Janneke Cox

Jessa Hospital · Infectious Diseases

The WHO defines different COVID-19 disease stages in which the pathophysiological mechanisms differ. We evaluated the characteristics of these COVID-19 disease stages. Forty-four PCR-confirmed COVID-19 patients were included in a prospective minimal invasive autopsy cohort. Patients were classified into mild-moderate (n = 4), severe-critical (n = 3...

Background To minimise the risk of COVID-19 transmission, an ambulant screening protocol for COVID-19 in patients before admission to the hospital was implemented, combining the SARS CoV-2 reverse-transcriptase polymerase chain reaction (RT-PCR) on a nasopharyngeal swab, a chest computed tomography (CT) and assessment of clinical symptoms. The aim...

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is not always confined to the respiratory system, as it impacts people on a broad clinical spectrum from asymptomatic to severe systemic manifestations resulting in death. Further, accumulation of intra-host single nucleotide variants during prolonged SARS-CoV-2 infection may le...

Introduction: Key populations have disproportionately higher HIV prevalence rates than the general population. Objective: To determine the level of virologic suppression and associated factors in female Commercial Sex Workers (CSW) who completed six months of ART and compare with the female general population (GP). Methods: Clinical records of...

Background The WHO defines different COVID-19 disease stages, where pathophysiological mechanisms differ. Clinical, radiological, histological, microbiological, and immunological characteristics of different COVID-19 disease stages were evaluated. Methods Forty-four PCR-confirmed COVID-19 patients were included in a prospective minimal invasive a...

Objectives To perform an audit of empirical antibiotic therapy (EAT) of sepsis at the emergency department and to analyse the impact of an antimicrobial stewardship (AMS) programme on process and patient outcomes. Patients and Methods A prospective single centre cohort study including patients with SOFA score ≥2 from whom blood cultures were taken...

Antibiotics as part of antimicrobial stewardship: clinical practice experiences Antibiotic rounds or weekly multidisciplinary consultations in various departments between the treating physician and a multidisciplinary antimicrobial stewardship (AMS) team are an important part of the antimicrobial stewardship program at the Jessa Hospital in Hasselt...

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has gripped the world for over a year 1,2 . SARS-CoV-2 impacts people on a broad clinical spectrum from asymptomatic to severe respiratory and systemic manifestations resulting in death ³ . In addition, intra-host SARS-CoV-2 gen...

An amendment to this paper has been published and can be accessed via the original article.

Background Belgium was among the first countries in Europe with confirmed coronavirus disease 2019 (COVID-19) cases. Since the first diagnosis on February 3rd, the epidemic has quickly evolved, with Belgium at the crossroads of Europe, being one of the hardest hit countries. Although risk factors for severe disease in COVID-19 patients have been de...

Background Minimally invasive autopsy (MIA) is a validated and safe method to establish the cause of death (COD), mainly in low-resource settings. However, the additional clinical value of MIA in Coronavirus disease (COVID-19) patients in a high-resource setting is unknown. The objective was to assess if and how MIA changed clinical COD and contrib...

The current Covid-19 outbreak poses many challenges on hospital organisation and patient care. Our hospital lies at the epicentre of the Belgian epidemic. On April 1st, a total of 235 Covid-19 patients had been admitted to our hospital. This demanded an unprecedented adaptation of our hospital organisation, and we have met many clinical issues in t...

A fever and low back pain in a Syrian refugee: a less common import pathology A 36-year-old Syrian refugee presented at the emergency department with a fever and lumbar pain. He was diagnosed with spondylodiscitis caused by Brucella melitensis. In the discussion, the increased incidence of specific infectious diseases in refugees and the impact on...

Objective To review the effectiveness of antibiotic stewardship interventions in hospitals in low- and middle-income countries. Methods We searched MEDLINE®, Embase®, Cochrane Central Register of Controlled Trials and regional indexes for studies of interventions to improve appropriate prescribing and use of antibiotics for hospitalized patients i...

Background Antibiotic resistance (ABR) is a quickly worsening problem worldwide, also in low-and middle-income countries (LMICs). Appropriate antibiotic use in humans and animals, i.e. antibiotic stewardship (ABS), is one of the corner stones of the World Health Organization’s global action plan for ABR. Many LMICs are in the process of developing...

Objective To study temporal trends of mortality in HIV-infected adults who attended an HIV clinic in Kampala, Uganda, between 2002 and 2012. Design Descriptive retrospective study. Methods Two doctors independently reviewed the clinic database that contained information derived from the clinic files and assigned one or more causes of death to each...

Point-of-care tests for TB meningitis (TBM) are needed. We studied the diagnostic accuracy of lipoarabinomannan (LAM) lateral flow assay (LFA), LAM ELISA and Xpert MTB/RIF in cerebrospinal fluid (CSF) in an autopsy cohort of Ugandan HIV-infected adults. We obtained written informed consent from the next of kin postmortem. A complete autopsy was don...

Objective: The detection of urinary lipoarabinomannan (LAM), a mycobacterial cell wall component, is used to diagnose tuberculosis (TB). How LAM enters the urine is not known. To investigate if urinary LAM-positivity is the result of renal TB infection we correlated the outcomes of urinary LAM-antigen testing to renal histology in an autopsy cohor...

Percutaneous needle autopsy can overcome a number of barriers that limit the use of complete autopsies. We performed blind-and ultrasound guided needle autopsies in HIV-infected adults in Uganda. In this study we describe in detail the methods we used, the ability of both procedures to obtain sufficient tissue for further examination and the learni...

Introduction: Minimal invasive but accurate methods to establish the cause of death in HIV-infected patients are needed. We studied the agreement in cause of death between blind and ultrasound-guided needle autopsy and complete autopsy in HIV-infected patients in Uganda. Methods: We subsequently performed a blind and ultrasound-guided needle aut...

Information on causes of death in HIV-infected patients in Sub-Saharan Africa is mainly derived from observational cohort and verbal autopsy studies. Autopsy is the gold standard to ascertain cause of death. We conducted an autopsy study to describe and compare the clinical and autopsy causes of death and contributory findings in hospitalized HIV-i...

Objective: To determine the autopsy acceptance rate and reasons for decline at Mulago Hospital, Kampala, Uganda. Methods: The next of kin of patients who died in a combined infectious diseases and gastro-enterology ward of Mulago Hospital were approached to answer a questionnaire concerning characteristics of their deceased relative. During the...

Despite the persistently high HIV-related mortality in sub-Saharan Africa, limited information on the causes of death is available. Pathological autopsies are the gold standard to establish causes of death. In this review we describe the autopsy series performed among HIV-infected individuals in sub-Saharan Africa over the last two decades. We iden...