Bivariate analysis of characteristics associated with bacteremia in parasitemic children <15 years stratified for parasite count (with p < 0.1).

<p>¹ Circulation impaired = cold extremities and/or capillary refill time ≤2 sec. and/or tachycardia</p><p>² Diarrhea >7 days</p><p>³ Dehydration ≥dehydration grade 1 (3–5%)</p><p>⁴ Leukocytosis = white blood cell count ≥10,000/μl; Leukopenia = white blood cell count <4,000/μl</p><p>Bivariate analysis of characteristics associated with bacteremia in parasitemic children <15 years stratified for parasite count (with p < 0.1).</p

Parsimonious multivariate regressions model of characteristics positively associated with bacteremia in parasitemic children, stratified for parasite count.

<p>¹ OR (CI), odds ratio (95% confidence interval)</p><p>² Dehydration ≥ grade 1 (3–5%)</p><p>Parsimonious multivariate regressions model of characteristics positively associated with bacteremia in parasitemic children, stratified for parasite count.</p

Unstratified bivariate and multivariate analysis of characteristics associated with bacteremia in parasitemic children <15 years (with p < 0.1).

<p>¹ OR (CI), odds ratio (95% confidence interval)</p><p>² Children who cannot hold their head at the age of three months, roll over at the age of 6 months, sit unsupported at the age of 9 months, stand unsupported at the age of 12 months or walk single steps at the age of 18 months</p><p>³ Circulation impaired = cold extremities and/or capillary refill time >2 sec. and/or tachycardia</p><p>⁴ Dehydration ≥dehydration grade 1 (3–5%)</p><p>⁵ Variables <i>developmental delay</i>, <i>exclusive breastfeeding</i> and <i>watery stool</i> were removed from multivariate analysis due to small case number (<300 cases)</p><p>* Predicts failure perfectly</p><p>** No calculation possible due to small case numbers</p><p>Unstratified bivariate and multivariate analysis of characteristics associated with bacteremia in parasitemic children <15 years (with p < 0.1).</p

Admissions, enrollment, frequencies and percentages of parasitemia/bacteremia.

<p>Admissions, enrollment, frequencies and percentages of parasitemia/bacteremia.</p

Test accuracy.

<p>¹ PPV, positive predictive value for bacteremia (for prevalence 12.7%)</p><p>² NPV, negative predictive value for bacteremia (for prevalence 12.7%)</p><p>³ Dehydration ≥ grade 1 (3–5%)</p><p>Test accuracy.</p

Basic data of the study group and socio-economic status.

<p>Basic data of the study group and socio-economic status.</p

Nasal Carriage of <i>Staphylococcus aureus</i> among Children in the Ashanti Region of Ghana

<div><p>Background</p><p>Nasal carriage with <i>Staphylococcus aureus</i> is a common risk factor for invasive infections, indicating the necessity to monitor prevalent strains, particularly in the vulnerable paediatric population. This surveillance study aims to identify carriage rates, subtypes, antimicrobial susceptibilities and virulence markers of nasal <i>S</i>. <i>aureus</i> isolates collected from children living in the Ashanti region of Ghana.</p><p>Methods</p><p>Nasal swabs were obtained from children < 15 years of age on admission to the Agogo Presbyterian Hospital between April 2014 and January 2015. <i>S</i>. <i>aureus</i> isolates were characterized by their antimicrobial susceptibility, the presence of genes encoding for Panton-Valentine leukocidin (PVL) and toxic shock syndrome toxin-1 (TSST-1) and further differentiated by <i>spa</i>-typing and multi-locus-sequence-typing.</p><p>Results</p><p>Out of 544 children 120 (22.1%) were colonized with <i>S</i>. <i>aureus</i>, with highest carriage rates during the rainy seasons (27.2%; p = 0.007), in females aged 6–8 years (43.7%) and males aged 8–10 years (35.2%). The 123 isolates belonged to 35 different <i>spa</i>-types and 19 sequence types (ST) with the three most prevalent <i>spa</i>-types being t355 (n = 25), t84 (n = 18), t939 (n = 13), corresponding to ST152, ST15 and ST45. Two (2%) isolates were methicillin-resistant <i>S</i>. <i>aureus</i> (MRSA), classified as t1096 (ST152) and t4454 (ST45), and 16 (13%) were resistant to three or more different antimicrobial classes. PVL and TSST-1 were detected in 71 (58%) and 17 (14%) isolates respectively.</p><p>Conclusion</p><p><i>S</i>. <i>aureus</i> carriage among Ghanaian children seems to depend on age, sex and seasonality. While MRSA rates are low, the high prevalence of PVL is of serious concern as these strains might serve not only as a source for severe invasive infections but may also transfer genes, leading to highly virulent MRSA clones.</p></div

No serological evidence for Zika virus infection and low specificity for anti-Zika virus ELISA in malaria positive individuals among pregnant women from Madagascar in 2010

<div><p>It was previously reported that a malaria infection may interfere with the specificity of a commercial ELISA test against Zika virus (ZIKV). We analyzed 1,216 plasma samples from healthy, pregnant women collected in two sites in Madagascar in 2010 for ZIKV antibodies using a commercial ELISA and for <i>Plasmodium</i> infection by PCR. This screen revealed six putative ZIKV-positive samples by ELISA. These results could not be confirmed by indirect immunofluorescence assays or virus neutralization tests. Four of these six samples were also positive for <i>P</i>. <i>falciparum</i>. We noted that the frequency of malaria positivity was higher in ZIKV-ELISA positive samples (50% and 100% in the two study sites) than ZIKV-negative samples (17% and 10%, respectively), suggesting that malaria may have led to false ZIKV-ELISA positives.</p></div

Demographic characteristics of study participants.

<p>Demographic characteristics of study participants.</p

Characterization of nasal <i>Staphylococcus aureus</i> isolates (n = 123).

<p>Characterization of nasal <i>Staphylococcus aureus</i> isolates (n = 123).</p