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1.
Topics in Antiviral Medicine ; 31(2):62, 2023.
Article in English | EMBASE | ID: covidwho-2313308

ABSTRACT

Background: Stage at time of diagnosis and survival after diagnosis are critical parameters regarding the control of any cancer in any geographical setting. Unlike in resource-rich settings where publicly funded cancer surveillance routinely monitors these parameters, these data are non-existent through routine means in resource-limited areas. This is particularly relevant for Kaposi sarcoma (KS) in East Africa, for which recent changes in HIV treatment and chemotherapy guidelines as well as the COVID-19 pandemic dictate an update regarding stage and survival. Method(s): From October 2021 to August 2022, we evaluated HIV-infected adults (age >= 18 years) with a new diagnosis of KS made in 4 different primary care facilities (or their associated inpatient units) in Kenya and Uganda using a process of rapid case ascertainment. KS diagnosis was confirmed by pathology. Participants were examined, at time of biopsy, to document the extent of lesions and subsequently monitored longitudinally for vital status. Result(s): Among 180 HIV-infected adults identified with new onset KS, 31% were women, and the median (IQR) age was 35 (29-42) years. At time of KS diagnosis, 95% of the participants were taking ART, and the median (IQR) CD4+ T cell count was 197 (46-354) cells/mm3;46%, 20%, 11% and 23% had plasma HIV RNA of < 40, 40-1000, 1001-10,000 and >10,000 copies/ml, respectively. The median number of anatomic sites with KS lesions per participant was 7 (4-11);26% of participants had oral KS lesions that interfered with either eating or speaking, 74% had KS-associated edema, and 86% had ACTG stage T1 (advanced KS). Over a median follow-up of 2.6 months (IQR: 0.75 to 5.5), 56 participants died, and only 3 lost to follow-up. Cumulative incidence of death (95% CI), via Kaplan-Meier estimation, at 2 months, 6 months and 8 months following KS diagnosis was 24% (18%-31%), 33% (26%-42%), and 38% (29- 49%), respectively (Figure). Conclusion(s): In a recently assembled community-based sample of adults with newly-diagnosed HIV-related KS in East Africa, the majority have advanced KS at the time of KS diagnosis, and survival is poor. The findings are stark in absolute terms for the Treat-All era and unchanged from parameters obtained in the 5 years prior, indicating no improvement in these aspects of the control of KS in the region. Along with primary prevention of KS (i.e., reducing its incidence), novel approaches are needed for earlier detection, more efficient linkage to oncologic care, and more potent therapy. Survival Among Adults with HIV-Related Kaposi Sarcoma in East Africa.

3.
Journal of Investigative Dermatology ; 143(5 Supplement):S76, 2023.
Article in English | EMBASE | ID: covidwho-2304242

ABSTRACT

In 2022, mpox virus spread globally with 99% of cases in non-endemic countries. People living with HIV (PLHIV) are disproportionally affected, often with more severe clinical features and outcomes. The AAD/ILDS Dermatology COVID-19, Monkeypox (mpox), and Emerging Infections registry captured mpox cases from 13 non-endemic countries in a de-identified REDCap registry. We aimed to examine cutaneous symptomatology and outcomes in cases of mpox in PLHIV. Of 119 reported cases, 44 were PLHIV (35%). Cases were 98% male, with a median age of 38 years, located in Europe (57%) and the U.S. (39%). Nearly half of PLHIV reported skin lesions as their initial sign (45%), and 43 (98%) reported skin lesions during illness. The primary initial lesion locations were peri-anal (34%) and genito-inguinal (34%). Co-infection with other sexually transmissible infections (STI) was more common in PLHIV, 57% vs. 38% in all-registry cases (p<0.01). The most common co-infections were gonorrhea, syphilis, and chlamydia. Time to resolution was 17 days, 3 days shorter than all-registry cases, which may be due to higher use of Tecovirimat in PLHIV (36% vs. 25% in all-registry cases;p<0.01). There were no differences in the frequency of hospitalization or scarring. One death was reported. Overall, cutaneous lesion count was similar in PLHIV and all-registry cases. Lesion location was more frequently reported in the peri-anal and genito-inguinal regions. Sample size was insufficient to detect differences in length of infection, hospitalization, or scarring in PLHIV. Co-infections were more common in PLHIV, highlighting a need for co-testing for STIs during mpox evaluation.Copyright © 2023

4.
Journal of Investigative Dermatology ; 143(5 Supplement):S91, 2023.
Article in English | EMBASE | ID: covidwho-2299175

ABSTRACT

The 2022 mpox outbreak affected 84,318 individuals in 110 countries. Mpox is transmitted by multiple modalities, including direct contact, respiratory droplets, and fomites among others. Identifying skin lesions aids prompt diagnosis. Variation in initial skin lesion location is not well understood;it is hypothesized that mode of transmission may determine primary inoculation site and subsequent clinical presentation. This study sourced healthcare provider-reported data from the AAD/ILDS Dermatology COVID-19, Mpox, and Emerging Infections Registry to explore factors related to the location of the first skin lesion in mpox cases. Out 119 mpox cases,115 had primary lesion location data. 97% were male with a median age of 37. Most (83/115, 72%) patients had first skin lesions in the genito-anal area, and 32/115 (27%) had lesions elsewhere or had morbilliform rash. 74% of males had the first lesion in the genito-anal region compared to females (25%, p=0.03). Males in same-sex relationships had ano-genital lesions more often than men in other relationships (77% vs. 44%, p=0.03). The type of mpox exposure was also associated with first lesion location: 83% of patients who contracted mpox from a spouse or other sexual contact had ano-genital lesions as compared to a non-sexual contact (0%, p=<0.01). This analysis characterized factors associated with the first mpox skin lesion location, which can aid healthcare providers in diagnosis and shed light on transmission. This data suggests that type of exposure and mode of transmission may be associated with primary lesion location;patients who contracted mpox from sexual contact were more likely to have ano-genital lesions.Copyright © 2023

5.
Bulletin of the American Meteorological Society ; 104(2):E389-E410, 2023.
Article in English | Scopus | ID: covidwho-2252857

ABSTRACT

The years since 2000 have been a golden age in in situ ocean observing with the proliferation and organization of autonomous platforms such as surface drogued buoys and subsurface Argo profiling floats augmenting ship-based observations. Global time series of mean sea surface temperature and ocean heat content are routinely calculated based on data from these platforms, enhancing our understanding of the ocean's role in Earth's climate system. Individual measurements of meteorological, sea surface, and subsurface variables directly improve our understanding of the Earth system, weather forecasting, and climate projections. They also provide the data necessary for validating and calibrating satellite observations. Maintaining this ocean observing system has been a technological, logistical, and funding challenge. The global COVID-19 pandemic, which took hold in 2020, added strain to the maintenance of the observing system. A survey of the contributing components of the observing system illustrates the impacts of the pandemic from January 2020 through December 2021. The pandemic did not reduce the short-term geographic coverage (days to months) capabilities mainly due to the continuation of autonomous platform observations. In contrast, the pandemic caused critical loss to longer-term (years to decades) observations, greatly impairing the monitoring of such crucial variables as ocean carbon and the state of the deep ocean. So, while the observing system has held under the stress of the pandemic, work must be done to restore the interrupted replenishment of the autonomous components and plan for more resilient methods to support components of the system that rely on cruise-based measurements. © 2023 American Meteorological Society.

6.
Dermatol Clin ; 39(4):i, 2021.
Article in English | PubMed Central | ID: covidwho-2184657
7.
Journal of Investigative Dermatology ; 142(8, Supplement):S29, 2022.
Article in English | ScienceDirect | ID: covidwho-1936803
8.
Journal of Investigative Dermatology ; 142(8, Supplement):S29, 2022.
Article in English | ScienceDirect | ID: covidwho-1936802
9.
Journal of Investigative Dermatology ; 142(8, Supplement):S25, 2022.
Article in English | ScienceDirect | ID: covidwho-1936799
10.
IEEE Transactions on Services Computing ; 2022.
Article in English | Scopus | ID: covidwho-1788797

ABSTRACT

We present the design and development of a data visualization service (RAMPVIS) in response to the urgent need to support epidemiological modeling workflows during the COVID-19 pandemic. Facing a set of demanding requirements and several practical challenges, our small team of volunteers had to rely on existing knowledge and components of services computing, while thinking on our feet in configuring services composition and adopting suitable approaches to services engineering. Through developing the RAMPVIS service, we have gained useful experience of ensuring conformation to services computing standards, enabling rapid development and early deployment, and facilitating effective and efficient maintenance and operation with limited resources. This experience can be valuable to the ongoing effort for combating the COVID-19 pandemic, and provides a blueprint for visualization service development when future needs for visual analytics arise during emergency response. IEEE

13.
Br J Dermatol ; 185(2): 445-447, 2021 08.
Article in English | MEDLINE | ID: covidwho-1202003
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15.
British Journal of Dermatology ; 183(SUPPL 1):200, 2020.
Article in English | EMBASE | ID: covidwho-1093710

ABSTRACT

Psoriasis is a common immune-mediated inflammatory skin disease with frequent multimorbidity, and immunosuppressants are the mainstay of treatment in moderate-to-severe disease. An understanding of the impact of COVID-19 on individuals with psoriasis and the effect of psoriasis therapies on the course of COVID-19 is urgently required to inform clinical decision-making. This study sought to characterize the clinical course of COVID-19 in patients with psoriasis and to identify factors associated with hospitalization. Clinicianreported cases of confirmed or suspected COVID-19 in psoriasis were collected via an international online registry. Multivariable-adjusted logistic regression identified factors associated with hospitalization. Patient risk-mitigating behaviours were characterized using an independent global selfreport registry. In total, 334 clinician-reported cases (median age 50 years, 62% male, median body mass index 28 kg m-2, 85% white) from 22 countries [most frequently, the U.K. (35%), Italy (22%) and Spain (16%)] were available between 27 March and 20 June 2020. Altogether, 245 (73.3%) patients were receiving a biologic, 54 (16.2%) a nonbiologic and 31 (9.3%) no systemic treatment. Overall, 311 (93.1%) achieved a full recovery, 71 (21.2%) were hospitalized and nine (2.7%) died. Risk factors associated with hospitalization were older age [adjusted odds ratio (aOR) 1.71, 95% confidence interval (CI) 1.26-2.32], male sex (aOR 2.37, 95% CI 1.11-5.04) and nonwhite ethnicity (aOR 3.40, 95% CI 1.27-9.11), in addition to chronic lung disease (aOR 4.37, 95% CI 1.62-11.74) and hypertension (aOR 2.23, 95% CI 1.05-4.74). Reduced risk of hospitalization was associated with use of a biologic (aOR 0.42, 95% CI 0.18-0.98) vs. nonbiological systemic therapy. There was no difference in risk of hospitalization between classes of biologics. An independent selfreport psoriasis registry (1167 patients from 39 countries) suggested increased social isolation (76% vs. 66%;P < 0.05) but similar nonadherence to medication (18% vs 22%) in patients receiving biologics vs. nonbiological systemic treatments. In this international moderate-to-severe psoriasis case series, most patients fully recovered from COVID-19;older age, being male and being of nonwhite ethnicity increased risk of hospitalization. Use of biologics, when compared with nonbiological systemic therapies, was associated with reduced risk of hospitalization;however, this requires further study owing to potential selection bias and unmeasured confounding such as a difference in risk-mitigating behaviours.

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