38 results on '"Njau, J."'
Search Results
2. Drug dispensing practices during implementation of artemisinin-based combination therapy at health facilities in rural Tanzania, 2002–2005
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Thwing, J. I., Njau, J. D., Goodman, C., Munkondya, J., Kahigwa, E., Bloland, P. B., Mkikima, S., Mills, A., Abdulla, S., and Kachur, S. P.
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- 2011
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3. Fever treatment and household wealth: the challenge posed for rolling out combination therapy for malaria
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Njau, J. D., Goodman, C., Kachur, S. P., Palmer, N., Khatib, R. A., Abdulla, S., Mills, A., and Bloland, P.
- Published
- 2006
4. Large mammal diets and paleoecology across the Oldowan–Acheulean transition at Olduvai Gorge, Tanzania from stable isotope and tooth wear analyses
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Universitat Rovira i Virgili, Uno K; Rivals F; Bibi F; Pante M; Njau J; de la Torre I, Universitat Rovira i Virgili, and Uno K; Rivals F; Bibi F; Pante M; Njau J; de la Torre I
- Abstract
© 2018 Elsevier Ltd The well-dated Pleistocene sediments at Olduvai Gorge have yielded a rich record of hominin fossils, stone tools, and vertebrate faunal remains that, taken together, provide insight to hominin behavior and paleoecology. Since 2008, the Olduvai Geochronology and Archaeology Project (OGAP) has undertaken extensive excavations in Bed II that have yielded a large collection of early Pleistocene stone tools and fossils. The strata of Lower, Middle and Upper Bed II at Olduvai Gorge capture the critical transition from Oldowan to Acheulean technology and therefore provide an opportunity to explore the possible role of biotic and abiotic change during the transition. Here, we analyze newly discovered and existing fossil teeth from Bed II sites using stable isotope and tooth wear methods to investigate the diets of large mammals. We reconstruct the dietary ecology of Bed II mammals and evaluate whether vegetation or hydroclimate shifts are associated with the technological change. Combined isotope and tooth wear data suggest most mammals were C4 grazers or mixed feeders. Carbon isotope data from bulk enamel samples indicate that a large majority of Bed II large mammals analyzed had diets comprising mostly C4 vegetation (>75% of diet), whereas only a small number of individuals had either mixed C3–C4 or mostly C3 diets (<25% C4). Mesowear generally indicates an increase of the abrasiveness of the diet between intervals IIA and IIB (∼1.66 Ma), probably reflecting increased grazing. Microwear indicates more abrasive diets in interval IIA suggesting stronger seasonal differences at the time of death during this interval. This is also supported by the intratooth isotope profiles from Equus oldowayensis molars, which suggest a possible decrease in seasonality acros
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- 2018
5. Rift Valley fever outbreak--Kenya, November 2006-January 2007
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Nguku, P., Sharif, S., Omar, A., Nzioka, C., Muthoka, P., Njau, J., Dahiye, A., Galgalo, T., Mwihia, J., Njoroge, J., Limo, H., Mutiso, J., Kalani, R., Sheikh, A., Nyikal, J., Mutonga, D., Omollo, J., Guracha, A., Muindi, J., Amwayi, S., Langat, D., Owiti, D., Mohammed, A., Musaa, J., Sang, R., Breiman, R., Njenga, K., Feikin, D., Katz, M., Burke, H., Nyaga, P., Ackers, M., Gikundi, S., Omballa, V., Nderitu, L., Wamola, N., Wanjala, R., Omulo, S., Richardson, J., Schnabel, D., Martin, S., Hoel, D., Hanafi, H., Weiner, M., Onsongo, J., Kojo, T., Duale, M., Hassan, A., Dabaar, M., Njuguna, C., Yao, M., Grein, T., Formenty, P., Telfer, B., Lepec, R., Feldmann, H., Grolla, A., Wainwright, S., Lederman, E., Farnon, E., Rao, C., Kapella, B.K., and Gould, H.
- Subjects
Market trend/market analysis ,Epidemics -- Kenya ,Epidemics -- Forecasts and trends ,Rift Valley fever -- Causes of ,Rift Valley fever -- Care and treatment - Abstract
In mid-December 2006, several unexplained fatalities associated with fever and generalized bleeding were reported to the Kenya Ministry of Health (KMOH) from Garissa District in North Eastern Province (NEP). By [...]
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- 2007
6. Outbreak of aflatoxin poisoning--Eastern and Central Provinces, Kenya, January-July 2004
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Nyikal, J., Misore, A., Nzioka, C., Njuguna, C., Muchiri, E., Njau, J., Maingi, S., Njoroge, J., Mutiso, J., Onteri, J., Langat, A., Kilei, I.K., Nyamongo, J., Ogana, G., Muture, B., Tukei, P., Onyango, C., Ochieng, W., Tetteh, C., Likimani, S., Nguku, P., Galgalo, T., Kibet, S., Manya, A., Dahiye, A., Mwihia, J., Mugoya, I., Onsongo, J., Ngindu, A., DeCock, K.M., Lindblade, K., Slutsker, L., Amornkul, P., Rosen, D., Feiken, D., Thomas, T., Mensah, P., Eseko, N., Nejjar, A., Onsongo, M., Kesell, F., Njapau, H., Park, D.L., Lewis, L., Luber, G., Rogers, H., Backer, L., Rubin, C., Gieseker, K.E., Azziz-Baumgartner, E., Chege, W., and Bowen, A.
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Food poisoning -- Development and progression ,Cocarcinogens ,Carcinogens ,Aflatoxins - Abstract
In May 2004, CDC Kenya, trainees of the CDC-supported Field Epidemiology and Laboratory Training Program (FELTP) in Kenya, the World Health Organization, and CDC were invited by the Kenya Ministry [...]
- Published
- 2004
7. Community directed approach beyond ivermectin in Tanzania: a promising mechanism for the delivery of complex health interventions
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Mutalemwa, P., Kisinza, W.N., Kisoka, W.J., Kilima, S., Njau, J., Tenu, F., Nkya, T., Magesa, S.M., Mutalemwa, P., Kisinza, W.N., Kisoka, W.J., Kilima, S., Njau, J., Tenu, F., Nkya, T., and Magesa, S.M.
- Abstract
The Community Directed Intervention (CDI) is currently used for Ivermectin distribution for the treatment of onchocerciasis in Africa. This study was carried out to determine the extent to which the CDI process can be used for the delivery of other health interventions with different degrees of complexity. The study was conducted in five districts of Kilosa, Muheza, Lushoto, Korogwe and Ulanga in Tanzania and involved communities, health facility and district healthcare providers. Implementation of CDI across these health interventions involved addressing six major processes, namely, stakeholder processes, health system dynamics, engaging communities, empowering communities, engaging CDI implementers and broader system effects. Community and health systems changes were triggered, such that the inherent value of community involvement and empowerment could be internalized by communities and health workers, leading to a more receptive health system. The CDI process was accepted at the community levels as many were willing and ready to adopt the approach. Health workers at community levels were readily available and supportive of the process. Additionally, noted were the verified willingness and ability of community implementers to deliver multiple interventions; confirmed efficiency of CDI leading to cost savings at health systems level; increasing interest of the health system in CDI; interest of health workers in the process of integrated planning. However, there were factors that may have a negative influence on the CDI process. Drug and supply policy for CDI process was lacking at the national and district levels and the presence of parallel community-based programmes that provide financial incentives for community members to run them discouraged community-directed distributors who in most cases are volunteers. In conclusion, the results have clearly and evidently demonstrated the potential of CDI approach for effectively and efficiently control of other diseases s
- Published
- 2009
8. Community directed interventions for malaria, tuberculosis and vitamin A in onchocerciasis endemic districts of Tanzania
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Kisinza, W.N., Kisoka, W.J., Mutalemwa, P.P., Njau, J., Tenu, F., Nkya, T., Kilima, S.P., Magesa, S.M., Kisinza, W.N., Kisoka, W.J., Mutalemwa, P.P., Njau, J., Tenu, F., Nkya, T., Kilima, S.P., and Magesa, S.M.
- Abstract
In recognising the success attained through community-directed treatment with Ivermectin, there has been a growing interest to use a similar approach for delivery of interventions against other communicable diseases. This study was conducted in 2007 to evaluate the impact of community directed intervention (CDI) on delivering five health interventions namely Vitamin A supplementation (VAS), community-directed treatment with Ivermectin (CDTi), distribution of insecticide-treated nets (ITN), directly observed treatment of tuberculosis (DOTS), and home-based management of malaria (HMM). The study was carried out in onchocerciasis endemic districts of Kilosa, Muheza, Lushoto, Korogwe and Ulanga districts in Tanzania. A total of 250 households were involved in the study for the period of two years. During the first year, one new intervention was added in each study district. A second new intervention was then added in the same manner during the second study year. In the control district all interventions, with the exception of Ivermectin distribution, continued to be delivered in the traditional manner throughout the study period. Results showed that Ivermectin treatment coverage in the CDI districts (88%) was significantly (P<0.005) higher than in the control district (77%). The coverage of VAS was 84 + 7%, showing very little difference between control and intervention districts (P>0.05). The DOTS treatment completion rate was observed only in Korogwe where 4 out 7 patients had completed their treatment. The proportions of pregnant women and <5 years children sleeping under ITN in the CDI districts (range: 83-100%) were significantly higher (P< 0.05) than those in the control district (40-43%). There was also a higher proportion of malaria cases referred in the intervention districts (42%) than in the control district (21%) (P<0.005). Likewise, the proportion of <5 years children who were presumptively diagnosed with malaria and received appropriated
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- 2009
9. Community directed approach beyond ivermectin in Tanzania: a promising mechanism for the delivery of complex health interventions
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Mutalemwa, P, primary, Kisinza, WN, additional, Kisoka, WJ, additional, Kilima, S, additional, Njau, J, additional, Tenu, F, additional, Nkya, T, additional, and Magesa, SM, additional
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- 2009
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10. Community directed interventions for malaria, tuberculosis and vitamin A in onchocerciasis endemic districts of Tanzania
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Kisinza, WN, primary, Kisoka, WJ, additional, Mutalemwa, PP, additional, Njau, J, additional, Tenu, F, additional, Nkya, T, additional, Kilima, SP, additional, and Magesa, SM, additional
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- 2009
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11. Aflatoxin Levels in Locally Grown Maize from Makueni District, Kenya
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Mwihia, JT, primary, Straetmans, M, additional, Ibrahim, A, additional, Njau, J, additional, Muhenje, O, additional, Guracha, A, additional, Gikundi, S, additional, Mutonga, D, additional, Tetteh, C, additional, Likimani, S, additional, Breiman, RF, additional, Njenga, K, additional, and Lewis, L, additional
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- 2008
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12. Community directed interventions for malaria, tuberculosis and vitamin A in onchocerciasis endemic districts of Tanzania.
- Author
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KISINZA, W. N., KISOKA, W. J., MUTALEMWA, P. P., NJAU, J., TENU, F., NKYA, T., KILIMA, S. P., and MAGESA, S. M.
- Abstract
In recognising the success attained through community-directed treatment with Ivermectin, there has been a growing interest to use a similar approach for delivery of interventions against other communicable diseases. This study was conducted in 2007 to evaluate the impact of community directed intervention (CDI) on delivering five health interventions namely Vitamin A supplementation (VAS), community-directed treatment with Ivermectin (CDTi), distribution of insecticide-treated nets (ITN), directly observed treatment of tuberculosis (DOTS), and home-based management of malaria (HMM). The study was carried out in onchocerciasis endemic districts of Kilosa, Muheza, Lushoto, Korogwe and Ulanga districts in Tanzania. A total of 250 households were involved in the study for the period of two years. During the first year, one new intervention was added in each study district. A second new intervention was then added in the same manner during the second study year. In the control district all interventions, with the exception of Ivermectin distribution, continued to be delivered in the traditional manner throughout the study period. Results showed that Ivermectin treatment coverage in the CDI districts (88%) was significantly (P<0.005) higher than in the control district (77%). The coverage of VAS was 84 ± 7%, showing very little difference between control and intervention districts (P>0.05). The DOTS treatment completion rate was observed only in Korogwe where 4 out 7 patients had completed their treatment. The proportions of pregnant women and <5 years children sleeping under ITN in the CDI districts (range: 83-100%) were significantly higher (P< 0.05) than those in the control district (40-43%). There was also a higher proportion of malaria cases referred in the intervention districts (42%) than in the control district (21%) (P<0.005). Likewise, the proportion of <5 years children who were presumptively diagnosed with malaria and received appropriated treatment within 24 hours in the intervention districts (17-29%) was higher than those in the control district (4%) (P<0.005). The costs incurred per integrated programme in the intervention districts were much lower than those in the control district. In conclusion, our results showed higher coverage of interventions in the CDI districts without necessarily increasing the cost. [ABSTRACT FROM AUTHOR]
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- 2008
13. Rift Valley fever outbreak - Kenya, November 2006-January 2007
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Nguku, P., Sharif, S., Omar, A., Nzioka, C., Muthoka, P., Njau, J., Dahiye, A., Galgalo, T., Mwihia, J., Njoroge, J., Limo, H., Mutiso, J., Kalani, R., Sheikh, A., Nyikal, J., Mutonga, D., Omollo, J., Guracha, A., Muindi, J., Amwayi, S., Langat, D., Owiti, D., Mohammed, A., Musaa, J., Sang, R., Breiman, R., Njenga, K., Feikin, D., Katz, M., Burke, H., Nyaga, P., Ackers, M., Gikundi, S., Omballa, V., Nderitu, L., Wamola, N., Wanjala, R., Omulo, S., Richardson, J., Schnabel, D., Martin, S., Hoel, D., Hanafi, H., Weiner, M., Onsongo, J., Kojo, T., Duale, M., Ali Hassan, Dabaar, M., Njuguna, C., Yao, M., Grein, T., Formenty, P., Telfer, B., Lepec, R., Feldmann, H., Grolla, A., Wainwright, S., Lederman, E., Farnon, E., Rao, C., Kapella, B. K., and Gould, H.
14. Long-term impact of rotavirus vaccination on all-cause and rotavirus-specific gastroenteritis and strain distribution in Central Kenya: An 11-year interrupted time-series analysis.
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Wandera EA, Kurokawa N, Mutua MM, Muriithi B, Nyangao J, Khamadi SA, Kathiiko C, Wachira M, Njuguna E, Mwaura B, Golicha RO, Njau J, Morita K, Kaneko S, Komoto S, Tsutsui N, and Ichinose Y
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- Humans, Kenya epidemiology, Child, Preschool, Infant, Hospitalization statistics & numerical data, Female, Feces virology, Male, Genotype, Vaccines, Attenuated immunology, Vaccines, Attenuated administration & dosage, Rotavirus Vaccines administration & dosage, Rotavirus Vaccines immunology, Rotavirus Infections prevention & control, Rotavirus Infections epidemiology, Gastroenteritis epidemiology, Gastroenteritis virology, Gastroenteritis prevention & control, Rotavirus immunology, Rotavirus genetics, Immunization Programs, Interrupted Time Series Analysis, Vaccination statistics & numerical data
- Abstract
Background: Kenya introduced a monovalent rotavirus vaccine administered orally at 6 and 10 weeks of age into her National Immunization Program in July 2014. The study evaluated the long-term impact of the vaccine on hospitalization for all-cause and rotavirus-specific acute gastroenteritis (AGE) and strain epidemiology in Kenya., Methods: Data on all-cause and rotavirus-specific AGE and strain distribution were derived from an eleven-year hospital-based surveillance of AGE among children aged <5 years at Kiambu County Teaching and Referral Hospital (KCTRH) in Central Kenya between 2009 and 2020. Fecal samples were screened for group A rotavirus using ELISA and genotyped using multiplex semi-nested RT-PCR. Trends in all-cause and rotavirus-related AGE and strain distribution were compared between the pre-vaccine (July 2009-June 2014), early post-vaccine (July 2014-June 2016) and late post-vaccine (February 2019-October 2020) periods., Results: Rotavirus-specific AGE was detected at 27.5% (429/1546, 95% CI: 25.5-30.1%) in the pre-vaccine period; 13.8% (91/658, 95% CI: 11.3-16.6%) in the early post-vaccine period (July 2014-June 2016); and 12.0% (229/1916, 95% CI: 10.6-13.5%) in the late post-vaccine period (February 2019-October 2020). This amounted to a decline of 49.8% (95% CI: 34.6%-63.7%) in rotavirus-specific AGE in the early post-vaccine period and 53.4% (95% CI: 41.5-70.3%) in the late post-vaccine period when compared to the pre-vaccine period. All-cause AGE hospitalizations declined by 40.2% (95% CI: 30.8%-50.2%) and 75.3% (95% CI: 65.9-83.1%) in the early post-vaccine and late post-vaccine periods, respectively, when compared to the pre-vaccine period. G3P [8] was the predominant strain in the late post-vaccine period, replacing G1P[8] which had predominated in the pre-vaccine and early post-vaccine periods. Additionally, we detected considerable proportions of uncommon strains G3P[6] (4.8%) and G12P[6] (3.5%) in the post-vaccine era., Conclusion: Rotavirus vaccination has resulted in a significant decline in all-cause and rotavirus-specific AGE, and thus, provides strong evidence for public health policy makers in Kenya to support the sustained use of the rotavirus vaccine in routine immunization. However, the shift in strain dominance and age distribution of rotavirus AGE in the post-vaccine era underscores the need for continued surveillance to assess any possible vaccine-induced selective pressure that could diminish the vaccine effectiveness over time., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)
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- 2024
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15. Genetic and nongenetic drivers of platelet reactivity in healthy Tanzanian individuals.
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Kullaya VI, Temba GS, Vadaq N, Njau J, Boahen CK, Nkambule BB, Thibord F, Chen MH, Pecht T, Lyamuya F, Kumar V, Netea MG, Mmbaga BT, van der Ven A, Johnson AD, and de Mast Q
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- Adult, Humans, Tanzania, Platelet Activation, Receptor, PAR-1 metabolism, Platelet Aggregation physiology, Blood Platelets metabolism
- Abstract
Background: Platelets play a key role in hemostasis, inflammation, and cardiovascular diseases. Platelet reactivity is highly variable between individuals. The drivers of this variability in populations from Sub-Saharan Africa remain largely unknown., Objectives: We aimed to investigate the nongenetic and genetic determinants of platelet reactivity in healthy adults living in a rapidly urbanizing area in Northern Tanzania., Methods: Platelet activation and reactivity were measured by platelet P-selectin expression and the binding of fibrinogen in unstimulated blood and after ex vivo stimulation with adenosine diphosphate and PAR-1 and PAR-4 ligands. We then analyzed the associations of platelet parameters with host genetic and nongenetic factors, environmental factors, plasma inflammatory markers, and plasma metabolites., Results: Only a few associations were found between platelet reactivity parameters and plasma inflammatory markers and nongenetic host and environmental factors. In contrast, untargeted plasma metabolomics revealed a large number of associations with food-derived metabolites, including phytochemicals that were previously reported to inhibit platelet reactivity. Genome-wide single-nucleotide polymorphism genotyping identified 2 novel single-nucleotide polymorphisms (rs903650 and rs4789332) that were associated with platelet reactivity at the genome-wide level (P < 5 × 10
-8 ) as well as a number of variants in the PAR4 gene (F2RL3) that were associated with PAR4-induced reactivity., Conclusion: Our study uncovered factors that determine variation in platelet reactivity in a population in East Africa that is rapidly transitioning to an urban lifestyle, including the importance of genetic ancestry and the gradual abandoning of the traditional East African diet., Competing Interests: Declaration of competing interests There are no competing interests to disclose., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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16. Mobilizing resources with an investment case to mitigate cross-border malaria transmission and achieve malaria elimination in South Africa.
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Kollipara A, Moonasar D, Balawanth R, Silal SP, Yuen A, Fox K, Njau J, Pillay YG, and Blecher M
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- Humans, South Africa epidemiology, Africa, Southern, Mozambique epidemiology, Financing, Organized, Malaria epidemiology, Malaria prevention & control
- Abstract
South Africa's effort to eliminate malaria is significantly challenged by a large number of imported malaria cases, especially from neighbouring Mozambique. The country has a funding gap to achieve its malaria elimination goals (prior to 2019) and is ineligible to receive a national allocation from the Global Fund. The findings of an IC were utilised to successfully mobilise resources for malaria elimination in South Africa in 2018. A five-step resource mobilisation strategy was implemented to highlight financing challenges and leverage the economic evidence from an IC for malaria elimination in South Africa. South Africa's malaria programme implements control and elimination activities in three malaria-endemic provinces (KwaZulu Natal, Limpopo, and Mpumalanga). Driven by the IC findings, the South African government took an unprecedented step and increased total domestic malaria financing by approximately 36%, from the 2018/19 to the 2019/20 financial years through the creation of a new conditional grant for malaria. The IC findings predicted that malaria control in southern Mozambique is a prerequisite to eliminate malaria in South Africa. Based on this, the South African government also allocated funding towards a co-financing mechanism to support malaria control efforts in southern Mozambique. The IC findings assisted the South African National Department of Health to make a convincing case to key government decision-makers to invest in national malaria elimination and maximise economic returns in the long run. The South African government is the first in Southern Africa to mobilise a significant increase in domestic malaria financing to address the financial sustainability of both national and regional malaria elimination efforts. Continued surveillance activities will be required to prevent the re-establishment of malaria transmission even after malaria elimination is achieved in South Africa. Information sharing and close collaboration with provincial and national government officials were key to the successful outcome.
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- 2023
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17. Nanopore sequencing technology for clinical diagnosis of infectious diseases where laboratory capacity is meager: A case report.
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Kumburu HH, Shayo M, van Zwetslaar M, Njau J, Kuchaka DJ, Ignas IP, Wadugu B, Kasworm R, Masaki LJ, Hallgren MB, Clausen PTLC, Mmbaga BT, Aarestrup FM, and Sonda TB
- Abstract
In resource-limited settings, patients are often first presented to clinical settings when seriously ill and access to proper clinical microbial diagnostics is often very limited or non-existing. On February 16th
, 2022 we were on a field trip to test a completely field-deployable metagenomics sequencing set-up, that includes DNA purification, sequencing, and bioinformatics analyses using bioinformatics tools installed on a laptop for water samples, just outside Moshi, Tanzania. On our way to the test site, we were contacted by the nearby Machame hospital regarding a child seriously ill with diarrhea and not responding to treatment. Within the same day, we conducted an onsite metagenomics examination of a fecal sample from the child, and Campylobacter jejuni was identified as the causative agent. The treatment was subsequently changed, with almost immediate improvement, and the child was discharged on February 21st., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 Published by Elsevier Ltd.)- Published
- 2023
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18. Cost and cost effectiveness of reactive case detection (RACD), reactive focal mass drug administration (rfMDA) and reactive focal vector control (RAVC) to reduce malaria in the low endemic setting of Namibia: an analysis alongside a 2×2 factorial design cluster randomised controlled trial.
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Ntuku H, Smith-Gueye C, Scott V, Njau J, Whittemore B, Zelman B, Tambo M, Prach LM, Wu L, Schrubbe L, Kang Dufour MS, Mwilima A, Uusiku P, Sturrock H, Bennett A, Smith J, Kleinschmidt I, Mumbengegwi D, Gosling R, and Hsiang M
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- Cost-Benefit Analysis, Humans, Namibia epidemiology, Research Design, Malaria diagnosis, Malaria epidemiology, Malaria prevention & control, Mass Drug Administration
- Abstract
Objectives: To estimate the cost and cost effectiveness of reactive case detection (RACD), reactive focal mass drug administration (rfMDA) and reactive focal vector control (RAVC) to reduce malaria in a low endemic setting., Setting: The study was part of a 2×2 factorial design cluster randomised controlled trial within the catchment area of 11 primary health facilities in Zambezi, Namibia., Participants: Cost and outcome data were collected from the trial, which included 8948 community members that received interventions due to their residence within 500 m of malaria index cases., Outcome Measures: The primary outcome was incremental cost effectiveness ratio (ICER) per in incident case averted. ICER per prevalent case and per disability-adjusted life years (DALY) averted were secondary outcomes, as were per unit interventions costs and personnel time. Outcomes were compared as: (1) rfMDA versus RACD, (2) RAVC versus no RAVC and (3) rfMDA+RAVC versus RACD only., Results: rfMDA cost 1.1× more than RACD, and RAVC cost 1.7× more than no RAVC. Relative to RACD only, the cost of rfMDA+RAVC was double ($3082 vs $1553 per event). The ICERs for rfMDA versus RACD, RAVC versus no RAVC and rfMDA+RAVC versus RACD only were $114, $1472 and $842, per incident case averted, respectively. Using prevalent infections and DALYs as outcomes, trends were similar. The median personnel time to implement rfMDA was 20% lower than for RACD (30 vs 38 min per person). The median personnel time for RAVC was 34 min per structure sprayed., Conclusion: Implemented alone or in combination, rfMDA and RAVC were cost effective in reducing malaria incidence and prevalence despite higher implementation costs in the intervention compared with control arms. Compared with RACD, rfMDA was time saving. Cost and time requirements for the combined intervention could be decreased by implementing rfMDA and RAVC simultaneously by a single team., Trial Registration Number: NCT02610400; Post-results., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)
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- 2022
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19. Ultrasensitive qPCR-Based Detection of Plasmodium falciparum in Pregnant Women Using Dried Blood or Whole Blood Pellet Samples Processed through Different DNA Extraction Methods.
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Saidi Q, Minja D, Njau J, Hansson H, Kavishe R, and Alifrangis M
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- DNA, Female, Humans, Plasmodium falciparum genetics, Pregnancy, Pregnant Women, Sensitivity and Specificity, Malaria diagnosis, Malaria, Falciparum diagnosis
- Abstract
Highly sensitive molecular techniques for the detection of low-level Plasmodium falciparum parasitemia are highly useful for various clinical and epidemiological studies. However, differences in how blood samples are preserved, the quantity of blood stored, as well as genomic DNA extraction methods used may compromise the potential usefulness of these methodologies. This study compared diagnostic sensitivity based on microscopy and malaria rapid diagnostic tests (mRDTs), with quantitative polymerase chain reaction (qPCR) P. falciparum positivity of dried blood spots (DBS) or whole blood pellets (WBP) from pregnant women using different DNA extraction protocols (Chelex-saponin or a commercial kit). Samples from 129 pregnant women were analyzed, of which 13 were P. falciparum positive by mRDT and 5 by microscopy. By using extraction kit on WBP and on DBS, qPCR positivity was 27 (20.9%) and 16 (12.4%), respectively, whereas Chelex extraction on DBS only resulted in 4 (3.1%) P. falciparum positive samples. Thus, extraction using commercial kits greatly improve the likelihood of detecting P. falciparum infections.
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- 2021
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20. Genomic characterization of an African G4P[6] human rotavirus strain identified in a diarrheic child in Kenya: Evidence for porcine-to-human interspecies transmission and reassortment.
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Wandera EA, Hatazawa R, Tsutsui N, Kurokawa N, Kathiiko C, Mumo M, Waithira E, Wachira M, Mwaura B, Nyangao J, Khamadi SA, Njau J, Fukuda S, Murata T, Taniguchi K, Ichinose Y, Kaneko S, and Komoto S
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- Animals, Child, Preschool, Female, Genome, Viral, Humans, Infant, Male, Rotavirus classification, Rotavirus Infections veterinary, Swine, Diarrhea virology, Genotype, Rotavirus isolation & purification, Rotavirus Infections virology, Swine Diseases virology, Viral Zoonoses virology
- Abstract
Human rotavirus strains having the unconventional G4P[6] genotype have been sporadically identified in diarrheic patients in different parts of the world. However, the whole genome of only one human G4P[6] strain from Africa (central Africa) has been sequenced and analyzed, and thus the exact origin and evolutionary pattern of African G4P[6] strains remain to be elucidated. In this study, we characterized the full genome of an African G4P[6] strain (RVA/Human-wt/KEN/KCH148/2019/G4P[6]) identified in a stool specimen from a diarrheic child in Kenya. Full genome analysis of strain KCH148 revealed a unique Wa-like genogroup constellation: G4-P[6]-I1-R1-C1-M1-A1-N1-T7-E1-H1. NSP3 genotype T7 is commonly found in porcine rotavirus strains. Furthermore, phylogenetic analysis showed that 10 of the 11 genes of strain KCH148 (VP7, VP4, VP6, VP1-VP3, NSP1, and NSP3-NSP5) appeared to be of porcine origin, the remaining NSP2 gene appearing to be of human origin. Therefore, strain KCH148 was found to have a porcine rotavirus backbone and thus is likely to be of porcine origin. Furthermore, strain KCH148 is assumed to have been derived through interspecies transmission and reassortment events involving porcine and human rotavirus strains. To our knowledge, this is the first report on full genome-based characterization of a human G4P[6] strain from east Africa. Our observations demonstrated the diversity of human G4P[6] strains in Africa, and provide important insights into the origin and evolutionary pattern of zoonotic G4P[6] strains on the African continent., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2021
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21. Investment case for malaria elimination in South Africa: a financing model for resource mobilization to accelerate regional malaria elimination.
- Author
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Njau J, Silal SP, Kollipara A, Fox K, Balawanth R, Yuen A, White LJ, Moya M, Pillay Y, and Moonasar D
- Subjects
- Humans, Models, Economic, South Africa, Disease Eradication economics, Malaria, Falciparum prevention & control
- Abstract
Background: Malaria continues to be a public health problem in South Africa. While the disease is mainly confined to three of the nine provinces, most local transmissions occur because of importation of cases from neighbouring countries. The government of South Africa has reiterated its commitment to eliminate malaria within its borders. To support the achievement of this goal, this study presents a cost-benefit analysis of malaria elimination in South Africa through simulating different scenarios aimed at achieving malaria elimination within a 10-year period., Methods: A dynamic mathematical transmission model was developed to estimate the costs and benefits of malaria elimination in South Africa between 2018 and 2030. The model simulated a range of malaria interventions and estimated their impact on the transmission of Plasmodium falciparum malaria between 2018 and 2030 in the three endemic provinces of Limpopo, Mpumalanga and KwaZulu-Natal. Local financial, economic, and epidemiological data were used to calibrate the transmission model., Results: Based on the three primary simulated scenarios: Business as Usual, Accelerate and Source Reduction, the total economic burden was estimated as follows: for the Business as Usual scenario, the total economic burden of malaria in South Africa was R 3.69 billion (USD 223.3 million) over an 11-year period (2018-2029). The economic burden of malaria was estimated at R4.88 billion (USD 295.5 million) and R6.34 billion (~ USD 384 million) for the Accelerate and Source Reduction scenarios, respectively. Costs and benefits are presented in midyear 2020 values. Malaria elimination was predicted to occur in all three provinces if the Source Reduction strategy was adopted to help reduce malaria rates in southern Mozambique. This could be achieved by limiting annual local incidence in South Africa to less than 1 indigenous case with a prediction of this goal being achieved by the year 2026., Conclusions: Malaria elimination in South Africa is feasible and economically worthwhile with a guaranteed positive return on investment (ROI). Findings of this study show that through securing funding for the proposed malaria interventions in the endemic areas of South Africa and neighbouring Mozambique, national elimination could be within reach in an 8-year period., (© 2021. The Author(s).)
- Published
- 2021
- Full Text
- View/download PDF
22. Bone tools from Beds II-IV, Olduvai Gorge, Tanzania, and implications for the origins and evolution of bone technology.
- Author
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Pante M, Torre I, d'Errico F, Njau J, and Blumenschine R
- Subjects
- Animals, Archaeology, Environment, Fossils, Tanzania, Technology, Hominidae
- Abstract
The advent of bone technology in Africa is often associated with behavioral modernity that began sometime in the Middle Stone Age. Yet, small numbers of bone tools are known from Early Pleistocene sites in East and South Africa, complicating our understanding of the evolutionary significance of osseous technologies. These early bone tools vary geographically, with those in South Africa indicating use in foraging activities such as termite extraction and those in East Africa intentionally shaped in a manner similar to lithic tool manufacture, leading some to infer multiple hominin species were responsible for bone technology in these regions, with Paranthropus robustus assumed to be the maker of South African bone tools and Homo erectus responsible for those in East Africa. Here, we present on an assemblage of 52 supposed bone tools primarily from Beds III and IV, Olduvai Gorge, Tanzania, that was excavated by Mary Leakey in the late 1960s and early 1970s, but was only partially published and was never studied in detail from a taphonomic perspective. The majority of the sites from which the tools were recovered were deposited when only H. erectus is known to have existed in the region, potentially allowing a direct link between this fossil hominin and bone technology. Our analysis confirms at least six bone tools in the assemblage, the majority of which are intentionally flaked large mammal bones. However, one of the tools is a preform of the oldest barbed bone point known to exist anywhere in the world and pushes back the initial appearance of this technology by 700 kyr., Competing Interests: Declaration of competing interest The authors declare there is no conflict of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)
- Published
- 2020
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23. Assessment of Economic Burden of Concurrent Measles and Rubella Outbreaks, Romania, 2011-2012.
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Njau J, Janta D, Stanescu A, Pallas SS, Pistol A, Khetsuriani N, Reef S, Ciurea D, Butu C, Wallace AS, and Zimmerman L
- Subjects
- Adolescent, Child, Child, Preschool, Costs and Cost Analysis, Female, Health Care Costs, History, 21st Century, Humans, Infant, Infant, Newborn, Male, Measles history, Measles virology, Public Health Surveillance, Romania epidemiology, Rubella history, Rubella virology, Rubella Syndrome, Congenital epidemiology, Rubella Syndrome, Congenital virology, Socioeconomic Factors, Coinfection, Cost of Illness, Disease Outbreaks, Measles epidemiology, Rubella epidemiology
- Abstract
We estimated the economic impact of concurrent measles and rubella outbreaks in Romania during 2011-2012. We collected costs from surveys of 428 case-patients and caretakers, government records, and health staff interviews. We then estimated financial and opportunity costs. During the study period, 12,427 measles cases and 24,627 rubella cases were recorded; 27 infants had congenital rubella syndrome (CRS). The cost of the outbreaks was US $9.9 million. Cost per case was US $439 for measles, US $132 for rubella, and US $44,051 for CRS. Up to 36% of households needed to borrow money to pay for illness treatment. Approximately 17% of patients continued to work while ill to pay their treatment expenses. Our key study findings were that households incurred a high economic burden compared with their incomes, the health sector bore most costs, and CRS costs were substantial and relevant to include in rubella outbreak cost studies.
- Published
- 2019
- Full Text
- View/download PDF
24. Connecting palaeoscientists in eastern Africa and the wider world.
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Alemseged Z, Njau J, Pobiner B, and Ndiema E
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- Africa, Eastern, Paleontology, Societies, Scientific
- Published
- 2019
- Full Text
- View/download PDF
25. From the Oldowan to the Acheulean at Olduvai Gorge, Tanzania - An introduction to the special issue.
- Author
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de la Torre I, McHenry L, and Njau J
- Subjects
- Animals, Paleontology, Tanzania, Archaeology, Hominidae
- Published
- 2018
- Full Text
- View/download PDF
26. Paleoecology of the Serengeti during the Oldowan-Acheulean transition at Olduvai Gorge, Tanzania: The mammal and fish evidence.
- Author
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Bibi F, Pante M, Souron A, Stewart K, Varela S, Werdelin L, Boisserie JR, Fortelius M, Hlusko L, Njau J, and de la Torre I
- Subjects
- Animals, Biota, Environment, Paleontology, Tanzania, Technology, Archaeology, Cultural Evolution, Fishes, Fossils, Hominidae, Mammals
- Abstract
Eight years of excavation work by the Olduvai Geochronology and Archaeology Project (OGAP) has produced a rich vertebrate fauna from several sites within Bed II, Olduvai Gorge, Tanzania. Study of these as well as recently re-organized collections from Mary Leakey's 1972 HWK EE excavations here provides a synthetic view of the faunal community of Olduvai during Middle Bed II at ∼1.7-1.4 Ma, an interval that captures the local transition from Oldowan to Acheulean technology. We expand the faunal list for this interval, name a new bovid species, clarify the evolution of several mammalian lineages, and record new local first and last appearances. Compositions of the fish and large mammal assemblages support previous indications for the dominance of open and seasonal grassland habitats at the margins of an alkaline lake. Fish diversity is low and dominated by cichlids, which indicates strongly saline conditions. The taphonomy of the fish assemblages supports reconstructions of fluctuating lake levels with mass die-offs in evaporating pools. The mammals are dominated by grazing bovids and equids. Habitats remained consistently dry and open throughout the entire Bed II sequence, with no major turnover or paleoecological changes taking place. Rather, wooded and wet habitats had already given way to drier and more open habitats by the top of Bed I, at 1.85-1.80 Ma. This ecological change is close to the age of the Oldowan-Acheulean transition in Kenya and Ethiopia, but precedes the local transition in Middle Bed II. The Middle Bed II large mammal community is much richer in species and includes a much larger number of large-bodied species (>300 kg) than the modern Serengeti. This reflects the severity of Pleistocene extinctions on African large mammals, with the loss of large species fitting a pattern typical of defaunation or 'downsizing' by human disturbance. However, trophic network (food web) analyses show that the Middle Bed II community was robust, and comparisons with the Serengeti community indicate that the fundamental structure of food webs remained intact despite Pleistocene extinctions. The presence of a generalized meat-eating hominin in the Middle Bed II community would have increased competition among carnivores and vulnerability among herbivores, but the high generality and interconnectedness of the Middle Bed II food web suggests this community was buffered against extinctions caused by trophic interactions., (Copyright © 2017. Published by Elsevier Ltd.)
- Published
- 2018
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- View/download PDF
27. Large mammal diets and paleoecology across the Oldowan-Acheulean transition at Olduvai Gorge, Tanzania from stable isotope and tooth wear analyses.
- Author
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Uno KT, Rivals F, Bibi F, Pante M, Njau J, and de la Torre I
- Subjects
- Animals, Cultural Evolution, Feeding Behavior, Hominidae, Tanzania, Technology, Carbon Isotopes analysis, Diet, Fossils, Mammals physiology, Tooth anatomy & histology
- Abstract
The well-dated Pleistocene sediments at Olduvai Gorge have yielded a rich record of hominin fossils, stone tools, and vertebrate faunal remains that, taken together, provide insight to hominin behavior and paleoecology. Since 2008, the Olduvai Geochronology and Archaeology Project (OGAP) has undertaken extensive excavations in Bed II that have yielded a large collection of early Pleistocene stone tools and fossils. The strata of Lower, Middle and Upper Bed II at Olduvai Gorge capture the critical transition from Oldowan to Acheulean technology and therefore provide an opportunity to explore the possible role of biotic and abiotic change during the transition. Here, we analyze newly discovered and existing fossil teeth from Bed II sites using stable isotope and tooth wear methods to investigate the diets of large mammals. We reconstruct the dietary ecology of Bed II mammals and evaluate whether vegetation or hydroclimate shifts are associated with the technological change. Combined isotope and tooth wear data suggest most mammals were C
4 grazers or mixed feeders. Carbon isotope data from bulk enamel samples indicate that a large majority of Bed II large mammals analyzed had diets comprising mostly C4 vegetation (>75% of diet), whereas only a small number of individuals had either mixed C3 -C4 or mostly C3 diets (<25% C4 ). Mesowear generally indicates an increase of the abrasiveness of the diet between intervals IIA and IIB (∼1.66 Ma), probably reflecting increased grazing. Microwear indicates more abrasive diets in interval IIA suggesting stronger seasonal differences at the time of death during this interval. This is also supported by the intratooth isotope profiles from Equus oldowayensis molars, which suggest a possible decrease in seasonality across the transition. Neither stable isotope nor tooth wear analyses indicate major vegetation or hydrological change across the Oldowan-Acheulean transition., (Copyright © 2018 Elsevier Ltd. All rights reserved.)- Published
- 2018
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28. Dietary traits of the ungulates from the HWK EE site at Olduvai Gorge (Tanzania): Diachronic changes and seasonality.
- Author
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Rivals F, Uno KT, Bibi F, Pante MC, Njau J, and de la Torre I
- Subjects
- Animals, Archaeology, Artiodactyla anatomy & histology, Carbon Isotopes analysis, Feeding Behavior, Oxygen Isotopes analysis, Paleontology, Perissodactyla anatomy & histology, Proboscidea Mammal anatomy & histology, Tanzania, Artiodactyla physiology, Diet, Perissodactyla physiology, Proboscidea Mammal physiology, Tooth anatomy & histology, Tooth chemistry
- Abstract
The Oldowan site HWK EE (Olduvai Gorge, Tanzania) has yielded a large fossil and stone tool assemblage at the transition from Lower to Middle Bed II, ∼1.7 Ma. Integrated tooth wear and stable isotope analyses were performed on the three most abundant ungulate taxa from HWK EE, namely Alcelaphini, cf. Antidorcas recki (Antilopini) and Equus oldowayensis (Equini), to infer dietary traits in each taxon. Some paleodietary changes were observed for cf. A. recki and E. oldowayensis based on tooth wear at the transition from the Lemuta to the Lower Augitic Sandstone (LAS) interval within the HWK EE sequence. Stable carbon and oxygen isotope data show no significant changes in bulk diet or hydroclimate between the Lemuta and LAS intervals. The combined tooth wear and stable isotope data suggest similar paleoecological conditions across the two HWK EE intervals, but that differences in vegetation consumed among ungulates may have resulted in changes in dietary niches. Integrating tooth wear and stable isotope analyses permits the characterization of ungulate diets and habitats at HWK EE where C
4 dominated and minor mixed C3 and C4 habitats were present. Our results provide a better understanding of the paleoenvironmental conditions of the Lemuta and LAS intervals. The LAS assemblage was mostly accumulated during relatively dry periods at Olduvai Gorge when grasses were not as readily available and grazing animals may have been more nutritionally-stressed than during the formation of the Lemuta assemblage. This helps to contextualize variations in hominin and carnivore feeding behavior observed from the faunal assemblages produced during the two main occupations of the site., (Copyright © 2017 Elsevier Ltd. All rights reserved.)- Published
- 2018
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- View/download PDF
29. Lahar inundated, modified, and preserved 1.88 Ma early hominin (OH24 and OH56) Olduvai DK site.
- Author
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Stanistreet IG, Stollhofen H, Njau JK, Farrugia P, Pante MC, Masao FT, Albert RM, and Bamford MK
- Subjects
- Animals, Fossils, Geologic Sediments analysis, Paleontology, Tanzania, Archaeology, Environment, Hominidae, Volcanic Eruptions
- Abstract
Archaeological excavations at the DK site in the eastern Olduvai Basin, Tanzania, age-bracketed between ∼1.88 Ma (Bed I Basalt) and ∼1.85 Ma (Tuff IB), record the oldest lahar inundation, modification, and preservation of a hominin "occupation" site yet identified. Our landscape approach reconstructs environments and processes at high resolution to explain the distribution and final preservation of archaeological materials at the DK site, where an early hominin (likely Homo habilis) assemblage of stone tools and bones, found close to hominin specimens OH24 and OH56, developed on an uneven heterogeneous surface that was rapidly inundated by a lahar and buried to a depth of 0.4-1.2 m (originally ∼1.0-2.4 m pre-compaction). The incoming intermediate to high viscosity mudflow selectively modified the original accumulation of "occupation debris," so that it is no longer confined to the original surface. A dispersive debris "halo" was identified within the lahar deposit: debris is densest immediately above the site, but tails off until not present >150 m laterally. Voorhies indices and metrics derived from limb bones are used to define this dispersive halo spatially and might indicate a possible second assemblage to the east that is now eroded away. Based upon our new data and prior descriptions, two possibilities for the OH24 skull are suggested: it was either entrained by the mudflow from the DK surface and floated due to lower density toward its top, or it was deposited upon the solid top surface after its consolidation. Matrix adhering to material found in association with the parietals indicates that OH56 at least was relocated by the mudflow., (Copyright © 2017 Elsevier Ltd. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
30. Household costs among patients hospitalized with malaria: evidence from a national survey in Malawi, 2012.
- Author
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Hennessee I, Chinkhumba J, Briggs-Hagen M, Bauleni A, Shah MP, Chalira A, Moyo D, Dodoli W, Luhanga M, Sande J, Ali D, Gutman J, Lindblade KA, Njau J, and Mathanga DP
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Cross-Sectional Studies, Female, Hospitalization statistics & numerical data, Humans, Infant, Malaria prevention & control, Malawi, Male, Young Adult, Health Expenditures statistics & numerical data, Hospitalization economics, Malaria economics
- Abstract
Background: With 71% of Malawians living on < $1.90 a day, high household costs associated with severe malaria are likely a major economic burden for low income families and may constitute an important barrier to care seeking. Nevertheless, few efforts have been made to examine these costs. This paper describes household costs associated with seeking and receiving inpatient care for malaria in health facilities in Malawi., Methods: A cross-sectional survey was conducted in a representative nationwide sample of 36 health facilities providing inpatient treatment for malaria from June-August, 2012. Patients admitted at least 12 h before study team visits who had been prescribed an antimalarial after admission were eligible to provide cost information for their malaria episode, including care seeking at previous health facilities. An ingredients-based approach was used to estimate direct costs. Indirect costs were estimated using a human capital approach. Key drivers of total household costs for illness episodes resulting in malaria admission were assessed by fitting a generalized linear model, accounting for clustering at the health facility level., Results: Out of 100 patients who met the eligibility criteria, 80 (80%) provided cost information for their entire illness episode to date and were included: 39% of patients were under 5 years old and 75% had sought care for the malaria episode at other facilities prior to coming to the current facility. Total household costs averaged $17.48 per patient; direct and indirect household costs averaged $7.59 and $9.90, respectively. Facility management type, household distance from the health facility, patient age, high household wealth, and duration of hospital stay were all significant drivers of overall costs., Conclusions: Although malaria treatment is supposed to be free in public health facilities, households in Malawi still incur high direct and indirect costs for malaria illness episodes that result in hospital admission. Finding ways to minimize the economic burden of inpatient malaria care is crucial to protect households from potentially catastrophic health expenditures.
- Published
- 2017
- Full Text
- View/download PDF
31. Cost Evaluation of a Government-Conducted Oral Cholera Vaccination Campaign-Haiti, 2013.
- Author
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Routh JA, Sreenivasan N, Adhikari BB, Andrecy LL, Bernateau M, Abimbola T, Njau J, Jackson E, Juin S, Francois J, Tohme RA, Meltzer MI, Katz MA, and Mintz ED
- Subjects
- Administration, Oral, Cholera epidemiology, Cholera Vaccines economics, Costs and Cost Analysis, Disease Outbreaks, Government Programs economics, Haiti epidemiology, Humans, Immunization Programs economics, Cholera prevention & control, Cholera Vaccines therapeutic use
- Abstract
The devastating 2010 cholera epidemic in Haiti prompted the government to introduce oral cholera vaccine (OCV) in two high-risk areas of Haiti. We evaluated the direct costs associated with the government's first vaccine campaign implemented in August-September 2013. We analyzed data for major cost categories and assessed the efficiency of available campaign resources to vaccinate the target population. For a target population of 107,906 persons, campaign costs totaled $624,000 and 215,295 OCV doses were dispensed. The total vaccine and operational cost was $2.90 per dose; vaccine alone cost $1.85 per dose, vaccine delivery and administration $0.70 per dose, and vaccine storage and transport $0.35 per dose. Resources were greater than needed-our analyses suggested that approximately 2.5-6 times as many persons could have been vaccinated during this campaign without increasing the resources allocated for vaccine delivery and administration. These results can inform future OCV campaigns in Haiti.
- Published
- 2017
- Full Text
- View/download PDF
32. Simulations Show Diagnostic Testing For Malaria In Young African Children Can Be Cost-Saving Or Cost-Effective.
- Author
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Phillips V, Njau J, Li S, and Kachur P
- Subjects
- Africa South of the Sahara, Antimalarials economics, Child, Preschool, Cost-Benefit Analysis, Health Surveys, Humans, Infant, Infant, Newborn, Malaria drug therapy, Markov Chains, Models, Econometric, World Health Organization, Antimalarials therapeutic use, Diagnostic Tests, Routine economics, Malaria diagnosis
- Abstract
Malaria imposes a substantial global disease burden. It disproportionately affects sub-Saharan Africans, particularly young children. In an effort to improve disease management, the World Health Organization (WHO) recommended in 2010 that countries test children younger than age five who present with suspected malaria fever to confirm the diagnosis instead of treating them presumptively with antimalarial drugs. Costs and concerns about the overall health impact of such diagnostic testing for malaria in children remain barriers to full implementation. Using data from national Malaria Indicator Surveys, we estimated two-stage microsimulation models for Angola, Tanzania, and Uganda to assess the policy's cost-effectiveness. We found that diagnostic testing for malaria in children younger than five is cost-saving in Angola. In Tanzania and Uganda the cost per life-year gained is $5.54 and $94.28, respectively. The costs projected for Tanzania and Uganda are less than the WHO standard of $150 per life-year gained. Our results were robust under varying assumptions about cost, prevalence of malaria, and behavior, and they strongly suggest the pursuit of policies that facilitate full implementation of testing for malaria in children younger than five., (Project HOPE—The People-to-People Health Foundation, Inc.)
- Published
- 2015
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33. Dental microwear texture analysis of hominins recovered by the Olduvai Landscape Paleoanthropology Project, 1995-2007.
- Author
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Ungar PS, Krueger KL, Blumenschine RJ, Njau J, and Scott RS
- Subjects
- Animals, Dentition, Food, Mastication, Tanzania, Tooth Wear, Diet, Fossils, Hominidae classification, Paleodontology, Tooth
- Abstract
Dental microwear analysis has proven to be a valuable tool for the reconstruction of aspects of diet in early hominins. That said, sample sizes for some groups are small, decreasing our confidence that results are representative of a given taxon and making it difficult to assess within-species variation. Here we present microwear texture data for several new specimens of Homo habilis and Paranthropus boisei from Olduvai Gorge, bringing sample sizes for these species in line with those published for most other early hominins. These data are added to those published to date, and microwear textures of the enlarged sample of H. habilis (n = 10) and P. boisei (n = 9) are compared with one another and with those of other early hominins. New results confirm that P. boisei does not have microwear patterns expected of a hard-object specialist. Further, the separate texture complexity analyses of early Homo species suggest that Homo erectus ate a broader range of foods, at least in terms of hardness, than did H. habilis, P. boisei, or the "gracile" australopiths studied. Finally, differences in scale of maximum complexity and perhaps textural fill volume between H. habilis and H. erectus are noted, suggesting further possible differences between these species in diet., (Copyright © 2011 Elsevier Ltd. All rights reserved.)
- Published
- 2012
- Full Text
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34. A platform for East African paleoanthropology: third biannual conference of the EAAPP.
- Author
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Alemseged Z, Kiura PW, Mbua E, Njau J, and Pobiner B
- Subjects
- Africa, Eastern, Humans, Societies, Scientific, Anthropology, Physical, Paleontology
- Published
- 2012
- Full Text
- View/download PDF
35. Paleontology. Reading Pliocene bones.
- Author
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Njau J
- Subjects
- Animals, Bites and Stings, Tooth, Bone and Bones, Carnivory, Fossils, Hominidae, Tool Use Behavior
- Published
- 2012
- Full Text
- View/download PDF
36. Tuberculosis in HIV-infected Tanzanian children below 14 years.
- Author
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Njau JC and Aboud S
- Subjects
- AIDS-Related Opportunistic Infections drug therapy, AIDS-Related Opportunistic Infections epidemiology, Adolescent, Antitubercular Agents therapeutic use, Child, Cross-Sectional Studies, Female, HIV Infections drug therapy, HIV Infections epidemiology, HIV Seropositivity complications, HIV Seropositivity drug therapy, Humans, Male, Prevalence, Risk Factors, Sputum virology, Surveys and Questionnaires, Tanzania epidemiology, Tuberculin Test, Tuberculosis, Pulmonary complications, Tuberculosis, Pulmonary drug therapy, Tuberculosis, Pulmonary epidemiology, AIDS-Related Opportunistic Infections diagnosis, HIV Infections complications, Tuberculosis, Pulmonary diagnosis
- Abstract
Objective: Tuberculosis (TB)-human immunodeficiency virus (HIV) co-infection is an important public health problem. Diagnosis of TB in children usually follows discovery of an adult case, and relies on clinical presentation, sputum examination and chest radiograph. However, clinical features are non-specific, chest radiographs are difficult to interpret, and routine laboratory tests are not helpful. The aim of the current study was to determine the prevalence of TB in HIV-infected children below 14 years attending a tertiary hospital., Methods: A cross-sectional study was conducted in HIV-infected children below 14 years of age at Muhimbili National Hospital, in Dar es Salaam, Tanzania, between July 2008 and January 2009. Information on socio-demographic and anthropometric characteristics was collected using a structured questionnaire. Following assessment of clinical presentation, physical examination, tuberculin skin test, and chest radiograph were performed for each child. Two consecutive sputum specimens and blopd sample were collected for microscopy and culture, and CD4 T-lymphocyte percentage test, respectively. Chi-square test was used to compare differences in proportions. Odds ratio (OR) and their 95% confidence interval (CI) are presented as the risk estimator., Results: Of 182 HIV-infected children enrolled in the study, 104 (57.1%) were males. Overall, thirty-seven (20.3%) children had TB. The prevalence of TB was highest in males (78.4%) compared to females (p = 0.003). There was a higher proportion of TB (45.9%) in the age group below 24 months compared to other age groups (p = 0.001). Male gender, history of positive TB contact and severe immunosuppression were found to be significant risk factors for TB while use of antiretroviral therapy was found to be associated with decreased risk for TB., Conclusions: One-fifth of children had TB/HIV co-infection. Presence of four or more clinical manifestations and a low CD4+ T-lymphocyte percentage can be used to predict active TB in HIV-infected children.
- Published
- 2010
- Full Text
- View/download PDF
37. A new horned crocodile from the Plio-Pleistocene hominid sites at Olduvai Gorge, Tanzania.
- Author
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Brochu CA, Njau J, Blumenschine RJ, and Densmore LD
- Subjects
- Alligators and Crocodiles classification, Alligators and Crocodiles growth & development, Animals, Archaeology, Biological Evolution, Hominidae growth & development, Humans, Skeleton, Species Specificity, Tanzania, Alligators and Crocodiles anatomy & histology, Fossils, Horns anatomy & histology, Skull anatomy & histology
- Abstract
Background: The fossil record reveals surprising crocodile diversity in the Neogene of Africa, but relationships with their living relatives and the biogeographic origins of the modern African crocodylian fauna are poorly understood. A Plio-Pleistocene crocodile from Olduvai Gorge, Tanzania, represents a new extinct species and shows that high crocodylian diversity in Africa persisted after the Miocene. It had prominent triangular "horns" over the ears and a relatively deep snout, these resemble those of the recently extinct Malagasy crocodile Voay robustus, but the new species lacks features found among osteolaemines and shares derived similarities with living species of Crocodylus., Methodology/principal Findings: The holotype consists of a partial skull and skeleton and was collected on the surface between two tuffs dated to approximately 1.84 million years (Ma), in the same interval near the type localities for the hominids Homo habilis and Australopithecus boisei. It was compared with previously-collected material from Olduvai Gorge referable to the same species. Phylogenetic analysis places the new form within or adjacent to crown Crocodylus., Conclusions/significance: The new crocodile species was the largest predator encountered by our ancestors at Olduvai Gorge, as indicated by hominid specimens preserving crocodile bite marks from these sites. The new species also reinforces the emerging view of high crocodylian diversity throughout the Neogene, and it represents one of the few extinct species referable to crown genus Crocodylus.
- Published
- 2010
- Full Text
- View/download PDF
38. Is there evidence for dual causation between malaria and socioeconomic status? Findings from rural Tanzania.
- Author
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Somi MF, Butler JR, Vahid F, Njau J, Kachur SP, and Abdulla S
- Subjects
- Adult, Analysis of Variance, Animals, Child, Preschool, Female, Humans, Male, Plasmodium isolation & purification, Regression Analysis, Risk Factors, Rural Health, Socioeconomic Factors, Tanzania epidemiology, Malaria economics, Malaria epidemiology, Parasitemia economics, Parasitemia epidemiology, Rural Population statistics & numerical data
- Abstract
Malaria's relationship with socioeconomic status at the macroeconomic level has been established. This is the first study to explore this relationship at the microeconomic (household) level and estimate the direction of association. Malaria prevalence was measured by parasitemia, and household socioeconomic status was measured using an asset based index. Results from an instrumental variable probit model suggest that socioeconomic status is negatively associated with malaria parasitemia. Other variables that are significantly associated with parasitemia include age of the individual, use of a mosquito net on the night before interview, the number of people living in the household, whether the household was residing at their farm home at the time of interview, household wall construction, and the region of residence. Matching estimators indicate that malaria parasitemia is associated with reduced household socioeconomic status.
- Published
- 2007
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