Search

SUMMARYEffective methods to increase awareness of preventable infectious diseases are key components of successful control programmes. Rabies is an example of a disease with significant impact, where public awareness is variable. A recent awareness campaign in a rabies endemic region of Azerbaijan provided a unique opportunity to assess the efficacy of such campaigns. A cluster cross-sectional survey concerning rabies was undertaken following the awareness campaign in 600 households in 38 randomly selected towns, in districts covered by the campaign and matched control regions. This survey demonstrated that the relatively simple awareness campaign was effective at improving knowledge of rabies symptoms and vaccination schedules. Crucially, those in the awareness campaign group were also 1·4 times more likely to report that they had vaccinated their pets, an essential component of human rabies prevention. In addition, low knowledge of appropriate post-exposure treatment and animal sources of rabies provide information useful for future public awareness campaigns in the region and other similar areas.

Summary The Caucasus is a region of geopolitical importance, in the gateway between Europe and Asia. This geographical location makes the region equally important in the epidemiology and control of transboundary infectious diseases such as rabies. Azerbaijan is the largest country in the Caucasus, and although rabies is notifiable and considered endemic, there is little information on the burden of human and animal rabies. Here, we describe a cross-disciplinary international collaboration aimed at improving rabies control in Azerbaijan. Partial nucleoprotein gene sequences were obtained from animal rabies cases for comparison with those from surrounding areas. Reported human and animal rabies cases between 2000 and 2010 were also reviewed and analysed by region and year. Comparison of rabies virus strains circulating in Azerbaijan demonstrates more than one lineage of rabies virus circulating concurrently in Azerbaijan and illustrates the need for further sample collection and characterization. Officially reported rabies data showed an increase in human and animal rabies cases, and an increase in animal bites requiring provision of post-exposure prophylaxis, since 2006. This is despite apparently consistent levels of dog vaccination and culling of stray dogs.

BACKGROUND: Bleeding from esophageal varices is a severe complication of portal hypertension. Endoscopic band ligation (EBL) is the treatment of choice for acute variceal bleeding. It is also performed for primary and secondary prophylaxis of bleeding from esophageal varices. After EBL, patients are at risk of postinterventional bleeding; the risk factors for this complication are poorly evaluated. METHODS: We retrospectively analyzed data from patients who underwent EBL. We evaluated clinical data, laboratory and endoscopic findings. RESULTS: 255 patients with 387 ligation sessions were included in the analysis. Patients with bleeding complications had a significantly higher severity of liver disease as measured by a higher Child-Pugh score (10.5 vs. 8, p = 0.002), lower albumin (26.5 vs. 31.9 [g/L], p = 0.0001) and lower prothrombin activity (46.5 vs. 70 [%], p = 0.0001). The incidence of bacterial infection was significantly higher in patients with postinterventional bleeding. As well, the white blood cell count was significantly higher in the bleeding group (9.5 vs. 6.5 [× 10 9 /L], p = 0.030). In patients with bleeding events we observed an elevated heart rate compared to those without this complication (80 vs. 72 [bpm], p = 0.017). Furthermore, we found a lower hemoglobin level (5.9 vs. 6.4 [mmol/L], p = 0.028) and a lower hematocrit (0.280 vs. 0.314, p = 0.031) in the bleeding group. Younger patients suffered more often from postinterventional bleeding (52.5 vs. 58 [years], p = 0.012). CONCLUSION: There are clinical data which can be ascertained easily in order to reflect the risk of bleeding complications after EBL.