March 28, 2022
WHO endorsed a catalog of mutations to assist prediction of drug resistance. With 500,000 more deaths from tuberculosis (TB) in 2020 than in 2019, the diagnosis and appropriate treatment of patients with drug-resistant TB is an urgent global health need. Using a candidate gene approach to identify mutations associated with resistance or consistent with susceptibility for antituberculosis drugs, researchers built a WHO-endorsed catalog of mutations to serve as a global standard for interpreting molecular information for drug resistance prediction. The availability of the catalog should facilitate the implementation of molecular diagnostics by national TB programs. [The Lancet Microbe]
Training in specimen collection and management is critical for AMR surveillance. A quasi-experimental study was conducted to determine the feasibility and benefits of the Global Antimicrobial Resistance Surveillance System (GLASS) as part of antimicrobial stewardship strategies in hospitals in Thailand. Data on the bacterial isolates and their antibiotic susceptibility during 2019 and between January and April 2020 were retrieved from participating hospitals. Hospital-acquired infection (HAI)-related bacteria were observed in 59% of isolates, while community-acquired infection (CAI)-related bacteria were observed in 41%. Antibiotic resistance in CAIs was high and may have been related to the misclassification of colonized bacteria. Researchers concluded the study results might not be valid because of inadequate data collection and specimen contamination. [Antibiotics]
COVID-19 mortality is greater than reported. Mortality measurements are affected by well-known biases that have been exacerbated during the COVID-19 pandemic. Using all-cause mortality reports, researchers estimated excess mortality from the COVID-19 pandemic in 191 countries and territories, and 252 subnational units, from 2020- 2021, compared to up to the previous 11 years. While reported COVID-19 deaths amount to over 5.9 million worldwide, 18.2 million people died worldwide because of the COVID-19 pandemic (as measured by excess mortality) over that period. While the global all-age rate of excess mortality due to the COVID-19 pandemic was 120.3 deaths per 100,000 of the population, it exceeded 300 deaths per 100,000 of the population in 21 countries. [The Lancet]
Geographic inequalities at sub-national level impact vaccination coverage in hard-to-reach populations. COVID-19 vaccination data representing the number of people given at least one dose of vaccine, the list of approved vaccination sites, population data, and ancillary GIS data were used to assess vaccination coverage in Kenya. The average travel time to a designated COVID-19 vaccination site was 76 minutes and over 87% of the population under 18 years reside within one hour of a vaccination site. COVID-19 vaccination coverage in December 2021 was 16.7 % and was forecasted to be 30.75% people by the end of March 2022. Approximately 21 million adults were still unvaccinated in December 2021 and, in the absence of vaccine uptake, over 17.2 million adults in Kenya may not be vaccinated by the end of March 2022. [Vaccine]
AMR will impact sex workers’ autonomy and safety. Through historical and ethnographic research on sex work in Zimbabwe, researchers examined the role of antibiotics in the management of sexually transmitted infections (STIs) among sex workers, from punitive colonial approaches to “empowerment”-based discourses. Programs for sex workers, while equipping many women with methods to mitigate dangers like STIs, depend on the efficacy of antibiotics. The programs frequently ignore structural and systemic vulnerabilities responsible for gendered inequalities that limit women’s options for paid work, favoring governance through antimicrobial “quick fixes.” With the threat of AMR and entrenched gender disparities, sex workers are vulnerable to greater surveillance, stigmatization, and criminalization to control both infections and women. [Medical Anthropology]
Vaccine hesitancy is currently the leading cause of low COVID-19 coverage in Nigeria. Until recently, COVID-19 vaccine scarcity was the root of low vaccine coverage in Nigeria. As vaccine availability increases, vaccine hesitancy and refusal, driven by conspiracy theories and misinformation, heavily impact vaccine coverage. Through focus group discussions and key informant interviews (totaling 178 participants), researchers thematically analyzed conspiracy theories or misinformation that participants reported they had heard regarding COVID-19, pandemic response, or vaccines. Analyzing the range of misinformation about COVID-19 could help the immunization program reduce hesitancy through communication targeting unsubstantiated claims. [Vaccine]
Pharmacological management of COVID-19 often varies according to patient demographics. Through a descriptive cross-sectional study, researchers analyzed the pharmacological management of COVID-19 patients in eight clinics in Colombia according to sex, age, and geographical origin between March 2020 and May 2021. Through descriptive analysis of the patients’ sociodemographic, clinical, and pharmacological variables, researchers determined the most used drugs were systemic corticosteroids, followed by colchicine, azithromycin, and ivermectin. Corticosteroids, anticoagulants, colchicine, azithromycin, ivermectin, and hydroxychloroquine were prescribed more frequently to men, and their overall use increased with age, especially in patients above 40 years old. Most patients were managed with medications included in management guidelines. [Antibiotics]
Genomic study of patients with severe COVID-19 could lead to targeted therapies. In the largest genomic study of severe COVID-19 so far, researchers found 16 genetic variants linked to an increased risk of developing severe COVID-19. Through analysis of the genomes of 7,500 people who had been treated for severe COVID-19 in United Kingdom intensive-care units and comparison of these genomes with those of 48,000 people in the general population, genetic variants linked to immune signaling and mucus production among others, increase the risk of critical COVID-19. While some of these variants occur in less than 1% of people of European ancestry, others occur in more than half of the population. [Nature News]
A longitudinal neuroimaging study reveals changes in the brain after COVID-19 infection. The UK biobank released data from 785 sets of neuroimaging scans from people between the ages of 51 and 81, of which 401 tested positive for COVID-19 between the two sessions, and 384 had not. Brain scans of the group that tested positive for COVID-19 exhibited reduced thickness and tissue contrast in some areas of the brain cortex compared to those in the control group. The same group also displayed increases in markers of tissue damage in brain regions connected to smell and taste systems. [Nature]
Photo: Shutterstock
