Burden Of Co-infection Research Articles

"You find yourself in a very humiliating situation": experiences of people living with post-tuberculosis lung disease in Brazil.

Brazil remains one of the 30 countries with the highest tuberculosis (TB) and TB-HIV coinfection burden. Post-TB lung disease (PTLD) is a set of sequelae that can occur in people who have been cured of TB. To learn about the experiences of people living with PTLD (PLPTLD) and how healthcare workers (HCW) manage PTLD. An exploratory qualitative study with a purposive sample of PLPTLD and HCW from two different cities. Open-ended interviews were conducted using a semi-structured interview guide, which were recorded and transcribed. Two researchers analyzed the interviews using an inductive approach and applied a content analysis framework to define categories. Forty-six participants were interviewed, and four categories emerged: PTLD as a social disease; stigma; the fragility of access; and limitations. The categories encompassed two main aspects like PTLD in activities of daily living and emotions in everyday life, for instance, challenges with preparing meals, getting a job, barriers to set clinical appointments or getting social assistance, and stigma. This study reveals specific needs from patients and providers such as a lack of knowledge about PTLD, physical limitations, and stigmatization due to PTLD. It is crucial to address these issues in public health policies.

Global, regional, and national burden of HIV and tuberculosis and predictions by Bayesian age-period-cohort analysis: a systematic analysis for the global burden of disease study 2021

ObjectiveTo assess sex, age, regional differences, and the changing trend in human immunodeficiency virus and tuberculosis (HIV-TB) in different regions from 1990 to 2021, and project future trends.MethodsGlobal Burden of Disease Study 2021 data were analyzed to assess HIV-TB incidence, death, prevalence, and DALY rates from 1990 to 2021, including different types of TB co-infections (drug-susceptible, multidrug-resistant, and extensively drug-resistant). Bayesian age-period-cohort models were used to forecast age-standardized DALY rates through 2035.ResultsIn 2021, there were approximately 1.76 million HIV-TB infections and 200,895 deaths globally. The highest burden of HIV-DS-TB and HIV-MDR-TB was found in Southern Sub-Saharan Africa, while HIV-XDR-TB was most prevalent in Eastern Europe. The co-infection burden was highest among individuals aged 30–49. Key risk factors were unsafe sex, drug use, and intimate partner violence, with regional variations. The global burden of HIV-TB remains high, and age-standardized DALY rates are expected to increase in the coming years, especially in regions with low socio-demographic indices (SDI).ConclusionThe burden of HIV-TB co-infection correlates with the socio-demographic index (SDI): countries with a low SDI have a higher burden. Therefore, clinical diagnosis and treatment in such areas are more challenging and may warrant more attention. High death rates underscore the importance of early management.

A Mathematical Model for the Co-infection Dynamics of Pneumocystis Pneumonia and HIV/AIDS with Treatment

The control of opportunistic infections among HIV infected individuals should be one of the major public health concerns in reducing mortality rate of individuals living with HIV/AIDS. In this study a deterministic co-infection mathematical model is developed to provide a quantification of treatment at each contagious stage against Pneumocystis Pneumonia (PCP) among HIV infected individuals on ART. The goal is to minimize the co-infection burden by putting the curable PCP under control. The disease-free equilibria for the HIV/AIDS sub-model, PCP sub-model and the co-infection model are shown to be locally asymptotically stable when their associated disease threshold parameter is less than a unity. By use of suitable Lyapunov functions, the endemic equilibria corresponding to HIV/AIDS and PCP sub-models are globally asymptotically stable whenever the HIV/AIDS related basic reproduction number <I>R</I><sub>0<I>H</I></sub> and the PCP related reproduction number <I>R</I><sub>0<I>P</I></sub> are respectively greater than a unity. The sensitivity analysis results implicate that the effective contact rates are the main mechanisms fueling the proliferation of the two diseases and on the other hand treatment efforts play an important role in reducing the incidence. The model numerical results reveal that PCP carriers have a considerable contribution in the transmission dynamics of PCP. Furthermore, treatment of PCP at all contagious phases significantly reduces the burden with HIV/AIDS and PCP co-infection.

Helminthiasis and malaria co-infection among women of reproductive age in a rural setting of Kilifi County, coastal Kenya: A mixed method study.

Soil transmitted helminthiasis (STH), Schistosoma haematobium and malaria co-infection lead to increased susceptibility to other infections and poor pregnancy outcomes among women of reproductive age (WRA). This study sought to establish risk factors, burden of co-infection with STH, S. haematobium and Plasmodium sp. among WRA in Kilifi County, Kenya.A mixed method cross-sectional study was conducted on 474 WRA in 2021. Simple random sampling was used to select WRA from four villages in two purposively sampled sub-counties. Study participants were interviewed, and stool samples collected and analysed using Kato-Katz technique for STH. Urine samples were collected for examination of S. haematobium while malaria microscopic test was done using finger prick blood samples. Further, 15 focus group discussions (FGDs) were conducted with purposively selected WRA and qualitative data analyzed thematically using Nvivo software. Quantitative and qualitative methods were triangulated to comprehensively strengthen the study findings. Prevalence of S. haematobium was 22.3% (95%CI: 13.5-36.9), any STH 5.2% (95%CI: 1.9-14.3) and malaria 8.3% (95%: 3.8-18.2). Co-infections between any STH and S. haematobium was 0.8% (95%CI: 0.2-3.2) and between S. haematobium and malaria 0.8% (95%CI: 0.2-3.1). Multivariable analysis showed increased odds of any STH infections among participants in Rabai Sub-County, (aOR = 9.74; p = 0.026), businesswomen (aOR = 5.25; p<0.001), housewives (aOR = 2.78; p = 0.003), and casual laborers (aOR = 27.03; p<0.001). Qualitative analysis showed that the three parasitic diseases were common and responsible for possible causes of low birth weight, susceptibility to other infections and complications such as infertility and cancer later in life.The study demonstrated that STH, S. haematobium and malaria are still a public health problem to WRA. Some of the associated risks of infection were geographical location, socio-economic and WASH factors. Hence the need to implement integrated control efforts of the three parasitic infection.

Vaccination impact on impending HIV-COVID-19 dual epidemic with autogenous behavior modification: Hill-type functional response and premeditated optimization technique.

An HIV-COVID-19 co-infection dynamics is modeled mathematically assimilating the vaccination mechanism that incorporates endogenous modification of human practices generated by the COVID-19 prevalence, absorbing the relevance of the treatment mechanism in suppressing the co-infection burden. Envisaging a COVID-19 situation, the HIV-subsystem is analyzed by introducing COVID-19 vaccination for the HIV-infected population as a prevention, and the "vaccination influenced basic reproduction number" of HIV is derived. The mono-infection systems experience forward bifurcation that evidences the persistence of diseases above unit epidemic thresholds. Delicate simulation methodologies are employed to explore the impacts of baseline vaccination, prevalence-dependent spontaneous behavioral change that induces supplementary vaccination, and medication on the dual epidemic. Captivatingly, a paradox is revealed showing that people start to get vaccinated at an additional rate with the increased COVID-19 prevalence, which ultimately diminishes the dual epidemic load. It suggests increasing the baseline vaccination rate and the potency of propagated awareness. Co-infection treatment needs to be emphasized parallelly with single infection medication under dual epidemic situations. Further, an optimization technique is introduced to the co-infection model integrating vaccination and treatment control mechanisms, which approves the strategy combining vaccination with awareness and medication as the ideal one for epidemic and economic gain. Conclusively, it is manifested that waiting frivolously for any anticipated outbreak, depending on autogenous behavior modification generated by the increased COVID-19 prevalence, instead of elevating vaccination campaigns and the efficacy of awareness beforehand, may cause devastation to the population under future co-epidemic conditions.

Optimal control analysis of pneumonia and HIV/AIDS co-infection model

A Pneumonia and HIV/AIDS deterministic co-infection model is constructed and utilized to assess how the dynamics of Pneumonia and HIV/AIDS impact on each other. In order to summarize the analysis of Pneumonia and HIV/AIDS co-infection model, the analysis of Pneumonia and HIV/AIDS sub-models is undertaken. The basic reproduction numbers [Formula: see text] for Pneumonia sub-model, [Formula: see text] for HIV/AIDS sub-model and [Formula: see text] for Pneumonia and HIV/AIDS co-infection model are computed, the results are then fielded to establish the local and global asymptotic stabilities of the corresponding models’ equilibrium points. Sensitivity analysis is done and results reveal that Pneumonia spreading rate, HIV spreading rate and treatment rates of the infected sub-populations are the most sensitive parameters. The model is further modified to incorporate intervention schemes, namely Pneumonia prevention, screening and treatment efforts, HIV/AIDS prevention, screening and treatment efforts in the form of time-dependent controls. Numerical simulations portray that prevention and treatment of both diseases averts the biggest numbers of co-infected individuals. However, in a situation when there are scarce resources to deploy all intervention schemes, a combination of treatment for both diseases become a scheme of choice in reducing the co-infection burden.

Global prevalence, burden and trend in HIV and drug-susceptible tuberculosis co-infection from 1990 to 2019 and prediction to 2040

ObjectivesThe purpose of this study is to describe the current situation and forecast the trends of co-infection between the human immunodeficiency virus (HIV) and drug-susceptible tuberculosis (DS-TB) in different countries, across various age groups and genders. MethodsWe obtained data on the number of cases, age-standardized incidence rate, age-standardized prevalence rate, age-standardized rate of disability-adjusted life years (DALYs), and age-standardized death rate from the Global Burden of Disease (GBD) 2019 database. These data were used to describe the distribution and burden of co-infection between the human immunodeficiency virus (HIV) and DS-TB in different regions, genders, and age groups. We employed joinpoint regression analysis to analyze the temporal trends from 1990 to 2019. Additionally, an age-period-cohort model was established to forecast the future trends of co-infection up to 2040. ResultsThe prevalence and burden of co-infection varied across different age groups and genders. The territories with the higher disease burden were distributed in some Asian and African countries. In terms of temporal trends, the age-standardized incidence rate and age-standardized prevalence rate of HIV and DS-TB co-infection exhibited an overall increasing trend from 1990 to 2019, and the prediction indicated a slow downward trend from 2019 to 2040. ConclusionsThe co-infection of HIV and DS-TB posed a grave threat to public health and economic development. What’s more, there existed a significant disparity between the actual state of co-infection and the desired goals for prevention and control.

Co-infection dynamics of COVID-19 and HIV/AIDS

Although there are many results that can be used to treat and prevent Coronavirus Disease 2019 (COVID-19) and Human Immunodeficiency Virus (HIV), these diseases continue to be public health concerns and cause socioeconomic consequences. Following compromised immunity, COVID-19 is considered to be a challenge for people with HIV. People with advanced HIV are considered a vulnerable population at high risk in several case studies that discuss COVID-19 and HIV co-infection. As there is no cure for HIV and there is a chance of contracting COVID-19 again, co-infection continues to pose a problem. The purpose of this study is to investigate the impact of intervention strategies and identify the role of different parameters in risking people living with HIV to death when they get infected with COVID-19. This is achieved through the development and rigorous analysis of a mathematical model that considers a population at risk of death due to COVID-19 and HIV. The model formulation provides a detailed explanation of the transmission dynamics of COVID-19 and HIV co-infection. The solution’s invariant region, positivity, and boundedness were established. The reproduction numbers of the sub-models and the co-infection model were determined. The existence and stability of equilibria, including backward bifurcation for the COVID-19 sub-model, were examined. The epidemiological significance of backward bifurcation is that the condition {mathscr {R}}_0 less than 1 for eliminating COVID-19, though necessary, is no longer sufficient. Parametric estimation and curve fitting were performed based on data from Ethiopia. Numerical simulations were employed to support and clarify the analytical findings and to show some parameter effects on COVID-19 and HIV co-infection. Accordingly, the simulations indicated that parameters gamma _c, gamma _h, epsilon, and kappa, related to HIV patients’ exposure to other diseases and the increase in infectiousness, have a positive role in increasing the number of co-infections. On the other hand, an increase in COVID-19 vaccination (xi) shows the suppression of co-infection cases. In addition, treating co-infected individuals for COVID-19, increasing treatment rates alpha and varphi, reduces the death risk of HIV-infected individuals due to the co-infection burden. It was implied that improving vaccine delivery programs and other medical interventions have important contributions to lowering the risk of COVID-19 infection-related fatalities in HIV patients.

Burden of hepatitis B virus and syphilis co-infections and its impact on HIV treatment outcome in Ethiopia: nationwide community-based study

Background Hepatitis B virus (HBV) and syphilis have been the most common co-infections that hinder treatment outcomes and increase early mortality among people living with human immunodeficiency virus (PLHIV). In this study, we aimed to determine the burden of HBV and syphilis co-infections and its impact on treatment outcomes among PLHIV in Ethiopia. Methods We used data from the Ethiopian Population-based HIV Impact Assessment (EPHIA), which was a household-based national survey in 2017/2018. Human immunodeficiency virus (HIV) testing was done among 19,136 participants using the national testing algorithm and 662 participants (3.50%) were HIV positives who were further tested for viral hepatitis and syphilis co-infections using HBV surface antigen and Chembio DPP syphilis assay, respectively. Viral load, CD4 count and high-sensitivity C-reactive protein (hsCRP) were done to measure HIV treatment outcomes. Descriptive statistics were used to determine the burden of co-infections and a logistic regression model to evaluate the determinants of co-infections using STATA V17.0. Results Overall prevalence of HBV and syphilis co-infection was 5.5% and 2.2%, respectively. HBV and syphilis (double co-infection) was 5.9%. The highest prevalence of HBV co-infection was observed among 10–19 years age group (12.9%) and male participants (7.44%) while the highest syphilis co-infection was among people aged ≥50 years (3.5%) followed by age groups 40–49 (3.3%) and 10–19 years (3.2%). Syphilis co-infection was higher among males (5.2%) compared to females (1.1%). After adjusted regression analysis, HBV co-infected PLHIV had higher odds of virologic failure (AOR (95% confidence interval (CI)) = 6.3 (4.2–14.3)), immunosuppression (CD4 count < 500 cells/mm3) (AOR (95%CI) = 2.1(1.3–4.9)) and inflammation (hsCRP >10 mg/dL) (AOR (95%CI) = 9.2(4.3–14.6)). Immunosuppression was also significantly higher among syphilis co-infected PLHIV (AOR (95%CI) = 3.4 (1.3–5.2)). Conclusions Burden of HBV and syphilis co-infections is high particularly among male and adolescent PLHIV and these co-infections hinder virologic and immunologic outcome in Ethiopia. Hence, the program shall enhance HBV and syphilis testing and treatment.

ESKAPE and Beyond: The Burden of Coinfections in the COVID-19 Pandemic.

The ESKAPE group constitute a threat to public health, since these microorganisms are associated with severe infections in hospitals and have a direct relationship with high mortality rates. The presence of these bacteria in hospitals had a direct impact on the incidence of healthcare-associated coinfections in the SARS-CoV-2 pandemic. In recent years, these pathogens have shown resistance to multiple antibiotic families. The presence of high-risk clones within this group of bacteria contributes to the spread of resistance mechanisms worldwide. In the pandemic, these pathogens were implicated in coinfections in severely ill COVID-19 patients. The aim of this review is to describe the main microorganisms of the ESKAPE group involved in coinfections in COVID-19 patients, addressing mainly antimicrobial resistance mechanisms, epidemiology, and high-risk clones.

High Burden of Co-Infection with Multiple Enteric Pathogens in Children Suffering with Diarrhoea from Rural and Peri-Urban Communities in South Africa.

Infectious diarrhoea contributes to high morbidity and mortality in young children from sub-Saharan Africa. The aim of this study was to assess the prevalence of single and multiple diarrhoeal-causing pathogen combinations in children suffering from diarrhoea from rural and peri-urban communities in South Africa. A total of 275 diarrhoea stool specimens were collected between 2014 and 2016 from Hospitals and Primary Health Care clinics. The BioFire® FilmArray® Gastrointestinal panel was used to simultaneously detect 22 diarrhoea pathogens (viruses, bacteria, parasites) known to cause diarrhoea. A total of 82% (226/275) enteric pathogens were detected in the stool specimens. The two most detected bacterial, viral and parasitic pathogens each included: EAEC (42%), EPEC (32%), Adenovirus F40/41 (19%), Norovirus (15%), Giardia (8%) and Cryptosporidium (6%), respectively. Single enteric pathogen infections were recorded in 24% (65/275) specimens with EAEC, and Norovirus was found in 26% (17/65) and 14% (9/65) of the specimens, respectively. Multiple enteric pathogen combinations were recorded in 59% (161/275) of the stool specimens with 53% (85/161) containing two pathogens, 22% (35/161) containing three pathogens and 25% (41/161) containing four or more pathogens. The results from this study demonstrated the complex nature of pathogen co-infections in diarrhoeal episodes which could have an impact on treatment effectiveness.

Risk factors and effect on mortality of superinfections in a newly established COVID-19 respiratory sub-intensive care unit at University Hospital in Rome

BackgroundLittle is known on the burden of co-infections and superinfections in a specific setting such as the respiratory COVID-19 sub-intensive care unit. This study aims to (i) assess the prevalence of concurrent and superinfections in a respiratory sub-intensive care unit, (ii) evaluate the risk factors for superinfections development and (iii) assess the impact of superinfections on in-hospital mortality.MethodsSingle-center retrospective analysis of prospectively collected data including COVID-19 patients hospitalized in a newly established respiratory sub-intensive care unit managed by pneumologists which has been set up from September 2020 at a large (1200 beds) University Hospital in Rome. Inclusion criteria were: (i) COVID-19 respiratory failure and/or ARDS; (ii) hospitalization in respiratory sub-intensive care unit and (iii) age > 18 years. Survival was analyzed by Kaplan–Meier curves and the statistical significance of the differences between the two groups was assessed using the log-rank test. Multivariable logistic regression and Cox regression model were performed to tease out the independent predictors for superinfections’ development and for mortality, respectively.ResultsA total of 201 patients were included. The majority (106, 52%) presented severe COVID-19. Co-infections were 4 (1.9%), whereas 46 patients (22%) developed superinfections, mostly primary bloodstream infections and pneumonia. In 40.6% of cases, multi-drug resistant pathogens were detected, with carbapenem-resistant Acinetobacter baumannii (CR-Ab) isolated in 47%. Overall mortality rate was 30%. Prior (30-d) infection and exposure to antibiotic therapy were independent risk factors for superinfection development whereas the development of superinfections was an independent risk factors for in-hospital mortality. CR-Ab resulted independently associated with 14-d mortality.ConclusionIn a COVID-19 respiratory sub-intensive care unit, superinfections were common and represented an independent predictor of mortality. CR-Ab infections occurred in almost half of patients and were associated with high mortality. Infection control rules and antimicrobial stewardship are crucial in this specific setting to limit the spread of multi-drug resistant organisms.

An optimal control model for COVID-19, zika, dengue, and chikungunya co-dynamics with reinfection.

The co‐circulation of different emerging viral diseases is a big challenge from an epidemiological point of view. The similarity of symptoms, cases of virus co‐infection, and cross‐reaction can mislead in the diagnosis of the disease. In this article, a new mathematical model for COVID‐19, zika, chikungunya, and dengue co‐dynamics is developed and studied to assess the impact of COVID‐19 on zika, dengue, and chikungunya dynamics and vice‐versa. The local and global stability analyses are carried out. The model is shown to undergo a backward bifurcation under a certain condition. Global sensitivity analysis is also performed on the parameters of the model to determine the most dominant parameters. If the zika‐related reproduction number ℛ0Z is used as the response function, then important parameters are: the effective contact rate for vector‐to‐human transmission of zika (β2h, which is positively correlated), the human natural death rate (ϑh, positively correlated), and the vector recruitment rate (Ψv, also positively correlated). In addition, using the class of individuals co‐infected with COVID‐19 and zika (ℐCZh) as response function, the most dominant parameters are: the effective contact rate for COVID‐19 transmission (β1, positively correlated), the effective contact rate for vector‐to‐human transmission of zika (β2h, positively correlated). To control the co‐circulation of all the diseases adequately under an endemic setting, time dependent controls in the form of COVID‐19, zika, dengue, and chikungunya preventions are incorporated into the model and analyzed using the Pontryagin's principle. The model is fitted to real COVID‐19, zika, dengue, and chikungunya datasets for Espirito Santo (a city with the co‐circulation of all the diseases), in Brazil and projections made for the cumulative cases of each of the diseases. Through simulations, it is shown that COVID‐19 prevention could greatly reduce the burden of co‐infections with zika, dengue, and chikungunya. The negative impact of the COVID‐19 pandemic on the control of the arbovirus diseases is also highlighted. Furthermore, it is observed that prevention controls for zika, dengue, and chikungunya can significantly reduce the burden of co‐infections with COVID‐19.

Burden of sexually transmitted infections from acute HIV infection among women in South Africa: Evidence from a prospective cohort study

PurposeHIV and other sexually transmitted infections (STIs) often co-occur. However, less evidence exists on the long-term STI dynamics among persons living with HIV in sub-Saharan Africa to inform interventions. We investigated the incidence, prevalence and factors associated with STIs, starting from acute HIV infection in a cohort of South African women. MethodsThe CAPRISA002 study enrolled women with acute HIV infection and performed STI testing and treatment 1-2 times annually from 2004-2020. We estimated STI incidence, re-infection, and prevalence trends before and after antiretroviral treatment (ART). We fitted Cox regression models to identify factors associated with STIs. ResultsWe followed up 235 women (median age = 25 years, IQR 22-29) for 7.5 years (IQR 5.7-10.8). New STI and re-infection cases per 100 person-years (PYs) were 5.1 and 9.5 for Neisseria gonorrhoeae (NG), 7.4 and 14.7 for Chlamydia trachomatis (CT), 8.0 and 26.6 for Trichomonas vaginalis (TV), 7.7 and 16.7 for Mycoplasma genitalium (MG) and 25.2 and 37.3 for any STI. STI incidence, was associated with HIV log10 viral load (AHR = 1.24, 95% CI 1.06-1.44), active syphilis (AHR = 16.55, 95% CI 7.49-36.55), a positive HSV-2 PCR (AHR = 1.54, 95% CI 1.01-2.35), bacterial vaginosis (AHR = 1.48, 95% CI 1.01-2.18), recent regular sexual partners at enrolment (one vs none: AHR = 2.62, 95% CI 1.41-4.87; two plus vs none: AHR = 3.68, 95% CI 1.79-7.59) and age (5-year fold: AHR = 0.80, 95% CI 0.70-0.92). ConclusionThe persistent STI/HIV co-infection burden among South African women highlights that early HIV diagnosis and ART initiation needs to be combined with better STI care for women and their partners to prevent HIV and STI transmission.

Prevalence of TB-HIV coinfection burden in a tertiary care center from 2018 to 2020, A retrospective four-year study

HIV is the most important cause of death amoung tuberculosis patient. About 25 % of all causes of death. HIV promote progression of latent TB infection, which become difficult to diagnose initially later on comorbidity and mortality leads to late diagnosis and death of patients. The current study was from Jan 2018 to Dec 2021, and a retrospective study design was conducted. Many TB patients were found to be hidden HIV infection so active screening is needed, for active case finding. Proper recording should be design, data including phone number should be collected for proper follow-up.

Backward bifurcation and optimal control in a co-infection model for SARS-CoV-2 and ZIKV

In co-infection models for two diseases, it is mostly claimed that, the dynamical behavior of the sub-models usually predict or drive the behavior of the complete models. However, under a certain assumption such as, allowing incident co-infection with both diseases, we have a different observation. In this paper, a new mathematical model for SARS-CoV-2 and Zika co-dynamics is presented which incorporates incident co-infection by susceptible individuals. It is worth mentioning that the assumption is missing in many existing co-infection models. We shall discuss the impact of this assumption on the dynamics of a co-infection model. The model also captures sexual transmission of Zika virus. The positivity and boundedness of solution of the proposed model are studied, in addition to the local asymptotic stability analysis. The model is shown to exhibit backward bifurcation caused by the disease-induced death rates and parameters associated with susceptibility to a second infection by those singly infected. Using Lyapunov functions, the disease free and endemic equilibria are shown to be globally asymptotically stable for R01, respectively. To manage the co-circulation of both infections effectively, under an endemic setting, time dependent controls in the form of SARS-CoV-2, Zika and co-infection prevention strategies are incorporated into the model. The simulations show that SARS-CoV-2 prevention could greatly reduce the burden of co-infections with Zika. Furthermore, it is also shown that prevention controls for Zika can significantly decrease the burden of co-infections with SARS-CoV-2.

Increased Mortality in HIV Infected Individuals with Tuberculosis: A Retrospective Cohort Study, Addis Ababa, Ethiopia.

BackgroundTuberculosis is one of the commonest coinfections and leading causes of death among people living with HIV in resource-limited countries. There is limited evidence on the short- and long-term mortality rate in people receiving antiretroviral therapy and coinfected by tuberculosis in sub-Saharan Africa, where the burden of coinfection is highest.PurposeThis study aimed to compare mortality among HIV positives with and without tuberculosis coinfection receiving antiretroviral therapy in Addis Ababa, Ethiopia.MethodsHIV positives’ medical records were reviewed between 2011 to 2018 and identified 7038 HIV-positive adults enrolled for antiretroviral therapy in Addis Ababa. The outcome of interest for this study was death. A parametric Gompertz regression model was applied to compare mortality between HIV with tuberculosis coinfection versus HIV without tuberculosis.ResultsOverall, 1123 (15.96%, 95% CI: 15.11–16.83%) individuals with HIV had tuberculosis coinfection at antiretroviral therapy enrollment. After adjusting for age, sex, education, marital status, cotrimoxazole therapy, body mass index, baseline CD4 cell count, and year in ART enrollment, HIV positives with tuberculosis coinfection had more than twice a higher overall mortality risk than HIV positives without tuberculosis coinfection (AHR: 2.53; 95% CI 1.63–3.91, p < 0.001).ConclusionThis large retrospective cohort study reveals significantly higher mortality in HIV and tuberculosis coinfected group. This suggests the need for enhanced utility of integrated HIV and tuberculosis health services in sub-Saharan Africa where tuberculosis prevalence is highest.

Process evaluation for the adaptation, testing and dissemination of a mobile health platform to support people with HIV and tuberculosis in Irkutsk, Siberia

ObjectivesWe developed and tested a mobile health-based programme to enhance integration of HIV and tuberculosis (TB) care and to promote a patient-centred approach in a region of high coinfection burden....

Occurrence Rate of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) Co - infection among Expectant Mothers Attending Antenatal Clinic in Rivers State University Teaching Hospital

The global burden of co-infection with human immunodeficiency virus (HIV), hepatitis B and C virus (HBV and HCV) has a negative impact in Sub-Saharan Africa.When HIV, HBV and HCV co-exist, they become life threatening and with high fatality rate particularly in gestation in which transmission occurs vertically, causing fetal and neonatal hepatitis. The study aimed at examining the occurrence rate of Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV) and Hepatitis C Virus (HCV) co - infection among expectant mothers attending antenatal clinic in Rivers State University Teaching Hospital (RSUTH). The study population comprised of one hundred and fifty (150) pregnant women. Venous blood was used in the study and screened for hepatitis B surface antigen (HBsAg), anti-HCV, and anti-HIV antibodies using commercially available immunoassay test kits. The prevalence of HCV, HIV and HBsAg among the pregnant subjects in relation to age group 21-30 and 31-40 in the study revealed a seropositive percentage of 0.7% and 1.3%. The other groups, however, showed no positive result among the three viruses. Furthermore, 0.7% of the pregnant women in their first, second and third trimester were co-infected with HCV and HBsAg while 1.3% out of 36.7% and 0.7% out of 61.3% of pregnant women within the age groups 21-30 and 31-40 respectively were seropositive for HIV. In relation to gestational age, it was seen from the study that 0.7% of the pregnant women in their first, second and third trimester were seropositive for HCV and HBsAg respectively, while 2% of the HIV seropositive pregnant women were in their first trimester. The overall seroprevalence of HCV, HIV and HBsAg as revealed in the study showed that infection was found to be 2% respectively among the pregnant women. The reduced prevalence of hepatitis B (HBsAg), hepatitis C (HCV) and human immunodeficiency virus (HIV) infection observed in the study among pregnant women attending antenatal care in the Rivers State University Teaching Hospital may be attributed to the increase in the awareness amongst the general populace in Port Harcourt especially couples about the consequences of sexually transmitted diseases such as HIV, Hepatitis B as well as Hepatitis C. In other words, there is reduction in seroprevalence of HBsAg, HCV and HIV which is premised on the efficacy of sensitization particularly on HBV vaccination and preventive protocols for HIV.

Schistosomiasis, soil transmitted helminthiasis, and malaria co-infections among women of reproductive age in rural communities of Kwale County, coastal Kenya

BackgroundSchistosoma haematobium, soil transmitted helminthes (STH), and malaria lead to a double burden in pregnancy that eventually leads to poor immunity, increased susceptibility to other infections, and poor pregnancy outcomes. Many studies have been carried out on pre-school and school aged children but very little has been done among the at risk adult population including women of reproductive age (WRA). Our current study sought to establish the risk factors and burden of co-infection with S. haematobium, STH, and Plasmodium sp. among WRA in Kwale County, Coastal Kenya.MethodsA total of 534 WRA between the ages of 15–50 were enrolled in this cross-sectional study from four villages; Bilashaka and Mwaluphamba in Matuga sub-County, and Mwachinga and Dumbule in Kinango sub-County. Socio-demographic information was collected using a pre-tested standardized questionnaire. Parasitological examination was done using urine filtration method for Schistosoma haematobium, Kato Katz for STH (Ascaris lumbricoides, Hookworm, Trichuris trichiura), and standard slide microscopy for Plasmodium sp. Statistical analyses were carried out using STATA version 15.1.ResultsThe overall prevalence of S. haematobium was 3.8% (95% CI: 2.6–5.4) while that for malaria was 4.9% (95% CI: 2.0–11.7). The prevalence of STH was 5.6% (95% CI: 2.8–11.3) with overall prevalence of 5.3% (95% CI: 2.5–10.9) for hookworm and 0.6% (95% CI: 0.2–1.9) for T. trichiura. The occurrence of co-infection was low and was recorded between S. haematobium and P. falciparum (0.6%), followed by S. haematobium and STH (0.4%).Among pregnant women, 2.6% had co-infection with S. haematobium and P. falciparum. Only 1.3% had co-infection with S. haematobium and hookworm or T. trichiura. Among non-pregnant women, co-infection with S. haematobium and P. falciparum was 0.2%. Similarly, co-infection with S. haematobium and hookworm or T. trichiura was 0.2%.Bed net ownership and usage among pregnant women was 87.8 and 96.6%, respectively. 66.3% of the women reported using improved water sources for drinking while 78.1% reported using improved sanitation facilities.ConclusionThe use of improved WASH activities might have contributed to the low prevalence of STHs and S. haematobium infections. Further, bed net ownership and usage might have resulted in the low prevalence of Plasmodium sp. infections observed.