Journal of Global Infectious Diseases最新文献

Introduction: Contacts of tuberculosis (TB) patients have an increased risk of latent TB infection (LTBI). Currently, it is diagnosed using one of the two methods: Tuberculin skin test (TST) or QuantiFERON-TB Gold Plus. This study aims to estimate the concordance of TST and QFT-TB Gold Plus and associated factors among 73 healthcare workers (HCWs) and 172 household contacts (HHCs) who came in contact with active TB patients. This study was conducted from January to June 2023.

Methods: Prevalence and agreement were calculated. A regression analysis was performed to assess the predictors of discordance factors.

Results: The prevalence of latent TB was 20.40% (n = 50), defined as a positive result on either test. The overall agreement among participants was 62.04%, with a kappa coefficient of 0.26 (0.16-0.36, 95% confidence interval [CI]) (McNemar, P < 0.001). A higher risk of LTBI was associated with BCG vaccination history, odd ratio 1.63, (95% CI 0.78-3.43) for TST and 0.51 (95% CI 0.22-1.15) for QFT, but this was not significant. Moreover, in our study, only the body mass index of 18.5-25 kg/m² yielded an odds ratio of 2.33 (95%CI 0.77-6.47) for TST and 1.72 (95% CI 0.48-6.05) for QFT, was significant. Compared with QFT-TB Gold Plus, the sensitivity and specificity of TST were 80.65 (68.63-89.58) and 55.74 (48.22-63.06).

Conclusion: TST exhibited a profound level of agreement with the QFT-Gold Plus assay but showed a higher rate of positivity due to some associated factors among HCWs, HHCs, and TB patients.

Accurate and rapid diagnosis is crucial for starting effective treatment for tuberculosis (TB) and mitigating the transmission. Globally, nearly one-third of all TB cases remain undetected each year and consequently these are not reported. On top of that, the emergence of drug-resistant TB poses an added challenge. In the past 15 years, several advances have been made for improved diagnosis, including liquid culture and drug susceptibility, line probe assay for drug resistance detection, and cartridge-based nucleic acid amplification tests for rapid diagnosis of TB and drug resistance detection. However, some challenges remain, despite the clear edge of these new advances over the age-old conventional methods. Despite these advances, accurate, affordable, and accessible diagnosis of TB remains a challenge, especially in rural and difficult-to-reach settings, where the most desirable test would be a point-of-care triage test. Nevertheless, several attempts are being made in this direction, and in this article, we review these research advances that can help the TB elimination from India.

Introduction: The disastrous impact of the coronavirus disease 2019 (COVID-19) pandemic worldwide necessitated the prompt development of vaccines to combat the situation; however, vaccination drives have been challenged by vaccine hesitancy among several communities across geographies. Understanding vaccine hesitancy and acceptance can help design appropriate vaccination strategies. With this background, a systematic review and meta-analysis were conducted to estimate the prevalence and assess the factors associated with vaccine hesitancy and acceptance among the Indian population.

Methods: This systematic review is reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The data were extracted from May 1, 2024, to May 30, 2024, using PubMed, Scopus, and DOAJ search engines. The keywords used in the search string are "COVID-19," "vaccine hesitancy," "vaccine acceptance," and "India." Finally, 26 articles were selected, and the included articles underwent a quality assessment with the help of the JBI-Checklist for cross-sectional studies. The pooled vaccine hesitancy and acceptance prevalence was estimated at a 95% confidence interval (CI) using a random effect model assuming potential heterogeneity. Analysis used Stata Now 18 SE (Stata Corp., College Station, TX, USA).

Results: Of the 26 studies, 14 studies were conducted among healthcare workers, seven studies among the general population, two studies among pregnant women and one each among school children, parents, and socioeconomically disadvantaged people. The reported highest vaccine acceptance was 92.74% and 86.3%, and hesitancy was 60.8% and 50% among healthcare workers and the general population, respectively. Between the general population and healthcare workers, the estimated pooled prevalence of vaccine acceptance is 66.1% (95% CI: 53%-78%) and 65.9% (95% CI: 57%-74%), respectively. The estimated pooled prevalence of vaccine hesitancy is 33% (95% CI: 20%-46%) among the general population and 24% (95% CI: 11%-40%) among healthcare workers. With the random effect model, high heterogeneity was observed in both acceptance (I ² >99%) and hesitancy (I ² >98%).

Conclusion: A significant variation in the acceptability of the COVID-19 vaccine has been reported across different regions of India. Hence, future research is needed to enable comparability and generalizability, as the variations may also reflect differences in study designs, demographics, and time frames.

Introduction: Antimicrobial resistance (AMR) is a growing threat to global public health. In hospitals, infant mortality due to bacterial sepsis is associated with AMR. The epidemiology of AMR in Bolivia (a lower-middle-income country) has not been sufficiently discussed. The aim of this study was to analyze AMR patterns over 8 years at a pediatric hospital in patients with hospital-acquired bloodstream infections.

Methods: This is a retrospective and analytical revision of AMR in bacteria isolated from blood cultures, performed between 2012 and 2019, in a pediatric hospital in Bolivia. Data analysis was conducted with Stata v14.0, and Fisher's exact tests were used to determine statistical significance.

Results: Four hundred and fifty-five (7.2%) positive blood cultures were identified from 6315 blood culture reports between 2012 and 2019. Klebsiella pneumoniae was the most frequently isolated bacteria and showed a significant change in its AMR profile over the 8 years of the study. Gram-negative bacteria and Staphylococcus aureus were also frequently isolated, and all demonstrated high levels of resistance to commonly used antibiotics. Overall, most of the clinically important microorganisms had high rates of AMR.

Conclusions: In the present study, we report that isolated bacteria showed significant resistance to multiple drugs, and most demonstrated increased resistance over time. Worryingly, K. pneumoniae showed an increasing resistance to commonly used antibiotics. Overall, despite the limitations, our study, which is one of the first of its kind in Bolivia, demonstrates the need for stricter policies of antibiotic stewardship in similar settings due to the global threat of AMR.

Human brucellosis is a chronic systemic infection mostly presenting as afebrile illness with musculoskeletal complaints with organomegaly and diagnosis is based on serology. The diagnostic tests are sparsely available in India and even less prescribed. We report six cases of human of brucellosis presenting as fever with rheumatic manifestation along with their outcome.

Introduction: Rotavirus is a frequent cause of gastroenteritis in young children. It is seasonal in many countries but occurs year-round in India.Since the launch of the Rotavirus Vaccine (RVV) morbidity and mortality in children have greatly decreased. This study was carried out prior to the inclusion of RVV in the state vaccination schedule in 2019. The objective of the study was to estimate the burden of Rota Virus Gastroeneteritis in kids under 5 years of age, attending a government tertiary care hospital in the state and to identify the common circulating genotypes of Rotavirus.

Methods: Stool samples from children with more than three episodes of loose stool that were negative for bacterial enteric pathogens were tested by Enzyme Linked Immunosorbent Assay (ELISA) for Rotavirus antigen. Positive stool samples were transported to the Regional Viral Research and Diagnostic Laboratory at National Institute for Cholera and Enteric Diseases for genotyping.

Results: 200 stool samples were screened and 40 samples (20%) were positive for Rotavirus antigen by ELISA. G3P [8] - 33% (9/27), followed by G1P[8] -15%(4/27) and G2P4 - 11%( 3/27) were the most common genotypes.

Conclusion: Rotavirus is a significant cause of gastroenteritis in children under five years of age in the Indian state of Sikkim.

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening syndrome of immune dysregulation that results in multiorgan failure; HIV and histoplasmosis are known triggers of HLH. A young patient with AIDS was found to have disseminated histoplasmosis and met criteria for HLH. Despite 10 days of treatment with liposomal amphotericin B, she developed shock and acute respiratory distress syndrome and ultimately died. The few reported cases of HLH due to histoplasmosis in AIDS offer a variety of treatment approaches. There have been successful outcomes combining amphotericin with chemotherapies for HLH. Targeted therapies for HLH may be considered on a case-by-case basis in the setting of concurrent disseminated histoplasmosis and HIV/AIDS.

Introduction: Identifying hemagglutination inhibition (HI) antibody titers as a key immune correlate of protection (CoP) is crucial for developing, licensing, and monitoring the ongoing effectiveness of new influenza vaccines. Using a new statistical methodology, we explored the link between an inactivated quadrivalent influenza vaccine's impact on HI antibody titers and its effectiveness against A/H1N1-associated influenza illness.

Methods: We utilized data from a phase 3, observer-blind, randomized, controlled trial in children aged 6-35 months to assess HI antibody titers as an immune CoP. The assessment used a statistical method developed within a causal inference framework and a new information-theoretic metric of surrogacy, the so-called individual causal association (ICA).

Results: The 75% and 85% uncertainty intervals of the ICA are 0.5511-0.8282 and 0.3632-0.8684, respectively, indicating a substantial reduction in the uncertainty about the vaccine's effect on the absence of infection when its impact on the HI antibody titers is known.

Conclusions: The evaluation yielded evidence supporting the validity of HI antibody titers as a CoP for influenza infection.