The epidemiological characterization and geographic distribution of hepatitis D virus infection in Libya.

INTRODUCTION: North Africa is known to be endemic for hepatitis D virus. However, data one the prevalence of this virus in Libya are scanty. This study aimed to determine the prevalence of hepatitis D virus infection in Libya and analyze the demographic factors associated with the infection, and also to assess the variations across the regions and districts. METHODS: A total of 1873 samples collected from all over the country were tested for antibodies against hepatitis B surface antigen and the results were correlated with demographic and geographic variables. RESULTS: The overall prevalence of hepatitis D virus infection was 1.7%. The prevalence rate was significantly high among those aged over 40 years (P < 0.001) and it was associated with intravenous drug use and coinfection with human immunodeficiency virus and/or hepatitis C virus infection (P < 0.001). The prevalence rates varied with geographic location and differed markedly within the regions the country. The highest rate reported was in the central region of Libya, followed by the western and eastern regions. CONCLUSION: Hepatitis D virus infection rate in Libya is considered to be low but is of some concern in some districts. This has been propagated by population displacement and African immigrants, indicating that a continuous epidemiological surveillance program should be implemented.

Spatiotemporal analysis and epidemiological characterization of the human immunodeficiency virus (HIV) in Libya within a twenty five year period: 1993-2017.

BACKGROUND: Infection with the human immunodeficiency virus (HIV) is an alarming problem in North African countries, but few studies have analyzed the geographical distribution of the epidemic. Libya, the second largest country in Africa and with the longest coast on the Mediterranean basin facing Europe, has experienced major outbreaks of HIV infection. Since then, no studies have followed up on the burden of HIV infections. To plan interventions and allocate resources, spatial analysis of HIV/AIDS clusters are required in order to identify epidemic foci and trends in the country. The objective of this study was to assess HIV infection clustering and trends in Libya. METHODS: Information on all recorded HIV/AIDS cases during 1993-2017 were extracted from the National Reporting System. A total of 8015 newly diagnosed HIV cases with address information were included. Spatial autocorrelation and spatial-temporal analysis were used to identify HIV clusters. Spatial correlations between cases and socio-demographic factors were determined using spatial regression. RESULTS: HIV cases steadily increased within the Libyan population, particularly among those aged < 27 years. Spatiotemporal analysis showed marked geographic and temporal variation of HIV infection, particularly during 2005-2012. The risk factors varied from one region to another, and the contribution of injection drug use to infection increased with time. Four clusters in three time periods were identified, three on the Mediterranean coast and one in the south. CONCLUSION: HIV is an emerging problem in Libya, particularly among young adults. The infection rate varies greatly among the regions and districts, particularly within certain definable geographical areas. Effective intervention strategies are needed to contain HIV infections, especially within the endemic areas.

A TRAINING PROGRAM FOR NURSING STAFF REGARDING BLOOD PARASITES ACQUIRED BY NEEDLE STICK INJURY IN A MILITARY HOSPITAL.

Nurses are likely to be exposed to microorganisms during their daily practice due to their close and frequent direct contact with patients. This could be one of the main causes of transmitting infection to the patients. Therefore, nurses should demonstrate the ability to effectively utilize principles of infection control, nurses should have professional and ethical responsibilities to make sure that their knowledge and skills regarding infection control are up-to-date and they practice safely and competently at all times. AIM: At assessing the effect of a training program for Military nursing staff knowledge, performance and attitude related to blood parasites acquired by needle stick injury. SETTING: The study was carried out at two military hospitals. Design An interventional study (pre-post study) was used. SUBJECT: The studied subjects were 90 nursing staff who accepted to participate in the study (10) of them pilot study were excluded from the study sample, (30) from The Military Fever Hospital and (50) from The Military General Hospital. Tools: The study tools used were composed of five tools as follows: (1) Educational needs assessment tool. (2) Knowledge questionnaire sheet (pre / post-test) (3) Observation check list (4) Attitude tool and (5) Participants 'evaluation Questionnaire sheet. RESULTS: Educational the intervention showed statistically significant improvements in nursing staff knowledge, performance and attitude. RECOMMENDATION: Continues training programs about blood parasites acquired by needle stick injury must be developed and provided on regular basis, this will enable nursing staff to improve their knowledge, performance and attitude about blood parasites acquired by needle stick injury.

MALARIA: A GENERAL MINIREVIEW WITH REFERENCE TO EGYPT.

The majority of world's population-live in areas at risk of malaria transmission. Malaria is a serious Anopheles-borne disease that pauses symptoms like the flu, as a high fever, chills, and muscle pain also, anemia, bloody stools, coma, convulsion, fever, headache, jaundice, nausea, sweating and vomiting. Symptoms tend to come and go in cycles. Apart from Anopheles vector, malaria could be transmitted nosocomial, blood transfusion or needle-stick injury Some types of malaria may cause more serious damage problems to heart, lungs, kidneys, or brain. These types can be deadly. The primary factors contributing to the resurgence of malaria are the appearance of drug-resistant strains of the parasite, the spread of insecticide-resistant strains of the mosquito and the lack of licensed malaria vaccines of proven efficacy. In rare cases, people can get malaria if they come into contact with infected blood as in blood transfusion or needle-stick injury also nosocomial and congenital malaria was reported. This is a mini-review of malaria with information on the lethal to humans, Plasmodium falciparum, together with other recent developments in the field.

Abdominal Obesity Indicators: Waist Circumference or Waist-to-hip Ratio in Malaysian Adults Population.

BACKGROUND: Waist circumference (WC) is an accurate and simple measure of abdominal obesity as compared to waist-hip ratio (WHR). The aim of this study was to determine the correlation between body mass index (BMI) with WC and WHR and suggest cutoff points for WC among Rural Malaysian adults. METHODS: A cross-sectional study was conducted among 669 respondents from three villages in Tanjung Karang, located in the district of Kuala Selangor. Data collection was carried out by guided questionnaires and anthropometric measures. RESULTS: The prevalence of abdominal obesity for BMI was almost similar for both gender across Caucasian and Asian BMI cutoff points. Based on Caucasian cutoff points, the prevalence of abdominal obesity for WC was 23.8% (male) and 66.4% (female) while for WHR was 6.2% (male) and 54.2% (female). Asian cutoff points gave higher prevalence of abdominal obesity compared to that of WC among male respondents and WHR for both genders. WC showed strong and positive correlation with BMI compared to WHR (in male WC r = 0.78, WHR r = 0.24 and in female WC r = 0.72, WHR r = 0.19; P < 0.001). Receiver operating characteristic curve analysis suggested WC cutoff points of 92.5 cm in men and 85.5 cm in women is the optimal number for detection of abdominal obesity. CONCLUSIONS: WC is the best indicator as compared with WHR for abdominal obesity for Malaysian adults.

HUMAN BABESIOSIS: A GENERAL REVIEW WITH SPECIAL REFERENCE TO EGYPT.

Babesiosis is a tick-borne malaria-like illness caused by species of the intra-erythrocytic protozoan Babesia. Humans are opportunistic hosts for Babesia when bitten by nymph or adult ticks. Currently, Babesia infection is transmitted by various tick vectors in Europe, Asia, Africa and the northwestern and northeastern United States. Human babesiosis was first described in 1957 but is now known to have worldwide distribution. The increase in reported cases is likely due to increases in actual incidence as well as increased awareness of the disease. Despite the diagnostic and preventive advances resulting from extensive research and a greater understanding of the disease, babesiosis continues to have significant medical impact as a confounding variable in the diagnosis and treatment of Lyme disease and as a potential threat to the blood supply, especially in the United States. Diagnostic advances, like the development of PCR assays, have resulted in increased sensitivity for detection as well as the discovery and characterization of new babesial species. Further studies using the molecular tools now available and those to be developed will lead to a better understanding of the natural history of these organisms, including the transmission cycle and the, potential role of Babesia parasites themselves as immunomodulAtor. Human babesiosis is usually an asymptomatic infection in healthy individuals. Several patients become symptomatic, and, within these subpopulations, significant morbidity and mortality occur, especially in elderly, immunocompromised, or asplenic patients. It is difficult to diagnose. Although the index of suspicion should be high in rural Babesia endemic areas, patients with babesiosis have few, if any, localizing signs to suggest the disease. Diagnosis confirmation depends on the parasitemia degree, the expertise and well trained laboratory personnel. Most patients infected by B microti who are otherwise healthy appear to have a mild illness and typically recover without specific chemotherapy; however, treatment is recommended for all diagnosed cases to prevent sequelae and potential transmission through blood donation. In addition, patients should be advised to take precautions against tick exposure and to refrain from donating blood until completely cured of babesiosis.