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[PMID]:29262783
[Au] Autor:Aaron D; Nagu TJ; Rwegasha J; Komba E
[Ad] Endereço:School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania.
[Ti] Título:Hepatitis B vaccination coverage among healthcare workers at national hospital in Tanzania: how much, who and why?
[So] Source:BMC Infect Dis;17(1):786, 2017 Dec 20.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hepatitis B vaccination for healthcare workers (HCWs) is a key component of the WHO Hepatitis B Elimination Strategy 2016-2021. Data on current hepatitis B vaccine coverage among health care workers in Sub-Saharan Africa are scarce, but these data are vital for effective programming. We assessed the proportion of HCWs vaccinated for hepatitis B and the factors associated with adequate vaccination coverage at a national hospital in Tanzania. METHODS: A descriptive cross-sectional study was conducted among consenting healthcare workers between 30th July and 30th September 2015. Vaccination histories were obtained through self-administered questionnaires. Means and proportions were used to summarize the data. Student's t and chi-squared tests were used as appropriate. Logistic regression was used to determine the factors associated with vaccination. RESULTS: A total of 348 HCWs were interviewed, of whom 198 (56.9%) had received at least one dose of hepatitis B vaccination, while only 117 (33.6%) were fully vaccinated. About half of the 81 HCWs with partial vaccination (49.4%) had missed their subsequent vaccination appointments. Among unvaccinated HCWs, 14 (9.3%) had either HBV infection or antibodies against HBV infection upon pre-vaccination screening. However, the remaining participants were not vaccinated and did not know their immune status against HBV. Nearly all respondents (347, 99.3%) had heard about the hepatitis B viral vaccine. The following reasons for non-vaccination were given: 98 (65.3%) reported that they had not been offered the vaccine; 70 (46.7%) observed standard precautions to ensure infection prevention and 60 (41.3%) blamed a low level of awareness regarding the availability of the hepatitis B vaccine. CONCLUSION: The current vaccination coverage among practicing healthcare workers at Muhimbili National Hospital is low, despite a high level of awareness and the acceptance of the vaccine. Expedited and concerted efforts to scale vaccine uptake should include improved access to the vaccine, especially for newly recruited HCWs. The extension of the study to private healthcare settings and lower-level facilities would be useful.
[Mh] Termos MeSH primário: Pessoal de Saúde/estatística & dados numéricos
Vacinas contra Hepatite B
Cobertura Vacinal/estatística & dados numéricos
[Mh] Termos MeSH secundário: Estudos Transversais
Seres Humanos
Tanzânia/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hepatitis B Vaccines)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2893-8


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[PMID]:28453843
[Au] Autor:Uprety P; Lindsey JC; Levin MJ; Rainwater-Lovett K; Ziemniak C; Bwakura-Dangarembizix M; Kaplan SS; Nelson M; Zadzilka A; Weinberg A; Persaud D
[Ad] Endereço:W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
[Ti] Título:Inflammation and Immune Activation in Antiretroviral-Treated Human Immunodeficiency Virus Type 1-Infected African Infants and Rotavirus Vaccine Responses.
[So] Source:J Infect Dis;215(6):928-932, 2017 03 15.
[Is] ISSN:1537-6613
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Biomarkers of inflammation and immune activation were correlated with rotavirus vaccine responses in 68 human immunodeficiency virus type 1 (HIV-1)­infected (and 116 HIV-exposed but uninfected (HEU) African infants receiving pentavalent rotavirus vaccine (RV5) in a clinical trial. Prevaccination, HIV-1+ infants had significantly higher concentrations of interferon γ (IFNγ), interleukin1ß, interleukin 2, interleukin 6, interleukin 10 (IL-10), and soluble CD14 compared with HEU infants. Postvaccination concentrations of neutralizing antibodies to RV5 were negatively correlated with prevaccination concentrations of IL-10 (RV5 surface proteins G1 and P1) and IFNγ (G1) in the HIV-1+ infants, whereas antirotavirus immunoglobulin A (IgA) levels were not. Heightened inflammation and immune activation in HIV-1+ infants did not alter IgA responses associated with protection from rotavirus disease.
[Mh] Termos MeSH primário: Infecções por HIV/tratamento farmacológico
Infecções por Rotavirus/prevenção & controle
Vacinas contra Rotavirus/uso terapêutico
[Mh] Termos MeSH secundário: Anticorpos Neutralizantes/sangue
Anticorpos Antivirais/sangue
Terapia Antirretroviral de Alta Atividade
Biomarcadores/sangue
Botsuana
Contagem de Linfócito CD4
Citocinas/sangue
Método Duplo-Cego
Feminino
HIV-1/imunologia
Seres Humanos
Imunoglobulina A/sangue
Lactente
Inflamação
Masculino
Análise Multivariada
Tanzânia
Zâmbia
Zimbábue
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antibodies, Neutralizing); 0 (Antibodies, Viral); 0 (Biomarkers); 0 (Cytokines); 0 (Immunoglobulin A); 0 (Rotavirus Vaccines)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/infdis/jix060


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[PMID]:29178597
[Au] Autor:Larson JR; Manyama MF; Cole JB; Gonzalez PN; Percival CJ; Liberton DK; Ferrara TM; Riccardi SL; Kimwaga EA; Mathayo J; Spitzmacher JA; Rolian C; Jamniczky HA; Weinberg SM; Roseman CC; Klein O; Lukowiak K; Spritz RA; Hallgrimsson B
[Ad] Endereço:Department of Cell Biology & Anatomy, Cumming School of Medicine, University of Calgary, Calgary, Canada.
[Ti] Título:Body size and allometric variation in facial shape in children.
[So] Source:Am J Phys Anthropol;165(2):327-342, 2018 02.
[Is] ISSN:1096-8644
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Morphological integration, or the tendency for covariation, is commonly seen in complex traits such as the human face. The effects of growth on shape, or allometry, represent a ubiquitous but poorly understood axis of integration. We address the question of to what extent age and measures of size converge on a single pattern of allometry for human facial shape. METHODS: Our study is based on two large cross-sectional cohorts of children, one from Tanzania and the other from the United States (N = 7,173). We employ 3D facial imaging and geometric morphometrics to relate facial shape to age and anthropometric measures. RESULTS: The two populations differ significantly in facial shape, but the magnitude of this difference is small relative to the variation within each group. Allometric variation for facial shape is similar in both populations, representing a small but significant proportion of total variation in facial shape. Different measures of size are associated with overlapping but statistically distinct aspects of shape variation. Only half of the size-related variation in facial shape can be explained by the first principal component of four size measures and age while the remainder associates distinctly with individual measures. CONCLUSIONS: Allometric variation in the human face is complex and should not be regarded as a singular effect. This finding has important implications for how size is treated in studies of human facial shape and for the developmental basis for allometric variation more generally.
[Mh] Termos MeSH primário: Tamanho Corporal/fisiologia
Face/anatomia & histologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Antropologia Física
Evolução Biológica
Biometria
Criança
Pré-Escolar
Estudos Transversais
Feminino
Seres Humanos
Imagem Tridimensional
Masculino
Tanzânia
Estados Unidos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1002/ajpa.23356


  4 / 9181 MEDLINE  
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[PMID]:28834700
[Au] Autor:Bowie RCK; Pasquet E; McEntee JP; Njilima F; Fjeldså J
[Ad] Endereço:Museum of Vertebrate Zoology and Department of Integrative Biology, 3101 Valley Life Science Building, University of California, Berkeley, CA 94720-3160, USA. Electronic address: bowie@berkeley.edu.
[Ti] Título:The systematics and biogeography of African tailorbirds (Cisticolidae: Artisornis) with comment on the choice of Bayesian branch-length prior when analyzing heterogeneous data.
[So] Source:Mol Phylogenet Evol;118:172-183, 2018 Jan.
[Is] ISSN:1095-9513
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The Long-billed Tailorbird (Artisornis moreaui), one of Africa's rarest birds, has a strikingly disjunct distribution, the origin of which has long puzzled biogeographers. One small population (subspecies moreaui) occurs in sub-montane forest in the East Usambara Mountains, a sky island near the coast of northern Tanzania, and another (subspecies sousae) on Serra Jeci in northwestern Mozambique, 950km away. The African Tailorbird, the putative sister-species of Long-billed Tailorbird, also occurs in the East Usambara Mountains and on Serra Jeci, but in addition occupies all the Eastern Arc Mountain forests between these disjunct sites. Stuart (1981) hypothesized that the two tailorbird distributions could be explained by strong ecological competition, with African Tailorbird populations having eliminated Long-billed Tailorbird populations via competitive exclusion in montane forests between the East Usambara and Serra Jeci. If such competitive exclusion explains these geographic distributions, the co-occurrence of the two species in the East Usambara and at Serra Jeci may be ephemeral, with the status of Long-billed Tailorbird especially in doubt. We sought to (1) determine whether the two species of African tailorbirds are indeed sister-species, and (2) test predictions from Stuart's (1981) competitive exclusion hypothesis using genetic data. Phylogenetic analyses of our seven gene dataset (3 mtDNA, 4 introns; 4784bp) indeed place these two species together in the genus Artisornis. Instead of finding shallow divergence among African Tailorbird populations and deep divergence between Long-billed Tailorbird populations as expected from Stuart's hypothesis, we recover deep genetic divergence and geographic structure among populations of both tailorbird species. This result is consistent with long-term co-existence of the two species at East Usambara and Serra Jeci. Observational data from both the East Usambara and Serra Jeci suggest that the two species have diverged in use of forest canopy strata. From a conservation standpoint, our results suggest that extinction of the Long-billed Tailorbird as a function of competition with African Tailorbird is highly unlikely, and should not be viewed as imminent. Threats to its survival are instead anthropogenic, and conservation measures should take this into account. Finally, our empirical results suggest that mis-specification of the branch-length prior in Bayesian analyses of mitochondrial DNA data can have a profound effect on the overall tree-length (sum of branch-lengths), whereas the topology and support values tend to remain more stable. In contrast, mis-specification of the branch-length prior had a lesser impact on all aspects of the nuclear-only DNA analyses. This problem may be exacerbated when mitochondrial and nuclear DNA analyses are combined in a total evidence approach.
[Mh] Termos MeSH primário: Passeriformes/classificação
Filogeografia
Estatística como Assunto
[Mh] Termos MeSH secundário: Animais
Teorema de Bayes
DNA Mitocondrial/genética
Loci Gênicos
Moçambique
Passeriformes/genética
Filogenia
Tanzânia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (DNA, Mitochondrial)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE


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[PMID]:29240660
[Au] Autor:Mboineki JF; Zhang W
[Ad] Endereço:Joanes Faustine Mboineki, MSc, is Tutorial Assistant, The University of Dodoma College of Health and Allied Sciences, Tanzania; and Student, School of Nursing, Zhengzhou University, China. Weihong Zhang, PhD, is Professor, School of Nursing, Zhengzhou University, China.
[Ti] Título:Healthcare Provider Views on Transitioning From Task Shifting to Advanced Practice Nursing in Tanzania.
[So] Source:Nurs Res;67(1):49-54, 2018 Jan/Feb.
[Is] ISSN:1538-9847
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The Tanzanian health sector suffers from shortages of healthcare workers as well as uneven distribution of healthcare workers in urban and rural areas. Task shifting-delegation of tasks from professionals to other healthcare team members with less training, such as medical attendants-is practiced, compromising quality of care. Advanced practice nursing is underutilized. OBJECTIVE: The purpose of this study was to explore the views of nurses and physicians on current responses to shortages of healthcare workers and the potential for utilization of advanced practice nurses. METHODS: A descriptive, qualitative design was used. Purposeful sampling was used to select 20 participants. An in-depth interview guide was used to obtain information. Interviews were conducted in Swahili or English. Content analysis was used to identify themes. RESULTS: Shortage of human resources in rural primary healthcare facilities was identified as a major rationale for implementation of the advanced practice nurse practitioner role because the current health providers in rural health facilities are less trained and doctors are not ready to work in these settings. Opposition from physicians is expected during the course of implementing the nurse practitioner role. Professional bodies and government should reach consensus before the implementation of this role in such a way that they should agree on scope and standards of practice of nurse practitioners in Tanzania. CONCLUSION: Shortage of human resources for health is greater in rural primary healthcare facilities. Task shifting in Tanzania is neither effective nor legally recognized. Transition to advanced practice nursing roles-particularly the nurse practitioner role-can facilitate provision of optimal care. Nurse practitioners should be prepared to work in rural primary healthcare facilities.
[Mh] Termos MeSH primário: Prática Avançada de Enfermagem/organização & administração
Papel do Profissional de Enfermagem
Atenção Primária à Saúde/organização & administração
Serviços de Saúde Rural/organização & administração
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Pessoal de Saúde/organização & administração
Seres Humanos
Programas Nacionais de Saúde/organização & administração
Tanzânia
Análise e Desempenho de Tarefas
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE
[do] DOI:10.1097/NNR.0000000000000259


  6 / 9181 MEDLINE  
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[PMID]:28744868
[Au] Autor:Wright JJ
[Ad] Endereço:New York State Museum, 3140 Cultural Education Center, Albany, NY, 12230, U.S.A.
[Ti] Título:A new diminutive genus and species of catfish from Lake Tanganyika (Siluriformes: Clariidae).
[So] Source:J Fish Biol;91(3):789-805, 2017 Sep.
[Is] ISSN:1095-8649
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The examination of material representing one of Lake Tanganyika's six previously recognized endemic catfish lineages, has revealed the presence of an additional genus of clariid, described here as Pseudotanganikallabes new genus. This genus is represented by a single species, Pseudotanganikallabes prognatha sp. nov., which is distinguished from all other clariids by its lack of an infraorbital series, the presence of multiple osseous connections between the swim bladder capsules and elements of the neurocranium, the absence of an ethmoid notch, the presence of a very large, egg-shaped occipital fontanelle and the extension of the lower lip beyond the margin of the upper jaw. A combination of additional external and molecular characters serves to further distinguish this taxon from all currently recognized clariid species. Phylogenetic analysis of mitochondrial (cytb) and nuclear (18S-ITS1-5.8S-ITS2-28S) sequence data supports the creation of a new genus for this species, as it appears to represent an independent, monophyletic lineage within the family Clariidae.
[Mh] Termos MeSH primário: Peixes-Gato/classificação
Filogenia
[Mh] Termos MeSH secundário: Animais
Peixes-Gato/anatomia & histologia
Peixes-Gato/genética
DNA Mitocondrial/química
Lagos
Especificidade da Espécie
Tanzânia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (DNA, Mitochondrial)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1111/jfb.13374


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[PMID]:29246361
[Au] Autor:Sania A; Smith ER; Manji K; Duggan C; Masanja H; Kisenge R; Msamanga G; Urassa W; Fawzi W
[Ad] Endereço:ICAP, Columbia University, Mailman School of Public Health, New York, NY.
[Ti] Título:Neonatal and Infant Mortality Risk Associated with Preterm and Small for Gestational Age Births in Tanzania: Individual Level Pooled Analysis Using the Intergrowth Standard.
[So] Source:J Pediatr;192:66-72.e4, 2018 Jan.
[Is] ISSN:1097-6833
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To evaluate the risk of newborn and infant mortality associated with preterm, small for gestational age (SGA), and low birth weight (LBW) stratified by maternal HIV status and the location of birth. STUDY DESIGN: We created a prospective cohort by pooling 5 individually randomized trials. We used Cox proportional hazard models to estimate the risk of mortality for SGA defined using the recently published Intergrowth standard, preterm, LBW, and gestational age and size for gestational age categories (preterm- appropriate for gestational age [AGA], term-SGA, and preterm-SGA). Effect modification by maternal HIV status and place of residence was assessed using the likelihood ratio test. RESULTS: Of the 31 988 infants, 15.3% were preterm, 16.6% were SGA, and 7.3% were LBW. The proportion of preterm and SGA births was higher among the HIV-infected cohort than in the uninfected cohort. Compared with term-AGA groups, infants born both preterm and SGA had a greater risk of neonatal mortality (hazard ratio [HR] 5.43, 95% CI 2.01-14.63) than preterm-AGA infants (HR 2.40, 95% CI 1.89-3.05) and term-SGA infants (HR 2.56, 95% CI 1.96-3.34). Maternal HIV infection modified the risk of infant mortality associated with being born preterm or LBW, with a higher relative risk among those born to HIV-uninfected women. Rural residence significantly modified the risk of neonatal mortality associated with being LBW (P for interaction = .005). CONCLUSIONS: Preterm and SGA newborns had an increased risk of mortality during the first year of life. Interventions targeting these conditions, especially in HIV-exposed and rural populations, should be integrated into existing maternal and child health programs.
[Mh] Termos MeSH primário: Mortalidade Infantil
Recém-Nascido de Baixo Peso
Recém-Nascido Prematuro
Recém-Nascido Pequeno para a Idade Gestacional
[Mh] Termos MeSH secundário: Feminino
Infecções por HIV
Seres Humanos
Lactente
Recém-Nascido
Estimativa de Kaplan-Meier
Masculino
Gravidez
Complicações Infecciosas na Gravidez
Modelos de Riscos Proporcionais
Fatores de Risco
Saúde da População Rural
Tanzânia/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180218
[Lr] Data última revisão:
180218
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE


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[PMID]:29236699
[Au] Autor:Solnes Miltenburg A; van der Eem L; Nyanza EC; van Pelt S; Ndaki P; Basinda N; Sundby J
[Ad] Endereço:Institute of Health and Society, Section for International Health, Faculty of Medicine, University of Oslo, Oslo, Norway.
[Ti] Título:Antenatal care and opportunities for quality improvement of service provision in resource limited settings: A mixed methods study.
[So] Source:PLoS One;12(12):e0188279, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Antenatal care is essential to improve maternal and newborn health and wellbeing. The majority of pregnant women in Tanzania attend at least one visit. Since implementation of the focused antenatal care model, quality of care assessments have mostly focused on utilization and coverage of routine interventions for antenatal care. This study aims to assess the quality of antenatal care provision from a holistic perspective in a rural district in Tanzania. Structure, process and outcome components of quality are explored. This paper reports on data collected over several periods from 2012 to 2015 through facility audits of supplies and services, ANC observations and exit interviews with pregnant women. Additional qualitative methods were used such as interviews, focus group observations and participant observations. Findings indicate variable performance of routine ANC services, partly explained by insufficient resources. Poor performance was also observed for appropriate history taking, attention for client's wellbeing, basic physical examination and adequate counseling and education. Achieving quality improvement for ANC requires increased attention for the process of care provision beyond coverage, including attention for response-based services, which should be assessed based on locally determined criteria.
[Mh] Termos MeSH primário: Serviços de Saúde da Criança/normas
Serviços de Saúde Materna/normas
Melhoria de Qualidade
Serviços de Saúde Rural/normas
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Lactente
Recém-Nascido
Gravidez
Tanzânia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188279


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[PMID]:29298306
[Au] Autor:Stewart FA; Piel AK; Luncz L; Osborn J; Li Y; Hahn BH; Haslam M
[Ad] Endereço:School of Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, United Kingdom.
[Ti] Título:DNA recovery from wild chimpanzee tools.
[So] Source:PLoS One;13(1):e0189657, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Most of our knowledge of wild chimpanzee behaviour stems from fewer than 10 long-term field sites. This bias limits studies to a potentially unrepresentative set of communities known to show great behavioural diversity on small geographic scales. Here, we introduce a new genetic approach to bridge the gap between behavioural material evidence in unhabituated chimpanzees and genetic advances in the field of primatology. The use of DNA analyses has revolutionised archaeological and primatological fields, whereby extraction of DNA from non-invasively collected samples allows researchers to reconstruct behaviour without ever directly observing individuals. We used commercially available forensic DNA kits to show that termite-fishing by wild chimpanzees (Pan troglodytes schweinfurthii) leaves behind detectable chimpanzee DNA evidence on tools. We then quantified the recovered DNA, compared the yield to that from faecal samples, and performed an initial assessment of mitochondrial and microsatellite markers to identify individuals. From 49 termite-fishing tools from the Issa Valley research site in western Tanzania, we recovered an average of 52 pg/µl chimpanzee DNA, compared to 376.2 pg/µl in faecal DNA extracts. Mitochondrial DNA haplotypes could be assigned to 41 of 49 tools (84%). Twenty-six tool DNA extracts yielded >25 pg/µl DNA and were selected for microsatellite analyses; genotypes were determined with confidence for 18 tools. These tools were used by a minimum of 11 individuals across the study period and termite mounds. These results demonstrate the utility of bio-molecular techniques and a primate archaeology approach in non-invasive monitoring and behavioural reconstruction of unhabituated primate populations.
[Mh] Termos MeSH primário: DNA/genética
Pan troglodytes/genética
[Mh] Termos MeSH secundário: Animais
Reação em Cadeia da Polimerase em Tempo Real
Tanzânia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
9007-49-2 (DNA)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180206
[Lr] Data última revisão:
180206
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189657


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[PMID]:29287070
[Au] Autor:Hercik C; Cosmas L; Mogeni OD; Wamola N; Kohi W; Omballa V; Ochieng M; Lidechi S; Bonventure J; Ochieng C; Onyango C; Fields BS; Mfinanga S; Montgomery JM
[Ad] Endereço:Georgetown University, Washington, DC, United States of America.
[Ti] Título:A diagnostic and epidemiologic investigation of acute febrile illness (AFI) in Kilombero, Tanzania.
[So] Source:PLoS One;12(12):e0189712, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: In low-resource settings, empiric case management of febrile illness is routine as a result of limited access to laboratory diagnostics. The use of comprehensive fever syndromic surveillance, with enhanced clinical microbiology, advanced diagnostics and more robust epidemiologic investigation, could enable healthcare providers to offer a differential diagnosis of fever syndrome and more appropriate care and treatment. METHODS: We conducted a year-long exploratory study of fever syndrome among patients ≥ 1 year if age, presenting to clinical settings with an axillary temperature of ≥37.5°C and symptomatic onset of ≤5 days. Blood and naso-pharyngeal/oral-pharyngeal (NP/OP) specimens were collected and analyzed, respectively, using AFI and respiratory TaqMan Array Cards (TAC) for multi-pathogen detection of 57 potential causative agents. Furthermore, we examined numerous epidemiologic correlates of febrile illness, and conducted demographic, clinical, and behavioral domain-specific multivariate regression to statistically establish associations with agent detection. RESULTS: From 15 September 2014-13 September 2015, 1007 febrile patients were enrolled, and 997 contributed an epidemiologic survey, including: 14% (n = 139) 1<5yrs, 19% (n = 186) 5-14yrs, and 67% (n = 672) ≥15yrs. AFI TAC and respiratory TAC were performed on 842 whole blood specimens and 385 NP/OP specimens, respectively. Of the 57 agents surveyed, Plasmodium was the most common agent detected. AFI TAC detected nucleic acid for one or more of seven microbial agents in 49% of AFI blood samples, including: Plasmodium (47%), Leptospira (3%), Bartonella (1%), Salmonella enterica (1%), Coxiella burnetii (1%), Rickettsia (1%), and West Nile virus (1%). Respiratory TAC detected nucleic acid for 24 different microbial agents, including 12 viruses and 12 bacteria. The most common agents detected among our surveyed population were: Haemophilus influenzae (67%), Streptococcus pneumoniae (55%), Moraxella catarrhalis (39%), Staphylococcus aureus (37%), Pseudomonas aeruginosa (36%), Human Rhinovirus (25%), influenza A (24%), Klebsiella pneumoniae (14%), Enterovirus (15%) and group A Streptococcus (12%). Our epidemiologic investigation demonstrated both age and symptomatic presentation to be associated with a number of detected agents, including, but not limited to, influenza A and Plasmodium. Linear regression of fully-adjusted mean cycle threshold (Ct) values for Plasmodium also identified statistically significant lower mean Ct values for older children (20.8), patients presenting with severe fever (21.1) and headache (21.5), as well as patients admitted for in-patient care and treatment (22.4). CONCLUSIONS: This study is the first to employ two syndromic TaqMan Array Cards for the simultaneous survey of 57 different organisms to better characterize the type and prevalence of detected agents among febrile patients. Additionally, we provide an analysis of the association between adjusted mean Ct values for Plasmodium and key clinical and demographic variables, which may further inform clinical decision-making based upon intensity of infection, as observed across endemic settings of sub-Saharan Africa.
[Mh] Termos MeSH primário: Febre/diagnóstico
Febre/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Criança
Pré-Escolar
Estudos Transversais
Feminino
Febre/microbiologia
Febre/virologia
Seres Humanos
Lactente
Masculino
Meia-Idade
Vigilância da População
Tanzânia/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171230
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189712



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