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Forter-Chee-A-Tow N, Smith A. Role of surgical embolectomy in the management of acute massive and submassive pulmonary embolism in the setting of a small island developing state. J Surg Case Rep 2023; 2023:rjad468. [PMID: 37593185 PMCID: PMC10432080 DOI: 10.1093/jscr/rjad468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 07/30/2023] [Indexed: 08/19/2023] Open
Abstract
Acute pulmonary embolism (PE) remains a life-threatening condition despite advances in diagnostic and therapeutic modalities. Treatment modalities include systemic thrombolysis, catheter-based therapies and surgical embolectomy. This case report describes the first recorded surgical embolectomy for acute PE in Barbados, a small island developing state.
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Affiliation(s)
| | - Alan Smith
- University of the West Indies at Cave Hill, Faculty of Medical Sciences, The Queen Elizabeth Hospital, Bridgetown, St Michael, Barbados
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2
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Ma HW, Lee HS, Ahn JY. Analysis of Factors Affecting the Rate of Latent Tuberculosis Infection and Management in Pediatrics. Children (Basel) 2022; 9. [PMID: 36291503 DOI: 10.3390/children9101567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/08/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
The incidence of tuberculosis remains high in South Korea; the management of latent tuberculosis infection (LTBI) has become the prime target for reducing the infection rate. The management of pediatric LTBI is especially crucial because children can serve as a long-term source of infection upon developing active tuberculosis. Therefore, it is important to assess pediatric LTBI using contact investigation and follow-up. We conducted a retrospective study on children aged between 0 and 18 years who visited our hospital for tuberculosis contact screening from February 2012 to February 2021. Tuberculosis index cases and their clinical characteristics were also reviewed retrospectively. A total of 350 children were investigated, and 68 of 247 (27.5%) were diagnosed with LTBI. The rate of LTBI (r = 7.98, p < 0.001) and the risk of loss to follow-up (r = 27.038, p < 0.001) were higher in cases with close household contact. Sputum (r = 10.992, p < 0.001) and positive acid-fast bacillus (AFB) stain (r = 4.458, p = 0.001) in tuberculosis index cases were related to the diagnosis of LTBI in pediatric contacts. Active management is needed for tuberculosis screening in pediatric contacts, especially when the contacts are older and the index case is within the family, and when the index case has sputum and has tested positive for AFB smear.
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Remera E, Nsanzimana S, Chammartin F, Semakula M, Rwibasira GN, Malamba SS, Riedel DJ, Tuyishime E, Condo JU, Ndimubanzi P, Sangwayire B, Forrest JI, Cantoreggi SL, Mills EJ, Bucher HC. Brief Report: Active HIV Case Finding in the City of Kigali, Rwanda: Assessment of Voluntary Assisted Partner Notification Modalities to Detect Undiagnosed HIV Infections. J Acquir Immune Defic Syndr 2022; 89:423-427. [PMID: 35202049 PMCID: PMC8860213 DOI: 10.1097/qai.0000000000002878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/15/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Voluntary assisted partner notification (VAPN) services that use contract, provider, or dual referral modalities may be efficient to identify individuals with undiagnosed HIV infection. We aimed to assess the relative effectiveness of VAPN modalities in identifying undiagnosed HIV infections. SETTING VAPN was piloted in 23 health facilities in Kigali, Rwanda. METHODS We identified individuals with a new HIV diagnosis before antiretroviral therapy initiation or individuals on antiretroviral therapy (index cases), who reported having had sexual partners with unknown HIV status, to assess the association between referral modalities and the odds of identifying HIV-positive partners using a Bayesian hierarchical logistic regression model. We adjusted our model for important factors identified through a Bayesian variable selection. RESULTS Between October 2018 and December 2019, 6336 index cases were recruited, leading to the testing of 7690 partners. HIV positivity rate was 7.1% (546/7690). We found no association between the different referral modalities and the odds of identifying HIV-positive partners. Notified partners of male individuals (adjusted odds ratio 1.84; 95% credible interval: 1.50 to 2.28) and index cases with a new HIV diagnosis (adjusted odds ratio 1.82; 95% credible interval: 1.45 to 2.30) were more likely to be infected with HIV. CONCLUSION All 3 VAPN modalities were comparable in identifying partners with HIV. Male individuals and newly diagnosed index cases were more likely to have partners with HIV. HIV-positive yield from index testing was higher than the national average and should be scaled up to reach the first UNAIDS-95 target by 2030.
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Affiliation(s)
- Eric Remera
- Institute of HIV Disease Prevention and Control, Rwanda Biomedical Centre, Kigali, Rwanda
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Basel, Faculty of Science, Basel- Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Sabin Nsanzimana
- Institute of HIV Disease Prevention and Control, Rwanda Biomedical Centre, Kigali, Rwanda
| | - Frédérique Chammartin
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Basel, Faculty of Science, Basel- Switzerland
| | - Muhammed Semakula
- Institute of HIV Disease Prevention and Control, Rwanda Biomedical Centre, Kigali, Rwanda
- I-BioStat, Hasselt University, Hasselt, Belgium
| | - Gallican N. Rwibasira
- Institute of HIV Disease Prevention and Control, Rwanda Biomedical Centre, Kigali, Rwanda
| | | | - David J. Riedel
- Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, MD
| | - Elysee Tuyishime
- African Center of Excellence in Data Science, University of Rwanda, Kigali, Rwanda
| | - Jeanine U. Condo
- School of Public Health, College of Medicine & Health Sciences, University of Rwanda, Kigali, Rwanda
- Tulane University, New Orleans, LA
| | | | - Beata Sangwayire
- Institute of HIV Disease Prevention and Control, Rwanda Biomedical Centre, Kigali, Rwanda
| | - Jamie I. Forrest
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; and
| | - Sara L. Cantoreggi
- Institute of HIV Disease Prevention and Control, Rwanda Biomedical Centre, Kigali, Rwanda
- University of Basel, Faculty of Science, Basel- Switzerland
| | - Edward J. Mills
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Heiner C. Bucher
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Basel, Faculty of Science, Basel- Switzerland
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4
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Babatunde OA, Olatunji MB, Omotajo OR, Ikwunne OI, Babatunde AM, Nihinlola ET, Patrick GF, Dairo DM. Impact of COVID-19 on routine immunization in Oyo State, Nigeria: trend analysis of immunization data in the pre- and post- index case period; 2019-2020. Pan Afr Med J 2022; 41:54. [PMID: 35317483 PMCID: PMC8917464 DOI: 10.11604/pamj.2022.41.54.28575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 12/19/2021] [Indexed: 12/13/2022] Open
Abstract
Introduction the response to COVID-19 pandemic has posed new obstacles to the fragile health system, most especially in the area of vaccination across much of Africa. As the response to the pandemic intensifies through the application of non-pharmacologic interventions as well as enforcement of the lockdowns across African cities, there is a significant risk that more children will miss out on life-saving vaccines that can prevent childhood killer diseases. This study was therefore conducted to look at the impact of the COVID-19 pandemic on routine immunization in Oyo State, Nigeria. Methods we conducted a descriptive secondary analysis of immunization data between July 2019 and August 2020. These data were retrieved from the monitoring and evaluation unit of Oyo State Primary Health Care Board. The data were extracted from the original paper format and entered into Excel sheets. Line graphs were plotted to compare the trends of the coverage rates before and after the index case of the COVID-19 pandemic. Results the average coverage rates for Bacillus Calmette-Guérin (BCG) before and after index case were 85.8% and 82.1% respectively, while it was 63.5% and 60.0% for HBV0. For the co-administered vaccines at 14 weeks, Penta 3, OPV 3, PCV 3 and IPV coverage rates dropped from 76.1%, 75.4%, 75.1% and 73.5% to 72.0%, 71.4%, 72.0% and 71.9% respectively. The average coverage rates for yellow fever and measles dropped sharply from 77.0% and 74.5% and 64.6% and 58.6% respectively. The average drop-out rates for the pre-and post-index case periods were 5.0% and 4.7% respectively. For the planned fixed and outreach sessions, none of the monthly sessions met the target of 100.0% in the post-index case period. Conclusion decreased vaccination coverage for vaccine-preventable diseases could cause parallel outbreaks with COVID-19 and further exacerbate the strain on health systems attempting to end the acute phase of this pandemic. Therefore, as the dramatic second wave unfolds, the Government of Nigeria must take deliberate steps to strike a balance between a fresh lockdown and the imperative of uninterrupted social service. In this wise, it must remain committed to a timely vaccination program.
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Affiliation(s)
- Olaniyan Akintunde Babatunde
- Oyo State Primary Health Care Board, State Secretariat, Agodi, Ibadan, Oyo State, Nigeria.,Oriire Local Government Health Authority, Ikoyi-Ile, Oyo State, Nigeria
| | | | | | | | | | | | | | - David Magbagbeola Dairo
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Oyo State, Nigeria
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Kelley SR, D'Angelo JD, D'Angelo ALD, Behm KT, Colibaseanu DT, Merchea A, Mishra N, Dozois EJ, Mathis KL. The Effect of Advanced Practice Providers on ACGME Colon and Rectal Surgery Resident Diagnostic Index Case Volumes. J Surg Educ 2022; 79:426-430. [PMID: 34702690 DOI: 10.1016/j.jsurg.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/04/2021] [Accepted: 10/02/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Prior to 2015 residents in our Accreditation Council for Graduation Medical Education (ACGME) colon and rectal surgery training program were in charge of managing, with faculty oversight, the outpatient anorectal clinic at our institution. Starting in 2015 advanced practice providers (APPs) working in the division assumed management of the clinic. The effect of APPs on ACGME resident index diagnostic case volumes has not been explored. Herein we examine ACGME case log graduate statistics to determine if the inclusion of APPs into our anorectal clinic practice has negatively affected resident index diagnostic anorectal case volumes. DESIGN ACGME year-end program reports were obtained for the years 2011 to 2019. Program anorectal diagnostic index volumes were recorded and compared to division volumes. Analysis of variance (ANOVA) and analysis of covariance (ANCOVA) tests were conducted to assess whether the number of cases per year (for each respective case type) prior to the introduction of APPs into the anorectal clinic (2011-2014) differed from the number of cases per year with the APP clinic in place (2015-2018). A p-value <0.05 was considered statistically significant. SETTING Mayo Clinic, Rochester, Minnesota (quaternary referral center). PARTICIPANTS Colon and rectal surgery resident year-end ACGME reports (2011-2019). RESULTS ANOVAs revealed a marginally significant (p = 0.007) downtrend for hemorrhoid diagnostic codes, and a significant uptrend (p = 0.000) for fistula cases. Controlling for overall division volume, ANCOVA only reveled significance for fistula cases (p = 0.004) with the involvement of APPs. CONCLUSIONS At our institution we found the inclusion of APPs into our anorectal clinic practice did not negatively affect colon and rectal surgery resident ACGME index diagnostic anorectal case volumes. Inclusion of APPs into a multidisciplinary practice can promote resident education by allowing trainees to pursue other educational opportunities without hindering ACGME index case volumes.
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Affiliation(s)
- Scott R Kelley
- Mayo Clinic, Division of Colon and Rectal Surgery, Rochester, Minnesota.
| | | | | | - Kevin T Behm
- Mayo Clinic, Division of Colon and Rectal Surgery, Rochester, Minnesota
| | | | - Amit Merchea
- Mayo Clinic, Division of Colon and Rectal Surgery, Jacksonville, Florida
| | - Nitin Mishra
- Mayo Clinic, Division of Colon and Rectal Surgery, Phoenix, Arizona
| | - Eric J Dozois
- Mayo Clinic, Division of Colon and Rectal Surgery, Rochester, Minnesota
| | - Kellie L Mathis
- Mayo Clinic, Division of Colon and Rectal Surgery, Rochester, Minnesota
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6
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Futema M, Taylor-Beadling A, Williams M, Humphries SE. Genetic testing for familial hypercholesterolemia-past, present, and future. J Lipid Res 2021; 62:100139. [PMID: 34666015 PMCID: PMC8572866 DOI: 10.1016/j.jlr.2021.100139] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/22/2021] [Accepted: 10/02/2021] [Indexed: 01/01/2023] Open
Abstract
In the early 1980s, the Nobel Prize winning cellular and molecular work of Mike Brown and Joe Goldstein led to the identification of the LDL receptor gene as the first gene where mutations cause the familial hypercholesterolemia (FH) phenotype. We now know that autosomal dominant monogenic FH can be caused by pathogenic variants of three additional genes (APOB/PCSK9/APOE) and that the plasma LDL-C concentration and risk of premature coronary heart disease differs according to the specific locus and associated molecular cause. It is now possible to use next-generation sequencing to sequence all exons of all four genes, processing 96 patient samples in one sequencing run, increasing the speed of test results, and reducing costs. This has resulted in the identification of not only many novel FH-causing variants but also some variants of unknown significance, which require further evidence to classify as pathogenic or benign. The identification of the FH-causing variant in an index case can be used as an unambiguous and rapid test for other family members. An FH-causing variant can be found in 20-40% of patients with the FH phenotype, and we now appreciate that in the majority of patients without a monogenic cause, a polygenic etiology for their phenotype is highly likely. Compared with those with a monogenic cause, these patients have significantly lower risk of future coronary heart disease. The use of these molecular genetic diagnostic methods in the characterization of FH is a prime example of the utility of precision or personalized medicine.
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Affiliation(s)
- Marta Futema
- Centre for Heart Muscle Disease, Institute of Cardiovascular Science, University College London, London, United Kingdom; Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom
| | - Alison Taylor-Beadling
- Regional Molecular Genetics Laboratory, Great Ormond Street Hospital for Children, London, United Kingdom
| | | | - Steve E Humphries
- Institute of Cardiovascular Science, University College London, London, United Kingdom.
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7
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Jefferies M, Rashid H, Hill-Cawthorne GA, Kayser V. A Brief History of Ebolavirus Disease: Paving the Way Forward by Learning from the Previous Outbreaks. Infect Disord Drug Targets 2021; 20:259-266. [PMID: 30277167 DOI: 10.2174/1871526518666181001125106] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 08/25/2018] [Accepted: 09/14/2018] [Indexed: 11/22/2022]
Abstract
In this review, Ebolavirus Disease (EVD) outbreaks have been comprehensively reviewed from their beginning until now. It chronologically discusses how each outbreak was tackled, national and international actions taken, diagnostic methods applied, the infection control procedures put in place, and the lessons learnt from each epidemic for the control of subsequent epidemics. Data for this review were obtained from literature published between 1967 and 2016 in key medical databases, the official websites of various governmental organisations, international public health agencies, and regulatory bodies. Despite major developments in the field of EVD, there has been little progress in its specific therapy or prevention. Historically, individuals who recovered from EVD acted as a source of fresh frozen plasma (containing IgG) that has been used to treat other acutely ill patients, however this therapeutic modality has limitations due to the risk of transmission of blood-borne infections. With the use of advanced and efficient purification methods the incidence of unwanted side effects following immune serum therapy has currently been greatly reduced. Creation of a safe plasma pool that covers immunoglobulins against all strains of EVD is now a research priority. Recommendations on how future EVD outbreaks can be better managed have been discussed.
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Affiliation(s)
- Meryem Jefferies
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Harunor Rashid
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children’s Hospital at Westmead, and the Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia,Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Grant A Hill-Cawthorne
- Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, The University of Sydney, Sydney, NSW, Australia,School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Veysel Kayser
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia
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8
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Sanville B, Corbett R, Pidcock W, Hardin K, Sebat C, Nguyen MV, Thompson GR, Haczku A, Schivo M, Cohen S. A Community-transmitted Case of Severe Acute Respiratory Distress Syndrome (SARS) Due to SARS-CoV-2 in the United States. Clin Infect Dis 2020; 71:2222-2226. [PMID: 32227197 PMCID: PMC7197621 DOI: 10.1093/cid/ciaa347] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 03/28/2020] [Indexed: 01/08/2023] Open
Affiliation(s)
- Bradley Sanville
- Division of Pulmonary, Critical Care, and Sleep Medicine, School of Medicine, University of California at Davis, Davis, California, USA
| | - Rebecca Corbett
- Division of Pulmonary, Critical Care, and Sleep Medicine, School of Medicine, University of California at Davis, Davis, California, USA
| | - Wesley Pidcock
- Division of Pulmonary, Critical Care, and Sleep Medicine, School of Medicine, University of California at Davis, Davis, California, USA
| | - Kaitlyn Hardin
- Division of Infectious Diseases, School of Medicine, University of California at Davis, Davis, California, USA
| | - Christian Sebat
- Division of Pulmonary, Critical Care, and Sleep Medicine, School of Medicine, University of California at Davis, Davis, California, USA
| | - Minh-Vu Nguyen
- Division of Infectious Diseases, School of Medicine, University of California at Davis, Davis, California, USA
| | - George R Thompson
- Division of Infectious Diseases, School of Medicine, University of California at Davis, Davis, California, USA
| | - Angela Haczku
- Division of Pulmonary, Critical Care, and Sleep Medicine, School of Medicine, University of California at Davis, Davis, California, USA
| | - Michael Schivo
- Division of Pulmonary, Critical Care, and Sleep Medicine, School of Medicine, University of California at Davis, Davis, California, USA
| | - Stuart Cohen
- Division of Infectious Diseases, School of Medicine, University of California at Davis, Davis, California, USA
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9
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Robles G, Dellucci TV, Stratton MJ, Jimenez RH, Starks TJ. The Utility of Index Case Recruitment for Establishing Couples' Eligibility: An Examination of Consistency in Reporting the Drug Use of a Primary Partner Among Sexual Minority Male Couples. ACTA ACUST UNITED AC 2019; 8:221-232. [PMID: 32395393 DOI: 10.1037/cfp0000128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Sexual minority men are disproportionately impacted by substance use, which is associated with greater HIV transmission behaviors. Novel approaches to drug use prevention and treatment are needed. Couple-based approaches have garnered significant attention. The recruitment of couples into substance use interventions has proven challenging. We evaluate an index-case approach to screening participants in couples' research. Seventy index cases, aged 18-29, and their main partner (140 individuals), were recruited. At screening, index participants reported their drug use and their partners' drug use for the previous 30 days. At baseline, both partners reported their drug use over the past 30 days. Individuals' self-reports and perceptions of their partner's concurrency were compared within couples using the κ (Kappa) coefficient. We found high levels of personal predictive accuracy from screening to baseline for cannabis (κ = .81, p < .01) and cocaine/crack (κ = .70, p < .01). Predictive accuracy of index case reporting of their partner's drug use behavior were moderately high among cocaine/crack use (κ = .68, p < .01) and MDMA/GHB/Ketamine (κ = .56, p < .01). Perceived partner similarity for recent drug use was also high for all drugs, with the highest levels among cocaine/crack (κ =.82) and prescription drugs (κ =.81). This study demonstrates that index partners report drug use with differing levels of agreement between drug types. Index recruitment has advantages in determining drug use-related eligibility requirements. Discrepancies in reporting were more frequently false positives, which reduces the risk of screening out potentially eligible couples.
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Affiliation(s)
- Gabriel Robles
- Department of Psychology, Hunter College of the City University of New York, New York, NY. USA
| | - Trey V Dellucci
- Health Psychology and Clinical Science Doctoral Program, Graduate Center of City University of New York, New York, NY. USA
| | - Mark J Stratton
- Department of Psychology, Hunter College of the City University of New York, New York, NY. USA
| | - Ruben H Jimenez
- Department of Psychology, Hunter College of the City University of New York, New York, NY. USA
| | - Tyrel J Starks
- Department of Psychology, Hunter College of the City University of New York, New York, NY. USA.,Health Psychology and Clinical Science Doctoral Program, Graduate Center of City University of New York, New York, NY. USA
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10
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Abstract
Filoviruses cause outbreaks which lead to high fatality in humans and non-human primates, thus tagging them as major threats to public health and species conservation. In this review, we give account of index cases responsible for filovirus disease outbreaks that have occurred over the past 52 years in a chronological fashion, by describing the circumstances that led to the outbreaks, and how each of the outbreaks broke out. Since the discovery of Marburg virus and Ebola virus in 1967 and 1976, respectively, more than 40 filovirus disease outbreaks have been reported; majority of which have occurred in Africa. The chronological presentation of this review is to provide a concise overview of filovirus disease outbreaks since the discovery of the viruses, and highlight the patterns in the occurrence of the outbreaks. This review will help researchers to better appreciate the need for surveillance, especially in areas where there have been no filovirus disease outbreaks. We conclude by summarizing some recommendations that have been proposed by health and policy decision makers over the years.
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Affiliation(s)
- Sylvester Languon
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - Osbourne Quaye
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
- Stellenbosch Institute for Advance Study (STIAS), Stellenbosch, South Africa
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11
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Keiser CN, Howell KA, Pinter-Wollman N, Pruitt JN. Personality composition alters the transmission of cuticular bacteria in social groups. Biol Lett 2017; 12:rsbl.2016.0297. [PMID: 27381885 DOI: 10.1098/rsbl.2016.0297] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 06/15/2016] [Indexed: 12/28/2022] Open
Abstract
The initial stages of a disease outbreak can determine the magnitude of the ensuing epidemic. Though rarely tested in unison, two factors with important consequences for the transmission dynamics of infectious agents are the collective traits of the susceptible population and the individual traits of the index case (i.e. 'patient zero'). Here, we test whether the personality composition of a social group can explain horizontal transmission dynamics of cuticular bacteria using the social spider Stegodyphus dumicola We exposed focal spiders of known behavioural phenotypes with a GFP-transformed cuticular bacterium (Pantoea sp.) and placed them in groups of 10 susceptible individuals (i.e. those with no experience with this bacterium). We measured bacterial transmission to groups composed of either all shy spiders, 10% bold spiders or 40% bold spiders. We found that colonies with 40% bold spiders experienced over twice the incidence of transmission compared to colonies with just 10% bold individuals after only 24 h of interaction. Colonies of all shy spiders experienced an intermediate degree of transmission. Interestingly, we did not detect an effect of the traits of the index case on transmission. These data suggest that the phenotypic composition of the susceptible population can have a greater influence on the degree of early transmission events than the traits of the index case.
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Affiliation(s)
- Carl N Keiser
- Department of Biological Sciences, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Kimberly A Howell
- Department of Biological Sciences, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Noa Pinter-Wollman
- BioCircuits Institute, University of California, San Diego, La Jolla, CA 92093, USA
| | - Jonathan N Pruitt
- Department of Ecology, Evolution, and Marine Biology, University of California, Santa Barbara, CA 93106, USA
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12
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Curran ET, Wilson J, Haig CE, McCowan C, Leanord A, Loveday H. The Where is Norovirus Control Lost (WINCL) Study: an enhanced surveillance project to identify norovirus index cases in care settings in the UK and Ireland. J Infect Prev 2016; 17:8-14. [PMID: 28989447 PMCID: PMC5074184 DOI: 10.1177/1757177415613133] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 09/26/2015] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Norovirus outbreaks have a significant impact on all care settings; little is known about the index cases from whom these outbreaks initiate. AIM To identify and categorise norovirus outbreak index cases in care settings. METHODS A mixed-methods, multi-centre, prospective, enhanced surveillance study identified and categorised index cases in acute and non-acute care settings. RESULTS From 54 participating centres, 537 outbreaks were reported (November 2013 to April 2014): 383 (71.3%) in acute care facilities (ACF); 115 (21.4%) in residential or care homes (RCH) and 39 (7.3%) in other care settings (OCS). Index cases were identified in 424 (79%) outbreaks. Of the 245 index cases who were asymptomatic on admission and not transferred within/into the care setting, 123 (50%) had been an inpatient/resident for 4 days. Four themes emerged: missing the diagnosis, care service under pressure, delay in outbreak control measures and patient/resident location and proximity. CONCLUSION The true index case is commonly not identified as the cause of a norovirus outbreak with at least 50% of index cases being misclassified. Unrecognised norovirus cross-transmission occurs frequently suggesting that either Standard Infection Control Precautions (SICPs) are being insufficiently well applied, and or SICPs are themselves are insufficient to prevent outbreaks.
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Affiliation(s)
| | - Jennie Wilson
- Richard Wells Research Centre, University of West London, UK
| | - Caroline E Haig
- Robertson Centre for Biostatistics, University of Glasgow, UK
| | - Colin McCowan
- Robertson Centre for Biostatistics, University of Glasgow, UK
| | - Alistair Leanord
- Department of Infection, Immunity and Inflammation, University of Glasgow, UK
| | - Heather Loveday
- Richard Wells Research Centre, University of West London, UK
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Osman M, Hesseling AC, Beyers N, Enarson DA, Rusen ID, Lombard C, van Wyk SS. Routine programmatic delivery of isoniazid preventive therapy to children in Cape Town, South Africa. Public Health Action 2015; 3:199-203. [PMID: 26393029 DOI: 10.5588/pha.13.0034] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 06/18/2013] [Indexed: 11/10/2022] Open
Abstract
SETTING Fourteen primary health care facilities in Cape Town, South Africa. OBJECTIVE To determine the proportion and characteristics of infectious adult tuberculosis (TB) cases that identify children aged <5 years who qualify for isoniazid preventive therapy (IPT), and to determine the proportion of children who initiate and complete IPT. DESIGN A retrospective clinical record review conducted as a stratified cluster survey. RESULTS Of 1179 records of infectious adult cases, 33.3% had no documentation of contacts. Of the remaining 786 records, 525 contacts aged <5 years were identified, representing 0.7 child contacts per infectious adult case. Older age, male, human immunodeficiency virus (HIV) positive, smear-negative and retreatment TB cases were all associated with no documentation of contacts. Of the 525 child contacts identified, less than half were screened for TB, 141 initiated IPT and 19 completed it. CONCLUSION Less than 67% of infectious TB case records had documentation of contacts. Younger, female, HIV-negative and new smear-positive TB cases were more likely to have had contacts identified. Less than 14% of children already initiated on IPT completed 6 months of treatment.
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Affiliation(s)
- M Osman
- City Health Directorate, City of Cape Town, Cape Town, South Africa
| | - A C Hesseling
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
| | - N Beyers
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
| | - D A Enarson
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa ; International Union Against Tuberculosis and Lung Disease, Paris, France
| | - I D Rusen
- International Union Against Tuberculosis and Lung Disease, Paris, France
| | - C Lombard
- The Medical Research Council of South Africa, Biostatistical Unit, Cape Town, South Africa
| | - S S van Wyk
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
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Brett T, Watts GF, Arnold-Reed DE, Bell DA, Garton-Smith J, Vickery AW, Ryan JDM, Pang J. Challenges in the care of familial hypercholesterolemia: a community care perspective. Expert Rev Cardiovasc Ther 2015; 13:1091-100. [PMID: 26313701 DOI: 10.1586/14779072.2015.1082907] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Familial hyperchoelsterolaemia (FH) remains under-diagnosed and under-treated in the community setting. Earlier evidence suggested a prevalence of 1:500 worldwide but newer evidence suggests it is more common. Less than 15% of FH patients are ever diagnosed, with children and young adults rarely tested despite having the most to gain given their lifetime exposure. Increasing awareness among primary care teams is critical to improve the detection profile for FH. Cascade testing in the community setting needs a sustainable approach to be developed to facilitate family tracing of index cases. The use of the Dutch Lipid Clinic Network Criteria score to facilitate a phenotypic diagnosis is the preferred approach adopted in Australia and eliminates the need to undertake genetic testing for all suspected FH cases.
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Affiliation(s)
- Tom Brett
- a 1 General Practice and Primary Health Care Research, School of Medicine, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Gerald F Watts
- b 2 School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.,c 3 Lipid Disorders Clinic, Cardiometabolic Services, Royal Perth Hospital, Western Australia, Australia
| | - Diane E Arnold-Reed
- a 1 General Practice and Primary Health Care Research, School of Medicine, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | | | - Jacquie Garton-Smith
- f 6 Cardiovascular Health Network, Department of Heath Western Australia, Perth, Western Australia, Australia.,g 7 Clinical Services, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Alistair W Vickery
- h 8 School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Crawley, Western Australia, Australia
| | - Jacqueline D M Ryan
- b 2 School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | - Jing Pang
- b 2 School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
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15
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Wauquier N, Bangura J, Moses L, Humarr Khan S, Coomber M, Lungay V, Gbakie M, Sesay MSK, Gassama IAK, Massally JLB, Gbakima A, Squire J, Lamin M, Kanneh L, Yillah M, Kargbo K, Roberts W, Vandi M, Kargbo D, Vincent T, Jambai A, Guttieri M, Fair J, Souris M, Gonzalez JP. Understanding the emergence of ebola virus disease in sierra leone: stalking the virus in the threatening wake of emergence. PLoS Curr 2015; 7. [PMID: 25969797 PMCID: PMC4423925 DOI: 10.1371/currents.outbreaks.9a6530ab7bb9096b34143230ab01cdef] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Since Ebola Virus Disease (EVD) was first identified in 1976 in what is now the Democratic Republic of Congo, and despite the numerous outbreaks recorded to date, rarely has an epidemic origin been identified. Indeed, among the twenty-one most documented EVD outbreaks in Africa, an index case has been identified four times, and hypothesized in only two other instances. The initial steps of emergence and spread of a virus are critical in the development of a potential outbreak and need to be thoroughly dissected and understood in order to improve on preventative strategies. In the current West African outbreak of EVD, a unique index case has been identified, pinpointing the geographical origin of the epidemic in Guinea. Herein, we provide an accounting of events that serve as the footprint of EVD emergence in Sierra Leone and a road map for risk mitigation fueled by lessons learned.
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Affiliation(s)
| | | | - Lina Moses
- Tulane University, New Orleans, Louisiana, USA
| | | | - Moinya Coomber
- Metabiota Inc., Kenema Government Hospital, Kenema, Sierra Leone
| | - Victor Lungay
- Metabiota Inc., Freetown, Sierra Leone; Ministry of Heath and Sanitation, Sierra Leone
| | - Michael Gbakie
- Tulane University, New Orleans, Louisiana, USA; Ministry of Heath and Sanitation, Sierra Leone
| | | | | | | | | | | | | | | | | | | | - Willie Roberts
- Metabiota Inc., Freetown, Sierra Leone; Ministry of Heath and Sanitation, Sierra Leone
| | | | - David Kargbo
- Directorate of Disease Prevention and Control, DPC Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Tom Vincent
- Metabiota Inc., Silver Spring and San Francisco, USA
| | | | - Mary Guttieri
- Metabiota Inc., Silver Spring and San Francisco, USA
| | | | - Marc Souris
- UMRD 190 Emergence des Pathologies Virales, IRD, Aix-Marseille University, Vientiane, Laos
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