Asian Pacific Journal of Tropical Medicine COVID-19 vaccine uptake and its determinants among teenagers and their parents in Zhejiang, China: An online cross-sectional study

Objective: To examine COVID-19 vaccine uptake and its determinants among teenagers and their parents in Zhejiang, China. Method(s): An online cross-sectional study was conducted among parents of teenagers in Zhejiang, China from May 1 to 31, 2022. Data were interpreted via univariate and multivariate analyses using the statistical package for the social sciences (SPSS) program. Result(s): A total of 11115 (96.11%) participants and 11449 (99.00%) of their children in Zhejiang, China had been vaccinated against COVID-19. Children whose parents did not receive COVID-19 vaccination were 19 times (aOR 18.96, 95%CI 12.36-29.08) more likely to be unvaccinated than their counterparts. In addition, children with no previous influenza vaccination, those whose parents doubted the COVID-19 vaccine's safety or effectiveness, were 6.11 times (aOR 6.11, 95%CI 2.80-13.34), 8.27 times (aOR 8.27, 95%CI 5.33-12.83), and 2.69 times (aOR 2.69, 95%CI 1.11-6.50) more likely to be unvaccinated than their counterparts, respectively. COVID-19 vaccine uptake varied between different sociodemographic groups. However, the odds of receiving the COVID-19 vaccine decreased as age and education level increased. The main refusal reasons claimed by participants were that they had medical conditions that may not qualify them for vaccination (53.78%), followed by safety concerns about the vaccine (13.56%), not knowing where to get vaccinated (6.44%), and concerns about fertility issues (5.56%). Conclusion(s): Despite a highly encouraging level of COVID-19 vaccine uptake in Zhejiang, China, the elderly and highly educated people had lower COVID-19 vaccine uptake. It is suggested that tailored health education strategies should be taken to increase the COVID-19 vaccine uptake in such groups. Furthermore, with vaccination rates at such a high level, the pandemic is still ongoing, and public confidence in vaccines may decline. Thus, sufficient evidence-based information regarding COVID-19 vaccines should be provided to the public. Copyright © 2023 Asian Pacific Journal of Tropical Medicine.

Highly cited tropical medicine articles in the Web of Science from 1991 to 2020: A bibliometric analysis.

BACKGROUND: An adequate response to health needs to include the identification of research patterns about the large number of people living in the tropics and subjected to tropical diseases. Studies have shown that research does not always match the real needs of those populations, and that citation reflects mostly the amount of money behind particular publications. Here we test the hypothesis that research from richer institutions is published in better-indexed journals, and thus has greater citation rates. METHODS: The data in this study were extracted from the Science Citation Index Expanded database; the 2020 journal Impact Factor (IF2020) was updated to 30 June 2021. We considered places, subjects, institutions and journals. RESULTS: We identified 1041 highly cited articles with ≥100 citations in the category of tropical medicine. About a decade is needed for an article to reach peak citation. Only two COVID-19-related articles were highly cited in the last 3 y. The most cited articles were published by the journals Memorias Do Instituto Oswaldo Cruz (Brazil), Acta Tropica (Switzerland) and PLoS Neglected Tropical Diseases (USA). The USA dominated five of the six publication indicators. International collaboration articles had more citations than single-country articles. The UK, South Africa and Switzerland had high citation rates, as did the London School of Hygiene and Tropical Medicine in the UK, the Centers for Disease Control and Prevention in the USA and the WHO in Switzerland. CONCLUSIONS: About 10 y of accumulated citations is needed to achieve ≥100 citations as highly cited articles in the Web of Science category of tropical medicine. Six publication and citation indicators, including authors' publication potential and characteristics evaluated by Y-index, indicate that the currently available indexing system places tropical researchers at a disadvantage against their colleagues in temperate countries, and suggest that, to progress towards better control of tropical diseases, international collaboration should increase, and other tropical countries should follow the example of Brazil, which provides significant financing to its scientific community.

SARS-CoV-2 seroprevalence and living conditions in Bamako (Mali): a cross-sectional multistage household survey after the first epidemic wave, 2020.

OBJECTIVES: In low-income settings with limited access to diagnosis, COVID-19 information is scarce. In September 2020, after the first COVID-19 wave, Mali reported 3086 confirmed cases and 130 deaths. Most reports originated from Bamako, with 1532 cases and 81 deaths (2.42 million inhabitants). This observed prevalence of 0.06% appeared very low. Our objective was to estimate SARS-CoV-2 infection among inhabitants of Bamako, after the first epidemic wave. We assessed demographic, social and living conditions, health behaviours and knowledges associated with SARS-CoV-2 seropositivity. SETTINGS: We conducted a cross-sectional multistage household survey during September 2020, in three neighbourhoods of the commune VI (Bamako), where 30% of the cases were reported. PARTICIPANTS: We recruited 1526 inhabitants in 3 areas, that is, 306 households, and 1327 serological results (≥1 years), 220 household questionnaires and collected answers for 962 participants (≥12 years). PRIMARY AND SECONDARY OUTCOME MEASURES: We measured serological status, detecting SARS-CoV-2 spike protein antibodies in blood sampled. We documented housing conditions and individual health behaviours through questionnaires among participants. We estimated the number of SARS-CoV-2 infections and deaths in the population of Bamako using the age and sex distributions. RESULTS: The prevalence of SARS-CoV-2 seropositivity was 16.4% (95% CI 15.1% to 19.1%) after adjusting on the population structure. This suggested that ~400 000 cases and ~2000 deaths could have occurred of which only 0.4% of cases and 5% of deaths were officially reported. Questionnaires analyses suggested strong agreement with washing hands but lower acceptability of movement restrictions (lockdown/curfew), and mask wearing. CONCLUSIONS: The first wave of SARS-CoV-2 spread broadly in Bamako. Expected fatalities remained limited largely due to the population age structure and the low prevalence of comorbidities. Improving diagnostic capacities to encourage testing and preventive behaviours, and avoiding the spread of false information remain key pillars, regardless of the developed or developing setting. ETHICS: This study was registered in the registry of the ethics committee of the Faculty of Medicine and Odonto-Stomatology and the Faculty of Pharmacy, Bamako, Mali, under the number: 2020/162/CA/FMOS/FAPH.

The Outbreak of Novel Coronavirus-a New Type of Threat in 2020: Genesis, Detection, Treatment, and Management

Background: COVID-19 is a new, health-threatening infectious disease in the world in 2020 and is caused by a novel coronavirus SARS-CoV-2. As of July 13, 2020, 4,881,579 active cases of COVID-19 were diagnosed, and 571,080 deaths were reported globally. In India, 301,850 active cases and 23,187 deaths were reported. To date, no effective treatment is available against the deadly virus SARS-CoV-2. Drug manufacturers, institutional laboratories, and other organizations have started developing vaccines to combat COVID-19 infection. Method(s): Science Direct, Elsevier, PubMed, Scopus, and Nature databases were referred to know the current scenario of the disease. Moreover, recent data have been obtained from the World Health Orga-nization, Centre of Disease Control, case studies, newspapers, and Worldometer reports. Data of Vaccine Centre at the London School of Hygiene & Tropical Medicine, Clinicaltrials.gov, and US National Library of Medicine have also been accessed to obtain the latest information about ongoing clinical tri-als. Result(s): The primary source of the SARS-CoV-2 outbreak is connected to the Hunan seafood and live animal market in Wuhan city, Hubei Province, China. Like;SARS-CoV, and MERS-CoV, SARS-CoV-2 is also a zoonotic virus affecting the lower respiratory tract in humans. The pathogenesis of COVID-19 involves attachment of its Spike (S) protein to the angiotensin-converting enzyme 2 (ACE2) receptor in the lower respiratory tract in humans. The most common symptoms of COVID-19 are fever, cough, sore throat, fatigue, headache, myalgia, septic shock, and breathlessness. Few patients with COVID-19 infection experience diarrhea, vomiting, and abdominal pain. Currently, FDA approved drugs being used to treat COVID-19. Conclusion(s): This review article presents the importance of traditional Indian herbs recommended by AYUSH as precautionary and curative measures of COVID-19 until vaccines and drugs are made avail-able. Moreover, this article discussed the origin, symptoms, mode of transmission, management, and diagnostics techniques for the detection of the SARS-CoV-2 virus.Copyright © 2021 Bentham Science Publishers.

International modified Delphi study on malaria preventive behaviour: new themes, contexts and framework for future research on Plasmodium knowlesi malaria.

INTRODUCTION: Plasmodium knowlesi malaria is a non-human simian malaria that threatens Southeast Asian rural communities. Studies indicate that non-compliant bednet usage, travelling into the forest and working as farmers and rubber tappers put communities at risk for infection. Despite guidelines, malaria incidence increases yearly and has become a public health concern. In addition to research gaps addressing factors that influence malaria prevention behaviour in these communities, there are no specific guidelines to facilitate strategies against the threat of P. knowlesi malaria. METHOD: To examine potential factors that influence malaria-prevention behaviour in communities exposed to P. knowlesi malaria, 12 malaria experts participated in a modified Delphi study; every participant maintained their anonymity throughout the study. Three Delphi rounds were conducted via different online platforms between 15 November 2021 and 26 February 2022, and consensus was achieved when 70% of the participants agreed on a particular point with a 4-5 median. The results from the open-ended questions were then subjected to thematic analysis, and the dataset generated by this study was analysed using a deductive and inductive approach. RESULTS: After a systematic, iterative process, knowledge and belief, social support, cognitive and environmental factors, past experience as a malaria patient, and the affordability and feasibility of a given intervention were critical contributors to malaria-prevention behaviour. CONCLUSION: Future research on P. knowlesi malaria could adapt this study's findings for a more nuanced understanding of factors that influence malaria-prevention behaviour and improve P. knowlesi malaria programmes based on the expert consensus.

[Malarial antigens in the era of mRNA vaccines]. / Malaria-Antigene in der Ära der mRNA-Impfstoffe: Mögliche Rettungen vor einer der relevantesten und gefährlichsten Kinderkrankheiten des Globalen Südens.

Even in the early 1990s, an immune response triggered by an mRNA vaccine was described for the first time. Since then, mRNA vaccines have been researched and discussed for possible prophylaxis; however, it was not until the COVID-19 pandemic that these vaccines experienced a real boom. The first mRNA vaccines were licensed against SARS-CoV­2 and showed great success. It is therefore not surprising that manufacturers are also focusing on other diseases and pathogens. Besides viral diseases, such as influenza and AIDS, malaria is high on this list. Many pharmaceutical companies (including the German companies BioNTech and CureVac) have already confirmed that they are researching mRNA vaccines against malaria. Yet developing a working vaccine against malaria is no easy feat. Research on possible vaccines has been going on since the 1960s. The results have been rather sobering. It was not until 2015 that the vaccine RTS,S/AS01 received a positive evaluation from the European Medicines Agency. Since then, the vaccine has been tested in Africa.

Mediterranean spotted fever with multiorgan involvement.

A previously well man in his 50s returned to the UK after a trip to the Mediterranean. The day after returning he developed malaise, fevers, rigors and severe headache. He was hospitalised with sepsis, multiorgan involvement, a maculopapular rash and an eschar on each hip. Serology was positive for Rickettsia spp (spotted fever group) with a rise in titre from 1:64 to 1:1024 eight days later. Blood and tissue PCR were also positive for Rickettsia spp. He had cardiac, pulmonary, renal, ocular and neurological involvement. He completed a 14-day course of doxycycline and recovered well. This is a case of likely Mediterranean spotted fever (MSF) caused by Rickettsia conorii, which is endemic to the Mediterranean basin. We highlight the need for awareness and early treatment to prevent severe complications. This case is also the first to describe Purtscher-like retinopathy in the context of likely MSF.

Case of myocarditis secondary to severe Plasmodium falciparum infection.

Malaria remains one of the most prevalent infectious diseases globally. Despite targets set out by the WHO in 2015, there has been a rise in the number of cases since 2019 as an indirect effect of the COVID-19 pandemic.Cardiac complications are very rarely witnessed with severe malaria. Of the cardiac sequelae, myocarditis is one of the most frequently observed with a handful of case reports in the literature. We report a case of a man in his 50s who developed myocarditis while being managed for severe Plasmodium falciparum malaria in an intensive care unit in the UK and review the literature relevant to this case. This is the second reported case of this condition in the UK.

Development and Implementation of a Novel Global Health Track in Pediatric Gastroenterology, Hepatology, and Nutrition Fellowship

Background Global health interest continues to rise among pediatric trainees including those entering pediatric fellowships. While global health opportunities are being incorporated into many pediatric fellowship programs, there remains a paucity of global health training in pediatric gastroenterology, hepatology, and nutrition (GHN) fellowships. In a 2014 survey by Jirapinyo et al. only 17% of responding GHN fellowships offered global health training activities. A 2018 survey by Crouse et al. showed that 34% of responding GHN fellowships offered global health electives, and none had formal global health tracks. We believe that creating a formalized global health track for GHN fellows will not only appeal to the increasing interest among applicants, but also provide a firm knowledge base on GHN topics specific to a more global level, build international collaborations, and contribute a unique perspective in our field. We aim to describe our experience with the development and implementation of a novel global health track in a pediatric GHN fellowship. Methods Planning commenced January 2021. A multidisciplinary team was assembled bringing together experts in different areas including those in other subspecialties involved in global health fellowship training. The team involved in development included GHN program director, GHN division chief, pediatric emergency medicine global health fellowship director, director of the pediatric infectious disease fellowship tropical and global medicine track, and Baylor international pediatric AIDS initiative (BIPAI) chief medical officer. Input was also received on certain aspects of the curriculum from the pediatric viral hepatitis program director, dieticians, a radiologist, an ultrasound technologist, and the pediatric point-of-care ultrasound fellowship program director. Existing clinical niche track curriculum developed within the GHN department at Texas Children's Hospital were used as a guide for the structure and different aspects to be incorporated into the track including, but not limited to, clinical activities, procedural opportunities, research, education, and teaching. Results A comprehensive, multifaceted global health curriculum was developed, and implementation began in July 2021. Clinical activities include participation in pediatric and adult viral hepatitis clinics, nutrition focused clinics, and tropical medicine clinic. Global health electives abroad were explored but deferred given travel restrictions during the COVID-19 pandemic. For procedural opportunities an ultrasound curriculum was developed including point of care ultrasound training as well as more focused training in liver, biliary, and gastrointestinal disease. A fellowship research project was developed in conjunction with the Baylor International Pediatric AIDS Initiative (BIPAI) network in sub-Saharan Africa with mentorship both from faculty in the GHN department as well as the BIPAI network locally and abroad. The project is public health focused examining hepatitis B screening rates and prevalence among people living with HIV in sub-Saharan Africa. Education includes attendance of lectures given in different departments as well as cross departmental within the institution, and global lectures attended virtually. Other educational activities include review of a global health focused GHN topics and assembly of a library of resources including recent seminal papers for current and future fellows to use for review. Last, completion of the Diploma in Tropical Medicine and the Certificate of knowledge in Clinical Tropical Medicine and Travelers' Health Examination. Teaching opportunities include involvement in general global health education for US-based medical students and residents interested in pursuing careers in global health, and teaching residents and faculty on topics such as viral hepatitis, malnutrition, and diarrhea. Conclusion We have developed to our knowledge the first formal global health track in pediatric GHN fellowship that is feasible to integrate into the 2nd and 3rd year and omplete in the available time frame. Participation in the global health track by the first fellow is still in process and improvements are being made based on experience. A multidisciplinary team including support within the fellowship program and experts in global health training is essential to the success of a pediatric GHN global health track. International relationships either previously established by the fellow, within the department, or the institution are also necessary for the success of the track. We believe that this track will help to equip future gastroenterologists to pursue a career with a focus in global health. Future directions include recruiting future fellows to complete the curriculum within our institution, formal evaluation by fellows participating in the curriculum, and securing ongoing funding. We also hope to incorporate global health electives abroad when feasible.

Understanding the widespread use of veterinary ivermectin for Chagas disease, underlying factors and implications for the COVID-19 pandemic: a convergent mixed-methods study.

OBJECTIVES: Veterinary ivermectin (vet-IVM) has been used widely in Latin America against COVID-19, despite the lack of scientific evidence and potential risks. Widespread vet-IVM intake was also discovered against Chagas disease during a study in Bolivia prior to the pandemic. All vet-IVM-related data were extracted to understand this phenomenon, its extent and underlying factors and to discuss potential implications for the current pandemic. DESIGN: A convergent mixed-methods study design including a survey, qualitative in-depth interviews (IDI) and focus group discussions (FGD). SETTING: A cross-sectional study conducted in 2018 covering the geographic area of Monteagudo, an endemic municipality for Chagas disease. PARTICIPANTS: A total of 669 adult household representatives from 26 communities participated in the survey, supplemented by 14 IDI and 2 FGD among patients, relatives and key informants. RESULTS: 9 IDI and 2 FGD contained narratives on vet-IVM use against Chagas disease. Five main themes emerged: (1) the extent of the vet-IVM phenomenon, (2) the perception of vet-IVM as a treatment for Chagas disease, (3) the vet-IVM market and the controversial role of stakeholders, (4) concerns about potential adverse events and (5) underlying factors of vet-IVM use against Chagas disease.In quantitative analysis, 28% of participants seropositive for Chagas disease had taken vet-IVM. Factors associated with multivariate analysis were advanced age (OR 17.01, 95 CI 1.24 to 36.55, p=0.027 for age above 60 years), the experience of someone close as information source (OR 3.13, 95 CI 1.62 to 5.02, p<0.001), seropositivity for Chagas disease (OR 3.89, 95 CI 1.39 to 6.20, p=0.005) and citing the unavailability of benznidazole as perceived healthcare barrier (OR 2.3, 95 CI 1.45 to 5.18, p=0.002). Participants with an academic education were less likely to report vet-IVM intake (OR 0.12, 95 CI 0.01 to 0.78, p=0.029). CONCLUSIONS: Social determinants of health, the unavailability of treatment and a wonder drug image might contribute to the phenomenon of vet-IVM.

American Society of Tropical Medicine and Hygiene, 70th Annual Meeting. Virtual - November 17-21, 2021

The 70th annual meeting of the American Society of Tropical Medicine and Hygiene was kicked off by Dr. Tedros Ghebreyesus, the Director-General of the World Health Organization (WHO). The virtual gathering format included plenary sessions, science and clinical sessions, E-poster sessions, and an exhibit hall featuring the latest products and services for tropical diseases and global health. This report provides highlights from the oral and poster sessions, focusing on developments in the treatment of tropical diseases.

New-onset Bell's palsy after neuroinvasive West Nile virus.

In this case report, a patient was diagnosed with new-onset Bell's palsy 3 weeks after the onset of neuroinvasive West Nile virus. This was the second case report of West Nile virus-associated Bell's palsy, highlighting the need to monitor these patients for peripheral neuropathies. This case report is also intended to raise awareness about the prevalence of West Nile virus in the USA.

Natural infection of SARS-CoV-2 in domestic cats and dogs of humans diagnosed with COVID-19 in Valle de Aburra, Antioquia

Introduction: The severe acute respiratory syndrome of the new coronavirus (SARS-CoV-2) is the causal agent of the health emergency due to the COVID-19 pandemic. Although humans are the main susceptible host, experimental studies and reported cases of natural infection have evidenced scenarios of SARS-CoV-2 reverse zoonosis in animals. Objective: To evaluate the natural infection of SARS-CoV-2 in cats and dogs of owners diagnosed with COVID-19 in the Aburra Valley, Antioquia, Colombia. Materials and methods: The circulation of SARS-CoV-2 was evaluated by RT-qPCR and RT-PCR in samples of nasopharyngeal and oropharyngeal smears from cats and dogs whose owners had latency due to COVID-19 infection. The positive cases were verified by amplifying fragments of the RdRp, N and E genes;and the RdRp amplicon was sequenced and phylogenetically analyzed. Results: Six cats and three dogs were confirmed cases of natural infection for SARS-CoV-2 from 80 tested animals. The animals did not show clinical signs;and their owners, who suffered from the infection, reported only mild signs of the disease without clinical complications. In the analysis of one of the sequences, a single nucleotide polymorphism (SNP) was found with a change in position 647 substituting the amino acid serine (S) for an isoleucine (I). The cases occurred in the municipalities of Caldas, Medellin and Envigado. Conclusions: It is inferred that natural infection in cats and dogs is associated with direct contact with a COVID-19 patient.