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Ursula Hofer
Nat Rev Microbiol, 1.08.2022
Tilføjet 1.08.2022
Nature Reviews Microbiology, Published online: 01 August 2022; doi:10.1038/s41579-022-00787-wThis study shows how Fusobacterium nucleatum integrates a metabolic network in the oral microbiota.
Læs mere Tjek på PubMedUrsula Hofer
Nat Rev Microbiol, 1.08.2022
Tilføjet 1.08.2022
Nature Reviews Microbiology, Published online: 01 August 2022; doi:10.1038/s41579-022-00788-9A study in cell lines suggests that SARS-CoV-2 potentially spreads through tunnelling nanotubes.
Læs mere Tjek på PubMedUrsula Hofer
Nat Rev Microbiol, 1.08.2022
Tilføjet 1.08.2022
Nature Reviews Microbiology, Published online: 01 August 2022; doi:10.1038/s41579-022-00786-xThis study compares insect-specific flaviviruses with those that can infect both mosquitoes and humans.
Læs mere Tjek på PubMedJoey Kuok Hoong Yam, Thet Tun Aung, Song Lin Chua, Yingying Cheng, Gurjeet Singh Kohli, Jianuan Zhou, Florentin Constancias, Yang Liu, Zhao Cai, May Margarette Santillan Salido, Daniela I. Drautz-Moses, Scott A. Rice, Stephan Christoph Schuster, Zhao Zhi Boo, Bin Wu, Staffan Kjelleberg, Tim Tolker-Nielsen, Rajamani Lakshminarayanan, Roger W. Beuerman, Liang Yang, Michael Givskov aSingapore Centre for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological Universitygrid.59025.3b, Singapore, Singapore bOcular Infections and Anti-Microbials Research Group, Singapore Eye Research Institute, Singapore, Singapore cDepartment of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore dDepartment of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong eForensics Genomics International (FGI), BGI-Shenzhen, Shenzhen, China fAlfred Wegener-Institut Helmholtz-Zentrum für Polar- und Meeresforschung, Bremerhaven, Germany gGuangdong Province Key Laboratory of Microbial Signals and Disease Control, Integrative Microbiology Research Centre, South China Agricultural University, Guangzhou, China hDepartment of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland iSchool of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong Province, China jSchool of Biological Sciences, Nanyang Technological Universitygrid.59025.3b, Singapore, Singapore kCSIRO, Agriculture and Food, Microbiomes for One Systems Health, Canberra, Australia lSchool of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, New South Wales, Australia mCosterton Biofilm Center, Department of Immunology and Microbiology, University of Copenhagengrid.5254.6, Copenhagen, Denmark nDepartment of Pharmacy, National University of Singapore, Singapore, Singapore oAcademic Clinical Program in Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore pSRP Neuroscience and Behavioural Disorders and Emerging Infectious Diseases, Duke-NUS, Singapore, Singapore qOphthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore rDepartment of Ophthalmology, The University of Tennessee Health Science Center, Memphis, Tennessee, USA, Igor E. Brodsky
Infection and Immunity, 1.08.2022
Tilføjet 1.08.2022
Luis Alberto Vega, Misu A. Sanson, María Belén Cubria, Shrijana Regmi, Brittany J. Shah, Samuel A. Shelburne, Anthony R. Flores aDivision of Infectious Diseases, Department of Pediatrics, McGovern Medical School, University of Texas Health Sciences Center at Houston, Houston, Texas, USA bCenter for Antimicrobial Resistance and Microbial Genomics, University of Texas Health Sciences Center at Houston, Houston, Texas, USA cDepartment of Infectious Diseases, Division of Internal Medicine, The University of Texas MD Anderson Cancer Centergrid.240145.6, Houston, Texas, USA, Nancy E. Freitag
Infection and Immunity, 1.08.2022
Tilføjet 1.08.2022
Azadeh Nasuhidehnavi, Yanlin Zhao, Ankita Punetha, Andrew Hemphill, Hong Li, Tyler J. Bechtel, Theresa Rager, Bingcong Xiong, Vasileios I. Petrou, Marc-Jan Gubbels, Eranthie Weerapana, George S. Yap aDepartment of Medicine, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA bDepartment of Microbiology, Biochemistry and Molecular Genetics, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA cInstitute of Parasitology, Department of Infectious Diseases and Pathobiology, University of Bern, Bern, Switzerland dDepartment of Chemistry, Boston Collegegrid.208226.c, Chestnut Hill, Massachusetts, USA eDepartment of Biology, Boston Collegegrid.208226.c, Chestnut Hill, Massachusetts, USA fCenter for Immunity and Inflammation, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA, Jeroen P. J. Saeij
Infection and Immunity, 1.08.2022
Tilføjet 1.08.2022
Melkayehu Kassa, Kassu Desta, Rozina Ambachew, Zenebe Gebreyohannes, Alganesh Gebreyohanns, Nuhamen Zena, Misikir Amare, Betselot Zerihun, Melak Getu, Addisu Gize
PLoS One Infectious Diseases, 1.08.2022
Tilføjet 1.08.2022
by Melkayehu Kassa, Kassu Desta, Rozina Ambachew, Zenebe Gebreyohannes, Alganesh Gebreyohanns, Nuhamen Zena, Misikir Amare, Betselot Zerihun, Melak Getu, Addisu Gize
Background Mycobacterium tuberculosis (M. tuberculosis) remains one of the most significant causes of death and a major public health problem in the community. As a result, the aim of this study was to determine magnitude of Mycobacterium tuberculosis, its drug resistance, and associated factors among presumptive tuberculosis (TB) patients at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods Cross-sectional study was conducted at St. Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia from January to July 2019. Demographic and clinical data were collected by structured questionnaire through face to face interview. Using microscopic examination and GeneXpert MTB/RIF assay and culturing in the Lowenstein-Jensen (LJ) culture media, we collected and analyzed both pulmonary and extra-pulmonary clinical samples. Data were analyzed by SPSS version 23. Binary logistic regression was done to identify the associated risk factors and p-value less than 0.05 was taken as significant association. Results Of the total 436 respondents, 223(51%) were male. The mean ±SD age of the participants was 38±17years. Overall, 27/436(6.2%) of the participants had confirmed Mycobacterium tuberculosis using the GeneXpert MTB/RIF assay and LJ culture media, and two isolates were resistant to RIF and one to INH medication, with two (0.5%) being MDR-TB. MTB infection was associated with previous TB contact history, patient weight loss, and CD4+ T-cell counts of 200-350/mm3 of blood. Conclusion The magnitude of M. tuberculosis and MDR-TB in this study underscores the need for improved early case detection and management of MDR-TB in order to reduce transmission and patient suffering.
Læs mere Tjek på PubMedPeiwen Liao, Claire M. Vajdic, Simone Reppermund, Rachael C. Cvejic, Tim R. Watkins, Preeyaporn Srasuebkul, Julian Trollor
PLoS One Infectious Diseases, 1.08.2022
Tilføjet 1.08.2022
by Peiwen Liao, Claire M. Vajdic, Simone Reppermund, Rachael C. Cvejic, Tim R. Watkins, Preeyaporn Srasuebkul, Julian Trollor
Background Despite the high prevalence of epilepsy and multiple barriers to care in people with intellectual disability, the risk of returning to hospital after an admission for epilepsy is largely unknown. In this study, we sought to quantify and compare readmission and emergency department (ED) presentations after hospitalisation for epilepsy in people with and without intellectual disability. Methods and findings Using linked administrative datasets, we conducted a retrospective cohort study of people aged 5–64 years with an acute hospitalisation for epilepsy from 2005–2014 in New South Wales, Australia. Acute readmission and ED presentation rates within 30, 90, and 365 days of the index hospitalisation were estimated and compared between people with and without intellectual disability using modified Poisson regression. Of 13537 individuals with an index hospitalisation, 712 children and 1862 adults had intellectual disability. Readmission and ED presentation after the index hospitalisation were common in people with intellectual disability. Within 30 days, 11% of children and 15.6% of adults had an all-cause readmission and 18% of children and 23.5% of adults had an ED presentation. Over 60% of both children and adults presented to an ED within a year. Neurological, respiratory, and infectious conditions were overrepresented reasons for readmission in people with intellectual disability. Age-adjusted relative risks (RRs) within each period showed a higher risk of readmission and ED presentation in children and adults with intellectual disability than without. Most RRs remained statistically significant after controlling for covariates. The largest adjusted RRs were observed for readmission for epilepsy (RR 1.70, 95% CI: 1.42 to 2.04) and non-epilepsy related conditions (RR 1.73, 95%: CI 1.43 to 2.10) in children. Study limitations include lack of clinical data. Conclusions Increased risk of returning to acute care after epilepsy hospitalisation suggests there is a need to improve epilepsy care for people with intellectual disability. We recommend research into strategies to improve management of both seizures and comorbidity.
Læs mere Tjek på PubMedAmanda N. Stephens, Steven Trawley, Justin Ispanovic, Sophie Lowrie
PLoS One Infectious Diseases, 1.08.2022
Tilføjet 1.08.2022
by Amanda N. Stephens, Steven Trawley, Justin Ispanovic, Sophie Lowrie
Aggressive driving is a significant road safety problem and is likely to get worse as the situations that provoke aggression become more prevalent in the road network (e.g. as traffic volumes and density increase and the grey fleet expands). In addition, driver frustration and stress, also recognised as triggers for aggression, are likely to stay high because of the COVID-19 pandemic and associated burdens, leading to increased aggression. However, although drivers report that other drivers are becoming more aggressive, self-report data suggests that the prevalence of aggression has not changed over time. This may be due to the methods used to define and measure aggression. This study sought to clarify whether self-reported aggression has increased over a five-year period and across three different types of aggression: verbal aggression, aggressive use of the vehicle and personal physical aggression. The influence of COVID-19 lockdowns on own and others’ driving styles was also investigated. A total of 774 drivers (males = 66.5%, mean age = 48.7; SD = 13.9) who had been licensed for at least five years (M = 30.6, SD = 14.3), responded to an online survey and provided retrospective frequencies for their current aggression (considered pre-COVID-19 lockdowns) and five years prior. Two open ended questions were included to understand perceived changes in driving styles (own and others) during the COVID-19 pandemic. One third (33%) of drivers believed they were more aggressive now than five years ago but 61% of the sample believed other drivers were more aggressive now than five years ago. Logistic regression analyses on changes in self-reported aggression (same or decreased vs increased) showed the main factor associated with increases in aggressive driving was the perception that other drivers’ aggression had increased. Further, almost half the sample (47%) reported that other drivers had become riskier and more dangerous during, and soon after, the COVID-19 lockdowns. These results show that the driving environment is seen as becoming more aggressive, both gradually and as a direct result of COVID-19 lockdowns. The data indicate that this perceived increase in aggression is likely to provoke higher levels of aggression in some drivers. Campaigns to reduce aggression on the roads need to focus on changing road culture and improving interactions, or perceived interactions, among road users.
Læs mere Tjek på PubMedAngkana Boonyakanog, Nisanart Charoenlap, Sorayut Chattrakarn, Paiboon Vattanaviboon, Skorn Mongkolsuk
PLoS One Infectious Diseases, 1.08.2022
Tilføjet 1.08.2022
by Angkana Boonyakanog, Nisanart Charoenlap, Sorayut Chattrakarn, Paiboon Vattanaviboon, Skorn Mongkolsuk
Stenotrophomonas maltophilia contains an operon comprising mfsB and mfsC, which encode membrane transporters in the major facilitator superfamily (MFS). The results of the topological analysis predicted that both MfsB and MfsC possess 12 transmembrane helices with the N- and C-termini located inside the cells. The deletion of mfsC increased the susceptibility to diamide, a chemical oxidizing agent, but not to antibiotics and oxidative stress-generating substances relative to wild-type K279a. Moreover, no altered phenotype was observed against all tested substances for the ΔmfsB mutant. The results of the expression analysis revealed that the mfsBC expression was significantly induced by exposure to diamide. The diamide-induced gene expression was mediated by DitR, a TetR-type transcriptional regulator encoded by smlt0547. A constitutively high expression of mfsC in the ditR mutant indicated that DitR acts as a transcriptional repressor of mfsBC under physiological conditions. Purified DitR was bound to three sites spanning from position + 21 to -57, corresponding to the putative mfsBC promoter sequence, thereby interfering with the binding of RNA polymerase. The results of electrophoretic mobility shift assays illustrated that the treatment of purified DitR with diamide caused the release of DitR from the mfsBC promoter region, and the diamide sensing mechanism of DitR required two conserved cysteine residues, Cys92 and Cys127. This suggests that exposure to diamide can oxidize DitR through the oxidation of cysteine residues, leading to its release from the promoter, thus allowing mfsBC transcription. Overall, MfsC and DitR play a role in adaptive resistance against the diamide of S. maltophilia.
Læs mere Tjek på PubMedFaisal Salman Alshaikh, Brian Godman, Oula Nawaf Sindi, R. Andrew Seaton, Amanj Kurdi
PLoS One Infectious Diseases, 1.08.2022
Tilføjet 1.08.2022
by Faisal Salman Alshaikh, Brian Godman, Oula Nawaf Sindi, R. Andrew Seaton, Amanj Kurdi
Background Evidence around prevalence of bacterial coinfection and pattern of antibiotic use in COVID-19 is controversial although high prevalence rates of bacterial coinfection have been reported in previous similar global viral respiratory pandemics. Early data on the prevalence of antibiotic prescribing in COVID-19 indicates conflicting low and high prevalence of antibiotic prescribing which challenges antimicrobial stewardship programmes and increases risk of antimicrobial resistance (AMR). Aim To determine current prevalence of bacterial coinfection and antibiotic prescribing in COVID-19 patients. Data source OVID MEDLINE, OVID EMBASE, Cochrane and MedRxiv between January 2020 and June 2021. Study eligibility English language studies of laboratory-confirmed COVID-19 patients which reported (a) prevalence of bacterial coinfection and/or (b) prevalence of antibiotic prescribing with no restrictions to study designs or healthcare setting. Participants Adults (aged ≥ 18 years) with RT-PCR confirmed diagnosis of COVID-19, regardless of study setting. Methods Systematic review and meta-analysis. Proportion (prevalence) data was pooled using random effects meta-analysis approach; and stratified based on region and study design. Results A total of 1058 studies were screened, of which 22, hospital-based studies were eligible, compromising 76,176 of COVID-19 patients. Pooled estimates for the prevalence of bacterial co-infection and antibiotic use were 5.62% (95% CI 2.26–10.31) and 61.77% (CI 50.95–70.90), respectively. Sub-group analysis by region demonstrated that bacterial co-infection was more prevalent in North American studies (7.89%, 95% CI 3.30–14.18). Conclusion Prevalence of bacterial coinfection in COVID-19 is low, yet prevalence of antibiotic prescribing is high, indicating the need for targeted COVID-19 antimicrobial stewardship initiatives to reduce the global threat of AMR.
Læs mere Tjek på PubMedRicardo Kenji Nawa, Ary Serpa Neto, Ana Carolina Lazarin, Ana Kelen da Silva, Camila Nascimento, Thais Dias Midega, Raquel Afonso Caserta Eid, Thiago Domingos Corrêa, Karina Tavares Timenetsky
PLoS One Infectious Diseases, 1.08.2022
Tilføjet 1.08.2022
by Ricardo Kenji Nawa, Ary Serpa Neto, Ana Carolina Lazarin, Ana Kelen da Silva, Camila Nascimento, Thais Dias Midega, Raquel Afonso Caserta Eid, Thiago Domingos Corrêa, Karina Tavares Timenetsky
Background Severe coronavirus disease 2019 (COVID-19) patients frequently require mechanical ventilation (MV) and undergo prolonged periods of bed rest with restriction of activities during the intensive care unit (ICU) stay. Our aim was to address the degree of mobilization in critically ill patients with COVID-19 undergoing to MV support. Methods Retrospective single-center cohort study. We analyzed patients’ mobility level, through the Perme ICU Mobility Score (Perme Score) of COVID-19 patients admitted to the ICU. The Perme Mobility Index (PMI) was calculated [PMI = ΔPerme Score (ICU discharge–ICU admission)/ICU length of stay], and patients were categorized as “improved” (PMI > 0) or “not improved” (PMI ≤ 0). Comparisons were performed with stratification according to the use of MV support. Results From February 2020, to February 2021, 1,297 patients with COVID-19 were admitted to the ICU and assessed for eligibility. Out of those, 949 patients were included in the study [524 (55.2%) were classified as “improved” and 425 (44.8%) as “not improved”], and 396 (41.7%) received MV during ICU stay. The overall rate of patients out of bed and able to walk ≥ 30 meters at ICU discharge were, respectively, 526 (63.3%) and 170 (20.5%). After adjusting for confounders, independent predictors of improvement of mobility level were frailty (OR: 0.52; 95% CI: 0.29–0.94; p = 0.03); SAPS III Score (OR: 0.75; 95% CI: 0.57–0.99; p = 0.04); SOFA Score (OR: 0.58; 95% CI: 0.43–0.78; p < 0.001); use of MV after the first hour of ICU admission (OR: 0.41; 95% CI: 0.17–0.99; p = 0.04); tracheostomy (OR: 0.54; 95% CI: 0.30–0.95; p = 0.03); use of extracorporeal membrane oxygenation (OR: 0.21; 95% CI: 0.05–0.8; p = 0.03); neuromuscular blockade (OR: 0.53; 95% CI: 0.3–0.95; p = 0.03); a higher Perme Score at admission (OR: 0.35; 95% CI: 0.28–0.43; p < 0.001); palliative care (OR: 0.05; 95% CI: 0.01–0.16; p < 0.001); and a longer ICU stay (OR: 0.79; 95% CI: 0.61–0.97; p = 0.04) were associated with a lower chance of mobility improvement, while non-invasive ventilation within the first hour of ICU admission and after the first hour of ICU admission (OR: 2.45; 95% CI: 1.59–3.81; p < 0.001) and (OR: 2.25; 95% CI: 1.56–3.26; p < 0.001), respectively; and vasopressor use (OR: 2.39; 95% CI: 1.07–5.5; p = 0.03) were associated with a higher chance of mobility improvement. Conclusion The use of MV reduced mobility status in less than half of critically ill COVID-19 patients.
Læs mere Tjek på PubMedHawi Abayneh, Negash Wakgari, Gemechu Ganfure, Gizachew Abdissa Bulto
PLoS One Infectious Diseases, 1.08.2022
Tilføjet 1.08.2022
by Hawi Abayneh, Negash Wakgari, Gemechu Ganfure, Gizachew Abdissa Bulto
Preconception care is biomedical, social, and behavioural care provided for a woman or couple before conception occurs or throughout their reproductive year. In Ethiopia, it’s reported that the majority of health care providers had poor knowledge and practice of preconception care. The institution-based cross-sectional study was conducted among 359 obstetric care providers to assess knowledge, attitude, and practice of preconception care in West Shoa Zone, Ethiopia. A stratified, simple random sampling technique selected five hospitals, 46 health centers, and study participants. Pretested and structured questionnaires were used to collect data. Data were entered into Epidata and exported to SPSS for analysis. Bivariate and multivariate logistic regressions were employed to identify an association between the independent predictors and the outcome variables. In this study, 173(48.2%) and 124(34.5%) of the obstetric care providers had good knowledge and practice of preconception care, respectively. Two-thirds 255(71%) of providers had a favorable attitude toward preconception care. The odds of having good knowledge were higher among Midwives’ providers [AOR: 2.03, 95%CI: 1.09–3.77] and had training on HIV testing [AOR: 3.5, 95%CI: 1.9–6.4]. The presence of a library [AOR: 1.7, 95%CI: 1.04–2.85] and internet access [AOR: 3.4, 95%CI: 2.0–5.8] in working health facility had a higher odds of good knowledge about preconception. Degree and above holders [AOR: 3.1, 95%CI: 1.5–6.1] also had higher odds of good preconception knowledge than diploma holders. Similarly, the odds of having good practice of preconception care were higher among health care providers: who did screening for reproductive life plans [AOR: 3.7, 95%CI:1.8–7.4], worked in maternity and child health unit [AOR:4.2,95%CI:2.0–8.6], perceive all health facilities should give preconception care services [AOR:2.3,95%CI:1.2–4.3], and perceive all health care providers should provide preconception services [AOR:3.0, 95%CI: 1.7–5.5]. This study found that more than half of obstetric care providers’ had poor knowledge, favorable attitude, and poor practice of preconception care. Provision of training, carrier development, and installation of internet and library services should be enhanced.
Læs mere Tjek på PubMedChangyu Jin, Huiyang Liu, Mingxiao Guo, Yunfeng Wang, Jinyao Zhu
PLoS One Infectious Diseases, 1.08.2022
Tilføjet 1.08.2022
by Changyu Jin, Huiyang Liu, Mingxiao Guo, Yunfeng Wang, Jinyao Zhu
The filling mining method is an effective method for controlling ground stress and preventing surface subsidence in the mining field during exploitation of underground resources. Tailings can be utilized as the filling material, so as to realize the reuse of industrial waste. However, utilization of the traditional Portland cement as the cementing material for tailings leads to groundwater pollution. In addition, production of Portland cement results in consumption of a great amount of ore and air pollution. In this paper, a tailings cementation method by using the microbial induced calcite precipitation (MICP) technique with immersion curing is proposed. Tailings are cemented by the MICP technique with aerobic bacteria (Sporosarcina pasteurii) under a soaked curing environment. The variable control method is applied to investigate the factors influencing the cementation effects by the MICP technique with Sporosarcina pasteurii, including the bacterial solution concentration, the cementing solution concentration, the particle size of tailings, and the curing temperature. The results indicate that: when OD600 of the Sporosarcina pasteurii solution is 1.6, the urea concentration in the cementing solution is 0.75 mol/L, the tailings are raw materials without grinding, and the curing temperature is 30°C, the cementation effect is the best. In view of uneven calcification during MICP with Sporosarcina pasteurii, mixed Sporosarcina pasteurii and Castellaniella denitrificans are used for tailings cementation. Higher strength of cemented tailings is achieved. It is proved that the MICP technique with mixed aerobic bacteria and facultative anaerobes is an effective method for tailings cementation.
Læs mere Tjek på PubMedLesko, Catherine R.; Edwards, Jessie K.; Hanna, David B.; Mayor, Angel M.; Silverberg, Michael J.; Horberg, Michael; Rebeiro, Peter F.; Moore, Richard D.; Rich, Ashleigh J.; Mcginnis, Kathleen A.; Buchacz, Kate; Crane, Heidi M.; Rabkin, Charles S.; Althoff, Keri N.; Poteat, Tonia C.
AIDS, 26.10.2022
Tilføjet 1.08.2022
Objective:
Describe engagement in HIV care over time after initial engagement in HIV care, by gender identity.
Design:
Observational, clinical cohort study of people with HIV engaged in routine HIV care across the United States.
Methods:
We followed people with HIV who linked to and engaged in clinical care (attending ≥2 visits in 12 months) in cohorts in the North American Transgender Cohort Collaboration, 2000–2018. Within strata of gender identity, we estimated the 7-year (84-month) restricted mean time spent: lost-to-clinic (stratified by pre-/post-antiretroviral therapy (ART) initiation); in care prior to ART initiation; on ART but not virally suppressed; virally suppressed (≤200 copies/mL); or dead (pre-/post-ART initiation).
Results:
Transgender women (N = 482/101,841) spent an average of 35.5 out of 84 months virally suppressed (this was 30.5 months for cisgender women and 34.4 months for cisgender men). After adjustment for age, race, ethnicity, history of injection drug use, cohort, and calendar year, transgender women were significantly less likely to die than cisgender people. Cisgender women spent more time in care not yet on ART, and less time on ART and virally suppressed, but were less likely to die compared with cisgender men. Other differences were not clinically meaningful.
Conclusions:
In this sample, transgender women and cisgender people spent similar amounts of time in care and virally suppressed. Additional efforts to improve retention in care and viral suppression are needed for all people with HIV, regardless of gender identity.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedPala, Andrea Norcini; Kempf, Mirjam-Colette; Konkle-Parker, Deborah; Wilson, Tracey E.; Tien, Phyllis C.; Wingood, Gina; Neilands, Torsten B.; Johnson, Mallory O.; Weiser, Sheri D.; Logie, Carmen H.; Turan, Janet M.; Turan, Bulent
AIDS, 26.10.2022
Tilføjet 1.08.2022
Objectives:
To explore the associations between intersectional poverty, HIV, gender, and racial stigma, adherence to antiretroviral therapy (ART), and viral suppression among women living with HIV (WLHIV).
Design:
We examined intersectional stigmas, self-report ART adherence, and viral suppression using cross-sectional data.
Methods:
Participants were WLHIV (N = 459) in the Women's Adherence and Visit Engagement, a Women's Interagency HIV Study substudy. We used Multidimensional Latent Class Item Response Theory and Bayesian models to analyze intersectional stigmas and viral load adjusting for sociodemographic and clinical covariates.
Results:
We identified five intersectional stigma-based latent classes. The likelihood of viral suppression was approximately 90% lower among WLHIV who experienced higher levels of poverty, gender, and racial stigma or higher levels of all intersectional stigmas compared with WLHIV who reported lower experiences of intersectional stigmas. ART adherence accounted for but did not fully mediate some of the associations between latent intersectional stigma classes and viral load.
Conclusion:
The negative impact of intersectional stigmas on viral suppression is likely mediated, but not fully explained, by reduced ART adherence. We discuss the research and clinical implications of our findings.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedYazdani, Kiana; Salters, Kate; Shen, Tian; Dolguikh, Katerina; Trigg, Jason; White, Randall F.; Closson, Kalysha; Nanditha, Ni Gusti Ayu; Honer, William G.; Vila-Rodriguez, Fidel; Lima, Viviane Dias; Montaner, Julio S.G.; Barrios, Rolando
AIDS, 26.10.2022
Tilføjet 1.08.2022
Objective:
We aimed to characterize mortality among people with HIV (PWH) and psychotic disorders (PWH/psychosis+) vs. PWH alone (PWH/psychosis−).
Method:
A population-based analysis of mortality in PWH (age ≥19) in British Columbia (BC) from April 1996 to March 2017 was conducted using data from the Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS) study. Deaths were identified from the Vital Statistics Data (classified as HIV vs. non-HIV causes). Mortality trends across all fiscal years were examined. Cox models assessed the hazard of psychotic disorders on mortality; possible differences between schizophrenia and nonschizophrenia types of psychotic disorders were also evaluated.
Results:
Among 13 410 PWH included in the analysis, 1572 (11.7%) met the case definition for at least one psychotic disorder. Over the study period, 3274 deaths (PWH/psychosis−: n = 2785, PWH/psychosis+: n = 489) occurred. A decline over time in all-cause mortality and HIV-related mortality was observed in both PWH/psychosis+ and PWH/psychosis− (P value
Læs mere Tjek på PubMedLumu, Ivan; Musaazi, Joseph; Castelnuovo, Barbara
AIDS, 26.10.2022
Tilføjet 1.08.2022
Objective:
The study investigated the durability of switched therapy and factors associated with the viral rebound among patients on second-line antiretroviral therapy (ART) in Uganda.
Design:
A retrospective dynamic cohort of adults initiated on second-line ART after virological failure to first-line ART.
Methods:
Patients on second-line treatment for at least 6 months between 2007 and 2017 were included. Patients were followed, until they experienced a viral rebound (viral load ≥200 copies/ml). Cumulative probability of viral rebounds and factors associated with viral rebound were determined using Kaplan–Meier methods and Cox proportional hazard models.
Results:
One thousand one hundred and one participants were enrolled of which 64% were women, the median age was 37 years [interquartile range (IQR) 31–43]. The preswitch median CD4+ count and viral load were 128 cells/μl (IQR 58–244) and 45 978 copies/ml (IQR 13 827–139 583), respectively. During the 4190.37 person-years, the incidence rate of viral rebound was 83.29 [95% confidence interval (CI) 74.99–92.49] per 1000 person-years. The probability of viral rebound at 5 and 10 years was 0.29 (95% CI 0.26–0.32) and 0.62 (95% CI 0.55–0.69), respectively. The median rebound-free survival was 8.7 years. Young adults (18–24 years) [adjusted hazard ratio (aHR) 2.49, 95% CI 1.32–4.67], preswitch viral load at least 100 000 copies/ml (aHR 1.53, 95% CI 1.22–1.92), and ATV/r-based second-line (aHR 1.73, 95% CI 1.29–2.32) were associated with an increased risk of viral rebound.
Conclusion:
Switched therapies are durable for 8 years after failure of recommended regimens. A high preswitch viral load, ATV/r-based regimens, and young adulthood are risk factors for viral rebound, which underscores the need for more durable regimens and differentiated care services.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedMann, Laura M.; Le Guillou, Adrien; Goodreau, Steven M.; Marcus, Julia L.; Sanchez, Travis; Weiss, Kevin M.; Jenness, Samuel M.
AIDS, 26.10.2022
Tilføjet 1.08.2022
Objective:
To evaluate if community-level HIV PrEP coverage is correlated with individual sexual behaviors.
Design:
We used demographic, behavioral, and sexual network data from ARTnet, a 2017–2019 study of US MSM.
Methods:
Multivariable regression models with a Bayesian modeling framework were used to estimate associations between area-level PrEP coverage and seven sexual behavior outcomes (number of total, main, and casual male partners [network degree]; count of one-time partnerships; consistent condom use in one-time partnerships; and frequency of casual partnership anal sex (total and condomless)), controlling for individual PrEP use.
Results:
PrEP coverage ranged from 10.3% (Philadelphia) to 38.9% (San Francisco). Total degree was highest in Miami (1.35) and lowest in Denver (0.78), while the count of one-time partners was highest in San Francisco (11.7/year) and lowest in Detroit (1.5/year). Adjusting for individual PrEP use and demographics, community PrEP coverage correlated with total degree (aIRR = 1.73; 95% CrI, 0.92–3.44), casual degree (aIRR = 2.05; 95% CrI, 0.90–5.07), and count of one-time partnerships (aIRR = 1.90; 95% CrI, 0.46–8.54). Without adjustment for individual PrEP use, these associations strengthened. There were weaker or no associations with consistent condom use in one-time partnerships (aIRR = 1.68; 95% CrI, 0.86–3.35), main degree (aIRR = 1.21; 95% CrI, 0.48–3.20), and frequency of casual partnership condomless anal sex (aIRR = 0.23; 95% CrI, 0.01–3.60).
Conclusion:
Most correlations between community PrEP coverage and sexual behavior were explained by individual PrEP use. However, some residual associations remained after controlling for individual PrEP use, suggesting that PrEP coverage may partially drive community-level differences in sexual behaviors.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedFitch, Kathleen V.; Mccallum, Sara A.; Erlandson, Kristine M.; Overton, Edgar Turner; Zanni, Markella V.; Fichtenbaum, Carl; Aberg, Judith A.; Fulda, Evelynne S.; Kileel, Emma M.; Moran, Laura E.; Bloomfield, Gerald S.; Novak, Richard M.; Pérez-Frontera, Sigrid; Abrams-Downey, Alexandra; Pierone, Gerald Jr.; Kumarasamy, Nagalingeswaran; Ruxrungtham, Kiat; Mngqibisa, Rosie; Douglas, Pamela S.; Ribaudo, Heather J.; Grinspoon, Steven K.
AIDS, 26.10.2022
Tilføjet 1.08.2022
Objective:
To characterize diet quality across a global cohort of people with HIV (PWH).
Design:
Cross-sectional analysis.
Methods:
Leveraging REPRIEVE data from baseline across five Global Burden of Disease (GBD) regions, we analyzed participant responses to the Rapid Eating Assessment for Participants questionnaire. An overall diet quality score and scores for specific diet components were generated. Higher scores indicate better diet quality.
Results:
Among 7736 participants (median age 50 years, 30% women, median BMI 25.8 kg/m2) overall diet quality score (max score 30) was optimal in 13% of participants and good, suboptimal or poor in 45, 38, and 4% of participants, respectively; saturated fat score (max score 18) was good, suboptimal, or poor in 38, 40, or 7% of participants, respectively. Diet quality scores differed across GBD region with the highest scores reported in the South Asia region [median 23 (21–25)] and lowest in the sub-Saharan Africa region [median 15 (12–18)]; 61% of participants in the South Asia region reported optimal diet quality compared with only 6% in the sub-Saharan Africa region. Higher atherosclerotic cardiovascular risk scores were seen with worsening diet quality.
Conclusion:
Among PWH eligible for primary CVD prevention, diet quality was suboptimal or poor for almost half of participants, and there were substantial variations in diet quality reported by GBD region.
TRIAL REGISTRATION:
NCT02344290
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedHackert, M. Q. N., Ankersmid, J. W., Engels, N., Prick, J. C. M., Teerenstra, S., Siesling, S., Drossaert, C. H. C., Strobbe, L. J. A., van Riet, Y. E. A., van den Dorpel, R. M. A., Bos, W. J. W., van der Nat, P. B., van den Berg-Vos, R. M., van Schaik, S. M., Garvelink, M. M., van der Wees, P. J., van Uden-Kraan, C. F., On behalf of the Santeon VBHC breast cancer, stroke and chronic kidney disease group, van Riet, Strobbe, Dassen, Olieman, Witjes, Koelemij, Doeksen, Contant, Brouwers, van Dijk, Gons, Hilkens, Saxena, van Schaik, Schut, Bos, van den Dorpel, Siegert, Konings, ter Meulen, Janssen, Brinkman
BMJ Open, 1.08.2022
Tilføjet 1.08.2022
Introduction
Within the value-based healthcare framework, outcome data can be used to inform patients about (treatment) options, and empower them to make shared decisions with their health care professional. To facilitate shared decision-making (SDM) supported by outcome data, a multicomponent intervention has been designed, including patient decision aids on the organisation of post-treatment surveillance (breast cancer); discharge location (stroke) and treatment modality (advanced kidney disease), and training on SDM for health care professionals. The SHared decision-making supported by OUTcome information (SHOUT) study will examine the effectiveness of the intervention and its implementation in clinical practice.
Methods and analysis
Multiple interrupted time series will be used to stepwise implement the intervention. Patients diagnosed with either breast cancer (N=630), stroke (N=630) or advanced kidney disease (N=473) will be included. Measurements will be performed at baseline, three (stroke), six and twelve (breast cancer and advanced kidney disease) months. Trends on outcomes will be measured over a period of 20 months. The primary outcome will be patients’ perceived level of involvement in decision-making. Secondary outcomes regarding effectiveness will include patient-reported SDM, decisional conflict, role in decision-making, knowledge, quality of life, preferred and chosen care, satisfaction with the intervention, healthcare utilisation and health outcomes. Outcomes regarding implementation will include the implementation rate and a questionnaire on the health care professionals’ perspective on the implementation process.
Ethics and dissemination
The Medical research Ethics Committees United in Nieuwegein, the Netherlands, has confirmed that the Medical Research Involving Human Subjects Act does not apply to this study. Bureau Onderzoek & Innovatie of Santeon, the Netherlands, approved this study. The results will contribute to insight in and knowledge on the use of outcome data for SDM, and can stimulate sustainable implementation of SDM.
Trial registration number
NL8374, NL8375 and NL8376.
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Zhou, Y., Mu, W., Zhang, J., Wen, S. W., Pakhale, S.
BMJ Open, 1.08.2022
Tilføjet 1.08.2022
Objective
To accurately estimate the global prevalence of non-tuberculous mycobacteria (NTM) in adults with non-cystic fibrosis (non-CF) bronchiectasis and to determine the proportion of NTM species and subspecies in clinical patients from 2006 to 2021.
Design
Systematic review and meta-analysis using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Data sources
Medline, Embase, Cochrane Library and Web of Science were searched for articles published between 2006 and 2021.
Eligibility criteria for selecting studies
We included all the prospective or retrospective studies without language restrictions and all patients were adults (≥18 years of age) with non-CF bronchiectasis. The studies estimated the effect size of the prevalence of NTM with a sample size ≥40, and patients were registered in and after 2006.
Data extraction and synthesis
Two reviewers screened the titles, abstracts and full texts independently. Relevant information was extracted and curated into tables. Risk of bias was evaluated following the Cochrane Collaboration’s tool. Meta-analysis was performed with software R Statistics V.3.6.3 using random effect model with 95% CI. I2 index and Q statistics were calculated to assess the heterogeneity, and mixed-effects meta-regression analyses were performed to identify the sources of heterogeneity. The proportions of NTM subspecies were examined using Shapiro-Wilk normality test in R.
Results
Of all the 2014 studies yielded, 24 met the inclusion criteria. Of these, 14 were identified to be randomised controlled studies and included for an accurate estimation. The global prevalence of NTM in adults with non-CF bronchiectasis from 2006 to 2021 was estimated to be approximately 10%, with great variations primarily due to geographical location. Mycobacterium avium complex was the most common subspecies, followed by Mycobacterium simiae and Mycobacterium gordonae.
Conclusions
The prevalence of NTM in adults with non-CF bronchiectasis has been on the rise and the most common subspecies changed greatly in recent years. More cohort studies should be done in many countries and regions for future estimates.
PROSPERO registration number
CRD42020168473.
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Barkati, S., Naeem, F., Hales, L., Quan, C., Libman, M.
BMJ Open, 1.08.2022
Tilføjet 1.08.2022
Introduction
Strongyloides stercoralis is an intestinal helminth ubiquitous in tropical and subtropical regions worldwide. It persists in the human host for a lifetime as a result of autoinfection and if undetected and untreated, can lead to increased morbidity and high mortality in immunocompromised individuals such as the transplant population. Transplant patients, including solid-organ and haematopoietic stem cell transplants (SOT and HSCT, respectively), are at a high risk of hyperinfection and disseminated strongyloidiasis. Unfortunately screening is often not systematically performed. Prevalence estimates of Strongyloides in this high-risk population is not well studied. Through this systematic review, we aim to summarise the descriptive evidence on Strongyloides prevalence in SOT and HSCT patients, including diagnostic and screening practices alongside the cases of hyperinfection, disseminated strongyloidiasis and the mortality rate in this population.
Methods and analyses
Through the use of various online library databases, we will conduct a systematic review including relevant literature on the prevalence of Strongyloides in SOT and HSCT patients as well as studies assessing hyperinfection and disseminated strongyloidiasis in this patient population. The Population, Intervention, Comparison, Outcome and Study Design strategy and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will be used to determine a final subset of studies for analysis. Quality assessment for case series and case reports will be determined by a modified quality assessment tool developed by the National Heart, Lung, and Blood Institute (NIH), and the CARE guidelines, respectively. We will provide a narrative synthesis of the findings pertaining to the primary and secondary outcomes of interest (prevalence of Strongyloides and mortality rate in transplant population, respectively) alongside the associated 95% CI. Estimates from individual studies will be pooled using a random effects model.
Ethics and dissemination
This systematic review does not require formal ethical approval since no primary data will be collected. Findings will be disseminated through a peer-reviewed publication and relevant conferences.
PROSPERO registration number
CRD42021269305.
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Nazzal, M. S., Oteir, A. O., Jaber, A. F., Alwidyan, M. T., Raffee, L.
BMJ Open, 1.08.2022
Tilføjet 1.08.2022
Objectives
This study aimed to explore the lived experience of Jordanian front-line healthcare workers (FHCWs), including their experienced challenges and adaptations amid the COVID-19 pandemic.
Design
A phenomenological qualitative design was used to highlight the experiences of a sample Jordanian FHCWs during the COVID-19 pandemic. Qualitative interviews were conducted using a semistructured guide with open-ended questions, audiotaped and then transcribed verbatim. Thematic analysis of the transcribed narratives was conducted using an open coding line by line to develop themes and related subthemes.
Setting
Mobile COVID-19 testing and contact tracing units during an active surge of cases in Jordan between May and September 2020.
Participants
Participants were recruited using purposive sampling method and consisted of 15 FHCWs (2 physicians, 10 nurses, 2 paramedics and 1 laboratory technician) who have worked in testing and contact tracing teams in the community and have dealt with suspected or confirmed cases of COVID-19 infection.
Results
Participant narratives were classified into two main overarching themes; challenges and adaptation themes. The challenges theme was exhibited as follows: (1) an excruciating encounter with an invisible enemy, (2) distorted knowledge about COVID-19 and (3) organisational and administrative challenges. The adaptation theme was exhibited as follows: (1) seeking relevant knowledge about the disease and (2) seeking more connectedness.
Conclusions
The COVID-19 pandemic exerted many challenges for FHCWs at multiple levels; intrapersonal and interpersonal, organisational and societal levels. Nevertheless, a number of adaptation strategies within these levels have been reported. This study helps to provide the base on which healthcare officials and public health personnel can formulate preparedness plans that tackle challenges faced by front-line workers, which ultimately enhance the resilience of healthcare systems to withstand future pandemics.
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Maretzki, M., Geiger, R., Buxton, J. A.
BMJ Open, 1.08.2022
Tilføjet 1.08.2022
Objectives
In Canada, individuals experiencing homelessness (IEH) rely on public health and social services for healthcare, food and basic necessities. The COVID-19 pandemic has disproportionately affected marginalised populations, in part by impacting their access to such services. We performed a scoping review to identify from the published literature how access to services has changed for Canadian IEH during the pandemic.
Data sources
OVID Medline, Web of Science, Sociological Abstracts, CINAHL and OVID EmCare databases, and websites for the Salvation Army, Homeless Hub, Canadian Alliance to End Homelessness, Canadian Network for the Health and Housing of People Experiencing Homelessness and BC Centre for Disease Control.
Study design
We used the scoping review methodology developed by the Joanna Briggs Institute framework and defined access to healthcare and social services using the 10-component Levesque framework. Academic databases and grey literature searches were used, with the final searches for each taking place 24 May and 1 June 2021, respectively. Data were compiled into an Excel spreadsheet. Title and abstract screening and full-text review were completed by two independent reviewers (RG and MM). Data extraction was completed by MM and cross checked by RG.
Results
In total, 17 academic and grey literature articles were included. Positive and negative changes in service access were reported in the literature. During the COVID-19 pandemic, access to social and healthcare resources was generally reduced for Canadian IEH. A new component of access, digital connectivity, was identified. Unexpectedly, coordination and collaboration of services improved, as did the number of outreach services.
Conclusions
Positive changes to service access such as improved coordination of services should be scaled up. Further work should be done to improve access to digital technologies for IEH.
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Hussein, H., Shamsipour, M., Yunesian, M., Hassanvand, M. S., Agordoh, P. D., Seidu, M. A., Fotouhi, A.
BMJ Open, 1.08.2022
Tilføjet 1.08.2022
Objective
Malaria remains endemic in most of sub-Saharan Africa and has a negative impact among pregnant women, resulting in morbidity and poor birth outcomes. The purpose of this study was to assess the relationship between malaria and adverse birth outcomes among prenatal women in the Northern Region of Ghana.
Design
This is a prospective cohort study of singleton pregnancies at 28 weeks of gestational age and above recruited between July 2018 and May 2019 from four public hospitals in the Northern Region of Ghana.
Outcome measures
Low birth weight (LBW), preterm birth and perinatal death.
Results
A total of 1323 pregnant women completed the study out of the 1626 recruited, with an average age of 27.3±5.2 years. The incidence of malaria in this population was 9.5% (95% CI 7.9 to 11.1). After adjusting for newborn admissions to the neonatal intensive care unit, parity, maternal age and glucose-6-phosphate dehydrogenase, women who were exposed to malaria during the third trimester of pregnancy had 2.02 times (95% CI 1.36 to 2.99) higher odds of premature delivery. Furthermore, they had 2.06 times (95% CI 1.09 to 3.93) higher chance of giving birth to babies with LBW, irrespective of their socioeconomic status. With an OR of 1.02 (95% CI 0.26 to 4.01), there was no difference in perinatal mortality between pregnant women with malaria and those without malaria after adjusting for caesarean section.
Conclusion
This study confirms that prenatal malaria increases the odds of both preterm and LBW deliveries. A decisive policy to eradicate or minimise perinatal malaria is needed to contribute to the prevention of LBW and adverse pregnancy outcomes.
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McCollum, R., Zaizay, Z., Dean, L., Watson, V., Frith, L., Alhassan, Y., Kollie, K., Piotrowski, H., Bates, I., Anderson de Cuevas, R., Harris, R., Chowdhury, S., Berrian, H., Smith, J. S., Tate, W. S., El Hajj, T., Ozano, K., Hastie, O., Parker, C., Kollie, J., Zawolo, G., Ding, Y., Dacombe, R., Taegtmeyer, M., Theobald, S.
BMJ Open, 1.08.2022
Tilføjet 1.08.2022
Introduction
COVID-19 has tested the resilience of health systems globally and exposed existing strengths and weaknesses. We sought to understand health systems COVID-19 adaptations and decision making in Liberia and Merseyside, UK.
Methods
We used a people-centred approach to carry out qualitative interviews with 24 health decision-makers at national and county level in Liberia and 42 actors at county and hospital level in the UK (Merseyside). We explored health systems’ decision-making processes and capacity to adapt and continue essential service delivery in response to COVID-19 in both contexts.
Results
Study respondents in Liberia and Merseyside had similar experiences in responding to COVID-19, despite significant differences in health systems context, and there is an opportunity for multidirectional learning between the global south and north. The need for early preparedness; strong community engagement; clear communication within the health system and health service delivery adaptations for essential health services emerged strongly in both settings. We found the Foreign, Commonwealth and Development Office (FCDO) principles to have value as a framework for reviewing health systems changes, across settings, in response to a shock such as a pandemic. In addition to the eight original principles, we expanded to include two additional principles: (1) the need for functional structures and mechanisms for preparation and (2) adaptable governance and leadership structures to facilitate timely decision making and response coordination. We find the use of a people-centred approach also has value to prompt policy-makers to consider the acceptance of service adaptations by patients and health workers, and to continue the provision of ‘routine services’ for individuals during health systems shocks.
Conclusion
Our study highlights the importance of a people-centred approach, placing the person at the centre of the health system, and value in applying and adapting the FCDO principles across diverse settings.
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Rizvi Jafree, S., Mahmood, Q. K., Mujahid, S., Asim, M., Barlow, J.
BMJ Open, 1.08.2022
Tilføjet 1.08.2022
Objective
Women living in Pakistan have complex health problems including infectious and non-communicable diseases, accident and injuries, and mental health problems. While a majority of these women rely on primary healthcare services for all of their healthcare needs, there has to date been no overview of the extent of their effectiveness. The objective of this review was to (1) synthesise the available evidence regarding the effectiveness of primary care based interventions aimed at improving women’s mental and physical health and (2) identify the factors that promote effectiveness for women’s health outcomes.
Methods
Five academic databases were searched, including PubMed, BMC Medicine, Medline, CINAHL and the Cochrane Library. A search was also made of the grey literature. The quality of included studies was assessed using a standardised critical appraisal tool, and the findings summarised using a narrative synthesis.
Results
In total, 18 studies were included in the review. Eight involved evaluations of counselling interventions, three health education and awareness interventions, two social and psychosocial interventions, and five were evaluations of combination interventions. Twelve of the included studies were randomised controlled trials. Of these 14 reported significant outcomes, and 4 further interventions showed partially favourable results. However, interventions mostly targeted women’s mental or reproductive health.
Conclusions
While the evidence is limited in terms of quality and what has been evaluated, a number of interventions appear to be effective in improving outcomes for women. The three key approaches include the adoption of an active door-to-door and group-based approach; utilisation of community peers who can deliver care cost-effectively and who are more accepted in the community; and the integration of financial vouchers to support uptake in poor populations.
PROSPERO registration number
CRD42020203472.
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BMC Infectious Diseases, 1.08.2022
Tilføjet 1.08.2022
Abstract
Background
Numerous scoring tools have been developed for assessing the probability of SARS-COV-2 test positivity, though few being suitable or adapted for outpatient triage of health care workers.
Methods
We retrospectively analysed 3069 patient records of health care workers admitted to the COVID-19 Testing Unit of the Ludwig-Maximilians-Universität of Munich between January 27 and September 30, 2020, for real-time polymerase chain reaction analysis of naso- or oropharyngeal swabs. Variables for a multivariable logistic regression model were collected from self-completed case report forms and selected through stepwise backward selection. Internal validation was conducted by bootstrapping. We then created a weighted point-scoring system from logistic regression coefficients.
Results
4076 (97.12%) negative and 121 (2.88%) positive test results were analysed. The majority were young (mean age: 38.0), female (69.8%) and asymptomatic (67.8%). Characteristics that correlated with PCR-positivity included close-contact professions (physicians, nurses, physiotherapists), flu-like symptoms (e.g., fever, rhinorrhoea, headache), abdominal symptoms (nausea/emesis, abdominal pain, diarrhoea), less days since symptom onset, and contact to a SARS-COV-2 positive index-case. Variables selected for the final model included symptoms (fever, cough, abdominal pain, anosmia/ageusia) and exposures (to SARS-COV-positive individuals and, specifically, to positive patients). Internal validation by bootstrapping yielded a corrected Area Under the Receiver Operating Characteristics Curve of 76.43%. We present sensitivity and specificity at different prediction cut-off points. In a subgroup with further workup, asthma seems to have a protective effect with regard to testing result positivity and measured temperature was found to be less predictive than anamnestic fever.
Conclusions
We consider low threshold testing for health care workers a valuable strategy for infection control and are able to provide an easily applicable triage score for the assessment of the probability of infection in health care workers in case of resource scarcity.
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BMC Infectious Diseases, 1.08.2022
Tilføjet 1.08.2022
Abstract
Background
Patients with adult-onset immunodeficiency syndrome due to anti-interferon-γ autoantibodies (AIGAs) are susceptible to disseminated Mycobacterium avium complex (MAC) infections. M. chimaera, a newly identified MAC species, is distinguished from the others due to the reduced virulence. Previous cases of disseminated M. chimaera infection have been linked to cardiothoracic surgery. Reports of disseminated M. chimaera in patients without a history of cardiothoracic surgery are rare.
Case presentation
A 57-year-old Asian man, previously healthy, presented with fever, dry cough, exertional dyspnea, and decreased appetite. The delayed resolution of pneumonia despite antibiotic treatment prompted further imaging studies and biopsies from the lung and lymph node. The fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) demonstrated intense uptake in lung consolidations and diffuse lymphadenopathy. Cultures of the specimens obtained from sputum, blood, stool, lung tissue, and lymph node grew M. chimaera. Further immunological evaluation disclosed the presence of neutralizing AIGAs, which possibly led to acquired immunodeficiency and disseminated M. chimaera infection.
Conclusions
We herein present the first case of adult-onset immunodeficiency due to AIGAs complicated with disseminated M. chimaera infection. Further immunological evaluation, including AIGAs, may be warranted in otherwise healthy patients who present with disseminated mycobacterial infection.
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BMC Infectious Diseases, 1.08.2022
Tilføjet 1.08.2022
Abstract
Background
China has experienced a continuous decreasing trend in the incidence of hepatitis A in recent years. Temporal trend analyses are helpful in exploring the reasons for the changing trend. Thus, this study aims to analyse the incidence trend of viral hepatitis A by region and age group in mainland China from 2004 to 2017 to evaluate the effectiveness of prevention and control measures.
Methods
Data on hepatitis A and population information were collected and analysed with a joinpoint regression model. Annual percentage changes (APCs) and average annual percentage changes (AAPCs) were estimated for the whole country and for each region and age group.
Results
From 2004 to 2017, the seasonality and periodicity of hepatitis A case numbers were obvious before 2008 but gradually diminished from 2008 to 2011 and disappeared from 2012–2017. The national incidence of hepatitis A (AAPC = − 12.1%) and the incidence rates for regions and age groups showed decreasing trends, with differences in the joinpoints and segments. Regarding regions, the hepatitis A incidence in the western region was always the highest among all regions, while a nonsignificant rebound was observed in the northeastern region from 2011 to 2017 (APC = 14.2%). Regarding age groups, the hepatitis A incidence showed the fastest decrease among children (AAPC = − 15.3%) and the slowest decrease among elderly individuals (AAPC = − 6.6%). Among all segments, the hepatitis A incidence among children had the largest APC value in 2007–2017, at − 20.4%.
Conclusion
The national annual incidence of hepatitis A continually declined from 2004 to 2017 and the gaps in hepatitis A incidence rates across different regions and age groups were greatly narrowed. Comprehensive hepatitis A prevention and control strategies, including the use of routine vaccination during childhood in mainland China, especially the implementation of the national Expanded Program on Immunization (EPI) in 2008, resulted in substantial progress from 2004 to 2017. However, gaps remain. Regular monitoring and analysis of hepatitis A epidemic data and prompt adjustment of hepatitis A prevention and control strategies focusing on children, elderly individuals and those living in certain regions are recommended.
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Malaria Journal, 1.08.2022
Tilføjet 1.08.2022
Abstract
Background
The increase in detections of Plasmodium vivax infection in Duffy-negative individuals in Africa has challenged the dogma establishing the unique P. vivax Duffy Binding Protein-Duffy antigen receptor for chemokines (PvDBP-DARC) pathway used by P. vivax merozoites to invade reticulocytes. Information on the impact of Duffy antigen polymorphisms on the epidemiology of P. vivax malaria remains elusive. The objective of this study was to determine the distribution of asexual parasitaemia of P. vivax according to the Duffy antigen polymorphisms in Ethiopia.
Methods
DNA was extracted from dried blood spots (DBS) collected from prospectively recruited 138 P. vivax-infected patients from health centres. The identification and estimation of P. vivax asexual parasitaemia were performed by microscopic examination and quantitative real-time polymerase chain reaction (PCR). Duffy genotyping was conducted by DNA sequencing in a total of 138 P.vivax infected samples.
Results
The proportion of Duffy-negatives (FY*BES/FY*BES) in P. vivax infected patients was 2.9% (4/138). Duffy genotype FY*B/FY*BES (48.6%) was the most common, followed by FY*A/FY*BES genotype (25.4%). In one patient, the FY*02 W.01/FY*02 N.01 genotype conferring a weak expression of the Fyb antigen was observed. All P.vivax infected Duffy-negative patients showed low asexual parasitaemia (≤ 110 parasites/µL). The median P. vivax parasitaemia in Duffy-negative patients (53 parasites/µL) was significantly lower than those found in homozygous and heterozygous individuals (P < 0.0001).
Conclusion
Plasmodium vivax in Duffy-negative patients shows invariably low asexual parasitaemia. This finding suggests that the pathway used by P. vivax to invade Duffy-negative reticulocytes is much less efficient than that used in Duffy-positives. Moreover, the low asexual parasitaemia observed in Duffy-negative individuals could constitute an ‘undetected silent reservoir', thus likely delaying the elimination of vivax malaria in Ethiopia.
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Bruno L. Ferreyro, Eddy Fan
American Journal of Respiratory and Critical Care Medicine , 1.08.2022
Tilføjet 1.08.2022
American Journal of Respiratory and Critical Care Medicine, Volume 206, Issue 3, Page 236-239, August 1, 2022.
Læs mere Tjek på PubMedCharles-Edouard Luyt
American Journal of Respiratory and Critical Care Medicine , 1.08.2022
Tilføjet 1.08.2022
American Journal of Respiratory and Critical Care Medicine, Volume 206, Issue 3, Page 239-240, August 1, 2022.
Læs mere Tjek på PubMedDavid Hajage, Alain Combes, Christophe Guervilly, Guillaume Lebreton, Alain Mercat, Arthur Pavot, Saad Nseir, Armand Mekontso-Dessap, Nicolas Mongardon, Jean Paul Mira, Jean-Damien Ricard, Alexandra Beurton, Guillaume Tachon, Loay Kontar, Christophe Le Terrier, Jean Christophe Richard, Bruno Mégarbane, Ruth H. Keogh, Aurélien Belot, Camille Maringe, Clémence Leyrat, Matthieu Schmidt
American Journal of Respiratory and Critical Care Medicine , 1.08.2022
Tilføjet 1.08.2022
American Journal of Respiratory and Critical Care Medicine, Volume 206, Issue 3, Page 281-294, August 1, 2022.
Læs mere Tjek på PubMedTanguy Chaumette, Raphael Cinotti, Alice Mollé, Pierre Solomon, Louise Castain, Cynthia Fourgeux, Hamish E. G. McWilliam, Barbara Misme-Aucouturier, Alexis Broquet, Cédric Jacqueline, Mickael Vourc’h, Delphine Fradin, Celine Bossard, Laurent David, Emmanuel Montassier, Cecile Braudeau, Régis Josien, Jose A. Villadangos, Karim Asehnoune, Celine Bressollette-Bodin, Jeremie Poschmann, Antoine Roquilly
American Journal of Respiratory and Critical Care Medicine , 1.08.2022
Tilføjet 1.08.2022
American Journal of Respiratory and Critical Care Medicine, Volume 206, Issue 3, Page 295-310, August 1, 2022.
Læs mere Tjek på PubMedRujittika Mungmunpuntipantip, Viroj Wiwanitkit
American Journal of Respiratory and Critical Care Medicine , 1.08.2022
Tilføjet 1.08.2022
American Journal of Respiratory and Critical Care Medicine, Volume 206, Issue 3, Page 360-361, August 1, 2022.
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American Journal of Respiratory and Critical Care Medicine , 1.08.2022
Tilføjet 1.08.2022
American Journal of Respiratory and Critical Care Medicine, Volume 206, Issue 3, Page 361-362, August 1, 2022.
Læs mere Tjek på PubMedYann Nguyen, Adrien Flahault, Nathalie Chavarot, Cléa Melenotte, Morgane Cheminant, Paul Deschamps, Nicolas Carlier, Emmanuel Lafont, Marion Thomas, Edouard Flamarion, David Lebeaux, Caroline Charlier, Anne Rachline, Corinne Guérin, Robert Ratiney, Justine Touchard, Hélène Péré, Flore Rozenberg, Fanny Lanternier, Jean-Benoît Arlet, Jérôme Avouac, Véronique Boussaud, Romain Guillemain, Marguerite Vignon, Eric Thervet, Anne Scemla, Laurence Weiss, Luc Mouthon, AP-HP-Centre Monoclonal Antibodies Working Group
Clinical Microbiology and Infection, 31.07.2022
Tilføjet 1.08.2022
Immunocompromised patients have an increased risk of severe form of COVID-19. The clinical efficacy of the tixagevimab/cilgavimab monoclonal antibody combination as pre-exposure prophylaxis against BA.1 and BA.2 SARS-CoV-2 Omicron sublineages is unknown. We aimed to describe the incidence and outcomes of COVID-19 among immunocompromised patients receiving tixagevimab/cilgavimab as preexposure prophylaxis, during the Omicron wave in France.
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