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Within East African countries many of the known infectious diseases of animals occur commonly and are poorly controlled. Foot-and-mouth disease (FMD) is one of the contagious viral diseases that has great impact on economic development both in terms of direct and indirect losses. The epidemiology of the disease is complex due to the presence of six of the seven serotypes and the presence of large numbers of both wild and domestic susceptible animals in the region. Decision-making to determine the importance of FMD control relative to the economic consequences and what FMD control strategies should be applied based on the epidemiological information is required. In this regard the first step is to investigate the genetic relationships/variability of East African isolates and their phylogeographic distribution. These can provide base-line information for designing control strategies by vaccination as well as the determination of the sources of infection. Sufficient genetic information on the FMO serotypes O, SAT-1 and SAT-2 are lacking and therefore the number of viral Iineages and genotypes or topotypes from East African countries could not be determined. Published studies on the relative occurrence and genotype distribution of FMO are largely confined to the southern and western part of the continent. In this study, the genetic profile of the 3 most prevalent serotypes (0, SAT-2 and SAT-1) recovered from outbreaks in East Africa between 1957 and 2003 was addressed. Phylogenetic analysis of partial and complete sequences of the 10 gene revealed the presence of distinct lineages and genotypes for East Africa as well as historical relationships of some of the genotypes with isolates from other regions. A great variation in the occurrence and distribution of these serotypes were found. All the African and the Middle East/South East Asian isolates of serotype O included in this study clustered into one lineage having 8 distinct topotypes. These results indicated that between countries as well as inter-regional (east and west Africa) spread of viruses occurred in the past. Inter-regional spread of the virus between eastern Africa and western Africa was also confirmed for SAT-1 viruses. The fact that phylogenetic links are found with both serotypes implies that the spread of viruses was possibly associated with unrestricted animal movement due to nomadic movement in Africa. The phylogenetic relationships of SAT-1 viruses are more diversified in Africa. Eight lineages and 11 genotypes were identified when the optimal nucleotide sequence differences of ≥ 23% for lineages and ≥ 6% for genotypes were used as a cut-off values. It was observed that viruses from Uganda are evolving independently from viruses elsewhere on the continent and clustered into 3 discrete lineages. In contrast, viruses from countries neighbouring Uganda, Kenya and Tanzania, clustered into one lineage. Uganda also harboured 3 topotypes of SAT-2 virus isolates, one is distinct for Uganda and the other are shared with Kenya and Zaire (DRC). This study highlighted distinct lineages found in Uganda and needs further investigation. Within SAT-2, 67 isolates from 22 African countries and Saudi Arabia clustered into 5 lineages which consisted of 15 genotypes. Clustering of viruses into distinct genotypes (topotypes) according to year of isolation and geographical origin was observed showing countries with common boundaries shared common epizootics in the past. These results also showed a link between eastern and southern African countries. Attempts were also made to investigate the incidence of FMD in Ethiopia using sera collected from cattle, small ruminants and wildlife. The results obtained from the liquid phase blocking ELISA and the 3ABC ELISA indicated the presence of SAT-1 and SAT-2 in buffalo populations in the southern part of Ethiopia while results from small ruminants and other wildlife were not indicative of any significant role in the epidemiology of FMD. Serological results also indicated that SAT-1 is present in cattle, although this serotype has not been previously identified. The cumulative molecular epidemiological results from this and previous studies indicated that genetic variability of FMD viruses can be independently maintained within country/countries or regions as well as inter-regions of Africa. The serological results from buffaloes in East Africa are also suggestive of a possible reservoir of the SAT types FMD in the region which has a great impact on the control of the disease. Furthermore, the numerous lineages and genotypes of FMD virus isolates in Africa having distinct or overlapping distributions as well as the genetic linkage between regions will complicate the epidemiology of the disease. Therefore, it is strategically important to consider a regional approach and the use of a vaccine which contains a cocktails of antigens of FMD virus strains. / Thesis (PhD)--University of Pretoria, 2004. / Veterinary Tropical Diseases / unrestricted

Magister Scientiae - MSc (Chemistry) / Tuberculosis (TB) is one of the major infectious diseases that affect the health of people all over the world. South Africa is one of the countries that account for most of the TB cases; it is the leading cause of death in South Africa and is known to be lethal when combined with HIV in patients. Various tests have been used to diagnose tuberculosis infected patients, but some of these tests give false positive results. Studies have shown that tuberculosis-related cytokines can serve as biological markers for the diagnosis of TB. Cytokines are signalling proteins secreted by immune cells and one such cytokine is interferon-gamma (IFN-?). Interferon-gamma is secreted by immune cells in response to various pathogens and has many physiological roles in the immune system and inflammatory stimuli. IFN-? was first detected using antibody-based immunosensing techniques but this approach is expensive, time consuming and has low stability, it is therefore vital that an alternative detection method for IFN-? be developed.

Objective: Use of ampicillin in outpatient parenteral antimicrobial therapy (OPAT) has historically been complicated by frequent dosing and limited stability. The purpose of this study was to evaluate stability of ampicillin using high-pressure liquid chromatography (HPLC) in an OPAT dosing model using continuous infusion at room temperature over 24 hours immediately following preparation compared with batches stored under refrigeration for 24 hours, 72 hours, and 7 days. Methods: An HPLC method was developed and validated as stability indicating using guidance in USP general Chapter <1225>. Four ampicillin batches were prepared for each experimental condition (immediate use and refrigerated storage for 24 hours, 72 hours, and 7 days). A pump was used to recirculate the solutions through medical-grade tubing for 24 hours. Triplicate 1-mL aliquots were removed from each batch at time 0, 4, 8, 12, and 24 hours and analyzed for ampicillin concentration. Results: Each batch was assayed for initial concentration (20.34-21.50 mg/mL), and percent recovery compared with that concentration thereafter. For the duration of infusion, the average recoveries were 96.4%, 95.8%, 94.6%, and 90.3% for immediate use, 24-hour storage, 72-hour storage, and 7-day storage, respectively. The recovery remained above 90% for all batches and time points, except for 7-day storage, which fell below 90% after 4 hours of circulation. Conclusion: Ampicillin can be prepared and stored in a refrigerator for up to 72 hours prior to continuously infusing at room temperature over 24 hours with less than a 10% loss of potency over the dosing period. This model supports twice weekly OPAT delivery of ampicillin.

This Diploma Thesis deals with the issue of knowledge of second grade pupils of a selected elementary school regarding selected infectious diseases. The aim of this diploma thesis is to find out to what extent pupils aged 11 - 15 are informed about infectious diseases, their transmission, treatment possibilities, protection against them and to what extent their school participates in such awareness procedures. The theoretical part includes the definition and approximation of basic terms concerning epidemiology, hygiene and microbiology. It provides basic information about infectious diseases, transmission methods, protection against them and their treatment. The practical part analyses and evaluates the data obtained by the questionnaire survey among second grade pupils of the selected elementary school. A total of 186 questionnaires were used to evaluate the results. Indeed, the results confirmed that the pupils' knowledge of infectious diseases is not sufficient for their own health and safety development. Many pupils have misinformation about vaccinations, incubation periods and protection against infectious diseases. I would therefore assume, we need to get closer to the pupils` problems of infectious diseases and to improve knowledge in these areas. Furthermore, it is necessary to strengthen...

Conventional methods for the detection of bacterial infection such as DNA or immunoassays are either expensive, time consuming, or not definitive; thus may not provide all the information sought by the medical professionals. In particular, it is difficult to obtain information about viability or drug effectiveness, which are crucial to formulate a treatment. Bacterial culture test is the “gold standard” because it is inexpensive and does not require extensive sample preparation, and most importantly, provides all the necessary information sought by healthcare professionals, such as bacterial presence, viability and drug effectiveness. These conventional culture methods, however, have a long turnaround time: anywhere between 1 day to 4 weeks. This thesis proposes to solve this problem by monitoring the growth of bacteria in thousands of nanowells simultaneously to identify its presence in the sample and its viability, faster. The segmentation of a sample with low bacterial concentration into thousands of nanoliter wells digitizes the samples and increases the effective concentration in those wells that contain bacteria. The user may then monitor the metabolism of the aerobic bacteria by using an oxygen sensitive fluorophore, ruthenium tris (2,2’-diprydl) dichloride hexahydrate (Ru(Bpy)3) by monitoring the dissolved oxygen concentration in the nanowells. Using E.Coli K12, it is demonstrated that the detection time of E.coli can be as fast as 35-60 minutes with sample concentrations varying from 104(62 minutes for detection), 106 (42 minutes) and 108 cells/mL (38 minutes). More importantly, throughout the thesis it is also demonstrated that reducing the well size can reduce the time of detection. Finally, this thesis will discuss how the drug effectiveness information can be obtained in this format by loading the wells with the drug and monitoring the metabolism of the bacteria. The method that is developed in this thesis is low cost, simple, requires minimal sample preparation and can potentially be used with a wide variety of samples in resource poor setting to detect bacterial infections such as Tuberculosis. / Thesis / Master of Science (MSc)

Emerging infectious diseases (EID) pose a serious threat to global public health. Computational epidemiology is a nascent subfield of public health that can provide insight into an outbreak in advance of traditional methodologies. Research in this dissertation will use fuse nontraditional, publicly available data sources with more traditional epidemiological data to build and parameterize models of emerging infectious diseases. These methods will be applied to avian influenza A (H7N9), Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV), and Ebola virus disease (EVD) outbreaks. This effort will provide quantitative, evidenced-based guidance for policymakers and public health responders to augment public health operations. / Ph. D.

Background The use of vaccines is among the most cost-effective tools for preventing infectious diseases and their complications. However, poor uptake and increasing exemption to routine childhood vaccination have been linked with outbreaks of infectious diseases such as measles, pertussis, and more recently poliomyelitis in the US. The objective of the study is to determine the prevalence, pattern, and predisposing factors of vaccine exemptions to childhood immunization amongst parents of children in the Northeast Region from 2017 to 2021. Methods The routine immunization data of children between 1-24 months in the Northeast region, Tennessee from 2017- 2021 was extracted. Based on the population of children within the birth cohort, a random sample of children was selected from birth certificates of children born in the first three months of 2 years prior in Tennessee’s eight counties in the Northeast region. Descriptive statistics with trends, Chi-square, and logistic regression were conducted to delineate factors associated with vaccine exemption in the region. Result The prevalence of vaccine exemption was 2% on average, but the vaccine exemption rate increased significantly from 1.5% in 2019 (pre-COVID pandemic) to 2.5% in 2020 (peri-COVID period). However, the mother’s level of education (aOR=2.37; CI=0.55-10.17), mother’s age (aOR=0.59; CI=0.14-2.51), TennCare attendance (aOR=0.57; CI=0.15-2.21) do not show statistically significant association with exemption to childhood vaccination in Northeast region in Tennessee. Conclusion There appears to be an increasing trend in the vaccine exemption to routine childhood immunizations in the Northeast region of Tennessee over the years. However, the impact of other factors associated with exemptions to childhood vaccinations needs further research.

Plasmodium vivax malaria threatens nearly half the world’s population. This relapsing disease may be more severe than previously recognised and is proving refractory to current malaria control measures. This thesis aimed to describe the burden of anaemia and mortality attributable to vivax malaria in Southern Papua, Indonesia, an area endemic for multidrug-resistant P. vivax and P. falciparum, and to determine the potential of currently available antimalarial drugs to reduce transmission of P. vivax in co-endemic regions. Approximately 0.5 million uniquely identified clinical records from patients presenting to Mitra Masyarakat Hospital between April 2004 and May 2009 were matched with corresponding laboratory and pharmacy data in order to determine the burden of anaemia in the hospital setting and the effectiveness of primaquine prescription for preventing P. vivax relapses. Clinical information extracted from patient notes was used to clarify the contribution of P. vivax malaria to a series of deaths detected by an active hospital-based surveillance system. Additional secondary sources of data used in this thesis included a large house-to-house survey and multiple clinical trials of antimalarial therapy from both Southern Papua and Northwestern Thailand. In Southern Papua, P. vivax malaria is an important cause of haematological morbidity both in the hospital and community setting. This morbidity is most significant in the first year of life when P. vivax infection accounts for 23% of all severe anaemia (haemoglobin <5g/dL) in the hospital and approximately 28% of all moderate-to-severe anaemia (haemoglobin <7g/dL) in the community. In this region concomitant P. vivax infection accentuates haematological impairment associated with P. falciparum malaria. Plasmodium vivax in Southern Papua rarely causes death directly but rather indirectly contributes to mortality through exacerbation of comorbid conditions. In Northwestern Thailand, 53.8% of patients with falciparum malaria who were treated with a rapidly eliminated drug between 1991 and 2005 had a recurrence of vivax malaria within two months making P. vivax infection the most common cause of parasitological failure in these individuals. Slowly eliminated artemisinin combination therapies (ACT) provided the greatest protection against recurrent P. vivax parasitaemia during 63 days of follow-up. In three randomised controlled trials from Papua and Thailand, P. vivax gametocytaemia was shown to mirror asexual parasitaemia closely and to have the same characteristics in acute and recurrent infections. This emphasises that the most important chemotherapeutic means of blocking P. vivax transmission is prevention of future relapse. Primaquine is recommended for this purpose but analyses in this thesis suggest that in Southern Papua, unsupervised primaquine at a dose of 0.5mg/kg/day for 14 days, does not reduce the risk of subsequent relapse (Adjusted Hazard Ratio = 1.01 [95% confidence interval 0.95-1.07]). Plasmodium vivax malaria should not be neglected. High priority must be given to new hypnozoitocidal drug discovery. In the interim, optimising the safety and effectiveness of primaquine and adoption of a unified ACT-based blood schizontocidal treatment strategy for malaria of any parasitological cause in co-endemic regions will be crucial for controlling P. vivax malaria.

<div><p>Zika virus (ZIKV) is a mosquito-borne pathogen that stayed unnoticed for over half a century. Only after the 2015-16 Brazilian outbreak did the severity of the infectious outcome, particularly the Congenital Zika Syndrome, become apparent. ZIKV is associated with severe neurodevelopmental impairments in human fetuses, including microencephaly, ventriculomegaly, retinopathy, and sensorineural hearing loss. Though the pandemic is now under control in the Latin American countries, several tropical countries could still be at risk of widespread infection. This warrants a better understanding of the congenital Zika syndrome; this project attempts to contribute towards this goal.</p><p><br></p><p>Previous reports examining neural progenitor tropism of ZIKV in organoid and animal models did not address whether the virus infects all neural progenitors uniformly. To explore this, ZIKV was injected into the neural tube of 2-day-old chicken embryos, resulting in non-uniform periventricular infection 3 days later. Recurrent foci of intense infection were present at specific signaling centers that influence neuroepithelial patterning at a distance through secretion of morphogens. ZIKV infection reduced transcript levels for 3 morphogens, SHH, BMP7, and FGF8, expressed at the midbrain basal plate, hypothalamic floor plate, and isthmus, respectively. Levels of Patched1, a SHH-pathway downstream gene, were also reduced and a SHH-dependent cell population in the ventral midbrain was shifted in position. Thus, the diminishment of signaling centers through ZIKV-mediated apoptosis may yield broader, non-cell autonomous changes in brain patterning.</p><p><br></p></div><p>Sensorineural hearing loss is a relatively understudied consequence of congenital Zika syndrome, and balance disorders are essentially unreported to date. ZIKV pathogenesis was explored in the developing inner ear using the accessible chicken embryo model system. One goal was to assess the spatiotemporal susceptibility of otic epithelial-derived structures to ZIKV infectivity. Direct injections of the inner ear or the inner ear primordium were performed <i>in ovo</i>with subsequent harvests at 2 to 8 days-post-infection. The degree of infection in sensory/prosensory organs was evaluated histologically to determine the susceptibility of one auditory and five vestibular organs. ZIKV infection of the sensory as well as non-sensory epithelia was observed at most stages of analysis, with no apparent preference for one over the other. The lagena, the ventral most tip of the chicken inner ear, and the endolymphatic sac/duct were least frequently infected. In this report, two novel findings in sequela of ZIKV infection are presented: the vestibular labyrinth can present with stalled canal morphogenesis, and the auditory ganglion can be severely shrunken, perhaps due to an increased cell death upon early ZIKV infection of the inner ear.</p><p><br></p><p>Additional methods of peripheral infection in the chicken embryos were tested to examine ZIKV transmission to the central nervous system: E3 blood vessel, E4 limb bud, and E10 chorioallantoic membrane infections. Although none of these methods resulted in a histologically significant infection of the developing brain 3 to 6 days-post-infection, evidence of ZIKV genome replication and viremia was detected in several tissue types.<br></p>