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Objective: Understanding transmission dynamics is useful for tuberculosis (TB) control. A population-based molecular epidemiological study was conducted to determine TB transmission in Ghana.

Methods: Mycobacterium tuberculosis complex (MTBC) isolates obtained from prospectively sampled pulmonary TB patients between July 2012 and December 2015 were characterized using spoligotyping and standard 15-locus mycobacterial interspersed repetitive unit variable number tandem repeat (MIRU-VNTR) typing for transmission studies.

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Results: Out of 2309 MTBC isolates, 1082 (46.9%) unique cases were identified, with 1227 (53.1%) isolates belonging to one of 276 clusters. The recent TB transmission rate was estimated to be 41.2%. Whereas TB strains of lineage 4 belonging to M. tuberculosis showed a high recent transmission rate (44.9%), reduced recent transmission rates were found for lineages of Mycobacterium africanum (lineage 5, 31.8%; lineage 6, 24.7%).

Conclusions: The study findings indicate high recent TB transmission, suggesting the occurrence of unsuspected outbreaks in Ghana. The observed reduced transmission rate of M. africanum suggests other factor(s) (host/environmental) may be responsible for its continuous presence in West Africa.

A new study found that mandatory school closures and other social distancing measures reduced influenza transmission rates in Mexico during the 2009 pandemic. The results suggest that similar measures could be useful for fighting future influenza pandemics.

These findings highlight variation in pandemic influenza incidence and severity among age groups. They also reveal the importance of school cycles on the transmission dynamics of this disease. The results suggest that school closure and other measures could help to mitigate future influenza pandemics.

Men and women infected with HIV reduced the risk of transmitting the virus to their sexual partners by taking oral antiretroviral medicines when their immune systems were relatively healthy, according to findings from a large-scale clinical study sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The clinical trial, known as HPTN 052, was slated to end in 2015 but the findings are being released early as the result of a scheduled interim review of the study data by an independent data and safety monitoring board (DSMB). The DSMB concluded that it was clear that use of antiretrovirals by HIV-infected individuals with relatively healthier immune systems substantially reduced transmission to their partners. The results are the first from a major randomized clinical trial to indicate that treating an HIV-infected individual can reduce the risk of sexual transmission of HIV to an uninfected partner.

In its review, the DSMB found a total of 39 cases of HIV infection among the previously uninfected partners. Of those, 28 were linked through genetic analysis to the HIV-infected partner as the source of infection. Seven infections were not linked to the HIV-infected partner, and four infections are still undergoing analysis. Of the 28 linked infections, 27 infections occurred among the 877 couples in which the HIV-infected partner did not begin antiretroviral therapy immediately. Only one case of HIV infection occurred among those couples where the HIV-infected partner began immediate antiretroviral therapy. This finding was statistically significant and means that earlier initiation of antiretrovirals led to a 96 percent reduction in HIV transmission to the HIV-uninfected partner. The infections were confirmed by genetic analysis of viruses from both partners.

The study was designed to evaluate whether antiretroviral use by the HIV-infected individual reduced HIV transmission to the uninfected partner and potentially benefited the HIV-infected individual as well. Additionally, the study was designed to evaluate the optimal time for a person infected with HIV to initiate antiretrovirals in order to reduce HIV-related sickness and death. Based on their analysis, the DSMB recommended that the deferred study arm be discontinued and that the study participants be informed of the trial's outcome.

Vaccination and boosting, especially when recent, helped to limit the spread of COVID-19 in California prisons during the first Omicron wave, according to an analysis by researchers at UC San Francisco that examined transmission between people living in the same cell.

The study demonstrates the benefits of vaccination and boosting, even in settings where many people are still getting infected, in reducing transmission. And it shows the cumulative effects from boosting and the additional protection that vaccination gives to those who were previously infected. The likelihood of transmission fell by 11% for each additional dose.

Among many neglected tropical diseases endemic in Honduras, soil-transmitted helminth (STH) infections are of particular importance. However, knowledge gaps remain in terms of risk factors involved in infection transmission. The aim of this study was to investigate risk factors associated with STH infections in schoolchildren living in rural Honduras.

With the exception of large urban centres, due to generalized deficient sanitization and hygiene, lack of clean water, and inadequate access to health care, STH transmission in Honduras occurs throughout the year and across the country. Since 2001, the Honduran government has systematically tackled the challenge of decreasing the burden of these infections [10, 20]. Preventive chemotherapy through national deworming campaigns targeting school-age children (and more recently pre-school children) implemented by the Ministries of Health and Education with the technical support of PAHO/WHO has been the chief intervention, as is the case in all endemic countries [4]. Due to these efforts, it is likely that STH transmission has decreased throughout Honduras, but still a national prevalence between 20 and 50% is consistently reported [15]. In addition, recent studies have identified high-risk areas where STH endemicity is greater than 50% [20]. These data have underscored the need for epidemiological studies that help understand the transmission dynamics of these geohelminthiases in the country. The aim of the present study was to identify risk factors associated with STH transmission and infection intensity among primary schoolchildren residing in rural Honduras.

A major finding from this study was that the hygiene conditions in the schools played an important role in the transmission of both A. lumbricoides and T. trichiura, and also in the prevalence of mixed infections. Further, independently of other factors, children enrolled in the schools with lower hygiene levels were more likely to harbour higher intensity infections by A. lumbricoides. There is no doubt that improvements to water, sanitation, and hygiene (WASH) contribute to a significant reduction in STH transmission [73, 74] but empirical evidence of this positive association is not always demonstrated. A recent meta-analysis was just able to show that WASH access and practices at the community level were associated with reduced odds of STH infection [75]. At the school level, some cross-sectional studies have shown that poor school sanitation increased the risk for parasitic infections [76]. More recently, a cluster-randomized trial undertaken in Kenya, demonstrated that school hygiene and sanitation reduced the re-infection prevalence of A. lumbricoides[77]. Our study is the first in Honduras to investigate the role of school hygiene on STH transmission and our results can perhaps open the discussion for greater involvement by school teachers. School teachers have already proven to be valuable aides in STH control programs [78]. As direct lines of communication with pupils, school authorities, and parents, teachers could become instrumental advocates for cleaner, more hygienic schools thus further preventing opportunities for STH transmission [79]. Given that they spend between 5 to 6 hours a day in school, such improvements may result in significant health gains for children.

Different patterns of drug resistance are observed in treated and therapy nave HIV-1 infected populations. Especially the NRTI-related M184I/V variants, which are among the most frequently encountered mutations in treated patients, are underrepresented in the antiretroviral nave population. M184I/V mutations are known to have a profound effect on viral replication and tend to revert over time in the new host. However it is debated whether a diminished transmission efficacy of HIV variants with a reduced replication capacity can also contribute to the observed discrepancy in genotypic patterns.

As dendritic cells (DCs) play a pivotal role in HIV-1 transmission, we used a model containing primary human Langerhans cells (LCs) and DCs to compare the transmission efficacy M184 variants (HIV-M184V/I/T) to HIV wild type (HIV-WT). As control, we used HIV harboring the NNRTI mutation K103N (HIV-K103N) which has a minor effect on replication and is found at a similar prevalence in treated and untreated individuals.

In comparison to HIV-WT, the HIV-M184 variants were less efficiently transmitted to CCR5+ Jurkat T cells by both LCs and DCs. The transmission rate of HIV-K103N was slightly reduced to HIV-WT in LCs and even higher than HIV-WT in DCs. Replication experiments in CCR5+ Jurkat T cells revealed no apparent differences in replication capacity between the mutant viruses and HIV-WT. However, viral replication in LCs and DCs was in concordance with the transmission results; replication by the HIV-M184 variants was lower than replication by HIV-WT, and the level of replication of HIV-K103N was intermediate for LCs and higher than HIV-WT for DCs.

Our data demonstrate that drug resistant M184-variants display a reduced replication capacity in LCs and DCs which directly impairs their transmission efficacy. As such, diminished transmission efficacy may contribute to the lower prevalence of drug resistant variants in therapy naive individuals. e24fc04721