Infectious Disease Commons^™

Determinants Of Immunization In Polio Super High-Risk Union Councils Of Pakistan, Ahmad Khan, Imtiaz Hussain, Dale A. Rhoda, Muhammad Umer, Uzair Ansari, Imran Ahmed, Caitlin Clary, Rana Muhammad Safdar, Sajid Bashir Soofi

Centre of Excellence in Women and Child Health

Background: The current polio epidemiology in Pakistan poses a unique challenge for global eradication as the country is affected by ongoing endemic poliovirus transmission. Across the country, 40 union councils (UCs) which serve as core reservoirs for poliovirus with continuous incidences of polio cases are categorized as super-high-risk union councils (SHRUCs).
Methodology: A cross-sectional survey was conducted in 39 SHRUCs using a two-stage stratified cluster sampling technique. 6,976 children aged 12-23 months were covered. A structured questionnaire was used for data collection. Data were analyzed using STATA version 17.
Results: Based on both vaccination records and recall, 48.3% of children …

Association Of Chlamydia Trachomatis Burden With The Vaginal Microbiota, Bacterial Vaginosis, And Metronidazole Treatment, Caleb M. Ardizzone, Christopher M. Taylor, Evelyn Toh, Rebecca A. Lillis, Jacob H. Elnaggar, John W. Lammons, Patricia Dehon Mott, Emily L. Duffy, Li Shen, Alison J. Quayle

School of Graduate Studies Faculty Publications

Bacterial vaginosis (BV), a dysbiosis of the vaginal microbiota, is a common coinfection with Chlamydia trachomatis (Ct), and BV-associated bacteria (BVAB) and their products have been implicated in aiding Ct evade natural immunity. Here, we determined if a non-optimal vaginal microbiota was associated with a higher genital Ct burden and if metronidazole, a standard treatment for BV, would reduce Ct burden or aid in natural clearance of Ct infection. Cervicovaginal samples were collected from women at enrollment and, if testing positive for Ct infection, at a follow-up visit approximately one week later. Cervical Ct burden was assessed by inclusion forming …

Feasibility, Enablers And Challenges Of Using Timeliness Metrics For Household Contact Tracing And Tb Preventive Therapy In Pakistan, Bushra Jamil, Divya Nair, Pruthu Thekkur, Neelofar Laeeq, Anum Adil, Mohammed Khogali, Rony Zachariah, Selma Dar Berger, Srinath Satyanarayana, Ajay M V Kumar

Department of Medicine

Introduction: Screening household contacts of TB patients and providing TB preventive therapy (TPT) is a key intervention to end the TB epidemic. Global and timely implementation of TPT in household contacts, however, is dismal. We adapted the 7-1-7 timeliness metric designed to evaluate and respond to infectious disease outbreaks or pandemics, and assessed the feasibility, enablers and challenges of implementing this metric for screening and management of household contacts of index patients with bacteriologically-confirmed pulmonary TB in Karachi city, Pakistan.
Methods: We conducted an explanatory mixed methods study with a quantitative component (cohort design) followed by a qualitative component (descriptive …

Sexually Transmitted Infection Prevention Perspectives In Black Men Who Have Sex With Men Taking Preexposure Prophylaxis In New Orleans, Meredith E. Clement, Jeremy Beckford, Aish Lovett, Julia Siren, Marie Adorno, Sara Legrand, Marsha Bennett, Jamilah Taylor, Emily Hanlen-Rosado, Brian Perry, Amy Corneli

School of Medicine Faculty Publications

INTRODUCTION: Profound sexual health disparities exist for Black men who have sex with men (MSM) in the US South, including a high prevalence of sexually transmitted infections (STIs). Sexually transmitted infection prevention strategies beyond condoms are needed for Black MSM taking preexposure prophylaxis (PrEP). METHODS: We conducted in-depth interviews with Black MSM taking PrEP in New Orleans, Louisiana. Informed by the Health Belief Model, we asked about participants' perceived susceptibility, severity, and concerns regarding STIs, and perceived benefits of STI prevention. We also asked about willingness to use various STI prevention strategies, including antibiotic prophylaxis. Interviews were audio-recorded and analyzed …

Social Determinants Of Health, Telehealth, And Hiv/Aids: Implications For Public Health Research And Practice In The State Of Virginia, Sonal S. Sathe, Adati Tarfa

Virginia Journal of Public Health

Purpose: The purpose of this commentary is to assert the importance of addressing the social determinants of health to support HIV/AIDS control efforts, to describe the importance of telehealth in HIV/AIDS control, and to recommend courses of action to support HIV/AIDS control efforts within the state of Virginia.

Discussion: We provide an overview of the social determinants of health and their role in HIV/AIDS control, telehealth and its uptake within the HIV/AIDS community, and issues in Virginia facing HIV/AIDS control.

Conclusion and Recommendations: We conclude that addressing social determinants of health, especially stigma, is an important measure of HIV/AIDS control …

Covid-19 Breakthrough Infections In Type 1 Diabetes Mellitus: A Cross-Sectional Study By The Covid-19 Vaccination In Autoimmune Diseases (Covad) Group, Suhrud Panchawagh, Naveen Ravichandran, Bhupen Barman, Arvind Nune, Mahnoor Javaid, Abraham Edgar Gracia-Ramos, Jessica Day, Mrudula Joshi, Masataka Kuwana, Sreoshy Saha

Medical College Documents

To investigate the frequency, profile, and severity of COVID-19 breakthrough infections (BI) in patients with type I diabetes mellitus (T1DM) compared to healthy controls (HC) after vaccination. The second COVID-19 Vaccination in Autoimmune Diseases (COVAD-2) survey is a multinational cross-sectional electronic survey which has collected data on patients suffering from various autoimmune diseases including T1DM. We performed a subgroup analysis on this cohort to investigate COVID-19 BI characteristics in patients with T1DM. Logistic regression with propensity score matching analysis was performed. A total of 9595 individuals were included in the analysis, with 100 patients having T1DM. Among the fully vaccinated …

The Modified Clinical Progression Scale For Pediatric Patients: Evaluation As A Severity Metric And Outcome Measure In Severe Acute Viral Respiratory Illness., Shannon B. Leland, Steven J. Staffa, Margaret M. Newhams, Robinder G. Khemani, John C. Marshall, Cameron C. Young, Aline B. Maddux, Mark W. Hall, Scott L. Weiss, Adam J. Schwarz, Bria M. Coates, Ronald C. Sanders, Michele Kong, Neal J. Thomas, Ryan A. Nofziger, Melissa L. Cullimore, Natasha B. Halasa, Laura L. Loftis, Natalie Z. Cvijanovich, Jennifer E. Schuster, Heidi Flori, Shira J. Gertz, Janet R. Hume, Samantha M. Olson, Manish M. Patel, David Zurakowski, Adrienne G. Randolph, Pediatric Acute Lung And Sepsis Investigator’S Network Pediatric Intensive Care Influenza Study Group (Palisi Picflu) Investigators And Overcoming Covid-19 Investigators

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To develop, evaluate, and explore the use of a pediatric ordinal score as a potential clinical trial outcome metric in children hospitalized with acute hypoxic respiratory failure caused by viral respiratory infections.

DESIGN: We modified the World Health Organization Clinical Progression Scale for pediatric patients (CPS-Ped) and assigned CPS-Ped at admission, days 2-4, 7, and 14. We identified predictors of clinical improvement (day 14 CPS-Ped ≤ 2 or a three-point decrease) using competing risks regression and compared clinical improvement to hospital length of stay (LOS) and ventilator-free days. We estimated sample sizes (80% power) to detect a 15% clinical …

Surgical Site Infections Post Cesarean Section And Associated Risk Factors: A Retrospective Case-Control Study At A Tertiary Hospital In Kenya, David Odada, Jasmit Shah, Annastacia Mbithi, Reena Shah

Internal Medicine, East Africa

Background: Surgical site infection is a common healthcare-associated infection that affects maternal health, yet it can be prevented or controlled. Caesarian sections are most likely to develop surgical site infections. The rates of delivery by caesarian section in reported to be higher that the acceptable rates in some healthcare facilities. Risk factors for surgical site infections can be identified and modified to reduce the occurrence of surgical site infections. This study aims to determine the risk factors that contribute to surgical site infections post caesarian section in a tertiary teaching hospital in Kenya.

Methods: This was a retrospective …

Morphological And Metabolic Criteria Of Covid-19 Vaccine Associated Axillary Nodes On 18-Fluorodeouxyglucose Pet/Ct Imaging In Breast Cancer Patients, Nosheen Fatima, Unaiza Zaman, Areeba Zaman, Sidra Zaman, Rabia Tehseen, Maseeh Uz Zaman

Department of Radiology

Background: In the current era vaccine-associated lymphadenopathy (VAL) is not an uncommon presentation on 18F-FDG PET/CT examinations in patients inoculated with Coronavirus disease 2019 (COVID-19) vaccination. In this study, we are presenting data of VAL on 18F-FDG PET/CT regarding its prevalence, temporal response to vaccination and imaging characteristics of VAL.
Methods: Seventy-eight (78) consecutive vaccinated breast cancer (BC) patients who had 18FDG PET/CT were retrospectively analyzed. All patients had COVID-19 vaccine shots in contralateral arms and none in breast cancer site axilla (BSA). In 35 patients 18FDG avid nodes were found in vaccine site axilla (VSA). In 25 patients 18FDG …

Sars-Cov-2 Epidemiology And Covid-19 Mrna Vaccine Effectiveness Among Infants And Children Aged 6 Months-4 Years - New Vaccine Surveillance Network, United States, July 2022-September 2023., Ayzsa Tannis, Janet A. Englund, Ariana Perez, Elizabeth J. Harker, Mary Allen Staat, Elizabeth P. Schlaudecker, Natasha B. Halasa, Laura S. Stewart, John V. Williams, Marian G. Michaels, Rangaraj Selvarangan, Jennifer E. Schuster, Leila C. Sahni, Julie A. Boom, Geoffrey A. Weinberg, Peter G. Szilagyi, Benjamin R. Clopper, Yingtao Zhou, Meredith L. Mcmorrow, Eileen J. Klein, Heidi L. Moline

Manuscripts, Articles, Book Chapters and Other Papers

SARS-CoV-2 infection in young children is often mild or asymptomatic; however, some children are at risk for severe disease. Data describing the protective effectiveness of COVID-19 mRNA vaccines against COVID-19-associated emergency department (ED) visits and hospitalization in this population are limited. Data from the New Vaccine Surveillance Network, a prospective population-based surveillance system, were used to estimate vaccine effectiveness using a test-negative, case-control design and describe the epidemiology of SARS-CoV-2 in infants and children aged 6 months-4 years during July 1, 2022-September 30, 2023. Among 7,434 children included, 5% received a positive SARS-CoV-2 test result, and 95% received a negative …

Re: Incidence Of Sars-Cov-2 Breakthrough Infections After Vaccination In Adults: A Population-Based Survey Through 1 March 2023, Stacia M Desantis, Ashraf Yaseen, Tianyao Hao, Luis León-Novelo, Yashar Talebi, Melissa A Valerio-Shewmaker, Cesar L Pinzon Gomez, Sarah E Messiah, Harold W Kohl, Steven H Kelder, Jessica A Ross, Lindsay N Padilla, Mark Silberman, Samantha Wylie, David Lakey, Jennifer A Shuford, Stephen J Pont, Eric Boerwinkle, Michael D Swartz

Journal Articles

No abstract provided.

Substitution Spectra Of Sars-Cov-2 Genome From Pakistan Reveals Insights Into The Evolution Of Variants Across The Pandemic, Javaria Ashraf, Sayed Ali Raza Bukhari, Akber Kanji, Tulaib Iqbal, Maliha Yameen, Waqasuddin Khan, Zahra Hasan

Department of Pathology and Laboratory Medicine

Changing morbidity and mortality due to COVID-19 across the pandemic has been linked with factors such as the emergence of SARS-CoV-2 variants and vaccination. Mutations in the Spike glycoprotein enhanced viral transmission and virulence. We investigated whether SARS-CoV-2 mutation rates and entropy were associated COVID-19 in Pakistan, before and after the introduction of vaccinations. We analyzed 1,705 SARS-CoV-2 genomes using the Augur phylogenetic pipeline. Substitution rates and entropy across the genome, and in the Spike glycoprotein were compared between 2020, 2021 and 2022 (as periods A, B and C). Mortality was greatest in B whilst cases were highest during C. …

Isolated Small Airways Obstruction Predicts Future Chronic Airflow Obstruction: A Multinational Longitudinal Study, Ben Knox Brown, James Potts, Valentina Quintero Santofimio, Cosetta Minelli, Jaymini Patel, Peter Gj Burney, Andre Fs Amaral, Najlaa Mohammed Abass, Dhiraj Agarwal, Asaad A. Nafees

Community Health Sciences

Background: Chronic airflow obstruction is a key characteristic of chronic obstructive pulmonary disease. We investigated whether isolated small airways obstruction is associated with chronic airflow obstruction later in life.
Methods: We used longitudinal data from 3957 participants of the multinational Burden of Obstructive Lung Disease study. We defined isolated small airways obstruction using the prebronchodilator mean forced expiratory flow rate between 25% and 75% of the forced vital capacity (FVC) (FEF25-75) if a result was less than the lower limit of normal.
Results: Median follow-up time was 8.3 years. Chronic airflow obstruction was more likely to develop in participants with …

The Implications Of Ferroptosis In Antibiotic Resistance, Marysol Hohl

Senior Honors Theses

Bacterial infections in the United States are becoming increasingly resistant to existing antibiotic treatments. Due to projected increases in resistance and the recent decrease in novel antibacterials, experts have determined that the United States is in the “post-antibiotic era.” The scientific community has failed to resolve resistance despite the continual discovery of new antibiotic compounds. In the past decade, a novel form of cell death called ferroptosis has been implicated in antibiotic treatment by employing the use of nanotechnology. This literature review will describe the problem of bacterial resistance and demonstrate how current research is pioneering a new age of …

Pharmacokinetics And Safety Of A Single Dose Of Telavancin In Pediatric Subjects 2-17 Years Of Age., John S. Bradley, Jennifer Goldman, Laura P. James, Byron Kaelin, Breanne H Y Gibson, Antonio Arrieta

Manuscripts, Articles, Book Chapters and Other Papers

Antimicrobial resistance increases infection morbidity in both adults and children, necessitating the development of new therapeutic options. Telavancin, an antibiotic approved in the United States for certain bacterial infections in adults, has not been examined in pediatric patients. The objectives of this study were to evaluate the short-term safety and pharmacokinetics (PK) of a single intravenous infusion of telavancin in pediatric patients. Single-dose safety and PK of 10 mg/kg telavancin was investigated in pediatric subjects >12 months to ≤17 years of age with known or suspected bacterial infection. Plasma was collected up to 24-h post-infusion and analyzed for concentrations of …

Frequency Of Dysnatremia In Patients Admitted With Covid-19 Infection And Its Prognostic Implication, Farah Gul Khan, Saadia Sattar, Muhammad M. Yaqoob, Nida Vallani, Maryam Asad

Section of Nephrology

Objective: We aimed to investigate the frequency of dysnatremia among patients admitted with COVID-19 infection and its association with inpatient mortality.
Methods: This retrospective longitudinal study was conducted for 12 weeks. Serum sodium levels were recorded at admission, during the hospital stay, and within 48 hours of discharge or death. Logistic regression was used to determine the predictors of mortality.
Results: This study included 574 patients (69.7% men, age 55.6 ± 14.4 years). On admission, mean sodium was 135.9 ± 6.4 mEq/L; 39% had hyponatremia and 4.7% had hypernatremia. During admission, hypernatremia increased to 18.8%; maximum sodium in patients who …

Building Up A Genomic Surveillance Platform For Sars-Cov-2 In The Middle Of A Pandemic: A True North-South Collaboration, Waqasuddin Khan, Furqan Kabir, Samiah Kanwar, Fatima Aziz, Sahrish Muneer, Adil Kalam, Mehdia Ali, Nadia Ansari, Fyezah Jehan, Muhammad Imran Nisar

Department of Paediatrics and Child Health

Next-generation sequencing technology has revolutionised pathogen surveillance over the last two decades. However, the benefits are not equitably distributed, with developing countries lagging far behind in acquiring the required technology and analytical capacity. Recent declines in the cost associated with sequencing-equipment and running consumables have created an opportunity for broader adoption. During the COVID-19 pandemic, rapid diagnostics development and DNA sequencing revolutionised the ability to diagnose and sequence SARS-CoV-2 rapidly. Socioeconomic inequalities substantially impact the ability to sequence SARS-CoV-2 strains and undermine a developing country's pandemic preparedness. Low- and middle-income countries face additional challenges in establishing, maintaining and expanding genomic …

Prevalence Of Comorbidities And Survival Analysis Of Covid-19 Patients – An Observational Study From A Tertiary Healthcare Center In North West Romania, Mihaela Simona Popoviciu, Lorena Paduraru, Roxana Adriana Stoica, Anca Pantea Stoian, Claudiu Teodorescu, Simona Cavalu

Journal of Mind and Medical Sciences

Objectives. The experience accumulated in the last two years shows that the prevention of COVID-19 in people with comorbidities (protective measures, vaccination, etc.) still remains a public health priority. In this context, the aim of our study was to perform a retrospective, observational study in order to assess the time-to-death and risk factors of mortality among COVID-19 patients. Materials and Methods. The study was conducted on 177 patients admitted to Oradea Emergency County Hospital, Bihor, Romania, between October and December 2021. Inclusion criteria were patients over 18 years positive for COVID-19 in upper respiratory tract samples using real-time PCR test. …

Best Therapeutic Practices In The Management Of Obstetric Sepsis, Gabriel Petre Gorecki, Oana Denisa Balalau, Diana Elena Comandasu, Anca Daniela Stanescu, Dana Rodica Tomescu

Journal of Mind and Medical Sciences

Background. Physiological changes that occur during pregnancy make maternal sepsis a difficult condition to diagnose and treat, still having a fairly high mortality rate. Consequently, an early diagnosis and prompt therapeutic management of sepsis can significantly decrease mortality. The purpose of this study is to review literature data that present current practices in the management of obstetric sepsis. Methods. To collect the data required for the study, we performed a search of published articles in the PubMed and Google Scholar databases related to obstetric sepsis. Research paper articles from the period 2012-2022 were included in the analysis. In addition, 145 …

From Covid-19 To Long Covid; The Forms Of The Neurological Manifestations, Sana Ahuja, Sufian Zaheer

Journal of Mind and Medical Sciences

Ever since the SARS-CoV-2 infection was declared a global pandemic in 2020, numerous multisystemic manifestations have been discovered. The COVID-19 is known to cause a wide spectrum of neurological symptoms like fatigue, headache, brain fog, stroke, smell and taste disorders, encephalopathy and neurodegenerative disorders. The neurological manifestations are more prevalent in the post-COVID syndrome or long COVID. The National Institute for Health and Care Excellence and WHO defined Ongoing Symptomatic COVID as 4-12 weeks post infection and post COVID-19 syndrome as persistence of symptoms beyond 12 weeks. So far there are limited data available regarding the pathophysiology of neurological symptoms …