Prevalence In Countries Research Articles

Limited impact of awareness-raising campaigns on hepatitis C testing practices among general practitioners.

The global hepatitis strategy calls for increased effort to diagnose those infected, with a target of 90% diagnosed by 2030. Scotland's Action Plan on Hepatitis C included awareness-raising campaigns, undertaken during 2008-2011, to promote testing by general practitioners. We examined hepatitis C virus (HCV) testing practice among general practitioners before and following these campaigns. Scottish general practitioners were surveyed, using Dillman's method, in 2007 and 2013; response rates were 69% and 60%, respectively. Most respondents offer testing when presented with a risk history (86% in 2007, 88% in 2013) but only one-fifth actively sought out risk factors (19% in 2007, 21% in 2013). Testing was reportedly always/almost always/usually offered to people who inject drugs (84% in 2007, 87% in 2013). Significant improvements in the offer of testing were reported in patients with abnormal LFTs (41% in 2007, 65% in 2013, P<.001) and who had received medical/dental treatment in high prevalence countries (14% in 2007, 24% in 2013, P=.001). In 2013, 25% of respondents had undertaken HCV-related continued professional development. This group was significantly more likely to actively seek out risk factors (P=.009) but only significantly more likely to offer a test to patients who had received medical/dental treatment in high prevalence countries (P=.001). Our findings suggest that government-led awareness raising campaigns have limited impact on general practitioners' testing practices. If the majority of the HCV-infected population are to be diagnosed, practitioner-based or physician-centred interventions should be considered alongside educational initiatives targeted at professionals.

Hepatitis B genotypes and surface antigen mutants present in Pakistani blood donors.

BackgroundThe prevalence of chronic Hepatitis B Virus (HBV) infection is 2–4% in the Pakistani population, defining Pakistan as an intermediate prevalence country. In this study, hepatitis B surface antigen (HBsAg) reactive blood donations were screened using a combination of serological and molecular methods to identify immune escape HBV mutant strains and to determine the HBV genotypes and subtypes present in Pakistan.MethodsBlood donations were collected at the Armed Forces Institute of Transfusion (AFIT) located in northern Pakistan and the Hussaini Blood Bank (HBB) located in the south. From 2009 to 2013 a total of 706,575 donations were screened with 2.04% (14,409) HBsAg reactive. A total of 2055 HBsAg reactive specimens, were collected and screened using a monoclonal antibody based research assay to identify immune escape mutants followed by PCR amplification and DNA sequencing to identify the mutation present. DNA sequences obtained from 192 specimens, including mutant candidates and wild type strains, were analyzed for escape mutations, genotype, and HBsAg subtype.ResultsMutations were identified in approximately 14% of HBsAg reactive donations. Mutations at HBsAg amino acid positions 143–145 are the most common (46%) with the mutation serine 143 to leucine the most frequently occurring change (28%). While regional differences were observed, the most prevalent HBV strains are subgenotypes of D with subgenotype D1/subtype ayw2 accounting for the majority of infections; 90.2% at AFIT and 52.5% at HBB.ConclusionsThe high frequency of immune escape HBV mutants in HBV infected Pakistani blood donors highlights the need for more studies into the prevalence of escape mutants. Differences between vaccinated and unvaccinated populations, the correlation of escape mutant frequency with genotype, and impact of escape mutations in different genotype backgrounds on the performance of commercially available HBsAg assays represent avenues for further investigation.

Epidemiological trends of tuberculosis in low and high prevalence countries.

The study of the epidemiology of tuberculosis and the need for a rational approach to the problem of tuberculosis control require a sound knowledge of the risk of transmission of tuberculosis infection from host to host. This knowledge is required today both in countries with a high prevalence and in those with a low prevalence of the disease. The risk of transmission of tuberculosis infection in a given community during a particular period of time is most reliably expressed numerically in terms of a series of average annual infection risks in successive calender years.The infection risk indicates the proportion of the population which will be primarily infected, or reinfected, with tubercle bacilli in the course of one year. The risk is usually expressed as a percentage or as a rate. The annual trend (decrease) in the risk of infection is even more important than the actual level of this risk.Tuberculin surveys in schoolchildren, which are repeated, say every five years, in the same area provide us with the necessary information to make estimates for the annual infection risk. In areas where infections with the socalled atypical mycobacteriae are frequent, simultaneous testing with two "Sensitins", one prepared from human tubercle bacilli and one from atypical mycobacteriae will be of value for estimating the proportion of those infected with virulent bacilli and those infected with other mycobacteriae.

Multilevel determinants of teenage childbearing in sub-Saharan Africa in the context of HIV/AIDS

This paper examined national variations and multilevel determinants of teenage childbearing in sub-Saharan Africa (SSA) in the context of HIV/AIDS using data from recent Demographic and Health Surveys conducted in 29 countries of SSA. Results showed significant community and national variations in teenage childbearing, partly explained by socio-economic and HIV/AIDS context. At community level, lower HIV/AIDS stigma, higher wealth and female education were associated with lower teenage childbearing. However, national socio-economic status had an intricate relationship with teenage childbearing. Higher national GDP per-capita was generally associated with higher teenage childbearing, and this relationship was stronger in lower HIV prevalence countries.

The relationship between substance use and suicidal behaviour among adolescents in selected European countries: A test of normalisation theory

Objective: Normalization thesis assumes that high prevalence rates of substance use are associated with a shift in the recruitment of substance users from risky to a more well-adjusted population. This study tests the application of normalisation thesis by examining levels of substance use (smoking, alcohol and cannabis) and its relation to reported suicide ideation and attempt in 13 European countries. The hypothesis of the study is that in countries with low prevalence of substance use the correlation and predicting odds ratios between substance use and suicide ideation and suicide attempt will be higher than in high prevalence countries. Method: Data from the ESPAD (European School Survey Project on Alcohol and Other Drugs) study from 13 countries was used for the analysis. The data were collected from a sample of 15-year-old adolescents using ESPAD standardised sampling strategy and data collection methodology across countries. Results: Evidence is provided for normalisation thesis, specifically, in countries with low prevalence of substance use reported higher association between substance use and suicidal behaviour compared to countries with higher prevalence of substance use. Conclusion: The normalisation thesis is a useful scheme to understand the relation of adolescent alcohol, tobacco and cannabis use in relation to suicide ideation and attempt in different cultural circumstances. Implications: study findings highlight the importance of selective and universal drug prevention programmes in different cultural contexts.

Helicobacter pylori infection in Icelandic children

Objective: The prevalence of Helicobacter pylori (HP) infection is decreasing in the western world. The seroprevalence among 25–50-year-old Icelandic adults was recently shown to be 30–40%. Information on the seroprevalence in Nordic children is limited. We aimed at ascertaining the infection prevalence among healthy Icelandic children.Methods: The infection status in stored frozen blood samples from two cross-sectional studies on the health of 7–9-year-old children (n = 125) and 16–18-year-old adolescents (n = 80) was determined by enzyme-linked immunosorbent assay (ELISA). Information on family demographics and GI symptoms was obtained by standardized questionnaires.Results: Overall, 3.4% (7/205) of the children were infected with H. pylori. The prevalence was 2.6% (5/190), missing data n = 3, among children with both parents born in a low prevalence country compared to 17% (2/12) among those with at least one parent born in a high prevalence area (p = .026). When at least one parent was born in a high prevalence country, the odds ratio for being H. pylori seropositive was 2.2 (95% CI, 1.02–54.67), when adjusted for the educational status of the mother. There was no significant association between H. pylori infection and gastrointestinal symptoms.Conclusion: Prevalence of H. pylori infection in Iceland has become very low, suggesting a great reduction in transmission from older generations. There was an association between H. pylori infection and origin from high prevalence areas but not with gastrointestinal symptoms. The results mirror recent studies of children of Scandinavian ancestry.

Risk factors for KPC-producing Enterobacteriaceae acquisition and infection in a healthcare setting with possible local transmission: a case–control study

Reports of Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-Kp) in Australia were previously uncommon, with cases imported sporadically by travellers from higher prevalence countries. The study institution reported the first outbreak of KPC-Kp in Australia. The aim of this study was to identify risk factors for KPC-Kp colonization and infection using a matched case-control study. The study included all hospitalized patients with KPC-Kp colonization or infection from January 2012 to September 2015. Thirty-four cases of KPC-producing Enterobacteriaceae (including 31 KPC-Kp cases) were matched with 136 controls. Variables associated with KPC-Kp acquisition included: length of hospital stay >28 days in the past 12 months, prior vancomycin-resistant enterococci (VRE) colonization, central venous catheter (CVC), gastrointestinal disease and invasive procedures. Exposure to broad-spectrum antibiotics was also found to be a significant risk factor. In the multi-variate analysis, three factors independently associated with KPC-Kp acquisition were length of hospital stay >28 days in the past 12 months [odds ratio (OR) 23.6, 95% confidence interval (CI) 4.9-113.3], presence of a CVC (OR 15.4, 95% CI 2.7-86.9), and prior VRE colonization (OR 6.0, 95% CI 1.6-23.2). Very few patients had a history of overseas travel. This study demonstrates that patients with prolonged hospital exposure are more likely to acquire KPC-Kp in the setting of a local outbreak, and suggests that risk factors for KPC-Kp acquisition may be shared with those for VRE colonization. Local screening strategies targeting overseas travellers would likely miss many cases. The results of this study will help to inform screening policies for carbapenemase-producing Enterobacteriaceae.

Incidence of multiple sclerosis in the Republic of Ireland: A prospective population-based study

BackgroundMultiple sclerosis (MS) incidence and prevalence is increasing worldwide, with a disproportionally higher rate in women. Recent studies have questioned the presence of a latitudinal gradient in Europe. Ireland is a high prevalence country for MS with a previously reported North-South gradient making it ideal to further explore this concept. ObjectivesIn this study we prospectively determined the incidence rate of newly diagnosed MS in Ireland over a 12-month period and demonstrated the presence of a North-South gradient. MethodsA national prospective population-based observational study was performed to ascertain all new cases of MS diagnosed from 1st March 2014 – 28th February 2015 in the Ireland. Within the main study there was a smaller nested cohort study to explore clinical outcomes with a view to future prospective follow-up of this cohort. Sources of case ascertainment included neurologists, MS nurse specialists and MS support services. The Irish census 2011 was used to obtain population statistics and the incidence rate was age-standardized to a European Standardised Population (ESP 2011). The North-South gradient was assessed, by comparing incidence rates between northern and southern counties. Results292 patients fulfilled the inclusion criteria equating to an age-standardised incidence rate (A-SIR) of 6/100,000 (95% CI: 5.3–6.6); for women the rate was 8.7/100,000 (95% CI: 7.7–9.6) and for men 3.3/100,000 (95% CI: 3.0–3.7). The female to male sex ratio was 2.7:1. Mean age at diagnosis amongst the RRMS group was 37 years (SD: 9.6) and 55 years (SD: 7.7) in the PPMS group; there were no gender differences associated with age of diagnosis. Onset was progressive in 10% of cases. A significant difference was seen in incidence rates between the northern region (A-SIR: 9.6×105, CI: 6.9–12.3) and the southern region (A-SIR: 5.1×105, CI: 3.8–6.3) (Z-score =3.34, p<0.05). Amongst the nested cohort (n=113) mean age at symptom onset in the RRMS group (n=106) was 34 years (SD: 8.7) and 50 years (SD: 11.8) in the PPMS group (n=7). The female to male sex ratio was 3.5:1. Eighty percent had started or were due to start disease modifying therapy at time of review and 77% were taking supplemental vitamin D. Using the hospital depression and anxiety scale (HADS) mild to severe depressive symptoms were reported in 34% with no prior history of depression. Seventy-five percent were in full or part-time employment with 8% not working due to disability arising from their MS. ConclusionsThis is the first study to prospectively assess the incidence rate of MS in Ireland and shows that Ireland has a high incidence rate, comparable with the rest of the British Isles, with a persistent North-South gradient. The age of onset of relapsing remitting multiple sclerosis appears to be increasing over the last 20 years. It will be of interest to re-assess this population over time to see if increasing incidence rates, as well as improved survival, are driving the reported increases in MS prevalence.

Endobronchial ultrasound experience in a high tuberculosis prevalence setting

BackgroundMost of the published endobronchial ultrasound-guided transbronchial needle aspiration (EBUS–TBNA) data are from the western countries, establishing the role of EBUS–TBNA in the diagnosis and staging of lung cancer. The etiology of mediastinal lymphadenopathy may be different in an ethnic group with a high prevalence of tuberculosis (TB). ObjectiveTo assess the etiology of mediastinal adenopathy in a high TB prevalence setting and to determine the performance of various tests in the diagnosis of tuberculous mediastinal lymphadenitis. MethodsRetrospective analysis of bronchoscopic data of patients who underwent endobronchial ultrasound (EBUS) in a tertiary care center in India. ResultsOut of 138 patients who underwent EBUS, 63 (46%) had granulomatous disease. Of the 35 patients with a diagnosis of TB, in 10 (29%), microbiology of EBUS specimens was diagnostic and in 3 (9%), this was the sole diagnostic feature. In 5 (14%) mycobacterial cultures were positive, in 6 (17%) GeneXpert for Mycobacterium tuberculosis/rifampicin resistance (Xpert MTB/RIF) was positive, and in 3 (9%) acid fast smears were positive. ConclusionIn high TB prevalence countries, EBUS diagnoses a higher number of granulomatous than malignant diseases. EBUS specimen should, therefore, be subjected also to mycobacterial smear, culture, and Xpert MTB/RIF for optimal results.

A population-based study of chronic hepatitis C in immigrants and non-immigrants in Quebec, Canada

BackgroundImmigrants originating from intermediate and high HCV prevalence countries may be at increased risk of exposure to hepatitis C infection (HCV) in their countries of origin, however they are not routinely screened after arrival in most low HCV prevalence host countries. We aimed to describe the epidemiology of HCV in immigrants compared to the Canadian born population.MethodsUsing the reportable infectious disease database linked to the landed immigration database and several provincial administrative databases, we assembled a cohort of all reported cases of HCV in Quebec, Canada (1998–2008). Underlying co-morbidities were identified in the health services databases. Stratum specific rates of reported cases/100,000, rate ratios (RRs) and trends over the study period were estimated.ResultsA total of 20,862 patients with HCV were identified, among whom 1922 (9.2%) were immigrants. Immigrants were older and diagnosed a mean of 9.8 ± 7 years after arrival. The Canadian born population was more likely to have behavior co-morbidities (problematic alcohol or drug use) and HIV co-infection. Immigrants from Sub-Saharan Africa, Asia and Eastern Europe had the highest HCV reported rates with RRs compared to non-immigrants ranging from 1.5 to 1.7. The age and sex adjusted rates decreased by 4.9% per year in non-immigrants but remained unchanged in immigrants. The proportion of HCV occurring in immigrants doubled over the study period from 5 to 11%.ConclusionsImmigrants from intermediate and high HCV prevalence countries are at increased risk for HCV and had a mean delay in diagnosis of almost 10 years after arrival suggesting that they may benefit from targeted HCV screening and earlier linkage to care.

Staphylococcal aureus Enterotoxin C and Enterotoxin-Like L Associated with Post-partum Mastitis.

Denmark is a low prevalence country with regard to methicillin resistant Staphylococcus aureus (MRSA). In 2008 and 2014, two neonatal wards in the Copenhagen area experienced outbreaks with a typical community acquired MRSA belonging to the same spa type and sequence type (t015:ST45) and both were PVL and ACME negative. In outbreak 1, the isolates harbored SCCmec IVa and in outbreak 2 SCCmec V. The clinical presentation differed between the two outbreaks, as none of five MRSA positive mothers in outbreak 1 had mastitis vs. five of six MRSA positive mothers in outbreak 2 (p < 0.02). To investigate if whole-genome sequencing could identify virulence genes associated with mastitis, t015:ST45 isolates from Denmark (N = 101) were whole-genome sequenced. Sequence analysis confirmed two separate outbreaks with no sign of sustained spread into the community. Analysis of the accessory genome between isolates from the two outbreaks revealed a S. aureus pathogenicity island containing enterotoxin C and enterotoxin-like L only in isolates from outbreak 2. Enterotoxin C and enterotoxin-like L carrying S. aureus are associated with bovine mastitis and our findings indicate that these may also be important virulence factors for human mastitis.

Global Asthma Network survey suggests more national asthma strategies could reduce burden of asthma

BackgroundSeveral countries or regions within countries have an effective national asthma strategy resulting in a reduction of the large burden of asthma to individuals and society. There has been no systematic appraisal of the extent of national asthma strategies in the world. MethodsThe Global Asthma Network (GAN) undertook an email survey of 276 Principal Investigators of GAN centres in 120 countries, in 2013–2014. One of the questions was: “Has a national asthma strategy been developed in your country for the next five years? For children? For adults?”. ResultsInvestigators in 112 (93.3%) countries answered this question. Of these, 26 (23.2%) reported having a national asthma strategy for children and 24 (21.4%) for adults; 22 (19.6%) countries had a strategy for both children and adults; 28 (25%) had a strategy for at least one age group. In countries with a high prevalence of current wheeze, strategies were significantly more common than in low prevalence countries (11/13 (85%) and 7/31 (22.6%) respectively, p<0.001). InterpretationIn 25% countries a national asthma strategy was reported. A large reduction in the global burden of asthma could be potentially achieved if more countries had an effective asthma strategy.

Evaluation of the Tsima community mobilization intervention to improve engagement in HIV testing and care in South Africa: study protocol for a cluster randomized trial

BackgroundHIV transmission can be decreased substantially by reducing the burden of undiagnosed HIV infection and expanding early and consistent use of antiretroviral therapy (ART). Treatment as prevention (TasP) has been proposed as key to ending the HIV epidemic. To activate TasP in high prevalence countries, like South Africa, communities must be motivated to know their status, engage in care, and remain in care. Community mobilization (CM) has the potential to significantly increase uptake testing, linkage to and retention in care by addressing the primary social barriers to engagement with HIV care—including poor understanding of HIV care; fear and stigma associated with infection, clinic attendance and disclosure; lack of social support; and gender norms that deter men from accessing care.Methods/designUsing a cluster randomized trial design, we are implementing a 3-year-theory-based CM intervention and comparing gains in HIV testing, linkage, and retention in care among individuals residing in 8 intervention communities to that of individuals residing in 7 control communities. Eligible communities include 15 villages within a health and demographic surveillance site (HDSS) in rural Mpumalanga, South Africa, that were not exposed to previous CM efforts. CM activities conducted in the 8 intervention villages map onto six mobilization domains that comprise the key components for community mobilization around HIV prevention. To evaluate the intervention, we will link a clinic-based electronic clinical tracking system in all area clinics to the HDSS longitudinal census data, thus creating an open, population-based cohort with over 30,000 18–49-year-old residents. We will estimate the marginal effect of the intervention on individual outcomes using generalized estimating equations. In addition, we will evaluate CM processes by conducting baseline and endline surveys among a random sample of 1200 community residents at each time point to monitor intervention exposure and community level change using validated measures of CM.DiscussionGiven the known importance of community social factors with regard to uptake of testing and HIV care, and the lack of rigorously evaluated community-level interventions effective in improving testing uptake, linkage and retention, the proposed study will yield much needed data to understand the potential of CM to improve the prevention and care cascade. Further, our work in developing a CM framework and domain measures will permit validation of a CM conceptual framework and process, which should prove valuable for community programming in Africa.Trial RegistrationNCT02197793 Registered July 21, 2014.

Identification of Key Beliefs Explaining Male Circumcision Motivation Among Adolescent Boys in Zimbabwe: Targets for Behavior Change Communication.

Male circumcision (MC) significantly reduces HIV acquisition among men, leading WHO/UNAIDS to recommend high HIV and low MC prevalence countries circumcise 80% of adolescents and men age 15-49. Despite significant investment to increase MC capacity only 27% of the goal has been achieved in Zimbabwe. To increase adoption, research to create evidence-based messages is greatly needed. The Integrated Behavioral Model (IBM) was used to investigate factors affecting MC motivation among adolescents. Based on qualitative elicitation study results a survey was designed and administered to a representative sample of 802 adolescent boys aged 13-17 in two urban and two rural areas in Zimbabwe. Multiple regression analysis found all six IBM constructs (2 attitude, 2 social influence, 2 personal agency) significantly explained MC intention (R2=0.55). Stepwise regression analysis of beliefs underlying each IBM belief-based construct found 9 behavioral, 6 injunctive norm, 2 descriptive norm, 5 efficacy, and 8 control beliefs significantly explained MC intention. A final stepwise regression of all the significant IBM construct beliefs identified 12 key beliefs best explaining intention. Similar analyses were carried out with subgroups of adolescents by urban-rural and age. Different sets of behavioral, normative, efficacy, and control beliefs were significant for each sub-group. This study demonstrates the application of theory-driven research to identify evidence-based targets for the design of effective MC messages for interventions to increase adolescents' motivation. Incorporating these findings into communication campaigns is likely to improve demand for MC.

Phage-Displayed Peptides Selected to Bind Envelope Glycoprotein Show Antiviral Activity against Dengue Virus Serotype 2.

Dengue virus is a growing public health threat that affects hundreds of million peoples every year and leave huge economic and social damage. The virus is transmitted by mosquitoes and the incidence of the disease is increasing, among other causes, due to the geographical expansion of the vector's range and the lack of effectiveness in public health interventions in most prevalent countries. So far, no highly effective vaccine or antiviral has been developed for this virus. Here we employed phage display technology to identify peptides able to block the DENV2. A random peptide library presented in M13 phages was screened with recombinant dengue envelope and its fragment domain III. After four rounds of panning, several binding peptides were identified, synthesized, and tested against the virus. Three peptides were able to block the infectivity of the virus while not being toxic to the target cells. Blind docking simulations were done to investigate the possible mode of binding, showing that all peptides appear to bind domain III of the protein and may be mostly stabilized by hydrophobic interactions. These results are relevant to the development of novel therapeutics against this important virus.

Zika virus: fourth pandemic threat of the last decade /Zika virus: son on yilin dorduncu pandemi tehdidi

After its first discovery for 70 years, World Health Organization has classified the Zika virus (ZIKV) as a global health risk. The ZIKV that is transmitted to human by some species of Aedes mosquitos has caused sporadic and epidemic infections generally in tropical and subtropical regions to date. Though it mainly produces a self-limiting febrile rash disease in symptomatic cases, its real significance has been better understood after detection of its ability to promote immune-mediated neurologic disorders such as Guillain Barre syndrome in healthy adults following the acute infection, and microcephalia in the fetus of infected pregnants. In addition to vectors, its ability to spread by bloodborne and sexual route were recognized as the most potent feature of ZIKV to spread in population. Wide global distribution of the vectors, including our country, poses a substantial continuous risk for Turkey. Furthermore, increasing human movement due to the Olympic Games that will be held in Brazil in 2016 summer, where the virus is the most prevalent country, is a growing concern about augmenting the spread of virus to the world. In this review, latest data about the ZIKV transmission, health problems caused by, and treatment properties were aimed to be evaluated in a historical progress, and some preventive measurements were suggested.

Prevalence of hepatitis C virus infection among hemodialysis patients in the Middle-East: A systematic review and meta-analysis.

To determine hepatitis C virus (HCV) infection prevalence in each country of the Middle-East and the overall prevalence of the region. In this systematic review, we gathered all documents related to HCV infection prevalence among hemodialysis patients in 17 middle-east countries from April 2006 to March 2016. We selected only cross-sectional studies that had proper sampling and measurement methods as well as a valid statistical analysis. After screening of 7311 documents, 56 studies were selected reporting the prevalence of HCV infection among hemodialysis patients from 10 countries of the region. Seven countries including United Arab Emirates, Afghanistan, Qatar, Bahrain, Kuwait, Oman, Israel, and Cyprus did not have any relevant document; thus, their latest reports were just mentioned. We performed the meta-analysis and determined the prevalence rates for each country as well as the whole region. The overall HCV infection prevalence among hemodialysis patients in the region was reported to be 25.3%; Egypt and Syria had the highest reported rates while Iran and Lebanon had the lowest. Further investigations are still needed to provide more reliable databases, find main risk factors, and to improve diagnosis and treatment plans, particularly in higher prevalent countries. Controlling the prevalence and improving the management methods of HCV infection among hemodialysis patients are of a great concern in the Middle-East region.

Marketing Policy that Accelerate Tobacco Use in Bangladesh: A Statistical Investigation

Background: Tobacco use is a manmade manner which causes severe chronic diseases and Bangladesh is one of the most tobacco prevalent countries in the world. Advertisement and promotion events may have a big contribution to accelerate this. Therefore, this study aimed to analyze the advertisement and promotion events that encouraged the tobacco user. Data and methods: Secondary data of sample size 9629 collected by the Global Adult Tobacco Survey (GATS), 2010 has been used. Along with descriptive analysis, binary logistic regression has been used to analyze the sociodemographic and economic correlates to be encouraged by marketing policy. Results: The most common site for noticing cigarette, bidi and smokeless tobacco product advertisements was in stores (49.90%, 26.25% and 13.97%). From logistic regression it has been found that rural respondents are 1.17 times more inspired to smoke (OR=1.17, 95% CI=1.06, 1.30) from marketing policy than urban respondents. Female respondents are less inspired to smoke (OR=0.24, 95% CI=0.20, 0.28) than male respondents. Older respondents are less inspired to smoke by marketing policy than younger respondents (OR=0.98, 95% CI=0.98, 0.99). On the other hand, Rural respondents are 1.15 times more likely to be inspired to use smokeless product than urban respondents (OR=1.15, 95% CI=1.02, 1.31). Female respondents are 0.63 times less inspired to use smokeless tobacco product than male respondents (OR=0.63, 95% CI=0.51, 0.77) by marketing policy. Older respondents are less inspired to use smokeless tobacco products by marketing policy than younger respondents (OR=0.99, 95% CI=0.98, 0.99). Conclusion: To reduce tobacco use in Bangladesh, Government, policy makers and research institutions that are working for reduction of tobacco use should pay attention more on young, student and female to advocate more. Also, Government could take action to limit advertisement in selling store.

Rare Biliopancreatic Diseases

In this presentation rare but important hepatobiliary and pancreatic diseases are summarized including the imaging features of papillomatosis of the biliary tree (1), tuberculosis of the pancreas (2), autoimmune pancreatitis (3-5) and other infectious (parasitic) diseases, e.g., ascariasis (6), hydatid cysts, schistosomiasis (7, 8), fascioliasis (9), and others. The presentation focusses on clinical features and hot topics of the diseases including a pictorial essay demonstrating the imaging features. Worldwide many infectious diseases, e.g., ascariasis are no longer widespread, therefore doctors may have little or no experience with case management. On the other hand, increasing numbers of travelers and immigrants from high prevalence countries challenge clinicians to remain updated in infectious diseases.

Mathematical Modeling Applied to Understand the Dynamical Behavior of HIV Infection

The study of viral dynamics of HIV/AIDS has resulted in a deep understanding of host-pathogenesis of HIV infection from which numerous mathematical modeling have been derived. Most of these models are based on nonlinear ordinary differential equations. In Bangladesh, the rate of increase of HIV infection comparing with the other countries of the world is not so high. Bangladesh is still considered to be a low prevalent country in the region with prevalence and shown the local and global stability at disease free and chronic infected equilibrium points. Also we have shown that if the basic reproduction number , then HIV infection is cleared from T cell population and it converges to disease free equilibrium point. Whereas if , then HIV infection persists.