Health and demographic status of unauthorized immigrants: the Albanian refugees landed in Italy (Apulia) in 1997

This study is aimed at assessing the health care demand of the Albanian groups arrived in Italy (Apulia) in 1997 and accommodated in the Cassano and Palese refugee camps. The analysis is based on the forms filled in on their arrival and first aid registers. Albanian health and demographic official data were also analyzed. The most common health problems observed amongst refugee groups were slight illnesses (23.3%), respiratory tract infections (11.3%), gastroenteritis (9.9%). In the light of these data, the refugees' status does not appear to be critical, although there remains the need to carry out constant monitoring to prevent infectious diseases and improve the quality of social facilities.     

HCV,HIV, HBV and HDV infections in intravenous drug addicts

Hepatitis viruses and the acquired immunodeficiency viruses often infect intravenous drug addicts (IVDAs). Our study includes 255 IVDAs (26 females and 229 males, aged 20–35 years) from Cagliari. Of 255 subjects examined, 207 (81.1%) were positive for anti-HCV and 84 (32.9%) for anti-HIV. Nineteen (7.4%) subjects were HBsAg carriers, and 12 of these (63%) had an HDV super-infection. Markers of previous HBV infections were tested in 223 cases and 137 (61.4%) were found positive; of these 14 (10.2%) also had HDV infection. Of the 223 drug addicts examined for all infection markers, 18 (8%) were negative to all markers, 46 (20.6%) were positive to only one, 89(39.9%) were positive to two, 64 (28.7%) to three and 6 (2.6%) were positive to all. Subjects with a single infection were significantly fewer than those with multiple infections. The correlations studied among the various markers did not point out any statistically significant associations. Even so, a previous HBV infection was more common while active HBV/HDV infections were less common among subjects with anti-HCV; HDV infection was more common among HIV-positive subjects. In HBsAg carriers neither HBV-DNA nor HCV-RNA was detected; HCV-RNA was found more frequently in anti-HIV positive subjects than in subjects with the anti-HCV isolate.     

Epidemiological research on trichinellosis in Apulia and Basilicata (Southern Italy)

Trichinellosis is a zoonotic infection and has a worldwide distribution. In Italy numerous sporadic cases and outbreaks of human trichinellosis have been reported. The authors report an epidemiological survey of trichinellosis in Apulia and Basilicata, two regions of southern Italy, where two outbreaks of human trichinellosi (about one hundred cases) have recently occurred, due to ingestion of wild boar meat (sausages). Serological and/or parasitological research was carried out in the trichinellosis patients, in uninfected people (control group), and in wild and synantropic animals. The incidence of infection found in various animal species (sylvatic trichinellosis) in these two regions is high and can represent a serious health risk.     

Prevalence of hepatitis virus infections in Albanian refugees

A sample of 393 Albanian refugees, including both children and adults, was tested for serological HAV, HBV, HDV and HCV markers. A high prevalence of infection with both the hepatitis A and B viruses was found, while HDV and HCV infections were uncommon. The overall prevalence of anti-HAV was 96%; it was very high in children 0-10 years, suggesting that HAV infection is largely acquired during childhood and that poor ambiental conditions influence the spreading of this viral infection.One or more serological markers of HBV infection were found in 295 Albanians (75%), confirming the endemic nature of this virus in the Albanian community. The overall prevalence of HBsAg was 19%, and the carrier rate was higher in males than in females. The high HBsAg prevalence among children suggests that HBV infection is usually acquired in early childhood.The serological data obtained in the Albanian sample examined clearly indicate the urgent need for measures to reduce the incidence of HAV and HBV infections and to avoid the further spread of HDV and HCV infections.Finally, the high prevalence of type B hepatitis indicates the necessity of vaccination against HBV for all risk groups and for all children at birth.     

Prevalence of HBV,HDV and HCV hepatitis markers in HIV-positive patients

Since HIV infection could condition the natural history of parenterally transmitted viral hepatitis (HBV, HCV, HDV), with possibly differing effects in different risk groups, we decided to retrospectively examine sera from a cohort of 637 HIV seropositive patients in different stages of infection, seen from 1985 to 1992, to study the prevalence and temporal course of these infections. Virological markers of HBV, HCV and HDV were determined by ELISA and RIBA methods. The severity of HIV infection was higher in homosexuals than in drug addicts. Prevalence of antiHBc antibodies was 82% in drug addicts and 77% in homosexuals, whereas antiHCV antibodies prevalence was 72% in drug addicts and only 7% in homosexuals (p<0.000001). When only antiHBc-positive patients were considered, there was a significant difference in antiHBs antibodies between drug addicts (DA) and homosexuals (OR for DA 0.29, 95% CI 0.08/0.83,p=0.02), suggesting that drug addicts are less able to produce a protective response. This fact cannot be explained by the severity of HIV infection (which was higher among the homosexual group) and suggests some immunodepressive effect of drug abuse. Delta infection was only detected in the drug addict group, and the prevalence was low. Finally, we cannot confirm the interference of HCV infection with the speed of HBsAg clearance: in this study the prevalence of HBsAg was almost the same in HCV-positive and negative patients.     

HBV,HDV and HIV infections in 242 drug addicts: Two-year follow-up

Of 242 north Italian heroin addicts, 24 (9.9%) were HBsAg positive. HBeAg was positive in two of them (8.3%), anti-HBe in 16 (66.6%) and anti-HDV in 21 (87.5%). Of the 218 HBsAg negative, 182 (83.5%) had anti-HBc, 72 (33.0%) anti-HBe and 97 (44.5%) anti-HBs. One-hundred-eighty-five drug addicts were anti-HIV positive (76.4%); 77 of these (41.6%) were asymptomatic, 93 (50.3%) had PGL and 15 (8.1%) ARC. T4+ cell count was significantly lower in subjects with ARC as was T4+/T8+ ratio in subjects with PGL and ARC. During a median follow-up of 9.5 months (range 4–25), we observed three new cases of hepatitis (two caused by NANBV and one by HBV with HDV coinfection) and one new HIV infection. Ten anti-HIV positive subjects developed PGL and one AIDS.     

Canine leishmaniasis in the Gargano promontory (Apulia,South Italy)

We examined 444 dogs by visiting farms and peripheral districts on the Gargano promontory (Province of Foggia, Apulia, South Italy). Clinical examination and immunofluorescence antibody test for leishmaniasis were performed. Bone marrow and lymph node samples obtained from 25 dogs with positive serological test were cultured on Tobie-Evans medium. The results obtained show both a higher seropositivity rate for canine leishmaniasis (14.4%) and a higher percentage of asymptomatic dogs with positive serological test (53.1%) compared to previous research in the same area. Seven strains isolated from infected dogs belonged to Leishmania infantum species zymodeme Montpellier 1. None of 82 sera of humans living in close contact with infected dogs were positive for leishmaniasis.     

Prevalence of HHV-8 Infection in Albanian Adults and Association with HBV and HCV

To estimate the prevalence of human herpesvirus type 8 (HHV-8) in Albania and its correlation with HBV and HCV, we tested 196 serum samples collected from apparently healthy adults (i.e., 154 women and 42 men). We found 20% anti-HHV-8 antibodies, about 10% HbsAg-positive, and 67% anti-HBc antibodies; anti-HCV antibody prevalence was 3%. It remains to be determined whether HHV-8 infection and HCV infection have common modes of transmission.     

Legionellosis in Apulia (Italy): an underevaluated disease

The frequent occurrence of Legionnaires' disease outbreaks in many countries, including Italy, highlights the importance of epidemiological investigations on this disease. For this purpose, an active surveillance programme of pneumonia patients was carried out in a large hospital in Apulia (Italy) from March 2001 to December 2003. A total of 612 patients were tested for Legionella pneumophila infection by urinary antigen detection and evaluation of antibodies titre. Culture of respiratory specimens was performed on 117 patients. Thirty-seven patients (6%) tested positive for legionellosis: 10 resulted nosocomial cases and 27 as community-acquired. Only 9 cases di Legionella pneumophila infection were reported from Apulia to the routine surveillance system between 1996 and 2000. The results of our study denote the level of underestimation of this disease in Apulia.     

Prevalence of HBV,HDV and HIV infections among intravenous drug addicts in Greece

The prevalence of HBV, HDV and HIV infection was studied in 288 imprisoned intravenous drug addicts (IVDA) and 329 controls. Commercially available radioimmunoassays for the detection of HBV and HDV serologic markers and enzyme-immunoassays for IgM anti-HBc and anti-HIV were used. Anti-HIV positive results were confirmed by Western Blot. The prevalence of IIBV serologic markers among IVDA (77.1%) was found considerably higher than among controls (22.5%). An increased prevalence of HBsAg carriers (6.9%) and anti-HBc alone positives (9.7%) was also found. IVDA carriers were more frequently HBeAg positive (25.0%) and HDV serologic markers were detected in 35.0% (7/20) of them. Anti-HIV were detected in 6 (2.1%) IVDA but in none control. These data show the widespread HBV and HDV infections among Greek IVDA and suggest the need for continuation of the initiated hepatitis B vaccination program. Anti-HIV prevalence is yet low. However there is urgent need for an extensive campaign to limit the further spread of the HIV among this high risk group.Corresponding author.     

病毒性肝炎联合诊断寡核苷酸芯片的临床应用性研究

目的：制备联合诊断乙型（HBV）、丙型（HCV）、丁型（HDV）肝炎病毒寡核苷酸（Oligo）芯片,并进行系列优化及临床应用性研究。方法：首先利用软件Array designer 3.0对BLAST检索所得的HBV、HCV、HDV种属保守序列逐一分析,设计出60mer Oligo探针。用PixSys5500型基因芯片打印仪将设计好的探针打印到氨基化玻片上制备成基因芯片,并对杂交条件进行系列优化以适应临床血清标本的检测。结果：芯片杂交条件进行优化后,芯片检测的敏感性、特异性都大大增强,还缩短了检测时间;杂交结果显示,Oligo芯片检测HBV、HCV、HDV的敏感性、特异性分别为92.2%,85.7%,91.3%和96.0%,94.5%,98.0%。结论：制备的长链Oligo集合肝炎病毒检测芯片检测敏感性、特异性均佳,为下一阶段进行中试规模的临床血清样品检测做好了准备,同时也为集合更多种、不同亚型肝炎病毒联合检测芯片的制备打下了坚实的基础。     

HBV、HCV和HDV混合感染在慢性肝病中的意义

采用酶联免疫法(ELISA)检测127例慢性肝病患者血清中的HBV、HCV和HDV感染标志,并采用逆转录—聚合酶链反应(RT-PCR)技术检测部分患者血清HCV-RNA。HBV、HCV和HDV混合感染共37例(29.1%)。混合感染者发生慢重肝的频率明显高于单独HBV感染者(P<0.05),混合感染占慢重肝病因的74.2%。混合感染所致慢重肝患者的凝血酶原时间、血清总胆红素及病死率明显高于单独HBV感染者。结果表明:HBV、HCV和HDV混合感染可能是慢性肝病重型化的主要原因,所致慢重肝患者的病情重、预后差。     

Carriers of Neisseria meningitidis among teen-agers in Apulia (Italy)

An investigation about N. meningitidis carriers was carried out in Apulia (Italy) among teen-agers. 85 healthy carriers were identified (1.4%): the 81.2% of isolates resulted polyagglutinable, 3.5% autoagglutinable and 1.2% were not classifiable with antisera. The other strains belonged to serogroup B (9.4%), W135 (2.3%), Y (1.2%) and 29E (1.2%). Some Authors report that non-groupable strains are usually isolated from healthy carriers pharynx. The most recent molecular methods permit to subdivide these bacteria in serotype and serosubtype by membrane protein antigens, too. So, today the only identification as serogroup is not able to study N. meningitidis epidemiology.     

乙丙型和乙戊型肝炎病毒双重感染的危险因素

目的 了解乙型病毒性肝炎（HepatitisB)患重叠感染丙型肝炎病毒（HCV）和戊型肝炎病毒（HEV）的危险因素。方法 对55例HBV和HCV双重感染及51例HBV和HEV双重感染病例,以1：1配对方式选取对照,用酶联免疫吸附测定法（ELISA）和聚合酶链反应（PCR）法检测各型肝炎病毒感染指标,配对x^2分析和多因素条件Logistic回归分析法确定危险因素。结果 单因素分析发现：输液史、牙科手术史、输血史、家庭外肝炎接触史、外餐习惯等因素与乙丙型肝炎病毒双重感染有关,其OR值分别为5．67、23．0、41．0、8．0、3．0。logistic多因素逐步回归分析,输血史为乙丙型肝炎病毒双重感染的独立 危险因素。家族成员肝火史和家庭外肝炎接触史与乙戊型肝炎病毒双重感染有相关性,其OR值分别为35．0和12．0。家庭成员乙型肝炎史为乙戊型肝炎病毒双重感染的危险因素。结论 输血史为乙丙型肝炎病毒双重感染的危险因素,家庭成员乙型肝炎史为乙戊型肝炎病毒双重感染的危险因素。     

延边农村地区朝鲜族HBV、HCV、HDV感染状况调查

为摸清延边农村地区朝鲜族人群乙、丙、丁型肝炎病毒(HBV、HCV、HDV)感染状况,用ELISA法对585名朝鲜族成年人进行了HBV、HCV和HDV感染标志物的检测.HBV、HCV标化感染率与HBsAg标化阳性率分别为50.91%、4.85%和8.57%,年龄组间差异无显著性.HBV、HCV双重感染率为2.56%,HBV与HCV的感染相关无显著性.42例HBsAg阳性者中HDV感染率4.76%.HBV感染模式有15种,其中以单项抗-HBs阳性多见,人群中占31.97%.表明人群中HBV、HCV和HDV感染的流行情况不同.     

Typhoid fever and environmental contamination in Apulia Region, Italy

The decrease of typhoid fever in Italy is described. In our country, the morbidity rate is now very close to 1/100,000, reached since the sixtie's in many european countries. It is highlighted the role of regions as Apulia and Campania which are contributing for more than 50% to the national morbidity. More specifically is analysed the endemic situation in the 12 AUSL of Apulia region allowing to evidentiate that the highest morbidity rates are found in the areas along the sea. Finally, based on the data collected from the investigations after the cholera outbreak in 1994, it is proved that the faecal contamination is responsible for the morbidity rate in Apulia 6.6/100,000 in 1999.     

HBV and HCV infection among non-European Union immigrants in North-East Italy.

The status of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection among non-European Union (non-EU) immigrants in North-East Italy was evaluated. Among the 1683 individuals tested the prevalence of HBsAg was 8.9% (150 subjects) and of HBV antibodies (anti-HBc with/without anti-HBs) was 38.9% (654 subjects). The distribution of HBV serological markers showed significant differences according to region of origin; the highest prevalence of infection (76.9%) and carriage (16.1%) was found in immigrants from sub-Saharan Africa. Among the 933 individuals screened for HCV infection, prevalence of antibody was much lower (0.9%) than that observed in the Italian general population (3.2-12.6%). The large number of HBV carriers among immigrants could increase the number of new adult infections due to life-style habits or professional risks in the host population. In contrast, the risk of HCV spread from non-EU immigrants is very low.