High Prevalence Of Infection Research Articles

Fatal neural angiostrongyliasis in the Bolivian squirrel monkey (Saimiri boliviensis boliviensis) leading to defining Angiostrongylus cantonensis risk map at a zoo in Australia

Neural angiostrongyliasis (NA) is a parasitic disease caused by Angiostrongylus cantonensis (rat lungworm). This study presents a case of NA in a captive Bolivian squirrel monkey from a zoo in western Sydney, Australia. The objective was to identify the A. cantonensis cox1 haplotype responsible for the infection and compare its mitochondrial DNA (mtDNA) to known Australian mtDNA. An epidemiological investigation was conducted to assess the risk of infection, focusing on the resident rat population in the zoo. Methods involved trapping rats and collecting rat faeces for Angiostrongylus detection, speciation, and cox1 haplotype confirmation. Various techniques were employed, including necropsy, morphological examination, and molecular methods such as ITS-2 qPCR, cox1 sequencing, and ITS-2 metabarcoding. Cluster analysis of rat faeces distribution and Angiostrongylus detection utilised an equal sampling effort (ESE) approach. Gastropods were collected throughout the study for Angiostrongylus surveillance using a hypersensitive qPCR assay. Results revealed significant clustering of rat faeces near exhibits with fresh food provision and absence of predators. Angiostrongylus-positive faeces were uniformly distributed across the zoo property. Mitochondrial DNA analysis confirmed the presence of the Ac13 haplotype of A. cantonensis in the monkey. Morphology, ITS-2 metabarcoding and partial cox1 sequencing detected only A. cantonensis, with the Ac13 cox1 haplotype predominating. A high prevalence of infection (64%, 9/14) was found in brown rats, with quantification of larvae indicating high shedding rates. Co-infections with both Ac13 and local SYD.1 A. cantonensis cox1 haplotypes were observed. Only three gastropods (all of which were Angiostrongylus-negative) were found in the survey. To minimise the risk of exposure for susceptible species, targeted rodent control was implemented in areas with higher exposure risk. A potential strategy (which requires further exploration) to consider for future zoo design was suggested. This study provides insights into the epidemiology and genetic diversity of A. cantonensis in Australia, emphasising the importance of control measures to prevent future outbreaks.

Multidrug-resistant Gram-negative bacterial infections and associated factors in a Kenyan intensive care unit: a cross-sectional study

BackgroundPatients admitted to intensive care units (ICU) are at risk of Gram-negative bacteria (GNB) infections, especially those caused by multidrug-resistant (MDR) isolates, increasing morbidity, mortality, and healthcare costs. However, epidemiological surveillance data on MDR bacteria to inform infection prevention and control (IPCs) interventions is limited in our study setting. Here we assessed the prevalence and factors associated with GNB infections in ICU- patients admitted in our study setting.MethodsThis was a hospital-based cross-sectional study among patients admitted to ICU at the Nairobi West Hospital, Kenya, between January and October 2022. Altogether, we recruited 162 patients, excluding those hospitalized for less than 48 h and declining consent, and collected demographics and clinical data by case report form. Blood, wound and throat swab, ascetic tap, stool, urine, tracheal aspirate, and sputum samples were collected cultured. Isolates identity and antimicrobial susceptibility were elucidated using the BD Phoenix system.ResultsThe prevalence of GNB infections was 55.6%, predominated by urinary tract infections (UTIs). We recovered 13 GNB types, with Escherichia coli (33.3%) and Klebsiella pneumoniae (31.1%) as the most common isolates. Factors associated with GNB infections were a history of antibiotic use (aOR = 4.23, p = 0.001), nasogastric tube use (NGT, aOR = 3.04, p = 0.013), respiratory tract (RT, aOR = 5.3, p = 0.005) and cardiovascular (CV, aOR = 5.7, p = 0.024) conditions. 92% of the isolates were MDR,predominantly Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa.ConclusionWe report a high prevalence of MDR-GNB infections, predominated by UTI, in ICU, whereby patients with a history of antibiotic use, using the NGT, and having RT and CV conditions were at increased risk. To improve the management of ICU-admitted patients, continuous education, training, monitoring, evaluation and feedback on infection prevention and control are warranted in our study setting.

Specialized active leprosy search strategies in an endemic area of the Brazilian Amazon identifies a hypermutated Mycobacterium leprae strain causing primary drug resistance.

Leprosy, an infectious disease caused by Mycobacterium leprae, remains a public health concern in endemic countries, particularly in Brazil. In this study, we conducted an active surveillance campaign in the hyperendemic city of Castanhal in the northeastern part of the state of Pará using clinical signs and symptoms combined with serological and molecular tools to diagnose new cases and to identify drug resistance of circulating M. leprae strains and their distribution in the community. During an active surveillance of one week, we enrolled 318 individuals using three different strategies to enroll subjects for this study: (i) an active survey of previously treated cases from 2006 to 2016 found in the Brazil National Notifiable Disease Information System database (n = 23) and their healthy household contacts (HHC) (n = 57); (ii) an active survey of school children (SC) from two primary public schools in low-income neighborhoods (n = 178), followed by visits to the houses of these newly diagnosed SC (n = 7) to examine their HHC (n = 34) where we diagnosed additional new cases (n = 6); (iii) and those people who spontaneously presented themselves to our team or the local health center with clinical signs and/or symptoms of leprosy (n = 6) with subsequent follow-up of their HHC when the case was confirmed (n = 20) where we diagnosed two additional cases (n = 2). Individuals received a dermato-neurological examination, 5 ml of peripheral blood was collected to assess the anti-PGL-I titer by ELISA and intradermal earlobe skin scrapings were taken from HHC and cases for amplification of the M. leprae RLEP region by qPCR. Anti-PGL-I positivity was highest in the new leprosy case group (52%) followed by the treated group (40.9%), HHC (40%) and lowest in SC (24.6%). RLEP qPCR from SSS was performed on 124 individuals, 22 in treated cases, 24 in newly diagnosed leprosy cases, and 78 in HHC. We detected 29.0% (36/124) positivity overall in this sample set. The positivity in treated cases was 31.8% (7/22), while in newly diagnosed leprosy cases the number of positives were higher, 45.8% (11/23) and lower in HHC at 23.7% (18/76). Whole genome sequencing of M. leprae from biopsies of three infected individuals from one extended family revealed a hypermutated M. leprae strain in an unusual case of primary drug resistance while the other two strains were drug sensitive. This study represents the extent of leprosy in an active surveillance campaign during a single week in the city of Castanhal, a city that we have previously surveyed several times during the past ten years. Our results indicate the continuing high transmission of leprosy that includes fairly high rates of new cases detected in children indicating recent spread by multiple foci of infection in the community. An unusual case of a hypermutated M. leprae strain in a case of primary drug resistance was discovered. It also revealed a high hidden prevalence of overt disease and subclinical infection that remains a challenge for correct clinical diagnosis by signs and symptoms that may be aided using adjunct laboratory tests, such as RLEP qPCR and anti-PGL-I serology.

Monkeypox Patients Living with HIV: A Systematic Review and Meta-Analysis of Geographic and Temporal Variations.

This index meta-analysis estimated the pooled prevalence of human immunodeficiency virus (HIV) among individuals with monkeypox (mpox) globally. We searched seven databases: PubMed, Scopus, Web of Science, EMBASE, ProQuest, EBSCOHost, and Cochrane, for human studies published in English till 4 January 2023, as per International Prospective Register of Systematic Reviews (PROSPERO) registration protocol (CRD42022383275). A random effects regression model was used to estimate the pooled prevalence owing to high heterogeneity. The risk of bias in the included studies was assessed using the National Heart, Lung, and Blood Institute (NHLBI) quality assessment tool. The systematic search yielded 677 articles; finally, 32 studies were found eligible for systematic review and 29 studies for meta-analysis. The pooled prevalence of HIV infection was 41% (95% confidence interval [CI], 35-48). All studies were rated as fair or good quality. Studies from Europe and North America reported a high prevalence of HIV infection among individuals with mpox- 41% (95% CI 33-49) and 52% (95% CI 28-76), respectively, while studies from Nigeria, Africa reported a relatively low prevalence of HIV infection of 21% (95% CI 15-26). A history of sexual orientation and sexual partners in the last 21 days must be taken from individuals with mpox to identify the potential source and contacts for quarantining and testing them.

Seroprevalence of Vibrio cholerae in Adults, Haiti, 2017.

In Haiti in 2017, the prevalence of serum vibriocidal antibody titers against Vibrio cholerae serogroup O1 among adults was 12.4% in Cerca-la-Source and 9.54% in Mirebalais, suggesting a high recent prevalence of infection. Improved surveillance programs to monitor cholera and guide public health interventions in Haiti are necessary.

Prevalence and risk factors of COVID-19 infection, mortality, and post-infection lung fibrosis in patients with type 2 diabetes: a cross-sectional study.

The clinical course of coronavirus disease 2019 (COVID-19) infection is often aggressive, with unfavorable outcomes for those with comorbidities such as type 2 diabetes mellitus (T2DM). We aimed to assess the prevalence and risk factors of COVID-19 infection, mortality, and post-infection lung fibrosis in patients with COVID-19 infection who had T2DM. In this cross-sectional study, we included adult patients with T2DM who attended an endocrinology clinic and underwent testing for COVID-19 infection. Among 1039 included patients, the mean age was 59.5 ± 11.0 years and 429 (41.3%) were men. Overall, 87.1% of patients had received COVID-19 vaccination and 32.3% had confirmed COVID-19 infection. The COVID-19-related mortality was 3.0% and rate of post-COVID-19 lung fibrosis was 19.1%. Vaccination was associated with lower COVID-19-related mortality (odds ratio [OR]: 0.03, 95% confidence interval [CI]: 0.0-0.3) and post-COVID-19 lung fibrosis risk (OR: 0.3, 95% CI: 0.1-0.9). Patients with T2DM exhibited a high prevalence of COVID-19 infection and associated mortality. However, COVID-19 vaccines were beneficial in reducing the risks of COVID-19-related mortality and post-infection lung fibrosis in these patients. COVID-19 vaccines and boosters are recommended for patients with T2DM. Further studies involving larger study populations are necessary to validate these findings.

High Specificity of HPV Cell-Free DNA Tests in Persons With HIV for the Detection of HPV-Related Cancer.

Persons with HIV (PWH) experience high rates of human papillomavirus (HPV)-associated cancers compared with the general population. Plasma HPV cell-free DNA (cfDNA) tests are sensitive in patients with known HPV-associated cancers. It is not known whether these tests can screen for invasive cancers in populations with high burdens of nonmalignant HPV disease such as PWH. It was not known whether HPV infection and/or noninvasive anal high-grade squamous intraepithelial lesions (HSIL) alone in this population would result in detectable HPV cfDNA, which would result in a high number of false positives if HPV cfDNA is used to screen for invasive cancers. We conducted a prospective study of PWH in 2 cohorts: 20 without anal HSIL and 20 with anal HSIL. We tested anal and vaginal swabs for HPV infection, and HPV genotyped the biopsies of anal HSIL. Finally, we performed HPV cfDNA droplet digital polymerase chain reaction to test for HPV16/18/33 from plasma samples. In the combined cohorts, the median age was 56 years, 12.5% were cisgender women, and none had detectable HIV. In total, 84.6% had prevalent anovaginal HPV infection, including 10 participants with HPV16, 13 with HPV18, and 2 with HPV33 infections. Five and 2 participants had HPV16 and HPV33 detected in anal HSIL, respectively. Despite the high prevalence of HPV infection and anal HSIL, no participant had HPV16/18/33 detectable cfDNA by droplet digital polymerase chain reaction. These results provide a strong rationale for investigating the use of HPV cfDNA in a screening setting for suspected HPV-related invasive cancers in PWH.

Prevalence, molecular characterization of integrons and its associated gene cassettes in Klebsiella pneumoniae and K. oxytoca recovered from diverse environmental matrices

The high prevalence of infections arising from Klebsiella species is related to their ability to acquire and disseminate exogenous genes associated with mobile genetic elements such as integrons. We assessed the prevalence, diversity, and associated gene cassettes (GCs) of integrons in Klebsiella species. The isolates recovered from wastewater and hospital effluents, rivers, and animal droppings were identified using the conventional Polymerase Chain Reaction (PCR) with primers targeting the gryA, pehX, and 16S–23S genes. The antimicrobial resistance profile and the Extended-Spectrum and Metallo β-lactamases production were carried out using standard microbiological techniques. PCR, DNA sequencing analyses, and Restriction Fragment Length Polymorphism were used to characterize the integrons and their associated GCs. Furthermore, the genotypic relationships between the different isolated K. pneumoniae were determined using Enterobacterial Repetitive Intergenic Consensus (ERIC)-PCR. About 98% (51/52) of the confirmed isolates harboured an integrase gene, with 80% intI1, while the remaining 20% concurrently harboured intI1 and intI2, with no intI3 observed. About 78% (40/51) of the bacterial strains were positive for a promoter, the P2R2, investigated, while 80% (41/51) harboured at least one of the qacEΔ1 and sul1. Three different GCs arrangements identified were aac(6′)-Ib, aadA1-dfrA1, and dfrA1-sat2. At a similarity index of 60%, the ERIC-PCR fingerprints generated were categorized into nine clusters. Our study is the first to reveal the features of integrons in Klebsiella spp. recovered from environmental sources in the Eastern Cape Province, South Africa. We conclude that the organisms' sources are repositories of integrons harbouring various gene cassettes, which can be readily mobilized to other microorganisms in similar or varied niches.

Dissemination of Class A Cephalosporinases and Class D Carbapenemases in Escherichia coli Isolates From a Tertiary Hospital in Sudan.

Introduction The high prevalence of urinary tract infections (UTIs) and rising resistance to beta-lactam antibiotics, which is a global therapeutic concern, are caused by Escherichia coli (E. coli) extended-spectrum beta-lactamases (ESBLs) producers. It is unclear how E. coli that produces ESBLs spreads throughout Gezira state,Sudan. The study aimed to evaluate the dissemination of class A and class D resistance genes amongE. coliand to recognize the antibacterial activity of the locally used cephalosporins and carbapenems. Methods One hundred and fifteen isolates of uropathogenicE. coliwere collected from patients who attended a tertiary hospital. The isolates were identified using colony morphology, gram staining, and biochemical tests and checked for 16S rRNA using PCR. The multidrug-resistant (MDR) testing was conducted using agar disk diffusion. Finally, the class A and D resistance genes were analyzed by multiplex PCR. Results The study enrolled 200 patients with UTIs.E. coliisolates were found in 115 (57.5%) urine specimens examined, and 60 (52.2%) of them produced resistance to most locally used antibiotics. The antibiotic resistance pattern was higher against cefepime (100%), ceftizoxime (90%), cefuroxime (81.7%), and ceftriaxone (81.7%) and had lower activity against meropenem (13.3%). The genotypic characterization of class A cephalosporinases was 85% forblaCTX-M, 70% forblaSHV, and 33.3% forblaTEM, while for class D carbapenemases, it was 10% for bothblaOXA-23andblaOXA-51. Conclusion The considerable antibiotic resistance to the cephalosporins and meropenem and the increased predominance of theblaCTX-MandblaSHVgenes are serious concerns for the health authorities. Meropenem could still be used as the drug of choice for ESBL-producing E. coli.

Enhancement of Tuberculosis Detection and Prevention in HIV-Infected Patients

Tuberculosis incidence and HIV infection incidence in the regions of the Russian Federation are declining, but the proportion of HIV positive people among the entire cohort of tuberculosis patients is clearly growing.The objective: to determine causes for increasing proportion of HIV infected people among tuberculosis patients and to provide additional recommendations for enhancement of tuberculosis detection in HIV infected patients. as well as prevention of its transmission.Subjects and Methods. The cohort of new tuberculosis patients with concurrent HIV infection (TB/HIV coinfection) in the Russian Federation region with a high prevalence of HIV infection was studied based personal medical records of patients for the first 6 months of 2022 (682 cases totally).Results. The cohort of patients with TB/HIV co-infection belonged to socially vulnerable population. Among them, the parenteral route of HIV infection transmission still prevails, while in the whole country, among new HIV patients, the sexual (heterosexual) route of transmission already prevails. The majority of patients with TB/HIV co-infection, who had been infected with HIV for more than 5 years by the time tuberculosis was detected, were not registered with the Center for AIDS Prevention and Control and accordingly received no antiretroviral therapy. In most cases, HIV-infected patients sought medical care in general medical services when they developed symptoms of tuberculosis, however they referred for help when the disease was advanced. When assessing effectiveness of tuberculosis treatment, the specific parameters of tuberculosis course in HIV-infected patients with compromised immunity have not been taken into account.

Prevalence and Factors Associated with Syphilis among Mothers with Missed Opportunities for Antenatal Syphilis Testing in Rural Western Uganda: A Cross-Sectional Study.

Early prenatal syphilis testing and treatment are essential preventative measures for maternal syphilis and associated adverse pregnancy outcomes of pregnancy; however, data shows that two-thirds of all cases are missed among women who visit prenatal care center at least once but are not tested for syphilis. This study determined the prevalence and factors associated with syphilis infection among mothers with missed opportunities for antenatal syphilis testing in rural western Uganda delivered at Fort Portal Regional Referral Hospital (FRRH). A cross-sectional study was done during the period from April 2022 to June 2022. A total of 124 participants had been recruited consecutively from postnatal ward of FRRH. Pretested questionnaires were used to obtain information on data required for analysis. Venous blood sampling (2 ml taken from the forearm using anticoagulant free vacutainer) was done for all mothers who missed opportunity for prenatal syphilis testing using both RPR and TPHA. Descriptive statistics followed by binary logistic regression analysis was done using SPSS version 22.0. The prevalence of syphilis infection was 27 (21.8%). After adjusted analysis, having more than one sexual partners in the past one year was associated with higher odds of syphilis infection (aOR = 24.922, 95% CI: 4.462-139.201, p < 0.001), and staying with the partner was found to be associated with lower odds of syphilis infection (aOR = 0.213, 95% CI: 0.040-1.142, p = 0.050). The study identified high prevalence of syphilis infection among mothers with missed opportunities for antenatal syphilis testing, and this was positively associated with having more than one sexual partners in the past one year and negatively associated with not staying with partner.

The caecal microbiota promotes the acute inflammatory response and the loss of the intestinal barrier integrity during severe Eimeria tenella infection.

Coccidiosis, a disease caused by intestinal apicomplexan parasites Eimeria, is a threat to poultry production. Eimeria tenella is one of the most pathogenic species, frequently causing a high prevalence of opportunistic infections. The objective of this study is to investigate the role of the microbiota in the pathogenesis of severe Eimeria tenella infection. We have previously shown that microbiota can promote parasite development. To study the effect of the microbiota on the pathogenesis of this infection, we used an experimental condition (inoculum of 10 000 oocysts E. tenella INRAE) in which the parasite load is similar between germ-free and conventional broilers at 7 days post-infection (pi). Thirteen conventional and 24 germ-free chickens were infected. Among this latter group, 12 remained germ-free and 12 received a microbiota from conventional healthy chickens at 4 days pi. Caeca and spleens were collected at 7 days pi. Our results demonstrated caecal lesions and epithelium damage in conventional chickens at 7 days pi but not in germ-free infected chickens. Administration of conventional microbiota to germ-free chickens partially restored these deleterious effects. At day 7 pi, both infected conventional and germ-free chickens exhibited increased gene expression of inflammatory mediators, including IL15, IFNγ, TNFα and the anti-inflammatory mediator SOCS1, whereas the inflammatory mediators CXCLi2, CCL20, IL18, CSF1, NOS2, PTGS2, IL1β, IL6, the receptor CCR2, and the anti-inflammatory mediators TGFβ1 and IL10 were upregulated only in infected conventional chickens. Notably, the IL18, PTGS2 gene expression was significantly higher in the infected conventional group. Overall, the inflammatory response enhanced by the microbiota might be in part responsible for higher lesion scores. Epithelial tight junction protein gene expression analysis revealed a significant upregulation of CLDN1 with the infection and microbiota, indicating a potential loss of the intestinal barrier integrity. These observations imply that, during E. tenella infection, the caecal microbiota could trigger an acute inflammatory response, resulting in a loss of intestinal integrity. Increase in bacterial translocation can then lead to the likelihood of opportunistic infections. Hence, modulating the microbiota may offer a promising strategy for improving poultry gut health and limiting caecal coccidiosis.

Comparison of glass and digital slides for cervical cytopathology screening and interpretation.

Cervical cancer is the second most common form of cancer and a leading cause of premature death among women aged 15 to 44 worldwide. In Brazil, there is a high prevalence of infection by the human papillomavirus - HPV. Digital pathology optimizes time and space for reading cervicovaginal cytology slides. We evaluated the feasibility of using whole slide images (WSI) for the routine interpretation of cytology exams. A total of 99 cases of vaginal cytology were selected from a reference laboratory in Northeastern Brazil. Three cytotechnicians participated in the study. Cellular atypia was the one that most presented concordance values. Two observers almost perfectly agreed (k = 0.86 and k = 0.84, respectively) on the negative diagnoses. The performance of the evaluators for NILM (negative for intraepithelial lesion and malignancy) showed high reproducibility and sensitivity in the digital slides, mainly between evaluators A and C. In contrast, the microbiology group showed disagreement between the diagnoses by digital slides and the standard- gold. The concordance between the digital diagnoses and the gold standard for ASCUS was 89%. In the inflammatory category, Spearman's test showed similar results between raters A, B, and C (rs = 0.47, rs = 0.41, and rs = 0.47, respectively). This study reports the diagnostic validation using digital slides in view of the need to optimize the cytology visualization process. Our experience shows good diagnostic agreement between digital and optical microscopy in several analyzed categories, but mainly in relation to cellular atypia and inflammatory processes.

Prevalence, drug-susceptibility pattern and associated factors of Mycobacterium tuberculosis infection among prisoners in western Arsi zonal prisons, Oromia, South West Ethiopia

ObjectivesEach year, tuberculosis (TB) in prisons is a major worldwide health concern that results in millions of diseases. It is particularly prevalent in low socio-economic countries like Ethiopia because of the poverty, overcrowding, starvation, lack of access to basic healthcare services, and high prevalence of HIV infection in these countries. MethodsA cross-sectional study with 259 prisoners was carried out in the western Arsi zonal prison from November to January 2021. The sputum samples were taken from suspected TB patients and evaluated using the Gene Xpert Mycobacterium tuberculosis/rifampcine test. Line probe assay was used to assess the molecular drug susceptibility of isolates from positive sputum. A bivariate and multivariate logistic regression was analyzed using SPSS version 24 packages. Odds ratio (OR) and corresponding 95% CI were used to quantify the degrees of association between target potential risk factors and Mycobacterium tuberculosis positivity. P-value of less than 0.05 was considered statistically significant. ResultsThe prevalence of undiagnosed pulmonary TB (PTB) verified positive cases was 5.4% (95% CI 2.7, 8.5) out of 259 research participants that were recruited in this study. One (0.38%) occurrence of mono-drug resistance to isoniazid was found among them. In this study, variables that were significantly linked with PTB positive were age ≥30 years, smoking (adjusted OR [AOR] = 0.087, 95% CI = 0.01-0.93, P = 0.043), body mass index 18.5 kg/m2, cough duration 4 weeks (AOR = 0.03, 95% CI = 0.1-0.13 P = 0.001), and coughing before incarceration (AOR = 6.2, 95% CI = 3.6-10.59, P = 0.004). ConclusionIn West Arsi zonal prisons, PTB and mono-drug resistance for isoniazid were found to be more common than in the general population.

High prevalence of Helicobacter pylori mixed infections identified by multilocus sequence typing in Ningbo, China.

This study used multilocus sequence typing (MLST) to investigate the prevalence of Helicobacter pylori (H. pylori) mixed infections and H. pylori mixed infections involving unrelated strains; and determined the phylogeographic groups of H. pylori recovered from patients in Ningbo, China. A total of 156 H. pylori isolates were obtained from a convenience sample of 33 patients with culture-positive H. pylori infection. MLST was used to classify 150 H. pylori clinical isolates and 12 methodological control strains (6 clinical isolates and 6 strains of American Type Culture Collection H. pylori) into 43 and 12 sequence types (STs), respectively. In this study, 246 new alleles and 53 new STs were identified by MLST. The prevalence of mixed infections was 41% (11/27). The prevalence of H. pylori mixed infections involving unrelated strains was 46% (5/11) and the prevalence of H. pylori mixed infections involving completely unrelated strains (strains with all 7 housekeeping genes different) was 36% (4/11). A phylogenetic tree was created to determine the evolutionary relationships between different strains. The STs in this study were clustered within the hspEAsia subgroup (98%) and hpEurope group (2%). H. pylori mixed infections were common in Ningbo, China. The H. pylori isolates belonging to the hpEurope group were recovered from three different biopsy samples in a native Chinese patient. Most of H. pylori strains colonizing the antrum, corpus, and duodenum bulb were homologous.

Incidence of Coronavirus Disease 2019 (COVID-19) among healthcare workers during the first and second wave in the Democratic Republic of the Congo: a descriptive study

BackgroundHealthcare workers (HCWs) are at the frontline of response to the COVID-19 pandemic. Protecting HCWs is of paramount importance to the World Health Organization (WHO). Outbreak investigation which is based on a critical assessment of core components of infection prevention and control (IPC) programs allows for the identification of different sources of exposure to the COVID-19 virus and for informing additional IPC recommendations. To date, the Democratic Republic of the Congo (DRC) is categorized as a high-risk country due to weaknesses in the health system, low capacity for diagnosis, socioeconomic characteristics of the population, and insufficient vaccination coverage.AimTo investigate the burden of COVID-19 among HCWs and identification of IPC gaps to reduce HCWs-associated infection at different levels (facilities, communities, and points of entry) following the WHO strategy for IPC program implementation during the first to the third wave of the pandemic.MethodsA retrospective cohort study was conducted using the DRC National Department of Health (NDOH) database and WHO questionnaire suspected and confirmed COVID-19 cases among HCWs from 10/03/2020 to 22/06/2021. The investigation was conducted by a trained IPC response team to identify the sources of the exposures. The questionnaire included demographics, profession, types of interaction between HCWs and patients, and community-based questions regarding family members and other behaviors. These variables were assessed using a multimodal strategy framework. Knowledge and adherence to IPC gaps using WHO guidelines were performed for each COVID-19-positive or suspected HCW. WHO rapid Scorecard dashboard was conducted for evaluating healthcare facilities (HCFs) performance during the COVID-19 pandemic.ResultsCumulative incidence of positive HCWs was 809 /35,898(2.2%) from the first to the third wave of COVID-19 among 6 provinces of DRC. The distribution of the HCWs infected by COVID-19 was predominated by nurses (42%), doctors (27%), biologists (8%), environmental health practitioners (5%), interns (3%), and other categories (15%). Other categories included nutritionists, physiotherapists, midwives, pharmacists, and paramedics. The investigation revealed that about 32% of HCWs were infected from household contacts, 11% were infected by HCFs, 35% were infected in the community and 22% were infected from unknown exposures. The mean score of IPC performance for all evaluated HCFs was 27/42(64%). This shows that IPC performance was moderate. Lower or minimal performance was noted in the implementation of the IPC program at the national and facility level, triage and screening, isolation handwashing and multimodal strategies of hand hygiene, PPE availability, and rationale, waste segregation, waste disposal, sterilization, and training of HCWs.ConclusionThis study revealed that the prevalence of HCWs who tested positive for the COVID-19 virus was high among frontline healthcare workers from 6 provinces of DRC. A high prevalence of nosocomial infection was correlated with insufficient IPC adherence in the context of COVID-19. Strategies to strengthen IPC capacity building and provide HCWs with sufficient PPE stocks and budgets may improve IPC performance in the Democratic Republic of the Congo. This will further allow for adherence to WHO recommendations for successful program implementation to minimize COVID-19 transmission in HCFs, communities, and public gatherings. And this may be transferable to other infectious diseases.

Evaluating the Prevalence of Malaria Parasite Infection among Adults in Wetlands Using Nested PCR and High Resolution Melting Analysis

Background: Wetlands serve as breeding grounds for mosquitoes, the vector of malaria Plasmodium. Effective detection of Plasmodium infection requires a very sensitive method.&#x0D; Aim: The aim of the present study was to evaluate the prevalence of malaria parasite infection in Sagbama LGA, Bayelsa State using nested PCR and high resolution melting analysis (HRMA) technique in comparison with microscopy.&#x0D; Methods: A community based cross sectional study design was employed to randomly select 206 study participants. DNA was extracted from 200 ⴗl of whole blood of each participant and a set of primers was used to target and amplify the 18S rRNA gene of Plasmodium falciparum in both molecular methods.&#x0D; Result: The prevalence of Plasmodium falciparum infection by microscopy was 33.01% (5.8% asymptomatic, 17% mild and 10.2% severe malaria).The prevalence of malaria parasite infection by nested genomic PCR was 71.36% (asymptomatic, 42.20% mild, 18.93%and severe malaria, 10.19%). Prevalence of malaria parasite infection by high resolution melting analysis 92.71% (asymptomatic, 63.59%, mild, 18.93% and severe, 10.19%). All the study participants that were positive for microscopy and nested genomic PCR were also positive for high resolution melting analysis. There were 59.71% and 21.36% false negatives by microscopy and nested PCR respectively. McNemar`s test for pair-wise performance comparisons among the different methods was statistically significant (p &lt; 0.001). High parasite density (19927 ± 749 parasites/µl blood) and hyper parasite density (103667 ± 5214 parasites/ⴗl of blood) were found among asymptomatic and severe malaria subjects (P &lt; 0.000).&#x0D; Conclusion: In conclusion, a high malaria parasite infection prevalence of 92.72% was found in Sagbama LGA. This requires urgent attention especially asymptomatic malaria. HRMA was the most sensitive molecular method and is therefore recommended for future molecular detection of malaria infection.

Prevalence of reproductive tract infections in rural areas studied by the community based intervention programme

In developing countries Reproductive tract infections are very important public health problem. RTI’s that are not sexually transmitted are considered even more common.2 These infections present major health, social and economic problems 3,4 A baseline study done among married young women in 1996–97 found a high prevalence of reproductive tract infections.14 In response to the findings of this study, CHAD has adopted a comprehensive community based interventional strategy to reduce the burden of RTIs. Health education providing information on RTI’s is provided to adolescents in school health programmes, out -Of-school youth and to young married couples. Regular mass education campaigns are held in the villages. The health team offers counseling on risk reduction both at the hospital and during home visits. In an attempt to expand health care services for early diagnosis and prompt treatment to the community level. Aim: To study the effect of a community - based intervention on the prevalence of reproductive tract infections in the community. Results: The total number of married women between the ages 15 - 25 years in Durgapur region from Gopalpur, Rajbandh and Panagargh villages were around 1740 participants.

Epidemiological characterization of viral etiological agents of the central nervous system infections among hospitalized patients in Egypt between 2016 and 2019

Viral infections of the central nervous system (CNS) are common worldwide and result in considerable morbidity and mortality associated with neurologic illness. Until now, there have been no epidemiologic data regarding viruses causing aseptic meningitis, encephalitis, and CNS infections in Egypt. We investigated 1735 archived cerebrospinal fluid samples collected from Egyptian patients between 2016 and 2019 and performed molecular characterization for infection for12 different viruses: herpes simplex viruses 1 and 2 (HSV-1 and HSV-2), varicella-zoster virus (VZV), Epstein–Barr virus (EBV), cytomegalovirus (CMV), human herpesviruses 6 and 7 (HHV-6 and HHV-7), human enteroviruses (HEVs), human parechovirus (HPeV), parvovirus B19 (B19V), adenovirus (AdV), and mumps virus (MuV). All included samples were negative for bacterial infection. Our results indicated a relatively high prevalence of viral infection, with HEVs being the most prevalent viruses, followed by HSV-1, EBV, and then HSV-2. The highest prevalence was among male patients, peaking during the summer. Data obtained from this study will contribute to improving the clinical management of viral infections of the CNS in Egypt.

Prevalence of Human Papillomavirus (HPV) Genotypes among Women During 2015-2020 in Mashhad, Iran.

Cervical cancer is the fourth most common cancer in women, and human papillomavirus (HPV) is the leading cause of cervical cancer. Cervical cancer screening and HPV vaccination are important in the incidence of cervical cancer. This study was performed on Liquid Base Cytology (LBC) samples of 1214 women in Mashhad who were referred for cervical cancer screening in 2015-2020. Samples were examined by Single-Step PCR and Reverse Line Blot for HPV genotyping. 386 women (31.8%) were HPV PCR positive. HPV genotyping of 277 samples showed that HPV 31 (3%), 16 (2.5%), 51 (2.2%), 18 (2%), and 66 (1.8%) were the most prevalent high-risk HPV (hrHPV) genotypes. Among low-risk HPV (lrHPV) genotypes, HPV 6 (9.2%), 53 (4.7%), and 42 (2.8%) were the most common genotypes. The range of multiple infections varied between two to eight genotypes and the prevalence of multiple HPV infections (12.4%) was higher than single infections (10.4%). For women with single HPV infections, HPV 31 and 66 were equally the most common hrHPV genotypes, followed by HPV 16 and 39. In women with multiple HPV infections, HPV 31 was the most common hrHPV genotype, followed by HPV 51 and 16. For both the single and multiple HPV infections, HPV 6 was the most common lrHPV genotype, followed by HPV 53 and 42. In conclusion, due to the high prevalence of HPV single and multiple infections, the need for governmentally supported HPV vaccination and through cervical cancer screening should be emphasized to prevent cervical cancer.