Infected Adults Research Articles

Anti-plasmodial activity of artemether-lumefantrine-tinidazole on plasmodium falciparum infected humans

Background: The emergence of multi-drug resistant strains of Plasmodium falciparum has intensified the search for effective compounds. This study aimed to evaluates the combined effects of tinidazole and artemether/lumefantrine on human participants infected with P. falciparum. Methods: The study involved 25 non-infected adults as controls and 75 infected adults, divided into three groups of 25. The groups were treated orally with 1g of Tinidazole (T) twice daily for 3 days, an 8-hourly initial dose followed by 12-hourly 80mg/480mg doses of Artemether/Lumefantrine (AL) for 3 days, and a combination of 1g tinidazole and artemether/lumefantrine (80mg/480mg) for 3 days. Venous blood samples were taken on days 0, 4, and 14 to evaluate renal function, parasitemia, hematological parameters, lipid profiles, and antioxidant measures (catalase, SOD, glutathione peroxidase, and malondialdehyde). Results: The percentage recovery with AL, T, and the combination of T and AL was 88%, 92%, and 100%, respectively. Malaria patients exhibited significantly lower levels of red blood cells, hemoglobin, packed cell volume, low-density lipoprotein, high-density lipoprotein, total cholesterol, catalase, superoxide dismutase, and glutathione peroxidase, and higher levels of white blood cells, triglycerides, and malondialdehyde compared to the control group. Post-treatment, there was a modest reversal on day 4 and a significant return to normal ranges by day 14. Malaria infection did not affect urea or creatinine levels. Conclusions: Tinidazole shows potential as a treatment for P. falciparum, with enhanced efficacy when combined with artemether/lumefantrine.

Prevalence and Genetic Diversity of Deer Tick Virus (Powassan Virus, Lineage II) in Ixodes scapularis Ticks in Five Habitats at a Nature Reserve in Southern Maine, United States.

Deer tick virus (DTV), also known as Powassan virus lineage II, is a rising health concern due to increased recognition as a cause of human encephalitis. Since European tick-borne encephalitis virus persists in nature in enzootic foci (i.e., higher prevalence rates in small pockets in nature), we sought to determine whether DTV is also focally maintained in relation to habitat type, to better understand factors leading to human risk of exposure. From 2018 to 2021, questing Ixodes scapularis ticks were collected from five habitats at the Wells National Estuarine Research Reserve (WNERR) in Wells, ME: forest with invasive vegetation in the understory, edge, shrub, forest with native vegetation in the understory, and open field. Deer tick virus prevalence was greater in adult ticks (2.0%) than in nymphs (0.5%). Deer tick virus prevalence in adult ticks collected from forest with invasive vegetation was 3.2% compared to 0 to 1.7% in other habitat types. A hot spot analysis revealed a higher number of infected adults collected per hour on one of the transects located in forest with invasive vegetation. Phylogenetic analysis of 37 full-length DTV genomes sequenced in this study revealed four major clades from the WNERR, and there was high genetic diversity within each transect, suggesting frequent, short-range dispersal between habitats. Analysis of DTV sequences from other New England counties and states also indicated long-distance dispersal to and/or from the WNERR. This study provides preliminary evidence that DTV is focal and that the risk of encountering DTV-infected ticks in forest with invasive vegetation may be greater than in other habitat types.

Myiasis by the Toad Fly (Lucilia bufonivora; Calliphoidae) in Amphibians in Montana, USA.

Toad flies in the genus Lucilia (previously referred to as Bufolucilia spp.) parasitize and cause myiasis in several amphibian species in North America. From 2019 to 2022, we documented Lucilia bufonivora infections in post-metamorphic western toads (Anaxyrus boreas) during amphibian surveys in four wetlands in Glacier National Park, Montana, US. We found nine infected adult toads in 2019, seven infected adults in 2020, one infected juvenile in 2021, and five infected adults plus one infected juvenile in 2022. We also captured Columbia spotted frogs (Rana luteiventris) during these same surveys but detected no infections. Only one of the four wetlands had infected toads in 2019, despite their proximity and hydrologic connectivity, but two of these wetlands had infections in 2020, and a third had a single infection in 2021. The same three of four wetlands had infections in 2022. In 2008, a similar parasitic infection in one western toad had been noted at the same wetland as in 2019. That toad had been captured again two years later without signs of infection.

Subclinical atherosclerosis burden in carotid and femoral territories in HIV subjects: relationships with HIV and non-HIV related factors

BackgroundCardiovascular disease is a major cause of morbidity in an aging HIV population. However, risk estimation with the most frequent equations usually classifies HIV patients as having a low or moderate risk. Several studies have described a very high prevalence of subclinical atherosclerosis in a middle-aged, non-HIV population. There is insufficient body of knowledge to understand if this is the case in people living with HIV (PLWH). We aim to calculate the proportion of patients with subclinical atherosclerosis in a single site cohort of HIV-infected subjects.MethodsWe have analyzed chronically HIV infected adults (≥ 18 years) who were on active follow-up in an HIV unit specialized in the care of cardiovascular health. The most recent clinical visit and vascular ultrasonography were used to assess the objectives of our research. Our primary objective was to describe the proportion of participants with subclinical atherosclerosis (focal protrusion into the lumen > 0.5 mm or > 50% of the surrounding IMT or a diffuse thickness > 1.5 mm) in a single site cohort of PLWH. Carotid and iliofemoral territories were evaluated. As a secondary objective we have run a multivariate analysis to determine which HIV and non-HIV factors might be related with the presence of atherosclerotic plaques.FindingsWe included a total of 463 participants between November 2017 to October 2019. Subjects were predominantly male (84.2%) with a mean age of 48.8 years (SD 10.7). Hypercholesterolemia (36%) was the most prevalent comorbidity followed by Hypertension (18%) and Hypertriglyceridemia (16%). Mean duration of HIV infection is 12.3 years. Overall, participants had been receiving cART for a median of 9.5 years. Subclinical atherosclerosis was found in 197 subjects (42.5%; CI 95% [38.0–47.2]). The disease was found more frequently in the femoral arteries (37.8%) than in the carotid vascular bed (18.6%). Despite some HIV factors correlated with the presence of plaques in a univariate analysis (e.g., time with HIV-1 RNA > 50 copies/mL or time from HIV diagnosis), the only two explanatory factors that remained associated with the presence of atherosclerotic plaques in the multivariate analysis were smoking (OR 5.47, 95% CI 3.36 – 8.90) and age (OR 1.13, 95%CI 1.10 – 1.16).InterpretationWe have found a very high prevalence of subclinical atherosclerosis among our cohort of PLWH. Despite having analyzed several HIV factors, age and smoking have been found to be the only factors associated with the development of atherosclerotic plaques.

Addressing the challenges in laboratory confirmation of paediatric tuberculosis: the role of induced sputum specimen

Tuberculosis (TB) remained the single leading infectious cause of ill health and death globally until the COVID-19 pandemic occurred. Tuberculosis contributes significantly to childhood mortality of about 16% among HIV-negative children worldwide. Childhood tuberculosis is a significant epidemiological tool as childhood TB represents recent transmission in the community and reflects the presence of an infected adult. Previously clinical research, diagnostic methods, and therapeutic discoveries have focused on adult tuberculosis to the neglect of childhood tuberculosis. Limited pediatric surveillance data, poor case ascertainment, and limited resources and capabilities have hindered the attainment of the true burden of childhood tuberculosis in countries with high tuberculosis disease burden. The difficulty in characterising the true burden of tuberculosis is mainly from the difficulty in obtaining adequate and reliable diagnostic samples to confirm TB in children. Sputum induction has proven to be feasible and effective in several LMIC settings. Gene Xpert MTB/Rif; polymerase chain reaction, performed on induced sputum samples is more sensitive in the detection of paucibacillary TB in children as compared to sputum smear testing. This allows for early diagnosis and timely initiation of therapy. It is necessary that we continue to utilize the available tools to improve TB diagnosis in children and ensure we meet End TB and SDG goal 3 targets on time

Trabecular bone score assessed by dual-energy X ray absorption predicts vertebral fractures in HIV infected young adults

IntroductionBone mineral density (BMD) is reduced in patients with human immunodeficiency virus (HIV) infection. Trabecular bone score (TBS) is an additional feature calculated by dual-energy X ray absorption (DXA) that measures texture inhomogeneity at lumbar spine level, providing an index of bone microarchitecture. However, its clinical value still needs to be fully addressed. Aims of the study were to assess BMD and TBS in a cohort of patients with HIV compared to a population of healthy subjects and to investigate the prognostic value of TBS in HIV infected patients. MethodBone health was assessed by DXA in 165 patients with HIV infection (120 men, mean age 40 ± 7 years) and in 164 healthy subjects (53 male, mean age 37 ± 10 years). BMD was measured at level of lumbar spine (L1-L4), femoral neck and total hip. TBS was computed from the images of lumbar spine using machine proprietary software. ResultsBMD at femoral neck level was similar in HIV infected patients and healthy subjects (p = 0.57), whereas BMD measured in total femur was lower in HIV infected patients compared to healthy subjects (p < 0.05). Although mean BMD in lumbar spine was similar between HIV infected patients and healthy subjects (p = 0.90), mean lumbar TBS was lower in patients with HIV infection compared to healthy subjects (p < 0.05). Age, sex and HIV infection resulted independent predictors of reduced TBS. In HIV infected patients age, sex and protease inhibitor duration resulted independent predictors of reduced TBS. TBS was a significant predictor of vertebral fractures during follow-up (p < 0.05). ConclusionPatients with HIV infection have a significant reduction of TBS, a texture parameter related to bone microarchitecture that may provide skeletal information that is not captured from the standard BMD measurement.

Factors Influencing Uptake of HIV/AIDS Care and Support Services among HIV Infected Adults in Baringo County, Kenya

Factors Influencing Uptake of HIV/AIDS Care and Support Services among HIV Infected Adults in Baringo County, Kenya

Cryptosporidiosis in Human Immunodeficiency Virus Patients in Tripoli Medical Center

Cryptosporidiosis is a leading cause of protracted, life threatening diarrhea in Human Immunodeficiency Virus (HIV) infected patients. The aim of this study was to identify risk factors for transmission of cryptosporidiosis in HIV infected adults and to assess prevalence of Cryptosporidium in HIV patients in Tripoli Medical Center (TMC) Hospital. The study was a descriptive prospective cross sectional study carried out on 65 HIV patients in TMC hospital, only symptomatic (diarrheal) HIV infected patients were screened. All Cryptosporidium spp. positive cases were enrolled in the study and interviewed to record socio-demographic information, water supply and animal contact. The results showed the prevalence of infection with cryptosporidium in HIV infected patients was 5% (5 cases) out of 65 patients. The finding of this study indicates that Cryptosporidium parvum is an important cause of morbidity and mortality in immunocompromised patients in Tripoli, Also pollution of water supply provides an important source of infection. And In addition to that the immune status of the patients play an important role in the infection. From the present study the following are recommended: Periodic examination of patients who are suspected to be in special risk, Improved environmental sanitation as water supply and sanitary sewage disposal system.

Assessment of Diabetic and Inflammatory Markers in HIV Infected Adults with and without Diabetes Mellitus in NAUTH, Nnewi, Nigeria

Assessment of Diabetic and Inflammatory Markers in HIV Infected Adults with and without Diabetes Mellitus in NAUTH, Nnewi, Nigeria

Hybrid immunity from severe acute respiratory syndrome coronavirus 2 infection and vaccination in Canadian adults: A cohort study.

Few national-level studies have evaluated the impact of 'hybrid' immunity (vaccination coupled with recovery from infection) from the Omicron variants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). From May 2020 to December 2022, we conducted serial assessments (each of ~4000-9000 adults) examining SARS-CoV-2 antibodies within a mostly representative Canadian cohort drawn from a national online polling platform. Adults, most of whom were vaccinated, reported viral test-confirmed infections and mailed self-collected dried blood spots (DBSs) to a central lab. Samples underwent highly sensitive and specific antibody assays to spike and nucleocapsid protein antigens, the latter triggered only by infection. We estimated cumulative SARS-CoV-2 incidence prior to the Omicron period and during the BA.1/1.1 and BA.2/5 waves. We assessed changes in antibody levels and in age-specific active immunity levels. Spike levels were higher in infected than in uninfected adults, regardless of vaccination doses. Among adults vaccinated at least thrice and infected more than 6 months earlier, spike levels fell notably and continuously for the 9-month post-vaccination. In contrast, among adults infected within 6 months, spike levels declined gradually. Declines were similar by sex, age group, and ethnicity. Recent vaccination attenuated declines in spike levels from older infections. In a convenience sample, spike antibody and cellular responses were correlated. Near the end of 2022, about 35% of adults above age 60 had their last vaccine dose more than 6 months ago, and about 25% remained uninfected. The cumulative incidence of SARS-CoV-2 infection rose from 13% (95% confidence interval 11-14%) before omicron to 78% (76-80%) by December 2022, equating to 25 million infected adults cumulatively. However, the coronavirus disease 2019 (COVID-19) weekly death rate during the BA.2/5 waves was less than half of that during the BA.1/1.1 wave, implying a protective role for hybrid immunity. Strategies to maintain population-level hybrid immunity require up-to-date vaccination coverage, including among those recovering from infection. Population-based, self-collected DBSs are a practicable biological surveillance platform. Funding was provided by the COVID-19 Immunity Task Force, Canadian Institutes of Health Research, Pfizer Global Medical Grants, and St. Michael's Hospital Foundation. PJ and ACG are funded by the Canada Research Chairs Program.

Overview, Trends and Mapping of The Scientific Production on Childhood Tuberculosis: A Scientometric Study

Background: Tuberculosis in children is highly prevalent and is considered community transmission by an infected adult. This study analyzed childhood tuberculosis literature from 2018 to 2023 on Scopus. Methodology: The study was an observational, retrospective design with a bibliometric approach focusing on the scientific production on childhood tuberculosis. A trend analysis and mapping of the literature published in Scopus was performed. The following selection criteria were applied: All types of papers published in Scopus during the study period were included. Papers published between 2018 and 2023 were included. Papers had to be focused on childhood tuberculosis. Results: Antoni Diez Noguera-Julián from SJD Barcelona Children’s Hospital had a field-weighted citation impact of 10.89. Anneke Catharina Hesseling and James Alexander Seddon had the highest output. The University of Melbourne and the University of Barcelona had high field-weighted citation impacts. Despite the United States’ high production, Spain and Australia showed significant influence. The “International Journal of Tuberculosis and Lung Disease” led in production. Conclusions: A bibliometric study on childhood tuberculosis literature from 2018-2023 highlighted Antoni Diez Noguera-Julián’s significant citation impact and the high output of Anneke Catharina Hesseling and James Alexander Seddon. Despite the U.S.'s high production, Spain and Australia showed significant influence.

Anti_spike and anti_nucleocapsid IgG responses to SARS-CoV-2 in children of Jordan

BackgroundIt is proven that children have significantly milder COVID-19 disease compared to adults. Various immunological characteristics influence this age-related difference in protection against COVID-19. Pediatric COVID-19 in Jordan is extremely under reported. ObjectivesThe primary goal of this work is to identify the anti_S and anti_N antibody responses in a random group of children in Jordan and compare it to that of naturally infected-unvaccinated adults. Methods151 unvaccinated children, 4 days to 18 years old, were screened for anti_S and anti_N antibodies. History of COVID-19 infection or exposure to infection and symptom severity were reported by parents on a special questionnaire. Results78.9 % and 65.3 % of participants were seropositive for anti_S IgG and anti_N Abs, respectively. There was a remarkable association between age and anti_S IgG and anti_N IgG antibody titers, as children aged 12 years or older had increased anti_S IgG titers (mean = 19.3 BAU/mL) compared to younger groups (means of 10.15, 9.24, 7.91 BAU/mL for age groups 6–12, 1–6, less than 1 year, respectively). Gender did not show a statistically important role in anti_S and anti_N IgG seropositivity rates or titers. Children displayed significantly elevated anti_S titers (mean = 13.23 BAU/mL) compared to naturally infected adults (mean = 9.72 BAU/mL), in contrast, adults’ anti_N titers (mean = 39.64 U/mL) were significantly higher compared to those of children (mean = 10.77 U/mL). ConclusionsThe current work provides evidence of distinctly robust and persistent humoral immunity displayed by high anti_S and anti_N IgG in children, even >12 months post-infection. Age was the only factor that had a significant statistical impact on anti_S and anti_N Ab levels among the pediatric group in this study. Children exhibited significantly higher anti_S titers than naturally infected adults. In contrast, adults’ anti_N titers were significantly higher. Such information can assist direct pediatric SARS-CoV-2 immunization programs, with implications for creating age-targeted strategies for diagnostic and population protection measures.

Genomic insights into the diversity, virulence, and antimicrobial resistance of group B Streptococcus clinical isolates from Saudi Arabia.

Detailed assessment of the population structure of group B Streptococcus (GBS) among adults is still lacking in Saudi Arabia. Here we characterized a representative collection of isolates from colonized and infected adults. GBS isolates (n=89) were sequenced by Illumina and screened for virulence and antimicrobial resistance determinants. Genetic diversity was assessed by single nucleotide polymorphisms and core-genome MLST analyses. Genome sequences revealed 28 sequence types (STs) and nine distinct serotypes, including uncommon serotypes VII and VIII. Majority of these STs (n=76) belonged to the human-associated clonal complexes (CCs) CC1 (33.71%), CC19 (25.84%), CC17 (11.24%), CC10/CC12 (7.87%), and CC452 (6.74%). Major CCs exhibited intra-lineage serotype diversity, except for the hypervirulent CC17, which exclusively expressed serotype III. Virulence profiling revealed that nearly all isolates (94.38%) carried at least one of the four alpha family protein genes (i.e., alphaC, alp1, alp2/3, and rib), and 92.13% expressed one of the two serine-rich repeat surface proteins Srr1 or Srr2. In addition, most isolates harbored the pilus island (PI)-2a alone (15.73%) or in combination with PI-1 (62.92%), and those carrying PI-2b alone (10.11%) belonged to CC17. Phylogenetic analysis grouped the sequenced isolates according to CCs and further subdivided them along with their serotypes. Overall, isolates across all CC1 phylogenetic clusters expressed Srr1 and carried the PI-1 and PI-2a loci, but differed in genes encoding the alpha-like proteins. CC19 clusters were dominated by the III/rib/srr1/PI-1+PI-2a (43.48%, 10/23) and V/alp1/srr1/PI-1+PI-2a (34.78%, 8/23) lineages, whereas most CC17 isolates (90%, 9/10) had the same III/rib/srr2/P1-2b genetic background. Interestingly, genes encoding the CC17-specific adhesins HvgA and Srr2 were detected in phylogenetically distant isolates belonging to ST1212, suggesting that other highly virulent strains might be circulating within the species. Resistance to macrolides and/or lincosamides across all major CCs (n=48) was associated with the acquisition of erm(B) (62.5%, 30/48), erm(A) (27.1%, 13/48), lsa(C) (8.3%, 4/48), and mef(A) (2.1%, 1/48) genes, whereas resistance to tetracycline was mainly mediated by presence of tet(M) (64.18%, 43/67) and tet(O) (20.9%, 14/67) alone or in combination (13.43%, 9/67). These findings underscore the necessity for more rigorous characterization of GBS isolates causing infections.

Transcriptome data reveal beneficial effects of Rickettsia (Rickettsiales: Rickettsiaceae) on Bemisia tabaci(Hemiptera: Aleyrodidae) through nutritional factors and defense mechanisms.

Whitefly Bemisia tabaci (Hemiptera: Aleyrodidae) is a destructive insect pest of many crops. Rickettsia infection in different cryptic species of B. tabaci has been observed worldwide. Understanding the interactions between these 2 organisms is critical to developing Rickettsia-based strategies to control B. tabaci and thereby reduce the transmission of related vector-borne viruses. In this study, we investigated the effects of Rickettsia infection on the biological characteristics of the Middle East Asia Minor 1 (MEAM1) strain of B. tabaci through biological analysis of infected and uninfected individuals. The results of this study suggest that Rickettsia may confer fitness benefits. These benefits include increased fertility, improved survival rates, accelerated development, and resulted in female bias. We also investigated the transcriptomics impact of Rickettsia infection on B. tabaci by performing a comparative RNA-seq analysis of nymphs and adult females, both with and without the infection. Our analysis revealed 218 significant differentially expressed genes (DEGs) in infected nymphs compared to uninfected ones and 748 significant DEGs in infected female adults compared to their uninfected whiteflies. Pathway analysis further revealed that Rickettsia can affect many important metabolic pathways in whiteflies. The results suggest that Rickettsia plays an essential role in energy metabolism, and nutrient synthesis in the B. tabaci MEAM1, and depends on metabolites obtained from the host to ensure its survival. Overall, our findings suggest that Rickettsia has beneficial effects on B. tabaci and offered insights into the potential molecular mechanisms governing the interactions between Rickettsia and B. tabaci MEAM1.

Predictors of severe hepatotoxicity among retroviral infected adults on HAART regimen in Ilubabor Zone, Southwest Ethiopia

Nearly half of the deaths among hospitalized human immuno deficiency virus-infected patients in the highly active antiretroviral therapy era have been attributed to liver disease. This may range from an asymptomatic mild increase of liver enzymes to cirrhosis and liver failure. Different works of literature elucidated both retroviral infection and the adverse effects of highly active antiretroviral therapy as a cause of hepatotoxicity. Individual adaptations to medications and environmental exposures, shaped by cultural norms and genetic predispositions, could potentially modulate the risk and progression of liver disease in this population. Therefore, this study aims to assess the predictors of severe hepatotoxicity in retroviral-infected adults receiving highly active antiretroviral therapy regimens within the Ilubabor Zone, Southwest Ethiopia. A facility-based cross-sectional study was conducted among adult retroviral-infected patients in five selected anti-retro virus therapy clinics from May1 to July 30/2022. A systematic sampling technique was used to select 457 study participants and Binary logistic regression statistical data analysis was used, P value < 0.05 was considered statistically significant. The prevalence of severe hepatotoxicity was 21.44% in the study population. CD+4 count < 200 cells/mm3 (AOR = 2.19, 95% CI 1.04–5.22, P = 0.01), human immunodeficiency virus co-infection with tuberculosis (AOR = 2.82, 95% CI 1.01–8.29, P = 0.03) and human immuno deficiency virus co-infection with hepatitis-B/hepatitis C virus (AOR = 5.02, 95% CI 1.82–16.41) were predictors of severe hepatotoxicity. The magnitude of severe hepatotoxicity was high among adult retroviral-infected patients on highly active anti-retroviral drug regimens. Co-infection of human immuno deficiency virus with hepatitis B virus or hepatitis C virus, tuberculosis and CD4+T-cell count below 200 cells/mm3 were predictors of severe hepatotoxicity. Therefore, HIV patients on highly active antiretroviral therapy require close attention and regular monitoring of their liver function.

Tobacco use profile among COVID-19 infected adults and clinical disease spectrum in Qatar during the early pandemic

ABSTRACT Objective To describe the tobacco use profile among COVID-19-infected adult smokers, to assess the nicotine addiction level, and its impact on the disease progression and outcome in Qatar during the early pandemic. Design A cross-sectional study was conducted between May 2020 and May 2021. Setting Electronic medical records from Qatar’s National Health Information System under the Communicable Disease Center. Participants All confirmed COVID-19-infected adults who could communicate in English and Arabic were randomly selected and invited to participate in a telephone survey. Result Among 576 subjects, 118 (20.48%) had a smoking history, with 76.3% being current tobacco smokers and 23.7% former smokers. Current smokers were predominantly male (93.3%), single (51.1%), and highly educated (80%). Cigarette smoking was prevalent among 66.4% of current smokers, with 49.3% smoking ten or fewer cigarettes daily and 71% having low nicotine dependence. In addition, many cigarette users smoked more than one tobacco product during the pandemic. Among COVID-19-infected smokers, 75.6% were symptomatic, and highly nicotine-addicted individuals experienced more hospitalizations, including ICU admissions, with all deaths occurring in this group. Conclusion This research concludes that deaths and poor health outcomes were more frequent among COVID-19-infected smokers. Prioritizing smokers for vaccination and promoting cessation is critical.

Viral Load Suppression Among HIV Infected Adults On Antiretroviral Treatment In Rural Settings Of The Centre Region Of Cameroon: A Retrospective Cohort Study

The Joint United Nations Program on HIV/AIDS (UNAIDS) set ambitious targets known as the 95-95-95 goals, aiming for 95% of people living with HIV to know their status, 95% of those diagnosed to be on sustained ART, and 95% of those on ART to have viral suppression by 2030. This underscores the significance of viral load (VL) monitoring and suppression as crucial components of the HIV care continuum towards reaching epidemic control. This study was meant to explore viral load suppression among HIV-infected adults on ART in the rural areas of the Centre Region of Cameroon. We conducted a retrospective cohort study on all HIV-infected adults who were initiated on ART between June 2020 and May 2021 in ten rural ART clinics. Patients’ medical records were reviewed for data collection. Of the 2 591 HIV-infected adults on ART whose medical files were reviewed, 1 727 (66.7%) had documented viral load (VL) results at 12 months post-ART initiation giving a viral load coverage of 66.7%. Among the 1,727 documented VL, the proportion of participants that achieved viral suppression (viral load &lt;1000 copies/mL) was 1 654, representing 95.8%. Occupation at initiation (aOR: 0.416, 95% CI: 0.196–0.885, p=0.023) and disclosure of HIV status to partners (cOR: 0.557, 95% CI: 0.317–0.978, p=0.042) emerged as significant predictors of VL suppression. Findings from this study show that as HIV care continues to evolve, interventions tailored to individual needs and context-specific challenges should be prioritized to optimize treatment outcomes.

Demographic, Behavioural and Clinical Characteristics of HIV-infected Adults Initiating Antiretroviral Therapy in Rural ART Clinics in the Centre Region of Cameroon

Despite considerable progress in the scale-up of antiretroviral therapy programs in Cameroon, disparities persist between urban and rural settings. Understanding the characteristics of rural populations is crucial for designing effective, context-specific interventions that address barriers to early HIV care engagement. A retrospective cohort study was conducted of all HIV infected adults who initiated ART at 10 rural ART clinics in the Centre Region of Cameroon between June 2020 and May 2021. Patients’ medical records were reviewed for data collection. Of the 2 591 HIV infected adults included in the analysis, 983 (37.9%) were males and 1 608 (62.1%) females. Mean age at initiation was 38.91 ± 11.41 years with statistically significant difference between genders (p = 0.0002). A higher percentage of females (34.8%) initiated care in the 21-30 years age group than males (18.6%) (χ² = 87.163, p &lt; 0.0001). More females initiating ART had no formal education (10.3%) or primary education (42.3%) compared to their male counterparts (8.1% and 40.7%, respectively) (χ² = 13.213, p=0.021). Females (56.7%) were more likely not to disclose their HIV status to their partners than males (53.2%) (χ² = 9.380, p = 0.009*). Moreover, more females (71.1%) compared to males (41.1%) initiated ART with TDF/3TC/DTG (χ² = 35.509, p &lt; 0.0001*). The findings from the study show the complexity of demographic, behavioural and clinical factors influencing ART engagement emphasising the importance of tailored interventions to address the unique challenges faced by both males and females during this critical phase of care.

Efficacy and Persistence of Entomopathogenic Fungi against Rhynchophorus ferrugineus on Date Palm: Host to Host Transmission

The red palm weevil (RPW), Rhynchophorus ferrugineus (Olivier) (Coleoptera: Dryophthoridae), is a destructive and voracious pest of palm species worldwide. Due to environmental and regulatory concerns, ecologically safe alternatives to synthetic chemical insecticides are needed to manage this cryptic insect species. Entomopathogenic fungi have the potential to manage this pest. The scope of management and effectiveness can be improved by direct control or horizontal transmission of entomopathogenic fungal isolates. We tested in the laboratory the virulence and pathogenicity of fifteen different entomopathogenic fungal isolates belonging to the following species: Beauveria bassiana, Metarhizium anisopliae, Beauveria brongniartii and Purpureocillium lilacinum. All fungal isolates were found virulent against larvae (14.9 ± 1.06 to 81.5 ± 1.48% mortality) and adults (5.6 ± 1.12 to 51.7 ± 1.51% mortality) at 12 d post-treatment. From a screening bioassay, five M. anisopliae (WG-08, WG-09) and B. bassiana (WG-23, WG-24, WG-25) isolates were tested for their concentration response mortality against larvae and adults after 7, 14 and 21 days (d) of treatment. Mortality was found positively correlated with concentration and time. At 21 d of treatment, WG-23 and WG-25 1 × 108 conidia/mL resulted in 100% mortality against larvae while only WG-25 1 × 109 conidia/mL caused 100% mortality of adults. Along with mortality, all the potential isolates have strong ovicidal effects that reduced 81.49% at 1 × 108 conidia/mL. The horizontal transmission bioassay indicated that the infected adults transmitted the disease to healthy individuals. Horizontal transmission of fungi from infected to non-infected adults not only caused significant mortality but also had a serious sublethal impact on insect development and fitness including reduced number of eggs/d fecundity, egg viability and neonate survival. Isolate WG-25 reduced oviposition (0.5 eggs/d), fecundity (11.7 eggs/female), egg viability (11.6%) along with larval survival 25.9% when infected male mated with normal female. In semi-field trials, all fungal isolates reduced survival of larvae found inside the palms and ultimately reduced infestations over a period of two months. The results of this study indicate that entomopathogenic fungi should be further tested for sustainable and efficient control of RPW in date palm production systems.

T-cell count and T-cell telomere length in patients with severe COVID-19.

Lymphocyte telomere length (TL) is highly variable and shortens with age. Short telomeres may impede TL-dependent T-cell clonal expansion with viral infection. As SARS-CoV-2 infection can induce prolonged and severe T-cell lymphopenia, infected adults, and particularly older adults with short telomeres, may display severe T-cell lymphopenia. To examine the relationship between T-cell TL parameters and T-cell counts, we studied 40 patients hospitalized with severe COVID-19. T-cells were isolated from lymphocytes, counted using flow cytometry, and their TL parameters were measured using the Telomere Shortest Length Assay. The cohort (median age = 62 years, 27% female) was racially and ethnically diverse (33% White, 35% Black, and 33% Other). On intensive care unit study day 1, T-cell count (mean=1.03 x109/L) was inversely related to age (p=0.007) and higher in females than males (p=0.025). Mean TL was 3.88 kilobases (kb), and 45.3% of telomeres were shorter than 3 kb. Using multiple regression analysis and adjusting for age and sex, T-cell count decreased with increased proportion of T-cell telomeres shorter than 3 kb (p=0.033) and increased with mean TL (p=0.052). Our findings suggest an association between the buildup of short telomeres within T-cells and explain in part reduced peripheral blood T-cell counts in patients with severe COVID-19. Shortened T-cell telomeres may be a risk factor for COVID-19-associated T-cell lymphopenia.