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Nankumbi J.,Makerere University | Groves S.,Johns Hopkins University | Kyegombe N.,London School of Hygiene and Tropical Medicine | Coutinho A.,Institute of Infectious Disease
BMC International Health and Human Rights | Year: 2011

Background: Improving provider performance is central to strengthening health services in developing countries. Because of critical shortages of physicians, many clinics in sub-Saharan Africa are led by nurses. In addition to clinical skills, nurse managers need practical managerial skills and adequate resources to ensure procurement of essential supplies, quality assurance implementation, and productive work environment. Giving nurses more autonomy in their work empowers them in the workplace and has shown to create positive influence on work attitudes and behaviors. The Infectious Disease Institute, an affiliate of Makerere University College of Health Science, in an effort to expand the needed HIV services in the Ugandan capital, established a community-university partnership with the Ministry of Health to implement an innovative model to build capacity in HIV service delivery. This paper evaluates the impact on the nurses from this innovative program to provide more health care in six nurse managed Kampala City Council (KCC) Clinics. Methods. A mixed method approach was used. The descriptive study collected key informant interviews from the six nurse managers, and administered a questionnaire to 20 staff nurses between September and December 2009. Key themes were manually identified from the interviews, and the questionnaire data were analyzed using SPSS. Results: Introducing new HIV services into six KCC clinics was positive for the nurses. They identified the project as successful because of perceived improved environment, increase in useful in-service training, new competence to manage patients and staff, improved physical infrastructure, provision of more direct patient care, motivation to improve the clinic because the project acted on their suggestions, and involvement in role expansion. All of these helped empower the nurses, improving quality of care and increasing job satisfaction. Conclusions: This community-university HIV innovative model was successful from the point of view of the nurses and nurse managers. This model shows promise in increasing effective, quality health service; HIV and other programs can build capacity and empower nurses and nurse managers to directly implement such services. It also demonstrates how MakCHS can be instrumental through partnerships in designing and testing effective strategies, building human health resources and improving Ugandan health outcomes. © 2011 Nankumbi et al; licensee BioMed Central Ltd.


PubMed | Philadelphia University, Institute of Infectious Disease, Public Health Agency of Canada, Kentucky BioProcessing and 3 more.
Type: Journal Article | Journal: Nature | Year: 2014

Without an approved vaccine or treatments, Ebola outbreak management has been limited to palliative care and barrier methods to prevent transmission. These approaches, however, have yet to end the 2014 outbreak of Ebola after its prolonged presence in West Africa. Here we show that a combination of monoclonal antibodies (ZMapp), optimized from two previous antibody cocktails, is able to rescue 100% of rhesus macaques when treatment is initiated up to 5days post-challenge. High fever, viraemia and abnormalities in blood count and blood chemistry were evident in many animals before ZMapp intervention. Advanced disease, as indicated by elevated liver enzymes, mucosal haemorrhages and generalized petechia could be reversed, leading to full recovery. ELISA and neutralizing antibody assays indicate that ZMapp is cross-reactive with the Guinean variant of Ebola. ZMapp exceeds the efficacy of any other therapeutics described so far, and results warrant further development of this cocktail for clinical use.


Qiu X.,University of Manitoba | Qiu X.,Public Health Agency of Canada | Audet J.,University of Manitoba | Lv M.,Chinese Institute of Basic Medical Sciences | And 26 more authors.
Science Translational Medicine | Year: 2016

The 2014-2015 Ebola virus (EBOV) outbreak in West Africa highlighted the urgent need for specific therapeutic interventions for infected patients. The human-mouse chimeric monoclonal antibody (mAb) cocktail ZMapp, previously shown to be efficacious in EBOV (variant Kikwit) lethally infected nonhuman primates (NHPs) when administration was initiated up to 5 days, was used in some patients during the outbreak. We show that a twoantibody cocktail, MIL77E, is fully protective in NHPs when administered at 50 mg/kg 3 days after challenge with a lethal dose of EBOV variant Makona, the virus responsible for the ongoing 2014-2015 outbreak, whereas a similar formulation of ZMapp protected two of three NHPs. The chimeric MIL77E mAb cocktail is produced in engineered Chinese hamster ovary cells and is based on mAbs c13C6 and c2G4 from ZMapp. The use of only two antibodies in MIL77E opens the door to a pan-ebolavirus cocktail.


PubMed | Institute of Infectious Disease, Beijing Institute of Biotechnology, Institute of Viral Disease, Tianjin CanSino Biotechnology and 2 more.
Type: Journal Article | Journal: The Journal of infectious diseases | Year: 2016

A licensed vaccine against Ebola virus (EBOV) remains unavailable, despite >11 000 deaths from the 2014-2016 outbreak of EBOV disease in West Africa. Past studies have shown that recombinant vaccine viruses expressing EBOV glycoprotein (GP) are able to protect nonhuman primates (NHPs) from a lethal EBOV challenge. However, these vaccines express the viral GP-based EBOV variants found in Central Africa, which has 97.3% amino acid homology to the Makona variant found in West Africa. Our previous study showed that a recombinant adenovirus serotype 5 (Ad5)-vectored vaccine expressing the Makona EBOV GP (MakGP) was safe and immunogenic during clinical trials in China, but it is unknown whether the vaccine protects against EBOV infection. Here, we demonstrate that guinea pigs immunized with Ad5-MakGP developed robust humoral responses and were protected against exposure to guinea pig-adapted EBOV. Ad5-MakGP also elicited specific B- and T-cell immunity in NHPs and conferred 100% protection when animals were challenged 4 weeks after immunization. These results support further clinical development of this candidate and highlight the utility of Ad5-MakGP as a prophylactic measure in future outbreaks of EBOV disease.


Shan A.L.,Institute of Infectious Disease
Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] | Year: 2010

To investigate the immunization status of hepatitis B vaccine who were inoculated at birth, HBV infections and the vaccine booster effect in the first-year middle school students (12 - 14 years old). A cluster, stratified simplified random sampling method was administrated. The sample size was at least 218, which was calculated by Epi Info 3.3.2 software at 53% the minimum acceptable anti-HBs positive rate and 95% confidence level. A total of 250 and 236 students participated in the infection status and booster immunization effects investigation. The HBsAg, anti-HBs and anti-HBc IgG were detected by Enzyme-linked immunosorbent assay (ELISA). HBV DNA was detected by fluorescence quantitative PCR, and the diagnostic test kit were produced respectively by ABBOTT, Diasorin and Beijing Wantai Biological Pharmacy Enterprise Co. For the immunization status before booster: the positive rate of anti-HBs was 62.80% (157/250), the GMT was 73.79 IU/L; the currently HBV infection rate (HBsAg and anti-HBc positive) was 2.80% (7/250). After injection, the anti-HBs positive rate was 94.92% (224/236). Compared with the before booster results, the significant difference was observed (χ(2) = 73.92, P = 0.00). The GMT was 521.15 IU/L, comparing with the before booster results, there was significant difference (t = 15.98, P = 0.00). The anti-HBs conversion rate (from negative to positive) was 91.86% (79/86) after immune-enhancement; of which, 11 students got the second dose of booster vaccine who are no-responders after first injection, in addition 8 students got the anti-HBs. It is an effective method to put the first-year middle school students into the immune-enhancement program, so as to improve the immunization memory effect and avoid the loss of protective antibodies.


Huang Y.,CAS Wuhan Institute of Virology | Mao P.,Institute of Infectious Disease | Wang H.,CAS Wuhan Institute of Virology
Clinical Microbiology and Infection | Year: 2010

A novel parvovirus, human bocavirus (HBoV), was first discovered in children with respiratory tract infections in Sweden. A retrospective study of HBoV in faecal samples from children suffering from diarrhea, covering a 3-year period (November 2000 to October 2003) in Wuhan, China, was undertaken. PCR assays were used to evaluate 214 faecal samples and to determine the role of HBoV in diarrhoea. Among 196 virus-infected children with diarrhoea, 2.55% were HBoV-positive; however, all HBoV-positive patients were co-infected with common enteric viruses. This result does not support the notion that HBoV is a viral agent causing acute diarrhoea. © 2009 The Authors. Journal Compilation © 2009 European Society of Clinical Microbiology and Infectious Diseases.


Liu Z.,Institute of Infectious Disease | Chen G.,Institute of Infectious Disease | Gong X.,Institute of Infectious Disease | Huang H.,Institute of Infectious Disease | And 2 more authors.
Chinese Journal of Endemiology | Year: 2014

To master the prevalence of plague and its trend in Guizhou Province, and to analyze the plague monitoring results from 2000 to 2012.The report of infectious disease, the information of plague natural focus and the epizootic monitoring data of Xingyi City, Anlong County and Dingxiao Distract of Guizhou Province from 2000 to 2012 were collected and the status of the plague natural focus was analyzed.There were 137 cases of gland plague in Xingyi City and Anlong county from 2000 - 2003, 1 death, and rat plague occurred in 66 villages. Fifty-four strains of Yersinia pestis were detected and 49 rats were plague antigen F1 positive (49/160). No human plague occurred between 2004 - 2012. A total of 4 plague antigen F1 positive rats were detected in Dingxiao District and Xingyi City in 2005 and 2006. There was no Yersinia pestis and F1 antibody in 2007 - 2012. The epidemic stage of plague was from 2000 - 2003; the active stage was from 2004 - 2006; and the quiescent stage was from 2007 - 2012. The dominant species of the plague natural focus was Rattus flavipestus (42.83% ,7 966/18 597), but was replaced by Rattus norvegiens at the epidemic stage (47.22%, 1 480/3 134) and the active stage(35.35%,2 071/5 196). The density of rodents was 5.34% at the epidemic stage, which was higher than that of the active stage(3.27%) and the quiescent stage(1.71%, x2 = 2 286.15, P < 0.01). Xenopsylla ckeopis(56.34%, 10 034/17 811) was the dominant species, and the index was 1.537 9, which was greater than those of the active stage(0.959 6) and the quiescent stage(0.540 4, x2 = 492.68, P < 0.01).The plague of Guizhou Province is at the quiescent stage. Both the density of rodents and the Xenopsylla cheopis index are lower than the national standard of controlling.


Wu S.,Beijing Institute of Biotechnology | Kroeker A.,Public Health Agency of Canada | Kroeker A.,University of Manitoba | Wong G.,CAS Institute of Microbiology | And 18 more authors.
Journal of Infectious Diseases | Year: 2016

A licensed vaccine against Ebola virus (EBOV) remains unavailable, despite >11 000 deaths from the 2014-2016 outbreak of EBOV disease in West Africa. Past studies have shown that recombinant vaccine viruses expressing EBOV glycoprotein (GP) are able to protect nonhuman primates (NHPs) from a lethal EBOV challenge. However, these vaccines express the viral GP-based EBOV variants found in Central Africa, which has 97.3% amino acid homology to the Makona variant found in West Africa. Our previous study showed that a recombinant adenovirus serotype 5 (Ad5)-vectored vaccine expressing the Makona EBOV GP (MakGP) was safe and immunogenic during clinical trials in China, but it is unknown whether the vaccine protects against EBOV infection. Here, we demonstrate that Guinea pigs immunized with Ad5-MakGP developed robust humoral responses and were protected against exposure to Guinea pig-adapted EBOV. Ad5-MakGP also elicited specific B- and T-cell immunity in NHPs and conferred 100% protection when animals were challenged 4 weeks after immunization. These results support further clinical development of this candidate and highlight the utility of Ad5-MakGP as a prophylactic measure in future outbreaks of EBOV disease. © 2016 The Author.


PubMed | Institute of Infectious Disease
Type: Journal Article | Journal: Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] | Year: 2010

To investigate the immunization status of hepatitis B vaccine who were inoculated at birth, HBV infections and the vaccine booster effect in the first-year middle school students (12 - 14 years old).A cluster, stratified simplified random sampling method was administrated. The sample size was at least 218, which was calculated by Epi Info 3.3.2 software at 53% the minimum acceptable anti-HBs positive rate and 95% confidence level. A total of 250 and 236 students participated in the infection status and booster immunization effects investigation. The HBsAg, anti-HBs and anti-HBc IgG were detected by Enzyme-linked immunosorbent assay (ELISA). HBV DNA was detected by fluorescence quantitative PCR, and the diagnostic test kit were produced respectively by ABBOTT, Diasorin and Beijing Wantai Biological Pharmacy Enterprise Co.For the immunization status before booster: the positive rate of anti-HBs was 62.80% (157/250), the GMT was 73.79 IU/L; the currently HBV infection rate (HBsAg and anti-HBc positive) was 2.80% (7/250). After injection, the anti-HBs positive rate was 94.92% (224/236). Compared with the before booster results, the significant difference was observed ((2) = 73.92, P = 0.00). The GMT was 521.15 IU/L, comparing with the before booster results, there was significant difference (t = 15.98, P = 0.00). The anti-HBs conversion rate (from negative to positive) was 91.86% (79/86) after immune-enhancement; of which, 11 students got the second dose of booster vaccine who are no-responders after first injection, in addition 8 students got the anti-HBs.It is an effective method to put the first-year middle school students into the immune-enhancement program, so as to improve the immunization memory effect and avoid the loss of protective antibodies.

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