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Jornal de doenças infecciosas e medicina

Volume 3, Emitir 1 (2018)

Artigo de Pesquisa

Health System Factors Influencing Partner Notification for STIs and HIV in Lilongwe Malawi. A Pre-intervention Phase Assessment for a Quality Improvement Project

Mitch Matoga, Pearson Mmodzi, Cecelia Massa, Agatha Bula, Mina Hosseinipour and Charles Chasela

Introduction: Despite its wide use, passive partner notification (PN) has a low yield of sexual partners influenced by patient-related and health system (HS) factors.
Methods: We conducted a qualitative study and clinic observations during a pre-intervention phase of a quality improvement (QI) project to identify HS factors that influenced passive PN at Bwaila STI unit (BSU) in Lilongwe Malawi from January to February 2016. We conducted 15 in-depth interviews with health workers and clinic observations for six clinic flow and PN processes at the clinic.
Results: The majority of health workers felt that the lack of incentives for sexual partners or couples who presented to the clinic was the most important negative HS factor that influenced passive PN. We observed an average clinic start time of 09:02 hours. The average duration of the group health talk was 56 minutes and there was no difference in the time spent at the clinic between index cases and partners (1 hour 41 minutes versus 1 hour 36 minutes respectively).
Discussion: Lack of incentives for sexual partners or couples was the most important HS factors that impacted the yield of sexual partners. Interventions focusing on designing simple non-monetary incentives and QI of passive PN should be encouraged.

Mini revisão

Infection and the People’s Rights Regarding MERS in the Republic of Korea

Mi Jeong Park

The first case was reported on May 20, 2015. The outbreak was traced back to a Korean man who returned from a trip to Bahrain via Qatar in early May and sought medical care at several hospitals before being diagnosed. But this patient did not initially report his travel to the Middle East, which significantly delayed the process identifying the source of the epidemic.
In Korea, a total of 26 first generation cases in a single hospital were traced back to a single index case (patient zero). In particular, #14 confirmed case occurred outbreak of SAMSUNG Medical Center, infected at least 90 cases. SAMSUNG Medical Center is one of the five largest hospitals located in Seoul with 3,980 healthcare professionals and more than 8,000 outpatient visits per day.
As a matter of fact, most of the people infected with MERS or who faced the risk of becoming infected with the disease appear to be those who stayed at the hospitals where patients of the disease were being housed. However, when the spread of the disease reached its peak in early June, a thousand or more schools and kindergartens were temporarily shut down, and a number of public events and festivals were cancelled. It was reported that the number of tourists visiting Korea decreased by 41% compared with the same time period of the previous year. During this time period, 16,752 people were ordered to stay in isolation within their own homes.

Artigo de Pesquisa

Plasma and Urine Malondialdehyde Levels of Infants with Acute Bronchopneumonia in the Assessment of Oxidative Response

Huseyin Dag, Ayşem Kaya, Vefik Arıca, Sadik Sami Hatipoglu, Guner Karatekin and Habip Gedik3

Objective: Acute lower respiratory tract infections are seen as a major public health problem in many developing countries. This study was carried out in order to evaluate plasma and urine malonyldialdehyde (MDA) levels which represents the lipid peroxidation and hence of oxidative stress in infants diagnosed with acute bronchopneumonia which is a cause of high mortality and morbidity in children.
Material and methods: This case-control study was carried out at the department of Paediatrics, Ministry of Health Bakırköy Sadi Konuk Training and Research Hospital in 2005. The patient group comprised of 25 patients who were admitted to the hospital with the diagnosis of acute bronchopneumonia. The control group consisted of 10 healthy children of the same age range who had no pathological findings on physical examination. MDA values of urine and plasma samples were compared between both groups as an oxidative stress indicator.
Results: The mean serum MDA value of the patient group was 3.91 ± 1.55 micromol/L and that of the control group was measured as 1.03 ± 0.1micromol/L. The difference was significantly higher (p<0.001) in the patient group. The mean first day urine MDA value of the patient group were 1.05 ± 0.90 micromol/L and that of the control group was 0.009 micromol/L. The difference was significantly higher (p<0.05) in the patient group. The mean urine MDA value of the patient group was found similar to that of the control group at the third and fifth day of follow up (p>0.05).
Conclusion: The urine MDA values on the first day of follow-up and the plasma MDA values may be used as a parameter in the diagnosis and following-up treatment of oxidative stress in the infants with acute bronchopneumonia.

Artigo de Pesquisa

Zeihl Neelsen Stain: Still a Reliable Option for EPTB Diagnosis in Resource Constraint Settings

Kumar A, Duggal SD, Paramita Jena P, Rainy Rongpharpi S and Gur R

Background: Endemic countries like India are burdened with the bludgeoning effects of tuberculosis. While pulmonary tuberculosis is more prevalent and communicable, diagnosis of extra pulmonary tuberculosis (EPTB) is more challenging.
Methods: This was a retrospective study done for three consecutive years 2013 to 2015. The extra-pulmonary smear samples from patients suspected of tuberculosis were stained with Zeihl Neelsen stain and examined. Results: Based on ZN stain, EPTB was diagnosed in 13.4%, 9.5%, 10.6% suspected cases between 2013 to 2015 respectively. Highest positivity was seen among pus aspirates from lymph nodes in 13-25 years age group.
Conclusion: New technological advances are being made all across the globe for faster and specific tuberculosis diagnosis. However in resource limited settings, reliance is often on the smear microscopy findings. Diligently observed smears increase chances of diagnosis and is often rewarding.

Relato de caso

A Rare Case of Tuberculous Pleural Effusion Diagnosed by Ziehl Neelson Stain

Avinash Kumar and Anshul Kumar

Mycobacterium tuberculosis is the etiologic agent of tuberculosis which remains the leading cause of mortality, internationally. It commonly affects the lungs but can also infect other parts of the body. Extra pulmonary tuberculosis (EPTB) includes lymphatic, pleural, skeletal, ocular, endometrial, pancreatic, genitourinary, cerebral, and meningeal or military tuberculosis. In India EPTB, particularly of Pleural cavity is reported rarely. Pleural effusion is an excessive accumulation of fluid in the pleural cavity which, in normal condition, contains a relatively small amount of fluid-approximately 10 ml on each side. The idea of this article is to diagnose TB of pleural cavity by Ziehl Neelson staining, which usually presents with fever, weight loss and cough.

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