Risultati per: L’eparina inibisce la proteina spike del virus SARS-Cov-2

Objective
To evaluate the use of antigen-based rapid diagnostic tests (Ag-RDTs) alongside a digital tool to deliver household-level COVID-19 testing by community health workers (CHWs), in line with Rwanda’s ambition to decentralise COVID-19 testing.

Design
This was an operational pilot study to evaluate the impact and operational characteristics of using the digital e-ASCov tool combined with Ag-RDTs to support COVID-19 symptom screening and rapid testing by CHWs across eight districts in Rwanda. A total of 800 CHWs selected from both rural and urban areas were trained in delivering Ag-RDTs for COVID-19 testing and using the e-ASCOV application for data capture on a smartphone. Laboratory technicians repeated a subset of Ag-RDTs to assess the concordance of results obtained by CHWs. The study also assessed CHWs’ experience of the intervention using a mixed-methods approach.

Setting
Eight rural, urban and semiurban districts in Rwanda.

Participants
A total of 19 544 individuals were enrolled and screened for signs and symptoms of COVID-19.

Interventions
Community-based screening for COVID-19 by CHWs using the digital tool e-ASCov combined with rapid testing using Ag-RDTs.

Main outcome measures
Number of participants screened and tested; concordance of Ag-RDT results between CHWs and laboratory technicians; feasibility of study procedures by CHWs and CHWs perceptions of the digital tool and Ag-RDT testing.

Results
From February to May 2022, CHWs screened 19 544 participants, of whom 4575 (23.4%) had COVID-19-related symptoms or a history of exposure to the infection. Among them, 86 (1.9%) were positive on Ag-RDTs. Concordance of Ag-RDT results between CHWs and laboratory technicians was 100%. Of the 800 trained CHWs, 746 (93.3%) were independently able to conduct household-based COVID-19 screening, perform the Ag-RDTs and send data to the central server. Most CHWs ( >80%) found Ag-RDTs and e-ASCOV easy to use.

Conclusions
This study demonstrated the feasibility of deploying a digital tool and Ag-RDTs for household-level SARS-CoV-2 detection in Rwanda. The findings support a broader roll-out of digitally supported rapid testing by CHWs to broaden access to testing for priority diseases.

New England Journal of Medicine, Volume 391, Issue 12, Page 1096-1107, September 26, 2024.

The Pan American Health Organization (PAHO) released an epidemiological alert following an increase in Oropouche cases in previously unaffected areas during the first half of 2024. At the end of July, there were more than 8000 confirmed cases and 2 confirmed deaths throughout 5 countries in Latin America.

These results support larger cross sectional findings indicating that mild Wildtype SARS-CoV-2 infection can be followed by small changes in cognition and memory that persist for at least a year. The mechanistic basis and clinical implications of these small changes remain unclear.

Objectives
To investigate the relationship between herpes simplex virus (HSV) and hearing loss using comprehensive population-based research.

Design
This cross-sectional study utilised data from the National Health and Nutrition Examination Survey (NHANES) to examine the relationship between HSV (types 1 and 2) and hearing loss. The final sample comprised 4608 participants aged 20–49 years. Weighted multivariate regression, subgroup and sensitivity analyses were employed for statistical evaluations.

Setting
Utilising the NHANES data, this cross-sectional study provides insights into the American population aged 20–49 years.

Participants
The study includes 4608 participants from the NHANES 2011–2012 and 2015–2016 cycles, focusing on those with complete data on HSV infection and hearing assessment.

Interventions (exposure)
The study analyses the association between HSV (types 1 and 2) infection and hearing loss, using weighted multivariate regression for statistical evaluations.

Results
We observed an association between HSV-1 infection and an increased likelihood of hearing impairment (OR, 1.4 (95% CI 1.1 to 1.9)). A similar association was noted for those coinfected with HSV-1 and HSV-2 (OR, 1.6 (95% CI 1.1 to 2.3)). Similarly, higher grades of hearing loss and elevated pure-tone averages were more prevalent in these groups. Notably, the association between HSV-1 and hearing impairment was more pronounced in individuals aged 20–34 (OR, 2.1 (95% CI 1.4 to 3.3); P for interaction=0.020) and those with a body mass index (BMI) below 30 (OR, 1.8 (95% CI 1.1 to 2.8); P for interaction=0.028).

Conclusions
Our findings suggest an association between HSV-1 infection or coinfections with HSV-1 and HSV-2 and the presence of hearing impairment. The association appears particularly pronounced among younger individuals and those with a lower BMI. Further prospective research is needed to explore the causal impact of HSV on auditory function.

Verso commissione straordinaria, possibile fascia A entro 2 mesi

Comunicato del 20/09/2024 n°27

Campitiello: “una nota alle Regioni, prevenzione per bambini”

SARS-CoV-2, the virus that causes COVID-19, has previously been identified in certain species of wildlife, including white-tailed deer. But new research in Nature Communications suggests it may be common in other types of wildlife, especially species living near high-trafficked human areas.

Lo rivela una ricerca sul New England Journal of Medicine

La scoperta apre la strada all’identificazione di un biomarcatore per la diagnosi precoce e a future vie terapeutiche

Studio UnivPM-Inrca, Università Catania e Università Cattolica

New England Journal of Medicine, Ahead of Print.

And vaccination against shingles was associated with lower subsequent risk for vascular dementia or Alzheimer disease.

Objectives
In high-income countries hepatitis E virus (HEV) is an uncommonly diagnosed porcine-derived zoonoses. After identifying disproportionate chronic HEV infections in persons with cystic fibrosis (pwCF) postlung transplant, we sought to understand its epidemiology and potential drivers.

Design
All pwCF post-transplant attending our regional CF centre were screened for HEV. HEV prevalence was compared against non-transplanted pwCF and with all persons screened for suspected HEV infection from 2016 to 2022 in Alberta, Canada. Those with chronic HEV infection underwent genomic sequencing and phylogenetic analysis. Owing to their swine derivation, independently sourced pancreatic enzyme replacement therapy (PERT) capsules were screened for HEV.

Results
HEV seropositivity was similar between transplanted and non-transplanted pwCF (6/29 (21%) vs 16/83 (19%); p=0.89). Relative to all other Albertans investigated for HEV as a cause of hepatitis (n=115/1079, 10.7%), pwCF had a twofold higher seropositivity relative risk and this was four times higher than the Canadian average. Only three chronic HEV infection cases were identified in all of Alberta, all in CF lung transplant recipients (n=3/29, 10.3%). Phylogenetics confirmed cases were unrelated porcine-derived HEV genotype 3a. Ninety-one per cent of pwCF were taking PERT (median 8760 capsules/person/year). HEV RNA was detected by RT-qPCR in 44% (47/107) of PERT capsules, and sequences clustered with chronic HEV cases.

Conclusion
PwCF had disproportionate rates of HEV seropositivity, regardless of transplant status. Chronic HEV infection was evident only in CF transplant recipients. HEV may represent a significant risk for pwCF, particularly post-transplant. Studies to assess HEV incidence and prevalence in pwCF, and potential role of PERT are required.

Infection with the hepatitis E virus (HEV) is the leading cause of acute viral hepatitis worldwide. With an estimated number of 20 million infections and 3.3 million symptomatic cases, accounting for 3.3% of viral hepatitis-related deaths annually, HEV poses a major public health threat.1 2 Transmission of HEV occurs mainly by the faecal-oral route in low-income and middle-income countries due to poor sanitation. Here, endemic outbreaks and sporadic cases are mainly caused by infection with genotypes 1 and 2 (HEV-1 and HEV-2), which exclusively infect humans. In developed countries, only sporadic cases of HEV infection are reported, which are attributed mostly to zoonotic genotypes 3 and 4 (HEV-3 and HEV-4) infections. As swine represents the main reservoir for HEV-3, transmission is usually linked to the consumption of undercooked pork products.3 However, due to the lack of specific antiviral therapy, thorough risk assessment is…