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MOLECULAR DETECTION PROTOCOL OF SARS-COV-2 THROUGH SELF-COLLECTED SALIVA SPECIMENS VERSUS NASOPHARYNGEAL SWABS.

Several reports have shown that saliva specimen is an excellent alternative biofluid sample for SARS-CoV-2 detection. We conducted this study, in order to assess the sensitivity and specificity of using saliva self-collected by adult and pediatric patients, as a biological sample for RT-PCR diagnosis. The present study was carried out to assess the sensitivity and specificity of using saliva self-collected from adult and pediatric patients, as a biological sample for RT-qPCR diagnosis. In this study, 50 symptomatic patients and 40 asymptomatic subjects (adult and pediatric) were enrolled between September 2020 and November 2020 at the Department of Infectious Diseases, Bejaia University Hospital (CHU), and tested simultaneously for the sensitivity and specificity of the SARS-CoV-2 viral genome by RT-PCR on both nasopharyngeal swabs NP swab and saliva samples. Our RT-qPCR results revealed that saliva samples showed the highest sensitivity (95% CI [27.67, 29.82]) followed by a nasopharyngeal swab for symptomatic (95% CI [29.64, 31.49]) as well as for asymptomatic adult patients. Moreover, the saliva of symptomatic and asymptomatic patients was monitored, and the presence of viral RNA was detected in >95% of the asymptomatic patients as well as the symptomatic patients. Surprisingly, the Ct values of ORF1ab and N genes are highly lower in nasopharyngeal swabs compared to saliva. Indeed, the mean difference note that for the ORF1ab gene and N gene, the mean of difference in ΔCt value were respectively 3.683 and 3.578. Together, including symptomatic and asymptomatic subjects, the overall agreement between the saliva sample and the nasopharyngeal is about 84%. The sensitivity of saliva samples remains acceptable; it may still be a viable option in locations where laboratory facilities are lacking for diagnostic purposes in the early phase of the disease.

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MODIFIABLE AND NON-MODIFIABLE RISK FACTORS FOR TUBERCULOSIS AMONG ADULTS IN INDONESIA: A SYSTEMATIC REVIEW AND META-ANALYSIS.

Controlling tuberculosis (TB) determinant factors in Indonesia is one way to control TB in the community. A review is needed to explore risk factors for TB in Indonesia as the key strategies for accelerating the TB preventive program.The purpose of this review was to determine modifiable and non-modifiable risk factors for TB among adults in Indonesia. A meta-analysis was undertaken to review current studies related to modifiable and non-modifiable risk factors for TB among adults in Indonesia. A search of PubMed, ProQuest, and Google Scholar for related articles published (January 2000 until December 2023). The Pooled Odds Ratio (POR) from the acquired data were calculated with a 95% CI. The fixed and random effects analysis was performed. The results were presented as forest plots, and Begg's test and Egger's test were used to examine study bias. Review Manager (RevMan) 5.4 and Stata 14.2 were used to process and analyze all of the data. This study results revealed the POR of non-modifiable risk factor (family history of TB) for TB among adults in Indonesia was 6.08 (95% CI 2.99-12.34). Based on modifiable risk factors, it is known that household contact have the highest POR (6.01, 2.57-14.04), followed by malnutrition (5.86, 2.50-13.69), inappropriate ventilation (5.57, 1.74-17.86), diabetes mellitus (4.92, 3.04-7.96), smoking behavior (3.24, 2.22-4.72), and low-income level (2.34, 1.42-3.87). Based on significant factors that are related to TB incidence, the results of this review may be valuable to the government in identifying the optimal strategy for TB prevention among adults.

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EFFECT OF PENICILLIUM SPECIES ON THE ANTIBIOTIC RESISTANCE PROFILE OF ALCALIGENES FAECALIS.

Infectious diseases due to antibiotic resistant pathogens are a global public health problem. This study aimed at determining the potential effect of bacterial-fungal interaction on the antibiotic susceptibility profile of Alcaligenes faecalis. Alcaligenes faecalis was isolated from water samples. The isolate was identified using the conventional biochemical tests and the 16S rRNA molecular sequencing technique. Additionally, Penicillium species was isolated and identified based on colony morphological characteristics and microscopic features. Standardized isolates were co-cultured in broth medium. Antibiotic susceptibility evaluation of the Alcaligenes faecalis from the co-culture and the original Alcaligenes faecalis was carried out using the Kirby bauer disk diffusion method. The antibiotic susceptibility profile of Alcaligenes faecalis before and after co-culture remained largely unchanged except in the case of chloramphenicol, where the isolate showed reduced susceptibility. Molecular analysis of resistance gene revealed the absence of tested gene encoding antibiotic resistance, including the streptomycin resistance (str) genes (stra and strb) and the erythromycin resistance methylase (erm) gene. The result of this study showed that there is a minimal influence of Penicillium cultures on the susceptibility of A. faecalis. Further research involving a wide spectrum of microorganisms and their interactions should be conducted to acquire a thorough understanding of the influence of microbial interactions on antibiotic susceptibility profiles in order to pave way for novel strategies to combat antimicrobial resistance.

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KNOWLEDGE AND PREDICTORS OF IMPLEMENTATION OF STANDARD PRECAUTIONS FOR INFECTION PREVENTION AND CONTROL AMONG HEALTH CARE PRACTITIONERS.

Infection prevention and control involve health care practitioners, who are saddled with the duty of ensuring implementation of standard preventive measures to prevent healthcare associated infections. To assess the knowledge and predictors of implementation of standard precautions for infection prevention and control among health care practitioners (HCPs). A questionnaire-based cross-sectional design was employed in assessing HCPs in Uganda in from April - October 2023. Data were analyzed using descriptive, Pearsons' correlation, linear and binary logistic regression with the aid of SPSS Version 22. Among the 222 healthcare practitioners assessed, 127 (57.2%) and 115 (51.8 %) had good knowledge and practice towards implementation of standard infection prevention and control precautions respectively. Chi square analysis indicated that age of healthcare practitioner (p=0.02; CI: 0.018 - 0.23), hospital unit of practice (p=0.003; CI: 0.002 - 0.004) and the type of facility where the health care practitioner works is significantly associated with their knowledge, while profession of the healthcare practitioner (p=0.002; CI: 0.001-0.003) and hospital unit of practice (p=0.002; CI: 0.001-0.003) were associated with implementation of the standard infection prevention and control precautions. Linear regression revealed knowledge is a significant predictor of good practice towards implementation of preventive measures (OR = 0.19; CI 0.102 - 0.272; p < 0.001). Healthcare practitioners had poor knowledge and practice towards infection prevention. Thus, emphasizing continuous education and training for all healthcare professionals about infection prevention and control interventions as well as strict adherence to proper infection prevention and control practices.

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CHANGING PATTERN OF NON ALBICANS CANDIDEMIA: OCCURENCE AND SUSCEPTIBILITY PROFILE IN AN INDONESIAN SECONDARY TEACHING HOSPITAL.

In recent years, bloodstream infections due to non-albicans Candida species have been reported significantly among hospitalized patients, mainly among immunocompromised patients with high morbidity and mortality rates. A better understanding and awareness regarding the shift of Candida albicans flora to non-albicans Candida species is essentially important to improve treatment outcomes. In this study, we evaluated the distribution of non-albicans Candida species and their susceptibility to various antifungals among candidemia patients. A total of 123 confirmed Candida blood culture episodes from January 2011 to June 2022 were analyzed by retrospective laboratory-based observation. Candida species identity and the in vitro activity against antifungal drugs determined by guidelines from the Clinical and Laboratory Standard Institute (CLSI). Most candidemia were caused by non-albicans Candida species, including Candida parapsilosis (37.4%), Candida tropicalis (17.1%), Candida glabrata (13.0%), Candida guilliermondii (3.2%) and others (4.8%). Meanwhile Candida albicans was found in 24.4% of cases. Among the patients, 57.7% were males and 68.3% were admitted to critical care with an age range of ≤ 28 days and 90 years. The pattern of in vitro susceptibility showed that 91.9% of the Candida strains were susceptible to amphotericin B, 89.3% to flucytosine, 97.3% to fluconazole, 98.3% to voriconazole, and 97.9% to echinocandins. Antifungal drug resistance was rare in our observation. The wide range of antifungal activities encourages management to carry out epidemiological surveillance in order to follow the dynamics of candidemia and influence the choice of therapeutic management for at-risk patients.

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GLO GERM AND COVID-19: ILLUMINATING HYGIENE AND PROMOTING TRANSMISSION AWARENESS.

Maintaining effective surface hygiene and preventing contamination is of paramount importance. Our study introduces Glo Germ, a versatile product available in various forms, which possesses the unique ability to reveal hidden truths under ultraviolet light, enhance understanding of hygiene, and spread awareness of COVID-19 transmission and preventive measures. A comprehensive study was conducted to assess different surface cleaning techniques' effectiveness. Glo Germ, containing a fluorescent dye activated by ultraviolet light, was used to visualize germ spread and compare disinfectant cleaners' efficacy. The study encompassed diverse surfaces and materials, aiming to identify optimal cleaning techniques for each context. Furthermore, a small illustrative study was conducted during a COVID-19 awareness presentation involving students. Glo Germ was applied to hands, revealing its subsequent spread to faces and surfaces. This visual experiment effectively emphasized hand hygiene and mask-wearing importance. Results indicated that while water alone achieved satisfactory cleaning results, using detergent and the appropriate cleaning tools further improved efficacy. Notably, adhering to consistent patterns and applying pressure during cleaning proved essential. The student demonstration showed how contaminants spread quickly, highlighting hand hygiene's significance and the potential extent of contamination through sneezing. Glo Germ inclusion in these experiments highlights its potential in educating about surface cleaning and microbial transmission, offering an interactive and engaging approach to promoting personal hygiene and fostering illness prevention awareness.

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SOCIAL MEDIA USE, KNOWLEDGE, AND ATTITUDES TOWARDS PEOPLE LIVING WITH HIV/AIDS AMONG HIGH SCHOOL STUDENTS IN AN INDONESIAN TOURISM REGION.

Social media has become an integral part of adolescent life in Indonesia, particularly in tourism regions. It serves as a platform for disseminating information, including about HIV/AIDS. However, it also has the potential to spread misinformation and harmful content, which can increase stigma and discrimination against people living with HIV/AIDS (PLWHA). The aim of this study was to determine the relationships between social media use, knowledge, and attitudes towards PLWHA among high school students in an Indonesian tourism region. This research utilized a school-based cross-sectional study design in several high schools located in Bukittinggi City, a renowned tourist destination in West Sumatra Province, Indonesia. The study sample comprised high school students aged 15-18 years, with a total of 118 respondents selected. The sample was chosen using a multistage stratified clustered sampling method. The variables measured in this study included social media usage, HIV/AIDS knowledge, and attitudes towards PLWHA. To test the research hypotheses, data analysis was conducted using structural equation modeling techniques. P<0.05 is considered significant. There were relationships between social media use and knowledge of HIV/AIDS (β=0.614, t-value=9.327, p-value=<0.001), knowledge of HIV/AIDS and attitudes towards PLWHA (β=0.601, t-value=8.344, p-value=0.014) and social media use and attitudes towards PLWHA (β=0.218, t-value=2.469, p-value=<0.001). This study confirmed significant relationships were found between social media use, knowledge, and attitudes towards PLWHA. The results highlight the necessity for comprehensive interventions and ongoing support to promote the well-being of students amid the dynamic changes in global tourism.

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CLINICAL PROFILES AND OUTCOMES OF ADMISSIONS FOLLOWING COVID-19 ADMISSIONS DURING THREE WAVES OF THE PANDEMIC: EXPERIENCE OF A TERTIARY HOSPITAL IN THE EASTERN CAPE PROVINCE OF SOUTH AFRICA.

South Africa was the country worst affected by the Covid-19 pandemic in Africa. There is a paucity of data on the clinical characteristics and mortality of Covid-19 from the Eastern Cape province of South Africa. We report on the demographic and clinical characteristics as well as the mortality of patients admitted to the Covid-19 ward of Nelson Mandela Academic Hospital (NMAH), Mthatha, during three waves of the Covid-19 pandemic in South Africa. We conducted a single centre retrospective observational study of patients admitted for Covid-19 in a tertiary hospital in the rural Eastern Cape of South Africa. Data were collected from patient files, electronic databases and the National Health Laboratory Services (NHLS) database. The outcomes were duration of admission and in-hospital mortality. There were 371 patients admitted across all three waves with a mean age of 52.2 ± 16.3 years. The proportion of females across the three waves is 61.2%. The commonly associated comorbidities, irrespective of the wave, were hypertension, diabetes and HIV infection. The median duration of admission was six days, with an overall mortality of 31%. The mortality for first, second and third wave were 29.3%, 31.5% and 37.9% respectively. Admissions for Covid-19 were predominantly in females and middle-aged. One third of the admitted patients died. Diabetes, hypertension and HIV infection were the most commonly associated comorbidities.

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