Is having sex with other men a risk factor for transfusion-transmissible infections in male blood donors in Western countries?: a systematic review

Background : Although increased prevalence of transfusion transmissible infections (TTI) among “men who have sex with men” (MSM) has been well documented, the exclusion of MSM as blood donors is contested. The aim of this systematic review is to find studies that describe the risk of TTI in MSM blood donors. Methods : We searched MEDLINE, Embase, The Cochrane Central Register of Controlled Trials, Cinahl, and Web of Science, and used GRADE for determining evidence quality. We included studies comparing MSM and non-MSM blood donors (or people eligible to give blood), living in areas most relevant for our Blood Service. Results : Out of 18 987 articles, 14 observational studies were included. Two studies directly compared MSM with non-MSM donors showing that MSM donors have a statistically significant higher risk of HIV-1 infections. In one of these studies it was shown that this was related to recent (< 12 months) MSM contact. In two additional studies no evidence was shown in favour of a certain deferral period for MSM. Ten studies, applying permanent deferral for MSM, compared infected versus non-infected donors. One study found that MSM is a statistically significant risk factor for HIV-1 infection in blood donors. For other TTI such as HBV or HCV, an increased risk of infection could not be demonstrated, because the precision of the results was affected by the low numbers of donors with MSM as risk factor, or because of risk of bias in the included studies. All studies included low level evidence, because of risk of bias and imprecision of the results. Conclusions : High-quality studies investigating the risk of TTI in MSM who donate blood are scarce. The available evidence suggests a link between MSM blood donors and HIV-1 infection, but is too limited to be able to unambiguously/clearly recommend a certain deferral policy

Promoting Handwashing and Sanitation Behaviour Change in Low- and Middle-Income Countries: A Mixed-Method Systematic Review

This systematic review shows which promotional approaches are effective in changing handwashing and sanitation behaviour and which implementation factors affect the success or failure of such interventions. The authors find that promotional approaches can be effective in terms of handwashing with soap, latrine use, safe faeces disposal and open defecation. No one specific approach is most effective. However, several promotional elements do induce behaviour change. Different barriers and facilitators that influence implementing promotional approaches should be carefully considered when developing new policy, programming, practice, or research in this area

An educational pathway and teaching materials for first aid training of children in sub-Saharan Africa based on the best available evidence

CITATION: De Buck, E., et al. 2020. An educational pathway and teaching materials for first aid training of children in sub-Saharan Africa based on the best available evidence. BMC Public Health, 20:836, doi:10.1186/s12889-020-08857-5.The original publication is available at https://bmcpublichealth.biomedcentral.comBackground: First aid training is a cost-effective way to decrease the burden of disease and injury in low- and middle-income countries (LMIC). Since evidence from Western countries has shown that children are able to learn first aid, first aid training of children in LMIC may be a promising way forward. Hence, our project aim was to develop contextualized materials to train sub-Saharan African children in first aid, based on the best available evidence. Methods: Systematic literature searches were conducted to identify studies on first aid education to children up to 18 years old (research question one), and studies investigating different teaching approaches (broader than first aid) in LMIC (research question two). A multidisciplinary expert panel translated the evidence to the context of sub- Saharan Africa, and evidence and expert input were used to develop teaching materials. Results: For question one, we identified 58 studies, measuring the effect of training children in resuscitation, first aid for skin wounds, poisoning etc. For question two, two systematic reviews were included from which we selected 36 studies, revealing the effectiveness of several pedagogical methods, such as problem-solving instruction and small-group instruction. However, the certainty of the evidence was low to very low. Hence expert input was necessary to formulate training objectives and age ranges based on “good practice” whenever the quantity or quality of the evidence was limited. The experts also placed the available evidence against the African context. Conclusions: The above approach resulted in an educational pathway (i.e. a scheme with educational goals concerning first aid for different age groups), a list of recommended educational approaches, and first aid teaching materials for children, based on the best available evidence and adapted to the African context.https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-08857-5Publisher's versio

Evidence-Based African First Aid Guidelines and Training Materials

Stijn Van de Velde and colleagues describe the African First Aid Materials project, which developed evidence-based guidelines on administering first aid in the African context as well as training materials to support the implementation of the guidelines

'The twin-arginine translocation pathway as a virulence factor in Legionella pneumophila'

Legionella pneumophila is een Gram-negatieve facultatief intracellulaire pathogeen die een ernstige pn eumonie kan veroorzaken, beter gekend als de veteranenziekte . In natuurlijke omstandigheden komt L. pneumophila voor als een intracellulaire parasiet van protozoa en tijdens infectie v indt replicatie plaats in humane alveolaire macrofagen. Er werden in L. pneum ophila reeds verschillende secretiewegen geïdentificeerd, waarvan werd aangetoond dat ze een belang rijke rol spelen in het virulentieproces. Daarom ging onze interesse uit naar de mogelijke aanwezigheid van de twin-arginine afhankelijke secretieweg (Ta t-weg) en het belang van dit secretiesysteem voor de virulentie van L. pneumoph ila. Er werd immers reeds aangetoond dat dit secretiesysteem een belangrijke rol speelt in het vir ulentieproces van verschillende plant- en humaanpathogene bacteriën. De Tat-weg is verantwoordelijk voor de secretie van gevouwen eiwitten doorheen de cytoplasmatische membraan. Het signaal­peptide van Tat-afhankelijke preproteïnen is gekenmerkt door 2 opeenvolgende arginines. Het Tat-secre tiesysteem is het best bestudeerd voor Escherichia coli, waarvoor werd aangetoond dat het Tat complex bestaat uit een TatA, TatB, TatC en TatE eiwit. In L. pneumophila Philadelphia werden een tatA, tatB en tatC gen geïdentificeerd. De overeenkomstige L. pneumophila Tat eiwitten vertonen dezelfde membraantopologie als hun E. coli homologen e n bezitten alle geconserveerde en essentiële aminozuren. De L. pneumophila tat genen komen tot expressie in de exponentiële en stationaire groeifase en ook intracellulair in de gastheer Acanthamoeba castellanii. De functionaliteit van de Tat-weg en de rol van dit secretiesysteem in de virulentie van L. pneumophila werd bestudeerd door het aanmaken van een tatB en tatC mutant. De functionaliteit van de Tat-weg in L. pneumophila kon niet worden aangetoond met algemeen aanvaarde heterologe Tat substraten, maar kon uiteindelijk worden bewezen met het alkalisch fosfatase van Thermus thermophilus. Er werd aangetoond dat Tat-secretie een rol speelt in verschillende cellulaire processen zo als intracellulaire replicatie in amoeben en macrofagen, stress respons, beweeglijkheid en biofilmvorming. Op deze manier werd een eerste indicat ie gegeven van het belang van de Tat-weg voor virulentie in L. pneumophila. Door gebruik te maken van een aantal parallelle methoden werden verschillende mogelijke Tat substraten geïden tificeerd, waaronder een aantal eiwitten die een rol spelen in de beweeglijkheid en virulentie van L. pneumophila. Er werden ook verschillende mogelijke Tat substraten geïdentificeerd met ee n afwijkend patroon in hun signaalpeptide. Op basis van deze bevinding, samen met he t feit dat heterologe Tat substraten niet gemakkelijk kunnen getransporteerd wo rden, werd de hypothese opgesteld dat de L. pneumophila Tat-weg in zekere mate een species specifiek systeem is dat afwijkende T at signaalpeptiden tolereert. De bekomen bevindingen dragen zeker bij tot het beter begrijpen van het virulentieproces in de pathogeen L. pneumophila. Aangezien de Tat-weg goed geconserveerd is bij belangrijke bacteriële pathogenen en afwezig is in zoogdiercellen, kan dit secreties ysteem een mogelijk alternatief doelwit vormen voor nieuwe antimicrobiële strat egieën.status: publishe

Response to "The effect of a standard blood donation on oxygen uptake"

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Evidence-based guidance to assist volunteers working with at-risk children in a school context

AIM: One of the activities of the Belgian Red Cross is the 'Bridging the Gap' project, in collaboration with local schools. In this project, volunteers join the teaching staff to improve personal development goals in at-risk children with poor performance. The aim of this study was to develop evidence-based guidance for the volunteers to help them choose the right didactical approach for supporting these children. METHOD: Systematic literature searches were performed in three bibliographic databases (the Campbell Library, MEDLINE and ERIC) to find the effectiveness of 16 different didactical activities. In addition, during a consensus meeting with relevant stakeholders, we discussed the applicability and meaningfulness of these activities for volunteers in the school context. RESULTS: We identified 38 relevant studies out of 12 056 references. Evidence of effectiveness was available for the following activities: book reading, road-safety education, number games, puzzle making, singing, block-building activities, reading poetry, computer-assisted instruction, storyboards, role play and a library visit. Based on the discussion with stakeholders, we developed evidence-based guidance with recommendations and suggestions to assist volunteers in their task. CONCLUSION: This evidence-based guidance was developed to help volunteers working in a school context to choose which didactical activities to carry out with at-risk children, with the aim of improving the children's personal development. The list of didactical approaches we promote is not exhaustive and will most likely continue to grow, as many activities are currently not (well) described in scientific studies. In addition, contextual factors that may play a role in the success or failure of certain didactical activities are also subject to change.status: publishe

Lyme disease in Western Europe: an emerging problem? A systematic review

Objectives: Lyme borreliosis is the most common zoonotic disease in Europe and causes an estimated total burden of 10.55 disability-adjusted life years (DALY) per 100 000 population. Its incidence in Western Europe is assumed to be increasing, yet this remains to be confirmed. The aim of this study was to assess the emergence of Lyme disease in Western Europe by performing a systematic review of the scientific literature.Methods: Pubmed, Embase and grey literature were searched from database inception until August 2018 for articles reporting the incidence of Lyme borreliosis in Western European countries. We included observational studies in English that reported data on a random sample of the population and fulfilled our definition of Lyme disease diagnosis. Annual population-weighted averages and the evolution of Lyme borreliosis incidence were extracted or calculated for every Western European country.Results: Our review identified 1514 and included 18 studies next to seven surveillance reports reporting data from 16 Western European countries. Incidence of Lyme borreliosis ranged from 0.001 (Italy) to 632 (Sweden, Blekinge county) cases/100 000/year. Iceland reported the strongest emergence with an average yearly increase of 21.15% over a 12-year period, whereas Italy reported the strongest average yearly decrease of 52.71% over a 5-year period. Very limited high-quality data were available on Lyme borreliosis incidence in the southern Western European countries.Conclusion: Diagnosis of Lyme borreliosis is on the rise in some Western European countries, mostly in the northern and central part. Better surveillance in the southern countries is necessary.status: publishe