Infectious Diseases Community Research Articles

"Like and Subscribe": A Compendium of Infectious Diseases Audio Podcasts.

In little more than 15 years, the podcast has gone from being virtually unknown to becoming a multibillion-dollar industry. There are an estimated half-billion podcast listeners worldwide. Podcasts are available for various interests, from entertainment to news, politics, sports, hobbies, and education. Podcasting in medicine has similar origins, beginning with journals and academic/educational institutions wishing to share information on new clinical trials or publications, as well as by those who wanted to promote the free and open access model of online education. The COVID-19 outbreak led to a renaissance in the availability of infectious diseases-oriented audio podcasts, due to the need for regular information about SARS-CoV-2 and the pandemic-related preference for virtual learning. However, many in the infectious diseases community have not yet been introduced to available infectious diseases podcast resources. In this article, we highlight 38 of the most popular infectious diseases-oriented audio podcasts.

Health and Nutrition Promotion Programs in Papua New Guinea: A Scoping Review.

There is a rising prevalence of non-communicable diseases (NCDs) in Papua New Guinea (PNG), adding to the disease burden from communicable infectious diseases and thus increasing the burden on the healthcare system in a low-resource setting. The aim of this review was to identify health and nutrition promotion programs conducted in PNG and the enablers and barriers to these programs. Four electronic databases and grey literature were searched. Two reviewers completed screening and data extraction. This review included 23 papers evaluating 22 health and nutrition promotion programs, which focused on the Ottawa Charter action areas of developing personal skills (12 programs), reorienting health services (12 programs) and strengthening community action (6 programs). Nineteen programs targeted communicable diseases; two addressed NCDs, and one addressed health services. Enablers of health promotion programs in PNG included community involvement, cultural appropriateness, strong leadership, and the use of mobile health technologies for the decentralisation of health services. Barriers included limited resources and funding and a lack of central leadership to drive ongoing implementation. There is an urgent need for health and nutrition promotion programs targeting NCDs and their modifiable risk factors, as well as longitudinal study designs for the evaluation of long-term impact and program sustainability.

Beyond Infection: Mortality and End-of-Life Care Associated with Infectious Disease Consultation in an Academic Health System.

Infectious diseases (ID) physicians are increasingly faced with the challenge of caring for patients with terminal illnesses or incurable infections. This was a retrospective cohort of all patients with an ID consult within an academic health system 1/1/2014 - 12/31/2023, including community, general, and transplant ID consult services. There were 60,820 inpatient ID consults (17,235 community, 29,999 general, and 13,586 transplant) involving 37,848 unique patients. The number of consults increased by 94% and the rate rose from 5.0 to 9.9 consults per 100 inpatients (p<0.001). In total, 7.5% of patients receiving an ID consult died during admission, and 1,006 (2.6%) of patients were discharged to hospice. In-hospital mortality was 5.2% for community ID, 7.8% for general ID, and 10.7% for transplant ID patients (p<0.001). Six-month mortality was 9% for all non-obstetric admissions, , vs. 19% for community ID, 20.9% for general ID, and 22.3% for transplant ID.In total 2,866 (7.6%) of all patients receiving ID consultation also received palliative care consultation during the same hospitalization. The index ID consult preceded any palliative consult in the majority (69.5%) of cases. 16.3% of patients had a do-not-resuscitate order during the index hospitalization. 12.2% of all patients with a do-not-resuscitate order had this placed on the same day as the ID consult. Patients receiving ID consultation were increasingly complex and more likely to die soon after consultation. These results provide a framework for ID clinicians to consider their role in end-of-life care.

Overcoming Challenges for Non-US International Medical Graduates in Pediatric Infectious Diseases.

International medical graduates (IMGs) in pediatric infectious diseases face unique and complex challenges related to their immigration status. This Perspective provides a review of challenges impacting non-US IMG trainees and early-career faculty, and how the infectious diseases community can respond.

Healthcare Sustainability to Address Climate Change: Call for Action to the Infectious Diseases Community.

The U.S. healthcare system's contribution to greenhouse gas emissions and climate change is disproportionately high and harms the public. Several medical specialties are now reassessing how they can mitigate healthcare's harmful environmental impact. Healthcare sustainability is broadly defined as measures to decrease greenhouse gas emissions, waste, and other pollutants generated during the healthcare delivery process. Prior efforts and programs by infectious diseases (ID) professionals, such as antimicrobial stewardship and infection prevention and control can form a framework for ID professionals to help apply this expertise to healthcare environmental sustainability more broadly. This call to action proposes strategies for ID societies and professionals to incorporate climate change education for trainees, increase research and funding opportunities in healthcare sustainability, and calls for action by ID societies to champion system changes to decrease greenhouse gas emissions.

Wastewater-based proteomics: A proof-of-concept for advancing early warning system for infectious diseases and immune response monitoring

In this proof-of-concept study, a new mass spectrometry-based framework was introduced for concurrent tracking of infectious disease prevalence and community responses. The study focused on the detection of SARS-CoV-2 as the test pathogen and C-reactive protein (CRP) as the representative acute phase response protein. Through mass spectrometry (MS), the research provided preliminary insights into the prevalence of the virus and community acute immune responses, suggesting its strong potential as an early warning system. The high specificity and sensitivity of MS, combined with wastewater-based epidemiology's ability to provide a population-level perspective on virus prevalence, make it a valuable tool for public health surveillance. The study's findings demonstrate the utility of targeted proteomics technology in detecting specific protein biomarkers associated with SARS-CoV-2 infection and inflammation in complex wastewater samples. This approach has advantages over traditional RNA-based methods, including the ability to simultaneously detect acute-phase response proteins such as CRP. The study lays the foundation for future research towards refining analytical techniques to extract more precise data from complex matrices. SynopsisWBE proteomics holds a strong potential in wastewater surveillance for pathogens and disease outcomes

Seasonal syndromic surveillance by sentinel system of ILI, ARI, SARI and pneumonia in Romania – season 2023/2024

Syndromic surveillance was initially developed for early detection compared to traditional methods of an epidemiological event with an impact on public health, but as it was applied by more countries it was observed that it can provide information on the size, dynamics of the spread with an emphasis on the potential for national, regional and global evolution, the severity and the most affected population groups, but also to the development of a quick, specific response. Globalization, which involves the intensification of the movement of people (including sick or incubating infectious diseases), live animals, or products of animal origin in and from any part of the planet, but also climate change and pollution, amplifies the danger of the spread of communicable infectious diseases from areas so-called “specific” diseases in new areas, unknown to populations and healthcare systems. In this context, the One Health initiative needs efficient surveillance methods to help promote the health of people, animals, the environment, and ultimately the planet Earth. Recently, there have been substantial changes in the surveillance and control of infectious diseases with an impact on public health aimed at assessing the risks of the emergence of infectious agents with epidemic and pandemic potential by identifying and analyzing favorable factors related to the infectious agent (virulence, variability, transmissibility, etc.), the host organism (immunity, physiological factors, vaccination status, associated chronic diseases, nutritional status, living conditions, etc.), demographic factors (birth rate, mortality, population agglomerations), climatic factors and insect populations vectors, rodents and wild animals (including birds) and last but not least domestic animal populations (including birds). Among these methods, syndromic surveillance stands out, which in addition has the quality of using automatic data acquisition and generating statistical alerts, monitors disease indicators in real-time or near real-time to detect disease outbreaks earlier than would be possible with conventional methods traditional public health. In this context, we will present the Romanian experience regarding the syndromic surveillance of ILI, ARI and SARI in Romania through the national sentinel system season 2023/2024.

Crises in Antimicrobial Stewardship: Misuse of Clarithromycin for Helicobacter pylori Therapy

Helicobacter pylori is a class I carcinogen that infects more than 100 million individuals in the United States. Antimicrobial therapy for H. pylori has typically been prescribed empirically rather than based on susceptibility testing. Until recently, therapeutic recommendations have generally ignored the principles of antibiotic stewardship. A combination of a proton pump inhibitor (PPI), amoxicillin, and clarithromycin (triple therapy) remains popular despite increasing clarithromycin resistance and poor cure rates. Concomitant therapy (a PPI, amoxicillin, clarithromycin, and metronidazole) is recommended and widely used despite all patients receiving at least one unneeded antibiotic. In 2020, the Food and Drug Administration approved vonoprazan, amoxicillin, and clarithromycin triple therapy, which administers unneeded clarithromycin to &gt;90% of patients (i.e., ~6 tons of unneeded clarithromycin/million treatments). In the late 1980s, the infectious disease community functionally transferred responsibility for the management of H. pylori to gastroenterology, which has managed the infection as another common gastrointestinal disease such as constipation. In 2022, both traditional and noninvasive molecular-based susceptibility testing for H. pylori became available in the United States. In order to reduce and prevent antibiotic misuse, the infectious disease community should reclaim responsibility for the management of this important infectious disease.

Mathematical modeling and dynamics of immunological exhaustion caused by measles transmissibility interaction with HIV host.

This paper mainly addressed the study of the transmission dynamics of infectious diseases and analysed the effect of two different types of viruses simultaneously that cause immunodeficiency in the host. The two infectious diseases that often spread in the populace are HIV and measles. The interaction between measles and HIV can cause severe illness and even fatal patient cases. The effects of the measles virus on the host with HIV infection are studied using a mathematical model and their dynamics. Analysing the dynamics of infectious diseases in communities requires the use of mathematical models. Decisions about public health policy are influenced by mathematical modeling, which sheds light on the efficacy of various control measures, immunization plans, and interventions. We build a mathematical model for disease spread through vertical and horizontal human population transmission, including six coupled nonlinear differential equations with logistic growth. The fundamental reproduction number is examined, which serves as a cutoff point for determining the degree to which a disease will persist or die. We look at the various disease equilibrium points and investigate the regional stability of the disease-free and endemic equilibrium points in the feasible region of the epidemic model. Concurrently, the global stability of the equilibrium points is investigated using the Lyapunov functional approach. Finally, the Runge-Kutta method is utilised for numerical simulation, and graphic illustrations are used to evaluate the impact of different factors on the spread of the illness. Critical factors that effect the dynamics of disease transmission and greatly affect the rate and range of the disease's spread in the population have been determined through a thorough analysis. These factors are crucial in determining the expansion of the disease.

A Genetic-Algorithm-Based Dynamic Transmission of Data for Communicable Disease in IoMT Environment

Recent advancements in the field of the Internet of medical things (IoMT) have enabled the real-time monitoring and treatment of patients with communicable infectious diseases while minimizing human intervention. However, IoMT devices face challenges such as unbalanced energy consumption, memory constraints, computation power, and low latency, which can deter the efficient transfer of patient monitoring data. Thus, there is an urgent need to establish an energy-efficient infrastructure for IoMT devices to remotely monitor and collect data on communicable diseases. For this, a genetic algorithm (GA) based dynamic transmission of data for communicable diseases in the IoMT environment is proposed in this paper. The energy utilization of the IoMT is enhanced by considering the GA evolutionary processing based on the dynamic sensor range. The proposed work incorporates a periphery of the fixed area for deploying the IoMT devices to settle the energy hole problem. Multiple sinks and direct information collection concepts are also introduced which further improve the performance and reduce the movement of data packets. The proposed protocols not only optimize energy usage but also provide a robust approach for massive data collection and communication.

Hematopoietic stem cell transplantation: an Italian monocentric experience on the health assessment and eligibility of adult-related donors.

Indications for HSCT are increasing worldwide, paralleled by a growing demand for donors of therapeutic cells. Herein, we report our real-world experience of adult HPC donor assessment during a 5-year study period (2018-2023): we have retrospectively revised data of 455 potential related stem cell donors, consecutively evaluated at our center. Donor medical history was assessed by a questionnaire and an interview with a trained physician experienced in donation procedures to evaluate donor fitness and medical history. Pre-existing health disorders were fully investigated. Behavioral risk factors for communicable infectious diseases were also routinely explored. Overall, 351 donors were finally assessed as eligible for HPC donation, and 233 underwent stem cell collection, 158 through apheresis from mobilized peripheral blood, and 75 through bone marrow harvest. Among them, 27 donors were selected despite the presence of pre-existing health conditions, which would be potential exclusion criteria for unrelated donors: 16 suffered from well-controlled cardiovascular diseases (CVD) and 11 from allergic diathesis. Most of the selected donors with pre-existing disorders were candidates for apheresis HPC collection (21, 77.8%), while only six (22.2%) underwent BM harvest. We then analyzed the data relative to the corresponding 233 allogeneic HSCT to explore if the presence of pre-existing diseases in the donors could show any association with transplant characteristics. Transplants from CVD and allergy donors showed no significant disparities in comparison with those from healthy donors. A significant difference emerged regarding the disease severity, with a higher proportion of patients with high/very high disease risk index (DRI) among those receiving grafts from CVD donors (68.7% in transplants from CVD donors versus 36.0% in transplants from healthy donors, p=0.005). Multivariate analysis confirmed that high/very high DRI patients had an increased probability of receiving donations from CVD donors (OR, 4.89; 95%CI, 1.15-20.86; p=0.031). Among donors with well-controlled pre-existing conditions, no adverse events were recorded during stem cell collection or at follow-up. Our results suggest that in patients at high risk for relapse requiring a prompt allogeneic transplant, a familiar donor might be accepted for HPC apheresis donation on less strict criteria than unrelated donors, without risk for both donor and patient.

High-Density Communities and Infectious Disease Vulnerability: A Built Environment Perspective for Sustainable Health Development

High-density communities have proliferated globally during rapid urbanization. They are characterized by a high population density and limited per capita public spaces, making them susceptible to infectious disease risks. The impact of infectious diseases in these communities, as evident during the COVID-19 pandemic, underscores their vulnerabilities. Yet, research on disease prevention in high-density areas remains limited. This study aims to investigate the relationship between the built environment and the transmission of infectious diseases in high-density urban communities, with a particular focus on the lessons learned during the COVID-19 pandemic. Utilizing Shenzhen city as a case study, this study collected data on the built environment and epidemic trends and involved a generalized linear regression analysis, aiming to understand the key built environment factors that affect epidemic spread in high-density areas. The results from the study revealed that high-density communities experience higher rates of infectious disease transmission compared to their medium- to low-density counterparts. The significant factors identified include land use mixture and walkability, with land use mixture showing the most substantial impact on infection rates. Through a combination of qualitative analysis and empirical research, we constructed a conceptual framework linking containment measures, non-pharmaceutical interventions, and the built environment. The findings emphasize the significance to focus on the health development of high-density communities and offer valuable insights for tailored urban planning and built environment design. These insights are crucial for promoting the healthy and sustainable transformation of existing high-density communities.

The Influence of Cultural Factors, Social Norms, and Social Support on the Spread of Infectious Diseases in Communities in Indonesia

This research investigates the influence of cultural factors, social norms, and social support on the spread of infectious diseases in communities in Indonesia through a quantitative analysis. The structural equation model (SEM) employed in this study examines the complex interplay between these sociocultural elements and their impact on the transmission of infectious diseases. Results indicate significant positive associations between cultural factors and the spread of infectious diseases, social norms and disease transmission, and unexpectedly, social support and disease spread. These findings challenge conventional assumptions, emphasizing the need for nuanced and culturally sensitive public health interventions. The study contributes valuable insights to the understanding of infectious disease dynamics within diverse communities and informs targeted strategies for effective mitigation.

Clinical and Demographic Patterns of Pulmonary Tuberculosis in Patients with Diabetes Mellitus: Impact of Diabetes Mellitus on Patient

Background: Tuberculosis (TB) is a communicable infectious disease and one of the leading causes of death. Until the coronavirus pandemic, tuberculosis was the leading cause of death from a single infectious agent, more than HIV/AIDS. Due to urbanization and rapid social and economic development, there is a rapidly increasing diabetes mellitus (DM) epidemic and India has the second largest number of DM patients in the world. There are around 74.2 million DM cases and 40.1 million people with impaired glucose tolerance. Tuberculosis is more common in low- and middle-income countries. The increasing trend of the two diseases poses a major challenge for the tuberculosis control program.&#x0D; Methods: The main goal of this research was to investigate clinical and demographic patterns of pulmonary tuberculosis in patients with DM. It is a prospective, observational, in-hospital study. We studied 165 PTB patients associated with DM who were at least scanty/1+ positive on smear or had Mycobacterium TB sputum CBNAAT detected.&#x0D; Results: Of the 165 patients, 127 PTB-DM patients were male and 38 were female. The most common symptom was cough, which occurred in 164 (99.4%) patients. Fever was the second most common symptom in 152 (92.1%) patients and anorexia was the third most common symptom, occurring in 119 (72.1%) patients.&#x0D; Conclusion: The majority of patients were from IPD 88 (54%), suggesting that PTB–DM cases have a more severe and complicated presentation. Male patients are affected more frequently than female patients. People in the age group 31–60 years often suffer from PTB–DM. Cough, fever, and anorexia are the most common symptoms, while chest pain and breathlessness are more common in the older age group. The history of PTB in DM patients is also of concern as the present study shows that there is a possible association with relapse or reactivation of PTB as well as drug resistance of PTB.

Nut Cracked? Does the ACORN Trial End the Debate Surrounding Vancomycin and Piperacillin-Tazobactam Combination Therapy and Increased Risk for Acute Kidney Injury?

Observational data published over the past decade have suggested that concomitant receipt of piperacillin-tazobactam with vancomycin significantly increases the risk for vancomycin-associated acute kidney injury. Importantly, however, there is significant controversy surrounding this association, and debate continues about the veracity of the risk. Given this ongoing debate, the recently published "Cefepime vs Piperacillin-Tazobactam in Adults Hospitalized With Acute Infection: The ACORN Randomized Clinical Trial" is of tremendous interest to the infectious diseases community. In ACORN, the authors conclude that there was no association between receipt of cefepime or piperacillin-tazobactam and the primary outcome of acute kidney injury or death by day 14, despite the fact that >75% of the population received concomitant vancomycin. In this perspective, we provide a brief history on the controversy, provide a critical analysis of the ACORN findings, and ultimately discuss how these data help inform the ongoing debate.

Global Estimates on Biological Risks at Work

IntroductionBiological risks are a major global problem in the workplace. The recent COVID-19 pandemic has highlighted the need for a more comprehensive understanding of the biological risks at work. This study presents data on both communicable infectious biological agents and noncommunicable factors leading to death and disability for the year 2021. MethodsWe followed the methodology established by the International Labour Organization (ILO) in their past global estimates on occupational accidents and work-related diseases. We used relevant ILO estimates for hazardous substances and related population attributable fractions derived from literature, which were then applied to World Health Organization mortality data. The communicable diseases included in the estimates were tuberculosis, pneumococcal diseases, malaria, diarrheal diseases, other infectious diseases, neglected tropical diseases, influenza associated respiratory diseases and COVID-19. Noncommunicable diseases and injuries considered were Chronic Obstructive Diseases (COPD) due to organic dusts, asthma, allergic reactions and risks related to animal contact. We estimated death attributable to biological risk at work and disability in terms of disability adjusted life years (DALYs). ResultsWe estimated that in 2022, 550,819 deaths were caused by biological risk factors, with 476,000 deaths attributed to communicable infectious diseases and 74,000 deaths caused by noncommunicable factors. Among these, there were 223,650 deaths attributed to COVID-19 at work. We calculated the rate of 584 DALYs per 100,000 workers, representing an 11% increase from the previous estimate of the global burden of work-related disabilities measured by DALYs. ConclusionThis is a first update since previous 2007 ILO estimates, which has now increased by 74% and covers most biological risks factors. However, it is important to note that there may be other diseases and deaths are missing from the data, which need to be included when new information becomes available. It is also worth mentioning that while deaths caused by major communicable diseases including COVID-19 are relatively rare within the working population, absences from work due to these diseases are likely to be very common within the active workforce.

FPGN: follower prediction framework for infectious disease prevention

In recent years, how to prevent the widespread transmission of infectious diseases in communities has been a research hot spot. Tracing close contact with infected individuals is one of the most severe problems. In this work, we present a model called Follower Prediction Graph Network (FPGN) to identify high-risk visitors, which is known as follower prediction. The model is designed to identify visitors who may be infected with a disease by tracking their activities at the exact location of infected visitors. FPGN is inspired by the state-of-the-art temporal graph edge prediction algorithm TGN and draws on the shortcomings of existing algorithms. It utilizes graph structure information based on (alpha , beta )-core, time interval statistics by using the statistics of timestamp information, and a GAT-based prediction module to achieve high accuracy in follower prediction. Extensive experiments are conducted on two real datasets, demonstrating the progress of FPGN. The experimental results show that FPGN can achieve the highest results compared with other SOTA baselines. Its AP scores are higher than 0.46, and its AUC scores are higher than 0.62.

A novel medical apparatus for the containment and evaluation of a pediatric patient under suspicion for highly communicable infectious disease.

Highly communicable infectious diseases (HCIDs) such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Ebola are a containment challenge for the emergency department (ED). Donning and doffing personal protective equipment is necessary to protect healthcare workers but is time consuming and rife with errors. Furthermore, children present an additional containment challenge since they are often unable to follow directions or be separated from family members. To address these challenges, a novel child-friendly medical apparatus was developed for the rapid containment and evaluation of a HCID patient in the ED. The primary objective was to determine if routine emergency triage procedures (vital signs and basic physical examination) can be performed using this medical apparatus. The secondary objective was to determine if invasive procedures (bag-valve-mask ventilation and endotracheal intubation) can be performed. This was a prospective pilot study. A clear acrylic apparatus was built containing arm ports with gloves, simulating a specialized HCID barrier. Emergency physicians attempted routine triage procedures on a healthy volunteer and invasive procedures using a simulation mannequin through this apparatus. Twenty-four physicians were enrolled. All physicians (100 percent) successfully obtained vital signs, auscultated heart/lung sounds, completed bag-valve-mask ventilation, and performed intubation through the apparatus. This novel apparatus is a feasible tool in the rapid evaluation of a HCID patient in the ED. A future study is needed to assess protection and training using this apparatus.

Low-cost and rapid sensors for wastewater surveillance at low-resource settings

Wastewater surveillance enables tracking infectious disease dynamics and community prevalence quantification for public health. However, the testing requirement of centralized laboratories and well-trained staff challenges underserved areas and low-resource settings. The development of new rapid and low-cost sensors enables in-field testing of wastewater from the community to the individual building levels for early warning of pandemics.

Influence of membrane pore-size on the recovery of endogenous viruses from wastewater using an adsorption-extraction method

The ongoing COVID-19 pandemic has emphasized the significance of wastewater surveillance in monitoring and tracking the spread of infectious diseases, including SARS-CoV-2. The wastewater surveillance approach detects genetic fragments from viruses in wastewater, which could provide an early warning of outbreaks in communities. In this study, we determined the concentrations of four types of endogenous viruses, including non-enveloped DNA (crAssphage and human adenovirus 40/41), non-enveloped RNA (enterovirus), and enveloped RNA (SARS-CoV-2) viruses, from wastewater samples using the adsorption-extraction (AE) method with electronegative HA membranes of different pore sizes (0.22, 0.45, and 0.80 µm). Our findings showed that the membrane with a pore size of 0.80 µm performed comparably to the membrane with a pore size of 0.45 µm for virus detection/quantitation (repeated measurement one-way ANOVA; p > 0.05). We also determined the recovery efficiencies of indigenous crAssphage and pepper mild mottle virus, which showed recovery efficiencies ranging from 50% to 94% and from 20% to 62%, respectively. Our results suggest that the use of larger pore size membranes may be beneficial for processing larger sample volumes, particularly for environmental waters containing low concentrations of viruses. This study offers valuable insights into the application of the AE method for virus recovery from wastewater, which is essential for monitoring and tracking infectious diseases in communities.