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Namusoke, F., Sekikubo, M., Namiiro, F., Nakigudde, J.
BMJ Open, 14.09.2021
Tilføjet 14.09.2021
Introduction
Babies born preterm often have challenges in feeding, temperature control and breathing difficulty and are prone to infection during the neonatal period. These usually necessitate admission to the neonatal intensive care unit (NICU). Admission to NICU disrupts the mother–baby bonding.
Objective
This study explored the lived experiences of mothers with preterm babies admitted to NICU in a low-resource setting.
Study design
This was a qualitative study where 16 participants took part in indepth interviews and 35 in focus group discussions. We included mothers who delivered and were caring for preterm babies at the NICU of Mulago National Referral Hospital.
Study setting
Data were collected from a public hospital, which works as a district and national referral hospital located in the capital of Uganda.
Participants
Fifty-one mothers with preterm babies in the NICU were sampled and recruited after informed consent. Data were analysed using manual thematic analysis.
Results
There were six themes on the experiences of mothers of preterm babies in NICU: constant worry and uncertainty about the survival of their babies, baby feeding challenges, worries of discharge, communication gaps between mothers and nurses, community acceptability and disdain for preterm babies, and financial challenges.
Conclusions and recommendations
Mothers of preterm babies admitted to NICU in a low-resource setting still need a lot of support other than the medical care given to their babies. Support groups in the hospital and community are recommended to help in dealing with these challenges.
Læs mere Tjek på PubMedMuller, G., Kamel, T., Contou, D., Ehrmann, S., Martin, M., Quenot, J.-P., Lacherade, J.-C., Boissier, F., Monnier, A., Vimeux, S., Brunet Houdard, S., Tavernier, E., Boulain, T.
BMJ Open, 14.09.2021
Tilføjet 14.09.2021
Introduction
The use of peripheral indwelling arterial catheter for haemodynamic monitoring is widespread in the intensive care unit and is recommended in patients with shock. However, there is no evidence that the arterial catheter could improve patient’s outcome, whereas the burden of morbidity generated is significant (pain, thrombosis, infections). We hypothesise that patients with shock may be managed without an arterial catheter.
Methods and analysis
The EVERDAC study is an investigator-initiated, pragmatic, multicentre, randomised, controlled, open-label, non-inferiority clinical trial, comparing a less invasive intervention (ie, no arterial catheter insertion until felt absolutely needed, according to predefined safety criteria) or usual care (ie, systematic arterial catheter insertion in the early hours of shock). 1010 patients will be randomised with a 1:1 ratio in two groups according to the strategy. The primary outcome is all-cause mortality by 28 days after inclusion. A health economic analysis will be carried out.
Ethics and dissemination
The study has been approved by the Ethics Committee (Comité de Protection des Personnes Île de France V, registration number 61606 CAT 2, 19 july 2018) and patients will be included after informed consent. The results will be submitted for publication in peer-reviewed journals.
Trial registration number
NCT03680963.
Læs mere Tjek på PubMedAbbasi J.
Journal of the American Medical Association, 14.09.2021
Tilføjet 14.09.2021
In a recent study, binding and functional antibodies against SARS-CoV-2 variants persisted for at least 6 months for most adults who received both doses of Moderna’s mRNA vaccine. However, the antibodies waned over that period and some serum samples collected at 6 months no longer neutralized the variants, the researchers reported in Science.
Læs mere Tjek på PubMedAbbasi J.
Journal of the American Medical Association, 14.09.2021
Tilføjet 14.09.2021
Researchers at Harvard’s Wyss Institute for Biologically Inspired Engineering recently described a low-cost, user-friendly point-of-care (POC) device that detects SARS-CoV-2 and several variants of concern in an hour using saliva samples.
Læs mere Tjek på PubMedJournal of the American Medical Association, 14.09.2021
Tilføjet 14.09.2021
In the Original Investigation titled “Association of Maternal SARS-CoV-2 Infection in Pregnancy With Neonatal Outcomes,” published in the May 25, 2021, issue of JAMA, an incorrect percentage appeared in the abstract and in the text. In the Results section of the abstract, the first sentence should have been “Of 88 159 infants (49.0% girls), 2323 (2.6%) were delivered by mothers who tested positive for SARS-CoV-2.” In the Results section of the text, the second sentence should have been “Among 88 159 newborn infants included (49.0% girls), 2323 (2.6%) were delivered by 2286 SARS-CoV-2–positive mothers.” This article was corrected online.
Læs mere Tjek på PubMedMarrazzo J, Dionne-Odom J.
Journal of the American Medical Association, 14.09.2021
Tilføjet 14.09.2021
The first large randomized clinical trial (RCT) to study the effect of screening asymptomatic women for Chlamydia trachomatis infection was conducted in the early 1990s in a managed care organization in the US Pacific Northwest. The investigators measured the incidence of symptomatic pelvic inflammatory disease (PID) diagnosed in clinic or hospital settings in 2607 women aged 18 to 34 years who were followed up for 1 year. To the surprise of many skeptics, the trial, despite a relatively small number of verified PID cases, demonstrated a significant reduction in PID among the women screened compared with usual care, with absolute rates of 8 per 10 000 woman-months vs 18 per 10 000 woman-months, respectively.
Læs mere Tjek på PubMedCantor A, Dana T, Griffin JC, et al.
Journal of the American Medical Association, 14.09.2021
Tilføjet 14.09.2021
This systematic review to support the 2021 US Preventive Services Task Force Recommendation Statement on screening for chlamydial and gonococcal infections summarizes published evidence on the benefits and harms of screening for chlamydial and gonococcal infection in adults and adolescents, including those who are pregnant.
Læs mere Tjek på PubMed, Davidson KW, Barry MJ, et al.
Journal of the American Medical Association, 14.09.2021
Tilføjet 14.09.2021
This 2021 Recommendation Statement from the US Preventive Services Task Force recommends that all sexually active women 24 years or younger and women 25 years or older at increased risk for infection be screened for chlamydia (B recommendation) and gonorrhea (B recommendation) and concludes that current evidence is insufficient to assess the balance of benefits and harms of screening for chlamydia and gonorrhea in men (I statement).
Læs mere Tjek på PubMedKuehn BM.
Journal of the American Medical Association, 14.09.2021
Tilføjet 14.09.2021
Postmarketing safety monitoring data suggest that nonserious local and systemic reactions are common among adolescents who receive a SARS-CoV-2 mRNA vaccine, while reports of severe adverse events like myocarditis are rare.
Læs mere Tjek på PubMedKuehn BM.
Journal of the American Medical Association, 14.09.2021
Tilføjet 14.09.2021
Tuberculosis (TB) diagnoses in San Francisco dropped by more than half during the initial months of the COVID-19 shelter-in-place order, which may have delayed care and contributed to increased hospitalizations and deaths compared with prepandemic rates, according to a report in Emerging Infectious Diseases.
Læs mere Tjek på PubMedUrner M, Calfee CS, Fan E.
Journal of the American Medical Association, 14.09.2021
Tilføjet 14.09.2021
The development of oxygen therapy is one of the major advances of modern medicine. Oxygen therapy laid the groundwork for intensive care medicine as a specialty and has saved millions of lives. During the COVID-19 pandemic, millions of patients survived due to provision of supplemental oxygen, with or without mechanical ventilation. In some regions of the world, where oxygen supply is limited, however, there were many preventable deaths from acute hypoxemic respiratory failure.
Læs mere Tjek på PubMedRubin R.
Journal of the American Medical Association, 14.09.2021
Tilføjet 14.09.2021
This Medical News feature examines potential scenarios about how severe the upcoming flu season might be, given the dearth of influenza worldwide since the COVID-19 pandemic began.
Læs mere Tjek på PubMedZuger A.
Journal of the American Medical Association, 14.09.2021
Tilføjet 14.09.2021
In this narrative medicine essay, an infectious diseases physician recalls the reluctance of some patients with AIDS who feared taking antiretroviral medications, offering the same arguments being raised for refusing COVID vaccinations, and suggests that story telling may be a compelling way to convince people to be vaccinated.
Læs mere Tjek på PubMedSchaefer G, Leland RJ, Emanuel EJ.
Journal of the American Medical Association, 14.09.2021
Tilføjet 14.09.2021
This Viewpoint highlights countries with higher concentrations of COVID-19–vaccinated residents and and excess vaccine supply vs those without, and it emphasizes the clinical and ethical reasons for prioritizing distribution of excess vaccine to underserved countries instead of keeping it for booster administration.
Læs mere Tjek på PubMedSimon P, Ho A, Shah MD, et al.
Journal of the American Medical Association, 14.09.2021
Tilføjet 14.09.2021
This study compares age-adjusted mortality rates before and during the COVID-19 pandemic (2011-2020) among Latino and White individuals living in Los Angeles County.
Læs mere Tjek på PubMedMarion Renault
Nature, 14.09.2021
Tilføjet 14.09.2021
Nature Medicine, Published online: 14 September 2021; doi:10.1038/s41591-021-01493-5
Tracking the coronavirus SARS-CoV-2, developing treatments and testing vaccines have relied on access to the health data of millions of people. This massive trove could be used to understand other diseases, but not everyone is convinced.
Læs mere Tjek på PubMedRanjit Chauhan Qilan Li Molly E. Woodson Makafui Gasonoo Marvin J. Meyers John E. Tavis 1Department of Molecular Microbiology and Immunology, School of Medicine, Saint Louis University, Saint Louis, MO USA 2Saint Louis University Institute for Drug and Biotherapeutic Innovation 3Department of Chemistry, Saint Louis University, Saint Louis, MO USA 4Saint Louis University Liver Center, Saint Louis, MO USA
Antimicrobial Agents And Chemotherapy, 13.09.2021
Tilføjet 14.09.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedArturo Luna-Tapia Josie E. Parker Steven L. Kelly Glen E. Palmer 1 Ministry of Science, Technology and Innovation, National Program in Biotechnology, Bogota, Colombia. 2 Institute of Life Science, Swansea University Medical School, Swansea, Wales, United Kingdom. 3 Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Sciences Center, Memphis, USA.
Antimicrobial Agents And Chemotherapy, 13.09.2021
Tilføjet 14.09.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedAnna Olsson Marcus Hong Hissa Al-Farsi Christian G. Giske Pernilla Lagerbäck Thomas Tängdén 1 Department of Medical Sciences, Uppsala University, Uppsala, Sweden. 2 Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institute, Stockholm, Sweden 3 Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
Antimicrobial Agents And Chemotherapy, 13.09.2021
Tilføjet 14.09.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedDan Li Philip E. Sabato Benjamin Guiastrennec Aziz Ouerdani Hwa-Ping Feng Vincent Duval Carisa S. De Anda Pamela S. Sears Margaret Z. Chou Catherine Hardalo Natalya Broyde Matthew L. Rizk aMerck & Co., Inc., Kenilworth, New Jersey, USA bCertara, Data Science Services, Basel, Switzerland cCertara, Data Science Services, Paris, France
Antimicrobial Agents And Chemotherapy, 13.09.2021
Tilføjet 14.09.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedWendy Ankrom Deanne Jackson Rudd Andrea Schaeffer Deborah Panebianco Evan J. Friedman Charles Tomek S. Aubrey Stoch Marian Iwamoto aMerck & Co., Inc., Kenilworth, NJ, USA bCelerion, Inc., Lincoln, NE, USA
Antimicrobial Agents And Chemotherapy, 13.09.2021
Tilføjet 14.09.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedOlumide Martins Jin Lee Amit Kaushik Nicole C. Ammerman Kelly E. Dooley Eric L. Nuermberger aCenter for Tuberculosis Research, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA bErasmus MC, University Medical Center Rotterdam, Department of Medical Microbiology and Infectious Diseases, Rotterdam, The Netherlands
Antimicrobial Agents And Chemotherapy, 13.09.2021
Tilføjet 14.09.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedSydney L. Drury Anderson R. Miller Clare L. Laut Alec B. Walter Monique R. Bennett Meng Su Mingfeng Bai Bingwen Jing Scott B Joseph Edward J. Metzger Charles E. Bane Chad C. Black Mary T. Macdonald Brendan F. Dutter Ian M. Romaine Alex G. Waterson Gary A. Sulikowski E. Duco Jansen James E. Crowe Richard J. Sciotti Eric P. Skaar 1Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA 2Vanderbilt Institute for Infection, Immunology, and Inflammation, Vanderbilt University Medical Center, Nashville, Tennessee, USA 3Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA 4Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, Tennessee, USA 5Vanderbilt Vaccine Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA 6Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA 7Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA 8Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA 9Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA 10Department of Chemical Biology, Vanderbilt University, Nashville, Tennessee 11Department of Chemistry, Vanderbilt University, Nashville, Tennessee 12Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 13Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Antimicrobial Agents And Chemotherapy, 13.09.2021
Tilføjet 14.09.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedMallika Imwong Kanokon Suwannasin Suttipat Srisutham Ranitha Vongpromek Cholrawee Promnarate Aungkana Saejeng Aung Pyae Phyo Stephane Proux Tiengkham Pongvongsa Chea Nguon Olivo Miotto Rupam Tripura Nguyen Hoang Chau Dysoley Lek Ho Dang Trung Nghia Thomas J Peto James J Callery Rob W van der Pluijm Chanaki Amaratunga Mavuto Mukaka Lorenz von Seidlein Mayfong Mayxay Nguyen Thanh Thuy-Nhien Paul N Newton Nicholas PJ Day Elizabeth A Ashley Francois H Nosten Frank M Smithuis Mehul Dhorda Nicholas J White Arjen M Dondorp 1Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand 2Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand 3Department of Clinical Microscopy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand 4Worldwide Antimalarial Resistance Network, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand 5Division of Vector-borne Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand. 6Myanmar Oxford Clinical Research Unit, Yangon, Myanmar 7Shoklo Malaria Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand 8Savannakhet Provincial Health Department, Savannakhet Province, Lao PDR 9National Center for Parasitology, Entomology, and Malaria Control, Phnom Penh, Cambodia 10Wellcome Sanger Institute, Hinxton, U.K. 11Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, U.K. 12Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam 13Institute of Research and Education Development, University of Health Sciences, Ministry of Health, Vientiane, Lao PDR 14Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
Antimicrobial Agents And Chemotherapy, 13.09.2021
Tilføjet 14.09.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedMaria E. Cilento Aaron B. Reeve Eleftherios Michailidis Tatiana V. Ilina Eva Nagy Hiroaki Mitsuya Michael A. Parniak Philip R. Tedbury Stefan G. Sarafianos aLaboratory of Biochemical Pharmacology, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia 30322, United States; Children’s Healthcare of Atlanta, Atlanta, Georgia 30307, United States bDepartment of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA cLaboratory of Virology and Infectious Disease, The Rockefeller University, New York, NY dDepartment of Refractory Viral Infections, National Center for Global Health & Medicine Research Institute, Tokyo, Japan; Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA; Department of Clinical Sciences, Kumamoto University Hospital, Kumamoto, Japan.
Antimicrobial Agents And Chemotherapy, 13.09.2021
Tilføjet 14.09.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedAleksandra Tymoszewska Kirill V. Ovchinnikov Dzung B. Diep MaŁgorzata SŁodownik Edyta Maron Beatriz MartÍnez Tamara Aleksandrzak-piekarczyk 1Institute of Biochemistry and Biophysics, Polish Academy of Sciences (IBB PAS), Pawińskiego 5a, 02-106 Warsaw, Poland 2Faculty of Chemistry, Biotechnology, and Food Science, Norwegian University of Life Sciences, As, Norway 3Department of Technology and Biotechnology of Dairy Products, Instituto de Productos Lácteos de Asturias, Consejo Superior de Investigaciones Científicas (IPLA-CSIC), Villaviciosa, Spain
Antimicrobial Agents And Chemotherapy, 13.09.2021
Tilføjet 14.09.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedYu Feng Ya Hu Zhiyong Zong aCenter for Pathogen Research, West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu 610041, Sichuan, China. bCenter of Infectious Diseases, West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu 610041, Sichuan, China. cDivision of Infectious Diseases, State Key Laboratory of Biotherapy, Guoxuexiang 37, Chengdu 610041, Sichuan, China. dDepartment of Infection Control, West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu 610041, Sichuan, China.
Antimicrobial Agents And Chemotherapy, 13.09.2021
Tilføjet 14.09.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedEmerging Infectious Diseases, 14.09.2021
Tilføjet 14.09.2021
Jesse M. Hall Graham J. Bitzer Megan A. DeJong Jason Kang Ting Y. Wong M. Allison Wolf Justin R Bevere Mariette Barbier F. Heath Damron 1 Department of Microbiology, Immunology and Cell Biology, School of Medicine, West Virginia University, Morgantown, West Virginia, USA 2 Vaccine Development Center, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA
Infection and Immunity, 13.09.2021
Tilføjet 14.09.2021
Infection and Immunity, <a href="https://journals.asm.org/toc/iai/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedSokratis A. Apostolidis, Mihir Kakara, Mark M. Painter, Rishi R. Goel, Divij Mathew, Kerry Lenzi, Ayman Rezk, Kristina R. Patterson, Diego A. Espinoza, Jessy C. Kadri, Daniel M. Markowitz, Clyde E. Markowitz, Ina Mexhitaj, Dina Jacobs, Allison Babb, Michael R. Betts, Eline T. Luning Prak, Daniela Weiskopf, Alba Grifoni, Kendall A. Lundgreen, Sigrid Gouma, Alessandro Sette, Paul Bates, Scott E. Hensley, Allison R. Greenplate, E. John Wherry, Rui Li, Amit Bar-Or
Nature, 14.09.2021
Tilføjet 14.09.2021
Nature Medicine, Published online: 14 September 2021; doi:10.1038/s41591-021-01507-2
SARS-CoV-2-specific antibodies and memory B cells are significantly reduced, but CD4+ and CD8+ T cells are robustly activated, in patients with multiple sclerosis on anti-CD20 monotherapy versus healthy controls after BNT162b2 or mRNA-1273 mRNA vaccination.
Læs mere Tjek på PubMedBMC Infectious Diseases, 13.09.2021
Tilføjet 14.09.2021
Abstract
Background
Maximising access to testing by targeting more than one infection is effective in identifying new infections in settings or populations. Within the EU funded Joint Action INTEGRATE, this paper examined the feasibility and impact of expanding integrated testing for HIV, hepatitis C (HCV), chlamydia, gonorrhoea and/or syphilis in four community-based pilots through targeted interventions in Croatia, Italy and Poland and the Spring European Testing Week since community settings are key in detecting new infections and reaching key populations.
Methods
Pilots led by local INTEGRATE partners prioritised testing for other infections or key populations. The Croatian pilot expanded testing for men who have sex with men to syphilis, chlamydia and gonorrhoea. Italian partners implemented a HIV and HCV testing/information event at a migrant centre. A second Italian pilot tested migrants for HIV and HCV through outreach and a low-threshold service for people who use drugs. Polish partners tested for HIV, HCV and syphilis among people who inject drugs in unstable housing via a mobile van. Pilots monitored the number of individuals tested for each infection and reactive results.
The pilot Spring European Testing Week from 18 to 25 May 2018 was an INTEGRATE-driven initiative to create more testing awareness and opportunities throughout Europe.
Results
The Croatian pilot found a high prevalence for each syphilis, chlamydia and gonorrhoea respectively, 2.1%, 12.4% and 6.7%. The Italian migrant centre pilot found low proportions who were previously tested for HIV (24%) or HCV (11%) and the second Italian pilot found an HCV prevalence of 6.2%, with low proportions previously tested for HIV (33%) or HCV (31%). The Polish pilot found rates of being previously tested for HIV, HCV and syphilis at 39%, 37%, and 38%, respectively. Results from the Spring European Testing Week pilot showed it was acceptable with increased integrated testing, from 50% in 2018 to 71% in 2019 in participants.
Conclusions
Results show that integrated testing is feasible and effective in community settings, in reaching key populations and minimising missed testing opportunities, and the pilots made feasible because of the European collaboration and funding. For sustainability and expansion of integrated community testing across Europe, local government investment in legislation, financial and structural support are crucial.
Læs mere Tjek på PubMedBMC Infectious Diseases, 13.09.2021
Tilføjet 14.09.2021
Abstract
Background
Health-related quality of life (HRQoL) is a crucial component in assessing and addressing the unmet needs of people, especially those with chronic illnesses such as HIV. The aim of the study was to examine and compare the health-related quality of life of people living with HIV in Romania and Spain, compared to the general populations of each country.
Methods
A cross-sectional survey was conducted among adults (≥ 18 years) attending for HIV care in Romania and Spain from October 2019 to March 2020. The survey included two validated HRQoL instruments: a generic instrument, EQ-5D-5L, and an HIV-specific instrument, PozQoL, and questions on socio-demographics, HIV-related characteristics, physical and mental health conditions, and substance use. Multivariable linear regression was used to determine factors associated with HRQoL.
Results
570 people living with HIV responded (170 in Romania and 400 in Spain). The median age was 31 (18–67) in Romania and 52 (19–83) in Spain. Anxiety/depression symptoms were frequently reported by people with HIV (Romania: 50% vs 30% in the Romanian population; Spain: 38% vs 15% in Spanish population). Spain reported higher mean EQ-5Dutility scores than Romania (0.88 and 0.85, respectively) but identical PozQoL scores (3.5, on a scale of 0–5). In both countries, health concerns were highlighted as a key issue for people with HIV. In multivariable analysis, two factors were consistently associated with worse HRQoL in people with HIV: bad or very bad self-rated health status and presence of a mental health condition. In Romania, being gay/bisexual and being disabled/unemployed were associated with worse HRQoL. Whereas in Spain, older age and financial insecurity were significant predictors.
Conclusions
Our results indicated a good HRQoL for people living with HIV in Romania and Spain; however, worse HRQoL profiles were characterized by health concerns, poor self-rated health status, and the presence of mental health conditions. This study highlights the importance of monitoring HRQoL in people living with HIV due to the chronic nature of the disease. In this highly-treatment experienced group, disparities were found, particularly highlighting mental health as an area which needs more attention to improve the well-being of people living with HIV.
Læs mere Tjek på PubMedBMC Infectious Diseases, 13.09.2021
Tilføjet 14.09.2021
Abstract
Background
The HIV pandemic impacts the lives of millions and despite the global coordinated response, innovative actions are still needed to end it. A major challenge is the added burden of coinfections such as viral hepatitis, tuberculosis and various sexually transmitted infections in terms of prevention, treatment and increased morbidity in individuals with HIV infection. A need for combination prevention strategies, tailored to high-risk key populations arises and technology-based interventions can be a valuable asset. The COVID-19 pandemic challenged the delivery of existing services and added stress to existing public health and clinical structures but also highlighted the potential of exploiting technical solutions for interventions regarding infectious diseases. In this paper we report the design process, results and evaluation findings from the pilots of ‘RiskRadar’—a web and mobile application aiming to support combination prevention, testing and linkage to care for HIV, viral hepatitis, various sexually transmitted infections and tuberculosis.
Methods
RiskRadar was developed for the INTEGRATE Joint Action’s aim to improve, adapt and pilot innovative digital tools for combination prevention. RiskRadar was designed iteratively using informed end-user-oriented approaches. Emphasis was placed on the Risk Calculator that enables users to assess their risk of exposure to one or more of the four disease areas, make informed decisions to seek testing or care and adjust their behaviours ultimately aiming to harm/risk reduction. RiskRadar has been piloted in three countries, namely Croatia, Italy and Lithuania.
Results
RiskRadar has been used 1347 times across all platforms so far. More than 90% of users have found RiskRadar useful and would use it again, especially the Risk Calculator component. Almost 49.25% are men and 29.85% are in the age group of 25–34. The application has scored 5.2/7 in the User Experience Questionnaire, where it is mainly described as “supportive” and “easy-to-use”. The qualitative evaluation of RiskRadar also yielded positive feedback.
Conclusions
Pilot results demonstrate above average satisfaction with RiskRadar and high user-reported usability scores, supporting the idea that technical interventions could significantly support combination prevention actions on Sexually Transmitted Infections.
Læs mere Tjek på PubMedBMC Infectious Diseases, 13.09.2021
Tilføjet 14.09.2021
Abstract
Background
National testing strategy, including monitoring and evaluation, is critical in responding to HIV, sexually transmitted infections, and viral hepatitis. Community-based voluntary counselling and testing contributes to early HIV diagnoses among key populations. Countries providing community-based testing, should integrate some core data on testing and linkage to care in these services into national surveillance and monitoring and evaluation systems. This study aimed to support the integration of community-based voluntary counselling and testing data into respective national surveillance and M&E systems for those infections.
Methods
Preliminary consensus on indicators for the integration of community-based voluntary counselling and testing data into respective national surveillance and monitoring and evaluation systems was reached. Pilot studies were conducted in Estonia, Poland, Serbia, Slovakia, Slovenia and Spain. After pilot activities were implemented, the final consensus on indicators was reached. An analysis of the facilitators and barriers faced during pilot studies was conducted to inform the final recommendations for implementation.
Results
The minimum set of six indicators to be integrated into national surveillance and monitoring and evaluation systems were: number of tests, number of clients tested, reactivity rate for tests and clients, positivity (active infection) rates for tests and clients, linkage to care rates for clients with reactive and/or positive test result, proportion of all new diagnoses in a country with first reactive test result at community-based voluntary counselling and testing service. Seven additional indicators were identified. Each indicator should be disaggregated by key population, sex and age group. A list of 10 recommendations for the collection and integration of community-based voluntary counselling and testing data into national surveillance and monitoring and evaluation systems for HIV, sexually transmitted infections and viral hepatitis was identified.
Conclusions
Integration of some community-based voluntary counselling and testing monitoring and evaluation data into national surveillance and monitoring and evaluation systems in all pilot countries was achieved. The recommendations will support such integration in other European countries. European Centre for Prevention and Control of Diseases included questions from the minimum list of indicators into their Dublin Declaration questionnaire 2020 to contribute to evidence based community testing policies in European countries.
Læs mere Tjek på PubMedBMC Infectious Diseases, 13.09.2021
Tilføjet 14.09.2021
Abstract
Background
Uptake of HIV self-tests (HIVST) remains low in Europe. We conducted two separate surveys to understand facilitators and barriers to the use of HIVST in two European countries, as part of the EU INTEGRATE Joint Action. In both countries, HIV has been legal since 2016. In Lithuania, where HIVST sales have been low, the survey primarily assessed acceptability whilst in Italy, with better HIVST uptake, usability was the focus.
Methods
Participants were recruited through community HIV testing sites, and in Lithuania also through social media. In Lithuania, participants self-completed a survey on their testing history, and attitudes toward and experiences with self-testing. In Italy participants performed an HIVST (Mylan Autotest) while being observed by a community health worker (CHW). Both participants and CHW completed a self-administered survey evaluating the experience of the participant.
Results
In Lithuania, awareness of HIV self-testing (75%) was high among the 138 people who completed the survey. Privacy and confidentiality (70%) was the most common reason to use an HIVST whilst cost was reported as the main barrier by 60%, only 15% were willing to pay the current price. Almost half (42%) were concerned about doing the test incorrectly and 36% preferred that a trained person could discuss their result. Purchasing HIVST at a pharmacy (70%) or online (61%) was favoured and 68% would opt to simultaneously test for other infections.
In Italy, 28 people who had never used an HIVST before were observed using one. 43% found the test easy to use but CHWs reported that 36% of participants failed at least one step. The quick result (68%) was the most common reason to use one again, yet the main concerns were the lack of counselling (50%) and reading result alone (32%).
Conclusions
HIVST are acceptable and usable, however cost is a major barrier. Local and national strategies are needed to increase awareness of and access to HIVST and target HIVST campaigns toward key risk groups such as MSM. Meanwhile, steps can be taken to improve testing instructions and support for self-testers. Offering multiplex testing for other infections would also likely increase uptake.
Læs mere Tjek på PubMedBMC Infectious Diseases, 13.09.2021
Tilføjet 14.09.2021
BMC Infectious Diseases, 13.09.2021
Tilføjet 14.09.2021
Abstract
Background
Indicator condition guided HIV testing is a proven effective strategy for increasing HIV diagnosis in health care facilities. As part of the INTEGRATE Joint Action, we conducted four pilot studies, aiming to increase integrated testing for HIV/HCV/HBV and sexually transmitted infections, by introducing and expanding existing indicator condition guided HIV testing methods.
Methods
Pilot interventions included combined HIV/HCV testing in a dermatovenerology clinic and a clinic for addictive disorders in Lithuania; Increasing HIV testing rates in a tuberculosis clinic in Romania by introducing a patient information leaflet and offering testing for HIV/HCV/sexually transmitted infections to chemsex-users in Barcelona. Methods for implementing indicator condition guided HIV testing were adapted to include integrated testing. Testing data were collected retrospectively and prospectively. Staff were trained in all settings, Plan-do-study-act cycles frequently performed and barriers to implementation reported.
Results
In established indicator conditions, HIV absolute testing rates increased from 10.6 to 71% in the dermatovenerology clinic over an 18 months period. HIV testing rates improved from 67.4% at baseline to 94% in the tuberculosis clinic. HCV testing was added to all individuals in the dermatovenerology clinic, eight patients of 1701 tested positive (0.47%). HBV testing was added to individuals with sexually transmitted infections with a 0.44% positivity rate (2/452 tested positive). The Indicator condition guided HIV testing strategy was expanded to offer HIV/HCV testing to people with alcohol dependency and chemsex-users. 52% of chemsex-users tested positive for ≥ 1 sexually transmitted infection and among people with alcohol dependency 0.3 and 3.7% tested positive for HIV and HCV respectively.
Conclusions
The four pilot studies successfully increased integrated testing in health care settings, by introducing testing for HBV/HCV and sexually transmitted infections along with HIV testing for established indicator conditions and expanding the strategy to include new indicators; alcohol dependency and chemsex. HCV testing of individuals with alcohol abuse showed high positivity rates and calls for further implementation studies. Methods used for implementing indicator condition guided HIV Testing have proven transferable to implementation of integrated testing.
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