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BMC Infectious Diseases, 5.02.2022
Tilføjet 6.02.2022
Abstract
Background
The city of Manaus, north Brazil, was stricken by a second epidemic wave of SARS-CoV-2 despite high seroprevalence estimates, coinciding with the emergence of the Gamma (P.1) variant. Reinfections were postulated as a partial explanation for the second surge. However, accurate calculation of reinfection rates is difficult when stringent criteria as two time-separated RT-PCR tests and/or genome sequencing are required. To estimate the proportion of reinfections caused by Gamma during the second wave in Manaus and the protection conferred by previous infection, we identified anti-SARS-CoV-2 antibody boosting in repeat blood donors as a mean to infer reinfection.
Methods
We tested serial blood samples from unvaccinated repeat blood donors in Manaus for the presence of anti-SARS-CoV-2 IgG antibodies using two assays that display waning in early convalescence, enabling the detection of reinfection-induced boosting. Donors were required to have three or more donations, being at least one during each epidemic wave. We propose a strict serological definition of reinfection (reactivity boosting following waning like a V-shaped curve in both assays or three spaced boostings), probable (two separate boosting events) and possible (reinfection detected by only one assay) reinfections. The serial samples were used to divide donors into six groups defined based on the inferred sequence of infection and reinfection with non-Gamma and Gamma variants.
Results
From 3655 repeat blood donors, 238 met all inclusion criteria, and 223 had enough residual sample volume to perform both serological assays. We found 13.6% (95% CI 7.0–24.5%) of all presumed Gamma infections that were observed in 2021 were reinfections. If we also include cases of probable or possible reinfections, these percentages increase respectively to 22.7% (95% CI 14.3–34.2%) and 39.3% (95% CI 29.5–50.0%). Previous infection conferred a protection against reinfection of 85.3% (95% CI 71.3–92.7%), decreasing to respectively 72.5% (95% CI 54.7–83.6%) and 39.5% (95% CI 14.1–57.8%) if probable and possible reinfections are included.
Conclusions
Reinfection by Gamma is common and may play a significant role in epidemics where Gamma is prevalent, highlighting the continued threat variants of concern pose even to settings previously hit by substantial epidemics.
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BMC Infectious Diseases, 5.02.2022
Tilføjet 6.02.2022
Abstract
Background
Schistosomiasis is one of the most contagious parasitic diseases affecting humans; however, glomerular injury is a rare complication mainly described with Schistosoma mansoni infection. We report a case of membranous nephropathy associated with Schistosoma japonicum infection in a Chinese man.
Case presentation
A 51-year-old Chinese male with a long history of S. japonicum infection presented to the hospital with a slowly progressing severe lower limb edema and foaming urine for over 5 months. Serum S. japonicumantigen test was positive and immunohistochemistry showed that the glomeruli were positive for the antigens. The renal pathologic diagnosis was stage III membranous nephropathy. The patient was treated with glucocorticoid, praziquantel, and an angiotensin-converting enzyme inhibitor. The edema in both lower limbs disappeared within 2 weeks, but his renal function declined progressively and proteinuria persisted after 5 months of therapy.
Conclusions
Different classes of schistosomal glomerulopathy have completely different clinical manifestation and prognosis. Therefore, efforts should focus on alleviating symptoms, prevention, and early detection. S. japonicumassociated with membranous nephropathy may show a good curative effect and prognosis. However, it is necessary to monitor the renal function in such patients.
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BMC Infectious Diseases, 5.02.2022
Tilføjet 6.02.2022
Abstract
Background
In the pediatric population, severe Clostridioides difficile infection (CDI) sometimes occurs, but most cases are asymptomatic. The asymptomatic carriage rate in pediatric populations is reportedly higher than in the adult population. It is difficult to diagnose CDI, even if C. difficile is detected in children with diarrhea. This study aimed to evaluate the positivity rate of toxigenic C. difficile in the pediatric population with diarrhea.
Methods
We collected and retrospectively analyzed gastrointestinal pathogen multiplex PCR results of 960 patients to estimate the positivity rate of toxigenic C. difficile in pediatric populations aged between 0 and 18 years.
Results
The overall rate of C. difficile toxin B positivity was 10.1% in the stool samples. The positivity rate peaked in 1-year-old infants (29/153, 19.0%) and continually decreased thereafter. The positivity rate we observed was lower than the rates described in the literature. Remarkably, no C. difficile was detected in neonates. Antibiotic usage was inversely related to the positivity rate, especially in infants < 2 years of age. The odds ratio of antibiotics was 0.44 (95% confidence interval (CI) 0.28–0.68; P < 0.001). The presence of concomitant gastrointestinal pathogens was not associated with toxigenic C. difficile positivity.
Conclusions
Even though toxigenic C. difficile infection is neither an important nor a common cause of pediatric diarrhea, children can spread it to adults at risk of developing CDI. The pediatric population can act as hidden reservoirs for pathogenic strains in the community.
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BMC Infectious Diseases, 5.02.2022
Tilføjet 6.02.2022
Abstract
Background
Congenital syphilis is preventable through timely access to prenatal care, syphilis screening and treatment of pregnant women diagnosed as infected. In 2018, California had the second highest number of congenital syphilis cases in the United States (U.S.), a nearly twofold increase in cases since 2014. This study assessed gaps in preventing congenital syphilis in the high morbidity region of Kern County, California.
Methods
Between May 2018 and January 2019, we conducted five focus group discussions with pregnant/postpartum women and ten semi-structured interviews with prenatal care providers in Kern County. Focus group and interview data were recorded, transcribed, and analyzed to identify emergent themes pertaining to facilitators and barriers at each step (prenatal care, syphilis screening and treatment) in the congenital syphilis prevention cascade.
Results
Gaps in congenital syphilis prevention discussed in focus group discussions with pregnant/postpartum women were related to limited prenatal care access, social-, economic-, and cultural-barriers, and substance use and co-occurring intimate partner/domestic violence. The gaps identified from interviews with prenatal care providers included social economic vulnerabilities of pregnant women and stigma and shame around the vulnerabilities, distrust in medical system, prenatal substance use, limited prenatal substance use disorder treatment facilities, and inadequate provider training on context-specific congenital syphilis management strategies. Gaps in partner notification, screening and treatment for syphilis were brought up by pregnant/postpartum women and prenatal care providers.
Conclusions
Congenital syphilis continues to increase in Kern County and throughout the U.S. In high syphilis morbidity areas, comprehensive and tailored public health approaches addressing setting-specific gaps in prenatal screening and treatment are needed.
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BMC Infectious Diseases, 5.02.2022
Tilføjet 6.02.2022
Abstract
Background
Both CMV and Rubella virus infections are associated with the risk of vertical transmission, fetal death or congenital malformations. In Angola, there are no reports of CMV and Rubella studies. Therefore, our objectives were to study the seroprevalence of anti-CMV and anti-Rubella antibodies in pregnant women of Luanda (Angola), identify the risk of primary infection during pregnancy and evaluate the socio-demographic risk factors associated with both infections.
Methods
A prospective cross-sectional study was conducted from August 2016 to May 2017. Specific anti-CMV and anti-Rubella antibodies were quantified by electrochemiluminescence and demographic and clinical data were collected using standardized questionnaire. Bivariate and multivariate logistic regression analysis were used to quantify the effect of clinical and obstetric risk factors on virus seroprevalence.
Results
We recruited 396 pregnant women aged from 15 to 47. Among them, 335 (84.6%) were immune to both CMV and Rubella virus infections, while 8 (2.0%) had active CMV infection and 4 (1.0%) active RV infection but none had an active dual infection. Five women (1.2%) were susceptible to only CMV infection, 43 (10.9%) to only RV infection, and 1 (0.3) to both infections. Multivariate analysis showed a significant association between Rubella virus infection and number of previous births and suffering spontaneous abortion.
Conclusions
Overall, this study showed that there is a high prevalence of anti-CMV and anti-Rubella antibodies in pregnant women in Luanda. It also showed that a small but important proportion of pregnant women, about 11%, are at risk of primary infection with rubella during pregnancy. This emphasizes the need for vaccination.
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Wheatley, Margo M.; Knowlton, Gregory; Kao, Szu-Yu; Jenness, Samuel M.; Enns, Eva A.
Journal of Acquired Immune Deficiency Syndromes, 26.01.2022
Tilføjet 6.02.2022
Background:
To help achieve Ending the HIV Epidemic (EHE) goals of reducing new HIV incidence, pre-exposure prophylaxis (PrEP) use and engagement must increase despite multidimensional barriers to scale-up and limitations in funding. We investigated the cost-effectiveness of interventions spanning the PrEP continuum of care.
Setting:
Men who have sex with men (MSM) in Atlanta, Georgia, a focal jurisdiction for the EHE plan.
Methods:
Using a network-based HIV transmission model, we simulated lifetime costs, quality-adjusted life years (QALYs), and infections averted for eight intervention strategies using a health sector perspective. Strategies included a status quo (no interventions), three distinct interventions (targeting PrEP initiation, adherence, or persistence), and all possible intervention combinations. Cost-effectiveness was evaluated incrementally using a $100,000/QALY gained threshold. We performed sensitivity analyses on PrEP costs, intervention costs, and intervention coverage.
Results:
Strategies averted 0.2–4.2% new infections and gained 0.0045%–0.24% QALYs compared to the status quo. Initiation strategies achieved 20%–23% PrEP coverage (up from 15% with no interventions) and moderate clinical benefits at a high cost, while adherence strategies were relatively low cost and low benefit. Under our assumptions, the adherence and initiation combination strategy was cost-effective ($86,927/QALY gained). Sensitivity analyses showed no strategies were cost-effective when intervention costs increased by 60% and the strategy combining all three interventions was cost-effective when PrEP costs decreased to $1,000/month.
Conclusion:
PrEP initiation interventions achieved moderate public health gains and could be cost-effective. However, substantial financial resources would be needed to improve the PrEP care continuum towards meeting EHE goals.
Corresponding Author: Eva Enns, PhD, 420 Delaware St SE, MMC 729 Mayo, Minneapolis, MN 55455, Fax: 612-624-2196, Tel: 612-626-4581, Email: eenns@umn.edu
Conflicts of Interest and Source of Funding: The authors declare no conflicts of interest. This work was supported by National Institutes of Health grant R01 AI138783.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedSuárez-García, Inés; Ruiz-Algueró, Marta; Alejos, Belén; García-Yubero, Cristina; Belza, Ma José; Espacio, Ramón; Hernández, Juanse; Sánchez, Josefa Muñoz; Garaialde, Ainhoa; Socas, María del Mar Alonso; Alcaraz, Antonia; Ruiz de Galarreta, Beatriz Pierola; Martínez Madrid, Onofre Juan; Cuéllar, Isabel Gutiérrez; Gómez-Ayerbe, Cristina; Olalla, Julián; Jarrín, I
Journal of Acquired Immune Deficiency Syndromes, 26.01.2022
Tilføjet 6.02.2022
Objectives:
The aims of this study were to describe patients’ experiences after single-tablet regimen (STR) de-simplification, and its impact on self-reported treatment adherence and quality of life.
Methods:
We performed a survey among all patients from the multicenter cohort of the Spanish HIV/AIDS Network (CoRIS) who had de-simplified the STRs dolutegravir/abacavir/lamivudine (DGT/ABC/3TC) or rilpivirine/tenofovir disoproxil fumarate/emtricitabine (RPV/TDF/FTC) to their separate components (DTG+generic ABC/3TC or RPV+generic TDF/FTC, respectively) between December 2016 and November 2018.
Results:
Among 216 patients who fulfilled inclusion criteria, 138 (63.9%) completed the questionnaire. The majority (78.3%) knew what generic drugs are, only 8.7% thought that treatment with two pills is less effective than treatment with an STR, and 67.4% agreed that it is reasonable to take two pills instead of one for HIV treatment in order to decrease costs for the healthcare system.
After de-simplification, 13.0% of the patients stated they had more secondary effects, 8.0% had forgotten one or more doses more frequently than before, and 10.9% had sometimes forgotten to take one pill, but not the other. A proportion of 30.4% reported not being happy to take more pills a day and 10.1% experienced a worse quality of life after the treatment de-simplification.
Conclusions:
After STR de-simplification, most patients had a fair knowledge about generic antiretrovirals , and they agreed to de-simplify their STR in order to decrease costs. Although almost a third of the respondents were not happy to take two pills a day, only a minority reported worse adherence or quality of life.
Corresponding author. Department of Internal Medicine. Hospital Universitario Infanta Sofía. Paseo de Europa, 34. 28702 San Sebastián de los Reyes, Madrid, Spain. Phone: +34 91 1914133. E-mail: inessuarez@hotmail.com
Conflicts of Interest and Sources of Funding: ISG has received conference or speaker fees from Viiv, MSD and Gilead. CGY has received conference fees from Gilead and Janssen. IJ has received teaching fees from Viiv and advisory fees from Gilead. All other authors: none to declare., This study was funded by the Instituto de Salud Carlos III (EPY 115/18 and Acción Estratégica en Salud, PI17/00774) and co-funded by the European Regional Development Fund, “A way to make Europe”. CoRIS is supported by the Instituto de Salud Carlos III through the Red Temática de Investigación Cooperativa en Sida (RD06/006, RD12/0017/0018 and RD16/0002/0006) as part of the Plan Nacional I+D+i and co-financed by Instituto de Salud Carlos III-Subdirección General de Evaluación and the European Regional Development Fund.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedEl Bouzidi, Kate; Murtala-Ibrahim, Fati; Kwaghe, Vivian; Datir, Rawlings P.; Ogbanufe, Obinna; Crowell, Trevor A.; Charurat, Man; Dakum, Patrick; Gupta, Ravindra K; Ndembi, Nicaise; Sabin, Caroline A
Journal of Acquired Immune Deficiency Syndromes, 26.01.2022
Tilføjet 6.02.2022
Background:
Understanding the correlates of disengagement from HIV care and treatment failure during second-line antiretroviral therapy (ART) could inform interventions to improve clinical outcomes among people living with HIV (PLHIV).
Methods:
We conducted a retrospective cohort study of PLHIV aged >15 years who started second-line ART at a tertiary centre in Nigeria between 2005 and 2017. Participants were considered to have disengaged from care if they had not returned within a year after each clinic visit. Cox proportional hazards models were used to investigate factors associated with: i) viral failure (HIV-1 RNA >1,000 copies/mL), ii) immunologic failure (CD4 count decrease or 10% of bodyweight), after >6 months of second-line ART.
Results:
Among 1031 participants, 33% (341) disengaged from care during a median follow-up of 6.9 years (IQR 3.7-8.5). Of these, 26% (89/341) subsequently re-entered care. Disengagement was associated with male gender, age
Læs mere Tjek på PubMedDe Almeida, Sergio M.; Rotta, Indianara; Tang, Bin; Umlauf, Anya; Vaida, Florin; Cherner, Mariana; Franklin, Donald; Letendre, Scott; Ellis, Ronald J.; the HNRC Group
Journal of Acquired Immune Deficiency Syndromes, 26.01.2022
Tilføjet 6.02.2022
Background:
We hypothesized that the induction of monocyte activation biomarkers, especially soluble urokinase-type plasminogen activator receptor (suPAR) and interferon γ-inducible protein 10 (IP-10), is lower in HIV-1C than HIV-1B owing to a defective Tat cysteine dimotif (C30S).
Methods:
A total of 68 paired cerebrospinal fluid (CSF) and blood samples from persons with HIV (PWH), free of CNS opportunistic infections, from a Southern Brazil outpatient HIV clinic were evaluated; HIV-1B subtype (n= 27), HIV-1C (n=26), other (n=15), and 19 HIV-negative controls. The levels of SuPAR, IP-10, neopterin, and β2 microglobulin (β2m) in the CSF and serum were quantified using different immunoassays.
Results:
Overall, in PWH, increases in CSF suPAR, CSF/serum suPAR, and CSF/serum β2m correlated with worse working memory deficits (r= 0.303, 0.353, and 0.289, respectively, all p<0.05). The medians of IP-10, suPAR, neopterin, and β2m in CSF and serum, as well as the CSF/serum ratio and suPAR index were comparable between the HIV-1B and HIV-1C subtypes. CSF IP-10 and neopterin, and serum IP-10 and suPAR levels were higher in PWH than the HIV-negative controls (p=0.015, p=0.001, p<0.0001, and p<0.001, respectively). Serum β2m level was higher in HIV-associated dementia (HAD) than neuropsychologically normal (NP-NML) or asymptomatic (ANI) (p= 0.024).
Discussion:
We observed that higher levels of CSF suPAR and the suPAR quotient correlated with worse working memory deficit. Elevated levels of monocyte activation were similar in both HIV-1 B and C subtypes, providing no evidence of reduced neuropathogenicity of HIV-1 subtype C Tat compared to subtype B.
Corresponding Author: Sérgio Monteiro de Almeida, MD, PhD, Complexo Hospital de Clínicas–UFPR, Seção de Virologia, Setor Análises Clínicas, Rua Padre Camargo, 280, Curitiba, PR, Brasil, 80060-240, Email: sergio.ma@ufpr.br, Telephone/Fax: +55 (41) 3360-7974
Conflicts of Interest and Source of Funding: The authors declare that there are no conflicts of interest regarding the publication of this article. This research was supported by NIH R21 MH76651 (principal investigators: R. Ellis, S. de Almeida), Ministério da Ciência e Tecnologia/Conselho Nacional de Desenvolvimento Científico e Tecnológico, MCT/CNPq-Universal 014/2008, Brazil (Almeida, Sergio M).
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedWei-Ming Watson, C.; Kamalyan, Lily; Tang, Bin; Hussain, Mariam A.; Cherner, Mariana; Mindt, Monica Rivera; Byrd, Desiree A.; Franklin, Donald R.; Collier, Ann C.; Clifford, David B.; Gelman, Benjamin; Morgello, Susan; McCutchan, J. Allen; Ellis, Ronald J.; Grant, Igor; Heaton, Robert K.; Marquine, María J.; for the CHARTER Group
Journal of Acquired Immune Deficiency Syndromes, 26.01.2022
Tilføjet 6.02.2022
Background:
To examine longitudinal neurocognitive decline among Latino, non-Latino Black, and non-Latino White people with HIV (PWH) and factors that might explain ethnic/racial disparities in neurocognitive decline.
Methods:
499 PWH (13.8% Latino, 42.7% Black, 43.5% White; baseline age: M=43.5) from the CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) study completed neurocognitive, neuromedical, and laboratory assessments every 6–12 months with up to five years of follow-up. Longitudinal neurocognitive change was determined via published regression-based norms. Survival analyses investigated the relationship between ethnicity/race and neurocognitive change, and baseline and time-dependent variables that might explain ethnic/racial disparities in neurocognitive decline, including socio-demographic, HIV-disease, medical, psychiatric, and substance use characteristics.
Results:
In Cox proportional hazard models, hazard ratios for neurocognitive decline were increased for Latino compared to White PWH (HR=2.25, 95% CI=1.35–3.73, p=0.002), and Latino compared to Black PWH (HR=1.86, 95% CI=1.14–3.04, p=0.013), with no significant differences between Black and White PWH (p=0.40). Comorbidities, including cardiometabolic factors and more severe neurocognitive comorbidity classification, accounted for 33.6% of the excess hazard for Latino compared to White PWH, decreasing the hazard ratio associated with Latino ethnicity (HR=1.83, 95% CI=1.06–3.16, p=0.03), but did not fully account for elevated risk of decline.
Conclusion:
Latino PWH may be at higher risk of early neurocognitive decline compared to Black and White PWH. Comorbidities accounted for some, but not all, of this increased risk among Latino PWH. Future research examining institutional, sociocultural, and biomedical factors, including structural discrimination and age-related biomarkers, may further explain the observed disparities.
Corresponding author: María J. Marquine, Ph.D., Departments of Medicine and Psychiatry, UCSD School of Medicine | 9500 Gilman Drive | La Jolla, CA 92093| Phone: 858-534-6748 | Fax: 858-822-6151 | Email: mmarquine@health.ucsd.edu
Conflicts of Interest and Source of Funding: The CNS HIV Anti-Retroviral Therapy Effects Research was supported by NIH awards N01 MH22005, HHSN271201000036C, HHSN271201000030C and R01 MH107345. Other support include the following NIH grants: T32-DA031098 (C.W.-M.W., M.A.H.), T32 AA013525 (L.K.), K23MH105297 (M.J.M.), and P30AG059299 (M.J.M). The authors declare no conflicts of interest.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedKobayashi, Miwako; Matanock, Almea; Xing, Wei; Adih, William K.; Li, Jianmin; Gierke, Ryan; Almendares, Olivia; Reingold, Arthur; Alden, Nisha; Petit, Susan; Farley, Monica M.; Harrison, Lee H.; Holtzman, Corinne; Baumbach, Joan; Thomas, Ann; Schaffner, William; McGee, Lesley; Pilishvili, Tamara
Journal of Acquired Immune Deficiency Syndromes, 26.01.2022
Tilføjet 6.02.2022
Background:
People with HIV (PWH) are at increased risk for invasive pneumococcal disease (IPD). 13-valent pneumococcal conjugate vaccine (PCV13) was recommended for use in U.S. children in 2010 and for PWH aged ≥19 years in 2012. We evaluated population-level impact of PCV13 on IPD among PWH and non-PWH aged ≥19 years.
Methods:
We identified IPD cases from 2008 to 2018 through the Active Bacterial Core surveillance platform. We estimated IPD incidence using the National HIV Surveillance System and U.S. Census Bureau data. We measured percent changes in IPD incidence from 2008–2009 to 2017–2018 by HIV status, age-group, and vaccine serotype group, including serotypes in recently licensed 15-valent (PCV15) and 20-valent (PCV20) PCVs.
Results:
In 2008–2009 and 2017–2018, 8.4% (552/6,548) and 8.0% (416/5,169) of adult IPD cases were among PWH, respectively. Compared to non-PWH, a larger proportion of IPD cases among PWH were in adults aged 19–64 years (94.7–97.4% vs. 56.0–60.1%) and non-Hispanic blacks (62.5–73.0% vs. 16.7–19.2%). Overall and PCV13-type IPD incidence in PWH declined by 40.3% (95% CI: -47.7 to -32.3) and 72.5% (95% CI: -78.8 to -65.6), respectively. In 2017–2018, IPD incidence was 16.8 (overall) and 12.6 (PCV13-type) times higher in PWH compared to non-PWH; PCV13, PCV15/non-PCV13, and PCV20/non-PCV15 serotypes comprised 21.5%, 11.2% and 16.5% of IPD in PWH, respectively.
Conclusions:
Despite reductions post PCV13 introduction, IPD incidence among PWH remained substantially higher than among non-PWH. Higher-valent PCVs provide opportunities to reduce remaining IPD burden in PWH.
Corresponding Author: Miwako Kobayashi Centers for Disease Control and Prevention, Atlanta, UNITED STATES
W.S. served as a consultant for VBI Vaccines. L.H.H served as a consultant for GSK, Merck, Pfizer, and Sanofi Pasteur. The remaining authors have no conflicts of interest to disclose.
* co-first authors
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedDusten T. Rose, Alexander Moskhos, Arya Wibisono, Kelly R. Reveles
International Journal of Infectious Diseases, 5.02.2022
Tilføjet 5.02.2022
Variability in minimum inhibitory concentration (MIC) with automated susceptibility testing instruments may influence methicillin-resistant Staphylococcus aureus (MRSA) treatment. The purpose of this study was to evaluate the difference in vancomycin MIC values and the impact on vancomycin alternative therapy for MRSA bacteremia using the MicroScan and Vitek 2 automated systems.
Læs mere Tjek på PubMedFrancisco Averhoff, Michael Berg, Mary Rodgers, Saladin Osmanov, Xinxin Luo, Mark Anderson, Todd Meyer, Alan Landay, Amiran Gamkrelidze, Esper G. Kallas, Karl Ciuoderis, Juan Pablo Hernandez, Jean Hugues Henry, Jorge Osorio, John Lindo, Johnson Deshommes, Joshua Anzinger, Justen Manasa, Maia Alkashvili, Mboup Souleyman, Pontiano Kaleebu, Rodrigo Correa-Oliveira, Sunil Solomon, Tulio de Olivera, Yupin Suputtamongkol, Gavin Cloherty
International Journal of Infectious Diseases, 5.02.2022
Tilføjet 5.02.2022
Nanyang Liu, Di Yang, Tingting Zhang, Jiahui Sun, Jianhua Fu, Hao Li
International Journal of Infectious Diseases, 5.02.2022
Tilføjet 5.02.2022
Coronavirus disease 2019 (COVID-19), which started at the end of 2019(Chen et al., 2020), is still prevalent worldwide. It has caused more than 200 million infections and 4.3 million deaths, with infection and death numbers continuing to be updated. People infected with the virus usually develop non-specific symptoms in the prodromal stage of the disease, in which fever, cough, dyspnea, muscle pain and fatigue are the most common symptoms (Huang et al., 2020; Wang et al., 2020). In the early stages of the outbreak, the world's attention focused on infected cases and people exposed to them.
Læs mere Tjek på PubMedBourahima Kone, Anou M. Somboro, Mahamadou Kone, Jane L. Holl, Bocar Baya, Djeneba Dabitao, Dramane Diallo, Bassirou Diarra, Amadou Kone, Yeya Dit Sadio Sarro, Moumine Sanogo, Antieme CG Togo, Robert L. Murphy, Souleymane Diallo, Nadie Coulibaly, Fatoumata Camara, Seydou Samake, Mahamadou Diakite, Seydou Doumbia, Mamoudou Maiga
International Journal of Infectious Diseases, 5.02.2022
Tilføjet 5.02.2022
Tuberculosis (TB) remains an important global health issue worldwide. Despite this scourge that threatens many human lives, especially in developing countries, thus far, no advanced molecular epidemiology study using recent and more accurate tools has been conducted in Mali. Therefore, this study aimed to employ the Variable-Number Tandem Repeats of Mycobacterial Interspersed Repetitive Units (MIRU-VNTR) technology coupled with spoligotyping method to determine with high accuracy the hot-spots and establish the epidemiological transmission links of TB in Bamako, Mali.
Læs mere Tjek på PubMedEttore Severi, Leonidas Georgalis, Roan Pijnacker, Lamprini Veneti, Iulia Adelina Turiac, Flaminia Chiesa, Caterina Rizzo, Domenico Martinelli, Line Vold, Bernardo Guzman Herrador, Carmen Varela Martinez, Elena Vanessa Martinez Sanchez, Jan C. Semenza, Pierluigi Lopalco, Lisen Arnheim Dahlström, Johan Giesecke
International Journal of Infectious Diseases, 5.02.2022
Tilføjet 5.02.2022
Falcone M, Tiseo G.
Clinical Infectious Diseases, 5.02.2022
Tilføjet 5.02.2022
Shields R, Stellfox M, Kline E, et al.
Clinical Infectious Diseases, 4.02.2022
Tilføjet 5.02.2022
AbstractWe report the emergence of imipenem-relebactam non-susceptible Pseudomonas aeruginosa in 5 patients treated for nosocomial pneumonia for 10–28 days. Genome sequence analysis identified treatment-emergent mutations in MexAB-OprM and/or MexEF-OprN efflux operons that arose independently in each patient and across distinct P. aeruginosa sequence types. Testing with efflux-inhibitor PAβN restored imipenem-relebactam susceptibility.
Læs mere Tjek på PubMedGarey K, McPherson J, Dinh A, et al.
Clinical Infectious Diseases, 4.02.2022
Tilføjet 5.02.2022
AbstractBackgroundThis study was the first human validation of the gram-positive bacterial DNA polymerase IIIC target in patients with Clostridioides difficile infection (CDI). The primary objectives were to assess clinical cure rates and adverse events (AE). Secondary objectives were to evaluate plasma/fecal pharmacokinetics (PK), microbiologic eradication, microbiome and bile acid effects, and sustained clinical cure (SCC) of ibezapolstat.MethodsThis single-arm, open-label, phase 2a study enrolled adults with CDI at four US centers. Patients received ibezapolstat 450 mg orally every 12 hours for 10 days and followed for an additional 28 days to assess study objectives.ResultsTen patients aged 49±15 years were enrolled. Seven AEs were reported classified as mild-moderate. Plasma levels of ibezapolstat ranged from 233-578 ng/mL while fecal levels averaged 416±494 µg/g (mean±SD) stool by treatment day 3 and >1,000 µg/g stool by days 8-10. A rapid increase in alpha diversity in the fecal microbiome was noted after starting ibezapolstat therapy that was maintained following completion of therapy. A proportional decrease in Bacteroidetes phylum was observed (10.0±4.8% decrease; p=0.043) with a concomitantly increased proportion of Firmicutes phylum (14.7±5.4% increase; p=0.009). Compared to baseline, total primary bile acids decreased by 40.1±9.6 ng/mg stool during therapy (p=0.0002) and 40.5±14.1 ng/mg stool after completion of therapy (p=0.0066). Rates of both initial clinical cure and SCC at 28 days were 100% (10 of 10 patients).ConclusionsIn this phase 2a study, ten of ten patients achieved SCC, demonstrated favorable pharmacokinetics, minimal adverse events, and beneficial microbiome and bile acids results. These results support continued clinical development.
Læs mere Tjek på PubMedVähäsarja N, Lund B, Ternhag A, et al.
Clinical Infectious Diseases, 4.02.2022
Tilføjet 5.02.2022
AbstractBackgroundA few years after the publication of the British guidelines, national recommendations were published by the Swedish Medical Products Agency in October 2012, promoting the cessation of antibiotic prophylaxis in dentistry for the prevention of infective endocarditis (IE). The aim of this study was to evaluate whether the incidence of oral streptococcal IE increased among high-risk individuals after October 2012.MethodsThis nationwide cohort study included all adult individuals (>17 years) living in Sweden from January 2008 to January 2018, with a diagnose code or surgical procedure code indicating high risk of IE. Cox proportional hazard models were performed to calculate adjusted ratios of oral streptococcal IE before and after October 2012 between high-risk individuals and references.ResultsThis study found no increased incidence of oral streptococcal IE among high-risk individuals during the five years after the cessation, compared to before. Hazard rate ratios were 15.4 (95% CI: 8.3 to 28.5) before and 20.7 (95% CI: 10.0 to 42.7) after October 2012 for prevalent high-risk individuals. Corresponding ratios for incident high-risk individuals were 66.8 (95% CI: 28.7 to 155.6) and 44.6 (95% CI: 22.9 to 86.9). Point estimates for interaction with time period: 1.4 (95% CI: 0.6 to 3.5) and 0.8 (95% CI: 0.5 to 1.3) for prevalent and incident high-risk individuals respectively.ConclusionThe results suggest that the current Swedish recommendation not to administer antibiotic prophylaxis for the prevention of IE in dentistry has not led to an increased incidence of oral streptococcal IE among high-risk individuals.
Læs mere Tjek på PubMedBéranger A, Bekker A, Solans B, et al.
Clinical Infectious Diseases, 4.02.2022
Tilføjet 5.02.2022
AbstractBackgroundIsoniazid (INH) metabolism depends on the N-acetyl transferase 2 (NAT2) enzyme, whose maturation process remains unknown in low birth weight (LBW) and preterm infants. We aimed to assess INH exposure and safety in infants receiving oral tuberculosis prevention.MethodsThis population pharmacokinetics (PK) analysis used INH and N-acetyl-isoniazid (ACL) concentrations in infants (BW ≤ 4 kg), including preterm, with follow-up for 6 months. PK parameters were described using nonlinear mixed effects modeling. Simulations were performed to assess INH exposure and optimal dosing regimens, using two targets: Cmax at 3-6 mg/L and AUC ≥ 10.52 mg.h/L.ResultsWe included 57 infants (79% preterm, 84% LBW) in the PK analysis, with a median (range) gestational age of 34 (28.7-39.4) weeks. At the time of sampling, postnatal age was 2.3 (0.2-7.3) months and weight (WT) was 3.7 (0.9-9.3) kg. NAT2 genotype was available in 43 (75.4%) patients (10 slow, 26 intermediate, and 7 fast metabolizers). Ninety percent of NAT2 maturation was attained by 4.4 post-natal months. WT, postmenstrual age and NAT2 genotype significantly influenced INH exposure, with a 5-fold difference in AUC between slow and fast metabolizers for the same dose. INH appeared safe across the broad range of exposure for 61 infants included in the safety analysis.ConclusionsIn LBW/preterm infants, INH dosing needs frequent adjustment to account for growth and maturation. Pharmacogenetics-based dosing regimens is the most powerful approach to deliver safe and equalized exposures for all infants, since NAT2 genotype highly impacts INH pharmacokinetic variability.
Læs mere Tjek på PubMedMiddleton B, Danchin M, Jones M, et al.
Journal of Infectious Diseases, 4.02.2022
Tilføjet 5.02.2022
AbstractBackgroundRotarix (GlaxoSmithKline) oral rotavirus vaccine is licensed as two doses in the first six months of life. In high child-mortality settings, clinical protection conferred by two doses of Rotarix is reduced. We assessed vaccine immune response when an additional dose of Rotarix was given to Australian Aboriginal children 6 to < 12 months old.MethodsORVAC is a two-stage, double-blind, randomised, placebo-controlled trial. Australian Aboriginal children 6 to < 12 months old who had received one or two prior doses of Rotarix rotavirus vaccine were randomised 1:1 to receive an additional dose of Rotarix or matched placebo. The primary immunological endpoint was seroresponse defined as an anti-rotavirus IgA level ≥ 20 AU/mL, 28 – 56 days following the additional dose of Rotarix or placebo.ResultsBetween March 2018 and August 2020, 253 infants were enrolled. Of these, 178 infants (70%) had analysable serological results after follow-up; 89 randomised to receive Rotarix and 89 to receive placebo. The proportion with seroresponse was 85% following Rotarix compared to 72% following placebo. There were no occurrences of intussusception or any serious adverse events.ConclusionsAn additional dose of Rotarix administered to Australian Aboriginal infants 6 to < 12 months increased the proportion with a vaccine seroresponse.
Læs mere Tjek på PubMedZuurbier R, Korsten K, Verheij T, et al.
Journal of Infectious Diseases, 4.02.2022
Tilføjet 5.02.2022
AbstractBackgroundRespiratory syncytial virus (RSV) causes a substantial burden in older adults. Viral load in RSV-infected adults is generally lower compared to young children, which could result in suboptimal sensitivity of RSV diagnostics. Although the Xpert® Xpress Flu/RSV assay has been used in routine clinical care, its sensitivity to diagnose RSV infection in older adults is largely unknown. We aimed to compare the performance of the Xpert® Xpress Flu/RSV assay with real-time reverse-transcription polymerase chain reaction (RT-PCR) in home-dwelling older adults (≥60 years of age).MethodsNasopharyngeal swabs were tested with Xpert® Xpress Flu/RSV and compared to RSV RT-PCR in older adults with acute respiratory tract infections with different levels of disease severity.ResultsWe studied 758 respiratory samples from 561 older adults from 2 consecutive RSV seasons. Thirty-five (4.6%) samples tested positive for RSV by at least 1 of the assays, of which 2 samples were negative by Xpert® Xpress Flu/RSV and 3 samples by real-time RT-PCR. The positive percentage agreement (PPA) was 90.9% (95% confidence interval [CI], 76.4%–96.8%) and negative percentage agreement was 99.7% (95% CI, 99.0%–99.9%). Viral loads were low (≤103 copies/mL or cycle threshold value ≥34) in all cases with discordant results for the 2 assays.ConclusionsThe PPA of Xpert® Xpress Flu/RSV compared to routine RT-PCR is high for RSV detection in home-dwelling older adults. The assay is fast and easy to use at the point of care.Clinical Trials RegistrationNCT03621930.
Læs mere Tjek på PubMedSmith R, Wu V, Song J, et al.
Journal of Infectious Diseases, 3.02.2022
Tilføjet 5.02.2022
AbstractBackgroundIntegrase inhibitors (INIs) are a key component of antiretroviral therapy (ART) for HIV-1 and HIV-2 infection. Although INI resistance pathways are well-defined for HIV-1, the mutations that emerge in HIV-2 in response to INIs are incompletely characterized.MethodsWe performed systematic searches of GenBank and the HIV-2 drug resistance literature to identify treatment-associated mutations for phenotypic evaluation. We then constructed a library of 95 mutants of HIV-2ROD9 that contained single or multiple amino acid changes in the integrase protein. Each variant was tested for susceptibility to raltegravir and dolutegravir using a single-cycle indicator cell assay.ResultsWe observed extensive cross-resistance between raltegravir and dolutegravir in HIV-2ROD9. HIV-2–specific integrase mutations Q91R, E92A, A153G, and H157Q/S, which have not been previously characterized, significantly increased the EC50 for raltegravir when introduced into one or more mutational backgrounds; mutations E92A/Q, T97A, and G140A/S conferred similar enhancements of dolutegravir resistance. HIV-2ROD9 variants encoding G118R alone, or insertions of residues SREGK or SREGR at position 231, were resistant to both INIs.ConclusionsOur analysis demonstrates the contributions of novel INI-associated mutations to raltegravir and dolutegravir resistance in HIV-2. These findings should help to improve algorithms for genotypic drug resistance testing in HIV-2–infected individuals.
Læs mere Tjek på PubMedFoster-Nyarko E, Pallen M.
FEMS Microbiology Reviews, 4.02.2022
Tilføjet 5.02.2022
AbstractEscherichia coli has a rich history as biology's ‘rock star’, driving advances across many fields. In the wild, E. coli resides innocuously in the gut of humans and animals but is also a versatile pathogen commonly associated with intestinal and extraintestinal infections and antimicrobial resistance—including large foodborne outbreaks such as the one that swept across Europe in 2011, killing fifty-four individuals and causing approximately 4 000 infections and 900 cases of haemolytic uraemic syndrome. Given that most E. coli are harmless gut colonisers, an important ecological question plaguing microbiologists is what makes E. coli an occasionally devastating pathogen? To address this question requires an enhanced understanding of the ecology of the organism as a commensal. Here, we review how our knowledge of the ecology and within-host diversity of this organism in the vertebrate gut has progressed in the 136 since E. coli was first described. We also review current approaches to the study of within-host bacterial diversity. In closing, we discuss some of the outstanding questions yet to be addressed and prospects for future research.
Læs mere Tjek på PubMedMalaria Journal, 5.02.2022
Tilføjet 5.02.2022
Abstract
Progress in gene drive research has engendered a lively discussion about community engagement and the ethical standards the work hinges on. While there is broad agreement regarding ethical principles and established best practices for conducting clinical public health research, projects developing area-wide vector control technologies and initiating ambitious engagement strategies raise specific questions: who to engage, when to engage, and how? When responding to these fundamental questions, with few best practices available for guidance, projects need to reflect on and articulate the ethical principles that motivate and justify their approach. Target Malaria is a not-for-profit research consortium that aims to develop and share malaria control and elimination technology. The consortium is currently investigating the potential of a genetic technique called gene drive to control populations of malaria vectoring mosquito species Anopheles gambiae. Due to the potentially broad geographical, environmental impact of gene drive technology, Target Malaria has committed to a robust form of tailored engagement with the local communities in Burkina Faso, Mali, and Uganda, where research activities are currently taking place. This paper presents the principles guiding Target Malaria’s engagement strategy. Herein the authors (i) articulate the principles; (ii) explain the rationale for selecting them; (iii) share early lessons about the application of the principles. Since gene drive technology is an emerging technology, with few best practices available for guidance, the authors hope by sharing these lessons, to add to the growing literature regarding engagement strategies and practices for area-wide vector control, and more specifically, for gene drive research.
Læs mere Tjek på PubMedMalaria Journal, 5.02.2022
Tilføjet 5.02.2022
Abstract
Background
Congenital malaria, which is caused by vertical transmission of malaria parasites, is a potentially fatal condition. Despite Africa’s high malaria burden, congenital malaria is not routinely screened for, and thus may go undiagnosed. Malaria, if not treated promptly, can quickly progress to severe forms and result in death. Severe congenital malaria is believed to be uncommon in neonates due to maternal antibodies, fetal haemoglobin, and the placenta’s sieving effect. The majority of reported cases were classified as having severe anaemia. Following a thorough review of the literature, only one case of congenital cerebral malaria (CCM) has been reported, and it was misdiagnosed.
Case presentation
A 5-day-old Nigerian neonate born to an apparently healthy mother initially displayed characteristics consistent with neonatal sepsis and severe neonatal hyperbilirubinaemia. He quickly developed characteristics consistent with meningitis. Surprisingly, the peripheral blood film revealed evidence of malaria parasites, which was immediately confirmed by Giemsa-stained thick and thin blood film microscopy for malaria. The patient was diagnosed with congenital cerebral malaria. The medication was modified to parenteral artesunate followed by oral artemisinin combination therapy. The neonate recovered fully and had no neurological deficits on follow up.
Conclusion
Because CCM and infant meningitis have similar clinical presentations, CCM could be misdiagnosed and lead to death if there isn’t a high index of suspicion.
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Malaria Journal, 5.02.2022
Tilføjet 5.02.2022
Abstract
Background
In sub-Saharan Africa, house design and ventilation affects the number of malaria mosquito vectors entering houses. This study hypothesized that indoor light from a CDC-light trap, visible from outside a hut, would increase entry of Anopheles arabiensis, an important malaria vector, and examined whether ventilation modifies this effect.
Methods
Four inhabited experimental huts, each situated within a large chamber, were used to assess how light and ventilation affect the number of hut-entering mosquitoes in Tanzania. Each night, 300 female laboratory-reared An. arabiensis were released inside each chamber for 72 nights. Nightly mosquito collections were made using light traps placed indoors. Temperature and carbon dioxide concentrations were measured using data loggers. Treatments and sleepers were rotated between huts using a randomized block design.
Results
When indoor light was visible outside the huts, there was an 84% increase in the odds of collecting mosquitoes indoors (Odds ratio, OR = 1.84, 95% confidence intervals, 95% CI 1.74–1.95, p < 0.001) compared with when it was not. Although the odds of collecting mosquitoes in huts with closed eaves (OR = 0.54, 95% CI 0.41–0.72, p < 0.001) was less than those with open eaves, few mosquitoes entered either type of well-ventilated hut. The odds of collecting mosquitoes was 99% less in well-ventilated huts, compared with poorly-ventilated traditional huts (OR = 0.01, 95% CI 0.01–0.03, p < 0.001). In well-ventilated huts, indoor temperatures were 1.3 °C (95% CI 0.9–1.7, p < 0.001) cooler, with lower carbon dioxide (CO2) levels (mean difference = 97 ppm, 77.8–116.2, p < 0.001) than in poorly-ventilated huts.
Conclusion
Although light visible from outside a hut increased mosquito house entry, good natural ventilation reduces indoor carbon dioxide concentrations, a major mosquito attractant, thereby reducing mosquito-hut entry.
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Malaria Journal, 5.02.2022
Tilføjet 5.02.2022
Abstract
Background
Primaquine (PQ) has been used for the radical cure of relapsing Plasmodium vivax malaria for more than 60 years. PQ is also recommended for prophylaxis and prevention of transmission of Plasmodium falciparum. However, clinical utility of PQ has been limited due to toxicity in individuals with genetic deficiencies in glucose 6-phosphate dehydrogenase (G6PD). PQ is currently approved for clinical use as a racemic mixture. Recent studies in animals as well as humans have established differential pharmacological and toxicological properties of the two enantiomers of PQ. This has been attributed to differential metabolism and pharmacokinetics of individual PQ enantiomers. The aim of the current study is to evaluate the comparative pharmacokinetics (PK), tissue distribution and metabolic profiles of the individual enantiomers in mice.
Methods
Two groups of 21 male Albino ND4 Swiss mice were dosed orally with 45 mg/kg of S-(+)-PQ and R-(−)PQ respectively. Each of the enantiomers was comprised of a 50:50 mixture of 12C- and 13C- stable isotope labelled species (at 6 carbons on the benzene ring of the quinoline core). Three mice were euthanized from each group at different time points (at 0, 0.5, 1, 2, 4, 8, 24 h) and blood was collected by terminal cardiac bleed. Liver, spleen, lungs, kidneys and brain were removed, extracted and analysed using UPLC/MS. The metabolites were profiled by tandem mass (MS/MS) fragmentation profile and fragments with 12C–13C twin peaks. Non-compartmental analysis was performed using the Phoenix WinNonLin PK software module.
Results
The plasma AUC0-last (µg h/mL) (1.6 vs. 0.6), T1/2 (h) (1.9 vs. 0.45), and Tmax (h) (1 vs. 0.5) were greater for SPQ as compared to RPQ. Generally, the concentration of SPQ was higher in all tissues. At Tmax, (0.5–1 h in all tissues), the level of SPQ was 3 times that of RPQ in the liver. Measured Cmax of SPQ and RPQ in the liver were about 100 and 40 times the Cmax values in plasma, respectively. Similar observations were recorded in other tissues where the concentration of SPQ was higher compared to RPQ (2× in the spleen, 6× in the kidneys, and 49× in the lungs) than in the plasma. CPQ, the major metabolite, was preferentially generated from RPQ, with higher levels in all tissues (> 10× in the liver, and 3.5× in the plasma) than from SPQ. The PQ-o-quinone was preferentially formed from the SPQ (> 4× compared to RPQ), with higher concentrations in the liver.
Conclusion
These studies show that in mice, PQ enantiomers are differentially biodistributed and metabolized, which may contribute to differential pharmacologic and toxicity profiles of PQ enantiomers. The findings on higher levels of PQ-o-quinone in liver and RBCs compared to plasma and preferential generation of this metabolite from SPQ are consistent with the higher anti-malarial efficacy of SPQ observed in the mouse causal prophylaxis test, and higher haemolytic toxicity in the humanized mouse model of G6PD deficiency. Potential relevance of these findings to clinical use of racemic PQ and other 8-aminoquinolines vis-à-vis need for further clinical evaluation of individual enantiomers are discussed.
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BMC Infectious Diseases, 4.02.2022
Tilføjet 5.02.2022
Abstract
Background
A new more highly sensitive rapid diagnostic test (HS-RDT) for Plasmodium falciparum malaria (Alere™/Abbott Malaria Ag P.f RDT [05FK140], now called NxTek™ Eliminate Malaria Ag Pf) was launched in 2017. The test has already been used in many research studies in a wide range of geographies and use cases.
Methods
In this study, we collate all published and available unpublished studies that use the HS-RDT and assess its performance in (i) prevalence surveys, (ii) clinical diagnosis, (iii) screening pregnant women, and (iv) active case detection. Two individual-level data sets from asymptomatic populations are used to fit logistic regression models to estimate the probability of HS-RDT positivity based on histidine-rich protein 2 (HRP2) concentration and parasite density. The performance of the HS-RDT in prevalence surveys is estimated by calculating the sensitivity and positive proportion in comparison to polymerase chain reaction (PCR) and conventional malaria RDTs.
Results
We find that across 18 studies, in prevalence surveys, the mean sensitivity of the HS-RDT is estimated to be 56.1% (95% confidence interval [CI] 46.9–65.4%) compared to 44.3% (95% CI 32.6–56.0%) for a conventional RDT (co-RDT) when using nucleic acid amplification techniques as the reference standard. In studies where prevalence was estimated using both the HS-RDT and a co-RDT, we found that prevalence was on average 46% higher using a HS-RDT compared to a co-RDT. For use in clinical diagnosis and screening pregnant women, the HS-RDT was not significantly more sensitive than a co-RDT.
Conclusions
Overall, the evidence presented here suggests that the HS-RDT is more sensitive in asymptomatic populations and could provide a marginal improvement in clinical diagnosis and screening pregnant women. Although the HS-RDT has limited temperature stability and shelf-life claims compared to co-RDTs, there is no evidence to suggest, given this test has the same cost as current RDTs, it would have any negative impacts in terms of malaria misdiagnosis if it were widely used in all four population groups explored here.
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BMC Infectious Diseases, 4.02.2022
Tilføjet 5.02.2022
Abstract
Background
People living with HIV, who take antiretroviral therapy (ART), often enjoy long and healthy lives, but this therapy has well known metabolic adverse effects. Physical activity is found to be an important factor in improving these physiological parameters. This study aimed to determine physical activity level and associated factors among HIV patients in Ethiopia.
Methods
An institutional based cross sectional study was conducted from May to June 2019. We selected a total of 422 adult HIV patients, attending antiretroviral therapy clinics in three selected hospitals in Southern Ethiopia. Data were collected at routine care consultations by nine trained nurses using a pre-tested structured questionnaire. The level of physical activity was measured by the international physical activity questionnaire (IPAQ).
Result
The mean age of participants was 38.7 ± 9.13 years. Of the participants, 68% were physically inactive, with a higher proportion of inactive women (74%) than men (61%) [(AOR = 1.64, 95% CI (1.07, 2.53)]. In addition, urban vs. rural residents [(AOR = 2.57, 95% CI (1.16, 5.72)] and patients who were on ART for ≥ 24 months [(AOR = 1.88, 95% CI (1.15, 3.08)] had higher odds of having a low physical activity level.
Conclusion
Most people living with HIV and receiving ART have low physical activity levels. Especially female and urban living patients and those with longer treatment duration have low levels of physical activity. More insight is needed on the reasons for physical inactivity among HIV patients and physical activity programs for HIV patients in low-income countries need to be developed.
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BMC Infectious Diseases, 4.02.2022
Tilføjet 5.02.2022
Abstract
Background
COVID-19 pandemic is the major public health problem in the world actually. It’s associated with high morbidity and mortality. To date, no therapeutic measure has a curative potential. Hydroxychloroquine (HCQ) is a drug with immunomodulatory properties that has demonstrated antiviral efficacy in in vitro experiments, with conflicting results in in vivo studies.
Methods
A single-center, prospective and interventional study, that evaluates the impact on mortality of the HCQ use in 154 patients hospitalized with COVID-19 in a Brazilian public hospital. The study also aims to determine prognostic factors that predict mortality, ICU admission and endotracheal intubation in this population.
Results
154 patients diagnosed with COVID-19 confirmed by RT-PCR and hospitalized were included. There was a male predominance (87/154, 56.5%), median age 60 years and 88% (136/154) had comorbidities. Among these, 76% (117/154) were admitted to the ICU and 29.2% (45/154) experienced EOT. The OMR was 51.3% (79/154). There was no difference in mortality between patients treated with HCQ (N = 95) and non-HCQ (N = 59) (44.1% × 55.8%, p = 0.758). In univariate analysis, age ≥ 60 years (HR 3.62, p < 0.001), need for mechanical ventilation (HR 2.17, p = 0.001), ≥ 2 comorbidities (HR 1.83, p = 0.049), SAH (HR: 1.56, p = 0.054) were predictors of mortality, as well as no use of prophylactic or therapeutic heparin (HR 3.60, p = 0.02). Multivariate analysis identified admission to the ICU (HR 8.98, p = 0.002) and advanced age (HR 3.37, p < 0.01) as independent predictors of mortality, although, use of heparin (HR 0.25, p = 0.001) was independently associated with a favorable outcome.
Conclusion
This study confirmed the absence of a benefit associated with the use of HCQ in Brazilian patients hospitalized with COVID-19. However, prophylactic or therapeutic heparin was an independent predictor for reducing mortality in this population.
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BMC Infectious Diseases, 4.02.2022
Tilføjet 5.02.2022
Abstract
Background
Given the importance of viral suppression in ending the HIV epidemic in the US and elsewhere, an optimal predictive model of viral status can help clinicians identify those at risk of poor viral control and inform clinical improvements in HIV treatment and care. With an increasing availability of electronic health record (EHR) data and social environmental information, there is a unique opportunity to improve our understanding of the dynamic pattern of viral suppression. Using a statewide cohort of people living with HIV (PLWH) in South Carolina (SC), the overall goal of the proposed research is to examine the dynamic patterns of viral suppression, develop optimal predictive models of various viral suppression indicators, and translate the models to a beta version of service-ready tools for clinical decision support.
Methods
The PLWH cohort will be identified through the SC Enhanced HIV/AIDS Reporting System (eHARS). The SC Office of Revenue and Fiscal Affairs (RFA) will extract longitudinal EHR clinical data of all PLWH in SC from multiple health systems, obtain data from other state agencies, and link the patient-level data with county-level data from multiple publicly available data sources. Using the deidentified data, the proposed study will consist of three operational phases: Phase 1: “Pattern Analysis” to identify the longitudinal dynamics of viral suppression using multiple viral load indicators; Phase 2: “Model Development” to determine the critical predictors of multiple viral load indicators through artificial intelligence (AI)-based modeling accounting for multilevel factors; and Phase 3: “Translational Research” to develop a multifactorial clinical decision system based on a risk prediction model to assist with the identification of the risk of viral failure or viral rebound when patients present at clinical visits.
Discussion
With both extensive data integration and data analytics, the proposed research will: (1) improve the understanding of the complex inter-related effects of longitudinal trajectories of HIV viral suppressions and HIV treatment history while taking into consideration multilevel factors; and (2) develop empirical public health approaches to achieve ending the HIV epidemic through translating the risk prediction model to a multifactorial decision system that enables the feasibility of AI-assisted clinical decisions.
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Antonin C. André, Matthieu Laborde, Benoit S. Marteyn
Trends in Microbiology, 4.02.2022
Tilføjet 5.02.2022
Bacterial and fungal pathogens face various microenvironmental conditions during infection. In addition to acidosis, nutrient consumption, and hypercapnia, pathogen infections are associated with hypoxia, which is induced by bacterial and fungal respiration during the formation of foci of infection or biofilms. Consequently, the in vivo interaction between host immune cells and pathogens is anticipated to occur mainly under low-oxygen conditions. Various infectious disease models have reported that pathogens benefit from hypoxia, which dampens the oxygen-dependent antimicrobial activities of macrophages and neutrophils, such as the production of reactive oxygen species (ROS).
Læs mere Tjek på PubMedJavier Barranco-Trabi, Stephen Morgan, Seema Singh, Jimmy Hill, Alexander Kayatani, Victoria Mank, Holly Nesmith, Heather Omara, Louis Tripoli, Michael Lustik, Jennifer Masel, Sharon Chi, Viseth Ngauy
PLoS One Infectious Diseases, 4.02.2022
Tilføjet 4.02.2022
by Javier Barranco-Trabi, Stephen Morgan, Seema Singh, Jimmy Hill, Alexander Kayatani, Victoria Mank, Holly Nesmith, Heather Omara, Louis Tripoli, Michael Lustik, Jennifer Masel, Sharon Chi, Viseth Ngauy
Health inequalities based on race are well-documented, and the COVID-19 pandemic is no exception. Despite the advances in modern medicine, access to health care remains a primary determinant of health outcomes, especially for communities of color. African-Americans and other minorities are disproportionately at risk for infection with COVID-19, but this problem extends beyond access alone. This study sought to identify trends in race-based disparities in COVID-19 in the setting of universal access to care. Tripler Army Medical Center (TAMC) is a Department of Defense Military Treatment Facility (DoD-MTF) that provides full access to healthcare to active duty military members, beneficiaries, and veterans. We evaluated the characteristics of individuals diagnosed with SARS-CoV-2 infection at TAMC in a retrospective, case-controlled (1:1) study. Most patients (69%) had received a COVID-19 test within 3 days of symptom onset. Multivariable logistic regression analyses were used to identify factors associated with testing positive and to estimate adjusted odds ratios. African-American patients and patients who identified as “Other” ethnicities were two times more likely to test positive for SARS-CoV-2 relative to Caucasian patients. Other factors associated with testing positive include: younger age, male gender, previous positive test, presenting with >3 symptoms, close contact with a COVID-19 positive patient, and being a member of the US Navy. African-Americans and patients who identify as “Other” ethnicities had disproportionately higher rates of positivity of COVID-19. Although other factors contribute to increased test positivity across all patient populations, access to care does not appear to itself explain this discrepancy with COVID-19.
Læs mere Tjek på PubMedLebapotswe B. Tlale, Lesego Gabaitiri, Lorato K. Totolo, Gomolemo Smith, Orapeleng Puswane-Katse, Eunice Ramonna, Basego Mothowaeng, John Tlhakanelo, Tiny Masupe, Goabaone Rankgoane-Pono, John Irige, Faith Mafa, Samuel Kolane
PLoS One Infectious Diseases, 4.02.2022
Tilføjet 4.02.2022
by Lebapotswe B. Tlale, Lesego Gabaitiri, Lorato K. Totolo, Gomolemo Smith, Orapeleng Puswane-Katse, Eunice Ramonna, Basego Mothowaeng, John Tlhakanelo, Tiny Masupe, Goabaone Rankgoane-Pono, John Irige, Faith Mafa, Samuel Kolane
Background The COVID-19 disease burden continues to be high worldwide and vaccines continue to be developed to help combat the pandemic. Acceptance and risk perception for COVID-19 vaccines is unknown in Botswana despite the government’s decision to roll out the vaccine nationally. Objectives This study aims to assess the acceptance rate and risk perception of COVID-19 vaccines amongst the general population in Botswana. Methods We interviewed 5300 adults in Botswana from 1–28 February 2021 using self-administered questionnaires. The main outcomes of the study were vaccine acceptance and hesitancy rates. Demographic, experiential and socio-cultural factors were explored for their association with outcome variables. Results Two-thirds of the participants were females (3199), with those aged 24–54 making the highest proportion (61%). The acceptance rate of COVID-19 vaccine was 73.4% (95% CI: 72.2%-74.6%) with vaccine hesitancy at 31.3% (95% CI: 30.0%-32.6%). When the dependent variable was vaccine acceptance, males had higher odds of accepting the vaccine compared to females (OR = 1.2, 95% CI: 1.0, 1.4). Individuals aged 55–64 had high odds of accepting the vaccine compared to those aged 65 and above (OR = 1.2, 95% CI: 0.6, 2.5). The odds of accepting the vaccine for someone with primary school education were about 2.5 times that of an individual with post graduate level of education. Finally, individuals with comorbidities had higher odds (OR = 1.2, 95% CI: 1.0, 1.5) of accepting the vaccine compared to those without any underlying conditions. Conclusion This study demonstrated a high acceptance rate for the COVID-19 vaccine and a low risk perception in Botswana. In order to achieve a high vaccine coverage and ensure a successful vaccination process, there is need to target populations with high vaccine hesitancy rates. A qualitative study to assess the factors associated with vaccine acceptance and hesitancy is recommended to provide an in-depth analysis of the findings.
Læs mere Tjek på PubMedShota Myojin, Kyongsun Pak, Mayumi Sako, Tohru Kobayashi, Takuri Takahashi, Tomimasa Sunagawa, Norihiko Tsuboi, Kenji Ishikura, Masaya Kubota, Mitsuru Kubota, Takashi Igarashi, Ichiro Morioka, Isao Miyairi
PLoS One Infectious Diseases, 4.02.2022
Tilføjet 4.02.2022
by Shota Myojin, Kyongsun Pak, Mayumi Sako, Tohru Kobayashi, Takuri Takahashi, Tomimasa Sunagawa, Norihiko Tsuboi, Kenji Ishikura, Masaya Kubota, Mitsuru Kubota, Takashi Igarashi, Ichiro Morioka, Isao Miyairi
Background The role of antibiotics in the treatment of Shiga toxin-producing Escherichia coli (STEC) infection is controversial. Objectives To evaluate the association between treatment (antibiotics, antidiarrheal agents, and probiotics) for STEC infection and hemolytic uremic syndrome (HUS) development. Patients and methods We performed a population-based matched case-control study using the data from the National Epidemiological Surveillance of Infectious Diseases (NESID) between January 1, 2017 and December 31, 2018. We identified all patients with STEC infection and HUS as cases and matched patients with STEC infection without HUS as controls, with a case-control a ratio of 1:5. Further medical information was obtained by a standardized questionnaire. Multivariable conditional logistic regression model was used. Results 7760 patients with STEC infection were registered in the NESID. 182 patients with HUS and 910 matched controls without HUS were selected. 90 patients with HUS (68 children and 22 adults) and 371 patients without HUS (266 children and 105 adults) were included in the main analysis. The matched ORs of any antibiotics and fosfomycin for HUS in children were 0.56 (95% CI 0.32–0.98), 0.58 (0.34–1.01). The matched ORs for HUS were 2.07 (1.07–4.03), 0.86 (0.46−1.61) in all ages treated with antidiarrheal agent and probiotics. Conclusions Antibiotics, especially fosfomycin, may prevent the development of HUS in children, while use of antidiarrheal agents should be avoided.
Læs mere Tjek på PubMedTilahun Adugna, Emana Getu, Delenasaw Yewhelew
PLoS One Infectious Diseases, 4.02.2022
Tilføjet 4.02.2022
by Tilahun Adugna, Emana Getu, Delenasaw Yewhelew
The intensity of malaria transmission is measured by parous rate, daily survival rate, human blood meal frequency, sporozoite rate, and entomological inoculation rates. Female parous status is a key index of vector competence, adult vector longevity, recruitment rate of adult, and the length of a gonotrophic cycle. Hence, the present study was aimed to investigate the parous rate and the longevity of Anopheles mosquitoes in Bure District, Northwestern Ethiopia. Parous rate was estimated as the number of mosquitoes with parous ovaries divided by the number of females dissected multiplied by 100. Mosquito life expectancy (longevity as d) was estimated by. One way- ANOVA was applied to confirm the presence of parous rate difference in the villages (p < 0.05). A total of 952 unfed hosts-seeking Anopheles mosquitoes was dissected for parous rate determination. The overall parous rate of An. arabiensis in the district was 52.0%, and the highest parous rate was recorded in Shnebekuma than other villages (F 2, 33 = 6.974; p = 0.003). Similarly, the parous rate of An. cinereus showed significant variation among villages (F 2, 33 = 5.044, p = 0.012) and the highest rate (63.0%) was recorded in Bukta. The mean longevity of An. funestus, An. arabiensis, An. coustani, An. squamosus, An. pharoensis, and An. cinereus was 6.5 days, 4.6 days, 3.5 days, 3.7 days, 2.7 days, and 2.2 days, respectively. The longevity of each species was not sufficient to complete the life cycle of malaria parasite for malaria transmission throughout the year because P. falciparum requires from 12–14 day.
Læs mere Tjek på PubMedEmerging Infectious Diseases, 4.02.2022
Tilføjet 4.02.2022
Emerging Infectious Diseases, 4.02.2022
Tilføjet 4.02.2022