Transmitted Infection Risk Research Articles

Envelope antibody HBeIgG and HBV DNA in HBeAg-seronegative young adults in Nigeria

Study background: Anti-HBe and hepatitis B virus (HBV) DNA are important markers in evaluating HBV infection. Anti-HBe indicates past or current infection that persists after hepatitis B e antigen (HBeAg) clearance. Detecting anti-HBe helps identify cleared or chronic infections. HBV DNA measures viral replication, indicating infection activity. Studying these markers in HBeAg-seronegative young adults provides insights into infection dynamics, immune responses, and transmission risk. It informs clinical management and public health interventions for preventing HBV transmission and reducing the burden of liver disease. Aim and objectives: This cross-sectional study aimed to determine the prevalence of HBeAg seronegativity and its association with HBV infection markers among young adults in Etsako, Edo State, Nigeria. Materials and methods: The study population consisted of HBeAg-seronegative individuals aged 18 to 30 years. A total of 400 participants (200 females and 200 males) were randomly selected from urban and rural communities using a multistage sampling technique. Anti-HBe and HBeAg were analyzed by ELISA, whereas HBV DNA was evaluated by polymerase chain reaction. Results: The prevalence of HBeAg seropositivity was 28%, whereas 72% of participants were seronegative. Among the HBeAg-seronegative participants, the frequencies of anti-HBe and HBV DNA were analyzed based on various categorical variables. The results showed no significant differences in the frequency of anti-HBe and HBV DNA based on occupation, training, or other categorical variables (P>0.05). However, there was a significantly higher proportion of males (60%) among the total number of anti-HBe-seropositive young adults compared to females (40%) (P<0.05). Additionally, a significantly higher proportion of single/unmarried individuals without children (63.3%) was observed among anti-HBe-seropositive young adults compared to those who were married (25%) and those who were single/unmarried with children (12.5%, P<0.05). Conclusion: The study findings contribute to the understanding of HBeAg seronegativity and its association with anti-HBe and HBV DNA in young adults in Etsako, Edo State, Nigeria. Further research and public health interventions are warranted to better comprehend the factors influencing HBeAg seronegativity and its association with anti-HBe and HBV DNA and its implications for HBV transmission and disease progression in this population.

Examining outpatients' hand hygiene behaviour and its relation to COVID-19 infection prevention measures

The increasing demand for outpatient care is associated with a higher risk of infection transmission in these settings. However, there is limited research on infection prevention and control practices in ambulatory clinics, and none focuses on patients. This study aims to examine outpatients' hand hygiene behaviours, their determinants, and their associations with other infection prevention measures during the COVID-19 pandemic. We observed the hand hygiene behaviour of one cohort of patients in one outpatient clinic and surveyed a separate sample in five clinics about their hand hygiene practice in outpatient facilities. A questionnaire based on the Theoretical Domains Framework (TDF) was used to examine predictors of the behaviour. Moreover, patients indicated their compliance with COVID-19 infection prevention measures, vaccination status, disease risk perception, and vaccine hesitancy. Observed hand hygiene rates among 618 patients were low (12.8%), while 67.3% of the 300 surveyed patients indicated sanitising their hands upon entering the clinic. The TDF domains memory, attention, and decision processes, and emotions significantly predicted both current (today's) and general hand hygiene behaviour in outpatient clinics. Hand hygiene behaviour and compliance with COVID-19 infection prevention showed a positive association; however, no significant connection was found with patients' vaccination status, suggesting different behavioural motivators. Hand hygiene among outpatients should be improved through interventions focusing on helping patients remember to clean their hands. More research on infection prevention in outpatient facilities is needed to ensure patient safety.

Numerical assessment of multiple vaccinations to mitigate the transmission of COVID-19 via a new epidemiological modeling approach

Vaccines play a crucial role in mitigating the transmission of COVID-19. The primary objective of COVID-19 vaccination campaigns is to induce immunity in individuals, thereby reducing the risk of infection, severe illness, and subsequent transmission within communities. The present study mainly focuses on examining the impact of multiple vaccinations on the transmission dynamics of COVID-19 using a new epidemic modeling approach. The vaccinated individuals are divided into three subclasses according to their vaccination status. The primary, secondary and booster shots of COVID-19 vaccines are considered in the construction of the model. Initially, the model is constructed using classical integer order differential equations and basic necessary properties are carried out. Furthermore, utilizing a fractional and fractal–fractional epidemiological approach with an exponential kernel, the model is extended with these operators in order to provide insights into the potential benefits of this vaccination strategy in controlling the spread of the disease. The uniqueness and existence criteria of the fractional and fractal–fractional models are presented and an efficient numerical solution is investigated using the modified Adams–Bashforth method. The impact of both fractional (memory index) and fractal parameters is demonstrated graphically for R0<1 and R0>1 showing the converges of solution trajectories to the disease-free and endemic steady states respectively. Moreover, we examine the impact of various vaccination rates (first and second dose, and booster short) on the reduction and mitigation of the disease incidence.

Developing a survival probability-based Lagrangian model for predicting ultraviolet disinfection of bioaerosols in enclosed environments

The transmission of airborne infectious diseases in enclosed environments has become a significant public health issue. Far-ultraviolet C (UVC) lights can be used safely and effectively to disinfect bioaerosols and reduce the risk of airborne infectious disease transmission. To ensure proper use of far-UVC systems, an improved Lagrangian method for predicting the dispersion, deposition, and far-UVC disinfection of bioaerosols was proposed. First, an improved Lagrangian model considering the probability of bioaerosol survival was developed for predicting the UVC disinfection of airborne bioaerosols in enclosed environments. The UVC disinfection of surfaces with deposited bioaerosols was implemented into the deposition module of the Lagrangian model by introducing the concept of equivalent deposition number. Experimental data on far-UVC disinfection of E. Coli in the air and on the surfaces in a ventilated chamber were used to validate the proposed model. The validation results show that the proposed model can predict the bioaerosol dispersion, deposition, and far-UVC disinfection reasonably well. The validated model was then employed to calculate the far-UVC disinfection of airborne and surface SARS-CoV-2 bioaerosols in a Mass Transit Railway (MTR) train compartment in Hong Kong. According to the calculation results, the far-UVC lamps are effective in reducing the passengers’ exposure to SARS-CoV-2 bioaerosols.

Cost-effectiveness of Kidney Transplantation From Donors at Increased Risk of Blood-borne Virus Infection Transmission.

Demand for donor kidneys outstrips supply. Using kidneys from selected donors with an increased risk of blood-borne virus (BBV) transmission (hepatitis B virus and hepatitis C virus [HCV], human immunodeficiency virus) may expand the donor pool, but cost-effectiveness of this strategy is uncertain. A Markov model was developed using real-world evidence to compare healthcare costs and quality-adjusted life years (QALYs) of accepting kidneys from deceased donors with potential increased risk of BBV transmission, because of increased risk behaviors and/or history of HCV, versus declining these kidneys. Model simulations were run over a 20-y time horizon. Parameter uncertainty was assessed through deterministic and probabilistic sensitivity analyses. Accepting kidneys from donors at increased risk of BBVs (2% from donors with increased-risk behaviors and 5% from donors with active or past HCV infection) incurred total costs of 311 303 Australian dollars with a gain of 8.53 QALYs. Foregoing kidneys from these donors incurred total costs of $330 517 and a gain of 8.44 QALYs. A cost-saving of $19 214 and additional 0.09 QALYs (~33 d in full health) per person would be generated compared with declining these donors. Increasing the availability of kidneys with increased risk by 15% led to further cost-savings of $57 425 and additional 0.23 QALY gains (~84 d in full health). Probabilistic sensitivity analysis using 10 000 iterations showed accepting kidneys from donors at increased risk led to lower costs and higher QALY gains. Shifting clinical practice to accept increased BBV risk donors would likely produce lower costs and higher QALYs for health systems.

Overview of The Infection Control Risk Assessment (ICRA) Implementation in Dental Practice at RSGM Unimus

Infections present while undergoing treatment or obtained from health services are called Healthcare-Associated Infections (HAIs). The impact of this incident is the length of treatment and costs provided, increased morbidity, and can result in death. One of the many occupations in the world with the highest risk of infection transmission is health workers working in dentistry since most of human microbial pathogens originate from oral secretions. In contrast, these health workers require their proximity to the patient’s oropharynx. The increase in HAIs occurs due to the lack of application of infection control, so we need to assess this implementation. The Centers for Disease Control and Prevention (CDC), in 2016, issued standardized Infection Control Risk Assessment (ICRA) guidelines to assess the risk of infection in dental and oral health services. This research aims to describe ICRA in the dentist practice at RSGM Unimus. The type of research used was observational, with quantitative analysis methods and a descriptive research design. The results showed that overall, infection control at RSGM Unimus had a percentage of 82%, which was included in the low infection risk category. RSGM Unimus was good at implementing infection control programs.

HBV, HCV, and HIV Seroprevalence in Hemodialysis Patients Admitted to a Tertiary Care Hospital in Mogadishu, Somalia

Hemodialysis (HD) patients are a special group of patients who are at high risk for infection and related complications. Blood-borne viruses associated with chronic diseases such as hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are important causes of morbidity and mortality in HD patients. Immunodeficiency of the patients, weak protective efficacy of vaccines (HBV etc.), invasive vascular procedures, long-term dialysis applications and device-related contaminated blood contact risk, need for blood transfusion, medical practices associated with the risk of nosocomial transmission are some of the factors associated with an increased risk of infection transmission in HD patients. In addition to standard precautions to prevent infection transmission, some additional practices specific to HD patients have been recommended. HBV vaccination, patient isolation (special staff and use of separated rooms, devices, and equipment) in case of indication, precautions to be taken during catheter application (selection of catheter location, catheter care, skin antisepsis, and performing the procedures under appropriate and sterile conditions), monitoring patients for infection markers (before dialysis and at recommended intervals), taking into account inadequate antibody production and the long incubation period of viral infections are some examples of preventive procedures specific to HD patients. In this study, the prevalence of HBV, HCV and HIV infections in HD patients treated in a tertiary care hospital in Somalia was investigated. A total of 744 HD patients, 419 (56.3%) males and 325 (43.7%) females, were included in the study. The mean age of the patients was 50.81±17.62 (range 7-91) and the median age was 53. 660 of the patients were tested for anti-HBs (386 positive patients; 58.5%), 718 for HBsAg (63 positive patients, 8.8%), 720 for anti-HCV (19 positive patients, 2.6%), and 599 for anti-HIV (one positive patient 0.17%). Seropositivity rates were found to increase with age in HD patients, in line with the prevalence of viral agents in the population. In 718 patients tested for HBsAg, the positivity rates in men and women were 10.8% (44/406) and 6.1% (19/312), respectively, and the seropositivity rate was significantly higher in men (p=0.026). Anti-HCV seropositivity (2.6%) was approximately twice and significantly higher in HD patients than the hospital general prevalence (1.41%) (p=0.005). Emergency responses to injuries related to ongoing conflict across the country, invasive procedures performed outside the hospital and under unsuitable conditions, lack of molecular diagnostic tests for viral infections in identifying seronegative cases, patients apply to various centers with different capabilities for dialysis procedures and irregular patient follow-up records, missing hemodialysis sessions due to economic or other reasons, high prevalence of HBV, and lack of trained and specialized personnel draw attention as problems specific to the region.

Infectious keratoconjunctivitis in semi-domesticated reindeer (Rangifer tarandus tarandus): a questionnaire-based study among reindeer herders in Norway and Sweden

BackgroundThe effects of climate change, loss of pastureland to other land usage and presence of large carnivores are the main reasons for the increase in supplementary feeding of semi-domesticated reindeer (Rangifer tarandus tarandus) in Fennoscandia over the last decades. Feeding might expose reindeer to stress and increased animal-to-animal contact, leading to an increased risk of infectious disease transmission, such as infectious keratoconjunctivitis (IKC). As it can develop rapidly and be very painful, IKC is described as an important animal welfare concern and a potential source of economic loss. The aim of this study was to investigate the current presence of IKC and potential associations between IKC and supplementary feeding through an online questionnaire survey, distributed among reindeer herders in Norway and Sweden in 2021.ResultsSeventy-six reindeer herders (33 from Norway and 43 from Sweden) responded to the questionnaire, representing 6% and 4% of the registered reindeer herding groups in Norway and Sweden, respectively. Infectious keratoconjunctivitis was common, with 54 (71%) of the 76 herders that responded having observed clinical signs during the past 10 years. These signs were mainly observed as increased lacrimation, causing “wet cheeks”, but also as keratitis and conjunctivitis. Autumn and winter were the seasons in which IKC was observed most. The herders reported several measures, such as slaughter and isolation of affected reindeer, to counteract the spread of disease. The herding year 2019/2020 was associated with reports of outbreaks of IKC in herds as well as being the herding year where most herders (80%) had performed supplementary feeding. A significant association was found between IKC and feeding performed in an enclosure (odds ratio = 15.20), while feeding on free-range areas had a non-significant, negative, relationship with the appearance of IKC outbreaks (odds ratio = 0.29). Finally, there was a trend in the data suggesting that IKC affected calves especially.ConclusionsInfectious keratoconjunctivitis is a common disease, mainly observed in winter and autumn. It usually has mild to moderately severe clinical signs. Our results imply that IKC is associated with stress and feeding situations and that calves might be more susceptible than adults, however, this needs to be confirmed with further studies, preferably at an individual animal level.

Bacterial contamination of water used as thermal transfer fluid in fluid-warming devices

Recent reports implied heater-cooler units (HCU), which are used for warming of infusions, blood or in ECMO devices, as possible origin of healthcare-associated infections (HAIs) with potentially pathogenic bacteria like nontuberculous mycobacteria [1]. This represents a source of contamination in a usually sterile setting. Aim of this study is to analyse water from infusion heating devices (IHDs) for bacterial contamination and to raise the question if IHDs act as a possible source in the transmission of HAIs. 300-500 ml of thermal transfer fluid (TTF) derived from the reservoirs of 22 independent IHDs were collected and processed on different selective and non-selective media for colony count and identification of bacteria. Strains of Mycobacterium species (spp.) were further analysed by whole genome sequencing. Bacterial growth was observed in each of the 22 collected TTFs after cultivation at 22°C and 36°C. Pseudomonas aeruginosa was the most frequent pathogen identified, being present in 13.64% (3/22) at > 100 CFU/100mL. Colonization with Mycobacterium chimaera, Ralstonia pickettii and Ralstonia mannitolilytica was detectable in 9.09% (2/22) of the isolates. Primary sequencing of the detected M. chimaera suggests a close relationship to a M. chimaera strain detected in an outbreak in Switzerland, which led to the death of two patients. A contamination of the TTF represents a germ reservoir in a sensitive setting. Handling errors of the IHD may lead to distribution of opportunistic or facultative bacterial pathogens, increasing the risk of nosocomial infection transmission.

552-P: Disparities in Preventive Reproductive Health Services in Women with Type 1 and Type 2 Diabetes

About 50% of (~13 million) reproductive aged women with Type I or II diabetes receive any preconception care. Even fewer receive contraceptive counseling, or other vital reproductive health services. This scoping review aimed to explore if reproductive aged women with diabetes receive adequate preventative reproductive health services compared to women without diabetes. A systematic search strategy of the published literature was built and applied in multiple databases (PubMed, Web of Science, Cochrane). Interventional and observational studies describing access to reproductive health services among reproductive-aged women with compared to those without diabetes were included. The Preferred Reporting Items for Scoping Reviews and Meta-Analyses (PRISMA) guidelines were followed. The search strategy identified 6785 unique records. A two reviewer method was used to screen abstracts, with 41 studies identified to be relevant. These studies were separated into the domains of contraception counseling (N=20), cervical cancer screening (N=12), counseling/screening for sexually transmitted infections (N=3), and preconception counseling (N=12). We did not include studies focusing on prenatal care, pregnancy, menstrual irregularities, sexual dysfunction, or breast cancer screening. While a vast amount of literature exists related to diabetes and pregnancy, this scoping review draws attention to the lack of research focused on the reproductive health of women with diabetes prior to pregnancy. The majority of available literature focuses on contraception and preconception management, consistently demonstrating that women with diabetes lack adequate preventative reproductive healthcare compared to their nondiabetic counterparts. Far less evidence exists for sexually transmitted infection risk assessment and screening. It is imperative that future research focus on ways to mitigate disparities in access to reproductive health services for women with diabetes. Disclosure M.Treasure: None. P.S.Nourbakhsh: None. A.Osuna-garcia: None. S.C.Esteves: None. L.N.Kransdorf: None. L.E.Wisk: None.

Health Care Provider Discussions Regarding HIV/Sexually Transmitted Infection Risk Factors and Associations with HIV/Sexually Transmitted Infection Screening Among Men.

Little is known regarding the specific discussions health care providers (HCP) have with their patients and how these discussions may increase rates of HIV/STI screening. The main objective of this study was to examine the content of HCP-patient discussions and associations with HIV/STI screening while adjusting for patient characteristics. Using the 2017-2019 National Survey of Family Growth data, seven survey-weighted multivariable multinomial/binary logistic regression models were analyzed in men ages 15-49years old (N = 4260). Patients had significantly higher odds of a lifetime HIV test when their HCP asked about number of sexual partners (adjusted odds ratio [aOR] = 2.325; 95% CI 1.379-3.919) and discussed HIV/AIDS (aOR = 4.149; 95% CI 2.877-5.983). Odds of a recent STI screening were higher among patients with HCP that asked about: sexual orientation (aOR = 1.534; 95% CI 1.027-2.291), number of sexual partners (aOR = 2.123; 95% CI 1.314-3.430), use of condoms (aOR = 2.295 95% CI 1.484-3.548), type of sexual intercourse (aOR = 1.900; 95% CI 1.234-2.925), and discussed HIV/AIDS (aOR = 1.549; 95% CI 1.167-2.056). Results may provide insight on how HCPs may potentially promote HIV/AIDS and STI screening among men and which patient groups are more likely to receive a discussion of risks factors from their HCPs.

Performance Evaluation of Different Texture Material Masks to Reduce Airborne Infection

At the end of 2019, the COVID-19 virus began to appear and quickly spread throughout the world. It transmits the infection to the respiratory tract by the transmission of pathogens within bioaerosols during speaking, coughing, and sneezing. Therefore, understanding the dynamics of aerosols plays an important role in developing mitigation strategies against droplet infections. Computational modeling, using fluid and computational dynamics, has become a useful feature in studying and visualizing the diffusion of micro-droplets that are difficult to reach using experimental methods. Through this study, the effects of using cloth face masks and social distancing, both recommended by the World Health Organization to the general public to avoid rapid transmission of COVID-19, were determined. This study made a comparison between different structural masks and the difference between social distancing with different porous masks at the droplet diameter during breathing from 0.5 µm to 2.5 µm. The results showed the effectiveness of wearing masks in reducing the risk of infection transmission. Also, with lower mask porosity, lower air permeability means higher filtration efficiency, trapping airborne particles more effectively, especially for small infection-carrying particle sizes, and, therefore, lowering the required social distancing. From the comparison, it is concluded that sample 6 has the highest efficiency of 82.9% compared to other samples (1, 2, 3, 4, and 5), which have efficiencies of 77.1%, 77.1%, 74.3%, 80.0%, and 65.7%, respectively

VIRTOPSY AS A BREAKTHROUGH IN NON-INVASIVE AUTOPSY: ITS PRINCIPLES AND POTENTIAL OF APPLICATION IN DEVELOPING COUNTRIES DURING THE COVID-19 PANDEMIC

Autopsy practice is often limited due to the risk of infection transmission and family objections. As an alternative, virtual autopsy (virtopsy) is proposed, which uses minimally invasive radiology techniques such as postmortem CT scan (PM-CT) and PM-MRI. However, there is a scarcity of literature comprehensively summarizing this topic. Therefore, this review article discusses the advantages and limitations of virtopsy in developing countries during the COVID-19 pandemic, along with ethical issues and a proposed algorithm for postmortem imaging. Virtopsy improves the sensitivity (93%) and specificity (83%) of diagnoses and offers several advantages, such as faster identification, good foreign body detection, three-dimensional reconstruction, and non-invasiveness. Limitations include difficulty in determining infection status and assessing internal organ characteristics, operator dependence, insufficient legal basis, and high costs. During the COVID-19 pandemic, this article compiles twenty-one studies from 2020 to 2022 that used virtopsy to investigate 191 cases of COVID-19 infection resulting in death. The studies were conducted in various countries, with only two developing countries [Brazil (n = 3) and India (n = 1)] reported to have used it. Most of the studies used PM-CT, while others used postmortem ultrasound, PM-MRI, and PM chest X-ray. Virtopsies were mostly performed within 24 hours. The age range of the deceased individuals investigated using virtopsy was between 11 and 99 years old, with males being predominant. Virtopsy was mostly used for triage or screening for conventional autopsy (CA) as well as adjuvant/complement to CA. In summary, virtopsy has potential benefits for developing countries during and after the COVID-19 pandemic, making it a valuable investment despite its limitations.

Relationship between Psychological States and Coping in Reproductive Cancer Patients in the Context of the Pandemic

Abstract Introduction Cancer is known as a disease caused by an uncontrolled division of abnormal cells with the potential to proliferate and destroy body tissues. While it is not uncommon to observe changes in psychological states among patients with cancer, the pandemic situation has been reported to have an impact more severely. Objective This study attempts to understand the psychological problems of cancer patients, and the process of coping adopted by reproductive cancer patients during the period of the pandemic. Materials and Methods This study uses a correlation research design and the tools used for assessment were the four-dimensional symptom questionnaire and Brief COPE inventory. Through nonrandom sampling, a sample of 120 cancer patients diagnosed with reproductive cancer, both male and female from the regional cancer center and private cancer hospitals in Hyderabad, was recruited for the pandemic period from May 2020 to September 2021. Descriptive statistics, correlation, and regression statistical analysis methods were implemented. Results Significant negative correlation was observed between psychological states and coping. Using multiple linear regression analysis, it was found that distress and depression predict problem-solving coping, distress and anxiety predict emotion-solving coping, and distress predicts adaptive coping. Conclusion This study examines the psychological factors and coping methods in adapting to the dual challenges of illness and potential risk of infection transmission, and emphasizes designing an effective intervention. During the coronavirus disease 2019 crisis, the lack of support through psychological counseling to address their coping mechanisms to face the challenges is also glaring.

감염병 팬데믹 상황에서 항공 여행에 대한 위험지각이 항공사 선택속성과 만족에 미치는 영향

This study investigated the effect of risk perception on airline selection attributes and satisfaction in an infectious disease pandemic situation. As a result of the study, it was all adopted that risk perception for air travel would affect airline selection attributes. Among them, social and psychological risks had a negative (-) effect on airline selection attributes. H2. It was partially adopted that airline selection attributes would affect satisfaction. Infectious disease prevention measures, flight services, and economic feasibility affected satisfaction, but in-flight services did not affect satisfaction. The implications are as follows. In order to reduce the risk of infectious disease transmission, it will be necessary to provide in-flight meals in the form of a snack box that is packaged in-flight food and beverage. In order to reduce time and economic risk, it will be necessary to exempt or reduce fees when customers change or refund their flights due to uncertainties in the spread of infectious diseases. A back-to-front by-row boarding method will be needed to relieve congestion during boarding and doing during preventive measures for infectious diseases.

An investigation of the bio-medical waste produced in India during the COVID-19 pandemic and Maharashtra state (pre-COVID-19 and post-COVID-19) analysis: a GIS-based approach

BackgroundThe COVID-19 pandemic exerted substantial pressure on global healthcare systems and facilities, putting the lives of countless individuals at risk. In addition, the treatment of patients during the pandemic resulted in an unprecedented increase in the volume of medical waste generated, including biomedical waste (BMW) or healthcare waste (HCW), which poses a risk of infectious disease transmission. As the second most populous country in the world, India faced a severe challenge in managing its healthcare waste infrastructure during this time (2020–2021). Proper disposal of BMW was of utmost importance to prevent the spread of infectious agents and to safeguard public health.MethodsThe environmental monitoring and management framework of the country is well planned and governed by the Central Pollution Control Board (CPCB), which carefully handles the BMW across the states and union territory of the country. Through the execution of Android based application named ‘COVID19BMW’, India has laid the foundation of identification, classification, data collection, and management regarding the BMW. Further, the temporal scale of BMW generation tracking was further improved from a monthly to a daily basis by using the COVID19BMW tool. This data was used to map the change taken place across the India. Additionally, by using Geographical Information System the BMW is mapped using Choropleth method.ResultsThe current study conducted a national-level analysis of BMW generated during the COVID-19 pandemic in India. The results revealed that, in the year 2020, the seven states and the National Capital Territory (NCT) of Delhi generated the highest amounts of BMW, with Gujarat, Maharashtra, Kerala, Karnataka, Tamil Nadu, Uttar Pradesh, and West Bengal being the top BMW generating states. Additionally, the change detection equation was used to map the changes. The investigation analysed the daily changes in BMW generation between 2020 and 2021 at the national level. The results indicated a significant decreasing trend of -50.35% in BMW generation per day. In the case of Maharashtra state, the change detection analysis for the pre-COVID-19 and post-COVID-19 pandemic periods showed an increased trend of approximately 32%. However, in 2021, a decreasing trend was observed, with a -2.23% reduction in BMW generation compared to 2020 on the daily basis of BMW generation. These findings suggest that the COVID-19 pandemic has influenced BMW generation of waste, and the results can provide insights for improving waste management policies and practices.DiscussionIn this study, a Geographical Information System (GIS) was employed to create a mapped representation of the BMW data at national scale. Further, the study investigated changes in BMW generation in Maharashtra state during the COVID-19 pandemic. Analysis of changes in BMW generation revealed a pattern of BMW generation during the pandemic. The use of GIS technology to track these changes proved to be a valuable tool in providing a synoptic view of the overall BMW condition across India and identifying areas where infectious waste poses a significant threat. The visualisation of data using the GIS technique provided an easy means of identifying hotspots of BMW generation, which is more effective compared to a tabular format.

Molecular Characterization of Influenza A/H3N2 Virus Isolated from Indonesian Hajj and Umrah Pilgrims 2013 to 2014.

The Hajj and Umrah are the annual mass gatherings of Muslims in Saudi Arabia and increase the transmission risk of acute respiratory infection. This study describes influenza infection among pilgrims upon arrival in Indonesia and the genetic characterization of imported influenza A/H3N2 virus. In total, 251 swab samples with influenza-like illness were tested using real-time RT-PCR for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and influenza viruses. Complete sequences of influenza A/H3N2 HA and NA genes were obtained using DNA sequencing and plotted to amino acid and antigenicity changes. Phylogenetic analysis was performed using a neighbour-joining method including the WHO vaccine strains and influenza A/H3N2 as references. The real-time RT-PCR test detected 100 (39.5%) samples positive with influenza with no positivity of MERS-CoV. Mutations in the HA gene were mainly located within the antigenic sites A, B, and D, while for the NA gene, no mutations related to oseltamivir resistance were observed. Phylogenetic analysis revealed that these viruses grouped together with clades 3C.2 and 3C.3; however, they were not closely grouped with the WHO-recommended vaccine (clades 3C.1). Sequences obtained from Hajj and Umrah pilgrims were also not grouped together with viruses from Middle East countries but clustered according to years of collection. This implies that the influenza A/H3N2 virus mutates continually across time.

Sexually Transmitted Infections Risk and Interstate Sexual Networks Among Men Who Have Sex With Men in New England.

By investigating relationships between sexual mobility and sexual transmitted infection (STI) risk factors among men who have sex with men, we found that STI history, number of sexual partners, and substance use are associated with increased odds of interstate sexual encounters, suggesting that interjurisdictional approaches to STI prevention are needed.

Undiagnosed and missed active pulmonary tuberculosis during mass gatherings: a prospective cross-sectional study from the Hajj pilgrimage

Mass gatherings increase the risk of infectious diseases transmission including tuberculosis (TB). The Hajj pilgrimage to Mecca, Saudi Arabia, is attended by over 2 million pilgrims many of whom are from high TB-burden countries, and has been linked to increased risk of TB acquisition among travellers. We investigated the burden of undiagnosed and missed active pulmonary TB (PTB) among Hajj pilgrims symptomatic for cough. The study was conducted among hospitalised and non-hospitalised travellers attending the Hajj pilgrimage in 2016 and 2017. Questionnaires were used to collect relevant data and sputum samples were collected from participants and processed using the Xpert MTB-RIF assay. Non-hospitalised pilgrims (n = 1510) originating from 16 high and medium TB-burden countries were enrolled. Undiagnosed, rifampicin-sensitive, active PTB was identified in 0.7%. Comorbidities (adjOR = 5.9 [95% CI = 1.2-27.8]), close contact with a TB case (adjOR = 5.9 [95% CI = 1.2-27.8]), cough in household (adjOR = 4.46 [95% CI = 1.1-19.5]), and previous TB treatment (adjOR = 10.1 [95% CI = 4.1-98.1]) were independent risk factors for TB. Of the hospitalised pilgrims (n = 304), 2.9% were positive for PTB, and 2.3% were missed, including a rifampicin-resistant case. History of TB treatment was associated with increased risk of TB (adjOR = 8.1 [95% CI = 1.3-48.7]). International mass gatherings may play an important role in the global epidemiology of TB. Preventive measures should be directed to reducing the risk of TB importation and transmission during Hajj and other similar events.

A Review of Basic Knowledge of HIV Infection for Orthodontic Management of HIV Patients.

Human immunodeficiency virus (HIV) is a retrovirus that causes an infection affectingimmunity-providing white blood cells. The HIV pandemic is far from over and is a major socio-economical burden. As there is no cure yet, prevention of new infections is the major path to control the infection. There is a low chance of orthodontic procedures carrying a risk ofHIV infection transmission. It is important to have knowledge about the disease to effectively and safely treat known or unknown patients with HIV.