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29 emner vises.
Patricia Eyu, Peter Elyanu, Alex R. Ario, Vivian Ntono, Doreen Birungi, Gerald Rukundo, Carol Nanziri, Ignatius Wadunde, Richard Migisha, Elizabeth Katana, Peter Oumo, Job Morukileng, Julie R. Harris
International Journal of Infectious Diseases, 16.05.2022
Tilføjet 17.05.2022
Priya Verma, Sayan Banerjee, Upasana Baskey, Supradip Dutta, Sagnik Bakshi, Raina Das, Sandip Samanta, Shanta Dutta, Provash Chandra Sadhukhan
Journal of Medical Virology, 17.05.2022
Tilføjet 17.05.2022
Kayzad Nilgiriwala, Pratibha Kadam, Grishma Patel, Ambreen Shaikh, Tejal Mestry, Smriti Vaswani, Shalini Sakthivel, Aruna Poojary, Bhavesh Gandhi, Seema Rohra, Zarir Udwadia, Vikas Oswal, Daksha Shah, Mangala Gomare, Kalpana Sriraman, Nerges Mistry
Journal of Medical Virology, 17.05.2022
Tilføjet 17.05.2022
Huifang Zhu, Rongzhao Zhang, Li Yi, Yan‐Dong Tang, Chunfu Zheng
Journal of Medical Virology, 17.05.2022
Tilføjet 17.05.2022
Thiago Cerqueira-Silva, Vinicius de Araujo Oliveira, Enny S Paixão, Pilar Tavares Veras Florentino, Gerson O Penna, Neil Pearce, Guilherme L Werneck, Maurício L Barreto, Viviane S Boaventura, Manoel Barral-Netto
Lancet Infectious Diseases, 17.05.2022
Tilføjet 17.05.2022
As of May 11, 2022, an estimated 519 million individuals have been infected with SARS-CoV-2, and at least 11 billion COVID-19 vaccine doses have been administered worldwide. Therefore, understanding hybrid immunity (ie, immunity derived from infection plus vaccination) is crucial to guide future vaccination policies. We found that vaccination provided additional protection to that induced by past infection during the gamma (P.1) and delta (B.1.617.2) variant waves of the pandemic in Brazil.1 With the emergence of the omicron (B.1.1.529) variant, vaccine effectiveness appears to decay,2,3 but protection in individuals who have been previously infected and vaccinated remains unknown.
Læs mere Tjek på PubMedKaren H Keddy
Lancet Infectious Diseases, 17.05.2022
Tilføjet 17.05.2022
One of the many lessons of the past 2 years has been the additional challenges faced by low-income and middle-income countries in accessing and distributing vaccines. Although the major focus has been accessing COVID-19 vaccination,1 ever-mounting evidence exists to suggest that childhood vaccination programmes generally have been disrupted, for a number of reasons, including restrictions of population movement due to national lockdowns early in the COVID-19 pandemic, and later predominantly due to vaccine stockouts.
Læs mere Tjek på PubMedSuman Kanungo, Pranab Chatterjee, Ashish Bavdekar, Manoj Murhekar, Sudhir Babji, Richa Garg, Sandip Samanta, Ranjan K Nandy, Anand Kawade, Kangusamy Boopathi, Kaliaperumal Kanagasabai, Vineet Kumar Kamal, Velusamy Saravana Kumar, Nivedita Gupta, Shanta Dutta
Lancet Infectious Diseases, 17.05.2022
Tilføjet 17.05.2022
Rotavac and Rotasiil can be safely used in an interchangeable manner for routine immunisation since the seroresponse was non-inferior in the mixed vaccine regimen compared with the single vaccine regimen. These results allow for flexibility in administering the vaccines, helping to overcome vaccine shortages and supply chain issues, and targeting migrant populations easily.
Læs mere Tjek på PubMedJ Daniel Kelly, Collin Van Ryn, Moses Badio, Tamba Fayiah, Kumblytee Johnson, Dehkontee Gayedyu-Dennis, Sheri D Weiser, Travis C Porco, Jeffery N Martin, Michael C Sneller, George W Rutherford, Cavan Reilly, Mosoka P Fallah, J Soka Moses
Lancet Infectious Diseases, 17.05.2022
Tilføjet 17.05.2022
Our findings provide evidence of post-Ebola virus disease clinical sequelae among contacts with unrecognised Ebola virus disease but not in people with pauci-symptomatic or asymptomatic Ebola virus infection.
Læs mere Tjek på PubMedJohn D. Perpich, Lan Yakoumatos, Kendall S. Stocke, Gina R. Lewin, Anayancy Ramos, Deborah R. Yoder-Himes, Marvin Whiteley, Richard J. Lamont aDepartment of Oral Immunology and Infectious Diseases, University of Louisvillegrid.266623.5, Louisville, Kentucky, USA bDepartment of Pharmaceutical Sciences, Sullivan University College of Pharmacy and Health Sciences, Louisville, Kentucky, USA cSchool of Biological Sciences, Georgia Institute of Technologygrid.213917.f, Atlanta, Georgia, USA dEmory-Children’s Cystic Fibrosis Center, Atlanta, Georgia, USA eCenter for Microbial Dynamics and Infection, Georgia Institute of Technologygrid.213917.f, Atlanta, Georgia, USA fDepartment of Biology, University of Louisvillegrid.266623.5, Louisville, Kentucky, USA, Andreas J. Bäumler
Infection and Immunity, 16.05.2022
Tilføjet 16.05.2022
Infection, 16.05.2022
Tilføjet 16.05.2022
Abstract
Purpose
Symptoms often persistent for more than 4 weeks after COVID-19—now commonly referred to as ‘Long COVID’. Independent of initial disease severity or pathological pulmonary functions tests, fatigue, exertional intolerance and dyspnea are among the most common COVID-19 sequelae. We hypothesized that respiratory muscle dysfunction might be prevalent in persistently symptomatic patients after COVID-19 with self-reported exercise intolerance.
Methods
In a small cross-sectional pilot study (n = 67) of mild-to-moderate (nonhospitalized) and moderate-to-critical convalescent (formerly hospitalized) patients presenting to our outpatient clinic approx. 5 months after acute infection, we measured neuroventilatory activity P0.1, inspiratory muscle strength (PImax) and total respiratory muscle strain (P0.1/PImax) in addition to standard pulmonary functions tests, capillary blood gas analysis, 6 min walking tests and functional questionnaires.
Results
Pathological P0.1/PImax was found in 88% of symptomatic patients. Mean PImax was reduced in hospitalized patients, but reduced PImax was also found in 65% of nonhospitalized patients. Mean P0.1 was pathologically increased in both groups. Increased P0.1 was associated with exercise-induced deoxygenation, impaired exercise tolerance, decreased activity and productivity and worse Post-COVID-19 functional status scale. Pathological changes in P0.1, PImax or P0.1/PImax were not associated with pre-existing conditions.
Conclusions
Our findings point towards respiratory muscle dysfunction as a novel aspect of COVID-19 sequelae. Thus, we strongly advocate for systematic respiratory muscle testing during the diagnostic workup of persistently symptomatic, convalescent COVID-19 patients.
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Hong Yuan, Hailan Wu, Yingyuan Zhang, Haihui Huang, Yi Li, Junzhen Wu, Guoying Cao, Jicheng Yu, Beining Guo, Jufang Wu, Zhengyu Yuan, Yuancheng Chen, Wanqiu Yang, Xiaojie Wu, Jing Zhang aInstitute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China bKey Laboratory of Clinical Pharmacology of Antibiotics, National Health Commission of People's Republic of China, Shanghai, China cPhase I Unit, Huashan Hospital, Fudan University, Shanghai, China dShanghai MicuRx Pharmaceutical Co., Ltd., Shanghai, China
Antimicrobial Agents And Chemotherapy, 16.05.2022
Tilføjet 16.05.2022
Selvi C. Ersoy, Adhar C. Manna, Richard A. Proctor, Henry F. Chambers, Ewan M. Harrison, Arnold S. Bayer, Ambrose Cheung aThe Lundquist Institute, Torrance, California, USA bDepartment of Microbiology & Immunology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA cUniversity of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA dUCSF School of Medicine, San Francisco, California, USA eWellcome Sanger Institute, Hinxton, United Kingdom fDepartment of Medicine, University of Cambridge, Cambridge, United Kingdom gDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom hThe Geffen School of Medicine, University of California, Los Angeles, California, USA
Antimicrobial Agents And Chemotherapy, 16.05.2022
Tilføjet 16.05.2022
BMC Infectious Diseases, 16.05.2022
Tilføjet 16.05.2022
Abstract
Background
Talaromyces marneffei is an opportunistic pathogen that infects immunodeficient and immunocompromised patients. We presented a pediatric patient with a diagnosis of T. marneffei infection who was followed up in the Guangzhou Women and Children’s Medical Centre.
Case presentation
The child was a 5-year-old girl with persistent cough and gasping over 2 months who was confirmed with T. marneffei infection by bronchoalveolar lavage fluid culture and high-throughput sequencing technology. Human immunodeficiency virus (HIV) was negative according to a serum-specific antibody test. She was treated with amphotericin B and itraconazole as antifungal agents, with good clinical response. At follow-up, high-resolution computed tomography showed a mosaic sign in the whole lung field with a diagnosis of post-infectious bronchiolitis obliterans (PIBO) as the sequela. She has a mutated COPA gene with uncertain pathogenic potential on whole-exome sequencing.
Conclusions
Clinicians should consider PIBO as a possible sequela in an HIV-negative paediatric patient with T. marneffei infection.
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BMC Infectious Diseases, 16.05.2022
Tilføjet 16.05.2022
Abstract
Background
Interactions between humans and animals are the key elements of zoonotic spillover leading to zoonotic disease emergence. Research to understand the high-risk behaviors associated with disease transmission at the human-animal interface is limited, and few consider regional and local contexts.
Objective
This study employed an integrated behavioral–biological surveillance approach for the early detection of novel and known zoonotic viruses in potentially high-risk populations, in an effort to identify risk factors for spillover and to determine potential foci for risk-mitigation measures.
Method
Participants were enrolled at two community-based sites (n = 472) in eastern and western Thailand and two hospital (clinical) sites (n = 206) in northeastern and central Thailand. A behavioral questionnaire was administered to understand participants’ demographics, living conditions, health history, and animal-contact behaviors and attitudes. Biological specimens were tested for coronaviruses, filoviruses, flaviviruses, influenza viruses, and paramyxoviruses using pan (consensus) RNA Virus assays.
Results
Overall 61/678 (9%) of participants tested positive for the viral families screened which included influenza viruses (75%), paramyxoviruses (15%), human coronaviruses (3%), flaviviruses (3%), and enteroviruses (3%). The most salient predictors of reporting unusual symptoms (i.e., any illness or sickness that is not known or recognized in the community or diagnosed by medical providers) in the past year were having other household members who had unusual symptoms and being scratched or bitten by animals in the same year. Many participants reported raising and handling poultry (10.3% and 24.2%), swine (2%, 14.6%), and cattle (4.9%, 7.8%) and several participants also reported eating raw or undercooked meat of these animals (2.2%, 5.5%, 10.3% respectively). Twenty four participants (3.5%) reported handling bats or having bats in the house roof. Gender, age, and livelihood activities were shown to be significantly associated with participants’ interactions with animals. Participants’ knowledge of risks influenced their health-seeking behavior.
Conclusion
The results suggest that there is a high level of interaction between humans, livestock, and wild animals in communities at sites we investigated in Thailand. This study highlights important differences among demographic and occupational risk factors as they relate to animal contact and zoonotic disease risk, which can be used by policymakers and local public health programs to build more effective surveillance strategies and behavior-focused interventions.
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BMC Infectious Diseases, 16.05.2022
Tilføjet 16.05.2022
Abstract
Background
The present study aimed to identify the clinical significance of Mycoplasma pneumoniae (MP)-specific immunoglobulin M (IgM) titer, in addition to a diagnosis of MP infection, in children with MP pneumonia.
Methods
This study was performed in 155 children hospitalized with MP pneumonia. The clinical features and laboratory and radiographic findings on admission in children with positive or negative MP-specific IgM titers were retrospectively reviewed from the electronic medical records.
Results
The mean age of the included children was 6.0 years, and 118 (76.1%) of the children were positive for MP-specific IgM. A longer duration between symptom onset and admission (adjusted odds ratio [aOR] 1.47, 95% confidence interval [CI] 1.24–1.75), longer duration of symptoms during the illness (aOR 1.15, 95% CI 1.02–1.30), and development of extra-pulmonary manifestations (aOR 9.16, 95% CI 1.96–42.81) were significantly associated with a positive MP-specific IgM titer. Serum lactate dehydrogenase levels (aOR 1.00, 95% CI 1.00–1.01) and pneumonic infiltration involving > 50% of the total lung volume on chest radiography (aOR 4.68, 95% CI 1.12–19.55) were associated with positive MP-specific IgM in children with MP pneumonia. A poor response to stepwise treatment for MP pneumonia was more common in children with a positive MP-specific IgM titer than those with a negative MP-specific IgM titer on admission.
Conclusions
A positive MP-specific IgM titer at diagnosis of MP pneumonia may partially suggest an exaggerated immune response with a higher disease burden compared to children with MP pneumonia with a negative MP-specific IgM titer.
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BMC Infectious Diseases, 16.05.2022
Tilføjet 16.05.2022
Abstract
Background
Symptoms of depression are prevalent in people living with human immune deficiency virus/acquired immune deficiency syndrome (PLWHA), and worsened by lack of physical activity/exercises, leading to restriction in social participation/functioning. This raises the question: what is the extent to which physical exercise training affected, symptoms of depression, physical activity level (PAL) and social participation in PLWHA compared to other forms of intervention, usual care, or no treatment controls?
Method
Eight databases were searched up to July 2020, according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol. Only randomised controlled trials involving adults who were either on HAART/HAART-naïve and reported in the English language, were included. Two independent reviewers determined the eligibility of the studies, extracted data, assessed their quality, and risk of bias using the Physiotherapy Evidence Database (PEDro) tool. Standardised mean difference (SMD) was used as summary statistics for the mean primary outcome (symptoms of depression) and secondary outcomes (PAL and social participation) since different measuring tools/units were used across the included studies. Summary estimates of effects were determined using a random-effects model (I2).
Results
Thirteen studies met the inclusion criteria with 779 participants (n = 596 participants at study completion) randomised into the study groups, comprising 378 males, 310 females and 91 participants with undisclosed gender, and with an age range of 18–86 years. Across the studies, aerobic or aerobic plus resistance exercises were performed 2–3 times/week, at 40–60 min/session, and for between 6-24 weeks, and the risk of bias vary from high to low. Comparing the intervention to control groups showed significant difference in the symptoms of depression (SMD = − 0.74, 95% confidence interval (CI) − 1.01, − 0.48, p ≤ 0.0002; I2 = 47%; 5 studies; 205 participants) unlike PAL (SMD = 0.98, 95% CI − 0.25, 2.17, p = 0.11; I2 = 82%; 2 studies; 62 participants) and social participation (SMD = 0.04, 95% CI − 0.65, 0.73, p = 0.91; I2 = 90%; 6 studies; 373 participants).
Conclusion
Physical exercise training could have an antidepressant-like effect in PLWHA but did not affect PAL and social participation. However, the high heterogeneity in the included studies, implies that adequately powered randomised controlled trials with clinical/methodological similarity are required in future studies.
Trail Registration number
INPLASY202040048.
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BMC Infectious Diseases, 16.05.2022
Tilføjet 16.05.2022
Abstract
Background
It is not known whether post-traumatic stress disorder (PTSD) increases HIV-risk behaviours among young people in sub-Saharan Africa. We assessed associations of PTSD symptoms with sexual behaviour, HIV risk perception, and attitudes towards PrEP among young people taking part in the CHAPS community survey. We hypothesised that PTSD symptoms would increase sexual behaviours associated with HIV risk, hinder PrEP uptake and influence preference for daily versus on-demand PrEP.
Methods
Young people without HIV, aged 13–24 years, were purposively recruited in Johannesburg and Cape Town in South Africa, Wakiso in Uganda, and Chitungwiza in Zimbabwe, and surveyed on socio-demographic characteristics, PrEP knowledge and attitudes, sexual behaviour, HIV perception and salience, and mental health. PTSD symptoms were measured using the Primary Care PTSD Screen for the Diagnostic and Statistical Manual of Mental Disorders 5 (PC-PTSD-5). Logistic and ordinal logistic regression was used to assess associations between PC-PTSD-5 score and socio-demographic characteristics, sexual behaviour, HIV risk perception, PrEP attitudes, and substance use, adjusting for age, sex, setting, depression and anxiety.
Results
Of 1330 young people (51% male, median age 19 years), 522 (39%) reported at least one PTSD symptom. There was strong evidence that having a higher PC-PTSD-5 score was associated with reported forced sex (OR 3.18, 95%CI: 2.05–4.93), self-perception as a person who takes risks (OR 1.12, 95%CI: 1.04–1.20), and increased frequency of thinking about risk of HIV acquisition (OR 1.16, 95%CI: 1.08–1.25). PTSD symptoms were not associated with willingness to take PrEP, preference for on-demand versus daily PrEP, or actual HIV risk behaviour such as condomless sex.
Conclusions
Symptoms consistent with probable PTSD were common among young people in South Africa, Uganda and Zimbabwe but did not impact PrEP attitudes or PrEP preferences. Evaluation for PTSD might form part of a general assessment in sexual and reproductive health services in these countries. More work is needed to understand the impact of PTSD on HIV-risk behaviour, forced sex and response to preventive strategies including PrEP.
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BMC Infectious Diseases, 16.05.2022
Tilføjet 16.05.2022
Abstract
Background
Adolescent girls and young women (AGYW) account for a disproportionate number of new HIV infections worldwide. HIV prevalence among young sex workers in Uganda is 22.5%. Although pre-exposure prophylaxis (PrEP) is a highly effective biomedical HIV prevention method, awareness of PrEP among AGYW in Uganda has not been studied systematically. We aimed to assess awareness of PrEP and factors associated with awareness of PrEP among AGYW who frequently reported paid sex.
Methods
We conducted a cross-sectional study among 14–24-year old AGYW at high risk of HIV infection in Kampala, Uganda from January to October 2019. Participants were screened for PrEP eligibility using a national screening tool of whom 82.3% were eligible. Data on socio-demographics, behavioral and sexual risks were collected by interview. Awareness of oral or injectable PrEP, the latter of which is currently in late-stage trials, was defined as whether an individual had heard about PrEP as an HIV prevention method. Multivariable robust poisson regression model was used to assess factors associated with oral PrEP awareness.
Results
We enrolled 285 participants of whom 39.3% were under 20 years old, 54.7% had completed secondary education, 68.8% had multiple sex partners in the past 3 months, 8.8% were screened as high risk drinkers’/ alcohol dependent (AUDIT tool) and 21.0% reported sex work as main occupation. Only 23.2% were aware of oral PrEP and 3.9% had heard about injectable PrEP. The prevalence of oral PrEP awareness was significantly higher among volunteers screened as alcohol dependents (aPR 1.89, 95% CI 1.08–3.29) and those with multiple sexual partners (aPR 1.84, 95% CI 1.01–3.35), but was lower among those who reported consistent condom use with recent sexual partners (aPR 0.58, 95% CI 0.37–0.91).
Conclusions
Majority of AGYW were not aware of any kind of PrEP. Those with higher risk behavior, i.e. alcohol dependents or multiple sexual partners, were more aware of oral PrEP. Interventions to increase awareness among female youth are needed. Improving PrEP awareness is critical to increasing PrEP uptake among high-risk AGYW in Uganda.
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BMC Infectious Diseases, 16.05.2022
Tilføjet 16.05.2022
Abstract
Background
Vaccination has been proven to be an effective approach against the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to determine the acceptance rate and factors influencing acceptance of COVID-19 vaccination among people living with HIV (PLWH) in Guangxi, China.
Methods
A cross-sectional survey was carried out in five cities in Guangxi, China from May 7 to June 1, 2021. Questionnaires on the acceptance of COVID-19 vaccination and the related factors were conducted among PLWH recruited by simple random sampling. Univariate and multivariate logistic regression analyses were performed to identify factors associated with acceptance of COVID-19 vaccination.
Results
Of all valid respondents (n = 903), 72.9% (n = 658) were willing to receive COVID-19 vaccination. Fear of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was the main reason for being willing to receive vaccination (76.0%), while the main reasons for not willing were the concerns about vaccine safety (54.7%) and the vaccination’s effect on antiretroviral therapy (ART) (50.6%). The most important factors influencing acceptance were the perception that vaccination is unsafe for HIV-infected people (aOR = 0.082, 95% CI = 0.024–0.282) and the poor efficacy in preventing SARS-CoV-2 infection in HIV-infected people (aOR = 0.093, 95% CI = 0.030–0.287). Other factors associated with acceptance included Zhuang ethnicity (aOR = 1.653, 95% CI = 1.109–2.465), highest education level of middle school, high school or above (aOR = 1.747, 95% CI = 1.170–2.608; aOR = 2.492, 95% CI = 1.326–4.682), and the vaccination having little effect on ART efficacy (aOR = 2.889, 95% CI = 1.378–6.059).
Conclusions
Acceptance rate of the COVID-19 vaccination is relatively low among PLWH compared to the general population in China, although some patients refused vaccination due to concerns about vaccine safety and vaccination affecting ART efficacy. More research is needed to investigate the impact of the COVID-19 vaccines on ART efficacy and the effectiveness in preventing SARS-CoV-2 infection among PLWH.
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Christopher A. Beaudoin, Arun P. Pandurangan, So Yeon Kim, Samir W. Hamaia, Christopher L.‐H. Huang, Tom L. Blundell, Sundeep Chaitanya Vedithi, Antony P. Jackson
Journal of Medical Virology, 16.05.2022
Tilføjet 16.05.2022
Wilfred Ouma Otambo, Collince J. Omondi, Kevin O. Ochwedo, Patrick O. Onyango, Harrysone Atieli, Ming-Chieh Lee, Chloe Wang, Guofa Zhou, Andrew K. Githeko, John Githure, Collins Ouma, Guiyun Yan, James Kazura
PLoS One Infectious Diseases, 16.05.2022
Tilføjet 16.05.2022
by Wilfred Ouma Otambo, Collince J. Omondi, Kevin O. Ochwedo, Patrick O. Onyango, Harrysone Atieli, Ming-Chieh Lee, Chloe Wang, Guofa Zhou, Andrew K. Githeko, John Githure, Collins Ouma, Guiyun Yan, James Kazura
Background Persons with submicroscopic malaria infection are a major reservoir of gametocytes that sustain malaria transmission in sub-Saharan Africa. Despite recent decreases in the national malaria burden in Kenya due to vector control interventions, malaria transmission continues to be high in western regions of the country bordering Lake Victoria. The objective of this study was to advance knowledge of the topographical, demographic and behavioral risk factors associated with submicroscopic malaria infection in the Lake Victoria basin in Kisumu County. Methods Cross-sectional community surveys for malaria infection were undertaken in three eco-epidemiologically distinct zones in Nyakach sub-County, Kisumu. Adjacent regions were topologically characterized as lakeshore, hillside and highland plateau. Surveys were conducted during the 2019 and 2020 wet and dry seasons. Finger prick blood smears and dry blood spots (DBS) on filter paper were collected from 1,777 healthy volunteers for microscopic inspection and real time-PCR (RT-PCR) diagnosis of Plasmodium infection. Persons who were PCR positive but blood smear negative were considered to harbor submicroscopic infections. Topographical, demographic and behavioral risk factors were correlated with community prevalence of submicroscopic infections. Results Out of a total of 1,777 blood samples collected, 14.2% (253/1,777) were diagnosed as submicroscopic infections. Blood smear microscopy and RT-PCR, respectively, detected 3.7% (66/1,777) and 18% (319/1,777) infections. Blood smears results were exclusively positive for P. falciparum, whereas RT-PCR also detected P. malariae and P. ovale mono- and co-infections. Submicroscopic infection prevalence was associated with topographical variation (χ2 = 39.344, df = 2, p
Læs mere Tjek på PubMedXiuzhen Lei, Wenbin Teng, Ying Fan, Yeke Zhu, Liuxu Yao, Yuhong Li, Shengmei Zhu
PLoS One Infectious Diseases, 16.05.2022
Tilføjet 16.05.2022
by Xiuzhen Lei, Wenbin Teng, Ying Fan, Yeke Zhu, Liuxu Yao, Yuhong Li, Shengmei Zhu
The integrity of the intestinal barrier is critical for protecting the host against the pathogen. The role of hypoxia-inducible factor-1α (HIF-1α) in the intestinal barrier disfunction related to sepsis remained unclear. The purpose of the present study is to investigate the role of HIF-1α on oxidative damage, the intestinal mucosal permeability, structural and morphological changes during sepsis. Twenty-four Sprague Dawley (SD) rats were randomly divided into four groups of 6 rats each: the sham group (sham), sepsis group (subjected to cecal ligation and perforation, CLP), sepsis + DMOG group (40 mg/kg of DMOG by intraperitoneal injection for 7 consecutive days before CLP), and sepsis + BAY 87–2243 group (9 mg/kg of BAY 87–2243 orally administered for 3 consecutive days before CLP). Sepsis increased plasma levels of inflammatory mediators, oxidative stress markers and HIF-1α expression; caused pathological damage; increased permeability (P < 0.05); and decreased TJ protein expression in the intestinal mucosa of rats with sepsis (P < 0.05). The addition of DMOG up-regulated HIF-1α, then decreased the plasma levels of inflammatory mediators, oxidative stress markers, alleviated pathological damage to the intestinal mucosa and decreased intestinal permeability (P < 0.05); while BAY 87–2243 treatment had the opposite effects. Our findings showed that HIF-1α protects the intestinal barrier function of septic rats by inhibiting intestinal inflammation and oxidative damage, our results provide a novel insight for developing sepsis treatment.
Læs mere Tjek på PubMedJeffrey Sonis, Donald E. Pathman, Susan Read, Bradley N. Gaynes
PLoS One Infectious Diseases, 16.05.2022
Tilføjet 16.05.2022
by Jeffrey Sonis, Donald E. Pathman, Susan Read, Bradley N. Gaynes
Background There have been no studies to date of moral distress during the COVID-19 pandemic in national samples of U.S. health workers. The purpose of this study was to determine, in a national sample of internal medicine physicians (internists) in the U.S.: 1) the intensity of moral distress; 2) the predictors of moral distress; 3) the outcomes of moral distress. Methods We conducted a national survey with an online panel of internists, representative of the membership of the American College of Physicians, the largest specialty organization of physicians in the United States, between September 21 and October 8, 2020. Moral distress was measured with the Moral Distress Thermometer, a one-item scale with a range of 0 (“none”) to 10 (“worst possible”). Outcomes were measured with short screening scales. Results The response rate was 37.8% (N = 810). Moral distress intensity was low (mean score = 2.4, 95% CI, 2.2–2.6); however, 13.3% (95% CI, 12.1% - 14.5%) had a moral distress score greater than or equal to 6 (“distressing”). In multiple linear regression models, perceived risk of death if infected with COVID-19 was the strongest predictor of higher moral distress (β (standardized regression coefficient) = 0.26, p < .001), and higher perceived organizational support (respondent belief that their health organization valued them) was most strongly associated with lower moral distress (β = -0.22, p < .001). Controlling for other factors, high levels of moral distress, but not low levels, were strongly associated (adjusted odds ratios 3.0 to 11.5) with screening positive for anxiety, depression, posttraumatic stress disorder, burnout, and intention to leave patient care. Conclusions The intensity of moral distress among U.S. internists was low overall. However, the 13% with high levels of moral distress had very high odds of adverse mental health outcomes. Organizational support may lower moral distress and thereby prevent adverse mental health outcomes.
Læs mere Tjek på PubMedMarjorie Canu, Charles Khouri, Stéphanie Marliere, Estelle Vautrin, Nicolas Piliero, Olivier Ormezzano, Bernard Bertrand, Hélène Bouvaist, Laurent Riou, Loic Djaileb, Clémence Charlon, Gerald Vanzetto, Matthieu Roustit, Gilles Barone-Rochette
PLoS One Infectious Diseases, 16.05.2022
Tilføjet 16.05.2022
by Marjorie Canu, Charles Khouri, Stéphanie Marliere, Estelle Vautrin, Nicolas Piliero, Olivier Ormezzano, Bernard Bertrand, Hélène Bouvaist, Laurent Riou, Loic Djaileb, Clémence Charlon, Gerald Vanzetto, Matthieu Roustit, Gilles Barone-Rochette
Coronary microvascular dysfunction (CMVD) is common and associated with poorer outcomes in patients with ST Segment Elevation Myocardial Infarction (STEMI). The index of microcirculatory resistance (IMR) and the index of hyperemic microvascular resistance (HMR) are both invasive indexes of microvascular resistance proposed for the diagnosis of severe CMVD after primary percutaneous coronary intervention (pPCI). However, these indexes are not routinely assessed in STEMI patients. Our main objective was to clarify the association between IMR or HMR and long-term major adverse cardiovascular events (MACE), through a systematic review and meta-analysis of observational studies. We searched Medline, PubMed, and Google Scholar for studies published in English until December 2020. The primary outcome was a composite of cardiovascular death, non-cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and rehospitalization for heart failure occurring after at least 6 months following CMVD assessment. We identified 6 studies, reporting outcomes in 1094 patients (mean age 59.7 ± 11.4 years; 18.2% of patients were women) followed-up from 6 months to 7 years. Severe CMVD, defined as IMR > 40 mmHg or HMR > 3mmHg/cm/sec was associated with MACE with a pooled HR of 3.42 [2.45; 4.79]. Severe CMVD is associated with an increased risk of long-term adverse cardiovascular events in patients with STEMI. Our results suggest that IMR and HMR are useful for the early identification of severe CMVD in patients with STEMI after PCI, and represent powerful prognostic assessments as well as new therapeutic targets for clinical intervention.
Læs mere Tjek på PubMedLarissa H. Unruh, Sadhana Dharmapuri, Yinglin Xia, Kenneth Soyemi
PLoS One Infectious Diseases, 16.05.2022
Tilføjet 16.05.2022
by Larissa H. Unruh, Sadhana Dharmapuri, Yinglin Xia, Kenneth Soyemi
Early data from the COVID-19 pandemic suggests that the disease has had a disproportionate impact on communities of color with higher infection and mortality rates within those communities. This study used demographic data from the 2018 US census estimates, mortality data from the Cook County Medical Examiner’s office, and testing results from the Illinois Department of Public Health to perform bivariate and multivariate regression analyses to explore the role race plays in COVID-19 outcomes at the individual and community levels. We used the ZCTA Social Deprivation Index (SDI), a measure of ZCTA area level deprivation based on seven demographic characteristics to quantify the socio-economic variation in health outcomes and levels of disadvantage across ZCTAs. Principal findings showed that: 1) while Black individuals make up 22% of Cook County’s population, they account for 28% of the county’s COVID-19 related deaths; 2) the average age of death from COVID-19 is seven years younger for Non-White compared with White decedents; 3) residents of Minority ZCTA areas were 1.02 times as likely to test positive for COVID-19, (Incidence Rate Ratio (IRR) 1.02, [95% CI 0.95, 1.10]); 1.77 times as likely to die (IRR 1.77, [95% CI 1.17, 2.66]); and were 1.15 times as likely to be tested (IRR 1.15, [95% CI 0.99, 1.33]). There are notable differences in COVID-19 related outcomes between racial and ethnic groups at individual and community levels. This study illustrates the health disparities and underlying systemic inequalities experienced by communities of color.
Læs mere Tjek på PubMedAndrew F. Brouwer, Lora P. Campredon, Heather M. Walline, Brittany M. Marinelli, Christine M. Goudsmit, Trey B. Thomas, Rachel L. Delinger, Yan Kwan Lau, Emily C. Andrus, Monica L. Yost, Jodi K. McCloskey, Taylor S. Sullivan, Alex S. Mortensen, Suiyuan Huang, Keith Murphy, Bonnie Cheng, Kayla Stanek, Thankam Nair, Thomas E. Carey, Rafael Meza, Marisa C. Eisenberg
PLoS One Infectious Diseases, 16.05.2022
Tilføjet 16.05.2022
by Andrew F. Brouwer, Lora P. Campredon, Heather M. Walline, Brittany M. Marinelli, Christine M. Goudsmit, Trey B. Thomas, Rachel L. Delinger, Yan Kwan Lau, Emily C. Andrus, Monica L. Yost, Jodi K. McCloskey, Taylor S. Sullivan, Alex S. Mortensen, Suiyuan Huang, Keith Murphy, Bonnie Cheng, Kayla Stanek, Thankam Nair, Thomas E. Carey, Rafael Meza, Marisa C. Eisenberg
We determined baseline oral and cervicogenital human papillomavirus (HPV) prevalence and determinants of infection in the Michigan HPV and Oropharyngeal Cancer (MHOC) study. We enrolled 394 college-age and older participants of both sexes in Ann Arbor, Michigan and the surrounding area. All participants provided an oral sample at baseline, and 130 females provided a cervicogenital sample. Samples were tested for 18 HPV genotypes using polymerase chain reaction (PCR) MassArray. Participants filled out sociodemographic and behavioral questionnaires. Prevalence ratios for HPV oral or cervicogenital prevalence by predictor variables were estimated in univariable log-binomial models. Analysis was conducted 2018–20. In the full cohort, baseline oral HPV prevalence was 10.0% for any detected genotype (among the 338 valid oral tests at baseline) and 6.5% for high-risk types, and cervicogenital prevalence was 20.0% and 10.8%, respectively (among the 130 first valid cervicogenital tests). Oral HPV prevalence did not vary by sex, with 10.5% of women and 9.0% of men having an infection. We found a high prevalence of oral and cervicogenital HPV infection in college-age participants reporting no lifetime sexual partners. Reporting a single recent partner was associated with a lower oral HPV prevalence (PR 0.39, 95% CI: 0.16, 0.96) than reporting no recent (but at least one ever) partner. No similar protective effect was seen for cervicogenital HPV. Both oral and cervicogenital prevalence increased with the number of recent partners for most sexual behaviors. We observed an ecological fallacy masking the direction of impact of vaccination on HPV prevalence in the full cohort compared to the college-aged and the age 23+ populations considered separately. Substance use was not significantly associated with oral or cervicogenital HPV infection. Many studies report substantially higher oral HPV infection prevalence in men than in women. That difference may not be uniform across populations in the US.
Læs mere Tjek på PubMedAnum Khan, Huma Ali, Ubaid Ur Rehman, Ali Osman Belduz, Amna Bibi, Mujib Abdulkadir Abdurahman, Aamer Ali Shah, Malik Badshah, Fariha Hasan, Ali Osman Kilic, Asad Ullah, Sarwat Jahan, Muhammad Maqsood Ur Rehman, Rashid Mansoor, Samiullah Khan
PLoS One Infectious Diseases, 16.05.2022
Tilføjet 16.05.2022
by Anum Khan, Huma Ali, Ubaid Ur Rehman, Ali Osman Belduz, Amna Bibi, Mujib Abdulkadir Abdurahman, Aamer Ali Shah, Malik Badshah, Fariha Hasan, Ali Osman Kilic, Asad Ullah, Sarwat Jahan, Muhammad Maqsood Ur Rehman, Rashid Mansoor, Samiullah Khan
The increase in consumer demand for high-quality food products has led to growth in the use of new technologies and ingredients. Resistant starch (RS) is a recently recognised source of fibre and has received much attention for its potential health benefits and functional properties. However, knowledge about the fate of RS in modulating complex intestinal communities, the microbial members involved in its degradation, enhancement of microbial metabolites, and its functional role in body physiology is still limited. For this purpose, the current study was designed to ratify the physiological and functional health benefits of enzymatically prepared resistant starch (EM-RSIII) from maize flour. To approve the beneficial health effects as prebiotic, EM-RSIII was supplemented in rat diets. After 21 days of the experiment, EM-RSIII fed rats showed a significant reduction in body weight gain, fecal pH, glycemic response, serum lipid profile, insulin level and reshaping gut microbiota, and enhancing short-chain fatty acid compared to control. The count of butyrate-producing and starch utilizing bacteria, such as Lactobacillus, Enterococcus, and Pediococcus genus in rat’s gut, elevated after the consumption of medium and high doses of EM-RSIII, while the E. coli completely suppressed in high EM-RSIII fed rats. Short-chain fatty acids precisely increased in feces of EM-RSIII feed rats. Correlation analysis demonstrated that the effect of butyrate on functional and physiological alteration on the body had been investigated during the current study. Conclusively, the present study demonstrated the unprecedented effect of utilising EM-RSIII as a diet on body physiology and redesigning gut microorganisms.
Læs mere Tjek på PubMedAndrew Kazibwe, Bonniface Oryokot, Levicatus Mugenyi, David Kagimu, Abraham Ignatius Oluka, Darlius Kato, Simple Ouma, Edmund Tayebwakushaba, Charles Odoi, Kizito Kakumba, Ronald Opito, Ceasar Godfrey Mafabi, Michael Ochwo, Robert Nkabala, Wilber Tusiimire, Agnes Kateeba Tusiime, Sarah Barbara Alinga, Yunus Miya, Michael Bernard Etukoit, Irene Andia Biraro, Bruce Kirenga
PLoS One Infectious Diseases, 16.05.2022
Tilføjet 16.05.2022
by Andrew Kazibwe, Bonniface Oryokot, Levicatus Mugenyi, David Kagimu, Abraham Ignatius Oluka, Darlius Kato, Simple Ouma, Edmund Tayebwakushaba, Charles Odoi, Kizito Kakumba, Ronald Opito, Ceasar Godfrey Mafabi, Michael Ochwo, Robert Nkabala, Wilber Tusiimire, Agnes Kateeba Tusiime, Sarah Barbara Alinga, Yunus Miya, Michael Bernard Etukoit, Irene Andia Biraro, Bruce Kirenga
Introduction Isoniazid preventive therapy (IPT) is effective in treating tuberculosis (TB) infection and hence limiting progression to active disease. However, the durability of protection, associated factors and cost-effectiveness of IPT remain uncertain in low-and-middle income countries, Uganda inclusive. The Uganda Ministry of health recommends a single standard-dose IPT course for eligible people living with HIV (PLHIV). In this study we determined the incidence, associated factors and median time to TB diagnosis among PLHIV on Antiretroviral therapy (ART) who initiated IPT. Materials and methods We conducted a retrospective cohort study at eleven The AIDS Support Organization (TASO) centers in Uganda. We reviewed medical records of 2634 PLHIV on ART who initiated IPT from 1st January 2016 to 30th June 2018, with 30th June 2021 as end of follow up date. We analyzed study data using STATA v.16. Incidence rate was computed as the number of new TB cases divided by the total person months. A Frailty model was used to determine factors associated with TB incidence. Results The 2634 individuals were observed for 116,360.7 person months. IPT completion rate was 92.8%. Cumulative proportion of patients who developed TB in this cohort was 0.83% (22/2634), an incidence rate of 18.9 per 100,000 person months. The median time to TB diagnosis was 18.5 months (minimum– 0.47; maximum– 47.3, IQR: 10.1–32.4). World Health Organization (WHO) HIV clinical stage III (adjusted hazard ratio (aHR) 95%CI: 3.66 (1.08, 12.42) (P = 0.037) and discontinuing IPT (aHR 95%CI: 25.96(4.12, 169.48) (p = 0.001)), were associated with higher odds of TB diagnosis compared with WHO clinical stage II and IPT completion respectively. Conclusion Incidence rates of TB were low overtime after one course of IPT, and this was mainly attributed to high completion rates.
Læs mere Tjek på PubMedMarincowitz, C., Stone, T., Hasan, M., Campbell, R., Bath, P. A., Turner, J., Pilbery, R., Thomas, B. D., Sutton, L., Bell, F., Biggs, K., Hopfgartner, F., Mazumdar, S., Petrie, J., Goodacre, S.
BMJ Open, 16.05.2022
Tilføjet 16.05.2022
Objective
To assess accuracy of emergency medical service (EMS) telephone triage in identifying patients who need an EMS response and identify factors which affect triage accuracy.
Design
Observational cohort study.
Setting
Emergency telephone triage provided by Yorkshire Ambulance Service (YAS) National Health Service (NHS) Trust.
Participants
12 653 adults who contacted EMS telephone triage services provided by YAS between 2 April 2020 and 29 June 2020 assessed by COVID-19 telephone triage pathways were included.
Outcome
Accuracy of call handler decision to dispatch an ambulance was assessed in terms of death or need for organ support at 30 days from first contact with the telephone triage service.
Results
Callers contacting EMS dispatch services had an 11.1% (1405/12 653) risk of death or needing organ support. In total, 2000/12 653 (16%) of callers did not receive an emergency response and they had a 70/2000 (3.5%) risk of death or organ support. Ambulances were dispatched to 4230 callers (33.4%) who were not conveyed to hospital and did not deteriorate. Multivariable modelling found variables of older age (1 year increase, OR: 1.05, 95% CI: 1.04 to 1.05) and presence of pre-existing respiratory disease (OR: 1.35, 95% CI: 1.13 to 1.60) to be predictors of false positive triage.
Conclusion
Telephone triage can reduce ambulance responses but, with low specificity. A small but significant proportion of patients who do not receive an initial emergency response deteriorated. Research to improve accuracy of EMS telephone triage is needed and, due to limitations of routinely collected data, this is likely to require prospective data collection.
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