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Epidemiological investigation and public health response to a diphtheria outbreak in Jalalabad Union, Sylhet, December 2023 2023年12月锡尔赫特贾拉拉巴德联盟白喉疫情流行病学调查和公共卫生应对
IF 1.7 Q4 INFECTIOUS DISEASES Pub Date : 2026-03-01 Epub Date: 2025-11-16 DOI: 10.1016/j.ijregi.2025.100805
Md. Mainul Hassan, Sohel Rahman, Md Foyjul Islam, Sadia Sultana, Md. Ahashan Habib, Mohammad Rashedul Hassan, Md. Omar Qayum, Manjur Hossain Khan Jony, Zakir Hossain Habib, Ahmed Nawsher Alam, Mahbubur Rahman, Tahmina Shirin

Objectives

Diphtheria incidence has significantly declined globally due to the Expanded Program on Immunization, yet breakthrough infections occur due to waning immunity in late childhood. Since 2010, Bangladesh has reported 148 cases. On December 10, 2023, a suspected diphtheria case was reported to the Institute of Epidemiology, Disease Control and Research, prompting an epidemiological investigation and public health response.

Methods

Following World Health Organization guidelines, the team identified suspected and confirmed cases, conducted interviews with the index case and contacts, and collected samples for polymerase chain reaction testing. Risk communication and active case searches were carried out in the affected area.

Results

The index case, a 10-year-old girl with classic diphtheria symptoms, was hospitalized for 15 days and recovered after receiving antibiotics and diphtheria antitoxin (DAT). Among 25 close contacts, 14 (56%) were suspected cases, and two (8%) were confirmed via polymerase chain reaction; these two positive cases were siblings of the index case and were previously vaccinated. Chemoprophylaxis, vaccination, isolation, and quarantine were implemented, although the two later confirmed cases did not receive DAT due to unavailability.

Conclusions

Despite a high average coverage rate of 95% (2018-2022) for Penta 3, the outbreak revealed potential waning immunity or vaccine failure. The outbreak was effectively contained through timely confirmation, contact tracing, prophylactic antibiotics, immunization, and quarantine. Booster doses, quantification of antibody titer, and DAT access remain critical.
目的由于扩大免疫规划的实施,白喉发病率在全球范围内显著下降,但由于儿童后期免疫力下降,出现了突破性感染。自2010年以来,孟加拉国报告了148例病例。2023年12月10日,向流行病学、疾病控制和研究所报告了一起疑似白喉病例,促使开展流行病学调查和公共卫生应对。方法按照世界卫生组织的指导方针,该小组确定了疑似病例和确诊病例,对指示病例和接触者进行了访谈,并收集了用于聚合酶链反应检测的样本。在受影响地区进行了风险沟通和积极的病例搜索。结果指示病例为10岁女童,典型白喉症状,住院15 d,经抗生素和白喉抗毒素治疗后痊愈。25例密切接触者中,疑似病例14例(56%),经聚合酶链反应确诊2例(8%);这两例阳性病例是指示病例的兄弟姐妹,以前曾接种过疫苗。实施了化学预防、疫苗接种、隔离和检疫,但后来确诊的两例病例由于无法获得疫苗而未接受DAT治疗。结论尽管Penta - 3的平均覆盖率高达95%(2018-2022),但疫情显示可能出现免疫力下降或疫苗失败的情况。通过及时确诊、追踪接触者、预防性抗生素、免疫接种和隔离等措施,疫情得到有效控制。加强剂量、抗体滴度定量和DAT获取仍然至关重要。
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引用次数: 0
Serotype diversity and risk factors for pneumococcal carriage among healthy children in Klang Valley, Malaysia: A pre-vaccination cross-sectional study 马来西亚巴生谷健康儿童肺炎球菌携带的血清型多样性和危险因素:一项接种前横断面研究
IF 1.7 Q4 INFECTIOUS DISEASES Pub Date : 2026-03-01 Epub Date: 2025-11-25 DOI: 10.1016/j.ijregi.2025.100814
Revathy Arushothy , Cheng Ngee Tan , Nur Asyura Nor Amdan , Mohammad Ridhuan Mohd Ali , Ratna Mohd Tap , Prem Ananth Paliappan , Yii Ling Liow , Saraswathiy Maniam , Salina Mohamed Sukur , Rohaidah Hashim

Objectives

Carriage of Streptococcus pneumoniae among children aged <5 years facilitates transmission and invasive pneumococcal disease (IPD) progression, contributing to global childhood morbidity and mortality. Pneumococcal conjugate vaccines (PCVs) can reduce disease and carriage prevalence, though their effectiveness varies by regional serotype distribution. Malaysia introduced PCVs into the National Immunization Program in late 2020, but data on pneumococcal carriage and risk factors in children before vaccine implementation remain limited. This study aims to identify pneumococcal carriage, diversity, and risk factors among the unvaccinated children in Klang Valley, Malaysia.

Methods

A cross-sectional study conducted from August 2018 to May 2019 involved 101 healthy children aged 2-5 years from 30 childcare centers in Klang Valley, Malaysia. Oropharyngeal swabs, which are more acceptable for young children although less sensitive than nasopharyngeal swabs for pneumococcal detection, were collected and enriched in Todd Hewitt Broth before DNA extraction. Carriage was identified using real-time polymerase chain reaction (PCR) targeting lytA gene, with positive samples serotyped using conventional multiplex PCR. Demographic and environmental data from structured questionnaires were analyzed for associations with pneumococcal carriage and multiple serotype colonization using logistic regression, chi-square, and Fisher exact test.

Results

Pneumococcal carriage was detected in 39.6% (n = 40) of children, with 33 distinct serotypes identified. Both vaccine serotypes (VTs) and non-VTs were detected, with 67.5% of carriers colonized by multiple serotypes. Household size >5 members was significantly associated with carriage (adjusted odds ratio 4.62, 95% confidence interval 1.07-23.10, P = 0.047), while no demographic, behavioral, or environmental factors were significantly associated with multiple serotype colonization. VTs detected (19F, 6A/6B, 3, 1, and 5) were previously associated with IPD in Malaysia.

Conclusions

This study provides crucial pre-PCV baseline data on pneumococcal carriage, serotype diversity, and risk factors in children of Klang Valley, Malaysia. The high prevalence of NVTs and frequent co-colonization highlight the need for ongoing surveillance to detect serotype replacement and guide evaluation of higher-valency PCVs. These findings can inform national immunization policy and strengthen strategies for monitoring vaccine impact in Malaysia.
目的:5岁儿童携带肺炎链球菌促进了传播和侵袭性肺炎球菌疾病(IPD)的进展,导致全球儿童发病率和死亡率升高。肺炎球菌结合疫苗(PCVs)可以降低疾病和携带率,尽管其有效性因地区血清型分布而异。马来西亚于2020年底将pcv纳入国家免疫规划,但在疫苗实施之前,儿童肺炎球菌携带和风险因素的数据仍然有限。本研究旨在确定马来西亚巴生谷未接种疫苗儿童中肺炎球菌的携带、多样性和危险因素。方法2018年8月至2019年5月进行的一项横断面研究涉及来自马来西亚巴生谷30个托儿中心的101名2-5岁健康儿童。在提取DNA之前,收集口咽拭子并在Todd Hewitt Broth中富集,口咽拭子对幼儿更容易接受,但对肺炎球菌检测的敏感性低于鼻咽拭子。采用靶向lytA基因的实时聚合酶链反应(real-time polymerase chain reaction, PCR)对携带菌株进行鉴定,阳性样本采用常规多重PCR进行血清分型。采用logistic回归、卡方检验和Fisher精确检验,分析来自结构化问卷的人口统计学和环境数据与肺炎球菌携带和多种血清型定植的关系。结果39.6% (n = 40)儿童检出肺炎球菌携带,鉴定出33种不同的血清型。疫苗血清型(VTs)和非VTs均有检测,67.5%的携带者有多种血清型定植。5口之家与携带显著相关(调整优势比4.62,95%可信区间1.07-23.10,P = 0.047),而人口统计学、行为或环境因素与多血清型定植无显著相关。在马来西亚,检测到的vt (19F、6A/6B、3、1和5)先前与IPD相关。结论:本研究为马来西亚巴生谷儿童肺炎球菌携带、血清型多样性和危险因素提供了重要的pcv前基线数据。NVTs的高流行率和频繁的共定植突出了持续监测的必要性,以发现血清型替代并指导评估高价pcv。这些发现可以为马来西亚的国家免疫政策提供信息,并加强监测疫苗影响的战略。
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引用次数: 0
Epidemiology and control of hepatitis C virus infection in Brunei Darussalam: a retrospective cohort study 文莱达鲁萨兰国丙型肝炎病毒感染的流行病学和控制:一项回顾性队列研究
IF 1.7 Q4 INFECTIOUS DISEASES Pub Date : 2026-03-01 Epub Date: 2025-11-29 DOI: 10.1016/j.ijregi.2025.100818
Kai Shing Koh , Justin Wong , Liling Chaw

Objectives

We describe the epidemiology of hepatitis C virus (HCV) cases in Brunei Darussalam and evaluate factors associated with its treatment outcomes.

Methods

A retrospective cohort study was conducted using data from two national databases between January 2013 and December 2022.

Results

We identified 801 anti-HCV-positive cases. Although incidence remained relatively stable, prevalence rates increased from 10.1 to 48.7 per 100,00 population. Among those with detectable HCV RNA, treatment was initiated in 52.3% (n = 239). Locals (adjusted odds ratio [aOR] = 2.42, 95% confidence interval [CI] 1.16, 5.36) and age (30-39 years [aOR = 2.41, 95% CI 1.17, 5.07], 40-44 years [aOR = 2.55, 95% CI 1.19, 5.58], and 50-54 years [aOR = 2.76, 95% CI 1.25, 6.24) were associated with treatment initiation. Among those who completed treatment (69.5%, n = 166), 64.5% (n = 107) achieved sustained virologic response. HCV-related complications at baseline were recorded in 7.4% (n = 59) of all cases, particularly among those aged ≥50 years (aOR = 3.32, 95% CI 1.93, 5.79). HCV-related deaths occurred in 36.4% (n = 47), among which 44.7% (n = 21) had HCV-related complications at baseline.

Conclusions

An increasing HCV prevalence (likely due to case management processes and patient-related factors) and the high proportion of deaths with baseline HCV-related complications suggest the need to strengthen HCV screening and management in Brunei.
目的描述文莱达鲁萨兰国丙型肝炎病毒(HCV)病例的流行病学,并评估与治疗结果相关的因素。方法采用2013年1月至2022年12月两个国家数据库的数据进行回顾性队列研究。结果共检出抗- hcv阳性801例。虽然发病率保持相对稳定,但患病率从每10万人10.1人上升到每10万人48.7人。在可检测到HCV RNA的患者中,有52.3% (n = 239)开始了治疗。当地(校正优势比[aOR] = 2.42, 95%可信区间[CI] 1.16, 5.36)和年龄(30-39岁[aOR = 2.41, 95% CI 1.17, 5.07]、40-44岁[aOR = 2.55, 95% CI 1.19, 5.58]和50-54岁[aOR = 2.76, 95% CI 1.25, 6.24)与开始治疗相关。在完成治疗的患者中(69.5%,n = 166), 64.5% (n = 107)达到持续病毒学应答。在所有病例中,基线时hcv相关并发症的发生率为7.4% (n = 59),尤其是年龄≥50岁的患者(aOR = 3.32, 95% CI 1.93, 5.79)。hcv相关死亡发生率为36.4% (n = 47),其中44.7% (n = 21)在基线时有hcv相关并发症。结论:丙型肝炎患病率的上升(可能是由于病例管理过程和患者相关因素)以及伴有丙型肝炎相关基线并发症的高比例死亡表明,文莱需要加强丙型肝炎筛查和管理。
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引用次数: 0
Global threats in local wards: Dissemination of high-risk clones resistant to last-generation cephalosporins and carbapenems in Iraqi hospitals 当地病房的全球威胁:在伊拉克医院传播对上一代头孢菌素和碳青霉烯类耐药的高风险克隆。
IF 1.7 Q4 INFECTIOUS DISEASES Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI: 10.1016/j.ijregi.2026.100852
Ehsan Adnan Hashim , Meriem Souguir , Véronique Métayer , Antoine Drapeau , Sana Azaiez , Hayder Ali Muhammed , Jean-Yves Madec , Marisa Haenni , Wejdene Mansour

Objectives

To conduct the first comprehensive molecular characterization of multidrug-resistant Gram-negative pathogens isolated from patients in six Iraqi hospitals.

Methods

Samples (n = 104) were collected from outpatients across six hospitals in Iraq between March and September 2022. Bacterial isolates were identified using standard microbiological techniques. Antimicrobial susceptibility testing was performed according to EUCAST guidelines. Genomic DNA was extracted and subjected to whole-genome sequencing (WGS).

Results

Over 104 samples, 42 resistant isolates were identified: Escherichia coli (n = 15), Klebsiella pneumoniae (n = 7), Pseudomonas aeruginosa (n = 15), and Acinetobacter baumannii (n = 5). WGS revealed genetic diversity, with the dominance of high-risk clones such as E. coli sequence type (ST131) (n = 6), K. pneumoniae ST14, ST15 or ST394 and P. aeruginosa ST308 or ST773. The extended-spectrum beta-lactamase phenotype in E. coli and K. pneumoniae was mainly conferred by the blaCTX-M-15 gene. Carbapenem-resistance was predominantly mediated by the blaNDM-1 gene, which was identified in K. pneumoniae ST15 and ST2943 isolates, and in P. aeruginosa ST308 and ST773. In A. baumannii ST2 isolates, carbapenem-resistance was due to the presence of the blaOXA-23 gene.

Conclusions

These findings highlight the dissemination of high-risk clones resistant to expanded-spectrum cephalosporins and carbapenems in geographically diverse Iraqi hospitals, underscoring the urgent necessity to establish comprehensive national antimicrobial resistance surveillance and infection control strategies.
目的:对伊拉克6家医院患者分离的多重耐药革兰氏阴性病原体进行首次综合分子鉴定。方法:在2022年3月至9月期间,从伊拉克6家医院的门诊患者中收集样本(n = 104)。采用标准微生物学技术鉴定分离的细菌。按照EUCAST指南进行药敏试验。提取基因组DNA并进行全基因组测序(WGS)。结果:104份样品中检出42株耐药菌株:大肠埃希菌15株、肺炎克雷伯菌7株、铜绿假单胞菌15株、鲍曼不动杆菌5株。WGS显示出遗传多样性,以大肠杆菌序列型(ST131) (n = 6)、肺炎克雷伯菌ST14、ST15或ST394、铜绿假单胞菌ST308或ST773等高危克隆为主。大肠杆菌和肺炎克雷伯菌的广谱β -内酰胺酶表型主要由bla CTX-M-15基因赋予。碳青霉烯耐药主要由bla NDM-1基因介导,该基因在肺炎克雷伯菌ST15和ST2943分离株以及铜绿假单胞菌ST308和ST773分离株中发现。在鲍曼不动杆菌ST2分离株中,碳青霉烯耐药是由于bla OXA-23基因的存在。结论:这些发现强调了在伊拉克地理位置不同的医院中,对广谱头孢菌素和碳青霉烯类耐药的高风险克隆的传播,强调了建立全面的国家抗菌素耐药性监测和感染控制战略的迫切必要性。
{"title":"Global threats in local wards: Dissemination of high-risk clones resistant to last-generation cephalosporins and carbapenems in Iraqi hospitals","authors":"Ehsan Adnan Hashim ,&nbsp;Meriem Souguir ,&nbsp;Véronique Métayer ,&nbsp;Antoine Drapeau ,&nbsp;Sana Azaiez ,&nbsp;Hayder Ali Muhammed ,&nbsp;Jean-Yves Madec ,&nbsp;Marisa Haenni ,&nbsp;Wejdene Mansour","doi":"10.1016/j.ijregi.2026.100852","DOIUrl":"10.1016/j.ijregi.2026.100852","url":null,"abstract":"<div><h3>Objectives</h3><div>To conduct the first comprehensive molecular characterization of multidrug-resistant Gram-negative pathogens isolated from patients in six Iraqi hospitals.</div></div><div><h3>Methods</h3><div>Samples (n = 104) were collected from outpatients across six hospitals in Iraq between March and September 2022. Bacterial isolates were identified using standard microbiological techniques. Antimicrobial susceptibility testing was performed according to EUCAST guidelines. Genomic DNA was extracted and subjected to whole-genome sequencing (WGS).</div></div><div><h3>Results</h3><div>Over 104 samples, 42 resistant isolates were identified: <em>Escherichia coli</em> (n = 15), <em>Klebsiella pneumoniae</em> (n = 7), <em>Pseudomonas aeruginosa</em> (n = 15), and <em>Acinetobacter baumannii</em> (n = 5). WGS revealed genetic diversity, with the dominance of high-risk clones such as <em>E. coli</em> sequence type (ST131) (n = 6), <em>K. pneumoniae</em> ST14, ST15 or ST394 and <em>P. aeruginosa</em> ST308 or ST773. The extended-spectrum beta-lactamase phenotype in <em>E. coli</em> and <em>K. pneumoniae</em> was mainly conferred by the <em>bla</em><sub>CTX-M-15</sub> gene. Carbapenem-resistance was predominantly mediated by the <em>bla</em><sub>NDM-1</sub> gene, which was identified in <em>K. pneumoniae</em> ST15 and ST2943 isolates, and in <em>P. aeruginosa</em> ST308 and ST773. In <em>A. baumannii</em> ST2 isolates, carbapenem-resistance was due to the presence of the <em>bla</em><sub>OXA-23</sub> gene.</div></div><div><h3>Conclusions</h3><div>These findings highlight the dissemination of high-risk clones resistant to expanded-spectrum cephalosporins and carbapenems in geographically diverse Iraqi hospitals, underscoring the urgent necessity to establish comprehensive national antimicrobial resistance surveillance and infection control strategies.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100852"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patterns and predictors of readmission among sepsis survivors in a tertiary emergency department in Ethiopia 埃塞俄比亚三级急诊科败血症幸存者再入院的模式和预测因素
IF 1.7 Q4 INFECTIOUS DISEASES Pub Date : 2026-03-01 Epub Date: 2025-11-17 DOI: 10.1016/j.ijregi.2025.100808
Meron H. Biza , Chernet T. Mengistie , Biruk T. Mengistie , Mikiyas G. Teferi , Tsion K. Admas , Nardos B. Feleke , Gadissa B. Tafa , Finot Debebe , Tigist Worku

Objectives

Sepsis is a leading cause of critical illness worldwide. Survivors often suffer long-term physical, cognitive, and psychological impairments. Post-sepsis rehospitalization is common but poorly characterized in low-resource settings. We aimed to determine 30/90/180-day readmission rates and predictors after emergency sepsis in Addis Ababa.

Methods

We conducted a retrospective cohort study of adult patients meeting Sepsis-3 criteria (infection with ≥2-point rise in Sequential Organ Failure Assessment [SOFA]) admitted to a tertiary Ethiopian emergency department from 2019-2021. A modified SOFA score (five parameters) was used to define organ dysfunction, as has been validated for resource-limited settings. We recorded patient demographics, comorbidities (including cardiovascular disease and malignancy), acute severity (modified SOFA, septic shock, intensive care unit admission), microbiology, antibiotic duration, and outcomes. Survivors were followed for 180 days for hospital readmissions at any site of suspected infection. Multivariable logistic regression identified factors independently associated with 180-day readmission.

Results

Of 110 sepsis patients, 39 (35.5%) died during index admission. Among 71 survivors, 32 (45.1%) were readmitted within 180 days (78.1% within 30 days; 15.6% days 31-90; 6.3% days 91-180). Infectious diagnoses accounted for 71.9% of readmissions (often recurrent pneumonia or urinary tract infection). Median time to first readmission was 16 days (interquartile range 5-41). Multivariable analysis showed higher odds of 180-day readmission in younger patients (adjusted odds ratio [OR] 2.53 per decade decrease in age, 95% confidence interval 1.09-5.87, P = 0.029), and lower odds in those with non-metastatic malignancy (adjusted OR 0.15, 0.03-0.75, P = 0.027) or longer index hospitalization (adjusted OR 0.31 per 5-day increase, 0.11-0.89, P = 0.033).

Conclusions

Nearly half of emergency sepsis survivors were readmitted within 180 days, predominantly within 30 days, and most readmissions were for infection. Predictors included younger age, malignancy status, and length of stay. These findings highlight the need for targeted discharge planning, antimicrobial stewardship, and early follow-up for high-risk patients in low-resource settings.
脓毒症是世界范围内严重疾病的主要原因。幸存者经常遭受长期的身体、认知和心理损伤。脓毒症后再住院很常见,但在资源匮乏的地区特征不佳。我们的目的是确定亚的斯亚贝巴急诊败血症后30/90/180天的再入院率和预测因素。方法:我们对2019-2021年在埃塞俄比亚三级急诊科就诊的符合脓毒症-3标准(连续器官衰竭评估[SOFA]感染上升≥2点)的成年患者进行了回顾性队列研究。一个改进的SOFA评分(五个参数)被用来定义器官功能障碍,这在资源有限的情况下已经得到验证。我们记录了患者的人口统计、合并症(包括心血管疾病和恶性肿瘤)、急性严重程度(改良SOFA、感染性休克、重症监护病房入院)、微生物学、抗生素持续时间和结果。对幸存者进行了180天的随访,以便在任何怀疑感染的地点再次住院。多变量logistic回归确定了与180天再入院独立相关的因素。结果110例败血症患者中,39例(35.5%)在入院时死亡。71例幸存者中,32例(45.1%)在180天内再次入院(30天内78.1%,31-90天15.6%,91-180天6.3%)。感染诊断占再入院的71.9%(通常是复发性肺炎或尿路感染)。到首次再入院的中位时间为16天(四分位数范围5-41)。多变量分析显示,年轻患者180天再入院的几率较高(校正比值比[OR] 2.53 / 10年,95%可信区间1.09-5.87,P = 0.029),而非转移性恶性肿瘤患者(校正比值比[OR] 0.15, 0.03-0.75, P = 0.027)或指数住院时间较长的患者(校正比值比[OR] 0.31 / 5天,0.11-0.89,P = 0.033)的再入院几率较低。结论近一半的急诊脓毒症幸存者在180天内再次入院,主要是在30天内,大多数是因感染再次入院。预测因素包括年龄较小、恶性肿瘤状态和住院时间。这些发现强调了有针对性的出院计划、抗菌药物管理和对低资源环境中高风险患者的早期随访的必要性。
{"title":"Patterns and predictors of readmission among sepsis survivors in a tertiary emergency department in Ethiopia","authors":"Meron H. Biza ,&nbsp;Chernet T. Mengistie ,&nbsp;Biruk T. Mengistie ,&nbsp;Mikiyas G. Teferi ,&nbsp;Tsion K. Admas ,&nbsp;Nardos B. Feleke ,&nbsp;Gadissa B. Tafa ,&nbsp;Finot Debebe ,&nbsp;Tigist Worku","doi":"10.1016/j.ijregi.2025.100808","DOIUrl":"10.1016/j.ijregi.2025.100808","url":null,"abstract":"<div><h3>Objectives</h3><div>Sepsis is a leading cause of critical illness worldwide. Survivors often suffer long-term physical, cognitive, and psychological impairments. Post-sepsis rehospitalization is common but poorly characterized in low-resource settings. We aimed to determine 30/90/180-day readmission rates and predictors after emergency sepsis in Addis Ababa.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of adult patients meeting Sepsis-3 criteria (infection with ≥2-point rise in Sequential Organ Failure Assessment [SOFA]) admitted to a tertiary Ethiopian emergency department from 2019-2021. A modified SOFA score (five parameters) was used to define organ dysfunction, as has been validated for resource-limited settings. We recorded patient demographics, comorbidities (including cardiovascular disease and malignancy), acute severity (modified SOFA, septic shock, intensive care unit admission), microbiology, antibiotic duration, and outcomes. Survivors were followed for 180 days for hospital readmissions at any site of suspected infection. Multivariable logistic regression identified factors independently associated with 180-day readmission.</div></div><div><h3>Results</h3><div>Of 110 sepsis patients, 39 (35.5%) died during index admission. Among 71 survivors, 32 (45.1%) were readmitted within 180 days (78.1% within 30 days; 15.6% days 31-90; 6.3% days 91-180). Infectious diagnoses accounted for 71.9% of readmissions (often recurrent pneumonia or urinary tract infection). Median time to first readmission was 16 days (interquartile range 5-41). Multivariable analysis showed higher odds of 180-day readmission in younger patients (adjusted odds ratio [OR] 2.53 per decade decrease in age, 95% confidence interval 1.09-5.87, <em>P</em> = 0.029), and lower odds in those with non-metastatic malignancy (adjusted OR 0.15, 0.03-0.75, <em>P</em> = 0.027) or longer index hospitalization (adjusted OR 0.31 per 5-day increase, 0.11-0.89, <em>P</em> = 0.033).</div></div><div><h3>Conclusions</h3><div>Nearly half of emergency sepsis survivors were readmitted within 180 days, predominantly within 30 days, and most readmissions were for infection. Predictors included younger age, malignancy status, and length of stay. These findings highlight the need for targeted discharge planning, antimicrobial stewardship, and early follow-up for high-risk patients in low-resource settings.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100808"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pre-travel health awareness and perceptions of voluntary airport PCR testing during COVID-19: A cross-sectional study in Okinawa, Japan COVID-19期间机场自愿PCR检测的旅行前健康意识和观念:日本冲绳的一项横断面研究
IF 1.7 Q4 INFECTIOUS DISEASES Pub Date : 2026-03-01 Epub Date: 2025-11-30 DOI: 10.1016/j.ijregi.2025.100817
Masahiro Kozuka , Yusuke Shimakawa , Gerardo Chowell , Tetsuharu Nagamoto , Ryota Matsuyama , Ryosuke Omori , Yining S. Xu , Yoshiro Shimoji , Kaoru Ogawa , Yoshihiro Takayama , Kenji Mizumoto

Objectives

During the COVID-19 pandemic, airport-based measures, such as fever screening and polymerase chain reaction (PCR) testing were implemented in Japan. Okinawa Prefecture introduced a voluntary airport PCR testing program for domestic travelers at Naha Airport (OKA). Their indirect behavioral effects on travelers remain underexplored. This study aims to describe self-reported pre-travel health awareness among participants in this program.

Methods

In February-March 2021, we conducted a cross-sectional questionnaire survey among Naha Airport PCR test Project (NAPP) participants (n = 4545; March subset n = 1859). The survey assessed demographics, travel purpose, awareness of airport screening (fever screening and PCR testing), pre-travel health awareness, COVID-19 history, and symptoms. Logistic regression evaluated factors associated with self-reported symptoms in the March subset.

Results

Among respondents aware of fever screening and PCR testing, 94.1% and 96.4%, respectively, reported increased attention to their physical condition before travel. Overall, 3.9% reported symptoms, mainly mild respiratory complaints. The proportion symptomatic varied by reason for testing; workplace-mandated testers reported fewer symptoms than family-motivated testers (adjusted odds ratio 0.36, 95% confidence interval 0.15-0.78).

Conclusions

Awareness of voluntary airport screening measures was associated with greater self-reported pre-travel health awareness among voluntary testers. These findings may inform context-specific behavioral strategies aimed at promoting health-conscious travel during infectious disease outbreaks.
目的在2019冠状病毒病大流行期间,日本在机场实施了发热筛查和聚合酶链反应(PCR)检测等措施。冲绳县在那霸机场(OKA)对国内旅客实施了自愿机场PCR检测计划。它们对旅行者的间接行为影响仍未得到充分研究。本研究旨在描述该计划参与者自我报告的旅行前健康意识。方法于2021年2月至3月对那霸机场PCR检测项目(NAPP)参与者(n = 4545人,3月子集n = 1859人)进行横断面问卷调查。该调查评估了人口统计、旅行目的、对机场筛查(发热筛查和PCR检测)的认识、旅行前的健康意识、COVID-19病史和症状。Logistic回归评估了与3月亚组自我报告症状相关的因素。结果在了解发热筛查和PCR检测的受访者中,分别有94.1%和96.4%的人表示在旅行前对自己的身体状况有所关注。总体而言,3.9%的患者报告了症状,主要是轻微的呼吸系统不适。有症状的比例因检测原因而异;工作场所强制测试者报告的症状比家庭动机测试者少(调整优势比0.36,95%置信区间0.15-0.78)。结论机场自愿筛查措施的意识与自愿测试者自报的旅行前健康意识相关。这些发现可能为在传染病暴发期间促进具有健康意识的旅行的特定环境行为策略提供信息。
{"title":"Pre-travel health awareness and perceptions of voluntary airport PCR testing during COVID-19: A cross-sectional study in Okinawa, Japan","authors":"Masahiro Kozuka ,&nbsp;Yusuke Shimakawa ,&nbsp;Gerardo Chowell ,&nbsp;Tetsuharu Nagamoto ,&nbsp;Ryota Matsuyama ,&nbsp;Ryosuke Omori ,&nbsp;Yining S. Xu ,&nbsp;Yoshiro Shimoji ,&nbsp;Kaoru Ogawa ,&nbsp;Yoshihiro Takayama ,&nbsp;Kenji Mizumoto","doi":"10.1016/j.ijregi.2025.100817","DOIUrl":"10.1016/j.ijregi.2025.100817","url":null,"abstract":"<div><h3>Objectives</h3><div>During the COVID-19 pandemic, airport-based measures, such as fever screening and polymerase chain reaction (PCR) testing were implemented in Japan. Okinawa Prefecture introduced a voluntary airport PCR testing program for domestic travelers at Naha Airport (OKA). Their indirect behavioral effects on travelers remain underexplored. This study aims to describe self-reported pre-travel health awareness among participants in this program.</div></div><div><h3>Methods</h3><div>In February-March 2021, we conducted a cross-sectional questionnaire survey among Naha Airport PCR test Project (NAPP) participants (n = 4545; March subset n = 1859). The survey assessed demographics, travel purpose, awareness of airport screening (fever screening and PCR testing), pre-travel health awareness, COVID-19 history, and symptoms. Logistic regression evaluated factors associated with self-reported symptoms in the March subset.</div></div><div><h3>Results</h3><div>Among respondents aware of fever screening and PCR testing, 94.1% and 96.4%, respectively, reported increased attention to their physical condition before travel. Overall, 3.9% reported symptoms, mainly mild respiratory complaints. The proportion symptomatic varied by reason for testing; workplace-mandated testers reported fewer symptoms than family-motivated testers (adjusted odds ratio 0.36, 95% confidence interval 0.15-0.78).</div></div><div><h3>Conclusions</h3><div>Awareness of voluntary airport screening measures was associated with greater self-reported pre-travel health awareness among voluntary testers. These findings may inform context-specific behavioral strategies aimed at promoting health-conscious travel during infectious disease outbreaks.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100817"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical and biological features of acute hepatic cytolysis in dengue fever: a study from Sourô Sanou University hospital, Bobo-Dioulasso 登革热急性肝细胞溶解的临床和生物学特征:来自Sourô萨努大学医院Bobo-Dioulasso的研究
IF 1.7 Q4 INFECTIOUS DISEASES Pub Date : 2026-03-01 Epub Date: 2025-11-24 DOI: 10.1016/j.ijregi.2025.100812
Zoungrana Jacques , Sawadogo Abdoulaye , SIB Tôh , Zongo-Napon P. Delphine , Diendere E. Arnaud , Some Dogbèponé , Ouedraogo G Arsène , Diallo Ismael , Savadogo Mamoudou , Sondo K. Apoline , Poda Armel , Sawadogo Appolinaire

Objective

To describe hepatic cytolysis in patients hospitalized for dengue at the Sourô Sanou University Hospital in Bobo-Dioulasso.

Methods

This was a cross-sectional, descriptive, retrospective, and analytical study conducted over 3 months. All patients hospitalized for dengue during this timeframe were included. Data were collected using the KoBoCollect v1.30.1 application and analyzed with Epi Info software.

Results

A total of 256 patients were included. The mean age was 38.10 ± 16.28 years. Elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were observed in 72.26% and 46.85% of patients, respectively. A reduced prothrombin time was noted in 4.68% of cases, and unconjugated hyperbilirubinemia in 3.9%. Patients with hypertension had a 2.3-fold higher risk of developing hepatic cytolysis. The median length of hospital stay was five days. The case-fatality rate was 7.03%. Transaminase levels normalized in 95.5% of cases, with a mean recovery time of 13 days.

Conclusions

Hepatic cytolysis is a common complication of severe dengue. Its clinical course is generally favorable. Hypertension appears to be a significant risk factor for the development of this liver injury.
目的了解博博迪乌拉索Sourô萨努大学医院登革热住院患者肝细胞溶解情况。方法采用横断面、描述性、回顾性、分析性研究,历时3个月。在此时间段内所有因登革热住院的患者均被纳入。使用KoBoCollect v1.30.1应用程序收集数据,并使用Epi Info软件进行分析。结果共纳入患者256例。平均年龄38.10±16.28岁。72.26%和46.85%的患者出现天冬氨酸转氨酶(AST)和丙氨酸转氨酶(ALT)升高。4.68%的病例出现凝血酶原时间降低,3.9%的病例出现未结合的高胆红素血症。高血压患者发生肝细胞溶解的风险高出2.3倍。住院时间中位数为5天。病死率为7.03%。95.5%的病例转氨酶水平恢复正常,平均恢复时间为13天。结论肝细胞溶解是重症登革热的常见并发症。其临床过程通常是有利的。高血压似乎是这种肝损伤发展的一个重要危险因素。
{"title":"Clinical and biological features of acute hepatic cytolysis in dengue fever: a study from Sourô Sanou University hospital, Bobo-Dioulasso","authors":"Zoungrana Jacques ,&nbsp;Sawadogo Abdoulaye ,&nbsp;SIB Tôh ,&nbsp;Zongo-Napon P. Delphine ,&nbsp;Diendere E. Arnaud ,&nbsp;Some Dogbèponé ,&nbsp;Ouedraogo G Arsène ,&nbsp;Diallo Ismael ,&nbsp;Savadogo Mamoudou ,&nbsp;Sondo K. Apoline ,&nbsp;Poda Armel ,&nbsp;Sawadogo Appolinaire","doi":"10.1016/j.ijregi.2025.100812","DOIUrl":"10.1016/j.ijregi.2025.100812","url":null,"abstract":"<div><h3>Objective</h3><div>To describe hepatic cytolysis in patients hospitalized for dengue at the Sourô Sanou University Hospital in Bobo-Dioulasso.</div></div><div><h3>Methods</h3><div>This was a cross-sectional, descriptive, retrospective, and analytical study conducted over 3 months. All patients hospitalized for dengue during this timeframe were included. Data were collected using the KoBoCollect v1.30.1 application and analyzed with Epi Info software.</div></div><div><h3>Results</h3><div>A total of 256 patients were included. The mean age was 38.10 ± 16.28 years. Elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were observed in 72.26% and 46.85% of patients, respectively. A reduced prothrombin time was noted in 4.68% of cases, and unconjugated hyperbilirubinemia in 3.9%. Patients with hypertension had a 2.3-fold higher risk of developing hepatic cytolysis. The median length of hospital stay was five days. The case-fatality rate was 7.03%. Transaminase levels normalized in 95.5% of cases, with a mean recovery time of 13 days.</div></div><div><h3>Conclusions</h3><div>Hepatic cytolysis is a common complication of severe dengue. Its clinical course is generally favorable. Hypertension appears to be a significant risk factor for the development of this liver injury.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100812"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The annual recurrence of dengue in Bangladesh: A persistent threat 孟加拉国每年复发的登革热:一个持续的威胁
IF 1.7 Q4 INFECTIOUS DISEASES Pub Date : 2026-03-01 Epub Date: 2025-12-25 DOI: 10.1016/j.ijregi.2025.100835
Tushar Ahmed Shishir, Nazifa Tabassum Tasnim, Akash Ahmed
This letter explores the annual recurrence of dengue infections in Bangladesh, a persistent threat to public health and well-being. We examine the cyclical nature of dengue infection across different regions, focusing on densely populated cities such as Dhaka and Chittagong. We also highlighted the challenges during the dengue epidemic by describing potential strategies for combating the spread, highlighting the severe health impacts on public health in high-prevalence areas such as Chittagong, Khulna, and Barisal. Recognizing dengue’s wide-reaching impact on health and daily life, we brainstorm the possible long and short-term solutions to prevent perpetuated future outbreaks.
这封信探讨了孟加拉国每年复发的登革热感染,这是对公共卫生和福祉的持续威胁。我们研究了不同地区登革热感染的周期性,重点关注人口稠密的城市,如达卡和吉大港。我们还强调了登革热流行期间的挑战,描述了防治传播的潜在战略,强调了吉大港、库尔纳和巴里萨尔等高流行地区对公共卫生的严重健康影响。认识到登革热对健康和日常生活的广泛影响,我们集思广益,探讨可能的长期和短期解决办法,以防止今后持续爆发登革热。
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引用次数: 0
Pre-exposure prophylaxis in Guyana: linking key populations and other vulnerable groups 圭亚那的接触前预防:将关键人群和其他弱势群体联系起来
IF 1.7 Q4 INFECTIOUS DISEASES Pub Date : 2026-03-01 Epub Date: 2025-12-09 DOI: 10.1016/j.ijregi.2025.100823
Alisa Khan , Tariq Jagnarine

Objectives

Despite the introduction of pre-exposure prophylaxis (PrEP) in Guyana as an effective HIV prevention tool, its uptake remains low among key and vulnerable populations, such as men who have sex with men, sex workers, and transgender individuals. This study assessed awareness, uptake, and barriers to PrEP among seronegative individuals in Guyana and proposed strategies to improve accessibility and use.

Methods

A cross-sectional, mixed-method study was conducted among 90 seronegative adults across Regions 3, 4, 6, and 10. Quantitative data were collected via structured questionnaires, whereas qualitative insights were gathered through interviews and focus group discussions. Statistical analyses (chi-square) and thematic coding were applied.

Results

Among participants, 59% were aware of PrEP, primarily through media sources (43%), whereas only 18% had ever been offered PrEP by a health care provider. None of the participants were active users. The key barriers identified were limited access (48%), fear of side effects (27%), and inadequate provider engagement. However, 57% expressed willingness to use PrEP and 74% would recommend it to peers.

Conclusions

PrEP awareness in Guyana is moderate but constrained by systemic barriers, misinformation, and health care inaccessibility. Strengthening provider training, integrating PrEP into routine services, and community outreach are essential to improve uptake.
尽管圭亚那将暴露前预防(PrEP)作为一种有效的艾滋病毒预防工具,但在关键和弱势人群(如男男性行为者、性工作者和变性人)中,PrEP的使用率仍然很低。本研究评估了圭亚那血清阴性个体对PrEP的认识、吸收和障碍,并提出了改善可及性和使用的策略。方法采用横断面混合方法对3、4、6和10区90名血清阴性成人进行研究。通过结构化问卷收集定量数据,而通过访谈和焦点小组讨论收集定性见解。采用统计学分析(卡方)和专题编码。结果在参与者中,59%的人主要通过媒体来源(43%)了解PrEP,而只有18%的人曾经由卫生保健提供者提供PrEP。所有参与者都不是活跃用户。确定的主要障碍是获取受限(48%)、担心副作用(27%)和提供者参与不足。然而,57%的人表示愿意使用PrEP, 74%的人会向同龄人推荐。结论圭亚那对sprep的认识程度一般,但受到系统障碍、错误信息和卫生保健不可及性的制约。加强提供者培训,将预防措施纳入常规服务,以及社区外展,对于提高使用率至关重要。
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引用次数: 0
Artificial intelligence for Africa: bridge or barrier for infectious disease control? 非洲的人工智能:传染病控制的桥梁还是障碍?
IF 1.7 Q4 INFECTIOUS DISEASES Pub Date : 2026-03-01 Epub Date: 2026-02-17 DOI: 10.1016/j.ijregi.2026.100863
Francesco Branda , Ntuli A. Kapologwe
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引用次数: 0
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