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- Abdulle, Sahra, 1970, et al.
(author)
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Family support is important for adherence to antiretroviral therapy among HIV positive mothers in Dar es Salaam, Tanzania.
- 2019
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In: CLINICAL MICROBIOLOGY AND RESEARCH. ; 1:1, s. 1-3
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Journal article (peer-reviewed)abstract
- Adherence to antiretroviral treatment (ART) is of utmost importance to reduce the risk of vertical transmission of HIV. We enrolled 106 patients from two Prevention of mother-to-child transmission (PMTCT) clinics in Dar es Salaam in September- November 2016. Study participants were given structured standardized questionnaires regarding their self-estimated adherence and barriers and enablers to adherence. Good adherence was defined as taking ≥95% of the pills as prescribed. About 70% of the participants achieved this level of adherence. The odds ratios for poor adherence among women with medium and poor family support were 5.69 (95% CI: 1.36-23-75) and 6.86 (95% CI: 1.89-24.96) respectively compared to good support. A large portion of the women failed to reach the high set limit for adherence. Increased spousal involvement and support could help many women to achieve good adherence.
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| 2. |
- Andersson, Christer, et al.
(author)
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Mortalitet bland sjukhusvårdade tycktes inte öka under sommaren [Mortality among hospitalized patients did not appear to increase during the summer]
- 2019
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In: Läkartidningen. - Stockholm, Sweden : Sveriges Läkarförbund. - 0023-7205 .- 1652-7518. ; 116
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Journal article (peer-reviewed)abstract
- A retrospective review of medical records (2017-2018) at Linköping University Hospital compared hospital mortality for the 2-month period of summer vacations (group A) with two months of regular activity (group B). The mortality was 163 patients in group A and 216 in group B. Emergency admittance dominated (95%) in both groups. Comorbidity was found in 81%, and at admittance the risk for death during the hospital stay was estimated to more than 50% in three out of four patients. There was no difference between the groups regarding demography, hospital stay, or diagnosis. Due to a 30% reduction of hospital beds during the summer some patients were relocated to other specialties. No relocated patient died in group A but six in group B. Eight deaths were judged as probably preventable, but none definitely preventable. The similarity between the groups regarding mortality does not allow estimations of differences in adverse events in general. Low mortality among relocated patients is probably due to identification of high-risk patients not suitable for relocation.
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| 3. |
- Andersson, Jakob, 1974-, et al.
(author)
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Geomapping Landscapes of Writing (GLoW): Large-Scale Spatial Analysis of the Cuneiform Corpus (c. 3400 BCE to 100 CE)
- 2019
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Conference paper (other academic/artistic)abstract
- Cuneiform writing ranks among the largest bodies of ancient historical documentation. No attempt has hitherto been made to fully geomap this corpus. Combining philology, archaeology, and comparative linguistics, GLoW assembles and analyses a full digital record of this corpus drawing on recent advances in digital humanities. As a first quantifiable, comprehensive study of the cuneiform corpus, GLoW provides a benchmark example of applying digital and spatial computing tools to the study of early writing. Engaging with artifacts marred by years of recent conflict, it also serves as a key reference document for protecting part of the common heritage of humankind.
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| 7. |
- Backhaus, Erik, et al.
(author)
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Epidemiology of invasive pneumococcal infections: manifestations, incidence and case fatality rate correlated to age, gender and risk factors
- 2016
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In: Bmc Infectious Diseases. - : Springer Science and Business Media LLC. - 1471-2334. ; 16
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Journal article (peer-reviewed)abstract
- Background: Incidence, manifestations and case-fatality rate (CFR) of invasive pneumococcal disease (IPD) vary with age and comorbidities. New vaccines, changing age distribution, prolonged survival among immunocompromised patients and improved sepsis management have created a need for an update of basic facts to inform vaccine recommendations. Methods: Age, gender and comorbidities were related to manifestations and death for 2977 consecutive patients with IPD in a Swedish region with 1.5 million inhabitants during 13 years before introduction of pneumococcal conjugate vaccines (PCV) in the infant vaccination program. These data were related to population statistics and prevalence of several comorbidities, and compared with two previous studies giving a total follow-up of 45 years in the same area. Results: The annual incidence was 15/100,000 for any IPD and 1.1/100,000 for meningitis; highest among elderly followed by children < 2 years. It was 2238/100,000 among myeloma patients, followed by chronic lymphatic leukemia, hemodialysis and lung cancer, but not elevated among asthma patients. CFR was 10 % among all patients, varying from 3 % below 18 years to 22 %>= 80 years. During 45 years, the IPD incidence increased threefold and CFR dropped from 20 to 10 %. Meningitis incidence remained stable (1.1/100,000/year) but CFR dropped from 33 to 13 %. IPD-specific mortality decreased among children < 2 years from 3.1 to 0.46/100,000/year but tripled among those >= 65 years. Conclusions: IPD incidence and CFR vary widely between age and risk groups and over time even without general infant vaccination. Knowledge about specific epidemiological characteristics is important for informing and evaluating vaccination policies.
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| 8. |
- Birindwa, Archippe M., et al.
(author)
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High rate of antibiotic resistance among pneumococci carried by healthy children in the eastern part of the Democratic Republic of the Congo
- 2018
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In: Bmc Pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 18
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Journal article (peer-reviewed)abstract
- BackgroundPneumococcal conjugate vaccines have been introduced in the infant immunisation programmes in many countries to reduce the rate of fatal pneumococcal infections. In the Democratic Republic of the Congo (DR Congo) a 13-valent vaccine (PCV13) was introduced in 2013. Data on the burden of circulating pneumococci among children after this introduction are lacking. In this study, we aimed to determine the risk factors related to pneumococcal carriage in healthy Congolese children after the vaccine introduction and to assess the antibiotic resistance rates and serotype distribution among the isolated pneumococci.MethodsIn 2014 and 2015, 794 healthy children aged one to 60months attending health centres in the eastern part of DR Congo for immunisation or growth monitoring were included in the study. Data on socio-demographic and medical factors were collected by interviews with the children's caregivers. Nasopharyngeal swabs were obtained from all the children for bacterial culture, and isolated pneumococci were further tested for antimicrobial resistance using disc diffusion tests and, when indicated, minimal inhibitory concentration (MIC) determination, and for serotype/serogroup by molecular testing.ResultsThe pneumococcal detection rate was 21%, being higher among children who had not received PCV13 vaccination, lived in rural areas, had an enclosed kitchen, were malnourished or presented with fever (p value <0.05). The predominant serotypes were 19F, 11, 6A/B/C/D and 10A. More than 50% of the pneumococcal isolates belonged to a serotype/serogroup not included in PCV13.Eighty per cent of the isolates were not susceptible to benzylpenicillin and non-susceptibility to ampicillin and ceftriaxone was also high (42 and 37% respectively). Almost all the isolates (94%) were resistant to trimethoprim-sulphamethoxazole, while 43% of the strains were resistant to 3 antibiotics.ConclusionsOur study shows alarmingly high levels of reduced susceptibility to commonly used antibiotics in pneumococci carried by healthy Congolese children. This highlights the importance of local antibiotic resistance surveillance and indicates the needs for the more appropriate use of antibiotics in the area. The results further indicate that improved living conditions are needed to reduce the pneumococcal burden, in addition to PCV13 vaccination.
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| 9. |
- Ebenhard, Torbjörn, et al.
(author)
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Environmental effects of brushwood harvesting for bioenergy
- 2017
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In: Forest Ecology and Management. - : Elsevier BV. - 0378-1127 .- 1872-7042. ; 383, s. 85-98
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Journal article (peer-reviewed)abstract
- Sweden aims to increase the proportion of renewable energy sources, ultimately to be able to phase out fossil fuels. To achieve this, new energy sources need to be explored. In this multi-disciplinary article, we examine the technical, economical, ecological and legal possibilities to commercially and sustainably harvest brushwood for bioenergy, while simultaneously gaining positive environmental effects, both for biological diversity, the cultural heritage, and the climate. The Swedish open landscape is becoming covered with secondary brushwood regrowth through natural succession, except where it is kept open. Brushwood is spreading along roads, railway lines, edge zones, in power line corridors, abandoned semi-natural grasslands, nature reserves, and in marginal land in urban areas. Such brushwood consists of saplings, bushes and young trees of a range of deciduous plant species, e.g. birch, aspen, alder and goat willow, sometimes mixed with conifers, often forming dense thickets. Such secondary brushwood regrowth could be systematically utilised as a new source of renewable bioenergy. Commercial brushwood harvesting in Sweden may contribute 26 PJ of energy annually, which may be a small but significant contribution, considering the favourable energy ratio (E-r = 28), indicating that large emission reductions can be achieved, if fossil fuels are replaced. Growing brushwood does not require fertilizers or pesticides, soil tillage or crop management, and it does not compete with any other potential land use. Many brushwood habitats are already being managed to clear brushwood, for other purposes, minimizing the added harvesting cost. Apart from providing bioenergy, it has also been suggested that brushwood harvesting would benefit biological diversity. A large number of nationally redlisted species are dependent on the active management of open habitats, including semi-natural grasslands, and man-made habitats such as road verges and power line corridors. Our literature review shows that brushwood harvesting could benefit both biological diversity and the cultural heritage, and contribute to the management of the open cultural landscape. There are however certain limitations. Brushwood harvesting would favour a certain set of species, including many redlisted, but it may also threaten another set of species, especially species associated with early successional stages of forest regeneration, as well as forest edge species, depending on how and where it is applied. Harvesting may be affected by legislation imposing limitations regarding habitats of particular importance for biodiversity. The environmental and legal constraints would probably reduce the profitability of brushwood harvesting in certain areas, as well as the annual production of bioenergy.
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| 10. |
- Edman-Wallér, Jon, et al.
(author)
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Systemic symptoms predict presence or development of severe sepsis and septic shock
- 2016
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In: Infectious Diseases. - : Informa UK Limited. - 2374-4235 .- 2374-4243. ; 48:3, s. 209-214
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Journal article (peer-reviewed)abstract
- Severe sepsis is a major cause of mortality and morbidity globally. As the time to adequate treatment is directly linked to outcome, early recognition is of critical importance. Early, accessible markers for severe sepsis are desirable. The systemic inflammatory response in sepsis leads to changes in vital signs and biomarkers and to symptoms unrelated to the focus of infection. This study investigated whether the occurrence of any of six systemic symptoms could predict severe sepsis in a cohort of patients admitted to hospital for suspected bacterial infections. Methods: A retrospective, consecutive study was conducted. All adult patients admitted during 1 month to a 550-bed secondary care hospital in western Sweden and given intravenous antibiotics for suspected community-acquired infection were included (n=289). Symptoms (fever/chills, muscle weakness, localised pain, dyspnea, altered mental status and gastrointestinal symptoms) were registered along with age, sex, vital signs and laboratory values. Patients who fulfilled criteria of severe sepsis within 48 h were compared with patients who did not. Odds ratios for severe sepsis were calculated, adjusted for age, sex and comorbidities. Results: Criteria for severe sepsis were fulfilled by 90/289 patients (31.1%). Altered mental status (OR=4.29, 95% CI=2.03–9.08), dyspnea (OR=2.92, 95% CI=1.69–5.02), gastrointestinal symptoms (OR=2.31, 95% CI=1.14–4.69) and muscle weakness (OR=2.24, 95% CI=1.06–4.75) were more common in patients who had or later developed severe sepsis. Conclusions: Systemic symptoms in combination with other signs of infection should be considered warning signs of severe sepsis.
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