Journal of Infection in Developing Countries最新文献

Introduction: Parvovirus B19 virus-mediated viral inflammation and immune-complex deposition generate mainly short-term manifestations in the affected individuals. The objective of this study was to determine Parvovirus B19 infection in rheumatoid arthritis (RA) patients.

Methodology: The study employed 50 patients diagnosed with RA and 30 healthy individuals. Blood samples were collected from both groups. The blood samples were screened for Parvovirus B19 infection using polymerase chain reaction to detect B19 DNA and enzyme-linked immunosorbent assay to detect anti-B19 IgM and IgG.

Results: 17 (34%) of 50 patients tested positive for parvovirus B19 DNA. In contrast, the mortality rate in the control group was significantly lower (6.7%; p = 0.005). Anti-B19 IgG antibody levels differed significantly with patients and control (p = 0.007), whereas anti-B19 IgM Ab levels did not (p = 0.6). There was a significant correlation between viremia B19 and all measured parameters. Parvovirus-affected patients had significantly higher CRP and ESR, elevated DAS28 scores, and more joint pain compared to parvovirus (-) patients.

Conclusion: Anti-CCP and RF values were significantly high in parvovirus (+) patients. Joint erosion was also prevalent in patients who tested positive for parvovirus. The findings of this study suggest that infection with parvovirus in patients with RA, and a possible role of this viral infection in the pathogenesis of RA may contribute to the pathogenesis of RA.

Introduction: Drug-resistant tuberculosis is a severe global public health threat. Virulence factors and antibiotic resistance are generally considered to play a significant role in bacterial pathogenesis. However, the interaction between resistance and virulence in Mycobacterium tuberculosis (MTB) remains unclear.

Methodology: Here, we used whole genome sequences from 667 MTB isolates from 14 countries to complete an in silico evaluation of the correlations between virulence gene mutations, drug resistance, and lineage classification. The chi-square (χ2) test was used to determine whether specific virulence gene mutations and drug resistance were related.

Results: Our results showed that Mce1R_G171R and Pks15_V333A, were positively correlated with streptomycin and ethambutol resistance, respectively, and Pks15_T46I was correlated with isoniazid, rifampin, ethambutol, pyrazinamide and streptomycin resistance. We also identified an additional 24 and 40 single nucleotide polymorphisms as well as 6 and 2 insertions or deletions in various virulence genes that are likely to be associated with changes in drug susceptibility in L2 and L4, respectively.

Conclusions: Taken together our data suggest that there may be some degree of co-selection between virulence and resistance factors, which may help MTB more easily adapt to new environments.

Introduction: Armenia's favorable geographical and climatic conditions support mosquitoes, sandflies, and ticks that can transmit various diseases. This study aimed to determine the prevalence of these vectors and circulating arboviruses in Armenia and assess healthcare workers` knowledge of arboviral diseases.

Methodology: In 2021, we conducted fieldwork, combining morphological identification of vectors with polymerase chain reaction (PCR) analysis of pathogens to map the distribution of potential arbovirus vectors across Armenia.

Results: Our entomological surveys identified four mosquito genera-Anopheles, Aedes, Culex, and Culiseta-comprising 20 species; and 11 species of Ixodidae ticks. Culex pipiens was found in all 11 regions, while Culiseta spp. was absent in Ararat Province. PCR testing of mosquito and tick samples revealed Crimean-Congo hemorrhagic fever virus (CCHFV) in 13 tick samples, but West Nile virus (WNV) was not detected in mosquitoes. Specifically, 13 out of 525 Ixodes tick pools tested positive for CCHFV; the positive samples originated from Hyalomma marginatum ticks in Syunik's Sisian region. None of the 11 pools that contained 473 Cx. pipiens mosquitoes tested positive for WNV. Analysis of questionnaires from 499 healthcare workers showed that epidemiologists, infectious disease specialists, and family doctors had greater awareness of arboviral diseases than other specialists. However, there was a low rate of sample submission for laboratory diagnosis and confirmation.

Conclusions: The extensive presence of vectors combined with limited knowledge of arboviral diseases complicates disease understanding in Armenia. Strengthening the surveillance system through training and improved sample collection is essential for disease monitoring and public health interventions.

Introduction: Favipiravir (FVP) is an antiviral, targeting RNA-dependent RNA polymerase. We aimed to evaluate the efficacy of FVP as a treatment for COVID-19.

Methods: We conducted a retrospective study in two centers (San Martino University Hospital in Genova, Italy, and Marmara University Pendik Training and Research Hospital, Turkey). Adult patients (inpatients) diagnosed with COVID-19 between March and June 2020 were included. All patients in the Italian center received the standard of care (SoC) treatment, while in the Turkish center patients received FVP in addition to SoC.

Results: Six hundred-nineteen patients were analyzed (225 from Turkey, all treated with FVP, and 394 from Italy, none treated with FVP). Propensity score-matching was done in 142 patients (71 from the SoC group vs. 71 from the SoC + FVP group). A Higher requirement of NIV/CPAP (n = 38; 53.5%) was registered in the SoC group compared to the SoC + FVP group (n = 9; 12.7%). A higher frequency of intubation was registered in the SoC + FVP group (n = 25; 35.2% vs n = 13, 18.3%). There was a trend towards better survival in SoC + FVP treated patients with HR = 0.64 (95% CI 0.30-1.34). At 28 days the OS was, respectively, 70.3% (95% CI: 53.2-82.1) vs 80.3% (95% CI: 69.0-87.8).

Conclusions: The addition of FVP to SoC did not show a significant difference in survival and invasive and noninvasive (CPAP/NIMV) mechanical ventilation compared to standard of care in moderate and severe COVID-19-infected patients.

Introduction: Updated data on the seroprevalences of hepatitis B and C viruses (HBV, HCV) are required to enable the adaptation of control strategies. In this study, we aimed to: (i) estimate the seroprevalences of HBsAg carriers and HCV exposure in the general population, and (ii) determine the impact of vaccination on HBV circulation since its introduction in 2006 in the Expanded Program on Immunization (EPI).

Methodology: From October 2020 to October 2022, a mass screening campaign was conducted in 10 cities across Burkina Faso. Individuals of all ages and genders who consented to participate were screened for viral markers (HBsAg, anti-HCV) using rapid diagnostic tests. The proportions of HBsAg carriers and HCV exposure were calculated using Stata, and logistic regression was used to assess the impact of HBV vaccination on HBsAg carriage.

Results: A total of 15,650 participants were enrolled in the study. Of these, 51.4% were women and the age range was from 1 to 97 years. All participants were screened for HBsAg and 7,507 were also screened for anti-HCV. Overall, the seroprevalence of HBsAg was 8.8% and 2.6% for anti-HCV. The results indicated that age, gender, and place of residence were associated with HBV infection.

Conclusions: The prevalence of HBV and HCV infections remains high in Burkina Faso. Prevention strategies, including initial mass screening with rapid diagnostic tests and vaccination, need to be intensified.

Introduction: Coronavirus disease 2019 (COVID-19) has an extremely high infection rate. This study aimed to investigate emotional states and COVID-19 infection of medical workers during the self-management strategy to COVID-19.

Methodology: Questionnaires were collected via an online questionnaire platform from 20 December 2022 to 19 January 2023, including demographic characteristics, number of vaccine doses, COVID-19 test results, occupation, attendant situations of workers, clinical symptoms, disease duration, and the Depression, Anxiety and Stress Scale 21.

Results: A total of 748 complete questionnaires were collected. The average age of participants was 33.61 ± 8.94 years, and 79.55% participants were female. The proportion of anxiety was significantly higher in the infection group (52.32%) than in the non-infection group (28.45%) (p < 0.001), as was the proportion of stress (41.47% vs. 31.90%, p = 0.046). Medical students (odds ratios (OR) 0.54, 95% confidence interval (CI) 0.31-0.93) and other staff (OR 0.63, 95% CI 0.40-0.98) had a lower risk for depression than doctors (p = 0.024), and attendant and infective situations of workers was the risk factor for depression (p = 0.007). Occupation (p = 0.029) and infected workers (p = 0.001) were related to anxiety. Infected attendant workers had a higher risk for stress (OR 1.97, 95% CI 1.12-3.48) than uninfected attendant workers (p = 0.019).

Conclusions: Most medical workers infected with COVID-19 had emotional disorders during the COVID-19 pandemic. Attention and useful measures are suggested to support medical workers.

Introduction: The dengue epidemic poses a significant public health challenge in Malaysia, and the concurrent presence of dengue and SARS-CoV-2 infections has further strained its healthcare system. Sabah, the second largest state in Malaysia, located in the northern part of Borneo Island, has been particularly hard-hit by both dengue and SARS-CoV-2 outbreaks. This study aims to analyze the status of dengue infections in Sabah over the past decade and understand the impact of the COVID-19 pandemic on dengue virus transmission.

Methodology: This study compared the annual dengue cases and associated deaths in Sabah from 2012 to 2022. Systematic data and information were collected from PubMed, the World Health Organization, the Centers for Disease Control and Prevention, and the official government reporting system of Malaysia.

Results: Dengue cases in Sabah increased overall with slight fluctuations over the years, marked by new outbreaks approximately every 3-5 years. The number of deaths did not consistently correlate with reported dengue cases. Early in the COVID-19 pandemic in 2020, dengue cases remained high; however, as COVID-19 cases surged, dengue cases experienced a significant decline. Conversely, from mid-2022, dengue cases surged in Sabah despite COVID-19 cases remaining relatively low and well-controlled. Particularly noteworthy is the 99% increase in dengue cases in Sabah, contrasting sharply with Malaysia's overall 36% decrease in 2022 compared to 2015 to 2019.

Conclusions: Monitoring and prioritizing efforts to prevent COVID-19 and control dengue transmission is crucial. The dual challenges posed by these diseases offer valuable lessons that should be incorporated into future pandemic-preparedness strategies.

Introduction: This study aimed to evaluate the antimicrobial resistance rates before and during the coronavirus disease 2019 (COVID-19) pandemic.

Methodology: 897 positive urine cultures collected from outpatients of all ages between January 1, 2017, and December 31, 2022, were analyzed. The antibiotic susceptibility tests (AST) were analyzed by using an automated VITEK 2 (Biomerieux, Marcy-l`Étoile, France) compact system. AST results were interpreted according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. The significance of resistance rates was tested with the Pearson's Chi-squared test and risk factors of extended-spectrum beta-lactamases (ESBL) positiveness were identified with binary logistic regression.

Results: E. coli (n = 774) and K. pneumoniae (n = 123) were isolated in 86.3% and 13.7% of the patients, respectively. During this period of six years before and during pandemic, the highest resistance rate was found for cefuroxime axetil (49.8%) and the lowest for nitrofuratoin (6.0%). Statistically significant increases in resistance compared to the pre-pandemic period were only determined for cefixime (37.2 vs 46.0%) and ceftriaxone (37.6 vs 46.1%) (p = 0.010). ESBL positivity was the most important factor that statistically increased resistance for all antibiotics (p < 0.001 for all). Being male [OR (95% CI) 1.56 (1.13-2.15)] and presenting to the clinic after the pandemic period [1.4 (1.1-1.8)] were found to increase ESBL positiveness significantly.

Conclusions: Ceftriaxone and Cefixime resistance rates and ESBL positivity among the uropathogens E. coli and K. pneumoniae increased during the pandemic compared with the pre-pandemic period. ESBL positivity was higher in males.

Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) Omicron variant infection has become widespread in China as a result of the alterations in epidemic control and prevention policies. We identified the clinical characteristics and lung computed tomography (CT) imaging characteristics of patients infected during the early stage of the Omicron BA.5 wave in Shanghai to provide a guide to the diagnosis, treatment, and prognosis of infection.

Methodology: Clinical information and lung CT imaging characteristics of patients with Omicron variant infection admitted to three designated hospitals in Shanghai from March to June 2022 were analyzed retrospectively.

Results: A total of 958 patients were included in the analysis. Among the patients, 169 (17.64%) had pneumonia confirmed by CT, of whom 70.41% (119/169) had lesions in < 10% of the lung area. Older age, unvaccinated status, and comorbid chronic lung disease, cerebrovascular disease, kidney disease, or Alzheimer`s disease were associated with poor prognosis. In patients with coronavirus disease 2019 (COVID-19) pneumonia, a large lesion size was associated with a poor prognosis. Age ≥ 65 years, unvaccinated status, fever > 5 days, and lymphocyte count < 0.5×109/L were risk factors for pneumonia.

Conclusions: Age ≥ 65 years, unvaccinated status, fever > 5 days, and lymphocyte count < 0.5×109/L can be used to identify high-risk individuals who warrant a CT scan to screen for COVID-19 pneumonia, especially during the period of Omicron variant predominance. Concurrently, the importance of immunization should be emphasized to help people withstand the effects of Omicron variant infection.

Introduction: The use of telemedicine for treatment of coronavirus disease 2019 (COVID-19) infection has been effective in lowering the risk of infection and relieving strain on the healthcare system. This study aimed to describe the clinical characteristics of COVID-19 cases, their follow-up, risk factors of disease severity, and predictors of hospital admission while using telemedicine.

Methodology: The study included 611 Egyptian patients with mild and moderate COVID-19 disease. The patients were isolated at home and monitored daily.

Results: Based on the World Health Organization classification, 79% of studied patients had mild illness while 20.5% had moderate illness. The initial symptoms included cough (51.7%), fever (50.8%), fatigue (45.9%), sore throat (41.1%), dyspnea (35.2%), and headache (34%); 25.2% patients had prolonged symptoms (≥ 21 days). Dyspnea was the most frequent (15.5%) long-term symptom. Age, co-existing diabetes, and COVID-19 infection with moderate severity, were associated with the need for hospitalization. We compared patients with COVID-19 infection who required hospital admission (n = 37) versus patients who continued in home isolation (n = 574). High neutrophil/lymphocyte ratio, transaminases, and ferritin significantly correlated with the need for hospitalization. 18.9% of the patients who required hospital admission had diabetes. Multivariate analysis described age and diabetes as independent predictors of disease severity. Age and high neutrophil/lymphocyte ratio were independent predictors of hospital admission.

Conclusions: Telemedicine is effective in-home management of mild/moderate COVID-19 patients, which may ease the pressure on the healthcare system, even beyond the pandemic.