Assessing the hazard of death, cardiac tamponade, and pericardial constriction among HIV and tuberculosis pericarditis patients using the extended Cox-hazard model: Intervention study.

Background and Aims: Tuberculous (TB) pericarditis (TBP), a TB of the heart, is linked to significant morbidity and mortality rates. Administering glucocorticoid therapy to individuals with TBP might enhance overall results and lower the likelihood of fatality. However, the actual clinical effectiveness of supplementary glucocorticoids remains uncertain. This study specifically evaluated the effects of prednisolone, prednisolone-antiretroviral therapy (ART) interaction, and other potential risk factors in reducing the hazard of the composite outcome, death, cardiac tamponade, and constriction, among TBP and human immunodeficiency virus (HIV) patients. Methods: The data used in this study were obtained from the investigation of the Management of Pericarditis trial, a multicentre international randomized double-blind placebo-controlled 2×2 factorial study that investigated the effects of two TB treatments, prednisolone and Mycobacterium indicus pranii  immunotherapy in patients with TBP in Africa. This study used a sample size of 587 TBP and HIV-positive patients randomized into prednisolone and its corresponding placebo arm. We used the extended Cox-proportional hazard model to evaluate the effects of the covariates on the hazard of the survival outcomes. Models fitting and parameter estimation were carried out using R version 4.3.1. Results: Prednisolone reduces the hazard of composite outcome (hazrad ratio [HR] = 0.32, 95% confidence interval [CI] = 0.19,0.54, p < 0.001), cardiac tamponade (HR = 0.14, 95% CI = 0.05, 0.42, p < 0.001) and constriction (HR = 0.81, 95% CI = 0.41, 1.61, p = 0.55). However, prednisolone increases the hazard of death (HR = 1.58, 95% CI = 1.11, 2.24, p = 0.01). Consistent usage of ART reduces the hazard of composite outcome, death, and constriction but insignificantly increased the hazard of cardiac tamponade. Conclusion: The study offers valuable insights into how prednisolone impact the hazard of different outcomes in patients with TBP and HIV. The findings hold potential clinical significance, particularly in guiding treatment decisions and devising strategies to enhance outcomes in this specific patient group. However, there are concerns about prednisolone potentially increasing the risk of death due to HIV-related death.

Dynamics of Tuberculosis (TB) with Drug Resistance to First-Line Treatment and Leaky Vaccination: A Deterministic Modelling Perspective.

A deterministic model was formulated and employed in the analysis of the dynamics of tuberculosis with a keen emphasis on vaccination and drug resistance as the first line of treatment. It was assumed that some of the susceptible population were vaccinated but with temporal immunity. This is due to the fact that vaccines do not confer permanent immunity. Moreover, part of the infected individual after treatment grows resistance to the drug. Infective immigrants were also considered to be part of the population. The basic reproductive number for the model is estimated using the next-generation matrix method. The equilibrium points of the TB model and their local and global stability were determined. It was established that if the basic reproductive number was less than unity (R 0 < 1), then the disease free equilibrium is stable and unstable if R 0 > 1. Furthermore, we investigated the optimal prevention, treatment, and vaccination as control measures for the disease. As the objective functional was optimised, there have been a significant reduction in the number of infections and an increase in the number of recovery. The best control measure in combating tuberculosis infections is prevention and vaccination of the susceptible population.

A predictive model for daily cumulative COVID-19 cases in Ghana.

Background: Coronavirus disease 2019 (COVID-19) is a pandemic that has affected the daily life, governments and economies of many countries all over the globe. Ghana is currently experiencing a surge in the number of cases with a corresponding increase in the cumulative confirmed cases and deaths. The surge in cases and deaths clearly shows that the preventive and management measures are ineffective and that policy makers lack a complete understanding of the dynamics of the disease. Most of the deaths in Ghana are due to lack of adequate health equipment and facilities for managing the disease. Knowledge of the number of cases in advance would aid policy makers in allocating sufficient resources for the effective management of the cases. Methods: A predictive tool is necessary for the effective management and prevention of cases. This study presents a predictive tool that has the ability to accurately forecast the number of cumulative cases. The study applied polynomial and spline models on the COVID-19 data for Ghana, to develop a generalized additive model (GAM) that accurately captures the growth pattern of the cumulative cases. Results: The spline model and the GAM provide accurate forecast values. Conclusion: Cumulative cases of COVID-19 in Ghana are expected to continue to increase if appropriate preventive measures are not enforced. Vaccination against the virus is ongoing in Ghana, thus, future research would consider evaluating the impact of the vaccine.

Deterministic epidemic model for ( S V C S y C A s y I R ) pneumonia dynamics, with vaccination and temporal immunity.

Streptococcus pneumonia is one of the leading causes of mobility and mortality in children under 6 years and the elderly especially in developing countries in which Ghana, the study area is not an exception.In this paper, a model of the spread and control of bacterial pneumonia that include symptomatic carriers, asymptomatic carriers and vaccination is formulated and analyzed to determine the effect of the vaccination intervention.Analysis of the system show that the disease free equilibrium is stable if and only if the basic reproductive number R 0 < 1 . For R 0 ≥ 1 , the endemic equilibrium is globally stable and the disease persist. Numerical simulation on the system show that with effective vaccine intervention pneumonia infection can be eradicated in the long term.