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Meghna Desai Penelope A. Phillips-Howard Frank O. Odhiambo Abraham Katana Peter Ouma Mary J. Hamel Jackton Omoto Sheila Macharia Annemieke van Eijk Sheila Ogwang Laurence Slutsker Kayla F. Laserson 《PloS one》2013,8(7)
Background
Pregnancy-related (PR) deaths are often a result of direct obstetric complications occurring at childbirth.Methods and Findings
To estimate the burden of and characterize risk factors for PR mortality, we evaluated deaths that occurred between 2003 and 2008 among women of childbearing age (15 to 49 years) using Health and Demographic Surveillance System data in rural western Kenya. WHO ICD definition of PR mortality was used: “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death”. In addition, symptoms and events at the time of death were examined using the WHO verbal autopsy methodology. Deaths were categorized as either (i) directly PR: main cause of death was ascribed as obstetric, or (ii) indirectly PR: main cause of death was non-obstetric. Of 3,223 deaths in women 15 to 49 years, 249 (7.7%) were PR. One-third (34%) of these were due to direct obstetric causes, predominantly postpartum hemorrhage, abortion complications and puerperal sepsis. Two-thirds were indirect; three-quarters were attributable to human immunodeficiency virus (HIV/AIDS), malaria and tuberculosis. Significantly more women who died in lower socio-economic groups sought care from traditional birth attendants (p = 0.034), while less impoverished women were more likely to seek hospital care (p = 0.001). The PR mortality ratio over the six years was 740 (95% CI 651–838) per 100,000 live births, with no evidence of reduction over time (χ2 linear trend = 1.07; p = 0.3).Conclusions
These data supplement current scanty information on the relationship between infectious diseases and poor maternal outcomes in Africa. They indicate low uptake of maternal health interventions in women dying during pregnancy and postpartum, suggesting improved access to and increased uptake of skilled obstetric care, as well as preventive measures against HIV/AIDS, malaria and tuberculosis among all women of childbearing age may help to reduce pregnancy-related mortality. 相似文献2.
Gabriele Pohlig Sonja C. Bernhard Johannes Blum Christian Burri Alain Mpanya Jean-Pierre Fina Lubaki Alfred Mpoo Mpoto Blaise Fungula Munungu Patrick Mangoni N’tombe Gratias Kambau Manesa Deo Pierre Nsele Mutantu Florent Mbo Kuikumbi Alain Fukinsia Mintwo Augustin Kayeye Munungi Amadeu Dala Stephen Macharia Constantin Miaka Mia Bilenge Victor Kande Betu Ku Mesu Jose Ramon Franco Ndinga Dieyi Dituvanga Richard R. Tidwell Carol A. Olson 《PLoS neglected tropical diseases》2016,10(2)
Background
Sleeping sickness (human African trypanosomiasis [HAT]) is a neglected tropical disease with limited treatment options that currently require parenteral administration. In previous studies, orally administered pafuramidine was well tolerated in healthy patients (for up to 21 days) and stage 1 HAT patients (for up to 10 days), and demonstrated efficacy comparable to pentamidine.Methods
This was a Phase 3, multi-center, randomized, open-label, parallel-group, active control study where 273 male and female patients with first stage Trypanosoma brucei gambiense HAT were treated at six sites: one trypanosomiasis reference center in Angola, one hospital in South Sudan, and four hospitals in the Democratic Republic of the Congo between August 2005 and September 2009 to support the registration of pafuramidine for treatment of first stage HAT in collaboration with the United States Food and Drug Administration. Patients were treated with either 100 mg of pafuramidine orally twice a day for 10 days or 4 mg/kg pentamidine intramuscularly once daily for 7 days to assess the efficacy and safety of pafuramidine versus pentamidine. Pregnant and lactating women as well as adolescents were included.The primary efficacy endpoint was the combined rate of clinical and parasitological cure at 12 months. The primary safety outcome was the frequency and severity of adverse events. The study was registered on the International Clinical Trials Registry Platform at www.clinicaltrials.gov with the number ISRCTN85534673.Findings/Conclusions
The overall cure rate at 12 months was 89% in the pafuramidine group and 95% in the pentamidine group; pafuramidine was non-inferior to pentamidine as the upper bound of the 95% confidence interval did not exceed 15%. The safety profile of pafuramidine was superior to pentamidine; however, 3 patients in the pafuramidine group had glomerulonephritis or nephropathy approximately 8 weeks post-treatment. Two of these events were judged as possibly related to pafuramidine. Despite good tolerability observed in preceding studies, the development program for pafuramidine was discontinued due to delayed post-treatment toxicity. 相似文献3.
Edward K. Mengich Daniel K. Too Joseph M. Macharia Ralph Mitloehner 《African Journal of Ecology》2015,53(1):3-15
This study assessed the composition and natural distribution of indigenous trees and shrubs as possible criteria for selecting suitable species for rehabilitation of degraded sites in semi‐arid rangelands. Study sites were identified at Nthangu, Kathonzweni and Kibwezi forests of Makueni County, Kenya using existing vegetation, agro‐climatic maps and Landsat imageries. The sites had mean annual rainfalls of 974 mm, 700 mm and 616 mm, respectively, and moisture indices of 49%, 35% and 32%. Data were collected by establishing sample plots and assessing species counts and diameters at breast height (DBH). Basal area, relative dominance, relative abundance, relative frequency and important value indices (IVIs) were computed for individual families and species at each site. The number of families, genera and species declined from Nthangu (33, 60, 77) through Kibwezi (30, 48, 70) to Kathonzweni (28, 42, 69). Corresponding mean basal areas were 16.7 m2 ha?1, 76.8 m2 ha?1 and 19.3 m2 ha?1. The families Combretaceae, Burseraceae and Mimosaceae were the most important and widely distributed. Based on ecological importance values, candidate species for rehabilitation of degraded sites at Nthangu, Kathonzweni and Kibwezi were Combretum molle and Acacia hockii; Combretum collinum, Commiphora campestris and Acacia tortilis; and Commiphora africana and A. tortilis, respectively. 相似文献
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Rosaline Macharia Paul Mireji Edwin Murungi Grace Murilla Alan Christoffels Serap Aksoy Daniel Masiga 《PLoS neglected tropical diseases》2016,10(2)
For decades, odour-baited traps have been used for control of tsetse flies (Diptera; Glossinidae), vectors of African trypanosomes. However, differential responses to known attractants have been reported in different Glossina species, hindering establishment of a universal vector control tool. Availability of full genome sequences of five Glossina species offers an opportunity to compare their chemosensory repertoire and enhance our understanding of their biology in relation to chemosensation. Here, we identified and annotated the major chemosensory gene families in Glossina. We identified a total of 118, 115, 124, and 123 chemosensory genes in Glossina austeni, G. brevipalpis, G. f. fuscipes, G. pallidipes, respectively, relative to 127 reported in G. m. morsitans. Our results show that tsetse fly genomes have fewer chemosensory genes when compared to other dipterans such as Musca domestica (n>393), Drosophila melanogaster (n = 246) and Anopheles gambiae (n>247). We also found that Glossina chemosensory genes are dispersed across distantly located scaffolds in their respective genomes, in contrast to other insects like D. melanogaster whose genes occur in clusters. Further, Glossina appears to be devoid of sugar receptors and to have expanded CO2 associated receptors, potentially reflecting Glossina''s obligate hematophagy and the need to detect hosts that may be out of sight. We also identified, in all species, homologs of Ir84a; a Drosophila-specific ionotropic receptor that promotes male courtship suggesting that this is a conserved trait in tsetse flies. Notably, our selection analysis revealed that a total of four gene loci (Gr21a, GluRIIA, Gr28b, and Obp83a) were under positive selection, which confers fitness advantage to species. These findings provide a platform for studies to further define the language of communication of tsetse with their environment, and influence development of novel approaches for control. 相似文献
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Musafiri Collins M. Macharia Joseph M. Kiboi Milka N. Ng’etich Onesmus K. Shisanya Chris A. Okeyo Jeremiah M. Okwuosa Elizabeth A. Ngetich Felix K. 《Plant and Soil》2021,463(1-2):395-413
Plant and Soil - Process-based biogeochemical models can be used to simulate soil nitrous oxide (N2O) fluxes and maize yields and draw insights on yields improvement and climate change mitigation... 相似文献
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