Prevalence Of Co-infection Research Articles

Molecular survey and phylogenetic analysis of bee pathogens; with a note first detection of Apis mellifera Filamentous Virus, Varroa destructor virus-1, Apis rhabdovirus-1, and Apis rhabdovirus-2 in Türkiye

Turkey is one of the most important bee centers in the world, but there is limited information about honey bee pathogens in the country. This study aimed to investigate bee pathogens using microscopic and molecular techniques (PCR, RT-PCR, nested-PCR, and sequencing) in Sivas province, the second-biggest beekeeping center in Turkey. For this purpose, bee samples were obtained from 149 bee colonies belonging to 74 local beekeepers in eight districts of the Sivas province. The bee samples were examined for pathogens, and at least one pathogen was detected in 148 bee colonies. In this study, a single infection was determined in 26.17% (39/149) of the bee samples, while the prevalence of co-infection was 73.15% (109/149). Nosema ceranae, Varroa destructor haplotype-K, Apis mellifera Filamentous Virus, Deformed wing virus, Varroa destructor virus-1, Lake Sinai virus-2, Apis rhabdovirus-1, and Apis rhabdovirus-2 were detected. Apis mellifera Filamentous Virus, Varroa destructor virus-1, Apis rhabdovirus-1, and Apis rhabdovirus-2 were found for the first time in Turkey with the current study. Furthermore, nucleotide sequence analysis and phylogeny relationships of bee pathogens obtained from samples were done, and sequences were deposited to GenBank. This study provides molecular data on the presence and prevalence of important bee pathogens in the region. As the prevalence of many pathogens has been determined, especially the existence of viral new species has been revealed, the effects of the species on beekeeping should be studied, and beekeepers should take effective control measures to reduce the effects of these pathogens.

Current Management and Awareness of Hepatitis Coinfection in HIV Care: A Single-Center Retrospective Study in Japan

BackgroundLiver disease remains a significant concern for people living with HIV (PLWH), especially in those with hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection. This study assessed the prevalence of viral hepatitis coinfections and evaluated the current state of hepatitis management by HIV care providers in Japan. MethodsThis single-center, retrospective, observational study analyzed data from PLWH treated with antiretroviral therapy between April 1, 2023 and March 31, 2024. Data included demographics, ART regimen, hepatitis status, and screening practices of 811 PLWH treated with antiretroviral therapy. ResultsThe median age of the study population was 48 years, and 97.8% were men. The HBV status was as follows: chronic HBV, 6.5%; clinical remission, 34.0%; uninfected, 30.9%; unknown, 14.2%. The HCV antibody positivity rate was 3.2%. Substantial gaps in hepatitis screening and monitoring were identified. Specifically, we found inadequate rates of abdominal ultrasound examinations and HCC screening among patients with HIV and viral hepatitis coinfection. Moreover, only 71.7% of patients chronically infected with HBV and 61.5% with HCV underwent abdominal ultrasound examinations in the preceding 12 months—only 5.7% and 3.8% of the participants in these groups had had received tumor marker testing in the previous 12 months. ConclusionThere are challenges in hepatitis and HCC screening and monitoring among patients with HIV and viral hepatitis coinfection in Japan. These findings underscore the need to improve adherence to clinical practice guidelines and implement integrated care models to enhance hepatitis management in PLWH.

Prevalence, Risk Factors, and Clinical Profiles of Hepatitis D Virus in Nigeria: A Systematic Review, 2009–2024

Background: The World Health Organization (WHO) recommends hepatitis D virus (HDV) screening among hepatitis B virus (HBV) infected individuals, with a focus on priority populations in resource-limited settings like Nigeria. HDV infection is a growing public health challenge, particularly among individuals with chronic hepatitis B virus (HBV) infection. HDV accelerates liver disease progression and significantly increases the risk of cirrhosis and hepatocellular carcinoma. Despite this, the epidemiology of HDV in Nigeria remains inadequately documented. This scoping review critically evaluates the prevalence, risk factors, and clinical outcomes of HDV co-infection among HBV patients in Nigeria. Method: We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. The review included observational cross-sectional studies published between 2009 and 2024. We focused on studies that used Immunoglobulin G (IgG) antibody testing or RNA-based diagnostics to assess HDV prevalence. We included PubMed, Google Scholar, and Dimensions databases due to their broad indexing and coverage of peer-reviewed articles and accessibility. We screened the studies for their relevance to HDV prevalence, risk factors, and clinical outcomes, while excluding those that only tested for IgM or HDV antigen. Eleven studies, with a combined sample size of 2308 participants, were included in the final analysis. We performed a narrative synthesis of the findings, considering geographic, gender, and age-based variations in HDV prevalence and clinical impact. Results: HDV prevalence among HBV-infected individuals in Nigeria ranged from 2.0% to 31.6%. The highest prevalence was reported in the Southwest (31.6%) among malaria patients, while lower rates were observed in the Southeast (2.8%). Prevalence was higher in males, particularly those aged 21–30 years in the Southwest and 31–40 years in other regions. RNA-based testing provided more accurate data on active viremia, with viremic HDV prevalence rates ranging from 3.2% to 16%. Triple infection with HIV/HBV/HDV was associated with significantly lower CD4+ cell counts and worse clinical outcomes, including elevated liver enzymes and rapid progression to liver cancer. Key risk factors for HDV co-infection included multiple sexual partners, sharing of needles, and unsafe medical practices. Co-infected patients demonstrated worse clinical outcomes, such as elevated liver enzymes, decompensated cirrhosis, and higher rates of hepatocellular carcinoma. Conclusions: Our review underscores the urgent need for routine HDV screening among HBV patients in Nigeria, especially given the severe clinical consequences of co-infection. The recent WHO guidelines recommending HDV screening align with our findings, which emphasize the importance of RNA-based HDV testing among HBV-positive patients to improve diagnostic accuracy. Public health efforts should prioritize tailored interventions based on geographic, age, and gender disparities in HDV prevalence. Triple infection with HIV/HBV/HDV requires integrated care models to address both immune suppressions as indicated by diminished CD4 cell count and liver disease progression, as these patients face worse outcomes. Targeted HDV screening in mostly affected demographics and geographies and improved Nigeria capacity for cheaper HDV RNA/PCR diagnostics can reduce liver-related morbidity and mortality caused by HBV, which can be worsened and accelerated by HDV coinfection.

High rates of Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachomatis, or Trichomonas vaginalis co-infection in people with HIV: a systematic review and meta-analysis.

People living with HIV (PWH) experience a disproportionate burden of sexually transmitted infections (STIs), leading to more severe health outcomes and increasing the risk of HIV transmission. The presence of untreated STIs can accelerate HIV disease progression, while HIV infection can complicate STI diagnosis and treatment. Despite this interconnectedness, comprehensive data on the global prevalence of specific STIs among PWH remain limited. This systematic review aims to synthesize existing data to provide a more accurate picture of the prevalence of co-infection with Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachomatis or Trichomonas vaginalis in PWH, while also identifying critical knowledge gaps and informing future research priorities. We searched databases for eligible studies reporting the prevalence of Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachomatis, or Trichomonas vaginalis among PWH, published from January 1, 2000, to February 1, 2023. From 22,290 identified articles, 127 independent studies meeting the inclusion criteria were included in this meta-analysis. The overall global co-infection prevalence of Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis in PWH, was 4.8% (95%CI: 4.7-5.0%), 0.8% (95%CI: 0.6-0.9%), 2.5% (95%CI: 2.2-2.7%), and 3.0% (95%CI: 2.7-3.3%), respectively. The global prevalence of these four STIs in PWH is high, especially in Africa and Southeast Asia and in MSM and TGW populations. Based on the subgroup analyses, we further found that there was a high prevalence of Treponema pallidum and Chlamydia trachomatis in Southeast Asia and a high infection of Trichomonas vaginalis in the whole of Africa. Treponema pallidum infection was more common in males than females, and Chlamydia trachomatis and Trichomonas vaginalis infections were more common in females than males. Besides, high infection rates of Treponema pallidum, Neisseria gonorrhoeae, and Chlamydia trachomatis were detected in men who have sex with men (MSM) + transgender women (TGW), while high infection rates of Trichomonas vaginalis were found in sex workers and pregnant women. The study confirmed high prevalence of four sexually transmitted pathogens in PWH, noting regional, gender, and subpopulation-specific differences. It offered insights for targeted interventions and healthcare strategies. The research underscored the necessity for enhanced data collection and expanded screening/treatment for vulnerable populations and regions.

Scrub typhus-leptospirosis co-infection in India: a systematic review and meta-analysis.

Scrub typhus and leptospirosis are re-emerging zoonotic infections with significant morbidity and mortality rates in India. Overlapping aetiological and epidemiological patterns indicate a high possibility of their co-infection in India, which can be a diagnostic challenge due to non-specific clinical features. A systematic search of the PubMed/MEDLINE, Scopus and Embase databases was conducted to identify relevant studies published through 31 August 2023. Studies reporting co-infection of scrub typhus and leptospirosis among the Indian population were included. Data extraction, quality assessment and statistical analysis were performed in accordance with established guidelines. Six studies met the inclusion criteria, comprising a total of 58 co-infection cases. Pooled prevalence of scrub typhus-leptospirosis co-infection among acute undifferentiated febrile illness patients was 3.7% (95% confidence interval [CI] 0.00 to 0.126). Among scrub typhus patients, the prevalence of co-infection with leptospirosis was 13.7% (95% CI 0.027 to 0.304). Significant heterogeneity was observed among the included studies, highlighting the need for cautious interpretation of prevalence estimates. This meta-analysis underscores the clinical importance of scrub typhus-leptospirosis co-infection in India and emphasizes the need for enhanced clinical awareness, improved diagnostic strategies and targeted research efforts to address this emerging infectious disease threat.

Prevalence of Co-infection of Hepatitis B Virus and Hepatitis C Virus among Human Immunodeficiency Virus Patients on Antiretroviral Therapy at A Tertiary Care Centre, Eluru, Andhra Pradesh, India

Prevalence of Co-infection of Hepatitis B Virus and Hepatitis C Virus among Human Immunodeficiency Virus Patients on Antiretroviral Therapy at A Tertiary Care Centre, Eluru, Andhra Pradesh, India

Coinfection of Toxoplasma gondii and Other Microorganisms: A Systematic Review and Meta-Analysis.

Toxoplasmosis is a disease caused by the intracellular protozoan Toxoplasma gondii, which has infected a third of the global population. Immunocompromised individuals and children with congenital disorders are most likely to be impacted by toxoplasmosis, and accurate diagnosis is essential. Toxoplasmosis is associated with HIV, schizophrenia, and diabetes. However, few studies have analyzed the association with other microorganisms. The purpose of this study was to determine the prevalence of coinfection of Toxoplasma gondii with other pathogens. From November 1997 to June 2024, PubMed, Science Direct, LAT index, Web of Science, Google Scholar, and Research Gate were searched. The keywords used were "Toxoplasma and microorganism coinfection", "Toxoplasma coinfection and parasites", "Toxoplasma coinfection and Protozoans or Bacteria or Helminths or Nematodes or Trematodes or Mycobacterium", "Toxoplasma gondii in coinfection with virus", and "Human Toxoplasmosis and coinfection". Next, OpenMeta Analyst Software version 12.11 was used for meta-analysis, creating forest plots, and determining heterogeneity I2. A total of 17,535 patients in 48 articles, of whom 5848 were seropositive to T. gondii, were included in this review. Population studies showed that the prevalence of virus infection was most frequent (32%), followed by parasites (18.4%), bacteria (29.7%), and fungi (5.8%). The pooled prevalence of coinfection was found to be 29.1%, with a lower bound of 0.232, an upper bound of 0.350, a standard error of 0.030, and p < 0.001. Heterogeneity (I2) was 99.12%, p < 0.001, with a global variance tau2 = 0.042. Toxoplasma gondii is an opportunist that mainly affects immunocompromised populations. The main coinfections were found to be viral infections, with HIV ranking first, followed by cytomegalovirus, hepatitis B and C, rubella, herpes simplex 1 and 2, SARS-CoV-2, and coxsackie virus.

Transfusion-transmissible coinfections among US blood donors.

Transfusion-transmissible infection (TTI) prevalence among US blood donors has been widely documented. Here we estimate the prevalence of donors presenting with ≥2 TTIs (multiple infections past or present referred to as coinfections) and describe their demographics and associations. Data from the Transfusion-Transmissible Infections Monitoring System were compiled for October 2020-September 2023 (3 years). Prevalence per million donations (pmd) was calculated for each TTI coinfection combination with demographic characteristics summarized. The odds of each TTI coinfection combination were estimated using logistic regression. Reactivity by NAT and/or serology (HIV, HBV, and HCV) defined donors as consensus positive (CP) for each infection while serology-based algorithms defined syphilis CP and the subset with active syphilis infections (ASIs). About 22 million donations were included, with 212 coinfections (9.7 pmd). Around 2% of donations positive for any TTI (n = 10,516) were coinfections. Coinfection prevalence per TTI combination ranged from 0.3 pmd for HIV CP and HCV CP, to 4.3 pmd for HIV CP and syphilis CP. There were high proportions of coinfections from donors who were male, aged 25-54 years, white or black, first time, and residing in the southern US Census Region. The odds of a second TTI occurring in an individual donor with a TTI ranged from 23 (95% CI: 13, 41) times more likely for HBV CP and ASI to 395 (95% CI: 298, 524) times more likely for HIV CP and ASI. Coinfections are relatively uncommon among blood donors in the United States; however, associations exist among HIV, HBV, HCV, and syphilis infections.

Seropositivity of hepatitis A and E viruses in patients attending a tertiary care center in central India

Objectives: Hepatitis A virus (HAV) and hepatitis E virus (HEV) infections are significant global health concerns that contribute to acute viral hepatitis. This study aimed to investigate the prevalence of HAV, HEV, and co-infections in a tertiary care hospital setting in central India. Materials and Methods: This retrospective observational study analyzed 987 clinical specimens collected from suspected acute viral hepatitis cases over 5 years (2019–2023). Commercially available enzyme-linked immunosorbent assay kits were used to detect HAV and HEV immunoglobulin M antibodies. Statistical analysis: Demographic data and clinical information were collected and analyzed using Chi-square tests. P &lt; 0.05 was considered statistically significant, indicating a significant association between the variables under investigation. Results: Overall, 32.72% of patients were seropositive for either HAV, HEV, or both. The prevalence of HAV was 22.9%, HEV was 9.83%, and co-infection was 3.24%. HAV infection was more prevalent in children (0–14 years), whereas HEV was more prevalent in adults. Both HAV and HEV infections were associated with elevated liver function markers, with the highest levels observed in co-infected cases. The monsoon season had the highest number of cases. Conclusions: This study revealed a substantial burden of HAV, HEV, and co-infections in central India. The observed sex—and age-specific prevalence patterns warrant further investigation. Effective public health strategies addressing sanitation, hygiene practices, and HAV vaccination programs are crucial to reducing the disease burden.

Concomitant Infection of Helicobacter pylori and Intestinal Parasites: Burden, Sociodemographic and Clinical Characteristics in Hospitalized Children and Adolescents in Northern Lebanon

Background Helicobacter pylori and intestinal parasites are well-known for their high prevalence in children, especially in developing countries. However, their concomitant infections are poorly documented. In this study, we aimed to evaluate the association between intestinal parasites and H. pylori among hospitalized children and adolescents with upper gastrointestinal complaints in Northern Lebanon. Methods A cross-sectional study was conducted involving 297 hospitalized pediatric patients, aged between 1 and 15 years, who presented with gastrointestinal symptoms. The socio-demographic, lifestyle, and gastrointestinal characteristics of all participants were analyzed. Fresh stool samples were collected and screened for the presence of intestinal parasites and H. pylori infections. Results 6.4% of the patients were positive for intestinal parasitic infections, 5.4% were positive for H. pylori infection, and 11.8% were co-infected. The results of the Chi-square test showed that H. pylori infection is significantly associated with parasitic infection but not with a particular species. The most frequent coinfection was H. pylori-Entamoeba histolytica (77.1%). Moreover, H. pylori infection was associated with overcrowding and infrequent washing of vegetables before eating. The prevalence of co-infections increased in patients of mothers with a primary educational level or less. In regards to clinical characteristics, our findings showed a statistically significant relationship between i) gastric reflux and H. pylori, and ii) severe diarrhea and parasitic infection. Conclusion Our data highlighted the association between H. pylori and intestinal parasitic infections. Thus, H. pylori detection could be taken into consideration while screening for parasitic infections in children and adolescents.

Analysis of multi-site HPV infection and vaccination willingness among men who have sex with men in Tianjin, China.

Men who have sex with men (MSM) are vulnerable to HPV infection. This study aims to explore the HPV infection status at different sites among HIV-positive MSM, HIV-negative MSM, and men who have sex with women (MSW), and to investigate their willingness to receive HPV vaccination. From September 2023 to April 2024, three groups were recruited in Tianjin, China. Participants completed an electronic self-administered questionnaire, which included demographic information, knowledge related to sexually transmitted diseases, behavioral information, and willingness to receive the HPV vaccine. Samples were collected from the anal region, genitals, and oral cavity for HPV typing. A total of 1,559 participants were recruited, including 300 HIV-positive MSM, 600 HIV-negative MSM, and 659 MSW. The HPV infection prevalence for any site were 62.0, 53.7 and 8.3%, respectively (p < 0.001). The infection prevalence for HPV genes covered by the 9-valent vaccine were 47.0, 36.8, and 3.5%, respectively (p < 0.001). Co-infection prevalence at anal and genital were 20.3, 14.2, 0.6%, respectively. Co-infection prevalence at anal and genital and oral were 1.3, 0.3%, 0, respectively. A total of 77.0% HIV-positive MSM and 75.3% HIV-negative MSM expressed willingness to receive the HPV vaccine, whereas 58.9% of MSW were unwilling (p < 0.001). Being HIV-positive (aOR, 3.119; 95% CI, 2.213-4.395), being over 46 years old (aOR, 1.994; 95% CI, 1.266-3.142), with an occupation classified as "white collar workers" (aOR, 1.620; 95% CI, 1.111-2.362) and "freelancing" (aOR, 2.025; 95% CI, 1.371-2.993) and a history of homosexual behavior in the past 6 months (aOR, 5.338; 95% CI, 3.802-7.495) were risk factors for HPV infection among men in Tianjin. Consistently using condoms in the past 6 months (aOR, 0.667; 95% CI, 0.513-0.867) were protective factors. The HPV infection prevalence among MSM in Tianjin is significantly higher than among MSW, with higher prevalence in the anal region compared to the genital and oral region. HPV infection is associated with HIV infection, older age, and homosexual behavior. Most MSM showed a positive willingness to receive the HPV vaccine, indicating the necessity to implement targeted HPV vaccination programs for MSM and to enhance necessary preventive knowledge and behavioral interventions.

Characterization of Respiratory Viruses in Patients with Acute Respiratory Infection in the City of Barranquilla during the SARS-CoV-2/COVID-19 Pandemic.

Introduction: Severe acute respiratory infection (SARI) is mainly caused by viral pathogens, with a high prevalence in high-risk populations such as infants and older adults. Coinfections by different viruses are frequent and, in some cases, associated with severe disease outcomes. Purpose: The main purpose of this study was to identify respiratory viruses circulating in Barranquilla during the peaks of the COVID-19 pandemic and estimate the prevalence of viral coinfections in samples from individuals with different degrees of respiratory infection. Methods: We received 5083 samples between epidemiological weeks 33-42 of 2021 submitted by the District Health Laboratory of Barranquilla and four local healthcare institutions during COVID-19 surveillance. Among them, we analyzed 101 samples from individuals presenting with influenza-like illness (ILI). Eighteen respiratory viruses, including SARS-CoV-2, were evaluated via qRT-PCR using nasal swabs or nasopharyngeal aspirate samples. Results: Of the 101 study individuals, 56 were male and 45 were female (55.5% and 44.5%, respectively); 25.7% of individuals were infected with at least one of the evaluated viruses. Respiratory syncytial virus (RSV) and human rhinovirus (HRV) were the two most frequently detected viruses (30.7% and 15.4% of total positives, respectively). Coinfections with two or more respiratory viruses accounted for 42% of the total positive cases. Discussion: Our findings indicate the presence of different respiratory viruses in swab or nasopharyngeal aspirate samples from individuals with ILI, including coinfections. These results reveal the circulation of several respiratory viruses in the city of Barranquilla, confirming their importance as potential causes of SARI in Colombia and the need for their active surveillance.

Manifestações dermatológicas da Monkeypox

Objective: This study aimed to identify the primary mucocutaneous manifestations secondary toMonkeypox infection and determine the prevalence of coinfection with other sexually transmittedinfections (STIs). Methods: Searches were conducted in the PubMed, LILACS, SciELO, Cochrane Library, andVirtual Health Library databases using the descriptors “monkeypox,” “dermatological,” “dermatology,”“cutaneous,” “skin,” and “mucocutaneous,” combined with the Boolean operators “and” and “or.” All articles published between January 2017 and October 2022 that addressed mucocutaneous manifestations secondary to Monkeypox infection, regardless of language, wereincluded. Technical notes from the Brazilian Ministry of Health and World Health Organization recommendations were also incorporated. The Joanna Briggs Institute (JBI) critical appraisal tool was used to assess the quality of the studies. Data were independently evaluated by three reviewers. Exclusion criteria included the absence of photographic records of the lesions, lack of laboratory confirmation of infection, “letter to the editor” publications, duplicates, and articles primarily focused on systemic manifestations without association with the integumentary system. Results: A total of 22 publications were included in this study. The most frequently affected anatomical sites were the genital and perianal regions, though lesions were also reported on the torso, face, oropharynx, limbs, palms, and soles. There is a possibility that the infection may present nonspecifically as a maculopapular rash. Lesions are typically multiple, with either localized orwidespread distribution. In the latter case, the progression is centrifugal, beginning on the face.The most prevalent characteristic of the elementary lesion is central umbilication, which eventuallydevelops a crusted appearance. Umbilicated papules are often associated with pain, which gradually transitions to varying degrees of pruritus. Coinfection with HIV and other STIs was particularly notable among men who have sex with other men and/or have multiple partners and who use condoms inconsistently.Conclusions: Monkeypox can present with various cutaneous manifestations, none of which arepathognomonic of the disease. The chronological evolution of the elementary lesions (papule, vesicle,pustule, crust) is not always precise, with multiple stages potentially coexisting in the same area of the body. The primary behavioral factor associated with infection is unprotected sexual activity, especially among men who have sex with other men. Coinfections with HIV, syphilis, gonorrhea, chlamydia, and/or herpes were observed in the majority of cases.

Seropositivity and coinfection of hepatitis B and hepatitis C viruses in Central India: A hospital-based study

ABSTRACT Background: Hepatitis B virus (HBV) and Hepatitis C virus (HCV) show similarity in the transmission, distribution, hepatotropism, and leading to chronic asymptomatic infection. Coinfection of HBV and HCV can lead to more severe liver disease and an increased risk for progression to hepatocellular carcinoma (HCC). Most of the people with chronic infection are unaware of their HBV and HCV infections, hence facilitating these to go undiagnosed until these viruses have caused serious liver damage and they act as a potential source of infection for the community at large. Therefore, the present study aimed to find the prevalence of HBV and HCV along with incidences of coinfection of HBV and HCV in patients seeking hospital care in central India. Methods: A five-year hospital-based study was carried out at the tertiary care hospital in Central India from 2018 to 2022. A total of 72402 patients attending the outdoor patients and admitted indoor patients who were advised for HBV and HCV for screening before any invasive/surgical procedure and patients who presented with symptoms of acute or chronic liver disease were included in this study. Screening was done by immunochromatography-based card test followed by the confirmation of all samples by enzyme immunoassay. Results: Seroprevalence of HBV and HCV was found to be 3.71% and 1.91%, respectively. Coinfection with HBV/HCV was seen in 0.13% of the individuals. The overall prevalence of HBV, HCV, and HBV-HCV coinfection was significantly higher in the male population as compared to females. Conclusion: The study findings of seroprevalence of HBV and HCV among the hospital-based population will help to get a baseline understanding of the disease burden in central India. The HBV/HCV coinfection rate also raises serious concerns owing to its high prevalence rate among the younger age.

Co-infection of Plasmodium and soil-transmitted helminth among pregnant women in Abaya district, South Ethiopia: A community-based study

ObjectivesCo-infection of malaria with helminths poses significant risks, including fetomaternal hemorrhage, fetal growth retardation, spontaneous abortion, and preterm delivery. However, there is a lack of community studies to demonstrate the prevalence of co-infection of helminths with Plasmodium and soil-transmitted helminths (STH) and associated factors among pregnant women in Ethiopia. MethodsA community-based cross-sectional study was conducted among 287 randomly selected pregnant women in the Abaya district from September to December 2022. Data were collected using a standardized questionnaire. Blood and stool samples were collected from each pregnant woman and data analysis was performed using SPSS. Logistic regression analysis was used to identify associated factors. ResultsThe co-infection prevalence of Plasmodium and STH was 19.5% (95% confidence interval [CI]: 14.92-24.08%), where STHs were 40.6% (95% CI: 34.9-46.3%) and Plasmodium was 32.4% (95% CI: 27-37.8%). Hookworm and Plasmodium falciparum were the most commonly identified parasite species. Factors significantly associated with co-infection with Plasmodium and STH included the habit of eating soil (adjusted odds ratio [AOR] = 2.70, 95% CI: 1.36-5.34), not using insecticide-treated bed nets (AOR = 3.47, 95% CI: 1.76-6.85), living near stagnant water (AOR = 2.23, 95% CI: 1.07-4.64), and rural residence (AOR = 2.23, 95% CI: 1.07-5.97). ConclusionsInterventions should prioritize enhancing sanitation, educating pregnant women on the use of insecticide-treated bed nets, avoiding eating soil, and eliminating stagnant water near homes. More research should be conducted on the area using more advanced methods.

Diagnosis of Causative Acute Childhood Viral Diarrhea by Multiplex Real-time PCR Among Children in a Referral Hospital, Tehran, Iran

Background: Viral gastroenteritis has significant public health implications and can greatly affect individuals' overall well-being. It spreads rapidly within communities, particularly among pediatric populations in settings like schools. Objectives: This study aimed to identify the most common viral causes of gastroenteritis in children aged one month to 18 years over a year in a referral tertiary children's hospital, highlighting the burden of the illness in this population. Methods: In this cross-sectional study, stool samples from children with viral gastroenteritis admitted to Mofid Children's Hospital were collected from January 2023 to October 2024. Total RNA extraction was performed following stool preparation. Detection of SARS-Cov-2, norovirus, sapovirus, rotavirus, adenovirus, and astrovirus was carried out using multiplex Real-Time PCR. Results: A total of 100 participants were included in this study, of which 62% were male and 38% female, with a mean age of 2.7 ± 3.44 years. Among all patients with diarrhea, 55.5% tested positive via PCR. Rotavirus was the most frequently detected virus, accounting for 43.6% of cases, followed by Norovirus and Adenovirus at 23.6%, Sapovirus and Coronavirus at 14.5%, and Astrovirus at 7.3%. Co-infection with two viruses was observed in 23.6% of patients, and 1.8% were co-infected with three viruses. Conclusions: This study highlights that gastroenteritis in young children has decreased in many countries following the introduction of the rotavirus vaccine. An important finding of this research is the prevalence of co-infection in pediatric patients, which should be taken into consideration by physicians.

Beyond Human Babesiosis: Prevalence and Association of Babesia Coinfection with Mortality in the United States, 2015-2022: A Retrospective Cohort Study.

The prevalence of Babesia coinfecting tick-borne zoonoses and mortality outcomes are not fully elucidated. The objective of the present study was to determine babesiosis coinfection prevalence rates and estimate the association with severe disease and mortality. We queried the TriNetX database between 2015 and 2022 for patients with babesiosis. The prevalence of Babesia coinfecting tick-borne zoonoses was estimated. The analysis focused on babesiosis coinfection with Borrelia burgdorferi, ehrlichiosis, and anaplasmosis. The exposure was coinfection, and the control group was the Babesia-only group. The primary outcome was 90-day mortality from the diagnosis of Babesia. Secondary outcomes were prevalence of coinfection, association of coinfection with acute respiratory distress syndrome, multiorgan failure, and disseminated intravascular coagulation. A multivariable logistic regression model was employed to estimate the disease severity and mortality risk associated with coinfections. Of the 3521 patients infected with Babesia, the mean age (SD) was 56 (18) years, 51% were male, and 78% were White. The frequency of overall malignancies, lymphomas, and asplenia was 19%, 2%, and 2%, respectively. Temporal distribution of coinfections followed the overall babesiosis pattern, peaking in the summer months. The prevalence of 1 or more coinfections was 42% (95% CI, 40%-43%). The rate of coinfection with Borrelia burgdorferi was the highest at 41% (95% CI, 39%-42%), followed by ehrlichiosis at 3.7% (95% CI, 3.1%-4.4%) and anaplasmosis at only 0.3% (95% CI, 0.2%-0.6%). Doxycycline was more likely to be prescribed in the coinfection group than the Babesia-only group (25% vs 18%; P < .0001). Overall, 90-day mortality was 1.4% (95% CI, 1.0%-1.8%). After adjusting for potential confounding factors, compared with the babesiosis-only group, the likelihood of 90-day mortality was lower in the coinfection group (adjusted odds ratio, 0.43; 95% CI, 0.20-0.91). Severe disease did not differ significantly between the 2 groups. In this extensive study of >3000 patients with babesiosis in the United States, 4 in 10 patients had coinfecting tick-borne zoonoses. The prevalence rates of coinfection were highest with Borrelia burgdorferi, followed by ehrlichiosis, and lowest with anaplasmosis. Coinfection with other tick-borne infections was not associated with severe disease. It is plausible that this finding is due to the likelihood of treatment of coinfections with doxycycline. Future studies are needed to investigate the possible therapeutic benefits of doxycycline in babesiosis patients as, to date, no trials with doxycycline have been conducted in human patients with Babesia infections.

Trichomonas vaginalis: comparison of primers for implementation as an in-house PCR in rural Vellore, South India

BackgroundTrichomonas vaginalis (TV) accounts for the highest burden of curable, non-viral sexually transmitted infections worldwide. Prevalence in India ranges from 0.4 to 27.4% in women and 0.0-5.6% in men. In 2015, the prevalence of TV among pregnant women of rural Vellore was 3.11% using Sekisui OSOM® Trichomonas test and culture methods. Molecular methods are the most sensitive, rapid diagnostic tool for Sexually Transmitted Infection’s (STI) albeit cost hinders implementation of commercial platforms. To determine a sensitive, sustainable molecular method, we compared three targets (Adhesin AP65, cytoskeleton Beta-tubulin BTUB 9/2 and TVK 3/7) with the highest published diagnostic accuracy against microscopy, culture and Real Time PCR (RT- PCR).Materials & methodsSix-hundred adult, sexually active women attending the Obstetrics-Gynaecology rural out-patient clinic the Rural Unit for Health and Social Affairs (RUHSA) from July 2020 - February 2021 were enrolled. A vaginal lateral and posterior fornix specimen was inoculated, onsite, into Biomed InPouch® TV culture and smeared onto a slide for fluorescence microscopy using Acridine orange. A flocked nylon swab specimen for PCR was used to determine the sensitivities of the Adhesin AP65, cytoskeleton Beta-tubulin BTUB 9/2 and TVK 3/7 gene targets. Seegene Allplex™ STI Essential Assay, S.Korea was used to confirm TV positives.ResultsNine specimens (9/600, 1.5%) were positive for TV. There was a 100% correlation between Biomed InPouch TV® culture, PCR with TVK 3/7 and RT-PCR while a correlation of 66.6% with BTUB 9/2 and AP65 gene targets. Clinically, 77.7% (n = 7) presented with white-greenish discharge per vagina, 11% (n = 1) with infertility, 22.2% (n = 2) were asymptomatic. Eight of nine patients (88.9%) had co-infections with other bacterial STIs. Prevalence of TV coinfection with Neisseria gonorrhoea was 1.1%.ConclusionCurrent hospital-based prevalence of TV in rural Vellore was 1.5%. Repetitive DNA target TVK 3/7 was more sensitive than AP65 and BTUB 9/2 primers.

Prevalence of intestinal parasites and Helicobacter pylori coinfection, and contributing factors among patients with gastrointestinal manifestations at Addis Zemen primary hospital, Northwest Ethiopia

BackgroundThe urease-producing Helicobacter pylori increase the likelihood that pathogenic intestinal protozoa will use the stomach’s increased hydrogen potential to propagate the disease. Coinfections exacerbate the onset and severity of gastrointestinal symptoms. This study aimed to assess the prevalence of intestinal parasites/Helicobacter pylori coinfection and contributing factors in patients with gastrointestinal symptoms at Addis Zemen Primary Hospital, Northwest Ethiopia.MethodsFrom April to July 2023, patients with gastrointestinal problems participated in a cross-sectional study carried out in a hospital. To collect the clinical and sociodemographic data, a questionnaire was employed. Intestinal parasites and Helicobacter pylori were detected using the saline stool wet mount and Helicobacter pylori stool antigen tests, respectively. SPSS version 20 was used to analyze the data and variables with p-values < 0.05 were considered statistically significant.ResultThe study included 384 participants in total, of which 47.3% (182/384) were farmers and 50.3% (193/384) were women. Of the study subjects, 69/384 or approximately 18%, had intestinal parasitic infections. In 12% of cases (46/384), Helicobacter pylori were detected. A coinfection of Helicobacter pylori and intestinal parasites was found in 5.5% (21/384) of the subjects. Multiple logistic regression revealed increased risk of coinfection of Helicobacter pylori and intestinal parasites in patients who drink surface water (AOR: 10.7, p = 0.03) family history of Helicobacter pylori (AOR: 3.3, p = 0.024) and those with untrimmed fingers (AOR: 4.9, p = 0.031).ConclusionsGiardia lamblia and Entamoeba histolytica/dispar/ moshkovskii/ bangladeshi complex are the most common protozoans that cause coinfection with Helicobacter pylori. Drinking surface water, family history of Helicobacter pylori and untrimmed fingers are the contributing factors to intestinal parasites/Helicobacter pylori coinfection.

Full genome sequence analysis of the predominant and uncommon G9P[4] rotavirus strains circulating in Tehran, Iran, 2021–2022: Evidence for inter and intra-genotype recombination

Group A rotaviruses (RVAs) are a major cause of acute gastroenteritis in children under 5 years of age worldwide. Herein, the genetic sequences of 11 RNA segments from three uncommon G9P[4] RVA strains found in the stool samples of children under 5 years of age in Iran were analyzed using next-generation sequencing (NGS) technology. The genomic constellations of these three uncommon G9P[4] strains indicated the presence of the double and quadruple reassortants of two G9P[4] strains, containing the VP7/NSP2 and VP7/VP2/NSP2/NSP4 genes on a DS-1-like genetic background, respectively. The genome of one strain indicated a Wa-like genetic backbone in a single-reassortant with the VP4 of the DS1-like human strains. With the exception of VP1, VP2, VP7, NSP2, NSP3, and NSP4 genes, which clustered with RVA of human origins belonging to cognate gene sequences of genogroup 1/2 genotypes/lineages, the remaining five genes (VP8/VP4, VP3, VP6, NSP1, NSP5) displayed direct evidence of recombination. It is presumed that the presence of uncommon G9P[4] strains in Iran is not linked to vaccination pressure, but rather to the high prevalence of RVA co-infection or the direct import of these uncommon RVA reassortants strains from other countries (especially those that have implemented RV vaccination).