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Fatigue in the general population: results of the “German Health Update 2023” study
No full textHintergrund:
Fatigue ist ein Symptomkomplex, geht mit Müdigkeit, Energiemangel und Konzentrationsschwäche einher und hat durch Zusammenhänge mit Arbeitsunfähigkeit, Unfallgefährdung und erhöhten Bedarfen an Gesundheitsversorgung hohe Public-Health-Relevanz.
Methode:
Die Analysen basieren auf Daten von 9766 Erwachsenen des Surveys „Gesundheit in Deutschland aktuell (GEDA)“ 2023. Fatigue wurde mit der Fatigue Assessment Scale (FAS) erfasst, ein validiertes Instrument mit 10 Fragen zur Selbsteinschätzung von Fatigue. Die Skala wurde dichotomisiert in Ja (mindestens milde bis moderate Fatigue) versus Nein (keine Fatigue). Bevölkerungsgewichtete Prävalenzen von Fatigue und assoziierten soziodemografischen und gesundheitsbezogenen Faktoren wurden in deskriptiven Analysen und multivariabler Poisson-Regression berechnet.
Ergebnisse:
Die Prävalenz von Fatigue bei Erwachsenen in Deutschland beträgt 29,7 % (95 %-KI: 28,1–31,2), ist bei 18- bis 29-Jährigen am höchsten (39,6 % (95 %-KI: 35,0–44,4)) und nimmt in den Altersgruppen von 65 bis 79 Jahren ab (20,6 % (95 %-KI: 18,2–23,3)). In der Gruppe der Hochaltrigen liegt sie wieder höher (33,2 % (95 %-KI: 28,9–37,7)). Frauen haben ein höheres Risiko für Fatigue als Männer (adjustiertes relatives Risiko (aRR) 1,19 (95 %-KI: 1,08–1,32)). Fatigue ist unabhängig von Kovariablen signifikant mit Alter, niedrigerer Bildung, chronischer Erkrankung, Depressivität und Long Covid assoziiert.
Diskussion:
GEDA 2023 gehört zu den wenigen bevölkerungsbezogenen Studien, die Daten zur Fatigue erhoben haben. Die Ergebnisse ermöglichen Einschätzungen für Deutschland zur Häufigkeit von Fatigue und zur Bedeutung körperlicher, psychischer und sozialer Einflussfaktoren. Sie können als Referenz bzw. als Basis für zeitliche Trends im kontinuierlichen Gesundheitsmonitoring in Deutschland genutzt werden.Background:
Fatigue is an unspecific symptom complex characterized by tiredness, lack of energy, and lack of concentration and is of considerable public health relevance, due to its links with incapacity for work, risk of accidents, and increased need for healthcare.
Methods:
The analyses are based on data from 9766 adults of the telephone survey “Gesundheit in Deutschland aktuell (GEDA)” 2023. Fatigue was recorded using the Fatigue Assessment Scale (FAS), a validated instrument with 10 questions for self-assessment of fatigue. The scale was dichotomized into yes (at least mild to moderate fatigue) versus no (no fatigue). Population-weighted prevalences of fatigue and associated sociodemographic and health-related factors were calculated in descriptive analyses and multivariable Poisson regression.
Results:
The overall prevalence of fatigue in adults in Germany is 29.7% (95% CI 28.1–31.2), is highest in 18- to 29-year-olds (39.6% (95% CI 35.0–44.4)), and decreases in the age groups up to 65–79 years (20.6% (95% CI 18.2–23.3)). It is higher again in the very old age group (33.2% (95% CI 28.9–37.7)). Women have a higher risk of fatigue than men (aRR 1.19 (95% CI 1.08–1.32)). Fatigue is significantly associated with age, lower education, chronic illness, depression, and long COVID, regardless of covariates.
Discussion:
GEDA 2023 is one of the few population-based studies to have collected data on fatigue. The results allow estimates to be made for Germany on the frequency of fatigue and the significance of physical, psychological, and social influencing factors. They can be used as a reference or as a basis for trends over time as part of continuous health monitoring in Germany.Peer Reviewe
Knowledge, attitudes and practices on prevention and control of high-consequence infectious diseases and critical care among intensive care personnel in Rwanda: a cross-sectional survey
Get PDFIntroduction:
Intensive care personnel in countries prone to outbreaks of high-consequence infectious diseases (HCIDs), such as Ebola virus disease, stand at the forefront of caring for affected patients. This study describes the knowledge, attitudes and practices (KAP) of intensive care personnel in Rwanda on the management and infection prevention and control (IPC) of HCIDs.
Methods:
A cross-sectional survey was carried out among staff working in the 4 operational intensive care units in September 2022. The self-administered questionnaire collected information on participants' background and their KAP on critical care (CC), HCIDs and IPC.
Results:
Of the 107 participants, 67 (62.6%) had less than 4 years' work experience in CC. 41 (38.3%) of them had attended trainings on IPC since 2020. In univariate analyses, a higher knowledge score was associated with being a physician, years of working in CC and differed by hospital. A large proportion perceived their knowledge on CC as good or very good (58.0%) and their everyday risk of acquiring an infection as at least high (48.6%). Overall, 72.9% reported compliance with hand hygiene measures. However, around a quarter of participants reported rarely or never avoiding recapping of needles or never or rarely taking additional precautions during aerosol-generating procedures.
Conclusions:
Staff had a moderate knowledge base and might benefit from continuous learning on CC and HCIDs. The perception of high risk of infection at work stands in contrast with lack of compliance with basic IPC practices which should be reinforced to avoid preventable and potentially fatal infections.Peer Reviewe
German adult population norm values of the short Warwick Edinburgh mental well-being scale (SWEMWBS)
Get PDFPurpose:
The Warwick-Edinburgh Mental Well-Being Scale represents an internationally established inventory to assess population mental well-being. Particularly the short form (SWEMWBS) is recommended for use in Mental Health Surveillance. In the present study, we present normative data of the SWEMWBS for the German adult population.
Methods:
Data from the telephone survey German Health Update (GEDA) in 2022 representative of the German adult population (48.9% women, 18–98 years) was processed to estimate SWEMWBS percentile norm values, T-values, z-values and internationally comparable logit-transformed raw scores for the total sample (N = 5,606) as well as stratified by sex, age group and sex with age group combinations.
Results:
The average mental well-being was comparable to that of other European countries at M = 27.3 (SD = 4.0; logit-transformed: M = 24.79, SD = 3.73). To provide a benchmark, the cut off for low well-being was set at the 15th percentile (raw score: 23; logit-transformed: 20.73), for high well-being at the 85th percentile (raw score: 32; logit-transformed: 29.31).
Conclusion:
The present study provides SWEMWBS norm values for the German adult population. The normative data can be used for national and international comparisons on a population level to initiate, plan and evaluate mental well-being promotion and prevention measures.Peer Reviewe
Estimation of COVID-19 vaccine effectiveness against infections and severe outcomes using routine surveillance data in Kosovo, July—September 2021
Get PDFBackground:
COVID-19 vaccines have proven effective against severe outcomes in many settings, yet vaccine effectiveness (VE) estimates remain lacking for Kosovo. We aimed to estimate VE against COVID-19 infections, hospitalisations, and deaths for one and two vaccine doses during the fourth pandemic wave in July—September 2021, the period when vaccination initially became widely available.
Methods:
We analysed routine surveillance data to define cases and vaccination status as partially (one dose) or completely (two doses) vaccinated. We used the screening method to calculate the proportion of cases with the outcomes vaccinated (PCV). The proportion of the population vaccinated (PPV) was based on numbers vaccinated and the Kosovo population estimate on 30/09/2021.
Results:
Between July—September 2021, 51,804 COVID-19 cases were reported in Kosovo with 9.3% of cases partially and 3.4% completely vaccinated. Estimated vaccine effectiveness for one dose was 93.1% (95%CI:92.9–93.2%) for infections, 90.3% (95%CI:88.8–91.7%) for hospitalisations, and 90.3% (95%CI:88.4–92.1%) for deaths. Estimated vaccine effectiveness for two doses was 97.8% (95%CI:97.6–97.9%) for infections, 94.5% (95%CI:93.3–95.6%) for hospitalisations, and 94.2% (95%CI: 93.7–96.5%) for deaths.
Conclusions:
This study provides real-world evidence for COVID-19 vaccine effectiveness in Kosovo using routine administrative data sources and the screening method. COVID-19 vaccine effectiveness against infections and severe outcomes in Kosovo was higher with two vaccine doses than one dose, which is in accordance with findings from other study designs and settings. Using the screening method in our study reflects an important initial methodology for estimating vaccine effectiveness with routine surveillance that may be particularly important for low- and middle-income settings with less robust surveillance systems or fewer opportunities to conduct more robust vaccine effectiveness study designs.Peer Reviewe
Epidemiological and Clinical Insights into the Enterovirus D68 Upsurge in Europe 2021–2022 and Emergence of Novel B3-Derived Lineages, ENPEN Multicentre Study
Get PDFEnterovirus D68 (EV-D68) infections are associated with severe respiratory disease and acute flaccid myelitis (AFM). The European Non-Polio Enterovirus Network (ENPEN) aimed to investigate the epidemiological and genetic characteristics of EV-D68 infections and its clinical impact during the fall-winter season of 2021–2022. From 19 European countries, 58 institutes reported 10 481 (6.8%) EV-positive samples of which 1004 (9.6%) were identified as EV-D68 (including 852 respiratory samples). Clinical data were reported for 969 cases; 78.9% of infections were reported in children (0–5 years); and 37.9% of cases were hospitalized. Acute respiratory distress was commonly noted (93.1%) followed by fever (49.4%). Neurological problems were observed in 6.4% of cases including 6 diagnosed with AFM. Phylodynamic/Nextstrain and phylogenetic analyses based on 694 sequences showed the emergence of 2 novel B3-derived lineages, with no regional clustering. In conclusion, we describe a large-scale European EV-D68 upsurge with severe clinical impact and the emergence of B3-derived lineages.Peer Reviewe
Prevalence of vaccine-derived hepatitis B surface antibodies in children and adolescents in Germany: results from a population-based survey, 2014–2017
Get PDFIntroduction:
Childhood vaccination against hepatitis B has been recommended in Germany since 1995. WHO defines a primary vaccination series as successful if the initial hepatitis B surface antibody (anti-HBs) level is ≥ 10 IU/L directly after vaccination. Anti-HBs levels vary depending on the number of doses, type of vaccine, and time interval between the last two doses. In 2021, Germany began to recommend three instead of four doses of polyvalent hepatitis-B-containing vaccines. Our aim was to estimate the proportion of vaccinated children in Germany with anti-HBs levels < 10 IU/L, 10–99 IU/L, and ≥ 100 IU/L by number and type of vaccine, and assess if number of doses and compliance with recommended time interval between the last two doses are associated with an anti-HBs level ≥ 10 IU/L when considering type of vaccine and time since last dose.
Methods:
We used data from a national cross-sectional study (2014–2017) of children (3–17 years). We excluded participants with unknown vaccination dates, unreadable or incomplete vaccination cards, and hepatitis B virus (HBV)-positive participants. We defined a recommended schedule as a vaccination series with at least six months between the two last doses and having three doses or more. We calculated weighted anti-HBs sero-prevalence for three anti-HBs levels: < 10 IU/L, 10–99 IU/L and ≥ 100 IU/L. We fitted two logistic regression models to examine the relationship between number of doses and recommended schedule on anti-HBs levels (≥ 10 IU/L and ≥ 100 IU/L) considering time since last dose and type of vaccine (Infanrix, Hexavac, Monovalent).
Results:
We included 2,489 participants. The weighted proportion of vaccinated children per anti-HBs level was < 10 IU/L: 36.3% [95%CI 34.0–38.7%], 10–99 IU/L: 35.7% [33.2–38.2%] and ≥ 100 IU/L: 28.0% [25.9–30.2%]. We did not find an association between a recommended schedule of three versus four doses and anti-HBs ≥ 10 IU/L or ≥ 100 IU/L.
Conclusions:
Anti-HBs levels in later childhood were about equal, whether children received three or four doses. This implies that the change in the recommendations does not affect the anti–HBs level among children in Germany. Future studies are needed on the association of anti-HBs levels and adequate sustained protection against HBV.Peer Reviewe
International Proficiency Test Targeting a Large Panel of Botulinum Neurotoxin Sero- and Subtypes in Different Matrices
Get PDFDetection of botulinum neurotoxins (BoNTs) involves a combination of technical challenges that call for the execution of inter-laboratory proficiency tests (PTs) to define the performance and ease of implementation of existing diagnostic methods regarding representative BoNT toxin-types spiked in clinical, food, or environmental matrices. In the framework of the EU project EuroBioTox, we organized an international proficiency test for the detection and quantification of the clinically relevant BoNT/A, B, E, and F sero- and subtypes including concentrations as low as 0.5 ng/mL. BoNTs were spiked in serum, milk, and soil matrices. Here, we evaluate the results of 18 laboratories participating in this PT. Participants have implemented a wide array of detection methods based on functional, immunological, and mass spectrometric principles. Methods implemented in this proficiency test notably included endopeptidase assays either coupled to mass spectrometry (Endopep-MS) or enzyme-linked immunosorbent assays (Endopep-ELISA). This interlaboratory exercise pinpoints the most effective and complementary methods shared by the greatest number of participants, also highlighting the importance of combining the training of selected methods and of distributing toxin reference material to reduce the variability of quantitative data.Peer Reviewe
Development and Evaluation of In-House ELISAs for the Detection of SARS-CoV-2-Specific Antibodies in COVID-19 Patients in Sri Lanka
Get PDFCOVID-19 serological tests complement the molecular diagnostics and can be used as important tool for serosurveillance and vaccine efficiency evaluation. The aim of this study was to develop and evaluate the diagnostic performance of an in-house ELISA for retrospective serosurveillance of SARS-CoV-2. Total IgG and IgM levels in sera of PCR positive SARS-CoV-2 patients (n = 50) from North Colombo Teaching Hospital were evaluated and compared with sera (n = 50) collected from prepandemic healthy individuals as controls. Patient sample collection was initiated before vaccination programme was widely started within the country. Seropositivity of 94.0% (n = 47/50) was observed for either IgG or IgM anti-SARS-CoV-2 antibodies against receptor binding domain of spike protein or nucleocapsid protein in confirmed cases while none of controls were seropositive. In contrast, the seropositivity of only 48.0% (n = 24/50) was demonstrated with commercial ELISA kits for detection of IgG or IgM. All samples detected seropositive by commercially available kits remained seropositive with either in-house IgM or IgG ELISA. Significant correlations (p ≤ 0.001) were observed between Ab levels and day of sampling from the onset of illness. The overall sensitivity values of the in-house assays were 66.7%, 96.9%, and 100.0% for the first, second, and third week or longer after onset of symptoms for either in-house IgM or IgG ELISAs. Majority of the patients (>80.0%) were seropositive, regardless of age (60 years), gender (male vs. female), or clinical severity (mild vs. moderate/severe). These data suggest that the developed in-house ELISAs can be applied to assess anti-SARS-CoV-2 antibody levels induced by either natural infections or vaccination.Peer Reviewe
Endogenous Bornavirus-like Elements in Bats: Evolutionary Insights from the Conserved Riboviral L-Gene in Microbats and Its Antisense Transcription in Myotis daubentonii
Get PDFBats are ecologically diverse vertebrates characterized by their ability to host a wide range of viruses without apparent illness and the presence of numerous endogenous viral elements (EVEs). EVEs are well preserved, expressed, and may affect host biology and immunity, but their role in bat immune system evolution remains unclear. Among EVEs, endogenous bornavirus-like elements (EBLs) are bornavirus sequences integrated into animal genomes. Here, we identified a novel EBL in the microbat Myotis daubentonii, EBLL-Cultervirus.10-MyoDau (short name is CV.10-MyoDau) that shows protein-level conservation with the L-protein of a Cultervirus (Wuhan sharpbelly bornavirus). Surprisingly, we discovered a transcript on the antisense strand comprising three exons, which we named AMCR-MyoDau. The active transcription in Myotis daubentonii tissues of AMCR-MyoDau, confirmed by RNA-Seq analysis and RT-PCR, highlights its potential role during viral infections. Using comparative genomics comprising 63 bat genomes, we demonstrate nucleotide-level conservation of CV.10-MyoDau and AMCR-MyoDau across various bat species and its detection in 22 Yangochiropera and 12 Yinpterochiroptera species. To the best of our knowledge, this marks the first occurrence of a conserved EVE shared among diverse bat species, which is accompanied by a conserved antisense transcript. This highlights the need for future research to explore the role of EVEs in shaping the evolution of bat immunity.Peer Reviewe