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Journal of Infectious Diseases, 3.02.2023
Tilføjet 3.02.2023
AbstractBackgroundBreakthrough infections of SARS-CoV-2 are well-documented. The current study estimates breakthrough incidence across pandemic waves, and evaluates predictors of breakthrough and severe breakthrough infections (defined as those requiring hospitalization).Methods89,762 participants underwent longitudinal antibody surveillance. Incidence rates were calculated using total person-days contributed. Bias-corrected and age-adjusted logistic regression determined multivariable predictors of breakthrough and severe breakthrough infection, respectively.ResultsThe incidence was 0.45 (0.38, 0.50) during pre-Delta, 2.80 (2.25, 3.14) during Delta, and 11.2 (8.80, 12.95) during Omicron, per 10,000 person-days. Factors associated with elevated odds of breakthrough included Hispanic ethnicity (vs non-Hispanic White, OR=1.243[1.073, 1.441]), larger household size (OR=1.251 [1.048, 1.494] for 3-5 vs. 1 and OR=1.726 [1.317, 2.262] for more than 5 vs. 1 person), rural vs urban living (OR=1.383 [1.122, 1.704]), receiving Pfizer or Johnson&Johnson vs. Moderna, and multiple comorbidities. Of the 1,700 breakthrough infections, 1,665 reported on severity; 112 (6.73%) were severe. Higher BMI, Hispanic ethnicity, vaccine type, asthma, and hypertension predicted severe breakthroughs.ConclusionBreakthrough infection was 4-25 times more common during the Omicron-dominant wave versus earlier waves. Higher burden of severe breakthrough infections was identified in subgroups.
Læs mere Tjek på PubMedClinical Infectious Diseases, 3.02.2023
Tilføjet 3.02.2023
AbstractBackgroundThe potential benefits of utilizing rapid influenza diagnostic tests (RIDT) in urgent care facilities on clinical care and prescribing practices are understudied. We compared antiviral and antibiotic prescribing, imaging, and laboratory ordering in clinical encounters with and without RIDT results.MethodsOur study compared patients with acute respiratory infection (ARI) symptoms who received an RIDT and patients who did not at two urgent care facilities. Primary analysis using one-to-one exact matching resulted in 1145 matched pairs to which McNemar’s 2x2 tests were used to assess association between the likelihood of prescribing, imaging or laboratory ordering, and RIDT use. Secondary analysis compared the same outcomes using logistic regression among the RIDT-tested population between participants who tested negative (RIDT(-)) and positive (RIDT(+)).ResultsPrimary analysis identified that compared to patients without RIDT testing, RIDT(+) patients were more likely to be prescribed antivirals (OR:10.23; 95% CI:5.78-19.72) and less likely to be prescribed antibiotics (OR:0.15; 95% CI:0.08-0.27). Comparing all RIDT-tested participants to all non-RIDT-tested participants, RIDT use increased antiviral prescribing odds (OR:3.07; 95% CI:2.25-4.26) and reduced antibiotic prescribing odds (OR:0.52; 95% CI:0.43-0.63). The secondary analysis identified an increased odds of prescribing antivirals (OR:28.21; 95% CI:18.15-43.86; P <0.0001) and a decreased odds of prescribing antibiotics (OR:0.20; 95% CI:0.13-0.30; P <0.0001) for RIDT(+) participants compared to RIDT(-).ConclusionsUtilization of RIDTs in patients presenting to urgent care with ARI symptoms influences clinician diagnostic and treatment decision-making, which could lead to improved patient outcomes, population-level reductions in influenza burden, and a decreased threat of antibiotic resistance.
Læs mere Tjek på PubMedClinical Infectious Diseases, 3.02.2023
Tilføjet 3.02.2023
Clinical Infectious Diseases, 3.02.2023
Tilføjet 3.02.2023
AbstractBackgroundWhile single nucleotide polymorphisms (SNPs) in Mycoplasma genitalium parC contribute to fluoroquinolone treatment failure, data are limited for the homologous gene, gyrA. This study investigated the prevalence of gyrA SNPs, and their contribution to fluoroquinolone failure.MethodsSamples from 411 patients (male and female) undergoing treatment for M. genitalium infection (Melbourne Sexual Health Centre, March 2019–February 2020) were analyzed by Sanger sequencing (gyrA and parC). For patients treated with moxifloxacin (n=194), the association between SNPs and microbiologic treatment outcome was analyzed.ResultsThe most common parC SNP was G248T/S83I (21.1% of samples), followed by D87N (2.3%). The most common gyrA SNP was G285A/M95I (7.1%). Dual parC/gyrA SNPs were found in 8.6% of cases. One third of infections harboring parC G248T/S83I SNP had a concurrent SNP in gyrA conferring M95I. SNPs in gyrA co-occurred with parC S83I variations. Treatment failure was higher in patients with parC S83I/gyrA dual SNPs, when compared to infections with single S83I SNP alone from analysis of (i) 194 cases in this study (81.2% vs 45.8%, p=0.047), and (ii) pooled analysis of a larger population of 535 cases (80.6% vs 43.2%; p=0.0027), indicating a strong additive effect.ConclusionsCompared to parC S83I SNP alone, M. genitalium infections with dual mutations affecting parC/gyrA had twice the likelihood of failing moxifloxacin. While AMR varies by region globally, these data indicate that gyrA should be considered as a target for future resistance assays in Australasia. We propose a strategy for the next generation of resistance-guided therapy incorporating parC and gyrA testing.
Læs mere Tjek på PubMedNat Rev Microbiol, 2.02.2023
Tilføjet 2.02.2023
Clinical & Experimental Immunology, 2.02.2023
Tilføjet 2.02.2023
AbstractThe trajectory of immune responses following the primary dose series determines the decline in vaccine effectiveness over time. Here we report on maintenance of immune responses during the year following a two-dose schedule of ChAdOx1 nCoV-19/AZD1222, in the absence of infection, and also explore the decay of antibody after infection. Total spike-specific IgG antibody titres were lower with two low-doses of ChAdOx1 nCoV-19 vaccines (LDLD) (p=0.0006) than with SDSD (the approved dose) or LDSD regimens. Longer intervals between first and second doses resulted in higher antibody titres (p<0.0001), however, there was no evidence that the trajectory of antibody decay differed by interval or by vaccine dose, and the decay of IgG antibody titres followed a similar trajectory after a third dose of ChAdOx1 nCoV-19. Trends in post-infection samples were similar with an initial rapid decay in responses but good persistence of measurable responses thereafter. Extrapolation of antibody data, following two doses of ChAdOx1 nCov-19, demonstrates a slow rate of antibody decay with modelling suggesting that antibody titres are well-maintained for at least two years. These data suggest a persistent immune response after two doses of ChAdOx1 nCov-19 which will likely have a positive impact against serious disease and hospitalisation.
Læs mere Tjek på PubMedClinical & Experimental Immunology, 2.02.2023
Tilføjet 2.02.2023
AbstractInflammation plays a fundamental role in the development of several metabolic diseases, including obesity and type 2 diabetes (T2D); the complement system has been implicated in their development. People of Black African (BA) ethnicity are disproportionately affected by T2D and other metabolic diseases but the impact of ethnicity on the complement system has not been explored. We investigated ethnic differences in complement biomarkers and activation status between men of BA and White European (WE) ethnicity and explored their association with parameters of metabolic health. We measured a panel of 15 complement components, regulators and activation products in fasting plasma from 89 BA and 96 WE men. Ethnic differences were statistically validated. Association of complement biomarkers with metabolic health indices (BMI, waist circumference, insulin resistance and HbA1c) were assessed in the groups. Plasma levels of the key complement components C3 and C4, the regulators clusterin and properdin and the activation marker iC3b were significantly higher in BA compared to WE men after age adjustment, while FD levels were significantly lower. C3 and C4 levels positively correlated with some or all markers of metabolic dysfunction in both ethnic groups while FD was inversely associated with HbA1c in both groups, and clusterin and properdin were inversely associated with some markers of metabolic dysfunction only in the WE group. Our findings of increased levels of complement components and activation products in BA compared to WE men suggest differences in complement regulation that may impact susceptibility to poor metabolic health.
Læs mere Tjek på PubMedBMJ Open, 2.02.2023
Tilføjet 2.02.2023
ObjectivesAlthough COVID-19 vaccines offer protection against infection and severe disease, there is limited information on the effect of vaccination on prolonged symptoms following COVID-19. Our objective was to determine differences in prevalence of prolonged symptoms 6 weeks after onset of COVID-19 among healthcare personnel (HCP) by vaccination status, and to assess differences in timing of return to work.DesignCohort analysis of HCP with COVID-19 enrolled in a multicentre vaccine effectiveness study. HCP with COVID-19 between December 2020 and August 2021 were followed up 6 weeks after illness onset.SettingHealth systems in 12 US states.ParticipantsHCP participating in a vaccine effectiveness study were eligible for inclusion if they had laboratory-confirmed symptomatic SARS-CoV-2 with mRNA vaccination (symptom onset ≥14 days after two doses) or no prior vaccination. Among 681 eligible participants, 419 (61%) completed a follow-up survey to assess symptoms reported 6 weeks after illness onset.ExposuresTwo doses of a COVID-19 mRNA vaccine compared with no COVID-19 vaccine.Main outcome measuresPrevalence of symptoms 6 weeks after onset of COVID-19 illness and days to return to work.ResultsAmong 419 HCP with COVID-19, 298 (71%) reported one or more COVID-like symptoms 6 weeks after illness onset, with a lower prevalence among vaccinated participants compared with unvaccinated participants (60.6% vs 79.1%; adjusted risk ratio 0.70, 95% CI 0.58 to 0.84). Following their illness, vaccinated HCP returned to work a median 2.0 days (95% CI 1.0 to 3.0) sooner than unvaccinated HCP (adjusted HR 1.37, 95% CI 1.04 to 1.79).ConclusionsReceipt of two doses of a COVID-19 mRNA vaccine among HCP with COVID-19 illness was associated with decreased prevalence of COVID-like symptoms at 6 weeks and earlier return to work.
Læs mere Tjek på PubMedBMJ Open, 2.02.2023
Tilføjet 2.02.2023
ObjectiveUK long-term care facility residents account for 185 000 emergency hospital admissions each year. Avoidance of unnecessary hospital transfers benefits residents, reduces demand on the healthcare systems but is difficult to implement. We synthesised evidence on interventions that influence unplanned hospital admissions or attendances by long-term care facility residents.MethodsThis is a systematic review of randomised controlled trials. PubMed, MEDLINE, EMBASE, ISI Web of Science, CINAHL and the Cochrane Library were searched from 2012 to 2022, building on a review published in 2013. We included randomised controlled trials that evaluated interventions that influence (decrease or increase) acute hospital admissions or attendances of long-term care facility residents. Risk of bias and evidence quality were assessed using Cochrane Risk Of Bias-2 and Grading of Recommendations Assessment, Development and Evaluation.ResultsForty-three randomised studies were included in this review. A narrative synthesis was conducted and the weight of evidence described with vote counting. Advance care planning and goals of care setting appear to be effective at reducing hospitalisations from long-term care facilities. Other effective interventions, in order of increasing risk of bias, were: nurse practitioner/specialist input, palliative care intervention, influenza vaccination and enhancing access to intravenous therapies in long-term care facilities.ConclusionsFactors that affect hospitalisation and emergency department attendances of long-term care facility residents are complex. This review supports the already established use of advance care planning and influenza vaccination to reduce unscheduled hospital attendances. It is likely that more than one intervention will be needed to impact on healthcare usage across the long-term care facility population. The findings of this review are useful to identify effective interventions that can be combined, as well as highlighting interventions that either need evaluation or are not effective at decreasing healthcare usage.PROSPERO registration numberCRD42020169604.
Læs mere Tjek på PubMedBMJ Open, 2.02.2023
Tilføjet 2.02.2023
IntroductionHuman papillomavirus (HPV) infection is the most common sexually transmissible infection worldwide. Although the prevalence of cervical HPV infection has been extensively reported in women worldwide, few epidemiological studies have examined the prevalence of non-cervical HPV infection among both women and men, especially in China.Methods and analysisPROGRESS-Plus is a national, multisite, cross-sectional study that aims to estimate the prevalence of non-cervical HPV infection in women and men aged 18–60 years residing in mainland China. More specifically, PROGRESS-Plus will estimate the prevalence rate of HPV DNA in oral samples from both women and men, and that of anogenital samples from men. The secondary study objectives are to (1) report the aforementioned prevalence rates by HPV genotype, age and geographical region, (2) examine the concordance (ie, prevalence of the same HPV genotype) between the oral and anogenital samples among men, (3) explore risk factors associated with oral (in both women and men) and anogenital (in men only) HPV infection and (4) describe study participants’ health-related quality of life, health behaviour, sexual behaviour and health status.Ethics and disseminationThe study protocol and all required documents have been submitted for review and approval to the Independent Ethics Committees of all the participating sites. All participants will provide their written informed consent on study entry, and all the recorded data will be treated as confidential.
Læs mere Tjek på PubMedBMJ Open, 2.02.2023
Tilføjet 2.02.2023
ObjectivesThe discovery and subsequent manufacture of various types of COVID-19 vaccines were considered a breakthrough in the fight against the COVID-19 pandemic. Initially, limited supplies of COVID-19 vaccines warranted vulnerable populations such as people living with chronic non-communicable diseases and the elderly to be prioritised for vaccination. Nevertheless, the uptake of the COVID-19 vaccines among these populations was suboptimal. In this study, we aimed to describe the drivers of COVID-19 vaccine hesitancy among people living with chronic non-communicable diseases in Ibadan, Nigeria.MethodWe applied qualitative methods to explore the feelings and thoughts of people living with chronic non-communicable diseases towards COVID-19 vaccines, at a tertiary hospital in Ibadan, Nigeria. Data were obtained from 25 people living with chronic conditions through in-depth interviews. We thematically analysed the transcripts inductively and deductively. Dedoose qualitative data management software was used to manage the data.FindingsEmerging subthemes were grouped into two major themes: Hesitancy towards the COVID-19 vaccine related to biological concerns and those related to sociopolitical issues. Hesitancy towards the COVID-19 vaccine associated with biological factors included: (1) concerns over the COVID-19 vaccine worsening the underlying chronic condition; (2) fear of harmful physiological consequences; (3) concerns over insufficient testing of vaccine for safety and (4) perceived vaccine infectiveness. Sociopolitical factors were related to (1) misconceptions of vaccines as a treatment for those with COVID-19; (2) mistrust of manufacturers (‘the whites’); (3) mistrust of government and (4) COVID-19 misinformation.ConclusionPublic health education on the nature and benefits of the COVID-19 vaccine is urgently needed among people living with chronic non-communicable diseases. These measures could improve COVID-19 vaccine uptake and healthcare usage in general. Paying attention to these factors could have implications for the management of the next global pandemic requiring mass vaccination.
Læs mere Tjek på PubMedBMJ Open, 2.02.2023
Tilføjet 2.02.2023
IntroductionThe protocol presents the methodology of a scoping review that aims to synthesise contemporary evidence on the management and outcomes of intracranial fungal infections in Africa.Methods and analysisThe scoping review will be conducted in accordance with the Arksey and O’Malley’s framework. The research question, inclusion and exclusion criteria and search strategy were developed based on the Population, Intervention, Comparator, Outcome framework. A search will be conducted in electronic bibliographic databases (Medline (OVID), Embase, African Journals Online, Cochrane Library and African Index Medicus). No restrictions on language or date of publication will be made. Quantitative and qualitative data extracted from included articles will be presented through descriptive statistics and a narrative description.Ethics and disseminationThis study protocol does not require ethical approval. Findings will be reported in a peer-reviewed medical journal and presented at local, regional, national and international conferences.
Læs mere Tjek på PubMedBMJ Open, 2.02.2023
Tilføjet 2.02.2023
ObjectiveThe objective of this study was to describe Ontario primary care teams’ experiences with collaboration during the COVID-19 pandemic. Descriptive qualitative methods using focus groups conducted virtually for data collection.SettingPrimary care teams located in Ontario, Canada.ParticipantsOur study conducted 11 focus groups with 10 primary care teams, with a total of 48 participants reflecting a diverse range of interprofessional healthcare providers and administrators working in primary care.ResultsThree themes were identified using thematic analysis: (1) prepandemic team functioning facilitated adaptation, (2) new processes of team interactions and collaboration, and (3) team as a foundation of support.ConclusionsResults revealed the importance of collaboration for provider well-being, and the challenges of providing collaborative team-based primary care in the pandemic context. Caution against converting primary care collaboration to predominantly virtual modalities postpandemic is recommended. Further research on team functioning during the COVID-19 pandemic in other healthcare organisations will offer additional insight regarding how primary care teams can work collaboratively in a postpandemic environment.
Læs mere Tjek på PubMedOlatunde Adebayo Adeoti, Kayode Samuel Adekeye
PLoS One Infectious Diseases, 2.02.2023
Tilføjet 2.02.2023
by Olatunde Adebayo Adeoti, Kayode Samuel AdekeyeThe increase in the number of infections and the worrisome state of mortality linked to the COVID-19 pandemic demand an optimal statistical model and efficient monitoring scheme to analyze the deaths. This paper aims to model the COVID-19 mortality in Nigeria using four non-normal distributions grouped under the generalized gamma distribution, by specifying the best-fit distribution to model the number of deaths linked to the COVID-19 pandemic. In addition, a control chart to monitor the COVID-19 deaths based on the best-fit distribution is proposed. The performance of the proposed Gamma-CUSUM chart as a monitoring scheme was compared with the standard normal-CUSUM chart. The results revealed that the Gamma-CUSUM chart first signals a change in the number of deaths on day 68 while there was no change in the number of deaths for the standard normal-CUSUM chart. Also, the exact point of change was visible on the Gamma-CUSUM chart which was impossible on a standard normal-CUSUM control chart.
Læs mere Tjek på PubMedShintaro Yamazaki, Ryoko Hirayama, Yayoi Ikeda, Sachiko Iseki, Tetsuya Yoda, Masa-Aki Ikeda
PLoS One Infectious Diseases, 2.02.2023
Tilføjet 2.02.2023
by Shintaro Yamazaki, Ryoko Hirayama, Yayoi Ikeda, Sachiko Iseki, Tetsuya Yoda, Masa-Aki IkedaEngineered cartilage tissue from differentiated mesenchymal stem cells (MSCs) can generate bone in vivo through endochondral ossification (ECO). This ECO-mediated approach has the potential to circumvent the severe problems associated with conventional MSC-based bone tissue engineering techniques that lack mechanisms to induce angiogenesis. Hyaluronic acid (HA) is a key component in the cartilage extracellular matrix. However, the ECO-supporting properties of HA remain largely unclear. This study aimed to compare the ability of HA and collagen hydrogels to support in vitro differentiation of MSC-based hypertrophic cartilage tissues and to promote endochondral bone formation in vivo. Following the chondrogenic and hypertrophic differentiation in vitro, both HA and collagen constructs accumulated sulfated glycosaminoglycan (sGAG) and type 1, type II, and type X collagen. However, HA hydrogels exhibited a more uniform distribution of sGAG, type 1 collagen, type X collagen, and osteocalcin proteins; in addition, the cells embedded in the hydrogels had more rounded cell morphologies than those in the collagen constructs. At week 5 of in vitro culture, two to three constructs were implanted into a subcutaneous pocket in nude mice and harvested after 4 and 8 weeks. Both HA and collagen constructs promoted endochondral bone formation with vascularization and bone marrow development; however, the HA constructs fused to form integrated bone tissues and the bone marrow developed along the space between the two adhered grafts in all implanted pockets (n = 5). In the collagen constructs, the integration was observed in 40% of the pockets (n = 5). Microcomputer CT analysis revealed that the bone volume of HA constructs was larger than that of collagen constructs. In conclusion, compared to collagen hydrogels, HA hydrogels had superior potential to generate integrated bone with vascularization and bone marrow development. This study provides valuable insights for applying ECO-mediated bone tissue engineering approaches for the repair of critical-sized bone defects.
Læs mere Tjek på PubMedMarcos I. Petersen, Hugo A. Carignano, Claudia Mongini, Diego D. Gonzalez, Juan P. Jaworski
PLoS One Infectious Diseases, 2.02.2023
Tilføjet 2.02.2023
by Marcos I. Petersen, Hugo A. Carignano, Claudia Mongini, Diego D. Gonzalez, Juan P. JaworskiBovine leukemia virus (BLV) is a retrovirus that causes malignant B-cell lymphoma in up to ten-percent of infected cattle. To date, the mechanisms of BLV linked to malignant transformation remain elusive. Although BLV-encoded miRNAs have been associated with the regulation of different genes involved in oncogenic pathways, this association has not been evaluated in cattle naturally infected with BLV. The objective of this study was to determine the relative expression of BLV-encoded miRNA blv-miR-b4-3p, the host analogous miRNA bo-miR-29a and a couple of potential target mRNAs (HBP-1 and PXDN, with anti-tumorigenic function in B-cells), in cattle naturally infected with BLV compared to uninfected animals (control group). We observed that PXDN was significantly downregulated in BLV-infected cattle (P = 0.03). Considering the similar expression of endogenous bo-miR-29a in both animal groups, the downregulation of PXDN in BLV-naturally infected cattle could be linked to blv-miR-b4-3p expression in these animals. Knowing that PXDN is involved in anti-tumoral pathways in B-cells, the results presented here suggest that blv-miR-b4-3p might be involved in BLV tumorigenesis during natural infection with BLV in cattle.
Læs mere Tjek på PubMedXiliang Zhang, Jin Liu, Siwei Chang, Peizhu Gong, Zhongdai Wu, Bing Han
PLoS One Infectious Diseases, 2.02.2023
Tilføjet 2.02.2023
by Xiliang Zhang, Jin Liu, Siwei Chang, Peizhu Gong, Zhongdai Wu, Bing HanVector-based retrieval have been widely adopted to process online users’ diverse interests for recommendations. However, most of them utilize a single vector to represent user multiple interests (UMI), inevitably impairing the accuracy and diversity of item retrieval. In addition, existing work often does not take into account the scale and speed of the model, and high-dimensional user representation vectors need high computation cost, leading to inefficient item retrieval. In this paper, we propose a novel lightweight multi-interest retrieval network (MIRN) by incorporating sequence-to-interest Expectation Maximization (EM) routing to deal with users’ multiple interests. By leveraging representation ability of the Capsule network, we design a multi-interest representation learning module that clusters multiple Capsule vectors from the user’s behavior sequence to represent each of their interests respectively. In addition, we introduce a composite capsule clustering strategy for the Capsule network framework to reduce the scale of the network model. Furthermore, a Capsule-aware module incorporating an attention mechanism has been developed to guide model training by adaptively learning multiple Capsule vectors of user representations. The experimental results demonstrate MIRN outperforms the state-of-the-art approaches for item retrieval and gains significant improvements in terms of metric evaluations.
Læs mere Tjek på PubMedSusana Aideé González-Chávez, Joan S. Salas-Leiva, Dayana E. Salas-Leiva, Salma Marcela López-Loeza, Jasanai Sausameda-García, Erasmo Orrantia-Borunda, Rubén Burgos-Vargas, Maria Fernanda Alvarado-Jáquez, Mayra Torres-Quintana, Rubén Cuevas-Martínez, Eduardo Chaparro-Barrera, Carlos Marín-Terrazas, Gerardo Pável Espino-Solís, José Pablo Romero-López, Brian de Jesús Bernal-Alferes, César Pacheco-Tena
PLoS One Infectious Diseases, 2.02.2023
Tilføjet 2.02.2023
by Susana Aideé González-Chávez, Joan S. Salas-Leiva, Dayana E. Salas-Leiva, Salma Marcela López-Loeza, Jasanai Sausameda-García, Erasmo Orrantia-Borunda, Rubén Burgos-Vargas, Maria Fernanda Alvarado-Jáquez, Mayra Torres-Quintana, Rubén Cuevas-Martínez, Eduardo Chaparro-Barrera, Carlos Marín-Terrazas, Gerardo Pável Espino-Solís, José Pablo Romero-López, Brian de Jesús Bernal-Alferes, César Pacheco-TenaTo analyze the effect of levofloxacin-induced intestinal microbiota modifications on intestinal, joint, and systemic inflammation in the DBA/1 mice with spontaneous arthritis. The study included two groups of mice, one of which received levofloxacin. The composition and structure of the microbiota were determined in the mice’s stool using 16S rRNA sequencing; the differential taxa and metabolic pathway between mice treated with levofloxacin and control mice were also defied. The effect of levofloxacin was evaluated in the intestines, hind paws, and spines of mice through DNA microarray transcriptome and histopathological analyses; systemic inflammation was measured by flow cytometry. Levofloxacin decreased the pro-inflammatory bacteria, including Prevotellaceae, Odoribacter, and Blautia, and increased the anti-inflammatory Muribaculaceae in mice’s stool. Histological analysis confirmed the intestinal inflammation in control mice, while in levofloxacin-treated mice, inflammation was reduced; in the hind paws and spines, levofloxacin also decreased the inflammation. Microarray showed the downregulation of genes and signaling pathways relevant in spondyloarthritis, including several cytokines and chemokines. Levofloxacin-treated mice showed differential transcriptomic profiles between peripheral and axial joints and intestines. Levofloxacin decreased the expression of TNF-α, IL-23a, and JAK3 in the three tissues, but IL-17 behaved differently in the intestine and the joints. Serum TNF-α was also reduced in levofloxacin-treated mice. Our results suggest that the microbiota modification aimed at reducing pro-inflammatory and increasing anti-inflammatory bacteria could potentially be a coadjuvant in treating inflammatory arthropathies.
Læs mere Tjek på PubMedBenard Langat, Edward K. Muge, Doris Night, Fredrick Okoth, Kevin O. Ochwedo, Elijah M. Songok
PLoS One Infectious Diseases, 2.02.2023
Tilføjet 2.02.2023
by Benard Langat, Edward K. Muge, Doris Night, Fredrick Okoth, Kevin O. Ochwedo, Elijah M. SongokBackground Hepatitis B is becoming a growing public health problem in Kenya. To combat the threat, HBV vaccination should be recommended, particularly for individuals who are not covered by the national immunization program. Vaccination provides sero-protection rates approaching 95% among healthy adults after completing the three-dose vaccination course, but decreases to 87% among those who receive only two doses, emphasizing the importance of completing the three-dose vaccination course. However, data on adult adherence to HBV multi-dose vaccines in Sub-Saharan Africa are limited, despite the fact that this information is critical for prevention. As a result, more research on HBV vaccine dose completion is required. The purpose of this study is to estimate the prevalence of hepatitis B virus infection among out-patient clinic attendees in Nairobi, Kenya, as well as to identify beneficiaries of free vaccination and barriers to completing the recommended vaccine doses. Methods Between July 30th and September 30th, 2015, 2644 outpatient clinic attendees aged ≥ 4 were recruited from three hospitals in Nairobi County, Kenya: Mama Lucy, Riruta, and Loco. Self-administered questionnaires were used to collect socio-demographic information, and blood samples were tested for hepatitis B surface antigen (HBsAg) using the KEMRI HEPCELL Rapid® (Hepatitis B Detection kit) test kit. Individuals who tested negative for HBsAg were given a free course of three doses of HBV vaccine. The vaccination register provided information on the number of doses administered. Results The average age of the study population was 31.4 years (range: 4–66), with females accounting for 59.2%. 1.82% (48/2644) of the participants tested positive for HBsAg. Among the 2596 individuals eligible for vaccination, 66% (1720/2596) received at least one dose, and 51.8% (1345/2596) received all three doses. Vaccination acceptance increased with age, with older patients more likely to return for subsequent dose (OR>1 for second and third dose). Unavailability and failure to contact client were cited as significant (p
Læs mere Tjek på PubMedShweta Singh, Shally Awasthi, Divas Kumar, Seema Rani Sarraf, Anuj Kumar Pandey, Girdhar G. Agarwal, Avivar Awasthi, Anish T. S., Joseph L. Mathew, Sonali Kar, Suma Nair, Chythra R. Rao, Harsh Pande, B. N. Mahanta, Bhavneet Bharti, C. M. Singh, Kuldeep Singh, Mushtaq A. Bhat, Somashekar A. R., Rajiv Awasthi, Abbas Ali Mahdi
PLoS One Infectious Diseases, 2.02.2023
Tilføjet 2.02.2023
by Shweta Singh, Shally Awasthi, Divas Kumar, Seema Rani Sarraf, Anuj Kumar Pandey, Girdhar G. Agarwal, Avivar Awasthi, Anish T. S., Joseph L. Mathew, Sonali Kar, Suma Nair, Chythra R. Rao, Harsh Pande, B. N. Mahanta, Bhavneet Bharti, C. M. Singh, Kuldeep Singh, Mushtaq A. Bhat, Somashekar A. R., Rajiv Awasthi, Abbas Ali MahdiBackground Micronutrient deficiency (MD) is associated with deficits in cognitive functioning of children. However, no comprehensive multicentric study has been conducted in India to explore the role of multiple MD in cognition of children and adolescents. The present study aimed to explore association of MD with level of general intelligence and specific cognitive functions, in urban school-going children and adolescents across ten cities of India. Method Cross-sectional multicentric study, enrolled participants aged 6–16 years. Blood samples were collected for biochemical analysis of calcium, iron, zinc, selenium, folate, vitamin A, D and B12. Colored Progressive Matrices / Standard Progressive Matrices (CPM/SPM), Coding, Digit Span and Arithmetic tests were used for the assessment of cognitive functions of participants. Height and weight measures were collected along with socio-economic status. Results From April-2019 to February-2020, 2428 participants were recruited from 60 schools. No MD was found in 7.0% (134/1918), any one MD in 23.8% (457/1918) and ≥ 2 MD in 69.2% (1327/1918) participants. In presence of ≥ 2 MD, adjusted odds ratio (OR) for borderline or dull normal in CPM/SPM was 1.63, (95% CI: 1.05–2.52), coding was 1.66 (95% CI: 1.02–2.71), digit span was 1.55 (95% CI: 1.06–2.25) and arithmetic was 1.72 (95% CI: 1.17–2.53), controlling for gender, socioeconomic status and anthropometric indicators. Conclusion Since ≥ 2 MD were found in more than 2/3rd of participants and was associated with impairment in cognitive function, attempts must be made to ameliorate them on priority in school going children in India. Trial registration number CTRI/2019/02/017783.
Læs mere Tjek på PubMedPaola Conigliaro, Arianna D’Antonio, Luca D’Erme, Giulia Lavinia Fonti, Paola Triggianese, Alberto Bergamini, Maria Sole Chimenti
PLoS One Infectious Diseases, 2.02.2023
Tilføjet 2.02.2023
by Paola Conigliaro, Arianna D’Antonio, Luca D’Erme, Giulia Lavinia Fonti, Paola Triggianese, Alberto Bergamini, Maria Sole ChimentiBackground Rheumatoid Arthritis (RA) is a chronic inflammatory disease with a heterogeneous treatments’ clinical response. Goals of treatment are remission and low disease activity, which are not achieved in all patients despite the introduction of early treatment and the treat to target strategy. Objective To investigate the causes of disease-modifying antirheumatic drugs (DMARDs) discontinuation and treatment failure and multiple failure for inefficacy, and to identify possible failure predictors’ according to RA patient characteristics in a real-world setting. Methods 718 RA patients were retrospectively evaluated. Conventional synthetic (cs) and biologic (b)DMARDs treatments line/s, effectiveness, and reasons of discontinuations were evaluated. Patients failing to at least two csDMARDs or bDMARDs’ drug for inefficacy were defined “csDMARDs multifailure” and “bDMARDs multifailure”, respectively. Discontinuation of at least two cs- and bDMARDs was termed “global multifailure”. Results In total, 1422 csDMARDs and 714 bDMARDs treatment were analysed. Causes of csDMARDs discontinuation were intolerance (21.8%), inefficacy (20.2%), acute adverse reactions (5.3%) and severe infections (0.6%) while csDMARDs multifailure for inefficacy was observed in 5.7% of cases. Reasons of bDMARDs withdrawal were inefficacy (29%), intolerance (10.0%), acute adverse reaction (6.3%) and severe infections (1.5%). Altogether, 8.4% of patients were bDMARDs multifailure for inefficacy while 16.6% were global multifailure. Longstanding disease (≥ 12 months) and smoke habit, resulted as positive predictor of csDMARDs failure (OR 2.6 and OR 2.7, respectively). Thyreopathy was associated with both csDMARDs failure and global multifailure (OR 2.4 and OR 1.8, respectively). Higher prevalence of failure to at least one bDMARDs and global multifailure was detected in female than male (OR 2.3 and OR 2, respectively). Conclusions Different causes of drug discontinuation were observed on DMARDs treatments. Demographic and clinical features were identified as possible predictors of both cs- and bDMARDs treatment failure and multiple failure, underlining the need of a more personalized therapeutic approach to achieve treatment targets.
Læs mere Tjek på PubMedMathew Hennessey, Ayako Ebata, Indranil Samanta, Ana Mateus, Jean-Christophe Arnold, Dominic Day, Meenakshi Gautham, Pablo Alarcon
PLoS One Infectious Diseases, 2.02.2023
Tilføjet 2.02.2023
by Mathew Hennessey, Ayako Ebata, Indranil Samanta, Ana Mateus, Jean-Christophe Arnold, Dominic Day, Meenakshi Gautham, Pablo AlarconAntibiotic resistance threatens provision of healthcare and livestock production worldwide with predicted negative socioeconomic impact. Antibiotic stewardship can be considered of importance to people living in rural communities, many of which depend on agriculture as a source of food and income and rely on antibiotics to control infectious diseases in livestock. Consequently, there is a need for clarity of the structure of antibiotic value chains to understand the complexity of antibiotic production and distribution in community settings as this will facilitate the development of effective policies and interventions. We used a value chain approach to investigate how relationships, behaviours, and influences are established during antibiotic distribution. Interviews were conducted with key informants (n = 17), value chain stakeholders (n = 22), and livestock keeping households (n = 36) in Kolkata, and two rural sites in West Bengal, India. Value chain mapping and an assessment of power dynamics, using manifest content analysis, were conducted to investigate antibiotic distribution and identify entry points for antibiotic stewardship. The flow of antibiotics from manufacturer to stockists is described and mapped and two local level maps showing distribution to final consumers presented. The maps illustrate that antibiotic distribution occurred through numerous formal and informal routes, many of which circumvent antibiotic use legislation. This was partly due to limited institutional power of the public sector to govern value chain activities. A ‘veterinary service lacuna’ existed resulting in livestock keepers having higher reliance on private and informal providers, who often lacked legal mandates to prescribe and dispense antibiotics. The illegitimacy of many antibiotic prescribers blocked access to formal training who instead relied on mimicking the behaviour of more experienced prescribers–who also lacked access to stewardship guidelines. We argue that limited institutional power to enforce existing antibiotic legislation and guide antibiotic usage and major gaps in livestock healthcare services make attempts to curb informal prescribing unsustainable. Alternative options could include addressing public sector deficits, with respect to both healthcare services and antibiotic provision, and by providing resources such as locally relevant antibiotic guidelines to all antibiotic prescribers. In addition, legitimacy of informal prescribers could be revised, which may allow formation of associations or groups to incentivise good antibiotic practices.
Læs mere Tjek på PubMedRaymond E. Mdachi, Kennedy O. Ogolla, Joanna E. Auma, Florence N. Wamwiri, Richard K. Kurgat, Kennedy B. Wanjala, Lawrence G. Mugunieri, Phylis M. Alusi, Judith K. Chemuliti, Phoebe W. Mukiria, Sylvance O. Okoth
PLoS One Infectious Diseases, 2.02.2023
Tilføjet 2.02.2023
by Raymond E. Mdachi, Kennedy O. Ogolla, Joanna E. Auma, Florence N. Wamwiri, Richard K. Kurgat, Kennedy B. Wanjala, Lawrence G. Mugunieri, Phylis M. Alusi, Judith K. Chemuliti, Phoebe W. Mukiria, Sylvance O. OkothTrypanocidal resistance is a major cause of treatment failure. This study evaluated the sensitivity of Trypanosoma evansi field isolates collected from Marsabit and Isiolo counties, Kenya. A total of 2,750 camels were screened using parasitological tests for trypanosomes. Of the screened camels, 113 tested positive from which 40 T. evansi isolates were tested using the single dose mice sensitivity test. Five treatment groups each comprising of 6 mice were inoculated intraperitoneally with 1x105 trypanosomes of each isolate and treated 24 hours later with isometamidium chloride at 1 mg/kg, homidium chloride at 1mg/kg, diminazene aceturate at 20 mg/kg and quinapyramine sulphate & chloride at 1 mg/kg. The fifth group was left untreated (positive control). The mice were monitored daily for 60 days. A survey on camel owners’ practices that influence development of resistance to trypanocidal drugs was then conducted. Results indicated presence of drug resistance in all the 7 study sites that had infected camels. Seven of the isolates tested were resistant to diminazene aceturate whereas, 28, 33 and 34 were resistant to isometamidium chloride, quinapyramine sulphate & chloride and homidium chloride, respectively. Seven (17.5%) isolates of the 40 tested were sensitive to all 4 drugs, whereas, 7.5%, 10%,55% and 10% were resistant to 1,2,3 and 4 drugs, respectively. The prevalence of multiple drug resistance was 75%. Survey data indicated that camel management practices influenced the prevalence and degree of drug resistance. In conclusion, the multiple drug resistance observed in the two counties may not be an indication of total trypanocidal drug failure. Judicious treatment of confirmed trypanosomiasis cases with correct dosage would still be effective in controlling the disease since the observed resistance was at the population and not clonal level. However, integrated control of the disease and the vectors using available alternative methods is recommended to reduce drug use.
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 293-295
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 296-304
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 305-312
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 313-316
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 317-319
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 320-327
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 328-334
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 335-339
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 340-345
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 346-352
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 353-355
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 356-358
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 359-362
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 363-365
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 366-376
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 377-383
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 384-393
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 394-402
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 403-411
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 412-423
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 424-427
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 428-432
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 433-440
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 441-448
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.02.2023
Tilføjet 2.02.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 2 Pages: 449-455
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