Transmission Of Infection Research Articles

Assessment and Empirical Treatment of Chronic Abdominal Pain from Suspected Helicobacter Pylori Infection In a Remote Setting

The prevalence of Helicobacter Pylori (H. Pylori) remains globally high, with an estimated 50% of the words population believed to be infected. Despite the continually high incident rates of infection 90% of those infected remain asymptomatic. H.Pylori is a gram-negative, microaerophilic bacteria, mostly found in stomach of affected individuals that causes inflammation and ulceration. Definitive routes of transmission and subsequent infection are still debated. The most likely mechanism of transmission is thought to be intrafamilliar, this encapsulates fecal-oral, gastric-oral, oral-oral and sexual vectors. Contaminated foods and water sources are also highly likely mechanisms of transmission. Therefore in developing countries with poor sanitation, potentially contaminated water sources and regions with social-economic hardship experience increased symptomatic cases of H.Pylori.

Assessment of Factors Associated with Adherence to Antiretroviral Therapy among HIV Patients at Kampala International University Teaching Hospital in Ishaka, Uganda

HIV has increasingly become a chronic, manageable disease due to the introduction of antiretroviral therapies (ARTs). For the effectiveness of antiretroviral therapy, a high level of adherence is required. This study therefore seeks to assess the adherence level and the influence of its determinants in HIV patients on antiretroviral therapy at the Kampala International University Teaching Hospital (KIUTH) HIV clinic in Ishaka, Uganda. Quantitative cross-section study approach was conducted to assess the factors associated with adherence to a-ntiretroviral therapy among HIV patients at KIUTH in Ishaka, Uganda. Data was collected using an interviewer-administered questionnaire in 150 respondents in this study. The qualitative data collected was statistically analysed and documented using Microsoft Excel and Word version 2019, which were then analyzed. The analysed data was presented in the form of tables and graphs, which formed the basis for discussion and conclusion. Of a total of 150 clients interviewed, equal proportions of 26% were in the age groups of 40–49 and 50–59 years, with a mean age of 46 years. The majority (65%) were female, with most (45%) being Anglicans, followed by Catholics (32%), Muslims (14%), and other religions (9%). Nearly half (45.1%) of the respondents were married. About 7% had tertiary education, while 37% had completed the ordinary level of high school. Nearly half (47%) knew the name of the ART they were taking, while 17% did not. Less than a third (26.7%) did not know the name of the ART drug they were taking. A large proportion (93%) stated that ART prevents mother-to-child transmission of infection, while 7% reported that they did not know. Nearly all (96%) respondents knew HIV could be controlled by ART. The majority (87%) stated that taking ART prevents disease progression, and 63% opined that missing ART drugs can lead to transmission of the disease. Overall, adherence to ART was 39% while non-adherence was 61%. In conclusion, the study discovered a high degree of awareness but a low level of adherence to ART among patients living with HIV. Forgetfulness, financial level, employment status, and knowledge of the benefits of the intervention are all important factors in nonadherence among some HIV patients. As a result, ART clinics should increase the level of education provided to customers to encourage patients to take complete responsibility for their health status. Keywords: Adherence, Antiretroviral Therapy, HIV, AIDS

Modeling and Optimal Control of Infectious Diseases

We propose a stochastic model of infectious disease transmission that is more realistic than those found in the literature. The model is based on jump-diffusion processes. However, it is defined in such a way that the number of people susceptible to be infected decreases over time, which is the case for a population of fixed size. Next, we consider the problem of finding the optimal control of the proposed model. The dynamic programming equation satisfied by the value function is derived. Estimators of the various model parameters are obtained.

The Effects of Climate Change on Maternal, Fetal and Neonatal Health: An in-Depth Review

The substantial elevation in atmospheric greenhouse gas levels is a consequence of human activities, resulting in a 1.1°C elevation in surface temperature as the worldwide average. The detrimental outcomes of this temperature rise encompass severe weather events, deterioration in food, water, and air quality, alongside an escalation in vector-borne infectious diseases and/or transmission risks. The mitigation and adaptation to climate change are pivotal factors for the survival of humanity in the midst of this existential crisis. Climate change exerts notable effects on maternal, fetal, and neonatal health, with women experiencing more adverse impacts compared to men. Pregnant women may face conditions such as hypertensive disorders like preeclampsia and eclampsia, gestational diabetes mellitus (GDM), variations in pregnancy duration, and mental health disorders. Fetal and newborn health can be affected, leading to results like preterm birth (<37 weeks of gestation), low birth weight (<2500 grams), congenital anomalies (including atrial septum issues), early membrane rupture (EMR), underdeveloped immune systems, intrauterine growth restriction (IUGR), and neonatal death. Effective interventions aimed at reducing heat-related risks should include health education on heat and heat increase risks for caregivers - other than parents - and clinicians responsible for childcare. Additionally, there is a need for improvements in cooling systems in healthcare facilities, fair enhancements in housing quality, and food systems. Focus should also be placed on nutrition and lifestyle counseling. Despite the growing attention to the influence of climate on human health, the risks associated with heat and other factors associated with climate for women, pregnant individuals, newborns, infants, and children are not sufficiently addressed. This review seeks to investigate the effects of climate change on maternal, fetal, and neonatal outcomes related to health based on existing literature.

Primary health care utilisation and delivery in remote Australian clinics during the COVID-19 pandemic

IntroductionThe COVID-19 pandemic period (2020 to 2022) challenged and overstretched the capacity of primary health care services to deliver health care globally. The sector faced a highly uncertain and dynamic period that encompassed anticipation of a new, unknown, lethal and highly transmissible infection, the introduction of various travel restrictions, health workforce shortages, new government funding announcements and various policies to restrict the spread of the COVID-19 virus, then vaccination and treatments. This qualitative study aims to document and explore how the pandemic affected primary health care utilisation and delivery in remote and regional Aboriginal and Torres Strait Islander communities.MethodsSemi-structured interviews were conducted with staff working in 11 Aboriginal Community-Controlled Health Services (ACCHSs) in outer regional, remote and very remote Australia. Interviews were transcribed, inductively coded and thematically analysed.Results248 staff working in outer regional, remote and very remote primary health care clinics were interviewed between February 2020 and June 2021. Participants reported a decline in numbers of primary health care presentations in most communities during the initial COVID-19 lock down period. The reasons for the decline were attributed to community members apprehension to go to the clinics, change in work priorities of primary health care staff (e.g. more emphasis on preventing the virus entering the communities and stopping the spread) and limited outreach programs. Staff forecasted a future spike in acute presentations of various chronic diseases leading to increased medical retrieval requirements from remote communities to hospital. Information dissemination during the pre-vaccine roll-out stage was perceived to be well received by community members, while vaccine roll-out stage information was challenged by misinformation circulated through social media.ConclusionsThe ability of ACCHSs to be able to adapt service delivery in response to the changing COVID-19 strategies and policies are highlighted in this study. The study signifies the need to adequately fund ACCHSs with staff, resources, space and appropriate information to enable them to connect with their communities and continue their work especially in an era where the additional challenges created by pandemics are likely to become more frequent. While the PHC seeking behaviour of community members during the COVID-19 period were aligned to the trends observed across the world, some of the reasons underlying the trends were unique to outer regional, remote and very remote populations. Policy makers will need to give due consideration to the potential effects of newly developed policies on ACCHSs operating in remote and regional contexts that already battle under resourcing issues and high numbers of chronically ill populations.

Spatiotemporally Explicit Epidemic Model for West Nile Virus Outbreak in Germany: An Inversely Calibrated Approach

Since the first autochthonous transmission of West Nile Virus was detected in Germany (WNV) in 2018, it has become endemic in several parts of the country and is continuing to spread due to the attainment of a suitable environment for vector occurrence and pathogen transmission. Increasing temperature associated with a changing climate has been identified as a potential driver of mosquito-borne disease in temperate regions. This scenario justifies the need for the development of a spatially and temporarily explicit model that describes the dynamics of WNV transmission in Germany. In this study, we developed a process-based mechanistic epidemic model driven by environmental and epidemiological data. Functional traits of mosquitoes and birds of interest were used to parameterize our compartmental model appropriately. Air temperature, precipitation, and relative humidity were the key climatic forcings used to replicate the fundamental niche responsible for supporting mosquito population and infection transmission risks in the study area. An inverse calibration method was used to optimize our parameter selection. Our model was able to generate spatially and temporally explicit basic reproductive number (R0) maps showing dynamics of the WNV occurrences across Germany, which was strongly associated with the deviation from daily means of climatic forcings, signaling the impact of a changing climate in vector-borne disease dynamics. Epidemiological data for human infections sourced from Robert Koch Institute and animal cases collected from the Animal Diseases Information System (TSIS) of the Friedrich-Loeffler-Institute were used to validate model-simulated transmission rates. From our results, it was evident that West Nile Virus is likely to spread towards the western parts of Germany with the rapid attainment of environmental suitability for vector mosquitoes and amplifying host birds, especially short-distance migratory birds. Locations with high risk of WNV outbreak (Baden-Württemberg, Bavaria, Berlin, Brandenburg, Hamburg, North Rhine-Westphalia, Rhineland-Palatinate, Saarland, Saxony-Anhalt and Saxony) were shown on R0 maps. This study presents a path for developing an early warning system for vector-borne diseases driven by climate change.

Contamination of Streptococcus suis and S. suis Serotype 2 in Raw Pork and Edible Pig Organs: A Public Health Concern in Chiang Mai, Thailand.

Streptococcus suis is one of the most important zoonotic pathogens causing serious diseases in both pigs and humans, especially serotype 2. In northern Thailand, there is a notable prevalence of S. suis infection in humans and transmission has occurred mainly through the consumption of raw pork products. Despite the continued practice of consuming raw pork in this region, limited data exist regarding S. suis contamination in such products. Therefore, this study aimed to assess the prevalence of S. suis and S. suis serotype 2 in retail raw pork meat and edible pig organs sold in Chiang Mai city, Thailand. A total of 200 samples, comprising raw pork meat and edible pig organs, were collected from nine fresh markets in Chiang Mai city between May and July 2023. Samples were prepared and cultured in Todd-Hewitt broth. Bacterial DNA was extracted and tested for any serotypes of S. suis and serotype 2 using loop-mediated isothermal amplification (LAMP) techniques. The study revealed contaminations of S. suis and serotype 2 at rates of 84% and 34%, respectively, with a higher prevalence observed in pig organs compared to raw pork. Both S. suis and serotype 2 were detected across all nine fresh markets investigated. The prevalence of S. suis remained consistently high throughout the study period, whereas serotype 2 showed peaks in May and July. These high rates of contamination indicate that people who consume or work in close contact with raw pork or edible pig organs are at a high risk of S. suis infection. Urgent implementation and maintenance of food safety campaigns and public health interventions are crucial for disease prevention and control.

Sequencing and Description of the Mitochondrial Genome of Orthopodomyia fascipes (Diptera: Culicidae).

The genus Orthopodomyia Theobald, 1904 (Diptera: Culicidae) comprises 36 wild mosquito species, with distribution largely restricted to tropical and temperate areas, most of which are not recognized as vectors of epidemiological importance due to the lack of information related to their bionomy and involvement in the cycle transmission of infectious agents. Furthermore, their evolutionary relationships are not completely understood, reflecting the scarcity of genetic information about the genus. Therefore, in this study, we report the first complete description of the mitochondrial genome of a Neotropical species representing the genus, Orthopodomyia fascipes Coquillet, 1906, collected in the Brazilian Amazon region. Using High Throughput Sequencing, we obtained a mitochondrial sequence of 15,598 bp, with an average coverage of 418.5×, comprising 37 functional subunits and a final portion rich in A + T, corresponding to the control region. The phylogenetic analysis, using Maximum Likelihood and Bayesian Inference based on the 13 protein-coding genes, corroborated the monophyly of Culicidae and its two subfamilies, supporting the proximity between the tribes Orthopodomyiini and Mansoniini, partially disagreeing with previous studies based on the use of molecular and morphological markers. The information generated in this study contributes to a better understanding of the taxonomy and evolutionary history of the genus and other groups of Culicidae.

Determining the optimal frequency of SARS-CoV-2 regular asymptomatic testing: A randomized feasibility trial in a home care setting.

The SARS-CoV-2 pandemic presented a challenge for caregiving relatives in the home care setting. Caregivers can transmit SARS-CoV-2 to their relatives who are often at high risk for a severe course of COVID-19. Regular testing of asymptomatic caregivers for SARS-CoV-2 may reduce the risk of transmission. The optimal method and frequency of regular asymptomatic testing is unknown. We conducted a prospective, randomised trial to assess the feasibility, recruitment and acceptance of different testing frequencies. This serves to inform a future definitive randomised controlled trial. We carried out a parallel three-armed feasibility trial, enrolling adult participants who provided home-based care for a relative at least twice a week. Participants were randomly assigned using sealed envelopes to either conduct saliva-based antigen self-testing at a frequency of once a week (group I), twice a week (group II), or every two days (group III). The participants completed questionnaires on a weekly basis. Main outcome measures were feasibility of recruitment, adherence to self-tests and distress caused by self-testing. We further collected data on the use of mouth-nose mask. From 25 March to 7 May 2021 we assessed 27 participants and randomised 26 in the study: 8 participants in group I, 8 in group II and 10 in group III. All participants completed the study. In group I 48/48 (100.0%; 95% CI 92.6% to 100.0%), in group II 93/96 (96.9%; 95% CI 91.2% to 98.9%) and in group III 209/210 (99.5%; 95% CI 97.4% to 99.9%) self-tests were carried out at home. Participants did not perceive regular self-testing as burdensome in any of the study arms. We did not observe any infection with SARS-CoV-2. During the study, mask adherence decreased from 35% to 19% in all groups. Conducting such a study was feasible. The participants tolerated regular self-testing well, which was reflected in a high level of test adherence. However, regular self-testing may have led to decreased protective behaviour. To demonstrate that regular asymptomatic testing reduces infection transmission, a future definitive trial should be performed at a time of a high prevalence of SARS-CoV-2 and be implemented as a multicentre study. The trial is registered with the German Clinical Trials Register, DRKS00026234.

Impact of extreme weather events on the occurrence of infectious diseases in Belgium from 2011 to 2021.

The role of meteorological factors, such as rainfall or temperature, as key players in the transmission and survival of infectious agents is poorly understood. The aim of this study was to compare meteorological surveillance data with epidemiological surveillance data in Belgium and to investigate the association between intense weather events and the occurrence of infectious diseases. Meteorological data were aggregated per Belgian province to obtain weekly average temperatures and rainfall per province and categorized according to the distribution of the variables. Epidemiological data included weekly cases of reported pathogens responsible for gastroenteritis, respiratory, vector-borne and invasive infections normalized per 100 000 population. The association between extreme weather events and infectious events was determined by comparing the mean weekly incidence of the considered infectious diseases after each weather event that occurred after a given number of weeks. Very low temperatures were associated with higher incidences of influenza and parainfluenza viruses, Mycoplasma pneumoniae, rotavirus and invasive Streptococcus pneumoniae and Streptococcus pyogenes infections, whereas very high temperatures were associated with higher incidences of Escherichia coli, Salmonella spp., Shigella spp., parasitic gastroenteritis and Borrelia burgdorferi infections. Very heavy rainfall was associated with a higher incidence of respiratory syncytial virus, whereas very low rainfall was associated with a lower incidence of adenovirus gastroenteritis. This work highlights not only the relationship between temperature or rainfall and infectious diseases but also the most extreme weather events that have an individual influence on their incidence. These findings could be used to develop adaptation and mitigation strategies.

Overlooked, dismissed, and downplayed: reversion of Mycobacterium tuberculosis immunoreactivity.

Tuberculosis (TB) is caused by Mycobacterium tuberculosis (Mtb). Following infection, immune responses to Mtb antigens can be measured using the tuberculin skin test or an interferon-γ release assay. The gain of Mtb immunoreactivity, a change from a negative to a positive tuberculin skin test or interferon-γ release assay result, is called conversion and has long been used as a measure of Mtb exposure. However, the loss of immunoreactivity (reversion; a positive followed by a negative result) has often been overlooked. Instead, in clinical and epidemiological circles, Mtb immunoreactivity is commonly considered to persist lifelong and confer a lifetime of disease risk. We present a critical review, describing the evidence for reversion from cohort studies, ecological studies and studies of TB progression risk. We outline the inconsistent reasons why reversion has been dismissed from common understanding and present evidence demonstrating that, just as conversion predominantly indicates prior exposure to Mtb antigens, so its opposite, reversion, suggests the reduction or absence of exposure (endogenous or exogenous). Mtb immunoreactivity is dynamic in both individuals and populations and this is why it is useful for stratifying short-term TB progression risk. The neglect of reversion has shaped TB research and policy at all levels, influencing clinical management and skewing Mtb infection risk estimation and transmission modelling, leading to an underestimation of the contribution of re-exposure to the burden of TB, a serious oversight for an infectious disease. More than a century after it was first demonstrated, it is time to incorporate reversion into our understanding of the natural history of TB.

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.

Pathological Consequences in Anti-HCV Antibody-Positive Organ Donation to an Anti-HCV Antibody-Negative Recipient

BackgroundThe need to expand the pool of available organs has meant that the use of marginal organs is increasingly widespread. With the advent of antiviral therapy for hepatitis C, it has made it possible to consider the donation of organs from HCV positive donors or even from viremic donors. MethodsIn HCV positive to HCV negative antibody donor transplantation, the development of antibodies to HCV is documented unevenly depending on the organ transplanted and with differences in the time of appearance and in some cases with subsequent disappearance that draws attention to the fact whether it is the development of antibodies or the transmission of immunity between donor and recipient. In transplantation from HCV infected donor to negative recipient the introduction pre-transplantation or a few days after transplantation of antiviral therapy into the recipient achieves sustained response in almost all cases. We wanted to deepen the argument by studying the literature data, focusing on kidney transplantation, in consideration of the fact that this could be of interest in particular for the possible long-term renal damage. ResultsHCV infection both ongoing and past but also the presence of HCV antibodies alone can be responsible for kidney damage. ConclusionsDAA therapy has revolutionized the history of HCV disease and the therapeutic possibilities of transplantation. However, we believ it is useful to keep in mind the pathophysiology of HCV-related damage especially in patients with long life expectancy, using all emerging strategies to minimize the risk of transmission of infection or development of viremia.

Staff Perspectives on Barriers & Facilitators to Meeting Hand Hygiene Goals in a Multicenter Academic Hospital System

Background: Proper hand hygiene is the most important practice to reduce the transmission of infections in healthcare settings. Despite this, healthcare institutions continue to struggle to achieve and maintain high rates of hand hygiene compliance among healthcare workers with some studies estimating national healthcare worker hand hygiene compliance to be approximately 50%. Methods: We conducted an anonymous one-time survey of our Lifespan Hospital System employees to evaluate barriers and facilitators to performing hand hygiene as well as interventions to improve hand hygiene compliance. The survey was designed with guidance from the Consolidated Framework for Implementation Research and input from Lifespan infection prevention staff. Result: Over four weeks 985 (6%) Lifespan employees completed the survey. Figure 1 shows the aggregate results of the first 4 survey questions which focused on hand hygiene infrastructure at Lifespan, including availability of sanitizer, staff to manage hand hygiene supplies, and educational materials/reminders. One significant finding was >70% of respondents reported that they either did not know if their unit/department has a person assigned to replace/monitor hand hygiene supplies, or if so, who that person is. We also asked employees to rate how effective different interventions would be at improving hand hygiene compliance. Figure 2 shows of five proposed interventions, three were rated as either “moderately effective” or “very effective” by >50% of respondents. These included displaying hand hygiene instructions, making hand hygiene data available to employees, and displaying materials/reminders promoting hand hygiene. There were also 977 free-text responses regarding “barriers or facilitators to proper hand hygiene”. Major barriers identified were a lack of staff to monitor and refill supplies, slow replacement of hand hygiene products, lack of sanitizer dispensers and sinks, inconsistency of sink location and dispenser placement, lack of hand hygiene reminders/educational materials, time constraints, skin irritation from sanitizer, and an inability to have dispensers in behavioral health units. Survey responses led us to enhance the following: educational materials and reminders in work areas; staff education; leadership involvement in hand hygiene initiatives; routine auditing and feedback; conveniently placed sanitizer dispensers and sinks at the point of care; and making hand hygiene compliance data readily available to staff. Conclusion: This survey identifies important barriers and facilitators to achieving high rates of hand hygiene compliance among healthcare workers and provides the basis for interventions aimed at improving hand hygiene compliance in a large multicenter academic hospital system.

Three decades of research in lymphatic filariasis-lessons learned.

Lymphatic filariasis (LF), one of the 21 Neglected Tropical Diseases (NTD) which is the second leading cause for disability globally. Wuchereria Bancrofti, Brugia malayi and Brugia timori are the parasites causing this infection. World Health Assembly in 1997 declared LF to be eliminated and the Global Program to eliminate LF (GPELF) was launched by WHO in 2000 with the two strategies viz, 1) stop transmission of infection through Mass Drug Administration (MDA) and 2) to alleviate the suffering of the people affected with the disease through Morbidity Management and Disability Prevention (MMDP. The 'Filariasis research unit' recommended by WHO TDR and ICMR was established in Alappuzha, Kerala in 1989 for research studies related to LF. Over the last three decades 23 studies have been completed, which included different trials to find out the dose, effectiveness and safety of the various drugs used in preventive chemotherapy as single drug or combinations, for treatment of microfilaraemia,, various studies related to morbidity management in filarial disease, socio-economic aspects of filarial disability, Pharmacokinetic study of antifilarial drugs, Study on lymphatic filariasis in children, Studies on dignostics of LF, efficacy of drugs in management of lymphedema etc. In this article an attempt is made to explain the lessons learned from these studies and its importance in development of policy decision making for GPELF.

Factors responsible for the re-emergence of Monkeypox and implications for global health

The eradication of smallpox in 1980 and the subsequent discontinuation of smallpox vaccination have resulted in a decline in immunity against orthopoxviruses. As a result, Monkeypox (Mpox) has reappeared as a significant virus with implications for public health. This article aims to determine some of the factors responsible for the re-emergence of Mpox and its implications for global health. A thorough literature search for this present article was conducted through a search of databases and journals, including the WHO and CDC websites, using keywords such as “Monkeypox”, “Re-emergence”, “Prevalence”, “Risk factors”, “Implications” and “Global Health” to find articles published from 2003 to 2023. We found that Mpox recently occurred in several countries in America, Europe, and Asia, including the United States of America (USA), Brazil, Spain, Colombia, Mexico, the United Kingdom (UK), Germany, and Pakistan, between 2022 and 2023. The rise in Mpox cases was also seen, with incidences documented in Western Europe (2599 cases, accounting for 42.76% of the total), Southern Europe (1932 cases, representing 31.79% of the total), Northern Europe (1487 cases, comprising 24.46% of the total), and Eastern Europe (59 cases, making up 0.97% of the total). Possible factors implicated in the re-emergence of MPOX include; the expansion of the human population, increased same sexual intercourse, and poor epidemiological surveillance. etc. The re-emergence of Mpox in the world is a difficult issue that requires world leaders to take a diverse approach to control the disease. World leaders and scientists must pursue natural compounds with antiviral properties. Hopefully, natural products will give alternate therapy alternatives for preventing infection transmission between humans and limiting virus proliferation in host organisms.

A secure visualization platform for pathogenic genome analysis with an accurate reference database

Investigating the genetic and developmental characteristics, infection transmission attributes, and epidemiological trends of pathogens using genomic data represents the foundation for pathogen surveillance and is a crucial prerequisite for guaranteeing global health security. To meet the analytical demands of research relating to pathogen prevention and control, we designed a secure visualization system capable of pathogen genome assembly, annotation, species identification, sequence typing, antibiotic resistance and virulence analysis, genomic mobile element and transferable resistance gene annotation, and phylogenetic tree reconstruction. For highly pathogenic organisms requiring complete data protection, we have developed a secure computing tool that utilizes a trusted execution environment, is combined with blockchain and privacy computing technologies, and is specifically designed for nucleotidebasiclocalalignmentsearchtool(BLASTn) comparison analysis. This technological advancement offers scientific support for in-depth investigations into pathogen transmission and epidemiological mechanisms, environmental adaptability, evolutionary trends, and immune evasion mechanisms, as well as the identification of new or emerging pathogen strains. This, in turn, aids efforts in infectious disease prevention, treatment, and research.

Self-contamination with use of personal protective equipment: Concept analysis using Rodgers’ evolutionary method

Background: Although self-contamination has been identified through relevant studies on the safe utilization of personal protective equipment (PPE) by healthcare personnel and the prevention of healthcare-associated infection transmission, there is a lack of in-depth understanding of self-contamination. This study aimed to review previous research on self-contamination and clarify the concept. By understanding this concept, healthcare personnel can improve their conscientiousness regarding self-contamination and gain a foundation for the requisite interventions to reduce self-contamination in healthcare settings. Method: MeSH terms such as “Health Personnel,” “Students, Health Occupations,” and keywords related to PPE combined with “contaminat*” and “self-contamination” to retrieve literature in OVID, EMBASE, Cochrane, CINAHL, and PsycINFO databases without time limits through December 2023 (Figure 1). The concept of self-contamination’s antecedents, attributes, and consequences were explained based on Rodgers’ evolutionary Results: After eliminating duplicates from the 2,195 studies that were initially searched, the authors reviewed the articles and determined eligibility independently. A total of 25 articles, published between 2006 and 2023, were included and analyzed. Antecedents to self-contamination were classified into three groups for each component (Figure 2). First, PPE factors included 1) types of PPE and/or ensemble choices, and 2) problems with PPE designs and/or their functions. Second, user factors involved 1) mistakes (errors of intent), 2) violations (deviations from recommendations), and 3) slips (natural flaws in humans). Third, organizational factors covered 1) unstandardized PPE protocol, 2) suboptimal and inconsistent PPE training, and 3) inadequate clinical environment. In total, five major concept attributes were the conveyance of organisms, unintentional behavior, preventable action, incidental contact, and difficulty discerning. Consequences were categorized into: 1) raising concerns about occupationally acquired infections, and 2) the potential transmission of the infection to the environment or other people (cross-contamination). Conclusion: While studies have raised questions about whether self-contamination causes infection, self-contamination was obvious among healthcare personnel when dealing with PPE. Considering the wide range of causes and potential results of self-contamination, multifaceted interventions, including improvement of the PPE design, tailoring protocols, and training for specific ensembles, should be implemented over an extended time period with suitable intervals to optimize interventions’ effectiveness.

The Impact of Mouth Masks on Oral Hygiene Status, Seeking Dental Care, Esthetics, and Temporomandibular Joint Disturbances Among the Adult Population in Nellore District: A Cross-sectional Study

Abstract Background: Despite preventing infection transmission, because of its prolonged use, the impact of masks on social life, behavior, and oral hygiene status and habits of everyday people are still unknown. The knowledge of the changes in patients’ esthetic complaints, perceptions, and habits with the use of masks is essential for clinicians. Aim and Objectives: The aim of the study was to evaluate the impact of the continuous use of face masks on oral hygiene habits; dental, smile and oral conditions, and self-perception; current reasons to seek dental care; and the importance attributed to teeth and smile esthetics among the adult population (students/employees) who wear masks 6 h per day for 6 months from August 30, 2021 to February 28, 2022. Materials and Methods: An electronic survey (Google Forms) was used to generate a web-based platform for the responses in the form of a questionnaire. A link to the structured questionnaire was posted on Facebook, Instagram, Twitter, and WhatsApp. The study considered all the individuals willing to participate, and the subjects were informed about the survey’s objectives. Data Analysis Method: The recorded data were analyzed using the SPSS software. Proportions were compared using the Chi-square test. P < 0.05 was selected to denote statistical significance with the confidence level, and the significance level was set at 95% and 5%, respectively. Conclusion: The study gave the current status of participants and their motivational levels toward seeking dental treatment, suggesting further studies in planning preventive strategies for the participants.

The Relationship Between Attitude, Belief, Experience, and Knowledge of Iranian Nurses Toward the Use of Personal Protective Equipment: A Cross-Sectional Study.

Utilizing Personal Protective Equipment (PPE) is pivotal in averting infection transmission to both patients and nurses. The attitude of nurses is a critical determinant in their compliance with PPE usage. This study seeks to explore the correlation between the attitudes of Iranian nurses and their beliefs, experiences, and knowledge concerning the application of PPE. In this cross-sectional study, 303 nurses employed in hospitals affiliated with Kurdistan University of Medical Sciences (Iran) were chosen using a quota sampling technique. Between April and June 2022, they completed self-administered questionnaires, which consisted of a Demographic Information form and a four-part questionnaire on "Attitude, Belief, Experience, Knowledge" concerning the utilization of PPE. Data were analyzed utilizing descriptive and inferential statistical methods. The multiple linear regression model was applied to investigate the relationship between attitude scores and various examined variables. The findings indicated that most participants held bachelor's degrees (93.07%), and their attitude scores toward using PPE exceeded 3.25 out of 6 for all 12 questions. Female gender, increased work experience, and higher organizational positions exhibited positive and significant associations with a favorable attitude toward PPE utilization. Conversely, the absence of training related to PPE, a lack of belief in infection control, and limited knowledge displayed negative correlations. Nurses have an ethical obligation to adhere to infection control guidelines, including consistently utilizing PPE, regardless of the level of infection risk or the visibility of the infection. Continuous training and regular monitoring of nurses in this context are indispensable.