Prevalence of Hepatitis B and Hepatitis C in Migrants from Sub-Saharan Africa Before Onward Dispersal Toward Europe.

Viral hepatitis is a global health care challenge due to its worldwide distribution, chronic persistence, complications, and high prevalence with unchecked conditions in areas like sub-Saharan Africa. A high proportion of asymptomatic infections allows serious complications and poses infection risk to destination populations. This study aimed to determine the prevalence of both HBV and HCV among 3248 migrants from different parts of sub-Saharan Africa newly arrived at Kufra, Libya, a remote agricultural North African city. All these migrants were required by the Libyan authorities to undergo a complete medical check-up for different purposes such as joining new jobs, and obtaining licenses for trade and commerce. UAT sera from 3248 migrants, aged 18-53 years, attending the Al Kufra city hospital from January 01 to December 31, 2019, were screened for HBsAg and anti-HCV antibody by rapid tests and positive samples were further tested by ELISA method. The results showed that 761/3248 (23.4%) of the migrants were positive for HBV and 1014/3248 (31.2%) were positive for HCV. Migrants from sub-Saharan Africa carry high rates of HBV and HCV infection. This suggests the importance of increased attention to actions to deal with findings among positive migrants, and for awareness about risks of transmission to the local population. Study results indicate the value of routine migrant monitoring, the need for awareness in destination country health authorities, and the potential for impact on migrant destination populations.

Giardia and Cryptosporidium in children with diarrhea, Kufra, Libya, a North African migration route city.

BACKGROUND: Giardia and Cryptosporidium are common parasitic diarrhea agents of children contributing to childhood morbidity and mortality in developing countries. Major risk factors, based on the international literature, are expected to include domestic animals, fresh vegetables and drinking water and foodstuffs purchased from street vendors. These factors and sub Saharan migrants are common in the study area. Reports elsewhere indicate that person-to-person transmission is also important. OBJECTIVE: To assess the prevalence Cryptosporidium and Giardia in children with diarrhea in the Kufra City hospital and to assess risk factors for cryptosporidiosis and giardiasis. METHODS: A 10-month study, September 2013-June 2014 provided a fecal sample from 505 patients with diarrhea aged from 2 to 17 attending the outpatient clinics of local Kufra hospital, plus100 non symptomatic controls. Specimens were assayed for parasitic infection and for bacterial pathogens. Demographic information was obtained by questionnaire. RESULTS: Giardia was found in nearly 1/3 of the symptomatic population but few had Cryptosporidium. Mixed parasite infections were found in 1/7th of samples including: Shigella, Salmonella, Ascaris ova, E. coli, and E. histolytica. Infection frequency was age related, and risk factors included: domestic animals, foreign workers from Africa, contaminated fresh vegetables and drinking water. CONCLUSION: Cryptosporidium and Giardia were frequently associated with diarrhea in children in a remote desert agricultural community with many opportunities for infection. Contact with animals, foreign workers from Africa, fresh vegetables and drinking water sources contaminated with sewage materials are the likely modes of transmission of both organisms.

Cryptosporidium oocysts and Giardia cysts-A practical and sensitive method for counting and manipulating small numbers.

A rapid and inexpensive method is described for accurate and reproducible counting and manipulating small numbers of Cryptosporidium oocysts and Giardia cysts. From a suspension of oocysts or cysts at concentration from 1000 to 5000/mL (1-5/µL), replicate 5µL droplets are micro pipetted onto the edge of a microscope slide. Unstained oocysts or cysts in each droplet can be counted in a few minutes and replicated for statistical strength. The concentration of the suspension can then be verified by pipetting desired volumes containing approximately desired numbers onto confined 13mm membranes for IFA staining and counting with replication as desired. Requiring only a micropipette, analytical balance, and a microscope, this provides a useful tool accessible to virtually any microbiology laboratory.

Distribution of Cryptosporidium oocysts and Giardia cysts in water above and below the normal limit of detection.

Analysis of water samples for Cryptosporidium oocysts and Giardia cysts is a specialised and demanding pursuit. Understanding and evaluating data resulting from such analyses is equally specialised and complicated by the most common result--not finding any of the target organisms. Coming to an accurate conclusion regarding such monitoring results has been hampered by a lack of pertinent information presented in the context of current monitoring requirements. The work reported here presents laboratory data demonstrating an appropriate skewed distribution model statistical framework. It is shown that the Poisson model provides for understanding how Cryptosporidium oocysts and Giardia cysts are distributed in water at typical ambient concentrations that are near or most commonly below the limit of detection of the most widely used analytical procedure, USEPA Method 1623. From three to six replicate 50-L volumes of particle-free water were seeded with Cryptosporidium oocysts and Giardia cysts each at concentrations of ca. 0.2/L, 1-2/L, and 6-8/L. The seeded 50-L volumes were analysed in five 10-L aliquots to determine the number of oocysts and cysts in each. The data conformed to the Poisson distribution. This supports the interpretation that analysis of 10-L surface water samples resulting in not finding any target organisms is the result of their presence below the limit of detection. This interpretation strongly suggests that analysing fewer larger volume samples would provide more useful information.