Attitudes To The Prevention Of Hiv Infection Of Persons, Exercising Maritime Professions

Въведение: Пристанището е транспортен възел като много от пътните центрове, които отдавна са част от програмите за превенция на HIV, но с още по-сложен микс от националности и доставчици на различни услуги. При лицата, упражняващи морски професии, естеството на тяхната работа и дългите периоди на отсъствие от дома определят тяхното поведение като рисково. Целта на настоящото проучване е да се изследват нагласите за превенция на HIV инфекцията сред лицата, упражняващи морска професия.Материал и методи: Чрез анонимна анкетна карта са изследвани 100 лица, упражняващи морска професия. Резултатите са обработени статистически с SPSS v. 20.0, като са използвани вариационен и сравнителен анализи.Резултати и обсъждане: Резултатите от проведените анализи показват, че лицата, упражняващи морска професия, продължават да не признават високорисковото си поведение, като подкрепят профилактичните прегледи за HIV инфекция, но не и задължителния им характер. Въпреки това те оценяват необходимостта от провеждането на обучение в посока безопасно сексуално поведение и информация относно разпространението и превенцията на ХИВ/СПИН.Изводи: Изправени пред липсата на ефективна ваксина, образованието и обучението играят ключова роля в превенцията на HIV/СПИН. Социалните партньори (морските лица, работодателите, местната общност, правителството) са в уникална позиция да насърчават усилията за превенция чрез информация, образование и подкрепа за промяна на поведението.Introduction: Ports are transport hubs like many of the road centers that have long been part of HIV prevention programs but with an even more complex mix of nationalities and service providers. In the case of persons practicing maritime professions, the nature of their work and long periods of absence from home determine their behavior as risky.Aim: The aim of this study is to explore attitudes to preventing HIV infection among seafarers.Materials and Methods: Anonymous questionnaire surveyed 100 people practicing a seafaring profession. The results were statistically processed with SPSS v. 20.0 using variation and comparison analysis.Results and Discussion: The results of the conducted analyses showed that seafaring professionals continue not to recognize their high-risk behavior, supporting prophylactic examinations of HIV infection, but not their mandatory nature. However, they confirmed the need to conduct training on safe sexual behavior and information on the spread and prevention of HIV/AIDS. Conclusion: Faced with the lack of an effective vaccine, education and training play a key role in the prevention of HIV/AIDS. The social partners (seafarers, employers, local community, government) are uniquely positioned to promote prevention efforts through information, education and behavioral support

Contemporary aspects of the epidemiological surveillance of socially significant tick-borne infections (TBIS) in Varna region

The modern system for epidemiological surveillance of tick-borne infections (TBIs) in the Varna region requires a systematic analysis of the epidemic process.Aim: The aim of this article is to trace the evolution in parameters of the parasitic system in Lyme Borreliosis, Boutonneuse fever, Crimean-Congo hemorrhagic fever, and Q-fever in the Varna region for the period 2001-2017 and the activities of the epidemiological surveillance system.Materials and Methods: Data from active epidemiological studies and analyses of TBIs in the region of Varna and Bulgaria for the period 2001-2017 were used; as well as epidemiological and entomological methods, statistical and graphic analyses, nosogeographic analyses and others.Results: Data from the epidemiological analysis determined the continuing health and social significance of registered TBIs in the Varna region during the considered period. High levels of morbidity in Lyme disease (LD) and Boutonneuse fever (BF) with characteristic summer seasonality, correlated with the activity of vectors - reservoirs (Ixodes ticks), have been established. The system of epidemiological surveillance includes events for effective dispensary monitoring of the bitten by a tick; collecting complete epidemiological information about the area where the bite has occurred; preparation of epidemiological analysis of the morbidity of transmissible infections on the territory of the Varna region with emphasis on Lyme borreliosis, Boutonneuse fever, Q fever, Crimean-Congo hemorrhagic fever (CCHF), surveillance over the species composition and territorial distribution of tick populations and expanding the tick control activities in the region. There is a timely diagnosis and treatment of the registered patients. It is necessary to expand and deepen the system of epidemiological surveillance with the proposed strategy for surveillance and control of socially significant TBIs in the Black Sea region of the Republic of Bulgaria

The Knowledge Of Medical Professionals On The Prevention Of Hiv/Aids Infection In Conditions Of Occupational Risk

Рискът от професионално придобити инфекции е неизбежна част от ежедневната грижа за пациентите. Професионално придобитите инфекции причиняват значителни заболявания сред здравните работници.Целта на настоящото изследване е да се проучат знанията на медицинските специалисти за вземане на адекватни решения след рискова експозиция за превенция на ХИВ/СПИН.Материал и методи. Чрез анонимна анкетна карта са изследвани 230 медицински лица с различна професионална ангажираност. Резултатите са обработени статистически с SPSS v. 20.0, като са използвани анализ на риска, вариационен и сравнителен анализ.Резултати и обсъждане: Резултатите от нашето изследване показват, че медицинските специалисти не са запознати с нормативните уредби относно рисковите на професионалната експозиция. Въпреки че повече от 1/3 от изследваните лица са били изложени на рискова експозиция, като рискът се увеличава с нарастването на стажа, близо половината не са запознати с правилата за докладване в случай на инцидент.Изводи: Тези резултати показват необходимостта от организирането и провеждането на адекватно обучение както на практикуващите специалисти, така и на обучаващите се такива с цел превенция на риска и ограничаването на кръвнопреносимите инфекции, включително и ХИВ/СПИН.Introduction: The risk of professionally acquired infections is an inevitable part of the day-to-day care for patients. Professionally acquired infections cause significant illnesses among health workers.Aim: The aim of this study is to investigate the medical professionals' knowledge of taking adequate decisions for HIV/AIDS prevention after risk exposure.Materials and Methods: Anonymous questionnaire surveyed 230 physicians with different professional engagement. The results were statistically processed with SPSS v. 20.0, using risk analysis, variance and comparative analysis.Results and Discussion: The results of our study show that medical professionals are not familiar with the regulations on the risks of occupational exposure. Although more than one third of the surveyed have had risk exposure, with the risk increasing with the increase of work experience, nearly half are unaware of the reporting rules in the event of an accident.Conclusion: These results show the need to organize and conduct adequate training of both practitioners and trainees to prevent the risk and limit blood-borne infections, including HIV/AIDS

CONTAMINATION WITH TOXOCARA SPP. EGGS OF ENVIRONMENTAL SAMPLES OF PUBLIC PLACES OF VARNA CITY, BULGARIA

Toxocariasis in humans is an unknown and underdiagnosed disease with increased risk of distribution determined by the large canine and cat populations. Contamination of the environment with pets faeces containing helminth eggs is the key route of transmission toxocariasis, threatening especially the youngest children. The purpose of this study is preliminary research of the degree of pollution of the environment with Toxocara spp. eggs by examining soil and sand samples from different public places of Varna, Bulgaria. Material and methods: In 2018, 40 soil and sand samples were collected from various locations of Varna city: public park areas, areas for dog-walking, playgrounds, sandboxes and yards with domestic animals. The samples were processed using a modified Romanеnko’s method. Results: Soil analysis showed Toxocara spp. eggs in one sample from a public park area in the central region of Varna. In another soil sample of a private yard with domestic dog typical ova of the Taeniidae family was observed (possibly of E. granulosus). In two other samples, eggs from other canine parasites were discovered. Conclusion: The first research on the environmental contamination with helminthic eggs in Northeastern Bulgaria showed Toxocara spp. eggs in one of the central and most populated areas of Varna city. Furthermore, at least 10% of the tested materials were contaminated with canine excrements that testify for the lack of proper control of domestic and stray animals, which represents a real and imminent danger from zoonotic infection for the public health in the region

ОЦЕНКА НА ИМУНИЗАЦИЯТА СРЕЩУ ЧОВЕШКИ ПАПИЛОМА ВИРУС ВЪВ ВАРНЕНСКИ РЕГИОН ЗА ПЕРИОДА 2015-2022Г.

Човешкият папиломен вирус (HPV) е най-често предаваната по полов път инфекция. Неговите патогенни и онкогенни качества са документирани и е известно, че причинителят се среща, както при жени, така и при мъже. Заразяването става предимно в юношеска и млада възраст. Към днешна дата,в световен мащаб са лицензирани шест HPV ваксини. В много страни нивото на ваксинация е високо не само сред подрастващите момичета, но и момчета. Към момента в България се изпълнява третата Национална програма за първична профилактика на рака на маточната шийка.Целта е да се представи епидемиологична характеристика на обхванатите с имунизация срещу HPV момичета във Варненска област за периода 2015-2022 г.Материали и методи. Ретроспективен анализ (2015г.-2022г.) на официални данни от годишните анализи на РЗИ-Варна.Резултати и дискусия. Поради незадължителния характер на ваксината, официалните данни не са пълни. През 2015г. са ваксинирани 667 момичета на възраст 12-13 години. За периода 2016г.- 2019г. сред обхванатите момичета с ваксината срещу HPV се отчита спад като най-малковаксинирани е имало през 2018г. - 275. През 2020г. се наблюдава покачване на броя на ваксинирате спрямо предходните четири години - 424, но през 2022 г. е регистрирана най-ниска активност на имунизацията срещу HPV за целия анализиран период - 170 момичета.Заключение. Забелязва се тенденция към понижаване на броя на обхванатите момичета с ваксина против човешки папилома вирус в регион Варна. Явлението се дължи най-вече на широко разпространения сред обществото негативизъм към ваксината срещу рак на маточната шийка

Immunoprophylaxis of measles in Dobrich region as a result of good organization of health care for full coverage of the groups subject to control

Въведение: На съвременния етап здравната практика разполага с моновалентни и комбинирани живи вирусни ваксини, които имат потенциала да постигнат високоефективен контрол и елиминиране на морбили. Рисковите фактори за натрупването на възприемчиви лица са сложни и разнообразни и варират от личните познания за ваксината до достъп до здравни грижи. В началото на XXI век заболяването морбили отново придоби епидемично разпространение както на европейския континент, така и в България. Цел: Да се проучат особеностите на епидемичния процес при морбили в условията на задължителна имунопрофилактика в Р. България и област Добрич за периода 2005-2015 г. и причините за епидемичното му разпространение през 2009-2011 г. Задачи: Да проучим видове ваксини против морбили, обхвата при специфичната иму нопрофилактика с морбилна ваксина в Добричка област за 2005-2015 година, сравнена с тази за страната и имунния статус на заболелите при епидемията през 2009-2011. Материали: Данни от Националната система за надзор на заразните болести, годишни отчети на МЗ, данни от Дирекция «Надзор на заразните болести» при РЗИ-Добрич за периода 2005-2015 г., данни от годишни сведения за извършени имунизации, подадени към Дирекция «Надзор на заразните болести» при РЗИ-Добрич за периода 2005-2015 г. Методи: Епидемиологичен метод, документален метод, статистически метод, включващ сравнителен анализ. Резултати: В страната се провежда имунизация с комбинирана тривалентна атенюирана жива ваксина МПР морбили, паротит, рубеола по схема – на 13 месеца имунизация и на 12 години реимунизация, субкутанно или мускулно в делтоидната област на ръката. За периода 2005-2015 г. и след 12 години без случаи на морбили през 2009 г. в област Добрич са регистрирани 614 заболели (304.72%ооо) и 163 случая (80.89%ооо) за 2010 г., като заболяемостта за 2009 г. значително надвишава средната за страната. За същия период заболяемостта от морбили в България е в границите от 0.01%ооо до 292.92%ооо. От месец юни 2009 г. до месец май 2010 г. (последен случай) в област Добрич са регистрирани 777 случая на заболели от морбили, заболяемост 383.15%ооо на възраст от 6 дни до 42 години. Изводи: 1. Имунопрофилактиката като държавна политика в условията на Добрички окръг допринася за ограничаване на заболяванията от морбили за периода 2005-2015 година, като потвърждава становището за натрупването на възприемчиво население във времето, 2009-2011 година, и възникване на епидемия. 2. Най-засегнати са децата под 1 година, тези в ранна детска и училищна възраст. 3. Потвърждава се не-обходимостта от поддържане на високо ваксинално покритие както на национално, така и на регионално ниво и повишаване на имунитета във всички общности на населението за постигане на елиминиране на морбили. Морбили е заболяване, което и в бъдеще ще вълнува научната мисъл. Контролът върху епидемиите е труден. Прилагането на подходяща стратегия би подпомогнало борбата с морбили за реализиране на крайната цел елиминиране и ликвидиране на заболяването.Introduction: Currently, health practice has monovalent and combined live viral vaccines that have the potential to achieve highly effective control and measles elimination. The risk factors for disease acquisition for susceptible persons are complex and varied, ranging from personal knowledge of the vaccine to access to health care. At the beginning of the 21st century, measles again gained epidemic dimension both on the European continent and in Bulgaria. Aim: The aim of this paper is to investigate the peculiarities of the epidemic process in measles in the conditions of obligatory immunoprophylaxis in the Republic of Bulgaria and the Dobrich region for the period 2005-2015 as well as the reasons for its epidemic spread in 2009-2011.The objective is to investigate types of measles vaccines, the scope of the specific immunoprophylaxis with measles vaccine in the Dobrich region for the period 2005-2015 compared to the coun try and the immune status of the patients during the 2009-2011 epidemic. Materials and Methods: We have used data from the National System for Surveillance of Contagious Diseases, annual reports of the Ministry of Health, data from the Directorate of Surveillance of Communicable Diseases at RHI-Dobrich for the period 2005- 2015. Data from annual reports on immunizations submitted to the Directorate of Surveillance of Communicable Diseases at RHI-Dobrich for the period 2005-2015. For the analysis of the data we used an ep-idemiological method, documentary method, statistical method and comparative analysis Results: The country population is vaccinated with a combination of trivalent attenuated live vaccine for measles, mumps, rubella following a 13-month immunization regimen and 12 years of reimmunization, subcutaneously or intramuscularly in the deltoid area of the arm. For the period 2005-2015 and after 12 years without measles cases in 2009, in the region of Dobrich, 614 patients (304.72%ооо) and 163 cases (80.89% ооо) for 2010 were registered, with the morbidity for 2009 significantly exceeding the country average. For the same period, measles morbidity in Bulgaria was in the range of 0.01% to 292.92%ooo. Since June 2009 until May 2010 (last case) in the Dobrich region, there were 777 cases of measles-infected with a morbidity of 383.15% from 6 days old to 42 years of age. Conclusions: Immunoprophylaxis as a state policy in the Dobrich region contributes to limiting measles diseases for the period 2005-2015, confirming the opinion on the accumulation of a susceptible population in time, 2009-2011, and the occurrence of an epidemic. The most affected are children under one year of age, those in early childhood and school age. There is a need to maintain high vaccine coverage, both at national and regional level, and to increase the immunity of all communities to achieve measles elimination. Measles is a disease that will continue to excite scientific thought in the future. Control of epidemics is difficult. Applying an appropriate strategy would help combat measles to realize the ultimate goal of eliminating and eradicating the disease

Manage epidemiological risk for HIV infection in the maritime transport and shipments

AIDS is a disease which is caused by the human immunodeficiency virus - HIV. Today HIV / AIDS is a global health, social and economic problem and a cause of high mortality. There are three main ways of HIV transmission: sexual transmission; blood and vertical. Lead is sexually transmitted - 87 percent in various forms of sexual intercourse without a condom. In particular, the use of services of prostitutes and nonuse of condom. Traveling abroad (mobile population) as economic migrants, on the occasion of trips, work, business trip, vacation is a vulnerable group for HIV / AIDS. Analyzing the spread of HIV / AIDS in the world and the country - 45% of new HIV infections occur in African Americans, 35% of whites and 17% for Hispanics. (10) our geographical location, the development of tourism, our status as a port city and describing the epidemiological risk for HIV among sailors and travelers have the need to study the epidemiology of HIV / AIDS in terms of shipping and transportation

Dangerous medical practices related to exposure tо blood and body liquids in medical staff at risk

Introduction: Health services create conditions for occupational risks related to the health and safety of health workers. The management of safe and healthy working conditions in healthcare is the basis of public healthcare.Aim: The aim of the study is to study and analyze the dangerous medical practices related to the exposure of blood and body fluids in high-risk medical staff—medical laboratory technicians in medical diagnostic laboratories in Varna.Results: The results of the surveys among 107 people, including 5 managers of clinical laboratories, 49 laboratory technicians, and 53 clients/patients, confirm the working hypotheses.Failure to follow the rules of safe technique at work creates conditions for exposure to bloodborne infections. The most common reasons lie in the capping of used needles, non-use of gloves, or improper disposal of a sharp object in inappropriate containers. The immune status of medical laboratory technicians is not checked regularly, and non-immunized persons also work. The results of the surveyed clients reveal insufficient awareness of the risk exposures and the spread of bloodborne infections. It is worrying that 23% of them assume that doctors are fully responsible for the prevention of blood-borne virus infections.Conclusion: Bloodborne infections pose a significant risk to both society and healthcare professionals, but they can be prevented by measures aimed at minimizing the risk of infections: prevention of high-risk practices, compliance with universal precautions, the introduction of low-risk instruments and devices, and hepatitis B vaccination

Border health control in ports of the republic of Bulgaria and programmes for the management of infectious risk

According to the International Health Regulations as a risk for the public health are determined infectious diseases, radiation and chemical pollution. Urbanization and technological progress are a prerequisite for increasing the importance of these risks. The border crossing is facilitated, the area of spread of some infectious diseases expanded, they emerged new ones. We are witnesses of intensive migration of large groups of people without information about their health status. The system of medical control has as a basic order not to hinder the transport of goods and cargo, not to hinder people in their professional and personal trips. There remains the need to control the medical and health risk. Underway are several international projects and programs in this area. Inspectors carrying out border health control at the port of Varna actively participate in these activities. The trainings have aim to exchange experience, best practices and research for objectification of control. It must be optimization of administrative procedures, unification of issued international documents, a providing of ongoing training for border medical services, manning companies and ships` crews.Materials and methods: We used official documents of the WHO and the Republic of Bulgaria, working materials of international programs, official statistics RHI Varna for 2013 and 2014.Results and discussion: The border health control is essential for communicable disease surveillance - the preventing of import and spread of quarantine and especially dangerous infections, timely assessment and response to health risks for public health. It is done in accordance with the International Health Regulations (2005), Regulations on border crossings and border health control. Electronic systems are introduced for exchanging information, which requires good professional training of border medical services. The responsibility of seafarers increases because completing and bringing specific information into the electronic system. The importance of experience and communication between crews and medical services in order preparedness for rapid reaction grows. Realized are various education and training projects, optimized are health documents and protocols. It is necessary a development of target programs on particular problems of border health control to maintain the preparedness of seafarers and institutions for timely identification of health risks and adequate response

Sea epidemiology in teaching maritime medicine - prevention of infectious diseases, being subject to international health regulation and controlled by WHO

Naval Medicine is a scientific and practical direction with a complex interdisciplinary character and is a state policy in countries like Spain, Britain, Poland and the USA. Naval Medicine is defined as a system of scientific knowledge and practical activities, whose purpose is to protect and to gain in health of seafarers, life extension, prevent and treat diseases in humans. Sea epidemiology is a very important part of the medical disciplines. It is formed as a separate direction of epidemiology and as a section of maritime medicine in the 70s-90s of the twentieth century. During a trip the parasitic system, which interacts with the crew of the ships, operates completely differently than in conditions of residence on land, which requires specific approaches for the organization of prevention of infectious diseases during the journey and on land. The control of diseases, which are subject to the international health regulation, is an essential aspect of the marine epidemiology. In the directions for work on the implementation of the International Health Regulations (2005) in 2007 is said, that we should be ready for response in infectious diseases, which may arise as a result of sudden and rapid environmental and climatic changes as a result of industrial pollution and accidents that can put at risk millions of people in many countries and that is why they require measures of worldwide importance to be taken. The measures to protect public health are a significant section in the travel and the transport. Тhe management of infections by means of vaccine agents takes an important place in the system of actions. It finds systemic application in terms of maritime epidemiology as a tool for managing the infectious risk according to the number of vaccination avertible infections. Maritime training epidemiology should include the main sections of the general and private epidemiology in a constantly changing ecological and social environment of sea travel and transport