Latent Tuberculosis Infection Treatment Outcomes in an At-Risk Underserved Population in Rhode Island.

OBJECTIVES: Within the United States (US), significant racial and ethnic disparities exist in the rates of latent TB infection (LTBI) and active TB disease. A disproportionate number of TB disease cases result from untreated LTBI among individuals born outside the US. This study evaluates LTBI treatment outcomes among an underserved, at-risk population in Rhode Island. METHODS: A quantitative retrospective chart review of adult patients with a positive screening test assessed LTBI care cascade outcomes including referral, treatment initiation, and completion. RESULTS: Seventy-four percent of patients found to have positive screening TB tests were born outside of the US; 80% identified as Hispanic or Black and 45% spoke a preferred language other than English. Twenty-one percent of potential candidates for LTBI treatment initiated treatment. CONCLUSIONS: Major gaps were identified in referral success and treatment initiation. Expanding LTBI treatment access into primary care settings could be a solution to improve outcomes and decrease health inequities among at-risk communities.

COVID-19 Vaccine Concerns and Acceptability by Language in a Marginalized Population in Rhode Island.

INTRODUCTION: We need to understand the continued concerns and acceptability of COVID-19 vaccines within marginalized communities in the United States. Our study explores the concerns and acceptability of COVID-19 vaccines, by language group, at a Federally Qualified Health Center (FQHC) in Rhode Island. METHODS: We conducted an exploratory, mixed data collection telephone survey in languages spoken in the community (Spanish, Cape Verdean (CV) Creole/Portuguese, and English). Participants were asked about their COVID-19 vaccination status, as well as vaccine concerns and acceptability via 9 closed-ended and 2 open-ended questions. Chi squared and multivariate analysis was used to compare concerns and acceptability across languages. Coding and immersion/crystallization techniques were used to identify qualitative data themes. RESULTS: The overall response rate was 58%. Side effects were cited as the most frequent (66%) concern among all language groups. Concern about the speed of vaccine development, vaccine ingredients, and being in a research trial varied significantly by language. Qualitative findings included concerns about chronic medical conditions and generalized fear of vaccine safety. English speakers were the most likely to report concerns and CV Creole/Portuguese speakers were the least likely to report concerns about the vaccine. Spanish and CV Creole/Portuguese participants who were not yet vaccinated reported higher acceptability to receive the vaccine compared to English speakers, with odds ratios of 2.00 (95% CI: 1.00-4.00) and 1.27 (95% CI: 0.62-2.60), respectively. CONCLUSION: To mitigate the effects of the COVID-19 pandemic and prepare for future pandemics, strategies must be based on understanding the beliefs and perceptions of marginalized communities.

SARS-CoV-2 in wastewater: Challenges for developing countries.

The COVID-19 pandemic that has engulfed the world, has affected the human lives in several aspects. The detection of SARS-CoV-2 in faeces and urine of the infected person, even after viral clearance in the respiratory tract, and its presence in untreated wastewater raises the possibility of fecal-oral transmission in future. The situation is likely to be more aggravated in developing and least developed countries struggling with the problem of ineffective waste disposal system, open defecation, poor sanitation, and limited access to clean drinking water. In this review, the available data on wastewater treatment, sanitation status and healthcare infrastructure from middle- and low-income countries is collected and correlated with the risk associated with the fecal-oral transmission of SARS-CoV-2. The review also highlights the limitation of COVID-19 surveillance through sewage monitoring in these countries owing to the absence of proper sewerage system. An inclusive approach of awareness, prevention, and mitigation from global to the local levels is required to overcome this challenging situation in developing countries.

Maternal effect for DNA mismatch repair in the mouse.

DNA mismatch repair (DMR) functions to maintain genome stability. Prokaryotic and eukaryotic cells deficient in DMR show a microsatellite instability (MSI) phenotype characterized by repeat length alterations at microsatellite sequences. Mice deficient in Pms2, a mammalian homolog of bacterial mutL, develop cancer and display MSI in all tissues examined, including the male germ line where a frequency of approximately 10% was observed. To determine the consequences of maternal DMR deficiency on genetic stability, we analyzed F(1) progeny from Pms2(-/-) female mice mated with wild-type males. Our analysis indicates that MSI in the female germ line was approximately 9%. MSI was also observed in paternal alleles, a surprising result since the alleles were obtained from wild-type males and the embryos were therefore DMR proficient. We propose that mosaicism for paternal alleles is a maternal effect that results from Pms2 deficiency during the early cleavage divisions. The absence of DMR in one-cell embryos leads to the formation of unrepaired replication errors in early cell divisions of the zygote. The occurrence of postzygotic mutation in the early mouse embryo suggests that Pms2 deficiency is a maternal effect, one of a limited number identified in the mouse and the first to involve a DNA repair gene.