Blood-borne Infectious Diseases Research Articles

Level of knowledge of prevention of blood-borne infectious diseases among Master’s degree students of nursing

Introduction. Blood-borne infections are a serious problem among medical staff, especially nursing staff, because nurses have the most frequent contact with patients. As future employees of health care, students of nursing are exposed to a number of hazardous factors. Work with patients of unknown serological status (during practical classes and apprenticeships) is associated with the risk of infection with various pathogens. Objective. The aim of the study was recognition of the level of knowledge concerning prevention of blood-borne infectious diseases among Master’s degree students of nursing. Material and Methods. The study was conducted in the second half of 2022 among 104 Master’s degree students of nursing, who were educated at the Radom School in Radom, by the method of a diagnostic survey, using an author-constructed questionnaire. Results. The majority of the examined students (96.2%) knew what diseases are transmitted through blood. More than a half of respondents (63.5%) evaluated their level of knowledge about blood-borne diseases as mediocre, and 19.2% - as low. A part of respondents (67.3%) had knowledge that trace amounts of blood are enough to cause infection with blood-borne diseases. All students in the study knew the main methods of prevention of infections transmitted via blood, and the deficit of knowledge concerned proper use of personal protection equipment (5.8%) and the observance of the procedure to be followed in the event of occupational exposure (3.8%). A large group of respondents (82.7%-100.0%) knew various risk factors of infection with blood-borne diseases. The majority of respondents (88.5%) knew that there is an effective vaccine against hepatitis B, but 43.3% of the students in the study did not know the main symptoms of infection with HBV. Students most often knew (90.4%) how to diagnose infection with HCV – anti-HCV test for the presence of antibodies against hepatitis C virus in blood; however, 26.9% of respondents were not aware that there is no vaccine against hepatitis C. The majority of the examined students (84.7%) knew early symptoms of infection with HIV, while the remainder had a deficit of knowledge in this area. A large group of respondents (82.0%-94.0%) knew various risk factors of infection with HIV. Conclusions. Students of nursing should be motivated to expand their knowledge concerning prevention of blood-borne diseases, observance of the principles of personal protection, prevention of occupational exposure, and proper post-exposure prophylaxis.

Localization of the questionnaire about sharps disposal at home among diabetes based on knowledge, attitude, and practice theory, and a cross-sectional survey of current conditions.

Diabetes Mellitus is a long duration disease, and if a person with diabetes is infected with a blood-borne infectious disease and proper syringe disposal practices are not followed, they run the danger of transmitting the infection to others for a very long period. Whereas fewer research has been done in China on the handing of sharp objects at home. Therefore, there is a need to translate and localize the Knowledge-Attitude-Practice Questionnaire regarding sharp disposal for diabetic patients to assess the current level of patient knowledge, attitudes, and practices and to improve the basis for promoting safe sharps handling practices. This investigation was a cross-sectional study. The Knowledge-Attitude-Practice Questionnaire regarding sharp disposal was localized and debugged and tested for reliability and validity, and then 334 patients were investigated by General Characteristics Questionnaire, Knowledge- Attitude-Practice Questionnaire regarding sharp disposal, and the influencing factors of practice level regarding sharp disposal of patients were analyzed. The Cronbach's α value of the attitude section was 0.864 and the content validity index was 0.923. The knowledge and practice sections are in line with continental language conventions and are easy to understand without any ambiguity. The majority (52%) of the participants had poor knowledge and a neutral attitude toward disposing of sharp objects. Sharps disposal practices among diabetes mellitus patients were poor since about 90% of patients dispose of their used sharps directly into the household waste. Furthermore, we found that level of education, knowledge and attitude were the major predictors of practices regarding sharps disposal among diabetic patients (R 2 = 0.573, p < 0.001). The Chinese version of the Knowledge-Attitude-Practice Questionnaire regarding sharp disposal has applicability in China. In China, current practice of disposing used sharps is improper. Additionally, the majority of the subjects had low levels of knowledge and attitudes. To raise awareness and encourage diabetic patients to follow appropriate sharps disposal practices, there needs to be ongoing education and a locally tailored safe sharp disposal alternative accessible.

A survey of bloodborne occupational exposure protection behavior among qualified Chinese midwives: A cross-sectional study

BackgroundBloodborne occupational exposure is a major public health concern of the China Health Commission, especially among midwives who are at high risk among healthcare workers. Knowledge of occupational exposure and appropriate protective behaviors play important roles in reducing occupational exposure. The purpose of this study was to understand the knowledge and level of protection against bloodborne occupational exposure among midwives in China. MethodsThis was a multi-center, cross-sectional study. Midwives from hospitals that are members of Infectious Disease Nursing Committee of Chinese Nursing Association were selected as survey participants from February 2019 to February 2022 using a judged sampling method. Data were collected by using a self-developed questionnaire for Chinese midwives to report their current knowledge and behavior related to bloodborne occupational exposure protection. ResultsA total of 2850 questionnaires were distributed and 2742 valid questionnaires were obtained, resulting in an effective rate of 96.21 %. Midwives scored 2742 (6.495 ± 1.529) points for their knowledge about bloodborne occupational exposure protection, with the level and type of hospital being independent factors affecting the midwives' knowledge of bloodborne occupational exposure protection (χ2 = 27.284, P = 0.038; χ2 = 28.374, P = 0.000). Of the midwives, 1460 were qualified for bloodborne occupational exposure protection behavior, with a qualified rate of 53.25 %. Working years (χ2 = 9.372, P = 0.002) and working hours (χ2 = 13.933, P = 0.000) were also the independent factors for bloodborne occupational exposure protective behavior in midwives. ConclusionChinese midwives possess relatively good knowledge of bloodborne exposure protection against bloodborne infectious diseases, but their behavioral level is not optimistic. Improvements to both knowledge and behavioral level of bloodborne occupational exposure protection are necessary.

Assessment of occupational risks of bloodborne infectious diseases for dental personnel

BACKGROUND: Awareness of dental workers about the epidemiology of blood-borne infections (HIV, hepatitis B virus [HBV], and hepatitis C virus infections) and knowledge about actions to take if accidents occur in the workplace such as contact with blood and other biological fluids are a key link in the prevention of these infections.&#x0D; AIMS: To assess awareness and adherence of dental personnel to the algorithm of postexposure prophylaxis of occupational infections with blood-borne pathogens.&#x0D; MATERIALS AND METHODS: This descriptive crosssectional study enrolled the dental staff of public and private dental clinics in Kazan, Russia. A survey of 173 dental staff was conducted in FebruaryMarch 2023. The rates of incidents caused by contact with blood and their nature among dental staff were determined, and the frequency of correctly performed algorithm of actions during an incident was calculated. The frequency of the implementation of measures for the prevention of occupational infections with blood-borne pathogens was estimated. Categorical data were described as absolute values and proportions (%).&#x0D; RESULTS: In total, 65 specialists (37.6%) had encountered incidents such as contact with blood at the workplace. These incidents were significantly more common among women than among men: 44.7% (55/123) vs. 20.0% (10/50), respectively (p=0.002). The last incident in 50 respondents was associated with skin damage (needlestick injury or cut exposure); in 17 participants, their mucous membranes were exposed to blood (including two people with a mixed characteristic of incident: skin damage + exposure of their mucous membranes to blood). After contact with blood, local treatment was carried out correctly (according to Russian recommendations) in 18.0% of the participants with skin damage and 70.5% with blood exposure to mucous membranes. After the incident, 58.5% of the participants (38/65) reported to the head of the department or clinic, and a third of the respondents (23/65, 35.4%) recorded a case of contact with blood in the incident log. Nearly all respondents always use gloves (172/173, 99.4%) when they work in the dental office. Moreover, 64.2% of the respondents (111/173) always use safety glasses or screens. Nine respondents (9/173, 5.2%) do not use personal eye protection. Others (53/173, 30.6%) wear safety glasses/screens only when performing certain procedures. In addition, 85.0% (147/173) of the respondents have been vaccinated against HBV, 18 have not been vaccinated (10.4%), and 8 (4.6%) do not know their vaccination status.&#x0D; CONCLUSIONS: The results of this study present the necessity of raising awareness among dental staff regarding the epidemiology and prevention of blood-borne infections to reduce the risk of occupational infections.

COVID-19 and severity of liver diseases: Possible crosstalk and clinical implications.

COVID-19-infected individuals and those who recovered from the infection have been demonstrated to have elevated liver enzymes or abnormal liver biochemistries, particularly with preexisting liver diseases, liver metabolic disorders, viral hepatitis, and other hepatic comorbidities. However, possible crosstalk and intricate interplay between COVID-19 and liver disease severity are still elusive, and the available data are murky and confined. Similarly, the syndemic of other blood-borne infectious diseases, chemical-induced liver injuries, and chronic hepatic diseases continued to take lives while showing signs of worsening due to the COVID-19 crisis. Moreover, the pandemic is not over yet and is transitioning to becoming an epidemic in recent years; hence, monitoring liver function tests (LFTs) and assessing hepatic consequences of COVID-19 in patients with or without liver illnesses would be of paramount interest. This pragmatic review explores the correlations between COVID-19 and liver disease severity based on abnormal liver biochemistries and other possible mechanisms in individuals of all ages from the emergence of the COVID-19 pandemic to the post-pandemic period. The review also alludes to clinical perspectives of such interactions to curb overlapping hepatic diseases in people who recovered from the infection or living with long COVID-19.

Prevalence of residual risks of the transfusion-transmitted infections in Riyadh hospitals: A two-year retrospective study

Abstract This study aimed to evaluate the prevalence and trends of transfusion-transmitted infections (TTIs) in two hospitals in Riyadh, as well as to judge the best type of tests to ensure blood transfusion safety. By using serological and nucleic acid test (NAT) tests, these donors were screened for human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV), human T-lymphotropic virus type 1 (HTLV-1), human T-lymphotropic virus type 2 (HTLV-2), syphilis, and malaria infection as a first time of donation. Out of 58,898 blood units, 336 units were reacted for HBsAg, 5,318 units for HBcAbs, 506 units for HCV antibodies, 214 units for HIV Ab/Ag combinations, 206 units for HTLV antibodies, 355 units for syphilis antibodies, and 81 units for malaria. Moreover, the genotypic prevalence of these products showed that 349 units reacted for HBV DNA, HCV RNA, and HIV RNA in blood donation. This study reflects the seriousness of the residual risk of TTI, which is still a threat factor for the transmission of blood-borne infectious diseases. It was discovered that utilising (NAT) could increase test sensitivities while also lowering residual TTI risks, improving blood safety, and being cost-effective.

AB112. SOH23ABS_017. A systematic review and meta-analysis assessing the use of blunt suture needles versus sharp suture needles in risk of transmission of bloodborne infectious diseases

AB112. SOH23ABS_017. A systematic review and meta-analysis assessing the use of blunt suture needles versus sharp suture needles in risk of transmission of bloodborne infectious diseases

Hepatitis B and C in individuals with a history of antipsychotic medication use: A population-based evaluation.

A better understanding of links between mental illness and risk of bloodborne infectious disease could inform preventive and therapeutic strategies in individuals with mental illness. We performed a cross-sectional study using the National Health and Nutrition Examination Survey (NHANES) to estimate the seroprevalence of hepatitis B and C in individuals with and without a prior prescription for antipsychotic medications, and to determine whether differences in seroprevalence could be explained by differential distribution in known infection risk factors. Multivariable logistic regression models were used to examine the association between receipt of antipsychotic medication and HBV and HCV seropositivity. Those who had HBV core antibody had 1.64 (95% CI: 0.89, 3.02) times the odds and those with HCV antibody (anti-HCV) had 3.48 (95% CI: 1.71, 7.09) times the odds of having a prescription for at least one antipsychotic medication compared to those who did not have HBV core antibody or HCV antibody, respectively. While prior antipsychotic receipt was a potent risk marker for HCV seropositivity, risk was explained by adjusting for known bloodborne infection risk factors (adjusted ORs 1.01 [95% CI: 0.50, 2.02] and 1.38 [95% CI: 0.44, 4.36] for HBV and HCV, respectively). Prior receipt of antipsychotic medications is a strong predictor of HCV (and to a lesser extent HBV) seropositivity. Treatment with antipsychotic medications should be considered as additional risk markers for individuals who may benefit from targeted prevention, screening, and harm reduction interventions for HCV.

Frequency and risk factors of bloodborne infectious diseases among informal solid waste handlers: A cross-sectional study.

Objective: To determine the frequency and risk factors of bloodborne infectious diseases among informal solid waste handlers. Study Design: Cross-sectional Analytical study. Setting: Marghzar Colony, Lahore, Pakistan. Period: October to November 2019. Material &amp; Methods: Convenience enrollment of 101 informal solid waste handlers out of total 150 invited subjects resulted in a response rate of 67.3%. A predesigned proforma was administered to collect demographic and clinical information. Whole blood specimen collected for subsequent screening of hepatitis B, hepatitis C &amp; human immunodeficiency virus by rapid immune-chromatographic technique. Crosstabs analysis performed to calculate the odds ratios for bloodborne infectious diseases and chi square test used to find the association between risk factors and bloodborne infectious diseases. Results: Mean age of study population was 31.9±12.8 years. Participation of females 65.3% was higher than males 34.7%. Overall 4.0% frequency of bloodborne infectious diseases included 2.0% hepatitis B and 2.0% hepatitis C. None of the respondents had HIV or co-infection of hepatitis B and C. Frequency of those who collected waste from clinical sites was 6.0%, who received sharps injuries (100.0%), and who never used personal protective equipment (100.0%). Gender male [OR=6.094; 95.0% CI, 0.609–60.927], smoking [OR=5.056; 95.0% CI, 0.454–56.245], and waste collection from clinical site [OR=6.133; 95.0% CI, 0.537–70.057] showed a higher risk of bloodborne infectious diseases. Conclusion: The proportions of hepatitis, sharps injuries and not using personal protective equipment were high among informal solid waste handlers. Waste collection from clinical sites showed higher risk of occupational transmission of hepatitis.

Law enforcement and syringe services program implementation in rural counties in Kentucky: a qualitative exploration

BackgroundExisting research in urban areas has documented a multitude of ways in which law enforcement may affect risks for bloodborne infectious disease acquisition among people who inject drugs (PWID), such as via syringe confiscation and engaging in practices that deter persons from accessing syringe services programs (SSPs). However, limited work has been conducted to explore how law enforcement may impact SSP implementation and operations in rural counties in the United States. This creates a significant gap in the HIV prevention literature given the volume of non-urban counties in the United States that are vulnerable to injection drug use-associated morbidity and mortality.ObjectiveThis study explores the influence of law enforcement during processes to acquire approvals for SSP implementation and subsequent program operations in rural Kentucky counties.MethodsFrom August 2020 to October 2020, we conducted eighteen in-depth qualitative interviews among persons involved with SSP implementation in rural counties in Kentucky (USA). Interviews explored the factors that served as barriers and facilitators to SSP implementation and operations, including the role of law enforcement.ResultsParticipants described scenarios in which rural law enforcement advocated for SSP implementation; however, they also reported police opposing rural SSP implementation and engaging in adverse behaviors (e.g., targeting SSP clients) that may jeopardize the public health of PWID. Participants reported that efforts to educate rural law enforcement about SSPs were particularly impactful when they discussed how SSP implementation may prevent needlestick injuries.ConclusionsThe results of this study suggest that there are multiple ways in which rural SSP implementation and subsequent operations in rural Kentucky counties are affected by law enforcement. Future work is needed to explore how to expeditiously engage rural law enforcement, and communities more broadly, about SSPs, their benefits, and public health necessity.

Impact of different pathogen reduction technologies on the biochemistry, function, and clinical effectiveness of platelet concentrates: An updated view during a pandemic.

Standard platelet concentrates (PCs) stored at 22°C have a limited shelf life of 5 days. Because of the storage temperature, bacterial contamination of PCs can result in life‐threatening infections in transfused patients. The potential of blood components to cause infections through contaminating pathogens or transmitting blood‐borne diseases has always been a concern. The current safety practice to prevent pathogen transmission through blood transfusion starts with a stringent screening of donors and regulated testing of blood samples to ensure that known infections cannot reach transfusion products. Pathogen reduction technologies (PRTs), initially implemented to ensure the safety of plasma products, have been adapted to treat platelet products. In addition to reducing bacterial contamination, PRT applied to PCs can extend their shelf life up to 7 days, alleviating the impact of their shortage, while providing an additional safety layer against emerging blood‐borne infectious diseases. While a deleterious action of PRTs in quantitative and qualitative aspects of plasma is accepted, the impact of PRTs on the quality, function, and clinical efficacy of PCs has been under constant examination. The potential of PRTs to prevent the possibility of new emerging diseases to reach cellular blood components has been considered more hypothetical than real. In 2019, a coronavirus‐related disease (COVID‐19) became a pandemic. This episode should help when reconsidering the possibility of future blood transmissible threats. The following text intends to evaluate the impact of different PRTs on the quality, function, and clinical effectiveness of platelets within the perspective of a developing pandemic.

Sociodemographic and clinical characteristics of patients admitted to an addiction center

ABSTRACT Objective: To investigate the sociodemographic and clinical characteristics of patients admitted to an addiction center. Methods: The medical files of 4990 patients were analyzed retrospectively. Results: 88.6% (n = 4421) of the patients were male, and the mean age was 33.51 ± 11.01 years. Substance use disorder was diagnosed in 78.5% (n = 3916) of the patients, alcohol use disorder in 20.3% (n = 1013), and prescription drug use in 1.1% (n = 57). Nearly three-quarters (72.7%, n = 2847) had multiple substance use 22.3% (n = 872) only used heroin, and 5% (n = 197) only used cannabis. 56.9% (2194/3856) of the patients had poor family relations, and 22.7% (96/422) were exposed to domestic violence. It was found that 77.9% (3882/4986) started the substance under the influence of their friends. One-fifth (20.4%, 979/4807) had intravenous substance use and 38.1% (94/247) reported non-sterile syringe sharing. We found that 10.3% (n = 512) had a blood-borne infectious disease, the most common of which was hepatitis C (n = 441). Conclusion: Our study revealed the sociodemographic and clinical characteristics of patients with substance use disorder. Knowing these features is very important for prevention and treatment strategies.

Hepatitis B-C and human immunodeficiency virus: seroprevalence and associated factors among health students in Saudi Arabia

ABSTRACT Objectives To assess the seroprevalence of Hepatitis B (HBV), Hepatitis C (HCV), and Human Immunodeficiency Virus (HIV) among newly admitted health track students in a large university in the Eastern Province of Saudi Arabia, and determine the students’ immunity against HBV, and bloodborne viral infection risk factors or practices among them. Methods Information about the 1145 students, vaccination history, and exposure to bloodborne viral infections risk factors/practices were collected using a structured questionnaire during August 2020. The results of serological data were obtained from students’ electronic files. Results All students tested negative for HBV, HCV, and HIV infections. The seroprevalence of positivity against HBV was 25.8%, and the frequencies of students with protective levels of anti-HBV were inversely related to their age. The majority (70.8%) of students had 1 or 2 identifiable risk factors for bloodborne diseases, and the most frequent risk factor was history of dental intervention. Female students were more than four-times likely to be in the high-risk group for bloodborne infections than males (OR = 4.4; 95% CI: 3.3–5.9). Being from the Central Province of Saudi Arabia (OR = 1.9; 95% CI: 1.2–3.1) and having a mother’s educational level of master or doctorate (OR = 3.0; 95% CI: 1.3–6.7) were found to be independent predictors of being in the high-risk group. On the other hand, having a family member in the healthcare field was found as a predictor of being in the low-risk group for bloodborne diseases (OR = 0.7; 95% CI: 0.5–0.9). Conclusion About three-fourth of students in this study were susceptible to HBV. Our findings stress the need to develop policies to raise awareness regarding bloodborne infectious diseases, in addition to expanding access to HBV vaccination for healthcare staff, especially in older ages.

A Survey on HIV, HCV, and HBV and Related Factors Among the Homeless Population, Southeast of Iran

Background: Homeless people are prone to sexually transmitted and blood-borne infectious diseases such as hepatitis B, hepatitis C, and HIV due to their risky behaviors and low awareness of various diseases. Objectives: Thus, the present research aimed to examine the epidemiologic patterns of HBV, HCV, HIV, and related factors among the homeless population of Zahedan in 2019. Methods: A cross-sectional study was conducted on a total of 329 homeless people. Eligible people were selected using a convenience sampling method from homeless individuals residing in care centers affiliated with the Welfare Organization and the Health Deputy of Zahedan University of Medical Sciences. Data on the demographic and behavioral characteristics of the cases were collected through a structured questionnaire completed in face-to-face interviews. A 10 cc blood sample was taken from each of the cases for serological tests of hepatitis B, hepatitis C, and HIV. The test results and collected data were entered in SPSS16 software. Logistic regression analysis and chi-square tests were used to analyze the data. Results: The majority of the cases (84%) were males, and 59% were in the age-group of 35 - 50 years. Of the subjects, 93% had a history of drug abuse, 74% reported a history of smoking, and 45% had tattoos. The prevalence of hepatitis C, hepatitis B, and HIV was 13%, 2.7%, and 0.3%, respectively (only one case of HIV was identified). In a multi-variate model, imprisonment history [OR = 2.32 (1.08 - 4.98)], history of sexual abuse [OR = 3.73 (1.36 - 10.26)], being widowed or divorced [OR = 2.83, (1.21 - 6.64)], and history of injection with shared needles and syringes [OR = 5.11 (1.97 - 13.28)] remained the predicting factors of hepatitis C. Conclusions: Based on the obtained results of the study, homeless people are more prone to infections with HCV, HBV, and HIV due to their risky behaviors. Therefore, a need is highlighted for preventive interventions and developing the level of health literacy in this group regarding behaviors contributing to the aforementioned infections.

Knowledge, awareness, and vaccination compliance of hepatitis B among medical students in Riyadh's governmental universities.

Background:Hepatitis B is a blood-borne infectious liver disease caused by the Hepatitis B Virus (HBV) and it is best prevented by immunization. Due to occupational exposure, medical students have an increased risk of contracting HBV. Therefore, it is essential for all medical students to have good knowledge about HBV and to complete their HBV vaccinations.Aims:The aim of this study was to assess and compare HBV knowledge, awareness, and vaccination compliance among pre-clinical medical students in four universities.Settings and Design:A cross-sectional study was conducted in September 2018 at the College of Medicine of four governmental universities: King Saud Bin Abdulaziz University for Health Sciences, King Saud University, Princess Noura university, and Imam Mohammed bin Saud Islamic University, in Riyadh, Saudi Arabia.Methods and Materials:Two-hundred-sixty-three pre-clinical medical students completed a questionnaire with sections about demographics, HBV awareness, knowledge, and vaccination compliance.Statistical analysis used:The data was transferred to Excel and SPSS version 22 was used for statistical analysis. A significance level of P < 0.05 was considered statistically significant.Results:The overall knowledge about HBV and vaccination compliance were poor. KSU students had the highest vaccination compliance (n = 52, 54.2%) and KSAU-HS the lowest (n = 19, 23,8%). The most-cited reasons for noncompliance were “forgetting about the vaccine” and “busy schedule“.Conclusion:Overall, most of the participants had poor HBV knowledge and vaccine compliance. Therefore, we recommend the implementation of pre-clinical vaccine checking and the addition of an infectious disease awareness and prevention program.

Infectious safety of donor blood

Infectious safety of donor blood

Prevalence and correlates of receptive syringe‐sharing among people who inject drugs in rural Appalachia

Syringe-sharing significantly increases the risk of HIV and viral hepatitis acquisition among people who inject drugs (PWID). Clearer understanding of the correlates of receptive syringe-sharing (RSS) is a critical step in preventing bloodborne infectious disease transmission among PWID in rural communities throughout the United States. This study aimed to measure the prevalence and correlates of RSS among PWID in a rural county in Appalachia. Observational, cross-sectional sample from a capture-recapture parent study. Cabell County, West Virginia (WV), USA, June-July 2018. The sample was restricted to people who reported injecting drugs in the past 6months (n=420). A total of 180 participants (43%) reported recent (past 6months) RSS. Participants reported high levels of homelessness (56.0%), food insecurity (64.8%) and unemployment (66.0%). The main outcome was recent re-use of syringes that participants knew someone else had used before them. Key explanatory variables of interest, selected from the risk environment framework, included: unemployment, arrest and receipt of sterile syringes from a syringe services program (SSP). Logistic regression was used to determine correlates of recent RSS. PWID reporting recent RSS also reported higher prevalence of homelessness, food insecurity and unemployment than their non-RSS-engaging counterparts. In adjusted analyses, correlates of RSS included: engagement in transactional sex work [adjusted odds ratio (aOR) =2.27, 95% confidence interval (CI)=1.26-4.09], unemployment (aOR=1.67, 95% CI=1.03-1.72), number of drug types injected (aOR=1.33, 95% CI=1.15-1.53) and injection in a public location (aOR=2.59, 95% CI=1.64-4.08). Having accessed sterile syringes at an SSP was protective against RSS (aOR=0.57, 95% CI=0.35-0.92). The prevalence of receptive syringe-sharing among people who inject drugs in a rural US county appears to be high and comparable to urban-based populations. Receptive syringe-sharing among people who inject drugs in a rural setting appears to be associated with several structural and substance use factors, including unemployment and engaging in public injection drug use. Having recently acquired sterile syringes at a syringe services program appears to be protective against receptive syringe sharing.

Analysis of causes of death and etiological characteristics of skin tissue donors

Objective: To investigate the causes of death and etiological characteristics of skin tissue donors, and to provide reference for allogeneic skin transplantation. Methods: From October 2008 to October 2018, 49 skin tissue donors accepted by the Burn Department of Wuhan Third Hospital met the inclusion criteria of this study, and a cross-sectional study was conducted. According to the cause of death, the donors were divided into accidental death group (19 cases) and non-accidental death group (30 cases). The sex and death age of 49 donors were recorded, and the death age between different sex donors and that of donors between accidental death group and non-accidental death group were compared. Diseases or circumstances that caused the death of donors, hepatitis B, hepatitis C, acquired immunodeficiency syndrome, syphilis virus carrying status, and peripheral blood microbial culture results of 49 donors were recorded, and the detection of blood-borne infectious risk factors of donors between accidental death group and non-accidental death group was compared. Abnormal skin tissue was also selected during allogenic skin graft preparing for pathological examination. Data were statistically analyzed with Mann-Whitney U test and continuity correction chi-square test. Results: (1) Out of the 49 donors in this group, 38 were male (77.55%) and 11 were female (22.45%). The death age was 42.00 (24.00, 55.00) years, and the death age of male donors was similar to that of female donors (Z=0.120, P>0.05). The death age of donors in accidental death group was lower than that in non-accidental death group, but the difference was not statistically significant (Z=-1.581, P>0.05). (2) Among the causes and circumstances of the 49 donors in this group, there were 19 cases (38.78%) of injury, poisoning, and some other consequences of external causes, 11 cases (22.45%) of circulatory system diseases, 9 cases (18.37%) of tumors, 3 cases (6.12%) of nervous system diseases, 2 cases (4.08%) of respiratory system diseases, and 2 cases (4.08%) of congenital malformation, deformation, and chromosome abnormality, 1 case (2.04%) of blood and hematopoietic organ diseases and some diseases related to immune mechanism, 1 case (2.04%) of digestive system disease, and 1 case (2.04%) of genitourinary system disease. (3) There were 9 donors (18.37%) with blood-borne infectious risk factors among the 49 donors in this group, including 8 cases (16.33%) of blood-borne infectious diseases, which were 5 cases (10.20%) of hepatitis B, 2 cases (4.08%) of syphilis, and 1 case (2.04%) of hepatitis C, respectively. Blood microorganism culture was positive in 1 case (2.04%), in which multi-drug resistant Pseudomonas aeruginosa was detected. Risk factors of blood-borne infection were detected in 2 donors in accidental death group, with detection ratio lower than that in non-accidental death group (7 cases), but the difference was not statistically significant (χ(2)=0.562, P>0.05). (4) A total of 8 donors' abnormal skin tissue were selected, including 4 cases of intradermal pigmented nevus, 1 case of scar, 1 case of pseudoepithelioma hyperplasia, 1 case of epidermal verrucous hyperplasia, and 1 case of large amount of pigment granules in dermis. Conclusions: Non-accidental death caused by diseases is the main cause of death of skin tissue donors, and the risk of donor-derived infection of non-accidentally dead donors is slightly higher than that of accidentally dead donors. Before the allogeneic skin is obtained and transplanted, the cause of death of the donor should be carefully investigated, and the health status should be evaluated, so as to avoid the occurrence of donor-derived infection.

Dental Care Implications in Coronavirus Disease-19 Scenario: Perspectives

The aim of this review is to discuss the implications of COVID-19 on various aspects of dental care. The COVID-19 pandemic had suspended dental practice globally for over 3 months. While dental practice is being resumed cautiously, standard infection control protocols that were traditionally overlooked are now being strictly implemented. Post-COVID-19, dental care is expected to see a drastic change in the way it is practiced. With a view on the natural history and disease dynamics of COVID-19, this review reports various aspects of dental care, viz., patient triaging, engineering and work practice controls, and administrative, financial, and ethical aspects of dental care during and after COVID-19 pandemic. Current evidence-based recommendations with regard to infection-control practices are discussed. A call for universal oral health care with suggestions regarding integration of medical and health care is also proposed. COVID-19 is expected to be a watershed moment in the field of dentistry. While we expect to see positive changes in safe delivery of dental care, an increase in cost of availing care is imminent. The practice of dentistry and dental infection control has undergone dimensional changes due to bloodborne infectious diseases such as hepatitis B virus infections and human immunodeficiency virus epidemic. Due to these pandemics, many regulatory organizations have provided safety recommendations and guidelines that impact the dental practice. Currently, we are faced with a highly infective disease with a high mortality rate among people with comorbidities and of predominantly droplet transmission and no concrete safety recommendations and guidelines. This manuscript addresses multiple issues, gaps, and pragmatic solutions in controlling transmission of SARS-CoV-2 in dental settings, during and after the pandemic.

Conducting Infectious and Communicable Disease Education in Hospitality Organizations Viewpoint

Every day, employees in the lodging and hospitality industry are potentially exposed to bloodborne pathogens and other infectious diseases. Federally sponsored biosafety and infectious disease training sessions were conducted at two lodging sites in an effort to promote infectious disease primary prevention, as well as mitigation and management techniques in the hospitality industry in an effort to develop interdisciplinary connections between public health and hospitality. The trainings were positively received, but as this viewpoint reveals, further research, partnerships, and curriculum development is needed in this area in order for it to have long-term and impactful effects.