Risk Factors For Transmission Research Articles

Avian Influenza: Lessons from Past Outbreaks and an Inventory of Data Sources, Mathematical and AI Models, and Early Warning Systems for Forecasting and Hotspot Detection to Tackle Ongoing Outbreaks

Background/Objectives: The ongoing avian influenza (H5N1) outbreak, one of the most widespread and persistent in recent history, has significantly impacted public health and the poultry and dairy cattle industries. This review covers lessons from past outbreaks, risk factors for transmission, molecular epidemiology, clinical features, surveillance strategies, and socioeconomic impacts. Since 1997, H5N1 has infected over 900 individuals globally, with a fatality rate exceeding 50%. Key factors influencing infection rates include demographic, socioeconomic, environmental, and ecological variables. The virus’s potential for sustained human-to-human transmission remains a concern. The current outbreak, marked by new viral clades, has complicated containment efforts. Methods: This review discusses how to integrate technological advances, such as mathematical modeling and artificial intelligence (AI), to improve forecasting, hotspot detection, and early warning systems. Results: We provide inventories of data sources, covering both conventional and unconventional data streams, as well as those of mathematical and AI models, which can be vital for comprehensive surveillance and outbreak responses. Conclusion: In conclusion, integrating AI, mathematical models, and technological innovations into a One-Health approach is essential for improving surveillance, forecasting, and response strategies to mitigate the impacts of the ongoing avian influenza outbreak. Strengthening international collaboration and biosecurity measures will be pivotal in controlling future outbreaks and protecting both human and animal populations from this evolving global threat.

Spatiotemporal patterns and socioeconomic determinants of pulmonary tuberculosis in Dongguan city, China, during 2011–2020: an ecological study

ObjectivePulmonary tuberculosis (PTB) is a critical challenge worldwide, particularly in China. This study aimed to explore the spatiotemporal transmission patterns and socioeconomic factors of PTB in Dongguan city, China.Methods/designAn ecological...

Antimalarial drug sulfadoxine induces gametocytogenesis in Plasmodium berghei

BackgroundThe spread of antimalarial drug resistance parasites is a major obstacle in eliminating malaria in endemic areas. This increases the urgency for developing novel antimalarial drugs with improved profiles to eliminate both sensitive and resistant parasites in populations. The invention of the drug candidates needs a model for sensitive and resistant parasites on a laboratory scale.MethodsRepeated Incomplete Treatment (RIcT) method was followed in raising the rodent malaria parasite, Plasmodium berghei, resistant to sulfadoxine. Plasmodium berghei were exposed to an adequate therapeutic dose of sulfadoxine without finishing the treatment to let the parasite recover. Cycles of drug treatment and parasite recovery were repeated until phenotypic resistance appeared.ResultsAfter undergoing 3–4 cycles, phenotypic resistance was not yet found in mice treated with sulfadoxine. Nevertheless, the molecular biology of dhps gene (the target of sulfadoxine) was analyzed at the end of the RIcT cycle. There was no mutations found in the gene target. Interestingly, the appearance of gametocytes at the end of every cycle of drug treatment and parasite recovery was observed. These gametocytes later on would no longer extend their life in the RBC stage, unless mosquitoes bite the infected host. This phenomenon is similar to the case in human malaria infections treated with sulfadoxine-pyrimethamine (SP).ConclusionsIn this study, the antimalarial drug sulfadoxine induced gametocytogenesis in P. berghei, which could raise the risk factor for malaria transmission.

Community knowledge, attitudes, and practices about toxoplasmosis in Unguja Island, Tanzania

Background: Toxoplasmosis is among the globally neglected zoonotic diseases caused by Toxoplasma gondii. Humans get infected after ingesting or coming into contact with oocysts from the feces of infected cats. Illiteracy about the infection is one of the significant risk factors for its transmission. The study aimed to determine the community knowledge, attitudes, and practices that influence toxoplasmosis transmission in Unguja Island, Zanzibar, Tanzania. Methods: The study used a cross-sectional design, which was done from February to April 2023. Semi-structured questionnaires collected data on 139 respondents' demographics, practices, knowledge, and attitudes regarding toxoplasmosis. The chi-square test was used to assess the statistical association between variables at a p-value of < 0.05. Results: Out of 139 recruited respondents, only 18.0% of respondents were aware of Toxoplasmosis. The study revealed several risk factors for Toxoplasmosis transmission, whereby 63.1% of the cat owners didn't deworm their cats regularly, 70.8% didn't clean the cat kennels, and 53.1% didn't wash their hands after cleaning kennels and touching a cat. Furthermore, out of all respondents, about two-thirds didn't drink treated water and 87.8% ate raw vegetables as salads. The study revealed both negative and positive attitudes concerning Toxoplasmosis, where 64.7% of respondents thought that cats cannot transmit pathogens to humans and 66.2% did not agree with people interacting with stray cats, respectively. There was an association of awareness of the disease's existence with high education levels (P value = 0.001) and sex (females) (P = 0.002). Conclusion: The study revealed a low awareness of the existence of the infection despite the higher interaction of cats with humans in the study area. We recommend the provision of public health education focusing on how the disease is transmitted, the relationship of the disease with cats, the management of cat feces, clinical signs of the disease, its treatment, and control.

Clinical burden of Plasmodium infection and associated risk factors among the local population of Chakwal, Punjab, Pakistan (2019–2023)

BackgroundThis study aimed to determine the clinical burden, spatial dynamics, and associated risk factors of Plasmodium infection among the natives of Chakwal, Punjab Pakistan from 2019 to 2023 to guide targeted screening and treatment interventions.MethodA community-based cross-sectional study was conducted using primary and secondary data sources. Participants were recruited using a multi-stage cluster sampling by taking informed consent for the primary data sources. Whereas a secondary dataset of Plasmodium infection was obtained from the database of surveyed hospitals after ethical consideration. All the participants living in the study area for at least 3 months were included, while patients with chronic illness were excluded. Sociodemographic and environmental data were collected using a structured questionnaire. Plasmodium infection was diagnosed using microscopy, rapid diagnostic tests (RDTs), and nested polymerase chain reaction (PCR) as the reference standard. A Zero-inflated negative binomial logistic regression model and interpolation of malaria distribution to environmental variables were employed to determine the association and spatiotemporal patterns of malaria in Chakwal.ResultsAmong the 2457 participants, the prevalence of Plasmodium vivax infection (99%) was significantly higher than P. falciparum (0.8%) and mixed infection (0.2%). Females had a higher infection rate than males and the infection rate was higher in adults (21–40 years) and children (0–20 years). Age category (61–100), P. vivax species, temperature, rainfall, monsoon season, and mixed infection factors were significantly associated (p < 0.05) with increased Plasmodium infection risk. Geospatial mapping indicated potential malaria hotspots in Sarkal Kasar, Chak Baili, Mulkwal, Chohan, and other close areas of the Potohar region.ConclusionThe clinical burden of P. vivax was the highest during monsoon season in Chakwal. Age, gender, climatic factors, and mixed infection were significant risk factors for malaria transmission in this region. Targeted screening and treatment strategies should prioritize identified hotspots and high-risk groups to effectively control malaria in Potohar region of Pakistan.

Overview of TB Patient Compliance for Control during the Covid-19 Pandemic at the UGM RSA TB Clinic

Tuberculosis (TB) is a public health problem that is a global challenge and is the third leading cause of death in Indonesia and the first leading cause of death due to infectious diseases. Based on data from the Ministry of Health of the Republic of Indonesia, there has been a decrease in the number of TB cases found and treated. As one of the strategies to control risk factors for TB disease transmission, RSA UGM provides a special clinic for TB patients whose rooms meet national standards. However, several times researchers found that there were still TB patients who controlled outside the TB clinic schedule so that they mingled with non-TB patients, which resulted in increasing the risk of TB disease transmission to patients visiting the UGM Hospital. The World Health Organization (WHO) declared Covid-19 a pandemic on 9 March 2020. This has caused public fear to visit health facilities. This study aims to determine the level of compliance of TB patient visits during the Covid-19 pandemic at the UGM RSA TB Clinic. This descriptive observational study used secondary data, with a total sampling technique and analyses using univariate analysis. Of the 40 samples that met the inclusion and exclusion criteria, 92.5% of patients were in the productive age range (18-65 years), mostly male (70%). The proportion of patients with pulmonary TB was 62.5% and the remaining 37.5% were extra- pulmonary TB patients. There was an increase in adherence of TB patients to control at the TB clinic and on schedule from month 1 to the following months.

Hepatitis B Prevalence and Referral Rates in Vulnerable Populations Undergoing Community-Based Screening-Results from the LIVE(RO)2 Program.

Background: Hepatitis B Virus (HBV) remains a major global health challenge, with significant morbidity and mortality associated with chronic infections. Methods: This study examines the epidemiology, screening, and risk factors associated with HBV in Romania, focusing on a comprehensive national screening program, LIVE(RO)2, involving 320,000 individuals (majority of them considered vulnerable population). A questionnaire was used to collect information on the potential risk factors for HBV transmission. Results: The overall prevalence rate of HBV chronic infection among all the participants tested was 1.67% (confidence interval: 1.63-1.72%), with significant differences (p = 0.0001) between participants from the main geographical regions of residence (North-East 1.89%, South 1.38%, South-East 2.06%, and South-West 1.54%). Male persons aged 30-49 or 60-69 years old, from the rural and Eastern parts of Romania and non-Romanian ethnia, with a low level of education, unvaccinated, not married, unemployed, with family members with hepatitis, with personal histories of blood or blood product transfusion, surgical interventions, tattooing, hospitalizations, imprisonment, haemodialysis, unsafe sexual contacts, or with sexual transmitted infectious diseases were risk factors associated with HBsAg seropositivity. Conclusions: Our findings highlight significant demographic and epidemiological patterns of reduced HBV prevalence even in vulnerable persons, as well as modified risk factors and the impact of socio-economic factors.

Genetic variants of IL-10 promoter influence susceptibility to HIV-1 infection and disease progression in the Polish population: IL-10 polymorphisms and HIV-1

The risk of HIV-1 infection and the rate of disease progression vary considerably among individuals and the genetic makeup of the host may be one of the possible reasons for this. We aimed to determine association of functional single nucleotide polymorphism (SNPs), −1082A/G (rs1800896), −819C/T (rs1800871), and −592C/A (rs1800872) in IL-10 gene, with the susceptibility to HIV-1 infection and clinical parameters expressed as a baseline CD4+ T cell count, CD8+ T cell count, and viral load. Therapy naïve HIV-1 infected individuals and HIV-1 seronegative controls from Poland were recruited for this study. Genotyping results revealed significantly higher frequency of −1082G/G genotype (28.1 % vs 16.1 %; p = 0.0019, OR=0.49) and −1082G allele (47.6 % vs 38.8 %; p = 0.0028, OR = 0.70) as well as lower frequency of −592 and −819 heterozygosity (45.0 % vs 34.4 %; p = 0.0266, OR = 1.47) in controls compared to seropositive subjects. High producing haplotype GCC was associated with increased risk of HIV-1 infection (p = 0.0018, OR = 1.52). Individuals possessing −592 and −819 minor allele had significantly higher CD8+ T cell count compared to the wild type allele carriers (p = 0.0303). Moreover, presence of −1082G allele was related with lower viral load as well as CD4+ and CD8+ T cells counts among patients infected with R5 HIV-1 variant. Thus, IL-10 gene promoter variants may be a risk factor for HIV-1 transmission and may modulate disease progression in the Polish population.

Risk factors for enteric diseases transmission through street vended juices: Assessment from empirical data in La Paz, Bolivia

Risk factors for enteric diseases transmission through street vended juices: Assessment from empirical data in La Paz, Bolivia

Transmission dynamics of tuberculosis in a high-burden area of China: An 8-year population-based study using whole genome sequencing

ObjectivesThis study investigated the transmission patterns of tuberculosis (TB) and its associated risk factors in Hunan province to inform the development of prevention and control strategies in the region. MethodsAn 8-year retrospective population-based genomic epidemiological study was conducted. Genomic clusters were defined using distance thresholds of 12-single-nucletide-polymorphisms. Risk factors associated with TB transmission were analyzed using logistic regression model. Kernel Density analysis was used to locate hotspots where transmission occurred. ResultsAmong 2649 TB cases included in this study, 275 clusters were identified, with an overall clustering rate of 24.7% (654/2649). Nearly 95% (620/654) of clustered strains were isolated from the same county. Of the 275 clusters, 23 (8.4%, 23/275) had differences in drug-resistant profiles, with FQs resistance mutations occurring most frequently (52.2%, 12/23). Multivariate analysis identified male TB patients, those aged 30-60 years, ethnic minorities, nonfarmers, retreated TB patients, and individuals infected with MDR/RR-TB as independent risk factors for TB transmission (P < 0.05). Kernel density analysis showed that among the 5 drug-resistant surveillance sites, Leiyang had the highest clustering rate, followed by Yongshun, Qidong, Hecheng, and Taojiang. ConclusionRecent transmission in the region is predominantly occurring within counties. The risk factors related to TB transmission and the hotspots where transmission occurs can provide a scientific basis for the formulation of targeted TB prevention and control strategies.

Obesity and age are transmission risk factors for SARS-CoV-2 infection among exposed individuals.

The coronavirus disease (COVID-19) pandemic has occurred in Massachusetts in multiple waves led by a series of emerging variants. While the evidence has linked obesity with severe symptoms of COVID-19, the effect of obesity on susceptibility to SARS-CoV-2 infection remains unclear. Identification of intrinsic factors, which increase the likelihood of exposed individuals succumbing to productive SARS-CoV-2 infection could help plan mitigation efforts to curb the illness. We aim to investigate whether obese individuals have a higher susceptibility to developing productive SARS-CoV-2 infection given comparable exposure to nonobese individuals. This case-control study leveraged data from the Mass General Brigham's (MGB) electronic medical records (EMR), containing 687,813 patients, to determine whether obesity at any age increases the proportion of infections. We used PCR results of 72,613 subjects who tested positive to SARS-CoV-2 or declared exposure to the virus independently of the result of the test. For this study, we defined susceptibility as the likelihood of testing positive upon suspected exposure. We demonstrate evidence that SARS-CoV-2 exposed obese individuals were more prone to become COVID positive than nonobese individuals [adjusted odds ratio = 1.34 (95% CI: 1.29-1.39)]. Temporal analysis showed significantly increased susceptibility in obese individuals across the duration of the pandemic in Massachusetts. Obese exposed individuals are at a higher risk of getting infected with SARS-CoV-2. This indicates that obesity is not only a risk factor for worsened outcomes but also increases the risk for infection upon exposure. Identifying such populations early will be crucial for curbing the spread of this infectious disease.

Identifying risk factors for COVID-19 cluster infections in schools in the Republic of Korea: a case-control study.

No study has yet analyzed risk factors to determine whether students with confirmed coronavirus disease 2019 (COVID-19) infections may affect students at neighboring schools. Therefore, this study aimed to determine risk factors for COVID-19 transmission among schools within a community in the Republic of Korea. An epidemiological investigation was conducted among 696 students and school staff members at 3 schools where COVID-19 clusters began on October 15, 2021. Interviews, visit history surveys, a facility risk assessment, and closed-circuit television were used to identify risk factors. The statistical significance of risk factors was also evaluated. We confirmed 129 cases (18.5%) among the individuals exposed to COVID-19 at the 3 schools, many of whom had a history of visiting the same multi-use facilities. The odds ratio of having visited multi-use facilities such as karaoke rooms was 1.90 (95% confidence interval, 1.03-3.50); the number of visits to a karaoke room and the visit durations were significantly higher among confirmed cases than non-confirmed cases (p=0.02 and p=0.03, respectively). Having a history of visiting karaoke rooms often and spending a long time there were risk factors for COVID-19 infection and inter-school transmission. Thus, it is necessary to investigate the status of multi-use facilities frequently visited by adolescents and consider incorporating them into the scope of school quarantine to prevent infectious diseases at schools in a community.

A case-control study of behavioural and built environment determinants of COVID-19 transmission in sheltered markets

BackgroundIn July 2021, amid occasional COVID-19 community transmission, an outbreak in a seafood wholesale centre propagated secondary clusters in sheltered markets in Singapore. This period offers a unique chance to study COVID-19 transmission risk factors related to environmental features and personal behaviours in markets. Only 40 % of the population was vaccinated during this period. MethodsA two-tier case-control study was conducted. The first tier entailed site assessments of markets where primary cases, presumed to have acquired COVID-19 at the seafood wholesale centre, worked. Markets with secondary cases (case markets) were compared against those without (control markets). The second tier comprised telephone questionnaires administered to individuals who worked at or visited the three markets with the highest number of secondary cases, with respondents either testing positive or negative for SARS-CoV-2. ResultsAssessment of 38 markets showed that markets “seeded” with more primary cases were more likely to experience a secondary outbreak (adjusted odds ratio, aOR: 2.0; 95 % confidence interval, CI: 1.3–4.7). From 333 visitor responses, maintaining social distancing (aOR: 0.34; 95 % CI: 0.11–1.06) and completing vaccination (aOR: 0.25; 95 % CI: 0.07–0.95) decreased infection risk, while using public washrooms increased the risk (aOR: 3.12; 95 % CI: 0.87–11.00). Among 86 staff responses, statistically significant risk factors were gender and mask type: male staff (aOR: 0.14; 95 % CI: 0.02–0.62) and those wearing surgical/N95 masks (aOR: 0.10; 95 % CI: 0.01–0.71) had lower infection risk. Wider aisles of the markets correlated with a higher chance of secondary transmission (aOR: 2.5; 95 % CI: 1.3–6.7). ConclusionThese findings underscore the importance of considering both built environment features and individual behaviours in devising effective measures to mitigate COVID-19 transmission in markets and community hubs in general. The observed association of wider market aisles with increased risk could be attributed to these facilitating the gathering and intermingling of more individuals, underlining the importance of maintaining social distancing. The identified individual risk factors among different populations within the market environment highlight the need for population-specific measures for infection prevention.

Seroprevalence and Risk Factors for Hepatitis B, Hepatitis C, and HIV in a Substance Abuse Treatment Center.

Alcohol and substance use disorders are important public health problems with an increased risk for bloodborne and sexually transmitted infections. To determine the frequency and risk factors of hepatitis B, hepatitis C and HIV in individuals with drug and alcohol addiction. This prospective study was conducted in the outpatient clinic of Alcohol and Substance Abuse Treatment and Education Center (ASATEC), Izmir, Turkey. Detailed anamneses were taken from alcohol and/or drug addicts who applied to the outpatient clinic; HBV, HCV, HIV serology results in the last 6 months were examined. The study group consisted of 478 persons, including 112 (23.4%) alcohol addicts, 322 (67.4%) substance addicts, and 44 (9.2%) combined alcohol and substance addicts. The mean age of the cases was 32 ± 11 years and 432 (90.4%) were male. Drug injection and needle sharing was recorded in 16.5% and 9.8% of participants, respectively. Hepatitis B surface antigen (HBsAg) positivity was found in 2.7%, anti-HCV positivity in 9.6% and HIV Ag/Ab positivity in 1.9% of the cases. Among patients using intravenous drugs, HBsAg positivity was found in 2%, anti-HCV positivity in 55%, while HIV Ag/Ab positivity was not detected. A history of sexually transmitted disease was a risk factor for HBsAg, HIV Ag/Ab positivity. Intravenous drug use, needle sharing and ecstasy use were determined as risk factors for anti-HCV positivity. Risky behaviors for HBV, HCV and HIV transmission are high in alcohol and substance addicts. The use of ecstasy is a novel risk factor for HCV transmission.

Fauna sinantrópica e silvestre no ciclo da leptospirose e impactos legais e forenses na “Saúde Única”

The term “synanthropic” qualifies animals that have adapted to living alongside humans, often involuntarily. Synanthropy is characterized by the potential transmission of diseases to humans. The One Health approach increasingly emphasizes the importance of veterinary medicine in animal and environmental healthcare, with a focus on human health. This review aims to identify, understand and discuss the impacts of synanthropic and wild fauna on animal, public and environmental health, as well as legal and forensic aspects within the framework of One Health. The challenges encompassing One Health challenge both veterinary medicine and the law. Veterinary expertise is a resource that can assist in legal matters relating to the environmental management of synanthropic and wild fauna. Humans exposed to synanthropic and wild animals are considered a risk factor for disease transmission. The presence of rodents in urban and rural areas generates economic and health problems as they transmit diseases directly or indirectly. The rodents involved in the transmission of leptospirosis are Rattus rattus, Rattus norvergicus and Mus musculus. Leptospirosis is a neglected disease transmitted both by rodents and wild animals. The understanding of this issue must communicate actions to public authorities to develop health and environmental education policies regarding this fauna in order to reduce, control or eliminate the risks of disease transmission. This review bases its information on the Pubmed platform, Google Scholar, articles and textbooks. Despite existing legislation, leptospirosis is still considered a neglected disease, and synanthropic and wild fauna represent a significant challenge to the One Health concept due to the lack of basic sanitation and poor urban infrastructure that facilitates the presence of this fauna, which cause health and economic problems for the population.

Mitigating the Risk of Dengue Fever in Nagpur City, India: Insights from a Five-year Retrospective Study

Objectives: Dengue is a significant global threat, with millions of infections yearly, primarily transmitted by Aedes mosquitoes. Vector control is crucial as no specific treatment is available, and urbanisation has led to increased susceptibility to the disease. We aimed to study dengue fever’s incidence, mortality, and various determinants in Nagpur, India. Material and Methods: This was a retrospective record-based study conducted for the period between January 2018 and December 2022 in Nagpur, India. Results: During 2018–2022, 17,306 blood samples were tested for dengue immunoglobulin M antibodies by enzyme-linked immunosorbent assay method with 2470 positive results indicating an overall test positivity of 14.27%. A median of 27 samples was tested monthly (interquartile range [IQR]: 5–178.5) with seven dengue cases (IQR: 1–15) diagnosed per month, yielding a monthly median dengue test positivity rate of 15.3 % (IQR: 6.41–24.28). Median annual dengue incidence rate (per 1,00,000 population) was 20.12 (IQR: 21.46). The median dengue-attributable death yearly was 2 (IQR: 2.25), remaining stable over the study period. The mean annual case fatality rate (CFR) was 0.43% (standard deviation [SD]: 0.34%). During the same period, India’s mean annual dengue incidence rate (per 1,00,000 population) was 1.74 (SD: 0.81), and the mean annual CFR was 0.134 % (SD: 0.042). During the five years, action was taken on 194,698 containers. The median values of environmental factors and public health interventions, as calculated on a monthly basis, were as follows: Container index: 1.15 % (IQR: 0.7–1.98); action taken on containers: 3108.5 (IQR: 2436–4282); house index: 3.02 % (IQR: 2–4.07); guppy fishes introduced: 1736.5 (1005.5–1794.5) and rainfall (mm): 26.05 (1–69.11). The total number of dengue cases, incidence rate, and CFR showed an overall decline in year-wise evaluation. The important determinants identified were as follows: Higher container index, house index, and total blood samples tested for dengue were significant determinants of the total number of dengue cases, and environmental factors such as Aedes density, container index, and house index were significant determinants of dengue-related mortality. Introducing guppy fishes and taking action on containers successfully arrested the absolute number of dengue deaths. The container index, house index, and rainfall were significant determinants of Aedes’ density. Conclusion: Our study emphasises the effectiveness of public health interventions in reducing the incidence and fatality rate of dengue fever in Nagpur City over the past five years, particularly through introducing guppy fish and container management. Stagnant water around households has been identified as a significant risk factor for dengue transmission. Prevention strategies must prioritise tackling this issue, with enhanced monitoring during the wet season, and encourage community members to take personal responsibility for eliminating stagnant water sources in their households.

Cryptosporidiosis in Human Immunodeficiency Virus Patients in Tripoli Medical Center

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

Impact of methamphetamine use on HIV and other health outcomes at an urban HIV medicine clinic.

The methamphetamine epidemic threatens progress towards ending the HIV epidemic in the United States. Further characterizing the prevalence and impact of methamphetamine use among people with HIV (PWH) is necessary to inform integrated HIV and methamphetamine treatment strategies. We conducted a retrospective chart review to characterize methamphetamine use among 3,092 PWH at an urban HIV Medicine clinic between July 1, 2022 and June 30, 2023. The Chi-squared test was utilized to assess for statistically significant differences in demographics and HIV and other health outcomes among PWH who use and do not use methamphetamine. The prevalence of methamphetamine use among PWH in this cohort was 17%. PWH who used methamphetamine were more likely to be < 40 years of age, identify as White race, live in neighborhoods with low Healthy Places Index scores, identify as lesbian, gay, or bisexual, report male sex with men (MSM), MSM and injection drug use (IDU), or IDU as HIV transmission risk factor, miss scheduled HIV primary care visits, and screen positive for hepatitis C virus antibody, gonorrhea, chlamydia, and major depressive disorder. PWH who use methamphetamine were also less likely to be virally suppressed and have a CD4 count ≥ 200 cells/mm3. Methamphetamine use is prevalent among PWH at this urban HIV Medicine Clinic and is associated with worse HIV and other health outcomes which likely increase the risk of HIV transmission. The integration of methamphetamine use disorder treatment into HIV primary care is necessary to work toward ending the syndemics of methamphetamine and HIV.

Assesment risk factor for tuberculosis transmission among children: Case study in Medan

Assesment risk factor for tuberculosis transmission among children: Case study in Medan

Stenotrophomonas maltophilia Bloodstream Infection Outbreak in an Acute Care Hospital — Alameda County, California 2022–2023

Background: Stenotrophomonas maltophilia is an opportunistic pathogen found in healthcare settings. During April–September 2022, nine S. maltophilia bloodstream infections (BSIs) were identified among intensive care unit (ICU) patients at a hospital in Alameda County, California. Whole genome sequencing found isolates to be highly related. Despite implementation of infection prevention and control (IPC) interventions, four additional S. maltophilia BSIs were identified during June–September 2023. We investigated to identify risk factors for infection and stop transmission. Methods: We conducted a matched case-control study. A case was defined as S. maltophilia isolated from a blood culture from an ICU patient with a fever during April 2022–September 2023; control-patient subjects were patients admitted to the ICU during the same period with hospital stay greater than or equal to their matched case. Three control subjects were matched to each case. We extracted information on risk factors for infection from medical charts and observed IPC practices in hospital locations of interest. We collected environmental samples from the ICU, radiology unit, and emergency department. Results: Among 13 cases and 39 control subjects, patients exposed to iodinated contrast Omnipaque-300 (odds ratio [OR]: 5.7; 95% CI: 1.2–28.0), injectable propofol (OR: 12.2; 95% CI: 1.5–101.4), or fentanyl (OR: 9.2; 95% CI: 1.8–Inf.) were more likely to have a S. maltophilia BSI, compared with control-subjects. IPC deficiencies included improper cleaning and storage of medical equipment, including the contrast injection system, and patient care supplies. The outbreak strain of S. maltophilia was not isolated from environmental samples. Conclusions: Although a point-source was not identified, S. maltophilia was likely transmitted through improper IPC practices involving injectable contrast or anesthesia. Recommendations on proper cleaning and disinfection of the contrast injection system and proper storage, preparation, and administration of medications were made to reduce risk for contamination.