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101. Schistosomiasis and Human Immunodeficiency Virus in Men in Tanzania

Author

Downs, Jennifer A., primary, de Dood, Claudia J., additional, Dee, Hannah E., additional, McGeehan, Megan, additional, Khan, Hijab, additional, Marenga, Abena, additional, Adel, Patrick E., additional, Faustine, Edward, additional, Issarow, Benson, additional, Kisanga, Emmanuel F., additional, Kisigo, Godfrey Alfred, additional, Ngahyolerwa, Salvius, additional, Zahoro, Frank, additional, Miyaye, Donald, additional, Magawa, Ruth Gideon, additional, Mngara, Julius, additional, Lee, Myung Hee, additional, Corstjens, Paul L. A. M., additional, van Dam, Govert J., additional, and Fitzgerald, Daniel W., additional

Published
2017
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102. Design and pilot testing of a church-based intervention to address interpersonal and intrapersonal barriers to uptake of family planning in rural Tanzania: a qualitative implementation study

Author

Aristide, Christine, Mwakisole, Agrey, Mwakisole, Nelusigwe, Emmanuel, Mary, Laizer, Evarist, Kihunrwa, Albert, Downs, David, Wamoyi, Joyce, and Downs, Jennifer

Abstract

BackgroundUse of family planning (FP) saves the lives of mothers and children, and contributes to better economic outcomes for households and empowerment for women. In Tanzania, the overall unmet need for FP is high. This study aimed: (1) to use focus group data to construct a theoretical framework to understand the multidimensional factors impacting the decision to use FP in rural Tanzania; (2) to design and pilot-test an educational seminar, informed by this framework, to promote uptake of FP; and (3) to assess acceptability and further refine the educational seminar based on focus group data collected 3 months after the education was provided.MethodsWe performed a thematic analysis of 10 focus group discussions about social and religious aspects of FP from predominantly Protestant church attenders prior to any intervention, and afterwards from six groups of church leaders who had attended the educational seminar.ResultsKey interpersonal influences included lack of support from husband/partner, family members, neighbours and church communities. Major intrapersonal factors impeding FP use were lack of medical knowledge and information, misconceptions, and perceived incompatibility of FP and Christian faith. Post-seminar, leaders reported renewed intrapersonal perspectives on FP and reported teaching these perspectives to community members.ConclusionsAddressing intrapersonal barriers to FP use for leaders led them to subsequently address both intrapersonal and interpersonal barriers in their church communities. This occurred primarily by increasing knowledge and support for FP in men, family members, neighbours and church communities.

Published
2020
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103. Centrally-located pulmonary hamartoma diagnosed in a 16-year-old boy presenting with chronic chest pain: a case report

Author

Mpondo, Bonaventura, Rusheke, Hamim, Meda, John R., Downs, Jennifer A., and Kilonzo, Semvua B.

Subjects
Hamartoma, pulmonary, chest pain, adolescent, Tanzania
Abstract

Pulmonary hamartomas are the most common benign tumors of the lung. They are usually diagnosed incidentally while evaluating for other conditions. These tumors have been shown to be uncommon below the age of 25 years. We report a case of a 16-year-old male who presented with chronic chest pain and was histologically confirmed to have pulmonary hamartoma. The tumor was successfully resected. This is the first case of hamartoma to be reported in our country, and the atypical age at presentation together with the tumor’s position makes it more unique. In conclusion, although very rare, pulmonary hamartomas can occur in young age with the central location. Clinically, the presentation is usually non-specific and the diagnosis is mostly incidental while investigating other conditions. There is a need to increase awareness among clinicians on hamartomas to improve early treatment for this rare disease in the adolescents.

Published
2014

104. Altered Cervical Mucosal Gene Expression and Lower Interleukin 15 Levels in Women With Schistosoma haematobium Infection but Not in Women With Schistosoma mansoni Infection.

Author

Dupnik, Kathryn M, Lee, Myung Hee, Mishra, Pallavi, Reust, Mary Juliet, Colombe, Soledad, Haider, Syeda Razia, Yao, Benjamin, Vick, Kaitlin, Zhang, Tuo, Xiang, Jenny, Miyaye, Donald, Magawa, Ruth, Lyimo, Eric, Mukerebe, Crispin, Mngara, Julius, Kalluvya, Samuel E, Dood, Claudia J de, Dam, Govert J van, Corstjens, Paul L A M, and Downs, Jennifer A

Subjects
SCHISTOSOMA haematobium, SCHISTOSOMA mansoni, GENE expression, HIV, THERAPEUTICS
Abstract

Background: Schistosomiasis increases the risk of human immunodeficiency virus (HIV) acquisition in women by mechanisms that are incompletely defined. Our objective was to determine how the cervical environment is impacted by Schistosoma haematobium or Schistosoma mansoni infection by quantifying gene expression in the cervical mucosa and cytokine levels in cervicovaginal lavage fluid.Methods: We recruited women with and those without S. haematobium infection and women with and those without S. mansoni infection from separate villages in rural Tanzania with high prevalences of S. haematobium and S. mansoni, respectively. Infection status was determined by urine and stool microscopy and testing for serum circulating anodic antigen. RNA was extracted from cervical cytobrush samples for transcriptome analysis. Cytokine levels were measured by magnetic bead immunoassay.Results: In the village where S. haematobium was prevalent, 110 genes were differentially expressed in the cervical mucosa of 18 women with versus 39 without S. haematobium infection. Among the 27 cytokines analyzed in cervicovaginal lavage fluid from women in this village, the level of interleukin 15 was lower in the S. haematobium-infected group (62.8 vs 102.9 pg/mL; adjusted P = .0013). Differences were not observed in the S. mansoni-prevalent villages between 11 women with and 29 without S. mansoni infection.Conclusions: We demonstrate altered cervical mucosal gene expression and lower interleukin 15 levels in women with S. haematobium infection as compared to those with S. mansoni infection, which may influence HIV acquisition and cancer risks. Studies to determine the effects of antischistosome treatment on these mucosal alterations are needed. [ABSTRACT FROM AUTHOR]

Published
2019
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105. Linkage to Primary Care and Survival After Hospital Discharge for HIV-Infected Adults in Tanzania: A Prospective Cohort Study.

Author

Peck, Robert N, Peck, Robert N, Wang, Richard J, Mtui, Graham, Smart, Luke, Yango, Missana, Elchaki, Rim, Wajanga, Bahati, Downs, Jennifer A, Mteta, Kien, Fitzgerald, Daniel W, Peck, Robert N, Peck, Robert N, Wang, Richard J, Mtui, Graham, Smart, Luke, Yango, Missana, Elchaki, Rim, Wajanga, Bahati, Downs, Jennifer A, Mteta, Kien, and Fitzgerald, Daniel W

Abstract

IntroductionLittle is known about outcomes after hospitalization for HIV-infected adults in sub-Saharan Africa. We determined 12-month, posthospital mortality rates in HIV-infected vs. uninfected adults and predictors of mortality.MethodsIn this prospective cohort study, we enrolled adults admitted to the medical wards of a public hospital in northwestern Tanzania. We conducted standardized questionnaires, physical examinations, and basic laboratory analyses including HIV testing. Participants or proxies were called at 1, 3, 6, and 12 months to determine outcomes. Predictors of in-hospital and posthospital mortality were determined using logistic regression. Cox regression models were used to analyze mortality incidence and associated factors. To confirm our findings, we studied adults admitted to another government hospital.ResultsWe enrolled 637 consecutive adult medical inpatients: 38/143 (26.6%) of the HIV-infected adults died in hospital vs. 104/494 (21.1%) of the HIV-uninfected adults. Twelve-month outcomes were determined for 98/105 (93.3%) vs. 352/390 (90.3%) discharged adults, respectively. Posthospital mortality was 53/105 (50.5%) for HIV-infected adults vs. 126/390 (32.3%) for HIV-uninfected adults (adjusted P = 0.006). The 66/105 (62.9%) HIV-infected adults who attended clinic within 1 month after discharge had significantly lower mortality than the other HIV-infected adults [adjusted hazards ratio = 0.17 (0.07-0.39), P < 0.001]. Adults admitted to a nearby government hospital had similar high rates of posthospital mortality.ConclusionsPosthospital mortality is disturbingly high among HIV-infected adult inpatients in Tanzania. The posthospital period may offer a window of opportunity to improve survival in this population. Interventions are urgently needed and should focus on increasing posthospital linkage to primary HIV care.

Published
2016

106. Antiretroviral Therapy, Renal Function among HIV-Infected Tanzanian, Adults, HIV/AIDS

Author

Mpondo, Bonaventura C T, Kalluvya, Samuel E, Peck, Robert N, Kabangila, Rodrick, Kidenya, Benson R, Ephraim, Lucheri, Fitzgerald, Daniel W, and Downs, Jennifer A

Subjects
Treatment, Surveillance, urologic and male genital diseases
Abstract

Data regarding the outcomes of HIV-infected adults with baseline renal dysfunction who start antiretroviral therapy are conflicting. We followed up a previously-published cohort of HIV-infected adult outpatients in northwest Tanzania who had high prevalence of renal dysfunction at the time of starting antiretroviral therapy (between November 2009 and February 2010). Patients had serum creatinine, proteinuria, microalbuminuria, and CD4(+) T-cell count measured at the time of antiretroviral therapy initiation and at follow-up. We used the adjusted Cockroft-Gault equation to calculate estimated glomerular filtration rates (eGFRs). In this cohort of 171 adults who had taken antiretroviral therapy for a median of two years, the prevalence of renal dysfunction (eGFR

Published
2014

110. Centrally-located pulmonary hamartoma diagnosed in a 16-year-old boy presenting with chronic chest pain: a case report

Author

MPONDO, BONAVENTURA, RUSHEKE, HAMIM, MEDA, JOHN R., DOWNS, JENNIFER A., KILONZO, SEMVUA B., MPONDO, BONAVENTURA, RUSHEKE, HAMIM, MEDA, JOHN R., DOWNS, JENNIFER A., and KILONZO, SEMVUA B.

Abstract

Pulmonary hamartomas are the most common benign tumors of the lung. They are usually diagnosed incidentally while evaluating for other conditions. These tumors have been shown to be uncommon below the age of 25 years. We report a case of a 16-year-old male who presented with chronic chest pain and was histologically confirmed to have pulmonary hamartoma. The tumor was successfully resected. This is the first case of hamartoma to be reported in our country, and the atypical age at presentation together with the tumor’s position makes it more unique. In conclusion, although very rare, pulmonary hamartomas can occur in young age with the central location. Clinically, the presentation is usually non-specific and the diagnosis is mostly incidental while investigating other conditions. There is a need to increase awareness among clinicians on hamartomas to improve early treatment for this rare disease in the adolescents.

Published
2015

111. ‘The body we leave behind’: a qualitative study of obstacles and opportunities for increasing uptake of male circumcision among Tanzanian Christians

Author

Downs, Jennifer A, Fuunay, Lucas D, Fuunay, Mary, Mbago, Mary, Mwakisole, Agrey, Peck, Robert N, and Downs, David J

Subjects
Research, HIV/AIDS
Abstract

Objectives Male circumcision (MC) reduces HIV infection by approximately 60% among heterosexual men and is recommended by the WHO for HIV prevention in sub-Saharan Africa. In northwest Tanzania, over 60% of Muslims but less than 25% of Christian men are circumcised. We hypothesised that the decision to circumcise may be heavily influenced by religious identity and that specific religious beliefs may offer both obstacles and opportunities to increasing MC uptake, and conducted focus group discussions to explore reasons for low rates of MC among Christian church attenders in the region. Design Qualitative study using focus group discussions and interpretative phenomenological analysis. Setting Discussions took place at churches in both rural and urban areas of the Mwanza region of northwest Tanzania. Participants We included 67 adult Christian churchgoers of both genders in a total of 10 single-gender focus groups. Results Christians frequently reported perceiving MC as a Muslim practice, as a practice for the sexually promiscuous, or as unnecessary since they are taught to focus on ‘circumcision of the heart’. Only one person had ever heard MC discussed at church, but nearly all Christian parishioners were eager for their churches to address MC and felt that MC could be consistent with their faith. Conclusions Christian religious beliefs among Tanzanian churchgoers provide both obstacles and opportunities for increasing uptake of MC. Since half of adults in sub-Saharan Africa identify themselves as Christians, addressing these issues is critical for MC efforts in this region.

Published
2013

119. Effects of schistosomiasis on susceptibility to HIV-1 infection and HIV-1 viral load at HIV-1 seroconversion: A nested case-control study.

Author

Dupnik, Kathryn M., Lee, Myung Hee, Jr.Johnson, Warren D., Fitzgerald, Daniel W., Downs, Jennifer A., Peck, Robert N., van Dam, Govert J., Kornelis, Dieuwke, Hoekstra, Pytsje, Urassa, Mark, Lutonja, Peter, Kanjala, Chifundo, Isingo, Raphael, Changalucha, John M., de Dood, Claudia J., Corstjens, Paul L. A. M., and Todd, Jim

Subjects
SCHISTOSOMIASIS, HIV-positive persons, IMMUNOREGULATION, SURVEYS, PATIENTS, DISEASE risk factors
Abstract

Background: Schistosomiasis affects 218 million people worldwide, with most infections in Africa. Prevalence studies suggest that people with chronic schistosomiasis may have higher risk of HIV-1 acquisition and impaired ability to control HIV-1 replication once infected. We hypothesized that: (1) pre-existing schistosome infection may increase the odds of HIV-1 acquisition and that the effects may differ between men and women, and (2) individuals with active schistosome infection at the time of HIV-1 acquisition may have impaired immune control of HIV-1, resulting in higher HIV-1 viral loads at HIV-1 seroconversion. Methology/Principal findings: We conducted a nested case-control study within a large population-based survey of HIV-1 transmission in Tanzania. A population of adults from seven villages was tested for HIV in 2007, 2010, and 2013 and dried blood spots were archived for future studies with participants’ consent. Approximately 40% of this population has Schistosoma mansoni infection, and 2% has S. haematobium. We tested for schistosome antigens in the pre- and post-HIV-1-seroconversion blood spots of people who acquired HIV-1. We also tested blood spots of matched controls who did not acquire HIV-1 and calculated the odds that a person with schistosomiasis would become HIV-1-infected compared to these matched controls. Analysis was stratified by gender. We compared 73 HIV-1 seroconverters with 265 controls. Women with schistosome infections had a higher odds of HIV-1 acquisition than those without (adjusted OR = 2.8 [1.2–6.6], p = 0.019). Schistosome-infected men did not have an increased odds of HIV-1 acquisition (adjusted OR = 0.7 [0.3–1.8], p = 0.42). We additionally compared HIV-1 RNA levels in the post-seroconversion blood spots in HIV-1 seroconverters with schistosomiasis versus those without who became HIV-infected in 2010, before antiretroviral therapy was widely available in the region. The median whole blood HIV-1 RNA level in the 15 HIV-1 seroconverters with schistosome infection was significantly higher than in the 22 without schistosomiasis: 4.4 [3.9–4.6] log10 copies/mL versus 3.7 [3.2–4.3], p = 0.017. Conclusions/Significance: We confirm, in an area with endemic S. mansoni, that pre-existing schistosome infection increases odds of HIV-1 acquisition in women and raises HIV-1 viral load at the time of HIV-1 seroconversion. This is the first study to demonstrate the effect of schistosome infection on HIV-1 susceptibility and viral control, and to differentiate effects by gender. Validation studies will be needed at additional sites. [ABSTRACT FROM AUTHOR]

Published
2017
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120. The C-Acylation of Trilithiated Acetoacetanilides Followed by Cyclization and Rearrangements to 3-Aryl-5-Aminoaryl-2H-Pyran-2-Ones

Author

Downs, Jennifer R., Grant, Sally P., Townsend, Jessica D., Pastine, Stefan J., Embree, Mildred C., Metz, Clyde R., Walsch, Rosa D. Bailey, Pennington, William T., and Beam, Charles F.

Subjects
Chemical research -- Analysis, Science and technology, Analysis
Abstract

The initially perceived routine condensation of trilithiated acetoacetanilides with several benzoate esters did not give the anticipated C-acylated or cyclized 4-pyranone product. A 2-pyranone resulting from several rearrangements of the [...]

Published
2001

123. Oesophageal varices, schistosomiasis, and mortality among patients admitted with haematemesis in Mwanza, Tanzania: a prospective cohort study

Author

Chofle, Awilly A, primary, Jaka, Hyasinta, additional, Koy, Mheta, additional, Smart, Luke R, additional, Kabangila, Rodrick, additional, Ewings, Fiona M, additional, Mazigo, Humphrey D, additional, Johnson, Warren D, additional, Fitzgerald, Daniel W, additional, Peck, Robert N, additional, and Downs, Jennifer A, additional

Published
2014
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130. Detectable urogenital schistosome DNA and cervical abnormalities 6 months after single-dose praziquantel in women withSchistosoma haematobiuminfection

Author

Downs, Jennifer A., primary, Kabangila, Rodrick, additional, Verweij, Jaco J., additional, Jaka, Hyasinta, additional, Peck, Robert N., additional, Kalluvya, Samuel E., additional, Changalucha, John M., additional, Johnson, Warren D., additional, van Lieshout, Lisette, additional, and Fitzgerald, Daniel W., additional

Published
2013
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132. Association of Schistosomiasis and HIV Infection in Tanzania

Author

Downs, Jennifer A., primary, Changalucha, John M., additional, Andreasen, Aura, additional, Johnson, Warren D., additional, Kalluvya, Samuel E., additional, Fitzgerald, Daniel W., additional, de Dood, Claudia J., additional, Bang, Heejung, additional, Corstjens, Paul L. A. M., additional, van Lieshout, Lisette, additional, Peck, Robert N., additional, and van Dam, Govert J., additional

Published
2012
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137. Preparation of 2-(1-phenyl-1H-pyrazol-5-yl)benzenesulfonamides from polylithiated C(α),N-phenylhydrazones and methyl 2-(aminosulfonyl)benzoate

Author

Meierhoefer, Michelle A., primary, Dunn, S. Patrick, additional, Hajiaghamohseni, Laela M., additional, Walters, Matthew J., additional, Embree, Mildred C., additional, Grant, Sally P., additional, Downs, Jennifer R., additional, Townsend, Jessica D., additional, Metz, Clyde R., additional, Beam, Charles F., additional, Pennington, William T., additional, VanDerveer, Donald G., additional, and Camper, N. Dwight, additional

Published
2005
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138. Condensation-cyclizaiton of polylithiated methyl (2-aminosulfonyl)benzoate with several dianion type intermediates. (South Carolina Academy of Sciences Abstracts)

Author

Dunn, S. Patrick, Walters, Matthew J., Downs, Jennifer R., Embree, Midred C., Grant, Sally P., Metz, Clyde R., and Beam, Charles F.

Subjects
Chemical research -- Research, Solvents -- Research, Heterocyclic compounds -- Research, Science and technology, Research
Abstract

Dilithiated oximes, phenylhydrazones or carboalkoxyhydrazones were prepared in excess lithium diisopropylamide [LDA] and condensed with polylithiated methyl (2-amino-sulfonyl)benzoate to give C-acylated intermediates that can be isolated or cyclized to the [...]

Published
2003

140. Accent on Chicago. (Acquisitions)

Author

Downs, Jennifer M.

Subjects
Art Institute of Chicago -- Collections and collecting, Art, Modern -- Collections and collecting
Abstract

The Art institute of Chicago's collection of Modern decorative arts was initially shaped by a group of innovative curators who promoted the Art Institute as a public educator as well […]

Published
2002

141. The preparation of 5-isoxazolecarboxamides and related compounds from the condensation and cyclization of dilithiated oximes or polylithiated hydrazones with polylithiated oxanilates

Author

Rhett, J. Matthew, Downs, Jennifer R., Choi, Emily, Malatanos, Maria D., Sahn, James J., and Beam, Charles F.

Subjects
Chemical research -- Analysis, Science and technology, Analysis
Abstract

Several dilithiated C(α), O-oximes were prepared in excess lithium diisopropylamide and condensed with lithiated ethyl oxanilates to give C-acylated intermediates that could be isolated and separately cyclized with aqueous acid [...]

Published
2002

142. The Preparation of N-Carboalkoxydihydrobenzindazoles and Related Materials from Dilithiated Carbalkoxyhydrazones of 1- and 2-Tetralone and Aromatic Esters or Lithiated Salicylate Esters

Author

Grant, Sally P., Embree, Mildred C., Downs, Jennifer R., Townsend, Jessica D., Overby, Jason S., and Beam, Charles F.

Subjects
Biochemistry -- Research, Science and technology, Research
Abstract

Carboalkoxyhydrazones of 1- and 2-tetralone were dilithiated with excess diisopropylamide, condense with select esters followed by acid cyclization to new dihydrobenzindazoles. These compounds have the potential for the preparation of [...]

Published
2001

143. The Preparation of N-H Pyrazoles from Dilithiated Carbo-tert-butoxyhydrazones and Aromatic Esters

Author

Embree, Mildred C., Grant, Sally P., Downs, Jennifer R., Bear, Jennifer J., Choi, Emily, Sahn, James J., Overby, Jason S., and Beam, Charles F.

Subjects
Biochemistry -- Research, Pyrazoles -- Research, Science and technology, Research
Abstract

C(α),N-Carbo-tert-butoxyhydrazones were prepared and dilithiated with excess lithium diisopropylamide, and condensed with a variety of aromatic esters to afford C-acylated intermediates that were not isolated. These intermediates were treated with [...]

Published
2001

144. The Preparation of 5-Isoxazolecarboxamides and Pyrazole-5-Carboxamides From the Condensation and Cyclization of Dilithiated Oximes, Phenylhydrazones, or Carboalkoxyhydrazones with Polylithiated Oximates or Oxanilates

Author

Downs, Jennifer R., Embree, Mildred C., Townsend, Jessica D., and Beam, Charles F.

Subjects
Chemical research -- Analysis, Science and technology, Analysis
Abstract

Several dilithiated C(α), O-oximes or C(α), N-hydrazones were prepared in excess lithium diisopropylamide and condensed with either dilithiated ethyl oximate or lithiated ethyl oxanilates to give C-acylated intermediates that could [...]

Published
2001

145. Preparation of substituted 1,2‐Dihydro‐3H‐pyrazol‐3‐ones from polylithiated 2′‐phenylphenylacetohydrazides and aromatic esters

Author

Downs, Jennifer R., primary, Pastine, Stefan J., additional, Townsend, Jessica D., additional, Greer, Heather A., additional, Kelley, Wayne, additional, Schady, Deborah A., additional, Mcconaughy, Teresa Lentz, additional, Metz, Clyde R., additional, Beam, Charles F., additional, Almquist, Catharine D., additional, Pennington, William T., additional, and Walsch, Rosa D. Bailey, additional

Published
2001
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148. Letters to the Editor

Author

Foy, Kate, primary, Fall, Amy Sue, additional, Elliott, Nancy, additional, Mulcock, Shawnie Morning, additional, Hopkins, Kirsten, additional, Lawson, Maya, additional, Burke, William, additional, White, Emily, additional, and Downs, Jennifer, additional

Published
2001
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149. ChemInform Abstract: The Preparation of 4,5-Dihydro-5-phenyl-5-(2-phenylethenyl)isoxazoles, 4,5-Dihydro-5-methyl-5-(2-phenylethenyl)isoxazoles, or 4,5-Dihydro-5,5-di-(2-phenylethenyl)isoxazoles from Dilithiated C(α),O-Oximes and Select α,β-Unsaturated Ket

Author

Townsend, Jessica D., primary, Kelley Jr., Wayne, additional, Rose, Kelly L., additional, Schady, Deborah A., additional, Downs, Jennifer R., additional, Greer, Heather A., additional, Pastine, Stefan J., additional, and Beam, Charles F., additional

Published
2000
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150. The Preparation of 4,5-Dihydro-5-Phenyl-5-(2-Phenylethenyl)Isoxazoles, 4,5-Dihydro-5-Methyl-5-(2-Phenylethenyl)Isoxazoles, or 4,5-Dihydro-5,5-DI-(2-Phenylethenyl)Isoxazoles from Dilithiated C(α),O-Oximes and Select α,β–-Unsaturated Ketones

Author

Townsend, Jessica D., primary, Kelley, Wayne, additional, Rose, Kelly L., additional, Schady, Deborah A., additional, Downs, Jennifer R., additional, Greer, Heather A., additional, Pastine, Stefan J., additional, and Beam, Charles F., additional

Published
2000
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