Suchergebnisse

In 1989, from May to December, 1,440 injection drug users (IDUs) in Newark and Jersey City, not enrolled in treatment, were recruited by outreach to storefront offices, where they were interviewed about AIDS-risk behaviors and tested for antibodies to HIV. Information was gathered on drug use and sexual patterns, health, criminality and demographics. Data from 1,278 IDUs (88.75%) were analyzed; 667 (52.5%) tested HIV-antibody positive. Using univariate and multivariate analysis, thirteen variables were identified that were significantly and independently associated with seropositivity, including years since first drug injection, injecting mixed heroin and cocaine, frequent injection of cocaine by itself, no "crack" use, no noninjected heroin use, time in jail, abuse of glue or paint thinner, absence of sexual activity, subjects' global rating of their own AIDS risk, health history, gender, race and education. Implications for HIV risk assessment in other regions and for the development of interventions are discussed.

AbstractThe aim of this study was to evaluate maternal serological status and fetal sonographic findings of Cytomegalovirus (CMV) infection. This is a retrospective study performed at Perinatology Department of Istanbul Başakşehir Çam and Sakura City Hospital. A computerized search was conducted to identify cases who underwent prenatal diagnosis of fetal CMV infection between September 2020 and December 2023. We identified nine cases with fetal CMV infection. The clinical data of the patients, gestational age at the time of diagnosis, serological, sonographic findings, and pregnancy outcomes were analyzed. A computer search of the database was made for the seroprevalance of CMV-IgM and CMV-IgG in our population. The CMV-IgM and IgG results of the 1235 patients who underwent CMV screening in the first trimester between September 2020 and December 2023 were evaluated. Fetal CMV infection was identified in nine patients. None of the 9 cases showed maternal CMV-IgM positivity. Seven of the 9 patients showed high IgG avidity index. Pregnant population had 98 % positivity for CMV-IgG. The evaluation of serologic tests for CMV is not straightforward in the second and third trimester. IgM and IgG avidity should be interpreted with caution in the second and third trimester. In the presence of ultrasound findings suggesting fetal CMV infection and CMV-IgG positivity, invasive diagnostic tests rather than serological test should be discussed with the patient, and non-primary infections should always be considered to minimize overlooked fetal cytomegalovirus infections and missed antiviral treatment opportunity.

Leishmaniasis is a severe vector-borne disease with two main clinical forms, visceral leishmaniasis and cutaneous leishmaniasis. Both forms of leishmaniasis are also endemic in Mediterranean countries including the Balkan region from where mainly visceral leishmaniasis is reported. Austrian soldiers returning from Kosovo were screened for anti-Leishmania antibodies to assess the risk of infection during operations. Anti-Leishmania antibodies were detected in more than 20% of the soldiers investigated, which indicates a considerable risk of infection during missions in this area and thus suggests the application of protective measures. Introduction Leishmaniasis is a zoonotic disease complex, caused by various species of the protozoan genus Leishmania and transmitted by the bite of infected female sand flies. The visceral form (VL) of the disease is estimated to cause 300,000 infections and over 20,000 deaths every year. For the cutaneous form (CL), over one million cases were reported in the past 5 years [1]. Leishmania infantum, causing zoonotic visceral leishmaniasis and occasionally also cutaneous leishmaniasis, is widespread and re-emerging in the Balkan region [2]. Leishmaniasis is known to occur in all bordering countries of Kosovo, namely Albania, Montenegro, North Macedonia and Serbia, dogs being the main reservoir and maintaining the transmission cycle [2,3,4,5,6]. The Republic of Kosovo is disputed territory and approximately one third of the population live below the poverty line [7]. Despite leishmaniasis being notifiable in Kosovo, data on human and canine leishmaniasis are scarce and numbers from bordering countries suggest considerable underreporting [4]. Soldiers are generally at increased risk of infection for vector-borne diseases during missions in endemic areas. In a recent study, 8.6% of Austrian soldiers deployed in Bosnia and Herzegovina (BIH) showed antibodies against Leishmania spp. after returning [8]. In order to assess the exposure to Leishmania spp. and associated risk factors, soldiers of the Austrian Armed Forces (AAF) returning from the Kosovo were screened for anti-Leishmania antibodies. Methods The Austrian Armed Forces (AAF) operate in Kosovo as part of the NATO mission Kosovo Force (KFOR). After return from a mission, soldiers are routinely subjected to a detailed health check. The AAF provided sera of 261 soldiers, taken immediately after their return from the Kosovo in 2013. All soldiers agreed to participate and to fill out a detailed questionnaire on demographic data (age, sex and place of residence), current and previous missions, duration of the missions, contact with animals in the mission area, insect bites, regular outdoor activities and holiday trips during the mission (see supplementary). The institutional review board of the AAF approved the study. All sera were tested for anti-Leishmania antibodies using the RIDASCREEN Leishmania AB enzyme-linked immunosorbent assay (ELISA) kit (R-Biopharm AG, Darmstadt, Germany), detecting IgM, IgG and IgA antibodies. The test was performed strictly following the manufacturer's instructions. Results are shown as positive (index >1.1), borderline (index 0.9–1.1) and negative (index <0.9). Descriptive statistics were performed with a one sample proportions test and Fisher's exact test. A two-sided p value <0.05 was considered statistically significant. Microsoft Excel 2011 for Mac (Microsoft, Washington, USA) and the R environment for Mac (R Foundation, Vienna, Austria) were used for data analysis. Results and conclusion Of the 261 individuals included in this study, 258 (98.9%) were male and 3 (1.1%) were female. The collective comprised 240 (92.0%) professional soldiers, 20 (7.7%) militiamen and 1 (0.3%) civil servant. Participants were between 20 and 61 years old (median 28 years). Altogether, 55 out of 261 soldiers (21.1%, 95% confidence interval, CI 16.4–26.6%) had anti-Leishmania antibodies. Of these 36 (13.8%, 95% CI 10.0–18.7%) were positive and 19 (7.3%, 95% CI 4.6–11.3%) were borderline in the ELISA. These results clearly indicate that the soldiers are at risk of infection with Leishmania spp. during missions in Kosovo. Seropositivity did not significantly correlate with analyzed anamnestic data; however, seropositivity increased with the number of completed missions (Table 1). But also 28 of the 136 (20.6%, 95% CI 14.3–28.6%) soldiers for whom this was the first mission showed anti-Leishmania antibodies. Of these 17 (12.5%, 95% CI 7.7–19.5%) were positive and 11 (8.1%, 95% CI 4.3–14.4%) were borderline. Altogether, positive Leishmania ELISA indices ranged from 1.13 to 4.6. The results clearly demonstrate a considerable risk of exposure to Leishmania spp. in Kosovo, which is further corroborated by 1.7% out of 121 tested stray dogs from Kosovo showing anti-Leishmania antibodies in a recent study [4]. Military personnel are known to be a particularly vulnerable group for leishmaniasis because the soldiers are usually immunologically naïve compared to the local population in endemic areas and, spending most time outdoors in rural areas and sleeping in tents or simple housing, are highly exposed to sand flies. This has also been shown for Austrian soldiers returning from BIH, Syria and Lebanon [8].

AIMS: The indigenously developed Indian Council of Medical Research (ICMR)-NIV COVID Kavach IgG enzyme linked immunosorbent assay (ELISA) has been recommended for seroprevalence among vulnerable populations in India, which provided essential services throughout the lockdown. The staff working in the High Court was one such group. We compared anti-SARS-CoV-2 IgG seropositivity among the staff of Jodhpur and Jaipur High Courts, Rajasthan, India. METHODS: Asymptomatic judiciary staff of Jodhpur and Jaipur benches of High Courts were enrolled after informed written consent. A questionnaire was filled and 3–5 ml venous blood was collected from participants. The ICMR-NIV COVID Kavach IgG ELISA and EUROIMMUN IgG ELISA were used for detection of Anti-SARS-CoV-2 IgG antibodies. RESULTS: A total of 63 samples (41 from Jodhpur and 22 from Jaipur) were collected between 28(th) July to 4(th) August 2020. The overall anti-SARS-CoV-2 IgG seroprevalence was found to be 6.35%. Seropositivity was higher among the staff from Jaipur (13.64%) as compared to Jodhpur (2.44%). The Kavach ELISA results were in complete agreement with EUROIMMUN ELISA. The infection control measures were deemed effective. CONCLUSION: Seroprevalence among the staff of Jodhpur High Court was found to be lower than Jaipur, reflecting higher susceptibility to COVID-19 in the former. Many offices worldwide are closed till mid 2020 but need to come up with pre-emptive policies eventually. This study may help to anticipate the possible challenges when other government/private offices start functioning. The infection control practices of one workplace may help formulate guidelines for other offices.

Background: Lyme borreliosis is the most prevalent vector-borne disease in Europe, and numbers might increase due to climate change. However, borreliosis is not notifiable in North Rhine-Westphalia (NRW), Germany. Hence, little is known about the current human seroprevalence in NRW. However, the proportion of Borrelia burgdorferi sensu lato-infected ticks has increased in a NRW nature reserve. The literature suggests increasing age and male sex as risk factors for seropositivity, whereas the influence of socioeconomic status is controversial. Thus, we aimed to determine regional seropositivity for Borrelia burgdorferi sensu lato (B. burgdorferi s.l.) and its risk factors in the Rhineland Study population in Bonn, NRW, and to compare it with previous surveys to evaluate potential effects of climate change. Methods: We assessed seropositivity in 2865 Rhineland Study participants by determining immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies for B. burgdorferi s.l. using a two-step algorithm combining enzyme-linked immunosorbent assay tests and line immunoblots. We calculated the odds of being classified as IgG or IgM positive as a function of age, sex, and educational level using binomial logistic regression models. We applied varying seropositivity classifications and weights considering age, sex and education to compensate for differences between the sample and regional population characteristics. Results: IgG antibodies for B. burgdorferi s.l. were present in 2.4% and IgM antibodies in 0.6% of the participants (weighted: 2.2% [IgG], 0.6% [IgM]). The likelihood of IgG seropositivity increased by 3.0% (95% confidence interval [CI] 1.5–5.2%) per 1 year increase in age. Men had 1.65 times the odds for IgG seropositivity as women (95% CI 1.01–2.73), and highly educated participants had 1.83 times the odds (95% CI 1.10–3.14) as participants with an intermediate level of education. We found no statistically significant link between age, sex, or education and IgM seropositivity. Our weighted and age-standardized IgG seroprevalence was comparable to the preceding serosurvey German Health Interview and Examination Survey for Adults (DEGS) for NRW. Conclusions: We confirmed that increasing age and male sex are associated with increased odds for IgG seropositivity and provide evidence for increased seropositivity in the highly educated group. B. burgdorferi s.l. seropositivity remained constant over the past decade in this regional German population.

Abstract Background Infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) can lead to chronic liver disease and hepato-cellular carcinoma (HCC). This cross-sectional study estimated the prevalence and identified risk factors associated with Hepatitis B surface antigen (HBsAg) and HCV antibody (anti-HCV) sero-positivity among children 1 to 15 years of age. Methods The study targeted the low to middle socioeconomic population that comprises 80% to 85% of the population. Consent was obtained from parents of the eligible children before administering questionnaire and collected a blood sample for anti-HCV and HBsAg serology. Results 3533 children were screened for HBsAg and anti-HCV. 1826 (52 %) were males. 65 (1.8 %) were positive for HBsAg, male to female ratio 38:27; mean age 10 ± 4 years. 55 (1.6 %) were positive for anti-HCV with a mean age 9 ± 4 years. 3 (0.11%) boys were positive for both HBsAg and anti-HCV. The overall infection rate was 3.3 % in the studied population. Hepatitis BsAg was more prevalent in subjects who received therapeutic injections 45 (69.2%) positive [Odd Ratio OR = 2.2; 95% Confidence interval CI: 1.3–3.6] inspite of using new needle and syringe 44 (67.7%) positive [OR = 2.2; 95% CI: 1.3–3.7] and vaccination in the government healthcare facilities 46 (70.7 %) positive with [OR = 3.0; 95% CI: 1.4–6.4]. These factors were not significant in anti-HCV positive cases. Conclusion There is a need to educate general population regarding HBV and HCV infection and risks associated with inappropriate therapeutic injections. Hepatitis B vaccine should be administered to all newborns regardless of maternal HBsAg status.

Background Infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) can lead to chronic liver disease and hepato-cellular carcinoma (HCC). This cross-sectional study estimated the prevalence and identified risk factors associated with Hepatitis B surface antigen (HBsAg) and HCV antibody (anti-HCV) sero-positivity among children 1 to 15 years of age. Methods The study targeted the low to middle socioeconomic population that comprises 80% to 85% of the population. Consent was obtained from parents of the eligible children before administering questionnaire and collected a blood sample for anti-HCV and HBsAg serology. Results 3533 children were screened for HBsAg and anti-HCV. 1826 (52 %) were males. 65 (1.8 %) were positive for HBsAg, male to female ratio 38:27; mean age 10 ± 4 years. 55 (1.6 %) were positive for anti-HCV with a mean age 9 ± 4 years. 3 (0.11%) boys were positive for both HBsAg and anti-HCV. The overall infection rate was 3.3 % in the studied population. Hepatitis BsAg was more prevalent in subjects who received therapeutic injections 45 (69.2%) positive [Odd Ratio OR = 2.2; 95% Confidence interval CI: 1.3–3.6] inspite of using new needle and syringe 44 (67.7%) positive [OR = 2.2; 95% CI: 1.3–3.7] and vaccination in the government healthcare facilities 46 (70.7 %) positive with [OR = 3.0; 95% CI: 1.4–6.4]. These factors were not significant in anti-HCV positive cases. Conclusion There is a need to educate general population regarding HBV and HCV infection and risks associated with inappropriate therapeutic injections. Hepatitis B vaccine should be administered to all newborns regardless of maternal HBsAg status.

The broad aim of this study is to investigate and recommend a model which would contribute to finding a solution to the AIDS pandemic facing the insurance industry. At present HIV positive persons are excluded from obtaining life insurance, and as a result of this they are excluded from obtaining access to finance as a life insurance policy is a vital financial instrument when attempting to access finance. The insurance industry has decided to protect itself and its response to the pandemic smacks of crisis intervention rather an attempt to find a solution acceptable to all parties. The intention is to investigate the role that all stakeholders, the public sector, the state and the industry can play in contributing to an imaginative response posed by this challenge. This study explores the causes and prognosis of AIDS, how the life insurance industry operates, how necessary life insurance is, strategies adopted by the industry in the face of this challenge, the experience of international insurers, as well as suggesting possible solutions and examining their mechanics. The study also investigates the impact of the Constitution and the Fundamental Rights on the suggested solutions. It recommends a particular solution as a workable model within a social policy perspective. It concludes with a request that all stakeholders participate in this solution for and to the benefit of everyone, as AIDS is not the problem of medical practitioners, or attorneys, or the insurance industry, but a societal problem.

Zoonotic leishmaniasis caused by Leishmania infantum is a disease of One Health concern since human and animal cases and environmental damage are interconnected. L. infantum has a complex epidemiological cycle with multiple hosts, including mammals—humans, domestic, and wild animals—and arthropod vectors. Knowledge on mammal infections in endemic areas is crucial for developing control strategies. This work aimed to detect and characterize L. infantum infection in domestic cats from areas where human and canine leishmaniasis cases occur. No cases of feline leishmaniasis (FeL) had been previously reported in those areas. Five municipalities from Bahia state were chosen, comprising 2,480.8 km(2) with 1,103,866 inhabitants. Ninety domiciliated and/or sheltered cats underwent clinical examination and serology by a rapid reference test recommended by the Brazilian government. Cytology, PCR, and parasite DNA sequencing were performed in bone marrow samples. Rapid tests detected antibodies in 5.6% (5/90) of the cats. Leishmania infantum infection was confirmed in 7.8% (7/90) of the cats by PCR, sequencing, and parasite isolation. Three out of the five municipalities (60%) had infected cats, and PCR positivity varied from 6.9 to 29%. One cat was categorized as harboring active L. infantum infection with amastigote forms in bone marrow smears. No clinical signs were detected at the first clinical exam, but 1 month later the cat developed severe FeL. The cat isolate was grown in culture, typed and its DNA sequence was homologous to the L. infantum reference strain (PP75). In conclusion, cats are potential hosts and may acquire L. infantum in endemic areas where canine and human cases occur. For cats, the need for surveillance, differential diagnosis and clinical care is highly recommended since a fast clinical progression of FeL developed in a subclinical animal. An accurate standardized immunodiagnostic assay for FeL is warranted.