Seroprevalence and risk factors for HIV transmission among female prostitutes: A community survey

To estimate the prevalence of HIV-1, HIV-2 and HTLV-I among female prostitutes, and to identify possible risk factors for HIV transmission in this collective, sera and epidemiological information from 71 prostitutes were obtained. Using the local network of a well-defined area in southern Catalonia, all prostitution bars were identified and their working women interviewed using a previously validated questionnaire. Eight sera were found positive for HIV-1 antibodies. Of those, 7 sera were also positive in the HIV-2 assay, probably as a result of cross-reactivity between the two viruses. All sera were negative for HTLV-I antibodies. In our area, where intravenous drug users (IVDUs) account for the majority of AIDS cases, the use of drugs by the prostitutes or by their steady sexual partners seems to be the most important risk factor for HIV infection in that group.     

Cancer incidence and risk factors among Montreal residents of Italian origin

Cancer risks associated with Italian ethnicity were investigated using data from a large case-control study on the aetiology of several cancer sites in the male population of Montreal. Two approaches were taken. First, incidence rates were computed for Italians and for others in the Montreal area using our ascertained cases as numerators and census-derived denominators. Secondly, for respondents to the case-control study, an analysis was carried out with Italian ethnicity as the risk factor and a number of covariates as potential confounders. Out of 4553 incident cases in men aged 35-69, 301 were of Italian origin. As compared with other Montreal males, those of Italian origin had higher incidence rates for cancers of the stomach (p = 0.016, based on 31 cases) and of the colon and rectum (p = 0.102, based on 75 cases) and lower rates for cancer of the lung (p = 0.006) and prostate (p = 0.102, based on 24 cases). For other sites the differences between Montrealers of Italian and non-Italian origins were small. Montreal Italians manifested risks similar to those of the country of origin for cancer of the prostate and similar to the host country for cancers of the colon, rectum and liver. For other sites it was difficult to characterize the pattern because of wide variations among Italian registries. Over 80% of the study subjects in Montreal were interviewed and odds ratios (OR) for Italian ethnicity were estimated for each cancer site using all other sites as controls, adjusting for five potential confounders.(ABSTRACT TRUNCATED AT 250 WORDS)     

Occupational risk factors for renal cell carcinoma in Montreal

BACKGROUND: Little is known about the role of workplace exposures on the risk of renal cell cancer. METHODS: A population-based case-control study was undertaken in Montreal to assess the association between hundreds of occupational circumstances and several cancer sites, including the kidney. A total of 142 male patients with pathologically confirmed renal cell carcinoma, 1900 controls with cancer at other sites and 533 population-based controls were interviewed. Detailed job histories and relevant data on potential confounders were obtained. A group of chemists-hygienists evaluated each job reported and translated them into a history of occupational exposures using a checklist of 294 substances. Multivariate logistic regression models using either population, cancer controls, or a pool of both groups were used to estimate odds ratios. RESULTS: There were some indications of excess risks among printers, nursery workers (gardening), aircraft mechanics, farmers, and horticulturists, as well as in the following industries: printing-related services, defense services, wholesale trade, and retail trade. Notwithstanding the low precision of many of the odds ratio estimates, the following workplace exposures showed some evidence of excess risk: chromium compounds, chromium (VI) compounds, inorganic acid solutions, styrene-butadiene rubber, ozone, hydrogen sulphide, ultraviolet radiation, hair dust, felt dust, jet fuel engine emissions, jet fuel, aviation gasoline, phosphoric acid and inks. CONCLUSIONS: For most of these associations there exist no, or very little, previous data. Some associations provide suggestive evidence for further studies.     

Seroprevalence of hepatitis A markers in subjects exposed to biological risk

Objectives: The seroprevalence of hepatitis A virus antibodies was investigated in a population of 1051 subjects, of whom 376 were controls and 675 were exposed to different degrees of biological risk. Methods: The exposed group was subdivided into subjects at low (242), intermediate (265), and high (168) biological hazard; all subjects were employed in the biomedical field. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were also determined. Results: The seroprevalence of positive hepatitis A antibodies was 44.9% in all subjects but was significantly higher in males (50.6%) than in females (34.2%) and increased according to age (25.9% in subjects aged ≤40 years and 62.2% in subjects aged >40 years). No difference related to exposure to the biological risk was observed. The prevalence of transaminases at levels above normal values (χ²= 4.079, P < 0.05 for AST and χ²= 4.806, P < 0.05 for ALT) and mean values (AST P < 0.05; ALT P < 0.001) appeared significant in hepatitis A virus-positive subjects. On the other hand, excluding individuals with positive hepatitis C virus antibodies (16) and positive hepatitis B virus surface antigen (12), a prevalence of transaminase alterations was not observed, but mean levels of ALT lasted significantly longer in subjects with positive hepatitis A virus antibodies (P < 0.01). Conclusions: The results confirm that hepatitis A virus is not a risk for employees in the biomedical field, but the presence of hepatitis A virus antibodies suggests a possible, though not clinically evident, liver involvement. Received: 15 June 1998 / Accepted: 23 October 1998     

Developmental risk factors for youth violence.

PURPOSE: To replicate earlier research findings on risk factors for youth violence and to explore the effects on violent behavior of constructs shown to increase risk for other problem behaviors, within a developmental frame. METHODS: Data were from the Seattle Social Development Project (SSDP), a prospective study involving a panel of youths followed since 1985. Potential risk factors for violence at age 18 years were measured at ages 10, 14, and 16 years. Bivariate relationships involving risk factor constructs in the individual, family, school, peer and community domains and violence were examined at each age to assess changes in their strength of prediction over time. Attention was also given to the additive strength of increasing numbers of risk factors in the prediction of violence at age 18 years. A final set of analyses explored the extent to which youths were correctly classified as having committed a violent act (or not) at age 18 years on the basis of their overall level of risk at ages 10, 14, and 16 years. RESULTS: At each age, risk factors strongly related to later violence were distributed among the five domains. Ten of 15 risk factors constructs measured at age 10 years were significantly predictive of violence at age 18 years. Twenty of 25 constructs measured at age 14 years and 19 of 21 constructs measured at age 16 years were significantly predictive of later violence. Many constructs predicted violence from more than one developmental point. Hyperactivity (parent rating), low academic performance, peer delinquency, and availability of drugs in the neighborhood predicted violence from ages 10, 14, and 16 years. Analyses of the additive effects of risk factors revealed that youths exposed to multiple risks were notably more likely than others to engage in later violence. The odds for violence of youths exposed to more than five risk factors compared to the odds for violence of youths exposed to fewer than two risk factors at each age were seven times greater at age 10 years, 10 times greater at age 14 years, and nearly 11 times greater at age 16 years. However, despite information gained from all significant risk factors, the overall accuracy in predicting youths who would go on to commit violent acts was limited. CONCLUSIONS: Findings from the study have important implications for preventive intervention programs. Prevention efforts must be comprehensive and developmentally sensitive, responding to large groups or populations exposed to multiple risks.     

Seroprevalence of hepatitis A among Thai population residing near Myanmar border

hen compared with Thailand, the seroprevalence of hepatitis A virus (HAV) is extremely high among its neighbouring countries. To investigate the seroprevalence of HAV among the Thai people residing in the border area between Thailand and Myanmar, 308 residents in Umphang, Maesod district, Tak, were recruited. Sera were tested for HAV IgG antibodies by enzyme-linked immunosorbent assay. The overall seroprevalence among the Thai people residing in the border area of Thailand was significantly higher than that among the general Thai population (71% vs 27% respectively, p < 0.05). As asymptomatic or mild HAV infection typically occurs in children, the Thai people residing in the border area may receive little benefit from universal HAV vaccination. Lower protective antibodies against HAV, along with the exclusion of HAV vaccine from the Expanded Programme on Immunization, potentially increase the susceptibility to HAV among the general Thai population and may lead to more future outbreaks if HAV is introduced from the border areas. The findings suggest that HAV vaccines should be recommended to travellers before their journey to the border between Thailand and Myanmar where HAV is endemic.     

An outbreak of hepatitis A among health care workers: risk factors for transmission.

OBJECTIVES. The purpose of this study was to investigate a nosocomial outbreak of hepatitis A that occurred in the burn treatment center of a referral hospital. METHODS. Retrospective cohort and case-control studies were performed to determine acquisition rates and risk factors for transmission. Adjusted infection rates were calculated by week of exposure. A case-control study was conducted to determine potential mechanisms for nosocomial acquisition. Recently infected health care workers were defined as case patients; exposed, serosusceptible health care workers without infection served as controls. RESULTS. The outbreak of hepatitis A affected 11 health care workers and 1 other burn patient (1 secondary patient case). All 11 health care workers became ill after the admission of a man and his 8-month-old son who developed hepatitis A while in the hospital. The cumulative incidence risk ratio was elevated for health care workers caring for either the infant or the father during the same week of exposure. The case-control study implicated the behavior of eating on the hospital ward as the single most important risk factor for infection. CONCLUSION. Inadequate hand-washing and subsequent oral contamination appear responsible for the outbreak. Hospitals may witness other institutional outbreaks if health care workers regularly eat on the wards.     

Reproductive health risk and protective factors among youth in Lusaka, Zambia.

PURPOSE: To: (a) identify risk and protective factors for behaviors that expose Zambian youth to risk of HIV infection and, (b) assess whether research findings from the United States concerning protective factors in "high-risk" environments might apply to other settings. METHODS: A community-based sample of 2328 youth ages 10-24 years residing in Lusaka, Zambia was interviewed. Multivariate statistical methods were used to isolate risk and protective factors for selected sexual and contraceptive behaviors. Seven categories of factors were considered: sociodemographic factors, sexual-reproductive health knowledge and perceptions, nonsexual risk behaviors, peer influence, connections with parents and social institutions, and communication with sexual partners. RESULTS: A sizeable number of factors were associated with each outcome. Only two factors, school attendance and knowledge of AIDS, were associated with both lower levels of sexual activity and consistent use of condoms, and only engaging in higher-risk social activities with close friends was a risk factor for both. The effects of the other factors considered varied by outcome and gender. As in prior research, strong influences of peers were observed, but connections with parents and social institutions unexpectedly did not emerge as protective. CONCLUSION: Because of the number and diverse nature of factors influencing adolescent behaviors, it is unlikely that a single intervention will be found to immediately change sexual risk-taking behaviors in Zambia.     

Seroprevalence and risk factors for hepatitis B virus infection by AgHBs and anti-HBs markers in prisoners and prime blood donors

Two cross-sectional surveys on hepatitis B virus (HBV) infection were carried out among 1,033 volunteer first-time blood donors in five blood banks (3 private, 2 public) and among 201 prisoners in the Penitentiary Center of Industrial Activity, in Goiania, Central Brazil, between June 1988 and February 1989. Those surveys were part of a major study designed to estimate seroprevalence of HBsAg and anti-HBsAg markers by ELISA test, and to study risk factors associated with seropositivity. The presence of any serum marker was considered as previous exposure to HBV. A standard questionnaire was applied to both populations to evaluate previous blood transfusion, number of sexual partners, homo/bisexual activity, history of sexually transmitted diseases, drug abusers, use of parenteral medicine, acupuncture, tattooing and VDRL seropositivity. Seroprevalence varied from 12.8% to 26.4% in blood donors and prisoners, respectively, (p less than 0.05) and increased with age (X2 trend=14.0 p less than 0.05%). Prisoners had higher percentages of all risk factors investigated than blood donors, with the exception of number of sexual partners. Among all risk factors studied, age, imprisonment and tattooing were statistically associated with seropositivity, even after multivariate analysis controlling for age and reclusion. The paper discusses the methodologic issues related to this epidemiologic investigation.     

Seroprevalence and risk factors of Toxoplasma gondii infection among pregnant women in Trinidad and Tobago.

OBJECTIVE: To determine the seroprevalence of toxoplasmosis and the frequency of risk factors for the disease in women attending antenatal clinics in hospitals and local health centers in Trinidad and Tobago. METHODS: From November 2002-September 2003, 232 pregnant women at the antenatal clinics of two large hospitals were sampled during their first trimesters. From October 2003-February 2005, 218 pregnant women at five health care centers were followed through three trimesters, wherever possible, and blood samples collected. Sera were screened for Toxoplasma gondii IgG and IgM immunoglobulins using an enzyme immunoassay. Data on demographics, as well as practices considered to be risk factors for toxoplasmosis, were obtained. RESULTS: Of the 232 women sampled at the two hospital clinics, 83 (35.8%) and 8 (3.4%) were seropositive for immunoglobulins of T. gondii IgG and IgM, respectively. Of the 218 women at the health centers, 76 (34.9%) had evidence of past infection (IgG), while 26 (11.9%) were seropositive for IgM immunoglobulin, suggesting new infections during pregnancy. Only having "3 or more" children was significantly associated with infection by T. gondii. CONCLUSION: In Trinidad and Tobago, the seroprevalence of past infection by T. gondii in pregnant women is relatively low (39.3%) for patients in both hospital and health center clinics. Consequently, there is an elevated risk of primary infection during pregnancy and the potential for congenital infection.     

Outreach health services for street youth.

A voluntary health agency operated a clinic at a drop-in center for street youth. Six hundred nine youths were seen, with an average age of 16 years, 9 months. There were 2,086 diagnoses made during 1,895 visits. Respiratory, dermatologic, and gynecologic problems represented 56% of all diagnoses. Pregnancy tests accounted for 38% of all procedures, 50% of all medications dispensed were either oral antibiotics or decongestants, and 17% of the visits resulted in referrals. This chart review revealed that street youth seen at a drop-in center sought care for common medical problems. Problems related to substance abuse and sexually transmitted diseases were seen much less frequently than anticipated. Elements critical to the success of this clinic included its on-site location, hours of operation when teenagers were using other services, close working relationships between clinic and center staffs, the capability to perform a few simple laboratory procedures, and an on-site pharmacy.     

Seroprevalence of hepatitis C among a juvenile detention population

The seroprevalence and determinants of hepatitis C virus (HCV) infection among adolescents in juvenile detention centers in Riverside County was assessed. Among 728 participants, 16 (2.2%, 95% CI 1.1%, 3.3%) demonstrated serologic evidence of HCV infection. Adolescents with a history of injection drug use (adjusted OR = 10.8, 95% CI 2.6, 45.3, P < .001) were more likely to be HCV seropositive, however the frequency of reported injection drug use was just 4%, and only 12% of HCV infection could be attributable to injecting drugs in this population. Additional information is needed on risk factors for HCV infection in adolescent populations. The relatively low level of HCV infection observed in this juvenile detention population underscores the opportunity for implementation of targeted intervention efforts.     

A multivariate analysis of risk factors for hepatitis B virus infection among hospital employees screened for vaccination

Previous studies of risk factors for hepatitis B virus infection among hospital employees have been based on surveys in single institutions or have been analyzed with univariate techniques. From November 1980 through August 1981, the authors performed a multi-institutional seroepidemiologic survey of hospital employees screened for entrance into a hepatitis B vaccine trial who represented groups at high risk for hepatitis B infection. Using a logistic regression model for the analysis of risk factors, the investigators determined the relative odds and 95% confidence intervals for risk of hepatitis B infection to be as follows: race (nonwhite/white: 3.4; 2.4-4.8) (p less than 0.001); history of acute viral hepatitis of an unspecified type (3.6; 2.2-5.9) (p less than 0.001); and employment at hospitals 1 through 5 as compared with hospital 6 (1.8; 1.1-2.9) (p = 0.015). In addition, certain job categories and the duration of employment within some of these categories were associated with increasing risk for hepatitis B infection over time. Laboratory workers (1.4; 1.2-1.7), surgical staff (1.2; 1.1-1.4), and medical staff (1.3; 1.1-1.5) had significant (p less than 0.05) increased risk of prior infection with longer duration of employment. Such time-job interaction was not demonstrable for nursing staff, anesthesiology staff, dental personnel, pathology staff, or ancillary personnel. The logistic regression model also shows that the highest gradient of risk for laboratory workers, surgeons, and medical staff occurs during the first five years of employment. An effective preventive strategy, such as the use of hepatitis B vaccine, should be targeted for these groups at the time of initial employment.     

Seroprevalence and risk factors for human herpesvirus 8 infection, rural Egypt

To determine whether human herpesvirus 8 (HHV-8) is associated with schistosomal and hepatitis C virus infections in Egypt, we surveyed 965 rural household participants who had been tested for HHV-8 and schistosomal infection (seroprevalence 14.2% and 68.6%, respectively, among those <15 years of age, and 24.2% and 72.8%, respectively, among those > or =15 years of age). Among adults, HHV-8 seropositivity was associated with higher age, lower education, dental treatment, tattoos, > or =10 lifetime injections, and hepatitis C virus seropositivity. In adjusted analyses, HHV-8 seropositivity was associated with dental treatment among men (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.1-5.2) and hepatitis C virus seropositivity among women (OR 3.3, 95% CI 1.4-7.9). HHV-8 association with antischistosomal antibodies was not significant for men (OR 2.1, 95% CI 0.3-16.4), but marginal for women (OR 1.5, 95% CI 1.0-2.5). Our findings suggest salivary and possible nosocomial HHV-8 transmission in rural Egypt.     

HIV risk profile and prostitution among female street youths

The objective of this study was to compare human immunodeficiency virus (HIV) risk factors among female street youths involved in prostitution and those with no history of prostitution. Youths aged 14 to 25 years were recruited into the Montreal Street Youth Cohort. Semiannually, youths completed an interviewer-administered questionnaire. Statistical analyses comparing characteristics and HIV risk factors for girls involved in prostitution and those never involved were carried out using parametric and nonparametric methods. Of the girls, 88 (27%) reported involvement in prostitution, and 177 girls reported no history of prostitution at the baseline interview. Girls involved in prostitution were two times and five times more likely to have reported bingeing on alcohol and on drugs, respectively. A history of injection drug use was four times more likely to have been reported by girls involved in prostitution. Further, these girls were 2.5 times more likely to have reported injected cocaine as their drug of choice. Girls involved in prostitution were younger the first time they had consensual sex and were twice as likely to have reported anal sex. Consistent condom use for anal, vaginal, and oral sex was low for all girls. Girls involved in prostitution reported more risky sexual partners. In conclusion, girls involved in prostitution may be at increased risk of HIV infection due to their injection drug use and risky sexual behaviors. Unique intervention strategies are necessary for reducing HIV infection among female street youths involved in prostitution.     

Outbreak of hepatitis A infection among intravenous drug users in Suffolk and suspected risk factors

A prolonged outbreak of hepatitis A infection amongst drug users in Suffolk prompted a study of the natural immunity against hepatitis A in this population, and a retrospective analysis of the relationship between specific drug-taking behaviours and the risk of hepatitis A infection. Prior to the outbreak, age-specific seroprevalence of hepatitis A IgG in drug users was similar to that amongst blood donors in the region. Of those without effective immunity, intravenous drug users, multiple drug users and those injecting frequently were more likely to have developed hepatitis. The reported frequency of equipment sharing and the number of injecting partners were not related to the risk of infection. The potential for blood-to-blood, and a suggested faecal-blood transmission were considered to be important in propagating the outbreak in this population. We suggest that a single dose of hepatitis A vaccine administered opportunistically should be used in outbreaks involving drug users.     

Seroprevalence of hepatitis B and C among oncology patients in Turkey

Hepatitis B virus (HBV) is one of the public-health issues worldwide. Approximately two billion people are infected with HBV, and about 350 million people are chronic carriers globally. About 3% of the world population is infected with hepatitis C virus (HCV). Oncology patients receiving packed red blood cell suspensions and other blood products usually are in the high-risk group for infections due to these viruses. The aim of the study was to detect the seroprevalence of hepatitis B and hepatitis C among chemotherapy patients at the Oncology Department of the Tepecik Education and Research Hospital. HBsAg, anti-HBs, anti-HBcIgM, anti-HBc total and anti-HCV assays were studied by enzyme immunoassay method (Diasorin, Italy) in serum samples of patients (n = 448) referred to the Department of Oncology of the Tepecik Education and Research Hospital during 1 June 2006-1 January 2007. Of the 448 patients, 19 (4.2%) were HBsAg-positive, and three (0.7%) had anti-HCV positivity. In this study, the seroprevalence of HBV was similar to previous data in Turkey. This could be due to widespread vaccination programmes. The seroprevalence of low anti-HCV may be because of controlled blood transfusion. Oncology patients should be monitored for their protective antibody levels against HBV, and they must be included in the vaccination programme. Their anti-HCV status should also be checked as well.     

A European risk model for hepatitis among health care workers

Hepatitis B (HBV) is the most important occupational hazardfacing workers in the hearth care and related environments.It is a serious, but underestimated, occupational hazard amongsuch personnel, who are at a 2 to 10 times greater risk of infectionthan the general population. In the light of recent changesin legislation concerning hepatitis B, we have designed a riskmodel for health care workers (HCW) in Western Europe to estimatethe number of cases of HBV infection in this group. An annualattack rate was derived, based on data from the literature andfrom hearth registers. The number of HCW exposed to HBV infectionwas calculated from official registers, taking into accountthe prevalence and incidence of HBV infection and vaccinationcoverage. Even with the present vaccination coverage of 40%among traditional HCW and 25% among allied HCW, we estimatethat 16,500 cases of HBV infection occur in these groups annually(i.e. over 40 per day). Approximately 5,800 workers will developacute symptoms and 990 will become carriers, of whom 240 willdie due to liver cirrhosis and/or primary hepatocellular cancer.If no further vaccinations are made, the number of infectionswill rise to approximately 24,000 each per year. An increasein vaccination coverage would greatly decrease these numbers.The amendments to the Biological Agents at Work EC Directive(EC90/679/EEC) were formally adopted on 12 October 1993. SinceApril 1994, a specific code of practice on vaccination shouldhave been in place in the national legislation of each memberstate. This represents an important step in achieving consensuson a preventive policy In Western Europe. It is equally importantthat the legislation obliges employers to identify and vacdnate(free of charge) those workers at risk of infection from hepatitisB.