Substance Use During Imprisonment in Low- and Middle-Income Countries

Substance use disorders are among the most common health problems of people involved in the criminal justice system. Scaling up addiction services in prisons is a global public health and human rights challenge especially in poorly resourced countries. The aim of the present study was to systematically review the prevalence of substance use in prison populations in low- and middle-income countries (LMIC). We searched for studies reporting prevalence rates of nicotine, alcohol, illicit drug and injection drug use during imprisonment in unselected samples of imprisoned people in LMIC. Data were meta-analyzed and sources of heterogeneity examined by meta-regression. The prevalence of nicotine use during imprisonment ranged from 5% to 87% with a random-effects pooled estimate of 56% (95% CI: 45, 66) with significant geographical heterogeneity. Alcohol use varied from 1% to 76%. The pooled prevalence was 16% (95% CI: 9, 25). A quarter of the people who are imprisoned (25%, 95% CI: 17, 33; range: 0, 78) used illicit drugs during imprisonment. The prevalence of injection drug use varied from 0% to 26% with a pooled estimate of 1.6% (95% CI: 0.8, 3.0). Secondary analyses investigated lifetime substance use. The high prevalence of smoking in prison suggests that policies around smoking need careful review. Furthermore, the findings underscore the importance of timely, scalable and available treatments for alcohol and illegal drugs in people involved with the criminal justice system

Towards better design and management of tsunami evacuation routes: A case study of Ao Jak Beach Road

10.1144/SP361.9Geological Society Special Publication3611107-11

Cholera toxin activates nonconventional adjuvant pathways that induce protective CD8 T-cell responses after epicutaneous vaccination

The ability to induce humoral and cellular immunity via antigen delivery through the unbroken skin (epicutaneous immunization, EPI) has immediate relevance for vaccine development. However, it is unclear which adjuvants induce protective memory CD8 T-cell responses by this route, and the molecular and cellular requirements for priming through intact skin are not defined. We report that cholera toxin (CT) is superior to other adjuvants in its ability to prime memory CD8 T cells that control bacterial and viral challenges. Epicutaneous immunization with CT does not require engagement of classic toll-like receptor (TLR) and inflammasome pathways and, surprisingly, is independent of skin langerin-expressing cells (including Langerhans cells). However, CT adjuvanticity required type-I IFN sensitivity, participation of a Batf3-dependent dendritic cell (DC) population and engagement of CT with suitable gangliosides. Chemoenzymatic generation of CT–antigen fusion proteins led to efficient priming of the CD8 T-cell responses, paving the way for development of this immunization strategy as a therapeutic option

Human T Lymphotropic Virus Type I/II Infection: Prevalence and Risk Factors in Individuals Testing for HIV in Counseling Centers From Southern Brazil

ObjectiveThe objective of this study was to ascertain the prevalence and to investigate risk factors for human T lymphotropic virus type I/II (HTLV I/II) infection among subjects who tested for HIV at three counseling centers in Porto Alegre, Brazil.MethodsThe authors conducted a cross-sectional study in which subjects screened for HIV were tested for HTLV. Socioeconomic and demographic data, social and sexual behavior, history of having been breastfed, and past blood transfusion or drug use were gathered with a standardized questionnaire.ResultsAmong 2985 participants, 2.4% had HTLV infection confirmed (1.4% HTLV I). The risk increased with age, but there was no difference among genders. The multivariate model shows that injecting cocaine users were 5.2 (95% confidence interval, 2.5-10.7) times more likely to be HTLV I/II-positive than non-injecting cocaine users and HIV infection persisted as an independent risk factor.ConclusionAmong persons presenting at HIV testing centers in Porto Alegre, Brazil, HTLV I was three times more common than HTLV II; injection drug use was the predominant mode of transmission