High-risk Countries Research Articles

A Smartphone App for Real-Time Assessment of Malaria Prophylaxis Adverse Events.

Background: Growth of international travel to malarial areas over the last decades has contributed to more travelers taking malaria prophylaxis. Travel-related symptoms may be wrongly attributed to malaria prophylaxis and hinder compliance. Here, we aimed to assess the frequency of real-time reporting of symptoms by travelers following malaria prophylaxis using a smartphone app. Method: Adult international travelers included in this single-center study (Barcelona, Spain) used the smartphone Trip Doctor® app developed by our group for real-time tracking of symptoms and adherence to prophylaxis. Results: Six hundred four (n = 604) international travelers were included in the study; 74.3% (449) used the app daily, and for one-quarter of travelers, malaria prophylaxis was prescribed. Participants from the prophylaxis group traveled more to Africa (86.7% vs. 4.3%; p < 0.01) and to high travel medical risk countries (60.8% vs. 18%; p < 0.01) and reported more immunosuppression (30.8% vs. 23.1% p < 0.01). Regarding symptoms, no significant intergroup differences were observed, and no relationship was found between the total number of malarial pills taken and reported symptoms. Conclusions: In our cohort, the number of symptoms due to malaria prophylaxis was not significantly higher than in participants for whom prophylaxis was not prescribed, and the overall proportion of symptoms is higher compared with other studies.

Is the conventional wisdom on resource taxation correct? Mining evidence from African countries' tax legislations

Our study reexamines the link between country risk and government take, following research by Adebayo et al. (2021). Our approach complements theirs. We study the mining tax policy choices in an environment of uncertainty and risk country for twenty-one African gold-producing countries. We calculate a de jure government take based on the complete application of laws and regulations for three “representative mines”. Our results reconcile Adebayo et al.'s theoretical model with empirical results. Higher country risk is associated with lower de jure government take. We also show a complex nonlinear relationship between country risk and de jure government take. Finally, our results suggest that stronger political institutions “capture” a lower de jure government take. The coefficient of the interaction term suggests that as the political regime becomes more democratic, the marginal effect of country risk on de jure government revenue becomes increasingly less adverse up to a specific threshold, beyond which it turns positive. We then introduce each political component of country risk and its interaction term to track transmission channels.

Identification of saliva biomarkers as tools for detection of early-stage oral squamous cell carcinoma

Cancer of the flat squamous cells of the oral cavity is called Oral Squamous Cancer Cell (OSCC). OSCC is responsible for 95% of all oral cancers. In high-risk countries like Pakistan, OSCC has one of the highest mortality rates amongst the general demographic. With most OSCC cases being identified in later stages, the 5-year survival rates have remained as low as 50%. However, with early diagnosis, OSCC patients have been shown to have a better chance of surviving. To that effect, identifying potential biomarkers to act as diagnostic indicators for OSCC can help in early diagnosis of the disease. An emerging field for alternative detection of cancer are non-invasive methods that use saliva as a fluid for liquid biopsies. Saliva comprises proteomes, microbiomes, metabolomes, transcriptomes, and genomes that can be used as potential tools for the early detection of cancer. “Salivaomics” has established itself as a promising area for diagnostic and prognostic purposes. In this review paper, we perform a meta-analysis and a systematic literature review to catalogue biomarkers found in saliva that could potentially be used in the early diagnosis of OSCC.

Assessing External Wheat Supply Risk: Perspectives from a Low Middle-Income Country on Wheat Imports

Sri Lanka, currently facing an economic crisis and food shortages, ranks 79th out of 113 countries in terms of food security. Despite the critical importance of food security, there is a significant lack of comprehensive research on the risks associated with reliance on imported food in the existing literature. This includes factors such as import dependence, the reliability of supplier countries, and transit risks. To address this gap, the study utilized the Herfindahl-Hirschman Index and the Shannon-Wiener Index to evaluate the external wheat supply risk for Sri Lanka. The analysis indicated a generally low overall risk in wheat supply but highlighted an increased risk due to dependence on Russia and other high-risk countries.

How regional courts in Russia affected multinational decisions on affiliate size, entry and organization

We investigate the impact of court conditions on multinational decisions on entry, subsidiary size and entry mode across subnational Russian regions in 2001–2014. We apply the literature on heterogeneous firms and the institution-based view of investor behaviour, which predict that higher institutional costs raise the size and productivity cut-off of start-up subsidiaries. Our empirical results based on microestablishment data of foreign-owned firms in Russia show that a weaker judicial framework and stronger political power of the local governor significantly de-stimulate entry. Most multinationals entered Russia, which is viewed as a high-risk country, through large and very large subsidiaries wholly owned by foreign parents. We largely explain business strategy variation of multinationals between regions by regional court conditions, as foreign investors adapted their strategic decisions to compensate court deficiencies by increasing the size of the subsidiary. When the investment climate deteriorated, firms turned to local partnerships as a viable mode of entry.

Prevalence of Cardiovascular Disease and Comparison of Risk Category Predictions of Systemic Coronary Risk Evaluation Score-2 and 4 Other Cardiovascular Disease Risk Assessment Tools Among People Living with Human Immunodefficiency Virus in Türkiye.

Cardiovascular disease (CVD) is a major cause of mortality among people living with HIV (PLWH). We aimed to assess the prevalence of diagnosed CVD and the risk of CVD among PLWH using 5 different tools. This retrospective, cross-sectional study was conducted in 20 tertiary centers in Türkiye between October 2021 and March 2022, among 1425 PLWH aged 40-75 years. About 82.7% were male, with a median age of 51. Web-based tools for each score were used for CVD risk calculations. Of 1425 PLWH enrolled, 10.8% had confirmed CVD, and 1132 had their risk scores evaluated. Of those participants, 42.8% had a higher risk of CVD (10-year risk of atherosclerotic CVD risk score (ASCVD) above 7.5%), and according to the European Society of Cardiology systemic coronary risk evaluation 2 (SCORE2), 71.7% had a high- to very high-risk rate. The agreement between various CVD risk tools varied, with Framingham heart study risk score (FRS), modified FRS, data collection on adverse effects of anti-HIV drugs (DAD), and SCORE2 for high-risk countries showing overall agreement rates of 82%, 94%, 91%, and 36%, respectively, compared to ASCVD. According to the 2021 European and 2019 American Cardiology guidelines, 75.3% and 47.1% of PLWH would be eligible for lipid-lowering agents, respectively. The diagnosed CVD prevalence highlighted the importance of monitoring cardiovascular health and comorbidities in this population. SCORE2 identified a greater number of individuals at high/very high risk compared to other prediction tools. The implementation of CVD prevention through lipid-lowering therapy was far from desired levels in our cohort.

Rapid cholera outbreak control following catastrophic landslides and floods: A case study of Bududa district, Uganda.

In June 2019, landslides and floods in Bududa district, eastern Uganda, claimed lives and led to a cholera outbreak. The affected communities had inadequate access to clean water and sanitation. To share the experience of controlling a cholera outbreak in Bududa district, after landslides and floods. A descriptive cross-sectional study was carried out in which outbreak investigation reports, weekly epidemiological data and disaster response reports were reviewed. On 4 - 5th June 2019, heavy rainfall resulted in four landslides which caused six fatalities, 27 injuries, floods and displaced 480 persons. Two weeks later, a cholera outbreak was confirmed in Bududa district. The Ministry of Health (MoH) rapidly deployed oral cholera vaccine (OCV) from local reserves and mass vaccinated 93% of the target population in 22 affected parishes. The outbreak was controlled in 10 weeks with 67 cholera cases and 1 death reported. However, WaSH conditions remained poor, with only, 24.2 % (879/3,628) of the households with washable latrines, 26.8% (1,023/3,818) had hand-washing facilities with soap and 33.6% (1617/4807) used unsafe water. The OCV stockpile by the MoH helped Uganda to control cholera promptly in Bududa district. High-risk countries should keep OCV reserves for emergencies.

The burden of HEV-related acute liver failure in Bangladesh, China and India: a systematic review and meta-analysis

BackgroundHepatitis E can potentially progress to HEV-related acute liver failure (HEV-ALF). East and South Asia bear a substantial burden of HEV infection, with Bangladesh, China, and India facing the most severe threat in this region. Therefore, we conducted a systematic review and meta-analysis to evaluate the burden of HEV-ALF in these three high-risk countries.MethodsA systematic literature search was performed utilizing PubMed, the Cochrane Library, Medline, Embase, and Web of Science databases. Studies in English or Chinese that reported data on the burden of HEV-ALF in Bangladesh, China and India were included. Outcomes were pooled with meta-analysis utilizing R software. Estimates were calculated with random-effects models, and subgroup analysis and sensitivity analysis were conducted to address heterogeneity. Egger’s test and Begg’s test were performed to assess publication bias.ResultsA total of 20 eligible studies were included in this study. The pooled HEV-attributable proportion of viral-related acute liver failure was estimated to be 40.0% (95% CI: 0.28–0.52), 30.0% (95% CI: 0.18–0.44), and 61.0% (95% CI: 0.49–0.72) among non-pregnant individuals in India, China and Bangladesh, while in Indian pregnant females, it was 71.0% (95% CI: 0.62–0.79). The combined prevalence among non-pregnant HEV-infected participants was 28.0% (95% CI: 0.20–0.37) and 10.0% (95% CI: 0.01–0.28) in India and China, and it was 34.0% (95% CI: 0.27–0.42) in Indian pregnant females with HEV infection. The overall mortality of HEV-ALF was estimated to be 32.0% (95% CI: 0.23–0.42) and 64.0% (95% CI: 0.50–0.77) among the non-pregnant and the pregnant participants in India, and it was 23.0% (95% CI: 0.14–0.34) in Chinese non-pregnant participants.ConclusionsThe burden of HEV-ALF in Bangladesh, China, and India is non-negligible despite geographic and population heterogeneity. The prevention of HEV infection and early recognition of HEV-ALF are of great significance, especially in high-risk countries and populations.RegistrationPROSPERO registration ID is CRD42022382101.

Country Risk and Financial Stability: A Focus on Commercial Banks in Africa

This paper employs dynamic panel models to investigate the impact of country risk on the financial stability of banks in Africa. Using country risk and bank specific data for 10 African countries over the period of 2000 and 2021, the results reveal that African countries have a high country risk exposure. The country risk negatively and significantly affects African bank stability. The study findings suggest that compliance with at least Basel II capital requirements is needed to protect African banks from the negative effects of country risk on their stability in the short run. However, the adverse effects of prolonged country risk are mitigated by the compliance with higher Basel capital requirements in the long run. The results further show that an efficient legal and regulatory framework is essential to complement the capital buffer against country risk. Policies must be introduced to reduce country risk to enable African banks to adequately support the African economy in good and challenging times. Overall, country risk remains a threatening factor for bank stability, and consequently, banks need adequate capital to reduce the impact of country risk on bank stability in Africa.

Cardiovascular risk factors among Polish employees of uniformed services.

Employees of uniformed services (EoUS) were screened for cardiovascular risk factors. A total of 1138 EoUS (age M±SD 49.9±6.0 years) and 263 controls (age M±SD 54.4±9.7 years) under the care of the cardiology clinic in Gdańsk, Poland, were included in the study. Medical history and blood samples were collected, and a physical examination was performed. Ten-year cardiovascular risk of death was calculated using the systematic coronary risk evaluation (SCORE) risk algorithm for high-risk countries. Significantly higher values of mean systolic and mean diastolic blood pressure, mean total cholesterol level and mean BMI were recorded among the EoUS compared to controls (M±SD 141.7±11.6 mm Hg vs. 135.5±11.0 mm Hg, p < 0.001; 90.1±5.9 mm Hg vs. 84.5±6.8 mm Hg, p < 0.001; 6.01±0.76 mmol vs. 5.44±0.87 mmol, p < 0.001; 29.3±4.7 vs. 29.0±4.1, p < 0.001, respectively). Smoking cigarettes was most frequently reported by the youngest group (20-39 years old) - 47.7% and it was significantly higher in the entire EoUS group compared to control group (35.5% vs. 16.7%, p = 0.001). The occurrence of observed risk factors (blood pressure ≥140/90 mm Hg, total cholesterol concentration >5 mmol, smoking,) was significantly higher among EoUS compared to controls (92.1% vs. 57.8%, p < 0.001; 89.0% vs. 66.9%, p < 0.001; 35.5% vs. 16.7%, p < 0.001, respectively). In the male group, the mean calculated ten-year risk of fatal cardiovascular events, the percentage of high calculated risk, and very high risk were higher in the EoUS group compared to controls (M±SD 4.44±3.49 vs. 4.23±3.86, p = 0.001; 23.7% vs. 20.2%, p = 0.007; 7.4% vs. 6.5%, p = 0.03, respectively). The prevalence of all identified risk factors was found to be higher among employees of uniformed services when compared to the control group. The presence of these risk factors within the population of uniformed service employees results in a greater risk of mortality from cardiovascular diseases. Int J Occup Med Environ Health. 2023;36(5):656-71.

Estimation of the potential geographical distribution of invasive peach fruit fly under climate change by integrated ecological niche models

Climate change and biological invasions of insect pests are interlinked global concerns that drive shifts in the distribution of invasive insects. The peach fruit fly, Bactrocera zonata Saunders, is one of the most economically important Tephritidae species that attack several host plants and causes serious damage in Asia and Africa. Currently, B. zonata is absent from many countries and regions but has a risk of invasion. Therefore, it is crucial to investigate the impact of climate change on the global potential distribution of B. zonata. In this study, we used MaxEnt and CLIMEX models to estimate the risk area for B. zonata under near current and future climate conditions. The MaxEnt and CLIMEX results showed that the south of North and Central America was suitable for B. zonata. The European countries were slightly suitable for B. zonata. In Asia, the highly suitable regions of B. zonata included Saudi Arabia, United Arab Emirates, Oman, Iran, Pakistan, India, Nepal, Bangladesh, Bhutan, Myanmar, Thailand, Vietnam, and Laos. Moreover, China, Philippines, Indonesia, and Japan showed highly climate suitability for B. zonata. The climate suitability of B. zonata was increasingly high in the projection under climate change. The result of the two models showed that the climatic suitability for B. zonata will increase under climate change in China. Taken together, these predictive results support the quarantine of B. zonata for high-risk countries and provide in-depth information on how climatic changes may affect its possible geographic range.

ANTIVIRAL RESPONSE OF DRUGS USED AGAINST HBV PATIENTS OF KHYBER PAKHTUNKHWA, PAKISTAN

Hepatitis B virus is an ample cause of end-stage liver diseases and hepatocellular carcinoma. Effective treatment in high-risk countries such as Pakistan can help delay or prevent these consequences.The existing study aims to evaluate the response rates of antiviral drugs tenofovir and entecavir (6-48 months) based on different clinical parameters. Sera collected from HBV patients (43) subjected to DNA extraction, followed by real-time PCR detection. Furthermore, ICT was performed to detect HBs-Ag and ELISA for HBe-Ag. Response rate after 6 months of tenofovir treatments showed 100% normal creatinine and ultrasound and ALT (50%) and while in the case of entecavir, each ALT and ultrasound normalization (66.7%), showed creatinine (100%). The fatty liver was reported 50% and 33.3% after tenofovir and entecavir treatment, respectively. The response after 12 months of treatment with tenofovir showed normalization of ALT and ultrasound (84.6%), bilirubin and creatinine normalization (92.3%), and fatty liver (15.4%). Whereas bilirubin and creatinine levels showed (100%) normal, ALT and ultrasound normalization (80%) with 20% of patients having congenital left lobe of the liver after entecavir. Patients profiles after 24 months of tenofovir treatment showed normal ALT and ultrasound (85.7%), bilirubin (100%), and renal impairment observed in patients (14.3%). The 24 months entecavir treatment showed significant improvement in various clinical parameters normalization with 100% such as ALT, bilirubin, and creatinine in all patients. The efficacy of entecavir showed a significant response as compared to Tenofovir. Furthermore, nucleoside/nucleotide analogues enhanced its efficacy with longer treatment duration.

Country risk factors and banking sector stability: Do countries’ income and risk-level matter? Evidence from global study

Extant literature suggests the essential role of a country's vulnerability in decreasing the stability of the banking sectors. However, the effect of country-specific risks on banking sector stability remains largely understudied. This study specifically examines the impact of country risk, encompassing political, economic, and financial risks, on the banking sector stability from a global perspective. Furthermore, we attempt to provide more insight by answering how this relationship varies by grouping countries based on income and risk levels. To achieve this purpose, we focus on 107 countries and employ a dynamic panel data model (SYS-GMM) between 2004 and 2017. The results indicate that a reduction in a country's vulnerability to specific political, economic, and financial risks, contributes to enhanced stability in the banking sector. This positive effect is particularly pronounced as countries move from low to medium and high-income levels. Furthermore, the study reveals that a decrease in country risk leads to increased banking sector stability in both low and high-risk countries, but the effect is more outstanding in low-risk environments. Moreover, the results highlight the significant influence of banking sector-specific factors and country-level determinants on stability, however, the magnitude and direction of these factors' coefficients depend on the income and risk levels of the countries. The results are robust and can have important suggestions to policymakers, regulators, and bank executives in understating and mitigating risk factors to enhance the stability of their banking sectors.

Specialist hybrid models with asymmetric training for malaria prevalence prediction.

Malaria is a common and serious disease that primarily affects developing countries and its spread is influenced by a variety of environmental and human behavioral factors; therefore, accurate prevalence prediction has been identified as a critical component of the Global Technical Strategy for Malaria from 2016 to 2030. While traditional differential equation models can perform basic forecasting, supervised machine learning algorithms provide more accurate predictions, as demonstrated by a recent study using an elastic net model (REMPS). Nevertheless, current short-term prediction systems do not achieve the required accuracy levels for routine clinical practice. To improve in this direction, stacked hybrid models have been proposed, in which the outputs of several machine learning models are aggregated by using a meta-learner predictive model. In this paper, we propose an alternative specialist hybrid approach that combines a linear predictive model that specializes in the linear component of the malaria prevalence signal and a recurrent neural network predictive model that specializes in the non-linear residuals of the linear prediction, trained with a novel asymmetric loss. Our findings show that the specialist hybrid approach outperforms the current state-of-the-art stacked models on an open-source dataset containing 22 years of malaria prevalence data from the city of Ibadan in southwest Nigeria. The specialist hybrid approach is a promising alternative to current prediction methods, as well as a tool to improve decision-making and resource allocation for malaria control in high-risk countries.

Differential treatment in the bond market: Sovereign risk and mutual fund portfolios

How do international investors adjust their portfolios in response to sovereign risk? We answer this question by combining data on default probabilities for 31 developed and emerging markets with monthly data on the portfolios of individual bond mutual funds. We show that bond funds reduce their exposure to a country when sovereign default risk increases, indicating that changes in yields do not fully compensate investors for additional sovereign risk. We find that the magnitude of the response is heterogeneous. Portfolio weights of high-risk countries are more sensitive to sovereign risk, while core developed markets appear to enjoy preferential treatment, with their portfolio weights little affected by sovereign risk. Fund characteristics, such as past performance, also affect sensitivity to sovereign risk. Finally, we document what determines the destination of reallocation flows. Funds shift their assets to countries outside the immediate geographic region while avoiding markets to which they are heavily exposed.

The worldwide epidemiology of lip and oral cavity cancer attributable to smoking based on the Global Burden of Disease Study 2019

Abstract Aim To analyze the worldwide epidemiology of lip and oral cavity cancer attributable to smoking. Methods The worldwide epidemiology of lip and oral cavity cancer attributable to smoking and its spatial distribution differences were analyzed using the age-standardized mortality rate, age-standardized disability-adjusted life years (DALYs) rate, and estimated annual percent change (EAPC) according to information from the Global Burden of Disease Study 2019. Results The number of deaths and DALYs associated with lip and oral cavity cancer attributable to smoking globally showed upward trends from 1990 to 2019, but the age-standardized mortality and DALYs rates decreased. The age-standardized mortality rate gradually increased with age. The age-standardized mortality and DALYs rates were markedly higher in low-middle social development index (SDI) regions than in other regions. The age-standardized mortality and DALYs rates showed slight increasing trends (EAPC = 0.16 and 0.07, respectively) in middle-SDI regions and the greatest decrease (EAPC = –1.60 and –1.74, respectively) in high-SDI regions. The three regions with the highest age-standardized mortality and DALYs rates were South Asia (1.59; 39.68), Eastern Europe (1.33; 40.59), and Central Europe (1.30; 37.67), but the largest increases were observed in East Asia (EAPC = 2.32, EAPC = 2.30), the Northern Mariana Islands (EAPC = 3.79, EAPC = 3.67), and Cabo Verde (EAPC = 2.84; DALY, EAPC = 3.38). Conclusion The overall disease burden attributable to smoking is decreasing, but the number of deaths and DALYs are still increasing. Moreover, there are regional and national differences, and high-risk regions and countries should implement targeted interventions to reduce the burden.

CEO wealth and cross-border acquisitions by SMEs

This study examines the role of chief executive officers’ (CEOs) wealth in explaining the cross-border acquisition (CBA) activity of small and medium-sized enterprises (SMEs). CBAs require substantial financial resources and expose the firm to additional risks. Within a micro-foundations framework, we integrate insights from the resource-based view and the upper echelons theory and argue that CEO wealth plays a dual role in the CBA activity of SMEs by alleviating financial constraints and increasing willingness to take risks. Using Norwegian census data for the period 2000–2013, we find consistent evidence that CEO wealth has a positive effect on the number, the geographic scope, and the likelihood of engaging in CBAs in high political risk countries.

Back to the roots of internal credit risk models: Does risk explain why banks' risk-weighted asset levels converge over time?

The internal ratings-based (IRB) approach maps bank risk profiles more adequately than the standardized approach. After switching to IRB, banks' risk-weighted asset (RWA) densities are thus expected to diverge, especially across countries with different supervisory strictness and risk levels. However, when examining 52 listed banks headquartered in 14 European countries that adopted the IRB approach, we observe a convergence of their RWA densities over time. We test whether this convergence can be entirely explained by differences in the size of the banks, loss levels, country risk, and/or time of IRB implementation. Our findings indicate that this is not the case. Whereas banks in high-risk countries with lax regulation, reduce their RWA densities, banks elsewhere increase theirs. Especially for banks in high-risk countries, RWA densities underestimate banks' economic risk. Hence, the IRB approach enables regulatory arbitrage, whereby authorities only enforce strict supervision on capital requirements if they do not jeopardize bank viability.

The Relationship between Disaster Knowledge and Disaster Preparedness Attitudes in Medical Students of Universitas Negeri Gorontalo

Introduction: The incidence of natural disasters worldwide is increasing and unpredictable. As one of the high-risk disaster countries, good knowledge and disaster preparedness in Indonesia residence are needed to reduce the risk of a disaster. As agents of change, students should have competent skills in disaster situations. This study aims to determine the relationship between disaster knowledge and disaster preparedness attitudes among medical students at Universitas Negeri Gorontalo (UNG).Method: This research is a descriptive study with a cross-sectional design and uses a total sampling technique on active UNG medical students during the research period. The research was conducted at the UNG Faculty of Medicine from September to November 2022. The research instrument used a questionnaire that had been used in previous studies. The independent variable is disaster knowledge, while the dependent variable is disaster preparedness attitudes. Bivariate analysis was carried out using the chi-square test to determine the relationship between the two variables.Results: Of the 208 respondents, most have a high level of disaster knowledge of 81.7%. The description of disaster preparedness attitudes shows that most respondents have a good attitude towards disaster preparedness, namely 52.4%. There is no significant relationship between disaster knowledge and preparedness attitudes (p-value 0.160).Conclusion: There is no relationship between disaster knowledge and disaster preparedness attitudes among UNG medical students. It is hoped that the institution will continue to develop disaster education so that students can have better disaster knowledge and be able to deal with disaster situations. Key words: Attitude, disaster, knowledge, preparedness

Tuberculosis screening practices and outcomes in an australian dialysis unit

BackgroundThe World Health Organisation (WHO) recommends all dialysis patients undertake routine screening for latent tuberculosis infection (LTBI) in high income countries such as Australia. However, we employ a targeted screening approach in our Australian dialysis unit in line with local and some international guidelines. We analysed our practices to assess the validity of our approach.MethodsA retrospective review of new dialysis patients during the period 2012–2018 was undertaken. Patient records were reviewed for basic demographic data, comorbidities, LTBI screening using Quantiferon Gold (QFG), and outcomes, including episodes of active TB, to June 2020.Results472 patients were included. WHO high risk country of origin patients accounted for 22% (n = 103). 229 patients (48.5%) were screened using QFG. The single main indication for screening was transplantation waitlisting. 34 patients had a positive QFG result. Active tuberculosis developed in two patients during the observation period. Both occurred in the screened cohort, the cases having previously tested negative via QFG at 11 and 16 months, prior to the development of active tuberculosis. No patients in the unscreened cohort developed active tuberculosis during the observation period. WHO high risk country of origin was associated with positive QFG status, odds ratio 10.4 (95% CI 3.3–31.2).ConclusionThe data failed to show a benefit from widening of the screening program within our dialysis unit. However, a much larger sample size will be required to confidently assess the impact of the current approach on patient outcomes. Analysis of current screening practices and outcomes across all Australian dialysis services is warranted to assess the risks and benefits of widening the screening practices to include all dialysis patients as recommended by the WHO.