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Potgieter RL, Mwangi PN, Mogotsi MT, Uwimana J, Mutesa L, Muganga N, Murenzi D, Tusiyenge L, Seheri ML, Steele AD, Mwenda JM, Nyaga MM. Genomic Analysis of Rwandan G9P[8] Rotavirus Strains Pre- and Post-RotaTeq ® Vaccine Reveals Significant Distinct Sub-Clustering in a Post-Vaccination Cohort. Viruses 2023; 15:2321. [PMID: 38140562 PMCID: PMC10747556 DOI: 10.3390/v15122321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/16/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Although the introduction of rotavirus vaccines has substantially contributed to the reduction in rotavirus morbidity and mortality, concerns persist about the re-emergence of variant strains that might alter vaccine effectiveness in the long term. The G9 strains re-emerged in Africa during the mid-1990s and have more recently become predominant in some countries, such as Ghana and Zambia. In Rwanda, during the 2011 to 2015 routine surveillance period, G9P[8] persisted during both the pre- and post-vaccine periods. The pre-vaccination cohort was based on the surveillance period of 2011 to 2012, and the post-vaccination cohort was based on the period of 2013 to 2015, excluding 2014. The RotaTeq® vaccine that was first introduced in Rwanda in 2012 is genotypically heterologous to Viral Protein 7 (VP7) G9. This study elucidated the whole genome of Rwandan G9P[8] rotavirus strains pre- and post-RotaTeq® vaccine introduction. Fecal samples from Rwandan children under the age of five years (pre-vaccine n = 23; post-vaccine n = 7), conventionally genotyped and identified as G9P[8], were included. Whole-genome sequencing was then performed using the Illumina® MiSeq platform. Phylogenetic analysis and pair-wise sequence analysis were performed using MEGA6 software. Distinct clustering of three post-vaccination study strains was observed in all 11 gene segments, compared to the other Rwandan G9P[8] study strains. Specific amino acid differences were identified across the gene segments of these three 2015 post-vaccine strains. Important amino acid differences were identified at position N242S in the VP7 genome segment of the three post-vaccine G9 strains compared to the other G9 strains. This substitution occurs at a neutralization epitope site and may slightly affect protein interaction at that position. These findings indicate that the Rwandan G9P[8] strains revealed a distinct sub-clustering pattern among post-vaccination study strains circulating in Rwanda, with changes at neutralization epitopes, which may play a role in neutralization escape from vaccine candidates. This emphasizes the need for continuous whole-genome surveillance to better understand the evolution and epidemiology of the G9P[8] strains post-vaccination.
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Affiliation(s)
- Robyn-Lee Potgieter
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein 9300, South Africa; (R.-L.P.); (P.N.M.); (M.T.M.)
| | - Peter N. Mwangi
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein 9300, South Africa; (R.-L.P.); (P.N.M.); (M.T.M.)
| | - Milton T. Mogotsi
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein 9300, South Africa; (R.-L.P.); (P.N.M.); (M.T.M.)
| | - Jeannine Uwimana
- Department of Pediatrics, Kigali University Teaching Hospital, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 4285, Rwanda; (J.U.); (L.M.); (N.M.); (D.M.); (L.T.)
| | - Leon Mutesa
- Department of Pediatrics, Kigali University Teaching Hospital, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 4285, Rwanda; (J.U.); (L.M.); (N.M.); (D.M.); (L.T.)
- Centre for Human Genetics, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 4285, Rwanda
| | - Narcisse Muganga
- Department of Pediatrics, Kigali University Teaching Hospital, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 4285, Rwanda; (J.U.); (L.M.); (N.M.); (D.M.); (L.T.)
| | - Didier Murenzi
- Department of Pediatrics, Kigali University Teaching Hospital, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 4285, Rwanda; (J.U.); (L.M.); (N.M.); (D.M.); (L.T.)
| | - Lisine Tusiyenge
- Department of Pediatrics, Kigali University Teaching Hospital, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 4285, Rwanda; (J.U.); (L.M.); (N.M.); (D.M.); (L.T.)
| | - Mapaseka L. Seheri
- Diarrheal Pathogens Research Unit, Sefako Makgatho Health Sciences University, Medunsa, Pretoria 0204, South Africa; (M.L.S.); (A.D.S.)
| | - A. Duncan Steele
- Diarrheal Pathogens Research Unit, Sefako Makgatho Health Sciences University, Medunsa, Pretoria 0204, South Africa; (M.L.S.); (A.D.S.)
| | - Jason M. Mwenda
- World Health Organization, Regional Office for Africa, Brazzaville P.O. Box 06, Congo;
| | - Martin M. Nyaga
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein 9300, South Africa; (R.-L.P.); (P.N.M.); (M.T.M.)
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Mwangi PN, Potgieter RL, Uwimana J, Mutesa L, Muganga N, Murenzi D, Tusiyenge L, Mwenda JM, Mogotsi MT, Rakau K, Esona MD, Steele AD, Seheri ML, Nyaga MM. The Evolution of Post-Vaccine G8P[4] Group a Rotavirus Strains in Rwanda; Notable Variance at the Neutralization Epitope Sites. Pathogens 2023; 12:658. [PMID: 37242329 PMCID: PMC10223037 DOI: 10.3390/pathogens12050658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Africa has a high level of genetic diversity of rotavirus strains, which is suggested to be a possible reason contributing to the suboptimal effectiveness of rotavirus vaccines in this region. One strain that contributes to this rotavirus diversity in Africa is the G8P[4]. This study aimed to elucidate the entire genome and evolution of Rwandan G8P[4] strains. Illumina sequencing was performed for twenty-one Rwandan G8P[4] rotavirus strains. Twenty of the Rwandan G8P[4] strains had a pure DS-1-like genotype constellation, and one strain had a reassortant genotype constellation. Notable radical amino acid differences were observed at the neutralization sites when compared with cognate regions in vaccine strains potentially playing a role in neutralization escape. Phylogenetic analysis revealed that the closest relationship was with East African human group A rotavirus (RVA) strains for five of the genome segments. Two genome sequences of the NSP4 genome segment were closely related to bovine members of the DS-1-like family. Fourteen VP1 and eleven VP3 sequences had the closest relationships with the RotaTeq™ vaccine WC3 bovine genes. These findings suggest that the evolution of VP1 and VP3 might have resulted from reassortment events with RotaTeq™ vaccine WC3 bovine genes. The close phylogenetic relationship with East African G8P[4] strains from Kenya and Uganda suggests co-circulation in these countries. These findings highlight the need for continued whole-genomic surveillance to elucidate the evolution of G8P[4] strains, especially after the introduction of rotavirus vaccination.
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Affiliation(s)
- Peter N. Mwangi
- Next Generation Sequencing Unit, Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein 9300, South Africa
| | - Robyn-Lee Potgieter
- Next Generation Sequencing Unit, Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein 9300, South Africa
| | - Jeannine Uwimana
- Kigali University Teaching Hospital, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 4285, Rwanda
| | - Leon Mutesa
- Kigali University Teaching Hospital, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 4285, Rwanda
- Centre for Human Genetics, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 4285, Rwanda
| | - Narcisse Muganga
- Kigali University Teaching Hospital, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 4285, Rwanda
| | - Didier Murenzi
- Kigali University Teaching Hospital, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 4285, Rwanda
| | - Lisine Tusiyenge
- Kigali University Teaching Hospital, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 4285, Rwanda
| | - Jason M. Mwenda
- World Health Organization, Regional Office for Africa, Brazzaville P.O. Box 06, Congo
| | - Milton T. Mogotsi
- Next Generation Sequencing Unit, Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein 9300, South Africa
| | - Kebareng Rakau
- Diarrhoeal Pathogens Research Unit, Sefako Makgatho Health Sciences University (MEDUNSA), Pretoria 0204, South Africa
| | - Mathew D. Esona
- Diarrhoeal Pathogens Research Unit, Sefako Makgatho Health Sciences University (MEDUNSA), Pretoria 0204, South Africa
| | - A. Duncan Steele
- Diarrhoeal Pathogens Research Unit, Sefako Makgatho Health Sciences University (MEDUNSA), Pretoria 0204, South Africa
| | - Mapaseka L. Seheri
- Diarrhoeal Pathogens Research Unit, Sefako Makgatho Health Sciences University (MEDUNSA), Pretoria 0204, South Africa
| | - Martin M. Nyaga
- Next Generation Sequencing Unit, Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein 9300, South Africa
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Mutwa PR, Boer KR, Asiimwe-Kateera B, Tuyishimire D, Muganga N, Lange JMA, van de Wijgert J, Asiimwe A, Reiss P, Geelen SPM. Safety and effectiveness of combination antiretroviral therapy during the first year of treatment in HIV-1 infected Rwandan children: a prospective study. PLoS One 2014; 9:e111948. [PMID: 25365302 PMCID: PMC4218827 DOI: 10.1371/journal.pone.0111948] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 10/08/2014] [Indexed: 11/19/2022] Open
Abstract
Background With increased availability of paediatric combination antiretroviral therapy (cART) in resource limited settings, cART outcomes and factors associated with outcomes should be assessed. Methods HIV-infected children <15 years of age, initiating cART in Kigali, Rwanda, were followed for 18 months. Prospective clinical and laboratory assessments included weight-for-age (WAZ) and height-for-age (HAZ) z-scores, complete blood cell count, liver transaminases, creatinine and lipid profiles, CD4 T-cell count/percent, and plasma HIV-1 RNA concentration. Clinical success was defined as WAZ and WAZ >−2, immunological success as CD4 cells ≥500/mm3 and ≥25% for respectively children over 5 years and under 5 years, and virological success as a plasma HIV-1 RNA concentration <40 copies/mL. Results Between March 2008 and December 2009, 123 HIV-infected children were included. The median (interquartile (IQR) age at cART initiation was 7.4 (3.2, 11.5) years; 40% were <5 years and 54% were female. Mean (95% confidence interval (95%CI)) HAZ and WAZ at baseline were −2.01 (−2.23, −1.80) and −1.73 (−1.95, −1.50) respectively and rose to −1.75 (−1.98, −1.51) and −1.17 (−1.38, −0.96) after 12 months of cART. The median (IQR) CD4 T-cell values for children <5 and ≥5 years of age were 20% (13, 28) and 337 (236, 484) cells/mm3respectively, and increased to 36% (28, 41) and 620 (375, 880) cells/mm3. After 12 months of cART, 24% of children had a detectable viral load, including 16% with virological failure (HIV-RNA>1000 c/mL). Older age at cART initiation, poor adherence, and exposure to antiretrovirals around birth were associated with virological failure. A third (33%) of children had side effects (by self-report or clinical assessment), but only 9% experienced a severe side effect requiring a cART regimen change. Conclusions cART in Rwandan HIV-infected children was successful but success might be improved further by initiating cART as early as possible, optimizing adherence and optimizing management of side effects.
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Affiliation(s)
- Philippe R. Mutwa
- Kigali University Teaching Hospital, Department of Pediatrics, Kigali, Rwanda
- Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, The Netherlands
- * E-mail:
| | - Kimberly R. Boer
- Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, The Netherlands
- Biomedical Research, Epidemiology Unit, Royal Tropical Institute, Amsterdam, The Netherlands
| | - Brenda Asiimwe-Kateera
- Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, The Netherlands
| | - Diane Tuyishimire
- Outpatients Clinic, Treatment and Research on HIV/AIDS Centre, Kigali, Rwanda
| | - Narcisse Muganga
- Kigali University Teaching Hospital, Department of Pediatrics, Kigali, Rwanda
| | - Joep M. A. Lange
- Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, The Netherlands
| | - Janneke van de Wijgert
- Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, The Netherlands
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United of Kingdom
- Rinda Ubuzima, Kigali, Rwanda
| | | | - Peter Reiss
- Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, The Netherlands
| | - Sibyl P. M. Geelen
- Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, The Netherlands
- Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands
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Teteli R, Uwineza A, Butera Y, Hitayezu J, Murorunkwere S, Umurerwa L, Ndinkabandi J, Hellin AC, Jamar M, Caberg JH, Muganga N, Mucumbitsi J, Rusingiza EK, Mutesa L. Pattern of congenital heart diseases in Rwandan children with genetic defects. Pan Afr Med J 2014; 19:85. [PMID: 25722758 PMCID: PMC4335284 DOI: 10.11604/pamj.2014.19.85.3428] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 02/28/2014] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Congenital heart diseases (CHD) are commonly associated with genetic defects. Our study aimed at determining the occurrence and pattern of CHD association with genetic defects among pediatric patients in Rwanda. METHODS A total of 125 patients with clinical features suggestive of genetic defects were recruited. Echocardiography and standard karyotype studies were performed in all patients. RESULTS CHDs were detected in the majority of patients with genetic defects. The commonest isolated CHD was ventricular septal defect found in many cases of Down syndrome. In total, chromosomal abnormalities represented the majority of cases in our cohort and were associated with various types of CHDs. CONCLUSION Our findings showed that CHDs are common in Rwandan pediatric patients with genetic defects. These results suggest that a routine echocardiography assessment combined with systematic genetic investigations including standard karyotype should be mandatory in patients presenting characteristic clinical features in whom CHD is suspected to be associated with genetic defect.
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Affiliation(s)
- Raissa Teteli
- Department of Pediatrics, Kigali University Teaching Hospital, University of Rwanda, Kigali, Rwanda
| | - Annette Uwineza
- Center for Medical Genetics, School of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda ; Center for Human Genetics, Centre Hospitalier Universitaire Sart-Tilman, University of Liège, Liège, Belgium ; Department of Clinical Genetics, Kigali University Teaching Hospital, University of Rwanda, Kigali, Rwanda
| | - Yvan Butera
- Medical Student, College of Medicine and Health Sciences, University of Rwanda
| | - Janvier Hitayezu
- Center for Medical Genetics, School of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda ; Department of Clinical Genetics, Kigali University Teaching Hospital, University of Rwanda, Kigali, Rwanda
| | - Seraphine Murorunkwere
- Center for Medical Genetics, School of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda
| | - Lamberte Umurerwa
- Center for Medical Genetics, School of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda
| | - Janvier Ndinkabandi
- Center for Medical Genetics, School of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda
| | - Anne-Cécile Hellin
- Center for Human Genetics, Centre Hospitalier Universitaire Sart-Tilman, University of Liège, Liège, Belgium
| | - Mauricette Jamar
- Center for Human Genetics, Centre Hospitalier Universitaire Sart-Tilman, University of Liège, Liège, Belgium
| | - Jean-Hubert Caberg
- Center for Human Genetics, Centre Hospitalier Universitaire Sart-Tilman, University of Liège, Liège, Belgium
| | - Narcisse Muganga
- Department of Pediatrics, Kigali University Teaching Hospital, University of Rwanda, Kigali, Rwanda
| | - Joseph Mucumbitsi
- Department of Pediatric Cardiology, King Faysal Hospital, Kigali, Rwanda
| | - Emmanuel Kamanzi Rusingiza
- Department of Pediatric Cardiology, Kigali University Teaching Hospital, University of Rwanda, Kigali, Rwanda
| | - Leon Mutesa
- Center for Medical Genetics, School of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda ; Department of Clinical Genetics, Kigali University Teaching Hospital, University of Rwanda, Kigali, Rwanda
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Mutesa L, Muganga N, Lissens W, Boemer F, Schoos R, Pierquin G, Bours V. Molecular analysis in two siblings African patients with severe form of Hunter Syndrome: identification of a novel (p.Y54X) nonsense mutation. J Trop Pediatr 2007; 53:434-7. [PMID: 17616540 DOI: 10.1093/tropej/fmm056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Hunter syndrome (or Mucopolysaccharidosis type II, MPS II) is an X-linked recessive disorder due to the deficiency of the iduronate-2-sulfatase (IDS) enzyme, resulting in the accumulation of heparan and dermatan sulfates in the lysosomes. The heterogeneity of clinical phenotypes, ranging from mild-to-severe forms, is a result of different mutations in the IDS gene. We report here, a novel nonsense mutation (p.Y54X) in two siblings MPS II African patients affected with a severe form of the disease. We postulated that the p.Y54X mutation which causes a loss of the IDS region highly conserved among sulfatase enzymes, could be predicted as a severe disease-causing mutation for Hunter syndrome.
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Affiliation(s)
- Léon Mutesa
- Center for Human Genetics, CHU Sart-Tilman, University of Liège, Belgium
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Muganga N, Uwimana J, Fidele N, Gahimbare L, Gessner BD, Mueller JE, Mhlanga BR, Katsande R, Herbinger KH, Rugambwa C. Haemophilus influenzae type b conjugate vaccine impact against purulent meningitis in Rwanda. Vaccine 2007; 25:7001-5. [PMID: 17709159 DOI: 10.1016/j.vaccine.2007.06.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2007] [Revised: 06/04/2007] [Accepted: 06/04/2007] [Indexed: 11/26/2022]
Abstract
Rwanda introduced Haemophilus influenzae type b (Hib) conjugate vaccine in January 2002 and simultaneously implemented pediatric bacterial meningitis surveillance at a major referral hospital in the capital Kigali. We reviewed clinical and laboratory information collected during January 2002 to June 2006. Due to a variety of laboratory limitations, only eight confirmed Hib cases were identified, all before 2004. However, the proportion of cerebrospinal fluid with purulence decreased from 26.0% during 2002, to 15.9% during 2003, 9.7% during 2004 and 8.4% in 2005 (p<0.001). Vaccine effectiveness of two or three doses of Hib vaccine against purulent meningitis was 52% (95% confidence interval, 5-75%). In an African setting with few resources and in which few confirmed Hib meningitis cases were identified, Hib vaccine impact nevertheless could be demonstrated against the outcome of purulent meningitis and was found to be high.
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Omanga U, Muganga N, Kapepela M. [Bacterial septicemias in children with homozygous sickle cell anemia. Analysis of 69 cases]. Ann Pediatr (Paris) 1989; 36:315-8. [PMID: 2742315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A retrospective analysis of 69 case-reports of children with homozygous sickle cell anemia hospitalized from 1964 through 1985 at the Kinshasa University Pediatric Hospital highlights these patient's high susceptibility to bacterial septicemia. Among causative organisms, the most prevalent were salmonellae (20 cases), pneumococci (15 cases), and klebsiella (12 cases). Clinical features of bacterial septicemia are identical in children with and without sickle cell anemia. Bone and/or joint infections are usually found in salmonella septicemia and meningeal or pleuropulmonary localizations in pneumococcal septicemia. Eighteen children (26%) died, including 10 with pneumococcal septicemia (5 cases) and 10 with Salmonella septicemia (5 cases). Poor prognosis factors include resistance to commonly used antimicrobial agents, frequently found with Salmonella organisms, and concomitant meningeal infection.
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Omanga U, Muganga N. [Fluorescent antibodies in children in acute P. falciparum malaria in an endemic area]. Ann Soc Belg Med Trop 1981; 61:5-14. [PMID: 7027981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Muganga N, Omanga U, Mbensa M. [Diphtheria: incidence, clinical manifestations and complications in urban environment of Kinshasa, Zaire]. Ann Soc Belg Med Trop 1980; 60:307-12. [PMID: 7247517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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