RESUMO
The aim of this study was to assess HIV prevalence and associated risk behaviours among international truck drivers (TDs) in Azerbaijan. The subjects signed consent and completed a questionnaire. Blood was tested using two rapid HIV tests: Determine and OraQuick. Genotyping was performed on 13 positives. Overall, 3763 TDs from 21 countries were enrolled. Fifty-eight (1.54%) were HIV-positive. Highest prevalence was among Russians (2.88%), Ukrainians (1.66%) and Azerbaijani (1.09%). On univariate analysis, highest prevalence (60%) was among injecting drug users (IDUs) compared with 0.4% among non-IDUs (P < 0.001). The prevalence in men who had sex with men (MSM) (42.9%) was high (P = 0.001). On multivariate analysis, IDUs and MSM remained as the main HIV independent risk factors. Additional risk factors include no condom use, no circumcision and a history of an sexually transmitted infection. Eleven of 13 samples were subtype A. In conclusion, HIV was highly associated with IDU and MSM. The detected HIV subtypes A and B are those predominant in the former Soviet Union.
Assuntos
Infecções por HIV/epidemiologia , Veículos Automotores , Ocupações , Viagem , Adulto , Idoso , Azerbaijão , Infecções por HIV/virologia , HIV-1 , Homossexualidade Masculina , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Federação Russa , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/virologia , Abuso de Substâncias por Via Intravenosa/complicações , Ucrânia , Adulto JovemRESUMO
Injecting drug use (IDU), common in global centers of heroin production, confers significant risk for HIV-1 infection. Once introduced into IDU networks, an explosive rise in HIV-1 infection typically occurs, fueled principally by needle sharing. New HIV-1 epidemics in IDUs have occurred in Russia, China, Thailand, Spain, Iran, and in other countries, and some have spread into other risk groups in their respective countries. In Afghanistan, the introduction of HIV-1 into IDU networks has begun, but a recent report of 3% HIV-1 prevalence suggests that the epidemic is still at an early stage. Here we establish, by complete genome sequencing and phylogenetic analysis of four viral strains from Afghan IDUs, that all are the same complex recombinant strain, combining HIV-1 subtypes A and D and herein termed CRF35_AD. Published partial HIV-1 sequences from an HIV-1 epidemic among IDUs in Iran, already at 23.2% HIV-1 prevalence, are either CRF35_AD or a related recombinant. Voluntary HIV-1 screening and harm reduction programs in Afghanistan, applied now, could limit the spread of HIV-1, both in IDUs and in other social networks.
Assuntos
Surtos de Doenças , Infecções por HIV/genética , HIV-1/genética , Vírus Reordenados/genética , Abuso de Substâncias por Via Intravenosa/virologia , Adulto , Afeganistão/epidemiologia , Genótipo , Infecções por HIV/epidemiologia , HIV-1/classificação , Humanos , Masculino , FilogeniaRESUMO
Hepatitis E virus (HEV) is an important cause of hepatitis among young Egyptian adults with high seroprevalence rates seen in both rural areas of the Nile Delta and in suburban Cairo. Because natural antibodies to HEV have been detected in animals and zoonotic transmission is postulated, we surveyed work horses in Cairo for evidence of HEV exposure and viremia. Sera from 200 Cairo work horses were tested by ELISA for the presence of IgG anti-HEV antibody revealed a seropositivity of 13%. Among 100 samples processed for detection of viral genome by means of nested polymerase chain reaction (N-PCR), 4% were positive and indicative of viremia. Viremic animals were less than 1 year old. Relative to PCR-negative horses, PCR-positive animals demonstrated significant elevation of AST (p=0.03). Phylogenetic analysis of a 253-bp fragment, in the ORF-1,2,3 overlap region of the HEV genome from the viremic animals showed that three of these viral strains to be identical, and closely related (97-100% nucleotide identity) to two human isolates from Egypt, and distant (78-96%) from 16 other HEV isolates from human and animals and shared 99.6% NI with the fourth strain. The consensus sequence of the four strains was origin obtained elsewhere. These data indicated that horses acquire HEV infection and suggest that cross-species transmission may occur. Whether horses play a role in the transmission of HEV needs further investigation.
Assuntos
Hepatite E/epidemiologia , Hepatite E/virologia , Doenças dos Cavalos/epidemiologia , Adulto , Animais , Anticorpos Antivirais/sangue , Egito/epidemiologia , Ensaio de Imunoadsorção Enzimática , Hepatite E/imunologia , Vírus da Hepatite E/classificação , Vírus da Hepatite E/genética , Vírus da Hepatite E/imunologia , Vírus da Hepatite E/isolamento & purificação , Doenças dos Cavalos/virologia , Cavalos , Humanos , Dados de Sequência Molecular , Filogenia , Reação em Cadeia da Polimerase , ZoonosesRESUMO
The objective of this cross-sectional study was to assess prevalence and correlates of self-treatment of sexually transmitted diseases (STD) among female sex workers (FSW) in Tashkent, Uzbekistan. Enrolled FSW completed a self-administered questionnaire, HIV serologic testing and optional pelvic examination. STD diagnosis was based on physical examination and/or microscopic findings. Of 448 women, 337 (75.0%) accepted examination; of these, 316 (93.8%) received at least one STD-related diagnosis. Nearly half (45.4%) reported prior STD self-treatment, which was associated with HIV infection (age-adjusted odds ratio [AOR] = 3.20, 95% confidence interval [CI] = 1.45-7.53) and condom knowledge (AOR = 2.10, 95% CI = 1.16-3.80). For those with history of STD, immediate resumption of sex work before completing treatment was common (87.0%). STD self-treatment is common among FSW in Tashkent, particularly women with HIV infection. Confidential venues for STD care and condom utilization programmes targeted to FSW and their clients are needed to prevent STD in this setting.
Assuntos
Infecções por HIV/complicações , Conhecimentos, Atitudes e Prática em Saúde , Automedicação/métodos , Trabalho Sexual , Comportamento Sexual , Infecções Sexualmente Transmissíveis/tratamento farmacológico , Infecções Sexualmente Transmissíveis/psicologia , Adolescente , Adulto , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde , Inquéritos Epidemiológicos , Humanos , Infecções Sexualmente Transmissíveis/complicações , Infecções Sexualmente Transmissíveis/epidemiologia , Uzbequistão/epidemiologiaRESUMO
An outbreak of a blistering disease was reported in a military unit training in the Arizona desert during heavy rain and flooding. In a unit of 249 personnel, 33 presented with dermatologic complaints, and 4 met stringent diagnostic criteria for dermatitis linearis. A fifth patient presented with symptoms and signs of "Nairobi eye." Staphylinid (rove) beetles related to the paederids, which have been responsible for vesicular dermatitis outbreaks in other parts of the world but not previously in the United States, were collected at the site. Reports in the antique scientific literature document paederids in the area after periodic floods. These findings suggest that rove beetle dermatitis should be added to the differential diagnosis of vesicular dermatitis in western North America.
Assuntos
Vesícula/diagnóstico , Vesícula/etiologia , Besouros , Surtos de Doenças/estatística & dados numéricos , Mordeduras e Picadas de Insetos/diagnóstico , Mordeduras e Picadas de Insetos/etiologia , Militares , Animais , Arizona/epidemiologia , Vesícula/epidemiologia , Diagnóstico Diferencial , Desastres , Humanos , Mordeduras e Picadas de Insetos/epidemiologia , Chuva , Estações do AnoAssuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Abscesso/diagnóstico , Imunocompetência , Infecção por Mycobacterium avium-intracellulare/diagnóstico , Pescoço , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Infecções Oportunistas Relacionadas com a AIDS/terapia , Abscesso/imunologia , Abscesso/terapia , Adulto , Fármacos Anti-HIV/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Antituberculosos/uso terapêutico , Biópsia por Agulha , Contagem de Linfócito CD4 , Terapia Combinada , Drenagem , Humanos , Masculino , Infecção por Mycobacterium avium-intracellulare/imunologia , Infecção por Mycobacterium avium-intracellulare/terapia , Prednisona/uso terapêutico , Radiografia Intervencionista , Tomografia Computadorizada por Raios XRESUMO
Bacillary angiomatosis is a cutaneous or visceral infection with Bartonella henselae or Bartonella quintana. Cases usually occur in HIV infected individuals. We present a 60-year-old man with chronic lymphocytic leukemia and neutropenic fever caused by bacillary angiomatosis. The nine BA cases in oncology patients are reviewed.
Assuntos
Angiomatose Bacilar/complicações , Leucemia Linfocítica Crônica de Células B/complicações , Adolescente , Adulto , Idoso , Angiomatose Bacilar/tratamento farmacológico , Angiomatose Bacilar/microbiologia , Infecções por Bartonella/complicações , Infecções por Bartonella/tratamento farmacológico , Infecções por Bartonella/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The objective of this paper is to describe prevalence and correlates of sexual risk behaviors among injection drug users (IDUs) in Tashkent, Uzbekistan. Participants in this cross-sectional study completed a questionnaire detailing sociodemographic, medical and drug and sexual risk behaviors and HIV antibody testing. Of 701 IDUs surveyed, only 20.5% reported consistent condom use, which was more likely for women. Prior sexually-transmitted infection (STI) diagnosis was reported by 36.2% of participants and was associated with early (=18 years) drug initiation, group drug use, being older, higher educational level, marriage, needle sharing, multiple sex partners in the preceding month and daily injection use. Having multiple partners in the preceding month was common (29.71%) and related to employment, consistent condom use with regular partners and STI self-treatment in multivariate logistic regression. Participants with a history of sharing needles were less likely to have had multiple partners in the previous month. Risky sexual behaviors are common and interrelated with risky injection habits among IDUs in Tashkent, Uzbekistan, representing a continued threat of infection with HIV and other blood-borne agents.
Assuntos
Preservativos/estatística & dados numéricos , Uso Comum de Agulhas e Seringas/efeitos adversos , Infecções Sexualmente Transmissíveis/prevenção & controle , Abuso de Substâncias por Via Intravenosa/complicações , Sexo sem Proteção/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Uso Comum de Agulhas e Seringas/psicologia , Razão de Chances , Prevalência , Fatores de Risco , Parceiros Sexuais/psicologia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Uzbequistão/epidemiologiaRESUMO
An outbreak of influenza A (H3N2) occurred aboard a U.S. Navy ship in February 1996, despite 95% of the crew's having been appropriately vaccinated. Virus isolated from ill crew members was antigenically distinct from the vaccination strain. With an attack rate of 42%, this outbreak demonstrates the potential for rapid spread of influenza in a confined population and the impact subsequent illness may have upon the workplace.