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29 emner vises.
Padrosa J, Pellicé M, RodrÃguez-Núñez O, et al.
Clinical Infectious Diseases, 26.04.2021
Tilføjet 26.04.2021
BMC Infectious Diseases, 26.04.2021
Tilføjet 26.04.2021
Abstract
Background
Antibiotic resistance is often reported and great concerned as one of public health problems especially people living with poverty in developing countries including Thailand. The hill tribe people is defined as vulnerable population for antibiotic resistance in Thailand due to poor economic and education status particularly the Lahu people who is the second greatest group of the hill tribe people in Thailand. The study aimed to estimate the prevalence, factors associated with, and typing major species of bacteria with antibiotic drugs resistance among the Lahu hill tribe people in northern Thailand.
Methods
A cross-sectional study was conducted to gather the information from the participants. A validated questionnaire was used for data collection. Participants who presented an illness related to infectious diseases were eligible to participate the study and were asked to obtain specific specimen; sputum, urine or stool. Antibiotic susceptibility was tested by Kirbey Bauer™s disc diffusion test. Chi-square and logistic regression were used to detect the associations between variables at the significant level of α‰=‰0.05.
Results
A total of 240 participants were recruited into the study. The majority had urinary tract infection (67.9%) with two major pathogenic species of the infection; Escherichia coli (12.8%), and Enterobacter cloacae (8.0%). The prevalence of antibiotic resistance was 16.0%. Escherichia coli and Klebsiella pneumoniae species were found to have multidrug resistance that was greater than that of other species, while ampicillin was found to have the greatest drug resistance. It was found that those who had poor knowledge of antibiotic use had a 2.56-fold greater chance (95% CI‰=‰1.09-5.32) of having antibiotic resistance than did those who had good knowledge of antibiotic use, and those who had poor antibiotic use behaviors had a 1.79-fold greater chance (95% CI‰=‰1.06-4.80) of having antibiotic resistance than did those who had good antibiotic use behaviors.
Conclusion
Effective public health interventions are urgently needed to reduce antibiotic drug resistance among the Lahu people by improving their knowledge and skills regarding the proper use of antibiotics and eventually minimizing antibiotic resistance. Moreover, health care professionals should strictly follow the standard guideline to prescribe antibiotics.
Læs mere Tjek på PubMedMalaria Journal, 26.04.2021
Tilføjet 26.04.2021
Abstract
Background
The aim of this study was to investigate and analyse the characteristics of malaria in Shanghai from 2010 to 2019 and to provide suggestions for areas with a similar elimination process in China in order to prompt development of strategies and interventions in the post-elimination stage.
Methods
This was a cross-sectional study exploring the malaria characteristics during 2010-2019 in Shanghai, China. Malaria data from the Infectious Diseases Information Reporting Management System (IDIRMS) between 2010 and 2012 and data from the Parasitic Diseases Information Reporting Management System (PDIRMS) between 2013 and 2019 were combined for analysis in this study.
Results
From 2010 to 2019, a total of 436 malaria cases were reported in Shanghai. Among them, 415 (95.18%) were imported from abroad, 19 (4.36%) were domestically acquired from other provinces, 1 (0.23%) case was caused by blood transfusion, and 1 (0.23%) had a long incubation. Only Plasmodium vivax was found in domestically indigenous cases; Plasmodium falciparum accounted for the largest proportion of imported cases. Domestically acquired cases were only reported in 2010-2011 and 88% occurred in June to September; no significant seasonal difference was observed for imported cases over the 10 years. No local transmission has occurred in Shanghai since 2012. The median interval from fever onset to diagnosis was 3 days. Between 2010 and 2019, among 308 foci, 33 were classified as potential transmission and dispersed in suburb areas (Minhang, Baoshan, Jiading, Pudong, Jinshan, Songjiang, Qingpu, Fengxian, and Chongming). Only Anopheles sinensis was present and the proportion of Anopheles sinensis in different species of mosquitoes under surveillance in Shanghai decreased from 2011 to 2019.
Conclusions
Shanghai faces the challenge of malaria re-establishment caused by imported malaria in the post-elimination stage. Therefore, risk investigation and assessment should be carried out, and receptivity and susceptibility should be assessed for every point of focus. Training should be continued to strengthen facility staff capability, and multisectoral coordination and cooperation need to be conducted efficiently to maintain malaria elimination in Shanghai.
Læs mere Tjek på PubMedRafael Dal-Ré, Walter Orenstein, Arthur L. Caplan
Nature, 26.04.2021
Tilføjet 26.04.2021
Nature Medicine, Published online: 26 April 2021; doi:10.1038/s41591-021-01338-1
Being fair to participants in placebo-controlled COVID-19 vaccine trials
Læs mere Tjek på PubMedBMC Infectious Diseases, 26.04.2021
Tilføjet 26.04.2021
Abstract
Background
The aim of the study was to conduct a meta-analysis to evaluate the accuracy of neutrophil CD64, procalcitonin (PCT), and interleukin-6 (IL-6) as markers for the diagnosis of sepsis in adult patients.
Methods
Various databases were searched to collect published studies on the diagnosis of sepsis in adult patients using neutrophil CD64, PCT, and IL-6 levels. Utilizing the Stata SE 15.0 software, forest plots and the area under the summary receiver operating characteristic curves were drawn. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve (AUC) were calculated.
Results
Fifty-four articles were included in the study. The pooled sensitivity, specificity, and AUC of neutrophil CD64 for the diagnosis of sepsis were 0.88 (95% confidence interval [CI], 0.81-0.92), 0.88 (95% CI, 0.83-0.91), and 0.94 (95% CI, 0.91-0.96), respectively. The pooled sensitivity, specificity, and AUC of PCT for the diagnosis of sepsis were 0.82 (95% CI, 0.78-0.85), 0.78 (95% CI, 0.74-0.82), and 0.87 (95% CI, 0.83-0.89), respectively. Subgroup analysis showed that the AUC for PCT diagnosis of intensive care unit (ICU) sepsis was 0.86 (95% CI, 0.83-0.89) and the AUC for PCT diagnosis of non-ICU sepsis was 0.82 (95% CI, 0.78-0.85). The pooled sensitivity, specificity, and AUC of IL-6 for the diagnosis of sepsis were 0.72 (95% CI, 0.65-0.78), 0.70 (95% CI, 0.62-0.76), and 0.77 (95% CI, 0.73-0.80), respectively.
Conclusions
Of the three biomarkers studied, neutrophil CD64 showed the highest diagnostic value for sepsis, followed by PCT, and IL-6. On the other hand, PCT showed a better diagnostic potential for the diagnosis of sepsis in patients with severe conditions compared with that in patients with non-severe conditions.
Læs mere Tjek på PubMedMalaria Journal, 26.04.2021
Tilføjet 26.04.2021
Abstract
Background
The World Health Organization (WHO) recommends consideration of mass drug administration (MDA) for malaria control in low-endemic settings approaching elimination. However, MDA remains a controversial strategy, as multiple individual, social, and operational factors have shown to affect its acceptability at local levels. This is further complicated by inconsistent definitions of key indicators derived from individual and community involvement”coverage, adherence, and compliance”that cast doubts about the actual and potential epidemiological impact of MDA on disease control and elimination. This study aimed to identify limitations and enabling factors impacting involvement at different stages of a large cluster-randomized trial assessing the effect of combining dihydroartemisinin-piperaquine (DP) and ivermectin (IVM) in malaria transmission in The Gambia.
Methods
This social science study used a mixed-methods approach. Qualitative data were collected in intervention and control villages through ethnographic methods, including in-depth interviews (IDIs), focus group discussions (FGDs), and participant observation conducted with trial participants and decliners, community leaders, and field staff. A cross-sectional survey was conducted in the intervention villages after the first year of MDA. Both strands of the study explored malaria knowledge and opinions, social dynamics influencing decision-making, as well as perceived risks, burdens, and benefits associated with this MDA.
Results
157 IDIs and 11 FGDs were conducted, and 864 respondents were included in the survey. Barriers and enabling factors to involvement were differentially influential at the various stages of the MDA. Issues of social influence, concerns regarding secondary effects of the medication, costs associated with malaria, and acceptability of the implementing organization, among other factors, differently affected the decision-making processes throughout the trial. Rather than a linear trajectory, involvement in this MDA trial was subjected to multiple revaluations from enrolment and consent to medicine intake and adherence to treatment.
Conclusions
This study went beyond the individual factors often associated with coverage and adherence, and found that nuanced social dynamics greatly influence the decision-making process at all phases of the trial. These issues need to be consider for MDA implementation strategies and inform discussions about more accurate ways of reporting on critical effectiveness indicators.
Læs mere Tjek på PubMedNenad Macesic, Luke V. Blakeway, James D. Stewart, Jane Hawkey, Kelly L. Wyres, Louise M. Judd, Ryan R. Wick, Adam W. Jenney, Kathryn E. Holt, Anton Y. Peleg
Clinical Microbiology and Infection, 26.04.2021
Tilføjet 26.04.2021
mcr-9.1 is a newly described mobile colistin resistance gene. We noted its presence in multiple species of carbapenem-resistant Enterobacterales (CRE) from our institution. We aimed to determine the clinical features, genomic context and phenotypic impact of mcr-9.1 carriage in a series of patients from 2010-2019.
Læs mere Tjek på PubMedBMC Infectious Diseases, 26.04.2021
Tilføjet 26.04.2021
Abstract
Background
The epidemiology and outcomes of COVID-19 patients in Thailand are scarce.
Methods
This retrospective cohort study included adult hospitalized patients who were diagnosed with COVID-19 at Siriraj Hospital during February 2020 to April 2020.
Results
The prevalence of COVID-19 was 7.5% (107 COVID-19 patients) among 1409 patients who underwent RT-PCR for SARS-CoV-2 detection at our hospital during the outbreak period. Patients with COVID-19 presented with symptoms in 94.4%. Among the 104 patients who were treated with antiviral medications, 78 (75%) received 2-drug regimen (lopinavir/ritonavir or darunavir/ritonavir plus chloroquine or hydroxychloroquine), and 26 (25%) received a 3-drug regimen with favipiravir added to the 2-drug regimen. Disease progression was observed in 18 patients (16.8%). All patients with COVID-19 were discharged alive.
Conclusions
The prevalence of COVID-19 was 7.5% among patients who underwent RT-PCR testing, and 10% among those having risk factors for COVID-19 acquisition. Combination antiviral therapies for COVID-19 patients were well-tolerated and produced a favorable outcome.
Læs mere Tjek på PubMedMalaria Journal, 26.04.2021
Tilføjet 26.04.2021
Abstract
Background
The lack of background disease incidence rates in sub-Saharan countries where the RTS,S/AS01E malaria vaccine is being implemented may hamper the assessment of vaccine safety and effectiveness. This study aimed to document baseline incidence rates of meningitis, malaria, mortality, and other health outcomes prior to vaccine introduction through the Malaria Vaccine Implementation Programme.
Methods
An ongoing disease surveillance study is combining prospective cohort event monitoring and hospital-based disease surveillance in three study sites in Ghana and Kenya. An interim analysis was performed on the prospective cohort in which children were enrolled in two age-groups (the 5 to 17 months or 6 to 12 weeks age-group), capturing data in the framework of routine medical practice before the introduction of the malaria vaccine. Incidence and mortality rates were computed with 95% confidential intervals (CI) using an exact method for a Poisson variable.
Results
This analysis includes 14,329 children; 7248 (50.6%) in the 6 to 12 weeks age-group and 7081 (49.4%) in the 5 to 17 months age-group. In the 5 to 17 months age-group (where the malaria vaccine was planned to be subsequently rolled out) the meningitis, malaria, severe malaria and cerebral malaria incidences were 92 (95% CI 25-236), 47,824 (95% CI 45,411-50,333), 1919 (95% CI 1461-2476) and 33 (95% CI 1-181) per 100,000 person-years, respectively. The all-cause mortality was 969 (95% CI 699-1310) per 100,000 person-years.
Conclusion
Incidence estimates of multiple health outcomes are being generated to allow before-after vaccine introduction comparisons that will further characterize the benefit-risk profile of the RTS,S/AS01E vaccine.
Trial registration: clinicaltrials.gov NCT02374450.
Læs mere Tjek på PubMedPoornima Baby, Vipin Mohan, Malini Eapen, Anna Kurian, Arya Ramachandran, Balu C. Babu, Anil Kumar
Clinical Microbiology and Infection, 25.04.2021
Tilføjet 26.04.2021
Eumycotic mycetoma or eumycetoma is a chronic cutaneous and subcutaneous granulomatous infection caused by various fungi. A 65 year old gentleman presented with a history of nodular swellings on the right foot with discharging sinuses of six years duration. Radiological features showed signs of osteomyelitis. Histopathological examination of the tissue was suggestive of eumycetoma. Fungal culture of the granular discharge grew Madurella species. The patient responded well to itraconazole oral therapy, 200 mg twice daily.
Læs mere Tjek på PubMedValérie Zeller, Sophie Magreault, Beate Heym, Dominique Salmon, Marie-Dominique Kitzis, Eliane Billaud, Simon Marmor, Anne-Sophie Jannot, Laurence Salomon, Vincent Jullien
Clinical Microbiology and Infection, 25.04.2021
Tilføjet 26.04.2021
An important clindamycin-rifampicin pharmacokinetic (PK) interaction was reported previously but the potential influence of the clindamycin-administration route on that interaction is unknown. This prospective, observational, comparative PK study was undertaken to characterize and analyze route impact, comparing the rifampicin enzyme-inductor effects on clindamycin clearance (CLclin) for oral vs intravenous (IV) administration.
Læs mere Tjek på PubMedClaire Amaris Hobson, Aurélie Cointe, Hervé Jacquier, Alaksh Choudhury, Mélanie Magnan, Céline Courroux, Olivier Tenaillon, Stéphane Bonacorsi, André Birgy
Clinical Microbiology and Infection, 25.04.2021
Tilføjet 26.04.2021
Ceftazidime-avibactam and cefiderocol are recently commercialized molecules active against highly drug-resistant bacteria, including carbapenem-resistant Enterobacteriaceae. Resistant mutants to ceftazidime-avibactam were described and notably in Klebsiella pneumoniae carbapenemase (KPC). Considering the structural similarities between ceftazidime and cefiderocol, we hypothesized that resistance to ceftazidime-avibactam in KPC-producing Enterobacterales may lead to cross-resistance to cefiderocol.
Læs mere Tjek på PubMedBMC Infectious Diseases, 24.04.2021
Tilføjet 24.04.2021
Abstract
Background
There is scarce knowledge on the prevalence of diseases caused by non-tuberculous mycobacteria (NTM) in Pakistan. In the absence of culture and identification, acid-fast bacilli (AFB) causing NTM disease are liable to be misinterpreted as tuberculosis (TB). Introduction of nucleic acid amplification testing for Mycobacterium tuberculosis complex (MTBC) offers improved diagnostic accuracy, compared with smear microscopy, and also assists in differentiating MTBC from other mycobacteria. This study aimed to investigate the prevalence of NTM among patients investigated for TB and describe NTM disease and treatment outcomes at a tertiary care hospital in Pakistan.
Methods
This is a retrospective study, data on NTM isolates among culture-positive clinical samples over 4 years (2016-19) was retrieved from laboratory records. Information on clinical specimens processed, AFB smear results, and for the AFB positive isolates, results of species identification for MTBC, and for NTM isolates, results of species characterization and drug susceptibility testing was collected. Additional clinical data including patient characteristics, treatment regimens, and outcomes were collected for patients with NTM disease treated at Gulab Devi Hospital, Lahore.
Results
During the study period, 12,561 clinical specimens were processed for mycobacterial culture and 3673 (29%) were reported positive for AFB. Among these 3482 (95%) were identified as MTBC and 191 (5%) as NTM. Among NTM, 169 (88%) were isolated from pulmonary and 22 (12%) from extrapulmonary specimens. Results of NTM speciation were available for 60 isolates and included 55% (n‰=‰33) M. avium complex and 25% (n‰=‰15) M. abscesses. Among these patients, complete clinical records were retrieved for 12 patients with pulmonary disease including nine infected with M. avium complex and three with M. abscessus. All 12 patients had a history of poor response to standard first-line anti-TB treatment. Ten patients were cured after 18‰months of treatment, whereas, one with M. abscessus infection died and another was lost to follow up.
Conclusion
In TB endemic areas, NTM can be misdiagnosed as pulmonary TB leading to repeated failed anti-TB treatment and increased morbidity, emphasizing the need for improved diagnosis.
Læs mere Tjek på PubMedMonroe-Wise, A., Mbogo, L., Guthrie, B., Bukusi, D., Sambai, B., Chohan, B., Scott, J., Cherutich, P., Musyoki, H., Bosire, R., Dunbar, M., Macharia, P., Masyuko, S., Wilkinson, E., De Oliveira, T., Ludwig-Barron, N., Sinkele, B., Herbeck, J., Farquhar, C.
BMJ Open, 24.04.2021
Tilføjet 24.04.2021
Introduction
Targeted, tailored interventions to test high-risk individuals for HIV and hepatitis C virus (HCV) are vital to achieving HIV control and HCV microelimination in Africa. Compared with the general population, people who inject drugs (PWID) are at increased risk of HIV and HCV and are less likely to be tested or successfully treated. Assisted partner services (APS) increases HIV testing among partners of people living with HIV and improves case finding and linkage to care. We describe a study in Kenya examining whether APS can be adapted to find, test and link to HIV care the partners of HIV-positive PWID using a network of community-embedded peer educators (PEs). Our study also identifies HCV-positive partners and uses phylogenetic analysis to determine risk factors for onward transmission of both viruses.
Methods
This prospective cohort study leverages a network of PEs to identify 1000 HIV-positive PWID for enrolment as index participants. Each index completes a questionnaire and provides names and contact information of all sexual and injecting partners during the previous 3 years. PEs then use a stepwise locator protocol to engage partners in the community and bring them to study sites for enrolment, questionnaire completion and rapid HIV and HCV testing. Outcomes include number and type of partners per index who are mentioned, enrolled, tested, diagnosed with HIV and HCV and linked to care.
Ethics and dissemination
Potential index participants are screened for intimate partner violence (IPV) and those at high risk are not eligible to enrol. Those at medium risk are monitored for IPV following enrolment. A community advisory board engages in feedback and discussion between the community and the research team. A safety monitoring board discusses study progress and reviews data, including IPV monitoring data. Dissemination plans include presentations at quarterly Ministry of Health meetings, local and international conferences and publications.
Trial registration number
NCT03447210, Pre-results stage.
Læs mere Tjek på PubMedBaral, R., Higgins, D., Regan, K., Pecenka, C.
BMJ Open, 24.04.2021
Tilføjet 24.04.2021
Objectives
Interventions to prevent childhood respiratory syncytial virus (RSV) disease are limited and costly. New interventions are in advanced stages of development and could be available soon. This study aims to evaluate the potential impact and cost-effectiveness of two interventions to prevent childhood RSV—a maternal vaccine and a monoclonal antibody (mAb).
Design
Using a static population-based cohort model, we evaluate impact and cost-effectiveness of RSV interventions, from a health systems perspective. The assumed baseline efficacy and duration of protection were higher for the mAb (60%–70% efficacy, protection 6 months) compared with the maternal vaccine (40%–60% efficacy, protection 3 months). Both interventions were evaluated at US$3 and US$5 per dose for Gavi and non-Gavi countries, respectively. A range of input values were considered to explore uncertainty.
Settings
131 low-income and middle-income countries.
Participants
Pregnant women and live birth cohorts.
Interventions
Maternal vaccine given to pregnant women and mAb given to young infants.
Primary and secondary outcome measures
Disability-adjusted life years averted, severe case averted, deaths averted, incremental cost effectiveness ratios.
Results
Under baseline assumptions, maternal vaccine and mAbs were projected to avert 25% and 55% of RSV-related deaths among infants younger than 6 months of age, respectively. The average incremental cost-effectiveness ratio per disability-adjusted life year averted was US$1342 (range US$800–US$1866) for maternal RSV vaccine and US$431 (range US$167–US$692) for mAbs. At a 50% gross domestic product per capita threshold, maternal vaccine and mAbs were cost-effective in 60 and 118 countries, respectively.
Conclusions
Both interventions are projected to be impactful and cost-effective in many countries, a finding that would be enhanced if country-specific Gavi cofinancing to eligible countries were included. mAbs, with assumed higher efficacy and duration of protection, are expected to be more cost-effective than RSV maternal vaccines at similar prices. Final product characteristics will influence this finding.
Læs mere Tjek på PubMedvan der Ham, M., Bolijn, R., de Vries, A., Campos Ponce, M., van Valkengoed, I. G. M.
BMJ Open, 24.04.2021
Tilføjet 24.04.2021
Introduction
Many low-income and middle-income countries (LMIC) suffer from a double burden of infectious diseases (ID) and non-communicable diseases (NCD). Previous research suggests that a high rate of gender inequality is associated with a higher ID and NCD burden in LMIC, but it is unknown whether gender inequality is also associated with a double burden of disease. In this ecological study, we explored the association between gender inequality and the double burden of disease in LMIC.
Methods
For 108 LMIC, we retrieved the Gender Inequality Index (GII, scale 0–1) and calculated the double burden of disease, based on disability-adjusted life-years for a selection of relevant ID and NCD, using WHO data. We performed logistic regression analysis to study the association between gender inequality and the double burden of disease for the total population, and stratified for men and women. We adjusted for income, political stability, type of labour, urbanisation, government health expenditure, health infrastructure and unemployment. Additionally, we conducted linear regression models for the ID and NCD separately.
Results
The GII ranged from 0.13 to 0.83. A total of 37 LMIC had a double burden of disease. Overall, the adjusted OR for double burden of disease was 1.05 per 0.01 increase of GII (95% CI 0.99 to 1.10, p=0.10). For women, there was a borderline significant positive association between gender inequality and double burden of disease (OR 1.05, 95% CI 1.00 to 1.11, p=0.06), while there was no association in men (OR 0.99, 95% CI 0.95 to 1.04, p=0.75).
Conclusion
We found patterns directing towards a positive association between gender inequality and double burden of disease, overall and in women. This finding suggests the need for more attention for structural factors underlying gender inequality to potentially reduce the double burden of disease.
Læs mere Tjek på PubMedRoss, J., Murenzi, G., Hill, S., Remera, E., Ingabire, C., Umwiza, F., Munyaneza, A., Muhoza, B., Habimana, D. S., Mugwaneza, P., Zhang, C., Yotebieng, M., Anastos, K.
BMJ Open, 24.04.2021
Tilføjet 24.04.2021
Introduction
Current HIV guidelines recommend differentiated service delivery (DSD) models that allow for fewer health centre visits for clinically stable people living with HIV (PLHIV). Newly diagnosed PLHIV may require more intensive care early in their treatment course, yet frequent appointments can be burdensome to patients and health systems. Determining the optimal parameters for defining clinical stability and transitioning to less frequent appointments could decrease patient burden and health system costs. The objectives of this pilot study are to explore the feasibility and acceptability of (1) reducing the time to DSD from 12 to 6 months after antiretroviral therapy (ART) initiation,and (2) reducing the number of suppressed viral loads required to enter DSD from two to one.
Methods and analyses
The present study is a pilot, unblinded trial taking place in three health facilities in Kigali, Rwanda. Current Rwandan guidelines require PLHIV to be on ART for ≥12 months with two consecutive suppressed viral loads in order to transition to less frequent appointments. We will randomise 90 participants to one of three arms: entry into DSD at 6 months after one suppressed viral load (n=30), entry into DSD at 6 months after two suppressed viral loads (n=30) or current standard of care (n=30). We will measure feasibility and acceptability of this intervention; clinical outcomes include viral suppression at 12 months (primary outcome) and appointment attendance (secondary outcome).
Ethics and dissemination
This clinical trial was approved by the institutional review board of Albert Einstein College of Medicine and by the Rwanda National Ethics Committee. Findings will be disseminated through conferences and peer-reviewed publications, as well as meetings with stakeholders.
Trial registration number
NCT04567693.
Læs mere Tjek på PubMedEnoch, J., Ghulakhszian, A., Crabb, D. P., Dinah, C., Taylor, D. J.
BMJ Open, 24.04.2021
Tilføjet 24.04.2021
Introduction
Age-related macular degeneration (AMD) is a common cause of visual impairment, affecting central vision. Geographic atrophy (GA) is an advanced form of the non-neovascular (dry) type of AMD. Late-stage clinical trials suggest that intravitreal injections of novel therapeutics may slow down the rate of GA progression by up to 30% in 1 year, thus allowing people with GA to preserve central vision for a longer period. While intravitreal injections have become an established treatment modality for neovascular (wet) AMD, it is unknown whether patients with (more gradually progressing) GA would accept regular injections that slow down, but do not stop or reverse, vision loss. Therefore, this mixed-methods pilot study will aim to explore whether regular intravitreal injections will be acceptable as treatment for patients with GA, and the factors that may affect treatment acceptability.
Methods and analysis
A mixed-methods survey has been designed in collaboration with a GA patient advisory group. The survey comprises of structured questionnaires, semi-structured interview questions regarding patients’ perceptions of intravitreal injections and the burden of treatment, and a task eliciting preferences between different potential treatments. Due to COVID-19 restrictions, this study will be conducted remotely by telephone. Thirty individuals will be recruited from NHS Medical Retina clinics at Central Middlesex Hospital, London. Half of the participants will be naïve to intravitreal injections, while half will have previous experience of intravitreal injections for neovascular (wet) AMD. Qualitative data analysis will be conducted using the Framework Method of analysis to identify key themes from participants’ accounts.
Ethics and dissemination
The study received Health Research Authority approval on 23 March 2021 (IRAS Project ID: 287824). Findings will be disseminated through peer-reviewed publications and conference presentations to the medical retina community, as well as through dialogue with patients and macular disease charities.
Læs mere Tjek på PubMedNah, E.-H., Cho, S., Park, H., Hwang, I., Cho, H.-I.
BMJ Open, 24.04.2021
Tilføjet 24.04.2021
Objective
Asymptomatic active infection might be an important contributor to the COVID-19 outbreak. Serological tests can assess the extent of exposure and herd immunity to COVID-19 in general populations. This study aimed to estimate the nationwide seroprevalence of SARS-CoV-2 antibodies according to age, sex and clinical status in South Korea.
Design, setting and participants
This cross-sectional study randomly selected health examinees who underwent health check-up at 16 health promotion centres in 13 Korean cities across the country between late September and early December 2020. Residual serum samples were obtained from 4085 subjects (2014 men and 2071 women). Antibodies to SARS-CoV-2 were measured by electrochemiluminescence immunoassay using Elecsys Anti-SARS-CoV-2 (Roche Elecsys, Mannheim, Germany).
Primary and secondary outcome measures
Fisher’s exact test was used to compare the seroprevalence according to sex, age group and region. The relative risks of being seropositive according to the characteristics of the study subjects were analysed using logistic regression analysis.
Results
The overall seroprevalence of anti-SARS-CoV-2 was 0.39% (95% CI=0.20% to 0.58%): 0.30% (95% CI=0.06% to 0.54%) for men and 0.48% (95% CI=0.18% to 0.78%) for women. The rate of anti-SARS-CoV-2 positivity varied significantly between different regions of Korea (p=0.003), but not with age group, sex, or the statuses of obesity, diabetes, hypertension or smoking.
Conclusions
Most of the Korean population is still immunologically vulnerable to SARS-CoV-2, but the seroprevalence has increased relative to that found in studies performed prior to September 2020 in Korea.
Læs mere Tjek på PubMedHandebo, S., Adugna, A., Kassie, A., Shitu, K.
BMJ Open, 24.04.2021
Tilføjet 24.04.2021
Purpose
In Ethiopia, more than 26 million students have been out of the classroom for nearly 9 months. On 18 September, the Ethiopian Minister of Health advised the Parliament the possibility of reopening schools provided certain conditions were met. Schools are currently reopening in the country for the first time since March 2020.
Objective
This study assessed the knowledge and preventive health behaviours toward COVID-19 and associated factors among secondary school students.
Design, setting, participants and outcome measures
An institution-based cross-sectional study was conducted from October to December 2020 in Gondar city, Northwest Ethiopia. A total of 370 secondary school students were included. Bivariable and multivariable ordinal logistic regression model were fitted to identify the predictors of knowledge about COVID-19. Simple and multiple linear regression analysis were done to identify factors associated with preventive behaviour. A p<0.05 was used to declare statistical significance.
Results
Only one-fourth (23.5%, 95% CI 19.5% to 28.1%) of the participants had a good knowledge about COVID-19. The mean score of preventive behaviour was 22.8±SD 6.2. Marital status, religion, father education, living arrangement and sources of information were significantly associated with knowledge about COVID-19. Being female and using health professionals as source of information increased the engagement in preventive behaviours. On the other hand, student whose father employed in non-governmental organisation and other jobs had decreased engagement in preventive health behaviours.
Conclusion
Significant number of the students had inadequate knowledge about COVID-19 and poorly engaged in COVID-19 preventive behaviour. Thus, it is suggested to include and disseminate about COVID-19 in related academic sessions, using school clubs and minimedias. The sources of COVID-19-related information need to strengthen the dissemination of tailored, credible and timely message to enhance the knowledge and engagement of the students in preventive behaviours.
Læs mere Tjek på PubMedPonsuge Chathurani Sigera, Praveen Weeratunga, Sumadhya Deepika Fernando, Nipun Lakshitha De Silva, Chaturaka Rodrigo, Senaka Rajapakse
Tropical Medicine & International Health, 24.04.2021
Tilføjet 24.04.2021
Simon Pierre Niyonsenga, Paul H. Park, Gedeon Ngoga, Evariste Ntaganda, Fred Kateera, Neil Gupta, Edson Rwagasore, Samuel Rwunganira, Antoine Munyarugo, Cadet Mutumbira, Symaque Dusabayezu, Arielle Eagan, Chantelle Boudreaux, Christopher Noble, Marie Aimee Muhimpundu, F Gilles Ndayisaba, Sabin Nsanzimana, Gene Bukhman, Francois Uwinkindi
Tropical Medicine & International Health, 24.04.2021
Tilføjet 24.04.2021
Banu Cakir
Journal of Medical Virology, 23.04.2021
Tilføjet 24.04.2021
Eduardo M. Lacap, Abraham Varghese, Faryal Khamis, Maher Al Bahrani, Hamed Al Naamani, Shajidmon Kolamban, Samata Al Dowaiki, Huda Salim Al Shuaily
International Journal of Infectious Diseases, 23.04.2021
Tilføjet 24.04.2021
Wuhan City, Hubei Province, People's Republic of China becomes the epicenter of the novel corona virus disease caused by severe acute respiratory syndrome corona virus 2 (SARS CoV-2) on December, 2019 (Huang et al., 2020; WHO, 2020). The disease spread worldwide, and the positivity rate increases exponentially that the World Health Organization subsequently declare the disease as pandemic on March 11, 2020. In Sultanate of Oman, from 2 confirmed cases on February, 2020, the cases reaches 107,213 with 1,053 deaths as of October 13, 2020 (Dong, 2020; Khamis, et al., 2020).
Læs mere Tjek på PubMedAlessandra D™Abramo, Serena Vita, Gaetano Maffongelli, Andrea Mariano, Chiara Agrati, Concetta Castilletti, Delia Goletti, Giuseppe Ippolito, Emanuele Nicastri, on behalf of Spallanzani COVID-19 Case Investigation Team
International Journal of Infectious Diseases, 23.04.2021
Tilføjet 24.04.2021
Patients with pre-existing comorbidities and immunosuppression including anti-CD20 monoclonal antibody, widely used for the treatment of haematological malignancies or autoimmune disease, are at greater risk for persistent Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2) infection (He et al, 2020). Prolonged B-cell depletion impairs the adaptive immune response and the ability to produce neutralizing antibodies causing severe manifestations and prolonged course of COVID-19 (Mehta et al, 2020, Hueso et al, 2020).
Læs mere Tjek på PubMedErika Matuschek, Alma Brolund, Oskar Karlsson Lindsjö, Christian G. Giske, Sara Byfors, Gunnar Kahlmeter
Clinical Microbiology and Infection, 23.04.2021
Tilføjet 24.04.2021
To investigate if adding calcium to Mueller-Hinton agar for gradient MIC or disk diffusion tests could improve separation between colistin susceptible and resistant populations of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter spp. and if this method could provide a reliable screening test for colistin resistance in routine laboratories.
Læs mere Tjek på PubMedRyohei Hirose, Risa Bandou, Hiroshi Ikegaya, Naoto Watanabe, Takuma Yoshida, Tomo Daidoji, Yuji Naito, Yoshito Itoh, Takaaki Nakaya
Clinical Microbiology and Infection, 23.04.2021
Tilføjet 24.04.2021
Disinfection effectiveness against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on human skin remains unclear due to the hazards of viral exposure. An evaluation model, which has been previously generated using human skin obtained from forensic autopsy samples, accurately mimics in vivo skin conditions for evaluating the effectiveness of disinfection against the virus. Using this model, we evaluated the disinfection effectiveness against viruses on human skin.
Læs mere Tjek på PubMedAnetta Ptasinska, Celina Whalley, Andrew Bosworth, Charlotte Poxon, Claire Bryer, Nicholas Machin, Seden Grippon, Emma L. Wise, Bryony Armson, Emma L.A. Howson, Alice Goring, Gemma Snell, Jade Forster, Chris Mattocks, Sarah Frampton, Rebecca Anderson, David Cleary, Joe Parker, Konstantinos Boukas, Nichola Graham, Doriana Cellura, Emma Garratt, Rachel Skilton, Hana Sheldon, Alla Collins, Nusreen Ahmad, Simon Friar, Daniel Burns, Tim Williams, Keith M. Godfrey, Zandra Deans, Angela Douglas, Sue Hill, Michael Kidd, Deborah Porter, Stephen P. Kidd, Nicholas J. Cortes, Veronica Fowler, Tony Williams, Alex Richter, Andrew D. Beggs
Clinical Microbiology and Infection, 23.04.2021
Tilføjet 24.04.2021
Rapid, high throughput diagnostics are a valuable tool, allowing the detection of SARS-CoV-2 in populations, in order to identify and isolate people with asymptomatic and symptomatic infections. Reagent shortages and restricted access to high throughput testing solutions have limited the effectiveness of conventional assays such as reverse transcriptase quantitative PCR (RT-qPCR), particularly throughout the first months of the COVID-19 pandemic. We investigated the use of LamPORE, where loop mediated isothermal amplification (LAMP) is coupled to nanopore sequencing technology, for the detection of SARS-CoV-2 in symptomatic and asymptomatic populations.
Læs mere Tjek på PubMedLancet Infectious Diseases, 24.04.2021
Tilføjet 24.04.2021
Gilbert SC, Lambe T. Recombinant protein vaccines against SARS-CoV-2. Lancet Infect Dis 2021; published online April 19. https://doi.org/10.1016/S1473-3099(21)00227-9”In this Comment the dose unit was incorrect. The dose unit should be œÎ¼g rather than œmg. This correction has been made to the online version as of April 23, 2021, and will be made to the printed version.
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