The association of tuberculosis (TB) with human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome over the past several years has become an emerging syndemic. Approximately 10% of people living with HIV (PLHIV) with latent TB infection will develop active TB disease each year. In this review, we highlight that this phenomenon is not limited to high endemic regions, such as Afro-Asian nations, but globalization/migration is causing increased case detection even in developed nations, such as the United States. Active screening should be performed for TB in PLHIV. A high degree of clinical suspicion for TB is warranted in PLHIV presenting with fever, cough, and unintentional weight loss. HIV–Mycobacterium tuberculosis (MTB) coinfection is often paucibacillary, precluding diagnosis by conventional diagnostics and/or smear microscopy/culture. Improved detection of pulmonary and extrapulmonary TB is now possible by incorporation of the GeneXPERT MTB/RIF assay (Cepheid Inc., Sunnyvale, CA, USA). The World Health Organization recommends instituting immediate therapy for MTB, in conjunction with ongoing or newly introduced anti-retroviral therapy. Vigilance is required to detect drug-induced organ injuries, and early-treatment-induced immune reconstitution inflammatory syndrome. Collaborating MTB and HIV activities in concentrated HIV epidemic settings should become a high public health priority.
Objective:
Routine childhood vaccination and well-child visits are essential for pediatric patients’ preventative and public healthcare services. The COVID-19 pandemic had an immediate and significant decline in well-child visits and vaccine administration. A one-of-a-kind’ Drive Through Vaccine Clinic’ was established to improve the vaccination rate and alleviate parental anxiety about being exposed to COVID-19 infection.
Methods:
Our initial focus was on children between 18 months – 4 years of age at the start of the pandemic, and then slowly extended this to the back-to-school vaccines and the Influenza vaccines.
Results:
The Drive-Through Immunization Station provided 745 vaccines to 415 patients between April and September 2020. The median wait time involved from patient arrival to completion of vaccine administration was five minutes at the Drive-Through location. Patient and parent feedback was positive. The addition of Drive Through Clinic helped significantly increase the total number of vaccines administered compared to the previous year.
Conclusion:
In a global pandemic, innovative ideas to increase access to preventive healthcare should be a priority. In the future, this method of nontraditional vaccine administration will allow for improved outreach efforts to underserved populations in our communities and better disaster preparedness.
CMPA is difficult to diagnose because of limited accurate diagnostic tools, especially in young children. This study suggests a relationship between CMPA and otolaryngologic conditions in children younger than 2 years. Some patients in this study showed symptom improvement via an elimination diet. Early recognition of otolaryngologic manifestations of CMPA may help manage this condition in young children.
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