High Prevalence Of Infection Research Articles

Combination of serological and cytokine release assays for improved diagnosis of childhood tuberculosis in Zambia (PROMISE-TB)

ObjectivesThe diagnostic gaps for childhood tuberculosis (TB) remain considerable in settings with high TB incidence and resource constraints. We established and evaluated the performance of a scoring system based on a combination of serological tests and T-cell cytokine release assays, chosen for their ability to detect immune responses indicative of TB, in a context of high prevalence of pediatric HIV infection. MethodsWe enrolled 628 consecutive children aged ≤15 years, admitted for TB suspicion. Multiple cytokine levels in QuantiFERON Gold In-Tube supernatants and antigen 85B (Ag85B) antibodies were assessed in children who tested positive with either Xpert TB or mycobacterial culture. The results were compared with those of control children. ResultsAmong the biomarkers most strongly associated with TB, random forest classification analysis selected Ag85B antibodies, interleukin-2/interferon-γ ratio, and monokine induced by interferon-γ for the scoring system. The receiver operating characteristic curve derived from our scoring system showed an area under the curve of 0.95 (0.91-0.99), yielding 91% sensitivity and 88% specificity. The internal bootstrap validation gave the following 95% confidence intervals for the score performance: sensitivity 71%-97% and specificity 79%-99%. ConclusionsThis study suggests that supplementing the QuantiFERON assay with a combination of serological and T-cell markers could enhance childhood TB screening regardless of HIV status and age. Further validation among the target population is necessary to confirm the performance of this scoring system.

Expanding Geographical Access to Cancer Care in Botswana: Current Status and Future Prospects.

The growing cancer burden in Botswana has been linked to aging, lifestyle factors, and high HIV infection prevalence. The government has designated four geographically distributed hospitals as public oncology centers (POCs). A needs assessment was undertaken to ascertain the characteristics of cancer care at these centers. A multisite cross-sectional survey study of cancer care was conducted with oncology staff at Princess Marina Hospital (PMH), Nyangabgwe Referral Hospital (NRH), Sekgoma Memorial Hospital (SMH), and Letsholathebe II Memorial Hospital (LMH) from February to April 2021. At each POC, a focal person (experienced nurse working in oncology) identified relevant oncology staff and confirmed service availability. Only PMH and NRH had a broad array of diagnostic, surgical, and treatment services. In addition, PMH was the only center with a a dedicated inpatient oncology service, a multidisciplinary committee to review patients, and a palliative care team. To support the only national cancer screening program, for cervical cancer, all POCs offered Pap tests. Mammography, available at PMH and NRH, was used solely for diagnosis. Patients from POCs requiring radiation therapy were referred to Gaborone Private Hospital at government expense. For perceived service availability, 51 staff, mainly oncologists, physicians, and nurses, were surveyed (66% based at PMH). Perceptions of services revealed a few concerns, for example, numerous staff considered hysterectomies for cervical cancer available when they were only performed at PMH. Despite Botswana's efforts to increase the proximity of cancer services to patients, there are marked gaps, particularly at the two district-level POCs, SMH and LMH. In the future, SMH and LMH could provide selected services for specific prevalent cancers on-site, as well as follow-up and palliative care.

Pathogenesis of Experimental Infection of Nile Tilapia (Oreochromis niloticus) with Nucleospora Braziliensis Pathology and Proteomic of Microsporidia.

The recent discovery of disease caused by Nucleospora braziliensis in Nile tilapia (Oreochromis niloticus) is important as it has highlighted the high prevalence of infection and associated mortality in cultured fish. Thus, this study conducted an experimental infection of this microsporidium to evaluate pathological alterations and conduct proteomic analysis. For pathological observation, samples of brain, eyes, gall bladder, gut, heart, kidney, liver, muscle, skin, spleen, and stomach tissue, were collected, and liquid chromatography-mass spectrometry (LC-MS/MS) was performed for proteomic analysis. The most prevalent lesions were brownish color of the liver, gill filament fusion, gut ischemia, hemorrhage of the lips and fins, hepatomegaly, spleen atrophy, splenomegaly, and stomach congestion. The most common microscopic lesions were degeneration, hemorrhage, and inflammation in the brain, gills, gut, kidney, liver, muscle, spleen, and stomach. The digested peptides were identified by LC-MS/MS and the intersection of each group showed that in the spleen there were 121 exclusive proteins in the infected sample and 252 in the control, while in the kidney, 129 proteins were identified in the infected specimen compared to 83 in the control. In conclusion, this study demonstrates the proteome profile of O. niloticus kidney and spleen tissue in response to infection with N. braziliensis.

Rickettsia helvetica in C3H/HeN mice: A model for studying pathogen-host interactions

An infection with the tick-borne Rickettsia helvetica has been associated with a broad spectrum of clinical manifestations in humans, but patients are only seldomly reported. Understanding its disease etiology necessitates well-stablished infection models, improving to recognize and diagnose patients with R. helvetica infection and facilitating the development of effective control strategies. In this study, we used C3H/HeN mice as a model to establish R. helvetica infection, achieving a high infection prevalence (89–100 %). While the liver and the spleen DNA consistently tested positive for infection in all challenged mice, additional infected organs included the kidneys, heart, and the lungs. Notably, a low prevalence of infection was observed in I. ricinus nymphs fed on R. helvetica-challenged mice. In addition, larvae were refractory to infection, suggesting that ticks exhibit low susceptibility to the pathogen. To the best of our knowledge, this is the first study of an animal model for R. helvetica infection. It serves as a valuable tool for advancing research on the interactions among the bacterium and its vertebrate host.

Routine Testing for Chlamydia trachomatis and Neisseria gonorrhoeae Infections within an HIV Pre-Exposure Prophylaxis Program in Hanoi, Vietnam: Implications for Low- and Middle-Income Countries.

Data on Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) infections within HIV pre-exposure prophylaxis (PrEP) programs in low- and middle-income countries (LMICs) are limited. Our study reports the prevalence, anatomical distribution, and correlates of NG and CT infections within an HIV PrEP program in Hanoi, Vietnam. From January-December 2022, HIV PrEP program clients who were male at birth, ≥16 years old, reported ≥1 male sex partner in the prior 12 months, were enrolled. A questionnaire collected sociodemographics, sexual behaviors, and clinical data. CT/NG testing was performed on self-collected urine, rectal, and pharyngeal specimens. Multivariate logistic regression was used to identify factors associated with CT and NG infections. There were 529 participants enrolled, the median age was 25.1 years. The overall prevalence of CT or NG was 28.9% (153/529). The prevalence of NG was 14.3% and highest for pharyngeal infections (11.7%), while for CT, the prevalence was 20.4% and highest for rectal infections (14.0%). Symptoms in the prior week were reported by 45.8% (70/153) of those with CT or NG infections. Condomless anal sex (aOR= 1.98; 95% CI: 1.27, 3.08) and sexualized drug use in the prior 6 months (aOR= 1.68; 95% CI: 1.07, 2.65) were associated with CT/NG infections. Our study found a high prevalence of NG and CT infections, including pharyngeal and rectal infections, within an HIV PrEP program in Hanoi, Vietnam. The findings underscore the need for further research on CT/NG prevention and the development of evidence-based guidelines for CT/NG screening in HIV PrEP programs in LMIC settings.

Unveiling the Disease Patterns and Infection Categories in MDRO-Infected Patients: Insights from a Comprehensive Study at Dr. Kariadi Hospital, Semarang

Background: Multi-drug resistant organisms (MDRO) pose a significant challenge to healthcare systems worldwide, leading to increased morbidity, mortality, and healthcare costs. Understanding the disease patterns and infection categories associated with MDRO infections is crucial for effective management and prevention strategies. This study aims to unveil the prevalent diseases and infection categories among MDRO-infected patients at Dr. Kariadi Hospital, Semarang in Indonesia.Methods: A comprehensive retrospective analysis was conducted on medical records of patients diagnosed with MDRO infections. Clinical characteristics were collected and analyzed. The diseases were classified into broader categories based on their organ system or common medical classification.Result: The study included 100 MDRO-infected patients and they presented with 81 various medical conditions/diseases. The most common diseases associated with MDRO infections were Covid-19, and Bronchopneumonia. Among the infection categories, gastrointestinal disorders, and Neoplastic Diseases were the predominant categories. The study revealed a high prevalence of MDRO infections in patients with these conditions while as the category of Autoimmune and Rheumatic Diseases accounted for the smallest proportion of cases with only one case.Conclusion : This comprehensive study provides valuable insights into the disease patterns and infection categories in MDRO-infected patients at Dr. Kariadi Hospital, Semarang. The findings highlight the need for targeted surveillance, infection control measures, and antimicrobial stewardship programs to effectively manage MDRO infections. Understanding the most prevalent diseases and infection categories associated with MDROs can aid in early detection, appropriate treatment, and the development of preventive strategies.

First Phase of the Clinical trial of the AS-Probionorm Probiotic Medication for the treatment of Human Intestinal Infections

The effectiveness of probiotic medications in the treatment of infectious diseases of the gastrointestinal tract has been proven in many clinical studies. Despite this, currently, some preparations do not have the appropriate quality and activity against pathogenic microorganisms. The reason for this is the lack of a stage for the selection of antagonists to specific pathogens at the stage of research and medication development. Given the high prevalence of intestinal infections among the population of Kazakhstan and the lack of made-in-Kazakhstan probiotic medications in the pharmaceutical market, there is a need to introduce an effective preparation based on probiotic microorganisms for the treatment of infectious diseases of the gastrointestinal tract. The purpose of this study was to demonstrate the methodology and results of the first phase of clinical trials of this preparation. The study was conducted following the ethical principles of the Helsinki Declaration, the Order of the Acting Minister of Health of the Republic of Kazakhstan, the Order of the Minister of Health of the Republic of Kazakhstan, and the Code of the Republic of Kazakhstan. 20 healthy volunteers of both sexes aged 18 to 50 years with a verified state of health, who had given informed consent, were examined before the start of the study, and the results of clinical measurement of the initial condition were also obtained, which was then compared with daily measurements during the use of the preparation under study and a week after the last administration. As a result of the study, it was concluded that the preparation was well-tolerated without noticeable side effects, which indicates the safety of the medication.

The Comparison between the conservative approach and pectoralis major flap transposition in the treatment of mediastinitis following median sternotomy

Background: Mediastinitis is a significant complication of open heart surgery and other thoracic operations. Deep sternal wound complications notably increase morbidity and mortality. The optimal treatment for deep sternal wounds following sternotomy remains a topic of discussion. Options such as repeated irrigation and debridement of the wound, closed chest catheter irrigation, and recent plastic surgery approaches like pectoralis major flap transposition all have their proponents Methods: Given the high prevalence of Deep Sternal Wound Infection (DSWI), we conducted this retrospective descriptive study. We used existing information to compare the conservative method of repeated irrigation and debridement with pectoralis major flap transposition. We presented the results using descriptive and analytic methods. We evaluated a total of 125 patient health records with deep sternal wound infection over a ten-year period (2003-2013). Results: The results of this study showed that 83.2% of patients who developed DSWI after surgery suffered from underlying diseases such as diabetes, renal failure, etc. However, no relationship was found between the presence of an underlying disease and recovery. Furthermore, no significant relationship was observed between diabetes and recovery. Among the 125 assessed files, 50 patients received a pectoralis flap, among which 48 patients recovered with sternal stabilization and only 2 patients recovered without stabilization. Conversely, among cases without pectoralis flapping, records were available for only 67 patients, of whom only 35 patients recovered with sternal stabilization while 32 patients recovered without sternal stabilization. Recovery was significantly enhanced in the group receiving flapping. Conclusions: The only factor that improved the outcome in our assessment was the use of pectoralis flapping. This is consistent with the results of studies published in recent years that used plastic surgery methods, i.e., pectorals muscle or omentum flapping, which are associated with a high success rate and reduced length of inpatient stay.

Role of Nano Particle Drug Delivery System in Antifungal Therapy

Effective illnesses are currently treated with oral and common effective strategies. Oral and effective courses encounter numerous challenges, including pharmaceutical drug interactions, higher metabolic rate, unfavorable retention, and toxicity. Controlled drug release has not been demonstrated using conventionally useful measuring forms such as gels, salves, and creams. According to written accounts, several lakhs of people are affected and over 1.5 lakh people are thought to have died as a result of infectious contaminations. The high prevalence of parasite infections, which has been disrupted by an expansion in inclination factors, has become a concerning general medical issue. It is essential to thoroughly investigate the relationships between the specifics, the organization method, pharmacological properties, pharmacokinetics, pharmacodynamics, strength, sufficiency, safety, and clinical signs in order to improve a successful novel antifungal medication delivery framework. This audit article looks at several types of nanoparticle processes that are used to deliver antifungal drugs, such as dendrimers, polymeric nanoparticles, inorganic nanoparticles, and nanoparticles based on phospholipids (nanovesicles).

Oropharyngeal microbiome profiling and its association with age and heart failure in the elderly population from the northernmost province of China.

Respiratory tract infections are the most common triggers for heart failure in elderly people. The healthy respiratory commensal microbiota can prevent invasion by infectious pathogens and decrease the risk of respiratory tract infections. However, upper respiratory tract (URT) microbiome in the elderly is not well understood. To comprehend the profiles of URT microbiota in the elderly, and the link between the microbiome and heart failure, we investigated the oropharyngeal (OP) microbiome of these populations in Heilongjiang Province, located in the North-East of China, a high-latitude and cold area with a high prevalence of respiratory tract infection and heart failure. Taxonomy-based analysis showed that six dominant phyla were represented in the OP microbial profiles. Compared with young adults, the OP in the elderly exhibited a significantly different microbial community, mainly characterized by highly prevalent Streptococcus, unidentified_Saccharibacteria, Veillonella, unidentified_Pre votellaceae, and Neisseria. While unidentified_Prevotellaceae dominated in the young OP microbiome. There was competition for niche dominance between Streptococcus and member of Prevotellaceae in the OP. Correlation analysis revealed that the abundance of unidentified_Saccharibacteria was positive, while Streptococcus was negatively correlated to age among healthy elderly. The bacterial structure and abundance in the elderly with heart failure were much like healthy controls. Certain changes in microbial diversity indicated the potential OP microbial disorder in heart failure patients. These results presented here identify the respiratory tract core microbiota in high latitude and cold regions, and reveal the robustness of OP microbiome in the aged, supplying the basis for microbiome-targeted interventions.IMPORTANCETo date, we still lack available data on the oropharyngeal (OP) microbial communities in healthy populations, especially the elderly, in high latitude and cold regions. A better understanding of the significantly changed respiratory tract microbiota in aging can provide greater insight into characteristics of longevity and age-related diseases. In addition, determining the relationship between heart failure and OP microbiome may provide novel prevention and therapeutic strategies. Here, we compared OP microbiome in different age groups and elderly people with or without heart failure in northeastern China. We found that OP microbial communities are strongly linked to healthy aging. And the disease status of heart failure was not a powerful factor affecting OP microbiome. The findings may provide basic data to reveal respiratory bacterial signatures of individuals in a cold geographic region.

Potential Biases in Test-Negative Design Studies of COVID-19 Vaccine Effectiveness Arising from the Inclusion of Asymptomatic Individuals.

The test-negative design (TND) is a popular method for evaluating vaccine effectiveness (VE). A "classical" TND study includes symptomatic individuals tested for the disease targeted by the vaccine to estimate VE against symptomatic infection. However, recent applications of the TND have attempted to estimate VE against infection by including all tested individuals, regardless of their symptoms. In this article, we use directed acyclic graphs and simulations to investigate potential biases in TND studies of COVID-19 VE arising from the use of this "alternative" approach, particularly when applied during periods of widespread testing. We show that the inclusion of asymptomatic individuals can potentially lead to collider stratification bias, uncontrolled confounding by health and healthcare-seeking behaviors (HSBs), and differential outcome misclassification. While our focus is on the COVID-19 setting, the issues discussed here may also be relevant in the context of other infectious diseases. This may be particularly true in scenarios where there is either a high baseline prevalence of infection, a strong correlation between HSBs and vaccination, different testing practices for vaccinated and unvaccinated individuals, or settings where both the vaccine under study attenuates symptoms of infection and diagnostic accuracy is modified by the presence of symptoms.

High prevalence of asymptomatic and subpatent Plasmodium falciparum infections but no histidine-rich protein 2 gene deletion in Bouaké, Côte d’Ivoire

This study aimed to estimate the prevalence of asymptomatic and subpatent P. falciparum infections in the city of Bouaké, Central Côte d’Ivoire, to compare the performance of three tests, and to investigate potential P. falciparum histidine-rich protein 2 (pfhrp2) gene deletions. A cross-sectional survey was conducted in nine neighborhoods in Bouaké in 2016. Matched light microscopy (LM), rapid diagnostic test (RDT), and quantitative PCR (qPCR) data were used to determine the prevalence of P. falciparum infection and compare the performance of the three diagnostic tests. Pfhrp2/3 deletions were genotyped by digital PCR. Among 2313 individuals, 97.2% were asymptomatic and 2.8% were symptomatic. P. falciparum prevalence among symptomatic individuals was 25.8%, 30.3%, and 40.9% by LM, RDT, and varATS qPCR, respectively, and among asymptomatic individuals, it was 10.3%, 12.5%, and 34.9%. Asymptomatic infections comprised 96.4% of all malaria infections, with 58.2% detectable only by varATS qPCR. Although the prevalence of asymptomatic P. falciparum infections was higher in school-age children (5–14 years: 42.0%) compared to < 5 years (17.3%) and ≥ 15 years (35.9%), subpatent infections were more likely in ≥ 15 years (70.4%) than in < 5 years (39.7%) and school-age children (41.2%). LM and RDTs were reliable only at parasite densities > 10,000 parasites/µL. Individuals who were positive according to all three tests had significantly greater parasite density (856.8 parasites/µL; 95% CI 707.3–1,038) than did those who were positive by varATS qPCR only (13.7 parasites/µL; 95% CI 11.4–16.3) (p < 0.0001). No pfhrp2 deletions were observed. The high prevalence of asymptomatic and subpatent infections highlights the need for targeted strategies to reduce malaria in urban Côte d’Ivoire.

Cardiovascular and Neurological Diseases and Association with Helicobacter Pylori Infection-An Overview.

This article investigates the link between Helicobacter pylori (H. pylori) infection and cardiovascular and neurological disorders. Recent research suggests that H. pylori may play a role in cardiovascular diseases like atherosclerosis, myocardial infarction, and stroke, as well as neurological diseases including Alzheimer's disease, multiple sclerosis, and Parkinson's disease. Cardiovascular Diseases: H. pylori induces endothelial dysfunction and chronic inflammation, promoting atherosclerotic plaque formation and other cardiac complications. High infection prevalence in cardiovascular patients implies that systemic inflammation from H. pylori accelerates disease progression. Eradication therapies combined with anti-inflammatory and lipid-lowering treatments may reduce cardiovascular risk. Neurological Diseases: H. pylori may contribute to Alzheimer's, multiple sclerosis, and Parkinson's through systemic inflammation, neuroinflammation, and autoimmune responses. Increased infection prevalence in these patients suggests bacterial involvement in disease pathogenesis. The eradication of H. pylori could reduce neuroinflammation and improve outcomes. Discussions and Future Research: Managing H. pylori infection in clinical practice could impact public health and treatment approaches. Further research is needed to clarify these relationships. Longitudinal and mechanistic studies are essential to fully understand H. pylori's role in these conditions. Conclusions: H. pylori infection is a potential risk factor for various cardiovascular and neurological conditions. Additional research is critical for developing effective prevention and treatment strategies. Targeted therapies, including H. pylori eradication combined with anti-inflammatory treatments, could improve clinical outcomes. These findings highlight the need for an integrated clinical approach to include H. pylori evaluation and treatment.

Anal high-grade intraepithelial neoplasia and cancer in women living with HIV and HIV-negative women with other risk factors.

To determine the prevalence and the risk factors for anal high-grade intraepithelial neoplasia and anal cancer (HSIL+) in women living with HIV (WLWHIV), and to compare them to HIV-negative women with other risk factors. Prospective cohort study. WLWHIV and HIV-negative women with other risk factors were included. Screening for anal HSIL+ using anal cytology and HPV testing was performed. A high-resolution anoscopy with directed biopsy was also performed in patients with an abnormal cytology result or a positive HPV testing for high-risk (HR) genotypes, and in those with anal symptoms. The period prevalence of anal HR-HPV infection and histological HSIL was 57.9% and 10.9% among WLWHIV, and 60.8% and 9.2% among HIV-negative women. The prevalence of anal HPV 18 infection was higher in WLWHIV. The risk factors for anal HSIL+ in WLWHIV included anal HPV 16, other HR genotypes and low-risk genotypes infection, as well as a history of vulvar HSIL+. In HIV-negative women, the risk factors included anal HPV 16 infection, history of anogenital warts and of vulvar HSIL+, and immunosuppressive treatment. A high prevalence of anal HPV infection and HSIL was observed in WLWHIV and women with other risk factors. Both groups share anal HPV 16 infection and history of vulvar HSIL+ as risk factors for the development of anal HSIL+. Genotyping for anal HPV 16 may help identify women at higher risk of anal cancer.

Survival rate and its predictors in HIV patients: A 15-year follow-up of 3030 patients

BackgroundThe high prevalence of HIV infection and the deaths caused by it is one of the challenges for the healthcare systems throughout the world. In this study, we analyzed the survival of people living with HIV and co-infections, and related factors. MethodsThis retrospective cohort study was performed on 3030 people living with HIV admitted to Imam Khomeini Behavioral Disease Counseling Center, Tehran, Iran, during 2004–2018. Required data were obtained from the individuals’ files. Kaplan Meier diagrams and Log-rank tests were used to assess the relationship between different factors and survival. In addition, Cox regression analysis was performed to determine the effective factors in HIV mortality. Data were analyzed using STATA software, version 14. ResultsThe mean age of studied population was 43.2 ± 9.5 [years] and 77.3 % were male. Among the subjects, 3.2 % were infected with hepatitis B, 31.5 % with hepatitis C, and 13.9 % with Tuberculosis (TB). One, five, ten, and fifteen-year survival rates were 97.0 %, 93.0 %, 86.0 %, and 54.0 %, respectively. The mean survival time was 154.2 ± 0.9 months. Age more than 35, history of imprisonment, Unsafe sexual behavior, TB, and hepatitis C are independently associated with death in people living with HIV (p < 0.05). ConclusionThe survival of people living with HIV in the present study was in the favorable range compared to previous studies. However, co-infection with hepatitis C was associated with reduced survival of the subjects in this study. Therefore, it is suggested to detect and then prevent and control HCV co-infection to increase the survival of subjects.

Optical Biosensor Based on Porous Silicon and Tamm Plasmon Polariton for Detection of CagA Antigen of Helicobacter pylori.

Helicobacter pylori (H. pylori) is a common pathogen with a high prevalence of infection in human populations. The diagnosis of H. pylori infection is critical for its treatment, eradication, and prognosis. Biosensors have been demonstrated to be powerful for the rapid onsite detection of pathogens, particularly for point-of-care test (POCT) scenarios. In this work, we propose a novel optical biosensor, based on nanomaterial porous silicon (PSi) and photonic surface state Tamm Plasmon Polariton (TPP), for the detection of cytotoxin-associated antigen A (CagA) of H. pylori bacterium. We fabricated the PSi TPP biosensor, analyzed its optical characteristics, and demonstrated through experiments, with the sensing of the CagA antigen, that the TPP biosensor has a sensitivity of 100 pm/(ng/mL), a limit of detection of 0.05 ng/mL, and specificity in terms of positive-to-negative ratio that is greater than six. From these performance factors, it can be concluded that the TPP biosensor can serve as an effective tool for the diagnosis of H. pylori infection, either in analytical labs or in POCT applications.

Thrombocytopenia in Plasmodium vivax Malaria: A Report from a Sub-zonal Hospital in Western Rajasthan

Abstract Background: Malaria continues to be a major public health problem in India. Vivax malaria is being increasingly seen with thrombocytopenia. The reported prevalence of the same has been extremely variable and its significance is not well established. This study was conducted to ascertain the prevalence and severity of thrombocytopenia in vivax malaria and assess the outcome of cases with severe thrombocytopenia. A secondary objective was to compare the clinical and laboratory profile of cases of vivax malaria with falciparum malaria and mixed infection. Materials and Methods: This hospital-based prospective study was carried out in the department of general medicine at a sub-zonal hospital in Western Rajasthan in the year 2022. Consecutive febrile patients with a diagnosis of malaria were included in the study after ruling out coexistent alternate infections. Results: A total of 396 cases were enrolled. Ninety-nine percent of patients were male. The mean age of the study group was 32.1 years. A total of 328 (90.8%) out of 361 vivax malaria cases had thrombocytopenia (platelet count &lt;150 × 103 μL) with 26.5% having severe thrombocytopenia (platelet count &lt;50 × 103 μL). The mean defervescence duration was 44.4 h in vivax malaria. 3.4% of severe vivax malaria cases required intensive care unit care due to hypotension, respiratory distress, and multiorgan dysfunction, and none of them had any bleeding manifestations. All cases recovered well after standard treatment. There was a significant statistical difference between the mean platelet count among the three types of malaria: vivax, falciparum, and mixed (vivax + falciparum infections) (P = 0.03). Similarly, on applying Chi-square test, there was a significant difference in severe thrombocytopenia across the groups (P = 0.01). Conclusion: There is a high prevalence of thrombocytopenia in vivax malaria including severe thrombocytopenia. In the majority of cases, this thrombocytopenia does not result in any adverse event, and cases respond well to conventional treatment. Clinicians need to be aware of the extent and severity of thrombocytopenia in vivax malaria and rule out this treatable condition in endemic areas with a high prevalence of other coexistent infections causing thrombocytopenia.

High-risk human papillomavirus infection and cervical cytopathology: relationship with cervical nitric oxide levels

BackgroundNitric oxide (NO) may contribute to the persistence of high-risk human papillomavirus (hrHPV) infection, which has been linked to the development of premalignant lesions and cervical cancer. Our study aimed to examine the relationship between cervical NO metabolite (NOx) levels, hrHPV infection, and cytopathological findings. Additionally, we assessed cervical NOx levels as a biomarker for predicting hrHPV infection and epithelial atypia.MethodsThe study involved 74 women who attended the Gynecology and Obstetrics outpatient clinics at Cairo University Hospitals between November 2021 and August 2022. Cervical samples were subjected to Pap testing, assessment of NOx levels by the Griess method, and detection of hrHPV DNA by real-time polymerase chain reaction.ResultsHigh-risk HPV was detected in 37.8% of women. EA was found in 17.1% of cases, with a higher percentage among hrHPV-positive than negative cases (35.7% vs. 4.3%, p = 0.001). The most prevalent hrHPV genotype was HPV 16 (89.3%). The cervical NOx level in hrHPV-positive cases was significantly higher (37.4 µmol/mL, IQR: 34.5–45.8) compared to negative cases (2.3 µmol/mL, IQR: 1.2–9.8) (p = < 0.001). Patients with high-grade atypia showed significantly higher NOx levels (38.0 µmol/mL, IQR: 24.6–94.7) in comparison to NILM and low-grade atypia cases (5.0 µmol/mL, IQR: 1.6–33.3 and 34.5 µmol/mL, IQR: 11.7–61.7, respectively) (p = 0.006). Although the NOx levels among hrHPV-positive cases with low-grade atypia (40.4 µmol/mL, IQR: 33.3‒61.8) were higher than those with NILM (36.2 µmol/mL, IQR: 35.7‒44.0) and high-grade atypia (38.0 µmol/mL, IQR: 24.6‒94.7), the difference was not significant (p = 0.771). ROC curve analysis indicated that the cervical NOx cut-off values of > 23.61 µmol/mL and > 11.35 µmol/mL exhibited good diagnostic accuracy for the prediction of hrHPV infection and EA, respectively.ConclusionsThe high prevalence of hrHPV infection, particularly HPV 16, in our hospital warrants targeted treatment and comprehensive screening. Elevated cervical NOx levels are associated with hrHPV infection and high-grade atypia, suggesting their potential use as biomarkers for predicting the presence of hrHPV and abnormal cytological changes.

Prevalence and intensity of soil-transmitted helminth infections among school-aged children in five districts in Uganda.

Soil-transmitted helminth (STH) infections, commonly caused by roundworms (Ascaris lumbricoides), whipworms (Trichuris trichiura), and hookworms (Necator americanus and Ancylostoma duodenale), were widespread among Ugandan schoolchildren in the late 1990s and early 2000s. Since 2003, the Ugandan Ministry of Health has administered biannual preventive chemotherapy to children aged 1-14 years to control these infections. Twenty years after the program's inception, there is scant data to show the long-term impact of these national deworming efforts. To estimate the prevalence and intensity of STH infections among 10-14-year-old primary school children, school-based, cross-sectional surveys were conducted in November 2023 across five districts (Kamwenge, Sheema, Adjumani, Lamwo, and Zombo). Sixty-five children from five schools per district were selected for inclusion. Fecal egg counts were determined using the Kato-Katz microscopy technique, performed in duplicate by trained laboratory technicians. The survey findings revealed a high prevalence of any STH infection in Kamwenge District (21.2%, 95% confidence limits (CL): 5.7%, 36.6%), while the remaining four districts exhibited lower prevalences, ranging from 0.4% (95% CL: 0.0%, 1.2%) in Adjumani District to 5.6% (95% CL: 0.0%, 11.4%) in Sheema District. The prevalence of moderate-to-heavy-intensity infections was below 1% across all districts. A. lumbricoides was identified infrequently. Hookworm infections were primarily identified in the western districts of Kamwenge and Sheema, while T. trichiura infections were common only in Kamwenge District. Hookworm and T. trichiura infections were uncommon in the northern districts of Adjumani, Lamwo, and Zombo. These surveys suggest that morbidity due to STH infections among schoolchildren may be well controlled in these five districts, as evidenced by low moderate-to-heavy-intensity infection prevalence. However, the prevalence of any intensity infection remains elevated in some districts, indicating the need for continued preventive chemotherapy distribution. A reduction from biannual treatment may be warranted in four districts, per World Health Organization recommendations.

Determinants of High HIV Infection Prevalence in Vijayapura, Bagalkot, and Belagavi Districts in Karnataka, India.

Introduction India has the second-highest number ofpeople living withhuman immunodeficiency virus (PLHIV). Despite the national decline in the prevalence of the human immunodeficiency virus (HIV) from 2000 to 2021, regional variations persist, particularly in the northeastern and southern states. High-risk populations, including female sex workers (FSW), men who have sex with men (MSM), and injecting drug users (IDU), significantly contribute to these dynamics. This study focuses on high-prevalence districts in Karnataka. Objectives This study aims to identify socioeconomic and behavioral factors associated with high HIV prevalence in high-burden districts of South Indian states. Methodology A cross-sectional study was conducted using data from Integrated Counseling and Testing Centers (ICTCs) and Designated STI/RTI (sexually transmitted infections/reproductive tract infections) Clinics (DSRCs) across 24 centers in the three districts. The centers were determined using a simple random sampling method. Data from 2501 HIV-positive individuals were analyzed, focusing on demographics, risk behaviors, and treatment history. Results Males constituted the majority of HIV cases, accounting for 448 (56.0%) in Vijayapura, 334 (51.4%) in Bagalkot, and 644 (61.1%) in Belagavi districts, with a significant portion referred by government hospitals. High HIV prevalence was linked to adults aged 25-49 years of age; the number of people with HIV was high among daily wage workersand individuals with multiple sexual partners compared to married and educated people. Newly diagnosed discordant couples ranged from 129 (12.2%) in Belagavito 133 (18.4%) in Vijayapuradistricts. Most patients were on first-line antiretroviral therapy (ART), with loss to follow-up attributed to system negligence and poor compliance. Conclusion Key determinants of high HIV prevalence include gender, age, marital status, socioeconomic status, and sexual behavior. Effective interventions require targeted education, improved healthcare services, robust surveillance, and strengthened collaboration among stakeholders.