Publications

@article{Kiemde2023,

title = {A Randomized Trial to Assess the Impact of a Package of Diagnostic Tools and Diagnostic Algorithm on Antibiotic Prescriptions for the Management of Febrile Illnesses Among Children and Adolescents in Primary Health Facilities in Burkina Faso},

author = {Francois Kiemde and Daniel Valia and Berenger Kabore and Toussaint Rouamba and Alima Nadine Kone and Seydou Sawadogo and Adelaide Compaore and Olawale Salami and Philip Horgan and Catrin E. Moore and Sabine Dittrich and Juvenal Nkeramahame and Piero Olliaro and Halidou Tinto},

url = {https://pubmed.ncbi.nlm.nih.gov/37490742/},

doi = {10.1093/CID/CIAD331},

issn = {1537-6591},

year  = {2023},

date = {2023-01-01},

journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},

volume = {77},

issue = {Suppl 2},

pages = {S134-S144},

publisher = {Clin Infect Dis},

abstract = {Background: Low- and middle-income countries face significant challenges in differentiating bacterial from viral causes of febrile illnesses, leading to inappropriate use of antibiotics. This trial aimed to evaluate the impact of an intervention package comprising diagnostic tests, a diagnostic algorithm, and a training-and-communication package on antibiotic prescriptions and clinical outcomes. Methods: Patients aged 6 months to 18 years with fever or history of fever within the past 7 days with no focus, or a suspected respiratory tract infection, arriving at 2 health facilities were randomized to either the intervention package or standard practice. The primary outcomes were the proportions of patients who recovered at day 7 (D7) and patients prescribed antibiotics at day 0. Results: Of 1718 patients randomized, 1681 (97.8%; intervention: 844; control: 837) completed follow-up: 99.5% recovered at D7 in the intervention arm versus 100% in standard practice (P =. 135). Antibiotics were prescribed to 40.6% of patients in the intervention group versus 57.5% in the control arm (risk ratio: 29.3%; 95% CI: 21.8-36.0%; risk difference [RD]: -16.8%; 95% CI: -21.7% to -12.0%; P \<. 001), which translates to 1 additional antibiotic prescription saved every 6 (95% CI: 5-8) consultations. This reduction was significant regardless of test results for malaria, but was greater in patients without malaria (RD: -46.0%; -54.7% to -37.4%; P \<. 001), those with a respiratory diagnosis (RD: -38.2%; -43.8% to -32.6%; P \<. 001), and in children 6-59 months old (RD: -20.4%; -26.0% to -14.9%; P \<. 001). Except for the period July-September, the reduction was consistent across the other quarters (P \<. 001). Conclusions: The implementation of the package can reduce inappropriate antibiotic prescription without compromising clinical outcomes. Clinical Trials Registration: clinicaltrials.gov; NCT04081051.},

keywords = {Adolescent, Algorithms, Anti-Bacterial Agents* / therapeutic use, Burkina Faso, Child, Daniel Valia, doi:10.1093/cid/ciad331, Francois Kiemde, Halidou Tinto, Health Facilities, Humans, Infant, Malaria* / drug therapy, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, PMC10368409, pmid:37490742, Preschool, Prescriptions, PubMed Abstract, Randomized controlled trial, Research Support},

pubstate = {published},

tppubtype = {article}

}

@article{nokey,

title = {Analytical sensitivity of loopamp and quantitative real-time PCR on dried blood spots and their potential role in monitoring human African trypanosomiasis elimination.},

author = {Charlie Franck Alfred Compaor\'{e} and Hamidou Ilboudo and Jacques Kabor\'{e} and Justin Windingoudi Kabor\'{e} and Oumou Camara and Mohamed Bamba and Hassane Sakande and Minay\'{e}gninrin Kon\'{e} and Mamadou Camara and Dramane Kaba and Adrien Marie Gaston Belem and Stijn Deborggraeve and Philippe B\"{u}scher and Bruno Bucheton and Veerle Lejon and Vincent Jamonneau},

doi = {10.1016/j.exppara.2020.108014},

issn = {1090-2449 0014-4894},

year  = {2020},

date = {2020-12-01},

urldate = {2020-12-01},

journal = {Experimental parasitology},

volume = {219},

pages = {108014},

address = {United States},

abstract = {The objective set by WHO to reach elimination of human African trypanosomiasis (HAT) as a public health problem by 2020 is being achieved. The next target is the interruption of gambiense-HAT transmission in humans by 2030. To monitor progress towards this target, in areas where specialized local HAT control capacities will disappear, is a major challenge. Test specimens should be easily collectable and safely transportable such as dried blood spots (DBS). Monitoring tests performed in regional reference centres should be reliable, cheap and allow analysis of large numbers of specimens in a high-throughput format. The aim of this study was to assess the analytical sensitivity of Loopamp, M18S quantitative real-time PCR (M18S qPCR) and TgsGP qPCR as molecular diagnostic tests for the presence of Trypanosoma brucei gambiense in DBS. The sensitivity of the Loopamp test, with a detection limit of 100 trypanosomes/mL, was in the range of parasitaemias commonly observed in HAT patients, while detection limits for M18S and TgsGP qPCR were respectively 1000 and 10,000 trypanosomes/mL. None of the tests was entirely suitable for high-throughput use and further development and implementation of sensitive high-throughput molecular tools for monitoring HAT elimination are needed.},

keywords = {African/blood/diagnosis/*prevention \& control, Algorithms, Animals, Blood Specimen Collection/methods/standards, Diagnosis, DNA, Dried blood spots, Feasibility, High-Throughput Screening Assays/methods/standards, Humans, Loopamp, Mice, Molecular Diagnostic Techniques/*standards, Nucleic Acid Amplification Techniques/*standards, Protozoan/isolation \& purification, Quantitative real-time PCR, Real-Time Polymerase Chain Reaction/methods/*standards, Sensitivity, Sensitivity and Specificity, Specimen Handling/methods/standards, Trypanosoma brucei gambiense, Trypanosoma brucei gambiense/genetics/*isolation \& purification, Trypanosomiasis},

pubstate = {published},

tppubtype = {article}

}