Joseph H Puyat, Sarah K Brode, Hennady Shulha, Kamily Romanowski, Dick Menzies, Andrea Benedetti, Raquel Duchen, Anjie Huang, Jiming Fang, Liane Macdonald, Ted K Marras, Elizabeth Rea, Jeffrey C Kwong, Michael A Campitelli, Jonathon R Campbell, Kevin Schwartzman, Victoria J Cook, James C Johnston
{"title":"Predicting risk of tuberculosis disease in people migrating to a low-TB incidence country: development and validation of a multivariable dynamic risk prediction model using health administrative data","authors":"Joseph H Puyat, Sarah K Brode, Hennady Shulha, Kamily Romanowski, Dick Menzies, Andrea Benedetti, Raquel Duchen, Anjie Huang, Jiming Fang, Liane Macdonald, Ted K Marras, Elizabeth Rea, Jeffrey C Kwong, Michael A Campitelli, Jonathon R Campbell, Kevin Schwartzman, Victoria J Cook, James C Johnston","doi":"10.1093/cid/ciae561","DOIUrl":"https://doi.org/10.1093/cid/ciae561","url":null,"abstract":"Background Tuberculosis (TB) incidence remains disproportionately high in people migrating to Canada and other low TB incidence countries, but systematic TB screening and prevention in migrants is often cost-prohibitive for TB programs. We aimed to develop and validate a TB risk prediction model to inform TB screening decisions in foreign-born permanent residents of Canada. Methods We developed and validated a proportional baselines landmark supermodel for TB risk prediction using health administrative data from British Columbia and Ontario, two distinct provincial healthcare systems in Canada. Demographic (age, sex, refugee status, year of entry, TB incidence in country of origin), TB exposure, and medical (HIV, kidney disease, diabetes, solid organ transplantation, cancer) covariates were used to derive and test models in British Columbia; one model was chosen for external validation in the Ontario cohort. The model’s ability to predict 2- and 5-year TB risk in the Ontario cohort was assessed using discrimination and calibration statistics. Results The study included 715,423 individuals (including 1,407 people with TB disease) in the British Columbia derivation cohort, and 958,131 individuals (including 1,361 people with TB disease) in the Ontario validation cohort. The 2- and 5-year concordance statistic in the validation cohort was 0.77 (95%CI: 0.75-0.78) and 0.77 (95%CI: 0.76-0.78), respectively. Calibration-in-the-large values were 0.14 (95% CI: 0.08-0.21) and -0.05 (95% CI: -0.12-0.02) in 2- and 5-year prediction windows. Conclusions This prediction model, available online at https://tb-migrate.com, may improve TB risk stratification in people migrating to low incidence countries and may help inform TB screening policy and guidelines.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"18 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142672863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erin Stafford, Dobromir Dimitrov, Susan Brown Trinidad, Laura Matrajt
{"title":"Closing the gap in race-based inequities for seasonal influenza hospitalizations: a modeling study.","authors":"Erin Stafford, Dobromir Dimitrov, Susan Brown Trinidad, Laura Matrajt","doi":"10.1093/cid/ciae564","DOIUrl":"10.1093/cid/ciae564","url":null,"abstract":"<p><strong>Background: </strong>BIPOC (Black, Indigenous, and other People of Color) communities bear a disproportional burden of seasonal influenza hospitalizations in the United States.</p><p><strong>Methods: </strong>We developed a race-stratified (5 racial-ethnic groups) agent-based model of seasonal influenza transmission and quantify the effects of 5 idealized interventions aimed at reducing inequities in symptomatic infections and hospitalizations. The interventions assumed (i) equalized vaccination rates, (ii) equalized comorbidities, (iii) work-risk distribution proportional to the distribution of the population, (iv) reduced work contacts for all, or (v) a combination of equalizing vaccination rates and comorbidities and reducing work contacts.</p><p><strong>Results: </strong>Our analysis suggests that symptomatic infections could be greatly reduced (by up to 17% in BIPOC adults aged 18-49) by strategies reducing work contacts or equalizing vaccination rates. All tested interventions reduced the inequity in influenza hospitalizations in all racial-ethnic groups, but interventions equalizing comorbidities were the most effective, with over 40% less hospitalizations in BIPOC groups. Inequities in hospitalizations in different racial-ethnic groups responded differently to interventions, pointing to the need of tailored interventions for different populations. Notably, these interventions resulted in better outcomes across all racial-ethnic groups, not only those prioritized by the interventions.</p><p><strong>Conclusions: </strong>In this simulation modeling study, equalizing vaccination rates and reducing number of work contacts (e.g., improving air filtration systems, tailored vaccination campaigns) reduced both inequity and the total number of symptomatic infections and hospitalizations in all age and racial-ethnic groups. Reducing inequity in influenza hospitalizations requires different interventions for different groups.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction to: Development of an Effective Immune Response in Adults With Down Syndrome After Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccination.","authors":"","doi":"10.1093/cid/ciae506","DOIUrl":"https://doi.org/10.1093/cid/ciae506","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction to: Immunogenicity, Safety, and Efficacy of a Tetravalent Dengue Vaccine in Children and Adolescents: An Analysis by Age Group.","authors":"","doi":"10.1093/cid/ciae504","DOIUrl":"https://doi.org/10.1093/cid/ciae504","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Linzy V Rosen, Acadia M Thielking, Caitlin M Dugdale, Grace Montepiedra, Emma Kalk, Soyeon Kim, Sylvia M LaCourse, Jyoti S Mathad, Kenneth A Freedberg, C Robert Horsburgh, A David Paltiel, Robin Wood, Andrea L Ciaranello, Krishna P Reddy
{"title":"Tuberculosis Preventive Treatment for Pregnant People With Human Immunodeficiency Virus in South Africa: A Modeling Analysis of Clinical Benefits and Risks.","authors":"Linzy V Rosen, Acadia M Thielking, Caitlin M Dugdale, Grace Montepiedra, Emma Kalk, Soyeon Kim, Sylvia M LaCourse, Jyoti S Mathad, Kenneth A Freedberg, C Robert Horsburgh, A David Paltiel, Robin Wood, Andrea L Ciaranello, Krishna P Reddy","doi":"10.1093/cid/ciae508","DOIUrl":"10.1093/cid/ciae508","url":null,"abstract":"<p><strong>Background: </strong>Although prior studies of tuberculosis-preventive treatment (TPT) for pregnant people with human immunodeficiency virus (PPWH) report conflicting adverse pregnancy outcome (APO) risks, international guidelines recommend TPT for PPWH.</p><p><strong>Methods: </strong>We used a microsimulation model to evaluate 5 TPT strategies among PPWH receiving antiretroviral therapy in South Africa: No TPT; 6 months of isoniazid (6H) or 3 months of isoniazid-rifapentine (3HP) during pregnancy (Immediate 6H or Immediate 3HP) or post partum (Deferred 6H or Deferred 3HP). The primary outcomes were maternal, fetal/infant, and combined deaths from causes potentially influenced by TPT (maternal tuberculosis, maternal hepatotoxicity, stillbirth, low birth weight [LBW], and infant tuberculosis). Tuberculosis during pregnancy confers 250% and 81% higher modeled risks of stillbirth and LBW, respectively. In lower-risk or higher-risk scenarios, immediate TPT confers 38% lower or 92% higher risks of stillbirth and 16% lower or 35% higher risks of LBW.</p><p><strong>Results: </strong>Immediate TPT would minimize deaths among PPWH. When TPT confers higher stillbirth and LBW risks, immediate TPT would produce the most combined maternal and fetal/infant deaths, even with low maternal CD4 cell count and high tuberculosis incidence. If immediate TPT yields a <4% or <20% increase in stillbirth or LBW, immediate TPT would produce fewer combined deaths than deferred TPT (sensitivity analysis range, <2%-22% and <11%-120%, respectively).</p><p><strong>Conclusions: </strong>If APO risks are below identifiable thresholds, TPT during pregnancy could decrease combined maternal and fetal/infant deaths. Given uncertainty around isoniazid's risks, and the low threshold at which APO risks could outweigh benefits from tuberculosis deaths averted, studies of newer TPT regimens among PPWH are warranted to inform guidelines.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ralph Habis, Anna Kolchinski, Ashley N Heck, Paris Bean, John C Probasco, Rodrigo Hasbun, Arun Venkatesan
{"title":"Encephalitis: playing with (bio)fire.","authors":"Ralph Habis, Anna Kolchinski, Ashley N Heck, Paris Bean, John C Probasco, Rodrigo Hasbun, Arun Venkatesan","doi":"10.1093/cid/ciae568","DOIUrl":"https://doi.org/10.1093/cid/ciae568","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecca Grant, Marlieke E A de Kraker, Niccolò Buetti, Holly Jackson, Mohamed Abbas, Jonathan Aryeh Sobel, Rami Sommerstein, Marcus Eder, Carlo Balmelli, Nicolas Troillet, Peter W Schreiber, Philipp Jent, Laurence Senn, Domenica Flury, Sarah Tschudin-Sutter, Michael Buettcher, Maria Süveges, Laura Urbini, Olivia Keiser, Ursina Roder, Stephan Harbarth, Marie-Céline Zanella
{"title":"In-hospital outcomes of healthcare-associated COVID-19 (Omicron) versus healthcare-associated influenza: a retrospective, nationwide cohort study in Switzerland.","authors":"Rebecca Grant, Marlieke E A de Kraker, Niccolò Buetti, Holly Jackson, Mohamed Abbas, Jonathan Aryeh Sobel, Rami Sommerstein, Marcus Eder, Carlo Balmelli, Nicolas Troillet, Peter W Schreiber, Philipp Jent, Laurence Senn, Domenica Flury, Sarah Tschudin-Sutter, Michael Buettcher, Maria Süveges, Laura Urbini, Olivia Keiser, Ursina Roder, Stephan Harbarth, Marie-Céline Zanella","doi":"10.1093/cid/ciae558","DOIUrl":"https://doi.org/10.1093/cid/ciae558","url":null,"abstract":"<p><strong>Background: </strong>As COVID-19 is integrated into existing infectious disease control programs, it is important to understand the comparative clinical impact of COVID-19 and other respiratory diseases.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients with symptomatic healthcare-associated COVID-19 or influenza reported to the nationwide, hospital-based surveillance system in Switzerland. Included patients were adults (≥18 years) hospitalized for ≥3 days in tertiary care and large regional hospitals. Patients had COVID-19 symptoms and a RT-PCR-confirmed SARS-CoV-2 infection ≥3 days after hospital admission between 1 February 2022 and 30 April 2023, or influenza symptoms and a RT-PCR-confirmed influenza A or B infection ≥3 days after hospital admission between 1 November 2018 and 30 April 2023. Primary and secondary outcomes were 30-day in-hospital mortality and admission to intensive care unit (ICU), respectively. Cox regression (Fine-Gray model) was used to account for time-dependency and competing events, with inverse probability weighting to adjust for confounding.</p><p><strong>Results: </strong>We included 2901 patients with symptomatic healthcare-associated COVID-19 (Omicron) and 868 patients with symptomatic healthcare-associated influenza from nine hospitals. We found a similar case fatality ratio between healthcare-associated COVID-19 (Omicron) (6.2%) and healthcare-associated influenza (6.1%) patients; after adjustment, patients had a comparable subdistribution hazard ratio for 30-day in-hospital mortality (0.91, 95%CI 0.67-1.24). A similar proportion of patients were admitted to ICU (2.4% COVID-19; 2.6% influenza).</p><p><strong>Conclusions: </strong>COVID-19 and influenza continue to cause severe disease among hospitalized patients. Our results suggest that in-hospital mortality risk of healthcare-associated COVID-19 (Omicron) and healthcare-associated influenza are comparable.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Oral antibiotics for S. aureus bacteremia including endocarditis: sauce for the goose is sauce for the gander.","authors":"Todd C Lee, Brad Spellberg, Emily G McDonald","doi":"10.1093/cid/ciae565","DOIUrl":"https://doi.org/10.1093/cid/ciae565","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Generalizability of oral therapy for S. aureus bacteremia or endocarditis: don't cook the goose.","authors":"Ahmad Mourad, Thomas L Holland, Timothy C Jenkins","doi":"10.1093/cid/ciae566","DOIUrl":"https://doi.org/10.1093/cid/ciae566","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}