High Prevalence Of Infectious Diseases Research Articles

New threats in the recovery of large carnivores inhabiting human-modified landscapes: the case of the Cantabrian brown bear (Ursus arctos)

Understanding mortality causes is important for the conservation of endangered species, especially in small and isolated populations inhabiting anthropized landscapes where both natural and human-caused mortality may hinder the conservation of these species. We investigated the mortality causes of 53 free-ranging brown bears (Ursus arctos) found dead between 1998 and 2023 in the Cantabrian Mountains (northwestern Spain), a highly human-modified region where bears are currently recovering after being critically threatened in the last century. We detected natural traumatic injuries in 52.63% and infectious diseases in 39.47% of the 38 bears for which the mortality causes were registered, with 21.05% of these cases presenting signs of both infectious diseases and traumas. More specifically, almost 30% of the bears died during or after intraspecific fights, including sexually selected infanticide (10.53%). In addition, primary infectious diseases such as infectious canine hepatitis, distemper, clostridiosis and colibacillosis caused the death of 15.79% of the bears. The number of direct human-caused deaths (i.e., shooting, poisoning, snare) decreased over the study period. This study also reveals three new mortality causes triggered by pathogens, two of which—Clostridium novyi and verotoxigenic Escherichia coli—not previously described in ursids, and the other one, canine distemper virus, never reported in brown bears as cause of death. New management strategies for the conservation of Cantabrian bears, which are urgently needed due to the rapid expansion of the population, should consider the mortality causes described in this study and must promote further research to elucidate how the high prevalence of infectious diseases may threaten the current recovery of the population.

Morbidity among the tribal populations of West Bengal: A study based on data collected from the Mobile Medical Clinic.

Tribes are the most socially excluded group in the nation due to their restricted access to healthcare. There are little data on the real burden and distribution of illnesses among tribes. The present study determines the types and patterns of sickness among tribal populations in West Bengal. Five blocks from five districts in West Bengal were used for this cross-sectional study. Between the years 2018 and 2019, 52,189 patients visited these mobile medical clinics (MMCs), but only 36,128 were included in our study. Data were analyzed using the SPSS software (ver. 27.0). Younger age groups (1-25 years) show higher primary registration compared to other age categories; older age groups (>60 years) show higher repeat registration. High prevalence in infectious diseases (44.5% of the total primary registration) and high repeated cases in NCDs (11.5% to 33.2%), which are nearly three times higher than primary cases (Cramer's V test = 0.29; P = .001) are observed. Among the studied MMCs, Binpur II and Matiali MMC have more than two times the risk of gastrointestinal problems, while Madarihat MMC has more than one time the risk. Garbeta II MMC shows more than three times the risk of NCDs (adjusted odds ratio = 3.97; 95% confidence interval: 3.05-5.17) than the other diseases. The present study shows high prevalence of infectious diseases, injury and pain, NCDs, gastrointestinal problems, and vertigo in tribal populations of West Bengal.

Infectious diseases in Afghanistan: Strategies for health system improvement.

Afghanistan is grappling with a severe health crisis marked by a high prevalence of infectious diseases, particularly tuberculosis, malaria, HIV, and the added strain of the COVID-19 pandemic. The nation's healthcare system, already fragile, faces formidable challenges. Socioeconomic constraints, including limited resources and financial barriers, hinder healthcare accessibility, leading to delayed or inadequate care. Environmental factors, such as poor sanitation and crowded living conditions, exacerbate the transmission of diseases, especially waterborne illnesses. Governance issues, encompassing transparency, corruption, and political instability, disrupt healthcare efficiency and resource allocation. Addressing these multifaceted issues is vital to enhance Afghanistan's healthcare system and overall well-being. The withdrawal of international support has exacerbated these challenges. The primary research goal is to deeply understand Afghanistan's health system, focusing on the major disease burdens: Tuberculosis, Malaria, AIDS, COVID-19, Measles, Hepatitis, and Cholera. The study aims to assess the feasibility and effectiveness of current approaches, presenting a comprehensive view of challenges and opportunities within the Afghan healthcare system. The research concludes by highlighting policy implications, practical implementation, and offering recommendations for future endeavors. This paper provides a thorough analysis of the literature concerning infectious diseases in Afghanistan and the enhancement of the healthcare system in the nation. A systematic exploration of the literature was conducted through PubMed and Google Scholar databases. The search terms used encompassed "Tuberculosis" OR "TB," "Malaria," "acquired immunodeficiency syndrome" OR "AIDS," "Human immunodeficiency virus" OR "HIV," "COVID-19," "Measles," "Hepatitis virus," "Cholera," "Health system improvement," and "Afghanistan." Additionally, external sources like UNICEF, CDC, and WHO were referenced. In conclusion, while improving access to vital medicines and vaccines is crucial for enhancing health outcomes in Afghanistan, significant challenges must be addressed to ensure the effectiveness and sustainability of such strategies. The Afghan health system's fragile governance, corruption, logistical complexities, and failure to address broader social and economic factors pose significant risks and obstacles to the implementation of proposed health strategies. Therefore, the strategies discussed in this analysis align with key Sustainable Development Goals, particularly SDG 3, and their successful implementation will have implications not only for the health and well-being of Afghanistan but also for global health. Hence, by adopting a comprehensive approach with complementary interventions as discussed, we can address issues in the Afghan health system and reduce transmissible diseases' burden, thereby building a better world for all.

The Impact of Co-Infections for Human Gammaherpesvirus Infection and Associated Pathologies.

The two oncogenic human gammaherpesviruses Epstein-Barr virus (EBV) and Kaposi's sarcoma-associated herpesvirus (KSHV) cause significant disease burden, particularly in immunosuppressed individuals. Both viruses display latent and lytic phases of their life cycle with different outcomes for their associated pathologies. The high prevalence of infectious diseases in Sub-Saharan Africa (SSA), particularly HIV/AIDS, tuberculosis, malaria, and more recently, COVID-19, as well as their associated inflammatory responses, could potentially impact either virus' infectious course. However, acute or lytically active EBV and/or KSHV infections often present with symptoms mimicking these predominant diseases leading to misdiagnosis or underdiagnosis of oncogenic herpesvirus-associated pathologies. EBV and/or KSHV infections are generally acquired early in life and remain latent until lytic reactivation is triggered by various stimuli. This review summarizes known associations between infectious agents prevalent in SSA and underlying EBV and/or KSHV infection. While presenting an overview of both viruses' biphasic life cycles, this review aims to highlight the importance of co-infections in the correct identification of risk factors for and diagnoses of EBV- and/or KSHV-associated pathologies, particularly in SSA, where both oncogenic herpesviruses as well as other infectious agents are highly pervasive and can lead to substantial morbidity and mortality.

Laboratory Surveillance, Quality Management, and Its Role in Addressing Antimicrobial Resistance in Africa: A Narrative Review.

AMR is a major public health concern that calls for extensive work and a multidisciplinary team approach. The high prevalence of infectious diseases in African nations leads to widespread antibiotic usage and eventual antimicrobial resistance, which has significant negative effects on people's health, the economy, and society. Additionally, inadequate or nonexistent antimicrobial drug regulations, inappropriate prescription practices, and restrictions on public health prevention initiatives such as immunization, water and sanitation, and sexual health may all contribute to the emergence of AMR. Despite the need for laboratory quality assurance, many African laboratories confront substantial difficulties in implementing efficient quality assurance programs. AMR surveillance in Africa is hampered by a lack of laboratory capacity, insufficient data collection and analysis, and poor stakeholder collaboration. Several initiatives and programs, including the World Health Organization's Global Antimicrobial Resistance and Use Surveillance System (GLASS), the Africa Centres for Disease Control and Prevention (Africa CDC) Antimicrobial Resistance Surveillance Network (AMRSNET), and the Fleming Fund, a UK government initiative aimed at tackling AMR in low- and middle-income countries, have been established to strengthen AMR surveillance in Africa and globally.

Maternal mortality in Greece: The evolution from traditional mammis to overmedicalized obstetric care during the 20th century

AbstractGreece has been absent from the literature on maternal mortality in historical Europe, as very little evidence is yet available regarding maternal mortality patterns before the 1950s. The discontinuity in the collection and publication of demographic data in Greece, as well as the nonavailability of continuous national published statistics are the most important reasons for the lack of studies on maternal mortality. Therefore, this study aims to address this gap by utilising annual published statistics at the aggregate level, focusing primarily on the first half of the 20th century, while also making a significant contribution to the postwar period. The results of the study indicate a high incidence of maternal deaths in Greece, particularly in the northern—mostly rural and later annexed—regions of the country until the late 1930s. An important reason may be the lack of obstetric care in these areas. Although major urban centres were primarily served by qualified midwives by the mid‐1920s, rural Greece had access only to untrained midwives due to the insufficient number of trained midwives that could cater the needs of the entire country. Other contributing factors may include the high prevalence of infectious diseases, such as tuberculosis and malaria in certain areas of the country, poor nutritional status throughout the country before the 1950s, low literacy rates, low living standards, and lack of public health infrastructures. Greece's case study is intriguing as it has transitioned from an almost absolute lack of obstetric care, with the exception of the mostly untrained rural midwives known asmammisbefore the 1950s, to becoming one of the most highly medicalised countries in Europe by the end of the 20th century, succeeding very low levels of maternal mortality.

Infectious Morbidity in Closed Long-Term Care Facilities in the «Pre-COVID Stage»

Relevance. Elderly people have become the fastest growing segment of the global population over the past few decades. The number of people over the working age in Russia, and with them citizens living in closed long-term care facilities (CLTFS), is growing. Residents of these organizations belong to the risk group, and CLTFS have a number of characteristics that turn these institutions into a unique environment for the spread of infectious diseases.Aims. To analyze the CLTFS residents infectious morbidity in the "pre-covid stage" (according to literature sources). A scientific review of research in Russian and English using information portals and platforms has been carried out eLIBRARY. ru , Web of Science, PubMed, Google Academy and Scopus for the period 1981-2022. The search was carried out by keywords. Information about the most frequent infectious diseases affecting residents of closed long-term care institutions was the criterion for inclusion in the sample of publications. Out of 16171 initially identified articles, 61 publications were selected after initial analysis.Conclusions. According to various estimates, the leading infectious diseases in CLTFS were: acute respiratory infections, pneumonia, urinary tract infections, skin and mucous infections, acute intestinal infections. The article describes pathogens and their prevalence in CLTFS including pathogens with multiple drug resistance (MDR), describes the resistance of bacteria to antimicrobial drugs formation problem in these organizations, as well as development of certain diseases risk factors. Studies conducted in various CLTFS in Europe, Russia, the USA, and Asia indicate a high prevalence of infectious diseases among their residents, high colonization of residents with antimicrobial-resistant pathogens, as well as the infection transmission probability from the CLTFS and its spread to other long-term care institutions and medical and preventive organizations.

Preventive healthcare among dogs and cats in Chile is positively associated with emotional owner-companion animal bond and socioeconomic factors

Global companion animal population has been increasing as well as the number of dogs and cats being considered as a family member. However, it is unclear whether this close relationship could be associated with higher preventive healthcare in companion animals. Using data from 7,048 questionnaires of dogs and 3,271 of cats from the First National Study on Responsible Companion Animal Ownership, we estimated the proportion of preventive healthcare in companion animals of Chile. We also conducted a general linear mixed-effect regression model to identify socioeconomic factors and indicators of the emotional owners-companion animal bond that could influence owners' practices related to vaccination, parasite control, and veterinary visits. Based on the owner's answers, Chile has a satisfactory overall rates of parasite control (71%) and annual veterinary visits (65%) but a low vaccination coverage of both dogs (39%) and cats (25%). 'Purebred', 'live in urban areas', 'acquired by monetary compensation', and 'dog species' were associated with a higher probability of preventive healthcare in companion animals. Conversely, this probability was lower among senior animals compared to adults, males, and those owned by the Silent Generation or Baby Boomers (i.e., owners born before 1964). 'Sleeping inside', 'acquired for an emotional reason' (e.g., companionship), and 'considered a family member' were positively associated with at least one of assessed preventive measures. Our findings suggest that emotional owner-companion animal bonds could positively impact the frequency and quality of preventive healthcare in dogs and cats. However, owners who totally disagreed that a companion animal is a "family member" were also associated with a higher likelihood of vaccination uptake and veterinary visits for their animals. This highlights that owner's compliance with veterinary preventive healthcare is multifactorial. Chile has a high prevalence of infectious diseases circulating among dogs and cats and increasingly close contacts between owners and companion animals due to emotional bonds. Thus, our study calls for One Health approaches to reduce the risks of cross-species disease transmission. Specifically, increasing vaccination coverage of companion animals in Chile is the most urgent preventive measure needed, especially among cats, males, and older animals. Expand preventive healthcare among dogs and cats will promote public and animal health, including local wildlife that is susceptible to infectious diseases circulating in companion animals.

Persistent Malnutrition among Children under five in Pastoral Communities of Aweil Centre, South Sudan

Malnutrition is one of the leading causes of morbidity and mortality among children globally, and has been linked to 60% of the 10.9M deaths annually of under-fives. High prevalence of infectious diseases contributes to malnutrition and vice versa making the situation even worse. In WHO’s African region, the median stunting prevalence is 31.3%.
 The worst scenarios are seen in the war tone countries; for example Aweil Center of South Sudan has consistently high malnutrition rates despite running nutrition projects by UN agencies, government and other partners with relative stability. Results from Survey carried out in 2013 indicated poverty levels  at 76%, severe acute malnutrition (SAM) prevalence rate of 6.3% (95% CI, 4.5-8.9), Global acute malnutrition (GAM) rate of 22.4% (95% CI, 17.8-27.7) with under five mortality rate of 152 deaths/ 1,000 live births.
 A cross-sectional study with two-stage cluster sampling method done to determine the associated factors of malnutrition among children 6-59 months in Aweil Center County. The results showed high burden of infectious diseases like fever, diarrhea, eye, skin  and respiratory tract infections at 94.5% with p-value 0.00022 (95%C.I, 0.1667-0.291). Very low household dietary diversity score of only 24 % (125out of 513 families). There was low coverage of primary health care interventions; e.g. Vitamin A, LLITN and measles vaccinations at 53%, 52.8% and 55% respectively. Accessibility to CBDs for iCCM associated with better nutrition status of children p-value 0.032 and OR 0.62 (95% CI 0.41-0.94). Poor feeding methods, family planning practices; and poor access roads to markets impact on nutrition status of children.
 Multifaceted approach is needed to root out the persistent malnutrition from Aweil Center: Shift from food aid to support of food production, scale up of primary health care and iCCM interventions to include IPT for malnourished children and community awareness on feeding practices and family planning

The high prevalence of infectious diseases among health workers indicates the need for improving surveillance

Resumo Objetivo: estimar soroprevalências de arboviroses, sífilis, HIV e Hepatite B (VHB) em trabalhadores de saúde (TS). Métodos: inquérito entre TS selecionados por amostragem aleatória, em uma cidade da Bahia - Brasil. Pesquisa realizada em 2019 por meio de questionário estruturado, que coletou informações sociodemográficas, ocupacionais e de saúde. Testes imunocromatográficos rápidos foram utilizados para rastrear as infecções; dessa forma, resultados positivos para arboviroses, sífilis, HIV e VHB indicaram soropositividade para a respectiva infecção. Além disso, detecção simultânea de anticorpos para zika (ZIKV) e dengue (DENV) indicou soropositividade para infecção por flavivírus. Resultados: 453 TS foram incluídos, sendo 82,8% do sexo feminino. A maioria (55,1%) relatou contato com material biológico; 5,2% referiram acidentes com material biológico. Encontrou-se soroprevalência de 34,7% (IC95%:30,1-39,4) para dengue, 1,7% (IC95%:0,7-3,4) para zika, 9,9% (IC95%:7,2-13,2) para chikungunya e 39,9% (95%CI:35,2-44,7) para flavivírus (ZIKV+DENV); 21,9% (IC95%:18,1-26,2) foram negativos para todos os arbovírus. Soropositividade para arbovírus aumentou com a idade e foi maior entre agentes de combate a endemias. Três TS testaram positivo para VHB (HBsAg); nenhum para HIV. Conclusão: elevado percentual de TS estava exposto a agentes infecciosos (contato com material biológico e/ou exposição a arbovírus). Entre as condições necessárias à prevenção de infecções no ambiente de trabalho, destacam-se: monitoramento de infecções entre TS, vigilância dos ambientes laborais e medidas de controle de exposições ocupacionais, como disponibilidade de repelentes.

Antibacterial and Antiviral Effects of Ag, Cu and Zn Metals, Respective Nanoparticles and Filter Materials Thereof against Coronavirus SARS-CoV-2 and Influenza A Virus.

Due to the high prevalence of infectious diseases and their concurrent outbreaks, there is a high interest in developing novel materials with antimicrobial properties. Antibacterial and antiviral properties of a range of metal-based nanoparticles (NPs) are a promising means to fight airborne diseases caused by viruses and bacteria. The aim of this study was to test antimicrobial metals and metal-based nanoparticles efficacy against three viruses, namely influenza A virus (H1N1; A/WSN/1933) and coronaviruses TGEV and SARS-CoV-2; and two bacteria, Escherichia coli and Staphylococcus aureus. The efficacy of ZnO, CuO, and Ag NPs and their respective metal salts, i.e., ZnSO4, CuSO4, and AgNO3, was evaluated in suspensions, and the compounds with the highest antiviral efficacy were chosen for incorporation into fibers of cellulose acetate (CA), using electrospinning to produce filter materials for face masks. Among the tested compounds, CuSO4 demonstrated the highest efficacy against influenza A virus and SARS-CoV-2 (1 h IC50 1.395 mg/L and 0.45 mg/L, respectively), followed by Zn salt and Ag salt. Therefore, Cu compounds were selected for incorporation into CA fibers to produce antiviral and antibacterial filter materials for face masks. CA fibers comprising CuSO4 decreased SARS-CoV-2 titer by 0.38 logarithms and influenza A virus titer by 1.08 logarithms after 5 min of contact; after 1 h of contact, SARS-COV-2 virus was completely inactivated. Developed CuO- and CuSO4-based filter materials also efficiently inactivated the bacteria Escherichia coli and Staphylococcus aureus. The metal NPs and respective metal salts were potent antibacterial and antiviral compounds that were successfully incorporated into the filter materials of face masks. New antibacterial and antiviral materials developed and characterized in this study are crucial in the context of the ongoing SARS-CoV-2 pandemic and beyond.

PENGARUH SOSIALISASI SOP ALAT PELINDUNG DIRI (APD) TERHADAP PERILAKU PERAWAT RUANG ICU DALAM PENGGUNAAN APD

Nurses as health workers can protect themselves from contact with infectious materials or exposure to infectious diseases by having knowledge of the infection process and proper barrier protection. The high number of work accident cases and the high prevalence of infectious diseases are indicators of the importance of nurses applying standard precautions. The purpose of this study was to identify the effect of socializing the use of PPE on the behavior of ICU Nurses in the use of PPE (Handscoon, Mask, Gown). This study uses a pre-experimental design in the form of a one group pretest-posttest design. The research sample of 35 respondents was taken using saturation sampling technique. There is a significant difference between before and after the socialization of PPE SOPs on the behavior of nurses in the use of PPE (Handscoons, Masks, Gowns) both on the 3rd and 6th day observations after the intervention was carried out with a p value of 0.000. Suggestions for hospital management to routinely hold PPE SOP socialization once a month so that the safety behavior of nurses, especially in the use of PPE can be maintained or increased as an effort to prevent nosocomial infections.Keywords: Use of PPE, Nurse Behavior, PPE SOP socialization

Gross necropsy, histopathology, and ancillary test results from neonatal beef calves submitted to a veterinary diagnostic laboratory.

The objective of this study was to evaluate the prevalence of abnormal findings in gross necropsy, histopathology, and ancillary test results from neonatal beef calves submitted to a veterinary diagnostic laboratory. This retrospective clinical case study was conducted by reviewing necropsy reports submitted between 2015 to 2020. Case inclusion criteria were animals had to be a bovine, 2 to 21 days of age, and a nondairy breed. Gross necropsy, histopathology, and laboratory test results were recorded. Identified lesions and abnormal test results were categorized based on body systems and infectious agent type. Age and system affected were analyzed using a 1-way ANOVA and Bonferonni pairwise comparisons. Overall, 1,060 reports were reviewed and 95 met the inclusion criteria. Median age of enrolled calves was 9 days (range, 2 to 21). A total of 252 lesions were identified with a median of 3 lesions/calf (range, 0 to 7) and 2 different body systems involved/calf (range, 0 to 5). The most common disorders were classified as digestive (42.1% [106/252]), respiratory (12.7% [32/252]), and multisystemic (11.1% [28/252]). With respect to age and system affected, calves with neurologic lesions were significantly younger (mean age, 5.1 days) than calves with digestive lesions (mean age 9.6 days). These data suggest a high prevalence of infectious diseases, mainly digestive, respiratory and multisystemic in origin. These findings could help guide producers and veterinarians when assessing factors contributing to neonatal beef calf loss.

Post-COVID-19 condition: current evidence and unanswered questions

As of July 2022, over 555 million cases of COVID-19 have been recorded globally, with more than 8·5 million confirmed cases reported in the African region.1Center for Systems Science and Engineering at Johns Hopkins UniversityCOVID-19 dashboard.https://coronavirus.jhu.edu/map.htmlDate accessed: July 10, 2022Google Scholar, 2WHO Regional Office for AfricaCOVID-19 (WHO African region).https://who.maps.arcgis.com/apps/opsdashboard/index.html#/0c9b3a8b68d0437a8cf28581e9c063a9Date accessed: July 10, 2022Google Scholar Various studies have been published in the past 2 years identifying persisting symptoms in individuals who had COVID-19 in different countries across the globe.3Jin H Lu L Fan H Global trends and research hotspots in long COVID: a bibliometric analysis.Int J Environ Res Public Health. 2022; 193742Google Scholar On the basis of this emerging condition—persisting symptoms linked to COVID-19 extending past the acute phase of infection—the UK's National Institute for Health and Care Excellence (NICE) published a guideline for clinicians on the long-term effects of COVID-19.4NICECOVID-19 rapid guideline: managing the long-term effects of COVID-19.https://www.nice.org.uk/guidance/ng188Date accessed: July 10, 2022Google Scholar The NICE guideline goes beyond clinical guidelines and defines the terms associated with these persistent signs and symptoms. The guideline distinguishes between the terminologies long COVID and post-COVID-19 condition, formerly used interchangeably. The term long COVID now refers to signs and symptoms that continue after acute COVID-19 disease (4–12 weeks),4NICECOVID-19 rapid guideline: managing the long-term effects of COVID-19.https://www.nice.org.uk/guidance/ng188Date accessed: July 10, 2022Google Scholar while the term post-COVID-19 condition (PCC) refers to signs and symptoms that develop during or after COVID-19 disease that continue for more than 12 weeks and cannot be explained by an alternative diagnosis.4NICECOVID-19 rapid guideline: managing the long-term effects of COVID-19.https://www.nice.org.uk/guidance/ng188Date accessed: July 10, 2022Google Scholar As the number of COVID-19 cases and survivors grows, the burden of PCC will also increase. Understanding the epidemiology and associated factors for PCC across diverse populations is crucial as the world transitions from the acute phase of the pandemic to a longer-term chronic phase. In The Lancet Global Health, Murray Dryden and colleagues prospectively investigate the prevalence and risk factors associated with PCC among individuals admitted to hospital with laboratory-confirmed SARS-CoV-2 infection in South Africa.5Dryden M Mudara C Vika C et al.Post-COVID-19 condition 3 months after hospitalisation with SARS-CoV-2 in South Africa: a prospective cohort study.Lancet Glob Health. 2022; 10: e1247-e1256Summary Full Text Full Text PDF PubMed Scopus (3) Google Scholar Participants aged 18 years or older were followed up by telephone at 1 month and 3 months after hospital discharge and assessed with use of a standardised questionnaire for the evaluation of symptoms, functional status, health-related quality of life, and occupational status. Of the 3094 participants who were selected and contacted for enrolment, 2410 (77·9%) consented to participate in the study at 1 month after discharge and of these, 1873 (77·7%) completed the 3-month follow-up. Dryden and colleagues’ study validates and adds to the literature on PCC and persisting COVID-19-related signs and symptoms globally. More so, because of the dearth of literature in the African region,3Jin H Lu L Fan H Global trends and research hotspots in long COVID: a bibliometric analysis.Int J Environ Res Public Health. 2022; 193742Google Scholar, 6Osikomaiya B Erinoso O Wright KO et al.‘Long COVID’: persistent COVID-19 symptoms in survivors managed in Lagos State, Nigeria.BMC Infect Dis. 2021; 21: 304Crossref PubMed Scopus (29) Google Scholar the study adds valuable knowledge by using a relatively large database to provide information on PCC in the region. Furthermore, considering the potential for phenotypic and genetic effects on the characteristics of COVID-19 disease, the racially and ethnically diverse population in South Africa expounds our understanding of PCC in this unique setting. Dryden and colleagues report a prevalence of 82·1% for long COVID and 66·7% for PCC in South Africa. The most common PCC symptoms were fatigue (50·3%) and shortness of breath (23·4%). Additionally, being female and being admitted to an intensive care unit (ICU) were associated with a higher likelihood of PCC signs and symptoms. Furthermore, individuals aged 40–64 years (compared with those younger than 40 years) had increased odds of new or worse disability. Within the context of current research, Dryden and colleagues validate previous findings about PCC within and outside the African region.6Osikomaiya B Erinoso O Wright KO et al.‘Long COVID’: persistent COVID-19 symptoms in survivors managed in Lagos State, Nigeria.BMC Infect Dis. 2021; 21: 304Crossref PubMed Scopus (29) Google Scholar, 7Lopez-Leon S Wegman-Ostrosky T Perelman C et al.More than 50 long-term effects of COVID-19: a systematic review and meta-analysis.Sci Rep. 2021; 1116144Crossref PubMed Scopus (455) Google Scholar The study findings also provide additional considerations for practice. For example, findings centred on the effect of PCC on different health domains such as functionality, health-related quality of life, and occupational status showed the need for a multifaceted approach to management. This approach should include managing the physical, mental, and cognitive effects of PCC in individuals. Additionally, several recommendations, such as the Stanford Hall Consensus statement,8Barker-Davies RM O'Sullivan O Senaratne KPP et al.The Stanford Hall consensus statement for post-COVID-19 rehabilitation.Br J Sports Med. 2020; 54: 949-959Crossref PubMed Scopus (252) Google Scholar provide examples of rehabilitation approaches in multidisciplinary domains for individuals with PCC that can be modified on the basis of the specificities of local health settings. Other findings in Dryden and colleagues’ study5Dryden M Mudara C Vika C et al.Post-COVID-19 condition 3 months after hospitalisation with SARS-CoV-2 in South Africa: a prospective cohort study.Lancet Glob Health. 2022; 10: e1247-e1256Summary Full Text Full Text PDF PubMed Scopus (3) Google Scholar that provide important considerations for health systems include the relatively high proportion (44·7%) of individuals with PCC who consulted with a general practitioner or primary health-care clinic. This finding suggests the need for the inclusion of primary health-care clinics in implementing PCC interventions. More so, over half of individuals in the study were employed full-time before developing COVID-19 and, among some who developed PCC, the condition altered their employment status. The effect on employment indicates the potential impact that PCC can have on the economy if timely interventions are not designed and implemented. Despite these findings by Dryden and colleagues, several questions remain unanswered. For example, the mechanism of PCC and persisting symptoms in individuals who had COVID-19 remains unknown. For instance, what pathophysiological mechanism drives this pathway in individuals who were admitted to ICU and ultimately developed PCC? Is it attributed to ICU-related post-traumatic stress or post-intensive care syndrome,9Kaseda ET Levine AJ Post-traumatic stress disorder: a differential diagnostic consideration for COVID-19 survivors.Clin Neuropsychol. 2020; 34: 1498-1514Crossref PubMed Scopus (85) Google Scholar the pulmonary injury from COVID-19, or a combination of both factors? Additionally, can the pattern of multiorgan symptoms or signs (ie, fatigue and shortness of breath) be explained by a resolving or different inflammation, persistent subacute SARS-CoV-2 infection, or a consequence of immunomodulatory therapy? Furthermore, the trajectory of PCC is not fully understood, as most studies have not assessed the condition for up to 12 months.7Lopez-Leon S Wegman-Ostrosky T Perelman C et al.More than 50 long-term effects of COVID-19: a systematic review and meta-analysis.Sci Rep. 2021; 1116144Crossref PubMed Scopus (455) Google Scholar As a step in the right direction, the US National Institutes of Health this year provided nearly US$470 million in funding to the Researching COVID to Enhance Recovery Initiative to help understand the trajectory and clarify the link between COVID-19 and the multiorgan effects of PCC.10Researching COVID to Enhance Recovery InitiativeMaking progress toward recovery.https://recovercovid.org/researchDate: 2022Date accessed: July 10, 2022Google Scholar Furthermore, no studies have assessed the outcome of multidisciplinary interventions in low-income and middle-income country (LMIC) settings, which account for a large proportion of COVID-19 cases globally. Identifying cost-effective and evidence-based multidisciplinary interventions is especially crucial for the sub-Saharan Africa region because of the limited capital and human resources available. Also, this region's relatively high prevalence of infectious diseases and malnutrition (competing for limited resources in the health system) suggests that interventions in high-income settings might not be readily applicable in LMIC settings. Another overarching question is how clinicians and researchers can work across disciplines and effectively communicate to address cross-disciplinary approaches to managing PCC. How can we design studies using a standardised approach across diverse settings with unequal health-care resources and access to measure the outcome of PCC interventions at the population level? The key findings from Dryden and colleagues’ study are twofold. First, two-thirds of individuals who had COVID-19 in their cohort reported PCC symptoms that affected their functional status, quality of life, and occupational status. Second, women and individuals admitted to ICU had an increased likelihood of reporting PCC. Findings from this study indicate the urgent need for research clarifying the link between COVID-19 status and persisting or new multiorgan PCC signs or symptoms, as well as the need for concerted efforts to develop an evidence-based multidisciplinary management strategy for individuals affected by the condition. I declare no competing interests. Post-COVID-19 condition 3 months after hospitalisation with SARS-CoV-2 in South Africa: a prospective cohort studyMost participants in this cohort of individuals previously hospitalised with COVID-19 reported persistent symptoms 3 months after hospital discharge and a significant impact of PCC on their functional and occupational status. The large burden of PCC symptoms identified in this study emphasises the need for a national health strategy. This should include the development of clinical guidelines and training of health-care workers for identifying, assessing, and caring for patients affected by PCC; establishment of multidisciplinary health services; and provision of information and support to people who have PCC. Full-Text PDF Open Access

Seroepidemiological investigation of Foot and Mouth Disease (FMD) in Northern Amhara, Ethiopia

Ethiopia's livestock resource is one of the largest in the world. However, it has been downgraded due to animal mortalities associated with higher prevalence of infectious diseases. These constraints are worse in Lalibela, Sekota and Ziquala districts where this study was carried out. Despite the availability of scanty animal health services in these areas, information on animal health, especially cattle, was never a significant research focus. Many transboundary infectious diseases are prevalent in Ethiopia, and Foot-and-Mouth Disease (FMD) is among the country's primary animal health challenges. Hence, to understand the epidemiology of FMD in these areas, a cross-sectional study was conducted in 2017 to estimate its seroprevalence of the disease and understand associated risk factors. Three hundred eighty-three randomly selected cattle from the three districts were included for the seroepidemiological analysis. The overall seroprevalence of FMD with a 3ABC ELISA test was estimated 3.4%, with no significant association with risk factors like study districts (agroecology), age, sex, and body condition score. The level of occurrence of FMD in the study areas may seem low. However, it needs attention from responsible bodies because of its transmission speed and economic impact. Besides, further studies involving serotyping with advanced diagnostic techniques are needed to understand the circulating serotypes in the study area.

Healthcare in Indonesia

Indonesia is a large state of Southeast Asia, located on several thousand volcanic islands. In terms of population (277 million people), Indonesia ranks 4th in the world, after China, India and the United States. Most of the population (about 58%) lives on the island of Java, despite the fact that its area is only 7% of the total area of the state, which makes this island the most densely populated in the world. The population of Indonesia is very multinational; the bulk are Javanese, about 4% are Malays and the same number are Chinese. The average life expectancy is 71 years: 68 for men and 74 for women, while the average age of Indonesians is 29 years. The main medical problem of Indonesians is the high prevalence of infectious diseases - typhoid fever, hepatitis A, dengue fever, malaria. This is largely due to climatic conditions and poor water quality - only about 80% of the population has access to drinking water, and the main method of disinfection is sunlight irradiation. The coronavirus pandemic has claimed the lives of 144,000 Indonesians, bringing the country's fatality rate to 3.4%. The maximum number of infections occurred in the summer of 2021, when up to 44,000 new cases were registered in the country per day. Compared to European countries, Indonesia is under-vaccinated with only 44.3% of the population completing the full course of vaccination and being able to receive two doses. Despite the fact that one of the significant sources of filling the country's budget is tourism revenue, as of the beginning of 2022, the country remains closed to tourists.

O02 Antibiotic prescribing practices in primary healthcare in sub-Saharan Africa: a systematic review and our experience on the use of telemedicine in Zambia

BackgroundAntimicrobial resistance (AMR) presents a challenge to clinicians globally, particularly in low- and middle-income countries (LMICs) which often have a high prevalence of infectious diseases, coupled with limited diagnostic, treatment and surveillance capabilities.1,2 To date, there is limited information on antimicrobial prescribing in sub-Saharan Africa, particularly in rural clinics,3 where systematic data gathering can be impacted by the resource-poor nature of these settings. The Virtual Doctors charity (VDrs)4 uses a bespoke smartphone app to give remote telemedical advice to clinicians throughout rural Zambia. This approach links primary healthcare workers with volunteer doctors, predominantly based in the UK. We propose that this approach may be a valuable tool to promote antimicrobial stewardship (AMS) in these locations, and consequently that telemedicine can play a key role in preventing a future AMR pandemic.MethodsWe carried out a systematic review to investigate current antibiotic prescribing practices in LMICs within sub-Saharan Africa, specifically the indications for use, choice of antimicrobial, and prescribing rates. Three Africa-specific databases, EMBASE, MEDLINE, Cochrane Library, Web of Science, Scopus, CINAHL, IRIS and Global Health databases were searched. English language studies evaluating antimicrobial use in primary care in LMICs in sub-Saharan Africa published between January 2010 and July 2021 were included. Data on the prevalence of antibiotic prescription, choice of agent and appropriateness was collated. We then reviewed anonymized prescribing data from the VDrs database, investigating antibiotic prescribing in cases over a period between January 2019 and June 2020. We excluded non-adult (<18 years old) patients, and reviewed cases that had been coded as ‘InfectiousDiseases’, ‘RespiratoryMedicine’ or ‘MedicineGeneral’ to identify those in which antibiotics were prescribed acutely and the impact of consultations on antibiotic prescriptions.ResultsSystematic review: 29 eligible studies from nine countries were identified, with 18 (62%) undertaken in urban settings and 7 (24%) encompassing rural settings. The prevalence of antibiotic prescription was 32.7%–84.4% (median 55.2%, IQR 44.5%–67.7%), with respiratory and genitourinary infections the most common indications. The most prescribed antibiotics were β-lactams (primarily amoxicillin), then quinolones and metronidazole. Only two studies assessed the appropriateness of prescriptions, with 13%–36.4% found to be inappropriate. Retrospective cohort analysis of VDrs database: 502 cases were reviewed. 154 (30.7%) were receiving 1–3 antibiotic agents at the time of consultation. The most prescribed agents were metronidazole and amoxicillin. Following consultation, 53 patients (10.5%) were initiated on antibiotics. Of those already receiving antibiotics, 29.2% had these actively continued, and 45.5% had antibiotics rationalized or stopped based on volunteers’ advice.ConclusionsOur systematic review confirms high rates of antimicrobial prescription in LMICs in sub-Saharan Africa, with a significant proportion being inappropriate. However, data are limited, and mainly from urban settings, hindering the generalizability of results. Our analysis of VDrs data reveals that 45.5% of antibiotic prescriptions were rationalized through our telemedicine-based approach. The VDrs model aims not only to deliver case-based guidance to rural healthcare practitioners, but also provide long-term educational gains to enhance local and global health. We suggest that the appropriate use of telemedicine can have short- and long-term benefits for AMS in LMICs.

Different diets and their effect on tuberculosis prevention in HIV patients.

Introduction:The relationship between nutrition and human immunodeficiency virus (HIV) infection, tuberculosis, and other infectious diseases is logically proven. Nutrition affects the immune system and the health of the organs. Inadequate dietary intake endangers the immune system, which itself increases susceptibility to disease and often culminates in active disease. The disease then reduces the body’s appetite and ability to absorb nutrients, and the cycle continues. Considering the importance of the role of nutrition in the health of acquired immune deficiency syndrome (AIDS) patients, this current review aimed to discuss the different diets and their effects on tuberculosis (TB) prevention in HIV patients.Method and Materials:The present study evaluates the important points related to AIDS and the prevention and treatment of this disease by considering the diet and known scientific cases during the last 10 years, in simple terms, the prevalence of this disease.Result:Articles were searched by valid databases in May 2021. The findings showed that in addition to malnutrition, the high prevalence of infectious diseases can have serious consequences for public health. Many people will be safe from getting infections if there are safe and effective interventions for many of these infectious diseases.Conclusion:Based on the information presented herein, it is clear that TB affects the nutritional status. Many patients with active TB experience severe weight loss, and many people with the symptoms show a lack of vitamins and minerals.

Tend and forecast of Global Market instruments for laboratory Diagnostic

In-vitro diagnostics is the process of diagnosing various diseases using test kits and analyzers. The in vitro diagnostics (IVD) market is growing at a steady pace as awareness of various diseases grows and the government initiates various plans to reduce the incidence. Most IVD tests are performed in medical and clinical laboratories, but the advent of point-of-care (POC) technology has enabled testing in the presence of the patient and even at home. This technological advancement is driving the growth of the market over the forecast period. Market growth over the forecast period is expected to be driven by factors such as the increase in lifestyle-related diseases, the growing adoption of POC testing, the growing demand for biomarker-based testing, and demand from developing countries. Factors hindering the growth of the market are the increase in sales of counterfeit glucose test strips and strict regulatory approval procedures. The regulatory scenario is of concern as there is a wide range of tools and analyzes that range from Class I to Class III devices. Recently, there have been changes in legislation in the European Region, which has become a serious problem for market participants. There is an emerging trend in the market towards non-invasive prenatal testing, next generation sequencing (NGS), fluid biopsy and circulating tumor cell testing. Markets in India, Brazil and China are expected to grow at a rapid pace during the forecast period due to the high prevalence of infectious diseases in these countries. The purpose of this study is to assess the current global market for medical devices for in vitro diagnosis, identify the main factors and drivers influencing the growth and prospects of this market in the future. To conduct this study, as materials and methods, we used the analysis of these indicators of expert assessments published by specialists in Russian and international journals specializing in the implementation, promotion and development of laboratory diagnostic products. The results of the study determine the key promising markets for medical devices for in vitro diagnostics, as well as the correct vector for the development of the medical industry. In the final part, the main regions with the highest development potential over the next 10 years were identified, and indicators of the dynamics of the global market for medical instruments over the past 5-9 years were determined.

Inappropriate Use of Antibiotics among Children Under Five in Rural and Urban Communities of Cambodia

Background: Inappropriate use of antibiotics is a major treat especially in low- and middle-income countries with antibiotic resistant. Cambodia with high prevalence of infectious diseases among children under five, antibiotics use in urban and rural setting has not been clearly identified. Therefore, this study aimed to investigate the situation of inappropriate antibiotic use among children under five in urban and rural communities of Cambodia.Methods: An analytical cross-sectional study was carried out in both urban and rural communities in Cambodia from September to November 2020 by structured questionnaire interviewed among 512 Cambodian caregivers on antibiotic use for the under 5 children.Results: Among 512 children, majority were males both in urban (55.6 %) and rural (50.3%) settings, with the median age of 29.5 (3:59) months in urban and 30.0 (3:59) months in rural. The prevalence of inappropriate use of antibiotics among children under five was 79.3% (95% CI = 75.55 to 82.60), of which it was 26.0 % in urban and 53.3% in rural. Most of the rural respondents (82.1%) use antibiotics for bacterial infection diagnosed by doctors. However, it was only 52.6% in rural areas. Similar proportion of 58.6 % in urban and 61.1 % rural used antibiotics for fewer days than prescription.Conclusions: Inappropriate use of antibiotics were found in more than 3 quarters of children under five, of which the proportion in rural areas were much higher than urban. The further investigation on factors contributing to inappropriate use of antibiotics should be conducted.