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Perspective
HIV–HBV Coinfection — A Global Challenge
Human immunodeficiency virus type 1 (HIV-1) and hepatitis B virus (HBV) exact a high toll worldwide. Both can lead to chronic disease, cancer, and death, and neither can be eradicated with the use of current therapies. Antiviral drug resistance often develops after patients have received treatment…
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Perspective
Measles in the 21st Century
Barely 20 years ago, such a high proportion of childhood deaths globally was attributable to measles that the going estimate of more than 1 million measles-related deaths per year was almost certainly an underestimate. Pediatric wards in the developing world were filled with patients with measles…
- Interactive/Multimedia
Original Article
Albendazole Therapy and Enteric Parasites in United States–Bound Refugees
Approximately 25% of the world's population is infected with intestinal helminths. These neglected tropical infections disproportionately affect the world's least privileged and most vulnerable populations and are among the most common medical conditions in refugees.– Among resettled refugees,…
Review Article
Current Concepts: Dengue
Dengue is a self-limited, systemic viral infection transmitted between humans by mosquitoes. The rapidly expanding global footprint of dengue is a public health challenge with an economic burden that is currently unmet by licensed vaccines, specific therapeutic agents, or efficient vector-control…
- CME
Original Article
Pyronaridine–Artesunate versus Mefloquine plus Artesunate for Malaria
Artemisinin-based combination therapy is critical for the effective treatment and control of Plasmodium falciparum malaria.– However, reports from the Cambodian–Thai border indicate the emergence of artemisinin tolerance or resistance in P. falciparum.– Pyronaridine–artesunate is a fixed…
- CME
Editorial
The Road to an Effective HIV Vaccine
During the 30 years since the discovery of HIV as the cause of AIDS, efforts to develop a vaccine have faced immense challenges. First, naturally acquired immunity to protect against infection that results in disease, found with virtually all other known infectious agents, may not exist for HIV.…
Original Article
HLA Class II Locus and Susceptibility to Podoconiosis
Podoconiosis (endemic nonfilarial elephantiasis) is a noninfectious geochemical disease that results in bilateral swelling of the lower legs (Figure 1). It is found among subsistence farmers whose feet are exposed over many years to red-clay soil derived from volcanic rock. Podoconiosis is an…
Perspective
Tropical Lymphedemas — Control and Prevention
There are two principal causes of elephantiasis, or lymphedema, in the tropics. The most common cause and a significant public health problem is lymphatic filariasis due to the parasitic nematode Wuchereria bancrofti (and, in Asia, Brugia malayi and B. timori), which is transmitted by mosquitoes.…
Perspective
Protecting Service Members in War — Non-Battle Morbidity and Command Responsibility
On August 31, 2011, a 24-year-old soldier from California died from complications of rabies treatment. He was infected months earlier, from a dog bite he sustained in Afghanistan. His death provides a glimpse of the risk of disease and non-battle injuries that service members face in war. Although…
Perspective
The Emerging Threat of Untreatable Gonococcal Infection
It is time to sound the alarm. During the past 3 years, the wily gonococcus has become less susceptible to our last line of antimicrobial defense, threatening our ability to cure gonorrhea and prevent severe sequelae. Gonorrhea is the second most commonly reported communicable disease in the United…
Editorial
Practical Preventive Therapy for Tuberculosis?
Every new episode of tuberculosis — there were 9 million in 2010 — follows a period of asymptomatic infection lasting from weeks to decades. These subclinical infections, which are detectable with a tuberculin skin test or interferon-γ release assay, offer a target for prophylactic treatment…
Original Article
Three Months of Rifapentine and Isoniazid for Latent Tuberculosis Infection
Tuberculosis results in nearly 2 million deaths annually worldwide. More than 2 billion persons are infected with Mycobacterium tuberculosis, and from this reservoir active tuberculosis will develop in millions of persons in coming decades. Treatment of latent M. tuberculosis infection among the…
- CME
Perspective
Global Health: War, Drought, Malnutrition, Measles — A Report from Somalia
Somalia has been in the grips of disaster for two decades. Throughout this past summer, the human catastrophe dramatically worsened. War and drought have driven hundreds of thousands of people from their homes in south and central Somalia, with some families walking for more than a week across the…
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Original Article
First Results of Phase 3 Trial of RTS,S/AS01 Malaria Vaccine in African Children
Each year, malaria occurs in approximately 225 million persons worldwide, and 781,000 persons, mostly African children, die from the disease. During the past decade, the scale-up of malaria-control interventions has resulted in considerable reductions in morbidity and mortality associated with…
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Editorial
A Vaccine for Malaria
It's been a long time coming, and indeed we are still not there yet, but it is becoming increasingly clear that we really do have the first effective vaccine against a parasitic disease in humans. If there are no unforeseen disasters, the RTS,S/AS01 Plasmodium falciparum malaria vaccine should…
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Review Article
Current Concepts: Hepatocellular Carcinoma
Each year, hepatocellular carcinoma is diagnosed in more than half a million people worldwide, including approximately 20,000 new cases in the United States. Liver cancer is the fifth most common cancer in men and the seventh in women. Most of the burden of disease (85%) is borne in developing…
- CME
Each year, more than half a million people worldwide receive a diagnosis of hepatocellular carcinoma, and hepatocellular carcinoma related to HCV is the fastest rising cause of U.S. cancer-related deaths. This review summarizes recent advances in prevention, surveillance, diagnosis, and treatment.
Perspective
The Threat of Artemisinin-Resistant Malaria
In the 1970s, Chinese government scientists working on a secret "Project 523" developed a new class of potent antimalarial drugs, the artemisinins or qinghaosu derivatives. In mostly unpublished work that has just been recognized by a 2011 Lasker Award to Tu Youyou, researchers in China isolated…
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Original Article
A Field Trial to Assess a Blood-Stage Malaria Vaccine
An effective malaria vaccine would improve the prospects for eradicating malaria. Vaccines that interrupt the transmission of malaria are emphasized in discussions of eradication, but the ideal malaria vaccine would provide a direct clinical benefit. Vaccines targeting the blood stages of malaria…
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Correspondence
Protection against Malaria by MSP3 Candidate Vaccine
To the Editor: In 2007, we conducted a double-blind, randomized, phase 1b clinical trial (ClinicalTrials.gov number, NCT00452088) using the merozoite surface protein 3 (MSP3) vaccine in a malaria-endemic area. A total of 45 children who were 12 to 24 months of age were randomly assigned in a 1:1:1…
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Correspondence
Childhood Diarrhea Deaths after Rotavirus Vaccination in Mexico
To the Editor: The World Health Organization (WHO) recommends the use of rotavirus vaccines for all children worldwide to control severe rotavirus disease, which causes 527,000 childhood deaths annually. After the phased national introduction of rotavirus vaccine in Mexico in 2006 and 2007, we…
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