RESUMEN
BACKGROUND: Evidence for mitigation of transfusion-transmitted dengue informed by surveillance data is lacking. In this study, we evaluated the risk of positive dengue viral (DENV) ribonucleic acid (RNA) from blood transfusions during a large outbreak in Taiwan. METHODS: Serum collected from blood donors living in districts experiencing the dengue epidemic were tested for DENV RNA using a qualitative transcription-mediated nucleic acid amplification assay (TMA). The TMA-reactive specimens were further tested for immunoglobulin (Ig)M and IgG antibodies, nonstructural protein 1 (NS1) antigen, and viral RNA by reverse-transcription polymerase chain reaction. We estimated DENV RNA prevalence and the number of DENV infections among blood donors. RESULTS: A total of 4976 specimens were tested for DENV RNA, and 21 were TMA-reactive. The detection rate was 0.84 (95% confidence interval [CI], 0.15-4.73), 3.36 (95% CI, 1.31-8.60), and 6.19 (95% CI, 3.14-12.17) per 1000 donors in districts where the weekly dengue incidence was 5-50, 50-200, and 200 or more per 100 000 residents, respectively. Alanine aminotransferase screening only detected 4.4% of TMA-reactive donations. A total of 143 transfusion-transmitted DENV infections probably occurred during this outbreak, accounting for 9.2 in 10 000 dengue infections. CONCLUSIONS: Approximately 0.5%-1% of blood donations were DENV RNA positive in epidemic districts. The correlation of DENV RNA rates with dengue incidence may inform the design of effective control measures.
Asunto(s)
Virus del Dengue , Dengue , Anticuerpos Antivirales , Donantes de Sangre , Virus del Dengue/genética , Brotes de Enfermedades , Humanos , Inmunoglobulina M , Incidencia , ARN Viral/genética , Taiwán/epidemiologíaRESUMEN
Hepatitis C virus (HCV) infection can cause permanent liver damage and hepatocellular carcinoma, and deaths related to HCV deaths have recently increased. Chronic HCV infection is often undiagnosed such that the virus remains infective and transmissible. Identifying HCV infection early is essential for limiting its spread, but distinguishing individuals who require further HCV tests is very challenging. Besides identifying high-risk populations, an optimal subset of indices for routine examination is needed to identify HCV screening candidates. Therefore, this study analyzed data from 312 randomly chosen blood donors, including 144 anti-HCV-positive donors and 168 anti-HCV-negative donors. The HCV viral load in each sample was measured by real-time polymerase chain reaction method. Receiver operating characteristic curves were used to find the optimal cell blood counts and thrombopoietin measurements for screening purposes. Correlations with values for key indices and viral load were also determined. Strong predictors of HCV infection were found by using receiver operating characteristics curves to analyze the optimal subsets among red blood cells, monocytes, platelet counts, platelet large cell ratios, and mean corpuscular hemoglobin concentrations. Sensitivity, specificity, and area under the receiver operator characteristic curve (P < 0.0001) were 75.6%, 78.5%, and 0.859, respectively.
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Biomarcadores/sangre , Hepatitis C/diagnóstico , Hepatitis C/epidemiología , Adulto , Alanina Transaminasa/sangre , Femenino , Hepacivirus , Hepatitis C/sangre , Hepatitis C/virología , Humanos , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Trombopoyetina/sangre , Carga ViralRESUMEN
This study aimed to evaluate the less stigmatizing positivity construct screening measurement and its association with recent self-harming behaviors among adolescents. Participants were 193 detained Taiwanese adolescents. Questionnaires consisted of a deliberate self-harm inventory, a positivity construct measurement, a depression scale, data concerning risky health behaviors and demographics. The prevalence rate of recent self-harming behavior among adolescents in the detention house was 43.5%. The logistic model showed that age, gender and level of positivity demonstrated significant odds ratios for self-harm behavior. Results showed that younger age and female gender increased self-harming behavior. In addition, low score on positivity construct screening measurement increased the probability of self-harming behavior. Furthermore, these adolescents also engaged in risky health behaviors and were more depressed. Parental and school awareness for these risky behaviors should be enhanced and appropriate early interventions implemented to prevent negative health outcomes.
Asunto(s)
Conducta del Adolescente/psicología , Actitud , Conducta Autodestructiva/epidemiología , Adolescente , Femenino , Humanos , Masculino , Prevalencia , Instituciones Residenciales , Factores de Riesgo , Asunción de Riesgos , Conducta Autodestructiva/psicología , Taiwán , Adulto JovenRESUMEN
AIM: Prevalence rates for deliberate self-harm (DSH) are unusually high among Taiwanese high school students. Several models have been advanced to explain the occurrence of DSH. One, the experiential avoidance model suggests that self-mutilation helps the individual escape from unwanted emotional experiences. The purpose of this study was to examine the demographic, health and behavioral correlates of DSH in a population (Taiwanese adolescents) known to have a high rate of DSH. METHOD: A structured, self-administered questionnaire survey was completed by a sample of 742 vocational high school students in Taiwan. RESULTS: Eighty-four students (11.3%) acknowledged DSH behavior. Results of multivariate logistic regression analysis indicated that female students were 3.47 times as likely as male students to be in the DSH group. Avoidance behaviors of running away from school [odds ratio (OR) = 3.45] and suicide attempt (OR = 13.05), a history of headache (OR = 8.96), a history of sexual abuse (OR = 4.26) and drinking (OR = 4.12) were also significantly associated with DSH. CONCLUSIONS: Gender and a history of headaches, a history of sexual abuse, drinking, running away from school, or suicidal attempts were factors associated with DSH among Taiwanese adolescents. School personnel should be aware of these to formulate appropriate and timely interventions.