Journal of Global Infectious Diseases最新文献

A 52-year-old woman presented with a tender swelling in the right axilla, fever, a headache, nausea, and general weakness. On examination, she was found to have lymphangitis on the right arm and red papules on the 1^st and 2^nd fingers of the right hand. She had had prepared wild rabbit stew 5 days before disease onset. Serology and an ultrasound of the right axilla confirmed the diagnosis of ulceroglandular tularemia. The lymphadenitis did not resolve after streptomycin treatment so an incision was made and 30 cc of purulent fluid drained. Over the course of the next 3 months, the fluid continued to drain. A radiographic fistulography was performed and it revealed a short main channel with a few long channels of varying caliber branching out from it, all terminating in a conglomerate of necrotic axillary lymph nodes. The lesions healed spontaneously and completely over the following 12 months without additional antibiotic therapy. Radiographic fistulography can help plot the course of the fistula/fistulas and demonstrate the anatomic features of the lesion in resource poor settings.

Introduction: Tuberculosis (TB) remains a deadliest infectious disease. Lack of rapid test with low cost is one of the important challenges to eradicate the TB. The objective of the study was to analyze the laboratory costs of conventional and newer molecular tests, for diagnosis of presumptive multidrug-resistant TB (MDR-TB) patients.

Methods: A detailed laboratory cost of various conventional tests (Ziehl - Neelsen [ZN] microscopy, light-emitting diode-fluorescent microscopy [LED-FM], culture and drug susceptibility testing [DST] using solid Lowenstein-Jensen media and liquid media [BACTEC MGIT 960]) was compared with rapid methods (GenoType MTBDRplus line probe assay [LPA] and GeneXpert MTB/RIF assay). Laboratory cost was also calculated in terms of cost per TB and MDR-TB case detected by using different diagnostic scenarios.

Results: Cost per test for ZN microscopy, LED-FM, LPA, GeneXpert MTB/RIF assay, solid culture plus DST, liquid culture plus DST was found as $2.5 (INR 156.8), $2.0 (INR128.9), $18.6 (INR1210), $13.8 (INR 895.2), $21.5 (INR 1396.6), and $29.1 (INR 1888.2), respectively. The laboratory cost for detecting TB and MDR-TB by diagnostic scenarios involving molecular DST was found to be less as compared to involving only conventional liquid culture-based test.

Conclusions: The implementation of rapid molecular tests with selective use of liquid culture-based DST may be less in cost as compared to the use of culture-based DST alone, at high burden reference TB laboratory.

Introduction: Among people living with HIV (PLHIV), fertility desire which is the desire to have more children is increasing due to the improvement in quality of life and survival resulting from anti-retroviral treatment and also improved sexual and reproductive health services. Fertility desires can result in increased risk of HIV transmission, especially in unprotected heterosexual intercourse. There is limited information regarding the fertility desires and predictors among PLHIV in our environment.

Methods: This study was aimed at assessing the fertility desires and predictors in PLHIV in Northcentral Nigeria. Study was descriptive cross-sectional. Semi-structured interviewer administered pretested questionnaires was used to get information from 170 PLHIV accessing care in a secondary health-care facility selected by the systematic sampling technique. Data were analyzed using the SPSS software version 23.0. At 95% confidence interval (CI), a P < 0.05 was considered to be statistically significant. Chi-square and logistic regression.

Results: Fertility desire was found among 64.1% of the respondents. Younger age (odds ratio [OR] = 0.2270; 95% CI = 0.0662-0.7791, P = 0.0184), having no child or a smaller number of children (OR = 0.0432; CI = 0.0046-0.4050; P = 0.0059) and suppressed viral loads (OR = 4.1069; CI = 1.1650-14.4784; P = 0.0280) were the predictors for fertility desire.

Conclusion: This study showed that PLHIV had high fertility desires but do not know any safe method of conception, hence intensified effort should be made by primary care providers and other health-care workers to include sexual and reproductive health counselling during routine HIV clinic visits to enable PLHIV make informed decision about their fertility desires.