Norbert Heinrich

Publications (15) View all

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  Available from: Norbert Heinrich

  Article: High seroprevalence for typhus group rickettsiae, southwestern Tanzania.

  Tatjana Dill, Gerhard Dobler, Elmar Saathoff, Petra Clowes, Inge Kroidl, Elias Ntinginya, Harun Machibya, Leonard Maboko, Thomas Löscher, Michael Hoelscher, Norbert Heinrich
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  ABSTRACT: Rickettsioses caused by typhus group rickettsiae have been reported in various African regions. We conducted a cross-sectional survey of 1,227 participants from 9 different sites in the Mbeya region, Tanzania; overall seroprevalence of typhus group rickettsiae was 9.3%. Risk factors identified in multivariable analysis included low vegetation density and highway proximity.
  Emerging Infectious Diseases 02/2013; 19(2):317-20. · 6.79 Impact Factor
• Article: Direct comparison of Xpert MTB/RIF with liquid and solid mycobacterial culture for the quantification of early bactericidal activity

  X. A. Kayigire, S. O. Friedrich, A. Venter, R. Dawson, S. H. Gillespie, M. J. Boeree, N. Heinrich, M. Hoelscher, A. H. Diacon
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  ABSTRACT: The early bactericidal activity of antituberculosis agents is usually determined by measuring the reduction of the sputum mycobacterial load over time on solid agar media or in liquid culture. This study investigated the value of a quantitative PCR for early bactericidal activity determination. Groups of 15 patients were treated with 6 different antituberculosis agents or regimens. Patients collected sputum for 16 hours overnight at baseline and at day 7 and 14 after treatment initiation. We determined the sputum bacterial load by colony forming unit counting (CFU, logCFU/ml sputum +/-SD), time to culture positivity (TTP, hours +/-SD) in liquid culture and Xpert MTB/RIF cycle thresholds (CT, n +/-SD). The ability to discriminate treatment effects between groups was analyzed with One-Way-ANOVA. All measurements showed a decrease in bacterial load from mean baseline (logCFU: 5.72 +/-1.00; TTP: 116.0 +/-47.6; CT: 19.3 +/-3.88) to day 7 (logCFU: -0.26 +/-1.23, P=0.2112; TTP: 35.5 +/-59.3, P=0.0002; CT: 0.55 +/-3.07, P=0.603) and day 14 (logCFU: -0.55 +/-1.24, P=0.0006; TTP: 54.8 +/-86.8, P<0.0001; CT: 2.06 +/-4.37, P=0.002). The best discrimination between group effects was found with TTP at day 7 and day 14 (F=9.012, P<0.0001 and F=11.58, P<0.0001), followed by logCFU (F=4.135, P=0.0024 and F=7.277, P<0.0001). CT was not significantly discriminative (F=1.995, P=0.091 and F=1.203, P=0.316, respectively). Culture based methods are superior to PCR for the quantification of early antituberculosis treatments effects in sputum.
  J Clin Microbiol. 01/2013;
• Article: Performance of the Xpert® MTB/RIF assay in an active case-finding strategy: a pilot study from Tanzania [Short communication].

  E N Ntinginya, S B Squire, K A Millington, B Mtafya, E Saathoff, N Heinrich, G Rojas-Ponce, D Kowuor, L Maboko, K Reither, P Clowes, M Hoelscher, A Rachow
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  ABSTRACT: In this pilot study, we evaluated the Xpert® MTB/RIF assay in an active case-finding strategy, using two spot sputum samples collected within a 1-hour interval from household contacts of smear-positive TB index cases. Tuberculosis (TB) confirmed by culture served as the reference standard. Among 219 enrolled contacts, the yield of active TB was 2.3%. While the sensitivity of smear microscopy was 60% (95%CI 14.7-94.7), Xpert MTB/RIF achieved a sensitivity of 100% (95%CI 47.81-100.0). All culture-confirmed cases tested positive by Xpert MTB/RIF on the first submitted sample, suggesting that the evaluation of only one sample could be sufficient for TB diagnosis in this context.
  The international journal of tuberculosis and lung disease: the official journal of the International Union against Tuberculosis and Lung Disease 09/2012; 16(11):1468-70. · 2.73 Impact Factor
• Article: A case of disseminated tuberculosis with psoas abscess in a 12-year-old girl with sickle cell trait.

  N Heinrich, J Prusseit, M Born, G Fleischhack, A Simon
  Klinische Pädiatrie 04/2012; 224(3):195-6. · 1.77 Impact Factor
• Article: Evaluation of tuberculosis diagnostics in children: 2. Methodological issues for conducting and reporting research evaluations of tuberculosis diagnostics for intrathoracic tuberculosis in children. Consensus from an expert panel.

  Luis E Cuevas, Renee Browning, Patrick Bossuyt, Martina Casenghi, Mark F Cotton, Andrea T Cruz, Lori E Dodd, Francis Drobniewski, Marianne Gale, Stephen M Graham, [......], Richard Oberhelman, Paul Palumbo, Estelle Russek-Cohen, David E Shapiro, Betsy Smith, Giselle Soto-Castellares, Jeffrey R Starke, Soumya Swaminathan, Claire Wingfield, Carol Worrell
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  ABSTRACT: Confirming the diagnosis of childhood tuberculosis is a major challenge. However, research on childhood tuberculosis as it relates to better diagnostics is often neglected because of technical difficulties, such as the slow growth in culture, the difficulty of obtaining specimens, and the diverse and relatively nonspecific clinical presentation of tuberculosis in this age group. Researchers often use individually designed criteria for enrollment, diagnostic classifications, and reference standards, thereby hindering the interpretation and comparability of their findings. The development of standardized research approaches and definitions is therefore needed to strengthen the evaluation of new diagnostics for detection and confirmation of tuberculosis in children. In this article we present consensus statements on methodological issues for conducting research of Tuberculosis diagnostics among children, with a focus on intrathoracic tuberculosis. The statements are complementary to a clinical research case definition presented in an accompanying publication and suggest a phased approach to diagnostics evaluation; entry criteria for enrollment; methods for classification of disease certainty, including the rational use of culture within the case definition; age categories and comorbidities for reporting results; and the need to use standard operating procedures. Special consideration is given to the performance of microbiological culture in children and we also recommend for alternative methodological approaches to report findings in a standardized manner to overcome these limitations are made. This consensus statement is an important step toward ensuring greater rigor and comparability of pediatric tuberculosis diagnostic research, with the aim of realizing the full potential of better tests for children.
  The Journal of Infectious Diseases 04/2012; 205 Suppl 2:S209-15. · 6.41 Impact Factor