2023
Paenibacillus spp infection among infants with postinfectious hydrocephalus in Uganda: an observational case-control study
Morton S, Hehnly C, Burgoine K, Ssentongo P, Ericson J, Kumar M, Hagmann C, Fronterre C, Smith J, Movassagh M, Streck N, Bebell L, Bazira J, Kumbakumba E, Bajunirwe F, Mulondo R, Mbabazi-Kabachelor E, Nsubuga B, Natukwatsa D, Nalule E, Magombe J, Erickson T, Ngonzi J, Ochora M, Olupot-Olupot P, Onen J, Ssenyonga P, Mugamba J, Warf B, Kulkarni A, Lane J, Whalen A, Zhang L, Sheldon K, Meier F, Kiwanuka J, Broach J, Paulson J, Schiff S. Paenibacillus spp infection among infants with postinfectious hydrocephalus in Uganda: an observational case-control study. The Lancet Microbe 2023, 4: e601-e611. PMID: 37348522, PMCID: PMC10529524, DOI: 10.1016/s2666-5247(23)00106-4.Peer-Reviewed Original ResearchConceptsMother-newborn pairsPostinfectious hydrocephalusCerebrospinal fluidNeonatal sepsisSpp infectionUgandan infantsMaternal bloodObservational case-control studyHospital OfficeInfant's cerebrospinal fluidBurden of morbidityCase-control studyRoute of infectionSubset of participantsMaternal feverCranial ultrasoundNeonatal infectionSepsis cohortOptimise treatmentTransplacental transmissionCord bloodObservational studyPlacental samplesSepsisHydrocephalusNeonatal Paenibacilliosis: Paenibacillus Infection as a Novel Cause of Sepsis in Term Neonates With High Risk of Sequelae in Uganda
Ericson J, Burgoine K, Kumbakumba E, Ochora M, Hehnly C, Bajunirwe F, Bazira J, Fronterre C, Hagmann C, Kulkarni A, Kumar M, Magombe J, Mbabazi-Kabachelor E, Morton S, Movassagh M, Mugamba J, Mulondo R, Natukwatsa D, Kaaya B, Olupot-Olupot P, Onen J, Sheldon K, Smith J, Ssentongo P, Ssenyonga P, Warf B, Wegoye E, Zhang L, Kiwanuka J, Paulson J, Broach J, Schiff S. Neonatal Paenibacilliosis: Paenibacillus Infection as a Novel Cause of Sepsis in Term Neonates With High Risk of Sequelae in Uganda. Clinical Infectious Diseases 2023, 77: 768-775. PMID: 37279589, PMCID: PMC10495130, DOI: 10.1093/cid/ciad337.Peer-Reviewed Original ResearchConceptsNeonatal sepsisPostinfectious hydrocephalusCerebrospinal fluidSigns of sepsisFull-term neonatesOptimal antibiotic treatmentUgandan referral hospitalQuantitative polymerase chain reactionNeonatal characteristicsClinical sepsisTerm neonatesUnderdiagnosed causeAntibiotic choiceMedian ageReferral hospitalUgandan hospitalNeurodevelopmental impairmentAdverse outcomesSpecimen typesAntibiotic treatmentPolymerase chain reactionClinical signsUnusual pathogensSepsisHigh risk
2022
Type IV Pili Are a Critical Virulence Factor in Clinical Isolates of Paenibacillus thiaminolyticus
Hehnly C, Shi A, Ssentongo P, Zhang L, Isaacs A, Morton S, Streck N, Erdmann-Gilmore P, Tolstoy I, Townsend R, Limbrick D, Paulson J, Ericson J, Galperin M, Schiff S, Broach J. Type IV Pili Are a Critical Virulence Factor in Clinical Isolates of Paenibacillus thiaminolyticus. MBio 2022, 13: e02688-22. PMID: 36374038, PMCID: PMC9765702, DOI: 10.1128/mbio.02688-22.Peer-Reviewed Original ResearchConceptsPostinfectious hydrocephalusClinical isolatesVirulence factorsCritical virulence factorPotential virulence factorsPoor long-term outcomesPrevention of hydrocephalusLong-term outcomesBacterial pathogensDevastating sequelaeNeonatal sepsisMiddle-income countriesNeonatal infectionSurgical interventionReference strainsNovel bacterial pathogensAfrican cohortBeta-lactamase genesChildhood mortalityHydrocephalusTherapeutic targetInfectionVirulent strainDevastating diseaseWhole-genome sequencingCytomegalovirus infections in infants in Uganda: Newborn-mother pairs, neonates with sepsis, and infants with hydrocephalus
Hehnly C, Ssentongo P, Bebell L, Burgoine K, Bazira J, Fronterre C, Kumbakumba E, Mulondo R, Mbabazi-Kabachelor E, Morton S, Ngonzi J, Ochora M, Olupot-Olupot P, Mugamba J, Onen J, Roberts D, Sheldon K, Sinnar S, Smith J, Ssenyonga P, Kiwanuka J, Paulson J, Meier F, Ericson J, Broach J, Schiff S. Cytomegalovirus infections in infants in Uganda: Newborn-mother pairs, neonates with sepsis, and infants with hydrocephalus. International Journal Of Infectious Diseases 2022, 118: 24-33. PMID: 35150915, PMCID: PMC9058984, DOI: 10.1016/j.ijid.2022.02.005.Peer-Reviewed Original ResearchConceptsNewborn-mother pairsCMV prevalenceClinical sepsisCytomegalovirus infectionCerebrospinal fluidPrevalence of CMVQuantitative PCRCMV positivityPostinfectious hydrocephalusVaginal sheddingCMV infectionHIV seropositivityNeonatal ageMaternal ageMaternal vaginalRisk factorsMedical CenterLong-term consequencesMother pairsSepsisNeonatesInfantsPrevalenceHydrocephalusCMV
2021
Preoperative risk and postoperative outcome from subdural fluid collections in African infants with postinfectious hydrocephalus.
Lane J, Ssentongo P, Peterson M, Harper J, Mbabazi-Kabachelor E, Mugamba J, Ssenyonga P, Onen J, Donnelly R, Levenbach J, Cherukuri V, Monga V, Kulkarni A, Warf B, Schiff S. Preoperative risk and postoperative outcome from subdural fluid collections in African infants with postinfectious hydrocephalus. Journal Of Neurosurgery Pediatrics 2021, 29: 31-39. PMID: 34598146, PMCID: PMC9078082, DOI: 10.3171/2021.7.peds21209.Peer-Reviewed Original ResearchVaginal microbiome topic modeling of laboring Ugandan women with and without fever
Movassagh M, Bebell L, Burgoine K, Hehnly C, Zhang L, Moran K, Sheldon K, Sinnar S, Mbabazi-Kabachelor E, Kumbakumba E, Bazira J, Ochora M, Mulondo R, Nsubuga B, Weeks A, Gladstone M, Olupot-Olupot P, Ngonzi J, Roberts D, Meier F, Irizarry R, Broach J, Schiff S, Paulson J. Vaginal microbiome topic modeling of laboring Ugandan women with and without fever. Npj Biofilms And Microbiomes 2021, 7: 75. PMID: 34508087, PMCID: PMC8433417, DOI: 10.1038/s41522-021-00244-1.Peer-Reviewed Original ResearchConceptsIntrapartum feverClinical variablesHigh prevalenceVaginal microbiomeUgandan womenLonger labour durationMaternal clinical featuresYoung maternal ageDuration of pregnancyOnset of laborMicrobial communitiesVaginal microbial communitiesAfebrile mothersFebrile mothersPeripartum courseMaternal feverNeonatal outcomesLabor durationClinical featuresMaternal ageVaginal microbesFeverOutcome riskVeillonella genusMicrobiome influences
2020
Paenibacillus infection with frequent viral coinfection contributes to postinfectious hydrocephalus in Ugandan infants
Paulson J, Williams B, Hehnly C, Mishra N, Sinnar S, Zhang L, Ssentongo P, Mbabazi-Kabachelor E, Wijetunge D, von Bredow B, Mulondo R, Kiwanuka J, Bajunirwe F, Bazira J, Bebell L, Burgoine K, Couto-Rodriguez M, Ericson J, Erickson T, Ferrari M, Gladstone M, Guo C, Haran M, Hornig M, Isaacs A, Kaaya B, Kangere S, Kulkarni A, Kumbakumba E, Li X, Limbrick D, Magombe J, Morton S, Mugamba J, Ng J, Olupot-Olupot P, Onen J, Peterson M, Roy F, Sheldon K, Townsend R, Weeks A, Whalen A, Quackenbush J, Ssenyonga P, Galperin M, Almeida M, Atkins H, Warf B, Lipkin W, Broach J, Schiff S. Paenibacillus infection with frequent viral coinfection contributes to postinfectious hydrocephalus in Ugandan infants. Science Translational Medicine 2020, 12 PMID: 32998967, PMCID: PMC7774825, DOI: 10.1126/scitranslmed.aba0565.Peer-Reviewed Original ResearchConceptsPostinfectious hydrocephalusCSF samplesPIH casesPotential causative organismsCerebrospinal fluid accumulationCytomegalovirus coinfectionUgandan infantsNeonatal sepsisSurgical palliationNeonatal infectionInfant casesOptimal treatmentInfant cohortCommon causeCausative organismPediatric hydrocephalusFluid accumulationHydrocephalusAnaerobic bacterial isolatesControl casesInfectionFacultative anaerobic bacterial isolatesInfantsParasitic DNADisease
2019
The Incidence of Postoperative Seizures Following Treatment of Postinfectious Hydrocephalus in Ugandan Infants: A Post Hoc Comparison of Endoscopic Treatment vs Shunt Placement in a Randomized Controlled Trial.
Punchak M, Mbabazi Kabachelor E, Ogwal M, Nalule E, Nalwoga J, Ssenyonga P, Mugamba J, Rattani A, Dewan M, Kulkarni A, Schiff S, Warf B. The Incidence of Postoperative Seizures Following Treatment of Postinfectious Hydrocephalus in Ugandan Infants: A Post Hoc Comparison of Endoscopic Treatment vs Shunt Placement in a Randomized Controlled Trial. Neurosurgery 2019, 85: e714-e721. PMID: 31086941, PMCID: PMC7534394, DOI: 10.1093/neuros/nyz122.Peer-Reviewed Original ResearchConceptsChoroid plexus cauterizationETV/CPCPostoperative seizure incidencePostinfectious hydrocephalusSeizure incidenceEndoscopic third ventriculostomyUgandan infantsShunt placementMantel-Haenszel hazard ratiosKaplan-Meier methodVentriculoperitoneal shunt placementPostoperative epilepsyPostoperative seizuresPreoperative symptomsEpilepsy incidenceFirst seizureHazard ratioControlled TrialsEndoscopic treatmentThird ventriculostomyTreatment modalitiesSeizure riskHead circumferenceRelative riskSeizure onset
2018
Changes in Ugandan Climate Rainfall at the Village and Forest Level
Ssentongo P, Muwanguzi A, Eden U, Sauer T, Bwanga G, Kateregga G, Aribo L, Ojara M, Mugerwa W, Schiff S. Changes in Ugandan Climate Rainfall at the Village and Forest Level. Scientific Reports 2018, 8: 3551. PMID: 29476058, PMCID: PMC5824879, DOI: 10.1038/s41598-018-21427-5.Peer-Reviewed Original ResearchConceptsDaily rainfall estimatesShort-term anomaliesRainfall estimatesRainfall decreaseHistorical rainfallAtmospheric AdministrationNational OceanographicAverage rainfallRainfallComplete recordsAgricultural regionsBwindi ForestAfrican continentSouthwest UgandaOverall decreaseAgriculture productionWestern UgandaSignificant implicationsWildlife habitatOceanographicContinentARC2AnomaliesGorilla habitatForest level
2017
Endoscopic Treatment versus Shunting for Infant Hydrocephalus in Uganda
Kulkarni A, Schiff S, Mbabazi-Kabachelor E, Mugamba J, Ssenyonga P, Donnelly R, Levenbach J, Monga V, Peterson M, MacDonald M, Cherukuri V, Warf B. Endoscopic Treatment versus Shunting for Infant Hydrocephalus in Uganda. New England Journal Of Medicine 2017, 377: 2456-2464. PMID: 29262276, PMCID: PMC5784827, DOI: 10.1056/nejmoa1707568.Peer-Reviewed Original ResearchConceptsETV-CPCPostinfectious hydrocephalusUgandan infantsTreatment failureCognitive outcomesBrain volumeSingle-center studyEndoscopic third ventriculostomyChoroid plexus cauterizationMajor health problemSignificant differencesLanguage scoresSecondary outcomesEndoscopic treatmentPrimary outcomeVentricular sizeThird ventriculostomyInfant hydrocephalusComputed tomographyTreatment groupsAlternative treatmentLate failureBayley ScalesBrain growthConventional treatment
2016
Prevalence and correlates of MRSA and MSSA nasal carriage at a Ugandan regional referral hospital
Bebell L, Ayebare A, Boum Y, Siedner M, Bazira J, Schiff S, Metlay J, Bangsberg D, Ttendo S, Firth P. Prevalence and correlates of MRSA and MSSA nasal carriage at a Ugandan regional referral hospital. Journal Of Antimicrobial Chemotherapy 2016, 72: 888-892. PMID: 27999030, PMCID: PMC5890783, DOI: 10.1093/jac/dkw472.Peer-Reviewed Original ResearchConceptsMRSA carriageMSSA carriersSA carriageNasal carriageAntibiotic useStaphylococcus aureusOpen woundsMRSA nasal carriage prevalenceUgandan Regional Referral HospitalMultivariable logistic regression analysisMSSA nasal carriageNasal carriage prevalenceSurgical ward admissionRegional Referral HospitalMRSA nasal carriageCurrent antibiotic useLogistic regression analysisResource-limited settingsMRSA carriersSA infectionsWard admissionHIV infectionReferral hospitalCarriage prevalenceAnterior nares
2014
Volumetric brain analysis in neurosurgery: Part 2. Brain and CSF volumes discriminate neurocognitive outcomes in hydrocephalus.
Mandell J, Kulkarni A, Warf B, Schiff S. Volumetric brain analysis in neurosurgery: Part 2. Brain and CSF volumes discriminate neurocognitive outcomes in hydrocephalus. Journal Of Neurosurgery Pediatrics 2014, 15: 125-32. PMID: 25431901, DOI: 10.3171/2014.9.peds12427.Peer-Reviewed Original ResearchConceptsFrontal-occipital horn ratioNeurocognitive outcomesBrain volumeCSF volumeFluid volumePediatric patientsBrain developmentEvaluation of hydrocephalusGoal of treatmentSmaller brain volumesLower cognitive outcomesPoor neurocognitive outcomesNormal brain developmentLarge fluid volumesHealthy brain developmentVolumetric brain analysisSurgical treatmentVentricular sizeHydrocephalic patientsCT scanHydrocephalusPatientsBayley ScalesBrain growthFine motorVolumetric brain analysis in neurosurgery: Part 3. Volumetric CT analysis as a predictor of seizure outcome following temporal lobectomy.
Mandell J, Hill K, Nguyen D, Moser K, Harbaugh R, McInerney J, Nsubuga B, Mugamba J, Johnson D, Warf B, Boling W, Webb A, Schiff S. Volumetric brain analysis in neurosurgery: Part 3. Volumetric CT analysis as a predictor of seizure outcome following temporal lobectomy. Journal Of Neurosurgery Pediatrics 2014, 15: 133-43. PMID: 25431899, DOI: 10.3171/2014.9.peds12428.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAnterior Temporal LobectomyBrainCerebrospinal FluidChildChild, PreschoolCognitionCone-Beam Computed TomographyEpilepsy, Temporal LobeFemaleFrontal LobeHumansHydrocephalusInfantMagnetic Resonance ImagingMaleNeurosurgical ProceduresOccipital LobeOrgan SizePredictive Value of TestsSeizuresTreatment OutcomeUgandaConceptsTemporal lobe volumeMesial temporal sclerosisTemporal lobe epilepsyTemporal lobe resectionSeizure outcomeTemporal lobeVolumetric CT analysisBrain volumeLobe volumeSeizure controlStructural MRILobe resectionEngel class Ia outcomeClass Ia outcomeSelection of patientsCT volumetric analysisPreoperative CT scanSmaller brain volumesSmaller temporal lobeCURE Children's HospitalIncomplete seizure controlNormalized brain volumeWhole brain volumeCT analysisTemporal lobe structures
2013
The Microbial Spectrum of Neonatal Sepsis in Uganda: Recovery of Culturable Bacteria in Mother-Infant Pairs
Kiwanuka J, Bazira J, Mwanga J, Tumusiime D, Nyesigire E, Lwanga N, Warf B, Kapur V, Poss M, Schiff S. The Microbial Spectrum of Neonatal Sepsis in Uganda: Recovery of Culturable Bacteria in Mother-Infant Pairs. PLOS ONE 2013, 8: e72775. PMID: 24013829, PMCID: PMC3754959, DOI: 10.1371/journal.pone.0072775.Peer-Reviewed Original ResearchConceptsNeonatal sepsisMother-infant pairsVaginal specimensConsecutive mother-infant pairsMicrobial spectrumSeptic newborn infantsCerebrospinal fluid culturesBacterial culture techniquesSensitive molecular approachesClinical criteriaNewborn infantsPutative causative agentFluid cultureInfant bloodMaternal bloodSepsisCerebrospinal fluidSpinal fluidInfantsBloodCausative agentMaternal transmissionEnvironmental sourcesIdentifiable bacteriaCulture techniques
2012
Rainfall drives hydrocephalus in East Africa.
Schiff S, Ranjeva S, Sauer T, Warf B. Rainfall drives hydrocephalus in East Africa. Journal Of Neurosurgery Pediatrics 2012, 10: 161-7. PMID: 22768966, DOI: 10.3171/2012.5.peds11557.Peer-Reviewed Original Research
2011
Costs and benefits of neurosurgical intervention for infant hydrocephalus in sub-Saharan Africa.
Warf B, Alkire B, Bhai S, Hughes C, Schiff S, Vincent J, Meara J. Costs and benefits of neurosurgical intervention for infant hydrocephalus in sub-Saharan Africa. Journal Of Neurosurgery Pediatrics 2011, 8: 509-21. PMID: 22044378, DOI: 10.3171/2011.8.peds11163.Peer-Reviewed Original ResearchConceptsBenefit-cost ratioDisability-adjusted life yearsHuman capital approachEconomic benefitsNeurosurgical interventionCapital approachCost/disability-adjusted life yearStatistical life approachFavorable benefit-cost ratioTotal economic benefitPotential economic impactMajor public health priorityEndoscopic third ventriculostomyBenefits of treatmentCases of hydrocephalusVSL approachPublic health priorityEconomic modelingCURE Children's HospitalTreatment of hydrocephalusEconomic impactLife yearsUntreated hydrocephalusRetrospective reviewShunt placementFive-year survival and outcome of treatment for postinfectious hydrocephalus in Ugandan infants.
Warf B, Dagi A, Kaaya B, Schiff S. Five-year survival and outcome of treatment for postinfectious hydrocephalus in Ugandan infants. Journal Of Neurosurgery Pediatrics 2011, 8: 502-8. PMID: 22044377, DOI: 10.3171/2011.8.peds11221.Peer-Reviewed Original ResearchConceptsPostinfectious hydrocephalusFive-year survivalShunt placementPrimary brain injuryWorse functional outcomeKaplan-Meier methodLong-term outcomesLog-rank testOutcome of treatmentEndoscopic third ventriculostomyTreatment selection biasPublic health measuresOne-thirdUgandan infantsWorst sequelaeOperative mortalityNeonatal infectionFunctional outcomeThird ventriculostomyBrain injuryPrimary treatmentCommon causeInfant hydrocephalusSurvival advantageOriginal infectionAssociation of bacteria with hydrocephalus in Ugandan infants.
Li L, Padhi A, Ranjeva S, Donaldson S, Warf B, Mugamba J, Johnson D, Opio Z, Jayarao B, Kapur V, Poss M, Schiff S. Association of bacteria with hydrocephalus in Ugandan infants. Journal Of Neurosurgery Pediatrics 2011, 7: 73-87. PMID: 21194290, DOI: 10.3171/2010.9.peds10162.Peer-Reviewed Original ResearchConceptsUgandan infantsNeonatal sepsisPostinfectious hydrocephalusMajority of patientsMost patientsRecent infectionPolymerase chain reactionEffective treatmentPatientsPrevention strategiesHydrocephalusInfectionInfantsAcinetobacter speciesChain reactionAssociation of bacteriaBacterial DNAGram-negative bacteriaNegative bacteriaSepsisEnvironmental samplingSyndromeSeason infection