Paediatrics (RCH) - Research Publications

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    Nontyphoid Salmonella Disease
    Gordon, MA ; Feasey, NA ; Nyirenda, TS ; Graham, SM ; Ryan, ET ; Hill, DR ; Solomon, T ; Aronson, NE ; Endy, TP (Elsevier, 2020)
    Nontyphoidal Salmonella (NTS) typically causes self-limiting enterocolitis in high-income settings. In sub-Saharan Africa (SSA), however, NTS is a major cause of bloodstream infections, termed invasive nontyphoidal Salmonella (iNTS) disease, causing an estimated 1.9 million cases and 388,000 deaths annually. In SSA, specific clades of Salmonella Typhimurium and Salmonella Enteritidis associated with genomic degradation and multi-drug resistance have emerged. iNTS disease disproportionately affects adults with advanced HIV infection and young children with immature immunity, HIV, and malaria. Children in SSA bear two-thirds of the burden of disease. The non-specific nature of iNTS disease makes it difficult to differentiate from other causes of non-focal febrile illness, and the widespread emergence of multi-drug resistance and emerging cephalosporin resistance presents increasing treatment challenges. iNTS disease causes a large burden of morbidity and mortality in SSA, and there is much that is still unknown about environmental and host reservoirs and transmission of the pathogen and about optimal therapy for this condition. iNTS is also a problem in other resource-limited areas among individuals with HIV, malaria, and compromised or immature immune systems, although SSA accounts for the largest global burden. Vaccine acceleration is a high priority.
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    Howie, SRC ; Hamer, DH ; GRAHAM, S ; Quah, SR (Elsevier, 2017)
    Pneumonia is an important cause of morbidity and mortality globally. It is the leading cause of death in infants and young children with the majority of these deaths occurring in low income countries. Risk factors affecting incidence and outcome include extremes of age, poor nutrition, immunosuppression, environmental exposures and socioeconomic determinants. Pneumonia can be caused by a wide range of pathogens including bacteria, viruses and fungi, and the etiology varies by epidemiological setting, comorbidities and whether the pneumonia is community-acquired or hospital-acquired. Streptococcus pneumoniae is the major cause of community-acquired bacterial pneumonia while Gram negative bacteria, often resistant to multiple antibiotics, are common causes of hospital-acquired pneumonia and pneumonia in immunosuppressed individuals. Diagnosis is generally clinical and management is based mainly on knowledge of likely causative pathogens as well as clinical severity and presence of known risk factors. Timely and effective antibiotic treatment and oxygen therapy if hypoxemic are critical to patient outcomes. Preventive measures range from improved nutrition and hygiene to specific vaccines that target common causes in children and adults such as the pneumococcal or influenza vaccines.
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    The Roadmap for Childhood Tuberculosis.
    GRAHAM, S ; Detjen, AK ; Starke, JR ; Donald, PR (Oxford University Press, 2016-02-11)
    The Handbook of Child and Adolescent Tuberculosis is a state of the art clinical reference written and edited by the world's leading experts in childhood tuberculosis.
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    Pneumonia in HIV-infected children.
    GRAHAM, S ; Mulholland, K ; Weber, MW (Pinter & Martin Ltd, 2016-02-29)
    A key text about the global health issue of pneumonia, written by experts in the field.