Impact of long COVID-19 on posttraumatic stress disorder as modified by health literacy: an observational study in Vietnam.

BACKGROUND: The prevalence of posttraumatic stress disorder (PTSD) has increased, particularly among individuals who have recovered from coronavirus disease 2019 (COVID-19) infection. Health literacy is considered a "social vaccine" that helps people respond effectively to the pandemic. We aimed to investigate the association between long COVID-19 and PTSD, and to examine the modifying role of health literacy in this association. METHODS: A cross-sectional study was conducted at 18 hospitals and health centers in Vietnam from December 2021 to October 2022. We recruited 4,463 individuals who had recovered from COVID-19 infection for at least 4 weeks. Participants provided information about their sociodemographics, clinical parameters, health-related behaviors, health literacy (using the 12-item short-form health literacy scale), long COVID-19 symptoms and PTSD (Impact Event Scale-Revised score of 33 or higher). Logistic regression models were used to examine associations and interactions. RESULTS: Out of the study sample, 55.9% had long COVID-19 symptoms, and 49.6% had PTSD. Individuals with long COVID-19 symptoms had a higher likelihood of PTSD (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.63-2.12; p<0.001). Higher health literacy was associated with a lower likelihood of PTSD (OR, 0.98; 95% CI, 0.97-0.99; p=0.001). Compared to those without long COVID-19 symptoms and the lowest health literacy score, those with long COVID-19 symptoms and a 1-point health literacy increment had a 3% lower likelihood of PTSD (OR, 0.97; 95% CI, 0.96-0.99; p=0.001). CONCLUSION: Health literacy was found to be a protective factor against PTSD and modified the negative impact of long COVID-19 symptoms on PTSD.

Randomized controlled trial of the relative efficacy of high-dose intravenous ceftriaxone and oral cefixime combined with doxycycline for the treatment of Chlamydia trachomatis and Neisseria gonorrhoeae co-infection.

OBJECTIVES: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the commonest bacterial causes of sexually transmitted infections in humans with high incidence of co-infection. Treatment with high doses of ceftriaxone (CRO) and cefixime (CFM) is strongly recommended due to the reduced drug susceptibility of NG. However, their safety and efficacy have not been confirmed. We compared the safety and efficacy of a single 1 g intravenous (IV) dose of ceftriaxone (CRO) plus doxycycline (DOX) versus a single 800 mg oral dose of cefixime (CFM) plus DOX for the treatment of NG-CT co-infection. METHODS: An open-label randomized controlled trial was conducted on 125 individuals aged > 18 years with untreated gonorrhea and chlamydia to compare a single 1 g intravenous dose of CRO + DOX and a single 800 mg oral dose of CFM + DOX. The primary outcome was the clearance of NG from all the initially infected sites. Secondary outcomes included symptom resolution, changes in the serum clearance levels, glomerular filtration rate, and antibiotic minimum inhibitory concentrations. RESULTS: Both regimens were highly effective in treating gonorrhea with success rates of 96.7% (95% confidence interval [CI] 88.8-99.1%) for CRO and 95.3% (95% CI 87.1-98.4%) for CFM. However, CRO + DOX was superior to CFM + DOX for the treatment of NG-CT co-infection (odds ratio 4.41, 95% CI 1.11-25.7). The safety profiles of the two regimens were similar. CONCLUSIONS: CRO + DOX was superior to CFM + DOX for the treatment of NG-CT co-infection. CFM + DOX may be indicated in patients with CRO allergy and in settings where CRO is unavailable. Trial registration ClinicalTrials.gov (NCT05216744) on 31/01/22.

DNA-HPV transition rate and related factors in HPV-infected women in Can Tho city, Vietnam.

OBJECTIVES: To determine DNA-HPV transition rates and related factors in HPV-infected women 18-69 years of age in Can Tho City from 2013 to 2018. METHODS: Both a retrospective and a prospective cohort study were done. Interviews, gynaecological examinations and HPV testing by PCR (cervical fluid) were used to collect data. The results were recorded and compared with those of HPV in 2013 to assess the development of HPV over time. Transition was defined as conversion to HPV-positive state in 2018 from a negative state in 2013. No transition was defined as clearance of HPV when the positive 2013 result was negative in 2018 or when the result remained negative or positive in 2013 and 2018. Factors related to the change were analysed. RESULTS: Among a sample size of 204 cases, the average age of participants was 48.9 ± 10.4 years. Women >45 comprised 63.2% of participants; 82.8% lived with their husbands, 6.4% were divorced, and 2.9% lived apart from their husbands due to work. After 5 years of observation, 16.2% of DNA-HPV cases had converted to HPV-positive state and 66.2% of DNA-HPV cases had cleared to HPV-negative state. Factors related to conversion to HPV-positive state were age ≤ 45 years (3.14 times higher risk of transition than in the >45 age group (95% CI: 1.12-8.8)); change of sexual partner (OR = 3.75 (95% CI: 1.15-12.2)); change of sexual partner by husband (OR = 3.69 (95% CI: 1.20-11.3); sexually transmitted diseases (OR = 5.19 (95% CI: 1.09-24.8)); and a history of vacuum aspiration or dilation and evacuation abortion (OR = 1.4 (95% CI: 0.29-6.4)). CONCLUSIONS: 16.2% of women with DNA-HPV transition converted to HPV-positive state. Changes in sexual habits increase the risk of developing HPV positivity.

TAUX DE TRANSITION ADN-VPH ET FACTEURS CONNEXES CHEZ LES FEMMES INFECTÉES PAR LE VPH À CAN THO CITY, VIETNAM: OBJECTIFS: Déterminer les taux de transition ADN-VPH et les facteurs connexes chez les femmes infectées par le VPH, âgées de 18 à 69 ans à Can Tho City de 2013 à 2018. MÉTHODES: Une étude de cohorte rétrospective et une prospective ont été effectuées. Des entretiens, des examens gynécologiques et des tests pour le VPH par PCR (liquide cervical) ont été utilisés pour collecter des données. Les résultats ont été enregistrés et comparés à ceux du VPH en 2013 afin d'évaluer l'évolution du VPH au fil du temps. La transition a été définie comme étant la conversion d'un état négatif au VPH en 2013 à un état positif en 2018. Aucune transition n'a été définie comme une élimination du VPH lorsque le résultat positif de 2013 était négatif en 2018 ou lorsque le résultat est resté négatif ou positif en 2013 et 2018. Les facteurs liés au changement ont été analysés. RÉSULTATS: Sur un échantillon de 204 cas, l'âge moyen des participantes était de 48,9 ± 10,4 ans. Les femmes > 45 ans représentaient 63,2% des participantes; 82,8% vivaient avec leur mari, 6,4% étaient divorcées et 2,9% vivaient séparées de leur mari à cause de leur travail. Après 5 ans d'observation, 16,2% des cas d'ADN-VPH étaient passés à l'état VPH positif et 66,2% des cas d'ADN-VPH avaient tout éliminé et étaient passés à l'état HPV négatif. Les facteurs liés à la conversion à l'état positif au VPH étaient les suivants: âge ≤ 45 ans (risque de transition de 3,14 fois supérieur à celui du groupe d'âge > 45 ans (IC95%: 1,12 à 8,8)), changement de partenaire sexuel (OR = 3,75 (IC95%: 1,15-12,2)), changement de partenaire sexuel par le mari (OR = 3,69 (IC95%: 1,20-11,3), maladies sexuellement transmissibles (OR = 5,19 (IC95%: 1,09-24,8)) et antécédents d'aspiration ou de dilatation et d'évacuation d'avortement (OR = 1,4 (IC95%: 0,29 à 6,4)). CONCLUSIONS: 16,2% des femmes présentant une transition ADN-VPH sont devenues positives au VPH. Les changements d'habitudes sexuelles augmentent le risque de développer une positivité au VPH.

Cladophialophora bantiana and Candida albicans mixed infection in cerebral abscess of an HIV-negative patient.

Cladophialophora bantiana is a black fungus recorded rarely as a cause of brain abscess. We describe the first case seen in Vietnam. A 35-year-old, previously healthy male, HIV negative, came to the hospital with a clinical diagnosis of brain tumor. He underwent surgery to remove the well-delineated circumscribed lesion. Pathology, directed physical examination and mycological examination revealed an abscess due to Cladophialophora bantiana, and Candida albicans. After two weeks of treatment with Fluconazole 400 mg per day intravenously, the clinical response remained unsatisfactory. Therapy was then withheld per the family's request.