Overview of oral health status and associated risk factors in maritime settings: An updated systematic review.

OBJECTIVES: The aim of this study is to provide an updated overview of the oral health status and associated risk factors in maritime settings. METHODS: We systematically searched PubMed, Ovid Embase, Web of Science, CINAHL and SCOPUS from January 2010 to April 2023. Two independent reviewers extracted the data. The quality of included studies was assessed using relevant assessment tools. RESULTS: A total of 260 records were found in the initial search; 24 articles met the inclusion criteria. Most studies had descriptive design, and only two randomized controlled trials were found. The main oral health issues noted are oral cancer, dental caries, periodontal diseases, oral mucosal lesions, and dental emergency. Male seafarers have higher risk of oral cancers in the tongue, lips, and oral cavity while oral mucosal lesions are more prevalent among fishermen. CONCLUSIONS: Dental caries and periodontal diseases are prevalent in both seafarers and fishermen. The consumption of tobacco, alcohol, fermentable carbohydrate, and poor oral hygiene are risk factors that affect the oral health status at sea. The occurrence of oral diseases in maritime setting requires more attention of researchers and authorities to develop strategies to tackle these issues. TRIAL REGISTRATION: Systematic review registration number in PROSPERO: CRD42020168692.

Diabetes among tuberculosis patients and its impact on tuberculosis treatment in South Asia: a systematic review and meta-analysis.

The escalating burden of diabetes is increasing the risk of contracting tuberculosis (TB) and has a pervasive impact on TB treatment outcomes. Therefore, we conducted this systematic review and meta-analysis to examine the burden of diabetes among TB patients and assess its impact on TB treatment in South Asia (Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, India, Pakistan, and Sri Lanka). PubMed, Excerpta Medica Database (EMBASE), and CINAHL databases were systematically searched for observational (cross-sectional, case-control and cohort) studies that reported prevalence of diabetes in TB patients and published between 1 January 1980 and 30 July 2020. A random-effect model for computing the pooled prevalence of diabetes and a fixed-effect model for assessing its impact on TB treatment were used. The review was registered with PROSPERO number CRD42020167896. Of the 3463 identified studies, a total of 74 studies (47 studies from India, 10 from Pakistan, four from Nepal and two from both Bangladesh and Sri-Lanka) were included in this systematic review: 65 studies for the prevalence of diabetes among TB patients and nine studies for the impact of diabetes on TB treatment outcomes. The pooled prevalence of diabetes in TB patients was 21% (95% CI 18.0, 23.0; I2 98.3%), varying from 11% in Bangladesh to 24% in Sri-Lanka. The prevalence was higher in studies having a sample size less than 300 (23%, 95% CI 18.0, 27.0), studies conducted in adults (21%, 95% CI 18.0, 23.0) and countries with high TB burden (21%, 95% CI 19.0, 24.0). Publication bias was detected based on the graphic asymmetry of the funnel plot and Egger's test (p < 0.001). Compared with non-diabetic TB patients, patients with TB and diabetes were associated with higher odds of mortality (Odds Ratio (OR) 1.7; 95% CI 1.2, 2.51; I2 19.4%) and treatment failure (OR 1.7; 95% CI 1.1, 2.4; I2 49.6%), but not associated with Multi-drug resistant TB (OR 1.0; 95% CI 0.6, 1.7; I2 40.7%). This study found a high burden of diabetes among TB patients in South Asia. Patients with TB-diabetes were at higher risk of treatment failure and mortality compared to TB alone. Screening for diabetes among TB patients along with planning and implementation of preventive and curative strategies for both TB and diabetes are urgently needed.

Electro-dewatering of sludge under pressure and non-pressure conditions.

The electro-dewatering method is regarded as a promising approach to reduce the water content in sludge. Laboratory scale non-pressure and pressure-driven dewatering reactors were set up to study the dewatering rate in different types of sludge and the water content in the final sludge cake after electro-dewatering process. It was observed that in non-pressure experiments, the water removal rate was highly dependent on sludge pH buffering capacity and the type of sludge; the highest water removal rate (83.2 lm(-2) day(-1)) was achieved with anaerobic sludge. When pressure was applied, the rate of removal of water from the anode and the cathode depended on alkalinity as well as current density. During the electro-dewatering process, pressure had a significant contribution to water reduction in the final sludge cake in experiments using raw sludge and raw sludge with added alkalinity in comparison with non-pressure experiments using the same types of sludge. However, experiments using anaerobically digested sludge in non-pressure and pressure-driven reactors resulted in the same water content in the final sludge cake (40%). In general, different types of sludge with various amounts of alkalinity affected sludge electro-dewatering capacity by changing zeta potential and pH. Migration of negatively charged organic substances occurred during the applied low-level direct current (15 V), and chemical oxygen demand and total organic carbon concentrations in removed water were found to be higher at the anode and lower at the cathode in comparison with control experiments.

SARS transmission in Vietnam outside of the health-care setting.

To evaluate the risk of transmission of SARS coronavirus outside of the health-care setting, close household and community contacts of laboratory-confirmed SARS cases were identified and followed up for clinical and laboratory evidence of SARS infection. Individual- and household-level risk factors for transmission were investigated. Nine persons with serological evidence of SARS infection were identified amongst 212 close contacts of 45 laboratory-confirmed SARS cases (secondary attack rate 4.2%, 95% CI 1.5-7). In this cohort, the average number of secondary infections caused by a single infectious case was 0.2. Two community contacts with laboratory evidence of SARS coronavirus infection had mild or sub-clinical infection, representing 3% (2/65) of Vietnamese SARS cases. There was no evidence of transmission of infection before symptom onset. Physically caring for a symptomatic laboratory-confirmed SARS case was the only independent risk factor for SARS transmission (OR 5.78, 95% CI 1.23-24.24).