Day 1 :
The Great Romagna Hub Laboratory, Italy
Keynote: How to facilitate and improve screening of Sexually-Transmitted Infections in women population
Time : 10:00-10:45
Vittorio Sambri is Director of the Great Romagna Hub Laboratory, Unit of Microbiology that is one of the largest public microbiology laboratory in Europe, and Associate Professor of Microbiology at the University of Bologna. His main research interest are spirochetes (in particular Treponema palidum infection) and emerging viral arthropod diseases. Recently his work has been focused on innovative moleculr diagnosis of sepsis and sexually transmited infections. His work resulted in 188 pblication in peer reviewed journal with an h-index of 37 amnd more than 4400 citations
Background: Sexually Transmitted Infections (STIs) are increasing worldwide. Innovative approaches are required to eliminate barriers to STIs testing such as home-based self-sampling for patients that are difficult to reach. Aim of this study was to evaluate performance of a new Home–based Self Vaginal FLOQSwabTM (HBSVF, COPAN Italia, Brescia) in combination with a commercially available real-time PCR assay, Anyplex™ II STI-7 (Seegene, Seoul, Korea) which detects seven pathogens in a single reaction (Chlamydia trachomatis CT, Neisseria gonorrhoeae NG, Trichomonas vaginalis TV, Mycoplasma hominis MH, Mycoplasma genitalium MG, Ureaplasma urealyticum UU, and Ureaplasma parvum UP). Methodology: 78 asymptomatic employees of a private industry (aged 18 to 45 years) were voluntarily enrolled to STIs screening. The subjects answered to a standardize anonymized questionnaire regarding the easy of use of self collection. The swab was collected in a domestic context by following the detailed “how to use it” instructions. After collection, swabs were shipped at room temperature to the laboratory in Pievesestina and processed within five weeks. The threshold cycle value (Ct) of a human genomic target (internal control, IC) and Ct of pathogens (CT, NG, TV, MH, MG, UU, UP) were taken as parameters to assess respectively, the efficiency of self-sampling and presence of any inhibitor effects, the stability of nucleic acids on dry swabs. Findings: no failure results were observed, the IC of all samples were amplified (average Ct 30). The real time PCR assay was able to identified 2/78 CT, 4/78 UU, 40/78 UP, 6/78 MH, 1/78 TV positive patients. No MG and NG positive patients were detected. Women reported self-collection with HBSVF easy and comfortable (100%). Conclusions: HBSVF device showed excellent recovery and stability of nucleic acid of STI pathogens up to 5 weeks at room temperature. The HBSVF is suitable for screening of STIs with real-time PCR assay.
China Medical University, Taiwan
Time : 11:05-11:50
Ying-Hen Hsieh is an applied mathematician and a professor at the College of Public Health, China Medical University in Taiwan. His primary research interests focus on mathematical and statistical modeling of infectious diseases as well as analysis of infectious disease epidemiology relating to public health policies.
Background/Objective Sexually transmitted disease is an ancient disease, although efficient treatment is available. Taiwan disease surveillance system disclosed that syphilis is the most common sexually transmitted disease. Among different age groups, the older population over 50 years of age had a relatively higher incidence. The study aims to focus the current syphilis epidemic in the ≧50 population in Taiwan.
Material and Methods Government syphilis surveillance data is used to infer the number of age over 50 years infected persons. Moreover, we utilize a discrete-time compartmental model to estimate important epidemiological parameters (i.e., infection rate, reporting rate) for two time periods, namely 2003-2006 and 2012-2014, in order to ascertain the recent trends of the epidemic.
Results Estimates for the first period (2003.9-2006.8) reveal that, new numbers entering ≧50-year old age group that are at risk of infection are 39.41% of 49-year-old population annually. The syphilis incidence of 50-plus age group is 1.6 cases per 100,000 persons. Estimate from the second period (2009.1-2011.12) indicate that, new numbers entering ≧50-year old age group that are at risk of infection are 1.26% of 49-year-old population annually. The syphilis incidence among 50-plus is 12.6 cases per 100,000 persons. Comparing the two period estimates, syphilis incidence surged sharply from 1.6 to 12.6 cases per 100, 000 persons, even though we have a decrease in newly entering syphilis at risk population (39.41 % to 1.26%). However, there has been a 3-fold increase in infection rate among the at-risk population.
Conclusions Syphilis incidence among age 50 and over population is increasing. Significant progress has been made on syphilis testing/surveillance program which led to substantial reduction in susceptible cases in general population. However, sexually transmitted disease prevention education program still need to be improved, to reduce infection in all adults, including the older aged population.
Coventry & Warwickshire Partnership Trust, UK
Time : 11:50-12:25
Dr Sris Allan is a consultant in Sexual health and HIV in Coventry, UK and an associate professor in Warwick medical school. He has been active in clinical practice, medical education and in the field of HIV research particularly HIV and ageing
Antibiotic resistance to Neisseria gonorrhoea(N.g) is rapidly developing and changing worldwide. Soon we may be faced with a situation where parenteral treatment is the only option.
Methods: All N.G cases in our clinic between 1st January to 30th June 2007 to 2016 were identified and analysed for antibiotic sensitivity.
Results: In 2016 there were 131 cases of N.g identified. Since the introduction of Ceftriaxone and Azithromycin as the treatment of choice in 2011 we saw a reduction in multi drug resistance until 2013, after which point we saw a gradual increase in cases reaching 23% in 2016. This is the first year we have identified the isolate resistant to four antibiotic groups including Cefuroxime
Sefako Makgatho Health Sciences University, South Africa
Title: Perceived uptake of partner notification using a referral slip and acceptability of provider-initiated partner notification using short-text-messages among men in the taxi
Time : 12:25-13:00
Mathildah is an associate professor in the School of Public Health at Sefako Makgatho Health Sciences University. She is a public health specialist with 15 years of experience in postgraduate teaching across the various disciplines of public health. Her expertise lies in teaching quantitative research, health program evaluation, quantitative statistical analysis. She successfully graduate numerous students in the Master of Public, postgraduate diploma and public health doctoral program. Her research niche is in social aspects of HIV and AIDS with a focus on orphans and vulnerable children, adolescent sexual health and STI/HIV prevention and control
Studies revealed that most men in the transport industry including taxi drivers are most likely to engage in unsafe sexual practices predisposing them to sexually transmitted infections. They often practice unsafe sex such as engaging in casual sexual relations, sex in exchange for money, and have multiple and concurrent sexual partners. A cross-sectional survey was conducted using anonymous structured self-administered questionnaires translated from English into a local language.
A sample of n=722 male taxi drivers with the mean age of 37.2 years old, 76% were within the age range of 25-44 years of old participated in the study. Up to 94% had sexual relationships, 59.5% had multiple partners amongst which 45.6% reported having causal partners. Perceived uptake of partner notification using a referral slip to a sexual partner was 93.2% (n=670), receiving a referral slip from a sexual partner to uptake STI health services was 91.8% (n=659), perceived ease of delivering a referral slip to a sexual partner was 69.5%. The level of acceptability of partner notification using a short-message-system (SMS) from a health care provider was 62.7% (n=452). From n=109 participants who responded, the reasons given for the non-acceptability of using SMS for partner notification and referral, telling partner face to face (n=55), SMS is not reliable (n=47), and SMS could cause conflict in a relationship (n=7). The study show that perceived uptake of and ease of use of partner notification using referral slip as well as acceptability of provider-initiated partner notification by SMS were high.
Hacettepe University Faculty of Medicine, Turkey
Title: Assessment of the data of pediatric patients with acute bacterial meningitis: 5 years experience
Time : 14:00-14:35
Kubra Aykac has graduated as a pediartician in 2012 and has been practising as a fellow in the Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey. She is interested in pneumococcal disease and multi-drug resistant gram-negative bacterial diseases
Statement of the Problem: Bacterial meningitis is a serious infection that can cause death within hours as well as neurological sequelae in patients. The majority of the causative agents are Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae type b. In recent years, meningitis epidemiology showed a rapid change due to vaccination. We aimed to invastigate the etiologic agents of bacterial meningitis in the present study.
Findings: Between January 2012 and January 2017, a total of 157 cerebrospinal fluid samples were studied in the study and 45 were evaluated as contamination. The median age of 112 patients diagnosed with acute bacterial meningitis was 1 year (minimum-maximum, 0-17) and the rate of female/ male was 48/64. The etiologic agents were 42 (37.5%) staphylococcus, 16 pneumococci (14.2%), 9 (8.9%) meningococci, 7 (6.2%) enterococci, 7 (4.4%) Acinetobacter spp, 7 (4.4%) E. coli, 4 (3.5%) Klebsiella spp. CSF shunt was presented in 53.6% of the patients and staphylococci was the most common causative agent (53.3%) in this population. According to the underlying diseases, there were totally 80 (71.4 %) patients with neurogical disease and %46.2 of them had staphylococcal meningitidis. In two patients with immunodeficiency, one of the causative agent was staphylococci and the other was multiple agents. Pneumococci (33.3%) and meningococci (28.6%) were the most frequent factors in children without no underlying disease. Serotypes could be detected in only four of 16 patients with pneumococcal meningitis. Two of them were nonvaccine serotype (15B) and others were serotype 19F and 1. The serogroups of nine patients with meningococcal meningitis were three serotype W , two serotype B, and and four nongroupable.o
Conclusion & Significance: Due to the high frequency of pneumococcal and meningococcal meningitis cases, our findings indicates the importance of vaccination against these pathogens. The frequency of shunt meningitis also suggests that shunt infections should be managed effectively.
PURPOSE: It is well known that physical activity is beneficial for people with positive results for physical status and mental wellbeing. However, physical exercise decrease the immune response and may induce a allergy anaphylaxis at some situation as follows. A common example is exercise-induced asthma, exercise-induced urticaria, exercise-induced anaphylaxis and FDEIAn. Generally, anaphylaxis is a severe, potentially fatal, hypersensitivity reaction of rapid onset. It is a dramatic clinical emergency. Actually, there are lots of etiologic factors of anaphylaxis, the principal immunologic triggers are foods, insect stings, and drugs. In recent, physical exercise is also related with the anaphylaxis.
In this paper, we present the current views of physiological mechanisms underlying physical anaphylaxis within the context of exercise immunology. we also deals with a detailed 2 kinds of EIA (exercise-induced asthma, exercise-induced anaphylaxis) and exercise prescription and medical treatment for exercise-induced asthma, exercise-induced anaphylaxis and CU (chronic urticaria).
METHODS: At first, we analyzed and presented the causes, symptoms, pathophysiology, testing, treatment and prescription of exercise-induced asthma, exercise-induced urticaria, exercise-induced anaphylaxis and FDEIAn through many experiments and references.
RESULTS: Exercise-induced asthma is a typical asthmatic attack which follows a strenuous exercise lasting 5 to 10 minutes in circumstances of dry and cold air situation. Avoid of exercise in that conditions and drug treatment (beta-2 adrenergic aseveralgonists) must preferentially be preventive.
Physical urticarias are a unique subgroup of CU in which patients develop urticaria secondary to environmental stimuli.
Common triggers include cold and heat temperature, water, sunlight and even physical exercise. it is responsible for approximately 20-30% of all cases of chronic urticaria.
FDEIAn is induced by different types and various intensities of physical exercise, and this is distinct from food allergy. It is useful to test both iseveraln vivo and in vitro an extensive panel of foods. Avoidance of allergeniseveralc foods for at least 4 h before exercise has prevented further episodes in all our patients with specific FDEIAn.
CONCLUSIONS: It is concluded that anaphylaxis remains a continuous challenge for the diagnosis and treatment. The adequate management of anaphylaxis requires rapid diagnosis, implementation of primary and secondary prevention measures, and immediate administration of subcutaneous epinephrine. Furthermore, patient education is necessary to heighten awareness of the sign and symptoms of 2 kinds of EIA and FEDIAn.
Hacettepe University Faculty of Medicine, Turkey
Title: Retrospective investigation of Serratia species infection in Tertiare Care Children's Hospital
Time : 15:10-15:45
Yasemin Ozsurekci has graduated as a pediatrician in 2009 and graduated as a pediatric infectious diseases specialist in 2013 from Hacettepe University Faculty of Medicine. In addition, she is a continuing student in Ph.D programme at the Bilkent University, Molecular Biology and Genetics for improving of her experiences in research and teaching and focusing the molecular epidemiology in the field of infectious diseases. She has her expertise in evaluation of hospital-acquired infections, particularly which caused by multi-drug resistant gram-negative bacteria and passion in investigating the zoonotic diseases as well as underlying mechanisms
Statement of the Problem: Serratia species are belonged to the family of Enterobacteriaceae which is thought to be an important pathogen in nosocomial infections over the last 30 years.
The aim of our study is to contribute to the determination of the ideal management by examining the clinical data and resistance patterns of children with Serratia infection in our hospital.
Findings: Between January 2000 and September 2016, a total of 89 patients with Serratia spp. were identified, 33.7% of patients were female, and 66.3% were male. Median age was 3 years (minimum-maximum, 0-17). We could only reach clinical data of 66 patients and 37 (56%) of them were considered to be infection agent, while 29 (44%) were diagnosed as colonization with no clinical findings. Serratia marcescens (n = 32, 86.5%) was the most common serratia species whereas non-marcescens species (Serratia liquefaciens, Serratia roridae, Serratia odorifera, Serratia plymuthica) were detected more rarely (n=4, 13.5%). Community-acquired serratia infection was 27% and hospital-acquired serratia infection was 73% of all. Serratia bacteremia (56.8%) was the most common type of infection among the patients. The other infection types were urinary tract infection (13.5%), wound infection (13.5%), pneumonia (5.4%), meningitis (5.4%) and peritonitis (5.4%). Antibiogram results showed that the rate of bacteries resistant to carbapenems is 10.8%, to amikacin is 10.8%, to third generation of cephalosporins is 13.5%, and to ciprofloxacin is 2.7%. Combination therapy with meropenem and amikacin (40.5%) was the most frequent used treatment option. Infection-related mortality was not seen in any of the patients.
Conclusion & Significance: Serratia species infections are seen as bacteremia commonly and they generally cause nosocomial infections. Current clinical study reveals that combined antibiotic therapy compatible with antibiogram improves clinical success and reduces mortality.
Flinders University, Australia
Hailay Gesesew has his expertise in Epidemiology. His multi-method approach assessing in each cascades of HIV care continuum will establish a significant contribution for the AIDS Ending goal. He has been publishing a lot of peer reviewed articles on the area of HIV care in reputable journals. Hiis publications produced from his PhD will improve the HIV care in developing countries especially Ethiopia. Hailay has been serving as a clinician, academician and researcher
Background: Antiretroviral therapy (ART) discontinuation obscures achievements for the UNAIDS treatment targets 2 and 3. Nevertheless, the magnitude, trend and its risk factors are not explored contextually. We carried out historical data analysis to assess prevalence, trend and risk factors for ART discontinuation among adults in Southwest Ethiopia. Methods: 12 years retrospective cohort analysis was performed with 4900 HIV-infected adults between 21 June 2003 and 15 March 2015 registered at the ART clinic at Jimma University Teaching Hospital. ART Discontinuation could be lost to follow-up, defaulting and/or stopping medication while remaining in care. 10 years trends for ART discontinuation was described using a line graph. We used binary logistic regression to identify factors that were correlated with ART discontinuation. To handle missing data, we applied multiple imputations assuming missing at random pattern. Results: In total, 4900 adults enrolled on ART, of whom 1090 (22.4%) had discontinued, 954 (19.6%) had transferred out, 300 (6.2%) had died, and the remaining 2517 (51.8%) were alive and on ART between 2003 and 2015. The recent trend of ART discontinuation showed an upward direction reaching a peak in 2004 and 2005 with 10%. Being female (AOR=2.1, 95%CI: 1.7-2.8), having an immunological failure (AOR=2.3, 1.9-8.2), having tuberculosis/HIV co-infection (AOR=1.5, 1.1-2.1) and no previous history of HIV testing (AOR=1.8, 1.4-2.9) were the risk factors for ART discontinuation. Conclusions: One of five adults had discontinued from ART, and the trend of ART discontinuation increased recently. Discontinued adults were more likely to be females, tuberculosis/HIV co-infected, with immunological failure and no history of HIV testing. Therefore, it is vital to implement effective programs such as community ART distribution and linkage-case-management to enhance ART linkage and retention. Key words: ART discontinuation, lost to follow-up, defaulting, retrospective cohort, prevalence, trend, and risk factors, Ethiopia
Sefako Makgatho Health Sciences University, South Africa
Title: Social disclosure of HIV positive status of perinatal infected adolescents: Do their views count?
Time : 16:40-17:15
Studies that examined self-disclosure by adolescents with perinatal acquired HIV (PAH) suggest that disclosure to sexual partners and friends remains low particularly in developing countries. The potential transmission of HIV to sexual partners if adolescents with PAH do not disclose is high. The study explored the views of adolescents with PAH about disclosure, onward self-disclosure, and intentions to disclose to friends, sexual partners, and others.
Semi-structured interviews were conducted with 22 adolescents aged 15–19 years who were enrolled in an HIV clinic in Johannesburg, South Africa. Four themes emerged to describe the adolescents’ views about disclosure. These were 1) keeping HIV status a secret; 2) desire to control who to disclose to; 3) support for disclosure; and 4) intentions to disclose. Most adolescents chose not to disclose to sexual partners, only three out of 22 adolescents disclosed. They believed their HIV status was their secret and they maintained secrecy in order to protect themselves from stigma, discrimination, and rejection. They also desired to control disclosure of their HIV positive status to extended family members in particular. They raised concerns about social disclosure, and felt that their caregivers disclosed their HIV positive status to other family members and school teachers without their consent. They felt that caregivers and health care workers needed support to handle disclosure. They intent to disclose when the time is right, and the right time would be informed by various occurrences in their relationships such as when they become sexually active. Adolescents desire to control disclosure of their HIV status to family, friends and sexual partners. Interventions to support disclosure should empower caregivers, health workers and adolescents with PAH to disclose
Sphiwe Madiba is professor in the School of Public Health at Sefako Makgatho Health Sciences University (Pretoria, South Africa). She is a public health specialist with 15 years of experience in post graduate teaching. Her research concerns social aspects of HIV and AIDS with a focus on disclosure of HIV positive status and adolescent sexual health and HIV prevention. She has authored and co-authored more than 50 articles published in reputed journals. She has presented research papers in national and international conferences. She is an editor for PULA: Botswana Journal of African studies and a reviewer of several international journals. She holds a Doctor of Public Health degree