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4. Index

Author

Okeke, Iruka N.

Published
2011

5. Notes

Author

Okeke, Iruka N.

Published
2011

16. Contents

Author

Okeke, Iruka N.

Published
2011

17. Preface

Author

Okeke, Iruka N.

Published
2011

21. Whole genomes from bacteria collected at diagnostic units around the world 2020

Author

Nag, Sidsel, Larsen, Gunhild, Szarvas, Judit, Birkedahl, Laura Elmlund Kohl, Gulyás, Gábor Máté, Ciok, Wojchiech Jakub, Lagermann, Timmie Mikkel, Tafaj, Silva, Bradbury, Susan, Collignon, Peter, Daley, Denise, Dougnon, Victorien, Fabiyi, Kafayath, Coulibaly, Boubacar, Dembélé, René, Nikiema, Georgette, Magloire, Natama, Ouindgueta, Isidore Juste, Hossain, Zenat Zebin, Begum, Anowara, Donchev, Deyan, Diggle, Mathew, Turnbull, LeeAnn, Lévesque, Simon, Berlinger, Livia, Sogaard, Kirstine Kobberoe, Guevara, Paula Diaz, Valderrama, Carolina Duarte, Maikanti, Panagiota, Amlerova, Jana, Drevinek, Pavel, Tkadlec, Jan, Dilas, Milica, Kaasch, Achim, Westh, Henrik Torkil, Bachtarzi, Mohamed Azzedine, Amhis, Wahiba, Salazar, Carolina Elisabeth Satán, Villacis, JoséEduardo, Lúzon, Mária Angeles Dominguez, Palau, Dámaris Berbel, Duployez, Claire, Paluche, Maxime, Asante-Sefa, Solomon, Moller, Mie, Ip, Margaret, Mareković, Ivana, Pál-Sonnevend, Agnes, Cocuzza, Clementiza Elvezia, Dambrauskiene, Asta, Macanze, Alexandre, Cossa, Anelsio, Mandomando, Inácio, Nwajiobi-Princewill, Philip, Okeke, Iruka N., Kehinde, Aderemi O., Adebiyi, Ini, Akintayo, Ifeoluwa, Popoola, Oluwafemi, Onipede, Anthony, Blomfeldt, Anita, Nyquist, Nora Elisabeth, Bocker, Kiri, Ussher, James, Ali, Amjad, Ullah, Nimat, Khan, Habibullah, Gustafson, Natalie Weiler, Jarrar, Ikhlas, Al-Hamad, Arif, Luvira, Viravarn, Paveenkittiporn, Wantana, Baran, Irmak, Mwansa, James C. L., Sikakwa, Linda, Yamba, Kaunda, Hendriksen, Rene Sjogren, and Aarestrup, Frank Moller

Published
2023
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22. Incidence of typhoid fever in Burkina Faso, Democratic Republic of the Congo, Ethiopia, Ghana, Madagascar, and Nigeria (the Severe Typhoid in Africa programme): a population-based study

Author

Marks, Florian, Im, Justin, Park, Se Eun, Pak, Gi Deok, Jeon, Hyon Jin, Wandji Nana, Lady Rosny, Phoba, Marie-France, Mbuyi-Kalonji, Lisette, Mogeni, Ondari D, Yeshitela, Biruk, Panzner, Ursula, Cruz Espinoza, Ligia María, Beyene, Tigist, Owusu-Ansah, Michael, Twumasi-Ankrah, Sampson, Yeshambaw, Melese, Alemu, Ashenafi, Adewusi, Oluwafemi J, Adekanmbi, Olukemi, Higginson, Ellen, Adepoju, Akinlolu, Agbi, Sarah, Cakpo, Enoch G, Ogunleye, Veronica O, Tunda, Gaëlle Nkoji, Ikhimiukor, Odion O, Mbuyamba, Jules, Toy, Trevor, Agyapong, Francis Opoku, Osei, Isaac, Amuasi, John, Razafindrabe, Tsiriniaina Jean Luco, Raminosoa, Tiana Mirana, Nyirenda, Gabriel, Randriamampionona, Njariharinjakampionona, Seo, Hyeong Won, Seo, Hyejin, Siribie, Mohamadou, Carey, Megan E, Owusu, Michael, Meyer, Christian G, Rakotozandrindrainy, Ndrainaharimira, Sarpong, Nimarko, Razafindrakalia, Mathilde, Razafimanantsoa, Ravomialisoa, Ouedraogo, Moussa, Kim, Yeonseon J, Lee, Jooah, Zellweger, Raphaël M, Kang, Sophie S Y, Park, Ju Yeon, Crump, John A, Hardy, Liselotte, Jacobs, Jan, Garrett, Denise O, Andrews, Jason R, Poudyal, Nimesh, Kim, Deok Ryun, Clemens, John D, Baker, Stephen G, Kim, Jerome H, Dougan, Gordon, Sugimoto, Jonathan D, Van Puyvelde, Sandra, Kehinde, Aderemi, Popoola, Oluwafemi A, Mogasale, Vittal, Breiman, Robert F, MacWright, William R, Aseffa, Abraham, Tadesse, Birkneh Tilahun, Haselbeck, Andrea, Adu-Sarkodie, Yaw, Teferi, Mekonnen, Bassiahi, Abdramane Soura, Okeke, Iruka N, Lunguya-Metila, Octavie, Owusu-Dabo, Ellis, and Rakotozandrindrainy, Raphaël

Published
2024
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23. WHO global research priorities for antimicrobial resistance in human health

Author

Aanensen, David, Alanio, Alexandre, Alastruey-Izquierdo, Ana, Alemayehu, Tinsae, Al-Hasan, Majdi, Allegaert, Karel, Al-Maani, Amal Saif, Al-Salman, Jameela, Alshukairi, Abeer Nizar, Amir, Afreenish, Applegate, Tanya, Araj, George F, Villalobos, Marlen Arce, Årdal, Christine, Ashiru-Oredope, Diane, Ashley, Elizabeth A, Babin, François-Xavier, Bachmann, Laura H, Bachmann, Till, Baker, Kate Susan, Balasegaram, Manica, Bamford, Colleen, Baquero, Fernando, Barcelona, Laura Isabel, Bassat, Quique, Bassetti, Matteo, Basu, Sulagna, Beardsley, Justin, Vásquez, Grey Benoit, Berkley, James A, Bhatnagar, Anuj K, Bielicki, Julia, Bines, Julie, Bongomin, Felix, Bonomo, Robert A, Bradley, John S, Bradshaw, Catriona, Brett, Ana, Brink, Adrian, Brown, Colin, Brown, Jeremy, Buising, Kirsty, Carson, Carolee, Carvalho, Anna Cristina, Castagnola, Elio, Cavaleri, Marco, Cecchini, Michele, Chabala, Chishala, Chaisson, Richard E, Chakrabarti, Arunaloke, Chandler, Clare, Chandy, Sujith John, Charani, Esmita, Chen, Lisa, Chiara, Francesca, Chowdhary, Anuradha, Chua, Arlene, Chuki, Pem, Chun, Doo Ryeon, Churchyard, Gavin, Cirillo, Daniela, Clack, Lauren, Coffin, Susan E, Cohn, Jennifer, Cole, Michelle, Conly, John, Cooper, Ben, Corso, Alejandra, Cosgrove, Sara E, Cox, Helen, Daley, Charles L, Darboe, Saffiatou, Darton, Tom, Davies, Gerry, de Egea, Viviana, Dedeić-Ljubović, Amela, Deeves, Miranda, Denkinger, Claudia, Dillon, Jo-Anne R, Dramowski, Angela, Eley, Brian, Roberta Esposito, Susanna Maria, Essack, Sabiha Y, Farida, Helmia, Farooqi, Joveria, Feasey, Nicholas, Ferreyra, Cecilia, Fifer, Helen, Finlayson, Heather, Frick, Mike, Gales, Ana Cristina, Galli, Luisa, Gandra, Sumanth, Gerber, Jeffrey S, Giske, Christian, Gordon, Bruce, Govender, Nelesh, Guessennd, Nathalie, Guindo, Ibrehima, Gurbanova, Elmira, Gwee, Amanda, Hagen, Ferry, Harbarth, Stephan, Haze, John, Heim, Jutta, Hendriksen, Rene, Heyderman, Robert Simon, Holt, Kathryn Elizabeth, Hönigl, Martin, Hook, Edward W, Hope, William, Hopkins, Heidi, Hughes, Gwenda, Ismail, Ghada, Issack, Mohammad Iqbal, Jacobs, Jan, Jasovský, Dušan, Jehan, Fyeza, Pearson, Antonieta Jimenez, Jones, Makoto, Joshi, Mohan P, Kapil, Arti, Kariuki, Samuel, Karkey, Abhilasha, Kearns, Gregory L, Keddy, Karen Helena, Khanna, Nina, Kitamura, Akiko, Kolho, Kaija-Leena, Kontoyiannis, Dimitrios P, Kotwani, Anita, Kozlov, Roman S, Kranzer, Katharina, Kularatne, Ranmini, Lahra, Monica M, Langford, Bradley J, Laniado-Laborin, Rafael, Larsson, Joakim, Lass-Flörl, Cornelia, Le Doare, Kirsty, Lee, Hyukmin, Lessa, Fernanda, Levin, Anna S, Limmathurotsakul, Direk, Lincopan, Nilton, Lo Vecchio, Andrea, Lodha, Rakesh, Loeb, Mark, Longtin, Yves, Lye, David Chien, Mahmud, Asif Mujtaba, Manaia, Célia, Manderson, Lenore, Mareković, Ivana, Marimuthu, Kalisvar, Martin, Irene, Mashe, Tapfumanei, Mei, Zeng, Meis, Jacques F, Lyra Tavares De Melo, Flávio Augusto, Mendelson, Marc, Miranda, Angelica Espinosa, Moore, David, Morel, Chantal, Moremi, Nyambura, Moro, Maria Luisa, Moussy, Francis, Mshana, Stephen, Mueller, Arno, Ndow, Francis J, Nicol, Mark, Nunn, Andrew, Obaro, Stephen, Obiero, Christina W, Okeke, Iruka N, Okomo, Uduak, Okwor, Tochi J, Oladele, Rita, Omulo, Sylvia, Ondoa, Pascale, Ortellado de Canese, Juana Medarda, Ostrosky-Zeichner, Luis, Padoveze, Maria Clara, Pai, Madhukar, Park, Benjamin, Parkhill, Julian, Parry, Christopher M, Peeling, Rosanna, Sobreira Vieira Peixe, Luísa Maria, Perovic, Olga, Pettigrew, Melinda M, Principi, Nicola, Pulcini, Céline, Puspandari, Nelly, Rawson, Timothy, Reddy, Denasha Lavanya, Reddy, Kessendri, Redner, Paulo, Rodríguez Tudela, Juan Luis, Rodríguez-Baño, Jesús, Van Katwyk, Susan Rogers, Roilides, Emmanuel, Rollier, Christine, Rollock, Leslie, Ronat, Jean-Baptiste, Ruppe, Etienne, Sadarangani, Manish, Salisbury, David, Salou, Mounerou, Samison, Luc Hervé, Sanguinetti, Maurizio, Sartelli, Massimo, Schellack, Natalie, Schouten, Jeroen, Schwaber, Mitchell J, Seni, Jeremiah, Senok, Abiola, Shafer, William M, Shakoor, Sadia, Sheppard, Donald, Shin, Jong-Hee, Sia, Sonia, Sievert, Dawn, Singh, Ishwar, Singla, Rupak, Skov, Robert Leo, Soge, Olusegun O, Sprute, Rosanne, Srinivasan, Arjun, Srinivasan, Subasree, Sundsfjord, Arnfinn, Tacconelli, Evelina, Tahseen, Sabira, Tangcharoensathien, Viroj, Tängdén, Thomas, Thursky, Karin, Thwaites, Guy, Tigulini de Souza Peral, Renata, Tong, Deborah, Tootla, Hafsah Deepa, Tsioutis, Constantinos, Turner, Katy M, Turner, Paul, Omar, Shaheed Vally, van de Sande, Wendy WJ, van den Hof, Susan, van Doorn, Rogier, Veeraraghavan, Balaji, Verweij, Paul, Wahyuningsih, Retno, Wang, Hui, Warris, Adilia, Weinstock, Hillard, Wesangula, Evelyn, Whiley, David, White, Peter J, Williams, Phoebe, Xiao, Yonghong, Moscoso, Martin Yagui, Yang, Hsu Li, Yoshida, Sachiyo, Yu, Yunsong, Żabicka, Dorota, Zignol, Matteo, Rudan, Igor, Bertagnolio, Silvia, Dobreva, Zlatina, Centner, Chad M, Olaru, Ioana Diana, Donà, Daniele, Burzo, Stefano, Huttner, Benedikt D, Chaillon, Antoine, Gebreselassie, Nebiat, Wi, Teodora, Hasso-Agopsowicz, Mateusz, Allegranzi, Benedetta, Sati, Hatim, Ivanovska, Verica, Kothari, Kavita U, Balkhy, Hanan H, Cassini, Alessandro, Hamers, Raph L, and Weezenbeek, Kitty Van

Published
2024
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25. Evidence review and recommendations for the implementation of genomics for antimicrobial resistance surveillance: reports from an international expert group

Author

Baker, Kate S, Jauneikaite, Elita, Nunn, Jamie G, Midega, Janet T, Atun, Rifat, Holt, Kathryn E, Walia, Kamini, Howden, Benjamin P, Tate, Heather, Okeke, Iruka N, Carattoli, Alessandra, Hsu, Li Yang, Hopkins, Katie L, Muloi, Dishon M, Wheeler, Nicole E, Aanensen, David M, Mason, Lewis C E, Rodgus, Jonah, Hendriksen, Rene S, Essack, Sabiha Y, Egyir, Beverly, Halpin, Alison L, MacCannell, Duncan R, Campos, Josefina, Srikantiah, Padmini, Feasey, Nicholas A, and Peacock, Sharon J

Published
2023
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28. The Surveillance for Enteric Fever in Asia Project (SEAP), Severe Typhoid Fever Surveillance in Africa (SETA), Surveillance of Enteric Fever in India (SEFI), and Strategic Typhoid Alliance Across Africa and Asia (STRATAA) Population-based Enteric Fever Studies: A Review of Methodological Similarities and Differences

Author

Carey, Megan E, MacWright, William R, Im, Justin, Meiring, James E, Gibani, Malick M, Park, Se Eun, Longley, Ashley, Jeon, Hyon Jin, Hemlock, Caitlin, Yu, Alexander T, Soura, Abdramane, Aiemjoy, Kristen, Owusu-Dabo, Ellis, Terferi, Mekonnen, Islam, Sahidul, Lunguya, Octavie, Jacobs, Jan, Gordon, Melita, Dolecek, Christiane, Baker, Stephen, Pitzer, Virginia E, Yousafzai, Mohammad Tahir, Tonks, Susan, Clemens, John D, Date, Kashmira, Qadri, Firdausi, Heyderman, Robert S, Saha, Samir K, Basnyat, Buddha, Okeke, Iruka N, Qamar, Farah N, Voysey, Merryn, Luby, Stephen, Kang, Gagandeep, Andrews, Jason, Pollard, Andrew J, John, Jacob, Garrett, Denise, and Marks, Florian

Subjects
Infectious Diseases, Vaccine Related, Digestive Diseases, Immunization, Clinical Research, Rare Diseases, Emerging Infectious Diseases, Biodefense, Prevention, Foodborne Illness, Prevention of disease and conditions, and promotion of well-being, 3.4 Vaccines, Aetiology, 2.4 Surveillance and distribution, 2.2 Factors relating to the physical environment, Infection, Good Health and Well Being, Clean Water and Sanitation, Africa South of the Sahara, Asia, Humans, India, Salmonella typhi, Typhoid Fever, Typhoid-Paratyphoid Vaccines, blood culture, enteric fever surveillance, Salmonella Typhi, typhoid fever, Salmonella Typhi, Biological Sciences, Medical and Health Sciences, Microbiology
Abstract

Building on previous multicountry surveillance studies of typhoid and others salmonelloses such as the Diseases of the Most Impoverished program and the Typhoid Surveillance in Africa Project, several ongoing blood culture surveillance studies are generating important data about incidence, severity, transmission, and clinical features of invasive Salmonella infections in sub-Saharan Africa and South Asia. These studies are also characterizing drug resistance patterns in their respective study sites. Each study answers a different set of research questions and employs slightly different methodologies, and the geographies under surveillance differ in size, population density, physician practices, access to healthcare facilities, and access to microbiologically safe water and improved sanitation. These differences in part reflect the heterogeneity of the epidemiology of invasive salmonellosis globally, and thus enable generation of data that are useful to policymakers in decision-making for the introduction of typhoid conjugate vaccines (TCVs). Moreover, each study is evaluating the large-scale deployment of TCVs, and may ultimately be used to assess post-introduction vaccine impact. The data generated by these studies will also be used to refine global disease burden estimates. It is important to ensure that lessons learned from these studies not only inform vaccination policy, but also are incorporated into sustainable, low-cost, integrated vaccine-preventable disease surveillance systems.

Published
2020

32. Population health outcomes in Nigeria compared with other west African countries, 1998–2019: a systematic analysis for the Global Burden of Disease Study

Author

Angell, Blake, Sanuade, Olutobi, Adetifa, Ifedayo M O, Okeke, Iruka N, Adamu, Aishatu Lawal, Aliyu, Muktar H, Ameh, Emmanuel A, Kyari, Fatima, Gadanya, Muktar A, Mabayoje, Diana A, Yinka-Ogunleye, Adesola, Oni, Tolu, Jalo, Rabiu Ibrahim, Tsiga-Ahmed, Fatimah I, Dalglish, Sarah L, Abimbola, Seye, Colbourn, Tim, Onwujekwe, Obinna, Owoaje, Eme Theodora, Aliyu, Gambo, Aliyu, Sani H, Archibong, Belinda, Ezeh, Alex, Ihekweazu, Chikwe, Iliyasu, Zubairu, Obaro, Stephen, Obadare, Ebenezer Babatunde, Okonofua, Friday, Pate, Muhammed, Salako, Babatunde L, Zanna, Fatima H, Glenn, Scott, Walker, Ally, Ezalarab, Maha, Naghavi, Mohsen, and Abubakar, Ibrahim

Published
2022
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33. The Lancet Nigeria Commission: investing in health and the future of the nation

Author

Abubakar, Ibrahim, Dalglish, Sarah L, Angell, Blake, Sanuade, Olutobi, Abimbola, Seye, Adamu, Aishatu Lawal, Adetifa, Ifedayo M O, Colbourn, Tim, Ogunlesi, Afolabi Olaniyi, Onwujekwe, Obinna, Owoaje, Eme T, Okeke, Iruka N, Adeyemo, Adebowale, Aliyu, Gambo, Aliyu, Muktar H, Aliyu, Sani Hussaini, Ameh, Emmanuel A, Archibong, Belinda, Ezeh, Alex, Gadanya, Muktar A, Ihekweazu, Chikwe, Ihekweazu, Vivianne, Iliyasu, Zubairu, Kwaku Chiroma, Aminatu, Mabayoje, Diana A, Nasir Sambo, Mohammed, Obaro, Stephen, Yinka-Ogunleye, Adesola, Okonofua, Friday, Oni, Tolu, Onyimadu, Olu, Pate, Muhammad Ali, Salako, Babatunde L, Shuaib, Faisal, Tsiga-Ahmed, Fatimah, and Zanna, Fatima H

Published
2022
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34. Diarrhoeagenic Escherichia coli associated with childhood diarrhoea in Osun state, Nigeria.

Author

Olayinka, Ademola A., Oginni-Falajiki, Ibukunoluwa O., Okeke, Iruka N., and Aboderin, Aaron O.

Subjects
ESCHERICHIA coli, MICROBIAL sensitivity tests, FISHER exact test, CAPITAL cities, DRUG resistance in bacteria
Abstract

Introduction: Diarrhoea is a major public health concern in developing countries, usually exacerbated by poor water, sanitation and hygiene but its aetiology is under-studied, particularly away from capital cities. We identified diarrhoeagenic Escherichia coli (DEC) from stools collected in Ile-Ife and Ilesa, Osun state, Nigeria and determined their antibiotic resistance profiles. Methods: Stool samples from 167 children with diarrhoea and 334 controls under the age of 5 years were cultured for Escherichia coli and Salmonella. Bacterial isolates were identified biochemically and DEC were identified by PCR. Antimicrobial susceptibility testing was by modified Kirby-Bauer disc diffusion method in accordance with the CLSI guidelines. Data were analyzed using Chi-square and Fisher's exact tests. Result: Diarrhoea infection is significantly high among children under 12 months (p = 0.002), caregivers without at least primary school education (p = 0.006), breastfeeding for under 6 months (p˂0.001), and caregivers who were siblings (p = 0.004). DEC was detected in 69(41.3%) cases but only 86(25.7%) controls (p < 0.001) and more commonly recovered during the wet season (p < 0.001). Enterotoxigenic E. coli (p = 0.031), enteropathogenic E. coli (p = 0.031) and Shiga-toxin-producing E. coli (p = 0.044) were recovered more commonly from cases than controls. DEC from patients with diarrhoea were commonly resistant to sulphonamides (91.3%), trimethoprim (82.6%), and ampicillin (78.3%) but were largely susceptible to quinolones and carbapenems (97.1%). Conclusion: Enteropathogenic, enterotoxigenic and Shiga toxin-producing E. coli are associated with diarrhoea in our setting, and show considerable resistance to first-line antimicrobials. Risk factors for DEC diarrhoea include infancy, inadequate breastfeeding and caregivers with education below primary school. [ABSTRACT FROM AUTHOR]

Published
2024
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37. Divining without Seeds

Author

Okeke, Iruka N.

Subjects
African history, thema EDItEUR::N History and Archaeology::NH History::NHH African history
Abstract

Infectious disease is the most common cause of illness and death in Africa, yet health practitioners routinely fail to identify causative microorganisms in most patients. As a result, patients often do not receive the right medicine in time to cure them promptly even when such medicine is available, outbreaks are larger and more devastating than they should be, and the impact of control interventions is difficult to measure. Wrong prescriptions and prolonged infections amount to needless costs for patients and for health systems. In Divining without Seeds, Iruka N. Okeke forcefully argues that laboratory diagnostics are essential to the effective practice of medicine in Africa. The diversity of endemic life-threatening infections and limited public health resources in tropical Africa make the need for basic laboratory diagnostic support even more acute than in other parts of the world. This book gathers compelling case studies of inadequate diagnoses of diseases ranging from fevers—including malaria—to respiratory infections and sexually transmitted diseases. The inherited and widely prevalent health clinic model, which excludes or diminishes the hospital laboratory, is flawed, to often devastating effect. Fortunately, there are new technologies that make it possible to inexpensively implement testing at the primary care level. Divining without Seeds makes clear that routine use of appropriate diagnostic support should be part of every drug delivery plan in Africa and that diagnostic development should be given high priority.

Published
2011
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38. Correction for Odih et al., “High Genetic Diversity of Carbapenem-Resistant Acinetobacter baumannii Isolates Recovered in Nigerian Hospitals in 2016 to 2020”

Author

Odih, Erkison Ewomazino, primary, Oaikhena, Anderson O., additional, Underwood, Anthony, additional, Hounmanou, Yaovi Mahuton Gildas, additional, Oduyebo, Oyinlola O., additional, Fadeyi, Abayomi, additional, Aboderin, Aaron O., additional, Ogunleye, Veronica O., additional, Argimón, Silvia, additional, Akpunonu, Vitus Nnaemeka, additional, Oshun, Phillip O., additional, Egwuenu, Abiodun, additional, Okwor, Tochi J., additional, Ihekweazu, Chikwe, additional, Aanensen, David M., additional, Dalsgaard, Anders, additional, and Okeke, Iruka N., additional

Published
2023
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43. Epidemiology and Risk Factors for Diarrheagenic Escherichia coli Carriage among Children in Northern Ibadan, Nigeria

Author

Akinlabi, Olabisi C., primary, Nwoko, El-shama Q., additional, Dada, Rotimi A., additional, Ekpo, Stella, additional, Omotuyi, Adeola, additional, Nwimo, Chukwuemeka C., additional, Adepoju, Akinlolu, additional, Popoola, Oluwafemi, additional, Dougan, Gordon, additional, Thomson, Nicholas R., additional, and Okeke, Iruka N., additional

Published
2023
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45. Characterization of Typhoid Intestinal Perforation in Africa: Results From the Severe Typhoid Fever Surveillance in Africa Program

Author

Birkhold, Megan, Datta, Shrimati, Pak, Gi Deok, Im, Justin, Ogundoyin, Olakayode O, Olulana, Dare I, Lawal, Taiwo A, Afuwape, Oludolapo O, Kehinde, Aderemi, Phoba, Marie-France, Nkoji, Gaëlle, Aseffa, Abraham, Teferi, Mekonnen, Yeshitela, Biruk, Popoola, Oluwafemi, Owusu, Michael, Nana, Lady Rosny Wandji, Cakpo, Enoch G, Ouedraogo, Moussa, Ouangre, Edgar, Ouedraogo, Isso, Heroes, Anne-Sophie, Jacobs, Jan, Mogeni, Ondari D, Haselbeck, Andrea, Sukri, Leah, Neuzil, Kathleen M, Metila, Octavie Lunguya, Owusu-Dabo, Ellis, Adu-Sarkodie, Yaw, Bassiahi, Abdramane Soura, Rakotozandrindrainy, Raphaël, Okeke, Iruka N, Zellweger, Raphaël M, Marks, Florian, Birkhold, Megan [0000-0002-5746-1321], Im, Justin [0000-0002-3762-084X], Okeke, Iruka N [0000-0002-1694-7587], Marks, Florian [0000-0002-6043-7170], and Apollo - University of Cambridge Repository

Subjects
intestinal perforation, Africa, Salmonella Typhi, severe typhoid, typhoid fever
Abstract

BACKGROUND: Typhoid intestinal perforation (TIP) remains the most serious complication of typhoid fever. In many countries, the diagnosis of TIP relies on intraoperative identification, as blood culture and pathology capacity remain limited. As a result, many cases of TIP may not be reported as typhoid. This study demonstrates the burden of TIP in sites in Burkina Faso, Democratic Republic of Congo (DRC), Ethiopia, Ghana, Madagascar, and Nigeria. METHODS: Patients with clinical suspicion of nontraumatic intestinal perforation were enrolled and demographic details, clinical findings, surgical records, blood cultures, tissue biopsies, and peritoneal fluid were collected. Participants were then classified as having confirmed TIP, probable TIP, possible TIP, or clinical intestinal perforation based on surgical descriptions and cultures. RESULTS: A total of 608 participants were investigated for nontraumatic intestinal perforation; 214 (35%) participants had surgically-confirmed TIP and 33 participants (5%) had culture-confirmed typhoid. The overall proportion of blood or surgical site Salmonella enterica subspecies enterica serovar Typhi positivity in surgically verified TIP cases was 10.3%. TIP was high in children aged 5-14 years in DRC, Ghana, and Nigeria. We provide evidence for correlation between monthly case counts of S. Typhi and the occurrence of intestinal perforation. CONCLUSIONS: Low S. Typhi culture positivity rates, as well as a lack of blood and tissue culture capability in many regions where typhoid remains endemic, significantly underestimate the true burden of typhoid fever. The occurrence of TIP may indicate underlying typhoid burden, particularly in countries with limited culture capability.

Published
2023

46. Divining without Seeds. The Case for Strengthening Laboratory Medicine in Africa.

Author

Okeke, Iruka N.

Subjects
African history
Abstract

Summary: Infectious disease is the most common cause of illness and death in Africa, yet health practitioners routinely fail to identify causative microorganisms in most patients. As a result, patients often do not receive the right medicine in time to cure them promptly even when such medicine is available, outbreaks are larger and more devastating than they should be, and the impact of control interventions is difficult to measure. Wrong prescriptions and prolonged infections amount to needless costs for patients and for health systems. In Divining without Seeds, Iruka N. Okeke forcefully argues that laboratory diagnostics are essential to the effective practice of medicine in Africa. The diversity of endemic life-threatening infections and limited public health resources in tropical Africa make the need for basic laboratory diagnostic support even more acute than in other parts of the world. This book gathers compelling case studies of inadequate diagnoses of diseases ranging from fevers-including malaria-to respiratory infections and sexually transmitted diseases. The inherited and widely prevalent health clinic model, which excludes or diminishes the hospital laboratory, is flawed, to often devastating effect. Fortunately, there are new technologies that make it possible to inexpensively implement testing at the primary care level. Divining without Seeds makes clear that routine use of appropriate diagnostic support should be part of every drug delivery plan in Africa and that diagnostic development should be given high priority.

47. Broadening Participation in the Sciences within and from Africa: Purpose, Challenges, and Prospects

Author

Okeke, Iruka N., Babalola, Chinedum P., Byarugaba, Denis K., Djimde, Abdoulaye, and Osoniyi, Omolaja R.

Abstract

Many of Africa's challenges have scientific solutions, but there are fewer individuals engaged in scientific activity per capita on this continent than on any other. Only a handful of African scientists use their skills to capacity or are leaders in their disciplines. Underrepresentation of Africans in scientific practice, discourse, and decision making reduces the richness of intellectual contributions toward hard problems worldwide. This essay outlines challenges faced by teacher-scholars from sub-Saharan Africa as we build scientific expertise. Access to tertiary-level science is difficult and uneven across Africa, and the quality of training available varies from top-range to inadequate. Access to science higher education needs to increase, particularly for female students, first-generation literates, and rural populations. We make suggestions for collaborative initiatives involving stakeholders outside Africa and/or outside academia that could extend educational opportunities available to African students and increase the chance that Africa-based expertise is globally available.

Published
2017
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