Prevalence and clinical relevance of helminth co-infections among tuberculosis patients in urban Tanzania
Identifieur interne : 000381 ( Main/Curation ); précédent : 000380; suivant : 000382Prevalence and clinical relevance of helminth co-infections among tuberculosis patients in urban Tanzania
Auteurs : Francis Mhimbira [Tanzanie, Suisse] ; Jerry Hella [Tanzanie, Suisse] ; Khadija Said [Tanzanie, Suisse] ; Lujeko Kamwela [Tanzanie] ; Mohamed Sasamalo [Tanzanie, Suisse] ; Thomas Maroa [Tanzanie] ; Magreth Chiryamkubi [Tanzanie] ; Grace Mhalu [Tanzanie, Suisse] ; Christian Schindler [Suisse] ; Klaus Reither [Tanzanie, Suisse] ; Stefanie Knopp [Suisse, Royaume-Uni] ; Jürg Utzinger [Suisse] ; Sébastien Gagneux [Suisse] ; Lukas Fenner [Tanzanie, Suisse]Source :
- PLoS Neglected Tropical Diseases [ 1935-2727 ] ; 2017.
Abstract
Helminth infections can negatively affect the immunologic host control, which may increase the risk of progression from latent
Between November 2013 and October 2015, we enrolled adult (≥18 years) sputum smear-positive TB patients and household contact controls without TB during an ongoing TB cohort study in Dar es Salaam, Tanzania. We used Baermann, FLOTAC, Kato-Katz, point-of-care circulating cathodic antigen, and urine filtration to diagnose helminth infections. Multivariable logistic regression models with and without random effects for households were used to assess for associations between helminth infection and TB.
A total of 597 TB patients and 375 household contact controls were included. The median age was 33 years and 60.2% (585/972) were men. The prevalence of any helminth infection among TB patients was 31.8% (190/597) and 25.9% (97/375) among controls.
Url:
DOI: 10.1371/journal.pntd.0005342
PubMed: 28178325
PubMed Central: 5319816
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Salaam, Tanzania</addr-line></nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>University of Basel, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation></author><author><name sortKey="Hella, Jerry" sort="Hella, Jerry" uniqKey="Hella J" first="Jerry" last="Hella">Jerry Hella</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam, Tanzania</addr-line></nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>University of Basel, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation></author><author><name sortKey="Said, Khadija" sort="Said, Khadija" uniqKey="Said K" first="Khadija" last="Said">Khadija Said</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam, Tanzania</addr-line></nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>University of Basel, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation></author><author><name sortKey="Kamwela, Lujeko" sort="Kamwela, Lujeko" uniqKey="Kamwela L" first="Lujeko" last="Kamwela">Lujeko Kamwela</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam, Tanzania</addr-line></nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation></author><author><name sortKey="Sasamalo, Mohamed" sort="Sasamalo, Mohamed" uniqKey="Sasamalo M" first="Mohamed" last="Sasamalo">Mohamed Sasamalo</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam, Tanzania</addr-line></nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>University of Basel, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation></author><author><name sortKey="Maroa, Thomas" sort="Maroa, Thomas" uniqKey="Maroa T" first="Thomas" last="Maroa">Thomas Maroa</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam, Tanzania</addr-line></nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation></author><author><name sortKey="Chiryamkubi, Magreth" sort="Chiryamkubi, Magreth" uniqKey="Chiryamkubi M" first="Magreth" last="Chiryamkubi">Magreth Chiryamkubi</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>Department of Curative Services, Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania</addr-line></nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Curative Services, Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation></author><author><name sortKey="Mhalu, Grace" sort="Mhalu, Grace" uniqKey="Mhalu G" first="Grace" last="Mhalu">Grace Mhalu</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam, Tanzania</addr-line></nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>University of Basel, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation></author><author><name sortKey="Schindler, Christian" sort="Schindler, Christian" uniqKey="Schindler C" first="Christian" last="Schindler">Christian Schindler</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>University of Basel, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff005"><addr-line>Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation></author><author><name sortKey="Reither, Klaus" sort="Reither, Klaus" uniqKey="Reither K" first="Klaus" last="Reither">Klaus Reither</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam, Tanzania</addr-line></nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>University of Basel, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation></author><author><name sortKey="Knopp, Stefanie" sort="Knopp, Stefanie" uniqKey="Knopp S" first="Stefanie" last="Knopp">Stefanie Knopp</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>University of Basel, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff005"><addr-line>Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="aff006"><addr-line>Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Utzinger, Jurg" sort="Utzinger, Jurg" uniqKey="Utzinger J" first="Jürg" last="Utzinger">Jürg Utzinger</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>University of Basel, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff005"><addr-line>Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation></author><author><name sortKey="Gagneux, Sebastien" sort="Gagneux, Sebastien" uniqKey="Gagneux S" first="Sébastien" last="Gagneux">Sébastien Gagneux</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>University of Basel, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation></author><author><name sortKey="Fenner, Lukas" sort="Fenner, Lukas" uniqKey="Fenner L" first="Lukas" last="Fenner">Lukas Fenner</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam, Tanzania</addr-line></nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>University of Basel, Basel, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff007"><addr-line>Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Institute of Social and Preventive Medicine, University of Bern, Bern</wicri:regionArea><placeName><settlement type="city">Berne</settlement><region type="région" nuts="3">Canton de Berne</region><settlement type="city">Berne</settlement></placeName><orgName type="university">Université de Berne</orgName></affiliation></author></analytic><series><title level="j">PLoS Neglected Tropical Diseases</title><idno type="ISSN">1935-2727</idno><idno type="eISSN">1935-2735</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title><p>Helminth infections can negatively affect the immunologic host control, which may increase the risk of progression from latent <italic>Mycobacterium tuberculosis</italic> infection to tuberculosis (TB) disease and alter the clinical presentation of TB. We assessed the prevalence and determined the clinical relevance of helminth co-infection among TB patients and household contact controls in urban Tanzania.</p></sec><sec id="sec002"><title>Methodology</title><p>Between November 2013 and October 2015, we enrolled adult (≥18 years) sputum smear-positive TB patients and household contact controls without TB during an ongoing TB cohort study in Dar es Salaam, Tanzania. We used Baermann, FLOTAC, Kato-Katz, point-of-care circulating cathodic antigen, and urine filtration to diagnose helminth infections. Multivariable logistic regression models with and without random effects for households were used to assess for associations between helminth infection and TB.</p></sec><sec id="sec003"><title>Principal findings</title><p>A total of 597 TB patients and 375 household contact controls were included. The median age was 33 years and 60.2% (585/972) were men. The prevalence of any helminth infection among TB patients was 31.8% (190/597) and 25.9% (97/375) among controls. <italic>Strongyloides stercoralis</italic> was the predominant helminth species (16.6%, 161), followed by hookworm (9.0%, 87) and <italic>Schistosoma mansoni</italic> (5.7%, 55). An infection with any helminth was not associated with TB (adjusted odds ratio (aOR) 1.26, 95% confidence interval (CI): 0.88–1.80, p = 0.22), but <italic>S</italic>. <italic>mansoni</italic> infection was (aOR 2.15, 95% CI: 1.03–4.45, p = 0.040). Moreover, <italic>S</italic>. <italic>mansoni</italic> infection was associated with lower sputum bacterial load (aOR 2.63, 95% CI: 1.38–5.26, p = 0.004) and tended to have fewer lung cavitations (aOR 0.41, 95% CI: 0.12–1.16, p = 0.088).</p></sec><sec id="sec004"><title>Conclusions/Significance</title><p><italic>S</italic>. <italic>mansoni</italic> infection was an independent risk factor for active TB and altered the clinical presentation in TB patients. These findings suggest a role for schistosomiasis in modulating the pathogenesis of human TB. Treatment of helminths should be considered in clinical management of TB and TB control programs.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Knopp, S" uniqKey="Knopp S">S Knopp</name></author><author><name sortKey="Steinmann, P" uniqKey="Steinmann P">P Steinmann</name></author><author><name sortKey="Keiser, J" uniqKey="Keiser J">J Keiser</name></author><author><name sortKey="Utzinger, J" uniqKey="Utzinger J">J Utzinger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pullan, Rl" uniqKey="Pullan R">RL Pullan</name></author><author><name sortKey="Smith, Jl" uniqKey="Smith J">JL Smith</name></author><author><name sortKey="Jasrasaria, R" uniqKey="Jasrasaria R">R Jasrasaria</name></author><author><name sortKey="Brooker, Sj" uniqKey="Brooker S">SJ Brooker</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Utzinger, J" 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Rodrigues, R" uniqKey="Ribeiro Rodrigues R">R Ribeiro-Rodrigues</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tristao Sa, R" uniqKey="Tristao Sa R">R Tristão-Sá</name></author><author><name sortKey="Ribeiro Rodrigues, R" uniqKey="Ribeiro Rodrigues R">R Ribeiro-Rodrigues</name></author><author><name sortKey="Johnson, Lt" uniqKey="Johnson L">LT Johnson</name></author><author><name sortKey="Pereira, Fel" uniqKey="Pereira F">FEL Pereira</name></author><author><name sortKey="Dietze, R" uniqKey="Dietze R">R Dietze</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sangare, Lr" uniqKey="Sangare L">LR Sangaré</name></author><author><name sortKey="Herrin, Br" uniqKey="Herrin B">BR Herrin</name></author><author><name sortKey="John Stewart, G" uniqKey="John Stewart G">G John-Stewart</name></author><author><name sortKey="Walson, Jl" uniqKey="Walson J">JL 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sortKey="Magnussen, P" uniqKey="Magnussen P">P Magnussen</name></author><author><name sortKey="Mugomela, A" uniqKey="Mugomela A">A Mugomela</name></author><author><name sortKey="Malenganisho, W" uniqKey="Malenganisho W">W Malenganisho</name></author><author><name sortKey="Changalucha, J" uniqKey="Changalucha J">J Changalucha</name></author><author><name sortKey="Temu, Mm" uniqKey="Temu M">MM Temu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Modjarrad, K" uniqKey="Modjarrad K">K Modjarrad</name></author><author><name sortKey="Vermund, Sh" uniqKey="Vermund S">SH Vermund</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Janssen, S" uniqKey="Janssen S">S Janssen</name></author><author><name sortKey="Hermans, S" uniqKey="Hermans S">S Hermans</name></author><author><name sortKey="Knap, M" uniqKey="Knap M">M Knap</name></author><author><name sortKey="Moekotte, A" uniqKey="Moekotte A">A Moekotte</name></author><author><name sortKey="Rossatanga, Eg" uniqKey="Rossatanga E">EG Rossatanga</name></author><author><name sortKey="Adegnika, Aa" uniqKey="Adegnika A">AA Adegnika</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tukahebwa, Em" uniqKey="Tukahebwa E">EM Tukahebwa</name></author><author><name sortKey="Vennervald, Bj" uniqKey="Vennervald B">BJ Vennervald</name></author><author><name sortKey="Nuwaha, F" uniqKey="Nuwaha F">F Nuwaha</name></author><author><name sortKey="Kabatereine, Nb" uniqKey="Kabatereine N">NB Kabatereine</name></author><author><name sortKey="Magnussen, P" uniqKey="Magnussen P">P Magnussen</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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