius Ngigi, Kathryn A. O'Connell, Ricki Orford, Carolyne Ochieng, Linda Ongwenyi, Stephen Poyer, Justin Rahariniaina, Lanto Razafindralambo, Christina Riley, John Rodgers, Tanya Shewchuk, Julianna Smith, Tsione Solomon, Raymond Sudoi, Martine Esther Tassiba, Katherine Thanel, Andria Rusk, Rachel Thompson, Mitsuru Toda, Marie-Alix Valensi, Vamsi Vasireddy, Cynthia Whitman, Godéfroid Mpanya, Antoinette Tshefu, Joris Losimba Likwela 2017 ACTwatch Group

The Malaria Testing And Treatment Market In Kinshasa, Democratic Republic Of The Congo, 2013, Angela Alum, Andrew Andrada, Julie Archer, Erik Auko, Katie Bates, Paul Bouanchaud, Meghan Bruce, Angela Camilleri, Emily Carter, Steven Chapman, Nikki Charman, Desmond Chavasse, Kevin Duff, Keith Esch, Anna Fulton, Illah Evance, Anna Fulton, Helen Gataaka, Tarryn Haslam, Emily Harris, Catherine A. Hurley, Beth Kangwana, Esther Kabui, Gloria Kigo, Aliza Lailari, Megan Littrell, Erik Munroe Julius Ngigi, Kathryn A. O'Connell, Ricki Orford, Carolyne Ochieng, Linda Ongwenyi, Stephen Poyer, Justin Rahariniaina, Lanto Razafindralambo, Christina Riley, John Rodgers, Tanya Shewchuk, Julianna Smith, Tsione Solomon, Raymond Sudoi, Martine Esther Tassiba, Katherine Thanel, Andria Rusk, Rachel Thompson, Mitsuru Toda, Marie-Alix Valensi, Vamsi Vasireddy, Cynthia Whitman, Godéfroid Mpanya, Antoinette Tshefu, Joris Losimba Likwela

Collected Faculty and Staff Scholarship

Background

The Democratic Republic of Congo (DRC) is one of the two most leading contributors to the global burden of disease due to malaria. This paper describes the malaria testing and treatment market in the nation’s capital province of Kinshasa, including availability of malaria testing and treatment and relative anti-malarial market share for the public and private sector.

Methods

A malaria medicine outlet survey was conducted in Kinshasa province in 2013. Stratified multi-staged sampling was used to select areas for the survey. Within sampled areas, all outlets with the potential to sell or distribute anti-malarials in the public and ...


Elevated Prevalence Of Helicobacter Species And Virulence Factors In Opisthorchiasis And Associated Hepatobiliary Disease., Raksawan Deenonpoe, Eimorn Mairiang, Pisaln Mairiang, Chawalit Pairojkul, Yaovalux Chamgramol, Gabriel Rinaldi, Alex Loukas, Paul J. Brindley, Banchob Sripa 2017 George Washington University

Elevated Prevalence Of Helicobacter Species And Virulence Factors In Opisthorchiasis And Associated Hepatobiliary Disease., Raksawan Deenonpoe, Eimorn Mairiang, Pisaln Mairiang, Chawalit Pairojkul, Yaovalux Chamgramol, Gabriel Rinaldi, Alex Loukas, Paul J. Brindley, Banchob Sripa

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Recent reports suggest that Opisthorchis viverrini serves as a reservoir of Helicobacter and implicate Helicobacter in pathogenesis of opisthorchiasis-associated cholangiocarcinoma (CCA). Here, 553 age-sex matched cases and controls, 293 and 260 positive and negative for liver fluke O. viverrini eggs, of residents in Northeastern Thailand were investigated for associations among infection with liver fluke, Helicobacter and hepatobiliary fibrosis. The prevalence of H. pylori infection was higher in O. viverrini-infected than uninfected participants. H. pylori bacterial load correlated positively with intensity of O. viverrini infection, and participants with opisthorchiasis exhibited higher frequency of virulent cagA-positive H. pylori than those free of ...


Advances In Neglected Tropical Disease Vaccines: Developing Relative Potency And Functional Assays For The Na-Gst-1/Alhydrogel Hookworm Vaccine., Jill B. Brelsford, Jordan L Plieskatt, Anna Yakovleva, Amar Jariwala, Brian P Keegan, Jin Peng, Pengjun Xia, Guangzhao Li, Doreen Campbell, Maria Victoria Periago, Rodrigo Correa-Oliveira, Maria Elena Bottazzi, Peter J. Hotez, David Diemert, Jeffrey M. Bethony 2017 George Washington University

Advances In Neglected Tropical Disease Vaccines: Developing Relative Potency And Functional Assays For The Na-Gst-1/Alhydrogel Hookworm Vaccine., Jill B. Brelsford, Jordan L Plieskatt, Anna Yakovleva, Amar Jariwala, Brian P Keegan, Jin Peng, Pengjun Xia, Guangzhao Li, Doreen Campbell, Maria Victoria Periago, Rodrigo Correa-Oliveira, Maria Elena Bottazzi, Peter J. Hotez, David Diemert, Jeffrey M. Bethony

Microbiology, Immunology, and Tropical Medicine Faculty Publications

A new generation of vaccines for the neglected tropical diseases (NTDs) have now advanced into clinical development, with the Na-GST-1/Alhydrogel Hookworm Vaccine already being tested in Phase 1 studies in healthy adults. The current manuscript focuses on the often overlooked critical aspects of NTD vaccine product development, more specifically, vaccine stability testing programs. A key measure of vaccine stability testing is "relative potency" or the immunogenicity of the vaccine during storage. As with most NTD vaccines, the Na-GST-1/Alhydrogel Hookworm Vaccine was not developed by attenuation or inactivation of the pathogen (Necator americanus), so conventional methods for measuring relative ...


Parasite Infection, Carcinogenesis And Human Malignancy., Hoang van Tong, Paul J. Brindley, Christian G Meyer, Thirumalaisamy P Velavan 2017 George Washington University

Parasite Infection, Carcinogenesis And Human Malignancy., Hoang Van Tong, Paul J. Brindley, Christian G Meyer, Thirumalaisamy P Velavan

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Cancer may be induced by many environmental and physiological conditions. Infections with viruses, bacteria and parasites have been recognized for years to be associated with human carcinogenicity. Here we review current concepts of carcinogenicity and its associations with parasitic infections. The helminth diseases schistosomiasis, opisthorchiasis, and clonorchiasis are highly carcinogenic while the protozoan Trypanosoma cruzi, the causing agent of Chagas disease, has a dual role in the development of cancer, including both carcinogenic and anticancer properties. Although malaria per se does not appear to be causative in carcinogenesis, it is strongly associated with the occurrence of endemic Burkitt lymphoma in ...


A Comparison Of The Quality Of Informed Consent For Clinical Trials Of An Experimental Hookworm Vaccine Conducted In Developed And Developing Countries., David J. Diemert, Lucas Lobato, Ashley Styczynski, Maria Zumer, Amanda Soares, Maria Flávia Gazzinelli 2017 George Washington University

A Comparison Of The Quality Of Informed Consent For Clinical Trials Of An Experimental Hookworm Vaccine Conducted In Developed And Developing Countries., David J. Diemert, Lucas Lobato, Ashley Styczynski, Maria Zumer, Amanda Soares, Maria Flávia Gazzinelli

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Informed consent is one of the principal ethical requirements of conducting clinical research, regardless of the study setting. Breaches in the quality of the informed consent process are frequently described in reference to clinical trials conducted in developing countries, due to low levels of formal education, a lack of familiarity with biomedical research, and limited access to health services in these countries. However, few studies have directly compared the quality of the informed consent process in developed and developing countries using the same tool and in similar clinical trials. This study was conducted to compare the quality of the informed ...


Identification Of Candidate Infection Genes From The Model Entomopathogenic Nematode Heterorhabditis Bacteriophora., Jonathan Vadnal, Ramesh Ratnappan, Melissa Keaney, Eric Kenney, Ioannis Eleftherianos, Damien O'Halloran, John M. Hawdon 2017 George Washington University

Identification Of Candidate Infection Genes From The Model Entomopathogenic Nematode Heterorhabditis Bacteriophora., Jonathan Vadnal, Ramesh Ratnappan, Melissa Keaney, Eric Kenney, Ioannis Eleftherianos, Damien O'Halloran, John M. Hawdon

Microbiology, Immunology, and Tropical Medicine Faculty Publications

BACKGROUND: Despite important progress in the field of innate immunity, our understanding of host immune responses to parasitic nematode infections lags behind that of responses to microbes. A limiting factor has been the obligate requirement for a vertebrate host which has hindered investigation of the parasitic nematode infective process. The nematode parasite Heterorhabditis bacteriophora offers great potential as a model to genetically dissect the process of infection. With its mutualistic Photorhabdus luminescens bacteria, H. bacteriophora invades multiple species of insects, which it kills and exploits as a food source for the development of several nematode generations. The ability to culture ...


Education On Tick Bites, Tick Borne Disease, And Prevention In Middlebury, Vt, Florence DiBiase 2017 University of Vermont

Education On Tick Bites, Tick Borne Disease, And Prevention In Middlebury, Vt, Florence Dibiase

Family Medicine Clerkship Student Projects

Tick borne disease and tick encounters are continuing to increase significantly in Vermont, and represent a significant portion of primary and urgent care visits. In order to spread awareness and educate both providers and patients as to the incidence, symptoms, treatment, and prevention of tick borne diseases, an informational guide was made. This guide includes information for providers including up to date statistics, a tick identification and life cycle guide, and a chart explaining symptoms, lab findings, diagnosis, and treatment of the diseases found in Vermont. It also includes a patient education handout with a cut out identification card. This ...


Guatemala : Chagas Disease, Audrey Datzman 2017 Augustana College, Rock Island Illinois

Guatemala : Chagas Disease, Audrey Datzman

Global Public Health

Chagas disease is a parasitic and vector-borne endemic prevalent across Latin American countries, particularly Guatemala. The parasite, Trypanosoma cruzi, is spread through triatomine insect vectors often found in low-income housing. Already claiming twelve-thousand deaths in 2016, Guatemala faces a major challenge in attempting to eliminate the triatomine vectors of Chagas disease. Various interventions have been undertaken in the country, including insecticide-based control and community-based vector surveillance.


"Beaver Fever" - Giardiasis In Vermont, Anthony Sassi 2017 University of Vermont

"Beaver Fever" - Giardiasis In Vermont, Anthony Sassi

Family Medicine Clerkship Student Projects

“Beaver Fever,” or Giardiasis, is caused by a single-celled parasite called Giardia intestinalis. According to the most recent reports by the CDC, Vermont consistently has the highest rate of Giardia infection in the nation. Since the risk of infection for Vermonters is so high, it is important for both patients and providers to understand the transmission, symptoms, and treatment of this very common disease.


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