Search results for “infection”

Strengthening TB Infection Control and Its Impact on TB Screening Practices Among Healthcare Workers During The COVID-19 Pandemic in Zimbabwe

Introduction The risk of exposure to M. tuberculosis among healthcare workers (HCW) remains a public health concern worldwide. During the COVID-19 pandemic, the Biomedical Research and Training Institute supported the Zimbabwe Ministry of Health and Child Care in strengthening infection prevention and control (IPC) practices in healthcare facilities (HCF), integrating tuberculosis (TB) infection control (TBIC) into the intervention strategy. We describe the impact of this intervention on TBIC practices and HCW screening outcomes. Methods The strategy, implemented from June 2021–September 2022, included IPC mentorship training, competency assessments, and use of a standardized risk assessment tool for progress monitoring. For the training purposes, the project developed eight practical problem-solving IPC modules including an occupational health component. Trained mentors conducted bi-monthly site support visits (SSV), used a checklist to track compliance, and assessed competencies of HCW at the targeted facilities. Facility-based risk assessments were conducted three times during the project implementation. Results During the intervention, 1,865 HCW from 105 facilities were trained. Availability and use of personal protective equipment improved by 49% and 42%, respectively. The proportion of HCF with designated areas for sputum collection increased by 43%. The proportion of HCF that screened HCW for TB increased by 42% with 3,761 HCW screened during the project period. Fourteen were diagnosed with TB and referred for care, resulting in 372 new cases per 100,000. Conclusion The implemented strategy of training, mentorship, and regular SSV strengthened TBIC measures, improved TB screening practices and case finding among HCW. Improving and maintaining practices is critical for effective TBIC.

Prevalence of Sexually Transmitted Infections in the United Kingdom from Home-Collected Samples: A Cross-Sectional Laboratory Analysis of over 6000 Cases

Background Sexually transmitted infections (STIs) continue to rise globally, with >1 million new cases reported daily in 2020. In England, newly diagnosed STIs increased by 23.8% in 2022 compared to 2021. Many infections remain asymptomatic yet contribute to infertility, pregnancy complications, and neonatal morbidity. While routine screening often focuses on Chlamydia trachomatis, broader detection is limited by laboratory turnaround times and restricted test panels. Methods We analysed 6003 home-collected urine and/or swab samples submitted for sexual health screening in the UK. Samples were tested in the laboratory for 10 bacterial and viral pathogens. A total of 5859 urine and 1627 swab samples were processed, with paired samples assessed for diagnostic agreement. Results The most common infections detected in urine were Ureaplasma urealyticum (12.1%), Mycoplasma hominis (8.6%), and Chlamydia trachomatis (2.4%). Swabs showed similar prevalence, with Ureaplasma urealyticum (11.6%) most frequent, followed by Mycoplasma hominis (10.4%) and HSV-2 (4.4%). Paired urine–swab samples demonstrated strong agreement, though swabs improved HSV detection. Conclusions Ureaplasma urealyticum was the most prevalent STI detected, yet only Chlamydia trachomatis is routinely screened in England. Comprehensive laboratory testing of home-collected samples could reduce the hidden burden of STIs, infertility, pregnancy complications, and neonatal infections, while offering confidential and accessible diagnostics.

Antibiotic-Resistant Urinary Tract Infection in a Bahamian Woman: A Case Report

Bacterial resistance to antibiotics is becoming a major public health challenge in the Bahamas. Indiscriminate use of antibiotics by medical practitioners is a major contributor to this problem. We describe a 53-year-old woman who presented with symptoms of a urinary tract infection. Empiric treatment with first- and second-line antibiotics, namely trimethoprim-sulfamethoxazole and ciprofloxacin, respectively, were ineffective in clearing the infection. After culture and sensitivity testing via minimum inhibitory concentration analysis, nitrofurantoin proved to be the only effective oral antibiotic.

Syphilis and Beyond: A Comprehensive Analysis of Associated Infections and Comorbidities in a Five-Year Retrospective Study in the United Arab Emirates (2018-2022)

Objectives This study explores the clinical characteristics, associated infections, and management outcomes of syphilis within a specific population over the years 2018 to 2022. With a focus on the frequency, clinical manifestations, and co-infections of syphilis, the research addresses a critical gap in understanding the nuanced dynamics of this sexually transmitted infection and its impact on public health. Methods The study employs a retrospective analysis of data collected from 2018 to 2022, utilizing three key serological tests (Syphilis AB, RPR/VDRL, and TPHA) to characterize syphilis infections within the population. Clinical manifestations and associated infections, including HIV, HBV, HCV, Chlamydia, Gonorrhea, and HPV, are systematically assessed. Treatment rates and re-infection patterns are also analyzed, providing a comprehensive overview of syphilis epidemiology within the studied timeframe. Results The frequency of syphilis, particularly indicated by the Syphilis AB test, exhibited a marked increase in 2020, reaching 96%, suggesting a heightened frequency within the population. RPR/VDRL test results demonstrated consistent frequency, emphasizing the persistent presence of active syphilis infections. Clinical manifestations, such as chancre, skin rashes, alopecia syphilitica, and lymphadenopathy, displayed dynamic patterns over the study years. Co-infection rates varied, with fluctuations observed in HIV, Chlamydia, Gonorrhea, and HPV, while HBV and HCV showed infrequent but stable frequency. The management of syphilis cases demonstrated commendable treatment rates, but an increase in re-infection rates in 2021 highlights the need for continued vigilance. Conclusion This study provides a comprehensive evaluation of syphilis epidemiology, clinical characteristics, and associated infections within the studied population. The results offer valuable insights into the dynamic nature of syphilis and its co-infections, informing public health initiatives and interventions. The findings contribute to our understanding of the epidemiological landscape and underscore the importance of sustained efforts in both prevention and treatment to curb the transmission of syphilis and its associated infections. The study, however, calls for continued vigilance and research to address the evolving trends and challenges in syphilis management within the specified population.

Antibiotic Prescribing Practices for Upper Respiratory Tract Infection Among Clinical Officers at Kiambu County

Background Antibiotics are the most prescribed medications worldwide. Global consumption rose by 65% in 76 low and middle-income countries between the years 2000 and 2015. According to the World Health Organization, improper administration of antibiotics occurs in over 60% of people with upper respiratory tract infections. Inadvertent antibiotic use has been identified as a contributor to antimicrobial resistance. Outpatient antibiotic use accounts for around 80-90% of all antibiotic use in patients. Clinical officers are non-physician healthcare workers who have received less training, have a more restricted scope of practice than physicians. Clinical officers are key service providers in this country especially at the primary healthcare level. Objective The study assessed the factors that influence antibiotic prescribing for upper respiratory tract infections by clinical officers. Method A prospective study was carried out at 20 public hospitals in Kiambu County, on 36 clinical officers and 600 patient prescriptions. The parameters measured were patient factors, prescriber factors, institutional factors and how they affected the antibiotic prescribing practices by either being rational or irrational. Rational prescribing was identified as prescribing the right drug, at the right frequency, in the right duration, right dose for the right indication. Prescriptions were considered irrational if they did not satisfy any of the rational indices. Data was collected via a questionnaire from the clinical officers while WHO prescription checklist was used to collect data from patient encounters. Data was analyzed using Statistical Package for Social Sciences version 22.0 (SPSS v22.0) with P-value, Confidence Interval and Odds Ratio. Results A total of 600 patient encounters were recorded and 79.8% of the 479 encounters had an antibiotic prescription for URTI, 91% of the antibiotics prescribed were the right dose, 98% had the right frequency, 75% had the right duration, and only 23% had the right indication. Patients above 65 years were more likely to receive an antibiotic prescription OR 3.98 CI 0.91,17.41 P=0.17 compared to children under 12 years old. Males were more likely to receive an antibiotic, but this was not significant OR 1.06 CI 0.70, 1.59 P=0.79. A total of 28 (4.6%) patients had fever, and all received antibiotics. A total of 36 clinical officers were sampled and only 5 (13.8%) were found to have rational prescriptions (P=0.63), prescriber age (P=0.92), prescriber level of education (P=0.99) and prescriber work experience (P=0.22) were not associated with antibiotic prescription. As per institutional factors, availability of antibiotics (P=0.026) and availability of prescription guidelines (P=0.012) were associated with rational prescription of antibiotics. Conclusion The study indicated that there was a high antibiotic prescription rate deviating from the WHO standard. It demonstrated that most antibiotic prescriptions were irrational.

Knowledge And Preventive Practice Towards Covid-19 Infection Among Pregnant Women In Public Hospitals Addis Ababa, Ethiopia, 2022

Background The novel coronavirus COVID-19 has created massive challenges to public health worldwide. Pregnant women are an immune-depressed status which makes pregnant women generally more vulnerable to COVID-19 infection and severe illness. The present preventive measure practices have gaps. Therefore, the current study aimed to present accurate and latest information regarding preventive measures for COVID-19 infection among pregnant women. Methods and materials Institution-based cross-sectional study design was conducted on 422 pregnant women in public hospitals in Addis Ababa using a pretested structured questionnaire. Face-to-face interview on pretested and structured questions was conducted to collect the data between January 12 and February 15, 2022. The collected data were entered into Epi data version 4.4.2.2 and exported to SPSS window version 25 for analysis. Descriptive statics and multivariable logistic regression were analyzed. Odds ratio with a 95% confidence interval and p-value ≤ 0.05 were declared statistical significance independent variables. Result A total of 418 pregnant women participated, and the response rate was 99.05%. About 417 (99.8%) pregnant women reported never hearing about COVID-19. Of those who heard about COVID-19, only 49% and 54.3% had good knowledge and had good practice towards COVID-19 infection respectively. Age (26-30yrs (AOR=0.46, 95%CI: 0.014,0.12), no education (AOR=0.23, 95%CI: 0.099-0.52), Primary school (AOR=0.199, 95%CI: 0.104-0.4) and Secondary school (AOR=0.282, 95%CI: 0.14-0.55), divorced (AOR=0.15, 95%CI: 0.065-0.34) and widowed (AOR=0.16, 95%CI: 0.024-1.03)) were factors that associated with knowledge towards COVID-19 infection. Age (30-35yrs (AOR=0.334, 95%: 0.115-0.97) and >36yrs (AOR=0.28, 95%CI: 0.11-0.69)), no education (AOR=0.06, 95%CI: 0.019-0.18), being a civil servant (AOR= 0.28, 95%CI: 0.122-0.66), divorced (AOR=0.042, 95%CI: 0.01-0.18), having >4 family size (AOR=0.334, 95%CI: 0.169-0.66), no previous complication of pregnancy outcomes (AOR=0.019, 95%CI: 0.01-0.061), chronic health problem (AOR=14.66, 95%CI: 0.457-39.4) and two ANC visit (AOR=5.704, 95%CI: 2.41-13.5) were factors that associated with the practice towards COVID-19. Conclusion In this study area, only half of pregnant women had good knowledge and good practice about covid-19 infection prevention measures.  

A Tandem of Rare Complications Due to Stent Infection

This report details sequential rare complications arising from a vascular stent infection. Clinical course, microbiology, and imaging are outlined, with emphasis on early recognition and multidisciplinary management. Lessons for device surveillance and antimicrobial stewardship are highlighted.

Epidemiological Profile of Intestinal Protozoan Infection in Dakar, Senegal: Results from Hospital-Based Survey

Background  Intestinal parasitic infections, especially intestinal protozoan parasites remain significant public health problem in Senegal. Several studies have demonstrated the endemicity of the diseases. The study was carried out with the objective of assessing the epidemiolocal profile of intestinal protozoan infection diagnosed among patients attending to Fann University Hospital in Dakar, Senegal. Materials and Method A retrospective study was conducted from 2016 to 2020. Samples were collected from patients attending to the laboratory for parasitological confirmation. Fresh stool samples were observed using direct examination, formal-ether concentration method and modified Zeilh Nielsen staining method. Descriptive analysis was performed using Stata MP 16 software. The significance level was set at 5%. Results Among 3825 patients selected in the study, 1009 were found with at least one intestinal protozoan parasite representing an overall prevalence of 26.4% (CI 95% (24.7– 28)). Mono-parasitic and di-parasitic infection represent 81.6% and 18.2% respectively while polyparasitism was observed in 26 patients representing 2,6%. Among positive samples, 16 (8.7%) were associated with helminths. Blastocystis sp. (40.8%), Entamoeba Coli (38.2%), Endolimax nana (8.2%) and Giardia intestinalis (8.1%) were mainly observed. Trophozoites Entamoeba histolytica was observed with 2.3%. Frequency of intestinal protozoa was higher in the 15 – 30 age group (28.3%) and in male group (26.9%). The parasite carriage was most important during the wet season comparing the dry season (p = 0.65). Asymptomatic patients (29.5%) were more infected than symptomatic patients (23.5%) (p <10-3). The main clinical symptoms were diarrhea, abdominal pain, dysenteric syndrome, fever, dyspeptic disorders, and vomiting. Conclusion These results showed that intestinal protozoan infections remain prevalent in Senegal with a high proportion of asymptomatic who constitute an important reservoir of parasites. Effective control strategies such as water supply, hands washing, and mass deworming campaign could reduce the prevalence of these diseases.

Knowledge, Attitudes and Practices towards Infection Prevention Control among Healthcare Workers in Selected Hospitals Located in Karongi district, Rwanda

Most hospitals have infection prevention and control committees but some of them are struggling to maintain and to apply infection prevention and control protocols due to lack of enough resources. Healthcare workers’ (HCWs) knowledge, attitude and practices (KAP) of infection prevention and control procedures are crucial for effective infection prevention and control (IPC). The study aimed to assess HCW’s KAP towards IPC in Rwanda. A cross-sectional hospital based study was directed in three hospitals in Karongi district from February to March 2022. Data were collected from 215 healthcare workers using a pre-tested self-administered questionnaire using a stratified sampling technique. Data were collected, checked, coded, and entered into the Kobo Collect Toolbox before being transferred to SPSS version 21 for analysis. Bivariate and multiple logistic regression analyses were performed. The KAP Score was also calculated. P-values of less than 0.05 were considered statistically significant. We found that 50.7% of HCWs were males, 63.3% were between the ages of 18 and 58.2% had a secondary education. The overall 78.6% of HCWs demonstrated high level of knowledge, 79.5% with a positive attitude, and 63.3% with good IPC practice. The results revealed that being over 45 years old(AOR=3.1;95%,CI=(2.16-5.25; p=0.024) having university level(AOR=3.3); 95%CI=(1.56-7.56;p=0.035), working experience between 5-10years(AOR=1.7; 95%CI=(1.37-5.45); (p=0.003), having high level of knowledge (AOR=2.7;95%CI: (1.68–7.95; p=0.045)and positive attitude(AOR=2.3; 95%CI:(1.36-7.72); p=0.017) towards IPC were associated with IPC good practice. Improving institutional supplies such as hand hygiene supplies, PPE, water supply and other facilities can improve safe infection prevention and control.

Molecular Detection of Mycoplasma Gallisepticum and Mycoplasma Synoviae Infection in Poultry

In Pakistan, production of poultry has been evolved as a good alternate of beef and mutton. In this study multiplex PCR approaches were adopted to differentiate and detect avian mycoplasma in a single PCR reaction as a step forward in the economization of PCR detection. From the total of 25 samples, 25 (100%) had a positive Mycoplasma isolation result. The biochemical test yielded the highest number of isolations, with MG accounting for 10/25. Commercial DNA-based PCR kits have been developed as a result of recent advancements in diagnostic techniques for Mycoplasma infections. Tetracyclines, fluoroquinolones, tilmicosin, tylosin, spiramycin Infections should be reduced as much as possible.

Impact of Intestinal Helminth Infections on Malnutrition and Haematological Indices of School-Age Children in Gondar Town, Ethiopia

In Ethiopia stunting, underweight and wasting in school children are very common. The aim of this research was to evaluate the impact of intestinal helminthes and schistosomiasis on malnutrition, anaemia and haematological indices in the school age children of Azezo Elementary School in Gondar town. Kato Katz technique was performed to determine infection and intensity of intestinal helminth infections. AnthroPlus software version 1.04 was used to get malnutrition indices while fully automated haematological analyzers were used to determine haematological and biochemical parameters. A total of 384 school children were recruited in this study. The overall prevalence of helminth infection was 45.8% (178/384) with the leading Ascarislumbericoides infection (20.6%) compared to the second leading Schistosomamansoni (17.4%) and third leading hook worm infections (13.3%). The prevalences of body mass indexes for age Z-scores (BAZ) indices were 9.6% (37) very sever thin, 17.2% (66) sever thin, 38.3% (147) thin, 34.4% (132) normal and 0.5% (2) overweight. On the other hand, the prevalences of height for age Z-scores (HAZ) indices were 12.2% (47) stunt, 87% (334) normal and 0.8% (3) over height. Of the total 384 school age children, 335 (87.2%) had normal blood glucose level (70 – 110 mg/dL) while the remaining 49 (12.8%) school age children were hypoglycemic. The number of the school children with normal total protein level (6.6 – 8 g/dL) was 259 (67.4%) while the remaining 125 (32.6%) school children were hypo-proteinaemic. The prevalence of anemia in the school age children was 33.1% (127). Intestinal helminth infections were statistically significantly associated (p = 0.000) with hypo-proteinaemia, anemia and number of lymphocytes compared with non-infected school children. The likelihood of anemia in intestinal helminth infected school children, when it was compared with uninfected, was 148 times higher for both Ascaris lumbericoides-Schistosoma mansoni co-infection, 38 times for Hookworm, 20 times for Schistosoma mansoni and 3 times for Ascaris lumbericoides mono-infections. Conclusion: Intestinal helminth infections in school age children aggravate malnutrition. Prolonged malnutrition and intestinal helminth infections could result in stunting in school-age children.

New Approach in Treatment of Cancer & Viral Infection by Apis Mellifera L Venom Extracts (Honeybees Venom)

Cancer cells need strong drug to be eliminated. Cancer lesions cure could achieve by topical application of crude bee venom. Bee venom medication used to prevent malignancies in groups most at risk (predisposing factors). Bee venom crosses the blood brain barriers because its components are very small. However, Bee venom contraindicated administered by intravenous injection because it’s hemolytic substance, mellitin which is powerful anticoagulant. However, the cationic peptides mellitin govern the mode of action of bee venom as anticancer and antiviral in vivo; 1 there is a negative charge on cancer cells, viral infected cells, diseased cells, and generally any cells that contain toxins or damage, and viruses are carrying negative charge even when it is outside the living body. 2Bee venom component (melittin) carries a positive charge, it destruct negatively charged cancer cells. 3 The role that the herpes virus is likely to play in increasing the severity of cancerous diseases, worsen the conditions: herpes viruses are opportunistic viruses that strike the body whose immunity is weakened for any reason. Therefore, the role of herpes virus must be neutralized when you planning to treat a cancer patient. Fortunately, bee venom is a powerful antiviral, and thus we hit three birds with one stone, that is, we kill cancer cells, kill opportunistic viruses, and improve tissue immunity to participate in the fight against cancer and get rid of toxic exudates more efficiently.

Cytokine Expression in Peripheral Blood Mononuclear Cell Cultures Obtained from Cattle with Different Stages of Natural Mycobacterium bovis Infection

In bovine tuberculosis (bTB), cellular, humoral, or both types of immune responses have been observed. The purpose of this study was to examine the immune status of tuberculous cows based on the differential cytokine gene expression associated with Th1 (IFN-γ, IL-2), or Th2 (IL-4, IL-10) responses. Twenty-three (23) cows belonging to a dairy herd located in a rural region of the State of Hidalgo, México, were selected for the study. Single Intradermal Comparative Cervical Tuberculin (SICCT) Test, Interferon-Gamma (IFN-γ) Release Assay (BOVIGAM), and Enzyme-Linked Immunosorbent Assay (ELISA) were used for detection of cattle infected by M. bovis. Thirteen cows were positive to all the tests (Group 1); ten cows were positive only to ELISA (Group 2), and the remaining Group (Group 3, control) included cows negative to all the tests. Peripheral blood mononuclear cells (PBMC) from animals were in vitro stimulated by bovin purified protein derivative (PPD), avian PPD, and Concanavalin A (Con A) mitogen for 72h. Changes in the levels of expression of mRNA of the respective cytokines was measured by Reverse Transcription-Polymerase Chain Reaction (RT-PCR) using β-actin gene as internal control. In group 1, PPD bovis and Con A-stimulated cells exhibited high production of IFN-γ, IL-2 and IL-4, but not IL-10. In contrast, PPD avium-stimulated cells displayed a low production of cytokine transcripts. In group 2, cells showed a significant production of IL-10 in response to bovine PPD (P< 0.001). In the control group, a high production of IFN-γ and IL-2 was observed only in Con A-stimulated cells. Post-mortem examinations in animals of group 1 showed slight and medium lesions in lymph nodes, whereas in group 2, the lesions were more extensive. Results indicate differences on gene expression levels of cytokines considered to determine balance in Th1/Th2 response among the evaluated groups. In addition, high levels of antibodies against M. bovis and high IL-10 expression in PBMC together are indicators of progressive bTB when both tuberculin test and IFN-γ assay are negative in tuberculous anergic cattle. Inclusion of serology and IL-10 cytokine expression in in the diagnosis checklist improves detection of infected cattle to help control bovine tuberculosis.

Urticaria as the First Presentation of COVID-19 Infection

A case report describes urticaria as an initial manifestation of COVID‑19. It outlines clinical course, differential diagnosis, and implications for testing and isolation.

RETRACTED: Profile of Children with Covid 19 Infection in our Set Up

This article has been retracted on July 20, 2022. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2692-1537.ijcv-25-5866) In December 2019, a novel coronavirus, now named as SARS-CoV-2, caused a series of acute atypical respiratory diseases in Wuhan, Hubei Province, China. The disease caused by this virus was termed COVID-19. The virus is transmittable between humans and has caused pandemic worldwide. The number of death tolls continues to rise and a large number of countries have been forced to do social distancing and lockdown. In humans, COVIDs mostly cause respiratory and gastrointestinal symptoms. Clinical manifestations range from a common cold to more severe disease such as bronchitis, pneumonia, severe acute respiratory distress syndrome, multi-organ failure and even death. Preliminary evidence suggests children are just as likely as adults to become infected with SARS-CoV-2 but are less likely to be symptomatic or develop severe symptoms. in our study , we consider the symptomatology , complications and mortality patterns of this disease in children.

Retraction Note: Profile of Children with Covid 19 Infection in our Set Up

Infection Prevention and Control in Healthcare Facilities During the Covid-19 Pandemic in Ghana

Background Infection prevention and control system in healthcare facilities is essential in dealing with the spread of infectious diseases, especially during an outbreak period such as the COVID-19 pandemic. Objectives The study assessed the infection prevention and control (IPC) situation in selected healthcare facilities in the Greater Accra and Ashanti Regions of Ghana during the Covid-19 pandemic. Methods This was a multi-facility based cross-sectional study that used a monitoring tool of the Health Facilities Regulatory Agency (HeFRA) of Ghana to collect information on the IPC practices at the peak of the Covid-19 pandemic. Data was gathered from 501 healthcare facilities in the Greater Accra (335) and Ashanti (151) Regions. Descriptive, Chi-square, and multiple logistic regression were performed. All statistical analyses were considered significant at an alpha level of 0.05. Results 50.6% of health facilities were assessed as having good IPC systems in the overall assessment. The majority of the health facilities were evaluated as good on governance/leadership. Similarly, the majority (54.3 %)of the facilities had effective infectious waste management. The assessment levels of governance/leadership, management, quality assurance system, human resource, IPC equipment, and water management were all significantly associated with the adherence to good IPC systems. Conclusion IPC systems in most facilities were assessed as good, but some areas require critical attention to help prevent the spread of infections in healthcare facilities in Ghana. Support systems such as revised policy on IPC, governance/leadership, and infectious waste management infrastructure are needed to strengthen facilities with weak or poor IPC systems.

Assessment of Knowledge, Attitude and Preventive Practices towards Sexually Transmitted Infections among Secondary School Students in Mlimba Division, Ifakara, Tanzania

Background This study was done to assess knowledge, attitude and preventive practices towards sexually transmitted infections among secondary school students in Mlimba Division, Ifakara, Tanzania. Method A descriptive cross-sectional study was conducted in March 2021. A total of 365 secondary school students (193 male; 172 female) aged between 12 and 23 years were surveyed by using a pretested self-administered questionnaire. Results The study found the majority 95.9% had heard of STDs, 77.8% knew symptoms of STDs, 86.8% knew mode of transmission, 94.0% knew the importance of use of condom during sexual intercourse. Among the sexually-active students, 70.7% had practiced sexual intercourse and 42.2% used condom during sexual intercourse. Conclusion The risky behavior practiced by the sexually-active students in this study is alarming. There is a need to introduce STD education curriculum in secondary schools so that appropriate intervention on STDs can be implemented.

Mucormycosis: A Surge in Mucorales Fungal Infection in Post – Covid Patients in Indian States and Insight into Known and Unknown Factors

Prevalence and Risk Factors of HIV Infection among Children Born from HIV Positive Women Musanze District, Rwanda

In Rwanda the prevalence of mother-to-child HIV transmission is 1.5%, the prevalence was found to be higher in rural area. The purpose of this study was to determine the Prevalence and Risk Factors of HIV Infection among Children born from HIV Positive Women in Musanze District. The study findings help to decrease the rate of HIV infection among children born from mother HIV positive to zero. This study was conducted in Musanze District, Northern Province in Rwanda. The study targeted 420 HIV positive mothers who delivery in different health facilities located in Musanze district form January 2019 to December 2020 and their children. SPSS version 22 was used for analysis. Of 420 children born from HIV positive mothers 91.7% were aged between 18-24 months, 55.2% were female. The majority of HIV positive mothers 80.2% who participated in the study were married. The prevalence of HIV infection among children born from HIV positive women was 2.9%. Children whose mother had poor adherence to ART were 1.5 times more likely to get HIV at birth compared to those whose mother had good adherence (AOR = 1.5; 95% CI: (1.12-2.21)). Children born from mothers in WHO stage II were more likely to get HIV from their mother (AOR = 1.24; 95% CI: (1.32-2.207)). Children born from HIV positive mother with one ANC visit were 2.5 times more likely to get HIV from their mothers (AOR = 1.56; 95% CI: (2.31-5.17)).  

Cell Therapy as an Alternative approach for COVID-19 Infection Consequences: A Non-Systematic Review

The current uncontrollable outbreak of novel coronavirus (COVID-19) has unleashed severe global consequences in all aspects of life and society, bringing the whole world to a complete halt and has modeled significant threats to the global economy. The COVID-19 infection manifests with flu-like symptoms such as cough, cold, and fever resulting in acute respiratory distress syndrome (ARDS), lung dysfunction, and other systemic complications in critical patients are creating panic across the globe. However, the licensed vaccine has started to show up; some resulted in side effects that would limit its possibility in some circumstances as allergic personnel, for example. Moreover, the production and approval of new drugs is a very complicated process and takes a long time. On the other hand, stem cells have gone the extra mile and intensively investigated at preclinical and clinical studies in various degenerative diseases, including infectious ones. Stem cells are proposed as a broad-spectrum therapeutic agent, which may suppress the exaggerated immune response and promote endogenous repair by enhancing COVID-19 infected lung microenvironment. Also, stem cells have different application manners, either direct transplantation, exosome transplantation, or drug delivery of specific cytokines or nanoparticles with antiviral property by engineering stem cells. This review discusses and summarizes the possible emerging role of cell-based therapy, especially stem cell therapy, as an alternative promising therapeutic option for the treatment and control of novel COVID-19 and its potential role in tissue rejuvenation after COVID-19 infection.

Can Vitamin D Mitigate Osteoarthritic Hip Joint Arthroplasty Infections Among Older Adults? A Narrative Overview of the Literature Amidst COVID-19 Lockdowns and Beyond

Background Older adults with hip joint osteoarthritis, a major cause of chronic progressively disabling highly painful functional experiences, may require a surgical joint replacement procedure known as total joint arthroplasty surgery. Objective This review aimed to address the question of whether there an association between hip joint arthroplasty infection rates and prevailing pre or preoperative vitamin D levels that warrants consideration in efforts to prevent or minimize infection related hip arthroplasty complications among older adults particularly during the current ongoing COVID-19 pandemic. Methods PUBMED, SCOPUS, and WEB OF SCIENCE articles related to the topic and published between January 2016-2021 were searched, examined, and summarized. Results Older adults with hip joint osteoarthritis and low vitamin D serum levels who undergo total hip joint arthroplasty surgery may be at higher risk for post-operative infections than those with adequate vitamin D serum levels. Conclusion More research to verify whether efforts to screen for, and maximize vitamin D levels, before and after surgery, as indicated, may be helpful in the context of minimizing total hip joint arthroplasty surgery infection susceptibility and severity among older vitamin D deficient severely disabled hip osteoarthritis cases.

Dynamics of Infections and Number of Vaccines Needed to Avoid Covid-19 in Europe

The work analyzes the dynamics of transmission of infections by the new coronavirus in twelve European countries, including France, Germany, Italy, Spain, UK, Austria, Croatia, Denmark, Greece, Romania, Czech Republic, and Portugal, whose data from contagion were obtained by Johns Hopkins University until September 24, 2020. The study confirmed that this new coronavirus (SARS-CoV-2) surprised all the countries of the world that had to improve their public health policies to confront this disease according to the results obtained from the calculation of the mantissa. Although the countries were able to improve their policies after the first wave of contagion, Spain and France have the highest proportion of cases that stand out significantly with the rest of the countries in the second wave of infections that the world faces again. Likewise, the beginning of the epidemic outbreak was determined, which could help to track the spread of the disease through European countries (not the first case registered in each country), from which it can be inferred that the outbreak begins in Italy and later the rebound begins in Germany, France, and Spain. Within days, it significantly affects Greece and Austria, reaching Denmark, the Czech Republic, Romania, and Croatia. Finally, the number of people who must be vaccinated to counteract the advance of Covid-19 in these European countries was determined based on the calculation of the Effective Reproductive Number, Rt. The number of people that would have to be vaccinated in all these countries to counteract this disease sums up to 206.830.361.

Therapeutic Evaluation of Neemazal® Against Experimental Eimeria Tenella Infection in Broiler Chickens, Jos - Nigeria

Coccidiosis in poultry is caused by protozoan parasites of the Eimeria species, which is responsible for worldwide economic losses. The aim of this study was to evaluated the therapeutic effect of NeemAzal® on Eimeria tenellain broiler Chickens as compared to Amprolium as a standard anticoccidial drug. A total of One Hundred and Sixty (160) broiler chicks were purchased, acclimatized and randomly divided into 4 groups (G1, G2, G3 & G4). G1 non-infected, non-treated (negative control), (G2) infected with 20000 E. tenella oocysts (positive control), (G3) infected and treated with Amprolium (Standard, 7 mg/kg b.w. for 5 days) and (G4) infected and treated with NeemAzal®200 mg/kg b.w. for 5 days). Evaluation was by clinical signs, performance data (weight gain, oocyst shed/gram faeces (OPG) and histopathology of the Caecum, Liver and Kidney. The data showed that birds infected with E. tenellahad an output of 1.3×105±3,333 oocysts per gram faeces on day 5 post inoculation. This output is significantly decreased to 0.37×105±3,111 oocysts in neem-treated birds. Infection with E. tenellainduced marked histopathological alterations in the caecum in the form of inflammation, vacuolation of the epithelium, and destruction of some villi. NeemAzal® decrease body weight loss of infected chickens. Moreover, the number of goblet cells stained with Hematoxylin and Eosin (H&E) within the infected villi was significantly lowered (P≤0.05). The results revealed that chicks of G1 had the best performance data compared to G2, G3& G4. In G3 & G4 there were a remarkable improvement in the data on performance, clinical signs, gross and microscopically caecal lesions compared to G2. Amprolium (G3) was shown to be superior to NeemAzal® (G4) compared to G2. NeemAzal® could be a good alternative for use as a coccidiostat to supplement the expensive anti-coccidiostats in the market.

Invivo Impact of Malaria and HIV Co-Infection on CD4 Cell Count of Infected Patients of Niger Delta Extraction

The study evaluated the impact of co-infection of malaria parasitaemia, and HIV positive indices on the CD4 cell count of 120 HIV infected subjects, who were already diagnosed and visiting Braithwaite Memorial Specialist Hospital Port Harcourt for routine Medical check-up. Also, a control group of 40 HIV negative were included as part of the study control group. The subjects were between the age ranges of ≤10–79 years respectively. A double check laboratory assay was conducted to detect the presence of antibody to HIV as confirmed using immunocomb 11 and Determine for HIV status. A thick Blood film stained with field stain (A and B) was used to detect the presence of malaria parasite in the subject’s blood. Furthermore, CD4 cell count was assayed using Partec cyflow counter (Partec, Germany). Excel and Graphpad statistical software were used for analysis of the data generated. The result among the HIV positive subjects and control subjects revealed that the highest positive for malaria infection was observed among ≤10 years age group as 2 (100%) and 11 (84.61%) respectively. In the HIV positive subjects, the distribution of malaria infection among sex revealed a high rate in male 42(77.78%) than in female 44 (66.67%). Similarly, the control recorded a high rate of malaria infection in male 11 (57.89%) than in female 7 (33.33%). However, 86 (71.67%) had malaria and HIV co-infection while 34 (65%) had only HIV mono infection. The positive HIV subjects who had CD4 cells count below 200 cells/mm3 were 15%, above 200-499cells/mm3 were 58.3% while 500 cells/mm3 and above had normal CD4 cells counts for 26%. Nonetheless, for the control subjects, no CD4 cells count of below 200cells/ mm was observed, 2.5% fell within the moderate category while 75% had normal CD4 cells count. Statistical analysis using ANOVA and t-test showed that there is significant difference between CD4 of seropositive and seronegative subjects infected with or without malaria (p=0.00). In addition, a t-test further demonstrated Comparison of Mean CD4 Cell Count among HIV and Malaria Infected and Non-Infected Subjects. MP/HIV Co-Infection and Mono Infection with No Infection showed strong mean difference (p=0.00) in the various CD4 counts while HIV Mono-Infection and others only had a non significant (p=0.44) mean difference between HIV Mono-Infection and No HIV or Malaria Infection. A robust and effective malaria and HIV control management programme should be strongly underpinned; so as to improve the quality of life of patients and HIV patients should be encouraged to live a healthy life style, through the provision of antiretroviral drugs and regular health education engagement, even as the provision of antimalarial treated net would be helpful to the subjects.

Reasons for Increased Social Distancing and Surface Disinfection from a Physics Perspective

This viewpoint uses physical principles to explain mechanisms behind social distancing and surface disinfection. It links particle dynamics and contact transfer to practical guidance and risk communication during respiratory epidemics.

Malaria and Typhoid Fever Coinfection in the Hospital University of Bobo-Dioulasso, Burkina Faso

Malaria and typhoid fever are two endemic infectious diseases in developing tropical countries including Burkina Faso. There are two distinct infectious diseases with many similar clinical signs. In each sanitary area, it is important to describe the "typhomalaria" epidemiology to elaborate adequate diagnosis algorithm and efficient treatment protocol. A cross-sectional study was carried out from July to October 2014 in the lab department of University Hospital Souro SANOU, Bobo-Dioulasso. All microscopy positive malaria during the study period was included. Serodiagnosis of Widal and Felix was performed systematically in all Plasmodium spmalaria cases. Titers of antibodies anti-agglutinin O equal or higher than 1/400 and/or 1/800 for anti-agglutinin H antibodies were considered positive for Salmonella sp. A total of 283 malaria cases were included in this study, majority falciparum malaria. In this malaria cases, 91 patients were seropositive for Salmonella sp. "Typhomalaria" co-infection prevalence was 34.3% (CI 95% (28.8%; 40.1%)). The patient with the normal hemoglobin rate had the highest prevalence of co-infection (46.7% versus 30.9; p=0.02). Malaria and typhoid fever co-infection was high (approximately 1/3 of malaria cases) in University hospital of Bobo-Dioulasso. This study revealed the need to explore typhoid fever in malaria confirmed cases, especially in persistent fevers and non-anemic situation despite adapting antimalarial treatment.

A Prevalence Study of Intestinal Parastic Infections in Patient Attend to Elajcentre

Among 500 persons referred to laboratories for performing stool examinations samples (51.43%) were male and (48.57%) were female, all this personshad Abdominal pain and Diarrhea and 39% had a blood in their stool Among these numbers, 298 (59.6%) were positive for parasitic infections 90 (30.2%) Giardia lamblia and 208 (69.8%) Entamoeba histolytica .Also the higher infection rates were recorded in the age 10-19 the infection was (42 % Based on the reliable answers obtained from the interviewed patients or guardians using the pre-formatted questionnaires.The prevalence of intestinal protozoan according to drinking water materials the Plastic and brass have higher infection rate with (50.3%) and (30.2%).

Role of Tie2, CD14, Angiopoietin as Angiogenetic Markers in Hepatocellular Carcinoma Complicating Hepatitis C Virus Infection

Background Identifying biomarkers for early detection of hepatocellular carcinoma (HCC) remains quite challenging. In this study we aimed to estimate the number of TIE2-expressing monocytes (TEMs) cells, which display pro-tumoral activities and are defined as CD14+, TIE2+, and angiopoietin-2; and its potential use as a possible diagnostic marker in HCC patients complicating HCV induced cirrhosis. Methods Current study was conducted on 112 patients. They were divided into two groups: Group I (78 patients) with HCC complicating HCV induced cirrhosis; and group II chronic hepatitis C patients (34 patients). Both groups were compared to (age and sex-matched) healthy persons as group III (38 persons). Result The number of the circulating TEMs: CD14+ and TIE2+ monocytes were significantly higher in the peripheral blood of HCC patients than HCV LC patients and healthy controls, sensitivity and specificity for HCC diagnosis were respectively: CD14 (89.7%, 83.3%), TIE 2 (76.9%, 83.3%), and Ang-2 (76.9%, 66.7%). Moreover, analysis of the P-value and the odd’s ratio showed that CD14 has the highest predictive value for HCC. Conclusion Our results suggest that TEMs and Ang-2can be used as diagnostic markers for HCC, especially among the high-risk group of patients.

The Prevalence of Intestinal Parasite Infection in El Behara Schoolchildren.

This study was conducted to evaluate the prevalence of intestinal parasite in schoolchildren in Damanhur, Egypt and some of its villages. The pathogenic enteric protozoa have been progressively involved in bargaining the soundness of a great many individuals, for the most part in creating nations. Mediations are being set up to control the dreariness and mortality because of these protozoan contaminations. A portion of these mediations target school going kids with regards to class based wellbeing intercession. The present examination concentrated on exploring the commonness of intestinal protozoan contaminations among younger students chose networks comprising of urban, urban-poor and per urban settlements in the Damanhour and a few towns. In the present work Giardia lamblia was the second usually identified protozoan with a diseases rate 10.4% among the analyzed cases. In the present examination generally speaking level of parasitic contaminations among the kids was 57.3%. It's viewed as Enterobius vermicularis was the most usually identified protozoan as it spoke to 4.1% of the parasitic diseases in the considered cases pursued by Ascaris lumbricoides; 1.4% and Giardia lamblia contaminations as they spoke to 0.6%; separately. The protozoa like Giardia and Cryptosporidium are regularly present in surface waters and cause episodes in this manner legitimately affecting human wellbeing.

Surgical Site Infection in Cesarean Section Operation: Risk and Management

Cesarean sections (CS) are one of the most commonly performed surgical procedures worldwide. There is great variability in the percentage of cesarean sections between countries, varying from 3% to 42.9%5. In the US, approximately 32% of deliveries occur through a cesarean section. Overall, a drastic increase in cesarean section rate has been reported reaching its highest level at the present time. In Brazil, considering the types of births by live births from 2006 to 2016, the national percentage of cesarean section was 52.37%. The variability in this percentage can still be perceived within Brazilian territory. The highest cesarean rate occurred in the Southern region, representing 58.33% of births, while the lowest rate occurred in the Northern region, with 41.79%. It is possible to see the steady increase in the percentage of CS over time, from 45.01% in 2006 to 55.39% in 2016.

Acute pneumonia: infection or inflammation in the lung?

This commentary examines pneumonia as infection and inflammatory syndrome, parsing diagnostic criteria and implications for antimicrobial stewardship.

Prevalence of Hiv Infection Among Pregnant Women Attending Ajiko Medical Clinic, Damaturu, Nigeria

Human immunodeficiency viruses causes HIV infection in humans belongs to two species of Lentivirus. It damages the cells of immune system which leads to weak immune system and the ability to fight from infections and diseases. This study was conducted to investigate the prevalence rate of HIV infection among pregnant women of different age groups attending Ajiko medical clinic, Damaturu, Nigeria. The prevalence rate was maximum (12.5%) in 36-45 age group and minimum (5%) in 26-35 age group but their was no HIV infection in 15-25 age group. The overall prevalence rate among pregnant women was 4%. General knowledge , training and campaigns of HIV prevention need to be tailored towards older women of age group 36-45 because of high prevalence rate.

Surgical Site Infections: A Still Ongoing Challenge

Surgical site infections (SSI) have a high incidence, accounting for 20% of all hospital-acquired in-fections. Surgical site infections are linked to a increased length of stay and the risk of mortality. Although most patients recover from an SSI, 77% of mortality can be attributed to the infection it-self 14. The incidence of SSI is 2% to 5% undergoing inpatient surgery 1. Estimated annual in-cidence varies, but may range from 160,000 to 300,000 in the US 14. These estimates might be understated, given the surveillance failure after discharge

Effect of Coinfection by Fasciola hepatica and Mycobacterium bovis on Bovine Tuberculosis Immunodiagnosis in an Enzootic Area Hidalgo State, Mexico.

Parasitic infection by the Fasciola hepatica (F. hepatica) promotes susceptibility towards other infections, such as Mycobacterium bovis. As consequence, could affect diagnostic tests for this disease. Hence, the objective of this study was to assess the impact of F. hepatica coinfection on the most commonly used immunodiagnostic bovine tuberculosis (bTB) tests in field conditions in an enzootic area for both diseases. Thus, from a dairy herd located in Hidalgo State, México, displaying a 59.2% and 28% prevalence of fascioliasis and bTB, respectively. Sixty-one cows were analyzed based on their response towards bTB immunodiagnostic tests, such as Single Intradermal Comparative Tuberculin Test (SICTT), gamma-interferon test (BOVIGAM) and enzyme-linked immunosorbent assay (ELISA), along with the assessment of the F. hepatica parasite load and serodiagnosis by ELISA. Three study groups were formed according to test results. Group 1: coinfected (n=22). Group 2: non-parasitized cows, and positive for bTB tests (n=13) and Group 3: parasitized cows without tuberculosis (n=26). In addition, a group of cows kept in fascioliasis - and tuberculosis-free zones were included (Group 4, n=10). A non-parametric Kruskal-Wallis test and a Dunn test were applied to analyze the results. In Group 1, significant differences were observed regarding IFN-γ production, but not for antibody levels to M. bovis or reactivity towards bovine PPD in relation Group 2. While, Groups 1 and 3 did not display difference in antibody levels against F. hepatica. Differences were observed regarding tuberculosis and Fasciola diagnostic tests when both coinfected and infected groups were compared to controls. It is concluded that F. hepatica coinfection in tuberculous animals studied, depressed the production of IFN-γ towards bovine PPD under in vitro conditions, but its reactivity to the SICTT not show to be altered.

Saccharomyces Kluyveri Fungemia in a Patient with Human Immunodeficiency Virus Infection

We report a case of a young woman with acquired immune deficiency syndrome admitted with fever and abdominal pain. Saccharomyces kluyveri was isolated in blood culture. She was successfully treated with fluconazole. This case demonstrates the pathogenicity of Saccharomyces Kluyveri in immunocompromised host.

The Development and Evaluation of A Multiplex Real-Time PCR Assay for the Detection of ESBL Genes in Urinary Tract Infections

Background Overuse of beta-lactam antibiotics has lead to selection for extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae, a major cause of antibiotic resistant urinary tract infections (UTIs). Standard detection methods are time-consuming, with disputed accuracy. This study describes a novel real-time PCR method to detect CTX-M, SHV, OXA and TEM. Methods 179 Enterobacteriaceae isolates from UTIs were collected from the Leicester Royal Infirmary, UK. A multiplex Plexor®-based real-time PCR assay detected ESBLs using their specific amplicon melting temperature, during each cycle, removing the need for a melt-curve analysis. Validation was achieved by end-point PCR and disk diffusion. Results The method was able to produce rapid and accurate results, achieving a sensitivity and specificity of 94.9% and 72% respectively, and the assay can differentiate between the different ESBL genes, with ease. Conclusions With further investigation, a Plexor®-based assay could form the basis of a high-throughput kit that health services could use to detect ESBLs or other antibiotic resistance genes.

Assessment of Knowledge, Attitudes and Practice on Prevention of Sparganosis Infection among Inhabitants of Babati District, Tanzania

The knowledge,attitudes, and practice among inhabitants of Babati district in Tanzania on sparganosis were evaluated. A cross-sectional study was carried out among 160 participants from the district. Demographic and socioeconomic information of the participants and their KAP on sparganosis was collected by using a pre-tested questionnaire. All 160(100%) participants had no knowledge about sparganosis. Regarding attitude of participants to keeping dogs and cats; all 160 (100%) participants were not aware of dangers associated with dogs and cats to transmission of sparganosis. 39 (30.0%) of the participants had knowledge of drinking boiled water. There is a need to organise health education programme about sparganosis to increase community knowledge.

Assessment of the Preferred Methods Used by Mothers to Prevent Malaria Infection among Children Under Five Years in the Hohoe Municipality Of Ghana

Background: The use of Long Lasting Insecticide Nets (LLINs) is seen as a major public health intervention and has shown to have both direct and indirect effects on the dynamics of malaria transmission. This report assessed the methods used by mothers to prevent malaria infection among their children under five years in the Hohoe Municipality. Method: A cross-sectional survey carried out in February 2017 among 418 mothers with children under five. Data were collected in the form of interviews using questionnaires on the usage of LLIN alone, LLIN with other methods (LLIN+) and use of other methods only (OMs). Chi square test and multinomial logistic regression were used to determine the association between dependent and independent variables. Results: Of the 418 mothers, 28.5% used LLIN only, 50.7% used LLIN+ and 20.8% used OMs only to prevent malaria. Mothers aged 30-39 and 40-49 years were 3.87 and 5.55 times more likely to use LLIN only rather than OMs as compared to those aged less than 20 years (AOR=3.87, p=0.019) and (AOR=5.55, p=0.029) respectively. Similarly, mothers aged 30-39 and 40-49 years were 3.08 and 4.02 times more likely to use LLIN+ rather than OMs as compared to those aged less than 20 years (AOR=3.08, p=0.023) and (AOR=4.02, p=0.050) respectively. Mothers who attained a higher level of education were 2.08 times more likely to use LLIN+ rather than OMs as compared to those with no formal education (AOR=2.08, p=0.015). Those who resided in rural areas were 2.00 times more likely to use LLIN only and LLIN+ rather than OMs only as compared to urban dwellers (AOR=2.00, p=0.002) and (AOR=2.00, p=0.013) respectively. Conclusion: More than half of the mothers preferred using LLIN+. One out of 3 mothers used only LLIN while one out of 5 used OMs only to prevent malaria. Age, educational level and place of residence were significantly associated with methods used to prevent malaria. There is the need for targeted education on LLINs in order to improve usage among younger mothers and mothers residing in urban areas. Further investigations to determine reasons for using OMs only and also determine the added value of OMs to LLINs in preventing malaria are recommended.

Natural Infection by H1-Like Influenza a Virus in South American Camelids from Argentina: Serological Evidences.

Serum samples from wild and domestic South American Camelids (SAC) from Argentina, collected before (2008), during (2009) and after (2010) the 2009 H1N1 influenza pandemic were tested by hemagglutination-inhibition assay (HIA) to evaluate the seroprevalence of antibodies (Ab) against different subtypes of influenza A viruses: A(H1N1)pdm09, A/sw/Argentina/SIV/2009(H3N2) and A/eq/Argentina/97(H3N8). For A(H1N1), an ELISA using a recombinant H1-hemmaglutinin from a reference strain (HA0 PuertoRico/8/1934) was also conducted. Serum samples from Guanacos (126), vicugnas (21) and llamas (100) from Jujuy, Mendoza and Río Negro provinces were analyzed; no clinical signs of respiratory disease were detected, reason for which no nasal swabs were obtained. No seropositive reactors to H3N2 nor H3N8 variants were detected, nevertheless high incidence of Ab reactive to A(H1N1)pdm09 were found by HIA; results which were confirmed by ELISA. The Ab seropositive animals to H1-like IAV found in llamas from Jujuy, and Mendoza (2009) were 78% and 86% by HIA and ELISA, respectively. Thirty-seven samples taken over the three years from guanacos kept in captivity in Rio Negro showed 62% of seropositive animals, while wild guanacos from Mendoza sampled in 2010 showed 36% seropositive animals to H1-like IAV, by both techniques. Finally, wild vicugnas from Jujuy, sampled in 2008 showed 38% and 52% seropositive animals to H1-like IAV by HIA and ELISA, respectively. Our results could indicate the potential role of these species as a reservoir of this zoonotic viral agent of high impact in Public Health, and may suggest that SAC populations might have been infected with an influenza strain antigenically related to H1 IAV. . Surprisingly, for llama and guanaco populations sampled over time in Jujuy and Río Negro, respectively, the HIA and ELISA geometric mean Ab titers (GMT) for 2008 were significantly higher than the ones of 2010. In addition, HIA and ELISA Ab titers found in domestic llamas were significantly higher than those detected in wild vicugnas sampled during that year (2008) in Jujuy. New field campaigns are in progress to collect serum samples and nasal swabs in order to isolate and characterize the virus responsible for triggering H1 reactive Abs. These findings remark the need to better understand the dynamics and ecology of influenza A virus within Sacs populations.

Dental Sinus Infections- Why are we Still Missing the Well Documented Diagnosis?

Background: Dental infections, salivary gland lesions, neoplasms and developmental abnormalities can cause oral cutaneous fistulae, fistulae of the neck and intraoral fistulae. Published case reports deliver the same message; that these lesions are misdiagnosed and treated late and ineffectively and this remains a significant on-going problem. Aim: It is important to reiterate the management and diagnosis of this condition, despite the fact that it is already well documented in the current literature as patients are still being subjected to unnecessary treatment. Design and Setting: We performed a retrospective review of 5 consecutive dental sinus infections between June 2013 and January 2014 that were misdiagnosed initially. Information was extracted from the medical case notes of 2 male and 3 female patients with an age range from 12-87 years. Method: The medical records of all 5 patients were analyzed, medical photography was taken and the patients were followed up regularly in our clinic. Results: Each patient presented with a non-healing lesion and all were treated with either oral or topical antibiotics. Patients were eventually referred to the craniofacial department where they all received an orthopantomogram and underwent dental extraction, which led to complete healing. Conclusion: Cutaneous facial sinus tracts of odontogenic origin are often initially misdiagnosed which leads to prolonged and inappropriate treatment. Correct diagnosis and treatment will result in predictable and rapid healing and thus it is essential to record these case series, to ensure that medical professionals are aware of the presenting symptoms, which can often be very subtle.

Regulation of Expression of Reactive Oxygen Intermediates During Plasmodium Infection to Reduce Immunopathology Provides a Possible Antioxidant Adjuvant to Enhance Anti-Malarial Drug Therapy

Malaria is a mosquito-transmitted infectious disease caused by intracellular protozoan parasites of the genus Plasmodium. In the absence of prompt and appropriate treatment contraction of primary infection by a human being often represents a medical emergency since it may progress rapidly to life-threatening complications. Exposure to parasites activates the immune system resulting in, among other effects, the release of reactive oxygen intermediates (ROI). This has the potential to induce oxidative damage, thereby causing cellular destruction, and hence to have a severe effect on vital organs of the body. Overexpression of ROI leads to immunosuppression and is a causal factor in the development of malaria-related disease symptoms. However, the body possesses various defence mechanisms, notably including the production of antioxidants, which are capable of reducing the cellular effects of ROI. Antioxidants are either sourced exogenously from the diet or synthesized through different intracellular mechanisms. Antioxidants that include glutathione peroxidase, catalase, EDTA and vitamin C suppress the initial production of ROI. Others such as uric acid, superoxide dismutase and vitamin E may also inhibit potentially damaging products of ROI metabolism. Current anti-malarial drugs often have damaging side-effects, as exemplified by memory impairment following treatment for cerebral malaria. Recent studies have explored the potential use of antioxidants alone or in combination with anti-malarials as a therapeutic means to negate Plasmodium-induced oxidative stress and its associated metabolic complications. It is indicated that when utilized in an adjuvant capacity antioxidants of natural and synthetic origin may improve anti-malarial therapy by causing less damage to the host during malaria infection.

A Rare Sellar Lesion: Pituitary Actinomyces Infection

Pituitary abscess is extremely rare and often misdiagnosed as pituitary tumor pre-operatively. We document a case of a 64-year-old lady presented to the outpatient department with complaints of headache and blurring vision of right eye for one month. Based on preliminary investigations, a clinical diagnosis of pituitary adenoma was made and the pituitary gland was surgically excised. Histopathological examination showed Actinomyces infection. This case has been documented due to the extremely rare involvement of the pituitary gland by actinomyces infection. Pituitary abscess is a rare pathology, but it must be considered during evaluating sellar masses, since its prognosis depends on surgical drainage and on the use of specific antibiotics. We report, to our knowledge, the fourth case of Actinomyces israelii infection of the pituitary region.

The Risk Factors, Complications, Management Strategies and Predictors of Morbidity & Mortality Among Pediatric Patients Presenting with Severe Diarrhea at Muhimbili National Hospital’s Emergency Medicine Department

Background Acute diarrhea is the major cause of health public problem among paediatric patients in Tanzania. And in Low income countries (LICs), studies have shown, Acute watery Diarrhea (AWD) is the cause of morbidity and mortality which can be prevented by immediate identification and treatment of complications. Methods A prospective cohort study was done between December 2021 and April 2022 to determine the risks, complications, management strategies and predictors of mortality among paediatric patients ≤12 years of age with severe diarrhea. We excluded those who arrived in cardiac arrest at the Emergency Medicine Department (EMD) of Muhimbili National Hospital (MNH). Proportion was used to summarize the counts and frequency of participants who were at risk of complications and management strategies given and for predictors of outcomes. A Modified Poisson log linear model with a robust estimation test was used to test for significant associations between predictors and outcomes. Multivariate logistic regression was used to adjust for confounders. Results A total 6,570 paediatric patients presented to EMD during study period, and we recruited 144 (2.2%). The median age was 1 (IQR 0.7-2.0) years and most were male 86 (59.7%). Among the study participants with diarrhea, 120 (83.3%) had dehydration, acidosis 60 (42.3%), hypoglycemia 8 (5.6%), hypokalemia 76 (53.1%), and Acute renal failure 11 (7.6%). Those patients with complications received appropriate management, including IV crystalloid solution given to 131 (90.97%), and correction of acidosis 60 (42.3%), hypoglycemia correction with IV dextrose 10% 6 (4.2%), and hypokalemia and infections were corrected with IV potassium chloride 52 (36.1%) and IV antibiotic treatment 84 (58.3%) respectively. Conclusion Pediatric patients under 2 years of age are at high risk of severe diarrhea with dehydration as compared to other ages. Early referral and availability of point care tests are essential in early recognition of accompanied complications.

Acquired Haemophilia: A Case Report and Literature Review

Acquired haemophilia (AHA) is a rare coagulation disorder secondary to autoantibodies against coagulation factor, most commonly factor VIII with potential for life threatening bleeding episodes. We report a case of an 88-year-old female presenting with frank haematuria three weeks after catheter insertion. Her background was of Alzheimer’s Dementia, Asthma and Bullous Pemphigoid for which she was on low dose maintenance prednisolone (5mg). Laboratory tests showed haemoglobin 98g/dl and partial thromboplastin time (PTT) of 60s, with corrected prothrombin time 52s. Fibrinogen 5.39. As such coagulation factors were tested which revealed factor VIII of 0%. Her case was complicated by urinary tract sepsis, as such she was treated with oral prednisolone 60mg without immunosuppressive agent usage. A pan-CT scan revealed likely mesothelioma for which she declined further investigation. This case report will describe a rare presentation of AHA associated with bullous pemphigoid and mesothelioma, complicated by infection and frailty.

Diabetic Foot and Leg Ulcer & Peri-wound Neuropathy Healing Feasibility Studies

Diabetic foot and leg ulcers represent a significant global health burden and are frequently associated with peripheral neuropathy, vascular compromise, infection, and high rates of recurrence and amputation. Standard wound care often fails to achieve healing in chronic cases due to unaddressed underlying neuropathic and vascular pathology. This feasibility study evaluated the Hemastyl™ System in patients with long-standing diabetic foot and leg ulcers that had failed standard care and, in many cases, had been diagnosed for amputation. Two prospective feasibility cohorts comprising 39 chronic infected diabetic wounds were treated with the Hemastyl™ System. Outcomes included rapid microbe reduction, high wound closure rates, subjective improvement in neuropathy-related symptoms, and avoidance of amputation in all amputation-diagnosed cases. These findings suggest that targeting neuropathy, vasculature, and microbial burden concurrently may offer a promising approach for healing complex chronic wounds in high-risk populations.

Prevalence and Risk Factors of Intestinal Parasitic Helminths among Primary School Children in Oru West Lga, Imo State, Nigeria

Intestinal parasitic helminths pose a significant public health burden, particularly among children. This cross-sectional study investigated the prevalence and risk factors of intestinal parasitic helminths among 550 school children aged 4-12 years in Oru-West L.G.A, Imo State, Nigeria. Stool samples were examined using parasitological techniques, and questionnaires were administered to collect data on risk factors. The overall prevalence of intestinal parasitic helminths was 49.1% (270/550), with Ascaris lumbricoides being the most prevalent (30.37%). Multivariate analysis revealed significant associations between intestinal parasitic helminths and lack of hand-washing, insufficient toilet facilities, consumption of unwashed vegetables, and poor environmental sanitation. Males had a significantly higher infection rate than females (P < 0.05). Age-related prevalence was highest among children aged 4-6 (51.85%). Occupational status and educational level of parents were also significant predictors of infection. These findings highlight the need for public health education, provision of basic sanitation facilities, and regular de-worming as preventive measures.

Review: The Role of Human Papillomavirus in Virus-Induced Carcinogenesis

Viral infections contribute to a significant proportion of human cancers, with human papillomavirus (HPV) being one of the most well-established oncogenic viruses. This review summarizes HPV biology, transmission, classification, molecular mechanisms of carcinogenesis, epidemiology of HPV-associated cancers, and current and emerging preventive and therapeutic approaches. particularly HPV-16 and HPV-18, drives malignant transformation through the E6 and E7 oncoproteins, which disrupt tumor suppressor pathways p53 and Rb. Prophylactic vaccination programs have demonstrated remarkable success in reducing HPV-related disease burden, but disparities in coverage remain. Cutting-edge strategies such as CRISPR/Cas9 and RNA-based therapeutics offer promising avenues for treating established infections. Integrating these biomedical advances with robust public health initiatives is essential to ultimately eliminate HPV-associated cancers worldwide (Figure1).

Iatrogenic Extra-Capsular Extension of Knee Septic Arthritis Via Intra-Articular Joint Injection

Background Septic arthritis is a potentially limb or life-threatening joint infection that requires prompt recognition and intervention to reduce morbidity and mortality. While intra-articular joint injections are commonly performed for osteoarthritis and other arthropathies, they carry a rare but significant risk of iatrogenic infection, particularly when performed in the presence of unrecognized joint or periarticular infection. Case Presentation We report a case of a 52-year-old female with a history of traumatic brain injury and chronic right knee pain who developed severe knee swelling, pain, and systemic symptoms following an intra-articular corticosteroid injection performed without ultrasound evaluation/guidance. Post-procedure, she presented with fever, elevated inflammatory markers, and purulent knee effusion. Operative washout revealed a purulent tract extending from the knee joint capsule to the lateral thigh. Cultures from joint aspiration and intraoperative samples grew Streptococcus dysgalactiae. Blood cultures were negative. The patient reported frequent cat scratches to the affected knee and described an unusual sensation of the injection needle tracking laterally during the joint injection. She was treated with surgical drainage and a four-week course of amoxicillin, with full clinical recovery. Discussion This case highlights an unusual presentation of septic arthritis with extra-capsular extension likely due to iatrogenic needle tracking during joint injection. The causative organism, S. dysgalactiae, is an uncommon pathogen in septic arthritis, and the presumed source was contiguous spread from untreated cellulitis, possibly related to cat scratches/bites. The absence of predisposing comorbidities and negative blood cultures further support a local rather than hematogenous source. The case emphasizes the importance of thorough clinical evaluation and consideration of infection prior to joint injections, as well as the potential benefits of ultrasound guidance to minimize procedural complications. Conclusion Careful history, physical examination, and appropriate imaging are essential prior to joint interventions to avoid iatrogenic complications. This case illustrates the rare but serious risk of extra-capsular extension of septic arthritis following intra-articular injection and emphasizes the need for vigilance in identifying underlying infection before proceeding with invasive procedures.

Malaria: A Driving Force to the Emergence and the Global Spread of Antibiotics Resistance

Malaria and bacteraemia are significant public health concerns and economic threats. In Africa, the intensity for simultaneous transmission and co-infection of Plasmodium spp and other bacteria pathogens are extremely high. It is believed that malaria suppress the immune system and enable the translocation of bacteria in the gastrointestinal tract to other cellular compartments in the body. Some of the factors that contributed to the co-emergence of these pathogens are poor access to clean water, sanitation and hygiene (WASH), poor infection control measures, inefficient health care systems. In addition, the similarities in the clinical signs and symptoms of these febrile diseases and the fact that the etiologic diagnostic testing can be complex, costly, and limited are the reasons why clinicians in resource-constrained setting often prescribe antibiotics empirically prior to or without laboratory testing to prevent severe outcomes in any patient hospitalized with malaria. However, this indiscriminate use of antibiotics has been identified as the driving force for antibiotic resistance, which is already at alarming rate in malaria endemic nations. In developed countries where malaria had been previously eradicated, there are increasing reports of imported malaria with concurrent bacteraemia. In this review, we emphasized the role of malaria in the indiscriminate use of antibiotics and the fact that eliminating malaria in Africa is one of the best strategies to address the emergence and the global spread of multi-drug resistance organisms.

Parasitological Examination of Fecal Samples from Sheep, Goats, and Cattle at the Techiman Slaughterhouse

This study investigates the parasitological examination of faecal samples collected from sheep, goats, and cattle at the Techiman Slaughterhouse. Initially, 341 samples were collected, which were subsequently sorted to 327 for analysis due to the loss of data for 14 samples. The primary aim was to identify the prevalence of parasitic infections and assess the health implications for livestock and public health. The samples were analyzed using qualitative and quantitative parasitological techniques, including flotation and sedimentation methods, to detect nematode and cestode eggs. Descriptive statistics were used to summarize the data and the prevalence of each parasite type. The findings reveal significant levels of parasitic infections, particularly strongyle ova and Moniezia expansa, highlighting the need for better management practices in livestock health.

Profile of Patients Who Died During One Year in the Pneumophthisiology Department of the Hospital National Ignace Deen CHU in Conakry

Introduction Mortality is one of the most important demographic phenomena in public health, and its rate is the primary indicator of a population's state of health. The aim of this study was to describe the profile of patients in the pneumo-phthisiology department of the Hospital National Ignace Deen CHU in Conakry. Methodology This was a retrospective descriptive study lasting one year, from 01 January to 31 December 2023, on 176 records of hospitalized patients who died in the pneumophthisiology department of the Ignace Deen National Hospital. Results A total of 1043 patients were hospitalized during our study period, 176 of whom died, giving a mortality rate of 16.87%. The mean age of the deceased patients was 49.57±18.8 years, with a male predominance (sex ratio=1.93). Clinical signs on admission were dominated by dyspnoea (70.45%) and chest pain (61.36%). Tuberculosis was the most common diagnosis with a frequency of 42.61%, followed by TB/HIV co-infection with a frequency of 22.16%. The average length of hospitalization was 8.79 days. Probable cause of death was dominated by respiratory distress (54.44%) and decompensated anaemia (32.95%). Conclusion Mortality in the pneumo-phthisiology department of the Ignace Deen National Hospital remains high. Anemia and respiratory distress were the most common diagnoses of severity, hence the need to improve management of these probable causes of death.

COVID-19-Induced Changes in the Fibrin Network of Pulmonary and Renal Microthrombi

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection often causes coagulation disorders that affect highly vascularized organs, such as the lungs and kidneys. Objective The objective of this study was to report the histopathological findings of variations in the fibrin pattern of pulmonary and renal microthrombi in patients who died from SARS-CoV-2 infection. Methods Minimally invasive autopsies were performed on 40 patients to collect lung (n=40) and kidney (n=16) tissue samples. Histochemical and immunohistochemical staining techniques were used for histopathological analyses. Premortem laboratory data were obtained from the patients' electronic medical records. Results The lung tissue showed a patchy pattern, characterized by areas of both minimal and severe damage. The most significant histopathological finding was the detection of thrombi with fibrin structures organized into discrete star-shaped units, which were more frequently observed in areas with severe lung injury than in those with minimal lung injury (p = 0.012). Star-shaped fibrin structures were also observed in the renal glomerular capillaries. Immunohistochemical staining revealed the presence of platelets and the procoagulant proteins von Willebrand factor (VWF) and Factor VIII within the star-shaped fibrin thrombi. Patients with star-shaped fibrin thrombi had higher levels of the systemic inflammatory indicators C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR). Conclusion Our observations suggest that the inflammatory microenvironment resulting from SARS-CoV-2 infection may contribute to the formation of star-shaped fibrin units in the pulmonary and renal microthrombi.

Prevalence and Antifungal Susceptibility of Candida species from patients attending Rivers State University Teaching Hospital, Nigeria

The development of medical therapy and patients profile has led to a rise in the incidence of nosocomial fungal infection. The frequency of candidiasis has surged worldwide, and the prevalent of healthcare diseases are now Candida species. Candida species causes a range of human infections known as Candidiasis. The non-albicans Candida (NAC) species have recently superseded Candida albicans as significant opportunistic pathogens. The study was conducted to determine the prevalence and antifungal susceptibility of Candida species isolated from various Clinical samples in Rivers State University Teaching Hospital, Port Harcourt, Nigeria. A total of 206 clinical specimens from male and female patients of all ages were sampled in the Department of Microbiology, Rivers State University Teaching Hospital, Port Harcourt, to investigate suspected Candida infections. The isolation and identification of Candida species was done by culture on SDA, Gram stain, sugar fermentation and phylogenetic profiling. Antifungal susceptibility pattern was done by Disc Diffusion method using Fluconazole, Ketoconazole, Miconazole, Nystatin and Itraconazole. The results showed that out of 206 specimens, 44 isolates (21.4%) were identified, with the majority (56.82%) from high vaginal swabs (HVS), followed by urine (31.82%) and oral swabs (11.36%). The age of patients ranged from four months to 73 years giving a Mean Age 1.86+ 0.344, with females (85.4%) outnumbering males (13.6%). Prevalence of Candida spp revealed Candida albicans (50%), Candida krusei (18.2%), Candida parapsilosis(11.4%), Candida glabrata and Candida tropicalis (9.1%) respectively and Candida pelliculosa (2.2%), with C. albicans being the most prevalent. The antifungal susceptibility testing among the azoles showed that Fluconazole (79.5%) and Ketoconazole (77.3%) were most sensitive agents against isolates from HVS, urine and oral swabs respectively and Itraconazole (34.1%) was most resistant especially to those from oral swabs. This study highlights the increasing prevalence of NAC species over Candida albicans and the growing resistance of Candida isolates to commonly used antifungal drugs. Diagnosis of these species of Candida and sensitivity to antifungal agents are critical components to treatment, particularly for patients with severe underlying illnesses who are hospitalized.

A Cross Sectional Analysis of Frailty and Markers of Frailty in Young People Living with HIV/AIDS

Background Frailty is an ageing-associated state linked to poor prognostic outcomes. Chronic inflammation due to HIV-infection, AIDS-related infections. and the adverse effects of antiretroviral therapy (ART) all contribute to frailty in people living with HIV/AIDS (PLHA). Frailty has been comprehensively studied in populations comprising predominantly of Caucasian PLHA. However, there remains a dearth of such data in Indian populations, especially in younger PLHA. Methodology This cross-sectional study aimed to estimate the prevalence of frailty in PLHA (18 - 50 years) who had been on ART for 24-60 months and identify markers linked to frailty. Frailty was assessed in 152 subjects using the Fried frailty-index. Parameters measured included the mid-upper arm and calf circumferences, pain-severity (using the Brief Pain Inventory), highly-sensitivity C-reactive protein, d-dimer, and interleukin-6. Results The prevalence of frailty and pre-frailty were 6.58% and 23.02%, respectively. Reduced grip strength and self-reported exhaustion were associated with frailty (15.79% and 13.16%, respectively). Low calf-circumference and mid-upper arm circumference were not significantly associated with frailty/pre-frailty. The prevalence of pain was 21.7% and both pain severity and pain interference were significantly associated with frailty/pre-frailty. CD-4 counts at the time of assessment showed an inverse association with frailty. Elevated C-reactive protein (CRP of 0.04 associated with 0.49 probability of frailty (95% CI 0.40 – 0.59), CRP of 0.12 associated with 0.63 probability of frailty (95% CI 0.47 – 0.76)). D-dimer levels were not significantly associated with frailty /pre-frailty. Conclusion In this first-of-its-kind study on frailty in young PLHA (mean age 37 years) from the Indian sub-continent, the prevalence of frailty and pre-frailty was 6.58% and 23.02%, respectively. Multivariate analysis showed a strong association of frailty with pain severity, CD4 count at time of assessment, hs-CRP levels and duration of ART.

Development of Municipal Decision-Making Strategies as Management Tools to Combat Waterborne Diseases

Waterborne diseases pose a significant global public health threat, particularly in sub-Saharan Africa, where frequent outbreaks occur. These diseases stemming from contaminated drinking water, poor waste management, and insufficient hygiene contribute to high morbidity and mortality in children under 5 years old. A study addressed waterborne diseases in N'Djamena, Chad's 3rd and 9th districts, through decision-making strategies. The research employed various methods, including a household survey using questionnaires, workshops, semi-structured interviews, and focus group discussions. Additionally, documentary research provided essential data for analysing the situation of diseases in the community. Epidemiological data from 2019- 2022 indicated a substantial prevalence of diseases such as diarrhoea, dysentery, skin infections, typhoid, abdominal pain, and malaria, with notable mortality, especially among children. Among surveyed households, 50% believed the consumed water was contaminated, attributing it to faecal matter, while 28% and 22% linked the diseases to inadequate hygiene and unsanitary conditions, respectively. The study advocates for comprehensive strategies, including improving water treatment efficiency, implementing safe waste management, promoting hygiene, and vaccination. Active involvement of all stakeholders, with municipal authorities leading, is crucial for effective implementation and combating waterborne diseases.

Fecal Shedding, Antimicrobial Resistance and In Vitro Biofilm formation on Simulated Gallstones by Salmonella Typhi Isolated from Typhoid Cases and Asymptomatic Carriers in Nairobi, Kenya

Typhoid fever, caused by the human restricted pathogen Salmonella Typhi, remains a major global public health concern. Even after successful treatment, approximately 3-5% of patients with typhoid fail to clear the bacteria within one year and become chronic carriers. Most typhoid carriers have gallstones in their gallbladder, and biofilm formation on gallstones is highly correlated with chronic carriage. This study’s goal was to identify asymptomatic typhoid carriers in an endemic setting in Kenya, and to compare acute versus chronic isolates. A cohort of typhoid fever patients identified through blood and/or stool culture, and their household contacts, were followed up after treatment to detect longitudinal S. Typhi stool shedding. An abdominal ultrasound scan was used to identify individuals with gallstones. A total of 32 index patients and 32 household contacts were successfully followed-up. Gallstones were detected in 4 cases and 1 household contact. The duration of S. Typhi shedding was significantly longer in individuals with gallstones compared to those without, P<0.001. Eighty-three (83) S. Typhi strains were tested for susceptibility to commonly used antimicrobials and examined by in vitro biofilm formation assays. Out of 37 infected individuals, 32.4% had infections caused by multidrug resistant (MDR) S. Typhi strains and only 18.9% were infected by susceptible strains. Non-MDR strains formed significantly better biofilms in vitro than the MDR strains (P<0.001). This study provides data on S. Typhi chronic carriage that will influence public health approaches aimed at reducing typhoid transmission and the burden of infection.

Exploring HIV Self-Testing: Barriers and Facilitators among Undergraduate Students

Introduction Globally, 36.7 million individuals live with HIV/AIDS, with 2.5 million new cases annually. Youth (14-25 years) account for 45% of these new infections. Those aged 15-24 years are less likely to be aware of their HIV status and engage in HIV care compared to older adults. This study explores the use of HIV self-testing to improve access to HIV care among Kenyatta University undergraduates. Objective To identify barriers and facilitators to HIV self-testing in this group. Methodology Employing multistage cluster sampling, 398 students were surveyed using a self-administered questionnaire. Results Of the participants (median age 21 years, 1:1.03 male-to-female ratio), 91.7% understood HIV's seriousness, with sexual intercourse as the primary transmission mode. Self-testing usage was 28.8%. Key barriers included fear of partner reaction, stigma, and lack of confidence. Significant facilitators were being female, knowledgeable about HIV, and sexually active. Conclusion Only 24% had prior HIV testing experience. The study highlights the importance of addressing fears and misconceptions while leveraging knowledge and sexual activity awareness to promote HIV self-testing.

Challenges in Diagnosis of Neurosarcoidosis

Sarcoidosis is granulomatous autoinflammatory autoimmune remitting relapsing disease affecting every organ in the body, it is the most difficult disease to diagnose in the absence of serum or imaging biomarker. Differential diagnosis is broad which included inflammatory, infective, neurodegenerative and neoplastic, histological biopsy is the only confirmative marker, and even histological confirmation is not robust as infection, malignancy and some drugs can induce granuloma, the most common organs affected are lung, lymph nodes, skin, eyes, liver, and less commonly pituitary gland, bones, brain, peripheral nerves, and heart, causing bilateral hilar lymphadenopathy, granulomatous lymphadenitis.

Spirometric profile of people living with HIV on antiretroviral drugs in Abidjan

Introduction People living with HIV (PLHIV) are susceptible to developing non- communicable chronic respiratory diseases. Our objective was to study the spirometric profile of this population. Material and methods This was a descriptive and analytical cross-sectional retro-prospective study conducted from March 15 to June 15, 2022 and relating to the analysis of the medical files of asymptomatic and eligible for spirometry PLHIV, aged 18 years and above. They were received in the voluntary counselling and testing (VCT) centres of one of the two pulmonology departments in Abidjan. Results The study involved 54 subjects including 22 men (40.7%) and 32 women (59.3%) with an average age of 48.9 years. The majority of patients were non-smokers (81.4%) and the main history was pulmonary tuberculosis (35.2%). Only 29.6% had chronic respiratory symptoms and 42.6% had a normal BMI. The frequency of spirometric abnormalities was 57.4%. These spirometric abnormalities included 40.7% peripheral obstructive pattern; 9.3% restrictive pattern; 3.7% asthma and 3.7% COPD. A more than 10 years duration of HIV infection (p=0.001 OR= 0.2 (0.1 – 0.7)) and a duration of ART of at least 10 years (p=0.001 OR= 0, 2 (0.1 – 0.7)) were significantly associated with the existence of ventilatory abnormalities. Conclusion The high frequency of ventilatory anomalies in PLHIV independently of the existence of chronic respiratory signs leads us to propose spirometry in the follow-up assessment of PLHIV while paying particular attention to those on ARVs for more than 10 years.

Helminth parasites prevalence and distribution among Sheep in Gudaya Bila District, East Wallaga, Ethiopia

Helminth parasite infections in sheep are of major veterinary importance in many agro-ecological zones and are a primary factor in the productivity of sheep. The main objective of this study was to determine helminth parasites prevalence and their economic loss caused on sheep with its control approach at the study area. A cross-sectional study using a simple random sampling procedure was used to study helminth parasite identification at Gudaya Bila district during 2022 in two seasons of the year: winter (January - March) and summer (June - August). Out of 384 sheep chosen at random sampling from five Kebeles in the Gudaya Bila district (Welenelemu, Harogodisa, Chalejima, Hagelogidami, and Bila) that underwent flotation and sedimentation procedures, about 149 were infected by ay helminth parasites, with an overall prevalence 38.8%. Regarding the distribution of helimenth parasites at the class level, the prevalence was 13.9%, 11.7%, and 3.9% in trematoda, nematode, and cestoda, respectively. The helminth species that had highest prevalence were Fasciola species (19.5%), Haemonchus species (14.76%), Strongyloides species (10.74%), and Schistosoma species (9.4%), and those that had the least prevalence were Moniezia species (6.04%), Paramphistomum species (5.4%), Taenia species (4.02%), Nematodirus species (3.3%) and Trichostrongylus species (1.34 %). The summer season was favorable for helminths parasite transmission. The prevalence of helminths in the summer season was 98 (25.5%), and in the winter season it was 51 (13.3%). The study shows that the gastrointestinal helminth parasite was a major health problem and had an impact on the production of sheep in the study area. Therefore, a detailed study should be conducted to identify the parasite at the species level, and further investigation will be needed to study the association of the prevalence of helminth parasites within age, sex and the agroecology of sheep in the area. Then educating the people about the impacts of helminths is needed to control them.

A Review on Monkey Pox: Role of One Health Approach Against Monkey Pox

The Ortho-poxvirus virus, which causes monkey pox, is a member of the Poxviridae genus. It was initially found in primates. In 1970, the Democratic Republic of the Congo reported the first instance of monkey pox. From there, it spread to a number of countries both inside and outside of Africa. There are two genetic varieties of monkey pox, which have been spread to people through respiratory droplets, and touch with objects contaminated by an affected person and consequently is often encountered in work situations. Among the countries with the worst effects are Nigeria and the Democratic Republic of the Congo. Non-human primates, rats, squirrel, and or mice are just a few of the creatures that can become infected by monkey pox. Although the origins of monkey pox infections are unknown, rodents from Africa and non-human primates like monkeys may contain the viruses and infect humans. Monkey pox is more likely to naturally infect rodents. Monkey pox has symptoms and lesions that are difficult to distinguish from smallpox in its clinical manifestations. Fever, chills, migraines, tiredness, tonia, swollen lymph nodes, back pain, and myalgia are some of the clinical symptoms of monkey-pox. A few examples of diagnostic tests include immune-fluorescent antibody assays, enzyme-linked immune-sorbent assays, and real-time polymerase chain reactions. A specialized vaccine that offers complete protection against by them on key-pox virus exists, yet there is no specific therapy for human monkey infection and interaction with the vaccinia virus. Smallpox vaccination can give cross-immunity with partial protection against infection and a reduction in symptom severity. Unfortunately, community health effects in the view of one health approach has not been addressed in vast. Therefore, the objectives of this review paper are to discuss the community health effects of monkey pox and to emphasize the role of one health approach against monkey pox.

Correlations with Congenital Syphilis in the United States: A Cross-Sectional Study

Syphilis is caused by the bacterium Treponema pallidum and is transmitted from human to human through sexual contact. Congenital syphilis (CS) occurs when the mother transmits the infection to the fetus. Clinical manifestations of CS include anemia, hepatosplenomegaly, blindness, deafness, meningitis, and deformities in bone structure. The number of cases of CS have increased over the past decade in the United States according to the CDC. A study was conducted correlating the number of Medicaid enrollees in 2020, the number of uninsured persons in 2020, and the number of cases of COVID-19 in 2020 to cases of CS in the United States in 2021. A Spearman rank correlation analysis was done using SPSS. Results were statistically significant for all three pairs of variables with positive correlations; Medicaid enrollment and CS cases (r = 0.735, P<.05), uninsured persons with CS cases (r = 0.713, P<.05), COVID-19 cases and CS cases (r = 0.689, P<.05). Reasons for the increase in CS cases are multifactorial, including variations in state laws regarding syphilis screening in the prenatal period, differences in provider processes for persons on Medicaid, persons uninsured, and restrictions to accessing healthcare providers during the COVID-19 pandemic. Future studies should include questionnaires and interviews with women on their experiences during prenatal visits in regards to syphilis screening, particularly women covered by Medicaid, and surveys completed by healthcare providers to gain insight and to identify factors that affect a woman not being tested for syphilis during her pregnancy.

Willingness to take COVID-19 Vaccination among People Living with HIV/AIDS on Anti-Retroviral Therapy and Associated Factors in Woldia Comprehensive Specialized Hospital, Woldia, Ethiopia

Background HIV causes immunosuppression, which reduces the body's immunity to diseases like COVID-19 by decreasing CD4 cells. The goal of this study is to determine whether persons living with HIV/AIDS (PLWHA) who are using anti-retroviral therapy (ART) are willing to accept the Coronavirus illness 2019 vaccination and the factors that influence their decision. Method From February 15 to March 15, 2022, 332 PLWHA on ART participated in this facility-based cross-sectional study. The correlation of outcome variables with predictors was investigated using binary and multivariable logistic regression. Result Of the 332 study participants, 110 (33.1 %) and 118 (35.5 %) had poor knowledge and a negative attitude toward the COVID-19 vaccination, respectively. Approximately 31 (9.3%) of study participants believe ART medications can also prevent COVID-19 infection. The willingness to receive the COVID-19 vaccine was 66.3 % with a 95 % confidence interval (60.9, 71.5). Knowledge, attitude, educational status, marital status, residency, duration, and monthly income were all significant predictors of willingness to receive COVID-19 vaccination. Conclusion Increased sensitization regarding the necessity of vaccines and the negative consequences of diseases, particularly among PLWHA, should be emphasized in the preparation of the COVID-19 immunization campaign involving prominent individuals such as health professionals and religious leaders.

Long COVID-19 Syndrome and Frailty: Cause or Consequence or Both?

Background Many older adults remain vulnerable to COVID-19 infections. They are also often at risk for frailty and poor health outcomes.  Aim This exploratory review examines the correlates of long COVID and frailty and their association insofar as the older adult’s wellbeing may be jeopardized.  Methods and procedures Articles that emerged between January 1 2022 and 2023 in major electronic data bases that addressed the current topic of interest were sought using the key words: Long COVID and Frailty. Those deemed relevant were duly downloaded, analyzed and summarized in narrative form.  Results A high proportion of older adults can be expected to remain vulnerable to COVID-19 long term impacts, plus new variants of infection, along with frailty as both an outcome and mediator. Many too are at risk for persistent long COVID-19 complications and a low life quality if more concerted preventive and rehabilitation efforts to avert frailty early on are not forthcoming in a timely manner.  Conclusion Prompt and continuing frailty assessments of older adults at risk for COVID-19 or recovering from this disease, especially those with long COVID manifestations who are frail or may become frail are strongly indicated.

Barriers and Opportunities to Improve the Implementation of Patient Screening and Linkage to Pre-Exposure Prophylaxis in Primary Care

Although pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV infection, only around 25% of at-risk individuals in the United States have accessed a prescription. One way to increase PrEP uptake is through the sexual health screening of patients and linkage to PrEP in primary care settings. The objective of this analysis was to assess the barriers and implementation strategies during a screening and linkage to PrEP pilot intervention. Primary care patients were screened for PrEP indication during routine primary care visits. Of the 1,225 individuals screened, 1.8% (n=22) were eligible for PrEP and from those, 77.3% (n=17) attended the specialist appointment and were prescribed PrEP. Primary care patients (n=30) and providers (n=8) then participated in semi-structured interviews assessing their experience with the pilot intervention. Using an applied thematic analytic approach, patients and providers identified barriers and related improvement strategies that could be classified into four main categories: 1) Financial Barriers: Individual- vs. Clinic-level Considerations 2) The Role of Stigma, Discomfort, and Cultural Factors 3) Logistical Hurdles and Streamlining the Intervention, and 4) The Lack of PrEP Knowledge and the Need for Education. Findings support the accepatability and feasibility of screening for PrEP in primary care along with appropriate implementation strategies. This study suggests that because of the high volume of patients seen in primary care, sexual health screenings and linkage to PrEP interventions have the potential to reduce new incident HIV infections among diverse sexual minority men.

CERN Large Hadron Collider (LHC) Radiation Source for Magnetic Resonance Biospectroscopy in Metabolic and Molecular Imaging and Diagnosis of Cancer

Molecular imaging is a new method in examining physiological studies in molecular dimensions. Among the various methods that have been introduced for this purpose, the magnetic resonance spectroscopy (MRS) method has made it possible to more accurately study the activities of the brain region as well as tumors in different parts of the body. MRS imaging is a type of non– invasive imaging technique that is used to study metabolic changes in the brain, stroke, seizure disorders, Alzheimer's disease, depression and also metabolic changes in other parts of the body such as muscles. In fact, since metabolic changes in the human body appear faster than anatomical and physiological changes, the use of this method can play an important role in the early detection and diagnosis of cancers, infections, metabolic changes and many other diseases. (Graphical Abstract) Graphical Abstract. CERN Large Hadron Collider (LHC) radiation source for magnetic resonance biospectroscopy in metabolic and molecular imaging and diagnosis of cancer.

Molecular Confirmation of Staphylococci Strain’s Identification Isolated in the Hospital and University Center of Brazzaville, Republic of Congo

Bacteria of the genus Staphylococcus are pathogenic Gram-positive bacteria responsible for various infections, including skin suppuration, which can be severe or chronic. The objective of this study was to confirm Staphylococci strain’s identification isolated by bacteriological methods from biological products of CHU-B patients, by molecular methods based on the analysis of the gene coding for 16S rRNA. In total, 30 strains of Staphylococci were isolated including 8 (26.66%) community strains, 22 (73.33%) hospital strains. The products of the amplification of gene fragments encoding 16S rRNA from 10 strains of Staphylococci including 6 strains of Staphylococcus aureus (S. aureus) and 4 Coagulase Negative Staphylococci (CNS) were sequenced. The sequences obtained were subjected to bioinformatics analysis to confirm the results of conventional bacteriological methods. Six (6) S. aureus strains, 2 Staphylococcus haemolyticus strains, 1 uncultured bacterium clone nbw618g09c1, and one Staphylococcus sp. have been identified. These results made it possible to confirm the effectiveness of the molecular method and to show the limits of traditional bacteriological methods in the complete identification of bacteria.

Fresh Water Snails of Public Health Importance in Canals in Okigwe Imo State Nigeria: Their Infectivity and Implications for Control

Studies have linked freshwater snails with human flukes as a result of repeated contacts with contaminated water. This study is aimed to determine the distribution of freshwater snails and their infectivity rates along human dwellings in Okigwe Imo state using Physico-Chemical parameters. Freshwater snails were collected by using long plastic spoons and with hand-picking method. The Physico-Chemical parameters were determined with appropriate instrument and freshwater snails harvested from the site were morphologically identified. One thousand four hundred and nine (1409) freshwater snails belonging to the species Lymneae and Bulinus were collected once a week throughout the period of study with the relative percentage of 43.9%; 29.9% ;26.2% respectively. The infectivity rate was highest in snails that were collected in the month of May compared to those collected in June and July, the rate was 69.2%, 50.1% and 33.6% in the months of May, June and July respectively. Dissolved oxygen (DO), Biological oxygen demand (BOD) and PH were found to significantly influence snail distribution in the site (p<0.05). The finding showed that 54.2% of all the snails collected were infected. The snail distribution observed may give an insight into some aspects of the epidemiology of trematodes infection in Okigwe the site for the study and their potential risks to infect human beings and animals.

COVID-19 and Hip Osteoarthritis Disability-Linkages and Emerging Practice Implications

Older adults suffering from chronically painful disabling osteoarthritis of one or more joints such as the hip joint continue to experience multiple health issues, commonly progressive debility, and excess disability. This mini review strove to examine current perspectives in the realm of hip joint osteoarthritis, a widespread disabling disease affecting many older adults in the face of the possible repercussions of the multiple COVID-19 restrictions in response to the SARS-CoV-2 pandemic that emerged in late 2019, along with the persistence of multiple evolving COVID-19 variants that remain lethal to many older adults, especially among the older chronically impaired population. Using multiple data bases, results reveal that very little progress has been made in recent times to mitigate hip osteoarthritis, along with very few innovative treatment approaches when severe, other than surgery and medication. Moreover, a multitude of non-pharmacologic approaches have not reduced numbers of cases requiring surgery to any extent, even when employed. In addition, outcomes of hip joint replacement surgery, and other treatments for ameliorating unrelenting pain remain largely suboptimal, especially where those undergoing surgery may now be more impaired than in pre pandemic times, and where high rates of opioid related deaths prevail in this regard. As such, it is concluded that whether in the community or being treated in hospital, exposure to COVID-19 remains risky especially in cases who are now weaker and frail, plus suffering from excess chronic disease manifestations, thus warranting more attention and protection of this high risk group, plus insightful preventive efforts to avert multiple interacting COVID-19 effects in the realm of osteoarthritis suffering, especially where patients are willing to risk infection by undergoing surgery.

Predictors of Adherence to Pre-Exposure Prophylaxis among Female Sex Workers in South-Western Nigeria

Introduction Pre-exposure prophylaxis (PrEP) is an element of the biomedical interventions of Human Immunodeficiency virus (HIV) prevention. The level of protection is strongly correlated to PrEP drug adherence. In Nigeria, the prevalence of HIV among female sex workers (FSW) is 15.5%. The 2020 integrated biological and behavioral surveillance survey did not report on PrEP adherence among FSW. This study therefore assessed the level of adherence to PrEP and its predictors among FSW in South-Western Nigeria. Methodology This cross-sectional analytical study was conducted in 2021. Study population were brothel-based FSW at Gambari Ogbomoso and Lagos, Nigeria. A total of 156 FSW participated in the study. Data was collected using interviewer-administered semi-structured questionnaire and analyzed using IBM SPSS Version 25. Results One hundred and forty-nine properly completed questionnaires were analyzed. Ninety-nine respondents (66.4%) have been working for more than 5years as a FSW and 65(43.6%) had initiation of sex work before 18 years of age. Respondents’ sexual behavior showed that 55 (36.9%) of total respondents had consistent use of condom. One hundred and thirty-four respondents (89.9%) had good knowledge of PrEP, 97 (65.1%) had good attitude towards PrEP while 111 (74.5%) had good perception of risk of HIV infection. One hundred and thirty-two (88.6%) reported to be taking PrEP and 119 (79.9%) had good adherence to PrEP. Predictors of adherence to PrEP were educational status, age of commencement of sex work and monthly income. It was found that educated sex workers were 2.67 times more likely to adhere to PrEP (OR=2.67, 95% CI=1.280-5.591, p=0.019). Those who commenced sex work after clocking 18 years of age were 75% times less likely to adhere to PrEP (OR=0.251, 95% CI=0.106-0.597, p=0.001) while those with average monthly income more than #10,000 were 1.65 times more likely to adhere to PrEP (OR=1.65, 95% CI=0.674-4.042, p=0.0275. Discussion and Recommendation The level of adherence to PrEP is considerably high and underscores a positive effect of the efforts of the Government of Nigeria in controlling HIV as a threat by 2030. Further studies would be useful to understand the behavioral factors associated with low adherence to PrEP among FSW who have spent more than 5 years in sex work.

HIV and Homosexuality: In the Light of Therapeutic Interventions

In this article the author reviews research on high risk factor of Human Immunodeficiency Virus in homosexuals and how lack of awareness & unprotected anal sex contribute substantially to new infections among this population. current HIV prevention efforts by providing insight into the patterns of Indian MSM behavior and sexual partnerships, and the specific cultural, social inequality, the gaps and lack of knowledge and psychological context in which HIV risk is occurring. And the need to develop effective awareness programs for well-functioning prevention of HIV and considerable understanding of the logistical and socio-cultural barriers MSM experience while accessing HIV prevention services. And in last will put light on therapeutic interventions for Human Immunodeficiency Virus, behavioral interventions that are socially and culturally appropriate for the population or community being prioritized and addressing multilevel psychosocial factors, including skills building and strategies to foster self-acceptance and increased social support for MSM. At the same time, prevention messages need to be designed and adapted to the knowledge level and culture of people.

Duodenocolic Fistula: A Rare Complication of Gastrointestinal Tuberculosis

Introduction Benign duodenocolic fistula (DCF), also known as a non-malignant fistula between the duodenum and colon, with or without cecum-involvement, is an unusual complication of different gastrointestinal (GI) diseases 12. Case This is a case of a 28-year-old Filipino female who presented with periumbilical pain for five months, with associated anorexia, fever, and weight loss. Biopsy showed chronic granulomatous inflammation with caseation necrosis and Langhan’s type giant cells consistent with tuberculous etiology (Figure 6 and Figure 7). Category I Anti-TB treatment for six months was started and the service planned to repeat both colonoscopy and CT-scan after the initial round of anti-TB treatment. Conclusion Benign duodenocolic fistula in the form of extrapulmonary TB is a rare GI finding that is triggered by inflammatory processes. Proper management in this case was to treat the underlying TB infection which is endemic in the Philippines.

Expression of Concern: Potential Risks and Unknown Effects of mRNA Vaccines on Population Health (6th Rev). Damages Are Being Materialized

Several mRNA vaccines are used on the population in the U.S. I started predicting the dangers of mRNA vaccines before March 2021 and update my findings periodically. My prior model study enabled me to identify many flaws in clinical trials, side-effect evaluation methods and mechanism studies, and I also considered consistent failure in predicting drug side effects in the past and systematic failure of FDA in keeping out dangerous drugs from market. I found that the risks of vaccination cannot be determined by experiments alone and must be determined by using a combination of methods. By studying mRNA expression dynamics and kinetics, I predict that vaccination with mRNA vaccines may increase cancer risks, multiple organ failure risks, earlier death risks, genome alteration speeds by one or more mechanisms, alter the normal selection process for viral evolution resulting in more virulent viruses, and aggravate chronic diseases or cause healed diseases to relapse. Two root problems are practical inability to control expression sites and severe adverse reactions from repeated vaccination. Based on mRNA bio-distribution, the mRNA mainly strikes the liver and other vital organs, and poses grave dangers to persons whose vascular functional reserves are relatively small, or whose vascular systems are temporarily burdened by other causes such as viral infections or life activities. If an mRNA vaccine is administered on a pregnant woman by second or booster shots, spike protein synthesis in fetus brain disrupts the highly regulated protein synthesis processes, resulting in potential brain damages. In less than a year, most of my early predicted damages are being materialized or are on the track to hit the population. In this update, I present a benefits-and-risks map to show how the number of deaths caused by mRNA vaccines is grossly underestimated and why claimed benefits like 95% effectiveness rate and 90% death rate reduction are meaningless and misleading.

What Could Represent the Mantissa of the Registered Covid-19 Cases?

In this work we present how it is possible to visualize the different coronavirus outbreaks from the calculation of the mantissa from the daily record of cases by Covid-19.This curve can also indicate the speed of propagation of the disease from the calculated infection rate. These conclusions are derived from the respective calculations in four different countries: Australia, Brazil, Italy, and Venezuela.

Post-Covid-19 Acute Disseminated Encephalomyelitis (ADEM) in a 27-year-old girl: Case Report

Acute disseminated encephalomyelitis (ADEM) is a monophasic, multifocal, demyelinating, autoimmune disease that affects the central nervous system (CNS). It usually occurs after a systemic infection, usually viral, including certain coronavirus infections. A 27-year-old girl presented with complaints of left interscapular pain, paresthesias and weakness in the ipsilateral upper limb. These symptoms followed paresthesias on the fingertips of her right hand the day before her admission. she was treated two weeks earlier for pneumonia with COVID-19. Her clinical pattern resulted in a moderate weakness of the left limbs associated with tactil and algic hypoesthesia in the lower left limb ascending until the C4 level in the left side. Magnetic resonance imaging (MRI) of the brain and spinal cord showed diffuse spontaneous hypersignals on fluid-attenuated inversion recovery (FLAIR) images at the cerebral level and on T2-weighted images at the spinal level. These imaging lesions coupled with the medical history of a recent COVID-19 infection led to the diagnosis of acute disseminated encephalomyelitis (ADEM) post covid-19. The clinical condition improved rapidly with intravenous (IV) corticosteroid therapy and IV immunoglobulin combined with physiotherapy. ADEM is a demyelinating autoimmune disease which is increasingly reported during this current corona virus pandemic.

A Theory on the Impact of Copper and Micronutrients Against COVID-19 in Humans

Copper (Cu) has a strong impact on the function of the immune system through several different pathways. These impacts include helping the function of monocytes, neutrophils, and macrophages, and enhancing Natural Killer cells’ activities. Cu also has a role in antimicrobial properties and inflammatory response. It is also important for IL-2 production and response, which is a component of adaptive immune cells. Additionally, Cu has multiple roles in both proliferation and differentiation of T cells and is involved in the production of antibodies. Cu deficiency can even lead to "increased viral virulence"1. Copper has a long history of use in medicine, and has continued to be used for purification of water, including use in hospitals to prevent legionnaires disease. The CDC pre released information on a study completed in March 2020 on the lifespan of COVID-19 on different surfaces which included its lifespan on copper, where it was completely dead within 4 hours. In addition, "Several reports demonstrated that Cu deficiency weakens the human immune response" 2. Given the multiple avenues of impact, it has been suggested that Cu supplementation, within recommended levels, be given to individuals who are low in Cu to help them fight off COVID-19. It is also possible that Cu supplementation, within recommended levels, may help prevent COVID-19 infection, or help individuals who are not low in Cu to fight off COVID-19 infection. However, dosage would have to be carefully managed, as excess levels of Cu can lead to both neurodegenerative and neurodevelopmental diseases.

Sexual Risk Behaviors of Sex Workers for HIV / AIDS and STIs in the City of Bamako, Mali

Background: HIV / AIDS affects all social strata and including female sex workers who are a particularly vulnerable group at risk of HIV infection. Objective To assess the risky sexual behavior of female sex workers in Bamako, Mali. Methods This is a quantitative cross-sectional analytical study conducted among 288 female sex workers in the city of Bamako, Mali. This study used a questionnaire to collect information from January to April 2021. Results Out of 288 sex workers, 41% came from neighboring countries (Burkina Faso, Cote d'Ivoire, Mauritania). More than half of the participants had started working as sex workers before the age of 20. More than half of sex workers do not always use a condom. About 32% of female sex workers had previously had anal sex, 20% had experienced group sex, and less than a quarter smoked or drank alcohol before sex. A significant relationship was found between the behavior or practice of sex workers with the following variables: ethnicity (P = 0.04); marital status (P = 0.01); monthly income (P = 0.001), age at first sexual intercourse (P = 0.03); the presence of STDs in the past (P = 0.02), knowledge of HIV status (P = 0.04) and nationality (P = 0.03). Conclusions This study highlights negative risk behaviors of sex workers such as not using condoms consistently, anal sex, alcohol, and smoking. It is therefore important to develop education actions to improve the knowledge, attitude, and practice of sex workers related to HIV/ AIDS in Mali.

Factors Influencing Hospital Cleaners’ Knowledge and Practices toward Hepatitis B prevention in Northern Province of Rwanda

This study aimed to assess factors influencing knowledge and practices of hospital cleaners towards hepatitis B prevention. This was a hospital-based cross-sectional study conducted at in Northern Province of Rwanda. A pretested self-administered questionnaire was used to gather data from study participants. A total of 134 cleaners were recruited in the study. Data were entered using Kobo collect toolbox and exported to Microsoft office excel for data cleaning and to entered in SPSS version 21 for analysis. Descriptive and logistic regression analysis was done and the significance level was 5%. More than a half of respondents were female (51.5%), and had primary level of education (54.5%). Results showed that only 9.7% of respondents had a high level of knowledge about HBV and only 2.2% had good practices on HBV practices. The odds of having high level of knowledge towards HBV prevention was 2.3 times (AOR=2.3, 95%CI: (1.1-27.3); p=0.045) among respondents with high school compared to those with no educational level. Respondents with work experience of 5-7 years were 1.5 times to have high level of knowledge towards HBV prevention than those with work experience of less than one year. Being aged between 20-30 years was associated with 2.5 times more likely to have good practices on HBV prevention than respondents aged less than 20 years. The odds of having good practice towards HBV had found to increase with work experience (AOR=2.3; 95%CI: (1.29-4.3); p=0.014). Considerable proportion of participants lacks the requisite knowledge of post-exposure treatment and prevention of HBV. Training programs on HBV infection, including PEP are highly recommended.

Nutritional Status of Inmates in the Central Prison of Mbuji-Mayi, Democratic Republic of Congo

Background The nutritional situation in prisons of developing countries and the health status of inmates remain a major human rights concern. The objective of the study was to assess the nutritional status of inmates jailed in a prison of the Democratic Republic of Congo (DRC). Methods This cross-sectional study was conducted over a 4-month period in the Central Prison of Mbuji-Mayi, DRC. Three hundred inmates were selected according to the Malnutrition Universal Screening Tool (MUST). Severe malnutrition was defined according to Buzby index and Nutritional Risk Index (NRI). Data were analyzed by Stata™ (version12.0). Results The inmates were aged between 18 and 70 years and primarily males (88.7%). Of them, 24% were suffering from severe malnutrition and 62% of moderate malnutrition as based on the NRI. At the time of study, 88% of inmates were incarcerated for more than 6 months. Multivariate logistic regression analysis showed that factors independently associated with severe malnutrition were incarceration of more than 6 months (OR=5.1; 95% CI (1.5-17.4)), origin of food (prison vs. family or NGO) (OR=4.7; 95% CI (1.6-13.8)) presence of tuberculosis, human immunodeficiency virus and/or intestinal infections (OR=2.6; 95% CI (1.4-4.7)). Conclusions The nutritional situation in the Central Prison of Mbuji-Mayi is precarious. There is urgent need to supply enough nutrient-rich food to improve health of inmates.

Liver Disease: A Retrospective Hospital Based Study in Addis Ababa-Ethiopia

Background Liver disease has caused significant morbidity and mortality worldwide. Its epidemiologic and clinical pattern, however, is not well characterized in sub-Saharan countries. Objective This study aimed to describe demographic, clinical characteristics, and patterns of liver disease in a community hospital in Addis Ababa, Ethiopia. Method A retrospective hospital-based study was conducted on patients with liver disease admitted at Ras Desta Damtew memorial hospital, in Addis Ababa-Ethiopia, from February 2015 to April 2020. Result Of the total 212 patients majority, 78.8% were male, 49.1% of patients were in the age range of 31-50 with a median age of 42. The most common initial clinical presentation was ascites (87.7 %), and more than half of patients (56.6%) had a history of alcohol misuse documented on their medical charts. Chronic liver disease (cirrhosis) was found in 177 (83.5%), and Hepatocellular Cancer accounted for 7.5% of the patients. Alcohol misuse caused 45% of chronic Liver Disease, followed by Hepatitis B virus infection. Conclusion Chronic liver disease is the most common form of liver disease, and the most affected were middle-aged men. The common cause of chronic liver disease was alcohol followed by hepatitis B virus infection.

SARS-Cov-2 Viral Kinetics in Mild COVID-19 Patients Treated with Chloroquine Regimens or Standard of Care

This study measures the impact of chloroquine (CQ) therapy in reducing SARS-CoV-2 viral load in infected individuals and hence its transmissibility by describing changes in nasopharyngeal SARS-CoV-2 RNA kinetics in patients receiving standard of care (SOC) or CQ +/- ritonavir-boosted lopinavir (LPV/r). The nasopharyngeal (NP) samples were collected from mild COVID-19 patients admitted at Bamrasnaradura Infectious Diseases Institute between March and April of 2020. These patients either received SOC, or a high dose of CQ with loading dose, or high dose of CQ plus LPV/r. The samples were tested at AFRIMS using a quantitative RT-PCR assay. Levels of CQ in the plasma were measured 6 days post initiation of their treatment. In some instances, viral isolation was attempted to determine SARS-CoV-2 viability. Analyses of the clinical outcomes showed that CQ +/- lopinavir did not contribute significantly to decreasing the number of days with detected SARS-CoV-2 RNA. Viral NP GEs declined faster in the CQ group, but benefits diminished rapidly with delays in treatment initiation. Funding Global Emerging Infections Surveillance, Armed Forces Health Surveillance Branch (GEIS-AFHSB) for all research-related activities at the AFRIMS

RETRACTED: Postulation of the Effect of Unpredicted Predisposing Factors for Post-Tonsillectomy Bleeding

This article has been retracted on 20 January 2022. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2379-8572.joa-25-5850) Back ground and Objectives Tonsillectomy is the most common surgical procedure in specialty of otorhinolaryngology. Therefore there are frequent premises regarding this procedure to be improved from different aspects, indications, time of surgery, techniques, safety measures, and postoperative care. Hence the tonsils and peritonsillar tissues are highly vascular zone that supplied by direct branches of external carotid artery thus the post-tonsillectomy bleeding remains one of significant issues in relation to this widely performed procedure. The post-tonsillectomy bleeding needs frequently to be postulated for its incidence, prevalence, etiology, predisposing factors, management and prevention. This subject constitutes one of most risky aspects that increase wariness of the surgeons regarding this commonly conducted procedure. Although there are huge numbers of presentative literatures coming from American as well as western institutes that tried to put guidelines for purpose of prevention and management of post-tonsillectomy bleeding but broadly at our middle-east region and locally at our Libyan society we found for some extent difficulties to apply all these guidelines. For this reason this issue has been take the wider spectrum of ENT surgeons’ concentration, discussions, and researches. Therefore this study was conducted prospectively and for long time to confirm the possible predisposing factors that could be responsible for increasing the risk of post-tonsillectomy bleeding at our region and in the same time to illustrate the concluded recommendations to prevent the occurrence of this important complication. Patients and Methods 2880 patients aged from 8 months to 85 years presented at ENT department-AL-hawari ENT and urology teaching center- Benghazi-city – Libya as well as AL-thowra central teaching hospital and AL-tarahom private center – Elbyda city – Libya at period in between September 2003 to March 2015 as cases of chronic adeno-tonsillitis and solitary acute as well as chronic related palatine tonsillar disease with variable patterns of indications for tonsillectomy namely snoring and apnea attacks, recurrent attacks of acute tonsillitis, persistent otitis media with effusion, recurrent attacks of acute suppurative otitis media, failure to thrive, recurrent attacks of chest infection, mal-occlusive dental deformity, unilateral enlarged tonsils, post-traumatic avulsed tonsils, history of quinsy abscess and persistent halitosis. All patients were assessed intra-operatively and post-operatively too for any evidences of primary, reactionary, or secondary hemorrhage in relation to wide spectrum of factors as patient's demographic, medical, and socio-habitual factors, in addition to technical as well as post-operative care factors. Results This presenting study confirmed that the most common type of post-tonsillectomy bleeding was the secondary variety (71%) as compared to primary (22%) and reactionary (7%) among all presented post-tonsillectomy bleeding cases. Although through this presenting serial study there were multifactorial pre-dispositions elucidated for secondary post-tonsillectomy hemorrhage but as general poor post-operative care can be considered as the cornerstone for the pathogenesis of this significantly raised incidence of secondary post-tonsillectomy bleeding this may be in form of inadequate patient's hydration and nutritional supply (47%), poor patient's antibiotic compliance (23%), and child's maternal negligence (19%). The time of surgery was found to be another important pre-disposing factor for post-tonsillectomy bleeding, it was postulated that the incidence of reactionary as well as secondary post-tonsillectomy hemorrhage significantly increased at summer and autumn seasons (69%) as compared to other seasons. The place of surgery was another interesting proposed studied factor among this serial presentation it was observed that the incidence of post-tonsillectomy bleeding among patients who operated at AL-hawari ENT and urology teaching center-Benghazi-city significantly higher (63%) than that among cases who interfered at AL-thowra central teaching hospital and AL-tarahom private center – Elbyda city. Conclusion Generally speaking, post-tonsillectomy bleeding is considered as one of important issues in ENT and one of significant post-tonsillectomy complications which may create a critical morbidity that may rarely extend to post-operative mortality. Hence the most common pattern of post-tonsillectomy bleeding is the secondary type; however this type of post-tonsillectomy hemorrhage is pre-disposed and induced by many factors. Most of these factors are treatable and curable thus the prophylaxis against this significant complication can be achievable.

Evaluation of Inflammatory Serum Cytokines after Treatment with the Consciousness Energy Healing Based Proprietary Test Formulation on Combination of Cecal Slurry, LPS and E. Coli Induced Systemic Inflammatory Response Syndrome (SIRS) in Sprague Dawley Rats

Sepsis is a systemic inflammatory response to a confirmed or suspected infection. The transition from sepsis to septic shock causes high rate of mortality. The aim of this experiment was to evaluate the anti-inflammatory potential of the Biofield Energy Treated (Blessed) Proprietary Test Formulation and Biofield Energy Healing (Blessing) Treatment per se to Sprague Dawley rats on Cecal Slurry, LPS, and E. coli-induced systemic inflammatory response syndrome (SIRS) model. In this experiment, various proinflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, IL-10, IL-12, 1L-17, and interferon-γ (IFN-γ) were analysed using ELISA. A test formulation was formulated including minerals (magnesium, zinc, calcium, selenium, and iron), vitamins (ascorbic acid, pyridoxine HCl, vitamin E, cyanocobalamin, and cholecalciferol), Panax ginseng extract, β-carotene, and cannabidiol isolate. The constituents of the test formulation were divided into two parts; one section was defined as the untreated test formulation, while the other portion of the test formulation and three group of animals received Biofield Energy Healing Treatment remotely for about 3 minutes by a renowned Biofield Energy Healer Mr. Mahendra Kumar Trivedi. The level of TNF-α was significantly reduced by 40.50%, 85.36% (p≤0.01), 50.66% (p≤0.01), 87.38% (p≤0.01), and 58.63% (p≤0.01) in G5 (Cecal Slurry, LPS, and E. coli + Biofield Energy Treated test formulation), G6 (Cecal Slurry, LPS, and E. coli + Biofield Energy Treatment per se to animals from day -15), G7 (Cecal Slurry, LPS, and E. coli + Biofield Energy Treated test formulation from day -15), G8 (Cecal Slurry, LPS, and E. coli + Biofield Energy Treatment per se + Biofield Energy Treated test formulation from day -15), and G9 (Cecal Slurry, LPS, and E. coli + Biofield Energy Treatment per se animals + untreated test formulation) groups, respectively as compared to the disease control (G2) group. Additionally, the level of IL-1β was decreased by 17.04%, 15.56%, and 12.59% in G6, G8, and G9 groups, respectively as compared to the untreated test formulation (G4) group. The level of IL-6 was significantly (p≤0.001) reduced by 36.18%, 50.24%, 43.25%, 52.69%, and 38.23% in the G5, G6, G7, G8, and G9 groups, respectively as compared to the G2 group. The level of IL-10 was altered by 70.53%, 49.25%, 60.18%, 41.54%, and 58.89% in G5, G6, G7, G8, and G9 groups, respectively as compared to the G2 group. Moreover, the level of IL-12 was decreased by 30.24%, 31.67%, 29.82%, 45.77%, and 50.54% in the G5, G6, G7, G8, and G9 groups, respectively as compared to the G2. The level of IL-17 was reduced by 48.75%, 59.61%, 59.28%, 62.49%, and 58.65% in the G5, G6, G7, G8, and G9 groups, respectively as compared to the G2. IFN-γ expression was reduced by 49.56%, 24.09%, 23.7%, 56.98%, and 44.94% in G5, G6, G7, G8, and G9 groups, respectively than G2. Overall, the data suggested anti-inflammatory potentials of the Biofield Energy Treated test formulation and Biofield Energy Treatment per se along with preventive measure on the animal with respect to various inflammatory conditions that might be beneficial various types of systemic inflammatory disorders specially sepsis, trauma, septic shock or any types of injuries. Therefore, the results showed the significant slowdown the inflammation-related disease progression and its complications in preventive treatment groups viz. G6, G7, G8, and G9.

Evaluation of Anthelmintic Activities of Fractions of Acanthus Montanus (Acanthaceae) on Adult Heligmosomoides Bakeri (Nematoda, Heligmosomatidae)

Acanthus montanusNees T. Anderson (Acanthaceae) has been employed in folk medicine for treatment of different kinds of ailment, but there is dearth of documented information on its therapeutic activities against parasites. In this study, pulverized Acanthus montanusleaf was subjected to four different extraction techniques. The percentage of yields were 25.58%, 31.42%, 11.58% and 3.00% weight by weight (w/w) of crude ethanol extract (CEE), aqueous (AQ), n-butanol (BUT) and chloroform (CHLO) portions, respectively. All the extracts, excluding the chloroform portion were administered to worm-infested mice per os at dose of 1.2 g/kg, 1.4 g/kg, 1.7 g/kg and 2.0 g/kg each for five days consecutive. Mice were euthanized and the adult worm counted for rates of deparasitization. The aqueous extract did not cause significant deparasitization even at the highest dose of 2.0 g/kg. The CEE caused significant (p<0.05) deparasitization rate of 72.35% at 2.0 g/kg dose. The n-butanol portion caused significant (p<0.05) deparasitization rates at doses between 1.4 mg/kg and 2.0 mg/kg (86.17% and 97.04% respectively) compared to figures from distilled water-treated mice (Control) as well as those from mice treated with the aqueous or crude ethanol portion. The 97.04% deparasitization produced by the 2.0 g/kg dose was not stastistically different (p>0.05) from the 100% deparasitization obtained using albendazole at the manufacturer’s recommended dose of 10 mg/kg. This study has demonstrated that the n-butanol extract of Acanthus montanus leaf has profound anthelmintic activity against experimental Heligmosomoidesbakeri infection in mice. Further phytochemical analysis and evaluation is being advocated in large animals and possibly human subjects.  

Use of the Remaining Sample from the Panbio COVID-19 Antigen Rapid Test Device for the Molecular Screening of the SARS-CoV-2 Variant of Concern B.1.1.7

Objective Real-time surveillance of SARS-CoV-2 variants of concern (VOC) is of essential public health importance. Rapid Antigen Detection Tests (RAgDT) have become first-line COVID-19 diagnostic methods in many regions, but this strategy can hamper the surveillance of the virus variants due to their decentralized performance. The aim of this study was to assess the usefulness of the remaining sample of a widely used RAgDT (Panbio) for the surveillance of the B.1.1.7 VOC using molecular methods. Methods Symptomatic individuals and asymptomatic close contacts of confirmed cases were routinely screened for SARS-CoV-2 infection using the RAgDT in Primary Health Care Centers. After performing the test, the extraction tubes containing the remaining biological material of RAgDT-positive cases were sent to the clinical microbiology laboratory where RT-PCRs detecting key mutations of the VOC were conducted. Results A valid result was obtained in 1770/1812 (97.7%) RAgDT-positive cases. Variant B.1.1.7 was detected in 34.7% of the patients, increasing from 0% to 87.7% between the weeks beginning January 4 and March 15, 2021. Conclusion The sample remaining after performing the Panbio RAgDT allowed to monitor the emergence and circulation of the B.1.1.7, greatly improving the population screened for the molecular study of SARS-CoV-2 variants.  

Community Health Needs Assessment in Urban Communities in Kigali City In Rwanda: A Cluster-Randomized Trial

Introduction Reporting of suspected or confirmed communicable diseases is paramount. Although physicians have primary responsibility for reporting, school nurses, laboratory directors, infection control practitioners, daycare center directors, health care facilities, state institutions and any other individuals providing health care services are also required to report communicable disease. Therefore, community health needs assessment in urban communities remains an essential instrument for the rapid and accurate dissemination of epidemiological information on cases and outbreaks of diseases under the national health regulations and other communicable diseases of public health importance, including emerging or re-emerging infections. Purpose of the Study Todescribe relevant medical needs of townspeople so that treatment plans can be developed accordingly. Methods The Study was a cross-sectional with qualitative approach. In-depth interviews and focus group interviews was used as research technique. Data was categorized to look for emerging themes then further distilled to identify any abstract themes that could be understood holistically. Results Urban decision-makers need to advocate the problem of human resources in public health facilities and the mutual health insurance to revise its insurance policy to allow their clients to be received even in private clinics. Dental services was wished to be available in public health centers. Study participants suggested that new useful information could be posted in private public premises rather than to be in public institutions only. Conclusion The patient waiting time, dental services in health centers, and the way of dissemination new health information, mutual health insurance and insufficient human resources are the major concerns of townspeople that they wish improvement.

Changes in Orthopedic Surgery at the Community Level

This perspective outlines how community orthopedic services adapted to shifting demands and constraints. It discusses scheduling, triage, infection control, and telemedicine adoption, and proposes metrics to track access and outcomes during system changes.

Structural Characterization and Isotopic Abundance Ratio Analysis of the Consciousness Energy Healing Treated Ofloxacin

Ofloxacin is an antibiotic, useful against the number of bacterial infections. This scientific investigation was performed to identify the impact of the Trivedi Effect®-Consciousness Energy Healing Treatment on the structural properties and the isotopic abundance ratio of ofloxacin using sophisticated analytical techniques. Ofloxacin sample was divided into control and treated parts. Only the treated ofloxacin received the Consciousness Energy Healing Treatment remotely by a well-known Biofield Energy Healer, Mr. Mahendra Kumar Trivedi. The LC-MS spectra of both the samples of ofloxacin at retention time 3 minutes exhibited the mass of the protonated molecular ion peak at m/z 362.17 (M+H)+. The chromatographic peak area% of the treated ofloxacin (52.4%) was increased by 2.03% compared to the control sample (51.36%). The LC-MS based isotopic abundance ratio of PM+1/PM in the Biofield Treated ofloxacin was significantly increased by 22.43% compared with the control sample. Similarly, the GC-MS based isotopic abundance ratio of PM+1/PM in the Biofield Treated ofloxacin was significantly increased by 19.24% compared with the control sample. The LC-MS and GC-MS based isotopic abundance ratio of PM+1/PM (2H/1H or 15N/14N or 13C/12C or 17O/16O) was significantly increased in the Biofield Treated ofloxacin as compared to the control sample. Thus,2H, 15N, 13C, and17O contributions from (C18H21FN3O4)+ to m/z 363.17 in the treated ofloxacin were significantly increased compared with the control sample. The increased isotopic abundance ratio of the Trivedi Effect®-Consciousness Energy Healing Treated ofloxacin may increase the intra-atomic bond strength and increase its physical stability. The new form of treated ofloxacin would be more stable, better soluble, and bioavailable compared to the control sample. It would be more useful to design efficacious pharmaceutical formulations that might offer better therapeutic response against infections in the urethra, urinary tract, gonorrhoea, pneumonia, infectious diarrhoea, bronchitis, cellulitis, bacterial infection of the eye and ear, multidrug-resistant tuberculosis, prostatitis, otitis media, plague, etc.  

Characterization of the Consciousness Energy Healing Treated Cholecalciferol Using LC-MS and GC-MS Spectrometry

Vitamin D3 (cholecalciferol) is a fat-soluble vitamin, which widely used for the prevention and treatment rickets, osteoporosis, arthritis, Parkinson’s and Alzheimer’s diseases, autoimmune disease, dementia, glucose intolerance, etc. The impact of the Trivedi Effect®-Consciousness Energy Healing Treatment on the structural properties and the isotopic abundance ratio of cholecalciferol were evaluated using LC-MS and GC-MS spectroscopy. The test sample cholecalciferol was divided into control and treated parts. Only, the treated cholecalciferol was received the Trivedi Effect®-Consciousness Energy Healing Treatment remotely by a renowned Biofield Energy Healer, Dahryn Trivedi. The LC-MS spectra of both the samples at retention time (Rt) ~22 minutes exhibited the mass of the molecular ion peak at m/z 385.25 (calcd for C27H45O+, 385.35). The LC-MS based isotopic abundance ratio of PM+1/PM in the treated cholecalciferol was increased by 0.74% compared with the control sample. But, the GC-MS based isotopic abundance ratio of PM+1/PM and PM+2/PM in the treated cholecalciferol was significantly increased by 66.39% and 62.69%, respectively compared with the control sample. Hence,13C, 2H, 17O, and 18O contributions from C27H44O+ to m/z 386 and 387 in the treated cholecalciferol were significantly increased compared with the control sample. The isotopic abundance ratios of PM+1/PM (2H/1H or 13C/12C or 17O/16O) and PM+2/PM (18O/16O) in the treated cholecalciferol were significantly increased as compared to the control sample. The increased isotopic composition of the Trivedi Effect®-Consciousness Energy Healing Treated cholecalciferol might have altered the neutron to proton ratio in the nucleus via the possible mediation of neutrino. The increased isotopic abundance ratio of the treated cholecalciferol may increase the intra-atomic bond strength, increase its stability. The new form of cholecalciferol would be better designing novel pharmaceutical formulations that might be more stable and more efficacious for the prevention and treatment of various diseases such as vitamin D deficiency, rickets, osteoporosis, arthritis, multiple sclerosis, cancer, diabetes mellitus, mental disorders, cardiovascular diseases, hypertension, infections, influenza, cognitive impairment in older adults, Parkinson’s and Alzheimer’s diseases, autoimmune disease, dementia, glucose intolerance, multiple sclerosis, etc.

The Multi Sectorial Approach to COVID-19 Pandemic in Limited-Resource Settings: Discussing Rwandan Experience

COVID-19 has unprecedentedly shaken the health systems across the globe. Rwanda, a low-income country in East Africa, has succeeded to contain the first wave but is struggling to curb the second wave in the wait for a massive vaccination program. The national committee composed of different ministries and a COVID-19 Joint Task Force was established as a Multi-sectoral approach in the early days of the pandemic. The approach together with transparent communication to the population has been effective. However, much more tailored and cost-effective measures against the drivers of cluster outbreaks are needed to save both the economy and more lives. It is challenging to produce evidence about behaviors attributable to the surge of infections, and their hardship, and how to allow the population to live their lives with less risk. With important research, policymakers will be able to think locally and provide easy and inexpensive recommended behaviors while awaiting the vaccine.

Risk Reduction Intervention Services for In-school Adolescents in the rural Areas of Abia State of Nigeria

Introduction Risk reduction intervention is meant to provide enhanced and desirable interventions for HIV prevention among adolescents especially the in-school. Adolescents have been identified as the most vulnerable groups that can easily acquire human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs). Therefore, adolescents are the appropriate target for HIV prevention efforts. Most interventions for adolescents focus on providing AIDS-related education with the assumption that improving knowledge would enable adolescents to protect themselves from sexually transmitted infections. Numerous studies have shown that using class-room education alone is insufficient in reducing adolescents’ risky sexual behaviours. Therefore, this study used role-plays and peer facilitation for the study. Materials and Method The study used role-play and peer facilitation for the intervention strategy. The theme of the role-play was ‘My Future is My Choice’ (MFMC) intervention which was aimed to reduce HIV risk behaviours among sexually inexperienced adolescents. The role-play was carried out by 4 peer leaders who were trained in the theoretical framework of role-plays and peer facilitation by a consultant. With mastery and experience they carried out the role play in a regular classroom section for over 3 class periods, co-facilitated with the assistance of a volunteer teacher. A unique feature of this intervention was the dual focus on strategies that influenced both individual risk factors (i.e., attitudes, behavioural skills) and social environments (e.g., peer resources). A school was chosen by simple random sampling for the intervention. In the school chosen, a total sample of 65 students in senior secondary classes 2&3 ( SS2&3) were included in the study. These were the students considered to be sexually active who can respond to the questions in the questionnaire. Self-administered pre-and post-questionnaire were completed by the students. The results were analysed using frequency tables, descriptive and inferential statistics. Results The students studied were between the ages of 13-18 years. There was evidence that the role play ‘My Future is My Choice’ (MFMC) intervention created positive effects on reduction of HIV risk behaviours among the sexually inexperienced participants aged 13–18. Perceptions on methods of preventing risk reduction behaviours were also positively impacted by the intervention as 12(18.5%) and 34(52.3 %) of the respondents realized after post- intervention that having sex with someone outside marriage and being transfused with infected blood respectively Will constitute risk to HIV infection. Conclusion The role play which used the theme ‘My Future is My Choice’ (MFMC) intervention provided safer choices for reducing one or more measures of sexual risk behaviours among the sexual inexperienced respondents. It created the opportunity for the students to recognize that engaging in unprotected sex constitutes high risk for HIV, other sexually transmitted infections and pregnancy.

Analytical Solutions of the Transmissibility of the SARS-CoV-2 in Three Interactive Populations

This paper resolves analytically a mathematical model that reproduces the transmission of Covid-19 in three interactive populations, i.e. from the initial source of contagion associated with the bat population, subsequently transmitted to unknown host (usually associate with pangolins). The host were sent and distributed to Seafood Market in Wuhan (defined reservoir), and finally infected to the human population. The model is based on a system of ten differential equations reproducing all the possible infection scenarios among all of them, that is: (1) there is no infection in any of the three populations, (2) only the population of bats is infected, (3) only the pangolins, (4) only the human people. Later, combinations between them, this is: (5) both the bat and pangolin populations, (6) bats and humans, (7) pangolins and humans, and finally, (8) all the previous populations. In each scenario, I deduced the critical points as well as the eigenvalues ​​that indicate the equilibrium conditions. Finally, it is demonstrated the validity of the model with the data corresponding to the second wave of infections in Australia.

Overview of HIV Prevention among In-school Adolescents in the Rural Areas of Abia State of Nigeria

Introduction HIV prevention services to in-school adolescents need good planning and management. HIV risk reduction interventions are geared toward measuring sexual risk behaviour outcomes of adolescents that predispose them to HIV infection. The sexual behaviour of adolescents, especially in-school adolescents should be assessed in the process. Adolescents have been identified as the most vulnerable group for acquiring human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) and as such, measures should be taken to prevent them from infection. One important reason for higher HIV prevalence among adolescents, especially girls, is the frequent practice of age-discrepant partnering, where older men, who are more likely to be infected with HIV, form sexual partners with younger girls. The objective of this study is to assess the knowledge and sexual behaviour of in-school adolescents in the prevention of HIV and AIDs in rural areas of Abia State. Materials and Methods This is a descriptive cross-sectional survey that was conducted between January and March 2020. Information was collected from 66 students of a community secondary school in the state. Participants were selected by a multi-stage sampling method and data were obtained using a semi-structured pre-tested questionnaire. Results Respondents consisted of 40(60.6%) females and 26(39.4%) males with ages ranging from 13 to 19. Some of the respondents 28 (42.4%), are living with parents while 24(36.4%) live with close relatives. A good number of the respondents 39(59.1%), accepted that their friends are HIV positive. Majority of them 49(74.2%) have not been approached for sexual relationships. About 17(25.8%) of the respondents accepted that they have boyfriends and girlfriends. Out of this number, 12(18.2%) of them said they have been approached for sex and only 2(3%) of them accepted having sexual relationships with the opposite sex. Finding showed that only 1(1.5%) of the respondents claimed to have ever used condoms during sex. Of the sexually active respondents, 49(74.2%) of them are aware that HIV is a virus infection caused by having multiple sex partners while 14(21.2%) were not sure whether HIV is a virus or bacterial infection. Conclusion The study revealed a gap in the knowledge of HIV prevention as well as inappropriate sexual behaviour among the respondents. Therefore, meaningful strategies that will be culturally sensitive to modify adolescent sexual risk behaviours should be adopted.

Mathematical Modeling of Covid-19

Background The novel coronavirus (COVID-19) suddenly appeared in Wuhan, Hubei since December 2019, and quickly swept across China, then the whole world. Today, after more than 100 days of fighting against the virus, China's epidemic has been effectively controlled, but when we looking at the entire world, the novel coronavirus has rampaged globally, especially in the United States and many European countries. This paper mainly studies the impact of COVID-19 outbreaks at Hubei Province and the United States, fits the given data and predicts future trends. Methods Based on the theoretical basis of traditional differential equations and SIR infectious disease model1, and combined with the actual situation to improve the model. Hubei Province is modeled in different time periods, and the effects of birth rate and natural mortality on the model are analyzed. Since the birth rate and natural mortality in the United States in recent years cannot be found, the epidemic situation in the United States can only be analyzed based on the absence of births and natural deaths. Finally, we used Netlogo2 to establish a closed environment (Small World), and combined with known data to conduct simulation experiments on COVID-19 infection. Findings Through the analysis of given data through the SIR model, it is found that before the Chinese government has taken comprehensive measures to cure patients (before 10 February), the number of patients in Hubei Province will reach the peak at the end of February, and will gradually decline thereafter, and on 20 March, the epidemic will be effectively controlled in the future, which coincides with the fact that Wuhan closed the last mobile cabin hospital on 10 March. On the other hand, after the Chinese government tried its best to cure the patients (after 21 February), the number of patients continued to decline over time and will reach 0 in mid-April, which is also consistent with the actual data. According to the factors of birth and natural death, the sensitivity analysis of the above model found that when the epidemic situation is at its peak, it has little effect on the curve, but when the epidemic situation gradually flattens, it still has a certain effect on the trend of the curve. Finally, looking at the situation in the United States, due to the high transmission rate, the number of patients in the United States continues to rise and is expected to reach its maximum in mid-June. We also use Netlogo to simulate the environment in which the virus spread, and find that the general trend of the curves is also consistent with the actual curves. Interpretation The Chinese government has taken various measures to deal with the novel coronavirus pneumonia, including the establishment of two temporary hospitals and dozens of sheltered hospitals, the temporary transformation of university dormitories into isolation rooms345, the closure of Wuhan, the ban on the movement of people and so on. These measures have helped to reduce the spread of the virus and greatly increased the patient's cure rate. But the US government ’s actions are not as effective as China’s, not only because the government ’s actions are inappropriate and untimely, and the people’s opposition to isolation has not subsided. As a result, the virus has spread widely in the United States. More than one million people have been infected with the virus, and tens of thousands of people have died from COVID-196.

Effect of COVID 19 Pandemic on Stroke Care and Admission - Single Centre Study

Background By the start of year 2020, the whole world was attacked by a rapidly spreading epidemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) which later was classified by WHO as Pandemic. some physicians reported multiple neurological manifestations including cerebrovascular strokes in patients with severe infection. Aim to assess the incidence of admitted stroke cases during 2019 in comparison to 2020 during COVID-19 pandemic in King Fahd Hospital, Saudi Arabia. Methodology A record based retrospective comparative study was conducted by reviewing all medical records for patients who admitted with stroke at King Fahd Hospital during March and April 2019 and March and April 2020. All data were extracted from patients’ medical files included personal data, nationality, date of admission, and stroke related data. Results The study included 121 patients whose ages ranged from 33 to 98 years with mean age of 59.9 years. At March 2019, there were 45 cases compared to 26 in March 2020. In April 2019 there were 20 admitted stroke cases compared to 30 in April 2020. Regarding clinical features of admitted stroke cases, Table 3 illustrates that 36.9% of stroke cases in 2019 were small vessel stroke compared to 58.9% of 2020 cases. Conclusions & Recommendations In conclusion, the study revealed there was no recorded significant change in the trend of admitted cases with stroke before and during COVID-19 pandemic.

Models and data Analysis of the Outbreak Risk of COVID-19

With the spread of the new coronavirus around the world, governments of various countries have begun to use the mathematical modeling method to construct some virus transmission models assessing the risks of spatial spread of the new coronavirus COVID-19, while carrying out epidemic prevention work, and then calculate the inflection point for better prevention and control of epidemic transmission. This work analyzes the spread of the new coronavirus in China, Italy, Germany, Spain, and France, and explores the quantitative relationship between the growth rate of the number of new coronavirus infections and time. In investigating the dynamics of a disease such as COVID-19, its mathematical representation can be constructed at many levels of details, guided by the questions the model tries to help answer. Mathematical sophistication may have to yield to a more pragmatic approach closer to the ability to make predictions that inform public health policies. Background In December 2019 , the first Chinese patients with pneumonia of unknown cause is China admitted to hospital in Wuhan, Hubei Jinyintan , since then, COVID-19 in the rapid expansion of China Wuhan, Hubei, in a few months time, COVID-19 is Soon it spread to a total of 34 provincial-level administrative regions in China and neighboring countries, and Hubei Province immediately became the hardest hit by the new coronavirus. In an emergency situation, we strive to establish an accurate infectious disease retardation growth model to predict the development and propagation of COVID-19, and on this basis, make some short-term effective predictions. The construction of this model has Relevant departments are helpful for the prevention and monitoring of the new coronavirus, and also strive for more time for the clinical trials of Chinese researchers and the research on vaccines against the virus to eliminate the new corona virus as soon as possible. Methods According to the original data change law, Establish a Logistic growth model, we collect and compare and integrate the spread of COVID-19 in China, Italy, France, Spain and Germany, record the virus transmission trend among people in each country and the protest measures of relevant government departments. Findings Based on the analysis results of the Logistic model model, the Logistic model has a good fitting effect on the actual cumulative number of confirmed cases, which can bring a better effect to the prediction of the epidemic situation and the prevention and control of the epidemic situation. Interpretation In the early stage of the epidemic, due to inadequate anti-epidemic measures in various countries, the epidemic situation in various countries spread rapidly. However, with the gradual understanding of COVI D -19, the epidemic situation began to be gradually controlled, thereby retarding growth

Osteoarthritis, COVID-19 Social Isolation-Impacts, and Counter Solutions

Background to the Issue Many older adults, including those already suffering from chronically painful disabling osteoarthritis of one or more joints remain more susceptible than healthy age and gender matched adults to the COVID-19 corona virus. Aims This report sought to examine what has been published in 2020 on this health condition from the perspective of the variable of widely imposed social isolation strategies designed to mitigate the spread of this highly infectious disease, and to especially keep older community dwelling adults ‘safe’ from infection. Methods Reviewed were all articles published in 2020 in PUBMED from January 1-December 24, 2020 on osteoarthritis and COVID-19 isolation impacts, plus relevant past osteoarthritis and isolation literature among older adults. The focus was on ascertaining how social isolation and distancing strategies might impact current community-dwelling adults diagnosed with osteoarthritis and whether more should be done specifically to mitigate any potentially preventable ‘socially’ induced negative health impact among this group, in spite of the laudable goals of this public health strategy. Results Older adults with osteoarthritis living in the community who are asked to self-isolate, may incur more osteoarthritis pain and disability than would otherwise be encountered if actions taken to counter this possibility are not forthcoming. Advocated over and above basic care approaches are several psychosocial strategies including the role of mobilizing various forms of social support. Conclusion Data indicate a need for concerted thoughtful and immediate attention to offset isolation, fear, and anxiety and depression effects as part of a carefully devised integrated plan of management to reduce excess osteoarthritis disability, as well as excess COVID-19 risk among otherwise free living older adults already compromised by osteoarthritis.

Prevalence and Risk Factors of Metabolic Syndrome Among Teaching Staff of Engineering Colleges in Central India

Background Prevalence of Metabolic syndrome is high among Asians including Indians, and is high among those having sedentary occupations. Teaching is one of the important occupations, which demands no strenuous physical activity. However, there is little information available about the prevalence of metabolic syndrome among teaching staff of engineering college. Hence, the present study was conducted to study its prevalence, certain risk factors and co-morbidities among teaching staff of engineering institutes. Methods Teachers from engineering colleges of Nagpur city were the study subjects. Data was collected by interview technique. Clinical examination and laboratory investigations like Fasting blood glucose, High Density Lipoproteins and Serum Triglycerides were done. National Cholesterol Evaluation Programme (NCEP) Adult Treatment Panel Three (ATPIII) criteria were used to study Metabolic syndrome. Blood pressure and anthropometric measurements like height, weight and waist circumference were obtained by standard methods. Results The prevalence of metabolic syndrome was found to be 20.5%. It was 25.32% in females and 19.31% in males. It was more common in subjects of higher age group, muslim religion, and among widows and separated. Alcohol consumption, smoking and sedentary life style was found to be significantly associated with presence of metabolic syndrome. Frozen shoulder, fungal infection and stroke were common co morbidities found among subjects having metabolic syndrome.

Restriction of Antimicrobial Usage in a Tertiary Care Neonatal Unit in South India: A Before After Trial

Background Overuse and abuse of antibiotics resulted in emergence of multidrug-resistant organisms (MDRO), increased rates of invasive candidiasis, prolonged hospital stay, NEC (Necrotizing enterocolitis), LOS (Late onset sepsis) or death. Restriction of the prescription, switching to a narrower spectrum and stopping antibiotics when not needed are some of the major approaches to antibiotic stewardship. Methods We identified restricted antimicrobials and devised an antimicrobial justification form. Clinicians needed to fill the form before prescribing restricted antimicrobials thereby comparing the antimicrobial usage pattern before and after the introduction of form. Babies enrolled before the introduction of the justification form were labelled as Group 1, and as Group 2 after justification form. The HIC (hospital infection control) staff nurse paid daily visits to NICU to monitor number of babies started on restricted antibiotics and whether the forms were duly filled or not. Any lag would be intimated to the Head HIC team for rectification. Any change of antibiotic within the restricted group also warranted justification. Culture report notified within 48 – 72 hrs so as to facilitate the stoppage of antibiotics in case of negative culture. Results There was a statistically significant reduction in the usage of restricted antimicrobials in the Group B as compared to Group A 150 (40.54%) vs 190 (49.35%) (p = 0.01). There was a statistically significant increase in the % of babies de-escalated from high end antimicrobials in Group B as compared to Group A 90 (60%) vs 56 (29.47%) (p = <0.0001). Duration of restricted antimicrobials reduced from 13.78 ± 2.7 days in Group A to 9.9 ±1.8 days in Group B (p = <0.0001). No difference in the number of babies started on any antibiotic between both the groups (p = 0.1). Conclusion Introduction of the antibiotic justification form as a part of antimicrobial stewardship program resulted in an overall reduced usage of restricted antimicrobials along with rapid de-escalation.