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Oesophagostomum stephanostomum causing parasitic granulomas in wild chimpanzees (Pan troglodytes verus) of Taï National Park, Côte d'Ivoire
Get PDFNematodes belonging to the genus Oesophagostomum frequently infect wild chimpanzees (Pan troglodytes) across widely separated field sites. Nodular lesions (granulomas) containing Oesophagostomum are commonly seen in the abdomen of infected chimpanzees post-mortem. At Taï National Park, Côte d'Ivoire, previous studies have identified larvae of a variety of Oesophagostomum spp. in wild chimpanzee stool, based on sequencing of larval DNA, and nodular lesions associated with Oesophagostomum, identified morphologically to the genus level but not sequenced. Here we present three recent cases of parasitic granulomas found post-mortem in chimpanzees at Taï. We complement descriptions of gross pathology, histopathology and parasitology with PCR and sequencing of DNA isolated from the parasitic nodules and from adult worms found inside the nodules. In all three cases, we identify Oesophagostomum stephanostomum as the causative agent. The sequences from this study were identical to the only other published sequences from nodules in nonhuman primates—those from the wild chimpanzees of Gombe, Tanzania.Peer Reviewe
The gut microbiome, resistome, and mycobiome in preterm newborn infants and mouse pups: lack of lasting effects by antimicrobial therapy or probiotic prophylaxis
Get PDFBackground:
Enhancing our understanding of the underlying influences of medical interventions on the microbiome, resistome and mycobiome of preterm born infants holds significant potential for advancing infection prevention and treatment strategies. We conducted a prospective quasi-intervention study to better understand how antibiotics, and probiotics, and other medical factors influence the gut development of preterm infants. A controlled neonatal mice model was conducted in parallel, designed to closely reflect and predict exposures. Preterm infants and neonatal mice were stratified into four groups: antibiotics only, probiotics only, antibiotics followed by probiotics, and none of these interventions. Stool samples from both preterm infants and neonatal mice were collected at varying time points and analyzed by 16 S rRNA amplicon sequencing, ITS amplicon sequencing and whole genome shotgun sequencing.
Results:
The human infant microbiomes showed an unexpectedly high degree of heterogeneity. Little impact from medical exposure (antibiotics/probiotics) was observed on the strain patterns, however, Bifidobacterium bifidum was found more abundant after exposure to probiotics, regardless of prior antibiotic administration. Twenty-seven antibiotic resistant genes were identified in the resistome. High intra-variability was evident within the different treatment groups. Lastly, we found significant effects of antibiotics and probiotics on the mycobiome but not on the microbiome and resistome of preterm infants.
Conclusions:
Although our analyses showed transient effects, these results provide positive motivation to continue the research on the effects of medical interventions on the microbiome, resistome and mycobiome of preterm infants.Peer Reviewe
The impact of information and communication technology on immunisation and immunisation programmes in low-income and middle-income countries: a systematic review and meta-analysis
Get PDFBackground:
Low-income and Middle-income Countries (LMIC) are continually working to ensure everyone can access life-saving vaccines. Recognising the considerable impact of Information and Communication Technology (ICT) in healthcare, we performed a systematic review and meta-analysis to summarise ICT effectiveness in improving vaccine delivery in LMICs.
Methods:
A systematic search from January 2010 to August 2023 in MEDLINE, EMBASE, Cochrane Library, BMJ Health & Care Informatics, and grey literature was performed. This search focused on randomised controlled trials (RCTs), non-RCTs, observational, and mixed-methods studies in English, examining ICT's effects on childhood immunisation in LMICs. Risk of bias in RCTs and non-RCTs was assessed using the Joanna Briggs Institute tool, and mixed-methods studies were evaluated with the Mixed Methods Appraisal Tool. A meta-analysis summarised ICT's impact on third pentavalent dose coverage and full immunisation by age one. The study is registered with PROSPERO (CRD42023446062).
Findings:
Of 6535 screened studies, 27 involving 354,979 children were included. All apart from one study demonstrated a positive impact on immunisation coverage and timeliness, completeness and accuracy of records, number of adverse events reporting, vaccine stockouts, and cold chain expansion. The meta-analysis demonstrated that reminders effectively improved coverage rate of the third dose of the pentavalent vaccine (OR 2.32, 95% CI 1.34–4.03) and the full immunisation at one year of age (OR 2.61, 95% CI 1.2–5.67) with significant degrees of heterogeneity, respectively I2 82% and I2 89%. Main concerns for bias in RCTs included unblinded outcome assessors and intervention providers. Interpreting quasi-experimental studies was more challenging due to the higher risk of baseline differences between study arms, statistical methods, and dropouts. Mixed-methods studies often lacked clarity in integrating qualitative and quantitative data.
Interpretation:
This systematic review confirms the benefits of ICT in immunisation programmes by enhancing various stages of vaccine delivery. Specifically, reminders have been shown to enhance childhood immunisation coverage rates.
Funding:
Deutsche Gesellschaft für Internationale Zusammenarbeit (German Corporation for International Cooperation, GIZ) as part of the Digital Innovation in Pandemic Control (DIPC) Initiative, financed by the Bundesministerium für Wirtschaftliche Zusammenarbeit (Federal Ministry for Economic Cooperation and Development, BMZ).Peer Reviewe
Diabetes self-management education programs: Results from a nationwide population-based study on characteristics of participants, rating of programs and reasons for non-participation
Get PDFObjective:
Population-based studies of reasons for not participating in diabetes self-management education (DSME) are scarce. Therefore, we investigated what sociodemographic and disease-related factors are associated with participation in DSME, the reasons for not participating in DSME and how participants evaluate DSME.
Research design and methods:
We used data from the nationwide survey “Disease knowledge and information needs–Diabetes mellitus 2017”, which included a total of 1396 participants diagnosed with diabetes mellitus (diabetes; n = 394 DSME-participants, n = 1002 DSME-never-participants). Analyses used weighted logistic or multinominal regression analyses with bivariate and multivariable approaches.
Results:
Participants were more likely to attend DSME if they had a medium (OR 1.82 [95%CI 1.21–2.73]),or high (OR 2.04 [95%CI 1.30–3.21]) level of education, had type 1 diabetes (OR 2.46 [1.24–4.90]) and insulin treatment (OR 1.96 [95%CI 1.33–2.90]). Participants were less likely to attend DSME if they lived in East Germany (OR 0.57 [95%CI 0.39–0.83]), had diabetes for >2 to 5 years (OR 0.52 [95%CI 0.31–0.88] compared to >5 years), did not agree that diabetes is a lifelong disease (OR 0.30 [95%CI 0.15–0.62], had never been encouraged by their physician to attend DSME (OR 0.19 [95%CI 0.13–0.27]) and were not familiar with disease management programs (OR 0.67 [95%CI 0.47–0.96]). The main reasons for non-participation were participant’s personal perception that DSME was not necessary (26.6%), followed by lack of recommendation from treating physician (25.7%) and lack of information on DSME (20.7%). DSME-participants found DSME more helpful if they had a medium educational level (OR 2.06 [95%CI 1.10–3.89] ref: low level of education) and less helpful if they were never encouraged by their treatment team (OR 0.46 [95%CI 0.26–0.82]).
Discussion:
Professionals treating persons with diabetes should encourage their patients to attend DSME and underline that diabetes is a lifelong disease. Overall, the majority of DSME participants rated DSME as helpful.Peer Reviewe
ARE-Wochenbericht KW 48
No full textDie ARE-Aktivität liegt weiterhin auf einem vergleichsweise hohen Niveau. Die Zahl schwer verlaufender Atemwegsinfektionen ist niedrig und liegt teilweise unter dem Niveau der Vorjahre. Das ARE-Geschehen wurde seit Juli 2024 hauptsächlich durch Rhinoviren und SARS-CoV-2 bestimmt. In den letzten Wochen war die SARS-CoV-2-Aktivität in den verschiedenen Surveillancesystemen rückläufig
Die Aktivität akuter respiratorischer Erkrankungen (ARE) in der Bevölkerung ist in der 48. KW 2024 im Vergleich zur Vorwoche gesunken.
Im ambulanten Bereich ist die Zahl der Arzt¬besuche wegen ARE in der 48. KW im Vergleich zur Vorwoche ebenfalls leicht gesunken.
Im Nationalen Referenzzentrum (NRZ) für Influenzaviren wurden in der 48. KW 2024 in insgesamt 104 der 161 eingesandten Proben aus dem ARE-Praxis-Sentinel respiratorische Viren identifiziert, darunter hauptsächlich Rhinoviren (27 %), mit größerem Abstand gefolgt von SARS-CoV-2 und humanen saisonalen Coronaviren (hCoV) mit jeweils 12 %, Parainfluenzaviren (PIV; 11 %) Influenza A- oder B-Viren (5 %) und Adenoviren (3 %). Respiratorische Synzytialviren (RSV) und humane Metapneumoviren (hMPV) wurden mit jeweils 1 % nachgewiesen. Influenza C-Viren wurden nicht detektiert.
Im Rahmen der ICD-10-Code basierten Krankenhaussurveillance (ICOSARI) ist die Zahl schwerer akuter respiratorischer Infektionen (SARI) in der 48. KW 2024 gesunken. Der Anteil der COVID 19-Diagnosen bei SARI-Patientinnen und -Patienten ist in den letzten Wochen zurückgegangen. Es wurde in der 48. KW bei 12 % der SARI-Fälle eine COVID-19-Diagnose vergeben. Eine Influenza-Diagnose wurde bei 2 % der Fälle vergeben und bei 1 % der Fälle eine RSV-Diagnose. In der virologischen SARI-Surveillance des NRZ für Influenzaviren wurden in drei der zwölf eingesandten Proben respiratorische Viren nachgewiesen (Rhinoviren, SARS-CoV-2, PIV). Die Zahl der an das RKI übermittelten COVID-19-Fälle gemäß IfSG ist in der 48. Meldewoche (MW) im Vergleich zur 47. MW weiter gesunken. Die Zahl der übermittelten Influenza- und RSV-Fälle ist dagegen gestiegen.
In der 46. KW 2024 wurde die rekombinante SARS-CoV-2 Sublinie XEC mit einem steigenden Anteil von 55 % nachgewiesen, die Sublinie KP.3.1.1 mit einem abnehmenden Anteil von 24 %.
Im Abwassermonitoring ist für die 48. KW kein klarer Trend der aggregierten SARS-CoV-2-Viruslast zu beobachten. Die Viruslast von Influenza A- und B-Viren liegt weiterhin im niedrigen Bereich, zeigt aber einen leicht erhöhten Wert im Vergleich zu den Vorwochen an
Surveillance of non-communicable diseases: What matters to users? A qualitative interview study
Get PDFBackground: Surveillance systems for diseases serve as an early warning system and orientation for decision-makers. As part of the National Diabetes Surveillance at the Robert Koch Institute (RKI), existing formats of information transfer were evaluated and an analysis of users’ requirements regarding the dissemination of results of surveillance for non-communicable diseases (NCD) was carried out.
Methods: 13 semi-structured guided interviews were conducted with persons from health politics, healthcare, media and science and analysed in a qualitative content analysis (interview survey period: 10/2022 – 01/2023).
Results: For all respondents, the frequency of diseases and their determinants, care and consequences were the focus of NCD surveillance. Wider determinants of health and illness situation were also considered relevant. Requirements regarding the presentation of these contents differed between the user groups. Factors that facilitate and inhibit the use of NCD surveillance information were consistent across the user groups.
Conclusions: There is a need for the presentation of options for action, especially for users involved in health politics and healthcare. Diabetes surveillance showed that many requirements are already met by the existing formats. Many of the users also wanted the content to be expanded to include other NCD
Jahre verlorenen Lebens (YLL) trotz frühzeitiger Diagnose und kompletter Entfernung eines pT1 Adenokarzinoms der Speiseröhre oder des Magens
No full textPatienten mit einem Frühkarzinom der Speiseröhre oder des Magens haben eine gute Prognose bei kurativer Entfernung des Tumors. Bisher wenig untersucht ist die Frage, ob die Diagnose eines solchen Tumors und die damit verbundene Therapie die Lebenserwartung der Patienten im Vergleich zur Normalbevölkerung beeinträchtigt.
Hauptfragestellung: Ist die Lebenserwartung von Patienten mit einem pT1-Adenokarzinom der Speiseröhre oder des Magens trotz kurativer Therapie im Vergleich zu einer geschlechts- und altersadaptierten Gruppe aus der Normalbevölkerung reduziert?
In einer aktuellen Studie haben wir untersucht, ob Patienten mit AC im Ösophagus bzw. Magen deren Tumor in einem frühen Stadium – pT1 – erfolgreich operiert wurden, die gleiche Lebenserwartung haben wie eine geschlechts- und altersadaptierte Gruppe aus der Normalbevölkerung. Die Ergebnisse zeigten, dass diese Patienten trotz R0-Resektion eine signifikant kürzere Lebenszeit im Vergleich zu der aktuellen Erwartung haben. Mit zunehmendem Alter nimmt die Anzahl verlorener Lebensjahre ab.
Da in der oben genannten Studie nur Patienten einer Klinik eingeschlossen waren, stellt sich die Frage, ob diese Ergebnisse auch für ein größeres Kollektiv nachzuweisen sind.
Hauptfragestellung: Ist die Lebenserwartung von Patienten mit einem pT1-Adenokarzinom der Speiseröhre oder des Magens trotz kurativer Therapie im Vergleich zu einer geschlechts- und altersadaptierten Gruppe aus der Normalbevölkerung reduziert
Maßnahmen bei Verdacht auf Infektion durch Marburg-Virus- Orientierungshilfe für Ärztinnen und Ärzte
Get PDFWastewater-based Surveillance on SARS-CoV-2
No full textThe viral load of SARS-CoV-2 as well as Influenza viruses is being tested at selected wastewater treatment plants (WWTP) in Germany as part of AMELAG (“Abwassermonitoring für die epidemiologische Lagebewertung”, German for wastewater monitoring for epidemiological situation assessment). Data from 169 WWTPs are currently included in the analyses for SARS-CoV-2 and 99 for Influenza A Virus and Influenza B Virus. For the calendar week 43 data from 136 WWTP were available for SARS-CoV-2 and from 89 WWTPs for Influenza A Virus and Influenza B Virus. Data from other WWTP are provided continuously.
A steep increase in the aggregated SARS-CoV-2 viral load can be observed since calendar week 38. The values for the Influenza viruses are currently low. The development observed over the last few weeks may still change due to late notifications, especially from WWTP with large population coverage