RESUMO
TB/HIV coinfection poses a complex public health challenge. Accurate forecasting of future trends is essential for efficient resource allocation and intervention strategy development. This study compares classical statistical and machine learning models to predict TB/HIV coinfection cases stratified by gender and the general populations. We analyzed time series data using exponential smoothing and ARIMA to establish the baseline trend and seasonality. Subsequently, machine learning models (SVR, XGBoost, LSTM, CNN, GRU, CNN-GRU, and CNN-LSTM) were employed to capture the complex dynamics and inherent non-linearities of TB/HIV coinfection data. Performance metrics (MSE, MAE, sMAPE) and the Diebold-Mariano test were used to evaluate the model performance. Results revealed that Deep Learning models, particularly Bidirectional LSTM and CNN-LSTM, significantly outperformed classical methods. This demonstrates the effectiveness of Deep Learning for modeling TB/HIV coinfection time series and generating more accurate forecasts.
Assuntos
Coinfecção , Previsões , Infecções por HIV , Aprendizado de Máquina , Tuberculose , Humanos , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Coinfecção/epidemiologia , Tuberculose/epidemiologia , Tuberculose/complicações , Previsões/métodos , Feminino , Masculino , Aprendizado ProfundoRESUMO
BACKGROUND: The Gran Chaco ecoregion is a well-known hotspot of several neglected tropical diseases (NTDs) including Chagas disease, soil-transmitted helminthiasis and multiparasitic infections. Interspecific interactions between parasite species can modify host susceptibility, pathogenesis and transmissibility through immunomodulation. Our objective was to test the association between human co-infection with intestinal parasites and host parasitaemia, infectiousness to the vector and immunological profiles in Trypanosoma cruzi-seropositive individuals residing in an endemic region of the Argentine Chaco. METHODS: We conducted a cross-sectional serological survey for T. cruzi infection along with an intestinal parasite survey in two adjacent rural villages. Each participant was tested for T. cruzi and Strongyloides stercoralis infection by serodiagnosis, and by coprological tests for intestinal parasite detection. Trypanosoma cruzi bloodstream parasite load was determined by quantitative PCR (qPCR), host infectiousness by artificial xenodiagnosis and serum human cytokine levels by flow cytometry. RESULTS: The seroprevalence for T. cruzi was 16.1% and for S. stercoralis 11.5% (n = 87). We found 25.3% of patients with Enterobius vermicularis. The most frequent protozoan parasites were Blastocystis spp. (39.1%), Giardia lamblia (6.9%) and Cryptosporidium spp. (3.4%). Multiparasitism occurred in 36.8% of the examined patients. Co-infection ranged from 6.9% to 8.1% for T. cruzi-seropositive humans simultaneously infected with at least one protozoan or helminth species, respectively. The relative odds of being positive by qPCR or xenodiagnosis (i.e. infectious) of 28 T. cruzi-seropositive patients was eight times higher in people co-infected with at least one helminth species than in patients with no such co-infection. Trypanosoma cruzi parasite load and host infectiousness were positively associated with helminth co-infection in a multiple regression analysis. Interferon-gamma (IFN-γ) response, measured in relation to interleukin (IL)-4 among humans infected with T. cruzi only, was 1.5-fold higher than for T. cruzi-seropositive patients co-infected with helminths. The median concentration of IL-4 was significantly higher in T. cruzi-seropositive patients with a positive qPCR test than in qPCR-negative patients. CONCLUSIONS: Our results show a high level of multiparasitism and suggest that co-infection with intestinal helminths increased T. cruzi parasitaemia and upregulated the Th2-type response in the study patients.
Assuntos
Doença de Chagas , Coinfecção , Helmintíase , Enteropatias Parasitárias , Trypanosoma cruzi , Humanos , Trypanosoma cruzi/imunologia , Trypanosoma cruzi/genética , Trypanosoma cruzi/isolamento & purificação , Coinfecção/parasitologia , Coinfecção/epidemiologia , Coinfecção/imunologia , Doença de Chagas/epidemiologia , Doença de Chagas/complicações , Doença de Chagas/parasitologia , Doença de Chagas/sangue , Doença de Chagas/imunologia , Animais , Adulto , Estudos Transversais , Masculino , Feminino , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Enteropatias Parasitárias/complicações , Enteropatias Parasitárias/imunologia , Pessoa de Meia-Idade , Helmintíase/complicações , Helmintíase/parasitologia , Helmintíase/epidemiologia , Helmintíase/imunologia , Adulto Jovem , Adolescente , Argentina/epidemiologia , Estudos Soroepidemiológicos , Strongyloides stercoralis/imunologia , Strongyloides stercoralis/isolamento & purificação , Parasitemia/parasitologia , Parasitemia/epidemiologia , Células Th2/imunologia , Criança , Estrongiloidíase/epidemiologia , Estrongiloidíase/parasitologia , Estrongiloidíase/complicações , Estrongiloidíase/imunologia , Estrongiloidíase/sangue , Idoso , Citocinas/sangue , Anticorpos Antiprotozoários/sangueRESUMO
Seven novel porcine parvoviruses (PPV2 to PPV8) have been discovered in the last two decades. The last one reported was PPV8 in China in 2022, which was proposed to be a member of the genus Protoparvovirus. Here, we report the first detection of PPV8 outside China - in two provinces from Colombia. Six out of 146 (4.1%) pigs showing porcine respiratory disease (PRD) tested positive for PPV8. Sequencing and phylogenetic analysis of two Colombian PPV8 isolates (GenBank database accession numbers PP335559 and PP335560) showed them to be members of the genus Protoparvovirus. Furthermore, PPV8 was detected in coinfections with porcine circovirus type 2 (PCV2) and porcine reproductive and respiratory syndrome virus (PRRSV), which are associated with PRD.
Assuntos
Infecções por Parvoviridae , Parvovirus Suíno , Doenças dos Suínos , Animais , Coinfecção/virologia , Coinfecção/veterinária , Coinfecção/epidemiologia , Colômbia/epidemiologia , Infecções por Parvoviridae/veterinária , Infecções por Parvoviridae/virologia , Infecções por Parvoviridae/epidemiologia , Parvovirus Suíno/genética , Parvovirus Suíno/isolamento & purificação , Parvovirus Suíno/classificação , Filogenia , Síndrome Respiratória e Reprodutiva Suína/virologia , Síndrome Respiratória e Reprodutiva Suína/epidemiologia , Vírus da Síndrome Respiratória e Reprodutiva Suína/genética , Vírus da Síndrome Respiratória e Reprodutiva Suína/isolamento & purificação , Vírus da Síndrome Respiratória e Reprodutiva Suína/classificação , Suínos , Doenças dos Suínos/virologia , Doenças dos Suínos/epidemiologiaRESUMO
BACKGROUND: In Latin America, Peru has the second highest number of cases of monkeypox (Mpox), of which more than 50 % are Human Immunodeficiency Virus (HIV)-positive. Here, we compared the epidemiological and clinical characteristics of Mpox between people with and without HIV in Peru. METHODS: We conducted a national retrospective study using data on confirmed cases of Mpox reported by the Peruvian National Surveillance System from 15 June 2022 to 31 December 2023. RESULTS: A total of 3561 confirmed cases of Mpox were included. Of these, 2123 (60 %) patients were people living with HIV (PLWH), with increased odds for those aged 30 years or older, homosexual (adjusted odds ratio [aOR] 8.58 [6.95-10.59], p<0.0001), bisexual (aOR=4.44 [3.46-5.69], p<0.0001), sex workers (aOR=2.24 [1.07-4.68], p=0.032), people with a history of syphilis (aOR=2.07 [1.66-2.58], p<0.001), and hospitalized (aOR=3.08 [2.03-4.68], p<0.001). PLWH were more likely to have proctitis (aOR=1.73 [1.26-2.37], p=0.001). The overall mortality was 20 of 3561 (0.56 %). Among PLWH and Mpox, more deaths occurred in hospitalized (p<0.001) and non-ART (p<0.001) individuals. CONCLUSION: Our findings highlight that HIV infection among Mpox cases in Peru is associated with high-risk sexual behaviour and a high likelihood of hospitalization.
Assuntos
Infecções por HIV , Mpox , Humanos , Peru/epidemiologia , Masculino , Feminino , Adulto , Infecções por HIV/epidemiologia , Infecções por HIV/complicações , Estudos Retrospectivos , Pessoa de Meia-Idade , Adulto Jovem , Mpox/epidemiologia , Adolescente , Fatores de Risco , Coinfecção/epidemiologia , Sífilis/epidemiologia , Sífilis/complicaçõesRESUMO
HIV-1, Hepatitis B and HTLV-1 have similar risk factors and shared routes of transmission and MSM are disproportionately affected by HIV. The aim of the study was to determine the prevalence of HTLV-1 and HBsAg positivity at initial enrolment among MSM attending a large HIV Clinic in Trinidad. Chart reviews were conducted between 2 and 15 January 2024, among self-identified MSM and a comparative group of randomly selected self-identified heterosexual males where sociodemographic, clinical and laboratory data were collected and analysed using SPSS Version 25. During the period April 2002-31 October 2023, in total there were 10,424 patients registered at the clinic, of whom 1255 (12.0%) were self-identified MSM, with an age range of 19-85 years and a median age of 40 years. There were 1822 randomly selected heterosexual males, with an age range of 18-94 years old and a median age of 52 years. Among the MSM, there were 21 (1.67%) patients who were HIV-1/HTLV-1-coinfected, 64 (5.10%) who were HIV-1/HBsAg-coinfected and two (0.16%) who were coinfected with all three viruses (HIV-1/HTLV-1/HBsAg) as compared to 47 ((2.58%) HIV-1/HTLV-1-coinfected (p = 0.12), 69 (3.79%) HIV-1/HBsAg-coinfected (p = 0.10) and three (0.16%) patients coinfected with all three viruses among the heterosexual males. There were no patients with HTLV-1-related diseases among the HIV-1/HTLV-1-coinfected patients and there were no deaths from chronic liver disease in patients coinfected with HIV-1/HBsAg. Despite the availability of an efficacious vaccine, there is a prevalence of hepatitis B of 5.1% among MSM attending the HIV Clinic in Trinidad; therefore, programmes to increase health literacy, screening and immunization are urgently needed.
Assuntos
Infecções por HIV , Infecções por HTLV-I , Antígenos de Superfície da Hepatite B , Hepatite B , Homossexualidade Masculina , Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Trinidad e Tobago/epidemiologia , Antígenos de Superfície da Hepatite B/sangue , Homossexualidade Masculina/estatística & dados numéricos , Idoso , Adulto Jovem , Prevalência , Hepatite B/epidemiologia , Idoso de 80 Anos ou mais , Infecções por HTLV-I/epidemiologia , Coinfecção/epidemiologia , Coinfecção/virologia , Vírus Linfotrópico T Tipo 1 Humano/imunologia , Adolescente , HIV-1 , Fatores de RiscoRESUMO
Understanding the proportion of SARS-CoV-2 patients with Mycoplasmapneumoniae coinfection is crucial for treating patients suffering from coronavirus disease (COVID-19), help to ensure responsible use of antibiotics and minimize the negative consequences of overuse. In addition, this knowledge could have an impact on empirical antibiotic management guidelines for patients with COVID-19. This systematic review aimed to identify the prevalence of M. pneumoniae in patients with coronavirus disease 2019 (COVID-19). A bibliographic search of studies published in Spanish or English was conducted using the PubMed search engine. Fourteen articles from different continents (America, Asia and Europe) were included, involving a total of 5855 patients in these studies. The mean age of COVID-19 patients with M. pneumoniae was 48 years old (range 1-107), most of whom were male. The detection of laboratory-confirmed M. pneumoniae infection varied between 0 and 33.3%. Most of patients referred fever, cough, and dyspnea, and received empirical antibiotic treatment. Bacterial coinfection was not associated with increased ICU admission and mortality. The prevalence of coinfection showed extremely dissimilar figures according to the population studied and diagnostic criteria. However, it is important to develop Latin American studies, given the heterogeneity observed in the studies conducted in different countries. Standardized definitions should be developed in order to be able to assess the impact of coinfections in patients with a diagnosis of COVID-19.
Assuntos
COVID-19 , Coinfecção , Pneumonia por Mycoplasma , Humanos , COVID-19/complicações , COVID-19/epidemiologia , Coinfecção/epidemiologia , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/complicações , Pneumonia por Mycoplasma/tratamento farmacológico , Prevalência , Mycoplasma pneumoniae , Criança , Idoso , Adulto , Idoso de 80 Anos ou mais , Pré-Escolar , Adulto Jovem , Pessoa de Meia-Idade , Adolescente , Masculino , Antibacterianos/uso terapêutico , Lactente , FemininoRESUMO
OBJECTIVE: To identify the epidemiological, spatial, and temporal pattern of TB-HIV coinfection in Brazil during the period from 2001 to 2020. METHODS: Ecological study using space-time analysis techniques. It included cases of TB-HIV coinfection registered in Brazil from 2001 to 2020. The temporal trend analysis was performed using segmented regression by Joinpoint regression. For spatial analysis, Moran indices were calculated and choropleth maps were produced using TerraView and QGIS software. RESULTS: A stable temporal trend was observed in the incidence rates of TB-HIV coinfection in Brazil during the analyzed period. In addition, high-risk areas for coinfection located in states in the North, Southeast, South, and Midwest regions were identified. CONCLUSION: There was stability in the incidence of TB-HIV coinfection in Brazil over the last 20 years and heterogeneous geographic distribution of risk areas for the condition.
Assuntos
Coinfecção , Infecções por HIV , Análise Espaço-Temporal , Humanos , Brasil/epidemiologia , Infecções por HIV/epidemiologia , Infecções por HIV/complicações , Coinfecção/epidemiologia , Incidência , Masculino , Feminino , Fatores de Tempo , Adulto , Tuberculose/epidemiologia , Fatores de Risco , Pessoa de Meia-IdadeRESUMO
The increase in incidence and geographical expansion of viruses transmitted by the Aedes mosquitoes, such as dengue (DENV) and zika (ZIKV) in the Americas, represents a burden for healthcare systems in tropical and subtropical regions. These and other under-detected arboviruses co-circulate in Costa Rica, adding additional complexity to their management due to their shared epidemiological behavior and similarity of symptoms in early stages. Since diagnostics of febrile illness is mostly based on clinical symptoms alone, we gathered acute-phase serum and urine from 399 samples of acute dengue-like cases from two healthcare facilities of Costa Rica, during an outbreak of arboviruses from July 2017 to May 2018, and tested them using molecular and serological methods. The analyses showed that of the clinically presumptive arbovirus cases that were reported, only 39.4% (n=153) of the samples were confirmed positive by RT-PCR to be DENV (DENV (10.3%), CHIKV (0.2%), ZIKV (27.3%), or mixed infections (1.5%). RT-PCR for other alphaviruses and flaviviruses, and PCR for Leptospira sp were negative. Furthermore, to assess flavivirus positivity in post-acute patients, the negative sera were tested against Dengue-IgM. 20% of sera were found positive, confounding even more the definitive number of cases, and emphasizing the need of several distinct diagnostic tools for accurate diagnostics. Molecular characterization of the prM and E genes from isolated viruses revealed that the American/Asian genotype of DENV-2 and the Asian lineage of ZIKV were circulating during this outbreak. Two different clades of DENV-2 American/Asian genotype were identified to co-circulate in the same region and a difference in the platelet and leukocyte count was noted between people infected with each clade, suggesting a putative distinct virulence. Our study sheds light on the necessity for healthcare strategies in managing arbovirus outbreaks, emphasizing the importance of comprehensive molecular and serological diagnostic approaches, as well as molecular characterization. This approach aids in enhancing our understanding of the clinical and epidemiological aspects of arboviral diseases during outbreaks. Our research highlights the need to strengthen training programs for health professionals and the need to increase research-based on laboratory evidence for diagnostic accuracy, guidance, development and implementation of public health interventions and epidemiological surveillance.
Assuntos
Vírus da Dengue , Dengue , Surtos de Doenças , Infecção por Zika virus , Zika virus , Humanos , Costa Rica/epidemiologia , Dengue/epidemiologia , Dengue/diagnóstico , Dengue/virologia , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/virologia , Zika virus/genética , Zika virus/isolamento & purificação , Vírus da Dengue/genética , Vírus da Dengue/isolamento & purificação , Vírus da Dengue/classificação , Feminino , Masculino , Adulto , Adolescente , Pessoa de Meia-Idade , Adulto Jovem , Criança , Pré-Escolar , Idoso , Região do Caribe/epidemiologia , Filogenia , Lactente , Animais , Coinfecção/epidemiologia , Coinfecção/virologia , Idoso de 80 Anos ou mais , Anticorpos Antivirais/sangueRESUMO
BACKGROUND: Syphilis and human papillomavirus (HPV) are sexually transmitted infections affecting women in the same risk group. Thus, the main objective of the present study was to investigate the prevalence of HPV in a population of women with and without syphilis and observe the characteristics of HPV cervical lesions when coinfection occurs. Sociodemographic factors associated with coinfection were also evaluated. METHODS: This case-control study was conducted at a Brazilian HIV/STD testing and training center. Study groups were composed of women with (case) and without syphilis (control), paired by age. The presence of HPV, HPV subtype, and lesion severity were investigated. All women were subjected to a sociodemographic interview, clinical data collection, cell collection for cytopathological analysis, and a hybrid capture test for HPV diagnosis. The chi-square test was used for statistical analysis. RESULTS: The sample consisted of 176 women, 88 in each group. The prevalence of HPV was 14.8 % in the case (n = 13) and 18.1 % in the control group (n = 16), and there was no statistically significant difference between them. Illiterate individuals were more prevalent in the control group (p = 0.023). Considering women with suggestive signs of STIs, 30 % (6) of the patients and controls had high-risk HPV, and 15 % (3) had coinfection. The cytopathological assessment showed no differences between the groups concerning cellular atypia. However, ASC-US and ASC-H (atypical squamous cells of undetermined significance and high-grade) were only found in women with coinfections, with 75 % of these patients testing positive for high-risk HPV. Considering the distribution of lesions on the cervix, the HSIL (high-grade intraepithelial lesion) was assessed in high-risk HPV patients, both cases and controls. CONCLUSIONS: The prevalence of HPV was not increased in patients infected with syphilis. In addition, coinfection does not seem to be an aggravating factor for the presence of precursor lesions of cervical cancer.
Assuntos
Coinfecção , Infecções por Papillomavirus , Sífilis , Humanos , Feminino , Estudos de Casos e Controles , Sífilis/epidemiologia , Sífilis/complicações , Adulto , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/complicações , Brasil/epidemiologia , Fatores de Risco , Prevalência , Pessoa de Meia-Idade , Coinfecção/epidemiologia , Coinfecção/virologia , Adulto Jovem , Papillomaviridae/isolamento & purificação , Adolescente , Colo do Útero/patologia , Colo do Útero/virologiaRESUMO
Parasitic co-infections are common in developing countries and can interfere with leprosy treatment, leading to an increased risk of inflammatory leprosy reactions. This study assessed serum immunoglobulin G (IgG) levels against Toxoplasma gondii and Visceral Leishmaniasis (VL) antigens in 270 leprosy patients from Brazilian states. Regarding the respective cut-offs, the prevalence of IgG seropositivity for T. gondii and VL were 21.05â¯% and 47.36â¯% in the leprosy-negative group, and 77.7â¯% and 52.6â¯% in the leprosy-positive group. Of the 270 leprosy patients, 158 (58.5â¯%) presented with inflammatory leprosy reactions. Of those, 72 (59.5â¯%) had neuritis, 35 (48.6â¯%) had reverse reactions, and 28 (38.9â¯%) had ENL in both Brazilian states. Leprosy patients with anti-Leishmania IgG seropositivity were 3.25 times more likely to develop neuritis (95â¯% C.I.: 1.187 - 9.154; p = 0.019). These findings are particularly relevant for clinical settings where both leprosy and parasitic diseases are prevalent and could provide essential guidance for detecting and addressing complications arising from parasitic co-infections in leprosy patients, thereby improving clinical management strategies.