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1.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-22269065

RESUMO

BackgroundCoronavirus disease 2019 (COVID-19) is also associated with other co-morbidities among with previous and current pulmonary tuberculosis (PTB). PTB is a risk factor for COVID-19, both in terms of severity and mortality, regardless of human immunodeficiency virus (HIV) status. However, there is less information available on COVID-19 associated with PTB in point of view incidence and mortality rates in sub-Saharan Africa (SSA) as a high burden TB region. This systematic review served to provide data synthesis of available evidence on COVID-19/PTB incidence and case fatality rates, and mortality rate found in clinical and post-mortem COVID-19/PTB diagnostics in SSA. MethodsWe conducted a systematic electronic search in the PubMed, Medline, Google Scholar, Medrxix and COVID-19 Global literature on coronavirus disease databases for studies including COVID-19 associated with PTB in sub-Saharan Africa. The main outcomes were the proportion of people with COVID-19 associated to current /or previous PTB and the case fatality associated to COVID-19/PTB. The combination method was based on methodological similarities in the included random effect model studies using Prometa 3 software. We further undertook sensitivity analysis and meta-regression. ResultsFrom the 548 references extracted by the literature search, 25 studies were selected and included in the meta-analysis with a total of 191, 250 COVID-19 infected patients and 11, 452 COVID-19 deaths. The pooled COVID-19/PTB incidence was 2% [1%-3%] and mortality of 10% [4%-20%]. The pooled estimates for case fatality rate among COVID-19/PTB were 6% [3%-11%] for clinical PTB diagnostic and 26% [14%-48%] for post-mortem PTB diagnostic. Meta-regression model including the effect sizes and cumulative COVID-19 cases (P= 0.032), HIV prevalence (P= 0.041) and TB incidence (P= 0.002) to explained high heterogeneity between studies. ConclusionAs a summary, the incidence of TB associated with COVID-19 and case fatality rates are higher in SSA. However, COVID-19 associated to TB may be underreported in the studies conducted in SSA as the post-mortem TB diagnostic was higher. Large-scale cohort studies that adequately clear tool on previous and/or current TB diagnostic tools are required to confirmed COVID-19/TB incidence and case fatality in SSA. Review registrationPROSPERO (CRD42021233387)

2.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-21268505

RESUMO

ObjectivesTo assess the real-world diagnostic performance of nasal and nasopharyngeal swabs for SD Biosensor STANDARD Q COVID-19 Antigen Rapid Diagnostic Test (Ag-RDT). MethodsIndividuals [≥]5 years with COVID-19 compatible symptoms or history of exposure to SARS-CoV-2 presenting at hospitals in Lesotho received two nasopharyngeal and one nasal swab. Ag-RDT from nasal and nasopharyngeal swabs were performed as point-of-care on site, the second nasopharyngeal swab used for polymerase chain reaction (PCR) as the reference standard. ResultsOut of 2198 participants enrolled, 2131 had a valid PCR result (61% female, median age 41 years, 8% children), 84.5% were symptomatic. Overall PCR positivity rate was 5.8%. The sensitivity for nasopharyngeal, nasal, and combined nasal and nasopharyngeal Ag-RDT result was 70.2% (95%CI: 61.3-78.0), 67.3% (57.3-76.3) and 74.4% (65.5-82.0), respectively. The respective specificity was 97.9% (97.1-98.4), 97.9% (97.2-98.5) and 97.5% (96.7-98.2). For both sampling modalities, sensitivity was higher in participants with symptom duration [≤] 3days versus [≤] 7days. Agreement between nasal and nasopharyngeal Ag-RDT was 99.4%. ConclusionsThe STANDARD Q Ag-RDT showed high specificity. Sensitivity was, however, below the WHO recommended minimum requirement of [≥] 80%. The high agreement between nasal and nasopharyngeal sampling suggests that for Ag-RDT nasal sampling is a good alternative to nasopharyngeal sampling. Highlights- Prospective study on real-world diagnostic performance of nasal and nasopharyngeal SD Biosensor STANDARD Q COVID-19 Ag Test in 2131 participants in a rural African setting - The sensitivity of the STANDARD Q COVID-19 Ag Test was below the World Health Organization requirement of [≥] 80% but met the specificity requirement of [≥]97%. - Sensitivity was higher in the following subpopulations: persons with symptoms [≤]3 days, and Ct value < 25. - In head-to-head comparison nasal and nasopharyngeal sampling had comparable sensitivity and specificity and an overall test agreement of 99.4%, indicating that the more convenient nasal sampling could be used for SARS-CoV-2 rapid antigen tests. - 24 of the 2131 participants with COVID-19 symptoms had pulmonary tuberculosis with a positive Xpert Ultra test on sputum.

4.
Int J Mol Sci ; 23(2)2022 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-35055170

RESUMO

Tuberculosis (TB) infection, caused by the airborne pathogen Mycobacterium tuberculosis (M.tb), resulted in almost 1.4 million deaths in 2019, and the number of deaths is predicted to increase by 20% over the next 5 years due to the COVID-19 pandemic. Upon reaching the alveolar space, M.tb comes into close contact with the lung mucosa before and after its encounter with host alveolar compartment cells. Our previous studies show that homeostatic, innate soluble components of the alveolar lining fluid (ALF) can quickly alter the cell envelope surface of M.tb upon contact, defining subsequent M.tb-host cell interactions and infection outcomes in vitro and in vivo. We also demonstrated that ALF from 60+ year old elders (E-ALF) vs. healthy 18- to 45-year-old adults (A-ALF) is dysfunctional, with loss of homeostatic capacity and impaired innate soluble responses linked to high local oxidative stress. In this study, a targeted transcriptional assay shows that M.tb exposure to human ALF alters the expression of its cell envelope genes. Specifically, our results indicate that A-ALF-exposed M.tb upregulates cell envelope genes associated with lipid, carbohydrate, and amino acid metabolism, as well as genes associated with redox homeostasis and transcriptional regulators. Conversely, M.tb exposure to E-ALF shows a lesser transcriptional response, with most of the M.tb genes unchanged or downregulated. Overall, this study indicates that M.tb responds and adapts to the lung alveolar environment upon contact, and that the host ALF status, determined by factors such as age, might play an important role in determining infection outcome.

5.
BMJ Open ; 12(1): e056009, 2022 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-34980628

RESUMO

OBJECTIVES: This study aims to identify levels of adherence to antiretroviral therapy (ART) drugs and factors associated with them in Northwest Ethiopia. We hypothesise that in the era of COVID-19, there would be suboptimal adherence to ART drugs. DESIGN: An observational cross-sectional study was conducted. Factors associated with the level of adherence were selected for multiple logistic regressions at a p value of less than 0.2 in the analysis. Statistically significant associated factors were identified at a p value less than 0.05 and adjusted OR with a 95% CI. SETTING: The study was conducted in one specialised hospital and three district hospitals found in the South Gondar zone, Northwest Ethiopia. PARTICIPANTS: About 432 people living with HIV/AIDS receiving highly active ART in South Gondar zone public hospitals and who have been on treatment for more than a 3-month period participated in the study. PRIMARY AND SECONDARY OUTCOME MEASURES: Levels of adherence to ART drugs and their associated factors. RESULTS: Among 432 study participants, 81.5% (95% CI: 78% to 85.2%) of participants were optimally adherent to ART drugs. Determinants of a low level of adherence: stigma or discrimination (OR=0.4, p=0.016), missed scheduled clinical visit (OR=0.45, p=0.034), being on tuberculosis treatment (OR=0.45, p=0.01), recent CD4 cell count less than 500 cells/mm3 (OR=0.3, p=0.023) and patients who had been on WHO clinical stage III at the time of ART initiation (OR=0.24, p=0.027) were factors significantly associated with adherence to ART drugs. CONCLUSIONS: Level of adherence was relatively low compared with some local studies. The intervention targeted to reduce discrimination, counselling before initiation of treatment and awareness regarding compliance is advised to improve adherence to antiretroviral regimens.


Assuntos
COVID-19 , Infecções por HIV , Estudos Transversais , Etiópia , Infecções por HIV/tratamento farmacológico , Humanos , Adesão à Medicação , SARS-CoV-2
6.
PLoS One ; 17(1): e0262057, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35025938

RESUMO

Respiratory tract infections (RTIs) are extremely common and can cause gastrointestinal tract symptoms and changes to the gut microbiota, yet these effects are poorly understood. We conducted a systematic review to evaluate the reported evidence of gut microbiome alterations in patients with a RTI compared to healthy controls (PROSPERO: CRD42019138853). We systematically searched Medline, Embase, Web of Science, Cochrane and the Clinical Trial Database for studies published between January 2015 and June 2021. Studies were eligible for inclusion if they were human cohorts describing the gut microbiome in patients with an RTI compared to healthy controls and the infection was caused by a viral or bacterial pathogen. Dual data screening and extraction with narrative synthesis was performed. We identified 1,593 articles and assessed 11 full texts for inclusion. Included studies (some nested) reported gut microbiome changes in the context of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (n = 5), influenza (H1N1 and H7N9) (n = 2), Tuberculosis (TB) (n = 4), Community-Acquired Pneumonia CAP (n = 2) and recurrent RTIs (rRTI) (n = 1) infections. We found studies of patients with an RTI compared to controls reported a decrease in gut microbiome diversity (Shannon) of 1.45 units (95% CI, 0.15-2.50 [p, <0.0001]) and a lower abundance of taxa (p, 0.0086). Meta-analysis of the Shannon value showed considerable heterogeneity between studies (I2, 94.42). Unbiased analysis displayed as a funnel plot revealed a depletion of Lachnospiraceae, Ruminococcaceae and Ruminococcus and enrichment of Enterococcus. There was an important absence in the lack of cohort studies reporting gut microbiome changes and high heterogeneity between studies may be explained by variations in microbiome methods and confounder effects. Further human cohort studies are needed to understand RTI-induced gut microbiome changes to better understand interplay between microbes and respiratory health.


Assuntos
Microbioma Gastrointestinal/fisiologia , Trato Gastrointestinal/microbiologia , Infecções Respiratórias/microbiologia , Animais , Bactérias/crescimento & desenvolvimento , Humanos
7.
Ear Nose Throat J ; : 1455613211070896, 2022 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-34974770

RESUMO

Laryngeal tuberculosis is the most frequent granulomatous disease of the larynx and it is prone to be diagnosed as cancer. COVID-19 pandemic caused considerable disruption in tuberculosis service provisions both in the primary care and hospital settings. This report describes a rare case of life-threatening stridor in a patient who presented with an ulceroproliferative laryngeal mass later confirmed as laryngeal tuberculosis. Urgent tracheostomy was performed. The patient's sputum and the computed tomography of the chest revealed a pulmonary, as well as laryngeal tuberculosis. The patient was commenced on a 24 week course of anti-tuberculous treatment which was interrupted because of a mild course of hospital-acquired coronavirus infection. 3 months after initial treatment for tuberculosis, his sputum cultures became negative. Flexible laryngoscopy was performed at our department 4 months after commencement of treatment, demonstrating complete regression of the lesion and symmetrical laryngeal mobility, hence the patient was successfully decannulated and discharged to be followed up to his community hospital. In the time of COVID-19 pandemic, we should never underestimate other severe infectious diseases.

9.
JCI Insight ; 2022 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-34990408

RESUMO

BACKGROUND: Adenoviral (Ad)-vectored vaccines are typically administered via intramuscular injection to humans, incapable of inducing respiratory mucosal immunity. However, aerosol delivery of Ad-vectored vaccines remains poorly characterized and its ability to induce mucosal immunity in humans is unknown. This phase 1b trial was to evaluate the safety and immunogenicity of human serotype-5 Ad-vectored tuberculosis (TB) vaccine (AdHu5Ag85A) delivered to humans via inhaled aerosol or intramuscular injection. METHODS: 31 healthy, previously BCG-vaccinated adults were enrolled. AdHu5Ag85A was administered by single-dose aerosol using Aeroneb® Solo Nebulizer or by intramuscular (IM) injection. The study consisted of the low dose (LD) aerosol, high dose (HD) aerosol and IM groups. The adverse events were assessed at various times post-vaccination. Immunogenicity data were collected from the peripheral blood and bronchoalveolar lavage samples at baseline and select timepoints post-vaccination. RESULTS: The nebulized aerosol droplets were <5.39µm in size. Both LD and HD of AdHu5Ag85A administered by aerosol inhalation and IM injection were safe and well-tolerated. Both aerosol doses, particularly LD, but not IM, vaccination markedly induced airway tissue-resident memory CD4 and CD8 T cells of polyfunctionality. While as expected, IM vaccination induced Ag85A-specific T cell responses in the blood, the LD aerosol vaccination also elicited such T cells in the blood. Furthermore, the LD aerosol vaccination induced persisting transcriptional changes in alveolar macrophages. CONCLUSIONS: Inhaled aerosol delivery of Ad-vectored vaccine is a safe and superior way to elicit respiratory mucosal immunity. This study warrants further development of aerosol vaccine strategies against respiratory pathogens including TB and COVID-19. TRIAL REGISTRATION: This trial is registered with ClinicalTrial.gov, NCT# 02337270. FUNDING: The Canadian Institutes for Health Research and the Natural Sciences and Engineering Research Council of Canada.

10.
J Korean Med Sci ; 37(3): e20, 2022 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-35040295

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic caused disruptions to healthcare systems, consequently endangering tuberculosis (TB) control. We investigated delays in TB treatment among notified patients during the first wave of the COVID-19 pandemic in Korea. METHODS: We systemically collected and analyzed data from the Korea TB cohort database from January to May 2020. Groups were categorized as 'before-pandemic' and 'during-pandemic' based on TB notification period. Presentation delay was defined as the period between initial onset of symptoms and the first hospital visit, and healthcare delay as the period between the first hospital visit and anti-TB treatment initiation. A multivariate logistic regression analysis was performed to evaluate factors associated with delays in TB treatment. RESULTS: Proportion of presentation delay > 14 days was not significantly different between two groups (48.3% vs. 43.7%, P = 0.067); however, proportion of healthcare delay > 5 days was significantly higher in the during-pandemic group (48.6% vs. 42.3%, P = 0.012). In multivariate analysis, the during-pandemic group was significantly associated with healthcare delay > 5 days (adjusted odds ratio = 0.884, 95% confidence interval = 0.715-1.094). CONCLUSION: The COVID-19 pandemic was associated with healthcare delay of > 5 days in Korea. Public health interventions are necessary to minimize the pandemic's impact on the national TB control project.

12.
Futur J Pharm Sci ; 8(1): 12, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35071609

RESUMO

Background: Nanotechnology is considered a new and rapidly emerging area in the pharmaceutical and medicinal field. Nanoparticles, as drug delivery systems, impart several advantages concerning improved efficacy as well as reduced adverse drug reactions. Main body: Different types of nanosystems have been fabricated including carbon nanotubes, paramagnetic nanoparticles, dendrimers, nanoemulsions, etc. Physicochemical properties of the starting materials and the selected method of preparation play a significant aspect in determining the shape and characteristics of the developed nanoparticles. Dispersion of preformed polymers, coacervation, polymerization, nano-spray drying and supercritical fluid technology are among the most extensively used techniques for the preparation of nanocarriers. Particle size, surface charge, surface hydrophobicity and drug release are the main factors affecting nanoparticles physical stability and biological performance of the incorporated drug. In clinical practice, many nanodrugs have been used for both diagnostic and therapeutic applications and are being investigated for various indications in clinical trials. Nanoparticles are used for the cure of kidney diseases, tuberculosis, skin conditions, Alzheimer's disease, different types of cancer as well as preparation of COVID-19 vaccines. Conclusion: In this review, we will confer the advantages, types, methods of preparation, characterization methods and some of the applications of nano-systems.

13.
Inform Med Unlocked ; 28: 100849, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35071729

RESUMO

Tuberculosis and COVID-19 are among the diseases with major global public health concern and great socio-economic impact. Co-infection of these two diseases is inevitable due to their geographical overlap, a potential double blow as their clinical similarities could hamper strategies to mitigate their spread and transmission dynamics. To theoretically investigate the impact of control measures on their long-term dynamics, we formulate and analyze a mathematical model for the co-infection of COVID-19 and tuberculosis. Basic properties of the tuberculosis only and COVID-19 only sub-models are investigated as well as bifurcation analysis (possibility of the co-existence of the disease-free and endemic equilibria). The disease-free and endemic equilibria are globally asymptotically stable. The model is extended into an optimal control system by incorporating five control measures. These are: tuberculosis awareness campaign, prevention against COVID-19 (e.g., face mask, physical distancing), control against co-infection, tuberculosis and COVID-19 treatment. Five strategies which are combinations of the control measures are investigated. Strategy B which focuses on COVID-19 prevention, treatment and control of co-infection yields a better outcome in terms of the number of COVID-19 cases prevented at a lower percentage of the total cost of this strategy.

14.
Indian J Tuberc ; 69(1): 104-108, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35074141

RESUMO

The effect of COVID-19 and measures in response to it on human lives, including healthcare, was enormous. The necessary healthcare services including communicable diseases, such as Tuberculosis (TB) were badly affected. Here an attempt has been made to trace the number of notified Pediatric TB cases during and after COVID-19 lockdown and unlock period, and then compared with the same period of previous year. The epidemic data on notified pediatric TB cases for 2019 and 2020 were extracted from the Health Management Information System (HMIS) database. The absolute numbers of monthly pediatric TB notifications from January to September for the year 2020 were compared to 2019, and the percentage decrease was estimated. The HMIS data shows that there is a significant decrease in pediatric TB notifications during COVID-19 epidemic in India. Especially, when the lockdown and related restrictions in response to COVID-19 was imposed, notifications were significantly decreased compared to the same period during the previous year. Even, the reduction numbers of pediatric TB notifications during post-lockdown are still more worrying. Though, little improvements were observed suddenly after lockdown was removed, but then-after again consisted decrease was reported; and these numbers again substantially lower than the numbers of previous year. Adequate measures to diagnose, control, and prevent TB focusing young children, should be implemented simultaneously with response to COVID-19 pandemic. Further, effective steps should be taken to remove the fear arising due COVID-19 pandemic among masses, so that the healthcare seeking may be improved.

15.
EBioMedicine ; 76: 103817, 2022 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-35074630

RESUMO

BACKGROUND: Kidney damage in COVID-19 patients has been of special concern. The association of acute kidney injury (AKI) with post-acute kidney function among COVID-19 survivors was not sufficiently elucidated. METHODS: An ambidirectional cohort study was conducted with enrollment of COVID-19 survivors discharged from hospital between Jan 7, and May 29, 2020. Study participants were invited to follow-up visits at 6 and 12 months after symptom onset. The primary outcome was percentage of estimated glomerular filtration rate (eGFR) decreased from acute phase (between symptom onset and hospital discharge) to follow-up, and secondary outcome was reduced renal function at follow-up. FINDINGS: In total, 1,734 study participants were included in this study. Median follow-up duration was 342.0 days (IQR, 223.0-358.0) after symptom onset. After multivariable adjustment, percentage of eGFR decreased from acute phase to follow-up was 8.30% (95% CI, 5.99-10.61) higher among AKI participants than those without AKI at acute phase. Participants with AKI had an odds ratio (OR) of 4.60 (95% CI, 2.10-10.08) for reduced renal function at follow-up. The percentage of eGFR decreased for participants with AKI stage 1, stage 2, and stage 3 was 6.02% (95% CI, 3.48-8.57), 15.99% (95% CI, 10.77-21.22), and 17.79% (95% CI, 9.14-26.43) higher compared with those without AKI, respectively. INTERPRETATION: AKI at acute phase of COVID-19 was closely related to the longitudinal decline and post-acute status of kidney function at nearly one-year after symptom onset. Earlier and more intense follow-up strategies on kidney function management could be beneficial to COVID-19 survivors. FUNDING: Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (CIFMS 2020-I2M-CoV19-005, 2018-I2M-1-003, and 2020-I2M-2-013); National Natural Science Foundation of China (82041011); National Key Research and Development Program of China (2018YFC1200102); Major Projects of National Science and Technology on New Drug Creation and Development of Pulmonary Tuberculosis (2020ZX09201001).

16.
Med Sci Monit ; 28: e934102, 2022 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-35075100

RESUMO

BACKGROUND Heat-clearing and detoxifying herbs (HDHs) play an important role in the prevention and treatment of coronavirus infection. However, their mechanism of action needs further study. This study aimed to explore the anti-coronavirus basis and mechanism of HDHs. MATERIAL AND METHODS Database mining was performed on 7 HDHs. Core ingredients and targets were screened according to ADME rules combined with Neighborhood, Co-occurrence, Co-expression, and other algorithms. GO enrichment and KEGG pathway analyses were performed using the R language. Finally, high-throughput molecular docking was used for verification. RESULTS HDHs mainly acts on NOS3, EGFR, IL-6, MAPK8, PTGS2, MAPK14, NFKB1, and CASP3 through quercetin, luteolin, wogonin, indirubin alkaloids, ß-sitosterol, and isolariciresinol. These targets are mainly involved in the regulation of biological processes such as inflammation, activation of MAPK activity, and positive regulation of NF-kappaB transcription factor activity. Pathway analysis further revealed that the pathways regulated by these targets mainly include: signaling pathways related to viral and bacterial infections such as tuberculosis, influenza A, Ras signaling pathways; inflammation-related pathways such as the TLR, TNF, MAPK, and HIF-1 signaling pathways; and immune-related pathways such as NOD receptor signaling pathways. These pathways play a synergistic role in inhibiting lung inflammation and regulating immunity and antiviral activity. CONCLUSIONS HDHs play a role in the treatment of coronavirus infection by regulating the body's immunity, fighting inflammation, and antiviral activities, suggesting a molecular basis and new strategies for the treatment of COVID-19 and a foundation for the screening of new antiviral drugs.

17.
Environ Sci Technol ; 56(2): 1125-1137, 2022 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-34985868

RESUMO

Some infectious diseases, including COVID-19, can undergo airborne transmission. This may happen at close proximity, but as time indoors increases, infections can occur in shared room air despite distancing. We propose two indicators of infection risk for this situation, that is, relative risk parameter (Hr) and risk parameter (H). They combine the key factors that control airborne disease transmission indoors: virus-containing aerosol generation rate, breathing flow rate, masking and its quality, ventilation and aerosol-removal rates, number of occupants, and duration of exposure. COVID-19 outbreaks show a clear trend that is consistent with airborne infection and enable recommendations to minimize transmission risk. Transmission in typical prepandemic indoor spaces is highly sensitive to mitigation efforts. Previous outbreaks of measles, influenza, and tuberculosis were also assessed. Measles outbreaks occur at much lower risk parameter values than COVID-19, while tuberculosis outbreaks are observed at higher risk parameter values. Because both diseases are accepted as airborne, the fact that COVID-19 is less contagious than measles does not rule out airborne transmission. It is important that future outbreak reports include information on masking, ventilation and aerosol-removal rates, number of occupants, and duration of exposure, to investigate airborne transmission.


Assuntos
Poluição do Ar em Ambientes Fechados , COVID-19 , Aerossóis , Surtos de Doenças , Humanos , SARS-CoV-2 , Ventilação
18.
Clin Infect Dis ; 2022 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-35015842

RESUMO

Testing programs for SARS-CoV-2 have relied on high-throughput PCR laboratories and rapid antigen assays to meet diagnostic needs. Both technologies are essential, however issues of cost, accessibility, manufacturing delays and performance have limited their use in low resource settings and contributed to the global inequity in Covid-19 testing. Emerging low-cost, multi-disease point-of-care nucleic acid tests may address these limitations and strengthen pandemic preparedness, especially within primary healthcare where most cases of disease first present. Widespread deployment of these novel technologies will also help close long-standing test access gaps for other diseases, including tuberculosis, HIV, cervical cancer, viral hepatitis and sexually transmitted infections. We propose a more optimized testing framework based on greater use of point-of-care nucleic acid tests together with rapid immunologic assays and high-throughput laboratory molecular tests to improve the diagnosis of priority endemic and epidemic diseases, as well as strengthen the overall delivery of primary healthcare services.

20.
J Telemed Telecare ; : 1357633X211068277, 2022 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-34989631

RESUMO

INTRODUCTION: Due to the growing burden of disease in South Africa, encompassing conditions such as tuberculosis, human immunodeficiency virus, and cancer, the holistic management of affected patients incorporating ototoxicity monitoring is a necessity. However, ototoxicity monitoring in developing countries may be limited due to a lack of resources and inadequate healthcare facilities. Subsequently, the use of tele-audiology may be a revolutionary technique with the potential to provide audiology services to under-served populations with limited access. METHODS: The study aimed to describe the use of tele-audiology services in ototoxicity monitoring through a scoping review of English peer-reviewed articles from June 2009 to June 2020. Seventeen articles were purposively selected from the following databases: PubMed, Science Direct, Taylor and Francis Online, WorldCat, and Google Scholar. Data was extracted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram and results were analyzed using deductive thematic analysis. RESULTS AND DISCUSSION: While a minority of the studies indicated that the cost of implementation and network connectivity within a South African context pose as barriers, most researchers reported that tele-audiology provides a reliable, time-efficient, cost-effective, and easily accessible alternative for ototoxicity monitoring. Hardware including the WAHTS, KUDUwave, and OtoID, along with software such as the TabSINT, Otocalc, uHear, and the hearTest, have proven to be useful for ototoxicity monitoring. A need for further investigations regarding the feasibility of tele-audiology implementation in South Africa is evident. Despite this, it provides audiologists with an opportunity to offer contact-less services during COVID-19, thus, confirming its versatility as an augmentative method for ototoxicity monitoring.

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