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Retraction: Evidence That Head and Body Lice on Homeless Persons Have the Same Genotype. PLoS One 2024; 19:e0312328. [PMID: 39401225 PMCID: PMC11472928 DOI: 10.1371/journal.pone.0312328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2024] Open
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2
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Diouf FS, Tidjani Alou M, Bassene H, Cortaredona S, Diatta G, Raoult D, Sokhna C, Lagier JC. Seasonal variation of asymptomatic viral and bacterial nasopharyngeal carriage in rural Senegal. J Infect Public Health 2024; 17:922-928. [PMID: 38579539 DOI: 10.1016/j.jiph.2024.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/26/2024] [Accepted: 03/17/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND The surveillance of respiratory pathogens in rural areas of West Africa has, to date, largely been focussed on symptoms. In this prospective study conducted prior to the COVID-19 pandemic, we aimed to assess the asymptomatic prevalence of respiratory pathogen carriage in a group of individuals living in a rural area of Senegalese. METHODS Longitudinal follow up was performed through monthly nasopharyngeal swabbing during the dry season and weekly swabbing during the rainy season. We enrolled 15 individuals from the village of Ndiop. A total of 368 nasopharyngeal swabs were collected over a one-year period. We investigated the prevalence of 18 respiratory viruses and eight respiratory bacteria in different age groups using singleplex and multiplex PCR. RESULTS In total, 19.56% of the samples (72/368) were positive for respiratory viruses and 13.60% of the samples (50/368) were positive for respiratory bacteria. Coronaviruses (19/72, 26.39%), adenoviruses (17/72, 23.61%), rhinoviruses (14/72, 19.44%), Streptococcus pneumoniae (17/50, 34%), and Moraxella catarrhalis (15/50, 30%) were the most frequently detected viruses. Interestingly, the carriage of respiratory pathogens was shown to be more frequent during the rainy season, as pluviometry was shown to be positively associated with the occurrence of respiratory viruses such as influenza (P = .0078, r2 =.523) and RSV (P = .0055, r2 =.554). CONCLUSIONS Our results show a non-negligible circulation of respiratory pathogens in a rural area in Senegal (West Africa) with an underestimated proportion of asymptomatic individuals. This study highlights the fact that the circulation of viruses and bacteria in the community has been overlooked.
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Affiliation(s)
- Fatou Samba Diouf
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal; IHU Méditerranée Infection, Marseille, France; Aix-Marseille Université, APHM, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Maryam Tidjani Alou
- IHU Méditerranée Infection, Marseille, France; Aix-Marseille Université, APHM, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Hubert Bassene
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal
| | - Sebastien Cortaredona
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal; IHU Méditerranée Infection, Marseille, France; Aix-Marseille Université, APHM, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Georges Diatta
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal
| | - Didier Raoult
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal; IHU Méditerranée Infection, Marseille, France; Aix-Marseille Université, APHM, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Cheikh Sokhna
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal; IHU Méditerranée Infection, Marseille, France; Aix-Marseille Université, APHM, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Jean-Christophe Lagier
- IHU Méditerranée Infection, Marseille, France; Aix-Marseille Université, APHM, MEPHI, IHU Méditerranée Infection, Marseille, France.
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3
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Diouf FS, Tidjani Alou M, Million M, Diatta G, Goumballa N, Ndiaye D, Bassene H, Dubourg G, Raoult D, Sokhna C, Lagier JC. Influence of Microbiota on Clinical Expressions of Respiratory Viral Infections. Am J Trop Med Hyg 2024; 110:391-398. [PMID: 38109763 PMCID: PMC10859809 DOI: 10.4269/ajtmh.23-0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/12/2023] [Indexed: 12/20/2023] Open
Abstract
Respiratory infections, mainly due to viruses, are among the leading causes of worldwide morbidity and mortality. We investigated the prevalence of viruses and bacteria in a cross-sectional survey conducted in Dielmo, a village in rural Senegal with a population of 481 inhabitants. Nasopharyngeal sampling was performed in 50 symptomatic subjects and 101 asymptomatic subjects. Symptomatic subjects were defined as individuals presenting with clinical signs of respiratory infection, whereas asymptomatic subjects were recruited in the same households. The identification of pathogens was performed by polymerase chain reaction for 18 respiratory viruses and eight respiratory bacteria. The prevalence results for respiratory viruses detected in each study group demonstrated that 83.6% of symptomatic samples were positive for at least one respiratory virus, and 21.8% were detected in asymptomatic samples. Influenza A (P = 0.0001), metapneumovirus (P = 0.04), and enterovirus (P = 0.001) were significantly more prevalent in symptomatic patients. Overall, 82.0% of symptomatic subjects and 26.9% of asymptomatic subjects were positive for at least one respiratory bacterium. The most frequent pathogenic bacteria detected were Moraxella catarrhalis (56%) and Streptococcus pneumoniae (48.0%) among symptomatic individuals, whereas in asymptomatic subjects Corynebacterium propinquum was more prevalent (18%). A principal component analysis showed that parainfluenzas 2 and 4 were associated with asymptomatic subjects, whereas influenza A was associated with the presence of symptoms. Considering these results, a large epidemiological surveillance of the circulation of these respiratory pathogens in the general population should be conducted to provide a better understanding of their carriage and to potentially prevent epidemics.
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Affiliation(s)
- Fatou Samba Diouf
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal
- Aix Marseille Université, Institut de recherche pour le développement, Assistance Publique - Hôpitaux de Marseille, Microbes, Évolution, Phylogénie et Infection, Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Maryam Tidjani Alou
- Aix Marseille Université, Institut de recherche pour le développement, Assistance Publique - Hôpitaux de Marseille, Microbes, Évolution, Phylogénie et Infection, Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Mathieu Million
- Aix Marseille Université, Institut de recherche pour le développement, Assistance Publique - Hôpitaux de Marseille, Microbes, Évolution, Phylogénie et Infection, Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Georges Diatta
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal
| | - Ndiaw Goumballa
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal
- Aix-Marseille Université, Institut de recherche pour le développement, Assistance Publique-Hôpitaux de Marseille, Service de santé des armées, Vecteurs – Infections Tropicales et Méditerranéennes, Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Dame Ndiaye
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal
| | - Hubert Bassene
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal
| | - Gregory Dubourg
- Aix Marseille Université, Institut de recherche pour le développement, Assistance Publique - Hôpitaux de Marseille, Microbes, Évolution, Phylogénie et Infection, Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Didier Raoult
- Aix Marseille Université, Institut de recherche pour le développement, Assistance Publique - Hôpitaux de Marseille, Microbes, Évolution, Phylogénie et Infection, Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Cheikh Sokhna
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal
- Aix Marseille Université, Institut de recherche pour le développement, Assistance Publique - Hôpitaux de Marseille, Microbes, Évolution, Phylogénie et Infection, Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Jean-Christophe Lagier
- Aix Marseille Université, Institut de recherche pour le développement, Assistance Publique - Hôpitaux de Marseille, Microbes, Évolution, Phylogénie et Infection, Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
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Riccò M, Baldassarre A, Corrado S, Bottazzoli M, Marchesi F. Respiratory Syncytial Virus, Influenza and SARS-CoV-2 in Homeless People from Urban Shelters: A Systematic Review and Meta-Analysis (2023). EPIDEMIOLOGIA 2024; 5:41-79. [PMID: 38390917 PMCID: PMC10885116 DOI: 10.3390/epidemiologia5010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Homeless people (HP) are disproportionally affected by respiratory disorders, including pneumococcal and mycobacterial infections. On the contrary, more limited evidence has been previously gathered on influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and very little is known about the occurrence of human respiratory syncytial virus (RSV), a common cause of respiratory tract infections among children and the elderly. The present systematic review was designed to collect available evidence about RSV, influenza and SARS-CoV-2 infections in HP, focusing on those from urban homeless shelters. Three medical databases (PubMed, Embase and Scopus) and the preprint repository medRxiv.org were therefore searched for eligible observational studies published up to 30 December 2023, and the collected cases were pooled in a random-effects model. Heterogeneity was assessed using the I2 statistics. Reporting bias was assessed by funnel plots and a regression analysis. Overall, 31 studies were retrieved, and of them, 17 reported on the point prevalence of respiratory pathogens, with pooled estimates of 4.91 cases per 1000 HP (95%CI: 2.46 to 9.80) for RSV, 3.47 per 1000 HP for influenza and 40.21 cases per 1000 HP (95%CI: 14.66 to 105.55) for SARS-CoV-2. Incidence estimates were calculated from 12 studies, and SARS-CoV-2 was characterized by the highest occurrence (9.58 diagnoses per 1000 persons-months, 95%CI: 3.00 to 16.16), followed by influenza (6.07, 95%CI: 0.00 to 15.06) and RSV (1.71, 95%CI: 0.00 to 4.13). Only four studies reported on the outcome of viral infections in HP: the assessed pathogens were associated with a high likelihood of hospitalization, while high rates of recurrence and eventual deaths were reported in cases of RSV infections. In summary, RSV, influenza and SARS-CoV-2 infections were documented in HP from urban shelters, and their potential outcomes stress the importance of specifically tailored preventive strategies.
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Affiliation(s)
- Matteo Riccò
- AUSL-IRCCS di Reggio Emilia, Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), Local Health Unit of Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Antonio Baldassarre
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Silvia Corrado
- ASST Rhodense, Dipartimento della Donna e Area Materno-Infantile, UOC Pediatria, 20024 Milan, Italy
| | - Marco Bottazzoli
- Department of Otorhinolaryngology, APSS Trento, 38122 Trento, Italy
| | - Federico Marchesi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
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Anastas TM, Stewart JC, Rand KL, Hirsh AT. Pain in People Experiencing Homelessness: A Scoping Review. Ann Behav Med 2023; 57:288-300. [PMID: 36745022 PMCID: PMC10094969 DOI: 10.1093/abm/kaac060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Prior work suggests that people experiencing homelessness (PEH) are at heightened risk for developing pain and have a uniquely burdensome pain experience. PURPOSE The aim of this scoping review was to map the current peer-reviewed, published literature on the pain experience of PEH. METHODS In accordance with the US Annual Homeless Assessment Report, we defined homelessness as lacking shelter or a fixed address within the last year. We conceptualized the pain experience via a modified version of the Social Communication Model of Pain, which considers patient, provider, and contextual factors. Published articles were identified with CINHAL, Embase, PubMed, PsycINFO, and Web of Science databases. RESULTS Sixty-nine studies met inclusion criteria. Studies revealed that PEH have high rates of pain and experience high levels of pain intensity and interference. Substantially fewer studies examined other factors relevant to the pain experience, such as self-management, treatment-seeking behaviors, and pain management within healthcare settings. Nonetheless, initial evidence suggests that pain is undermanaged in PEH. CONCLUSIONS Future research directions to understand pain and homelessness are discussed, including factors contributing to the under-management of pain. This scoping review may inform future work to develop interventions to address the specific pain care needs of PEH.
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Affiliation(s)
- Tracy M Anastas
- Department of Psychology, Indiana University – Purdue University Indianapolis (IUPUI), Indianapolis, IN, USA
| | - Jesse C Stewart
- Department of Psychology, Indiana University – Purdue University Indianapolis (IUPUI), Indianapolis, IN, USA
| | - Kevin L Rand
- Department of Psychology, Indiana University – Purdue University Indianapolis (IUPUI), Indianapolis, IN, USA
| | - Adam T Hirsh
- Department of Psychology, Indiana University – Purdue University Indianapolis (IUPUI), Indianapolis, IN, USA
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6
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Chow EJ, Casto AM, Rogers JH, Roychoudhury P, Han PD, Xie H, Mills MG, Nguyen TV, Pfau B, Cox SN, Wolf CR, Hughes JP, Uyeki TM, Rolfes MA, Mosites E, Shim MM, Duchin JS, Sugg N, Starita LA, Englund JA, Chu HY. The clinical and genomic epidemiology of seasonal human coronaviruses in congregate homeless shelter settings: A repeated cross-sectional study. LANCET REGIONAL HEALTH. AMERICAS 2022; 15:100348. [PMID: 35996440 PMCID: PMC9387177 DOI: 10.1016/j.lana.2022.100348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background The circulation of respiratory viruses poses a significant health risk among those residing in congregate settings. Data are limited on seasonal human coronavirus (HCoV) infections in homeless shelter settings. Methods We analysed data from a clinical trial and SARS-CoV-2 surveillance study at 23 homeless shelter sites in King County, Washington between October 2019-May 2021. Eligible participants were shelter residents aged ≥3 months with acute respiratory illness. We collected enrolment data and nasal samples for respiratory virus testing using multiplex RT-PCR platform including HCoV. Beginning April 1, 2020, eligibility expanded to shelter residents and staff regardless of symptoms. HCoV species was determined by RT-PCR with species-specific primers, OpenArray assay or genomic sequencing for samples with an OpenArray relative cycle threshold <22. Findings Of the 14,464 samples from 3281 participants between October 2019-May 2021, 107 were positive for HCoV from 90 participants (median age 40 years, range: 0·9-81 years, 38% female). HCoV-HKU1 was the most common species identified before and after community-wide mitigation. No HCoV-positive samples were identified between May 2020-December 2020. Adults aged ≥50 years had the highest detection of HCoV (11%) among virus-positive samples among all age-groups. Species and sequence data showed diversity between and within HCoV species over the study period. Interpretation HCoV infections occurred in all congregate homeless shelter site age-groups with the greatest proportion among those aged ≥50 years. Species and sequencing data highlight the complexity of HCoV epidemiology within and between shelters sites. Funding Gates Ventures, Centers for Disease Control and Prevention, National Institute of Health.
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Affiliation(s)
- Eric J. Chow
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Amanda M. Casto
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Julia H. Rogers
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Pavitra Roychoudhury
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Virology Division, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Peter D. Han
- Brotman Baty Institute for Precision Medicine, Seattle, Washington, USA
- Department of Genome Sciences, University of Washington, Seattle, Washington, USA
| | - Hong Xie
- Virology Division, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Margaret G. Mills
- Virology Division, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Tien V. Nguyen
- Virology Division, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Brian Pfau
- Brotman Baty Institute for Precision Medicine, Seattle, Washington, USA
- Department of Genome Sciences, University of Washington, Seattle, Washington, USA
| | - Sarah N. Cox
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Caitlin R. Wolf
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - James P. Hughes
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Timothy M. Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Melissa A. Rolfes
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Emily Mosites
- Office of the Deputy Director for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - M. Mia Shim
- Public Health – Seattle & King County, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Jeffrey S. Duchin
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
- Public Health – Seattle & King County, Seattle, Washington, USA
| | - Nancy Sugg
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Lea A. Starita
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Virology Division, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Janet A. Englund
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Washington, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Helen Y. Chu
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
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Chow EJ, Casto AM, Roychoudhury P, Han PD, Xie H, Pfau B, Nguyen TV, Sereewit J, Rogers JH, Cox SN, Wolf CR, Rolfes MA, Mosites E, Uyeki TM, Greninger AL, Hughes JP, Shim MM, Sugg N, Duchin JS, Starita LM, Englund JA, Chu HY. The Clinical and Genomic Epidemiology of Rhinovirus in Homeless Shelters-King County, Washington. J Infect Dis 2022; 226:S304-S314. [PMID: 35749582 PMCID: PMC9384451 DOI: 10.1093/infdis/jiac239] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Rhinovirus (RV) is a common cause of respiratory illness in all people, including those experiencing homelessness. RV epidemiology in homeless shelters is unknown. METHODS We analyzed data from a cross-sectional homeless shelter study in King County, Washington, October 2019-May 2021. Shelter residents or guardians aged ≥3 months reporting acute respiratory illness completed questionnaires and submitted nasal swabs. After 1 April 2020, enrollment expanded to residents and staff regardless of symptoms. Samples were tested by multiplex RT-PCR for respiratory viruses. A subset of RV-positive samples was sequenced. RESULTS There were 1066 RV-positive samples with RV present every month of the study period. RV was the most common virus before and during the coronavirus disease 2019 (COVID-19) pandemic (43% and 77% of virus-positive samples, respectively). Participants from family shelters had the highest prevalence of RV. Among 131 sequenced samples, 33 RV serotypes were identified with each serotype detected for ≤4 months. CONCLUSIONS RV infections persisted through community mitigation measures and were most prevalent in shelters housing families. Sequencing showed a diversity of circulating RV serotypes, each detected over short periods of time. Community-based surveillance in congregate settings is important to characterize respiratory viral infections during and after the COVID-19 pandemic. CLINICAL TRIALS REGISTRATION NCT04141917.
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Affiliation(s)
- Eric J Chow
- Corresponding author: Eric J. Chow, MD, MS, MPH, Division of Allergy and Infectious Diseases, University of Washington, 1959 NE Pacific Street Box 356423, S512020125, Washington 98195, E-mail: , Ph:206-685-4456, Fax:206-616-3892
| | - Amanda M Casto
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle (98195), Washington, USA,Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle (98109), Washington, USA
| | - Pavitra Roychoudhury
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle (98109), Washington, USA,Virology Division, Department of Laboratory Medicine and Pathology, University of Washington, Seattle (98195), Washington, USA
| | - Peter D Han
- Brotman Baty Institute for Precision Medicine, Seattle (98195), Washington, USA,Department of Genome Sciences, University of Washington, Seattle (98195), Washington, USA
| | - Hong Xie
- Virology Division, Department of Laboratory Medicine and Pathology, University of Washington, Seattle (98195), Washington, USA
| | - Brian Pfau
- Brotman Baty Institute for Precision Medicine, Seattle (98195), Washington, USA,Department of Genome Sciences, University of Washington, Seattle (98195), Washington, USA
| | - Tien V Nguyen
- Virology Division, Department of Laboratory Medicine and Pathology, University of Washington, Seattle (98195), Washington, USA
| | - Jaydee Sereewit
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle (98195), Washington, USA
| | - Julia H Rogers
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle (98195), Washington, USA,Department of Epidemiology, University of Washington, Seattle (98195), Washington, USA
| | - Sarah N Cox
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle (98195), Washington, USA,Department of Epidemiology, University of Washington, Seattle (98195), Washington, USA
| | - Caitlin R Wolf
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle (98195), Washington, USA
| | - Melissa A Rolfes
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta (30333), Georgia, USA
| | - Emily Mosites
- Office of the Deputy Director for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta (30333), Georgia, USA
| | - Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta (30333), Georgia, USA
| | - Alexander L Greninger
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle (98109), Washington, USA,Department of Laboratory Medicine and Pathology, University of Washington, Seattle (98195), Washington, USA
| | - James P Hughes
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle (98109), Washington, USA,Department of Biostatistics, University of Washington, Seattle (98105), Washington, USA
| | - M Mia Shim
- Public Health – Seattle & King County, Seattle (98104), Washington, USA,Department of Medicine, University of Washington, Seattle (98195), Washington, USA
| | - Nancy Sugg
- Department of Medicine, University of Washington, Seattle (98195), Washington, USA
| | - Jeffrey S Duchin
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle (98195), Washington, USA,Public Health – Seattle & King County, Seattle (98104), Washington, USA
| | - Lea M Starita
- Brotman Baty Institute for Precision Medicine, Seattle (98195), Washington, USA,Department of Genome Sciences, University of Washington, Seattle (98195), Washington, USA
| | - Janet A Englund
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Washington, Seattle Children’s Research Institute, Seattle (98105), Washington, USA
| | - Helen Y Chu
- Alternate Corresponding Author: Helen Y. Chu, MD, MPH, Division of Allergy and Infectious Diseases, University of Washington, 750 Republican Street, Seattle, Washington 98109, Ph: 206-685-8702, E-mail:
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8
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Corey J, Lyons J, O’Carroll A, Stafford R, Ivers JH. A Scoping Review of the Health Impact of the COVID-19 Pandemic on Persons Experiencing Homelessness in North America and Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3219. [PMID: 35328907 PMCID: PMC8954292 DOI: 10.3390/ijerph19063219] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 02/04/2023]
Abstract
Persons experiencing homelessness (PEH) are at heightened risk for infection, morbidity, and mortality from COVID-19. However, health consequences of the pandemic extend far beyond those directly caused by the virus. This scoping review aimed to explore the impacts of the COVID-19 pandemic on the health and well-being of PEH in North America and Europe. A systematic search of academic and grey literature was conducted in September 2021. To be included, studies had to include primary data related to the impact of the pandemic on health or well-being of PEH and be written in English. All potentially relevant references were independently screened by two reviewers, and minor conflicts were settled with input of a third reviewer. A total of 96 articles met criteria for inclusion. Data extraction was completed for all included studies, and findings synthesised and presented thematically. Numerous health impacts of the pandemic on PEH were identified, including SARS-CoV-2 infection, morbidity, mortality, and hospitalisation, fear of infection, access to housing, hygiene, PPE, food, as well as mental health, substance use, other health-related outcomes and treatment services. Gaps in the literature relating to persons using alcohol, access to mental health support, and violence were also identified. Implications for future research are discussed.
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Affiliation(s)
- Julia Corey
- Department of Public Health & Primary Care, School of Medicine, Trinity College Dublin, D24H74 Dublin, Ireland; (J.C.); (J.L.)
| | - James Lyons
- Department of Public Health & Primary Care, School of Medicine, Trinity College Dublin, D24H74 Dublin, Ireland; (J.C.); (J.L.)
| | | | - Richie Stafford
- HSE Community Healthcare Organisation Dublin North City & County, D09C8P5 Dublin, Ireland;
| | - Jo-Hanna Ivers
- Department of Public Health & Primary Care, School of Medicine, Trinity College Dublin, D24H74 Dublin, Ireland; (J.C.); (J.L.)
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9
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Dao TL, Hoang VT, Ly TDA, Goumballa N, Gautret P. Epidemiological Investigations of Infectious Diseases among Mobile Populations at the University Hospital Institute Mediterranean Infection in Marseille, France. J Epidemiol Glob Health 2021; 11:271-282. [PMID: 34514760 PMCID: PMC8435867 DOI: 10.2991/jegh.k.210526.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 05/21/2021] [Indexed: 11/29/2022] Open
Abstract
We review the most recent work conducted by our group on the circulation of infectious agents in mobile populations, including pilgrims participating in the Hajj (Mecca, Saudi Arabia) and the Grand Magal of Touba (Senegal) pilgrimages, homeless people, and medical students participating in an elective abroad. Using a similar epidemiological study design with standardized questionnaires and molecular assays allows comparison of different populations of travelers. The main infectious pathogens and antibiotic resistance genes linked to travel were identified in certain specific populations of travelers, as well as in a group of homeless migrant people in Marseille. The role of several risk factors has also been demonstrated, allowing identifying individuals at increased risk of disease or pathogen carriage on which to base targeted preventive measures. Such results, together with those obtained through international surveillance networks allow better description of the epidemiology of travel-associated infectious diseases.
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Affiliation(s)
- Thi Loi Dao
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, France.,IHU-Méditerranée Infection, 19-21 Boulevard Jean, Moulin 13385, Marseille Cedex 05, France.,Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Van Thuan Hoang
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, France.,IHU-Méditerranée Infection, 19-21 Boulevard Jean, Moulin 13385, Marseille Cedex 05, France.,Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Tran Duc Anh Ly
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, France.,IHU-Méditerranée Infection, 19-21 Boulevard Jean, Moulin 13385, Marseille Cedex 05, France
| | - Ndiaw Goumballa
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, France.,IHU-Méditerranée Infection, 19-21 Boulevard Jean, Moulin 13385, Marseille Cedex 05, France
| | - Philippe Gautret
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, France.,IHU-Méditerranée Infection, 19-21 Boulevard Jean, Moulin 13385, Marseille Cedex 05, France
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10
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Ly TDA, Hoang VT, Goumballa N, Louni M, Canard N, Dao TL, Medkour H, Borg A, Bardy K, Esteves-Vieira V, Filosa V, Davoust B, Mediannikov O, Fournier PE, Raoult D, Gautret P. Variations in respiratory pathogen carriage among a homeless population in a shelter for men in Marseille, France, March-July 2020: cross-sectional 1-day surveys. Eur J Clin Microbiol Infect Dis 2021; 40:1579-1582. [PMID: 33580843 PMCID: PMC7881748 DOI: 10.1007/s10096-020-04127-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/13/2020] [Indexed: 12/03/2022]
Abstract
We aimed to compare respiratory pathogen carriage by PCR during three different time periods in 2020 in sheltered homeless people in Marseille, France. The overall prevalence of respiratory pathogen carriage in late March-early April (69.9%) was significantly higher than in late April (42.3%) and mid-July (45.1%). Bacterial carriage significantly decreased between late March-early April and late April. SARS-CoV-2 was detected only in late March-early April samples (20.6%). Measures aiming at mitigating SARS-CoV-2 transmission were effective and also impacted bacterial carriage. Seasonal variations of bacterial carriage between winter and summer in this population were not marked.
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Affiliation(s)
- Tran Duc Anh Ly
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - Van Thuan Hoang
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
- Family Medicine Department, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Ndiaw Goumballa
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France
- VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal
| | - Meriem Louni
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - Naomie Canard
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - Thi Loi Dao
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
- Pneumology Department, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Hacene Medkour
- IHU-Méditerranée Infection, Marseille, France
- IRD, AP-HM, SSA, MEPHI, Aix Marseille Univ, Marseille, France
| | - Audrey Borg
- IHU-Méditerranée Infection, Marseille, France
| | - Kevin Bardy
- IHU-Méditerranée Infection, Marseille, France
| | | | | | - Bernard Davoust
- IHU-Méditerranée Infection, Marseille, France
- IRD, AP-HM, SSA, MEPHI, Aix Marseille Univ, Marseille, France
| | - Oleg Mediannikov
- IHU-Méditerranée Infection, Marseille, France
- IRD, AP-HM, SSA, MEPHI, Aix Marseille Univ, Marseille, France
| | - Pierre-Edouard Fournier
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - Didier Raoult
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
- IRD, AP-HM, SSA, MEPHI, Aix Marseille Univ, Marseille, France
| | - Philippe Gautret
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France.
- IHU-Méditerranée Infection, Marseille, France.
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11
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Ly TDA, Castaneda S, Hoang VT, Dao TL, Gautret P. Vaccine-preventable diseases other than tuberculosis, and homelessness: A scoping review of the published literature, 1980 to 2020. Vaccine 2021; 39:1205-1224. [PMID: 33509694 DOI: 10.1016/j.vaccine.2021.01.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/12/2020] [Accepted: 01/13/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Homelessness may result in the breakdown of regular health services, including routine vaccination programmes. A scoping review was conducted to describe vaccine-preventable diseases (VPD) other than tuberculosis in people experiencing homelessness (PEH). METHODS We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We searched peer-reviewed literature published in English, French, Spanish or Portuguese reporting the outbreak of VPD or VPD prevalence in both infant and adult homeless populations published between 1980 and 2020, using PubMed/Medline, SciELO, Google Scholar, and Web of Science databases. Relevant information from the studies was charted in Microsoft Excel and results were summarised using a descriptive analytical method. RESULTS Eighty-one articles were included. A high prevalence of past hepatitis B virus (HBV) and hepatitis A virus (HAV) infections were observed through serosurveys, mostly in high income countries or high-middle income countries (USA, Canada, France, Iran or Brazil). Ten outbreaks of HAV infection were also reported, with lethality rates ranging from 0 to 4.8%. The studies identified numerous risk factors positively associated with HBV infection, including older age, homosexual or bisexual practice, injected drug use (IDU), and, with HAV infection including IDU, having sexual partner(s) with a history of unspecified hepatitis, insertive anal penetration, or originating from a country with a high prevalence of anti-HAV antibody. Eleven outbreaks of pneumococcal infection affecting PEH were reported in Canada and USA, with lethality rates from 0 to 15.6%. Six diphtheria outbreaks were reported. Vaccination status was rarely documented in these studies. CONCLUSIONS The literature suggests that homeless populations generally experience a high VPD burden suggesting the need for a national vaccination programme and planning for delivering vaccines in this population.
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Affiliation(s)
- Tran Duc Anh Ly
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | | | - Van Thuan Hoang
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France; Family Medicine Department, Thai Binh University of Medicine and Pharmacy, Viet Nam
| | - Thi Loi Dao
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France; Pneumology Department, Thai Binh University of Medicine and Pharmacy, Viet Nam
| | - Philippe Gautret
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
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12
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Ly TDA, Nguyen NN, Hoang VT, Goumballa N, Louni M, Canard N, Dao TL, Medkour H, Borg A, Bardy K, Esteves-Vieira V, Filosa V, Davoust B, Mediannikov O, Fournier PE, Raoult D, Gautret P. Screening of SARS-CoV-2 among homeless people, asylum-seekers and other people living in precarious conditions in Marseille, France, March-April 2020. Int J Infect Dis 2021; 105:1-6. [PMID: 33578010 PMCID: PMC7872841 DOI: 10.1016/j.ijid.2021.02.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/05/2021] [Indexed: 11/25/2022] Open
Abstract
Background Surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among sheltered homeless and other vulnerable people might provide the information needed to prevent its spread within accommodation centres. Methods Data were obtained from 698 participants in different accommodation centres (411 homeless individuals, 77 asylum-seekers, 58 other people living in precarious conditions and 152 employees working in these accommodation centres) who completed questionnaires and had nasal samples collected between 26 March and 17 April 2020. SARS-CoV-2 carriage was assessed by quantitative PCR. Results We found a high acceptance rate (78.9%) for testing. Overall, 49 people (7.0%) were positive for SARS-CoV-2, including 37 homeless individuals (of 411, 9.0%) and 12 employees (of 152, 7.9%). SARS-CoV-2 positivity correlated with symptoms, although 51% of patients who tested positive did not report respiratory symptoms or fever. Among homeless people, being young (18–34 years) (odds ratio 3.83, 95% confidence interval 1.47–10.0, p = 0.006) and being housed in one specific shelter (odds ratio 9.13, 95% confidence interval 4.09–20.37, p < 0.001) were independent factors associated with SARS-CoV-2 positivity (rates of 11.4% and 20.6%, respectively). Discussion Symptom screening alone is insufficient to prevent SARS-CoV-2 transmission in vulnerable sheltered people. Systematic testing should be promoted.
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Affiliation(s)
- Tran Duc Anh Ly
- Aix-Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Nhu Ngoc Nguyen
- Aix-Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Van Thuan Hoang
- Aix-Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France; Family Medicine Department, Thai Binh University of Medicine and Pharmacy, Viet Nam
| | - Ndiaw Goumballa
- Aix-Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal
| | - Meriem Louni
- Aix-Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Naomie Canard
- Aix-Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Thi Loi Dao
- Aix-Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France; Pneumology Department, Thai Binh University of Medicine and Pharmacy, Viet Nam
| | - Hacene Medkour
- IHU-Méditerranée Infection, Marseille, France; Aix-Marseille University, IRD, AP-HM, SSA, MEPHI, Marseille, France
| | - Audrey Borg
- IHU-Méditerranée Infection, Marseille, France
| | - Kevin Bardy
- IHU-Méditerranée Infection, Marseille, France
| | | | | | - Bernard Davoust
- IHU-Méditerranée Infection, Marseille, France; Aix-Marseille University, IRD, AP-HM, SSA, MEPHI, Marseille, France
| | - Oleg Mediannikov
- IHU-Méditerranée Infection, Marseille, France; Aix-Marseille University, IRD, AP-HM, SSA, MEPHI, Marseille, France
| | - Pierre-Edouard Fournier
- Aix-Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Didier Raoult
- Aix-Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France; Aix-Marseille University, IRD, AP-HM, SSA, MEPHI, Marseille, France
| | - Philippe Gautret
- Aix-Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
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13
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Haddad G, Bellali S, Fontanini A, Francis R, La Scola B, Levasseur A, Bou Khalil J, Raoult D. Rapid Scanning Electron Microscopy Detection and Sequencing of Severe Acute Respiratory Syndrome Coronavirus 2 and Other Respiratory Viruses. Front Microbiol 2020; 11:596180. [PMID: 33329483 PMCID: PMC7711091 DOI: 10.3389/fmicb.2020.596180] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/23/2020] [Indexed: 12/23/2022] Open
Abstract
There is an urgent need for accurate and rapid testing methods to quickly identify infected patients as well as asymptomatic carriers, in order to prevent the spread of emerging viruses. Here, we developed a rapid testing strategy by scanning electron microscopy capable of detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory viruses directly from patients. We evaluated our results by comparing them to real-time reverse transcription-polymerase chain reaction (RT-PCR) and metagenomic sequencing results. We correlated the presence of the SARS-CoV-2 to the viral load, where samples with Ct values lower than 18 were all detected by scanning electron microscopy (SEM). The sensitivity deacresed progressively with higher Ct values. In addition, we found a correlation with metagenomic sequencing, where all samples detected by SEM were sequenced and viral sequences were easily recovered. Following this study, SEM proved its efficiency as a frontline method for directly detecting previously unknown microorganisms that cannot be targeted by molecular methods and can cause potential outbreaks.
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Affiliation(s)
- Gabriel Haddad
- Aix-Marseille Université, Institut de Recherche pour le Développement(IRD), UMR Microbes Evolution Phylogeny and Infections (MEPHI), Marseille, France.,Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Sara Bellali
- Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Anthony Fontanini
- Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Rania Francis
- Aix-Marseille Université, Institut de Recherche pour le Développement(IRD), UMR Microbes Evolution Phylogeny and Infections (MEPHI), Marseille, France.,Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Bernard La Scola
- Aix-Marseille Université, Institut de Recherche pour le Développement(IRD), UMR Microbes Evolution Phylogeny and Infections (MEPHI), Marseille, France.,Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Anthony Levasseur
- Aix-Marseille Université, Institut de Recherche pour le Développement(IRD), UMR Microbes Evolution Phylogeny and Infections (MEPHI), Marseille, France.,Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Jacques Bou Khalil
- Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Didier Raoult
- Aix-Marseille Université, Institut de Recherche pour le Développement(IRD), UMR Microbes Evolution Phylogeny and Infections (MEPHI), Marseille, France.,Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
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14
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Ly TDA, Dao TL, Hoang VT, Braunstein D, Brouqui P, Lagier JC, Parola P, Gautret P. Pattern of infections in French and migrant homeless hospitalised at Marseille infectious disease units, France: A retrospective study, 2017-2018. Travel Med Infect Dis 2020; 36:101768. [PMID: 32504668 DOI: 10.1016/j.tmaid.2020.101768] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/25/2020] [Accepted: 05/30/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND No research has been conducted on the clinical characteristics and outcomes of homeless patients (HP) hospitalized in Infectious Disease Units (IDU). METHODS We conducted a retrospective survey among 98 HP and 98 non-HP admitted between 2017 and 2018 in several IDUs in Marseille, France. RESULTS HP were more likely to be migrant, to report frequent alcohol consumption or illicit drug use, and to present with respiratory symptoms at admission compared to controls. The most common final diagnoses in HP were respiratory tract infections (other than pulmonary tuberculosis [PTB], 35.7%), sexually transmitted infections (20.4%), cutaneous and mucosal infections (19.4%) and tuberculosis (12.2%). Sexually transmitted infections and ectoparasite infestations were significantly more frequent in HP compared to controls. One HP died from pleural effusion as a complication of PTB. The surviving HP had a longer length of stay (LOS, average 11.6 ± 13.6 days, p < 0.0001) than controls; independent factors of increased LOS were tobacco use (p = 0.009), tuberculosis infection (p < 0.0001), urinary tract infection (p = 0.018) and bacteraemia (p = 0.018). After hospital discharge, attendance at subsequent planned consultations was significantly lower in HP (0.72 ± 1.25 times/persons) compared to controls (2.03 ± 2.2). CONCLUSIONS We suggest that HP present specific demographic characteristics and patterns of infectious diseases compared to other patients and therefore require adapted management.
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Affiliation(s)
- Tran Duc Anh Ly
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Thi Loi Dao
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France; Pneumology Department, Thai Binh University of Medicine and Pharmacy, Viet Nam
| | - Van Thuan Hoang
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France; Family Medicine Department, Thai Binh University of Medicine and Pharmacy, Viet Nam
| | - David Braunstein
- Department of Medical Information, APHM, Marseille, France; Aix-Marseille Univ, EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005, Marseille, France
| | - Philippe Brouqui
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Jean-Christophe Lagier
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Philippe Parola
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Philippe Gautret
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
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15
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Ly TDA, Hadjadj L, Hoang VT, Louni M, Dao TL, Badiaga S, Tissot-Dupont H, Raoult D, Rolain JM, Gautret P. Low prevalence of resistance genes in sheltered homeless population in Marseille, France, 2014-2018. Infect Drug Resist 2019; 12:1139-1151. [PMID: 31123411 PMCID: PMC6511248 DOI: 10.2147/idr.s202048] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 03/07/2019] [Indexed: 12/23/2022] Open
Abstract
Objectives: The present study has explored the prevalence and potential factors contributing to the presence of nasal/pharyngeal resistant genes in homeless people. Methods: During the winters 2014-2018, we enrolled sheltered homeless adults and controls and collected nasal/pharyngeal samples. Sixteen antibiotic resistance genes (ARGs), including genes encoding for beta-lactamases and colistin-resistance genes, were searched by real-time polymerase chain reaction (qPCR) performed directly on respiratory samples and followed by conventional PCR and sequencing. Results: Over a 5-year period, using qPCR, we identified in homeless group (n=715) the presence of bla TEM (396/710, 54.7%), blaSHV (27/708, 3.6%), bla OXA-23 (1/708, 0.1%), while other genes including colistin-resistance genes (mcr-1 to mcr-5) were absent. We found a significantly higher proportion of ARG carriage among controls (74.1%) compared to homeless population (57.1%), p=0.038. Tobacco smoking (OR=4.72, p<0.0001) and respiratory clinical signs (OR=4.03, p=0.002) were most prevalent in homeless people, while vaccination against influenza (OR=0.31, p=0.016) was lower compared to controls. Among homeless people, type of housing (shelter A versus B, OR=1.59, p=0.006) and smoking tobacco (smoker versus non-smoker, OR=0.55, p=0.001) were independent factors associated with ARG carriage. By sequencing, we obtained a high diversity of bla TEM and blaSHV in both populations. Conclusion: The lower risk for ARGs in the homeless population could be explained by limited access to health care and subsequently reduced exposure to antibiotics.
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Affiliation(s)
- Tran Duc Anh Ly
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ., Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Linda Hadjadj
- IHU-Méditerranée Infection, Marseille, France.,MEPHI, Aix Marseille Univ., Marseille, France
| | - Van Thuan Hoang
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ., Marseille, France.,IHU-Méditerranée Infection, Marseille, France.,Family Medicine Department, Thai Binh University of Medicine and Pharmacy, Thành Phố Thái Bình, Vietnam
| | - Meriem Louni
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ., Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Thi Loi Dao
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ., Marseille, France.,IHU-Méditerranée Infection, Marseille, France.,Pneumology Department, Thai Binh University of Medicine and Pharmacy, Thành Phố Thái Bình, Vietnam
| | - Sekene Badiaga
- IHU-Méditerranée Infection, Marseille, France.,Emergency Department, North Hospital, AP-HM, Marseille, France
| | - Herve Tissot-Dupont
- IHU-Méditerranée Infection, Marseille, France.,MEPHI, Aix Marseille Univ., Marseille, France
| | - Didier Raoult
- IHU-Méditerranée Infection, Marseille, France.,MEPHI, Aix Marseille Univ., Marseille, France
| | - Jean-Marc Rolain
- IHU-Méditerranée Infection, Marseille, France.,MEPHI, Aix Marseille Univ., Marseille, France
| | - Philippe Gautret
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ., Marseille, France.,IHU-Méditerranée Infection, Marseille, France
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