8 results on '"Jessica McLellan"'
Search Results
2. Schistosoma and Strongyloides screening in migrants initiating HIV Care in Canada: a cross sectional study
- Author
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Jessica McLellan, M. John Gill, Stephen Vaughan, and Bonnie Meatherall
- Subjects
HIV ,Schistosoma ,Strongyloides ,Seroprevalence ,Immigrant ,Screening ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Following migration from Schistosoma and Strongyloides endemic to non-endemic regions, people remain at high risk for adverse sequelae from these chronic infections. HIV co-infected persons are particularly vulnerable to the serious and potentially fatal consequences of untreated helminth infection. While general screening guidelines exist for parasitic infection screening in immigrant populations, they remain silent on HIV positive populations. This study assessed the seroprevalence, epidemiology and laboratory characteristics of these two parasitic infections in a non-endemic setting in an immigrant/refugee HIV positive community. Methods Between February 2015 and 2018 individuals born outside of Canada receiving care at the centralized HIV clinic serving southern Alberta, Canada were screened by serology and direct stool analysis for schistosomiasis and strongyloidiasis. Canadian born persons with travel-based exposure risk factors were also screened. Epidemiologic and laboratory values were analyzed using bivariate logistic regression. We assessed the screening utility of serology, direct stool analysis, eosinophilia and hematuria. Results 253 HIV positive participants were screened. The prevalence of positive serology for Schistosoma and Strongyloides was 19.9 and 4.4%, respectively. Age between 40 and 50 years (OR 2.50, 95% CI 1.13–5.50), refugee status (3.55, 1.72–7.33), country of origin within Africa (6.15, 2.44–18.60), eosinophilia (3.56, 1.25–10.16) and CD4 count
- Published
- 2020
- Full Text
- View/download PDF
3. Association of C-Reactive Protein With Bacterial and Respiratory Syncytial Virus–Associated Pneumonia Among Children Aged <5 Years in the PERCH Study
- Author
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Azwifarwi Mudau, Zhenke Wu, Henry C. Baggett, Daniel R. Feikin, W. Abdullah Brooks, Alice Kamau, Rasheed Salaudeen, Juliet O. Awori, Khalequ Zaman, Stephanie Cascio, Peter V. Adrian, Locadiah Kuwanda, Lawrence Mwananyanda, Doli Goswami, James Chipeta, Mengying Li, James Mwansa, Pongpun Sawatwong, Donald M. Thea, Laura L. Hammitt, Hasan Ashraf, David R. Murdoch, Hubert P. Endtz, Julia Rhodes, Charatdao Bunthi, Geoff Kahn, Susan A. Maloney, Trevor P. Anderson, Phil Seidenberg, Stephen R. C. Howie, Uma Onwuchekwa, Amanda J. Driscoll, Somwe Wa Somwe, Shabir A. Madhi, Boubou Tamboura, Maria Deloria Knoll, Grant A. Mackenzie, Daniel E. Park, Pasakorn Akarasewi, Karen L. Kotloff, Jessica McLellan, Nasreen Mahomed, Christine Prosperi, Joanne L. Mitchell, Nana Kourouma, Mamadou Sylla, Orin S. Levine, Micah Silaba Ominde, Eunice M. Machuka, Katherine L. O'Brien, Vicky L. Baillie, Milagritos D. Tapia, Arifin Shamsul, Martin Antonio, Nora L. Watson, Susan C. Morpeth, E Wangeci Kagucia, Mohammed Ziaur Rahman, Nicholas Fancourt, David P. Moore, Sidi Kazungu, Melissa M. Higdon, Andrea DeLuca, Aliou Toure, Geoffrey Kwenda, Scott L. Zeger, Michelle J. Groome, Somsak Thamthitiwat, Angela Karani, Lokman Hossain, Yasmin Jahan, Samba O. Sow, Syed M. A. Zaman, Jane Crawley, Tham T Le, J. Anthony G. Scott, Anek Kaewpan, Somchai Chuananon, Ruth A. Karron, Bernard E. Ebruke, Wei Fu, and Medical Microbiology & Infectious Diseases
- Subjects
Male ,0301 basic medicine ,Microbiology (medical) ,Pneumonia, Viral ,030106 microbiology ,Oropharynx ,Respiratory Syncytial Virus Infections ,Polymerase Chain Reaction ,Sensitivity and Specificity ,Virus ,C-reactive protein ,03 medical and health sciences ,0302 clinical medicine ,Nasopharynx ,Pneumonia, Bacterial ,medicine ,Humans ,030212 general & internal medicine ,bacteria ,Lung ,biology ,business.industry ,pneumonia ,Infant, Newborn ,Area under the curve ,Bacterial pneumonia ,RSV ,Infant ,medicine.disease ,respiratory tract diseases ,3. Good health ,Community-Acquired Infections ,Pneumonia ,Infectious Diseases ,medicine.anatomical_structure ,ROC Curve ,Case-Control Studies ,Child, Preschool ,Respiratory Syncytial Virus, Human ,Immunology ,biology.protein ,Etiology ,biomarker ,Biomarker (medicine) ,Supplement Article ,Female ,business ,Biomarkers - Abstract
Background Lack of a gold standard for identifying bacterial and viral etiologies of pneumonia has limited evaluation of C-reactive protein (CRP) for identifying bacterial pneumonia. We evaluated the sensitivity and specificity of CRP for identifying bacterial vs respiratory syncytial virus (RSV) pneumonia in the Pneumonia Etiology Research for Child Health (PERCH) multicenter case-control study. Methods We measured serum CRP levels in cases with World Health Organization–defined severe or very severe pneumonia and a subset of community controls. We evaluated the sensitivity and specificity of elevated CRP for “confirmed” bacterial pneumonia (positive blood culture or positive lung aspirate or pleural fluid culture or polymerase chain reaction [PCR]) compared to “RSV pneumonia” (nasopharyngeal/oropharyngeal or induced sputum PCR-positive without confirmed/suspected bacterial pneumonia). Receiver operating characteristic (ROC) curves were constructed to assess the performance of elevated CRP in distinguishing these cases. Results Among 601 human immunodeficiency virus (HIV)–negative tested controls, 3% had CRP ≥40 mg/L. Among 119 HIV-negative cases with confirmed bacterial pneumonia, 77% had CRP ≥40 mg/L compared with 17% of 556 RSV pneumonia cases. The ROC analysis produced an area under the curve of 0.87, indicating very good discrimination; a cut-point of 37.1 mg/L best discriminated confirmed bacterial pneumonia (sensitivity 77%) from RSV pneumonia (specificity 82%). CRP ≥100 mg/L substantially improved specificity over CRP ≥40 mg/L, though at a loss to sensitivity. Conclusions Elevated CRP was positively associated with confirmed bacterial pneumonia and negatively associated with RSV pneumonia in PERCH. CRP may be useful for distinguishing bacterial from RSV-associated pneumonia, although its role in discriminating against other respiratory viral-associated pneumonia needs further study.
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- 2017
4. The diagnostic utility of induced sputum microscopy and culture in childhood pneumonia
- Author
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Salim Mwarumba, J. Anthony G. Scott, Amanda J. Driscoll, Nora L. Watson, David P. Moore, Melissa M. Higdon, Christine Prosperi, Donald M. Thea, Dilruba Ahmed, David R. Murdoch, Orin S. Levine, Stephen R. C. Howie, Katherine L. O'Brien, Milagritos D. Tapia, Ornuma Sangwichian, Seydou Sissoko, John Mwaba, Daniel R. Feikin, Susan C. Morpeth, Andrea DeLuca, Shabir A. Madhi, W. Abdullah Brooks, Henry C. Baggett, Ruth A. Karron, Daniel E. Park, Maria Deloria Knoll, Jessica McLellan, Eunice M. Machuka, Peter V. Adrian, Laura L. Hammitt, Juliet O. Awori, Geoffrey Kwenda, Sirirat Makprasert, Scott L. Zeger, Muntasir Alam, and Karen L. Kotloff
- Subjects
Adult ,Male ,0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Pathology ,medicine.drug_class ,030106 microbiology ,Antibiotics ,Induced sputum ,Child health ,03 medical and health sciences ,0302 clinical medicine ,Childhood pneumonia ,Internal medicine ,Pneumonia, Bacterial ,medicine ,Humans ,030212 general & internal medicine ,Respiratory Tract Infections ,Microscopy ,Bacteria ,medicine.diagnostic_test ,business.industry ,Infant, Newborn ,Sputum ,Infant ,Pneumonia ,medicine.disease ,culture ,respiratory tract diseases ,3. Good health ,Community-Acquired Infections ,children ,Infectious Diseases ,induced sputum ,Child, Preschool ,Etiology ,Female ,Supplement Article ,medicine.symptom ,Chest radiograph ,business - Abstract
Background.Sputum microscopy and culture are commonly used for diagnosing the cause of pneumonia in adults but are rarely performed in children due to difficulties in obtaining specimens. Induced sputum is occasionally used to investigate lower respiratory infections in children but has not been widely used in pneumonia etiology studies. Methods.We evaluated the diagnostic utility of induced sputum microscopy and culture in patients enrolled in the Pneumonia Etiology Research for Child Health (PERCH) study, a large study of community-acquired pneumonia in children aged 1–59 months. Comparisons were made between induced sputum samples from hospitalized children with radiographically confirmed pneumonia and children categorized as nonpneumonia (due to the absence of prespecified clinical and laboratory signs and absence of infiltrate on chest radiograph). Results.One induced sputum sample was available for analysis from 3772 (89.1%) of 4232 suspected pneumonia cases enrolled in PERCH. Of these, sputum from 2608 (69.1%) met the quality criterion of Conclusions.The findings of this study do not support the culture of induced sputum specimens as a diagnostic tool for pneumonia in young children as part of routine clinical practice.
- Published
- 2018
5. The Effect of Antibiotic Exposure and Specimen Volume on the Detection of Bacterial Pathogens in Children With Pneumonia
- Author
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Christine Prosperi, Daniel R. Feikin, Caroline W. Gitahi, Shabir A. Madhi, Dilruba Ahmed, Jessica McLellan, Muhammad Saifullah, Amanda J. Driscoll, David P. Moore, Phil Seidenberg, Ruth A. Karron, Orin S. Levine, Brooks Wa, Melissa M. Higdon, Boubou Tamboura, Deloria Knoll M, Peter V. Adrian, Henry C. Baggett, David R. Murdoch, Karen L. Kotloff, Razib Mazumder, Howie Src, Donald M. Thea, Bernard E. Ebruke, Samba O. Sow, Katherine L O'Brien, Anek Kaewpan, Julia Rhodes, Daniel E. Park, Lawrence Mwananyanda, Laura L. Hammitt, Scott Jag., Angela Karani, Andrea DeLuca, and Scott L. Zeger
- Subjects
0301 basic medicine ,Male ,Internationality ,Antibiotics ,Oropharynx ,medicine.disease_cause ,blood culture ,law.invention ,0302 clinical medicine ,law ,Nasopharynx ,Medicine ,Bioassay ,Blood culture ,030212 general & internal medicine ,Polymerase chain reaction ,medicine.diagnostic_test ,biology ,3. Good health ,Anti-Bacterial Agents ,Infectious Diseases ,Streptococcus pneumoniae ,Specimen collection ,Molecular Diagnostic Techniques ,Child, Preschool ,Female ,Supplement Article ,Microbiology (medical) ,medicine.drug_class ,030106 microbiology ,Real-Time Polymerase Chain Reaction ,Microbiology ,03 medical and health sciences ,Pneumonia, Bacterial ,Humans ,pneumonia ,Bacteriological Techniques ,Bacteria ,business.industry ,Infant, Newborn ,Sputum ,Infant ,biology.organism_classification ,medicine.disease ,Pneumonia ,children ,antibiotic exposure ,Case-Control Studies ,Immunology ,business - Abstract
Background Antibiotic exposure and specimen volume are known to affect pathogen detection by culture. Here we assess their effects on bacterial pathogen detection by both culture and polymerase chain reaction (PCR) in children. Methods PERCH (Pneumonia Etiology Research for Child Health) is a case-control study of pneumonia in children aged 1–59 months investigating pathogens in blood, nasopharyngeal/oropharyngeal (NP/OP) swabs, and induced sputum by culture and PCR. Antibiotic exposure was ascertained by serum bioassay, and for cases, by a record of antibiotic treatment prior to specimen collection. Inoculated blood culture bottles were weighed to estimate volume. Results Antibiotic exposure ranged by specimen type from 43.5% to 81.7% in 4223 cases and was detected in 2.3% of 4863 controls. Antibiotics were associated with a 45% reduction in blood culture yield and approximately 20% reduction in yield from induced sputum culture. Reduction in yield of Streptococcus pneumoniae from NP culture was approximately 30% in cases and approximately 32% in controls. Several bacteria had significant but marginal reductions (by 5%–7%) in detection by PCR in NP/ OP swabs from both cases and controls, with the exception of S. pneumoniae in exposed controls, which was detected 25% less frequently compared to nonexposed controls. Bacterial detection in induced sputum by PCR decreased 7% for exposed compared to nonexposed cases. For every additional 1 mL of blood culture specimen collected, microbial yield increased 0.51% (95% confidence interval, 0.47%–0.54%), from 2% when volume was ≤1 mL to approximately 6% for ≥3 mL. Conclusions Antibiotic exposure and blood culture volume affect detection of bacterial pathogens in children with pneumonia and should be accounted for in studies of etiology and in clinical management.
- Published
- 2017
6. Anterograde amnesia and disorientation are associated with in-patients without traumatic brain injury taking opioids. Retrograde amnesia (RA) is absent. RA assessment should be integral to post-traumatic amnesia testing
- Author
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Jessica McLellan, Laurence A.G. Marshman, and Maria Hennessy
- Subjects
Adult ,Male ,030506 rehabilitation ,Anterograde amnesia ,Traumatic brain injury ,Amnesia ,03 medical and health sciences ,Galveston Orientation and Amnesia Test ,0302 clinical medicine ,Physiology (medical) ,Brain Injuries, Traumatic ,medicine ,Humans ,Glasgow Coma Scale ,Confusion ,Aged ,Post-traumatic amnesia ,business.industry ,Retrograde amnesia ,General Medicine ,Middle Aged ,medicine.disease ,Amnesia, Anterograde ,Analgesics, Opioid ,Neurology ,Anesthesia ,Surgery ,Amnesia, Retrograde ,Female ,Neurology (clinical) ,Opiate ,medicine.symptom ,0305 other medical science ,business ,030217 neurology & neurosurgery - Abstract
The Glasgow Coma Scale (GCS) only assesses orientation after traumatic brain injury (TBI). ‘Post-traumatic amnesia’ (PTA) comprises orientation, anterograde amnesia (AA) and retrograde amnesia (RA). However, RA is often disregarded in formalized PTA assessment. Drugs can potentially confound PTA assessment: e.g. midazolam can cause AA. However, potential drug confounders are also often disregarded in formalized PTA testing. One study of medium-stay elective-surgery orthopaedic patients (without TBI) demonstrated AA in 80% taking opiates after general anesthesia. However, RA was not assessed. Opiates/opioids are frequently administered after TBI. We compared AA and RA in short-stay orthopaedic surgery in-patients (without TBI) taking post-operative opioids after opiate/opioid/benzodiazepine-free spinal anesthesia. In a prospective cohort, the Westmead PTA Scale (WPTAS) was used to assess AA (WPTAS < 12), whilst RA was assessed using the Galveston Orientation and Amnesia Test RA item. Results were obtained in n = 25 (60 ± 14 yrs, M:F 17:8). Surgery was uncomplicated: all were discharged by Day-4. All were taking regular oxycodone as a new post-operative prescription. Only one co-administered non-opioid was potentially confounding (temezepam, n = 4). Of 25, 14 (56%) demonstrated AA: five (20%) were simultaneously disorientated. Mean WPTAS was 11.08 ± 1.22. RA occurred in 0%. Conclusions: AA and disorientation, but not RA, were associated with in-patients (without TBI) taking opioids. Caution should therefore be applied in assessing AA/orientation in TBI in-patients taking opioids. By contrast, retrograde memory was robust and more reliable: even in older patients with iatrogenic AA and disorientation. RA assessment should therefore be integral to assessing TBI severity in all formalized PTA and GCS testing.
- Published
- 2016
7. Associations between nasopharyngeal carriage of Group B Streptococcus and other respiratory pathogens during early infancy
- Author
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Martin O. C. Ota, Ifedayo M. O. Adetifa, Jessica McLellan, Sheikh Jarju, Beate Kampmann, James Jafali, Fatima Ceesay, Ebenezer Foster-Nyarko, Abdoulie Bojang, Brenda Kwambana, Martin Antonio, and Odutola Aderonke
- Subjects
0301 basic medicine ,Microbiology (medical) ,Staphylococcus aureus ,Group B streptococcus ,030106 microbiology ,Microbial Sensitivity Tests ,Biology ,medicine.disease_cause ,Microbiology ,Group B ,Streptococcus agalactiae ,Haemophilus influenzae ,03 medical and health sciences ,Nasopharynx ,Beta-haemolytic streptococci ,Moraxella (Branhamella) catarrhalis ,Drug Resistance, Bacterial ,parasitic diseases ,Streptococcus pneumoniae ,Prevalence ,medicine ,Humans ,reproductive and urinary physiology ,Coinfection ,Streptococcus ,Infant ,Tetracycline ,bacterial infections and mycoses ,medicine.disease ,Anti-Bacterial Agents ,Carriage ,Carrier State ,Immunology ,bacteria ,Gambia ,Moraxella catarrhalis ,Nasopharyngeal ,Research Article - Abstract
BACKGROUND: In West Africa, the carriage of Group B Streptococcus (GBS), among infants is poorly characterised. We investigated co-carriage of GBS with other respiratory pathogens in the infants' nasopharynx in The Gambia. METHODS: We assessed the carriage, serotypes and antibiotic susceptibility of Beta-haemolytic Streptococci (BHS) groups A-G; along with the carriage of Streptococcus pneumoniae; Haemophilus influenzae; Staphylococcus aureus and Moraxella catarrhalis in 1200 two-month old infants. RESULTS: The BHS prevalence was 20.0 % and GBS dominated (13.8 %), particularly serotypes V and II; serotype V being negatively associated with H. Influenzae carriage (OR 0.41 [95 % CI: 0.18-0.93], p = 0.033). Although co-colonization of GBS and other BHS was not seen, colonization with GBS was positively associated with S. aureus (OR 1.89 [95 % CI: 1.33-2.69], P < 0.001) and negatively associated with S. pneumoniae (OR 0.47 [95 % CI: 0.33-0.67], p < 0.001) and M. catarrhalis (OR 0.61 [95 % CI: 0.40-0.92], p = 0.017). ≥ 89 % of GBS isolates were susceptible to most antibiotics tested, except for tetracycline resistance, which was 89 %. CONCLUSION: This study provides baseline data on the carriage of GBS in two month old infants from West Africa. The dominant serotypes of GBS in this setting are serotypes V and II. This may be important for future GBS vaccine development for the West African sub-region.
- Published
- 2016
8. Anterograde amnesia and disorientation are associated with in-patients without traumatic brain injury taking opioids. Retrograde amnesia (RA) is absent. RA assessment should be integral to post-traumatic amnesia testing.
- Author
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BPsych, Jessica McLellan, Marshman, Laurence A.G., and Hennessy, Maria
- Abstract
The Glasgow Coma Scale (GCS) only assesses orientation after traumatic brain injury (TBI). ‘Post-traumatic amnesia’ (PTA) comprises orientation, anterograde amnesia (AA) and retrograde amnesia (RA). However, RA is often disregarded in formalized PTA assessment. Drugs can potentially confound PTA assessment: e.g. midazolam can cause AA. However, potential drug confounders are also often disregarded in formalized PTA testing. One study of medium-stay elective-surgery orthopaedic patients (without TBI) demonstrated AA in 80% taking opiates after general anesthesia. However, RA was not assessed. Opiates/opioids are frequently administered after TBI. We compared AA and RA in short-stay orthopaedic surgery in-patients (without TBI) taking post-operative opioids after opiate/opioid/benzodiazepine-free spinal anesthesia. In a prospective cohort, the Westmead PTA Scale (WPTAS) was used to assess AA (WPTAS < 12), whilst RA was assessed using the Galveston Orientation and Amnesia Test RA item. Results were obtained in n = 25 (60 ± 14 yrs, M:F 17:8). Surgery was uncomplicated: all were discharged by Day-4. All were taking regular oxycodone as a new post-operative prescription. Only one co-administered non-opioid was potentially confounding (temezepam, n = 4). Of 25, 14 (56%) demonstrated AA: five (20%) were simultaneously disorientated. Mean WPTAS was 11.08 ± 1.22. RA occurred in 0%. Conclusions : AA and disorientation, but not RA, were associated with in-patients (without TBI) taking opioids. Caution should therefore be applied in assessing AA/orientation in TBI in-patients taking opioids. By contrast, retrograde memory was robust and more reliable: even in older patients with iatrogenic AA and disorientation. RA assessment should therefore be integral to assessing TBI severity in all formalized PTA and GCS testing. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
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