Browsing by Author "Kreppel, K."
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Item Evaluation of the sentinel surveillance system for influenza-like illnesses in the Greater Accra region, Ghana, 2018(PLoS ONE, 2019-03) Nuvey, F.S.; Edu-Quansah, E.P.; Kuma, G.K.; Eleeza, J.; Kenu, E.; Sackey, S.; Ameme, D.; Abakar, M.F.; Kreppel, K.; Ngandolo, R.B.; Afari, E.; Bonfoh, B.Background Influenza-like Illness (ILI) is a medical diagnosis of possible influenza or another respiratory illness with a common set of symptoms. The deaths of four schoolchildren, during a pandemic influenza outbreak in December 2017 in Ghana, raised doubts about the ILI surveillance system’s performance. We evaluated the ILI surveillance system in the Greater Accra region, Ghana, to assess the system’s attributes and its performance on set objectives. Methods CDC guidelines were used to evaluate the data of the ILI surveillance system between 2013 and 2017. We interviewed the surveillance personnel on the system’s description and operation. Additionally, routinely entered ILI data from the National Influenza Center provided by the six sentinel sites in Accra was extracted. We sampled and reviewed 120 ILI case-investigation forms from these sites. Surveillance activities were examined on system’s performance indicators, each being scored on a scale of 1 to 3 (poorest to best performance). Results All population and age groups were under ILI surveillance over the period evaluated. Overall, 2948 suspected case-patients, including 392 (13.3%) children under-five were reported, with 219 being positive for influenza virus (Predictive value positive = 7.4%). The predominant influenza subtype was H3N2, recorded in 90 (41.1%) of positive case-patients. The system only met two out of its four objectives. None of the six sentinel sites consistently met their annual 260 suspected case-detection quota. Samples reached the laboratory on average 48 hours after collection and results were disseminated within 7 days. Of 120 case-investigation forms sampled, 91 (76.3%) were completely filled in. Conclusions The ILI surveillance system in the Greater Accra region is only partially meeting its objectives. While it is found to be sensitive, representative and timely, the data quality was sub-optimal. We recommend the determination of thresholds for alert and outbreak detection and ensuring that sentinel sites meet their weekly case-detection targets.Item Mycobactericidal Effects of Different Regimens Measured by Molecular Bacterial Load Assay among People Treated for Multidrug-Resistant Tuberculosis in Tanzania(Journal of Clinical Microbiology, 2021) Mbelele, P.M.; Mpolya, E.A.; Sauli, E.; Mtafya, B.; Ntinginya, N.E.; Addo, K.K.; Kreppel, K.; Mfinanga, S.; Phillips, P.P.J.; Gillespie, S.H.; Heysell, S.K.; Sabiiti, W.; Mpagama, S.G.Rifampin or multidrug-resistant tuberculosis (RR/MDR-TB) treatment has largely transitioned to regimens free of the injectable aminoglycoside component, despite the drug class’ purported bactericidal activity early in treatment. We tested whether Mycobacterium tuberculosis killing rates measured by tuberculosis molecular bacterial load assay (TB-MBLA) in sputa correlate with composition of the RR/MDRTB regimen. Serial sputa were collected from patients with RR/MDR- and drug-sensitive TB at days 0, 3, 7, and 14, and then monthly for 4 months of anti-TB treatment. TB-MBLA was used to quantify viable M. tuberculosis 16S rRNA in sputum for estimation of colony forming units per ml (eCFU/ml). M. tuberculosis killing rates were compared among regimens using nonlinear-mixed-effects modeling of repeated measures. Thirty-seven patients produced 296 serial sputa and received treatment as follows: 13 patients received an injectable bedaquiline-free reference regimen, 9 received an injectable bedaquiline-containing regimen, 8 received an all-oral bedaquiline-based regimen, and 7 patients were treated for drug-sensitive TB with conventional rifampin/isoniazid/ pyrazinamide/ethambutol (RHZE). Compared to the adjusted M. tuberculosis killing of 20.17 (95% confidence interval [CI] 20.23 to 20.12) for the injectable bedaquiline-free reference regimen, the killing rates were 20.62 (95% CI 21.05 to 20.20) log10 eCFU/ml for the injectable bedaquiline-containing regimen (P=0.019), 20.35 (95% CI 20.65 to 20.13) log10 eCFU/ml for the all-oral bedaquiline-based regimen (P=0.054), and 20.29 (95% CI 20.78 to 10.22) log10 eCFU/ml for the RHZE regimen (P=0.332). Thus, M. tuberculosis killing rates from sputa were higher among patients who received bedaquiline but were further improved with the addition of an injectable aminoglycoside.