infection study
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2021 ◽  
Vol 6 ◽  
pp. 89
Author(s):  
Neema Mtunthama Toto ◽  
Kate Gooding ◽  
Blessings M. Kapumba ◽  
Kondwani Jambo ◽  
Jamie Rylance ◽  
...  

Background: Human infection studies (HIS) involve deliberately infecting healthy volunteers with a pathogen in a controlled environment to understand infection and support the development of effective vaccines or treatments. HIS research is expanding to many low and middle-income settings to accelerate vaccine development. Given the implementation of the first HIS research to establish the experimental human pneumococcal carriage model’s feasibility, we sought to understand the participant’s opinions and experiences. Methods: We used a qualitative, descriptive approach to understand participants perceptions and experiences on HIS participation. Sixteen healthy adult participants were invited to participate in in-depth exit interviews to discuss their experiences, motivations and concerns. Results: Our findings showed that the likelihood of participation in HIS research rests on three essential conditions: motivation to participate, compensation and advocacy. The motivation and decision to participate was based on reasons including altruism, patriotism, monetary and material incentives, and while compensation was deemed appropriate, concerns about unanticipated research-related risks were raised. Participant advocate groups were recommended for increasing awareness and educating others in the broader community about HIS research. Conclusions: Participants’ experiences of HIS in Malawi provide the basis of what can be acceptable in HIS research in lower-income countries and areas where study procedures could be adjusted.


2021 ◽  
Vol 890 (1) ◽  
pp. 012034
Author(s):  
I Koesharyani ◽  
N L A Lasmika ◽  
K Sugama

Abstract Milky Haemolymph Disease in Spiny Lobster (MHD-SL) is the most pathogenic diseases in spiny lobster (Panulirus homarus). Research on MHD-SL infection has not been undertaken in Indonesia. Therefore, present study aims to determine the infection of MHD-SL lobster. In 2016 a total of 240 lobsters for 30 each both from wild and cultured sample were collected from four locations (Candi Kusuma Bay of Bali Island, Gerupuk, Awang, and Telong-Elong Bays of Lombok Island) and in 2019, 50 lobster samples were collected for artificial infection study. While in January 2020, another 40 lobsters were collected from 2 different sites of culture (coastal and offshore cages) within Telong Elong Bay to determine infection of MHD-SL and for transmission study. The MHD-SL diseased was first check by clinical sign and confirmed by PCR-DNA molecular with specific primer of 254 bp. An experimental infection of MHD-SL was carried out by injection and cohabitation. The result showed that infected MHD-SL lobster shows inactive, loose appetite to eat, reddish and white colour of abdomen then moribund and all positive by PCR test. MHD-SL was found only in cultured lobster on the cages located at coastal water and no in the cages located at offshore within Telong-Elong Bay. In the experiment of artificial infection, either by injection or cohabitation, shows clinical sign of MHD-SL appeared at 8 days and all died after 14 days for both treatments. The present study approved that MHD-SL is pathogenic agent belonged to Rickettsia-like bacterium and infection occurred by horizontal transmission.


BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e054200
Author(s):  
Xuejie Ding ◽  
David M Brazel ◽  
Melinda C Mills

ObjectiveNon-pharmaceutical interventions (NPIs), including wearing face covering/masks, social distancing and working from home, have been introduced to control SARS-CoV-2 infections. We provide individual-level empirical evidence of whether adherence reduces infections.Setting and participantsThe COVID-19 Infection Study (CIS) was used from 10 May 2020 to 2 February 2021 with 409 009 COVID-19 nose and throat swab tests nested in 72 866 households for 100 138 individuals in the labour force aged 18–64.AnalysisORs for a positive COVID-19 test were calculated using multilevel logistic regression models, stratified by sex and time, by an index of autonomy to abide by NPIs, adjusted for various socioeconomic and behavioural covariates.ResultsInability to comply with NPIs predicted higher infections when individuals reported not wearing a face covering outside. The main effect for inability to comply was OR 0.79 (95% CI 0.67 to 0.92), for wearing face covering/masks was OR 0.29 (95% CI 0.15 to 0.56) and the interaction term being OR 1.25 (95% CI 1.07 to 1.46). The youngest age groups had a significantly higher risk of infection (OR 1.52, 95% CI 1.28 to 1.82) as did women in larger households (OR 1.04, 95% CI 1.02 to 1.06). Effects varied over time with autonomy to follow NPIs only significant in the pre-second lockdown May–November 2020 period. Wearing a face covering outside was a significant predictor of a lower chance of infection before mid-December 2020 when a stricter second lockdown was implemented (OR 0.44, 95% CI 0.27 to 0.73).ConclusionThe protective effect of wearing a face covering/mask was the strongest for those who were the most unable to comply with NPIs. Higher infection rates were in younger groups and women in large households. Wearing a face covering or mask outside the home consistently and significantly predicted lower infection before the 2020 Christmas period and among women.


2021 ◽  
Vol 16 (Supp. 1) ◽  
pp. 73-81
Author(s):  
Dwi Kartika Sari ◽  
Febrina Rahmayanti ◽  
Harum Sasanti ◽  
Ambar Kusuma Astuti

The symptoms of recurrent oral herpes infection may vary, from mild discomfort to life threatening. Dentists are more likely to be consulted in this oral infection, hence the ability to diagnose and treat this disease is mandatory. This article described manifestation and therapy of recurrent oral herpes infection. In the first case, a 41-year-old woman came with a complaint of painful sore mouth in her lower gingiva. She experienced canker sores for two to three times a year on the tongue, lips and palate. Laboratory results showed positive IgM anti HSV-2, which matched with the primary herpes infection. However, based on the history and clinical manifestations, she was diagnosed with recurrent intra oral herpes infection. In the second case, a 70-year-old man came with a very painful canker sores in his entire mouth. The patient had to be hospitalised for three days and received analgesic, antibiotic and gel containing triamcinolone. After hospitalisation, canker sores did not heal. Extraorally, we found a crust in the vermillion border of the upper lip and intraorally, we found multiple ulceration of keratinised and non-keratinised mucosa. The use of topical steroid in this patient may aggravated ulceration due to its ability to cause rapid spreading of the virus. The first patient was given chlorhexidine gluconate 0.2% and the second patient was prescribed with doxycycline rinse. Both patients received multivitamin containing zinc. Complete history taking, objective and adjunctive examination played a role in establishing the diagnosis and treatment of recurrent oral herpes infections.


Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Primus Che Chi ◽  
Esther Awuor Owino ◽  
Irene Jao ◽  
Fredrick Olewe ◽  
Bernhards Ogutu ◽  
...  

Abstract Background Human infection studies (HIS) that involve deliberately infecting healthy volunteers with a pathogen raise important ethical issues, including the need to ensure that benefits and burdens are understood and appropriately accounted for. Building on earlier work, we embedded social science research within an ongoing malaria human infection study in coastal Kenya to understand the study benefits and burdens experienced by study stakeholders in this low-resource setting and assess the wider implications for future research planning and policy. Methods Data were collected using qualitative research methods, including in-depth interviews (44), focus group discussions (10) and non-participation observation. Study participants were purposively selected (key informant or maximal diversity sampling), including volunteers in the human infection study, study staff, community representatives and local administrative authorities. Data were collected during and up to 18 months following study residency, from sites in Coastal and Western Kenya. Voice recordings of interviews and discussions were transcribed, translated, and analysed using framework analysis, combining data- and theory-driven perspectives. Findings Physical, psychological, economic and social forms of benefits and burdens were experienced across study stages. Important benefits for volunteers included the study compensation, access to health checks, good residential living conditions, new learning opportunities, developing friendships and satisfaction at contributing towards a new malaria vaccine. Burdens primarily affected study volunteers, including experiences of discomfort and ill health; fear and anxiety around aspects of the trial process, particularly deliberate infection and the implications of prolonged residency; anxieties about early residency exit; and interpersonal conflict. These issues had important implications for volunteers’ families, study staff and the research institution’s reputation more widely. Conclusion Developing ethically and scientifically strong HIS relies on grounded accounts of volunteers, study staff and the wider community, understood in the socioeconomic, political and cultural context where studies are implemented. Recognition of the diverse, and sometimes perverse, nature of potential benefits and burdens in a given context, and who this might implicate, is critical to this process. Prior and ongoing stakeholder engagement is core to developing these insights.


2021 ◽  
Author(s):  
Joshua L Kennedy ◽  
J Craig Forrest ◽  
Sean G Young ◽  
Benjamin Amick ◽  
Mark Williams ◽  
...  

Objective: Our objective is to estimate CoV-2 infection rates in a rural state using seroprevalence of antibodies to CoV-2 as an indicator of infection. Study Design and Setting: This is a single-site study within an academic center and regional programs within the state of Arkansas. We obtained residual serum samples from a convenience sample of adults who were outpatients and came to the hospital or regional clinic for non-COVID-related reasons. We collected remnant in three time periods (August 15 to September 5, September 12 to October 24, and November 7 to December 19). Results: In 2020, the overall age, gender, and race standardized prevalence of CoV-2 antibodies was 2.6% (August to September), 4.1% (September to October), and 7.4% (November to December). There was no difference in seroprevalence between urban compared to rural areas. Positive tests were not uniformly distributed across racial and ethnic minorities. Higher seroprevalence rates were found in Hispanics and Blacks or African Americans compared to whites across all time periods. Conclusions: In a state with a large rural population, 2.6-7.4% of people experienced CoV-2 infection by December 2020. Blacks and Hispanics had disproportionately higher rates of CoV-2 infections than whites.


2021 ◽  
Vol 9 (7) ◽  
pp. 1394
Author(s):  
Elizabeth Jones ◽  
Celina Jin ◽  
Lisa Stockdale ◽  
Christina Dold ◽  
Andrew J. Pollard ◽  
...  

Vi-polysaccharide conjugate vaccines are efficacious against typhoid fever in children living in endemic settings, their recent deployment is a promising step in the control of typhoid fever. However, there is currently no accepted correlate of protection. IgG and IgA antibodies generated in response to Vi conjugate or Vi plain polysaccharide vaccination are important but there are no definitive protective titre thresholds. We adapted a luminescence-based serum bactericidal activity (SBA) for use with S. Typhi and assessed whether bactericidal antibodies induced by either Vi tetanus toxoid conjugate (Vi-TT) or Vi plain polysaccharide (Vi-PS) were associated with protection in a controlled human infection model of typhoid fever. Both Vi-PS and Vi-TT induced significant increase in SBA titre after 28 days (Vi-PS; p < 0.0001, Vi-TT; p = 0.003), however higher SBA titre at the point of challenge did not correlate with protection from infection or reduced symptom severity. We cannot eliminate the role of SBA as part of a multifactorial immune response which protects against infection, however, our results do not support a strong role for SBA as a mechanism of Vi vaccine mediated protection in the CHIM setting.


2021 ◽  
Author(s):  
Primus Che Chi ◽  
Esther Awuor Owino ◽  
Irene Jao ◽  
Fredrick Olewe ◽  
Bernhards Ogutu ◽  
...  

Abstract Background Human infection studies that involve deliberately infecting healthy volunteers with a pathogen raise important ethical issues, including the need to ensure that benefits and burdens are understood and appropriately accounted for. Building on earlier work, we embedded social science research within an ongoing malaria human infection study in coastal Kenya to understand the study benefits and burdens experienced by study stakeholders in this low-resource setting and assess the wider implications for future research planning and policy. Methods Data were collected using qualitative research methods, including in-depth interviews (44), focus group discussions (10) and non-participation observation. Study participants were purposively selected (key informant or maximal diversity sampling), including volunteers in the human infection study, study staff, community representatives and local administrative authorities. Data were collected during and up to 18 months following study residency, from sites in Coastal and Western Kenya. Voice recordings of interviews and discussions were transcribed, translated and analysed using Framework Analysis, combining data- and theory-driven perspectives. Findings Physical, psychological, economic and social forms of benefits and burdens were experienced across study stages. Important benefits for volunteers included the study compensation, access to health checks, good residential living conditions, new learning opportunities, developing friendships and satisfaction at contributing towards a new malaria vaccine. Burdens primarily affected study volunteers, including experiences of discomfort and ill-health; fear and anxiety around aspects of the trial process, particularly deliberate infection and the implications of prolonged residency; anxieties about early residency exit and interpersonal conflict. These issues had important implications for volunteers’ families, study staff and the research institution’s reputation more widely. Conclusion Developing ethically and scientifically strong HIS relies on grounded accounts of volunteers, study staff and the wider community, understood in the socioeconomic, political and cultural context where studies are implemented. Recognition of the diverse, and sometimes perverse, nature of potential benefits and burdens in a given context, and who this might implicate, is critical to this process. Prior and on-going stakeholder engagement is core to developing these insights, which can be importantly expanded and underlined through embedded forms of social science research.


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