Analysis of hepatitis B virus-mixed genotype infection by ultra deep pyrosequencing in Sudanese patients, 2015-2016.

PURPOSE: The frequency of detection of HBV co-infection with multiple HBV genotypes is influenced by the detection method; usually co-infections are detected by multiplex PCR or hybridization assays, and are rarely confirmed by sequencing and conventional cloning. The objective of this study was to confirm by ultra-deep pyrosequencing (UDPS) mixed HBV infections, previously detected by multiplex-nested PCR. METHODS: Sixteen samples from HBV co-infected Sudanese patients detected by multiplex-nested PCR, were amplified targeting the P/S region and sequenced by UDPS. RESULTS: The only genotypes identified using UDPS were D and E, while A, B, C and F genotypes, previously detected by multiplex-nested PCR, were not detected. Specifically, 10 samples were shown to be mono-infected (D or E); in 3 out of 10 mono-infected D patients, a subtype combination was observed: D1 + D7 in 2 cases and D2 + D6 in 1 case. The remaining 6 subjects were D + E co-infected (harboring different mixtures of D subtypes). CONCLUSIONS: Overall, UDPS is more effective than multiplex-nested PCR for identifying multiple HBV genotypes and subtypes infections.

Systemic antibody response to nano-size calcium phospate biocompatible adjuvant adsorbed HEV-71 killed vaccine.

PURPOSE: Since 1980s, human enterovirus-71 virus (HEV-71) is one of the common infectious disease in Asian Pacific region since late 1970s without effective commercial antiviral or protective vaccine is unavailable yet. The work examines the role of vaccine adjuvant particle size and the route of administration on postvaccination antibody response towards HEV-71 vaccine adsorbed to calcium phosphate (CaP) adjuvant. MATERIALS AND METHODS: First, CaP nano-particles were compared to a commercial micro-size and vaccine alone. Secondly, intradermal reduced dosage was compared to the conventional intramuscular immunization. Killed HEV-71 vaccines adsorbed to CaP nano-size (73 nm) and commercial one of micro-size (1.7 µm) were administered through intradermal, intramuscular, rabbits received vaccine alone and unvaccinated animals. RESULTS: CaP nano-particles adsorbed HEV-71 vaccine displayed higher antibody than the micro-size or unadsorbed vaccine alone, through both parenteral immunization routes. Moreover, the intradermal route (0.5 µg/mL) of 0.1-mL volume per vaccine dose induced equal IgG antibody level to 1.0-mL intramuscular route (0.5 µg/mL). CONCLUSION: The intradermal vaccine adsorbed CaP nano-adjuvant showed safer and significant antibody response after one-tenth reduced dose quantity (0.5 µg/mL) of only 0.1-mL volume as the most suitable protective, cost effective and affordable formulation not only for HEV-71; but also for developing further effective vaccines toward other human pathogens.

Hazards analysis, within departments and occupations, for hepatitis B virus among health care workers in Public Teaching Hospitals in Khartoum State; Sudan.

BACKGROUND: Infection with hepatitis B virus (HBV) can lead to a range of clinical illnesses. OBJECTIVES: To examine hazards of hepatitis B virus associated with clinical departments and occupations; among health care workers in Public Teaching Hospitals in Khartoum State, Sudan. METHODS: The study was a cross sectional, facility-based study. It was conducted on stratified two-stage cluster random sample of 843 subjects of whom 324 were at high-hazard, 445 at moderate hazard, and 74 at low hazard; depending on degree of exposure to blood and body fluids of patients. To assess hazards of HBV among departments and occupations of HCWs, non-parametric Methods of Chi-square test, was used. RESULTS: For Anti-HBc vulnerable departments was Renal Dialysis (100%); while for occupations was midwives (73.3%). For carrier rate (+ve HBsAg), highest rate found in department of Management (6.8%); while for occupations was Midwives (6.7%). Regarding immunity (+ve Anti-HBs), the highest percentage found in the department of Dentistry (25.9%); while for occupations was associated with Doctors (14.8%). For a profile of high infectivity (+ve HBeAg), the most vulnerable department in terms of HBV hazards was the Surgery (1.4%); while for occupations was nurses (0.9%). CONCLUSION: There was a significant association for infection rate of HBV with occupation and type of department. The most hazardous departments, was Surgery with a profile of high infectivity rate, followed by other departments (medicine, pediatrics, psychiatry & ophthalmology). As for occupations, the most hazardous group was nurses group with a profile of high infectivity rate.

Socio-demographic characteristics of health care workers and hepatitis B virus (HBV) infection in public teaching hospitals in Khartoum State, Sudan.

BACKGROUND: HBV is second to tobacco as a known human carcinogen and the 10th leading cause of death worldwide. OBJECTIVES: To examine the socio-demographic characteristics of health care workers and hepatitis B virus in Public Teaching Hospitals in Khartoum State, Sudan, in 2004. METHODS: It was an observational, cross sectional, facility-based study. A total of 843 subjects were selected. It was conducted through multistage cluster sampling. The clustering was based on: type of hospital (Federal or State) and degree of exposure (type of department). For the analysis, Z-test for single proportion and some non-parametric tests such as Chi-Square test were used. RESULTS: Among the 843 subjects tested for HBV markers (Anti-HBc, HBsAg, HBsAb, and HBeAg), the prevalence of Anti-HBc, HBsAg, HBsAb, and HBeAg was found to be 57%, 6%, 37% and 9% respectively. Seroprevalence of all HBV markers was found to be statistically significant with demographic factors (P<0.05). CONCLUSION: Infection rate, carrier rate and a profile of high infectivity rate were found to be high. The immunity rate was low. There is a significant association between HBV markers and socio-demographic characteristics. Highest rate of infection was found in State Hospitals, South and West regions, married HCWs and HCWs of age group 30-49.

Past Medical History of Blood Transfusion; Surgical Operation; Vaccination against HBV; Cutter Scar and Tattoo; and HBV Infection Among Health Care Workers in Public Teaching Hospitals in Khartoum State; Sudan

Background:Infection with the hepatitis B virus (HBV) can lead to a range of clinical illnesses. Hepatitisis a general term meaning inflammation of the liver and the most common cause is infection with a variety of different viruses. All of these can cause an acute disease and symptoms lasting several weeks includingyellowing of the skin and eyes; dark urine; extreme fatigue; nausea; vomiting and abdominal pain.Aim:This study examined the prevalence of sero-epidemiologic markers of hepatitis B virus (HBV)among health care workers (HCWs) in Public Teaching Hospitals in Khartoum State; in the year 2004. Itattempted to determine the relation of the past medical history of blood transfusion; surgical operation;vaccination against HBV; cutter scar and tattoo with HBV infection among HCWs.Method:The study is anobservational; cross sectional; facility-based study. It was conducted on stratified two-stage cluster randomsample of 843 subjects. The study followed multivariate analytical techniques; using Multiple DiscriminantAnalysis (MDA); and some non-parametric tests using Chi-square test results:Among the 843 subjectstested for all HBV markers (Anti-HBc; HBsAg; HBsAb; and HBeAg); the prevalence of Anti-HBc; HBsAg;HBsAb; and HBeAg was found to be 57 (CI95:53-60); 6 (CI95:4.0-8.0); 37 (CI95:34-40) and 9 (CI95:7-11) respectively. The prevalence rate differs according to past medical historyfactors. Significant association of past medical history factors was found with seroprevalence of HBsAgmarkers (P0.05). No significant association was found with any of the past medical history factors forseroprevalence of Anti-HBc and HBeAg and HBsAb markers (P0.05).Conclusion:Tattooing and itsduration had shown significant result with HBsAg