S. Johnson

To investigate epidemiology of and risk factors for laboratory-confirmed mpox during the 2022 outbreak in Nigeria, we enrolled 265 persons with suspected mpox. A total of 163 (61.5%) were confirmed to have mpox; 137 (84.0%) were adults, 112 (68.7%) male, 143 (87.7%) urban/semi-urban dwellers, 12 (7.4%) self-reported gay men, and 3 (1.8%) female sex workers. Significant risk factors for adults were sexual and nonsexual contact with persons who had mpox, as well as risky sexual behavior. For children, risk factors were close contact with an mpox-positive person and prior animal exposure. Odds of being mpox positive were higher for adults with HIV and lower for those co-infected with varicella zoster virus (VZV). No children were HIV-seropositive; odds of being mpox positive were higher for children with VZV infection. Our findings indicate mpox affects primarily adults in Nigeria, partially driven by sexual activity; childhood cases were driven by close contact, animal exposure, and VZV co-infection.

Background: Tuberculosis (TB) and the Human Immune Deficiency Virus (HIV) represent major public health challenges and are intricately linked to each other. This is more prevalent in the sub-Saharan African region, where about 80% of this co-infection is recorded. This study aimed to review the prevalence, profile, and treatment outcome of TB-HIV co-infected patients. Methodology: A hospital-based retrospective study was conducted in a tertiary center in southeast Nigeria for the period 2015-2017. Information elicited from participant's medical records included socio-demographic profile (age, sex, residential area, and occupation), Cluster of Differentiation 4 (CD4) count level at the time of diagnosis of co-infection, weight, treatment outcome, as well as the record of the number of TB patients who presented within this same period. Results: The total number of TB/HIV co-infected patients who participated in the study during this period was 207, with a prevalence of TB/HIV co-infection of 33.9%. The highest proportion of cases was recorded among participants within the age group of 31-40, and the cases of co-infection were more common in males (58.9%) and students (27.5%). The results also showed a significant relationship between gender, occupation, residential area, and TB/HIV co-infection. Most of the co-infected participants had a CD4 count of <300 cells/mm3 and an associated poor treatment outcome of 41.1%. Conclusions: TB/HIV co-infection needs to be properly addressed, and screening for HIV among TB patients should be a priority. This will help in early diagnosis and subsequently improve the treatment outcome of both diseases.

<h3>Background</h3> Juvenile systemic sclerosis (jSSc) is an orphan disease with a prevalence of 3 in 1 000 000 children. The Juvenile Systemic Scleroderma Inception cohort (jSScC) is the largest cohort of jSSc patients in the world. The jSScC collects data prospectively in jSSc, allowing the evaluation of the development of organ involvement and patient and physician reported outcomes in jSSc over time. <h3>Objectives</h3> To review the changes in the clinical characteristics, and patient and physician reported outcomes, over a 24 month observation period from the time of inclusion into the cohort. <h3>Methods</h3> The jSScC cohort enrolls jSSc patients who developed the first non-Raynaud´s symptom before the age of 16 years and are under the age of 18 years at the time of inclusion. We reviewed jSScC patient clinical data and patient and physician reported outcomes, who had 24 months follow up from the time of inclusion until 1^st of December 2022. <h3>Results</h3> We extracted data from 90 patients, 77% of them had the diffuse subtype. The female/male ratio was 3.5:1. Median age of onset of Raynaud´s was 9.4 years and the median age of onset of non-Raynaud´s was 10.0 years. Eighty-nine percent of the patients were treated with disease modifying anti-rheumatic drugs (DMARDs) at time of inclusion in the cohort (T0) and 96% after 24 months (T24). Median disease duration was 2.4 years at T0. No patient died during the follow up. Antibody profile stayed unchanged. Only 3 clinical parameters changed and all improved significantly, the median modified Rodnan skin score improved from 11 to 8 (p=0.021), number of patients with joints with pain on motion decreased from 21% to 10% (p=0.04) and the number of patients with muscle weakness decreased from 13% to 4% (p=0.03). All other organ involvement did not show any statistically significant change from T0 to T24. All collected patient reported outcomes improved significantly from T0 to T24: the patient reported disease activity by VAS 0-100 from 40 to 20 (p=0.001), the patient reported disease damage by VAS 0-100 from 35 to 20 (p=0.027), patient reported ulceration activity by VAS 0-100) from 8 to 0 (p=0.001) and the patient reported Raynaud activity by VAS 0-100 from 20 to 10 (p=0.002). Two of the three physician reported outcomes improved significantly, the physician global disease activity by VAS 0-100 from 30 to 20 (p=0.001) and physician reported ulceration activity by VAS 0-100 from 5 to 0 (p=0.017). (Table 1.) <h3>Conclusion</h3> Skin and musculoskeletal clinical features improved over 24 months, with almost all patients on DMARDs, supporting the response of these features to therapy. It was promising that internal organ involvement, like cardiac, lung and gastrointestinal, did not significantly worsen or increase. The most striking observation is the positive direction and improvement all patients and two of the three physician reported outcome measures over 24 months in this large international cohort. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.