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Infectious causes of fever of unknown origin in developing countries: An international ID-IRI study

Journal of Intensive Medicine 2024年第1期4卷 94-100页

作者： Hakan Erdem Jaffar AAl-Tawfiq Maha Abid Wissal Ben Yahia George Akafity Manar Ezzelarab Ramadan Fatma Amer Amani El-Kholy Atousa Hakamifard Bilal Ahmad Rahimi Farouq Dayyab Hulya Caskurlu Reham Khedr Muhammad Tahir Lysien Zambrano Mumtaz Ali Khan Aun Raza Nagwa Mostafa El-Sayed Magdalena Baymakova Aysun Yalci Yasemin Cag Umran Elbahr aamer ikram Department of Infectious Diseases&Clinical Microbiology Gulhane School of MedicineTurkish Health Sciences UniversityAnkaraTurkey Specialty Internal Medicine and Quality and Patient Safety Department Johns Hopkins Aramco HealthcareDhahranSaudi Arabia Division of Infectious Diseases Indiana University School of MedicineIndianapolisINUSA Department of Infectious Diseases Farhat Hached University HospitalIbn El Jazzar Medical SchoolUniversity of SousseSousseTunisia Internal Medicine Department Farhat Hached University HospitalIbn El Jazzar Medical SchoolUniversity of SousseSousseTunisia Cape Coast Teaching Hospital Cape CoastGhana Medical Parasitology Faculty of MedicineSuez UniversitySuezEgypt Department of Medical Microbiology and Immunology Faculty of MedicineZagazig UniversityZagazigEgypt Department of Clinical Pathology Faculty of MedicineCairo UniversityGizaEgypt Department of Infectious Diseases School of MedicineIsfahan University of Medical SciencesIsfahanIran Department of Infectious Diseases Kandahar University Medical FacultyTeaching HospitalKandaharAfghanistan Department of Infectious Diseases Mohammed Bn Khalifa Bn Salman Alkhalifa Specialist Cardiac CenterAwaliBahrain Department of Infectious Diseases and Clinical Microbiology Faculty of MedicineIstanbul Medeniyet UniversityIstanbulTurkey Department of Pediatric Oncology National Cancer Institute–Cairo UniversityChildren Cancer Hospital EgyptCairoEgypt Department of Medicine Federal General HospitalIslamabadPakistan Institute for Research in Medical Sciences and Right to Health(ICIMEDES) Scientific Research Unit(UIC)Faculty of Medical Sciences(FCM)National Autonomous University of Honduras(UNAH)TegucigalpaHonduras National Institute of Health IslamabadPakistan Shaukat Khanum Memorial Cancer Hospital and Research Center LahorePakistan Medical Parasitology Department Research Institute of OphthalmologyGizaEgypt Department of Infectious Diseases Military Medical AcademySofiaBulgaria Department of Infecti

Background:Fever of unknown origin(FUO)in developing countries is an important dilemma and further research is needed to elucidate the infectious causes of ***:A multi-center study for infectious causes of FUO in lower middle-income countries(LMIC)and lowincome countries(LIC)was conducted between January 1,2018 and January 1,*** total,15 participating centers from seven different countries provided the data,which were collected through the Infectious DiseasesInternational Research Initiative *** adult patients with confirmed infection as the cause of FUO were included in the *** severity parameters were quick Sequential Organ Failure Assessment(qSOFA)≥2,intensive care unit(ICU)admission,vasopressor use,and invasive mechanical ventilation(IMV).Results:A total of 160 patients with infectious FUO were included in the ***,148(92.5%)patients had community-acquired infections and 12(7.5%)had hospital-acquired *** most common infectious syndromes were tuberculosis(TB)(n=27,16.9%),infective endocarditis(n=25,15.6%),malaria(n=21,13.1%),brucellosis(n=15,9.4%),and typhoid fever(n=9,5.6%).Plasmodium falciparum,Mycobacterium tuberculosis,Brucellae,Staphylococcus aureus,Salmonella typhi,and Rickettsiae were the leading infectious agents in this study.A total of 56(35.0%)cases had invasive procedures for *** mean qSOFA score was 0.76±0.94{median(interquartile range[IQR]):0(0–1)}.ICU admission(n=26,16.2%),vasopressor use(n=14,8.8%),and IMV(n=10,6.3%)were not ***,38(23.8%)patients had at least one of the severity *** mortality rate was 15(9.4%),and the mortality was attributable to the infection causing FUO in 12(7.5%)***:In LMIC and LIC,tuberculosis and cardiac infections were the most severe and the leading infections causing FUO.

关键词： Developing countries Fever of unknown origin Infection

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Footprints of SARS-CoV-2 genome diversity in Pakistan,2020–2021

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Virologica Sinica 2022年第1期37卷 153-155页

作者： Zaira Rehman Massab Umair aamer ikram Ammad Fahim Muhammad Salman National Institute of Health(NIH) Islamabad44000Pakistan Maroof International Hospital

The rapid spread of SARS-Co V-2 has significantly impacted the worldwide health *** SARS-Co V-2 currently bears a remarkably low genetic diversity even though it carries one of the largest RNA genomes among viruses(Rausch et al.,2020).However,the coronaviruses harbor the capability of undergoing recombination at a high rate which can lead to the emergence of novel viral derivatives(Rausch et al.,2020;Gribble et al.,2021).

关键词： al. harbor system.

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The outbreak of dengue during the COVID-19 pandemic in Pakistan:The emergence of overlapping crises

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Asian Pacific Journal of Tropical Medicine 2022年第2期15卷 53-55页

作者： Muhammad Suleman Rana Muhammad Usman Muhammad Masroor Alam aamer ikram Muhammad Salman Rani Faryal Massab Umair National Institute of Health IslamabadPakistan Department of Microbiology Quaid-I-Azam University Islamabad Pakistan

COVID-19 pandemic has become a serious public health crisis for developed and developing countries around the *** of February 17,2022,over 420 million cases including 5.8 million deaths have been reported across the globe[1].The first case of COVID-19 in Pakistan was detected on February 26,2020;since then,the toll of confirmed COVID-19 cases reached 1491423 including 29877 deaths as of February 17,2022[1].

关键词： cases Pakistan COV

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Mobile biosafety level (BSL) 2 laboratories deployment: Strengthening the diagnostic facilities in Pakistan with emerging public health challenges and the way forward

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Journal of Biosafety and Biosecurity 2023年第2期5卷 79-83页

作者： Shamsul Arfin Qasmi aamer ikram Muhammad Tariq Muhammad Tahir Khadim Nabeel Ahmed Maqbool Principal/HOD Pathology Bahawalpur Medical&Dental CollegeBahawalpur Pakistan Executive Director National Institute of Health IslamabadPakistan Country Director Chemonics International IslamabadPakistan Principal Fazaia Medical College and Dean Faculty Health Sciences Air University IslamabadPakistan GHSC.PSM Pakistan

Availability of mobile laboratories can facilitate rapid on-spot detection of pathogens,monitor its presence in certain populations and inform health authorities to take immediate remedial *** available biosafety and biosecurity guidelines and policies may not completely articulate the increased demand to manage mobile units in infectious disease outbreaks in remote parts of the country for rapid diagnosis,and also allows research and epidemiological study take place *** main objective of this study is to evaluate the current limitations and develop and implement biosafety and biosecurity guidelines as well as the protocols for operations,security,and response plan of mobile biosafety level 2 laboratories and their *** in view the sensitivity of it,a comprehensive plan was developed to address it in view of Global Health Security *** and biosecurity protocols were developed including Risk Assessment Tool(RAT)fitting the needs and strengthen the diagnostic and epidemiological capacity in the field covering remote parts of country to fill the gaps observed during the COVID-19 *** the biosafety and biosecurity best practices guidelines and biosecurity policy and regulations are directed mostly towards static laboratories.A biosafety and biosecurity manual developed to adopt and meet the requirements for MBSL *** acute health infectious threats including the COVID-19 outbreak and other epidemics,rapid diagnosis can curb and mitigate the problem before it gets out of its boundaries creating significant health risks for the public and *** deployment of mobile laboratories will certainly help in curbing these catastrophes.

关键词： Biosafety manual Biorisk Management Risk Assessment Mobile BSL 2 Laboratories(MBSL2Laboratories) Outbreak Response

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Assessing Tuberculosis among Smokers: Secondary Analysis of an Active Case Finding Project

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Journal of Tuberculosis Research 2019年第4期7卷 246-252页

作者： Razia Fatima Aashifa Yaqoob Kamran Siddiqi Omara Dogar Sarwat Shah aamer ikram Common Management Unit (HIV/AIDs TB & Malaria) Islamabad Pakistan University of York Heslington UK National Institute of Health Islamabad Pakistan

Background: Previous case-control studies and a small number of cohort studies in high-risk populations have found an association between smoking and tuberculosis, but limited studies are available in the general population that predicts association of smoking and TB. Objectives: To investigate the association between smoking and tuberculosis in a cohort of a general population. Methods: Four districts of Punjab province (Lahore, Rawalpindi, Faisalabad and Islamabad) were randomly selected. In routine, household contact investigation is practiced by the National TB Control Programme. For two years from July 2013-June 2015, all people who were living within 50 metres from the household of smear positive TB patients were screened for tuberculosis. Those found presumptive TB were investigated through smear microscopy and those found smear negative;the Xpert MTB/RIF test was done. All the diagnosed TB patients were referred to nearest basic health unit for further treatment and care. Results: A total of 783,043 contacts were screened for tuberculosis, of whom 19,815 (2.53%) were smokers. Smoking was common among men, in diabetic & teenage, elderly age population and in household contact of smear positive TB patients. Smoking was associated with an increased risk of tuberculosis (odds ratio [OR], 2.43;95% confidence interval, 2.27 - 2.60) in household contact of smear positive TB patients. The association was stronger among those greater than 45 years of age (OR, 11.09) than those between 25 - 44 years of age (OR, 5.83) and diabetic persons (OR, 2.0). Conclusions: Smoking was associated with a twofold increased risk of active tuberculosis in a cohort of general population.

关键词： Smoking Tuberculosis Close Contacts Pakistan

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Is Tuberculosis Treatment Truly Free? A Study to Identify Key Factors Contributing to the Catastrophic Cost of TB Care in Pakistan

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Journal of Tuberculosis Research 2020年第4期8卷 181-198页

作者： aamer ikram Amna Ali Sana Habib Abbasi Nosheen Ashraf Sidra Wali Mohammad Salman Mumtaz A. Khan Naveed Syed Jamil A. Ansari National Institute of Health Islamabad Pakistan Public Health England London UK

Background: The interplay between financial deprivation and tuberculosis (TB) is considered one of the vital socio-economic determinants of disease. This is the first study of its kind to be carried in Pakistan, which aims to identify leading factors contributing towards catastrophic costs of TB diagnosis and management in order to help policy makers. Methodology: From four tertiary care hospitals (TCH) in Islamabad and Rawalpindi, 400 TB patients were interviewed through a cross-sectional survey. The patient’s pre and post-TB income and direct and indirect costs for treatment were analysed following WHO recommendations. Multivariable logistic regression model was used to identify the determinants of catastrophic total cost. Results: For TB management expenditures, the median (interquartile range) of total costs by households was Rs. 58,175 Rs (32,050 - 97,500). At 20% threshold, 67% of TB patient’s households were affected by catastrophic

关键词： Tuberculosis Financial Deprivation Catastrophic Cost

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Genomic Epidemiology of SARS-CoV-2 in Pakistan

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Genomics, Proteomics & Bioinformatics 2021年第5期19卷 727-740页

作者： Shuhui Song Cuiping Li Lu Kang Dongmei Tian Nazish Badar Wentai Ma Shilei Zhao Xuan Jiang Chun Wang Yongqiao Sun Wenjie Li Meng Lei Shuangli Li Qiuhui Qi aamer ikram Muhammad Salman Massab Umair Huma Shireen Fatima Batool Bing Zhang Hua Chen Yun-Gui Yang Amir Ali Abbasi Mingkun Li Yongbiao Xue Yiming Bao China National Center for Bioinformation Beijing 100101China National Genomics Data Center Beijing Institute of GenomicsChinese Academy of SciencesBeijing 100101China CAS Key Laboratory of Genome Sciences and Information Beijing Institute of GenomicsChinese Academy of SciencesBeijing 100101China University of Chinese Academy of Sciences Beijing 100049China CAS Key Laboratory of Genomic and Precision Medicine Beijing Institute of GenomicsChinese Academy of SciencesBeijing 100101China Department of Virology and Immunology National Institute of HealthIslamabad 45500Pakistan National Center for Bioinformatics Programme of Comparative and Evolutionary GenomicsFaculty of Biological SciencesQuaid-i-Azam UniversityIslamabad 45320Pakistan Center for Excellence in Animal Evolution and Genetics Chinese Academy of SciencesKunming 650223China State Key Laboratory of Plant Cell and Chromosome Engineering Institute of Genetics and Developmental BiologyThe Innovation Academy of Seed DesignChinese Academy of SciencesBeijing 100101China

COVID-19 has swept globally and Pakistan is no *** investigate the initial introductions and transmissions of the SARS-CoV-2 in Pakistan,we performed the largest genomic epidemiology study of COVID-19 in Pakistan and generated 150 complete SARS-CoV-2 genome sequences from samples collected from March 16 to June 1,*** identified a total of 347 mutated positions,31 of which were over-represented in ***,we found over 1000 intra-host single-nucleotide variants(iSNVs).Several of them occurred concurrently,indicating possible interactions among them or *** of the high-frequency iSNVs in Pakistan were not observed in the global population,suggesting strong purifying *** genomic epidemiology revealed five distinctive spreading *** largest cluster consisted of 74 viruses which were derived from different geographic locations of Pakistan and formed a deep hierarchical structure,indicating an extensive and persistent nation-wide transmission of the virus that was probably attributed to a signature mutation(G8371T in ORF1ab)of this ***,28 putative international introductions were identified,several of which are consistent with the epidemiological *** all,this study has inferred the possible pathways of introductions and transmissions of SARS-CoV-2 in Pakistan,which could aid ongoing and future viral surveillance and COVID-19 control.

关键词： SARS-CoV-2 Virus Molecular evolution Haplotype network Pakistan

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