http://dspace.lamu.edu.zm:8080/handle/123456789/117 2026-10-13T05:27:24Z http://dspace.lamu.edu.zm:8080/handle/123456789/196 Title: Acomparison of vitamin D and cathelicidin (LL-37) levels between patients with active TB and their healthy contacts in a high HIV prevalence setting: Authors: Lungu, Patrick Saili; Kilembe, William; Lakhi, Shabir; Sukwa, Thomas; Njelesani, Evarist; Zumla, Alimuddin I; Mwaba, Peter Abstract: Vitamin D(25-OHvitaminD)is afat-soluble vitamin that appears to play an important role in innate and acquired cellular immune responses to human infection with members of the Mycobacterium tuberculosis complex. Both ex vivo and in vivo studies have indicated that vitamin D may enhance the clearance of M. tuberculosis.1-5 Vitamin D stimulates macrophage production of a pore-forming peptide molecule called cathelicidin (LL37) and plays an important role in effecting phagocytosis of M. tuberculosis. LL-37 is raised in patients infected with intracellular pathogens, including active TB disease.6 Torres-Juarez et al. demonstrated the immune modulatory effect of exogenous LL37 by decreasing the production of TNF-alpha and IL-17 and inducing the production of IL-10, which is anti-inflamatory.7 The regions of the world with the highest burden of TB mirror those with the highest burden of vitamin D deficiency. Studies from Asia and Europe have shown an association between vitamin D deficiency and susceptibility to TB.8-10 Conventional assumptions that vitamin D deficiency in sub-Saharan Africa may not be an important factor in TB patients require further study. We performed a prospective observational case-control study to determinelevelsofvitaminDandLL-37inZambianadultpatientswith TB and compare them with healthy controls. Description: This article can be accessed at this link: https://doi.org/10.1093/trstmh/trab126 2021-01-01T00:00:00Z http://dspace.lamu.edu.zm:8080/handle/123456789/191 Title: Immune correlates of Mycobacterium Tuberculosis patients in Zambia stratified by HIV serostatus and level of immunity-a crosssectional analytical laboratory based study Authors: Lungu, Patrick; Njelesani, Evarist; Sukwa, Thomas; Ngalamika, Owen; Munsaka, Sody; Kilembe, William; Lakhi, Shabir; Mwaba, Peter Abstract: Background People living with HIV (PLHIV) co-infected with tuberculosis (TB) have a distinct clinical presentation and poorer treatment outcomes compared to HIV-seronegative TB patients. Excluding low CD4 count, innate immune factors associated with TB are not fully elucidated. We, therefore, characterised and compared the expression of IL-6, TNF-α, IFN-γ, and IL-10 in whole blood of treatment naïve TB patients stimulated with heat-killed Mycobacterium tuberculosis stratified by HIV status and the level of CD4 count. Results We recruited 39 HIV seropositive and 31 HIV seronegative TB patients. Median (IQR) age was 35(28–42) years and 31(25–36) years respectively, and a majority had pulmonary tuberculosis i.e. 38(95%) and 30(97%), respectively. The two groups were significantly different in the distribution of CD4 count, 563 [465–702.5 cells/mm3] vs 345 [157–483 cell/ mm3] in HIV negative vs HIV positive respectively p = <0.001. Post stimulation, the expression of IL-6 in HIV negative TB patients was significantly higher than in the HIV positive 16,757366 [8,827–23,686 pg/ml] vs. 9,508 [5,514–15,008 pg/ml], respectively; p = 0.0360. TNF-α and IFN-γ were highly expressed in HIV negative TB patients compared to the HIV positive though not statistically significant. We only observed higher expression of IL-6 in HIV negative patients in comparison to the HIV positive when stratified by level of CD4 counts as < 500 and � 500 cell/mm3 for both cohorts. 21,953 [8,990–24,206 pg/ml] vs 9,505 [5,400–15,313 pg/ml], p value = 0.0585 in patients with CD4 count < 500 cell/mm3 and 13,168 [7,087–22,584 pg/ml] vs 10,413 [7,397–14,806 pg/ml], p value = 0.3744 for patients with CD4 count of � 500 cell/mm3 respectively. We found a positive pairwise correlation between TNF-α -alpha and IL-6 in both HIV positive and HIV negative patients, r = 0.61(95% CI 0.36–0.72; p < 0.0001) and r = 0.48 (95% CI 0.15–0.68; p = 0.005) respectively. The IFNγ/IL-10 ratio was higher in HIV negative when compared to HIV positive individuals, 0.052 [0.0–0.28] vs 0.007 [0–0.32] respectively; p = 0.05759. IL-6 independently reduced the probability of TB/HIV, Adjusted odds ratio 0.99, p value 0.007. Conclusions This study suggests that HIV seronegative TB patients have a higher pro-inflammatory response to MTB than HIV seropositive TB patients. Further, it also shows that the level of CD4 influences immunomodulation. The findings suggest that the difference in cytokine expression may be responsible for the distinct patterns of TB presentation between HIV positive and HIV negative patient. Description: This article can be accessed at this link: https://doi.org/10.1371/journal.pone.0262454 2022-01-01T00:00:00Z http://dspace.lamu.edu.zm:8080/handle/123456789/185 Title: Strengthening Faculty Recruitment for Health Professions Training in Basic Sciences in Zambia Authors: Simuyemba, Moses; Talib, MD, Zohray; Michelo, Michelo, MD,MPH, MBA, PhD; Wilbroad, Mutale, MD, MPH,; Zulu, Joseph, MSc; Andrews, Benjamin; Nzala, Selestine, MD,; Katubulushi, Max; Njelesani, Evarist; Bowa, Kasonde, MD, DPH,; Maimbolwa, Margaret, BSc, PhD,; Mudenda, John,MD, MSc; Mulla, Yakub,MD, MMed Abstract: Zambia is facing a crisis in its human resources for health, with deficits in the number and skill mix of health workers. The University of Zambia School of Medicine (UNZA SOM) was the only medical school in the country for decades, but recently it was joined by three new medical schools—two private and one public. In addition to expanding medical education, the government has also approved several allied health programs, including pharmacy, physiotherapy, biomedical sciences, and environmental health. This expansion has been constrained by insufficient numbers of faculty. Through a grant from the Medical Education Partnership Initiative (MEPI), UNZA SOM has been investing in ways to address faculty recruitment, training, and retention. The MEPI-funded strategy involves directly sponsoring a cohort of faculty at UNZA SOM during the five-year grant, as well as establishing more than a dozen new master’s programs, with the goal that all sponsored faculty are locally trained and retained. Because the issue of limited basic science faculty plagues medical schools throughout Sub-Saharan Africa, this strategy of using seed funding to build sustainable local capacity to recruit, train, and retain faculty could be a model for the region. Description: This article can be accessed at this link: https://journals.lww.com/academicmedicine/Fulltext/2014/08001/Strengthening_Faculty_Recruitment_for_Health.25.aspx 2014-01-01T00:00:00Z http://dspace.lamu.edu.zm:8080/handle/123456789/179 Title: Plumonary candidiasis in a sixteen year old Zambian African Girl Authors: El, Amin, A.M.; Njelesani, Evarist Abstract: Pulmonary Candidiasis is amongst the rare fungal infections of the bronchopulmonary system encountered on the African continent. Although a few cases of the disease have been reported in certain areas of the continent, none has been described in Zambia. Description: This article can be accessed at this link: https://library.adhl.africa/handle/123456789/11616 1976-01-01T00:00:00Z