Mental health and resilience among Eritrean refugees at arrival and one-year post-registration in Switzerland: a cohort study

OBJECTIVE: Eritrea is the most frequent country of origin among asylum seekers in Switzerland. On their journey through the desert and across the Mediterranean Sea, Eritrea refugees are often exposed to traumatizing experiences. The aim of this study is to assess the mental health status and resilience of Eritrean migrants in Switzerland upon arrival and one-year post-arrival, using standardized mental health screening and resilience assessment tools. RESULTS: At baseline, 107 refugees (11.2% female, median age 25) were interviewed: 52 (48.6%) screened positive for Post-Traumatic Stress Disorder (score ≥ 30), 10.3% for anxiety (≥ 10) and 15.0% for depression (≥ 10); 17.8% scored as risk/hazardous drinkers (≥ 8). The majority (94.4%) had a high resilience score (≥ 65). For one-year follow-up, 48 asylum seekers could be reached. In interviews 18 (38%) of these reported imprisonment in a transit country and 28 (58%) that they had witnessed the death of a close person along the migration route. At the one year assessment, rates of risky/hazardous alcohol use remained unchanged, rates of positive PTSD screening tended to be lower (50.0% (24/48) at baseline vs 25.0% (12/48) at follow-up), as were rates of positive screening for anxiety (8.3% vs 4.2%) and depression (14.6 vs 6.3%)

Long-term outcome after SARS-CoV-2 infection in healthcare workers: a single centre cohort study

BACKGROUND: Long-term symptoms after acute COVID-19 are highly debated. Nevertheless, data on long-term symptoms of COVID-19 in healthcare workers are scarce. METHODS: We assessed frequency and risk factors of persisting symptoms in a retrospective cohort of healthcare workers infected with SARS-CoV-2. RESULTS: Persistent symptoms at 3 and 12 months were reported by 26.5% and 13.5% of participants, respectively. Most commonly reported symptoms were fatigue, impaired sense of taste or smell and general weakness. A history of depression or state of exhaustion, pre-existing lung disease and older age were associated with persisting symptoms. CONCLUSION: Our study shows that a relevant proportion of healthcare workers with mild COVID-19 report persisting symptoms over 3 and 12 months. Although in the majority of cases symptoms are mild, this study highlights the need for further research into causes and therapy

Reaching absent and refusing individuals during home-based HIV testing through self-testing-at what cost?

Introduction: In the HOSENG trial (NCT03598686), the secondary distribution of oral self-tests for persons absent or refusing to test during a home-based HIV testing campaign in rural Lesotho resulted in an increase in testing coverage of 21% compared to a testing campaign without secondary distribution. This study aims to determine the per patient costs of both HOSENG trial arms. Method: We conducted a micro-costing study to estimate the cost of home-based HIV testing with (HOSENG intervention arm) and without (HOSENG control arm) secondary self-test distribution from a provider's perspective. A mixture of top-down and bottom-up costing was used. We estimated both the financial and economic per patient costs of each possible testing cascade scenario. The costs were adjusted to 2018 US$. Results: The overall provider cost for delivering the home-based HIV testing with secondary distribution was US$36,481 among the 4,174 persons enumerated and 3,094 eligible for testing in the intervention villages compared to US$28,620 for 3,642 persons enumerated and 2,727 eligible for testing in the control. The cost per person eligible for testing was US$11.79 in the intervention vs. US$10.50 in the control. This difference was mainly driven by the cost of distributed oral self-tests. The cost per person tested was, however, lower in intervention villages (US$15.70 vs. US$22.15) due to the higher testing coverage achieved through self-test distribution. The cost per person confirmed new HIV+ was US$889.79 in the intervention and US$753.17 in the control. Conclusion: During home-based HIV testing in Lesotho, the secondary distribution of self-tests for persons absent or refusing to test during the visit reduced the costs per person tested and thus presents a promising add-on for such campaigns. Trial Registration:https://ClinicalTrials.gov/, identifier: NCT03598686

Cepheid Calibration of the Peak Brightness of SNe Ia. X. SN 1991T in NGC 4527

Repeated imaging observations have been made of NGC 4527 with the Hubble Space Telescope between April and June 1999, over an interval of 69 days. Images were obtained on 12 epochs in the F555W band and on five epochs in the F814W band. The galaxy hosted the type Ia supernova SN1991T, which showed relatively unusual behavior by having both an abnormal spectrum near light maximum, and a slower declining light curve than the proto-typical Branch normal SNe Ia. A total of 86 variables that are putative Cepheids have been found, with periods ranging from 7.4 days to over 70 days. From photometry with the DoPHOT program, the de-reddened distance modulus is determined to be (m-M)_0 = 30.67 +/- 0.12 (internal uncertainty) using a subset of the Cepheid data whose reddening and error parameters are secure. A parallel analysis of the Cepheids using photometry with ROMAFOT yields (m -M)_0 =30.82 +/- 0.11. The final adopted modulus is (m -M)_0 =30.74 +/- 0.12 +/- 0.12 (d=14.1 +/- 0.8 +/- 0.8 Mpc). The photometric data for SN1991T are used in combination with the Cepheid distance to NGC 4527 to obtain the absolute magnitude for this supernova of M_V^0(max) = -19.85 +/- 0.29. The relatively large uncertainty is a result of the range in estimates of the reddening to the supernova. Thus SN1991T is seen to be only moderately brighter (by ~ 0.3 mag) than the mean for spectroscopically normal supernovae, although magnitude differences of up to 0.6 mag cannot be ruled out.Comment: 46 pages, LATEX using aaspp4.sty, including 9 embedded tables, 19 figures (gif and jpg files), a full-resolution version (ps files) is available at http://www.astro.unibas.ch/forschung/ll/cepheid.shtml, accepted for publication in the Astrophysical Journa

Cepheid Calibration of the Peak Brightness of SNe Ia -- IX. SN 1989B in NGC 3627

(Abridged) Repeated imaging observations have been made of NGC 3627 with the HST in 1997/98, over an interval of 58 days. Images were obtained on 12 epochs in the F555W band and on five epochs in the F814W band. The galaxy hosted the prototypical, `Branch normal', type Ia supernova SN 1989B. A total of 83 variables have been found, of which 68 are definite Cepheid variables with periods ranging from 75 days to 3.85 days. The de-reddened distance modulus is determined to be (m-M)_0= 30.22+/-0.12 (internal uncertainty) using a subset of the Cepheid data whose reddening and error parameters are secure. The photometric data of Wells et al. (1994), combined with the Cepheid data for NGC 3627 give M_B(max)= -19.36+/-0.18 and M_V(max)= -19.34+/-0.16 for SN 1989B. Combined with the previous six calibrations in this program, plus two additional calibrations determined by others gives the mean absolute magnitudes at maximum of = -19.48+/-0.07 and = -19.48 +/-0.07 for `Branch normal' SNe Ia at this interim stage in the calibration program. The second parameter correlations of M(max) of blue SNe Ia with decay rate, color at maximum, and Hubble type are re-investigated. The dependence of on decay rate is non-linear, showing a minimum for decay rates between 1.0< Delta m_15 <1.6. Magnitudes corrected for decay rate show no dependence on Hubble type, but a dependence on color remains. Correcting both the fiducial sample of 34 SNe Ia with decay-rate data and the current 8 calibrating SNe Ia for the correlation with decay rate as well as color gives H_0= 60+/-2 (internal) km/s/Mpc, in both B and V. The same value to within 4% is obtained if only the SNe Ia in spirals (without second parameter corrections) are considered.Comment: 32 pages (with 7 tables and 14 figures) LaTeX, uses emulateapj.sty; a full-resolution version with complete figs. 4 and 5 is available at http://www.astro.unibas.ch/cosmology/papers.html ; accepted for publication in Ap

Effectiveness of a peer educator-coordinated preference-based differentiated service delivery model on viral suppression among young people living with HIV in Lesotho: the PEBRA cluster-randomized trial

BACKGROUND: Southern and Eastern Africa is home to more than 2.1 million young people aged 15 to 24 years living with HIV. As compared with other age groups, this population group has poorer outcomes along the HIV care cascade. Young people living with HIV and the research team co-created the PEBRA (Peer Educator-Based Refill of ART) care model. In PEBRA, a peer educator (PE) delivered services as per regularly assessed patient preferences for medication pick-up, short message service (SMS) notifications, and psychosocial support. The cluster-randomized trial compared PEBRA model versus standard clinic care (no PE and ART refill done by nurses) in 3 districts in Lesotho. METHODS AND FINDINGS: Individuals taking antiretroviral therapy (ART) aged 15 to 24 years at 20 clinics (clusters) were eligible. In the 10 clinics randomized to the intervention arm, participants were offered the PEBRA model, coordinated by a trained PE and supported by an eHealth application (PEBRApp). In the 10 control clusters, participants received standard nurse-coordinated care without any service coordination by a PE. The primary endpoint was 12-month viral suppression below 20 copies/mL. Analyses were intention-to-treat and adjusted for sex. From November 6, 2019 to February 4, 2020, we enrolled 307 individuals (150 intervention, 157 control; 218 [71%] female, median age 19 years [interquartile range, IQR, 17 to 22]). At 12 months, 99 of 150 (66%) participants in the intervention versus 95 of 157 (61%) participants in the control arm had viral suppression (adjusted odds ratio (OR) 1.27; 95% confidence interval [CI] [0.79 to 2.03]; p = 0.327); 4 of 150 (2.7%) versus 1 of 157 (0.6%) had died (adjusted OR 4.12; 95% CI [0.45 to 37.62]; p = 0.210); and 12 of 150 (8%) versus 23 of 157 (14.7%) had transferred out (adjusted OR 0.53; 95% CI [0.25 to 1.13]; p = 0.099). There were no significant differences between arms in other secondary outcomes. Twenty participants (11 in intervention and 9 in control) were lost to follow-up over the entire study period. The main limitation was that the data collectors in the control clusters were also young peers; however, they used a restricted version of the PEBRApp to collect data and thus were not able to provide the PEBRA model. The trial was prospectively registered on ClinicalTrials.gov (NCT03969030). CONCLUSIONS: Preference-based peer-coordinated care for young people living with HIV, compared to nurse-based care only, did not lead to conclusive evidence for an effect on viral suppression. TRIAL REGISTRATION: clinicaltrials.gov, NCT03969030, https://clinicaltrials.gov/ct2/show/NCT03969030

Emergence of human immunodeficiency virus-1 drug resistance during the 3-month World Health Organization-recommended enhanced adherence counseling period in the CART-1 cohort study

Background: In resource-limited settings, the World Health Organization recommends enhanced adherence counseling (EAC) for individuals with an unsuppressed human immunodeficiency virus (HIV)-1 viral load (VL) and to remeasure VL after 3 months to avoid unnecessary regimen switches. In cases in which this follow-up VL remains unsuppressed, a regimen switch is indicated. We aimed to assess levels of HIV-1 drug resistance before and after the EAC period among people with ongoing viremia (>/=80 c/mL) after EAC. Methods: We included adult participants of the CART-1 cohort study conducted in Lesotho who had a VL >/=80 c/mL after EAC. Paired plasma samples (before and after EAC) were analyzed by next-generation sequencing. We assessed the prevalence of resistance-associated mutations and viral susceptibility scores to each participant's antiretroviral therapy (ART) regimen (range, 0-3; 3 indicates complete susceptibility). Results: Among 93 participants taking nonnucleoside reverse-transcriptase inhibitor-based ART with an initial VL >/=1000 copies/mL who received a follow-up VL test after EAC, 76 still had a VL >/=80 copies/mL after EAC, and paired samples were available for 57 of 76. The number of individuals without full susceptibility to any drug in their regimen increased from 31 of 57 (54.4%) before to 36 of 57 (63.2%) after EAC. Median susceptibility scores dropped from 0.5 (interquartile range [IQR] = 0.25-) to 0.25 (IQR = 0.25-1) during the EAC period (P = .16). Conclusions: Despite high levels of resistance before EAC, we observed a slight decline in susceptibility scores after EAC. The risk of further accumulation of resistance during EAC has to be balanced against the benefit of avoiding unnecessary switches in those with spontaneous resuppression after EAC

Diagnosis of SARS-CoV-2 infection from breath - a proof-of-concept study

Bioaerosol capture and analysis is emerging as a non-invasive diagnostic method for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this proof-of-concept study conducted in Lesotho, we evaluated the novel and simple AL2 bioaerosol detection device in comparison to conventional nasopharyngeal sampling methods. We demonstrated for the first time that SARS-CoV-2 can be detected using the AL2 bioaerosol capture device. However, studies with a larger sample size are needed to further evaluate this bioaerosol capture device for the detection of SARS-CoV-2

A Cepheid Distance to NGC 4603 in Centaurus

In an attempt to use Cepheid variables to determine the distance to the Centaurus cluster, we have obtained images of NGC 4603 with the Hubble Space Telescope on 9 epochs using WFPC2 and the F555W and F814W filters. This galaxy has been suggested to lie within the ``Cen30'' portion of the cluster and is the most distant object for which this method has been attempted. Previous distance estimates for Cen30 have varied significantly and some have presented disagreements with the peculiar velocity predicted from redshift surveys, motivating this investigation. Using our observations, we have found 61 candidate Cepheid variable stars; however, a significant fraction of these candidates are likely to be nonvariable stars whose magnitude measurement errors happen to fit a Cepheid light curve of significant amplitude for some choice of period and phase. Through a maximum likelihood technique, we determine that we have observed 43 +/- 7 real Cepheids and that NGC 4603 has a distance modulus of 32.61 +0.11/-0.10 (random, 1 sigma) +0.24/-0.25 (systematic, adding in quadrature), corresponding to a distance of 33.3 Mpc. This is consistent with a number of recent estimates of the distance to NGC 4603 or Cen30 and implies a small peculiar velocity consistent with predictions from the IRAS 1.2 Jy redshift survey if the galaxy lies in the foreground of the cluster.Comment: Accepted for publication in the Astrophysical Journal. 17 pages with 17 embedded figures and 3 tables using emulateapj.sty. Additional figures and images may be obtained from http://astro.berkeley.edu/~marc/n4603