Search results for: prevention of infection
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2813

Search results for: prevention of infection

2753 The Investigation on the Status of Disaster Prevention and Reduction Knowledge in Rural Pupils in China

Authors: Jian-Na Zhang, Xiao-Li Chen, Si-Jian Li

Abstract:

Objective: In order to investigate current status on knowledge of disaster prevention and reduction in rural pupils, to explore education method on disaster prevention and reduction for rural pupils. Method: A questionnaire was designed based on literature review. Convenient sampling was used in the survey. The questionnaire survey was conducted among 180 students from Huodehong town central primary school which located in Ludian county of Zhaotong city in Yunnan province, where 6.5 magnitude earthquake happened in 2014. The result indicated that the pupils’ knowledge and skills on disaster prevention and reduction relevant poor. The source for them to obtain the knowledge of disaster prevention and reduction included TV (68.9%), followed by their parents (43.9%), while only 24.4% of knowledge is from the teachers. The scores about different natural disaster are ranking in descending order: earthquake (5.39 ±1.27), floods (3.77 ±1.17); debris flow (2.81 ±1.05), family fire (2.16± 0.96). And the disaster experience did not help the pupils enhance the knowledge reserves. There is no statistical significance (P > 0.05) in knowledge scores of disaster prevention and reduction between experienced and non-experienced group. Conclusion: The local disaster experiences did not draw the attention of parents and schools. Knowledge popularization of disaster for local pupils is extremely urgent. It is necessary to take advantage of more mediums to popularize the knowledge and skills about disaster prevention and reduction, for example, family education, school education, newspapers, brochures, etc. The training courses on disaster prevention and reduction which are based on the characteristics of the local rural pupils and the characteristics of the local disasters would be useful.

Keywords: rural, pupils, disaster prevention and reduction knowledge, popularization

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2752 Inhibition of Mixed Infection Caused by Human Immunodeficiency Virus and Herpes Virus by Fullerene Compound

Authors: Dmitry Nosik, Nickolay Nosik, Elli Kaplina, Olga Lobach, Marina Chataeva, Lev Rasnetsov

Abstract:

Background and aims: Human Immunodeficiency Virus (HIV) infection is very often associated with Herpes Simplex Virus (HSV) infection but HIV patients are treated with a cocktail of antiretroviral drugs which are toxic. The use of an antiviral drug which will be active against both viruses like ferrovir found in our previous studies is rather actual. Earlier we had shown that Fullerene poly-amino capronic acid (FPACA) was active in case of monoinfection of HIV-1 or HSV-1. The aim of the study was to analyze the efficiency of FPACA against mixed infection of HIV and HSV. Methods: The peripheral blood lymphocytes, CEM, MT-4 cells were simultaneously infected with HIV-1 and HSV-1. FPACA was added 1 hour before infection. Cells viability was detected by MTT assay, virus antigens detected by ELISA, syncytium formation detected by microscopy. The different multiplicity of HIV-1/HSV-1 ratio was used. Results: The double viral HIV-1/HSV-1 infection was more cytopathic comparing with monoinfections. In mixed infection by the HIV-1/HSV-1 concentration of HIV-1 antigens and syncytium formations increased by 1,7 to 2,3 times in different cells in comparison with the culture infected with HIV-1 alone. The concentration of HSV-1 increased by 1,5-1,7 times, respectively. Administration of FPACA (1 microg/ml) protected cells: HIV-1/HSV-1 (1:1) – 80,1%; HIV-1/HSV-1 (1:4) – 57,2%; HIV-1/HSV-1 (1:8) – 46,3 %; HIV-1/HSV-1 (1:16) – 17,0%. Virus’s antigen levels were also reduced. Syncytium formation was totally inhibited in all cases of mixed infection. Conclusion: FPACA showed antiviral activity in case of mixed viral infection induced by Human Immunodeficiency Virus and Herpes Simplex Virus. The effect of viral inhibition increased with the multiplicity of HIV-1 in the inoculum. The mechanism of FPACA action is connected with the blocking of the virus particles adsorption to the cells and it could be suggested that it can have an antiviral activity against some other viruses too. Now FPACA could be considered as a potential drug for treatment of HIV disease complicated with opportunistic herpes viral infection.

Keywords: antiviral drug, human immunodeficiency virus (hiv), herpes simplex virus (hsv), mixed viral infection

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2751 Differentially Response of Superoxide Dismutase in Wheat Susceptible and Resistant Cultivars against FHB

Authors: M. Sorahi Nobar, V. Niknam, H. Ebrahimzadeh, H. Soltanloo

Abstract:

Fusarium graminearum is one of the most destructive crop diseases in the world. Infection occurs during the flowering period in warm and humid conditions. It causes reduction in yield. Moreover, harvested grain is often contaminated with mycotoxins and its acetylated derivatives. Fusarium mycotoxines are potent inhibitor of protein synthesis, and thereby presents hazards for both human and animal health. A rapid production of reactive oxygen intermediates, primarily superoxide and hydrogen peroxide at the site of attempted infection considered as key feature underlying successful pathogen recognition. Here, we compared the time course activity of superoxide dismutase (SOD) as a first line of defenses against ROS- induced oxidative burst between FHB- resistant Sumai3 and susceptible Falat at 48, 96 and 144 hours after infection. Our results showed that Sumai3 SOD activity increased with time and reached the highest-level 4 days after infection while in susceptible cultivar Falat, SOD activity decreased during the first 96 h. after infection. Decreased was followed by an increased at 6 days after infection. According to our results rapid induction of SOD activity in resistant cultivar may play an important role in resistance against FHB in wheat.

Keywords: Fusarium graminearum, mycotoxins, resistant cultivar, superoxide dismutase

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2750 Hepatitis B, Hepatitis C and HIV Infections and Associated Risk Factors among Substance Abusers in Mekelle Substance Users Treatment and Rehabilitation Centers, Tigrai, Northern Ethiopia

Authors: Tadele Araya, Tsehaye Asmelash, Girmatsion Fiseha

Abstract:

Background: Hepatitis B virus (HBV), Hepatitis C virus (HCV) and Human Immunodeficiency Virus (HIV) constitute serious healthcare problems worldwide. Blood-borne pathogens HBV, HCV and HIV are commonly associated with infections among substance or Injection Drug Users (IDUs). The objective of this study was to determine the prevalence of HBV, HCV, and HIV infections among substance users in Mekelle Substance users Treatment and Rehabilitation Centers. Methods: A cross-sectional study design was used from Dec 2020 to Sep / 2021 to conduct the study. A total of 600 substance users were included. Data regarding the socio-demographic, clinical and sexual behaviors of the substance users were collected using a structured questionnaire. For laboratory analysis, 5-10 ml of venous blood was taken from the substance users. The laboratory analysis was performed by Enzyme-Linked Immunosorbent Assay (ELISA) at Mekelle University, Department of Medical Microbiology and Immunology Research Laboratory. The Data was analyzed using SPSS and Epi-data. The association of variables with HBV, HCV and HIV infections was determined using multivariate analysis and a P value < 0.05 was considered statistically significant. Result: The overall prevalence rate of HBV, HCV and HIV infections were 10%, 6.6%, and 7.5%, respectively. The mean age of the study participants was 28.12 ± 6.9. A higher prevalence of HBV infection was seen in participants who were users of drug injections and in those who were infected with HIV. HCV was comparatively higher in those who had a previous history of unsafe surgical procedures than their counterparts. Homeless participants were highly exposed to HCV and HIV infections than their counterparts. The HBV/HIV Co-infection prevalence was 3.5%. Those doing unprotected sexual practices [P= 0.03], Injection Drug users [P= 0.03], those who had an HBV-infected person in their family [P=0.02], infected with HIV [P= 0.025] were statistically associated with HBV infection. HCV was significantly associated with Substance users and previous history of unsafe surgical procedures [p=0.03, p=0.04), respectively. HIV was significantly associated with unprotected sexual practices and being homeless [p=0.045, p=0.05) respectively. Conclusion-The highly prevalent viral infection was HBV compared to others. There was a High prevalence of HBV/HIV co-infection. The presence of HBV-infected persons in a family, unprotected sexual practices and sharing of needles for drug injection were the risk factors associated with HBV, HIV, and HCV. Continuous health education and screening of the viral infection coupled with medical and psychological treatment is mandatory for the prevention and control of the infections.

Keywords: hepatitis b virus, hepatitis c virus, HIV, substance users

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2749 A Survey on Frequency of Cryptosporidiosis and Giardiasis in Horses in Ahvaz South-West of Iran

Authors: Ali R. Ghadrdan-Mashhadi, Hosein Hamidi-Nejat, Parisa Alizadehnia

Abstract:

Cryptosporidia and Giardia are protozoan parasites that have worldwide distribution and infect a variety of animals. Although, the infection to these parasites rarely caused to illness in horses, but some veterinarian recorded the clinical signs (such as diarrhea and malabsorbtion) especially in foals. In present study, the frequency of Cryptosporidiosis and Giardiasis in horses in Ahvaz investigated. The feces samples were taken from 100 horses that keep in seven horse breeding clubs, during spring and summer. The ages of horses were from 1 month to 27 years old. Fecal samples were stained by modified Ziehl-Neelsen and Tri-chrome methods. Results were analyzed with Chi-square Test and Fisher’s exact test. The results showed that the rate of infection to Cryptosporidium and Giardia were 18% and 40%, respectively. There weren't significant differences between infection to Cryptosporidium and Giardia with sex, age and fecal constancy. Although, the rate of infection to Cryptosporidium in studied horses is very similar to other studies but it seems, the rate of infection to Giardia is high in compare to other studies were done in the other countries.

Keywords: Ahvaz, cryptosporidium, giardia, horse

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2748 The Combination of Curcuma Extract and IgG Colostrum on Strongyloides Infection in CD1 Mice

Authors: Laurentius J. M. Rumokoy, Jimmy Posangi, Wisje Lusia Toar, Julio Lopez Aban

Abstract:

The threat of pathogen infection agents to the neonates is a major health problem to the new born life livestock. Neonate losses became an important case in the world as well as in Indonesia. This condition can be triggered by an infection with nematode in conjunction with a failure of immunoglobulin passive transfer. The study was conducted to evaluate the role of the curcuma combined with IgG colostrum on the development of parasites in the gut of CD1 mice. Animal experiments were divided in four groups (G) based on the treatment: G1 (infection only); G2 (curcuma+infection), G3 (IgG + infection) and G4 (curcuma+IgG+infection). The parameters measured were EPG (eggs per gram) and female in the intestine. The results obtained showed that the treatment has no a significant influence on the number of eggs per gram of feces in the group infected compared to the control group without receiving IgG nor curcuma. However, the EGP response tended to decrease at day 6 in G3 and G4 with a minimum number at zero eggs. This performant showed that the immunoglobulin-G and curcuma substances could slightly decreased the number of eggs in animal infected with Strongyloides. The results obtained showed also that the treatment has no significant difference (P > 0.05) on female larva in the gut of MCD1 experimental. In other side, we found that the best performance to inhibit the female quantity in the gut was the treatment with IgG and infection of parasite in G3. In this treatment, the minimum number was five female only in the gut. The results described IgG response was better than the curcuma single use in reducing the female parasite in the gut. This positive response of IgG compared to other controls group was associated with the function of colostrum antibodies.

Keywords: parasites, livestock, curcuma, colostrums

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2747 A Study on Hospital Acquired Infections Among Patients in University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State in Southern Part of Nigeria

Authors: Ibeku Bernadine Ezenwanyi

Abstract:

Hospital-Acquired Infections (HAI), also called ‘Nosocomial Infection’ is an infection you get while in the hospital for another reason. They are an important cause of morbidity and mortality. This study examined the epidemiology, clinical outcomes of some instruments used on patients especially catheter that was passed on them during their stay in the hospital. It was discovered that they had catheter–associated urinary tract infection (CAUTI). An observational study was carried out from January to March, 2022, on 180 patients (80 males and 100 females) admitted in the surgical wards, medical wards, dialysis unit and intensive care unit (ICU) of the hospital. The patient’s urine samples were collected for urine culture and the isolation was carried out using plate count agar medium and macconkey agar. Among the 80 males, 45 had Urinary Tract Infections (UTI) mostly proteus infection and among the 100 females, 70 also had (UTI) and the most common was caused by Escherichia coli. Other strain of microorganisms such as Klebsiella, Staphylococcus aureus and Pseudomonas aeruginosa. It is important to follow up patients that these devices were used on with antibiotics to make sure that these infections are not developed because the rate of these infections (UTI) are high especially in females.

Keywords: catheter, urinary tract infection, nosocomial infection, microorganisms

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2746 The Effectiveness of an Injury Prevention Workshop in Increasing Knowledge and Understanding in Grass-Root Youth Coaches

Authors: Mark De Ste Croix, Jonathan Hughes, Francisco Ayala, Michal Lehnert

Abstract:

There are well-known challenges to implementing injury prevention training for youth players but no data are available on the knowledge and understanding of deliverers of such programmes at grass root level. To increase adoption and adherence to such programmes coach knowledge and understanding of injury risk and prevention is essential. Therefore, the purpose of this study was to examine grass-root coaches knowledge and understanding of injury risk and prevention in youth players. 68 grass root coaches (18 females and 50 males) who were attending a one-day injury prevention workshop completed a modified validated questionnaire exploring knowledge and understanding of injury risk and prevention in youth players. Only 59% of coaches agreed that youth players are at a high risk of suffering an injury. There were high levels of agreement that injuries can have negative impacts on team performance (75%) and can cause physical problems in later life (85%), however only around half of coaches felt that injuries affect youth players current quality of life (59%). There was strong agreement that it is possible to prevent injuries in youth players (84%), but coaches were generally unaware of programs to help prevent injuries (84%), and only 9% used some form of injury prevention program. Despite this, nearly all coaches felt that their coaching could benefit from a greater understanding of growth and maturation (91%), injury prevention programmes (91%) and specific exercises (93%) for youth athletes. 17% of coaches rated their knowledge of injury prevention as good/very good at the start of the workshop and this increased to 94% at the end of the workshop. 62% of coaches identified their attitude towards injury prevention as indifferent at the start of the workshop compared with only 1% at the end. Only 14% of coaches at the start of the workshop were confident to deliver an injury prevention session but 83% stated they were confident by the end of the workshop. Finally, 98% of coaches felt that the workshop provided them with the confidence and the knowledge to deliver an injury prevention session and 98% suggested that they would implement injury prevention into their coaching. These data suggest that there is a lack of understanding of grass root coaches that children are a high-risk group for injuries, and that such injuries impact on current quality of life. Despite understanding that injuries can be prevented most grass root coaches do not have the knowledge to implement injury prevention into their coaching and very few do. There is a common consensus amongst these coaches that a greater understanding of such programmes will enhance their coaching. The injury prevention workshop appears to have increased the knowledge and changed the attitude of coaches towards injury prevention. All coaches felt that the workshop provided them with the tools to adopt, implement and deliver injury prevention in their coaching. These data highlight that there is a clear need for education regarding injury risk and prevention to be embedded within the coach education pathway, especially at grass root level.

Keywords: coach education, injury prevention, knowledge, and understanding, youth

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2745 A Study on the Prevalence and Microbiological Profile of Nosocomial Infections in the ICU of a Tertiary Care Hospital in Eastern India

Authors: Pampita Chakraborty, Sukumar Mukherjee

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This study was done to determine the prevalence of nosocomial infections in the ICU and to identify the common microorganisms causing these infections and their antimicrobial sensitivity pattern. Nosocomial infection or hospital-acquired infection is a localized or a systemic condition resulting from an adverse reaction to the presence of infectious agents. Nosocomial infections are not present or incubating when the patient is admitted to hospital or other health care facility. They are caused by pathogens that easily spread through the body. Many hospitalized patients have compromised immune systems, so they are less able to fight off infections. These infections occur worldwide, both in the developed and developing the world. They are a significant burden to patients and public health. They are a major cause of death and increased morbidity in hospitalized patients, which is a matter of serious concern today. This study was done during the period of one year (2012-2013) in the ICU of the tertiary care hospital in eastern India. Prevalence of nosocomial infection was determined; site of infection and the pattern of microorganisms were identified along with the assessment of antibiotic susceptibility profile. Patients who developed an infection after 48 hours of admission to the ICU were included in the study. A total of 324 ICU patients were analyzed, of these 79 patients were found to have developed a nosocomial infection (24.3% prevalence). Urinary tract infection was found to be more predominant followed by respiratory tract infection and soft tissue infection. The most frequently isolated microorganism was E. coli, Pseudomonas aeruginosa, Klebsiella pneumoniae followed by other organisms respectively. Antibiotic susceptibility test of these isolates was done against commonly used antibiotics. Patients admitted to the ICU are especially susceptible to nosocomial infections. Despite adequate antimicrobial treatment, nosocomial ICU infections can significantly affect ICU stay and can cause an increase in patient’s morbidity and mortality. Adherence to infection protocol, proper monitoring and the judicious use of antibiotics are important in preventing such infections on a regular basis.

Keywords: antibiotic susceptibility, intensive care unit, nosocomial infection, nosocomial pathogen

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2744 Grape Seed Extract in Prevention and Treatment of Liver Toxic Cirrhosis in Rats

Authors: S. Buloyan, V. Mamikonyan, H. Hakobyan, H. Harutyunyan, H. Gasparyan

Abstract:

The liver is the strongest regenerating organ of the organism, and even with 2/3 surgically removed, it can regenerate completely. Hence, liver cirrhosis may only develop when the regenerating system is off. We present the results of a comparative study of structural and functional characteristics of rat liver tissue under the conditions of toxic liver cirrhosis development, induced by carbon tetrachloride, and its prevention/treatment by natural compounds with antioxidant and immune stimulating action. Studies were made on Wister rats, weighing 120~140 g. Grape seeds extracts, separately and in combination with well known anticirrhotic drug ursodeoxycholic acid (ursodiol) have demonstrated effectiveness in prevention of liver cirrhosis development and its treatment.

Keywords: carbon tetrachloride, GSE, liver cirrhosis, prevention, treatment

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2743 Developing Community Resilience amongst Indigenous Youth in Canada: A Review of Culturally Adapted Substance Use Prevention Programs

Authors: Megan E. Davies

Abstract:

As substance use become an increasing prevalent occurrence amongst young people, prevention programs designed specifically for children and adolescents are required to protect against associated cognitive, psychological, and behavioural issues. Further, young people from marginalized backgrounds would highly benefit from culturally adapted substance use prevention programs. The first and second phase of the Life Skills Training (LST) program, the Maskwacis Life Skills Training (MLST) program, the Bii-Zin-Da-De-Da (BZDDD; “Listening to One Another”), and a culturally sensitive smoking prevention program, all of which have been adapted to Canadian Indigenous cultures and are applied within the school and family settings, are discussed. Additionally, comorbid disorders, at-risk personality types, and motivating factors associated with substance use amongst Canadian children and adolescents, specifically Indigenous youth, are explored through the application of a biopsychosocial model. Requital efforts being made in Canada towards Indigenous communities are described within a historical context, and substance use prevention programs targeting Indigenous children and adolescents are compared. Through this lens, suggestions are presented for future research on preventative interventions directed towards substance use within minority groups.

Keywords: early intervention, cultural appropriateness, life skills training, smoking prevention, drug and alcohol prevention

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2742 New Test Algorithm to Detect Acute and Chronic HIV Infection Using a 4th Generation Combo Test

Authors: Barun K. De

Abstract:

Acquired immunodeficiency syndrome (AIDS) is caused by two types of human immunodeficiency viruses, collectively designated HIV. HIV infection is spreading globally particularly in developing countries. Before an individual is diagnosed with HIV, the disease goes through different phases. First there is an acute early phase that is followed by an established or chronic phase. Subsequently, there is a latency period after which the individual becomes immunodeficient. It is in the acute phase that an individual is highly infectious due to a high viral load. Presently, HIV diagnosis involves use of tests that do not detect the acute phase infection during which both the viral RNA and p24 antigen are expressed. Instead, these less sensitive tests detect antibodies to viral antigens which are typically sero-converted later in the disease process following acute infection. These antibodies are detected in both asymptomatic HIV-infected individuals as well as AIDS patients. Studies indicate that early diagnosis and treatment of HIV infection can reduce medical costs, improve survival, and reduce spreading of infection to new uninfected partners. Newer 4th generation combination antigen/antibody tests are highly sensitive and specific for detection of acute and established HIV infection (HIV1 and HIV2) enabling immediate linkage to care. The CDC (Center of Disease Control, USA) recently recommended an algorithm involving three different tests to screen and diagnose acute and established infections of HIV-1 and HIV-2 in a general population. Initially a 4th generation combo test detects a viral antigen p24 and specific antibodies against HIV -1 and HIV-2 envelope proteins. If the test is positive it is followed by a second test known as a differentiation assay which detects antibodies against specific HIV-1 and HIV-2 envelope proteins confirming established infection of HIV-1 or HIV-2. However if it is negative then another test is performed that measures viral load confirming an acute HIV-1 infection. Screening results of a Phoenix area population detected 0.3% new HIV infections among which 32.4% were acute cases. Studies in the U.S. indicate that this algorithm effectively reduces HIV infection through immediate treatment and education following diagnosis.

Keywords: new algorithm, HIV, diagnosis, infection

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2741 Cultural Collisions, Ethics and HIV: On Local Values in a Globalized Medical World

Authors: Norbert W. Paul

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In 1988, parts of the scientific community still heralded findings to support that AIDS was likely to remain largely a ‘gay disease’. The value-ladden terminology of some of the articles suggested that rectum and fragile urethra are not sufficiently robust to provide a barrier against infectious fluids, especially body fluids contaminated with HIV while the female vagina, would provide natural protection against injuries and trauma facilitating HIV-infection. Anal sexual intercourse was constituted not only as dangerous but also as unnatural practice, while penile-vaginal intercourse would follow natural design and thus be relatively safe practice minimizing the risk of HIV. Statements like the latter were not uncommon in the early times of HIV/AIDS and contributed to captious certainties and an underestimation of heterosexual risks. Pseudo-scientific discourses on the origin of HIV were linked to local and global health politics in the 1980ies. The pathways of infection were related to normative concepts like deviant, subcultural behavior, cultural otherness, and guilt used to target, tag and separate specific groups at risk from the ‘normal’ population. Controlling populations at risk became the top item on the agenda rather than controlling modes of transmission and the virus. Hence, the Thai strategy to cope with HIV/AIDS by acknowledging social and sexual practices as they were – not as they were imagined – has become a role model for successful prevention in the highly scandalized realm of sexually transmitted disease. By accepting the globalized character of local HIV-risk and projecting the risk onto populations which are neither particularly vocal groups nor vested with the means to strive for health and justice Thailand managed to culturally implement knowledge-based tools of prevention. This paper argues, that pertinent cultural collisions regarding our strategies to cope with HIV/AIDS are deeply rooted in misconceptions, misreadings and scandalizations brought about in the early history of HIV in the 1980ties. The Thai strategy is used to demonstrate how local values can be balanced against globalized health risk and used to effectuated prevention by which knowledge and norms are translated into local practices. Issues of global health and injustice will be addressed in the final part of the paper dealing with the achievability of health as a human right.

Keywords: bioethics, HIV, global health, justice

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2740 Determining the Frequency of Pneumonia Emerging in COVID-19 Infection

Authors: Zoirov Amirdin Olimovich, Akbarov Elbek Elmurodovich

Abstract:

Introduction: Pneumonia that occurs during COVID-19 infection is common among patients. This research was conducted to determine the frequency of symptoms occurring during pneumonia according to the purpose. Objective and Task: The goal of our research is to develop clinical concepts of pneumonia that occur during COVID-19 infection. Our main task is to analyze the results of blood tests and understand the progression of the disease. Research Materials and Methods: The research was conducted among patients admitted to the Tashkent Medical Academy multi-profile clinic in the department of infectious diseases undergoing stationary treatment with a diagnosis of COVID-19. The analyzed patients had an average age of 46, with a total of 48 patients, 23 of whom were female and 25 were male. Research Results: The research results showed the development of pneumonia within three days in 27 patients after COVID-19 infection. During the observation period, 24 patients (88.8%) recovered completely. The X-ray revealed no signs of pneumonia in those who fully recovered. The remaining three patients showed a persistent form of pneumonia. Conclusion: The conclusion of the research indicates that pneumonia during COVID-19 infection develops in many patients, and 88.8% of patients recover completely without any lingering symptoms.

Keywords: COVID-19, pneumonia, the X-ray, blood, TTA

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2739 Perceptions of Mothers on Their Role in the Prevention of the Spread of Human Immunodeficiency Virus to Their Children and Childcare Received in the Healthcare Facility in a Rural Area

Authors: Sibusiso Buthelezi, Rugira Regis Marie-Modeste, Deliwe Rene Phetlhu

Abstract:

Introduction: Mother-to-child transmission persists owing to inadequate implementation of prevention of mother-to-child transmission programmes, particularly in rural areas. To achieve a target of zero new HIV infection in children born from women living with HIV, the involvement of mothers and caregivers is undeniable. Therefore, there is a need to explore the views of the mothers because of the role they play in their own right when it comes to preventing their children from contracting HIV by consistently adhering to the guidelines of the prevention of mother-to-child transmission programme. Thus, this study sought to explore and describe the perceptions of mothers on their role in the prevention of HIV to their children exposed to HIV and further explore their perceptions of the childcare received in the healthcare facility. Methods: The study was conducted in November-December 2019 in Ngaka Modiri Molema in North West Province in South Africa. A qualitative exploratory, descriptive research design was used. Purposive sampling was used to select the mothers of children exposed to HIV during the mother`s clinic attendance. Data collection was done through semi-structured individual interviews with mothers of children exposed to HIV. Colaizzi`s method of data analysis was used to analyse data in this study. Results: Seven themes emerged from data analysis, namely: health benefits from coming to the healthcare facility, communication, information needs, attitude of healthcare workers, healthcare administration system, the role of a mother, and disclosure of HIV status. Conclusion: This study revealed systematic gaps that exist in the programme, which hinder the childcare services of children exposed to HIV and socio-economically related hindrances. Mothers’ roles, such as exclusive breastfeeding, taking their own medication, and child follow-up visits, remain inadequate. The study findings show that there is a need to develop a contextual-tailored intervention strategy that would improve the implementation of prevention of mother-to-child transmission in rural areas.

Keywords: children exposed to HIV, mothers’ role to prevent MTCT, mothers’ perceptions on childcare, PMTCT in rural areas

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2738 Knowledge of Operation Rooms’ Staff toward Sources, Prevention and Control of Fires at Governmental Hospitals in Sana’a, Yemen

Authors: Abdulnasser Ahmed Haza’a, Marzoq Ali Odhah, Saddam Ahmed Al-Ahdal, Abdulfatah Saleh Al-Jaradi, Gamil Ghaleb Alrubaiee

Abstract:

Patient safety in hospitals is an essential professional indicator that should be noticed. The threat of fires is potentially the most dangerous risk that could harm patients and personnel. The aim of the study is to assess the knowledge of operating room (OR) staff toward prevention and control sources of fires. Between March 1 and March 30, 2022, data collection was done. A descriptive cross-sectional study was conducted. The sample of the study consisted of 89 OR staff from different governmental hospitals. Convenient sampling was applied to select the sample size. Official approvals were obtained from selected settings for start collection data. Data were collected using a close-ended questionnaire and tested for knowledge. This study was conducted in four governmental hospitals in Sana'a, Yemen. Most of the OR staff were male. Of these, 50.6% of them were operation technician professionals. More than two-thirds of OR staff have less than ten years of experience; 93% of OR staff had inadequate knowledge of sources of fires, and inadequate knowledge of them toward controls and prevention of fires (73%, 79.8%), respectively; 77.5% of OR staff had inadequate knowledge of prevention and control sources of fires. The study concluded that most of OR staff had inadequate knowledge of sources, controls, and prevention of fires, while 22.5% of them had adequate knowledge of prevention and control sources of fires. We recommended the implementation of training programs toward sources, controls, and prevention of fires or related workshops in their educational planning for OR staff of hospitals.

Keywords: knowledge, operation rooms staff, fires, prevention

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2737 Comparison of Maternal and Perinatal Outcomes of Obstetric Population Diagnosed with Covid-19 in Reference to Influenza A/H1N1: A Systematic Review and Meta-Analysis

Authors: Maria Vargas Hernandez, Jose Rojas Suarez, Carmelo Dueñas Castell, Sandra Contreras, Camilo Bello, Diana Borre, Walter Anichiarico, Harold Vasquez, Eduard Perez, Jose Santacruz

Abstract:

In the last two decades, there have been outbreaks of emerging infectious diseases, with an impact on both the general population and the obstetric population. These infections, which affect the general population, pose a high risk for adverse maternal and perinatal outcomes, taking into account that physiological and immunological changes that occur during pregnancy can increase their risk or severity. Among these, the pandemics of viral infections, Influenza A/H1N1 and SARS-CoV-2/COVID-19, stand out. In 2009, Influenza A/H1N1 infection (H1N1 2009pdm) affected approximately 3,110 obstetric patients, with data reported from 29 countries, including 1,625 (52.3%) cases that were hospitalized, 378 (23.3%) admissions to ICU and 130 (8%) deaths; and since the end of 2019, the Severe Acute Respiratory Syndrome - 2 (SARS-CoV-2) has been identified, causing the COVID-19 pandemic, with global mortality that is around 2-4% for the general population, and higher mortality in patients requiring admission to the intensive care unit. Its impact on the obstetric population is still unknown. Objectives: To evaluate the impact on maternal and perinatal outcomes of COVID-19 infection in reference to influenza A/H1N1 infection in the obstetric population. Methodology: Systematic review of the literature and meta-analysis. Results: Mortality from maternal infection with influenza A/H1N1 appears to be higher (8%) than mortality due to maternal infection with COVID-19 (3%). The rates of ICU admission, hospitalization, the requirement for invasive mechanical ventilation, and fetal death also appear to be higher in the maternal population with A/H1N1 infection, in reference to the maternal population with COVID-19 infection. Within perinatal outcomes, the admission to the neonatal ICU appears to be higher in the infants born to mothers with COVID-19 infection (28% vs. 15% for COVID-19 and A/H1N1, respectively). Conclusion: A/H1N1 infection in the obstetric population seems to be associated with a higher proportion of adverse outcomes in relation to COVID-19 infection. The actual impact of maternal influenza A/H1N1 infection on perinatal outcomes is unknown. More COVID-19 studies are needed to understand the impact of maternal infection on perinatal outcomes in this population.

Keywords: A/H1N1, COVID-19, maternal outcomes, perinatal outcomes

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2736 Molecular Epidemiologic Distribution of HDV Genotypes among Different Ethnic Groups in Iran: A Systematic Review

Authors: Khabat Barkhordari

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Hepatitis delta virus (HDV) is a RNA virus that needs the function of hepatitis B virus (HBV) for its propagation and assembly. Infection by HDV can occur spontaneously with HBV infection and cause acute hepatitis or develop as secondary infection in HBV suffering patients. Based on genome sequence analysis, HDV has several genotypes which show broad geographic and diverse clinical features. The aim of current study is determine the molecular epidemiology of hepatitis delta virus genotype in patients with positive HBsAg among different ethnic groups of Iran. This systematic review study reviews the results of different studies which examined 2000 Iranian patients with HBV infection from 2010 to 2015. Among 2000 patients in this study, 16.75 % were containing anti-HDV antibody and HDV RNA was found in just 1.75% cases. All of positive cases also have genotype I.

Keywords: HDV, genotype, epidemiology, distribution

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2735 Prevalence of Gastrointestinal Nematodes of Farm Animals by Copro-Culture

Authors: Mosaab A. Omar, Mohammad Saleh Al-Aboody

Abstract:

In the present study, examination of 442 faecal samples was performed: 171 from cattle, 128 from buffaloes and 143 from sheep. During the period from May, 2014 to April, 2015, fecal examination showed the infection rate with abomasal nematodes was 30% in cattle, 22.6% in buffaloes, and 31.4% in sheep. Fecal culture gave results of 47.5%, 30%, and 50.3% in cattle, buffaloes and sheep respectively. Seasonal infection with abomasal nematodes as shown by faecal culture in cattle, reveals the highest infection rate is in summer (55.9%), followed by spring (54.1%), autumn (50%), and winter (33.3%). Cooperia spp. is the most prevalent larva in both cattle and buffaloes; Strongyloides papillosus is the most predominant one in sheep. Here we introduce the first study of abomasal worms infection in ruminants in Qena, Egypt. The prevalence is found to be so high among the all examined animals, that we recommend that the authorities apply suitable control programs.

Keywords: haemonchus, ostertagia, seasonal dynamics, floatation

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2734 HIV/AIDS Knowledge and Social Integration among Street Children: A Systematic Review

Authors: Dewi Indah Irianti

Abstract:

Introduction: Street children include one of the populations at risk of HIV infection. Their vulnerability to these situations is increased by their lack of understanding of the changes associated with adolescence, the lack of knowledge and skills which could help them to make healthy choices. Social integration increased AIDS knowledge among migrant workers in Thailand. Although social integration has been incorporated into health research in other areas, it has received less attention in AIDS prevention research. This factor has not been integrated into models for HIV prevention. Objectives: The goal of this review is to summarize available knowledge about factors related to HIV/AIDS knowledge and to examine whether social integration was reviewed among street children. Methodology: This study performed a systematic search for English language articles published between January 2006 and March 2016 using the following keywords in various combination: street children, HIV/AIDS knowledge and social integration from the following bibliographic databases: Scopus, ProQuest, JSTOR, ScienceDirect, SpringerLink, EBSCOhost, Sage Publication, Clinical Key, Google Web, and Google Scholar . Results: A total of 10 articles met the inclusion criteria were systematically reviewed. This study reviews the existing quantitative and qualitative literature regarding the HIV/AIDS knowledge of street children in many countries. The study locations were Asia, the Americas, Europe, and Africa. The most determinants associated with HIV/AIDS knowledge among street children are age and sex. In this review, social integration that may be associated with HIV/AIDS knowledge among street children has not been investigated. Conclusion: To the best of the author’s knowledge, this study found that there is no research examining the relationship of social integration with the HIV knowledge among street children. This information may assist in the development of relevant strategies and HIV prevention programs to improve HIV knowledge and decrease risk behaviors among street children.

Keywords: HIV/AIDS knowledge, review, social integration, street children

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2733 Seroprevalence of Herpes Simplex Virus and Rubella Confection in Tropical Regions in Bihar, India

Authors: Bhawana, Roshan Kamal Topno, Maneesh Kumar, Major Madhukar, Krishna Pandey, Ganesh Chandra Sahoo, Manas Ranjan Dikhit, Surya Suman, Devendra Prasad Yadav, Rishikesh Kumar, Pradeep Das

Abstract:

Viral co-infection is now very common across taxa and environments that are involved in congenital infections. Herpes simplex virus (HSV) and Rubella are the two serious viral infections, well categorized in TORCH Syndrome. Here we had endeavoured the seroprevalence of co-infection of HSV and Rubella. Systematic tests have been performed to check the virulence pattern of the co-infection. The study was conducted at Department of Virology, Rajendra Memorial Research Institute of Medical Sciences (ICMR), Patna, Bihar, India during January 2018-July 2018. 299 newly cases were attended with the sign and symptoms of HSV and Rubella. After taking written consent forms from all the subjects, blood samples were collected for serological detection. ELISA was performed to detect the presence of IgM antibody level. 12 patients were found to be IgM positive from each HSV and Rubella infection. The findings of our study showed that 6 patients were positive for both HSV and rubella and hence were co-infected. Such co-infection causes severe health problems as it leads to the mortality rate of the patients during viral infectivity. Epidemiologically, proper screening should be needed to check any chance of occurrence of such co-infection in the affected regions in large scale and take suitable preventive approach to decrease the case totality. Concern has to be given to aid proper diagnosis and treatment in order to decrease the spread of HSV and Rubella co-infection.

Keywords: HSV, Rubella, seroprevalence, co-infection, ELISA, viral infectivity

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2732 Prevention of the Post – Intensive Care Syndrome (PICS) by Implementation of an ICU Delirium Prevention Strategy (DPB)

Authors: Paul M. H. J. Roekaerts

Abstract:

In recent years, it became clear that much intensive care (ICU) survivors develop a post-intensive care syndrome (PICS) consisting of psychiatric, cognitive and physical problems for a prolonged period after their ICU stay. Physical inactivity and delirium during the ICU stay are the main determinants of the post-ICU PICS. This presentation will focus on delirium, its epidemiology, prevalence, effect on outcome, risk factors and the current standard of care for managing delirium. Because ICU delirium is a predictor of prolonged length-of-stay in the ICU and of death, the use of a delirium prevention bundle (DPB) becomes mandatory in every ICU. In this presentation, a DPB bundle will be discussed consisting of six components: pain, sedation, sleep, sensory and intellectual stimulation, early mobilization, and hydration. For every of the six components, what to do and what not to do will be discussed. The author will present his own institutional policy on pharmacological and non-pharmacological interventions in the management of delirium. The component ‘early mobilization’ will be discussed more in detail, as this component is extremely important in the prevention of delirium as well as in the prevention of the PICS. The author will conclude his presentation with the remaining areas of uncertainties/work and research to be done.

Keywords: delirium, delirium prevention bundle, early mobilisation in intensive care (ICU), post-intensive care syndrome (PICS)

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2731 Integrating Concepts in Positive Psychology with Suicide Prevention in Children and Adolescents

Authors: S. Wietrzychowski

Abstract:

This systematic review incorporates concepts used in the field of positive psychology in order to integrate important elements into suicide prevention programs for children and adolescents. The goal of this review is to help students and professionals gain insight to available prevention programs for suicide and to incorporate aspects of positive psychology into these programs. Evidence-based interventions such as Positive Youth Development will be discussed in detail in its relation to prevention and positive psychology. Concepts such as hope, optimism, coping, and resilience will be related to these interventions in order to improve these interventions. The review will also explain how these programs can help prevent suicidal thoughts and/or behaviors. Research on mentorship programs and early intervention programs will be included and related to the aforementioned positive psychology concepts. Since children and adolescents are such a vulnerable population, the review will highlight specific considerations for working with children in order to prevent risk factors for suicide and to build protective factors. This review will discuss the effectiveness of school-based programs that are integrated with positive psychology. Elements of these programs that have been shown to be most effective in preventing suicide in schools will also be identified. As a result of this presentation, participants will be able to 1) List at least 2 evidence-based suicide prevention programs, 2) Understand the connection between specific positive psychology concepts and suicide prevention, 3) Identify at least 3 factors which protect against suicide, 4) Describe at least 3 risk factors for suicide, and 5) Think critically about the positive elements of suicide prevention programs.

Keywords: children, adolescents, suicide, positive

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2730 Assessment of HIV/Hepatitis B Virus Co-Infection among Patients Living with HIV in Northern and Southern Region of Nigeria

Authors: Folajinmi Oluwasina, Greg Abiaziem, Moses Luke, Mobolaji Kolawole, Nancy Yibowei, Anne Taiwo

Abstract:

Background: Occurrence of HIV infection has an adverse effect on the natural causes of Hepatitis B Viral (HBV) infection, faster progression of hepatic fibrosis demonstrated in patients with co-infection. This study was carried out to determine the incidence of HBV infection among HIV-positive patients, and to retrospectively evaluate laboratory characteristics of patients with HIV/HBV co-infection. Methods: A retrospective analysis of patient files for all HIV-infected cases followed-up and treated at 52 health facilities. Among HIV-infected cases, those with HBsAg positivity and HIV/Hepatitis B co-infection were determined. Socio demographic, alcohol or substance use, ART, CD4, Viral Load levels and treatment durations were retrospectively evaluated. Results: Of the 125 HIV-infected patients evaluated retrospectively, 17 (13.6%) had HBsAg positivity. Of these 17 cases were 11(64.7%) male and 6 (35.3%) female, with a mean age of 48.7 years. No patients had a history of alcohol or substance use. The mean duration of follow up was 28 months. 9 (52.9%) patients had negative HBV DNA at presentation while 8(47%) had positive HBV DNA, with normal ALT levels in all subjects. Among the 9 cases with negative HBV DNA who had no indication for the treatment of chronic hepatitis B. In five cases, treatment was commenced since HBV DNA was elevated in conjunction with low CD4. One patient in whom treatment was not indicated based on HBV DNA and CD4 levels in conjunction with the absence of AIDS defining clinical picture was currently being followed-up without treatment. Of the patients receiving HAART therapy, the average CD4 count at presentation was 278 cells/mm3 vs. 466 cells/mm3 at the end of 12 months. In three subjects with positive HBV DNA, a decrease in HBV DNA was noted after initiation of treatment. In four patients with negative DNA who received treatment, the HBV DNA negative status was found to remain, while one patient who did not receive treatment had elevated HBV DNA and decreased CD4 levels. Conclusion: It was shown that this group of patients with HIV/HBV co-infection, HAART was found to be associated with a decrease in HBV DNA in HBV DNA positive cases, absence of transition to positivity among those with negative HBV DNA, and with increased CD4 in all subjects.

Keywords: Hepatitis B, DNA, anti retroviral therapy, co-infection

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2729 Modelling the Effect of Distancing and Wearing of Face Masks on Transmission of COVID-19 Infection Dynamics

Authors: Nurudeen Oluwasola Lasisi

Abstract:

The COVID-19 is an infection caused by coronavirus, which has been designated as a pandemic in the world. In this paper, we proposed a model to study the effect of distancing and wearing masks on the transmission of COVID-19 infection dynamics. The invariant region of the model is established. The COVID-19 free equilibrium and the reproduction number of the model were obtained. The local and global stability of the model is determined using the linearization technique method and Lyapunov method. It was found that COVID-19 free equilibrium state is locally asymptotically stable in feasible region Ω if R₀ < 1 and globally asymptomatically stable if R₀ < 1, otherwise unstable if R₀ > 1. More so, numerical analysis and simulations of the dynamics of the COVID-19 infection are presented.

Keywords: distancing, reproduction number, wearing of mask, local and global stability, modelling, transmission

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2728 The Cytomegalovirus Infection among Iranian Kidney Graft Recipients

Authors: Zakieh Rostamzadeh , Nariman Sepehrvand-Zahra Shirmohamadi

Abstract:

Background: Cytomegalovirus (CMV) infection is one of the most common infectious problems following kidney transplantation. In this study, we are aimed to investigate the CMV infection in the setting of renal transplant recipients in Urmia-Iran, using both ELISA and polymerase chain reaction (PCR) methods. Methods: Ninety-six renal transplant recipients were selected randomly and enrolled in a cross-sectional study. Blood sampling was done via venipuncture, and all sera were investigated for anti-CMV IgM, and the seropositive cases in association with 14 randomly selected seronegative cases were investigated with PCR assay. Results: Thirty-three patients (34.3%) were seropositive for anti-CMV IgM, 3 patients (3.1%) were in borderline range, and 60 patients (62.5%) were seronegative. By considering the patients with borderline anti-CMV IgM levels as seropositive, 37.5% were seropositive for anti-CMV IgM. Among 36 seropositive cases, the CMV infection was confirmed in 19 (52.7%) of them using PCR. Age (P = 0.40), educational status (P = 0.77), history of pre-transplantation dialysis (0.52), history of blood transfusion (P = 0.52), and immunosuppressive regimen were not statistically different among recipients with positive versus negative CMV PCR study results. Conclusion: The seroprevalence of CMV infection was demonstrated to be high in renal transplant recipients of Urmia-Iran. The rate was higher compared to several previous reports in the literature. ELISA method has an appropriate sensitivity to screen the recipients for CMV infection but considering its relatively low specificity, the seropositive cases are better to be confirmed by further PCR study.

Keywords: cytomegalovirus, renal transplantation, ELISA, IgM, PCR

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2727 Epidemiology of Healthcare-Associated Infections among Hematology/Oncology Patients: Results of a Prospective Incidence Survey in a Tunisian University Hospital

Authors: Ezzi Olfa, Bouafia Nabiha, Ammar Asma, Ben Cheikh Asma, Mahjoub Mohamed, Bannour Wadiaa, Achour Bechir, Khelif Abderrahim, Njah Mansour

Abstract:

Background: In hematology/oncology, health care improvement has allowed increasingly aggressive management in diagnostic and therapeutic procedures. Nevertheless, these intensified procedures have been associated with higher risk of healthcare associated infections (HAIs). We undertook this study to estimate the burden of HAIs in the cancer patients in an onco -hematology unit in a Tunisian university hospital. Materials/Methods: A prospective, observational study, based on active surveillance for a period of 06 months from Mars through September 2016, was undertaken in the department of onco-hematology in a university hospital in Tunisia. Patients, who stayed in the unit for ≥ 48 h, were followed until hospital discharge. The Centers for Disease Control and Prevention criteria (CDC) for site-specific infections were used as standard definitions for HAIs. Results: One hundred fifty patients were included in the study. The gender distribution was 33.3% for girls and 66.6% boys. They have a mean age of 23.12 years (SD = 18.36 years). The main patient’s diagnosis is: Acute Lymphoblastic Leukemia (ALL): 48.7 %( n=73). The mean length of stay was 21 days +/- 18 days. Almost 8% of patients had an implantable port (n= 12), 34.9 % (n=52) had a lumber puncture and 42.7 % (n= 64) had a medullary puncture. Chemotherapy was instituted in 88% of patients (n=132). Eighty (53.3%) patients had neutropenia at admission. The incidence rate of HAIs was 32.66 % per patient; the incidence density was 15.73 per 1000 patient-days in the unit. Mortality rate was 9.3% (n= 14), and 50% of cases of death were caused by HAIs. The most frequent episodes of infection were: infection of skin and superficial mucosa (5.3%), pulmonary aspergillosis (4.6%), Healthcare associated pneumonia (HAP) (4%), Central venous catheter associated infection (4%), digestive infection (5%), and primary bloodstream infection (2.6%). Finally, fever of unknown origin (FUO) incidence rate was 14%. In case of skin and superficial infection (n= 8), 4 episodes were documented, and organisms implicated were Escherichia.coli, Geotricum capitatum and Proteus mirabilis. For pulmonary aspergillosis, 6 cases were diagnosed clinically and radiologically, and one was proved by positive aspergillus antigen in bronchial aspiration. Only one patient died due this infection. In HAP (6 cases), four episodes were diagnosed clinically and radiologically. No bacterial etiology was established in these cases. Two patients died due to HAP. For primary bloodstream infection (4 cases), implicated germs were Enterobacter cloacae, Geotricum capitatum, klebsiella pneumoniae, and Streptococcus pneumoniae. Conclusion: This type of prospective study is an indispensable tool for internal quality control. It is necessary to evaluate preventive measures and design control guides and strategies aimed to reduce the HAI’s rate and the morbidity and mortality associated with infection in a hematology/oncology unit.

Keywords: cohort prospective studies, healthcare associated infections, hematology oncology department, incidence

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2726 Vancomycin Resistance Enterococcus and Implications to Trauma and Orthopaedic Care

Authors: O. Davies, K. Veravalli, P. Panwalkar, M. Tofighi, P. Butterick, B. Healy, A. Mofidi

Abstract:

Vancomycin resistant enterococcus infection is a condition that usually impacts ICUs, transplant, dialysis, and cancer units, often as a nosocomial infection. After an outbreak in the acute trauma and orthopaedic unit in Morriston hospital, we aimed to access the conditions that predispose VRE infections in our unit. Thirteen cases of VRE infection and five cases of VRE colonisations were identified in patients who were treated for orthopaedic care between 1/1/2020 and 1/11/2021. Cases were reviewed to identify predisposing factors, specifically looking at age, presenting condition and treatment, presence of infection and antibiotic care, active haemo-oncological condition, long term renal dialysis, previous hospitalisation, VRE predisposition, and clearance (PREVENT) scores, and outcome of care. The presenting condition, treatment, presence of postoperative infection, VRE scores, age was compared between colonised and the infected cohort. VRE type in both colonised and infection group was Enterococcus Faecium in all but one patient. The colonised group had the same age (T=0.6 P>0.05) and sex (2=0.115, p=0.74), presenting condition and treatment which consisted of peri-femoral fixation or arthroplasty in all patients. The infected group had one case of myelodysplasia and four cases of chronic renal failure requiring dialysis. All of the infected patient had sustained an infected complication of their fracture fixation or arthroplasty requiring reoperation and antibiotics. The infected group had an average VRE predisposition score of 8.5 versus the score of 3 in the colonised group (F=36, p<0.001). PREVENT score was 7 in the infected group and 2 in the colonised group(F=153, p<0.001). Six patients(55%) succumbed to their infection, and one VRE infection resulted in limb loss. In the orthopaedic cohort, VRE infection is a nosocomial condition that has peri-femoral predilection and is seen in association with immunosuppression or renal failure. The VRE infection cohort has been treated for infective complication of original surgery weeks prior to VRE infection. Based on our findings, we advise avoidance of infective complications, change of practice in use of antibiotics and use radical surgery and surveillance for VRE infections beyond infective precautions. PREVENT score shows that the infected group are unlikely to clear their VRE in the future but not the colonised group.

Keywords: surgical site infection, enterococcus, orthopaedic surgery, vancomycin resistance

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2725 Urinary Schistosomiasis among Pre-School and School Aged Children in Two Peri-Urban Communities in Southwest Nigeria

Authors: Isiaka Akinwale, Tolulope Babatunde, Oladepo Sowemimo

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A cross-sectional study was conducted between March and April, 2016 among pre-school and school-aged children in two peri-urban communities in Osun State, Southwest Nigeria. Urine samples were collected from the pre-school and school-aged children, tested for microhaematuria using reagent strips, processed and examined for Schistosoma haematobium ova. Out of 274 pupils examined, 132 (48.2%) had infection, with no statistically significant difference (P > 0.05) in infection between male (48.6%) and female pupils (47.6%). The prevalence of infection increases significantly with age (P < 0.05), with the peak (93.3%) of infection recorded in pupils aged 15 to 16 years and the lowest infection (10.0%) in pupils aged 3 to 4 years. There was no statistically significant association (P > 0.05) between intensity in male pupils (156.0 ± 34.5/10 ml) and female pupils (141.7 ± 29.5/10 ml). The prevalence of pupils with microhaematuria was 65.0% and it increased significantly with age (P < 0.001). The conclusion drawn from the study is that to reduce the transmission of S. haematobium in endemic communities, health education and provision of potable water are advocated.

Keywords: Schistosoma haematobium, microhaeamturia, prevalence, urinary schistosomiasis, school aged children, Nigeria

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2724 Attributable Mortality of Nosocomial Infection: A Nested Case Control Study in Tunisia

Authors: S. Ben Fredj, H. Ghali, M. Ben Rejeb, S. Layouni, S. Khefacha, L. Dhidah, H. Said

Abstract:

Background: The Intensive Care Unit (ICU) provides continuous care and uses a high level of treatment technologies. Although developed country hospitals allocate only 5–10% of beds in critical care areas, approximately 20% of nosocomial infections (NI) occur among patients treated in ICUs. Whereas in the developing countries the situation is still less accurate. The aim of our study is to assess mortality rates in ICUs and to determine its predictive factors. Methods: We carried out a nested case-control study in a 630-beds public tertiary care hospital in Eastern Tunisia. We included in the study all patients hospitalized for more than two days in the surgical or medical ICU during the entire period of the surveillance. Cases were patients who died before ICU discharge, whereas controls were patients who survived to discharge. NIs were diagnosed according to the definitions of ‘Comité Technique des Infections Nosocomiales et les Infections Liées aux Soins’ (CTINLIS, France). Data collection was based on the protocol of Rea-RAISIN 2009 of the National Institute for Health Watch (InVS, France). Results: Overall, 301 patients were enrolled from medical and surgical ICUs. The mean age was 44.8 ± 21.3 years. The crude ICU mortality rate was 20.6% (62/301). It was 35.8% for patients who acquired at least one NI during their stay in ICU and 16.2% for those without any NI, yielding an overall crude excess mortality rate of 19.6% (OR= 2.9, 95% CI, 1.6 to 5.3). The population-attributable fraction due to ICU-NI in patients who died before ICU discharge was 23.46% (95% CI, 13.43%–29.04%). Overall, 62 case-patients were compared to 239 control patients for the final analysis. Case patients and control patients differed by age (p=0,003), simplified acute physiology score II (p < 10-3), NI (p < 10-3), nosocomial pneumonia (p=0.008), infection upon admission (p=0.002), immunosuppression (p=0.006), days of intubation (p < 10-3), tracheostomy (p=0.004), days with urinary catheterization (p < 10-3), days with CVC ( p=0.03), and length of stay in ICU (p=0.003). Multivariate analysis demonstrated 3 factors: age older than 65 years (OR, 5.78 [95% CI, 2.03-16.05] p=0.001), duration of intubation 1-10 days (OR, 6.82 [95% CI, [1.90-24.45] p=0.003), duration of intubation > 10 days (OR, 11.11 [95% CI, [2.85-43.28] p=0.001), duration of CVC 1-7 days (OR, 6.85[95% CI, [1.71-27.45] p=0.007) and duration of CVC > 7 days (OR, 5.55[95% CI, [1.70-18.04] p=0.004). Conclusion: While surveillance provides important baseline data, successful trials with more active intervention protocols, adopting multimodal approach for the prevention of nosocomial infection incited us to think about the feasibility of similar trial in our context. Therefore, the implementation of an efficient infection control strategy is a crucial step to improve the quality of care.

Keywords: intensive care unit, mortality, nosocomial infection, risk factors

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