Conectar
by Job Kasule, Julius L. Tonzel, Natalie Burns, Tyler Hamby, Roger Ying, Grace Mirembe, Immaculate Nakabuye, Hannah Kibuuka, Margaret Yacovone, Betty Mwesigwa, Trevor A. Crowell, for the Multinational Observational Cohort of HIV and other Infections (MOCHI) Study Group
BackgroundPeople with behavioral vulnerability to HIV face barriers to healthcare engagement that may impede uptake of non-pharmaceutical and other interventions to prevent COVID-19. Understanding COVID-19 knowledge, attitudes, and practices in this population can inform disease prevention efforts during future pandemics.
Materials and methodsFrom October 2022 to September 2024, we enrolled participants aged 14–55 years without HIV who endorsed recent sexually transmitted infection, injection drug use, transactional sex, condomless sex, and/or anal sex with male partners. At enrollment, we collected socio-behavioral data, including assessments of COVID-19 knowledge, attitudes, and practices. Robust Poisson regression with purposeful variable selection was used to estimate prevalence ratios with 95% confidence intervals for factors associated with COVID-19 preventive practices.
ResultsAmong 418 participants, 228 (56.9%) were female, the median age was 21 years (interquartile range 19−24), and 362 (84.9%) reported sex work. Knowledge about SARS-CoV-2 transmission routes was high (95.4%) but lower for the consequences of genetic variants (48.5%−69.7%) and possibility for asymptomatic infection or transmission (66.7%−80.8%). Handwashing was practiced by 90.8% of participants in the preceding month, whereas mask-wearing (76.5%), avoiding symptomatic people (73.7%), and any history of COVID-19 vaccination (46.9%) were less prevalent. Males were more likely to report avoiding symptomatic people (adjusted prevalence ratio 1.16 [95% confidence interval 1.03–1.31]) and COVID-19 vaccination (1.30 [1.05–1.60]). Enrollment during the BQ.1/BQ.1.1 Omicron wave was associated with less mask-wearing (0.81 [0.67–0.99]) but more vaccination (1.59 [1.29–1.95]).
DiscussionWe observed variable COVID-19 knowledge and attitudes among Ugandan adolescents and adults with little impact on COVID-19 preventive practices. Efforts to address suboptimal uptake of disease preventive practices during this and future disease outbreaks will require more than just improving knowledge.
by Annyi Tatiana Belalcazar, Valeria Monroy Lasso, José Darío Álvarez Herazo, Ana Clarete, Roger Figueroa-Paz, Duban Maya-Portillo, Julio Diez-Sepúlveda
BackgroundThe Shock Index (SI) is a validated prognostic tool in conditions such as severe trauma and obstetric hemorrhage. During the COVID-19 pandemic, it was used to identify patients at higher risk of clinical deterioration, but results have been inconsistent. This study aimed to evaluate the prognostic value of the SI and its variants in predicting mortality, need for mechanical ventilation, and hospital length of stay in patients with moderate COVID-19.
Methods and findingsThis longitudinal analytical observational study was conducted at a high-complexity hospital in southwestern Colombia and included adults over 18 years of age with moderate COVID-19 treated between 2020 and 2022, using data from the institutional RECOVID registry. A total of 283 patients were analyzed (median age: 61 years; 58.7% male), with cardiovascular and renal comorbidities being predominant. On admission, vital signs were stable (NEWS2: 3.0; shock index: 0.7). ICU admission was required in 29.3% of cases, and overall mortality was 12%. ROC curves and diagnostic accuracy parameters were used to assess the discriminatory ability of the SI and its variants. Most SI variants showed low discriminatory power (AUC Conclusions
Early identification of patients at risk for complications in moderate COVID-19 is essential for optimizing hospital resources. The shock index and its variants showed limited utility as standalone predictors for mortality, ICU admission, and hospital length of stay. Combining SI with other clinical parameters may offer some benefit, but heterogeneity limits generalizability. Future studies should develop and prospectively validate multivariable models integrating clinical, laboratory, and imaging biomarkers.
by Danai Sangthong, Pradit Sangthong, Warin Rangubpit, Prapasiri Pongprayoon, Eukote Suwan, Kannika Wongpanit, Wissanuwat Chimnoi, Pacharathon Simking, Sinsamut Sae Ngow, Serge Morand, Roger W. Stich, Sathaporn Jittapalapong
Phylogenetic and population genetic analyses were conducted on tick specimens collected from cattle in northern, northeastern, central, and southern regions of Thailand. Morphological identification indicated these ticks consisted of three species, Rhipicephalus microplus from all four regions, R. sanguineus from the northern and northeastern regions, and a Haemaphysalis species only collected from the northeastern region. Analysis of cytochrome c oxidase subunit I gene (COI) sequences identified R. microplus clades A and C, while clade B was not detected in this study. The same analysis indicated specimens morphologically identified as Haemaphysalis were H. bispinosa, confirming previous reports of their prevalence in northeastern Thailand. H. bispinosa showed low haplotype and nucleotide diversity, suggesting either a bottleneck or founder effect. Both R. microplus clades displayed high haplotype diversity and low nucleotide diversity, a pattern associated with population expansion. Genetic structural analysis revealed significant genetic differences in R. microplus clade A, especially between mainland (northern, northeastern, and central regions) and peninsular (southern region) populations, which indicated limited gene flow between these areas while suggesting movement of these ticks across the mainland. The sequence analyses described in this report enhance understanding of the natural history of ticks in Thailand and are expected to guide and strengthen tick control strategies across Southeast Asia.
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