Therapeutic Advances in Infectious Disease最新文献

{"title":"Secondary spontaneous pneumothorax due to extensive pulmonary tuberculosis in a patient with acute hepatitis B flare: clinical challenges and therapeutic decision making-a case report.","authors":"Loi Trinh Duc, Bang Ngoc Dao, Cong Nguyen Hai","doi":"10.1177/20499361261452939","DOIUrl":"10.1177/20499361261452939","url":null,"abstract":"<p><p>Secondary spontaneous pneumothorax (SSP), particularly when complicated by a persistent air leak, is an uncommon but serious manifestation of active pulmonary tuberculosis. Such cases often require pleural drainage or surgical intervention. Management becomes significantly more challenging when patients present with extensive pulmonary disease, compromised general condition, and severe comorbidities. We describe a 28-year-old male with bilateral extensive pulmonary tuberculosis, persistent right-sided pneumothorax, and a severe acute flare of chronic hepatitis B. Conventional management, including pleural drainage and chemical pleurodesis, was unsuccessful, and the patient's acute hepatic injury precluded the use of standard first-line anti-tuberculosis therapy. The primary clinical dilemma involved balancing the need for surgical repair of the persistent air fistula against the prohibitive perioperative risks posed by his hepatic dysfunction and poor systemic condition. A conservative, individualized medical strategy-comprising modified anti-tuberculosis therapy, supplemental oxygen, nutritional optimization, and comprehensive liver support-was selected. Over 6 months, the patient demonstrated progressive improvement in hepatic function and overall physical status, substantial radiologic recovery of pulmonary lesions, and complete resolution of the right pneumothorax. This case highlights that a carefully tailored, conservative medical approach may yield favorable long-term outcomes in SPP secondary to pulmonary tuberculosis, particularly in patients with significant surgical contraindications. Optimizing anti-tuberculosis therapy remains central to promoting lung parenchymal healing and resolving pneumothorax.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261452939"},"PeriodicalIF":3.8,"publicationDate":"2026-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision geospatial targeting for cost-effective tuberculosis case finding in Eastern Uganda: a quasi-experimental study.","authors":"Clark Joshua Brianwong, Diana Cherotin, Lwanga Sssekiswa Zimwanguyiza, Richard Kyakuwa Jjuuko, Patricia Ntege Nahirya, Alexander Mugume, Dithan Kiragga","doi":"10.1177/20499361261456596","DOIUrl":"10.1177/20499361261456596","url":null,"abstract":"<p><strong>Background: </strong>Universal community-based tuberculosis (TB) screening in high-burden settings is resource-intensive and inefficient, frequently missing cases and leading to suboptimal resource allocation. Integrating routine surveillance data with geospatial analytics offers a promising approach to enhance the efficiency and cost-effectiveness of active case finding.</p><p><strong>Objective: </strong>To evaluate whether integrating Uganda's electronic Case-Based Surveillance System (eCBSS) data with geospatial hotspot analytics improves the efficiency, yield and cost-effectiveness of integrated TB case finding (CAST+) in Eastern Uganda.</p><p><strong>Design: </strong>We conducted a quasi-experimental before-and-after study comparing a universal community screening campaign (September 2022) with a geospatially targeted campaign (March 2024) in Eastern Uganda.</p><p><strong>Methods: </strong>We analysed routine eCBSS data from 166 diagnostic and treatment units using a sequential two-stage geospatial approach in Quantum Geographic Information System (QGIS). Statistically significant hotspot parishes were identified using the Getis-Ord Gi* statistic (<i>p</i> < 0.05), followed by the prioritisation of villages reporting > 2 bacteriologically confirmed TB cases (March 2023-February 2024). Comparative effectiveness was assessed with a cluster-adjusted chi-square test (Rao-Scott correction). Cost-effectiveness was evaluated from the provider perspective using inflation-adjusted 2024 USD costs, disability-adjusted life years (DALYs) averted, cost-effectiveness ratios (CERs) and incremental cost-effectiveness ratios (ICERs).</p><p><strong>Results: </strong>The targeted strategy screened 49,373 individuals across 313 villages, compared with 627,082 in 3252 villages under the universal campaign, representing a 92.1% reduction in screening volume. Despite this, TB yield increased by 10% (1.68%-1.85%; <i>p</i> < 0.001). Total inflation-adjusted costs declined by 90.9% (from USD 62,804 to USD 5704), unit cost per TB case fell by 55.2% (USD 82.20-USD 36.80), and cost per DALY averted decreased from USD 4.72 to USD 2.11 (ICER: USD 5.39 per DALY averted). All diagnosed TB cases were initiated on treatment.</p><p><strong>Conclusion: </strong>eCBSS-guided geospatial targeting improved efficiency, precision and cost-effectiveness of TB screening, supporting a shift from universal to targeted TB case finding, and provides programmatic evidence for high-value public health interventions in resource-limited settings.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261456596"},"PeriodicalIF":3.8,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacterial neonatal sepsis, antimicrobial resistance, and risk factors among neonates in Ethiopia: a systematic review and meta-analysis.","authors":"Habtamu Belew, Bantayehu Addis Tegegne, Yonatan Kindie, Adane Tilahun, Mastewal Yechale Mihret, Zigale Hibstu Teffera, Adane Adugna, Gashaw Azanaw Amare, Desalegn Abebaw, Mekuriaw Belayneh, Mamaru Getinet","doi":"10.1177/20499361261451360","DOIUrl":"10.1177/20499361261451360","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Antimicrobial resistance and bacterial neonatal sepsis are major threats causing high morbidity and mortality among neonates in developing countries, including in Ethiopia. Given the lack of comprehensive and synthesized evidence on the magnitude of the bacterial profile, neonatal sepsis, and antimicrobial resistance among neonates, this systematic review and meta-analysis were initiated to address this gap.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of this meta-analysis aims to assess the prevalence, antimicrobial resistance patterns, and risk factors of neonatal sepsis in Ethiopian neonates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Systematic review and meta-analysis were conducted among Ethiopian neonates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data source and methods: &lt;/strong&gt;Preferred reporting item for systematic review and meta-analysis &lt;b&gt;(&lt;/b&gt;PRISMA) was used to screen the identified studies. We conducted a systematic search of various electronic databases including PubMed/MEDLINE, Cochrane Library, African Journals Online (AJOL), Web of Science, Grey literature and Google Scholar. The data were extracted in Microsoft Excel using a standardized data extraction format by two authors. The analysis was carried out with STATA version 17. To detect heterogeneity across studies, the &lt;i&gt;I&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; and the Cochrane Q test statistics were computed. To determine the overall pooled prevalence, a random-effect meta-analysis model was used. This systematic review and meta-analysis were performed according to the updated guidelines, rigorous meta-analytical methodologies to ensure accuracy and reliability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 9013 retrieved articles, 20 studies containing 11,754 neonates with a total of 3168 bacterial isolates (837 Gram-positive, 2328 Gram-negative). The predominant bacteria identified were: &lt;i&gt;Klebsiella pneumoniae&lt;/i&gt; (1343), &lt;i&gt;Escherichia coli&lt;/i&gt; (854), &lt;i&gt;Staphylococcus aureus&lt;/i&gt; (356), other &lt;i&gt;Klebsiella&lt;/i&gt; spp (234), CoNS (192), &lt;i&gt;Acinetobacter&lt;/i&gt; species (172), GBS (164). The overall pooled prevalence of bacterial neonatal sepsis and multi-drug resistance (MDR) were 29.92% (25.79-34.05) and 66.20 (55.43-76.97). The subgroup analysis of this systematic review further revealed that the highest prevalence was observed in Oromia (31.62%) and Amhara (31.56%). The isolated bacteria were more resistant to penicillin groups, cephalosporins, and aminoglycosides. Preterm birth AOR = 8.2, 95%CI: 1.12-15.77), premature rupture of membranes (AOR = 4.8, 95%CI: 3.17-12.77), history of urinary tract infection at antenatal care (AOR = 33.21, 95%; 3.2-63.21), and low birth weight (AOR = 13.73, 95%CI: 4.48-31.95) were significantly associated with bacterial neonatal sepsis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Bacterial neonatal sepsis and MDR have been relatively high. Preterm birth, premature rupture of membranes, history of urinary tract infection at antenatal care, and low birth weight were significantly associated. ","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261451360"},"PeriodicalIF":3.8,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community perspectives on hepatitis B transmission and vaccination among adults in Northwest Ethiopia: a qualitative study.","authors":"Desalegn Addis Mussie, Tigabu Eskeziya Zerihun, Samuel Berihun Dagnew, Abel Temeche Kassaw, Woretaw Sisay Zewdu, Tilaye Arega Moges, Fasil Bayafers Tamene, Samuel Agegnew Wondm, Getachew Yitayew Tarekegn, Teferi Bihonegn Melese","doi":"10.1177/20499361261451362","DOIUrl":"10.1177/20499361261451362","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B virus (HBV) infection remains a major public health problem in sub-Saharan Africa, including Ethiopia, where adult vaccination uptake is limited. While quantitative studies have assessed knowledge and attitudes, little is known about how culturally embedded beliefs shape community perceptions of HBV transmission and vaccination.</p><p><strong>Objectives: </strong>This study explored adult community perspectives on HBV transmission and vaccination in Northwest Ethiopia.</p><p><strong>Design: </strong>A qualitative study using conventional content analysis.</p><p><strong>Methods: </strong>The study was conducted in Debre Tabor between December 2025 and February 2026. Data were collected through 20 in-depth interviews and six focus group discussions involving 68 adults selected through purposive sampling. Interviews were conducted in Amharic, audio-recorded, transcribed verbatim, translated into English, and analyzed inductively using Open Code software. Trustworthiness was ensured through independent coding, member checking, and reflexive documentation.</p><p><strong>Results: </strong>Three major themes emerged: (1) fragmented knowledge and moral framing of risk, (2) coexistence of biomedical and cultural explanatory models, and (3) the vaccine paradox-acknowledged benefits amid persistent barriers. A dominant culturally embedded belief attributed HBV to bat exposure (\"wof zura\"), often reducing the perceived relevance of vaccination. Although participants recognized disease severity, perceived personal susceptibility was low and frequently linked to moral behavior. Structural barriers including limited awareness of adult vaccination, cost concerns, and uncertainty about service availability further constrained uptake. Healthcare provider recommendation and community-based health education were identified as key facilitators.</p><p><strong>Conclusion: </strong>HBV vaccination decisions among adults are shaped by culturally grounded explanatory beliefs, low perceived susceptibility, and structural barriers. Context-sensitive health education and strengthened provider-initiated recommendations are critical for improving adult HBV vaccine uptake, thereby contributing to the global goal of eliminating viral hepatitis as a public health threat by 2030.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261451362"},"PeriodicalIF":3.8,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duration of antimicrobial therapy in cardiovascular implantable electronic device associated systemic infections: a retrospective analysis.","authors":"Emily Y Xiao, Patrick T Lynch, Sarwat Khalil, Derrick A Draeger, Alexandra M Lewis, Faiz M Baqai, Mihail G Chelu, M Rizwan Sohail","doi":"10.1177/20499361261451368","DOIUrl":"10.1177/20499361261451368","url":null,"abstract":"<p><strong>Background: </strong>While the need for complete device removal is well-established for cardiovascular implantable electronic device (CIED) infections, there is insufficient evidence on the optimal duration of antimicrobial therapy.</p><p><strong>Objectives: </strong>To examine how antimicrobial duration affects clinical outcomes of patients presenting with CIED-associated bacteremia and lead endocarditis.</p><p><strong>Design: </strong>This is a retrospective cohort study conducted at a quaternary care hospital in Houston, TX, USA.</p><p><strong>Methods: </strong>Patients who underwent device removal for a primary indication of bacteremia or lead endocarditis over a 10-year period were stratified by prescribed duration of antibiotics as ⩽2 weeks or >2 weeks post-extraction. Measured outcomes included all-cause mortality at 90 days, recurrent bacteremia, infectious complications, and hospital length of stay.</p><p><strong>Results: </strong>Of 747 patients who underwent lead extraction at Baylor St. Luke's Medical Center between June 2013 and December 2023, 79 cases met the inclusion criteria. Baseline characteristics were similar between cohorts. Mean duration of antibiotics prescription was 12.6 versus 38.6 days. There was no observed difference in survival (HR 0.693, 95% CI 0.085-5.652, <i>p</i> = 0.438), recurrent bacteremia (7% vs 6%, <i>p</i> = 0.952), infectious complications (27% vs 30%, <i>p</i> = 0.817), and hospital length of stay (mean 9.9 vs 13.3, <i>p</i> = 0.360) between the ⩽2 weeks and >2 weeks cohort, respectively. Five patients had recurrence, all of whom had bacteremia from <i>Staphylococcus aureus</i> or <i>Serratia</i> sp. and an underlying left ventricular assist device or valve replacement.</p><p><strong>Conclusion: </strong>Shorter duration of antibiotics after complete CIED removal had similar rates of mortality or recurrent bacteremia. Recurrence was associated with bacteremia from high-risk organisms with potential for secondary seeding of other cardiovascular prostheses. Larger prospective studies are needed to explore these findings.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261451368"},"PeriodicalIF":3.8,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-onset cytomegalovirus pneumonia after autologous stem cell transplantation for angioimmunoblastic T-cell lymphoma: a case report.","authors":"Zhe Zhang, Zihan Jia, Xinjun Zhang, Wailong Zou, Jichao Chen","doi":"10.1177/20499361261450721","DOIUrl":"10.1177/20499361261450721","url":null,"abstract":"<p><p>This case report illustrates a diagnostic and therapeutic challenge in a highly immunocompromised host: severe pneumonia occurring late after autologous hematopoietic stem cell transplantation (auto-HSCT). A 57-year-old male with angioimmunoblastic T-cell lymphoma (AITL) presented with hypoxemic respiratory failure 1 year post-auto-HSCT, a timeline extending beyond the typical high-risk period for opportunistic infections. A profoundly low CD4+ T-cell count (172/µL) was identified as the key predisposing factor. Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) enabled rapid, unbiased pathogen detection, confirming cytomegalovirus (CMV) pneumonia (viral load: 3.0 × 10⁴ copies/mL) with <i>Klebsiella pneumoniae</i> coinfection. An integrated management strategy was instituted, comprising early empiric coverage for <i>Pneumocystis jirovecii</i> pneumonia, targeted therapy with ganciclovir and levofloxacin, and adjunctive immunomodulation using intravenous immunoglobulin and corticosteroids. This comprehensive approach resulted in full recovery, highlighting that the severity of immune suppression-rather than time since transplantation alone-determines infection risk. This case challenges the conventional time-based risk paradigm and supports immune-guided surveillance. It underscores the transformative role of mNGS in diagnosing complex infections in immunocompromised patients and advocates for a management paradigm that concurrently addresses pathogen eradication and host immune dysfunction.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261450721"},"PeriodicalIF":3.8,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous tuberculosis with features suggestive of scrofuloderma masquerading as hidradenitis suppurativa: a case report.","authors":"Midhun Raj, Tarun Kumar Suvvari, Vimal Thomas, Anand Krishnan R G, Aishwarya Nitin Dnyate, Ryan Chris Thaddaeus, Noel Thomas Kandathil, Tejinder Singh","doi":"10.1177/20499361261449091","DOIUrl":"10.1177/20499361261449091","url":null,"abstract":"<p><p>Scrofuloderma is a form of cutaneous tuberculosis that results from the spread of infection from an underlying focus, most commonly lymph nodes or bone, to the overlying skin. It shares overlapping features with various other cutaneous diseases, such as hidradenitis suppurativa. We report a 47-year-old woman presenting with a 4-year history of anterior chest swelling and a 2-year history of a right axillary mass that had ruptured spontaneously. The patient had undergone multiple incisions and drainage procedures and received several courses of antibiotics with limited success. Diagnostic investigations including imaging, biopsy, and ultrasound-guided cartridge-based nucleic acid amplification test supported a diagnosis of cutaneous tuberculosis with features suggestive of scrofuloderma involving the right axilla. The patient was subsequently initiated on antitubercular therapy. Cutaneous tuberculosis should be considered in the differential diagnosis of chronic or recurrent atypical cutaneous lesions in regions with a high burden of tuberculosis.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261449091"},"PeriodicalIF":3.8,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, attitudes, and practices on antibiotic use and antimicrobial resistance among graduating health care professionals at Debre Tabor University, Ethiopia: a cross-sectional study with implications for antimicrobial stewardship education.","authors":"Yared Andargie Ferede, Tilaye Arega Moges, Muluken Adela Alemu, Samuel Berihun Dagnew, Achenef Bogale Kassie, Tigabu Eskeziya Zerihun, Addisu Melake Bayafers, Woretaw Sisay Zewdu","doi":"10.1177/20499361261448476","DOIUrl":"10.1177/20499361261448476","url":null,"abstract":"<p><strong>Background: </strong>Rational use of antimicrobials is a key strategy for preventing antimicrobial resistance (AMR) and relies primarily on the knowledge and practices of future health care professionals.</p><p><strong>Objectives: </strong>To assess the knowledge, attitudes, and practices of graduating health care students regarding antibiotic use and AMR at Debre Tabor University.</p><p><strong>Design: </strong>An institution-based cross-sectional study was employed.</p><p><strong>Methods: </strong>The study was conducted from March to April 2025 among graduating students at the College of Health Sciences. A validated self-administered questionnaire was used to assess knowledge, attitude, and practice (KAP). Scores were categorized using previous studies and modified Bloom's cut-off criteria (⩾80% = good; <80% = poor). Data were analyzed using descriptive statistics, chi-square tests, pearson correlation, and logistic regression, with <i>p</i>-values < 0.05 considered statistically significant.</p><p><strong>Results: </strong>Antibiotic use in the past year was reported by 75.2% of participants, with ciprofloxacin and amoxicillin being the most commonly used agents. Overall, 55.8% showed good knowledge, 41.3% had a positive attitude and 51.4% reported good practices. While awareness of AMR was high, only 32.5% correctly identified antimicrobial stewardship (AMS). A total of 68% of students purchased antibiotics without a prescription, and 69.9% discontinued treatment once symptoms improved. Significant differences in KAP across departments were observed (<i>p</i> < 0.005). Knowledge was positively correlated with attitude (<i>r</i> = 0.31, <i>p</i> = 0.001), and attitude with practice (<i>r</i> = 0.29, <i>p</i> = 0.002), whereas knowledge was not significantly associated with practice. Knowledge and Attitude levels were independent predictors of good attitude and practice, respectively. Additionally, birthplace, department of study, prior antibiotic use, AMR training, and family health background were associated with KAP outcomes, respectively.</p><p><strong>Conclusion: </strong>The study showed that 55.8% of respondents had good knowledge, but attitudes (41.3%) and practices (51.4%) were lower, highlighting a clear knowledge-practice gap and the need for strengthened AMS training.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261448476"},"PeriodicalIF":3.8,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with HIV RNA viral non-suppression among children and adolescents with HIV attending public health facilities in Gulu City, Uganda: a retrospective cohort study.","authors":"Ventrina Lanyero, Felix Bongomin, Daniel S Ebbs, Ritah Nantale, Emmanuel Ochola","doi":"10.1177/20499361261448464","DOIUrl":"10.1177/20499361261448464","url":null,"abstract":"<p><strong>Background: </strong>Human immunodeficiency virus (HIV) RNA viral load testing is the gold standard for monitoring antiretroviral therapy (ART), and sustained viral suppression is critical for preventing HIV-related morbidity and transmission. However, children and adolescents with HIV (CAWH) often experience lower viral suppression rates than adults. Data on the incidence of HIV RNA viral non-suppression and its determinants among CAWH in northern Uganda remain limited.</p><p><strong>Objectives: </strong>To determine the incidence and factors associated with HIV RNA viral load non-suppression among CAWH receiving ART in Gulu City, Uganda.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>We reviewed records of CAWH receiving ART at public health facilities in Gulu City. Data were abstracted for HIV RNA viral load outcomes at 6, 12, 18, and 24 months and at the most recent follow-up. The primary outcome was HIV RNA viral non-suppression during follow-up. Bivariable and multivariable Cox proportional hazards regression models were used to identify factors associated with viral load non-suppression. Adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) were reported.</p><p><strong>Results: </strong>Among 218 participants, the median age was 12.5 years (interquartile range (IQR), 7-18), and 153 (70.2%) were female. During follow-up, 99 participants (45.4%) experienced viral load non-suppression. The incidence rate of viral load non-suppression was 25.6 cases per 100 person-years. Factors independently associated with non-suppression included age <5 years (aHR: 2.59, 95% CI: 1.30-5.17), poor ART adherence (aHR: 1.96, 95% CI: 1.21-3.17), non-disclosure of HIV status (aHR: 2.19, 95% CI: 1.27-3.80), advanced WHO clinical stage (III-IV) at presentation (aHR: 3.07, 95% CI: 1.41-6.69), and economic hardship (aHR: 2.13, 95% CI: 1.32-3.42).</p><p><strong>Conclusion: </strong>Viral load non-suppression among CAWH in Gulu City was high, with the majority experiencing viral non-suppression by approximately 6 months after ART initiation. Strengthening adherence support, early disclosure of HIV status, and targeted interventions for younger children and socioeconomically vulnerable households may improve viral suppression outcomes in this population.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261448464"},"PeriodicalIF":3.8,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, attitudes and practices on antimicrobial resistance among healthcare workers in sub-Saharan Africa: a systematic review and meta-analysis.","authors":"Herbert Melariri, Prince Campbell, Rosa Du Randt, Ilse Truter, Simo Zulu, Beth Rose Wiehahn, Alive Ntunja, Marilyn Hutton-Willemse, Zukiswa Ntlokonkulu, Ntokozo Mzimela, Opeoluwa Oyedele, Paula Melariri","doi":"10.1177/20499361251410677","DOIUrl":"10.1177/20499361251410677","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) poses a significant threat to public health in sub-Saharan Africa (SSA). Healthcare workers (HCWs) are critical to preventing and controlling AMR.</p><p><strong>Objectives: </strong>This systematic review and meta-analysis aimed to synthesise evidence on the knowledge, attitude and practices (KAP) of HCWs regarding AMR in SSA.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Data sources and methods: </strong>We conducted a comprehensive search of multiple databases (PubMed, Web of Science, APA PschINFO and CINAHL via EBSCOhost) for studies published between 2014 and 2024. Studies reporting KAP of HCWs regarding AMR in SSA were eligible. MeSH search terms and related keywords were used. Data extraction was conducted individually by each team member and then cross-verified to ensure accuracy. Quality appraisal was conducted using the Critical Appraisal Skills Programme Checklist to evaluate the methodological rigour of the included studies. Meta-analysis was performed using a random-effects model. All statistical data analyses were performed in the R software (version 4.5.0) using both the meta and metafor packages.</p><p><strong>Results: </strong>Thirty-one studies involving 8873 HCWs were included. The pooled proportions of AMR knowledge, attitude and practices were 65.4% (95% CI: 55.7-74.5), 69.2% (95% CI: 58.1-79.3) and 54.1% (95% CI: 44.1-63.9), respectively. Doctors had the highest knowledge (65.1%) yet poor practices (42.8%), while pharmacists and nurses showed lower knowledge and inconsistent practices. Despite favourable attitudes, especially among nurses, behavioural implementation remained weak, underscoring substantial knowledge-practice gaps across professional groups.</p><p><strong>Conclusion: </strong>HCWs demonstrated moderate knowledge and attitudes but poor practices, revealing a persistent knowledge-practice gap. Targeted, context-specific interventions and strengthened professional training are urgently needed to enhance evidence-based practice and improve healthcare quality and patient outcomes.</p><p><strong>Trial registration: </strong>The review protocol was prospectively registered with PROSPERO, CRD42024579356.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361251410677"},"PeriodicalIF":3.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}