The HIV paradox: Perinatal mortality is lower in HIV-positive mothers-A field case-control study in Ethiopia.

OBJECTIVE: Sub-Saharan African countries have the highest perinatal mortality rates. Although HIV is a risk factor for perinatal death, antioretroviral therapy (ART) programs have been associated with better outcomes. We aimed to investigate how maternal HIV affects perinatal mortality. METHODS: The authors performed a nested case-control study at Saint Luke Hospital, Wolisso, Ethiopia. Data on sociodemographic characteristics, current maternal conditions, obstetric history, and antenatal care (ANC) services utilization were collected. The association between perinatal mortality and HIV was assessed with logistic regression adjusting for potential confounders. RESULTS: A total of 3525 birthing women were enrolled, including 1175 cases and 2350 controls. Perinatal mortality was lower among HIV-positive women (18.3% vs. 33.6%, P = 0.007). Crude analysis showed a protective effect of HIV (odds ratio, 0.442 [95% confidence interval, 0.241-0.810]), which remained after adjustment (adjusted odds ratio, 0.483 [95% confidence interval, 0.246-0.947]). Among HIV-negative women, access to ANC for women from rural areas was almost half (18.8% vs. 36.2%; P < 0.001), whereas in HIV-positive women, no differences were noted (P = 0.795). CONCLUSION: Among HIV-positive mothers, perinatal mortality was halved and differences in access to ANC services by area were eliminated. These data highlight the benefits of integrating ANC and HIV services in promoting access to the health care system, reducing inequalities and improving neonatal mortality.

Evaluating the presence of SARS-CoV-2 RNA in the particulate matters during the peak of COVID-19 in Padua, northern Italy.

The airborne transmission of SARS-CoV-2, the etiologic agent of the current COVID-19 pandemic, has been hypothesized as one of the primary routes of transmission. Current data suggest a low probability of airborne transmission of the virus in open environments and a higher probability in closed ones, particularly in hospitals or quarantine facilities. However, the potential diffusion of the virus in open environments, especially using particulate matter (PM) as a transport carrier, generated concern in the exposed populations. Several authors found a correlation between the exceeding of the PM10 concentration limits in some Italian cities and the prevalence of Covid-19 cases detected in those areas. This study investigated the potential presence of SARS-COV-2 RNA on a representative series of PM samples collected in the province of Padua in Northeastern Italy during the first wave of COVID pandemic. Forty-four samples of PM2.5 and PM10 were collected between February 24 and March 9, 2020 and analyzed with RT-qPCR for SARS-CoV-2 RNA. The experimental results did not indicate the presence of SARS-CoV-2 RNA in the outdoor PMs, thus confirming the low probability of virus airborne transmission through PM.

Holistic model-based monitoring of the human health status in an urban environment system: pilot study in Verona city, Italy.

INTRODUCTION: In recent decades the global health paradigm gained an increasing systemic characterization. The ecosystem health theory states that a healthy ecosystem, whether natural or artificial, significantly contributes to the good health status of the human population. METHODS: The present study describes an interdisciplinary monitoring model that retrospectively analyzes the intersection between the urban environment and citizens. The model analyzes both the biophysical and the anthropic subsystems through the application of landscape ecology and environmental quality indexes along with human health indicators. Particularly, ecological quality of landscape pattern, atmospheric pollution, outdoor noise levels and local health indicators were assessed. Verona municipality was chosen as study area to test the preliminary efficiency of the model. Territory was split into two superimposed layers of land units, which were further geo-referentiated with Geographical Information System (GIS) technology. Interdependence of any of the analyzed traits was further investigated with Fisher exact test. RESULTS: Landscape composition was assessed and an Average Ecological Quality (AEQ) score assigned to each land unit. A direct proportionality emerged for concentrations of considered air pollutants and traffic levels: a spatial model for the atmospheric pollution was drawn. A map depicting the distribution of traffic-related noise levels was also drawn. From chosen indicators, a quality class score was assigned to every minor and major land unit. Age-standardised rates about hospitalizations for the municipal population and specific rates for the over-65s/1000 inhabitants were calculated. Quality class assignement for each health indicator was graphically rendered. After direct standardisation of rates for the population sample, data were compared with two reference populations, the Regional population and the Local Socio-sanitary Unit (ULSS20) population. Standardised hospitalization rates for the whole municipal population always resulted lower than the ULSS20 rates, except for auditory pathologies. It was notable that rates of hospitalizations for cancerous diseases for Verona municipal population were four times and two times lower than the ULSS20 and the Regional population ones, respectively. Contingency table were made for the health main indicator (specific rates for the over-65s/1000 inhabitants) and the environmental quality key factors of landscape ecological quality, outdoor noise level and air pollution. H0 of independence was rejected for respiratory pathologies and air pollution and for the triad cardiocirculatory pathologies, air pollution and landscape ecological quality at (a = 0.05). Fisher exact test confirmed the non-independence of cardiocirculatory diseases and biophysical environment and the analogous association for respiratory pathologies when comparison was made with global environmental quality index. DISCUSSION: The first testing of the model suggests some possible elements of implementation and integration which could further enhance it. Among them, the subjective investigation of the health status assumes a primary role. On the whole the monitoring model seems to effectively represent the real complexity of the urban environment systems and should be regarded as an important contribution to the new way of health research.