19 research outputs found
Risk factors for death among children 0–59 months of age with moderate-to-severe diarrhea in Manhiça district, southern Mozambique
Background: Despite major improvements in child survival rates, the number of deaths due to diarrhea remains
unacceptably high. We aimed to describe diarrhea-associated mortality and evaluate risk factors for death among
Mozambican children with moderate-to-severe diarrhea (MSD).
Methods: Between December 2007 and November 2012, children under-five with MSD were enrolled in Manhiça
district, as part of the Global Enteric Multicenter study (GEMS). Clinical, epidemiological, and socio-demographic
characteristics were collected. Anthropometric measurements were performed and stool samples collected upon
recruitment. A follow-up visit ~ 60 days post-enrolment was conducted and verbal autopsies performed in all death
cases.
Results: Of the 916 MSD-cases analyzed; 90% (821/916) completed 60 days follow-up and 69 patients died. The
case fatality rate at follow-up was 8% (69/821), and the mortality rate 10.2 (95%CI: 7.75–13.59) deaths per 1000
persons-week at risk. Nearly half of the deaths 48% (33/69) among study participants clustered within 2 weeks of
the onset of diarrhea.
Typical enteropathogenic Escherichia coli (typical EPEC) and Cryptosporidium were the two pathogens associated to
an increased risk of death in the univariate analysis with (HR = 4.16, p = 0.0461) and (H = 2.84, p = 0.0001)
respectively. Conversely, Rotavirus infection was associated to a decreased risk of death (HR = 0.52, p = 0.0198).
According to the multivariate analysis, risk factors for death included co-morbidities such as malnutrition (HR = 4.13,
p < 0.0001), pneumonia/lower respiratory infection (HR = 3.51, p < 0.0001) or invasive bacterial disease (IBD) (HR = 6.
80, p = 0.0009), presenting on arrival with lethargy or overt unconsciousness (HR = 1.73, p = 0.0302) or wrinkled skin
(HR = 1.71, p = 0.0393), and cryptosporidium infection (HR = 2.14, p = 0.0038).
When restricting the analysis to those with available HIV results (n = 191, 22% of the total study sample), HIV was
shown to be a significant risk factor for death (HR = 5.05, p = 0.0009).
Verbal autopsies were conducted in 100% of study deaths, and highlighted diarrhea as the main underlying cause
of death 39%, (27/69); followed by HIV/AIDS related deaths 29.0% (20/69) and sepsis 11.6% (8/69).Conclusion: Preventive strategies targeting Cryptosporidium, malnutrition and early identification and treatment of
associated co-morbidities could contribute to the prevention of the majority of diarrhea associated deaths in
Mozambican children
Invasive bacterial disease trends and characterization of group B streptococcal isolates among young infants in southern Mozambique, 2001-2015
BACKGROUND: Maternal group B streptococcal (GBS) vaccines under
development hold promise to prevent GBS disease in young
infants. Sub-Saharan Africa has the highest estimated disease
burden, although data on incidence and circulating strains are
limited. We described invasive bacterial disease (IBD) trends
among infants <90 days in rural Mozambique during 2001-2015,
with a focus on GBS epidemiology and strain characteristics.
METHODS: Community-level birth and mortality data were obtained
from Manhica's demographic surveillance system. IBD cases were
captured through ongoing surveillance at Manhica district
hospital. Stored GBS isolates from cases underwent serotyping by
multiplex PCR, antimicrobial susceptibility testing, and whole
genome sequencing. RESULTS: There were 437 IBD cases, including
57 GBS cases. Significant declines in overall IBD, neonatal
mortality, and stillbirth rates were observed (P<0.0001), but
not for GBS (P = 0.17). In 2015, GBS was the leading cause of
young infant IBD (2.7 per 1,000 live births). Among 35 GBS
isolates available for testing, 31 (88.6%) were highly related
serotype III isolates within multilocus sequence types (STs) 17
(68.6%) or 109 (20.0%). All seven ST109 isolates (21.9%) had
elevated minimum inhibitory concentration (MIC) to penicillin
(>/=0.12 mug/mL) associated with penicillin-binding protein
(PBP) 2x substitution G398A. Epidemiologic and molecular data
suggest this is a well-established clone. CONCLUSION: A notable
young infant GBS disease burden persisted despite improvements
in overall maternal and neonatal health. We report an
established strain with pbp2x point mutation, a first-step
mutation associated with reduced penicillin susceptibility
within a well-known virulent lineage in rural Mozambique. Our
findings further underscores the need for non-antibiotic GBS
prevention strategies
Escherichia coli ST131 clones harbouring AggR and AAF/V fimbriae causing bacteremia in Mozambican children: Emergence of new variant of fimH27subclone
Multidrug-resistant Escherichia coli ST131 fimH30 responsible for extra-intestinal pathogenic (ExPEC) infections is globally distributed. However, the occurrence of a subclone fimH27 of ST131 harboring both ExPEC and enteroaggregative E. coli (EAEC) related genes and belonging to commonly reported O25:H4 and other serotypes causing bacteremia in African children remain unknown. We characterized 325 E. coli isolates causing bacteremia in Mozambican children between 2001 and 2014 by conventional multiplex polymerase chain reaction and whole genome sequencing. Incidence rate of EAEC bacteremia was calculated among cases from the demographic surveillance study area. Approximately 17.5% (57/325) of isolates were EAEC, yielding an incidence rate of 45.3 episodes/105 children-years-at-risk among infants; and 44 of isolates were sequenced. 72.7% (32/44) of sequenced strains contained simultaneously genes associated with ExPEC (iutA, fyuA and traT); 88.6% (39/44) harbored the aggregative adherence fimbriae type V variant (AAF/V). Sequence type ST-131 accounted for 84.1% (37/44), predominantly belonging to serotype O25:H4 (59% of the 37); 95.6% (35/44) harbored fimH27. Approximately 15% (6/41) of the children died, and five of the six yielded ST131 strains (83.3%) mostly (60%; 3/5) due to serotypes other than O25:H4. We report the emergence of a new subclone of ST-131 E. coli strains belonging to O25:H4 and other serotypes harboring both ExPEC and EAEC virulence genes, including agg5A, associated with poor outcome in bacteremic Mozambican children, suggesting the need for prompt recognition for appropriate management
Burden of invasive pneumococcal disease among children in rural Mozambique: 2001-2012
BACKGROUND: Invasive pneumococcal disease (IPD) is a major cause
of illness and death among children worldwide. 10-valent
pneumococcal conjugate vaccine (PCV10) was introduced as part of
the Mozambican routine immunization program in April 2013. We
characterized the IPD burden in a rural area of Mozambique
before PCV introduction and estimated the potential impact of
this intervention. METHODS: We conducted population-based
surveillance for IPD, defined as S. pneumoniae isolated from
blood or cerebrospinal fluid, among children <5 years old
admitted to Manhica District Hospital, a referral hospital in a
rural area with high prevalence of human immunodiciency virus
infection. S. pneumoniae was identified using standard
microbiologic methods and serotyped using sequential multiplex
PCR or Quellung. IPD incidence was calculated among cases from a
defined catchment area. RESULTS: From January 2001 through
December 2012, we isolated 768 cases of IPD, 498 (65%) of which
were bacteraemic pneumonia episodes. A total of 391 (51%) were
from the catchment area, yielding IPD incidence rates of 479,
390 and 107 episodes per 100,000 children-years at risk among
children <12, 12-23 and 24-<60 months old, respectively.
The overall IPD incidence fluctuated and showed a downward trend
over time. In these same age groups, in-hospital death occurred
in 48 (17%), 26 (12%), and 21 (13%) of all IPD cases,
respectively. Overall 90% (543/603) of IPD isolates were
available for serotyping; of those, 65% were covered by PCV10
and 83% by PCV13. Among 77 hospital deaths associated with
serotyped IPD, 49% and 69% were caused by isolates included in
the PCV10 and PCV13, respectively. CONCLUSIONS: We describe very
high rates of IPD among children in rural Mozambique that were
declining before PCV introduction. Children <1 year old have
the greatest incidence and case fatality; although the rates
remain high among older groups as well. Most IPD episodes and
many deaths among children <5 years old will likely be
prevented through PCV10 introduction in Mozambique
The International Natural Product Sciences Taskforce (INPST) and the power of Twitter networking exemplified through #INPST hashtag analysis
Background: The development of digital technologies and the evolution of open innovation approaches have enabled the creation of diverse virtual organizations and enterprises coordinating their activities primarily online. The open innovation platform titled "International Natural Product Sciences Taskforce" (INPST) was established in 2018, to bring together in collaborative environment individuals and organizations interested in natural product scientific research, and to empower their interactions by using digital communication tools. Methods: In this work, we present a general overview of INPST activities and showcase the specific use of Twitter as a powerful networking tool that was used to host a one-week "2021 INPST Twitter Networking Event" (spanning from 31st May 2021 to 6th June 2021) based on the application of the Twitter hashtag #INPST. Results and Conclusion: The use of this hashtag during the networking event period was analyzed with Symplur Signals (https://www.symplur.com/), revealing a total of 6,036 tweets, shared by 686 users, which generated a total of 65,004,773 impressions (views of the respective tweets). This networking event's achieved high visibility and participation rate showcases a convincing example of how this social media platform can be used as a highly effective tool to host virtual Twitter-based international biomedical research events
Proyecto, investigación e innovación en urbanismo, arquitectura y diseño industrial
Actas de congresoLas VII Jornadas de Investigación “Encuentro y Reflexión” y I Jornadas de Investigación de becarios y doctorandos. Proyecto, investigación e innovación en Urbanismo, Arquitectura y Diseño Industrial se centraron en cuatro ejes: el proyecto; la dimensión tecnológica y la gestión; la dimensión social y cultural y la enseñanza en Arquitectura, Urbanismo y Diseño Industrial, sustentados en las líneas prioritarias de investigación definidas epistemológicamente en el Consejo Asesor de Ciencia y Tecnología de esta Universidad Nacional de Córdoba.
Con el objetivo de afianzar continuidad, formación y transferencia de métodos, metodología y recursos se incorporó becarios y doctorandos de los Institutos de investigación.
La Comisión Honoraria la integraron las tres Secretarias de Investigación de la Facultad, arquitectas Marta Polo, quien fundó y María del Carmen Franchello y Nora Gutiérrez Crespo quienes continuaron la tradición de la buena práctica del debate en la cotidianeidad de la propia Facultad.
Los textos que conforman las VII Jornadas son los avances y resultados de las investigaciones realizadas en el bienio 2016-2018.Fil: Novello, María Alejandra. Universidad Nacional de Córdoba. Facultad de Arquitectura, Urbanismo y Diseño; ArgentinaFil: Repiso, Luciana. Universidad Nacional de Córdoba. Facultad de Arquitectura, Urbanismo y Diseño; ArgentinaFil: Mir, Guillermo. Universidad Nacional de Córdoba. Facultad de Arquitectura, Urbanismo y Diseño; ArgentinaFil: Brizuela, Natalia. Universidad Nacional de Córdoba. Facultad de Arquitectura, Urbanismo y Diseño; ArgentinaFil: Herrera, Fernanda. Universidad Nacional de Córdoba. Facultad de Arquitectura, Urbanismo y Diseño; ArgentinaFil: Períes, Lucas. Universidad Nacional de Córdoba. Facultad de Arquitectura, Urbanismo y Diseño; ArgentinaFil: Romo, Claudia. Universidad Nacional de Córdoba. Facultad de Arquitectura, Urbanismo y Diseño; ArgentinaFil: Gordillo, Natalia. Universidad Nacional de Córdoba. Facultad de Arquitectura, Urbanismo y Diseño; ArgentinaFil: Andrade, Elena Beatriz. Universidad Nacional de Córdoba. Facultad de Arquitectura, Urbanismo y Diseño; Argentin
Carta de Víctor Delfino a Pedro Dorado Montero, de 12 de septiembre de 1918
Carta desde Buenos Aires (Argentina), de Víctor Delfino, médico y escritor argentino, a Pedro Dorado Montero, remitiéndole varios ejemplares del diario "La República" con comentarios sobre medidas adoptadas por el Ministerio de Justicia de Argentina para que Dorado exprese su opinión acera de las iniciativas de carácter penal