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5 results on '"Kaimba, Sylvester"'

4. Distinct clinical and immunological profiles of patients with evidence of SARS-CoV-2 infection in sub-Saharan Africa

Author

Morton, Ben, Barnes, Kayla G., Anscombe, Catherine, Jere, Khuzwayo, Matambo, Prisca, Mandolo, Jonathan, Kamng’ona, Raphael, Brown, Comfort, Nyirenda, James, Phiri, Tamara, Banda, Ndaziona P., Van Der Veer, Charlotte, Mndolo, Kwazizira S., Mponda, Kelvin, Rylance, Jamie, Phiri, Chimota, Mallewa, Jane, Nyirenda, Mulinda, Katha, Grace, Kambiya, Paul, Jafali, James, Mwandumba, Henry C., Gordon, Stephen B., Cornick, Jennifer, Jambo, Kondwani C., Phulusa, Jacob, Mkandawire, Mercy, Kaimba, Sylvester, Thole, Herbert, Nthala, Sharon, Nsomba, Edna, Keyala, Lucy, Mandala, Peter, Chinoko, Beatrice, Gmeiner, Markus, Kaudzu, Vella, Lissauer, Samantha, Freyne, Bridget, MacPherson, Peter, Swarthout, Todd D., Iroh Tam, Pui-Ying, Sichone, Simon, Ahmadu, Ajisa, Kanjewa, Oscar, Nyasulu, Vita, Chinyama, End, Zuza, Allan, Denis, Brigitte, Storey, Evance, Bondera, Nedson, Matchado, Danford, Chande, Adams, Chingota, Arthur, Ntwea, Chimenya, Mkandawire, Langford, Mhango, Chimwemwe, Lakudzala, Agness, Chaponda, Mphatso, Mwenechanya, Percy, Mvaya, Leonard, Tembo, Dumizulu, Henrion, Marc Y. R., Chirombo, James, Masesa, Clemens, and Gondwe, Joel

Subjects
wa_105, qw_568, mental disorders, wc_505, qw_160, wa_395
Abstract

Although the COVID-19 pandemic has left no country untouched there has been limited research to understand clinical and immunological responses in African populations. Here we characterise patients hospitalised with suspected (PCR-negative/IgG-positive) or confirmed (PCR-positive) COVID-19, and healthy community controls (PCR-negative/IgG-negative). PCR-positive COVID-19 participants were more likely to receive dexamethasone and a beta-lactam antibiotic, and survive to hospital discharge than PCR-negative/IgG-positive and PCR-negative/IgG-negative participants. PCR-negative/IgG-positive participants exhibited a nasal and systemic cytokine signature analogous to PCR-positive COVID-19 participants, predominated by chemokines and neutrophils and distinct from PCR-negative/IgG-negative participants. PCR-negative/IgG-positive participants had increased propensity for Staphylococcus aureus and Streptococcus pneumoniae colonisation. PCR-negative/IgG-positive individuals with high COVID-19 clinical suspicion had inflammatory profiles analogous to PCR-confirmed disease and potentially represent a target population for COVID-19 treatment strategies.

Published
2021

5. Causes, outcomes and diagnosis of acute breathlessness hospital admissions in Malawi: protocol for a multicentre prospective cohort study.

Author

Spencer SA, Malowa F, McCarty D, Joekes E, Phulusa J, Chinoko B, Kaimba S, Keyala L, Mandala P, Mkandawire M, Mlongoti M, Mnesa B, Mukatipa A, Mijumbi R, Nyirenda M, Sawe HR, Henrion M, Augustine DX, Oxborough D, Worrall E, Limbani F, Dark P, Gordon SB, Rylance J, and Morton B

Abstract

Background: Hospital admission due to breathlessness carries a significant burden to patients and healthcare systems, particularly impacting people in low-income countries. Prompt appropriate treatment is vital to improve outcomes, but this relies on accurate diagnostic tests which are of limited availability in resource-constrained settings. We will provide an accurate description of acute breathlessness presentations in a multicentre prospective cohort study in Malawi, a low resource setting in Southern Africa, and explore approaches to strengthen diagnostic capacity., Objectives: Primary objective: Delineate between causes of breathlessness among adults admitted to hospital in Malawi and report disease prevalence. Secondary objectives : Determine patient outcomes, including mortality and hospital readmission 90 days after admission; determine the diagnostic accuracy of biomarkers to differentiate between heart failure and respiratory infections (such as pneumonia) including brain natriuretic peptides, procalcitonin and C-reactive protein., Methods: This is a prospective longitudinal cohort study of adults (≥18 years) admitted to hospital with breathlessness across two hospitals: 1) Queen Elizabeth Central Hospital, Blantyre, Malawi; 2) Chiradzulu District Hospital, Chiradzulu, Malawi. Patients will be consecutively recruited within 24 hours of emergency presentation and followed-up until 90 days from hospital admission. We will conduct enhanced diagnostic tests with robust quality assurance and quality control to determine estimates of disease pathology. Diagnostic case definitions were selected following a systematic literature search., Discussion: This study will provide detailed epidemiological description of adult hospital admissions due to breathlessness in low-income settings, which is currently poorly understood. We will delineate between causes using established case definitions and conduct nested diagnostic evaluation. The results have the potential to facilitate development of interventions targeted to strengthen diagnostic capacity, enable prompt and appropriate treatment, and ultimately improve both patient care and outcomes., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Spencer SA et al.)

Published
2024
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