Burden Of Infection Research Articles

Consistent and Correct Use of Condoms With Lubricants and Associated Factors Among Men Who Have Sex With Men from the Ghana Men's Study II: Protocol for a Mixed Methods Study.

Men who have sex with men (MSM) experience a disproportionate burden of HIV infection globally, including in Ghana. The use of condoms with lubricants correctly and consistently plays a vital role in reducing the number of new HIV infections among MSM. However, there are concerns about the consistent and correct use of condoms and lubricants among MSM in Ghana. In this regard, there is a need to understand context-specific factors associated with consistent and correct condom use with lubricants. This study aims to determine the current scope of consistent and correct use of condoms with lubricants, associated factors, interventions, and user- and service-related challenges on correct condom and lubricant use among the MSM population in Ghana. The study will use a mixed methods study approach. First, a retrospective analysis of the Ghana Men's Study II data set involving 4095 MSM will be conducted to determine the scope of consistency and correct use of condoms with lubricants as well as associated factors. The data will be imported into STATA (version 17; StataCorp LLC) to treat missing data and outliers before the analysis. Bivariate and multivariate logistic regression analyses will be conducted to determine the associated factors of consistent condom use with lubricants. All statistical analyses will be done at a 95% CI, with significant differences at P<.05. Second, in-depth interviews with a purposive sample of about 15-20 stakeholders will also be conducted to understand contextual issues regarding the factors identified, identify existing interventions for correct condom and lubricant use, user and service-related challenges, and how best to address those challenges from the stakeholders' perspectives. For qualitative data, thematic analysis will be conducted using Atlas.ti version 23.1.1. Qualitative and quantitative results will be triangulated together with systematic review results, and key findings will be highlighted and used to guide the development of a predictive model for improving correct and consistent condom use with lubrication among MSM. This protocol paper, part of a doctoral study by the first author (RA), received approval from the Research and Ethics Committee of the University of Johannesburg on May 10, 2024. Data collection commenced on August 20, 2024, and the expected results will be published by October 2025. Results from qualitative interviews and secondary data analysis will be triangulated to develop a predictive model to strengthen the correct and consistent use of condoms with condom-compatible lubricants among MSM and other key population groups in Ghana and other parts of sub-Saharan Africa for future pandemic preparedness, policy making, and targeted budget allocation. DERR1-10.2196/63276.

Global, regional, and national burden of dengue infection in children and adolescents: an analysis of the Global Burden of Disease Study 2021

Dengue remains a global threat to public health, however, its disease burden among children and adolescents has always been poorly quantified. Therefore, we aimed to systematically estimate the global, regional, and national burden and temporal trends of dengue infection in children and adolescents from 1990 to2021. Data on the number and rate of incidence and disability-adjusted life-years (DALYs) of dengue infection among children and adolescents under 20 years were obtained from the Global Burden of Disease Study (GBD) 2021. Estimated annual percentage changes (EAPCs) of the age-standardised incidence rate (ASIR) and age-standardised DALYs rate (ASDR), by age, sex, and different countries and regions, were calculated to quantify the temporal trends of dengue burden. The association between development levels (measured using the socio-demographic index [SDI]) and dengue burden was also determined. From 1990 to 2021, the global burden of dengue incidence and its associated DALYs was consistently higher in children and adolescents than in the entire population. Globally, among children and adolescents, there were 21,641,016 incident cases in 2021, an increase of 64.43% compared to 13,241,719 in 1990. The ASIR per 100,000 population increased from 587.81 in 1990 to 812.16 in 2021, with an EAPC of 1.39% (95% confidence interval [CI], 1.13%-1.65%). Besides, the number of dengue-associated DALYs among children and adolescents increased by 16.36%, from 910,458.60 in 1990 to 1,059,428.31 in 2021. The increase in DALYs was less pronounced than incidence, with the ASDR per 100,000 population increasing from 40.17 in 1990 to 41.50 in 2021, and the EAPC was only 0.67% (95% CI, 0.40%-0.95%). The incidence and DALYs burden of dengue in children and adolescents was highest in middle SDI regions, followed by low-middle SDI regions, with the lowest burden in high SDI regions. Furthermore, Tropical Latin America had an extremely high ASIR (6040.29 per 100,000 population in 2021), and Southeast Asia had an extremely high ASDR (298.20 per 100,000 population in 2021), much higher than other regions around the world. The global dengue burden in children and adolescents is high and has been increasing from 1990 to 2021, even though the distribution patterns vary across different countries and territories. This study first reported the global disease burden and temporal trends of children and adolescents, which has significant implications for policymakers and public health officials, as it underscores the need for age- and region-specific strategies to mitigate the growing global burden of dengue. National Natural Science Foundation of China.

Key Risk Factors of Asthma-Like Symptoms Are Mediated Through Infection Burden in Early Childhood.

Key Risk Factors of Asthma-Like Symptoms Are Mediated Through Infection Burden in Early Childhood.

Differential distribution of NAT2 polymorphisms and NAT2 acetylator phenotypes among indigenous populations of the Brazilian Amazon.

We report, for the first time, the distribution of four no-function NAT2 single nucleotide polymorphisms and inferred NAT2 acetylator phenotypes in three indigenous groups (Munduruku, Paiter-Suruí, and Yanomami), living in reservation areas in the Brazilian Amazon. Two hundred and seventy-six participants from three indigenous groups (92 for each group) were included and genotyped for four NAT2 polymorphisms (rs1801279, rs1801280, rs1799930, and rs1799931) by the TaqMan system. Minor Allele Frequency (MAF) was determined and NAT2 acetylator phenotypes were inferred. NAT2 rs1801279G>A was absent in all cohorts; rs1799930G>A was absent in Yanomami and rare (MAF 0.016) in Munduruku and Paiter-Suruí; MAF of rs1801280T>C ranged five-fold (0.092-0.433), and MAF of rs1799931G>A varied between 0.179 and 0.283, among the three groups. The distribution of NAT2 phenotypes differed significantly across cohorts; the prevalence of the slow acetylator phenotype ranged from 16.3% in Yanomami to 33.3% in Munduruku to 48.9% in Paiter-Suruí. This three-fold range of variation is of major clinical relevance because the NAT2 slow phenotype is associated with higher risk of hepatotoxicity with antituberculosis chemotherapy and high incidence rates of tuberculosis and burden of latent infection among Munduruku, Paiter-Surui, and Yanomami peoples. According to the frequency of the NAT2 slow acetylator phenotype, the estimated number of individuals needed to be genotyped to prevent one additional event of hepatotoxicity range from 31 (Munduruku) to 39 (Paiter-Surui) and to 67 (Yanomami). The rs1801279 polymorphism was not found in any of the cohorts, while the MAF of the other polymorphisms showed significant variation between the cohorts. The difference in the prevalence of the NAT2 slow acetylator phenotype, which is linked to isoniazid-induced hepatotoxicity, was observed in the different study cohorts.

Antibiotic Utilization Among People With Multiple Sclerosis in the Netherlands, 2018-2020.

The purpose of this study was to describe the intensity and patterns of antibiotic drug use among people with multiple sclerosis (pwMS) in the Netherlands. People with prevalent MS between 1 January 2018 and 31 December 2020 were identified using ambulatory hospital records from the PHARMO Database Network that contains routinely collected healthcare data from the Netherlands. Out-patient pharmacy dispensing data were used to assess type of antibiotic, dosage, and amounts dispensed. Antibiotic intensity in defined daily doses (DDD)/1000 patient-days (PD) was calculated together with frequency of dispensing of the same (prolongation) or different (switch) antibiotic up to 3 days after the end of the last antibiotic prescription; and stratified by sex, age, polypharmacy (use of > 4 out-patient prescription drugs for > 29 days), type of disease-modifying treatment, and Sars-CoV-2-related lockdown. A total of 1960 (37.8%) out of 5179 pwMS were dispensed ≥ 1 antibiotic. Of the 8762 dispensing events, 27.6%% were part of a prolongation, and 16.3% of a switch. Overall antibiotic use among pwMS was 18.8 DDD/1000 PD (95% confidence interval [95% CI]: 18.7-19.0) compared to 7.77-8.90 DDD/1000 PD in the general out-patient population, as reported by the Dutch Working Party on Antibiotic Policy. Antibiotic use was higher among women, increased with age, and was higher in people with polypharmacy and lower during lockdown. Nitrofurantoin was the most commonly dispensed antibiotic (41.7%). The intensity of antibiotic use is considerably higher among pwMS than the general population. This reflects the burden of infection in this susceptible population.

The Epidemiology, Clinical, and Economic Burdens of Respiratory Syncytial Virus Infections Amongst Hospitalized Children Under 5 Years of Age in Jordan: A National Multi-Center Cross-Sectional Study

Respiratory syncytial virus (RSV) has been recognized as a highly important cause of morbidity and mortality among children and adults. A cross-sectional study at representative sites in Jordan was undertaken to provide an assessment of the epidemiology and health and economic burdens of RSV and influenza infections in Jordan amongst hospitalized children under 5 years old for the period between 15 November 2022 and 14 April 2023. This study involved 1000 patients with a mean age of 17.10 (SD: 16.57) months. Of these, half (n = 506, 50.6%) had positive results for RSV. Furthermore, 33% and 17.4% of the participants had positive results for RSV-B and RSV-A, respectively. The findings underscore the severity of RSV infections, where a significant proportion of the children experienced severe respiratory distress, which led to bronchiolitis and pneumonia. This study meticulously documented the clinical outcomes, including the need for intensive care, mechanical ventilation, and prolonged hospital stays. There was no statistically significant difference in the financial burdens between the RSV-positive and RSV-negative patients. This study revealed the urgent need for preventive measures to control the substantial burden of RSV among children under 5 years old in Jordan.

Prevalence and determinants of TB/HIV coinfection: the double tragedy of infectious disease burden – a 5-year retrospective study in a tertiary health facility in Enugu State, Nigeria

ObjectiveTo ascertain the prevalence and determinants of tuberculosis (TB)/HIV coinfection in Enugu State Nigeria.Study designA 5-year record-based retrospective study (2018–2022) conducted at a tertiary health facility to identify TB/HIV coinfections.SettingAbout...

Predictors of Nosocomial Infections among Geriatric Patients in the Internal Medicine Department of the University Teaching Hospital of Butare (CHUB), South, Huye, Rwanda

Purpose: Nosocomial infections pose a significant burden worldwide, particularly in resource-limited settings. This study aimed to determine predictors of nosocomial infections among geriatric patients at the University Teaching Hospital of Butare (CHUB) in Rwanda. Methodology: A quantitative cross-sectional cohort study over seven months included participants admitted to CHUB's Internal Medicine department from July 2023 to January 2024 with the aim to determine the Nosocomial infections predictors among elderly aged 61 years and above. The target sample size was 313, but a census approach with 400+ participants was used. Data collection involved physician examinations, laboratory testing, interviews, facility observations, specimen culture, antimicrobial susceptibility testing, and logistic regression analyses. Findings: The study included 206 participants who were screened infection-free at admission, predominantly from Southern Province (85%) and female (56%), with a median hospital stay of 3 days. Most were admitted from Kabutare District Hospital (22%) to Internal Medicine (90%). Age distribution peaked at 61 years and above (38.8%) and 60 years and below (61.2%). Unemployment was high (83%), especially among females (60%) and those with low education. Prior 30-day hospitalization occurred in 34%, mainly for non-communicable diseases (41%) and infections (20%). Chronic conditions were reported by 41%, commonly hypertension (37%), other non-communicable diseases (14%), and diabetes (10%). Recent antibiotic use was 23%, primarily ceftriaxone (54%). Urine samples dominated (55%), with prevalent pathogens like Escherichia coli and Staphylococcus species. But more importantly this study demonstrated a strong association between nosocomial infection level and some predictors with significant P values as follows: time of stay (P=0.002), Health Care providers following WHO 5 Moments of hand hygiene (P=0.005), disinfection of medical devices by Health Care providers (P=0.036) and hands washing before taking medicines (P=0.047). Unique Contribution to Theory, Practice and Policy: The environmental decontamination and antibiotic rotation policies should be implemented to manage Acinetobacter spp. infections. As well hand hygiene adherence and preventive measures for urinary tract infections will address Escherichia Coli infections. Efforts to mitigate the burden of nosocomial infections should prioritize the enhanced surveillance, establishing robust infection tracking systems across healthcare facilities, invest in antimicrobial stewardship and targeted interventions tailoring infection control practices to high-risk groups like geriatric patients.

Fractional-Calculus Analysis of the Dynamics of a Vector-Borne Infection with Preventive Measures

Vector-borne infections pose serious public health challenges due to the complex interplay of biological, environmental, and social factors. Therefore, comprehensive approaches are essential to mitigate the burden of vector-borne infections and minimize their impact on public health. In this research, an epidemic model for the vector-borne disease malaria is structured with a saturated incidence rate via fractional calculus and preventive measures. The essential results and concepts are introduced to examine the proposed model. The solution of the system is examined for some necessary results, and the threshold parameter of the model, indicated by R0, is calculated. In this paper, the proposed malaria model is analyzed both quantitatively and qualitatively. The fixed-point theorems of Banach and Schaefer are utilized to examine the uniqueness and existence of the solution dynamics. Furthermore, the necessary conditions for the stability of the model have been determined. A numerical approach is offered to visualize the solution pathways of the system and identify its key factors. Through the results, the most influential factors for the control and management of the disease are highlighted.

Burden of Common Respiratory Pathogens Among Cats in China.

Feline respiratory disease complex (FRDC) is a set of illnesses which are primarily associated with different types of viruses and bacteria. There is scarcity of data on pathogens associated with FRDC in China. The primary objective of this study was to investigate the prevalence and dynamics of FRDC pathogens in China. A total of 458 samples were retrieved from veterinary clinics during 2021-2024 from cats suffering from respiratory infections. Four viruses and three bacteria associated with FRDC were targeted for molecular detection with real time qPCR/RT-qPCR assays. At least 1 targeted respiratory pathogen was detected in 423 samples (92.3%), whereas no pathogens were detected in 7.7% of samples. Bacteria were detected in 32.1% of samples, and viruses were detected in 60.2% of samples. The prevalence of viruses detected were feline calicivirus (31.2%), feline herpesvirus-1 (24.6%), influenza A virus (2.8%) and severe acute respiratory syndrome coronavirus-2 (1.5%), whereas the detection rate for bacteria was Mycoplasma felis (15.5%), Chlamydia felis (10.2%) and Bordetella bronchiseptica (6.3%). Significantly higher cases were reported from kittens (57.4%). Pathogen detection was more common during the cold season. Mono-infections involving one bacteria or virus were detected in 44.7% of samples, whereas coinfections were detected in 47.5% of samples. No quadruple coinfections were recorded in this study. The frequency of detection of feline respiratory pathogens alone or in combinations among diseased cats was high, indicating a heavy burden of respiratory infections among cats in Kunshan, China. Continued surveillance is desired, and newly emerged respiratory pathogens should also be monitored in routine diagnostic testing.

Infectious morbidity and white blood cell count associated with grade repetition and school absenteeism.

Infections can impair cognitive development, but their role on adverse childhood educational outcomes is unknown. We examined the associations of infectious morbidity and inflammatory biomarkers with grade repetition and school absenteeism. We followed 2762 Colombian children aged 5-12 years for a school year. We quantified inflammatory biomarkers at enrolment and prospectively recorded incidence of gastrointestinal and respiratory infections, doctor visits and absent days from school using pictorial diaries. We estimated adjusted relative risks (ARR) with 95% confidence intervals (CI) for grade repetition and absenteeism by infectious morbidity burden and inflammatory biomarker categories, and percentages of the associations mediated through absenteeism. Morbidity was associated with increased risk of grade repetition. ARR (95% CI) of grade repetition comparing high versus no incidence of gastrointestinal, respiratory and ear infections were, respectively, 2.17 (1.00, 4.72), 2.31 (1.28, 4.16) and 2.57 (1.13, 5.86). Infections also predicted school absenteeism, which mediated 35%, 31% and 38% of the corresponding morbidity-grade repetition associations. Elevated white blood cells (WBC), especially granulocytes, were related to increased grade repetition and school absenteeism risks. Childhood infections and elevated WBC are associated with grade repetition and school absenteeism. Absenteeism does not fully explain the morbidity-grade repetition associations.

Efficient modelling of infectious diseases in wildlife: A case study of bovine tuberculosis in wild badgers.

Bovine tuberculosis (bTB) has significant socio-economic and welfare impacts on the cattle industry in parts of the world. In the United Kingdom and Ireland, disease control is complicated by the presence of infection in wildlife, principally the European badger. Control strategies tend to be applied to whole populations, but better identification of key sources of transmission, whether individuals or groups, could help inform more efficient approaches. Mechanistic transmission models can be used to better understand key epidemiological drivers of disease spread and identify high-risk individuals and groups if they can be adequately fitted to observed data. However, this is a significant challenge, especially within wildlife populations, because monitoring relies on imperfect diagnostic test information, and even under systematic surveillance efforts (such as capture-mark-recapture sampling) epidemiological events are only partially observed. To this end we develop a stochastic compartmental model of bTB transmission, and fit this to individual-level data from a unique > 40-year longitudinal study of 2,391 badgers using a recently developed individual forward filtering backward sampling algorithm. Modelling challenges are further compounded by spatio-temporal meta-population structures and age-dependent mortality. We develop a novel estimator for the individual effective reproduction number that provides quantitative evidence for the presence of superspreader badgers, despite the population-level effective reproduction number being less than one. We also infer measures of the hidden burden of infection in the host population through time; the relative likelihoods of competing routes of transmission; effective and realised infectious periods; and longitudinal measures of diagnostic test performance. This modelling framework provides an efficient and generalisable way to fit state-space models to individual-level data in wildlife populations, which allows identification of high-risk individuals and exploration of important epidemiological questions about bTB and other wildlife diseases.

Prevalence and risk factors of gunshot wound infection in the eastern Democratic Republic of the Congo: A hospital‐based cross‐sectional study

AbstractBackgroundSurvivors of gunshot injuries are at high risk of developing infections at the injury site. However, data on gunshot wound infections and their associated burdens are limited. This study aims to determine the prevalence of gunshot wound infections and identify the risk factors associated with them in a tertiary hospital located in the eastern part of the Democratic Republic of the Congo.Materials and MethodsThis retrospective observational study was conducted at the Provincial General Reference Hospital of Bukavu in the Democratic Republic of the Congo, reviewing data from patients hospitalised between January 1, 2019, and December 31, 2020.ResultsA total of 549 patients were included in the study, with wound infections occurring in 26.6% of cases. Multivariate logistic regression analysis identified fractures (adjusted odds ratio [aOR] = 1.81; 95% confidence interval [CI] 1.12–2.92; P = .0146), nerve damage (aOR = 2.65; 95% CI 1.70–4.14; P &lt; .0001), trunk injuries (aOR = 5.64; 95% CI 2.61–12.16; P &lt; .0001), lower extremity injuries (aOR = 2.71; 95% CI 1.39–5.28; P = .0034), and multiple injuries (&gt;2; aOR = 2.35; 95% CI 1.05–5.25; P = .0378) as independent predictors of gunshot wound infection.ConclusionThe main factors predisposing gunshot wounds to infection, identified in this study, require thorough evaluation and urgent management. In cases of abdominal gunshot trauma, fractures, and vascular or nerve lesions, management procedures are aimed at reducing the infection burden.

Diversity, Distribution, and Resistance Profiles of Bacterial Bloodstream Infections in Three Tertiary Referral Hospitals in Rwanda Between 2020 and 2022.

Background: The burden of bacterial bloodstream infections (BSIs) is rapidly increasing in Africa including Rwanda. Methods: This is a retrospective study that investigates the diversity, distribution, and antimicrobial susceptibility profiles of BSI bacteria in three tertiary referral hospitals in Rwanda between 2020 and 2022. Results: A total of 1532 blood culture tests were performed for visiting patients. Overall, the proportions of Gram-negative and Gram-positive bacteria were 48.2% and 51.8, respectively. Staphylococcus aureus was the predominant species accounting for 25% of all Gram-positive BSI species, and Klebsiella species represented 41% of all Gram-negative BSI species. Antimicrobial susceptibility testing revealed that Amikacin exhibited the highest activity against Enterobacter spp., Serratia spp., and Escherichia coli in >92% of cases and Klebsiella spp. in 75.7%. Meropenem and Imipenem were highly efficacious to Salmonella spp. (100% susceptibility), Enterobacter spp. (96.2% and 91.7%, respectively), and Escherichia coli (94.7% and 95.5%, respectively). The susceptibility of Enterococcus spp., S. aureus, and Streptococcus spp. to Vancomycin was 100%, 99.5%, and 97.1%, respectively. Klebsiella spp. was highly sensitive to Colistin (98.7%), Polymyxin B (85.6%), Imipenem (84.9%), and Meropenem (78.5%). Conclusions: We recommend strengthening the implementation of integrated transdisciplinary and multisectoral One Health including AMR stewardship for the surveillance, prevention, and control of AMR in Rwanda.

Low-cost, real-time detection of bacterial growth via diffraction-based sensing.

The emergence of antibacterial resistance impacts healthcare networks globally, with mortality rates and linked burdens of infection disproportionately affecting the developing world. Rapid alternatives to antibiotic susceptibility testing (AST) allow for swifter, more effective treatment, though they are limited in use in low-resource settings due to significant cost barriers. Herein we demonstrate a simple, cost-effective diffraction sensing-based approach for rapidly detecting bacterial growth (a precursor to AST). Diffraction gratings (1D, lined) directly comprised of our test bacteria (Escherichia coli DH5α) were produced using soft agar-based gel templates designed to direct bacterial attachment and produce a near-zero background signal. The diffraction spot intensities from the live bacterial gratings were monitored in growth and no growth (ampicillin) conditions at room temperature, using a simple fixed laser and photodetector setup. Growth-induced differences in signal were observed within 10-20 minutes, highlighting the sensitivity of this approach and its potential to be adapted as a rapid and accessible AST alternative.

The economic burden of nosocomial infections for hospitals: evidence from Germany

BackgroundNosocomial infections (NI) significantly worsen patient outcomes, resulting in higher mortality rates and reduced health-related quality of life. Furthermore, they pose substantial economic strain on healthcare systems and hospitals. For instance, patients with nosocomial infections (NIs) experience prolonged hospital stays compared to those without NIs. These extended stays result in occupied bed-days, leading to opportunity costs for hospitals. This study aimed to estimate the opportunity costs for a German hospital based on hospital stays, daily revenue, and occupancy rates (OCR).MethodsWe analysed cost data obtained from routine records maintained by the accounting department of a German hospital's surgical and orthopedic units from 2018 to 2019 for the “HygArzt” research project. To ensure balance, we employed genetic matching. We estimated the differences in length of stay (LOS) and daily revenue between patients with and without nosocomial infections (NI) using linear regression. Finally, we calculated the opportunity cost borne by the hospital by treating NI patients instead of non-NI patients. All costs are reported in 2018 Euros.ResultsThe final sample included 81 patients with NI matched with 207 patients without NI. The majority of the NI patients (77.0%) had surgical site infection (SSI). Compared to non-NI patients, we observed that NI patients had a longer LOS (10 days, p < 0.001) and lower daily revenue (€400, p < 0.001). We also found that comorbidities and the frequency of operations had significant impact on the LOS. Using a baseline 30 to 50% preventable NIs, successful prevention of a single NI could potentially reduce the length of hospital stay by 3 to 5 days and increase hospital revenue by approximately €120 to €200 per day per prevented NI. Consequently, the hospital saves 3 to 5 more bed-days to backfill and generate more revenue, and/or make more efficient resource allocation by changing bed-capacity and staffing. The resulting opportunity costs can potentially exceed €1,000 per preventable case.ConclusionNIs pose a substantial economic burden for hospitals. From a health economics’ perspective, there are strong economic incentives for hospitals to implement infection control interventions, such as the involvement of a prevention link physician/nurse.

Factors associated with HIV self-testing and PrEP use among Nigerian youth: Baseline outcomes of a pragmatic, stepped-wedge, cluster-randomized controlled trial

IntroductionAdolescents and young adults (AYA, 14–24 years) bear a disproportionate burden of new HIV infections in Nigeria and are more likely to have worse HIV outcomes compared to other age groups. However, little is known about their access to recommended sexual health care services, including HIV self-testing (HIVST), sexually transmitted infections (STI) testing, sexual behavior patterns, awareness and or access to pre-exposure prophylaxis (PrEP), and overall risk for HIV. MethodsWe present a baseline analysis of the 4 Youth by Youth randomized controlled trial aimed to evaluate the uptake and sustainability of crowdsourced HIVST strategies led by and for young people across 14 states in Nigeria. None of the participants had received intervention at the time of completing this self-reported behavioral survey. We conducted a descriptive analysis to summarize participants' characteristics, sexual behavior, HIV testing, STI testing, and knowledge of PrEP and use across the study sample of the AYAs. We conducted a chi-square test, and the level of significance was set at ≤0.05. ResultsA total of 1551 participants completed the baseline survey comprising males (777, 50.1 %) and females (774, 49.9 %). The majority (77 %) of the participants were students at enrollment. Very few of the participants had ever tested for syphilis, 47 (3.1 %), gonorrhea, 49 (3.2 %), chlamydia, 31 (2.0 %), and hepatitis B, 106 (6.9 %). 678 (43.8 %) of the participants reported to be sexually active at the time of enrolment into the study, of which about 38 % of them engaged in condomless sex. Paying for sex, alcohol use, and drug use are all significant sexual behaviors (p < 0.01). Only 14 (1 %) have ever used PrEP. 481 (31.4 %) have ever tested for HIV, and 104 (6.8 %) have ever used an HIV self-testing kit at baseline. 457 (38.6 %) were eligible for PrEP. ConclusionsHIVST and STI uptake were low at baseline among the AYA in this study. Most AYAs also do not receive recommended sexual health care services, including STI testing services. This underlines the need for interventions to increase the uptake of HIV/STI prevention services among Nigerian AYA.

Survey of clinical microbiology and infectious disease testing capabilities among institutions in Africa.

Inadequate laboratory infrastructure and testing capabilities are a major impediment to addressing the infectious disease burden in Africa. Therefore, the aims of this study were to characterize the clinical microbiology/infectious disease laboratory capabilities among countries in Africa. A survey to assess the microbiological testing capabilities at hospitals, government laboratories, and free-standing public and private laboratories in African countries was developed by subject matter experts. Questions included institutional demographics and microbiology services in the broad categories of bacteriology, virology, mycology, parasitology, and rapid diagnostics/point-of-care testing. The survey was distributed using the American Society of Clinical Pathology email listserv between June and August 2022. In total, 131 unique institutions in 28 countries endorsed at least 1 type of microbiology service, with parasitology (80.9%, 106/131) and bacteriology (77.9%, 102/131) being most common, while mycology (45.0%, 59/131) and virology (45.8%, 60/131) laboratories were less prevalent. The most frequently performed bacteriology test was bacterial identification (90.2%, 92/102), followed by aerobic bacterial cultures and antimicrobial susceptibility testing (both 89.2%, 91/102). Among all clinical microbiology/infectious disease laboratories, the most commonly tested agents were HIV (90.8%, 119/131), Treponema pallidum (78.6%, 103/131), Plasmodium falciparum (76.3%, 100/131), Mycobacterium tuberculosis (76.3%, 100/131), and hepatitis C virus (74.8%, 98/131). These findings provide contemporary data regarding the availability of critical infectious disease testing capabilities among institutions in Africa. These results and future additional studies will be crucial for understanding where strategic investment in the laboratory and public health infrastructure is warranted.

Factors associated with outcome in a national cohort of rhinovirus hospitalized patients in Brazil in 2022

The common cold is the primary cause of illness in the community, with over 200 viral strains identified, and rhinovirus infections being the most prevalent. Coronavirus Disease 19 (COVID-19) is also a significant cause of severe illness. The burden of acute respiratory infections has a significant impact on the economy, resulting in absenteeism from work and school. Rhinovirus infections can exacerbate asthma and other chronic diseases, leading to hospitalization. The objective of this study is to investigate the factors associated with death and survival in patients hospitalized for rhinovirus in Brazil in 2022. This is a retrospective cohort study using data from the national surveillance of Severe Acute Respiratory Syndrome (SARS) in 2022 in Brazil, with all the norrifications. We analysed and compared clinical and epidemiological factors and outcomes between survivors and deaths in patients hospitalised for rhinovirus. The absolute and relative frequencies were calculated according to the states. Bivariate analysis was performed using chi-squared test and Fisher’s exact test, while multivariate analysis was performed using COX regression. Out of 8,130 cases of SARS caused by rhinovirus, 291 (3.58%) resulted in death while 7839 (96.47%) patients survived. The factors associated with death were invasive ventilation (p- < 0.001 HR 4.888 CI 95% 3.816–6.262), bocavirus (p- < 0.001 HR 4.204 CI 95% 2.595–6.812), immunodepression/Immunosuppression (p- < 0.001 HR 2.417 CI 95% 1. 544–3, 786), COVID-19 (p- < 0.001 HR 2.167 CI 95% 1.495–3.142), chronic neurological diseases (p-0.007 HR 1.610 CI 95% 1.137–2.280), abdominal pain (p-0.005 HR 1.734 CI 95% 1.186–2.537), age (p- < 0.001 HR 1.038 CI 95% 1.034–1.042). The survival factors identified in this study were dyspnea (p = 0.005; HR 0.683; CI 95% 0.524–0.889), cough (p < 0.001; HR 0.603; CI 95% 0.472–0.769), and asthma (p = 0.052; HR 0.583; CI 95% 0.339–1.004). Additionally, the study found that receiving a COVID-19 booster dose was also a significant survival factor (p = 0.001; HR 0.570; CI 95% 0.415–0.784). The factors associated with death were similar to those in the literature, and the factors associated with survival were also similar, except for the booster dose of the COVID-19 vaccine, which we didn’t find in any studies. Our study is the first to associate the full course of the COVID-19 vaccine with survival in those hospitalized for rhinovirus, regardless of COVID-19 and rhinovirus co-detection.

Assessing humoral immunity in daily practice: A retrospective study in a pediatric tertiary center

The evaluation of humoral immunity is usually performed through the assessment of serum immunoglobulin levels, vaccine titer responses, and B-cell enumeration and phenotyping. We performed a retrospective study assessing humoral immunity in 469 pediatric patients referred at the Sainte-Justine University Hospital Center. Almost half of the patients had at least one abnormal humoral immunological parameter at their evaluation, with low vaccine response titer to protein antigen being the most frequent. Fifteen patients (3.2 %) had a proven monogenic IEI, and 21 patients (4.5 %) required Ig replacement. Besides the infectious burden, hypoIgG remains the only parameter associated with Ig replacement therapy after the age of 6 years. Low antibody titers against conjugate vaccines had low sensitivity and positive predictive values for starting Ig replacement. Our study highlights the challenge of evaluating the humoral function in the pediatric population with suspected IEI with significant age and sex-dependent variability between parameters.