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Background Loa loa and Mansonella perstans–the causative agents of loiasis and mansonellosis—are vector-borne filarial parasites co-endemic in sub-Saharan Africa. Diagnosis of both infections is usually established by microscopic analysis of blood samples. It was recently established that the odds for detecting Plasmodium spp. is higher in capillary (CAP) blood than in venous (VEN) blood. In analogy to this finding this analysis evaluates potential differences in microfilaraemia of L. loa and M. perstans in samples of CAP and VEN blood. Methods Recruitment took place between 2015 and 2019 at the CERMEL in Lambaréné, Gabon and its surrounding villages. Persons of all ages presenting to diagnostic services of the research center around noon were invited to participate in the study. A thick smear of each 10 microliters of CAP and VEN blood was prepared and analysed by a minimum of two independent microscopists. Differences of log2-transformed CAP and VEN microfilaraemia were computed and expressed as percentages. Furthermore, odds ratios for paired data were computed to quantify the odds to detect microfilariae in CAP blood versus in VEN blood. Results A total of 713 participants were recruited among whom 52% were below 30 years of age, 27% between 30–59 years of age and 21% above 60 years of age. Male-female ratio was 0.84. Among 152 participants with microscopically-confirmed L. loa infection median (IQR) microfilaraemia was 3,650 (275–11,100) per milliliter blood in CAP blood and 2,775 (200–8,875) in VEN blood (p<0.0001), while among 102 participants with M. perstans this was 100 (0–200) and 100 (0–200), respectively (p = 0.44). Differences in linear models amount up to an average of +34.5% (95% CI: +11.0 to +63.0) higher L. loa microfilaria quantity in CAP blood versus VEN blood and for M. perstans it was on average higher by +24.8% (95% CI: +0.0 to +60.5). Concordantly, the odds for detection of microfilaraemia in CAP samples versus VEN samples was 1.24 (95% CI: 0.65–2.34) and 1.65 (95% CI: 1.0–2.68) for infections with L. loa and M. perstans, respectively. Conclusion This analysis indicates that average levels of microfilaraemia of L. loa are higher in CAP blood samples than in VEN blood samples. This might have implications for treatment algorithms of onchocerciasis and loiasis, in which exact quantification of L. loa microfilaraemia is of importance. Furthermore, the odds for detection of M. perstans microfilariae was higher in CAP than in VEN blood which may pre-dispose CAP blood for detection of M. perstans infection in large epidemiological studies when sampling of large blood quantities is not feasible. No solid evidence for a higher odds of L. loa microfilariae detection in CAP blood was revealed, which might be explained by generally high levels of L. loa microfilaraemia in CAP and VEN blood above the limit of detection of 100 microfilariae/ml. Yet, it cannot be excluded that the study was underpowered to detect a moderate difference.
Johannes Mischlinger; Rella Zoleko Manego; Ghyslain Mombo-Ngoma; Dorothea Ekoka Mbassi; Nina Hackbarth; Franck-Aurelien Ekoka Mbassi; Saskia Dede Davi; Ruth Kreuzmair; Luzia Veletzky; Jennifer Hergeth; Wilfrid Nzebe Ndoumba; Paul Pitzinger; Mirjam Groger; Pierre Blaise Matsiegui; Ayôla Akim Adegnika; Selidji Todagbe Agnandji; Bertrand Lell; Michael Ramharter. Diagnostic performance of capillary and venous blood samples in the detection of Loa loa and Mansonella perstans microfilaraemia using light microscopy. PLOS Neglected Tropical Diseases 2021, 15, e0009623 .
AMA StyleJohannes Mischlinger, Rella Zoleko Manego, Ghyslain Mombo-Ngoma, Dorothea Ekoka Mbassi, Nina Hackbarth, Franck-Aurelien Ekoka Mbassi, Saskia Dede Davi, Ruth Kreuzmair, Luzia Veletzky, Jennifer Hergeth, Wilfrid Nzebe Ndoumba, Paul Pitzinger, Mirjam Groger, Pierre Blaise Matsiegui, Ayôla Akim Adegnika, Selidji Todagbe Agnandji, Bertrand Lell, Michael Ramharter. Diagnostic performance of capillary and venous blood samples in the detection of Loa loa and Mansonella perstans microfilaraemia using light microscopy. PLOS Neglected Tropical Diseases. 2021; 15 (8):e0009623.
Chicago/Turabian StyleJohannes Mischlinger; Rella Zoleko Manego; Ghyslain Mombo-Ngoma; Dorothea Ekoka Mbassi; Nina Hackbarth; Franck-Aurelien Ekoka Mbassi; Saskia Dede Davi; Ruth Kreuzmair; Luzia Veletzky; Jennifer Hergeth; Wilfrid Nzebe Ndoumba; Paul Pitzinger; Mirjam Groger; Pierre Blaise Matsiegui; Ayôla Akim Adegnika; Selidji Todagbe Agnandji; Bertrand Lell; Michael Ramharter. 2021. "Diagnostic performance of capillary and venous blood samples in the detection of Loa loa and Mansonella perstans microfilaraemia using light microscopy." PLOS Neglected Tropical Diseases 15, no. 8: e0009623.
The aim of this prospective study was to assess lymphocyte proliferative and cytokine response prior to and following tick-borne encephalitis (TBE) immunization among patients after allogeneic hematopoietic stem cell transplantation (HSCT). Seventeen adult patients 11–13 months after HSCT and eight unvaccinated healthy adults received up to three TBE vaccinations. Following in vitro stimulation with TBE-antigen, lymphocyte proliferation and cytokine secretion (IL-2, IL-10, IL-13, TNF-alpha, IFN-gamma, GM-CSF) were analyzed by thymidine incorporation assay and the Luminex system. Ten patients (59%) showed significant baseline TBE-specific lymphocyte proliferation (stimulation index (SI) > 3) prior to vaccination, but none of the unvaccinated controls (p = 0.002). All patients with a TBE-specific antibody response after two vaccinations (at least 2-fold increase of neutralization test titers) exhibited a strong TBE-specific lymphocyte proliferative response at baseline (SI > 10). Patients with sibling donors had a significantly stronger baseline TBE-specific lymphocyte proliferative and IL-13 cytokine response than patients with unrelated donors (p< 0.05). In conclusion, a relevant proportion of patients showed TBE-specific lymphocyte proliferative and cytokine responses prior to vaccination after HSCT, which predicted the humoral response to the vaccine. Patients with vaccinated sibling donors were more likely to elicit a cellular immune response than patients with unrelated donors of unknown vaccination status.
Nicole Harrison; Katharina Grabmeier-Pfistershammer; Alexandra Graf; Doris Trapin; Peter Tauber; Judith H. Aberle; Karin Stiasny; Ralf Schmidt; Hildegard Greinix; Werner Rabitsch; Michael Ramharter; Heinz Burgmann; Winfried F. Pickl; Christina Bahrs. Tick-Borne Encephalitis Specific Lymphocyte Response after Allogeneic Hematopoietic Stem Cell Transplantation Predicts Humoral Immunity after Vaccination. Vaccines 2021, 9, 908 .
AMA StyleNicole Harrison, Katharina Grabmeier-Pfistershammer, Alexandra Graf, Doris Trapin, Peter Tauber, Judith H. Aberle, Karin Stiasny, Ralf Schmidt, Hildegard Greinix, Werner Rabitsch, Michael Ramharter, Heinz Burgmann, Winfried F. Pickl, Christina Bahrs. Tick-Borne Encephalitis Specific Lymphocyte Response after Allogeneic Hematopoietic Stem Cell Transplantation Predicts Humoral Immunity after Vaccination. Vaccines. 2021; 9 (8):908.
Chicago/Turabian StyleNicole Harrison; Katharina Grabmeier-Pfistershammer; Alexandra Graf; Doris Trapin; Peter Tauber; Judith H. Aberle; Karin Stiasny; Ralf Schmidt; Hildegard Greinix; Werner Rabitsch; Michael Ramharter; Heinz Burgmann; Winfried F. Pickl; Christina Bahrs. 2021. "Tick-Borne Encephalitis Specific Lymphocyte Response after Allogeneic Hematopoietic Stem Cell Transplantation Predicts Humoral Immunity after Vaccination." Vaccines 9, no. 8: 908.
Background Schistosomiasis is highly prevalent in Africa. Praziquantel is effective against adult schistosomes but leaves prepatent stages unaffected—which is a limit to patient management and elimination. Given the large-scale use of praziquantel, development of drug resistance by Schistosoma is feared. Antimalarials are promising drugs for alternative treatment strategies of Schistosoma infections. Development of drugs with activity against both malaria and schistosomiasis is particularly appealing as schistosome infections often occur concomitantly with malaria parasites in sub-Saharan Africa. Therefore, antiplasmodial compounds were progressively tested against Schistosoma in vitro, in mice, and in a clinical study. Results Amongst 16 drugs and 1 control tested, pyronaridine, methylene blue and 5 other antimalarials were highly active in vitro against larval stage schistosomula with a 50% inhibitory concentration below 10 μM. Both drugs were lethal to ex vivo adult worms tested at 30 μM with methylene blue also active at 10 μM. Pyronaridine treatment of mice infected with S. mansoni at the prepatent stage reduced worm burden by 82% and cured 7 out of 12 animals, however in mice adult stages remained viable. In contrast, methylene blue inhibited adult worms by 60% but cure was not achieved. In an observational pilot trial in Gabon in children, the antimalarial drug combination pyronaridine-artesunate (Pyramax) reduced S. haematobium egg excretion from 10/10 ml urine to 0/10 ml urine, and 3 out of 4 children were cured. Conclusion Pyronaridine and methylene blue warrant further investigation as candidates for schistosomiasis treatment. Both compounds are approved for human use and evidence for their potential as antischistosomal compounds can be obtained directly from clinical testing. Particularly, pyronaridine-artesunate, already available as an antimalarial drug, calls for further clinical evaluation. Trial registration ClinicalTrials.gov Identifier NCT03201770.
Erik Koehne; Nina Zander; Miriam Rodi; Jana Held; Wolfgang Hoffmann; Rella Zoleko-Manego; Michael Ramharter; Ghyslain Mombo-Ngoma; Peter G. Kremsner; Andrea Kreidenweiss. Evidence for in vitro and in vivo activity of the antimalarial pyronaridine against Schistosoma. PLOS Neglected Tropical Diseases 2021, 15, e0009511 .
AMA StyleErik Koehne, Nina Zander, Miriam Rodi, Jana Held, Wolfgang Hoffmann, Rella Zoleko-Manego, Michael Ramharter, Ghyslain Mombo-Ngoma, Peter G. Kremsner, Andrea Kreidenweiss. Evidence for in vitro and in vivo activity of the antimalarial pyronaridine against Schistosoma. PLOS Neglected Tropical Diseases. 2021; 15 (6):e0009511.
Chicago/Turabian StyleErik Koehne; Nina Zander; Miriam Rodi; Jana Held; Wolfgang Hoffmann; Rella Zoleko-Manego; Michael Ramharter; Ghyslain Mombo-Ngoma; Peter G. Kremsner; Andrea Kreidenweiss. 2021. "Evidence for in vitro and in vivo activity of the antimalarial pyronaridine against Schistosoma." PLOS Neglected Tropical Diseases 15, no. 6: e0009511.
Background In Phase II/III randomized controlled clinical trials for the treatment of acute uncomplicated malaria, pyronaridine–artesunate demonstrated high efficacy and a safety profile consistent with that of comparators, except that asymptomatic, mainly mild-to-moderate transient increases in liver aminotransferases were reported for some patients. Hepatic safety, tolerability, and effectiveness have not been previously assessed under real-world conditions in Africa. Methods and findings This single-arm, open-label, cohort event monitoring study was conducted at 6 health centers in Cameroon, Democratic Republic of Congo, Gabon, Ivory Coast, and Republic of Congo between June 2017 and April 2019. The trial protocol as closely as possible resembled real-world clinical practice for the treatment of malaria at the centers. Eligible patients were adults or children of either sex, weighing at least 5 kg, with acute uncomplicated malaria who did not have contraindications for pyronaridine–artesunate treatment as per the summary of product characteristics. Patients received fixed-dose pyronaridine–artesunate once daily for 3 days, dosed by body weight, without regard to food intake. A tablet formulation was used in adults and adolescents and a pediatric granule formulation in children and infants under 20 kg body weight. The primary outcome was the hepatic event incidence, defined as the appearance of the clinical signs and symptoms of hepatotoxicity confirmed by a >2× rise in alanine aminotransferase/aspartate aminotransferase (ALT/AST) versus baseline in patients with baseline ALT/AST >2× the upper limit of normal (ULN). As a secondary outcome, this was assessed in patients with ALT/AST >2× ULN prior to treatment versus a matched cohort of patients with normal baseline ALT/AST. The safety population comprised 7,154 patients, of mean age 13.9 years (standard deviation (SD) 14.6), around half of whom were male (3,569 [49.9%]). Patients experienced 8,560 malaria episodes; 158 occurred in patients with baseline ALT/AST elevations >2×ULN. No protocol-defined hepatic events occurred following pyronaridine–artesunate treatment of malaria patients with or without baseline hepatic dysfunction. Thus, no cohort comparison could be undertaken. Also, as postbaseline clinical chemistry was only performed where clinically indicated, postbaseline ALT/AST levels were not systematically assessed for all patients. Adverse events of any cause occurred in 20.8% (1,490/7,154) of patients, most frequently pyrexia (5.1% [366/7,154]) and vomiting (4.2% [303/7,154]). Adjusting for Plasmodium falciparum reinfection, clinical effectiveness at day 28 was 98.6% ([7,369/7,746] 95% confidence interval (CI) 98.3 to 98.9) in the per-protocol population. There was no indication that comorbidities or malnutrition adversely affected outcomes. The key study limitation was that postbaseline clinical biochemistry was only evaluated when clinically indicated. Conclusions Pyronaridine–artesunate had good tolerability and effectiveness in a representative African population under conditions similar to everyday clinical practice. These findings support pyronaridine–artesunate as an operationally useful addition to the management of acute uncomplicated malaria. Trial registration ClinicalTrials.gov NCT03201770.
Gaston Tona Lutete; Ghyslain Mombo-Ngoma; Serge-Brice Assi; Jude D. Bigoga; Felix Koukouikila-Koussounda; Nsengi Y. Ntamabyaliro; Francine Ntoumi; Selidji T. Agnandji; Mirjam Groger; Jangsik Shin; Isabelle Borghini-Fuhrer; Sarah Arbe-Barnes; Stephen J. Allen; Peter G. Kremsner; Robert Miller; Stephan Duparc; Michael Ramharter; the CANTAM study group. Pyronaridine–artesunate real-world safety, tolerability, and effectiveness in malaria patients in 5 African countries: A single-arm, open-label, cohort event monitoring study. PLOS Medicine 2021, 18, e1003669 .
AMA StyleGaston Tona Lutete, Ghyslain Mombo-Ngoma, Serge-Brice Assi, Jude D. Bigoga, Felix Koukouikila-Koussounda, Nsengi Y. Ntamabyaliro, Francine Ntoumi, Selidji T. Agnandji, Mirjam Groger, Jangsik Shin, Isabelle Borghini-Fuhrer, Sarah Arbe-Barnes, Stephen J. Allen, Peter G. Kremsner, Robert Miller, Stephan Duparc, Michael Ramharter, the CANTAM study group. Pyronaridine–artesunate real-world safety, tolerability, and effectiveness in malaria patients in 5 African countries: A single-arm, open-label, cohort event monitoring study. PLOS Medicine. 2021; 18 (6):e1003669.
Chicago/Turabian StyleGaston Tona Lutete; Ghyslain Mombo-Ngoma; Serge-Brice Assi; Jude D. Bigoga; Felix Koukouikila-Koussounda; Nsengi Y. Ntamabyaliro; Francine Ntoumi; Selidji T. Agnandji; Mirjam Groger; Jangsik Shin; Isabelle Borghini-Fuhrer; Sarah Arbe-Barnes; Stephen J. Allen; Peter G. Kremsner; Robert Miller; Stephan Duparc; Michael Ramharter; the CANTAM study group. 2021. "Pyronaridine–artesunate real-world safety, tolerability, and effectiveness in malaria patients in 5 African countries: A single-arm, open-label, cohort event monitoring study." PLOS Medicine 18, no. 6: e1003669.
Background Helminths can modulate the host immune response to Plasmodium falciparum and can therefore affect the risk of clinical malaria. We assessed here the effect of helminth infections on both the immunogenicity and efficacy of the GMZ2 malaria vaccine candidate, a recombinant protein consisting of conserved domains of GLURP and MSP3, two asexual blood-stage antigens of P. falciparum. Controlled human malaria infection (CHMI) was used to assess the efficacy of the vaccine. Methodology In a randomized, double-blind Phase I clinical trial, fifty, healthy, lifelong malaria-exposed adult volunteers received three doses of GMZ2 adjuvanted with either Cationic Adjuvant Formulation (CAF) 01 or Alhydrogel, or a control vaccine (Rabies) on days (D) 0, D28 and D56, followed by direct venous inoculation (DVI) of 3,200 P. falciparum sporozoites (PfSPZ Challenge) approximately 13 weeks after last vaccination to assess vaccine efficacy. Participants were followed-up on a daily basis with clinical examinations and thick blood smears to monitor P. falciparum parasitemia for 35 days. Malaria was defined as the presence of P. falciparum parasites in the blood associated with at least one symptom that can be associated to malaria over 35 days following DVI of PfSPZ Challenge. Soil-transmitted helminth (STH) infection was assessed by microscopy and by polymerase chain reaction (PCR) on stool, and Schistosoma infection was assessed by microscopy on urine. Participants were considered as infected if positive for any helminth either by PCR and/or microscopy at D0 and/or at D84 (Helm+) and were classified as mono-infection or co-infection. Total vaccine-specific IgG concentrations assessed on D84 were analysed as immunogenicity outcome. Main findings The helminth in mono-infection, particularly Schistosoma haematobium and STH were significantly associated with earlier malaria episodes following CHMI, while no association was found in case of coinfection. In further analyses, the anti-GMZ2 IgG concentration on D84 was significantly higher in the S. haematobium-infected and significantly lower in the Strongyloides stercoralis-infected groups, compared to helminth-negative volunteers. Interesting, in the absence of helminth infection, a high anti-GMZ2 IgG concentration on D84 was significantly associated with protection against malaria. Conclusions Our results suggest that helminth infection may reduce naturally acquired and vaccine-induced protection against malaria. Vaccine-specific antibody concentrations on D84 may be associated with protection in participants with no helminth infection. These results suggest that helminth infection affect malaria vaccine immunogenicity and efficacy in helminth endemic countries.
Odilon Nouatin; Juliana Boex Mengue; Jean Claude Dejon-Agobé; Rolf Fendel; Javier Ibáñez; Ulysse Ateba Ngoa; Jean Ronald Edoa; Bayodé Roméo Adégbité; Yabo Josiane Honkpéhédji; Jeannot Fréjus Zinsou; Aurore Bouyoukou Hounkpatin; Kabirou Moutairou; Andreas Homoet; Meral Esen; Andrea Kreidenweiss; Stephen L. Hoffman; Michael Theisen; Adrian J. F. Luty; Bertrand Lell; Selidji Todagbe Agnandji; Ghyslain Mombo-Ngoma; Michael Ramharter; Peter Kremsner; Benjamin Mordmüller; Ayôla Akim Adegnika. Exploratory analysis of the effect of helminth infection on the immunogenicity and efficacy of the asexual blood-stage malaria vaccine candidate GMZ2. PLOS Neglected Tropical Diseases 2021, 15, e0009361 .
AMA StyleOdilon Nouatin, Juliana Boex Mengue, Jean Claude Dejon-Agobé, Rolf Fendel, Javier Ibáñez, Ulysse Ateba Ngoa, Jean Ronald Edoa, Bayodé Roméo Adégbité, Yabo Josiane Honkpéhédji, Jeannot Fréjus Zinsou, Aurore Bouyoukou Hounkpatin, Kabirou Moutairou, Andreas Homoet, Meral Esen, Andrea Kreidenweiss, Stephen L. Hoffman, Michael Theisen, Adrian J. F. Luty, Bertrand Lell, Selidji Todagbe Agnandji, Ghyslain Mombo-Ngoma, Michael Ramharter, Peter Kremsner, Benjamin Mordmüller, Ayôla Akim Adegnika. Exploratory analysis of the effect of helminth infection on the immunogenicity and efficacy of the asexual blood-stage malaria vaccine candidate GMZ2. PLOS Neglected Tropical Diseases. 2021; 15 (6):e0009361.
Chicago/Turabian StyleOdilon Nouatin; Juliana Boex Mengue; Jean Claude Dejon-Agobé; Rolf Fendel; Javier Ibáñez; Ulysse Ateba Ngoa; Jean Ronald Edoa; Bayodé Roméo Adégbité; Yabo Josiane Honkpéhédji; Jeannot Fréjus Zinsou; Aurore Bouyoukou Hounkpatin; Kabirou Moutairou; Andreas Homoet; Meral Esen; Andrea Kreidenweiss; Stephen L. Hoffman; Michael Theisen; Adrian J. F. Luty; Bertrand Lell; Selidji Todagbe Agnandji; Ghyslain Mombo-Ngoma; Michael Ramharter; Peter Kremsner; Benjamin Mordmüller; Ayôla Akim Adegnika. 2021. "Exploratory analysis of the effect of helminth infection on the immunogenicity and efficacy of the asexual blood-stage malaria vaccine candidate GMZ2." PLOS Neglected Tropical Diseases 15, no. 6: e0009361.
Overwhelming activation of T cells in acute malaria is associated with severe outcomes. Thus, counter-regulation by anti-inflammatory mechanisms is indispensable for an optimal resolution of disease. Using Plasmodium berghei ANKA (PbA) infection of C57BL/6 mice, we performed a comprehensive analysis of co-inhibitory molecules expressed on CD4+ and CD8+ T cells using an unbiased cluster analysis approach. We identified similar T cell clusters co-expressing several co-inhibitory molecules like programmed cell death protein 1 (PD-1) and lymphocyte activation gene 3 (LAG-3) in the CD4+ and the CD8+ T cell compartment. Interestingly, despite expressing co-inhibitory molecules, which are associated with T cell exhaustion in chronic settings, these T cells were more functional compared to activated T cells that were negative for co-inhibitory molecules. However, T cells expressing high levels of PD-1 and LAG-3 also conferred suppressive capacity and thus resembled type I regulatory T cells. To our knowledge, this is the first description of malaria-induced CD8+ T cells with suppressive capacity. In conclusion, we demonstrate that malaria-induced T cells expressing co-inhibitory molecules are not exhausted but acquire additional suppressive capacity, which might represent an immune regulatory pathway to prevent further activation of T cells during acute malaria.
Johannes Brandi; Cari Lehmann; Lea-Christina Kaminski; Julian Schulze Zur Wiesch; Marylyn Addo; Michael Ramharter; Maria Mackroth; Thomas Jacobs; Mathias Riehn. T cells expressing multiple co-inhibitory molecules in acute malaria are not exhausted but exert a suppressive function. 2021, 1 .
AMA StyleJohannes Brandi, Cari Lehmann, Lea-Christina Kaminski, Julian Schulze Zur Wiesch, Marylyn Addo, Michael Ramharter, Maria Mackroth, Thomas Jacobs, Mathias Riehn. T cells expressing multiple co-inhibitory molecules in acute malaria are not exhausted but exert a suppressive function. . 2021; ():1.
Chicago/Turabian StyleJohannes Brandi; Cari Lehmann; Lea-Christina Kaminski; Julian Schulze Zur Wiesch; Marylyn Addo; Michael Ramharter; Maria Mackroth; Thomas Jacobs; Mathias Riehn. 2021. "T cells expressing multiple co-inhibitory molecules in acute malaria are not exhausted but exert a suppressive function." , no. : 1.
Julian J. Gabor; Andrea Kreidenweiss; Stefan Weber; Moaaz Salama; Mihaly Sulyok; Zita Sulyok; Erik Koehne; Meral Esen; Benno Kreuels; Parichehr Shamsrizi; Erwin Biecker; Benjamin Mordmüller; Christoph P. Berg; Stefano Fusco; Carsten Köhler; Stefan Kubicka; Jens Leitlein; Marylyn Addo; Michael Ramharter; Matthias Schwab; Alfred Lennart Bissinger; Thirumalaisamy P. Velavan; Sanjeev Krishna; Peter G. Kremsner. A call to caution when hydroxychloroquine is given to elderly COVID-19 patients. 2021, 1 .
AMA StyleJulian J. Gabor, Andrea Kreidenweiss, Stefan Weber, Moaaz Salama, Mihaly Sulyok, Zita Sulyok, Erik Koehne, Meral Esen, Benno Kreuels, Parichehr Shamsrizi, Erwin Biecker, Benjamin Mordmüller, Christoph P. Berg, Stefano Fusco, Carsten Köhler, Stefan Kubicka, Jens Leitlein, Marylyn Addo, Michael Ramharter, Matthias Schwab, Alfred Lennart Bissinger, Thirumalaisamy P. Velavan, Sanjeev Krishna, Peter G. Kremsner. A call to caution when hydroxychloroquine is given to elderly COVID-19 patients. . 2021; ():1.
Chicago/Turabian StyleJulian J. Gabor; Andrea Kreidenweiss; Stefan Weber; Moaaz Salama; Mihaly Sulyok; Zita Sulyok; Erik Koehne; Meral Esen; Benno Kreuels; Parichehr Shamsrizi; Erwin Biecker; Benjamin Mordmüller; Christoph P. Berg; Stefano Fusco; Carsten Köhler; Stefan Kubicka; Jens Leitlein; Marylyn Addo; Michael Ramharter; Matthias Schwab; Alfred Lennart Bissinger; Thirumalaisamy P. Velavan; Sanjeev Krishna; Peter G. Kremsner. 2021. "A call to caution when hydroxychloroquine is given to elderly COVID-19 patients." , no. : 1.
We report a case of Plasmodium falciparum malaria in a patient asymptomatically co-infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the current ongoing coronavirus pandemic, co-infections with unrelated life-threatening febrile conditions may pose a particular challenge to clinicians. The current situation increases the risk for cognitive biases in medical management.
Johannes Jochum; Benno Kreuels; Egbert Tannich; Samuel Huber; Julian Schulze Zur Wiesch; Stefan Schmiedel; Michael Ramharter; Marylyn Addo. Malaria in the Time of COVID-19: Do Not Miss the Real Cause of Illness. Tropical Medicine and Infectious Disease 2021, 6, 40 .
AMA StyleJohannes Jochum, Benno Kreuels, Egbert Tannich, Samuel Huber, Julian Schulze Zur Wiesch, Stefan Schmiedel, Michael Ramharter, Marylyn Addo. Malaria in the Time of COVID-19: Do Not Miss the Real Cause of Illness. Tropical Medicine and Infectious Disease. 2021; 6 (2):40.
Chicago/Turabian StyleJohannes Jochum; Benno Kreuels; Egbert Tannich; Samuel Huber; Julian Schulze Zur Wiesch; Stefan Schmiedel; Michael Ramharter; Marylyn Addo. 2021. "Malaria in the Time of COVID-19: Do Not Miss the Real Cause of Illness." Tropical Medicine and Infectious Disease 6, no. 2: 40.
Background Integrated community case management (iCCM) of malaria complements and extends the reach of public health services to improve access to timely diagnosis and treatment of malaria. Such community-based programmes rely on standardised test-and-treat algorithms implemented by community health workers using malaria rapid diagnostic tests (RDTs). However, due to a changing epidemiology of fever causes, positive RDT results might not correctly reflect malaria-disease in all malaria-endemic settings in Africa. This study modelled diagnostic predictive values for all malaria-endemic African regions as an indicator of the programmatic usefulness of RDTs in iCCM campaigns on malaria. Methods Positive predictive values (PPV) and negative predictive values (NPV) of RDTs for clinical malaria were modelled. Assay-specific performance characteristics stem from the Cochrane Library and publicly available data on the proportion of malaria-attributable fevers among African febrile children under five years of age were used as prevalence matrix. Results Average country-level PPVs vary considerably: Ethiopia had lowest PPVs (HRP2-assay: 17.35%; pLDH-assay: 39.73%) and Guinea the highest PPVs (HRP2-assay: 95.32%; pLDH-assay: 98.46%). On the contrary, NPVs were above 90% in all countries (HRP2-assay: ≥94.87%; pLDH-assay ≥93.36%). Conclusions PPVs differed considerably within Africa when used for screening of febrile children indicating unfavourable performance of RDT-based test-and-treat algorithms in low-PPV settings. This suggests that the administration of antimalarials alone may not constitute causal treatment in the presence of a positive RDT result for a substantial proportion of patients particularly in low-PPV settings. Therefore, current iCCM algorithms should be complemented by information on other setting-specific major causes of fever.
Johannes Mischlinger; Veronika Dudek; Michael Ramharter. Predictive performance of rapid diagnostic tests for falciparum malaria and its modelled impact on integrated community case management of malaria in sub-Saharan African febrile children. Clinical Infectious Diseases 2021, 1 .
AMA StyleJohannes Mischlinger, Veronika Dudek, Michael Ramharter. Predictive performance of rapid diagnostic tests for falciparum malaria and its modelled impact on integrated community case management of malaria in sub-Saharan African febrile children. Clinical Infectious Diseases. 2021; ():1.
Chicago/Turabian StyleJohannes Mischlinger; Veronika Dudek; Michael Ramharter. 2021. "Predictive performance of rapid diagnostic tests for falciparum malaria and its modelled impact on integrated community case management of malaria in sub-Saharan African febrile children." Clinical Infectious Diseases , no. : 1.
International travel has been identified as a major contributing factor to the global spread of MRSA. We examined the incidence of MRSA-colonization in a cohort of 196 travellers. We observed a low rate of only one case of MRSA, indicating a low risk of acquisition of MRSA-colonization in travel.
Dai T Tran; Doris Winter; Martin Christner; Michael Ramharter; Marylyn M Addo; Thierry Rolling; Christof Vinnemeier; Till Koch. Less than you’d think—a prospective study on MRSA-colonization in healthy travellers. Journal of Travel Medicine 2021, 28, 1 .
AMA StyleDai T Tran, Doris Winter, Martin Christner, Michael Ramharter, Marylyn M Addo, Thierry Rolling, Christof Vinnemeier, Till Koch. Less than you’d think—a prospective study on MRSA-colonization in healthy travellers. Journal of Travel Medicine. 2021; 28 (3):1.
Chicago/Turabian StyleDai T Tran; Doris Winter; Martin Christner; Michael Ramharter; Marylyn M Addo; Thierry Rolling; Christof Vinnemeier; Till Koch. 2021. "Less than you’d think—a prospective study on MRSA-colonization in healthy travellers." Journal of Travel Medicine 28, no. 3: 1.
Summary Medical research in sub-Saharan Africa is of high priority for societies to respond adequately to local health needs. Often enough it remains a challenge to build up capacity in infrastructure and human resources to highest international standards and to sustain this over mid-term to long-term periods due to difficulties in obtaining long-term institutional core funding, attracting highly qualified scientists for medical research and coping with ever changing structural and political environments. The Centre de Recherches Médicales de Lambaréné (CERMEL) serves as model for how to overcome such challenges and to continuously increase its impact on medical care in Central Africa and beyond. Starting off as a research annex to the Albert Schweitzer Hospital in Lambaréné, Gabon, it has since then expanded its activities to academic and regulatory clinical trials for drugs, vaccines and diagnostics in the field of malaria, tuberculosis, and a wide range of poverty related and neglected tropical infectious diseases. Advancing bioethics in medical research in Africa and steadily improving its global networks and infrastructures, CERMEL serves as a reference centre for several international consortia. In close collaboration with national authorities, CERMEL has become one of the main training hubs for medical research in Central Africa. It is hoped that CERMEL and its leitmotiv “to improve medical care for local populations” will serve as an inspiration to other institutions in sub-Saharan Africa to further increase African capacity to advance medicine.
Michael Ramharter; Selidji T. Agnandji; Ayôla A. Adegnika; Bertrand Lell; Ghyslain Mombo-Ngoma; Martin P. Grobusch; Matthew McCall; Riko Muranaka; Andrea Kreidenweiss; Thirumalaisamy P. Velavan; Meral Esen; Frieder Schaumburg; Abraham Alabi; Christiane Druml; Benjamin Mordmüller; Carsten Köhler; Peter G. Kremsner. Development of sustainable research excellence with a global perspective on infectious diseases: Centre de Recherches Médicales de Lambaréné (CERMEL), Gabon. Wiener klinische Wochenschrift 2021, 133, 500 -508.
AMA StyleMichael Ramharter, Selidji T. Agnandji, Ayôla A. Adegnika, Bertrand Lell, Ghyslain Mombo-Ngoma, Martin P. Grobusch, Matthew McCall, Riko Muranaka, Andrea Kreidenweiss, Thirumalaisamy P. Velavan, Meral Esen, Frieder Schaumburg, Abraham Alabi, Christiane Druml, Benjamin Mordmüller, Carsten Köhler, Peter G. Kremsner. Development of sustainable research excellence with a global perspective on infectious diseases: Centre de Recherches Médicales de Lambaréné (CERMEL), Gabon. Wiener klinische Wochenschrift. 2021; 133 (9-10):500-508.
Chicago/Turabian StyleMichael Ramharter; Selidji T. Agnandji; Ayôla A. Adegnika; Bertrand Lell; Ghyslain Mombo-Ngoma; Martin P. Grobusch; Matthew McCall; Riko Muranaka; Andrea Kreidenweiss; Thirumalaisamy P. Velavan; Meral Esen; Frieder Schaumburg; Abraham Alabi; Christiane Druml; Benjamin Mordmüller; Carsten Köhler; Peter G. Kremsner. 2021. "Development of sustainable research excellence with a global perspective on infectious diseases: Centre de Recherches Médicales de Lambaréné (CERMEL), Gabon." Wiener klinische Wochenschrift 133, no. 9-10: 500-508.
Background In endemic malarial areas, young children have high levels of malaria morbidity and mortality. The World Health Organization recommends oral artemisinin‐based combination therapy (ACT) for treating uncomplicated malaria. Paediatric formulations of ACT have been developed to make it easier to treat children. Objectives To evaluate evidence from trials on the efficacy, safety, tolerability, and acceptability of paediatric ACT formulations compared to tablet ACT formulations for uncomplicated P falciparum malaria in children up to 14 years old. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; Embase; the Latin American and Caribbean Health Science Information database (LILACS); ISI Web of Science; Google Scholar; Scopus; and the metaRegister of Controlled Trials (mRCT) to 11 December 2019. Selection criteria We included randomised controlled clinical trials (RCTs) of paediatric versus non‐paediatric formulated ACT in children aged 14 years or younger with acute uncomplicated malaria. Data collection and analysis Two authors independently assessed eligibility and risk of bias, and carried out data extraction. We analyzed the primary outcomes of efficacy, safety and tolerability of paediatric versus non‐paediatric ACT using risk ratios (RR) and 95% confidence intervals (CI). Secondary outcomes were: treatment failure on the last day of observation (day 42), fever clearance time, parasite clearance time, pharmacokinetics, and acceptability. Main results Three trials met the inclusion criteria. Two compared a paediatric dispersible tablet formulation against crushed tablets of artemether‐lumefantrine (AL) and dihydroartemisinin‐piperaquine (DHA‐PQ), and one trial assessed artemether‐lumefantrine formulated as powder for suspension compared with crushed tablets. The trials were carried out between 2006 and 2015 in sub‐Saharan Africa (Benin, Mali, Mozambique, Tanzania, Kenya, Democratic Republic of the Congo, Burkina Faso, and The Gambia). In all three trials, the paediatric and control ACT achieved polymerase chain reaction (PCR)‐adjusted treatment failure rates of < 10% on day 28 in the per‐protocol (PP) population. For the comparison of dispersible versus crushed tablets, the two trials did not detect a difference for treatment failure by day 28 (PCR‐adjusted PP population: RR 1.35, 95% CI 0.49 to 3.72; 1061 participants, 2 studies, low‐certainty evidence). Similarly, for the comparison of suspension versus crushed tablet ACT, we did not detect any difference in treatment failure at day 28 (PCR‐adjusted PP population: RR 1.64, 95% CI 0.55 to 4.87; 245 participants, 1 study). We did not detect any difference in serious adverse events for the comparison of dispersible versus crushed tablets (RR 1.05, 95% CI 0.38 to 2.88; 1197 participants, 2 studies, low‐certainty evidence), or for the comparison of suspension versus crushed tablet ACT (RR 0.74, 95% CI 0.17 to 3.26; 267 participants, 1 study). In the dispersible ACT arms, drug‐related adverse events occurred in 9% of children in the AL study and 34% of children in the DHA‐PQ study. In the control arms, drug‐related adverse events occurred in 12% of children in the AL study and in 42% of children in the DHA‐PQ study. Drug‐related adverse events were lower in the dispersible ACT arms (RR 0.78, 95% CI 0.62 to 0.99; 1197 participants, 2 studies, moderate‐certainty evidence). There was no detected difference in the rate of drug‐related adverse events for suspension ACT versus crushed tablet ACT (RR 0.66, 95% CI 0.33 to 1.32; 267 participants, 1 study). Drug‐related vomiting appeared to be less common in the dispersible ACT arms (RR 0.75, 95% CI 0.56 to 1.01; 1197 participants, 2 studies, low‐certainty evidence) and in the suspension ACT arm (RR 0.66, 95% CI 0.33 to 1.32; 267 participants, 1 study), but both analyses were underpowered. No study assessed acceptability. Authors' conclusions Trials did not demonstrate a difference in efficacy between paediatric dispersible or suspension ACT when compared with the respective crushed tablet ACT for treating uncomplicated P falciparum malaria in children. However, the evidence is of low to moderate certainty due to limited power. There appeared to be fewer drug‐related adverse events with dispersible ACT compared to crushed tablet ACT. None of the included studies assessed acceptability of paediatric ACT formulation.
Sabine Bélard; Michael Ramharter; Florian Kurth. Paediatric formulations of artemisinin-based combination therapies for treating uncomplicated malaria in children. Cochrane Database of Systematic Reviews 2020, 2020, CD009568 .
AMA StyleSabine Bélard, Michael Ramharter, Florian Kurth. Paediatric formulations of artemisinin-based combination therapies for treating uncomplicated malaria in children. Cochrane Database of Systematic Reviews. 2020; 2020 (12):CD009568.
Chicago/Turabian StyleSabine Bélard; Michael Ramharter; Florian Kurth. 2020. "Paediatric formulations of artemisinin-based combination therapies for treating uncomplicated malaria in children." Cochrane Database of Systematic Reviews 2020, no. 12: CD009568.
COVID-19 is highly variable in its clinical presentation, ranging from asymptomatic infection to severe organ damage and death. There is an urgent need for predictive markers that can guide clinical decision-making, inform about the effect of experimental therapies, and point to novel therapeutic targets. Here, we characterize the time-dependent progression of COVID-19 through different stages of the disease, by measuring 86 accredited diagnostic parameters and plasma proteomes at 687 sampling points, in a cohort of 139 patients during hospitalization. We report that the time-resolved patient molecular phenotypes reflect an initial spike in the systemic inflammatory response, which is gradually alleviated and followed by a protein signature indicative of tissue repair, metabolic reconstitution and immunomodulation. Further, we show that the early host response is predictive for the disease trajectory and gives rise to proteomic and diagnostic marker signatures that classify the need for supplemental oxygen therapy and mechanical ventilation, and that predict the time to recovery of mildly ill patients. In severely ill patients, the molecular phenotype of the early host response predicts survival, in two independent cohorts and weeks before outcome. We also identify age-specific molecular response to COVID-19, which involves increased inflammation and lipoprotein dysregulation in older patients. Our study provides a deep and time resolved molecular characterization of COVID-19 disease progression, and reports biomarkers for risk-adapted treatment strategies and molecular disease monitoring. Our study demonstrates accurate prognosis of COVID-19 outcome from proteomic signatures recorded weeks earlier.
Vadim Demichev; Pinkus Tober-Lau; Tatiana Nazarenko; Charlotte Thibeault; Harry Whitwell; Oliver Lemke; Annika Röhl; Anja Freiwald; Lukasz Szyrwiel; Daniela Ludwig; Clara Correia-Melo; Elisa T. Helbig; Paula Stubbemann; Nana-Maria Grüning; Oleg Blyuss; Spyros Vernardis; Matthew White; Christoph B. Messner; Michael Joannidis; Thomas Sonnweber; Sebastian J. Klein; Alex Pizzini; Yvonne Wohlfarter; Sabina Sahanic; Richard Hilbe; Benedikt Schaefer; Sonja Wagner; Mirja Mittermaier; Felix Machleidt; Carmen Garcia; Christoph Ruwwe-Glösenkamp; Tilman Lingscheid; Laure Bosquillon De Jarcy; Miriam S. Stegemann; Moritz Pfeiffer; Linda Jürgens; Sophy Denker; Daniel Zickler; Philipp Enghard; Aleksej Zelezniak; Archie Campbell; Caroline Hayward; David J. Porteous; Riccardo E. Marioni; Alexander Uhrig; Holger Müller-Redetzky; Heinz Zoller; Judith Löffler-Ragg; Markus A. Keller; Ivan Tancevski; John F. Timms; Alexey Zaikin; Stefan Hippenstiel; Michael Ramharter; Martin Witzenrath; Norbert Suttorp; Kathryn Lilley; Michael Mülleder; Leif Erik Sander; Markus Ralser; Florian Kurth; PA-COVID-19 Study group. A time-resolved proteomic and diagnostic map characterizes COVID-19 disease progression and predicts outcome. 2020, 1 .
AMA StyleVadim Demichev, Pinkus Tober-Lau, Tatiana Nazarenko, Charlotte Thibeault, Harry Whitwell, Oliver Lemke, Annika Röhl, Anja Freiwald, Lukasz Szyrwiel, Daniela Ludwig, Clara Correia-Melo, Elisa T. Helbig, Paula Stubbemann, Nana-Maria Grüning, Oleg Blyuss, Spyros Vernardis, Matthew White, Christoph B. Messner, Michael Joannidis, Thomas Sonnweber, Sebastian J. Klein, Alex Pizzini, Yvonne Wohlfarter, Sabina Sahanic, Richard Hilbe, Benedikt Schaefer, Sonja Wagner, Mirja Mittermaier, Felix Machleidt, Carmen Garcia, Christoph Ruwwe-Glösenkamp, Tilman Lingscheid, Laure Bosquillon De Jarcy, Miriam S. Stegemann, Moritz Pfeiffer, Linda Jürgens, Sophy Denker, Daniel Zickler, Philipp Enghard, Aleksej Zelezniak, Archie Campbell, Caroline Hayward, David J. Porteous, Riccardo E. Marioni, Alexander Uhrig, Holger Müller-Redetzky, Heinz Zoller, Judith Löffler-Ragg, Markus A. Keller, Ivan Tancevski, John F. Timms, Alexey Zaikin, Stefan Hippenstiel, Michael Ramharter, Martin Witzenrath, Norbert Suttorp, Kathryn Lilley, Michael Mülleder, Leif Erik Sander, Markus Ralser, Florian Kurth, PA-COVID-19 Study group. A time-resolved proteomic and diagnostic map characterizes COVID-19 disease progression and predicts outcome. . 2020; ():1.
Chicago/Turabian StyleVadim Demichev; Pinkus Tober-Lau; Tatiana Nazarenko; Charlotte Thibeault; Harry Whitwell; Oliver Lemke; Annika Röhl; Anja Freiwald; Lukasz Szyrwiel; Daniela Ludwig; Clara Correia-Melo; Elisa T. Helbig; Paula Stubbemann; Nana-Maria Grüning; Oleg Blyuss; Spyros Vernardis; Matthew White; Christoph B. Messner; Michael Joannidis; Thomas Sonnweber; Sebastian J. Klein; Alex Pizzini; Yvonne Wohlfarter; Sabina Sahanic; Richard Hilbe; Benedikt Schaefer; Sonja Wagner; Mirja Mittermaier; Felix Machleidt; Carmen Garcia; Christoph Ruwwe-Glösenkamp; Tilman Lingscheid; Laure Bosquillon De Jarcy; Miriam S. Stegemann; Moritz Pfeiffer; Linda Jürgens; Sophy Denker; Daniel Zickler; Philipp Enghard; Aleksej Zelezniak; Archie Campbell; Caroline Hayward; David J. Porteous; Riccardo E. Marioni; Alexander Uhrig; Holger Müller-Redetzky; Heinz Zoller; Judith Löffler-Ragg; Markus A. Keller; Ivan Tancevski; John F. Timms; Alexey Zaikin; Stefan Hippenstiel; Michael Ramharter; Martin Witzenrath; Norbert Suttorp; Kathryn Lilley; Michael Mülleder; Leif Erik Sander; Markus Ralser; Florian Kurth; PA-COVID-19 Study group. 2020. "A time-resolved proteomic and diagnostic map characterizes COVID-19 disease progression and predicts outcome." , no. : 1.
Ocular complications are rare in patients with dengue fever, but may cause permanent loss of vision. We present the case of a 29-year-old German woman who developed severe acute vision loss because of dengue-associated maculopathy after traveling to Vietnam and Cambodia. Initially, the optical coherence tomography showed detachment of the retinal pigment epithelium, a central shift in the retinal pigmentation and intraretinal cysts. The patient was hospitalized and treated with a short course of intravenous prednisolone. Vision improved, and the patient showed full recovery at 9 months after the onset. This case highlights the importance of awareness and adequate management for ocular involvement in patients with dengue fever, including travelers.
Melina Heinemann; Eileen Bigdon; Luzia Veletzky; Sabine Jordan; Johannes Jochum; Volker Knospe; Stefan Schmiedel; Michael Ramharter. Case Report: Acute Vision Loss in a Young Returning Traveler with Dengue Fever. The American Journal of Tropical Medicine and Hygiene 2020, 103, 2026 -2028.
AMA StyleMelina Heinemann, Eileen Bigdon, Luzia Veletzky, Sabine Jordan, Johannes Jochum, Volker Knospe, Stefan Schmiedel, Michael Ramharter. Case Report: Acute Vision Loss in a Young Returning Traveler with Dengue Fever. The American Journal of Tropical Medicine and Hygiene. 2020; 103 (5):2026-2028.
Chicago/Turabian StyleMelina Heinemann; Eileen Bigdon; Luzia Veletzky; Sabine Jordan; Johannes Jochum; Volker Knospe; Stefan Schmiedel; Michael Ramharter. 2020. "Case Report: Acute Vision Loss in a Young Returning Traveler with Dengue Fever." The American Journal of Tropical Medicine and Hygiene 103, no. 5: 2026-2028.
Farah Saffar; Florian Kurth; Egbert Tannich; Michael Ramharter; Johannes Jochum. Hookworm infection in returning travellers and migrants: a 10-year case series at a German center for tropical medicine. Journal of Travel Medicine 2020, 28, 1 .
AMA StyleFarah Saffar, Florian Kurth, Egbert Tannich, Michael Ramharter, Johannes Jochum. Hookworm infection in returning travellers and migrants: a 10-year case series at a German center for tropical medicine. Journal of Travel Medicine. 2020; 28 (1):1.
Chicago/Turabian StyleFarah Saffar; Florian Kurth; Egbert Tannich; Michael Ramharter; Johannes Jochum. 2020. "Hookworm infection in returning travellers and migrants: a 10-year case series at a German center for tropical medicine." Journal of Travel Medicine 28, no. 1: 1.
Mansonella perstans, a filarial nematode, infects large populations in Africa and Latin America. Recently, a potential new species, Mansonella sp “DEUX,” was reported. Carriage of endosymbiotic Wolbachia opens treatment options for Mansonella infections. Within a cross-sectional study, we assessed the prevalence of filarial infections in 834 Gabonese individuals and the presence of the endosymbiont Wolbachia. Almost half of the participants (400/834 [48%]) were infected with filarial nematodes, with Mansonella sp “DEUX” being the most frequent (295/400 [74%]), followed by Loa loa (273/400 [68%]) and Mansonella perstans (82/400 [21%]). Being adult/elderly, male, and living in rural areas was associated with a higher risk of infection. Wolbachia carriage was confirmed in M. perstans and Mansonella sp “DEUX.” In silico analysis revealed that Mansonella sp “DEUX” is not detected with currently published M. perstans–specific assays. Mansonella infections are highly prevalent in Gabon and might have been underreported, likely also beyond Gabon.
Thaisa Lucas Sandri; Andrea Kreidenweiss; Simon Cavallo; David Weber; Sascha Juhas; Miriam Rodi; Tamirat Gebru Woldearegai; Markus Gmeiner; Luzia Veletzky; Michael Ramharter; Gildas B Tazemda-Kuitsouc; Pierre Blaise Matsiegui; Benjamin Mordmüller; Jana Held. Molecular Epidemiology of Mansonella Species in Gabon. Journal of Infectious Diseases 2020, 223, 287 -296.
AMA StyleThaisa Lucas Sandri, Andrea Kreidenweiss, Simon Cavallo, David Weber, Sascha Juhas, Miriam Rodi, Tamirat Gebru Woldearegai, Markus Gmeiner, Luzia Veletzky, Michael Ramharter, Gildas B Tazemda-Kuitsouc, Pierre Blaise Matsiegui, Benjamin Mordmüller, Jana Held. Molecular Epidemiology of Mansonella Species in Gabon. Journal of Infectious Diseases. 2020; 223 (2):287-296.
Chicago/Turabian StyleThaisa Lucas Sandri; Andrea Kreidenweiss; Simon Cavallo; David Weber; Sascha Juhas; Miriam Rodi; Tamirat Gebru Woldearegai; Markus Gmeiner; Luzia Veletzky; Michael Ramharter; Gildas B Tazemda-Kuitsouc; Pierre Blaise Matsiegui; Benjamin Mordmüller; Jana Held. 2020. "Molecular Epidemiology of Mansonella Species in Gabon." Journal of Infectious Diseases 223, no. 2: 287-296.
The emergence and international spread of SARS-CoV-2 led to unprecedented challenges for international travelers including health-related concerns and international travel restrictions. Remarkably, overseas travelers consulted at our travel clinic during the first quarter of 2020 were apparently not disconcerted by the evolving pandemic with a continuously high rate of consultations at our center; 85% of travelers did not actively inquire about COVID-19 during the pretravel consultation including individuals with clinically significant immunosuppression constituting a high-risk group for COVID-19–related adverse health outcome. This experience demonstrates the societal responsibility of travel medicine practitioners to proactively provide unbiased information about the health-related and travel-related impact of newly emerging infections.
Parichehr Shamsrizi; Johannes Jochum; Benno Kreuels; Michael Ramharter. Traveling into the Abyss: Risk Perception of German Travelers at the Onset of the COVID-19 Pandemic. The American Journal of Tropical Medicine and Hygiene 2020, 103, 1640 -1641.
AMA StyleParichehr Shamsrizi, Johannes Jochum, Benno Kreuels, Michael Ramharter. Traveling into the Abyss: Risk Perception of German Travelers at the Onset of the COVID-19 Pandemic. The American Journal of Tropical Medicine and Hygiene. 2020; 103 (4):1640-1641.
Chicago/Turabian StyleParichehr Shamsrizi; Johannes Jochum; Benno Kreuels; Michael Ramharter. 2020. "Traveling into the Abyss: Risk Perception of German Travelers at the Onset of the COVID-19 Pandemic." The American Journal of Tropical Medicine and Hygiene 103, no. 4: 1640-1641.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents a global health emergency. To improve the understanding of the systemic component of SARS-CoV-2, we investigated if viral load dynamics in plasma and respiratory samples are associated with antibody response and severity of coronavirus disease 2019 (COVID-19). SARS-CoV-2 RNA was found in plasma samples from 14 (44%) out of 32 patients. RNAemia was detected in 5 out of 6 fatal cases. Peak IgG values were significantly lower in mild/moderate than in severe (0.6 (interquartile range, IQR, 0.4–3.2) vs. 11.8 (IQR, 9.9–13.0), adjusted p = 0.003) or critical cases (11.29 (IQR, 8.3–12.0), adjusted p = 0.042). IgG titers were significantly associated with virus Ct (Cycle threshold) value in plasma and respiratory specimens ((ß = 0.4, 95% CI (confidence interval, 0.2; 0.5), p < 0.001 and ß = 0.5, 95% CI (0.2; 0.6), p = 0.002). A classification as severe or a critical case was additionally inversely associated with Ct values in plasma in comparison to mild/moderate cases (ß = −3.3, 95% CI (−5.8; 0.8), p = 0.024 and ß = −4.4, 95% CI (−7.2; 1.6), p = 0.007, respectively). Based on the present data, our hypothesis is that the early stage of SARS-CoV-2 infection is characterized by a primary RNAemia, as a potential manifestation of a systemic infection. Additionally, the viral load in plasma seems to be associated with a worse disease outcome.
Kirsten Alexandra Eberhardt; Charlotte Meyer-Schwickerath; Eva Heger; Elena Knops; Clara Lehmann; Jan Rybniker; Philipp Schommers; Dennis A. Eichenauer; Florian Kurth; Michael Ramharter; Rolf Kaiser; Udo Holtick; Florian Klein; Norma Jung; Veronica Di Cristanziano. RNAemia Corresponds to Disease Severity and Antibody Response in Hospitalized COVID-19 Patients. Viruses 2020, 12, 1045 .
AMA StyleKirsten Alexandra Eberhardt, Charlotte Meyer-Schwickerath, Eva Heger, Elena Knops, Clara Lehmann, Jan Rybniker, Philipp Schommers, Dennis A. Eichenauer, Florian Kurth, Michael Ramharter, Rolf Kaiser, Udo Holtick, Florian Klein, Norma Jung, Veronica Di Cristanziano. RNAemia Corresponds to Disease Severity and Antibody Response in Hospitalized COVID-19 Patients. Viruses. 2020; 12 (9):1045.
Chicago/Turabian StyleKirsten Alexandra Eberhardt; Charlotte Meyer-Schwickerath; Eva Heger; Elena Knops; Clara Lehmann; Jan Rybniker; Philipp Schommers; Dennis A. Eichenauer; Florian Kurth; Michael Ramharter; Rolf Kaiser; Udo Holtick; Florian Klein; Norma Jung; Veronica Di Cristanziano. 2020. "RNAemia Corresponds to Disease Severity and Antibody Response in Hospitalized COVID-19 Patients." Viruses 12, no. 9: 1045.
Cystic (CE) and alveolar (AE) echinococcosis are chronic, neglected parasitic diseases burdened by high morbidity and, for AE, by high mortality, if left untreated. CE and AE have a widespread distribution, including Europe. Albendazole (ABZ), a broad-spectrum benzimidazole drug widely used to treat parasitic infections, is the drug of choice for the management of CE and AE, and is parasitostatic on echinococcal metacestodes. In Europe, ABZ is licensed for interrupted “cyclic” treatment, for a maximum of 3 cycles. However, better efficacy with no increased side effects has been shown when the drug is administered continuously and for longer periods. Current international recommendations, on the basis of clinical, pharmacological, and biological studies, recommend continuous administration of ABZ for months to years for the treatment of CE and AE, and this schedule has been widely in use for the past 20 years. However, in Europe this internationally recommended schedule, with the exception of France, is technically “off-label”, and, as such, requires an informed consent by the patient and, in some countries, even precludes the reimbursement of the drug cost. Adding to the very high cost of the drug, frequent “out-of-stock” situation, and packaging format impractical for long therapies, these conditions put patients with CE and AE regularly at risk of treatment discontinuation and disease progression. European regulations envisage variations to marketing authorization, but postauthorization studies should be carried out by the holder of the license of the drug, in the form of randomized controlled trials. While such studies do not seem feasible and would probably not be ethically justified for CE and AE, European regulations envisage other possibilities in particular situations, which apply to CE and AE, but there is limited interest to invest in this perspective. We urge a coordination between stakeholders to find effective and feasible ways to take action to revise the benzimidazole dosage regimens for CE and AE and to ensure a fair, regular, and easy access to the appropriate treatment to those suffering from these serious diseases.
Francesca Tamarozzi; John Horton; Marin Muhtarov; Michael Ramharter; Mar Siles-Lucas; Beate Gruener; Dominique A. Vuitton; Solange Bresson-Hadni; Tommaso Manciulli; Enrico Brunetti. A case for adoption of continuous albendazole treatment regimen for human echinococcal infections. PLOS Neglected Tropical Diseases 2020, 14, e0008566 .
AMA StyleFrancesca Tamarozzi, John Horton, Marin Muhtarov, Michael Ramharter, Mar Siles-Lucas, Beate Gruener, Dominique A. Vuitton, Solange Bresson-Hadni, Tommaso Manciulli, Enrico Brunetti. A case for adoption of continuous albendazole treatment regimen for human echinococcal infections. PLOS Neglected Tropical Diseases. 2020; 14 (9):e0008566.
Chicago/Turabian StyleFrancesca Tamarozzi; John Horton; Marin Muhtarov; Michael Ramharter; Mar Siles-Lucas; Beate Gruener; Dominique A. Vuitton; Solange Bresson-Hadni; Tommaso Manciulli; Enrico Brunetti. 2020. "A case for adoption of continuous albendazole treatment regimen for human echinococcal infections." PLOS Neglected Tropical Diseases 14, no. 9: e0008566.
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Nicole Harrison; Katharina Grabmeier-Pfistershammer; Alexandra Graf; Ilse Schwarzinger; Judith H. Aberle; Karin Stiasny; Hildegard Greinix; Werner Rabitsch; Peter Kalhs; Michael Ramharter; Heinz Burgmann; Christina Forstner. Author Correction: Humoral immune response to tick-borne encephalitis vaccination in allogeneic blood and marrow graft recipients. npj Vaccines 2020, 5, 1 -1.
AMA StyleNicole Harrison, Katharina Grabmeier-Pfistershammer, Alexandra Graf, Ilse Schwarzinger, Judith H. Aberle, Karin Stiasny, Hildegard Greinix, Werner Rabitsch, Peter Kalhs, Michael Ramharter, Heinz Burgmann, Christina Forstner. Author Correction: Humoral immune response to tick-borne encephalitis vaccination in allogeneic blood and marrow graft recipients. npj Vaccines. 2020; 5 (1):1-1.
Chicago/Turabian StyleNicole Harrison; Katharina Grabmeier-Pfistershammer; Alexandra Graf; Ilse Schwarzinger; Judith H. Aberle; Karin Stiasny; Hildegard Greinix; Werner Rabitsch; Peter Kalhs; Michael Ramharter; Heinz Burgmann; Christina Forstner. 2020. "Author Correction: Humoral immune response to tick-borne encephalitis vaccination in allogeneic blood and marrow graft recipients." npj Vaccines 5, no. 1: 1-1.