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[PMID]:28749333
[Au] Autor:Bassi C; Taha MK; Merle C; Hong E; Lévy-Bruhl D; Barret AS; Mounchetrou Njoya I
[Ad] Endereço:Santé publique France, French National Public Health Agency, Regional Unit (Cire) Ile-de-France, Paris, France.
[Ti] Título:A cluster of invasive meningococcal disease (IMD) caused by Neisseria meningitidis serogroup W among university students, France, February to May 2017.
[So] Source:Euro Surveill;22(28), 2017 Jul 13.
[Is] ISSN:1560-7917
[Cp] País de publicação:Sweden
[La] Idioma:eng
[Ab] Resumo:Between February and May 2017, two cases of invasive meningococcal disease caused by a new, rapidly expanding serogroup W meningococci variant were reported among students of an international university in Paris. Bacteriological investigations showed that isolates shared identical genotypic formula (W:P1.5,2:F1-1:cc11) and belonged to the South American/UK lineage. A vaccination campaign was organised that aimed at preventing new cases linked to potential persistence of the circulation of the bacteria in the students.
[Mh] Termos MeSH primário: Infecções Meningocócicas/diagnóstico
Neisseria meningitidis Sorogrupo W-135/isolamento & purificação
[Mh] Termos MeSH secundário: Busca de Comunicante
Febre/etiologia
Genótipo
Seres Humanos
Masculino
Infecções Meningocócicas/sangue
Infecções Meningocócicas/microbiologia
Tipagem Molecular
Neisseria meningitidis Sorogrupo W-135/genética
Paris
Sorogrupo
Estudantes
Sequenciamento Completo do Genoma
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE


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[PMID]:28468648
[Au] Autor:Clark JL; Segura ER; Oldenburg CE; Rios J; Montano SM; Perez-Brumer A; Villaran M; Sanchez J; Coates TJ; Lama JR
[Ad] Endereço:David Geffen School of Medicine, University of California, Los Angeles, CA, USA. jlclark@mednet.ucla.edu.
[Ti] Título:Expedited Partner Therapy (EPT) increases the frequency of partner notification among MSM in Lima, Peru: a pilot randomized controlled trial.
[So] Source:BMC Med;15(1):94, 2017 05 04.
[Is] ISSN:1741-7015
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Expedited Partner Therapy (EPT) has been shown to improve treatment outcomes among heterosexual partners of individuals with curable sexually transmitted infections (STIs). Although the use of EPT with men who have sex with men (MSM) has been debated, due to the potential for missed opportunities to diagnose unidentified cases of HIV and syphilis infection in symptomatic partners, increases in partner notification (PN) resulting from use of EPT may promote testing and treatment of otherwise unidentified partners. We assessed the impact of EPT on self-reported PN among MSM in Peru with gonorrheal (GC) and/or chlamydial (CT) infection. METHODS: We enrolled 173 MSM in Lima, Peru with symptomatic or asymptomatic GC and/or CT infection between 2012 and 2014. We enrolled 44 MSM with symptomatic urethritis/proctitis and 129 MSM with asymptomatic GC/CT infection, diagnosed based on nucleic acid testing (Aptima Combo 2 Transcription-Mediated Amplification [TMA]) from urethral, pharyngeal, and rectal sites. Eligible participants were randomly assigned to receive either standard PN counseling (n = 84) or counseling plus EPT (cefixime 400 mg/azithromycin 1 g) for up to five recent partners (n = 89). Self-reported notification was assessed by computer-assisted self-administered survey among 155 participants who returned for 14-day follow-up. RESULTS: The median age of participants was 26 (interquartile range [IQR]: 23-31) with a median of 3 sexual partners (IQR: 2-4) in the previous 30-day period. Among all participants, 111/155 (71.6%) notified at least one partner at 14-day follow-up with a median of 1 partner notified per participant (IQR: 0-2). For participants randomized to receive EPT, 69/83 (83.1%) reported notifying at least one partner, compared with 42/72 (58.3%) of participants in the control arm (odds ratio = 3.52; 95% confidence interval [CI]: 1.68-7.39). The proportion of all recent partners notified was significantly greater in the EPT than in the control arm (53.5%, 95% CI: 45.0-62.0% versus 36.4%, 95% CI: 27.0-47.4%). CONCLUSIONS: Provision of EPT led to significant increases in notification among Peruvian MSM diagnosed with GC/CT infection. Additional research is needed to assess the impact of EPT on biological outcomes, including persistent or recurrent infection, antimicrobial resistance, and HIV/STI transmission, in MSM sexual networks. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01720654 . Registered on 10/29/2012.
[Mh] Termos MeSH primário: Infecções por Chlamydia/terapia
Busca de Comunicante
Gonorreia/terapia
Parceiros Sexuais
[Mh] Termos MeSH secundário: Adulto
Homossexualidade Masculina
Seres Humanos
Masculino
Peru
Projetos Piloto
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1186/s12916-017-0858-9


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[PMID]:29179780
[Au] Autor:Godoy P; Alsedà M; Falguera M; Puig T; Bach P; Monrabà M; Manonelles A
[Ad] Endereço:Agència de Salut Pública de Catalunya,Barcelona,Spain.
[Ti] Título:A highly transmissible tuberculosis outbreak: the importance of bars.
[So] Source:Epidemiol Infect;145(16):3497-3504, 2017 12.
[Is] ISSN:1469-4409
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The transmission of tuberculosis (TB) in bars is difficult to study. The objective was to describe a large TB outbreak in a company's bar and other leisure settings. A descriptive study of a TB outbreak was carried out. Contacts were studied in the index case's workplace bar (five circles of contacts) and other recreational areas (social network of three bars in the index case's neighbourhood). Chest X-rays were recommended to contacts with positive tuberculin skin tests (TST) (⩾5 mm). The risk of latent tuberculosis infection (LTBI) was determined using an adjusted odds ratio. The dose-response relationship was determined using the chi-square test for linear trend. We studied 316 contacts at the index case's workplace and detected five new cases of TB. The prevalence of LTBI was 57·9% (183/316) and was higher in the first circle, 96·0% (24/25), and lower in the fifth, 46·5% (20/43) (P < 0·0001). Among 58 contacts in the three neighbourhood bars, two TB cases were detected and the LTBI prevalence was 51·7% (30/58). Two children of one secondary TB company patient became ill. Bars may be transmission locations for TB and, as they are popular venues for social events, should be considered as potential areas of exposure.
[Mh] Termos MeSH primário: Surtos de Doenças/estatística & dados numéricos
Tuberculose Latente/epidemiologia
Tuberculose Latente/transmissão
Logradouros Públicos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Pré-Escolar
Busca de Comunicante
Feminino
Seres Humanos
Atividades de Lazer
Masculino
Meia-Idade
Espanha/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.1017/S0950268817002588


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[PMID]:29323843
[Au] Autor:Borisevich IV; Chemikova NK; Markov VI; Krasnianskiy VP; Borisevich SV; Rozhdestvenskiy EV
[Ti] Título:An experience in the clinical use of specific immunoglobulin from horse blood serum for prophylaxis of Ebola haemorrhagic fever.
[So] Source:Vopr Virusol;62(1):25-9, 2017.
[Is] ISSN:0507-4088
[Cp] País de publicação:Russia (Federation)
[La] Idioma:eng
[Ab] Resumo:The aim of this work was to estimate the efficacy and safety of single intramuscular introduction of specific heterologous immunoglobulin as prophylactic drug against Ebola hemorrhagic fever. Materials and methods. The specific heterologous immunoglobulin was introduced as a special prophylactic drug to 28 patients in epidemic situations, after skin hurt with infectious materials or contact with infectious blood. Clinico-laboratory observation was performed in 24 subjects after single intramuscular introduction of heterologous immunoglobulin Ebola. The samples of blood serum were investigated for immunoglobulin Ebola and antibodies to horse gamma-globulin on the 30th and 60th days after prophylaxis. Results. None of the subjects of the study contracted Ebola fever. There were no anaphylactic reactions after special prophylaxis with specific heterologous immunoglobulin. Among the subjects with normal allergic state 31% responded with local reactions; 13%, with a general reaction (mild case of the serum disease). Almost no reaction was observed in patients with unfavorable allergic state subjected to desensitizing therapy; in the absence of desensitizing therapy, 50% of patients with unfavorable allergic state exhibited local reactions; 17%, mild cases of the serum disease; 33%, moderate cases of the serum disease. In summary, if the tactics of immunoglobulin application was right, the quantity of local allergic reactions was 28%; of wide spread reactions, 6%. Weak serum disease was observed in 11% of the subjects. The prognostic period of resistance to Ebola fever was less than 30 days. Conclusion. The prophylactic use of specific immunoglobulin from horse blood serum against hemorrhagic Ebola fever is effective and relatively safe in patients subjected to desensitizing therapy.
[Mh] Termos MeSH primário: Anticorpos Antivirais/administração & dosagem
Ebolavirus/imunologia
Doença pelo Vírus Ebola/prevenção & controle
Imunoglobulina G/administração & dosagem
Profilaxia Pré-Exposição/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Animais
Anticorpos Antivirais/efeitos adversos
Anticorpos Antivirais/sangue
Criança
Busca de Comunicante
Dessensibilização Imunológica
Ebolavirus/patogenicidade
Feminino
Doença pelo Vírus Ebola/imunologia
Doença pelo Vírus Ebola/transmissão
Doença pelo Vírus Ebola/virologia
Cavalos/sangue
Cavalos/imunologia
Seres Humanos
Hipersensibilidade/imunologia
Hipersensibilidade/fisiopatologia
Imunização Passiva
Imunoglobulina G/efeitos adversos
Imunoglobulina G/sangue
Injeções Intramusculares
Masculino
Meia-Idade
Ferimentos Penetrantes Produzidos por Agulha/imunologia
Segurança do Paciente
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Viral); 0 (Immunoglobulin G)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180112
[St] Status:MEDLINE


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[PMID]:28745556
[Au] Autor:Berntsen S; Karlsen APH; Pedersen ML; Mulvad G
[Ad] Endereço:a Queen Ingrid Health Care Center , Nuuk , Greenland.
[Ti] Título:Gonorrhoea in Greenland, incidence and previous preventive measures: a review to improve future strategies.
[So] Source:Int J Circumpolar Health;76(1):1350092, 2017.
[Is] ISSN:2242-3982
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Gonorrhoea continues to be a significant health challenge in Greenland. The aim of this study was to describe the development of gonorrhoea in Greenland through time including incidence rates and previous measures taken to address the challenge. A systematic literature search in PubMed, Embase and The Cochrane Library was conducted. Furthermore, local archives were searched in the Health Clinic in Nuuk for relevant literature. From the 1940s the incidence of gonorrhoea increased steadily with a steep incline around 1970, possibly as a consequence of changes in living conditions and urbanisation. Significant declines in the incidence were seen the late 1970s and again in the late 1980s, most likely in the wake of an outbreak of ulcus molle/chancroid in the 1970s and as a result of focused education in venereology for Greenlandic nurses in the late 1980s combined with the stop-AIDS campaign. Since the early 1990s the incidence of gonorrhoea in Greenland has not risen to previously high levels. However, the incidence remains high and with a gradually increasing trend. Prevention intervention strategies such as peer-to-peer sexual education, storytelling and involvement of parent/guardian in sexual education of the youth could be appropriate approaches to improve sexual health in Greenland.
[Mh] Termos MeSH primário: Serviços de Saúde Comunitária/organização & administração
Gonorreia/epidemiologia
Gonorreia/prevenção & controle
Prevenção Primária/organização & administração
Comportamento Sexual/estatística & dados numéricos
[Mh] Termos MeSH secundário: Busca de Comunicante
Feminino
Gonorreia/diagnóstico
Groenlândia
Seres Humanos
Masculino
Neisseria gonorrhoeae/isolamento & purificação
Prevalência
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1080/22423982.2017.1350092


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[PMID]:29211731
[Au] Autor:Watson CH; Coriakula J; Ngoc DTT; Flasche S; Kucharski AJ; Lau CL; Thieu NTV; le Polain de Waroux O; Rawalai K; Van TT; Taufa M; Baker S; Nilles EJ; Kama M; Edmunds WJ
[Ad] Endereço:Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
[Ti] Título:Social mixing in Fiji: Who-eats-with-whom contact patterns and the implications of age and ethnic heterogeneity for disease dynamics in the Pacific Islands.
[So] Source:PLoS One;12(12):e0186911, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Empirical data on contact patterns can inform dynamic models of infectious disease transmission. Such information has not been widely reported from Pacific islands, nor strongly multi-ethnic settings, and few attempts have been made to quantify contact patterns relevant for the spread of gastrointestinal infections. As part of enteric fever investigations, we conducted a cross-sectional survey of the general public in Fiji, finding that within the 9,650 mealtime contacts reported by 1,814 participants, there was strong like-with-like mixing by age and ethnicity, with higher contact rates amongst iTaukei than non-iTaukei Fijians. Extra-domiciliary lunchtime contacts follow these mixing patterns, indicating the overall data do not simply reflect household structures. Inter-ethnic mixing was most common amongst school-age children. Serological responses indicative of recent Salmonella Typhi infection were found to be associated, after adjusting for age, with increased contact rates between meal-sharing iTaukei, with no association observed for other contact groups. Animal ownership and travel within the geographical division were common. These are novel data that identify ethnicity as an important social mixing variable, and use retrospective mealtime contacts as a socially acceptable metric of relevance to enteric, contact and respiratory diseases that can be collected in a single visit to participants. Application of these data to other island settings will enable communicable disease models to incorporate locally relevant mixing patterns in parameterisation.
[Mh] Termos MeSH primário: Fatores Etários
Ingestão de Alimentos
Grupos Étnicos
Infecções por Salmonella/transmissão
Comportamento Social
[Mh] Termos MeSH secundário: Animais
Animais Domésticos
Busca de Comunicante
Fiji
Seres Humanos
Propriedade
Ilhas do Pacífico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180110
[Lr] Data última revisão:
180110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0186911


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[PMID]:28933935
[Au] Autor:Cohen AC; Zimmerman F; Prelip M; Glik D
[Ad] Endereço:Adam Carl Cohen is with the Public Health Division, AIDS Healthcare Foundation, Los Angeles, CA. Frederick Zimmerman is with the Department of Health Policy and Management, University of California, Los Angeles (UCLA) Fielding School of Public Health. Michael Prelip and Deborah Glik are with the Dep
[Ti] Título:A Smartphone Application to Reduce Time-to-Notification of Sexually Transmitted Infections.
[So] Source:Am J Public Health;107(11):1795-1800, 2017 Nov.
[Is] ISSN:1541-0048
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To measure whether the implementation of Healthvana-an online patient engagement platform and smartphone application-reduced the number of days between sexually transmitted infection (STI) testing, notification, and treatment at AIDS Healthcare Foundation (AHF) Wellness Centers. METHODS: We analyzed the retrospective data for 917 male clients who tested positive and received treatment for chlamydia, gonorrhea, or syphilis between January 1, 2014, and December 31, 2015. We included 8 AHF Wellness Centers from California and Florida in the study. We used regression models to evaluate the relationship between Healthvana implementation (pre-Healthvana vs post-Healthvana) and the number of days between the STI test, notification, and treatment. RESULTS: Following Healthvana implementation at the AHF Wellness Centers, the mean number of days decreased between the STI test and notification, from 8 to 6 days. The mean number of days between the overall STI test and treatment decreased from 12 to 10 days. Regression models found the reduction in the number of days from STI test to notification to be statistically significant. CONCLUSIONS: Smartphone applications like Healthvana are promising technologies to ensure clients are successfully and immediately notified of their STI test results.
[Mh] Termos MeSH primário: Busca de Comunicante/métodos
Aplicativos Móveis
Doenças Sexualmente Transmissíveis/prevenção & controle
Smartphone
[Mh] Termos MeSH secundário: Adulto
California
Infecções por Chlamydia/prevenção & controle
Florida
Gonorreia/prevenção & controle
Seres Humanos
Masculino
Estudos Retrospectivos
Doenças Sexualmente Transmissíveis/diagnóstico
Sífilis/prevenção & controle
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170922
[St] Status:MEDLINE
[do] DOI:10.2105/AJPH.2017.303999


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[PMID]:28902677
[Au] Autor:Misra K; Udeagu CC
[Ad] Endereço:New York City Department of Health and Mental Hygiene, New York City, NY.
[Ti] Título:Disparities in Awareness of HIV Postexposure and Preexposure Prophylaxis Among Notified Partners of HIV-Positive Individuals, New York City 2015-2017.
[So] Source:J Acquir Immune Defic Syndr;76(2):132-140, 2017 Oct 01.
[Is] ISSN:1944-7884
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Named sex- or needle-sharing partners of HIV-positive individuals are a priority prevention population due to their known HIV exposure. Understanding postexposure and preexposure prophylaxis (PEP and PrEP) awareness and use among them is important for successful interventions. METHODS: Data from notified partners of HIV-positive individuals (New York City, May 2015-April 2017) were analyzed to describe PEP/PrEP awareness, provider discussion, and use by sociodemographic and risk characteristics. Multivariate logistic regression was used to generate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of partners' PEP and PrEP awareness. RESULTS: Among notified partners (n = 621), PEP and PrEP awareness were 34% and 44%, respectively; provider discussion of PEP was reported by 32% and of PrEP by 42%; PEP use was reported by 2% and PrEP use by 14%. PEP awareness was higher among men who have sex with men sex partners than among heterosexual sex partners (aOR: 4.21; 95% CI: 2.10 to 8.44). Odds of PrEP awareness were lower among black (aOR: 0.34; 95% CI: 0.15 to 0.75) and Hispanic partners (aOR: 0.37; 95% CI: 0.17 to 0.84) than among white partners, and higher among men who have sex with men than heterosexual sex partners (aOR: 4.60; 95% CI: 2.38 to 8.87). Black partners were less likely than whites to report a provider discussion of PrEP. Postnotification HIV-positive test results were significantly lower among partners reporting PEP awareness than among those who had not heard of PEP. CONCLUSIONS: Low levels of PEP/PrEP awareness and of provider PEP/PrEP discussion among notified partners, particularly blacks, Hispanics, and heterosexual sex partners, indicate the timeliness of tailored prevention messaging, provider training, and sensitization, to avoid disparities in PEP/PrEP use.
[Mh] Termos MeSH primário: Busca de Comunicante
Infecções por HIV/prevenção & controle
Conhecimentos, Atitudes e Prática em Saúde
Profilaxia Pós-Exposição
Profilaxia Pré-Exposição
[Mh] Termos MeSH secundário: Adolescente
Adulto
Feminino
Soropositividade para HIV/epidemiologia
Heterossexualidade
Homossexualidade Masculina
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Uso Comum de Agulhas e Seringas
Cidade de Nova Iorque/epidemiologia
Profilaxia Pós-Exposição/métodos
Fatores de Risco
Fatores Socioeconômicos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170914
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000001473


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[PMID]:28884524
[Au] Autor:Haas AD; van Oosterhout JJ; Tenthani L; Jahn A; Zwahlen M; Msukwa MT; Davies MA; Tal K; Phiri N; Spoerri A; Chimbwandira F; Egger M; Keiser O
[Ad] Endereço:Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
[Ti] Título:HIV transmission and retention in care among HIV-exposed children enrolled in Malawi's prevention of mother-to-child transmission programme.
[So] Source:J Int AIDS Soc;20(1):21947, 2017 09 04.
[Is] ISSN:1758-2652
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: In Malawi, HIV-infected pregnant and breastfeeding women are offered lifelong antiretroviral therapy (ART) regardless of CD4 count or clinical stage (Option B+). Their HIV-exposed children are enrolled in the national prevention of mother-to-child transmission (PMTCT) programme, but many are lost to follow-up. We estimated the cumulative incidence of vertical HIV transmission, taking loss to follow-up into account. METHODS: We abstracted data from HIV-exposed children enrolled into care between September 2011 and June 2014 from patient records at 21 health facilities in central and southern Malawi. We used competing risk models to estimate the probability of loss to follow-up, death, ART initiation and discharge, and used pooled logistic regression and inverse probability of censoring weighting to estimate the vertical HIV transmission risk. RESULTS: A total of 11,285 children were included; 9285 (82%) were born to women who initiated ART during pregnancy. At age 30 months, an estimated 57.9% (95% CI 56.6-59.2) of children were lost to follow-up, 0.8% (0.6-1.0) had died, 2.6% (2.3-3.0) initiated ART, 36.5% (35.2-37.9) were discharged HIV-negative and 2.2% (1.5-2.8) continued follow-up. We estimated that 5.3% (95% CI 4.7-5.9) of the children who enrolled were HIV-infected by the age of 30 months, but only about half of these children (2.6%; 95% CI 2.3-2.9) were diagnosed. CONCLUSIONS: Confirmed mother-to-child transmission rates were low, but due to poor retention only about half of HIV-infected children were diagnosed. Tracing of children lost to follow-up and HIV testing in outpatient clinics should be scaled up to ensure that all HIV-positive children have access to early ART.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/administração & dosagem
Busca de Comunicante
Infecções por HIV/prevenção & controle
Transmissão Vertical de Doença Infecciosa/prevenção & controle
Complicações Infecciosas na Gravidez/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Aleitamento Materno
Pré-Escolar
Feminino
Infecções por HIV/tratamento farmacológico
Infecções por HIV/transmissão
Seres Humanos
Lactente
Recém-Nascido
Modelos Logísticos
Perda de Seguimento
Malaui
Masculino
Mães
Gravidez
Sistema de Registros/normas
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170909
[St] Status:MEDLINE
[do] DOI:10.7448/IAS.20.1.21947


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[PMID]:28854216
[Au] Autor:Muñoz L; Gonzalez L; Soldevila L; Dorca J; Alcaide F; Santin M
[Ad] Endereço:Infectious Diseases Department, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.
[Ti] Título:QuantiFERON®-TB Gold In-Tube for contact screening in BCG-vaccinated adults: A longitudinal cohort study.
[So] Source:PLoS One;12(8):e0183258, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess the utility of QuantiFERON®-TB Gold In-tube (QFT-GIT) for targeting preventive therapy in BCG-vaccinated contacts of tuberculosis (TB), based on its high specificity and negative predictive value for development of TB. METHODS: We compared two screening strategies for TB contact tracing in two consecutive periods: the tuberculin skin test (TST) period, when all contacts were screened with the TST alone; and the QFT-GIT period, when BCG-vaccinated contacts underwent TST and QFT-GIT. Diagnosis of TB infection among BCG-vaccinated contacts relied on TST ≥5 mm in the TST period, while in the QFT-GIT period either a positive QFT-GIT or a TST ≥15 mm was required. MEASUREMENTS AND MAIN RESULTS: Six hundred and sixty-one contacts were compared. In the QFT-GIT period there was a reduction in diagnoses of TB infection (77.4% vs. 51.2%; p <0.01) and preventive therapy prescribed (62.1% vs. 48.2%; p = 0.02) among the 290 BCG-vaccinated contacts. After a median follow-up of 5 years, cumulative incidences of TB were 0.62 and 0.29 in the TST and QFT-GIT periods respectively (p = 0.59). CONCLUSIONS: In BCG-vaccinated TB contacts, the addition of QFT-GIT safely reduced TB diagnosis and treatment rates without increasing the risk of subsequent active TB.
[Mh] Termos MeSH primário: Vacina BCG/administração & dosagem
Busca de Comunicante/métodos
Testes de Liberação de Interferon-gama/métodos
Mycobacterium tuberculosis/isolamento & purificação
Tuberculose Pulmonar/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Antituberculosos/economia
Antituberculosos/uso terapêutico
Feminino
Seres Humanos
Masculino
Meia-Idade
Mycobacterium tuberculosis/imunologia
Prevenção Primária/economia
Prevenção Primária/estatística & dados numéricos
Kit de Reagentes para Diagnóstico
Estudos Retrospectivos
Espanha
Teste Tuberculínico
Tuberculose Pulmonar/imunologia
Tuberculose Pulmonar/microbiologia
Tuberculose Pulmonar/prevenção & controle
Vacinação
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antitubercular Agents); 0 (BCG Vaccine); 0 (Reagent Kits, Diagnostic)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170831
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0183258



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