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Background: Antibiotic-recalcitrant recurrent urinary tract infection (rUTI) is has become increasingly observed in postmenopausal women. Therefore, when standard antibiotic therapies have failed, some elect electrofulguration (EF) of areas of chronic cystitis when detected on office cystoscopy. EF is thought to remove tissue-resident bacteria that have been previously detected in the bladder walls of postmenopausal women with rUTI. We hypothesized that increased bladder bacterial burden may be associated with incomplete rUTI resolution following EF. Methods: Following IRB approval, bladder biopsies were obtained from 34 consenting menopausal women electing EF for the advanced management of rUTI. 16S rRNA FISH was performed using both universal and Escherichia probes and tissue-resident bacterial load was quantified. Time to UTI relapse after EF was recorded during a six-month follow-up period and the association of bladder bacterial burden and clinical covariates with UTI relapse was assessed. Results: We observed bladder-resident Escherichia in 52% of all participants and in 92% of participants with recent E. coli UTI. Time-to-relapse analysis revealed that women with high bladder bacterial burden as detected by the universal probe had a significantly ( p =0.035) higher risk of UTI within six months of EF (HR=3.15, 95% CI: 1.09-9.11). Interestingly, bladder-resident Escherichia was not significantly associated ( p =0.26) with a higher risk of UTI relapse (HR= 2.14, 95% CI: 0.58-7.90). Conclusions: We observed that total bladder bacterial burden was associated with a 3.1x increased risk of rUTI relapse within six months. Continued analysis of the relationship between bladder bacterial burden and rUTI outcomes may provide insight into the management of these challenging patients.
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OBJECTIVE: To examine the global literature database on uncomplicated recurrent urinary tract infections (rUTI), this systematic review assesses the availability of rUTI data based on geographic region and elucidates the current state of research and gaps in knowledge. METHODS: The databases PubMed, Embase, WHO Global Index Medicus, and SciELO were searched for keywords related to rUTI between 2000 and 2023. Three independent reviewers screened studies restricted to female participants age ≥18 years with uncomplicated rUTIs. Studies were excluded if they did not provide a definition for rUTI or did not cite or report an estimate for rUTI prevalence. The review was registered in PROSPERO and conformed to PRISMA guidelines. RESULTS: The search yielded 2947 studies of which 124 were ultimately included. Convenience samples were used for 91% of studies and sample sizes were 30% n <50, 29% n = 50-99, 22% n = 100-199, 36% n ≥200. Most studies were conducted in Europe (41%) or North America (39%), were prospective (52%), at tertiary centers (49%) and included all ages ≥18 (60%). The most common definition for rUTI was 2 UTI/6 m or 3 UTI/1y (62%). Regardless of study location, most studies cited prevalence estimates for rUTI derived from U.S.-based populations. CONCLUSION: This study represents the first formal investigation of the global literature base on uncomplicated rUTI. Studies on rUTIs are globally of small scale and definitions used for rUTI are heterogeneous. More studies are needed to ascertain the true prevalence of rUTI outside of North America and Europe.
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OBJECTIVE: To gather preliminary evidence on short- and long-term care priorities for people with lower extremity amputations. DESIGN: A three-round modified Delphi study using semi-structured interviews. PARTICIPANTS: A convenience sample of 20 adult participants who had undergone lower extremity amputations at a tertiary public hospital. MAIN MEASURE: Consensus on each care priority was defined a priori as an agreement of more than 50%. Semi-structured interviews were conducted to understand the rationales for endorsing the care priorities. RESULTS: Consensus was reached on 24 short-term care priorities and 12 long-term care priorities in the biomedical, practical and psychological and spiritual domains. The rationales for endorsing each of the care priorities generated three themes: preparedness; mental health, psychological and spiritual well-being; and participating in life, with respect and dignity. CONCLUSIONS: Our results highlight the substantial need to improve patient access to education and planning support prior to undergoing limb amputation, and optimising post-amputation rehabilitation programmes, enabling people with amputations to participate in meaningful life roles that provide them with purpose, dignity, and self-respect. The knowledge of care priorities revealed in this study may promote effective patient-centred care and improve clinical outcomes.
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The need for improved wet adhesives has driven research on mussel-inspired materials incorporating dihydroxyphenylalanine (DOPA) and related analogs of the parent catechol, but their susceptibility to oxidation limits practical application of these functionalities. Here, we investigate the molecular-level adhesion of the catechol analogs dihydroxybenzamide (DHB) and hydroxypyridinone (HOPO) as a function of pH. We find that the molecular structure of the catechol analogs influences their susceptibility to oxidation in alkaline conditions, with HOPO emerging as a particularly promising candidate for pH-tolerant adhesives for diverse environmental conditions.
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Objectives: Identifying the key factors associated with vaccine hesitancy remains a challenge as has been highlighted throughout the COVID-19 vaccine roll out and pandemic. The aim of this study was to determine characteristics associated with vaccine safety and compare perceived safety by vaccine. Our hypothesis is that vaccine safety perception will vary by vaccine with COVID-19 as ranked lowest for safety. Study design: Cross sectional. Methods: A statewide sample (n = 1024) responded to an online 28-point questionnaire via anonymous linked invitation. Results: Among the eight vaccines assessed, COVID-19 had the lowest perceived safety (53.13%) followed by human papillomavirus HPV (63.38%). A binomial logistic regression assessed COVID-19 vaccine safety beliefs (safe v not safe) finding age, political orientation, and perceived safety of certain vaccines as statistically significant. As age increased by year, vaccine safety beliefs increased. Persons who identified as conservative demonstrated less belief in vaccine safety than all other groups. Among persons who did not perceive the COVID-19 vaccine as safe, 65.8% believed chicken pox was safe, 63.3% and 61.1% perceived hepatitis A& B were safe. Conclusions: These findings demonstrate that vaccine safety beliefs differ by vaccine and that persons who do not believe in the safety of the COVID-19 are not exclusively against all vaccines. Understanding factors that increase vaccine safety by vaccine could assist in developing an intervention which could increase belief in safety for all vaccines.
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BACKGROUND: We previously performed a systematic review and meta-analysis which revealed a Phantom Limb Pain (PLP) prevalence estimate of 64% [95% CI: 60.01-68.1]. The prevalence estimates varied significantly between developed and developing countries. Remarkably, there is limited evidence on the prevalence of PLP and associated risk factors in African populations. METHODS: Adults who had undergone limb amputations between January 2018 and October 2022 were recruited from healthcare facilities in the Western and Eastern Cape Provinces. We excluded individuals with auditory or speech impairments that hindered clear communication via telephone. Data on the prevalence and risk factors for PLP were collected telephonically from consenting and eligible participants. The prevalence of PLP was expressed as a percentage with a 95% confidence interval. The associations between PLP and risk factors for PLP were tested using univariate and multivariable logistic regression analyses. The strength of association was calculated using the Odds Ratio where association was confirmed. RESULTS: The overall PLP prevalence was 71.73% [95% CI: 65.45-77.46]. Persistent pre-operative pain, residual limb pain, and non-painful phantom limb sensations were identified as risk factors for PLP. CONCLUSION: This study revealed a high prevalence of PLP. The use of effective treatments targeting pre-amputation pain may yield more effective and targeted pre-amputation care, leading to improved quality of life after amputation.
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Miembro Fantasma , Humanos , Estudios Transversales , Prevalencia , Calidad de Vida , Factores de RiesgoRESUMEN
Introduction: To review the postrobotic-assisted sacrocolpopexy (RASC) course of women admitted for 23 hours post-RASC and identify events requiring intensive medical care or potentially leading to deleterious outcome or urgent readmission if that patient had same-day discharge (SDD) instead of observed overnight. Methods: Patients undergoing RASC from January to December 2020 at one institution were identified and relevant data were obtained via retrospective chart review. Patient exclusions: RASC start time after 12:00 PM, concurrent posterior colporrhaphy, rectopexy, or hysterectomy, or conversion to open. Results: Sixty-nine patients (median age 71 years old) met study criteria with majority American Society of Anesthesiologists class 2 (n = 46, 67%) or 3 (n = 22, 32%). Patient characteristics included prior abdominal surgeries (n = 58, 84%), prior hysterectomy/prolapse repair (n = 25, 37%), known allergy to pain medication (n = 25, 36%), and administration of a postoperative antiemetic (n = 37, 54%) or intra-/postoperative keterolac (n = 36, 52%). Median surgery length was 269 minutes. Postoperative events that may have resulted in urgent readmissions if they had SDD were observed in 6% of patients. In the 1st week post-RASC, there were no readmissions. Conclusions: In this limited quality assurance study, patients undergoing RASC experienced no major complications requiring intensive care. Postoperative events were almost entirely nausea and pain, with no readmissions within the 1st week.
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Prolapso de Órgano Pélvico , Procedimientos Quirúrgicos Robotizados , Humanos , Femenino , Anciano , Alta del Paciente , Estudios Retrospectivos , Prolapso de Órgano Pélvico/cirugía , Procedimientos Quirúrgicos Robotizados/métodos , Dolor , Complicaciones Posoperatorias , Procedimientos Quirúrgicos Ginecológicos/métodosRESUMEN
PURPOSE: Open repair of groin hernia is an essential skill for the general surgeon. This study aimed to develop a low-cost hernia model based on a validated high-fidelity model and assess its effectiveness in teaching inguinal hernia repair to surgical trainees from many institutions throughout Africa. METHODS: Using inexpensive, locally available materials, a low-cost hernia model was created. Six models were constructed, and a workshop was conducted for surgical residents. Pre- and post-workshop surveys were administered to assess knowledge, confidence, and understanding. Statistical analyses were performed using paired t tests and the Wilcoxon signed-rank test. RESULTS: The low-cost hernia model consisted of various readily available materials and cost an average of $5.07. Sixty-eight trainees participated in the workshop, and 59 completed the post-workshop survey. Participants reported a significant increase in confidence for both mesh and non-mesh repairs and an improved understanding of hernia anatomy after the workshop. Trainees scored an average of 5.6 (SD 1.9) out of 10 questions on the pre-workshop quiz and 7.9 (SD 1.4) out of 10 on the post-workshop quiz (p < 0.001), indicating improved knowledge. All trainees supported the use of the model for education. CONCLUSION: The low-cost hernia model demonstrated its effectiveness in enhancing trainees' understanding of hernia anatomy and increasing their confidence in hernia repair. Integrating low-cost hernia models into training programs can help improve trainees' knowledge and confidence in a safe and affordable environment.
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Hernia Inguinal , Internado y Residencia , Cirujanos , Humanos , Hernia Inguinal/cirugía , Herniorrafia/educación , Mallas QuirúrgicasRESUMEN
We employed digital light processing-stereolithography 3D printing to create microfluidic devices with different designs for microchip electrophoresis (µCE). Short or long straight channel, and two- or four-turn serpentine channel microfluidic devices with separation channel lengths of 1.3, 3.1, 3.0, and 4.7 cm, respectively, all with a cross injector design, were fabricated. We measured current as a function of time and voltage to determine a separation time window and conditions for the onset of Joule heating in these designs. Separations in these devices were evaluated by performing µCE and measuring theoretical plate counts for electric field strengths near and above the onset of Joule heating, with fluorescently labeled glycine and phenylalanine as model analytes. We further demonstrated µCE of peptides and proteins related to preterm birth risk, showing increased peak capacity and resolution compared to previous results with 3D printed microdevices. These results mark an important step forward in the use of 3D printed microfluidic devices for rapid bioanalysis by µCE.
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Electroforesis por Microchip , Nacimiento Prematuro , Recién Nacido , Femenino , Humanos , Nacimiento Prematuro/diagnóstico , Dispositivos Laboratorio en un Chip , Biomarcadores , Impresión TridimensionalRESUMEN
BACKGROUND: Vaccine hesitancy (VH) is a major public health problem which includes not only concerns about vaccine, but often includes beliefs not aligned with evidence. The etiology of VH is complicate, including genuine concerns about vaccine safety to beliefs in disproven or unsubstantiated theories. Understanding VH includes determining the factors associated with people most likely to be susceptible. OBJECTIVES: To identify characteristics of persons more likely to have VH based on perceived vaccine safety. DESIGN: We conducted a cross sectional, targeted online survey of 1,024 respondents. METHODS: The survey collected data on demographics and vaccine beliefs. A seven-question VH scale was created based on an extensive literature review. When measured, this scale had high internal validity based on Cronbach's Alpha (α = 0.80, 95% CI, 0.79, 0.82) and provided a continuous measurement to understand the VH degree. RESULTS: Persons reporting a conservative political ideology had the highest VH score ([Formula: see text] = 15.0), followed by other ([Formula: see text] =12.7), moderate ([Formula: see text] =9.29), and liberal ([Formula: see text] =6.72). Education level was another strong indicator of VH, decreasing from the highest score of high school graduates ( [Formula: see text] = 13.2) to graduate degree holders ([Formula: see text] = 9.22). CONCLUSION: The more conservative a person's political ideology, the higher the VHS. We asked for ideology, rather than political party, although they are related, they are not the same. Ideology influences more domains than voting patterns. Higher educational attainment shows a protective effect against VH. These findings have direct implication for public health interventions, new interventions should be designed to be more accessible for persons with less formal education and more amenable to persons who hold a more conservative ideology.
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Vacilación a la Vacunación , Vacunas , Humanos , Alaska , Estudios Transversales , Recolección de Datos , VacunaciónRESUMEN
3D printing, an additive manufacturing technology, has made significant inroads into improving systems for bioanalysis in recent years. This approach is particularly powerful due to the ease and flexibility in rapidly creating novel and complex designs for analytical applications. As such, 3D printing offers an emerging technology for creating systems for electrophoretic analysis. Here, we review 3D printing work on improving and miniaturizing capillary electrophoresis (CE), emphasizing publications from 2019â2022. We describe enabling uses of 3D printing in interfacing upstream sample preparation or downstream detection with CE. Recent developments in miniaturized CE enabled by 3D printing are also elaborated, including key areas where 3D printing could further improve over the current state-of-the-art. Lastly, we highlight promising future trends for using 3D printing in miniaturizing CE and the significant potential for innovative advancements. 3D printing is poised to play a key role in moving forward miniaturized CE in the coming years.
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Responding to increases in overdose, addiction, and substance misuse, local public health experts need accurate data to plan and implement evidence-based prevention and treatment programs. In many countries, national data are the tool most readily available for these efforts. In the United States, the National Study on Drug Use and Health and the Treatment Episode Data Set are data sources used by states to determine the extent of addiction. This project sought to determine if these national data sources are applicable for local use in addiction prevention and program planning. NSDUH prevalence estimates from 2015 to 2019 were applied to the state population to determine the number of persons estimated to be substance users. The prevalence estimates were compared over time with the population data and substance use treatment admissions to assess the covariance and population change as an indicator of efficacy. The primary drivers of fatal overdose in Alaska are fentanyl, heroin, and methamphetamine. Fentanyl use was not assessed in either dataset. When applying the estimated use prevalence to the population, heroin users varied annually by 1777 persons and methamphetamine varied up to 2143 persons. These observed variances did not correspond with state population changes nor any trend in the persons seeking treatment for these substances. Our analyses do not support the use of NSDUH data for planning in rural and remote areas. The methods used in NSDUH data collection exclude ~ 20% of the state population, mostly Native persons, based on location and language. The annual prevalence estimates applied to the population did not correspond with changes in population nor changes in treatment. Fentanyl, which causes the most overdoses in Alaska and is of primary concern locally, was not assessed.
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Sobredosis de Droga , Metanfetamina , Trastornos Relacionados con Sustancias , Humanos , Estados Unidos/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Sobredosis de Droga/epidemiología , Prevalencia , FentaniloRESUMEN
Mental illnesses including anxiety disorders, autism spectrum disorder, post-traumatic stress disorder, schizophrenia, depression, and others exact an immense toll on the healthcare system and society at large. Depression alone impacts 21 million adults and costs over $200 billion annually in the United States. However, pharmaceutical strategies to treat mental illnesses are lagging behind drug development in many other disease areas. Because many of the shortcomings of therapeutics for mental illness relate to delivery problems, drug delivery technologies have the potential to radically improve the effectiveness of therapeutics for these diseases. This review describes the current pharmacotherapeutic approaches to treating mental illnesses as well as drug delivery approaches that have improved existing therapies. Approaches to improve drug bioavailability, provide controlled release of therapeutics, and enable drug targeting to the central nervous system (CNS) will be highlighted. Moreover, next-generation delivery approaches such as environmentally-controlled release and interval/sequential drug release will be addressed. Based on the evolving landscape of the treatment of mental illnesses, the nascent field of drug delivery in mental health has tremendous potential for growth in terms of both economic and patient impact.
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Trastorno del Espectro Autista , Trastornos Mentales , Farmacia , Adulto , Humanos , Estados Unidos , Preparaciones de Acción Retardada , Trastornos Mentales/tratamiento farmacológico , Sistemas de Liberación de MedicamentosRESUMEN
SUMMARY: Wound dehiscence, with an estimated occurrence rate greater than 4% in plastic surgery, is generally underreported, and can be an indicator of increased mortality and remission rates. The authors developed the lasso suture as a stronger alternative to the current standard patterns. The lasso suture takes less time to perform than the standard high-tension wound repair method. The authors dissected caprine skin specimens to create full-thickness wounds for suture repair using simple interrupted, vertical mattress, horizontal mattress, and deep dermal with running intradermal (DDR) sutures ( n = 10) and lasso sutures ( n = 9). They then conducted uniaxial failure testing to quantify the suture rupture stresses and strains. They also measured the suture operating time with medical students and residents (PGY or MS programs) performing wound repair (10-cm wide, 2-cm deep, 2-0 polydioxanone sutures) on soft-fixed human cadaver skin. The lasso stitch had a greater first-suture rupture stress compared with all other patterns ( P < 0.001): 2.46 ± 0.27 MPa for lasso versus 0.69 ± 0.14 MPa for simple interrupted, 0.68 ± 0.13 MPa for vertical mattress, 0.50 ± 0.10 MPa for horizontal mattress, and 1.17 ± 0.28 MPa for DDR sutures. Performing the lasso suture was 28% faster than performing standard DDR (264 ± 21 versus 349 ± 25 seconds; P = 0.027). In summary, the authors showed that the lasso has superior mechanical properties compared with the studied traditional sutures, and that the new technique can be performed more quickly than the current standard (DDR stitch) for high-tension wounds. Future animal and in-clinic studies will be helpful to confirm the authors' findings in this proof-of-concept study. CLINICAL RELEVANCE STATEMENT: The authors propose the lasso suture, a new suturing method with improved tensile performance compared with traditional techniques and a faster operative time than the deep dermal stitch typically used for high-tension wounds in reconstructive surgery to prevent wound dehiscence.
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Cabras , Procedimientos de Cirugía Plástica , Humanos , Animales , Piel , Procedimientos Quirúrgicos Dermatologicos , Suturas , Técnicas de SuturaRESUMEN
Optically Mie-resonant crystalline silicon nanoparticles have long attracted interest for their unique scattering behaviors. Here, we report a bottom-up nonthermal plasma process that produces highly monodisperse particles, with diameters controllable between 60 and 214 nm, by temporarily electrostatically trapping nanoparticles inside a continuous-flow plasma reactor. The particle size is tuned by adjusting the gas residence time in the reactor. By dispersing the nanoparticles in water, optical extinction measurements indicate colloidal solutions of a particle-based metafluid in which particles support both strong magnetic and electric dipole resonances at visible wavelengths. The spectral overlap of the electric and magnetic resonances gives rise to directional Kerker scattering. The extinction measurements show excellent agreement with Mie theory, supporting the idea that the fabrication process enables particles with narrow distributions in size, shape, and composition. This single-step gas-phase process can also produce Mie-resonant nanoparticles of dielectric materials other than silicon and directly deposit them on the desired substrates.
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PURPOSE: Our aim was to study the influence of segmental variations in intervertebral disc degeneration on the location of acute osteoporotic compression fractures and to investigate chronic effect of such fractures on adjacent discs. METHODS: This retrospective study included 83 patients (69 females; mean ± SD age: 72.3 ± 14.0 years) with osteoporotic vertebral fractures. Using lumbar MRI, two neuroradiologists evaluated 498 lumbar vertebral segments for the presence and acuity of fractures and graded adjacent intervertebral disc degeneration on Pfirrmann's scale. Absolute and relative (to average patient-specific degeneration grade) segmental degeneration grades were compared against the presence and chronicity of vertebral fractures for all segments and for upper (T12-L2) and lower (L3-L5) subgroups. Intergroup analysis was conducted using Mann-Whitney U tests, with p value of < .05 considered significant. RESULTS: Fractures involved 149/498 (29.9%; 15.1% acute) vertebral segments, majority (61.1%) involving T12-L2 segments. Segments with acute fractures had significantly lower degeneration grades (mean ± SD: absolute: 2.72 ± 0.62; relative: 0.91 ± 0.17) than those with no (absolute: 3.03 ± 0.79, p = 0.003; relative: 0.99 ± 0.16, p < 0.001) or chronic fractures (absolute: 3.03 ± 0.62, p = 0.003; relative: 1.02 ± 0.16, p < 0.001). Degeneration grades were higher in the lower lumbar spine (p < 0.001) in the absence of fractures, but comparable to upper spine for segments with acute or chronic fractures (p = 0.28 and 0.56, respectively). CONCLUSIONS: Osteoporotic vertebral fractures favour segments with lower burden of disc degeneration, but likely contribute to subsequent worsening of adjacent disc degeneration.
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Degeneración del Disco Intervertebral , Disco Intervertebral , Fracturas Osteoporóticas , Fracturas de la Columna Vertebral , Femenino , Humanos , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Degeneración del Disco Intervertebral/complicaciones , Degeneración del Disco Intervertebral/diagnóstico por imagen , Fracturas Osteoporóticas/diagnóstico por imagen , Estudios Retrospectivos , Vértebras Lumbares/diagnóstico por imagen , Fracturas de la Columna Vertebral/diagnóstico por imagenRESUMEN
Hyperlactatemia often occurs in critically ill patients during severe sepsis/septic shock and is a powerful predictor of mortality. Lactate is the end product of glycolysis. While hypoxia due to inadequate oxygen delivery may result in anaerobic glycolysis, sepsis also enhances glycolysis under hyperdynamic circulation with adequate oxygen delivery. However, the molecular mechanisms involved are not fully understood. Mitogen-activated protein kinase (MAPK) families regulate many aspects of the immune response during microbial infections. MAPK phosphatase (MKP)-1 serves as a feedback control mechanism for p38 and JNK MAPK activities via dephosphorylation. Here, we found that mice deficient in Mkp-1 exhibited substantially enhanced expression and phosphorylation of 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase (PFKFB) 3, a key enzyme that regulates glycolysis following systemic Escherichia coli infection. Enhanced PFKFB3 expression was observed in a variety of tissues and cell types, including hepatocytes, macrophages, and epithelial cells. In bone marrow-derived macrophages, Pfkfb3 was robustly induced by both E. coli and lipopolysaccharide, and Mkp-1 deficiency enhanced PFKFB3 expression with no effect on Pfkfb3 mRNA stability. PFKFB3 induction was correlated with lactate production in both WT and Mkp-1-/- bone marrow-derived macrophage following lipopolysaccharide stimulation. Furthermore, we determined that a PFKFB3 inhibitor markedly attenuated lactate production, highlighting the critical role of PFKFB3 in the glycolysis program. Finally, pharmacological inhibition of p38 MAPK, but not JNK, substantially attenuated PFKFB3 expression and lactate production. Taken together, our studies suggest a critical role of p38 MAPK and MKP-1 in the regulation of glycolysis during sepsis.
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Fosfatasa 1 de Especificidad Dual , Glucólisis , Sepsis , Proteínas Quinasas p38 Activadas por Mitógenos , Animales , Ratones , Fosfatasa 1 de Especificidad Dual/genética , Fosfatasa 1 de Especificidad Dual/metabolismo , Escherichia coli/metabolismo , Lactatos , Lipopolisacáridos , Oxígeno , Proteínas Quinasas p38 Activadas por Mitógenos/metabolismo , Proteínas Tirosina Fosfatasas/metabolismo , Sepsis/genética , Fosfofructoquinasa-2/metabolismoRESUMEN
In this prospective, observational, method comparison clinical study, the Xpert Xpress MVP test (MVP) was evaluated using both clinician-collected (CVS) and self-collected vaginal swabs (SVS) collected in a clinical setting. The study was conducted at 12 sites, including point-of-care (POC) settings, from geographically diverse locations in the United States. Participants were biologically female patients ≥ 14 years old with signs and/or symptoms of vaginitis/vaginosis. MVP test results for BV were compared to the BD MAX Vaginal Panel (BDVP). Results for Candida group and Candida glabrata and Candida krusei targets (species not differentiated) were assessed relative to yeast culture followed by mass spectrometry for species identification. Trichomonas vaginalis (TV) results were compared relative to a composite method that included results from the BDVP and InPouch TV culture. The investigational test demonstrated high positive percent agreement ranging from 93.6 to 99.0%, and negative percent agreement ranging from 92.1% to 99.8% for both CVS and SVS specimens, indicating it may be a valuable tool for the diagnosis of vaginitis/vaginosis in laboratory and POC settings.
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Candidiasis Vulvovaginal , Vaginitis por Trichomonas , Trichomonas vaginalis , Vaginosis Bacteriana , Humanos , Femenino , Adolescente , Vaginitis por Trichomonas/diagnóstico , Candidiasis Vulvovaginal/diagnóstico , Vaginosis Bacteriana/diagnóstico , Estudios Prospectivos , Vagina , Trichomonas vaginalis/genéticaRESUMEN
BACKGROUND/AIM: Malaria is a vector borne disease with high morbidity and mortality in endemic regions. In view to eliminating the disease, integrated vector and environmental hygiene practices have been advocated. There is paucity of studies on the effect of vector control measures on asymptomatic malaria infection which has been observed to be a reflection of malaria transmission. METHODS: Longitudinal community-based intervention study carried out from October to December 2017. Study participants were 477 individuals living in 100 households selected by snow-balling sampling methods. Pre-intervention period included training of all heads of households on vector control methods. During the intervention period, each household received waste bins, two long lasting insecticide bed nets and had wire screen on their doors and windows; every household member was screened for malaria (antigen) using the pf rapid diagnostic test kits. Each household were monitored to ensure they comply with the environmental hygiene practices they were taught. Post-intervention malaria infection was obtained at 8 week being end of the intervention period. RESULTS: Of the 100 households selected, 54.0% were from the lower social class, 45.0% middle class and only 1.0% upper class. Mean age [±] of the heads of the households was 37.1 ± 11.0 (range 16-68) years. There were 477 individuals recruited in the study from the 100 households; 234 (49.0%) females and 243 (51.0%) males; median age was 20.0 (range 1-100) years. Prevalence of malaria infection using mRDT during pre-intervention was 16.8% and an incidence of 1.3% post-intervention. There was 92.0% reduction in asymptomatic malaria infection showing marked reduction in malaria transmission in the study locale. CONCLUSION: Some integrated vector control measures such as use of insecticide-treated net and sanitation were found effective methods for reducing malaria infection and transmission in endemic region.
CONTEXTE/OBJECTIF: Le paludisme est une maladie à transmission vectorielle avec une morbidité et une mortalité élevées dans les régions endémiques. En vue d'éliminer la maladie, des pratiques d'hygiène intégrée des vecteurs et de l'environnement ont été préconisées. Il existe peu d'études sur l'effet des mesures de lutte antivectorielle sur l'infection palustre asymptomatique, qui s'est avérée être le reflet de la transmission du paludisme. MÉTHODES: Étude longitudinale d'intervention communautaire réalisée d'octobre à décembre 2017. Les participants à l'étude étaient 477 personnes vivant dans 100 ménages sélectionnés par des méthodes d'échantillonnage en boule de neige. La période de pré-intervention comprenait la formation de tous les chefs de ménage sur les méthodes de lutte antivectorielle. Au cours de la période d'intervention, chaque ménage a reçu des poubelles, deux moustiquaires à insecticide longue durée et avait des grillages sur leurs portes et fenêtres ; chaque membre du ménage a été dépisté pour le paludisme (antigène) à l'aide des kits de test de diagnostic rapide pf. Chaque ménage a été suivi pour s'assurer qu'il respecte les pratiques d'hygiène environnementale qui lui ont été enseignées. L'infection antipaludique post-intervention a été obtenue à 8 semaines, fin de la période d'intervention. RÉSULTATS: Sur les 100 ménages sélectionnés, 54,0% appartenaient à la classe sociale inférieure, 45,0% à la classe moyenne et seulement 1,0% à la classe supérieure. L'âge moyen [±] des chefs de ménage était de 37,1 ± 11,0 (fourchette de 16 à 68) ans. Il y avait 477 personnes recrutées dans l'étude à partir des 100 ménages ; 234 (49,0 %) femmes et 243 (51,0 %) hommes ; l'âge médian était de 20,0 (intervalle de 1 à 100) ans. La prévalence de l'infection du paludisme à l'aide de mRDT pendant la pré-intervention était de 16,8 % et l'incidence de 1,3 % après l'intervention. Il y avait une réduction de 92,0 % de l'infection asymptomatique du paludisme, montrant une réduction marquée de la transmission du paludisme dans le lieu de l'étude. CONCLUSION: Certaines mesures intégrées de lutte antivectorielle telles que l'utilisation de moustiquaires imprégnées d'insecticide et l'assainissement se sont révélées être des méthodes efficaces pour réduire l'infection et la transmission du paludisme dans les régions endémiques. Mots clés: Endémique, Hygiène Environnementale, Ménages, Intervention, Paludisme, Transmission, Vecteur.