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Magnitude of anemia and associated factors among HIV infected children on antiretroviral therapy in Awi zone health facilities, Northwest Ethiopia, 2023. 2023 年埃塞俄比亚西北部阿维地区医疗机构中接受抗逆转录病毒治疗的艾滋病毒感染儿童的贫血程度及相关因素。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-25 DOI: 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。
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引用次数: 0
A case of severe psittacosis pneumonia complicated by splenic infarction. 一例严重鹦鹉热肺炎并发脾梗塞。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-25 DOI: 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.

临床数据:鹦鹉热衣原体肺炎是由鹦鹉热衣原体引起的社区获得性肺炎。虽然重症病例可能会导致呼吸衰竭等危重情况,但脾梗死却相对少见。我院收治的一名鹦鹉热衣原体肺炎重症患者在治疗过程中发生了脾梗塞。幸运的是,经过精心治疗,患者的情况有所好转。目前,患者已康复出院。对并发脾梗死的机制还需进一步探讨:鹦鹉热肺炎是一种由鸟类传染给人类的人畜共患传染病,由鹦鹉热衣原体引起,是衣原体肺炎的一种[1]。在某些情况下,这种疾病会发展成重症肺炎和呼吸衰竭,必须采取包括机械通气在内的强化支持措施。用于传染病病原学诊断的元基因组下一代测序(mNGS)等技术的出现[2]提高了鹦鹉热的诊断率和治疗成功率。严重的衣原体肺炎并发脾梗塞等并发症的病例并不多见。海宁市人民医院急诊重症监护室(EICU)收治了一名并发脾梗死的重症鹦鹉热肺炎患者,经过有效的抗感染和抗凝治疗后,患者病情好转。特此报告。
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引用次数: 0
A conceptual health state diagram for modelling the transmission of a (re)emerging infectious respiratory disease in a human population. 用于模拟(再)出现的呼吸道传染病在人群中传播的概念健康状态图。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-24 DOI: 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.

由于数据和监测有限、疾病自然史的不确定性以及公共卫生和个人对疾病爆发的反应,对人类(再)新发传染性呼吸道疾病的数学建模给建模者带来了多重挑战。在此,我们提出了一个受 COVID-19 启发的健康状态图(HSD),作为一个基础框架,用于概念化(再)新发呼吸道疾病的建模过程,以及在其出现的早期阶段的公共卫生应对措施。HSD 旨在作为思考传播模型结构和参数化的起点,以评估(再)新出现疾病的影响和公共卫生干预措施控制传播的能力。我们还利用历史上对公共卫生具有重要意义的三种呼吸道疾病的特点,探讨了 HSD 对不同(再)新出现疾病的适应性。我们概述了在将(再)新出现的传染病应用和调整 HSD 时需要考虑的关键问题,并对调整该框架用于公共卫生相关干预措施进行了思考。
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引用次数: 0
Community-acquired pneumonia caused by Micrococcus antarcticus: a rare case report. 南极微球菌引起的社区获得性肺炎:罕见病例报告。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-24 DOI: 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.

背景:南极微球菌(M. antarcticus)是一种需氧革兰阳性球形放线菌,最初于 2000 年从中国南极长城站分离出来。南极蘑菇菌被认为是低致病性菌,以前从未有过该菌感染人类的报道。在此,我们首次报道了由南极蘑菇引起的社区获得性肺炎(CAP):一名 87 岁的女性于 2023 年 11 月到武汉市中心医院就诊,主诉为咳嗽、咳痰和胸闷 2 周。对患者支气管肺泡灌洗液(BALF)进行微生物培养,并使用基质辅助激光解吸电离/飞行时间质谱(MALDI-TOF MS)和 16S rRNA 基因测序对分离物进行鉴定,结果显示患者感染了南极蘑菇。结合临床症状、实验室和影像学检查,患者被诊断为 CAP。随后给予头孢哌酮/舒巴坦和左氧氟沙星治疗,患者病情好转,入院一周后出院,随访5个月未发现异常:本病例表明,从一名 CAP 患者身上首次发现的南极米氏杆菌是一种极为罕见的病原微生物。临床医生在诊断和治疗 CAP 时应认识到它作为病原体的潜力。
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引用次数: 0
Emergence of ECSA-IOL E1-K211E/E2-V264A Lineage of Chikungunya virus during Malaysian 2021 outbreak. 2021 年马来西亚疫情爆发期间出现的基孔肯雅病毒 ECSA-IOL E1-K211E/E2-V264A 系。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-24 DOI: 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.

背景:据报道,2019 年至 2021 年马来西亚的基孔肯雅病例将呈上升趋势。虽然以前曾描述过潜在的地方流行性,但在 2008 年疫情爆发期间,源于 2004 年印度洋群岛疫情爆发的基因型发生了转变,这表明目前 CHIKV 有可能从邻国传播。这是由于新的IOL亚系的流行,该亚系由E1-226A野生型或还原型毒株组成,这些毒株在印度次大陆流行,然后在2018-2019年疫情期间传播到邻国泰国:本研究分析了主要来自柔佛州唐卡的样本。根据样本选择标准,马来西亚医学研究所(IMR)于 2021 年共采集了 56 份 CHIKV 阳性血清样本。对所选样本进行了总 RNA 提取、全基因组测序以及系统发育、变异和突变分析等生物信息学分析:结果:根据基因组和系统发育分析,2021 年疫情中的 CHIKV 样本属于 ECSA-IOL 基因型。基因组相似性分析还显示,这些CHIKV与2018-2019年泰国疫情毒株高度相似。与2008年爆发的CHIKV分离株相比,目前的CHIKV缺乏E1-A226V突变,并携带新的E1-K211E/E2-V264A亚序列突变。由于 E1-K211E/E2-V264A 突变有利于适应埃及伊蚊,而 E1-A226V 突变则改善了对白喉伊蚊的适应,因此可以推测马来西亚出现的 2021 年 CHIKV 疫情是由于病媒转移所致。有趣的是,本研究中检测到的一种新型 nsP3-T441A/V 突变也可能在病毒传播、致病性、适应性和病媒适应性方面发挥作用:总之,目前爆发的 CHIKV 是源于印度次大陆、途经泰国的毒株,它们可能利用了病媒的转移,适应了埃及蚁。新型 nsP3-T441A/V 突变的存在也可能是导致该病毒在马来西亚半岛传播的原因之一。
{"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}
引用次数: 0
COVID-19 severity and corticosteroid treatment have minimal effect on specific antibody production. COVID-19 的严重程度和皮质类固醇治疗对特异性抗体的产生影响甚微。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-24 DOI: 10.1186/s12879-024-10090-z
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

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.

背景:目前,地塞米松可用于治疗冠状病毒病2019(COVID-19);然而,人们担心地塞米松会影响特异性抗体的产生。本研究旨在评估特异性抗体是否受COVID-19严重程度和皮质类固醇治疗的影响:方法:在 2020 年 1 月 26 日至 8 月 10 日(大流行早期)期间,本院收治了 251 名确诊 COVID-19 的患者,其中 75 名患者的血清在发病 1 个月内和 1 个月或更长时间内。研究共收集了这些患者的 253 份血清样本。对严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)的特异性抗体、免疫球蛋白 G(IgG)和 M(IgM)水平进行了回顾性测定。结果分别与 COVID-19 严重程度、是否接受皮质类固醇治疗进行了比较:在 75 名患者中,轻度、中度和重度患者分别为 47 人、18 人和 10 人。中位年龄为 53.0 岁,女性 22 人(占 29%)。最常见的合并症是高血压和血脂异常。中度和重度患者中分别有 20 人(27%)和 10 人(53%)使用了皮质类固醇。无论 COVID-19 的严重程度如何,IgM 阳性率首先升高,IgG 在第 16 天后几乎总是阳性。在第 6-10 天,中度患者的 IgG 和 IgM 阳性率均高于轻度或重度患者。在中度疾病患者中,无论皮质类固醇治疗与否,IgG 阳性率在不同时期都相似:结论:在 COVID-19 患者中,特异性 IgG 呈阳性,即使在皮质类固醇治疗后也能长期保持。在使用特异性 IgG 抗体进行的 COVID-19 流行病学研究中,皮质类固醇治疗的影响被认为很小。COVID-19 患者在发病 1 周后如果 IgM 阳性,则更有可能接受吸氧,但机械通气则不然。发病一周后的 IgM 测量结果可预测 COVID-19 的严重程度。
{"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}
引用次数: 0
Atypical presentation of PJP: hypercalcemia and kidney injury in an allogeneic stem cell transplant recipient. PJP 的非典型表现:异体干细胞移植受者的高钙血症和肾损伤。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-24 DOI: 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.

背景:肺孢子虫肺炎(PJP)是一种机会性感染,主要影响免疫力低下的人群。PJP 的典型症状包括亚急性呼吸困难、无排泄性咳嗽和低烧。对于血液病患者,尤其是接受异体干细胞移植的患者,该病的临床表现通常更为凶险。虽然高钙血症是一些实体器官移植受者的 PJP 表现,但在血液科或干细胞移植患者中却未见报道:在此,我们介绍了一例 56 岁男性异体干细胞移植受者的 PJP 病例,该患者在移植后晚期出现了高钙血症和肾功能衰竭。患者曾因急性髓性白血病接受异基因干细胞移植。他出现了疲劳和虚弱的症状。实验室检查显示他患有高钙血症(13.8毫克/分升)和血清肌酐水平升高(2.3毫克/分升)。患者被送入医院,尽管最初使用了补液和呋塞米治疗,但高钙血症仍持续存在,因此需要使用地诺单抗。在随访期间,发现患者缺氧,胸部 CT 扫描发现马赛克衰减和磨玻璃不透明。患者接受了支气管镜检查,PCR 检测证实其体内存在肺孢子虫。排除了导致高钙血症的其他原因,测得PTH为13.8 pg/mL(正常范围15-65 pg/mL),白蛋白为3.71 g/dL,1.25-二羟维生素D3为96 ng/dL(正常范围26-95 ng/dL),25-羟维生素D为32.5 ng/mL(正常范围20-40 ng/mL)。PET-CT 扫描显示,除了提示肺部感染的结果外,没有病理 FDG 摄取。在接受三甲双胍-磺胺甲噁唑和地诺单抗治疗后,患者的高钙血症和感染症状消失: 结论:PJP虽然罕见,但可在异体干细胞移植受者中出现高钙血症和肾损伤。早期诊断和治疗可改善PJP和高钙血症。
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引用次数: 0
Molecular characterisation of virulence genes in bacterial pathogens from daycare centres in Ile-Ife, Nigeria: implications for infection control. 尼日利亚伊费岛日托中心细菌病原体毒力基因的分子特征:对感染控制的影响。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-23 DOI: 10.1186/s12879-024-10095-8
Eunice Damilola Wilkie, Jude Oluwapelumi Alao, Toyosi Teniola Sotala, Anthonia Olufunke Oluduro

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.

背景:日托中心在儿童早期发展中起着至关重要的作用,但由于密切的身体接触、共用玩具、卫生条件差和通风不良等原因,日托中心是传染病传播的高风险环境。这些风险在尼日利亚等中低收入国家尤为严重,因为这些国家用于感染控制的资源可能有限。本研究旨在鉴定和描述尼日利亚伊费岛日托中心细菌分离物中的毒力基因,以评估感染风险:2017 年 11 月至 2019 年 7 月期间,从 17 个日托中心的 76 名儿童、33 名日托工作者和 124 个场所收集了 233 份样本。使用常规 PCR 和 RAPD 分析方法对细菌分离物进行分析,以检测是否存在毒力基因。记录了关键毒力基因的频率和每种细菌的感染率:结果:检测到的关键毒力基因包括克雷伯氏菌的 fimH(占革兰氏阴性分离株的 22.73%)、铜绿假单胞菌的 algD(50%)以及金黄色葡萄球菌的 icaA 和 cna(16.67%)。金黄色葡萄球菌是最常见的菌种(35%),其次是克雷伯氏菌(28%)和铜绿假单胞菌(20%):本研究强调了日托环境中存在剧毒细菌病原体,给儿童带来了严重的感染风险。为降低这些风险,必须采取强化的感染控制措施,如定期进行微生物筛查、改善手部卫生习惯和对场所进行消毒。对日托工作者进行卫生习惯和常规监测方面的培训计划也能大大减少感染传播。这些干预措施对于保障尼日利亚和全球类似环境中日托儿童的健康至关重要。
{"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}
引用次数: 0
Molecular identification and antimicrobial resistance patterns of enterobacterales in community urinary tract infections among indigenous women in Ecuador: addressing microbiological misidentification. 厄瓜多尔土著妇女社区尿路感染中肠杆菌的分子鉴定和抗菌药耐药性模式:解决微生物鉴定错误问题。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-23 DOI: 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。
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引用次数: 0
Spatial distribution and factors associated with HIV testing among adolescent girls and young women in Sierra Leone. 塞拉利昂少女和年轻妇女艾滋病毒检测的空间分布和相关因素。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-22 DOI: 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":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;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).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;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}
引用次数: 0
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BMC Infectious Diseases
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