Infectious Disease Commons^™

From A Papule To Friable Papillary Projections: A Case Of Old World Cutaneous Leishmaniasis, Zamanali Khakhar, Adil Salyani, Soraiya Manji, Rajiv Patel, Sayed Karar

Internal Medicine, East Africa

This case aims to characterize an unusual cutaneous manifestation in a patient with confirmed cutaneous leishmaniasis, highlighting clinical features that are often underrecognized and may contribute to diagnostic uncertainty. By exploring this atypical presentation, it underscores the potential for misdiagnosis and its implications for patient management. Additionally, it emphasizes the broad spectrum of cutaneous lesions that can mimic Old World cutaneous leishmaniasis, further increasing the risk of diagnostic error.

Investigating Neonatal Sepsis: Anti-Infectives, Diagnostics And Guidelines Used In Health Systems Across Sub-Saharan Africa – The Insights Study, Jack Louis Stanley, David Hettle, Rachel Poffley, Larisse Bolton, Emelyne Gres, Isabel Coelho, Raana Hussain, Gildas Boris Hedible, Gwendoline Lilly Chimhini, Valeriane Leroy

Paediatrics and Child Health, East Africa

Background Sepsis is a leading cause of neonatal mortality in sub-Saharan Africa (SSA), where microbiological diagnostic capacity and antibiotic access are limited. High antimicrobial resistance (AMR) rates limit the effectiveness of current treatment guidelines, with concern that available antibiotics are rarely adequate treatment for neonatal sepsis in the region.

Methods A cross-sectional online survey was electronically distributed in English, French and Portuguese to neonatal clinicians across SSA between April and June 2025. Questions focused on the management of neonatal sepsis including diagnostic, antibiotic and guideline use. Responses were analysed descriptively and presented as percentages of the total number of responses. …

Altered Natural Killer Cell Function In Children With Severe Malaria, Grace Turyasingura, Kagan A. Mellencamp, Ruth Namazzi, Robert Opoka, Chandy C. John, Geoffrey T. Hart

Paediatrics and Child Health, East Africa

Memory-like natural killer (NK) cells with enhanced antibody-dependent cellular cytotoxicity (ADCC) have correlated with protection from uncomplicated malaria in prior studies. However, the role of NK cells in severe malaria (SM) has not been characterized. In Ugandan sites with moderate and low malaria transmission, we evaluated NK cell (CD56bright, CD56dim, CD56neg) phenotype and ADCC function by flow cytometry in children < 5 years of age with SM (n = 21) and control community children (CC, n = 19). Children with SM had similar total NK cell counts to CC. Children with SM had a higher proportion of LILRB1+ NK cells than CC. The level of malaria transmission …

Uptake Of Covid-19 Vaccination And Associated Factors Among Patients Attending Oncology Services At The Ocean Road Cancer Institute In Dar Es Salaam, Tanzania: Insights From Mixed Design Methods’ Trajectory, David Makoko, Anthony Kapesa, Micheal Mugerwa, Mamsau Ngoma, Mark Mseti, Mary Lyimo, Lucy Kisaka, Ntuli Kapologwe, Jeremiah Seni

School of Nursing & Midwifery, East Africa

Background

COVID-19 vaccination campaigns have reduced disease severity and fatalities around the globe. Global data shows that 67.7% of the general population are vaccinated, and Tanzania has reported appealing findings of over 70% coverage among individuals over 18 years of age. However, a group-specific assessment of vaccination coverage is needed in sub-Saharan Africa. This study aimed at assessing the COVID-19 vaccination uptake and associated factors among cancer patients owing to their vulnerability.

Methods

A cross-sectional analytical study design was conducted in September 2022 at Ocean Road Cancer Institute (ORCI) in Dar es Salaam, Tanzania. A multistage sampling approach was employed …

Placental Transfer Of Sars-Cov-2 Antibodies In Mother-Neonate Pairs: A Prospective Nested Cohort Study, Alex Mugo, Angela Koech, Liberty Cantrell, Moses Mukhanya, Isaac Mwaniki, Joseph Mutunga, Merryn Voysey, Rachel Craik, Marleen Temmerman, Geoffrey Omuse

Centre of Excellence in Women and Child Health

Background: Newborns depend on the transfer of IgG across the placenta to acquire protection against pathogens. We assessed the placental transfer of SARS-CoV-2 antibodies, primarily derived from infection, from seropositive pregnant women enrolled in a pregnancy cohort in Kilifi, Kenya.

Methods :The study was nested within a prospective observational multi-country cohort study. All available paired maternal delivery and cord blood samples were selected. Maternal sera were tested for SARS-CoV-2 receptor binding domain (RBD) IgM/IgG total antibodies using the Wantai assay. For positive samples, maternal and corresponding cord blood samples were tested for SARS-CoV-2 IgG antibodies against the spike (anti-spike) and …

Supplementation With Ready-To-Use Therapeutic Food Has No Effect On Adverse Outcomes Among Undernourished Children Aged 6–59 Months With Severe Pneumonia, Damalie Nalwanga, Elisa Giallongo, Victor Musiime, Sarah Kiguli, Peter Olupot-Olupot, Florence Alaroker, Robert Opoka, Abner Tagoola, Mainga Hamaluba, Christabel Mogaka

Paediatrics and Child Health, East Africa

Objectives: To investigate the effect of supplementation with ready-to-use therapeutic food (RUTF) on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia.

Methods: This secondary analysis of the COAST-Nutrition (ISRCTN10829073) included children hospitalized for severe pneumonia in Uganda and Kenya. Undernutrition was defined as having either a weight-for-age z score, height-for-age z score, or weight-for-height/length z score below the median of the WHO reference population (< 0) or mid-upper arm circumference (MUAC) below 13.5 cm. Participants were randomized to receive 1 sachet of RUTF daily for 8 weeks in addition to the usual diet (intervention) or usual diet alone (control). The primary composite outcome for adverse events was any one of mortality, re-admission, or deterioration of nutritional status by day 90 of follow-up.

Results: Of 846 main trial participants, 741 (88%) met the inclusion criteria (intervention: 374 versus control: 367). Of 687 (93%) participants in whom the primary outcome was assessed, 370 …

Epidemiology Of Shigella Species And Serotypes In Children: A Retrospective Substudy Of The Mal-Ed Observational Birth Cohort Study, Elizabeth T. Rogawski Mcquade, Jie Liu, Mustafa Mahfuz, Alexandre Havt, Furqan Kabir, Adil Kalam, Fatima Aziz, Sahrish Muneer, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Shigellosis is a leading cause of diarrhoea in children globally. We aimed to assess the burden of specific Shigella species and Shigella flexneri serotypes, characterise their clinical syndromes and natural immunity, and evaluate their relevance as causes of diarrhoea and linear growth faltering.
Methods: In the MAL-ED birth cohort study, children younger than 17 days were enrolled from Nov 3, 2009, to Feb 29, 2012, in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, Tanzania, and South Africa and were followed up for 2 years. In this retrospective substudy, we retested Shigella quantitative PCR-positive diarrhoeal and non-diarrhoeal stool samples with molecular …

Knowledge, Attitudes, And Practices Regarding Antimicrobial Resistance And Antimicrobial Stewardship Among Healthcare Workers In Outpatient Medical Centers In Kenya: A Qualitative Study, Mary Kaniu, Wahu Gitakah, Rupali Jain, Ann Munyare, Rodney Adam, Aliza Monroe Wise

Paediatrics and Child Health, East Africa

Objective: Antimicrobial resistance (AMR) is a major global health threat with a projected 10 million deaths globally by 2050. Antimicrobial stewardship (AMS) programs are coordinated efforts involving doctors, nurses, pharmacists, and other healthcare providers. Understanding knowledge, attitudes, and practices of health providers is pivotal for implementing strategies to curb the spread of AMR. The aim of this study was to evaluate knowledge, attitudes, and practices surrounding AMR and AMS among healthcare workers in Kenya.

Design: A qualitative study using in-depth semi-structured interviews

Setting: 12 private outpatient clinics in Kenya.

Participants: Healthcare workers including administrators and clinicians. …

Estimation Of Therapeutic Threshold For Tuberculosis Using Adapted Nominal Group Technique And Clinical Vignettes In Clinical And Community Settings In Southern Africa, Alfred Kipyegon Keter, Alastair Van Heerden, Tom Decroo, Tom Boyles, Shannon Bosman, Thandanani Madonsela, Lindani Innocent Msimango, Lenika Naiken, Carlos Kiyan, Mashaete Kamele

Population Health, East Africa

Background: When confronted with diagnostic uncertainty and a decision on whether to start treatment or not, clinicians consider the potential harm and benefit of offering versus withholding treatment. Treatment can be offered if the probability of tuberculosis (TB) in the patient is above the “therapeutic threshold” (ThT): the probability of disease at which the expected utility of treating and not treating is the same. We estimated ThT for TB in clinical and community settings in Southern Africa using two methods: an adapted nominal group technique (aNGT), and decisions made based on clinical vignettes (CVs).

Methods: We enrolled health …

Seroprevalence And Associated Factors For Hepatitis B And Hepatitis C Viral Infection Among Patients With Diabetes Mellitus In Northern Tanzania, Doreen T. Eliah, Nyasatu G. Chamba, Abid M. Sadiq, Amos Mwasamwaja, Faustini C. Kimondo, Cuthbert D. Matay, Eliada B. Nziku, Tumaini E. Mirai, Ibrahim Ali Ibrahim Muhina, Fuad H. Said

Internal Medicine, East Africa

Background: The coexistence of viral hepatitis with diabetes mellitus (DM) significantly escalates the risk of severe outcomes. This study aimed to determine the seroprevalence and associated factors of hepatitis B (HBV) and hepatitis C (HCV) viral infections among DM patients in northern Tanzania.

Materials and methods: Conducted between February 2023 and May 2023, this hospital-based cross-sectional study enrolled 189 patients with DM from the Diabetic Clinic of Kilimanjaro Christian Medical Centre. A structured questionnaire captured relevant clinical information, and plasma blood sample was assessed for hepatitis B surface antigen and anti-hepatitis C antibody seropositivity. Data analysis employed SPSS v26, and …

Outcomes Of Pregnant Icu Patients With Severe Covid-19 Pneumonia In Qatar During The Three Waves Of The Covid-19 Pandemic: A Retrospective Cohort Study, Layla J.M Kily, Sohel M.G Ahmed, Tamam A.K.M Alhusban, Mohammed J. Orompurath, Marcus Lance, Mogahed I.H Hussein, Salwa M. Abuyaqoub, Huda A. Saleh, Eynas Abdalla, Santhosh Gopalakrishnan

Anaesthesiology, East Africa

Introduction: Pregnant women are considered a high-risk group for COVID-19 infection/pneumonia as they are known to be more vulnerable to viral infections. They require close monitoring and appropriate timely intervention to minimize the impact on both the mother and the fetus. Although the more prevalent Omicron variant led to fewer severe infections and fewer intensive care unit (ICU) admissions globally during the third wave, the effect on pregnant women and pregnancy outcomes was unknown. The vaccination campaign was thoroughly established by the third wave of the pandemic in Qatar. This retrospective descriptive cohort study investigates the characteristics, hospital stay, interventions, …

Antibiotics For Acute Watery Or Persistent With Or Without Bloody Diarrhoea In Children: A Systematic Review And Meta-Analysis, Syeda Kanza Naqvi, Mustafa Bin Ali Zubairi, Ayesha Arshad Ali, Ashraf Sharif, Rehana Abdus Salam, Zain Hasnain, Sajid Bashir Soofi, Shabina Ariff, Yasir Bin Nisar, Jai K. Das

Institute for Global Health and Development

Background: The use of antibiotics in the treatment of acute and persistent watery diarrhoea has long been a subject of contention. While the advantages of using antimicrobials are acknowledged, concerns remain regarding potential adverse effects and antibiotic resistance. Therefore, we conducted a systematic review and meta-analysis to assess the efficacy of antibiotics compared to placebos for the treatment of diarrhoea.
Methods: We searched PubMed, CINAHL, the Cochrane Library, ClinicalTrials.gov, the World Health Organization (WHO) International Clinical Trials Registry Platform, and Scopus from inception until 20 July 2023 for studies published after the year 2000 assessing antibiotics vs placebo in acute …

Dynamics Of The Blood Plasma Proteome During Hyperacute Hiv-1 Infection, Jamirah Nazziwa, Eva Freyhult, Mun-Gwan Hong, Emil Johansson, Filip Årman, Jonathan Hare, Kamini Gounder, Melinda Rezeli, Tirthankar Mohanty, Amin Hassan

Institute for Human Development, East Africa

The complex dynamics of protein expression in plasma during hyperacute HIV-1 infection and its relation to acute retroviral syndrome, viral control, and disease progression are largely unknown. Here, we quantify 1293 blood plasma proteins from 157 longitudinally linked plasma samples collected before, during, and after hyperacute HIV-1 infection of 54 participants from four sub-Saharan African countries. Six distinct longitudinal expression profiles are identified, of which four demonstrate a consistent decrease in protein levels following HIV-1 infection. Proteins involved in inflammatory responses, immune regulation, and cell motility are significantly altered during the transition from pre-infection to one month post-infection. Specifically, decreased …

Assessing Pattern Of The Pediatric Multisystem Inflammatory Syndrome (Pmis) In Children During The Covid-19 Pandemic: Experience From The Emergency Department Of Tertiary Care Center Of A Low-Middle-Income Country, Saleem Akhtar, Iqra Anis, Kumar Nirdosh, Muhammad Ihsan Tayyab Ihsan, Ahmed Raheem Buksh, Surraiya Bano

Department of Paediatrics and Child Health

Background: Pediatric Multisystem Inflammatory Syndrome (PMIS) is a hyperinflammatory condition affecting multiple organs in children, often resembling incomplete Kawasaki Disease during later phases of COVID-19 infection. Data on PMIS in low-middle-income countries, particularly in emergency department settings, is limited.
Objectives: This prospective observational study at Aga Khan University Hospital, Karachi, aimed to determine the frequency, clinical presentation patterns, and laboratory parameters of children with PMIS visiting the emergency department during the COVID-19 pandemic. Secondary objectives included assessing factors associated with in-hospital mortality.
Methods: From March 2020 to September 2021, patients meeting World Health Organization PMIS criteria were enrolled. COVID-19 testing …

Diagnostic Accuracy Of Intraoperative Frozen Section For Margin Evaluation Of Oral Cavity Squamous Cell Carcinoma, Javaria P. Ali, Bakhtawar Allauddin Mallick, Khushbakht Rashid, Umair Arshad Malik, Atif Ali Hashmi, Shamail Zia, Muhammad Irfan, Amir Khan, Naveen Faridi

Section of Internal Medicine

Objectives: Intraoperative frozen-section evaluation is a valuable technique for detecting positive margins intraoperatively for oral squamous cell carcinoma. We conducted this study to determine the diagnostic accuracy of frozen section in detecting margin status and the effect of tumor grade and stage on diagnostic accuracy.
Results: A total of 251 biopsy-proven cases of oral squamous cell carcinoma were included in this study. The tissue specimen resected during surgery was sent to the laboratory for frozen section evaluation. The frozen section results were then compared with the permanent section results to determine the sensitivity, specificity, positive predictive value, negative predictive value, …

Metabolic Syndrome And Obesity Among Marginalised School-Going Adolescents In Karachi, Pakistan: A Cross-Sectional Study, Hina Sharif, Sana Sharif Sheikh, Tooba Seemi, Hira Naeem, Unab Khan, Shah Sumaya Jan

Department of Family Medicine

Background: Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors which increase the likelihood of developing type 2 diabetes and cardiovascular disease. This study aimed to determine the prevalence of MetS among adolescents living in slums aged 11-18 years in Karachi, Pakistan.
Methods: Data were collected from 689 adolescents attending five schools in two slum areas of Karachi, Korangi and Baldia, from February 2023 to March 2023. Measurements of weight, height, waist circumference, and blood pressure were obtained from the study participants. Blood samples were collected to assess fasting plasma glucose, High density lipoprotein HDL-cholesterol, and triglyceride levels as …

Exploring The Role Of Information And Communication Technologies In Allergic Rhinitis In Specialist Centers: Patient Perspectives On Usefulness, Value, And Impact On Healthcare, Ivan Cherrez-Ojeda, Jean Bousquet, Zouina Sarfraz, Azza Sarfraz, Monica Rodriguez Gonzales, Anna Bedbrook, Nelson Rosario, Benjamin Zepeda-Ortega, Guillermo Guidos, Ulbio Alcivar Molina

Department of Paediatrics and Child Health

Introduction: Information and communication technologies (ICTs) improve patient-centered care and are routinely used in Allergic Rhinitis (AR), but patients' preferences and attitudes are unexplored. This study examines AR-related information preferences and ICT use by AR patients.
Methods: A survey-based cross-sectional study was carried out in Ecuador from July to September 2019 in seven centers of reference for allergic disease. Participants were 18 years or older, diagnosed with AR and had access to ICT and the Internet. Descriptive and binomial logistic regressions were performed. A value of less than 0.05 was considered statistically significant.
Results: 217 patients were included. 47% (n …

Exploring The Role Of Information And Communication Technologies In Allergic Rhinitis In Specialist Centers: Patient Perspectives On Usefulness, Value, And Impact On Healthcare, Ivan Cherrez Ojeda, Jean Bousquet, Zouina Sarfraz, Azza Sarfraz, Monica Rodriguez Gonzales, Anna Bedbrook, Nelson Rosario, Benjamin Zepeda Ortega, Guillermo Guidos, Ulbio Alcivar Molina

Department of Paediatrics and Child Health

Introduction: Information and communication technologies (ICTs) improve patient-centered care and are routinely used in Allergic Rhinitis (AR), but patients' preferences and attitudes are unexplored. This study examines AR-related information preferences and ICT use by AR patients.
Methods: A survey-based cross-sectional study was carried out in Ecuador from July to September 2019 in seven centers of reference for allergic disease. Participants were 18 years or older, diagnosed with AR and had access to ICT and the Internet. Descriptive and binomial logistic regressions were performed. A value of less than 0.05 was considered statistically significant.
Results: 217 patients were included. 47% (n …

Fungal Empyema Thoracis, A Rare But An Emerging Entity: A Retrospective Case Series From Pakistan, Nousheen Iqbal, Akbar Shoukat Ali, Aqusa Zahid, Kauser Jabeen, Muhammad Irfan

Section of Pulmonary & Critical Care

Background and objective: Fungal empyema is a rare entity which is associated with high mortality. It is mostly seen in immune-compromised hosts. However, there is limited data available on fungal empyema from developing countries regarding risk factors, treatment, and outcome. This study was conducted to determine the risk factors, clinical features, treatment, and outcome of fungal empyema.
Methods: A retrospective observational study was performed on proven fungal empyema cases, admitted at Aga Khan University Hospital, Karachi, Pakistan during January 2018 to May 2021. We excluded all those patients with polymicrobial bacterial and fungal empyema or with negative pleural fluid cultures. …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

Reducing The Rate Of Central Line-Associated Bloodstream Infections; A Quality Improvement Project, David Odada, Hellen Munyi, Japhet Gatuiku, Ruth Thuku, Jared Nyandigisi, Anne Wangui, Emilie Ashihundu, Beatrice Nyakiringa, Jemimah Kimeu, Martin Musumbi, Rodney Adam

Internal Medicine, East Africa

Background The burden of central line-associated bloodstream infections is significant and has negative implications for healthcare, increasing morbidity and mortality risks, increasing inpatient hospital stays, and increasing the cost of hospitalization. Efforts to reduce the incidence of central line-associated bloodstream infections have utilized quality improvement projects that implement, measure, and monitor outcomes. However, variations in location, healthcare organization, patient risks, and practice gaps are key to the success of interventions and approaches. This study aims to evaluate interventions of a quality improvement project on the reduction of central line-associated bloodstream infection rates at a university teaching hospital.

Methods This was …

Who O2cov2: Oxygen Requirements And Respiratory Support In Patients With Covid-19 In Low-And-Middle Income Countries—Protocol For A Multicountry, Prospective, Observational Cohort Study, Pryanka Relan, Srinivas Murthy, John Marshall, Djillali Annane, Sylvie Chevret, Yaseen Arabi, Wangari Siika, Sara Dominguez Rodriguez, Pauline Convocar, Janet Diaz

Anaesthesiology, East Africa

Introduction: SARS-CoV-2 has been identified as the cause of the disease officially named COVID-19, primarily a respiratory illness. COVID-19 was characterised as a pandemic on 11 March 2020. It has been estimated that approximately 20% of people with COVID-19 require oxygen therapy. Oxygen has been listed on the WHO Model List of Essential Medicines List and Essential Medicines List for Children for almost two decades. The COVID-19 pandemic has highlighted, more than ever, the acute need for scale-up of oxygen therapy. Detailed data on the use of oxygen therapy in low-and-middle income countries at the patient and facility level are …

Community Centred Co-Design Methodology For Designing And Implementing Socio-Behavioural Interventions To Counter Covid-19 Related Misinformation Among Marginalized Population Living In The Squatter Settlements Of Karachi, Pakistan: A Methodology Paper, Rubina Qasim, Waqas Ahmed Farooqui, Atiya Rahman, Rukhsana Haroon, Madiha Saleem, Muhammad Rafique, Fiza Noor, Afifa Ghani, Muhammad Yaqoob, Mohammad Tahir Yousafzai

Community Health Sciences

Background: Misinformation regarding COVID-19 pandemic and vaccination is damaging COVID-19 vaccine trust and acceptance in Low- and Middle-Income Countries (LMIC). Identification of misinformation and designing locally acceptable solutions are needed to improve COVID-19 vaccine acceptance. This study aimed to utilize community-led co-design methodology to evaluate misinformation regarding COVID-19 and develop contextual interventions to address misinformation in a marginalized peri urban slum communities of Landhi town Karachi, Pakistan.
Methods: This study was conducted between January and December 2021, in marginalized peri-urban slum dwellers of Muslimabad Colony, Landhi Town Karachi, Pakistan. We used a community-centred co-design methodology embedded within mixed study design …