scholarly journals Diagnostic Yield of Screening for SARS-CoV-2 among Patients Admitted for Alternate Diagnoses

2021 ◽  
Author(s):  
Phil Davis ◽  
Rhonda J Rosychuk ◽  
Jeffrey P Hau ◽  
Ivy Cheng ◽  
Andrew D McRae ◽  
...  
Keyword(s):  
Risk Factors ◽  
Universal Screening ◽  
Outcome Measure ◽  
Diagnostic Yield ◽  
Nucleic Acid Amplification Test ◽  
Household Contact ◽  
Nucleic Acid Amplification ◽  
Individual Level ◽  
Factors Associated ◽  
Response Network

Objectives: To determine the diagnostic yield of screening patients for SARS-CoV-2 who were admitted with a diagnosis unrelated to COVID-19, and identify risk factors for positive tests. Design: Cohort from the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN) registry Setting: 30 acute care hospitals across Canada Participants: Patients hospitalized for non-COVID-19 related diagnoses who were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between March 1, and December 29, 2020 Main outcome: Positive nucleic acid amplification test (NAAT) for SARS-CoV-2 Outcome measure: Diagnostic yield Results: We enrolled 15,690 consecutive eligible adults who were admitted to hospital without clinically suspected COVID-19. Among these patients, 122 tested positive for COVID-19, resulting in a diagnostic yield of 0.8% (95% CI 0.64% - 0.92%). Factors associated with a positive test included presence of a fever, being a healthcare worker, having a positive household contact or institutional exposure, and living in an area with higher 7-day average incident COVID-19 cases. Conclusions: Universal screening of hospitalized patients for COVID-19 across two pandemic waves had a low diagnostic yield and should be informed by individual-level risk assessment in addition to regional COVID-19 prevalence.

scholarly journals Hepatitis B vaccination coverage and risk factors associated with incomplete vaccination of children born to hepatitis B surface antigen-positive mothers, Denmark, 2006 to 2010

2016 ◽  
Vol 21 (7) ◽  
Author(s):  
Asja Kunoee ◽  
Jens Nielsen ◽  
Susan Cowan
Keyword(s):  
Risk Factors ◽  
Hepatitis B ◽  
Pregnant Women ◽  
Surface Antigen ◽  
Vaccination Coverage ◽  
Universal Screening ◽  
Hepatitis B Surface Antigen ◽  
Hepatitis B Vaccination ◽  
Factors Associated ◽  
Chronic Hbv

In Denmark, universal screening of pregnant women for hepatitis B has been in place since November 2005, with the first two years as a trial period with enhanced surveillance. It is unknown what the change to universal screening without enhanced surveillance has meant for vaccination coverage among children born to hepatitis B surface antigen (HBsAg)-positive mothers and what risk factors exist for incomplete vaccination. This retrospective cohort study included 699 children of mothers positive for HBsAg. Information on vaccination and risk factors was collected from central registers. In total, 93% (651/699) of the children were vaccinated within 48 hours of birth, with considerable variation between birthplaces. Only 64% (306/475) of the children had received all four vaccinations through their general practitioner (GP) at the age of two years, and 10% (47/475) of the children had received no hepatitis B vaccinations at all. Enhanced surveillance was correlated positively with coverage of birth vaccination but not with coverage at the GP. No or few prenatal examinations were a risk factor for incomplete vaccination at the GP. Maternity wards and GPs are encouraged to revise their vaccination procedures and routines for pregnant women, mothers with chronic HBV infection and their children.

Time to resolution of genital symptoms for uncomplicated gonorrhoea: a prospective cohort study

2020 ◽  
pp. sextrans-2020-054626
Author(s):  
Oluseyi Ayinde ◽  
Jonathan D C Ross
Keyword(s):  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Chlamydia Infection ◽  
Health Clinic ◽  
Study Cohort ◽  
Symptom Resolution ◽  
Factors Associated ◽  
Baseline Visit ◽  
Report Symptom

ObjectivesTo determine the time to resolution of symptoms (TTR) following treatment of uncomplicated gonorrhoea and to identify factors associated with TTR in a cohort of sexual health clinic attendees.MethodsParticipants were recruited from 14 clinics across England into the ‘Gentamicin for the Treatment of Gonorrhoea (GToG)’ trial between October 2014 and November 2016. We analysed demographic, behavioural and clinical data in a subset of the GToG study cohort presenting with genital discharge and/or dysuria, who subsequently experienced microbiological clearance of Neisseria gonorrhoeae 2 weeks after treatment. Testing for gonorrhoea was performed using a nucleic acid amplification test. The results were expressed as median TTR (IQR) and HRs with 95% CIs for resolution of symptoms.Results216 participants (89% male) with a mean age of 32 years reported genital discharge (204/216 (94%)) or dysuria (173/216 (80%)) at their baseline visit. Symptom resolution occurred in 202/216 (94%) at the 2-week follow-up appointment. The median TTR was 2 days (IQR 1–3 days). 50/216 (23%) patients presented with gonorrhoea–chlamydia coinfection at their baseline attendance and in this group symptom resolution was slower (3 days for gonorrhoea–chlamydia coinfection compared with 2 days for gonorrhoea only, HR 0.68 (95% CI 0.48 to 0.95)). TTR was also longer in women (4 days for females compared with 2 days for males, HR 0.47 (95% CI 0.29 to 0.77)).ConclusionsThe time to resolution of genital symptoms following effective treatment of gonorrhoea is variable, but 90% of patients report symptom resolution within 1 week. Concurrent chlamydia infection and being female were associated with prolonged TTR.

scholarly journals Individual- and Community-Level Risk Factors Associated with Childhood Diarrhea in Ethiopia: A Multilevel Analysis of 2016 Ethiopia Demographic and Health Survey

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Setegn Muche Fenta ◽  
Teshager Zerihun Nigussie
Keyword(s):  
Risk Factors ◽  
Drinking Water ◽  
Health Survey ◽  
Community Level ◽  
World Health ◽  
Childhood Diarrhea ◽  
Individual Level ◽  
Factors Associated ◽  
Health Organization ◽  
The Individual

Background. Diarrhea is the second cause of child deaths globally. According to World Health Organization reports, in each year, it kills more than 525,000 children under 5 years. More than half of these deaths occur in five countries including Ethiopia. This study is aimed at identifying both individual- and community-level risk factors of childhood diarrhea in Ethiopia. Methods. Ethiopian demography and health survey of 2016 data were used for the analysis. A total of 10,641 children aged 0–59 months were included in the analysis. A multilevel mixed-effects logistic regression model was used to identify both individual- and community-level risk factors associated with childhood diarrhea. Result. The incidence of childhood diarrhea was 12% (95% CI: 11.39, 12.63). The random-effects model revealed that 67% of the variability of childhood diarrhea was explained by individual- and community-level factors. From the individual-level factors, children aged 36–59 months ( AOR = 3.166 ; 95% CI: 2.569, 3.900), twin child ( AOR = 1.871 ; 95% CI: 1.390, 2.527), birth order 5 and above ( AOR = 2.210 , 95% CI: 1.721, 2.839), not received any vaccination ( AOR = 1.197 ; 95% CI: 1.190, 1.527), smaller size of child at birth ( AOR = 1.303 ; 95% CI: 1.130, 1.504), and never breastfed children ( AOR = 2.91 ; 95% CI: 2.380, 3.567) associated with the higher incidence of childhood diarrhea. From the community-level factors, living in a rural area ( AOR = 1.505 ; 95% CI: 1.233, 1.836)), unprotected source of drinking water ( AOR = 1.289 ; 95% CI: 1.060, 1.567), and availability of unimproved latrine facilities (OR: 1.289; 95% CI: 1.239, 1.759) associated with the higher incidence of childhood diarrhea. Besides, children who live in Afar, Amhara, Benishangul-Gumuz, Gambella, SNNPR, and Dire Dawa regions had higher incidence of childhood diarrhea. Conclusion. The incidence of childhood diarrhea was different from cluster to cluster in Ethiopia. Therefore, integrated child health intervention programs including provisions of toilet facility, access to a clean source of drinking water, educate parents about the importance of breastfeeding, and vaccination have to be strongly implemented in order to reduce the high incidence of childhood diarrhea among children in Ethiopia.

scholarly journals Risk factors for recurrent positive results of the nucleic acid amplification test for COVID-19 patients: a retrospective study

Human Cell ◽  
2021 ◽  
Author(s):  
Wanwan Yi ◽  
Xuan Long ◽  
Jin Liu ◽  
LiShuai Shi ◽  
Zichen Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nucleic Acid ◽  
Symptom Onset ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Health Concern ◽  
Serum Chloride ◽  
Increased Risk ◽  
Multivariable Regression ◽  
Chloride Concentrations

AbstractPositive retests of COVID-19 represent a public health concern because of the increased risk of transmission. This study explored whether factors other than the nucleic acid amplification test (NAAT) contribute to positive retest results. Patients with COVID-19 admitted to the Guanggu district of the Hubei Maternal and Child Health Hospital between February 17 and March 28, 2020, were retrospectively included. The patients were grouped into the negative (n = 133) and positive (n = 51) retest groups. The results showed that the proportion of patients presenting with cough was higher (P < 0.001) and the proportion of patients with dyspnea was lower (P = 0.018) in the positive than in the negative retest group. The positive retest group showed shorter durations between symptom onset and hospitalization (P < 0.001) and symptom onset and the first positive NAAT (P = 0.033). The positive retest group had higher basophil counts (P = 0.023) and direct bilirubin (P = 0.032) and chlorine concentrations (P = 0.023) but lower potassium concentrations (P = 0.001) than the negative retest group. Multivariable regression analysis showed that coughing (OR = 7.59, 95% CI 2.28–25.32, P = 0.001) and serum chloride concentrations (OR = 1.38, 95% CI 1.08–1.77, P = 0.010) were independently associated with a positive retest result. Coughing and serum chloride concentrations were independent risk factors for positive NAAT retest results. Patients with a hospital stay of < 2 weeks or a short incubation period should stay in isolation and be monitored to reduce transmission. These results could help identify patients who require closer surveillance.

scholarly journals Cartridge based nucleic acid amplification test negative in highly suspected case of tuberculosis: a case report

2020 ◽  
Vol 8 (3) ◽  
pp. 1130 ◽  
Author(s):  
Kalpesh Moradiya ◽  
Arti Muley ◽  
Sunil Kumar ◽  
Kinjal Patel ◽  
Harshal Mahida
Keyword(s):  
Nucleic Acid ◽  
Pulmonary Tuberculosis ◽  
Diagnostic Yield ◽  
False Negative ◽  
Control Program ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Smear Microscopy ◽  
Suspected Case ◽  
Bacteriological Diagnosis

Diagnosis of pulmonary tuberculosis is challenging till today. Smear microscopy is the easiest, commonest and widely employed tool for confirmatory diagnosis of pulmonary tuberculosis, but it has low sensitivity and specificity. Sputum culture can increase the diagnostic yield by 20-40%, but it takes long duration of 2-8 weeks to give result. The role of newly introduced cartridge based nucleic acid amplification test (CBNAAT) in the revised national TB control program (RNTCP) is highly promising with a higher yield of bacteriological diagnosis in sputum negative pulmonary tuberculosis patients with detection of rifampicin resistance rapidly. However, it also has some limitations which may result in false negative results. Case of a 50- year-old-male was reported who was initially managed for community-acquired pneumonia in view of negative sputum and CBNAAT but was later confirmed to have TB but by then he had developed cavities in lung and had transmitted the infection to his son.

Comparison of Diagnostic Yield of Tuberculosis Loop-Mediated Isothermal Amplification Assay With Cartridge-Based Nucleic Acid Amplification Test, Acid-Fast Bacilli Microscopy, and Mycobacteria Growth Indicator Tube Culture in Children With Pulmonary Tuberculosis

2020 ◽  
Author(s):  
Rajeshwar Dayal ◽  
Alok Yadav ◽  
Dipti Agarwal ◽  
Manoj Kumar ◽  
Raj Kamal ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Diagnostic Yield ◽  
Lamp Assay ◽  
Nucleic Acid Amplification Test ◽  
Isothermal Amplification ◽  
Nucleic Acid Amplification ◽  
Pulmonary Tb ◽  
Indicator Tube ◽  
Mgit Culture ◽  
Growth Indicator

Abstract Background Cartridge-based nucleic acid amplification test (CB-NAAT) has been recommended for diagnosis of tuberculosis (TB) in children, but its wide use is limited by high cost and the need for well-equipped laboratories. This study was conducted in children with pulmonary TB to compare the diagnostic yield of TB-LAMP (loop-mediated isothermal amplification test) with CB-NAAT and other conventional methods. Methods Patients ≤ 14 years of age diagnosed with probable pulmonary TB were included in the study. Induced sputum/gastric aspirate was obtained and subjected to acid-fast bacilli (AFB) microscopy, mycobacteria growth indicator tube (MGIT) culture, CB-NAAT, and TB-LAMP. The TB-LAMP assay was performed using 2 different primers, IS6110 and mpb64, for detection of Mycobacterium tuberculosis (MTB). TB-LAMP assays were compared to other assays using appropriate statistical tests. Results One hundred fourteen subjects were recruited in the study. AFB microscopy, MGIT culture, CB-NAAT, TB-LAMP IS6110, and TB-LAMP mpb64 showed positivity of 32 (28.1%), 59 (51.7%), 66 (57.9%), 75 (65.8%), and 81 (71%), respectively. TB-LAMP IS6110 showed significantly higher MTB detection in comparison to AFB microscopy and MGIT culture (P = .0001 and P = .03, respectively), and showed no significant difference in MTB detection in comparison with CB-NAAT (P = .219). TB-LAMP mpb64 showed significantly higher MTB detection as compared to AFB microscopy, MGIT culture, and CB-NAAT (P = .0001, P = .003, and P = .037, respectively). TB-LAMP mpb64 and IS6110 showed sensitivity of 94.9% (95% confidence interval [CI], 85.9%–98.9%) and 89.8% (95% CI, 79.7%–96.2%), respectively, in reference to MGIT culture. The degree of agreement between TB-LAMP (mpb64 and IS6110) with CB-NAAT showed κ values of 0.718 and 0.834, respectively. Conclusions TB-LAMP assay can be a useful alternative test in diagnosis of pulmonary TB in children.

scholarly journals Factors associated with childhood diarrheal in Ethiopia; a multilevel analysis

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Setegn Muche Fenta ◽  
Teshager Zerihun Nigussie
Keyword(s):  
Risk Factors ◽  
Drinking Water ◽  
Random Effect ◽  
Random Effect Model ◽  
Community Level ◽  
World Health ◽  
Childhood Diarrhea ◽  
Mixed Effect ◽  
Individual Level ◽  
Factors Associated

Abstract Background Diarrhea is the second cause of child deaths globally. According to World Health Organization reports, in each year it kills more than 525,000 children under-5 years. More than half of these deaths occur in five countries including Ethiopia. This study aimed to identify both individual and community-level risk factors of childhood diarrheal in Ethiopia. Methods Ethiopian demography and health survey of 2016 data were used for the analysis. A total of 10,641 children aged 0–59 months were included in the analysis. A multi-level mixed-effect logistic regression model was used to identify both individual and community-level risk factors associated with childhood diarrheal. Result The incidence of childhood diarrheal was 12% (95%CI: 11.39, 12.63). The random effect model revealed that 67% of the variability of childhood diarrhea explained by individual and community level factors. From the individual-level factors, children aged 36–59 month (AOR = 3.166; 95% CI: 2.569, 3.900), twin child (AOR = 1.871; 95% CI: 1.390, 2.527), birth order 5 and above (AOR = 2.210, 95% CI: 1.721, 2.839), not received any vaccination (AOR = 1.197; 95% CI: 1.190,1.527), smaller size of child at birth (AOR = 1.303;95% CI: 1.130,1.504) and never breastfed children (AOR = 2.91;95%CI:2.380,3.567) associated with the higher incidence of childhood diarrhea. From the community-level factors, living in a rural area ((AOR = 1.505; 95%CI: 1.233, 1.836)), unprotected source of drinking water (AOR: 1.289; 95% CI: 1.060, 1.567) and availability of unimproved latrine facilities (OR: 1.289; 95% CI: 1.239, 1.759) associated with the higher incidence of childhood diarrhea. Besides, Children live in Afar, Amhara, Benishangul-Gumuz, Gambella, SNNPR and Dire Dawa regions had higher incidence of childhood diarrhea. Conclusion The incidence of childhood diarrhea was different from cluster to clusters in Ethiopia. Therefore, integrated child health intervention programs including provisions of toilet facility, access to a clean source of drinking water, educate parents about the importance of breastfeeding and vaccination have to be strongly implemented in order to reduce the high incidence of childhood diarrhea among children in Ethiopia.

scholarly journals The Effects of a Systemwide Diagnostic Stewardship Change on West Nile Virus Disease Ordering Practices

2019 ◽  
Author(s):  
Andrew H Karaba ◽  
Paul W Blair ◽  
Kevin Martin ◽  
Mustapha O Saheed ◽  
Karen C Carroll ◽  
...  
Keyword(s):  
West Nile Virus ◽  
Nucleic Acid ◽  
Electronic Health Record ◽  
Virus Disease ◽  
Diagnostic Yield ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Health Record ◽  
West Nile ◽  
Electronic Health

Abstract We report that removing the clinically insensitive West Nile virus CSF nucleic acid amplification test (NAAT) from the electronic health record (EHR) test menu decreased costs and may have improved diagnostic yield. Removing high-cost, low yield tests from the EHR can be an effective diagnostic stewardship intervention.

scholarly journals Seroprevalence of Leptospira spp. infection in sheep from northwest of Rio Grande do Sul, Brazil

2019 ◽  
Vol 49 (12) ◽  
Author(s):  
Angélica Consalter ◽  
Eraldo Lourenso Zanella ◽  
Gabriel Mendes de Souza Martins ◽  
Hugo Libonati de Araujo ◽  
Walter Lilenbaum ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rio Grande ◽  
Economic Losses ◽  
Subclinical Infection ◽  
Rio Grande Do Sul ◽  
Serum Samples ◽  
Individual Level ◽  
Factors Associated ◽  
Reproductive Losses ◽  
And Control

ABSTRACT: Leptospirosis is a zoonosis that is widely distributed in tropical countries. This infection is also associated with reproductive losses in livestock, which has a significant economic impact. The objective of this study is to investigate the seroprevalence and risk factors associated with leptospiral infection in commercial sheep flocks from the northwestern mesoregion of Rio Grande do Sul. Serum samples were analyzed in 319 sheep using the Microscopic Agglutination Test (MAT). At the time of sampling, an individual and herd questionnaire was carried out to investigate the risk factors. On an individual level, positive reactions were observed in 5.6% (18/319) of the studied sera, with Sejroe being the most prevalent serogroup. Animals >3 years old were more likely to be seropositive than animals 1-3 years old (OR 14.4; 95% CI 1.9-110). The predominance of Sejroe serogroup in this manner draws attention to how subclinical infection is associated with economic losses. Therefore, the importance of maintaining measures for the prevention and control of leptospirosis among the sheep flocks of the studied region is reiterated.

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