High Infection Rates Research Articles

The Incidence of Infection Following Open Tibia Fractures in Low-Income Countries: A Systematic Review

Introduction: Open tibial fractures (OTFs) are common in low-income countries (LICs), primarily caused by road traffic collisions. High rates of infection in OTFs contribute to prolonged recovery, disability, and economic loss. Identifying infection rates and causative organisms is essential for improving outcomes and guiding antibiotic treatment in LICs. This systematic review aimed to determine the incidence of surgical site infections (SSIs) following OTF treatment in LICs and identify the most prevalent microorganisms involved. Methods: Following PRISMA and Cochrane guidelines, a systematic review was conducted using five databases. Eligible studies included randomised controlled trials, cohort studies, and case series investigating OTFs in LICs. Studies with fewer than ten participants, military medical resources, or those from high-income countries were excluded. Data were extracted for infection rates, causative organisms, and treatment modalities, with a meta-analysis performed using a random effects model to calculate incidence in person-years. Results: Five studies, including two retrospective cohorts, two prospective cohorts, and one RCT, were analysed. The overall infection incidence was 23.21 per 100 person-years (95% CI: 9.19; 58.62). Subgroup analysis showed a slightly lower incidence of 21.88 per 100 person-years for surgical interventions. A high degree of heterogeneity (I² = 91%) was noted. Common causative organisms were not consistently reported. Conclusion: The incidence of SSIs following OTFs in LICs is high, particularly in severe fractures. Establishing a baseline infection rate is critical for future studies to evaluate treatment efficacy and improve outcomes in resource-limited settings. Further research should focus on standardising definitions and reporting of infections to reduce heterogeneity.

Sensitivity Pattern in Children Respiratory Bacterial Infections

Background: Bacterial respiratory infections are a major health concern, especially in underdeveloped and developing countries. This study aims to evaluate the prevalence of Gram-negative and Gram-positive bacteria in respiratory infections and assess the efficacy of antibiotics. Methods: A prospective, observational study was conducted from July 2010 to July 2011. Patients with respiratory infections were categorized by age, bacterial pathogen, disease type, and season of infection. Diagnostic methods, including throat swabs, blood cultures, and antibiograms, were used to identify pathogens and determine antibiotic resistance profiles. The infection rate was calculated using standard epidemiological formulas. Results: Gram-negative bacteria accounted for 84.7% of infections, with Acinetobacter baumannii (26.4%) being the most common pathogen. Gram-positive infections, primarily caused by Streptococcus pneumoniae (77%), were also prevalent. The highest infection rates were observed in the spring, particularly among children under one year and those aged 1-6 years. Pneumonia was the most common diagnosis (43.5%). Ampicillin resistance was widespread, but Acinetobacter baumannii, E. coli, and Klebsiella pneumoniae showed sensitivity to Sulbactam, Cefoperazone, and Piperacillin/Tazobactam. Conclusion: Acinetobacter baumannii was the predominant cause of respiratory infections, especially in young children and during spring. Ampicillin resistance was common, but Sulbactam, Cefoperazone, and Piperacillin/Tazobactam were more effective. These findings highlight the importance of targeted antibiotic therapy, particularly for Gram-negative bacterial infections.

Impact of alcohol use disorder on antiretroviral therapy adherence in adults with HIV/AIDS at University of Gondar, Northwest Ethiopia

Background Alcohol use disorder in people living with the human immunodeficiency virus is an important public health problem associated with high rates of HIV infection and lower antiretroviral treatment adherence. However, little is known about the prevalence of alcohol use disorders and its impact on ART adherence among people living with HIV/AIDS (PLWHA). Thus, this study aimed to evaluate the magnitude of alcohol use disorder and its impact on medication adherence among PLWHA attending the ART clinic. Methods A hospital based cross sectional study design was conducted at University of Gondar Comprehensive Specialized Hospital (UOGCSH) ART clinic from September 30, 2023 to February 30, 2024. The World Health Organization’s Alcohol Use Disorders Identification Tool (AUDIT) was utilized to assess alcohol use disorder. Bivariate and multivariate logistic regression analyses were employed to investigate the relationship between AUDs and other variables. Statistical analysis was conducted using SPSS version 26, with a significance level set at P < 0.05. Results The overall prevalence of AUDs was 38.8%, with hazardous use, harmful use, and alcohol dependence accounting for 24.6%, 6.1%, and 8.1% of the total, respectively. In addition, 67.8% of the participants had medication adherence above 95%. Factors associated with alcohol use disorder were male AOR = 1.52; 95% CI (1.01, 2.30), cigarette smoking AOR = 2.384, 95% CI (1.183, 4.80), educational status AOR = 1.96, 95% CI (1.016, 3.764), and age 45–57 years AOR = 3.05, CI (1.587, 5.871). In present study, compared with social drinkers, harmful drinkers and alcohol dependents showed low medication adherence under 95% (AOR = 4.08 and AOR = 8.89, respectively). Conclusion The study reveals a high prevalence of alcohol use and dependence in PLWHA, underscoring the need for effective detection and intervention strategies particularly for males, cigarette smoker, and age between 54 and 75 years in healthcare and community settings. Alcohol use is strongly associated with poor adherence to antiretroviral therapy (ART). Individuals with hazardous alcohol use are four times more likely to have low adherence, while alcohol-dependent individuals are nearly nine times more likely to have low adherence compared to social drinkers.

Preparedness of Countries in Preventing Monkeypox in The Upcoming Mass Gathering Events: Status and Recommendations

A dangerous zoonotic illness call monkeypox (MPX) is endangering public health by spreading around the world. It is endemic to western and central Africa, particularly in the Democratic Republic of the Congo, where it was first reported in a human being. Concern is raised by the recent increase of incidence across several continents in non-endemic nations. Thus, there are 86746 confirmed cases as of 31 March 2023. MPX cases are significantly rising, with males seeing the highest rates of infection. Concise recommendations by World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) should be considered towards mass gatherings events(MG) to reduce the spreading of this disease. Football leagues and other sport matches, which attract a very large number of participants and audience, impose serious risks and public health consequences. Thus, with the beginning of vaccinations in July 2022, globally healthcare policymakers must make a difficult choice about the monkeypox vaccine at this point in the disease's progression. Since, CDC recommends that healthcare practitioners establish clinical guidelines that will help them recognize instances and give the appropriate monitoring, follow-up, and treatment updates. In the current global outbreak, gay, bisexual, and other men who have sex with men (MSM) are the most impacted demographic group. Therefore, it is essential to curb the spread of the monkeypox virus by increasing vaccine demand among local LGBTQIA+ community members and educating them about the value of immunization.

Necessity of Using Drains in Thyroid Surgery: Systematic Review and Meta-Analysis

Thyroid surgery, characterized by its high risk due to the vascular nature of the thyroid gland, often leads to significant postoperative bleeding. This study assesses the efficacy of using drains to prevent complications such as hematomas, seromas, and bleeding, and their impact on infection rates and hospitalization duration post-thyroidectomy. Following the PRISMA guidelines, a systematic search was conducted across PubMed, Embase, and the Cochrane Library, including randomized controlled trials and published prospective studies on patients undergoing thyroidectomy by November 15, 2023. The analysis focused on postoperative complications and the length of hospital stay as primary outcomes. Thirty-five studies with 4283 participants (2162 with drains and 2121 without) were analyzed. The meta-analysis showed no significant reduction in hematomas, bleeding, or seroma formation in the drain group. However, drain usage was correlated with a higher infection rate (odds ratio 3.31; 95% confidence interval [CI] 1.92-5.70, p&lt;0.001) and longer hospital stays (mean difference=1.38 days, 95% CI 1.00-1.76, p&lt;0.001). The employment of drains in thyroid surgery does not significantly impact the prevention of typical surgical complications but is linked to increased infection risks and extended hospitalization. These findings challenge the conventional practice of utilizing drains in thyroidectomy, highlighting the necessity for a tailored approach based on individual patient assessments.

Predicting leishmaniasis outbreaks in Brazil using machine learning models based on disease surveillance and meteorological data

Leishmaniasis poses a significant global health concern due to the absence of vaccines for humans and high infection rates in some countries. It is classified as a neglected tropical disease. In 2022, roughly 85% of global visceral leishmaniasis cases were reported in seven countries: Brazil, Ethiopia, India, Kenya, Somalia, South Sudan, and Sudan. Despite Brazil’s advanced medical capabilities compared to other affected regions, certain areas still witness a significant number of cases, prompting increased attention from researchers and raising concerns within the healthcare system. This study explores the application of artificial intelligence algorithms, particularly machine learning (ML) models to predict leishmaniasis outbreaks in selected Brazilian cities based on accumulated cases from 2007 to 2022, leveraging available meteorological data to enhance model accuracy. Our investigation concentrated on the following cities in Brazil: Fortaleza/CE, Teresina/PI, and São Luís/MA were chosen for the study of visceral leishmaniasis, whereas Manaus/AM, Rio Branco/AC, and Macapá/AP were selected for the study of tegumentary leishmaniasis, encompassing both cutaneous and mucocutaneous forms. Several Artificial Neural Network (ANN) architectures were evaluated, including a Simple Feedforward Neural Network (SFNN), a Deep Feedforward Neural Network (DFNN), and a Long Short-Term Memory (LSTM) recurrent neural network. Additionally, the Support Vector Machine (SVM), specifically the Support Vector Regression (SVR), was tested. Various metrics were used to identify the most effective models, in which the Root Mean Squared Error (RMSE) was the primary one. The results highlight the significance of meteorological data as a crucial factor in ML models for predicting leishmaniasis outbreaks, while also emphasizing the importance of fine-tuning these models to achieve greater accuracy. Finally, data and the pseudo-code of the models are accessible through an open repository to encourage further studies in this area.

Epidemiological Study of Respiratory Virus Infections in Pediatric Patients with Systemic Inflammatory Response Syndrome

Background: Respiratory infections are a common cause of systemic inflammatory response syndrome (SIRS) in pediatric patients. However, literature specifically addressing respiratory viruses that lead to SIRS or sepsis in children is limited, primarily consisting of case reports and lacking data for more comprehensive conclusions. Objectives: This study aims to investigate the relationship between respiratory viral infections and SIRS in children, focusing on virus detection rates, patient profiles, and the incidence of septic shock associated with different respiratory viruses. Methods: A retrospective analysis was conducted from January 2022 to December 2023 on hospitalized children diagnosed with respiratory infections and SIRS. Respiratory viruses were detected through qualitative PCR testing, and procalcitonin levels were measured using an enzyme-linked fluorescent immunoassay. Results: A total of 931 pediatric patients with SIRS were tested for respiratory viruses and/or other pathogens. Among these, 298 (32.0%) were positive for respiratory viruses, with 263 (28.2%) cases attributed solely to respiratory viruses. Human rhinovirus (HRV) had the highest infection rate at 37.3% (98/263), followed by human adenovirus (HAdV) at 24.3% (64/263). Seasonal distribution among the 263 SIRS cases associated with respiratory viral infections showed the highest incidence in spring (39.5%), followed by summer (25.5%), winter (17.9%), and autumn (17.1%). Septic shock rates were highest among cases of influenza A) FluA(, human metapneumovirus (hMP), and co-infections, with incidences of 27.8%, 18.2%, and 22.7%, respectively. There was significant variation in septic shock rates across different viral infections in pediatric patients (P &lt; 0.001). Conclusions: Many hospitalized children with respiratory viral infections develop SIRS, and a subset of these cases can progress to septic shock.

Highly Pathogenic H5N1 Influenza A Virus (IAV) in Blue-Winged Teal in the Mississippi Flyway Is Following the Historic Seasonal Pattern of Low-Pathogenicity IAV in Ducks.

Highly pathogenic H5N1 (HP H5N1) influenza A virus (IAV) has been detected annually in North American ducks since its introduction during 2021, but it is unknown if this virus will follow the same seasonal and geographic patterns that have been observed with low-pathogenicity (LP) IAV in this reservoir. We monitored blue-winged teal in the Mississippi flyway prior to the detection of HP H5N1 and during two post-introduction migration cycles from spring 2022 to spring 2024, testing birds for infection and antibodies to IAV nucleoprotein (NP), hemagglutinin subtype H5, and neuraminidase subtype N1. Antigens representing clade 2.3.4.4b HP H5 and LP North American H5 were used for hemagglutination inhibition (HI) and virus neutralization (VN) tests for H5 antibodies. Virologic results were consistent with historic seasonal and geographic patterns reported for LP IAV with peak infections occurring in pre-migration staging areas in Minnesota during fall 2022. However, the high prevalence of the H5 subtype was exceptional compared to historic prevalence estimates at this same site and for the Mississippi flyway. HP H5N1 was detected on wintering areas in Louisiana and Texas during the fall of that same year and this was followed by an increase in estimated antibody prevalence to NP, H5, and N1 with no HP H5N1 detections during the wintering or spring migration periods of 2022/2023. HP H5N1 was not detected in Minnesota during fall 2023 but was detected from a single bird in Louisiana. However, a similar increase in antibody prevalence was observed during the winter and spring period of 2023 and 2024. Over the two migration cycles, there was a temporal shift in observed prevalence and relative titers against the H5 antigens with a higher proportion of ducks testing positive to the 2.3.4.4b H5 antigen and higher relative titer to that antigen compared to the representative LP North American H5 antigen. The seasonal and geographic patterns observed appear to be driven by population immunity during the migration cycle. Results support an initial high infection rate of HP H5N1 in blue-winged teal in the Mississippi flyway followed by a high prevalence of antibodies to NP, H5, and N1. Although prevalence was much reduced in the second migration cycle following introduction, it is not known if this pattern will persist in the longer term or affect historic patterns of subtype diversity in this reservoir.

Ultra-High-Performance Liquid Chromatography-Orbitrap-MS-Based Untargeted Lipidomics Reveal Lipid Characteristics of a Clinical Strain of Mycoplasma bovis from Holstein Cow.

Mycoplasma bovis is a global concern for the cattle industry owing to its high rates of infection and resulting morbidity, but there are no reports on the lipid composition and metabolic pathways. This study examined the lipidomics of M. bovis to better investigate the biological characteristics of clinical isolates of M. bovis. The M. bovis strains NX114 and PG45, cultivated to log-phase, underwent untargeted lipidomics via ultra-high-performance liquid chromatography-mass spectrometry for differential analysis. Over 65 lipid types and 1476 lipid molecules were identified. We found that glycerophospholipids and sphingolipids constitute the predominant lipid components of M. bovis, with significant constituents of its cell membrane comprising ceramides, phosphatidylglycerols, sphingomyelins, triacylglycerols, hexosylceramides, ether-linked oxidized phosphatidylcholines, and oxidized phosphatidylglycerols. Secondly, 562 differentially expressed lipid molecules were identified, including 17 lipid subclasses (15 up-regulated and 2 down-regulated) with significant differences in relative content. These findings indicate that distinct M. bovis isolates contain structurally varied lipid molecules, with sphingomyelin, phosphatidylinositol, cardiolipin, and phosphatidylcholine being characteristic lipids. The glycerophospholipid metabolism pathway was identified as a key pathway regulating lipid metabolism in M. bovis by KEGG pathway enrichment analysis. The results indicated alterations in the lipid metabolism of M. bovis, offering insights into its pathogenic mechanisms.

Research progress of spike protein mutation of SARS-CoV-2 mutant strain and antibody development.

The coronavirus disease 2019 (COVID-19) is a respiratory disease with a very high infectious rate caused by the Severe Acute Respiratory Syndrome Coronavirus-2(SARS-CoV-2). Because SARS-CoV-2 is easy to mutate, the continuous emergence of SARS-CoV-2 variant strains not only enhances the infectivity of the SARS-CoV-2 but also brings great obstacles to the treatment of COVID-19. Neutralizing antibodies have achieved good results in the clinical application of the novel coronavirus pneumonia, which can be used for pre-infection protection and treatment of novel coronavirus patients. This review makes a detailed introduction to the mutation characteristics of SARS-CoV-2, focusing on the molecular mechanism of mutation affecting the infectivity of SARS-CoV-2, and the impact of mutation on monoclonal antibody therapy, providing scientific reference for the prevention of SARS-CoV-2 variant strains and the research and development of antibody drugs.

Dermatophytes in skin, nails, and hair among the patients attending the outpatient department of Zliten Medical Center.

Background: Dermatophytes represent the most prevalent infections in the human body, primarily affecting the scalp, skin, and nails. Dermatophytes are classified into three genera: Trichophyton, Epidermophyton, and Microsporum. Materials and methods: A cross-sectional study was conducted in 60 clinically suspected cases of dermatophytosis irrespective of gender and from all age groups, attending the outpatient department of dermatology and Venereology at Zliten Medical Center. The study was conducted from April 2023 to March 2024. A pro forma document incorporating a structured questionnaire was completed. Skin, nail, and scalp scrapings were collected All specimens underwent microscopic examination for dermatophytes using (KOH) preparation. Positive results were further confirmed through fungal culture. Results: Dermatophytes were isolated and identified in 23 (38.3%) patients. dermatophytes infect concentrated in the group younger &lt; 20 years at a rate of (69.6%) and was more predominant among males from females. tinea capitis and tinea ungiumm had the highest infection rate (43.5%) and (21.7%), respectively. The commonest isolate was Trichophyton violaceum. The highest percentage of dermatophytes infection was found in the scalp, at a rate of (47.8%). Conclusions: culture positive was (38.3%). females were less frequently affected than males, dermatophytes infect concentrated in the group younger &lt; 20 years at a rate of (69.6%), T. capitis followed by T. ungiuum as predominant clinical type of dermatophytes and the commonest isolate was Trichophyton violaceum. The highest percentage of dermatophytes infection was found in the scalp, at a rate of (47.8%).

Prevalence and antimicrobial susceptibility profile of uropathogens in dogs and cats with signs of urinary tract infection.

To determine the prevalence of uropathogens in dogs and cats with signs of urinary tract infection and to characterise their antimicrobial susceptibility. Urine samples from canine and feline patients with clinical signs of urinary tract infection were collected between September 2015 and December 2019 in Santiago, Chile. Bacterial identification and bacterial susceptibility profile was performed through biochemical and antimicrobial susceptibility tests. Four hundred sixty-six samples from dogs (37.7%) and 152 from cats (26.1%) showed bacterial growth. Positive samples were mainly from females (dogs: 52.8%; cats: 48.0%), with the highest infection rates in senior dogs (57.7%) and adult cats (45.4%). A single organism caused the infection in 78.2% of the cases, whereas the remaining 21.8% corresponded to a mixed infection. The most prevalent isolated pathogen in dogs and cats was Escherichia coli (42.6% and 49.7%, respectively). Staphylococcus spp. (15.6% and 14.6%), Enterococcus spp. (8.6% and 15.2%) and Proteus spp. (9.7% and 6.4%) were also commonly isolated. A total of 52.4% of Escherichia coli isolates were resistant to amoxicillin, 44.3% to amoxicillin/clavulanic acid, 40.0% to cephradine and 25.3% to ciprofloxacin. Regarding the other three uropathogens commonly isolated in this study, all of them showed a percentage of resistance to the antimicrobials analysed. In addition, 24.6% of multidrug resistance was detected in the E. coli isolates. Penicillin, cephalosporins and fluoroquinolones showed the lowest susceptibility levels. The observed high rates of resistance to commonly prescribed antimicrobials raise concerns for public health.

Chronic Strongyloides stercoralis infection in Fijian migrants to the UK.

Introduction. Strongyloides stercoralis, the human threadworm, is a parasitic nematode with global distribution, estimated to infect over 600 million people. Chronic infection is often asymptomatic, but hyperinfection and dissemination syndromes can occur in the immunosuppressed with high case fatality rates. Whilst strongyloidiasis is endemic in Fiji, its prevalence in Fijian migrant groups in the UK is unknown.Gap Statement. No previous studies have been conducted on the prevalence of Strongyloides and other gastrointestinal parasites (GIPs) in Fijian migrants to the UK.Aim. We conducted a cross-sectional study of the prevalence of GIPs in a Fijian migrant population.Methodology. Participants completed a questionnaire on residence, travel and clinical symptoms and were asked to provide a serum sample for S. stercoralis IgG ELISA, venous blood samples for eosinophil count and a faecal sample for charcoal culture, multiplex real-time PCR (rtPCR) and microscopy after formalin-ethyl acetate concentration. Sequencing was performed on pooled Strongyloides larvae for nuclear 18S rRNA hyper-variable regions (HVRs) I and IV.Results. A total of 250 participants (94% male) with median (range) age 37 (20-51) years entered the study, 15 (1-24) years since leaving Fiji. S. stercoralis IgG ELISA was positive in 87/248 (35.1 %) and 14/74 (18.9 %) had a GIP detected in faeces. This included 7/74 (9.5 %) with Strongyloides and 5/74 (6.8 %) with hookworms. Dermatological symptoms were more common in those with Strongyloides, and eosinophilia (>0.5×109 cells per litre) was present in 55.6% of those with positive S. stercoralis IgG. rtPCR was the most sensitive faecal diagnostic test for Strongyloides and hookworms in faeces. Sequences of nuclear 18S rRNA for HVRs I and IV confirmed the presence of S. stercoralis.Conclusion. This first cross-sectional study in Fijian migrants found a high rate of chronic infection with GIPs, particularly S. stercoralis. Faecal microscopy was insensitive compared to charcoal culture, rtPCR or serology, demonstrating the importance of specialist parasitological tests when investigating people with a suspected chronic infection. Our study highlights an overlooked burden of strongyloidiasis in the UK and has implications for screening and treatment programmes in Fiji and for migrants from Fiji.

High Rates of High-Risk HPV Anal Infection and Abnormal Cytology in a Cohort of Transgender People Assigned Male at Birth

Abstract Background Transgender people assigned male at birth (TG-AMAB) have higher rates of anal Human-Papillomaviruses (HPV) infection and anal cancer compared to cisgender populations. In a cohort of TG-AMAB in Washington DC, we determined prevalence and epidemiological factors associated with anal high-risk-HPV (HR-HPV) infection and cytological abnormalities. Methods In an urban academic-community clinic we recruited adults identifying as a gender different than their sex assigned at birth. Participants provided blood samples, anal swabs for HR-HPV and cytology, and completed surveys on sexual behaviors and use of gender-affirming hormones. Logistic regression was used to identify predictors of HR-HPV and abnormal cytology. Results Of 97 TG, 80 were AMAB, of whom 66% were living-with-HIV (LWH), 73% tested positive for any anal HR-HPV, and 48% had abnormal cytology. Only 24% recalled HPV immunization. While TG-AMAB LWH had increased risk of HPV16 infection (37% vs 8%, p=0.014), the prevalence of any HR-HPV (80% vs 62%, p=0.097) and abnormal cytology (56% vs 32%, p=0.085) was similarly elevated regardless of HIV status. Among TG-AMAB, estradiol use was not associated with increased odds of any HR-HPV or abnormal cytology (all p&amp;gt;0.05), however higher testosterone levels were associated with any HR-HPV (p=0.014). Age ≥35 years was associated with abnormal cytology in TG-AMAB (59% vs 34%, p=0.035). Conclusion TG-AMAB have high prevalence of any HR-HPV and abnormal cytology, regardless of age, HIV status, or hormone use. Given high risk for anal cancer and low rates of HPV vaccination, there is a pressing need for primary and secondary anal cancer prevention strategies targeting this population.

Prevalence of surgical site infections in a tertiary care teaching hospital in Goa, India: a cross-sectional study

Background: Surgical site infections (SSIs) are a major category of healthcare-associated infections (HAIs), particularly in surgical settings. They lead to extended hospital stays, increased morbidity, and financial burden. The study was conducted in the surgical wards of Goa medical college, a tertiary care hospital, to assess the prevalence of SSIs and identify the key bacterial pathogens and associated risk factors. Methods: A cross-sectional, prospective study design was employed, involving 378 patients aged over 18 years admitted for surgical procedures. Data collection included daily follow-up for signs of infection, identification of bacterial pathogens, and analysis of potential risk factors such as age, type of surgery, duration of postoperative drain, length of hospital stays, and wound classification. Statistical analyses were conducted using SPSS software, with significance set at p&lt;0.05. Results: The study identified an SSI prevalence of 12.69% among the participants, with Pseudomonas being the most common causative agent. Significant risk factors included extended postoperative drain duration, longer hospital stays, emergency surgical procedures, and surgeries involving contaminated or clean-contaminated wounds. Patients with prolonged postoperative drains had a markedly higher incidence of SSIs (63.63%). Conclusions: The findings reveal a considerable burden of SSIs in the studied setting, with high infection rates in patients undergoing prolonged drain usage, emergency surgeries, and surgeries on contaminated wounds. Strengthening infection prevention measures, particularly in high-risk cases, and enforcing strict adherence to hygiene and sterilization practices are critical. Enhanced infection surveillance programs and targeted interventions could help reduce SSI rates, improve patient outcomes, and minimize healthcare costs.

OUTCOME OF BURIED VERSUS EXPOSED KIRCHNER WIRES IN TERMS OF INFECTION IN FRACTURE OF PHALANGES AND METACARPAL BONE OF HAND

Kirschner wire (K-wire) fixation is a common technique for treating phalangeal and metacarpal fractures due to its cost-effectiveness and efficiency. However, the risk of infection associated with exposed K-wires remains a significant concern. This study aimed to compare infection rates and clinical outcomes in hand fractures treated with buried versus exposed K-wires. Objective: To assess and compare infection rates, clinical interventions, and patient comfort between buried and exposed K-wires in phalangeal and metacarpal fractures. Method: This study was conducted at Bolan Medical Complex Hospital, Quetta, with 110 patients divided into two groups: Group A (55 patients with buried K-wires) and Group B (55 patients with exposed K-wires). Infection rates were evaluated by categorizing infections as superficial or deep. Clinical outcomes, including the need for antibiotics, K-wire removal, and patient comfort, were assessed for both groups. Results: Group A (buried K-wires) had significantly lower infection rates, with 3.6% of patients developing superficial infections and 1.8% deep infections. In contrast, Group B (exposed K-wires) had higher infection rates, with 10.9% experiencing superficial infections and 5.4% deep infections. Additionally, exposed K-wire patients required more clinical interventions, including increased antibiotic use and K-wire removal. Conclusion: Buried K-wires provide a safer and more comfortable alternative for hand fracture management, with significantly lower infection rates and reduced need for further medical intervention compared to exposed K-wires. Therefore, the use of buried K-wires is preferable for reducing infection risk and enhancing patient comfort.

SARS-CoV-2 seroprevalence and associated factors among outpatient attendees at health facilities in different provinces in Chad

BackgroundChad with 7,698 confirmed cases of infection and 194 deaths since the beginning of the COVID-19 pandemic, is one of the African countries with the lowest reported case numbers. However, this figure likely underestimates the true spread of the virus due to the low rate of diagnosis. The high rate of asymptomatic infections reflects the reality of SARS-CoV-2 transmission in Chad. In this study, we estimated the seroprevalence and identified factors associated with SARS-CoV-2 infection.MethodsA cross-sectional study was conducted between September 2022 and February 2023. A total of 1,290 plasma samples were collected from outpatient attendees at Health Facilities located in 11 provinces of Chad and tested by ELISA method, for the presence of IgG antibodies to SARS-CoV2 nucleocapsid (N) protein. KoboToolbox was used to gather data from the participants and data were analyzed using STATA 16.ResultsThe overall seroprevalence was 83.0% [95% CI = 81.6%—85.5%], with variations between provinces, ranging from 99.2% [95% CI = 94.0%—100%] in Moundou (Southern Chad) to 46.8% [95% CI = 36.0% -57.1%] in Biltine (Eastern Chad). Factors associated with the seroprevalence included military occupation (OR = 0.37 CI [0.80–1.77] p = 0.025) and age group between 55–64 years (OR = 0.33 CI [0.15–0.72] p = 0.005). While, other factors, such as gender and age were not significantly associated with seroprevalence.ConclusionOur results indicated that, the seroprevalence of COVID-19 in Chad is among the highest in Sub-Saharan Africa. These estimates could guide the response and public health policy decisions, enhancing the management of future outbreaks involving respiratory pathogens.

Experimental arboviral infection of mosquito larvae: A novel approach for vector competence studies

Vector competence studies in mosquitoes present valuable opportunities to explore arboviral transmission and virus-vector interactions. However, oral infection studies in mosquitoes can be challenging. An alternative approach is to infect mosquitoes during their aquatic larval stage, resulting in the emergence of infected adults. To investigate the potential of this method, Culex pipiens biotype molestus larvae were infected with Usutu virus (USUV, Orthoflavivirus usutuense). For this purpose, larvae were exposed to USUV-infected mammalian and mosquito cell cultures for 24 h before being reared to adults. Subsequent analysis via RT-qPCR revealed that the Culex larvae successfully acquired USUV from the infected cells and exhibited high susceptibility to infection. Immediately after emergence, 32.10 % (26/81) of male and 41.03 % (16/39) of female mosquitoes tested positive for USUV RNA. Notably, females that were incubated for 15 days post-emergence demonstrated even higher infection rates, reaching 100.00 % (23/23). In addition, viral RNA and infectious particles were detected in some saliva samples, indicating the potential for transmission. This experimental infection of mosquito larvae thus offers the opportunity to produce infected adult mosquitoes for studies enhancing our understanding of virus-vector interactions, co-infections, and transmission routes. Such research contributes to better public health strategies addressing arboviral diseases.

Bacterial communities in Asecodes hispinarum (Hymenoptera: Eulophidae) and its host Brontispa longissima (Coleoptera: Chrysomelidae), with comparison of Wolbachia dominance.

The endoparasitoid Asecodes hispinarum (Bouček) (Hymenoptera: Eulophidae) serves as an effective biological control agent against Brontispa longissima (Gestro) (Coleoptera: Chrysomelidae), a notorious palm pest. Endosymbionts found in parasitoids and their hosts have attracted significant attention due to their substantial influence on biocontrol efficacy. In this study, we employed 16S rRNA sequencing, polymerase chain reaction, and fluorescence in situ hybridization to assess the symbiotic bacteria composition, diversity, phylogeny, and localization in A. hispinarum and its host B. longissima. Our findings showed significant differences in the richness, diversity, and composition of symbiotic bacteria among different life stages of B. longissima. Notably, the bacterial richness, diversity, and composition of A. hispinarum was similar to that of B. longissima. Firmicutes and Proteobacteria were the dominant phyla, while Wolbachia was the dominant genera across the parasitoid and host. It was discovered for the first time that Wolbachia was present in A. hispinarum with a high infection rate at ≥ 96.67%. Notably, the Wolbachia strain in A. hispinarum was placed in supergroup A, whereas it was categorized under supergroup B in B. longissima. Furthermore, Wolbachia is concentrated in the abdomen of A. hispinarum, with particularly high levels observed in the ovipositors of female adults. These findings highlight the composition and diversity of symbiotic bacteria in both A. hispinarum and its host B. longissima, providing a foundation for the development of population regulation strategies targeting B. longissima.

Strong association between high burden of soil-transmitted helminthiasis and household transmission among Malaysian Negritos, urging anthelmintic treatment beyond children

The Orang Asli (OA), Malaysia’s indigenous minority, continue to experience ongoing soil-transmitted helminth (STH) infections despite efforts including the Resettlement Programme (RPS). This study explores STH epidemiology and associated risks of moderate-to-heavy infections among 259 indigenous Negritos across four states in Peninsular Malaysia. Stool samples, anthropometrics, haemoglobin levels (finger-prick) and sociodemographic and environmental-sanitation factors via pretested questionnaires were collected. Parasitological examinations (direct faecal smear, formol-ether concentration, and Kato-Katz techniques) were thoroughly performed. The study revealed a 63.3% overall STH prevalence, with Trichuris trichiura (57.9%) being the most common, followed by Ascaris lumbricoides (35.5%) and hookworm (8.9%). Moderate-to-heavy infections were observed in 39.3% for T. trichiura and 48.9% for A. lumbricoides, with mixed infections of these two species being the most prevalent (50.6%). The risk for moderate-to-heavy infection increased significantly if other household members were infected (P < 0.001). Adults and adolescents also showed high infection rates, with no significant differences with children’s groups. These findings emphasize the need for anthelmintic treatment across all age groups and strategize local policies targeting older groups of the OA community to control ongoing transmission and reduce the STH burden and protect the future well-being of OA children, who deserve a healthier future.