Prevalence of hiv infection, Syphilis, and Syphilis/HIV coinfection in blood donors from a blood bank of Porto Alegre, southern Brazil

Introduction: Hemotherapy consists of therapeutic treatments performed through blood transfusion. Clinical and serological screening of donors is an essential strategy to avoid transmission of infectious agents in blood transfusion.Objectives: Toassess the seroprevalence of HIV infection, syphilis and syphilis/HIV coinfection in blood donors from a blood bank in Porto Alegre from 2014 to 2016.Methods: Retrospective analysis of all blood donors registered on a software for managing hemotherapy services (Hemodot) of the Blood Bank in the Marques Pereira Laboratory, Porto Alegre / RS, from 2014 to 2016.Results: Of the 28,173 users of the hemotherapy service during the study period, 198 (0.70%) were positive for syphilis, HIV infection, or syphilis/HIV co infection. The prevalence of positive results for syphilis was 0.3%, 0.57% and 0.70% in 2014, 2015 and 2016, respectively, and for HIV infection was 0.18%, 0.14%, and 0.16% for the same period. However, the prevalence of syphilis/HIV coinfection was not statistically significant.Conclusions: The prevalence of syphilis increased significantly from 2014 to 2016. Hovever, this did not occur with HIV infection or with coinfection. This finding may reflect the requirement of the nucleic acid technique (NAT) for HIV screening in blood banks, a procedure that has been increasing transfusion safety and reducing the window period. Further studies may shed new light on the combined use of serological tests and NAT assays in blood banks to diagnose HIV cases and syphilis/HIV coinfection.Key Words: Coinfection; transfusion safety; hemocenter; infectious disease; syphilis; HIVIntroduction: Hemotherapy consists of therapeutic treatments performed through blood transfusion. Clinical and serological screening of donors is an essential strategy to avoid transmission of infectious agents in blood transfusion. The objective of this study is to assess the seroprevalence of HIV infection, syphilis and syphilis/HIV coinfection in blood donors from a blood bank in Porto Alegre from 2014 to 2016.Methods: Retrospective analysis of all blood donors registered on a software for managing hemotherapy services (Hemodot) of the Blood Bank in the Marques Pereira Laboratory, Porto Alegre / RS, from 2014 to 2016.Results: Of the 28,173 users of the hemotherapy service during the study period, 198 (0.70%) were positive for syphilis, HIV infection, or syphilis/HIV co infection. The prevalence of positive results for syphilis was 0.3%, 0.57% and 0.70% in 2014, 2015 and 2016, respectively, and for HIV infection was 0.18%, 0.14%, and 0.16% for the same period. However, the prevalence of syphilis/HIV coinfection was not statistically significant.Conclusions: The prevalence of syphilis increased significantly from 2014 to 2016. Hovever, this did not occur with HIV infection or with coinfection. This finding may reflect the requirement of the nucleic acid technique (NAT) for HIV screening in blood banks, a procedure that has been increasing transfusion safety and reducing the window period. Further studies may shed new light on the combined use of serological tests and NAT assays in blood banks to diagnose HIV cases and syphilis/HIV coinfection.Keywords: Coinfection; transfusion safety; hemocenter; infectious disease; syphilis; HI

The Government’s Moral Crusade: America’s Campaign against Venereal Diseases at Home during World War I

During World War I, the American Government with the help of non-profit organizations waged an internal and external campaign against venereal diseases. With the creation of the Committee of Training Camp Activities, the Federal Government identified venereal diseases as a threat to the war effort. Internally, the government restructured the atmosphere of training camps by offering intellectual and athletic activities that stimulate the mind rather than sexual desires. Externally, the government used its prestige and power to eliminate factors that caused venereal diseases, including prostitution and red-light districts. Although the internal and external reforms succeeded in restricting the potentiality of venereal diseases, it, nevertheless limited an individual’s freedom and inspired negative connotations that women struggle to evade today

Molecular typing of Treponema pallidum isolates from Buenos Aires, Argentina: Frequent Nichols-like isolates and low levels of macrolide resistance

A total of 54 clinical samples, including genital lesion swabs, whole blood and cerebrospinal fluid from patients diagnosed with syphilis were collected in 2006 and in 2013 in Buenos Aires, Argentina. Treponemal DNA was detected in 43 of the analyzed samples (79.6%) and further analyzed using Sequencing-based molecular typing (SBMT) and Enhanced CDC-typing (ECDCT). By SBMT, 10 different Treponema pallidum subsp. pallidum (TPA) genotypes were found, of which six were related to the TPA SS14 strain, and four to the TPA Nichols strain. The 23S rRNA gene was amplified in samples isolated from 42 patients, and in six of them (14.3%), either the A2058G (four patients, 9.5%) or the A2059G (two patients, 4.8%) mutations were found. In addition to Taiwan, Madagascar and Peru, Argentina is another country where the prevalence of Nichols-like isolates (26.8%) is greater than 10%.Fil: Gallo Vaulet, Maria Lucia. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica; ArgentinaFil: Grillová, Linda. Masaryk University; República ChecaFil: Mikalová, Lenka. Masaryk University; República ChecaFil: Casco, Ricardo. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Rodríguez Fermepin, Marcelo. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica; ArgentinaFil: Pando, María de los Ángeles. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; ArgentinaFil: Smajs, David. Masaryk University; República Chec

Patient Experience and the Treatment of Venereal Disease in Toronto’s Military Base Hospital during the First World War

During the First World War, the Canadian Espeditionary Force (cef) was infamous for having the highest rates of venereal infection among the Allies. Soldiers could be inspected at random, questioned about the source of their infection, and held in quarantine in hospital until cured. While medical officers published research on the prevalence and treatment of venereal disease, little has been written on the experiences of patients. This paper examines the experiences of venereal patients in Toronto’s Military Base Hospital in 1916. Soldiers’ correspondences reveal their perspectives, along with the ways in which the military’s management of venereal disease was laden with the prevailing beliefs concerning sexually transmitted infections

Cryo-Electron Tomography Elucidates the Molecular Architecture of Treponema pallidum, the Syphilis Spirochete

Cryo-electron tomography (CET) was used to examine the native cellular organization of Treponema pallidum, the syphilis spirochete. T. pallidum cells appeared to form flat waves, did not contain an outer coat and, except for bulges over the basal bodies and widening in the vicinity of flagellar filaments, displayed a uniform periplasmic space. Although the outer membrane (OM) generally was smooth in contour, OM extrusions and blebs frequently were observed, highlighting the structure’s fluidity and lack of attachment to underlying periplasmic constituents. Cytoplasmic filaments converged from their attachment points opposite the basal bodies to form arrays that ran roughly parallel to the flagellar filaments along the inner surface of the cytoplasmic membrane (CM). Motile treponemes stably attached to rabbit epithelial cells predominantly via their tips. CET revealed that T. pallidum cell ends have a complex morphology and assume at least four distinct morphotypes. Images of dividing treponemes and organisms shedding cell envelope-derived blebs provided evidence for the spirochete’s complex membrane biology. In the regions without flagellar filaments, peptidoglycan (PG) was visualized as a thin layer that divided the periplasmic space into zones of higher and lower electron densities adjacent to the CM and OM, respectively. Flagellar filaments were observed overlying the PG layer, while image modeling placed the PG-basal body contact site in the vicinity of the stator–P-collar junction. Bioinformatics and homology modeling indicated that the MotB proteins of T. pallidum, Treponema denticola, and Borrelia burgdorferi have membrane topologies and PG binding sites highly similar to those of their well-characterized Escherichia coli and Helicobacter pylori orthologs. Collectively, our results help to clarify fundamental differences in cell envelope ultrastructure between spirochetes and gram-negative bacteria. They also confirm that PG stabilizes the flagellar motor and enable us to propose that in most spirochetes motility results from rotation of the flagellar filaments against the PG

\u27Whatsoever a Man Soweth:\u27 Sex Education about Venereal Disease, Racial Health, and Social Hygiene during the First World War

In 1917, the British War Office released a film directed by Joseph Best titled Whatsoever a Man Soweth. The 38-minute silent film used intertitles to convey dialogue, and the film’s narrative, which focuses on three Canadian soldiers on leave in London, England, was intended to provide sex education for soldiers. This paper examines how the film reflected and constructed a wartime reality through cultural representations, as increased attention was paid to the threat of venereal disease and its impact on racial health and the British Empire during the First World War. Ultimately, this sex education film provided soldiers with a medical-moral education about racial health; it vividly conveyed fears about VD and racial degeneration, but also highlighted a belief in social hygiene and racialized moral arguments to protect and ensure the health of the Anglo-Saxon race

An economic analysis of midwifery training programmes in South Kalimantan, Indonesia.

In order to improve the knowledge and skills of midwives at health facilities and those based in villages in South Kalimantan, Indonesia, three in-service training programmes were carried out during 1995-98. A scheme used for both facility and village midwives included training at training centres, peer review and continuing education. One restricted to village midwives involved an internship programme in district hospitals. The incremental cost-effectiveness of these programmes was assessed from the standpoint of the health care provider. It was estimated that the first scheme could be expanded to increase the number of competent midwives based in facilities and villages in South Kalimantan by 1% at incremental costs of US$764.6 and US$ 1175.7 respectively, and that replication beyond South Kalimantan could increase the number of competent midwives based in facilities and villages by 1% at incremental costs of US$1225.5 and US$ 1786.4 per midwife respectively. It was also estimated that the number of competent village midwives could be increased by 1% at an incremental cost of US$898.1 per intern if replicated elsewhere, and at a cost of US$ 146.2 per intern for expanding the scheme in South Kalimantan. It was not clear whether the training programmes were more or less cost-effective than other safe motherhood interventions because the nature of the outcome measures hindered comparison

Is the HCV-HIV co-infection prevalence amongst injecting drug users a marker for the level of sexual and injection related HIV transmission?

BACKGROUND: Amongst injecting drug users (IDUs), HIV is transmitted sexually and parenterally, but HCV is transmitted primarily parenterally. We assess and model the antibody prevalence of HCV amongst HIV-infected IDUs (denoted as HCV-HIV co-infection prevalence) and consider whether it proxies the degree of sexual HIV transmission amongst IDUs. METHODS: HIV, HCV and HCV-HIV co-infection prevalence data amongst IDU was reviewed. An HIV/HCV transmission model was adapted. Multivariate model uncertainty analyses determined whether the model's ability to replicate observed data trends required the inclusion of sexual HIV transmission. The correlation between the model's HCV-HIV co-infection prevalence and estimated proportion of HIV infections due to injecting was evaluated. RESULTS: The median HCV-HIV co-infection prevalence (prevalence of HCV amongst HIV-infected IDUs) was 90% across 195 estimates from 43 countries. High HCV-HIV co-infection prevalences (>80%) occur in most (75%) settings, but can be lower in settings with low HIV prevalence (0.75). The model without sexual HIV transmission reproduced some data trends but could not reproduce any epidemics with high HIV/HCV prevalence ratios (>0.85) or low HCV-HIV co-infection prevalence (10%. The model with sexual HIV transmission reproduced data trends more closely. The proportion of HIV infections due to injecting correlated with HCV-HIV co-infection prevalence; suggesting that up to 80/60/90%. CONCLUSION: Substantial sexual HIV transmission may occur in many IDU populations; HCV-HIV co-infection prevalence could signify its importance