Co-Infection Prevalence of Herpes Simplex Virus Types 1 and 2 with Human Papillomavirus and Associated Risk Factors among Asymptomatic Women in Ghana
Agyemang-Yeboah Francis,
Debrah Oksana,
Donkoh Emmanuel Timmy,
Asmah Harry Richard,
Seini Mustapha Mohammed
Issue:
Volume 3, Issue 3, September 2018
Pages:
45-51
Received:
30 August 2018
Accepted:
21 September 2018
Published:
23 October 2018
Abstract: Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) are among the most common human viral infections worldwide and associated with increased risk for other sexually transmitted infections, such as HPV. Unfortunately, there is a dearth of population data on the joint epidemiology of HPV-HSV infections in Ghana. In order to determine the prevalence of HSV-1 and HSV-2 co-infection with HPV and associated risk factors, 317 asymptomatic women attending the Cervicare Centers in Ghana were invited to participate in cross-sectional study. Serum HSV-1 and HSV-2 IgG were determined by ELISA method. Genomic DNA from cervical swabs was extracted using QIAamp Mini kit. HPV-DNA detection was carried out by nested multiplex PCR as was described by Sotlar et al., (2004). The mean age of study participants was 40.7 years (SD ± 11.2). Our result showed the prevalence of HSV-1 and HSV-2 infection among HPV positive women as 98.6% and 80.4% respectively. Among unscreened women participating in the study the co-infection of HSV-1/HPV and HSV-2/HPV was 42.9% and 35.0%, respectively. Age of coitache was associated with sero-prevalence of HSV-1 (p=0.010), HPV infection (p=0.016), and with co-infection HPV and HSV-1 (p=0.025), HPV and HSV-2 (p=0.011) and weakly with single HSV-2 infection (p=0.054). In conclusion, the high prevalence of co-infection was due to the endemicity and inadequate intervention in the study population. A woman’s age of sexual debut was a strong risk factor for co-infection of HPV and HSV-1 or HSV-2. The outcome of this novel observation stresses the urgent need to develop appropriate interventional strategies to manage and cancel patients presenting with asymptomatic genital herpes.
Abstract: Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) are among the most common human viral infections worldwide and associated with increased risk for other sexually transmitted infections, such as HPV. Unfortunately, there is a dearth of population data on the joint epidemiology of HPV-HSV infections in Ghana. In order to determine the prevalenc...
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Treatment of Clostridium Difficile Infection in Community Teaching Hospital: A Retrospective Study
Issue:
Volume 3, Issue 3, September 2018
Pages:
52-61
Received:
14 September 2018
Accepted:
9 October 2018
Published:
23 October 2018
Abstract: Clostridium difficile infection (CDI) is responsible for 15 – 25% cases of health-care associated diarrhea. The CDI treatment algorithm used at our hospital is adapted from the Infectious Diseases Society of America 2010 C. difficile guideline. The primary objective of this study was to assess the treatment adherence to our algorithm; this was defined as therapy consisting of the appropriate antibiotic, dose, route, interval and duration indicated based on the disease severity and episode within 24 hours of diagnosis. In addition, our study also described the population and their risk factors for CDI at our hospital. This was a single-centre, retrospective cohort chart review of CDI cases that were diagnosed at admission or during hospitalization from June 1st 2017 to June 30th 2018. Sixty cases were included, of which adherence to our algorithm was 50%. Overall, severe CDI had the highest treatment non-adherence (83%) and the biggest contributing factor was prescribing the wrong antibiotic (72%). In severe CDI, which warrants vancomycin monotherapy, wrong antibiotic consisted of metronidazole monotherapy (55%) or dual therapy with metronidazole and vancomycin (45%). Patients were mostly older, females being treated for an initial episode of mild to moderate CDI. Common risk factors identified were age over 65 years (80%), use of antibiotics (83%) and proton pump inhibitors (PPI) (68%) within the previous three months. The use of a PPI in this study, a modifiable risk factor without a clear indication was 35%. The conclusion was that there is an area for antimicrobial stewardship intervention in CDI treatment at our hospital is prescribing the right antibiotic based on the CDI indication. In severe CDI, an emphasis should be on prescribing vancomycin monotherapy as the drug of choice. PPI use should be reassessed for tapering when appropriate.
Abstract: Clostridium difficile infection (CDI) is responsible for 15 – 25% cases of health-care associated diarrhea. The CDI treatment algorithm used at our hospital is adapted from the Infectious Diseases Society of America 2010 C. difficile guideline. The primary objective of this study was to assess the treatment adherence to our algorithm; this was defi...
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Systemic Nocardiosis as Unusual Clinical Onset of Late Advanced HIV Infection: A Case Report
Santoro Carmen Rita,
Brindicci Gaetano,
Mazzola Michele,
Giannelli Anna,
Infante Giovanni,
Fiorella Carmen Silvia,
Pappalettera Antonio,
Capodivento Saverio,
Cascarano Marina,
Quinto Nicola,
Losappio Ruggero,
Laura Monno
Issue:
Volume 3, Issue 3, September 2018
Pages:
62-65
Received:
3 August 2018
Accepted:
12 September 2018
Published:
25 October 2018
Abstract: The genus Nocardia includes aerobic actinomycetes causing disease in both humans and animals. Nocardiosis is a rare bacterial infection, but the incidence of human disease has increased in the recent years in association with an increasing population of immune-compromised hosts and the improved methods for detection and identification of Nocardia spp. in the clinical laboratory. All those situations of immune-system compromise are conditions associated with increased risk, especially when cell-mediated immunity is involved. The prognosis depends both upon the immediacy of therapy initiation, concomitant disorders and the immune status of the patient. Recently cases of multi-drug resistance nocardiosis and the epidemiology and drug susceptibility of less common Nocardia species have been described. In HIV positive patients pulmonary nocardiosis, the most common clinical presentation, has a low reported prevalence of 0.3%, and it is not considered an AIDS-defining disease. The difficulties in isolation, the non-specific clinical and radiologic presentation, and the widespread use of cotrimoxazole (TMP/SMX) prophylaxis could be responsible for this low prevalence. In this paper, it is described a rare and fatal case of systemic nocardiosis arising with chest pain in a patient with a severe immune deficiency, unaware of his HIV positivity. Systemic nocardiosis is generally caused by N. asteroids and the prognosis is good, but in patients with AIDS, mortality in disseminated forms with central nervous system involvement is more than 50%.
Abstract: The genus Nocardia includes aerobic actinomycetes causing disease in both humans and animals. Nocardiosis is a rare bacterial infection, but the incidence of human disease has increased in the recent years in association with an increasing population of immune-compromised hosts and the improved methods for detection and identification of Nocardia s...
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