Tuberculosis among the homeless and inmates kept in custody and in penitentiary institutions in the Silesia region.

INTRODUCTION: There are more than 10 million prisoners in the world. Tuberculosis incidence is 10-100 times higher in prisoners than in the general population. Inmates have close contact with other prisoners and with prison workers and visitors, so tubercle bacilli may be easily spread. Most of the inmates come back to normal life and contact with the general population. The aim of the study was to assess active tuberculosis incidence among prisoners and homeless persons in the Silesia region. MATERIAL AND METHODS: In total 897 people entered the study, of whom 720 were Silesian penitentiary system inmates, and 177 were homeless. BACTEC MGIT fast TB detection system and GenoType Mycobacteria Direct test were used. Drug susceptibility testing was done using SIRE KIT and PZA KIT. RESULTS: Tuberculosis was diagnosed in 13 out of 897 persons (1.45%): in 11 out of 720 inmates (1.53%) and in 2 out of 177 homeless persons (1.13%). Data concerning drug susceptibility were obtained for 11 persons. M. tuberculosis strains isolated from eight persons were susceptible to four first-line antituberculosis drugs (streptomycin, isoniazid, rifampin, ethambutol), while M. tuberculosis strains isolated from three persons were drug-resistant. One out of three isolated strains was resistant to ethambutol, but susceptible to streptomycin, isoniazid, rifampin, and pirazynamide. The second strain was resistant to streptomycin and pyrazinamide but susceptible to isoniazid, rifampin, and ethambutol. The third strain was susceptible to rifampin but resistant to the other four tested drugs. According to the obtained data, culture-positive pulmonary tuberculosis was 100 times more frequent in the examined population than in the general population of the Silesia region in the same period of time. CONCLUSIONS: The health project enabled effective detection of tuberculosis in risk groups and should be continued in the following years. The set of the applied diagnostic methods allowed the detection of in the studied subpopulations people suffering from tuberculosis. Patients were treated with antituberculosis drugs that would stop them from spreading the disease to other people.

Prevalence and basic determinants of hepatitis C antibodies in medical students in Katowice, Poland.

BACKGROUND: Potential exposure of medical students to infectious material and the lack of specific prevention measures could contribute to an increased risk of HCV infection in this group. OBJECTIVE: To find out if the occurrence of HCV antibodies is more frequent in medical students than in non-medical students and to determine risk factors for HCV antibodies in students. METHODS: A cross-sectional study performed in 2003-2004 included 566 medical students (Medical University, Katowice) and 517 students of non-medical faculties (University, Katowice). HCV antibodies were determined using the 3rd generation EIA test, in doubtful cases a Western-blot INNO-LIA-HCV confirmation test was applied. Risk factors were identified based on questionnaire derived data. Between-group difference in the prevalence of positive anti-HCV tests was evaluated by means of ch2 test and candidates for risk factors were evaluated according to logistic odds ratios. RESULTS: Prevalence of HCV antibodies was statistically insignificantly lower in medical students (1.4%) than that in non-medical students (1.9%). In the group of 1068 subjects with no history of ever-diagnosed viral hepatitis the respective figures were 1.4% and 1.7%. In this group the presence of the positive anti-HCV tests was associated with dermal cosmetic interventions in the past (logOR=4.85), percutaneous medical interventions (excluding surgery) (logOR=3.18) and individual history of blood transfusion (logOR=1.71). However, the results were not statistically significant. CONCLUSIONS: Medical students at the Medical University in Katowice, Poland are not at increased risk of HCV infection. The findings suggest an important role of cosmetic and percutaneous medical interventions, and blood transfusion as risk factors for HCV infection.

[Assessment of the occurrence and basic determinants of hepatitis C virus (HCV) infection among medical students in Silesian voivodeship]. / Ocena czestosci i podstawowych uwarunkowan zakazen wirusem zapalenia watroby typu C (HCV) wsród studentów wydzialów lekarskich w województwie slaskim.

HCV infection may result in serious health consequences such as chronic hepatitis C and liver cancer. In Poland, the data on the prevalence of HCV infection is limited and available information suggests an increased risk among young males. The aim of the study was to assess the prevalence of hepatitis C virus (HCV) infection between medical and non medical students, and to explore probable routes of HCV transmission. The project was conducted as a cross-sectional study. The study group included medical students (IV, V and VI year) and non medical students as a control group. The subjects were examined in the period from November 2002 to January 2003, (study group: n = 221; control group: n = 129). Serum samples were tested for antibody to HCV by ELISA method and anti-HCV positive samples were verified using Western Blot Line technique. Probable routes of infection were assessed by questionnaire. Preliminary results obtained in 29% of the target group suggested, that the prevalence of positive anti-HCV among students was 2.6% (95% PU: 1.2%-4.8%). It was higher among non medical than medical students (4.7% vs 1.4%). Anti-hepatitis C virus seropositivity was associated with a history of hepatitis. Verification of 9 positive anti-HCV cases proved only 1 HCV infection. Results presented in this paper are preliminary and will be verified after obtaining data for 600 medical students and for 600 subjects in the control group.