Conectar
Globally, curable sexually transmitted infections (STIs) are increasing, particularly in sub-Saharan Africa, yet epidemiological data remain limited, hindering progress towards the 2030 global STI targets. This study assessed the prevalence of self-reported STIs in the last 12 months among adolescent girls and women (AGW) and adolescent boys and men (ABM) aged 15–59 who ever had sex in Zambia and Zimbabwe at three time points. It also assessed whether observed changes across survey rounds persisted after adjusting for sociodemographic and sexual behaviour characteristics.
We analysed six rounds of Demographic and Health Surveys, three per country, collected between 2005 and 2018, using descriptive statistics and logistic regression, while accounting for survey design.
Zambia and Zimbabwe.
A total weighted sample of 86 366 AGW and ABM was included in the study.
Self-reported STIs in the last 12 months.
Overall, self-reported STI prevalence was higher in Zimbabwe than Zambia. Among Zambian ABM, self-reported STIs increased from 6.2% in 2007 to 7.1% in 2018 (adjOR=1.28, 95% CI 1.05 to 1.57, p=0.005). Among Zimbabwean AGW, prevalence decreased from 11.7% in 2005/2006 to 8.3% in 2015 (adjOR=0.72, 95% CI 0.61 to 0.85, p
These findings highlight differences in STI prevalence by sex and country across survey rounds, underscoring the need for tailored STI prevention, diagnostic and treatment strategies, particularly for high-risk groups.
To evaluate and map research examining clinical associations with the Duffy-null variant.
Scoping review of the existing literature.
We conducted a systematic search of PubMed, Embase, CINAHL and Web of Science for studies published in English between 1 January 2000 and 25 June 2024.
Studies were eligible for inclusion if they examined associations relevant to current standard clinical practice and met our protocol’s inclusion criteria.
We extracted the following information from included studies: study year(s), patient population, sample size, study design, primary outcome and primary findings. Studies were grouped by outcome and synthesised in tabular and qualitative formats.
A total of 2737 studies were screened, and 44 met our inclusion criteria. Most studies were observational, and the most common research question examined was the association with resistance to Plasmodium vivax malaria (9/44). Overall, we observed that the association between the Duffy-null variant and asymptomatic lower absolute neutrophil count (ANC) is demonstrated in large prospective cohort studies. The association with resistance to P. vivax malaria is primarily supported by large cross-sectional studies. There were no studies examining the practical applications of these findings, for example, optimal Duffy-genotype adjusted ANC thresholds for clinical decision-making in patients receiving chemotherapy. Finally, we observed that 19 different associations with this trait have been explored, several in conditions with no clear link to the Duffy trait, for example, progression rates in HIV/AIDS, risk of diabetes, etc.
We found established associations between the Duffy-null variant and asymptomatic lower ANC and with resistance to P. vivax malaria but a lack of data for the practical utilisation of these findings in clinical care. Future studies, such as those examining safe ANC values for entry into clinical trials and for ANC nadir for Duffy-null patients receiving medications associated with increased risk of neutropenia, for example, clozapine, are needed. We observed numerous reported associations of unclear clinical utility. Studies investigating associations with the Duffy trait should be guided by biologic plausibility and clinical utility of positive findings.
Previous studies have shown the COVID-19 pandemic was associated with reductions in volume across a spectrum of non-SARS-CoV-2 hospitalizations. In the present study, we examine the impact of the pandemic on patient safety and quality of care.
This is a retrospective population-based study of discharge abstracts.
We applied a set of nationally validated indicators for measuring the quality of inpatient care to hospitalizations in Ontario, Canada between January 2010 and December 2022. We measured 90-day mortality after selected types of higher risk admissions (such as cancer surgery and cardiovascular emergency) and the rate of patient harm events (such as delirium, pressure injuries and hospital-acquired infections) occurring during the hospital stay.
A total 13,876,377 hospitalization episodes were captured. Compared with the pre-pandemic period, and independent of SARS-CoV-2 infection, the pandemic period was associated with higher rates of mortality after bladder cancer resection (adjusted risk ratio [aRR] 1.20 (1.07–1.34)) and open repair for abdominal aortic aneurysm (aRR 1.45 (1.06–1.99)). The pandemic was also associated with higher rates of delirium (adjusted odds ratio [aOR] 1.04 (1.02–1.06)), venous thromboembolism (aOR 1.10 (1.06–1.13)), pressure injuries (aOR 1.28 (1.24–1.33)), aspiration pneumonitis (aOR 1.15 (1.12–1.18)), urinary tract infections (aOR 1.02 (1.01–1.04)), Clostridiodes difficile infection (aOR 1.05 (1.02–1.09)), pneumothorax (aOR 1.08 (1.03–1.13)), and use of restraints (aOR 1.12 (1.10–1.14)), but was associated with lower rates of viral gastroenteritis (aOR 0.22 (0.18–0.28)). During the pandemic, SARS-CoV-2-positive admissions were associated with a higher likelihood of various harm events.
The COVID-19 pandemic was associated with higher rates of patient harm for a wide range of non-SARS-CoV-2 inpatient populations.
Understanding which quality measures are improving or deteriorating can help health systems prioritize quality improvement initiatives.
No patient or public contribution.
To evaluate nurse practitioner (NP) roles during the peri-operative period and their association with healthcare outcomes, including length of stay (LOS), post-operative emergency department (ED) visits and 30-day readmissions.
A prospective observational study.
This study, conducted at an Israeli tertiary care centre between 2022 and 2023, included 188 patients from Paediatric Orthopaedics, General Surgery and Breast and Stoma Services. Data on patient demographics, clinical details and outcomes, including LOS, post-operative ED visits and 30-day readmissions, were extracted from medical records. NPs documented interventions they performed across the pre-operative, in-hospital and post-hospital phases. Associations between NP interventions and patient outcomes were analysed using multivariate regression models.
NPs performed an average of 6.7 interventions per patient across the peri-operative phases. A moderate-to-high number of interventions performed during the pre-operative phase was significantly associated with a shorter LOS. Performing a moderate-to-high number of interventions during the post-hospital phase was correlated with fewer ED visits and lower rates of 30-day readmission.
Interventions performed by NPs during the pre-operative and post-hospital phases were significantly linked to better patient outcomes, notably shorter hospitalizations and fewer post-discharge complications.
Recognising the role of NPs in peri-operative care may guide healthcare systems in optimising post-surgical care pathways, ultimately minimising preventable emergency visits, reducing hospital LOS and lowering readmission rates.
This study underscores the value of NPs as integral providers in peri-operative surgical care. Their involvement in pre-operative preparation and post-discharge coordination contributes meaningfully to patient recovery trajectories. The findings support expanding their role within surgical teams to enhance care continuity and promote better recovery outcomes.
The EQUATOR guidelines were used with the STROBE checklist for reporting this study.
No patient or public contribution.
FreshRSS 