Background: Treatment for tuberculosis infection (TBI) is often discontinued owing to adverse drug effects. The impact of treatment completion on TB reactivation remains poorly understood.
Methods: We conducted a retrospective analysis of 1432 patients at one medical centre in Taiwan from 2016 to 2021. Patients with TBI were divided into three groups: non-initiation (N), incomplete treatment (IC), and complete treatment (C). Those exposure to TB but without TBI formed a control group. TB reactivation was analysed using multivariable Cox regression models, with follow-up for up to three years.
Results: The overall TB reactivation rate was 2.3 % (34/1432), ranging from 6.1 % in the TBI (N) group (n = 378), 2.1 % in the TBI (IC) group (n = 330), 0.5 % in the TBI (C) group (n = 430), and 0.7 % in the control group (n = 294). TBI treatment was independently associated with a reduced risk of TB reactivation. The adjusted hazard ratio (aHR) for TBI (IC) versus TBI (N) was 0.32 (95 % CI 0.12-0.85, p = 0.022), and for TBI (C) versus TBI (N), the aHR was 0.05 (95 % CI 0.01-0.29, p < 0.001). Each 10 % increase in treatment adherence rate resulted in a 23 % reduction in the risk of TB reactivation (aHR 0.77, 95 % CI 0.67-0.88, p < 0.001).
Conclusions: TBI treatment, prescribed to 67 % and completed by 38 % of patients, significantly reduces TB reactivation risk, especially with high adherence. Enhancing adherence, particularly among elderly patients and those with comorbidities, is crucial for improving the effectiveness of TBI treatment.
背景：结核感染（TBI）的治疗经常因药物不良反应而中断。完成治疗对结核病再激活的影响仍然知之甚少。方法：对2016年至2021年台湾某医疗中心1432例患者进行回顾性分析。TBI患者分为三组：未开始治疗(N)、不完全治疗（IC）和完全治疗(C)。那些接触过结核病但没有创伤性脑损伤的人组成了对照组。使用多变量Cox回归模型分析结核病再激活情况，随访时间长达三年。结果:整体结核病重新激活率是2.3 %(34/1432),从6.1 %在创伤性脑损伤(N)组(N = 378),2.1 %在创伤性脑损伤(IC)组(N = 330),0.5 %在创伤性脑损伤(C)组(N = 430)和0.7 %在对照组(N = 294)。TBI治疗与结核病再激活风险降低独立相关。TBI （IC）与TBI (N)的校正危险比（aHR）为0.32(95 % CI 0.12-0.85, p = 0.022),TBI (C)与TBI (N)的校正危险比（aHR）为0.05（95 % CI 0.01-0.29, p ）结论：TBI治疗，处方率为67% %，完成率为38% %的患者，显著降低了结核病再激活风险，特别是高依从性。加强依从性，特别是老年患者和有合并症的患者，对于提高创伤性脑损伤治疗的有效性至关重要。
{"title":"Adherence to tuberculosis infection treatment and its impact on prevention of tuberculosis reactivation: A retrospective cohort study from Taiwan.","authors":"Ying-Chun Chien, Chin-Hao Chang, Chin-Chung Shu, Hao-Chien Wang, Chong-Jen Yu","doi":"10.1016/j.jiph.2025.102917","DOIUrl":"10.1016/j.jiph.2025.102917","url":null,"abstract":"<p><strong>Background: </strong>Treatment for tuberculosis infection (TBI) is often discontinued owing to adverse drug effects. The impact of treatment completion on TB reactivation remains poorly understood.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 1432 patients at one medical centre in Taiwan from 2016 to 2021. Patients with TBI were divided into three groups: non-initiation (N), incomplete treatment (IC), and complete treatment (C). Those exposure to TB but without TBI formed a control group. TB reactivation was analysed using multivariable Cox regression models, with follow-up for up to three years.</p><p><strong>Results: </strong>The overall TB reactivation rate was 2.3 % (34/1432), ranging from 6.1 % in the TBI (N) group (n = 378), 2.1 % in the TBI (IC) group (n = 330), 0.5 % in the TBI (C) group (n = 430), and 0.7 % in the control group (n = 294). TBI treatment was independently associated with a reduced risk of TB reactivation. The adjusted hazard ratio (aHR) for TBI (IC) versus TBI (N) was 0.32 (95 % CI 0.12-0.85, p = 0.022), and for TBI (C) versus TBI (N), the aHR was 0.05 (95 % CI 0.01-0.29, p < 0.001). Each 10 % increase in treatment adherence rate resulted in a 23 % reduction in the risk of TB reactivation (aHR 0.77, 95 % CI 0.67-0.88, p < 0.001).</p><p><strong>Conclusions: </strong>TBI treatment, prescribed to 67 % and completed by 38 % of patients, significantly reduces TB reactivation risk, especially with high adherence. Enhancing adherence, particularly among elderly patients and those with comorbidities, is crucial for improving the effectiveness of TBI treatment.</p>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 11","pages":"102917"},"PeriodicalIF":4.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-08-05DOI: 10.1016/j.jiph.2025.102920
Majed Al-Mourgi, Anwar Shams, Majed Wasal Al-Morgi, Ziyad Al-Morgi
Background: The incidence and prevalence of multi-drug-resistant and extensively drug-resistant pulmonary tuberculosis are increasing, posing profound health concerns; therefore, surgical intervention is gaining popularity again. However, the effectiveness of surgical treatment needs to be reassessed. This study attempted to determine the efficacy of surgical treatment and chemotherapy compared to chemotherapy alone among patients with pulmonary tuberculosis.
Methods: A systematic search and meta-analysis were conducted from inception to June 2025 of the existing databases, including PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar. All double-arm studies available in English published between 2005 and August 2019 were included. Among 618 studies, 468 were selected based on abstract review. Eight out of 468 (8/468) studies were double-arm retrospective cohorts and observational studies, which included 1929 persons who matched the inclusion criteria. To measure the success of the surgical intervention, we used the pooled rate ratio, loss of patient follow-up, and the incidence of mortality using the random effects heterogeneity model.
Results: Overall, there was no statistically significant difference in the treatment success rate (RR=1.24 (0.98-1.56), p = 0.07) and mortality rate (RR=1.82 (0.31-10.63, p = 0.51) between the two groups. Interestingly, the summary rate ratio (RR=0.41 (0.18-0.93), p = 0.03) showed that the surgical group had a considerably lower loss rate to follow-up than the non-surgical group. There was no evidence of heterogeneity amongst the trials (I2 =0 %, τ2 =0.00, df=2, p = 0.36).
Conclusions: The current meta-analysis was the first to use a factor of loss of follow-up collected from several reports as a predictive tool to assess the effectiveness of surgical participation in treating drug-resistant tuberculosis patients. The rate of patient loss to follow-up in the surgical group suggested that the combination approach of surgery and chemotherapy showed a potential superiority over chemotherapy alone.
背景：耐多药和广泛耐药肺结核的发病率和流行率正在上升，造成严重的健康问题；因此，手术干预再次受到欢迎。然而，手术治疗的有效性需要重新评估。本研究试图确定手术治疗和化疗与单独化疗在肺结核患者中的疗效。方法：对PubMed、EMBASE、Cochrane Central Register of Controlled Trials、谷歌Scholar等现有数据库进行系统检索和meta分析。纳入了2005年至2019年8月期间发表的所有英文双联研究。在618项研究中，采用摘要综述的方法筛选出468项。468项（8/468）研究中有8项是双臂回顾性队列和观察性研究，其中包括1929名符合纳入标准的人。为了衡量手术干预的成功，我们使用了合并率比、患者随访损失和使用随机效应异质性模型的死亡率。结果：总体而言，两组治疗成功率（RR=1.24 (0.98-1.56), p = 0.07）、死亡率(RR=1.82 （0.31-10.63, p = 0.51）差异均无统计学意义。有趣的是，总结率比（RR=0.41 (0.18-0.93), p = 0.03）显示手术组的随访失踪率明显低于非手术组。试验之间没有异质性的证据（I2 =0 %,τ2 =0.00,df=2, p = 0.36）。结论：当前的荟萃分析首次使用从几份报告中收集的随访缺失因素作为预测工具来评估手术参与治疗耐药结核病患者的有效性。手术组患者失访率提示手术联合化疗比单纯化疗有潜在优势。
{"title":"Re-visiting the surgical role in treating chemotherapeutic-resistance pulmonary tuberculosis: Results from a systematic review and meta-analysis.","authors":"Majed Al-Mourgi, Anwar Shams, Majed Wasal Al-Morgi, Ziyad Al-Morgi","doi":"10.1016/j.jiph.2025.102920","DOIUrl":"10.1016/j.jiph.2025.102920","url":null,"abstract":"<p><strong>Background: </strong>The incidence and prevalence of multi-drug-resistant and extensively drug-resistant pulmonary tuberculosis are increasing, posing profound health concerns; therefore, surgical intervention is gaining popularity again. However, the effectiveness of surgical treatment needs to be reassessed. This study attempted to determine the efficacy of surgical treatment and chemotherapy compared to chemotherapy alone among patients with pulmonary tuberculosis.</p><p><strong>Methods: </strong>A systematic search and meta-analysis were conducted from inception to June 2025 of the existing databases, including PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar. All double-arm studies available in English published between 2005 and August 2019 were included. Among 618 studies, 468 were selected based on abstract review. Eight out of 468 (8/468) studies were double-arm retrospective cohorts and observational studies, which included 1929 persons who matched the inclusion criteria. To measure the success of the surgical intervention, we used the pooled rate ratio, loss of patient follow-up, and the incidence of mortality using the random effects heterogeneity model.</p><p><strong>Results: </strong>Overall, there was no statistically significant difference in the treatment success rate (RR=1.24 (0.98-1.56), p = 0.07) and mortality rate (RR=1.82 (0.31-10.63, p = 0.51) between the two groups. Interestingly, the summary rate ratio (RR=0.41 (0.18-0.93), p = 0.03) showed that the surgical group had a considerably lower loss rate to follow-up than the non-surgical group. There was no evidence of heterogeneity amongst the trials (I2 =0 %, τ2 =0.00, df=2, p = 0.36).</p><p><strong>Conclusions: </strong>The current meta-analysis was the first to use a factor of loss of follow-up collected from several reports as a predictive tool to assess the effectiveness of surgical participation in treating drug-resistant tuberculosis patients. The rate of patient loss to follow-up in the surgical group suggested that the combination approach of surgery and chemotherapy showed a potential superiority over chemotherapy alone.</p>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 11","pages":"102920"},"PeriodicalIF":4.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-31DOI: 10.1016/j.jiph.2025.103029
Chun-Yuan Lee , Yi-Pei Lin , Bih-O. Lee , Shin-Huei Kuo , Shih-Hao Lo , Po-Liang Lu
Background
Information on the usage patterns of human immunodeficiency virus (HIV) self-tests (HIV-STs), the factors influencing these patterns, and reasons for delays between positive HIV-ST results and confirmatory testing in people with HIV in Taiwan is lacking.
Methods
We conducted a multicenter, cross-sectional survey in Taiwan over the period from February 2023 to December 2024 to examine the use of HIV-STs among individuals who received a diagnosis of HIV from 2017 to 2024. We employed exploratory factor and multivariable analyses to identify the barriers hindering and the factors influencing HIV-ST use.
Results
We recruited 458 participants who had received a diagnosis of HIV, predominantly men who had sex with men (92.79 %), aged ≤ 30 years at HIV presentation (51.75 %). We analyzed their prediagnosis HIV-ST use along a five-tier cascade: (1) being diagnosed as HIV, (2) being aware of HIV-ST, (3) considering HIV-ST use, (4) having used an HIV-ST previously, and (5) using HIV-STs annually. Exploratory factor analysis categorized 16 barriers into four domains: indifference to HIV risk, fear of negative consequences (including discrimination and stigmatization after a positive result), and structural barriers to accessing HIV-ST services. From 2017–2024, awareness, willingness, and use of HIV-STs increased, yet significant drop-offs occurred between stages—most notably, a 51.31 % reduction from Tier 1 to Tier 2. Participants aged 30–50 were less likely to use HIV-STs than their younger counterparts, and usage was significantly higher in 2021 versus 2017. Notably, 33.33 % of individuals delayed confirmatory testing for more than two weeks after a positive HIV-ST, primarily due to fear of negative consequences, which was also the leading barrier to progression along the HIV-ST cascade.
Conclusions
High attrition in the HIV-ST cascade, due to low awareness, and delays in confirmatory testing, driven by fear of negative consequences, undermine its public health impact. Optimizing its utility requires dual strategies: targeted campaigns to increase awareness and supportive systems to facilitate linkage-to-care by mitigating stigma.
{"title":"Gaps in the HIV self-testing cascade among people with HIV in Taiwan: Usage patterns, barriers, and public health implications","authors":"Chun-Yuan Lee , Yi-Pei Lin , Bih-O. Lee , Shin-Huei Kuo , Shih-Hao Lo , Po-Liang Lu","doi":"10.1016/j.jiph.2025.103029","DOIUrl":"10.1016/j.jiph.2025.103029","url":null,"abstract":"<div><h3>Background</h3><div>Information on the usage patterns of human immunodeficiency virus (HIV) self-tests (HIV-STs), the factors influencing these patterns, and reasons for delays between positive HIV-ST results and confirmatory testing in people with HIV in Taiwan is lacking.</div></div><div><h3>Methods</h3><div>We conducted a multicenter, cross-sectional survey in Taiwan over the period from February 2023 to December 2024 to examine the use of HIV-STs among individuals who received a diagnosis of HIV from 2017 to 2024. We employed exploratory factor and multivariable analyses to identify the barriers hindering and the factors influencing HIV-ST use.</div></div><div><h3>Results</h3><div>We recruited 458 participants who had received a diagnosis of HIV, predominantly men who had sex with men (92.79 %), aged ≤ 30 years at HIV presentation (51.75 %). We analyzed their prediagnosis HIV-ST use along a five-tier cascade: (1) being diagnosed as HIV, (2) being aware of HIV-ST, (3) considering HIV-ST use, (4) having used an HIV-ST previously, and (5) using HIV-STs annually. Exploratory factor analysis categorized 16 barriers into four domains: indifference to HIV risk, fear of negative consequences (including discrimination and stigmatization after a positive result), and structural barriers to accessing HIV-ST services. From 2017–2024, awareness, willingness, and use of HIV-STs increased, yet significant drop-offs occurred between stages—most notably, a 51.31 % reduction from Tier 1 to Tier 2. Participants aged 30–50 were less likely to use HIV-STs than their younger counterparts, and usage was significantly higher in 2021 versus 2017. Notably, 33.33 % of individuals delayed confirmatory testing for more than two weeks after a positive HIV-ST, primarily due to fear of negative consequences, which was also the leading barrier to progression along the HIV-ST cascade.</div></div><div><h3>Conclusions</h3><div>High attrition in the HIV-ST cascade, due to low awareness, and delays in confirmatory testing, driven by fear of negative consequences, undermine its public health impact. Optimizing its utility requires dual strategies: targeted campaigns to increase awareness and supportive systems to facilitate linkage-to-care by mitigating stigma.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 1","pages":"Article 103029"},"PeriodicalIF":4.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-30DOI: 10.1016/j.jiph.2025.103017
Hyunsuk Frank Roh , Dong Kwon Shin , Do-Yeon Kim , Jung Mogg Kim
Background
Prior long-term-care (LTC) studies confound anatomic reservoir and pathogen effects when multiple multidrug-resistant organisms (MDROs) circulate. We created a four-tier clearance framework to disentangle site- and species-specific behavior and quantify decolonization, mortality, and asymmetric co-colonization.
Methods
Between January 2024 and May 2025, 98 LTC residents colonized with carbapenem-resistant Enterobacterales (CRE), vancomycin-resistant Enterococcus (VRE), or multidrug-resistant Pseudomonas aeruginosa (MRPA) or Acinetobacter baumannii (MRAB) underwent weekly stool, urine, sputum, wound, blood cultures, yielding a total of 2772 specimens. Clearance— operationally defined as three consecutive negatives—was analyzed across four tiers (site-atomic, pathogen-atomic, pathogen-level, patient-level). Conditional-probability tables were constructed to summarize how frequently the four MDROs co-colonized the same patient.
Results
Clearance was slowest in stool and for CRE, independent of patient attributes of age or sex. In this LTCF cohort, mortality depended on sputum carriage and host factors rather than pathogen identity. More than half of residents carried multiple MDROs, and conditional-probability analysis revealed asymmetric co-colonization: non-CRE organisms almost always co-colonized with CRE, whereas the reverse was uncommon.
Conclusions
The hierarchical analysis showed that, contrary to common expectations, decolonization was independent of patient attributes (age and sex) and that, in this LTCF setting, mortality was unrelated to pathogen identity. Asymmetric co-colonization therefore warrants automatic CRE screening following MRAB, MRPA, or VRE isolation, and underscores the need to investigate directional co-colonization patterns among multiple MDRO co-colonizations commonly observed in LTCFs—as exemplified by vanA transfer from VRE to MRSA (methicillin-resistant Staphylococcus aureus) yielding VRSA (vancomycin-resistant Staphylococcus aureus).
{"title":"Hierarchical multilevel prospective study of multidrug-resistant organisms: Decolonization, mortality, and co-colonization in a long-term care facility","authors":"Hyunsuk Frank Roh , Dong Kwon Shin , Do-Yeon Kim , Jung Mogg Kim","doi":"10.1016/j.jiph.2025.103017","DOIUrl":"10.1016/j.jiph.2025.103017","url":null,"abstract":"<div><h3>Background</h3><div>Prior long-term-care (LTC) studies confound anatomic reservoir and pathogen effects when multiple multidrug-resistant organisms (MDROs) circulate. We created a four-tier clearance framework to disentangle site- and species-specific behavior and quantify decolonization, mortality, and asymmetric co-colonization.</div></div><div><h3>Methods</h3><div>Between January 2024 and May 2025, 98 LTC residents colonized with carbapenem-resistant <em>Enterobacterales</em> (CRE), vancomycin-resistant <em>Enterococcus</em> (VRE), or multidrug-resistant <em>Pseudomonas aeruginosa</em> (MRPA) or <em>Acinetobacter baumannii</em> (MRAB) underwent weekly stool, urine, sputum, wound, blood cultures, yielding a total of 2772 specimens. Clearance— operationally defined as three consecutive negatives—was analyzed across four tiers (site-atomic, pathogen-atomic, pathogen-level, patient-level). Conditional-probability tables were constructed to summarize how frequently the four MDROs co-colonized the same patient.</div></div><div><h3>Results</h3><div>Clearance was slowest in stool and for CRE, independent of patient attributes of age or sex. In this LTCF cohort, mortality depended on sputum carriage and host factors rather than pathogen identity. More than half of residents carried multiple MDROs, and conditional-probability analysis revealed asymmetric co-colonization: non-CRE organisms almost always co-colonized with CRE, whereas the reverse was uncommon.</div></div><div><h3>Conclusions</h3><div>The hierarchical analysis showed that, contrary to common expectations, decolonization was independent of patient attributes (age and sex) and that, in this LTCF setting, mortality was unrelated to pathogen identity. Asymmetric co-colonization therefore warrants automatic CRE screening following MRAB, MRPA, or VRE isolation, and underscores the need to investigate directional co-colonization patterns among multiple MDRO co-colonizations commonly observed in LTCFs—as exemplified by <em>vanA</em> transfer from VRE to MRSA (methicillin-resistant <em>Staphylococcus aureus</em>) yielding VRSA (vancomycin-resistant <em>Staphylococcus aureus</em>).</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 1","pages":"Article 103017"},"PeriodicalIF":4.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145418611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Two-dimensional (2D) nanosheets provide orthogonal, multi-modal strategies to control infection at a time of rising antimicrobial resistance. This review highlights material families most relevant to graphene derivatives, transition-metal dichalcogenides (TMDs), MXenes, graphitic carbon nitride, hexagonal boron nitride, and phosphorene. The review highlights antibacterial, antiviral, and antifungal applications. We highlight convergent extracellular mechanisms across families, including membrane stress from atomically thin edges, reactive-oxygen-species generation, photothermal and photodynamic conversion, electron-transfer imbalance, and (in hybrids) controlled metal-ion release. From a translational standpoint, these mechanisms are increasingly being harnessed in deployable healthcare formats such as hydrogels, wound dressings, anti-biofilm and implant coatings, microneedles, and photo-addressable composites. These architectures enable localized, on-demand activation, high local payloads, and minimal systemic exposure, addressing key challenges in multidrug resistance and biofilm persistence. Collectively, these attributes position 2D nanosheets as modular building blocks for next-generation anti-infective technologies.
{"title":"Two-dimensional nanomaterials for infection control: A comprehensive review","authors":"Salma Younes , Nadin Younes , Nader Al-Dewik , Laith J. Abu-Raddad , Gheyath Nasrallah","doi":"10.1016/j.jiph.2025.103027","DOIUrl":"10.1016/j.jiph.2025.103027","url":null,"abstract":"<div><div>Two-dimensional (2D) nanosheets provide orthogonal, multi-modal strategies to control infection at a time of rising antimicrobial resistance. This review highlights material families most relevant to graphene derivatives, transition-metal dichalcogenides (TMDs), MXenes, graphitic carbon nitride, hexagonal boron nitride, and phosphorene. The review highlights antibacterial, antiviral, and antifungal applications. We highlight convergent extracellular mechanisms across families, including membrane stress from atomically thin edges, reactive-oxygen-species generation, photothermal and photodynamic conversion, electron-transfer imbalance, and (in hybrids) controlled metal-ion release. From a translational standpoint, these mechanisms are increasingly being harnessed in deployable healthcare formats such as hydrogels, wound dressings, anti-biofilm and implant coatings, microneedles, and photo-addressable composites. These architectures enable localized, on-demand activation, high local payloads, and minimal systemic exposure, addressing key challenges in multidrug resistance and biofilm persistence. Collectively, these attributes position 2D nanosheets as modular building blocks for next-generation anti-infective technologies.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 1","pages":"Article 103027"},"PeriodicalIF":4.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145467942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-30DOI: 10.1016/j.jiph.2025.103028
Madhu C. Mohanty , Ketki S. Jawade , Sushmita S. Rane , Ameet Dravid , Yogesh K. Gurav , Sumit D. Bhardwaj , Rohidas Borse , Medha D. Bargaje , Vinayak Sawardekar , Taruna M. Gupta , Swapnil Y. Varose , Ankita P. Patil , Nagnath Redewad , Ganesh Bandare , Sailee More , Vikrant M. Bhor , Prakash Doke , Priya Abraham
Background
Post-Acute Sequelae of COVID-19 or Long COVID (LC) affects millions globally, with persistent immune, neurological, and cardiovascular symptoms posing challenges to healthcare. This study analyses clinical, demographic, and lifestyle differences between LC and recovered (RC) individuals residing in Western India, extending observations up to four years post-infection.
Methods
A cross-sectional study was conducted in four urban setting tertiary-care hospitals of Western India. Individuals aged 19–70 with documented SARS-CoV-2 infection and persistent or fluctuating symptoms beyond four weeks, unexplained by other diagnoses were recruited in LC group. Recovered individuals with confirmed past infection, negative SARS-CoV-2 RT-PCR at the time of enrolment, and no lingering symptoms were recruited in RC group. The demographic, socio-economic, and clinical data were collected.
Results
Severe acute COVID-19 patients were more frequent in the LC group (n = 104) compared to the RC group (n = 83), though both LC and RC had similar proportions of mild/moderate acute COVID-19 patients. Fatigue was the most persistent symptom (79.80 %), followed by cough and anxiety. Respiratory, cardiovascular, neuro-psychiatric symptoms declined over time, while dermatological, ENT, gastrointestinal, and muscular symptoms fluctuated. LC patients predominantly had hypertension as comorbidity, lower SPO2, and higher pulse rates (p < 0.0001). Rates of hospitalization for COVID-19 treatment were similar, but mechanical ventilation use was exclusively observed in LC patients (10.6 %). Sedentary lifestyles were more frequent in LC (17.30 %) vs. RC (6.02 %, p = 0.0248).
Conclusion
Our study is one of the few in Indian population showing occurrence of multiple LC symptoms after 3–4 years of infection. We report severity of COVID-19, use of Remdesivir and mechanical ventilation to be associated with increased odds of LC. Fatigue, cough and anxiety were the most common symptoms reported by LC participants. Our findings establish a much-needed baseline for understanding symptom progression in LC patients, emphasizing the need for targeted interventions and long-term monitoring.
{"title":"Persistence of post-acute COVID-19 sequelae up to four years in patients with long COVID from Western India: A cross-sectional descriptive study","authors":"Madhu C. Mohanty , Ketki S. Jawade , Sushmita S. Rane , Ameet Dravid , Yogesh K. Gurav , Sumit D. Bhardwaj , Rohidas Borse , Medha D. Bargaje , Vinayak Sawardekar , Taruna M. Gupta , Swapnil Y. Varose , Ankita P. Patil , Nagnath Redewad , Ganesh Bandare , Sailee More , Vikrant M. Bhor , Prakash Doke , Priya Abraham","doi":"10.1016/j.jiph.2025.103028","DOIUrl":"10.1016/j.jiph.2025.103028","url":null,"abstract":"<div><h3>Background</h3><div>Post-Acute Sequelae of COVID-19 or Long COVID (LC) affects millions globally, with persistent immune, neurological, and cardiovascular symptoms posing challenges to healthcare. This study analyses clinical, demographic, and lifestyle differences between LC and recovered (RC) individuals residing in Western India, extending observations up to four years post-infection.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted in four urban setting tertiary-care hospitals of Western India. Individuals aged 19–70 with documented SARS-CoV-2 infection and persistent or fluctuating symptoms beyond four weeks, unexplained by other diagnoses were recruited in LC group. Recovered individuals with confirmed past infection, negative SARS-CoV-2 RT-PCR at the time of enrolment, and no lingering symptoms were recruited in RC group. The demographic, socio-economic, and clinical data were collected.</div></div><div><h3>Results</h3><div>Severe acute COVID-19 patients were more frequent in the LC group (n = 104) compared to the RC group (n = 83), though both LC and RC had similar proportions of mild/moderate acute COVID-19 patients. Fatigue was the most persistent symptom (79.80 %), followed by cough and anxiety. Respiratory, cardiovascular, neuro-psychiatric symptoms declined over time, while dermatological, ENT, gastrointestinal, and muscular symptoms fluctuated. LC patients predominantly had hypertension as comorbidity, lower SPO2, and higher pulse rates (p < 0.0001). Rates of hospitalization for COVID-19 treatment were similar, but mechanical ventilation use was exclusively observed in LC patients (10.6 %). Sedentary lifestyles were more frequent in LC (17.30 %) vs. RC (6.02 %, p = 0.0248).</div></div><div><h3>Conclusion</h3><div>Our study is one of the few in Indian population showing occurrence of multiple LC symptoms after 3–4 years of infection. We report severity of COVID-19, use of Remdesivir and mechanical ventilation to be associated with increased odds of LC. Fatigue, cough and anxiety were the most common symptoms reported by LC participants. Our findings establish a much-needed baseline for understanding symptom progression in LC patients, emphasizing the need for targeted interventions and long-term monitoring.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 1","pages":"Article 103028"},"PeriodicalIF":4.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-30DOI: 10.1016/j.jiph.2025.103026
Debaprasad Parai , Matrujyoti Pattnaik , Arashmika Dash , Haimanti Bhattacharya , Shishirendu Ghosal , Hari Ram Choudhary , A.K. Kavitha , Srikanta Kanungo , Debdutta Bhattacharya , Sanghamitra Pati
This epidemiological study aimed to determine the prevalence and risk factors of scrub typhus infection among Particularly Vulnerable Tribal Groups (PVTGs) in an Indian state to make more effective management and control strategies. We conducted a tribal community-based cross-sectional survey from June 2022 to May 2023 in 9 PVTG-dominated districts in Odisha, India. A total of 1485 sera samples were collected, both immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies against scrub typhus were tested using commercially available enzyme-linked immunosorbent assay (ELISA) kits. Multivariable logistic regression analysis identified the scrub typhus-associated risk factors. Out of 1485 participants, the weighted prevalence of IgG was 48.95 % and that of IgM was 18.19 %. Participants were associated with risk factors like: sitting on muddy floors (aOR: 2.00), use of non-concrete materials (aOR: 1.35) in roofing, being involved in agricultural practices (aOR: 1.32), forest collection (aOR: 1.53), childcare (aOR: 1.63) and living in a bigger household (HH) (aOR: 1.27). This is the first study to estimate scrub typhus seroprevalence among PVTG community members in this geographical region. The study highlights the determinants of the disease in PVTGs and recommends refined policies and awareness programs for enriched health quality among these underprivileged PVTG communities.
{"title":"Scrub typhus among particularly vulnerable tribal groups of Odisha, India","authors":"Debaprasad Parai , Matrujyoti Pattnaik , Arashmika Dash , Haimanti Bhattacharya , Shishirendu Ghosal , Hari Ram Choudhary , A.K. Kavitha , Srikanta Kanungo , Debdutta Bhattacharya , Sanghamitra Pati","doi":"10.1016/j.jiph.2025.103026","DOIUrl":"10.1016/j.jiph.2025.103026","url":null,"abstract":"<div><div>This epidemiological study aimed to determine the prevalence and risk factors of scrub typhus infection among Particularly Vulnerable Tribal Groups (PVTGs) in an Indian state to make more effective management and control strategies. We conducted a tribal community-based cross-sectional survey from June 2022 to May 2023 in 9 PVTG-dominated districts in Odisha, India. A total of 1485 sera samples were collected, both immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies against scrub typhus were tested using commercially available enzyme-linked immunosorbent assay (ELISA) kits. Multivariable logistic regression analysis identified the scrub typhus-associated risk factors. Out of 1485 participants, the weighted prevalence of IgG was 48.95 % and that of IgM was 18.19 %. Participants were associated with risk factors like: sitting on muddy floors (aOR: 2.00), use of non-concrete materials (aOR: 1.35) in roofing, being involved in agricultural practices (aOR: 1.32), forest collection (aOR: 1.53), childcare (aOR: 1.63) and living in a bigger household (HH) (aOR: 1.27). This is the first study to estimate scrub typhus seroprevalence among PVTG community members in this geographical region. The study highlights the determinants of the disease in PVTGs and recommends refined policies and awareness programs for enriched health quality among these underprivileged PVTG communities.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 1","pages":"Article 103026"},"PeriodicalIF":4.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-28DOI: 10.1016/j.jiph.2025.103025
Liang Chen , Jie Hua , Xiao-Pu He
Objective
This study aimed to compare the effectiveness of different antimicrobial regimens used in the treatment of hospital-acquired pneumonia caused by extensively drug-resistant Acinetobacter baumannii (XDRAb-HAP).
Methods
A retrospective analysis was performed using clinical data from 376 patients diagnosed with XDRAb-HAP across four tertiary teaching hospitals in China between January 2017 and May 2022.
Results
The overall 30-day treatment failure rate was 55.1 % (207/376). Multivariate logistic regression identified immunocompromised status, APACHE II score, septic shock, invasive mechanical ventilation, and delayed initiation of definitive therapy as independent predictors of 30-day treatment failure. After adjusting for potential confounders, tigecycline (TGC) monotherapy was associated with a significantly higher risk of 30-day treatment failure compared with polymyxin B (PMB) monotherapy (OR 8.910, 95 % CI 3.211–24.724, p < 0.001). A comparable risk was observed with the PMB plus TGC combination (OR 1.290, 95 % CI 0.619–2.689, p = 0.496). The addition of sulbactam (OR 0.636, 95 % CI 0.276–1.465, p = 0.288) or a carbapenem (OR 1.066, 95 % CI 0.496–2.290, p = 0.871) did not significantly influence the 30-day treatment outcome compared with regimens lacking these agents. Weighted propensity score analyses further supported these associations between treatment regimens and clinical outcomes.
Conclusion
In the current therapeutic landscape, lacking effective novel agents, PMB appears to be a reasonable first-line option for managing XDRAb-HAP. However, PMB-based combination therapies did not demonstrate improved clinical efficacy over PMB monotherapy.
目的比较不同抗菌方案治疗广泛耐药鲍曼不动杆菌（XDRAb-HAP）引起的医院获得性肺炎的疗效。方法回顾性分析2017年1月至2022年5月在中国四所三级教学医院诊断为XDRAb-HAP的376例患者的临床资料。结果30 d总治疗失败率为55.1% %（207/376）。多因素logistic回归发现免疫功能低下状态、APACHE II评分、感染性休克、有创机械通气和延迟开始最终治疗是30天治疗失败的独立预测因素。在调整潜在混杂因素后，替加环素（TGC）单药治疗与多黏菌素B （PMB）单药治疗相比，30天治疗失败的风险明显更高（OR 8.910, 95 % CI 3.211-24.724, p <； 0.001）。PMB + TGC组合的风险相当（OR 1.290, 95 % CI 0.619-2.689, p = 0.496）。与缺乏这些药物的方案相比，添加sulbactam （OR 0.636, 95 % CI 0.276-1.465, p = 0.288）或碳青霉烯（OR 1.066, 95 % CI 0.496-2.290, p = 0.871）对30天的治疗结果没有显著影响。加权倾向评分分析进一步支持了治疗方案与临床结果之间的关联。结论在目前治疗领域，缺乏有效的新药，PMB似乎是治疗XDRAb-HAP的合理一线选择。然而，基于PMB的联合治疗并没有显示出比PMB单药治疗更好的临床疗效。
{"title":"Evaluation of the relative effectiveness of various antibiotic regimens used to treat hospital-acquired pneumonia induced by drug-resistant Acinetobacter baumannii","authors":"Liang Chen , Jie Hua , Xiao-Pu He","doi":"10.1016/j.jiph.2025.103025","DOIUrl":"10.1016/j.jiph.2025.103025","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to compare the effectiveness of different antimicrobial regimens used in the treatment of hospital-acquired pneumonia caused by extensively drug-resistant <em>Acinetobacter baumannii</em> (XDRAb-HAP).</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed using clinical data from 376 patients diagnosed with XDRAb-HAP across four tertiary teaching hospitals in China between January 2017 and May 2022.</div></div><div><h3>Results</h3><div>The overall 30-day treatment failure rate was 55.1 % (207/376). Multivariate logistic regression identified immunocompromised status, APACHE II score, septic shock, invasive mechanical ventilation, and delayed initiation of definitive therapy as independent predictors of 30-day treatment failure. After adjusting for potential confounders, tigecycline (TGC) monotherapy was associated with a significantly higher risk of 30-day treatment failure compared with polymyxin B (PMB) monotherapy (OR 8.910, 95 % CI 3.211–24.724, <em>p</em> < 0.001). A comparable risk was observed with the PMB plus TGC combination (OR 1.290, 95 % CI 0.619–2.689, <em>p</em> = 0.496). The addition of sulbactam (OR 0.636, 95 % CI 0.276–1.465, <em>p</em> = 0.288) or a carbapenem (OR 1.066, 95 % CI 0.496–2.290, <em>p</em> = 0.871) did not significantly influence the 30-day treatment outcome compared with regimens lacking these agents. Weighted propensity score analyses further supported these associations between treatment regimens and clinical outcomes.</div></div><div><h3>Conclusion</h3><div>In the current therapeutic landscape, lacking effective novel agents, PMB appears to be a reasonable first-line option for managing XDRAb-HAP. However, PMB-based combination therapies did not demonstrate improved clinical efficacy over PMB monotherapy.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 1","pages":"Article 103025"},"PeriodicalIF":4.0,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145418612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-28DOI: 10.1016/j.jiph.2025.103024
Mirza Mienur Meher , Marya Afrin
Human metapneumovirus (hMPV) is a significant virus of the lungs that causes diversified symptoms such as mild colds to severe pneumonia in people of all ages, especially in children, the elderly, and immunosuppressed individuals. The review highlights the global escalation of hMPV and explores how the human microbiome may shape the susceptibility of infections, immune responses and disease severity. The virus can form inclusion bodies inside the host cells and increase hMPV virulence to induce severe viral infection. hMPV also exploits immune-evasion strategy that weaken the host-body’s defenses. Disturbances of gut-lung-microbiota can weaken the host immunity and worsen the disease severity. Nevertheless, intestinal microbes may promote the lung health through the compounds e.g., short-chain fatty acids. Although no particular treatment exists, there is an increasing concern in microbiome-based therapeutic approaches and personalized medicine. Understanding the microbiome interaction to hMPV may develop strategies to predict, prevent, and manage the hMPV infections.
{"title":"Global surge of human metapneumovirus (hMPV) and its interactions with microbiome to disease severity","authors":"Mirza Mienur Meher , Marya Afrin","doi":"10.1016/j.jiph.2025.103024","DOIUrl":"10.1016/j.jiph.2025.103024","url":null,"abstract":"<div><div>Human metapneumovirus (hMPV) is a significant virus of the lungs that causes diversified symptoms such as mild colds to severe pneumonia in people of all ages, especially in children, the elderly, and immunosuppressed individuals. The review highlights the global escalation of hMPV and explores how the human microbiome may shape the susceptibility of infections, immune responses and disease severity. The virus can form inclusion bodies inside the host cells and increase hMPV virulence to induce severe viral infection. hMPV also exploits immune-evasion strategy that weaken the host-body’s defenses. Disturbances of gut-lung-microbiota can weaken the host immunity and worsen the disease severity. Nevertheless, intestinal microbes may promote the lung health through the compounds e.g., short-chain fatty acids. Although no particular treatment exists, there is an increasing concern in microbiome-based therapeutic approaches and personalized medicine. Understanding the microbiome interaction to hMPV may develop strategies to predict, prevent, and manage the hMPV infections.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 1","pages":"Article 103024"},"PeriodicalIF":4.0,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145418614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Reports of potential side effects have led to public concerns regarding COVID-19 vaccines. This systematic review and meta-analysis globally investigated the adverse effects, focusing specifically on the risks of stroke, myocarditis, and pneumonia following COVID-19 vaccination. A systematic search was performed across databases (including PubMed, Scopus, and Google Scholar) using MeSH terms such as “adverse events,” “COVID-19,” and “SARS-CoV-2,” spanning from February 2019 to December 2023. From 708 reports identified, 8 studies were ultimately included. For hemorrhagic and ischemic stroke, the pooled risk ratio was 1.13 (95 % CI: 0.87 −1.47), but this result showed high heterogeneity (I2=97.7 %). Subgroup analysis confirmed that the study country was a significant contributor to this variability. Overall, the meta-analysis revealed no statistically significant increase in the pooled risk of the investigated adverse outcomes (stroke, myocarditis, or pneumonia). Given the substantial disease prevention benefits, these findings support the recommendation for widespread vaccination across all age groups.
{"title":"COVID-19 vaccination and stroke risk: A systematic review and meta-analysis of ischemic and hemorrhagic events","authors":"Monireh Faghir-Ganji , Narjes Abdolmohammadi , Alireza Ansari-Moghaddam , Saeedeh Askari , Babak Eshrati","doi":"10.1016/j.jiph.2025.103021","DOIUrl":"10.1016/j.jiph.2025.103021","url":null,"abstract":"<div><div>Reports of potential side effects have led to public concerns regarding COVID-19 vaccines. This systematic review and meta-analysis globally investigated the adverse effects, focusing specifically on the risks of stroke, myocarditis, and pneumonia following COVID-19 vaccination. A systematic search was performed across databases (including PubMed, Scopus, and Google Scholar) using MeSH terms such as “adverse events,” “COVID-19,” and “SARS-CoV-2,” spanning from February 2019 to December 2023. From 708 reports identified, 8 studies were ultimately included. For hemorrhagic and ischemic stroke, the pooled risk ratio was 1.13 (95 % CI: 0.87 −1.47), but this result showed high heterogeneity (I<sup>2</sup>=97.7 %). Subgroup analysis confirmed that the study country was a significant contributor to this variability. Overall, the meta-analysis revealed no statistically significant increase in the pooled risk of the investigated adverse outcomes (stroke, myocarditis, or pneumonia). Given the substantial disease prevention benefits, these findings support the recommendation for widespread vaccination across all age groups.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 1","pages":"Article 103021"},"PeriodicalIF":4.0,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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