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Background@#Studies on previous viral pandemics showed poorer outcomes of patients with concomitant bacterial infection. During the early period of COVID-19 pandemic, empiric antibiotic therapy is commonly given among COVID-19 patients despite lack of strong recommendations for its use.@*Objectives@#We determined the prevalence of bacterial co-infection and of empiric use of antibiotics among COVID-19 admissions. We also determined association between COVID-19 severity, ICU admissions, length of hospital stay, and mortality outcomes of those with and without bacterial co-infection.@*Methods@#A total of 159 patients hospitalized with COVID-19 from April 2020 to April 2021 were analyzed in this crosssectional chart review study. Data on empiric antibiotic administration and cultures taken within 3 days of admission were collected. Chi-square, Fischer-Exact, and T-tests were used to analyze the data.@*Results@#Empiric antibiotics were given in 94.97% of COVID-19 admissions with azithromycin as the most common agent. The prevalence of bacterial co-infection among COVID-19 admitted patients was 10%. There were higher ICU admissions and longer hospital stay among those with bacterial co-infection although it did not reach statistical significance. No mortality was seen among patients with bacterial co-infection.@*Conclusion@#There was a high use of empiric antibiotic treatment in hospitalized COVID-19 patients despite the low prevalence of bacterial co-infection among these cases. This warrants development of strategies for antimicrobial stewardship programs especially during the COVID-19 pandemic.
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COVID-19 , PneumoniaABSTRACT
@#Objective To analyze rash and fever illness(RFI) and other respiratory virus co-infection in some confirmed measles cases in Jilin Province from 2013 to 2022,and to provide scientific basis for measles co-infection and multi-pathogen diagnosis.Methods The throat swab specimens of 106 measles confirmed cases in Jilin Province from 2013 to 2022 were collected,of which nine kinds of RFI associated virus and respiratory virus with similar clinical symptoms were detected by fluorescence quantitative PCR,including varicella-zoster virus(VZV),Dengue virus(DENY),human parvovirus B19(HPV-B19),Epstein-Barr virus(EBV),human herpesvirus6(HHV6),human rhinovirus(HRV),respiratory syncytial virus(RSV),human adenovirus(HAdV) and human cytomegalovirus(HCMV),and statistical analysis was conducted by using SPSS 23.0 software.Results VZV and DENV were not detected in the 106 collected specimens,and the other 7viruses were detected.30.18% of the measles cases were co-infected with other viruses,of which only HCMV co-infection cases showed significant difference in the age groups(≤24 months old,24 months old to 15 years old,> 15 years old)(χ~2=9.941,P <0.05);there was no significant difference between the genders in cases co-infected with other viruses(χ~2=0.200—2.778,each P> 0.05).Conclusion Some confirmed cases of measles might be co-infected with one or more other viruses in Jilin Province from 2013 to 2022,and it is recommended to strengthen targeted surveillance and differential diagnosis,especially for infants and young children,women of childbearing age and pregnant women.
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@#Objective To analyze rash and fever illness(RFI) and other respiratory virus co-infection in some confirmed measles cases in Jilin Province from 2013 to 2022,and to provide scientific basis for measles co-infection and multi-pathogen diagnosis.Methods The throat swab specimens of 106 measles confirmed cases in Jilin Province from 2013 to 2022 were collected,of which nine kinds of RFI associated virus and respiratory virus with similar clinical symptoms were detected by fluorescence quantitative PCR,including varicella-zoster virus(VZV),Dengue virus(DENY),human parvovirus B19(HPV-B19),Epstein-Barr virus(EBV),human herpesvirus6(HHV6),human rhinovirus(HRV),respiratory syncytial virus(RSV),human adenovirus(HAdV) and human cytomegalovirus(HCMV),and statistical analysis was conducted by using SPSS 23.0 software.Results VZV and DENV were not detected in the 106 collected specimens,and the other 7viruses were detected.30.18% of the measles cases were co-infected with other viruses,of which only HCMV co-infection cases showed significant difference in the age groups(≤24 months old,24 months old to 15 years old,> 15 years old)(χ~2=9.941,P <0.05);there was no significant difference between the genders in cases co-infected with other viruses(χ~2=0.200—2.778,each P> 0.05).Conclusion Some confirmed cases of measles might be co-infected with one or more other viruses in Jilin Province from 2013 to 2022,and it is recommended to strengthen targeted surveillance and differential diagnosis,especially for infants and young children,women of childbearing age and pregnant women.
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Introduction: The 2022 mpox global outbreak underscores the need for an improved understanding of mpox epidemiology, co-morbidities, and clinical management/outcome. We report a case of a30-year-old Nigerian antiretroviral treatment-experienced person living with human immunodeficiency virus (PLHIV) who had PCR-confirmed mpox and chickenpox co-infection. Case presentation: The patient presented with a generalized itchy rash of three weeks and antecedent low-grade fever. He had no recent travel, animal exposure, or same-sex relationship. Examination revealed generalized pustular and nodular eruptions without peripheral lymphadenopathy. Results: CD4 count was 78 cells/mm3, wound swab microscopy revealed Gram-positive cocci in clusters and Gram-negative bacilli while culture yielded Pseudomonas aeruginosa. Despite supportive care and definitive antimicrobial therapy, his clinical condition deteriorated with sepsis-related multi-organ dysfunction and ultimately death. Conclusions: Mpox and chickenpox co-infection may occur, with potentially fatal complications in the setting of advanced HIV disease. Increased surveillance for co-viral infections in PLHIV with febrile exanthema and aggressive management to improve outcome are recommended.
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HIV Infections , CoinfectionABSTRACT
SUMMARY OBJECTIVE: COVID-19 infection poses significant risks, including life-threatening consequences and fungus synchronization, making it a significant concern. This study seeks to assess the effect of concurrent infection of COVID-19 with Thrush Candida albicans on the patient's health state by measuring the proportion of immune cells and certain interleukins such as IL-8, -10, -17, and -33. METHODS: The study involved 70 patients (30 patients with COVID-19, 17 patients with thrush candidiasis, and 23 patients with Thrush Candida albicans) and 50 healthy individuals as a control group. COVID-19 was identified using RT-PCR, while C. albicans were identified through culture media, biochemical testing, and oral swabs. Ruby equipment and ELISA kits were used for blood counts and interleukin detection. RESULTS: COVID-19, thrush candidiasis, and Thrush Candida albicans infections occur in a wide range of age groups (4-80 years), with no significant differences between sexes (p>0.05). Immunologically, our study found that Thrush Candida albicans patients had the highest rate of neutrophils (89.6%) and basophils (2.01%), while corona patients had the highest percentage of lymphocytes (70.12%) and eosinophils (7.11%), and patients with thrush candidiasis had the highest percentage of monocytes. Thrush Candida albicans patients showed increased IL-8 (56.7 pg/mL) and IL-17 (101.1 pg/mL) concentrations, with the greatest concentration of IL-33 (200.5 pg/mL) in COVID-19, and a decrease in the level of IL-10 in patient groups compared with controls. CONCLUSION: Patient groups showed increased neutrophils, lymphocytes, monocytes, and IL-8 levels, with a significant linear association between proinflammatory interleukins and these cells.
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A 60-year-old male patient who presented with generalized weakness and low-grade fever was diagnosed to be human immunodeficiency virus (HIV) positive with a CD4 count of 17. Routine laboratory investigations revealed pancytopenia. Serum cytomegalovirus (CMV) DNA polymerase chain reaction (PCR) was positive and fundoscopy showed CMV retinitis in the right eye. The patient was started on tablet valganciclovir. After 2 weeks, the patient was brought back in an altered sensorium. He was found to have hyponatremia which was corrected. He was started on antiretroviral therapy and tablet valganciclovir was continued. The patient came back again after one and a half months with a urinary tract infection and fissure-in-ano. He was found to have severe neutropenia. Valganciclovir was stopped. He was started on injection granulocyte colony-stimulating factor. The patient clinically improved and his hematological parameters became normal. Patients having HIV and CMV co-infection with pre-existing pancytopenia have to be closely monitored as the medicines used for treatment can exacerbate the existing conditions.
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Background and Objectives: The identification, evaluation, and use of methodological resources for data quality analysis is important to support planning actions of public policies for the control of tuberculosis (TB) and the co-infection TB and human immunodeficiency virus (HIV). The objective was to analyze the quality and timeliness of notification of TB and TB-HIV co-infection cases from the Notifiable Diseases Information System (SINAN - Sistema de Informação de Agravos de Notificação) in Espírito Santo State, from 2016 to 2018. Methods: This is a cross-sectional study of the quality of SINAN data using the Centers for Disease Control and Prevention (CDC) guidelines to analyze the quality and timeliness of SINAN-TB notification, with emphasis on the description of TB-HIV co-infection in Espírito Santo State, from 2016 to 2018. It considered five methodological steps that included quality analysis, standardization of records, duplicity analysis, the completeness of data through linkage with the SINAN-HIV database and anonymization of data. It obtained ethical approval under the number 4022892 on 12/05/2020. Results: The study showed that 89% of mandatory variables and 91% of essential variables showed satisfactory completeness. In TB-HIV co-infection 73% of the variables were completed, but essential variables related to TB treatment follow-up showed unsatisfactory completeness. The timeliness of reporting was considered regular. Conclusion: Improvements in work processes and the development of a specific methodological process for data treatment are necessary to qualify the information available in SINAN-TB.(AU)
Justificativa e Objetivos: A identificação, avaliação e emprego de recursos metodológicos para análise da qualidade dos dados é importante para fundamentar ações de planejamento das políticas públicas no controle da tuberculose (TB) e da coinfecção TB e o vírus da imunodeficiência humana (HIV). O objetivo é analisar a qualidade e a oportunidade de notificação dos casos de TB e coinfecção TB-HIV do Sistema de Informação de Agravos de Notificação (SINAN) no Espírito Santo, de 2016 a 2018. Métodos: Trata-se de um estudo transversal da qualidade dos dados do SINAN com uso do Guia do Centers for Disease Control and Prevention (CDC) de análise da qualidade e oportunidade de notificação do SINAN-TB, com ênfase na descrição da coinfecção TB-HIV no Espírito Santo, de 2016 a 2018. Considerou-se cinco etapas metodológicas que incluíram análise da qualidade, padronização dos registros, análise de duplicidade, a completitude dos dados por meio de linkage com o banco de dados do SINAN-HIV e anonimização dos dados. Obteve aprovação ética sob parecer de nº 4022892 em 12/05/2020. Resultados: O estudo mostrou que 89% das variáveis obrigatórias e 91% das variáveis essenciais apresentaram completitude satisfatória. Na coinfecção TB-HIV 73% das variáveis foram preenchidas, porém variáveis essenciais relacionadas ao acompanhamento do tratamento para TB apresentaram completitude insatisfatória. A oportunidade de notificação foi considerada regular. Conclusão: Melhorias nos processos de trabalho e elaboração de processo metodológico específico para o tratamento dos dados são necessárias para qualificar as informações disponíveis no SINAN-TB.(AU)
Justificación y Objetivos: La identificación, evaluación y utilización de recursos metodológicos de análisis de la calidad de los datos es importante para apoyar la planificación de políticas públicas de control de la tuberculosis (TB) y la coinfección con el virus de la inmunodeficiencia humana (VIH). El objetivo es analizar la calidad y oportunidad de la notificación de casos de TB y coinfección TB-VIH del Sistema de Informação de Agravos de Notificação (SINAN), en el Estado del Espírito Santo, desde el año 2016 hasta 2018. Métodos: Este es un estudio transversal utilizando el análisis de la Guía de los Centros para el Control y Prevención de Enfermedades (CDC) de la calidad y oportunidad de la notificación en SINAN-TB, con énfasis en la descripción de la coinfección TB-VIH, en el Estado del Espírito Santo, desde el año 2016 hasta 2018. Fueran considerados cinco pasos metodológicos que incluyeron análisis de calidad, estandarización de registros, análisis de duplicidad, vinculación con la base de datos SINAN-VIH y anonimización de datos. Obtuvo aprobación ética bajo dictamen nº 4022892 el 12/05/2020. Resultados: El 89% de las variables obligatorias y el 91% de las variables esenciales se completaron satisfactoriamente. En la coinfección TB-VIH el 73% de las variables fueron completadas, mientras que las variables esenciales relacionadas con el acompañamiento del tratamiento para la TB presentaron una completitud insatisfactoria. La oportunidad de notificación fue considerada regular. Conclusión: Las mejoras en los procesos de trabajo y la elaboración de un proceso metodológico específico para el tratamiento de los datos son necesarias para cualificar la información disponible en el SINAN-TB.(AU)
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Humans , Tuberculosis , HIV Infections , Health Information Systems , Cross-Sectional Studies , CoinfectionABSTRACT
Objectives: This prospective observational study aimed to identify the current trend of the circulating viral strains responsible for hand foot mouth disease (HFMD) outbreak in four tertiary care centers in Rajasthan, amidst the coronavirus disease (COVID-19) pandemic (April-October 2022). Methods: Cases with suspected HFMD, presenting to our skin outpatient department were assessed clinically and serologically (IgM antibodies against coxsackie virus (CV) A6, A16 and enterovirus 71) for evidence of the disease. Results: We identified 718 new HFMD patients (161 adults) with peaks in May and August, 2022. Male:female ratio decreased with increasing age. Most children were asymptomatic. A total of 385/409 patients assessed serologically, were found positive, most commonly against CV-A6. Conclusion: Though HFMD typically affects young children, an unusually higher proportion of adults were affected during the current pandemic. There were some differences between pediatric and adult presentation of HFMD.
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Objective: this study aimed to determine the frequency and the clinical-epidemiological profile of the human immunodeficiency virus (HIV) and syphilis co-infection between genders in specialized care services in Northeast Brazil. Methods: an analytical cross-sectional study was conducted with secondary data from 171 individuals with HIV and syphilis co-infection. Data were collected in a reference center for acquired immunodeficiency syndrome (AIDS) in Northeast Brazil from 2015 to 2020. Welch's test compared the means of independent samples; the chi-square and Fisher's exact test assessed the association between categoric variables. The significance level was set at 5%. This study has ethical approval. Results: the HIV and syphilis co-infection frequency was 15.4%. Individuals with co-infection had a mean age of 34.2 (± 11.0) years and were predominantly men. The women sample started their sex life earlier, had a lower education level and per capita family income, used more illicit drugs, and were mostly heterosexual, married or in a stable union, and unemployed. Men had more anal sex. Moreover, most individuals had syphilis in the asymptomatic phase and HIV with undetectable viral load; CD4 T cells were greater than 350 cells/mm³. Conclusion: the high prevalence of HIV and syphilis co-infection in specialized care services, especially in men who have sex with men (MSM), highlights the need to improve counseling to reduce sexual risk behavior and improve prevention and care strategies to control these diseases.
Objetivo: este estudo teve como objetivo determinar a frequência e o perfil clínico-epidemiológico da coinfecção pelo vírus da imunodeficiência humana (HIV) e sífilis em ambos os gêneros num serviço de atenção especializada no Nordeste do Brasil. Métodos: trata-se de um estudo transversal, analítico, com dados secundários de 171 pacientes com coinfecção por HIV e sífilis de um centro de referência para síndrome da imunodeficiência adquirida (SIDA) de 2015 a 2020. O teste de Welch foi utilizado para comparar as médias de amostras independentes; os testes qui-quadrado e exato de Fisher avaliaram a associação entre variáveis categóricas. O nível de significância adotado foi de 5%. Este estudo obteve aprovação ética. Resultados: a frequência da coinfecção por HIV e sífilis foi de 15,4%. Os indivíduos tinham idade média de 34,2 (± 11,0) anos e eram predominantemente homens. As mulheres iniciaram a vida sexual mais cedo, tinham menor escolaridade e renda familiar per capita, usavam mais drogas ilícitas e eram, em sua maioria, heterossexuais, casadas ou em união estável, e desempregadas. Os homens praticavam mais sexo anal. A maioria dos indivíduos apresentava sífilis na fase assintomática e HIV com carga viral indetectável, além de células T CD4 superiores a 350 células/mm³. Conclusão: a alta prevalência de coinfecção por HIV e sífilis em serviços de atenção especializada, principalmente em homens que fazem sexo com homens (HSH), evidencia a necessidade de aprimorar o aconselhamento a fim de reduzir comportamentos sexuais de risco e melhorar as estratégias de prevenção e cuidado para o controle dessas doenças.
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Humans , Syphilis , Acquired Immunodeficiency Syndrome , Sexually Transmitted Diseases , HIVABSTRACT
Objective:To analyze the features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co-infected with other common respiratory pathogens among coronavirus disease 2019 (COVID-19) patients in Shanghai City, and to provide a reference for scientific prevention and control of COVID-19 and other respiratory infectious diseases.Methods:Descriptive epidemiological approaches were used to analyze the data of COVID-19 reported cases in Shanghai City from January 2020 to February 2021 in the information system of Chinese Disease Prevention and Control. Clinical data of the participants were collected, and their SARS-CoV-2 nucleic acid-positive respiratory specimens were collected at the time of illness onset or admission. Multiplex reverse transcription-polymerase chain reaction (RT-PCR) was performed to detect the 22 respiratory pathogens. Independent-samples t test was used for statistical analysis. Results:Of the 272 patients with COVID-19, 15(5.5%) had co-infection of SARS-CoV-2 with other respiratory pathogens, all of which were double infection. There were three cases infected with enterovirus/rhinovirus, two of each with adenovirus, human metapneumovirus and coronavirus NL63/HKU1, and one of each with coronavirus 229E, influenza A virus H1N1, parainfluenza virus 1 and respiratory syncytial virus B. Two cases infected with Mycoplasma pneumoniae. Among the 272 COVID-19 patients, 212(77.9%) had fever, 117(43.0%) had cough, 46(16.9%) had fatigue, and 35(12.9%) had sore throat. The white blood cell count of co-infection cases was higher than that of non-co-infection cases ((6.8±1.7)×10 9/L vs (5.3±1.6)×10 9/L), and the difference was statistically significant ( t=3.09, P=0.008). Conclusions:There is a certain proportion of co-infection of SARS-CoV-2 with other respiratory pathogens among the COVID-19 cases in Shanghai City, mainly viral pathogens, especially enterovirus/rhinovirus. A rational combination of drugs was recommended to improve the cure rate. Surveillance of acute respiratory infection should be further strengthened as well.
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Strongyloides stercoralis is an opportunistic pathogenic parasite that can cause severe strongyloidiasis and even death among immunocompromised individuals. Previous clinical studies have reported cases co-infected with S. stercoralis and other pathogens, such as parasites, viruses, bacteria and fungi. This review summarizes strongyloidiasis patients co-infected with pathogens, and analyzes the impact of co-infection on strongyloidiasis, so as to provide insights into the reduction of the morbidity and mortality of disorders associated with S. stercoralis infections.
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Blastocystis is a common unicellular intestinal protozoa in humans and animals, and the most common clinical manifestations of infections include abdominal pain and diarrhea. Based on the sequence of the small-subunit ribosomal RNA (SSU rRNA) gene, 28 subtypes of B. hominis (ST1 to ST17, ST21 and ST23 to ST32) have been characterized. Previous studies have demonstrated that B. hominis infection is strongly associated with inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and other intestinal diseases, which threatens the health and quality of life among patients with B. hominis infection and is considered as an important public health problem. This review summarizes the progress of researches on B. hominis infection among IBD and IBS patients during the past 20 years, so as to provide insights into management of blastocystosis in China.
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Animals , Humans , Irritable Bowel Syndrome/parasitology , Blastocystis Infections/complications , Quality of Life , Blastocystis hominis/genetics , Feces/parasitology , Inflammatory Bowel Diseases/parasitologyABSTRACT
Objective:To investigate the epidemic characteristics of influenza in children and the features of severe influenza.Methods:From January 2016 to September 2022, 1 600 samples from hospitalized cases of severe acute respiratory tract infection and 7 660 samples from outpatients with influenza-like illness were collected. Influenza virus was detected by real-time RT-PCR. Other respiratory viruses in the samples of severe hospitalized cases and some samples of outpatients were detected. Clinical features of influenza virus infection and co-infection were analyzed.Results:The positive rate of influenza virus in the 1 600 hospitalized cases of severe acute respiratory infection was 6.63% (106 cases). H1N1, H3N2, BV and BY were deteted in 49.06% (52 cases), 17.92% (19 cases), 29.25% (31 cases) and 3.77% (4 cases) of the 106 cases, respectively. The positive rate of influenza virus in the 7 660 out-patient cases was 15.01% (1 150 cases), and H1N1, H3N2, BV and BY were detected in 22.17% (255 cases), 30.96% (356 cases), 41.39% (476 cases) and 5.48% (63 cases) of the infected cases, respectively. Influenza A (H1N1) virus was more likely to cause severe influenza in children (χ 2=37.978, P<0.001), while seasonal H3N2 and BV strains were less likely to cause severe influenza in children (χ 2=7.871, P=0.005; χ 2=5.948, P=0.015). There was no statistically significant difference in the positive rates of BY lineage in the two groups. Severe influenza mainly occured in the peak season of influenza epidemic. There was no significant difference in the clinical manifestations between the children infected with the four different influenza viruses. In the 106 severe cases of influenza, the co-infection rate of influenza virus with other respiratory viruses was 17.92% (19 cases), while the co-infection rate reached 34.81% (47 cases) in 135 outpatient cases of influenza. The difference in the co-infection rates was statistically significant between outpatient and hospitalized cases (χ 2=10.734, P=0.001). Conclusions:Influenza A (H1N1) virus was more likely to cause severe influenza in infants and young children in comparison with seasonal H3N2 and BV. There was no significant difference in the clinical features of influenza caused by H1N1, H3N2, BV and BY. Co-infection of influenza virus with other respiratory viruses is not a major risk factor for severe influenza in infants.
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Objective:To analyze and reveal the genetic evolution and variation of influenza viruses in cases of co-infection in Guangdong Province.Methods:Throat swab samples were collected from four cases of H1N1pdm and H3N2 co-infection for viral isolation. The isolated strains were subjected to antigen analysis and neuraminidase inhibitor susceptibility test. High-throughput sequencing was used to detect the sequences of strains in three throat swab samples and one virus strain, and then genetic variations were analyzed.Results:Four influenza viruses were isolated with one strain of H1N1pdm and three of H3N2 subtype, and all of them were genetically similar to the vaccine strain in 2022-2023. The HA genes of H1N1pdm and H3N2 strains belonged to clade 6B.1A.5a.2a and 2a.3a.1, respectively. The isolated strains belonged to the same clade as the strains prevalent in Guangdong during the same period. No drug-resistant variations were detected in N1 or N2 gene, and the isolated strains were sensitive to oseltamivir and zanamivir.Conclusions:H1pdm subtype had stronger replication ability than H3 subtype in the influenza viruses isolated from co-infected cases. H1N1pdm and H3N2 subtype influenza viruses were genetically similar to the strains circulating in Guangdong at the same time. The isolated H1N1pdm and H3N2 strains were sensitive to both oseltamivir and zanamivir, indicating that they could continue to be used in the treatment of influenza virus infections caused by one or two genotypes.
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Introdução: A tuberculose é a infecção oportunista mais comum entre pacientes com HIV e uma das principais causas de morte. Objetivo: Analisar a epidemiologia e os índices de notificação de coinfecção por tuberculose (TB) e HIV, nas principais regiões de saúde (CIR) de notificação, no estado de Mato Grosso do Sul, comparando entre períodos pré e durante a pandemia de COVID-19. Materiais e Métodos: Foi realizado um estudo descritivo, qualitativo, relacionado aos casos notificados de coinfecção por HIV/TB, no período de 2015 a 2022, com coleta dos indicativos sociodemográficos e clínicos através do Departamento de Informática do Sistema Único de Saúde (DATASUS). Os dados obtidos foram tabulados e analisados estatisticamente. Resultados: Foram notificados 870 casos de coinfecção HIV/TB sendo Campo Grande a região com mais notificações. Os casos de infecção TB/HIV foram predominantes em indivíduos de 20 a 39 anos (51,1%), do sexo masculino (74,8%), com ensino fundamental incompleto (12,4%) e predomínio da forma clínica pulmonar (61,8%). Foi observado um ligeiro aumento no número de notificações no primeiro ano da pandemia de COVID-19, com restabelecimento no ano seguinte. Entretanto, no ano de 2022, apesar do menor impacto da pandemia, observou-se acentuada queda nas notificações. Conclusão: O perfil epidemiológico dos pacientes com HIV/TB é similar ao encontrado em outras regiões do país. A pandemia de COVID-19, não apresentou efeito inicial nas notificações da coinfecção nos primeiros anos, entretanto, houve efeito significativo no ano de 2022 com drástica redução no número de notificações.
Introduction: Tuberculosis is the most common opportunistic infection among HIV patients and one of the leading causes of death. Objective: To analyze the epidemiology and reporting rates of tuberculosis (TB) and HIV co-infection in the main reporting health regions (CIR) in the state of Mato Grosso do Sul, comparing periods before and during the COVID-19 pandemic. 19. Materials and Methods: A descriptive, qualitative study was carried out, related to reported cases of HIV/TB co-infection, from 2015 to 2022, with the collection of sociodemographic and clinical indicators through the Department of Informatics of the Unified Health System (DATASUS). The data obtained were tabulated and statistically analyzed. Results: 870 cases of HIV/TB co-infection were reported, with Campo Grande being the region with the most notifications. Cases of TB/HIV infection were predominant in individuals aged 20 to 39 years (51.1%), male (74.8%), with incomplete primary education (12.4%) and predominance of the pulmonary clinical form ( 61.8%). A slight increase in the number of notifications was observed in the first year of the COVID-19 pandemic, with reestablishment in the following year. However, in 2022, despite the lesser impact of the pandemic, there was a sharp drop in notifications. Conclusion: The epidemiological profile of patients with HIV/TB is similar to that found in other regions of the country. The COVID-19 pandemic had no initial effect on coinfection notifications in the early years, however, there was a significant effect in 2022 with a drastic reduction in the number of notifications.
Introducción: La tuberculosis es la infección oportunista más común entre los pacientes con VIH y una de las principales causas de muerte. Objetivo: Analizar la epidemiología y las tasas de notificación de la coinfección tuberculosis (TB) y VIH en las principales regiones sanitarias (CIR) de notificación, en el estado de Mato Grosso do Sul, comparando los períodos antes y durante la pandemia de COVID - 19 Materiales y Métodos: Se realizó un estudio descriptivo, cualitativo, relacionado con los casos notificados de coinfección VIH/TB, en el período 2015 a 2022, con el levantamiento de indicadores sociodemográficos y clínicos a través del Departamento de Informática de la Sistema Único de Salud (DATASUS) . Los datos obtenidos fueron tabulados y analizados estadísticamente. Resultados: Fueron notificados 870 casos de coinfección VIH/TB, siendo Campo Grande la región con más notificaciones. Predominaron los casos de infección por TB/VIH en individuos de 20 a 39 años (51,1%), del sexo masculino (74,8%), con instrucción primaria incompleta (12,4%) y dominio de la forma clínica pulmonar (61,8%). Se observó un ligero aumento en el número de notificaciones en el primer año de la pandemia de COVID-19, con restablecimiento en el año siguiente. Sin embargo, en 2022, a pesar del menor impacto de la pandemia, se produjo una fuerte caída de notificaciones. Conclusión: El perfil epidemiológico de los pacientes con VIH/TB es similar al encontrado en otras regiones del país. La pandemia de COVID-19 no tuvo un efecto inicial en las notificaciones de coinfección en los primeros años, sin embargo, tuvo un efecto significativo en 2022 con una reducción drástica en el número de notificaciones.
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Introduction: Dengue and Chikungunya (CHIK) infections appear to be increasing in all parts of India. Aedes aegypti mosquitoes are common vectors for dengue virus (DENV) and CHIK virus (CHIKV - Chikungunya Virus). In areas where both viruses co circulate, they can be transmitted together. Aim: The present study was undertaken to study the prevalence of dengue–CHIK co infection and compare with monoinfection. Methods: IgM antibody capture ELISA (Enzyme linked immunosorbent assay) for dengue IgM and CHIK IgM and ELISA for dengue non structural protein 1 antigen was performed on serum samples obtained from suspected patients. Results: Out of total 1071 samples from suspected patients for dengue & chikungunya infection, 212 (19.7%) samples were positive for DENV while CHIK IgM antibodies were positive in 145 (13.53%) patients. Total 44 sera were positive (4.10%) for co-infection of dengue and CHIK. Conclusion: Increase in the number of Dengue and Chikungunya infections and their cocirculation is an important public health concern which warrants the implementation of strict control measures
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Background: The objective of this study was to analyse the clinical characteristics of HIV+ and HIV- tuberculosis patients followed and treated at the Oyem Regional Hospital Centre (ORHC). Materials and Methods: During this study conducted between January 2019 and December 2021, data collection was based on the exploitation of medical records and registers of results from the medical analysis laboratory of the regional hospital of Oyem, in which there were personal data (gender and age) of the patients, the status of HIV infection, clinical characteristics (pulmonary or extra pulmonary TB), and finally, the therapeutic outcomes of the patients after anti-tuberculosis and antiretroviral treatment. Binomial test following the Normal distribution was used to find an association between the percentages of extrapulmonary TB and TB+/HIV+ co-infection. Results: In this study, 128 confirmed TB cases were selected. While 54 (42.19%) were co-infected with TB+/HIV+, 74 patients (57.81%) were monoinfected with TB+/HIV+. Among all these patients, 93 (72.66%) were reported to have extra pulmonary TB and 35 (27.34%) had pulmonary TB. A normal binomial test showed that TB+/HIV+ co-infection was significantly associated with extrapulmonary TB (p=0.04). Patients were put on anti-tuberculosis treatment according to the manufacturers' indications. Despite a total of 15 deaths (8.93%) in both mono- and co-infected patients, there was a favourable outcome, with 35 patients (27.34%) declared cured. With 8 deaths, mortality was higher in the co-infected than in the non-HIV infected TB patients who recorded 7 deaths. Conclusion: By indicating a relatively high prevalence of HIV infection in TB patients, this study showed that TB+/HIV+ co-infection was associated with extra pulmonary TB, the severe form of the disease, and increased mortality in patients, hence the need to strengthen joint activities to control this co-infection.
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Resumen Tanto el Virus de Inmunodeficiencia Humana-1 (VIH-1), como el protozoo Toxoplasma gondii son capaces de infectar al ser humano e invadir su sistema nervioso central (SNC). En individuos inmunocompetentes T. gondii causa infecciones crónicas, generalmente asintomáticas; sin embargo, la inmunodeficiencia asociada a etapas avanzadas de la infección por VIH-1, se relaciona con la pérdida del control de la infección parasitaria latente y enfermedades graves a nivel del SNC, como encefalitis toxoplásmica. Este trabajo tuvo como objetivo evaluar la evolución de la respuesta inmunitaria contra T. gondii en pacientes co-infectados con VIH-1, en distintas etapas de la infección viral. La respuesta contra T. gondii se evaluó a través de la producción in vitro de citosinas en respuesta a antígenos parasitarios, en individuos con serología positiva para VIH-1 y negativa para T. gondii (P1), positiva para VIH-1 y T. gondii (P2), negativa para VIH-1 y T. gondii (C1) y negativa para VIH-1 y positiva para T. gondii (C2). Los pacientes (P1 y P2) se agruparon en tempranos/asintomáticos (P1A, P2A) o tardíos/sintomáticos (P1B/C, P2B/C) de acuerdo a su recuento de linfocitos T CD4+ en sangre periférica (>350 o <350 células/μL, respectivamente). La infección por VIH-1, desde etapas tempranas, se asoció con una producción de IL-2, TNF-α e IFN-γ en respuesta a T. gondii significativamente menor. Estos defectos pueden entorpecer la respuesta anti-T. gondii en pacientes co-infectados, aumentando la posibilidad de reactivación de las infecciones latentes, lo que representa un riesgo para la integridad y funcionalidad del SNC.
Abstract Both HIV-1 and Toxoplasma gondii are able to invade central nervous system and affect its functionality. Advanced HIV-1 infection has been associated with defects in immune response to T. gondii, leading to reactivation of latent infections and the appearing of toxoplasmic encephalitis. This study evaluated changes in the immune response to T. gondii in different stages of HIV infection. Immune response to T. gondii was assessed studying cytokine production in response to parasite antigens in HIV-1-infected/T. gondii-noninfected (P1), HIV-1/T. gondii co-infected (P2), HIV-1-non-infected/T. gondiinon-infected (C1) and HIV-1-non-infected/T. gondii-infected (C2) individuals. Patients (P1 and P2) were divided in early/asymptomatic (P1A, P2A) or late/symptomatic (P1B/C, P2B/C) according to peripheral blood CD4+ T lymphocyte counts (>350 or <350/μL, respectively). The HIV-1 infection, from early/asymptomatic stages, was associated with significant lower production of IL-2, TNF-α and IFN-γ in response to T. gondii, when P2 patients were compared with C2 controls. These early defects may impair anti-parasitic response in co-infected patients, allowing to reactivation of parasitic latent infection, enhancing the risk of CNS damage and impairment of neurocognitive functions.
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COVID-19 pandemic in dengue endemic countries has becoming a concern due to its similarities in early clinical symptoms and laboratory features. The cases of co-infection between the two diseases are inevitable and associated with higher morbidity and mortality. Here we presented a case of a 28 years old female diagnosed with co-infection of COVID-19 and dengue hemorrhagic fever that complicated with severe thrombocytopenia and spontaneous bleeding.She came with fever that started 3 days prior to admission. Laboratory examination showed leucopenia, thrombocytopenia, elevated liver enzymes, and D-dimer. Patient tested positive for non-structural protein 1 (NS-1)dengue antigen. She had a pre-screening rapid test for COVID-19 as part of hospital protocol, and she tested positive. Followed by positive COVID-19 reverse transcriptase-polymerase chain reaction (RT-PCR)test confirmingthe diagnosis. During admission, patient started menstruating, resulting in active spontaneous bleeding while platelet counts dropped to below 10×109/l. Patient was given platelet transfusion, supportive therapy and put under close monitoring. The case ofco-infection between COVID-19 and dengue is inevitable in tropical and sub-tropical countries. Both infections shared similar pathophysiology through different mechanism, such as plasma leakage, thrombocytopenia, and coagulopathy.Complications may arise and physician must aware of the therapeutical approach. Diagnostic testing must not be withheld when there was suspicion towards the infection. Prompt treatment and close monitoring can result in good prognosis.
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Background: In resource-limited setting, co-infection between HIV and hepatitis B virus (HBV) poses important public health considerations. This cross-sectional study was undertaken with the aim of determining HBV seroprevalence patterns in urban blood banks.Methods: A cross-sectional study was conducted at an urban blood bank setting. A total of 1610 blood donors were enrolled, and 283 consecutive plasma samples with unknown HBsAg status were selected for risks factors. HBV seroprevalence was based on the Chemiluminescence method (Cobas® e601, Roche). Potential risk factors associated with overt HBV infection were assessed by calculating the crude and adjusted odds ratio, 95% confidence intervalley (95% CI) and p values.Results: Of 1610 participants, overall rate seroprevalence of HBsAg was 5.5% (95% CI: 4.36%–6.58%) ranging from 0.06% (95% CI: 0-0.18) (HCV) to 0.12% (95% CI: 0-0.30)(Syphilis). Seroprevalence of infection increased in older age groups (20-39 years) but men had a statistically significant higher prevalence of overt HBV infection than women (P=0.0001). The multivariate model showed the following to be predictors of HBV infection: male gender (OR=2.5 (95% CI 1.14-5.58), P= 0.02), first-time donor status (OR = 11.06, (95% CI 5.34-22.9), P= 0.01) andresidence outside of Libreville (OR = 2.52, 95% CI 1.09-5.83), P=0.03).Conclusion: HB and co-infection are n o t common in Gabon. Intermediate seroprevalence was associated with male gender, first-time donor status and residence outside of Libreville. HCV andHBV infection among the younger age groups are becoming an alarming issue. Prevention and control of HBV infection are needed to reduce HBV transmission