[Prenatal screening and the prevalence of hepatitis B infection in pregnant women in the Marche Region (Central Italy): differences between ethnic groups]. / Lo screening prenatale e la prevalenza dell'infezione da epatite B nelle donne in gravidanza nelle Marche: differenze tra gruppi etnici.

OBJECTIVES: to evaluate the epidemiology of hepatitis B infection in pregnant women living in the Marche Region (Central Italy), according to the Country of origin. DESIGN: cross sectional observational study conducted from May 2011 to April 2012, which involved 13 of the 15 birthing centres in the Marche region. SETTING AND PARTICIPANTS: serological data of hepatitis B infection were obtained during the execution of mandatory prenatal screening. The total number of pregnant women was of 10,232 of which 7,669 were Italian (74.9%) and 2,563 were foreign (25.1%). MAIN OUTCOME MEASURES: rate of adherence to prenatal serologic screening and prevalence of hepatitis B infection in Italian and foreign pregnant women. The 95% confidence intervals were calculated using the exact method for proportions. The test for proportions was applied to make comparisons between groups (significance level: 0.05). RESULTS: the rate of adherence to prenatal serologic screening and the overall prevalence of hepatitis B infection in pregnancy ware 98.6% and 0.8%, respectively. In foreign women, compared to native ones, differences of adherence to screening and the prevalence of infection were significant (96.7% vs. 99.3% and 2.7% vs. 0.2%). The highest prevalence was observed in pregnant women who came from the Western Pacific Region, Eastern Europe, and Africa (7.0%, 4.0%, and 3.3%, respectively). More than half of the cases of pregnant women, positive for hepatitis B surface antigen, were originating in Albania and China (60.6%). The prevalence of hepatitis B infection was significantly higher in pregnant women from China (8.1%), Albania (7.7%), Ukraine (7.2%), and Senegal (6.1%). CONCLUSIONS: the study emphasises the need to organise targeted interventions to facilitate access to prenatal screening programmes to foreign women for better control of hepatitis B infection in the Marche Region.

[Congenital and perinatal infections in the Marche region (Italy): an epidemiological study and differences between ethnic groups]. / Le infezioni congenite e perinatali nella regione Marche (Italia). Studio epidemiologico e differenze tra gruppi etnici.

The purpose of this study was to evaluate the epidemiological data regarding congenital and perinatal infections in the Marche region to verify the existence of differences in relation to maternal country of origin. This prospective study was conducted from May 2001 to April 2012, and it involved all the maternity units of the Marche region. A total of 10232 pregnant women were included, 25.1% of whom were of foreign nationality while the number of births totalled 10371. Estimated uptake of antenatal screening was 80.5% for CMV infection, 98.6% for HBV infection, 97.5% for HCV infection, 97.4% for HIV infection, 93.1% for syphilis and 98.5% for toxoplasmosis. For group B streptococcus vaginal and perianal swabs were performed in 81.2% of all women (78.4% in immigrant and 90.4% in Italian women; the difference was statistically significant [p 0.001]) and 13.6% were positive. The overall prevalence for CMV infection was 72.3% (91.9% in immigrant women) while for toxoplasmosis it was 27.5% (28.8% in immigrant women). The rate of seroconversion in pregnant women investigated for CMV infection was 0.28%, while that for toxoplasmosis was 0.09%. The overall prevalence for HBV infection was 0.79% (4.3% in immigrant and 0.4% in Italian pregnant women; the difference was statistically significant [p 0.001]), 0.4% for HCV infection (1% in immigrant and 0.48% in Italian pregnant women; the difference was not statistically significant [p 0.413]), 0.22% for syphilis (0.8% in immigrant and 0.08% in Italian pregnant women; the difference was not statistically significant [p 0.062]), 0.09% for HIV infection, and 0.03% for tuberculosis. The prevalence of congenital CMV infection was 0.04% and that of congenital toxoplasmosis 0.01%. The prevalence of early-onset infection from Group B streptococcus was 0.029%. No cases were observed of congenital syphilis, congenital tuberculosis or maternal and neonatal HSV infections. The study proves that in the Marche region there is a high percentage of women who undergo prenatal screening, including screening for infections, not offered by the National Health Service, such as CMV and HCV. The data also demonstrate that some infections, such as tuberculosis, HIV and HBV, almost exclusively affect immigrant women. Regarding neonatal infections, the data presented are in line with those in the literature, with the exception of congenital CMV infection, in which the low prevalence observed could be linked to the recent and massive migration of already immunized women.

Características da reprodução de tartarugas marinhas (Testudines, Cheloniidae) no litoral sul da Bahia, Brasil / Reproduction of sea turtles (Testudines, Cheloniidae) in the Southern Coast of Bahia, Brazil

Poucos estudos foram realizados sobre a nidificação de tartarugas marinhas no litoral sul da Bahia, região que está passando por um processo rápido de ocupação turística que pode ameaçar ainda mais estas espécies. Por estes motivos, este estudo teve como objetivos identificar as espécies de tartarugas marinhas que desovam no local e descrever as principais características de suas ninhadas. Durante quatro temporadas reprodutivas, de 2004 a 2008, foram identificados e monitorados os ninhos encontrados nas praias localizadas entre Uruçuca e Itacaré no litoral sul da Bahia. As variáveis coletadas foram: tamanho de ninhada, duração da incubação, sucesso de eclosão e fases de mortalidade embrionária. Foi registrada uma média de 37 ± 6,2 ninhos por temporada, com maior freqüência de ninhos das espécies Caretta caretta e Eretmochelys imbricata, tendo sido registradas também desovas esporádicas de Chelonia mydas. A temporada de desova de C. caretta ocorre de outubro a janeiro e de E. imbricata de dezembro a março. Este deslocamento temporal das temporadas reprodutivas pode estar relacionado a uma adaptação para minimizar a competição interespecífica. Além da época de nidificação, as duas espécies diferiram no tamanho de suas ninhadas, mas não diferiram na duração da incubação e no sucesso de eclosão. Diante dos resultados, acredita-se que áreas com baixa concentração de ninhos também devem ser alvo de programas de conservação, devido à sua relevância para a ampliação da variação genotípica e, sobretudo, fenotípica, das espécies de tartarugas marinhas, de forma que as mesmas possam se adaptar e sobreviver às constantes ameaças às quais estão submetidas. Tais programas de conservação podem ser estabelecidos por meio de parcerias entre organizações não governamentais e instituições privadas e a instituição governamental responsável pela conservação das tartarugas marinhas (Centro TAMAR/ICMBio).

Few studies have been carried out on nesting of sea turtles in the southern coast of Bahia, an area that is experiencing a fast process of tourist occupation what can increase levels of threat to these species. Thus, this study aimed to identify sea turtle species that nest in the area and to describe the main characteristics of their clutches. During four reproductive seasons, from 2004 to 2008, we identified and monitored nests found at beaches located between the municipalities of Uruçuca and Itacaré, in the southern coast of Bahia. The collected variables were: clutch size, incubation duration, hatching success and stages of embryonic mortality. We registered an average of 37 ± 6.2 nests per season, with nests of Caretta caretta and Eretmochelys imbricata being more frequent, along with sporadic nests of Chelonia mydas. Nesting season of C. caretta extends from October to January and that of E. imbricata from December to March. This temporary displacement of reproductive seasons might be related to a selective adjustment to minimize competition among species. Besides the time of nesting, the two species differed also in clutch size, but they did not differ in incubation duration and in hatching success. According to our results, we believe that areas with low concentration of nests should also be a target of conservation programs, due to their relevance to the increase of genotypic, and specially fenotypic, variation of sea turtle species, so that Brazilian populations can adapt and survive to the constant threats. Those conservation programs can be established by partnerships between non-governmental organizations and private institutions and the Brazilian government institution for the conservation of sea turtles (Centro TAMAR/ICMBio).