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BMC Infectious Diseases, 16.04.2021
Tilføjet 16.04.2021
Abstract
Background
To prevent antimicrobial resistance, both antimicrobial stewardship (AMS) and antifungal stewardship (AFS) in inpatient settings are needed in small/middle-sized hospitals as well as large hospitals.
Methods
We conducted the web-based, self-administered, nationwide cross-sectional study regarding AMS and AFS in inpatient settings in Japan, targeting hospitals that participated in a hospital epidemiology workshop conducted in July 2018. The questionnaire was composed of intervention protocols for use of broad-spectrum antimicrobials and antifungals within 7 or 28 d of beginning usage. These broad-spectrum antimicrobial and antifungal protocols were compared between large (≥501beds) and small/middle-sized (≤500 beds) hospitals.
Results
Of 240 hospitals surveyed, 39 (16%; 18 large and 21 small/middle-sized) responded. The number of hospitals that intervened in the use of broad-spectrum antimicrobials within 7 and 28 d were 17 (44%) and 34 (87%), respectively; those that intervened for antifungals were 3 (8%) and 10 (26%), respectively. Interventions for use of broad-spectrum antimicrobials within 7 d were significantly more frequent in small/middle-sized hospitals compared to large hospitals [13 (61. 9%) vs. 4 (22. 2%), odds ratio‰=‰5.7, 95% confidence interval‰=‰1.4-23.3, p‰=‰0.023].
Conclusions
Small/middle-sized hospitals had more frequent interventions within 7 d of broad-spectrum antimicrobial use than large hospitals. More effort to improve AFS is needed among all hospitals.
Læs mere Tjek på PubMedBMC Infectious Diseases, 16.04.2021
Tilføjet 16.04.2021
Abstract
Background and purpose
COVID-19 pandemic led to wide-spread use of face-masks, respirators and other personal protective equipment (PPE) by healthcare workers. Various symptoms attributed to the use of PPE are believed to be, at least in part, due to elevated carbon-dioxide (CO2) levels. We evaluated concentrations of CO2 under various PPE.
Methods
In a prospective observational study on healthy volunteers, CO2 levels were measured during regular breathing while donning 1) no mask, 2) JustAir® powered air purifying respirator (PAPR), 3) KN95 respirator, and 4) valved-respirator. Serial CO2 measurements were taken with a nasal canula at a frequency of 1-Hz for 15-min for each PPE configuration to evaluate whether National Institute for Occupational Safety and Health (NIOSH) limits were breached.
Results
The study included 11 healthy volunteers, median age 32‰years (range 16-54) and 6 (55%) men. Percent mean (SD) changes in CO2 values for no mask, JustAir® PAPR, KN95 respirator and valve respirator were 0.26 (0.12), 0.59 (0.097), 2.6 (0.14) and 2.4 (0.59), respectively. Use of face masks (KN95 and valved-respirator) resulted in significant increases in CO2 concentrations, which exceeded the 8-h NIOSH exposure threshold limit value-weighted average (TLV-TWA). However, the increases in CO2 concentrations did not breach short-term (15-min) limits. Importantly, these levels were considerably lower than the long-term (8-h) NIOSH limits during donning JustAir® PAPR. There was a statistically significant difference between all pairs (p‰<‰0.0001, except KN95 and valved-respirator (p‰=‰0.25). However, whether increase in CO2 levels are clinically significant remains debatable.
Conclusion
Although, significant increase in CO2 concentrations are noted with routinely used face-masks, the levels still remain within the NIOSH limits for short-term use. Therefore, there should not be a concern in their regular day-to-day use for healthcare providers. The clinical implications of elevated CO2 levels with long-term use of face masks needs further studies. Use of PAPR prevents relative hypercapnoea. However, whether PAPR should be advocated for healthcare workers requiring PPE for extended hours needs to evaluated in further studies.
Læs mere Tjek på PubMedThe Lancet
Lancet, 17.04.2021
Tilføjet 16.04.2021
April 24, 2021, marks 1 year since the formation of the Access to COVID-19 Tools Accelerator (ACT-A) partnership. Its mission is to accelerate the development, production, and equitable access to COVID-19 tests, treatments, and vaccines, which is central to ending the acute phase of the COVID-19 pandemic. With the pandemic still raging, has ACT-A been successful so far? And what does the future hold?
Læs mere Tjek på PubMedMattias Soop
Lancet, 17.04.2021
Tilføjet 16.04.2021
In an audit in 2015 of European intensive care units, central venous access was used in 70·7 per 100 patient days,1 and is also widely used in other clinical settings. It remains associated with considerable risks, in particular systemic infection, which can be severe and even lethal. In clinical studies, the most widely reported metric of this complication among patients is the number of catheter-related bloodstream infections (CRBSIs) per 1000 catheter days. In prospective studies across a range of clinical settings, reported rates are typically in the range of 1·0-2·7 CRBSI per 1000 central venous catheter days.
Læs mere Tjek på PubMedFlorian Krammer
Lancet, 10.04.2021
Tilføjet 16.04.2021
Since the beginning of the COVID-19 pandemic, many scientists and public health officials assumed that infection with SARS-CoV-2 would protect from reinfection and that neutralising antibodies would correlate with protection or would be at least one of the protective immune mechanisms.1 Early on, these assumptions were supported by non-human primate data showing protection from reinfection, a correlation between neutralising antibodies protection, and protection afforded by passive transfer of neutralising antibodies.
Læs mere Tjek på PubMedMichael J Mina, Tim E Peto, Marta GarcÃa-Fiñana, Malcolm G Semple, Iain E Buchan
Lancet, 18.02.2021
Tilføjet 16.04.2021
The use of rapid lateral flow antigen testing (LFT) for SARS-CoV-2 has been questioned1-3 with uncorroborated4 reports of poor LFT sensitivity. The debate surrounding the use of the Innova Lateral Flow SARS-CoV-2 Antigen Test in the UK risks confusing policy makers internationally and potentially stalling deployment of LFTs in other countries.5 As scientists and health professionals evaluating some of the world's largest pilots of LFT, we wish to challenge those interpretations and clarify the evidence on how such testing might be used to detect SARS-CoV-2 in minutes and improve COVID-19 control measures.
Læs mere Tjek på PubMedVikram Patel, Kiran Mazumdar-Shaw, Gagandeep Kang, Pamela Das, Tarun Khanna
Lancet, 11.12.2020
Tilføjet 16.04.2021
The COVID-19 pandemic and response are having profound impacts on India's people, leading to myriad health-care challenges, a looming economic recession, and humanitarian crises.1 The long-standing need for universal health coverage (UHC) in India has been brought into sharp focus by the pandemic. The mission of the Lancet Citizens™ Commission on reimagining India's health system is to lay out the path to achieving UHC in India in the coming decade.
Læs mere Tjek på PubMedLise Alves
Lancet, 17.04.2021
Tilføjet 16.04.2021
Doctors are reporting shortages of critical drugs and the need to ration care, pointing to public health failures. Lise Alves reports from São Paulo.
Læs mere Tjek på PubMedSøren Dinesen Østergaard, Morten Schmidt, Erzsébet Horváth-Puhó, Reimar Wernich Thomsen, Henrik Toft Sørensen
Lancet, 31.03.2021
Tilføjet 16.04.2021
By mid March, 2021, vaccination against COVID-19 using the ChAdOx1 nCoV-19 (AZD1222) vaccine from Oxford-AstraZeneca1,2 was paused in a number of European countries due to reports of thromboembolic events in vaccinated individuals.3 According to the European Medicines Agency (EMA), 30 cases of thromboembolic events (predominantly venous) had been reported by March 10, 2021, among the approximately 5 million recipients of the Oxford-AstraZeneca COVID-19 vaccine in the European Economic Area.3 The EMA subsequently stated that œThe number of thromboembolic events in vaccinated people is no higher than the number seen in the general population.
Læs mere Tjek på PubMedSarah N Ali, Wasim Hanif, Kiran Patel, Kamlesh Khunti, South Asian Health Foundation, UK
Lancet, 8.04.2021
Tilføjet 16.04.2021
The Islamic month of fasting, Ramadan, begins around April 12, 2021. In 2020, Ramadan coincided with the beginning of the COVID-19 pandemic, moving what is a month of communal prayers and social gatherings into the era of virtual prayers. 2021 brings further challenges with ongoing virtual prayers and a global vaccination programme. For 1·9 billion Muslims worldwide, Ramadan coinciding with the vaccination programmes crucially means that their vaccinations might be offered during this time. With ongoing concerns of vaccine hesitancy among minority ethnic populations,1 could Ramadan impede successful vaccination roll-out?
Læs mere Tjek på PubMedRichard Armitage
Lancet, 17.04.2021
Tilføjet 16.04.2021
Soham Bandyopadhyay1 claimed that the UK Government's national lockdown, announced in November, 2020, to control COVID-19, was an institutionally racist policy. Claims of institutional racism are serious allegations and thus warrant critical appraisal. I therefore raise three points.
Læs mere Tjek på PubMedClaire M Rickard, Nicole M Marsh, Emily N Larsen, Matthew R McGrail, Nicholas Graves, Naomi Runnegar, Joan Webster, Amanda Corley, David McMillan, John R Gowardman, Debbie A Long, John F Fraser, Fenella J Gill, Jeanine Young, Marghie Murgo, Evan Alexandrou, Md Abu Choudhury, Raymond J Chan, Nicole C Gavin, Azlina Daud, Annamaria Palermo, Adrian Regli, E Geoffrey Playford
Lancet, 17.04.2021
Tilføjet 16.04.2021
Infusion set use can be safely extended to 7 days with resultant cost and workload reductions.
Læs mere Tjek på PubMedVictoria Jane Hall, Sarah Foulkes, Andre Charlett, Ana Atti, Edward J M Monk, Ruth Simmons, Edgar Wellington, Michelle J Cole, Ayoub Saei, Blanche Oguti, Katie Munro, Sarah Wallace, Peter D Kirwan, Madhumita Shrotri, Amoolya Vusirikala, Sakib Rokadiya, Meaghan Kall, Maria Zambon, Mary Ramsay, Tim Brooks, Colin S Brown, Meera A Chand, Susan Hopkins, SIREN Study Group
Lancet, 10.04.2021
Tilføjet 16.04.2021
A previous history of SARS-CoV-2 infection was associated with an 84% lower risk of infection, with median protective effect observed 7 months following primary infection. This time period is the minimum probable effect because seroconversions were not included. This study shows that previous infection with SARS-CoV-2 induces effective immunity to future infections in most individuals.
Læs mere Tjek på PubMedPierre Cuchet, Xavier Valette
Lancet, 17.04.2021
Tilføjet 16.04.2021
A 66-year-old man attended our hospital with increasing shortness of breath, asthenia, and fever.
Læs mere Tjek på PubMedPaul Turner, Priscilla Rupali, Japheth A Opintan, Walter Jaoko, Nicholas A Feasey, Sharon J Peacock, Elizabeth A Ashley
Lancet Infectious Diseases, 16.04.2021
Tilføjet 16.04.2021
Antimicrobial resistance (AMR) is a major threat to human health globally. Surveillance is a key activity to determine AMR burden, impacts, and trends and to monitor effects of interventions. Surveillance systems require efficient capture and onward sharing of high-quality laboratory data. Substantial investment is being made to improve laboratory capacity, particularly in low-income and middle-income countries (LMICs) with high disease burdens. However, building capacity for effective laboratory data management remains an under-resourced area, which, unless addressed, will limit progress towards comprehensive AMR surveillance in LMICs.
Læs mere Tjek på PubMedEmerging Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
Emerging Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
Emerging Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
Emerging Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
Lauren E. Parmley, Kieran Hartsough, Oliver Eleeza, Akopon Bertin, Bockarie Sesay, Amon Njenga, Mame Toure, Ginika Egesimba, Haja Bah, Alex Bayoh, Abdulraheem Yakubu, Ellen A. B. Morrison, Susan Michaels-Strasser
PLoS One Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
by Lauren E. Parmley, Kieran Hartsough, Oliver Eleeza, Akopon Bertin, Bockarie Sesay, Amon Njenga, Mame Toure, Ginika Egesimba, Haja Bah, Alex Bayoh, Abdulraheem Yakubu, Ellen A. B. Morrison, Susan Michaels-Strasser
After a decade of civil war and the 2014-2016 West African Ebola outbreak, Sierra Leone now faces the COVID-19 pandemic with a fragile health system. As was demonstrated during Ebola, preparedness is key to limiting a health crisis™ spread and impact on health systems and ensuring continued care for vulnerable populations including people living with HIV (PLHIV). To assess COVID-19 preparedness and inform interventions to ensure continuity of HIV services at health facilities (HFs) and community service points (CSPs), we conducted site readiness assessments in Freetown, the epicenter of COVID-19 in Sierra Leone. Data were collected at nine high-volume HIV HFs and seven CSPs in April 2020, a month after COVID-19 was declared a pandemic. CSPs comprised three community drop-in centers providing HIV counseling and testing services as well as HIV prevention services (e.g., condoms and lubricants) for key and priority populations and four community-based support groups serving PLHIV. At the time of assessment, CSPs did not provide antiretroviral therapy (ART) but were considered potential sites for expansion of differentiated service delivery (DSD)”a client-centered approach to HIV care”in the context of COVID-19. Overall, 5/9 HFs had trained staff on use of personal protective equipment (PPE) and prevention of COVID-19 transmission. Most had access to masks (5/9) and gloves (7/9) for management of suspected/confirmed COVID-19 cases, and 4/9 HFs had triage procedures for isolation of suspected cases. Conversely, few CSPs had access to masks (2/7) or gloves (2/7) and no staff were trained on PPE use or COVID-19 transmission. 7/9 HFs had adequate ART stock for multi-month dispensing though few had procedures for (3/9) or had trained staff in providing DSD (2/9). Among CSPs where measures were applicable, 2/4 had procedures for DSD, 1/3 had staff trained on DSD and none had adequate ART stock. Identification of gaps in COVID-19 preparedness is a critical step in providing support for infection control and modified service delivery. Findings from this assessment highlight gaps in COVID-19 preparedness measures at sites supporting PLHIV in Sierra Leone and indicate CSPs may require intensive supervision and training to ensure HIV services are uninterrupted while minimizing COVID-19 risk, especially if used as sites to scale up DSD.
Læs mere Tjek på PubMedRachael Phadnis, Champika Wickramasinghe, Juan Carlos Zevallos, Stacy Davlin, Vindya Kumarapeli, Veronica Lea, Juliette Lee, Udara Perera, Francisco Xavier Solórzano, Juan Francisco Vásconez
PLoS One Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
by Rachael Phadnis, Champika Wickramasinghe, Juan Carlos Zevallos, Stacy Davlin, Vindya Kumarapeli, Veronica Lea, Juliette Lee, Udara Perera, Francisco Xavier Solórzano, Juan Francisco Vásconez
Effective and rapid decision making during a pandemic requires data not only about infections, but also about human behavior. Mobile phone surveys (MPS) offer the opportunity to collect real-time data on behavior, exposure, knowledge, and perception, as well as care and treatment to inform decision making. The surveys aimed to collect coronavirus disease 2019 (COVID-19) related information in Ecuador and Sri Lanka using mobile phones. In Ecuador, a Knowledge, Attitudes and Practices (KAP) survey was conducted. In Sri Lanka, an evaluation of a novel medicine delivery system was conducted. Using the established mobile network operator channels and technical assistance provided through The Bloomberg Philanthropies Data for Health Initiative (D4H), Ministries of Health fielded a population-based COVID-19-specific MPS using Surveda, the open source data collection tool developed as part of the initiative. A total of 1,185 adults in Ecuador completed the MPS in 14 days. A total of 5,001 adults over the age of 35 in Sri Lanka completed the MPS in 44 days. Both samples were adjusted to the 2019 United Nations Population Estimates to produce population-based estimates by age and sex. The Ecuador COVID-19 MPS found that there was compliance with the mitigation strategies implemented in that country. Overall, 96.5% of Ecuadorians reported wearing a face mask or face covering when leaving home. Overall, 3.8% of Sri Lankans used the service to receive medicines from a government clinic. Among those who used the medicine delivery service in Sri Lanka, 95.8% of those who used a private pharmacy received their medications within one week, and 69.9% of those using a government clinic reported the same. These studies demonstrate that MPS can be conducted quickly and gather essential data. MPS can help monitor the impact of interventions and programs, and rapidly identify what works in mitigating the impact of COVID-19.
Læs mere Tjek på PubMedDani Zoorob, Shivam Shah, Danielle La Saevig, Courtney Murphy, Shaza Aouthmany, Kris Brickman
PLoS One Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
by Dani Zoorob, Shivam Shah, Danielle La Saevig, Courtney Murphy, Shaza Aouthmany, Kris Brickman
Background Acute augmentation of stress and disruption of training, such as during the COVID-19 pandemic, may impact resident wellbeing.
Objectives We investigated how residents in various specialties in the United States were impacted by COVID-19 on mental wellbeing and resilience levels, and the methodology for coping with the stress incurred.
Methods In April 2020, the authors electronically surveyed 200 residency programs of all specialties nationally. The survey utilized two validated questionnaires to assess wellbeing and resilience, while investigating demographics and coping mechanisms. The authors used student t-test and ANOVA to quantitatively analyze the data.
Results The sample consisted of 1115 respondents (with an 18% response rate). Male gender & Age >39 years were associated with more favorable average well-being indices (both p<0.01). Regarding resources, institutional support (IS) appeared favorable for resident well-being (IS 2.74, SD1.96 vs NoIS 3.71, SD2.29, p<0.01) & resilience (IS 3.72, SD0.70 vs NoIS 3.53, SD0.73, p = 0.05). The effects of mindfulness practices (MP) were not statistically significant for improvement of wellness (MP 2.87, SD 1.99 vs No MP 2.76, SD 2.15, p = 0.85) or resilience (MP 3.71, SD 0.70 vs No MP 3.72, SD 0.68, p = 0.87).
Conclusions Findings highlight the critical importance of resident mental status in cases of augmented stress situations. Institutional support may contribute to promotion of resident wellbeing.
Læs mere Tjek på PubMedPaulo Gonçalves, Emma Sáez-López, Sofia Carneiro, Maria João Simões
PLoS One Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
by Paulo Gonçalves, Emma Sáez-López, Sofia Carneiro, Maria João Simões
Background The incidence of invasive meningococcal disease due to serogroup C (MenC) decreased in Portugal since the introduction of the conjugate vaccine (MCC) in the free market in 2001 and in the National Immunisation Plan in 2006. Considering the potential waning of the antibody response reported in the literature, the different vaccination schemes that were used in our country over the past decade, and that Neisseria meningitidis serogroup C continues to circulate, the Portuguese population may currently be at increased risk of infection. In the absence of national data, we evaluated the seroprotection level of the Portuguese population against MenC, in order to identify the protected fraction of the population and ponder on the necessity of a booster dose of the MCC vaccine.
Methods We measured serum bactericidal antibody levels against MenC in a representative sample of the population (n = 1500) aged 2-64 years who participated in the 2015/2016 National Serological Survey.
Results A total of 31.1% (466/1500, 95%CI: 29-33%) of the individuals studied were protected against MenC. The geometric mean titre was 6.5. The proportion of seroprotected was particularly low in children aged 2-4 years (
Læs mere Tjek på PubMedXiu-Fen Yang, Meng-qi Li, Lu-lu Liao, Hui Feng, Si Zhao, Shuang Wu, Ping Yin
PLoS One Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
by Xiu-Fen Yang, Meng-qi Li, Lu-lu Liao, Hui Feng, Si Zhao, Shuang Wu, Ping Yin
Background The pandemic of coronavirus disease 2019 (COVID-19) has global impact, Wuhan in Hubei province is a high-risk area. And the older people in nursing homes are the most susceptible group to COVID-19. The aim of this study was to describe the practice and experience of the first-line medical team, to provide insights of coping with COVID-19 in China.
Method This qualitative study used a descriptive phenomenological design to describe the experience of medical staff supported the nursing homes in Wuhan fighting against COVID-19. Unstructured interviews via online video were conducted with seven medical staffs who supported the nursing homes in Wuhan. Data were analyzed using content analysis in five main themes: for nursing homes, we interviewed the difficulties faced at the most difficult time, services for the older people, and prevention and management strategies, for the medical staff, the psychological experience were interviewed, and the implications for public health emergencies were also reported.
Conclusions It is imperative that effective preventive and response measures be implemented to face the outbreak of COVID-19 and meet the care needs of older people in the context of COVID-19.
Implications Findings will inform managers of some reasonable instructional strategies for implementing effective infection management. Nursing homes need to provide targeted services to help alleviating their bad psychology for residents.
Læs mere Tjek på PubMedCarvalho, I. d. S., Mendes, R. C. M. G., Melo, P. d. O. C., Simoes, C. F., Leal, L. P., Guedes, T. G., Ormeno, G. I. R., Linhares, F. M. P.
BMJ Open, 15.04.2021
Tilføjet 15.04.2021
Introduction
Prisons are places with high vulnerability and high risk for the development of sexually transmitted infections. World Health Agencies recommend establishing intervention measures, such as information and education, on the prevention of diseases. Thus, technologies as tools for health education have been used to reduce sexually transmitted infections. However, no systematic review has investigated the effectiveness of these interventions. Therefore, this review’s objective is to examine the effect of educational technologies used for preventing sexually transmitted infections in incarcerated women.
Methods and analysis
Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will be strictly followed. The following electronic databases will be searched: Scopus; Cumulative Index of Nursing and Allied Health, Education Resources Information Center, Embase, PsycINFO, PubMed/Medline, Web of Science and Google Scholar. Randomised clinical trials of interventions that used educational technologies to prevent sexually transmitted infections in incarcerated women will be searched in the databases from the beginning of 2020 until December by two researchers independently. A narrative synthesis will be constructed for all included studies, and if there are sufficient data, a meta-analysis will be performed using the Review Manager software (V.5.3). Continuous results will be presented as the weighted mean difference or the standardised mean difference with 95% CIs. Under the heterogeneity of the included studies, a random-effects or fixed-effects model will be used. The studies’ heterogeneity will be assessed by the I2 method. The sensitivity analysis will be carried out to examine the magnitude of each study’s influence on the general results. A significance level of p≤0.05 will be adopted.
Ethics and disclosure
Ethical approval is not required because no primary data will be collected. The results will be published in journals reviewed by peers.
PROSPERO registration number
CRD42020163820.
Læs mere Tjek på PubMedMisra, R., Kesarwani, V., Nath, A.
BMJ Open, 15.04.2021
Tilføjet 15.04.2021
Objectives
We aim to define the burden of rifampicin monoresistant tuberculosis (TB) at a tertiary care centre in northern India as well as determine the second-line drug susceptibilities (SL-DST) in a subset of patients.
Methods
A total of 3045 pulmonary (n=1883) and extrapulmonary (n=1162) samples from likely patients with TB were subjected to microscopy, culture and the Xpert MTB/RIF assay from March 2017 to June 2019. SL-DST testing by line probe assay version 2 for fluoroquinolones (FQs) and second-line injectable drugs were performed on 62 samples.
Results
Out of 3045 samples processed in our laboratory during the study period, 36.1% (1101/3045) were positive for Mycobacterium tuberculosis complex (MTBC) and 21.6% were rifampicin monoresistant (223/1032). The rate of rifampicin resistance in pulmonary samples was 23.5% (166/706) and in extrapulmonary cases, it was 17.4% (57/326). Out of 62 cases included for second-line testing, 48 were resistant to FQs (77.4%) while 11 were extensively drug resistant.
Conclusions
India urgently needs to arrest an emerging multidrug-resistant TB epidemic with associated resistance to FQs. A robust surveillance system is needed to execute the National Strategic Plan for 2017–2025.
Læs mere Tjek på PubMedPorter, C., Favara, M., Hittmeyer, A., Scott, D., Sanchez Jimenez, A., Ellanki, R., Woldehanna, T., Duc, L. T., Craske, M. G., Stein, A.
BMJ Open, 15.04.2021
Tilføjet 15.04.2021
Objective
To provide evidence on the effect of the COVID-19 pandemic on the mental health of young people who grew up in poverty in low/middle-income countries (LMICs).
Design
A phone survey administered between August and October 2020 to participants of a population-based longitudinal cohort study established in 2002 comprising two cohorts born in 1994–1995 and 2001–2002 in Ethiopia, India (Andhra Pradesh and Telangana), Peru and Vietnam. We use logistic regressions to examine associations between mental health and pandemic-related stressors, structural factors (gender, age), and lifelong protective/risk factors (parent and peer relationship, wealth, long-term health problems, past emotional problems, subjective well-being) measured at younger ages.
Setting
A geographically diverse, poverty-focused sample, also reaching those without mobile phones or internet access.
Participants
10 496 individuals were approached; 9730 participated. Overall, 8988 individuals were included in this study; 4610 (51%) men and 4378 (49%) women. Non-inclusion was due to non-location or missing data.
Main outcome measures
Symptoms consistent with at least mild anxiety or depression were measured by Generalized Anxiety Disorder-7 (≥5) or Patient Health Questionnaire-8 (≥5).
Results
Rates of symptoms of at least mild anxiety (depression) were highest in Peru at 41% (32%) (95% CI 38.63% to 43.12%; (29.49–33.74)), and lowest in Vietnam at 9% (9%) (95% CI 8.16% to 10.58%; (8.33–10.77)), mirroring COVID-19 mortality rates. Women were most affected in all countries except Ethiopia. Pandemic-related stressors such as health risks/expenses, economic adversity, food insecurity, and educational or employment disruption were risk factors for anxiety and depression, though showed varying levels of importance across countries. Prior parent/peer relationships were protective factors, while long-term health or emotional problems were risk factors.
Conclusion
Pandemic-related health, economic and social stress present significant risks to the mental health of young people in LMICs where mental health support is limited, but urgently needed to prevent long-term consequences.
Læs mere Tjek på PubMedZhongjie Li, Fengfeng Liu, Jinzhao Cui, Zhibin Peng, Zhaorui Chang, Shengjie Lai, Qiulan Chen, Liping Wang, George F. Gao, Zijian Feng
Nature, 15.04.2021
Tilføjet 15.04.2021
Nature Medicine, Published online: 15 April 2021; doi:10.1038/s41591-021-01308-7
Comprehensive large-scale nucleic acid-testing strategies support China™s sustained containment of COVID-19
Læs mere Tjek på PubMedThi H.O. Nguyen, Louise C. Rowntree, Jan Petersen, Brendon Y. Chua, Luca Hensen, Lukasz Kedzierski, Carolien E. van de Sandt, Priyanka Chaurasia, Hyon-Xhi Tan, Jennifer R. Habel, Wuji Zhang, Lily Allen, Linda Earnest, Kai Yan Mak, Jennifer A. Juno, Kathleen Wragg, Francesca L. Mordant, Fatima Amanat, Florian Krammer, Nicole A. Mifsud, Denise L. Doolan, Katie L. Flanagan, Sabrina Sonda, Jasveen Kaur, Linda M. Wakim, Glen P. Westall, Fiona James, Effie Mouhtouris, Claire L. Gordon, Natasha E. Holmes, Olivia C. Smibert, Jason A. Trubiano, Allen C. Cheng, Peter Harcourt, Patrick Clifton, Jeremy Chase Crawford, Paul G. Thomas, Adam K. Wheatley, Stephen J. Kent, Jamie Rossjohn, Joseph Torresi, Katherine Kedzierska
Immunity, 15.04.2021
Tilføjet 15.04.2021
Examining unmanipulated SARS-CoV-2-specific T cells is important for understanding primary and recall responses during COVID-19. Nguyen et al. analyze ex vivo CD8+ T cells specific for SARS-CoV-2 epitopes and find that immunodominant B7/N105-specific CD8+ T cells are present at high frequencies in blood samples from unexposed, acute COVID-19, and convalescence individuals, which is underpinned by diverse TCR repertoires.
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