Pub Date : 2024-10-25DOI: 10.1186/s12879-024-10098-5
Tameru Menberu, Tewodros Getnet Amera, Amanuel Addisu, Molla Getie
Background: Anemia is a common complication of HIV infected children and it is enabling HIV disease progression, and decreasing survival. In Ethiopia, there is limited evidence on the prevalence of anemia and its associated factors among HIV infected children particularly in the Awi Zone. Therefore, this study aimed to assess the magnitude and associated factors of anemia among HIV infected children on ART aged from 6 months to 15 year-old in ART Clinic, Awi-Zone, Ethiopia.
Objective: To assess the magnitude and associated factors of anemia among HIV infected children on antiretroviral therapy in Awi zone health facilities, Northwest, Ethiopia, 2022.
Methods: A facility based cross-sectional study design was conducted from October to December 2022. A simple random sampling method was used to select the study participants. Descriptive statistics, including frequencies and proportions was used to summarize the study variables and data had been entered in to Epi data 4.2 and exported to SPSS version 25. Bivariable logistic regression followed by multivariable logistic regression was performed. Degree of association between dependent and independent variables had been assessed using adjusted odds ratio with 95% CI at p value of ≤ 0.05.
Result: From 346 participants in the selected sample 339 (97.9%) of them responded. Prevalence of anemia was 13.3% (n = 45) among which, majority (44.4%) of them had mild anemia, while about (42.2%,) had moderate anemia and around 13.3%, of them were severely anemic. Baseline CD4 count (AOR = 6.58, 95% CI: 2.85-15.22), WHO clinical stage III or IV (AOR = 8.42, 95% CI = 3.47, 20.45), hookworm infection (AOR = 5.06, 95% CI = 2.04, 12) and malaria infection (AOR = 4.92, 95% CI (2.19-11.02) were significantly associated with anemia among children on HAART.
Conclusion: The prevalence of anemia among participants was relatively low in this study. However, a considerable proportion of participants had moderate to severe anemia. Lower CD4 count at enrolment, advanced HIV clinical stage, malaria and hookworm infection were significantly linked with anemia. Thus, it requires regular monitoring of anemia status in these patients for better clinical outcomes and quality of life improvements.
背景:贫血是感染艾滋病病毒的儿童常见的并发症,它会导致艾滋病病情恶化,降低存活率。在埃塞俄比亚,特别是在阿维地区,关于受艾滋病病毒感染的儿童中贫血症的发病率及其相关因素的证据非常有限。因此,本研究旨在评估埃塞俄比亚阿维区抗逆转录病毒疗法诊所中接受抗逆转录病毒疗法的 6 个月至 15 岁艾滋病病毒感染儿童贫血的严重程度和相关因素:评估埃塞俄比亚西北部阿维区医疗机构中接受抗逆转录病毒疗法的HIV感染儿童贫血的严重程度和相关因素:方法:2022 年 10 月至 12 月进行了一项基于医疗机构的横断面研究。研究采用简单随机抽样法选取参与者。使用描述性统计(包括频率和比例)总结研究变量,数据已输入 Epi data 4.2 并导出到 SPSS 25 版。进行了二变量逻辑回归和多变量逻辑回归。因变量和自变量之间的关联程度使用调整后的几率进行评估,在 p 值小于 0.05 时,调整后的几率为 95% CI:在所选样本的 346 名参与者中,有 339 人(97.9%)做出了回答。贫血患病率为 13.3%(n = 45),其中大部分(44.4%)为轻度贫血,约(42.2%)为中度贫血,约 13.3%为重度贫血。基线 CD4 细胞数(AOR = 6.58,95% CI:2.85-15.22)、世卫组织临床 III 期或 IV 期(AOR = 8.42,95% CI = 3.47-20.45)、钩虫感染(AOR = 5.06,95% CI = 2.04-12)和疟疾感染(AOR = 4.92,95% CI (2.19-11.02))与接受 HAART 治疗的儿童贫血显著相关:结论:在本研究中,参与者的贫血患病率相对较低。结论:在这项研究中,参与者的贫血发生率相对较低,但相当一部分参与者患有中度至重度贫血。入学时 CD4 细胞计数较低、HIV 临床分期较晚、疟疾和钩虫感染与贫血密切相关。因此,需要定期监测这些患者的贫血状况,以获得更好的临床疗效和生活质量。
{"title":"Magnitude of anemia and associated factors among HIV infected children on antiretroviral therapy in Awi zone health facilities, Northwest Ethiopia, 2023.","authors":"Tameru Menberu, Tewodros Getnet Amera, Amanuel Addisu, Molla Getie","doi":"10.1186/s12879-024-10098-5","DOIUrl":"10.1186/s12879-024-10098-5","url":null,"abstract":"<p><strong>Background: </strong>Anemia is a common complication of HIV infected children and it is enabling HIV disease progression, and decreasing survival. In Ethiopia, there is limited evidence on the prevalence of anemia and its associated factors among HIV infected children particularly in the Awi Zone. Therefore, this study aimed to assess the magnitude and associated factors of anemia among HIV infected children on ART aged from 6 months to 15 year-old in ART Clinic, Awi-Zone, Ethiopia.</p><p><strong>Objective: </strong>To assess the magnitude and associated factors of anemia among HIV infected children on antiretroviral therapy in Awi zone health facilities, Northwest, Ethiopia, 2022.</p><p><strong>Methods: </strong>A facility based cross-sectional study design was conducted from October to December 2022. A simple random sampling method was used to select the study participants. Descriptive statistics, including frequencies and proportions was used to summarize the study variables and data had been entered in to Epi data 4.2 and exported to SPSS version 25. Bivariable logistic regression followed by multivariable logistic regression was performed. Degree of association between dependent and independent variables had been assessed using adjusted odds ratio with 95% CI at p value of ≤ 0.05.</p><p><strong>Result: </strong>From 346 participants in the selected sample 339 (97.9%) of them responded. Prevalence of anemia was 13.3% (n = 45) among which, majority (44.4%) of them had mild anemia, while about (42.2%,) had moderate anemia and around 13.3%, of them were severely anemic. Baseline CD4 count (AOR = 6.58, 95% CI: 2.85-15.22), WHO clinical stage III or IV (AOR = 8.42, 95% CI = 3.47, 20.45), hookworm infection (AOR = 5.06, 95% CI = 2.04, 12) and malaria infection (AOR = 4.92, 95% CI (2.19-11.02) were significantly associated with anemia among children on HAART.</p><p><strong>Conclusion: </strong>The prevalence of anemia among participants was relatively low in this study. However, a considerable proportion of participants had moderate to severe anemia. Lower CD4 count at enrolment, advanced HIV clinical stage, malaria and hookworm infection were significantly linked with anemia. Thus, it requires regular monitoring of anemia status in these patients for better clinical outcomes and quality of life improvements.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-25DOI: 10.1186/s12879-024-10111-x
Zhao Yu, Yuanyuan Qian, Lan Lv, Wenqing Hu
Clinical data: Chlamydia psittaci pneumonia is a community-acquired pneumonia caused by Chlamydia psittaci. While severe cases may lead to critical conditions such as respiratory failure, splenic infarction is relatively uncommon. A severe patient with Chlamydia psittaci pneumonia admitted to our hospital experienced a splenic infarction during treatment. Fortunately, the patient's situation was improved after careful treatment. Now, the patient has been discharged. Further exploration of the mechanism of concurrent splenic infarction is required.
Backgroud: Psittacosis pneumonia, a zoonotic infectious disease transmitted from birds to humans, is caused by Chlamydia psittaci and represents a type of chlamydial pneumonia [1]. Insome instances, the disease may progress to severe pneumonia and respiratory failure, necessitating intensive support measures, including mechanical ventilation. The advent of technologies such as Metagenomic Next-Generation Sequencing (mNGS) for the etiological diagnosis of infectious diseases [2] has improved the diagnostic and treatment success rates for Psittacosis. Instances of severe chlamydial pneumonia with complications such as splenic infarction are uncommon. A patient with severe Psittacosis pneumonia complicated by splenic infarction was admitted to the Emergency Intensive Care Unit (EICU) of Haining People's Hospital and subsequently improved following effective anti-infective and anticoagulant therapy. This report is provided herein.
{"title":"A case of severe psittacosis pneumonia complicated by splenic infarction.","authors":"Zhao Yu, Yuanyuan Qian, Lan Lv, Wenqing Hu","doi":"10.1186/s12879-024-10111-x","DOIUrl":"10.1186/s12879-024-10111-x","url":null,"abstract":"<p><strong>Clinical data: </strong>Chlamydia psittaci pneumonia is a community-acquired pneumonia caused by Chlamydia psittaci. While severe cases may lead to critical conditions such as respiratory failure, splenic infarction is relatively uncommon. A severe patient with Chlamydia psittaci pneumonia admitted to our hospital experienced a splenic infarction during treatment. Fortunately, the patient's situation was improved after careful treatment. Now, the patient has been discharged. Further exploration of the mechanism of concurrent splenic infarction is required.</p><p><strong>Backgroud: </strong>Psittacosis pneumonia, a zoonotic infectious disease transmitted from birds to humans, is caused by Chlamydia psittaci and represents a type of chlamydial pneumonia [1]. Insome instances, the disease may progress to severe pneumonia and respiratory failure, necessitating intensive support measures, including mechanical ventilation. The advent of technologies such as Metagenomic Next-Generation Sequencing (mNGS) for the etiological diagnosis of infectious diseases [2] has improved the diagnostic and treatment success rates for Psittacosis. Instances of severe chlamydial pneumonia with complications such as splenic infarction are uncommon. A patient with severe Psittacosis pneumonia complicated by splenic infarction was admitted to the Emergency Intensive Care Unit (EICU) of Haining People's Hospital and subsequently improved following effective anti-infective and anticoagulant therapy. This report is provided herein.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-24DOI: 10.1186/s12879-024-10017-8
Marc Avramov, Vanessa Gabriele-Rivet, Rachael M Milwid, Victoria Ng, Nicholas H Ogden, Valerie Hongoh
Mathematical modelling of (re)emerging infectious respiratory diseases among humans poses multiple challenges for modellers, which can arise as a result of limited data and surveillance, uncertainty in the natural history of the disease, as well as public health and individual responses to outbreaks. Here, we propose a COVID-19-inspired health state diagram (HSD) to serve as a foundational framework for conceptualising the modelling process for (re)emerging respiratory diseases, and public health responses, in the early stages of their emergence. The HSD aims to serve as a starting point for reflection on the structure and parameterisation of a transmission model to assess the impact of the (re)emerging disease and the capacity of public health interventions to control transmission. We also explore the adaptability of the HSD to different (re)emerging diseases using the characteristics of three respiratory diseases of historical public health importance. We outline key questions to contemplate when applying and adapting this HSD to (re)emerging infectious diseases and provide reflections on adapting the framework for public health-related interventions.
{"title":"A conceptual health state diagram for modelling the transmission of a (re)emerging infectious respiratory disease in a human population.","authors":"Marc Avramov, Vanessa Gabriele-Rivet, Rachael M Milwid, Victoria Ng, Nicholas H Ogden, Valerie Hongoh","doi":"10.1186/s12879-024-10017-8","DOIUrl":"10.1186/s12879-024-10017-8","url":null,"abstract":"<p><p>Mathematical modelling of (re)emerging infectious respiratory diseases among humans poses multiple challenges for modellers, which can arise as a result of limited data and surveillance, uncertainty in the natural history of the disease, as well as public health and individual responses to outbreaks. Here, we propose a COVID-19-inspired health state diagram (HSD) to serve as a foundational framework for conceptualising the modelling process for (re)emerging respiratory diseases, and public health responses, in the early stages of their emergence. The HSD aims to serve as a starting point for reflection on the structure and parameterisation of a transmission model to assess the impact of the (re)emerging disease and the capacity of public health interventions to control transmission. We also explore the adaptability of the HSD to different (re)emerging diseases using the characteristics of three respiratory diseases of historical public health importance. We outline key questions to contemplate when applying and adapting this HSD to (re)emerging infectious diseases and provide reflections on adapting the framework for public health-related interventions.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-24DOI: 10.1186/s12879-024-10084-x
Jia Xu, Yingmiao Zhang, Lifeng Shi, Hui Wang, Ming Zeng, Zhongxin Lu
Background: Micrococcus antarcticus (M. antarcticus) is an aerobic Gram-positive spherical actinobacterium that was initially isolated from Chinese Great-Wall station in Antarctica in 2000. M. antarcticus was considered to be of low pathogenicity, no previous cases of human infection by this organism have been reported. Here we describe the first report with community-acquired pneumonia (CAP) caused by M. antarcticus.
Case presentation: An 87-year-old female was presented to the Central Hospital of Wuhan in November 2023 with a chief complaint of cough, sputum production, and chest tightness for 2 weeks. Microbial culture of the patient's bronchoalveolar lavage fluid (BALF) and identification of the isolates using Matrix-assisted laser desorption ionization/time of flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing revealed M. antarcticus infection. Combined with clinical symptoms, laboratory and imaging examination, the patient was diagnosed with CAP. Then cefoperazone/sulbactam and levofloxacin was administrated, the patient's condition was improved and she was discharged after a week after admission, no abnormalities were detected during a 5-month follow-up.
Conclusions: This case highlights that M. antarcticus, first identified from a patient with CAP, is an extremely rare pathogenic microorganism. Clinicians should be aware of its potential as a pathogen in the diagnosis and treatment of CAP.
{"title":"Community-acquired pneumonia caused by Micrococcus antarcticus: a rare case report.","authors":"Jia Xu, Yingmiao Zhang, Lifeng Shi, Hui Wang, Ming Zeng, Zhongxin Lu","doi":"10.1186/s12879-024-10084-x","DOIUrl":"10.1186/s12879-024-10084-x","url":null,"abstract":"<p><strong>Background: </strong>Micrococcus antarcticus (M. antarcticus) is an aerobic Gram-positive spherical actinobacterium that was initially isolated from Chinese Great-Wall station in Antarctica in 2000. M. antarcticus was considered to be of low pathogenicity, no previous cases of human infection by this organism have been reported. Here we describe the first report with community-acquired pneumonia (CAP) caused by M. antarcticus.</p><p><strong>Case presentation: </strong>An 87-year-old female was presented to the Central Hospital of Wuhan in November 2023 with a chief complaint of cough, sputum production, and chest tightness for 2 weeks. Microbial culture of the patient's bronchoalveolar lavage fluid (BALF) and identification of the isolates using Matrix-assisted laser desorption ionization/time of flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing revealed M. antarcticus infection. Combined with clinical symptoms, laboratory and imaging examination, the patient was diagnosed with CAP. Then cefoperazone/sulbactam and levofloxacin was administrated, the patient's condition was improved and she was discharged after a week after admission, no abnormalities were detected during a 5-month follow-up.</p><p><strong>Conclusions: </strong>This case highlights that M. antarcticus, first identified from a patient with CAP, is an extremely rare pathogenic microorganism. Clinicians should be aware of its potential as a pathogen in the diagnosis and treatment of CAP.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-24DOI: 10.1186/s12879-024-10102-y
Jeevanathan Kalyanasundram, Zarina Mohd Zawawi, Khayri Azizi Kamel, Emmanuel Tiagaraj Aroidoss, Kavithambigai Ellan, Mohd Ishtiaq Anasir, Muhammad Afif Azizan, Murni Maya Sari Zulkifli, Rozainanee Mohd Zain
Background: Chikungunya cases was reported to be on the rise in Malaysia from 2019 to 2021. Although potential endemicity was described previously, genotype shift during 2008 outbreak originating from the 2004 Indian Ocean Islands outbreak presents the probability of current CHIKV spread from neighboring countries. This is due to the prevalence of the new IOL sub-lineage which consists of E1-226A wildtype or reverted strains that are circulating in the Indian subcontinent before spreading to neighboring Thailand during 2018-2019 outbreak.
Method: In this study, samples received mostly from the Tangkak, Johor were analyzed. A total 56 CHIKV positive serum samples received in 2021 by Institute of Medical Research Malaysia (IMR), were collected based on sample selection criteria. Selected samples were subjected to total RNA extraction, whole-genome sequencing as well as bioinformatic analysis such as phylogenetic, variant and mutation analysis.
Results: Based on the genomic and phylogenetic analysis, the CHIKV samples from 2021 outbreak were of ECSA-IOL genotype. Genome similarity analysis also revealed that these CHIKVs were highly similar to 2018-2019 outbreak strain from Thailand. In comparison to the 2008 outbreak CHIKV isolate, the current CHIKVs lacked the E1-A226V mutation and harbored the new E1-K211E/E2-V264A sub-linage mutation. Since the E1-K211E/E2-V264A mutation facilitates adaptation to Ae. aegypti as opposed to the E1-A226V mutation which improves adaptation to Ae. albopictus, the emergence 2021 CHIKV outbreak in Malaysia can be postulated due to vector shift. Interestingly, a novel nsP3-T441A/V mutation detected in this study, may also play a role in virus transmission, pathogenicity, fitness and vector adaptation.
Conclusion: In summary, the current CHIKV outbreak are strains originated from the Indian subcontinent through Thailand which may have capitalized on vector shifting by adapting to Ae. aegypti. The presence of novel nsP3-T441A/V mutation may also contribute to the spread of this virus across peninsular Malaysia.
{"title":"Emergence of ECSA-IOL E1-K211E/E2-V264A Lineage of Chikungunya virus during Malaysian 2021 outbreak.","authors":"Jeevanathan Kalyanasundram, Zarina Mohd Zawawi, Khayri Azizi Kamel, Emmanuel Tiagaraj Aroidoss, Kavithambigai Ellan, Mohd Ishtiaq Anasir, Muhammad Afif Azizan, Murni Maya Sari Zulkifli, Rozainanee Mohd Zain","doi":"10.1186/s12879-024-10102-y","DOIUrl":"10.1186/s12879-024-10102-y","url":null,"abstract":"<p><strong>Background: </strong>Chikungunya cases was reported to be on the rise in Malaysia from 2019 to 2021. Although potential endemicity was described previously, genotype shift during 2008 outbreak originating from the 2004 Indian Ocean Islands outbreak presents the probability of current CHIKV spread from neighboring countries. This is due to the prevalence of the new IOL sub-lineage which consists of E1-226A wildtype or reverted strains that are circulating in the Indian subcontinent before spreading to neighboring Thailand during 2018-2019 outbreak.</p><p><strong>Method: </strong>In this study, samples received mostly from the Tangkak, Johor were analyzed. A total 56 CHIKV positive serum samples received in 2021 by Institute of Medical Research Malaysia (IMR), were collected based on sample selection criteria. Selected samples were subjected to total RNA extraction, whole-genome sequencing as well as bioinformatic analysis such as phylogenetic, variant and mutation analysis.</p><p><strong>Results: </strong>Based on the genomic and phylogenetic analysis, the CHIKV samples from 2021 outbreak were of ECSA-IOL genotype. Genome similarity analysis also revealed that these CHIKVs were highly similar to 2018-2019 outbreak strain from Thailand. In comparison to the 2008 outbreak CHIKV isolate, the current CHIKVs lacked the E1-A226V mutation and harbored the new E1-K211E/E2-V264A sub-linage mutation. Since the E1-K211E/E2-V264A mutation facilitates adaptation to Ae. aegypti as opposed to the E1-A226V mutation which improves adaptation to Ae. albopictus, the emergence 2021 CHIKV outbreak in Malaysia can be postulated due to vector shift. Interestingly, a novel nsP3-T441A/V mutation detected in this study, may also play a role in virus transmission, pathogenicity, fitness and vector adaptation.</p><p><strong>Conclusion: </strong>In summary, the current CHIKV outbreak are strains originated from the Indian subcontinent through Thailand which may have capitalized on vector shifting by adapting to Ae. aegypti. The presence of novel nsP3-T441A/V mutation may also contribute to the spread of this virus across peninsular Malaysia.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Dexamethasone is currently administered for Coronavirus disease 2019(COVID-19); however, there are concerns about its effect on specific antibodies' production. The aim of this study was to evaluate whether specific antibodies were affected by COVID-19 severity and corticosteroid treatment.
Methods: Of 251 confirmed COVID-19 patients admitted to our hospital between January 26 and August 10, 2020, the early period of the pandemic, 75 patients with sera within 1 month of onset and 1 month or longer were included in the research. A total of 253 serum samples from these patients were collected. The levels of specific antibodies for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2), immunoglobulin G (IgG) and M (IgM), were measured retrospectively. The results were compared separately of each COVID-19 severity, and with or without corticosteroid treatment.
Results: Among the 75 patients, 47, 18, and 10 had mild, moderate, and severe disease, respectively. The median age was 53.0 years and 22 (29%) were women. The most common comorbidities were hypertension and dyslipidemia. Corticosteroids were administered to 20 (27%) and 10 (53%), patients with moderate and severe disease, respectively. The positivity rates IgM increased first, and IgG was almost always positive after day 16, regardless of the severity of COVID-19. On days 6-10, both IgG and IgM positivity rates were higher in patients with moderate disease than in those with mild or severe disease. In patients with moderate disease, IgG positivity was similar over time, regardless of corticosteroid treatment.
Conclusions: In COVID-19 patients, specific IgG is positive and maintained for a long period of time, even after corticosteroid treatment. The effect of corticosteroid treatment in a COVID-19 epidemiological study using specific IgG antibodies was considered minor. COVID-19 patients were more likely to receive oxygen if IgM was positive 1 week after onset, but not mechanical ventilation. IgM measurement 1 week after onset may predict COVID-19 severity.
{"title":"COVID-19 severity and corticosteroid treatment have minimal effect on specific antibody production.","authors":"Takato Nakamoto, Noriko Iwamoto, Yusuke Oshiro, Natsumi Inamura, Takashi Nemoto, Satohi Ide, Keiji Nakamura, Hidetoshi Nomoto, Yutaro Akiyama, Tetsuya Suzuki, Yusuke Miyazato, Michiyo Suzuki, Kumiko Suzuki, Moto Kimura, Sho Saito, Satoshi Kutsuna, Norio Ohmagari","doi":"10.1186/s12879-024-10090-z","DOIUrl":"10.1186/s12879-024-10090-z","url":null,"abstract":"<p><strong>Background: </strong>Dexamethasone is currently administered for Coronavirus disease 2019(COVID-19); however, there are concerns about its effect on specific antibodies' production. The aim of this study was to evaluate whether specific antibodies were affected by COVID-19 severity and corticosteroid treatment.</p><p><strong>Methods: </strong>Of 251 confirmed COVID-19 patients admitted to our hospital between January 26 and August 10, 2020, the early period of the pandemic, 75 patients with sera within 1 month of onset and 1 month or longer were included in the research. A total of 253 serum samples from these patients were collected. The levels of specific antibodies for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2), immunoglobulin G (IgG) and M (IgM), were measured retrospectively. The results were compared separately of each COVID-19 severity, and with or without corticosteroid treatment.</p><p><strong>Results: </strong>Among the 75 patients, 47, 18, and 10 had mild, moderate, and severe disease, respectively. The median age was 53.0 years and 22 (29%) were women. The most common comorbidities were hypertension and dyslipidemia. Corticosteroids were administered to 20 (27%) and 10 (53%), patients with moderate and severe disease, respectively. The positivity rates IgM increased first, and IgG was almost always positive after day 16, regardless of the severity of COVID-19. On days 6-10, both IgG and IgM positivity rates were higher in patients with moderate disease than in those with mild or severe disease. In patients with moderate disease, IgG positivity was similar over time, regardless of corticosteroid treatment.</p><p><strong>Conclusions: </strong>In COVID-19 patients, specific IgG is positive and maintained for a long period of time, even after corticosteroid treatment. The effect of corticosteroid treatment in a COVID-19 epidemiological study using specific IgG antibodies was considered minor. COVID-19 patients were more likely to receive oxygen if IgM was positive 1 week after onset, but not mechanical ventilation. IgM measurement 1 week after onset may predict COVID-19 severity.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-24DOI: 10.1186/s12879-024-10074-z
Yunus Can Özalp, Hajrij Shehabie, Mehmet Günhan Tekin, Süreyya Yiğit Kaya, Hüseyin Saffet Beköz, Senem Maral, Ömür Gökmen Sevindik, Leylagül Kaynar
Background: Pneumocystis jirovecii pneumonia (PJP) is an opportunistic infection that primarily affects immunocompromised individuals. Typical symptoms of PJP include the subacute onset of dyspnea, nonproductive cough, and low-grade fever. In hematology patients, particularly those who are allogeneic stem cell transplant recipients, the disease often presents with a more aggressive clinical course. While hypercalcemia has been documented as a manifestation of PJP in some solid organ transplant recipients, it has not been reported in hematology or stem cell transplant patients.
Case presentation: Here, we present a case of PJP in a 56-year-old male allogeneic stem cell transplant recipient, who developed hypercalcemia and renal failure during the late post-transplant period. The patient had a history of allogeneic stem cell transplantation due to acute myeloid leukemia. He presented with symptoms of fatigue and weakness. Laboratory tests revealed hypercalcemia (13.8 mg/dL) and elevated serum creatinine levels (2.3 mg/dL). The patient was hospitalized, and despite initial treatment with hydration and furosemide, the hypercalcemia persisted, leading to the administration of denosumab. During follow-up, hypoxia was detected, and a chest CT scan revealed mosaic attenuation and ground-glass opacities. Bronchoscopy was performed, and PCR testing confirmed the presence of Pneumocystis jirovecii. Other causes of hypercalcemia were ruled out, with PTH measured at 13.8 pg/mL (normal range 15-65 pg/mL), albumin at 3.71 g/dL, 1.25-dihydroxy vitamin D3 at 96 ng/dL (normal range 26-95 ng/dL), and 25-hydroxy vitamin D at 32.5 ng/mL (normal range 20-40 ng/mL). A PET-CT scan demonstrated no pathological FDG uptake, with the exception of findings suggestive of a pulmonary infection. Following treatment with trimethoprim-sulfamethoxazole and denosumab, the patient's hypercalcemia and infection resolved.
Conclusions: Although rare, PJP can present with hypercalcemia and kidney injury in allogeneic stem cell transplant recipients. Early diagnosis and treatment can improve both PJP and hypercalcemia.
{"title":"Atypical presentation of PJP: hypercalcemia and kidney injury in an allogeneic stem cell transplant recipient.","authors":"Yunus Can Özalp, Hajrij Shehabie, Mehmet Günhan Tekin, Süreyya Yiğit Kaya, Hüseyin Saffet Beköz, Senem Maral, Ömür Gökmen Sevindik, Leylagül Kaynar","doi":"10.1186/s12879-024-10074-z","DOIUrl":"10.1186/s12879-024-10074-z","url":null,"abstract":"<p><strong>Background: </strong>Pneumocystis jirovecii pneumonia (PJP) is an opportunistic infection that primarily affects immunocompromised individuals. Typical symptoms of PJP include the subacute onset of dyspnea, nonproductive cough, and low-grade fever. In hematology patients, particularly those who are allogeneic stem cell transplant recipients, the disease often presents with a more aggressive clinical course. While hypercalcemia has been documented as a manifestation of PJP in some solid organ transplant recipients, it has not been reported in hematology or stem cell transplant patients.</p><p><strong>Case presentation: </strong>Here, we present a case of PJP in a 56-year-old male allogeneic stem cell transplant recipient, who developed hypercalcemia and renal failure during the late post-transplant period. The patient had a history of allogeneic stem cell transplantation due to acute myeloid leukemia. He presented with symptoms of fatigue and weakness. Laboratory tests revealed hypercalcemia (13.8 mg/dL) and elevated serum creatinine levels (2.3 mg/dL). The patient was hospitalized, and despite initial treatment with hydration and furosemide, the hypercalcemia persisted, leading to the administration of denosumab. During follow-up, hypoxia was detected, and a chest CT scan revealed mosaic attenuation and ground-glass opacities. Bronchoscopy was performed, and PCR testing confirmed the presence of Pneumocystis jirovecii. Other causes of hypercalcemia were ruled out, with PTH measured at 13.8 pg/mL (normal range 15-65 pg/mL), albumin at 3.71 g/dL, 1.25-dihydroxy vitamin D3 at 96 ng/dL (normal range 26-95 ng/dL), and 25-hydroxy vitamin D at 32.5 ng/mL (normal range 20-40 ng/mL). A PET-CT scan demonstrated no pathological FDG uptake, with the exception of findings suggestive of a pulmonary infection. Following treatment with trimethoprim-sulfamethoxazole and denosumab, the patient's hypercalcemia and infection resolved.</p><p><strong>Conclusions: </strong> Although rare, PJP can present with hypercalcemia and kidney injury in allogeneic stem cell transplant recipients. Early diagnosis and treatment can improve both PJP and hypercalcemia.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Daycare centres play a critical role in early childhood development but are high-risk environments for infectious disease transmission due to close physical contact, shared toys, inadequate hygiene, and poor ventilation. These risks are especially concerning in low- and middle-income countries (LMICs) like Nigeria, where resources for infection control may be limited. This study aimed to identify and characterise virulence genes in bacterial isolates from daycare centres in Ile-Ife, Nigeria, to assess infection risks.
Methods: Between November 2017 and July 2019, 233 samples were collected from 76 children, 33 daycare workers, and 124 fomites in 17 daycare centres. The bacterial isolates were analysed using conventional PCR and RAPD analysis to detect the presence of virulence genes. The frequency of crucial virulence genes and the prevalence of each bacterial species were recorded.
Results: Key virulence genes were detected, including fimH in Klebsiella species (22.73% of Gram-negative isolates), algD in Pseudomonas aeruginosa (50%), and icaA and cna in Staphylococcus aureus (16.67%). Staphylococcus aureus was the most prevalent species (35%), followed by Klebsiella (28%) and Pseudomonas aeruginosa (20%).
Conclusion: This study highlights the presence of virulent bacterial pathogens in daycare environments, posing a severe infection risk to children. To mitigate these risks, it is essential to implement enhanced infection control measures, such as regular microbial screening, improved hand hygiene practices, and disinfection protocols for fomites. Training programs for daycare workers on hygiene practices and routine monitoring could also significantly reduce infection transmission. These interventions are vital for safeguarding the health of daycare children in Nigeria and similar settings globally.
{"title":"Molecular characterisation of virulence genes in bacterial pathogens from daycare centres in Ile-Ife, Nigeria: implications for infection control.","authors":"Eunice Damilola Wilkie, Jude Oluwapelumi Alao, Toyosi Teniola Sotala, Anthonia Olufunke Oluduro","doi":"10.1186/s12879-024-10095-8","DOIUrl":"10.1186/s12879-024-10095-8","url":null,"abstract":"<p><strong>Background: </strong>Daycare centres play a critical role in early childhood development but are high-risk environments for infectious disease transmission due to close physical contact, shared toys, inadequate hygiene, and poor ventilation. These risks are especially concerning in low- and middle-income countries (LMICs) like Nigeria, where resources for infection control may be limited. This study aimed to identify and characterise virulence genes in bacterial isolates from daycare centres in Ile-Ife, Nigeria, to assess infection risks.</p><p><strong>Methods: </strong>Between November 2017 and July 2019, 233 samples were collected from 76 children, 33 daycare workers, and 124 fomites in 17 daycare centres. The bacterial isolates were analysed using conventional PCR and RAPD analysis to detect the presence of virulence genes. The frequency of crucial virulence genes and the prevalence of each bacterial species were recorded.</p><p><strong>Results: </strong>Key virulence genes were detected, including fimH in Klebsiella species (22.73% of Gram-negative isolates), algD in Pseudomonas aeruginosa (50%), and icaA and cna in Staphylococcus aureus (16.67%). Staphylococcus aureus was the most prevalent species (35%), followed by Klebsiella (28%) and Pseudomonas aeruginosa (20%).</p><p><strong>Conclusion: </strong>This study highlights the presence of virulent bacterial pathogens in daycare environments, posing a severe infection risk to children. To mitigate these risks, it is essential to implement enhanced infection control measures, such as regular microbial screening, improved hand hygiene practices, and disinfection protocols for fomites. Training programs for daycare workers on hygiene practices and routine monitoring could also significantly reduce infection transmission. These interventions are vital for safeguarding the health of daycare children in Nigeria and similar settings globally.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-23DOI: 10.1186/s12879-024-10096-7
Carlos Bastidas-Caldes, Fernanda Hernández-Alomía, Miguel Almeida, Mirian Ormaza, Josué Boada, Jay Graham, Manuel Calvopiña, Pablo Castillejo
Background: Antibiotic resistance of Enterobacterales poses a major challenge in the treatment of urinary tract infections (UTIs). In low- and middle-income countries (LMICs), standard microbiological (i.e. urine culture and simple disk diffusion test) methods are considered the "gold standard" for bacterial identification and drug susceptibility testing, while PCR and DNA sequencing are less commonly used. In this study, we aimed to re-identifying Enterobacterales as the primary bacterial agents responsible for urinary tract infections (UTIs) by comparing the sensitivity and specificity of traditional microbiological methods with advanced molecular techniques for the detection of uropathogens in indigenous women from Otavalo, Ecuador.
Methods: A facility-based cross-sectional study was conducted from October 2021 to February 2022 among Kichwa-Otavalo women. Pathogens from urine samples were identified using culture and biochemical typing. Morphological identification was doble-checked through PCR and DNA sequencing of 16S, recA, and rpoB molecular barcodes. The isolates were subjected to antimicrobial susceptibility-testing using disk diffusion test.
Results: This study highlighted a 32% misidentification rate between biochemical and molecular identification. Using traditional methods, E. coli was 26.19% underrepresented meanwhile Klebsiella oxytoca was overrepresented by 92.86%. Furthermore, the genera Pseudomonas, Proteus, and Serratia were confirmed to be E. coli and Klebsiella spp. by molecular method, and one Klebsiella spp. was reidentified as Enterobacter spp. The susceptibility profile showed that 59% of the isolates were multidrug resistant strains and 31% produced extended spectrum beta-lactamases (ESBLs). Co-trimoxazole was the least effective antibiotic with 61% of the isolates resistant. Compared to previous reports, resistance to nitrofurantoin and fosfomycin showed an increase in resistance by 25% and 15%, respectively.
Conclusions: Community-acquired UTIs in indigenous women in Otavalo were primarily caused by E. coli and Klebsiella spp. Molecular identification (16S/rpoB/recA) revealed a high rate of misidentification by standard biochemical and microbiological techniques, which could lead to incorrect antibiotic prescriptions. UTI isolates in this population displayed higher levels of resistance to commonly used antibiotics compared with non-indigenous groups. Accurate identification of pathogens causing UTIs and their antibiotic susceptibility in local populations is important for local antibiotic prescribing guidelines.
背景:肠杆菌的抗生素耐药性是治疗尿路感染(UTI)的一大挑战。在中低收入国家(LMICs),标准微生物学方法(即尿液培养和简单的磁盘扩散试验)被认为是细菌鉴定和药敏试验的 "金标准",而 PCR 和 DNA 测序则较少使用。在这项研究中,我们旨在通过比较传统微生物学方法和先进分子技术在厄瓜多尔奥塔瓦洛土著妇女尿路病原体检测中的灵敏度和特异性,重新确定肠杆菌科细菌是导致尿路感染(UTI)的主要细菌:方法:2021 年 10 月至 2022 年 2 月,在 Kichwa-Otavalo 妇女中开展了一项基于设施的横断面研究。通过培养和生化分型鉴定了尿液样本中的病原体。通过对 16S、recA 和 rpoB 分子条形码进行 PCR 和 DNA 测序,对形态学鉴定进行双重检查。利用盘扩散试验对分离物进行抗菌药敏感性测试:结果:这项研究表明,生化鉴定和分子鉴定之间的误判率高达 32%。使用传统方法,大肠杆菌的比例偏低 26.19%,而土生克雷伯菌的比例偏高 92.86%。此外,假单胞菌属、变形杆菌属和沙雷氏菌属通过分子方法被确认为大肠杆菌和克雷伯菌属,其中一个克雷伯菌属被重新鉴定为肠杆菌属。 药敏谱显示,59%的分离菌株为多重耐药菌株,31%产生广谱β-内酰胺酶(ESBLs)。共三唑是效果最差的抗生素,61%的分离菌株对其产生耐药性。与之前的报告相比,对硝基呋喃妥因和磷霉素的耐药性分别增加了25%和15%:分子鉴定(16S/rpoB/recA)显示,标准生化和微生物技术的错误鉴定率很高,这可能导致错误的抗生素处方。与非土著群体相比,该人群中的 UTI 分离物对常用抗生素的耐药性水平更高。准确鉴定当地人群中导致UTI的病原体及其对抗生素的敏感性对于制定当地抗生素处方指南非常重要。
{"title":"Molecular identification and antimicrobial resistance patterns of enterobacterales in community urinary tract infections among indigenous women in Ecuador: addressing microbiological misidentification.","authors":"Carlos Bastidas-Caldes, Fernanda Hernández-Alomía, Miguel Almeida, Mirian Ormaza, Josué Boada, Jay Graham, Manuel Calvopiña, Pablo Castillejo","doi":"10.1186/s12879-024-10096-7","DOIUrl":"10.1186/s12879-024-10096-7","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic resistance of Enterobacterales poses a major challenge in the treatment of urinary tract infections (UTIs). In low- and middle-income countries (LMICs), standard microbiological (i.e. urine culture and simple disk diffusion test) methods are considered the \"gold standard\" for bacterial identification and drug susceptibility testing, while PCR and DNA sequencing are less commonly used. In this study, we aimed to re-identifying Enterobacterales as the primary bacterial agents responsible for urinary tract infections (UTIs) by comparing the sensitivity and specificity of traditional microbiological methods with advanced molecular techniques for the detection of uropathogens in indigenous women from Otavalo, Ecuador.</p><p><strong>Methods: </strong>A facility-based cross-sectional study was conducted from October 2021 to February 2022 among Kichwa-Otavalo women. Pathogens from urine samples were identified using culture and biochemical typing. Morphological identification was doble-checked through PCR and DNA sequencing of 16S, recA, and rpoB molecular barcodes. The isolates were subjected to antimicrobial susceptibility-testing using disk diffusion test.</p><p><strong>Results: </strong>This study highlighted a 32% misidentification rate between biochemical and molecular identification. Using traditional methods, E. coli was 26.19% underrepresented meanwhile Klebsiella oxytoca was overrepresented by 92.86%. Furthermore, the genera Pseudomonas, Proteus, and Serratia were confirmed to be E. coli and Klebsiella spp. by molecular method, and one Klebsiella spp. was reidentified as Enterobacter spp. The susceptibility profile showed that 59% of the isolates were multidrug resistant strains and 31% produced extended spectrum beta-lactamases (ESBLs). Co-trimoxazole was the least effective antibiotic with 61% of the isolates resistant. Compared to previous reports, resistance to nitrofurantoin and fosfomycin showed an increase in resistance by 25% and 15%, respectively.</p><p><strong>Conclusions: </strong>Community-acquired UTIs in indigenous women in Otavalo were primarily caused by E. coli and Klebsiella spp. Molecular identification (16S/rpoB/recA) revealed a high rate of misidentification by standard biochemical and microbiological techniques, which could lead to incorrect antibiotic prescriptions. UTI isolates in this population displayed higher levels of resistance to commonly used antibiotics compared with non-indigenous groups. Accurate identification of pathogens causing UTIs and their antibiotic susceptibility in local populations is important for local antibiotic prescribing guidelines.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-22DOI: 10.1186/s12879-024-10031-w
Augustus Osborne, Camilla Bangura, Samuel Maxwell Tom Williams, Alusine H Koroma, Lovel Fornah, Regina M Yillah, Bright Opoku Ahinkorah
<p><strong>Background: </strong>Sierra Leone faces a significant challenge in addressing HIV/AIDS, particularly among adolescent girls and young women. This age group is considered highly vulnerable due to biological factors and social inequalities. Understanding the prevalence of HIV testing in this demographic is crucial for designing effective prevention and treatment strategies. This study investigated the spatial distribution of HIV testing and its associated factors among adolescent girls and young women in Sierra Leone.</p><p><strong>Methods: </strong>Data from the 2019 Sierra Leone Demographic and Health Survey was used for the study. The sample comprised 6,062 adolescent girls and young women between the ages of 15 and 24. Spatial autocorrelation and Moran's I statistic were employed to analyze the spatial distribution of HIV testing. An analysis utilising mixed-effect multilevel binary logistic regression was performed to determine the factors associated with HIV testing. The findings were presented as adjusted odds ratios (aOR) and a 95% confidence interval (CI).</p><p><strong>Results: </strong>The national prevalence of HIV testing among adolescents and young women in Sierra Leone was 42.1% [40.3,43.9]. Kailahun, Kambia, Tonkolil, some parts of the Western rural area, and Bonthe districts were found to be statistically significant hotspot for HIV testing. Whereas, Karene, Falaba, Bo, kenema, and some parts of Pujuhun were statistically cold spot districts. Adolescent girls and young women aged 20-24 [aOR = 1.63, 95% CI = 1.29, 2.07] had higher odds of HIV testing than those aged 15-19. Those with secondary/higher education [aOR = 1.87, 95% CI = 1.40, 2.51] had higher odds of HIV testing than those with no education. The odds of HIV testing was higher among adolescent girls and young women who use the Internet [aOR = 1.75, 95% CI = 1.32, 2.33] than those who did not use internet. Adolescent girls and young women with one [aOR = 16.56, 95% CI = 12.31, 22.29] and two or more parity [aOR = 16.37, 95% CI = 10.86, 24.68] had higher odds of HIV testing than those with no parity. The likelihood of HIV testing was higher among adolescent girls and young women who had sex below 18 [aOR = 4.54, 95% CI = 3.25, 6.34] and those who had sex at 18+ [aOR = 5.70, 95% CI = 3.84, 8.45] compared to those who had never had sex. Adolescent girls and young women who visited health facilities in the past 12 months [aOR = 1.82, 95% CI = 1.46, 2.26] had higher odds of HIV testing than those who did not.</p><p><strong>Conclusion: </strong>Despite some positive trends, HIV testing rates among adolescent girls and young women in Sierra Leone remain moderate. Spatial autocorrelation analysis consistently revealed hotspots and cold spots for HIV testing, with Kailahun, Kambia, Tonkolil, some parts of the Western rural area, and Bonthe districts remaining persistent hotspots. Age, education, internet use, sexual history, parity, and healthcare access are significant
背景:塞拉利昂在应对艾滋病毒/艾滋病方面面临重大挑战,尤其是在少女和年轻妇女中。由于生理因素和社会不平等,这一年龄段的人群被认为极易感染艾滋病。了解这一人群中艾滋病检测的普及率对于制定有效的预防和治疗策略至关重要。本研究调查了塞拉利昂少女和年轻女性中 HIV 检测的空间分布及其相关因素:研究采用了 2019 年塞拉利昂人口与健康调查的数据。样本包括 6,062 名 15 至 24 岁的少女和年轻女性。研究采用了空间自相关和莫兰 I 统计来分析 HIV 检测的空间分布。利用混合效应多层次二元逻辑回归进行分析,以确定与艾滋病毒检测相关的因素。结果以调整后的几率比(aOR)和 95% 的置信区间(CI)表示:塞拉利昂全国青少年和年轻女性的 HIV 检测率为 42.1% [40.3,43.9]。据统计,凯拉洪、坎比亚、通科利尔、西部农村地区的部分地区和邦特区是艾滋病毒检测的热点地区。而卡莱内、法拉巴、博城、凯内马和普朱洪的部分地区则是统计上的冷点地区。20-24 岁的少女和年轻妇女[aOR = 1.63, 95% CI = 1.29, 2.07]比 15-19 岁的少女和年轻妇女接受 HIV 检测的几率更高。受过中等/高等教育的人群[aOR = 1.87,95% CI = 1.40,2.51]比未受过教育的人群有更高的 HIV 检测几率。使用互联网的少女和年轻女性进行 HIV 检测的几率 [aOR = 1.75,95% CI = 1.32,2.33] 要高于不使用互联网的少女和年轻女性。有一次[aOR = 16.56, 95% CI = 12.31, 22.29]和两次或两次以上[aOR = 16.37, 95% CI = 10.86, 24.68]同居的少女和青年妇女比没有同居的少女和青年妇女进行 HIV 检测的几率更高。与从未发生过性行为的少女和年轻妇女相比,18 岁以下发生过性行为的少女和年轻妇女[aOR = 4.54,95% CI = 3.25,6.34]和 18 岁以上发生过性行为的少女和年轻妇女[aOR = 5.70,95% CI = 3.84,8.45]接受 HIV 检测的可能性更高。在过去 12 个月中去过医疗机构的少女和年轻女性[aOR = 1.82,95% CI = 1.46,2.26]比没有去过医疗机构的少女和年轻女性接受 HIV 检测的几率更高:尽管出现了一些积极的趋势,但塞拉利昂少女和年轻妇女的艾滋病毒检测率仍然不高。空间自相关分析持续显示了艾滋病毒检测的热点和冷点,凯拉洪、坎比亚、通科利尔、西部农村地区的一些地方以及邦特地区仍然是持续的热点地区。年龄、教育程度、互联网使用情况、性史、奇偶性和医疗服务的可及性是影响检测行为的重要因素。为提高检测率,政府和政策制定者应优先考虑教育活动、扩大互联网接入、将艾滋病毒检测纳入常规医疗保健,并解决与艾滋病毒相关的污名化问题。
{"title":"Spatial distribution and factors associated with HIV testing among adolescent girls and young women in Sierra Leone.","authors":"Augustus Osborne, Camilla Bangura, Samuel Maxwell Tom Williams, Alusine H Koroma, Lovel Fornah, Regina M Yillah, Bright Opoku Ahinkorah","doi":"10.1186/s12879-024-10031-w","DOIUrl":"10.1186/s12879-024-10031-w","url":null,"abstract":"<p><strong>Background: </strong>Sierra Leone faces a significant challenge in addressing HIV/AIDS, particularly among adolescent girls and young women. This age group is considered highly vulnerable due to biological factors and social inequalities. Understanding the prevalence of HIV testing in this demographic is crucial for designing effective prevention and treatment strategies. This study investigated the spatial distribution of HIV testing and its associated factors among adolescent girls and young women in Sierra Leone.</p><p><strong>Methods: </strong>Data from the 2019 Sierra Leone Demographic and Health Survey was used for the study. The sample comprised 6,062 adolescent girls and young women between the ages of 15 and 24. Spatial autocorrelation and Moran's I statistic were employed to analyze the spatial distribution of HIV testing. An analysis utilising mixed-effect multilevel binary logistic regression was performed to determine the factors associated with HIV testing. The findings were presented as adjusted odds ratios (aOR) and a 95% confidence interval (CI).</p><p><strong>Results: </strong>The national prevalence of HIV testing among adolescents and young women in Sierra Leone was 42.1% [40.3,43.9]. Kailahun, Kambia, Tonkolil, some parts of the Western rural area, and Bonthe districts were found to be statistically significant hotspot for HIV testing. Whereas, Karene, Falaba, Bo, kenema, and some parts of Pujuhun were statistically cold spot districts. Adolescent girls and young women aged 20-24 [aOR = 1.63, 95% CI = 1.29, 2.07] had higher odds of HIV testing than those aged 15-19. Those with secondary/higher education [aOR = 1.87, 95% CI = 1.40, 2.51] had higher odds of HIV testing than those with no education. The odds of HIV testing was higher among adolescent girls and young women who use the Internet [aOR = 1.75, 95% CI = 1.32, 2.33] than those who did not use internet. Adolescent girls and young women with one [aOR = 16.56, 95% CI = 12.31, 22.29] and two or more parity [aOR = 16.37, 95% CI = 10.86, 24.68] had higher odds of HIV testing than those with no parity. The likelihood of HIV testing was higher among adolescent girls and young women who had sex below 18 [aOR = 4.54, 95% CI = 3.25, 6.34] and those who had sex at 18+ [aOR = 5.70, 95% CI = 3.84, 8.45] compared to those who had never had sex. Adolescent girls and young women who visited health facilities in the past 12 months [aOR = 1.82, 95% CI = 1.46, 2.26] had higher odds of HIV testing than those who did not.</p><p><strong>Conclusion: </strong>Despite some positive trends, HIV testing rates among adolescent girls and young women in Sierra Leone remain moderate. Spatial autocorrelation analysis consistently revealed hotspots and cold spots for HIV testing, with Kailahun, Kambia, Tonkolil, some parts of the Western rural area, and Bonthe districts remaining persistent hotspots. Age, education, internet use, sexual history, parity, and healthcare access are significant ","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}