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Malaria Journal, 17.10.2024
Tilføjet 17.10.2024
Abstract Background Malaria in pregnancy (MiP) is a public health concern especially for pregnant women living in slums. The World Health Organization recommends at least three doses of Sulfadoxine-Pyrimethamine (SP) to prevent MiP. In Ghana, it is recommended that pregnant women receive a minimum of five doses of the medication. This study sought to determine the level of adherence to IPT5 policy and factors associated with adherence among pregnant women in a slum community in Ghana. Methods This was a cross-sectional study involving 232 nursing mothers and four healthcare workers at the St. Martin’s Memorial Hospital, Sukura, Ghana. Sociodemographic characteristics of nursing mothers were obtained using an interview-administered questionnaire. Data on the number of SP doses and other obstetrics characteristics were collected by reviewing the antenatal record books. To obtain information about healthcare and health system factors associated with adherence to the five-dose policy, four healthcare providers were interviewed. A data extraction form was used to obtain information about the availability of SP at the facility. Results The level of adherence to IPT5 was 8.6% (20/232) (95% CI 5.0–12.3) among the participants. Only 8.4% of the participants received their first dose at 16 weeks. Respondents who began ANC in the second trimester were 81% less likely to adhere to IPT5 than those who began in the first trimester (aOR = 0.19, 95% CI 90.01–0.65, p
Læs mere Tjek på PubMedInfection, 17.10.2024
Tilføjet 17.10.2024
Abstract Purpose Since winter 2022, invasive GAS (iGAS) infections have re-emerged in Europe, causing severe diseases in children and adults. We aimed to examine whether this reported post-pandemic increase was associated with an increased disease severity and/or a shift in clinical disease phenotypes. Methods We performed detailed clinical phenotyping of patients hospitalized with iGAS infections at a 1410-bed tertiary German Medical Center from 01/2015 to 09/2023. Results One hundred seventy-eight patients were included: 50 children (28.1%) and 128 adults (71.9%). IGAS infections of Q1/2023 exceeded the pre-pandemic average by 551% (1200% for children). The mean age of affected patients shifted significantly post-pandemically (49.5 ± 26.5 to 32.4 ± 28.2 years of age, p
Læs mere Tjek på PubMedInfection, 17.10.2024
Tilføjet 17.10.2024
Abstract Purpose This study aims to use bibliometric methods to explore the evolving landscape, hotspots, and emerging frontiers of pertussis vaccine research, providing deeper insights into the current research landscape and guiding future vaccine development efforts. Methods We conducted a comprehensive search of the Web of Science Core Collection database (WoSCC) from January 1, 1994, to December 31, 2023, employing search terms related to vaccination (vacc* or immun*) and pertussis (pertussis, Whooping Cough, Bordetella pertussis, B. pertussis, Bordetella pertussis infection, or B. pertussis infection) in the Title or Author keywords fields. Bibliometrics analysis of pertussis research was performed utilizing the bibliometrix-biblioshiny package in RStudio, alongside CiteSpace and VOSviewer software. Results In total, 2,623 records were analyzed, comprising 89.63% (n = 2,351) original research articles and 10.37% (n = 272) review articles. The study revealed that academic research on the pertussis vaccine was growing at a rate of 4.64% per year. The United States and Canada lead in the number of publications. GlaxoSmithKline and the Centers for Disease Control & Prevention– United States emerged as leading institutions, with Halperin SA and Locht C as the most active authors. Vaccine was the most influential journal. Most studies focused on vaccine effectiveness duration, vaccination schedules for high-risk groups, and people’s attitudes toward vaccination. Conclusion Our analysis showed increasing interest of researchers in pertussis literature, yet current research mainly emphasized expanding vaccine coverage and optimizing strategies, neglecting new vaccine development. This emphasized the need for prioritizing novel pertussis vaccines to tackle the resurgence challenge.
Læs mere Tjek på PubMedInfection, 17.10.2024
Tilføjet 17.10.2024
Abstract Purpose In the 2020 emergence of SARS-CoV-2, global response lacked unified treatment and surveillance, resulting in diverse impacts due to varied healthcare resources and national guidelines. Germany and Switzerland curbed the virus initially by promptly tracking and testing, bolstered by strong governmental capacity. This study aimed to assess country-specific healthcare disparities and their impact on ICU admission rates, mechanical ventilation, and in-hospital mortality. Methods To enhance healthcare quality using real-world data, the “Initiative of Quality Medicine” (IQM) was established. Pseudonymised routine data from participating hospitals, during 01/01/2019–31/12/2022, was retrospectively analysed, focusing on patients with SARI ± SARS-CoV-2-infection (U07.1). Cohorts were matched based on various factors and multivariable analyses included logistic regression. Results 1.421.922 cases of SARI ± U07.1 involving 386 German and 41 Swiss hospitals were included. Patients in Germany were older (mean: 69.4 vs. 66.5 years) and had more comorbidities than in Switzerland (p
Læs mere Tjek på PubMedZhang Lu, Tian Pu, Li Boning, Xu Ling, Qiu Lihua, Bi Zhaori, Chen Limei, Sui Long
Journal of Medical Virology, 17.10.2024
Tilføjet 17.10.2024
Elisa de A. N. Azevedo, Alexandre F. da Silva, Verônica G. da Silva, Lais C. Machado, Gustavo B. de Lima, Bruno I. M. Ishigami, Keilla M. Paz e Silva, Mayara M. de O. M. da Costa, Diego A. Falcão, Andreza P. Vasconcelos, Clintiano C. da Silva, Felipe G. Naveca, Matheus F. Bezerra, Tulio de L. Campos, Bartolomeu Acioli‐Santos, Marcelo H. S. Paiva, Clarice N. L. de Morais, Gabriel L. Wallau
Journal of Medical Virology, 17.10.2024
Tilføjet 17.10.2024
Alberto Rizzo, M. Mendola, F. Salari, Alessandra Lombardi, M. Longo, Andrea Giacomelli, P. Carrer, Maria Rita Gismondo
Journal of Medical Virology, 17.10.2024
Tilføjet 17.10.2024
Manuel Gil‐Mosquera, Ruth Gómez‐Guerra, Elena Sanz‐Rodríguez, Aránzazu Mata‐Martínez, Francisco López‐Medrano, Rafael San Juan, Julia Origüen, Lorena Castro‐Arias, José María Aguado, Mario Fernández‐Ruiz
Journal of Medical Virology, 17.10.2024
Tilføjet 17.10.2024
Xiaoping Huang, Xueliang Huang, Yushao Li, Lixia Li, Jiaman Liao, Hao Huang, Ying Zhao, Yiqiang Zhan
Journal of Medical Virology, 17.10.2024
Tilføjet 17.10.2024
Rogers, Brooke; Ramsey, Susan; Ames, Evan; Gomes, Nyx; Murphy, Matthew
Journal of Acquired Immune Deficiency Syndromes, 17.10.2024
Tilføjet 17.10.2024
Introduction: Within the United States, individuals experiencing incarceration are at higher risk for HIV acquisition compared to the general population, yet may face additional difficulty engaging in HIV prevention clinical services. HIV pre-exposure prophylaxis (PrEP) is an effective approach to preventing HIV transmission, and the Centers for Disease Control (CDC) recommends that PrEP be offered in carceral settings, particularly during the vulnerable community re-entry period. However, there have been few efforts to scale PrEP in this setting. Methods: Based on our experience implementing PrEP in Rhode Island’s state carceral system, we have identified potential approaches to overcoming barriers to PrEP use in this unique practice environment by utilizing the implementation research logic model (IRLM). We then evaluated specific implementation determinants and barriers as well as strategies used to overcome those barriers to effectively scale PrEP in this setting. Results: We developed a “toolkit,” or 14-step guide, for others in the field to use for implementing PrEP in carceral settings including the development and use of clinical protocols as well as community linkage strategies. Discussion: Our experiences with barriers in the carceral setting, identifying and leveraging implementation strategies, allowed us to develop a “toolkit” to guide other PrEP implementation projects in carceral settings. We encourage others to scale-out our work to other carceral settings to better reach and engage a group of individuals both at elevated risk for HIV and currently underserved by HIV prevention strategies, including PrEP. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedWanitchaya Kittikraisak, Yeny Tinoco, Min Z. Levine, Joshua A. Mott, Wiboon Kanjanapattanakul, Cesar Munayco, Boonsong Rawangban, Danielle Rentz Hunt, Sarita Mohanty, Meredith Wesley, Giselle Soto, Richard Florian, Oswaldo Gonzales, Santiago Cabrera, Edwin Llajaruna, Suvanna Asavapiriyanont, Damon W. Ellison, Parker Malek, Eduardo Azziz-Baumgartner, Fatimah S. Dawood
International Journal of Infectious Diseases, 17.10.2024
Tilføjet 17.10.2024
The World Health Organization (WHO) recommends prioritizing pregnant persons for influenza vaccination and influenza vaccines have been shown to effectively reduce the risk of influenza illness among both pregnant people and their infants during the first few months of life.[1] However, use of influenza vaccines among pregnant persons remains low globally, in part because of insufficient information about the local burden of influenza. A WHO systematic review from 2017 highlighted the continued paucity of data about influenza disease burden among pregnant persons in low- and middle-income countries.[2,3]
Læs mere Tjek på PubMedYun Sang Tang, Chee Wah Tan, Ka Chun Chong, Chunke Chen, Yuanxin Sun, Karen Yiu, Kwun Cheung Ling, Ken KP Chan, Malik Peiris, Chris Ka Pun Mok, David S Hui
International Journal of Infectious Diseases, 17.10.2024
Tilføjet 17.10.2024
Since its emergence in January 2020, SARS-CoV-2, the causative agent of COVID-19, has evolved from the ancestral Wuhan strain into multiple variants, including Alpha, Beta, Gamma, Delta, Mu, and Omicron. The Omicron lineage first appeared as BA.1 in early 2022 and subsequently evolved into BA.2, BA.4/5, and XBB variants. In August 2023, the EG.5 subvariant of XBB emerged, followed by the antigenically distinct JN.1 variant in early 2024, which evolved from the BA.2.86 lineage. More recently, the JN.1 variant further evolved into a descendant strain, KP.2, which has been causing increasing numbers of infections since April 2024 [1–3].
Læs mere Tjek på PubMedRemidius Kakulu, Josephine Kapinga, Sima Rugarabamu, Elison Kemibala, Medard Beyanga, Peter M Mbelele, Khalid Massa, Esther G. Kimaro, Emmanuel Mpolya
International Journal of Infectious Diseases, 17.10.2024
Tilføjet 17.10.2024
Yellow fever (YF) is an acute viral illness caused by the yellow fever virus, a member of the Flaviviridae family. It is transmitted through the bites of infected mosquitoes, predominantly the Aedes aegypti species [1]. Yellow fever poses a significant public health threat in tropical regions of Africa and the southern America, characterized by sporadic outbreaks and a potential for large-scale epidemics [2-4]. The disease manifests as a spectrum of symptoms, ranging from mild febrile illness to severe hepatitis and haemorrhagic fever.
Læs mere Tjek på PubMedChutchawan Ungthammakhun, Vasin Vasikasin, Waristha Simsiriporn, Piraporn Juntanawiwat, Dhitiwat Changpradub
International Journal of Infectious Diseases, 17.10.2024
Tilføjet 17.10.2024
Acinetobacter baumannii has attracted increasing attention from clinicians worldwide due to its persistently rising levels of antimicrobial resistance and its role in causing nosocomial infections [1]. Its ability to acquire or upregulate various resistance determinants, leading to resistance against multiple classes of antibiotics, poses a significant challenge to current antibiotic therapies [2]. Therefore, the World Health Organization (WHO) has designated carbapenem-resistant A. baumannii (CRAB) as a critical priority pathogen [3].
Læs mere Tjek på PubMedElisa de Lazzari, Daniel K. Nomah, Jose L. Blanco, Naira Rico, Xabier Filella, Natalia Egri, Raquel Ruiz, Maria Angeles Marcos, Maria del Mar Mosquera, Jose Alcamí, Sonsoles Sánchez-Palomino, Andreu Bruguera, Carmen Hurtado, Cristina Rovira, Juan Ambrosioni, Iván Chivite, Ana González-Cordón, Alexy Inciarte, Montserrat Laguno, María Martínez-Rebollar, Lorena de la Mora, Berta Torres, Yesika Díaz, Esteban Martínez, Josep Mallolas, Jose M. Miro, Hospital Clinic HIV investigators
International Journal of Infectious Diseases, 17.10.2024
Tilføjet 17.10.2024
Studies on HIV and COVID-19 coinfection are inconclusive especially in the context of unvaccinated individuals.[1] The severity of COVID-19 outcomes among people with HIV (PWH) can vary based on specific settings, health system conditions, and individual clinical attributes such as age and comorbidities.[2] The protective role of antiretroviral therapy (ART), particularly tenofovir, has been a subject of debate. The inclination towards tenofovir as a viable treatment option for SARS-CoV-2 infection stems from the nucleotide analogue\'s capacity to inhibit RNA-dependent RNA polymerase, a pivotal enzyme for SARS-CoV-2 replication, [3] with tenofovir disoproxil fumarate (TDF) exhibiting higher plasma concentrations compared to tenofovir alafenamide (TAF).[4] Nevertheless, the clinical effectiveness of tenofovir in COVID-19 patients remains uncertain, with conflicting findings emerging from studies among PWH.[1] The study aimed to determine the prevalence of SARS-CoV-2 infection among unvaccinated PWH and to explore the impact of different factors including ART on the SARS-CoV-2 acquisition and COVID-19 severity.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 17.10.2024
Tilføjet 17.10.2024
Abstract Background Both HIV and hepatitis C virus (HCV) infection increase the risk of hepatic steatosis (HS), which in turn contributes to the severity and progression of liver disease. Direct acting antivirals (DAAs) can cure HCV but whether they reduce HS is unclear.Methods HS was assessed using the controlled attenuation parameter (CAP) and the hepatic steatosis index (HSI) in participants coinfected with HIV-HCV from the Canadian Coinfection Cohort. Changes in HS, before, during and after successful DAA treatment, were estimated using generalized additive mixed models, adjusted for covariates measured prior to treatment (age, sex, duration of HCV infection, body mass index, diabetes, prior exposure to dideoxynucleosides and hazardous drinking).Results 431 participants with at least one measure of CAP or HSI before treatment were included. CAP steadily increased over time: adjusted annual slope 3.3 dB/m (95% credible interval (CrI) 1.6, 4.9) before, and 3.9 dB/m (95% CrI: 1.9, 5.9) after DAA treatment, irrespective of pre-treatment CAP. In contrast, HSI changed little over time: annual slope 0.2 (95% CrI: -0.1, 0.5) before and 0.2 (95% CrI -0.1, 0.5) after, but demonstrated a marked reduction during treatment -4.5 (95% CrI -5.9, -3.1).Conclusions When assessed by CAP, HS was unaffected by DAA treatment and steadily increased over time. In contrast, HSI did not appear to reflect changes in HS, with the decrease during treatment likely related to resolution of hepatic inflammation. Ongoing HS may pose a risk for liver disease in coinfected people cured of HCV.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 17.10.2024
Tilføjet 17.10.2024
Abstract The development of SARS-CoV-2 next-generation vaccines with the potential for increased effectiveness, durability, breadth, and ability to decrease transmission are of public health importance. We highlight alternative routes of administration of next-generation SARS-CoV-2 vaccines such as mucosal and intradermal administration.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 17.10.2024
Tilføjet 17.10.2024
Abstract Background Drug-resistant tuberculosis is a growing public health threat, and early characterization of the resistance phenotype is essential for guiding treatment and mitigating the high mortality associated with the disease. However, the slow growth rate of Mycobacterium tuberculosis, the causative agent of tuberculosis, necessitates several weeks for conventional culture-dependent drug susceptibility testing (DST). In addition, there are no widely available molecular diagnostic assays for evaluating resistance to newer tuberculosis drugs or drugs with complex resistance mechanisms.Methods We have developed a luciferase-based reporter mycobacteriophage assay that can determine drug resistance within 48 hours. We engineered the TM4 mycobacteriophage to express green enhanced nanoluciferase (GeNL) cassette and optimized DST for bedaquiline, pretomanid, linezolid, clofazimine, and rifampicin using clinical M. tuberculosis isolates.Results To assess the feasibility of this assay, we conducted a proof-of-principle study using 53 clinical M. tuberculosis isolates. TM4::GeNL phage DST effectively distinguished between sensitive and resistant isolates for bedaquiline and rifampicin at a concentration of 0.125 μg/mL. Optimal differentiation between sensitive and resistant isolates for pretomanid, clofazimine, and linezolid was achieved at concentrations of 0.5 μg/mL, 0.25 μg/mL, and 1 μg/mL, respectively. Additionally, TM4::GeNL DST identified low-level rifampicin resistance in clinical isolates even though they were classified as sensitive by Mycobacteria Growth Indicator Tube DST.Conclusions TM4::GeNL reporter phage DST offers a rapid method to identify M. tuberculosis drug resistance, including resistance to newer tuberculosis drugs.
Læs mere Tjek på PubMedMaiken Cavling Arendrup, Shawn R. Lockhart, Nathan Wiederhold
Clinical Microbiology and Infection, 17.10.2024
Tilføjet 17.10.2024
Reported amphotericin B resistance rates for Candida auris vary considerably. This may reflect clinically relevant differences in susceptibility, technical issues with testing or adoption of a clinical breakpoint (BP) that bisects the wild-type population. We compared reference methods and two gradient diffusion strips using a shared C. auris strain collection.
Læs mere Tjek på PubMedMaëli van Waasdijk, Suzanne D. van der Werff, Daniel Sjöholm, Katja Wyss, Hilmir Asgeirsson, Pontus Naucler, Anna Färnert, Ana Requena-Méndez
Clinical Microbiology and Infection, 17.10.2024
Tilføjet 17.10.2024
The aim of this study was to determine predictors for helminthiasis among travellers and migrants with eosinophilia for which a visto to tropical regions or endemic regions for common helminthiasis had been registered.
Læs mere Tjek på PubMedTomas, A., Wettermark, B., Nyberg, F., Hajiebrahimi, M.
BMJ Open, 17.10.2024
Tilføjet 17.10.2024
ObjectivesAntihypertensives reduce the risk of myocardial infarction and stroke. Restrictions during the COVID-19 pandemic limited access to healthcare, which may have had a negative impact on drug prescribing. This study aimed to assess the effect of the COVID-19 pandemic on the initiation of antihypertensive drugs. DesignInterrupted time series study using a segmented linear regression model. SettingSwedish population assessed through linked national healthcare registers. Participants720 300 new users of antihypertensives. InterventionMarch 2020, COVID-19 pandemic onset. Main outcomes measuresThe change in the initiation of antihypertensives expressed as monthly cumulative incidence, stratified by age and sex. Data on dispensed prescriptions of diuretics, beta-blockers, calcium channel blockers, ACE inhibitors (ACEi) and angiotensin receptor blockers were extracted from the Swedish Prescribed Drug Register, from March 2018 to November 2021. Initiation (new use) was defined as having no previous dispensations before March 2019. Monthly cumulative incidence in March 2019–November 2021 was calculated as the number of patients initiating each drug class in each month divided by the population. ResultsThe start of the pandemic was associated with an immediate drop in the initiation of any antihypertensive, but no sustained effects were observed, as the incidence continued to increase in the postinterruption period by +0.02% each month in both sexes. The immediate drop was statistically significant for ACEi in both sexes and all antihypertensive classes except diuretics in patients >65 years. A significant postintervention trend change was observed for initiation of diuretics (+0.013% overall), driven mainly by a significant increase in patients >65 years. Similar findings were also observed for diuretics in females (+0.02%) and ACEi (+0.03%) in patients >65 years. ConclusionsThe pandemic had an immediate negative short-term effect, but we found no major long-term negative influence of the COVID-19 pandemic on initiation of any type of antihypertensive drugs.
Læs mere Tjek på PubMedScreti, C., Atkinson, L., Shaw, R., Muhammed, R., Heath, G.
BMJ Open, 17.10.2024
Tilføjet 17.10.2024
IntroductionTreatment non-adherence is common in young people with inflammatory bowel disease (IBD), yet support is lacking. A self-led self-management intervention supporting teens with IBD (ASSIST-IBD) is a new theory-based digital treatment adherence intervention, co-developed by young people living with IBD. ASSIST-IBD includes 10 short modules supporting adolescents to feel confident to follow their treatment plan, develop skills to overcome adherence obstacles, feel confident when talking to others about IBD and feel positive about the future. This research aims to determine the feasibility of implementing and measuring the effectiveness of ASSIST-IBD, using a single-arm mixed-methods feasibility trial. Methods and analysis24 young people (aged 13–17) with IBD identified as being ≤80% adherent, and their parents, will use ASSIST-IBD for 6–12 weeks. For the primary endpoint of progression to randomised controlled trial, qualitative and quantitative data will be collected on; number of eligible members of the target population; number of recruited participants; reasons for non-participation and ineligibility; retention and follow-up rates; reasons for early withdrawal; completeness and utility of outcome measures; as well as further data on intervention acceptability, user experiences and user engagement. Secondary outcomes of preliminary effectiveness will include pre-intervention and post-intervention measures of treatment adherence (MARS-5), quality-of-life (IMPACT-III) and well-being (WEMWBS), and self-reported behaviour change success. Quantitative data will be analysed using descriptive statistics; qualitative data will be analysed thematically. An active patient and public involvement and engagement group will advise on the research throughout, including the development of the protocol. Ethics and disseminationThe study has been granted ethical approval by Aston University’s Health and Life Sciences Research Ethics Committee (ref:#HLS2112) and NHS Research Ethics Committee, Nottingham 1 Board (IRAS:#344918). Findings will be disseminated via peer-reviewed publications and lay summaries. Registration detailsThis protocol is registered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/KC649).
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.10.2024
Tilføjet 17.10.2024
Abstract Background The diagnosis of healthcare-associated ventriculitis and meningitis (HCAVM) can be complex because multiple factors confound the interpretation of cerebrospinal fluid (CSF) tests. The cell index (CI) may help in the diagnosis of HCAVM. It does not incur additional medical cost and it avoids delays from the turnaround time of CSF cultures. It is derived by calculating the ratio of CSF white blood cell (WBC) and red blood cell (RBC) divided by the ratio of peripheral WBC and RBC. This study aimed to evaluate the diagnostic utility of this parameter. Methods An analytic, observational, cross-sectional study was conducted at the University of the Philippines – Philippine General Hospital. All admitted pediatric and adult patients from 2015 to 2022 who underwent external ventricular drain (EVD) insertion for hydrocephalus secondary to intracranial hemorrhage (ICH), acute ischemic stroke, intracranial neoplasms, traumatic brain injury, or congenital hydrocephalus were screened. Records of patients fulfilling the inclusion criteria were then reviewed. Results A total of 363 patients underwent EVD insertion from 2015 to 2022. Of these, 161 were included in the study. Two-thirds (66.5%) were adults ≥ 19 years old whereas the remaining were pediatric patients 1 to
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.10.2024
Tilføjet 17.10.2024
Abstract Introduction During the mpox outbreak in 2022, the highest number of cases in Germany were registered in Berlin, almost all of them in men who have sex with men (MSM). However, the frequency of clinically undiagnosed infections is unknown. Methods A cross-sectional study was conducted among MSM in Berlin, Germany. Participants were recruited from private practices and community-based checkpoints specialised in HIV and STI care for MSM. They were asked to complete an online questionnaire on socio-demographic data, mpox diagnosis, vaccination history and sexual behaviour, and to provide a blood sample for serological analysis. The samples were tested for antibodies against a range of antigens to distinguish between antibodies induced by mpox infection and MVA vaccination, with pre-immune sera from childhood smallpox vaccination as a confounding factor. Associations of behavioural variables with reported and suspected mpox diagnosis as the outcome were tested using univariable and multivariable logistic regression models. Results Between the 11th April and 1st July 2023, 1,119 participants were recruited in eight private practices and two community-based checkpoints in Berlin. All participants provided a blood sample for serological testing. Information for the online questionnaire was provided by 728 participants; core data on age and mpox history for participants who did not provide questionnaire data were provided by the practices for an additional 218 participants. A previous diagnosis of mpox was reported for/by 70 participants (7.4%). Using a conservative and strict case definition, we serologically identified an additional 91 individuals with suspected undiagnosed mpox infection. Individuals with reported or suspected mpox infections reported more condomless anal sex partners in the past 3 months (OR = 5.93; 95% CI 2.10-18.35 for 5–10 partners; OR = 9.53; 95% CI 2.72–37.54 for > 10 partners) and were more likely to report sexual contact with partners diagnosed with mpox (OR = 2.87; 95% CI 1.39–5.84). Conclusion A substantial proportion of mpox infections were clinically undiagnosed. The number of condomless anal sex partners was strongly associated with both confirmed and suspected undiagnosed mpox infection. Therefore, mpox control measures based on clinical diagnosis of mpox are likely to have limited effectiveness in preventing mpox transmission in outbreak situations because many infections remain unrecognised and undiagnosed.
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.10.2024
Tilføjet 17.10.2024
Abstract Background This study examined onchocerciasis transmission in Kwanware and Ottou in the Wenchi Health District of Ghana, where persistent onchocercal microfilariae (mf) levels have been reported since 2012. Methods This study was conducted from 2019 to 2021 and involved the following: (i) reviewing past records of ivermectin mass drug administration (MDA); (ii) conducting a treatment coverage evaluation survey (CES); (iii) conducting key informant interviews; (iv) prospecting blackfly breeding sites; (v) collecting and dissecting blackflies; and (vi) conducting parasitological and serological surveys. Results (i) The review indicated ongoing MDA treatment for the past 27 years, with a reported coverage of over 65% in the last 17 yearly rounds; (ii) estimated treatment coverage by the CES in 2019 was 71.3%, with most of those not taking medicine stating that they were not offered; (iii) however, the key informant interviews revealed insufficiencies in reaching a significant number of people for treatment due to remote settlement, mobility, transport logistical issues, failure to register some people for treatment, leading to a false impression of good coverage, and a short distribution time; (iv) the most productive breeding was found within 5 km of Kwanware-Ottou; and (v) blackfly daily biting rates were highest in Kwanware and Ottou, with 199 and 160 bites per day, respectively. Infection in blackflies was found only in Kwanware and Ottou, with infectivity rates of 5.9‰ (per 1000) and 6.7‰, respectively. (vi) The mf prevalence in Ottou and Kwanware, respectively, was 40.0% and 30.0% among adults aged ≥ 20 years, and the anti-(Onchocerca volvulus) Ov16 IgG4 antibodies seroprevalence rates were 8.3% and 13.3% among children aged 5–9 years. These values were reduced to undetectable levels at a radius of 10 km from Ottou. Conclusions This study confirms that active onchocerciasis transmission centres on Kwanware/Ottou and is confined to a 10 km radius despite 27 yearly treatment rounds. The main contributing factors are suboptimal coverage and high biting rates. Identifying and targeting such a focus with a combination of interventions will be cost-effective in accelerating onchocerciasis elimination in Ghana.
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.10.2024
Tilføjet 17.10.2024
Abstract Introduction Neurobrucellosis (NB) can be associated with meningitis and present as a headache with or without meningeal signs. Pseudotumor presentation of NB has been reported to be accompanied by lymphocytic predominant cerebrospinal fluid(CSF) pleocytosis. NB is diagnosed by means of isolation of Brucella from blood or CSF and/or the presence of anti-Brucella antibodies in the CSF. Molecular techniques have been used in chronic or challenging cases of NB. Clinical findings We report on seven cases of NB presenting with different types of headache and signs of meningeal involvement. In five cases, signs of intracranial hypertension were evident in the form of papilledema, sixth nerve palsy and blurred vision. Diagnosis MRIs of the brain revealed signs of intracranial hypertension in three patients, basal meningeal enhancement in one patient and white matter lesions in one patient. Brucella serology in the blood and CSF was negative in all patients. It was interesting that four patients had normocellular CSF analysis with normal glucose and protein results. The diagnosis was made by Brucella PCR in all patients. Conclusion NB should be considered in the differential diagnoses of pseudotumor cerebri syndrome in endemic areas. It is important to employ molecular techniques using sterile CSF samples in the investigation of Brucella.
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.10.2024
Tilføjet 17.10.2024
Abstract Background The COVID-19 pandemic negatively impacted tuberculosis (TB) treatment services, including directly observed therapy (DOT) programs used to promote medication adherence. We compared DOT adherence embedded in a research study before and after COVID-19 lockdowns in South Africa. Methods We analyzed data from 263 observational study participants undergoing drug susceptible (DS)-TB DOT between May 2017 to March 2022. Participants enrolled before October 2019 were considered ‘pre-COVID-19’ and those enrolled after September 2020 were considered ‘post-COVID-19 lockdown groups. Negative binomial regression models were used to compare DOT non-adherence rates between the two lockdown groups. We then conducted a sensitivity analysis which only included participants enrolled in the immediate period following the first COVID-19 lockdown. Results DOT non-adherence rate was higher in the post-COVID-19 lockdown group (aIRR = 1.42, 95% CI = 1.04–1.96; p = 0.028) compared to pre-COVID-19 lockdown period, adjusting for age, sex, employment status, household hunger, depression risk, and smoked substance use. DOT non-adherence was highest immediately following the initial lockdown (aIRR = 1.74, 95% CI = 1.17–2.67; p = 0.006). Conclusion The COVID-19 lockdowns adversely effected adherence to TB DOT in the period after lockdowns were lifted. The change in DOT adherence persisted even after adjusting for socioeconomic and behavioral variables. We need a better understanding of what treatment adherence barriers were exacerbated by COVID-19 lockdowns to improve outcomes in post-pandemic times. Trial registration ClinicalTrials.gov Registration Number: NCT02840877. Registered on 19 July 2016.
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.10.2024
Tilføjet 17.10.2024
Abstract Background Cerebral venous sinus thrombosis (CVST), a serious cerebrovascular and neurological emergency, is common in pregnant individuals and accounts for approximately 0.5–1.0% of all cerebrovascular diseases. However, CVST with cryptococcal meningoencephalitis in immunocompetent pregnant patients is rare. Case presentation A 30-year-old woman who was 33 weeks pregnant presented with recurrent dizziness, headache, and vomiting as the main clinical manifestations, all of which were initially nonspecific. After assessment of the cerebrospinal fluid, skull computerized tomography, magnetic resonance imaging, and other laboratory and imaging examinations, the patient was diagnosed with secondary pregnancy-related CVST with cryptococcal meningoencephalitis. Despite receiving potent anticoagulant and antifungal treatment, the patient’s condition deteriorated, and the patient’s family opted to cease treatment. Conclusions We present a rare case of CVST with cryptococcal meningoencephalitis in an immunocompetent pregnant patient. The difficulty of diagnosing and treating secondary pregnancy-related CVST caused by cryptococcal meningoencephalitis, as well as the great challenges faced at present are highlighted. One crucial lesson from the present case is that when clinical and imaging signs are unusual for CVST during pregnancy, it is essential to account for the possibility of other central nervous system (CNS) diseases, such as CNS infections with Cryptococcus, which may cause CVST.
Læs mere Tjek på PubMed