Ho Chi Minh City, Vietnam
Ho Chi Minh City, Vietnam

Time filter

Source Type

Nguyen H.P.,Hospital of Tropical Diseases | Hanson J.,Cairns Base Hospital | Nguyen T.H.,Hospital of Tropical Diseases | Tran T.H.,Hospital of Tropical Diseases | And 10 more authors.
PLoS ONE | Year: 2011

Background: Optimising the fluid resuscitation of patients with severe malaria is a simple and potentially cost-effective intervention. Current WHO guidelines recommend central venous pressure (CVP) guided, crystalloid based, resuscitation in adults. Methods: Prospectively collected haemodynamic data from intervention trials in Vietnamese adults with severe malaria were analysed retrospectively to assess the responses to fluid resuscitation. Results: 43 patients were studied of whom 24 received a fluid load. The fluid load resulted in an increase in cardiac index (mean increase: 0.75 L/min/m2 (95% Confidence interval (CI): 0.41 to 1.1)), but no significant change in acid-base status post resuscitation (mean increase base deficit 0.6 mmol/L (95% CI: -0.1 to 1.3). The CVP and PAoP (pulmonary artery occlusion pressure) were highly inter-correlated (rs = 0.7, p&0.0001), but neither were correlated with acid-base status (arterial pH, serum bicarbonate, base deficit) or respiratory status (PaO2/FiO2 ratio). There was no correlation between the oxygen delivery (DO2) and base deficit at the 63 time-points where they were assessed simultaneously (rs=-0.09, p=0.46). Conclusions: In adults with severe falciparum malaria there was no observed improvement in patient outcomes or acid-base status with fluid loading. Neither CVP nor PAoP correlated with markers of end-organ perfusion or respiratory status, suggesting these measures are poor predictors of their fluid resuscitation needs. © 2011 Phu et al.


Tho D.Q.,University of Oxford | Lan N.T.N.,Pham Ngoc Thach Hospital for Tuberculosis and Lung Diseases | Chau N.V.V.,Hospital of Tropical Diseases | Farrar J.,University of Oxford | Caws M.,University of Oxford
International Journal of Tuberculosis and Lung Disease | Year: 2011

SETTING: Pham Ngoc Thach Tuberculosis Reference Hospital, Ho Chi Minh City, Viet Nam. DESIGN: A multiplex allele-specific polymerase chain reaction (MAS-PCR) was developed to detect mutations at the two most common sites responsible for isonia-zid (INH) resistance in Mycobacterium tuberculosis: katG315 and inhA-15. The MAS-PCR is able to detect rare mutations at katG315, in addition to katG S315T. Conventional phenotypic proportion drug susceptibility testing on Löwenstein-Jensen media was used as a gold standard to compare the sensitivity and specificity of the commercial MTBDRplus line-probe assay and the MAS-PCR in 100 INH-resistant and 50 INH-susceptible isolates collected consecutively at Pham Ngoc Thach Hospital reference laboratory. RESULTS: The sensitivity and specificity on culture isolates were 90% (n = 90/100, 95%CI 0.83-0.94) and 100% (n = 50/50, 95%CI 0.93-1.0), respectively, for the MAS-PCR and the MTBDRplus assay. CONCLUSION: The MAS-PCR described here represents an alternative method for rapid screening for INH resistance in M. tuberculosis isolates. © 2011 The Union.


Polycarpou A.,London School of Hygiene and Tropical Medicine | Walker S.L.,London School of Hygiene and Tropical Medicine | Lockwood D.N.,London School of Hygiene and Tropical Medicine | Lockwood D.N.,Hospital of Tropical Diseases
Current Opinion in Infectious Diseases | Year: 2013

Purpose of Review: This review focuses on recent work in leprosy pathogenesis. New research of both innate and adaptive immune responses to Mycobacterium leprae is described. The proposition that Mycobacterium lepromatosis is a new species causing leprosy is discussed. Recent Findings: Modulation of the lipid metabolism and reprogramming of adult Schwann cells have both been suggested as mechanisms used by M. leprae to disseminate the disease. New markers associated with localized, disseminated disease or the occurrences of leprosy reactions include the human interferons, CD163, microRNA-21, NOD2, galectin-3 and toll-like receptor 4. The role of keratinocytes instead of macrophages is underlined in the pathogenesis of leprosy. Adaptive immunity reports focus on the role of T regulatory cells and cytokines secreted by T helper cells in leprosy. Finally, a newly identified species named M. lepromatosis has been detected in patients with leprosy and severe erythema nodosum leprosum. Summary: Novel biological pathways have been identified to be associated with the clinical phenotype of leprosy or the occurrence of leprosy reactions. Future work should include larger numbers of clinical samples from across the leprosy spectrum in order to give new insights in the pathogenesis and management of the disease. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.


de Lemos P.A.P.,Hospital of Tropical Diseases | Garcia-Zapata M.T.A.,Hospital of Tropical Diseases
International Journal of Tropical Medicine | Year: 2010

The frequency of Trichomonas vaginalis infection in HIV-positive and negative women attending hospitals in Goiania, Brazil was evaluated using the gold standard diagnostic method of culture. A total of 237 vaginal swab specimens were examined: 125 (52.7%) comprising the HIV-positive group and 112 (47.3%) the HIV-negative control group. T. vaginalis was detected in 13.5% of the women, 23 (18.4%) of whom were HIV-positive while 9 (8.0%) were HIV-negative. This difference was statistically significant however, infection by this parasite was not found to be associated with immune status. T. vaginalis was found in 23.1% of the pregnant women and there was a statistically significant difference in the rate of infection by this parasite between the pregnant HIV-positive and the pregnant HIV-negative women (25.8% versus 12.5%). T. vaginalis was more prevalent in HIV-positive compared to HIV-negative women however, no association was found between the infection and the immune status of the patients. © Medwell Journals, 2010.


PubMed | Hospital of Tropical Diseases
Type: Journal Article | Journal: PloS one | Year: 2011

Optimising the fluid resuscitation of patients with severe malaria is a simple and potentially cost-effective intervention. Current WHO guidelines recommend central venous pressure (CVP) guided, crystalloid based, resuscitation in adults.Prospectively collected haemodynamic data from intervention trials in Vietnamese adults with severe malaria were analysed retrospectively to assess the responses to fluid resuscitation.43 patients were studied of whom 24 received a fluid load. The fluid load resulted in an increase in cardiac index (mean increase: 0.75 L/min/m(2) (95% Confidence interval (CI): 0.41 to 1.1)), but no significant change in acid-base status post resuscitation (mean increase base deficit 0.6 mmol/L (95% CI: -0.1 to 1.3). The CVP and PAoP (pulmonary artery occlusion pressure) were highly inter-correlated (r(s)=0.7, p<0.0001), but neither were correlated with acid-base status (arterial pH, serum bicarbonate, base deficit) or respiratory status (PaO(2)/FiO(2) ratio). There was no correlation between the oxygen delivery (DO(2)) and base deficit at the 63 time-points where they were assessed simultaneously (r(s)=-0.09, p=0.46).In adults with severe falciparum malaria there was no observed improvement in patient outcomes or acid-base status with fluid loading. Neither CVP nor PAoP correlated with markers of end-organ perfusion or respiratory status, suggesting these measures are poor predictors of their fluid resuscitation needs.

Loading Hospital of Tropical Diseases collaborators
Loading Hospital of Tropical Diseases collaborators