The edition · Infectious Diseases
Oropouche in pregnancy carries a threefold risk of fetal loss, and community AWaRe training cuts Watch antibiotic use
A Brazilian cohort quantifies harm from Oropouche virus in pregnancy; a cluster trial in two African districts shows prescriber and community education can shift broad-spectrum antibiotic use; and a shorter benznidazole course for Chagas disease is better tolerated.
The edition in brief
In a prospective cohort of 544 pregnant women in Rio de Janeiro state, confirmed Oropouche virus infection was associated with adverse maternal outcomes in 18% versus 7% (aRR 2.90), with roughly threefold risks of fetal loss and haemorrhage and CNS abnormalities in 8% of infants against none in uninfected pregnancies; 38% of confirmed infections had no symptoms. The CABU-EICO cluster-randomised trial in 44 villages in Burkina Faso and DR Congo found that a nine-month bundle of community education and provider training in WHO AWaRe guidance reduced Watch-group antibiotic use (adjusted prevalence ratio 0.33) without worsening simulated-patient management. The TESEO phase 2b trial in 450 Bolivian adults with chronic Chagas disease found benznidazole 150 mg once daily for 30 days non-inferior to the standard 60-day twice-daily course, with drug-related adverse events in 37% versus 60%. A laboratory study of 191 people found that smallpox vaccination and prior clade IIb mpox infection produced little neutralising antibody against clade Ib. The pearl covers the AWaRe groups for everyday prescribing.
Oropouche virus in pregnancy: fetal loss, haemorrhage and infant CNS abnormalities
Treat Oropouche infection in pregnancy as a risk to the fetus, and ask pregnant women with fever about travel to affected regions.
A 30-day once-daily benznidazole course for chronic Chagas disease
A 30-day once-daily benznidazole course matched the standard for clearance with fewer side effects, but needs phase 3 confirmation.
Little cross-clade neutralisation against mpox clade Ib after vaccine or infection
Do not assume prior mpox vaccination or infection rules out clade Ib; test compatible lesions.
Access, Watch, Reserve: the three-tier check before writing an antibiotic
Before prescribing, ask whether an Access antibiotic would do; reserve Watch agents for when it would not.
Training every local provider in AWaRe cut Watch antibiotic use by two-thirds
Extend stewardship to every community dispenser using AWaRe; it cut broad-spectrum antibiotic use without harming care.
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