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Ziyad Al-Aly and Eric Topol
Science, 23.02.2024
Tilføjet 23.02.2024
Sharmila Devi
Lancet Infectious Diseases, 23.02.2024
Tilføjet 23.02.2024
A sharp rise in cases of cutaneous leishmaniasis in Pakistan has been reported by Médecins Sans Frontières. Sharmila Devi reports.
Læs mere Tjek på PubMedRageshri Dhairyawan
Lancet, 23.02.2024
Tilføjet 23.02.2024
In 2021, Breathtaking, palliative care consultant Rachel Clarke\'s memoir about the start of the COVID-19 pandemic, movingly captured the lived experiences of health-care workers in the UK\'s National Health Service (NHS). With co-writers Jed Mercurio and Prasanna Puwanarajah, who are both former physicians, Clarke has now adapted her book for television. This visual medium gives the narrative a power to reach further than the book to validate not only the experiences of staff, but also service users, and to speak to a wider audience.
Læs mere Tjek på PubMedFlorian Wagenlehner, Caroline R Perry, Thomas M Hooton, Nicole E Scangarella-Oman, Helen Millns, Marcy Powell, Emily Jarvis, Jeremy Dennison, Amanda Sheets, Deborah Butler, John Breton, Salim Janmohamed
Lancet, 23.02.2024
Tilføjet 23.02.2024
Gepotidacin is an efficacious oral antibiotic with acceptable safety and tolerability profiles. As a first-in-class investigational oral antibiotic with activity against common uropathogens, including clinically important drug-resistant phenotypes, gepotidacin has the potential to offer substantial benefit to patients.
Læs mere Tjek på PubMedLayal Chaker, David S Cooper, John P Walsh, Robin P Peeters
Lancet, 23.02.2024
Tilføjet 23.02.2024
Thyrotoxicosis causes a variety of symptoms and adverse health outcomes. Hyperthyroidism refers to increased thyroid hormone synthesis and secretion, most commonly from Graves\' disease or toxic nodular goitre, whereas thyroiditis (typically autoimmune, viral, or drug induced) causes thyrotoxicosis without hyperthyroidism. The diagnosis is based on suppressed serum concentrations of thyroid-stimulating hormone (TSH), accompanied by free thyroxine and total or free tri-iodothyronine concentrations, which are raised (overt hyperthyroidism) or within range (subclinical hyperthyroidism).
Læs mere Tjek på PubMedNature, 23.02.2024
Tilføjet 23.02.2024
Sanne Kaelen, Wilma van den Boogaard, Umberto Pellecchia, Sofie Spiers, Caroline De Cramer, Gwennin Demaegd, Edouard Fouqueray, Rafael Van den Bergh, Stephanie Goublomme, Tom Decroo, Muriel Quinet, Elke Van Hoof, Bertrand Draguez
PLoS One Infectious Diseases, 23.02.2024
Tilføjet 23.02.2024
by Sanne Kaelen, Wilma van den Boogaard, Umberto Pellecchia, Sofie Spiers, Caroline De Cramer, Gwennin Demaegd, Edouard Fouqueray, Rafael Van den Bergh, Stephanie Goublomme, Tom Decroo, Muriel Quinet, Elke Van Hoof, Bertrand Draguez
Læs mere Tjek på PubMedAnita Mesic, Tom Decroo, Htay Thet Mar, Bart K. M. Jacobs, Moe Pyae Thandar, Thin Thin Thwe, Aung Aung Kyaw, Mitchell Sangma, David Beversluis, Elkin Bermudez-Aza, Alexander Spina, Darli Po Po Aung, Erwan Piriou, Koert Ritmeijer, Josefien Van Olmen, Htun Nyunt Oo, Lutgarde Lynen
PLoS One Infectious Diseases, 23.02.2024
Tilføjet 23.02.2024
by Anita Mesic, Tom Decroo, Htay Thet Mar, Bart K. M. Jacobs, Moe Pyae Thandar, Thin Thin Thwe, Aung Aung Kyaw, Mitchell Sangma, David Beversluis, Elkin Bermudez-Aza, Alexander Spina, Darli Po Po Aung, Erwan Piriou, Koert Ritmeijer, Josefien Van Olmen, Htun Nyunt Oo, Lutgarde Lynen
Læs mere Tjek på PubMedSupattra Rungmaitree, Peerawong Werarak, Wadchara Pumpradit, Wanatpreeya Phongsamart, Keswadee Lapphra, Orasri Wittawatmongkol, Yuitiang Durier, Alan Maleesatharn, Beena Kuttiparambil, Tim R. Cressey, Risa M. Hoffman, Kulkanya Chokephaibulkit
PLoS One Infectious Diseases, 23.02.2024
Tilføjet 23.02.2024
by Supattra Rungmaitree, Peerawong Werarak, Wadchara Pumpradit, Wanatpreeya Phongsamart, Keswadee Lapphra, Orasri Wittawatmongkol, Yuitiang Durier, Alan Maleesatharn, Beena Kuttiparambil, Tim R. Cressey, Risa M. Hoffman, Kulkanya Chokephaibulkit Introduction There are gaps in knowledge and experience of antiretroviral pre-exposure prophylaxis (PrEP) delivery in adolescents. Methods This pilot study enrolled Thai adolescents 14–20 year-old without HIV who reported risk behaviour. All participants were offered daily tenofovir/emtricitabine (TDF-FTC) and followed for 24 weeks. HIV testing, renal function, bone density scan, and sexually transmitted infection (STI) testing including syphilis serology and urine molecular testing for gonorrhoea and C. trachomatis were performed at baseline and weeks 12 and 24. Adherence was evaluated through intracellular tenofovir diphosphate (TFV-DP) levels in dried blood spots. Results Of the 61 enrolled adolescents, median age 18.1 (IQR: 14.8–20.9) years, 46 (75.4%) were males and 36 (59%) were MSM. Retention to week 24 was 80.3%. One third (36%) had TFV-DP levels consistent with taking ≥6 pills/week at week 12 and 29% at week 24. The factors associated with taking ≥6 pills/week were being MSM (adjusted odds ratio [aOR]: 53.2, 95% CI: 1.6–1811; p = 0.027), presence of STI at baseline (aOR: 9.4, 95% CI: 1.5–58.5; p = 0.016), and self-report of decreased condom use while taking PrEP (aOR: 8.7, 95% CI: 1.4–56.6; p = 0.023). 31% had an STI at baseline and this declined to 18% at week 24. No renal or bone toxicity was observed and there were no HIV seroconversions. Conclusions Daily oral PrEP with FTC-TDF in high-risk Thai adolescents is feasible, accepted, well-tolerated, and had no increased risk compensation; however, low adherence was a major challenge. Adolescent-specific PrEP strategies including long-acting modalities are needed for successful HIV prevention.
Læs mere Tjek på PubMedAugustine Ngmenemandel Balegha, Suburu Abdul-Aziz, Louis Mornah
PLoS One Infectious Diseases, 23.02.2024
Tilføjet 23.02.2024
by Augustine Ngmenemandel Balegha, Suburu Abdul-Aziz, Louis Mornah Introduction The novel coronavirus SARS-CoV-2 causes Coronavirus Disease 2019 (COVID-19). Vaccination has been identified as one of the most effective strategies for combating COVID-19. Positive perceptions and attitudes of HCPs towards the COVID-19 vaccination are essential to vaccine uptake and adherence. However, the perceptions and attitudes of HCPs towards the COVID-19 vaccination remain largely unexplored. We therefore assessed healthcare professionals’ perceptions, attitudes, and predictors of their attitudes towards COVID-19 vaccination in the Wa Municipality, Upper West Region of Ghana. Methods In 2023, from January 16th to February 28th, we administered a multi-centre e-survey to a cross-section of 403 healthcare professionals in Wa Municipality of the Upper West Region, Ghana. We used STATA version 13 to analyze the data. Frequencies, percentages, and composite scores were used to assess perceptions and attitudes towards the COVID-19 vaccination. Hierarchical binary logistic regression modeling was then used to determine the predictors of attitudes towards the COVID-19 vaccination. Results The healthcare professionals had positive perceptions [6.00; IQR = 4.00–7.00] and attitudes [5.00; IQR = 4.00–5.00] towards theCOVID-19 vaccination. Positive perception [aOR = 1.81; 95% CI = 1.14–2.87, p < 0.05], female sex [aOR = 0.58; 95% CI = 0.35–0.97, p < 0.05], marital status [aOR = 1.94; 95% CI = 1.20–3.12; p < 0.01], having a bachelor’s degree or higher [aOR = 2.03; 95% CI = 1.01–4.12; p < 0.05], and working in the Wa North sub-Municipal area [aOR = 0.22; 95% CI = 0.05–0.96; p < 0.05] were statistically significantly associated with attitudes towards COVID-19 vaccination. Conclusion The healthcare professionals’ perceptions and attitudes towards the COVID-19 vaccination were positive but suboptimal. We recommend regular education on COVID-19 vaccine benefits, safety, and efficacy. Enabling the work environment and addressing vaccine availability and accessibility for healthcare professionals should also be prioritized. These measures should particularly focus on female, single healthcare professionals who possess below a bachelor’s degree and are working in the Wa North sub-municipal area.
Læs mere Tjek på PubMedArish Mudra Rakshasa-Loots, Shalena Naidoo, Thandi Hamana, Busiswa Fanqa, Kaylee S. van Wyhe, Filicity Lindani, Andre J. W. van der Kouwe, Richard Glashoff, Sharon Kruger, Frances Robertson, Simon R. Cox, Ernesta M. Meintjes, Barbara Laughton
PLoS One Infectious Diseases, 23.02.2024
Tilføjet 23.02.2024
by Arish Mudra Rakshasa-Loots, Shalena Naidoo, Thandi Hamana, Busiswa Fanqa, Kaylee S. van Wyhe, Filicity Lindani, Andre J. W. van der Kouwe, Richard Glashoff, Sharon Kruger, Frances Robertson, Simon R. Cox, Ernesta M. Meintjes, Barbara Laughton People living with HIV are at three times greater risk for depressive symptoms. Inflammation is a notable predictor of depression, and people with HIV exhibit chronic inflammation despite antiretroviral therapy. We hypothesised that inflammatory biomarkers may mediate the association between HIV status and depressive symptoms. Participants (N = 60, 53% girls, median [interquartile range (IQR)] age 15.5 [15.0, 16.0] years, 70% living with HIV, of whom 90.5% were virally-suppressed) completed the nine-item Patient Health Questionnaire (PHQ-9). We measured choline and myo-inositol in basal ganglia, midfrontal gray matter, and peritrigonal white matter using magnetic resonance spectroscopy, and 16 inflammatory proteins in blood serum using ELISA and Luminex™ multiplex immunoassays. Using structural equation mediation modelling, we calculated standardised indirect effect estimates with 95% confidence intervals. Median [IQR] total PHQ-9 score was 3 [0, 7]. HIV status was significantly associated with total PHQ-9 score (B = 3.32, p = 0.022). Participants with HIV showed a higher choline-to-creatine ratio in the basal ganglia than those without HIV (β = 0.86, pFDR = 0.035). In blood serum, participants with HIV showed higher monocyte chemoattractant protein-1 (MCP-1, β = 0.59, pFDR = 0.040), higher chitinase-3 like-1 (YKL-40, β = 0.73, pFDR = 0.032), and lower interleukin-1beta (IL-1β, β = -0.67, pFDR = 0.047) than those without HIV. There were no significant associations of any biomarkers with total PHQ-9 score. None of the indirect effects were significant, mediating
Læs mere Tjek på PubMedFredrik Nyman
PLoS One Infectious Diseases, 23.02.2024
Tilføjet 23.02.2024
by Fredrik Nyman The human immunodeficiency virus (HIV) emerged as an endemic health crisis in the United States during the early 1980s. Initially labelled a “gay disease” due to its prevalence among gay men, the spread of HIV led to widespread fear and moral panic, as there was limited medical knowledge on preventing its transmission. While HIV is often associated with Sub-Saharan Africa, this article focuses on Sweden, a pioneering nation that became the first to achieve the remarkable Joint UNAIDS/WHO 90-90-90 continuum in addressing the epidemic. However, despite this significant milestone, the punitive legislation and attitudes prevalent in Sweden have had a counterproductive effect on curbing the virus’s spread. Drawing upon a comprehensive triangulation of various data and sources on the evolution of public policy in Sweden, this article argues for the urgent need to reduce stigma surrounding HIV and AIDS. By undertaking further measures to combat stigmatisation, we not only have the potential to prevent the spread of HIV but also significantly enhance the quality of life for individuals living with the virus. An essential step in this journey is to eliminate the legally-enforced mandatory disclosure of one’s HIV status, which would mark a tremendous victory for all those affected. With limited evidence to support the effectiveness of criminalisation and penal laws, no longer being viewed as criminals for non-disclosure would be a monumental achievement, positively transforming the lives of people living with HIV and fostering a more inclusive and supportive society.
Læs mere Tjek på PubMedZichen Xu, Lei Li, Luqing Jiang, Ying Zhai, Yu Tang, Daoqin Liu, Qiwen Wu
PLoS One Infectious Diseases, 23.02.2024
Tilføjet 23.02.2024
by Zichen Xu, Lei Li, Luqing Jiang, Ying Zhai, Yu Tang, Daoqin Liu, Qiwen Wu Purpose The number of CKD patients is on the rise worldwide, and diet has become an essential aspect influencing the treatment and prognosis of CKD. However, limited research has explored the association of the Dietary Inflammatory Index (DII) with CKD progression and the essential kidney function indicator, eGFR, in CKD patients. This study aimed to analyze the association between DII and CKD progression and eGFR in the US CKD population using data from the National Health and Nutrition Examination Survey (NHANES). Methods This study utilized data obtained from the National Health and Nutrition Examination Survey (NHANES) spanning from 2007 to 2018, with a total sample size of 2,488 individuals. Study used multiple imputation, based on 5 replications and a chained equation approach method in the R MI procedure, to account for missing data. Weighted multiple logistic regression was used to analyze the relationship between DII and the risk of higher CKD stage and a weighted multiple regression analysis was used to assess the relationship between DII and eGFR. Weighted Generalized Additive Models and smoothed curve fitting were applied to detect potential non-linear relationships in this association. Results In all three models, it was found that DII was positively associated with the risk of higher CKD stage (P < 0.0001), and an increase in DII was associated with a decrease in eGFR (P < 0.0001). The trend across quartiles of DII remained statistically significant, revealing a gradual elevation in higher CKD stage risk and reduction in eGFR levels for the second, third, and fourth quartiles compared to the lowest quartile (P for trend < 0.0001). Upon adjusting for age, gender, race, education level, poverty income ratio (PIR), marital status, body mass index (BMI), metabolic equivalent (MET) score, drinking, smoking, history of hypertension, history of diabetes, cotinine, systolic blood pressure, diastolic blood pressure, total triglycerides, and total cholesterol, we found a positive correlation between DII and the risk of higher CKD stage (OR = 1.26, 95% CI: 1.14–1.40). Further investigation revealed that an increase in DII was associated with a decrease in eGFR (β = -1.29, 95% CI: -1.75, -0.83). Smooth curves illustrated a non-linear positive correlation between DII and CKD risk, while a non-linear negative correlation was observed between DII and eGFR. Conclusions Our study results indicate that an increase in DII is associated with an increased risk of higher CKD stage and a decrease in eGFR in all three models. In the fully adjusted model, the risk of higher CKD stage increased by 26% and the eGFR decreased by 1.29 ml/min/1.73 m2 for each unit increase in DII. This finding suggests that in patients with CKD in the US, improved diet and lower DII values may help slow the decline in eGFR and delay the progression of CKD.
Læs mere Tjek på PubMedArrani Senthinathan, Stephanie Cimino, Susan B. Jaglal, B. Catharine Craven, Karen Tu, Sara Guilcher
PLoS One Infectious Diseases, 23.02.2024
Tilføjet 23.02.2024
by Arrani Senthinathan, Stephanie Cimino, Susan B. Jaglal, B. Catharine Craven, Karen Tu, Sara Guilcher Background Individuals with spinal cord injuries or disease (SCI/D) require frequent healthcare services. The COVID-19 pandemic may have impacted healthcare. Furthermore, due to secondary health conditions and comorbidities persons with SCI/D are at increased risk of experiencing severe symptoms or outcomes if infected with the COVID-19 virus. It is unclear to what extent research has investigated the pandemic and virus impacts on the SCI/D population. Objective To identify and summarize what is reported in the literature on the impact the COVID-19 virus and pandemic had on healthcare, health outcomes, and experiences in the adult SCI/D population. Methods Electronic databases and grey literature were searched for articles that included an adult population with a SCI/D and investigated the impact the COVID-19 virus and pandemic had on healthcare-related outcomes and experiences. Articles were double screened, and data were extracted, and synthesized to provide a descriptive summary of the findings. Results Twenty-four studies were included in this review with eight qualitative, fifteen quantitative, and one mixed methods study. Sixteen studies investigated healthcare utilization/access; nine investigated care delivery, nine investigated patient outcomes, and eight investigated patient experiences, with multiple studies spanning different categories of investigation. The pandemic was detrimental to healthcare utilization, access, and outcomes, but no studies quantified these changes. Virtual care was well-received by the SCI/D population to maintain continuity of care. The SCI/D population had issues with maintaining caregiving support. It was unclear if the COVID-19 virus infection impacted individuals with SCI/D differently than the general population. Conclusions This scoping review found the pandemic negatively impacted multiple aspects of healthcare in individuals with SCI/D, however further investigation on health outcomes is required. More research, particularly large-scale quantitative studies, investigating healthcare access, utilization, and delivery, as well as patient outcomes and experiences is needed to improve care in the SCI/D population post-pandemic onset.
Læs mere Tjek på PubMedJohn Gachohi, Peris Njoki, Eddy Mogoa, Fredrick Otieno, Mathew Muturi, Athman Mwatondo, Isaac Ngere, Jeanette Dawa, Carolyne Nasimiyu, Eric Osoro, Bernard Bett, Kariuki Njenga
PLoS One Infectious Diseases, 23.02.2024
Tilføjet 23.02.2024
by John Gachohi, Peris Njoki, Eddy Mogoa, Fredrick Otieno, Mathew Muturi, Athman Mwatondo, Isaac Ngere, Jeanette Dawa, Carolyne Nasimiyu, Eric Osoro, Bernard Bett, Kariuki Njenga Tracking livestock abortion patterns over time and across factors such as species and agroecological zones (AEZs) could inform policies to mitigate disease emergence, zoonoses risk, and reproductive losses. We conducted a year-long population-based active surveillance of livestock abortion between 2019 and 2020, in administrative areas covering 52% of Kenya’s landmass and home to 50% of Kenya’s livestock. Surveillance sites were randomly selected to represent all AEZs in the country. Local animal health practitioners electronically transmitted weekly abortion reports from each ward, the smallest administrative unit, to a central server, using a simple short messaging service (SMS). Data were analyzed descriptively by administrative unit, species, and AEZ to reveal spatiotemporal patterns and relationships with rainfall and temperature. Of 23,766 abortions reported in all livestock species, sheep and goats contributed 77%, with goats alone contributing 53%. Seventy-seven per cent (n = 18,280) of these abortions occurred in arid and semi-arid lands (ASALs) that primarily practice pastoralism production systems. While spatiotemporal clustering of cases was observed in May-July 2019 in the ASALs, there was a substantial seasonal fluctuation across AEZs. Kenya experiences high livestock abortion rates, most of which go unreported. We recommend further research to document the national true burden of abortions. In ASALs, studies linking pathogen, climate, and environmental surveillance are needed to assign livestock abortions to infectious or non-infectious aetiologies and conducting human acute febrile illnesses surveillance to detect any links with the abortions.
Læs mere Tjek på PubMedMalaria Journal, 23.02.2024
Tilføjet 23.02.2024
Abstract Background Mass Drug Administration (MDA) has become a mainstay for the control of several diseases over the last two decades. Successful implementation of MDA programmes requires community participation and can be threatened by systematic non-participation. Such concerns are particularly pertinent for MDA programmes against malaria, as they require multi-day treatment over several consecutive months. Factors associated with non-participation to the MDA campaign with ivermectin (IVM) and dihydroartemisinin-piperaquine (DHP) implemented within the MASSIV cluster randomized trial were determined. Methods Coverage data was extracted from the MASSIV trial study database, with every datapoint being a directly observed therapy (DOT). A complete month of MDA was classified as receiving all three daily doses of treatment. For both ivermectin and DHP, ordinal logistic regression was used to identify individual and household level variables associated with non-participation. Results For ivermectin, 51.5% of eligible participants received all 3 months of treatment while 30.7% received either one or two complete months. For DHP, 56.7% of eligible participants received all 3 months of treatment and 30.5% received either one or two complete months. Children aged 5–15 years and adults aged more than 50 years were more likely to receive at least one complete month of MDA than working age adults, both for ivermectin (aOR 4.3, 95% CI 3.51–5.28 and aOR of 2.26, 95% CI 1.75–2.95) and DHP (aOR 2.47, 95%CI 2.02–3.02 and aOR 1.33, 95%CI 1.01–1.35), respectively. Members of households where the head received a complete month of MDA were more likely to themselves have received a complete month of MDA, both for ivermectin (aOR 1.71, 95%CI 1.35–2.14) and for DHP (aOR 1.64, 95%CI 1.33–2.04). Conclusion Personal and household-level variables were associated with participation in the MDA programme for malaria control. Specific strategies to (increase participation amongst some groups may be important to ensure maximum impact of MDA strategies in achieving malaria elimination. Trial registration: The MASSIV trial is registered under NCT03576313.
Læs mere Tjek på PubMedGriesel, Rulan; Banda, Clifford G; Zhao, Ying; Omar, Zaayid; Wiesner, Lubbe; Meintjes, Graeme; Sinxadi, Phumla; Maartens, Gary
Journal of Acquired Immune Deficiency Syndromes, 23.02.2024
Tilføjet 23.02.2024
Background Dolutegravir exposure is reduced after switching from efavirenz, which could select for dolutegravir resistance if switching occurs during virologic failure. Methods We measured serial dolutegravir trough concentrations after switching from efavirenz in a clinical trial, which randomised some participants to a supplemental dolutegravir dose or placebo for the first 14 days. Changes in dolutegravir trough concentrations between days 3, 7, 14 and 28 were evaluated. The primary outcome was the geometric mean ratio (GMR) of dolutegravir trough concentrations on day 7 versus day 28. Results Twenty-four participants received double-dose dolutegravir (50 mg twice daily) and 11 standard-dose for the first 14 days. Baseline characteristics were: 77% female, median age 36 years, CD4 cell count 254 cells/mm3, and HIV-1 RNA 4.0 log10 copies/mL. The GMR (90% CI) of dolutegravir trough concentrations on day 7 versus day 28 were: 0.637 (0.485 to 0.837) in the standard-dose group and 1.654 (1.404 to 1.948) in the double-dose group. There was a prolonged induction effect at day 28 in participants with efavirenz slow metaboliser genotypes. One participant in the double-dose group had a dolutegravir trough concentration below the protein-binding adjusted concentration needed to inhibit 90% of HIV-1 (PA-IC90) at day 3. Conclusions No participants on standard-dose dolutegravir had dolutegravir trough concentrations below the PA-IC90. Slow efavirenz metaboliser genotypes had higher baseline efavirenz concentrations and more pronounced and longer period of induction post-switch. These findings suggest that a 14-day lead-in supplemental dolutegravir dose may not be necessary when switching from a failing efavirenz-based first-line regimen. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedStoner, Marie C.D.; Smith, Louis; Ming, Kristin; Mancuso, Noah; Patani, Henna; Sukhija-Cohen, Adam; Granados, Yancy; Wagner, Danielle; Johnson, Mallory O.; Napierala, Sue; Neilands, Torsten B.; Saberi, Parya
Journal of Acquired Immune Deficiency Syndromes, 23.02.2024
Tilføjet 23.02.2024
Background: Despite improvements in antiretroviral therapy (ART) availability, suboptimal adherence is common among youth with HIV (YWH) and can increase drug resistance and poor clinical outcomes. Our study examined an innovative mobile app-based intervention that used automated directly observed therapy (aDOT) using artificial intelligence, along with conditional economic incentives (CEIs) to improve ART adherence and enhance viral suppression among YWH. Setting: We conducted a pilot study of the aDOT-CEI intervention, informed by the operant framework of Key Principles in Contingency Management Implementation, to improve ART adherence among YWH (18–29) in California and Florida who had an unsuppressed HIV viral load. Methods: We recruited 28 virally unsuppressed YWH from AIDS Healthcare Foundation (AHF) clinics, who used the aDOT platform for 3 months. Study outcomes included feasibility and acceptability, self-reported ART adherence, and HIV viral load. Results: Participants reported high satisfaction with the app (91%), and 82% said that it helped them take their medication. Comfort with the security and privacy of the app was moderate (55%), and 59% indicated the incentives helped improve daily adherence. Conclusion: Acceptability and feasibility of the aDOT-CEI intervention were high with potential to improve viral suppression, although some a priori metrics were not met. Pilot results suggest refinements which may improve intervention outcomes, including increased incentive amounts, provision of additional information, and reassurance about app privacy and security. Additional research is recommended to test the efficacy of the aDOT-CEI intervention to improve viral suppression in a larger sample. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedD.T.P. Buis
International Journal of Infectious Diseases, 23.02.2024
Tilføjet 23.02.2024
With great interest, I read the article by Herrera-Hidalgo et al. on cefazolin versus cloxacillin for MSSA endocarditis [1]. This topic is relevant for clinical practice, since MSSA endocarditis is difficult to treat and new studies comparing treatment strategies are urgently needed. However, I have a few concerns regarding the methodological and statistical approach used and their consequences for the conclusions reached.
Læs mere Tjek på PubMedTan Wei Chuan, Samuel Chuan Xian Lau, Lim Yi Ting
International Journal of Infectious Diseases, 23.02.2024
Tilføjet 23.02.2024
A 72-year-old female presents with lethargy, fever, and right hip pain for six days. She denies any trauma and had no prior surgical history. Investigations revealed leucocytosis (18.85 × 10^9/L), elevated serum glucose (46.3 mmol/L), ketosis (serum Beta-Hydroxy-butyrate 2.4 mmol/L), and mild acidosis (pH 7.30).
Læs mere Tjek på PubMedTomáš Fürst, Angelika Bazalová, Tadeáš Fryčák, Jaroslav Janošek
International Journal of Infectious Diseases, 23.02.2024
Tilføjet 23.02.2024
Vaccination against COVID-19 was the key measure in battling the pandemic and its effectiveness against death and severe course has been demonstrated in a multitude of studies. However, a vast majority of these studies (apart from registration studies) were observational. It has been proposed that observational studies are subject to inherent biases, including differences in testing strategies between vaccinated and unvaccinated groups or in determining the cause of death (with COVID vs due to COVID)[1,2].
Læs mere Tjek på PubMedDario CattaneoMarta FusiLucia GalliCamilla GenoveseRiccardo GiorgiMaddalena MatoneStefania MerliMarta ColaneriAndrea Gori1Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy2Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy, James E. Leggett
Antimicrobial Agents And Chemotherapy, 23.02.2024
Tilføjet 23.02.2024
Clinical & Experimental Immunology, 22.02.2024
Tilføjet 22.02.2024
Abstract A high percentage of patients with acute coronary syndrome develop heart failure due to the ischemic event. Regulatory T (Treg) cells are lymphocytes with suppressive capacity that control the immune response and include the conventional CD4+ CD25hi Foxp3+ cells and the CD4+ CD25var CD69+ LAP+ Foxp3- IL-10+ cells. No human follow-up studies focus on Treg cells’ behavior after infarction and their possible relationship with ventricular function as a sign of post-ischemic cardiac remodeling. This study aimed to analyze, by flow cytometry, the circulating levels of CD69+ regulatory T cells and CD4+ CD25hi Foxp3+ cells, its IL-10+ production as well as their function in patients with acute myocardial infarction (AMI), and its possible relation with ventricular dysfunction. We found a significant difference in the percentage of CD4+ CD25hi Foxp3+ cells and IL-10+ MFI in patients with AMI at 72 hours compared with the healthy control group, and the levels of these cells were reduced six months post-AMI. Regarding the suppressive function of CD4+ CD25+ regulatory cells, they were dysfunctional at three- and six-months post-AMI. The frequency of CD69+ Treg cells was similar between patients with AMI at 72 hours post-infarction and the control groups. Moreover, the frequency of CD69+ Treg cells at three months and six months post-ischemic event did not vary over time. Treg cells play a role in regulating inflammation after an acute myocardial infarction, and its function may be compromised in this pathology. This work is the first report to evaluate CD69+ Foxp3- Treg cells in AMI patients.
Læs mere Tjek på PubMedClinical & Experimental Immunology, 22.02.2024
Tilføjet 22.02.2024
Abstract The spleen plays a role in innate- and adaptive immunity, and autoimmune diseases like rheumatoid arthritis (RA). We investigated the effect of splenectomy in early and moderate stages of autoimmune arthritis in a mouse model. To induce recombinant human G1-induced arthritis (GIA), BALB/c mice were immunized intraperitoneally three times in 4 weeks interval with the rhG1 antigen. Mice were splenectomized on day 7 (SPE1) or day 35 (SPE2) after the initiation of immunization, and were tested for clinical severity, joint radiological- and histological changes, serum levels of inflammatory cytokines and autoantibodies, and rhG1-specific immune responses, and compared to those in control mice with spleen left intact. Circulating Tregs and T-helper subset ratios in the spleen and inguinal lymph nodes were also examined using flow cytometry. The onset of severe inflammatory response was significantly delayed in SPE1 and SPE2 groups compared to control mice at early stages of GIA, which was associated with increased circulating Tregs. After the third immunization, as disease progressed, the severity scores were robustly increased in all mice. Nevertheless, in splenectomized mice, we observed reduced joint deterioration and cartilage damage, more Th2 cells in lymph nodes, and reduced levels of pro-inflammatory cytokines and autoantibodies in their sera. Mesenteric lymph node cells of splenectomized mice exhibited weaker response in vitro against the rhG1 antigen compared to control mice spleen. In conclusion, splenectomy in early stages of GIA delayed the inflammatory response, suggesting a protective effect against the development and progression of severe destructive arthritis.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Background People who have coronary artery disease are more likely to develop signs and symptoms of COVID-19 due to their special circumstances. Coronary artery bypass grafting surgery (CABG)does not cure the disease but reduces the signs and symptoms, therefore, there is a possibility of severe complications of Covid-19 after it. Materials and methods This study is a descriptive and cross-sectional study conducted from June to July 2020 on 200 patients who underwent CABG from February 2018 to February 2020. The instrument consisted of socio-demographic variables and COVID’s signs and symptoms checklist. Data were collected by census method by telephone. Data were analyzed using descriptive statistics, Fisher’s exact test, Mann Whitney U test, and logistic regression model. Results The results showed that the majority of the samples were male (67%). The mean age of them was 62.02 ± 9.06 years and 10% of the m had signs and symptoms of Covid 19. Having the symptoms of COVID-19 is significant in terms of the variables of decreased sense of smell (p
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Background Diabetes mellitus (DM) has a direct impact on the clinical manifestation and prognosis of active tuberculosis disease (TB) and is known to increase the chance of developing the condition. We sought to determine the prevalence of DM in adult Ugandan patients with recently diagnosed TB and the associated sociodemographic, anthropometric, and metabolic characteristics of TB-DM comorbidity. Methods In this cross-sectional study conducted at the adult TB treatment centres of three tertiary healthcare facilities in Uganda, we screened adult participants with recently diagnosed TB (diagnosed in
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Background Tuberculosis(TB) remains a pressing public health challenge, with multidrug-resistant tuberculosis (MDR-TB) emerging as a major threat. And healthcare authorities require reliable epidemiological evidence as a crucial reference to address this issue effectively. The aim was to offer a comprehensive epidemiological assessment of the global prevalence and burden of MDR-TB from 1990 to 2019. Methods Estimates and 95% uncertainty intervals (UIs) for the age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), age-standardized disability-adjusted life years rate (ASR of DALYs), and age-standardized death rate (ASDR) of MDR-TB were obtained from the Global Burden of Disease (GBD) 2019 database. The prevalence and burden of MDR-TB in 2019 were illustrated in the population and regional distribution. Temporal trends were analyzed by using Joinpoint regression analysis to calculate the annual percentage change (APC), average annual percentage change (AAPC) and its 95% confidence interval(CI). Results The estimates of the number of cases were 687,839(95% UIs: 365,512 to 1223,262), the ASPR were 8.26 per 100,000 (95%UIs: 4.61 to 15.20), the ASR of DALYs were 52.38 per 100,000 (95%UIs: 22.64 to 97.60) and the ASDR were 1.36 per 100,000 (95%UIs: 0.54 to 2.59) of MDR-TB at global in 2019. Substantial burden was observed in Africa and Southeast Asia. Males exhibited higher ASPR, ASR of DALYs, and ASDR than females across most age groups, with the burden of MDR-TB increasing with age. Additionally, significant increases were observed globally in the ASIR (AAPC = 5.8; 95%CI: 5.4 to 6.1; P
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Background In Kenya, diarrhoeal disease is the third leading cause of child mortality after malaria and pneumonia, accounting for nearly 100 deaths daily. We conducted a cross-sectional study in Mukuru informal settlements to determine the bacteria associated with diarrhea and their ASTs to provide data essential for implementing appropriate intervention measures. Methods Diarrheagenic children (≤ 5 years) were purposively recruited from outpatient clinics of Municipal City Council, Mukuru kwa Reuben, Medical Missionaries of Mary, and Mama Lucy Kibaki Hospital, Nairobi. A total of 219 stool samples were collected between May 2021 and August 2021. Stool culture was done on MacConkey and Salmonella Shigella agar, while the recovered bacteria were identified using VITEK®2GNID and polymerase chain reaction (PCR) used for E. coli pathotyping. Antibiotic Susceptibility Testing was done using VITEK®2AST-GN83. Results At least one bacterial organism was recovered from each of the 213 (97%) participants, with 115 (56%) participants having only one bacterial type isolated, 90 (43%) with two types of bacteria, and 2 (1%) with three types of bacteria recovered. The most predominant bacteria recovered was 85% (93/109) non-pathogenic E.coli and 15% (16/109)of pathogenic E.coli, with 2 (1%) were Enterohemorrhagic E.coli (EHEC), 6 (3%) were Enteroaggregative E.coli (EAEC), and 8 (4%) were Enteropathogenic E.coli (EPEC). Other potentially pathogenic bacteria included Enterobacter sp (27.8%), Klebsiella sp 33(11%), and Citrobacter sp 15(4.7%). Pathogenic isolates such as Salmonella 7 (2%), Proteus mirabilis 16 (6%), Providencia alcalifaciens 1 (0.3%), and Shigella 16 (4.7%) were detected. Isolates such as Pantoea spp 2(0.67%), Raoultella planticola 1(0.33%), and Kluyvera 6(2%) rarely reported but implicated with opportunistic diarrhoeal disease were also recovered. Ampicillin, cefazolin, and sulfamethoxazole-trimethoprim were the least effective antimicrobials at 64%, 57%, and 55% resistance, respectively, while meropenem (99%), amikacin (99%), tazobactam piperacillin (96%), and cefepime (95%) were the most effective. Overall, 33(21%) of all enterics recovered were multidrug-resistant. Conclusion The study documented different bacteria potentially implicated with childhood diarrhea that were not limited to E. coli, Shigella, and Salmonella, as previously observed in Kenya. The strains were resistant to the commonly used antibiotics, thus narrowing the treatment options for diarrheal disease.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Background The incidence of Antimicrobial Resistance (AMR) in uropathogens varies between countries and over time. We aim to study the patterns and potential predictors of AMR among patients with UTIs admitted to the Urology Department at Alexandria University Hospital. Methods An observational retrospective record-based study was conducted on all patients admitted to the Urology department from October 2018 to October 2020. Data collected from patients’ records included: demographic data, diagnosis on admission, history of chronic diseases, duration of hospital stay, insertion of a urinary catheter, duration of the catheter in days, history of the use of antibiotics in the previous three months, and history of urinary tract operations. If UTI was documented, we abstracted data about urine culture, use of antibiotics, results of urine cultures, type of organism isolated, and sensitivity to antibiotics. We conducted a multivariable logistic regression model. We performed Classification and Regression Tree Analysis (CART) for predicting risk factors associated with drug resistance among patients with UTI. Data were analyzed using SPSS statistical package, Version 28.0, and R software (2022). Results This study encompassed 469 patients with UTIs. The most commonly isolated bacterium was Escherichia coli, followed by Klebsiella pneumoniae. Multidrug resistance (MDR) was found in 67.7% (149/220) of patients with hospital-acquired UTIs and in 49.4% (83/168) of patients with community-acquired UTIs. Risk factors independently associated with antimicrobial resistance according to logistic regression analysis were the use of antibiotics within three months (AOR = 5.2, 95% CI 2.19–12.31), hospital-acquired UTI (AOR = 5.7, 95% CI 3.06–10.76), diabetes mellitus (AOR = 3.8, 95% CI 1.24–11.84), age over 60 years (AOR = 2.9, 95% CI 1.27–6.72), and recurrent UTI (AOR = 2.6, 95% CI 1.08–6.20). Classification and regression tree (CART) analysis revealed that antibiotic use in the previous three months was the most significant predictor for developing drug resistance. Conclusion The study concluded a high level of antimicrobial resistance as well as significant MDR predictors among hospitalized patients with UTIs. It is vital to assess resistance patterns in our hospitals frequently to improve rational antibiotic treatment as well as to sustain antimicrobial stewardship programs and a rational strategy in the use of antibiotics. Empirical therapy for UTI treatment should be tailored to the potential pathogens’ susceptibility to ensure optimal treatment. Strategic antibiotic use is essential to prevent further AMR increases. Further research should focus on suggesting new biological systems or designed drugs to combat the resistance of UTI pathogens.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Background BK polyomavirus (BKPyV) infection after kidney transplantation can lead to serious complications such as BKPyV-associated nephropathy (BKPyVAN) and graft loss. The aim of this study was to investigate the incidence of BKPyVAN after implementing a BKPyV screening program, to map the distribution of BKPyV genotypes and subtypes in the Uppsala-Örebro region and to identify host and viral risk factors for clinically significant events. Methods This single-center prospective cohort study included kidney transplant patients aged ≥ 18 years at the Uppsala University Hospital in Sweden between 2016 and 2018. BKPyV DNA was analyzed in plasma and urine every 3 months until 18 months after transplantation. Also genotype and subtype were determined. A logistic regression model was used to analyze selected risk factors including recipient sex and age, AB0 incompatibility and rejection treatment prior to BKPyVAN or high-level BKPyV DNAemia. Results In total, 205 patients were included. Of these, 151 (73.7%) followed the screening protocol with 6 plasma samples, while184 (89.8%) were sampled at least 5 times. Ten (4.9%) patients developed biopsy confirmed BKPyVAN and 33 (16.1%) patients met criteria for high-level BKPyV DNAemia. Male sex (OR 2.85, p = 0.025) and age (OR 1.03 per year, p = 0.020) were identified as significant risk factors for developing BKPyVAN or high-level BKPyV DNAemia. BKPyVAN was associated with increased viral load at 3 months post transplantation (82,000 vs.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Background Hospital admission outcomes for people living with HIV (PLHIV) in resource-limited settings are understudied. We describe in-hospital mortality and associated clinical-demographic factors among PLHIV admitted at a tertiary-level public hospital in Uganda. Methods We performed a cross-sectional analysis of routinely collected data for PLHIV admitted at Kiruddu National Referral Hospital between March 2020 and March 2023. We estimated the proportion of PLHIV who had died during hospitalization and performed logistic regression modelling to identify predictors of mortality. Results Of the 5,827 hospitalized PLHIV, the median age was 39 years (interquartile range [IQR] 31–49) and 3,293 (56.51%) were female. The median CD4 + cell count was 109 cells/µL (IQR 25–343). At admission, 3,710 (63.67%) were active on antiretroviral therapy (ART); 1,144 (19.63%) had interrupted ART > 3 months and 973 (16.70%) were ART naïve. In-hospital mortality was 26% (1,524) with a median time-to-death of 3 days (IQR 1–7). Factors associated with mortality (with adjusted odds ratios) included ART interruption, 1.33, 95% confidence intervals (CI) 1.13–1.57, p 0.001; CD4 + counts ≤ 200 cells/µL 1.59, 95%CI 1.33–1.91, p
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Objective This study aimed to investigate the clinical characteristics of severe fever with thrombocytopenia syndrome complicated by viral myocarditis (SFTS-VM) and analyze relevant influencing factors. Methods Retrospective analysis was conducted on clinical data from 79 SFTS-VM patients, categorized into common (SFTS-CVM, n = 40) and severe groups (SFTS-SVM, n = 39). Clinical manifestations, laboratory results, cardiac ultrasonography, and electrocardiogram features were analyzed. Univariate and multivariate analyses identified significant indicators, which were further assessed using ROC curves to predict SFTS-SVM. Results SFTS-SVM group exhibited higher rates of hypotension, shock, abdominal pain, cough with sputum, and consciousness disorders compared to SFTS-CVM group. Laboratory findings showed elevated platelet count, ALT, AST, amylase, lipase, LDH, D-dimer, procalcitonin, TNI, and NT-proBNP in SFTS-SVM. Abnormal electrocardiograms, especially atrial fibrillation, were more prevalent in SFTS-SVM (P 978.5U/L) and NT-proBNP (> 857.5pg/ml)) indicated increased likelihood of SFTS progression into SVM. Conclusion Elevated LDH, NT-proBNP, and consciousness disorders independently correlate with SFTS-SVM. LDH and NT-proBNP can aid in early identification of SFTS-SVM development when above specified thresholds.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Background Kaposi Varicelliform Eruptions (KVE), also known as eczema herpeticum, is a rare and potentially life-threatening dermatological condition primarily attributed to herpes simplex virus (HSV) infection, with less frequent involvement of Coxsackie A16, vaccinia, Varicella Zoster, and smallpox viruses. Typically associated with pre-existing skin diseases, especially atopic dermatitis, KVE predominantly affects children but can manifest in healthy adults. Characterized by painful clusters of vesicles and sores on the skin and mucous membranes, it often masquerades as other dermatological disorders. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used for pain relief and inflammation, though their potential role as KVE triggers remains uncertain. Case report Here, we present a case of an 18-year-old female with KVE attributed to Varicella Zoster virus (VZV) and successfully treated with oral acyclovir within a week, underscoring the significance of early recognition and intervention. KVE can manifest with systemic symptoms like fever, fatigue, and lymphadenopathy and may involve multiple organ systems, necessitating possible antibiotic use for complications. Conclusion This case underscores the importance of prompt KVE identification and consideration of antiviral therapy to enhance patient outcomes. Further research is warranted to elucidate predisposing factors for this rare condition.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
BMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Background With the global increase in the older population, the proportion of those receiving care in long-term care facilities (LTCFs) has also been increasing. We assessed the epidemiology, antibiotic susceptibility, and colonization status of drug-resistant organisms in patients transferred from LTCFs. Methods We retrospectively reviewed the medical records of patients transferred from LTCFs between 2017 and 2022. The reasons for admission, antimicrobial susceptibility, and colonization rates of carbapenem-resistant Enterobacterales (CRE), methicillin-resistant Staphylococcus aureus (MRSA), and carbapenem-resistant Acinetobacter baumannii (CRAB) were recorded. We analyzed the susceptibility and colonization rates by year to identify trends. Results Of the 936 patients transferred from LTCFs, 54.3% were admitted to the intensive care unit and 12.5% died. The most common reason for admission was infection (n = 573, 61.2%), followed by gastrointestinal bleeding (n = 67, 7.2%) and cerebrovascular disorder (n = 65, 6.9%). A total of 452 Enterobacterales strains were isolated, and their susceptibility rates to ciprofloxacin and cefotaxime were 33.3% and 35.6%, respectively. A total of 54.9% were extended-spectrum beta-lactamase-producing strains, and 4.9% of them were carbapenem-resistant, both of which showed an increasing trend (P = 0.024 and P
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Background Tuberculosis (TB) is a major cause of mortality worldwide. Children and people living with HIV (PLHIV) have an increased risk of mortality, particularly in the absence of rapid diagnosis. The main challenges of diagnosing TB in these populations are due to the unspecific and paucibacillary disease presentation and the difficulty of obtaining respiratory samples. Thus, novel diagnostic strategies, based on non-respiratory specimens could improve clinical decision making and TB outcomes in high burden TB settings. We propose a multi-country, prospective diagnostic evaluation study with a nested longitudinal cohort evaluation to assess the performance of a new stool-based qPCR, developed by researchers at Baylor College of Medicine (Houston, Texas, USA) for TB bacteriological confirmation with promising results in pilot studies. Methods The study will take place in high TB/HIV burden countries (Mozambique, Eswatini and Uganda) where we will enroll, over a period of 30 months, 650 PLHIV (> 15) and 1295 children under 8 years of age (irrespective of HIV status) presenting pressumptive TB. At baseline, all participants will provide clinical history, complete a physical assessment, and undergo thoracic chest X-ray imaging. To obtain bacteriological confirmation, participants will provide respiratory samples (1 for adults, 2 in children) and 1 stool sample for Xpert Ultra MTB/RIF (Cepheid, Sunnyvale, CA, USA). Mycobacterium tuberculosis (M.tb) liquid culture will only be performed in respiratory samples and lateral flow lipoarabinomannan (LF-LAM) in urine following WHO recommendations. Participants will complete 2 months follow-up if they are not diagnosed with TB, and 6 months if they are. For analytical purposes, the participants in the pediatric cohort will be classified into “confirmed tuberculosis”, “unconfirmed tuberculosis” and “unlikely tuberculosis”. Participants of the adult cohort will be classified as “bacteriologically confirmed TB”, “clinically diagnosed TB” or “not TB”. We will assess accuracy of the novel qPCR test compared to bacteriological confirmation and Tb diagnosis irrespective of laboratory results. Longitudinal qPCR results will be analyzed to assess its use as treatment response monitoring. Discussion The proposed stool-based qPCR is an innovation because both the strategy of using a non-sputum based sample and a technique specially designed to detect M.tb DNA in stool. Protocol registration details ClinicalTrials.gov Identifier: NCT05047315.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Background Ghana’s mask-wearing compliance with COVID-19 prevention protocols has not been as impressive among the general population. In this study, we examined factors influencing compliance with mask-wearing among public university students in Ghana to make recommendations for the prevention of new COVID-19 infections in public universities. Methods We conducted this Census in a public university in Ghana between January and December 2022. The study design was an exploratory-cross-sectional and online survey. Structured questionnaires developed by the authors were used to collect data from 3,272 students. Data were analyzed with Jeffreys’s Amazing Statistics Program (JASP). Frequency distributions were used to summarize the data into tables and graphs whilst logistic regression analysis was done to examine the factors influencing compliance with mask-wearing among participants as well as their mask-wearing behaviors in school. Results Compliance with mask-wearing measures was high with 85.9% of the students wearing a nose mask always or often. Agreeing that the reusable masks do not last long was associated with a reduced chance of non-compliance (OR = 0.70, 95% CI = 0.57, 0.86). However, agreeing with some challenges was associated with increased chances of non-compliance. These included concerns that it is boring to mask after wearing makeup or having a haircut (OR = 1.71, 95% CI = 1.37, 2.14), and that masking is burdensome because it has to be removed when talking (OR = 1.26, 95% CI 1.01, 1.57), and that it is difficult to hear while masked (OR = 1.36, 95% CI = 1.04, 1.79). Conclusion Cost-benefit analyses, opinions about one’s look, and communication difficulties are the key factors influencing students’ non-compliance with mask-wearing regulations. To encourage student compliance with mask-wearing regulations at Ghana’s public universities, we recommend innovation in nose mask manufacture.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Background Over a dozen vaccines are in or have completed phase III trials at an unprecedented speed since the World Health Organization (WHO) declared COVID-19 a pandemic. In this review, we aimed to compare and rank these vaccines indirectly in terms of efficacy and safety using a network meta-analysis. Methods We searched Embase, MEDLINE, and the Cochrane Library for phase III randomized controlled trials (RCTs) from their inception to September 30, 2023. Two investigators independently selected articles, extracted data, and assessed the risk of bias. Outcomes included efficacy in preventing symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the incidence of serious adverse events (SAEs) according to vaccine type and individual vaccines in adults and elderly individuals. The risk ratio and mean differences were calculated with 95% confidence intervals using a Bayesian network meta-analysis. Results A total of 25 RCTs involving 22 vaccines were included in the study. None of vaccines had a higher incidence of SAEs than the placebo. Inactivated virus vaccines might be the safest, with a surface under the cumulative ranking curve (SUCRA) value of 0.16. BIV1-CovIran showed the highest safety index (SUCRA value: 0.13), followed by BBV152, Soberana, Gam-COVID-Vac, and ZF2001. There were no significant differences among the various types of vaccines regarding the efficacy in preventing symptomatic SARS-CoV-2 infection, although there was a trend toward higher efficacy of the mRNA vaccines (SUCRA value: 0.09). BNT162b2 showed the highest efficacy (SUCRA value: 0.02) among the individual vaccines, followed by mRNA-1273, Abdala, Gam-COVID-Vac, and NVX-CoV2373. BNT162b2 had the highest efficacy (SUCRA value: 0.08) in the elderly population, whereas CVnCoV, CoVLP + AS03, and CoronaVac were not significantly different from the placebo. Conclusions None of the different types of vaccines were significantly superior in terms of efficacy, while mRNA vaccines were significantly inferior in safety to other types. BNT162b2 had the highest efficacy in preventing symptomatic SARS-CoV-2 infection in adults and the elderly, whereas BIV1-CovIran had the lowest incidence of SAEs in adults.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Background Influenza and flu-like syndromes are difficult to monitor because the symptoms are not specific, laboratory tests are not routinely performed, and diagnosis codes are often lacking or incompletely registered in medical records. This may result in an underestimation of hospital admissions, associated costs, and in-hospital mortality. Therefore, this study aimed to estimate the public health and economic burden of hospitalisations associated with influenza in Italy, at the national and regional levels. Methods This 11-year retrospective study included patients admitted to hospitals for influenza or diagnoses associated with influenza (including respiratory and cardiocirculatory conditions) from 2008/09 to 2018/19. Data on hospitalisations were extracted from the Italian Hospital Discharge Records. Information on weekly influenza-like syndrome incidence and weekly average temperature were used to estimate the burden of influenza in terms of hospital admissions in every Italian region and for different age groups by applying a negative binomial model. The model was also applied to estimate in-hospital mortality and the total costs of influenza and influenza-like hospital admissions. Results Over the study period, in addition to 3,970 average seasonal admissions coded as influenza, we estimated an average of 21,500 excess hospitalization associated with influenza per season, which corresponds to 36.4 cases per 100,000. Most of the excess hospitalisations concerned older individuals (> 65 years) and children (0–4 years) with 86 and 125 cases per 100,000, respectively. Large variations were observed across regions. Overall, the total estimated hospital burden associated with influenza (including respiratory and cardiocirculatory conditions) was approximately €123 m per year. While the in-hospital mortality for admissions with a primary diagnosis of influenza was very low (~ 150 cases per season), cases increased dramatically for primary diagnoses of influenza and pneumonia (about 9,500 cases per season). The average seasonal in-hospital deaths attributable to influenza were equal to 2,775 cases. Conclusions Our findings suggest a remarkable underestimation of the burden of influenza, mostly in the older population but not neglectable in younger individuals. Our results may aid the management of current and future flu seasons and should be used for policy making (e.g., vaccine strategies) and operation management choices (e.g., planning and staffing beds during influenza peaks). Overall, the present study supports the need for increased testing for influenza in Italy to tackle the current underestimation of influenza burden.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Background The aim of this study was to investigate the pathogenicity of vancomycin-resistant Enterococcus faecalis (VREs) to human colon cells in vitro. Methods Three E. faecalis isolates (2 VREs and E. faecalis ATCC 29212) were cocultured with NCM460, HT-29 and HCT116 cells. Changes in cell morphology and bacterial adhesion were assessed at different time points. Interleukin-8 (IL-8) and vascular endothelial growth factor A (VEGFA) expression were measured via RT-qPCR and enzyme-linked immunosorbent assay (ELISA), respectively. Cell migration and human umbilical vein endothelial cells (HUVECs) tube formation assays were used for angiogenesis studies. The activity of PI3K/AKT/mTOR signaling pathway was measured by Western blotting. Results The growth and adhesion of E. faecalis at a multiplicity of infection (MOI) of 1:1 were greater than those at a MOI of 100:1(p
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Background Hematopoietic stem cell transplantation (HSCT) was associated with potentially life-threatening complications. Among patients supported by extracorporeal membrane oxygenation (ECMO), those who underwent HSCT had a worse prognosis than those who did not. Advances in HSCT and critical care management have improved the prognosis of ECMO-supported HSCT patients. Case The patient in the remission stage of lymphoma after 22 months of allogeneic hematopoietic stem cell transplantation, suffered from ARDS, severe neutropenia, thrombocytopenia, and long-term COVID-19. We evaluated the benefits and risks of ECMO for the patient, including the possibility of being free from ECMO, the status of malignancy, the interval from HSCT to ARDS, the function of the graft, the amount of organ failure, and the comorbidities. ECMO was ultimately used to save his life. Conclusions We did not advocate for the general use of ECMO in HSCT patients and we believed that highly selected patients, with well-controlled tumors, few comorbidities, and fewer risk factors for death, tended to benefit from ECMO with well ICU management.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Background In November 2021, the B.1.1.529 (omicron) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected in South Africa and subsequently rapidly spread around the world. Despite the reduced severity of the omicron variants, many patients become severely ill after infection and undergo invasive mechanical ventilation, but there are few reports on their background and prognosis throughout all variant periods. This study aimed to evaluate risk factors affecting patients requiring invasive mechanical ventilation with each variant of COVID-19 pandemic in Japan from nonvariants to omicron variants. Method This retrospective observational study was conducted at the Department of Emergency and Critical Care Medicine, Kansai Medical University Hospital and Kansai Medical University Medical Center, Osaka, Japan, from March 2020 to March 2023. Eligible patients were those who underwent invasive ventilation for COVID-19 pneumonia. We set the primary endpoint as in-hospital mortality. Multivariable logistic regression analysis adjusted for clinically important variables was performed to evaluate the clinical outcomes. Results We included 377 patients: 118 in the Nonvariant group, 154 in the Alpha group, 42 in the Delta group, and 63 patients in the Omicron group. Mortality rates for each group were 23.7% for the Nonvariant group, 12.3% for the Alpha group, 7.1% for the Delta group, and 30.5% for the Omicron group. Patient age was significantly associated with increased mortality (adjusted odds ratio [AOR]: 1.097; 95% confidence interval [CI]: 1.057–0.138, P
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Introduction The frequency of mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) in Latin America has decreased considerably. However, new infections continue to be recorded, and the pediatric population remains one of the most vulnerable groups in this region. The main objective of the study was to describe the clinical, epidemiological and psychosocial characteristics of new diagnoses of HIV MTCT in 2018 in the PLANTAIDS network (Paediatric Network for Prevention, Early Detection and Treatment of HIV in Children) during the 3 years following diagnosis. Methodology Retrospective, multicenter, descriptive study based on a 3-year follow-up of patients diagnosed with HIV infection due to MTCT in 2018 in 10 hospitals in 8 Latin American countries (Costa Rica, Ecuador, Mexico, Honduras, El Salvador, Panama, Guatemala and Venezuela). The hospitals belonged to the PLANTAIDS network, which is included in CYTED (Ibero-American Programme of Science and Technology for Development). Results The study population comprised 72 pediatric patients (38.9% male). The median age at diagnosis was 2.4 years (IQR: 0.8–5.4). There were 35 cases of opportunistic infections corresponding to 25 patients (34.7%), with tuberculosis being the most common. Adequate childhood vaccination coverage was achieved in 80.5%. There were 3 cases of acute SARS-CoV-2 infection, and these were asymptomatic or mildly symptomatic. According to the Centers for Disease Control and Prevention (CDC) classification, the most frequent clinical-immunological stage at all check-ups was C1. Three patients died from opportunistic infections and/or advanced HIV infection. Conclusions It is important to diagnose HIV infection early in pediatrics, since early initiation of ART is associated with a decrease in mortality. Despite this, HIV infection has a poor prognosis in children, necessitating adequate follow-up to ensure adherence to health care and ART, although it can sometimes prove difficult in children.
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