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Shiza Malik, Yasir Waheed
Journal of Medical Virology, 1.11.2022
Tilføjet 1.11.2022
Ancha Baranova, Hongbao Cao, Shaolei Teng, Fuquan Zhang
Journal of Medical Virology, 1.11.2022
Tilføjet 1.11.2022
Umberto D’Alessandro
New England Journal of Medicine, 1.11.2022
Tilføjet 1.11.2022
Kassoum Kayentao, Aissata Ongoiba, Anne C. Preston, Sara A. Healy, Safiatou Doumbo, Didier Doumtabe, Abdrahamane Traore, Hamadi Traore, Adama Djiguiba, Shanping Li, Mary E. Peterson, Shinyi Telscher, Azza H. Idris, Neville K. Kisalu, Kevin Carlton, Leonid Serebryannyy, Sandeep Narpala, Adrian B. McDermott, Martin Gaudinski, Siriman Traore, Hamidou Cisse, Mamadou Keita, Jeff Skinner, Zonghui Hu, Amatigué Zéguimé, Adama Ouattara, M’Bouye Doucoure, Amagana Dolo, Abdoulaye Djimdé, Boubacar Traore, Robert A. Seder, Peter D. Crompton
New England Journal of Medicine, 1.11.2022
Tilføjet 1.11.2022
Siripat Pasittungkul, Ilada Thongpan, Preeyaporn Vichaiwattana, Thanunrat Thongmee, Sirapa Klinfueng, Nungruthai Suntronwong, Nasamon Wanlapakorn, Sompong Vongpunsawad, Yong Poovorawan
International Journal of Infectious Diseases, 31.10.2022
Tilføjet 1.11.2022
To investigate the seroprevalence of RSV infections in young children, the correlation between RSV antibody levels in maternal and cord blood, and to provide evidence of RSV reinfection in Thai children after primary infections.
Læs mere Tjek på PubMedSaurabh C Sharda, Kamlesh Bisht, Vikas Sharma, Prabhakara Reddy Lakku, Mandip S Bhatia, Navneet Sharma, Manisha Biswal
International Journal of Infectious Diseases, 31.10.2022
Tilføjet 1.11.2022
Charlotte M. Ahle, Cecilie Feidenhansl, Holger Brüggemann
Trends in Microbiology, 31.10.2022
Tilføjet 1.11.2022
Cutibacterium acnes is a Gram-positive bacterium that colonizes human skin. The lipophilic anaerobic bacterium resides mainly in the sebum-rich pilosebaceaous units, but is also detected in nonsebaceous areas. The species is polyphyletic and includes three different subspecies. Multiple phylogenetic lineages usually coexist on an individual’s skin; however, each pilosebaceous unit is predominately colonized by a single lineage. The bacterium is thought to contribute to skin homeostasis through colonization resistance, antioxidant activity, and immunomodulatory properties.
Læs mere Tjek på PubMedPrerna Arora, Lu Zhang, Inga Nehlmeier, Amy Kempf, Anne Cossmann, Alexandra Dopfer-Jablonka, Sebastian R Schulz, Hans-Martin Jäck, Georg M N Behrens, Stefan Pöhlmann, Markus Hoffmann
Lancet Infectious Diseases, 1.11.2022
Tilføjet 1.11.2022
Since the first detection of the SARS-CoV-2 omicron variant (B.1.1.529 and sublineages) in November 2021 in South Africa, Botswana, and Hong Kong, several omicron sublineages have evolved. Some of these sublineages, including BA.2.75, BA.4, and BA.5, have shown augmented resistance against antibody-mediated neutralisation.1–3
Læs mere Tjek på PubMedNadine Kayiba Kalenda, Evariste Tshibangu-Kabamba, Yu Nakagama, Natsuko Kaku, Akira Kaneko, Niko Speybroeck, Yasutoshi Kido
Lancet Infectious Diseases, 31.10.2022
Tilføjet 1.11.2022
Seasonal malaria chemoprevention is an important intervention recommended for children aged 3–59 months living in highly seasonal transmission areas of the Sahel subregion of Africa to provide protection against malaria during the rainy season.1 In The Lancet Infectious Diseases, Colin J Sutherland and colleagues2 report on the prevalence of Plasmodium falciparum genetic variants associated with drug resistance before and after the implementation of seasonal malaria chemoprevention with sulfadoxine–pyrimethamine plus amodiaquine in areas across seven Sahelian countries (Burkina Faso, Chad, Guinea, Mali, Nigeria, Niger, and The Gambia).
Læs mere Tjek på PubMedLancet Infectious Diseases, 1.11.2022
Tilføjet 1.11.2022
Rajasingham R, Govender NP, Jordan A, et al. The global burden of HIV-associated cryptococcal infection in adults in 2020: a modelling analysis. Lancet Infect Dis 2022; published online Aug 29. https://doi.org/10.1016/S1473-3099(22)00499-6— In figure 2 of this Article, the spelling of Colombia was incorrect and the appendix has been corrected. These corrections have been made to the online version as of Oct 31, 2022, and will be made to the printed version.
Læs mere Tjek på PubMedKhalid B Beshir, Julian Muwanguzi, Johanna Nader, Raoul Mansukhani, Aliou Traore, Kadidja Gamougam, Sainey Ceesay, Thomas Bazie, Fassou Kolie, Mahaman M Lamine, Matt Cairns, Paul Snell, Susana Scott, Abdoulaye Diallo, Corinne S Merle, Jean Louis NDiaye, Lanto Razafindralambo, Diego Moroso, Jean-Bosco Ouedraogo, Issaka Zongo, Hamit Kessely, Daugla Doumagoum, Kalifa Bojang, Serign Ceesay, Kovana Loua, Hamma Maiga, Alassane Dicko, Issaka Sagara, Ibrahim M Laminou, Sonny Johnbull Ogboi, Tony Eloike, Paul Milligan, Colin J Sutherland
Lancet Infectious Diseases, 31.10.2022
Tilføjet 1.11.2022
In seven African countries, evidence of a significant reduction in parasite carriage among children receiving seasonal malaria chemoprevention was found 2 years after intervention scale-up. Combined resistance-associated haplotypes remained rare, and seasonal malaria chemoprevention with sulfadoxine–pyrimethamine and amodiaquine is expected to retain effectiveness. The threat of future erosion of effectiveness due to dhps variant haplotypes requires further monitoring.
Læs mere Tjek på PubMedChiara Farroni, Alessandra Aiello, Andrea Picchianti-Diamanti, Bruno Laganà, Elisa Petruccioli, Chiara Agrati, Anna Rosa Garbuglia, Silvia Meschi, Daniele Lapa, Gilda Cuzzi, Linda Petrone, Valentina Vanini, Andrea Salmi, Anna Maria Gerarda Altera, Federica Repele, Germana Grassi, Aurora Bettini, Serena Vita, Andrea Mariano, Arianna Damiani, Maria Infantino, Valentina Grossi, Mariangela Manfredi, Laura Niccoli, Vincenzo Puro, Roberta Di Rosa, Simonetta Salemi, Giorgio Sesti, Palma Scolieri, Vincenzo Bruzzese, Maurizio Benucci, Fabrizio Cantini, Emanuele Nicastri, Delia Goletti
International Journal of Infectious Diseases, 31.10.2022
Tilføjet 31.10.2022
Can Chen, Xiaoxiao Liu, Danying Yan, Yuqing Zhou, Cheng Ding, Lu Chen, Lei Lan, Chenyang Huang, Daixi Jiang, Xiaobao Zhang, Zhou Guan, Xiaofang Fu, Yuxia Du, Yushi Lin, Changtai Zhu, Jie Wu, Lanjuan Li, Shigui Yang
International Journal of Infectious Diseases, 31.10.2022
Tilføjet 31.10.2022
Influenza vaccination is an effective method for preventing influenza virus infection. Herein, we performed a meta-analysis to quantify global influenza vaccination rates (IVRs) and the factors influencing its uptake in the general population, individuals with chronic diseases, pregnant women, and healthcare workers.
Læs mere Tjek på PubMedHae Won Kim, Jong Won Hong, Eun Ji Nam, Ka Young Kim, Ji Hye Kim, Jee In Kang
PLoS One Infectious Diseases, 31.10.2022
Tilføjet 31.10.2022
by Hae Won Kim, Jong Won Hong, Eun Ji Nam, Ka Young Kim, Ji Hye Kim, Jee In Kang
Background It is important to ensure that both the qualitative and quantitative aspects of clinical education are maintained during the pandemic. Understanding students’ views on clinical rotations and the extent of their perceived pandemic-related stress would thus be useful for designing and implementing effective clerkship programs. Therefore, this study aimed to investigate perceived stress and perceptions regarding clinical clerkship among incoming clinical students (third year) and senior clinical students (fourth year) during the COVID-19 pandemic. Methods After completing orientation programs at the beginning of the academic year, we surveyed students on their perceived stress, their general perspectives regarding the appropriate scope of clinical clerkship, and their preferences regarding level of participation in clerkship. We examined the differences in stress and clerkship-related perceptions based on the students’ study year and sex using independent t-test, chi-squared test, and Fisher’s exact test. In addition, the influences of stress, sex, and study year on clerkship-related perceptions were examined using multinomial logistic regression. Results The independent t-test indicated that third-year students experienced lower stress than did fourth-year students. Clerkship-related perceptions also differed significantly between third- and fourth-year students. Multinomial logistic regression analyses on the scope of and participation levels in clinical clerkship revealed that third-year students had significantly lower odds of preferring a limited range of clinical rotations and lower engagement in clerkships compared to fourth-year students. Conclusion The COVID-19 pandemic has affected clinical education and, consequently, medical students’ inclination toward active participation in clinical rotations. It is thus essential to understand students’ views and provide them with relevant intra-pandemic educational supports.
Læs mere Tjek på PubMedTadesse Sime, Lemessa Oljira, Aboma Diriba, Gamachis Firdisa, Wubishet Gezimu
PLoS One Infectious Diseases, 31.10.2022
Tilføjet 31.10.2022
by Tadesse Sime, Lemessa Oljira, Aboma Diriba, Gamachis Firdisa, Wubishet Gezimu
Background In resource-limited countries such as Ethiopia, tuberculosis is the major cause of morbidity and mortality among people living with the human immunodeficiency virus. In the era of antiretroviral therapy, the effect of tuberculosis on the survival of patients who are living with human immunodeficiency virus has been poorly understood in Ethiopia. Therefore, this study aimed to determine the effect of active tuberculosis on the survival of HIV-infected adult patients who initiated antiretroviral therapy in public hospitals in Eastern Ethiopia. Methods An institution-based retrospective cohort study was conducted among 566 participants from January 1, 2014, to June 30, 2018. The collected data were entered into EpiData version 3.1 before being exported to Stata version 14 for analysis. A Cox proportional hazard model was used to determine the effect of active tuberculosis on the survival of HIV-infected adult patients who initiated antiretroviral therapy, and a p-value less than 0.05 and a 95% confidence level were used to declare statistical significance. Result Of the 566 patients included in the study, 76 died. The mortality rate was 11.04 per 100 person-years in tuberculosis co-infected patients, while it was 2.52 per 100 person-years in non-tuberculosis co-infected patients. The patients with tuberculosis co-infection had a 2.19 times higher hazard of death (AHR: 2.19; 95% CI: 1.17, 4.12) compared to those without tuberculosis. Advanced clinical stage, low CD4+ cell count, and previous episodes of an opportunistic infection other than tuberculosis were found to be independent predictors of mortality. Conclusion Co-infection with tuberculosis at antiretroviral therapy initiation increases the hazard of death approximately two-fold. Hence, we recommend key organizations to enhance the region’s collaborative interventional and preventative strategies for TB and HIV.
Læs mere Tjek på PubMedArash Roostaei, Hadi Barzegar, Fakhteh Ghanbarnejad
PLoS One Infectious Diseases, 31.10.2022
Tilføjet 31.10.2022
by Arash Roostaei, Hadi Barzegar, Fakhteh Ghanbarnejad
In this paper, the original SIR model is improved by considering a new compartment, representing the hospitalization of critical cases. A system of differential equations with four blocks is developed to analyze the treatment of severe cases in an Intensive Care Unit (ICU). The outgoing rate of the infected individuals who survive is divided into nI and b I I + b where the second term represents the transition rate of critical cases that are hospitalized in ICU. The findings demonstrate the existence of forward, backward and Hopf bifurcations in various ranges of parameters.
Læs mere Tjek på PubMedDmitry V. Zaretsky, Maria V. Zaretskaia, Yaroslav I. Molkov, for the Alzheimer’s Disease Neuroimaging Initiative
PLoS One Infectious Diseases, 31.10.2022
Tilføjet 31.10.2022
by Dmitry V. Zaretsky, Maria V. Zaretskaia, Yaroslav I. Molkov, for the Alzheimer’s Disease Neuroimaging Initiative
Senile plaques, which are mostly composed of beta-amyloid peptide, are the main signature of Alzheimer’s disease (AD). Two main forms of beta-amyloid in humans are 40 and 42-amino acid, long; the latter is considered more relevant to AD etiology. The concentration of soluble beta-amyloid-42 (Aβ42) in cerebrospinal fluid (CSF-Aβ42) and the density of amyloid depositions have a strong negative correlation. However, AD patients have lower CSF-Aβ42 levels compared to individuals with normal cognition (NC), even after accounting for this correlation. The goal of this study was to infer deviations of Aβ42 metabolism parameters that underlie this difference using data from the Alzheimer’s Disease Neuroimaging Initiative cohort. Aβ42 is released to the interstitial fluid (ISF) by cells and is removed by several processes. First, growth of insoluble fibrils by aggregation decreases the concentration of soluble beta-amyloid in the ISF. Second, Aβ42 is physically transferred from the brain to the CSF and removed with the CSF flow. Finally, there is an intratissue removal of Aβ42 ending in proteolysis, which can occur either in the ISF or inside the cells after the peptide is endocytosed. Unlike aggregation, which preserves the peptide in the brain, transfer to the CSF and intratissue proteolysis together represent amyloid removal. Using a kinetic model of Aβ42 turnover, we found that compared to NC subjects, AD patients had dramatically increased rates of amyloid removal. A group with late-onset mild cognitive impairment (LMCI) also exhibited a higher rate of amyloid removal; however, this was less pronounced than in the AD group. Estimated parameters in the early-onset MCI group did not differ significantly from those in the NC group. We hypothesize that increased amyloid removal is mediated by Aβ42 cellular uptake; this is because CSF flow is not increased in AD patients, while most proteases are intracellular. Aβ cytotoxicity depends on both the amount of beta-amyloid internalized by cells and its intracellular conversion into toxic products. We speculate that AD and LMCI are associated with increased cellular amyloid uptake, which leads to faster disease progression. The early-onset MCI (EMCI) patients do not differ from the NC participants in terms of cellular amyloid uptake. Therefore, EMCI may be mediated by the increased production of toxic amyloid metabolites.
Læs mere Tjek på PubMedTianchu Lyu, Chen Liang, Jihong Liu, Berry Campbell, Peiyin Hung, Yi-Wen Shih, Nadia Ghumman, Xiaoming Li, on behalf of the National COVID Cohort Collaborative Consortium
PLoS One Infectious Diseases, 31.10.2022
Tilføjet 31.10.2022
by Tianchu Lyu, Chen Liang, Jihong Liu, Berry Campbell, Peiyin Hung, Yi-Wen Shih, Nadia Ghumman, Xiaoming Li, on behalf of the National COVID Cohort Collaborative Consortium
Objective Identifying the time of SARS-CoV-2 viral infection relative to specific gestational weeks is critical for delineating the role of viral infection timing in adverse pregnancy outcomes. However, this task is difficult when it comes to Electronic Health Records (EHR). In combating the COVID-19 pandemic for maternal health, we sought to develop and validate a clinical information extraction algorithm to detect the time of clinical events relative to gestational weeks. Materials and methods We used EHR from the National COVID Cohort Collaborative (N3C), in which the EHR are normalized by the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). We performed EHR phenotyping, resulting in 270,897 pregnant women (June 1st, 2018 to May 31st, 2021). We developed a rule-based algorithm and performed a multi-level evaluation to test content validity and clinical validity, and extreme length of gestation (300). Results The algorithm identified 296,194 pregnancies (16,659 COVID-19, 174,744 without COVID-19) in 270,897 pregnant women. For inferring gestational age, 95% cases (n = 40) have moderate-high accuracy (Cohen’s Kappa = 0.62); 100% cases (n = 40) have moderate-high granularity of temporal information (Cohen’s Kappa = 1). For inferring delivery dates, the accuracy is 100% (Cohen’s Kappa = 1). The accuracy of gestational age detection for the extreme length of gestation is 93.3% (Cohen’s Kappa = 1). Mothers with COVID-19 showed higher prevalence in obesity or overweight (35.1% vs. 29.5%), diabetes (17.8% vs. 17.0%), chronic obstructive pulmonary disease (0.2% vs. 0.1%), respiratory distress syndrome or acute respiratory failure (1.8% vs. 0.2%). Discussion We explored the characteristics of pregnant women by different gestational weeks of SARS-CoV-2 infection with our algorithm. TED-PC is the first to infer the exact gestational week linked with every clinical event from EHR and detect the timing of SARS-CoV-2 infection in pregnant women. Conclusion The algorithm shows excellent clinical validity in inferring gestational age and delivery dates, which supports multiple EHR cohorts on N3C studying the impact of COVID-19 on pregnancy.
Læs mere Tjek på PubMedAtefeh Homayuni, Zahra Hosseini, Nahid Shahabi, Roghayeh Ezati Rad, Farah Moayedi
PLoS One Infectious Diseases, 31.10.2022
Tilføjet 31.10.2022
by Atefeh Homayuni, Zahra Hosseini, Nahid Shahabi, Roghayeh Ezati Rad, Farah Moayedi
Background The prevalence of coronavirus disease 2019 (COVID-19) has endangered the psychological health of individuals. This study aimed to assess the quality of life and its related psychological problems during COVID-19 pandemic. Methods In this cross-sectional study, 559 citizens above the age of 16 years, in Isfahan and Bandar Abbas cities in Iran were selected with a convenient sampling method. An online questionnaire was used to collect the data, which consisted of five sections: demographic information, short health anxiety inventory (SHAI), perceived stress scale (PSS), world health organization quality of life questionnaire (WHOQOL-BREF) and Padua inventory. Data were analyzed using statistical tests including t-test, path analysis and structural equation modeling (SEM) using SPSS 24 and Amos 21 statistical software. Results A total of 559 subjects with the mean age of 37.34 ± 11.19 years participated in this study. Most of the participants were female (78.5%), married (71.6%) and employed (40.9%). The majority of them also had a bachelor’s degree (42.9%). There were significant negative correlations between perceived helplessness (r = -.597, p = .000), perceived stress (r = -.715, p = .000), risk of disease (r = -.302, p = .000), negative effect of disease (r = -.424, p = .000), health anxiety (r = -.366, p = .000), contamination obsessions (r = -.187, p = .000) and washing compulsions (r = -.193, p = .000) with quality of life. On other hand, significant positive correlation was found between perceived self-efficacy (r = .665, p = .000) and quality of life. Conclusions According to our findings, health anxiety, perceived stress and obsessive-compulsive disorder were negatively affected psychological health during COVID-19 which in turn decreased quality of life. Therefore, we suggest considering prevention and treatment of theses psychological problems to diminish the risk of reduced quality of life during COVID-19 global pandemic crisis.
Læs mere Tjek på PubMedTomas Di Mambro, Tania Vanzolini, Marzia Bianchi, Rita Crinelli, Barbara Canonico, Filippo Tasini, Michele Menotta, Mauro Magnani
PLoS One Infectious Diseases, 31.10.2022
Tilføjet 31.10.2022
by Tomas Di Mambro, Tania Vanzolini, Marzia Bianchi, Rita Crinelli, Barbara Canonico, Filippo Tasini, Michele Menotta, Mauro Magnani
The resistance and the birth of new intrinsic and multidrug-resistant pathogenic species like C. auris is creating great concern in the antifungal world. Given the limited drug arsenal and the lack of effectiveness of the available compounds, there is an urgent need for innovative approaches. The murine mAb 2G8 was humanized and engineered in silico to develop a single-chain fragment variable (hscFv) antibody against β-1,3-glucans which was then expressed in E. coli. Among the recombinant proteins developed, a soluble candidate with high stability and affinity was obtained. This selected protein is VL-linker-VH oriented, and it is characterized by the presence of two ubiquitin monomers at the N-terminus and a His tag at the C-terminus. This construct, Ub2-hscFv-His, guaranteed stability, solubility, efficient purification and satisfactory recovery of the recombinant product. HscFv can bind β-1,3-glucans both as coated antigens and on C. auris and C. albicans cells similarly to its murine parental and showed long stability and retention of binding ability when stored at 4°, -20° and -80° C. Furthermore, it was efficient in enhancing the antifungal activity of drugs caspofungin and amphotericin B against C. auris. The use of biological drugs as antifungals is limited; here we present a promising hscFv which has the potential to be useful in combination with currently available antifungal drugs.
Læs mere Tjek på PubMedAna Paula Andrade Barreto, Marcio Andrade Barreto Filho, Lucimeire Cardoso Duarte, Thiago Cerqueira-Silva, Aquiles Camelier, Natalia Machado Tavares, Manoel Barral-Netto, Viviane Boaventura, Marcelo Chalhoub Coelho Lima, on behalf of the CPC study group
PLoS One Infectious Diseases, 31.10.2022
Tilføjet 31.10.2022
by Ana Paula Andrade Barreto, Marcio Andrade Barreto Filho, Lucimeire Cardoso Duarte, Thiago Cerqueira-Silva, Aquiles Camelier, Natalia Machado Tavares, Manoel Barral-Netto, Viviane Boaventura, Marcelo Chalhoub Coelho Lima, on behalf of the CPC study group
Background Although low-middle income countries have been disproportionately affected by the COVID-19 pandemic, there is scarce information about the impact of long COVID on their population. This study aimed to evaluate long COVID symptomatology, complications (hospital readmission and metabolic disorders), and main clinical features that impact Quality of Life (QoL). Methods This cross-sectional study provides a detailed clinical and laboratory picture of individuals who presented residual symptoms after mild to severe acute COVID-19. Between Aug-2020 to Sep-2021, long COVID patients were evaluated in a reference center for long COVID in Bahia State, Brazil. The EQ-5D-5L questionnaire accessed QoL. Results A total of 1164 (52 ±13.4 years, 57% female, 88% black/mixed-race) were evaluated 2.3 [IQR = 1.6–3.7] months after mild (n = 351, 30.2%), moderate (338, 29.0%) or severe (475, 40.8%) acute illness. Dyspnea (790, 67.9%), fatigue (738, 63.5%), and chest pain (525, 42.9%) were the most frequent residual symptoms regardless of acute severity, affecting the QoL of 88.9% of patients (n/N—826/925), mainly the domains of anxiety/depression and pain/discomfort. High levels of HbA1c were detected for 175 out of 664 patients (26.6%), 40% of them without a previous diagnosis of diabetes mellitus. Of note, hospital admission one-to-three months after the acute phase of disease was required for 51 (4.4%) patients. Conclusion In this majority-black/mixed-race population, long COVID was associated with post-acute hospitalization, newly diagnosed diabetes mellitus, and decreased QoL, particularly in women and regardless of disease severity of acute infection, suggesting important implications for health care system.
Læs mere Tjek på PubMedSrivastava, N., Deval, H., Mittal, M., Deoshatwar, A., Bondre, V. P., Kant, R., Yadav, R.
BMJ Open, 31.10.2022
Tilføjet 31.10.2022
Objective
To determine the Japanese encephalitis (JE)-associated long-term functional and neurological outcomes, the extent of reduced social participation and predictors of poor outcomes among paediatric JE survivors.
Design
A retrospective cohort study.
Setting
Laboratory-confirmed JE-positive paediatric cases (<16 years of age) hospitalised at the paediatric ward of Baba Raghav Das Medical College, Gorakhpur, India, between 1 January 2017 and 31 December 2017, were followed up after 6–12 months of hospital discharge.
Participants
126 patients were included in the study; median age was 7.5 years (range: 1.5–15 years), and 74 (58.73%) were male.
Outcome measures
Functional outcome defined by Liverpool Outcome Score (LOS) dichotomised into poor (LOS=1–2) and good (LOS=3–5) outcome groups compared for demographic, clinical and biochemical parameters for prognostic factors of poor outcomes. Social participation of patients scaled on Child and Adolescent Scale of Participation score 2–5.
Results
About 94 of 126 (74.6%) children developed neurological sequelae at different levels of severity. Age-expected social participation was compromised in 90 out of 118 children. In multivariate logistic regression analysis, a combination of parameters, JE unvaccinated status (OR: 61.03, 95% CI (14.10 to 264); p<0.001), low Glasgow Coma Score (GCS) at admission (≤8) (OR: 8.6, 95% CI (1.3 to 57.1); p=0.026), malnutrition (OR: 13.56, 95% CI (2.77 to 66.46); p=0.001) and requirement of endotracheal intubation (OR: 5.43, 95% CI (1.20 to 24.44); p=0.027) statistically significantly predicted the poor outcome with 77.8% sensitivity and 94.6% specificity. The goodness-of-fit test showed that the model fit well (Hosmer-Lemeshow goodness-of-fit test) (2=3.13, p=0.988), and area under the receiver operating characteristic curve was 0.950.
Conclusion
This study estimates the burden of JE-presenting post-discharge deaths (15.4%) and disability (63.08%). Those who did not receive JE vaccine, were suffering from malnutrition, had GCS ≤8 at admission and required endotracheal intubation had poorer outcomes.
Læs mere Tjek på PubMed
Kohler, P., Agot, K., Njuguna, I. N., Dyer, J., Badia, J., Jiang, W., Beima-Sofie, K., Chhun, N., Inwani, I., Shah, S. K., Richardson, B. A., Chaktoura, N., John-Stewart, G.
BMJ Open, 31.10.2022
Tilføjet 31.10.2022
Introduction
Adolescents and youth living with HIV (AYLHIV) have lower retention in care, adherence to treatment, and viral suppression compared with adults. Stepped care is a process by which clients are assigned to increasingly intensive services or ‘steps’ according to level of need. Differentiated care, in which stable clients access less frequent services, can be combined with stepped care to align needs and preferences of youth to promote optimal engagement in care.
Methods and analysis
This hybrid type I effectiveness implementation cluster randomised trial aims to evaluate a data-informed stepped care (DiSC) intervention for AYLHIV. AYLHIV ages 10–24 receiving care at 24 HIV treatment facilities in Kisumu, Homabay and Migori counties in Kenya will be enrolled. Twelve facilities will be randomised to the DiSC intervention, and 12 will provide standard care. A clinical assignment tool developed by the study team will be used at intervention sites to assign AYLHIV to one of four steps based on risk for loss to follow-up: differentiated care, standard care, counselling services or intensive support services. The primary clinical outcome is retention in care, specifically missed visits (failure to return within 30 days for any visit) and 12-month loss to follow-up. Implementation outcomes are based on the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. Proportions of missed visits will be compared using mixed effect models clustered by facility and participant.
Ethics and dissemination
This study has been approved by the University of Washington Institutional Review Board (STUDY00011096), Maseno University Ethical Review Committee (MUERC/00917/20) and the Kenya National Commission for Science, Technology and Innovation (444824). AYLHIV provide written informed consent when legally permitted, or assent with caregiver permission for minors. Study staff will work with a Community Advisory Board, including youth members, to disseminate results via discussions, presentations, journal publications and local or international conferences.
Trial registration number
NCT05007717.
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Mremi, A., Mchome, B., Mlay, J., Schledermann, D., Blaakaer, J., Rasch, V.
BMJ Open, 31.10.2022
Tilføjet 31.10.2022
Objective
There is a concern about performance of the screening approaches, where information on the quality of novel and affordable screening approaches that will perform well in remote areas is warranted. This lack of information makes it difficult to prioritise resource use in efforts to improve cervical cancer outcomes. We aimed to compare the diagnostic value of human papillomavirus (HPV) testing on self-collected samples, Pap smear and visual inspection of the cervix with acetic acid (VIA) tests for detection of high-grade cervical intraepithelial neoplasia or worse (CIN2+).
Design
A combined cross-sectional and cohort study.
Setting
Three primary healthcare centres in Kilimanjaro region, Tanzania.
Participants
1620 women undergoing cervical cancer screening from December 2018 to September 2021. Inclusion criteria were being aged 25–60 years, and no history of premalignant or cervical cancer. Exclusion criteria were overt signs of cancer and previous hysterectomy.
Interventions
Participants underwent HPV self-sampling with Evalyn Brush and Care HPV kit assay was used to determine prevalence of high-risk HPV infection. Women with positive HPV test were together with a random sample of HPV negative women scheduled for follow-up where VIA was performed, and Pap smear and cervical biopsies obtained.
Results
Of 1620 women enrolled, 229 (14.1%) were HPV positive and 222 of these attended follow-up together with 290 (20.8%) women with negative HPV test. On VIA, 17.6% were positive. On Pap smear, 8.0% were classified as high-grade squamous intraepithelial lesion. The sensitivity and specificity, respectively, of the various tests, compared with histopathology for the detection of CIN2+ were: HPV test 62.5%, 59.3%; Pap smear 82.8%, 82.1% and; VIA 48.4%, 56.8%. When combined, the sensitivity and specificity for HPV and Pap smear were 90.6%, 70.6% while HPV and VIA were 65.6% and 75.5% for the detection of CIN2+.
Conclusions
The performance of care HPV testing on self-collected samples opens the possibility of increasing coverage and early detection in resource-constrained settings.
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BMC Infectious Diseases, 31.10.2022
Tilføjet 31.10.2022
Abstract
Background
Identifying the transmission mode and resistance mechanism of Mycobacterium tuberculosis (MTB) is key to prevent disease transmission. However, there is a lack of regional data. Therefore, the aim of this study was to identify risk factors associated with the transmission of MTB and regional patterns of resistance to isoniazid (INH) and rifampicin (RFP), as well as the prevalence of multidrug-resistant tuberculosis (MDR-TB).
Methods
High-resolution melt (HRM) analysis was conducted using sputum, alveolar lavage fluid, and pleural fluid samples collected from 17,515 patients with suspected or confirmed MTB infection in the downtown area and nine counties of Luoyang City from 2019 to 2021.
Results
Of the 17,515 patients, 82.6% resided in rural areas, and 96.0% appeared for an initial screening. The HRM positivity rate was 16.8%, with a higher rate in males than females (18.0% vs. 14.1%, p < 0.001). As expected, a positive sputum smear was correlated with a positive result for HRM analysis. By age, the highest rates of MTB infection occurred in males (22.9%) aged 26–30 years and females (28.1%) aged 21–25. The rates of resistance to RFP and INH and the incidence of MDR were higher in males than females (20.5% vs. 16.1%, p < 0.001, 15.9% vs. 12.0%, p < 0.001 and 12.9% vs. 10.2%, p < 0.001, respectively). The HRM positivity rate was much higher in previously treated patients than those newly diagnosed for MTB infection. Notably, males at the initial screening had significantly higher rates of HRM positive, INH resistance, RFP resistance, and MDR-TB than females (all, p < 0.05), but not those previously treated for MTB infection. The HRM positivity and drug resistance rates were much higher in the urban vs. rural population. By multivariate analyses, previous treatment, age < 51 years, residing in an urban area, and male sex were significantly and positively associated with drug resistance after adjusting for smear results and year of testing.
Conclusion
Males were at higher risks for MTB infection and drug resistance, while a younger age was associated with MTB infection, resistance to INH and RFP, and MDR-TB. Further comprehensive monitoring of resistance patterns is needed to control the spread of MTB infection and manage drug resistance locally.
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BMC Infectious Diseases, 31.10.2022
Tilføjet 31.10.2022
Abstract
Background:
There is limited information to compare the qualitative and semi-quantitative performance of rapid diagnostic tests (RDT) and serology for the assessment of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Therefore, the objective of the study was (a) to compare the efficacy of SARS-CoV-2 antibody detection between RDT and laboratory serology, trying to identify appropriate semi-quantitative cut-offs for RDT in relation with quantitative serology values and to (b) evaluate diagnostic accuracy of RDT compared to the NAAT gold standard in an unselected adult population.
Methods:
SARS-CoV-2 antibodies were simultaneously measured with lateral flow immunochromatographic assays (LFA), the Cellex qSARS-CoV-2 IgG/IgM Rapid Test (by capillary blood), the iFlash-SARS-CoV-2 IgG/IgM chemiluminescent immunoassay (CLIA) (by venous blood) and the nucleic acid amplification test (NAAT) in samples from in- and out-patients with confirmed, suspected and negative diagnosis of coronavirus disease 2019 (COVID-19) attending Udine Hospital (Italy) (March-May 2020). Interpretation of RDT was qualitative (positive/negative) and semi-quantitative based on a chromatographic intensity scale (negative, weak positive, positive).
Results:
Overall, 720 paired antibody measures were performed on 858 patients. The qualitative and semiquantitative agreement analysis performed in the whole sample between LFA and CLIA provided a Kendall’s tau of 0.578 (p < 0.001) and of 0.623 (p < 0.001), respectively, for IgM and IgG. In patients with a diagnosis of COVID-19, accordance between LFA and CLIA was maintained as a function of time from the onset of COVID-19 disease and the severity of disease both for qualitative and semi-quantitative assessments. RDT compared to the NAAT gold standard in 858 patients showed 78.5% sensitivity (95% CI 75.1%-81.7%) and 94.1% specificity (95% CI 90.4%-96.8%), with variable accordance depending on the timing from symptom onset.
Conclusion:
The RDT used in our study can be a non-invasive and reliable alternative to serological tests and facilitate both qualitative and a semi-quantitative antibody detection in COVID-19.
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BMC Infectious Diseases, 31.10.2022
Tilføjet 31.10.2022
Abstract
Background
The Meningitis/Encephalitis FilmArray® Panel (ME panel) was approved by the U.S. Food and Drug Administration in 2015 and provides rapid results when assessing patients with suspected meningitis or encephalitis. These patients are evaluated by various subspecialties including pediatric hospital medicine (PHM), pediatric emergency medicine (PEM), pediatric infectious diseases, and pediatric intensive care unit (PICU) physicians. The objective of this study was to evaluate the current use of the ME panel and describe the provider and subspecialty practice variation.
Methods
We conducted an online cross-sectional survey via the American Academy of Pediatrics Section of Hospital Medicine (AAP-SOHM) ListServe, Brown University PEM ListServe, and PICU Virtual pediatric system (VPS) Listserve.
Results
A total of 335 participants out of an estimated 6998 ListServe subscribers responded to the survey. 68% reported currently using the ME panel at their institutions. Among test users, most reported not having institutional guidelines on test indications (75%) or interpretation (76%). 58% of providers self-reported lack of knowledge of the test’s performance characteristics. Providers from institutions that have established guidelines reported higher knowledge compared to those that did not (51% vs. 38%; p = 0.01). More PHM providers reported awareness of ME panel performance characteristics compared to PEM physicians (48% vs. 27%; p = 0.004); confidence in test interpretation was similar between both groups (72 vs. 69%; p = 0.80).
Conclusion
Despite the widespread use of the ME panel, few providers report having institutional guidelines on test indications or interpretation. There is an opportunity to provide knowledge and guidance about the ME panel among various pediatric subspecialties.
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BMC Infectious Diseases, 31.10.2022
Tilføjet 31.10.2022
Abstract
Background
Schistosomiasis is known to affect the cognitive functions of children, however, but there is paucity of information on its impact on early childhood development in developing countries where the disease is endemic. This study aimed at determining the effects of schistosomiasis due to Schistosoma haematobium on early childhood development in children below 5 years old from Murewa District, Zimbabwe, including the benefits of treatment.
Methods
Preschool age children (PSAC) under the age of 5 years were screened at baseline and at 6 months post-treatment for S. haematobium infections diagnosed using the urine filtration method. Cognitive domains were assessed using the Griffith Mental Developmental Scales III on 136 PSAC. Multivariate logistic regression was used to determine the level of association between S. haematobium infection and performance in the cognitive domains adjusting for confounding factors (i.e. nutrition, hemoglobin levels, gender and age). Median Development Quotient scores of each cognitive domain at baseline and at 6 months post-treatment were compared and quantified.
Results
After adjusting for confounding factors, PSAC infected with S. haematobium had greater odds of having lower scores in the Foundation of Learning Domain (OR = 3.9, p = 0.008), Language and Communication Domain (OR = 3.2, p = 0.017), Eye-Hand Coordination Domains (OR = 10.7, p = 0.001), Personal-Social-Emotional Domain (19.3, p = 0.001) and in the Overall General Development Domain (7.2, p = 0.011). Improvement of cognitive performance was observed at 6 months post treatment in the following Domains; Language and Communication Domain (p = 0.003), Eye-Hand Coordination Domain (p = 0.02) and General Development Domain (p = 0.006).
Conclusion
The study showed that S. haematobium infection in PSAC is associated with lower cognitive scores in the Foundation of Learning, Language and Communication, Eye-Hand Coordination, Personal-Social-Emotional and in the Overall General Development domains. Our results strengthen the call for inclusion of PSAC in routine deworming programs for the control of urinary schistosomiasis and the need to develop locally validated tools to monitor early child development in endemic areas where resources are limited.
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BMC Infectious Diseases, 31.10.2022
Tilføjet 31.10.2022
Abstract
Background
In 2020, the Japanese government implemented first of two Go To Travel campaigns to promote the tourism sector as well as eating and drinking establishments, especially in remote areas. The present study aimed to explore the relationship between enhanced travel and geographic propagation of COVID-19 across Japan, focusing on the second campaign with nationwide large-scale economic boost in 2020.
Methods
We carried out an interrupted time-series analysis to identify the possible cause-outcome relationship between the Go To Travel campaign and the spread of infection to nonurban areas in Japan. Specifically, we counted the number of prefectures that experienced a weekly incidence of three, five, and seven COVID-19 cases or more per 100,000 population, and we compared the rate of change before and after the campaign.
Results
Three threshold values and three different models identified an increasing number of prefectures above the threshold, indicating that the inter-prefectural spread intensified following the launch of the second Go To Travel campaign from October 1st, 2020. The simplest model that accounted for an increase in the rate of change only provided the best fit. We estimated that 0.24 (95% confidence interval 0.15 to 0.34) additional prefectures newly exceeded five COVID-19 cases per 100,000 population per week during the second campaign.
Conclusions
The enhanced movement resulting from the Go To Travel campaign facilitated spatial spread of COVID-19 from urban to nonurban locations, where health-care capacity may have been limited.
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