ABSTRACT
Diarrheal disease continues to be a leading cause of death in children under five years old in developing countries, where it is responsible for the death of approximately half a million children each year. Establishing the cause of diarrheal disease can be difficult in developing areas due to the lack of diagnostic tests, and thus empirical therapies are often required. In these settings, the choice of antibiotic (or the choice to not give it) depends on suspected agents, host conditions and local epidemiology. Herein, we report a representative case of a ten-month-old male patient with severe acute malnutrition (SAM) admitted to the Emergency Paediatric Clinic in Port Sudan for amoebic dysentery complicated by hypovolemic shock and sepsis, treated by target therapy for Entamoeba histolytica infection associated with empiric antibiotic therapy. Due to the absence of clinical improvement, Ciprofloxacin was added to the first-line treatment. This case highlights that in low-income countries amoebiasis, especially in children with SAM, may result in life-threatening complications. Although stool microscopy remains the most used diagnostic test in these settings, a novel inexpensive, easy to use and rapid diagnostic test would be warranted to reach a microbiological diagnosis and guide clinical decision. Further studies will be necessary to identify the patterns of antimicrobial resistance in order to appropriately manage these complicated cases.
ABSTRACT
[This corrects the article DOI: 10.1093/ofid/ofab488.].
ABSTRACT
BACKGROUND: Medication adherence is a common reason for treatment deferment in persons experiencing homelessness. We evaluated adherence to hepatitis C virus (HCV) therapy following HCV education in a shelter-based care model. METHODS: Prospective study conducted at 4 homeless shelters in Minneapolis, Minnesota and San Francisco, California from November 2018 to January 2021. Sixty-three patients underwent HCV education and treatment. Multivariable modeling evaluated factors associated with (1) medication and (2) overall (composite score of medication, laboratory, and clinic visit) adherence. RESULTS: Median age was 56 years; 73% of participants were male, 43% were Black, 52% had psychiatric illness, and 81% used illicit drugs and 60% used alcohol in the past year. Following education, 52% were extremely confident in their ability to be adherent to HCV therapy. Medication adherence by patient and provider report was 88% and 48%, respectively, and 81% achieved HCV cure. Active alcohol use was associated with less confidence in medication adherence (43% vs 78%, P = .04). Older age was positively (coefficient = 0.3) associated with overall adherence to HCV treatment whereas prior therapy was associated with both medication (odds ratio, 0.08) and overall treatment (coefficient = -0.87) nonadherence. CONCLUSIONS: Despite imperfect adherence, sustained virologic response rates were still high. Expanding opportunities to treat persons experiencing homelessness in a structured and supportive setting is critical to HCV elimination efforts.
ABSTRACT
In this study, functional, rheological and physicochemical characteristics were carried out for composite gluten-free (CGF) flours, dough and biscuits, respectively fortified with fermented and unfermented Agaricus bisporus polysaccharide (FABP and UABP) flours. Addition of both FABP flour and UABP flour improved functional properties, while addition of FABP flour decreased viscosity property. Incorporation of both polysaccharide flours in CGF biscuit dough revealed a significant increase in rheological moduli (G' and Gâ³) and a decrease in tan (δ). Supplementation of UABP flour increased thickness, whereas supplementation of FABP flour increased diameter and spread ratio. All CGF biscuit formulations exhibited lower fracture strength and hardness compared to the control. Furthermore, both UABP flour and FABP flour formulation (F3) contained the highest nutrients in terms of protein, dietary fibers, amino acids and minerals among the CGF biscuit formulations. The sensory evaluation result showed that FABP flour formulation (F1) and UABP flour F1 were most acceptable.
