May 02, 2022
A meningitis vaccine could offer cross-protection against gonorrhea. Outer membrane vesicles are released naturally from gram-negative bacteria and have been successfully used in vaccine platforms. Researchers evaluated the effectiveness of a serogroup B meningococcal outer membrane vesicle vaccine (MenB-4C) against gonorrhea in individuals aged 16–23 years in New York City and Philadelphia from 2016 to 2018. Adjusted prevalence ratios revealed complete and partial MenB-4C vaccination were 40% and 26% effective against gonorrhea, respectively. In the absence of A gonorrhea vaccine, cross-protection from MenB-4C vaccine may provide an opportunity for gonorrhea prevention and control in high-risk groups. [The Lancet Infectious Diseases]
Unexpected Hepatitis outbreak impacts young children. Scientists are investigating the cause of an obscure and dangerous outbreak of severe hepatitis in young children, with 74 cases documented in the United Kingdom and three in Spain as of April 15, 2022. Physicians in Denmark, the Netherlands, and Alabama reported similar cases. The leading hypotheses of the origin of the hepatitis center around a new adenovirus variant with a distinct clinical syndrome or a routinely circulating variant that severely impacts younger children. Isolation of young children during COVID-19 lockdowns may have left them immunologically vulnerable due to a lack of exposure to a multiplicity of viruses, including adenoviruses, that typically affect toddlers. [Science]
Initiatives and research to address neonatal sepsis in low- and middle-income countries (LMICs) are needed. Neonatal infections constitute over 3 million out of the 20 million sepsis cases in children under five years, with an average mortality of 7.6%. Mortality rates from early-onset sepsis in term infants in high-income countries are close to zero, however, a recent study reveals the urgent need to develop and test effective interventions to prevent, diagnose, treat, and follow up neonatal sepsis in LMICs. Efforts to address neonatal sepsis are likely to be cost-effective as the disease causes the loss of over 8 million disability-adjusted life years in sub-Saharan Africa alone. [The Lancet Global Health]
Antimicrobial resistance in urinary tract infections is a major issue. A retrospective study using antimicrobial susceptibility test results from urine samples and other related data from 2010-2019 investigated antimicrobial resistance trends among patients with urinary tract infections at university hospital in Northwest Ethiopia. The overall prevalence of urinary tract infection among 4,441 patients was 24.1%, with the elderly patients being most affected. More than 70% of both gram-positive and gram-negative isolates were resistant to Penicillin, Ampicillin, Amoxicillin-clavulanate, Tetracycline, Cefuroxime, and Trimethoprim-sulfamethoxazole. More than 44% of the isolates were multidrug-resistant. [PLOS one]
Qualitative evaluation of antibiotic use in Korea reveals inappropriate prescribing. Infectious disease specialists determined the prevalence and appropriateness of antibiotic prescriptions on August 29, 2018, for 20 hospitals in Korea. On the study date, the prevalence of antibiotic prescription was 14.1% (8,400 out of 59,216 patients). Approximately one-third of antibiotic prescriptions were inappropriate. Surgical prophylaxis was inadequately prescribed most frequently (54.4%), followed by medical prophylaxis (29.5%) and therapeutic antibiotics (20.5%). [Journal of Global Antimicrobial Resistance]
Misdiagnosis is an often ignored problem in rapid HIV testing. Laboratory testing service shortages in many low-income countries have ignited a global trend with the introduction of point-of-care diagnostic tests. While the population aware of their HIV status has increased with the availability of rapid tests, misdiagnosis rates are substantial. A recent study in Zimbabwe found 0.1% of adults tested were told they were HIV positive, when they were negative, while 10% of those given a negative result, were in fact positive. Through interview data and participant observations from health facilities, researchers found that Healthcare workers conducting rapid HIV tests, in contexts of limited external quality assurance mechanisms, have few opportunities to develop certainty or question the reliability of diagnoses. [Medical Anthropology]
Inappropriate antibiotic distribution is common in private Vietnamese pharmacies. Standardized clinical scenarios were enacted by patient actors in community pharmacies across 40 districts in Vietnam to evaluate the appropriateness of antibiotic dispensing in private pharmacies. Patient actors attended 949 pharmacies, resulting in 1,266 clinical interactions. Antibiotics were inappropriately distributed to 92% (291/316) of adults requesting treatment for upper respiratory tract infections (URTI) symptoms, 43% (135/316) for children with acute diarrhea symptoms, and to 84% (267/317) of direct requests for antibiotics. Only 49% of pharmacies provided orientation to patients about antibiotic use. Female actors were more likely to be given antibiotics than male actors for URTI but not for diarrhea symptoms. [The Lancet Regional Health – Western Pacific]
WHO documented interruptions in progress towards polio eradication. High-performance poliovirus surveillance is critical to tracking poliovirus transmission. Reported poliomyelitis cases worldwide have decreased by approximately 99.99% since 1988. However, in 2021, wild poliovirus remained endemic in Afghanistan and Pakistan. During 2020–2021, circulating vaccine-derived poliovirus cases were reported from 31 countries. The COVID-19 pandemic disrupted polio vaccination and surveillance across WHO regions in 2020. During January–September 2020, the number of reported cases of acute flacid paralysis decreased, and the interval between stool collection for polio testing and receipt by laboratories increased as compared with the same period in 2019. [World Health Organization Weekly Epidemiological Records]
Negative perceptions of vaccination and misperceptions about antibiotic use are associated with one other. Using data from the Wellcome Trust Monitor Wave 4, researchers explored whether attitudes towards vaccination and antibiotic use are attitudinally parallel. An ordinal logistic regression model predicting knowledge level about antibiotics was fitted using 2,654 observations, with perceptions of the risk of side-effects from vaccination and of the efficacy of vaccination as a preventative intervention as independent variables. Respondents who rated the risk of serious side-effects from vaccination as ‘Very high’ or ‘Fairly high’ were more likely to provide incorrect responses to questions regarding antibiotic treatments. Conversely, respondents who felt there was ‘No risk at all’ were less likely to provide incorrect responses about antibiotic use. [Vaccine]
More stringent COVID-19 policies were associated with poorer mental health. Daily policy stringency data from the Oxford COVID-19 Government Response Tracker were combined with psychological distress scores and life evaluations from the Imperial College London-YouGov COVID-19 Behaviour Tracker Global Survey in fortnightly cross-sections from 15 countries between April 2020, and June 2021 to assess the association between COVID-19 policy restrictions and mental health during the early COVID-19 pandemic. Controlling for individual and contextual variables, greater policy stringency was associated with poorer mental health (higher psychological distress scores and lower life evaluations). The negative association between policy stringency and mental health was mediated by observed physical distancing and perceptions of the government’s handling of the pandemic. [The Lancet Public Health]
