P Godfrey-Faussett

Publications (73)640.59 Total impact

• Article: Ivermectin in the treatment of onchocerciasis in Britain.

  P Godfrey-Faussett, C Dow, M E Black, A D Bryceson
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  ABSTRACT: Thirty-one patients with onchocerciasis were treated with a single dose of 150-200 micrograms/kg ivermectin. They were observed for three days to detect acute reactions and were reassessed clinically and parasitologically three, six and twelve months after treatment. 22 patients were expatriates. All had early, light and often localised infections and were not reexposed to infection during the course of the study. 25 patients completed follow-up. Patients who relapsed were retreated with the same dose after an interval of not less than five months. Adverse reactions were less severe than those experienced by similar patients treated with diethylcarbamazine and only one patient was given corticosteroids. 17 patients (68%) relapsed within one year and two thirds of these had done so within 6 months. A similar pattern was seen after the second dose. A single dose of ivermectin, repeated every three to six months as necessary, is likely to be the treatment of choice for patients in non-endemic areas, lightly infected with Onchocerca volvulus, until a safe macrofilaricidal drug emerges. One third of such patients may be cured with each treatment.
  Tropical medicine and parasitology: official organ of Deutsche Tropenmedizinische Gesellschaft and of Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) 07/1991; 42(2):82-4.
• Article: Adverse reactions in expatriates treated with ivermectin.

  R N Davidson, P Godfrey-Faussett, A D Bryceson
  The Lancet 11/1990; 336(8721):1005. · 38.28 Impact Factor
• Article: Diagnosis of pulmonary disease in human immunodeficiency virus infection: role of transbronchial biopsy and bronchoalveolar lavage.

  M H Griffiths, G Kocjan, R F Miller, P Godfrey-Faussett
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  ABSTRACT: The value of transbronchial biopsy and bronchoalveolar lavage was assessed in the diagnosis of pulmonary disease in patients infected with the human immunodeficiency virus (HIV). Seventy four transbronchial biopsy and 66 bronchoalveolar lavage specimens (60 paired specimens) from 80 examinations in 64 patients were reviewed. Pneumocystis carinii was the most common pathogen isolated (43 patients). Bronchoalveolar lavage was superior to transbronchial biopsy for the diagnosis of this pathogen, the sensitivities being 90% and 56%. Cytomegalovirus was identified three times by lavage and once by transbronchial biopsy. Neither method detected Kaposi's sarcoma in the one patient shown to have it by open lung biopsy. The complication rate in a concurrent study of bronchoscopy with transbronchial biopsy in 74 consecutive HIV positive patients was 22%. This study does not support the use of transbronchial biopsy in these patients.
  Thorax 08/1989; 44(7):554-8. · 6.84 Impact Factor
• Article: Nebulised pentamidine as treatment for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome.

  R F Miller, P Godfrey-Faussett, S J Semple
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  ABSTRACT: Nebulised pentamidine was used to treat 30 patients with Pneumocystis carinii pneumonia. Fourteen patients (group 1) received pentamidine isethionate 4 mg/kg (six patients) or 8 mg/kg (eight patients) via a standard jet nebuliser (Acorn, system 22) with a flow rate of 8 l/min. The aerosol droplets had a mass median aerodynamic diameter of 2.6 microns (geometric standard deviation (GSD) 2.9) and 46% of droplets were less than 3.9 microns. A further 16 patients (group 2) received 8 mg/kg pentamidine via a jet nebuliser with baffles to limit droplet size to below 4 microns (Respirgard II). This generated aerosol droplets with a mass median aerodynamic diameter of 0.8 micron (GSD 1.5) and 98% were less than 3.9 microns. Only three of the 14 patients in group 1 responded clinically to treatment, one after the lower dose of pentamidine. Treatment was discontinued in 10 patients and one patient died at bronchoscopy from haemorrhage. Thirteen of the 16 patients in group 2 responded. Side effects occurred infrequently; two patients from group 1 had a cough, six patients (four from group 2) had contact bleeding at bronchoscopy, and two further patients had haemoptysis. The differing response rate may be due to differences in the mean droplet size of the aerosols produced by the nebulisers. Nebulised pentamidine (8 mg/kg) when delivered by Respirgard II nebuliser appears to be as effective as conventional treatment for Pneumocystis carinii pneumonia of mild to moderate severity.
  Thorax 08/1989; 44(7):565-9. · 6.84 Impact Factor
• Article: Nebulised pentamidine.

  P Godfrey-Faussett, R F Miller, S J Semple
  The Lancet 04/1988; 1(8586):645-6. · 38.28 Impact Factor
• Article: A trial of a three-dose regimen of ivermectin for the treatment of patients with onchocerciasis in the UK.

  D R Churchill, P Godfrey-Faussett, H D Birley, A Malin, R N Davidson, A D Bryceson
  Transactions of the Royal Society of Tropical Medicine and Hygiene 88(2):242. · 2.16 Impact Factor
• Article: Recruitment to a trial of tuberculosis preventive therapy from a voluntary HIV testing centre in Lusaka: relevance to implementation.

  P Godfrey-Faussett, R Baggaley, A Mwinga, M Hosp, J Porter, N Luo, M Kelly, R Msiska, K McAdam
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  ABSTRACT: To determine the number of clients attending for voluntary human immunodeficiency virus (HIV) testing who are able to enter a trial of preventive therapy for tuberculosis, and the factors that determine who receives therapy, we studied 475 consecutive people attending for an HIV test at Lusaka's first voluntary HIV testing centre and the preventive therapy study clinic at the University Teaching Hospital, Lusaka, Zambia. Semi-structured interviews were conducted by counsellors and collated with recruitment data from the trial. Two hundred and twenty-five people were seropositive, of whom 201 returned to collect their results; 77 (38%) of these (16% of the total number screened) entered the trial. Reasons for not entering the trial included exclusion by trial protocol (30), including 18 who had active tuberculosis; psychological adjustment to a positive result (27); death (6); worries about confidentiality (3); the experimental nature of the trial (12); attitudes of staff in the hospital (5); and cost of transport (7). Targeting preventive therapy at those who are already choosing to be tested for HIV seems appropriate and may be cost-effective. Although visiting a hospital may deter some people, the prevalence of active tuberculosis among this group emphasized the importance of arranging adequate screening facilities.
  Transactions of the Royal Society of Tropical Medicine and Hygiene 89(4):354-8. · 2.16 Impact Factor
• Article: Tuberculosis treatment failure and drug resistance--same strain or reinfection?

  P Sonnenberg, J Murray, S Shearer, J R Glynn, B Kambashi, P Godfrey-Faussett
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  ABSTRACT: Tuberculosis patients may have Mycobacterium tuberculosis in their sputum at the end of treatment, and may show new drug resistance, due to either inadequate treatment of the original episode or reinfection with a new strain during therapy. In a cohort study of mineworkers with tuberculosis in South Africa, 57 of 438 patients had positive sputum cultures 6 months after recruitment in 1995. Of the 31 patients who initially had fully sensitive strains, 3 developed multidrug resistance (MDR) and 3 single-drug resistance (SDR). Of the 6 who started with SDR, 3 became MDR. HIV infection was not associated with drug resistance at enrollment or 6 months later. We compared pairs of DNA fingerprints from isolates of M. tuberculosis at recruitment and 6 months later in the 48 patients for whom we had both available. In 45, the pairs were identical. In 1 patient, although both isolates were fully sensitive, the later fingerprint had 1 less band (transposition). In 2 pairs, the fingerprint patterns were completely different: one seemed to be the result of laboratory error and the other was a true reinfection with an MDR strain. Despite a high risk of infection, with a moderate proportion of background drug-resistant strains (11% SDR, 6% MDR), reinfection is not a common cause of treatment failure or drug resistance at 6 months.
  Transactions of the Royal Society of Tropical Medicine and Hygiene 94(6):603-7. · 2.16 Impact Factor
• Article: DNA fingerprints of Mycobacterium tuberculosis do not change during the development of rifampicin resistance

  P. Godfrey-Faussett, N.G. Stoker, J.A.G. Scott, G. Pasvol, P. Kelly, L. Clancy
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  ABSTRACT: Drug-resistant tuberculosis has become a major public health problem. Resistance to rifampicin probably arises through mutations in the mycobacterial RNA polymerase. Patients may acquire rifampicin resistant tuberculosis by three mechanisms: (1) infection with a resistant organism, (2) selection of a sub-population of resistant organisms that remain contained whilst the more virulent wild type is present, (3) mutations within the population of bacilli causing the original infection. Sequential isolates of Mycobacterium tuberculosis were collected from 2 patients who developed rifampicin resistance whilst on treatment. One patient was immunosuppressed with HIV-infection; in the other patient the original isolate was also resistant to isoniazid. DNA fingerprinting techniques were used to type the isolates. No differences were found between the fingerprints of isolates from before and after the development of resistance. These data suggest that the third of the mechanisms listed above was responsible for the acquisition of rifampicin resistance in these 2 patients.RésuméLa tuberculose résistant aux drogues est devenue un problème majeur de santé publique. La résistance à la rifampicine est probablement due aux mutations de la ARN-polymérase mycobactérienne. Des patients peuvent acquérir une tuberculose résistant à la rifampicine par trois mécanismes: (1) infection par un organisme résistant, (2) sélection d'une sous-population d'organismes résistants qui demeurent conservés tant que le phénotype sauvage le plus virulent est présent, (3) mutations à l'intérieur de la population de bacilles responsables de l'infection d'origine. Des isolats séquentiels de Mycobacterium tuberculosis ont été recueillis à partir de deux patients qui avaient développé une résistance à la rifampicine au cours de leur traitement. L'un des patients était en état d'immunosuppression avec une infection VIH; chez l'autre patient l'isolat d'origine était résistant aussi à l'isoniazide. Des techniques d'empreinte génomique ont été utilisées pour typer les isolats. Aucune différence n'a été trouvée entre les empreintes des isolats effectués avant et après l'évolution de la résistance. Ces données suggèrent que le troisième des mécanismes cités ci-dessus a été responsable de l'acquisition d'une résistance à la rifampicine chez ces deux patients.ResumenLa tuberculosis resistente a los medicamentos ha llegado a ser un importante problema de salud pública. La resistencia a la rifampicina probablemente se produce a través de mutaciones en la ARN-polimerasa de las micobacterias. Los pacientes pueden adquirir una tuberculosis resistente a la rifampicina por tres mecanismos: (1) infección con un microrrganismo resistente; (2) selección de una subpoblación de microorganismos resisstentes que permanece inactiva mientras se encuentran presentes los tipos salvajes que son mas virulentos; (3) mutaciones dentro de la población de bacilos causantes de la infección original. Se recolectaron aislados de Mycobacterium tuberculosis en forma secuencial de dos pacientes que desarollaron una resistencia a la rifampicina durante el tratamiento. Uno de los pacientes presentaba una inmunodepresión con infection VIH; en el ontro paciente el aislado original también era resistente a la isoniacida. Para tipificar los aislados se usó la técnica de huellas (‘fingerprinting’) del ADN. No se encontró diferencia entre las huellas de los aislados recolectados antes y después del desarrollo de la resistencia. Estos resultados sugieren que el tercer mecanismo de la lista mencionada más ariba fue el responsable de la adquisición de la resistencia a la rifampicina en estos dos pacientes.
  Tubercle and Lung Disease.
• Source

  Available from: Sandra Wallman

  Article: Multidisciplinary approach: mapping potential TB transmission 'hot spots' in high burden communities

  EJ Murray, BJ Marais, G Mans, N Beyers, H Ayles, P Godfrey-Faussett, S Wallman, V Bond
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  ABSTRACT: Copyright: 2009 International Union Against Tuberculosis and Lung Disease. This the author's version of the work. The definitive version is published in the International Journal of Tuberculosis and Lung Disease, Vol. 13(6), pp 767-774 Global control of the tuberculosis (TB) epidemic remains poor, especially in high burden settings where ongoing transmission sustains the epidemic. In such settings, a significant amount of transmission takes place outside of the household and practical approaches to understanding transmission at a community level are needed. We introduce a novel multidisciplinary approach to identify and map potential TB transmission `hot spots' within high burden communities.
• Article: Simplification of the polymerase chain reaction for detection of Mycobacterium tuberculosis in the tropics.

  S M Wilson, E Nava, A Morales, P Godfrey-Faussett, S Gillespie, N Andersson
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  ABSTRACT: It has been suggested that the technical complexities, the expense of equipment and consumables, and problems associated with contamination make the polymerase chain reaction (PCR) inappropriate for use in developing countries. These problems were addressed using a novel one-tube nested PCR, small reaction volumes and a 'three room' system for the detection of Mycobacterium tuberculosis. The PCR of sputum samples dried on small filter paper disks was also investigated. Using this strategy 5 smear-positive and 15 smear-negative specimens were correctly identified by PCR. This method of sample collection has the advantage that samples can be sent by post and stored in a minimum of space, and remain viable for PCR for at least 4 years after collection. These and future modifications to the PCR protocol will make the assay more suitable for use in the tropics.
  Transactions of the Royal Society of Tropical Medicine and Hygiene 87(2):177-80. · 2.16 Impact Factor
• Article: Aspects of tuberculosis in Africa. 3. Genetic 'fingerprinting' for clues to the pathogenesis of tuberculosis.

  P Godfrey-Faussett, N G Stoker
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  ABSTRACT: The recent discovery of a repetitive element within the DNA of Mycobacterium tuberculosis, which is present in variable numbers at different locations in separate strains of the organism, has led to the development of genetic 'fingerprinting' to distinguish between different isolates. Clusters of cases of tuberculosis have been identified in Europe and the USA in which the organisms cultured had identical 'fingerprints' confirming that transmission was occurring. Unrelated isolates generally have distinct 'fingerprints'. In Africa, where transmission is more common than in Europe, there is less heterogeneity between isolates. We have typed 117 isolates of M. tuberculosis collected from continuing studies in Malawi and Kenya. Paired isolates from an individual patient produced matching 'fingerprints' in 22 of 25 cases. There were 18 isolates which had an identical matched pair from a separate patient; we have not yet found any epidemiological link between these patients. These data show that there is sufficient heterogeneity amongst African isolates of M. tuberculosis to make studies of transmission feasible and to address questions of pathogenesis and epidemiology.
  Transactions of the Royal Society of Tropical Medicine and Hygiene 86(5):472-5. · 2.16 Impact Factor
• Article: Mononeuritis multiplex in Plasmodium falciparum malaria.

  P Godfrey-Faussett, R H Behrens, R Kapoor
  Transactions of the Royal Society of Tropical Medicine and Hygiene 84(3):351-2. · 2.16 Impact Factor