Pub Date : 2025-02-01DOI: 10.1016/j.jiph.2025.102661
Antonio Anastasia , Walter Mazzucco , Luca Pipitò , Santo Fruscione , Roberta Gaudiano , Marcello Trizzino , Maurizio Zarcone , Antonio Cascio
Background
HIV infection has been associated with an increased risk of cancer development and Kaposi’s sarcoma, non-Hodgkin’s lymphoma, and invasive cervical cancers have been a manifestation of AIDS. With the advent of antiretroviral therapy, a collateral appearance of non-AIDS defining cancers (NADC) has been observed in HIV positive patients.
Methods
From January 1997 to December 2022, we performed an observational cross-sectional study, involving HIV-infected outpatients with both AIDS-defining cancers (ADC) and NADC, followed up in a tertiary hospital in Italy.
Results
Overall, 153 cases of malignancy were observed, with a higher percentage of NADC (60.8 %) rather than ADC (39.2 %). Mean age at tumour diagnosis was significantly lower for ADC than for NADC in HIV positive individuals (p-value= 0.001). No statistical difference was found between the mean values of zenith HIV-RNA and CD4 count in HIV outpatients with cancer and in those without cancer, while a statistically significant difference was found between the HIV-RNA zenith in HIV outpatients with ADC as compared with NADC (10.2 copies/mL versus 8.1 copies/mL; p-value= 0.007).
Conclusions
Our study revealed a considerably high proportion of non-AIDS defining malignancies in HIV individuals, emphasizing the need to improve the management of these cancer patients at follow up according to the risk profiles and the changing epidemiology.
{"title":"Malignancies in people living with HIV: A 25-years observational study from a tertiary hospital in Italy","authors":"Antonio Anastasia , Walter Mazzucco , Luca Pipitò , Santo Fruscione , Roberta Gaudiano , Marcello Trizzino , Maurizio Zarcone , Antonio Cascio","doi":"10.1016/j.jiph.2025.102661","DOIUrl":"10.1016/j.jiph.2025.102661","url":null,"abstract":"<div><h3>Background</h3><div>HIV infection has been associated with an increased risk of cancer development and Kaposi’s sarcoma, non-Hodgkin’s lymphoma, and invasive cervical cancers have been a manifestation of AIDS. With the advent of antiretroviral therapy, a collateral appearance of non-AIDS defining cancers (NADC) has been observed in HIV positive patients.</div></div><div><h3>Methods</h3><div>From January 1997 to December 2022, we performed an observational cross-sectional study, involving HIV-infected outpatients with both AIDS-defining cancers (ADC) and NADC, followed up in a tertiary hospital in Italy.</div></div><div><h3>Results</h3><div>Overall, 153 cases of malignancy were observed, with a higher percentage of NADC (60.8 %) rather than ADC (39.2 %). Mean age at tumour diagnosis was significantly lower for ADC than for NADC in HIV positive individuals (p-value= 0.001). No statistical difference was found between the mean values of zenith HIV-RNA and CD4 count in HIV outpatients with cancer and in those without cancer, while a statistically significant difference was found between the HIV-RNA zenith in HIV outpatients with ADC as compared with NADC (10.2 copies/mL versus 8.1 copies/mL; p-value= 0.007).</div></div><div><h3>Conclusions</h3><div>Our study revealed a considerably high proportion of non-AIDS defining malignancies in HIV individuals, emphasizing the need to improve the management of these cancer patients at follow up according to the risk profiles and the changing epidemiology.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 2","pages":"Article 102661"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-29DOI: 10.1016/j.jiph.2025.102688
Geunsoo Jang , Jihyeon Kim , Robin N. Thompson , Hyojung Lee
Background
Vaccination has played a key role in limiting the impacts of COVID-19. Even though the acute phase of the COVID-19 pandemic is now over, the potential for substantial numbers of cases and deaths due to novel SARS-CoV-2 variants remains. In the Republic of Korea, a strategy of vaccinating individuals in high-risk groups annually began in October 2023.
Methods
We used mathematical modeling to assess the effectiveness of alternative vaccination strategies under different assumptions about the number of available vaccine doses. An age-structured transmission model was developed using vaccination and seropositivity data. Various vaccination scenarios were considered, taking into account the effect of undetected or unreported cases (with different levels of reporting by age group): S1: prioritizing vaccination towards the oldest individuals; S2: prioritizing vaccination towards the youngest individuals; and S3: spreading vaccines among all age groups.
Results
Our analysis reveals three key findings. First, administering vaccines to older age groups reduces the number of deaths, while instead targeting younger individuals reduces the number of infections. Second, with approximately 6,000,000 doses available annually, it is recommended that older age groups are prioritized for vaccination, achieving a substantial reduction in the number of deaths compared to a scenario without vaccination. Finally, since case detection (and subsequent isolation) affects transmission, the number of cumulative cases was found to be affected substantially by changes in the reporting rate.
Conclusions
In conclusion, vaccination and case detection (facilitated by contact tracing) both play important roles in limiting the impacts of COVID-19. The mathematical modeling approach presented here provides a framework for assessing the effectiveness of different vaccination strategies in scenarios with limited vaccine supply.
{"title":"Modeling vaccination prioritization strategies for post-pandemic COVID-19 in the Republic of Korea accounting for under-reporting and age-structure","authors":"Geunsoo Jang , Jihyeon Kim , Robin N. Thompson , Hyojung Lee","doi":"10.1016/j.jiph.2025.102688","DOIUrl":"10.1016/j.jiph.2025.102688","url":null,"abstract":"<div><h3>Background</h3><div>Vaccination has played a key role in limiting the impacts of COVID-19. Even though the acute phase of the COVID-19 pandemic is now over, the potential for substantial numbers of cases and deaths due to novel SARS-CoV-2 variants remains. In the Republic of Korea, a strategy of vaccinating individuals in high-risk groups annually began in October 2023.</div></div><div><h3>Methods</h3><div>We used mathematical modeling to assess the effectiveness of alternative vaccination strategies under different assumptions about the number of available vaccine doses. An age-structured transmission model was developed using vaccination and seropositivity data. Various vaccination scenarios were considered, taking into account the effect of undetected or unreported cases (with different levels of reporting by age group): S1: prioritizing vaccination towards the oldest individuals; S2: prioritizing vaccination towards the youngest individuals; and S3: spreading vaccines among all age groups.</div></div><div><h3>Results</h3><div>Our analysis reveals three key findings. First, administering vaccines to older age groups reduces the number of deaths, while instead targeting younger individuals reduces the number of infections. Second, with approximately 6,000,000 doses available annually, it is recommended that older age groups are prioritized for vaccination, achieving a substantial reduction in the number of deaths compared to a scenario without vaccination. Finally, since case detection (and subsequent isolation) affects transmission, the number of cumulative cases was found to be affected substantially by changes in the reporting rate.</div></div><div><h3>Conclusions</h3><div>In conclusion, vaccination and case detection (facilitated by contact tracing) both play important roles in limiting the impacts of COVID-19. The mathematical modeling approach presented here provides a framework for assessing the effectiveness of different vaccination strategies in scenarios with limited vaccine supply.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 4","pages":"Article 102688"},"PeriodicalIF":4.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143099922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-27DOI: 10.1016/j.jiph.2025.102684
Kinkar Ghosh , Selim Reza Tony , Khaleda Islam , Reaz Mobarak , Md. Jahangir Alam , Md. Kamruzzaman , Sumaira Alam , Muhammad Talha , Abdullah Al Faisal , Nahidul Islam , Md Mobarok Hossain , Mst. Noorjahan Begum , Mustafizur Rahman
Background
Dengue fever is the most rapidly spreading mosquito-borne disease and has grown to be a major public health issue, especially in tropical nations like Bangladesh. Globally, children, adolescents, and young adults bear the largest burden of Dengue; the infection rate is highest among infants. However, the epidemiology of pediatric dengue virus infection has been poorly explored in Bangladesh.
Materials and Methods
This study was carried out at the Bangladesh Shishu Hospital & Institute from July to October 2023. Among 1102 admitted patients, 722 who were positive for dengue rapid test were enrolled.
Results
The highest number of positive patients were 1-5 years old (38%) followed by 5-10 years (32%). Vomiting (49%) was most common after fever (100%). 71% of patients showed warning signs, with 17 deaths. All patients received antibiotics, and the number of different antibiotics increased with hospital stay. Real-time RT-PCR was conducted on purposively selected 104 rapid test positives and 50 negatives for serotyping. DENV-2 was the most predominant serotype (80%), followed by DENV-3 (20%).
Conclusion
This study underscored the need for targeted public health interventions, especially for children with warning signs, to address the high burden of pediatric dengue infection in Bangladesh.
{"title":"Epidemiology of pediatric dengue virus infection, Scenario from a tertiary level hospital in Bangladesh","authors":"Kinkar Ghosh , Selim Reza Tony , Khaleda Islam , Reaz Mobarak , Md. Jahangir Alam , Md. Kamruzzaman , Sumaira Alam , Muhammad Talha , Abdullah Al Faisal , Nahidul Islam , Md Mobarok Hossain , Mst. Noorjahan Begum , Mustafizur Rahman","doi":"10.1016/j.jiph.2025.102684","DOIUrl":"10.1016/j.jiph.2025.102684","url":null,"abstract":"<div><h3>Background</h3><div>Dengue fever is the most rapidly spreading mosquito-borne disease and has grown to be a major public health issue, especially in tropical nations like Bangladesh. Globally, children, adolescents, and young adults bear the largest burden of Dengue; the infection rate is highest among infants. However, the epidemiology of pediatric dengue virus infection has been poorly explored in Bangladesh.</div></div><div><h3>Materials and Methods</h3><div>This study was carried out at the Bangladesh Shishu Hospital & Institute from July to October 2023. Among 1102 admitted patients, 722 who were positive for dengue rapid test were enrolled.</div></div><div><h3>Results</h3><div>The highest number of positive patients were 1-5 years old (38%) followed by 5-10 years (32%). Vomiting (49%) was most common after fever (100%). 71% of patients showed warning signs, with 17 deaths. All patients received antibiotics, and the number of different antibiotics increased with hospital stay. Real-time RT-PCR was conducted on purposively selected 104 rapid test positives and 50 negatives for serotyping. DENV-2 was the most predominant serotype (80%), followed by DENV-3 (20%).</div></div><div><h3>Conclusion</h3><div>This study underscored the need for targeted public health interventions, especially for children with warning signs, to address the high burden of pediatric dengue infection in Bangladesh.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 4","pages":"Article 102684"},"PeriodicalIF":4.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143099919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-27DOI: 10.1016/j.jiph.2025.102682
Khalid Salman , Sittna Hayder El Nagar , Abdel Rahim M. El Hussein , Mohammed A. El Hussein , Hadi M. Yassine , Hebah A. Al Khatib , Mashael Ali Al- Badr , Ibrahim Farah , Khalid A. Enan
Background
Patients with haematological disorders, such as sickle cell anaemia, are at an elevated risk of transient aplastic crisis due to parvovirus B19 infection. The virus targets specific integration sites in the human genome, disrupting cellular division. However, the molecular mechanisms of infection remain poorly understood.
Aim
This study aimed to determine the prevalence of human parvovirus B19 among patients with sickle cell anaemia in Khartoum State, Sudan.
Methods
Ninety patients (aged <5 to >15 years) with sickle cell disease attending Gaafer Ibnouaf Children’s Hospital between November 2016 and February 2017 were recruited. Sera and plasma samples were analyzed. IgG and IgM antibodies were measured using ELISA, and viral DNA was detected in plasma using nested-PCR. Phylogenetic analysis of sequenced B19 strains focused on the overlapping region of the minor (VP1) and major (VP2) capsid protein genes.
Results
Anti-parvovirus B19 IgG antibodies were detected in 57 of 90 patients (63.3 %), while IgM antibodies were present in 7 (7.8 %). Viral DNA was identified in 23 (25.5 %) patients. Among the 23 DNA-positive patients, 7 (30 %) were seronegative for both IgG and IgM antibodies, highlighting the importance of molecular diagnostics in identifying active infections, especially in early stages. Children under 5 years of age exhibited a higher nucleic acid detection rate compared to older age groups, suggesting the importance of molecular testing in younger patients particularly in the early detection of Parvovirus B19 during the acute phase of infection, before the body has developed detectable antibodies and also in immunocompromised children, who may not mount an antibody response detectable by serological methods. Phylogenetic analysis revealed two distinct Sudanese clusters: one (50 % of sequences) formed a unique clade with low similarity to existing genotypes, while the other (50 %) closely resembled genotype 1 A sequences from Iraq, Iran, and Tanzania.
Conclusion
Parvovirus B19 antibodies and DNA were detected at high prevalence among Sudanese children with sickle cell anaemia. Screening for parvovirus B19 is critical for patients requiring blood transfusions, particularly those with haematological disorders. This study provides the first report of parvovirus B19 detection, sequencing, and characterization among Sudanese patients with sickle cell anaemia.
{"title":"First report of serological, molecular detection, and characterization of human parvovirus B19 infections among sickle cell anaemia patients in Khartoum State, Sudan","authors":"Khalid Salman , Sittna Hayder El Nagar , Abdel Rahim M. El Hussein , Mohammed A. El Hussein , Hadi M. Yassine , Hebah A. Al Khatib , Mashael Ali Al- Badr , Ibrahim Farah , Khalid A. Enan","doi":"10.1016/j.jiph.2025.102682","DOIUrl":"10.1016/j.jiph.2025.102682","url":null,"abstract":"<div><h3>Background</h3><div>Patients with haematological disorders, such as sickle cell anaemia, are at an elevated risk of transient aplastic crisis due to parvovirus B19 infection. The virus targets specific integration sites in the human genome, disrupting cellular division. However, the molecular mechanisms of infection remain poorly understood.</div></div><div><h3>Aim</h3><div>This study aimed to determine the prevalence of human parvovirus B19 among patients with sickle cell anaemia in Khartoum State, Sudan.</div></div><div><h3>Methods</h3><div>Ninety patients (aged <5 to >15 years) with sickle cell disease attending Gaafer Ibnouaf Children’s Hospital between November 2016 and February 2017 were recruited. Sera and plasma samples were analyzed. IgG and IgM antibodies were measured using ELISA, and viral DNA was detected in plasma using nested-PCR. Phylogenetic analysis of sequenced B19 strains focused on the overlapping region of the minor (VP1) and major (VP2) capsid protein genes.</div></div><div><h3>Results</h3><div>Anti-parvovirus B19 IgG antibodies were detected in 57 of 90 patients (63.3 %), while IgM antibodies were present in 7 (7.8 %). Viral DNA was identified in 23 (25.5 %) patients. Among the 23 DNA-positive patients, 7 (30 %) were seronegative for both IgG and IgM antibodies, highlighting the importance of molecular diagnostics in identifying active infections, especially in early stages. Children under 5 years of age exhibited a higher nucleic acid detection rate compared to older age groups, suggesting the importance of molecular testing in younger patients particularly in the early detection of Parvovirus B19 during the acute phase of infection, before the body has developed detectable antibodies and also in immunocompromised children, who may not mount an antibody response detectable by serological methods. Phylogenetic analysis revealed two distinct Sudanese clusters: one (50 % of sequences) formed a unique clade with low similarity to existing genotypes, while the other (50 %) closely resembled genotype 1 A sequences from Iraq, Iran, and Tanzania.</div></div><div><h3>Conclusion</h3><div>Parvovirus B19 antibodies and DNA were detected at high prevalence among Sudanese children with sickle cell anaemia. Screening for parvovirus B19 is critical for patients requiring blood transfusions, particularly those with haematological disorders. This study provides the first report of parvovirus B19 detection, sequencing, and characterization among Sudanese patients with sickle cell anaemia.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 4","pages":"Article 102682"},"PeriodicalIF":4.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-27DOI: 10.1016/j.jiph.2025.102679
Shovanur Haque , Stephen B. Lambert , Kerrie Mengersen , Ian G. Barr , Liping Wang , Puntani Pongsumpun , Zhongjie Li , Weizhong Yang , Sotiris Vardoulakis , Hilary Bambrick , Wenbiao Hu
Background
Several studies have examined the effect of non-pharmaceutical interventions (NPIs) on COVID-19 and other infectious diseases in Australia and globally. However, to our knowledge none have sufficiently explored their impact on other infectious diseases with robust time series model. In this study, we aimed to use Bayesian Structural Time Series model (BSTS) to systematically assess the impact of NPIs on 64 National Notifiable Infectious Diseases (NNIDs) by conducting a comprehensive and comparative analysis across eight disease categories within each Australian state and territory, as well as nationally.
Methods
Monthly data on 64 NNIDs from eight categories were obtained from the Australian National Notifiable Disease Surveillance System. The incidence rates for each infectious disease in 2020 were compared with the 2015–2019 average and then with the expected rates in 2020 using a BSTS model. The study investigated the causal effects of 2020 interventions and analysed the impact of government policy restrictions at the national level from January 2020 to December 2022.
Results
During the COVID-19 pandemic interventions in Australia, there was a 38 % (95 % Credible Interval [CI] [9 %, 54 %]) overall relative reduction in incidence reported across all disease categories compared to the 2015–2019 average. Significant reductions were observed in bloodborne diseases: 20 % (95 % CI [10 %, 29 %]), respiratory diseases: 79 % (95 % CI [52 %, 91 %]), and zoonoses: 8 % (95 % CI [1 %, 17 %]). Conversely, vector-borne diseases increased by 9 % over the same period. Reductions and intervention effects varied by state and territory, with higher policy stringency linked to fewer cases for some diseases.
Conclusions
COVID-19 NPIs also impacted the transmission of other infectious diseases, with varying effects across regions reflecting diverse outcomes in response strategies throughout Australia. The findings could inform public health strategies and provide scientific evidence to support the development of early warning systems for future disease outbreaks.
{"title":"Assessing the impact of non-pharmaceutical interventions against COVID-19 on 64 notifiable infectious diseases in Australia: A Bayesian Structural Time Series model","authors":"Shovanur Haque , Stephen B. Lambert , Kerrie Mengersen , Ian G. Barr , Liping Wang , Puntani Pongsumpun , Zhongjie Li , Weizhong Yang , Sotiris Vardoulakis , Hilary Bambrick , Wenbiao Hu","doi":"10.1016/j.jiph.2025.102679","DOIUrl":"10.1016/j.jiph.2025.102679","url":null,"abstract":"<div><h3>Background</h3><div>Several studies have examined the effect of non-pharmaceutical interventions (NPIs) on COVID-19 and other infectious diseases in Australia and globally. However, to our knowledge none have sufficiently explored their impact on other infectious diseases with robust time series model. In this study, we aimed to use Bayesian Structural Time Series model (BSTS) to systematically assess the impact of NPIs on 64 National Notifiable Infectious Diseases (NNIDs) by conducting a comprehensive and comparative analysis across eight disease categories within each Australian state and territory, as well as nationally.</div></div><div><h3>Methods</h3><div>Monthly data on 64 NNIDs from eight categories were obtained from the Australian National Notifiable Disease Surveillance System. The incidence rates for each infectious disease in 2020 were compared with the 2015–2019 average and then with the expected rates in 2020 using a BSTS model. The study investigated the causal effects of 2020 interventions and analysed the impact of government policy restrictions at the national level from January 2020 to December 2022.</div></div><div><h3>Results</h3><div>During the COVID-19 pandemic interventions in Australia, there was a 38 % (95 % Credible Interval [CI] [9 %, 54 %]) overall relative reduction in incidence reported across all disease categories compared to the 2015–2019 average. Significant reductions were observed in bloodborne diseases: 20 % (95 % CI [10 %, 29 %]), respiratory diseases: 79 % (95 % CI [52 %, 91 %]), and zoonoses: 8 % (95 % CI [1 %, 17 %]). Conversely, vector-borne diseases increased by 9 % over the same period. Reductions and intervention effects varied by state and territory, with higher policy stringency linked to fewer cases for some diseases.</div></div><div><h3>Conclusions</h3><div>COVID-19 NPIs also impacted the transmission of other infectious diseases, with varying effects across regions reflecting diverse outcomes in response strategies throughout Australia. The findings could inform public health strategies and provide scientific evidence to support the development of early warning systems for future disease outbreaks.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 3","pages":"Article 102679"},"PeriodicalIF":4.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-24DOI: 10.1016/j.jiph.2025.102680
Denis Sauré , Miguel O’Ryan , Juan Pablo Torres , Natalia Trigo , Gonzalo Diaz , Marcel Goic , Charles Thraves , Jorge Pacheco , Patricio Aguilera , Andrea Caro , Leonardo J. Basso
Background
In the latter half of 2023, the northern hemisphere initiated the rollout of nirsevimab immunization strategies for infants, yielding promising early results. As Chile prepared for its 2024 strategy implementation, we retrospectively evaluated the potential cost-saving nature of various immunization strategies.
Methods
Leveraging comprehensive inpatient, outpatient, and sentinel programs data, we conduct a simulation-based retrospective analysis to evaluate the net cost savings of various immunization strategies based on nirsevimab. We first characterize RSV burden among Chilean infants between 2019 and 2023, focusing on medically attended lower respiratory tract infections (MA LRTI), hospital admissions (HA LRTI), and severe cases requiring ICU admission (ICU LRTI). Utilizing nirsevimab efficacy estimates, we simulate counterfactual scenarios to estimate reductions in outpatient visits, hospitalizations, and ICU admissions had nirsevimab been used. We evaluate diverse immunization strategies and estimate their cost-saving status.
Findings
With nirsevimab costing about USD$225 per dose, immunizing infants under 6 months before the RSV season, all newborns during the season, and high-risk groups would have been cost-saving in 2023 and 2019. This strategy would have significantly decreased the strain on the healthcare system during the seasonal surge, reducing 13,533 ICU (77·81/1000 live newborns) and 27,465 hospital bed requirements (157·91/1000 live newborns), alongside 46,886 emergency room visits (269·58/1000 live newborns).
Interpretation
In Chile, a country with a GDP per capita of USD$17,000, various immunization strategies are cost-saving for scenarios comparable to pre-pandemic 2019 and to the particularly severe 2023 when considering only those direct costs associated with patient care, albeit differing in their impact in health outcomes. The resulting decrease in healthcare strain during the Winter virus surge underscores the strategy’s impact.
{"title":"Cost-savings and health impact of strategies for prevention of Respiratory Syncytial Virus with nirsevimab in Chile based on the integrated analysis of 2019–2023 national databases: A retrospective study","authors":"Denis Sauré , Miguel O’Ryan , Juan Pablo Torres , Natalia Trigo , Gonzalo Diaz , Marcel Goic , Charles Thraves , Jorge Pacheco , Patricio Aguilera , Andrea Caro , Leonardo J. Basso","doi":"10.1016/j.jiph.2025.102680","DOIUrl":"10.1016/j.jiph.2025.102680","url":null,"abstract":"<div><h3>Background</h3><div>In the latter half of 2023, the northern hemisphere initiated the rollout of nirsevimab immunization strategies for infants, yielding promising early results. As Chile prepared for its 2024 strategy implementation, we retrospectively evaluated the potential cost-saving nature of various immunization strategies.</div></div><div><h3>Methods</h3><div>Leveraging comprehensive inpatient, outpatient, and sentinel programs data, we conduct a simulation-based retrospective analysis to evaluate the net cost savings of various immunization strategies based on nirsevimab. We first characterize RSV burden among Chilean infants between 2019 and 2023, focusing on medically attended lower respiratory tract infections (MA LRTI), hospital admissions (HA LRTI), and severe cases requiring ICU admission (ICU LRTI). Utilizing nirsevimab efficacy estimates, we simulate counterfactual scenarios to estimate reductions in outpatient visits, hospitalizations, and ICU admissions had nirsevimab been used. We evaluate diverse immunization strategies and estimate their cost-saving status.</div></div><div><h3>Findings</h3><div>With nirsevimab costing about USD$225 per dose, immunizing infants under 6 months before the RSV season, all newborns during the season, and high-risk groups would have been cost-saving in 2023 and 2019. This strategy would have significantly decreased the strain on the healthcare system during the seasonal surge, reducing 13,533 ICU (77·81/1000 live newborns) and 27,465 hospital bed requirements (157·91/1000 live newborns), alongside 46,886 emergency room visits (269·58/1000 live newborns).</div></div><div><h3>Interpretation</h3><div>In Chile, a country with a GDP per capita of USD$17,000, various immunization strategies are cost-saving for scenarios comparable to pre-pandemic 2019 and to the particularly severe 2023 when considering only those direct costs associated with patient care, albeit differing in their impact in health outcomes. The resulting decrease in healthcare strain during the Winter virus surge underscores the strategy’s impact.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 4","pages":"Article 102680"},"PeriodicalIF":4.7,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143099921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-23DOI: 10.1016/j.jiph.2025.102683
Zichen Li , Leiliang Zhang
{"title":"Addressing challenges in meningococcal meningitis prevention: Key highlights from recent cases in Xining, China","authors":"Zichen Li , Leiliang Zhang","doi":"10.1016/j.jiph.2025.102683","DOIUrl":"10.1016/j.jiph.2025.102683","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 3","pages":"Article 102683"},"PeriodicalIF":4.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-22DOI: 10.1016/j.jiph.2025.102678
Nawal M. Alanazi , Nasser H. Alshanbari , Hala M. Roushdy , Yahya I. Alnshbah , Eman Ali Barnawi , Nawaf M. Almatrafi , Rula Felemban , Zainah M. Al Shahrani , Nadeen Burhan , Aiman El-Saed , Khalid H. Alanazi
Background
Healthcare-associated outbreaks have serious impacts on patient morbidity and mortality, and healthcare resources. The objective was to describe the epidemiology of healthcare outbreaks notified to the Saudi Ministry of Health (MOH) over a year.
Methods
A retrospective analysis of national data collected through timely notifications to the MOH during 2023. Data included hospital and patient information. Healthcare outbreaks were defined as per the MOH outbreak manual. Outbreaks notified by 117 MOH hospitals and 53 private hospitals in 20 Saudi regions were included.
Results
A total of 1240 outbreaks were notified, including 2392 patients, 2703 infections, and 806 deaths. Males represented 62.3 % of the patients, and the average age was 51.2 ± 27.7 years. Almost all patients had devices: central line (63.6 %), foley catheters (52.7 %), or mechanical ventilation (50.4 %). More than 70 % of the outbreaks occurred in intensive care units and two-thirds were manifested as infection. The main device-associated infections were central line-associated bloodstream infection (38.5 %) and ventilator-associated pneumonia (39.0 %). The main pathogens were Candida auris (29.9 %), Klebsiella spp. (24.5 %), Acinetobacter baumanni (19.6 %) and Pseudomonas spp. (7.7 %). More than 60 % of the bacteria were resistant, including Carbapenem-resistant Enterobacteriaceae (32.5 %), multidrug-resistant bacteria (26.4 %), and Extended spectrum B-lactamases (23.0 %). Approximately 33.7 % of the patients died, 24.1 % cured, 19.3 % transferred, and 17.0 % discharged.
Conclusions
Outbreaks caused by Gram-negative bacteria and Candida auris remain the main challenge in Saudi hospitals, representing 90 % of the outbreaks. The high resistance of causative pathogens and high associated mortality underscore the importance of strict implementation of infection control measures.
{"title":"Epidemiology of notifiable outbreaks in different hospital units in Saudi Arabia: A national descriptive study","authors":"Nawal M. Alanazi , Nasser H. Alshanbari , Hala M. Roushdy , Yahya I. Alnshbah , Eman Ali Barnawi , Nawaf M. Almatrafi , Rula Felemban , Zainah M. Al Shahrani , Nadeen Burhan , Aiman El-Saed , Khalid H. Alanazi","doi":"10.1016/j.jiph.2025.102678","DOIUrl":"10.1016/j.jiph.2025.102678","url":null,"abstract":"<div><h3>Background</h3><div>Healthcare-associated outbreaks have serious impacts on patient morbidity and mortality, and healthcare resources. The objective was to describe the epidemiology of healthcare outbreaks notified to the Saudi Ministry of Health (MOH) over a year.</div></div><div><h3>Methods</h3><div>A retrospective analysis of national data collected through timely notifications to the MOH during 2023. Data included hospital and patient information. Healthcare outbreaks were defined as per the MOH outbreak manual. Outbreaks notified by 117 MOH hospitals and 53 private hospitals in 20 Saudi regions were included.</div></div><div><h3>Results</h3><div>A total of 1240 outbreaks were notified, including 2392 patients, 2703 infections, and 806 deaths. Males represented 62.3 % of the patients, and the average age was 51.2 ± 27.7 years. Almost all patients had devices: central line (63.6 %), foley catheters (52.7 %), or mechanical ventilation (50.4 %). More than 70 % of the outbreaks occurred in intensive care units and two-thirds were manifested as infection. The main device-associated infections were central line-associated bloodstream infection (38.5 %) and ventilator-associated pneumonia (39.0 %). The main pathogens were <em>Candida auris</em> (29.9 %), <em>Klebsiella</em> spp. (24.5 %), <em>Acinetobacter baumanni</em> (19.6 %) and <em>Pseudomonas</em> spp. (7.7 %). More than 60 % of the bacteria were resistant, including Carbapenem-resistant <em>Enterobacteriaceae</em> (32.5 %), multidrug-resistant bacteria (26.4 %), and Extended spectrum B-lactamases (23.0 %). Approximately 33.7 % of the patients died, 24.1 % cured, 19.3 % transferred, and 17.0 % discharged.</div></div><div><h3>Conclusions</h3><div>Outbreaks caused by Gram-negative bacteria and <em>Candida auris</em> remain the main challenge in Saudi hospitals, representing 90 % of the outbreaks. The high resistance of causative pathogens and high associated mortality underscore the importance of strict implementation of infection control measures.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 3","pages":"Article 102678"},"PeriodicalIF":4.7,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143136003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-22DOI: 10.1016/j.jiph.2025.102681
Gabriel Berkebile , Françoise Barbé , Catherine Malaplate , Lauriane Le Collen , Jean-Louis Guéant , Marc Klein , Abderrahim Oussalah
Purpose
Reports have highlighted thyroid abnormalities, including subacute thyroiditis and thyrotoxicosis, in COVID-19 patients, with a potential link between thyroid dysfunction and disease severity. However, population-level studies on COVID-19’s impact on thyroid hormone levels are limited. We aimed to assess the impact of the COVID-19 pandemic on thyroid function tests at the population level.
Methods
We conducted a repeated cross-sectional study on consecutive patients who underwent thyroid function tests between March 1 and April 15, 2020, during the first wave of COVID-19 in northeastern France, and compared the results with those from the same period in 2018 and 2019.
Results
The study analyzed 3968 tests, including 1534 in 2018, 1547 in 2019, and 887 in 2020. Patients tested in the first wave of COVID-19 had significantly lower TSH and FT3 levels and higher FT4 levels than those in reference periods. On ROC analysis, the optimal thresholds for FT3 and FT4 were ≤ 4.5 pmol/L and > 12 pmol/L, respectively. On multivariable analysis, FT3 ≤ 4.5 pmol/L and FT4 > 12 pmol/L were independently associated with the first wave of COVID-19. The proportion of subjects with concurrent changes in FT3 and FT4 levels was significantly higher in 2020 than in the reference periods, with an odds ratio of 3.62 (95 % CI, 2.77–4.73). A phenome-wide association study of 128 clinical and biological predictors identified an independent association between a low FT3/FT4 ratio and COVID-19, hypertension, or amiodarone therapy, suggesting the contribution of euthyroid sick syndrome to this presentation. This association remained significant after adjustment for potential confounders such as thyroid disease, steroids, and iodinated contrast injection.
Conclusion
These findings suggest that COVID-19 is associated with significant population-level variation in thyroid function tests, which may have implications for managing COVID-19 patients.
{"title":"Population-level impact of COVID-19 on thyroid function tests: Results from a repeated cross-sectional study","authors":"Gabriel Berkebile , Françoise Barbé , Catherine Malaplate , Lauriane Le Collen , Jean-Louis Guéant , Marc Klein , Abderrahim Oussalah","doi":"10.1016/j.jiph.2025.102681","DOIUrl":"10.1016/j.jiph.2025.102681","url":null,"abstract":"<div><h3>Purpose</h3><div>Reports have highlighted thyroid abnormalities, including subacute thyroiditis and thyrotoxicosis, in COVID-19 patients, with a potential link between thyroid dysfunction and disease severity. However, population-level studies on COVID-19’s impact on thyroid hormone levels are limited. We aimed to assess the impact of the COVID-19 pandemic on thyroid function tests at the population level.</div></div><div><h3>Methods</h3><div>We conducted a repeated cross-sectional study on consecutive patients who underwent thyroid function tests between March 1 and April 15, 2020, during the first wave of COVID-19 in northeastern France, and compared the results with those from the same period in 2018 and 2019.</div></div><div><h3>Results</h3><div>The study analyzed 3968 tests, including 1534 in 2018, 1547 in 2019, and 887 in 2020. Patients tested in the first wave of COVID-19 had significantly lower TSH and FT3 levels and higher FT4 levels than those in reference periods. On ROC analysis, the optimal thresholds for FT3 and FT4 were ≤ 4.5 pmol/L and > 12 pmol/L, respectively. On multivariable analysis, FT3 ≤ 4.5 pmol/L and FT4 > 12 pmol/L were independently associated with the first wave of COVID-19. The proportion of subjects with concurrent changes in FT3 and FT4 levels was significantly higher in 2020 than in the reference periods, with an odds ratio of 3.62 (95 % CI, 2.77–4.73). A phenome-wide association study of 128 clinical and biological predictors identified an independent association between a low FT3/FT4 ratio and COVID-19, hypertension, or amiodarone therapy, suggesting the contribution of euthyroid sick syndrome to this presentation. This association remained significant after adjustment for potential confounders such as thyroid disease, steroids, and iodinated contrast injection.</div></div><div><h3>Conclusion</h3><div>These findings suggest that COVID-19 is associated with significant population-level variation in thyroid function tests, which may have implications for managing COVID-19 patients.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 3","pages":"Article 102681"},"PeriodicalIF":4.7,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Care retention and medication adherence are crucial for individuals living with human immunodeficiency virus (HIV). Discrepancies exist between real-world evidence and randomized trials regarding early antiretroviral therapy (ART) initiation and care retention. We investigated the effects of same-day ART initiation on care and medication discontinuation in new patients with acquired immunodeficiency syndrome (AIDS) and those newly infected with HIV.
Methods
The two groups commenced ART from January 2017 to December 2021 in Taiwan. Data were collected from the National Health Insurance claims database. We defined care discontinuation as having no clinical visits for over 90 days since the last clinical visit and medication discontinuation as failing to pick up medication 30 days after the expected medication pick-up date. We used a doubly robust weighted Cox regression model to estimate the average hazard ratio for same-day ART initiation compared to rapid ART initiation within 7 days over a 12-month care- and medication-discontinuation risk horizon.
Results
Among the 1528 HIV- and 5373 AIDS-group individuals, 1329 and 4494 initiated same-day ART, respectively. Same-day ART initiation did not impact care or medication discontinuation among HIV-infected patients. However, it was associated with a significantly lower hazard of care discontinuation (adjusted average hazard ratio [aAHR] = 0.86, 95 % CI: 0.74–0.99) and a higher, though not significant, hazard of medication discontinuation (aAHR = 1.14, 95 % CI: 0.86–1.52) among patients with AIDS.
Conclusion
Same-day ART initiation demonstrates varying impacts on care and medication continuation. While it improves care retention, caution is advised regarding medication discontinuation among patients with AIDS.
{"title":"Impact of same-day ART initiation on medical care and medication discontinuation among patients with incident HIV infection or AIDS in Taiwan: A population-based cohort study","authors":"Chen-Han Chueh , Hsiao-Jou Yu , Yu-Wen Wen , Ming-Neng Shiu , Yi-Ying Chen , Shao-Chin Chiang , Yi-Wen Tsai","doi":"10.1016/j.jiph.2025.102677","DOIUrl":"10.1016/j.jiph.2025.102677","url":null,"abstract":"<div><h3>Background</h3><div>Care retention and medication adherence are crucial for individuals living with human immunodeficiency virus (HIV). Discrepancies exist between real-world evidence and randomized trials regarding early antiretroviral therapy (ART) initiation and care retention. We investigated the effects of same-day ART initiation on care and medication discontinuation in new patients with acquired immunodeficiency syndrome (AIDS) and those newly infected with HIV.</div></div><div><h3>Methods</h3><div>The two groups commenced ART from January 2017 to December 2021 in Taiwan. Data were collected from the National Health Insurance claims database. We defined care discontinuation as having no clinical visits for over 90 days since the last clinical visit and medication discontinuation as failing to pick up medication 30 days after the expected medication pick-up date. We used a doubly robust weighted Cox regression model to estimate the average hazard ratio for same-day ART initiation compared to rapid ART initiation within 7 days over a 12-month care- and medication-discontinuation risk horizon.</div></div><div><h3>Results</h3><div>Among the 1528 HIV- and 5373 AIDS-group individuals, 1329 and 4494 initiated same-day ART, respectively. Same-day ART initiation did not impact care or medication discontinuation among HIV-infected patients. However, it was associated with a significantly lower hazard of care discontinuation (adjusted average hazard ratio [aAHR] = 0.86, 95 % CI: 0.74–0.99) and a higher, though not significant, hazard of medication discontinuation (aAHR = 1.14, 95 % CI: 0.86–1.52) among patients with AIDS.</div></div><div><h3>Conclusion</h3><div>Same-day ART initiation demonstrates varying impacts on care and medication continuation. While it improves care retention, caution is advised regarding medication discontinuation among patients with AIDS.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 4","pages":"Article 102677"},"PeriodicalIF":4.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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