المؤلفون: Adam W Bartlett, Elsa P Mendes, Latifeh Dahmash, Marta S Palmeirim, Maria C de Almeida, Luis B Peliganga, Luis M M Lufunda, Ana Direito, Julio Ramirez, Pauline N Mwinzi, Sergio Lopes, Susana Vaz Nery

المصدر: PLoS Neglected Tropical Diseases, Vol 17, Iss 5, p e0010849 (2023)

مصطلحات موضوعية: Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270

الوصف: BackgroundA school preventive chemotherapy (PC) program for soil-transmitted helminths (STHs) and schistosomiasis has operated in Huambo, Uige and Zaire provinces, Angola, since 2013 and 2014, respectively; complemented by a school water, sanitation and hygiene (WASH) program in a subset of schools from 2016. Conducted in 2021, this is the first impact assessment of the school program for the control of schistosomiasis and STHs.Methodology/principal findingsA two-stage cluster design was used to select schools and schoolchildren for parasitological and WASH surveys. The rapid diagnostic tests (RDTs), point of care circulating cathodic antigen (POC-CCA) and Hemastix, were used to estimate Schistosoma mansoni and Schistosoma haematobium prevalence, respectively. Kato Katz was used to detect STHs, and quantify STH and S. mansoni infections. Urine filtration was used to quantify S. haematobium infections. Prevalence, infection intensity, relative prevalence reduction and egg reduction rates were calculated for schistosomiasis and STHs. Cohen's Kappa co-efficient was used to assess agreement between RDTs and microscopy. Chi-square or Fisher's exact test was used to compare WASH indicators in WASH-supported and WASH-unsupported schools. Overall, 17,880 schoolchildren (599 schools) and 6,461 schoolchildren (214 schools) participated in the schistosomiasis and STH surveys, respectively. Prevalence of any schistosomiasis in Huambo was 29.6%, Uige 35.4%, and Zaire 28.2%. Relative reduction in schistosomiasis prevalence from 2014 for Huambo was 18.8% (95% confidence interval (CI) 8.6, 29.0), Uige -92.3% (95%CI -162.2, -58.3), and Zaire -14.0% (95%CI -48.6, 20.6). Prevalence of any STH in Huambo was 16.3%, Uige 65.1%, and Zaire 28.2%. Relative reduction in STH prevalence for Huambo was -28.4% (95%CI -92.1, 35.2), Uige -10.7% (95%CI -30.2, 8.8), and Zaire -20.9% (95%CI -79.5, 37.8). A higher proportion of WASH-supported schools had improved water sources, and toilet and handwashing facilities compared to WASH-unsupported schools.Conclusions/significanceThe limited impact this school program has had in controlling schistosomiasis and STHs identifies the need for a comprehensive understanding of individual, community, and environmental factors associated with transmission, and consideration for a community-wide control program.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1935-2727Test; https://doaj.org/toc/1935-2735Test

الوصول الحر: https://doaj.org/article/ed9390ac10a24ecaaa3a9f6343d0c774Test

المؤلفون: Paul E Gray, Adam W Bartlett, Stuart G Tangye

المصدر: Clinical & Translational Immunology, Vol 11, Iss 4, Pp n/a-n/a (2022)

مصطلحات موضوعية: COVID‐19, inborn errors of immunity, interferon autoantibodies, primary immunodeficiency, Immunologic diseases. Allergy, RC581-607

الوصف: Abstract Since the emergence of the COVID‐19 pandemic in early 2020, a key challenge has been to define risk factors, other than age and pre‐existing comorbidities, that predispose some people to severe disease, while many other SARS‐CoV‐2‐infected individuals experience mild, if any, consequences. One explanation for intra‐individual differences in susceptibility to severe COVID‐19 may be that a growing percentage of otherwise healthy people have a pre‐existing asymptomatic primary immunodeficiency (PID) that is unmasked by SARS‐CoV‐2 infection. Germline genetic defects have been identified in individuals with life‐threatening COVID‐19 that compromise local type I interferon (IFN)‐mediated innate immune responses to SARS‐CoV‐2. Remarkably, these variants – which impact responses initiated through TLR3 and TLR7, as well as the response to type I IFN cytokines – may account for between 3% and 5% of severe COVID‐19 in people under 70 years of age. Similarly, autoantibodies against type I IFN cytokines (IFN‐α, IFN‐ω) have been detected in patients' serum prior to infection with SARS‐CoV‐2 and were found to cause c. 20% of severe COVID‐19 in the above 70s and 20% of total COVID‐19 deaths. These autoantibodies, which are more common in the elderly, neutralise type I IFNs, thereby impeding innate antiviral immunity and phenocopying an inborn error of immunity. The discovery of PIDs underlying a significant percentage of severe COVID‐19 may go some way to explain disease susceptibility, may allow for the application of targeted therapies such as plasma exchange, IFN‐α or IFN‐β, and may facilitate better management of social distancing, vaccination and early post‐exposure prophylaxis.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2050-0068Test

الوصول الحر: https://doaj.org/article/28dc737af2784ace942d75b66c289e1eTest

المؤلفون: Janaya Elizabeth Perron, Penelope Uther, Michael Jonathon Coffey, Andrew Lovell-Simons, Adam W. Bartlett, Ashlene McKay, Millie Garg, Sarah Lucas, Jane Cichero, Isabella Dobrescu, Alberto Motta, Silas Taylor, Sean Edward Kennedy, Chee Yee Ooi

مصطلحات موضوعية: Medicine, Sociology, Science Policy, Biological Sciences not elsewhere classified, Pediatrics, undergraduate, medical education research, serious games, simulation

الوصف: Serious games (SGs) have great potential for pediatric medical education. This study evaluated the efficacy of a SG in improving learner satisfaction, knowledge, and behavior. This was an investigator-blinded randomized controlled trial (RCT) comparing a SG against two controls: (i) adaptive tutorial (AT), and (ii) low-stimulus control (LSC). SG is a highly immersive role-playing game in a virtual hospital. AT delivers interactive web-based lessons. LSC is paper-based clinical practice guidelines. Metropolitan senior medical students at UNSW were eligible. A total of 154 enrolled and were block randomized to one intervention. Participants had access to one intervention for 8 weeks which taught pediatric acute asthma and seizure assessment and management. Satisfaction was assessed with Likert-scale responses to 5 statements and 2 free-text comments. Knowledge was assessed with 10 multiple-choice questions (MCQs). Clinical behavior was assessed during a 30-point simulated clinical management scenario (CMS). Primary analysis was performed on a modified intention-to-treat basis and compared: (1) SG vs. AT; and (2) SG vs. LSC. A total of 118 participants were included in the primary analysis (modified intention-to-treat model). No significant differences in MCQ results between the SG and control groups. SG group outperformed the LSC group in the CMS, with a moderate effect (score out of 30: 20.8 (3.2) vs. 18.7 (3.2), respectively, d = 0.65 (0.2–1.1), p = 0.005). No statistically significant difference between SG and AT groups in the CMS (score: 20.8 (3.2) vs. 19.8 (3.1), respectively, d = 0.31 (–0.1 to 0.8), p = 0.18). A sensitivity analysis (per-protocol model) was performed with similar outcomes. This is the first investigator-blinded RCT assessing the efficacy of a highly immersive SG on learner attitudes, knowledge acquisition, and performance in simulated pediatric clinical scenarios. The SG demonstrated improved translation of knowledge to a simulated clinical environment, particularly compared to LSC. SGs show ...

العلاقة: https://figshare.com/articles/journal_contribution/Are_serious_games_seriously_good_at_preparing_students_for_clinical_practice_A_randomized_controlled_trial/25375985Test

الإتاحة: https://doi.org/10.6084/m9.figshare.25375985.v1Test

المؤلفون: Techalew Shimelis, Susana Vaz Nery, Birkneh Tilahun Tadesse, Adam W. Bartlett, Fitsum W/Gebriel Belay, Gill Schierhout, Sabine Dittrich, John A. Crump, John M. Kaldor

المصدر: BMC Infectious Diseases, Vol 22, Iss 1, Pp 1-11 (2022)

مصطلحات موضوعية: Fever, Pneumonia, Antibacterial, Antimalarial, Overprescribing, Clinical management, Infectious and parasitic diseases, RC109-216

الوصف: Abstract Background The management of febrile illnesses is challenging in settings where diagnostic laboratory facilities are limited, and there are few published longitudinal data on children presenting with fever in such settings. We have previously conducted the first comprehensive study of infectious aetiologies of febrile children presenting to a tertiary care facility in Ethiopia. We now report on clinicians’ prescribing adherence with guidelines and outcomes of management in this cohort. Methods We consecutively enrolled febrile children aged 2 months and under 13 years, who were then managed by clinicians based on presentation and available laboratory and radiologic findings on day of enrolment. We prospectively collected outcome data on days 7 and 14, and retrospectively evaluated prescribing adherence with national clinical management guidelines. Results Of 433 children enrolled, the most common presenting syndromes were pneumonia and acute diarrhoea, diagnosed in 177 (40.9%) and 82 (18.9%), respectively. Antibacterial agents were prescribed to 360 (84.7%) of 425 children, including 36 (34.0%) of 106 children without an initial indication for antibacterials according to guidelines. Antimalarial drugs were prescribed to 47 (11.1%) of 425 children, including 30 (7.3%) of 411 children with negative malaria microscopy. Fever had resolved in 357 (89.7%) of 398 children assessed at day 7, and in-hospital death within 7 days occurred in 9 (5.9%) of 153 admitted patients. Among children with pneumonia, independent predictors of persisting fever or death by 7 days were young age and underweight for age. Antibacterial prescribing in the absence of a guideline-specified indication (overprescribing) was more likely among infants and those without tachypnea, while overprescribing antimalarials was associated with older age, anaemia, absence of cough, and higher fevers. Conclusion Our study underscores the need for improving diagnostic support to properly guide management decisions and enhance adherence by clinicians to treatment guidelines.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2334Test

الوصول الحر: https://doaj.org/article/851055205d6342999d55a995ea2e6cd1Test

المؤلفون: Adam W. Bartlett, Elsa P. Mendes, Latifeh Dahmash, Luis B. Peliganga, Luis M. M. Lufunda, Ana Direito, Pauline N. Mwinzi, Pablo Eulogio, Sergio Lopes, Susana Vaz Nery

مصطلحات موضوعية: Health Care, Diseases, Epidemiology, schistosomiasis, soil-transmitted helminths, knowledge, attitudes and practices, water, sanitation and hygiene, preventive chemotherapy

الوصف: 52-item questionnaire provided to participants

العلاقة: https://figshare.com/articles/journal_contribution/Student_Knowledge_Attitudes_and_Practices_KAP_Questionnaire_from_Knowledge_attitudes_practices_and_acceptability_of_a_school_preventive_chemotherapy_program_for_schistosomiasis_and_soil-transmitted_helminths_control_in_Angola/23716503Test

الإتاحة: https://doi.org/10.6084/m9.figshare.23716503.v1Test
https://figshare.com/articles/journal_contribution/Student_Knowledge_Attitudes_and_Practices_KAP_Questionnaire_from_Knowledge_attitudes_practices_and_acceptability_of_a_school_preventive_chemotherapy_program_for_schistosomiasis_and_soil-transmitted_helminths_control_in_Angola/23716503Test

المؤلفون: Techalew Shimelis, Andargachew Mulu, Mesfin Mengesha, Aynalem Alemu, Adane Mihret, Birkneh Tilahun Tadesse, Adam W. Bartlett, Fitsum W/Gebriel Belay, Gill Schierhout, Sabine Dittrich, John A. Crump, Susana Vaz Nery, John M. Kaldor

المصدر: Scientific Reports, Vol 13, Iss 1, Pp 1-7 (2023)

مصطلحات موضوعية: Medicine, Science

الوصف: Dengue fever is a mosquito-borne viral infection, with rising incidence globally. Eastern Ethiopia has had dengue fever outbreaks in recent years. However, the extent to which the infection contributes to hospital presentation among children with fever in southern Ethiopia is unknown. We examined 407 stored plasma samples collected to investigate the aetiology of fever in children aged at least 2 months and under 13 years presenting to the outpatient of the largest tertiary hospital in southern Ethiopia. We analyzed samples for dengue virus non-structural 1 antigen using enzyme-linked immunosorbent assay. The median (interquartile range) age of the 407 children examined was 20 (10–48) months, and 166 (40.8%) of the children were females. Of 407 samples analyzed, 9 (2.2%) were positive for dengue virus non-structural 1 antigen, of whom 2 were initially treated with antimalarial drugs despite having negative malaria microscopy, and 1 of the 8 patients had a persistent fever at the seventh day of follow-up time. The presence of active dengue virus infection in the study area highlights the need for studies at the community level as well as the integration of dengue diagnostics into fever-management strategies. Further research to characterize circulating strains is warranted.

العلاقة: https://doi.org/10.1038/s41598-023-35143-2Test; https://doaj.org/toc/2045-2322Test; https://doaj.org/article/cf7f86eb87294afab3ab11fab13402f1Test

الإتاحة: https://doi.org/10.1038/s41598-023-35143-2Test
https://doaj.org/article/cf7f86eb87294afab3ab11fab13402f1Test

المؤلفون: Adam W. Bartlett, Jose C. Sousa-Figueiredo, Roelofje C. van Goor, Paul Monaghan, Warren Lancaster, Rukaaka Mugizi, Elsa P. Mendes, Susana Vaz Nery, Sergio Lopes

المصدر: Infectious Diseases of Poverty, Vol 11, Iss 1, Pp 1-15 (2022)

مصطلحات موضوعية: Schistosomiasis, Soil-transmitted helminths, Circulating cathodic antigen, Rapid diagnostic test, Water, sanitation and hygiene, Infectious and parasitic diseases, RC109-216, Public aspects of medicine, RA1-1270

الوصف: Background Schistosomiasis and soil-transmitted helminths (STHs) contribute high disease burdens amongst the neglected tropical diseases (NTDs) and are public health problems in Angola. This study reports the prevalence, intensity and risk factors for schistosomiasis and STH infection in Huambo, Uige and Zaire provinces, Angola, to inform a school-based preventive chemotherapy program. Methods A two-stage cluster design was used to select schools and schoolchildren to participate in parasitological and water, sanitation and hygiene (WASH) surveys across Huambo, Uige, and Zaire provinces. Point-of-care circulating cathodic antigen and urinalysis rapid diagnostic tests (RDTs) were used to determine the prevalence of Schistosoma mansoni and S. haematobium, respectively. Kato-Katz was used to identify and quantify STH species and quantify and compare with RDTs for S. mansoni. Urine filtration was used to quantify and compare with RDTs for S. haematobium. Descriptive statistics were used for prevalence and infection intensity of schistosomiasis and STH infection. Performance of RDTs was assessed through specificity and Cohen’s Kappa agreement with microscopy. A multivariate regression analysis was used to determine demographic and WASH factors associated with schistosomiasis and STH infection. Results A total 575 schools and 17,093 schoolchildren participated in the schistosomiasis survey, of which 121 schools and 3649 schoolchildren participated in the STH survey. Overall prevalence of S. mansoni was 21.2% (municipality range 0.9–74.8%) and S. haematobium 13.6% (range 0–31.2%), with an overall prevalence of schistosomiasis of 31.4% (range 5.9–77.3%). Overall prevalence of Ascaris lumbricoides was 25.1% (range 0–89.7%), hookworm 5.2% (range 0–42.6%), and Trichuris trichiura 3.6% (range 0–24.2%), with an overall prevalence of STH infection of 29.5% (range 0.8–89.7%). Ecological zone and ethnicity were factors associated with schistosomiasis and STH infection, with older age and female sex additional risk ...

العلاقة: https://doi.org/10.1186/s40249-022-00975-zTest; https://doaj.org/toc/2049-9957Test; https://doaj.org/article/bffd1c0637c04aaeb8ec900f5d22aff8Test

الإتاحة: https://doi.org/10.1186/s40249-022-00975-zTest
https://doaj.org/article/bffd1c0637c04aaeb8ec900f5d22aff8Test

المؤلفون: Money, Gupta, Harikrishnan, Balachandran, Raymond H Y, Louie, Hui, Li, David, Agapiou, Elizabeth, Keoshkerian, Daniel, Christ, William, Rawlinson, Michael M, Mina, Jeffrey J, Post, Bernard, Hudson, Nicky, Gilroy, Pamela, Konecny, Adam W, Bartlett, Sarah C, Sasson, Golo, Ahlenstiel, Dominic, Dwyer, Andrew R, Lloyd, Marianne, Martinello, Fabio, Luciani, Rowena A, Bull

المصدر: Immunology & Cell Biology. 101:142-155

مصطلحات موضوعية: Immunology, Immunology and Allergy, Cell Biology

الوصف: The long-term health consequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are still being understood. The molecular and phenotypic properties of SARS-CoV-2 antigen-specific T cells suggest a dysfunctional profile that persists in convalescence in those who were severely ill. By contrast, the antigen-specific memory B-cell (MBC) population has not yet been analyzed to the same degree, but phenotypic analysis suggests differences following recovery from mild or severe coronavirus disease 2019 (COVID-19). Here, we performed single-cell molecular analysis of the SARS-CoV-2 receptor-binding domain (RBD)-specific MBC population in three patients after severe COVID-19 and four patients after mild/moderate COVID-19. We analyzed the transcriptomic and B-cell receptor repertoire profiles at ~2 months and ~4 months after symptom onset. Transcriptomic analysis revealed a higher level of tumor necrosis factor-alpha (TNF-α) signaling via nuclear factor-kappa B in the severe group, involving CD80, FOS, CD83 and TNFAIP3 genes that was maintained over time. We demonstrated the presence of two distinct activated MBCs subsets based on expression of CD80

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1d65b50cc82650617fe0e57380cdd4a4Test
https://doi.org/10.1111/imcb.12607Test

المؤلفون: Adam W. Bartlett, Elsa P. Mendes, Latifeh Dahmash, Marta S. Palmeirim, Maria C. de Almeida, Luis B. Peliganga, Luis M. M. Lufunda, Ana Direito, Julio Ramirez, Pauline N. Mwinzi, Sergio Lopes, Susana Vaz Nery

مصطلحات موضوعية: Infectious Diseases, Public Health, Environmental and Occupational Health

الوصف: Background A school preventive chemotherapy (PC) program for soil-transmitted helminths (STHs) and schistosomiasis has operated in Huambo, Uige and Zaire provinces, Angola, since 2013 and 2014, respectively; complemented by a school water, sanitation and hygiene (WASH) program in a subset of schools from 2016. Conducted in 2021, this is the first impact assessment of the school program for the control of schistosomiasis and STHs. Methodology/Principal findings A two-stage cluster design was used to select schools and schoolchildren for parasitological and WASH surveys. The rapid diagnostic tests (RDTs), point of care circulating cathodic antigen (POC-CCA) and Hemastix, were used to estimate Schistosoma mansoni and Schistosoma haematobium prevalence, respectively. Kato Katz was used to detect STHs, and quantify STH and S. mansoni infections. Urine filtration was used to quantify S. haematobium infections. Prevalence, infection intensity, relative prevalence reduction and egg reduction rates were calculated for schistosomiasis and STHs. Cohen’s Kappa co-efficient was used to assess agreement between RDTs and microscopy. Chi-square or Fisher’s exact test was used to compare WASH indicators in WASH-supported and WASH-unsupported schools. Overall, 17,880 schoolchildren (599 schools) and 6,461 schoolchildren (214 schools) participated in the schistosomiasis and STH surveys, respectively. Prevalence of any schistosomiasis in Huambo was 29.6%, Uige 35.4%, and Zaire 28.2%. Relative reduction in schistosomiasis prevalence from 2014 for Huambo was 18.8% (95% confidence interval (CI) 8.6, 29.0), Uige -92.3% (95%CI -162.2, -58.3), and Zaire -14.0% (95%CI -48.6, 20.6). Prevalence of any STH in Huambo was 16.3%, Uige 65.1%, and Zaire 28.2%. Relative reduction in STH prevalence for Huambo was -28.4% (95%CI -92.1, 35.2), Uige -10.7% (95%CI -30.2, 8.8), and Zaire -20.9% (95%CI -79.5, 37.8). A higher proportion of WASH-supported schools had improved water sources, and toilet and handwashing facilities compared to WASH-unsupported schools. Conclusions/Significance The limited impact this school program has had in controlling schistosomiasis and STHs identifies the need for a comprehensive understanding of individual, community, and environmental factors associated with transmission, and consideration for a community-wide control program.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a279339f2480fea641ebf32fca3becf7Test
https://edoc.unibas.ch/94866Test/

المؤلفون: Rebecca J. Traub, Carolina da Costa Maia, Paul Arkell, Maria Imaculada Soares, Sze Fui Hii, Josefina D. Prisca Guterres, Virginia da Conceicao, Patsy A. Zendejas-Heredia, Naomi E. Clarke, Merita Monteiro, Susana Vaz Nery, Jane E. Francis, Salvador Amaral, Alexander Matthews, Adam W. Bartlett

المصدر: Am J Trop Med Hyg

مصطلحات موضوعية: chemistry.chemical_compound, Infectious Diseases, Real-time polymerase chain reaction, Chromatography, chemistry, Soil-transmitted helminth, Sodium nitrate, Virology, Microscopy, Parasitology, Article

الوصف: There is evolving interest in alternate microscopy techniques and quantitative polymerase chain reaction (qPCR) to evaluate soil-transmitted helminth (STH) burden. Using data from a cross-sectional survey of 540 schoolchildren across six primary schools in three municipalities of Timor-Leste, we compared the performance of microscopy using sodium nitrate flotation (SNF) and qPCR in determining STH prevalence and infection intensity. Prevalence by qPCR was higher than SNF for Ascaris lumbricoides (17.5% versus 11.2%), hookworm (8.3% versus 1.2%), and Trichuris trichiura (4.7% versus 1.6%). Agreement between SNF and qPCR was fair for hookworm (κ = 0.21) and moderate for A. lumbricoides (κ = 0.59) and T. trichiura (κ = 0.44). Moderate or heavy intensity infections were identified in 15.9% of infections detected by SNF, whereas qPCR identified 36.1% as moderate or heavy infections using cycle threshold to eggs per gram conversion formulas. Quantitative PCR is a promising diagnostic technique, though further studies validating infection intensity correlates are required.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7713f482becba21cfd9a4695a94b7613Test
https://doi.org/10.4269/ajtmh.21-0227Test