Healthcare

Editorial

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2 pages, 166 KiB

Open AccessEditorial

Editorial Commentary for the Special Issue “Infectious Disease Prevention and Public Health Promotion”

by Vito Fiore

Healthcare 2023, 11(10), 1422; https://doi.org/10.3390/healthcare11101422 - 14 May 2023

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Abstract

HIV testing and treatment, as well as sexually transmitted infections (STIs), remain popular topics for infectious disease specialists [...] Full article

(This article belongs to the Special Issue Infectious Disease Prevention and Public Health Promotion)

Research

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14 pages, 2077 KiB

Open AccessArticle

Constructing a Learning Curve to Discuss the Medical Treatments and the Effect of Vaccination of COVID-19

by Yi-Tui Chen, Emily Chia-Yu Su, Fang Ming Hung, Tomoru Hiramatsu, Tzu-Jen Hung and Chao-Yang Kuo

Healthcare 2023, 11(11), 1591; https://doi.org/10.3390/healthcare11111591 - 29 May 2023

Viewed by 995

Abstract

Acknowledging the extreme risk COVID-19 poses to humans, this paper attempted to analyze and compare case fatality rates, identify the existence of learning curves for COVID-19 medical treatments, and examine the impact of vaccination on fatality rate reduction. Confirmed cases and deaths were [...] Read more.

Acknowledging the extreme risk COVID-19 poses to humans, this paper attempted to analyze and compare case fatality rates, identify the existence of learning curves for COVID-19 medical treatments, and examine the impact of vaccination on fatality rate reduction. Confirmed cases and deaths were extracted from the “Daily Situation Report” provided by the World Health Organization. The results showed that low registration and low viral test rates resulted in low fatality rates, and the learning curve was significant for all countries except China. Treatment for COVID-19 can be improved through repeated experience. Vaccinations in the U.K. and U.S.A. are highly effective in reducing fatality rates, but not in other countries. The positive impact of vaccines may be attributed to higher vaccination rates. In addition to China, this study identified the existence of learning curves for the medical treatment of COVID-19 that can explain the effect of vaccination rates on fatalities. Full article

(This article belongs to the Special Issue Infectious Disease Prevention and Public Health Promotion)

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17 pages, 2519 KiB

Open AccessArticle

Medical Students’ and Radiology Technician Trainees’ eHealth Literacy and Hygiene Awareness—Asynchronous and Synchronous Digital Hand Hygiene Training in a Single-Center Trial

by Christian Kühnel, Sarah Salomo, Helena Pagiatakis, Jutta Hübner, Philipp Seifert, Martin Freesmeyer and Falk Gühne

Healthcare 2023, 11(10), 1475; https://doi.org/10.3390/healthcare11101475 - 18 May 2023

Viewed by 1016

Abstract

Next to the known nosocomial infections, the COVID-19 pandemic was an example for the need for the immediate implementation of functioning hygiene concepts and knowledge transfer. The aim of this study was to evaluate the self-assessment of ehealth literacy in terms of finding, [...] Read more.

Next to the known nosocomial infections, the COVID-19 pandemic was an example for the need for the immediate implementation of functioning hygiene concepts and knowledge transfer. The aim of this study was to evaluate the self-assessment of ehealth literacy in terms of finding, using and critically evaluating health information and theoretical and practical hygiene awareness on a voluntary participation basis at the Jena University Hospital in 2022. The well-established and validated eHEALS and WHO questionnaire on hand hygiene (HH) knowledge for healthcare workers was completely filled by 204 participants (191 medical students; 13 healthcare trainees). In a second step, after the questionnaire, 77 participants completed additional asynchronous, digitally guided self-training using DesiCoach 2Go. In the end, a synchronous hand disinfection was carried out in the hospital using Visirub, by separating it into a group without (n = 191; with and without HH questionnaire) and a group with (n = 31; with HH questionnaire) previously completed self-training. For the eHL, the respondents tended to have a positive self-assessment of finding, using and critically evaluating health information. The voluntary participants of the practical hand disinfection who had received self-training were able to achieve significantly better results (p = 0.0047), resulting in fewer wetting gaps in a subsequent performance with Visirub than those who had not received digital self-training. The survey showed that healthcare-related participants belonging to the “digital native” generation have above-average knowledge on HH and profit by digitally guided self-training. Full article

(This article belongs to the Special Issue Infectious Disease Prevention and Public Health Promotion)

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9 pages, 264 KiB

Open AccessArticle

Comparison of Clinical Features, Complete Blood Count Parameters, and Outcomes between Two Distinct Waves of COVID-19: A Monocentric Report from Italy

by Sara Solveig Fois, Elisabetta Zinellu, Angelo Zinellu, Michela Merella, Maria Carmina Pau, Ciriaco Carru, Alessandro Giuseppe Fois and Pietro Pirina

Healthcare 2022, 10(12), 2427; https://doi.org/10.3390/healthcare10122427 - 30 Nov 2022

Cited by 4 | Viewed by 1370

Abstract

Background: Since the beginning of the SARS-CoV-2 pandemic, the ability to predict the trajectory of the disease has represented a major challenge for clinicians. There is recent evidence that complete blood cell count (CBC)-derived inflammation indexes have predictive value in COVID-19. We aimed [...] Read more.

Background: Since the beginning of the SARS-CoV-2 pandemic, the ability to predict the trajectory of the disease has represented a major challenge for clinicians. There is recent evidence that complete blood cell count (CBC)-derived inflammation indexes have predictive value in COVID-19. We aimed to describe any changes in the clinical features, CBC-derived ratios, and outcomes of patients admitted to our hospital across two temporally distinct waves. Methods: We retrospectively assessed and compared the clinical characteristics and blood cell count values of patients hospitalized during the second and fourth waves of COVID-19, and explored any outcome differences in terms of the level of respiratory support required and transfer to intensive care. Results: We observed that fourth-wave patients were older, less male-predominant, and carried more comorbidities compared to the second-wave patients but, nevertheless, experienced more favorable outcomes. A strong internal correlation was documented for both waves between outcomes and CBC-derived ratios, with the fourth-wave cases displaying lower admission values of the neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammation index (SII). No significant differences were found for lymphocyte-to-monocyte ratio (LMR), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI). Conclusions: We observed that both admission values of CBC-derived indexes and adverse respiratory outcomes decreased from the second to the fourth wave of COVID-19. These data represent a contribution to the existing knowledge on the role of CBC-derived indexes as a potential tool to help clinicians to quickly differentiate in-hospital patients at increased risk of serious illness and death. Full article

(This article belongs to the Special Issue Infectious Disease Prevention and Public Health Promotion)

11 pages, 1236 KiB

Open AccessArticle

Serostatus and Epidemiological Characteristics for Atypical Pneumonia Causative Bacteria among Healthy Individuals in Medina, Saudi Arabia, a Retrospective Study

by Sari T. Alhoufie, Areej A. Alhhazmi, Waleed H. Mahallawi, Khalid O. Alfarouk and Nadir A. Ibrahim

Healthcare 2022, 10(11), 2316; https://doi.org/10.3390/healthcare10112316 - 18 Nov 2022

Cited by 2 | Viewed by 1970

Abstract

Background: Community-acquired atypical pneumonia is generally a mild and self-limiting infection. Still, it may lead to hospitalization and progressive clinical complications in some cases, particularly among the elderly and individuals with chronic diseases. Chlamydia pneumoniae, Legionella pneumophila, and Mycoplasma pneumoniae are the [...] Read more.

Background: Community-acquired atypical pneumonia is generally a mild and self-limiting infection. Still, it may lead to hospitalization and progressive clinical complications in some cases, particularly among the elderly and individuals with chronic diseases. Chlamydia pneumoniae, Legionella pneumophila, and Mycoplasma pneumoniae are the community’s main causative agents of atypical pneumonia. However, most published studies evaluated their incidence in the hospital setting, and little is known about their prevalence among healthy individuals. This work aims to assess the seroprevalence of these bacteria among healthy people to determine the status of immunity against these bacteria in the community. Methodology: Two hundred and eighty-three serum samples from a multicenter in Medina, Saudi Arabia, were collected in this study. Serum samples were subjected to indirect enzyme-linked immunosorbent assays (ELISAs) to detect IgG antibodies against C. pneumoniae, L. pneumophila, and M. pneumoniae to investigate the seroprevalence of these bacteria and their distribution among different genders and age groups of healthy people. Results: IgG seropositivity for at least one of the three atypical pneumonia-causative bacteria occurred in 85.8% (n= 243/283) of the sample population. IgG seropositivity for C. pneumoniae occurred in 80.6% (228/283) of the population, followed by 37.5% for L. pneumophila and 23% for M. pneumoniae (66/283). In addition, the IgG seropositivity rates for the three bacteria were observed predominantly among male participants. Furthermore, no significant difference in IgG seropositivity distribution occurred between different age groups of healthy people for C. pneumoniae, L. pneumophila and M. pneumoniae. Conclusions: The current study found that C. pneumoniae, L. pneumophila, and M. pneumoniae tended to be highly prevalent among healthy people and more common among males than females. Additionally, their pattern of distribution among healthy individuals seemed to be predominant among young adults (aged 20–40 years), which differs from their predominant distribution among elderly patients in hospital settings (>50 years). Full article

(This article belongs to the Special Issue Infectious Disease Prevention and Public Health Promotion)

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16 pages, 2099 KiB

Open AccessArticle

Assessing Healthcare Workers’ Knowledge and Their Confidence in the Diagnosis and Management of Human Monkeypox: A Cross-Sectional Study in a Middle Eastern Country

by Malik Sallam, Kholoud Al-Mahzoum, Ala’a B. Al-Tammemi, Mohammed Alkurtas, Fatemeh Mirzaei, Nariman Kareem, Hala Al-Naimat, Laila Jardaneh, Laith Al-Majali, Akram AlHadidi, Khaled Al-Salahat, Eyad Al-Ajlouni, Nadin Mohammad AlHadidi, Faris G. Bakri, Harapan Harapan and Azmi Mahafzah

Healthcare 2022, 10(9), 1722; https://doi.org/10.3390/healthcare10091722 - 08 Sep 2022

Cited by 46 | Viewed by 4956

Abstract

The ongoing multi-country human monkeypox (HMPX) outbreak was declared as a public health emergency of international concern. Considering the key role of healthcare workers (HCWs) in mitigating the HMPX outbreak, we aimed to assess their level of knowledge and their confidence in diagnosis [...] Read more.

The ongoing multi-country human monkeypox (HMPX) outbreak was declared as a public health emergency of international concern. Considering the key role of healthcare workers (HCWs) in mitigating the HMPX outbreak, we aimed to assess their level of knowledge and their confidence in diagnosis and management of the disease, besides the assessment of their attitude towards emerging virus infections from a conspiracy point of view. An online survey was distributed among HCWs in Jordan, a Middle Eastern country, during May–July 2022 using a questionnaire published in a previous study among university students in health schools in Jordan. The study sample comprised 606 HCWs, with about two-thirds being either physicians (n = 204, 33.7%) or nurses (n = 190, 31.4%). Four out of the 11 HMPX knowledge items had <50% correct responses with only 33.3% of the study respondents having previous knowledge that vaccination is available to prevent HMPX. A majority of study respondents (n = 356, 58.7%) strongly agreed, agreed or somewhat agreed that the spread of HMPX is related to a role of male homosexuals. Confidence in the ability of diagnosis based on the available monkeypox virus diagnostic tests was reported by 50.2% of the respondents, while the confidence levels were lower for the ability to manage (38.9%) and to diagnose (38.0%) HMPX cases based on their current level of knowledge and skills. Higher confidence levels for HMPX diagnosis and management were found among physicians compared to nurses. The endorsement of conspiracy beliefs about virus emergence was associated with lower HMPX knowledge, the belief in the role of male homosexuals in HMPX spread, and with lower diagnosis and management confidence levels. The current study highlighted the gaps in knowledge regarding HMPX among HCWs in Jordan as well as the lack of confidence to diagnose and manage cases among physicians and nurses. Raising the awareness about the disease is needed urgently considering the rapid escalation in the number of cases worldwide with reported cases in the Middle East. The attitude towards male homosexuals’ role in HMPX spread necessitates proper intervention measures to prevent stigma and discrimination among this risk group. The adoption of conspiratorial beliefs regarding virus emergence was widely prevalent and this issue needs to be addressed with proper and accurate knowledge considering its potential harmful impact. Full article

(This article belongs to the Special Issue Infectious Disease Prevention and Public Health Promotion)

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8 pages, 610 KiB

Open AccessArticle

How Little Do We Know about HIV and STIs Prevention? Results from a Web-Based Survey among the General Population

by Andrea De Vito, Agnese Colpani, Beatrice Zauli, Maria Chiara Meloni, Marco Fois, Vito Fiore, Giovanni Antonio Pintus, Vincenzo Gesualdo Nardi, Sergio Babudieri and Giordano Madeddu

Healthcare 2022, 10(6), 1059; https://doi.org/10.3390/healthcare10061059 - 08 Jun 2022

Cited by 5 | Viewed by 1622

Abstract

Background: Prevention campaigns have led to a significant decrease in new HIV diagnoses in Western Europe, while other sexual transmitted infections (STIs) have shown an opposite trend. Several educational programs are promoted among young students, whereas informational campaigns addressing the general population are [...] Read more.

Background: Prevention campaigns have led to a significant decrease in new HIV diagnoses in Western Europe, while other sexual transmitted infections (STIs) have shown an opposite trend. Several educational programs are promoted among young students, whereas informational campaigns addressing the general population are scarce. We aimed to investigate the level of awareness regarding STIs among the general population. Methods: We proposed a questionnaire regarding STIs and HIV to the general population in Italy. We assigned 1 point to correct, 0.5 point to partially correct, and 0 point to wrong answers. We collected data about age, sex, region of origin, level of education and whether they were health workers. Results: Overall, 2183 people answered the questionnaire, of which 555 aged over 50 years old. Being male, older than 50 years old, retired or unemployed, not educated, and no regular use of condoms were associated with lower scores. Only 16% of participants knew the Undetectable = Untransmittable (U = U) campaign. Overall, 2131 (97.6%) people think more educational campaigns should be offered. Of interest, 80% said the questionnaire led them to learn more about HIV and STIs. Conclusion: Our study reveals several gaps in general population awareness about HIV and STIs, especially among people aged over 50 years old. Most participants stated that the questionnaire was a learning opportunity. These data suggest that improvement of knowledge could start from easy-to-dispose medium, such as surveys and questionnaires delivered through social media. Furthermore, particular attention should be paid to population segmentation and campaign tailoring to enhance interventions effectiveness. Our data reinforce the need for more informational and educational campaigns tailored to the specific segments of the population. Full article

(This article belongs to the Special Issue Infectious Disease Prevention and Public Health Promotion)

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6 pages, 364 KiB

Open AccessArticle

Persistent RNA SARS-CoV-2 Detection in a HIV-Infected Patient

by Lucian Giubelan, Ilona Stanciu, Cristina Ilie and Vlad Pădureanu

Healthcare 2022, 10(6), 982; https://doi.org/10.3390/healthcare10060982 - 25 May 2022

Cited by 3 | Viewed by 1441

Abstract

The aim of this paper is to present a case of COVID-19 in a newly diagnosed HIV-infected, severely immunodepressed patient with a long persistence of positive RT-PCR for RNA SARS-CoV-2. Indirect data suggests that viable virus persisted for a long time in the [...] Read more.

The aim of this paper is to present a case of COVID-19 in a newly diagnosed HIV-infected, severely immunodepressed patient with a long persistence of positive RT-PCR for RNA SARS-CoV-2. Indirect data suggests that viable virus persisted for a long time in the absence of an adequate defense of the host. Improved immunity after starting antiretroviral treatment was not associated with an increased inflammatory reaction as regarding the infection due to the coronavirus and, apparently, was the main factor to control the infection. Remdesivir used to combat the SARS-CoV-2 infection had no immediate effect on the recorded cycle-threshold. Full article

(This article belongs to the Special Issue Infectious Disease Prevention and Public Health Promotion)

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Review

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12 pages, 1230 KiB

Open AccessReview

Candida auris as an Emergent Public Health Problem: A Current Update on European Outbreaks and Cases

by Nicholas Geremia, Pierluigi Brugnaro, Maria Solinas, Claudio Scarparo and Sandro Panese

Healthcare 2023, 11(3), 425; https://doi.org/10.3390/healthcare11030425 - 02 Feb 2023

Cited by 18 | Viewed by 5107

Abstract

Candida auris is considered to be an emerging fungal pathogen and is related to high mortality rates, persistent candidemia, inconsistencies in susceptibility testing results and misidentification by available commercial identification systems. Multidrug-resistant (MDR) and pandrug-resistant (PDR) strains are increasingly detected. In Europe, hospital outbreaks [...] Read more.

Candida auris is considered to be an emerging fungal pathogen and is related to high mortality rates, persistent candidemia, inconsistencies in susceptibility testing results and misidentification by available commercial identification systems. Multidrug-resistant (MDR) and pandrug-resistant (PDR) strains are increasingly detected. In Europe, hospital outbreaks caused by C. auris have been reported in the United Kingdom (UK), Italy and Spain; however, several cases have been sporadically detected in all European countries. C. auris is difficult to control despite enhanced control measures due to its ability to survive for a long time in environments and colonize patients for prolonged periods. An adequate laboratory diagnostic capacity and national surveillance are fundamental to rapidly detect new C. auris cases and to apply the correct measures to circumscribe them and prevent their spread. Our narrative review aims to highlight the primary C. auris outbreaks and case reports that have occurred in Europe. Full article

(This article belongs to the Special Issue Infectious Disease Prevention and Public Health Promotion)

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13 pages, 1640 KiB

Open AccessReview

Hepatitis of Unknown Origin and Etiology (Acute Non HepA-E Hepatitis) among Children in 2021/2022: Review of the Current Findings

by Malik Sallam, Azmi Mahafzah, Gülşen Özkaya Şahin and on behalf of ESCMID Study Group for Viral Hepatitis—(ESGVH)

Healthcare 2022, 10(6), 973; https://doi.org/10.3390/healthcare10060973 - 24 May 2022

Cited by 12 | Viewed by 5870

Abstract

Several clusters and individual cases of acute hepatitis have been reported in the US, Europe and recently in Asia and Central America since October 2021. A laboratory investigation of the common viral hepatitis agents (HAV, HBV, HCV, HDV and HEV) yielded negative results [...] Read more.

Several clusters and individual cases of acute hepatitis have been reported in the US, Europe and recently in Asia and Central America since October 2021. A laboratory investigation of the common viral hepatitis agents (HAV, HBV, HCV, HDV and HEV) yielded negative results prompting the use of the term “acute non HepA-E hepatitis” to describe this condition. The cases were characterized by the manifestations of acute hepatitis (abdominal pain, vomiting, diarrhea, jaundice and very high levels of liver enzymes) affecting children with a median age of 3–4 years. The exact underlying etiology has not been revealed yet; however, a leading hypothesis is that an infectious agent is the culprit, underlying cause or a risk factor for acute non HepA-E hepatitis occurrence. So far, laboratory testing has shown the presence of the group F human adenovirus serotype 41 (HAdV-F41) in about three-fourths of the investigated cases. As of 13 May 2022, more than 450 cases were reported worldwide, the majority of which were in the UK (n = 176), the US (n = 109), 13 European countries (at least 103 cases) and in Argentina, Brazil, Canada, Costa Rica, Indonesia, Israel, Japan, Palestine, Panama, Singapore and South Korea. Vigilant surveillance and epidemiologic investigations to identify further cases are warranted to delineate the features of this emergent public health issue. The possible role of environmental and toxic agents including foodborne toxins should also be considered. Specific guidelines for identification of further cases are necessary, particularly in low-income settings where testing for adenoviruses is not considered routinely. A genetic analysis of HAdV-F41 isolates is recommended to assess the potential changes in the virus genome with subsequent possible altered virus behavior. Immunopathogenesis is another possibility that should be evaluated considering the lack of viral structures in liver biopsies of the affected children in the US. Full article

(This article belongs to the Special Issue Infectious Disease Prevention and Public Health Promotion)

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Other

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7 pages, 234 KiB

Open AccessCommentary

Personal Freedom and Public Responsibility: Remaining Questions after First Case of HIV Transmission via Blood Transfusion in North Serbia

by Jasmina Grujić, Nevenka Bujandrić and Pavle Banović

Healthcare 2022, 10(8), 1397; https://doi.org/10.3390/healthcare10081397 - 27 Jul 2022

Cited by 1 | Viewed by 1669

Abstract

The reduction in the risk of transfusion-transmissible infections (including HIV infection) is an essential part of transfusion patient care. Here, we report the first incident of HIV transmission via transfusion in north Serbia due to blood donor dishonesty, and the failure of the [...] Read more.

The reduction in the risk of transfusion-transmissible infections (including HIV infection) is an essential part of transfusion patient care. Here, we report the first incident of HIV transmission via transfusion in north Serbia due to blood donor dishonesty, and the failure of the laboratory screen tests to detect the presence of HIV particles in his blood. Infected blood products were distributed to two recipients, and HIV infection was confirmed in one. This incident finally led to the implementation of Nucleic Acid Amplification Technology as mandatory testing of blood donors for HIV infection in Serbia and raised many questions related to the responsibility and ethics of all the participants in the blood transfusion supply chain. There is a need for the implementation of modern and non-discriminative laws in Serbia in order to reduce transfusion-transmissible infections. In addition, transfusion institutes in Serbia need to be obliged to pursue the constant upgrade of their diagnostic capacities in order to prevent similar incidents and to provide the best possible care for blood donation recipients. Full article

(This article belongs to the Special Issue Infectious Disease Prevention and Public Health Promotion)

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