Monkeypox Outbreak 2022, from a Rare Disease to Global Health Emergence: Implications for Travellers.

Monkeypox (mpox), a zoonotic disease caused by the monkeypox virus (MPXV), poses a significant public health threat with the potential for global dissemination beyond its endemic regions in Central and West Africa. This study explores the multifaceted aspects of monkeypox, covering its epidemiology, genomics, travel-related spread, mass gathering implications, and economic consequences. Epidemiologically, mpox exhibits distinct patterns, with variations in age and gender susceptibility. Severe cases can arise in immunocompromised individuals, underscoring the importance of understanding the factors contributing to its transmission. Genomic analysis of MPXV highlights its evolutionary relationship with the variola virus and vaccinia virus. Different MPXV clades exhibit varying levels of virulence and transmission potential, with Clade I associated with higher mortality rates. Moreover, the role of recombination in MPXV evolution remains a subject of interest, with implications for understanding its genetic diversity. Travel and mass gatherings play a pivotal role in the spread of monkeypox. The ease of international travel and increasing globalization have led to outbreaks beyond African borders. The economic ramifications of mpox outbreaks extend beyond public health. Direct treatment costs, productivity losses, and resource-intensive control efforts can strain healthcare systems and economies. While vaccination and mitigation strategies have proven effective, the cost-effectiveness of routine vaccination in non-endemic countries remains a subject of debate. This study emphasizes the role of travel, mass gatherings, and genomics in its spread and underscores the economic impacts on affected regions. Enhancing surveillance, vaccination strategies, and public health measures are essential in controlling this emerging infectious disease.

A comprehensive study of the epidemiology of haematological malignancies in North Queensland.

BACKGROUND: There is an absence of clinically relevant epidemiological data in regional Australia pertaining to haematological malignancies. AIM: To determine the incidence and geographical variation of haematological malignancies in North Queensland using a clinically appropriate disease classification. METHODS: Retrospective, observational study of individual patient data records of all adults diagnosed with a haematological malignancy between 2005 and 2014 and residing within The Townsville Hospital Haematology catchment region. We report descriptive summaries, incidence rates and incidence-rate ratios of haematological malignancies by geographic regions. RESULTS: One thousand, five hundred and eighty-one haematological malignancies (69% lymphoid, 31% myeloid) were diagnosed over the 10-year study period. Descriptive data are presented for 58 major subtypes, as per the WHO diagnostic classification of tumours of haemopoietic and lymphoid tissues. The overall median age at diagnosis was 66 years with a male predominance (60%). We demonstrate a temporal increase in the incidence of haematological malignancies over the study period. We observed geographical variations in the age-standardised incidence rates per 100 000 ranging from 0.5 to 233.5. Our data suggest an increased incidence rate ratio for haematological malignancies in some postcodes within the Mackay area compared with other regions. CONCLUSION: The present study successfully reports on the incidence of haematological malignancies in regional Queensland using a clinically meaningful diagnostic classification system and identifies potential geographic hotspots. We advocate for such contemporary, comprehensive and clinically meaningful epidemiological data reporting of blood cancer diagnoses in wider Australia. Such an approach will have significant implications towards developing appropriate data-driven management strategies and public health responses for haematological malignancies.

Use of telemedicine for rheumatology practice in Queensland, Australia: experiences before and during the COVID-19 pandemic.

BACKGROUND: In Australia there is a shortage of rheumatologists potentially translating to poorer outcomes. A possible solution in this setting is telemedicine (TM). AIMS: To examine the utilisation and provider perceptions of TM in rheumatology in Queensland and explore the challenges faced when using TM before and during COVID-19. METHODS: A sequential mixed-methods study design was used. Rheumatologists completed a questionnaire on demographics, clinical practice, TM uptake, models of care and clinician perceptions of TM. The qualitative phase utilised purposeful sampling of active users of TM through in-depth semi-structured interviews. RESULTS: Thirty rheumatologists participated, with 76.7% identifying as active TM users. Use of TM was limited prior to COVID-19 with 80.9% examining less than five patients per week. Patient populations served by TM included capital city (53.3%), regional (63.3%) and rural/remote (23.3%). Most rheumatologists prescribed conventional or biological disease modifying agents (90% and 55%) through TM consultations. Barriers to TM use included low confidence in joint assessments, limited distribution of technology, access to administrative and peripheral clinical staff and lack of financial incentives. During the COVID-19 pandemic, a significant expansion of TM via telephone calls occurred and rheumatologists reported low confidence and satisfaction with this model. CONCLUSIONS: Familiarity with TM exists in this rheumatologist cohort; however, its use in routine practice is limited due to multiple barriers. The COVID-19 pandemic highlighted low confidence in telephone calls as a form of TM underlining the need for appropriate TM models of care for rheumatology practice.

Readiness to enter the workforce: perceptions of health professions students at a regional Australian university.

BACKGROUND: Perceived readiness for practice can help mitigate the stress and uncertainty associated with transitioning from university into the workforce. This study aimed to identify factors influencing the readiness for clinical practice among final-year medical, dental, and pharmacy students at an Australian regional university. METHODS: The study utilised a sequential explanatory mixed-methods approach with surveys administered for the quantitative phase and interviews/focus groups for the qualitative phase. Descriptive statistics and inductive thematic analysis were utilised for the quantitative and qualitative data, respectively. Triangulation of findings from both phases facilitated in-depth understanding of the factors that influenced participants' self-perceived readiness for clinical practice. RESULTS: From the three disciplines, 132 students completed the survey and 14 participated in the focus groups and interviews. Students felt most prepared in their patient-centred capabilities, core skills, and advanced consultation skills, and least prepared in their system-related capabilities and clinical care skills. Themes identified as essential enablers and confidence builders in relation to workforce readiness in all three disciplines were: gained knowledge and skills, value of clinical placement experiences, support from peers, family and staff. However, students felt their work-readiness was impaired by heavy academic workloads and poor knowledge of health care systems, which affected skills development. Participants suggested additional support in health care system and clinical governance, mental healthcare, and induction to placement sites to further improve their work readiness. CONCLUSIONS: The findings of this study suggest that improving work-readiness of healthcare students requires alignment of learning needs to real-world practice opportunities, ensuring support systems are appropriate, and early familiarisation with the healthcare system.

Preclinical to clinical transition experiences of dental students at an Australian Regional University.

INTRODUCTION: Clinical experience is a crucial component of dental education as it prepares students for real-world practice. Our study aimed to investigate the transition from preclinical to clinical training experiences of dental students at a regional Australian dental school. MATERIALS AND METHODS: A mixed-methods study was conducted using a survey and focus groups. Participants were dental students who recently transitioned into clinical training. Survey data were analysed quantitatively using descriptive statistics, whilst the qualitative data were thematically analysed using the conceptual framework of organisational socialisation theory (OST). RESULTS: Forty-eight of the 69 students in the cohort completed the survey and 10 participated in the focus groups. The quantitative findings revealed that the transition was perceived to be abrupt and associated with a heavy workload. However, orientation sessions and engaging in chairside teaching made transitioning into clinical studies easier. The qualitative findings revealed that the transition process occurred in three phases. In phase 1, participants navigated the educational and social challenges using developmental characteristics such as resilience and positivity. Lessons learnt in phase 1 were used to make necessary learning adjustments in phase 2 and this subsequently enhanced developmental growth in the final phase, which helped ease the transition. CONCLUSION: This study confirms that transitioning into clinical training can be complex. However, the educational and socialisation challenges associated with the transition can provide stimulating developmental learning opportunities that advance students' adjustments to the clinical environment with positive, empowering and motivational outcomes that facilitate a smooth transition.

Individual Anthropometric, Aerobic Capacity and Demographic Characteristics as Predictors of Heat Intolerance in Military Populations.

Background and objectives: The Australian Defence Force (ADF) engages in combat-related activities in hot climatic conditions, which exposes ADF members to the threat of exertional heat illness (EHI). After an episode of EHI, the heat tolerance test (HTT) is conducted to determine heat tolerance. Heat intolerance is the inability to maintain thermal balance while exercising in a hot environment. This study investigated the predictive roles of individual characteristics (age, gender, aerobic capacity (VO2max) and body composition) on physiological responses to the HTT in a group comprising ADF personnel and civilian volunteers. Materials and Methods: A quasi-experimental design was used and 52 (38 males and 14 females) participants were recruited from the ADF and the general population for the HTT. Heat intolerance was defined following the standard criteria for the HTT (temperature and heart rate). Data were analysed using inferential statistics. Results: The mean age of the participants was 31.1 ± 11.6 years, and 44% (23 people: 19 males and 4 females) of the participants were heat intolerant. Independent samples T-test showed that body mass index (p = 0.011) and body fat% (p = 0.034) of heat-intolerant participants were significantly higher than their heat-tolerant counterparts. Body surface area to mass ratio (p = 0.005) and aerobic capacity (p = 0.001) were significantly lower in heat-intolerant participants. Regression analyses showed that age, gender, aerobic capacity and body fat% were significant (p < 0.001) predictors of heat tolerance outcomes, with R2 values ranging from 0.505 to 0.636. Conclusions: This study showed that aerobic capacity, body fat%, age and gender are predictors of heat intolerance among military and non-military populations. However, there may be a need for future studies to consider identifying other indicators such as clinical biomarkers of heat intolerance, which could be used to develop a more reliable HTT protocol.

Perceptions and processes influencing the transition of medical students from pre-clinical to clinical training.

BACKGROUND: The transition from pre-clinical to clinical medical training is often characterised by several challenges which may have different impacts on students' well-being and learning experiences. To ensure smooth transition, it's important to understand how these students navigate through the challenging processes. METHODS: This study employed a mixed-methods design using a survey, focus groups and interviews among medical students who had entered their first clinical year of study (Year 4). Using a 5-point Likert scale, survey participants rated items which related to their transition experience in the areas of professional socialisation; workload; patient contact; knowledge and skills; and learning and education. The qualitative questions explored challenges in transition, coping strategies and recommendations to foster smooth transitioning. The survey data was analysed using descriptive and inferential statistics while thematic analysis was used to establish emerging themes from the qualitative data. The Westerman Transition Framework was utilised in the triangulation of study findings. RESULTS: A total of 141 students participated in the survey while 12 students participated in the focus group discussions and interviews. The quantitative part of the study showed that the students were anxious about the process and considered the workload to be heavy while also identifying gaps in their knowledge. Similarly, the qualitative findings revealed that workload and professional socialisation were identified as disruptive novel elements and the students also reported feelings of inadequacy and incompetence due to perceived knowledge gaps. These shortcomings and challenges were tackled by seeking support from peers and senior medical students as a way of coping with the anxiety and stress. As the students progressed, they admitted and accepted that the transition was a gradual process and an essential learning curve. CONCLUSION: The process of transitioning from preclinical to clinical years is considered stressful and abrupt with the introduction of disruptive novel elements that create feelings of incompetence and unpreparedness in students. Educators need to consider developing social and developmental strategies that emphasise nurturing and empowering clinical learning environments and facilitate reflective and transformative life-long learning opportunities for students.

Factors Influencing Medical Students' Experiences and Satisfaction with Blended Integrated E-Learning.

OBJECTIVES: Blended learning has been presented as a promising learner-centred model that emphasises the learning outcome rather than the process of education, but it can negatively affect learners' engagement with learning. SUBJECT AND METHODS: Using a mixed-methods approach, this study aimed to determine the significant predictors of learning satisfaction and to evaluate the experiences of medical students with the different domains of an introduced blended integrated learning approach. RESULTS: The survey was administered to 92 respondents with a mean age of 20.5 years. Male students had significantly higher computer self-efficacy and overall learner satisfaction ratings than their female counterparts. Multiple regression analysis showed that gender (student characteristics), performance expectations (cognitive factors), and learning climate (social environment) were predictors of the perceived satisfaction of learners. CONCLUSION: Wider integration of blended learning into pre-clinical undergraduate medical education could enhance the shift towards competency-based education and life-long learning among medical students. However, effective implementation would depend largely on student characteristics, as well as environmental and cognitive components of the delivery method.

Non-urgent paediatric emergency department presentation: A systematic review.

There has been an increase in the use of the emergency department (ED) for non-urgent presentations. The aim of this systematic review was to identify the proportion, criteria and predictors of non-urgent ED presentations in paediatric populations. A search of multiple databases was conducted for articles published from inception of the databases to 20 August 2018, which reported the proportion, criteria and predictors of non-urgent ED presentation in paediatric populations. Thirty-one articles met the inclusion criteria. The mean proportion of non-urgent paediatric ED presentations was 41.06 ± 15.16%. There appears to be a weak association between predisposing, enabling and needs factors and non-urgent ED use in paediatric populations. The findings of this review suggest that non-urgent ED use in paediatric populations is high. However, non-urgent ED use and the reasons for the visits in paediatric populations remain understudied.

Perceived clinical relevance and retention of basic sciences across the medical education continuum.

Medical programs are under pressure to maintain currency with scientific and technical advances, as well as prepare graduates for clinical work and a wide range of postgraduate careers. The value of the basic sciences in primary medical education was assessed by exploring the perceived clinical relevance and test performance trends among medical students, interns, residents, and experienced clinicians. A pilot study conducted in 2014 involved administration of a voluntary 60-item multiple-choice question test to 225 medical students and 4 interns. These participants and 26 teaching clinicians rated the items for clinical relevance. In 2016, a similarly constructed test (main study) was made a mandatory formative assessment, attempted by 563 students in years 2, 4, and 6 and by 120 commencing general practice residents. Test scores, performance trends, clinical relevance ratings, and correlations were assessed using relevant parametric and nonparametric tests. Rank order and pass-fail decisions were also reviewed. The mean test scores were 57% (SD 7.1) and 52% (SD 6.1) for the pilot and main studies, respectively. Highest scores were observed in pathology and social sciences. Overall performance increased with increasing year of study. Test scores were positively correlated with perceived relevance. There were moderate correlations (r = 0.50-0.63; P < 0.001) between participants' scores in the basic science and summative exams. Assessments may be key to fostering relevance and integration of the basic sciences. Benchmarking knowledge retention and result comparisons across topics are useful in program evaluation.

Validity of the scan of postgraduate educational environment domains (SPEED) questionnaire in a rural general practice training setting.

BACKGROUND: The educational environment is critical to learning and is determined by social interactions. Trainee satisfaction translates to career commitment, retention and a positive professional attitude as well as being an important factor in assessing the impact of the training program. This study aimed to validate the Scan of Postgraduate Educational Environment Domain (SPEED) tool and assess its appropriateness in evaluating the quality of General Practice (GP) rural postgraduate educational environment. METHODS: A questionnaire containing the 15-item SPEED tool was administered to GP registrars to examine their perceptions of the educational environment. Principal component analysis (PCA) and exploratory factor analysis (EFA) were used to gather evidences of the validity of the instrument based on its internal structure. Additional validity evidence and reliability estimates were obtained using many-facet Rasch model analysis (MFRM). RESULTS: The survey was completed by 351 registrars with a response rate of 60%. Parallel analysis performed using principal component analysis and exploratory factor analysis suggests that the SPEED tool is unidimensional. The MFRM analysis demonstrated an excellent degree of infit and outfit for items and training sites, but not for persons. The MFRM analysis also estimated high reliability levels for items (0.98), training sites (0.95) and persons within training sites (ranging from 0.87 to 0.93 in each training sites). Overall, the registrars agreed that the educational environment had high quality, with most (13 out of 15) of the items rated above 4 out of 5. CONCLUSIONS: This study demonstrated a high degree of validity and reliability of the SPEED tool for the measurement of the quality of the educational environment in a rural postgraduate GP training context. However, when applied in a new setting, the tool may not function as a multidimensional tool consistent with its theoretical grounding.

Epidemiology, Risk Factors and Measures for Preventing Drowning in Africa: A Systematic Review.

: Background: Drowning is a leading cause of unintentional injury related mortality worldwide, and accounts for roughly 320,000 deaths yearly. Over 90% of these deaths occur in low- and middle-income countries with inadequate prevention measures. The highest rates of drowning are observed in Africa. The aim of this review is to describe the epidemiology of drowning and identify the risk factors and strategies for prevention of drowning in Africa. Methods: A review of multiple databases (MEDLINE, CINAHL, PsycINFO, Scopus and Emcare) was conducted from inception of the databases to the 1st of April 2019 to identify studies investigating drowning in Africa. The preferred reporting items for systematic review and meta-analysis (PRISMA) was utilised. Results: Forty-two articles from 15 countries were included. Twelve articles explored drowning, while in 30 articles, drowning was reported as part of a wider study. The data sources were coronial, central registry, hospital record, sea rescue and self-generated data. Measures used to describe drowning were proportions and rates. There was a huge variation in the proportion and incidence rate of drowning reported by the studies included in the review. The potential risk factors for drowning included young age, male gender, ethnicity, alcohol, access to bodies of water, age and carrying capacity of the boat, weather and summer season. No study evaluated prevention strategies, however, strategies proposed were education, increased supervision and community awareness. Conclusions: There is a need to address the high rate of drowning in Africa. Good epidemiological studies across all African countries are needed to describe the patterns of drowning and understand risk factors. Further research is needed to investigate the risk factors and to evaluate prevention strategies.

Socio-economic composition of low-acuity paediatric presentation at a regional hospital emergency department.

AIM: Despite increasing rates of emergency department (ED) utilisation, little is known about low-acuity presentations in children ≤5 years. The aims of the study were to estimate the proportion and cost of low-acuity presentations in children ≤5 years presenting to the ED and to determine the relative effect of socio-economic status (SES) on paediatric low-acuity presentations at the ED. METHODS: This is a retrospective observational study of children ≤5 years presenting to the Cairns Hospital ED over 4 years. A multivariate logistic regression model was used to assess the association between SES and low-acuity presentations. Cost of low-acuity presentations was calculated based on triage score and admission status, using costs obtained from the National Hospital Cost Data Collection. RESULTS: A total of 23 086 children were included in the study, of whom 56.7% were male (mean age = 1.85 ± 1.63 years). Approximately one-third of ED visits were low-acuity presentations (32.4%), and low-acuity presentations increased progressively with SES. In multivariate analysis, children from families with very high SES were twice as likely to have a low-acuity presentation (odds ratio 2.17; 95% confidence interval, 1.66-2.85). Low-acuity ED presentations cost the health-care system in excess of A$895 000-A$1 110 000 per year. CONCLUSIONS: These findings demonstrate that a significant proportion of paediatric ED visits are of low acuity and that these visits yield a substantial cost to the health system. Further research is required regarding care givers' rationale and potentially other reasons underlying these low-acuity ED presentations.

Assessment for learning: a needs analysis study using formative assessment to evaluate the need for curriculum reform in basic sciences.

A needs analysis study for curriculum reform in basic sciences was conducted at Melaka Manipal Medical College, India, by means of a formative assessment method, namely Basic Science Retention Examination (BSRE). Students participated in a BSRE, which comprised recall and clinical multiple-choice questions in six discipline areas. They also rated the clinical relevance of each question and provided responses to three open-text questions about the exam. Pass rates were determined; clinical relevance ratings and performance scores were compared between recall type and clinical questions to test students' level of clinical application of basic science knowledge. Text comments were thematically analyzed to identify recurring themes. Only one-third of students passed the BSRE (32.2%). Students performed better in recall questions compared with clinical questions in anatomy (51.0 vs. 40.2%), pathology (45.1 vs. 38.1%), pharmacology (41.8 vs. 31.7%), and biochemistry (43.5 vs. 26.9%). In physiology, students performed better in clinical questions compared with the recall type (56.2 vs. 45.8%). Students' response to BSRE was positive. The findings imply that transfer of basic science knowledge was poor, and that assessment methods should emphasize clinical application of basic science knowledge.

A comprehensive review of monkeypox virus and mpox characteristics.

Monkeypox virus (MPXV) is the etiological agent of monkeypox (mpox), a zoonotic disease. MPXV is endemic in the forested regions of West and Central Africa, but the virus has recently spread globally, causing outbreaks in multiple non-endemic countries. In this paper, we review the characteristics of the virus, including its ecology, genomics, infection biology, and evolution. We estimate by phylogenomic molecular clock that the B.1 lineage responsible for the 2022 mpox outbreaks has been in circulation since 2016. We interrogate the host-virus interactions that modulate the virus infection biology, signal transduction, pathogenesis, and host immune responses. We highlight the changing pathophysiology and epidemiology of MPXV and summarize recent advances in the prevention and treatment of mpox. In addition, this review identifies knowledge gaps with respect to the virus and the disease, suggests future research directions to address the knowledge gaps, and proposes a One Health approach as an effective strategy to prevent current and future epidemics of mpox.

Noma disease among internally displaced persons in Northeast Nigeria: a retrospective descriptive study.

Background: Recently recognized by the World Health Organization as a neglected tropical disease, Noma, an acute and destructive gangrenous disease affecting the gums and facial structures within the oral cavity, has a high mortality rate if untreated. Objectives: To investigate the prevalence and impact of Noma among internally displaced populations in Northeastern Nigeria. Design: A retrospective study. Methods: This retrospective study investigates the prevalence and impact of Noma among internally displaced populations in Northeastern Nigeria. Noma is endemic in Northern Nigeria, Africa, and its occurrence has been linked to extreme poverty, malnutrition, poor hygiene, and inadequate healthcare - conditions exacerbated by the ongoing Boko Haram conflict. Results: The retrospective descriptive cross-sectional analysis of 17 cases reveals a median age of 8 years, with most of the patients being children who suffer significant social stigmas, such as difficulties in speaking, eating, and social integration, including reduced school attendance and marital prospects. Conclusion: The study highlights the urgent need for comprehensive research into the etiology of Noma and its socio-economic impact. It emphasizes the necessity for early and effective intervention strategies, particularly in conflict-stricken areas with limited healthcare access.

Prognostic Accuracy of Antenatal Doppler Ultrasound Measures in Predicting Adverse Perinatal Outcomes for Pregnancies Complicated by Diabetes: A Systematic Review.

OBJECTIVE: This study aimed to assess the prognostic accuracies of Doppler ultrasound measures in predicting adverse perinatal outcomes for pregnancies complicated with preexisting or gestational diabetes mellitus. DATA SOURCES: An online database search of MEDLINE, Cochrane, Embase, CINAHL, Scopus, and Emcare from inception to April 2022 was conducted. STUDY ELIGIBILITY CRITERIA: Studies reporting singleton, nonanomalous fetuses of women with either preexisting (type 1 or 2 diabetes mellitus) or gestational diabetes mellitus during pregnancy were included. In addition, the included studies assessed cerebroplacental ratio and middle cerebral artery and/or umbilical artery pulsatility index in the prediction of either: preterm birth, cesarean delivery for fetal distress, APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) score <7 at 5 minutes, neonatal intensive care unit admission (>24 hours), acute respiratory distress syndrome, jaundice, hypoglycemia, hypocalcemia, or neonatal death. METHODS: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed and 610 articles were identified, of which 15 were included. Two authors independently extracted prognostic data from each article and assessed the study applicability and risk of bias using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies-2) scoring criteria. RESULTS: A total of 15 studies were included in the review and comprised prospective (n=10; 66%) and retrospective (n=5; 33%) cohorts. Sensitivity and positive predictive values varied widely across each Doppler measurement. Umbilical artery sensitivities were higher than those of cerebroplacental ratio and middle cerebral artery for hypoglycemia, jaundice, neonatal intensive care unit admission, respiratory distress, and preterm birth. Cerebroplacental ratio was the most reported index test; however, prognostic accuracy was worse than that of umbilical artery and middle cerebral artery Doppler across all adverse perinatal outcomes. Significant risk of bias was present in 14 (94%) studies, with substantial heterogeneity observed across studies in terms of study design and outcomes assessed. CONCLUSION: Abnormal umbilical artery pulsatility index may be of more clinical value in predicting adverse perinatal outcomes compared with cerebroplacental ratio and middle cerebral artery pulsatility index in diabetic pregnancies. Further evaluation of umbilical artery Doppler measurements in diabetic pregnancies using standardized variables across studies is required for broader clinical application. The significant association between abnormal Doppler measurement and hypoglycemia may warrant further investigation.

Corrigendum: The epidemiological trend of monkeypox and monkeypox-varicella zoster viruses co-infection in North-Eastern Nigeria.

[This corrects the article DOI: 10.3389/fpubh.2022.1066589.].

The epidemiological trend of monkeypox and monkeypox-varicella zoster viruses co-infection in North-Eastern Nigeria.

Background: Monkeypox (MPX) is endemic in Nigeria, but it was first reported in Adamawa state, North-Eastern Nigeria, in January 2022. There are currently 172 cases of MPX in Nigeria, with four reported deaths, and Adamawa has the second-highest case count. Therefore, this study was undertaken to evaluate the epidemiological profile of this viral disease. Methods: This is a cross-sectional study. The skin and blood samples were screened for the presence for Monkeypox virus (MPXV) and Varicella Zoster virus (VZV) DNA by real-time PCR; the clinical diagnosis was based on symptoms of visual signs of skin lesions and other clinical symptoms from January to July 2022. Results: A total of 33 suspected cases aged 1-57 years [26 (79%) males vs. 7 (21%) females] were screened for MPX and VZV. Twenty-four (72.7%) were positive (6.1% were MPX only, 39% were VZV only, and 27% were both MPX and VZV). Most cases of MPX (82%), VZV (69%) and MPX-VZV co-infection (78%) occurred in males. More than half (54%) of those infected were children and adolescents between 0 and 19 years. All patients experienced body rashes and itching, and other clinical symptoms included fever, headache, mouth sores, muscle aches and lymphadenopathy. Over 64 and 86% of patients had contact with livestock and rodents, respectively. Conclusion: MPXV, VZV and MPXV-VZV co-infections occurred predominantly among males and children in Adamawa state, Nigeria. Given the patient contact with rodents and livestock, further research on the animal reservoir is needed to highlight the transmission of MPXV in Adamawa.

Effectiveness of the BNT162b2 (Pfizer-BioNTech) Vaccine in Children and Adolescents: A Systematic Review and Meta-Analysis.

Efforts to control the COVID-19 pandemic have expanded to the vaccination of children and adolescents. This systematic review assesses the utility of the BNT162b2 (Pfizer-BioNTech) vaccine in children and adolescents aged 5-18 years, considering its effectiveness against COVID infection, hospital and intensive care admission and duration of effectiveness after vaccination. Six databases were searched following the PRISMA guidelines. Pooled estimates and 95% confidence intervals (CIs) were calculated using meta-analysis. Fifteen studies were included in the systematic review, while 12 studies were included in the meta-analysis. Evidence suggests that the two-dose vaccination regime provided high effectiveness of 92% (95% CI, 86-96) against COVID infection. Vaccination also conferred high protection against hospitalisation (91%) and intensive care admission (85%). The vaccine was highly protective against the Delta variant of the virus, but showed a lower protection against the Omicron variant. Most adverse effects were transient and mild, commonly including pain at the injection site, fatigue and headache. Current findings are suggestive of waning immunity over time; however, further research is needed to investigate the relevance of booster doses in this age group. In summary, the Pfizer-BioNTech BNT162b2 vaccine demonstrated high levels of protection against COVID-19 infection and its complications while maintaining an adequate safety profile in children and adolescents.