Psychosocial and Cultural Processes Underlying the Epidemiological Paradox within U.S. Latino Sexual Risk: A Systematic Review.

According to the epidemiological paradox, less acculturated Latina/o youth display fewer sexual risk behaviors. A systematic review was performed on psychosocial and cultural mechanisms potentially underlying the epidemiological paradox in sexual risk behaviors of U.S. Latina/o youth across acculturation measures (between January 2000 to October 2022). Thirty-five publications (n = 35) with forty-eight analyses of underlying mechanisms met the inclusion criteria. Thirty-one results from twenty-three publications found supporting evidence that one of the five factors was an underlying mechanism in the epidemiological paradox (n = 13 parenting practices, n = 4 peer influences, n = 4 familismo values, n = 4 religiosity, n = 6 traditional gender norms) as, generally protective, mediators or moderators in the link between acculturation and sexual risk behaviors. Studies varied in the sexual risk behavior examined and measurement of acculturation, but primarily employed cross-sectional designs and recruited samples through schools. Mechanisms that enhance close ties and unity of the family, such as those of familismo values and positive parenting, reduce the likelihood of sexual risk behaviors as Latina/o youth become more acculturated. Future directions are discussed which may provide guidance for risk prevention and intervention.

Mycobacterium riyadhense in Saudi Arabia.

We explored in detail the nationwide existence of Mycobacterium riyadhense in Saudi Arabia. In 18 months, 12 new cases of M. riyadhense infection were observed, predominantly among Saudi nationals, as a cause of pulmonary disease. M. riyadhense may be emerging as a more common pathogen in Saudi Arabia.

Interferon Gamma Release Assay versus Tuberculin Skin Testing among Healthcare Workers of Highly Diverse Origin in a Moderate Tuberculosis Burden Country.

Health care workers (HCW's) are always at an increased risk of contracting tuberculosis (TB) infection. In Saudi Arabia, Interferon Gamma Release Assay (IGRA) has not been evaluated as a screening tool for latent TB infection (LTBI) among HCW's considering their high demographic diversity. During February 2012 to January 2015 a cross sectional study has been conducted in a tertiary care center with maximum demographically diverse staff population in the capital city-Riyadh. After a short interview and consenting, all the candidates were subjected to tuberculin skin test (TST) and QuantiFERON TB gold In-tube test (QFT). A logistic regression analysis was carried out for establishing the associations between putative risk factors and the diagnostic tests. The candidates were classified according to geographical origin and a detailed analysis was conducted on the impact of their origin towards the results of TST and QFT. Of the 1595 candidates enrolled, 90.6% were BCG vaccinated, female (67.9%) and mainly nurses (53.2%). Candidates with high risk of suspected or confirmed TB patient exposure were 56.1% and 76.5% of them had <10 year's work experience. TST positivity was observed in 503 (31.5%) candidates, while QFT was positive among 399 (25%). Majority of the candidates were non-Saudi (83%) and predominantly (52.4%) from Western Pacific region. Concordant results were obtained in 14.2% of positive cases and 57.7% negative cases. The disagreements between the two tests were relatively high (kappa co-efficient-0.312±0.026, p value- <0.00001) as TST positive/QFT negative discordance was 54.8% while TST negative/QFT positive discordance was 15.7%. Age of the candidates, BCG vaccination, and South East Asian origin were associated with TST positivity while Occupational TB exposure and geographical origin of the candidates were associated with QFT positivity. A regular follow up on recently TST converted candidates showed no progression to active TB. The putative factors associated with the discordance were origin of the candidate (p value <0.001), profession (p value-0.001), BCG vaccination (p value-0.001) and occupational TB exposure level (P value-0.001). The study demonstrated high level prevalence of LTBI among the demographically diverse study candidates. The agreement between QFT and TST was poor, thus QFT alone cannot be recommended in our setting for a routine LTBI screening. Origin of the candidates has strong association with the results of TST and QFT. The discordant results particularly TST negative and QFT positive needs more detailed analysis.