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1.
Georgian Med News ; (322): 7-12, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35134751

RESUMO

Designing effective interventions for youth to address STI/HIV risk factors requires local context knowledge. This study gathers information about STI/HIV knowledge among Georgian youth, identifies STI/HIV risk behaviors and quantifies associations between socio-demographic factors and risk practices with HIV/STIs knowledge. Cross-sectional survey was conducted among 411 students using self-administered questionnaire. Bivariate analysis was conducted and prevalence ratios with 95% confidence intervals were computed. Study participants were more knowledgeable about HIV/AIDS than other STIs, though still lacked information about HIV/AIDS transmission routes. Only 10.1% had ever received HIV testing. Men were less likely to have current permanent sex partner (44.5% vs 79.2%; PR=0.2; 95% CI:0.1-0.5) and more likely to have occasional sex partner past 12 months than women (51% vs 19%; PR=4.3; 95% CI:1.8-10.2). Study describes relatively low awareness of STIs in Georgian youth and revealed possibilities to influence STI transmission through designing gender-tailored public health interventions.


Assuntos
Infecções por HIV , Infecções Sexualmente Transmissíveis , Adolescente , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Prevalência , Fatores de Risco , Comportamento Sexual , Infecções Sexualmente Transmissíveis/epidemiologia , Estudantes
2.
Georgian Med News ; (322): 21-25, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35134753

RESUMO

The prevalence of viral hepatitis B and C in Georgia is among the highest in the region. US Centers for Disease Control and Prevention (CDC) has selected Georgia as a pilot country for hepatitis C elimination program. Since 2015, Georgia launched a multi-year program of HCV elimination, including treatment of infected individuals with Direct Acting Antivirals (DAAs) and implementation of prevention programs, including infection control in health care facilities. The objective of this study was to evaluate the attitude and knowledge of blood borne infections (HIV, HCV, HBV) among Georgian Health Care Workers (HCWs). HCWs were recruited from six participating multi-profile hospitals and dental care institutions in three large cities of Georgia (Batumi (Western Georgia), Rustavi (Eastern Georgia) and the capital city, Tbilisi). A self - administered questionnaire included sections regarding sociodemographic and professional characteristics; awareness of blood-borne infections; practice for transmission risk reduction and perceived educational interventions acceptable among HCWs. The selection of HCWs was done through simple random sampling from the list of staff as a sampling frame. HCW's survey results were compared to the one from Dental health care workers (DHCWs). The total number of surveyed individuals was 442. Among them, 246 (55.6%) were HCWs (physicians, nurses, physician assistants and residents) from different departments, including family medicine (38.6 %), surgery (21.7%), gynecology (23.4%) and intensive care (13.9%) and 196 DHCWs (44.6%). Only few respondents (15.6%) correctly identified the prevalence of HIV infection in Georgia. HCWs have better understanding about the prevalence of viral hepatitis compared to DHCWs (Prevalence of HBsAg was correctly identified by 33.2 % vs 22.3%; prevalence of HCV- by 18.9 % vs 17.3%). Knowledge regarding transmission risks of blood-borne infections (HIV, HCV, HBV) among HCWs is higher compared to DHCWS (for HIV 73% vs 45.3%, for HCV 49.2% vs 37.9% and for HBV 54.8% vs 33.7%) (p<0.005). Vast majority of DHCWs as well as HCWs believed that probability of transmission of blood-borne infections after contaminated needle stick is 50-70% (p<0.05). There was a poor knowledge on availability of post exposure prophylaxis (42.9% of HCWs compare to 36.1% DHCWs believed that HCV post-exposure prophylaxis is available) (p<0.005). The practice of using facemasks (81% vs 74.4% always use, respectively), protective clothes (96.8% vs 83.3% always use) and eyewears (46.9% vs 27.4% always use) was reported by DHCWs and HCWs. Some nosocomial risk events were reported by higher proportion of DHCWs, compared to HCWs and included accidental needle stick injuries (65.1% vs 45.5%) and blood splashes (48.3% vs 28.2%). Cuts with contaminated instruments was more common among HCWs compared to DCHWs (41.4% vs 35.1%) during medical procedures. The study suggests that level of knowledge on blood borne infections among both HCWs and DHCWs is not adequate. Data from this study can be utilized to design educational programs for Georgian HCWs/DHCWs to improve knowledge and practice about blood borne diseases.


Assuntos
Infecções por HIV , Hepatite B , Hepatite C Crônica , Hepatite C , Antivirais , Infecções Transmitidas por Sangue , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Hepatite C/epidemiologia , Hepatite C/prevenção & controle , Humanos , Inquéritos e Questionários
3.
Georgian Med News ; (322): 26-29, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35134754

RESUMO

Hepatitis B virus infection remains one of the major healthcare problems in Georgia with an exposure prevalence of 25.9% (Positive Anti-HBc) and chronic HBV infection (Positive HBsAg) 2.9%. Determination of clinical phase of chronic HBV infection is crucial for evaluation prognosis and accordingly, initiation of antiviral treatment, which might be lifelong. The specific aim of our study was to collect data on clinical characteristics of HBV-infected patients and determine the clinical phases of chronic HBV infection in the Georgian population. We randomly selected 111 chronic HBV-infected patients from the database of the medical center Mrcheveli. Liver fibrosis was assessed by Fibroscan, and viral load data were computed by the Real Time polymerase chain reaction (PCR) methodology. Liver fibrosis results were available for 74 of the patients (67%), and a majority of patients (72 of the 74, 97%) had no signs of advanced liver fibrosis. Viral load data were available for 94 patients, of whom 70 (74.5%) had an HBV-DNA level less than 2000 IU/ml, while 18 (19.1%) had an HBV-DNA level between 2000 and 20000 IU/ml and 6 (6.4%) were higher than 20000 IU/ml. Data for the assessment of the clinical phase of chronic HBV infection were available for 54% of patients (60 of the 111). Only 3.3% (2/60) of patients had undetectable HBV-DNA and 75% (45/60) had a viral load <2000 IU/ml. Two patients were HBeAg-positive, one of them with hepatitis and another with normal ALT. A few patients classified as HBeAg-negative with chronic hepatitis given normal ALT criteria: 3/60 (5%) by EASL and 6/50 (10%) patients by AASLD. In summary, 11/60 (18.5%) and 8/60 (13.5%) patients had HBV-DNA >2000 IU/ml but a normal ALT. Given the small number of patients, we cautiously conclude that most patients (75%) had HBeAg-positive or -negative chronic HBV infection without hepatitis. However, up to 19% of patients were not possible to classify in any of the internationally recognized phases of HBV infection. Patients within this indeterminate grey area, should be evaluated cautiously and management needs to be individualized. It will be interesting to evaluate the reason high viral load in HBeAg negative patients with normal ALT and long-term outcome among these patients (liver fibroses and/or HCC development).


Assuntos
Carcinoma Hepatocelular , Hepatite B Crônica , Hepatite B , Neoplasias Hepáticas , Alanina Transaminase , DNA Viral/genética , República da Geórgia/epidemiologia , Antígenos de Superfície da Hepatite B , Antígenos E da Hepatite B , Vírus da Hepatite B/genética , Hepatite B Crônica/tratamento farmacológico , Hepatite B Crônica/epidemiologia , Humanos
4.
Georgian Med News ; (322): 32-37, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35134756

RESUMO

A seroprevalence survey was conducted in 2015 in Georgia among adults aged ≥18 years. This survey data was used to estimate anti-HCV seroprevalence in Georgia at 7.7% and HCV RNA prevalence at 5.4%. Treatment adherence, recovery and quality of life are interrelated, however, there are limited data on the role of successful antiviral treatments in changing the quality of life (QOL) of patients in Georgia. A questionnaire assessed the QOL for patients involved in the hepatitis C elimination program. Patient responses were analyzed to estimate the magnitude of any association between quality of life with the degree of liver fibrosis and various laboratory parameters. Liver fibrosis status was measured by the FIB4 score and liver elastography. We recruited 378 eligible adult participants who were beneficiaries of the hepatitis C elimination program (HCV RNA-positive) before the start of antiviral treatment. Of the surveyed individuals, 283 (77.5%) were males; the median age was 47 years (range 20 to 83). Almost 30% of participants had advanced liver fibrosis. The following factors were associated with advanced liver fibrosis: older age (PR=7.05; 95% CI:3.93-12.65), general weakness (PR=5.88; CI:2.23-15.45) and insomnia (PR=3.5, CI:1.37-9.19). Muscle pain (PR=2.75, CI:1.91-3.96) and abdominal pain (PR=3.23, CI:2.19-4.77) were more common among participants with a high FIB4 score; these patients were also more likely to report that liver disease affects family life (PR=4.23, CI:2.94-6.09). This study suggests that advanced liver fibrosis is associated with poorer QOL, an association that has been noted by research elsewhere in Europe. Given that the Georgian experience appears to be similar to other European countries, public health interventions to improve QOL may be expedited by collaboration with regional neighbors.


Assuntos
Hepatite C Crônica , Hepatite C , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antivirais/uso terapêutico , República da Geórgia/epidemiologia , Hepatite C/complicações , Hepatite C/tratamento farmacológico , Hepatite C/epidemiologia , Hepatite C Crônica/complicações , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/epidemiologia , Humanos , Cirrose Hepática/tratamento farmacológico , Cirrose Hepática/epidemiologia , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Estudos Soroepidemiológicos , Adulto Jovem
5.
Georgian Med News ; (322): 29-32, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35134755

RESUMO

Hepatitis B virus (HBV) infection is one of the major healthcare problems in Georgia with a prevalence of 2.9% in the adult population. There is no published data on HBV genotype distribution among different age groups in the country. The study aims to evaluate genotype distribution in Georgian HBV-infected patients among different age groups. Data was extracted from the clinical database of Mrcheveli medical center. Genotyping was performed using INNO-LiPA methodology. Statistical analysis was done using the statistical software SPSS 23.0. The total number of patients enrolled in the study was 84, of which 52 (62.1%) were males. Participants were mostly from Tbillisi (63.2%, N=53). Even though HBV genotype D was more predominant (found in 57.1% (N=48) of study participants), than genotype A (found in 42.9% (N=36) of the study population). Age was significantly associated with genotype distribution. The majority of the participants (58.3%, N=49) were 35 years old or younger. Genotype D was predominant in 71.4% of the study participants older than 35 years old, versus 46.9% of individuals 35 or younger with genotype D (p<0.001). Genotype A, among those <35 and >= 35 was presented in 53.1% and 28.6% of cases, respectively. Our data suggests that HBV genotype D is most prevalent among older Georgian patients chronically infected with hepatitis B. More than half of younger patients (35 years old or younger) have Genotype A.


Assuntos
Hepatite B Crônica , Hepatite B , Adulto , DNA Viral , Genótipo , República da Geórgia/epidemiologia , Hepatite B/epidemiologia , Vírus da Hepatite B/genética , Humanos , Masculino , Prevalência
6.
Georgian Med News ; (322): 38-43, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35134757

RESUMO

Integration of TB/HIV/HCV screening into primary health care has been implemented in Georgia since 2018. The aim of the program is to strengthen TB, HIV/HCV screening and early detection capabilities in the primary health care, as early detection and treatment are considered to be the most effective strategies to prevent these infections. The goal of the study was to evaluate and compare the baseline and follow-up knowledge about TB, HIV and HCV infectious among primary health care workers in Kvemo Kartli Region. The study instrument was a self-administered questionnaire. A total of 459 primary HCWs from Kvemo Kartli region were surveyed. The proportion of HCWs correctly knowing MDR TB definition increased from 34.6% to 82.8% and this difference was statistically significant (p<0.01). Nurses were less informed about HIV infection. Only 70.7% of them knew modes of HIV transmission, while 89.3% of physicians answered this question correctly (p<0.001). An assessment of knowledge among primary health care workers (PHC) providers is important, as they represent the first level of community contact with health care. The post-test after the training showed significant improvement in knowledge among trained HCWs. Follow-up knowledge and practice surveys are needed to understand the long-term impact of training on the rate screening referrals by PHC providers.


Assuntos
Infecções por HIV , Hepatite C , Estudos Transversais , República da Geórgia , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Hepatite C/diagnóstico , Hepatite C/epidemiologia , Humanos , Atenção Primária à Saúde
7.
Georgian Med News ; (322): 43-47, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35134758

RESUMO

TB remains to be the major public health concern in Georgia. TB awareness and knowledge is usually low in the general population, which leads to delayed referral to a medical facility, which in turn hinders timely initiation of diagnostic and treatment interventions. Lack of knowledge also contributes much to the widespread stigma in the society. The aim of the study was to qualitatively explore TB knowledge, attitudes and practice, as well as related barriers and facilitators by conducting FGDs among representatives of general population as well as TB risk groups. The qualitative data was collected through FGDs among different target groups: (1) TB patients; (2) TB contacts; (3) Injecting drug users; (4) health care providers and (5) students. FGD recordings were transcribed using a predefined coding scheme and followed by contextual analysis. According to the study results, there is a good level of TB knowledge and awareness among current/former TB patients, their contacts, and health care providers, which is linked to their practice and experience. IDUs receive sufficient information on the disease within the educational component of the Needle and Syringe program. A significant lack of TB knowledge was revealed in a segment of the general population such as students. Lack of TB knowledge among general population is highly linked to the stigmatized attitude towards TB patients. Accurate TB knowledge is an important prerequisite determining positive attitude towards the disease and supporting stigma reduction. Correct information on TB should be disseminated through all possible channels and the process should have permanent nature.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Estigma Social , República da Geórgia , Pessoal de Saúde , Humanos , Pesquisa Qualitativa
8.
Georgian Med News ; (322): 58-62, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35134761

RESUMO

The goal of this study was to assess the level of knowledge about air pollution and the health effects of lead exposure among the population of Georgia. In 2019, a project entitled "Protect Environment" was conducted by the National Center for Disease Control and Public Health and the Health Research Union. The online survey was carried out using a Facebook advertisement, which included the title, body text, the banner, and a link to the questionnaire. The target population was the entire country and the language used was Georgian. We collected information on knowledge about health problems caused by polluted air, diverse environmental pollutants (such as the smoke of burning leaves, cigarette butts and smoke, effects of lead), and the effectiveness of a face mask to filter pollutants. Finally, we assessed awareness of the informational website www.air.gov.ge. The study was conducted over 3 days among 349 respondents in October 2019. Most (90.3%) of the respondents correctly answered the question related to air pollution causing different types of diseases, a similar proportion were concerned about the impact of environmental pollution and the impact of exposure to lead (76.8%). These findings indicate the importance of promoting educational websites that provide detailed information about various contaminants, as well as different preventive measures to mitigate environmental pollution. This study provides important information about the level of awareness among the Georgian population regarding air pollution and lead poisoning, research which is still very nascent. These findings should inform the development of educational campaigns to raise awareness about air pollution.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Exposição Ambiental/efeitos adversos , República da Geórgia , Humanos , Idioma , Chumbo/toxicidade
9.
Georgian Med News ; (322): 62-65, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35134762

RESUMO

The aim of the study was to identify risk-factors associated with hypersensitivity to local anesthetic drugs in an ethnically homogenous population. Allergy to anesthetic agents were evaluated by skin tests and venous blood tests for presence of allergen-specific immunoglobulins type E (IgE) by Enzyme-linked Immunoassay (ELISA). The skin tests were performed for the following local anesthetic groups: lidocaine, mepivacaine, articaine. HLA/KIR typing was performed by PCR using sequence-specific oligonucleotide probes (SSOP). 450 patients have been included in the study with age range between 4 and 79 years. Special questionnaire was used to collect demographic, family history and clinical data. By statistical analysis, the allergic status to anesthetic agent was associated with the presence of allergy to the different types of allergens among patients' mothers or sibships, presence of drug allergy, presence of food allergy in addition to the drug allergy among patients, presence of current or recent infectious diseases and specific HLA/KIR profiles (specifically HLAC1C1; KIR2DL2/2DL2; KIR2DL3/2DL3). Both genetic (family history, immunogentic profiles) and acquired (presence of recent or current infections) are associated with the development of hypersensitivity to local anesthetic agents. The obtained data can contribute to the clarification of immunogenetic mechanisms of development of drug-related allergies.


Assuntos
Hipersensibilidade Alimentar , Hipersensibilidade , Preparações Farmacêuticas , Adolescente , Adulto , Idoso , Alérgenos , Anestésicos Locais/efeitos adversos , Criança , Pré-Escolar , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Testes Cutâneos , Adulto Jovem
10.
Georgian Med News ; (322): 66-75, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35134763

RESUMO

Georgia confirmed its first case of SARS-COV-2 infection on February 26, 2020. Despite the government's proactive measures during the early stages of the epidemic, number of new infections of SARS-COV-2 is increasing and by March 31, a total of 110 cases have been reported. Limited understanding about epidemics can lead to panic and disrupt public health efforts to contain transmission. Thus, it is very important to understand the perceptions of the population regarding the disease and perceived level of government preparedness to fight against the spread of infection. This study reports results of a survey designed to understand attitudes and knowledge regarding SARS-COV-2 virus among Georgian population, including health care workers (HCWs). The online survey was conducted using a Facebook advertisement. The target was the whole country and the language used was Georgian. We collected information on demographic data, knowledge of symptoms and transmission modes of coronavirus, perceived differences between coronavirus and influenza, availability of antiviral medication and vaccination. We also included questions to capture the Georgian population's perceptions about government preparedness to combat the new coronavirus. The survey was open for three days (March 2-4, 2020). 5228 participants completed the survey. Of these, 40.3% were 25-45 years old and 58.2% were female. 20.7% of respondents had university degree and 10.3% were HCWs. For 25.8% of respondents, COVID-19 and influenza are the same diseases; 10.9% did not know if they are different. The majority correctly identified the transmission route and symptoms (96.9% and 98.0%, respectively). Regarding physical distancing, 13.2% indicated they would attend public events if needed even if they had COVID-19 symptoms. 19.1% think that Georgia is ready for COVID 19 epidemic, while according to 55% the county is not ready, but HCWs are trying hard to respond to this challenge properly. For 18% response is inadequate. There was no difference in knowledge between HCWs, non-HCWs and unemployed. 20% of HCWs as well as other study subjects believe that SARS-COV-2 vaccine and medications do exist but are simply not available in Georgia. One in five Georgians believe that there is a vaccine and medication to treat coronavirus, but that it is not available in the country. Given that information regarding coronavirus is changing very rapidly, the need to reach people with time-sensitive educational messages as well as prevention strategies is vital. Three months have elapsed since discovery of the novel coronavirus causing severe acute respiratory syndrome and classified as SARS-COV-2.


Assuntos
COVID-19 , SARS-CoV-2 , Adulto , Vacinas contra COVID-19 , Feminino , República da Geórgia/epidemiologia , Pessoal de Saúde , Humanos , Idioma , Pessoa de Meia-Idade
11.
Georgian Med News ; (295): 105-109, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31804209

RESUMO

Georgia is among the countries with a very high prevalence of hepatitis C virus (HCV) infection. The recent availability of highly effective, direct-acting antivirals (DAAs) capable of curing >90% of persons treated has made HCV elimination a possibility. All adult citizens infected with HCV are eligible to receive free DAAs through the Georgia National HCV Elimination Program (Program). From April 2015 to December 2018, 54,087 persons were enrolled in the Program throughout the country. However, more than 20,000 individuals are aware of their HCV antibody positive status but did not have HCV RNA testing, a necessary step to determine treatment needs. We hypothesized that a reason for hesitance to enroll in the Program may be a low level of trust of the Program. A cross-sectional study was conducted in Tbilisi, the capital of Georgia. Reproductive aged women were randomly selected from three maternity care centers during prenatal care. The self-administered questionnaire included questions on socio-demographic information, knowledge about HCV infection and trust in the Program. A total of 2185 women of reproductive age were enrolled in the study. The mean age was 28.5 (age range: 17-46) years. The majority of the study participants (76.4%) had a university degree. The vast majority of study participants (>95%) were married and 95.1% were Georgian ethnicity. Almost 90% of the participants were aware of their HCV infection status. Most women (85.3%) had heard of HCV elimination program in Georgia; 74.6% stated that they trust the Program. However, almost 10% of surveyed women stated they would refuse to get enrolled in the Program if their anti-HCV test result is positive. Trust in the Program was higher among women aged >25 years (80.7%) compared to younger women (68.4%) (p<0.0001). Level of education was also associated with trust to the program: more women with higher education level reported that they trust the Program (78.7%) compared to women with lower education level (68.5%) (p<0.0001). Trust in the Georgia National HCV Elimination Program is not sufficiently high among women of reproductive age in Georgia. Effective educational campaigns are needed to improve trust to the Program for this targeted group.


Assuntos
Antivirais , Hepatite C , Adolescente , Adulto , Antivirais/uso terapêutico , Estudos Transversais , Feminino , República da Geórgia , Hepacivirus , Hepatite C/tratamento farmacológico , Hepatite C/epidemiologia , Humanos , Pessoa de Meia-Idade , Adulto Jovem
12.
Georgian Med News ; (295): 109-114, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31804210

RESUMO

Georgia is a country with high prevalence of hepatitis B. Based on a 2015 population serosurvey, the prevalence of hepatitis B surface antigen (HBsAg) is 2.9% and prevalence of anti-HBc is 25.5% in general population. Hepatitis B vaccine has been included in the national immunization schedule of Georgia only since 2002. Thus, most reproductive aged women were not vaccinated during young childhood. Cross-sectional study was conducted in the capital of Georgia, Tbilisi. Reproductive aged women were randomly selected and then recruited from three maternity care centers during prenatal care. The self-administered questionnaire included questions on socio-demographic information, hepatitis B vaccination status and awareness of HBV infection status. A total of 2185 reproductive aged women were enrolled in the study. The mean age was 28.5 (age range 17-46) years. Most (76.4%) had a bachelor and/or master's degree. 20.0% of respondents never heard about HBV. Very few (3.3%) knew they were infected with HBV. We could not determine if women were chronically infected or were exposed and developed antibodies. HBV knowledge was limited: 57.5% were not aware of available HBV treatment; 51.6% didn't know HBV infection could be prevented (35.8% named HBV vaccination, 29.3% named condom use). Only 10% of study participants reported being vaccinated for HBV. Awareness of HBV infection was higher among women over age 25 (72.1%) compared to women aged 25 years or less (27.9%) (P<0.0001). Among women who reported having an HBV infection, 40.6% did not name vaccine as a prevention method and 38.2% did not have information about availability of HBV treatment (P<0.05). Based on our study results, knowledge about HBV infection and vaccination is very low among reproductive aged women in Georgia. Women's health centers can be a good place to reach reproductive aged women for counseling on HBV infection and promote vaccination against hepatitis B.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Vacinas contra Hepatite B , Hepatite B , Vacinação , Adolescente , Adulto , Estudos Transversais , Feminino , República da Geórgia , Hepatite B/prevenção & controle , Anticorpos Anti-Hepatite B , Antígenos de Superfície da Hepatite B , Vírus da Hepatite B , Humanos , Pessoa de Meia-Idade , Gravidez , Prevalência , Adulto Jovem
13.
Georgian Med News ; (295): 114-118, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31804211

RESUMO

Nosocomial transmission of hepatitis C virus (HCV) is well established, however the role of dental care in HCV transmission has been speculated but particularly difficult to quantify. This study investigated the potential for nosocomial transmission of HCV in dental clinics in a high HCV prevalence, middle-income country.  Dental health care workers (DHCWs) in 13 clinics in 3 cities were invited to participate. After informed consent was obtained, the DHCWs were asked to provide a blood sample to test for anti-HCV and complete a questionnaire that included questions on risk behaviors. A second sample of dental clinics was recruited to conduct environmental testing for HCV RNA. Among the 244 DHCWs invited to participate in the study, 196 (80.3%) enrolled including 115 doctors, 49 nurses and 32 dental residents. The seroprevalence of anti-HCV among DHCWs was 4%. Of the 46 private dental clinics invited to participate, 37 (80.4%) dental clinics agreed to allow the environmental study. Overall, 23 (62.2%) clinics had HCV RNA detected in at least one location. The most frequently contaminated location was the suction unit with HCV RNA retrieved from 14 (37.8%) clinics, followed by contaminated samples from the general dental room in 9 (24.3%) clinics. Given that HCV RNA can be viable for up to six weeks, without fastidious attention to infection control procedures, patients may be exposed to contaminated dental equipment and nosocomial transmission can occur.


Assuntos
Clínicas Odontológicas , Hepacivirus , Hepatite C , Pessoal de Saúde , Hepatite C/transmissão , Anticorpos Anti-Hepatite C , Humanos , Transmissão de Doença Infecciosa do Profissional para o Paciente , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos
14.
Georgian Med News ; (288): 48-54, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31101775

RESUMO

Clostridium difficile represents an example of healthcare-associated pathogen causing disease in community and hospital setting. The number of clinical studies determining risk factors for Clostridium difficile infection in children is limited as compared to adult patients. The aim of this study was to determine the association between antibiotic exposure in hospital setting and risk of Clostridium difficile infection in children. Systematic review of the electronic databases was used to update the literature, collect secondary data, critically appraise research studies, and synthesize study result from our institutions with available literature. Paper aimed to provide a complete, exhaustive summary of current literature relevant to our research question. A systematic review of the literature using databases PubMed (1935-2018) was conducted to compare our study results with available literature and determine significant differences and similarities that might impact clinical decisions in the country Georgia. The study of the association of several factors with the development of Clostridium difficile infection showed that the age more than 4 years old represented independent risk-factors of the development of Clostridium difficile infection, while the gender and ethnicity was not associated with the infection. Antibiotic exposure within the month preceding the onset of diarrhea was statistically significantly associated with an increased risk of Clostridium difficile infection. The risk was greatest with cephalosporins, followed by penicillins, carbapenems and macrolides. Antibiotic exposure in children is associated with increased risk of Clostridium difficile infections in hospital setting.


Assuntos
Antibacterianos , Clostridioides difficile , Infecções por Clostridium , Infecção Hospitalar , Adulto , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Infecções por Clostridium/etiologia , Diarreia , República da Geórgia , Humanos , Fatores de Risco
15.
Georgian Med News ; (Issue): 176-183, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29578446

RESUMO

Georgia had several waves of internally displaced people (IDPs) as a result of military conflicts on the territories of Abkhazia and Samachablo starting from 1990's with the latest large wave in 2008. Most of the IDPs live in compact settlements, such as old administrative buildings or specially constructed camps. In both cases, living conditions and social-economic status of IDPs are below Georgia's national average. There is extremely limited data on the health status of the IDPs in Georgia. Health Research Union (HRU) with support from ELRHA/R2HC program conducted a survey to study health service utilization and expenditures among IDPs, and measure the effect of targeted intervention versus untargeted, integrated approach to health financing. The aim of the current study was to analyze the self-reported health status among IDPs on the basis of the data collected through this survey. The survey was carried out among IDPs currently living in Georgia mainly residing in compact settlements. Sampling from the target population was performed by a multi-stage cluster sampling approach. In total 1.319 households with 4,359 household members were recruited and interviewed for the survey. Male accounted for almost 55% of all household members in the survey. Slightly less than half of respondents were married; children under the age of 15 constituted 23% of all IDPs surveyed. In total, 40% of all respondents (1729 persons) report being chronically ill and identify a wide range of conditions. Of them 532 report having 2 or more chronic diseases. About a third of occurrences (29%) of chronic diseases is attributed to cardiovascular diseases. Musculoskeletal and gastrointestinal diseases (each) constitute 13% of all occurrences of chronic diseases. During last 24 months 129 household members gave birth. The prevalence of chronic diseases among adult population increases as the age advances with the highest rate among those aged above 65 with 84% reporting having at least one chronic disease. Self-perceived overall health status was characterized as excellent, very good and good by 53%, as fair by 32% and as poor and very poor by 16% of the respondents. The conducted research was the first wide-scale study of the health status among internally displaced people in Georgia. These data may contribute to better understand the problems in this vulnerable population and evaluate impact of the implementation of the different models of the health care including targeted health insurance for IDPs.


Assuntos
Doenças Cardiovasculares/epidemiologia , Gastroenteropatias/epidemiologia , Nível de Saúde , Doenças Musculoesqueléticas/epidemiologia , Refugiados , Adulto , Criança , Atenção à Saúde/economia , Atenção à Saúde/ética , Autoavaliação Diagnóstica , Características da Família , República da Geórgia/epidemiologia , Serviços de Saúde/provisão & distribuição , Humanos , Masculino , Múltiplas Afecções Crônicas , Prevalência , Campos de Refugiados , Fatores Socioeconômicos , Inquéritos e Questionários/estatística & dados numéricos
16.
Georgian Med News ; (Issue): 172-176, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29578445

RESUMO

Clostridium difficile, a Gram-positive spore-forming bacillus, is the most common identifiable etiologic agent of antibiotic-associated diarrhea. The incidence of Clostridium difficile infections among hospitalized children has been increasing across the world. The aim of our study was to evaluate occurrence of Clostridium difficile and some other gastrointestinal pathogens among hospitalized pediatric patients in Georgia, as far as currently statistical data on the topic is very limited in the country. One of the objectives of the study was to test and pilot the real-time Polymerase Chain Reaction diagnostic systems for rapid and simultaneous identification of number of pathogens with a particular emphasis on diarrheal disease diagnostics as these are one of the primary public health priorities in Georgia and worldwide. Cross-Sectional study has been performed on 211 samples collected from 192 pediatric patients. Two pediatric hospitals were involved in the study: M. Iashvili Children's Central Hospital and Tbilisi Children's Clinical Hospital for Infectious Diseases. Laboratory investigations were done in the Clinic NeoLab, Tbilisi, Georgia. Study materials collected for testing were stool samples. Samples were tested by EIA kits (CerTest biotec, Zaragoza, Spain) for presence of A/B toxin according to the manufacturer's instructions. EIA test positive samples were analyzed by home-made multiplex real-time polymerase chain reaction (NeoPCR Diagnostics, NeoLab, Tbilisi, Gerogia) for confirmation of the infection and for simultaneous identification of additional gastrointestinal pathogens including Entamoeba histolitica, Giardia lamblia, Cryptsporidium parvum, Adenovirus, Rotavirus, Norovirus and Astrovirus. All samples were also tested for the presence of the above listed pathogenic agents using the same type EIA kits as for Clostridium difficile described above (CerTestbiotec, Zaragoza, Spain) for presence of the corresponding pathogen. The average age of the study participants was 3.5 years, 56.7% were male and 43.3% were female patients. Presence of Clostridium difficile have been documented in 21 samples out of 211 (10%). Besides the Clostridium difficile, other enteric pathogens have been revealed with the following frequencies: Rotavirus in 12 cases (5.7%), Adenovirus in 11 (5.2%), Giardia lamblia in 10 (4.7%), Astrovirus in 3 (1.4%), Cryptsporidium parvum in 3 (1.4%), Entamoeba histolitica in 2 (0.9%), Norovirus in 2 (0.9%). 49 samples were from out-patient cases (2 samples were positive for Clostridium difficile) and 162 samples were from in-patient cases (19 samples were positive for Clostridium difficile). Clostridium difficile is the frequent pathogenic agent causing diarrheal disease among hospitalized pediatric patients. Development of Clostridium difficile related diarrhea is associated with the antibiotic treatment of pediatric patients hospitalized due to different clinical diagnosis. Targeted early detection of these pathogens is important for the optimal management of diarrheal infection in pediatric patient which will lead to the better clinical outcome and reduction of morbidity rate among hospitalized pediatric patients.


Assuntos
Clostridioides difficile/isolamento & purificação , Infecções por Clostridium/epidemiologia , Diarreia/epidemiologia , Infecções por Protozoários/epidemiologia , Viroses/epidemiologia , Adenoviridae/genética , Adenoviridae/imunologia , Adenoviridae/isolamento & purificação , Adolescente , Astroviridae/genética , Astroviridae/imunologia , Astroviridae/isolamento & purificação , Criança , Criança Hospitalizada , Pré-Escolar , Clostridioides difficile/genética , Clostridioides difficile/imunologia , Infecções por Clostridium/diagnóstico , Infecções por Clostridium/microbiologia , Cryptosporidium parvum/genética , Cryptosporidium parvum/imunologia , Cryptosporidium parvum/isolamento & purificação , Diarreia/diagnóstico , Diarreia/microbiologia , Entamoeba histolytica/genética , Entamoeba histolytica/imunologia , Entamoeba histolytica/isolamento & purificação , Ensaio de Imunoadsorção Enzimática , Feminino , República da Geórgia/epidemiologia , Giardia lamblia/genética , Giardia lamblia/imunologia , Giardia lamblia/isolamento & purificação , Humanos , Lactente , Recém-Nascido , Masculino , Norovirus/genética , Norovirus/imunologia , Norovirus/isolamento & purificação , Infecções por Protozoários/diagnóstico , Infecções por Protozoários/parasitologia , Reação em Cadeia da Polimerase em Tempo Real , Rotavirus/genética , Rotavirus/imunologia , Rotavirus/isolamento & purificação , Viroses/diagnóstico , Viroses/virologia
17.
Georgian Med News ; (274): 130-137, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29461241

RESUMO

Risky behaviours, particularly illegal and heavily stigmatized behaviours, are difficult to measure through self-report in both high risk groups and the general population. Underreporting can result in substantially biased estimates of non-injection drug use (IDU) risk of hepatitis C virus (HCV) infection. We hypothesized that asking about the existence of social networks injection drug use may be a useful marker of IDU. A cross-sectional survey of physicians and nurses was conducted in seven hospitals in Georgia. Based on survey responses participants were categorized into three IDU risk groups: ever used injecting drugs (Self IDU), reported a friend, family member or colleague used injecting drugs (Associate IDU), or reported neither (No IDU). Testing on anti-HCV was done using third generation ELISA methods. Both unadjusted and adjusted prevalence ratios between IDU risk groups and HCV prevalence were estimated. Of the 1312 (82.2%) participants, 10 (0.8%), 75 (5.7%), and 1227 (93.5%) were categorized as Self IDU, Associate IDU and No IDU, respectively; with HCV prevalence of 20%, 9.3% and 4.6%, respectively (p=0.016). The association was due primarily to women's reports. Those who reported some IDU risk were more likely to report other personal risk behaviors (e.g., multiple sex partners) and occupational risk behaviors (e.g., frequent exposure to blood and body fluids). This study represents a start of measurement development by assessing the potential usefulness of a marker to measure of IDU. Improved measurement of stigmatized behaviors is needed for confounding adjustment to improve estimates of occupational risks of blood-borne infections.


Assuntos
Pessoal de Saúde/psicologia , Hepacivirus/isolamento & purificação , Hepatite C/diagnóstico , Doenças Profissionais/diagnóstico , Assunção de Riscos , Abuso de Substâncias por Via Intravenosa/diagnóstico , Adulto , Patógenos Transmitidos pelo Sangue/isolamento & purificação , Estudos Transversais , Feminino , República da Geórgia/epidemiologia , Hepatite C/epidemiologia , Hepatite C/psicologia , Hepatite C/virologia , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/psicologia , Doenças Profissionais/epidemiologia , Doenças Profissionais/psicologia , Doenças Profissionais/virologia , Saúde Ocupacional/ética , Médicos/psicologia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Abuso de Substâncias por Via Intravenosa/psicologia , Abuso de Substâncias por Via Intravenosa/virologia , Inquéritos e Questionários
18.
Georgian Med News ; (258): 40-43, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27770526

RESUMO

Of the 100 types of human papillomaviruses (HPV), approximately 35 infect the genital tract. The viruses are categorized as "high risk" and "low risk" depending on whether they are known to cause cancer or not. Cervical cancer is an important cause of cancer mortality in Georgia, and worldwide. Only limited and incomplete data are available about the epidemiology of HPV infection and related molecular and cellular changes in Georgia. Objectives of our study included the estimation of the prevalence and the distribution of HPV genotypes among women in Georgia. The study participants were women (~2000) aged 18-49 years randomly selected during a clinic appointment with a gynecologist for a regular check-up at one of the women's consultation centers (WCC) participating in the study. Venous blood (5 ml) was drawn and the prevalence of HPV evaluated by the detection of the HPV DNA. For genotyping, HPV DNA were extracted from the cervical samples, amplified first by consensus and then by primer-specific PCR, followed by a detection step on agarose gel. Of the total samples, 250 were positive for HPV DNA; these were further tested to identify the specific HPV genotype. The genotype distribution was as follows: type 6, 98 women (39.2 %); type 16, 64 (25.6%); type 18, 47 (18.8%); type 33, 23 (9.2%); type 11, 27 (10.8%); type 45, 19 (7.6%); and type 66, 9 (3.6%). In 37 women (14.8%), we found coexistence of several different HPV genotypes. The HPV genotypic profile among Georgian women is similar to data generated from studies conducted among the populations in other European countries. Presence of the subset of HPV genotypes not covered by quadrivalent anti-HPV vaccine (types 33, 45 and 66) was demonstrated among Georgian women.


Assuntos
Papillomaviridae/genética , Adolescente , Adulto , Feminino , Genótipo , República da Geórgia , Humanos , Pessoa de Meia-Idade , Papillomaviridae/isolamento & purificação , Adulto Jovem
19.
Georgian Med News ; (258): 43-46, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27770527

RESUMO

In Georgia, causative agents among infants with systemic infections are generally not identified and "neonatal sepsis" is usually diagnosed and treated without determining the etiology. The objective of this study was to estimate the role of viral pathogens (Herpesviridae and Enteroviruses) among neonates with generalized infections. A cross-sectional study was performed among neonates younger than <8 weeks admitted to a neonatal intensive care unit (NICU) at the two largest pediatric hospitals in Tbilisi, Georgia. Laboratory tests were performed by consensus and then by type-specific PCR methods. A total of 187 infants were recruited from the NICUs; most participants (74.9%) were of normal birth weight at admission to the NICU and half (51.3%) were younger than 7 days of age. Almost all babies (91.4%) were treated with a broad-spectrum antibiotic despite a lack of microbe identification. While the overall mortality rate of infants with a systemic infection was 21.9 %, neonatal outcomes were more favorable when the infection was due to enteroviruses (2.9% mortality rate) compared to a herpesvirus infection (16.1% mortality rate). Multivariate analyses identified independent predictors associated with neonatal mortality. These included etiology of infection, APGAR score and the type of delivery. Our investigation suggests that viral pathogens play a substantial role in systemic infections among NICU infants. Utilizing molecular-based testing in these cases could improve both the clinical management and outcomes of neonates with generalized infections.


Assuntos
Encefalite Viral/virologia , Infecções por Enterovirus/virologia , Infecções por Herpesviridae/virologia , Meningite Viral/virologia , Antivirais/uso terapêutico , Estudos Transversais , Encefalite Viral/tratamento farmacológico , Encefalite Viral/mortalidade , Enterovirus/isolamento & purificação , Infecções por Enterovirus/tratamento farmacológico , Infecções por Enterovirus/mortalidade , Feminino , República da Geórgia , Herpesviridae/isolamento & purificação , Infecções por Herpesviridae/tratamento farmacológico , Infecções por Herpesviridae/mortalidade , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Masculino , Meningite Viral/tratamento farmacológico , Meningite Viral/mortalidade
20.
Georgian Med News ; (258): 68-73, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27770533

RESUMO

In 2014-2016, the Georgia Red Cross Society (GRCS) implemented a project to improve diabetes prevention, detection and care in rural Georgia, namely in the Gardabani district. The KAP survey was conducted to determine current levels of knowledge, attitudes and practices regarding diabetes among the general population in the Gardabani district. We compared current findings with baseline results from a 2014 survey to identify trends. A cross sectional study design with multi-stage random sampling was used to select participants. Data were collected at households through face-to-face individual interviews using a specially designed questionnaire. In total, 716 individuals were surveyed, the majority of whom (98.9%) were aware of diabetes. Most respondents (85.3%) believed that diabetes can be prevented and correctly identified measures of diabetes prevention. Compared to the previous survey, the level of knowledge regarding risk factors, symptoms and complication of diabetes had improved significantly. Knowledge of diabetes prevention correlated positively with individuals having a higher education level (62.6% vs. 50.8%; p=0.05), higher family income (62.2% vs. 53.5%; p=0.03) and residing in rural settlements (58.6% vs. 25%; p<0.001). Knowledge of diabetes management was significantly associated with type of residence (rural 50.3% vs. urban 28.4%; p<0.001) and family income (high family income 52.3% vs. low family income 45.5%; p=0.05). Respondents identifying GRCS as a source of information tended to have a higher awareness of diabetes prevention and management. Knowledge of diabetes has significantly improved among the general population of the Garabani district from 2014 to 2016. The development and implementation of similar public health programs to increase the level of awareness and knowledge about diabetes is required in other parts of Georgia to improve control and management of the disease throughout the country.


Assuntos
Diabetes Mellitus , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Idoso , Escolaridade , Feminino , República da Geórgia , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , População Rural , Fatores Socioeconômicos , Inquéritos e Questionários , População Urbana
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