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BMC Infectious Diseases, 27.02.2024
Tilføjet 27.02.2024
Abstract Background The presence of untreated sexually transmitted infections (STIs) significantly increases the chance of acquiring HIV. In Brazil, testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) among Pre-Exposure Prophylaxis (PrEP) users is insufficient, and syndromic treatment is a priority in clinical practice. Multi-site testing for CT/NG improves thescreening of asymptomatic cases and ensures timely treatment. Therefore, it is essential for HIV prevention. This study aims to test the importance of two-site testing for better screening of these pathogens and to determine whether the presence of symptoms is an indicator of CT/NG infection. Methods This is a cross-sectional study carried out in four public infectious diseases clinics in São Paulo State, Brazil between January of 2022 and March of 2023. All participants had an anal swab and a first-pass or mid-stream urine collected for CT/NG analysis by Polymerase chain reaction (PCR). Data about sociodemographic, sexual behavioural and clinical aspects were collected. Pathway analysis was used to examine the direct and indirect relationships between variables according to the theoretical model. Results We screened 171 PrEP users which had two samples collected, resulting in 342 samples. Comparing the anatomic sites, the urine samples showed lower sensitivity for CT and NG than anal samples. Gonorrhoea was directly linked to lower age (β= -0.161, p = 0.001). Time of PrEP use was directly associated with CT infection (β = 0.202; p = 0.042) and inversely associated with dysuria (β= -0.121, p = 0.009). Lower occurrence of yellow-green secretion was linked to detection of CT (β= -0.089, p = 0.005) and NG (β= -0.048, p = 0.002) infections. Foul-smelling discharge was directly associated with CT (β = 0.275, p = 0.004) and NG (β = 0.295, p = 0.037) infection. Conclusion The symptoms are a bad indicator of CT and NG infection, and the screening must be done in more than one site since most of the positive results would be missed if only urines were tested. In the case of testing only one anatomical site, specifically the urethra, the CT/NG incidence and prevalence would be underestimated. The two-sites testing improves detection rates of CT/NG, and PrEP follow-up benefits people offering STI testing.
Læs mere Tjek på PubMedPaulo Cesar Pereira dos Santos, Nicole Louise Messina, Roberto Dias de Oliveira, Patricia Vieira da Silva, Marco Antonio Moreira Puga, Margareth Dalcolmo, Glauce dos Santos, Marcus Vinícius Guimarães de Lacerda, Bruno Araújo Jardim, Fernando Fonseca de Almeida e Val, Nigel Curtis, Jason R Andrews, Julio Croda
Lancet Infectious Diseases, 27.02.2024
Tilføjet 27.02.2024
BCG-Denmark vaccination did not reduce initial QFT Plus conversion risk in Brazilian health-care workers. This finding underscores the need to better understand tuberculosis prevention in populations at high risk.
Læs mere Tjek på PubMedAlexandra D. Peterson, Mindy M. Kibbey, Samantha G. Farris
PLoS One Infectious Diseases, 26.02.2024
Tilføjet 26.02.2024
by Alexandra D. Peterson, Mindy M. Kibbey, Samantha G. Farris Health anxiety, which is defined as fear of having or contracting serious physical illness, is particularly salient in light of the COVID-19 pandemic. We conducted a mixed methods study in which 578 narrative samples were analyzed using Linguistic Inquiry and Word Count (LIWC) software to determine linguistic markers from six LIWC categories relevant to cognitive-behavioral features of health anxiety. Broad linguistic predictors were analyzed through three backward elimination regression models in order to inform subcategory predictors of each area of health anxiety. Thus, both broad and specific linguistic predictors of general health anxiety, virus-relevant body vigilance, and fears of viral contamination were examined. Greater use of affective category words in written narratives predicted general health anxiety, as well as body vigilance and viral contamination fears. These findings represent the first direct demonstration of linguistic analysis of health anxiety and provide nuanced information about the nature and etiology of health anxiety.
Læs mere Tjek på PubMedBethlehem Abera Tekleyohannes, Yared Mamushet Yifru, Beshir Bedru Nasir
PLoS One Infectious Diseases, 26.02.2024
Tilføjet 26.02.2024
by Bethlehem Abera Tekleyohannes, Yared Mamushet Yifru, Beshir Bedru Nasir Background The world continues to be challenged by the Coronavirus disease 2019 (COVID-19) and preventive measures like maintaining social distancing and lockdowns challenge patients to attend regular follow-ups and get a refill for medication that causes adherence problems. Hence, this study attempts to assess the impact of COVID-19 on treatment follow-up and medication adherence among patients with epilepsy. Method A total of 276 patients with epilepsy were enrolled in the study. Data collection was carried out through medical record reviews and patient interviews. Patients who visited Zewditu Memorial Hospital from August to September 2021 and those who had follow-up at least for two years before the outbreak of the pandemic were included. The data was analyzed using SPSS v.24. Result About 69.6% of patients were adherent to their treatment and 83.3% of the patients had a seizure-free period of less than 1 year. Ninety (32.6%) of the participants missed their treatment follow-up during the pandemic, mainly due to fear of being infected with COVID-19. Sixty-eight (24.6%) patients have experienced increased seizure episodes during the pandemic as compared to the previous times. Moreover, 56 (20.3%) participants were not taking their antiseizure medications (ASMs) during the pandemic because of the unavailability of medications and they discontinued hospital visits for their medication refills. Among those who missed their treatment follow-up, 20% had seizure-related physical injuries. Only educational level has a significant association with visiting health facilities during the pandemic. Thus, participants who completed college and above (OR = 2.58, 95% CI (1.32–6.38)) were more likely to attend their follow-up during the pandemics as compared to participants who can’t read and write. Conclusion The present study revealed that COVID-19 might have impacts on treatment follow-up and medication adherence due to fear of infection, travel restrictions and the indirect impact on the availability and affordability of medications. These might lead to poor treatment outcomes like increased seizure frequency and seizure-related physical injuries.
Læs mere Tjek på PubMedDaniela P. Ladner, Michael Gmeiner, Bima J. Hasjim, Nikhilesh Mazumder, Raymond Kang, Emily Parker, John Stephen, Praneet Polineni, Anna Chorniy, Lihui Zhao, Lisa B. VanWagner, Ronald T. Ackermann, Charles F. Manski
PLoS One Infectious Diseases, 26.02.2024
Tilføjet 26.02.2024
by Daniela P. Ladner, Michael Gmeiner, Bima J. Hasjim, Nikhilesh Mazumder, Raymond Kang, Emily Parker, John Stephen, Praneet Polineni, Anna Chorniy, Lihui Zhao, Lisa B. VanWagner, Ronald T. Ackermann, Charles F. Manski Background Liver cirrhosis is a chronic disease that is known as a “silent killer” and its true prevalence is difficult to describe. It is imperative to accurately characterize the prevalence of cirrhosis because of its increasing healthcare burden. Methods In this retrospective cohort study, trends in cirrhosis prevalence were evaluated using administrative data from one of the largest national health insurance providers in the US. (2011–2018). Enrolled adult (≥18-years-old) patients with cirrhosis defined by ICD-9 and ICD-10 were included in the study. The primary outcome measured in the study was the prevalence of cirrhosis 2011–2018. Results Among the 371,482 patients with cirrhosis, the mean age was 62.2 (±13.7) years; 53.3% had commercial insurance and 46.4% had Medicare Advantage. The most frequent cirrhosis etiologies were alcohol-related (26.0%), NASH (20.9%) and HCV (20.0%). Mean time of follow-up was 725 (±732.3) days. The observed cirrhosis prevalence was 0.71% in 2018, a 2-fold increase from 2012 (0.34%). The highest prevalence observed was among patients with Medicare Advantage insurance (1.67%) in 2018. Prevalence increased in each US. state, with Southern states having the most rapid rise (2.3-fold). The most significant increases were observed in patients with NASH (3.9-fold) and alcohol-related (2-fold) cirrhosis. Conclusion Between 2012–2018, the prevalence of liver cirrhosis doubled among insured patients. Alcohol-related and NASH cirrhosis were the most significant contributors to this increase. Patients living in the South, and those insured by Medicare Advantage also have disproportionately higher prevalence of cirrhosis. Public health interventions are important to mitigate this concerning trajectory of strain to the health system.
Læs mere Tjek på PubMedB. Sajeewa Amaradasa, Chuansheng Mei, Yimeng He, Robert L. Chretien, Mitchell Doss, Tim Durham, Scott Lowman
PLoS One Infectious Diseases, 26.02.2024
Tilføjet 26.02.2024
by B. Sajeewa Amaradasa, Chuansheng Mei, Yimeng He, Robert L. Chretien, Mitchell Doss, Tim Durham, Scott Lowman The use of fungicides to manage disease has led to multiple environmental externalities, including resistance development, pollution, and non-target mortality. Growers have limited options as legacy chemistry is withdrawn from the market. Moreover, fungicides are generally labeled for traditional soil-based production, and not for liquid culture systems. Biocontrol agents for disease management are a more sustainable and environmentally friendly alternative to conventional agroprotectants. Pythium ultimum is a soil borne oomycete plant pathogen with a broad taxonomic host range exceeding 300 plants. Cucumber seedlings exposed to P. ultimum 1 day after a protective inoculation with bacterial endophyte accession IALR1619 (Pseudomonas sp.) recorded 59% survival; with the control assessed at 18%. When the pathogen was added 5 days post endophyte inoculation, 74% of the seedlings treated survived, compared to 36% of the control, indicating a longer-term effect of IALR1619. Under hydroponic conditions, IALR1619 treated leaf type lettuce cv. ‘Cristabel’ and Romaine cv. ‘Red Rosie’ showed 29% and 42% higher shoot fresh weight compared to their controls, respectively. Similar results with less growth decline were observed for a repeat experiment with IALR1619. Additionally, an experiment on hydroponic lettuce in pots with perlite was carried out with a mixture of P. ultimum and P. dissotocum after IALR1619 inoculation. The endophyte treated ‘Cristabel’ showed fresh weight gain, but the second cultivar ‘Pensacola’ yielded no increase. In summary, the endophyte IALR1619 provided short term as well as medium-term protection against Pythium blight in cucumber seedlings and may be used as an alternative to conventional fungicides in a greenhouse setting. This study also demonstrated the potential of ALR1619 as a biocontrol agent against Pythium blight in hydroponic lettuce.
Læs mere Tjek på PubMedJerin Lee, Jenna Wilson, Benjamin Oosterhoff, Natalie J. Shook
PLoS One Infectious Diseases, 26.02.2024
Tilføjet 26.02.2024
by Jerin Lee, Jenna Wilson, Benjamin Oosterhoff, Natalie J. Shook Social isolation and disconnectedness increase the risk of worse mental health, which might suggest that preventive health measures (i.e., self-quarantining, social distancing) negatively affect mental health. This longitudinal study examined relations of self-quarantining and social distancing with mental health during the COVID-19 pandemic. A U.S. national sample (N = 1,011) completed eight weekly online surveys from March 20, 2020 to May 17, 2020. Surveys assessed self-quarantining, social distancing, anxiety, and depression. Fixed-effect autoregressive cross-lagged models provided a good fit to the data, allowing for disaggregation of between-person and within-person effects. Significant between-person effects suggested those who engaged in more self-quarantining and social distancing had higher anxiety and depression compared to those who engaged in less social distancing and quarantining. Significant within-person effects indicated those who engaged in greater social distancing for a given week experienced higher anxiety and depression that week. However, there was no support for self-quarantining or social distancing as prospective predictors of mental health, or vice versa. Findings suggest a relationship between mental health and both self-quarantining and social distancing, but further longitudinal research is required to understand the prospective nature of this relationship and identify third variables that may explain these associations.
Læs mere Tjek på PubMedMarcia Facey, Nancy Baxter, Melanie Hammond Mobilio, Elizabeth Peter, Carol-anne Moulton, Elise Paradis
PLoS One Infectious Diseases, 26.02.2024
Tilføjet 26.02.2024
by Marcia Facey, Nancy Baxter, Melanie Hammond Mobilio, Elizabeth Peter, Carol-anne Moulton, Elise Paradis Background Charting is an essential component of professional nursing practice and is arguably a key element of patient safety in surgery: without proper, objective, and timely documentation, both benign and tragical errors can occur. From surgery on wrong patients to wrong limbs, to the omission of antibiotics administration, many harms can happen in the operating room. Documentation has thus served as a safeguard for patient safety, professional responsibility, and professional accountability. In this context, we were puzzled by the practices we observed with respect to charting compliance with the surgical safety checklist (SSC) during a study of surgical teams in a large, urban teaching hospital in Canada (pseudonym ‘C&C’). Methods This article leverages institutional ethnography and a subset of data from a larger study to describe and explain the social organisation of the system that monitored surgical safety compliance at C&C from the standpoint of operating room nurses. This data included fieldnotes from observations of 51 surgical cases, on-the-spot interviews with nurses, formal interviews with individuals who were involved in the design and implementation of the SSC, and open-ended questions from two rounds of survey of OR teams. Findings We found that the compliance form and not the SSC itself formed the basis for reporting. To meet hospital accuracy in charting goals and legislated compliance documentation reporting requirements nurses ‘pre-charted’ compliance with the surgical checklist. The adoption of this workaround technically violated nursing charting principles and put them in ethically untenable positions. Conclusions Documenting compliance of the SSC constituted a moral hazard, constrained nurses’ autonomy and moral agency, and obscured poor checklist adherence. The findings highlight how local and extra local texts, technologies and relations create ethical issues, raise questions about the effectiveness of resulting data for decision-making and contribute to ongoing conversations about nursing workarounds.
Læs mere Tjek på PubMedJudith I. Tsui, Sarah L. Rossi, Debbie M. Cheng, Sally Bendiks, Marina Vetrova, Elena Blokhina, Michael Winter, Natalia Gnatienko, Miroslav Backonja, Kendall Bryant, Evgeny Krupitsky, Jeffrey H. Samet
PLoS One Infectious Diseases, 26.02.2024
Tilføjet 26.02.2024
by Judith I. Tsui, Sarah L. Rossi, Debbie M. Cheng, Sally Bendiks, Marina Vetrova, Elena Blokhina, Michael Winter, Natalia Gnatienko, Miroslav Backonja, Kendall Bryant, Evgeny Krupitsky, Jeffrey H. Samet Background To estimate the effects on pain of two medications (low-dose naltrexone and gabapentin) compared to placebo among people with HIV (PWH) with heavy alcohol use and chronic pain. Methods We conducted a pilot, randomized, double-blinded, 3-arm study of PWH with chronic pain and past-year heavy alcohol use in 2021. Participants were recruited in St. Petersburg, Russia, and randomized to receive daily low-dose naltrexone (4.5mg), gabapentin (up to 1800mg), or placebo. The two primary outcomes were change in self-reported pain severity and pain interference measured with the Brief Pain Inventory from baseline to 8 weeks. Results Participants (N = 45, 15 in each arm) had the following baseline characteristics: 64% male; age 41 years (SD±7); mean 2 (SD±4) heavy drinking days in the past month and mean pain severity and interference were 3.2 (SD±1) and 3.0 (SD±2), respectively. Pain severity decreased for all three arms. Mean differences in change in pain severity for gabapentin vs. placebo, and naltrexone vs. placebo were -0.27 (95% confidence interval [CI] -1.76, 1.23; p = 0.73) and 0.88 (95% CI -0.7, 2.46; p = 0.55), respectively. Pain interference decreased for all three arms. Mean differences in change in pain interference for gabapentin vs. placebo, and naltrexone vs. placebo was 0.16 (95% CI -1.38, 1.71; p = 0.83) and 0.40 (95% CI -1.18, 1.99; p = 0.83), respectively. Conclusion Neither gabapentin nor low-dose naltrexone appeared to improve pain more than placebo among PWH with chronic pain and past-year heavy alcohol use. Clinical trial registration ClinicalTrials.gov (NCT4052139).
Læs mere Tjek på PubMedKarolina Pich, Natalia Respekta, Patrycja Kurowska, Christelle Rame, Kamil Dobrzyń, Nina Smolińska, Joëlle Dupont, Agnieszka Rak
PLoS One Infectious Diseases, 26.02.2024
Tilføjet 26.02.2024
by Karolina Pich, Natalia Respekta, Patrycja Kurowska, Christelle Rame, Kamil Dobrzyń, Nina Smolińska, Joëlle Dupont, Agnieszka Rak Omentin (ITLN1) is a novel adipokine mainly expressed in the white adipose tissue. It plays a crucial role in the metabolic homeostasis and insulin sensitivity. Our last study documented that ITLN1 levels in the adipose tissue and plasma are lower in fat Meishan (MS) compared to normal weight Large White (LW) pigs. The aim of this study was to investigate transcript and protein concentrations of ITLN1 as well as its immunolocalisation in the ovarian follicles and examine the molecular mechanism involved in the regulation of its expression in response to gonadotropins (FSH, LH) and steroids (P4, T, E2). Ovarian follicles were collected from LW and MS sows on days 2–3, 10–12, and 14–16 of the oestrous. We found the elevated ITLN1 expression in the ovarian follicles and the increase of concentrations in follicular fluid (FF) of LW pigs vs MS pigs; in both breeds of pigs, the levels of ITLN1 increased with the oestrous progression. We noted ITLN1 signals in oocyte, granulosa and theca cells. Gonadotropins and steroids increased ITLN1 levels in the ovarian follicle cells of LW pigs, while in MS pigs, we observed only the stimulatory effect of LH and T. Both extracellular signal-regulated kinase (ERK1/2) and phosphatidylinositol 3′-kinase (PI3K) were involved in the regulation of ITLN1. Our study demonstrated the levels and regulation of ITLN1 in the porcine ovarian follicles through ERK1/2 and PI3K signaling pathways.
Læs mere Tjek på PubMedAdrian Jochim-Vukosavic, Frank Schwab, Leonard Knegendorf, Dirk Schlüter, Franz-Christoph Bange, Ella Ebadi, Claas Baier
PLoS One Infectious Diseases, 26.02.2024
Tilføjet 26.02.2024
by Adrian Jochim-Vukosavic, Frank Schwab, Leonard Knegendorf, Dirk Schlüter, Franz-Christoph Bange, Ella Ebadi, Claas Baier Vancomycin-resistant enterococci (VRE) occur in hospitalized patients, causing both infection and colonization. In recent years, there has been an increase in VRE in German and other hospitals, raising the question of how to control this epidemic best. To better understand the specific epidemiology and to guide infection control, we conducted a retrospective cohort study analyzing all patients with VRE at Hannover Medical School, a tertiary university clinic in Germany that specializes in solid organ transplantation. Epidemiologic and clinical characteristics of patients with VRE from 2015–2017 were collected. Basic epidemiologic parameters, including VRE incidence and incidence density, were calculated. Independent risk factors for nosocomial VRE infection compared to colonization were assessed using a logistic regression model. There were 1,492 VRE cases corresponding to 822 individual patients. The incidence was 0.8 VRE cases per 100 cases. A total of 536 (35.9%) of the 1,492 VRE cases were acquired nosocomially. Of the 1,492 cases, 912 cases had VRE-positive samples (894 Enterococcus (E.) faecium and 18 E. faecalis) in our hospital laboratory and the remaining cases were known VRE carriers. The vanB-phenotype was observed in 369 of the 894 (41.3%) E. faecium isolates and in 6 of the 18 (33.3%) E. faecalis isolates. There was an increase over time in the vanB-phenotype proportion in E. faecium (2015: 63 of 171, 36.8%, 2016: 115 of 322, 35.7% and 2017: 191 of 401, 47.6%). A total of 107 cases had a VRE infection (7.2% of all VRE cases) according to the criteria of the German National Reference Center for Surveillance of Nosocomial Infections. The remaining cases were only colonized. Among other factors, leukocytopenia (
Læs mere Tjek på PubMedShouwen Du, Yuhang Wang, Jiamin Wang, Yidan Ma, Wang Xu, Xiaoshuang Shi, Letian Li, Pengfei Hao, Quan Liu, Ming Liao, Boping Zhou, Ningyi Jin, Yin K. Wong, Lifen Hu, Jigang Wang, Wei Liu, Chang Li
Journal of Medical Virology, 26.02.2024
Tilføjet 26.02.2024
Lijuan Zhang, Yan Ju, Haixu Hu, Chunhui Ma, Yanju Yu, Yan Huang, Lili Gong, Wei Zhao, Yujia Liu, Yi Liu, Lihong Bian
Journal of Medical Virology, 26.02.2024
Tilføjet 26.02.2024
Xu Ou‐Yang, Yang Cao, Qihao Leng, Yan Wang, Hang Yi, Guochao Zhang
Journal of Medical Virology, 26.02.2024
Tilføjet 26.02.2024
Ifeorah M. Ijeomah, Faleye O. C. Temitope, De Coninck Lander, Agbaje T. Sheriff, George E. Uwem, Onoja A. Bernard, Olayinka A. Oluseyi, Oni I. Elijah, Ajileye G. Toluwani, Oragwa O. Arthur, Akinleye E. Toluwanimi, Popoola O. Bolutife, Osasona G. Damilola, Olayinka O. Titilola, George A. Oluwadamilola, Ahmed I. Muhammad, Komolafe I. Omotosho, Adeniji A. Johnson, Matthijnssens Jelle, Adewumi M. Olubusuyi
Journal of Medical Virology, 26.02.2024
Tilføjet 26.02.2024
Patrick Wu, Chin‐Yuan Yii, Su‐Boon Yong
Journal of Medical Virology, 26.02.2024
Tilføjet 26.02.2024
Nicolas Fortin, Mathilde Hénaut, Nathalie Goyette, René Maltais, Jean‐Yves Sancéau, André Marette, Donald Poirier, Yacine Abed, Guy Boivin
Journal of Medical Virology, 26.02.2024
Tilføjet 26.02.2024
Adrian R. Martineau, Shruthi Chandran, Winnie Palukani, Patricia Garrido, Jonathan Mayito, Stephen T Reece, Divya Tiwari
International Journal of Infectious Diseases, 26.02.2024
Tilføjet 26.02.2024
Mycobacterium tuberculosis (Mtb) is a major human pathogen, responsible for an estimated 10.6 million cases of active tuberculosis (TB) and 1.3 million deaths worldwide in 2022.[1] Most adult cases of active TB arise from progression of asymptomatic Mtb infection, whose global prevalence has been estimated at 23%.[2] Risk of progression from infection to disease can be significantly reduced by administration of preventive antimicrobial therapy,[3] and global roll-out of this intervention will be needed to achieve the World Health Organization (WHO) target of TB elimination by 2050.
Læs mere Tjek på PubMedChristopher da Costa, Christine S Benn, Thomas Nyirenda, Evans Mpabalwani, Harleen M.S. Grewal, Rizwan Ahmed, Nathan Kapata, Peter S Nyasulu, Markus Maeurer, David S Hui, Delia Goletti, Alimuddin Zumla
International Journal of Infectious Diseases, 26.02.2024
Tilføjet 26.02.2024
Tuberculosis, caused by the bacterium Mycobacterium tuberculosis, is responsible for an estimated 1.3 million deaths each year, despite effective treatment being available for the past six decades. Progress in the development and point of care rollout of improved vaccines, diagnostics and treatments has been very slow, and TB remains a neglected global health problem. Moreover, access to available WHO recommended TB diagnostics and treatment regimens for all forms of TB remains a major challenge, especially in low- and middle-income countries, where 80% of annual TB case load occurs [1].
Læs mere Tjek på PubMedMarek Petráš, Daniela Janovská, Danuše Lomozová, Martina Franklová, Pavel Dlouhý, Jozef Rosina, Ivana Králová Lesná
International Journal of Infectious Diseases, 26.02.2024
Tilføjet 26.02.2024
The SARS-CoV-2 pandemic necessitated the implementation of specific measures to minimize its impact on global public health. Non-pharmaceutical precautions played a crucial role in preventing the massive spread of SARS-CoV-2.[1] However, it was widely recognized that only widespread and global vaccination could effectively bring the virus under control.[2] The rapid development of various types of vaccines, supported by numerous countries and international organizations, was successfully completed within less than a year, enabling the commencement of widespread vaccination of the world\'s population in December 2020.
Læs mere Tjek på PubMedLaverdure Sylvain, Kazadi Donatien, Kone Kadidia, Callier Viviane, Dabitao Djeneba, Dennis Dehkontee, Haidara Mory Cherif, Hunsberger Sally, Mbaya Olivier Tshiani, Ridzon Renee, Sereti Irini, Shaw-Saliba Katy, the InVITE Study Team
International Journal of Infectious Diseases, 26.02.2024
Tilføjet 26.02.2024
In the four years since COVID-19 was declared a global pandemic on March 11, 2020, more than 760 million cases have been reported worldwide leading to a death toll of almost 7 million people [1]. During the first year of the pandemic, while high rates of SARS-CoV-2 infections were reported globally, initial reports suggested that infection rates were significantly lower in sub-Saharan Africa than in other parts of the world [2,3]. Subsequent studies revealed that although seroprevalence was rapidly increasing in sub-Saharan African countries during the start of the pandemic, it was estimated that less than 1% of infections were detected [4].
Læs mere Tjek på PubMedGunilla Källenius, Margarida Correia-Neves, Christopher Sundling
International Journal of Infectious Diseases, 26.02.2024
Tilføjet 26.02.2024
There is a need to identify biomarkers to predict progression and to diagnose TB disease at an early stage. Following infection with Mtb, only about 10% of individuals progress to TB disease, while the majority mount a protective immune response that clears the infection or controls it in the long term [1]. Those Individuals whose immune system exhibit measurable memory response to Mtb are termed Mtb-immunoreactive. The immune profile of Mtb-immunoreactive individuals, without TB disease, reflects a more protective pattern compared to individuals with TB disease, who have failed to control Mtb growth [2].
Læs mere Tjek på PubMedSudhasini Panda, Kendall Kearns, Catherine Cheng, Cecilia S. Lindestam Arlehamn
International Journal of Infectious Diseases, 26.02.2024
Tilføjet 26.02.2024
Tuberculosis (TB) is an airborne infectious disease caused by Mycobacterium tuberculosis (Mtb). The stages of Mtb infection exist on a continuum, ranging from an eliminated infection to contagious TB disease. Standard diagnostics for determining whether someone has latent, non-infectious TB include the tuberculin skin test (TST) and interferon-γ release assay (IGRA). However, due to the complexity of the Mtb infection and heterogeneity between individuals, there is currently a debate whether it is correct to use IGRA to determine the presence of truly “latent” TB infection (LTBI), i.e., which can reactivate to the contagious form of the disease, as a positive result can be due to memory T cell responses, which may not be indicative of current infection [1].
Læs mere Tjek på PubMedMulugeta Molla Birhanu, Ayse Zengin, Rohina Joshi, Roger G. Evans, Kartik Kalyanram, Kamakshi Kartik, Michaela A. Riddell, Oduru Suresh, Velandai K. Srikanth, Simin Arabshahi, Nihal Thomas, Amanda G. Thrift
Tropical Medicine & International Health, 26.02.2024
Tilføjet 26.02.2024
Clinical Infectious Diseases, 26.02.2024
Tilføjet 26.02.2024
Abstract Background The duration of the protective effect of TB preventive therapy (TPT) is controversial. Some studies have found that the protective effect of TPT is lost after cessation of therapy among people living with HIV in settings with very high tuberculosis incidence, but others have found long-term protection in low incidence settings.Methods We estimated the incidence rate (IR) of new tuberculosis disease (TB) for up to 12 years after randomization to four months of rifampin or nine months of isoniazid, among 991 Brazilian participants in a TPT trial in the state of Rio de Janeiro, with incidence 68.6/100,000 population in 2022. Adjusted hazard ratios (aHR) of independent variables for incident TB were calculated.Results Overall TB incidence rate (IR) was 1.7 (1.01; 2.7)/1,000 person years (PY). The TB IR among those who did not complete TPT was higher than in those who completed [2.9/1000 PY (95% CI: 1.3; 5.6) versus 1.1/1000 PY (95% CI: 0.4; 2.3), IR ratio (IRR)= 2.7 (95% CI: 1.0; 7.2)]. TB IR was higher within 28 months after randomization [IR: 3.5/1000 PY (1.6; 6.6) PY, compared to 1.1/1000 PY (95% CI: 0.5; 2.1) between 28 and 143 months, IRR= 3.1, 95% CI: 1.2-8.2]. Treatment non-completion was the only variable associated with incident TB [aHR= 3.2 (1.1; 9.7)].Conclusion In a mostly HIV non-infected population, a complete course of TPT conferred long-term protection against tuberculosis.
Læs mere Tjek på PubMedInfection, 26.02.2024
Tilføjet 26.02.2024
Infection, 26.02.2024
Tilføjet 26.02.2024
Infection, 26.02.2024
Tilføjet 26.02.2024
Infection, 26.02.2024
Tilføjet 26.02.2024
Abstract Purpose This aimed to identify the factors associated with severe/critical coronavirus disease 2019 (COVID-19) infection in rheumatoid arthritis (RA) patients. Methods Two-hundred RA patients diagnosed according to the American College of Rheumatology/ European League Against Rheumatism (ACR/EULAR) classification criteria with proven COVID-19 infection were recruited and categorized according to the world health organization (WHO) COVID-19 severity grading into 2 groups: patients with mild/moderate COVID-19 (n = 164) and patients with severe/critical COVID-19 (n = 36). Comparison between both groups was done to identify the risk factors associated with severe/critical infection. Incidence of RA disease activity flare defined as increase in clinical disease activity index (CDAI) more than 10 points following infection was calculated. Results Multivariate analysis identified history of previous serious infection, age > 60 years, and diabetes as factors positively associated, whereas COVID-19 vaccination was negatively associated with severe/critical infection. Following COVID-19 infection, the number of patients with severe/critical COVID-19 who had high RA disease activity and the incidence of flares was significantly higher in comparison to patients with mild/moderate COVID-19 (P 60 years, diabetes, and history of previous serious infections are risk factors for severe/critical COVID-19, while vaccination has a protective role in RA patients. Infection particularly when severe is associated with risk of disease flare.
Læs mere Tjek på PubMedInfection, 26.02.2024
Tilføjet 26.02.2024
Abstract Purpose This study examined the characteristics, incidence and prognostic factors of the first AIDS-defining condition developed after more than one year of continuous antiretroviral therapy (ART) among people living with HIV (PLHIV). Methods We used data from two multicentre observational cohorts of PLHIV in Germany between 1999 and 2018. Our outcome was the first AIDS-defining event that occurred during follow-up after more than one year of continuous ART. Descriptive analyses at ART initiation, at the time of the AIDS event and of the most frequently observed types of AIDS-defining illnesses were performed. We calculated the incidence rate (IR) per 1000 person-years (PY) and used a bootstrap stepwise selection procedure to identify predictors of the outcome. Results A total of 12,466 PLHIV were included in the analyses. 378 developed the outcome, constituting an overall IR of 5.6 (95% CI 5.1–6.2) AIDS events per 1000 PY. The majority of PLHIV was virally suppressed at the time of the event. Oesophageal candidiasis and wasting syndrome were the most frequently diagnosed AIDS-defining illnesses. We found a low CD4 count at ART initiation, a previous AIDS-defining condition and transmission through intravenous drug use to be meaningful prognostic factors of the outcome. Conclusion The overall rate of AIDS-defining events among PLHIV under long-term ART was low, highlighting the importance of continuous treatment. PLHIV who started ART with indicators of impaired immune functioning were more susceptible to disease progression, suggesting that the public health response should continue to focus on early and sustained treatment for all PLHIV.
Læs mere Tjek på PubMedInfection, 26.02.2024
Tilføjet 26.02.2024
Abstract Purpose Sepsis suspicion by Emergency Medical Services (EMS) is associated with improved patient outcomes. This study assessed sepsis incidence and recognition by EMS and analyzed which of the screening tools recommended by the Surviving Sepsis Campaign best facilitates sepsis prediction. Methods Retrospective cohort study of claims data from health insurances (n = 221,429 EMS cases), and paramedics’ and emergency physicians’ EMS documentation (n = 110,419); analyzed outcomes were: sepsis incidence and case fatality compared to stroke and myocardial infarction, the extent of documentation for screening-relevant variables and sepsis suspicion, tools’ intersections for screening positive in identical EMS cases and their predictive ability for an inpatient sepsis diagnosis. Results Incidence of sepsis (1.6%) was similar to myocardial infarction (2.6%) and stroke (2.7%); however, 30-day case fatality rate was almost threefold higher (31.7% vs. 13.4%; 11.8%). Complete vital sign documentation was achieved in 8.2% of all cases. Paramedics never, emergency physicians rarely (0.1%) documented a sepsis suspicion, respectively septic shock. NEWS2 had the highest sensitivity (73.1%; Specificity:81.6%) compared to qSOFA (23.1%; Sp:96.6%), SIRS (28.2%; Sp:94.3%) and MEWS (48.7%; Sp:88.1%). Depending on the tool, 3.7% to 19.4% of all cases screened positive; only 0.8% in all tools simultaneously. Conclusion Incidence and mortality underline the need for better sepsis awareness, documentation of vital signs and use of screening tools. Guidelines may omit MEWS and SIRS as recommendations for prehospital providers since they were inferior in all accuracy measures. Though no tool performed ideally, NEWS2 qualifies as the best tool to predict the highest proportion of septic patients and to rule out cases that are likely non-septic.
Læs mere Tjek på PubMedInfection, 26.02.2024
Tilføjet 26.02.2024
Abstract Background Infectious etiologies of lower respiratory tract infections (LRTIs) by the conventional microbiology tests (CMTs) can be challenging. Metagenomic next-generation sequencing (mNGS) has great potential in clinical use for its comprehensiveness in identifying pathogens, particularly those difficult-to-culture organisms. Methods We analyzed a total of 205 clinical samples from 201 patients with suspected LRTIs using mNGS in parallel with CMTs. mNGS results were used to guide treatment adjustments for patients who had negative CMT results. The efficacy of treatment was subsequently evaluated in these patients. Results mNGS-detected microorganisms in 91.7% (188/205) of the clinical samples, whereas CMTs demonstrated a lower detection rate, identifying microorganisms in only 37.6% (77/205) of samples. Compared to CMT results, mNGS exhibited a detection sensitivity of 93.5% and 95.4% in all 205 clinical samples and 180 bronchoalveolar lavage fluid (BALF) samples, respectively. A total of 114 patients (114/201; 56.7%) showed negative CMT results, among which 92 received treatment adjustments guided by their positive mNGS results. Notably, 67.4% (62/92) of patients demonstrated effective treatment, while 25% (23/92) experienced a stabilized condition. Subgroup analysis of cancer patients revealed that 41.9% (13/31) exhibited an effective response to treatment, and 35.5% (11/31) maintained a stable condition following medication adjustments guided by mNGS. Conclusion mNGS demonstrated great potential in identifying microorganisms of clinical significance in LRTIs. The rapid turnaround time and reduced susceptibility to the impact of antimicrobial administration make mNGS a valuable supplementary tool for diagnosis and treatment decision-making for suspected LRTIs in clinical practice.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 25.02.2024
Tilføjet 25.02.2024
Abstract Klebsiella pneumoniae is the leading cause of neonatal sepsis and is increasingly difficult to treat due to antibiotic resistance. Vaccination represents a tractable approach to combat this resistant bacterium; however, there is currently not a licensed vaccine. Surface polysaccharides, including O-antigens of lipopolysaccharide, have long been attractive candidates for vaccine inclusion. Herein we describe the generation of a bioconjugate vaccine targeting seven predominant O-antigen subtypes in K. pneumoniae. Each bioconjugate was immunogenic in isolation, with limited cross-reactivity among subtypes. Vaccine-induced antibodies demonstrated varying degrees of binding to a wide variety of K. pneumoniae strains. Further, sera from vaccinated mice induced complement-mediated killing of many of these strains. Finally, increased capsule interfered with O-antigen antibodies’ ability to bind and mediate killing of some K. pneumoniae strains. Taken together, these data indicate that this novel heptavalent O-antigen bioconjugate vaccine formulation exhibits limited efficacy against some, but not all, K. pneumoniae isolates.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 25.02.2024
Tilføjet 25.02.2024
Abstract Background Atypical/Nor98 scrapie (AS) is an idiopathic infectious prion disease affecting sheep and goats. Recent findings suggest that zoonotic prions from bovine spongiform encephalopathy (C-BSE) may co-propagate with atypical/Nor98 prions in AS sheep brains. Investigating the risk AS poses to humans is crucial.Methods To assess the risk of sheep/goat-to-human transmission of AS, we serially inoculated brain tissue from field and laboratory isolates into transgenic mice overexpressing human prion protein (Met129 allele). We studied clinical outcomes as well as presence of prions in brains and spleens.Results No transmission occurred on the primary passage, with no clinical disease or pathological prion protein in brains and spleens. On subsequent passages, one isolate gradually adapted, manifesting as prions with a phenotype resembling those causing MM1-type sporadic Creutzfeldt-Jakob disease in humans. However, further characterization using in vivo and in vitro techniques confirmed both prion agents as different strains, revealing a case of phenotypic convergence. Importantly, no C-BSE prions emerged in these mice, especially in the spleen, which is more permissive than the brain for C-BSE cross-species transmission.Conclusions The results obtained suggest a low the zoonotic for AS. Rare adaptation may allow the emergence of prions phenotypically resembling those spontaneously forming in humans.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 25.02.2024
Tilføjet 25.02.2024
HCVHIVdirect acting antiviralsnon-invasive liver fibrosis markerstransient elastometryTIMP-1
Læs mere Tjek på PubMedJournal of Infectious Diseases, 25.02.2024
Tilføjet 25.02.2024
Abstract Background Chlamydia trachomatis (CT) testing and treatment strategies have not decreased infection rates, justifying need for a CT vaccine. A murine study showed that a vaccine consisting of MOMP and 4 polymorphic membrane proteins (Pmps E, F, G, H) elicited protective immunity; studies on human cellular immune responses to Pmps are sparse.Methods Interferon gamma (IFN-γ) responses to these 5 CT proteins were measured by ELISPOT in PBMCs from women returning for treatment of a positive CT screening test. Responses were compared in those with spontaneous CT clearance vs. persisting infection at baseline and no reinfection vs. reinfection at a 3-month follow-up visit.Results IFN-γ response to one or more proteins was detected in 39% at baseline and 51.5% at follow-up; PmpE and MOMP most often elicited positive responses. IFN-γ responses to MOMP were detected less often at follow-up vs. baseline in women with reinfection, but were maintained in those without reinfection. Women with spontaneous clearance had a higher magnitude of IFN-γ response to PmpE and MOMP.Conclusions IFN-γ responses to these 5 CT vaccine candidate proteins were heterogenous and primarily directed against MOMP and PmpE. Spontaneous clearance of infection and absence of reinfection may be clinical correlates of protection.
Læs mere Tjek på PubMedInfection, 25.02.2024
Tilføjet 25.02.2024
BMC Infectious Diseases, 25.02.2024
Tilføjet 25.02.2024
Abstract Objective To evaluate the efficacy of urokinase (UK) treatment for tuberculous pleural effusion (TPE). Methods We searched Chinese biomedical literature database, WanFang data, CNKI, PubMed, EMbase, Web of Science and The Cochrane Library for the randomized controlled trials (RCTs) of urokinase treatment for tuberculous pleurisy from January 2000 to February 2023. Pleural tuberculosis, urokinase and randomized controlled trial were used as keywords. The eligible studies were meta-analyzed by using Revman 5.4.1: risk of bias was assessed, mean difference (MD) and 95% CI were used for continuous variables, pooled studies were conducted using random-effects or fixed-effects models, forest plots were drawn to analyze efficacy, and funnel plots were drawn to discuss publication bias. Results Twenty-nine RCTs were included. The meta-analyzed results showed that, on the basis of routine anti-tuberculosis, comparison between the treatment group treated with urokinase and the control group treated with antituberculosis alone, the time of pleural effusion absorption [MD-5.82, 95%CI (− 7.77, − 3.87); P
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.02.2024
Tilføjet 25.02.2024
Abstract Background While there is a high burden of methicillin-resistant Staphylococcus aureus (MRSA) infections among pediatric patients, studies on the molecular epidemiology of MRSA infections in Korean children since the 2010s are lacking. This study aimed to investigate the molecular genotypes and clinical characteristics of MRSA isolates from children with MRSA bacteremia at Asan Medical Center Children’s Hospital from 2016 to 2021. Methods Clinical data were retrospectively reviewed, and the molecular types of MRSA were determined using multilocus sequence typing (MLST) and Staphylococcal cassette chromosome mec (SCCmec) typing. Results The overall methicillin resistance rate of S. aureus bacteremia was 44.8% (77/172); 49.5% in the period 2016–2018 (period 1) and 37.3% in the period 2019–2021 (period 2) (P = 0.116). Community-acquired infections accounted for only 3.9% of cases. The predominant ST group was ST72 group (67.6%), followed by ST5 group (18.9%) and ST1 group (5.4%). The proportion of ST5 was significantly lower in period 2 compared to period 1 (P = 0.02). Compared to the ST5 and ST1 groups, the ST72 group exhibited lower overall antibiotic resistance and multidrug-resistant (MDR) rates (12.0% [6/50] in ST72 group vs. 100.0% [14/14] in ST5 group vs. 50.0% [2/4] in ST1 group; P
Læs mere Tjek på PubMedMalaria Journal, 24.02.2024
Tilføjet 24.02.2024
Abstract Background Gabon still bears significant malaria burden despite numerous efforts. To reduce this burden, policy-makers need strategies to design effective interventions. Besides, malaria distribution is well known to be related to the meteorological conditions. In Gabon, there is limited knowledge of the spatio-temporal effect or the environmental factors on this distribution. This study aimed to investigate on the spatio-temporal effects and environmental factors on the distribution of malaria prevalence among children 2–10 years of age in Gabon. Methods The study used cross-sectional data from the Demographic Health Survey (DHS) carried out in 2000, 2005, 2010, and 2015. The malaria prevalence was obtained by considering the weighting scheme and using the space–time smoothing model. Spatial autocorrelation was inferred using the Moran’s I index, and hotspots were identified with the local statistic Getis-Ord General Gi. For the effect of covariates on the prevalence, several spatial methods implemented in the Integrated Nested Laplace Approximation (INLA) approach using Stochastic Partial Differential Equations (SPDE) were compared. Results The study considered 336 clusters, with 153 (46%) in rural and 183 (54%) in urban areas. The prevalence was highest in the Estuaire province in 2000, reaching 46%. It decreased until 2010, exhibiting strong spatial correlation (P
Læs mere Tjek på PubMedInfectious Disease Modelling, 24.02.2024
Tilføjet 24.02.2024
Publication date: Available online 23 February 2024 Source: Infectious Disease Modelling Author(s): Marta C. Nunes, Edward Thommes, Holger Fröhlich, Antoine Flahault, Julien Arino, Marc Baguelin, Matthew Biggerstaff, Gaston Bizel-Bizellot, Rebecca Borchering, Giacomo Cacciapaglia, Simon Cauchemez, Alex Barbier––Chebbah, Carsten Claussen, Christine Choirat, Monica Cojocaru, Catherine Commaille-Chapus, Chitin Hon, Jude Kong, Nicolas Lambert, Katharina B. Lauer
Læs mere Tjek på PubMedTetsuo Yamaguchi, Kenji Furuno, Kohji Komori, Tomoko Abe, Takahiro Sato, Shinji Ogihara, Kotaro Aoki, Yoshikazu Ishii, Kazuhiro Tateda
Clinical Microbiology and Infection, 24.02.2024
Tilføjet 24.02.2024
Globally, the isolation of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) harbouring both the Panton–Valentine leucocidin (PVL) and toxic shock syndrome toxin 1 (TSST-1) genes is rare. However, we encountered an outbreak of the ST22-PT clone exhibiting this phenotype in Japan. Notably, the TSST-1 gene was duplicated in most of the strains. This study aimed to elucidate the mechanisms underlying this gene duplication.
Læs mere Tjek på PubMedClinical & Experimental Immunology, 24.02.2024
Tilføjet 24.02.2024
Abstract Chronic immune activation from persistent malaria infections can induce immunophenotypic changes associated with T cell exhaustion. However, associations between T and B cells during chronic exposure remain undefined. We analyzed peripheral blood mononuclear cells from malaria-exposed pregnant women from Papua New Guinea and Spanish malaria-naïve individuals using flow cytometry to profile T cell exhaustion markers phenotypically. T cell lineage (CD3, CD4, CD8), inhibitory (PD1, TIM3, LAG3, CTLA4, 2B4) and senescence (CD28-) markers were assessed. Dimensionality reduction methods revealed increased PD1, TIM3, and LAG3 expression in malaria-exposed individuals. Manual gating confirmed significantly higher frequencies of PD1+CD4+ and CD4+, CD8+, and double-negative (DN) T cells expressing TIM3 in malaria-exposed individuals. Increased frequencies of T cells co-expressing multiple markers were also found in malaria-exposed individuals. T cell data were analyzed with B cell populations from a previous study where we reported an alteration of B cell subsets, including increased frequencies of atypical memory B cells (aMBC) and reduction in marginal zone-like (MZ-like) B cells during malaria exposure. Frequencies of aMBC subsets and MZ-like B cells expressing CD95+ had significant positive correlations with CD4+ and DN T cells expressing CD28+PD1+TIM3+ and CD28+TIM3+2B4+CD8+ T cells. Frequencies of aMBC, known to associate with malaria anemia, were inversely correlated with hemoglobin levels in malaria-exposed women. Similarly, inverse correlations with hemoglobin levels were found for TIM3+CD8+ and CD28+PD1+TIM3+CD4+ T cells. Our findings provide further insights into the effects of chronic malaria exposure on circulating B and T cell populations, which could impact immunity and responses to vaccination.
Læs mere Tjek på PubMedCheng, L., Kong, J., Xie, X., Zhang, L., Zhang, F.
BMJ Open, 24.02.2024
Tilføjet 24.02.2024
ObjectivesEnsuring that children receive timely vaccinations is paramount for preventing infectious diseases, and parental attitude plays a pivotal role in this process. This study addresses this gap in the existing literature by examining parental attitudes towards vaccinating their children. DesignA cross-sectional study. MethodsAn online survey including parents’ sociodemographic characteristics, risk perception and attitudes towards child vaccination towards COVID-19 was conducted. The modified large-scale group decision-making approach for practicality and binary logistic regression was used to identify the predictors influencing parents’ decision-making. ResultsOf the 1292 parents participated, 957 (74.1%) were willing to vaccinate their children, while 335 (25.9%) refused the vaccination. The study indicated that age, parental anxiety regarding child vaccination, concerns about the child’s susceptibility to the disease, opinions towards vaccination benefits versus disadvantages, place of residence, average family income and children’s health were significant predictors (p
Læs mere Tjek på PubMedLovendorf, M. B., Johansen, J. D., Skov, L.
BMJ Open, 24.02.2024
Tilføjet 24.02.2024
IntroductionPsoriasis, atopic dermatitis and contact dermatitis are common chronic inflammatory skin diseases that have a significant impact on individuals and society. Methods and analysisThe Copenhagen Translational Skin Immunology Biobank and Research Programme (BIOSKIN) is a translational biobank and research study that aims to prospectively collect high-quality biological samples and clinical data from 3000 patients with psoriasis, atopic dermatitis and contact dermatitis over a minimum period of 5 years. The longitudinal open design allows participants to enter and leave the study at different time points depending on their disease and treatment course. At every visit, the investigator collects biological samples, conducts interviews and assembles self-reported questionnaires on disease-specific and general health-related information. Clinical examination and biological sampling will be conducted at enrolment, during and after disease flare, before and after initiation of new treatment and at least once per year. The clinical examination includes dermatological verification of diagnosis, evaluation of disease severity and detailed information on phenotype. The biological samples include blood and when accessible and relevant, skin biopsies, tape strips and skin swabs. The data collected will undergo rigorous statistical analysis using appropriate analytical methods. As of December 2023, 825 patients have been enrolled in the study. Ethics and disseminationThe study is approved by the Scientific Ethical Committee of the Capital Region (H-21032986) and the Danish Data Protection Agency. Results will be published in peer-reviewed scientific journals and presented at national and international conferences.
Læs mere Tjek på PubMedLu, H., Chen, H., Liang, S., Zhu, Q., Tan, G., Pang, X., Ruan, Y., Li, J., Ge, X., Huang, Y., Chen, Z., Zhang, S., Cai, W., Lan, G., Lin, M.
BMJ Open, 24.02.2024
Tilføjet 24.02.2024
ObjectivesTo evaluate the diagnostic performance of urine HIV antibody rapid test kits in screening diverse populations and to analyse subjects’ willingness regarding reagent types, purchase channels, acceptable prices, and self-testing. DesignsDiagnostic accuracy studies ParticipantsA total of 2606 valid and eligible samples were collected in the study, including 202 samples from female sex workers (FSWs), 304 persons with injection drug use (IDU), 1000 pregnant women (PW), 100 subjects undergoing voluntary HIV counselling and testing (VCT) and 1000 students in higher education schools or colleges (STUs). Subjects should simultaneously meet the following inclusion criteria: (1) being at least 18 years old and in full civil capacity, (2) signing an informed consent form and (3) providing truthful identifying information to ensure that the subjects and their samples are unique. ResultsThe sensitivity, specificity and area under the curve (AUC) of the urine HIV-1 antibody rapid test kits were 92.16%, 99.92% and 0.960 (95% CI: 0.952 to 0.968, p
Læs mere Tjek på PubMedMorin, K. A., Tatangelo, M., Marsh, D.
BMJ Open, 24.02.2024
Tilføjet 24.02.2024
PurposeThe Canadian Addiction Treatment Centre (CATC) cohort was established during a period of increased provision of opioid agonist treatment (OAT), to study patient outcomes and trends related to the treatment of opioid use disorder (OUD) in Canada. The CATC cohort’s strengths lie in its unique physician network, shared care model and event-level data, making it valuable for validation and integration studies. The CATC cohort is a valuable resource for examining OAT outcomes, providing insights into substance use trends and the impact of service-level factors. ParticipantsThe CATC cohort comprises 32 246 people who received OAT prescriptions between April 2014 and February 2021, with ongoing tri-annual updates planned until 2027. The cohort includes data from all CATC clinics’ electronic medical records and includes demographic information and OAT clinical indicators. Findings to dateThis cohort profile describes the demographic and clinical characteristics of patients being treated in a large OAT physician network. As well, we report the longitudinal OAT retention by treatment type during a time of increasing exposure to a contaminated dangerous drug supply. Notable findings also include retention differences between methadone (32% of patients at 1 year) and buprenorphine (20% at 1 year). Previously published research from this cohort indicated that patient-level factors associated with retention include geographic location, concurrent substance use and prior treatment attempts. Service-level factors such as telemedicine delivery and frequency of urine drug screenings also influence retention. Additionally, the cohort identified rising OAT participation and a substantial increase in fentanyl use during the COVID-19 pandemic. Future plansFuture research objectives are the longitudinal evaluation of retention and flexible modelling techniques that account for the changes as patients are treated with OAT. Furthermore, future research aims are the use of conditional models, and linkage with provincial-level administrative datasets.
Læs mere Tjek på PubMedQixia LuoPing LuYunbo ChenPing ShenBeiwen ZhengJinru JiChaoqun YingZhiying LiuYonghong XiaoState Key Laboratory for Diagnosis and Treatment of Infectious Diseases; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Medical School, College of medicine, Zhejiang University, Hangzhou, People’s Republic of China
Emerg Microbes Infect, 24.02.2024
Tilføjet 24.02.2024