International Journal of Infection
Volume:8 Issue: 2, Apr 2021

 Crimean-Congo hemorrhagic fever (CCHF) is an acute fetal illness the case fatality rate (CFR), which without treatment is between 26% to more than 80%. Despite the administration of ribavirin as a specific antiviral drug for the treatment of CCHF from many years ago, its clinical efficacy is still controversial.

 This systematic review aimed to evaluate the clinical efficacy of ribavirin, favipiravir, and other treatment options for CCHF, including steroids, immunoglobulin, etc.

 This systematic review included 31 articles, three factsheet from WHO, CDC, and ECDC, two editorial letters, and two textbooks from 2002 to 2020. The following databases were searched: Google Scholar, PubMed, Medscape, Cochrane, WHO, CDC, and ECDC.

 The selected results of the above articles were concentrated on the different options of supportive treatment, including steroids, immunoglobulin, etc., as well as the efficacy of antiviral drugs, especially ribavirin and favipiravir. While some studies confirmed the clinical efficacy of ribavirin in the treatment of CCHF, some other studies did not confirm its efficacy. All studies justified that supportive therapies are the mainstay of treatment.

 The cornerstone of therapy of CCHF is supportive treatment. The clinical efficacy of ribavirin for CCHF treatment is questionable, and further randomized case-control clinical trials are required to confirm and recommend it for CCHF treatment. Also, other treatment strategies, including administration of steroids, immunoglobulin, and monoclonal antibodies (mAbs) require more conclusive data. The promising antiviral drug for CCHF treatment is favipiravir.

 Multiple case reports have shown promising results with remdesivir, tocilizumab and convalescent plasma. We evaluated the efficacy and safety of combination therapy with remdesivir, tocilizumab, steroids, antibiotics and convalescent plasma in COVID-19 patients.

 To assess whether a multi-pronged approach to tackling SARS-CoV-2 had an impact on our primary end goal of decreasing the need for mechanical ventilation and identify some of the complexities involved with combination treatment regimens.

 In this retrospective, single center study, six confirmed SARS-CoV-2 patients with similar demographics and comorbidities treated with a combination of remdesivir, tocilizumab, antibiotics, steroids and convalescent plasma were followed.

 At the time of initiation of treatment, all six patients were requiring at least 3 liters of supplemental oxygenation via nasal cannula. All patients received remdesivir for 5 - 10 days, tocilizumab for a total of 4 doses each across 2 days, methylprednisone and antibiotics. Commonly used antibiotics were cefepime, azithromycin, ceftriaxone and piperacillin/tazobactam. Convalescent plasma was given to three out of the six patients. Despite combination therapy with remdesivir, tocilizumab, steroids, antibiotics and convalescent plasma, four out of the six patients (66.67%) deteriorated and required invasive mechanical ventilation.

 There are currently no set treatment guidelines for COVID 19. Most institutions appear to be utilizing some form of combination therapy against COVID-19. In this study, invasive mechanical ventilation was avoided in only two of six patients despite robust use of combination therapy in all patients. Our study suggests that multiple medications may not be the answer. Instead, a clearer understanding of the pathophysiology along with timing at which medications are introduced might play a more important role. We propose judicious use of combination therapy in a methodical and sequential use in patients requiring three or more liters of supplemental oxygen. Use of any of these medications, either by itself or in combination, after mechanical ventilation has minimal if any benefits and should be used as a last resort. Currently, a few clinical trials in the recruiting stage are underway that look at various combination therapies that could provide a more comprehensive understanding regarding the efficacy of combination therapy against SARS-CoV-2.

 Malaria causes diverse adverse effects in the fetus due to the invasion of the placenta by Plasmodium. The use of intermittent preventive treatment (Sulphadoxinepyrimethamine- IPTp-SP) as a control measure for malaria in pregnancy has been recommended and shown to reduce unwanted birth outcomes.

 This work aimed to evaluate the effects of intervention schemes on sulphadoxine-pyrimethamine (SP) compliance and utilization among pregnant women in a health facility in Port Harcourt, Nigeria.

 A hospital-based survey was carried out among pregnant women admitted to the Labor ward of Obio-Cottage hospital. The information of mothers was collected using a well-structured and pre-tested questionnaire and from their antenatal care (ANC) records.

 Time of ANC registration indicated that 87%, 11.33%, and 1.66% of mothers were registered during their first, second, and third trimesters, respectively. Sulphadoxinepyrimethamine was the drug of choice for 93.66% of the women while 6.33% took other drugs. The survey revealed that 97.15% and 2.85% of the women started SP usage in their second and third trimesters, respectively. It was observed that the majority of the women (69.39%) took SP thrice while 24.19% and 6.40% consumed it twice and once, respectively. Regarding knowledge about SP, 89% of the women viewed SP as a preventive drug for malaria while 11% acknowledged it as a therapeutic drug. The birth outcomes of the neonates whose mothers took SP indicated that 1.42% had low birth weight (LBW) while 98.57% had acceptable birth weight. Meanwhile, 10.53% of the babies born to the mothers who did not use SP had LBW, and 89.47% of them had acceptable birth weights. Overall, 98.93% of the neonates of SP-compliant women and 89.48% of the babies of non-compliant women were alive. Non- compliant women had higher prevalence of preterm birth (5.76%) and fetal death (5.26%) than SP-compliant women (0.7% and 0.35%, respectively).

 Adequate knowledge and compliance with SP usage were high in the studied population, which was associated with favorable birth outcomes.

 Toxoplasmosis is caused by Toxoplasma gondii, a protozoan parasite, and is among the diseases generally referred to as neglected tropical disease (NTD). It can be a reason for impulsive abortion in pregnant women or hereditary chorioretinitis in neonates.

 The present study examined seroprevalence and related risk issues of toxoplasmosis in pregnant women (PTW) and non-pregnant females (NPF) of two health facilities in Port Harcourt.

 Venous blood was collected from 380 women and analyzed by immunodiagnostic techniques using ELISA (Enzyme-Linked Immunosorbent assay) IgG and IgM tests and real-time polymerase chain reaction (PCR). Data were collected using a well-structured questionnaire on the socio-demographic risk issues linked with toxoplasmosis.

 Among the study population, PTW and NPF had seroprevalence of 33.0% and 19.4%, respectively (P < 0.05). PTW recorded a higher overall seroprevalence than NPF with 16.1%, 1.3%, and 8.4%, 0.8% for Toxoplasma gondii ELISA IgG, and IgM tests, respectively. IgM-positive cases were all authenticated by the real-time PCR technique and were all negative. Age group 35-39 years had the highest IgG seroprevalence of 24.3% for PTW, while the age group > 40 years had the highest IgG seroprevalence of 18.2% for NPF. Traders recorded the uppermost seroprevalence of 20.9% and 2.6% for IgG and IgM among PTW, respectively, while teachers and traders recorded the maximum seroprevalence of 15.6% and 1.7% for IgG and IgM among NPF, respectively. Statistical analysis showed that there was no association between the age group, occupation, trimester, and toxoplasmosis.

 The toxoplasmosis was significantly high in pregnant women. It is recommended that Toxoplasma gondii tests should be included as a routine test during antenatal.

 One of the most challenging aspects of coronavirus disease 2019 (COVID-19) is that a newly infected individual shows diagnosable symptoms, such as body temperature (Tb) rise, several days after contracting the disease. In the early phase of infection (i.e., incubation period), an undiagnosed and unaware individual can spread the virus to others. The fastest and most efficient route of COVID-19 transmission is the respiratory system. Therefore, developing a model of the respiratory system to predict changes in the lung performance upon COVID-19 infection is useful for early diagnosis and intervention during the incubation period.

 This modeling study aimed to evaluate the respiratory system to present an early intervention for COVID-19 and its transmission.

 A simple model was developed by performing mass and energy balances on the lungs; it was simulated by the Aspen HYSYS chemical process simulator.

 To compensate for the virus-infected lung inefficiency, the O2 concentration increased in the exhaled air at the cost of decreased CO2 concentration. Contrary to previous findings on the reduced stability of coronavirus in hot and humid environments, it was found that very hot and humid environments promote the viral transmission rate because of the direct heat transfer to the body via respiration and condensation of water vapor that may cause infection in the respiratory tract.

 Our model revealed that measurement of O2 or CO2 composition of exhaled gas, using a non-invasive and inexpensive device at home, allows for the early diagnosis of infection and its prevention. This study also aimed to highlight the actual effects of high temperature and high relative humidity (RH) on increasing the virus transmission rates, as opposed to the generally accepted hypothesis of decreased coronavirus stability under these conditions.
 

 The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) causes severe respiratory infection. Gastrointestinal symptoms have been reported in up to 10% of patients.

 We here report a case of COVID-19-associated acute mesenteric ischemia in a patient presenting with fever and abdominal pain, deteriorating over a four-day period. The diagnosis was initially missed due to a low suspicion level. COVID-19 infection was confirmed by chest CT scan and RT-PCR. Then the patient underwent an emergency laparotomy showing segmental small bowel ischemia of about 2 meters (between the lower jejunum and upper ileum). Resection of the ischemic segment was performed by end-to-end anastomosis. He was then discharged from the hospital after recovering from COVID-19.

 The present case report highlights the importance of being vigilant about mesenteric ischemia symptoms in the patients with COVID-19, presenting with progressive abdominal pain for timely ordering appropriate diagnostic and therapeutic procedures.