TY  - JOUR
AB  - BACKGROUND: Studies have demonstrated an inverse log-linear relationship between body mass index (BMI) and tuberculosis incidence. However, a person's BMI is dynamic and longitudinal changes may be more informative than cross-sectional assessments. We evaluate the association between cross-sectional and changing BMI and risk of tuberculosis and describe longitudinal trajectories in a high-risk cohort. METHODS: ERASE-TB was a prospective longitudinal cohort study of household contacts ≥10 years in Southern Africa (Zimbabwe, Tanzania, and Mozambique), with 6-monthly follow-up up to 24 months. Associations between BMI and tuberculosis were investigated based on baseline (including haemoglobin) and changing BMI, using logistic, Poisson, and Cox models. Prevalent tuberculosis was defined as diagnosis during <30 days after recruitment. Growth mixture modelling (GMM) was used to model longitudinal latent trajectories. RESULTS: Of 2,107 recruited household contacts (621 [29.5%] adolescents and 1,310 [62.2%] female), 520 (24.7%) were underweight. There were 21 and 41 people diagnosed with prevalent and incident tuberculosis, of whom 5/21 (23.8%) and 12/41 (29.3%) were underweight. Being underweight and anaemic (aHR: 3.77, 95% CI: 1.50-9.51) and >10% negative change in BMI during follow-up (aIRR: 2.27 (95% CI: 0.22-22.9) were associated with increased risk of incident tuberculosis. The association between continuous BMI-for-age Z-scores were non-linear, with increased risk of tuberculosis with lower BMI. Four latent groups were defined in the GMM: increasing, decreasing, and low/high stable BMI. CONCLUSIONS: Declining BMI, regardless of absolute value, is a strong predictor of tuberculosis among household contacts. Longitudinal measurements should be considered in active case finding among tuberculosis-affected households.
AU  - Larsson, L.*
AU  - Calderwood, C.J.*
AU  - Marambire, E.T.*
AU  - Held, K.
AU  - Banze, D.*
AU  - Mfinanga, A.*
AU  - Madziva, K.*
AU  - Walsh, P.*
AU  - Jacob, J.*
AU  - Fernandez, F.T.*
AU  - Lungu, P.*
AU  - Mesic, A.*
AU  - Khosa, C.*
AU  - Minja, L.T.*
AU  - Mutsvangwa, J.*
AU  - Bhargava, M.*
AU  - Lauseker, M.*
AU  - Gupta, R.K.*
AU  - Heinrich, N.*
AU  - Kranzer, K.*
C1  - 74211
C2  - 57397
CY  - Journals Dept, 2001 Evans Rd, Cary, Nc 27513 Usa
TI  - Body mass index trajectories and association with tuberculosis risk in a cohort of household contacts in Southern Africa.
JO  - Clin. Infect. Dis.
PB  - Oxford Univ Press Inc
PY  - 2025
SN  - 1058-4838
ER  - 

TY  - JOUR
AB  - BACKGROUND: We assessed the impact of point-of-care (PoC) test-and-treat at birth on clinical outcomes and viral suppression among HIV-positive infants in Mozambique and Tanzania. METHODS: This cluster-randomized trial allocated health facilities to intervention, providing PoC-testing and antiretroviral treatment (ART) at birth and week 4-8, or control, starting these at week 4-8. The primary outcome was proportions of clinical events (mortality, morbidity, retention, virological failure, toxicity) among HIV-positive infants at month-18. We estimated incidence rate ratios adjusted for timing of HIV-detection (aIRR) and reported viral suppression <1000 copies/mL. FINDINGS: Among 6602 neonates enrolled October 2019-September 2021, 125 were diagnosed HIV-positive by week 12. In the intervention arm, 38/69 (55.1%) were diagnosed at birth with 35 initiating ART within two days. In the control arm, 27/56 (48.2%) were retrospectively detected HIV-positive at birth, of whom 6/56 (10.7%) died or were lost to follow-up before testing. Median age at ART initiation was 6 (intervention) versus 33 days (control). Birth test-and-treat was not associated with a significant reduction in clinical outcomes up to month-18 [53 (76.8%) versus 48 (85.7%); aIRR 0.857; 95% CI 0.505-1.492], but showed a 68% relative reduction in 6-month mortality. Viral suppression was poor overall, but improved in the intervention group at month 18 (65.7% versus 29.6%; p=0.005). INTERPRETATION: PoC test-and-treat at birth is feasible in resource-poor settings and resulted in clinically-relevant reduction of early infant mortality, though improved clinical outcomes were not sustained to month-18. Poor viral suppression may undermine early survival benefits, calling for better paediatric treatments and tailored adherence interventions.
AU  - Jani, I.V.*
AU  - Sabi, I.*
AU  - Elsbernd, K.*
AU  - Meggi, B.*
AU  - Mahumane, A.*
AU  - Lwilla, A.F.*
AU  - Pereira, K.*
AU  - Boniface, S.*
AU  - Edom, R.*
AU  - Lequechane, J.*
AU  - Chale, F.*
AU  - Chiwerengo, N.*
AU  - Ntinginya, N.E.*
AU  - Mudenyanga, C.*
AU  - Mueller, M.*
AU  - Rauscher, M.*
AU  - Hoelscher, M.
AU  - Taveira, N.*
AU  - Buck, W.C.*
AU  - Kroidl, A.*
C1  - 72317
C2  - 56593
CY  - Journals Dept, 2001 Evans Rd, Cary, Nc 27513 Usa
SP  - 1114-1124
TI  - Impact of point-of-care birth test-and-treat on clinical outcomes among infants with HIV: A cluster randomized trial in Mozambique and Tanzania.
JO  - Clin. Infect. Dis.
VL  - 80
IS  - 5
PB  - Oxford Univ Press Inc
PY  - 2024
SN  - 1058-4838
ER  - 

TY  - JOUR
AB  - A 9-month-old infant died from Ebola virus (EBOV) disease with unknown epidemiological link. While her parents did not report previous illness, laboratory investigations revealed persisting EBOV RNA in the mother's breast milk and the father's seminal fluid. Genomic analysis strongly suggests EBOV transmission to the child through breastfeeding.
AU  - Sissoko, D.*
AU  - Keita, M.*
AU  - Diallo, B.*
AU  - Aliabadi, N.*
AU  - Fitter, D.L.*
AU  - Dahl, B.A.*
AU  - Bore, J.A.*
AU  - Koundouno, F.R.*
AU  - Singethan, K.
AU  - Meisel, S.*
AU  - Enkirch, T.*
AU  - Mazzarelli, A.*
AU  - Amburgey, V.*
AU  - Faye, O.*
AU  - Sall, A.A.*
AU  - Magassouba, N.*
AU  - Carroll, M.W.*
AU  - Anglaret, X.*
AU  - Malvy, D.*
AU  - Formenty, P.*
AU  - Aylward, R.B.*
AU  - Keita, S.*
AU  - Djingarey, M.H.*
AU  - Loman, N.J.*
AU  - Guenther, S.*
AU  - Duraffour, S.*
C1  - 50867
C2  - 42919
CY  - Cary
SP  - 513-516
TI  - Ebola virus persistence in breast milk after no reported illness: A likely source of virus transmission from mother to child.
JO  - Clin. Infect. Dis.
VL  - 64
IS  - 4
PB  - Oxford Univ Press Inc
PY  - 2017
SN  - 1058-4838
ER  - 

TY  - JOUR
AB  - STAT3 hyper-IgE syndrome (STAT3-HIES) patients presented with significantly lower Staphylococcus aureus-specific serum IgG compared to cystic fibrosis patients despite recurrent S. aureus infections. Immunoglobulin replacement therapy increased S. aureus-specific IgG in STAT3-HIES patients and attenuated the clinical course of disease suggesting a role of humoral immunity in S. aureus clearance.
AU  - Stentzel, S.*
AU  - Hagl, B.
AU  - Abel, F.*
AU  - Kahl, B.C.*
AU  - Rack-Hoch, A.*
AU  - Broeker, B.M.*
AU  - Renner, E.D.
C1  - 51025
C2  - 42910
CY  - Cary
SP  - 1279-1282
TI  - Reduced immunoglobulin (Ig) G response to Staphylococcus aureus in STAT3 hyper-IgE syndrome.
JO  - Clin. Infect. Dis.
VL  - 64
IS  - 9
PB  - Oxford Univ Press Inc
PY  - 2017
SN  - 1058-4838
ER  -