Central Public Health Research Articles

Significance of miR-122 -and miR- 150 in the pathogenicity of hepatitis B infection

Background: HBV, a contagious infection, causes chronic hepatitis, cirrhosis, and hepatocellular cancer in many people. The WHO estimates that 2 billion people are exposed to HBV annually, depending on when. The Hepadnaviridae family virus has an unfinished 3.2-kilobase double-stranded DNA molecule. Increased ALT, AST, and HBsAg positive or HBV DNA viral load are used to identify the illness. Despite global immunization campaigns, nations with low vaccination coverage and no diagnosis remain concerned. The worldwide HBV burden remains high. MicroRNAs (miRNAs) bind to mRNAs after transcription to govern gene expression, hepatitis B virus replication, and extracellular matrix development.Methods: Sixty six Iraqi HBV patients were involved in a case-sectional control study. From September 2021 to February 2022, blood samples were taken from Al-Yarmook Teaching Hospital and Central Public Health Laboratory in Baghdad. ELISA verified HBV markers, HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb in all samples, and real-time PCR estimated viral load from DNA. The research found that miR122 and miR150 gene expressions affect HBV fibrosis severity.Results: The gene expression of miR-122 and miR-150 was found using RT-PCR after normalization with Glyceraldehyde-3-phosphate dehydrogenase (GAPDH), a common housekeeping gene. The analysis of variance found substantial differences between patients and controls. The research found a considerable downregulation of miRNA-122 and miRNA-150 in HBV-infected individuals.Conclusions: Depending on HBV severity, miRNA levels may vary. HBV patients, especially those with fibrosis and chronic HBV, have reduced miR122 and miR150. MiR-122 and miR-150 may be interesting HBV diagnostic, fibrosis progression, and therapeutic targets.Keywords: Hepatitis B virus; MicroRNAs (miRNAs); RT-PCR; Primers; Gene expression; Liver disease

Laboratory readiness and genomic surveillance of Covid-19 in the capital of Brazil.

This study aims to analyze the diagnostic readiness to Covid-19 and the genomic surveillance of SARS-CoV-2 in Brasília, the capital of Brazil. This is a retrospective, cross-sectional study, with data from: cases/deaths-Ministry of Health; RT-PCR analyses Brasília Central Public Health Laboratory (LACEN); genomics-Global Initiative on Sharing All Influenza Data (GISAID). It was found that in March 2021, with the Gamma variant was predominant, RT-PCR diagnostic tests administered by LACEN reached their peak, followed by a reduction, possibly due to the start of vaccination. New peaks were observed in September 2021 and January 2022. The average time for releasing RT-PCR results was reduced from eight days (July 2020), to around eight hours in 2023. The participation of private laboratories was evident in sequencing the SARS-CoV-2 variants of concern in Brasília (n = 1,897). LACEN sequenced 50% of the samples received (571). A decrease in the incidence of cases and deaths due to Covid-19 was noted in the years 2022 to 2023, following the national trend. LACEN maintained RT-PCR diagnostic tests administered satisfactorily throughout the period. Regarding the genomic surveillance of SARS-CoV-2, the vast majority of samples were sequenced by private laboratories when compared to the public laboratory.

Causal effects of sedentary breaks on affective and cognitive parameters in daily life: a within-person encouragement design

Understanding the complex relationship between sedentary breaks, affective well-being and cognition in daily life is critical as modern lifestyles are increasingly characterized by sedentary behavior. Consequently, the World Health Organization, with its slogan “every move counts”, emphasizes a central public health goal: reducing daily time spent in sedentary behavior. Previous studies have provided evidence that short sedentary breaks are feasible to integrate into daily life and can improve affective and cognitive parameters. However, observational studies do not allow for causal interpretation. To overcome this limitation, we conducted the first empirical study that integrated the within-person encouragement approach to test the causal effects of short 3-min sedentary breaks on affective and cognitive parameters in daily life. The results suggest that brief sedentary breaks may have a beneficial impact on valence and energetic arousal. Moreover, our methodological approach powerfully demonstrated the possibility of moving towards causal effects in everyday life.

Dynamics of COVID-19 risk perception and predictors in South Korea: a two-year longitudinal study from the pandemic’s beginning (2020–2021)

Understanding the public’s cognitive and affective perceptions of risk, along with their predictors and the role of trust in various stakeholders, is essential for effective risk management. Cognitive and affective dimensions of perceived risk play a critical role in engaging the public during health emergencies, particularly in the early stages. This study investigates the evolving dynamics of COVID-19 risk perception, identifies its predictors, and examines how these factors changed over time from the beginning of the pandemic. We conducted a longitudinal repeated cross-sectional survey in South Korea, over the initial two years of the pandemic (2020–2021) from over 9,000 participants, beginning four weeks after the first confirmed case. Data were analyzed using one-way ANOVA and multiple linear regression, with time included as an interaction term. Results showed significant fluctuations in both cognitive and affective risk perceptions throughout the study period. Specifically, perceived susceptibility to infection was associated with respondents’ locality, policy stringency, and daily case counts, while perceived severity was significantly related to age and subjective health. Affective risk perception was predicted by gender and socioeconomic status. Notably, a contradictory association emerged between trust in the central government and public health authorities and perceived risk; while trust in the central government correlated with lower perceived risk, trust in public health authorities was linked to higher perceived risk. Additionally, the influence of trust in the central government on perceived risk diminished over time. These findings underscore the dynamic nature of risk perception and highlight the importance of fostering public trust in risk management strategies. Moreover, the study highlights the importance of communication strategies that respond to changing risk perceptions during emergencies, ensuring messages align with the evolving concerns of different sociodemographic groups and supporting ‘person-centered’ approaches to promote effective behavioral responses and strengthen public health efforts.

Development and evaluation of an antigen targeting lateral flow test for Crimean-Congo Haemorrhagic Fever

Crimean-Congo Haemorrhagic Fever (CCHF) is a viral haemorrhagic fever with a case fatality rate of 5-25% that has been prioritised for research and development by the World Health Organisation. There are no CCHF rapid diagnostic tests (RDTs) commercially available. We describe the development and evaluation of an antigen-targeting lateral flow immunoassay RDT for CCHF. Prospective clinical samples were collected and tested between July and October 2023 in Türkiye. Retrospective stored samples were obtained from the Central Public Health Laboratory, Baghdad, Iraq. The sensitivity and specificity of the CCHF RDT was compared to reverse transcription quantitative polymerase chain reaction assays. On prospective clinical samples in Türkiye, the sensitivity and specificity of the CCHF RDT was 90.4% [95% CI 81.5-95.3%] (n=73) and 96.2% [95% CI 87.0-99.3%] (n=52), respectively with a sensitivity of 92.9% [95% CI 84.3-96.9%] (n=70) in samples with a cycle threshold (Ct) ≤30. On retrospective stored samples in Iraq, sensitivity and specificity of the RDT was 71.7% [95% CI 59.2-81.5%] (n=60) and 92.5% [95% CI 80.1-97.8%] (n=40), respectively with a sensitivity of 82.2% [95% CI 68.7-90.7%] (n=45) in samples of Ct ≤30. The CCHF RDT was an effective rapid diagnostic test in this preliminary clinical evaluation, showing this RDT has the potential diagnostic capability for use at the point-of-care. Definitive evaluation is now required to ensure the RDT meets the regulatory requirements for commercialisation. The Liverpool School of Tropical Medicine, National Institute for Health Research Health Protection Research Unit in Emerging Zoonotic Infections, The Medical Research Council and The Pandemic Institute.

Seroprevalence and Distribution of Toxoplasma gondii Infections among Patients in the West Bank, Palestine (2017-2021).

Toxoplasmosis is a zoonotic disease caused by the obligate intracellular protozoan Toxoplasma gondii. The current study assessed the seroepidemiological status and risk factors of T. gondii in the West Bank, Palestine. We conducted a retrospective study among 1,475 patients referred for serological examination for toxoplasmosis between 2017 and 2021 at the Central Public Health Laboratory. The overall prevalences of anti-T. gondii IgG and IgM antibodies were 1.0% [18.9-23.0%] and 1.0% [0.5-1.6%], respectively. Multifactorial analysis showed that age and sex were significantly associated with the presence of IgG antibodies. The prevalence of IgG antibodies was highest in 2018 and decreased significantly each year until 2021. Routine serological screening in women of childbearing age and pregnant women is recommended.

Hydraulic Design Concept of 6.60MLD Water Treatment Plant

Abstract: The design and construction of a 6.6 million liters per day (MLD) water treatment plant (WTP) in Belpada Village, Odisha, aim to meet the increasing water demand while ensuring public health through effective water treatment processes. The plant, which sources raw water from the Tel River, follows a well-structured treatment process that includes aeration, sedimentation, filtration, and disinfection. This journal outlines the hydraulic design, treatment schemes, and structural components of the WTP. Design calculations, based on CPHEEO standards, are also discussed, focusing on the hydraulic detention times, surface loading, filtration rates, and sludge management techniques.The design of water treatment plants (WTPs) plays a crucial role in delivering safe drinking water, especially in areas with high population density and industrial growth. The 6.6 MLD WTP designed for Belpada Village in Balangir District draws water from Tel River and utilizes a cascade aeration system for the removal of contaminants. This paper discusses the hydraulic and process design, focusing on flow rates, detention times, and surface loading parameters that meet the Central Public Health and Environmental Engineering Organization (CPHEEO) standards.

Emergence of NDM-1-Producing Pseudomonas aeruginosa Nosocomial Isolates in Attica Region of Greece.

Here, we report on the emergence and spread of multidrug-resistant NDM-1-producing P. aeruginosa isolates from patients hospitalized in the Attica region, Greece, in 2022 to provide data on their resistome, their virulome, the genetic environment of blaNDM-1, and their molecular epidemiology. A total of 17 carbapenem-resistant P. aeruginosa isolates identified as NDM-producers by immunochromatography at the hospital level were sent to the Central Public Health Laboratory, in the frame of the laboratory surveillance of carbapenem-resistant pathogens, for further characterization. The initial screening for genetic AMR determinants was carried out by PCR and the MDR Direct Flow Chip assay. Typing was performed by MLST and DLST, the latter in a subset of isolates. Further analysis was performed by whole-genome sequencing (WGS) of six isolates from both hospitals to analyze their entire genomes and elucidate their genetic relatedness. All isolates were allocated to international high-risk clones, sixteen to ST773 and one to ST308. Five ST773 and the sole ST308 isolate were found to harbor the blaNDM-1 gene, along with various other ARGs integrated into their chromosomes, as well as with a wide variety of virulence genes. The blaNDM-1 gene was located in the integrative and conjugative elements ICE6600-like and ICETn43716385 in ST773 and ST308 isolates, respectively. Single-nucleotide polymorphism analysis of the five ST773 isolates indicated their clonal spread in both hospitals. These results suggested that two different molecular events contributed to the emergence of NDM-1-producing P. aeruginosa isolates in Athenian hospitals, highlighting the need for ongoing surveillance.

Distribution of human papillomavirus in women by genotype, age, education, and geography in Baghdad, 2021-2022

Background: Human papillomavirus (HPV) is the main causative agent of cervical cancer and genital warts. HPV infection can be persistent with high-risk HR-HPV genotype. Objective: Investigate the distribution of HPV genotype in Baghdad province, to afford a scientific source for initial detection policies and immunization for cervical tumors in the province. Methodology: From January 2021 to September 2022, 400 women who were tested for HPV genotyping, were referred to the Central Public Health Laboratory (CPHL) in Baghdad province. They have one or more of the following (intermenstrual bleeding, post-menopausal bleeding, post-coital bleeding, vaginal discharge, and warts). Results: The prevalence of HPV infection showed a high percentage in Rusafa about 74.17%, however, Al-karkh showed about 25.83%. Both regions appeared high distribution for genotypes (16&18) as predominant types for HR-HPV. Two major rates of HPV infection have been found in women aged group (20-30) years, about (45.31%) and (36.72%) in women aged (30-40) years, these groups consider reproductive age therefore HR-HPV risking persistent infection. In comparison, HPV infections show (13.28%) among women aged 40-50 years. finally, HPV infection in the elderly group 50-65 years was (4.69%) showing the lowest percentage, also women with secondary education level appeared higher percentage of HPV infection about (42.63%) compared with primary and higher education. Conclusion: The prevalence of high-risk-HPV infection showed a high percentage in Baghdad providence and there was an important for age specificity, in addition to an inverse relationship with the education level.

HEMATOLOGICAL CHANGES ASSOCIATED WITH COVID-19 INFECTION IN ADEN/ YEMEN

Chronic Hematological alterations in COVID-19 patients range from mild to severe, with common changes including lymphopenia, neutrophilia, and thrombocytopenia. The gold standard for diagnosis is the polymerase chain reaction (PCR) test, which is highly specific and sensitive for detecting SARS-CoV-2 genetic material. The study was a single isolation center retrospective analysis of 200 patients with COVID-19 confirmed cases. The hematological indicators were taken after sample blood collected from the staff of Central Public Health Laboratory to determine the changes, and compared between different grades of severity and prognosis with the hematological indicators. The data was analyzed using Statistical Package for the Social Sciences (SPSS) version 22.0. simple frequencies and percentage were used, while chi-square test used to determine the association between variables. Males consisted 73.5% in this study, while 63% of participants suffered from moderate severity. Related to the hematological changes; and comparisons made according to real-time PCR test results revealed that the Lymphocytopenia and leukocytosis presented among 47.5% and 46.5% respectively with significance association with illness severity and outcome of patients with p-value< 0.05. hematological changes in COVID-19 patients are a common and significant aspect of the disease. Lymphopenia, neutrophilia, thrombocytopenia, and increased levels of inflammatory markers are frequently observed. These hematological abnormalities are associated with disease severity, poor clinical outcomes. Blood parameters aid in COVID-19 diagnosis and prognosis, with abnormal hematological parameters providing early evidence. However, interpretation should consider limitations, sample size, and potential biases. Further research needed.

Sociodemographic and psychological factors affecting motor vehicle crashes (MVCs): a classification analysis based on the contextual-mediated model of traffic-accident involvement

The study aimed to determine the sociodemographic and psychological profiles of drivers with a history of motor vehicle crashes (MVCs), following the contextual-mediated model of crash involvement, and trying to define similarities and differences with drivers without MVCs. Although road trauma prevention has become a central public health issue, the study of psychological determinants of MVCs does not have consistent results due to methodological and theoretical weaknesses. Three-hundred and forty-five active drivers (20% females) completed an extensive office-based fitness-to-drive evaluation including measures of cognition, personality, self-reported driving-related behaviors, attitudes, as well as computerized measures of driving performance. The Classification and Regression Tree method (CART) was used to identify discriminant predictors. The classification identified several relevant predictors; the personality trait of Discostraint (as a distal context variable; cut-point: 50 T points) and motor speed (as a proximal context variable; cut-point: 64 percentile ranks). The global classification model increased approximately 3 times the probability of identifying people with a history of MVC involvement, starting from an estimated prevalence of being involved in an MVC in a period of five years in the population of active drivers. Consistent with the ‘contextual-mediated model of traffic accident involvement’, the results of the present study suggest that road trauma analysis should focus on both distal and proximal driver-related factors by paying attention to their association in determining MVCs. These results represent a valuable source of knowledge for researchers and practitioners for preventing road trauma.

High viral suppression rates among PLHIV on dolutegravir who had an initial episode of viral non-suppression in Uganda September 2020-July 2021.

In 2019, WHO recommended dolutegravir (DTG) as a backbone for first- and second-line antiretroviral therapy (ART) regimens for people living with HIV (PLHIV). According to the 2018 Uganda's HIV treatment guidelines, patients with viral non-suppression (≥1,000 copies/mL) should receive intensive adherence counseling (IAC) with repeat viral load (VL) within 6 months. This analysis focused on the prevalence and factors associated with viral suppression following IAC among PLHIV on DTG-based regimens (DBRs) with an initial episode of viral non-suppression (VNS) in Uganda. We conducted a retrospective analysis for PLHIV on DBRs with an initial episode of VNS (≥1,000 copies/mL) in Uganda during October 2019-September 2020 who had a follow up VL test result during September 2020-July 2021. Data were abstracted from the Central Public Health Laboratory (CPHL) database, including patient demographics and VL results. Viral non-suppression (VNS) was defined as a VL test result of ≥1,000 copies/mL. We characterized PLHIV on DBRs and used logistic regression models to determine factors associated with VL suppression after an initial episode of VNS. A total of 564 PLHIV on DBRs with an initial episode of VNS were followed up and 43 were excluded due to missing data. Of the 521, 220 (42.2%) were children (<15 years) and 231 (44.3%) were female. Median age was 28 years (interquartile range [IQR]: 12-43 years), and median duration on DBRs was 12 months (IQR: 6-15 months). Overall, 80.8% (421/521) PLHIV had a suppressed viral load at first follow up testing (children = 74.5% [164/220]; adults = 85.4% [257/301]). Children with initial VL results ≥5,000 copies/mL were less likely to achieve viral suppression at follow up testing compared to those with <5,000 copies/mL (AOR: 0.38; 95% CI: 0.20-0.71; p = 0.002). In a programmatic setting, most adults and children suppressed following an initial episode of VNS on DBRs. High rates of suppression after VNS suggest adherence challenges, rather than drug resistance. Continuation of DBRs should be considered before regimen switch.

Pre-Pandemic Landscape of the Oklahoma Public Health Workforce: A Case Study From the Region 6 Training Needs Assessment Survey, 2019.

The COVID-19 pandemic highlighted the need for a well-trained public health workforce prior to the public health crisis. Public health training centers regularly assess workforce needs and their pre-pandemic data play vital roles in guiding public health workforce development beyond the crisis. In 2019, Oklahoma partners of the Region 6 South Central Public Health Training Center (R6SCPHTC) co-conducted an online survey of the public health workforce located in the Health Resources & Services Administration Region 6. Between March and April, the R6SCPHTC collected 503 surveys, including 201 surveys from Oklahoma. Questions inquired about demographic and workforce characteristics, work contexts, training needs and interests, training access and logistics, and knowledge of R6SCPHTC online resources. Key findings included that two-thirds of the pre-pandemic Oklahoma public health workforce consisted of employees age 40 or older with few holding public health or medical degrees. The majority of respondents worked for health departments and Tribes, and almost half were frontline workers. Although at least half of the participants interested in training on public health activities and topics were familiar with them, confidence in their abilities related to these activities and topics was expressed by less than half. Qualitative data provided details on training needs addressed quantitatively and described new training areas. Survey participants expressed interest in diverse training delivery methods and technological devices. Most respondents were not familiar with the free trainings available through the R6SCPHTC. Similar to the regional and national public health workforce, Oklahoma's workforce needed training and support already before COVID-19. Time and resources need to be invested into the current and future workforce. While addressing priority public health skills and topics remains important, training on current and emerging topics is needed. Providing accessible trainings with expanded content will prepare Oklahoma's public health workforce for the future.

Canine visceral leishmaniasis: Seroprevalence and georeferencing in the state of Santa Catarina, Brazil

Canine visceral leishmaniasis (CVL) has long been considered an endemic disease in the northern and northeastern regions of Brazil, while the southern region remains non-endemic. However, in recent years, several cases of CVL have been reported in southern states. The objective of this work was to determine the seroprevalence of CVL in dogs in the state of Santa Catarina, Brazil, through immunochromatographic tests (DPP®) and ELISA (Enzyme-Linked Immunosorbent Assay) and its correlation with environmental characteristics through georeferencing. Blood samples from dogs (n = 1227) were collected in six mesoregions of the state and evaluated by the rapid test (DPP®). Positive samples were sent to Lacen (Central Public Health Laboratory) in Santa Catarina to be tested using ELISA. Information obtained from the epidemiological questionnaire was subjected to statistical analysis (Chi-square and Student's t-test; P < 0.05) to verify the correlation between serology and the analyzed variables. The locations (GPS) of the samples were used for georeferencing and creating heatmaps (Kernel Method). Four animals that died from CVL were necropsied and organ samples were collected for molecular analysis (PCR), immunohistochemistry, and histopathology (HE). Of the 1227 dogs analyzed, 22 (1.8%) were reactive in the DPP® and of these, 7 (0.6%) were also positive in the ELISA. A correlation (P < 0.01) was observed between positive serology and region, environment, access to the street, and clinical signs. The positive cases were concentrated in the eastern region of the state, in low-altitude areas with average rainfall and higher average temperatures, and in more populated areas close to forest fragments. PCR, HE, and immunohistochemistry, along with serology, have proven to be efficient for characterizing positive cases.

Assessing the risks for stillbirth in São Paulo, Brazil: protocol for a multidisciplinary case–control study – FetRisks

Stillbirth is a fundamental component of childhood mortality, but its causes are still insufficiently understood. This study aims to explore stillbirth risk factors by using a multidisciplinary approach to stimulate...

Zamzam Water Surpasses Global Standards in Quality and Mineral Content

This study investigates the physical, chemical, and bacteriological properties of Zamzam tap water and two popular bottled waters, "Rounaq" and "Naba' Al- Rayan," in Diyala Governorate. Conducted at Al-Rafidain University College and the Central Public Health Laboratory in Baghdad, the research analyzes taste, odor, color, pH, essential minerals, and bacterial contamination. Findings indicate that Zamzam water excels in sensory qualities and contains beneficial minerals like potassium and magnesium within safe limits, with no bacterial contamination detected. These results affirm Zamzam's superior quality and underline the necessity for regular quality checks of bottled waters to ensure public health safety. Highlights: Superior Sensory Qualities: Zamzam water was notably superior in taste, odor, and color compared to the other bottled waters tested. Mineral Content and Safety: All water samples contained essential minerals like potassium and magnesium within safe limits, confirming their nutritional value and compliance with health standards. Bacterial Purity: No bacterial or pathogenic contamination was detected in any of the water samples, ensuring their safety for consumption. Keywords: Zamzam Water, Bottled Water Quality, Mineral Content, Bacteriological Safety, Sensory Properties

Biodiversity of carbapenem-resistant bacteria in clinical samples from the Southwest Amazon region (Rondônia/Brazil)

Brazil is recognized for its biodiversity and the genetic variability of its organisms. This genetic variability becomes even more valuable when it is properly documented and accessible. Understanding bacterial diversity through molecular characterization is necessary as it can improve patient treatment, reduce the length of hospital stays and the selection of resistant bacteria, and generate data for health and epidemiological surveillance. In this sense, in this study, we aimed to understand the biodiversity and molecular epidemiology of carbapenem-resistant bacteria in clinical samples recovered in the state of Rondônia, located in the Southwest Amazon region. Retrospective data from the Central Public Health Laboratories (LACEN/RO) between 2018 and 2021 were analysed using the Laboratory Environment Manager Platform (GAL). Seventy-two species with carbapenem resistance profiles were identified, of which 25 species carried at least one gene encoding carbapenemases of classes A (blaKPC-like), B (blaNDM-like, blaSPM-like or blaVIM-like) and D (blaOXA-23-like, blaOXA-24-like, blaOXA-48-like, blaOXA-58-like or blaOXA-143-like), among which we will highlight Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Serratia marcescens, and Providencia spp. With these results, we hope to contribute to the field by providing epidemiological molecular data for state surveillance on bacterial resistance and assisting in public policy decision-making.

Prevention of flash floods in the town of Kokrajhar through efficient drainage network design

Flash floods are common in the town of Kokrajhar in north-eastern Indian state of Assam. Many areas in the town of Kokrajhar are submerged in water almost every year due to floods during rainy season. These floods cause heavy damage to roads, agricultural production and halt the progress of major infrastructural development projects. Hence, prevention of floods has become an important concern in the town of Kokrajhar. This study investigated the causes of floods and offered a solution for their elimination. The investigation showed that inadequate and inefficient network of storm drains was the reason for the flash floods. A new drainage network for the town of Kokrajhar has resulted from studying the shortcomings of the existing network of storm drains. The new network is designed in accordance with the recommendations stated in the “Manual on storm water drainage systems” prepared by the Central Public Health and Environmental Engineering Organization in 2019.

Evaluation of the GeneXpert MTB/RIF to diagnose tuberculosis in a public health laboratory.

To evaluate the performance of geneXpert MTB/Rif versus conventional methods (bacilloscopy and culture) in the diagnosis of tuberculosis in a Central Public Health Laboratory (LACEN, Tocantins), Northern Brazil. Retrospective study, with information from 1,973 suspected cases of tuberculosis from patients treated from January 2015 to December 2020. From the culture (reference standard), the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the geneXpert MTB/Rif were 100%, 97%, 74%, 100%, and 97%, respectively, against 85%, 98%, 80%, 98%, and 97% of bacilloscopy. The geneXpert MTB/Rif performed similarly to culture and better than bacilloscopy. Although positive cases with negative culture should be evaluated with caution, its routine use is important for the early detection of tuberculosis.

Effectiveness of BNT162b2 BA.4/5 Bivalent COVID-19 Vaccine against Long COVID Symptoms: A US Nationwide Study.

Long COVID has become a central public health concern. This study characterized the effectiveness of BNT162b2 BA.4/5 bivalent COVID-19 vaccine (bivalent) against long COVID symptoms. Symptomatic US adult outpatients testing positive for SARS-CoV-2 were recruited between 2 March and 18 May 2023. Symptoms were assessed longitudinally using a CDC-based symptom questionnaire at Week 4, Month 3, and Month 6 following infection. The odds ratio (OR) of long COVID between vaccination groups was assessed by using mixed-effects logistic models, adjusting for multiple covariates. At Week 4, among 505 participants, 260 (51%) were vaccinated with bivalent and 245 (49%) were unvaccinated. Mean age was 46.3 years, 70.7% were female, 25.1% had ≥1 comorbidity, 43.0% prior infection, 23.0% reported Nirmatrelvir/Ritonavir use. At Month 6, the bivalent cohort had 41% lower risk of long COVID with ≥3 symptoms (OR: 0.59, 95% CI, 0.36-0.96, p = 0.034) and 37% lower risk of ≥2 symptoms (OR: 0.63, 95% CI, 0.41-0.96, p = 0.030). The bivalent cohort reported fewer and less durable symptoms throughout the six-month follow-up, driven by neurologic and general symptoms, especially fatigue. Compared with unvaccinated participants, participants vaccinated with the bivalent were associated with approximately 40% lower risk of long COVID and less symptom burden over the six-month study duration.