Suchergebnisse

Finding new HIV-positive cases remains a priority to achieve the UNAIDS goals. An enhanced peer outreach approach (EPOA) was implemented to expand the delivery of HIV services to female sex workers (FSWs) and men who have sex with men (MSM) in three countries in West and Central Africa. The aim of EPOA is to identify new HIV-positive cases. EPOA was implemented in Burundi among FSWs, and in Cote d'Ivoire and Democratic Republic of the Congo (DRC) among both FSWs and MSM. Implementation ranged from five to nine weeks and was nested within a three-month reporting period. Standard outreach was suspended for the duration of EPOA implementation but was resumed thereafter. Summary service statistics were used to compare HIV seropositivity during standard outreach and EPOA. Trends were analyzed during the quarter in which EPOA was implemented, and these were compared with the two preceding quarters. Differences in proportions of HIV seropositivity were tested using Pearson's chi-square test; p-values of less than 0.05 were considered statistically significant. Overall, EPOA resulted in a higher proportion of new HIV-positive cases being found, both within and between quarters. In Burundi, HIV seropositivity among FSWs was significantly higher during EPOA than during standard outreach (10.8% vs. 4.1%, p<0.001). In Cote d'Ivoire, HIV seropositivity was significantly higher during EPOA among both populations (FSWs: 5.6% vs. 1.81%, p<0.01; MSM: 15.4% vs. 5.9%; p<0.01). In DRC, HIV seropositivity was significantly higher during EPOA among MSM (6.9% vs. 1.6%; p<0.001), but not among FSWs (5.2% vs. 4.3%; p = 0.08). Trends in HIV seropositivity during routine outreach for both populations were constant during three successive quarters but increased with the introduction of EPOA. EPOA is a public health approach with great potential for reaching new populations and ensuring that they are aware of their HIV status.

Abstract
Background
Racialized communities, including Black Canadians, have disproportionately higher COVID-19 cases. We examined the extent to which SARS-CoV-2 infection has affected the Black Canadian community and the factors associated with the infection.

Methods
We conducted a cross-sectional survey in an area of Ontario (northwest Toronto/Peel Region) with a high proportion of Black residents along with 2 areas that have lower proportions of Black residents (Oakville and London, Ontario). SARS-CoV-2 IgG antibodies were determined using the EUROIMMUN assay. The study was conducted between August 15, 2020, and December 15, 2020.

Results
Among 387 evaluable subjects, the majority, 273 (70.5%), were enrolled from northwest Toronto and adjoining suburban areas of Peel, Ontario. The seropositivity values for Oakville and London were comparable (3.3% (2/60; 95% CI 0.4–11.5) and 3.9% (2/51; 95% CI 0.5–13.5), respectively). Relative to these areas, the seropositivity was higher for the northwest Toronto/Peel area at 12.1% (33/273), relative risk (RR) 3.35 (1.22–9.25). Persons 19 years of age or less had the highest seropositivity (10/50; 20.0%, 95% CI 10.3–33.7%), RR 2.27 (1.23–3.59). There was a trend for an interaction effect between race and location of residence as this relates to the relative risk of seropositivity.

Interpretation
During the early phases of the pandemic, the seropositivity within a COVID-19 high-prevalence zone was threefold greater than lower prevalence areas of Ontario. Black individuals were among those with the highest seroprevalence of SARS-CoV-2.

Goat raising is a growing industry in Lao People's Democratic Republic, with minimal disease investigation to date, especially zoonoses. This study determined the proportional seropositivity of two zoonotic diseases: Q fever (causative agent Coxiella burnetii) and Brucellosis (Brucella species) in goats across five provinces (Vientiane Capital, Xayaboury, Xiengkhuang, Savannakhet and Attapeu). A total of 1458 goat serum samples were tested using commercial indirect ELISA for both pathogens, plus Rose Bengal agglutination test for Brucellosis. Overall individual seropositivity of C. burnetii was 4.1% and Brucella spp. was 1.4%. A multiple logistic regression model identified that province (Vientiane Capital, p = 0.05), breed (introduced Boer mixed breed, p = 0.006) and age (goats ≥3 years old, p = 0.014) were significant risk factors for C. burnetii seropositivity. The results of the survey indicated that province (Vientiane Capital, p<0.001), breed (introduced Boer mixed breed, p<0.001), production system (commercial, p<0.001), age (adult, p = 0.004), and farm size (large, 0.001) were all significant risk factors seropositivity for Brucella spp. It was concluded that Lao goats have been exposed to both C. burnetii and Brucella spp. however the risk of clinical disease has not yet been determined and there is an urgent need to determine human health risks and economic losses caused by Q fever and Brucellosis.

Influenza A viruses of H5 and H7 subtype in poultry can circulate subclinically, and subsequently mutate from low to high pathogenicity with potentially devastating economic and welfare consequences. European Union Member States undertake surveillance of commercial and backyard poultry for early detection and control of subclinical H5 and H7 influenza A infection. This surveillance has moved towards a risk‐based sampling approach in recent years; however quantitative measures of relative risk associated with risk factors utilised in this approach are necessary for optimisation. This study describes serosurveillance for H5 and H7 influenza A in domestic and commercial poultry undertaken in the European Union from 2004 to 2010, where a random sampling and thus representative approach to serosurveillance was undertaken. Using these representative data, this study measured relative risk of seropositivity across poultry categories and spatially across the EU. Data were analysed using multivariable logistic regression. Domestic waterfowl, game birds, fattening turkeys, ratites, backyard poultry and the "other" poultry category holdings had relatively increased probability of H5 and/or H7 influenza A seropositivity, compared to laying‐hen holdings. Amongst laying‐hen holdings, free‐range rearing was associated with increased probability of H7 seropositivity. Spatial analyses detected 'hotspots' for H5 influenza A seropositivity in western France and England, and H7 influenza A seropositivity in Italy and Belgium, which may be explained by the demographics and distribution of poultry categories. Findings suggest certain poultry category holdings are at increased risk of subclinical H5 and/or H7 influenza A circulation, and free‐range rearing increases the likelihood of exposure to H7 influenza A. These findings may be used in further refining risk‐based surveillance strategies, and prioritising management strategies in influenza A outbreaks.

This study has determined the proportional seropositivity of two zoonotic diseases, Q fever and brucellosis, and bluetongue virus (BTV) which is nonzoonotic, in five provinces of Lao People's Democratic Republic (PDR) (Loungphabang, Luangnumtha, Xayaboury, Xiengkhouang, and Champasak, and Vientiane Province and Vientiane capital). A total of 1,089 samples from buffalo, cattle, pigs, and goats were tested, with seropositivity of BTV (96.7%), Q fever (1.2%), and brucellosis (0.3%). The results of this survey indicated that Q fever seropositivity is not widely distributed in Lao PDR; however, Xayaboury Province had a cluster of seropositive cattle in seven villages in four districts (Botan, Kenthao, Paklaiy, and Phiang) that share a border with Thailand. Further studies are required to determine if Xayaboury Province is indeed an epidemiological hot spot of Q fever activity. There is an urgent need to determine the levels of economic loss and human health-related issues caused by Q fever, brucellosis, and BTV in Lao PDR.

We studied HIV seropositivity among a targeted sample of migrant workers who used drugs, primarily crack cocaine, and their sexual partners in rural southern Florida from 1993 to 1995. We enrolled men and women who were born in the United States (n = 369) or in other countries (n = 174). Overall, 11.2% of the sample were HIV positive, including 18% of Blacks from the United States, and about 8% of non-Hispanic whites from the United States, Blacks from the Caribbean, and persons from Central or South America. No Hispanics from the United States or the Caribbean, but 3.4% of Hispanics from Mexico, were HIV positive. In logistic regression analyses, race/ethnicity, gender, and age were most highly associated with HIV seropositivity. Immigration status, current drug use, and current sexual activity were not related to HIV seropositivity. HIV prevention programs must help reduce heterosexual transmission of HIV associated with drug use both locally and where migrants travel and work.

IntroductionWhile HIV/AIDS remains an important cause of death among people who inject drugs (PWID), the potential mortality burden attributable to hepatitis C virus (HCV) infection among this population is of increasing concern. Therefore, we sought to identify trends in and predictors of liver‐related mortality among PWID.MethodsData were derived from prospective cohorts of PWID in Vancouver, Canada, between 1996 and 2011. Cohort data were linked to the provincial vital statistics database to ascertain mortality rates and causes of death. Multivariate Cox proportional hazards regression was used to examine the relationship between HCV infection and time to liver‐related death. A sub‐analysis examined the effect of HIV/HCV co‐infection.Results and discussionIn total, 2,279 PWID participated in this study, with 1,921 (84.3%) having seroconverted to anti‐HCV prior to baseline assessments and 124 (5.4%) during follow‐up. The liver‐related mortality rate was 2.1 (95% confidence interval [CI]: 1.5–3.0) deaths per 1,000 person‐years and was stable over time. In multivariate analyses, HCV seropositivity was not significantly associated with liver‐related mortality (adjusted relative hazard [ARH]: 0.45; 95% CI: 0.15–1.37), but HIV seropositivity was (ARH: 2.67; 95% CI: 1.27–5.63). In sub‐analysis, HIV/HCV co‐infection had a 2.53 (95% CI: 1.18–5.46) times hazard of liver‐related death compared with HCV mono‐infection.ConclusionsIn this study, HCV seropositivity did not predict liver‐related mortality while HIV seropositivity did. The findings highlight the critical role of HIV mono‐ and co‐infection rather than HCV infection in contributing to liver‐related mortality among PWID in this setting.

Host–pathogen epidemiological processes are often unclear due both to their complexity and over-simplistic approaches used to quantify them. We applied a multi-event capture–recapture procedure on two years of data from three rabbit populations to test hypotheses about the effects on survival of, and the dynamics of host immunity to, both myxoma virus and Rabbit Hemorrhagic Disease Virus (MV and RHDV). Although the populations shared the same climatic and management conditions, MV and RHDV dynamics varied greatly among them; MV and RHDV seroprevalences were positively related to density in one population, but RHDV seroprevalence was negatively related to density in another. In addition, (i) juvenile survival was most often negatively related to seropositivity, (ii) RHDV seropositives never had considerably higher survival, and (iii) seroconversion to seropositivity was more likely than the reverse. We suggest seropositivity affects survival depending on trade-offs among antibody protection, immunosuppression and virus lethality. Negative effects of seropositivity might be greater on juveniles due to their immature immune system. Also, while RHDV directly affects survival through the hemorrhagic syndrome, MV lack of direct lethal effects means that interactions influencing survival are likely to be more complex. Multi-event modeling allowed us to quantify patterns of host–pathogen dynamics otherwise difficult to discern. Such an approach offers a promising tool to shed light on causative mechanisms. ; Funding was provided by an Ingenierıa de Protección Ambiental-Consejo Superior de Investigaciones Científicas (IPA-CSIC) contract through projects 20070687_5 and 20091418. The work reported in this paper complies with standards and procedures promulgated by Spanish legislation. ; Peer reviewed

The aims of the present study were: to estimate the seroprevalence of Bluetongue vírus (BTV), bovine alphaherpesvirus 1 (BoHV-1), bovine viral diarrhea virus (BVDV), Brucella abortus and Leptospira spp. in cattle from family farms in North of Minas Gerais; to determine the intercurrence and association among these pathogens; and to assess the possible associated factors to seropositive herds and animals. For this, 476 cows from 46 farms were sampled and evaluated serologically. The seroprevalence in herds and cattle was, respectively, for BTV 100% and 52.0%, for BoHV-1 95.7% and 48.6%, for BVDV 78.3% and 46.1%, for Leptospira spp. 76.1% and 29.1%, and for B. abortus was 0% in herd and cattle. More than 65% of the herds was simultaneously seropositive for BTV, BoHV-1, BVDV and Leptospira spp. Seropositivity for BoHV-1, Leptospira spp. serovar Autumnalis and serovar Hardjoprajitno were associated with abortion, whereas seropositivity for BVDV was associated with BoHV-1. Moreover, association among seropositivity for BVDV, BoHV-1 and Leptospira spp. was also observed. In conclusion, BTV, BoHV-1, BVDV and Leptospira spp. are highly seroprevalent and occurred simultaneously in cattle from family farms in Minas Gerais, indicating the need for the implementation of control measures to avoid economic losses related to these diseases.

PURPOSE: This study aims to determine the prevalence of malaria and HIV seropositivity among children with undernutrition in the Democratic Republic of the Congo. METHODS: A cross-sectional study of undernourished children aged between 12 and 60 months in Kalembe-Lembe hospital was carried out. Blood samples were collected for the analyses of malaria parasite, haemoglobin and haematocrit levels. HIV serostatus was determined with rapid HIV antibody tests and enzyme-linked immunosorbent assay. Logistic regression analyses were used to identify clinical predictors of HIV seropositivity. RESULTS: Of 225 children, 88.9% had malaria; the parasite loads were 16 000 para per μL (38.0%); 24 400 para per μL (56.8%), P 12 months, HIV seroprevalence was 29.3%; 86.0% had undernutrition and malaria, 6.8% had undernutrition and HIV and 4.3% had undernutrition, HIV and malaria (P < 0.001). The occurrence of at least three or more symptoms was highly specific (96.4–100.0%) for HIV seropositivity (P < 0.05). The overall mortality rate was 18.4%, higher in children with malaria and HIV (39.6% vs 12.2%, P < 0.001) and those with lower weight gain (4.3 vs 7.5 g kg(−1) day(−1), P < 0.001). CONCLUSIONS: There was high prevalence of malaria and HIV and mortality among severely undernourished children with malaria and HIV.

Objectives: To evaluate the prevalence of HIV-related misconceptions in an Outpatient Centre of Kinshasa (D.R.Congo) and analyze the association between these beliefs and HIV infection. Methods: A case-control study was carried out from December 2010 until June 2012. We assessed 1,630 participants aged 15-49 attending a primary outpatient centre in Kinshasa: 762 HIV Voluntary Counseling and Testing attendees and 868 blood donors. A 59-item questionnaire about knowledge, attitudes and practice was administered during a face-to-face interview, followed by an HIV test. Cases and controls were respondents with a newly diagnosed HIV positive or negative test, respectively. Unconditional logistic regression was used to analyse the association between misconceptions and HIV seropositivity. Results:Two hundred and seventy four cases and 1,340 controls were recruited. Cases were more likely than controls to have a low socioeconomic status, no education, to be divorced/separated or widowed. An association was found between the following variables and HIV-seropositivity: having a poor HIV knowledge (adjusted OR=2.79; 95%CI:1.43-5.45), not knowing a virus is the cause of AIDS (adjusted OR=2.03; 95%CI:1.38-2.98) and reporting more than three HIV-transmission-related misconceptions (adjusted OR=3.30; 95%CI:1.64-6.64), such as thinking an HIV+ person cannot look healthy and that HIV is transmitted by sorcery, God´s punishment, a kiss on the mouth, mosquitoes, coughs/sneezes or undercooked food. Conclusion:Despite having access to health care services, there are still many people in Kinshasa that have HIV-related misconceptions which increase their HIV risk. Our findings underscore the need for a culturally-adapted and gender-orientated basic HIV information into Congolese HIV prevention programs.

Ebolavirus disease (EVD) cases may go unreported because they are asymptomatic or unrecognized. We present serologic evidence of Ebolavirus exposure in a population residing in non-EBOV outbreak locations in DRC and identify activities and animal exposures associated with EBOV seropositivity.

BACKGROUND: Vertical transmission is also mode of transmission of HBV, HCV and HIV. Viral infections may cause abortion, ectopic pregnancies and HBV, HCV also causes hepatitis, cirrhosis. 'Janani Sureksha Yojana' (safe motherhood program) is a scheme in which pregnant women are benefited if they deliver in government medical facility. Antenatal screening for HBV, HCV and HIV should be done so as to provide appropriate antiviral therapy. The aim of study was to detect the frequency of HBsAg, HCV antibody, HIV antibody and their correlation with risk factors.METHODS: Present study was conducted in central laboratory of Rural Institute of Medical Science and Research Saifai, Etawah (Uttar Pradesh) on pregnant women from 1 January to 31 December 2014.RESULTS: Out of 7867 women, 2.07% were positive for HBsAg, 0.43% and 0.13% for HCV antibody and HIV antibody, respectively. The age group with maximum seropositivity was in 21-30 year (76.44%) and parity with maximum seropositivity was 3-4 children (42.30%). Seropositivity was high among low socio economic status (77.40%). Among the associated risk factors Obstetric and Gynaecology surgeries (46.15%) and blood transfusion (20%) were prominent. These associated risk factors were found more among HBsAg seropositive females (86.66%) and (84.61%) respectively.CONCLUSIONS: The prevalence of HBsAg positive (2.07%) was more. Obstetric and Gynaecology surgery, blood transfusion were major risk factors. So, screening for HBsAg, HCV antibody, HIV antibody should be mandatory for pregnant women to reduce mortality and morbidity.