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Ting Huang, Jinfeng Cai, Peipei Wang, Jiasheng Zhou, Haitao Zhang, Ziqi Wu, Jiacong Zhao, Zhanlian Huang, Kai DengaInstitute of Human Virology, Key Laboratory of Tropical Disease Control of Ministry of Education, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, ChinabDepartment of Immunology and Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, ChinacSchool of Medicine, Sun Yat-sen University, Shenzhen, ChinadDepartment of Infectious Diseases, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaeDepartment of Infectious Diseases, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, ChinafAdvanced Medical Technology Center, The First Affiliated Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
Antimicrobial Agents And Chemotherapy, 22.05.2023
Tilføjet 22.05.2023
Thanh Quang Nguyen, Bo Eun Heo, Bui Thi Bich Hanh, Seunghyeon Jeon, Yujin Park, Arunima Choudhary, Sujin Lee, Tae Ho Kim, Cheol Moon, Sun-Joon Min, Jichan JangaDivision of Life Science, Department of Bio & Medical Big Data (BK21 Four Program), Research Institute of Life Science, Gyeongsang National University, Jinju, Republic of KoreabDivision of Applied Life Science (BK21 Four Program), Research Institute of Life Science, Gyeongsang National University, Jinju, Republic of KoreacDepartment of Applied Chemistry, Hanyang University, Ansan, Gyeonggi-do, Republic of KoreadCenter for Bionano Intelligence Education and Research, Hanyang University, Ansan, Gyeonggi-do, Republic of KoreaeDepartment of Clinical Laboratory Science, Semyung University, Jecheon, Republic of KoreafDepartment of Chemical and Molecular Engineering, Hanyang University, Ansan, Gyeonggi-do, Republic of Korea
Antimicrobial Agents And Chemotherapy, 22.05.2023
Tilføjet 22.05.2023
Hanane, G., Amine, Z., Roomila, N., Prazuck, T., Amirouche, A., Olivier, V., Benyamina, A., Serreau, R.
BMJ Open, 22.05.2023
Tilføjet 22.05.2023
ObjectiveTo evaluate the SARS-CoV-2 seroprevalence among local authority workers, depending on their position and potential interaction with the public. MethodsA cohort of volunteer participants was recruited among local authority workers of the Centre Val de Loire region in France, to be tested using a rapid serological test (COVID-PRESTO). The collected data were analysed by comparing different parameters including, gender, age, position held, and contact or not with the public. The study was carried out from August to December 2020 and included 3228 participants (n=3228), from 18 to 65 years old. ResultsThe seroprevalence of SARS-CoV-2 among local authority workers was estimated at 3.04%. No significant difference could be observed according to the position held by the workers and whether they were or not in contact with the public. Nevertheless, a significant difference was observed between the different investigating centres, in correlation with the geographical location. ConclusionContact with members of the public was not a critical parameter for SARS-CoV-2 seroprevalence as long as protective measures are applied. Among the population included in the study, childcare workers were more at risk of getting infected by the virus. Trial registration numberNCT04387968
Læs mere Tjek på PubMedPham, B. N., Abori, N., Maraga, S., Jorry, R., Jaukae, G. S., Silas, V. D., Aga, T., Okely, T., Pomat, W.
BMJ Open, 22.05.2023
Tilføjet 22.05.2023
ObjectiveInterVA-5 is a new version of an analytical tool for cause of death (COD) analysis at the population level. This study validates the InterVA-5 against the medical review method, using mortality data in Papua New Guinea (PNG). Design and settingThis study used mortality data collected from January 2018 to December 2020 in eight surveillance sites of the Comprehensive Health and Epidemiological Surveillance System (CHESS), established by the PNG Institute of Medical Research in six major provinces. MethodsThe CHESS demographic team conducted verbal autopsy (VA) interviews with close relatives of the deceased, who died in communities within the catchment areas of CHESS, using the WHO 2016 VA instrument. COD of the deceased was assigned by InterVA-5 tool, and independently certified by the medical team. Consistency, difference and agreement between the InterVA-5 model and medical review were assessed. Sensitivity and positive predictive value (PPV) of the InterVA-5 tool were calculated with reference to the medical review method. ResultsSpecific COD of 926 deceased people was included in the validation. Agreement between the InterVA-5 tool and medical review was high (kappa test: 0.72; p
Læs mere Tjek på PubMedFigueroa-Romero, A., Mendes, A., Mombo-Ngoma, G., Mischlinger, J., Esen, M., Vogler, M., Mazuze, M., Mombo-Nzamba, L., Mbadinga, B., Sanz, S., Ramharter, M., Saute, F., Nhampossa, T., Menendez, C., Gonzalez, R.
BMJ Open, 22.05.2023
Tilføjet 22.05.2023
IntroductionPregnant women are currently considered a vulnerable population to SARS-CoV-2 infection, with increased risk of severe COVID-19, preterm birth and maternal mortality. There is, however, a paucity of data on the burden of maternal SARS-CoV-2 infection in sub-Saharan countries. The objective of this study is to determine the prevalence and health effects of maternal SARS-CoV-2 infection in selected sites from Gabon and Mozambique. Methods and analysisMA-CoV (MAternal CoVid) is an observational, multicentre prospective cohort study where 1000 pregnant women (500 per country) will be enrolled at the antenatal clinic visits. Participants will undergo monthly follow-up at each antenatal care visit, delivery and postpartum visit. The primary study outcome is the prevalence of SARS-CoV-2 infection during pregnancy. The clinical presentation of COVID-19 in pregnancy will also be characterised, and incidence of infection during pregnancy will be evaluated, as well as the risk factors of maternal and neonatal morbidity and mortality associated with SARS-CoV-2 infection and the risk of mother to child transmission of SARS-CoV-2. SARS-CoV-2 infection screening will be performed through PCR diagnosis. Ethics and disseminationThe protocol was reviewed and approved by the Comité National d’Éthique pour la Recherche au Gabon, Comité Nacional de Bioética para Saúde de Mocambique and the Ethics Committee of the Hospital Clinic of Barcelona (Spain). Project results will be presented to all stakeholders and published in open access journals. Trial registration numberNCT05303168.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.05.2023
Tilføjet 22.05.2023
Abstract Background The World Health Organization (WHO) recommends the diagnosis of tuberculosis (TB) using molecular tests, such as Xpert MTB/RIF (MTB/RIF) or Xpert Ultra (Ultra). These tests are expensive and resource-consuming, and cost-effective approaches are needed for greater coverage. Methods We evaluated the cost-effectiveness of pooling sputum samples for TB testing by using a fixed amount of 1,000 MTB/RIF or Ultra cartridges. We used the number of people with TB detected as the indicator for cost-effectiveness. Cost-minimization analysis was conducted from the healthcare system perspective and included the costs to the healthcare system using pooled and individual testing. Results There was no significant difference in the overall performance of the pooled testing using MTB/RIF or Ultra (sensitivity, 93.9% vs. 97.6%, specificity 98% vs. 97%, p-value > 0.1 for both). The mean unit cost across all studies to test one person was 34.10 international dollars for the individual testing and 21.95 international dollars for the pooled testing, resulting in a savings of 12.15 international dollars per test performed (35.6% decrease). The mean unit cost per bacteriologically confirmed TB case was 249.64 international dollars for the individual testing and 162.44 international dollars for the pooled testing (34.9% decrease). Cost-minimization analysis indicates savings are directly associated with the proportion of samples that are positive. If the TB prevalence is ≥ 30%, pooled testing is not cost-effective. Conclusion Pooled sputum testing can be a cost-effective strategy for diagnosis of TB, resulting in significant resource savings. This approach could increase testing capacity and affordability in resource-limited settings and support increased testing towards achievement of WHO End TB strategy.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.05.2023
Tilføjet 22.05.2023
Abstract Background Besides impaired respiratory function and immune system, COVID-19 can affect renal function from elevated blood urea nitrogen (BUN) or serum creatinine (sCr) levels to acute kidney injury (AKI) and renal failure. This study aims to investigate the relationship between Cystatin C and other inflammatory factors with the consequences of COVID-19. Methods A total of 125 patients with confirmed Covid-19 pneumonia were recruited in this cross-sectional study from March 2021 to May 2022 at Firoozgar educational hospital in Tehran, Iran. Lymphopenia was an absolute lymphocyte count of less than 1.5 × 109/L. AKI was identified as elevated serum Cr concentration or reduced urine output. Pulmonary consequences were evaluated. Mortality was recorded in the hospital one and three months after discharge. The effect of baseline biochemical and inflammatory factors on odds of death was examined. SPSS, version 26, was used for all analyses. P-vale less than 0.05 was considered significant. Results The highest amount of co-morbidities was attributed to COPD (31%; n = 39), dyslipidemia and hypertension (27%; n = 34 for each) and diabetes (25%; n = 31). The mean baseline cystatin C level was 1.42 ± 0.93 mg/L, baseline creatinine was 1.38 ± 0.86 mg/L, and baseline NLR was 6.17 ± 4.50. Baseline cystatin C level had a direct and highly significant linear relationship with baseline creatinine level of patients (P
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.05.2023
Tilføjet 22.05.2023
Abstract Background Healthcare-Acquired Infections are a major problem in the world and within the healthcare delivery system. An estimated 5–10% and around 25% of hospitalized patients have healthcare-acquired infections in developed and developing countries, respectively. Infection prevention and control programs have proven to be successful in lowering the incidence and spread of infections. Thus, this evaluation aims to evaluate the implementation fidelity of infection prevention practices at Debre Tabor comprehensive specialized hospital in Northwest Ethiopia. Methods A facility-based cross-sectional design with a concurrent mixed method was used to evaluate the implementation fidelity of infection prevention practices. A total of 36 indicators were used to measure adherence, participant responsiveness, and facilitation strategy dimensions. A total of 423 clients were administered for an interview, an inventory checklist, a document review, 35 non-participatory observations, and 11 key informant interviews were conducted. A multivariable logistic regression analysis was used to identify factors significantly associated with the satisfaction of clients. The findings were presented using descriptions, tables, and graphs. Result The overall implementation fidelity of the infection prevention practices was 61.8%. The dimensions of adherence to infection prevention and control guidelines were 71.4%, participant responsiveness was 60.6%, and facilitation strategy was 48%. In multivariable analysis, ward admission and educational level had a p-value of below 0.05 and were significantly associated with the satisfaction of clients with infection prevention practices at the hospital. The major themes that emerged in qualitative data analysis were healthcare worker-related factors, management-related factors, and patient- and visitor-related factors. Conclusion The evaluation result of this study concluded that the overall implementation fidelity of infection prevention practice was judged to be medium and needed improvement. It included dimensions of adherence and participant responsiveness that were rated as medium, as well as a facilitation strategy that was rated as low. Enablers and barriers were thematized into factors related to healthcare providers, management, institutions, and patient and visitor relations.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.05.2023
Tilføjet 22.05.2023
Abstract Background Tuberculosis (TB) is among the leading causes of death globally. The disease has a huge burden in Namibia, with a case notification rate of at least 442 per 100,000. To date, Namibia is among the countries with the highest global TB burden, despite all efforts to reduce it. This study aimed to determine the factors associated with the unsuccessful treatment outcomes of the Directly Observed Therapy Short course (DOTS) programme in the Kunene and Oshana regions. Methods The study utilised a mixed-methods explanatory-sequential design to collect data from all TB patient records and healthcare workers who work directly with the DOTS strategy for TB patients. The relationship between independent and dependent variables was analysed using multiple logistic regression analysis, while interviews were analysed using inductive thematic analysis. Results The overall treatment success rates of the Kunene and Oshana regions throughout the review period were 50.6% and 49.4%, respectively. The logistic regression analyses showed that in the Kunene region, the type of DOT used (Community-based DOTS) (aOR = 0.356, 95% CI: 0.835–2.768, p = 0.006) was statistically significant with the unsuccessful treatment outcomes. While in the Oshana region, age groups 21–30 years old (aOR = 1.643, 95% CI = 1.005–2.686, p = 0.048), 31–40 years old (aOR = 1.725, 95% CI = 11.026–2.9, p = 0.040), 41–50 years old (aOR = 2.003, 95% CI = 1.155–3.476, p = 0.013) and 51–60 years old (aOR = 2.106, 95% CI = 1.228–3.612, p = 0.007) had statistically significant associations with the poor TB-TO. Inductive thematic analysis revealed that patients in the Kunene region were challenging to reach owing to their nomadic lifestyle and the vastness of the area, adversely affecting their ability to observe TB therapy directly. In the Oshana region, it was found that stigma and poor TB awareness among adult patients, as well as mixing anti-TB medication with alcohol and tobacco products among adult patients, was a prevalent issue affecting TB therapy. Conclusion The study recommends that regional health directorates embark on rigorous community health education about TB treatment and risk factors and establish a robust patient observation and monitoring system to enhance inclusive access to all health services and ensure treatment adherence.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.05.2023
Tilføjet 22.05.2023
Abstract Introduction Acute pancreatitis (AP) accounts for a high proportion of digestive diseases worldwide and has a high risk of infection. Pseudomonas aeruginosa, a common pathogen of hospital infections, has been observed to increase the resistance rate to several antibiotics, causing difficulties in treatments. Our study aims to investigate the impact of the multi-drug resistant Pseudomonas aeruginosa (MDR-PA) infections on AP patients. Methods At two Chinese tertiary referral centers for AP patients infected with MDR-PA, a retrospective case-control study with a 1:2 case-control ratio was performed. Comparisons were preformed between with/without MDR-PA infections and different drug-resistance of MDR-PA infections patients, respectively. Independent risk factors of overall mortality were assessed via univariate and multivariate binary logistic regression analyses, and the distribution and antibiotic resistant rates of strains were described. Results Mortality in AP patients with MDR-PA infections was significantly higher than in those without MDR-PA infections (7 (30.4%) vs. 4 (8.7%), P = 0.048). The rate of prophylactic use of carbapenem for 3 days (0 vs. 50%, P = 0.019) and the incidence rate of multiple organ failure (MOF) (0 vs. 57.1%, P = 0.018) were remarkably higher in the carbapenem-resistant Pseudomonas aeruginosa group compared with the carbapenem-sensitive Pseudomonas aeruginosa group. In the multivariate analysis, the severe categories of AP (OR = 13.624, 95% CIs = 1.567–118.491, P = 0.018) and MDR-PA infections (OR = 4.788, 95% CIs = 1.107–20.709, P = 0.036) were independent risk factors for mortality. The resistance rates of MDR-PA strains were low for amikacin (7.4%), tobramycin (3.7%), and gentamicin (18.5%). The resistance rates of MDR-PA strains to imipenem and meropenem were up to, 51.9% and 55.6%, respectively. Conclusion In AP patients, severe categories of AP and MDR-PA infections were both independent risk factors for mortality. Inappropriate use of carbapenem antibiotics and MOF were related to carbapenem-resistant Pseudomonas aeruginosa infections. Amikacin, tobramycin, and gentamicin are recommended for the treatment of AP patients with MDR-PA infections.
Læs mere Tjek på PubMedAndrea Du Toit
Nat Rev Microbiol, 22.05.2023
Tilføjet 22.05.2023
Clinical Infectious Diseases, 22.05.2023
Tilføjet 22.05.2023
Clinical Infectious Diseases, 22.05.2023
Tilføjet 22.05.2023
Surya P. Bhatt, Klaus F. Rabe, Nicola A. Hanania, Claus F. Vogelmeier, Jeremy Cole, Mona Bafadhel, Stephanie A. Christenson, Alberto Papi, Dave Singh, Elizabeth Laws, Leda P. Mannent, Naimish Patel, Heribert W. Staudinger, George D. Yancopoulos, Eric R. Mortensen, Bolanle Akinlade, Jennifer Maloney, Xin Lu, Deborah Bauer, Ashish Bansal, Lacey B. Robinson, Raolat M. Abdulai
New England Journal of Medicine, 22.05.2023
Tilføjet 22.05.2023
Abioye, Ajibola Ibraheem; Hughes, Michael D.; Sudfeld, Christopher R.; Noor, Ramadhani Abdallah; Isanaka, Sheila; Lukmanji, Zohra; Mugusi, Ferdinand; Fawzi, Wafaie W.
Journal of Acquired Immune Deficiency Syndromes, 22.05.2023
Tilføjet 22.05.2023
Objective: Anemia is highly prevalent among people living with HIV (PLWHIV) and is often due to iron deficiency. This study evaluated the relationship of dietary iron intake levels and sources with mortality and clinical outcomes among adults initiating HAART. Design: We conducted a secondary analysis of a multivitamin supplementation trial among 2293 PLWHIV initiating HAART in Dar es Salaam, Tanzania. Methods: Dietary iron intake was assessed with a food frequency questionnaire at HAART initiation, and participants followed until death or censoring. Total, animal and plant-sourced iron were categorized into quartiles. Intake of food groups were categorized into 0 – 1, 2 – 3 and ≥4 servings/wk. Cox proportional models estimated hazard ratios for mortality and incident clinical outcomes. Results: There were 175 deaths (8%). Red meat intake was associated with a lower risk of all-cause mortality (HR: 0.54; 95% CI: 0.35 – 0.83), AIDS-related mortality (HR: 0.49; 95% CI: 0.28 – 0.85) and severe anemia (HR: 0.57; 95% CI: 0.35 – 0.91), when intake ≥4 servings/wk, compared to 0 – 1 servings/wk. Legume intake was a lower risk of associated with all-cause mortality (HR: 0.49; 95% CI: 0.31 – 0.77) and AIDS-related mortality (HR: 0.37; 95% CI: 0.23 – 0.61), when intake ≥4 servings/wk, compared to 0 – 1 servings/wk. While total dietary iron and overall plant-sourced iron intake were not associated with the risk of mortality or HIV-related outcomes, the highest quartile of animal-sourced iron intake was associated with a lower risk of all-cause mortality (HR: 0.56; 95% CI: 0.35, 0.90) and a lower risk of AIDS-related mortality (HR: 0.50; 95% CI: 0.30, 0.90), compared to the lowest quartile. Conclusion: Intake of iron-rich food groups may be associated with a lower risk of mortality and critical HIV-related outcomes among adults initiating HAART. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedChang, Larry W.; Pollard, Rose; Mbabali, Ismail; Anok, Aggrey; Hutton, Heidi; Amico, K. Rivet; Kong, Xiangrong; Mulamba, Jeremiah; Ssekasanvu, Joseph; Long, Amanda; Thomas, Alvin G.; Thomas, Kristin; Bugos, Eva; van Wickle, Kimiko; Kennedy, Caitlin E.; Nalugoda, Fred; Beres, Laura K.; Bollinger, Robert C.; Quinn, Thomas C.; Serwadda, David; Gray, Ronald H.; Wawer, Maria J.; Reynolds, Steven J.; Nakigozi, Gertrude
Journal of Acquired Immune Deficiency Syndromes, 22.05.2023
Tilføjet 22.05.2023
Background: A trial found that a community health worker (CHW) strategy using “Health Scouts” improved HIV care uptake and ART coverage. To better understand outcomes and areas for improvement, we conducted an implementation science evaluation. Methods: Using the RE-AIM framework, quantitative methods included analyses of a community-wide survey (n=1,903), CHW log books, and phone application data. Qualitative methods included in-depth interviews (n=72) with CHWs, clients, staff, and community leaders. Results: 13 Health Scouts logged 11,221 counseling sessions; 2,532 unique clients were counseled. 95.7% (1789/1891) of residents reported awareness of the Health Scouts. Overall, reach (self-reported receipt of counseling) was 30.7% (580/1891). Unreached residents were more likely to be male and HIV seronegative (p
Læs mere Tjek på PubMedVhembo, Tichaona; Baltrusaitis, Kristin; Tierney, Camlin; Owor, Maxensia; Dadabhai, Sufia; Violari, Avy; Theron, Gerhard; Moodley, Dhayendre; Mukwasi-Kahari, Cynthia; George, Kathleen; Shepherd, John; Siberry, George K.; Browning, Renee; Fowler, Mary Glenn; Stranix-Chibanda, Lynda; for the IMPAACT P1084s study team
Journal of Acquired Immune Deficiency Syndromes, 22.05.2023
Tilføjet 22.05.2023
Background: We assessed bone and kidney outcomes in infants randomized post-delivery as mother-infant pairs within the IMPAACT PROMISE trial to maternal TDF-based ART (mART) or infant nevirapine prophylaxis (iNVP) to prevent breastfeeding HIV transmission. Methods: Infants were co-enrolled in the P1084s substudy on randomization day and followed through Week 74. Lumbar spine bone mineral content (LS-BMC) was assessed at entry (6-21 days of life) and Week 26 by dual-energy x-ray absorptiometry. Creatinine clearance (CrCl) was calculated at entry and Weeks 10, 26, and 74. Student t-tests compared mean LS-BMC and CrCl at Week 26 and mean change from entry between arms. Results: Of 400 enrolled infants, mean (standard deviation (sd); n) for entry LS-BMC was 1.68g (0.35; n=363) and CrCl was 64.2mL/min/1.73m2 (24.6; n=357). At Week 26, 98% of infants were breastfeeding and 96% were on their assigned HIV prevention strategy. Mean (sd) Week 26 LS-BMC was 2.64g (0.48) for mART and 2.77g (0.44) for iNVP; mean difference (95% confidence interval (CI)) -0.13g (-0.22, -0.04), P=0.007, n=375/398 (94%). Mean absolute (-0.14g (-0.23, -0.06)) and percent (-10.88% (-18.53, -3.23)) increase in LS-BMC from entry was smaller for mART than iNVP. At Week 26, mean (sd) CrCl was 130.0mL/min/1.73m2 (34.9) for mART vs. 126.1mL/min/1.73m2 (30.0) for iNVP; mean difference (95% CI) 3.8 (-3.0, 10.7), P=0.27, n=349/398 (88%). Conclusion: Week 26 mean LS-BMC was lower in infants in the mART group compared with the iNVP group. However, this difference (∼0.23g) was less than the one-half sd considered potentially clinically relevant. No infant renal safety concerns were observed. Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedEaton, Lisa A.; Layland, Eric A.; Driver, Redd; Kalichman, Seth C.; Kalichman, Moira O.; Watson, Ryan J.; Kalinowski, Jolaade; Chandler, Cristian J.; Earnshaw, Valerie A.
Journal of Acquired Immune Deficiency Syndromes, 22.05.2023
Tilføjet 22.05.2023
Background: Pre-exposure prophylaxis (PrEP) has demonstrated efficacy for HIV prevention, yet uptake of PrEP among populations in urgent need of prevention tools (e.g., Black sexual minority men [BSMM]) is limited, and stigma and medical mistrust remain strong barriers to accessing PrEP. Purpose: To evaluate a test of concept brief intervention to address stigma and medical mistrust as barriers to PrEP uptake using novel latent profile analysis. Methods: Participants (N=177) residing in the southeastern US were randomized to one of four arms to establish the potential impact of a brief, stigma focused counseling intervention (referred to as Jumpstart) to increase PrEP uptake. We estimated intervention effect size (Cramer’s V) for PrEP uptake and then explored differential intervention effects across latent profiles of psychosocial barriers to PrEP use. Results: The intervention resulted in small, but meaningful effect size, with self-reported PrEP uptake increasing across Jumpstart conditions with the control condition reporting 24% uptake and Jumpstart plus text/phone calls (the most intensive intervention arm) reporting 37% uptake, and a similar pattern emerging for biologically confirmed PrEP use. Among participants 30 and older, Jumpstart participants were more likely to move to a post-intervention profile with fewer barriers than control participants and reported the highest uptake of PrEP. Conclusions: Addressing social/emotional barriers to PrEP uptake is an essential component of bridging the gap between advances being made in biomedical forms of HIV prevention, and establishing and supporting access to those advances. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedBroady, Timothy R.; Chan, Curtis; MacGibbon, James; Mao, Limin; Prestage, Garrett; Clifton, Brent; Paynter, Heath; Bavinton, Benjamin R.; Holt, Martin
Journal of Acquired Immune Deficiency Syndromes, 22.05.2023
Tilføjet 22.05.2023
Objective: To assess changes in personal and relationship characteristics among HIV-positive Australian gay and bisexual men (GBM) as rates of antiretroviral therapy (ART) and knowledge and confidence regarding the effectiveness of viral suppression in preventing HIV transmission have increased. Design: Repeated behavioural surveillance of GBM recruited from venues, events, and online in seven Australian states and territories. Methods: HIV-positive participants were included. Trends in demographics, HIV treatment, and relationship characteristics were assessed with binary and multivariable logistic regression. Results: A total of 3,643 survey responses (2016-2020) were included. Over time, HIV-positive GBM became less likely to identify as gay or report an Anglo-Australian ethnicity. The average length of time since HIV diagnosis increased and the frequency of attending HIV-related clinical appointments decreased. There were no changes in the reported number of recent sex partners or proportion reporting regular male partners over time. Among HIV-positive GBM in relationships, the proportion reporting HIV-positive partners decreased, and the proportion reporting HIV-negative partners increased. Levels of condomless sex with regular partners increased over time, however, this was concentrated among HIV-positive GBM in serodiscordant relationships. Conclusion: Findings suggest that increased accessibility and trust in biomedical prevention strategies have contributed to broader relationship and sexual opportunities for HIV-positive GBM in Australia. Our findings suggest future health promotion activities could highlight the social and relationship benefits of to further promote the effectiveness of treatment as prevention to further increase trust in it as an HIV prevention strategy among GBM. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedKnettel, Brandon A.; Amiri, Ismail; Minja, Linda; Martinez, Alyssa J.; Knippler, Elizabeth T.; Madundo, Kim; Staton, Catherine; Vissoci, Joao Ricardo N.; Mwobobia, Judith; Mmbaga, Blandina T.; Kaaya, Sylvia; Relf, Michael V.; Goldston, David B.
Journal of Acquired Immune Deficiency Syndromes, 22.05.2023
Tilføjet 22.05.2023
Background: Suicide is a leading cause of death among people living with HIV (PLWH) worldwide, with suicide deaths occurring twice as frequently among PLWH than among the general public. In Tanzania, resources for mental health care are sorely lacking, with 55 psychiatrists and psychologists providing treatment for 60 million people. In light of this shortage, non-specialists play a crucial role. The objective of this study was to assess feasibility of implementing task-shifted screening, assessment, and safety planning for suicide risk among PLWH. Setting: Two adult HIV clinics in Kilimanjaro, Tanzania. Methods: Registered professional nurses in the HIV clinics were trained to administer brief screening of suicidal ideation in the past month. Patients experiencing suicidal ideation were referred to Bachelor’s-level counselors for further assessment and safety planning, supervised by specialist providers who reviewed audio recordings for quality assurance. Results: During 180 days of implementation, nurses screened patients attending 2745 HIV appointments. Sixty-one (2.2%) endorsed suicidal ideation and were linked to further assessment and safety planning. We cross-checked screening with clinic attendance logs on seven random days and found high fidelity to screening (206/228 screened, 90%). Quality assurance ratings demonstrated key assessment pieces were consistently completed (mean=9.3/10 possible), with “Good” to “Excellent” counseling skills (mean=23.7/28), and “Good” to “Excellent” quality (mean=17.1/20), including appropriate referral for higher levels of care. Conclusions: Brief screening can be implemented and paired with task-shifted counseling to facilitate high-quality assessment of suicide risk. This model shows excellent potential to extend mental health services for PLWH in low-resource settings. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedvan Diepen, Sean; McAlister, Finlay A.; Chu, Luan Manh; Youngson, Erik; Kaul, Padma; Kadri, Sameer S.
Critical Care Medicine, 21.05.2023
Tilføjet 21.05.2023
Objectives: Although COVID-19 vaccines can reduce the need for intensive care unit admission in COVID-19, their effect on outcomes in critical illness remains unclear. We evaluated outcomes in vaccinated patients admitted to the ICU with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and the association between vaccination and booster status on clinical outcomes. Design: Retrospective cohort. Setting and Patients: All patients were admitted to an ICU between January 2021 (after vaccination was available) and July 2022 with a diagnosis of COVID-19 based on a SARS-CoV-2 polymerase chain reaction test in Alberta, Canada. Interventions: None. Measurement: The propensity-matched primary outcome of all-cause in-hospital mortality was compared between vaccinated and unvaccinated patients, and vaccinated patients were stratified by booster dosing. Secondary outcomes were mechanical ventilation (MV) duration ICU length of stay (LOS). Main Results: The study included 3,293 patients: 743 (22.6%) were fully vaccinated (54.6% with booster), 166 (5.0%) were partially vaccinated, and 2,384 (72.4%) were unvaccinated. Unvaccinated patients were more likely to require invasive MV (78.4% vs 68.2%), vasopressor use (71.1% vs 66.6%), and extracorporeal membrane oxygenation (2.1% vs 0.5%). In a propensity-matched analysis, in-hospital mortality was similar (31.8% vs 34.0%, adjusted odds ratio [OR], 1.25; 95% CI, 0.97–1.61), but median duration MV (7.6 vs 4.7 d; p < 0.001) and ICU LOS (6.6 vs 5.2 d; p < 0.001) were longer in unvaccinated compared to fully vaccinated patients. Among vaccinated patients, greater than or equal to 1 booster had lower in-hospital mortality (25.5% vs 40.9%; adjusted OR, 0.50; 95% CI, 0.0.36–0.68) and duration of MV (3.8 vs 5.6 d; p = 0.025). Conclusions: Nearly one in four patients admitted to the ICU with COVID-19 after widespread COVID-19 vaccine availability represented a vaccine-breakthrough case. Mortality risk remains substantial in vaccinated patients and similar between vaccinated and unvaccinated patients after the onset of critical illness. However, COVID-19 vaccination is associated with reduced ICU resource utilization and booster dosing may increase survivability from COVID-19-related critical illness.
Læs mere Tjek på PubMedInternational Journal for Parasitology, 21.05.2023
Tilføjet 21.05.2023
Publication date: Available online 20 May 2023 Source: International Journal for Parasitology Author(s): Andrew Hemphill, Alexandre Leitão, Luis-Miguel Ortega-Mora, Brian M. Cooke
Læs mere Tjek på PubMedXi Zeng, Yuyouye Wang, Binghan Liu, Xinjie Rao, Canhui Cao, Fang Peng, Wenhua Zhi, Ping Wu, Ting Peng, Ye Wei, Tian Chu, Miaochun Xu, Yashi Xu, Wencheng Ding, Guoliang Li, Shitong Lin, Peng Wu
Journal of Medical Virology, 21.05.2023
Tilføjet 21.05.2023
Ejovwokeoghene J. Omohwovo
Journal of Medical Virology, 21.05.2023
Tilføjet 21.05.2023
Chu Xie, Lan‐Yi Zhong, Guo‐Long Bu, Ge‐Xin Zhao, Bo‐Yu Yuan, Yuan‐Tao Liu, Cong Sun, Mu‐Sheng Zeng
Journal of Medical Virology, 21.05.2023
Tilføjet 21.05.2023
Journal of Infectious Diseases, 21.05.2023
Tilføjet 21.05.2023
AbstractBackgroundNVX-CoV2373 is an efficacious COVID-19 vaccine comprising full-length 5-µg recombinant SARS-CoV-2 spike (rS) glycoprotein and Matrix-M™ adjuvant. Phase 2 of a randomized, placebo-controlled, phase 1/2 trial in healthy adults (18-84 years) previously reported good safety/tolerability and robust humoral immunogenicity.MethodsParticipants were randomized to placebo or 1 or 2 doses of 5-µg or 25-µg rS with 50 µg Matrix-M adjuvant 21 days apart. CD4+ T-cell responses to SARS-CoV-2 intact S or pooled peptide stimulation (with ancestral or variant S sequences) were measured via enzyme-linked immunosorbent spot (ELISpot) assay and intracellular cytokine staining (ICCS).ResultsA clearly discernable spike antigen-specific CD4+ T-cell response was induced after 1 dose, but markedly enhanced after 2 doses. Counts and fold-increases in cells producing Th1 cytokines exceeded those secreting Th2 cytokines, although both phenotypes were clearly present. Interferon-γ responses to rS were detected in 93.5% of 2-dose 5-µg recipients. A polyfunctional CD4+ T-cell response was cross-reactive and of equivalent magnitude to all tested variants, including Omicron BA.1/BA.5.ConclusionsNVX-CoV2373 elicits a moderately Th1-biased CD4+ T-cell response that is cross-reactive with ancestral and variant S proteins after 2 doses.Clinical Trial RegistrationNCT04368988.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 21.05.2023
Tilføjet 21.05.2023
AbstractBackgroundKlebsiella pneumoniae liver abscess (KPLA) with extrahepatic migratory infections is defined as invasive KPLA (IKPLA). The type VI secretion system (T6SS) is involved in the pathogenesis of KPLA. We hypothesized that T6SS play a role in the IKPLA.Methods16S rRNA gene sequencing was performed on abscess samples. Polymerase chain reaction (PCR) and reverse transcription (RT)-PCR was used to validate the expression difference of T6SS hallmark genes. In vitro and in vivo experiments were performed to identify the pathogenic feature of T6SS.ResultsPICRUSt2 predicted that the T6SS-related genes were notably enriched in the IKPLA group. PCR detection of T6SS hallmark genes (hcp, vgrG, and icmF) showed that 197 (81.1%) were T6SS-positive strains. The T6SS-positive strains detection rate of IKPLA group was higher than KPLA group (97.1% versus 78.4%; p
Læs mere Tjek på PubMedOstaizka Aizpurua, Kees Blijleven, Urvish Trivedi, M. Thomas P. Gilbert, Antton Alberdi
Trends in Microbiology, 21.05.2023
Tilføjet 21.05.2023
Many microorganisms that are associated with animals partake in, influence, or even drive their hosts’ biological functions [1]. This realisation has led to an intuitive notion that host–microbiota interactions might have shaped the evolutionary trajectories of animals. Large-scale studies spanning dozens of host species and hundreds of microorganisms have revealed patterns (e.g., diet-driven convergence [2], cophylogeny [3], phylosymbiosis [4]) that suggest some relevance of microorganisms for animal evolution.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.05.2023
Tilføjet 21.05.2023
Abstract Background Bacterial meningitis caused by non-typhoid Salmonella can be a fatal condition which is more common in low and middle-income countries. Case presentation We report the case of a Salmonella meningitis in a Belgian six-month old male infant. The first clinical examination was reassuring, but after a few hours, his general state deteriorated. A blood test and a lumbar puncture were therefore performed. The cerebrospinal fluid analysis was compatible with a bacterial meningitis which was later identified by the NRC (National Reference Center) as Salmonella enterica serovar Durban. Conclusions In this paper, we present the clinical presentation, genomic typing, and probable sources of infection for an unusually rare serovar of Salmonella. Through an extended genomic analysis, we established its relationship to historical cases with links to Guinea.
Læs mere Tjek på PubMedMalaria Journal, 20.05.2023
Tilføjet 20.05.2023
Abstract Background The unmet demand for effective malaria transmission-blocking agents targeting the transmissible stages of Plasmodium necessitates intensive discovery efforts. In this study, a bioactive bisbenzylisoquinoline (BBIQ), isoliensinine, from Cissampelos pariera (Menispermaceae) rhizomes was identified and characterized for its anti-malarial activity. Methods Malaria SYBR Green I fluorescence assay was performed to evaluate the in vitro antimalarial activity against D6, Dd2, and F32-ART5 clones, and immediate ex vivo (IEV) susceptibility for 10 freshly collected P. falciparum isolates. To determine the speed- and stage-of-action of isoliensinine, an IC50 speed assay and morphological analyses were performed using synchronized Dd2 asexuals. Gametocytocidal activity against two culture-adapted gametocyte-producing clinical isolates was determined using microscopy readouts, with possible molecular targets and their binding affinities deduced in silico. Results Isoliensinine displayed a potent in vitro gametocytocidal activity at mean IC50gam values ranging between 0.41 and 0.69 µM for Plasmodium falciparum clinical isolates. The BBIQ compound also inhibited asexual replication at mean IC50Asexual of 2.17 µM, 2.22 µM, and 2.39 µM for D6, Dd2 and F32-ART5 respectively, targeting the late-trophozoite to schizont transition. Further characterization demonstrated a considerable immediate ex vivo potency against human clinical isolates at a geometric mean IC50IEV = 1.433 µM (95% CI 0.917–2.242). In silico analyses postulated a probable anti-malarial mechanism of action by high binding affinities for four mitotic division protein kinases; Pfnek1, Pfmap2, Pfclk1, and Pfclk4. Additionally, isoliensinine was predicted to possess an optimal pharmacokinetics profile and drug-likeness properties. Conclusion These findings highlight considerable grounds for further exploration of isoliensinine as an amenable scaffold for malaria transmission-blocking chemistry and target validation.
Læs mere Tjek på PubMedMalaria Journal, 20.05.2023
Tilføjet 20.05.2023
Abstract Background Reducing the risk of recurrent Plasmodium vivax malaria is critical for malaria control and elimination. Primaquine (PQ) is the only widely available drug against P. vivax dormant liver stages, but is recommended as a 14-day regimen, which can undermine adherence to a complete course of treatment. Methods This is a mixed-methods study to assess socio-cultural factors influencing adherence to a 14-day PQ regimen in a 3-arm, treatment effectiveness trial in Papua, Indonesia. The qualitative strand, consisting of interviews and participant observation was triangulated with a quantitative strand in which trial participants were surveyed using a questionnaire. Results Trial participants differentiated between two types of malaria: tersiana and tropika, equivalent to P. vivax and Plasmodium falciparum infection, respectively. The perceived severity of both types was similar with 44.0% (267/607) perceiving tersiana vs. 45.1% (274/607) perceiving tropika as more severe. There was no perceived differentiation whether malaria episodes were due to a new infection or relapse; and 71.3% (433/607) acknowledged the possibility of recurrence. Participants were familiar with malaria symptoms and delaying health facility visit by 1–2 days was perceived to increase the likelihood of a positive test. Prior to health facility visits, symptoms were treated with leftover drugs kept at home (40.4%; 245/607) or bought over the counter (17.0%; 103/607). Malaria was considered to be cured with ‘blue drugs’ (referring to dihydroartemisinin-piperaquine). Conversely, ‘brown drugs,’ referring to PQ, were not considered malaria medication and instead were perceived as supplements. Adherence to malaria treatment was 71.2% (131/184), in the supervised arm, 56.9% (91/160) in the unsupervised arm and 62.4% (164/263) in the control arm; p = 0.019. Adherence was 47.5% (47/99) among highland Papuans, 51.7% (76/147) among lowland Papuans, and 72.9% (263/361) among non-Papuans; p
Læs mere Tjek på PubMedMalaria Journal, 20.05.2023
Tilføjet 20.05.2023
Abstract Background Malaria remains one of the most serious public health problems in sub-Saharan Africa and Mozambique is the world\'s fourth largest contributor, with 4.7% of disease cases and 3.6% of total deaths due to malaria. Its control relies on the fight against the vector and treatment of confirmed cases with anti-malarial drugs. Molecular surveillance is an important tool for monitoring the spread of anti-malarial drug resistance. Methods A cross-sectional study recruited 450 participants with malaria infection detected by Rapid Diagnostic Tests, from three different study sites (Niassa, Manica and Maputo) between April and August 2021. Correspondent blood samples were collected on filter paper (Whatman® FTA® cards), parasite DNA extracted and pfk13 gene sequenced using Sanger method. SIFT software (Sorting Intolerant From Tolerant) was used, predict whether an amino acid substitution affects protein function. Results No pfkelch13-mediated artemisinin resistance gene mutation was detected in this study settings. However, non-synonymous mutations were detected at prevalence of 10.2%, 6% and 5% in Niassa, Manica and Maputo, respectively. Most (56.3%) of the reported non-synonymous mutations were due to substitution at the first base of the codon, 25% at the second base and 18.8% at the third base. Additionally, 50% of non-synonymous mutations showed a SIFTscore bellow cut off value of 0.05, therefore, they were predicted to be deleterious. Conclusion These results do not show an emergence of artemisinin resistance cases in Mozambique. However, the increased number of novel non-synonymous mutations highlights the relevance of increasing the number of studies focused on the molecular surveillance of artemisinin resistance markers, for its early detection.
Læs mere Tjek på PubMedEmerging Infectious Diseases, 20.05.2023
Tilføjet 20.05.2023
Such complications occurred in 60% of patients and were associated with high-grade parasitemia, renal failure, and history of diabetes mellitus.
Læs mere Tjek på PubMedEmerging Infectious Diseases, 20.05.2023
Tilføjet 20.05.2023
Emerging Infectious Diseases, 20.05.2023
Tilføjet 20.05.2023
Research Letter - Microscopic Evidence of Malaria Infection in Visceral Tissue from Medici Family, Italy
Læs mere Tjek på PubMedEmerging Infectious Diseases, 20.05.2023
Tilføjet 20.05.2023
Research Letter - Mycobacterium marinum Infection after Iguana Bite in Costa Rica
Læs mere Tjek på PubMedEmerging Infectious Diseases, 20.05.2023
Tilføjet 20.05.2023
We describe 3 cases of this rare condition in France and review the literature on previous cases.
Læs mere Tjek på PubMedEmerging Infectious Diseases, 20.05.2023
Tilføjet 20.05.2023
Dispatch - Enterovirus D68 Outbreak in Children, Finland, August-September 2022
Læs mere Tjek på PubMedEmerging Infectious Diseases, 20.05.2023
Tilføjet 20.05.2023
Synopsis - Association of Persistent Symptoms after Lyme Neuroborreliosis and Increased Levels of Interferon-α in Blood
Læs mere Tjek på PubMedEmerging Infectious Diseases, 20.05.2023
Tilføjet 20.05.2023
Research - Increased Incidence of Legionellosis after Improved Diagnostic Methods, New Zealand, 2000-2020
Læs mere Tjek på PubMedPatrick O. Hanafin, Andrea Kwa, Alexandre P. Zavascki, Ana Maria Sandri, Marc H. Scheetz, Christine J. Kubin, Jayesh Shah, Benjamin P.Z. Cherng, Michael T. Yin, Jiping Wang, Lu Wang, David P. Calfee, Maureen Bolon, Jason M. Pogue, Anthony W. Purcell, Roger L. Nation, Jian Li, Keith S. Kaye, Gauri G. Rao
Clinical Microbiology and Infection, 20.05.2023
Tilføjet 20.05.2023
To develop a population pharmacokinetic (PK) model with data from the largest polymyxin B-treated patient population studied to date to optimise its dosing in hospitalised patients.
Læs mere Tjek på PubMedJun-Dong Wu, Jing-Xin Li, Jian Liu, Hao-Meng Wang, Guang-Hui Zhou, Jin Li, Dou Wu, Xiang Chen, Yan Feng, Xiao-Yuan Qi, Xue Wang, Jin-Bo Gou, Tie-Liang Ma, Xiao-Yun Yang, Li-Feng Xu, Peng Wan, Tao Zhu, Zhong-Fang Wang, Feng-Cai Zhu, CanSino COVID-19 Study Group
Lancet Infectious Diseases, 20.05.2023
Tilføjet 20.05.2023
Both the administration of mRNA vaccine CS-2034 and inactivated vaccine BBIBP-CorV as a fourth dose were well tolerated. Heterologous boosting with mRNA vaccine CS-2034 induced higher immune responses and protection against symptomatic SARS-CoV-2 omicron infections compared with homologous boosting, which could support the emergency use authorisation of CS-2034 in adults.
Læs mere Tjek på PubMed