Long-term complications after coronavirus disease 2019 (COVID-19) are common in hospitalized patients, but the spectrum of symptoms in milder cases needs further investigation. We conducted a long-term follow-up in a prospective cohort study of 312 patients—247 home-isolated and 65 hospitalized—comprising 82% of total cases in Bergen during the first pandemic wave in Norway. At 6 months, 61% (189/312) of all patients had persistent symptoms, which were independently associated with severity of initial illness, increased convalescent antibody titers and pre-existing chronic lung disease. We found that 52% (32/61) of home-isolated young adults, aged 16–30 years, had symptoms at 6 months, including loss of taste and/or smell (28%, 17/61), fatigue (21%, 13/61), dyspnea (13%, 8/61), impaired concentration (13%, 8/61) and memory problems (11%, 7/61). Our findings that young, home-isolated adults with mild COVID-19 are at risk of long-lasting dyspnea and cognitive symptoms highlight the importance of infection control measures, such as vaccination.

To assess the validity of the reference values for hematologic and immunologic indices currently used in Africa, we evaluated blood samples from 3,311 human immunodeficiency virus (HIV)-negative Ugandans aged 1 week to 92 years. Erythrocyte, hemoglobin, and hematocrit levels and mean corpuscular volume all significantly increased with age (P < 0.001) and were independent of gender until the age of 13 years, after which the levels were higher in males than in females (P < 0.001). White blood cell, neutrophil, lymphocyte, basophil, and monocyte counts significantly declined with age until the age of 13 years (P < 0.001), with no differences by gender, while platelet counts declined with age (P < 0.001) and showed differences by gender only among adults older than age 24 years. CD4؉ -and CD8 ؉ -cell counts declined with age until the age of 18 years; thereafter, females had higher counts than males. The absolute values for many of these parameters differed from those reported for populations outside Africa, suggesting that it may be necessary to develop tables of reference values for hematologic and immunologic indices specific for the African population. This may be particularly important with regard to CD4 ؉ -cell counts among children because significant differences in absolute and percent CD4 ؉ -cell counts exist between the values for Western populations and the values for the population evaluated in our study. These differences could influence the decision to initiate antiretroviral therapy among children infected with HIV.The reference values of hematologic and immunologic indices currently used in Africa are derived from data collected for populations living in industrialized countries (27). The few small studies with African populations that have been reported indicate differences in normal values compared with those for populations in industrialized countries (2,3,5,8,10,23,25,26). Ethnic origin, genetics, gender, altitude, and environmental factors, especially pathogens, may influence some values of

Background: Bloodstream infection is a common cause of hospitalization, morbidity and death in children. The impact of antimicrobial resistance and HIV infection on outcome is not firmly established.

Extended-spectrum beta-lactamases (ESBLs) were present in high proportions of Escherichia coli (25% [9 of 36]) and Klebsiella pneumoniae isolates (17% [9 of 52]) causing pediatric septicemia at a tertiary hospital in Tanzania. Patients with septicemia due to ESBL-producing organisms had a significantly higher fatality rate than those with non-ESBL isolates (71% versus 39%, P ‫؍‬ 0.039). This is the first report of the CTX-M-15 genotype of ESBLs on the African continent and the first observation of SHV-12 genotype in an isolate of Salmonella enterica serotype Newport. Resistance to beta-lactam antibiotics was demonstrated inEscherichia coli even before penicillin was released for clinical use. In the 1960s, the first plasmid-transferable beta-lactamase was discovered and named TEM-1 after Temoniera, the Greek girl who harbored the E. coli isolate from which the enzyme was obtained. Since the 1980s, a large number of plasmid-transferable extended-spectrum beta-lactamases (ESBLs) capable of inactivating extended-spectrum cephalosporins has been discovered (6). Most of the ESBLs are derived from TEM-1 and SHV-1 (sulfhydryl variable) by mutations. ESBLs have spread widely and have become a major cause of nosocomial infections associated with high mortality rates, particularly in serious infections such as septicemia (12). In Africa, ESBLs have been reported in Egypt (19), Tunisia (4, 5), Morocco (2), Senegal (18,20), Nigeria (1), South Africa (9), and Kenya (11) but not previously from Tanzania. In the present study, we investigated the prevalence and clinical implications of ESBL production in E. coli, Klebsiella pneumoniae, and salmonellae causing septicemia in infants and children admitted to a tertiary teaching hospital in Tanzania. MATERIALS AND METHODSFrom August 2001 to August 2002, blood cultures were obtained from 1,798 children aged 0 to 7 years with a fever of Ն38°C or other signs of severe infections admitted to the Pediatric Department at Muhimbili National Hospital, a tertiary referral hospital in Dar es Salaam, Tanzania. We included in the present study 113 children who had growth in blood culture of one or more isolates of E. coli, Klebsiella spp., or salmonellae.Blood specimens (1 ml from neonates and 5 ml from older children) were inoculated in BACTEC Myco/F lytic blood culturing vials (Becton Dickinson, Franklin Lakes, N.J). Positive blood cultures were subcultured on Columbia II agar base (Oxoid Ltd, Basingstoke, United Kingdom) with 5% human blood, chocolate agar, and MacConkey agar (Difco/BD Diagnostic Systems, Sparks, Mich.). The isolates were identified according to established procedures (7).Klebsiella spp. were identified with the API 20E system (bioMérieux SA, Marcy l'Etoile, France). Susceptibilities against antimicrobial agents were tested by the disk diffusion method according to NCCLS guidelines (15). Isolates of E. coli, Klebsiella spp., and salmonellae with reduced susceptibilities to cefotaxime (zone diameter of Յ27 mm) and/or ceftazidime (zone diameter of Յ22 mm) according to guidel...

Previous trials investigating the efficacy of treatment durations shorter than the standard of 24 weeks for chronic hepatitis C virus (HCV) genotype 2/3 infections have yielded discordant results. The aims of this investigator-initiated phase III study were to compare the efficacy of 12 or 24 weeks of treatment and to identify patients suitable for short-term therapy. Three hundred eighty-two genotype 2/3-infected patients [intention-to-treat (ITT) population] at 31 centers in Denmark, Finland, Norway, and Sweden were randomized to 12 or 24 weeks of peginterferon ␣-2a (180 g/week) plus ribavirin (800 mg/day). Twelve weeks of therapy was inferior to 24 weeks in the ITT population (sustained viral response [SVR] rates: 59% versus 78%, P < 0.0001) and in the subgroups of patients infected with genotype 2 (56% versus 82%, P ‫؍‬ 0.006) or 3 (58% versus 78%, P ‫؍‬ 0.0015). These differences were observed regardless of the fibrosis stage. Age and HCV-RNA levels on days 7 and 29 were independent predictors of SVR. Short-term treatment was useful in patients < 40 years old, especially if HCV-RNA was undetectable on day 29, and also in patients > 40 years old, provided that HCV-RNA was below 1000 IU/mL on day 7 in addition to being undetectable on day 29. If neither of these two criteria were met for patients > 40 years old, 24 weeks of therapy was superior (P < 0.0001). Conclusion: Peginterferon/ribavirin treatment for 12 weeks in HCV genotype 2/3 infection is overall inferior to 24 weeks of treatment but may be useful in some patients with a rapid initial clearance of virus.

Background: Relatively few studies have been done in Tanzania to detect and classify diarrheagenic Escherichia coli (DEC) strains among children with diarrhea. This study aimed at investigating DEC among children in Dar es Salaam aged less than five years hospitalized due to acute/persistent diarrhea.

Infection with Giardia lamblia in a non-endemic area was associated with a high prevalence of IBS and chronic fatigue 3 years after acute illness, and the risk was significantly higher than in the control group. This shows that the potential consequences of giardiasis are more serious than previously known. Further studies are needed, especially in areas where giardiasis is endemic.

No abstract