History and perspectives of medical research at the Albert Schweitzer Hospital in Lambaréné, Gabon

Ramharter, Michael; Adegnika, Ayôla Akim; Agnandji, Selidji Todagbé; Matsiegui, Pierre Blaise; Grobusch, Martin P.; Winkler, Stefan; Graninger, Wolfgang; Krishna, Sanjeev; Yazdanbakhsh, Maria; Mordmüller, Benjamin; Lell, Bertrand; Missinou, Michel A.; Mavoungou, Elie; Issifou, Saadou; Kremsner, Peter G.

doi:10.1007/s00508-007-0857-5

Cited by 52 publications

(48 citation statements)

References 31 publications

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“…6 Patients were recruited at five different sites in Lambaréné: 1) in-and outpatient departments of HAS; 2) in-and outpatient departments of Georges Rawiri Regional Hospital (CHRGR); 3) local outpatient HIV clinic (Centre de Traitement Ambulatoire [CTA]); 4) local outpatient TB clinic (Base d'épidémiologie [BELE]); and 5) CERMEL; thus representing all "ports of entry" for TB patients into the local health-care system (catchment area of approximately 50,000 people).…”

Section: Methodsmentioning

confidence: 99%

Tuberculosis Treatment Outcome and Drug Resistance in Lambaréné, Gabon: A Prospective Cohort Study

Bélard

Remppis

Bootsma

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Despite overall global progress in tuberculosis (TB) control, TB remains one of the deadliest communicable diseases. This study prospectively assessed TB epidemiology in Lambaréné, Gabon, a Central African country ranking 10th in terms of TB incidence rate in the 2014 World Health Organization TB report. In Lambaréné, between 2012 and 2014, 201 adult and pediatric TB patients were enrolled and followed up; 66% had bacteriologically confirmed TB and 95% had pulmonary TB. The human immunodeficiency virus (HIV) coinfection rate was 42% in adults and 16% in children. Mycobacterium tuberculosis and Mycobacterium africanum were identified in 82% and 16% of 108 culture-confirmed TB cases, respectively. Isoniazid (INH) and streptomycin yielded the highest resistance rates (13% and 12%, respectively). The multidrug resistant TB (MDR-TB) rate was 4/91 (4%) and 4/13 (31%) in new and retreatment TB cases, respectively. Treatment success was achieved in 53% of patients. In TB/HIV coinfected patients, mortality rate was 25%. In this setting, TB epidemiology is characterized by a high rate of TB/HIV coinfection and low treatment success rates. MDR-TB is a major public health concern; the need to step-up in-country diagnostic capacity for culture and drug susceptibility testing as well as access to second-line TB drugs urgently requires action.

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Section: Methodsmentioning

confidence: 99%

Tuberculosis Treatment Outcome and Drug Resistance in Lambaréné, Gabon: A Prospective Cohort Study

Bélard

Remppis

Bootsma

et al. 2016

The American Society of Tropical Medicine and Hygiene

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“…Exclusion criteria were known HIV infection, allergy to albendazole, severe anemia, and any other underlying severe physical condition. The study was conducted from August 2010 to June 2011 at the Centre de Recherches Médicales de Lambaréné, Gabon (formerly Medical Research Unit) (25,26). Study participants resided in the rural villages of Makouke and Bindo, situated approximately 50 kilometers northeast of Lambaréné on both sides of the Ogooué River.…”

Section: Methodsmentioning

confidence: 99%

Randomized, Controlled, Assessor-Blind Clinical Trial To Assess the Efficacy of Single- versus Repeated-Dose Albendazole To Treat Ascaris lumbricoides, Trichuris trichiura, and Hookworm Infection

Adegnika

Zinsou

Issifou

et al. 2014

Antimicrob Agents Chemother

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In many regions where soil-transmitted helminth infections are endemic, single-dose albendazole is used in mass drug administration programs to control infections. There are little data on the efficacy of the standard single-dose administration compared to that of alternative regimens. We conducted a randomized, controlled, assessor-blinded clinical trial to determine the efficacies of standard and extended albendazole treatment against soil-transmitted helminth infection in Gabon. A total of 175 children were included. Adequate cure rates and egg reduction rates above 85% were found with a single dose of albendazole for Ascaris infection, 85% (95% confidence interval [CI], 73, 96) and 93.8% (CI, 87.6, 100), respectively, while two doses were necessary for hookworm infestation (92% [CI, 78, 100] and 92% [CI, 78, 100], respectively). However, while a 3-day regimen was not sufficient to cure Trichuris (cure rate, 83% [CI, 73, 93]), this regimen reduced the number of eggs up to 90.6% (CI, 83.1, 100). The rate ratios of two-and three-dose regimens compared to a single-dose treatment were 1.7 (CI, 1.1, 2.5) and 2.1 (CI, 1.5, 2.9) for Trichuris and 1.7 (CI, 1.0, 2.9) and 1.7 (CI, 1.0, 2.9) for hookworm. Albendazole was safe and well tolerated in all regimens. A singledose albendazole treatment considerably reduces Ascaris infection but has only a moderate effect on hookworm and Trichuris infections. The single-dose option may still be the preferred regimen because it balances efficacy, safety, and compliance during mass drug administration, keeping in mind that asymptomatic low-level helminth carriage may also have beneficial effects. (This study has been registered at ClinicalTrials.gov under registration number NCT01192802.) S oil-transmitted helminths affect more than two billion people worldwide (1, 2). They are widely endemic in the tropics and are prevalent mostly in preschool and school-age children (3, 4) as well as in pregnant women (5). Infections are related to poor sanitation and hygiene and classified as neglected tropical diseases (6). These infections are responsible for significant morbidity, which includes anemia (7,8), stunting (9), and iron and vitamin A deficiencies (10-13). Additionally, helminth infections have the capacity to reduce the host immune response to vaccines as well as to environmental and parasitic antigens (14-16). The consequences of such hyporesponsiveness may explain changes in host susceptibility to commonly encountered pathogens, as reported recently (17)(18)(19). However, helminths may have beneficial effects as well, such as dampening of excessive inflammatory responses against other pathogens or environmental antigens (14, 20,21). Nevertheless, it is commonly accepted that the risks of helminth infection outweigh the benefits, and several public health interventions are in place to control soil-transmitted helminths.Albendazole is frequently used in mass drug administration (MDA) campaigns as a principal control tool for intestinal helminth infections (2,(22)(23)(24). Howeve...

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“…Unit of the Albert Schweitzer Hospital in Lambaréné, Gabon (38). The epidemiological situation there is characterized by a stable transmission of Plasmodium falciparum throughout the year, with a nearly 100% predominance of chloroquine-resistant field strains since 1995 (34).…”

Section: Study Design and Study Drug Administration Three Phase I Clmentioning

confidence: 99%

Pharmacokinetics of Ferroquine, a Novel 4-Aminoquinoline, in Asymptomatic Carriers of Plasmodium falciparum Infections

Supan

Mombo-Ngoma

Dal-Bianco

et al. 2012

Antimicrob Agents Chemother

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Ferroquine (SSR97193), a ferrocene-quinoline conjugate, is a promising novel antimalarial currently undergoing clinical evaluation. This study characterizes its pharmacokinetic properties. Young male African volunteers with asymptomatic Plasmodium falciparum infection were administered a single oral dose (n ‫؍‬ 40) or a repeated oral dose (n ‫؍‬ 26) given over 3 days of ferroquine in two dose-escalation, double-blind, randomized, placebo-controlled clinical trials. In addition, a food interaction study was performed in a subsample of participants (n ‫؍‬ 16). The studies were carried out in Lambaréné, Gabon. After single-dose administration of ferroquine, dose linearity was demonstrated in a dose range of 400 to 1,200 mg for maximum mean blood concentrations ([C max ] 82 to 270 ng/ml) and in a dose range of 400 to 1,600 mg for overall exposure to ferroquine (area under the concentration-time curve [AUC], 13,100 to 49,200 ng · h/ml). Overall mean estimate for blood apparent terminal half-life of ferroquine was 16 days and 31 days for its active and major metabolite desmethylferroquine (SSR97213). In the 3-day repeated-dose study, C max and overall cumulated exposure to ferroquine (AUC cum ) increased in proportion with the dose from day 1 to day 3 between 400 and 800 mg. No major food effect on ferroquine pharmacokinetics was observed after single administration of 100 mg of ferroquine except for a slight delay of time to maximum blood concentration (t max ) by approximately 3 h. The pharmacokinetics of ferroquine and its active main metabolite are characterized by sustained levels in blood, and the properties of ferroquine as a partner drug in antimalarial combination therapy should be evaluated.

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History and perspectives of medical research at the Albert Schweitzer Hospital in Lambaréné, Gabon

Cited by 52 publications

References 31 publications

Tuberculosis Treatment Outcome and Drug Resistance in Lambaréné, Gabon: A Prospective Cohort Study

Tuberculosis Treatment Outcome and Drug Resistance in Lambaréné, Gabon: A Prospective Cohort Study

Randomized, Controlled, Assessor-Blind Clinical Trial To Assess the Efficacy of Single- versus Repeated-Dose Albendazole To Treat Ascaris lumbricoides, Trichuris trichiura, and Hookworm Infection

Pharmacokinetics of Ferroquine, a Novel 4-Aminoquinoline, in Asymptomatic Carriers of Plasmodium falciparum Infections

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