AIM： To analyze the Hepatitis C virus （HCV） genotype distribution and transmission risk factors in a population of unselected patients in Luxembourg.METHODS： Epidemiological information （gender, age and transmiss...AIM： To analyze the Hepatitis C virus （HCV） genotype distribution and transmission risk factors in a population of unselected patients in Luxembourg.METHODS： Epidemiological information （gender, age and transmission risks） were collected from 802 patients newly diagnosed for hepatitis C and living in Luxembourg, among whom 228 patients referred from prison. Genotyping using 5＇noncoding （5＇NC） sequencing was performed. We compared categorical data using the Fisher＇s exact F-test and odds ratios （OR） were calculated for evaluating association of HCV genotype and risk factors.RESULTS： The sex ratio was predominantly male （2.2） and individuals aged less than 40 years represented 49.6% of the population. Genotype 1 was predominant （53.4%） followed by genotype 3 （33%）. Among risk factors, intravenous drug usage （IVDU） was the most frequently reported （71.4%） followed by medical-related transmission （17.6%） including haemophilia, transfusion recipients and other nosocomial reasons. Genotype 3 was significantly associated to IVDU （OR = 4.84, P 〈 0.0001） whereas genotype 1 was significantly associated with a medical procedure （OR = 2.42, P 〈 0.001）. The HCV genotype distribution from inmate patients differed significantly from the rest of the population （Chi-square test with four degrees of freedom, P 〈 0.0001） with a higher frequency of genotype 3 （46.5% vs 27.5%） and a lower frequency of genotype 1 and 4 （44.7% vs 56.8% and 5.3% vs 9.6%, respectively）. IVDU was nearly exclusively reported as a risk factor in prison.CONCLUSION： We report the first description of the HCV genotype distribution in Luxembourg. The repartition is similar to other European counties, with one of the highest European prevalence rates of genotype 3 （33%）. Since serology screening became available in 2992, IVDU remains the most common way of HCV transmission in Luxembourg.展开更多
Background: Conditions in prisons favour rapid transmission of Mycobacterium tuberculosis and progression to tuberculosis (TB) disease, resulting in higher prevalence rates of TB in prisons than in the corresponding g...Background: Conditions in prisons favour rapid transmission of Mycobacterium tuberculosis and progression to tuberculosis (TB) disease, resulting in higher prevalence rates of TB in prisons than in the corresponding general population. However, in many developing countries with high TB burden, passive case-finding remains the usual approach to case detection of TB in prisons. On this premise, the Abia State TB Control Programme conducted a pilot study to assess the contribution of active case finding to tuberculosis control in Aba Federal Prison. Methods: The inmates were clinically screened and those with symptoms suggestive of TB cases were tested by sputum smear microscopy. Results: Out of the total number of 477 prison inmates present in the prison at the time of study, 449 (94.1%) were clinically screened for history of cough of 2 weeks’ duration;52 (10.42%) met the inclusion criteria for sputum smear microscopy. Eleven of the 52 (21.15%) tested for acid fast bacilli (AFB) by direct smear light microscopy were positive for AFB. One inmate was on anti-tuberculosis therapy;this with the 11 cases detected in the course of this study gave a total of 12 inmates of Aba prison with active pulmonary tuberculosis at the time of this study. This gives a minimum point prevalence rate of 2405 cases per 100,000 prison inmates. Four of the 11 prison cells had at least one smear positive case with 7 of the 11 cases concentrated in two cells. The age group of 25 - 34 years had the highest number of sputum positive cases. Conclusion: Active case-finding resulted in detection of 11 new cases of sputum positive tuberculosis (an increase in detection rate of 1100%) and the prevalence of sputum positive TB is very high (2405 cases per 100,000 prison inmates) in Aba prison. There is an urgent need to institute more effective TB case-finding and control in the prison.展开更多
Inmates in jails and prisons are a high-risk group for suicide. Often, legal claims of medical negligence and §1983 based on deliberate indifference by the correctional officials follow. Unique stable and dynamic...Inmates in jails and prisons are a high-risk group for suicide. Often, legal claims of medical negligence and §1983 based on deliberate indifference by the correctional officials follow. Unique stable and dynamic factors and circumstances and their interaction explain most suicides. A systematic suicide screening using a well-designed suicide screening questionnaire that captures known risk factors will identify most inmates at risk if adequately used. Identification and subsequent mental health assessment set the stage for preventive intervention, monitoring, and treatment of the inmates. A multidimensional suicide prevention program saves not only lives but also the best defense against a liability lawsuit.展开更多
An increase in energy efficiency and a reduction of carbon emissions in buildings are prerequisites for mitigating climate change. Public buildings should be energy-refurbished for minimizing their energy use, complyi...An increase in energy efficiency and a reduction of carbon emissions in buildings are prerequisites for mitigating climate change. Public buildings should be energy-refurbished for minimizing their energy use, complying with EU legislation and directives. The creation of net zero carbon emissions prisons in Crete, Greece with reference to the agricultural prison of Agia has been examined. The prison’s capacity is 178 offenders and the annual energy consumption has been estimated at 4000 KWh/prisoner. The use of a solar thermal system for hot water production and a solar-PV system for electricity generation has been proposed for generating the energy required in the prison. Two scenarios have been examined. In the first, the two solar energy systems would generate all the required energy in the prison, while in the second, the two solar energy systems would generate 50% of the annual required energy in the prison, and the rest would be produced by fossil fuels. A tree plantation, either with olive trees or with Eucalyptus trees, would be created for offsetting the carbon emissions due to fossil fuels used in the prison. The surface of the flat plate solar collectors in the solar thermal system has been estimated at 113.9 M<sup>2</sup> to 227.8 M<sup>2</sup> while its cost is at 34,170€ to 68,340€. The nominal power of the solar-PV system has been estimated at 151.9 KW<sub>p</sub> to 303.8 KW<sub>p</sub> while its cost is at 182,280€ to 364,560€. The area of the tree plantation sequestrating 50% of the current CO<sub>2</sub> emissions due to fossil fuels use in the prison has been estimated at 14.74 ha for olive trees and at 5.9 ha for Eucalyptus trees. The results indicated that the energy refurbishment in Agia’s agricultural prison in Crete, Greece, in order to zero its annual net carbon emissions, is feasible.展开更多
Background Hepatitis B virus(HBV)and hepatitis C virus(HCV)infections are common among individuals with human immune deficiency virus(HIV)infection worldwide.In this study,we did a systematic review and meta-analysis ...Background Hepatitis B virus(HBV)and hepatitis C virus(HCV)infections are common among individuals with human immune deficiency virus(HIV)infection worldwide.In this study,we did a systematic review and meta-analysis of the published literature to estimate the global and regional prevalence of HCV,HBV and HIV coinfections among HIV-positive prisoners.Methods We searched PubMed via MEDLINE,Embase,the Cochrane Library,SCOPUS,and Web of science(ISI)to identify studies that reported the prevalence of HBV and HCV among prisoners living with HIV.We used an eight-item checklist for critically appraisal studies of prevalence/incidence of a health problem to assess the quality of publications in the included 48 cross-sectional and 4 cohort studies.We used random-effect models and meta-regression for the meta-analysis of the results of the included studies.Results The number of the included studies were 50 for HCV-HIV,and 23 for HBV-HIV co-infections.The pooled prevalence rates of the coinfections were 12%[95%confidence interval(CI)9.0–16.0]for HBV-HIV and 62%(95%CI 53.0–71.0)for HCV-HIV.Among HIV-positive prisoners who reported drug injection,the prevalence of HBV increased to 15%(95%CI 5.0–23.0),and the HCV prevalence increased to 78%(95%CI 51.0–100).The prevalence of HBV-HIV coinfection among prisoners ranged from 3%in the East Mediterranean region to 27%in the American region.Also,the prevalence of HCV-HIV coinfections among prisoners ranged from 6%in Europe to 98%in the East Mediterranean regions.Conclusions Our findings suggested that the high prevalence of HBV and HCV co-infection among HIV-positive prisoners,particularly among those with a history of drug injection,varies significantly across the globe.The results of Meta-regression analysis showed a sliding increase in the prevalence of the studied co-infections among prisoners over the past decades,rising a call for better screening and treatment programs targeting this high-risk population.To prevent the above coinfections among prisoners,aimed public he展开更多
基金The "Centre de Recherche Public-Santé" (CRP-Santé, project LRV-REC-06-01)
文摘AIM： To analyze the Hepatitis C virus （HCV） genotype distribution and transmission risk factors in a population of unselected patients in Luxembourg.METHODS： Epidemiological information （gender, age and transmission risks） were collected from 802 patients newly diagnosed for hepatitis C and living in Luxembourg, among whom 228 patients referred from prison. Genotyping using 5＇noncoding （5＇NC） sequencing was performed. We compared categorical data using the Fisher＇s exact F-test and odds ratios （OR） were calculated for evaluating association of HCV genotype and risk factors.RESULTS： The sex ratio was predominantly male （2.2） and individuals aged less than 40 years represented 49.6% of the population. Genotype 1 was predominant （53.4%） followed by genotype 3 （33%）. Among risk factors, intravenous drug usage （IVDU） was the most frequently reported （71.4%） followed by medical-related transmission （17.6%） including haemophilia, transfusion recipients and other nosocomial reasons. Genotype 3 was significantly associated to IVDU （OR = 4.84, P 〈 0.0001） whereas genotype 1 was significantly associated with a medical procedure （OR = 2.42, P 〈 0.001）. The HCV genotype distribution from inmate patients differed significantly from the rest of the population （Chi-square test with four degrees of freedom, P 〈 0.0001） with a higher frequency of genotype 3 （46.5% vs 27.5%） and a lower frequency of genotype 1 and 4 （44.7% vs 56.8% and 5.3% vs 9.6%, respectively）. IVDU was nearly exclusively reported as a risk factor in prison.CONCLUSION： We report the first description of the HCV genotype distribution in Luxembourg. The repartition is similar to other European counties, with one of the highest European prevalence rates of genotype 3 （33%）. Since serology screening became available in 2992, IVDU remains the most common way of HCV transmission in Luxembourg.
文摘Background: Conditions in prisons favour rapid transmission of Mycobacterium tuberculosis and progression to tuberculosis (TB) disease, resulting in higher prevalence rates of TB in prisons than in the corresponding general population. However, in many developing countries with high TB burden, passive case-finding remains the usual approach to case detection of TB in prisons. On this premise, the Abia State TB Control Programme conducted a pilot study to assess the contribution of active case finding to tuberculosis control in Aba Federal Prison. Methods: The inmates were clinically screened and those with symptoms suggestive of TB cases were tested by sputum smear microscopy. Results: Out of the total number of 477 prison inmates present in the prison at the time of study, 449 (94.1%) were clinically screened for history of cough of 2 weeks’ duration;52 (10.42%) met the inclusion criteria for sputum smear microscopy. Eleven of the 52 (21.15%) tested for acid fast bacilli (AFB) by direct smear light microscopy were positive for AFB. One inmate was on anti-tuberculosis therapy;this with the 11 cases detected in the course of this study gave a total of 12 inmates of Aba prison with active pulmonary tuberculosis at the time of this study. This gives a minimum point prevalence rate of 2405 cases per 100,000 prison inmates. Four of the 11 prison cells had at least one smear positive case with 7 of the 11 cases concentrated in two cells. The age group of 25 - 34 years had the highest number of sputum positive cases. Conclusion: Active case-finding resulted in detection of 11 new cases of sputum positive tuberculosis (an increase in detection rate of 1100%) and the prevalence of sputum positive TB is very high (2405 cases per 100,000 prison inmates) in Aba prison. There is an urgent need to institute more effective TB case-finding and control in the prison.
文摘Inmates in jails and prisons are a high-risk group for suicide. Often, legal claims of medical negligence and §1983 based on deliberate indifference by the correctional officials follow. Unique stable and dynamic factors and circumstances and their interaction explain most suicides. A systematic suicide screening using a well-designed suicide screening questionnaire that captures known risk factors will identify most inmates at risk if adequately used. Identification and subsequent mental health assessment set the stage for preventive intervention, monitoring, and treatment of the inmates. A multidimensional suicide prevention program saves not only lives but also the best defense against a liability lawsuit.
文摘An increase in energy efficiency and a reduction of carbon emissions in buildings are prerequisites for mitigating climate change. Public buildings should be energy-refurbished for minimizing their energy use, complying with EU legislation and directives. The creation of net zero carbon emissions prisons in Crete, Greece with reference to the agricultural prison of Agia has been examined. The prison’s capacity is 178 offenders and the annual energy consumption has been estimated at 4000 KWh/prisoner. The use of a solar thermal system for hot water production and a solar-PV system for electricity generation has been proposed for generating the energy required in the prison. Two scenarios have been examined. In the first, the two solar energy systems would generate all the required energy in the prison, while in the second, the two solar energy systems would generate 50% of the annual required energy in the prison, and the rest would be produced by fossil fuels. A tree plantation, either with olive trees or with Eucalyptus trees, would be created for offsetting the carbon emissions due to fossil fuels used in the prison. The surface of the flat plate solar collectors in the solar thermal system has been estimated at 113.9 M<sup>2</sup> to 227.8 M<sup>2</sup> while its cost is at 34,170€ to 68,340€. The nominal power of the solar-PV system has been estimated at 151.9 KW<sub>p</sub> to 303.8 KW<sub>p</sub> while its cost is at 182,280€ to 364,560€. The area of the tree plantation sequestrating 50% of the current CO<sub>2</sub> emissions due to fossil fuels use in the prison has been estimated at 14.74 ha for olive trees and at 5.9 ha for Eucalyptus trees. The results indicated that the energy refurbishment in Agia’s agricultural prison in Crete, Greece, in order to zero its annual net carbon emissions, is feasible.
文摘Background Hepatitis B virus(HBV)and hepatitis C virus(HCV)infections are common among individuals with human immune deficiency virus(HIV)infection worldwide.In this study,we did a systematic review and meta-analysis of the published literature to estimate the global and regional prevalence of HCV,HBV and HIV coinfections among HIV-positive prisoners.Methods We searched PubMed via MEDLINE,Embase,the Cochrane Library,SCOPUS,and Web of science(ISI)to identify studies that reported the prevalence of HBV and HCV among prisoners living with HIV.We used an eight-item checklist for critically appraisal studies of prevalence/incidence of a health problem to assess the quality of publications in the included 48 cross-sectional and 4 cohort studies.We used random-effect models and meta-regression for the meta-analysis of the results of the included studies.Results The number of the included studies were 50 for HCV-HIV,and 23 for HBV-HIV co-infections.The pooled prevalence rates of the coinfections were 12%[95%confidence interval(CI)9.0–16.0]for HBV-HIV and 62%(95%CI 53.0–71.0)for HCV-HIV.Among HIV-positive prisoners who reported drug injection,the prevalence of HBV increased to 15%(95%CI 5.0–23.0),and the HCV prevalence increased to 78%(95%CI 51.0–100).The prevalence of HBV-HIV coinfection among prisoners ranged from 3%in the East Mediterranean region to 27%in the American region.Also,the prevalence of HCV-HIV coinfections among prisoners ranged from 6%in Europe to 98%in the East Mediterranean regions.Conclusions Our findings suggested that the high prevalence of HBV and HCV co-infection among HIV-positive prisoners,particularly among those with a history of drug injection,varies significantly across the globe.The results of Meta-regression analysis showed a sliding increase in the prevalence of the studied co-infections among prisoners over the past decades,rising a call for better screening and treatment programs targeting this high-risk population.To prevent the above coinfections among prisoners,aimed public he
