Household Members Of Patients Research Articles

P530 The Burden on Cohabitants of Patients with Inflammatory Bowel Disease: A Cross-Sectional Study

Abstract Background Inflammatory bowel disease is a chronic disease characterized by digestive symptoms with an increasing incidence and prevalence. It is well established its impact on the quality of life of patients and their main caregivers but no study has yet considered the consequences of IBD on cohabitants with no direct involvement in patient`s care. Our aims were to analyze quality of life in cohabitants of people with IBD and identify potential related factors. Methods We conducted a cross-sectional study that included patients with IBD and their house-hold members. Participants were recruited from a period of two months from patients attending the IBD unit of our hospital. Inclusion criteria were a definite diagnosis of IBD and household members living in the same house for a period of 1 year or more. Exclusion criteria were an age <18, refusal to participate or subjects unable to fulfill the questionnaires. Demographic data was obtained for patients and household members. IBD activity was assessed by using the Partial Mayo Score and the Harvey-Bradshaw score. Other relevant information regarding the prior and current state of the disease was collected. Quality of life was assessed in the case of the patients with the Inflammatory Bowel Disease Questionnaire (IBDQ-32) and for the household members we used the Household Members Quality of Life-Inflammatory Bowel Disease (HHMQoL-IBD) questionnaire. Results We included 22 patients with UC, 32 patients with CD and 2 patients with indeterminate colitis and 82 household members. Both groups had similar sociodemographic characteristics. The univariate analysis of the quality of life of cohabitants showed a significant association of HHMQoL-IBD and IBDQ-32 score in their relatives (p<0.0001) (Figure 1), last CRP (p=0.043), number of disease flares in the last year (p=0.04), extraintestinal diseases (p=0.01) and particularly articular disease (p=0.04). Cohabitants of patients with CD had significantly lower HHMQoL-IBD than UC ones (53 ± 18 vs. 62 ± 23; p=0.049). Among cohabitants of patients with UC and CD, patient’s CRP in the last control was related to HHMQoL-IBD score (p=0.043 and p=0.04 respectively). In a linear multiple regression analysis, IBDQ-32 score (p<0.0001) in patients and the presence of extraintestinal disease (p=0.048) were independent predictors of cohabitant’s quality of life, and particularly articular disease. Conclusion Quality of life in household members of patients with IBD is related to patient’s quality of life and extraintestinal conditions related to the disease. Our study shows how important is to analyze and act in the patient’s whole environment, taking into consideration not only clinical variables but also the relational conditions and impact of the disease.

Individual and household risk factors for COVID-19 infection among household members of COVID-19 patients in home-based care in western Uganda, 2020

ObjectiveTo investigate factors associated with COVID-19 among household members of patients in home-based care (HBC) in western Uganda. MethodsWe conducted a case-control and cohort study. Cases were reverse transcriptase–polymerase chain reaction-confirmed SARS-CoV-2 diagnosed 1−30 November 2020 among persons in HBC in Kasese or Kabarole districts. We compared 78 case-households (≥1 secondary case) with 59 control-households (no secondary cases). The cohort included all case-household members. Data were captured by in-person questionnaire. We used bivariate regression to calculate odds and risk ratios. ResultsCase-households were larger than control-households (mean 5.8 vs 4.3 members, P<0.0001). Having ≥1 household member per room (adjusted odds ratio (aOR)=4.5, 95% CI 2.0−9.9), symptom development (aOR=2.3, 95% CI 1.1−5.0), or interaction with primary case-patient (aOR=4.6, 95% CI 1.4−14.7) increased odds of case-household status. Households assessed for suitability for HBC reduced odds of case-household status (aOR=0.4, 95% CI=0.2−0.8). Interacting with a primary case-patient increased the risk of individual infection among household members (adjusted risk ratio=1.7, 95% CI 1.1−2.8). ConclusionHousehold and individual factors influence secondary infection risk in HBC. Decisions about HBC should be made with these in mind.

Lost microbes of COVID-19: Bifidobacterium, Faecalibacterium depletion and decreased microbiome diversity associated with SARS-CoV-2 infection severity

ObjectiveThe study objective was to compare gut microbiome diversity and composition in SARS-CoV-2 PCR-positive patients whose symptoms ranged from asymptomatic to severe versus PCR-negative exposed controls.DesignUsing a cross-sectional design, we...

Formative research to scale up a handwashing with soap and water treatment intervention for household members of diarrhea patients in health facilities in Dhaka, Bangladesh (CHoBI7 program)

BackgroundDuring the time a diarrhea patient presents at a health facility, the household members of the patient are at higher risk of developing diarrheal diseases (> 100 times for cholera) than the general population. The Cholera-Hospital-based-Intervention-for-7-Days (CHoBI7) is a health facility-initiated water treatment and handwashing with soap intervention designed to reduce transmission of diarrheal diseases between patients and their household members. The present research aimed to (1) develop a scalable approach to integrate the CHoBI7 intervention program into services provided at government and private health facilities in Bangladesh; and (2) tailor the intervention program for the household members of all diarrhea patients, irrespective of the etiology of disease.MethodsWe conducted 8 months of formative research, including 60 semi-structured interviews, 2 group discussions, and a pilot study. Thirty-two interviews were conducted with diarrhea patients and their family caregivers, government stakeholders, and health care providers both to explore existing WASH and diarrhea patient care practices in health facilities and to identify considerations for scaling the CHoBI7 program. Fifty-two diarrhea patient households participated in a pilot study of a modified version of the CHoBI7 intervention program for tailoring. Twenty-eight interviews and 2 group discussions were conducted with pilot households to explore experiences with and recommendations for intervention delivery.ResultsThe intervention program was modified based on formative research findings. Pilot study participants recognized the benefits of the CHoBI7 intervention program and made suggestions to improve the acceptability and feasibility of the intervention. Modifications included 1) providing additional pictorial modules, cues to action, enabling technologies, and supplies for safe drinking water and handwashing with soap behaviors in the health facility; 2) switching out technology prone to breaks and leaks as well as sourcing plastic technologies from a high-quality, local manufacturer; and 3) including instructions discouraging the non-use or misuse of technologies and supplies. Considerations for scalability include the local availability and marketing of enabling technologies and supplies, staff for program delivery in health facilities, and potential integration into existing government or health promotion programs.ConclusionsFormative research identified important considerations for the content, delivery, and scalability of the CHoBI7 health facility-initiated WASH intervention program.

Screening of Brucellosis in Household Members of Patients with Brucellosis in Hamadan

Screening of Brucellosis in Household Members of Patients with Brucellosis in Hamadan

Impact of Information Leaflets on Behavior of Patients with Gastroenteritis or Tonsillitis: A Cluster Randomized Trial in French Primary Care

To assess the impact of four patient information leaflets on patients' behavior in primary care. Cluster randomized multicenter controlled trial between November 2009 and January 2011. French adults and children consulting a participating primary care physician and diagnosed with gastroenteritis or tonsillitis. Patients were randomized to receive patient information leaflets or not, according to the cluster randomization of their primary care physician. Adult patients or adults accompanying a child diagnosed with gastroenteritis or tonsillitis were informed of the study. Physicians in the intervention group gave patients an information leaflet about their condition. Two weeks after the consultation patients (or their accompanying adult) answered a telephone questionnaire on their behavior and knowledge about the condition. The main and secondary outcomes, mean behavior and knowledge scores respectively, were calculated from the replies to this questionnaire. Twenty-four physicians included 400 patients. Twelve patients were lost to follow-up (3 %). In the group that received the patient information leaflet, patient behavior was closer to that recommended by the guidelines than in the control group (mean behavior score 4.9 versus 4.2, p < 0.01). Knowledge was better for adults receiving the leaflet than in the control group (mean knowledge score 4.2 versus 3.6, p < 0.01). There were fewer visits for the same symptoms by household members of patients given leaflets (23.4 % vs. 56.2 %, p < 0.01). Patient information leaflets given by the physician during the consultation significantly modify the patient's behavior and knowledge of the disease, compared with patients not receiving the leaflets, for the conditions studied.

Prevalence of Nasal Colonization Among Patients With Community-Associated Methicillin-ResistantStaphylococcus aureusInfection and Their Household Contacts

To evaluate the prevalence of colonization among patients with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection and their household contacts. Prospective, observational laboratory study of nasal colonization among patients and their household members from September 15, 2004, to February 20, 2006. A 600-bed, urban, academic medical center. Fifty-one patients who presented with CA-MRSA infections and 49 household members had cultures of nasal swab specimens performed. Skin and soft-tissue infections were seen in 50 patients (98%) and 2 household members. Twenty-one (41%) of 51 patients and 10 (20%) of 49 household members were colonized with MRSA. An additional 5 patients (10%) and 12 household members (24%) were colonized with methicillin-susceptible Staphylococcus aureus. Most MRSA isolates (95%; infective and colonizing) carried the staphylococcal cassette chromosome mec type IV complex, and 67% represented a single clone, identical to USA 300. Of the colonized household members, 5 had isolates related to the patients' infective isolate. The frequency of CA-MRSA colonization among household members of patients with CA-MRSA infections is higher than rates reported among the general population. Among colonized household members, only half of the MRSA strains were related to the patients' infective isolate. Within the same household, multiple strains of CA-MRSA may be present.

Strain typing and contact tracing—A clinician's viewpoint

Active case-finding is an important element in the control of tuberculosis. Household members of patients with tuberculosis are investigated on the grounds that an index case with pulmonary tuberculosis may have passed on the disease. If the index has any other form of tuberculosis, such as mediastinal lymph node involvement, pleural effusion or meningitis, the source may be another member of the family. Contact tracing usually begins with household members of an infectious case and then expands to include casual contacts, if evidence of transmission is obtained. However, strain typing combined with epidemiological studies suggest that transmission commonly occurs outside the home. The frequency with which this occurs will depend on the social group, the environment in which transmission may occur and the transmissibility of the strain of tuberculosis. Changes in the population with tuberculosis have occurred over the last 5–10 years within developed countries such that many do not have a stable home and have associated problems of alcohol and drug addictions, chaotic lifestyles and mental illness. These factors have been especially important in the continuing outbreak of an isoniazid-resistant strain of Mycobacterium tuberculosis in North and East London. This outbreak was identified by strain typing, but problems with contact tracing and adherence to treatment mean that control has not yet been achieved and the outbreak now numbers 4293 individuals. The contention is that strain typing of all isolates of M. tuberculosis might have prevented such an outbreak at an early stage by identifying clusters indicating recent

Prevalence of mental disorders in household-members of patients with inflammatory bowel disease

Prevalence of mental disorders in household-members of patients with inflammatory bowel disease

Prevalence of mental disorders in household-members of patients with inflammatory bowel disease

Prevalence of mental disorders in household-members of patients with inflammatory bowel disease

Impact factor versus psychometric method for development of a quality of life questionnaire for household members of patients with inflammatory bowel disease

Impact factor versus psychometric method for development of a quality of life questionnaire for household members of patients with inflammatory bowel disease

Development and validation of a quality of life questionnaire for household-members of patients with inflammatory bowel disease

Development and validation of a quality of life questionnaire for household-members of patients with inflammatory bowel disease

Book reviews: A Colour Atlas of Venereology.

<h3>Abstract</h3> <h3>Objective</h3> To compare gut microbiome diversity and composition in SARS-CoV-2 polymerase chain reaction (PCR)-confirmed positive patients whose symptoms ranged from asymptomatic to severe versus PCR-negative exposed controls. <h3>Design</h3> Using a cross-sectional study design, we used shotgun next-generation sequencing (NGS) to evaluate microbiome composition and diversity in both patients with SARS-CoV-2 PCR-confirmed infections presenting to Ventura Clinical Trials for care from March 2020 through January 2021 and SARS-CoV-2 PCR-negative exposed controls. Patients were classified as being asymptomatic or having mild, moderate, or severe symptoms based on NIH criteria.¹ Exposed controls were individuals with prolonged or repeated close contact with patients with SARS-CoV-2 infection or their samples, e.g. household members of patients or frontline healthcare workers. Microbiome diversity and composition were compared between patients and exposed controls and across patient subgroups at all taxonomic levels. <h3>Results</h3> There were 52 patients and 20 controls. Compared with controls, patients had significantly less bacterial diversity, a lower abundance of <i>Bifidobacterium</i> and <i>Faecalibacterium</i> as well as some other bacteria, and a higher abundance of <i>Bacteroides</i> at the genus level. Additionally, there was an inverse association between disease severity and both bacterial diversity and <i>Bifidobacterium</i> and <i>Faecalibacterium</i> abundance. <h3>Conclusion</h3> We hypothesize that low bacterial diversity and depletion of <i>Bifidobacterium</i> and <i>Faecalibacterium</i> genera either before or after infection led to reduced pro-immune function, thereby allowing SARS-CoV-2 infection to become symptomatic. This particular dysbiosis pattern may be a susceptibility marker for severe symptoms from SARS-CoV-2 infection and may be amenable to pre-, intra-, or post infection intervention.