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1.
Sao Paulo Med J ; 139(6): 607-614, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34787295

RESUMO

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) infection is a worldwide concern given its presence even in non-hospitalized healthy individuals, such as university students. OBJECTIVE: To identify in the literature the prevalence of colonization by MRSA among healthcare students. DESIGN AND SETTING: Integrative review of the literature conducted in Universidade Federal do Piauí. METHOD: A search for primary studies was performed in the following databases: Medical Literature Analysis and Retrieval System on-line; Cumulative Index to Nursing and Allied Health Literature; Web of Science; Scopus; and LILACS. RESULTS: This review included 27 studies that demonstrated MRSA infection prevalence ranging from 0.0 to 15.3% among students. CONCLUSION: The prevalence of colonization of MRSA among healthcare students is high, and the nasal cavity was cited as an important reservoir location for these microorganisms.


Assuntos
Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas , Portador Sadio/epidemiologia , Atenção à Saúde , Humanos , Prevalência , Infecções Estafilocócicas/epidemiologia , Estudantes
2.
J Gen Virol ; 102(11)2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34788210

RESUMO

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread worldwide as a severe pandemic, and a significant portion of the infected population may remain asymptomatic. Given this, five surveys were carried out between May and September 2020 with a total of 3585 volunteers in the municipality of Foz do Iguaçu, State of Paraná, a triple border region between Brazil/Argentina/Paraguay. Five months after the first infection, volunteers were re-analysed for the production of IgG anti-Spike and anti-RBD-Spike, in addition to analyses of cellular immunity. Seroconversion rates ranged from 4.4 % to a peak of 37.21 % followed by a reduction in seroconversion to 21.1 % in September, indicating that 25 % of the population lost their circulating anti-SARS-CoV-2 antibodies 3 months after infection. Analyses after 5 months of infection showed that only 17.2 % of people still had anti-RBD-Spike antibodies, however, most volunteers had some degree of cellular immune response. The strategy of letting people become naturally infected with SARS-CoV-2 to achieve herd immunity is flawed, and the first contact with the virus may not generate enough immunogenic stimulus to prevent a possible second infection.


Assuntos
COVID-19/imunologia , Portador Sadio/imunologia , Imunidade Coletiva , SARS-CoV-2/imunologia , Anticorpos Antivirais/imunologia , Argentina/epidemiologia , Brasil/epidemiologia , COVID-19/epidemiologia , COVID-19/virologia , Portador Sadio/epidemiologia , Portador Sadio/virologia , Humanos , Imunidade Celular , SARS-CoV-2/genética , SARS-CoV-2/fisiologia , Glicoproteína da Espícula de Coronavírus/imunologia
3.
J Res Health Sci ; 21(2): e00512, 2021 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-34465636

RESUMO

BACKGROUND: This study aimed to analyze the demographic and epidemiological features of identified COVID-19 cases in Kazakhstan. STUDY DESIGN: A cross-sectional study. METHODS: This cross-sectional study aimed to analyze COVID-19 cases (n=5116) collected from March 13 to June 6, 2020, in Kazakhstan. The data were obtained from a state official medical electronic database. The study investigated the geographic and demographic data of patients as well as the association of COVID-19 cases with gender and age. The prevalence of symptoms, the presence of comorbidities, complications, and COVID-19 mortality were determined for all patients. RESULTS: The mean±SD age of the patients in this study was 34.8±17.6 years, and the majority (55.7%) of COVID-19 cases were male and residents of cities (79.6%). In total, 80% of the cases had the asymptomatic/mild form of the disease. Cough (20.8 %) and sore throat (17.1%) were the most common symptoms among patients, and pneumonia was diagnosed in 1 out of 5 cases. Acute respiratory distress syndrome (ARDS) was recorded in 1.2% of the patients. The fatality rate was 1% in the study population and lethality was 2.6 times higher in males compared to females.  Each additional year in age increased the probability of COVID-19 infection by 1.06 times. The presence of cardiovascular, diabetes, respiratory, and kidney diseases affected the rate of mortality (P<0.05). CONCLUSION: The results demonstrated a high proportion (40%) of the asymptomatic type of coronavirus infection in the Kazakhstan population. The severity of COVID-19 symptoms and lethality were directly related to the age of patients and the presence of comorbidities.


Assuntos
COVID-19 , Portador Sadio/virologia , Tosse/etiologia , Pandemias , Faringite/etiologia , Adolescente , Adulto , Fatores Etários , Idoso , COVID-19/complicações , COVID-19/epidemiologia , COVID-19/mortalidade , COVID-19/virologia , Portador Sadio/epidemiologia , Criança , Comorbidade , Tosse/epidemiologia , Estudos Transversais , Feminino , Humanos , Cazaquistão/epidemiologia , Masculino , Pessoa de Meia-Idade , Faringite/epidemiologia , Pneumonia/epidemiologia , Pneumonia/etiologia , Síndrome do Desconforto Respiratório/epidemiologia , Síndrome do Desconforto Respiratório/etiologia , Estudos Retrospectivos , SARS-CoV-2 , Fatores Sexuais , Adulto Jovem
4.
Int J Infect Dis ; 111: 328-332, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34508859

RESUMO

BACKGROUND: Nasopharyngeal (NP) colonization with Streptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) is common in children, and may evolve as the source of invasive infections. In Korea, the pneumococcal conjugate vaccines (PCVs) were introduced >10 years ago, enabling the authors to study the effect of the vaccine in preventing carriage. METHODS: NP swabs were taken and a household survey was conducted at daycare centres located in different regions of Korea in 2014 and 2019. Pneumococcal serotypes were identified using the Quellung method and sequencing. NTHi were identified based on pilA and bexA genes. RESULTS: In total, 1460 NP swabs were obtained with pneumococcal carriage rates of 36.4-42.1% and NTHi carriage rates of 36.5-26.7%. Among children carrying pneumococci, a significant increase was seen in serotype 23A between 2014 and 2019 (from 12.6% to 22.0%; P=0.005). Children who had received PCV were at lower risk of vaccine-type carriage (2.9% vs 0.8%; P=0.005). CONCLUSIONS: Between 2014 and 2019, the proportion of children carrying serotype 23A increased significantly, while the carriage rate of NTHi decreased. Continuous surveillance is needed to assess the long-term effects of the PCVs on carriage dynamics of pneumococcus and NTHi.


Assuntos
Infecções Pneumocócicas , Streptococcus pneumoniae , Portador Sadio/epidemiologia , Criança , Haemophilus influenzae , Humanos , Lactente , Nasofaringe , Infecções Pneumocócicas/epidemiologia , Vacinas Pneumocócicas , República da Coreia/epidemiologia
5.
JNMA J Nepal Med Assoc ; 59(233): 19-21, 2021 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-34508453

RESUMO

INTRODUCTION: Methicillin-Resistant Staphylococcus aureus exhibit multiple drug resistance phenotypes. Colonizers harboring Methicillin-Resistant Staphylococcus aureus are often associated with its outbreaks in both hospital and community settings. This study was done to determine the prevalence of nasal carriage rate of Methicillin-Resistant Staphylococcus aureus among basic science MBBS and BDS students of Kathmandu Medical College. METHODS: A descriptive cross-sectional study was done in Kathmandu Medical College from March 5 to June 5 2020. Ethical clearance was obtained from the Institutional Review Committee with reference no. 040320201. A convenient sampling method was used, and the sample size was calculated with a prevalence of 50%. Two hundred students studying MBBS and BDS were enrolled. The nasal swab was collected and processed using standard microbiological methods. The data obtained were computed and analyzed using Statistical Package for Social Sciences 16.0 Version. RESULTS: Among 200 participants, 9 (4.5%) were found to be nasal carriers of Methicillin-Resistant Staphylococcus aureus. CONCLUSIONS: Colonization of anterior nares by Methicillin-Resistant Staphylococcus aureus in apparently healthy individuals is a cause of concern. Education regarding Methicillin-Resistant Staphylococcus aureus, its carrier and significance, and its screening must be included early on in MBBS and BDS.


Assuntos
Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas , Estudantes de Medicina , Portador Sadio/epidemiologia , Estudos Transversais , Humanos , Prevalência , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus
6.
Biomed Environ Sci ; 34(9): 743-749, 2021 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-34530966

RESUMO

The aim of this study was to estimate the seroprevalence of immunoglobulin M (IgM) and G (IgG) antibodies against SARS-CoV-2 in asymptomatic people in Wuhan. This was a cross-sectional study, which enrolled 18,712 asymptomatic participants from 154 work units in Wuhan. Pearson Chi-square test, t-test, and Mann-Whitney test were used to compare the standardized seroprevalence of IgG and IgM for age and gender between different groups. The results indicated the standardized seroprevalence of IgG and IgM showed a downward trend and was significantly higher among females than males. Besides, different geographic areas and workplaces had different seroprevalence of IgG among asymptomatic people, and the number of abnormalities in CT imaging were higher in IgG antibody-positive cases than IgG-negative cases. We hope these findings can provide references for herd immunity investigation and provide basis for vaccine development.


Assuntos
Anticorpos Antivirais/sangue , COVID-19/epidemiologia , Portador Sadio/epidemiologia , Imunoglobulina G/sangue , Imunoglobulina M/sangue , SARS-CoV-2/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/imunologia , Portador Sadio/imunologia , Criança , Pré-Escolar , China/epidemiologia , Proteínas do Nucleocapsídeo de Coronavírus/imunologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ocupações/classificação , Fosfoproteínas/imunologia , Estudos Soroepidemiológicos , Glicoproteína da Espícula de Coronavírus/imunologia , Adulto Jovem
7.
J Glob Health ; 11: 04054, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34552723

RESUMO

Background: Nasopharyngeal pneumococcal carriage (NPC) is a prerequisite for invasive pneumococcal disease and reduced carriage of vaccine serotypes is a marker for the protection offered by the pneumococcal conjugate vaccine (PCV). The present study reports NPC during the first year of life in a vaccinated (with PCV10) cohort in Bangladesh and an unvaccinated cohort in India. Methods: A total of 450 and 459 infants were recruited from India and Bangladesh respectively within 0-7 days after birth. Nasopharyngeal swabs were collected at baseline, 18 and 36 weeks after birth. The swabs were processed for pneumococcal culture and identification of serotypes by the Quellung test and polymerase chain reaction (PCR). An identical protocol was applied at both sites. Results: Prevalence of NPC was 48% in the Indian and 54.8% in the Bangladeshi cohort at 18 weeks. It increased to 53% and 64.8% respectively at 36 weeks. The average prevalence of vaccine serotypes was higher in the Indian cohort (17.8% vs 9.8% for PCV-10 and 26.1% vs17.6% for PCV-13) with 6A, 6B, 19F, 23F, and 19A as the common serotypes. On the other hand, the prevalence of non-vaccine serotypes was higher (43.6% vs 27.1% for non-PCV13) in the Bangladeshi cohort with 34, 15B, 17F, and 35B as the common serotypes. Overcrowding was associated with increased risk of pneumococcal carriage. The present PCV-13 vaccine would cover 28%-30% and 47%-48% serotypes in the Bangladeshi and Indian cohorts respectively. Conclusions: South Asian infants get colonised with pneumococci early in infancy; predominantly vaccine serotypes in PCV naïve population (India) and non-vaccine serotypes in the vaccinated population (Bangladesh). These local findings are important to inform the public health policy and the development of higher valent pneumococcal vaccines.


Assuntos
Portador Sadio , Vacinas Pneumocócicas , Portador Sadio/epidemiologia , Estudos de Coortes , Humanos , Lactente , Nasofaringe , Sorogrupo , Streptococcus pneumoniae
8.
Nature ; 599(7883): 108-113, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34551425

RESUMO

Throughout the coronavirus disease 2019 (COVID-19) pandemic, countries have relied on a variety of ad hoc border control protocols to allow for non-essential travel while safeguarding public health, from quarantining all travellers to restricting entry from select nations on the basis of population-level epidemiological metrics such as cases, deaths or testing positivity rates1,2. Here we report the design and performance of a reinforcement learning system, nicknamed Eva. In the summer of 2020, Eva was deployed across all Greek borders to limit the influx of asymptomatic travellers infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and to inform border policies through real-time estimates of COVID-19 prevalence. In contrast to country-wide protocols, Eva allocated Greece's limited testing resources on the basis of incoming travellers' demographic information and testing results from previous travellers. By comparing Eva's performance against modelled counterfactual scenarios, we show that Eva identified 1.85 times as many asymptomatic, infected travellers as random surveillance testing, with up to 2-4 times as many during peak travel, and 1.25-1.45 times as many asymptomatic, infected travellers as testing policies that utilize only epidemiological metrics. We demonstrate that this latter benefit arises, at least partially, because population-level epidemiological metrics had limited predictive value for the actual prevalence of SARS-CoV-2 among asymptomatic travellers and exhibited strong country-specific idiosyncrasies in the summer of 2020. Our results raise serious concerns on the effectiveness of country-agnostic internationally proposed border control policies3 that are based on population-level epidemiological metrics. Instead, our work represents a successful example of the potential of reinforcement learning and real-time data for safeguarding public health.


Assuntos
COVID-19/diagnóstico , COVID-19/prevenção & controle , Portador Sadio/diagnóstico , Portador Sadio/prevenção & controle , Aprendizado de Máquina , Medicina de Viagem , Viagem , COVID-19/epidemiologia , COVID-19/transmissão , Portador Sadio/epidemiologia , Portador Sadio/transmissão , Grécia , Humanos , Prevalência , Saúde Pública
9.
Vaccine ; 39(40): 5757-5761, 2021 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-34481698

RESUMO

BACKGROUND: Following pneumococcal conjugate vaccines (PCVs) implementation, worldwide, pneumococcal carriage rates remained stable, indicating full replacement of vaccine-serotypes (VT) with non-VT. However, data are scarce regarding PCV impact on pneumococcal carriage rates in healthy vs. sick children. We assessed pneumococcal carriage rates dynamics in healthy and sick children 6-23 months, following PCV introduction. METHODS: This is a prospective, population-based surveillance conducted during the years 2009-2017, in southern Israel. Three groups were defined as follows: Children without respiratory infection signs (the healthy/non-respiratory group); Children who had a chest radiography at the hospital (the Hosp-CXR group); and children with community-acquired alveolar pneumonia (CAAP). Rate ratios (RRs; 95% CI) were calculated, comparing between late-13-valent PCV (PCV13) period (2016-2017) and early-PCV period (2009-2010). Rate ratios were adjusted for antibiotic administration, seasonality and ethnicity, and separate calculations were performed for 6-11 and 12-23 month old children. RESULTS: Overall, 51% of 8627 nasopharyngeal cultures were positive. In 2009-2010 (early-PCV period), the overall carriage rate was 55%; serotypes included in the PCV13 carriage rates were 28%, 31% and 38% in the healthy/non-respiratory, Hosp-CXR, and CAAP groups, respectively. Overall carriage rates in healthy/non-respiratory episodes were stable (~54%) when comparing between 2016 and 17 and 2009-10 (RR = 0.98; 0.84-1.15). In contrast, rates significantly declined for Hosp-CXR (RR = 0.78; 0.63-0.98) and CAAP (RR = 0.65; 0.47-0.89). These trends were driven by ~ 80% VT reductions, coupled with non-VT increase. CONCLUSIONS: Following 7-valent PCV/ PCV13 introduction, pneumococcal carriage rates declined in respiratory diseases, but not in healthy children and children without respiratory infections. These trends suggest that a reduction in pneumococcal carriage rates during respiratory infections indicates a decline in respiratory infections caused by VT, while carriage rates in non-respiratory cases reflect non-VT predominance, that have low disease potential for respiratory disease.


Assuntos
Infecções Pneumocócicas , Portador Sadio/epidemiologia , Criança , Humanos , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas , Estudos Prospectivos , Vacinas Conjugadas
10.
APMIS ; 129(12): 711-716, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34580908

RESUMO

The pharyngeal mucosa can be colonized with bacteria that have potential to cause pharyngotonsillitis. By the use of culturing techniques and PCR, we aimed to assess the prevalence of bacterial pharyngeal pathogens among healthy adolescents and young adults. We performed a cross-sectional study in a community-based cohort of 217 healthy individuals between 16 and 25 years of age. Samples were analyzed for Group A streptococci (GAS), Group C/G streptococci (SDSE), Fusobacterium necrophorum, and Arcanobacterium haemolyticum. Compared to culturing, the PCR method resulted in more frequent detection, albeit in most cases with low levels of DNA, of GAS (20/217 vs. 5/217; p < 0.01) and F. necrophorum (20/217 vs. 8/217; p < 0.01). Culturing and PCR yielded similar rates of SDSE detection (14/217 vs. 12/217; p = 0.73). Arcanobacterium haemolyticum was rarely detected (3/217), and only by PCR. Overall, in 25.3% (55/217) of these healthy adolescents and young adults at least one of these pathogens was detected, a rate that is higher than previously described. Further studies are needed before clinical adoption of PCR-based detection methods for pharyngeal bacterial pathogens, as our findings suggest a high incidence of asymptomatic carriage among adolescents and young adults without throat infections.


Assuntos
Bactérias/isolamento & purificação , Portador Sadio/epidemiologia , Faringe/microbiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Fusobacterium necrophorum/isolamento & purificação , Humanos , Masculino , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , Streptococcus pyogenes/isolamento & purificação , Adulto Jovem
11.
J Pak Med Assoc ; 71(8): 2069-2072, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34418032

RESUMO

We aimed to detect typhoid carriers by performing duodenal fluid culture in patients in a tertiary care hospital in Pakistan. A cross-sectional study was conducted during 2017 at the Aga Khan University Hospital, Karachi. Patients who underwent upper gastrointestinal endoscopy were included. Participants were interviewed, and duodenal fluid samples were taken for culture to detect Salmonella typhi (S. typhi) and paratyphi. A polymerase chain reaction on 100 randomly selected sub-samples was also conducted. A total of 477 participants were enrolled. The mean age was 42.4±15.5 years. History of typhoid fever was present in 73 (15.3%) participants. Out of the 477 duodenal fluid cultures tested for various micro-organisms, 250 (52.4%) were positive. Neither S. typhi nor paratyphi were isolated. S. typhi was also not detected by PCR. To better detect S. typhi carriage in general population, future studies should target people with gall bladder diseases and screen them using culture and PCR based methods.


Assuntos
Febre Tifoide , Adulto , Portador Sadio/diagnóstico , Portador Sadio/epidemiologia , Estudos Transversais , Humanos , Pessoa de Meia-Idade , Salmonella typhi , Centros de Atenção Terciária , Febre Tifoide/diagnóstico , Febre Tifoide/epidemiologia
12.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(8): 973-977, 2021 Aug 06.
Artigo em Chinês | MEDLINE | ID: mdl-34445835

RESUMO

Objective: To analyze the carriage characteristics of Neisseria meningitidis (Nm) among healthy population of epidemic cerebrospinal meningitis in Shandong province. Methods: From April 2008 to April 2020, a total of 16 848 healthy population were recruited from Lixia District of Jinan City, Gaomi City of Weifang City, Jiaxiang County of Jining City, Wendeng District of Weihai City, Tancheng County of Linyi City and Linyi County of Dezhou City for the investigation.Throat swab samples were collected, Nm was isolated, cultured and identified, and Nm carrying characteristics of healthy population with different characteristics were analyzed. Results: Among the 16 848 healthy population, male accounted for 51.86% (8 737). A total of 136 Nm strains were isolated, and the carriage rate was 0.81%. Among the 136 Nm strains, serogroup B (60.29%) and ungroupable strains (23.53%) were dominant. Analysis of the Nm carriage rate, that were higher in the healthy population of Linyi (1.39%) and Jinan (1.14%), higher in 13-16 years old (1.60%) and 17-19 years old (1.10%) healthy population, and higher in male (1.02%). Conclusion: The Nm carriage rate of healthy population is relatively low in Shandong Province, and the proportion of serogroup B and ungroupable Nm is relatively high.


Assuntos
Meningite Meningocócica , Neisseria meningitidis , Adolescente , Portador Sadio/epidemiologia , Cidades , Nível de Saúde , Humanos , Masculino , Meningite Meningocócica/epidemiologia , Sorogrupo
13.
Vaccine ; 39(38): 5401-5409, 2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34384633

RESUMO

BACKGROUND: Papua New Guinea (PNG) introduced the 13-valent pneumococcal conjugate vaccine (PCV13) in 2014, with administration at 1, 2, and 3 months of age. PCV13 has reduced or eliminated carriage of vaccine types in populations with low pneumococcal carriage prevalence, carriage density and serotype diversity. This study investigated PCV13 impact on serotype-specific pneumococcal carriage prevalence, density, and serotype diversity in PNG infants, who have some of the highest reported rates of pneumococcal carriage and disease in the world. METHODS: Nasopharyngeal swabs were collected at 1, 4 and 9 months of age from PCV13-vaccinated infants (n = 57) and age-/season-matched, unvaccinated infants (at approximately 1 month, n = 53; 4 months, n = 57; 9 months, n = 52). Serotype-specific pneumococcal carriage density and antimicrobial resistance genes were identified by qPCR and microarray. RESULTS: Pneumococci were present in 89% of swabs, with 60 different serotypes and four non-encapsulated variants detected. Multiple serotype carriage was common (47% of swabs). Vaccine type carriage prevalence was similar between PCV13-vaccinated and unvaccinated infants at 4 and 9 months of age. The prevalence of non-vaccine type carriage was also similar between cohorts, with non-vaccine types present in three-quarters of samples (from both vaccinated and unvaccinated infants) by 4 months of age. The median pneumococcal carriage density was high and similar at each age group (~7.0 log10genome equivalents/mL). PCV13 had no effect on overall pneumococcal carriage density, vaccine type density, non-vaccine type density, or the prevalence of antimicrobial resistance genes. CONCLUSION: PNG infants experience dense and diverse pneumococcal colonisation with concurrent serotypes from 1 month of age. PCV13 had no impact on pneumococcal carriage density, even for vaccine serotypes. The low prevalence of vaccine serotypes, high pneumococcal carriage density and abundance of non-vaccine serotypes likely contribute to the lack of PCV13 impact on carriage in PNG infants. Indirect effects of the infant PCV programs are likely to be limited in PNG. Alternative vaccines with broader coverage should be considered.


Assuntos
Infecções Pneumocócicas , Portador Sadio/epidemiologia , Estudos Transversais , Humanos , Lactente , Nasofaringe , Papua Nova Guiné/epidemiologia , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Vacinação
14.
BMC Infect Dis ; 21(1): 661, 2021 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-34233627

RESUMO

BACKGROUND: Pneumococcal vaccine immunizations may be responsible for alterations in serotype epidemiology within a region. This study investigated the pneumococcal carriage prevalence and the impact of the 13-valent pneumococcal conjugate vaccine (PCV-13) on circulating serotypes among healthy children in Northern Ghana. METHODS: This was a cross sectional study conducted in the Kassena-Nankana districts of Northern Ghana from November to December during the dry season of 2018. Nasopharyngeal swabs collected from 193 participants were cultured per standard microbiological protocols and pneumococcal isolates were serotyped using the latex agglutination technique and the capsular Quellung reaction test. We examined for any association between the demographic characteristics of study participants and pneumococcal carriage using chi-square test and logistic regression. RESULTS: Of the 193 participants that were enrolled the mean age was 8.6 years and 54.4% were females. The carriage rate among the participants was 32.6% (63/193), and twenty different serotypes were identified. These included both vaccine serotypes (VT), 35% (7/20) and non-vaccine serotypes (NVT), 65% (13/20). The predominant serotypes (34 and 11A), both of which were NVT, accounted for a prevalence of 12.8%. PCV-13 covered only 35% of serotypes identified whiles 40% of serotypes are covered by PPV 23. CONCLUSION: Post-vaccination carriage of S. pneumoniae is high and is dominated by non-vaccine serotypes. There is therefore a need for the conduct of invasive pneumococcal disease surveillance (IPD) to find out if the high non-vaccine serotype carriage translates to disease. And in addition, a review of the currently used PCV-13 vaccine in the country would be considered relevant.


Assuntos
Portador Sadio/epidemiologia , Nasofaringe/microbiologia , Infecções Pneumocócicas/diagnóstico , Vacinas Pneumocócicas/administração & dosagem , Streptococcus pneumoniae/isolamento & purificação , Portador Sadio/microbiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Lactente , Testes de Fixação do Látex , Masculino , Infecções Pneumocócicas/epidemiologia , Vacinas Pneumocócicas/imunologia , Prevalência , Sorogrupo , Streptococcus pneumoniae/imunologia , Vacinação
15.
Nat Commun ; 12(1): 4169, 2021 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-34234124

RESUMO

Reports of P. vivax infections among Duffy-negative hosts have accumulated throughout sub-Saharan Africa. Despite this growing body of evidence, no nationally representative epidemiological surveys of P. vivax in sub-Saharan Africa have been performed. To overcome this gap in knowledge, we screened over 17,000 adults in the Democratic Republic of the Congo (DRC) for P. vivax using samples from the 2013-2014 Demographic Health Survey. Overall, we found a 2.97% (95% CI: 2.28%, 3.65%) prevalence of P. vivax infections across the DRC. Infections were associated with few risk-factors and demonstrated a relatively flat distribution of prevalence across space with focal regions of relatively higher prevalence in the north and northeast. Mitochondrial genomes suggested that DRC P. vivax were distinct from circulating non-human ape strains and an ancestral European P. vivax strain, and instead may be part of a separate contemporary clade. Our findings suggest P. vivax is diffusely spread across the DRC at a low prevalence, which may be associated with long-term carriage of low parasitemia, frequent relapses, or a general pool of infections with limited forward propagation.


Assuntos
Portador Sadio/epidemiologia , Malária Vivax/epidemiologia , Parasitemia/epidemiologia , Plasmodium vivax/isolamento & purificação , Adolescente , Adulto , Fatores Etários , Portador Sadio/diagnóstico , Portador Sadio/parasitologia , Estudos Transversais , República Democrática do Congo/epidemiologia , Feminino , Humanos , Malária Vivax/diagnóstico , Malária Vivax/parasitologia , Masculino , Programas de Rastreamento/estatística & dados numéricos , Parasitemia/parasitologia , Prevalência , Fatores de Risco , Adulto Jovem
16.
J Infect ; 83(3): 332-338, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34303737

RESUMO

OBJECTIVES: Previous studies have been unable to identify patient or staff reservoirs for the majority of the nosocomial S. aureus acquisitions which occur in the presence of good infection control practice. We set out to establish the extent to which undetected pre-existing carriage explains apparent nosocomial S. aureus acquisition. METHODS: Over two years elective cardiothoracic admissions were screened for S. aureus carriage before and during hospital admission. Routine screening (nose/groin/wound sampling), was supplemented by sampling additional body sites (axilla/throat/rectum) and culture-based methods optimised to detect fastidious phenotypes (small colony variants, cell wall deficient variants) and molecular identification by PCR. RESULTS: 35% of participants (53/151) were S. aureus carriers according to routine pre-healthcare screening; increasing to 42% (63/151) when additional body sites and enhanced cultures were employed. 71% (5/7) of apparent acquisitions were explained by pre-existing carriage using augmented measures. Enhanced culture identified a minority of colonised individuals (3/151 including 1 MRSA carrier) who were undetected by routine and additional screening cultures. 4/14 (29%) participants who became culture-negative during admission had S. aureus genomic material detected at discharge. CONCLUSIONS: Conventional sampling under-estimates carriage of S. aureus and this explains the majority of apparent S. aureus acquisitions among elective cardiothoracic patients.


Assuntos
Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas , Portador Sadio/diagnóstico , Portador Sadio/epidemiologia , Atenção à Saúde , Humanos , Nariz , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/genética
17.
PLoS One ; 16(7): e0253781, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34242263

RESUMO

BACKGROUND: Up to 15% of deaths of people living with HIV is attributable to meningeal cryptococcosis, with nearly 75% occuring in sub-Saharan Africa. Although rare in children, it is a major cause of morbidity and mortality in people living with HIV. A strong association between cryptococcal antigenemia and the development of meningeal cryptococcosis has been shown in adults. Thus, in 2018, the World Health Organization published an updated version of its guidelines for the diagnosis, prevention and management of cryptococcal infection in adults, adolescents and the HIV-infected child. GOAL: To determine the prevalence of cryptococcal antigenemia and to identify its determinants in children infected with HIV. METHODS: An analytical cross-sectional study was carried out at the approved treatment center of Laquintinie hospital in Douala over a period of 4 months. Children were recruited consecutively after informed parental consent. Cryptococcal antigenemia and CD4 assay were performed using a Cryptops® immunochromatographic rapid diagnostic test and flow cytometry, respectively. The data collected included the socio-demographic, clinical and paraclinical variables of the children, as well as their antecedents. Data analysis was performed using Epiinfo software version 3.1 and SPSS 21.0. The significance threshold was set at 5%. RESULTS: A total of 147 children were enrolled. The mean age was 9.8 ± 4.09 years. The majority were on antiretroviral therapy (142, 96.60%). Only 13 (8.80%) were in severe immunosuppression. No child showed signs of meningeal cryptococcosis. The prevalence of cryptococcal antigenemia was 6.12%. Severe immunosuppression [OR: 10.03 (1.52-65.91), p = 0.016] and contact with pigeons [OR: 9.76 (1.14-83.65), p = 0.037] were independent factors significantly associated with the carriage of the cryptococcal antigen. CONCLUSION: We recommend screening for cryptococcal antigenemia and routine treatment with fluconazole of all HIV positive children with cryptococcal antigen whether symptomatic or not.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Antígenos de Fungos/sangue , Portador Sadio/epidemiologia , Criptococose/epidemiologia , Cryptococcus/isolamento & purificação , Infecções Oportunistas Relacionadas com a AIDS/sangue , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Adolescente , Antígenos de Fungos/imunologia , Camarões/epidemiologia , Portador Sadio/sangue , Portador Sadio/imunologia , Portador Sadio/microbiologia , Criança , Pré-Escolar , Estudos Transversais , Criptococose/sangue , Criptococose/imunologia , Criptococose/microbiologia , Cryptococcus/imunologia , Feminino , Humanos , Lactente , Masculino , Prevalência
18.
J Pak Med Assoc ; 71(5): 1472-1475, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34091637

RESUMO

Healthcare workers (HCWs) with MRSA nasal colonisation pose a serious threat of passing on the infection to patients. A cross sectional study was designed to investigate the effect of ablution on MRSA nasal colonisation and was conducted at the Department of Pathology, King Edward Medical University. A total of 220 nasal swab samples, 110 from ablution performing HCWs and 110 from non-ablution performing HCWs were processed for the identification of Staphylococcus aureus and sensitivity testing for Cefoxitin. In the ablution performing group, 11(10%) HCW were harbouring Staphylococcus aureus in their nose, while in non-ablution performing group 32 (29%) HCWs had colonisation of Staphylococcus aureus. Frequency of MRSA colonised HCWs was 9/11 (82%) in ablution performing group, while in the non-ablution group 16/32 (55%) had MRSA in their nose. Logistic regression analysis demonstrated that the duration of working experience and non-performance of ablution are the potential risk factors.


Assuntos
Staphylococcus aureus Resistente à Meticilina , Portador Sadio/epidemiologia , Estudos Transversais , Pessoal de Saúde , Humanos , Prevalência
19.
Artigo em Inglês | MEDLINE | ID: mdl-34147408

RESUMO

INTRODUCTION: Due to its high transmissibility, measures aimed at reducing the spread of SARS CoV2 have become mandatory. Different organizations have recommended performing polymerase chain reaction tests (PCR) as part of the preoperative screening of surgical patients. We aimed to determine the performance of PCR testing to detect asymptomatic carriers. METHODS: Observational study carried out at a tertiary care center. We compared the results of preoperative real-time reverse-transcription-PCR test (RT-PCR) performed on a cohort of patients pending surgery with the results we would have expected assuming the epidemiological data released by government offices. RESULTS: We registered no positives in the 2,722 preoperative RT-PCR tests performed in our health care area between epidemiological Weeks 18 to 21, meaning a cumulative incidence trending to zero. Assuming public epidemiological data, the probabilistic projection of potential asymptomatic individuals ranged from 0.27 × 10e-4 (according to official data of new cases diagnosed by PCR) to 4.69 × 10e-4 if we assumed cases confirmed by IgG test in our province. Assuming a RT-PCR sensitivity of 95%, to obtain a positive result we should perform 38,461 and 2,028 tests respectively. CONCLUSIONS: In scenarios of very low prevalence and despite high sensitivity scores, indiscriminate preoperative RT-PCR screening is of a questionable effectiveness for detecting asymptomatic carriers. Our findings evidence the difficulty of establishing reliable predictive models for the episodic and rapidly evolving incidence of infections such as has characterized the SARS CoV2 pandemic.


Assuntos
Teste de Ácido Nucleico para COVID-19 , COVID-19/diagnóstico , Portador Sadio/diagnóstico , Pandemias , Cuidados Pré-Operatórios , SARS-CoV-2 , COVID-19/epidemiologia , Teste de Ácido Nucleico para COVID-19/estatística & dados numéricos , Portador Sadio/epidemiologia , Humanos , Incidência , Prevalência , Estudos Retrospectivos , Espanha/epidemiologia
20.
BMJ Open ; 11(6): e050312, 2021 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-34140345

RESUMO

INTRODUCTION: Streptococcus pneumoniae (the pneumococcus) is commonly carried as a commensal bacterium in the nasopharynx but can cause life-threatening disease. Transmission occurs by human respiratory droplets and interruption of this process provides herd immunity. A 2017 WHO Consultation on Optimisation of pneumococcal conjugate vaccines (PCV) Impact highlighted a substantial research gap in investigating why the impact of PCV vaccines in low-income countries has been lower than expected. Malawi introduced the 13-valent PCV (PCV13) into the national Expanded Programme of Immunisations in 2011, using a 3+0 (3 primary +0 booster doses) schedule. With evidence of greater impact of a 2+1 (2 primary +1 booster dose) schedule in other settings, including South Africa, Malawi's National Immunisations Technical Advisory Group is seeking evidence of adequate superiority of a 2+1 schedule to inform vaccine policy. METHODS: A pragmatic health centre-based evaluation comparing impact of a PCV13 schedule change from 3+0 to 2+1 in Blantyre district, Malawi. Twenty government health centres will be randomly selected, with ten implementing a 2+1 and 10 to continue with the 3+0 schedule. Health centres implementing 3+0 will serve as the direct comparator in evaluating 2+1 providing superior direct and indirect protection against pneumococcal carriage. Pneumococcal carriage surveys will evaluate carriage prevalence among children 15-24 months, randomised at household level, and schoolgoers 5-10 years of age, randomly selected from school registers. Carriage surveys will be conducted 18 and 33 months following 2+1 implementation. ANALYSIS: The primary endpoint is powered to detect an effect size of 50% reduction in vaccine serotype (VT) carriage among vaccinated children 15-24 months old, expecting a 14% and 7% VT carriage prevalence in the 3+0 and 2+1 arms, respectively. ETHICS AND DISSEMINATION: The study has been approved by the Malawi College of Medicine Research Ethics Committee (COMREC; Ref: P05.19.2680), the University College London Research Ethics Committee (Ref: 8603.002) and the University of Liverpool Research Ethics Committee (Ref: 5439). The results from this study will be actively disseminated through manuscript publications and conference presentations. TRIAL REGISTRATION NUMBER: NCT04078997.


Assuntos
Infecções Pneumocócicas , Streptococcus pneumoniae , Portador Sadio/epidemiologia , Criança , Pré-Escolar , Efeitos Psicossociais da Doença , Humanos , Lactente , Londres , Malaui/epidemiologia , Nasofaringe , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas , África do Sul , Vacinas Conjugadas
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