Mamane N Garba, Lamine M Moustapha, Djiby Sow, Aichatou Karimoun, Ibrahima Issa, Mamane K Sanoussi, Mamadou A Diallo, Mahamadou Doutchi, Khadim Diongue, Maman L Ibrahim, Daouda Ndiaye, Aida S Badiane
Rationale Niger’s National Malaria Control Programme (NMCP) and its partners use HRP2-based RDTs which are specific to Plasmodium falciparum diagnosis. This study aimed to screen for the circulation of Non-falciparum species in Zinder, a region of Niger, West Africa. Methods A cross-sectional study was carried out from July to December 2022 at the district hospital of the Zinder region of Niger. PfHRP2-RDTs were performed, and Dried blood spots (DBS) samples were collected for further laboratory multiplexed PET-PCR analysis on positive light microscopy from all febrile patients who attended the Zinder district hospital during the study period. Results Three hundred forty (340) DBS were collected and analyzed by the PET-PCR. Overall, 73.2% [95% CI 68.2-77.9%] (249/340) were positive for Plasmodium genus and species and represented the study population. The Plasmodium species proportions are 89.5% [95% CI 85.1-93.1%] (223/249) for Plasmodium falciparum, 38.5% [95% CI 32.5-44.9%] (96/249) for Plasmodium malariae, 10.8% [95% CI 7.3-15.4%] (27/249) for Plasmodium vivax, and 1.6% [95% CI 0.4-4.1%] (4/249) for P. ovale. Single infection with Plasmodium species counted for 61.8% [95% CI 55.5-67.9%] (154/249), and the mixed infections rate, with at least two Plasmodium species, was 38.1% [95% CI 32.1-44.5%] (95/249). The overall single Non-falciparum infections represented a rate of 10.0% [95% CI 6.6-14.5%] (25/249). Conclusions This study confirms the first evidence of Plasmodium vivax by PET-PCR in Niger in addition to the other three Plasmodium species. These findings underline the need to adapt malaria diagnostic tools and therapeutic management as well as the training of microscopists for recognition of Non-falciparum plasmodial species circulating in the country which will better inform the strategies towards malaria control and elimination as well as the decision-making of the health authorities of Niger.
理由尼日尔国家疟疾控制计划（NMCP）及其合作伙伴使用基于 HRP2 的 RDT，该 RDT 专门用于恶性疟原虫诊断。本研究旨在筛查西非尼日尔津德尔地区的非恶性疟原虫。方法 2022 年 7 月至 12 月在尼日尔津德尔地区的地区医院进行了一项横断面研究。对研究期间在津德尔地区医院就诊的所有发热患者进行了PfHRP2-RDT检测，并采集了干血斑（DBS）样本，在光镜下对阳性样本进行了进一步的实验室多重PET-PCR分析。结果 收集了 340 份 DBS 样本并进行了 PET-PCR 分析。总体而言，73.2% [95% CI 68.2-77.9%]（249/340）的疟原虫属和种呈阳性，代表了研究人群。恶性疟原虫的疟原虫属种比例为 89.5% [95% CI 85.1-93.1%]（223/249），疟疾疟原虫的疟原虫属种比例为 38.5% [95% CI 32.5-44.9%]（96/249），间日疟原虫的疟原虫属种比例为 10.8% [95% CI 7.3-15.4%]（27/249），卵形疟原虫的疟原虫属种比例为 1.6% [95% CI 0.4-4.1%]（4/249）。单一疟原虫感染率为 61.8% [95% CI 55.5-67.9%]（154/249），混合感染率为 38.1% [95% CI 32.1-44.5%]（95/249），至少有两种疟原虫。非疟原虫感染率为 10.0% [95% CI 6.6-14.5%]（25/249）。结论 本研究首次通过 PET-PCR 在尼日尔证实了间日疟原虫以及其他三种疟原虫。这些发现突出表明，有必要调整疟疾诊断工具和治疗管理，并对显微镜医师进行培训，以识别该国流行的非疟原虫疟原虫种类，从而为尼日尔疟疾控制和消除战略以及卫生当局的决策提供更好的信息。
{"title":"Circulation of Non-falciparum species in Niger: Implications for malaria diagnosis","authors":"Mamane N Garba, Lamine M Moustapha, Djiby Sow, Aichatou Karimoun, Ibrahima Issa, Mamane K Sanoussi, Mamadou A Diallo, Mahamadou Doutchi, Khadim Diongue, Maman L Ibrahim, Daouda Ndiaye, Aida S Badiane","doi":"10.1093/ofid/ofae474","DOIUrl":"https://doi.org/10.1093/ofid/ofae474","url":null,"abstract":"Rationale Niger’s National Malaria Control Programme (NMCP) and its partners use HRP2-based RDTs which are specific to Plasmodium falciparum diagnosis. This study aimed to screen for the circulation of Non-falciparum species in Zinder, a region of Niger, West Africa. Methods A cross-sectional study was carried out from July to December 2022 at the district hospital of the Zinder region of Niger. PfHRP2-RDTs were performed, and Dried blood spots (DBS) samples were collected for further laboratory multiplexed PET-PCR analysis on positive light microscopy from all febrile patients who attended the Zinder district hospital during the study period. Results Three hundred forty (340) DBS were collected and analyzed by the PET-PCR. Overall, 73.2% [95% CI 68.2-77.9%] (249/340) were positive for Plasmodium genus and species and represented the study population. The Plasmodium species proportions are 89.5% [95% CI 85.1-93.1%] (223/249) for Plasmodium falciparum, 38.5% [95% CI 32.5-44.9%] (96/249) for Plasmodium malariae, 10.8% [95% CI 7.3-15.4%] (27/249) for Plasmodium vivax, and 1.6% [95% CI 0.4-4.1%] (4/249) for P. ovale. Single infection with Plasmodium species counted for 61.8% [95% CI 55.5-67.9%] (154/249), and the mixed infections rate, with at least two Plasmodium species, was 38.1% [95% CI 32.1-44.5%] (95/249). The overall single Non-falciparum infections represented a rate of 10.0% [95% CI 6.6-14.5%] (25/249). Conclusions This study confirms the first evidence of Plasmodium vivax by PET-PCR in Niger in addition to the other three Plasmodium species. These findings underline the need to adapt malaria diagnostic tools and therapeutic management as well as the training of microscopists for recognition of Non-falciparum plasmodial species circulating in the country which will better inform the strategies towards malaria control and elimination as well as the decision-making of the health authorities of Niger.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142189324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-16eCollection Date: 2024-09-01DOI: 10.1093/ofid/ofae465
Rebecca J Rubinstein, Lester Gutiérrez, Christian Toval-Ruíz, Kelli Hammond, Lars Bode, Jan Vinjé, Samuel Vilchez, Sylvia Becker-Dreps, Filemón Bucardo, Nadja A Vielot, Yaoska Reyes
Background: Astrovirus is a leading cause of acute gastroenteritis in children worldwide. However, few prospective studies have analyzed astrovirus in community-dwelling pediatric populations in low- and middle-income countries.
Methods: We assessed the incidence, risk factors, clinical characteristics, genotypes, viral coinfections, and time distribution of astrovirus gastroenteritis in 443 healthy Nicaraguan children born in 2017 to 2018 who were followed for 36 months. Children were recruited from hospitals and birth records in an economically diverse neighborhood of León city. Astrovirus-positive episodes and genotypes were identified from stool with reverse transcription quantitative polymerase chain reaction and Sanger sequencing.
Results: Of 1708 total specimens tested, 80 children (18%) experienced at least 1 astrovirus episode, and 9 experienced repeat episodes, mostly during the rainy season (May-October). Initial astrovirus episodes were not associated with a lowered risk against future episodes. In exploratory analyses, home toilets were associated with a lower risk of future astrovirus episodes (hazard ratio, 0.19; 95% CI, .04-.91). Human astrovirus 5 episodes, representing 15% of all typed episodes, were associated with longer diarrhea and more symptomatic rotavirus coinfections.
Conclusions: Astrovirus was a common cause of gastroenteritis in this cohort, and future studies should clarify the role of astrovirus genotype in clinical infection severity.
{"title":"Epidemiology of Pediatric Astrovirus Gastroenteritis in a Nicaraguan Birth Cohort.","authors":"Rebecca J Rubinstein, Lester Gutiérrez, Christian Toval-Ruíz, Kelli Hammond, Lars Bode, Jan Vinjé, Samuel Vilchez, Sylvia Becker-Dreps, Filemón Bucardo, Nadja A Vielot, Yaoska Reyes","doi":"10.1093/ofid/ofae465","DOIUrl":"10.1093/ofid/ofae465","url":null,"abstract":"<p><strong>Background: </strong>Astrovirus is a leading cause of acute gastroenteritis in children worldwide. However, few prospective studies have analyzed astrovirus in community-dwelling pediatric populations in low- and middle-income countries.</p><p><strong>Methods: </strong>We assessed the incidence, risk factors, clinical characteristics, genotypes, viral coinfections, and time distribution of astrovirus gastroenteritis in 443 healthy Nicaraguan children born in 2017 to 2018 who were followed for 36 months. Children were recruited from hospitals and birth records in an economically diverse neighborhood of León city. Astrovirus-positive episodes and genotypes were identified from stool with reverse transcription quantitative polymerase chain reaction and Sanger sequencing.</p><p><strong>Results: </strong>Of 1708 total specimens tested, 80 children (18%) experienced at least 1 astrovirus episode, and 9 experienced repeat episodes, mostly during the rainy season (May-October). Initial astrovirus episodes were not associated with a lowered risk against future episodes. In exploratory analyses, home toilets were associated with a lower risk of future astrovirus episodes (hazard ratio, 0.19; 95% CI, .04-.91). Human astrovirus 5 episodes, representing 15% of all typed episodes, were associated with longer diarrhea and more symptomatic rotavirus coinfections.</p><p><strong>Conclusions: </strong>Astrovirus was a common cause of gastroenteritis in this cohort, and future studies should clarify the role of astrovirus genotype in clinical infection severity.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-16eCollection Date: 2024-08-01DOI: 10.1093/ofid/ofae459
Mahrukh Imran, Carrie W Mills, Kimberly W McDermott, Alex Dean, Alina Bogdanov, Ian McGovern, Mendel D M Haag
Background: This study estimated the relative vaccine effectiveness (rVE) of the MF59-adjuvanted trivalent influenza vaccine (aTIV) versus high-dose trivalent inactivated influenza vaccine (HD-TIV) for prevention of influenza-related medical encounters (IRMEs) during the 2019-2020 United States (US) influenza season stratified by the cumulative number of influenza risk factors. A secondary objective evaluated outpatient IRMEs and influenza- and pneumonia-related hospitalizations.
Methods: This retrospective cohort study included US adults ≥65 years old vaccinated with aTIV or HD-TIV between 1 August 2019 and 31 January 2020. Electronic health records linked to claims were used to ascertain exposure, covariates, risk factors, and outcomes. Multivariable adjusted odds ratios (ORs) were derived using inverse probability of treatment-weighted samples to calculate rVEs independently for individuals with 0, ≥1, 1-2, or ≥3 risk factors.
Results: The study included 1 115 725 aTIV and 2 561 718 HD-TIV recipients. For the primary outcome of any IRME, the analysis found comparable effectiveness between aTIV and HD-TIV (rVE, 5.2% [95% confidence interval {CI}, -5.9% to 15.1%]) among those with 0 risk factors, whereas aTIV was more effective than HD-TIV among patients with ≥1, 1-2, or ≥3 risk factors (12.5% [95% CI, 10.0%-15.0%], 18.4% [95% CI, 13.7%-22.9%], and 10.4% [7.4%-13.3%], respectively). The same trends were observed for the secondary outcomes.
Conclusions: This study demonstrated comparable effectiveness of aTIV and HD-TIV among individuals with no identified risk factors and higher effectiveness of aTIV compared with HD-TIV in preventing any IRMEs, outpatient IRMEs, and influenza- or pneumonia-related hospitalizations among those with at least 1 or multiple high-risk factors in adults ≥65 years old.
{"title":"Relative Effectiveness of the MF59-Adjuvanted Influenza Vaccine Versus High-Dose Influenza Vaccine in Older Adults With Influenza Risk Factors During the 2019-2020 US Influenza Season.","authors":"Mahrukh Imran, Carrie W Mills, Kimberly W McDermott, Alex Dean, Alina Bogdanov, Ian McGovern, Mendel D M Haag","doi":"10.1093/ofid/ofae459","DOIUrl":"10.1093/ofid/ofae459","url":null,"abstract":"<p><strong>Background: </strong>This study estimated the relative vaccine effectiveness (rVE) of the MF59-adjuvanted trivalent influenza vaccine (aTIV) versus high-dose trivalent inactivated influenza vaccine (HD-TIV) for prevention of influenza-related medical encounters (IRMEs) during the 2019-2020 United States (US) influenza season stratified by the cumulative number of influenza risk factors. A secondary objective evaluated outpatient IRMEs and influenza- and pneumonia-related hospitalizations.</p><p><strong>Methods: </strong>This retrospective cohort study included US adults ≥65 years old vaccinated with aTIV or HD-TIV between 1 August 2019 and 31 January 2020. Electronic health records linked to claims were used to ascertain exposure, covariates, risk factors, and outcomes. Multivariable adjusted odds ratios (ORs) were derived using inverse probability of treatment-weighted samples to calculate rVEs independently for individuals with 0, ≥1, 1-2, or ≥3 risk factors.</p><p><strong>Results: </strong>The study included 1 115 725 aTIV and 2 561 718 HD-TIV recipients. For the primary outcome of any IRME, the analysis found comparable effectiveness between aTIV and HD-TIV (rVE, 5.2% [95% confidence interval {CI}, -5.9% to 15.1%]) among those with 0 risk factors, whereas aTIV was more effective than HD-TIV among patients with ≥1, 1-2, or ≥3 risk factors (12.5% [95% CI, 10.0%-15.0%], 18.4% [95% CI, 13.7%-22.9%], and 10.4% [7.4%-13.3%], respectively). The same trends were observed for the secondary outcomes.</p><p><strong>Conclusions: </strong>This study demonstrated comparable effectiveness of aTIV and HD-TIV among individuals with no identified risk factors and higher effectiveness of aTIV compared with HD-TIV in preventing any IRMEs, outpatient IRMEs, and influenza- or pneumonia-related hospitalizations among those with at least 1 or multiple high-risk factors in adults ≥65 years old.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11337123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-14eCollection Date: 2024-08-01DOI: 10.1093/ofid/ofae463
Henry U Michael, Antony M Rapulana, Theresa Smit, Njabulo Xulu, Sivapragashini Danaviah, Suvira Ramlall, Frasia Oosthuizen
Background: Despite antiretroviral therapy (ART), human immunodeficiency virus (HIV)-associated neurocognitive impairment persists. We investigated the association between serum levels of mature brain-derived neurotrophic factor (mBDNF), precursor brain-derived neurotrophic factor (proBDNF), and neurocognitive changes over time among adults with HIV in sub-Saharan Africa, seeking to elucidate the interplay between neurotrophic factors and neurocognitive outcomes post-ART.
Methods: Utilizing data from the ACTG 5199 study in Johannesburg and Harare, serum mBDNF and proBDNF levels were measured via enzyme-linked immunosorbent assay. Neurocognitive performance was assessed at baseline and 24, 48, and 96 weeks using neuropsychological tests. The Friedman test and linear mixed-effects models were used to assess changes in mBDNF, proBDNF, and neurocognitive performance over time, accounting for individual variability and adjusting for multiple comparisons.
Results: Among 155 participants, there were significant cognitive improvements (P < .001) and a rise in mBDNF levels from baseline to 96 weeks. The proBDNF levels initially remained stable (P = .57) but notably increased by 48 weeks (P = .04). Higher mBDNF levels were positively associated with enhanced neurocognitive performance at 48 weeks (β = .16, P = .01) and 96 weeks (β = .32, P < .001). Similarly, higher proBDNF levels were positively associated with neurocognitive performance at 96 weeks (β = .25, P < .001).
Conclusions: This study highlights the significant association between serum BDNF levels and neurocognitive improvement post-ART in adults with HIV. However, more research is needed to replicate these findings, establish causal relationships, and explore whether BDNF-enhancing activities can improve neurocognitive outcomes in people with HIV.
{"title":"The Association Between Serum Mature and Precursor Brain-Derived Neurotrophic Factor and Neurocognitive Function in People With Human Immunodeficiency Virus: A Longitudinal Study.","authors":"Henry U Michael, Antony M Rapulana, Theresa Smit, Njabulo Xulu, Sivapragashini Danaviah, Suvira Ramlall, Frasia Oosthuizen","doi":"10.1093/ofid/ofae463","DOIUrl":"10.1093/ofid/ofae463","url":null,"abstract":"<p><strong>Background: </strong>Despite antiretroviral therapy (ART), human immunodeficiency virus (HIV)-associated neurocognitive impairment persists. We investigated the association between serum levels of mature brain-derived neurotrophic factor (mBDNF), precursor brain-derived neurotrophic factor (proBDNF), and neurocognitive changes over time among adults with HIV in sub-Saharan Africa, seeking to elucidate the interplay between neurotrophic factors and neurocognitive outcomes post-ART.</p><p><strong>Methods: </strong>Utilizing data from the ACTG 5199 study in Johannesburg and Harare, serum mBDNF and proBDNF levels were measured via enzyme-linked immunosorbent assay. Neurocognitive performance was assessed at baseline and 24, 48, and 96 weeks using neuropsychological tests. The Friedman test and linear mixed-effects models were used to assess changes in mBDNF, proBDNF, and neurocognitive performance over time, accounting for individual variability and adjusting for multiple comparisons.</p><p><strong>Results: </strong>Among 155 participants, there were significant cognitive improvements (<i>P</i> < .001) and a rise in mBDNF levels from baseline to 96 weeks. The proBDNF levels initially remained stable (<i>P</i> = .57) but notably increased by 48 weeks (<i>P</i> = .04). Higher mBDNF levels were positively associated with enhanced neurocognitive performance at 48 weeks (β = .16, <i>P</i> = .01) and 96 weeks (β = .32, <i>P</i> < .001). Similarly, higher proBDNF levels were positively associated with neurocognitive performance at 96 weeks (β = .25, <i>P</i> < .001).</p><p><strong>Conclusions: </strong>This study highlights the significant association between serum BDNF levels and neurocognitive improvement post-ART in adults with HIV. However, more research is needed to replicate these findings, establish causal relationships, and explore whether BDNF-enhancing activities can improve neurocognitive outcomes in people with HIV.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mariana Buziashvili, Mamuka Djibuti, Nestani Tukvadze, Jack DeHovitz, Davit Baliashvili
Background Tuberculosis is a leading cause of morbidity and mortality among people living with HIV (PLHIV) globally. Our study is the first to evaluate TB incidence and its risk factors among PLHIV in the country of Georgia, where previously no data was available. Methods A retrospective cohort study was conducted among persons newly diagnosed with HIV in Georgia during 2019-2020. Active TB incidence was calculated within a minimum of 2-year follow-up period from HIV diagnosis. Cox proportional hazard model was used for evaluating risk factors for TB development. Results The median age in the final cohort of 1,165 PLHIV was 38 (IQR 30-48) and 76.3% were male. 29% of patients had CD4 cell count <200 at HIV diagnosis and 89.9% initiated antiretroviral therapy (ART). TB incidence rate was 10/1,000 person-years (95%CI 9.6-10.4), with rates being higher within several sub-groups, mainly: PLHIV aged 40-49 (17.5/1,000p-y [95%CI 16.8-18.2]); those not receiving ART (22/1,000p-y [95%CI 20.9-23.1]); those with CD4<200 at baseline (28/1,000p-y [95%CI 27.4-28.6]); and those who developed AIDS (29.1/1,000p-y [95%CI 28.6-29.6]). Age (aHR 1.2, 95%CI 1.03-1.39, p=0.01) and AIDS diagnosis (aHR 3.2, 95%CI 3.06-27.9, p=0.001) were associated with TB development, while high CD4 count was protective against TB (aHR 0.18, 95%CI 0.06-0.61, p=0.005). Conclusions Study results highlight an imperative role of CD4 cell count management and the need for early HIV diagnosis and timely initiation of ART to ensure an effective immune response against tuberculosis, stressing the need for further in-depth evaluation of the TB preventive treatment delivery system’s efficiency and gaps.
{"title":"Incidence rate and risk factors for developing active tuberculosis among people living with HIV in Georgia in 2019-2020 cohort","authors":"Mariana Buziashvili, Mamuka Djibuti, Nestani Tukvadze, Jack DeHovitz, Davit Baliashvili","doi":"10.1093/ofid/ofae466","DOIUrl":"https://doi.org/10.1093/ofid/ofae466","url":null,"abstract":"Background Tuberculosis is a leading cause of morbidity and mortality among people living with HIV (PLHIV) globally. Our study is the first to evaluate TB incidence and its risk factors among PLHIV in the country of Georgia, where previously no data was available. Methods A retrospective cohort study was conducted among persons newly diagnosed with HIV in Georgia during 2019-2020. Active TB incidence was calculated within a minimum of 2-year follow-up period from HIV diagnosis. Cox proportional hazard model was used for evaluating risk factors for TB development. Results The median age in the final cohort of 1,165 PLHIV was 38 (IQR 30-48) and 76.3% were male. 29% of patients had CD4 cell count &lt;200 at HIV diagnosis and 89.9% initiated antiretroviral therapy (ART). TB incidence rate was 10/1,000 person-years (95%CI 9.6-10.4), with rates being higher within several sub-groups, mainly: PLHIV aged 40-49 (17.5/1,000p-y [95%CI 16.8-18.2]); those not receiving ART (22/1,000p-y [95%CI 20.9-23.1]); those with CD4&lt;200 at baseline (28/1,000p-y [95%CI 27.4-28.6]); and those who developed AIDS (29.1/1,000p-y [95%CI 28.6-29.6]). Age (aHR 1.2, 95%CI 1.03-1.39, p=0.01) and AIDS diagnosis (aHR 3.2, 95%CI 3.06-27.9, p=0.001) were associated with TB development, while high CD4 count was protective against TB (aHR 0.18, 95%CI 0.06-0.61, p=0.005). Conclusions Study results highlight an imperative role of CD4 cell count management and the need for early HIV diagnosis and timely initiation of ART to ensure an effective immune response against tuberculosis, stressing the need for further in-depth evaluation of the TB preventive treatment delivery system’s efficiency and gaps.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142189325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Grace X Li, Komal Gopchandani, N. Brazer, Ashley Tippett, Chris Choi, Hui-Mien Hsiao, Miriam Oseguera, Abiodun Foresythe, Sanchita Bhattacharya, V. Servellita, Alicia Sotomayor Gonzalez, J. Spinler, Mark D Gonzalez, D. Gulick, Colleen S. Kraft, Vyjayanti Kasinathan, Yun F (Wayne) Wang, J. Dien Bard, Pei Ying Chen, Jessica Flores-Vazquez, Audrey R Odom John, P. Planet, Sridevi Devaraj, A. V. Annapragada, R. A. Luna, Charles Y Chiu, C. Rostad
COVID-19 continues to cause hospitalizations and severe disease in children and adults. This study compared the risk factors, symptoms, and outcomes of children and adults hospitalized for COVID-19 from March 2020 to May 2023 across age strata at five US sites participating in the PreVAIL consortium. Eligible patients had an upper respiratory swab that tested positive for SARS-CoV-2 by nucleic acid amplification. Adjusted odds ratios of clinical outcomes were determined for children versus adults, for pediatric age strata compared to adolescents (12-17 years), and for adult age strata compared to young adults (22-49 years). Of 9101 patients in the PreVAIL cohort, 1560 were hospitalized for COVID-19 as the primary reason. Compared to adults (22-105 years, n=675), children (0-21 years, n=885) were less commonly vaccinated (14.3% vs. 34.5%), more commonly infected with the Omicron variant (49.5% vs. 26.1%) and had fewer comorbidities (p<0.001 for most comparisons), except for lung disease (p = 0.24). After adjusting for confounding variables, children had significantly lower odds of receiving supplemental oxygen (aOR 0.57, 95%CI 0.35, 0.92) and death (aOR 0.011, 95%CI <0.01, 0.58) compared to adults. Among pediatric age strata, adolescents 12-17 years had the highest odds of receiving supplemental oxygen, high-flow oxygen, and ICU admission. Among adults, those 50-64 years had the highest odds of mechanical ventilation and ICU admission. Clinical outcomes of COVID-19 differed across pediatric and adult age strata. Adolescents experienced the most severe disease among children, while adults 50-64 years experienced the most severe disease among adults.
{"title":"Clinical Features and Outcomes of Pediatric and Adult Patients Hospitalized for Covid-19: A Comparison across Age Strata","authors":"Grace X Li, Komal Gopchandani, N. Brazer, Ashley Tippett, Chris Choi, Hui-Mien Hsiao, Miriam Oseguera, Abiodun Foresythe, Sanchita Bhattacharya, V. Servellita, Alicia Sotomayor Gonzalez, J. Spinler, Mark D Gonzalez, D. Gulick, Colleen S. Kraft, Vyjayanti Kasinathan, Yun F (Wayne) Wang, J. Dien Bard, Pei Ying Chen, Jessica Flores-Vazquez, Audrey R Odom John, P. Planet, Sridevi Devaraj, A. V. Annapragada, R. A. Luna, Charles Y Chiu, C. Rostad","doi":"10.1093/ofid/ofae443","DOIUrl":"https://doi.org/10.1093/ofid/ofae443","url":null,"abstract":"\u0000 \u0000 \u0000 COVID-19 continues to cause hospitalizations and severe disease in children and adults.\u0000 \u0000 \u0000 \u0000 This study compared the risk factors, symptoms, and outcomes of children and adults hospitalized for COVID-19 from March 2020 to May 2023 across age strata at five US sites participating in the PreVAIL consortium. Eligible patients had an upper respiratory swab that tested positive for SARS-CoV-2 by nucleic acid amplification. Adjusted odds ratios of clinical outcomes were determined for children versus adults, for pediatric age strata compared to adolescents (12-17 years), and for adult age strata compared to young adults (22-49 years).\u0000 \u0000 \u0000 \u0000 Of 9101 patients in the PreVAIL cohort, 1560 were hospitalized for COVID-19 as the primary reason. Compared to adults (22-105 years, n=675), children (0-21 years, n=885) were less commonly vaccinated (14.3% vs. 34.5%), more commonly infected with the Omicron variant (49.5% vs. 26.1%) and had fewer comorbidities (p<0.001 for most comparisons), except for lung disease (p = 0.24). After adjusting for confounding variables, children had significantly lower odds of receiving supplemental oxygen (aOR 0.57, 95%CI 0.35, 0.92) and death (aOR 0.011, 95%CI <0.01, 0.58) compared to adults. Among pediatric age strata, adolescents 12-17 years had the highest odds of receiving supplemental oxygen, high-flow oxygen, and ICU admission. Among adults, those 50-64 years had the highest odds of mechanical ventilation and ICU admission.\u0000 \u0000 \u0000 \u0000 Clinical outcomes of COVID-19 differed across pediatric and adult age strata. Adolescents experienced the most severe disease among children, while adults 50-64 years experienced the most severe disease among adults.\u0000","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141919868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kat Schmidt, S. Pollett, S. Richard, Vivian Hogan, Emily Hone, Jennifer Rothenberg, R. Tant, Michele Wayman, Chantele Friend, Kamala Thapa, L. Ulomi, Julian Davies, Amber Michel, Timothy H Burgess, C. R. J. O’Connell, C. M. P. Simons, C. D. H. Tilley, A. Fries, R. Colombo
We sequenced and genotyped SARS-CoV-2, influenza, adenovirus, and respiratory syncytial virus (RSV), among other pathogens, from residual anterior nasal swabs self-collected for rapid SARS-CoV-2 antigen testing at the US Naval Academy. This is a key proof-of-concept for an acute respiratory infection surveillance approach, which could leverage prevalent SARS-CoV-2 antigen self-testing.
{"title":"Opportunities for enhanced public health surveillance via molecular detection and sequencing of diverse respiratory viruses from self-collected SARS-CoV-2 antigen test swabs","authors":"Kat Schmidt, S. Pollett, S. Richard, Vivian Hogan, Emily Hone, Jennifer Rothenberg, R. Tant, Michele Wayman, Chantele Friend, Kamala Thapa, L. Ulomi, Julian Davies, Amber Michel, Timothy H Burgess, C. R. J. O’Connell, C. M. P. Simons, C. D. H. Tilley, A. Fries, R. Colombo","doi":"10.1093/ofid/ofae447","DOIUrl":"https://doi.org/10.1093/ofid/ofae447","url":null,"abstract":"\u0000 We sequenced and genotyped SARS-CoV-2, influenza, adenovirus, and respiratory syncytial virus (RSV), among other pathogens, from residual anterior nasal swabs self-collected for rapid SARS-CoV-2 antigen testing at the US Naval Academy. This is a key proof-of-concept for an acute respiratory infection surveillance approach, which could leverage prevalent SARS-CoV-2 antigen self-testing.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141920670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Vesty, Xiaoyun Ren, Prachi Sharma, Natalie Lorenz, T. Proft, Allan Hardaker, Christina Straub, J. Morgan, Audrey Tiong, Anneka Anderson, Rachel H Webb, Julie Bennett, Philip E Carter, N. Moreland
M1UK is associated with current surges in invasive infection globally, partly due to increased production of superantigen SpeA. We show M1UK is now the dominant invasive emm1 lineage in New Zealand and is genomically related to community infections, suggesting measures that effectively prevent GAS-pharyngitis in children could reduce invasive disease.
{"title":"The emergence and impact of the M1UK lineage on invasive Group A Streptococcus disease in Aotearoa New Zealand","authors":"Anna Vesty, Xiaoyun Ren, Prachi Sharma, Natalie Lorenz, T. Proft, Allan Hardaker, Christina Straub, J. Morgan, Audrey Tiong, Anneka Anderson, Rachel H Webb, Julie Bennett, Philip E Carter, N. Moreland","doi":"10.1093/ofid/ofae457","DOIUrl":"https://doi.org/10.1093/ofid/ofae457","url":null,"abstract":"\u0000 M1UK is associated with current surges in invasive infection globally, partly due to increased production of superantigen SpeA. We show M1UK is now the dominant invasive emm1 lineage in New Zealand and is genomically related to community infections, suggesting measures that effectively prevent GAS-pharyngitis in children could reduce invasive disease.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141922915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hypoalbuminemia and Posaconazole Therapeutic Drug Monitoring","authors":"David E Nix, M. Al-Obaidi, T. Zangeneh","doi":"10.1093/ofid/ofae452","DOIUrl":"https://doi.org/10.1093/ofid/ofae452","url":null,"abstract":"","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141921680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cody A Cunningham, Ashlyn T Brown, Srekar N Ravi, Jeremiah J Bearss, Michael P O’Shea, Amani K Elshaer, Matt V Biondi, Bobak Seddighzadeh, Sandra N Elmasry, Amogh Havanur, Avanika Mahajan, Juliana Savic, Nneoma U Alozie, Douglas Rappaport, Andrej Urumov, Janis E Blair
Coccidioidomycosis is a common cause of community-acquired pneumonia in endemic regions. Approximately 20,000 cases of coccidioidomycosis occur annually, however this statistic is limited by a widespread lack of testing. Here, we analyze emergency medicine provider attitudes towards coccidioidal testing and assess the effect of an intervention to improve testing rates.
{"title":"Improving Coccidioidomycosis testing for emergency department patients with suspect community-acquired pneumonia: Analysis of provider attitudes and the effect of a targeted intervention","authors":"Cody A Cunningham, Ashlyn T Brown, Srekar N Ravi, Jeremiah J Bearss, Michael P O’Shea, Amani K Elshaer, Matt V Biondi, Bobak Seddighzadeh, Sandra N Elmasry, Amogh Havanur, Avanika Mahajan, Juliana Savic, Nneoma U Alozie, Douglas Rappaport, Andrej Urumov, Janis E Blair","doi":"10.1093/ofid/ofae461","DOIUrl":"https://doi.org/10.1093/ofid/ofae461","url":null,"abstract":"Coccidioidomycosis is a common cause of community-acquired pneumonia in endemic regions. Approximately 20,000 cases of coccidioidomycosis occur annually, however this statistic is limited by a widespread lack of testing. Here, we analyze emergency medicine provider attitudes towards coccidioidal testing and assess the effect of an intervention to improve testing rates.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141969304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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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