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Evelina Tacconelli, Marc Mendelson, Elena Carrara
Lancet Infectious Diseases, 5.10.2022
Tilføjet 5.10.2022
Evidence from the past 20 years has made us confident that antibiotic stewardship interventions should be considered the gold standard for patient care, being safe and effective in improving the quality of antibiotic prescribing.1 However, how to successfully translate evidence for antibiotic stewardship interventions to implementation into practice still requires research.2
Læs mere Tjek på PubMedAna Estela Gamiño-Arroyo, Paola Del Carmen Guerra de Blas
Lancet Infectious Diseases, 5.10.2022
Tilføjet 5.10.2022
Worldwide, influenza virus accounts for 7% of all acute lower respiratory tract infections, and 4% of deaths due to acute lower respiratory tract infections in children younger than 5 years.1 In The Lancet Infectious Diseases, Annette K Regan and colleagues2 report the results of an interesting multicentre, multicountry, surveillance study aiming to assess whether influenza vaccination is associated with illness attenuation. The study involved 41 sentinel sites across four countries in South America as part of REVELAC-i (Red para la Evaluación de Vacunas En Latino América y el Caribe—influenza), a network that annually evaluates influenza vaccine effectiveness using a test-negative design.
Læs mere Tjek på PubMedMartin J Llewelyn, Eric P Budgell, Magda Laskawiec-Szkonter, Elizabeth L A Cross, Rebecca Alexander, Stuart Bond, Phil Coles, Geraldine Conlon-Bingham, Samantha Dymond, Morgan Evans, Rosemary Fok, Kevin J Frost, Veronica Garcia-Arias, Stephen Glass, Cairine Gormley, Katherine Gray, Clare Hamson, David Harvey, Tim Hills, Shabnam Iyer, Alison Johnson, Nicola Jones, Parmjit Kang, Gloria Kiapi, Damien Mack, Charlotte Makanga, Damian Mawer, Bernie McCullagh, Mariyam Mirfenderesky, Ruth McEwen, Sath Nag, Aaron Nagar, John Northfield, Jean O'Driscoll, Amanda Pegden, Robert Porter, Neil Powell, David Price, Elizabeth Sheridan, Mandy Slatter, Bruce Stewart, Cassandra Watson, Immo Weichert, Katy Sivyer, Sarah Wordsworth, Jack Quaddy, Marta Santillo, Adele Krusche, Laurence S J Roope, Fiona Mowbray, Kieran S Hand, Melissa Dobson, Derrick W Crook, Louella Vaughan, Susan Hopkins, Lucy Yardley, Timothy E A Peto, Ann Sarah Walker
Lancet Infectious Diseases, 5.10.2022
Tilføjet 5.10.2022
The antibiotic review kit intervention resulted in sustained reductions in antibiotic use among adult acute general medical inpatients. The weak, inconsistent intervention effects on mortality are probably explained by the onset of the COVID-19 pandemic. Hospitals should use the antibiotic review kit to reduce antibiotic overuse.
Læs mere Tjek på PubMedAnnette K Regan, Carmen Sofia Arriola, Paula Couto, Lindsey Duca, Sergio Loayza, Francisco Nogareda, Walquiria Aparecida Ferreira de Almeida, Julian Antman, Soraya Araya, Marcela Alejandra Avendaño Vigueras, Silvia Carolina Battaglia Paredes, Ivan Fedor Brstilo, Patricia Bustos, Maria Eugenia Fandiño, Rodrigo Fasce, Carlos Maria Giovacchini, Cecilia Isaura González Caro, Marta von Horoch, Maria del Valle Juarez, Nathalia Katz, Maria Fernanda Olivares, Daiana Araújo da Silva, Erica Tatiane da Silva, Viviana Sotomayor, Natalia Vergara, Eduardo Azziz-Baumgartner, Alba Maria Ropero
Lancet Infectious Diseases, 5.10.2022
Tilføjet 5.10.2022
Influenza vaccination was associated with illness attenuation among those hospitalised with influenza, although results differed by vaccine target group. These findings might suggest that attenuation of disease severity might be specific to certain target groups, seasons, or settings.
Læs mere Tjek på PubMedHuiling Tan, Xin Wang, Kaiyou Ye, Jianmin Lin, E. Song, Lihua Gong
PLoS One Infectious Diseases, 4.10.2022
Tilføjet 4.10.2022
by Huiling Tan, Xin Wang, Kaiyou Ye, Jianmin Lin, E. Song, Lihua Gong
Background To investigate the prevalence and risk factors of diabetic retinopathy (DR) in a Chinese population with type 2 diabetes mellitus (T2DM) in a suburb (Qingpu) of Shanghai, China. Methods A population-based cross-sectional study. A total of 7462 residents with T2DM in Qingpu were enrolled according to the resident health archives from January 2020 to December 2020. Blood and urine samples of the subjects were collected. Disc- and macula-centred retinal images were taken to assess DR. SPSS was used to analyse and investigate the prevalence and risk factors of DR. Results The fundus images of 6380 (85.5%) subjects were of sufficiently good quality for grading. The average (range) age of 6380 subjects was 63.46±7.77 (28–92) years. Six hundred forty-four subjects were diagnosed with DR. The prevalence of DR was 10.1% (95% CI 9.4%-10.8%), with mild, moderate, and severe non-proliferative retinopathy and proliferative retinopathy being 2.1%, 6.3%, 1.3% and 0.4%, respectively. The prevalence of bilateral DR was 6.5%. Higher T2DM duration (OR, 1.057), fasting plasma glucose (OR, 1.063), glycated hemoglobinA1c (OR, 1.269), urea nitrogen (OR, 1.059), and urinary albumin (OR, 1.001) were associated with the higher DR prevalence. Conclusion The prevalence of DR among Chinese adults with T2DM in Qingpu was 10.1%, in which non-proliferative DR was more common. Higher fasting plasma glucose and glycated hemoglobinA1c are well-known risk factors of DR, consistent with the findings in our study. Our study didn’t find the risk between lipid indicators and DR. However, several renal function indicators, like higher urea nitrogen and urinary albumin, were risk factors for DR in this study. Appropriate diagnosis and intervention should be taken in time to prevent and control DR development.
Læs mere Tjek på PubMedGideon Awenabisa Atanuriba, Felix Apiribu, Veronica Millicent Dzomeku, Philemon Adoliwine Amooba, Adwoa Bemah Boamah Mensah, Richard Adongo Afaya, Timothy Gazari, Timothy Tienbia Laari, Moses Haruna Akor, Linda Abnory
PLoS One Infectious Diseases, 4.10.2022
Tilføjet 4.10.2022
by Gideon Awenabisa Atanuriba, Felix Apiribu, Veronica Millicent Dzomeku, Philemon Adoliwine Amooba, Adwoa Bemah Boamah Mensah, Richard Adongo Afaya, Timothy Gazari, Timothy Tienbia Laari, Moses Haruna Akor, Linda Abnory
Background HIV/AIDS is now a chronic disease, as adherence to anti-retrovirals impacts positively on the quality as well as expectancy of life. However, there exist multifaceted barriers to treatments for which children are most disadvantaged. Since Ghana subscribed to the “treat all” policy less percentage (25.5%) of children (2–14 years) living with HIV/AIDS have been enrolled on the antiretroviral program compared to other categories of the population by 2019. At present no study has explored these barriers to children living with HIV/AIDS enrollment and adherence. This study aims to explore the perceived barriers of caregivers of children living with HIV/AIDS in the Tamale Metropolis. Methods We used descriptive phenomenology to explore the phenomena. Caregivers were purposively selected and interviewed till information became repetitive at the ninth (9th) caregiver. A semi-structured interview guide was used to collect data through face-to-face in-depth interviews which were audio recorded. The interviews lasted an average of 47 minutes. Audio interviews were transcribed verbatim (English) and translated back-to-back (Daghani) before analysis was done manually according to Collaizi’s seven-step approach. We used the Guba and Lincoln guidelines to ensure the rigour of the study and its findings. Results are presented in themes and supported with quotes. Results Six themes emerged from the analysis of the caregivers’ transcripts; (1) denial of HIV/AID diagnosis, (2) stock-outs and privacy at the clinic, (3) busy schedule and poor support, (4) ignorance and alternative herbal cure, (5) stigma and discrimination, (6) transportation and distance. Conclusion Perceived barriers are multi-dimensional and encountered by all PLWHA, especially children. These barriers could derail the gains of HIV/AIDS interventions among children. Adherence counselling among caregivers alongside campaigns among faith and herbal healers are of grave concern to reduce myths of cure.
Læs mere Tjek på PubMedTejasri Chandrabhatla, Henok Asgedom, Zehra P. Gaudiano, Leyla de Avila, Kenneth L. Roach, Chapy Venkatesan, Ali A. Weinstein, Zobair M. Younossi
PLoS One Infectious Diseases, 4.10.2022
Tilføjet 4.10.2022
by Tejasri Chandrabhatla, Henok Asgedom, Zehra P. Gaudiano, Leyla de Avila, Kenneth L. Roach, Chapy Venkatesan, Ali A. Weinstein, Zobair M. Younossi
Background The increasing number of physicians leaving practice, especially hospitalists, has been well-documented. The most commonly examined factor associated with this exodus has been burnout. The COVID-19 pandemic has put a unique and unprecedented stress on hospitalists who have been at the front lines of patient care. Therefore, the investigation of burnout and its related factors in hospitalists is essential to preventing future physician shortages. Objective This study examined the relationship between burnout, second victim, and moral injury experiences before and during the COVID-19 pandemic among hospitalists. Methods Two anonymous cross-sectional surveys of hospitalists from a community hospital in the metropolitan Washington, DC area were conducted. One was conducted pre-COVID-19 (September-November 2019) and one was conducted during COVID-19 (July-August 2020). The surveys were sent to all full-time hospitalists via an online survey platform. A variety of areas were assessed including demographic (e.g., age, gender), work information (e.g., hours per week, years of experience), burnout, second victim experiences, well-being, and moral injury. Results Burnout rates among providers during these two time periods were similar. Second victim experiences remained prevalent in those who experienced burnout both pre and during COVID-19, but interestingly the prevalence increased in those without burnout during COVID-19. Moral injury was predictive of burnout during COVID-19. Conclusion While there were some factors that predicted burnout that were similar both pre- and during-pandemic, moral injury was unique to predicting burnout during COVID-19. With burnout as a contributing factor to future physician shortages, it is imperative that predictive factors in a variety of different environments are well understood to prevent future shortages. Hospitalists may be an excellent barometer of these factors given their presence on the front line during the pandemic, and their experiences need to be further explored so that targeted interventions aimed at addressing those factors may be created.
Læs mere Tjek på PubMedFatemeh Aliverdi, Zahra Bayat Jozani, Nooshin Ghavidel, Mostafa Qorbani, Nami Mohammadian Khonsari, Farima Mohamadi, Minoo Mohraz, Zohreh Mahmoodi
PLoS One Infectious Diseases, 4.10.2022
Tilføjet 4.10.2022
by Fatemeh Aliverdi, Zahra Bayat Jozani, Nooshin Ghavidel, Mostafa Qorbani, Nami Mohammadian Khonsari, Farima Mohamadi, Minoo Mohraz, Zohreh Mahmoodi
Introduction The COVID-19 pandemic and its consequences have caused fear and anxiety worldwide and imposed a significant physical and psychological burden on people, especially women living with HIV (WLHIV). However, WLHIV were not studied as well as others during the pandemic. Hence, this study aimed to determine the relationships between COVID-19 phobia, health anxiety, and social relations in WLHIV. Materials and methods This cross-sectional study enrolled 300 WLHIV who had records at the Iranian Research Center for HIV/AIDS of Tehran University of Medical Sciences. Data were collected using sociodemographic questionnaire, the fear of COVID-19 scale, the social relations questionnaire, the socioeconomic status scale and the health anxiety inventory. Path-analysis was used to assess the direct and indirct associations between variables. Results Based on the path analysis, among variables that had significant causal relationships with social relations, socioeconomic status (β = -0.14) showed the greatest negative relationship, and health anxiety (β = 0.11) had the strongest positive relationship on the direct path. On the indirect path, fear of COVID-19 (β = 0.049) displayed the greatest positive relationship. The level of education (β = 0.29) was the only variable showing a significant positive relationship with social relations on both direct and indirect paths. Conclusion Our result showed that increased fear and health anxiety related to a higher social relations score in WLHIV. Hence, due to their vulnerability, these people require more support and education to adhere to health protocols in future pandemics and similar situations.
Læs mere Tjek på PubMedVictor Márquez-Alvarez, Joaquín Amigó-Vega, Aramis Rivera, Alfo José Batista-Leyva, Ernesto Altshuler
PLoS One Infectious Diseases, 4.10.2022
Tilføjet 4.10.2022
by Victor Márquez-Alvarez, Joaquín Amigó-Vega, Aramis Rivera, Alfo José Batista-Leyva, Ernesto Altshuler
During the COVID-19 pandemic, the relevance of evaluating the effectiveness of face masks–especially those made at home using a variety of materials–has become obvious. However, quantifying mask protection often requires sophisticated equipment. Using a frugal stain technique, here we quantify the “ballistic” droplets reaching a receptor from a jet-emitting source which mimics a coughing, sneezing or talking human–in real life, such droplets may host active SARS-CoV-2 virus able to replicate in the nasopharynx. We demonstrate that materials often used in home-made face masks block most of the droplets. Mimicking situations eventually found in daily life, we also show quantitatively that less liquid carried by ballistic droplets reaches a receptor when a blocking material is deployed near the source than when located near the receptor, which supports the paradigm that your face mask does protect you, but protects others even better than you. Finally, the blocking behavior can be quantitatively explained by a simple mechanical model.
Læs mere Tjek på PubMedTeija Lund, Dietrich Schlenzka, Martina Lohman, Leena Ristolainen, Hannu Kautiainen, Erkko Klemetti, Kalevi Österman
PLoS One Infectious Diseases, 4.10.2022
Tilføjet 4.10.2022
by Teija Lund, Dietrich Schlenzka, Martina Lohman, Leena Ristolainen, Hannu Kautiainen, Erkko Klemetti, Kalevi Österman
Life-time prevalence of low back pain (LBP) in children and adolescents varies from 7% to 72%. Disc changes on magnetic resonance imaging (MRI) have been reported in up to 44% of children with earliest observations around pre-puberty. In this longitudinal cohort study, our objective was to determine the natural history of disc changes from childhood to early adulthood, and the possible association of these changes to LBP. Healthy 8-year-old schoolchildren were recruited for this longitudinal study consisting of a semi-structured interview, a clinical examination, and an MRI investigation at the age of 8–9 (Y8), 11–12 (Y12) and 18–19 (Y19) years. The interview inquired about LBP without trauma. T2-weighted sagittal MRI of the lumbar spine was acquired. Life-long prevalence of LBP was determined, and the disc signal intensity (SI) at the three lowest lumbar levels was assessed both visually using the Schneiderman classification (Bright-Speckled-Dark), and digitally using the disc to cerebrospinal fluid -SI ratio. Possible associations between SI changes and LBP were analyzed. Ninety-four of 208 eligible children were included at Y8 in 1994, 13 and 23 participants were lost to follow-up at Y12 and Y19, respectively. Prevalence of LBP increased after the pubertal growth spurt reaching 54% at Y19. On MRI, 18%, 10% and 38% of participants had disc SI changes at Y8, Y12 and Y19, respectively. No significant associations between self-reported LBP and either qualitative or quantitative disc SI changes were observed at any age. Life-time prevalence of LBP reached 54% by early adulthood. Disc SI changes on MRI traditionally labeled as degenerative were seen earlier than previously reported. Changes in disc SI were not associated with the presence of LBP in childhood, adolescence or early adulthood.
Læs mere Tjek på PubMedSachi O’Hoski, Ayse Kuspinar, Joshua Wald, Julie Richardson, Roger Goldstein, Marla K. Beauchamp
PLoS One Infectious Diseases, 4.10.2022
Tilføjet 4.10.2022
by Sachi O’Hoski, Ayse Kuspinar, Joshua Wald, Julie Richardson, Roger Goldstein, Marla K. Beauchamp
Background Participation restriction has detrimental effects for older adults but it is unknown how participation differs for people with chronic obstructive pulmonary disease (COPD) compared to older adults of the same age without respiratory conditions. We compared scores on the Late Life Disability Instrument (LLDI) between people with COPD (study group) and a random sample of older adults (control group). Methods Participants with COPD (study group) were recruited from two hospitals in Ontario and age- and sex-matched with a ratio of 1:2 with participants from a random sample of community-dwelling older adults who did not report having respiratory conditions (control group). The study group completed the LLDI prior to the COVID-19 pandemic and the control group completed the LLDI at the end of the first wave of the pandemic. LLDI frequency and limitation scores were compared between groups using Wilcoxon rank-sum tests. Results Forty-six study group participants (mean age 74.2 (SD 5.5) years) and 92 control group participants (mean age 74.4 (SD 5.4) years) were included. Fifty-four percent of the participants were female. The majority of the study group had severe COPD (median forced expiratory volume in one second of 34.5 (25th-75th percentile 27.0–56.0) % predicted). LLDI sores were lower for the study group compared to the control group for both the frequency (median difference -5.4 points, p<0.001) and limitation (median difference -7.6 points, p<0.001) domains. The personal subscale demonstrated the largest magnitude of difference between groups (median difference -13.4 points) and the social subscale demonstrated the smallest magnitude of difference (-5.2 points). Conclusion People with COPD had greater participation restrictions than a random sample of older adults without ongoing respiratory conditions. The differences seen in participation between the two groups may have been reduced due to temporal confounding from the COVID-19 pandemic. While participation is relevant to all older adults, our results suggest that it is especially important that it be assessed in those with COPD.
Læs mere Tjek på PubMedTsegaye Sewunet, Sriram K. K., Ha Hoang Nguyen, Noikaseumsy Sithivong, Ngoc Thi Bich Hoang, Vanphanom Sychareun, Kokasia Nengmongvang, Mattias Larsson, Linus Olson, Fredrik Westerlund, Christian G. Giske
PLoS One Infectious Diseases, 4.10.2022
Tilføjet 4.10.2022
by Tsegaye Sewunet, Sriram K. K., Ha Hoang Nguyen, Noikaseumsy Sithivong, Ngoc Thi Bich Hoang, Vanphanom Sychareun, Kokasia Nengmongvang, Mattias Larsson, Linus Olson, Fredrik Westerlund, Christian G. Giske
Objectives Carbapenemase-producing Enterobacterales (CPE) are high priority targets of global antimicrobial surveillance. Herein, we determined the colonization rate of CPE on admission to intensive care units in Vientiane, Lao PDR in August-September 2019. Methods Data regarding clinical conditions, infection control, and antibiotic usage were collected during admission. Rectal swab samples (n = 137) collected during admission were inoculated to selective chromogenic agars, followed by confirmatory tests for extended-spectrum beta-lactamases and carbapenemases. All CPE isolates were sequenced on Illumina (HiSeq2500), reads assembled using SPAdes 3.13, and the draft genomes used to query a database (https://www.genomicepidemiology.org) for resistome, plasmid replicons, and sequence types (ST). Optical DNA mapping (ODM) was used to characterize plasmids and to determine location of resistance genes. Minimum spanning tree was generated using the Bacterial Isolate Genome Sequence database (BIGSdb) and annotated using iTOL. Result From 47 Enterobacterales isolated on selective agars, K. pneumoniae (25/47) and E. coli (12/47) were the most prevalent species, followed by K aerogenes (2/47), K. variicola (1/47), and K. oxytoca (1/47). The overall prevalence of ESBLs was 51.0%; E. coli 83.3% (10/12) and Klebsiella spp. 41.3% (12/29). Twenty percent of the K. pneumoniae (5/25) isolates were carbapenem-resistant, and 4/5 contained the blaNDM-1 gene. All blaNDM-1 isolates belonged to ST147 and were indistinguishable with cgMLST. ODM showed that the blaNDM-1 gene was located on identical plasmids in all isolates. Conclusion The prevalence of ESBL-producing Enterobacterales was high, while carbapenemases were less common. However, the detection of clonal dissemination of blaNDM-1-producing K. pneumoniae isolates in one of the intensive care units calls for vigilance. Stringent infection prevention and antimicrobial stewardship strategies are highly important measures.
Læs mere Tjek på PubMedTadesse Awoke Ayele, Tesfa Sewunet Alamneh, Habtewold Shibru, Malede Mequanent Sisay, Tesfahun Melese Yilma, Melkitu Fentie Melak, Telake Azale Bisetegn, Tariku Belachew, Mahteme Haile, Taye Zeru, Mezgebu Selamsew Asres, Kegnie Shitu
PLoS One Infectious Diseases, 4.10.2022
Tilføjet 4.10.2022
by Tadesse Awoke Ayele, Tesfa Sewunet Alamneh, Habtewold Shibru, Malede Mequanent Sisay, Tesfahun Melese Yilma, Melkitu Fentie Melak, Telake Azale Bisetegn, Tariku Belachew, Mahteme Haile, Taye Zeru, Mezgebu Selamsew Asres, Kegnie Shitu
Background COVID-19 had affected the health-care-seeking behavior of people with chronic medical conditions. The impact is even worse in resource-limited settings like Ethiopia. Therefore, this study was aimed to assess the extent and correlates of missed appointments among adults with chronic disease conditions before and during the COVID-19 pandemic in the Northwest Ethiopia. Methods A retrospective chart review and cross-sectional survey were conducted from December 2020 to February 2021. A total of 1833 patients with common chronic disease were included by using a stratified systematic random sampling technique. Web-based data collection was done using Kobo collect. The data were explored using descriptive statistical techniques, the rate of missed appointments s before and during the COVID-19 pandemic was determined. A negative binomial regression model was fitted to identify the factors of missed appointment. An incidence rate ratio with its 95% confidence interval (CI) and p-value of the final model were reported. Results The rate of missed appointments was 12.5% (95% CI: 11.13%, 14.20%) before the pandemic, increased to 26.8% (95% CI: 24.73%, 28.82%) during the pandemic (p-value < 0.001). Fear of COVID-19 infection and lack of transport was the most common reasons for missing appointments. Older patients (Adjusted Incidence Rate Ratio (AIRR) = 1.01, 95% CI: 1.001; 1.015), having treatment follow up more than 5 years (AIRR = 1.36, 95%CI: 1.103; 1.69), shorter frequency of follow-up (AIRR = 2.22, 95% CI: 1.63; 2.49), covering expense out of pocket (AIRR = 2.26, 95%CI: 1.41; 2.95), having a sedentary lifestyle (AIRR = 1.36, 95%CI: 1.12; 1.71), and history of missed appointments before COVID-19 pandemic (AIRR = 4.27, 95%CI: 3.35; 5.43) were positively associated with the incidence of missed appointments. Conclusion The rate of missed appointment increased significantly during the COVID-19 pandemic. Older age, longer duration of follow up, more frequent follow-up, out-of-pocket expenditure for health service, history of poor follow-up, and sedentary lifestyle had positive relationship with missed appointments during the pandemic. Therefore, it is important to give special emphasis to individuals with these risk factors while designing and implementing policies and strategies for peoples with chronic diseases to ensure the continuity of care and to avoid the long-term impact on their health.
Læs mere Tjek på PubMedMalaria Journal, 4.10.2022
Tilføjet 4.10.2022
Abstract
Background
Quantitative measurement of Glucose-6-Phosphate Dehydrogenase (G6PD) enzyme activity is critical to decide on appropriate treatment and provision of radical cure regimens for vivax malaria. Biosensors are point-of-care semi-quantitative analysers that measure G6PD enzyme activity. The main objective of this study was to evaluate the operational aspects of biosensor deployment in the hands of village malaria workers (VMWs) in Cambodia over a year.
Methods
Following initial orientation and training at Kravanh Referral Hospital, each VMW (n = 28) and laboratory technician (n = 5) was provided a biosensor (STANDARD SD Biosensor, Republic of Korea) with supplies for routine use. Over the next 12 months VMWs convened every month for refresher training, to collect supplies, and to recalibrate and test their biosensors. A quantitative self-administered questionnaire was used to assess the skills necessary to use the biosensor after the initial training. Subsequently, VMWs were visited at their location of work for field observation and evaluation using an observer-administered questionnaire. All quantitative questionnaire-based data were analysed descriptively. Semi-structured interviews (SSIs) were conducted among all participants to explore their experience and practicalities of using the biosensor in the field. SSIs were transcribed and translated into English and underwent thematic analysis.
Results
A total of 33 participants completed the training and subsequently used the biosensor in the community. Quantitative assessments demonstrated progressive improvement in skills using the biosensor. VMWs expressed confidence and enthusiasm to use biosensors in their routine work. Providing G6PD testing at the point of first contact avoids a multitude of barriers patients have to overcome when travelling to health centres for G6PD testing and radical cure. Deploying biosensors in routine work of VMWs was also considered an opportunity to expand and strengthen the role of VMWs as health care providers in the community. VMWs reported practical concerns related to the use of biosensor such as difficulty in using two pipettes, difficulty in extracting the code chip from the machine, and the narrow base of buffer tube.
Conclusions
VMWs considered the biosensor a practical and beneficial tool in their routine work. Providing VMWs with biosensors can be considered when followed by appropriate training and regular supervision. Providing community management of vivax malaria at the point of first contact could be key for elimination.
Læs mere Tjek på PubMed
Ana Simon-Gozalbo, Maria Gamo-Guerrero, Soledad Alonso-Garcia, Cristina Mauleon-Fernandez, Guillermo Cuevas-Tascon
Clinical Microbiology and Infection, 4.10.2022
Tilføjet 4.10.2022
A multi-country outbreak of monkeypox infection starting in May 2022 has rapidly spread throughout the USA and Western Europe with more than 18.000 cases reported from European countries (1).
Læs mere Tjek på PubMedWearn-Xin Yee, Christoph M. Tang, Hayley Lavender aSir William Dunn School of Pathology, University of Oxfordgrid.4991.5, Oxford, United Kingdom, Denise Monack
Infection and Immunity, 4.10.2022
Tilføjet 4.10.2022
Journal of the American Medical Association, 4.10.2022
Tilføjet 4.10.2022
In the Viewpoint titled “Remote Patient Monitoring During COVID-19: An Unexpected Patient Safety Benefit,” published in the March 22, 2022, issue of JAMA, and in a related Letter in Reply titled “Remote Patient Monitoring During COVID-19—Reply,” published in the July 19, 2022, issue of JAMA, the authors’ conflict of interest disclosures were incomplete. For the Viewpoint, the disclosures should have read as follows: “Dr Pronovost reported grants from Masimo (collection of data on remote monitoring) during the conduct of the study. Ms Cole reported receipt of grants from Masimo (analysis of home-monitoring data). Dr Hughes reported receipt of a grant from Masimo (analysis of home-monitoring data).” For the Letter in Reply, the disclosures should have read as follows: “Dr Pronovost reported grants from Masimo (collection of data on remote monitoring) during the conduct of the study. Ms Cole reported receipt of grants from Masimo (analysis of home-monitoring data) and from the Federal Communications Commission (FCC) Coronavirus Aid, Relief, and Economic Security (CARES) Act (for purchase of home-monitoring devices). Dr Hughes reported receipt of a grant from Masimo (analysis of home-monitoring data).” These articles have been corrected online.
Læs mere Tjek på PubMedJournal of the American Medical Association, 4.10.2022
Tilføjet 4.10.2022
Treatment of complicated urinary tract infections (UTIs) has become increasingly complex, with rising antimicrobial resistance, high-risk patient populations, and limited numbers of novel antimicrobial therapies for resistant organisms. There is a particular need for effective therapies to treat complicated UTIs caused by organisms that produce extended-spectrum β-lactamases (ESBL).
Læs mere Tjek på PubMedJournal of the American Medical Association, 4.10.2022
Tilføjet 4.10.2022
The FDA has updated a checklist designed to help evaluate potential drug interactions and other patient factors before prescribing Paxlovid (copackaged nirmatrelvir and ritonavir tablets) for COVID-19. It incorporates additional guidance on drugs that should not be taken with Paxlovid or may require dose or other treatment adjustments.
Læs mere Tjek på PubMedJournal of the American Medical Association, 4.10.2022
Tilføjet 4.10.2022
Postacute sequelae of SARS-CoV-2 infection (PASC) appears to be uncommon in children and presents with features different from long COVID in adults, according to a cohort study published in JAMA Pediatrics that included 659 286 children.
Læs mere Tjek på PubMedJournal of the American Medical Association, 4.10.2022
Tilføjet 4.10.2022
When huge armies were throwing every ounce of their energies against the opposing line, it was constantly realized that the spread of epidemic disease might mean defeat for the affected side. Preventive medicine, in thus being called on to keep every possible man at the front, came into unusual prominence. Foci of contagion existed in various parts of the globe, and the intermingling of peoples, and the crossing and recrossing of seas, invited contagion to spread; but with one exception, the major demons were kept confined to regions in which they commonly prevail in endemic form. With the World War ended, the sanitary organization was largely dismantled; but the urge for conservation of life and energy did not stop and is still going on. From an examination of developments in the world-wide warfare on disease now being waged by various institutions and agencies, Showalter, in an illustrated article in the National Geographic Magazine (September), predicts three announcements of almost unprecedented importance to mankind at no distant date: that (1) yellow fever has been banished from the face of the earth; (2) hookworm disease can be driven from any community which has the will to get rid of it, and (3) malaria can be eradicated from almost any community having enough vital force left to push a thorough yet inexpensive campaign for its extirpation. The widespread incidence of hookworm disease is revealed when it is known that three out of five persons examined in China, three out of four in Siam, and five out of eight in various parts of India are so afflicted. Similar conditions prevail in Brazil, Colombia, Central America, the West Indies and elsewhere. How successful a campaign against this disease may be was shown in Richmond County, Va., where the world-wide fight against hookworm had its inception. About thirteen years ago, when the eradication work began, 82 per cent. of the people of Richmond County had this disease. A survey a few years later showed that only 35 per cent. had the disease; a more recent survey reduced it to 2 per cent., and in 1922 there is apparently not a single person in the county with symptoms of hookworm disease.
Læs mere Tjek på PubMedJournal of the American Medical Association, 4.10.2022
Tilføjet 4.10.2022
To the Editor In their recently published randomized clinical trial evaluating the efficacy of awake prone positioning in patients with COVID-19 and acute respiratory failure, the authors chose the primary outcome of endotracheal intubation within 30 days of randomization. I wonder about the implications of this choice because there was no provision of a standardized approach to intubation decisions and this trial was unblinded; the participants, research team, and treating clinicians all knew the group to which patients were assigned. Because blinding is used to avoid introducing bias, it is really important that the primary outcome is as resistant to bias as possible in trials that cannot be blinded.
Læs mere Tjek på PubMedJournal of the American Medical Association, 4.10.2022
Tilføjet 4.10.2022
In Reply In response to our recently published trial about the effect of awake prone positioning in patients with COVID-19 and acute respiratory failure, Dr Gershengorn states that to minimize bias we should have either mandated criteria for endotracheal intubation or used another primary outcome. Although we agree, in principle, that standardizing co-interventions and trial outcomes is important in situations when blinding is not possible, there were barriers to implementing this concept in our trial.
Læs mere Tjek på PubMedJournal of the American Medical Association, 4.10.2022
Tilføjet 4.10.2022
This randomized clinical trial compares the efficacy of cefepime/enmetazobactam vs piperacillin/tazobactam in achieving overall treatment success in patients with complicated urinary tract infections (UTIs) or acute pyelonephritis.
Læs mere Tjek på PubMedJournal of the American Medical Association, 4.10.2022
Tilføjet 4.10.2022
In this Viewpoint, Lauren Gardner, winner of the 2022 Lasker-Bloomberg Public Service Award for creating the COVID-19 Dashboard, discusses the development of the Dashboard and the factors that contributed to its success.
Læs mere Tjek på PubMedJournal of the American Medical Association, 4.10.2022
Tilføjet 4.10.2022
Anthony Fauci, MD, who announced he will step down as chief medical advisor to US President Joe Biden and as director of the National Institute of Allergy and Infectious Diseases, discusses best practices for conveying scientific information to the public in a polarized era.
Læs mere Tjek på PubMedJournal of the American Medical Association, 4.10.2022
Tilføjet 4.10.2022
This case series describes the clinical resolution of systemic symptoms and lesions, along with any adverse events, in patients with monkeypox infection who were treated with tecovirimat on a compassionate use basis.
Læs mere Tjek på PubMedBMC Infectious Diseases, 4.10.2022
Tilføjet 4.10.2022
Abstract
Background
Protection by preventive Ebola vaccines has been demonstrated in clinical trials, but a complete picture of real-world effectiveness is lacking. Our previous study modeling the impact of preventively vaccinating healthcare workers (HCW) alone or with a proportion of the general population (GP) estimated significant reductions in incidence and mortality. The model assumed 100% vaccine efficacy, which is unlikely in the real world. We enhanced this model to account for lower vaccine efficacy and to factor in reduced infectiousness and lower case fatality rate in vaccinated individuals with breakthrough infections.
Methods
The previous model was enhanced to still permit a risk, although lower, for vaccinated individuals to become infected. The enhanced model, calibrated with data from epidemics in Sierra Leone (SL) and North Kivu, Democratic Republic of the Congo, helped evaluate the impact of preventive Ebola vaccination in different scenarios based on different vaccine efficacy rates (90% and 30% reductions in infection risk in the base and conservative scenarios, respectively; additionally, both scenarios with 50% reductions in infectiousness and mortality) and vaccination coverage among HCWs (30%, 90%) and GP (0%, 5%, and 10%).
Results
The base scenario estimated that, depending upon the proportions of vaccinated HCWs and GP, 33–85% of cases and 34–87% of deaths during the 2014 SL epidemic and 42–89% of cases and 41–89% of deaths during the 2018 North Kivu epidemic would be averted versus no vaccination. Corresponding estimates for the conservative scenario were: 23–74% of cases and 23–77% of deaths averted during the SL epidemic and 31–80% of both cases and deaths averted during the North Kivu epidemic.
Conclusions
Preventive vaccination targeting HCW alone or with GP may significantly reduce the size and mortality of an EVD outbreak, even with modest efficacy and coverage. Vaccines may also confer additional benefits through reduced infectiousness and mortality in breakthrough cases.
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BMC Infectious Diseases, 4.10.2022
Tilføjet 4.10.2022
Abstract
Background
Sarcoidosis is a systemic inflammatory disease that is characterized by non-caseating epithelioid-cell granulomas upon histology. However, similar histological findings may also be seen with certain infections. Thus, differentiation from infection is pivotal to ensure appropriate treatment. Here, we present a case of a disseminated infection with Mycobacterium genavense owing to an interleukin 12 receptor subunit beta 1 (IL-12Rβ1) associated immunodeficiency in a previously healthy female who was initially misdiagnosed with sarcoidosis. M. genavense is a nontuberculous mycobacterium which can cause lymphadenopathy, gastrointestinal and bone marrow infiltration in immunocompromised patients. With this case report we aim to highlight that an infection with M. genavense on the ground of a genetic defect of mycobacterial immune control may represent a rare differential diagnosis of sarcoidosis.
Case presentation
A 31-year-old female was referred to our hospital with progressive lymphadenopathy, hepatosplenomegaly, pancytopenia and systemic inflammation. She had previously been evaluated for generalized lymphadenopathy in another hospital. At that time, lymph node biopsies had revealed sarcoid-like lesions and a systemic corticosteroid treatment was initiated based on a putative diagnosis of sarcoidosis. When her condition worsened, she was transferred to our university clinic, where the diagnosis of disseminated M. genavense infection owing to an inborn interferonopathy was made. Her family history revealed that her brother had also suffered from IL-12Rβ1 deficiency and had died from a systemic infection with M. genavense at the age of 21. The patient received antimycobacterial treatment combined with subcutaneous type I interferon, which eventually led to a gradual improvement over the next months.
Conclusions
Differentiating between sarcoidosis and sarcoid-like lesions secondary to infections may be challenging, especially when pathogens are difficult to detect or not expected in an apparently immunocompetent patient. Patients with IL-12Rβ1-associated immunodeficiency may be asymptomatic until adulthood, and disseminated M. genavense infection on the grounds of an IL-12Rβ1-associated immunodeficiency may represent a rare differential diagnosis of sarcoidosis.
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BMC Infectious Diseases, 4.10.2022
Tilføjet 4.10.2022
Abstract
Background
Ultrasonographic guidance is widely used for central venous catheterization. Several studies have revealed that ultrasound-guided central venous catheterization increases the rate of success during the first attempt and reduces the procedural duration when compared to the anatomical landmark-guided insertion technique, which could result in protection from infectious complications. However, the effect of ultrasound-guided central venous catheterization on catheter-related bloodstream infections remains unclear. We aimed to conduct a systematic review and meta-analysis to evaluate the value of ultrasound guidance in preventing catheter-related bloodstream infections and catheter colonization associated with central venous catheterization.
Methods
The Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE (via PubMed) were searched up to May 9, 2022 for randomized controlled trials (RCTs) comparing ultrasound-guided and anatomical landmark-guided insertion techniques for central venous catheterization. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool for RCTs. A meta-analysis was performed for catheter-related bloodstream infections and catheter colonization, as primary and secondary outcomes, respectively.
Results
Four RCTs involving 1268 patients met the inclusion criteria and were analyzed. Ultrasound-guided central venous catheterization was associated with a slightly lower incidence of catheter-related bloodstream infections (risk ratio, 0.46; 95% confidence interval [CI], 0.16–1.32) and was not associated with a lower incidence of catheter colonization (risk ratio, 1.36; 95% CI, 0.57–3.26).
Conclusion
Ultrasound-guided central venous catheterization might reduce the incidence of catheter-related bloodstream infections. Additional RCTs are necessary to further evaluate the value of ultrasound guidance in preventing catheter-related bloodstream infections with central venous catheterization.
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BMC Infectious Diseases, 4.10.2022
Tilføjet 4.10.2022
Abstract
Background and objectives:
Bloodstream infection (BSI) is a life-threatening condition in critically ill patients, but pathogen quantification techniques during treatment are laborious. This study aimed to explore the impact of monitoring pathogen DNA load changes and polymicrobial infection in blood by droplet digital polymerase chain reaction (ddPCR) on the prognosis of patients with BSIs.
Methods
This prospective case series study was conducted in the general intensive care unit of the Zhejiang Provincial People’s Hospital and included patients with BSIs from May 2020 to January 2021. Pathogens DNA load and presence of polymicrobial BSIs were dynamically monitored by ddPCR.
Results
Sixteen patients with BSIs proven by blood culture were recruited (87.5% men; mean age, 69.3 ± 13.7 years). All pathogens identified by blood culture were Gram-negative bacteria, among which seven were multidrug-resistant strains. The 28-day mortality rate was 62.5%. Compared to the 28-day survivors, the non-survivors were older (P = 0.04), had higher pathogen DNA load on the second (day 3–4) and third (day 6–7) ddPCR assay (P < 0.01 in both cases). In addition, the changes of pathogen DNA load in the 28-day survivors had a downward trend in the first three ddPCR assay, whereas stable load or an upward trend was observed in the 28-day non-survivors. Moreover, the number of pathogen species in patients with BSIs in the 28-day survivors decreased during the period of effective antibiotic treatment.
Conclusion
The changes of pathogen DNA load and species monitored in blood by ddPCR may be used to determine antibiotic efficacy and make a more accurate prognostic assessment in patients with BSIs.
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Infection, 4.10.2022
Tilføjet 4.10.2022
Abstract
Purpose
Following the emergency use authorization of BNT162b2 by the Food and Drug administration (FDA) in early December 2020, mRNA- and vector-based vaccines became an important means of reducing the spread and mortality of the COVID-19 pandemic. The European Medicines Agency labelled immune thrombocytopenia (ITP) as a rare adverse reaction of unknown frequency after vector-, but not mRNA-vaccination. Here, we report on the long-term outcome of 6 patients who were diagnosed with de-novo, vaccine-associated ITP (VA-ITP), and on the outcome of subsequent SARS-CoV-2 re-vaccinations.
Methods
Patients were included after presenting to our emergency department. Therapy was applied according to ITP guidelines. Follow-up data were obtained from outpatient departments. Both mRNA- or vector-based vaccines were each used in 3 cases, respectively.
Results
In all patients, the onset of symptoms occurred after the 1st dose of vaccine was applied. 5 patients required treatment, 3 of them 2nd line therapy. All patients showed a complete response eventually. After up to 359 days of follow-up, 2 patients were still under 2nd line therapy with thrombopoietin receptor agonists. 5 patients have been re-vaccinated with up to 3 consecutive doses of SARS-CoV-2 vaccines, 4 of them showing stable platelet counts hereafter.
Conclusion
Thrombocytopenia after COVID-19 vaccination should trigger a diagnostic workup to exclude vaccine-induced immune thrombotic thrombocytopenia (VITT) and, if confirmed, VA-ITP should be treated according to current ITP guidelines. Re-vaccination of patients seems feasible under close monitoring of blood counts and using a vaccine that differs from the one triggering the initial episode of VA-ITP.
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Alessia Beccacece, Tommaso Ascoli Bartoli, Emanuele Nicastri
Clinical Microbiology and Infection, 4.10.2022
Tilføjet 4.10.2022
we read with interest the systematic review and meta-analysis by Lee et al. concerning remdesivir use for the treatment of patients with COVID-19. Authors conclude that there is a high probability that remdesivir reduces mortality for nonventilated patients with COVID-19 requiring supplemental oxygen therapy (1).
Læs mere Tjek på PubMedSatish, Sanjana; Bravo, Licia; McAllister, Arden; Teitelman, Anne; Sonalkar, Sarita
AIDS, 26.10.2022
Tilføjet 4.10.2022
Objective:
We conducted a scoping review to assess barriers to and facilitators of integrating HIV pre-exposure prophylaxis (PrEP) and family planning (FP) at the patient, provider, and implementation levels, and to identify gaps in knowledge.
Methods:
We conducted a search of five bibliographic databases from database inception to March 2022: PubMed, CINAHL, Embase, Web of Science and Scopus. Two reviewers screened abstracts and full texts to determine eligibility based on a priori inclusion and exclusion criteria. We categorized studies by their relevance to patient, provider, and implementation barriers, and extracted data based on pre-specified elements.
Results:
Our initial search strategy yielded 1151 results, and 34 publications were included. Barriers to PrEP implementation in family planning settings included low PrEP knowledge among patients, hesitance to take PrEP due to perceived stigma, decreased willingness of providers unfamiliar with PrEP to prescribe PrEP, and limited financial and staffing resources that make prescribing and monitoring PrEP difficult. Facilitators included robust training for providers, stigma reduction efforts, leadership engagement, and increased resources specifically in settings with processes in place that ease the process of prescribing and monitoring PrEP.
Conclusions:
Advances in implementation strategy development, stigma reduction, and drug development will be essential to reinforcing PrEP care in family planning settings and thereby reducing the incidence of HIV in women through highly effective pharmacologic HIV prevention methods.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedHagenimana, Marc; Kodan, Asha E.; George, Nivya; Businge, Lydia; Francois, Uwikindi; Nsanzimana, Sabin; Riedel, David J.
AIDS, 26.10.2022
Tilføjet 4.10.2022
Objective:
As antiretroviral therapy (ART) has been widely scaled up in Rwanda, life expectancies among people with HIV (PWH) have increased. With increasing viral suppression, AIDS-defining cancers (ADCs) typically decrease; however, as the PWH population ages, non-AIDS-defining cancers (NADCs) will be expected to increase. The aim of this study was to compare cancer diagnoses between PWH and patients without HIV in Rwanda and to describe the changes in the number and types of cancer over time.
Design:
Retrospective cohort study.
Methods:
Rwanda National Cancer Registry (RNCR) recorded the HIV status, primary site, and morphological description for cancer diagnoses from 2007 to 2018. Descriptive analyses were carried out by cancer group (HIV+ and HIV–). A portion of patients whose HIV status was unknown (63%) were excluded from the present analysis.
Results:
Among the 20 258 cases registered in the Registry, there were 1048 PWH and 6359 HIV– individuals. The proportion of ADCs were significantly higher in the PWH group compared to those without HIV (P
Læs mere Tjek på PubMedNevrekar, Neetal; Butler, Kevin; Shapiro, David E.; Atuhaire, Patience; Taha, Taha E; Makanani, Bonus; Chinula, Lameck; Owor, Maxensia; Moodley, Dhayendre; Chipato, Tsungai; McCarthy, Katie; Flynn, Patricia M.; Currier, Judith; Fowler, Mary Glenn; Gupta, Amita; Suryavanshi, Nishi
Journal of Acquired Immune Deficiency Syndromes, 13.05.2022
Tilføjet 4.10.2022
Introduction:
Optimal adherence to antiretroviral therapy (ART) is crucial to promoting maternal-infant health.
Setting:
Fourteen sites in seven countries within Sub-Saharan Africa and India.
Methods:
The multi-component, open-label strategy PROMISE trial enrolled breastfeeding mother-infant pairs not meeting in-country criteria for maternal ART (mART) initiation in the postpartum component within 5 days of delivery. Randomization was to mART versus iNVP prophylaxis. Infants in mART arm also received 6 weeks of iNVP. Self-reported adherence was assessed in a secondary analysis. Time-to-event analyses were performed to explore the association between adherence and maternal viral load (MVL) in the mART arm.
Results:
2431 mother-infant pairs were enrolled between 2011-2014; baseline maternal median CD4 was 686 (IQR 553-869) and median MVL was 322 copies/mL (IQR 40-1422). Self-reported adherence was lower in the mART arm compared to the iNVP arm (no missed doses within 4 weeks of all study visits: 66% vs 83%; within 2 weeks: 71% vs 85 %; p<0.0001). The iNVP adherence at week 6 was high in both arms: 97% in mART; 95% in iNVP arm. Time-to-event analyses showed that adherence to mART was associated with time to first MVL ≥400 copies/ml (p<0.0001). Missing one full day of doses over 3 days was associated with a 66% risk of MVL ≥1000 copies/ml (HR: 1.66; 95% CI: 1.37, 1.99).
Conclusions:
Postpartum women were less adherent to their own ART than mothers providing their infant’s nevirapine prophylaxis. The self-reported missed mART doses were associated with high MVL. Strategies to optimize postpartum mART adherence are urgently needed.
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedCranmer, Lisa M.; Njuguna, Irene N.; LaCourse, Sylvia M.; Figueroa, Janet; Gillespie, Scott; Maleche-Obimbo, Elizabeth; Otieno, Vincent; Mugo, Cyrus; Okinyi, Helen; Benki-Nugent, Sarah; Pavlinac, Patricia B.; Malik, Amyn A.; Gandhi, Neel R.; Richardson, Barbara A.; Stern, Joshua; Wamalwa, Dalton C.; John-Stewart, Grace C.
Journal of Acquired Immune Deficiency Syndromes, 13.05.2022
Tilføjet 4.10.2022
Background:
The World Health Organization (WHO) recommends tuberculosis (TB) diagnostic evaluation for children with HIV (CHIV) who have history of TB contact, poor weight gain, cough or fever. These screening criteria were developed based on studies of symptomatic CHIV with incomplete microbiologic confirmation. We performed routine TB microbiologic evaluation of hospitalized CHIV with and without symptoms in order to develop a data-driven TB symptom screen.
Methods:
Among hospitalized ART-naïve Kenyan CHIV enrolled in the Pediatric Urgent Start of HAART (PUSH) trial, we performed Xpert Mtb/RIF and mycobacterial culture of respiratory and stool specimens independent of TB symptoms. We evaluated performance of WHO and other published pediatric TB screening criteria and derived optimized criteria using a combination of symptoms.
Results:
Of 168 CHIV who underwent TB microbiologic evaluation, 13 (8%) had confirmed TB. WHO TB symptom screening had 100% sensitivity and 4% specificity to detect confirmed TB. Published TB screening criteria that relied on prolonged symptoms missed cases of confirmed TB (sensitivity 85-92%). An optimized symptom screen including weight loss, cough, anorexia or TB contact had 100% sensitivity and improved specificity (31%) compared to the WHO pediatric TB symptom screen.
Conclusions:
The WHO TB symptom screen was highly sensitive but resulted in a high proportion of hospitalized CHIV who would require TB diagnostic evaluation. Other published TB screening criteria missed CHIV with confirmed TB. Our optimized screening tool increased specificity while preserving sensitivity. Future multi-center studies are needed to improve TB screening tools for CHIV in both inpatient and outpatient settings.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedVyas, Kartavya J.; Marconi, Vincent C.; Moanna, Abeer; Rimland, David; Guest, Jodie L.
Journal of Acquired Immune Deficiency Syndromes, 13.05.2022
Tilføjet 4.10.2022
Background:
Causes of death and their trends among Veterans with HIV (VWH) are different than those in the general population with HIV, but this has not been fully described. The objective was to understand the trends in, and risk factors for, all-cause and cause-specific mortality across eras of combination antiretroviral therapy (cART) among VWH.
Setting:
The HIV Atlanta VA Cohort Study (HAVACS) includes all VWH who ever sought care at the Atlanta VA Medical Center.
Methods:
Age-adjusted all-cause and cause-specific mortality rates were calculated annually and compared between pre- (1982-1996), early- (1997-2006), and late-cART (2007-2016) eras. Trends were assessed using Kaplan-Meier curves, cumulative incidence functions, and join-point regression models. Risk factors were identified by Cox proportional hazards models.
Results:
Of the 4,674 VWH in HAVACS, 1,752 died; of whom, 1,399 (79.9%), 301 (17.2%), and 52 (3.0%) were diagnosed with HIV in the pre-, early-, and late-cART eras, respectively. Significant increases were observed in rates of all-cause, AIDS-related, and non-AIDS-related mortality in the pre-cART era, followed by declines in the early- and late-cART eras. All-cause, AIDS-related, and non-AIDS-related mortality rates plummeted by 65%, 81%, and 45%, respectively, from the pre- to late-cART eras. However, VWH continue to die at higher rates due to AIDS-related infections, non-AIDS-related malignancies, respiratory disease, cardiovascular disease, and renal failure than those in the general population with HIV.
Conclusions:
In older populations with HIV, it is important that providers not only monitor for and treat diseases associated with aging, but also intervene and address lifestyle risk factors.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedWang, Guoshen; Song, Wei; Rao, Shubha; Heitgerd, Janet; Mulatu, Mesfin S.; Karch, Debra; Belcher, Lisa
Journal of Acquired Immune Deficiency Syndromes, 13.05.2022
Tilføjet 4.10.2022
Abstract:
Objectives.
Gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV. This study reports data on HIV testing program outcomes among MSM tested for HIV in non-healthcare settings in the United States.
Methods.
We analyzed CDC’s National HIV Prevention Program Monitoring and Evaluation data collected in 2019. Descriptive and multivariate robust Poisson regression analyses were conducted to summarize the patterns of HIV testing program outcomes (i.e., positivity, linkage to HIV medical care within 30 days of diagnosis, interview for partner services (PS), and PrEP awareness and referral) by demographic characteristics, HIV prevalence, and testing site type.
Results.
A total of 123,251 HIV tests were conducted among MSM; of these, 1,773 (1.4%) were newly diagnosed with HIV. Among MSM newly diagnosed with HIV, 75% were linked to HIV medical care and 80% were interviewed for PS. Among MSM who tested HIV-negative, 63% were aware of PrEP and 47% of those who were eligible for PrEP were referred to PrEP providers. Referral or linkage to services varied by demographic characteristics or other factors.
Conclusions.
Linkage to HIV medical care and interview for PS among MSM newly diagnosed with HIV in non-healthcare settings were below national or funding program targets. The majority of MSM with risk factors for HIV infection were not referred to PrEP providers. Expanded efforts to address barriers to equitable access to services may help improve HIV-related outcomes among MSM and contribute to ending the HIV epidemic in the United States.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedTodd C. Lee, Emily G. McDonald
Clinical Microbiology and Infection, 4.10.2022
Tilføjet 4.10.2022
We thank Dr. Beccacece et al. for their letter to the editor notifying us that a study we included our recent meta-analysis has since been retracted. We believe it is paramount to avoid citing retracted works, particularly in meta-analyses [1]. With respect to our publication [2], we originally conducted a sensitivity analysis which excluded the now retracted trial, as it was at high risk of bias; however, that sensitivity analysis did not include the final results of WHO Solidarity [3]. To that end, we have updated our analysis herein.
Læs mere Tjek på PubMedEnsie Sadat Mirsharif, Maryam Rajabnia Chenary, Mahmood Bozorgmehr, Saeed Mohammadi, Seyed Mahmoud Hashemi, Susan Kabudanian Ardestani, Mohammad‐Taghi Beigmohammadi, Alireza Abdollahi, Alireza Sadeghipour, Amina Kariminia, Fatemeh Tuserkani, Tooba Ghazanfari
Journal of Medical Virology, 4.10.2022
Tilføjet 4.10.2022