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30 emner vises.
Jared Feldman Julia Bals Clara G. Altomare Kerri St. Denis Evan C. Lam Blake M. Hauser Larance Ronsard Maya Sangesland Thalia Bracamonte Moreno Vintus Okonkwo Nathania Hartojo Alejandro B. Balazs Goran Bajic Daniel Lingwood Aaron G. Schmidt
Science, 14.10.2021
Tilføjet 14.10.2021
Sarah Sanchez Nicole Palacio Tanushree Dangi Thomas Ciucci Pablo Penaloza-MacMaster
Science, 14.10.2021
Tilføjet 14.10.2021
Felice D’Agnillo Kathie-Anne Walters Yongli Xiao Zong-Mei Sheng Kelsey Scherler Jaekeun Park Sebastian Gygli Luz Angela Rosas Kaitlyn Sadtler Heather Kalish Charles A. Blatti Ruoqing Zhu Lisa Gatzke Colleen Bushell Matthew J. Memoli Steven J. O’Day Trevan D. Fischer Terese C. Hammond Raymond C. Lee J. Christan Cash Matthew E. Powers Grant E. O’Keefe Kelly J. Butnor Amy V. Rapkiewicz William D. Travis Scott P. Layne John C. Kash Jeffery K. Taubenberger
Science, 14.10.2021
Tilføjet 14.10.2021
Augustine Ngmenemandel Balegha, Adadow Yidana, Gilbert Abotisem Abiiro
PLoS One Infectious Diseases, 14.10.2021
Tilføjet 14.10.2021
by Augustine Ngmenemandel Balegha, Adadow Yidana, Gilbert Abotisem Abiiro
Introduction Hepatitis B infection remains a public health threat associated with undesirable statistics of morbidity and mortality. Good knowledge, attitude and practice (KAP) of hepatitis B infection (HBI) prevention are essential for HBI control. However, there is limited evidence concerning the KAP of HBI prevention among nursing students, who are significantly exposed to HBI. We assessed the KAP of HBI prevention and the factors associated with the practice of HBI prevention among nursing students in the Upper West Region of Ghana.
Methods We administered an online cross-sectional survey in November 2020 to a stratified random sample of 402 nursing students in two nursing training colleges in the Upper West Region. Using STATA version 13, we computed composite scores of KAP of HBI prevention with maximum scores of 18 for knowledge and 8 each for attitude and practice. A generalised ordered logistic regression model was run to assess the factors associated with the practice of HBI prevention.
Results The students had moderate median scores for knowledge (12.00; IQR = 10–13) and attitude (6.00; IQR = 5.00–7.00) but a poor median score (5.00; IQR = 4.00–6.00) for the practice of HBI prevention. High knowledge (aOR = 2.05; p = 0.06), good attitude, being a male, second year student and having parents with tertiary education were significantly associated with higher likelihoods (aOR >1; p < 0.05) of demonstrating good practice of HBI prevention. Students who had never married were significantly (aOR = 0.34; p = 0.010) less likely to exhibit good practice of HBI prevention.
Conclusion The KAP scores of HBI prevention among the students were sub-optimal. We recommend institution-based policies and regular education on HBI prevention, free/subsidised HBI prevention services, and the enforcement of proper professional ethics on HBI prevention in nursing training colleges. Such interventions should predominantly target female, non-married and first year nursing students.
Læs mere Tjek på PubMedNobuhisa Ishiguro, Rikako Sato, Toshihiko Mori, Hiroshi Tanaka, Mitsuo Narita, Takashi Nagano, Masato Owaku, Kensuke Miyajima, Atsushi Manabe
PLoS One Infectious Diseases, 14.10.2021
Tilføjet 14.10.2021
by Nobuhisa Ishiguro, Rikako Sato, Toshihiko Mori, Hiroshi Tanaka, Mitsuo Narita, Takashi Nagano, Masato Owaku, Kensuke Miyajima, Atsushi Manabe
Objectives Macrolides are generally considered to be the drugs of choice for treatment of patients with Mycoplasma pneumoniae infection. However, macrolide-resistant M. pneumoniae has been emerging since about 2000. The Smart Gene® system (MIZUHO MEDY Co., Ltd., Tosu, Japan) is a novel fully automated system for detection of pathogens using the method of quantitative polymerase chain reaction (qPCR) with QProbe (QProbe PCR). The entire procedure is completed within 50 min and the size of the instrument is small (15 x 34 x 30 cm). The purpose of this study was to evaluate the usefulness of the Smart Gene® system for detection of M. pneumoniae and detection of a point mutation at domain V of the 23S rRNA gene of M. pneumoniae.
Materials Pharyngeal swab samples were collected from 154 patients who were suspected of having respiratory tract infections associated with M. pneumoniae.
Results Compared with the results of qPCR, the sensitivity and specificity of the Smart Gene® system were 98.7% (78/79) and 100.0% (75/75), respectively. A point mutation at domain V of the 23S rRNA gene was detected from 7 (9.0%) of 78 M. pneumoniae-positive samples by the Smart Gene® system and these results were confirmed by direct sequencing. The minimum inhibitory concentrations of clarithromycin among the 5 isolates of M. pneumoniae with a point mutation at domain V of the 23S rRNA gene were >64 μg/ml and those among the 33 isolates without a mutation in the 23S rRNA gene were
Læs mere Tjek på PubMedSebastian G. Schönherr, Donald Ranft, Norman Lippmann, Christoph Lübbert
PLoS One Infectious Diseases, 14.10.2021
Tilføjet 14.10.2021
by Sebastian G. Schönherr, Donald Ranft, Norman Lippmann, Christoph Lübbert
Background Institution-specific guidelines (ISGs) within the framework of antimicrobial stewardship programs offer locally tailored decision support taking into account local pathogen and resistance epidemiology as well as national and international guidelines.
Objectives To assess the impact of ISGs for antimicrobial therapy on antibiotic consumption and subsequent changes in resistance rates and Clostridioides difficile infections (CDIs).
Methods The study was conducted at the Leipzig University Hospital, a 1,451-bed tertiary-care medical center, and covered the years 2012 to 2020. Since 2014, ISGs were provided to optimize empirical therapies, appropriate diagnostics, and antimicrobial prophylaxis. We used interrupted time series analysis (ITSA) and simple linear regression to analyze changes in antimicrobial consumption, resistance and CDIs.
Results Over the study period, 1,672,200 defined daily doses (DDD) of antibiotics were dispensed, and 85,645 bacterial isolates as well as 2,576 positive C. difficile cultures were collected. Total antimicrobial consumption decreased by 14% from 2012 to 2020, without clear impact of the deployment of ISGs. However, implementation of ISGs was associated with significant decreases in the use of substances that were rarely recommended (e.g., fluoroquinolones). Over the whole study period, we observed declining resistance rates to most antibiotic classes of up to 25% in Enterobacterales, staphylococci, and Pseudomonas aeruginosa. Switching from ceftriaxone to cefotaxime was associated with reduced resistance to third-generation cephalosporins. The number of CDI cases fell by 65%, from 501 in 2012 to 174 in 2020.
Conclusions Well-implemented ISGs can have a significant, immediate, and lasting impact on the prescription behavior. ISGs might thereby contribute to reduce resistance rates and CDI incidences in the hospital setting.
Læs mere Tjek på PubMedYock Ping Chow, Brenda Huey Zien Chin, Jin Ming Loo, Loshini R. Moorthy, Jamuna Jairaman, Lian Huat Tan, Wendy Wan Ying Tay
PLoS One Infectious Diseases, 14.10.2021
Tilføjet 14.10.2021
by Yock Ping Chow, Brenda Huey Zien Chin, Jin Ming Loo, Loshini R. Moorthy, Jamuna Jairaman, Lian Huat Tan, Wendy Wan Ying Tay
Objective This cross-sectional observational study summarized the baseline characteristics of subjects who underwent COVID-19 molecular testing in a private medical centre located in the state of Selangor in Malaysia between 1 Oct 2020 and 31 Jan 2021. We compared the baseline characteristics between subjects who were tested positive and negative of SARS-CoV-2 infection, and identified risk factors which may be predictive of SARS-CoV-2 positivity.
Methods and findings A total of 36603 subjects who were tested for COVID-19 infection via molecular assays at Sunway Medical Centre between Oct 1, 2020 and Jan 31, 2021, and consented to participate in this observation study were included for analysis. Descriptive statistics was used to summarize the study cohort, whereas logistic regression analysis was used to identify risk factors associated with SARS-CoV-2 positivity. Among the reasons listed for COVID-19 screening were those who needed clearance for travelling, clearance to return to work, or clearance prior to hospital admission. They accounted for 67.7% of tested subjects, followed by the self-referred group (27.3%). Most of the confirmed cases were asymptomatic (62.6%), had no travel history (99.6%), and had neither exposure to SARS-CoV-2 confirmed cases (61.9%) nor exposure to patients under investigation (82.7%) and disease clusters (89.2%). Those who presented with loss of smell or taste (OR: 26.91; 95% CI: 14.81–48.92, p<0.001), fever (OR:3.97; 95% CI: 2.54–6.20, p<0.001), running nose (OR: 1.75; 95% CI:1.10–2.79, p = 0.019) or other symptoms (OR: 5.63; 95% CI:1.68–18.91, p = 0.005) were significantly associated with SARS-CoV-2 positivity in the multivariate logistic regression analysis.
Conclusion Our study showed that majority of patients seeking COVID-19 testing in a private healthcare setting were mainly asymptomatic with low epidemiological risk. Consequently, the average positivity rate was 1.2% compared to the national cumulative positivity rate of 4.65%. Consistent with other studies, we found that loss of smell or taste, fever and running nose were associated with SARS-CoV-2 positivity. We believe that strengthening the capacity of private health institutions is important in the national battle against the COVID-19 pandemic, emphasizing the importance of public-private partnership to improve the quality of clinical care.
Læs mere Tjek på PubMedGeorge G. A. Pujalte, Isaac I. Effiong, Tais G. O. Bertasi, Raphael A. O. Bertasi, Susannah S. Rothstein, Ryan Cudahy, Lorenzo O. Hernandez, Timothy M. Davlantes
PLoS One Infectious Diseases, 14.10.2021
Tilføjet 14.10.2021
by George G. A. Pujalte, Isaac I. Effiong, Tais G. O. Bertasi, Raphael A. O. Bertasi, Susannah S. Rothstein, Ryan Cudahy, Lorenzo O. Hernandez, Timothy M. Davlantes
Background Hospital performance is often monitored by surveys that assess patient experiences with hospital care. Certain patient characteristics may shape how some aspects of hospital care are viewed and reported on surveys.
Objective The aim of the study was to examine factors considered important to patients and determine whether there were differences in answers based on age, gender, or educational level.
Methods Cross-sectional study based on a hospital survey developed via literature review and specialist recommendations. This study included randomly selected patients 18 years or older who were recently admitted to the hospital or admitted more than 50 days before the survey was being applied. Survey domains included age, gender, educational level, factors considered important for the health care in a hospital setting and sources of information about hospital quality used by each subject. Answers description and statistical analysis using Fisher exact test were performed.
Results The survey was applied to 262 patients who were admitted under different services. The most important concern reported was the risk of getting a hospital-acquired infection (67.18%), followed by understanding explanation from the doctors’ plans (64.12%) and doctors’ ability to listen carefully (58.78%). Women are more concerned about their risk of falling (p = 0.03). Patients older than 65 years find important that the doctors explain everything in a way they can easily understand (p = 0.02), while lower educated patients consider most if the doctor treats them with courtesy and respect (p = 0.0027).
Conclusion Patient characteristics have an effect on how hospital care is perceived. Regardless of the characteristics of the population, the risk of getting an infection was the main concern overall, so it is important that hospitals promote actions to prevent it and share them with patients.
Læs mere Tjek på PubMedPei-Shan Wu, Yun-Cheng Hsieh, Kuei-Chuan Lee, Yi-Hsiang Huang, Ming-Chih Hou, Han-Chieh Lin
PLoS One Infectious Diseases, 14.10.2021
Tilføjet 14.10.2021
by Pei-Shan Wu, Yun-Cheng Hsieh, Kuei-Chuan Lee, Yi-Hsiang Huang, Ming-Chih Hou, Han-Chieh Lin
Objectives Mac-2-binding protein glycosylation isomer (M2BPGi) is a novel plasma biomarker for liver fibrosis, but less is known about its role in portal hypertension. We aimed to evaluate the association between M2BPGi and hepatic venous pressure gradient (HVPG) and to investigate its predictive value on prognosis of cirrhotic patients.
Methods Forty-eight cirrhotic patients who underwent HVPG measurement in Taipei Veterans General hospital were retrospectively enrolled. The Spearman’s correlation test was used to analyze the correlation between plasma M2BPGi levels and HVPG and other parameters. Cox proportional hazards regression models were used to identify predictors for clinical outcomes.
Results Plasma M2BPGi levels were higher in cirrhotic patients than healthy subjects and significantly correlated with HVPG levels (rs = 0.45, p = 0.001). On multivariate Cox regression analysis, higher plasma M2BPGi levels [≥ 6 cut-off index (C.O.I)] did not predict mortality within five years for cirrhotic patients and the result was similar in patients without hepatocellular carcinoma. Interestingly, M2BPGi ≥ 6 C.O.I was a potential predictor of bacterial infection within five years [Hazar ratio (HR) = 4.51, p = 0.003]. However, M2BPGi failed to predict occurrence of other cirrhosis-related complications, including variceal bleeding, ascites formation, spontaneous bacterial peritonitis, hepatorenal syndrome and hepatic encephalopathy.
Conclusion Plasma M2BPGi levels positively correlated with HVPG and higher serum M2BPGi levels might have a potential role in predicting development of bacterial infection for cirrhotic patients with portal hypertension.
Læs mere Tjek på PubMedKoichi Shichijo, Shunsuke Takeuchi, Takahiro Tayama, Mikiko Takei, Keisuke Fujioka, Akemi Ono, Miki Shono, Kenichi Suga, Reiko Kondo, Takashi Kaimen, Nobuo Arima, Shuji Kondo
PLoS One Infectious Diseases, 14.10.2021
Tilføjet 14.10.2021
by Koichi Shichijo, Shunsuke Takeuchi, Takahiro Tayama, Mikiko Takei, Keisuke Fujioka, Akemi Ono, Miki Shono, Kenichi Suga, Reiko Kondo, Takashi Kaimen, Nobuo Arima, Shuji Kondo
The purpose of this study was to clarify the effects of individual infection control measures and physical distancing on pediatric medical care in a local prefecture in Japan, where the incidence of coronavirus disease (COVID-19) in pediatric patients was extremely low. We extracted data from hospital records on the number of outpatients, inpatients, infectious disease consultations, and consultations for representative pediatric diseases. We compared attendance in 2017–2019, before the COVID-19 pandemic, with 2020, when COVID-19 spread to Japan. There were no COVID-19 patients in the pediatric department during the study period. The total number outpatient visits decreased by 24.4%, and the number of hospital admissions, excluding neonatal care unit admissions, decreased by approximately 35%. There was a marked reduction in the number of hospitalizations for infectious diseases such as influenza (−74.8%) and respiratory syncytial virus infection (−93.5%), and the number of hospitalizations for bronchitis/pneumonia, Kawasaki disease, and bronchial asthma decreased. In contrast, the number of clinical psychological interventions and cases reported to the child guidance center increased. In the context of pandemic infectious diseases, it is important to control the spread of problematic infectious diseases by individual infection control measures and physical distancing. However, it is necessary to maintain social life as much as possible for the mental health and physical development of children.
Læs mere Tjek på PubMedKonstantinos Kapetanos, Stella Mazeri, Despo Constantinou, Anna Vavlitou, Marios Karaiskakis, Demetra Kourouzidou, Christoforos Nikolaides, Niki Savvidou, Savvas Katsouris, Maria Koliou
PLoS One Infectious Diseases, 14.10.2021
Tilføjet 14.10.2021
by Konstantinos Kapetanos, Stella Mazeri, Despo Constantinou, Anna Vavlitou, Marios Karaiskakis, Demetra Kourouzidou, Christoforos Nikolaides, Niki Savvidou, Savvas Katsouris, Maria Koliou
Introduction The spread of COVID-19 into a global pandemic has negatively affected the mental health of frontline healthcare-workers. This study is a multi-centre, cross-sectional epidemiological study that uses nationwide data to assess the prevalence of stress, anxiety, depression and burnout among health care workers managing COVID-19 patients in Cyprus. The study also investigates the mechanism behind the manifestation of these pathologies, as to allow for the design of more effective protective measures.
Methods Data on the mental health status of the healthcare workers were collected from healthcare professionals from all over the nation, who worked directly with Covid patients. This was done via the use of 64-item, self-administered questionnaire, which was comprised of the DASS21 questionnaire, the Maslach Burnout Inventory and a number of original questions. Multivariable logistic regression models were used to investigate factors associated with each of the mental health measures.
Results The sample population was comprised of 381 healthcare professionals, out of which 72.7% were nursing staff, 12.9% were medical doctors and 14.4% belonged to other occupations. The prevalence of anxiety, stress and depression among the sample population were 28.6%, 18.11% and 15% respectively. The prevalence of burnout was 12.3%. This was in parallel with several changes in the lives of the healthcare professionals, including; working longer hours, spending time in isolation and being separated from family.
Discussion This study indicates that the mental health of a significant portion of the nation’s workforce is compromised and, therefore, highlights the need for an urgent intervention particularly since many countries, including Cyprus, are suffering a second wave of the pandemic. The identified risk factors should offer guidance for employers aiming to protect their frontline healthcare workers from the negative effects of the COVID-19 pandemic.
Læs mere Tjek på PubMedKei Yamamoto, Michiyo Suzuki, Mugen Ujiie, Shuzo Kanagawa, Norio Ohmagari
PLoS One Infectious Diseases, 14.10.2021
Tilføjet 14.10.2021
by Kei Yamamoto, Michiyo Suzuki, Mugen Ujiie, Shuzo Kanagawa, Norio Ohmagari
Rubella and measles outbreaks in adults occur because of unimmunized or partially immunized status. Travel clinics play an important role in catch-up measles, rubella, mumps, and varicella immunization for adults. We evaluated the need for catch-up measles, rubella, mumps, and varicella immunization by young adults at our travel clinic. This retrospective observational study was conducted at the National Center for Global Health and Medicine from June 1, 2017 to May 31, 2018. Adults aged 16–49 years who received pre-travel consultation and had childhood immunization records were included. Individuals who fully or partially received planned measles, rubella, mumps, and varicella catch-up immunization were classified as “immunized.” We calculated the proportion of “immunized” individuals and analyzed the factors associated with catch-up measles, rubella, mumps, and varicella immunization at pre-travel consultation using logistic regression analysis. Overall, 3,456 individuals received pre-travel consultations during the study period; 827 (336 men, median age 22 years) had childhood immunization records. The most common trip purposes were study (33%) and tourism (24%). The most common destination was Asia (39%). Catch-up immunization of any measles, rubella, mumps, and varicella vaccine was needed by 755 individuals. After consultation, 20–46% of these participants who needed catchup immunization received at least one dose of immunization. Factors that are negatively associated with measles, rubella, mumps, and varicella catch-up immunization were tourism (odds ratio 0.37 to 0.58), yellow fever vaccination (0.45 to 0.50) (excluding varicella), and each disease history (0.13 to 0.40) (excluding rubella and varicella). Further studies are needed to identify barriers to catch-up immunization.
Læs mere Tjek på PubMedEmily Peckham, Victoria Allgar, Suzanne Crosland, Paul Heron, Gordon Johnston, Elizabeth Newbronner, Panagiotis Spanakis, Ruth Wadman, Lauren Walker, Simon Gilbody
PLoS One Infectious Diseases, 14.10.2021
Tilføjet 14.10.2021
by Emily Peckham, Victoria Allgar, Suzanne Crosland, Paul Heron, Gordon Johnston, Elizabeth Newbronner, Panagiotis Spanakis, Ruth Wadman, Lauren Walker, Simon Gilbody
Background People with severe mental ill health (SMI) experience a mortality gap of 15–20 years. COVID-19 has amplified population health inequalities, and there is concern that people with SMI will be disproportionately affected. Understanding how health risk behaviours have changed during the pandemic is important when developing strategies to mitigate future increases in health inequalities.
Methods We sampled from an existing cohort of people with SMI. Researchers contacted participants by phone or post to invite them to take part in a survey about how the pandemic had affected them. We asked people about their health risk behaviours and how these had changed during the pandemic. We created an index of changed behaviours, comprising dietary factors, smoking, lack of exercise, and drinking patterns. By creating data linkages, we compared their responses during pandemic restrictions to responses they gave prior to the pandemic.
Outcomes 367 people provided health risk data. The mean age of the participants was 50.5 (range = 20 to 86, SD ± 15.69) with 51.0% male and 77.4% white British. 47.5% of participants reported taking less physical activity during the pandemic and of those who smoke 54.5% reported smoking more heavily. Self-reported deterioration in physical health was significantly associated with an increase in health risk behaviours (adjusted OR for physical health 1.59, 95%CI 1.22–2.07; adjusted OR for Age 0.99, 95%CI 0.98–1.00).
Interpretation COVID-19 is likely to amplify health inequalities for people with SMI. Health services should target health risk behaviours for people with SMI to mitigate the immediate and long lasting impacts of the COVID-19 pandemic.
Læs mere Tjek på PubMedJimmy Phuong, Stephanie L. Hyland, Stephen J. Mooney, Dustin R. Long, Kenji Takeda, Monica S. Vavilala, Kenton O’Hara
PLoS One Infectious Diseases, 14.10.2021
Tilføjet 14.10.2021
by Jimmy Phuong, Stephanie L. Hyland, Stephen J. Mooney, Dustin R. Long, Kenji Takeda, Monica S. Vavilala, Kenton O’Hara
Background Despite increased testing efforts and the deployment of vaccines, COVID-19 cases and death toll continue to rise at record rates. Health systems routinely collect clinical and non-clinical information in electronic health records (EHR), yet little is known about how the minimal or intermediate spectra of EHR data can be leveraged to characterize patient SARS-CoV-2 pretest probability in support of interventional strategies.
Methods and findings We modeled patient pretest probability for SARS-CoV-2 test positivity and determined which features were contributing to the prediction and relative to patients triaged in inpatient, outpatient, and telehealth/drive-up visit-types. Data from the University of Washington (UW) Medicine Health System, which excluded UW Medicine care providers, included patients predominately residing in the Seattle Puget Sound area, were used to develop a gradient-boosting decision tree (GBDT) model. Patients were included if they had at least one visit prior to initial SARS-CoV-2 RT-PCR testing between January 01, 2020 through August 7, 2020. Model performance assessments used area-under-the-receiver-operating-characteristic (AUROC) and area-under-the-precision-recall (AUPR) curves. Feature performance assessments used SHapley Additive exPlanations (SHAP) values. The generalized pretest probability model using all available features achieved high overall discriminative performance (AUROC, 0.82). Performance among inpatients (AUROC, 0.86) was higher than telehealth/drive-up testing (AUROC, 0.81) or outpatient testing (AUROC, 0.76). The two-week test positivity rate in patient ZIP code was the most informative feature towards test positivity across visit-types. Geographic and sociodemographic factors were more important predictors of SARS-CoV-2 positivity than individual clinical characteristics.
Conclusions Recent geographic and sociodemographic factors, routinely collected in EHR though not routinely considered in clinical care, are the strongest predictors of initial SARS-CoV-2 test result. These findings were consistent across visit types, informing our understanding of individual SARS-CoV-2 risk factors with implications for deployment of testing, outreach, and population-level prevention efforts.
Læs mere Tjek på PubMedJess A. Millar, Hanh Dung N. Dao, Marianne E. Stefopulos, Camila G. Estevam, Katharine Fagan-Garcia, Diana H. Taft, Christopher Park, Amaal Alruwaily, Angel N. Desai, Maimuna S. Majumder
PLoS One Infectious Diseases, 14.10.2021
Tilføjet 14.10.2021
by Jess A. Millar, Hanh Dung N. Dao, Marianne E. Stefopulos, Camila G. Estevam, Katharine Fagan-Garcia, Diana H. Taft, Christopher Park, Amaal Alruwaily, Angel N. Desai, Maimuna S. Majumder
The ongoing COVID-19 pandemic is causing significant morbidity and mortality across the US. In this ecological study, we identified county-level variables associated with the COVID-19 case-fatality rate (CFR) using publicly available datasets and a negative binomial generalized linear model. Variables associated with decreased CFR included a greater number of hospitals per 10,000 people, banning religious gatherings, a higher percentage of people living in mobile homes, and a higher percentage of uninsured people. Variables associated with increased CFR included a higher percentage of the population over age 65, a higher percentage of Black or African Americans, a higher asthma prevalence, and a greater number of hospitals in a county. By identifying factors that are associated with COVID-19 CFR in US counties, we hope to help officials target public health interventions and healthcare resources to locations that are at increased risk of COVID-19 fatalities.
Læs mere Tjek på PubMedRamia Zakhour, Hani Tamim, Farah Faytrouni, Joanne Khoury, Maha Makki, Lama Charafeddine
PLoS One Infectious Diseases, 14.10.2021
Tilføjet 14.10.2021
by Ramia Zakhour, Hani Tamim, Farah Faytrouni, Joanne Khoury, Maha Makki, Lama Charafeddine
Background A growing number of parents refuse vaccination due to concerns about side effects. Influenza vaccine is no exception and remains one of the most controversial vaccines. Data regarding influenza vaccine uptake and parental knowledge, attitude and practice towards vaccination in the Lebanese population is lacking. The aim of this study was to assess the rate of vaccination refusal and potential associated factors among Lebanese parents of school-aged children, in general and with a focus on influenza vaccine.
Methods A parent questionnaire was distributed in randomly selected 2 public and 2 private schools from the greater Beirut area during the school year 2017–2018. Questionnaires covered knowledge, attitude (including themes of efficacy, hesitancy and trust), and practice of vaccination in general and influenza vaccine in particular.
Results The response rate was 76.5% (306/400). Overall, 29.4% parents reported vaccinating their children against influenza (62.2% in private and 37.7% in public schools). Younger age, paternal employment and higher household income were associated with higher vaccination rates (p = 0.01, 0.02 and
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.10.2021
Tilføjet 14.10.2021
Abstract
Background
Transgender and gender diverse individuals often face structural barriers to health care because of their gender minority status. The aim of this study was to examine the association between gender minority stress and access to specific health care services among transgender women and transfeminine people in China.
Methods
This multicenter cross-sectional study recruited participants between January 1st and June 30th 2020. Eligible participants were 18 years or older, assigned male at birth, not currently identifying as male, and living in China. Gender minority stress was measured using 45 items adapted from validated subscales. We examined access to health care services and interventions relevant to transgender and gender diverse people, including gender affirming interventions (hormones, surgeries), human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) testing, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). Multivariable regression was used to measure correlations between gender minority stress and access to health care service.
Results
Three hundred and twenty-four people completed a survey and data from 277 (85.5%) people were analyzed. The mean age was 29 years old (standard deviation [SD] = 8). Participants used hormones (118/277, 42.6%), gender affirming surgery (26/277, 9.4%), HIV testing (220/277, 79.4%), STI testing (132/277, 47.7%), PrEP (24/276, 8.7%), and PEP (29/267, 10.9%). Using gender affirming hormones was associated with higher levels of discrimination (adjusted odds ratio [aOR] 1.41, 95% confidence interval [CI] 1.17–1.70) and internalized transphobia (aOR 1.06, 95%CI 1.00–1.12). STI testing was associated with lower levels of internalized transphobia (aOR 0.91, 95%CI 0.84–0.98).
Conclusions
Our data suggest that gender minority stress is closely related to using health services. Stigma reduction interventions and gender-affirming medical support are needed to improve transgender health.
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.10.2021
Tilføjet 14.10.2021
Abstract
Background
In 2018, Rwanda launched a 5-year hepatitis C virus (HCV) elimination plan as per the World Health Organization global targets to eliminate HCV by 2030. To improve awareness of HCV status, strategies are needed to ensure easy access to HCV testing by as-yet unreached populations. HCV-self-testing, an innovative strategy, could further increase HCV testing uptake. This assessment explores perceptions around HCV self-testing among members of the public and healthcare workers in Rwanda.
Methods
A qualitative study was undertaken in Masaka District Hospital, comprising individual interviews, group interviews and participatory action research (PAR) activities. Purposive and snowball sampling methods guided the selection of informants. Informed consent was obtained from all participants. A thematic analysis approach was used to analyse the findings.
Results
The participants comprised 36 members of the public and 36 healthcare workers. Informants appreciated HCV self-testing as an innovative means of increasing access to HCV testing, as well as an opportunity to test privately and subsequently autonomously decide whether to seek further HCV care. Informants further highlighted the need to make HCV self-testing services free of charge at the nearest health facility. Disadvantages identified included the lack of pre/post-test counselling, as well as the potential psychosocial harm which may result from the use of HCV self-testing.
Conclusion
HCV self-testing is perceived to be an acceptable method to increase HCV testing in Rwanda. Further research is needed to assess the impact of HCV self-testing on HCV cascade of care outcomes.
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.10.2021
Tilføjet 14.10.2021
Abstract
Background
The COVID-19 and HIV epidemics have exacerbated existing inequities among vulnerable groups and severely impacted communities of color. People living with HIV (PLWH), who may already face stigma or discrimination, are at risk of experiencing further stigma as a result of COVID-19, which can result in medical mistrust.
Methods
We performed qualitative interviews between June and August 2020 among 32 PLWH, including 10 individuals diagnosed with COVID-19. A majority of participants perceived themselves as having an increased risk of contracting COVID-19 due to their HIV status.
Results
Of those who tested positive for COVID-19, the majority regarded their HIV diagnosis as having a more profound impact on their lives but found similarities between COVID-19 stigma and HIV-related stigma. Many participants also expressed mistrust.
Conclusions
These results can be used to better understand the perspectives of PLWH during the COVID-19 pandemic and have important implications for potential COVID-19 vaccine hesitancy and future health crises.
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.10.2021
Tilføjet 14.10.2021
Abstract
Background
Evidence of glucocorticoids on viral clearance delay of COVID-19 patients is not clear.
Methods
In this systematic review and meta-analysis, we searched for studies on Medline, Embase, EBSCO, ScienceDirect, Web of Science, Cochrane Library, and ClinicalTrials.gov from 2019 to April 20, 2021. We mainly pooled the risk ratios (RRs) and mean difference (MD) for viral clearance delay and did subgroup analyses by the severity of illness and doses of glucocorticoids.
Results
38 studies with a total of 9572 patients were identified. Glucocorticoids treatment was associated with delayed viral clearance in COVID-19 patients (adjusted RR 1.52, 95% CI 1.29 to 1.80, I2 = 52%), based on moderate-quality evidence. In subgroup analyses, risk of viral clearance delay was significant both for COVID-19 patients being mild or moderate ill (adjusted RR 1.86, 95% CI 1.35 to 2.57, I2 = 48%), and for patients of being severe or critical ill (adjusted RR 1.59, 95% CI 1.23 to 2.07, I2 = 0%); however, this risk significantly increased for patients taking high doses (unadjusted RR 1.85, 95% CI 1.08 to 3.18; MD 7.19, 95% CI 2.78 to 11.61) or medium doses (adjusted RR 1.86, 95% CI 0.96 to 3.62, I2 = 45%; MD 3.98, 95% CI 3.07 to 4.88, I2 = 4%), rather those taking low doses (adjusted RR 1.38, 95% CI 0.94 to 2.02, I2 = 59%; MD 1.46, 95% CI −0.79 to 3.70, I2 = 82%).
Conclusions
Glucocorticoids treatment delayed viral clearance in COVID-19 patients of taking high doses or medium doses, rather in those of taking low doses of glucocorticoids.
Læs mere Tjek på PubMedKoen B. Pouwels, Emma Pritchard, Philippa C. Matthews, Nicole Stoesser, David W. Eyre, Karina-Doris Vihta, Thomas House, Jodie Hay, John I. Bell, John N. Newton, Jeremy Farrar, Derrick Crook, Duncan Cook, Emma Rourke, Ruth Studley, Tim E. A. Peto, Ian Diamond, A. Sarah Walker
Nature, 14.10.2021
Tilføjet 14.10.2021
Nature Medicine, Published online: 14 October 2021; doi:10.1038/s41591-021-01548-7
A large, community-based study in the United Kingdom indicates that the effectiveness of BNT162b2 and ChAdOx1 vaccines against SARS-CoV-2 infections with symptoms or high viral burden is reduced with the Delta variant compared to the Alpha variant.
Læs mere Tjek på PubMedTerence Nolan, Alexandre C. Fortanier, Brett Leav, Airi Põder, Lulu C. Bravo, Henryk T. Szymański, Marten Heeringa, Wim Vermeulen, Vince Matassa, Igor Smolenov, Jonathan M. Edelman
New England Journal of Medicine, 13.10.2021
Tilføjet 14.10.2021
New England Journal of Medicine, Volume 385, Issue 16, Page 1485-1495, October 2021.
Læs mere Tjek på PubMedGeorge R. Thompson, Jo-Anne H. Young
New England Journal of Medicine, 13.10.2021
Tilføjet 14.10.2021
New England Journal of Medicine, Volume 385, Issue 16, Page 1496-1509, October 2021.
Læs mere Tjek på PubMedEric J. Rubin, Lindsey R. Baden, Katherine J. Wu, Stephen Morrissey
New England Journal of Medicine, 13.10.2021
Tilføjet 14.10.2021
New England Journal of Medicine, 13.10.2021
Tilføjet 14.10.2021
New England Journal of Medicine, 13.10.2021
Tilføjet 14.10.2021
Shuyi Fang, Sheng Liu, Jikui Shen, Alex Z Lu, Audrey K. Y. Wang, Yucheng Zhang, Kailing Li, Juli Liu, Lei Yang, Chang‐Deng Hu, Jun Wan
Journal of Medical Virology, 13.10.2021
Tilføjet 14.10.2021
Saverio Marchi, Gianluca Morroni, Paolo Pinton, Lorenzo Galluzzi
Trends in Microbiology, 13.10.2021
Tilføjet 14.10.2021
Mitochondria control various processes that are integral to cellular and organismal homeostasis, including Ca2+ fluxes, bioenergetic metabolism, and cell death. Perhaps not surprisingly, multiple pathogenic bacteria have evolved strategies to subvert mitochondrial functions in support of their survival and dissemination. Here, we discuss nonimmunological pathogenic mechanisms that converge on the ability of bacteria to control the mitochondrial compartment of host cells.
Læs mere Tjek på PubMedMalaria Journal, 13.10.2021
Tilføjet 14.10.2021
Abstract
Background
Despite the growing evidence that malaria and anaemia are two interlinked health problems of school-aged children (SAC) in developing countries, there is scarce information about malaria among SAC in Ethiopia. Moreover, anaemia-related studies were more concentrated in easily accessible areas. This study aimed to assess the prevalence of malaria and anaemia and corresponding risk factors among SAC in Dara Mallo and Uba Debretshay districts, in hard to reach areas, so as to inform appropriate integrated interventions for both diseases.
Methods
This study was part of baseline data collected for a cluster-randomized trial registered in Pan African Clinical Trials Registry (PACTR202001837195738). Data were collected from 2167 SAC and their households through face-to-face interview; malaria was diagnosed by using rapid diagnostic test (RDT); haemoglobin concentration was determined using hemoCue hb 301 and adjusted for altitude to determine anaemic status; helminth infections were determined by using kato-katz, and anthropometric measurements were made to determine nutritional status of children. Generalized mixed effects logistic regression model was used to assess the association between predictor variables and malaria and anaemia using school as a random variable.
Results
The overall prevalence of malaria was 1.62% (95% CI 1.15–2.27%) (35/2167). Of the 35 children positive for malaria, 20 (57.14%), 3 (8.57%) and 12 (34.29%) were due to Plasmodium falciparum, Plasmodium vivax and mixed infections of P. falciparum and P. vivax, respectively. Malaria was significantly lower among children from literate household head (Adjusted OR = 0.38; 95% CI 0.15–0.95) and residence house located at an altitude range above 1100 masl (AOR = 0.40; 95% CI 0.17–0.94). The prevalence of anaemia was 22.00% (95% CI 20.3–23.8%) (477/2167) and was significantly reduced by eating legumes, nuts or seed group of food in their 24-h dietary diversity recall (AOR = 0.64; 95% CI 0.41–0.99).
Conclusions
The prevalence of malaria was low and unevenly distributed per school while the overall prevalence of anaemia was moderate. It is important to implement integrated interventions targeting both malaria and anaemia, with special emphasis given to children from illiterate households and living at an altitude below 1100 masl. The micronutrient content of locally grown legumes should be further investigated to recommend specific interventions to overcome anaemia.
Læs mere Tjek på PubMedMalaria Journal, 13.10.2021
Tilføjet 14.10.2021
Abstract
Artemisinin resistance has emerged and spread in the Greater Mekong Sub-region (GMS), followed by artemisinin-based combination therapy failure, due to both artemisinin and partner drug resistance. More worrying, artemisinin resistance has been recently reported and confirmed in Rwanda. Therefore, there is an urgent need to strengthen surveillance systems beyond the GMS to track the emergence or spread of artemisinin and partner drug resistance in other endemic settings. Currently, anti-malarial drug efficacy is monitored primarily through therapeutic efficacy studies (TES). Even though essential for anti-malarial drug policy change, these studies are difficult to conduct, expensive, and may not detect the early emergence of resistance. Additionally, results from TES may take years to be available to the stakeholders, jeopardizing their usefulness. Molecular markers are additional and useful tools to monitor anti-malarial drug resistance, as samples collected on dried blood spots are sufficient to monitor known and validated molecular markers of resistance, and could help detecting and monitoring the early emergence of resistance. However, molecular markers are not monitored systematically by national malaria control programmes, and are often assessed in research studies, but not in routine surveillance. The implementation of molecular markers as a routine tool for anti-malarial drug resistance surveillance could greatly improve surveillance of anti-malarial drug efficacy, making it possible to detect resistance before it translates to treatment failures. When possible, ex vivo assays should be included as their data could be useful complementary, especially when no molecular markers are validated.
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