Malaria remains the most important parasitic disease of humans, with an estimated 200 million cas... more Malaria remains the most important parasitic disease of humans, with an estimated 200 million cases per year and 600 000 to 1.2 million deaths annually. Severe and cerebral malaria carry mortality rates on the order of 10–30% and are almost universally caused by Plasmodium falciparum. The greatest burden of illness is borne by children under the age of five residing in sub-Saharan Africa. We herein discuss the protean clinical manifestations, up-to-date management, and current preventive strategies for malaria.
HAL (Le Centre pour la Communication Scientifique Directe), Nov 1, 2017
65th Annual Meeting of the American-Society-of-Tropical-Medicine-and-Hygiene (ASTMH), Atlanta, GA... more 65th Annual Meeting of the American-Society-of-Tropical-Medicine-and-Hygiene (ASTMH), Atlanta, GA, NOV 13-16, 2016International audienc
Background.Inappropriate antibiotics in lower respiratory tract infections (LRTI) is a major cont... more Background.Inappropriate antibiotics in lower respiratory tract infections (LRTI) is a major contributor to resistance. We aimed to design an algorithm based on clinical signs and host biomarkers to identify bacterial community-acquired pneumonia (CAP) among patients with LRTI.Methods. Participants with LRTI were selected in a prospective cohort of febrile (≥38°C) adults presenting to outpatient clinics in Dar es Salaam. Participants underwent chest X-ray, multiplex PCR for respiratory pathogens, and measurements of 13 biomarkers. We evaluated the predictive accuracy of clinical signs and biomarkers using logistic regression and classification and regression tree analysis.Results. Of 110 patients with LRTI, 17 had bacterial CAP. Procalcitonin (PCT), interleukin-6 (IL-6) and soluble triggering receptor expressed by myeloid cells-1 (sTREM-1) showed excellent predictive accuracy to identify bacterial CAP (AUROC 0.88, 95%CI 0.78-0.98; 0.84, 0.72-0.99; 0.83, 0.74-0.92, respectively). Com...
Background Cutaneous leishmaniasis (CL) may be emerging among international travellers and migran... more Background Cutaneous leishmaniasis (CL) may be emerging among international travellers and migrants. Limited data exist on mucocutaneous leishmaniasis (MCL) in travellers. We describe the epidemiology of travel-associated CL and MCL among international travellers and immigrants over a 20-year period through descriptive analysis of GeoSentinel data. Methods Demographic and travel-related data on returned international travellers diagnosed with CL or MCL at a GeoSentinel Surveillance Network site between 1 September 1997 and 31 August 2017 were analysed. Results A total of 955 returned travellers or migrants were diagnosed with travel-acquired CL (n = 916) or MCL during the study period, of whom 10% (n = 97) were migrants. For the 858 non-migrant travellers, common source countries were Bolivia (n = 156, 18.2%) and Costa Rica (n = 97, 11.3%), while for migrants, they were Syria (n = 34, 35%) and Afghanistan (n = 22, 22.7%). A total of 99 travellers (10%) acquired their disease on trip...
Official Journal of the Association of Medical Microbiology and Infectious Disease Canada, 2016
BACKGROUND: Established in the Americas since late 2013, chikungunya is an emerging infection amo... more BACKGROUND: Established in the Americas since late 2013, chikungunya is an emerging infection among travellers. OBJECTIVE: To examine demographic and travel correlates of chikungunya among Canadian travellers to establish a detailed epidemiological framework of this infection for Canadian practitioners encountering prospective and returned travellers. METHODS: Data regarding ill returned Canadian travellers presenting to a CanTravNet site between 2006 and 2015 were analyzed. RESULTS: During the study period, 22,387 ill travellers and immigrants presented to a CanTravNet site and, of these, 118 (0.5%) received a diagnosis of chikungunya. Those travelling for tourism were the most well-represented (n=49, 41.5%), followed by those travelling to visit friends and relatives (n=36, 30.5%). The Caribbean was the most likely source region, accounting for 64 (54.2%) diagnoses, followed by South Central Asia (n=18, 15.3%). Haiti was the most well-represented source country, accounting for 22 ...
Malaria remains the most important parasitic disease of humans, with an estimated 200 million cas... more Malaria remains the most important parasitic disease of humans, with an estimated 200 million cases per year and 600 000 to 1.2 million deaths annually. Severe and cerebral malaria carry mortality rates on the order of 10–30% and are almost universally caused by Plasmodium falciparum. The greatest burden of illness is borne by children under the age of five residing in sub-Saharan Africa. We herein discuss the protean clinical manifestations, up-to-date management, and current preventive strategies for malaria.
HAL (Le Centre pour la Communication Scientifique Directe), Nov 1, 2017
65th Annual Meeting of the American-Society-of-Tropical-Medicine-and-Hygiene (ASTMH), Atlanta, GA... more 65th Annual Meeting of the American-Society-of-Tropical-Medicine-and-Hygiene (ASTMH), Atlanta, GA, NOV 13-16, 2016International audienc
Background.Inappropriate antibiotics in lower respiratory tract infections (LRTI) is a major cont... more Background.Inappropriate antibiotics in lower respiratory tract infections (LRTI) is a major contributor to resistance. We aimed to design an algorithm based on clinical signs and host biomarkers to identify bacterial community-acquired pneumonia (CAP) among patients with LRTI.Methods. Participants with LRTI were selected in a prospective cohort of febrile (≥38°C) adults presenting to outpatient clinics in Dar es Salaam. Participants underwent chest X-ray, multiplex PCR for respiratory pathogens, and measurements of 13 biomarkers. We evaluated the predictive accuracy of clinical signs and biomarkers using logistic regression and classification and regression tree analysis.Results. Of 110 patients with LRTI, 17 had bacterial CAP. Procalcitonin (PCT), interleukin-6 (IL-6) and soluble triggering receptor expressed by myeloid cells-1 (sTREM-1) showed excellent predictive accuracy to identify bacterial CAP (AUROC 0.88, 95%CI 0.78-0.98; 0.84, 0.72-0.99; 0.83, 0.74-0.92, respectively). Com...
Background Cutaneous leishmaniasis (CL) may be emerging among international travellers and migran... more Background Cutaneous leishmaniasis (CL) may be emerging among international travellers and migrants. Limited data exist on mucocutaneous leishmaniasis (MCL) in travellers. We describe the epidemiology of travel-associated CL and MCL among international travellers and immigrants over a 20-year period through descriptive analysis of GeoSentinel data. Methods Demographic and travel-related data on returned international travellers diagnosed with CL or MCL at a GeoSentinel Surveillance Network site between 1 September 1997 and 31 August 2017 were analysed. Results A total of 955 returned travellers or migrants were diagnosed with travel-acquired CL (n = 916) or MCL during the study period, of whom 10% (n = 97) were migrants. For the 858 non-migrant travellers, common source countries were Bolivia (n = 156, 18.2%) and Costa Rica (n = 97, 11.3%), while for migrants, they were Syria (n = 34, 35%) and Afghanistan (n = 22, 22.7%). A total of 99 travellers (10%) acquired their disease on trip...
Official Journal of the Association of Medical Microbiology and Infectious Disease Canada, 2016
BACKGROUND: Established in the Americas since late 2013, chikungunya is an emerging infection amo... more BACKGROUND: Established in the Americas since late 2013, chikungunya is an emerging infection among travellers. OBJECTIVE: To examine demographic and travel correlates of chikungunya among Canadian travellers to establish a detailed epidemiological framework of this infection for Canadian practitioners encountering prospective and returned travellers. METHODS: Data regarding ill returned Canadian travellers presenting to a CanTravNet site between 2006 and 2015 were analyzed. RESULTS: During the study period, 22,387 ill travellers and immigrants presented to a CanTravNet site and, of these, 118 (0.5%) received a diagnosis of chikungunya. Those travelling for tourism were the most well-represented (n=49, 41.5%), followed by those travelling to visit friends and relatives (n=36, 30.5%). The Caribbean was the most likely source region, accounting for 64 (54.2%) diagnoses, followed by South Central Asia (n=18, 15.3%). Haiti was the most well-represented source country, accounting for 22 ...
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Papers by Kevin Kain