Third- generation anti-HCV tests (EIA-3 and RIBA-3, respectively) contain antigens from the HCV core, nonstructural 3, nonstructural 4, and nonstructural 5 genes. HCV tridot is a visual, qualitative, fourth generation HCV-Ab screening assay, based on flow through technology, utilizing a unique combination of modified antigens from the putative core, NS3, NS4, and NS5 regions of HCV. These antigens are immobilized on a porous immunofiltration membrane.  Detection of HCV RNA in patient specimens by polymerase chain reaction (PCR) provides evidence of active HCV infection and is potentially useful for confirming the diagnosis and monitoring the antiviral response to therapy. 
Sexual transmission has long been recognized as a major source of HBV transmission in the world . It is, therefore, not surprising to identify multiple sexual exposures as significant risk factor for HBsAg seroposi- tivity. In the current study, statistically significant associ- ation was observed between history of multiple sexual exposure and HBV infection ( P < 0.05). Individuals who had multiple sexual partners were at five fold of elevated risk of acquiring HBV infection. This is in agreement with the findings of Rabiu et al.  and Obi et al. , who also demonstrated a history of multiple sexual part- ners to be significant riskfactors for HBV infection during pregnancy. Changes in sexual practice and behav- ior modification may therefore be an important step towards reduction of hepatitis B infection.
Early diagnosis and treatment of HBV and HCV in- fections in mothers are important to combat transmis- sion to children, which can lead to the rapid spread of these diseases in the community (9, 10). Studies on seroepidemiology of HBV and HCV prevalence in Ethiopia have been previously done among different risk population groups including pregnant women (2, 10). However, there is very limited data about the prevalence of HBV and HCV infections among the general population like healthy mothers or women in Harar town and its neighbouring areas. Therefore this study attempted to determine seroprevalence of HBV and HCV and their associatedriskfactors among mothers living in Harar town, Eastern Ethiopia
HBV infection prevalence in pregnant women is esti- mated to be around 3.7% (16), whereas the preva- lence of HCV in pregnant women ranges from 0.5 to 8.5% (17). Most of the previous studies in Ethiopia focused mainly on blood donors and pregnant women at health facilities, which may underestimate or exaggerate the actual prevalence. Furthermore, most studies on seroprevalence of HBV infection depend either on rapid test kits or ELISA method to capture HBsAg markers (11-17). In this study, anti- HBc levels determined using ELISA are used as a marker to identify mothers exposed to the virus in the past but test negative for HBsAg marker. Overall, this community-based cross-sectional study was con- ducted to determine the magnitude of HBV and HCV infections and associatedriskfactors among mothers in Jimma, southwest Ethiopia.
Human Immunodeficiency virus (HIV), Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections remain a global public health concern especially in Africa [1, 2]. West and central Africa region accounts for 21% of the world’s new HIV-infections and 30% of global deaths from AIDS-related illness . Both the rate of new HIV- infections and the burden of HIV remain high in west- ern and central Africa. The incidence prevalence ratio in the region has changed little since 2010, it stood at 0.06 [0.04–0.09] in 2017, twice as high as the epidemic transi- tion benchmark of 0.03 . Deaths from AIDS-related illness in the region have declined by nearly a quarter since 2010, and annual new HIV-infections declined by 8%. Cameroon, Ivory Coast and Nigeria together accounted for approximately 71% of new HIV-infections in the region in 2017 . The World Health Organization (WHO) estimated that globally in 2015, viral hepatitis led to 1.34 million deaths and 96% were the results of complication of chronic HBV (66%) and HCV (33%) infections . In African region, prevalence of this two virus infections was respectively 6.1% (about 60 million people) and 1% (about 11 million people) . In 2019, Hepatitis Scorecard 2019 for WHO Africa Re- gion reported HBV and HCV prevalence for various countries located in West Africa: Nigeria 5.5 and 2.1%, Ivory Coast 6.1 and 1.7%, Cameroon 4.4 and 0.7% or Mali 8.5 and 3.1% respectively . Otherwise, Syphilis prevalence in Africa varies according to population study; among blood donors in Nigeria prevalence was 3.1%  whereas in a population of men who have sex with men (MSM) living in Burkina Faso, 6.1% were tested positive for Treponema pallidum antibodies .
drug as well as the D-drug group of antiretrovirals (didano- sine, zalcitabine) in other studies [23,38,41,42,61,62]. Re- cently, in a meta-analysis of the riskfactorsassociated with HS in HIV-HCV patients, Machado et al. failed to find any association with antiretrovirals of any class and HS as well as in our study [16,22]. Moreover, Woreta et al., showed in a study including a majority of Black patients (87%) with 94% genotype 1, the lack of association with antiretroviral drugs with a median cumulative drug exposure similar to ours . Despite its relatively small sample size, our study had a statistical power of 80% to detect an increased risk of steatosis of 3 for the antiretroviral drugs used less fre- quently such as abacavir, tenofovir and lopinavir. We could hypothesize that discrepancies with other studies were linked to the differential prevalence of Caucasion subjects, of metabolic characteristics and frequency of genotype 1
Background: Toxoplasmosis is serious in the case of immune suppression and prenatal transmission. In immuno- compromised hosts, it is manifested primarily as a life-threatening condition, toxoplasmic encephalitis. Congenital toxoplasmosis results in abortion or congenitally acquired disorders which primarily affect the central nervous system. This study assessed seroprevalence of Toxoplasma gondii (T. gondii) infection and associatedfactors among HIV-infected women within the reproductive age group (18–49 years) at Mizan Aman General Hospital, Southwest Ethiopia. An institution based cross-sectional study was conducted from February 01 to May 30, 2015. Systematic random sampling technique was employed for participant selection. Enzyme linked immuno sorbent assay was used to test for T. gondii from venous blood specimens. Participants were interviewed using structured questionnaire for different variables. Descriptive statistics, binary and multivariable logistic regression analyses were performed during data analysis. P value of less than 0.05 was considered statistically significant.
Polypharmacy is defined as the use of potentially inappropriate drugs and/or as the concurrent use of multiple medications including prescription and over-the-counter drugs [1–5]. The exact number of medications indicating polypharmacy has been defined variously, e.g., 2 or more , 4 or more , 5 or more [1, 3, 7–11], 6 or more [2, 12–14] and excessive poly- pharmacy (defined as ≥10 medications)  . It has been suggested that based only on the number of medications, five or more items per day could be considered poly- pharmacy . Polypharmacy has been shown to have an association with falls; including fall riskfactors and fall-related injuries, adverse drug events [6, 16, 17], po- tentially inappropriate medications (PIMS), potential drug-drug interactions (PDDIs), increased healthcare utilization , increased hospitalization  and in- creased mortality  as well as a variety physical symp- toms including decreased cognitive function, poor quality of life and increased risk of dying [6, 7, 10, 18]. Polypharmacy is common among the elderly. The preva- lence of polypharmacy in the elderly (≥ 6 drugs) has been reported to be 86.4% in Korea , 29.4% in US  and, 83.5% in Taiwan . In US, the prevalence of eld- erly using eight or more drugs was report to be 15.7% . Using a definition of five or more drugs, the preva- lence of polypharmacy was 29% among elderly Thais  and 26.7% in older adult in Germany . At an internal medicine outpatient clinic of a tertiary care hospital in Thailand, the median number of medicines was 5.6 per patient. Using the Beers criteria for potentially inappro- priate medications (PIMs), 19.2% of elderly patients were classified as PIMs while by the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions. (STOPP) criteria found 31.5% were classified as PIMs . The prevalence of polypharmacy (five or more drugs daily) in elderly inpatients at the facility was 51.9% with an overall average of 4.9 medications. Moreover, the prevalence increased to 67% at discharge with an average of six medications . A study at Thai tertiary care hospital reported a polypharmacy incidence at dis- charge of 76.3% . A population-based study found the prevalence of using at least 5 medications daily in the elderly aged between 75 and 85 years increased from 30.6 to 35.8% over a period of 7 years (2005–2011) . A study of elderly people with hypertension found that patients were prescribed an average of 3.08 daily medica- tion . Riskfactors found to be associated with in- creased medication use were include increasing age, Indian ethnicity and a higher number of comorbidities specifically those diagnosed with cardiovascular, endo- crine and gastrointestinal disorders . Frailty, multi- morbidity, obesity, decreased physical and mental health status have been identified as riskfactors for excessive
The prevalence of HCV antibodies in our study population was estimated at 4.4%.The seroprevalence of HCV infection in the general population in Camer- oon is still a matter of concern. Up to now no nationwide representative study has provided better estimates of the seroprevalence of HCV in the country. A recent meta-analysis on 31 studies including 36 407 individuals from different groups has reported an overall pooled HCVseroprevalence of 6.5%  that was higher compared to the 2.5% reported by Njouom et al. in 2018  in patients aged between 15 - 59 years. In most published studies in Cameroon HCV sero- prevalence is higher in older population and the low prevalence reported by Njouom et al. could be explained by the fact that they do not included patients of more than 60 years. Nevertheless, HCVseroprevalence of 4.4% reported in this study is high and could be explained by the presence of several riskfactors for HCV transmission in our prison setting including homosexuality, scarifications, sharing of toiletries, both intravenous and non-intravenous drug use, history of tattooing and piercing.
Abstract: Toxoplasma gondii (T. gondii), which infects many warm-blooded animals including humans, causes toxoplasmosis, a globally widespread condition. To date, no research has explored the overall T. gondii infection seroprevalence among women in Saudi Arabia, nor have the riskfactorsassociated with the infection been examined in the Saudi Arabian context. The present systematic review and meta-analysis therefore aimed to investigate toxoplasmosis seroprevalence based on previous study samples of Saudi women of reproductive age, and to establish the potentially riskfactors in this national context. PubMed, Science Direct, and Scopus were searched for studies on T. gondii seroprevalence among women in mainland Saudi Arabia published between January 2000 and December 2017. Seroprevalence with 95% CI was presented for each study, and point estimates and their 95% CIs of pooled seroprevalence were then calculated. Twenty papers were eligible for inclusion, with samples totaling 13,597 females of childbearing age (ie, between 15 and 49 years) covering various regions of Saudi Arabia. The pooled estimation for T. gondii prevalence using a random-effect model was calculated as 27.8% (95% CI =20.6%–36.3%). A significant association was observed between age and T. gondii seroprevalence. This review represents the first comprehensive and systematic evalu- ation of T. gondii infection seroprevalence among Saudi Arabian women, and reports a high prevalence of Toxoplasma infection. Further research is required to support the development of more cost-effective preventive strategies.
Data were analyzed using the ‘meta’ packages of the statistical software R (version 3.3.3, The R Foundation for statistical computing, Vienna, Austria). Unadjusted prevalence was recalculated based on crude numerators and denominators provided by individual studies. To minimize the effect of studies with extremely small or extremely large prevalence estimates, the variance of the study-specific prevalence was stabilized with the Freeman-Tukey double arcsine transformation before pooling the data within a random-effects meta-analysis model . Egger’s test served to assess the presence of publication bias . A p-value < 0.05 on the Egger test was considered indicative of statistically significant publication bias. Heterogeneity was evaluated by the χ 2 test on Cochrane’s Q statistic , which was quantified by H and I 2 values. The I 2 statistic estimates the percent- age of total variation across studies due to true between-study differences rather than chance. In gen- eral, I 2 values greater than 60–70% indicate the presence of substantial heterogeneity .
patients. They are used for diagnostic test, reflex test after antibody testing to distinguish infected from non infected HCV seropositive individuals. It is also used for monitoring antiviral therapy in HCV posi- tive patient (13). HCV core antigen has the advan- tage of being used for confirmation of infection(14). It utilizes standard ELISA format, it is easy to per- form, cheap and less cumbersome(14). In a setting where samples need to be shipped to a laboratory, HCV core antigen could prove to be more stable than HCV RNA.(15) HCV RNA testing is technologically difficult, cumbersome, expensive and require more skill.(14) Hence, the need for HCV core antigen test- ing in low resource environment. Most of the HCV seropostive samples tested for HCV core antigen, the detection rate were between 50-76.7%.(10-14) The transmission of HCV can follow exposure to infected blood and blood products including blood transfusion. Intravenous drug abuse, transplantation of infected organs as well as common cultural prac- tices in some African countries such as scarification, circumcision and tattoos with unclean instruments constitute risks.(16-20)
The purpose of this study was to estimate a point prevalence of depression and anxiety disorders among Sudanese peri-natal women attending ant-natal and postnatal clinics in the capital city of Sudan. Simultaneously, to examine the associated risks factors. Participants were 945 peri-natal women in two main women antenatal and post natal clinics in the Capital City of Sudan screened consecutively. They were divided into two groups. The first group was of, Four Hundreds eighty (480) women in their third trimester, and the second group consisted of Four Hundreds Sixty Five (465) women in the first 10 week of postnatal period. All participants were screened, using Beck Depression Inventory (BDI), Hospital Anxiety and Depression scale (HADS), and Personal infor- mation Questionnaire (PIQ) for collecting socio-demographic, personal, medical, social and family history data. Routine urine and blood results were recorded. Results: 59% of prenatal and 46% of postnatal women suffered from high levels of distress in the form of mixed anxiety and depressive symptoms. However, only 20.9% of peri-natal women suffered of moderate to severe depression. Over 90% of the depressed women were not formally diagnosed or received psychiatric help. Poor marital relationship, physical co-morbidity, positive family history and past psychiatric history of depression were the main significant riskfactorsassociated with perinatal depression and anxiety. Conclusion: Contrary to the commonly held views that perinatal women are mainly plighted with depression as the main mental illness, this study confirms initial findings that, anxiety disorder is far more prevalent and more distressing to this vulnerable group. Moreover, psychiatric morbidi- ties in both prenatal and postnatal periods attract high prevalence rates in low income countries. Maternal health policies in low income countries must incorporate routine screening for mental health status, basic support and interventions for mental illnesses in perinatal women. Depression and emotional disorders in perinatal women should be seen as important public health priority.
Methods: An institution based cross-sectional study was conducted from May to August 2016. A total of 519 con- secutive acute febrile patients attending the outpatient departments of Teltelle Health Center, Yabelo and Moyale Hospitals were enrolled. Data on socio-demographic and environmental riskfactors were collected using a struc- tured questionnaire. Blood samples were collected from all participants and screened for yellow fever virus expo- sure using the indirect immunofluorescent assay.
This study reported a negative correlation between parental education level and HAV antibody seroprevalence. This has also been observed in other previous studies  . It has been noted that parental education level has a direct effect on lifestyle led by the family through influencing sanitation, living in a less crowded area and thus being accessible to portable treated water . On the contrary children from a low SES, whose parental level of education was low, may have been exposed to negative en- vironmental factors that facilitated hepatitis A transmission and hence infection.
association with their counterparts. The major significant correlates of depression were unplanned pregnancy, lack of family support, and mothers as housewives, whereas for anxiety disorders, lack of family support and dissatisfaction in married life were the significant correlates. Older mothers (40 to 45 years old) and marital dissatisfaction were the major significant correlates for stress disorders. These study results reveal that the depression, anxiety and stress, the quality of relationships with husbands, and family support are all significantly intercorrelated. There was a nearly two- fold increase in the odds of reporting depression, anxiety, and stress in women experiencing one to two stressful life events, confirming the marked association between stressful life events and emotional distress in their postpartum period. The most common life events that affected our postpartum mothers were unplanned pregnancy and poor relationships with their mothers-in-law. International studies 2,23 have also
Different countries successfully eradicated brucellosis from their livestock but brucellosis is at present a persis- tent problem in Pakistan. No attempts have been made to control brucellosis in or to eradicate it from livestock in this country yet. It is well known that brucellosis in livestock poses also a severe risk for human health. The seroprevalence in this study was 6.3% and varied across different sampling regions. At herd level, herd size, abor- tion and insemination methods were considered as poten- tial riskfactors for brucellosis. While at animal level, sex, age and stock replacement were associated with Brucella seropositivity. Detection of B. abortus biovar 1 in cat- tle and buffalo raw milk highlights the significant danger to public health. Although the MRT and RBPT are first line screening tests for brucellosis in livestock in Paki- stan, their lack of specificity is of concern. Therefore, the requirement for other more specific confirmatory tests but still fairly cheap should be considered for the control and eradication of brucellosis from livestock in Pakistan, so the risk to humans can be minimized.
Remarkably, in the present study we found an associ- ation of T. gondii exposure with the presence of dizziness and memory impairment in Huicholes. This finding may indicate a causal association of infection with T. gondii and central nervous system illness in Huicholes. The asso- ciation of T. gondii exposure with dizziness and memory impairment was also found in a recent study in migrant agricultural workers in Durango . The association of memory impairment and T. gondii exposure was also assessed in other ethnic groups in Durango including Mennonites  and Tepehuanos ; however, no asso- ciation was found. The association of dizziness and T. gondii exposure was not assessed in Mennonites  and Tepehuanos . We are not aware of further reports on the association of dizziness with T. gondii infection. On the other hand, the association of memory impair- ment with T. gondii infection found in the present study agrees with previous reports [27,28]. In a previous study in gardeners in Durango City, T. gondii seropositivity was associated with memory impairment . In a recent study in seniors in Germany, researchers found that T. gondii seropositivity was associated with a reduction of about 35% in working memory, a lower performance in verbal memory, and a decreased quality of life . A number of reports indicate that T. gondii infection may lead to neurological and behavioral changes. Experiments in adult mice have shown that infections with T. gondii
viruses (tick-borne encephalitis virus), protozoans (Babesia sp.) or bacteria (Anaplasma phagocytophilum). The most famous bacteria transmitted by ixodid ticks is the spiro- chete Borrelia burgdorferi (Bb) (s.l.), which can cause Lyme disease (LD) [3, 4]. A Belgian study reported that 12.0% of ticks were infected by Bb . The most frequent genomos- pecies were Borrelia afzelii (55%) and B. garinii (21%). Another recent study showed that 17.6% of nymphs were infected, most commonly by B. afzelii . The main clinical manifestation of LD is erythema migrans (EM) but the spirochete can cause early disseminated LD (arthritis, neuroborreliosis) and late disseminated LD, with manifestations such as acrodermatitis chronica atro- phicans or Lyme arthritis [3, 7]. LD diagnosis is mainly based on clinical history and symptoms (presence of EM,
Methods: A prospective observational study was conducted in ESIC MC and PGIMSR, Rajajinagar, Bangalore, Karnataka, India. All cases of intrauterine fetal death confirmed either with ultrasound or on clinical examination by absence of fetal heart rate and fetal movements were studied. The age, parity, literacy, socio-economic status was recorded. Detailed history, clinical examination, associated conditions. Mode of delivery and details of the fetus and their placentas were noted. They were followed for 3 days for complications.