Omicron COVID-19 variant

Qualitative methods reveal human elements that could strengthen pediatric antimicrobial stewardship efforts. A multidisciplinary team highlights qualitative approaches that bring deeper insights, in areas of high relevance for pediatric stewardship work, including provider attitudes; provider prescribing behaviors; stewardship in low-resource settings; parents’ perspectives on stewardship; and stewardship work with high-risk patients. There are opportunities for multidisciplinary academic collaboration in research on pediatric stewardship. Qualitative approaches can offer insight into contextual and human elements that impact diagnostic and treatment decisions not always perceived using quantitative methods. [JAC Antimicrobial Resistance] 

Investments in primary health care could protect against increases in tuberculosis incidence worldwide. Researchers evaluated the effects of the Brazilian Family Health Strategy (FHS), one of the world’s largest primary health care programs, on tuberculosis morbidity and mortality in a cohort study involving 7.3 million individuals over a 10-year period. Residents in municipalities with no FHS coverage were compared with residents in municipalities with full FHS coverage. FHS exposure was associated with lower tuberculosis incidence and mortality and was positively associated with tuberculosis cure rates. FHS associations were stronger among the poorest individuals for all tuberculosis indicators. In the context of a global economic recession due to COVID-19, investment in primary health care could decrease the inequity of tuberculosis burden in LMICs and mitigate the expected increase in tuberculosis incidence related to increasing poverty rates. [The Lancet Global Health] 

Multi-omics integration grants a holistic view of the pathophysiology of multiple sclerosis. Given recent evidence implicating the gut microbiome in multiple sclerosis (MS) pathogenesis, researchers addressed the need for a longitudinal study on interactions between the microbiome and host immune system, metabolism, and diet in individuals with MS by, conducting a six-month multi-omics study including 49 participants. The authors identified multi-system alterations in gut microbiota, immune, and blood metabolome of MS patients at the global and individual feature level. Multi-omics integration allows for a comprehensive view of the pathophysiology of MS, allowing for precision medicine that links advanced technologies with clinical practice to better understand MS etiology and patient care. [eBioMedicine] 

China’s zero-COVID strategy faces challenges. China’s zero-COVID approach has involved large-scale lockdowns, mass testing, and international travel bans. The strategy has been strained since China’s first Omicron cases were reported in December. The highly infectious variant causes alarm for larger outbreaks after the Chinese New Year and Winter Olympics in Beijing. As China plans to exit the zero-COVID strategy, there are calls for greater booster vaccine campaigns and different kinds of booster vaccines outside of the inactivated-virus variety most widely used in the country. Outbreaks stemming from the events may cause authorities to loosen zero-COVID regulations and the population could be more tolerant of outbreaks. [Nature] 

Automated translation services and human translators are often unaware of medically offensive terms. A study focusing on outdated terms for cleft lip showed that when using Google Translate, translations in multiple languages of the term “cleft lip” were outdated and could cause stigma. The same issue occurred when using an international, professional translation service. As medical terminology evolves, offensive and harmful terms must be removed from medical communications. Automated translation services and human translators may not understand nuances in current medical terminology and stigma and distress caused by outdated terms. Therefore, it is important for a native speaker with knowledge of the relevant clinical field to check official medical communications. [BMJ Global Health

Omicron’s origins remain unknown. The latest SARS-CoV-2 variant of concern was first detected in South Africa and Botswana in Nov. 2021, but likely emerged that September/October. The variant possesses over 50 mutations, 30 of which affect the spike protein, making omicron the most mutated variant to date in that region. Several theories attempt to explain the emergence of Omicron. Fast-paced evolution may have occurred following the infection of individuals with compromised immune systems, then spread to the general population. Omicron’s mutations also allow it to infect a wider range of animals, including turkeys, chickens, and mice. Another theory speculates that the virus initially jumped from an immunocompromised person to rats, and then reinfected humans, enabling its diversity of mutations. [Nature] 

Helicobacter pylori infection has a global prevalence of 32.3% in children and adolescents. A systematic review and meta-analysis evaluated observational population-based studies to determine the global prevalence of H. pylori infection in individuals aged 18 or younger. Low- and middle-income country individuals were at greater risk of infection(43.2%) than those in higher-income countries (21.7%). Infection risk increased with age, with individuals aged 13-18 having the highest prevalence (41.6%). Pediatric H. pylori infection was also associated with lower economic status, more youths in the household, room sharing, lack of sewage system access, having an infected mother or sibling, and drinking untreated water. [The Lancet Child & Adolescent Health

Physical, mental, and cognitive symptoms are frequently reported 1-year post ICU treatment for COVID-19. An exploratory prospective cohort study assessed 1-year outcomes among patients who had survived intensive care unit treatment for COVID-19. Among 452 patients, 74.3% reported physical symptoms, 26.2% reported mental symptoms, and 16.2% reported cognitive symptoms. Problems most frequently reported were weakened condition (38.9%), joint stiffness (26.3%), joint pain (25.5%), muscle weakness (24.8%), myalgia (21.3%), dyspnea (20.8%), lung disease (18.5%), depression (18.3%), anxiety (17.9%), and neuropathic pain (17.4%). [JAMA] 

Malaria infections with artemisinin resistance profiles are increasing geographically. A systematic review and spatiotemporal analysis investigated the increase in prevalence and geographical extent of artemisinin resistance markers in Asia between 2002 and 2018. A steady increase was identified in both the locations and proportions of infected individuals. However, inconsistent data collection over both time and regions, data sharing limitations, and the need for rapid dissemination of molecular marker data are all needed to better understand the spread and evolution of resistance as it unfolds. This would in turn enable policy-maker strategies to support malaria control and elimination. [The Lancet Microbe]

A $51 rapid, sensitive, end-to-end system for SARS-CoV-2 early detection has been developed. This non-invasive testing system allows for COVID-19 testing in resource-poor and field-test settings, with $3.50 reagent costs per sample. The system utilizes a saliva-based LAMP colorimetric test kit and a $51 lab-in-a-backpack system made of eight chemicals, a thermometer, a thermos bottle, two micropipettes, and an electronically-operated centrifuge. The test can detect as little as 4 viral RNA copies per microliter, taking 90 minutes to process 6 samples. Given its cost-effectiveness and portability, the test can be used at home, mobile testing centers, or in the field. [PLOS One] 

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