Pub Date : 2024-11-11DOI: 10.1186/s12879-024-10181-x
Endrias Markos Woldesemayat, Taye Gari
Background: There is lack of evidence on the TB treatment outcomes of TB/HIV co-infected patients who received anti-TB treatment in Sidama region. In this study, we aimed to assess the treatment outcome of TB/HIV co-infected patients receiving care at Adare Hospital in Hawasa City, Sidama Region.
Methods: A cross sectional study based on retrospective data among TB/HIV co-infected cases was conducted at Adare Hospital. The unit TB registry and antiretroviral therapy (ART) registry were reviewed for the period between September 1, 2016 and August 31, 2022 to measure TB treatment outcomes. Target population for this study was all TB/HIV co-infected cases aged 15 years or more treated at Adare Hospital in the Hawassa City Administration. The data sources for this study were the unit TB register at the TB clinics, patient charts, and the ART register of the facility. Data were entered and analysed using the statistical package SPSS version 26. A summary descriptive analysis was calculated. Bivariable and multivariable analyses were performed to identify associations between variables.
Results: During the study period, 298 TB/HIV co-infected cases were treated for TB in the Hospital. Thirty three (11.1%), of the cases had an unfavourable TB treatment outcome. The risk of an unfavourable treatment outcome was over three times higher among re-treated TB cases than among the new TB cases (AOR = 3.3, 95% CI (1.4, 7.9)). The risk of death was higher among stage-IV HIV cases (AOR = 8.1, 95% CI (2.3, 28.9)), and among participants who used non-communicable diseases medications during the cohort period (AOR = 7.3, 95% CI (1.6, 33.6).
Conclusion: TB treatment success rate among TB/HIV co-infected cases in the current study was comparable to many other reports. There are factors that contributed for unsuccessful TB treatment outcome. Cautious follow-up of cases and managing these factors could help in improving the TB treatment outcome.
背景:关于西达马地区接受抗结核治疗的结核病/艾滋病毒合并感染者的结核病治疗效果,目前还缺乏相关证据。本研究旨在评估在西达马地区哈瓦萨市阿达雷医院接受治疗的肺结核/艾滋病毒合并感染者的治疗效果:方法:我们在阿达雷医院对结核病/艾滋病毒合并感染病例进行了一项基于回顾性数据的横断面研究。研究回顾了2016年9月1日至2022年8月31日期间的单位结核病登记和抗逆转录病毒疗法(ART)登记,以衡量结核病治疗效果。本研究的目标人群是在哈瓦萨市政府阿达雷医院接受治疗的所有 15 岁或以上结核病/艾滋病毒合并感染病例。本研究的数据来源包括结核病诊所的结核病单位登记簿、病历以及该机构的抗逆转录病毒疗法登记簿。数据使用 SPSS 26 版统计软件包进行输入和分析。计算描述性分析摘要。为确定变量之间的关联性,还进行了二变量和多变量分析:研究期间,医院共收治了 298 例结核病/艾滋病毒合并感染者。其中 33 例(11.1%)的结核病治疗结果不理想。再次接受治疗的肺结核病例出现不良治疗结果的风险是新发肺结核病例的三倍多(AOR = 3.3,95% CI (1.4, 7.9))。在 HIV IV 期病例(AOR = 8.1,95% CI (2.3,28.9))和在队列期间使用非传染性疾病药物的参与者(AOR = 7.3,95% CI (1.6,33.6))中,死亡风险更高:结论:在本次研究中,结核病/艾滋病毒合并感染病例的结核病治疗成功率与许多其他报告不相上下。导致结核病治疗结果不成功的因素有很多。对病例进行谨慎的随访并控制这些因素有助于改善结核病的治疗效果。
{"title":"Tuberculosis treatment outcome of TB/HIV co-infected patients at Adare Hospital, Hawassa City Administration, Sidama Region.","authors":"Endrias Markos Woldesemayat, Taye Gari","doi":"10.1186/s12879-024-10181-x","DOIUrl":"10.1186/s12879-024-10181-x","url":null,"abstract":"<p><strong>Background: </strong>There is lack of evidence on the TB treatment outcomes of TB/HIV co-infected patients who received anti-TB treatment in Sidama region. In this study, we aimed to assess the treatment outcome of TB/HIV co-infected patients receiving care at Adare Hospital in Hawasa City, Sidama Region.</p><p><strong>Methods: </strong>A cross sectional study based on retrospective data among TB/HIV co-infected cases was conducted at Adare Hospital. The unit TB registry and antiretroviral therapy (ART) registry were reviewed for the period between September 1, 2016 and August 31, 2022 to measure TB treatment outcomes. Target population for this study was all TB/HIV co-infected cases aged 15 years or more treated at Adare Hospital in the Hawassa City Administration. The data sources for this study were the unit TB register at the TB clinics, patient charts, and the ART register of the facility. Data were entered and analysed using the statistical package SPSS version 26. A summary descriptive analysis was calculated. Bivariable and multivariable analyses were performed to identify associations between variables.</p><p><strong>Results: </strong>During the study period, 298 TB/HIV co-infected cases were treated for TB in the Hospital. Thirty three (11.1%), of the cases had an unfavourable TB treatment outcome. The risk of an unfavourable treatment outcome was over three times higher among re-treated TB cases than among the new TB cases (AOR = 3.3, 95% CI (1.4, 7.9)). The risk of death was higher among stage-IV HIV cases (AOR = 8.1, 95% CI (2.3, 28.9)), and among participants who used non-communicable diseases medications during the cohort period (AOR = 7.3, 95% CI (1.6, 33.6).</p><p><strong>Conclusion: </strong>TB treatment success rate among TB/HIV co-infected cases in the current study was comparable to many other reports. There are factors that contributed for unsuccessful TB treatment outcome. Cautious follow-up of cases and managing these factors could help in improving the TB treatment outcome.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1281"},"PeriodicalIF":3.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613980","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 : 2024-11-11DOI: 10.1186/s12879-024-10155-z
Xingna Zhang, Christopher P Cheyne, Christopher Jones, Michael Humann, Gary Leeming, Claire Smith, David M Hughes, Girvan Burnside, Susanna Dodd, Rebekah Penrice-Randal, Xiaofeng Dong, Malcolm G Semple, Tim Neal, Sarah Tunkel, Tom Fowler, Lance Turtle, Marta García-Fiñana, Iain E Buchan
Background: Covid-19 healthcare worker testing, isolation and quarantine policies had to balance risks to patients from the virus and from staff absence. The emergence of the Omicron variant led to dangerous levels of key-worker absence globally. We evaluated whether using two manufacturers' lateral flow tests (LFTs) concurrently improved SARS-CoV-2 Omicron detection significantly and was acceptable to hospital staff. In a nested study, to understand risks of return to work after a 5-day isolation/quarantine period, we examined virus culture 5-7 days after positive test or significant exposure.
Methods: Fully-vaccinated Liverpool (UK) University Hospitals staff participated (February-May 2022) in a random-order, open-label trial testing whether dual LFTs improved SARS-CoV-2 detection, and whether dual swabbing was acceptable to users. Participants used nose-throat swab Innova and nose-only swab Orient Gene LFTs in daily randomised order for 10 days. A user-experience questionnaire was administered on exit. Selected participants gave swabs for viral culture on days 5-7 after symptom onset or first positive test. Cultures were considered positive if cytopathic effect was apparent or SARS-CoV-2 N gene sub-genomic RNA was detected.
Results: Two hundred and twenty-six individuals reported 1466 pairs of LFT results. Tests disagreed in 127 cases (8.7%). Orient Gene was more likely (78 cf. 49; OR: 2.1, 1.1-4.1; P = 0.03) to be positive. If Innova was swabbed second, it was less likely to agree with a positive Orient Gene result (OR: 2.7, 1.3-5.2; P = 0.005); swabbing first with Innova made no significant difference (OR: 1.1, 0.5-2.3; P = 0.85). Orient Gene positive Innova negative result-pairs became more frequent over time (OR: 1.2, 1.1-1.3; P < 0.001). Of individuals completing the exit questionnaire, 90.7% reported dual swabbing was easy, 57.1% said it was no barrier to their daily routine and 65.6% preferred dual testing. Respondents had more confidence in dual versus single test results. Viral cultures from days 5-7 were positive for 6/31 (19.4%, 7.5%-37.5%) and indeterminate for 11/31 (35.5%, 19.2%-54.6%) LFT-positive participants, indicating they were likely still infectious.
Conclusions: Dual brand testing increased LFT detection of SARS-CoV-2 antigen by a small but meaningful margin and was acceptable to hospital workers. Viral cultures demonstrated that policies recommending safe return to work ~ 5 days after Omicron infection/exposure were flawed. Key-workers should be prepared for dynamic self-testing protocols in future pandemics.
Trial registration: https://www.isrctn.com/ISRCTN47058442 (26 January 2022).
{"title":"Can self-testing be enhanced to hasten safe return of healthcare workers in pandemics? Random order, open label trial using two manufacturers' SARS-CoV-2 lateral flow devices concurrently and nested viral culture study.","authors":"Xingna Zhang, Christopher P Cheyne, Christopher Jones, Michael Humann, Gary Leeming, Claire Smith, David M Hughes, Girvan Burnside, Susanna Dodd, Rebekah Penrice-Randal, Xiaofeng Dong, Malcolm G Semple, Tim Neal, Sarah Tunkel, Tom Fowler, Lance Turtle, Marta García-Fiñana, Iain E Buchan","doi":"10.1186/s12879-024-10155-z","DOIUrl":"10.1186/s12879-024-10155-z","url":null,"abstract":"<p><strong>Background: </strong>Covid-19 healthcare worker testing, isolation and quarantine policies had to balance risks to patients from the virus and from staff absence. The emergence of the Omicron variant led to dangerous levels of key-worker absence globally. We evaluated whether using two manufacturers' lateral flow tests (LFTs) concurrently improved SARS-CoV-2 Omicron detection significantly and was acceptable to hospital staff. In a nested study, to understand risks of return to work after a 5-day isolation/quarantine period, we examined virus culture 5-7 days after positive test or significant exposure.</p><p><strong>Methods: </strong>Fully-vaccinated Liverpool (UK) University Hospitals staff participated (February-May 2022) in a random-order, open-label trial testing whether dual LFTs improved SARS-CoV-2 detection, and whether dual swabbing was acceptable to users. Participants used nose-throat swab Innova and nose-only swab Orient Gene LFTs in daily randomised order for 10 days. A user-experience questionnaire was administered on exit. Selected participants gave swabs for viral culture on days 5-7 after symptom onset or first positive test. Cultures were considered positive if cytopathic effect was apparent or SARS-CoV-2 N gene sub-genomic RNA was detected.</p><p><strong>Results: </strong>Two hundred and twenty-six individuals reported 1466 pairs of LFT results. Tests disagreed in 127 cases (8.7%). Orient Gene was more likely (78 cf. 49; OR: 2.1, 1.1-4.1; P = 0.03) to be positive. If Innova was swabbed second, it was less likely to agree with a positive Orient Gene result (OR: 2.7, 1.3-5.2; P = 0.005); swabbing first with Innova made no significant difference (OR: 1.1, 0.5-2.3; P = 0.85). Orient Gene positive Innova negative result-pairs became more frequent over time (OR: 1.2, 1.1-1.3; P < 0.001). Of individuals completing the exit questionnaire, 90.7% reported dual swabbing was easy, 57.1% said it was no barrier to their daily routine and 65.6% preferred dual testing. Respondents had more confidence in dual versus single test results. Viral cultures from days 5-7 were positive for 6/31 (19.4%, 7.5%-37.5%) and indeterminate for 11/31 (35.5%, 19.2%-54.6%) LFT-positive participants, indicating they were likely still infectious.</p><p><strong>Conclusions: </strong>Dual brand testing increased LFT detection of SARS-CoV-2 antigen by a small but meaningful margin and was acceptable to hospital workers. Viral cultures demonstrated that policies recommending safe return to work ~ 5 days after Omicron infection/exposure were flawed. Key-workers should be prepared for dynamic self-testing protocols in future pandemics.</p><p><strong>Trial registration: </strong>https://www.isrctn.com/ISRCTN47058442 (26 January 2022).</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1276"},"PeriodicalIF":3.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614369","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: The global initiative to eliminate measles, spearheaded by the World Health Organization, has yet to achieve its intended goals. In Turkey, despite robust vaccination strategies, recent increases in measles cases have been attributed to vaccine hesitancy and irregular migration. This study evaluates measles serology within a pediatric population to determine the impact of vaccination regimens on immunity.
Methods: A retrospective study at Ankara Bilkent City Hospital analyzed serum measles IgG levels in children aged 1-18 years from January 2020 to August 2023. Exclusions were applied for individuals with positive IgM results, incomplete vaccinations, and immunocompromised conditions. Patients were categorized based on their M-M-R®II vaccine status into those having received either one or two doses. Seropositivity was assessed using the ELISA method.
Results: Of the 686 children, 30.2% received a single dose, and 69.8% received two doses of the MMR vaccine. Overall, 70.7% exhibited positive IgG levels. No significant differences were found in IgG levels between those who received one dose and those who received two doses. However, a decline in IgG levels was observed with age, particularly notable in adolescents aged 14-18 years.
Conclusion: The study reveals seropositivity rates lower than expected, highlighting challenges in achieving WHO targets. This suggests a potential need for booster doses during adolescence to maintain protective antibody levels. The findings emphasize the importance of continued surveillance and research to adapt vaccination strategies effectively and prevent measles outbreaks, particularly considering the decline in antibody levels and diverse vaccination histories across populations.
{"title":"Securing long-term immunity: The possible necessity of supplementary measles vaccination.","authors":"Furkan Kalayci, Metin Yigit, Belgin Gulhan, Saliha Kanik Yuksek, Enes Kaan Kilic, Yunus Emre Ince, Betul Demircioglu Kalayci, Hasan Salih Yuzdemir, Aslinur Ozkaya Parlakay","doi":"10.1186/s12879-024-10149-x","DOIUrl":"10.1186/s12879-024-10149-x","url":null,"abstract":"<p><strong>Background: </strong>The global initiative to eliminate measles, spearheaded by the World Health Organization, has yet to achieve its intended goals. In Turkey, despite robust vaccination strategies, recent increases in measles cases have been attributed to vaccine hesitancy and irregular migration. This study evaluates measles serology within a pediatric population to determine the impact of vaccination regimens on immunity.</p><p><strong>Methods: </strong>A retrospective study at Ankara Bilkent City Hospital analyzed serum measles IgG levels in children aged 1-18 years from January 2020 to August 2023. Exclusions were applied for individuals with positive IgM results, incomplete vaccinations, and immunocompromised conditions. Patients were categorized based on their M-M-R<sup>®</sup>II vaccine status into those having received either one or two doses. Seropositivity was assessed using the ELISA method.</p><p><strong>Results: </strong>Of the 686 children, 30.2% received a single dose, and 69.8% received two doses of the MMR vaccine. Overall, 70.7% exhibited positive IgG levels. No significant differences were found in IgG levels between those who received one dose and those who received two doses. However, a decline in IgG levels was observed with age, particularly notable in adolescents aged 14-18 years.</p><p><strong>Conclusion: </strong>The study reveals seropositivity rates lower than expected, highlighting challenges in achieving WHO targets. This suggests a potential need for booster doses during adolescence to maintain protective antibody levels. The findings emphasize the importance of continued surveillance and research to adapt vaccination strategies effectively and prevent measles outbreaks, particularly considering the decline in antibody levels and diverse vaccination histories across populations.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1274"},"PeriodicalIF":3.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613768","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: Chad with 7,698 confirmed cases of infection and 194 deaths since the beginning of the COVID-19 pandemic, is one of the African countries with the lowest reported case numbers. However, this figure likely underestimates the true spread of the virus due to the low rate of diagnosis. The high rate of asymptomatic infections reflects the reality of SARS-CoV-2 transmission in Chad. In this study, we estimated the seroprevalence and identified factors associated with SARS-CoV-2 infection.
Methods: A cross-sectional study was conducted between September 2022 and February 2023. A total of 1,290 plasma samples were collected from outpatient attendees at Health Facilities located in 11 provinces of Chad and tested by ELISA method, for the presence of IgG antibodies to SARS-CoV2 nucleocapsid (N) protein. KoboToolbox was used to gather data from the participants and data were analyzed using STATA 16.
Results: The overall seroprevalence was 83.0% [95% CI = 81.6%-85.5%], with variations between provinces, ranging from 99.2% [95% CI = 94.0%-100%] in Moundou (Southern Chad) to 46.8% [95% CI = 36.0% -57.1%] in Biltine (Eastern Chad). Factors associated with the seroprevalence included military occupation (OR = 0.37 CI [0.80-1.77] p = 0.025) and age group between 55-64 years (OR = 0.33 CI [0.15-0.72] p = 0.005). While, other factors, such as gender and age were not significantly associated with seroprevalence.
Conclusion: Our results indicated that, the seroprevalence of COVID-19 in Chad is among the highest in Sub-Saharan Africa. These estimates could guide the response and public health policy decisions, enhancing the management of future outbreaks involving respiratory pathogens.
背景:自 COVID-19 大流行以来,乍得确诊感染病例 7698 例,死亡 194 例,是报告病例数最少的非洲国家之一。然而,由于诊断率低,这一数字很可能低估了病毒的真实传播情况。无症状感染率高反映了 SARS-CoV-2 在乍得传播的实际情况。在这项研究中,我们估算了血清流行率,并确定了与 SARS-CoV-2 感染相关的因素:方法:我们在 2022 年 9 月至 2023 年 2 月期间进行了一项横断面研究。我们从乍得 11 个省医疗机构的门诊病人中收集了 1,290 份血浆样本,采用 ELISA 方法检测 SARS-CoV2 核头壳(N)蛋白 IgG 抗体。使用 KoboToolbox 收集参与者的数据,并使用 STATA 16 对数据进行分析:总血清阳性率为 83.0% [95% CI = 81.6% -85.5%],各省之间存在差异,蒙杜(乍得南部)为 99.2% [95% CI = 94.0% -100%],比尔廷(乍得东部)为 46.8% [95% CI = 36.0% -57.1%]。与血清阳性率相关的因素包括军人职业(OR = 0.37 CI [0.80-1.77] p = 0.025)和 55-64 岁年龄组(OR = 0.33 CI [0.15-0.72] p = 0.005)。而性别和年龄等其他因素与血清阳性率无明显关系:我们的研究结果表明,乍得的 COVID-19 血清流行率在撒哈拉以南非洲地区是最高的。这些估计值可为应对措施和公共卫生政策决策提供指导,从而加强对未来涉及呼吸道病原体的疫情的管理。
{"title":"SARS-CoV-2 seroprevalence and associated factors among outpatient attendees at health facilities in different provinces in Chad.","authors":"Koutaya Dezoumbe, Oumaima Djarma, Andrillene Laure Deutou Wondeu, Fatima Abdelrazak Zakaria, Sabrina Atturo, Nathan Naïbeï, Franck J D Mennechet, Denise Campagna, Abdoulaye Boukar, Choroma Ahmat Moussa, Issa Mahamat, Nontegyol Armand, Mahamat Idriss Hamad, Netalar Honorine, Kayanlengar Frederic, Adam Adami Moustapha, Yanda Mberkissam Daniel, Adam Moussa Alim, Mahamat Grene, Noubaramadji Yamti Suitombaye, Amine Akouya, Ouchemi Choua, Hota Mathieu, Djallaye Djimtoïbaye, Vittorio Colizzi, Giulia Cappelli, Takoudjou Dzomo Guy Rodrigue, Mahamat Fayiz Abakar, Ali Mahamat Moussa","doi":"10.1186/s12879-024-10099-4","DOIUrl":"10.1186/s12879-024-10099-4","url":null,"abstract":"<p><strong>Background: </strong>Chad with 7,698 confirmed cases of infection and 194 deaths since the beginning of the COVID-19 pandemic, is one of the African countries with the lowest reported case numbers. However, this figure likely underestimates the true spread of the virus due to the low rate of diagnosis. The high rate of asymptomatic infections reflects the reality of SARS-CoV-2 transmission in Chad. In this study, we estimated the seroprevalence and identified factors associated with SARS-CoV-2 infection.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between September 2022 and February 2023. A total of 1,290 plasma samples were collected from outpatient attendees at Health Facilities located in 11 provinces of Chad and tested by ELISA method, for the presence of IgG antibodies to SARS-CoV2 nucleocapsid (N) protein. KoboToolbox was used to gather data from the participants and data were analyzed using STATA 16.</p><p><strong>Results: </strong>The overall seroprevalence was 83.0% [95% CI = 81.6%-85.5%], with variations between provinces, ranging from 99.2% [95% CI = 94.0%-100%] in Moundou (Southern Chad) to 46.8% [95% CI = 36.0% -57.1%] in Biltine (Eastern Chad). Factors associated with the seroprevalence included military occupation (OR = 0.37 CI [0.80-1.77] p = 0.025) and age group between 55-64 years (OR = 0.33 CI [0.15-0.72] p = 0.005). While, other factors, such as gender and age were not significantly associated with seroprevalence.</p><p><strong>Conclusion: </strong>Our results indicated that, the seroprevalence of COVID-19 in Chad is among the highest in Sub-Saharan Africa. These estimates could guide the response and public health policy decisions, enhancing the management of future outbreaks involving respiratory pathogens.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1271"},"PeriodicalIF":3.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613654","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 : 2024-11-11DOI: 10.1186/s12879-024-10167-9
Yuyin Zhou, Junfang Xu
Background: International migrants are vulnerable to sexually transmitted infections, and their flow may accelerate the related virus (e.g., HIV, HCV, and syphilis) transmission. When international migrants enter a new environment, there will be a process of adaptation in all areas of life, and social integration plays an important role in international migrants' daily life.
Objective: This study aimed to explore the influence of social integration on the risky sexual behaviors of international migrants in China and provided evidence both for healthcare intervention and global health development.
Methods: A cross-sectional survey was conducted between January and September 2021 among international migrants who lived in China by snowball sampling method. Descriptive statistics were used to analyze the basic characteristics and risky sexual behaviors of international migrants. Multivariable logistic regression analyses were used to identify the influencing factors of risky sexual behaviors.
Results: In total, 1433 international migrants were incorporated into the study. There were 23.10% (331) participants who considered their Chinese fluent, and 34.40% (493) considered it hard. The average number of Chinese friends they frequently interact with was (5.45 ± 2.16), and 77.60% (1112) of international migrants often attend activities held by Chinese people with 84.86% (1216) having a Chinese name. The probability of engaging in risky sexual behaviors was higher among people with lower Chinese or English level. Moreover, participants with fewer Chinese friends frequently interacted with had more unprotected sexual behaviors. People who did not often attend activities held by Chinese people had more multiple sexual partners (AOR 1.441; 95%CI 1.019,2.039) and unprotected sexual behaviors (AOR 1.523; 95%CI 1.006,2.306).
Conclusions: Social integration was related to the prevalence of risky sexual behaviors among international migrants. Improving Chinese level, increasing social interaction with locals as well as maintaining a healthy lifestyle may help decrease risky sexual behaviors. Therefore, more attention should be paid to social integration among international migrants, helping them integrate into local society, and promote their health condition to effectively address the health challenges faced by them in a globalized world.
{"title":"Social integration and risky sexual behaviors among international migrants in China: a cross-sectional study.","authors":"Yuyin Zhou, Junfang Xu","doi":"10.1186/s12879-024-10167-9","DOIUrl":"10.1186/s12879-024-10167-9","url":null,"abstract":"<p><strong>Background: </strong>International migrants are vulnerable to sexually transmitted infections, and their flow may accelerate the related virus (e.g., HIV, HCV, and syphilis) transmission. When international migrants enter a new environment, there will be a process of adaptation in all areas of life, and social integration plays an important role in international migrants' daily life.</p><p><strong>Objective: </strong>This study aimed to explore the influence of social integration on the risky sexual behaviors of international migrants in China and provided evidence both for healthcare intervention and global health development.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted between January and September 2021 among international migrants who lived in China by snowball sampling method. Descriptive statistics were used to analyze the basic characteristics and risky sexual behaviors of international migrants. Multivariable logistic regression analyses were used to identify the influencing factors of risky sexual behaviors.</p><p><strong>Results: </strong>In total, 1433 international migrants were incorporated into the study. There were 23.10% (331) participants who considered their Chinese fluent, and 34.40% (493) considered it hard. The average number of Chinese friends they frequently interact with was (5.45 ± 2.16), and 77.60% (1112) of international migrants often attend activities held by Chinese people with 84.86% (1216) having a Chinese name. The probability of engaging in risky sexual behaviors was higher among people with lower Chinese or English level. Moreover, participants with fewer Chinese friends frequently interacted with had more unprotected sexual behaviors. People who did not often attend activities held by Chinese people had more multiple sexual partners (AOR 1.441; 95%CI 1.019,2.039) and unprotected sexual behaviors (AOR 1.523; 95%CI 1.006,2.306).</p><p><strong>Conclusions: </strong>Social integration was related to the prevalence of risky sexual behaviors among international migrants. Improving Chinese level, increasing social interaction with locals as well as maintaining a healthy lifestyle may help decrease risky sexual behaviors. Therefore, more attention should be paid to social integration among international migrants, helping them integrate into local society, and promote their health condition to effectively address the health challenges faced by them in a globalized world.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1270"},"PeriodicalIF":3.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613774","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}
<p><strong>Background: </strong>Measles, a highly contagious and potentially fatal disease, remains a significant public health concern, particularly in low- and middle-income countries. Vaccination is the most effective way to prevent measles and achieving high immunization coverage is crucial for protecting children and communities. This study investigated the trends and inequalities in measles immunization coverage among two-year-olds in Sierra Leone between 2008 and 2019.</p><p><strong>Methods: </strong>The study utilized data from the Sierra Leone Demographic Health Surveys conducted in 2008, 2013, and 2019. The World Health Organisation Health Equity Assessment Toolkit was used to calculate various inequality measures, including Difference (D), Ratio (R), Population Attributable Risk (PAR), and Population Attributable Fraction (PAF). An inequality assessment was conducted for six stratifiers: age, economic status, level of education, place of residence, sex of the child, and sub-national province.</p><p><strong>Results: </strong>In Sierra Leone, measles immunization coverage increased between 2008 and 2013 and decreased slightly in 2019. In 2008, 66.2% of two-year-olds were immunized, which increased to 86.2% in 2013 and then fell slightly to 82.2% in 2019. There was a decrease in inequality for age from 4.2 percentage points in 2008 to 3.0 percentage points in 2019 (D = 4.2 in 2008 and 3.0 in 2019). Economic-related inequality decreased from 8.1 percentage points in 2008 to 7.5 percentage points in 2019 (D = 8.1 in 2008 and 7.5 in 2019). Inequality in education decreased from 10.3 percentage points in 2008 to 7.4 percentage points in 2019 based on results from the inequality measure D. For place of residence, inequality decreased from 6.0 percentage points in 2008 to 4.0 percentage points in 2019. For the child's sex, the inequality increased from 1.9 percentage points in 2008 to 4.5 percentage points in 2019. The PAF revealed that the setting average could have been 1.4% higher in 2008 and 2.7% higher in 2019 without the child's sex inequality. Provincial inequality decreased from 19.4 percentage points in 2008 to 16.9 percentage points in 2019 (D = 19.4 in 2008 and 16.9 in 2019).</p><p><strong>Conclusion: </strong>The observed fluctuations in national measles immunization coverage for children under two underscore the need for sustained efforts in vaccination programs. While improvements in access based on age, socioeconomic status, education level, and place of residence suggest progress in reducing inequalities, the persistent provincial disparities, with a significant gap in 2019, highlight ongoing challenges that must be addressed to ensure equitable health outcomes. Additionally, the increase in inequalities based on the child's sex during the study period raises concerns about targeted interventions that may inadvertently neglect specific groups. These findings imply that policymakers must prioritize strategies that maintain high v
{"title":"Inequalities in measles immunization coverage among two-year-olds in Sierra Leone, 2008-2019.","authors":"Augustus Osborne, Alpha Umaru Bai-Sesay, Umaru Sesay, Alieu Tommy, Camilla Bangura, Bright Opoku Ahinkorah","doi":"10.1186/s12879-024-10088-7","DOIUrl":"10.1186/s12879-024-10088-7","url":null,"abstract":"<p><strong>Background: </strong>Measles, a highly contagious and potentially fatal disease, remains a significant public health concern, particularly in low- and middle-income countries. Vaccination is the most effective way to prevent measles and achieving high immunization coverage is crucial for protecting children and communities. This study investigated the trends and inequalities in measles immunization coverage among two-year-olds in Sierra Leone between 2008 and 2019.</p><p><strong>Methods: </strong>The study utilized data from the Sierra Leone Demographic Health Surveys conducted in 2008, 2013, and 2019. The World Health Organisation Health Equity Assessment Toolkit was used to calculate various inequality measures, including Difference (D), Ratio (R), Population Attributable Risk (PAR), and Population Attributable Fraction (PAF). An inequality assessment was conducted for six stratifiers: age, economic status, level of education, place of residence, sex of the child, and sub-national province.</p><p><strong>Results: </strong>In Sierra Leone, measles immunization coverage increased between 2008 and 2013 and decreased slightly in 2019. In 2008, 66.2% of two-year-olds were immunized, which increased to 86.2% in 2013 and then fell slightly to 82.2% in 2019. There was a decrease in inequality for age from 4.2 percentage points in 2008 to 3.0 percentage points in 2019 (D = 4.2 in 2008 and 3.0 in 2019). Economic-related inequality decreased from 8.1 percentage points in 2008 to 7.5 percentage points in 2019 (D = 8.1 in 2008 and 7.5 in 2019). Inequality in education decreased from 10.3 percentage points in 2008 to 7.4 percentage points in 2019 based on results from the inequality measure D. For place of residence, inequality decreased from 6.0 percentage points in 2008 to 4.0 percentage points in 2019. For the child's sex, the inequality increased from 1.9 percentage points in 2008 to 4.5 percentage points in 2019. The PAF revealed that the setting average could have been 1.4% higher in 2008 and 2.7% higher in 2019 without the child's sex inequality. Provincial inequality decreased from 19.4 percentage points in 2008 to 16.9 percentage points in 2019 (D = 19.4 in 2008 and 16.9 in 2019).</p><p><strong>Conclusion: </strong>The observed fluctuations in national measles immunization coverage for children under two underscore the need for sustained efforts in vaccination programs. While improvements in access based on age, socioeconomic status, education level, and place of residence suggest progress in reducing inequalities, the persistent provincial disparities, with a significant gap in 2019, highlight ongoing challenges that must be addressed to ensure equitable health outcomes. Additionally, the increase in inequalities based on the child's sex during the study period raises concerns about targeted interventions that may inadvertently neglect specific groups. These findings imply that policymakers must prioritize strategies that maintain high v","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1280"},"PeriodicalIF":3.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614447","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 : 2024-11-09DOI: 10.1186/s12879-024-10186-6
Nikolett Orosz, Gabriella Gömöri, Ulambayar Battamir, Attila Csaba Nagy
Background: Severe acute respiratory infection (SARI) is a major cause for hospital admission and associated with high mortality among children worldwide. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza viruses and respiratory syncytial virus (RSV) are the most frequently identified pathogens in children with SARI. The duration of care can be affected by the type of infection and patient characteristics. Therefore, the objective of this study was to identify factors affecting the length of hospitalization in children infected with SARS-CoV-2, influenza A and RSV.
Methods: We collected data on 713 children with SARI from the medical databases of a university hospital in Hungary. To examine whether there is a difference in the length of hospitalization in children with the SARI Kruskal-Wallis test was performed. To determine the factors that may have an impact on the duration of care a multiple logistic regression analysis was executed.
Results: Our results showed that among RSV infected patients the proportions of children requiring intensive care (8.94%), mechanical ventilation (8.94%) and oxygen therapy (13.01%) and suffering from pneumonia (29.27%) were larger than among cases with SARS-CoV-2 and influenza A infection. Considering the age distribution and the duration of care in children with SARI, cases with RSV were significantly younger (p < 0.001) and stayed longer in the hospital (median: 5 days, IQR: 4-7 days, p < 0.001) than those with SARS-CoV-2 and influenza A virus. Multiple logistic regression analysis showed that RSV infection (adjusted odds ratio (aOR): 3.25, 95% confidence interval (CI): 1.43-7.38; p = 0.005), pneumonia (aOR: 3.65, 95% CI: 2.14-6.24; p < 0.001), mechanical ventilation or oxygen therapy (aOR: 3.23, 95% CI: 1.29-8.11; p = 0.012) and underlying illnesses (aOR: 2.39, 95% CI: 1.35-4.23; p = 0.003) significantly increased the odds of hospitalization for more than 4 days.
Conclusions: Our research showed that of the viruses causing SARI, RSV had the greatest clinical relevance, contributing to hospital stays of more than 4 days in a large share of paediatric patients below 1 year of age. Our results supply new information on children with SARI, and provide evidence for health policy makers to allocate additional resources to hospitals during SARI epidemics.
背景:严重急性呼吸道感染(SARI)是全球儿童入院治疗的主要原因,死亡率也很高。严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)、流感病毒和呼吸道合胞病毒(RSV)是 SARI 患儿中最常见的病原体。护理时间的长短会受到感染类型和患者特征的影响。因此,本研究旨在确定影响感染 SARS-CoV-2、甲型流感和 RSV 儿童住院时间的因素:我们从匈牙利一所大学医院的医疗数据库中收集了 713 名感染 SARI 儿童的数据。为了研究 SARI 患儿的住院时间是否存在差异,我们进行了 Kruskal-Wallis 检验。为了确定可能对护理时间产生影响的因素,我们进行了多元逻辑回归分析:结果表明,在 RSV 感染者中,需要重症监护(8.94%)、机械通气(8.94%)和氧疗(13.01%)以及肺炎(29.27%)的儿童比例高于 SARS-CoV-2 和甲型流感感染者。考虑到 SARI 患儿的年龄分布和护理时间,RSV 患儿的年龄明显更小(p 结论):我们的研究表明,在导致 SARI 的病毒中,RSV 的临床意义最大,导致大量 1 岁以下儿童患者的住院时间超过 4 天。我们的研究结果提供了有关 SARI 儿童的新信息,并为卫生决策者在 SARI 流行期间向医院分配额外资源提供了证据。
{"title":"Hospital-based cross-sectional study on the clinical characteristics of children with severe acute respiratory infections in Hungary.","authors":"Nikolett Orosz, Gabriella Gömöri, Ulambayar Battamir, Attila Csaba Nagy","doi":"10.1186/s12879-024-10186-6","DOIUrl":"10.1186/s12879-024-10186-6","url":null,"abstract":"<p><strong>Background: </strong>Severe acute respiratory infection (SARI) is a major cause for hospital admission and associated with high mortality among children worldwide. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza viruses and respiratory syncytial virus (RSV) are the most frequently identified pathogens in children with SARI. The duration of care can be affected by the type of infection and patient characteristics. Therefore, the objective of this study was to identify factors affecting the length of hospitalization in children infected with SARS-CoV-2, influenza A and RSV.</p><p><strong>Methods: </strong>We collected data on 713 children with SARI from the medical databases of a university hospital in Hungary. To examine whether there is a difference in the length of hospitalization in children with the SARI Kruskal-Wallis test was performed. To determine the factors that may have an impact on the duration of care a multiple logistic regression analysis was executed.</p><p><strong>Results: </strong>Our results showed that among RSV infected patients the proportions of children requiring intensive care (8.94%), mechanical ventilation (8.94%) and oxygen therapy (13.01%) and suffering from pneumonia (29.27%) were larger than among cases with SARS-CoV-2 and influenza A infection. Considering the age distribution and the duration of care in children with SARI, cases with RSV were significantly younger (p < 0.001) and stayed longer in the hospital (median: 5 days, IQR: 4-7 days, p < 0.001) than those with SARS-CoV-2 and influenza A virus. Multiple logistic regression analysis showed that RSV infection (adjusted odds ratio (aOR): 3.25, 95% confidence interval (CI): 1.43-7.38; p = 0.005), pneumonia (aOR: 3.65, 95% CI: 2.14-6.24; p < 0.001), mechanical ventilation or oxygen therapy (aOR: 3.23, 95% CI: 1.29-8.11; p = 0.012) and underlying illnesses (aOR: 2.39, 95% CI: 1.35-4.23; p = 0.003) significantly increased the odds of hospitalization for more than 4 days.</p><p><strong>Conclusions: </strong>Our research showed that of the viruses causing SARI, RSV had the greatest clinical relevance, contributing to hospital stays of more than 4 days in a large share of paediatric patients below 1 year of age. Our results supply new information on children with SARI, and provide evidence for health policy makers to allocate additional resources to hospitals during SARI epidemics.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1268"},"PeriodicalIF":3.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614444","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 : 2024-11-08DOI: 10.1186/s12879-024-09912-x
Flavia Camponovo, Aurélie Jeandron, Laura A Skrip, Monica Golumbeanu, Clara Champagne, Tasmin L Symons, Mark Connell, Peter W Gething, Theodoor Visser, Arnaud Le Menach, Justin M Cohen, Emilie Pothin
Background: Testing and treating symptomatic malaria cases is crucial for case management, but it may also prevent future illness by reducing mean infection duration. Measuring the impact of effective treatment on burden and transmission via field studies or routine surveillance systems is difficult and potentially unethical. This project uses mathematical modeling to explore how increasing treatment of symptomatic cases impacts malaria prevalence and incidence.
Methods: Leveraging the OpenMalaria stochastic agent-based transmission model, we first simulated an array of transmission intensities with baseline effective treatment coverages of 28%, 44%, and 54% incorporated to reflect the 2023 coverage distribution across Africa, as estimated by the Malaria Atlas Project. We assessed the impact of increasing coverage to as high as 60%, the highest 2023 estimate on the continent. Subsequently, we performed simulations resembling the specific subnational endemicities of Kenya, Mozambique, and Benin, using the Malaria Atlas Project estimates of intervention coverages to reproduce historical subnational prevalence. We estimated the impact of increasing effective treatment coverage in these example settings in terms of prevalence reduction and clinical cases averted in children under 5 years old and the total population.
Results: The most significant prevalence reduction - up to 50% - was observed in young children from lower transmission settings (prevalence below 0.2), alongside a 35% reduction in incidence, when increasing effective treatment from 28% to 60%. A nonlinear relationship between baseline transmission intensity and the impact of treatment was observed. Increasing effective treatment coverage to 60% reduced the risk in high-risk areas (prevalence in children under 5 years old > 0.3), affecting 39% of young children in Benin and 20% in Mozambique previously living in those areas. In Kenya where most of the population lives in areas with prevalence below 0.15, and case management is fairly high (53.9%), 0.39% of children were estimated to transition to lower-risk areas.
Conclusions: Improving case management directly reduces the burden of illness, but these results suggest it also reduces transmission, especially for young children. With vector control interventions, enhancing case management can be an important tool for reducing transmission intensity over time.
{"title":"Malaria treatment for prevention: a modelling study of the impact of routine case management on malaria prevalence and burden.","authors":"Flavia Camponovo, Aurélie Jeandron, Laura A Skrip, Monica Golumbeanu, Clara Champagne, Tasmin L Symons, Mark Connell, Peter W Gething, Theodoor Visser, Arnaud Le Menach, Justin M Cohen, Emilie Pothin","doi":"10.1186/s12879-024-09912-x","DOIUrl":"10.1186/s12879-024-09912-x","url":null,"abstract":"<p><strong>Background: </strong>Testing and treating symptomatic malaria cases is crucial for case management, but it may also prevent future illness by reducing mean infection duration. Measuring the impact of effective treatment on burden and transmission via field studies or routine surveillance systems is difficult and potentially unethical. This project uses mathematical modeling to explore how increasing treatment of symptomatic cases impacts malaria prevalence and incidence.</p><p><strong>Methods: </strong>Leveraging the OpenMalaria stochastic agent-based transmission model, we first simulated an array of transmission intensities with baseline effective treatment coverages of 28%, 44%, and 54% incorporated to reflect the 2023 coverage distribution across Africa, as estimated by the Malaria Atlas Project. We assessed the impact of increasing coverage to as high as 60%, the highest 2023 estimate on the continent. Subsequently, we performed simulations resembling the specific subnational endemicities of Kenya, Mozambique, and Benin, using the Malaria Atlas Project estimates of intervention coverages to reproduce historical subnational prevalence. We estimated the impact of increasing effective treatment coverage in these example settings in terms of prevalence reduction and clinical cases averted in children under 5 years old and the total population.</p><p><strong>Results: </strong>The most significant prevalence reduction - up to 50% - was observed in young children from lower transmission settings (prevalence below 0.2), alongside a 35% reduction in incidence, when increasing effective treatment from 28% to 60%. A nonlinear relationship between baseline transmission intensity and the impact of treatment was observed. Increasing effective treatment coverage to 60% reduced the risk in high-risk areas (prevalence in children under 5 years old > 0.3), affecting 39% of young children in Benin and 20% in Mozambique previously living in those areas. In Kenya where most of the population lives in areas with prevalence below 0.15, and case management is fairly high (53.9%), 0.39% of children were estimated to transition to lower-risk areas.</p><p><strong>Conclusions: </strong>Improving case management directly reduces the burden of illness, but these results suggest it also reduces transmission, especially for young children. With vector control interventions, enhancing case management can be an important tool for reducing transmission intensity over time.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1267"},"PeriodicalIF":3.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614449","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: The stress hyperglycemia ratio (SHR) is associated with poor outcomes in critically ill patients. However, the relationship between SHR and mortality in patients with sepsis-associated acute kidney injury (SA-AKI) remains unclear.
Methods: The data of patients with SA-AKI, identified based on the KDIGO criteria, were retrospectively collected from the Beth Israel Deaconess Medical Center between 2008 and 2019. SHR was calculated as follows: (glycemia [mmol/L]) / (1.59 × HbA1c [%] - 2.59). Primary outcomes were 30-day and 1-year mortality. The cumulative incidence of all-cause mortality was assessed using Kaplan-Meier survival analysis. Multivariable-adjusted logistic and Cox models and restricted cubic spline curves were used to analyze the correlation between SHR and all-cause mortality. Post-hoc subgroup analysis was performed to compare the effects of SHR across different subgroups.
Results: 1161 patients with SA-AKI were identified and categorized into four SHR quartiles as follows: Q1 (0.26, 0.90), Q2 (0.91, 1.08), Q3 (1.09, 1.30), and Q4 (1.31, 5.42). The median age of patients was 69 years, with 42.7% of the patients being women and 20.2% of the patients having chronic kidney disease. The 30-day and 1-year mortality were 22.1% and 35.0% respectively. Kaplan-Meier survival analysis indicated a gradual decrease in survival probability with increasing SHR quartiles. An increased SHR exhibited a strong correlation with 30-day mortality (hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.18-1.90; P < 0.001) and 1-year mortality (HR, 1.32; 95% CI, 1.06-1.65; P = 0.014). SHR has a nonlinear relationship with 1-year mortality but not with 30-day mortality (P-nonlinear = 0.048 and 0.114, respectively). The results of subgroup analysis were mostly consistent with these findings.
Conclusion: An increased SHR is independently associated with 30-day and 1-year mortality in patients with SA-AKI. Therefore, SHR may serve as an effective tool for risk stratification in patients with SA-AKI.
{"title":"The association between stress hyperglycemia ratio and clinical outcomes in patients with sepsis-associated acute kidney injury: a secondary analysis of the MIMIC-IV database.","authors":"Yuanjun Zhou, Liping Zhong, Yuting Zhong, Yilin Liao","doi":"10.1186/s12879-024-10179-5","DOIUrl":"10.1186/s12879-024-10179-5","url":null,"abstract":"<p><strong>Background: </strong>The stress hyperglycemia ratio (SHR) is associated with poor outcomes in critically ill patients. However, the relationship between SHR and mortality in patients with sepsis-associated acute kidney injury (SA-AKI) remains unclear.</p><p><strong>Methods: </strong>The data of patients with SA-AKI, identified based on the KDIGO criteria, were retrospectively collected from the Beth Israel Deaconess Medical Center between 2008 and 2019. SHR was calculated as follows: (glycemia [mmol/L]) / (1.59 × HbA1c [%] - 2.59). Primary outcomes were 30-day and 1-year mortality. The cumulative incidence of all-cause mortality was assessed using Kaplan-Meier survival analysis. Multivariable-adjusted logistic and Cox models and restricted cubic spline curves were used to analyze the correlation between SHR and all-cause mortality. Post-hoc subgroup analysis was performed to compare the effects of SHR across different subgroups.</p><p><strong>Results: </strong>1161 patients with SA-AKI were identified and categorized into four SHR quartiles as follows: Q1 (0.26, 0.90), Q2 (0.91, 1.08), Q3 (1.09, 1.30), and Q4 (1.31, 5.42). The median age of patients was 69 years, with 42.7% of the patients being women and 20.2% of the patients having chronic kidney disease. The 30-day and 1-year mortality were 22.1% and 35.0% respectively. Kaplan-Meier survival analysis indicated a gradual decrease in survival probability with increasing SHR quartiles. An increased SHR exhibited a strong correlation with 30-day mortality (hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.18-1.90; P < 0.001) and 1-year mortality (HR, 1.32; 95% CI, 1.06-1.65; P = 0.014). SHR has a nonlinear relationship with 1-year mortality but not with 30-day mortality (P-nonlinear = 0.048 and 0.114, respectively). The results of subgroup analysis were mostly consistent with these findings.</p><p><strong>Conclusion: </strong>An increased SHR is independently associated with 30-day and 1-year mortality in patients with SA-AKI. Therefore, SHR may serve as an effective tool for risk stratification in patients with SA-AKI.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1263"},"PeriodicalIF":3.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613794","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 : 2024-11-08DOI: 10.1186/s12879-024-10124-6
Rowan Abuyadek, Mira Mousa, Jumana AlAzazi, Ahmed Al Romaithi, Francis Selvaraj, Habiba Alsafar, Nawal Al Kaabi, Farida Al Hosani
Background: In the pursuit of global health security, continuous monitoring of vaccine effectiveness across various viral strains emerges as a crucial imperative. The emergence of SARS-CoV-2 major variants of concern (VOCs), including Alpha, Beta, Delta, and Omicron, has added complexity to the COVID-19 vaccination landscape.
Objectives: To assess illness severity, evaluate vaccine efficacy across varying doses and types, and determine effectiveness against major VOCs within the population.
Methods: This retrospective cohort study, conducted in Abu Dhabi, United Arab Emirates, focuses on a cohort of 44,073 SARS-CoV-2 positive cases from February 2021 to May 2022, dominated by the Delta and Omicron variants. The study employed a nested case-control design, analyzing hospital admissions for confirmed SARS-CoV-2 infection.
Results: Vaccine effectiveness was higher among heterologus-boosted individuals at 87% (95% CI:79%-93%) compared to homologus-boosted individuals at 59% (95% CI: 48%-68%) and fully vaccinated, non-boosted adults at 53% (95% CI: 46%-59%). These findings highlight the importance of heterologous boosting, particularly against rapidly evolving viral variants, offering valuable insights for refining pandemic response strategies.
Conclusion: The study underscores the critical need for ongoing assessment and adaptation of vaccination strategies to the evolving viral landscape.
{"title":"Genomic characteristics, disease outcome and heterologous vaccine effectiveness among cases with SARS CoV-2 infection.","authors":"Rowan Abuyadek, Mira Mousa, Jumana AlAzazi, Ahmed Al Romaithi, Francis Selvaraj, Habiba Alsafar, Nawal Al Kaabi, Farida Al Hosani","doi":"10.1186/s12879-024-10124-6","DOIUrl":"10.1186/s12879-024-10124-6","url":null,"abstract":"<p><strong>Background: </strong>In the pursuit of global health security, continuous monitoring of vaccine effectiveness across various viral strains emerges as a crucial imperative. The emergence of SARS-CoV-2 major variants of concern (VOCs), including Alpha, Beta, Delta, and Omicron, has added complexity to the COVID-19 vaccination landscape.</p><p><strong>Objectives: </strong>To assess illness severity, evaluate vaccine efficacy across varying doses and types, and determine effectiveness against major VOCs within the population.</p><p><strong>Methods: </strong>This retrospective cohort study, conducted in Abu Dhabi, United Arab Emirates, focuses on a cohort of 44,073 SARS-CoV-2 positive cases from February 2021 to May 2022, dominated by the Delta and Omicron variants. The study employed a nested case-control design, analyzing hospital admissions for confirmed SARS-CoV-2 infection.</p><p><strong>Results: </strong>Vaccine effectiveness was higher among heterologus-boosted individuals at 87% (95% CI:79%-93%) compared to homologus-boosted individuals at 59% (95% CI: 48%-68%) and fully vaccinated, non-boosted adults at 53% (95% CI: 46%-59%). These findings highlight the importance of heterologous boosting, particularly against rapidly evolving viral variants, offering valuable insights for refining pandemic response strategies.</p><p><strong>Conclusion: </strong>The study underscores the critical need for ongoing assessment and adaptation of vaccination strategies to the evolving viral landscape.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1266"},"PeriodicalIF":3.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11545176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614442","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}