Weekly Digest: African Medicines Agency enters into force; Rapid diagnostic test for bloodstream infections; How does malaria co-infection affect COVID-19 severity?

African Medicines Agency enters into force. In a significant milestone, the treaty for establishing the African Medicines Agency (AMA) has been ratified by fifteen African Union member countries, paving the way for an operational agency from November 2021. This development sets the stage for strengthening regulatory systems and harmonizing standards for medicines and medical products in the continent. [IFPMA], [CIDRAP]

Risk factors for multidrug-resistant tuberculosis in Ethiopia. A cross-sectional study conducted between March and October 2019 in Ethiopia revealed that multidrug-resistant tuberculosis (MDR-TB) prevalence among 395 TB patients was 3.8% (95% CI: 2.0– 5.8%). Factors such as gender, previous history of TB, treatment failure or default, and HIV co-infection were associated with higher odds of MDR-TB infection, with previous history of contact with MDR-TB patients carrying the highest risk. [Infection and Drug Resistance]

Rapid diagnostic test for bloodstream infections. A recent multicenter, quasi-experimental study in the United States highlighted the value of a rapid diagnostic test for Bloodstream infections (Accelerate PhenoTest® BC Kit) as an antimicrobial stewardship tool. While the use of the kit did not impact the clinical outcome, it approximately halved the median time to optimal therapy. Additionally, it reduced the time to first antimicrobial de-escalation and hospital length of stay. [Clinical Infectious Diseases]

Seroprevalence among healthcare workers in Africa. A scoping review of twelve studies from eleven African countries revealed that seroprevalence among healthcare workers (HCWs) varied widely, from 0% and 4.2% in Libya to 23% and 44.6% in South Africa. Seropositivity was associated with older age, lower education, working as a nurse or non-clinical HCW, or working in gynecology, emergency, outpatient, or surgery departments. [Health Policy and Planning]

How does malaria co-infection affect COVID-19 severity? An exploratory cohort study in Uganda explored the effects of incident or previous exposure to malaria on COVID-19 severity. Malaria prevalence among 600 COVID-19 patients was 12%, and this group of patients more frequently experienced vomiting and confusion. However, there was a higher frequency of severe or critical COVID-19 presentation among patients with low previous P falciparum exposure than patients with high previous P falciparum exposure. These findings warrant further investigations into the clinical and therapeutic implications of overlapping co-infections. [The Lancet]

COVID-19 infection before vaccination reduces the risk of breakthrough infection. A recent cohort study in Qatar involving more than 1.5 million mRNA-vaccinated individuals showed that infection with SARS-CoV-2 before vaccination significantly lowered the risk of breakthrough infections in vaccinated individuals. Adjusted hazard ratios were 0.62 and 0.40 for the mRNA-1273 (Moderna) and BNT162b2 (Pfizer-BioNTech) vaccines, respectively. [JAMA Network]

Higher mortality for men with DRTB/HIV co-infection. A study led by researchers in Uganda explored the role of gender differences on treatment outcomes among patients with drug-resistant tuberculosis (DRTB) and HIV co-infection. While treatment success did not differ between genders, mortality was higher among men (25.7% vs. 18.5%). Predictors for mortality included cigarette smoking and several clinical parameters. [BMC Infectious Diseases]

Effectiveness of a typhoid conjugate vaccine two years after administration. A randomized trial investigating the efficacy of a typhoid conjugate vaccine (TCV) in Nepal reported on the final results of a 2-year follow-up. During the trial, 20,019 children were randomized 1:1 to receive a single dose of TCV or the meningococcal conjugate vaccine (MenA). The incidence of typhoid fever was 72 per 100,000 in the TCV group and 342 per 100,000 in the MenA group. The efficacy of TCV at two years was 79%, indicating no waning of the vaccine’s protective effect during this period. [The Lancet]

Adverse childhood experiences are linked to chronic disease later in life. In a cross-sectional study, researchers in China explored whether adverse childhood experiences (ACEs) such as abuse are associated with chronic disease later in life. Among the 11 972 participants, 80.9% of those surveyed had been exposed to at least one ACE, and 18.0% reported exposure to four or more ACEs. Those who experienced four or more ACEs had an increased risk of chronic disease and multimorbidity. Socioeconomic factors such as age, sex, educational level, annual per capita household expenditure, and childhood economic hardship did not significantly affect the associations. [JAMA Network]

Reduction in outpatient antibiotic prescribing during the COVID-19 in Canada. An interrupted time-series analysis on outpatient antibiotic prescriptions in Ontario, Canada, between January 2017 and December 2020 shows a 31.2% relative reduction in total antibiotic prescriptions between March and December 2020. The decline was observed among various specialties and patient conditions and was largely driven by decreased visits for respiratory infections. [Open Forum Infectious Diseases]

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