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Tomer Rosen, Kwo-Kwang A. Wang, Elizabeth M. Nolan
Trends in Microbiology, 24.01.2022
Tilføjet 25.01.2022
During infection, the mammalian host initiates a metal-withholding response against invading microbial pathogens to inhibit their growth and survival, a process often termed ‘nutritional immunity’. The host-defense S100 proteins calprotectin (CP) (S100A8/S100A9 oligomer), S100A12, and S100A7 play key roles in the innate immune response by sequestrating essential transition metal nutrients from microbes in the extracellular space. Accumulating evidence suggests that the antimicrobial activity of these proteins varies between infection sites and may be affected by the local chemical environment.
Læs mere Tjek på PubMedAbolfazl Adli, Mandana Rahimi, Reza Khodaie, Niloofar Hashemzaei, Sayed Mostafa Hosseini
Journal of Medical Virology, 25.01.2022
Tilføjet 25.01.2022
Ming‐Hui Sun, Yu‐Fei Ji, Guo‐Hui Li, Jian‐Wei Shao, Rui‐Xu Chen, Huan‐Yu Gong, Shou‐Yi Chen, Ji‐Ming Chen
Journal of Medical Virology, 24.01.2022
Tilføjet 25.01.2022
Siddharth Sridhar, Kelvin Kai-Wang To
Lancet Infectious Diseases, 25.01.2022
Tilføjet 25.01.2022
Neuraminidase inhibitors have been approved for over 20 years and are currently the standard of care for the treatment of influenza. However, meta-analyses have shown only modest benefit of neuraminidase inhibitors for influenza.1,2 New treatment strategies for severe influenza are urgently required. A novel antiviral, baloxavir marboxil (baloxavir hereafter), was first approved in Japan in 2018, and subsequently in other countries. Baloxavir belongs to a new class of antivirals that inhibit the endonuclease function of the polymerase acidic protein.
Læs mere Tjek på PubMedDeepali Kumar, Michael G Ison, Jean-Paul Mira, Tobias Welte, Jick Hwan Ha, David S Hui, Nanshan Zhong, Takefumi Saito, Laurie Katugampola, Neil Collinson, Sarah Williams, Steffen Wildum, Andrew Ackrill, Barry Clinch, Nelson Lee
Lancet Infectious Diseases, 25.01.2022
Tilføjet 25.01.2022
Combining baloxavir with NAIs did not result in superior clinical outcomes compared with NAIs alone. The combination of baloxavir plus NAI was well tolerated. The findings suggest that combination antivirals would not be routinely indicated in clinical practice for hospitalised patients with severe influenza.
Læs mere Tjek på PubMedAndrzej Jan Rys, Irene Norstedt
Clinical Microbiology and Infection, 24.01.2022
Tilføjet 24.01.2022
The European Commission appreciates the importance of large, multinational clinical trials to generate robust and reliable data to support rapid regulatory and public health decisions.
Læs mere Tjek på PubMedDustin Farr Dhrubajyoti Nag Walter J. Chazin Simone Harrison Ryan Thummel Xixia Luo Saumya Raychaudhuri Jeffrey H. Withey 1Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit, MI USA 2Departments of Biochemistry and Chemistry, Center for Structural Biology, Vanderbilt University, Nashville, TN USA 3Department of Ophthalmology, Visual and Anatomical Sciences, Wayne State University School of Medicine, Detroit, MI USA 4CSIR – Institute of Microbial Technology, Chandigarh, India
Infection and Immunity, 24.01.2022
Tilføjet 24.01.2022
Infection and Immunity, <a href='https://journals.asm.org/toc/iai/0/ja'>Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedBinod Acharya, Keshab Subedi, Pramod Acharya, Shweta Ghimire
PLoS One Infectious Diseases, 24.01.2022
Tilføjet 24.01.2022
by Binod Acharya, Keshab Subedi, Pramod Acharya, Shweta Ghimire
Background Past works have linked the COVID-19 pandemic and subsequent public health responses such as isolation, quarantine, and lockdown to increased anxiety, sleep disorders, depressive symptoms, and suicidal ideation. Only a few studies, mostly carried out in high-income countries, have investigated the association between the pandemic and suicide rate. We seek to investigate the changes in the monthly suicide rates during the COVID-19 pandemic in Nepal, compared to the pre-pandemic suicide rates. Methods and findings This is a retrospective study investigating the changes in suicide rates in Nepal during the COVID-19 pandemic period (April 2020 to June 2021), compared to the pre-pandemic period (July 2017 to March 2020), adjusted for seasonality and long-term trend in the suicide rate. We performed analysis for the entire country as well as sub-sample analyses stratified by gender and provinces. A total of 24350 suicides deaths during four years of the study window were analyzed. We found an overall increase in the monthly suicide rate in Nepal with an average increase of 0.28 (CI: 0.12,0.45) suicide per 100,000 during the pandemic months. The increase in suicide rate was significant both among males (increase in rate = 0.26, CI: 0.02,0.50) and females (increase in rate = 0.30, CI: 0.18,0.43). The most striking increments in suicide rates were observed in June, July, and August 2020. The pattern of increased suicide rates faded away early on among males, but the effect was sustained for a longer duration among females. Sudurpaschim and Karnali provinces had the highest increase in suicide rates associated with the COVID-19 pandemic. Conclusions The COVID-19 pandemic is associated with an increased suicide rate in Nepal. The findings may inform policymakers in designing appropriate public health responses to the pandemic that are considerate of the potential impact on mental health and suicide.
Læs mere Tjek på PubMedFarhana Aminuddin, Nur Amalina Zaimi, Mohd Shaiful Jefri Mohd Nor Sham Kunusagaran, Mohd Shahri Bahari, Nor Zam Azihan Mohd Hassan
PLoS One Infectious Diseases, 24.01.2022
Tilføjet 24.01.2022
by Farhana Aminuddin, Nur Amalina Zaimi, Mohd Shaiful Jefri Mohd Nor Sham Kunusagaran, Mohd Shahri Bahari, Nor Zam Azihan Mohd Hassan
The potential occurrence of disease outbreaks during the hajj season is of great concern due to extreme congestion in a confined space. This promotes the acquisition, spread and transmission of pathogenic microorganisms and pneumococcal disease are one of the most frequent infections among Hajj pilgrims. This study aimed to assess the cost-effectiveness and budget impact of introducing the PPV23 to Malaysian Hajj pilgrims. A decision tree framework with a 1-year cycle length was adapted to evaluate the cost-effectiveness of a PPV23 vaccination program with no vaccination. The cost information was retrieved from the Lembaga Tabung Haji Malaysia (LTH) database. Vaccine effectiveness was based on the locally published data and the disease incidence specifically related to Streptococcus pneumoniae was based on a literature search. Analyses were conducted from the perspective of the provider: Ministry of Health and LTH Malaysia. The incremental cost-effectiveness ratios (ICER), cases averted, and net cost savings were estimated. Findings from this study showed that PPV23 vaccination for Malaysian Hajj pilgrims was cost-effective. The PPV23 vaccination programme has an ICER of MYR -449.3 (US$-110.95) per case averted. Based on the national threshold value of US$6,200-US$8,900 per capita, the base-case result shows that introduction of the PPV23 vaccine for Malaysian Hajj pilgrims is very cost-effective. Sensitivity analysis revealed parameters related to annual incidence and hospitalised cost of septicemia and disease without vaccination as the key drivers of the model outputs. Compared with no vaccination, the inclusion of PPV23 vaccination for Malaysian Hajj pilgrims was projected to result in a net cost saving of MYR59.6 million and 109,996 cases averted over 5 years period. The PPV23 vaccination program could substantially offer additional benefits in reducing the pneumococcal disease burden and healthcare cost. This could be of help for policymakers to consider the implementation of PPV23 vaccination for Malaysian performing hajj.
Læs mere Tjek på PubMedZiyu Sun, Mandlaa, Hui Wen, Li Ma, Zhongjun Chen
PLoS One Infectious Diseases, 24.01.2022
Tilføjet 24.01.2022
by Ziyu Sun, Mandlaa, Hui Wen, Li Ma, Zhongjun Chen
Salmonella is a common foodborne pathogen, especially in meat and meat products. Lytic phages are promising alternatives to conventional methods for Salmonella biocontrol in food and food processing. In this study, a virulent bacteriophage (PSDA-2) against Salmonella enterica serovar Typhimurium was isolated from the sewage and it was found that PSDA-2 belongs to Cornellvirus genus of Siphoviridae family by morphological and phylogenetic analysis. Based on the one-step growth curve, PSDA-2 has a short latent period (10 min) and a high burst size (120 PFU/cell). The stability test in vitro reveals that PSDA-2 is stable at 30–70°C and pH 3–10. Bioinformatics analysis show that PSDA-2 genome consists of 40,062 bp with a GC content of 50.21% and encodes 63 open reading frames (ORFs); no tRNA genes, lysogenic genes, drug resistance genes and virulence genes were identified in the genome. Moreover, the capacity for PSDA-2 to control Salmonella Typhimurium in chilled mutton was investigated. The results show that incubation of PSDA-2 at 4°C reduced recoverable Salmonella by 1.7 log CFU/mL and 2.1 log CFU/mL at multiplicity of infection (MOI) of 100 and 10,000 respectively, as relative to the phage-excluded control. The features of phage PSDA-2 suggest that it has the potential to be an agent to control Salmonella.
Læs mere Tjek på PubMedMohammed Yesuf, Mehd Abdu
PLoS One Infectious Diseases, 24.01.2022
Tilføjet 24.01.2022
by Mohammed Yesuf, Mehd Abdu
Introduction As of February 2021 COVID-19 report in 57 African countries, there were 3,761,512 confirmed cases and 98,088 deaths. Ethiopia reported the highest number of cases in East Africa with a total of 147,092 cases and 2,194 deaths. Over 1.5 billion students from 195 countries across the world separated from school as a consequence of the closure of schools related to the pandemic. This study aimed to determine the level of knowledge, attitude, prevention practices, and determinant factors regarding COVID-19 among preparatory school students in southwest Ethiopia. Methods An institution-based cross-sectional study design was used for 422 samples. Each respondent was selected using simple random sampling. Data were collected using a self-administered questionnaire. The collected data were entered and analyzed using Statistical Package for social science software version 25.0. Multivariable binary logistic regression was used to identify factors that were significantly associated with the practice of COVID-19 prevention. Results The response rate in this study was 96.2%. A higher proportion of the respondents were female (53.9%), Bench (43.6%), and protestant (47.3%). The level of good knowledge, positive attitude, and good practice were 81.8%, 70.9%, and 47.0% respectively. Using social media [AOR: 1.801, 95% CI: 1.005, 3.226], watching television [AOR: 1.884 95% CI: 1.093, 3.247], being knowledgeable [AOR: 5.173 95% CI: 2.276, 11.755], and having a positive attitude [AOR: 4.300 95% CI: 2.351, 7.868] were positively associated with COVID-19 prevention practice. Conclusion Despite the high level of knowledge and a moderate level of positive attitude, the practice of COVID-19 prevention measures was low. Using social media, watching television, being knowledgeable, and having positive attitudes towards COVID-19 increases the tendency to practice COVID-19 prevention measures. School directors and teachers should strictly monitor students for their adherence to COVID-19 prevention measures as directed by the local and national health care departments.
Læs mere Tjek på PubMedAbdur Razzaque Sarker, S. M. Zulfiqar Ali, Maruf Ahmed, S. M. Zahedul Islam Chowdhury, Nausad Ali
PLoS One Infectious Diseases, 24.01.2022
Tilføjet 24.01.2022
by Abdur Razzaque Sarker, S. M. Zulfiqar Ali, Maruf Ahmed, S. M. Zahedul Islam Chowdhury, Nausad Ali
Objectives Out-of-pocket (OOP) payment is the major payment strategy for healthcare in Bangladesh, and the share of OOP expenditure has increased alarmingly. Dhaka is recognised as one of the fastest-growing megacities in the world. The objective of this study is to capture the self-reported illnesses among urban citizens and to identify whether and to what extent socioeconomic, demographic and behavioural factors of the population influence OOP healthcare expenditures. Subject and methods This study utilises cross-sectional survey data collected from May to August 2019 in urban Dhaka, Bangladesh. A total of 3,100 households were randomly selected. Simple descriptive statistics including frequencies, percentage, mean (95% CI), median and inter-quartile range were presented. Bivariate analysis and multivariate regression models were employed. Results We observed that acute illnesses (e.g., fever, flu/cough) were dominant among participants. Among the chronic illnesses, approximately 9.6% of people had diabetes, while 5.3% had high/low blood pressure. The richest quintile only spent 5.2% of their household income on healthcare, while the poorest households spent approximately six times more than the richest households. We noted that various factors such as marital status, religion, source of care, access to safe water, income quintile and even the location of households had a significant relationship with OOP expenditure. Conclusions Our findings can serve as important source of data in terms of disease- specific symptoms and out-of-pocket cost among urban citizens in Dhaka. The people belonging to wealthier households tended to choose better healthcare facilities and spend more. A pro-poor policy initiative and even an urban health protection scheme may be necessary to ensure that healthcare services are accessible and affordable, in line with the Bangladesh National Urban Health Strategy.
Læs mere Tjek på PubMedAli Reza Yusefi, Mehrdad Sharifi, Narjes sadat Nasabi, Esmat Rezabeigi Davarani, Peivand Bastani
PLoS One Infectious Diseases, 24.01.2022
Tilføjet 24.01.2022
by Ali Reza Yusefi, Mehrdad Sharifi, Narjes sadat Nasabi, Esmat Rezabeigi Davarani, Peivand Bastani
Background One of the main forthcoming challenges of healthcare systems against preparedness and management of the pandemic is the challenge of procurement and recruitment of the human resources. This study is aimed to explore the health human resources challenges during COVID-19 pandemic in Iran. Methods This qualitative content analysis study was conducted in 2020. The study population includes all the Iranian human resources managers affiliated in Universities of Medical Sciences, hospitals and health centers managers and the health networks managers all over the country. 23 participants were included via purposeful sampling considering the inclusion criteria and were interviewed individually. After 23 semi-structured interviews, data were saturated. Then the data were analyzed through content analysis approach applying MAXQDA10. Results Three main themes of “organizational challenges”, “legal challenges”, and “personal challenges” were explored as the main challenges of health human resources management during COVID-19. On the one hand, organizational challenges include restricted financial resources, compensation discrimination, staffing distinction points, imbalance in the workload, weak organizational coordination, inefficient inter-sectoral relationships, parallel decisions, inefficient distribution of the human resources, lack of applied education, lack of integrated health protocols, lack of appropriate evaluation of performance, employee turnover, lack of clear approaches for staffing, and shortage of specialized manpower, and on the other hand, the personal challenges include insufficient knowledge of the employees, psychological disorders, reduction of self-confidence, burnout, workload increase, reduced level of job satisfaction, effects of colleague and patients bereavement and unsafety sense against the work place. Finally, the legal challenges that mostly related to the governments laws and regulations include lack of protocols for continuous supportive services, inappropriate approaches and instructions for teleworking, and lack of alternative plans and regulations for the human resources. Conclusion Organizational, legal and personal challenges are among three main challenges of health human resources management during COVID-19 pandemic. Serious attention to these challenges should be considered by health policymakers in order to be prepared for facing new probable outbreaks and managing the present condition. The integrated comprehensive planning of human resources management for COVID-19 along with supportive packages for the personnel can be helpful.
Læs mere Tjek på PubMedColleen Blue, Mara Buchbinder, Mersedes E. Brown, Steve Bradley-Bull, David L. Rosen
PLoS One Infectious Diseases, 24.01.2022
Tilføjet 24.01.2022
by Colleen Blue, Mara Buchbinder, Mersedes E. Brown, Steve Bradley-Bull, David L. Rosen
Most incarcerations for people living with HIV (PLWH) occur in jails, yet studies of HIV care during jail incarceration are limited. As part of a larger study to explore the ethical considerations in extending public health HIV surveillance to jail settings, we conducted semi-structured interviews with twenty-three PLWH with more than 300 distinct jail incarcerations post HIV diagnosis in 21 unique North Carolina jails. Interviews included questions about HIV disclosure in jail, the type of HIV care received in jail, and overall experiences with HIV care in jail. We report on participants’ experiences and perspectives in four domains: access to HIV care in jail; impact of jail incarceration on continuity of HIV care; privacy and stigma; and satisfaction with HIV care in jail. Although most participants received HIV medications and saw providers while in jail, almost half reported that their greatest challenge in regard to HIV care was obtaining their HIV medications in the face of limited jail resources or policies that made access to medications difficult. Findings from this study suggest that jail leadership should review internal policies regarding HIV medications to ensure that PLWH can receive them quickly upon entry into jail. Findings also suggest that more external resources are needed, for example from state and local health departments, so that jails can provide timely HIV medications for PLWH incarcerated in their facilities.
Læs mere Tjek på PubMedAe-Young Her, Youngjune Bhak, Eun Jung Jun, Song Lin Yuan, Scot Garg, Semin Lee, Jong Bhak, Eun-Seok Shin
PLoS One Infectious Diseases, 24.01.2022
Tilføjet 24.01.2022
by Ae-Young Her, Youngjune Bhak, Eun Jung Jun, Song Lin Yuan, Scot Garg, Semin Lee, Jong Bhak, Eun-Seok Shin
We sought to assess the impact of sex on in-hospital mortality of patients with COVID-19 infection in South Korea. The study recruited 5,628 prospective consecutive patients who were hospitalized in South Korea with COVID-19 infection, and enrolled in the Korea Centers for Disease Control and Prevention (KCDC) dataset between January 20, 2020, and April 30, 2020. The primary endpoint was in-hospital death from COVID-19. The cohort comprised of 3,308 women (59%) and 2,320 men (41%). In-hospital death was significantly lower in women than men (3.5% vs. 5.5%, hazard ratio (HR): 0.61; 95% confidence interval (CI): 0.47 to 0.79, p
Læs mere Tjek på PubMedMaria Burton, Janina A. Krumbeck, Guangxi Wu, Shuiquan Tang, Aishani Prem, Aditya K. Gupta, Thomas L. Dawson Jr
PLoS One Infectious Diseases, 24.01.2022
Tilføjet 24.01.2022
by Maria Burton, Janina A. Krumbeck, Guangxi Wu, Shuiquan Tang, Aishani Prem, Aditya K. Gupta, Thomas L. Dawson Jr
Otitis media (OM) and externa (OE) are painful, recurrent ear conditions. As most otitis publications focus on the bacterial content of childhood ears, there remains a dearth of information regarding the adult ear microbiome including both bacteria and fungi. This study compares the outer ear microbiome of healthy adults to adults affected by OE and OM using both intergenic-transcribed-spacer (ITS) and 16S-rDNA sequencing. The adult ear core microbiome consists of the prokaryote Cutibacterium acnes and the eukaryotic Malassezia arunalokei, M. globosa, and M. restricta. The healthy ear mycobiome is dominated by Malassezia and can be divided into two groups, one dominated by M. arunalokei, the other by M. restricta. Microbiome diversity and biomass varied significantly between healthy and diseased ears, and analyses reveal the presence of a potential mutualistic, protective effect of Malassezia species and C. acnes. The healthy ear core microbiome includes the bacteria Staphylococcus capitis and S. capitis/caprae, while the diseased ear core is composed of known bacterial and fungal pathogens including Aspergillus sp., Candida sp., Pseudomonas aeruginosa, S. aureus, and Corynebacterium jeikeium. The data presented highlight the need for early detection of the cause of otitis to direct more appropriate, efficient treatments. This will improve patient outcomes and promote improved antimicrobial stewardship.
Læs mere Tjek på PubMedAnne Mette Plomgaard, Christoph E. Schwarz, Olivier Claris, Eugene M. Dempsey, Monica Fumagalli, Simon Hyttel-Sorensen, Petra Lemmers, Adelina Pellicer, Gerhard Pichler, Gorm Greisen
PLoS One Infectious Diseases, 24.01.2022
Tilføjet 24.01.2022
by Anne Mette Plomgaard, Christoph E. Schwarz, Olivier Claris, Eugene M. Dempsey, Monica Fumagalli, Simon Hyttel-Sorensen, Petra Lemmers, Adelina Pellicer, Gerhard Pichler, Gorm Greisen
Background The SafeBoosC II, randomised clinical trial, showed that the burden of cerebral hypoxia was reduced with the combination of near infrared spectroscopy and a treatment guideline in extremely preterm infants during the first 72 hours after birth. We have previously reported that a high burden of cerebral hypoxia was associated with cerebral haemorrhage and EEG suppression towards the end of the 72-hour intervention period, regardless of allocation. In this study we describe the associations between the burden of cerebral hypoxia and the 2-year outcome. Methods Cerebral oxygenation was continuously monitored from 3 to 72 hours after birth in 166 extremely preterm infants. At 2 years of age 114 of 133 surviving children participated in the follow-up program: medical examination, Bayley II or III test and the parental Ages and Stages Questionnaire. The infants were classified according to the burden of hypoxia: within the first three quartiles (n = 86, low burden) or within in the 4th quartile (n = 28, high burden). All analyses were conducted post hoc. Results There were no statistically significant differences between the quantitative assessments of neurodevelopment in the groups of infants with the low burden of cerebral hypoxia versus the group of infants with the high burden of cerebral hypoxia. The infants in the high hypoxia burden group had a higher–though again not statistically significant—rate of cerebral palsy (OR 2.14 (0.33–13.78)) and severe developmental impairment (OR 4.74 (0.74–30.49). Conclusions The burden of cerebral hypoxia was not significantly associated with impaired 2-year neurodevelopmental outcome in this post-hoc analysis of a feasibility trial.
Læs mere Tjek på PubMedDaniel Penados, José P. Pineda, Elisa Laparra-Ruiz, Manuel F. Galván, Anna M. Schmoker, Bryan A. Ballif, M. Carlota Monroy, Lori Stevens
PLoS One Infectious Diseases, 24.01.2022
Tilføjet 24.01.2022
by Daniel Penados, José P. Pineda, Elisa Laparra-Ruiz, Manuel F. Galván, Anna M. Schmoker, Bryan A. Ballif, M. Carlota Monroy, Lori Stevens
Chagas disease is mainly transmitted by triatomine insect vectors that feed on vertebrate blood. The disease has complex domiciliary infestation patterns and parasite transmission dynamics, influenced by biological, ecological, and socioeconomic factors. In this context, feeding patterns have been used to understand vector movement and transmission risk. Recently, a new technique using Liquid chromatography tandem mass spectrometry (LC-MS/MS) targeting hemoglobin peptides has showed excellent results for understanding triatomines’ feeding patterns. The aim of this study was to further develop the automated computational analysis pipeline for peptide sequence taxonomic identification, enhancing the ability to analyze large datasets data. We then used the enhanced pipeline to evaluate the feeding patterns of Triatoma dimidiata, along with domiciliary infestation risk variables, such as unkempt piles of firewood or construction material, cracks in bajareque and adobe walls and intradomiciliary animals. Our new python scripts were able to detect blood meal sources in 100% of the bugs analyzed and identified nine different species of blood meal sources. Human, chicken, and dog were the main blood sources found in 78.7%, 50.4% and 44.8% of the bugs, respectively. In addition, 14% of the bugs feeding on chicken and 15% of those feeding on dogs were captured in houses with no evidence of those animals being present. This suggests a high mobility among ecotopes and houses. Two of the three main blood sources, dog and chicken, were significantly (p < 0.05) affected by domiciliary infestation risk variables, including cracks in walls, construction material and birds sleeping in the intradomicile. This suggests that these variables are important for maintaining reproducing Triatoma dimidiata populations and that it is critical to mitigate these variables in all the houses of a village for effective control of these mobile vectors.
Læs mere Tjek på PubMedAppleby, J. A., King, N., Saunders, K. E., Bast, A., Rivera, D., Byun, J., Cunningham, S., Khera, C., Duffy, A. C.
BMJ Open, 24.01.2022
Tilføjet 24.01.2022
Objectives
To explore the impact of the COVID-19 pandemic on the experiences and mental health of university students.
Design
A cross-sectional study consisting of an electronic survey about students’ experiences and concerns during the pandemic and the associated impact. In addition to the quantitative analysis, free-text responses were extracted and analysed using a framework technique.
Setting
Queen’s University in Canada and the University of Oxford in the UK.
Participants
Undergraduate students at Queen’s University and first-year undergraduate students at the University of Oxford were invited to complete the COVID-19 supplement survey. This study included data from 3013 Queen’s students as the primary focus and 339 Oxford students as a secondary comparison.
Results
Females at Queen’s reported greater adherence to government recommendations to prevent the spread of COVID-19 (91.3% vs 86.7%, 2 p<0.01) and were more likely to self-isolate (63.9% vs 57.0%, 2 p<0.01) than males. A similar trend was seen among Oxford students. Students’ concerns were wide ranging including those related to their learning experience, finances and future academic and career prospects. 78.9% of Queen’s students and 50.4% of first-year Oxford students reported worries about the long-term impact on their academic and job prospects. A sizeable proportion of students also reported that the pandemic negatively impacted their plans to continue at university (29.4% of Queen’s, 14.2% of Oxford) and disrupted activities important to their mental well-being. Key themes identified in the qualitative component included the negative impacts of social isolation, challenging academic changes and disruption to support services and means of coping.
Conclusions
Overall, findings underscore the importance of addressing areas of student concern and the aspects of student life negatively impacted by the pandemic in order to maintain student well-being and support a successful university experience.
Læs mere Tjek på PubMed
Gedde, M. H., Husebo, B. S., Vahia, I. V., Mannseth, J., Vislapuu, M., Naik, M., Berge, L. I.
BMJ Open, 24.01.2022
Tilføjet 24.01.2022
Objectives
To investigate the impact of the COVID-19 restrictions on behavioural and psychological symptoms of dementia (BPSD).
Design
Prospective cohort study (PAN.DEM) nested within the halted parent trial (LIVE@Home.Path).
Setting
Households in Norway immediate before and 6–9 weeks into the COVID-19 restrictions.
Participants
104 dyads (persons with mild to moderate dementia aged ≥65 and their informal carers) completed both prepandemic and pandemic assessments, among 237 in the parent trial. Mini-Mental Status Examination score 15–26 or Functional Assessment Staging score 3–7 covered dementia severity.
Main outcome measures
Neuropsychiatric Inventory (NPI-12) total (range 0–144), psychosis (range 0–24), hyperactive behaviour (range 0–60) and mood subsyndrome (range 0–48) scores; Cornell Scale for Depression in Dementia (CSDD) total score (range 0–38).
Results
We found an overall increase in BPSD by NPI-12 total score comparing prepandemic to pandemic levels (median 16 IQR (4.5–29) to 20 (7–32.5), p=0.03) over a mean of 86 days (SD 19). NPI-12 total score worsened in 57 (55%) of people with dementia and was associated with postponed or averted contacts with healthcare professionals (logistic regression, OR 3.96, 95% CI 1.05 to 14.95). Psychosis subsyndrome levels increased (0 (0–3) to 0.5 (0–6), p=0.01) in 37 (36%) persons; this worsening was associated with partial insight (9.57, 1.14 to 80.71) and reduced informal carer contact (4.45, 1.01 to 19.71). Moreover, depressive symptoms increased as assessed by CSDD total score (5 (3–9) to 7 (4–12), p=0.01) and worsened for 56 (54%), which was inversely associated with psychotropic drugs on-demand (0.16, 0.03 to 0.75).
Conclusions
BPSD worsened during the first months of the COVID-19 restrictions, most pronounced for psychosis and depression. These BPSD exacerbations have implications for pandemic policies, emphasising that restrictions must balance COVID-19 morbidity and mortality against dementia deterioration.
Trial registration number
NCT04043364; Results.
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Yellappa, V., Bindu, H., Rao, N., Narayanan, D.
BMJ Open, 24.01.2022
Tilføjet 24.01.2022
Objectives
In India, retail private pharmacists (RPPs) are often patients’ first point of contact for diseases, including tuberculosis (TB). We assessed the factors influencing RPPs’ referral of patients with chest symptoms to the National TB Elimination Programme (NTEP) and the way business is carried out with reference to TB drugs.
Design
We conducted semistructured interviews with a purposive sample of 41 RPPs in a South Indian district between May and October 2013. Data were collected from urban areas (21 RPPs) and rural areas (20 RPPs) employing the principle of data saturation. Data were analysed thematically using NVivo V.9.
Results
Knowledge and compliance of RPPs regarding TB symptoms and regulatory requirements were found to be poor. The RPPs routinely dispensed medicines over the counter and less than half of the respondents had pharmacy qualifications. None of them had received TB-related training, yet half of them knew about TB symptoms. Practice of self-referrals was common particularly among economically poorer populations who preferred purchasing medicines over the counter based on RPPs’ advice. Inability of patients with TB to purchase the full course of TB drugs was conspicuous. Rural RPPs were more likely to refer patients with TB symptoms to the NTEP compared with urban ones who mostly referred such clients to private practitioners (PPs). Reciprocal relationships between the RPPs, PPs, medical representatives and the prevalence of kickbacks influenced RPPs’ drug-stocking patterns. PPs wielded power in this nexus, especially in urban areas.
Conclusion
India hopes to end TB by 2025. Our study findings will help the NTEP to design policy and interventions to engage RPPs in public health initiatives by taking cognisance of symbiotic relationships and power differentials that exist between PPs, RPPs and medical representatives. Concurrently, there should be a strong enforcement mechanism for existing regulatory norms regarding over-the-counter sales and record keeping.
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Pilar Domenech Esma Mouhoub Michael B. Reed 1The Infectious Diseases and Immunity in Global Health Program of The Research Institute of the McGill University Health Centre 2The McGill international TB Centre 3The Department of Microbiology & Immunology, McGill University 4The Department of Medicine, McGill University, Montreal, Quebec, Canada.
Antimicrobial Agents And Chemotherapy, 24.01.2022
Tilføjet 24.01.2022
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 PubMedAlessandra Biffi
Nature, 24.01.2022
Tilføjet 24.01.2022
Nature Medicine, Published online: 24 January 2022; doi:10.1038/s41591-021-01653-7Long-term follow-up data reinforce the curative potential of hematopoietic stem-cell gene therapy for this rare primary immunodeficiency disorder.
Læs mere Tjek på PubMedLan Wang, Xiangyu Guo, Na Zhao, Yanyan Ouyang, Binghui Du, Wangli Xu, Ta‐Chien Chan, Hui Jiang, Shelan Liu
Journal of Medical Virology, 24.01.2022
Tilføjet 24.01.2022
Fabiola Justina Fumero León, Lucas Lima da Silva, Alanna Calheiros Santos, Vanessa Duarte da Costa, Juliana Custódio Miguel, Julia Trece Marques, Giselle Prado do Nascimento, Elisangela Ferreira da Silva, Lia Laura Lewis‐Ximenez, Livia Melo Villar, Vanessa Salete Paula
Journal of Medical Virology, 22.01.2022
Tilføjet 23.01.2022
Rafael San-Juan, Mario Fernández-Ruiz, Francisco López-Medrano, Octavio Carretero, Antonio Lalueza, Guillermo Maestro de la Calle, María Asunción Pérez-Jacoiste Asín, Héctor Bueno, José Manuel Caro-Teller, Mercedes Catalán, Cristina de la Calle, Rocío García-García, Carlos Gómez, Rocío Laguna-Goya, Manuel Lizasoáin, Joaquín Martínez-López, Julia Origüen, Ángel Sevillano, Eduardo Gutiérrez, Borja de Miguel, Fernando Aguilar, Patricia Parra, Mar Ripoll, Tamara Ruiz-Merlo, Hernando Trujillo, José Luis Pablos, Estela Paz-Artal, Carlos Lumbreras, José María Aguado, H12O Immunomodulation Therapy for COVID-19 Group, the Spanish Network for Research in Infectious Diseases (REIPI)
International Journal of Infectious Diseases, 22.01.2022
Tilføjet 23.01.2022
Qihua Ye, Barbara Balestrieri, Nora A. Barrett
Trends in Parasitology, 22.01.2022
Tilføjet 23.01.2022
Type 2 inflammation (T2I) accompanies many inflammatory diseases. In a recent issue of Cell, Ahrends et al. demonstrate that helminth-elicited T2I preserves excitatory neurons and enteric function through the expansion of Arginase-1 (Arg-1)-expressing macrophages, thereby extending our understanding of the protective functions that T2I can orchestrate in inflamed barrier tissue.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.01.2022
Tilføjet 23.01.2022
Abstract
Background
Despite reports of malaria and coronavirus diseases 2019 (COVID-19) co-infection, malaria-endemic regions have so far recorded fewer cases of COVID-19 and deaths from COVID-19, indicating a probable protection from the poor outcome of COVID-19 by malaria. On the contrary, other evidence suggests that malaria might contribute to the death caused by COVID-19. Hence, this paper reviewed existing evidence hypothesizing poor outcome or protection of COVID-19 patients when co-infected with malaria.
Methods
PRISMA guidelines for systematic review were employed in this study. Published articles from December 2019 to May 2021on COVID-19 and malaria co-infection and outcome were systematically searched in relevant and accessible databases following a pre-defined strategy. Studies involving human, in vivo animal studies, and in vitro studies were included.
Results
Twenty three (23) studies were included in the review out of the 3866 records identified in the selected scientific databases. Nine (9) papers reported on co-infection of COVID-19 and malaria. Five (5) papers provided information about synergism of malaria and COVID-19 poor prognosis, 2 papers reported on syndemic of COVID-19 and malaria intervention, and 7 studies indicated that malaria protects individuals from COVID-19.
Conclusions
Low incidence of COVID-19 in malaria-endemic regions supports the hypothesis that COVID-19 poor prognosis is prevented by malaria. Although further studies are required to ascertain this hypothesis, cross-immunity and common immunodominant isotopes provide strong evidence to support this hypothesis. Also, increase in co-inhibitory receptors and atypical memory B cells indicate synergy between COVID-19 and malaria outcome, though, more studies are required to make a definite conclusion.
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BMC Infectious Diseases, 22.01.2022
Tilføjet 23.01.2022
Abstract
Background
From the initial stages of the pandemic in early 2020, COVID-19-related olfactory and gustatory dysfunctions have been widely reported and are emerging as one of the most frequent long-term sequelae of SARS-CoV-2 infection. However, data regarding the long-term recovery of the sense of smell and taste are lacking. This study aimed to characterize the evolution up to one year after the diagnosis of self-reported olfactory and gustatory dysfunctions in COVID-19 cases.
Methods
Based on the data of the active surveillance platform of the Apulia region, Italy, we selected the residents of Foggia district who were confirmed positive for SARS-CoV-2 from March 1st to June 16th, 2020, and home-quarantined with paucisymptomatic-to-mild clinical presentation. Self-reported olfactory and gustatory dysfunctions were recorded at baseline through a survey of dichotomous questions. The evolution of these symptoms at approximately one year was prospectively assessed via telephone by the validated sino-nasal outcome test 22 (SNOT-22, Italian version).
Results
Among the 1,175 COVID-19 cases notified in the Foggia district during the first epidemic wave, 488 had paucisymptomatic-to-mild clinical presentation. Of these, 41.2% (n = 201, 95% confidence interval [CI] 36.8–45.7%) reported at least one sensory dysfunction. A total of 178 to 201 (88.5%) patients agreed to participate in the follow-up survey. According to the SNOT-22 results, the persistence of a sensory dysfunction was observed in the 29.8% (n = 53, 95% CI 23.2–37.1%) of them. Particularly, loss of smell persisted in 25.8% (n = 46, 95% CI 19.6–32.9%), loss of taste in 21.3% (n = 38, 95% CI 15.6–28.1%), loss of both in 17.4% (n = 31, 95% CI 12.2–23.8%) of participants in the follow-up. The rates of full recovery increased over time: from 59% at 30 days to 71.9% at 90 days for the sense of smell; from 61.3% at 30 days to 74.7% at 90 days for the sense of taste.
Conclusions
The persistence of COVID-19-related olfactory and gustatory dysfunctions up to 12 months after the disease onset in a noteworthy proportion (approximately 3 out of 10) of patients with paucisymptomatic-to-mild clinical presentation deserves further investigations due to its possible pathophysiological implications and impact on the quality of life.
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BMC Infectious Diseases, 22.01.2022
Tilføjet 23.01.2022
Abstract
Background
Individuals with end-stage renal disease have a higher risk of hepatitis C virus (HCV) acquisition during long-term hemodialysis (HD). Our report was designed to investigate HCV prevalence and genotype, in addition to the clinical use of HCV core antigen (HCVcAg), within multiple HD facilities in Thailand.
Methods
This cross‐sectional report was investigated between January and June 2019. HCV infection was assessed by anti-HCV and confirmed active infection by measuring HCV RNA and HCVcAg. HCV genotype was determined by phylogenetic analysis using nucleotide sequences of NS5B region.
Results
Overall, 140 of 3,305 (4.2%) patients in 15 dialysis centers had anti-HCV positive. Among them, HCV RNA was further assessed in 93 patients and was detectable in 59 (63.4%) persons. Considering HCV viremia, HCVcAg measurement exhibited high accuracy (96.8%), sensitivity (94.9%) and specificity (100%) in comparison with HCV RNA testing. Moreover, individuals infected with HCV received a longer duration of dialysis vintage when compared to anti-HCV negative controls. The major sub-genotypes were 1a, 1b, 3a, 3b, 6f and 6n. Regarding phylogenetic analysis, there were 7 clusters of isolates with high sequence homology affecting 17 individuals, indicating possible HCV transmission within the same HD centers.
Conclusions
HCV frequency and common sub-genotypes in HD centers were different from those found in the Thai general population. HCVcAg might be an alternate testing for viremia within resource-limited countries. Enhanced preventive practices, dialyzer reuse policy and better access to antiviral therapy are crucial for HCV micro-elimination within HD facilities.
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BMC Infectious Diseases, 22.01.2022
Tilføjet 23.01.2022
Abstract
Background
Bacteraemia is associated with high morbidity and mortality, with delayed antibiotic treatment associated with poorer outcomes. Early identification is challenging, but clinically important. Multiple scoring systems have been developed to identify individuals in the broader categories of sepsis. We designed this study to assess the performance of existing scoring systems and pathways—CEC SEPSIS KILLS pathway (an Australian sepsis care package), quick sequential organ failure score (qSOFA), systemic inflammatory response syndrome (SIRS) and the Shapiro criteria.
Methods
This was a retrospective cohort study performed in two metropolitan hospitals in NSW, consisting of adult patients (> 18 years) with positive blood cultures containing a true pathogen and patients matched by age without positive blood cultures. Performance (sensitivity, specificity, and mortality prediction) of recognised sepsis and bacteraemia criteria and pathways—qSOFA, SIRS, Shapiro criteria and CEC SEPSIS KILLS pathway in the first 4 h following ED triage was assessed.
Results
There were 251 patients in each cohort. Sepsis-related mortality was higher in the bacteraemic group (OR 0.4, p = 0.03). Of the criteria studied, the modified Shapiro criteria had the highest sensitivity (88%) with modest specificity (37.85%), and qSOFA had the highest specificity (83.67%) with poor sensitivity (19.82%). SIRS had reasonable sensitivity (82.07%), with poor sensitivity (20.72%). The CEC SEPSIS pathway sensitivity of 70.1% and specificity of 71.1%. The SEPSIS KILLS was activated on only 14% of bacteraemic patients.
Conclusion
The performance of all scoring systems and pathways was suboptimal in the identification of patients at risk of bacteraemia presenting to the emergency department.
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Moore, David M.; Kremer, Hayden; Wang, Lu; Lepik, Katherine J.; Li, Jenny; Salters, Kate; Montaner, Julio S.G.; Tam, Clara; Kling, Rakel; Bharmal, Aamir; Goodison, Karin; Pakhomova, Tatiana; Barrios, Rolando
Journal of Acquired Immune Deficiency Syndromes, 10.01.2022
Tilføjet 22.01.2022
Background:
In 2016, the British Columbia (BC) HIV/AIDS Drug Treatment Program (DTP) modified its prescriber alert system for antiretroviral therapy (ART) interruptions to include referrals to regional public health nursing teams for direct outreach support for those who remain off treatment for four months or longer. We evaluated clinically-relevant outcomes of this Re-Engagement and Engagement in Treatment for Antiretroviral Interrupted and Naïve populations (RETAIN) initiative, in comparison to previous time-periods.
Methods:
We analyzed ART interruptions triggering alerts in pre-RETAIN (July 2013-April 2016) and post-RETAIN periods (May 2016-October 2017) with follow-up continuing until October 2018. We compared the proportions who re-started ART and achieved viral suppression in pre- and post-RETAIN periods and the time to ART re-start using generalized estimating equations. Cox proportional hazards modelling was used to examine associations with time-to-ART-restart.
Results:
A total of 1805 individuals experienced ART interruptions triggering 3219 alerts; 2050 in pre-RETAIN and 1169 in post-RETAIN periods. Participants were predominantly male (74%) and had a median duration of ART of 5 years. Among persons who remained interrupted >4 months after an ART interruption alert was sent, the median time from interruption to ART re-initiation declined from 8.7 months to 7.4 months (p<0.001) from pre- to post-RETAIN periods. Interruptions in the post-RETAIN era were associated with an increased hazard of re-starting ART (adjusted hazard ratio 1.51; 95% CI 1.34 - 1.69).
Conclusion:
Public health referrals shortened the length of ART interruptions after alerts sent to prescribers had not resulted in re-engagement. Similar programs should be considered in other jurisdictions.
Corresponding author: Address for correspondence: 608 – 1081 Burrard Street, Vancouver, BC, Canada V6T 1Y6, Email: dmoore@bccfe.ca
The authors report no conflicts of interest related to this work.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedDonenberg, Geri R.; Fitts, Jessica; Ingabire, Charles; Nsanzimana, Sabin; Fabri, Mary; Emerson, Erin; Remera, Eric; Manzi, Olivier; Bray, Bethany; Cohen, Mardge H.
Journal of Acquired Immune Deficiency Syndromes, 10.01.2022
Tilføjet 22.01.2022
Background:
Adolescents living with HIV have elevated mental distress and suboptimal ART adherence.
Setting:
Two urban clinics in Kigali, Rwanda.
Methods:
A 2-arm individual randomized controlled trial compared Trauma Informed Cognitive Behavioral Therapy enhanced to address HIV (TI-CBTe) to usual care (time-matched, long-standing, unstructured support groups) with 356 12-21 year-old (M=16.78) Rwandans living with HIV. TI-CBTe included six group-based 2-hour sessions led by trained and supervised 21-25 year old Rwandans living with HIV. Participants reported their ART adherence, depression/anxiety, and PTSD symptoms at baseline, 6-, 12-, and 18-months.
Results:
ART adherence was relatively high at baseline, and youth reported elevated rates of depression/anxiety and trauma symptoms. There was no differential treatment effects on adherence, but depression/anxiety improved over time. Youth with lower depression/anxiety at baseline appeared to benefit more from TI-CBTe than usual care, whereas females with high baseline distress appeared to benefit more from usual care. Youth were less likely to score in high PTSD symptom categories at follow-up, with no differential treatment effects.
Conclusions:
TI-CBTe did not outperform usual care on ART adherence, possibly reflecting relatively high adherence at baseline, simplified medication regimens over time, a strong comparison condition, or because youth assigned to TI-CBTe returned to their support groups following the intervention. TI-CBTe was more effective for youth with lower depression/anxiety symptoms, whereas youth with high distress benefitted more from the support groups. TI-CBTe was feasible and acceptable, and young adults living with HIV were able to deliver a mental health intervention with fidelity. The powerful nature of the comparison group, ongoing support groups, points to the potential value of locally-crafted interventions in low resource settings.
Corresponding Author: Geri R. Donenberg, PhD, Center for Dissemination and Implementation Science, University of Illinois at Chicago 818 W. Wolcott, SRH – 3rd Floor, Room 332 (M/C 579) Chicago, IL 60612 FAX: 312-996-6893 TEL: 312-996-8602 Email: gerid@uic.edu
Conflicts of Interest and Source of Funding: This study was funded by the National Institute of Child Health and Human Development (R01HD074977). None of the authors have a conflict of interest.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedSchröter, Juliane; Anelone, Anet J.N.; de Boer, Rob J.
Journal of Acquired Immune Deficiency Syndromes, 10.01.2022
Tilføjet 22.01.2022
Background:
Perinatally HIV-acquired infants benefit from an early ART initiation. Thanks to a short viral exposure time, their immune system can be maintained or reconstituted, allowing a”normal” immune development.
Methods:
In this study, we mathematically modelled and quantified individual CD4+ T-cell reconstitu- tion of a subset of 276 children who started treatment within 6 months of age and achieved sustained viral suppression. Considering natural age differences in CD4+ T-cell dynamics, we fitted distances to age-matched healthy reference values with a linear model approaching an asymptote.
Results:
Depleted CD4+ percentages (CD4%) and CD4+ counts (CD4ct) restored healthy levels during treatment. CD4ct recovered with a median rate of 4 cells per µl per day, and individual re- covery rates were correlated negatively with their initial CD4ct. CD4 values at onset of treatment decrease with age, while recovery times and levels seem to be age-independent. CD4 recovery correlates positively with viral suppression, and the stabilisation of CD4 levels usually occurs after viral suppression. CD4 levels stabilise within 3 to 13 months after treatment initiation. The recovery dynamics of the CD4% is comparable to those of the CD4ct.
Conclusion:
In early-treated children with successful viral suppression, the CD4 depletion is typi- cally mild and CD4+ T-cells tend to”fully” recover in numbers.
Corresponding author: Juliane Schröter, Theoretical Biology, Utrecht University, Padualaan 8, 3584 CH Utrecht, The Netherlands. Email: schj.work@gmail.com; Tel: +31 30 253 1497.
Declaration of interest: There are no conflicts of interest.
aCurrent address: School of Mathematics and Statistics, University of Sydney, Sydney, Australia
#Authors contributed equally to this work.
This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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