An Automated Surveillance System (SurCeGGID) for the French Sexually Transmitted Infection Clinics: Epidemiological Monitoring Study.

BACKGROUND: Viral and bacterial sexually transmitted infections (STIs) are public health concerns worldwide, but surveillance systems are not comprehensive enough to design and monitor accurately STI control strategies in most countries. In 2016, 320 STI clinics (CeGIDDs in French) were implemented in France, primarily targeting most exposed populations, although access is free of charge for anybody. OBJECTIVE: This article describes the mandatory surveillance system (SurCeGIDD) based on CeGIDD's individual data aiming to better guide STI prevention. METHODS: A decree ensured the use of software to manage consultations in CeGIDDs and to transfer surveillance data. A web service was implemented to secure data transfer from CeGIDDs' software to a centralized database. CeGIDDs can also transfer data in CSV format via a secured data-sharing platform. Then, data are automatically checked before integration. Data on sociodemographic variables, sexual exposure, blood exposure, symptoms, STI tests, STI diagnoses, and sexual health services delivery were collected for the previous year (n-1). Preliminary and descriptive analyses of 2017-2018 data transmitted in 2018 and 2019, respectively, were performed using numbers and proportions for qualitative variables. RESULTS: In 2017, 54/320 (16.9%) CeGIDDs transmitted their data. In 2018, this number of participants increased to 143/320 (44.7%) CeGIDDs. The corresponding volume of records increased from 2414 in 2017 to 382,890 in 2018. In 2018, most attendances were hospital based (263,480/382,890, 68.81%). In 2018, attendees were mostly men 227,326/379,921 (59.84%), while 151,963/379,921 (40%) were women 632/379,921 (0.17%) transgenders. The median age was 27 years for men, 23 years for women, and 30 years for transgender. Half of the attendees (81,964/174,932, 46.85%) were heterosexual men, 69,016/174,932 (39.45%) heterosexual women, 20,764/174,932 (11.87%) men who have sex with men, and 3188/174,932 (1.82%) women who have sex with women. A majority of them were born in France (227,698/286,289, 79.53%) and unemployed 115,913/211,707 (54.75%). The positivity rates were 0.37% for 205,348 HIV serologies, 1.31% for 131,551 hepatitis B virus serologies, 7.16% for 161,241 Chlamydia trachomatis PCR, 2.83% for 146,649 gonorrhea PCR, 1.04% for the syphilis combination of treponema and nontreponema serologies, and 5.96% for 13,313 Mycoplasma genitalium PCR. CONCLUSIONS: Despite challenges, the effectiveness of the SurCeGIDD surveillance based on routine patients' records was demonstrated. The wide range of information, including socioeconomic determinants, might help to better guide and evaluate the prevention policies and services delivery. However, the growing volumes of information will require adapted tools and algorithms for the data management and analyses.

The Metabolic Syndrome: Emerging Novel Insights Regarding the Relationship between the Homeostasis Model Assessment of Insulin Resistance and other Key Predictive Markers in Young Adults of Western Algeria.

Several biological markers have been identified as risk factors for cardiovascular disease and are associated with increased risk of metabolic syndrome (MetS). This study provides a factual information on promising biomarkers that are associated with MetS and can aid in early detection and management of MetS in young adults of Western Algeria. We studied a total of one hundred subjects aged between thirty and forty years with MetS, in which anthropometric measurements, insulin resistance, C peptide and HbA1c, lipid profile, circulating adipokines and glucagon-like peptide-1 were measured by suitable methods, in comparison to two groups of control. MetS is closely linked to altered glucose homeostasis, the plasma insulin/glucose ratio; i.e., the insulinogenic index helps to estimate the level of insulin secretion and also for assessing ß-cell function. The correlation between homeostasis model assessment insulin resistance index (HOMA-IR) and HbA1c, body mass index or plasma triglycerides yielded positive and significant values. Biomarkers with a known and predictable association with MetS can provide a means to detect those at risk and intervene as needed. This could significantly decrease the burden complications impose on patients and the healthcare system.

Relationship between the insulin resistance and circulating predictive biochemical markers in metabolic syndrome among young adults in western Algeria.

AIM: The metabolic syndrome (MetS) becomes increasingly obvious from an early age. The current study aimed at exploring the relationship between insulin resistance and the main biomarkers of MetS in young adult algerian patients. METHODS: Glucose, HbA1C, total cholesterol (TC), hjgh bensity lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), insulinemia and C-peptide, adipokins (leptin, adiponectin), inflammatory cytokines (IL-6 and TNF-a), us-CRP and GLP-1 were measured by suitable methods. Homeostasis model assessment (HOMA) was used to detect the degree of insulin resistance. RESULTS: The MetS patients displayed higher glucose, insulin, HbA1c values and impaired lipid profile as judged by increasing TC, TG, LDL-C levels and lower HDL-C. Furthermore, adipokines, HDL-C and CRP contents were significantly higher whilst TG and LDL-C were much lower in MetS female group as compared to male patients suggesting most pronounced metabolic perturbation in the latter group. The probability of a significant correlation between HOMA and studied variables was often higher in female than male subjects. Such was the case for total cholesterol, HDL-cholesterol, triglycerides, adiponectin, interleukin-6, TNF-α and hs-CRP. CONCLUSION: The high rate of metabolic syndrome among young obese adults is alarming, this requiring extensive investigations in prone subjects.