Journal of Infection in Developing Countries最新文献

Introduction: Cancer patients were more likely to be affected by the coronavirus disease 2019 (COVID-19) pandemic. Therefore, we analyzed the clinical characteristics and outcomes in cancer patients who were infected with COVID-19 to determine if they were more vulnerable to COVID-19 than non-cancer patients.

Methodology: This retrospective study involved 150 cancer patients and 300 non-cancer patients with a laboratory-confirmed diagnosis of COVID-19 at the Cancer Hospital of the Chinese Academy of Medical Sciences, at the end of 2022. Multivariable analysis was carried out on the factors associated with COVID-19 severity in cancer patients.

Results: Compared to the non-cancer group, the cancer group saw a notably higher number of hospitalizations and fatalities. Multivariate analysis showed that COVID-19 severity was correlated with male gender (OR: 5.60, 95% CI, 1.89-16.57), and recovery duration was longer than 10 days (OR: 3.19, 95% CI, 1.09-9.32) in the cancer group. However, the severity of COVID-19 was not made worse by the administration of systemic anticancer treatments prior to the outbreak.

Conclusions: During the COVID-19 Omicron epidemic, there seemed to be some association between various antitumor therapies, treatment intervals, and COVID-19 severity. The findings of this study can potentially help allay cancer patients` fears regarding COVID-19 infection and enable them to continue with crucial therapeutic processes for the treatment of cancer.

Introduction: Identifying inflammation and lung damage markers is crucial in reducing morbidity and mortality of coronavirus disease 2019 (COVID-19). This study aimed to examine the validity and reliability of severity and post-infection lung damage and analyse their relationship.

Methodology: This was a prospective analysis study at the Airlangga University Hospital, Surabaya, Indonesia, from March to August 2021. The infection`s severity was measured by examining angiotensin-converting enzyme 2 (ACE2) levels and complete blood count. Lung damage was estimated by reviewing Krebs von de Lungen (KL)-6, matrix metalloproteinase (MMP)-9, tissue inhibitor metalloproteinase (TIMP)-1, and MMP-9/TIMP-1. Two-factor confirmatory factor analysis (CFA) and canonical correlation were calculated using Lisrel and SPSS (version 25).

Results: The research sample included 76 patients. The t count loading factor values were calculated: ACE2 (6.00), neutrophils (-0.80), lymphocytes (-0.63), neutrophil-lymphocyte ratio (NLR, 1.27), eosinophils (-1.52), basophils (1.72), monocytes (0.05), platelets (0.53), leukocytes (-0.51), platelet-lymphocyte ratio (PLR, -1.15), KL-6 (10.47), MMP-9 (11.91), TIMP-1 (11.79), and MMP-9/TIMP-1 (-0.24). The t values were: neutrophil covariance error (6.11), lymphocytes (6.12), NLR (6.10), eosinophils (6.08), basophils (6.07), monocytes (6.12), platelets (6.12), leukocytes (6.12), PLR (6.10), ACE2 (0.97), KL-6 (5.63), MMP-9 (2.08), TIMP-1 (2.77), and MMP-9/TIMP-1 (6.12). t value canonical correlation of 7.04 (t count > 1.96) indicated a correlation between the severity of the patient and post-infection lung damage.

Conclusions: The severity was adequately measured through ACE2, IL-6, IL-10, neutrophils, lymphocytes, leukocytes, and NLR. Lung damage was measured with KL-6, MMP-9, and TIMP-1. There was a correlation between disease severity and lung damage.

Introduction: It is known that health literacy and fear of COVID-19 are effective in complying with COVID-19 prevention measures. A limited number of studies have shown the relationship between health literacy, fear of COVID-19, and compliance with COVID-19 prevention measures. The purpose of this study is to investigate the fear of COVID-19, health literacy, compliance levels with prevention measures of adult individuals and influential factors.

Methodology: The cross-sectional study used an online questionnaire and was conducted with 1018 adults aged 18-64 in Turkey between 01-31 December 2020. The convenience sampling method was used to determine the sample. Student t-test, ANOVA, correlation, and multiple linear regression were used.

Results: Half of the participants (49.9%) had inadequate and problematic-limited health literacy (HL). Adults` compliance with measures during the COVID-19 pandemic and some sociodemographic characteristics had a significant relationship with HL and fear of COVID-19 (p < 0.05). It was determined that those with high HL and those afraid of COVID-19 paid more attention to precautions (p < 0.05). Health literacy was a predictor of fear of COVID-19 (β = -0.091; p < 0.001).

Conclusions: Governments need to invest in increasing health literacy.

Introduction: Diagnosis with Western blot test (WB) may not provide clear results for certain patients, including those who are not infected with human immunodeficiency virus (HIV) but produce non-specific reactions, individuals in the HIV window period (WP), those with acute HIV infection, and advanced acquired immunodeficiency syndrome (AIDS) patients. HIV-positive individuals face an elevated risk of developing kidney disease. HIV peritoneal dialysis patients may be more susceptible to catheter-related infections. This study reports a case of HIV detected during early development of a nephrotic syndrome into uremic syndrome.

Case presentation: A 46-year-old male individual diagnosed with stage 5 chronic kidney disease was admitted to the hospital in preparation for his first renal replacement therapy. During routine check-ups, the patient was identified as having a reactive response to the HIV antigen/antibody test. The rapid detection results exhibited a weak reaction across all manufacturers, while the enzyme-linked immunosorbent assay (ELISA) test (Bio-Rad, Hercules, USA) showed a reactive response. Nonetheless, the third and fourth generation tests did not yield a response, suggesting that the patient`s internal concentration of HIV antigen or antibody was relatively low at the time. However, the confirmation test did not provide conclusive results, leading the patient to decline further renal replacement therapy. Two months later, the patient`s HIV antigen/antibody levels were measured as 95.23 in the outpatient department of our hospital.

Conclusions: This case underscores the importance of actively exploring various detection strategies to enhance the efficiency of detecting acute phase HIV infection during the testing process.

Introduction: Coronavirus disease 2019 (COVID-19) has been associated with secondary fungal infections such as mucormycosis. We investigated the relapse rate of mucormycosis and its risk factors.

Methodology: A prospective study was conducted on COVID-19-associated mucormycosis (CAM) patients discharged from Imam Khomeini Hospital Complex, Tehran, Iran, from July 2021 to February 2022. Patients who received posaconazole as a step-down therapy were included and examined monthly for six months. A relapsing mucormycosis case was defined as a patient with new clinical or radiological symptoms, confirmed by observing aseptate hyphae in the histopathological examination or tissue culture. The characteristics of patients with and without relapse were analyzed and compared.

Results: Seventy-seven patients completed the six-month follow-up after discharge. Most patients were male (n = 46, 59.8%), with a mean age of 53.1 years (median 19-84). The most common underlying diseases were diabetes (52/77, 67.5%), hypertension (33/77, 42.8%), and cancer/chemotherapy (25/77, 32.4%). Seven patients (7/77, 9%) were reported as relapsing cases. There was no difference in demographic features and underlying diseases between the groups. A significant difference was seen in the mean duration of posaconazole consumption between patients with and without relapse (24 ± 4.4 days vs. 49.4 ± 4.3 days, respectively, p = 0.015). The primary orbital involvement was also significantly associated with relapse (p = 0.04).

Conclusions: Our findings showed a significant relapse of CAM (9%). A longer duration of posaconazole consumption and completion of treatment for initial orbital involvement in CAM patients are recommended for better patient management and prevention of relapse.

Introduction: A resurgence of pertussis has been reported in numerous countries. This study aimed to determine the incidence, clinical characteristics, and outcome of pertussis among infants in Sarawak, Malaysia.

Methodology: We conducted a descriptive retrospective study of infants aged < 12 months with laboratory-confirmed pertussis admitted to Bintulu Hospital in Sarawak, Malaysian Borneo, from 2015 until 2021. Pertussis was confirmed in all patients using a polymerase chain reaction of nasopharyngeal aspirates.

Results: Of 588 infants who had a nasopharyngeal aspirate, 108 (18%) had laboratory-confirmed pertussis. The average annual incidence was 482 per 100,000 infants aged < 12 months between 2015 and 2019, with a marked decline in 2020 and 2021. Eighty-two (76%) were < 3 months of age. Seventy-eight (72%) were unvaccinated for pertussis, including 75 (96%) who were too young to receive the first dose. A third of the cases had atypical presentations. Severe disease characterized by hypoxemia, pulmonary hypertension, recurrent apnea, encephalopathy, or cardiovascular dysfunction occurred in 32%. Forty-eight percent required humidified high-flow nasal cannula oxygen therapy and 22% required invasive ventilation. Twenty-four percent overall needed intensive care. One (1%) infant had a fatal outcome. Nearly all cases of severe disease or those that required invasive ventilation or intensive care had received ≤ 1 dose of pertussis vaccination.

Conclusions: A high incidence of pertussis with a high rate of severe disease was observed in Sarawak, Malaysia, predominantly among infants too young to be vaccinated. Additional vaccination strategies such as maternal vaccination or cocooning should be considered.

Introduction: The annual incidence of brain abscesses is 1-2% in developed countries and up to 8% in developing countries. Our aim was to describe the profile and etiological agents of patients with surgical brain infections according to their nosological diagnosis on admission, and to analyze whether the initial diagnosis influenced the neurological deficit at discharge.

Methodology: This was an observational study with convenience sampling. All surgical cases operated between January 2017 and February 2022 with a final diagnosis of an infectious process were included. Three groups were analyzed according to admission diagnosis: a) infection, b) neoplasia, and c) miscellaneous. The time before admission, final histological diagnosis, etiological agent, length of hospital stay, and secondary neurological deficits were investigated. Descriptive and comparative statistics were used.

Results: 24 cases, including 18 (75%) men and 6 (25%) women, of ages 19 to 61 years (average 43.7 years) were studied. Nosological diagnoses on admission were infection in 9 (37.5%) patients, cerebral neoplasia in 9 (37.5%) patients, and miscellaneous diagnoses in 6 (25%) patients. Among the miscellaneous, neoplastic, and infectious groups, 33.3%, 33.3%, and 22.2% of patients were discharged with some neurological deficits with overall neurological morbidity and mortality of 29.6% and 8%, respectively. The etiological agents were Mycobacterium tuberculosis (16.6%), Streptococcus sp. (13%), Morganella morganii (8.7%), Nocardia sp. (4.3%), Cryptococcus sp. (4.3%), and Klebsiella sp. (4.3%).

Conclusions: Nosological diagnosis on admission did not influence the percentage of patients with neurological deficits in our study. Mycobacterium was the most frequent etiological agent.

Introduction: We compared the clinical characteristics of vaccinated and non-vaccinated Omicron patients in order to provide a reference for the clinical diagnosis and treatment of coronavirus disease 2019 (COVID-19).

Methodology: This study included 360 patients diagnosed with COVID-19. The serum immunoglobulin G (IgG) and serum immunoglobulin M (IgM) antibody levels of the patients and the duration of virus shedding were analyzed according to age, gender, vaccine dose, and the time from the most recent vaccination to the onset of Omicron infection.

Results: Age (OR = 0.974), days from last vaccination to onset ≤ 180 days (OR = 4.409), and booster dose of the vaccine (OR = 4.999) were protective factors associated with patients who were IgG antibody positive. The duration of virus shedding in IgG -antibody-positive patients was 9 (8-11) days; and this was significantly lower than that in IgG-antibody-negative patients, who had virus shedding duration of 10 (8-12) days (p < 0.05).

Conclusions: Booster immunizations could increase IgG-antibody in patients who have already been infected with the Omicron variant and enhance immune protection. In addition, COVID-19 vaccination may shorten the duration of virus shedding.

Introduction: Coronavirus disease 2019 (COVID-19) first appeared in Iraq, including the Iraqi Kurdistan region governorates, in March 2020.

Methodology: 48,494 samples were collected from public hospitals in the Kurdish governates from February 2021 to May 2022. Viral RNA was extracted, and real time quantitative polymerase chain reaction (RT-PCR) was used to detect the COVID-19 variants. Statistical analysis of patients' clinical data was performed.

Results: The RT-PCR results identified the Alpha (B.1.1.7), Delta (B.1.617.2), and Omicron (B.1.1.529) variants in the Kurdistan governorates. Young adults (20-39 years) had significantly higher rate of infection than children (1-11 months) and older adults (80-89 years). The Delta wave was more contiguous, spread more easily, and more fatal than the Alpha and Omicron waves. The highest number of COVID-19 cases was reported in Sulaymaniyah and Duhok; and the highest death rate was reported in Sulaymaniyah. The death rate in males was higher than in females, especially among older people. Fatigue, cough, and fever were common symptoms among the three variants. The phylogenetic tree revealed that the L-type of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was a descendant of the S-type at an early stage of evolution. The L-type could spread faster in Kurdistan. Multiple sequence alignment (MSA) confirmed that all L-type variants in different countries were 100% similar in sequence, and all were mutated in the regions 8782: ORF1ab and 28144: ORF8 703.

Conclusions: This study described the COVID-19 waves, pathogenesis, and evolution of the virus in the Iraqi Kurdistan region.

Introduction: Coronavirus disease 2019 (COVID-19) has caused many injuries and deaths worldwide. Obesity is reported to be an important risk factor for severe COVID-19, although the underlying mechanism is not fully understood. The present study aimed to determine whether obesity or being overweight is associated with the clinical course and severity of COVID-19 in children.

Methodology: In this retrospective study, pediatric patients under the age of 18 years, who applied to our hospital between June 2021 and August 2021, and tested positive with the COVID-19 reverse transcriptase-polymerase chain reaction test were included. Age, gender, symptoms at admission, body weight, height, chest radiographs, hemograms, C-reactive protein and other laboratory findings, and days of hospitalization of the pediatric patients were obtained from the hospital automation system. All data were statistically analyzed and compared between underweight, normal, overweight, and obese groups; categorized according to body mass index (BMI).

Results: The study included 116 patients. The results showed that the incidence of symptoms was higher in overweight and obese children compared to other groups (p < 0.05), while the rate of lung involvement was significantly higher in obese patients compared to other groups (p < 0.05). The optimum cut-off point for BMI percentile values in terms of lung involvement was determined to be > 91.

Conclusions: The results of this study revealed that obese children show more symptoms of COVID-19 disease than normal-weight children. In addition, these children have more frequent lung involvement and therefore have more severe disease.