Recent increase of ulcerative lesions caused by Anisakis spp. in cetaceans from the north-east Atlantic.

Species of Anisakis typically infect the stomach of cetaceans worldwide, often causing ulcerative lesions that may compromise the host's health. These nematodes also cause anisakiasis or allergic reactions in humans. To assess the risks of this emerging zoonosis, data on long-term changes in Anisakis infections in cetaceans are necessary. Here, we compare the prevalence and severity of ulcerative lesions caused by Anisakis spp. in five cetacean species stranded along the north-west Spanish coast in 2017-2018 with published data from 1991-1996. Open ulcers were found in 32/43 short-beaked common dolphins, Delphinus delphis; 3/5 striped dolphins, Stenella coeruleoalba; 1/7 bottlenose dolphins, Tursiops truncatus; and 1/3 harbour porpoises, Phocoena phocoena meridionalis; a single individual of long-finned pilot whale, Globicephala melas, was found uninfected. In common dolphins, the mean abundance of open ulcers per host was 1.1 (95% confidence interval: 0.8-1.3), with a maximum diameter (mean ± standard deviation) of 25.4 ± 16.9 mm. Stomachs with scars or extensive fibrosis putatively associated with Anisakis were detected in 14 and five animals, respectively. A molecular analysis based on the mitochondrial cytochrome c oxidase II gene using 18 worms from three cetacean species revealed single or mixed infections of Anisakis simplex sensu stricto and Anisakis pegreffii. Compared with the period 1991-1996, we found a strong increase of prevalence, abundance and extension of ulcerative lesions in most cetacean species. Anisakis populations could have increased in the study area over the last decades, although we cannot rule out that a higher environmental stress has also boosted the pathological effects of these parasites.

A Potential Role for the STXBP5-AS1 Gene in Adult ADHD Symptoms.

We aimed to detect Attention-deficit/hyperactivity (ADHD) risk-conferring genes in adults. In children, ADHD is characterized by age-inappropriate levels of inattention and/or hyperactivity-impulsivity and may persists into adulthood. Childhood and adulthood ADHD are heritable, and are thought to represent the clinical extreme of a continuous distribution of ADHD symptoms in the general population. We aimed to leverage the power of studies of quantitative ADHD symptoms in adults who were genotyped. Within the SAGA (Study of ADHD trait genetics in adults) consortium, we estimated the single nucleotide polymorphism (SNP)-based heritability of quantitative self-reported ADHD symptoms and carried out a genome-wide association meta-analysis in nine adult population-based and case-only cohorts of adults. A total of n = 14,689 individuals were included. In two of the SAGA cohorts we found a significant SNP-based heritability for self-rated ADHD symptom scores of respectively 15% (n = 3656) and 30% (n = 1841). The top hit of the genome-wide meta-analysis (SNP rs12661753; p-value = 3.02 × 10-7) was present in the long non-coding RNA gene STXBP5-AS1. This association was also observed in a meta-analysis of childhood ADHD symptom scores in eight population-based pediatric cohorts from the Early Genetics and Lifecourse Epidemiology (EAGLE) ADHD consortium (n = 14,776). Genome-wide meta-analysis of the SAGA and EAGLE data (n = 29,465) increased the strength of the association with the SNP rs12661753. In human HEK293 cells, expression of STXBP5-AS1 enhanced the expression of a reporter construct of STXBP5, a gene known to be involved in "SNAP" (Soluble NSF attachment protein) Receptor" (SNARE) complex formation. In mouse strains featuring different levels of impulsivity, transcript levels in the prefrontal cortex of the mouse ortholog Gm28905 strongly correlated negatively with motor impulsivity as measured in the five choice serial reaction time task (r2 = - 0.61; p = 0.004). Our results are consistent with an effect of the STXBP5-AS1 gene on ADHD symptom scores distribution and point to a possible biological mechanism, other than antisense RNA inhibition, involved in ADHD-related impulsivity levels.

Pathways to smoking behaviours: biological insights from the Tobacco and Genetics Consortium meta-analysis.

By running gene and pathway analyses for several smoking behaviours in the Tobacco and Genetics Consortium (TAG) sample of 74 053 individuals, 21 genes and several chains of biological pathways were implicated. Analyses were carried out using the HYbrid Set-based Test (HYST) as implemented in the Knowledge-based mining system for Genome-wide Genetic studies software. Fifteen genes are novel and were not detected with the single nucleotide polymorphism-based approach in the original TAG analysis. For quantity smoked, 14 genes passed the false discovery rate of 0.05 (corrected for multiple testing), with the top association signal located at the IREB2 gene (P=1.57E-37). Three genomic loci were significantly associated with ever smoked. The top signal is located at the noncoding antisense RNA transcript BDNF-AS (P=6.25E-07) on 11p14. The SLC25A21 gene (P=2.09E-08) yielded the top association signal in the analysis of smoking cessation. The 19q13 noncoding RNA locus exceeded the genome-wide significance in the analysis of age at initiation (P=1.33E-06). Pathways belonging to the Neuronal system pathways, harbouring the nicotinic acetylcholine receptor genes expressing the α (CHRNA 1-9), ß (CHRNB 1-4), γ, δ and ɛ subunits, yielded the smallest P-values in the pathway analysis of the quantity smoked (lowest P=4.90E-42). Additionally, pathways belonging to 'a subway map of cancer pathways' regulating the cell cycle, mitotic DNA replication, axon growth and synaptic plasticity were found significantly enriched for genetic variants in ever smokers relative to never smokers (lowest P=1.61E-07). In addition, these pathways were also significantly associated with the quantity smoked (lowest P=4.28E-17). Our results shed light on one of the world's leading causes of preventable death and open a path to potential therapeutic targets. These results are informative in decoding the biological bases of other disease traits, such as depression and cancers, with which smoking shares genetic vulnerabilities.

Pneumolysin activates neutrophil extracellular trap formation.

The primary objective of the current study was to investigate the potential of the pneumococcal toxin, pneumolysin (Ply), to activate neutrophil extracellular trap (NET) formation in vitro. Isolated human blood neutrophils were exposed to recombinant Ply (5-20 ng ml(-1) ) for 30-90 min at 37°C and NET formation measured using the following procedures to detect extracellular DNA: (i) flow cytometry using Vybrant® DyeCycle™ Ruby; (ii) spectrofluorimetry using the fluorophore, Sytox(®) Orange (5 µM); and (iii) NanoDrop(®) technology. These procedures were complemented by fluorescence microscopy using 4', 6-diamino-2-phenylindole (DAPI) (nuclear stain) in combination with anti-citrullinated histone monoclonal antibodies to visualize nets. Exposure of neutrophils to Ply resulted in relatively rapid (detected within 30-60 min), statistically significant (P < 0·05) dose- and time-related increases in the release of cellular DNA impregnated with both citrullinated histone and myeloperoxidase. Microscopy revealed that NETosis appeared to be restricted to a subpopulation of neutrophils, the numbers of NET-forming cells in the control and Ply-treated systems (10 and 20 ng ml(-1) ) were 4·3 (4·2), 14.3 (9·9) and 16·5 (7·5), respectively (n = 4, P < 0·0001 for comparison of the control with both Ply-treated systems). Ply-induced NETosis occurred in the setting of retention of cell viability, and apparent lack of involvement of reactive oxygen species and Toll-like receptor 4. In conclusion, Ply induces vital NETosis in human neutrophils, a process which may either contribute to host defence or worsen disease severity, depending on the intensity of the inflammatory response during pneumococcal infection.

Advanced wound healing in a patient with transmetatarsal amputation caused by severe diabetic foot infection: A case report.

Introduction and importance: Diabetic foot accounts for 50% to 95 % of non-traumatic amputations. The healing process of a surgical wound resulting from amputation in the diabetic foot is complex, and it is difficult to achieve an optimal outcome, which should include obtaining a functional stump for the patient. Healing is mainly hindered by infection, vascular disease, and wound size. In turn, biofilm formation significantly delays the healing process, increasing morbidity and impairing the amputee's quality of life. Case presentation: This study analyzes the case of an 80-year-old male patient with diabetes who had failed to respond to previous treatment on an infected wound from a transmetatarsal amputation. The new treatment involved spraying the wound with silver sulfadiazine, lidocaine, and vitamin A aerosol and covering it with gauze dressings soaked in silver sulfadiazine, lidocaine, and vitamin A. The case evolution indicators used were total wound area, percentage of granulation tissue, wound perimeter, and maximum distance between the wound edges. A 3D simulation was also used to assess the wound bed. Clinical Discussion: Biofilm is linked to slower wound healing and wound chronicity, as this community of microorganisms in the wound slows down healing even when there are no apparent signs of infection. Therefore, treatment should be geared toward preventing contamination from leading to biofilm formation. Conclusion: Our results show that silver sulfadiazine, lidocaine, vitamin A gauze dressings, and aerosol have promoted fast and effective healing in a diabetic patient with a wound at high risk of greater amputation.

Spike-timing-dependent plasticity and reliability optimization: the role of neuron dynamics.

Plastic changes in synaptic efficacy can depend on the time ordering of presynaptic and postsynaptic spikes. This phenomenon is called spike-timing-dependent plasticity (STDP). One of the most striking aspects of this plasticity mechanism is that the STDP windows display a great variety of forms in different parts of the nervous system. We explore this issue from a theoretical point of view. We choose as the optimization principle the minimization of conditional entropy or maximization of reliability in the transmission of information. We apply this principle to two types of postsynaptic dynamics, designated type I and type II. The first is characterized as being an integrator, while the second is a resonator. We find that, depending on the parameters of the models, the optimization principle can give rise to a wide variety of STDP windows, such as antisymmetric Hebbian, predominantly depressing or symmetric with one positive region and two lateral negative regions. We can relate each of these forms to the dynamical behavior of the different models. We also propose experimental tests to assess the validity of the optimization principle.

Nonossifying fibroma in the mandible of a goat.

An 8-year-old male Nubian goat was presented with a peracute history of straining to urinate and unilateral mandibular swelling. At necropsy, the rostral half body of the left mandible was distorted by fusiform swelling that, on sagittal section, had marked medullary bone loss and replacement with a well-demarcated fibrous mass. Histologically, the mass comprised streaming spindloid cells with whorls and storiform patterns, interspersed with numerous multinucleated giant cells. Bone formation was not present in the neoplasm. The mandibular mass was diagnosed as nonossifying fibroma, a relatively common tumor in children but seldom reported in domestic animals.

Recommended guidelines for submission, trimming, margin evaluation, and reporting of tumor biopsy specimens in veterinary surgical pathology.

Neoplastic diseases are typically diagnosed by biopsy and histopathological evaluation. The pathology report is key in determining prognosis, therapeutic decisions, and overall case management and therefore requires diagnostic accuracy, completeness, and clarity. Successful management relies on collaboration between clinical veterinarians, oncologists, and pathologists. To date there has been no standardized approach or guideline for the submission, trimming, margin evaluation, or reporting of neoplastic biopsy specimens in veterinary medicine. To address this issue, a committee consisting of veterinary pathologists and oncologists was established under the auspices of the American College of Veterinary Pathologists Oncology Committee. These consensus guidelines were subsequently reviewed and endorsed by a large international group of veterinary pathologists. These recommended guidelines are not mandated but rather exist to help clinicians and veterinary pathologists optimally handle neoplastic biopsy samples. Many of these guidelines represent the collective experience of the committee members and consensus group when assessing neoplastic lesions from veterinary patients but have not met the rigors of definitive scientific study and investigation. These questions of technique, analysis, and evaluation should be put through formal scrutiny in rigorous clinical studies in the near future so that more definitive guidelines can be derived.

Ketone body 3-hydroxybutyrate as a biomarker of aggression.

Human aggression is a complex behaviour, the biological underpinnings of which remain poorly known. To gain insights into aggression biology, we studied relationships with aggression of 11 low-molecular-weight metabolites (amino acids, ketone bodies), processed using 1H nuclear magnetic resonance spectroscopy. We used a discovery sample of young adults and an independent adult replication sample. We studied 725 young adults from a population-based Finnish twin cohort born 1983-1987, with aggression levels rated in adolescence (ages 12, 14, 17) by multiple raters and blood plasma samples at age 22. Linear regression models specified metabolites as the response variable and aggression ratings as predictor variables, and included several potential confounders. All metabolites showed low correlations with aggression, with only one-3-hydroxybutyrate, a ketone body produced during fasting-showing significant (negative) associations with aggression. Effect sizes for different raters were generally similar in magnitude, while teacher-rated (age 12) and self-rated (age 14) aggression were both significant predictors of 3-hydroxybutyrate in multi-rater models. In an independent replication sample of 960 adults from the Netherlands Twin Register, higher aggression (self-rated) was also related to lower levels of 3-hydroxybutyrate. These exploratory epidemiologic results warrant further studies on the role of ketone metabolism in aggression.

Hebbian plasticity and homeostasis in a model of hypercolumn of the visual cortex.

Neurons in the nervous system display a wide variety of plasticity processes. Among them are covariance-based rules and homeostatic plasticity. By themselves, the first ones tend to generate instabilities because of the unbounded potentiation of synapses. The second ones tend to stabilize the system by setting a target for the postsynaptic firing rate. In this work, we analyze the combined effect of these two mechanisms in a simple model of hypercolumn of the visual cortex. We find that the presence of homeostatic plasticity together with nonplastic uniform inhibition stabilizes the effect of Hebbian plasticity. The system can reach nontrivial solutions, where the recurrent intracortical connections are strongly modulated. The modulation is strong enough to generate contrast invariance. Moreover, this state can be reached even beginning from a weakly modulated initial condition.

The distal sesamoidean impar ligament: comparison between its appearance on magnetic resonance imaging and histology of the axial third of the ligament.

REASONS FOR PERFORMING STUDY: There is limited knowledge about the interpretation of alterations in the distal sesamoidean impar ligament (DSIL) detected using magnetic resonance imaging (MRI) and their correlation with histopathology. HYPOTHESES: There would be: 1) a correlation between histopathology and MRI findings; and 2) a relationship between MR abnormalities at the origin and the insertion of the DSIL, between insertion and body; and origin and body. METHODS: Fifty limbs from 28 horses were examined using high-field MRI and histopathology. MR abnormalities of the DSIL, its origin on the navicular bone and its insertion on the distal phalanx were graded. Sections of the axial third of the DSIL were examined histologically and graded according to fibre orientation, integrity of fibroblasts, collagen architecture and vascularity. Associations between MRI and histology findings were tested by Spearman rank correlation and Chi-squared tests. RESULTS: There were significant correlations between the presence of a cystic structure in the distal third of the navicular bone, or a distal border fragment, or increased signal intensity in fat suppressed images at the insertion of the DSIL on the distal phalanx and the histological grade of the body of the DSIL. There were significant associations between a cystic structure in the distal third of the navicular bone and the presence of either a distal border fragment or entheseous new bone at the insertion of the DSIL, swelling of the DSIL and increased signal intensity in the DSIL in fat suppressed images; between distal elongation of the flexor border of the navicular bone and the presence of one or more distal border fragments and between swelling of the body of the DSIL and irregularity of its palmar border or increased signal intensity in fat suppressed images in the DSIL. CONCLUSIONS AND CLINICAL RELEVANCE: The presence of a cystic structure in the distal third of the navicular bone detected using MRI, a distal border fragment or increased signal intensity at the insertion of the DSIL are suggestive of significant alterations in the infrastructure of the DSIL.

Evidence for both prelysosomal and lysosomal intermediates in endocytic pathways.

Horseradish peroxidase (HRP), an enzyme internalized by fluid phase pinocytosis, has been used to study the process by which pinosome contents are delivered to lysosomes in Chinese hamster ovary cells. Pinosome contents were labeled by allowing cells to internalize HRP for 3-5 min. Following various chase times, cells were either processed for HRP and acid phosphatase (AcPase) cytochemistry or homogenized and fractionated in Percoll gradients. In Percoll gradients, pinosomes labeled by a 3-5 min HRP pulse behaved as a vesicle population more dense than plasma membrane and less dense than lysosomes. In pulse-chase experiments, internalized HRP was chased rapidly (3-6 min chase) to a density position intermediate between the "initial" pinocytic vesicle population and lysosomes. With longer chase periods, a progressive accumulation of HRP in more dense vesicles was observed. Correspondence between the HRP distribution and lysosomal marker distribution was reached after a approximately 1-h chase. By electron microscope cytochemistry of intact cells, the predominant class of HRP-positive vesicles after pulse uptakes or a 3-min chase period was characterized by a peripheral rim of reaction product and was AcPase negative. After 10-120-min chase periods, the predominant class of HRP-positive vesicles was characterized by luminal deposits and HRP activity was frequently observed in multivesicular bodies. HRP-positive vesicles after a 10- or 30-min chase were AcPase-positive. No HRP activity was detected in Golgi apparatus. Together these observations indicate that progressive processing of vesicular components of the vacuolar apparatus occurs at both a prelysosomal and lysosomal stage.

Advances in measurement science.

Year after year, physicists measure various quantities with increasing accuracy and see various objects in increasing detail. These advances are vital, because science's understanding of the physical world is necessarily limited by the accuracy with which science can measure that world. The Instrument and Measurement Science Topical Group of the American Physical Society sponsored several symposia at the recent APS March meeting in New Orleans that discussed recent advances in measurement and observation.

Turning down the heat on thin films.

Superconducting thin films will be essential to any practical application of superconductivity to microelectronics. Scientists have now succeeded in putting these thin films onto silicon, which is the base element in most integrated circuits.

Accelerated ray tracing for radiotherapy dose calculations on a GPU.

PURPOSE: The graphical processing unit (GPU) on modern graphics cards offers the possibility of accelerating arithmetically intensive tasks. By splitting the work into a large number of independent jobs, order-of-magnitude speedups are reported. In this article, the possible speedup of PLATO's ray tracing algorithm for dose calculations using a GPU is investigated. METHODS: A GPU version of the ray tracing algorithm was implemented using NVIDIA's CUDA, which extends the standard C language with functionality to program graphics cards. The developed algorithm was compared based on the accuracy and speed to a multithreaded version of the PLATO ray tracing algorithm. This comparison was performed for three test geometries, a phantom and two radiotherapy planning CT datasets (a pelvic and a head-and-neck case). For each geometry, four different source positions were evaluated. In addition to this, for the head-and-neck case also a vertex field was evaluated. RESULTS: The GPU algorithm was proven to be more accurate than the PLATO algorithm by elimination of the look-up table for z indices that introduces discretization errors in the reference algorithm. Speedups for ray tracing were found to be in the range of 2.1-10.1, relative to the multithreaded PLATO algorithm running four threads. For dose calculations the speedup measured was in the range of 1.5-6.2. For the speedup of both the ray tracing and the dose calculation, a strong dependency on the tested geometry was found. This dependency is related to the fraction of air within the patient's bounding box resulting in idle threads. CONCLUSIONS: With the use of a GPU, ray tracing for dose calculations can be performed accurately in considerably less time. Ray tracing was accelerated, on average, with a factor of 6 for the evaluated cases. Dose calculation for a single beam can typically be carried out in 0.6-0.9 s for clinically realistic datasets. These findings can be used in conventional planning to enable (nearly) real-time dose calculations. Also the importance for treatment optimization techniques is evident.

Changes to articular cartilage following remote application of radiofrequency energy and with or without Cosequin therapy.

OBJECTIVE: To determine the short- and long-term changes in the biomechanical properties and metabolic activity of articular cartilage following the remote application of bipolar radiofrequency (bRF) and monopolar radiofrequency (mRF) energy within the rabbit stifle joint. METHODS: The rabbits were randomly assigned to either Group-1 (normal rabbit food), or they were assigned to Group-2 (2% Cosequin in the diet). Each rabbit underwent bilateral stifle arthroscopy with either bRF or mRF applied to the infrapatellar fat pad for 45 seconds. Cartilage samples were collected at zero, four, and 14 weeks after surgery. Data were analyzed with a mixed model analysis of variance (ANOVA) for chondrocyte death, amount of GAG synthesis, and the equilibrium compressive modulus. RESULTS: A significant increase in histological damage was noted at weeks four and 14 compared to week zero. Most of the chondrocyte death noted with confocal laser microscopy (49 of 56 samples) was noted in the superficial region (outer 25%) of the articular cartilage. GAG synthesis was not significantly different between groups or devices at any time point. A significant difference was not noted in equilibrium compressive modulus throughout the study. CONCLUSIONS: Remote application of bRF and mRF energy lead to immediate chondrocyte death. Most of the damage was superficial hence the metabolic activity and biomechanical properties of the extracellular matrix were maintained throughout this study. Treatment with Cosequin did not prevent superficial chondrocyte death caused by the application of radiofrequency (RF) energy with in the joint.

Osteoblastoma in the Distal Humerus of a Cat.

A 7-year-old neutered male domestic shorthair cat was presented with chronic lameness in the right forelimb. A cystic bony lesion was identified in the distal right humerus and amputation was performed. The epiphyseal trabecular bones of the capitulum and trochlea was replaced by a tan to pink, expansile mass that was surrounded by a thin rim of cortical bone. Microscopically, the tumour was composed of a bland, osteoid producing spindle cell population within a well-vascularized fibrous stroma. Radiographical and histological features were consistent with osteoblastoma. Osteoblastoma and the related osteoid osteoma are uncommon, benign osteoblastic tumours that are reported rarely in animals. These tumours should be considered as differential diagnoses for slow growing, cystic bony lesions in cats.

The role of partnership dynamics in determining the acceptability of condoms and microbicides.

Microbicides are a class of substances under development that could reduce the sexual transmission of HIV and other sexually transmitted diseases when applied locally to genital mucosal surfaces. Microbicide acceptability research has largely focused on product characteristics, rather than processes of negotiation within relationships about use. Gender relations, decision-making power and communication within sexual relationships are recognised as important determinants of condom and contraceptive use, and are likely to determine microbicide use also. As part of social science research linked to the Microbicides Development Programme (MDP) we combine relationship-based theories with anthropological work conducted with women and men using a placebo gel. We explore communication and decision-making in gel and condom use, including constructions of risk and trust. During the MDP301 Phase III pilot study, in-depth interviews were conducted at sites in South Africa, Tanzania, Uganda and Zambia. Following four weeks of placebo gel use, women and their partners were asked about gel use and acceptability, partner involvement, sexual practices and condom use. Data from 45 couples at five sites were analysed using a grounded theory approach in NVivo. Participation in the study did not require women to inform their partners, yet our data shows women seeking permission from their partners, negotiating disclosure, exchanging information and persuading or motivating for gel use. Although gel was supposedly 'woman-controlled', men exercised considerable influence in determining whether and how it was used. Despite this, negotiations around use were largely successful, since the gel increased sexual pleasure and provided opportunities for intimate communication and the building of trust. Decisions about condom and microbicide use are made in a dyadic context and involve a complex negotiation of risk and trust. Whilst preferences relating to product characteristics are largely individual, use itself is dependent on partnership dynamics and the broader social context in which sexual risk management occurs.

Application of the AMLprofiler Diagnostic Microarray in the South African Setting.

Acute myeloid leukemia (AML) is characterized by proliferation of the myeloid lineage and accumulation of immature hematopoietic cells in the bone marrow and is typified by marked heterogeneity both in response to treatment and survival. AMLprofiler is a qualitative in vitro diagnostic microarray incorporating seven molecular biomarkers used to diagnose and predict posttherapy survival rates. In this study, we compared AMLprofiler to routine AML diagnostic methodologies employed in South Africa, focusing on consistency of the results, cost, and time to result. RNA was isolated from bone marrow and peripheral blood samples from patients with de novo AML and was processed using Affymetrix Gene Profiling Reagent kits. The results from AMLprofiler and standard methodologies were highly comparable. In addition, many samples were determined to be positive for biomarkers not routinely investigated in South Africa, namely, CEBPA double mutants, NPM1 variants, and altered expression levels of BAALC and EVI1. 38% of samples presented with no positive biomarker; AMLprofiler nonetheless enabled 26% of AML patients to be classified into either favorable or poor prognostic categories. This study highlights the comprehensive nature of the microarray. Decreased time to result and refinement of risk stratification are notable benefits.

Perceptions and experiences of tuberculosis among African patients attending a tuberculosis clinic in London.

SETTING: Little is known of the social and cultural issues influencing the uptake of and attitudes to tuberculosis (TB) care by people of African extraction living in the UK. OBJECTIVE: To describe the perceptions and experiences of African patients with TB in London, focusing on issues relating to diagnosis, treatment adherence and stigma. DESIGN: Qualitative study using in-depth interviews. RESULTS: Misinterpretation of early symptoms led to delays in seeking health care. Although half of the respondents reported denial of the diagnosis, they reported good treatment adherence, noting the role of TB specialist nurses in promoting adherence. Respondents felt stigmatised by the diagnosis, although actual experiences of stigma were rare. Experience of TB in a known person mitigated stigma. Human immunodeficiency virus (HIV) disease was perceived to have worsened TB stigma, and most patients offered HIV testing initially declined, fearing stigmatisation and poor illness outcomes if positive. CONCLUSIONS: Awareness of TB can be improved among migrants at high risk of developing the disease and among health professionals. Counselling around HIV testing for TB patients must take their beliefs into account if a high uptake of testing is to be achieved.