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BMC Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
Abstract
Objective
Rotavirus A (RVA) is a significant cause of severe diarrheal illness and one of the common causes of death in children under the age of five. This study was aimed at detecting the prevalence of RVA in Pakistan after rotavirus vaccines were introduced. Fecal samples were obtained from 813 children from different hospitals in Rawalpindi and Islamabad, Pakistan, from January 2018 to December 2018. To obtain additional information from the parents / guardians of the children, a standard questionnaire was used.
Results
Using an enzyme-linked immunosorbent assay kit (ELISA), rotavirus antigen was detected and ELISA positive samples were subjected to reverse transcription PCR (RT-PCR). The findings showed 22% prevalence of RVA in children with acute gastroenteritis (AGE) via ELISA and 21% prevalence via RT-PCR in children with AGE. There was no statistically significant difference between gender, age and RVA infections. The winter, spring and fall/autumn seasons were statistically significant for RVA prevalence.
Conclusion
The present study will provide post vaccine prevalence data for the health policy makers. The implementation of rotavirus vaccines, along with adequate nutrition for babies, clean water supply and maternal hygienic activities during infant feeding, is recommended. Furthermore, continuous surveillance is mandatory in the whole country to calculate the disease burden caused by RVA.
Læs mere Tjek på PubMedChiara Sorbera, Amelia Brigandì, Vincenzo Cimino, Lilla Bonanno, Rosella Ciurleo, Placido Bramanti, Giuseppe Di Lorenzo, Silvia Marino
PLoS One Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
by Chiara Sorbera, Amelia Brigandì, Vincenzo Cimino, Lilla Bonanno, Rosella Ciurleo, Placido Bramanti, Giuseppe Di Lorenzo, Silvia Marino
On March 2019 the World Health Organization declared Coronavirus disease (COVID-19) pandemic. Several recent reports disclose that the outcome of the infection is related to age, sex and can be influenced by underlying clinical conditions. Parkinson™s disease (PD) and other parkinsonisms are the most common chronic disease which can cause, directly or indirectly, the patient to be more exposed to other diseases, mostly respiratory system™s ones. Our primary outcome is to evaluate if PD patients are more susceptible than non-PD to take COVID-19 infection. Second, to detect if the infection course is worse in PD-COVID+ patients versus non-PD. This is a retrospective observational study on a cohort of 18 patients (13 PD- 5 non-PD), hospitalized in a Rehabilitative Unit during the occurrence of SARS-CoV2 epidemic outbreak. All patients performed laboratory tests, lung Computed Tomography (CT) and have been tested for COVID-19 thorough pharyngeal swab. PD and non-PD groups were comparable for age, gender and Hoehn and Yahr stage. Seventy-seven (77)% of PD and 60% of non-PD resulted positive for COVID-19. PD-COVID+ and PD-COVID- did not differ for age, disease duration and L-dopa daily dose. PD COVID-19+ subjects were mainly asymptomatic (50%) while non-PD ones were all symptomatic, mostly with respiratory difficulties. PD doesn™t seem to be a risk factor to take SARS-COV2 infection, even if our study is related to a limited sample size. Our results, together with those of other recent studies, highlight the need to evaluate the actual susceptibility of patients with Parkinson™s disease to develop COVID-19 disease, and how the infection may influence the risk of clinical worsening and increase of mortality.
Læs mere Tjek på PubMedSangsoo Han, Hye Ji Park, Sangun Nah, Eun Hae Lee, Hyun Ji Lee, Ju Ok Park, Choung Ah Lee
PLoS One Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
by Sangsoo Han, Hye Ji Park, Sangun Nah, Eun Hae Lee, Hyun Ji Lee, Ju Ok Park, Choung Ah Lee
Study hypothesis Cardiopulmonary resuscitation (CPR) training can increase the likelihood of patient survival and better neurological outcomes. However, conventional learning (CL) has cost, time, and space constraints. This study aimed to evaluate whether laypersons who completed instructor-led distance learning (DL) acquired a level of CPR skill comparable to that achieved via CL training.
Methods This randomized controlled study recruited students from 28 Korean high schools who were randomized to complete instructor-led DL or CL training. The CL training involved classroom-based face-to-face training, whereas the instructor-led DL training was provided online using a videoconferencing system.
Results The study enrolled 62 students who were randomized to the CL group (31 participants) or the DL group (31 participants). Relative to the CL group, the DL group achieved remarkably similar results in terms of most CPR variables. In addition, the DL group had a significant improvement in the mean compression depth (before: 46 mm [interquartile range: 37-52 mm] vs. after: 49 mm [interquartile range: 46-54 mm], p<0.001).
Conclusions Instructor-led DL can be a suitable alternative to CL for providing CPR training to laypersons. In settings like the current COVID-19 pandemic, where face-to-face CL is not practical, DL may be a useful tool for delivering CPR training.
Læs mere Tjek på PubMedHiba J. Barqawi, Drishti D. Kampani, Enad S. Haddad, Nora M. Al-Roub, Eman Abu-Gharbieh
PLoS One Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
by Hiba J. Barqawi, Drishti D. Kampani, Enad S. Haddad, Nora M. Al-Roub, Eman Abu-Gharbieh
Background Coronavirus disease (COVID-19), caused by Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV2), is the defining global health crisis of this time. It is responsible for significant morbidity and has had severe socioeconomic consequences. This study aims to assess the knowledge, preparedness and attitudes of medical students, physicians and faculty members in the United Arab Emirates (UAE) on COVID-19 and their perspective on the roles of educational and healthcare institution towards improving pandemic preparedness and enabling optimal care.
Methodology An exploratory, descriptive cross-sectional study was conducted with 444 participants, using a non-probability convenience sampling method. English-speaking participants from the medical field aged 18 and above were included in the study. The validated questionnaire was administered online and distributed across social media platforms from May-July 2020. T-test, ANOVA, Kruskal-Wallis test and Mann-Whitney-U test were used when appropriate. Responses were analysed and statistical tests applied using IBM SPSS, version 25.
Results The knowledge scores were calculated amongst different ages and professional status, and the mean was 59.08% (SD = 12.848%). Almost half of the participants obtained poor knowledge scores (less than 60%). Most of the participants followed the latest updates on COVID-19 (86.7%). The majority opted to obtain information from the national health authorities (63.4%). The mean preparedness score among the participants was 68.65% (SD = 17.456%). Being in contact with patients significantly increased the preparedness score (p < 0.001). Only 27.9% of the participants believed their college education provided adequate knowledge to deal with epidemics or pandemics. Several barriers affect willingness to work in a pandemic, with 80.6% of participants worried about posing a risk to family members.
Conclusion This study highlights the importance of establishing tailored COVID-19 related education programs to improve knowledge levels, especially in medical students. Efforts are still needed to promote effective control measures and address the barriers affecting willingness to work in a pandemic.
Læs mere Tjek på PubMedGretchen Antelman, Michelle M. Gill, Ola Jahanpour, Roland van de Ven, Catherine Kahabuka, Asheri Barankana, Sharon Lwezaura, Naftali Ngondi, Alison Koler, Peris Urasa, Rhoderick Machekano
PLoS One Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
by Gretchen Antelman, Michelle M. Gill, Ola Jahanpour, Roland van de Ven, Catherine Kahabuka, Asheri Barankana, Sharon Lwezaura, Naftali Ngondi, Alison Koler, Peris Urasa, Rhoderick Machekano
To optimize HIV testing resources, programs are moving away from universal testing strategies toward a risk-based screening approach to testing children/adolescents, but there is little consensus around what defines an optimal risk screening tool. This study aimed to validate a 12-item risk screening tool among children and adolescents and provide suggested fewer-item tool options for screening both facility out-patient and community populations by age strata (
Læs mere Tjek på PubMedNi Luh Ayu Megasari, Takako Utsumi, Laura Navika Yamani, Juniastuti, Emily Gunawan, Koichi Furukawa, Mitsuhiro Nishimura, Maria Inge Lusida, Yasuko Mori
PLoS One Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
by Ni Luh Ayu Megasari, Takako Utsumi, Laura Navika Yamani, Juniastuti, Emily Gunawan, Koichi Furukawa, Mitsuhiro Nishimura, Maria Inge Lusida, Yasuko Mori
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a global pandemic, including Indonesia. However, there are only limited data regarding the precise prevalence of the COVID-19 pandemic in Indonesia. Here, to estimate the magnitude of SARS-CoV-2 infection in East Java, Indonesia, we investigated the prevalence of immunoglobulin G (IgG) antibodies. We enrolled 1,819 individuals from June to December 2020 and observed that the subjects™ overall prevalence of IgG antibody to SARS-CoV-2 was 11.4% (207/1,819). The prevalence of anti-SARS-CoV-2 antibodies differed significantly between the job/occupation groups (P = 0.0001). A greater prevalence of IgG was detected in laboratory technicians (who take samples from suspected cases and deal with polymerase chain reaction [PCR] procedures, 22.2%) compared to medical personnel who see and take direct care of patients with COVID-19 (e.g., physicians and nurses, 6.0%), other staff in medical facilities (2.9%), general population (12.1%) and non-COVID-19 patients (14.6%). The highest prevalence among age groups was in the 40-49-year-olds (14.8%), and the lowest prevalence was in the 20-29-year-olds (7.4%). However, the younger population still showed a higher prevalence than generally reported, suggesting greater exposure to the virus but less susceptibility to the disease. A geographical difference was also observed: a higher prevalence in Surabaya (13.1%) than in Jombang (9.9%). In conclusion, the COVID-19 outbreak among asymptomatic populations was characterized by a high prevalence of infection in East Java, Indonesia.
Læs mere Tjek på PubMedN. Dehghansai, R. A. Pinder, J. Baker, I. Renshaw
PLoS One Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
by N. Dehghansai, R. A. Pinder, J. Baker, I. Renshaw
The demands of high-performance sport are exacerbated during the lead up to the Major Games (i.e., Paralympics). The purpose of this study was to better understand the challenges experienced and strategies utilized by Australian athletes (n = 7) and coaches (n = 5) preparing for the Tokyo Paralympic Games using semi-structured interviews. The thematic analysis highlighted challenges specific to participants™ sport (e.g., budgetary constraints, decentralized experiences, athletes with various impairments), personal life (e.g., moving cities to access coaching, postponing vocational/educational developments, isolation from social circles), and associated uncertainties (e.g., COVID-19, qualifications, accreditations). Participants managed these challenges by utilizing strategies to ˜anticipate and prepare™ (e.g., detailed planning, effective communication, contingency plans) and ˜manage expectations™ (e.g., understanding specific roles and boundaries, focusing on the process [i.e., effort over results]). Trust and communication between athletes and coaches was key in coaches™ better understanding of how athletes™ impairments interact with their training and competition environments and tailor support to each athlete™s unique needs. Last, participants reflected on the ˜pressure™ of the Games due to their performance having an impact on their career trajectory ˜post-Tokyo™ with some athletes contemplating retirement and others realizing the consequences of their performance on sport-related vocation and sponsorship. Coaches also accepted the success of their programs and job security will depend on outcomes at the Games. The findings from this study shed light on factors to consider to reduce challenges for teams preparing for major competitions but also highlight key practical implications to support athletes and coaches leading up, during, and post-major Games.
Læs mere Tjek på PubMedJackson S. Musuuza, Lauren Watson, Vishala Parmasad, Nathan Putman-Buehler, Leslie Christensen, Nasia Safdar
PLoS One Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
by Jackson S. Musuuza, Lauren Watson, Vishala Parmasad, Nathan Putman-Buehler, Leslie Christensen, Nasia Safdar
Introduction The recovery of other pathogens in patients with SARS-CoV-2 infection has been reported, either at the time of a SARS-CoV-2 infection diagnosis (co-infection) or subsequently (superinfection). However, data on the prevalence, microbiology, and outcomes of co-infection and superinfection are limited. The purpose of this study was to examine the occurrence of co-infections and superinfections and their outcomes among patients with SARS-CoV-2 infection.
Patients and methods We searched literature databases for studies published from October 1, 2019, through February 8, 2021. We included studies that reported clinical features and outcomes of co-infection or superinfection of SARS-CoV-2 and other pathogens in hospitalized and non-hospitalized patients. We followed PRISMA guidelines, and we registered the protocol with PROSPERO as: CRD42020189763.
Results Of 6639 articles screened, 118 were included in the random effects meta-analysis. The pooled prevalence of co-infection was 19% (95% confidence interval [CI]: 14%-25%, I2 = 98%) and that of superinfection was 24% (95% CI: 19%-30%). Pooled prevalence of pathogen type stratified by co- or superinfection were: viral co-infections, 10% (95% CI: 6%-14%); viral superinfections, 4% (95% CI: 0%-10%); bacterial co-infections, 8% (95% CI: 5%-11%); bacterial superinfections, 20% (95% CI: 13%-28%); fungal co-infections, 4% (95% CI: 2%-7%); and fungal superinfections, 8% (95% CI: 4%-13%). Patients with a co-infection or superinfection had higher odds of dying than those who only had SARS-CoV-2 infection (odds ratio = 3.31, 95% CI: 1.82-5.99). Compared to those with co-infections, patients with superinfections had a higher prevalence of mechanical ventilation (45% [95% CI: 33%-58%] vs. 10% [95% CI: 5%-16%]), but patients with co-infections had a greater average length of hospital stay than those with superinfections (mean = 29.0 days, standard deviation [SD] = 6.7 vs. mean = 16 days, SD = 6.2, respectively).
Conclusions Our study showed that as many as 19% of patients with COVID-19 have co-infections and 24% have superinfections. The presence of either co-infection or superinfection was associated with poor outcomes, including increased mortality. Our findings support the need for diagnostic testing to identify and treat co-occurring respiratory infections among patients with SARS-CoV-2 infection.
Læs mere Tjek på PubMedChun-Yuan Lee, Pei-Hua Wu, Meng-Wei Lu, Tun-Chieh Chen, Po-Liang Lu
PLoS One Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
by Chun-Yuan Lee, Pei-Hua Wu, Meng-Wei Lu, Tun-Chieh Chen, Po-Liang Lu
Objectives HCV infection status awareness is crucial in the HCV care continuum for both HCV-seropositive (HCV-positive status awareness) and seronegative (HCV-negative status awareness) populations. However, trends in the unawareness of HCV infection status (UoHCV) remain unknown in HIV-positive patients. This study investigated UoHCV prevalence, the associated factors of UoHCV, and its association with HCV-related knowledge in HIV-positive patients.
Methods For this cross-sectional, multicenter, questionnaire-based study, 844 HIV-infected participants were recruited from three hospitals in Taiwan from June 2018 to March 2020. Participants were grouped by HCV serostatus (HCV-seronegative [n = 734] and HCV-seropositive [n = 110]) and categorized by their HIV diagnosis date (before 2008, 2008-2013, and 2014-2020). Exploratory factor analysis was used to categorize the 15 items of HCV-related knowledge into three domains: route of HCV transmission, HCV course and complications, and HCV treatment.
Results The prevalence of UoHCV was 58.7%-62.6% and 15.1%-31.3% in the HCV-seronegative and HCV-seropositive groups, respectively, across 3 periods. More participants with UoHCV believed that HCV infection was only contracted by intravenous injection. In the HCV-seropositive group, participants with UoHCV were more likely to have HIV diagnosis before 2008 (vs. 2014-2020), be men who have sex with men (vs. people who inject drugs), and have hepatitis A virus seronegativity. In the HCV-seronegative group, participants with UoHCV were more likely to have a recent history of sexually transmitted diseases, but had a lower education level, had received less information on HCV infection from clinicians, and were less likely to have heard of HCV infection prior to the research. UoHCV was associated with lower scores for three domains of HCV-related knowledge in both groups.
Conclusions The negative association of UoHCV with HCV-related knowledge suggests that strategies targeting patients according to their HCV serostatus should be implemented to reduce UoHCV and eradicate HCV infection among HIV-positive patients.
Læs mere Tjek på PubMedAshu Rastogi, Priya Hiteshi, Anil Bhansali A., Edward B. Jude
PLoS One Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
by Ashu Rastogi, Priya Hiteshi, Anil Bhansali A., Edward B. Jude
Aims Limb and patient outcomes in people with diabetic foot complications including diabetic foot ulcer (DFU) provided virtual triage and personalized video consultations during COVID-19 pandemic are not known.
Methods Patients with foot complications attending the diabetic foot clinic prior to lockdown who sought teleconsultations during COVID-19 lockdown underwent virtual triage to include clinical history, visual inspection of feet, domiciliary wound care (community nurse assisted dressings) and offloading instructions. The subsequent ulcer, limb and mortality outcomes during the following 24 weeks of COVID-19 lockdown (April-September 2020, group 1) were assessed and compared with those who attended foot clinic during the same period in 2019 (April-September, group 2).
Results Group 1 included 561 participants with foot complications provided with teleconsultations, median age 57 (51 to 63) years and diabetes duration of 10 (5 to 16) years. Twelve patients with severe DFU were excluded and 549 patients [357 (65%) neuropathic foot, 104 (18.9%) ischemic foot and 88 (16%) chronic Charcot foot with deformities] were evaluated. There were 227 (41.3%) participants with active DFU at start of lockdown, 32 (5.8%) with new onset ulcer during lockdown (47.1%) and 290 patients without ulcers. Group 2 included 650 participants; active foot ulcer was present in 366 patients. Wound closed or reduced in area in 78.4% of participants of group 1 compared to 76.0% (p = 0.318) in group 2. Fourteen (5.4%) patients required amputations [3 major and 11 minor] in group 1 during the study period compared to 6.8% in group 2 (p = 0.191). Twenty-one (3.8%) and 28 (4.3%) patients died (p = 0.532) during 24 weeks of follow up in group 1 and 2, respectively.
Conclusions Targeted foot-care service through virtual triage and teleconsultations during COVID-19 pandemic for people with foot complications have similar ulcer and limb outcomes compared to face-to-face foot care delivery.
Læs mere Tjek på PubMedMatti Erlichman, Todd Zalut, Shepard Schwartz, Giora Weiser
PLoS One Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
by Matti Erlichman, Todd Zalut, Shepard Schwartz, Giora Weiser
Introduction The SARS-CoV-2 coronavirus pandemic may cause significant morbidity and mortality in adults, yet severe cases are rare among children. The indirect impact of the pandemic on health care delivery in general and pediatric emergency department (PED) visits in particular has been widely reported.
Aims To assess the impact of the pandemic and the social restrictions imposed in its wake on PED visits and hospitalization rates in our Israeli medical center. We also sought to track these data in relation to the variation in pandemic severity and social restrictions over time. A comparison of this data with that of the adult emergency department was also performed.
Methods Data for this study were drawn from the Shaare Zedek Medical Center (SZMC), Jerusalem, Israel computerized databank. The daily number of PED and adult ER visits as well as hospitalizations resulting from these visits during the months January-July during the years 2018, 2019, 2020 were recorded. We compared the risk ratio for hospitalization in 2019 and 2020, as well as the incidence rate ratio.
Results During March and April there was a decrease in PED visits from 4,588 visits in 2019 to 2,527 visits in 2020 (ratio = .551, 95%CI [.52,.58]. Despite the drop in PED visits, the rate of hospitalizations rose with respect to 2019 (Risk Ratio = 1.31, p < .001, 95%CI [1.17,1.47]). Similar but more moderate trends were seen in the adult ED. From May-July 2020, after the lockdown was lifted, PED visits remained 30% below the same time period from 2018 and 2019, while the hospitalization rate returned to its pre-pandemic level.
Conclusions A significant drop in PED visits is seen to extend well beyond the peak of the pandemic and the lockdown period. This highlights the potential risk of children with serious emergencies becoming casualties of the pandemic by their not being brought to medical attention. Efforts should be made to raise public awareness among parents and other caretakers of children regarding this matter.
Læs mere Tjek på PubMedMarie-Lise Bats, Benoit Rucheton, Tara Fleur, Arthur Orieux, Clément Chemin, Sébastien Rubin, Brigitte Colombies, Arnaud Desclaux, Claire Rivoisy, Etienne Mériglier, Etienne Rivière, Alexandre Boyer, Didier Gruson, Isabelle Pellegrin, Pascale Trimoulet, Isabelle Garrigue, Rana Alkouri, Charles Dupin, François Moreau-Gaudry, Aurélie Bedel, Sandrine Dabernat
PLoS One Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
by Marie-Lise Bats, Benoit Rucheton, Tara Fleur, Arthur Orieux, Clément Chemin, Sébastien Rubin, Brigitte Colombies, Arnaud Desclaux, Claire Rivoisy, Etienne Mériglier, Etienne Rivière, Alexandre Boyer, Didier Gruson, Isabelle Pellegrin, Pascale Trimoulet, Isabelle Garrigue, Rana Alkouri, Charles Dupin, François Moreau-Gaudry, Aurélie Bedel, Sandrine Dabernat
Clinical and laboratory predictors of COVID-19 severity are now well described and combined to propose mortality or severity scores. However, they all necessitate saturable equipment such as scanners, or procedures difficult to implement such as blood gas measures. To provide an easy and fast COVID-19 severity risk score upon hospital admission, and keeping in mind the above limits, we sought for a scoring system needing limited invasive data such as a simple blood test and co-morbidity assessment by anamnesis. A retrospective study of 303 patients (203 from Bordeaux University hospital and an external independent cohort of 100 patients from Paris Pitié-Salpêtrière hospital) collected clinical and biochemical parameters at admission. Using stepwise model selection by Akaike Information Criterion (AIC), we built the severity score Covichem. Among 26 tested variables, 7: obesity, cardiovascular conditions, plasma sodium, albumin, ferritin, LDH and CK were the independent predictors of severity used in Covichem (accuracy 0.87, AUROC 0.91). Accuracy was 0.92 in the external validation cohort (89% sensitivity and 95% specificity). Covichem score could be useful as a rapid, costless and easy to implement severity assessment tool during acute COVID-19 pandemic waves.
Læs mere Tjek på PubMedXing Song, Mei Liu, Lemuel R. Waitman, Anurag Patel, Steven Q. Simpson
PLoS One Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
by Xing Song, Mei Liu, Lemuel R. Waitman, Anurag Patel, Steven Q. Simpson
Purpose To understand what clinical presenting features of sepsis patients are historically associated with rapid treatment involving antibiotics and fluids, as appropriate.
Design This was a retrospective, observational cohort study using a machine-learning model with an embedded feature selection mechanism (gradient boosting machine).
Methods For adult patients (age ≥ 18 years) who were admitted through Emergency Department (ED) meeting clinical criteria of severe sepsis from 11/2007 to 05/2018 at an urban tertiary academic medical center, we developed gradient boosting models (GBMs) using a total of 760 original and derived variables, including demographic variables, laboratory values, vital signs, infection diagnosis present on admission, and historical comorbidities. We identified the most impactful factors having strong association with rapid treatment, and further applied the Shapley Additive exPlanation (SHAP) values to examine the marginal effects for each factor.
Results For the subgroups with or without fluid bolus treatment component, the models achieved high accuracy of area-under-receiver-operating-curve of 0.91 [95% CI, 0.86-0.95] and 0.84 [95% CI, 0.81-0.86], and sensitivity of 0.81[95% CI, 0.72-0.87] and 0.91 [95% CI, 0.81-0.97], respectively. We identified the 20 most impactful factors associated with rapid treatment for each subgroup. In the non-hypotensive subgroup, initial physiological values were the most impactful to the model, while in the fluid bolus subgroup, value minima and maxima tended to be the most impactful.
Conclusion These machine learning methods identified factors associated with rapid treatment of severe sepsis patients from a large volume of high-dimensional clinical data. The results provide insight into differences in the rapid provision of treatment among patients with sepsis.
Læs mere Tjek på PubMedDemelash Woldeyohannes, Yohannes Tekalegn, Biniyam Sahiledengle, Tesfaye Assefa, Rameto Aman, Zeleke Hailemariam, Lillian Mwanri, Alemu Girma
PLoS One Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
by Demelash Woldeyohannes, Yohannes Tekalegn, Biniyam Sahiledengle, Tesfaye Assefa, Rameto Aman, Zeleke Hailemariam, Lillian Mwanri, Alemu Girma
Background Drug resistance tuberculosis (DR-TB) patients™ mortality and loss to follow-up (LTF) from treatment and care is a growing worry in Ethiopia. However, little is known about predictors of mortality and LTF among drug-resistant tuberculosis patients in Oromia region, Ethiopia. The current study aimed to identify predictors of mortality and loss to follow-up among drug resistance tuberculosis patients in Oromia Hospitals, Ethiopia.
Methods A retrospective follow up study was carried out from 01 November 2012 to 31 December 2017 among DR-TB patients after calculating sample size using single proportion population formula. Mean, median, Frequency tables and bar charts were used to describe patients™ characteristics in the cohort. The Kaplan-Meier curve was used to estimate the probability of death and LTF after the treatment was initiated. The log-rank test was used to compare time to death and time to LTF. The Cox proportional hazard model was used to determine predictors of mortality and LTF after DR-TB diagnosis. The Crude and adjusted Cox proportional hazard ratio was used to measure the strength of association whereas p-value less than 0.05 were used to declare statistically significant predictors.
Result A total of 406 DR-TB patients were followed for 7084 person-months observations. Among the patients, 71 (17.5%) died and 32 (7.9%) were lost to follow up (LTF). The incidence density of death and LTF in the cohort was 9.8 and 4.5 per 1000 person-months, respectively. The median age of the study participants was 28 years (IQR: 27.1, 29.1). The overall cumulative survival probability of patients at the end of 24 months was 77.5% and 84.5% for the mortality and LTF, respectively. The independent predictors of death was chest radiographic findings (AHR = 0.37, 95% CI: 0.17-0.79) and HIV serostatus 2.98 (95% CI: 1.72-5.19). Drug adverse effect (AHR = 6.1; 95% CI: 2.5, 14.34) and culture test result (AHR = 0.1; 95% CI: 0.1, 0.3) were independent predictors of LTF.
Conclusion This study concluded that drug-resistant tuberculosis mortality and LTF remains high in the study area. Continual support of the integration of TB/HIV service with emphasis and work to identified predictors may help in reducing drug-resistant tuberculosis mortality and LTF.
Læs mere Tjek på PubMedHaley L. Dugan, Christopher T. Stamper, Lei Li, Siriruk Changrob, Nicholas W. Asby, Peter J. Halfmann, Nai-Ying Zheng, Min Huang, Dustin G. Shaw, Mari S. Cobb, Steven A. Erickson, Jenna J. Guthmiller, Olivia Stovicek, Jiaolong Wang, Emma S. Winkler, Maria Lucia Madariaga, Kumaran Shanmugarajah, Maud O. Jansen, Fatima Amanat, Isabelle Stewart, Henry A. Utset, Jun Huang, Christopher A. Nelson, Ya-Nan Dai, Paige D. Hall, Robert P. Jedrzejczak, Andrzej Joachimiak, Florian Krammer, Michael S. Diamond, Daved H. Fremont, Yoshihiro Kawaoka, Patrick C. Wilson
Immunity, 6.05.2021
Tilføjet 6.05.2021
Dugan et al. utilize a multi-antigen bait sorting and single cell sequencing approach to profile B cell immunodominance upon SARS-CoV-2 infection, revealing a dynamic response that evolves toward internal virus proteins over time. Antibodies to internal proteins were non-protective in vivo, suggesting vaccination may generate superior anti-spike immunological memory.
Læs mere Tjek på PubMedde Souza, R., Mhatre, S., Qayyumi, B., Chitkara, G., Madke, T., Joshi, M., Bharmal, R., Asgaonkar, D. S., Lakhani, P., Gupta, S., Chaturvedi, P., Dikshit, R., Badwe, R.
BMJ Open, 6.05.2021
Tilføjet 6.05.2021
Objective
To understand the outcome of hospitalised patients from Mumbai City, which had the highest number of COVID-19 cases in India.
Design
Observational study with follow-up.
Setting
Data extraction from medical records of patients with COVID-19 admitted to Nair Hospital & TN Medical College, Mumbai, India.
Participants
689 patients with COVID-19 were admitted in the hospital from 26 March 2020 to 11 May 2020.
Primary and secondary outcome measures
In-hospital mortality; joint effect of comorbidity and age on the risk of dying.
Results
A total of 689 patients (median age 44 years) admitted with RT-PCR-confirmed COVID-19 were included in the study. Of these, 77.36% of patients were discharged alive while 22.64% died. 11.61% required some kind of oxygen support while 2.8% of patients required intensive care unit admissions. Older age (HR 2.88, 95% CI 2.09 to 3.98), presence of comorbidities (HR 2.56, 95% CI 1.84 to 3.55), history of hypertension (HR 3.19, 95% CI 1.67 to 6.08), and presence of symptoms at the time of admission (HR 3.21, 95% CI 1.41 to 7.26) were associated with increased risk of in-hospital mortality. Treatment with a combination of azithromycin with hydroxychloroquine, antiviral or steroid compared with no treatment did not alter the disease course and in-hospital mortality. The combined effect of old age and presence of comorbid conditions was more pronounced in women than men.
Conclusions
In-hospital patients were younger, less symptomatic with lesser need of ventilators and oxygen support as compared with many western countries.
Trial registration
Not applicable (observational study, not a clinical trial).
Læs mere Tjek på PubMedGasper, H., Ahern, E., Roberts, N., Chan, B., Hughes, B., Kennedy, G., Wyld, D., Eastgate, M., Lwin, Z.
BMJ Open, 6.05.2021
Tilføjet 6.05.2021
Introduction
Sars-CoV-2 is a novel coronavirus responsible for COVID-19 officially declared pandemic in March 2020. Health systems worldwide responded with swift changes to increase workflow capacity while protecting the vulnerable, including those with cancer. This led to unprecedented and rapid restructuring of health service provision. Published data from the 2003 SARS pandemic focuses on medical and nursing staff, overlooking other departmental employees such as administration officers or food service workers. Our protocol aims to document directives and adjustments communicated to staff in two cancer care departments and correlate this with measures of distress and perceived preparedness across the spectrum of all staff involved in cancer care.
Methods and analysis
We use a semiqualitative approach comprising weekly diarising of events and simultaneous staff surveys. Principal investigators will document changes at a metropolitan quaternary cancer centre and a regional cancer centre. Communications, directives and changes will be diarised in real time in four executional domains. Simultaneously, prospective voluntary self-administered online surveys will be conducted at regular intervals by staff. The survey assesses the perceived institutional preparedness and personal well-being, with a combination of Likert scaled and open response questions. A semiquantitative self-assessment of distress adapted from National Comprehensive Cancer Network distress thermometer is incorporated. Additionally, open-text personal reflections on themes including difficult decisions will be invited. Survey participants will be drawn from various work areas of the cancer care departments: administrative staff, health professionals, for example, allied health, ancillary workers, nursing and medical.
Ethics and dissemination
The study has been reviewed and approved by the Human Research Ethics Committee (LNR/2020/QRBW/62982). Published literature on domains of distress neglects categories of healthcare worker who form an essential part of the care delivery team. Our study hopes to gather insights about psychosocial impact and adjustment which could direct responses in future emergencies.
Læs mere Tjek på PubMedEmerging Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
Emerging Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
Emerging Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
Emerging Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
Emerging Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
Emerging Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
Malaria Journal, 6.05.2021
Tilføjet 6.05.2021
Abstract
Background
Regular monitoring of anti-malarial drug efficacy is vital for establishing rational malaria treatment guidelines and ensuring adequate treatment outcomes. This study aimed to synthesize the available evidence on the efficacy of artemether-lumefantrine for the management of uncomplicated falciparum malaria in Ethiopia.
Methods
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Relevant published studies were searched from the databases (PubMed, Google Scholar and Clinical trial registry) on published artemether-lumefantrine therapeutic efficacy studies conducted in Ethiopia from 2004 to 2020. The retrieved studies were assessed for quality using the modified Newcastle Ottawa Scale for observational studies and modified Jadad scale for interventional studies. Risk of bias was also assessed by using ROBINS-I tool. OpenMeta-Analyst software was used for the statistical analysis. The review protocol is registered in PROSPERO, number CRD42020201859.
Results
Fifteen studies (1523 participants) were included in the final analysis. The overall PCR-uncorrected pooled proportion of treatment success of artemether-lumefantrine therapy for uncomplicated falciparum malaria was 98.4% (95%CI 97.6-99.1). A random-effects model was used because of considerable heterogeneity [χ2‰=‰20.48, df (14), P‰=‰0.011 and I2‰=‰31.65]. PCR-corrected pooled proportion of treatment success of artemether-lumefantrine therapy was 98.7% (95% CI 97.7-99.6). A random-effects model was used [χ2‰=‰7.37, df(6), P‰=‰0.287 and I2‰=‰18.69]. Most studies included in the present review achieved a rapid reduction of fevers and parasitaemia between D0 and D3 of assessment. Adverse events were mostly mild and only two cases were reported as serious, but were not directly attributed to the drug.
Conclusion
The present meta-analysis suggests that artemether-lumefantrine therapy is efficacious and safe in treating uncomplicated falciparum malaria in Ethiopia. However, owing to the high risk of bias in the included studies, strong conclusions cannot be drawn. Further high-quality RCTs assessing anti-malarial efficacy and safety should be performed to demonstrates strong evidence of changes in parasite sensitivity to artemether-lumefantrine in Ethiopia.
Læs mere Tjek på PubMedBMC Infectious Diseases, 6.05.2021
Tilføjet 6.05.2021
Abstract
Background
Candida auris infections are an emerging global threat with poor clinical outcome, high mortality rate, high transmission rate and outbreak potential. The objective of this work is to describe a multidisciplinary approach towards the investigation and containment of a Candida auris outbreak and the preventive measures adopted in a resource limited setting.
Methods
This outbreak investigational study was conducted at a 1300-bedded tertiary care academic hospital in South India. The study included 15 adult inpatients with laboratory confirmed Candida auris isolates. The outbreak cluster was identified in adult patients admitted from September 2017 to 2019. The system response consisted of a critical alert system for laboratory confirmed Candida auris infection and multidisciplinary ˜Candida auris care team™ for patient management. The team implemented stringent Infection Prevention and Control (IPC) measures including patient cohorting, standardized therapy and decolonization, staff training, prospective surveillance and introduction of Candida auris specific care bundle.
Results
Two outbreak clusters were identified; first cluster occurring between October and November 2017 and the second cluster in May 2018. The cohorts consisted of 7 and 8 Candida auris positive patients in the first and second waves of the outbreak respectively with a total survival rate of 93% (14/15). Deployment of containment measures led to gradual decline in the incidence of adult Candida auris positive cases and prevented further cluster formation.
Conclusions
The sustained implementation of guideline and evidence-based IPC measures and training of healthcare workers for improving awareness on systematically following standardized protocols of Candida auris related IPC practices successfully contained Candida auris outbreaks at our hospital. This demonstrates the feasibility of establishing a multidisciplinary model and bundling of practices for preventing Candida auris outbreaks in a Low- and Middle-income country.
Læs mere Tjek på PubMedSusan E. Dorman, Payam Nahid, Ekaterina V. Kurbatova, Patrick P.J. Phillips, Kia Bryant, Kelly E. Dooley, Melissa Engle, Stefan V. Goldberg, Ha T.T. Phan, James Hakim, John L. Johnson, Madeleine Lourens, Neil A. Martinson, Grace Muzanyi, Kim Narunsky, Sandy Nerette, Nhung V. Nguyen, Thuong H. Pham, Samuel Pierre, Anne E. Purfield, Wadzanai Samaneka, Radojka M. Savic, Ian Sanne, Nigel A. Scott, Justin Shenje, Erin Sizemore, Andrew Vernon, Ziyaad Waja, Marc Weiner, Susan Swindells, Richard E. Chaisson
New England Journal of Medicine, 5.05.2021
Tilføjet 6.05.2021
New England Journal of Medicine, Volume 384, Issue 18, Page 1705-1718, May 2021.
Læs mere Tjek på PubMedTomás B. Corcoran, Paul S. Myles, Andrew B. Forbes, Allen C. Cheng, Leon A. Bach, Edmond O™Loughlin, Kate Leslie, Matthew T.V. Chan, David Story, Timothy G. Short, Catherine Martin, Pauline Coutts, Kwok M. Ho
New England Journal of Medicine, 5.05.2021
Tilføjet 6.05.2021
New England Journal of Medicine, Volume 384, Issue 18, Page 1731-1741, May 2021.
Læs mere Tjek på PubMedEric J. Rubin, Valerie Mizrahi
New England Journal of Medicine, 5.05.2021
Tilføjet 6.05.2021
New England Journal of Medicine, Volume 384, Issue 18, Page 1764-1765, May 2021.
Læs mere Tjek på PubMedEric J. Rubin, Lindsey R. Baden, Zarir F. Udwadia, Stephen Morrissey
New England Journal of Medicine, 5.05.2021
Tilføjet 6.05.2021
Laith J. Abu-Raddad, Hiam Chemaitelly, Adeel A. Butt
New England Journal of Medicine, 5.05.2021
Tilføjet 6.05.2021
Kathleen M. Neuzil
New England Journal of Medicine, 5.05.2021
Tilføjet 6.05.2021
Vivek Shinde, Sutika Bhikha, Zaheer Hoosain, Moherndran Archary, Qasim Bhorat, Lee Fairlie, Umesh Lalloo, Mduduzi S.L. Masilela, Dhayendre Moodley, Sherika Hanley, Leon Fouche, Cheryl Louw, Michele Tameris, Nishanta Singh, Ameena Goga, Keertan Dheda, Coert Grobbelaar, Gertruida Kruger, Nazira Carrim-Ganey, Vicky Baillie, Tulio de Oliveira, Anthonet Lombard Koen, Johan J. Lombaard, Rosie Mngqibisa, As™ad E. Bhorat, Gabriella Benadé, Natasha Lalloo, Annah Pitsi, Pieter-Louis Vollgraaff, Angelique Luabeya, Aliasgar Esmail, Friedrich G. Petrick, Aylin Oommen-Jose, Sharne Foulkes, Khatija Ahmed, Asha Thombrayil, Lou Fries, Shane Cloney-Clark, Mingzhu Zhu, Chijioke Bennett, Gary Albert, Emmanuel Faust, Joyce S. Plested, Andreana Robertson, Susan Neal, Iksung Cho, Greg M. Glenn, Filip Dubovsky, Shabir A. Madhi
New England Journal of Medicine, 5.05.2021
Tilføjet 6.05.2021
Scott Ratzan, Eric C. Schneider, Hilary Hatch, Joseph Cacchione
New England Journal of Medicine, 5.05.2021
Tilføjet 6.05.2021
Xuchang Zhang, Man Jiang, Jianshe Yang
International Journal of Infectious Diseases, 5.05.2021
Tilføjet 6.05.2021
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread throughout the world. To date, more than 33 million people have had a confirmed diagnosis of coronavirus disease 2019 (COVID-19), and over 1 million people have died from it. At the onset of the COVID-19 pandemic, it was considered to be a mono-organ disease involving lesions; however, the pulmonary system, gastrointestinal system, kidney, heart, and liver have now been identified as targets of SARS-CoV-2 infection (Cheung et al., 2020; Puelles et al., 2020).
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