Browsing by Author "Surendra Uranw"

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Clinical Research on Neglected Tropical Diseases: Challenges and Solutions
(Public Library of Science, 2016) Marleen Boelaert; The NIDIAG Consortium; Barbara Barbé; Emmanuel Bottieau; Christophe Burm; Philippe Büscher; Jozefien Buyze; Stijn Deborggraeve; Koen De Winne; Philippe Gillet; David Hendrickx; Arabella Huys; Jan Jacobs; Veerle Lejon; Filip Meheus; Joris Menten; Evelien Paessens; Katja Polman; Raffaella Ravinetto; Stijn Rogé; Céline Schurmans; Achilleas Tsoumanis; Johan Van Griensven; Harry van Loen; Kristien Verdonck; Cédric Yansouni; François Chappuis; Emilie Alirol; Ninon S. Horié; Suman Rijal; Nisha K. Bhatta; Narayan R. Bhattarai; Prahlad Karki; Basudha Khanal; Kanika Koirala; Bickram Pradhan; Surendra Uranw; Jürg Utzinger; Sören L. Becker; Martin W. Bratschi; Justin K. Chatigre; Jean T. Coulibaly; Jean-Paul Gohou; Mathias Herrmann; Stefanie Knopp; Hanspeter Marti; Eliézer K. N’Goran; Beatrice Nickel; Pierre H.H. Schneeberger; Kigbafori D. Silué; Peter Steinmann; Lutz von Müller; Penelope Vounatsou; Joel A. Yao; Patrick K. Yao; Peiling Yap; Pascal Lutumba; Claude Basilua; Edmonde Bonebe; Gustave Bukasa; Sebastien Inamba; Jean Roger Kalo Lilo; Vincent Kambale; Tharcisse Kayembe; Octavie Lunguya; Maria Mashako; Luigi Mininkulu; Alain Mpanya; Deby Mukendi; Dieudonné Mumba; Jean-Jacques Muyembe; Pati Pyan; Sayda El-Safi; Mannar Abdel-Rahman; Saad Ageed Al farazdag; Atia Atia; Abdallah Bashir; Ahmed Bashir; Mohammed Bashir; Mohamedelfateh Eljack; Alhabib Elhabib; Husam Elshikh; Awad Hammad; Mohammed Issa; Mohamed S. Mohamed; Mohammed O. Mohammedali; Salah Mohammed Ali; Modether Morsal; Shawgi Hago Almugadam; Lim Kruy; P. Maling Ellen; Leng Long; Manoza Maricel; Saman Ratanakneary; Bouy Sok; Sok Sopheak; Ros Sreyphors; Teav Syna; Sopheak Thai; Phe Thong; So Veasna; Che Yanith; Michael Miles; Tapan Bhattacharyya; Sakib Burza; Graham Clark; Andrew Falconar; Tegwen Marlais; Adelaide Michaels; Rosanna Peeling; Matthew Yeo; Shyam Sundar; Shahnawaj Alam; Jaya Chakravarty; Poonam Kumari; Madhukar Rai; Deepak K. Verma; Pascal Mertens; Stéphane Degallaix; Laurence Denorme; Quentin Gilleman; Thierry Leclipteux; Thomas Simon; Caroline Thunissen; Moussa Sacko; Cheik O. Coulibaly; Birama D. Diakité; Mama N. Doumbia; Aly Landouré; Rénion Saye; Mamadou S. Traoré; Hassan K.M. Fofana; Yodi Mahendradhata; Riris A. Ahmad; Bintari Dwihardiani; Norma S. Hurif; Rizqiani A. Kusumasari; Fransiska Meyanti; Elsa H. Murhandarwati; Haripurnomo Kushadiwijaya; Trisasi Lestari; Irene M. Rahakbauw; Ratih Restiani; Supargiyono; Henry Surendra; Mohamad Syairaji; Jarir A. Thobari
[No abstract available]
Evolutionary genomics of epidemic visceral leishmaniasis in the Indian subcontinent
(eLife Sciences Publications Ltd, 2016) Hideo Imamura; Tim Downing; Frederik van den Broeck; Mandy J. Sanders; Suman Rijal; Shyam Sundar; An Mannaert; Manu Vanaerschot; Maya Berg; Géraldine de Muylder; Franck Dumetz; Bart Cuypers; Ilse Maes; Malgorzata Domagalska; Saskia Decuypere; Keshav Rai; Surendra Uranw; Narayan Raj Bhattarai; Basudha Khanal; Vijay Kumar Prajapati; Smriti Sharma; Olivia Stark; Gabriele Schönian; Harry P. de Koning; Luca Settimo; Benoit Vanhollebeke; Syamal Roy; Bart Ostyn; Marleen Boelaert; Louis Maes; Matthew Berriman; Jean-Claude Dujardin; James A. Cotton
Leishmania donovani causes visceral leishmaniasis (VL), the second most deadly vector- borne parasitic disease. A recent epidemic in the Indian subcontinent (ISC) caused up to 80% of global VL and over 30,000 deaths per year. Resistance against antimonial drugs has probably been a contributing factor in the persistence of this epidemic. Here we use whole genome sequences from 204 clinical isolates to track the evolution and epidemiology of L. donovani from the ISC. We identify independent radiations that have emerged since a bottleneck coincident with 1960s DDT spraying campaigns. A genetically distinct population frequently resistant to antimonials has a two base-pair insertion in the aquaglyceroporin gene LdAQP1 that prevents the transport of trivalent antimonials. We find evidence of genetic exchange between ISC populations, and show that the mutation in LdAQP1 has spread by recombination. Our results reveal the complexity of L. donovani evolution in the ISC in response to drug treatment. © Imamura et al.
Longlasting insecticidal nets for prevention of Leishmania donovaniinfection in India and Nepal: Paired cluster randomised trial
(2011) Albert Picado; Shri Prakash Singh; Suman Rijal; Shyam Sundar; Bart Ostyn; François Chappuis; Surendra Uranw; Kamlesh Gidwani; Basudha Khanal; Madhukar Rai; Ishwari Sharma Paudel; Murari Lal Das; Rajiv Kumar; Pankaj Srivastava; Jean Claude Dujardin; Veerle Vanlerberghe; Elisabeth Wreford Andersen; Clive Richard Davies; Marleen Boelaert
Objective: To test the effectiveness of large scale distribution of longlasting nets treated with insecticide in reducing the incidence of visceral leishmaniasis in India and Nepal. Design: Paired cluster randomised controlled trial designed to detect a 50% reduction in incidence of Leishmania donovani infection. Setting: Villages in Muzaffarpur district in India and Saptari, Sunsari, and Morang districts in Nepal. Participants: 13 intervention and 13 control clusters. 12 691 people were included in the analysis of the main outcome (infection), and 19 810 were enrolled for the secondary (disease) end point. Intervention: Longlasting insecticidal nets (treated with deltamethrin) were distributed in the intervention clusters in December 2006. Main outcome measures: Infection was determined by direct agglutination test at 12 and 24 months after the intervention in those who had negative results (titre <1:1600) at baseline. The effect estimate was computed as the geometric mean of the risk ratios for seroconversion for each cluster pair (net/no net), with its 95% confidence interval. Formal tests of effect of no intervention were obtained with a paired t test. Results: There was no significant difference in the risk of seroconversion over 24 months in intervention (5.4%; 347/6372) compared with control (5.5%; 345/6319 people) clusters (risk ratio 0.90, 95% confidence interval 0.49 to 1.65) nor in the risk of clinical visceral leishmaniasis (0.99, 0.46 to 1.40). Adjustment for covariates did not alter these conclusions. Conclusions: There is no evidence that large scale distribution of longlasting insecticidal nets provides additional protection against visceral leishmaniasis compared with existing control practice in the Indian subcontinent. The observed effect was small and not significant, though the confidence intervals did not exclude a 50% change in either direction. Trial registration: Clinical Trials NCT 2005-015374.
Residual activity and integrity of PermaNet® 2.0 after 24 months of household use in a community randomised trial of long lasting insecticidal nets against visceral leishmaniasis in India and Nepal
(2012) Albert Picado; Shri Prakash Singh; Veerle Vanlerberghe; Surendra Uranw; Bart Ostyn; Harparkash Kaur; Murari Lal Das; Shyam Sundar; Suman Rijal; Patrick Tungu; Marleen Boelaert; Mark Rowland
The World Health Organization (WHO) recommends several brands of long lasting insecticidal net (LN) for protection against insect vectors but also advises national programmes to monitor and evaluate performance under local conditions to help them select the most suitable LN for their setting. During the course of a community randomised trial of LNs against visceral leishmaniasis in northern India and Nepal, opportunity arose to assess the efficacy of PermaNet 2.0 (Vestergaard-Frandsen, Denmark) after two years of use against sandfly vectors. Between 63% (India) and 78% (Nepal) of LNs became holed over the course of two years, deltamethrin residues fell from 55mg/m2 to an average of 11.6mg/m2 (India) and 27.9mg/m2 (Nepal), but on the basis of bioassay criteria all LNs tested still met the WHO Pesticide Evaluation Scheme standard for LN effectiveness. Nets had on average only been washed 2.5 times (India) and 0.6 times (Nepal) by householders over the course of two years. The loss of insecticide was attributed to factors which had little or nothing to do with washing, such as handling, friction and torsion during daily use. Under conditions pertaining in this region of south Asia, and for two years at least, this brand of net continues to meet the criteria established by WHO for LNs. © 2011 Royal Society of Tropical Medicine and Hygiene.
Retrospective Quarterly Cohort Monitoring for patients with Visceral Leishmaniasis in the Indian subcontinent: Outcomes of a pilot project
(2013) Bart Ostyn; Paritosh Malaviya; Epco Hasker; Surendra Uranw; Rudra P. Singh; Suman Rijal; Shyam Sundar; Jean-Claude Dujardin; Marleen Boelaert
Objective: To evaluate a new tool for the monitoring of Visceral Leishmaniasis (VL) treatment outcomes in primary healthcare (PHC) settings, adapted from the standardised Retrospective Quarterly Cohort Monitoring done in tuberculosis control. Methods: We developed standard case definitions for early and late VL treatment outcomes, a single register allowing for one-line entry per patient as registration tool, and quarterly reporting formats for the clinical outcomes. We pilot-tested these tools in three Indian Primary Health Centres and two Nepalese district hospitals, as well as in a charity VL treatment centre and a university hospital. Results: Data collection for early treatment outcome was easily implemented but information on late treatment outcome was hard to obtain. Effectiveness of Miltefosine under routine care conditions was about 87% at end of treatment, and 76% at 6 months post-treatment related to the high number of patients lost to follow up at the latter end point. Conclusion: A retrospective cohort monitoring methodology is conceptually a good framework for monitoring clinical outcomes for chronic conditions as VL. The monitoring of early outcomes of VL treatment is perfectly feasible in Primary Care settings. The completeness of information on late outcomes can be improved by a number of strategies that remain to be field tested. Generally, clinical outcome monitoring should be strengthened in the VL control programmes. © 2013 John Wiley & Sons Ltd.
Risk factors for visceral leishmaniasis and asymptomatic Leishmania donovani infection in India and Nepal
(Public Library of Science, 2014) Albert Picado; Bart Ostyn; Shri Prakash Singh; Surendra Uranw; Epco Hasker; Suman Rijal; Shyam Sundar; Marleen Boelaert; François Chappuis
There is increasing interest in the role of asymptomatic infection in transmission of Visceral Leishmaniasis (VL). We studied the individual, household and environmental factors associated with asymptomatic Leishmania donovani infected individuals and VL. 7,538 individuals living in VL endemic villages in India and Nepal were divided into three mutually exclusive groups based on their VL history and Direct Agglutination Test (DAT) results in yearly serosurveys over a two-year period. The groups were (1) VL cases, (2) asymptomatically infected individuals (seroconverters) and (3) seronegative individuals. VL cases and seroconverters were compared to seronegative individuals in mixed logistic regression models. The risk of seroconversion and disease was significantly increased in individuals aged 14 to 24 years old and by the presence of other DAT-positive, asymptomatically infected individuals and VL cases in the house. The risk of seroconversion was higher in Indian than in Nepalese villages and it increased significantly with age, but not so for VL. This study demonstrates that, when risk factors for leishmanial infection and VL disease are evaluated in the same population, epidemiological determinants for asymptomatic infection and VL are largely similar. © 2014 Picado et al.
Serological markers of sand fly exposure to evaluate insecticidal nets against visceral leishmaniasis in India and Nepal: A cluster-randomized trial
(2011) Kamlesh Gidwani; Albert Picado; Suman Rijal; Shri Prakash Singh; Lalita Roy; Vera Volfova; Elisabeth Wreford Andersen; Surendra Uranw; Bart Ostyn; Medhavi Sudarshan; Jaya Chakravarty; Petr Volf; Shyam Sundar; Marleen Boelaert; Matthew Edward Rogers
Background: Visceral leishmaniasis is the world' second largest vector-borne parasitic killer and a neglected tropical disease, prevalent in poor communities. Long-lasting insecticidal nets (LNs) are a low cost proven vector intervention method for malaria control; however, their effectiveness against visceral leishmaniasis (VL) is unknown. This study quantified the effect of LNs on exposure to the sand fly vector of VL in India and Nepal during a two year community intervention trial. Methods: As part of a paired-cluster randomized controlled clinical trial in VL-endemic regions of India and Nepal we tested the effect of LNs on sand fly biting by measuring the antibody response of subjects to the saliva of Leishmania donovani vector Phlebotomus argentipes and the sympatric (non-vector) Phlebotomus papatasi. Fifteen to 20 individuals above 15 years of age from 26 VL endemic clusters were asked to provide a blood sample at baseline, 12 and 24 months post-intervention. Results: A total of 305 individuals were included in the study, 68 participants provided two blood samples and 237 gave three samples. A random effect linear regression model showed that cluster-wide distribution of LNs reduced exposure to P. argentipes by 12% at 12 months (effect 0.88; 95% CI 0.83-0.94) and 9% at 24 months (effect 0.91; 95% CI 0.80-1.02) in the intervention group compared to control adjusting for baseline values and pair. Similar results were obtained for P. papatasi. Conclusions: This trial provides evidence that LNs have a limited effect on sand fly exposure in VL endemic communities in India and Nepal and supports the use of sand fly saliva antibodies as a marker to evaluate vector control interventions. © 2011 Gidwani et al.