INFECTIOUS DISEASE

Please find below the presentation abstracts for this session's theme.

 

Use the links below to see the full presentation schedule and to vote for your favourite presentation for the "Students' Choice" prize!

Presentation 1

 

A Clinical Audit Cycle Examining Inhaler Prescriptions for Asthmatics at Brookside Surgery. Is COVID affecting Asthma Care?

Jasmine Zanelli & Laura Wheeler | University of Warwick

 

Background
Despite availability of effective treatment, asthma mortality rates in the UK are on the rise with 2019 seeing the highest deaths for 20 years. A recent national report into asthma deaths carried out by the RCP found in up to 50% of cases there were avoidable factors that may have contributed. Based on four key recommendations from this report, an audit into the practice at Brookside surgery revealed particular weaknesses in adherence to annual asthma reviews and over-prescription of short-acting beta agonists (SABA). This study aims to re-audit and assess effectiveness of implementations made post-audit. We will also consider the impact of the COVID-19 pandemic on these measures.
 

Methods
Aligned with methodology of the original audit, we randomly selected 100 patients currently registered at Brookside surgery and, using EMIS, searched for and recorded their medication history for the preceding 12 months. Searches were also made for evidence of an asthma review and RCP questions.
 

Results
At re-audit 63% of patients attended for their annual asthma review. This compares to 69% of patients the year prior. The percentage of patients with dangerous SABA use stayed relatively stable with 5% at re-audit compared to 6% previously. However, 10% less patients were using SABA’s at levels which are suggestive of need for clinical review- reducing from 37% to 27%. Further results are still being elucidated.
 

Key messages
The shift to virtual management of patients during the COVID-19 pandemic does not appear to have significantly impacted adherence to annual asthma reviews. On further inspection of our data we will try and establish whether this also translates to maintaining safe inhaler prescriptions.

Presentation 2

Coronavirus Disease 2019 (COVID‐19) Outcomes in HIV/AIDS Patients: a Systematic Review

Todd James Cooper, Beth Woodward | University of Birmingham

 

Background
The aim of the study was to systematically review current studies reporting on clinical outcomes in people living with HIV (PLHIV) infected with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2).
 

Methods
We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta‐analysis (PRISMA) guidelines. A comprehensive literature search was conducted in Global Health, SCOPUS, Medline and EMBASE using pertinent key words and Medical Subject Headings (MeSH) terms relating to coronavirus disease 2019 (COVID‐19) and HIV. A narrative synthesis was undertaken. Articles are summarized in relevant sections.
 

Results
Two hundred and eighty‐five articles were identified after duplicates had been removed. After screening, eight studies were analysed, totalling 70 HIV‐infected patients (57 without AIDS and 13 with AIDS). Three themes were identified: (1) controlled HIV infection does not appear to result in poorer COVID‐19 outcomes, (2) more data are needed to determine COVID‐19 outcomes in patients with AIDS and (3) HIV‐infected patients presenting with COVID‐19 symptoms should be investigated for superinfections.
 

Key messages

Our findings suggest that PLHIV with well‐controlled disease are not at risk of poorer COVID‐19 disease outcomes than the general population. It is not clear whether those with poorly controlled HIV disease and AIDS have poorer outcomes. Superimposed bacterial pneumonia may be a risk factor for more severe COVID‐19 but further research is urgently needed to elucidate whether PLHIV are more at risk than the general population

Presentation 3

Coronavirus Disease 2019 (COVID‐19) Outcomes in HIV/AIDS Patients: a Systematic Review

Todd James Cooper, Beth Woodward | University of Birmingham

 

Background
The aim of the study was to systematically review current studies reporting on clinical outcomes in people living with HIV (PLHIV) infected with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2).
 

Methods
We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta‐analysis (PRISMA) guidelines. A comprehensive literature search was conducted in Global Health, SCOPUS, Medline and EMBASE using pertinent key words and Medical Subject Headings (MeSH) terms relating to coronavirus disease 2019 (COVID‐19) and HIV. A narrative synthesis was undertaken. Articles are summarized in relevant sections.
 

Results
Two hundred and eighty‐five articles were identified after duplicates had been removed. After screening, eight studies were analysed, totalling 70 HIV‐infected patients (57 without AIDS and 13 with AIDS). Three themes were identified: (1) controlled HIV infection does not appear to result in poorer COVID‐19 outcomes, (2) more data are needed to determine COVID‐19 outcomes in patients with AIDS and (3) HIV‐infected patients presenting with COVID‐19 symptoms should be investigated for superinfections.
 

Key messages

Our findings suggest that PLHIV with well‐controlled disease are not at risk of poorer COVID‐19 disease outcomes than the general population. It is not clear whether those with poorly controlled HIV disease and AIDS have poorer outcomes. Superimposed bacterial pneumonia may be a risk factor for more severe COVID‐19 but further research is urgently needed to elucidate whether PLHIV are more at risk than the general population

Presentation 4

Effects of Incentives and Subsidies on Tuberculosis Testing Rates in Rural Philippines

Jayson (Seung Gwan) Ryoo | Swansea University

 

Background
International Care Ministries (ICM) is a Philippines-based non-governmental organization with a mission to reduce the burden of “ultrapoverty” in the Philippines. Between February 2018 and January 2019, ICM conducted the first randomized controlled trial (RCT) to investigate whether providing food and transportation costs increases the rate of attendance to the rural health unit (RHU) for tuberculosis (TB) testing.
 

Methods
Study participants were assigned to one of four RCT groups based on incentives or subsidies that they were given: A) no incentives or subsidies (i.e., control group); B) food; C) transportation costs to the RHU; and D) food and transportation costs to the RHU. Between February 2019 and January 2020, ICM conducted the second RCT with three RCT groups: A) food and transportation costs to the RHU (i.e., control group); B) food, transportation costs to the RHU, and subsidies for chest x-ray; and C) food, transportation costs to the RHU, subsidies for chest x-ray, and accompaniment of a counsellor (i.e., a trusted community member) to the RHU. To elucidate the effect of incentives and subsidies in increasing the rate of RHU attendance for TB testing, a logistic regression model was developed using RHU attendance for TB testing as the outcome, and RCT group, age, and sex as the predictors.
 

Results & Key Messages
The first RCT has shown that providing both food and transportation costs was associated with the highest odds of attending the RHU for TB testing (Odds Ratio (OR) = 7.06, 95% Confidence Interval (CI) [4.79, 10.38], p < 0.05), compared to providing no incentives or subsidies. Males had significantly lower odds of attending the RHU for TB testing (OR = 0.63, 95% CI [0.47, 0.83], p < 0.05), compared to females. In the second RCT, chest x-ray subsidies and counsellor accompaniment did not significantly increase the odds of attending the RHU for TB testing (p > 0.05).

Presentation 5

Effects of Incentives and Subsidies on Tuberculosis Testing Rates in Rural Philippines

Jayson (Seung Gwan) Ryoo | Swansea University

 

Background
International Care Ministries (ICM) is a Philippines-based non-governmental organization with a mission to reduce the burden of “ultrapoverty” in the Philippines. Between February 2018 and January 2019, ICM conducted the first randomized controlled trial (RCT) to investigate whether providing food and transportation costs increases the rate of attendance to the rural health unit (RHU) for tuberculosis (TB) testing.
 

Methods
Study participants were assigned to one of four RCT groups based on incentives or subsidies that they were given: A) no incentives or subsidies (i.e., control group); B) food; C) transportation costs to the RHU; and D) food and transportation costs to the RHU. Between February 2019 and January 2020, ICM conducted the second RCT with three RCT groups: A) food and transportation costs to the RHU (i.e., control group); B) food, transportation costs to the RHU, and subsidies for chest x-ray; and C) food, transportation costs to the RHU, subsidies for chest x-ray, and accompaniment of a counsellor (i.e., a trusted community member) to the RHU. To elucidate the effect of incentives and subsidies in increasing the rate of RHU attendance for TB testing, a logistic regression model was developed using RHU attendance for TB testing as the outcome, and RCT group, age, and sex as the predictors.
 

Results & Key Messages
The first RCT has shown that providing both food and transportation costs was associated with the highest odds of attending the RHU for TB testing (Odds Ratio (OR) = 7.06, 95% Confidence Interval (CI) [4.79, 10.38], p < 0.05), compared to providing no incentives or subsidies. Males had significantly lower odds of attending the RHU for TB testing (OR = 0.63, 95% CI [0.47, 0.83], p < 0.05), compared to females. In the second RCT, chest x-ray subsidies and counsellor accompaniment did not significantly increase the odds of attending the RHU for TB testing (p > 0.05).