Risk Of Communicable Diseases Research Articles

First Aid during Civil Aviation Flights: Peculiarities in the COVID-19 era

The rising average age of passengers, the chronic illnesses that passengers suffer from and the stress of flying are just some of the factors that contribute to emergencies in flight. Passengers at risk are those with heart or respiratory problems. Cardiopulmonary arrest, burns and gastrointestinal problems are the main reasons for first aid. The purpose of this review is to present the most common emergency health problems that may occur during a flight, as well as the first aid equipment available on the aircraft. To achieve this goal, a literature review of articles related to this field in Pubmed and Google Scholar databases was carried out in the period 2010-2020. Most conditions are treated by the crew with a simple painkiller. However, there are more complex conditions that require a different treatment, such as oxygen administration to patients with respiratory problems. In some cases, medical advice and assistance is sought from passengers who are healthcare professionals. Some companies require crews to be trained and certified every two years for the use of automated external defibrillators, as well as cardiopulmonary resuscitation. All aircrafts have an emergency medical kit with a limited number of drugs and universal precaution kit in cases where there is a risk of communicable disease. Due to the spread of COVID-19, the World Health Organization has issued specific guidelines for both protecting crews from the virus and treating a passenger who may have been infected with the virus.

Pattern of diseases among Bangladeshi Hajj Pilgrimsin Mecca, Saudi Arabia

Background & objective: Each year millions of Muslims embark on a religious pilgrimage called the “Hajj” to Mecca in Saudi Arabia. The mass migration during the Hajj is unparalleled in scale, and pilgrims face numerous health hazards. Performing the tasks of pilgrimage is stressful and laborious and as such requires immense mental and physical fitness on the part of the pilgrims. But a substantial proportion of the pilgrims lack it. Besides, the hot and dry environment and untold overcrowding predispose them to the risk of many communicable diseases. The present study, was therefore, intended to find the pattern of diseases among Bangladeshi Hajj pilgrims at Mecca, Saudi Arabia.
 Methods: This descriptive cross-sectional study was carried out on Bangladeshi Hazz pilgrims in Mecca Saudi Arabia over a period of 1 month from mid-September to mid-October, 2015. A total of 710 pilgrims (18 or > 18 years) attending at Bangladeshi Hazz Medical Center (BHMC) in Mecca, Saudi Arabia during the period were consecutively included in the study after having voluntary verbal consent obtained from them. Diseases were diagnosed mainly on the basis of clinical signs and symptoms with provision of only random and fasting blood sugar estimation and ECG. The diagnosed diseases were grouped into major and minor problems or conditions and were treated as out-patient basis.
 Result: In the present study upper middle-aged (50 – 60 years) and elderly (≥ 60 years) pilgrims together formed nearly 73% of the patients with mean age of the patients being 56 years. Males were a bit higher than the females with male-female ratio being roughly 11:9. The study demonstrated that the commonest cause of out-patient visit was respiratory illness (41.2%) followed by diabetes (17.2%), peptic ulcer disease (PUD) (11.7%) and cardiovascular diseases (10.7%)(which included hypertension, new onset ischemia or exacerbation of preexisting ischemic heart diseases). A few (3.2%) of the patients presented with diarrhoeal diseases (loose motion or dysentery). Other minor ailments were allergy or dermatitis, insomnia, paronychia, anxiety, UTI, hemorrhoids, epistaxis, glossitis, oral ulcer, earache, conjunctivitis, worm infestation, spot bleeding etc., accounting for 4.8% of the patients.
 Conclusion: The study concluded that respiratory illness is the most common health problems among pilgrims visiting to Mecca, Saudi Arabia followed by diabetes, PUD and cardio-vascular diseases. The pilgrims should be educated in their home country before starting for pilgrimage as how to maintain their health in their new and challenging environment and Bangladesh Hazz Mission in Mecca should ensure enough medical support to them.
 Ibrahim Card Med J 2020; 10 (1&2): 96-101

Численное моделирование эволюции бактериальной популяции в легких человека

The present work focuses on building up a mathematical model showing bacteria population evolution in human lungs taking into account dynamics of immune processes; the model would be useful for assessing functional damage to the lungs. Numeric modeling of processes that occur in a human body is a promising tool for analyzing and predicting impacts exerted by risk factors on health. The suggested approach was developed within a concept describing a human body as a multi-level model that allowed for interaction between various systems and functional state of examined organs given effects produced on them by different adverse factors. Since direct modeling of the structure and processes occurring in the lungs is rather complicated, these organs are usually described with a porous medium model and it requires a lot of computing resources. Damage to the lungs determined via an evolution equation was introduced into the model. The equation described dependence between damage and infiltrate distribution and effects produced on alveolar cells by toxicants excreted by bacteria. The work dwells on certain results that characterize how concentrations of immune system components and bacteria population are spatially distributed when an immune response is evolving. Our research provides a qualitative insight into reasons for quantitative changes in bacteria population under immune reactions occurring in a body under exposure to different factors. This approach can be used for obtaining more precise parameters for existing population models that show spread and clinical course of bacterial infections and for making a long-term prediction of an epidemiological situation. Results obtained with this approach can be useful for analyzing risks of communicable diseases including those occurring under exposure to adverse environmental factors.

Numeric modeling of bacteria population evolution in human lungs

The present work focuses on building up a mathematical model showing bacteria population evolution in human lungs taking into account dynamics of immune processes; the model would be useful for assessing functional damage to the lungs. Numeric modeling of processes that occur in a human body is a promising tool for analyzing and predicting impacts exerted by risk factors on health. The suggested approach was developed within a concept describing a human body as a multi-level model that allowed for interaction between various systems and functional state of examined organs given effects produced on them by different adverse factors. Since direct modeling of the structure and processes occurring in the lungs is rather complicated, these organs are usually described with a porous medium model and it requires a lot of computing resources. Damage to the lungs determined via an evolution equation was introduced into the model. The equation described dependence between damage and infiltrate distribution and effects produced on alveolar cells by toxicants excreted by bacteria. The work dwells on certain results that characterize how concentrations of immune system components and bacteria population are spatially distributed when an immune response is evolving. Our research provides a qualitative insight into reasons for quantitative changes in bacteria population under immune reactions occurring in a body under exposure to different factors. This approach can be used for obtaining more precise parameters for existing population models that show spread and clinical course of bacterial infections and for making a long-term prediction of an epidemiological situation. Results obtained with this approach can be useful for analyzing risks of communicable diseases including those occurring under exposure to adverse environmental factors.

Scaling of contact networks for epidemic spreading in urban transit systems

Improved mobility not only contributes to more intensive human activities but also facilitates the spread of communicable disease, thus constituting a major threat to billions of urban commuters. In this study, we present a multi-city investigation of communicable diseases percolating among metro travelers. We use smart card data from three megacities in China to construct individual-level contact networks, based on which the spread of disease is modeled and studied. We observe that, though differing in urban forms, network layouts, and mobility patterns, the metro systems of the three cities share similar contact network structures. This motivates us to develop a universal generation model that captures the distributions of the number of contacts as well as the contact duration among individual travelers. This model explains how the structural properties of the metro contact network are associated with the risk level of communicable diseases. Our results highlight the vulnerability of urban mass transit systems during disease outbreaks and suggest important planning and operation strategies for mitigating the risk of communicable diseases.

EFFECT OF PHYSICAL EXERCISE PARTICIPATION ON SELECTED INDICES OF MENTAL HEALTH BETWEEN STUDENT ATHLETES AND NON-ATHLETES OF OBAFEMI AWOLOWO UNIVERSITY, ILE-IFE, NIGERIA

Participation in physical exercise is regarded as a healthy behaviour that promotes both physical and mental health among students. It is a preventive and therapeutic measure for mental health illness. However, despite the positive relationship between participation in physical exercise and mental health, many students of the Obafemi Awolowo University, Ile Ife, Nigeria still engage in sedentary life style which increases their vulnerability to mental health issues. Several studies have been carried out on students and mental health, behavioural health risks such as substance use, unsafe sexual behaviour, violence and increased risk of communicable and non-communicable diseases, injury and mortality and anxiety as the most prevalent disorder found in men and women but little research effort has been directed towards the influence of exercise participation on these selected indices of mental health between student athletes and non-athletes of Obafemi Awolowo University. Correlation survey research design was used for this study. Data obtained were coded and analyzed using descriptive statistics of frequency count, simple percentage, mean, standard deviation and bar chart for the demographic variables and research questions. Chi square (CRAMMER V) and multiple regression were used to test hypotheses at 0.05 alpha level of significance. The population for this study comprises of male and female student athletes and non-athletes of Obafemi Awolowo University, Ile-Ife, as participants. Multi-stage sampling technique was used to select Two hundred (200) respondents from five (5) faculties. A standardised questionnaire on depression and anxiety scale was used as instrument for data collection with reliability co-efficient (r) of 0.71. Two research questions were answered and five hypotheses tested at 0.05 level of significance. Findings from this study showed significance on depression between student athletes and non-athletes (X2=58.791, df=12, p<0.05), anxiety disorder (X2=50.974, df=12, p<0.05), gender difference (F=12.67, df=198, p< 0.05), joint contribution of exercise, gender and course of study (F(3,195)= 19.877) and independent contributions of Exercise 55.5% (ß=.555, t=29.452, p<0.05), gender 30.8% (ß=.308, t=15.616, p<0.05) and study 19.9% (ß=.199, t=14.519, p<0.05). It was concluded that those students who participate in exercise (athletes) show better mental health in terms of depression and anxiety disorder than non-athletes. Also, it was recommended that the Obafemi Awolowo University, Ile Ife must see it as a point of importance to give students ample opportunity to engage in physical exercise.
 
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Uticaj pandemije kovida 19 na osiguranje

In this paper, the author analyses the impact of the COVID-19 pandemic on internal and external aspects of insurance organizations, and particularly on insurance terms and conditions. The introductory part provides general remarks on the impact of the pandemic on community and economy, also defining the subject of the paper. In the second part, the author explores how insurers responded to new working conditions and behaved in relation to their self-organization and to the public and the insured persons. Particular developments in a macroeconomic and political context relating to covering losses from COVID-19 are also analyzed. The author concludes that a certain delay in making the amendments and supplements to the list of communicable diseases was justified, whereas the main characteristic of extended cover for COVID-19 provided by domestic insurers is not the reimbursement of medical treatment costs but the payment of daily allowance and provision of information and particular services. In addition, the author concludes that wordings used to exclude the risk of communicable diseases may create particular dilemmas as to whether a loss event may be considered insured, depending on the circumstances and time of its occurrence, and depending on the provisions of positive legal regulations.

Hyperglycemia and dyslipidemia: Reduced HLA-DR expression in monocyte subpopulations from diabetes patients

Immune dysfunction contributes to the higher risk of communicable and non-communicable diseases among diabetics. HLA-DR expression is a robust marker of immune competence in mononuclear cells, including antigen presentation to CD4 lymphocytes. Given the high prevalence of obesity among diabetics, we evaluated the independent association between hyperglycemia and dyslipidemias with respect to HLA-DR expression in blood monocytes from type 2 diabetes patients. The monocytes from individuals with (n = 16) or without diabetes (n = 25) were phenotyped by flow cytometry to assess the differential expression of HLA-DR on their three subpopulations (classical, intermediate and non-classical monocytes). Diabetes was independently associated with lower HLA-DR expression across all monocyte subpopulations (p < 0.05). Blood triglycerides were associated with further HLA-DR depression (interaction p < 0.002). Cholesterols counterbalanced the reductive effect, with CD36, a receptor for oxidized cholesterol, correlating with HLA-DR (rho = 0.373; p = 0.016). Future studies are warranted to elucidate the complex interactions between hyperglycemia and dyslipidemias on antigen presentation in diabetic monocytes.

Listeria monocytogenes in Cooked Chicken: Detection of an Outbreak in the United Kingdom (2016 to 2017) and Analysis of L. monocytogenes from Unrelated Monitoring of Foods (2013 to 2017)

In England and Wales, Public Health England applies whole genome sequencing to cultures of Listeria monocytogenes recovered from human cases of listeriosis, foods, and food production environments. Following the routine inspection of a small retailer in February and March 2016, two unopened packs of cooked chicken produced by the same manufacturer were found to be contaminated with L. monocytogenes at levels of 340 and 20 CFU/g. A public recall of this product was issued in March 2016. Early in 2017, a less than five single-nucleotide polymorphism single-linkage cluster was detected between the L. monocytogenes isolates from the two cooked chicken products and cultures from five cases of human listeriosis in England and Scotland with onsets of illness between March 2016 and February 2017. Epidemiological data provided further supportive evidence that this cluster was an outbreak linked to a manufacturer of cooked chicken whose products were supplied to the small retailer that initiated the outbreak investigation. Unrelated to this outbreak, 34 L. monocytogenes isolates recovered from routine food monitoring of 2,007 samples of cooked chicken during 2013 to 2017 were analyzed by whole genome sequencing. Previously undetected fewer than five single-nucleotide polymorphism single-linkage clusters were identified between cultures from cooked chicken and with those from two clusters and two sporadic cases of human listeriosis that were consistent with foodborne transmission. This analysis identified linkage of L. monocytogenes clusters within specific food chains more readily than traditional manual tracing. Linking of data associated with L. monocytogenes cultures from cases of listeriosis with those from unrelated food testing is a unique source of information for communicable disease risk assessment, epidemiological studies, and disease prevention and control. This report provides further evidence that should act as a reminder of the association between cooked chicken consumption and human listeriosis.

Knowledge and awareness regarding occupational needle stick and sharp injuries among dental personnel in Malaysia.

Accidental occupational injuries increase the risk of communicable diseases like hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) among dental personnel. Such occupational injuries affect healthcare quality by enhancing dissatisfaction and lack of motivation to work among dental personnel. The present study aims to assess knowledge and awareness regarding needle stick and sharp injury among dental personnel and compared the knowledge and awareness level about needle stick injuries between dental professionals and dental supporting staff working at the School of Dental Sciences, Universiti Sains Malaysia. This cross-sectional study was conducted from March 2016 to March 2017. The total sample included 112 registered dental personnel including dental professionals (lecturers, dental officers, and postgraduate students) and dental supportive staff (including staff nurses and dental surgery assistant) who were selected from the School of Dental Sciences, Universiti Sains Malaysia at Kelantan District of Malaysia. Data were collected by a structured questionnaire. In our study 60.7% respondents answered correctly for all the statements regarding knowledge and 51.8% of the respondents answered correctly for the statements regarding awareness on needle stick and sharp injury. No significant difference of knowledge level has been observed between the dental professionals and dental supportive staff (p < 0.819), whereas the awareness level was significantly different between these two groups (p < 0.016). There is a difference regarding awareness level on needle stick and sharp injury between dental professionals and dental supportive staff in our study but no differences were found in knowledge level between two groups.

Lack of Consensus on Humoral Immune Status Among Survivors of Pediatric Hematological Malignancies: An Integrative Review.

Leukemias and lymphomas account for more than half of new cancer cases in children each year. As a result of advancements in clinical protocols, survival rates for hematological malignancies in children now approximately 80% to 90%. The short-term effects of chemotherapy are well documented; however, many late effects remain unclear, notably those on the humoral immune system. The recent resistance toward childhood vaccination in some communities in conjunction with a growing number of potentially underprotected survivors could place this population at increased risk for common communicable diseases. Additionally, survivors could serve as a significant reservoir for further spread of disease within the general population. The state of the scientific knowledge regarding humoral immunity in this population is insufficient for concrete conclusions. An intensive search of the literature on various platforms was performed to identify articles reporting on the rates of protection to common vaccine-preventable diseases in survivors of pediatric hematological malignancies. Articles were selected with respect to inclusion and exclusion criteria. Quality was evaluated against specific methodological standards. Each study shows evidence that participants were lacking immunity to at least one vaccination following treatment. A majority of participants recovered immunity after revaccination, with a small percentage remaining unprotected. There is no consistency between studies regarding the rates at which immunity is present; furthermore, there are no particulars on how long immunity persists following revaccination. Vaccination represents an instrumental public health initiative for reducing morbidity and mortality globally. The clinical ramifications of losing protection against vaccine preventable diseases are therefore serious.

Increased Dengue Transmissions in Singapore Attributable to SARS-CoV-2 Social Distancing Measures.

Social distancing (SD) measures aimed at curbing the spread of SARS-CoV-2 remain an important public health intervention. Little is known about the collateral impact of reduced mobility on the risk of other communicable diseases. We used differences in dengue case counts pre- and post implementation of SD measures and exploited heterogeneity in SD treatment effects among different age groups in Singapore to identify the spillover effects of SD measures. SD policy caused an increase of over 37.2% in dengue cases from baseline. Additional measures to preemptively mitigate the risk of other communicable diseases must be considered before the implementation/reimplementation of SARS-CoV-2 SD measures.

Relationship Between Teachers and Students for Motivation (A Case Study of Community School of Nepal)

This research paper is focused to analyze how teachers - students’ relationship plays a crucial role in students’ motivation in learning. This paper is based on the Gardner model of motivation. By adopting a qualitative method approach and a phenomenological research design, the research paper has been prepared. Convenience sampling technique has been used in it. Data were collected by using a questionnaire and unstructured interview via telephone. Four issues were identified between the teachers-student’s relationships throughout the unstructured interview: the importance of teacher-student relationship, teacher expectation, students’ motivation, and increase in academic learning. The delimitation of this researcher was to collect the data from the telephone call due to the high transmission and risk of communicable diseases like corona virus (COVID -19) spreading all over the world. The research found out that, the better contact and mutual relationship between teachers and students result in higher students’ motivation in learning.

A Cross Sectional Study to Assess Knowledge and Practices of Hand Washing among Primary School Children in the Kapurthala District, India

Background: Hand washing is a believed to be a simple and effective practice to prevent communicable diseases. The infectious transmission of agents is rapid among school children due to their close relation with each other. To curtail the transmission, proper hand washing with soap is of great importance. However, in spite of its effectiveness, most of developing nations do not adhere to practices of hand washing. Since children are known as the vulnerable group who are at increased risk of communicable diseases, this study was performed to assess hand washing knowledge and practices among primary school children.The present study aims to assess the knowledge of hand-washing and its practices among primary school children and to discover the associated socio-demographic factors regarding the same issue. Methods: A community based cross-sectional study was conducted in the primary schools of Kapurthala District from October 2019 to November 2019 in order to assess the hand washing practices among the children. A total of 200 primary school children were evaluated using a self designed, self-reported and pre-tested questionnaire. Results: Statistically significant results were found in urban population regarding hand washing before eating (P=0.006), after handling dirty things (P=0.042) and after blowing nose/coughing (P=0.024). The rural participants showed correct handwashing techniques with statistically significant P value of 0.015. Correct handwashing techniques were statistically associated with education of the children’s mothers with P value of 0.001. Conclusion: Regular hand washing awareness sessions in the schools should be organized in order to keep our society safe and healthy.

Vulnerability and everyday health risks of urban informal settlements in Sub-Saharan Africa

More than half of the world population lives in the cities and around one billion in poor urban areas. These numbers are projected to increase, while Sub-Saharan Africa is the region with the highest rate of informal settlements due his rapid urbanization. The urban informal settlements of Sub-Saharan Africa house everyday health risks. These risks have considerable cumulative impacts on the wellbeing and health of the urban vulnerable group. Despite the public health consequences of urbanization and the increase of informal settlements number in African cities, there is a paucity in data about the risks at small scale and the vulnerability in poor urban areas. Through the database search engine of MEDLINE, WHO Library and Information Networks for Knowledge and website of Urban Africa Risk Knowledge; from information of the existing literature, this paper tried to analyse the everyday health risks, and vulnerabilities in urban informal settlement in Sub-Saharan Africa region. A search combining keywords associated with health risks and informal settlement in Sub-Saharan Africa were used to identify the relevant documents, and this search yielded 86 articles, of which 15 met the criteria for inclusion in the analysis. The risks of communicable diseases due to inadequate sanitation have been the most frequent subjects of study. Informal settlers in Sub-Saharan Africa face everyday health risks arising from lack of clean water, adequate sanitation, and life in overcrowding houses. Consequently, there is a burden of communicable and non-communicable diseases, undernourishment and injuries. The most vulnerable group is children under five with a high rate of mortality. Everyday health risks in urban informal settlements must be taken into account for a better understanding of the full spectrum of urban risks. This is essential in the establishment of efficient public health policies and intervention in urban areas.

S128. IMPACT OF COMORBIDITIES ON SURVIVAL ESTIMATE FOR PATIENTS WITH MENTAL DISORDERS

BackgroundA systematic review, including 203 studies, estimated that people with mental disorders have a mortality rate 2.2 times higher than the general population or control samples; the majority of these studies were conducted in developed countries. A possibility that underlies this excess mortality is that mental disorders increase the risk for communicable and non-communicable diseases and unintentional and intentional injuries. On the other hand, many health conditions increase the risk of mental disorders, and this comorbidity compromises the search for health care and may also impact survival estimates.We investigated the main causes of mortality in patients with mental disorders and the most prevalent psychiatric diagnoses involved, as well as the impact of communicable and non-communicable comorbidities on the survival estimates of these patients in a Brazilian cohort.MethodsWe evaluated 3,011 patients hospitalized due to mental disorders, over 18 years old, included in a web-based system of mental health information (SISAM-13). The SISAM-13 database is composed, in addition to sociodemographic data, of comorbidities such as hypertension, diabetes, infectious disease, trauma, respiratory problems, sequelae of cerebrovascular accident and epilepsy. This cohort was registered between April 2011 and November 2016. Information on mortality was conducted in collaboration with the SEADE, the center of São Paulo State Government in production of socioeconomic and health data, and December 2016 was the final point of the survival time. Diagnosis and mortality cause were coded according to ICD-10. The Kaplan-Meier method was used to estimate the survival function. Differences between groups were assessed with the log-rank test.ResultsIn total, 568 (26.2%) of valid cases presented comorbidities, and 124 patients (4.1%) died. The most prevalent causes of death were related to external causes (24.2%), and respiratory (17.7%), circulatory (11.3%) and digestive (8.1%) diseases. The presence of comorbidity decreased patients’ life expectancy: the median survival estimate for patients with comorbidities was 77.9 years (95% CI, 74.9 to 79.5 years), while for those without comorbidity was 80.8 years (95% CI, 78.9 to 83.2 years); X2(1) = 4.202; p = 0.040. The three most prevalent diagnoses were mental disorders due to substance use (40.7%), affective disorders (22.7%) and psychotic disorders (20.0%). The average survival estimate was lower among patients with substance use disorder (69.2 years; 95% CI, 66.4 to 72.0 years) compared to affective disorders (78.7 years; 95% CI, 76.6 to 80.8 years) and psychoses (80.3 years; 95% CI, 78.0 to 82.7 years); X2(2) = 30.807; p <0.001. No differences were observed in the interaction between the most prevalent diagnoses and presence of comorbidities.DiscussionThis study is the first of our knowledge to explore life estimates related to comorbidities and the most prevalent psychiatric diagnoses in patients living in a low- and middle-income country (LAMIC). In this sense, it was found that having comorbidity reduced life expectancy, independently of the psychiatric diagnosis; and among the most prevalent disorders, those related to psychoactive substance use presented the lowest life expectancy. These findings suggest the need for a comprehensive view of the psychiatric patient with comorbidities, as well as the urgency of public health policies directed at psychoactive substance users given the high prevalence and low life expectancy in this group of patients.

Assessing public health risk factors for internally displaced households in North Darfur, Sudan

PurposeThe purpose of this paper is to assess the public health risk factors of internally displaced households and suggest appropriate measures and strategies for health risk reduction in the context of IDPs.Design/methodology/approachThe composite Index (CI) method was used to compare the public health risk factors at the household level in three IDP camps. A set of 22 indicators were studied in 326 households. Households were selected by using a two-stage cluster sampling technique.FindingsThe findings indicate that the Shangil Tobaya camp is at the highest risk for communicable diseases (63.6%) followed by Zamzam (52.4%) and Abu Shouk (42.7%) at the household level. Eight indicators appeared to have made differential impacts between Abu Shouk and Shangil Tobaya, these include: level of education, walking time to health facilities, water source, latrines type, safe disposal of child feces, frequency of visit by pregnant women to antenatal care services, place of delivery and women delivering their children with the help of skilled birth attendants.Research limitations/implicationsSince the selection criteria of the camps were predefined; there are variations in the number of samples between the camps. Therefore, the generalizability may be compromised.Social implicationsIncreased access to healthcare services particularly reproductive health services to the most vulnerable groups (women). Community involvement in services management to promote ownership.Originality/valueThe methods used in this study is original and flexible and can be replicated for other emergency areas and risks.

Awareness of Primary Health Care Providers about Vaccination in Eastern regions of Ukraine

Background. A dramatic drop in routine immunization coverage is observed in Ukraine during recent years. Ukraine has the lowest rate of vaccination in Europe that imposes a high risk of communicable diseases on a population. More than 56.000 people sickened with measles from 2018-2019 yrs. Although Primary Health Care providers (PHCPs) in Ukraine play an important role in administering vaccines to their patients the data about PHCP's awareness regarding immunization are lacking. Methods. A self-administered survey among 265 PHCPs (44 doctors, 221 nurses) was conducted during Public Health Trainings from 01 March to 31 April 2019 in three Eastern Ukrainian regions (Zaporizhia, Dnipro, Kharkiv). The level of basic knowledge on vaccines schedule, safety and efficacy of vaccination, communication skills ect (totally ten statements and ten questions) were evaluated. Results. Overall 264 (99.6%) PHCPs highlighted the obvious need in strengthening evidence-based knowledge related to immunization topics and communication skills. Right answers regarding safety and efficacy of vaccines were obtained in 21% participants, 47% PHCPs had doubts for vaccine's safety and contradictions. Only 8% of participants were convinced in aspects of effective communication. Physicians had higher knowledge scores in routine vaccines schedule (32; 73%), compared to nurses (105; 47.5%), p=0.0016; but did not differ in aspects of vaccine's safety: 16% among physicians’ vs 17% among nurses (p&gt;0,05). Conclusion. The majority of PHCPs in Eastern regions of Ukraine have concerns about vaccines safety and efficacy, as well as lack of communication knowledge. Effective continuing evidence-based education of providers may help address these concerns.

Communicable disease among people experiencing homelessness in California.

California has a large population of people experiencing homelessness (PEH) that is characterised by a high proportion of people who are unsheltered and chronically homeless. PEH are at increased risk of communicable diseases due to multiple, intersecting factors, including increased exposures, comorbid conditions including substance use disorder and mental illness and lack of access to hygiene and healthcare facilities. Data available for several communicable diseases show that PEH in California experiences an increased burden of communicable diseases compared to people not experiencing homelessness. Public health agencies face unique challenges in serving this population. Efforts to reduce homelessness, increase access to health care for PEH, enhance data availability and strengthen partnerships among agencies serving PEH can help reduce the disparity in communicable disease burden faced by PEH.

Reporting of notifiable infectious diseases during the COVID-19 response.

The Norwegian Surveillance System for Communicable Diseases (MSIS) is based on reporting of cases of 72mandatory notifiable diseases by clinical microbiological laboratories and diagnosing physicians. The aim of our study was to investigate a potential temporal association between measures against COVID-19 in February-April 2020 and incidence of other infectious diseases reported to MSIS. We compared the number of disease cases reported to MSIS during weeks 6-14 in 2020 with the median of cases reported in corresponding weeks during three previous years (2017-2019). Compared to the median of cases reported during corresponding weeks in three previous years, physicians and laboratories reported 47% fewer cases (159 vs. 301) in week 12, 50% fewer cases (131 vs. 261) in week 13, and 69% fewer cases (77 vs. 252) in week 14. There was a reduction in the number of notifications of all included disease groups. The observed decline in reporting of diseases other than COVID-19may indicate a reduced risk of communicable diseases due to comprehensive advice and the requirement for social distancing. However, it is also possible that the sensitivity of the surveillance system was affected by increased resource use on COVID-19 cases management.