Effect of Preventive Supplementation with Zinc and other Micronutrients on Non-Malarial Morbidity in Tanzanian Pre-School Children: A Randomized Trial.

The efficacy of preventive zinc supplementation against diarrhea and respiratory illness may depend on simultaneous supplementation with other micronutrients. We aimed to assess the effect of supplementation with zinc and multiple micronutrients on diarrhea and other causes of non-malarial morbidity. Rural Tanzanian children (n = 612) aged 6-60 months and with height-for-age z-score < -1.5 SD were randomized to daily supplementation with zinc (10 mg) alone, multi-nutrients without zinc, multi-nutrients with zinc, or placebo. Children were followed for an average of 45 weeks. During follow-up, we recorded morbidity episodes. We found no evidence that concurrent supplementation with multi-nutrients influenced the magnitude of the effect of zinc on rates of diarrhea, respiratory illness, fever without localizing signs, or other illness (guardian-reported illness with symptoms involving skin, ears, eyes and abscesses, but excluding trauma or burns). Zinc supplementation reduced the hazard rate of diarrhea by 24% (4%-40%). By contrast, multi-nutrients seemed to increase this rate (HR; 95% CI: 1.19; 0.94-1.50), particularly in children with asymptomatic Giardia infection at baseline (2.03; 1.24-3.32). Zinc also protected against episodes of fever without localizing signs (0.75; 0.57-0.96), but we found no evidence that it reduced the overall number of clinic visits. We found no evidence that the efficacy of zinc supplements in reducing diarrhea rates is enhanced by concurrent supplementation with other micronutrients. By reducing rates of fever without localizing signs, supplementation with zinc may reduce inappropriate drug use with anti-malarial medications and antibiotics. ClinicalTrials.gov NCT00623857

Clinical Sensitivity, Specificity and Epidemiology of SARS-CoV-2 Serological Testing Using the Biozek COVID-19 Test

Background: Clinical validation using the Biozek COVID-19 test including sensitivity and specificity and associated patient-reported symptoms with SARS-CoV-2 seropositivity. Methods: 316 sera were analyzed including 47 hospitalized cases, 50 mild cases and 219 negative controls. Results were read visually by two technicians and in case of discrepancy by a third. Models were created between independent variables and IgG seropositivity using multivariable logistic regression analysis. Results: Sensitivity of both IgM and IgG together for hospitalized patients at all time periods was 68.1% (32/47) and 90.0% (27/30) after 10 days or more. From mild/asymptomatic cases the combined IgM and IgG sensitivity was 92.0% (46/50) and 91.8% (45/49) after 10 days or more. In the group of non-COVID-19 cases, the overall specificity was 99.1% (217/219). For IgG alone, the specificity was 99.5% (218/219). In the multivariable analysis loss of smell remained the strongest associated variable with an odds ratio (95%CI): 6.82 (5.61&ndash;8.31), p-value &lt; 0.001. Our final prediction model yielded a ROC-AUC of 0.77 (0.74&ndash;0.81) showing acceptable discrimination. Conclusions: The Biozek COVID-19 test showed high specificity and good sensitivity 10 days after the first sickness day. Solely IgM positive tests must be interpreted with caution and preferably excluded. In order to capture most symptomatic COVID-19 cases, loss of smell should be included within symptomatic screening policies

Performance of a novel melting curve-based qPCR assay for malaria parasites in routine clinical practice in non-endemic setting

Abstract Background High-quality malaria diagnosis is essential for effective treatment and clinical disease management. Microscopy and rapid diagnostic tests are the conventional methods performed as first-line malaria diagnostics in non-endemic countries. However, these methods lack the characteristic to detect very low parasitaemia, and accurate identification of the Plasmodium species can be difficult. This study evaluated the performance of the MC004 melting curve-based qPCR for the diagnosis of malaria in routine clinical practice in non-endemic setting. Methods and results Whole blood samples were collected from 304 patients with clinical suspicion of malaria and analysed by both the MC004 assay and conventional diagnostics. Two discrepancies were found between the MC004 assay and microscopy. Repeated microscopic analysis confirmed the qPCR results. Comparison of the parasitaemia of nineteen Plasmodium falciparum samples determined by both microscopy and qPCR showed the potential of the MC004 assay to estimate the parasite load of P. falciparum. Eight Plasmodium infected patients were followed after anti-malarial treatment by the MC004 assay and microscopy. The MC004 assay still detected Plasmodium DNA although no parasites were seen with microscopy in post-treatment samples. The rapid decline in Plasmodium DNA showed the potential for therapy-monitoring. Conclusion Implementation of the MC004 assay in non-endemic clinical setting improved the diagnosis of malaria. The MC004 assay demonstrated superior Plasmodium species identification, the ability to indicate the Plasmodium parasite load, and can potentially detect submicroscopic Plasmodium infections

Einleitung in die schönen Wissenschaften

nach dem Französischen des Herrn Batteux mit Zusätzen vermehret von Karl Wilhelm RamlerIn Fraktu

Incidence of various illnesses, by treatment group.

<p>Values indicate the total number of episodes per child-year observed. Numbers between brackets indicate the number of cases.</p>*<p>Measured in a Cox proportional hazard model as the hazard ratio associated with the interaction term between zinc and multi-nutrients.</p

Trial profile.

<p>Compliance was measured as the proportion of children who consumed.95% of scheduled supplements.</p

Incidence rates for various illnesses, stratified by the presence of fever.

<p>Values indicate the total number of episodes per child-year observed. Numbers between brackets indicate the number of episodes.</p><p>NA: Not applicable (fever is part of the case definition).</p>*<p>Among these, the following number of cases was also classified as malaria: reported diarrhea: 137 (35%); reported diarrhea with ≥3 loose stools/24 h: 69 (30%); reported cough: 491 (36%); other: 166 (22%).</p>†<p>Includes symptoms of skin, ears, and eyes and abscesses; excluding trauma or burns.</p>‡<p>Cases classified as fever without localizing signs are not included in any of the other categories.</p