Nyt fra tidsskrifterne
Søgeord (prep) valgt.
45 emner vises.
Huang, Ya-Lin A.; Lowy, Elliott; Zhu, Weiming; Yu, Lei; Wei, Wei; Maier, Marissa M.; Hoover, Karen W.; Beste, Lauren A.
Journal of Acquired Immune Deficiency Syndromes, 20.09.2024
Tilføjet 20.09.2024
Objectives. It is important to monitor national HIV preexposure prophylaxis (PrEP) use in the United States. However, PrEP use data in the Veterans Health Administration (VHA) system are not included in the current monitoring surveillance. To address this gap, we examined the trends in PrEP use among U.S. Veterans receiving health services in the VHA system. Methods. We analyzed 2014-2022 VHA data to identify the annual number and prevalence of persons aged ≥18 years prescribed PrEP, stratified by sex, age, race and ethnicity, and region. We also assessed trends by calculating the estimated annual percent change (EAPC) and 95% confidence intervals (CIs) using Poisson models. Results. The number of Veterans prescribed PrEP increased from 361 in 2014 to 6,050 in 2022 with an EAPC of 29.6% (95% CI, 22.6–37.1). Of 6,050 Veterans with PrEP prescriptions in 2022, 95.2% were men, 4.8% were women, 50.4% were White, 24.5% Black or African American (Black) and 14.0% Hispanic or Latino. The prevalence of Black and Hispanic or Latino individuals prescribed PrEP increased significantly from 2014-2022. Conclusion. VHA data fill a gap in monitoring PrEP use in the United States. We observed an increasing trend in the number of Veterans prescribed PrEP similar to trends among persons with commercial or public health insurance. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedRui Yan, Yu Jiang, Chenhao Zhang, Rui Tang, Ran Liu, Jinghua Wu, Houcheng Su
PLoS One Infectious Diseases, 19.09.2024
Tilføjet 19.09.2024
by Rui Yan, Yu Jiang, Chenhao Zhang, Rui Tang, Ran Liu, Jinghua Wu, Houcheng Su Image stitching is a traditional but challenging computer vision task. The goal is to stitch together multiple images with overlapping areas into a single, natural-looking, high-resolution image without ghosts or seams. This article aims to increase the field of view of gastroenteroscopy and reduce the missed detection rate. To this end, an improved depth framework based on unsupervised panoramic image stitching of the gastrointestinal tract is proposed. In addition, preprocessing for aberration correction of monocular endoscope images is introduced, and a C2f module is added to the image reconstruction network to improve the network’s ability to extract features. A comprehensive real image data set, GASE-Dataset, is proposed to establish an evaluation benchmark and training learning framework for unsupervised deep gastrointestinal image splicing. Experimental results show that the MSE, RMSE, PSNR, SSIM and RMSE_SW indicators are improved, while the splicing time remains within an acceptable range. Compared with traditional image stitching methods, the performance of this method is enhanced. In addition, improvements are proposed to address the problems of lack of annotated data, insufficient generalization ability and insufficient comprehensive performance in image stitching schemes based on supervised learning. These improvements provide valuable aids in gastrointestinal examination.
Læs mere Tjek på PubMedJaimie P. Meyer, Elizabeth Lazarus, Karlye Phillips, Z. Thomasina Watts, Brenice Duroseau, Cindy Carlson, Carolina R. Price, Trace Kershaw, Tiara C. Willie
PLoS One Infectious Diseases, 18.09.2024
Tilføjet 18.09.2024
by Jaimie P. Meyer, Elizabeth Lazarus, Karlye Phillips, Z. Thomasina Watts, Brenice Duroseau, Cindy Carlson, Carolina R. Price, Trace Kershaw, Tiara C. Willie Background Women exposed to intimate partner violence (IPV) experience multiple social and structural barriers to accessing HIV pre-exposure prophylaxis (PrEP), despite being at increased risk for HIV. In addition, few existing HIV prevention interventions address IPV. A recently developed PrEP decision aid for women has the potential to reach IPV survivors at risk for HIV if it could be integrated into existing domestic violence agencies that prioritize trust and rapport with female IPV survivors. Leveraging non-traditional service delivery mechanisms in the community could expand reach to women who are IPV survivors for PrEP. Methods We conducted qualitative interviews and online qualitative surveys with 33 IPV survivors and 9 domestic violence agency staff at two agencies in Connecticut. We applied the Consolidated Framework for Implementation Research (CFIR) to understand barriers and facilitators to delivering a novel PrEP decision aid to IPV survivors in the context of domestic violence service agencies. Results Most IPV survivors and agency staff thought the PrEP decision aid intervention could be compatible with agencies’ existing practices, especially if adapted to be trauma-responsive and delivered by trusted counselors and staff members. PrEP conversations could be packaged into already well-developed safety planning and wellness practices. Agency staff noted some concerns about prioritizing urgent safety needs over longer-term preventive health needs during crisis periods and expressed interest in receiving further training on PrEP to provide resources for their clients. Conclusions IPV survivors and agency staff identified key intervention characteristics of a PrEP decision aid and inner setting factors of the service agencies that are compatible. Any HIV prevention intervention in this setting would need to be adapted to be trauma-responsive and staff would need to be equipped with proper training to be successful.
Læs mere Tjek på PubMedAuxiliare Kuretu, Mamosheledi Mothibe, Phikelelani Ngubane, Ntethelelo Sibiya
PLoS One Infectious Diseases, 18.09.2024
Tilføjet 18.09.2024
by Auxiliare Kuretu, Mamosheledi Mothibe, Phikelelani Ngubane, Ntethelelo Sibiya Efavirenz, tenofovir, rifampicin, simvastatin, lamotrigine and clarithromycin are known potential mitochondrial toxicants. Mitochondrial toxicity has been reported to disrupt the chain of events in the insulin signalling pathway. Considering the upward trajectory of diabetes mellitus prevalence, studies which seek to uncover probable risk factors for developing diabetes should be encouraged. This study aimed to evaluate the intracellular mechanisms leading to the development of insulin resistance in the presence of various conventional pharmacological agents reported as potential mitochondrial toxicants in skeletal muscle cell line. Differentiated C2C12 preparations were exposed to multiple concentrations of efavirenz, tenofovir, rifampicin, simvastatin, lamotrigine, and clarithromycin, separately. Glucose handling was evaluated by observing the changes in insulin-stimulated glucose uptake and assessing the changes in GLUT4 translocation, GLUT4 expression and Akt expression. The changes in mitochondrial function were evaluated by assessing mitochondrial membrane integrity, cellular ATP production, generation of intracellular reactive oxygen species, expression of tafazzin and quantification of medium malonaldehyde. Insulin stimulated glucose uptake was perturbed in C2C12 pre-treated with potential mitotoxicants. Additionally, ATP synthesis, alterations in mitochondrial membrane potential, excessive accumulation of ROS and malonaldehyde were observed in the presence of potential mitotoxicants. Particularly, we observed suppression of proteins involved in the insulin signalling pathway and maintenance of mitochondrial function namely GLUT4, Akt and tafazzin. Mitochondrial toxicants can potentially induce insulin resistance emanating from mitochondrial dysfunction. These new findings will contribute to the understanding of underlying mechanisms involved in the development of insulin resistance linked to mitochondrial dysfunction.
Læs mere Tjek på PubMedMalaria Journal, 18.09.2024
Tilføjet 18.09.2024
Abstract Background Artemether–lumefantrine (AL) has been the primary anti-malarial drug used to treat uncomplicated Plasmodium falciparum malaria in Ethiopia since 2004. However, there have been recent reports of AL resistance mutations in different African countries, including Ethiopia. This is concerning and requires periodic monitoring of anti-malarial drug resistance. Therefore, the current study aimed to evaluate the therapeutic efficacy of AL in treating uncomplicated P. falciparum malaria in the Arba Minch Zuria District, Gamo Zone, Southwest Ethiopia. Methods A single-arm prospective study with a 28-day follow-up period was conducted from July to October 2022. Capillary blood samples were collected for RDT and microscopic examination. The study enrolled monoinfected P. falciparum patients aged ≥ 18 years at Ganta Sira Health Post. Sociodemographic and clinical data were recorded, and a dried blood spot (DBS) was prepared for each participant. Nested polymerase chain reaction (nPCR) genotyping of the msp-1 and msp-2 genes was only performed for recurrent cases to distinguish between recurrence and reinfection. Data entry and analysis were performed using the WHO Excel spreadsheet and SPSS version 26. Results A total of 89 patients were enrolled, and 67 adequately completed the 28-day follow-up period. AL showed a 100% clearance rate for fever on day 2 and asexual parasites on day 3. Gametocytes were detected in 13.5% (12/89) of the participants. The gametocyte clearance rate was 58.3% (7/12) until day 7 and 100% (12/12) until day 14. Five participants developed recurrent malaria, three of whom experienced relapse and two of whom experienced reinfection. Based on the Kaplan–Meier survival analysis, the PCR-uncorrected and PCR-corrected cumulative incidence of success were 93.7% (95% CI 85.5–97.3) and 96.2% (95% CI 85.5–98.7), respectively. Conclusion AL was efficacious in treating uncomplicated P. falciparum malaria in the study area. However, the detection of recurrent patients highlights the need for continuous efficacy studies in this area.
Læs mere Tjek på PubMedClinical & Experimental Immunology, 18.09.2024
Tilføjet 18.09.2024
Abstract This study aimed to investigate the effects of CpG Oligodeoxynucleotide (CpG ODNs)-Coated Chitosan Nanoparticles (CNP) on the phenotype of murine macrophages and their pro-inflammatory cytokine profile in vitro. CNP-CpG ODNs loaded with FITC-scrambled siRNA were prepared using the ionotropic gelation method. Peritoneal macrophages were isolated and exposed to CNP-CpG ODNs. Treated macrophages were assessed for uptake capacity. Flow cytometry was used to evaluate the expression levels of MHC-II, CD40, and CD86 costimulatory molecules in treated macrophages. Furthermore, the secretion levels of proinflammatory cytokines (TNF-α and IL-6) and the release of nitric oxide (NO) were measured in the culture supernatant of treated macrophages using sandwich ELISA and the Griess reaction, respectively. These in vitro studies showed that CNP-CpG ODNs had no cytotoxic effect on macrophages and were efficiently taken up by them. Additionally, CNP-CpG ODNs significantly increased the production of TNF-α, IL-6, and NO in the culture supernatant compared to CNP alone. Moreover, CNP-CpG ODNs enhanced the expression of MHC-II, CD40, and CD86 costimulatory molecules on macrophages. These findings indicate that incorporating CpG ODNs into CNPs promotes macrophage maturation and a proinflammatory phenotype. Therefore, CNP-CpG ODNs may serve as an effective system for targeted gene delivery to macrophages, enhancing immune responses.
Læs mere Tjek på PubMedHastie, Elizabeth; Srivatsa, Megha S; Gianella, Sara; Cottrell, Mackenzie; Forsyth, Kyra; Porrachia, Magali; Burke, Leah; Morris, Sheldon; Rawlings, Stephen A; Karris, Maile; Chaillon, Antoine; Blumenthal, Jill
Journal of Acquired Immune Deficiency Syndromes, 13.09.2024
Tilføjet 13.09.2024
Background: Little is known about the efficacy of pre-exposure prophylaxis (PrEP) or what biologic factors may influence HIV transmission in transgender men (TGM). In this study, we sought to explore the effect of testosterone on the vaginal microbiome, cervicovaginal fluid (CVF) tenofovir concentrations, and levels of CVF inflammatory markers in TGM on PrEP. Methods: CVF was collected from 13 TGM (7 using testosterone) and 32 cisgender women (CGW) on PrEP. The vaginal microbiome, CVF tenofovir concentrations, and CVF inflammatory markers were determined and compared. Results: The proportion of CVF Lactobacillus was significantly higher in CGW than in TGM (78% vs 24%, p
Læs mere Tjek på PubMedMalaria Journal, 12.09.2024
Tilføjet 12.09.2024
Abstract Background Malaria remains an important public health problem, particularly in sub-Saharan Africa. In Rwanda, where malaria ranks among the leading causes of mortality and morbidity, disease transmission is influenced by climatic factors. However, there is a paucity of studies investigating the link between climate change and malaria dynamics, which hinders the development of effective national malaria response strategies. Addressing this critical gap, this study analyses how climatic factors influence malaria transmission across Rwanda, thereby informing tailored interventions and enhancing disease management frameworks. Methods The study analysed the potential impact of temperature and cumulative rainfall on malaria incidence in Rwanda from 2012 to 2021 using meteorological data from the Rwanda Meteorological Agency and malaria case records from the Rwanda Health Management and Information System. The analysis was performed in two stages. First, district-specific generalized linear models with a quasi-Poisson distribution were applied, which were enhanced by distributed lag non-linear models to explore non-linear and lagged effects. Second, random effects multivariate meta-analysis was employed to pool the estimates and to refine them through best linear unbiased predictions. Results A 1-month lag with specific temperature and rainfall thresholds influenced malaria incidence across Rwanda. Average temperature of 18.5 °C was associated with higher malaria risk, while temperature above 23.9 °C reduced the risk. Rainfall demonstrated a dual effect on malaria risk: conditions of low (below 73 mm per month) and high (above 223 mm per month) precipitation correlated with lower risk, while moderate rainfall (87 to 223 mm per month) correlated with higher risk. Seasonal patterns showed increased malaria risk during the major rainy season, while the short dry season presented lower risk. Conclusion The study underscores the influence of temperature and rainfall on malaria transmission in Rwanda and calls for tailored interventions that are specific to location and season. The findings are crucial for informing policy that enhance preparedness and contribute to malaria elimination efforts. Future research should explore additional ecological and socioeconomic factors and their differential contribution to malaria transmission.
Læs mere Tjek på PubMedBMC Infectious Diseases, 12.09.2024
Tilføjet 12.09.2024
Abstract Background Hospitals should prepare for emerging diseases and protect healthcare workers (HCWs) from work-related infection. This study aims to assess public hospital preparedness for the coronavirus disease 2019 (COVID-19) a year after the Myanmar government began implementing COVID-19 prevention measures, and to identify factors associated with work-related COVID-19 infection among HCWs in Myanmar. Methods In January 2021, data were collected from 101 hospitals and 706 HCWs who had COVID-19 in Myanmar in 2020. Data from the hospitals included basic information, the status of infection prevention and control (IPC), the preparedness for COVID-19 (guidelines, checklists, fever screening, patient pathway, and training), handwashing facilities, and availability of personal protective equipment (PPE). Data of COVID-19 infected HCWs included age, occupation, workplace, severity and source of COVID-19 infection, knowledge and practice of handwashing, and working environment. Chi-square test was performed to compare the preparedness for COVID-19 among three hospital levels (primary, secondary and tertiary levels). Logistic regression analysis was performed to identify the associated factors of work-related infection of HCWs. Results The total number of beds, HCWs, and COVID-19 patients in 2020 at the 101 hospitals was 12,888, 14,421, and 19,835, respectively. The availability of PPE was high in hospitals at all levels. Approximately 80% of hospitals had functional status of IPC, set up fever screening and patient pathway, and provided training on IPC and COVID-19. However, only 39.6% of hospitals had developed COVID-19 guidelines and 55.4% had developed checklists. The percentage of hospitals that prepared each measurement was lowest at the primary level. The factors associated with work-related COVID-19 among HCWs were being 30–39 years old, working as a doctor, working at isolation wards, having disinfection technique training, and having enough PPE at the workplace. Conclusion The preparedness for COVID-19 at public hospitals in Myanmar in January 2021 was insufficient, especially in the availability of the guidelines and checklists and at primary hospitals. A support system for hospital pandemic preparedness and monitoring of IPC implementation is needed. The government should prepare for emerging diseases and provide appropriate and adequate PPE and additional training to all HCWs, especially HCWs who work for isolation wards.
Læs mere Tjek på PubMedYue Yao Tailong Lei Junbo Gao Qingye Xu Lei Xu Buhui Zhao Shangshang Qin Yunsong Yu Xiaoting Hua a Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of Chinab Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, People’s Republic of Chinac Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of Chinad Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, People’s Republic of Chinae Institute of Bioinformatics and Medical Engineering, School of Electrical and Information Engineering, Jiangsu University of Technology, Changzhou, People’s Republic of Chinaf School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, People’s Republic of Chinag Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education, Zhengzhou University, Zhengzhou, People’s Republic of China
Emerg Microbes Infect, 10.09.2024
Tilføjet 10.09.2024
Eustaquio, Patrick C.; Burnett, Janet; Prejean, Joseph; Chapin-Bardales, Johanna; Cha, Susan; for the National HIV Behavioral Surveillance Study Group
AIDS, 9.09.2024
Tilføjet 9.09.2024
Background: Men who inject drugs who have sex with men (MWIDSM) may acquire HIV through injecting drugs or sex. Interventions to increase awareness of HIV preexposure prophylaxis (PrEP) have focused on gay/bisexual MSM and may not be reaching heterosexual-identifying men or people who inject drugs (PWID). We explored changes in PrEP awareness and use among MWIDSM from 2018 to 2022 by sexual identity. Methods: We used data from the 2018 and 2022 National HIV Behavioral Surveillance among PWID recruited via respondent-driven sampling in 19 urban areas in the US. We examined changes in PrEP awareness and use over time by sexual identity among HIV-negative men who inject drugs and who had sex with another man in the past 12 months using log-linked Poisson regression models with robust standard errors with an interaction term between year and sexual identity. Results: Among 758 HIV-negative MWIDSM (463 in 2018; 295 in 2022), nearly all sample participants were likely indicated for PrEP (94.2 and 92.9%, respectively). PrEP awareness increased from 2018 to 2022 among gay/bisexual-identifying MWIDSM [45.5–65.5%; aPR = 1.49, 95% confidence interval (95% CI) = 1.30–1.70] but remained stable for heterosexual-identifying MWIDSM (39.4–40.8%; aPR = 1.01, 95% CI 0.75–1.36). PrEP use remained low among all MWIDSM (2.5–7.7%, among heterosexually identifying; 15.3 to 10.2% among gay/bisexual-identifying). Conclusion: PrEP awareness increased among gay/bisexual-identifying MWIDSM but not among heterosexual-identifying. PrEP use was low for all MWIDSM. Public health initiatives catered to MWIDSM should focus on improved campaigns and expanding PrEP accessibility in existing healthcare, harm reduction, and social services. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedKumar, R., Rao, D., Sharma, A., Phiri, J., Zimba, M., Phiri, M., Zyambo, R., Kalo, G. M., Chilembo, L., Kunda, P. M., Mulubwa, C., Ngosa, B., Mugwanya, K. K., Barrington, W. E., Herce, M. E., Musheke, M.
BMJ Open, 6.09.2024
Tilføjet 6.09.2024
IntroductionWomen engaging in sex work (WESW) have 21 times the risk of HIV acquisition compared with the general population. However, accessing HIV pre-exposure prophylaxis (PrEP) remains challenging, and PrEP initiation and persistence are low due to stigma and related psychosocial factors. The WiSSPr (Women in Sex work, Stigma and PrEP) study aims to (1) estimate the effect of multiple stigmas on PrEP initiation and persistence and (2) qualitatively explore the enablers and barriers to PrEP use for WESW in Lusaka, Zambia. Methods and analysisWiSSPr is a prospective observational cohort study grounded in community-based participatory research principles with a community advisory board (CAB) of key population (KP) civil society organi sations (KP-CSOs) and the Ministry of Health (MoH). We will administer a one-time psychosocial survey vetted by the CAB and follow 300 WESW in the electronic medical record for three months to measure PrEP initiation (#/% ever taking PrEP) and persistence (immediate discontinuation and a medication possession ratio). We will conduct in-depth interviews with a purposive sample of 18 women, including 12 WESW and 6 peer navigators who support routine HIV screening and PrEP delivery, in two community hubs serving KPs since October 2021. We seek to value KP communities as equal contributors to the knowledge production process by actively engaging KP-CSOs throughout the research process. Expected outcomes include quantitative measures of PrEP initiation and persistence among WESW, and qualitative insights into the enablers and barriers to PrEP use informed by participants’ lived experiences. Ethics and disseminationWiSSPr was approved by the Institutional Review Boards of the University of Zambia (#3650-2023) and University of North Carolina (#22-3147). Participants must give written informed consent. Findings will be disseminated to the CAB, who will determine how to relay them to the community and stakeholders.
Læs mere Tjek på PubMedConrad Keating
Lancet, 6.09.2024
Tilføjet 6.09.2024
This is a dangerous time for global health, not least given widespread vaccine disinformation across social media, with the aim of undermining societal trust in life-saving vaccines. Compounding this spread of fake propaganda and its potential to contribute to avoidable deaths are ongoing pandemic threats. In June, 2024, No Time to Gamble: Leaders Must Unite to Prevent Pandemics, a report by Helen Clark and Ellen Johnson Sirleaf, former Co-Chairs of the influential Independent Panel for Pandemic Preparedness and Response, highlighted two alarming developments: the transmission of highly pathogenic influenza A(H5N1) into mammals and the emergence of the more virulent clade 1b variant of mpox virus in DR Congo.
Læs mere Tjek på PubMedHexin Li, Negin Ashrafi, Chris Kang, Guanlan Zhao, Yubing Chen, Maryam Pishgar
PLoS One Infectious Diseases, 5.09.2024
Tilføjet 5.09.2024
by Hexin Li, Negin Ashrafi, Chris Kang, Guanlan Zhao, Yubing Chen, Maryam Pishgar Background Mechanical ventilation (MV) is vital for critically ill ICU patients but carries significant mortality risks. This study aims to develop a predictive model to estimate hospital mortality among MV patients, utilizing comprehensive health data to assist ICU physicians with early-stage alerts. Methods We developed a Machine Learning (ML) framework to predict hospital mortality in ICU patients receiving MV. Using the MIMIC-III database, we identified 25,202 eligible patients through ICD-9 codes. We employed backward elimination and the Lasso method, selecting 32 features based on clinical insights and literature. Data preprocessing included eliminating columns with over 90% missing data and using mean imputation for the remaining missing values. To address class imbalance, we used the Synthetic Minority Over-sampling Technique (SMOTE). We evaluated several ML models, including CatBoost, XGBoost, Decision Tree, Random Forest, Support Vector Machine (SVM), K-Nearest Neighbors (KNN), and Logistic Regression, using a 70/30 train-test split. The CatBoost model was chosen for its superior performance in terms of accuracy, precision, recall, F1-score, AUROC metrics, and calibration plots. Results The study involved a cohort of 25,202 patients on MV. The CatBoost model attained an AUROC of 0.862, an increase from an initial AUROC of 0.821, which was the best reported in the literature. It also demonstrated an accuracy of 0.789, an F1-score of 0.747, and better calibration, outperforming other models. These improvements are due to systematic feature selection and the robust gradient boosting architecture of CatBoost. Conclusion The preprocessing methodology significantly reduced the number of relevant features, simplifying computational processes, and identified critical features previously overlooked. Integrating these features and tuning the parameters, our model demonstrated strong generalization to unseen data. This highlights the potential of ML as a crucial tool in ICUs, enhancing resource allocation and providing more personalized interventions for MV patients.
Læs mere Tjek på PubMedBMC Infectious Diseases, 3.09.2024
Tilføjet 3.09.2024
Abstract Background Studying the characteristics of hospitalized Coronavirus Disease 2019 (COVID-19) patients is vital for understanding the disease and preparing for future outbreaks. The aim of this study was to analyze and describe the clinical profiles and factors associated with mortality among COVID-19 patients admitted to Jimma Medical Center COVID-19 Treatment Center (JMC CTC) in Ethiopia. Methods All confirmed COVID-19 patients admitted to JMC CTC between 17 April 2020 and 05 March 2022 were included in this study. Socio-demographic data, clinical information, and outcome variables were collected retrospectively from medical records and COVID-19 database at the hospital. Bivariable and multivariable analyses were performed to determine factors associated with COVID-19 severity and mortality. A P-value
Læs mere Tjek på PubMedIlhem Berrou, Laura Hobbs, Sue Jones, Sian Hughes, Hannah Bailey, Sally Quigg, Thomas Manning, Anne Morris
PLoS One Infectious Diseases, 29.08.2024
Tilføjet 29.08.2024
by Ilhem Berrou, Laura Hobbs, Sue Jones, Sian Hughes, Hannah Bailey, Sally Quigg, Thomas Manning, Anne Morris Background Vaccination remains one of the most successful public health interventions in preventing severe disease and death. The roll-out of Covid-19 vaccination programmes has helped protect billions of people around the world against Covid-19. Most of these programmes have been unprecedented in terms of scale and resources, and have been implemented at times of significant humanitarian crisis. This study aims to outline the lessons learnt from the implementation of a regional Covid-19 vaccination programme. These will help inform emergency preparedness and future crisis management. Methods This qualitative study sought to explore the key drivers to the successful implementation of the Covid-19 vaccination programme in a region in the Southwest of England, applying the Normalisation Process Theory lens (NPT) to examine multi-stakeholder perspectives. Data collection involved semi-structured interviews with 75 participants. Document analysis was also used to corroborate the findings emerging from the interviews. Inductive thematic analysis of the data was used to identify the key drivers for the successful implementation of the programme. The NPT lens was then applied to map the themes identified to the domains and constructs of the framework. Results Ten key drivers to the successful implementation of the Covid-19 vaccination programme locally were identified, including: the clarity and consistency of the programme’s goal; the diverse representation of stakeholders within the programme leadership team and the mechanisms created by this team to ensure psychological safety, autonomy, operational flexibility and staff empowerment; Communication and data specialists’ input, and collaboration with local communities to maximise the reach of the programme; and allocating funding to tackle health inequalities. Conclusions This study highlights the lessons learnt from the implementation of the Covid-19 vaccination programme at a local level, and the mechanisms that can be used in future crises to respond efficiently to the needs of individuals, communities and governments.
Læs mere Tjek på PubMedVineet DubeyNicola FarringtonNicholas HarperAdam JohnsonIona HornerAdam StevensonAnnie ParkesLewis HoareShampa DasWilliam Hope1Antimicrobial Pharmacodynamics and Therapeutics, University of Liverpool, Liverpool, United KingdomRyan K. Shields
Antimicrobial Agents And Chemotherapy, 27.08.2024
Tilføjet 27.08.2024
Vivian I. Avelino-Silva, Mars Stone, Sonia Bakkour, Clara Di Germanio, Michael Schmidt, Ashtyn L. Conway, David Wright, Eduard Grebe, Brian Custer, Steven H. Kleinman, Xutao Deng, Jairam R. Lingappa, Patricia Defechereux, Megha Mehrotra, Robert M. Grant, Sandhya Vasan, Shelley Facente, Nittaya Phanuphak, Carlo Sacdalan, Siriwat Akapirat, Mark de Souza, Michael P. Busch, Philip J. Norris, NHLBI Recipient Epidemiology and Donor Evaluation Study-IV-Pediatric (REDS-IV-P)
International Journal of Infectious Diseases, 25.08.2024
Tilføjet 25.08.2024
Highly accurate assays are currently available for HIV diagnosis, detecting nucleic acids, antigens, or HIV-specific antibodies (Abs). Typically, RNA becomes detectable in 10-14 days, p24 antigen (Ag) in 17-21 days, and Abs in 22-26 days following HIV acquisition [1,2]. However, currently available tests may undergo delays or fail to detect infections in a few circumstances. Exposure to antiretrovirals at or early after HIV acquisition can suppress viral replication, leading to diminished detectability of HIV RNA and p24, and an inconsistent antibody (Ab) response [3–7].
Læs mere Tjek på PubMedMaria Carolina Mesquita, Márcio Antônio Mendonça, Raquel Braz Assunção Botelho, Sandra Fernandes Arruda, Eliana dos Santos Leandro
PLoS One Infectious Diseases, 24.08.2024
Tilføjet 24.08.2024
by Maria Carolina Mesquita, Márcio Antônio Mendonça, Raquel Braz Assunção Botelho, Sandra Fernandes Arruda, Eliana dos Santos Leandro The demand for plant-based products has increased in recent years, due to several aspects related to health and environmental consciousness. This study aimed to produce and characterize a plant-based dairy alternative dessert based on araticum pulp and chickpea extract without added sugar and fat. Three formulations were prepared: Formulation 1 (F1): 20% araticum pulp + 80% chickpea extract; Formulation 2 (F2): 30% araticum pulp + 70% chickpea extract; and Formulation 3 (F3): 40% araticum pulp + 60% chickpea extract. All formulations’ chemical composition, sensorial characteristics, viscosity, total phenolic content, antioxidant activity, and microbiological stability were analyzed during 28 days of storage at 4°C and a relative humidity of 23%. Energetic value ranged from 64 to 71 kcal/100g, and carbohydrate content from 9.68 to 11.06, protein from 3.38 to 3.04, lipids from 1.41 to 1.60, ashes from 0.53 to 0.59 and crude fiber from 0.86 to 1.34 g/100g among the formulations. The increase in the proportion of araticum pulp in the formulations reduced moisture content by 1.2 to 2.1% (F1: 84.2, F2: 83.2, and F3: 82.4), protein content by 3 to 9% (F1: 3.3, F2: 3.2, and F3: 3.0), and pH value by 5.8 to 10.7% (F1: 5.50, F2: 5.18, and F3: 4.91), and increased the TSS by 1.1 to 1.3-fold (F1: 8.36, F2: 8.98, and F3: 10.63 º Brix), total phenolics content by 1.5 to 2.0-fold (F1: 4,677, F2: 6,943, and F3: 10,112 gallic acid μmol/L) and antioxidant activity by 1.8 to 2.8-fold (F1: 1,974, F2: 3,664, and F3: 5.523). During the 28 days of storage at 4°C, the formulations F1 and F2 showed better stability of phenolic compounds and antioxidant activity; however, the formulation F3 showed acceptable microbiological quality up to 28 days of storage, higher viscosity, 8 to 16-fold higher than the formulations F1 and F2, respectively (F1: 238.90, F2: 474.30, and F3:3,959.77 mPa.s), antioxidant capacity and better scores in sensory analysis. The present study showed that the plant-based dessert elaborated with araticum pulp and chickpea extract might be considered a potential dairy alternative product with high antioxidant activity, protein content, and a viscosity similar to yogurt; however, its sensory aspects need improvement.
Læs mere Tjek på PubMedReitsema, Maarten; Wallinga, Jacco; van Sighem, Ard I; Bezemer, Daniela; van der Valk, Marc; van Aar, Fleur; Maria Heijne, Janneke Cornelia; Hoornenborg, Elske; Rozhnova, Ganna; van Benthem, Birgit; Xiridou, Maria
Journal of Acquired Immune Deficiency Syndromes, 23.08.2024
Tilføjet 23.08.2024
Background: In 2019, a five-year pre-exposure prophylaxis (PrEP) program started in the Netherlands, in which up to 8,500 men who have sex with men (MSM) can obtain PrEP and 3-monthly consultations with HIV/STI testing. Setting: We assessed the impact of the PrEP program on transmission of HIV and Neisseria gonorrhea (NG) among MSM in the Netherlands and examined prospective variations of the program after 2024. Methods: We used an agent-based model to estimate the effect of the PrEP program. For prospective PrEP programs from 2024, we varied the capacity (8,500; 12,000; 16,000 participants) and consultation frequency (3-monthly; 6-monthly; 70% 3-monthly and 30% 6-monthly) for t. Results: At a capacity of 8,500 participants and 3-monthly consultations, the PrEP program could lead to 3,140 (95%CrI 1,780 – 4,780) and 27,930 (95%CrI 14,560 – 46,280) averted HIV and NG infections; requiring 316,050 (95%CrI 314,120 – 317,580) consultations. At a capacity of 16,000 participants the programs with 3-monthly consultations and 6-monthly consultations could lead to comparable numbers of averted HIV (3,940 (95%CrI 2,420 – 5,460), and 3,900 (2,320 – 5,630) respectively) and NG infections (29,970 (95%CrI 15,490 – 50,350), and 29,960 (95%CrI 13,610 – 50,620) respectively), while requiring substantially different numbers of consultations: 589,330 (95%CrI 586,240 – 591,160) and 272,590 (95%CrI 271,770 – 273,290) respectively. Conclusion: Continuation of a PrEP program could lead to a substantial reduction in HIV and NG transmission. More infections could be averted if the number of participants is increased. In turn, the consultations frequency could be reduced without reducing the number of averted infections if capacity is increased. Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedEgger, M., Sauermann, M., Loosli, T., Hossmann, S., Riedo, S., Beerenwinkel, N., Jaquet, A., Minga, A., Ross, J., Giandhari, J., Kouyos, R. D., Lessells, R.
BMJ Open, 23.08.2024
Tilføjet 23.08.2024
IntroductionHIV drug resistance poses a challenge to the United Nation’s goal of ending the HIV/AIDS epidemic. The integrase strand transfer inhibitor (InSTI) dolutegravir, which has a higher resistance barrier, was endorsed by the WHO in 2019 for first-line, second-line and third-line antiretroviral therapy (ART). This multiplicity of roles of dolutegravir in ART may facilitate the emergence of dolutegravir resistance. Methods and analysisNested within the International epidemiology Databases to Evaluate AIDS (IeDEA), DTG RESIST is a multicentre study of adults and adolescents living with HIV in sub-Saharan Africa, Asia, and South and Central America who experienced virological failure on dolutegravir-based ART. At the time of virological failure, whole blood will be collected and processed to prepare plasma or dried blood spots. Laboratories in Durban, Mexico City and Bangkok will perform genotyping. Analyses will focus on (1) individuals who experienced virological failure on dolutegravir and (2) those who started or switched to such a regimen and were at risk of virological failure. For population (1), the outcome will be any InSTI drug resistance mutations, and for population (2) virological failure is defined as a viral load >1000 copies/mL. Phenotypic testing will focus on non-B subtype viruses with major InSTI resistance mutations. Bayesian evolutionary models will explore and predict treatment failure genotypes. The study will have intermediate statistical power to detect differences in resistance mutation prevalence between major HIV-1 subtypes; ample power to identify risk factors for virological failure and limited power for analysing factors associated with individual InSTI drug resistance mutations. Ethics and disseminationThe research protocol was approved by the Biomedical Research Ethics Committee at the University of KwaZulu-Natal, South Africa and the Ethics Committee of the Canton of Bern, Switzerland. All sites participate in International epidemiology Databases to Evaluate AIDS and have obtained ethics approval from their local ethics committee to collect additional data. Trial registration number NCT06285110.
Læs mere Tjek på PubMedRachel SintesPaul McLellanGabriele NavelliCécilia LandmanSandrine DelageSandrine TruongNicolas BenechNathalie KapelAlicia Moreino SabaterAurélie SchnurigerCatherine EckertAlexandre BleibtreuAnne-Christine JolyHarry Sokol1Department of Pharmacy, Sorbonne Université, AP-HP, Saint-Antoine Hospital, Paris, France2Assistance Publique-Hopitaux de Paris (AP-HP) FMT Center, Paris, France3Paris Center for Microbiome Medicine (PaCeMM) FHU, Paris, France4French Group for Fecal Microbiota Transplantation (GFTF), Paris, France5Department of Gastroenterology, Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Saint-Antoine Hospital, Paris, France6Department of Hepato-Gastroenterology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France7Functional Coprology Laboratory, APHP, Pitié Salpêtrière Hospital and Université Paris Cité, INSERM UMRS-1139, Centre d'Immunologie et des Maladies Infectieuses, (CIMI-PARIS), Inserm U1135, Sorbonne Université, Paris, France8Sorbonne Université, APHP, National Institute of Health and Medical Research, Center for Immunology and Infectious Diseases-Paris, Saint Antoine Hospital, Parasitology-Mycology, Paris, France9Sorbonne Université, AP-HP, Saint-Antoine Hospital, Virology, Paris, France10Sorbonne Université, AP-HP, Saint-Antoine Hospital, Bacteriology et Centre d'Immunologie et des Maladies Infectieuses, INSERM, U1135, Sorbonne Université, Paris, France11Department of Infectious Disease, Sorbonne Université, AP-HP, Pitié-Salpêtrière Hospital, Paris, France12Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, Jouy-en-Josas, FranceJared A. Silverman
Antimicrobial Agents And Chemotherapy, 22.08.2024
Tilføjet 22.08.2024
Paine, Emily Allen; Appenroth, Max; Scheim, Ayden; Goldrich, Madison; Giguere, Rebecca; Sandfort, Theodorus
Journal of Acquired Immune Deficiency Syndromes, 22.08.2024
Tilføjet 22.08.2024
Background: We assessed access to pre-exposure prophylaxis (PrEP) and interest in integration of PrEP with gender-affirmative care (GAC) in a global sample of transmasculine persons. Methods: Transmasculine persons (n=590) aged 18 and above from 57 countries completed a brief online survey 4/2022 to 7/2022 about sexual behavior, knowledge and interest in PrEP, current access to PrEP and GAC, and preferred context for accessing PrEP. Descriptive analyses were stratified by country income group. Results: Most participants (54.4%) lived near a health center offering care to trans people. 1.9% of respondents reported ever receiving a positive HIV test result. Among those who had not (n=579), over a third reported engaging in receptive sex in the past year (35.2%) or anticipated doing so in the next year (41.5%), 86.9% had never received information about HIV prevention specific to transmasculine people, and 76.3% had heard of PrEP. Among those who had heard of PrEP (n=440), only 18.9% had discussed or been offered it by a provider, and only 3.6% were currently taking it—yet 67.9% who had heard of it but were not using it would “definitely” (28.5%) or “maybe” (39.4%) be interested in taking it were it available for free. Out of these participants, the majority (60.5%) preferred the idea of accessing PrEP from the same clinic they received gender affirming care. Conclusion: Interventions are needed to improve PrEP access for transmasculine people globally. Clinics already providing gender-affirming care to trans people are acceptable clinical contexts to integrate such interventions. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedClinical Infectious Diseases, 20.08.2024
Tilføjet 20.08.2024
Abstract Background Little is known about the potential benefits or harms of statins on physical function among people with HIV (PWH).Methods REPRIEVE was a double-blind randomized controlled trial evaluating pitavastatin for primary prevention of major adverse cardiovascular events (MACE) in PWH. Time to complete ten chair rises, 4-meter gait speed, grip strength, and a modified short physical performance test were assessed annually for up to 5 years in the ancillary study PREPARE and analyzed using linear mixed models.Findings Of 602 PWH, 52% were randomized to pitavastatin and 48% to placebo. Median age was 51 years; 18% were female at birth; 2% transgender; 40% Black, and 18% Hispanic. Median PREPARE follow-up was 4.7 (4.3, 5.0) years. Muscle symptoms (grade ≥3 or treatment-limiting) occurred in 5% of both groups. There was no evidence of decline in chair rise rate in either treatment group, and no difference in the pitavastatin group compared to placebo (estimated difference -0.10 [95% CI: -0.30, 0.10] rises/min/year; p=0.31). Small declines over time were observed in other physical function tests in both treatment groups, with no apparent differences between groups.Interpretation We observed minimal declines in physical function over 5 years of follow-up among middle-aged PWH, with no differences among PWH randomized to pitavastatin compared to placebo. This finding, combined with low prevalence of myalgias, supports the long-term safety of statin therapy on physical function, when used for primary prevention of MACE among PWH.
Læs mere Tjek på PubMedMelissa Vera, Helen Aketch, Caroline Omom, Felix Otieno, George Owiti, Joseph Sila, John Kinuthia, Kristin Beima-Sofie, Jillian Pintye, Valarie Kemunto, Eunita Akim, Grace John-Stewart, Pamela Kohler
PLoS One Infectious Diseases, 19.08.2024
Tilføjet 19.08.2024
by Melissa Vera, Helen Aketch, Caroline Omom, Felix Otieno, George Owiti, Joseph Sila, John Kinuthia, Kristin Beima-Sofie, Jillian Pintye, Valarie Kemunto, Eunita Akim, Grace John-Stewart, Pamela Kohler Pre-exposure prophylaxis (PrEP) is being scaled up to prevent HIV acquisition among adolescent girls and young women (AGYW) in Eastern and Southern Africa. In a prior study more than one-third of AGYW ‘mystery shoppers’ stated they would not return to care based on interactions with health providers. We examined the experiences of AGYW in this study to identify main barriers to effective PrEP services. Unannounced patient actors (USP/‘mystery shoppers’) posed as AGYWs seeking PrEP using standardized scenarios 8 months after providers had received training to improve PrEP services. We conducted targeted debriefings using open-ended questions to assess PrEP service provision and counseling quality with USPs immediately following their visit. Debriefings were audio-recorded and transcribed. Transcripts were analyzed using thematic analysis to explore why USPs reported either positive or negative encounters. We conducted 91 USP debriefings at 24 facilities and identified three primary influences on PrEP service experiences: 1) Privacy improved likelihood of continuing care, 2) respectful attitudes created a safe environment for USPs, and 3) patient-centered communication improved the experience and increased confidence for PrEP initiation among USPs. Privacy and provider attitudes were primary drivers that influenced decision-making around PrEP in USP debriefs. Access to privacy and improving provider attitudes is important for scale-up of PrEP to AGYW.
Læs mere Tjek på PubMedTamar Klaiman, Nsenga Farrell, Dorothy Sheu, Aerielle Belk, Jasmine Silvestri, Jannie Kim, Ryan Coffman, Joanna Hart
PLoS One Infectious Diseases, 19.08.2024
Tilføjet 19.08.2024
by Tamar Klaiman, Nsenga Farrell, Dorothy Sheu, Aerielle Belk, Jasmine Silvestri, Jannie Kim, Ryan Coffman, Joanna Hart The COVID-19 pandemic produced stress for people around the world. The perception that tobacco can be a coping tool for stress relief suggests that the conditions during the COVID-19 pandemic can provide insight into the relationship between stress and tobacco use patterns, particularly among those most at risk for severe COVID-19 disease. The goal was to identify the impacts of the COVID-19 pandemic on tobacco use and preparedness for smoking cessation among individuals who smoke and are older and medically underserved. We conducted in-depth interviews with 39 patients to learn about individuals’ smoking behavior during the COVID-19 pandemic. We used a modified grounded theory approach to code and analyze all qualitative data. We conducted thematic analysis to identify key factors associated with smoking behaviors during COVID-19. Our results indicated that increases in perceived stress and social isolation may have been associated with increased tobacco use during the COVID-19 pandemic. Pandemic-related social isolation contributed to increases in smoking, despite respondents being concerned about the severity of COVID-19. While many respondents felt that smoking relieved their stress from the pandemic, they appeared unaware of the stress-inducing properties of tobacco use. Our findings indicate that pandemic-related stress impacted smoking behavior among older, medically underserved smokers. Results may assist clinicians in addressing the role of tobacco use in response to highly stressful events. Smoking cessation strategies should consider the implications of stress on smoking behavior, including smoking relapse in response to highly stressful events–particularly for medically underserved populations.
Læs mere Tjek på PubMedBick, S., White, S., Hasund Thorseth, A., Friedrich, M. N. D., Gavin, I., Prasad Gautam, O., Dreibelbis, R.
BMJ Open, 18.08.2024
Tilføjet 18.08.2024
ObjectivesThis multicountry analysis aimed to assess the prevalence of key hygiene prevention behaviours and their determinants, associated with international non-governmental organisation (WaterAid) hygiene behaviour change programmes for COVID-19 prevention. The goal of this analysis is to inform future outbreak preparedness and pandemic response in low and middle-income countries. DesignCross-sectional study. SettingHouseholds in seven countries where WaterAid implemented a first-phase COVID-19 response programme in 2020 (Ethiopia, Ghana, Nepal, Nigeria, Rwanda, Tanzania and Zambia). Participants3033 adults (1469 men and 1564 women, alternately sampled from one household to the next to maintain gender balance) in specific programme areas (211 villages) surveyed between October and November 2020. Primary outcome measuresSelf-reported primary outcomes were: a composite measure of HWWS for prevention of respiratory infection/COVID-19 (total of 5 key moments); respondent increased HWWS behaviour after the COVID-19 pandemic; respondent always wears a mask in public spaces; respondent always practices physical distancing in public spaces. ResultsMost respondents (80%) reported increasing their handwashing behaviour after the pandemic, but practice of HWWS at COVID-19-specific prevention moments was low. Mask wearing (58%) and physical distancing (29%) varied substantially between countries. Determinants of key behaviours were identified, including age and socioeconomic status, perceived norms, self-regulation and the motive of protecting others. Incidence rate ratios or odds ratios and 95% CIs for a range of psychosocial determinants for each of the four primary outcomes are reported. ConclusionsThese findings highlight that leveraging behaviour-specific emotional drivers and norms, reducing common barriers and promoting targeted messages about specific behaviours and actions individuals can take to reduce risk are necessary to support large-scale behaviour change. Learning from the COVID-19 response to more effectively integrate novel behaviours into existing health promotion will be vital for disease prevention and outbreak resilience.
Læs mere Tjek på PubMedBhatt, R., Madsen, J., Castillo-Hernandez, T., Chant, K., Dehbi, H.-M., Marlow, N., Clark, H.
BMJ Open, 18.08.2024
Tilføjet 18.08.2024
IntroductionChronic respiratory morbidity from bronchopulmonary dysplasia (BPD) remains the most common complication of preterm birth and has consequences for later respiratory, cardiovascular and neurodevelopmental outcomes. The early phases of respiratory illness are characterised by rapid consumption of endogenous surfactant and slow replenishment. Exogenous surfactant is routinely administered to infants born before 28 weeks of gestation as prophylaxis. Endogenous surfactant includes four proteins, known as surfactant proteins (SPs) A, B, C and D. Current bovine-derived and porcine-derived surfactant preparations only contain SPs B and C. SP-D has a key role in lung immune homeostasis as part of the innate immune system. Laboratory studies using recombinant SP-D have demonstrated reduced inflammation, which may be a pathway to reducing the associated morbidity from BPD. RESPONSE uses a recombinant fragment of human SP D (rfhSP-D), in a phase I safety and dose-escalation trial as the first stage in determining its effect in humans. Methods and analysisThis is a single-centre, dose-escalation, phase I safety study aiming to recruit 24 infants born before 30 weeks gestation with respiratory distress syndrome. In addition to routine surfactant replacement therapy, participants will receive three doses of rfhSP-D via endotracheal route at either 1 mg/kg, 2 mg/kg or 4 mg/kg. The study uses a Bayesian continual reassessment method to make dose escalation decisions. Dose-limiting events (DLE) in this trial will be graded according to the published Neonatal Adverse Event Severity Score. The primary outcome of this study is to evaluate the safety profile of rfhSP-D across each dose level based on the profile of DLE to establish the recommended phase 2 dose (RP2D) of rfhSP-D. Ethics and disseminationThe RESPONSE study has received ethical approval from London-Brent NHS Research Health Authority ethics committee. Results from the study will be published in peer-reviewed journals and presented at national and international conferences. Trial registration numbersISRCTN17083028, NCT05898633. Protocol versionRESPONSE Protocol V.4.0 24th July 2024.
Læs mere Tjek på PubMedManjulika Das
Lancet Infectious Diseases, 17.08.2024
Tilføjet 17.08.2024
In their book The outbreak atlas, authors Rebecca Katz and Mackenzie S Moore, both affiliated to the Center for Global Health Science & Security, Washington DC, USA, sketch various aspects of disease outbreaks. They also portray fascinating case studies and visuals to help readers understand the complexity associated with outbreak preparedness and response.
Læs mere Tjek på PubMedHo, Ken; Hoesley, Craig; Anderson, Peter L.; Fernández-Romero, Jose A.; Friedland, Barbara A.; Kelly, Clifton W.; Jiao, Yuqing; Edick, Stacey; Brand, Rhonda; Kunjara Na Ayudhya, Ratiya Pamela; Zyhowski, Ashley; Hartman, Douglas J.; Reddy, Nipun B.; Al-Khouja, Amer; Piper, Jeanna; Bauermeister, Jose A.; Teleshova, Natalia; Melo, Claudia; Cornejal, Nadjet; Barnable, Patrick; Singh, Devika; Scheckter, Rachel; McClure, Tara; Hillier, Sharon L.; Hendrix, Craig W.; on behalf of the MTN-037 Study Team
Journal of Acquired Immune Deficiency Syndromes, 16.08.2024
Tilføjet 16.08.2024
Background. On demand, topical PrEP is desired by those preferring episodic, non-systemic PrEP. PC-1005 gel (MIV-150, zinc, and carrageenan) exhibits in vitro antiviral HIV-1, HPV, and HSV-2 activity, attractive for a multipurpose prevention technology (MPT) candidate. We evaluated the safety, pharmacokinetics, and antiviral effect of rectally-applied PC-1005. Methods. HIV-uninfected adults received a series of three rectal PC-1005 doses - 4, 16, and 32 mL separated by 2-week washout periods. Following each dose, plasma, rectal fluid and tissue, and vaginal fluid were collected over 48 h. Results. Thirteen adults enrolled; 12 completed all 3 doses. All 13 adverse events reported were Grade 1 or 2; five were judged study drug-related. Plasma MIV-150 peaked 1-2 h after dosing with a median peak concentrations range of 0.07-0.23 ng/mL and median half-life range of 4.9-7.4 hours across dose volumes; median concentrations were below assay quantitation limits (BLQ) 24 h after dosing. Rectal Tissue MIV-150 peaked 0.5-1 hours after dosing at 1.4 ng/g (ng/mL) (0.8, 1.9), 46.0 (30.7, 831.0), and 79.7 (11.9, 116.0), respectively, after each dose volume; median tissue concentrations were BLQ beyond 5 hours for all doses. All vaginal fluid samples were BLQ. Ex vivo antiviral assays showed 5 h of antiviral HPV and HSV effect, but no anti-HIV activity. Conclusions. MIV-150 rectal tissue concentrations were below the 100 ng/g target concentration and transient. Ex vivo assays demonstrated antiviral HSV and HPV effects, but not against HIV. PC-1005 requires a more potent antiviral and longer-lasting formulation for further consideration as an MPT candidate. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedPhu Dinh Vu, Thuong Thi Nguyen, Duyet Van Le
PLoS One Infectious Diseases, 15.08.2024
Tilføjet 15.08.2024
by Phu Dinh Vu, Thuong Thi Nguyen, Duyet Van Le Background Nursing professional is one of the most stressful jobs, particularly during the COVID-19 pandemic. When caring for COVID-19 patients, nurses face challenging conditions and limited resources, as well as the fear of infecting themselves and their families, putting them at risk for depression, anxiety, and insomnia. The purpose of this study was to determine the frequency, sources, and risk factors for occupational stress among clinical nurses caring for COVID-19 patients in a Vietnamese tertiary hospital. Methods A cross-sectional survey was conducted among all clinical nurses (184 nurses) at a tertiary hospital in Vietnam from March 15 to April 15, 2021. A questionnaire was used for collecting data. Data analysis was done by descriptive statistics, bivariate and multivariate logistic regressions. Risk factors were identified by adjusted odds ratio with 95% confidence interval and P values less than 0.05. Results The survey was completed by 89.7% (165/184) of clinical nurses. Most participants were female (85.5%) and ≤ 40 years old (97.6%). Overall, participants reported a medium stress level with an Extended Nursing Stress Scale (ENSS) mean score of 1.79 points, and 32.1% had occupational stress. Prevalence of occupational stress among participants caring for COVID-19 patients (34.0%) was not statistically significant difference with that among those who did not (29.4%). Nurses’ occupational stress in emergency and intensive care units (50.0%) was substantially higher than that in the other departments (11.7%). The most stressors for participants were difficulties connected to inadequate emotional preparedness, patients and families, and death and dying, with subscale mean scores of 1.97, 1.88, and 1.88 points, respectively. In multivariate analysis, working at an emergency and intensive care unit (OR 4.97), usually or more frequently feeling heavy duty for patients (OR 3.17), and income decrease (OR 3.03) were risk factors associated with occupational stress. Conclusion One-third of clinical nurses at a tertiary hospital experienced occupational stress, with highest rate occurred at emergency and intensive care units. Nurses’ working conditions at emergency and intensive care units should be essentially addressed to improve nurses’ occupational stress.
Læs mere Tjek på PubMedArunima S., Alakesh Das, Prakash Jyoti Kalita, Rahul Ishwar Patil, Neha Pandey, Mamta Bhattacharjee, Bidyut Kumar Sharma, Debajit Das, Sumita Acharjee
PLoS One Infectious Diseases, 15.08.2024
Tilføjet 15.08.2024
by Arunima S., Alakesh Das, Prakash Jyoti Kalita, Rahul Ishwar Patil, Neha Pandey, Mamta Bhattacharjee, Bidyut Kumar Sharma, Debajit Das, Sumita Acharjee The recent advances in pigeon pea genomics, including high-quality whole genome and chloroplast genome sequence information helped develop improved varieties. However, a comprehensive Cajanus proteome, including the organelle proteome, is yet to be fully mapped. The spatial delineation of pigeon pea proteins at sub-cellular levels and inter-organelle communication could offer valuable insights into its defense mechanism against various stresses. However, the major bottleneck in the proteomic study is the lack of a suitable method of protein extraction and sample preparation compatible with two-dimensional gel electrophoresis (2D-PAGE), liquid chromatography-mass spectrometry (LCMS), or matrix-assisted laser desorption ionization-time of flight (MALDi-ToF). Our study introduces two efficient methods, one for isolating total proteins and another for organelle (chloroplast) proteins from various Cajanus spp. For total protein extraction, we have optimized a protocol using phenol in combination with a reducing agent (DTT) and protease inhibitor cocktail, also washing (6–7 times) with ice-cold acetone after overnight protein precipitation of total proteins. Our modified extraction method using phenol for total leaf protein yielded approximately 2-fold more proteins than the previously reported protocols from C. cajan (3.18 ± 0.11 mg/gm) and C. scarabaeoides (2.06 ± 0.08 mg/gm). We have also optimized a protocol for plastid protein extraction, which yielded 1.33 ± 0.25 mg/10 gm plastid proteins from C. cajan and 0.88 ± 0.19 mg/10 gm plastid proteins from C. scarabaeoides. The 2D-PAGE analysis revealed 678 ± 08 reproducible total protein spots from C. cajan and 597 ± 22 protein spots from C. scarabaeoides. Similarly, we found 566 ± 10 and 486 ± 14 reproducible chloroplast protein spots in C. cajan and C. scarabaeoides, respectively. We confirmed the plastid protein fractions through immunoblot analysis using antibodies against LHCb1/LHCⅡ type Ⅰ protein. We found both methods suitable for 2D-PAGE and mass spectrometry (MS). This is the first report on developing protocols for total and chloroplastic protein extraction of Cajanus spp. suitable for advanced proteomics research.
Læs mere Tjek på PubMedBMC Infectious Diseases, 15.08.2024
Tilføjet 15.08.2024
Abstract Background There is an increasing number of human immunodeficiency virus (HIV) reported cases among students in Southwest China. However, the data on HIV/sex-related knowledge, attitude toward sex, sexual behaviors, and correlates of pre-exposure prophylaxis (PrEP)-eligible behaviors among college students in this area is still limited. This study aimed to assess the prevalence of HIV/sex-related knowledge, sexual attitudes, sexual behaviors, and factors associated with PrEP-eligible behaviors among college students. Method An online survey from 2020 to 2021 based on a multistage stratified and cluster sampling method was conducted among college students in Southwest China, and a well-designed questionnaire collected data. Propensity score matching (PSM), logistic, and log-binomial regression were used to identify the determinants of PrEP-eligible behaviors. Result A total of 108,987 students participated in the survey, and 92,946 provided valid responses. 91.6% (85,145/92,946) had good HIV-related knowledge, while only 26.0% (24,137/92,946) reported awareness of sex-related knowledge. Furthermore, more than half of the participants (64.5%) held negative stances towards engaging in “one-night stand”, and 58.9% (617/1,047) reported PrEP-eligible behaviors. Log-binomial regression analysis indicated that unaware of HIV-related knowledge (aPR = 1.66, 95% CI:1.22–2.26, P = 0.001), not discussing about sex with their parent(s) (aPR = 1.16, 95% CI:1.01–1.33, P = 0.021), not receiving sex-related education in school(aPR = 1.24, 95% CI: 1.07–1.45, P = 0.005), not participating in HIV/AIDS prevention activities in the past year (aPR = 1.32, 95%CI:1.09–1.60, P = 0.004), experiencing forced sex (aPR = 2.08, 95% CI: 1.19–3.63, P = 0.010), and having the drug abuse (aPR = 22.21, 95% CI:5.59–88.31, P
Læs mere Tjek på PubMedSilva, Mayara ST.; Torres, Thiago S.; Coutinho, Carolina; Jalil, Emilia M.; Yanavich, Carolyn; Martins, Pedro S.; Bastos, Matheus O.; Mesquita, Maira B.; Echeverría-Guevara, Amanda; Nazer, Sandro; Peixoto, Eduardo M.; Terra, Marcela; Lovetro, Ana; Reges, Paula PS.; Meneguetti, Maria Roberta; Moreira, Ronaldo I.; Lessa, Flavia CS.; Hoagland, Brenda; Nunes, Estevão P.; Cardoso, Sandra Wagner; Veloso, Valdilea G.; Grinsztejn, Beatriz; the INI-Fiocruz Mpox Study Group
AIDS, 15.08.2024
Tilføjet 15.08.2024
Objective: To evaluate the prevalence and characteristics of concurrent bacterial sexually transmitted infections (bSTIs) among individuals with mpox. Design: Prospective cohort study of participants aged 18 years or older with confirmed mpox conducted in Rio de Janeiro, Brazil. This cross-sectional analysis include only participants who underwent bSTI testing at baseline between June 2022 and January 2024. Methods: Participants were offered testing for chlamydia/gonorrhea (NAAT, anorectal swabs) and syphilis (active diagnosis if VDRL ≥ 1/8). Baseline prevalence of bSTIs was calculated, and participant characteristics were described based on bSTI diagnosis (yes/no). Chi-squared/Fisher\'s tests were used for qualitative variables, and the Wilcoxon rank-sum test for quantitative variables. Results: Out of 634 enrolled participants, 538 (84.9%) were tested for STIs and included in this analysis, mostly cisgender men, aged 30–39 years with post-secondary education. Overall prevalence of concurrent bSTI was 37.3%, mainly syphilis, followed by chlamydia and gonorrhea. Half of the participants had HIV coinfection, and one-third were on PrEP. Concurrent bSTI diagnosis at the time of mpox assessment was associated with being aged 30–39 years, self-identifying as cisgender men, having HIV-positive status, reporting proctitis symptoms and reporting any STI in the past 12 months. Conclusions: Our data reveals a notable prevalence of concurrent STIs among participants with confirmed mpox at a prominent infectious diseases’ referral center in Rio de Janeiro, Brazil. These findings underscore the importance of integrating mpox into the differential diagnosis of anogenital manifestations and to promote combination prevention strategies within sexual health care services. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedBassi, S., Bahl, D., Maity, H., Dringus, S., Rizvi, Z. A., Kumar, D., Raina, A., Arora, M.
BMJ Open, 13.08.2024
Tilføjet 13.08.2024
BackgroundThe COVID-19 pandemic strained India’s healthcare system and health workers unprecedentedly. PurposeThe extent of the contribution by peer educators (PEs) from India’s National Adolescent Health Programme-Rashtriya Kishor Swasthya Karyakram (RKSK) to COVID-19 response activities remains uncertain necessitating an imperative investigation. Within the overarching objective of the ‘i-Saathiya’ study (‘i’ signifies implementation science and Saathiya represents PEs in Madhya Pradesh), a key focus was to understand the role of PEs recruited under RKSK during COVID-19 in two Indian states, namely Madhya Pradesh and Maharashtra. The study states differ in sociodemographic characteristics and peer education implementation models. MethodsIn-depth interviews (IDIs) were conducted with stakeholders (n=110, Maharashtra: 57; Madhya Pradesh: 53) engaged in the implementation of RKSK’s peer education programme at state, district, block and village levels. Focus group discussions (FGDs) (n=16 adolescents, Maharashtra: 8; Madhya Pradesh: 8) were conducted with adolescents, part of the peer group of PEs (n=120 adolescents, Maharashtra: 66; Madhya Pradesh: 54). IDIs and FGDs were audio-recorded, translated, transcribed verbatim and analysed thematically. Adopting inductive and deductive approaches, a data-driven open coding framework was developed for thematic analysis. ResultsThe PE recruited under RKSK took a central role that extended beyond their predefined responsibilities within the RKSK. They provided crucial support to healthcare workers in curbing the spread of COVID-19. Their diverse contributions, including COVID-19 pandemic response support, addressing community and adolescent needs, role in COVID-19 vaccination efforts, navigating access to the health system and facilitating health workers in the implementation of various national health programmes and campaigns during COVID-19. ConclusionThe findings underscore the potential of PEs in bolstering the health system. Despite their unpreparedness for the context (COVID-19), PEs demonstrated tenacity and adaptability, extending their roles beyond their predefined responsibilities. Recognising PEs through awards and incentives, skill courses and additional grades, can enhance their visibility, sustaining impactful work within RKSK and beyond.
Læs mere Tjek på PubMedYuan, Y., Dube, C. E., Xu, S., Lim, E., Qu, S., McPhillips, E., Lapane, K. L.
BMJ Open, 13.08.2024
Tilføjet 13.08.2024
IntroductionAsian American caregivers supporting loved ones with dementia experience greater burden and more stress than other racial/ethnic groups, warranting the need for more culturally and linguistically appropriate formal support, such as in nursing homes. Transitioning loved ones into nursing homes with dementia care units is a complex process that can be impacted by a multitude of factors. Employing several established frameworks, including the socioecological model, this qualitative study will focus on the largest Asian American subgroup (people of Chinese descent) and explore the experience of family caregivers as they support the transition of their loved ones with dementia into nursing homes in the USA. Our focus will be on the nuanced influences of the Chinese language and culture and COVID-19-related social isolation and racial discrimination. Methods and analysisRecruitment will take place starting in January 2024. Current or former Chinese caregivers for Chinese loved ones with dementia, able to communicate in Mandarin Chinese or English, and currently residing in the USA will be eligible. Key informants with intimate understanding and experience with this population will also be included. Data will be collected through 2024 using semistructured, in-depth interviews with each participant. Depending on participants’ preferences, interviews will be conducted in either Mandarin Chinese or English and either in person, via Zoom or by phone. Interviews will be transcribed verbatim. Iterative thematic analysis will be employed. A coding structure will be developed based on interview questions and themes and patterns that are revealed through data immersion. Transcripts, prepared in their original language, will be dual-coded by bilingual researchers using NVivo 14. Consensus summaries of themes will be prepared. Relevant direct quotes for each thematic area will be identified (those in Chinese will be translated into English) and cited in reports and manuscripts. Ethics and disseminationThe study is approved by the UMass Chan Medical School Institutional Review Board (ID: STUDY00001376). Findings will be published in peer-review journals following the consolidated criteria for reporting qualitative research.
Læs mere Tjek på PubMedBMC Infectious Diseases, 10.08.2024
Tilføjet 10.08.2024
Abstract Background It is important to assess the relationship between specific HPV genotype or multiple infection and cervical cytology. The protection provided by the HPV vaccine is type-specific, and the epidemiology feature of coinfections needs to be investigated. The aim is to provide baseline information for developing HPV vaccination and management of HPV-positive populations in the region. Methods A total of 3649 HPV-positive women were collected from 25,572 women who underwent 15 HR-HPV genotypes and ThinPrep cytologic test (TCT) results. Logistic regression was used to determine the correlation between the risk of cytology abnormalities and specific HPV infection. We calculated odds ratios (ORs) to assess coinfection patterns for the common two-type HPV infections. chi-squared test was used to estimate the relationship between single or multiple HPV (divided into species groups) infection and cytology results. Results The results showed there was a positive correlation between HPV16 (OR = 4.742; 95% CI 3.063–7.342) and HPV33 (OR = 4.361; 95% CI 2.307–8.243) infection and HSIL positive. There was a positive correlation between HPV66 (OR = 2.445; 95% CI 1.579–3.787), HPV51 (OR = 1.651; 95% CI 1.086–2.510) and HPV58(OR = 1.661; 95% CI 1.166–2.366) infection and LSIL. Multiple HPV infections with α9 species (OR = 1.995; 95% CI 1.101–3.616) were associated with a higher risk of high-grade intraepithelial lesions (HSIL) compared with single HPV infection. There were positive correlations between HPV66 and HPV56 (α6) (OR = 3.321; 95% CI 2.329–4.735) and HPV39 and HPV68 (α7). (OR = 1.677; 95% CI 1.127–2.495). There were negative correlations between HPV52, 58, 16 and the other HPV gene subtypes. Conclusion HPV33 may be equally managed with HPV16. The management of multiple infections with α9 may be strengthened. The 9-valent vaccine may provide better protection for the population in Chongqing currently. The development of future vaccines against HPV51 and HPV66 may be considered in this region.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.08.2024
Tilføjet 9.08.2024
Abstract Background This study aimed to determine the prevalence and factors associated with susceptibility to hepatitis B virus (HBV) among cisgender men who have sex with men (MSM) on HIV pre-exposure prophylaxis (PrEP) in Northeastern Brazil. Methods This was a cross-sectional, analytical study conducted between September 2021 and June 2023. Participants underwent structured interviews to collect sociodemographic and clinical information, including hepatitis B vaccination history, HIV PrEP use and sexual health history. Blood samples were collected for hepatitis B serologic testing: HBV surface antigen (HBsAg), HBV surface antibody (anti-HBs), total and IgM HBV core antibody (anti-HBc). HBV susceptibility was defined as nonreactive results for all these serological markers. Results A total of 287 participants were enrolled into the study. The median age of the individuals was 31 years (interquartile range: 27; 36). HBV susceptibility was found in 58 out 286 individuals (20.3%; 95% CI: 15.9–25.2). Seventy-six percent of the participants reported completing the three-dose hepatitis B vaccine schedule. Susceptibility was significantly associated with a monthly income ≤ 5 minimum wages (PR: 2.02; 95% CI: 1.01–4.05), lack of complete hepatitis B vaccination schedule (PR: 4.52; 95% CI: 2.89–7.06), initiation of HIV PrEP (PR: 2.18; 95% CI: 1.21–3.94), duration of six months of HIV PrEP (PR: 2.16; 95% CI: 1.19–3.91), absence of tattoos (PR: 1.55; 95% CI: 1.00–2.40) and no history of sexually transmitted infections (PR: 1.65; 95% CI: 1.07–2.54). Conclusion Our findings highlight the significant burden of HBV susceptibility among MSM on HIV PrEP in Northeastern Brazil. Socioeconomic factors, vaccination status, PrEP use and sexual health behaviors play critical roles in determining susceptibility to HBV. Integrating hepatitis B screening and vaccination into PrEP services is critical for identifying and addressing HBV susceptibility among MSM. Interventions aimed at increasing vaccination coverage and promoting safer sexual practices are essential for mitigating the burden of HBV infection in this population.
Læs mere Tjek på PubMedZewdie, Kidist; Muwonge, Timothy; Ssebuliba, Timothy; Bambia, Felix; Badaru, Josephine; Nampewo, Olivia; Stein, Gabrielle; Mugwanya, Kenneth K.; Thomas, Katherine K.; Wyatt, Christina; Yin, Michael T.; Wang, Guohong; Gandhi, Monica; Mujugira, Andrew; Heffron, Renee
AIDS, 9.08.2024
Tilføjet 9.08.2024
Objectives: We evaluated a recently developed and validated point-of-care urine tenofovir (POC TFV) test to determine whether its use improves the accuracy of self-reported adherence to pre-exposure prophylaxis (PrEP) and sexual behavior. Design: We enrolled sexually active HIV-negative women ages 16–25 years in Kampala, Uganda. Methods: Women were followed quarterly for 24 months with HIV prevention counseling, PrEP dispensation, and adherence counseling. Midway through the study, the POC TFV test was introduced as part of routine study procedures. We examined changes in self-reported PrEP adherence, sexual behavior, and accuracy of self-reported PrEP adherence before and after the introduction of the POC TFV test. Results: A total of 146 women receiving PrEP refills had ≥1 visit with a POC TFV test administered before the study exit. At baseline, the median age was 19 years (interquartile range [IQR]: 18–21) and the majority (76%) reported having condomless sex within the last three months. Participants more frequently self-reported low PrEP adherence (OR: 2.96, 95% confidence interval [CI]: 1.89–4.67, p = 0.001) and condomless sex (OR: 1.47, 95% CI: 1.04–2.06, p = 0.03) during visits using the test compared to visits without the test. The accuracy of self-reported PrEP adherence (determined by concordance with TFV-diphosphate levels) was greater when the test was used (61% versus 24%, OR: 4.86, 95% CI: 2.85–8.30, p
Læs mere Tjek på PubMedSonia Muliyil
Nature, 8.08.2024
Tilføjet 8.08.2024
Malaria Journal, 6.08.2024
Tilføjet 6.08.2024
Abstract Background More than 95% of malaria transmission in Brazil occurs in the Legal Amazon Region, which in 2010 recorded around 333,429 cases reported in the Epidemiological Surveillance Information System-Malaria (Sivep_malaria), presenting an annual parasitic incidence (IPA) of 13.1 cases/1000 inhabitants. Methods This was a descriptive study that measured the community prevalence of Plasmodium infection and its relationship with land use in Três Fronteiras District, Colniza Municipality, Mato Grosso State. Data were collected during household visits in July 2011, with blood collection from finger pricks for the preparation of thick smear slides, and completion of a standardized case notification form. A georeferenced database was analysed, with land use evaluated as categorical variables. A kernel density map was built to show the density of cases and their location. Results Of the 621 respondents, 68(11%) had Plasmodium infection: 39 (57.4%) with Plasmodium vivax, 27(39.7%) with Plasmodium falciparum and two (2.9%) with mixed infections. Among infected individuals, 49 (72.1%) were men. Cases of malaria were distributed over the district, with greater occurrence of cases per household in open areas close to the mining company and artisanal mining sites. The was a greater density of cases located in the gold mining region. Conclusion Transmission of malaria in Três Fronteiras District has a heterogeneous distribution. Individuals residing in mining and timber extraction sites have increased occurrence of Plasmodium infection.
Læs mere Tjek på PubMedFarooq, S., Donnan, J. R., Lukewich, J., Mathews, M., Lee, T. A.
BMJ Open, 6.08.2024
Tilføjet 6.08.2024
ObjectivesTo explore the experiences and perspectives of community pharmacists regarding their roles during the closure stage (ie, March to May 2020) of the COVID-19 pandemic in Newfoundland and Labrador (NL), Canada. DesignThis qualitative case study included a document analysis and semistructured interviews with community pharmacists who provided direct patient care during the COVID-19 pandemic. The document analysis was used to develop a chronology that informed the interviews. Themes from qualitative interviews were developed through iterative cycles of data review and analysis using applied thematic analysis. Findings are presented specifically for the time period between March and May 2020, defined as the ‘Closure Stage’. SettingCommunity pharmacies in NL, Canada. Results12 community pharmacists participated in the interviews. Four themes were developed including (1) pharmacists’ leadership in continuity of care, (2) pharmacists as medication stewards, (3) pharmacists as a source of COVID-19 health information and (4) the impact of COVID-19 on pharmacists’ mental health and well-being. The first three themes described the key roles played by community pharmacists during the early days of the COVID-19 pandemic, including coordinating care, prescribing for common ailments, delivering medications and supplies, providing information on COVID-19 symptoms and their management, renewing chronic medications and protecting the medication supply. Unclear guidance on scope of practice, limited scope of practice, inadequate staffing and limited support from government bodies were identified as barriers to these roles. Facilitators included access to a delivery service, swift regulatory changes, reimbursement and support from colleagues and other healthcare professionals. The fourth theme is presented independently, emphasising the impact of working within the primary healthcare (PHC) system during the COVID-19 pandemic on pharmacists’ mental health and well-being. ConclusionPharmacists played a critical role in the delivery of PHC services during the closure stage of the COVID-19 pandemic. The findings of this research highlight the essential elements of a strong PHC pandemic preparedness plan that is inclusive of community pharmacists, including improved communication strategies, mental health support and access to resources.
Læs mere Tjek på PubMedBMC Infectious Diseases, 6.08.2024
Tilføjet 6.08.2024
Abstract Background The GeneXpert MTB/RIF (Xpert) assay is a widely used technology for detecting Mycobacterium tuberculosis (MTB) in clinical samples. However, the study on the failure of the Xpert assay during routine implementation and its potential solutions is limited. Methods We retrospectively analyzed the records of unsuccessful tests in the Xpert and the GeneXpert MTB/RIF Ultra (Ultra) assays between April 2017 and April 2021 at the Shanghai Public Health Clinical Center. To further investigate the effect of prolonged preprocessing on clinical sputum, an additional 120 sputum samples were collected for Xpert testing after 15 min, 3 h, and 6 h preprocessing. The analysis was performed by SPSS version 19.0 software. Results A total of 11,314 test records were analyzed, of which 268 (2.37%) had unsuccessful test results. Among these, 221 (1.95%) were reported as “Error”, 43 (0.38%) as “Invalid”, and 4 (0.04%) as “No result”. The most common clinical specimen for Xpert tests was sputum, accounting for 114 (2.17%) unsuccessful tests. The failure rate of urine specimens was lower than that of sputum (OR = 0.12, 95% CI: 0.02–0.88, χ2 = 6.22, p = 0.021). In contrast, the failure rate of stool specimens was approximately twice as high as that of sputum (OR = 1.93, 95% CI: 1.09–3.40, χ2 = 5.35, p = 0.014). In the prolonged preprocessing experiment, 102 cases (85%) yielded consistent results in Xpert tests. Furthermore, 7 cases (5.83%) detected an increase in MTB load, 8 cases (6.67%) detected a decrease in MTB load, and 3 cases (2.5%) yielded incongruent results in MTB and rifampicin resistance detection. Conclusions The primary cause of unsuccessful tests in the Xpert assay was reported as “Error”. Despite varying failure rates depending on the samples, the Xpert assay can be applied to extrapulmonary samples. For paucibacillary specimens, retesting the remaining preprocessed mixture should be carefully considered.
Læs mere Tjek på PubMedEllerbroek, H., Schellekens, A. F. A., Kalkman, G. A., Visser, D. A., Kramers, C., Dahan, A., van den Heuvel, S. A. S., Bouvy, M. L., van Dorp, E. L. A.
BMJ Open, 4.08.2024
Tilføjet 4.08.2024
ObjectivesThe COVID-19 pandemic and related lockdown measures disrupted global healthcare provision, including opioid prescribing. In North America, opioid sales declined while opioid-related deaths increased. In Europe, the effect of the pandemic on prescribing is not yet known. Given the ongoing increase in opioid-related harm and mortality, it is crucial to analyse the impact of the COVID-19 crisis and lockdown measures on opioid prescribing. Therefore, the objective of this study was to characterise opioid prescribing in the Netherlands during the COVID-19 pandemic. DesignA nationwide register-based study characterising opioid prescribing using aggregated insurance reimbursement data. SettingDutch healthcare during the first 2 years of the COVID lockdown. ParticipantsThe whole Dutch population. Primary and secondary outcome measuresComparing the number of opioid prescriptions during the pandemic with a prepandemic period using a risk ratio (RR), with separate analysis on the prescription type (first-time or repeat prescription), patients’ sex, age and socioeconomic status. We also explored lockdown effects. ResultsDuring the first lockdown, the total number of new opioid prescriptions and prescriptions to young patients (briefly) decreased (RR 0.88, 95% CI 0.88 to 0.89 and RR 0.73, 95% CI 0.70 to 0.75, respectively), but the overall number of opioid prescriptions remained stable throughout the pandemic compared with prepandemic. Women, older patients and patients living in lower socioeconomic areas received more opioids per capita, but the pandemic did not amplify these differences. ConclusionsThe pandemic appears to have had a limited impact on opioid prescribing in the Netherlands. Yet, chronic use of opioids remains an important public health issue.
Læs mere Tjek på PubMedBMC Infectious Diseases, 2.08.2024
Tilføjet 2.08.2024
Abstract Background The GeneXpert MTB/RIF (Xpert) assay is a widely used technology for detecting Mycobacterium tuberculosis (MTB) in clinical samples. However, the study on the failure of the Xpert assay during routine implementation and its potential solutions is limited. Methods We retrospectively analyzed the records of unsuccessful tests in the Xpert and the GeneXpert MTB/RIF Ultra (Ultra) assays between April 2017 and April 2021 at the Shanghai Public Health Clinical Center. To further investigate the effect of prolonged preprocessing on clinical sputum, an additional 120 sputum samples were collected for Xpert testing after 15 min, 3 h, and 6 h preprocessing. The analysis was performed by SPSS version 19.0 software. Results A total of 11,314 test records were analyzed, of which 268 (2.37%) had unsuccessful test results. Among these, 221 (1.95%) were reported as “Error”, 43 (0.38%) as “Invalid”, and 4 (0.04%) as “No result”. The most common clinical specimen for Xpert tests was sputum, accounting for 114 (2.17%) unsuccessful tests. The failure rate of urine specimens was lower than that of sputum (OR = 0.12, 95% CI: 0.02–0.88, χ2 = 6.22, p = 0.021). In contrast, the failure rate of stool specimens was approximately twice as high as that of sputum (OR = 1.93, 95% CI: 1.09–3.40, χ2 = 5.35, p = 0.014). In the prolonged preprocessing experiment, 102 cases (85%) yielded consistent results in Xpert tests. Furthermore, 7 cases (5.83%) detected an increase in MTB load, 8 cases (6.67%) detected a decrease in MTB load, and 3 cases (2.5%) yielded incongruent results in MTB and rifampicin resistance detection. Conclusions The primary cause of unsuccessful tests in the Xpert assay was reported as “Error”. Despite varying failure rates depending on the samples, the Xpert assay can be applied to extrapulmonary samples. For paucibacillary specimens, retesting the remaining preprocessed mixture should be carefully considered.
Læs mere Tjek på PubMed