Health sequelae of human cryptosporidiosis—a 12-month prospective follow-up study

A prospective cohort study of all patients with laboratory-confirmed, genotyped cryptosporidiosis in Wales, aged 6 months -45 years of age was carried out over a two year period. 205/515 cases participated, a 40% response rate. At 12 months, bewteen a fifth and a third of cases reported persistent abdominal pain and diarrhea, joint pain and/or fatigue. The number reporting symptoms after C. hominis infection was statistically significantly greater compared with C. parvum. Post-infectious gastrointestinal dysfunction were common after cryptosporidiosis and around 10% of people merited a formal diagnosis of IBS following cryptosporidiosis

Cryptosporidium

The protozoan Cryptosporidium is notorious for its resistance to chlorine disinfection, a mainstay of water treatment. Human infections, mainly of the small intestine, arise from consumption of faecally contaminated food or water, environmental exposure, and person-to-person or animal-to-person spread. Acute gastrointestinal symptoms can be prolonged but are usually self-limiting. Problems arise with immune-deficient, including malnourished, people including chronic diarrhoea, hepato-biliary tree and extra-gastrointestinal site infection, and few options for treatment or prevention exist. Although genomics has enabled refined classification, identification of chemotherapeutic targets and vaccine candidates, and putative factors for host adaption and pathogenesis, their confirmation has been hampered by a lack of biological tools

Phylogenetic analysis of Mycobacterium tuberculosis strains in Wales using core genome MLST to analyse whole genome sequencing data

Inability to standardize the bioinformatic data produced by whole genome sequencing (WGS) has been a barrier to its widespread use in tuberculosis phylogenetics. The aim of this study was to carry out a phylogenetic analysis of tuberculosis in Wales, using Ridom Seqsphere software for core genome MLST (cgMLST) analysis of whole genome sequencing data. The phylogenetics of tuberculosis in Wales has not previously been studied. Sixty-six Mycobacterium tuberculosis isolates (including 42 outbreak-associated isolates) from South Wales were sequenced using an Illumina platform. Isolates were assigned to Principal Genetic Groups, Single Nucleotide Polymorphism (SNP) cluster groups, lineages and sub-lineages using SNP-calling protocols. WGS data were submitted to the Ridom SeqSphere software for cgMLST analysis and analysed alongside 179 previously lineage-defined isolates. The dataset was dominated by the Euro-American lineage, with the sub-lineage composition being dominated by T, X and Haarlem family strains. The cgMLST analysis successfully assigned 58 isolates to major lineages and results were consistent with those obtained by traditional SNP mapping methods. In addition, the cgMLST scheme was used to resolve an outbreak of tuberculosis occurring in the region. This study supports the use of a cgMLST method for standardized phylogenetic assignment of tuberculosis isolates and for outbreak resolution, and provides the first insight into Welsh tuberculosis phylogenetics, identifying the presence of the Haarlem sub-lineage commonly associated with virulent traits

Student Attainment in the First Year of a Master’s Degree in Veterinary Nursing: Do Entry Qualifications Matter?

Background: Entry to the VN profession is achieved through a parallel pathway of degree and diploma-level qualification. Post-registration, VNs are encouraged by the RCVS to participate in lifelong learning and gain higher levels of specialised skills, and since 2019 they have accredited a selection of postgraduate (PG) programmes. These programmes typically recruit students from varied academic backgrounds, however it is unclear if this impacts their attainment. Summary of work: This study aimed to describe student attainment and retention in the first year (PG certificate) of a three-year master’s degree in Advanced Practice in Veterinary Nursing. All 68 student admissions records were reviewed and anonymised demographic and academic data collected, including route of qualification and grade point average (GPA) following completion of 60-credits. The majority resided in the UK (63.2%), were female (95.6%), with a median age of 34 years. Most held a VN qualification that was below degree-level (73.5%), though 8.8% had also ‘topped-up’ to a degree. The median length of qualification was 7 years. Of the 41 students who had thus far completed 60-credits, all had achieved a passing GPA, with 51.2% classified as a merit, and 7.3% with a distinction. Students in the latter group all held VN qualifications below degree-level. The overall attrition rate was 14.7%, where 10.3% withdrew at the outset. Of the non-completers, 70% were below degree-level, 20% were degree-level, and 10% held both qualifications. No academic factors were associated with attainment at the 95% level of statistical significance. Take home message: Levels of student attainment on this PG programme were high and showed that VNs from all academic backgrounds can succeed at masters-level study. VNs who have qualified through non-degree routes should not be excluded from PG study but may require additional support at the start to prevent withdrawal