Diseases Commons^™

Inferior St-Elevation Myocardial Infarction Presenting When Urgent Primary Percutaneous Coronary Intervention Is Unavailable: Should We Adhere To Current Guidelines?, Yochai Birnbaum, Glenn N Levine, John French, Juan Carlos Kaski, Dan Atar, Mahboob Alam, David Hasdai, Hani Jneid, Barry F Uretsky

Faculty, Staff and Students Publications

The pivotal studies that led to the recommendations for emergent reperfusion therapy for ST-elevation myocardial infarction (STEMI) were conducted for the most part over 25 years ago. At that time, contemporary standard treatments including aspirin, statin, and even anticoagulation were not commonly used. The 2013 American College of Cardiology Foundation (ACCF)/American Heart Association (AHA) guidelines and the 2017 European Society of Cardiology guidelines give a class I recommendation (with the level of evidence A) for primary percutaneous coronary intervention (pPCI) in patients with STEMI and ischemic symptoms of less than 12 h. However, if the patient presents to a hospital …

Spinal Cord Injury Provider Knowledge And Attitudes Toward Bacteriuria Management And Antibiotic Stewardship, Felicia Skelton, Sarah May, Larissa Grigoryan, Ivy Poon, Sally Ann Holmes, Lindsey Martin, Barbara W Trautner

Faculty, Staff and Students Publications

INTRODUCTION: Bacteriuria, either asymptomatic or urinary tract infection, is common in persons with spinal cord injury or disorder (SCI/D). In the Veterans Health Administration (VHA), conflicting clinical practice guidelines make appropriate bacteriuria management and antibiotic stewardship challenging.

OBJECTIVE: To explore SCI/D provider knowledge, attitudes, and teamwork around bacteriuria management during the VHA SCI/D annual examination.

DESIGN: Mixed methods.

SETTING: VHA SCI/D centers.

PARTICIPANTS: SCI/D staff providers and physical medicine and rehabilitation resident physicians.

MAIN OUTCOME MEASUREMENTS: Knowledge, safety, and teamwork scores on bacteriuria management using a validated questionnaire. Themes on barriers and facilitators to bacteriuria management during the SCI/D annual …

Stat1 Dissociates Adipose Tissue Inflammation From Insulin Sensitivity In Obesity, Aaron R Cox, Natasha Chernis, David A Bader, Pradip K Saha, Peter M Masschelin, Jessica B Felix, Robert Sharp, Zeqin Lian, Vasanta Putluri, Kimal Rajapakshe, Kang Ho Kim, Dennis T Villareal, Reina Armamento-Villareal, Huaizhu Wu, Cristian Coarfa, Nagireddy Putluri, Sean M Hartig

Faculty, Staff and Students Publications

Obesity fosters low-grade inflammation in white adipose tissue (WAT) that may contribute to the insulin resistance that characterizes type 2 diabetes. However, the causal relationship of these events remains unclear. The established dominance of STAT1 function in the immune response suggests an obligate link between inflammation and the comorbidities of obesity. To this end, we sought to determine how STAT1 activity in white adipocytes affects insulin sensitivity. STAT1 expression in WAT inversely correlated with fasting plasma glucose in both obese mice and humans. Metabolomic and gene expression profiling established STAT1 deletion in adipocytes (STAT1a-KO) enhanced mitochondrial function …

A Functional Three-Dimensional Microphysiological Model Of Myeloma Bone Disease, Richard Visconti

Seton Hall University Dissertations and Theses (ETDs)

Multiple myeloma (MM) is a hematologic cancer caused by a mature B cell neoplasm, or plasmacytoma, that infiltrates the skeleton at several sites. The disease is characterized by uninhibited transformed plasma cell proliferation that disrupts skeletal homeostasis leading to decreased bone modeling and increased bone resorption. Osteolytic lesions (OL) or voids left in the bone, remain long after the treatment of the cancer and indicate disease progression to myeloma bone disease (MBD). Current combinatorial MM therapies inhibit malignant plasma cell proliferation, slow the progression towards MBD, and increase the mean five-year survival rate, but do little to improve osteoblastic function …

Change In The Spectrum Of Orthopedic Trauma: Effects Of Covid-19 Pandemic In A Developing Nation During The Upsurge; A Cross-Sectional Study, Pervaiz Mahmood Hashmi, Marij Zahid, Syed Arif Ali, Hammad Naqi Khan, Anum Sadruddin Pidani, Alizah Pervaiz Hashmi, Shahryar Noordin

Section of Orthopaedic Surgery

Background: The COVID-19 pandemic has caused a great impact on orthopedic surgery with a significant curtailment in elective surgeries which is the major bread and butter for orthopedic surgeons. It was also observed that the spectrum of orthopedic trauma injuries has shifted from more severe and frequent road traffic accidents (high energy trauma) to general, low energy house-hold injuries like low energy fractures in the elderly, pediatric fractures, house-hold sharp cut injuries and nail bed lacerations. The aim of this study is to appraise the effect of the COVID-19 pandemic on orthopedic surgical practice, both inpatient and outpatient facility.
Materials …

A Collaborative Effort To Establish A Convalescent Plasma Program In South Florida, Roberto L. Roman Laporte, Edwina Brathwaite

Nursing & Health Sciences Research Journal

On March 11, 2020, Miami-Dade County had its first diagnosed case of COVID-19 and quickly became the top hotspot of COVID-19 cases in Florida. Hospitals were challenged to find effective treatments to combat the virus. A collaborative effort between Doctors Hospital and Boca Raton Regional Hospital established a robust convalescent plasma program for critically ill patients diagnosed with COVID-19 within Baptist Health South Florida.

A Drive-Thru Anticoagulation Testing Clinic During Covid-19 Pandemic, Tina Hyman, Nohemi Sadule Rios, Robert P. Ramirez

Nursing & Health Sciences Research Journal

As COVID-19 started to spread rapidly in their community, a team of nurses at South Miami Hospital initiated a drive-thru anticoagulation testing process to provide safe access to care for patients on anticoagulation therapy, requiring Internationalized Ratio (INR) testing. This article describes the implementation of a drive-thru anticoagulation testing process and implications for best practices during a pandemic crisis.

Efficacy Of The Nutritional Supplement, Evenflo, In The Management Of Sickle Cell Disease: A Randomized Controlled Trial, Richard Muga, Arthur Ajwang, James Ouma, Josephine Ojigo, Juliana Otieno, Peter Okoth, Caroline Wafula, Sophia Ajwang, David Ogolla, Abraham Hollist, James Adefisoye

Nursing & Health Sciences Research Journal

Background: In this study, we investigated if a combination of the nutraceutical supplement, EvenFlo and folic acid will be superior to the standard stand-alone use of folic acid.

Methods: We conducted a randomized double-blind, active-controlled, clinical trial. A total of 70 subjects with SCD ages 5-12 years were enrolled into the study with 35 in the intervention group and 35 in the control group; 61 completed the trial (32 from the intervention group and 29 from the control group).

Results: Participants in the intervention group were significantly less likely to experience crises compared to subjects in the control group. None …

A Healthcare Organization’S Response To Challenges During A Pandemic, Debora O'Cathey, Judy Bowling

Nursing & Health Sciences Research Journal

The pandemic of 2020 has added many new challenges for healthcare organizations. Front-line nurses have borne the brunt of these challenges and were tested as never before to deliver excellent patient care during such arduous time. This story details the efforts of one hospital to rise above the chaos and overcome the challenges presented during this time.

The Outstanding Service Of A Nurse Supervisor During Covid-19, Judy Bowling

Nursing & Health Sciences Research Journal

Nurses are heroes but are often hesitant to use this title. Nurses stand at the center of the public health crises with the coronavirus pandemic, demonstrating courage, bravery, knowledge, and commitment, often putting themselves in harms’ way while caring for and guarding their patients. Nurses respond to the call to care at every level, from the direct care nurses in hospitals to board members shaping national policies. One special category of nurses on the front line, administrative nursing supervisors, are experienced and dedicated nurses who exemplify the finest characteristics of nurses. This article relates the exploits of one nursing supervisor …

Hyperpolarized Carbon-13 Magnetic Resonance Measurements Of Tissue Perfusion And Metabolism, Keith Michel

Dissertations and Theses (Open Access)

Hyperpolarized Magnetic Resonance Imaging (HP MRI) is an emerging modality that enables non-invasive interrogation of cells and tissues with unprecedented biochemical detail. This technology provides rapid imaging measurements of the activity of a small quantity of molecules with a strongly polarized nuclear magnetic moment. This polarization is created in a polarizer separate from the imaging magnet, and decays continuously towards a non-detectable thermal equilibrium once the imaging agent is removed from the polarizer and administered by intravenous injection. Specialized imaging strategies are therefore needed to extract as much information as possible from the HP signal during its limited lifetime.

In …

A Context-Forward In Vivo Functional Genomics Platform For Target Discovery And Establishing Vulnerability Context In Pancreatic Cancer, Johnathon Rose, Johnathon Lynn Rose

Dissertations and Theses (Open Access)

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy with a very poor patient prognosis (5-year survival of ≤ 7%). While transcriptional profiling has aided in the classification of this disease into at least two broader subtypes, this alone has so far been insufficient to inform on more nuanced patterns of oncogenic dependency. We hypothesized that a more comprehensive and granular characterization of PDAC disease diversity is required to establish relevant context for targeted therapy. To this end, we sought to establish an integrated platform to: i) more comprehensively characterize differential oncogenic signaling across our tumor models, and ii) establish …

Nuclear-Targeted Gold Nanoparticles Enhance The Effects Of Radiation Therapy With And Without Liposomal Delivery, Maureen Aliru

Dissertations and Theses (Open Access)

Less that 10% of pancreatic cancer patients are eligible for curative resection, and clinical trials evaluating chemoradiation in locally advanced patients with unresectable disease have been largely disappointing. New and creative therapeutic approaches are needed to address the unment need for treatment options. The objective of this thesis is to advance radiosensitization of treatment-resistant densely desmoplastic pancreatic cancer using nanoparticles to surmount biological barriers to effective particle distribution for DNA-targeting.

Clinical translation of radiosensitizing nanoparticles has stalled owing to technical challenges. Current strategies to use AuNPs for radiosensitization require large quantities of gold, kilovoltage x-rays, immediate irradiation after intravenous administration, …

Great Expectations: Phosph(On)Ate Prodrugs In Drug Design—Opportunities And Limitations, Victoria Yan

Dissertations and Theses (Open Access)

Phosphate and phosphonates are chemical moieties with historical precedence in anticancer and antiviral nucleotide analogues. Synchronous to modern efforts identifying novel therapeutic targets in cancer, such chemical moieties are being investigated in the design of novel inhibitors with antineoplastic potential. A central challenge to the delivery of phosph(on)ate-containing drugs is their anionic character at physiological pH, which portends poor membrane permeability. This limitation has been successfully overcome through the use of prodrugs. When attached to the phosph(on)ate moiety, prodrugs mask the negative charge and easily enable cell permeability. Upon cellular entry, the promoieties are enzymatically or environmentally cleaved to unveil …

Qki-Mediated Cholesterol Biosynthesis In Eye Lens And Myelin Of The Central Nervous System, Seula Shin, Seula Shin

Dissertations and Theses (Open Access)

Cells obtain cholesterol in two ways, de novo biosynthesis and uptake from circulation. While most tissues utilize both sources, eye lens and brain depend extensively on cholesterol biosynthesis due to the limited supply from circulation. Lens cell membrane consists of highest portion of cholesterol. Brain is the most cholesterol-rich organ, which accounts for 23% of total cholesterol. Genetic mutations of cholesterol biosynthesis enzymes in humans and animal models present cataracts and hypomyelinating disorders linked to neurological impairment. Yet, it remains unclear how gene expression of cholesterol biosynthesis is regulated in lens and brain. Therefore, studying cholesterol biosynthesis in both tissues …

Qki-Mediated Cholesterol Biosynthesis In Eye Lens And Myelin Of The Central Nervous System, Seula Shin, Seula Shin

Dissertations and Theses (Open Access)

Cells obtain cholesterol in two ways, de novo biosynthesis and uptake from circulation. While most tissues utilize both sources, eye lens and brain depend extensively on cholesterol biosynthesis due to the limited supply from circulation. Lens cell membrane consists of highest portion of cholesterol. Brain is the most cholesterol-rich organ, which accounts for 23% of total cholesterol. Genetic mutations of cholesterol biosynthesis enzymes in humans and animal models present cataracts and hypomyelinating disorders linked to neurological impairment. Yet, it remains unclear how gene expression of cholesterol biosynthesis is regulated in lens and brain. Therefore, studying cholesterol biosynthesis in both tissues …

Examining Pathogenesis And Preventatives In Spontaneous And Staphylococcus-Induced Bacterial Chondronecrosis With Osteomyelitis In Broilers, Nnamdi Simon Ekesi

Graduate Theses and Dissertations

Bacterial chondronecrosis with osteomyelitis is the most important cause of lameness in broilers. This is important to poultry production, as it poses animal welfare issues, and causes a significant loss in revenue. The remediation of this disease requires the study of its etiology with fitting models and evaluating preventatives. The research reported herein covers genomic virulence analysis of BCO isolates, mainly Staphylococcus aureus, and Escherichia coli retrieved from lame birds. We found that S. aureus isolates were closest to chicken strains in Europe but may have been in the Arkansas area for a decade. Phylogenomics suggest our S. aureus is …

Fate And Dissemination Of Salmonella Reading In Market-Age Turkeys At Processing Using Oral Gavage Challenge Model, Aaron Ashcraft

Graduate Theses and Dissertations

This study aimed to evaluate the fate and dissemination of Salmonella Reading (SR) in market-age turkeys using an oral gavage challenge model. One hundred twenty-eight-week-old commercial turkey hens were moved from commercial production to research facilities. Upon arrival, a combination of enrofloxacin, 10 mg/kg, and florfenicol, 20 mg/kg, were orally administered sequentially before comingled placement on fresh pine shavings. Turkeys were challenged with 108 cfu SR by oral gavage on days 4 and 7 post-placement. Subsets were subjected to simulated commercial processing on days 14 (n=40), 21 (n=40) and 28 (n=32) post-placement (corresponding to 10, 11, and 12 weeks of …

Biogeography Of The Bovine Respiratory Microbiome And Its Relationship With Bovine Respiratory Disease, Jianmin Chai

Graduate Theses and Dissertations

Bovine respiratory disease (BRD) is the most common and costly disease in the beef cattle industry, leading to high morbidity, mortality and huge economic loss. Despite the recent advances in vaccination and antimicrobial techniques, no significant health-improved outcomes have developed. Due to a deep investigation of the microbiome, respiratory microbiotas are known to have important roles for host health and disease. However, BRD specific pathogens have not yet been identified since they are found in both healthy and diseased animals. A systemic and comprehensive study of the biogeography of the bovine respiratory microbiome and its relationship with BRD is lacking …

Shared Volatile Organic Compounds Between Camel Metabolic Products Elicits Strong Stomoxys Calcitrans Attraction, Merid Negash Getahun, Peter Ahuya, John Ngiela, Abel Orone, Daniel Masiga, Baldwyn Torto

All Peer-Reviewed Publications

The sources of animal odours are highly diverse, yet their ecological importance, in host–vector communication, remains unexplored. Here, using the camel (host)–Stomoxys calcitrans (vector) interaction, we collected and analyzed the Volatile Organic Compounds (VOCs) of camels from four of its different odour sources: breath, body (skin), urine, and dung. On non-metric model multivariate analyses of VOCs we show that substantial chemo-diversity exists between metabolic products associated with an individual camel. VOCs from the four metabolic products were distinct and widely segregated. Next, we show electrophysiologically, that VOCs shared between metabolic products activated more Olfactory Sensory Neurons (OSNs) and elicited strong …

Multiomics Characterization Of Preterm Birth In Low- And Middle-Income Countries, Fyezah Jehan, Muhammad Imran Nisar, Muhammad Ilyas, Usma Mehmood, Aneeta Hotwani, Ambreen Nizar, Sajid Muhammad, Waqasuddin Khan, Javairia Khalid, Furqan Kabir

Department of Paediatrics and Child Health

Importance: Worldwide, preterm birth (PTB) is the single largest cause of deaths in the perinatal and neonatal period and is associated with increased morbidity in young children. The cause of PTB is multifactorial, and the development of generalizable biological models may enable early detection and guide therapeutic studies.
Objective: To investigate the ability of transcriptomics and proteomics profiling of plasma and metabolomics analysis of urine to identify early biological measurements associated with PTB.
Design, setting, and participants: This diagnostic/prognostic study analyzed plasma and urine samples collected from May 2014 to June 2017 from pregnant women in 5 biorepository cohorts in …

Burden Of Culture Confirmed Enteric Fever Cases In Karachi, Pakistan: Surveillance For Enteric Fever In Asia Project (Seap), 2016-2019, Mohammad Tahir Yousafzai, Seema Irfan, Rozina Thobani, Abdul Momin Kazi, Aneeta Hotwani, Ashraf M. Memon, Khalid Iqbal, Saqib Hamid Qazi, Nasir S. Saddal, Najeeb Rehman, Irum Fatima Dehraj, Mohammed J. Hunzai, Junaid Mehmood, Farah Naz Qamar

Department of Paediatrics and Child Health

Background: The Surveillance for Enteric Fever in Asia Project (SEAP) is a multicenter, multicountry study conducted in Pakistan, Nepal, and Bangladesh. The objectives of the study were to characterize disease incidence among patients with enteric fever. We report the burden of enteric fever at selected sites of Karachi, Pakistan.
Methods: During September 2016 to September 2019, prospective surveillance was conducted at inpatient, outpatient, surgical departments, and laboratory networks of Aga Khan University Hospital, Kharadar General Hospital, and surgery units of National Institute of Child Health and Jinnah Postgraduate Medical Centre. Socio-demographic, clinical, and laboratory data were obtained from all suspected …

A Cluster-Based, Spatial-Sampling Method For Assessing Household Healthcare Utilization Patterns In Resource-Limited Settings, Alexander T. Yu, Rajani Shakya, Bikram Adhikari, Dipesh Tamraka, Krista Vaidya, Stace Maples, Kashmira Date, Isaac I. Bogoch, Farah Naz Qamar, Mohammad Tahir Yousafzai

Department of Paediatrics and Child Health

Background: Implementation of population-based surveys is resource intensive and logistically demanding, especially in areas with rapidly changing demographics and incomplete or no enumeration of the underlying population and their residences. To remove the need for pre-enumeration and to simplify field logistics for the population healthcare utilization survey used for the Surveillance for Enteric Fever in Asia Project in Nepal, we incorporated a geographic information system-based geosurvey and field mapping system into a single-stage cluster sampling approach.
Methods: A survey was administered to ascertain healthcare-seeking behavior in individuals with recent suspected enteric fever. Catchment areas were based on residential addresses of …

Utilization Of Blood Culture In South Asia For The Diagnosis And Treatment Of Febrile Illness, Caitlin Hemlock, Stephen P. Luby, Shampa Saha, Farah Naz Qamar, Jason R. Andrews, Samir K. Saha, Dipesh Tamrakar, Kashmira Date, Ashley T. Longley, Denise O. Garrett, Isaac I. Bogoch

Department of Paediatrics and Child Health

Background: Blood culture is the current standard for diagnosing bacteremic illnesses, yet it is not clear how physicians in many low- and middle-income countries utilize blood culture for diagnostic purposes and to inform treatment decisions.
Methods: We screened suspected enteric fever cases from 6 hospitals in Bangladesh, Nepal, and Pakistan, and enrolled patients if blood culture was prescribed by the treating physician. We used generalized additive regression models to analyze the probability of receiving blood culture by age, and linear regression models to analyze changes by month to the proportion of febrile cases prescribed a blood culture compared with the …

Diagnostic Value Of Clinical Features To Distinguish Enteric Fever From Other Febrile Illnesses In Bangladesh, Nepal, And Pakistan, Kristen Aiemjoy, Dipesh Tamrakar, Shampa Saha, Shiva R. Naga, Alexander T. Yu, Ashley Longley, Kashmira Date, Caitlin Hemlock, Farah Naz Qamar, Samir K. Saha

Department of Paediatrics and Child Health

Background: Enteric fever, a bacterial infection caused by Salmonella enterica serotypes Typhi and Paratyphi A, frequently presents as a nonlocalizing febrile illness that is difficult to distinguish from other infectious causes of fever. Blood culture is not widely available in endemic settings and, even when available, results can take up to 5 days. We evaluated the diagnostic performance of clinical features, including both reported symptoms and clinical signs, of enteric fever among patients participating in the Surveillance for Enteric Fever in Asia Project (SEAP), a 3-year surveillance study in Bangladesh, Nepal, and Pakistan.
Methods: Outpatients presenting with ≥3 consecutive days …

Frequency Of Hypocalcemic Fits In Children 2 Months To 2 Years Of Age, Presenting With The First Episode Of Afebrile Seizures At Hospital Settings In Urban Pakistan: A Cross-Sectional Study, Waseem Rahman, Heeramani Lohana, Sarwat Urooj, Sheraz Ahmed, Abdul Moeed, Khadija Nuzhat Humayun

Department of Paediatrics and Child Health

Introduction: Seizures are common in the pediatric age group, occurring approximately 10% of children. Hypocalcemia is one of the most common metabolic causes of afebrile seizures. The objective of the study was to determine the frequency of hypocalcemic fits in children presenting with the first episode of afebrile seizures from 2 months to 2 years of age.
Methods: The study was conducted at the Aga Khan hospital Karachi and its three secondary hospitals including the following sites of Kharadar, Hyderabad, and garden. It was a cross-sectional study. The duration of the study was of 6 months from 18th July 2017 …

Maternal Risk Factors And Short Term Outcome Of Prematurity: A Descriptive Study At A Secondary Care Hospital, Heeramani Lohana, Shakeel Ahmed, Nigar Jabeen, Farida Karim, Sarwat Urooj, Ayesha Ahmed

Department of Paediatrics and Child Health

Background: Approximately 15 million babies are born premature (before 37 weeks of gestation) and 1 million babies die due to prematurity complications every year. Less is known about risk factors of prematurity in middle and low-income countries. The prevalence of prematurity ranges from 5% - 18%.
Objective: To determine the prevalence of premature births and to assess the rate of survival, along with the morbidity, among preterm newborns. Furthermore, to document our experience with different gestational age groups of preterm births; and to analyze the association among these strata and their clinical outcomes.
Study Design: A descriptive study.
Place …

Spatial Heterogeneity Of Enteric Fever In 2 Diverse Communities In Nepal, Dipesh Tamrakar, Krista Vaidya, Alexander T. Yu, Kristen Aiemjo, Shiva Ram Naga, Yanjia Cao, Caryn Bern, Rajeev Shrestha, Biraj M. Karmacharya, Farah Naz Qamar

Department of Paediatrics and Child Health

Background: Typhoid fever is endemic in the urban Kathmandu Valley of Nepal; however, there have been no population-based studies of typhoid outside of this community in the past 3 decades. Whether typhoid immunization should be prioritized in periurban and rural communities has been unclear.
Methods: We performed population-based surveillance for enteric fever in 1 urban catchment (Kathmandu) and 1 periurban and rural catchment (Kavrepalanchok) as part of the Surveillance for Enteric Fever in Asia Project (SEAP). We recruited individuals presenting to outpatient and emergency departments at 2 study hospitals with suspected enteric fever and performed blood cultures. Additionally, we conducted …

Antimicrobial Resistance In Typhoidal Salmonella: Surveillance For Enteric Fever In Asia Project, 2016-2019, Farah Naz Qamar, Mohammad Tahir Yousafzai, Irum Fatima Dehraj, Sadia Shakoor, Seema Irfan, Aneeta Hotwani, Muhammad J. Hunzai, Rozina Thobani, Najeeb Rahman, Junaid Mehmood, Ashraf M. Memon

Department of Paediatrics and Child Health

Background: Clinicians have limited therapeutic options for enteric as a result of increasing antimicrobial resistance, and therefore typhoid vaccination is recommended as a preventive measure. As a part of the Surveillance for Enteric Fever in Asia Project (SEAP), we investigated the extent measured the burden of antimicrobial resistance (AMR) among confirmed enteric fever cases in Bangladesh, Nepal, and Pakistan.
Methods: From September 2016-September 2019, SEAP recruited study participants of all age groups from its outpatient, inpatient, hospital laboratory, laboratory network, and surgical sites who had a diagnosis of febrile illness that was either suspected or blood culture confirmed for enteric …

Antibiotic Use Prior To Hospital Presentation Among Individuals With Suspected Enteric Fever In Nepal, Bangladesh, And Pakistan, Krista Vaidya, Kristen Aiemjoy, Farah Naz Qamar, Samir K. Saha, Dipesh Tamrakar, Shiva R. Naga, Shampa Saha, Caitlin Hemlock, Ashley T. Longley, Kashmira Date

Department of Paediatrics and Child Health

Background: Antibiotic use prior to seeking care at a hospital may reduce the sensitivity of blood culture for enteric fever, with implications for both clinical care and surveillance. The Surveillance for Enteric Fever in Asia Project (SEAP) is a prospective study of enteric fever incidence in Nepal, Bangladesh, and Pakistan. Nested within SEAP, we evaluated the accuracy of self-reported antibiotic use and investigated the association between antibiotic use and blood culture positivity.
Methods: Between November 2016 and April 2019, we collected urine samples among a subset of SEAP participants to test for antibiotic use prior to the hospital visit using …