There is growing concern that COVID-19 will lead to the disruptions for HIV testing and treatment services, which could result in excess HIV-related deaths and onward transmission, jeopardizing the ...fulfillment of the first UNAIDS global 90-90-90 target that 90% of all people living with HIV will know their status 2. Compared to HIV-negative, a higher proportion of HIV-positive patients were homosexual (p < 0.001), had sexual intercourse under the influence of alcohol/drugs in the last six months (p = 0.044), and had syphilis history (p < 0.001) (Table 1). Total (n = 118; 100%) HIV-negative patients (n = 113; 95.8%) HIV-positive patients (n = 5; 4.2%) p-value Epidemiological characteristics Age, mean (SD), years 41 (14) 41 (14) 38 (14) 0.622a Sex, female/male (%) 61/57 (57.1/48.3) 59/54 (52.2/47.8) 2/3 (40/60) 0.468b Provenance, n (%) 0.129b Distrito Capital 95 (80.5) 92 (81.4) 3 (60) Miranda 18 (15.3) 17 (15) 1 (20) Other 5 (4.2) 4 (3.5) 1 (20) Occupation, n (%) 0.508b Employed 51 (43.2) 49 (43.4) 2 (40) Self-employed 23 (19.5) 23 (20.4) – Healthcare worker 23 (19.5) 22 (19.5) 1 (20) Unemployed/Retired 21 (17.8) 19 (16.8) 2 (40) Personal history Sexual orientation, n (%) Heterosexual 110 (93.2) 108 (95.6) 2 (40) <0.001c Homosexual 6 (5.1) 3 (2.7) 3 (60) <0.001c Bisexual 2 (1.7) 2 (1.8) 0 (0) 1c Age at first sexual intercourse, median IQR, years 17 3 17 3 16 2 0.517d Number of sexual partners in the last six months, median IQR, partners 1 0 1 0 1 1 0.236d Sexual intercourse under the influence of alcohol/drugs in the last six months, yes (%) 20 (16.9) 17 (15) 3 (60) 0.044d Sexual assault victim, yes (%) 10 (8.5) 8 (7.1) 2 (40) 0.057c STD history, yes (%) HPV 4 (3.4) 3 (2.7) 1 (20) 0.404b Gonorrhea 4 (3.4) 3 (2.7) 1 (20) 0.404b Syphilis 5 (4.2) 2 (1.8) 3 (60) <0.001b Other 4 (3.4) 3 (2.7) 1 (20) 0.404b Table 1 Epidemiological characteristics and personal history of 118 patients with suspected COVID-19 according to coinfection status.
Despite nearly a quarter of Venezuelans remaining unvaccinated against coronavirus disease 2019 (COVID-19), the factors contributing to vaccine hesitancy in the country have not been thoroughly ...investigated.
A cross-sectional study was conducted from October 15
to 30
, 2022, using a knowledge, attitudes, and practices (KAP) survey to identify factors associated with COVID-19 vaccine hesitancy.
The study analyzed data from 1,930 participants from all 24 states of Venezuela. The majority (93.4%) were vaccinated. The mean age was 40 years, predominantly female (67.3%), and held a university degree (70.6%). The mean KAP score was significantly higher among vaccinated individuals compared to unvaccinated ones (7.79 vs. 3.94 points for knowledge, 40 vs. 24 points for attitudes, and 16 vs. 10 points for practices, all p < 0.001). Increases in the scores for KAP were associated with increased odds of being vaccinated (84.6%, 25.6%, and 33% respectively for each one-point increase, all p < 0.001). Certain demographic factors such as marital status, occupation, religious beliefs, monthly income, and location influence COVID-19 vaccine knowledge. Higher income and certain occupations decrease the odds of low knowledge, while residing in specific states increases it. Attitudes towards the COVID-19 vaccine are influenced by age, health status, vaccination status, and location. Higher income and absence of certain health conditions decrease the odds of negative attitudes. Lastly, age, occupation, monthly income, and location affect vaccine practices. Advanced age and higher income decrease the odds of inappropriate practices, while residing in La Guaira state increases them.
Factors such as age, education level, occupation, monthly income, and location were found to be associated with knowledge and attitudes towards COVID-19 vaccine among the surveyed Venezuelans.
Objetivo Describir y analizar la actividad científica sobre la COVID-19 en Latinoamérica.Materiales y Métodos Mediante una revisión sistemática de la literatura en PubMed, LILACS y los repositorios ...preimpresos BioRxiv y medRxiv, se recuperaron todos los documentos disponibles sobre la COVID-19 en Latinoamérica desde el primero de enero hasta el 24 de abril de 2020, para su análisis bibliométrico.Resultados Un total de 29 publicaciones fueron incluidas en el análisis. El país con más producción científica fue Brasil (10/29; 34,4%), seguido de Colombia (6/29; 20,6%) y México (6/29; 20,6%). La universidad con más artículos fue la Universidad Tecnológica de Pereira, Colombia (5/29; 17,24%). El 41,3% de las publicaciones fueron documentos preimpresos. La mayoría de los estudios excluidos fueron comentarios editoriales u opiniones de expertos. Tres de cada cuatro investigaciones tenían un enfoque epidemiológico (21/29; 72,4%); limitados estudios sobre el diagnóstico (5/29; 17,2%), la fisiopatogenia (2/29; 2,8%) y los aspectos terapéuticos (1/29; 3,4%) fueron encontrados.Conclusión Pese al crecimiento exponencial de publicaciones en el mundo, existe una limitada cantidad de información sobre el comportamiento de esta infección en Latinoamérica. Se requiere la publicación de estudios con alta calidad metodológica, que aporten conocimiento sobre el impacto de la pandemia en la región.
Describe and analyze scientific activity on COVID-19 in Latin America.
Through a systematic review of the literature in PubMed, LILACS, and the preprinted repositories BioRxiv and medRxiv, all ...available documents on COVID-19 in Latin America from January 1 to April 24, 2020, were retrieved for review and bibliometric analysis.
A total of 29 publications were included in the analysis. The country with the most scientific production was Brazil (10/29; 34,4%) followed by Colombia (6/29; 20,6%) and Mexico (6/29; 20,6%). The university with the most articles was the Technological University of Pereira, Colombia (5/29; 17,2%). 41,3% of the publications were preprinted documents. Most of the excluded studies were editorial comments or expert opinions. Three out of four investigations had an epidemiological focus (21/29; 72,4%); Limited studies on diagnosis (5/29; 17,24%), pathophysiology (2/29, 2,8%) and therapeutic.
Despite the exponential growth of publications in the world, there is a limited amount of information on the behavior of this infection in Latin America. The publication of studies with high methodological quality is required, which provide knowledge of the impact of the pandemic in the region.
Purpose of Review
The aim of this study was to compile all cases of yellow fever (YF) recorded in the Guiana Shield (GS), a region located on the northeastern shore of South America.
Recent Findings
...Yellow fever causes several deaths in French Guiana during the last years. In this context, we wanted to know if it was due to a lack of vaccination or a reemergence of YF as in Brazil and if it was the same trouble in the neighborhood countries.
Summary
People living in or returning from the GS with YF-compatible symptoms confirmed by reverse transcriptase polymerase chain reaction between 1990 and 2022 were included. In French Guiana (FG), patients were identified through results from the National Reference Center for Arboviruses at the Pasteur Institute in FG and hospital medical charts. For the other countries, medical literature and the WHO database were reviewed. Public health and infectious diseases specialists were solicited to identify unknown and unpublished cases. Nine patients were identified in the study period: five in FG, two in Venezuela, one in Suriname, one in Brazil, including six autochthonous people, Guiana Shield native, and three tourists. The case fatality rate was 7/9 (78%) within 8 days (range: 7–11 days). The M/F sex ratio was 6/3 (2). They had severe liver involvement progressing to multivisceral failure in 89% of cases. Only the two native Amerindian patients in FG had previously benefited from a YF vaccination in childhood and/or for more than 10 years. In conclusion, the sylvatic cycle of the YF virus is likely to persist in this region. Absence of vaccination or unknown immunization status was documented in most patients (78%). The mortality rate of this case series was high thus highlighting the need to strengthen vaccination coverage for the population and travelers to the GS.
Abstract
Background
The public health impact of the coronavirus disease 2019 (COVID-19) pandemic has motivated a rapid search for potential therapeutics, with some key successes. However, the ...potential impact of different treatments, and consequently research and procurement priorities, have not been clear.
Methods
Using a mathematical model of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission, COVID-19 disease and clinical care, we explore the public-health impact of different potential therapeutics, under a range of scenarios varying healthcare capacity, epidemic trajectories; and drug efficacy in the absence of supportive care.
Results
The impact of drugs like dexamethasone (delivered to the most critically-ill in hospital and whose therapeutic benefit is expected to depend on the availability of supportive care such as oxygen and mechanical ventilation) is likely to be limited in settings where healthcare capacity is lowest or where uncontrolled epidemics result in hospitals being overwhelmed. As such, it may avert 22% of deaths in high-income countries but only 8% in low-income countries (assuming R = 1.35). Therapeutics for different patient populations (those not in hospital, early in the course of infection) and types of benefit (reducing disease severity or infectiousness, preventing hospitalization) could have much greater benefits, particularly in resource-poor settings facing large epidemics.
Conclusions
Advances in the treatment of COVID-19 to date have been focused on hospitalized-patients and predicated on an assumption of adequate access to supportive care. Therapeutics delivered earlier in the course of infection that reduce the need for healthcare or reduce infectiousness could have significant impact, and research into their efficacy and means of delivery should be a priority.
Coronavirus disease 2019 (COVID-19) drug development to date has focused on reducing deaths among hospitalized patients, but greater public-health impact could come from drugs delivered to outpatients early in the course of disease, and that prevent hospitalization and/or onwards transmission.
The coronavirus disease 2019 (COVID‐19) pandemic has particularly affected countries with weakened health services in Latin America, where proper patient management could be a critical step to ...address the epidemic. In this study, we aimed to characterize and identify which epidemiological, clinical, and paraclinical risk factors defined COVID‐19 infection from the first confirmed cases through the first epidemic wave in Venezuela. A retrospective analysis of consecutive suspected cases of COVID‐19 admitted to a sentinel hospital was carried out, including 576 patient cases subsequently confirmed for severe acute respiratory syndrome coronavirus 2 infection. Of these, 162 (28.1%) patients met the definition criteria for severe/critical disease, and 414 (71.2%) were classified as mild/moderate disease. The mean age was 47 (SD 16) years, the majority of which were men (59.5%), and the most frequent comorbidity was arterial hypertension (23.3%). The most common symptoms included fever (88.7%), headache (65.6%), and dry cough (63.9%). Severe/critical disease affected mostly older males with low schooling (p < 0.001). Similarly, higher levels of glycemia, urea, aminotransferases, total bilirubin, lactate dehydrogenase, and erythrocyte sedimentation rate were observed in severe/critical disease patients compared to those with mild/moderate disease. Overall mortality was 7.6% (44/576), with 41.7% (28/68) dying in hospital. We identified risk factors related to COVID‐19 infection, which could help healthcare providers take appropriate measures and prevent severe clinical outcomes. Our results suggest that the mortality registered by this disease in Venezuela during the first epidemic wave was underestimated. An increase in fatalities is expected to occur in the coming months unless measures that are more effective are implemented to mitigate the epidemic while the vaccination process is ongoing.
Highlights
To the best of our knowledge, our study is the first to assess the epidemiological, clinical, and paraclinical characteristics of COVID‐19 patients in Venezuela.
Regarding the occupation, 15% of the patients were healthcare workers.
Patients with more year's smoking, bilateral crackles and altered state of consciousness were associated with severe/critical disease.
Only 42% of the patients with severe/critical disease criteria were hospitalized, of which 41.7% died.
RESUMEN Objetivo Describir y analizar la actividad científica sobre la COVID-19 en Latinoamérica. Materiales y Métodos Mediante una revisión sistemática de la literatura en PubMed, LILACS y los ...repositorios preimpresos BioRxiv y medRxiv, se recuperaron todos los documentos disponibles sobre la COVID-19 en Latinoamérica desde el primero de enero hasta el 24 de abril de 2020, para su análisis bibliométrico. Resultados Un total de 29 publicaciones fueron incluidas en el análisis. El país con más producción científica fue Brasil (10/29; 34,4%), seguido de Colombia (6/29; 20,6%) y México (6/29; 20,6%). La universidad con más artículos fue la Universidad Tecnológica de Pereira, Colombia (5/29; 17,24%). El 41,3% de las publicaciones fueron documentos preimpresos. La mayoría de los estudios excluidos fueron comentarios editoriales u opiniones de expertos. Tres de cada cuatro investigaciones tenían un enfoque epidemiológico (21/29; 72,4%); limitados estudios sobre el diagnóstico (5/29; 17,2%), la fisiopatogenia (2/29; 2,8%) y los aspectos terapéuticos (1/29; 3,4%) fueron encontrados. Conclusión Pese al crecimiento exponencial de publicaciones en el mundo, existe una limitada cantidad de información sobre el comportamiento de esta infección en Latinoamérica. Se requiere la publicación de estudios con alta calidad metodológica, que aporten conocimiento sobre el impacto de la pandemia en la región.
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