ABSTRACT
Background and Objectives: several patients with COVID-19 require hospital admission due to severe respiratory complications and undergo intensive care with mechanical ventilation (MV) support. Associated with this situation, there is an increase in fungal co-infections, which has a negative impact on the outcome of COVID-19. In this regard, this study intended to compare Candida spp. incidence in the respiratory tract of patients admitted in the COVID and General Intensive Care Units (ICU) at a teaching hospital in 2021. Methods: the results of protected tracheal aspirate samples from 556 patients admitted to the COVID ICU and 260 to General ICU as well as the respective records. Results: of the patients analyzed, 38 revealed a positive sample for Candida in the COVID ICU and 10 in the General ICU, with an incidence of 68.3/1000 and 38.5/1000, respectively. Males were predominant in both wards. The most affected age group was the population over 60 years old, and the average hospital admission for the COVID ICU was 22.1 years, and for the General ICU, 24.2. Conclusion: Candida albicans was the most frequently isolated species, and the mortality rate in patients positive for Candida was higher in patients with COVID-19 compared to patients in the General ICU, suggesting that patients infected with SARS-CoV-2, admitted to the ICU under MV, are more predisposed to colonization by Candida spp., which can have a fatal outcome in these patients.(AU)
Justificativa e objetivos: muitos pacientes com COVID-19 necessitam de hospitalização devido às complicações respiratórias graves, e são submetidos a cuidados intensivos com suporte de ventilação mecânica (VM). Associado a esse quadro, verifica-se o aumento de coinfecções fúngicas, que tem impacto negativo no desfecho da COVID-19. Nesse sentido, este estudo pretendeu comparar a incidência de Candida spp. no trato respiratório de pacientes internados nas Unidades de Terapia Intensiva (UTI) COVID e Geral em um hospital escola em 2021. Métodos: foram avaliados os resultados de amostras de aspirado traqueal protegido provenientes de 556 pacientes internados na UTI COVID e 260 na UTI Geral, bem como os respectivos prontuários. Resultados: dos pacientes analisados, 38 revelaram amostra positiva para Candida na UTI COVID e 10 na UTI Geral, com incidência de 68,3/1000 e 38,5/1000, respectivamente. O sexo masculino foi predominante em ambas as alas. A faixa etária mais acometida foi a população acima de 60 anos, e a média de internação para a UTI COVID foi de 22,1 anos, e para a UTI Geral, 24,2. Conclusão: Candida albicans foi a espécie isolada com maior frequência, e a taxa de mortalidade em pacientes com positivos para Candida foi maior em pacientes com COVID-19 em relação aos pacientes da UTI Geral, sugerindo que pacientes infectados com SARS-CoV-2, internados em UTI sob VM, são mais predispostos à colonização por Candida spp., que pode ter um desfecho fatal nesses pacientes.(AU)
Justificación y objetivos: muchos pacientes con COVID-19 requieren hospitalización debido a complicaciones respiratorias graves y se someten a cuidados intensivos con soporte de ventilación mecánica (VM). Asociado a esta situación, hay un aumento de las coinfecciones fúngicas, lo que repercute negativamente en el desenlace de la COVID-19. En este sentido, este estudio pretendió comparar la incidencia de Candida spp. en el tracto respiratorio de pacientes ingresados en las Unidades de Cuidados Intensivos (UCI) COVID y General de un hospital escuela en 2021. Métodos: los resultados de muestras de aspirado traqueal protegidas de 556 pacientes ingresados en la UCI COVID y 260 en el UCI General, así como los respectivos registros. Resultados: de los pacientes analizados, 38 presentaron muestra positiva a Candida en UCI COVID y 10 en UCI General, con una incidencia de 68,3/1000 y 38,5/1000, respectivamente. Los machos predominaban en ambas alas. El grupo de edad más afectado fue la población mayor de 60 años, y la hospitalización promedio en la UCI COVID fue de 22,1 años, y en la UCI General, de 24,2. Conclusiones: Candida albicans fue la especie aislada con mayor frecuencia, y la tasa de mortalidad en pacientes positivos para Candida fue mayor en pacientes con COVID-19 en comparación con los pacientes en la UCI General, lo que sugiere que los pacientes infectados con SARS-CoV-2, ingresados en la UCI bajo VM, están más predispuestos a la colonización por Candida spp., lo que puede tener un desenlace fatal en estos pacientes.(AU)
Subject(s)
Humans , Candida/isolation & purification , Clinical Evolution , Coinfection , COVID-19 , Respiration, Artificial , Intensive Care UnitsABSTRACT
Background and Objective: Hepatitis B is an infectious disease caused by a virus from the hepadnaviridae family, with worldwide distribution, and represents a serious global health problem. The pathology may have been affected by the COVID-19 pandemic, caused by the SARS-CoV-2 virus, making it possible for serious outcomes to occur when overlapping viral types. This study sought to describe the levels of scientific evidence of research carried out on the topic, establishing a relationship between hepatitis B virus infection and SARS-CoV-2 infection. Content: integrative literature review, with searches performed in the databases of the Medical Literature Analysis and Retrieval System Online, and Scientific Electronic Library Online, with analysis centered on the description of the methodological design, and on the classification of the level of evidence. Conclusion: the scientific production on hepatitis B associated with SARS-CoV-2 infection corresponds mostly to studies with a low level of evidence. The selected publications presented limitations such as the occurrence of studies with a small number of samples, lack of subsidiary data of patients in treatment, and occurrence of non-randomized selection. The results suggest the need for further investigations for the purpose of technological improvement, identification of risk factors, therapeutic intervention, and advanced clinical investigation, in order to encourage evidence-based healthcare practices.(AU)
Justificativa e Objetivos: a hepatite B é uma doença infectocontagiosa provocada por um vírus da família hepadnaviridae, com distribuição mundial, e representa um grave problema de saúde global. A patologia pode ter sido afetada pela pandemia de COVID-19, provocada pelo vírus SARS-CoV-2, sendo possível a ocorrência de desfechos graves na sobreposição entre os dos tipos virais. Este estudo buscou descrever os níveis de evidências científicas de pesquisas realizadas sobre o tema, estabelecendo relação entre a infecção por vírus da hepatite B e a infecção por SARS-CoV-2. Conteúdo: revisão integrativa da literatura, com buscas realizadas nas bases de dados do Medical Literature Analysis and Retrieval System Online e Scientific Electronic Library Online, com análise centrada na descrição do delineamento metodológico e na classificação do nível de evidência. Conclusão: a produção científica sobre hepatite B associada a infecção por SARS-CoV-2 corresponde majoritariamente a pesquisas com baixo nível de evidência. As publicações selecionadas apresentaram limitações, como a ocorrência de estudos com número reduzido de amostras, falta de dados subsidiários de pacientes em tratamento e ocorrência de seleção não randomizada. Os resultados sugerem a necessidade de novas investigações para fins de incrementos tecnológicos, identificação de fatores de risco, intervenção terapêutica e investigação clínica avançada, de forma a fomentar práticas assistenciais em saúde baseadas em evidências.(AU)
Justificación y Objetivo: la hepatitis B es una enfermedad infecciosa contagiosa causada por un virus de la familia hepadnaviridae, de distribución mundial, y representa un grave problema de salud mundial. Su patología puede haberse visto afectada por la pandemia de COVID-19, provocada por el virus SARS-CoV-2, y son posibles desenlaces graves cuando se superponen tipos virales. Este estudio buscó describir los niveles de evidencia científica de las investigaciones realizadas sobre el tema, estableciendo una relación entre la infección por el virus de la hepatitis B y la infección por el SARS-CoV-2. Contenido: revisión integradora de la literatura, con búsquedas realizadas en las bases de datos Medical Literature Analysis and Retrieval System Online y Scientific Electronic Library Online, con un análisis centrado en la descripción del diseño metodológico y en la clasificación del nivel de evidencia. Conclusión: la producción científica sobre la hepatitis B asociada a la infección por SARS-CoV-2 corresponde, en su mayoría, a investigaciones con bajo nivel de evidencia. Las publicaciones seleccionadas presentaron limitaciones como la ocurrencia de estudios con un número reducido de muestras, la falta de datos subsidiarios de los pacientes en tratamiento y la ocurrencia de selección no aleatoria. Los resultados sugieren la necesidad de seguir investigando para mejorar la tecnología, identificar los factores de riesgo, intervenir terapéuticamente y realizar investigación clínica avanzada, con el fin de promover prácticas sanitarias basadas en la evidencia.(AU)
Subject(s)
Humans , COVID-19 , Hepatitis B , CoinfectionABSTRACT
Background and Objectives: HIV/syphilis coinfection is an important problem to be considered during pregnancy due to the various negative outcomes such as abortion, stillbirth, prematurity and congenital infections. The study is justified by the need to identify scientific evidence of clinical-epidemiological characteristics and vulnerabilities related to infections, factors that influence the prevalence, and if there are related health problems. The objective was to synthesize scientific evidence about sociodemographic characteristics and clinical manifestations of associated cases of syphilis and HIV. Content: this is an integrative literature review, searching the PubMed, MEDLINE, CINAHL, LILACS, BDENF and MedCarib databases, using the descriptors "HIV", "Syphilis", "Epidemiology", "Coinfection" and "Pregnant woman", combined by Boolean operators "AND" and "OR", guided by the question: what is the scientific evidence related to the clinical-epidemiological characteristics of pregnant women co-infected with HIV/syphilis? It was held from June to September 2022, including articles published in the last eight years. Nine primary articles published between 2015 and 2020 were selected. The association of infections was present in pregnant women of young adult age, non-white race/color, married, low level of education, housewives, residents of urban areas and belonging to more economically disadvantaged social classes. Conclusion: the study highlighted the importance of improving prenatal care, with the aim of reducing the risks of vertical transmission of these diseases, especially with the implementation of public policies aimed at the clinical management of co-infected pregnant women, the allocation of resources and the development of specific intervention protocols.(AU)
Justificativa e Objetivos: A coinfecção HIV/sífilis é um problema importante a ser considerado durante a gravidez devido aos diversos desfechos negativos como aborto, natimorto, prematuridade e infecções congênitas. O estudo justifica-se pela necessidade de identificar evidências científicas de características clínico-epidemiológicas e vulnerabilidades relacionadas às infecções, fatores que influenciam a prevalência e se há problemas de saúde relacionados. O objetivo foi sintetizar evidências científicas sobre características sociodemográficas e manifestações clínicas de casos associados de sífilis e HIV. Conteúdo: trata-se de uma revisão integrativa da literatura, com busca nas bases de dados PubMed, MEDLINE, CINAHL, LILACS, BDENF e MedCarib, utilizando os descritores "HIV", "Syphilis", "Epidemiology", "Coinfection" e "Pregnant woman", combinados por Operadores booleanos "AND" e "OR", norteados pela questão: quais as evidências científicas relacionadas às características clínico-epidemiológicas de gestantes coinfectadas com HIV/sífilis? Foi realizado de junho a setembro de 2022, incluindo artigos publicados nos últimos oito anos. Foram selecionados nove artigos primários publicados entre 2015 e 2020. A associação das infecções esteve presente em gestantes em idade adulta jovem, raça/cor não branca, casadas, baixa escolaridade, donas de casa, residentes em zona urbana e pertencentes a classes sociais mais desfavorecidas economicamente. Conclusão: o estudo destacou a importância da melhoria da assistência pré-natal, com o objetivo de reduzir os riscos de transmissão vertical dessas doenças, especialmente com a implementação de políticas públicas voltadas ao manejo clínico das gestantes coinfectadas, à alocação de recursos e o desenvolvimento de protocolos de intervenção específicos.(AU)
Antecedentes y objetivos: La coinfección VIH/sífilis es un problema importante a considerar durante el embarazo debido a los diversos resultados negativos como aborto, muerte fetal, prematuridad e infecciones congénitas. El estudio se justifica por la necesidad de identificar evidencia científica de características clínico-epidemiológicas y vulnerabilidades relacionadas con las infecciones, factores que influyen en la prevalencia y si existen problemas de salud relacionados. El objetivo fue sintetizar evidencia científica sobre las características sociodemográficas y manifestaciones clínicas de los casos asociados de sífilis y VIH. Contenido: se trata de una revisión integradora de la literatura, buscando en las bases de datos PubMed, MEDLINE, CINAHL, LILACS, BDENF y MedCarib, utilizando los descriptores "VIH", "Sífilis", "Epidemiología", "Coinfección" y "Mujer embarazada", combinados por Operadores booleanos "Y" y "O", guiados por la pregunta: ¿cuál es la evidencia científica relacionada con las características clínico- -epidemiológicas de las gestantes coinfectadas con VIH/sífilis? Se realizó de junio a septiembre de 2022, incluyendo artículos publicados en los últimos ocho años. Se seleccionaron nueve artículos primarios publicados entre 2015 y 2020. La asociación de infecciones estuvo presente en mujeres embarazadas de edad adulta joven, de raza/color no blanca, casadas, de bajo nivel educativo, amas de casa, residentes de áreas urbanas y pertenecientes a clases sociales más desfavorecidas económicamente. Conclusión: el estudio destacó la importancia de mejorar la atención prenatal, con el objetivo de reducir los riesgos de transmisión vertical de estas enfermedades, especialmente con la implementación de políticas públicas orientadas al manejo clínico de las gestantes coinfectadas, la asignación de recursos y el desarrollo de protocolos de intervención específicos.(AU)
Subject(s)
Humans , Female , Pregnancy , Syphilis , HIV , Pregnant Women , Coinfection/epidemiology , Health Profile , Infectious Disease Transmission, VerticalABSTRACT
INTRODUCCIÓN. La procalcitonina, es un biomarcador que puede usarse como apoyo diagnóstico en infecciones bacterianas y la monitorización del tratamiento antibiótico, sobre todo en pacientes con sepsis. De ahí que, fue utilizado durante la pandemia COVID-19 OBJETIVO. Determinar los valores de procalcitonina en pacientes con COVID-19 y definir una p osible correlación entre su incremento y vinculación en coinfección o infección secundaria por Klebsiella pneumoniae y Pseudomonas aeruginosa con multidrogo resistencia y resistencia extendida a los antibióticos. MATERIALES Y MÉTODOS. Estudio retrospectivo observacional, descriptivo transversal, realizado del 1 de mayo al 31 de octubre del 2020 en el Hospital de Especialidades Carlos Andrade Marín sobre 7028 pacientes adultos, hospitalizados, con diagnóstico de COVID-19, y resultados de procalcitonina, cuyas muestras de secreción traqueal y/o hemocultivo presentaron desarrollo de Klebsiella pneumoniae y Pseudomonas aeruginosa. Su análisis estadístico fue desarrollado mediante la prueba Chi Cuadrado de Pearson. RESULTADOS. Se recibieron 861 muestras de hemocultivo y 391 de secreción traqueal, obteniéndose: 32% aislamientos de Klebsiella pneumoniae y Pseudomonas aeruginosa multidrogo y extremadamente resistente. Entre los pacientes COVID-19 que fallecieron, 34,4% mostraron incrementos de procalcitonina. Al contrario, entre los pacientes que sobrevivieron sólo en 8,8% se observó incrementos de procalcitonina evidenciándose un vínculo entre el incremento de procalcitonina y mortalidad. CONCLUSIONES. No existe diferencia en relación al incremento en los valores de procalcitonina en pacientes COVID-19 con co-infección o infección secundaria por Klebsiella pneumoniae y Pseudomonas aeruginosa multidrogo y extremadamente resistente y los valores de procalcitonina en pacientes con coinfección e infección secundaria con otro tipo de aislamientos bacterianos.
INTRODUCTION. Procalcitonin is a biomarker that can be used as a diagnostic support in bacterial infections and the monitoring of antibiotic treatment, especially in patients with sepsis. Hence, it was used during the COVID-19 pandemic OBJECTIVE. To determine the values of procalcitonin in patients with COVID-19 and to define a possible correlation between its increase and linkage in co-infection or secondary infection by Klebsiella pneumoniae and Pseudomonas aeruginosa with multidrug resistance and extended resistance to antibiotics. MATERIALS AND METHODS. Retrospective observational, descriptive cross-sectional study, conducted from May 1 to October 31, 2020 at the Hospital de Especialidades Carlos Andrade Marín on 7028 adult patients, hospitalized, with diagnosis of COVID-19, and procalcitonin results, whose tracheal secretion and/or blood culture samples presented development of Klebsiella pneumoniae and Pseudomonas aeruginosa. Their statistical analysis was developed using Pearson's Chi-squared test. RESULTS. We received 861 blood culture and 391 tracheal secretion samples, obtaining: 32% isolates of Klebsiella pneumoniae and multidrug-resistant and extremely resistant Pseudomonas aeruginosa. Among the COVID-19 patients who died, 34.4% showed increased procalcitonin levels. On the contrary, among patients who survived, only 8.8% showed increased procalcitonin levels, showing a link between increased procalcitonin levels and mortality. CONCLUSIONS. There is no difference in relation to the increase in procalcitonin values in COVID-19 patients with co-infection or secondary infection by Klebsiella pneumoniae and multidrug-resistant and extremely resistant Pseudomonas aeruginosa and procalcitonin values in patients with co-infection and secondary infection with other types of bacterial isolates.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Pseudomonas aeruginosa , Drug Resistance, Multiple , Coinfection , Procalcitonin , COVID-19 , Klebsiella pneumoniae , Trachea , Biomarkers , Sepsis , Ecuador , Anti-Bacterial AgentsABSTRACT
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)
Subject(s)
Humans , Tuberculosis , HIV Infections , Health Information Systems , Cross-Sectional Studies , CoinfectionABSTRACT
Antecedentes: Se ha demostrado que la coinfección tu-berculosis y COVID-19 presenta peor evolución clínica. La inmunidad protectora se debilita frente a esta situación, generando fallo en el control de ambas infecciones, reac-tivación de formas latentes de tuberculosis y progresión exacerbada de los casos activos. Asimismo, la terapia con corticoides utilizada dentro del tratamiento de infecciones graves por COVID-19 puede generar inmunosupresión y precipitar la progresión de la tuberculosis.Objetivos: Describir las características clínicas, presenta-ción y evolución de los pacientes críticos con coinfección COVID-19 y tuberculosis. Evaluar la incidencia y letalidad de la asociación COVID-19 y tuberculosis en cuidados in-tensivos. Materiales y métodos: Se realizó un estudio retrospectivo, descriptivo. Se revisaron 12 historias clínicas de pacientes con coinfección COVID-19-tuberculosis sobre 1014 histo-rias clínicas de pacientes ingresados con diagnóstico de COVID-19, durante el periodo comprendido enero 2020 y junio 2022. Se utilizó estadística descriptiva. Resultados y discusión: Sobre un total de 1014 historias clínicas, se encontraron 12 pacientes con coinfección (in-cidencia de 0,011). La letalidad global en cuidados inten-sivos fue del 75%, a los 45 días fue del 83,3%, duplicando la letalidad general de los pacientes COVID-19 no coinfec-tados ingresados durante el mismo periodo (75% versus 37%). Los pacientes que requirieron ingreso a ventilación RESUMENARTÍCULO ORIGINALmecánica tuvieron una letalidad del 100% y aquellos que tenían infección por virus de inmunodeficiencia adquirida presentaron una letalidad de 100%. Resulta importante describir los hallazgos y alertar sobre la evolución desfavorable de aquellos pacientes que pre-sentan esta asociación a fin de optimizar el manejo y espe-cialmente recomendar la búsqueda de coinfección cuando el criterio clínico lo requiera
Background: Coinfection with tuberculosis and COVID-19 has been shown to have a worse clinical course. Protective immunity is weakened in this situation, leading to failure to control both infections, reactivation of latent forms of TB and exacerbated progression of active cases. Furthermore, corticosteroid therapy used in the treatment of severe COVID-19 infections can lead to immunosuppression and precipitate TB progression.Objectives: To describe the clinical characteristics, presentation and evolution of critically ill patients with COVID-19 and tuberculosis co-infection.To evaluate the incidence and lethality of COVID-19 and tuberculosis association in intensive care.Materials and methods: A retrospective, descriptive study was conducted. Twelve medical records of patients aged 18 years or older admitted to intensive care with a diagnosis of COVID-19 during the period January 2020 to July 2022 were reviewed. Descriptive statistics were used.Results and discussion: Out of a total of 1014 medical records, 12 patients were found with co-infection (incidence 0.011). The global intensive care case fatality was 75%, at 45 days it was 83.3%. This was twice the overall case fatality of non-co-infected COVID-19 patients admitted during the same period (75% versus 37%). Patients requiring admission to mechanical ventilation had a 100% case fatality and those with acquired immunodeficiency virus infection had a 100% case fatality.It is important to describe the findings and to alert to the worse evolution of those patients presenting with this association, in order to improve management and recommend searching for co-infection when clinical criteria require it
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Tuberculosis/therapy , Critical Care , Coinfection/immunology , COVID-19/immunologyABSTRACT
Background: Initiating newly diagnosed people living with human immunodeficiency virus (HIV) onto antiretroviral treatment (ART) and retaining patients on treatment are vital to South Africa's ART programme. In 2020, coronavirus disease 2019 (COVID-19) and its accompanying containment (lockdown) measures presented unprecedented challenges to achieving these objectives. Aim: This study describes the impact of COVID-19 and related restrictions on district-level numbers of newly diagnosed people living with HIV and defaulting ART patients. Setting: Buffalo City Metropolitan Municipality (BCMM) in the Eastern Cape of South Africa. Methods: Mixed-methods approach: Monthly aggregated electronic patient data (newly initiated and restarted on ART) from 113 public healthcare (PHC) facilities were analysed (December 2019 to November 2020) across varying levels of COVID-19 lockdown regulation periods; telephonic in-depth interviews at 10 rural BCMM PHC facilities were conducted with facility staff, community health workers (CHWs) and intervention personnel. Results: The number of newly initiated ART patients decreased dramatically compared with pre-COVID-19 levels. The overall number of restarted ART patients increased in response to fears of co-infection with COVID-19. Facility-level communications and community outreach promoting HIV testing and treatment were disrupted. Novel approaches to providing services to ART patients were developed. Conclusion: Programmes for identifying undiagnosed people living with HIV and services aimed at retaining ART patients in care were profoundly impacted by COVID-19. The value of CHWs was highlighted, as were communication innovations. Contribution: This study describes the impact of COVID-19 and related regulations on HIV testing, ART initiation and adherence to treatment in a District of the Eastern Cape of South Africa.
Subject(s)
Humans , Male , Female , Therapeutics , HIV Infections , Community Health Workers , Coinfection , COVID-19 , Delivery of Health Care , DiagnosisABSTRACT
Background. The COVID-19 pandemic has added an additional burden in countries with already fragile health systems. Our objective was to determine the prevalence and seroprevalence of COVID-19 in suspected malaria during the second wave in Yaounde. Methods. A descriptive cross-sectional study was conducted at the Jordan Medical Services for 8 weeks from April 19 to June 13, 2021, i.e., during the second wave in Cameroon. For the 86 patients with suspected malaria, nasopharyngeal and blood samples were taken for SARS-CoV-2 antigen and anti-SARS-CoV-2 IgG and IgM using the STANDARD TM Q COVID-19 Ag kit from SD BIOSENSOR, Korea, 2020 and Standard TM Q COVID 19 Ac IgG/IgM kit from SD BIOSENSOR, Korea, 2020 respectively. Confirmation of malaria was done by microscopic examination of stained blood smears. Results. Malaria was confirmed in 20.9% (18) of cases. The prevalences of COVID-19 and COVID-19/malaria co-infection were 8.1% and 0.9% respectively. Of the 25.6% (54) of patients with anti-COVID-19 IgM, no positive microscopic cases were found. On the other hand, a little more than half of the patients had IgG antibodies against COVID-19 whether they had a positive thick drop or not (56.0% (42/75) and 52.2% (71/136) respectively). Conclusion. In case of suspicion of malaria in a malaria area, it seems important to consider COVID-19 as a differential diagnosis.
Introduction. La pandémie de la COVID-19 a ajouté un fardeau supplémentaire dans les pays aux systèmes de santé déjà fragiles. Objectif : déterminer la prévalence et la séroprévalence de la COVID-19 en cas de suspicion du paludisme au cours de la deuxième vagueà Yaoundé. Méthodologie. Une étude transversale descriptive a été menée au Centre Médical le Jourdain pendant 8 semaines du 19 Avril au 13 Juin 2021 soit durant la deuxième vague au Cameroun. Pour les 86 patients avec suspicion de paludisme, des prélèvements nasopharyngé et sanguins ont été réalisés pour la recherche d'antigène du SRAS- CoV 2 et des IgG et IgM anti-SARS-CoV-2 grâce aux kits STANDARDTM Q COVID-19 Ag de SD BIOSENSOR, Corée, 2020 et StandardTM Q COVID 19 Ac IgG/IgM de SD BIOSENSOR, Corée, 2020 respectivement. La confirmation du paludisme a été faite grâce à l'examen microscopique des étalements de sang colorés. Résultats. Le paludisme était confirmé dans 20,9% (18) des cas. Les prévalences de la COVID-19 et de la coïnfection COVID19/Paludisme étaient de 8,1% et de 0,9% respectivement. Sur les 25,6% (54) des patients avec des IgM anti-COVID-19, aucun cas de microscopie positive n'a été retrouvé. Par ailleurs un peu plus de la moitié des patients avaient des anticorps IgG anti-COVID-19 qu'ils aient une goutte épaisse positive ou pas soit 56,0% (42/75) et 52,2% (71/136) respectivement. Conclusion. En cas de suspicion du paludisme en zone impaludée, il parait non négligeable de considérer la COVID-19 comme un diagnostic différentiel.
Subject(s)
Humans , Male , Female , Signs and Symptoms , COVID-19 , Malaria , Therapeutics , Prevalence , Coinfection , SARS-CoV-2ABSTRACT
Background. Health care personnel constitute a group at high risk of contracting COVID-19. However, the vaccination rate in this group in our context remains low. The objective of our study was to determine the factors associated with COVID-19 vaccine hesitancy among health care workers in Yaounde. Methods.We conducted a cross-sectional study of 360 health personnel in three hospitals in the city of Yaounde from January to March 2022, i.e., 3 months. All health personnel who gave their free consent were included. Ethical clearance was obtained from the Institutional Ethics and Research Committee of the Faculty of Medicine and Biomedical Sciences of the University of Yaounde I. A logistic regression was performed to search for factors associated with reluctance to vaccinate, with a significance level of 0.05. Results.The vaccination rate against COVID-19 was 34% (123). Factors associated with vaccine hesitancy were female gender (OR [95% CI] =3.5[2.2-5.5]; p<0.001), working outside a COVID-19 management unit (OR [95% CI]=6, [2.1-18.5]; p=0.001), fear of the harmfulness of COVID-19 vaccines (OR [CI 95%] =2.7[1.7-4.2]; p<0.001), and doubt of vaccine efficacy (OR [CI 95%] =4.0[2.5-6.4]; p<0.001). Conclusion:Health personnel are still reluctant to vaccinate in our context. Factors associated with hesitancy to vaccination against COVID-19 could help deconstruct apprehensions.
Introduction. La pandémie de la COVID-19 a ajouté un fardeau supplémentaire dans les pays aux systèmes de santé déjà fragiles. Objectif : déterminer la prévalence et la séroprévalence de la COVID-19 en cas de suspicion du paludisme au cours de la deuxième vagueà Yaoundé. Méthodologie. Une étude transversale descriptive a été menée au Centre Médical le Jourdain pendant 8 semaines du 19 Avril au 13 Juin 2021 soit durant la deuxième vague au Cameroun. Pour les 86 patients avec suspicion de paludisme, des prélèvements nasopharyngé et sanguins ont été réalisés pour la recherche d'antigène du SRAS- CoV 2 et des IgG et IgM anti-SARS-CoV-2 grâce aux kits STANDARDTM Q COVID-19 Ag de SD BIOSENSOR, Corée, 2020 et StandardTM Q COVID 19 Ac IgG/IgM de SD BIOSENSOR, Corée, 2020 respectivement. La confirmation du paludisme a été faite grâce à l'examen microscopique des étalements de sang colorés. Résultats. Le paludisme était confirmé dans 20,9% (18) des cas. Les prévalences de la COVID-19 et de la coïnfection COVID19/Paludisme étaient de 8,1% et de 0,9% respectivement. Sur les 25,6% (54) des patients avec des IgM anti-COVID-19, aucun cas de microscopie positive n'a été retrouvé. Par ailleurs un peu plus de la moitié des patients avaient des anticorps IgG anti-COVID-19 qu'ils aient une goutte épaisse positive ou pas soit 56,0% (42/75) et 52,2% (71/136) respectivement. Conclusion. En cas de suspicion du paludisme en zone impaludée, il parait non négligeable de considérer la COVID-19 comme un diagnostic différentiel.
Subject(s)
Humans , Male , Female , Immunoglobulin G , Immunoglobulin M , Health Personnel , Severe Acute Respiratory Syndrome , Delivery of Health Care , Coinfection , COVID-19 Vaccines , COVID-19 , Vaccination Hesitancy , Cross-Sectional Studies , PandemicsABSTRACT
Introduction Mycobacterium tuberculosis remains the main cause of death as an infectious agent of Tuberculosis in humans, particularly in resource-poor settings. Worldwide, Tuberculosis is one of the top 10 causes of mortality. Objective of the study This study aims to determine the outcomes of TB treatment and assess the factors associated with unsuccessful TB treatment outcome among TB/HIV co-infected patients in Rwanda. Methods This was a retrospective cohort study of all TB/HIV co-infected patients reported in the national electronic TB reporting system (e-TB) by all health facilities from July 2019 to June 2020. Frequencies, proportions, bivariate and multivariate logistic regression were performed to determine factors associated with unsuccessful TB treatment. Results There were 1,144 people reported in the e-TB, however, only 987 were included in the study because 157 patients did not meet the inclusion criteria.The TB/HIV coinfected patients who were not given nutritional support, OR 7.3, 95%CI [1.4, 37.6] and those who were not on ART,OR15.3, 95%CI [3.6, 69.6],were more likely to have unsuccessful treatment outcome than their counterparts. Conclusion Unsuccessful TB treatment outcomes were highly observed among TB/HIV coinfected patients. The study recommended reinforcing nutritional support and early initiation of ART among TB/HIV co-infected patients.
Subject(s)
Humans , Male , Female , Tuberculosis , HIV Infections , Cohort Studies , CoinfectionABSTRACT
Objective: To investigate the clinical characteristics and the risk factors of severe human metapneumovirus (hMPV)-associated community acquired pneumonia (CAP) in children. Methods: A retrospective case summary was conducted. From December 2020 to March 2022, 721 children who were diagnosed with CAP and tested positive for hMPV nucleic acid by PCR-capillary electrophoresis fragment analysis of nasopharyngeal secretions at the Yuying Children's Hospital, the Second Affiliated Hospital of Wenzhou Medical University were selected as the research objects. The clinical characteristics, epidemiological characteristics and mixed pathogens of the two groups were analyzed. According to CAP diagnostic criteria, the children were divided into the severe group and the mild group. Chi-square test or Mann-Whitney rank and contrast analysis was used for comparison between groups, while multivariate Logistic regression was applied to analyze the risk factors of the severe hMPV-associated CAP. Results: A total of 721 children who were diagnosed with hMPV-associated CAP were included in this study, with 397 males and 324 females. There were 154 cases in the severe group. The age of onset was 1.0 (0.9, 3.0) years, <3 years old 104 cases (67.5%), and the length of hospital stay was 7 (6, 9) days. In the severe group, 67 children (43.5%) were complicated with underlying diseases. In the severe group, 154 cases (100.0%) had cough, 148 cases (96.1%) had shortness of breath and pulmonary moist rales, and 132 cases (85.7%) had fever, 23 cases (14.9%) were complicated with respiratory failure. C-reactive protein (CRP) was elevated in 86 children (55.8%), including CRP≥50 mg/L in 33 children (21.4%). Co-infection was detected in 77 cases (50.0%) and 102 strains of pathogen were detected, 25 strains of rhinovirus, 17 strains of Mycoplasma pneumoniae, 15 strains of Streptococcus pneumoniae, 12 strains of Haemophilus influenzae and 10 strains of respiratory syncytial virus were detected. Six cases (3.9%) received heated and humidified high flow nasal cannula oxygen therapy, 15 cases (9.7%) were admitted to intensive care unit, and 2 cases (1.3%) received mechanical ventilation. In the severe group, 108 children were cured, 42 children were improved, 4 chlidren were discharged automatically without recovery and no death occurred. There were 567 cases in the mild group. The age of onset was 2.7 (1.0, 4.0) years, and the length of hospital stay was 4 (4, 6) days.Compared with the mild group, the proportion of children who age of disease onset <6 months, CRP≥50 mg/L, the proportions of preterm birth, congenital heart disease, malnutrition, congenital airway malformation, neuromuscular disease, mixed respiratory syncytial viruses infection were higher (20 cases (13.0%) vs. 31 cases (5.5%), 32 cases (20.8%) vs. 64 cases (11.3%), 23 cases (14.9%) vs. 44 cases (7.8%), 11 cases (7.1%) vs. 18 cases (3.2%), 9 cases (5.8%) vs. 6 cases (1.1%), 11 cases (7.1%) vs. 12 cases (2.1%), 8 cases (5.2%) vs. 4 cases (0.7%), 10 cases (6.5%) vs. 13 cases (2.3%), χ2=0.42, 9.45, 7.40, 4.94, 11.40, 8.35, 3.52, 6.92, all P<0.05). Multivariate Logistic regression analysis showed that age<6 months (OR=2.51, 95%CI 1.29-4.89), CRP≥50 mg/L (OR=2.20, 95%CI 1.36-3.57), prematurity (OR=2.19, 95%CI 1.26-3.81), malnutrition (OR=6.05, 95%CI 1.89-19.39) were the independent risk factors for severe hMPV-associated CAP. Conclusions: Severe hMPV-associated CAP is most likely to occur in infants under 3 years old and has a higher proportion of underlying diseases and co-infection. The main clinical manifestations are cough, shortness of breath and pulmonary moist rales, fever. The overall prognosis is good. Age<6 months, CRP≥50 mg/L, preterm birth, malnutrition are the independent risk factors for severe hMPV-associated CAP.
Subject(s)
Infant , Male , Female , Humans , Child , Infant, Newborn , Child, Preschool , Retrospective Studies , Cough , Coinfection , Premature Birth , Respiratory Sounds , Metapneumovirus , Pneumonia, Viral/epidemiology , Respiratory Syncytial Virus, Human , Community-Acquired Infections/epidemiology , Risk Factors , Dyspnea , MalnutritionABSTRACT
Objective: To understand the infection status and epidemiological characteristics of hepatitis C in people aged 1-69 years in Henan Province in 2020. Methods: The estimated sample size was 5 827. From August to December 2020, multistage sampling was used to select 8 counties (districts) in Henan, and two survey sites were selected in each county (district), and a questionnaire survey was conducted in local people aged 1-69 years, blood samples were collected from them for anti-HCV, HCV RNA and genotype detections. Results: A total of 5 165 people aged 1-69 years completed the questionnaire survey. Men accounted for 44.76% (2 312/5 165), women accounted for 55.24% (2 853/5 165). In the people aged 1-69 years, the overall prevalence rates of anti-HCV and HCV RNA were 0.69% (95%CI: 0.68%-0.70%) and 0.20% (95%CI: 0.19%-0.21%) respectively. The prevalence rates of anti-HCV and HCV RNA were 0.48% (95%CI: 0.46%-0.50%), 0.09% (95%CI: 0.08%-0.10%) in men and 0.86% (95%CI: 0.85%-0.87%), 0.30% (95%CI: 0.28%-0.32%) in women. The prevalence rates of anti-HCV and HCV RNA increased with age. The prevalence rates of anti-HCV and HCV RNA were 0.87% (95%CI: 0.86%-0.88%), 0.28% (95%CI: 0.26%-0.30%) in urban residents and 0.53% (95%CI: 0.51%-0.55%), 0.14% (95%CI: 0.13%-0.15%) in rural residents. The genotyping results of 10 HCV RNA positive samples ware genotype 1b (4/10), genotype 2 (3/10), genotype 1b/3 (1/10), genotype 1b/3/6 (1/10) and genotype 2/6 (1/10). Conclusions: The prevalence of hepatitis C was low in Henan in 2020. It is necessary to strengthen hepatitis C surveillance in people aged 40 years and above. The major HCV genotypes were 1b and 2, and mixed genotype infection existed.
Subject(s)
Female , Humans , Male , Infant , Child, Preschool , Child , Adolescent , Young Adult , Adult , Middle Aged , Aged , Coinfection , Genotype , Hepacivirus/genetics , Hepatitis C/epidemiology , Hepatitis C Antibodies/genetics , Prevalence , RNA, Viral/genetics , Surveys and QuestionnairesABSTRACT
Objective: We analyze the characteristics of Clostridioides difficile (C. difficile) infection among diarrhea patients in Kunming from 2018 to 2020 and provide evidence for follow-up surveillance and prevention. Methods: A total of 388 fecal samples of diarrhea patients from four sentinel hospitals in Yunnan Province from 2018 to 2020 were collected. Real-time quantitative PCR was used to detect the fecal toxin genes of C. difficile. The positive fecal samples isolated the bacteria, and isolates were identified by mass spectrometry. The genomic DNA of the strains was extracted for multi-locus sequence typing (MLST). The fecal toxin, strain isolation, and clinical patient characteristics, including co-infection with other pathogens, were analyzed. Results: Among the 388 fecal samples, 47 samples with positive reference genes of C. difficile were positive, with a total positive rate of 12.11%. There were 4 (8.51%) non-toxigenic and 43 (91.49%) toxigenic ones. A total of 18 strains C. difficile were isolated from 47 positive specimens, and the isolation rate of positive specimens was 38.30%. Among them, 14 strains were positive for tcdA, tcdB, tcdC, tcdR, and tcdE. All 18 strains of C. difficile were negative for binary toxins. The MLST results showed 10 sequence types (ST), including 5 strains of ST37, accounting for 27.78%; 2 strains of ST129, ST3, ST54, and ST2, respectively; and 1 strain of ST35, ST532, ST48, ST27, and ST39, respectively. Fecal toxin gene positive (tcdB+) results were statistically associated with the patient's age group and with or without fever before the visit; positive isolates were only statistically associated with the patient's age group. In addition, some C. difficile patients have co-infection with other diarrhea-related viruses. Conclusions: The infection of C. difficile in diarrhea patients in Kunming is mostly toxigenic strains, and the high diversity of strains was identified using the MLST method. Therefore, the surveillance and prevention of C. difficile should be strengthened.
Subject(s)
Humans , Bacterial Toxins/genetics , Enterotoxins/genetics , Clostridioides difficile/genetics , Multilocus Sequence Typing , Coinfection , Bacterial Proteins/genetics , China/epidemiology , Clostridium Infections/epidemiology , Diarrhea/microbiologyABSTRACT
Human bocavirus is a novel pathogen first detected in respiratory tract samples in 2005. People of different ages can be infected by human bocavirus. Children are the susceptible population, especially the infants aged from 6-24 months old. The epidemic season varies in different regions due to the differences in climate and geographical location, and it mainly occurs in autumn and winter. It's demonstrated that human bocavirus-1 is closely related to respiratory system diseases and even causes life-threatening critical illness. Also, the severity of symptom is positively correlated with viral load. Co-infections between human bocavirus-1 and other viruses often present high frequency occurrence. Human bocavirus-1 interferes immune function of host by inhibiting interferon secrete pathway. Currently, it remains limited knowledge and understanding of the roles of human bocavirus 2-4 in diseases, but the gastrointestinal diseases should be paid more attention. Detection of human bocavirus DNA by traditional polymerase chain reaction (PCR) assay shouldn't be regarded as conclusive diagnostic basis. Instead, combined with mRNA and specific antigen detection, it is beneficial to improve the accuracy of diagnosis. Till now, the knowledge of human bocavirus remains poorly studied, which is deserved to further progress.
Subject(s)
Infant , Humans , Child , Child, Preschool , Human bocavirus , Climate , Coinfection , Epidemics , InterferonsABSTRACT
El número de casos totales de la enfermedad coronavirus-2019 (Covid-19) sigue aumentando rápidamente, amenazando a miles o millones de personas con condiciones crónicas preexistentes que se ven afectados de manera desproporcionada. Hasta el 2020, el centro de recursos de coronavirus de la Universidad Johns Hopkins informó que en todo el mundo más de 180 países han sido afectados con Covid-19 con más de doce millones de casos confirmados y más de 500,000 muertes. A medida que continúa la investigación relacionada con los posibles factores de riesgo de mortalidad por Covid-19, se hace evidente que las personas con comorbilidades subyacentes, como enfermedades cardiovasculares, hipertensión, diabetes, insuficiencia cardíaca congestiva, enfermedad cerebrovascular, enfermedad renal crónica, enfermedad hepática crónica, cáncer, enfermedad pulmonar obstructiva crónica, el asma y el VIH/SIDA pueden tener un mayor riesgo de muerte por Covid-19. El objetivo de este trabajo es determinar las comorbilidades infecciosas en la gravedad y mortalidad por Covid-19 especialmente asociadas con VIH/SIDA y tubercolosis, respodiendo a la siguiente pregunta: ¿La comunidad científica mundial se ha preocupado por la comorbilidad infecciosa en casos de covid-19 severos y fatales?. Un análisis hecho al grupo de referencias The Lancet Publishing Group fue realizado para dar repuesta a dicha pregunta(AU)
The number of total cases of coronavirus disease-2019 (COVID-19) continues to rise rapidly, threatening thousands or millions of people with pre-existing chronic conditions who are disproportionately affected. As of 2020, the Johns Hopkins University Coronavirus Resource Center reported that worldwide more than 180 countries have been affected with COVID-19 with more than twelve million confirmed cases and more than 500,000 deaths. As research related to potential risk factors for mortality from COVID-19 continues, it becomes clear that people with underlying comorbidities, such as cardiovascular disease, hypertension, diabetes, congestive heart failure, cerebrovascular disease, chronic kidney disease, chronic liver disease, cancer, chronic obstructive pulmonary disease, asthma, and HIV/AIDS may be at increased risk of death from COVID-19. The objective of this work is to determine the infectious comorbidities in severity and mortality from Covid-19, especially associated with HIV/AIDS and tuberculosis, answering the following question: Has the world scientific community been concerned about infectious comorbidity in covid-19 severe and fatal cases? An analysis made to the reference group The Lancet Publishing Group was carried out to answer this question(AU)
Subject(s)
Humans , Comorbidity , HIV Infections , Communicable Diseases/mortality , COVID-19/epidemiology , Meta-Analysis , Coinfection/epidemiologyABSTRACT
Um dos grandes desafios para o controle da coinfecção de tuberculose (TB) e do vírus da imunodeficiência humana (HIV) é o tratamento, que, apesar de ser disponibilizado gratuitamente no Sistema Único de Saúde, apresenta baixos índices de adesão, bem como abandono do tratamento de ambas as doenças por diversos motivos, por exemplo, ausência de vínculo com os serviços de saúde, difícil ingestão dos múltiplos medicamentos e suas possíveis reações adversas, entre outros, consequentemente levando a desfechos desfavoráveis. Nesse sentido, este artigo pretende analisar os desfechos do tratamento de TB em pessoas vivendo com HIV em Rondônia, entre 2008 e 2018. Trata-se de um estudo ecológico com abordagem quantitativa, a partir do levantamento das variáveis clínicas, município de residência e notificação dos casos de coinfecção TB/HIV, com idade igual ou superior a 18 anos, residentes do estado e que não apresentassem a variável "situação de encerramento" em branco. Os dados foram analisados espacialmente no TabWin. Dos 721 casos selecionados, identificou-se baixo percentual de cura (50-84%) e elevado de abandono (6-49%), com tempo médio entre diagnóstico e tratamento de nove dias e, de tratamento, de 158 dias. Somente 25 municípios do estado notificaram casos de coinfecção, embora 34 se caracterizassem como municípios de residência. Com isso, verificam-se centralização das notificações e dificuldades nas estratégias de adesão e vínculo, tal como o tratamento diretamente observado, repercutindo nas ações de controle e, consequentemente, nos desfechos desfavoráveis para o tratamento da TB em pessoas vivendo com HIV em Rondônia.
One of the great challenges for the control of tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection is the treatment, which, despite being available free of charge within the scope of the Brazilian National Health System, has low adherence rates and abandonment of treatment of both diseases for various reasons, for example, lack of a bond with health services, difficulty of ingestion of the multiple medications and their possible adverse reactions, among others, which consequently leads to unfavorable outcomes. In this sense, this article aimed to analyze the outcomes of TB treatment in people living with HIV in Rondônia, between 2008 and 2018. It is an ecological study with a quantitative approach, based on a survey of the clinical variables, municipality of residence and notification of cases of TB/HIV co-infection aged 18 years or over, residents of the state, and who did not have the variable "closure status" blank. Data were spatially analyzed in TabWin. Of the 721 selected cases, a low percentage of cure (50-84%) and a high percentage for abandonment (6-49%) were identified, with a mean time between diagnosis and treatment of nine days and treatment time of 158 days. Only 25 municipalities in the state reported cases of coinfection, although 34 were characterized as the municipality of residence. Thus, there is a centralization of notifications and difficulties in adherence and bonding strategies, such as the treatment directly observed, having repercussions on control actions and, consequently, on unfavorable outcomes for TB treatment in people living with HIV in Rondônia.
Uno de los grandes desafíos para controlar la coinfección de tuberculosis (TB) y del virus de la inmunodeficiencia humana (VIH) es el tratamiento, que, a pesar de ser gratuito en el ámbito del Sistema Único de Salud, presenta bajas tasas de adherencia y abandono de ambas enfermedades, por diversas razones, ya sea por la falta de vinculación con los servicios de salud y múltiples medicamentos de difícil toma y sus posibles reacciones adversas, por ejemplo, que en consecuencia conducen a desenlaces desfavorables. En ese sentido, este estudio tuvo como objetivo analizar los resultados del tratamiento de la TB en personas que viven con el VIH en Rondônia (Brasil), en el periodo entre 2008 y 2018. Este es un estudio ecológico con enfoque cuantitativo, basado en la encuesta de variables clínicas, municipio de residencia y notificación de casos de infección por TB/VIH en pacientes de 18 años o más, residentes en el estado y que no tenían en blanco la variable "estado de cierre". Los datos se analizaron espacialmente en TabWin. De los 721 casos seleccionados se identificó un bajo porcentaje de curación (50-84%) y un alto porcentaje de abandono (6-49%), con un tiempo promedio entre diagnóstico y tratamiento de nueve días y, por tratamiento, de 158 días. Solamente 25 municipios del estado reportaron casos de coinfección, aunque 34 se caracterizaron como municipios de residencia. Esto demuestra haber una centralización de las notificaciones y dificultades en las estrategias de adhesión y vinculación, como el tratamiento directamente observado, teniendo repercusiones en las acciones de control y, consecuentemente, en resultados desfavorables para el tratamiento de la TB en personas que viven con VIH en Rondônia.
Subject(s)
Tuberculosis , HIV Infections , HIV , Treatment Outcome , CoinfectionABSTRACT
Existen numerosas entidades en la población pediátrica que pueden presentarse en forma de quistes o como lesiones de similares características. De estas patologías, las infecciosas son las más frecuentes. Se presenta el caso de una paciente oriunda de Bolivia con migración reciente a la Argentina que presentó una coinfección con tuberculosis e hidatidosis pulmonar. Ambas infecciones se pueden presentar con signos y síntomas similares y, aunque la asociación citada es poco frecuente en la bibliografía, ciertos mecanismos inmunitarios podrían intervenir en la coinfección de parásitos helmintos y micobacterias. Ambas patologías son infecciones prevalentes en nuestra región y deben ser tenidas en cuenta entre los diagnósticos diferenciales ante pacientes con imágenes quísticas o cavitarias pulmonares.
Numerous entities in the pediatric population can present in the form of cysts or as lesions with similar characteristics. Of the pathologies that can cause these images in children, infectious diseases are the most frequent. We present the case of a native of Bolivia with recent immigration to Argentina who presented a pulmonary co-infection with tuberculosis and hydatidosis. Both infections can present with similar signs and symptoms and although this association is rarely reported in the literature, certain immunological mechanisms could intervene in the causal association of co-infection between helminth parasites and mycobacteria. Both pathologies are very prevalent infections in our region and should be taken into account among the differential diagnoses in patients with cystic or cavitary pulmonary diseases.
Subject(s)
Humans , Female , Adolescent , Tuberculosis/complications , Tuberculosis/diagnosis , Cysts , Echinococcosis/diagnosis , Coinfection/diagnosis , Lung DiseasesABSTRACT
Objetivo: identificar as evidências disponíveis na literatura científica sobre as manifestações clínicas da coinfecção entre COVID-19 e Dengue em adultos. Método: revisão integrativa, realizadas nas bases MEDLINE/PUBMED, LILACS, IBECS, WoS e EMBASE, em junho de 2021. Os descritores "adulto", "Infecções por Coronavírus" e "dengue" junto aos seus sinônimos, foram cruzados por meio de operadores booleanos "AND" e "OR". Resultados: Foram incluídos 23 estudos, predominando estudos de caso 19 (82,6%). As principais manifestações clínicas identificadas a partir dos estudos foram: febre, cefaleia, dispneia, tosse, mialgia, dor retro orbital e rash cutâneo. Além de achados laboratoriais como: trombocitopenia, linfopenia e leucopenia. Conclusão: a coinfecção COVID-19 e Dengue foi identificada e aponta-se a necessidade da busca imediata do diagnóstico diferencial, para prevenir os agravos clínicos e diminuir os desfechos inesperados.
Objective: to identify the evidence available in the scientific literature on the clinical manifestations of co-infection between Covid-19 and dengue in adults. Method: integrative review, carried out in the MEDLINE/PUBMED, LILACS, IBECS, WoS and EMBASE databases, in June 2021. The descriptors "adult", "Coronavirus infections" and "dengue" with their synonyms were crossed by means of operators Booleans AND and OR. Results: 23 studies were included, with a predominance of 19 case studies (82.6%).The main clinical manifestations identified from the studies were: fever, headache, dyspnea, cough, myalgia, retro orbital pain, and skin rash. In addition to laboratory findings such as: thrombocytopenia, lymphopenia, and leukopenia. Conclusion: covid-19 and Dengue coinfection was identified and the need for an immediate search for a differential diagnosis is pointed out, in order to prevent clinical problems and reduce unexpected outcomes.
Objetivo: identificar la evidencia disponible en la literatura científica sobre las manifestaciones clínicas de la coinfección entre Covid-19 y Dengue en adultos. Método: revisión integrativa, realizada en las bases de datos MEDLINE / PUBMED, LILACS, IBECS, WoS y EMBASE, en junio de 2021. Los descriptores "adulto", "Infecciones por coronavirus" y "dengue" con sus sinónimos fueron cruzados mediante operadores booleanos "AND" y "OR". Resultados: se incluyeron 23 estudios, con predominio de 19 estudiosde casos (82,6%). Las principales manifestaciones clínicas identificadas en los estudios fueron: fiebre, cefalea, disnea, tos, mialgia, dolor retro orbital y erupción cutánea. Además de los hallazgos de laboratorio como: trombocitopenia, linfopenia y leucopenia. Conclusión: se identificó la coinfección por Covid-19 y Dengue y se señala la necesidad de una búsqueda inmediata de un diagnóstico diferencial, con el fin de prevenir problemas clínicos y reducir resultados inesperados.
Subject(s)
Humans , Male , Female , Signs and Symptoms , Adult , Dengue , Coinfection , COVID-19ABSTRACT
Objetivo: caracterizar perfil clínico-epidemiológico das pessoas vivendo com HIV com registro de tratamento da Infecção Latente pelo Mycobacterium tuberculosis no Estado do Paraná em 2019 e 2020. Método: estudo descritivo, com dados do Sistema de Informação Nacional para notificação das pessoas em tratamento para tuberculose, disponibilizados pela Secretaria Estadual de Saúde do Paraná. A análise dos dados foi descritiva. Resultados: houve redução significativa do número de pessoas em tratamento, com perfil predominante de homens brancos com idade média de 41 anos, com radiografia de tórax normal, imunizados contra tuberculose, sem realização de prova tuberculínica, em uso de isoniazida, sem histórico de contato de tuberculose e com tratamento da fase latente. Conclusões: evidencia-se a importância da ação conjunta entre Programas de Controle de HIV e tuberculose, com foco na ampliação do tratamento preventivo e na educação em saúde para conscientização, em especial de homens adultos.(AU)
Objective: to characterize clinical-epidemiological profile of people living with HIV with a record of treatment for Latent Infection by Mycobacterium tuberculosis in the State of Paraná in 2019 and 2020. Method: descriptive study, with data from the National Information System for notifying people undergoing treatment for tuberculosis, made available by the State Department of Health of Paraná. Data analysis was descriptive. Results: there was a significant reduction in the number of people undergoing treatment, with a predominant profile of white men with a mean age of 41 years, with normal chest X-rays, immunized against tuberculosis, without tuberculin skin testing, using isoniazid, no history of contact with tuberculosis and, with treatment of the latent phase. Conclusions: the importance of joint action between HIV and Tuberculosis Control Programs is evident, with a focus on expanding preventive treatment and health education for awareness, especially for adult men.(AU)
Objetivo: caracterizar perfil clínico-epidemiológico de personas que viven con VIH con registro de tratamiento para Infección Latente por Mycobacterium tuberculosis en el Estado de Paraná en 2019 y 2020. Método: estudio descriptivo, con datos del Sistema Nacional para notificar personas en tratamiento por tuberculosis, puesto a disposición por la Secretaría de Estado de Salud de Paraná. El análisis fue descriptivo. Resultados: hubo una reducción significativa en el número de personas en tratamiento, con perfil predominante de hombres blancos, edad media de 41 años, con radiografías de tórax normales, inmunizados contra la tuberculosis, sin prueba cutánea de la tuberculina, usando isoniazida, sin antecedentes de contacto de tuberculosis y con tratamiento de la fase latente. Conclusiones: se evidencia la importancia de la acción conjunta entre Programas de Control del VIH y la Tuberculosis, con foco en ampliar el tratamiento preventivo y la educación en salud para la concientización, especialmente de hombres adultos.(AU)
Subject(s)
Tuberculosis , Health Profile , HIV , Latent Tuberculosis , CoinfectionABSTRACT
Introducción: Los pacientes con COVID-19 pueden evolucionar hacia una falla respiratoria aguda grave y requerir ventilación mecánica invasiva (VMI). La complicación más frecuente en estos pacientes es la neumonía asociada a ventilación mecánica (NAVM), con incidencias reportadas más altas que en la época pre-COVID. El objetivo de este estudio es reportar la incidencia, tasa de incidencia y microbiología de la NAVM en pacientes en VMI con COVID-19. Métodos: Se incluyeron a todos los pacientes con neumonía grave y PCR (+) para SARS-CoV-2 que ingresaron y requirieron VMI entre marzo y julio del 2021 en el Instituto Nacional del Tórax (INT). Se recolectaron datos demográficos, clínicos y de laboratorio de la ficha electrónica. Se registraron y caracterizaron los casos de neumonía asociado a la ventilación mecánica. Resultados: Se incluyeron 112 pacientes de los cuales el 42,8% presentó NAVM, con una tasa de incidencia de 28,8/1.000 días de VMI. Los microorganismos aislados más frecuentes fueron Klebsiella pneumoniae (29,6%), Staphylococcus aureus (21,8%) y Pseudomonas aeruginosa (12,5%). Los pacientes que cursaron NAVM estuvieron casi el doble de tiempo en VMI, pero sin presentar aumento de la mortalidad. Conclusión: La NAVM es una complicación frecuente en los pacientes con neumonía grave asociada a COVID-19. La microbiología de estas entidades no ha cambiado respecto a la era pre-pandémica. Estos resultados cobran relevancia en el inicio y suspensión de antibióticos en este grupo de pacientes.
Introduction: Patients with COVID-19 can progress to severe acute respiratory failure and require invasive mechanical ventilation (IMV). The most frequent complication in these patients is ventilator-associated pneumonia (VAP), with higher reported incidences than in the pre-COVID era. The objective of this study is to report the prevalence, incidence rate and microbiology of VAP in patients on IMV with COVID-19. Methods: Patients with severe pneumonia and PCR (+) for SARS-CoV-2 who were admitted to IMV between march and july 2021 at the Instituto Nacional del Tórax (Chile) were included. Demographic, clinical and laboratory data from electronic records were collected. Cases of pneumonia associated with mechanical ventilation were recorded and characterized. Results: 112 patients were included, 42.8% of them presented VAP with an incidence rate of 28.8/1,000 IMV days. The most frequent isolated microorganisms were Klebsiella pneumoniae (29.6%), Staphylococcus aureus (21.8%) and Pseudomonas aeruginosa (12.5%). Patients who underwent VAP spent almost twice as long on IMV, although they had not increase in mortality. Conclusion: VAP is a common complication in patients with severe pneumonia associated with COVID-19. The microbiology of these entities has not changed from the pre-pandemic era. These results become relevant in the initiation and suspension of antibiotics in this group of patients.