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The surgical nature of dental practice, which frequently includes a combination of using sharp tools and the presence of blood, puts dental practitioners at a significant risk for infection with bloodborne pathogens, mainly hepatitis B, hepatitis C, and HIV. Several seroprevalence studies and case reports traced back newly diagnosed cases of hepatitis B and C to recent episodes of dental treatments. This paper provides an update on the prevalence of hepatitis B and C and HIV, the likelihood of acquiring an infection following an occupational injury, the manner in which serologic tests should be interpreted, and practical advice on ways to reduce the risk of occupational exposure., Competing Interests: Conflict of interest None disclosed., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Despite saving a vast number of lives through blood transfusions, transfusion-transmitted infections (TTIs) still threaten the lives of people needing blood transfusion. Hence, screening blood donors and reviewing the prevalence of TTIs amongst blood donors might show the impact of these infections among our people. The aim of this study was to evaluate the prevalence rates of transfusion-transmitted infections among blood donors in Makkah as foundation for providing harmless blood transfusion in Makkah, Saudi Arabia., Methods: A retrospective study was carried out at the Central Blood Bank in Makkah city, Saudi Arabia, from January 1, 2023, to December 31, 2023. A total of 13,706 samples were collected and screened for hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (HBsAbs), hepatitis B core antibodies (HBcAbs), antibodies to hepatitis C virus (anti-HCV), antibodies to HIV 1 and 2 (HIV I/II Ab), antibodies to HTLV 1 and 2 (HTLV I/II Ab), Malarial antibodies, and antibodies to VDRL., Results: A total of 13,706 blood units were received and tested. Out of the total, 52% were non-Saudi donors and 47.9% were Saudi donors; 28.4% were aged 18 - 28 years, 42.8% were aged 29 - 39 years, 24.4% were aged 40 - 50 years, and 4.4% were aged 51 - 60 years. The majority was O+ blood group (42.7%), followed by A+ (26.2%), B+ (18.7%), AB+ (4.6%), O- (3.8%), A- (2.1%), B- (1.5%), and AB- (0.4%). While 42.6% of the blood units donated were from voluntary donors, 57.4% were donated by replacement donors. Sixty-one samples (0.4%) tested positive for HBsAg, 824 samples (6%) for HBcAb, 43 samples (0.3%) for HCV antibodies, 754 samples (5.5%) for HBsAb, and 44 samples (0.3%) for HIV I/II Ag/Ab combinations. Further, 44 samples (0.3%) were positive for HTLV I/II antibodies, 83 samples (0.6%) for VDRL antibodies, and only 3 samples (nearly 0%) for malaria antibodies. Forty-three samples (0.3%) were positive for NAT-HBV, 7 samples (0.1%) were positive for NAT-HCV, and 6 samples (0.1%) were positive for NAT-HIV. The analysis revealed a statistically significant and strong correlation between HBsAgs and NAT-HBV (r = 0.819, p < 0.0001). In contrast, while there was a statistically significant association between HBsAgs and HBcAbs, the correlation was weak (r = 0.191, p < 0.0001). Additionally, there was an association between HBsAbs and HBsAgs, but the Spearman correlation indicated a very weak relationship (r = 0.042, p < 0.0001)., Conclusions: Prevalence rates of transfusion-transmitted infections showed a steady decline in 2023, and these rates were much lower in Makkah than in other parts of the country or in neighboring countries. The importance of using NAT in the screening of blood donors was indicated in this study. These findings could contribute to improving the understanding of TTIs epidemiology and supporting health authorities in controlling blood-borne pathologies.

This review describes the risks and benefits of expanding screening for transmissible pathogens in deceased organ donors. The focus is on the experience and procedure in Germany to make a decision on how to proceed with a possible donor. Three issues are of interest in how screening policies impact the process with the aim of mitigating unexpected transmission risks: (1) Should we add universal or targeted nucleic acid testing to serological tests for common blood-borne viruses (BBVs; HIV, HBV, and HCV)? (2) Which tests should be added for screening in a geographically restricted region beyond testing for these BBVs? (3) Being faced with changes (e.g., climate and population) in the own geographically restricted region, what strategies are needed before implementing new tests, and which considerations apply for proper indication to do this? Testing may only be effective when during donor characterization the appropriate conclusions are drawn from the existing findings and screening tests are initiated. This statement overlaps the need to implement universal screening for a pathogen or targeted screening based on the risk that the donor has acquired the transmissible pathogen or is not as possible to identify by current methods of clinical judgment and/or specific tests., (© 2024 Wiley Periodicals LLC.)

Background: With the need to expedite the detection of multiple sexually transmitted blood-borne infections (STBBIs), there is an increased demand for digital innovations and tests that improve the efficiency of point-of-care testing in outreach community settings. Multiplexed testing is being offered to at-risk populations by frontline health care professionals., Objective: With this in mind, we evaluated AideSmart! (for health aides or health care workers), an integrated app and platform solution that enables multiplexed STBBI screening at the point of care, for feasibility, preference, accuracy, and impact. With AideSmart!, we provided trained health care workers with the ability to perform rapid multiplexed tests; offer STBBI pre- or posttest counseling; maintain quality assurance of testing; facilitate linkages to care; and enhance health care provider-patient communication, data documentation, and patient engagement through the multiplexed STBBI screening and linkage process. We evaluated the performance of multiplexed tests., Methods: In a cross-sectional study conducted during the COVID-19 pandemic, we recruited at-risk populations in Canada from community-based organizations in Montreal, Quebec, and Saint John, New Brunswick, with unknown serostatus for HIV, hepatitis C virus (HCV), and syphilis. Following orientation and pretest counseling with AideSmart!, we performed multiplexed tests, simultaneously screening for HIV, HCV, and syphilis, using 2 rapid investigational multiplexed tests (Chembio for HIV and syphilis and MedMira for HIV, HCV, and syphilis) followed by confirmatory testing from local and national laboratories., Results: Of the 401 participants, all (100%) accepted the AideSmart! multiplexed strategy: 59.4% (148/249) preferred multiplexed rapid tests over laboratory tests, and 56.6% (141/249) preferred receiving same-day test results. Rapid test results were obtained in 15 minutes (vs laboratory tests at 4-24 days). A total of 29 new infections (n=27, 93% HCV; n=1, 3% syphilis; and n=1, 3% HIV) were identified and treated within a week. Feasibility of the strategy (completion of testing and linkages to care) was at 76.1% (305/401). Health care professionals provided positive feedback and emphasized the importance of knowing one's negative or positive serostatus, especially during a pandemic. Multiplexed rapid tests' specificity (against laboratory reference standards) exceeded 98% (98.7%-100%) for all pathogens and devices. An electronic reader, used by the Chembio rapid test, enhanced sensitivity (HIV: 100%, 95% CI 79.4%-100%; syphilis: 86.8%, 95% CI 71.9%-95.6% [Chembio] vs HIV: 100%, 95% CI 78.2%-100%; HCV: 90.3%, 95% CI 80.1%-96.4%; and syphilis: 57.9%, 95% CI 40.8%-73.7% [MedMira])., Conclusions: The AideSmart! digital multiplexed rapid screening strategy for health care workers facilitated STBBI testing for multiple STBBIs and arranged for pre- or posttest counseling and rapid linkages with high feasibility and acceptability. Electronic readers enhanced the diagnostic performance of multiplexed biomarker tests. This study generated data in support of digital multiplexed strategies in digitally enabled settings for at-risk populations nationally and worldwide., (©Angela Karellis, Duncan Webster, Jean Boulanger, Kate Harland, Paige Feltmate, Stefanie Materniak, Gabriel Daunais-Laurin, Christine Mesa, Olivia Vaikla, John Kim, Nitika Pant Pai. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 18.10.2024.)

Background Sydney Sexual Health Centre (SSHC) is the largest sexual health clinic in New South Wales (NSW), servicing clients at high risk of sexually transmissible infections and bloodborne viruses. SSHC piloted a direct-to-pathology pathway that facilitated bloodborne virus/sexually transmissible infection testing at one of the ~500 participating pathology collection centres located across NSW. This qualitative study sought to understand SSHC client and provider perspectives of acceptability of the MyCheck intervention. Methods Semi-structured in-depth interviews were conducted with 11 clients who underwent testing via the MyCheck pathway and eight staff members involved in implementing MyCheck. The seven components of Sekhon's Theoretical Framework of Acceptability informed this analysis. Results Participants broadly conveyed 'affective attitude' toward the MyCheck pathway. The telehealth intervention reduced client 'burden' and 'opportunity cost' through enabling greater testing convenience at a location suitable to them and provided timely results. Issues of 'ethicality' were raised by clients and staff as pathology centre staff were, on a few occasions, regarded as being judgmental of SSHC clients. 'Intervention coherence' issues were largely attributed to pathology centre personnel being unfamiliar with the intervention, with billing issues being a recurrent concern. Participants perceived MyCheck as an 'effective' testing pathway. SSHC staff were able to offer the intervention with ease through seamless IT integration ('self-efficacy'). Conclusion The MyCheck intervention was perceived by both SSHC clients and staff as an acceptable bloodborne virus/sexually transmissible infection testing pathway. However, further work is required to address stigma experienced by some clients when attending pathology collection centres.

Background: The Deadly Liver Mob (DLM) program is a peer-led health promotion program that aims to improve access to screening and treatment for blood borne viruses and sexually transmissible infections for Aboriginal and Torres Strait Islander Australians. In this paper, we used client and staff insights to explore the successes and challenges of implementing the DLM program according to the RE-AIM framework, which explores real-world implementation of interventions according to reach, effectiveness, adoption, implementation, and maintenance., Methods: Clients and staff were recruited through the DLM program. Semi-structured interviews were conducted with four Aboriginal and Torres Strait Islander and 11 non-Aboriginal or Torres Strait Islander health workers, as well as 33 Aboriginal and Torres Strait Islander clients of the program., Results: Findings show the positive effects of the DLM program, in creating a culturally safe and sensitive environment for Aboriginal and Torres Strait Islander clients to access care. In particular, the employment of frontline Aboriginal and Torres Strait Islander workers to deliver the education was touted as one of the primary successes of the program, in enabling workers to build trust between clients and mainstream health systems, which has the flow on effect of encouraging clients to go through to screening. The use of the RE-AIM framework illustrates the challenges of implementing real-world interventions across various locations, such as the difficulties in delivering DLM in regional and remote areas due to covering large geographic areas with minimal public transport available., Conclusions: The data emphasise the need for interventions to be adaptable and flexible, altering elements of the program to suit local and community needs, such as by offering mobile and outreach services to enable access across regional and rural areas. The findings of this evaluation have been used to develop tools so that the learnings from DLM can be shared with others who may be hoping to implement DLM or other similar programs., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Aboriginal and Torres Strait Islander Australians are disproportionately impacted by blood-borne viruses (BBVs) and sexually transmissible infections (STIs). Stigma remains one of the key barriers to testing and treatment for BBVs and STIs, particularly among Aboriginal and Torres Strait Islander people. The Deadly Liver Mob (DLM) is a peer-delivered incentivised health promotion program by and for Aboriginal and Torres Strait Islander Australians. The program aims to increase access to BBV and STI education, screening, treatment, and vaccination for Aboriginal and Torres Strait Islander Australians in recognition of the systemic barriers for First Nations people to primary care, including BBV- and STI-related stigma, and institutional racism. This paper presents routinely collected data across nine sites on the 'cascade of care' progression of Aboriginal and Torres Strait Islander clients through the DLM program: hepatitis C education, screening, returning for results, and recruitment of peers., Methods: Routinely collected data were collated from each of the DLM sites, including date of attendance, basic demographic characteristics, eligibility for the program, recruitment of others, and engagement in the cascade of care., Results: Between 2013 and 2020, a total of 1787 Aboriginal and Torres Strait Islander clients were educated as part of DLM, of which 74% went on to be screened and 42% (or 57% of those screened) returned to receive their results. The total monetary investment of the cascade of care progression was approximately $56,220. Data highlight the positive impacts of the DLM program for engagement in screening, highlighting the need for culturally sensitive, and safe programs led by and for Aboriginal and Torres Strait Islander people. However, the data also indicate the points at which clients 'fall off' the cascade, underscoring the need to address any remaining barriers to care., Conclusions: The DLM program shows promise in acting as a 'one stop shop' in addressing the needs of Aboriginal and Torres Strait Islander people in relation to BBVs and STIs. Future implementation could focus on addressing any potential barriers to participation in the program, such as co-location of services and transportation., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Evidence of long-term impacts of COVID-19-related public health restrictions on digital sexually transmitted and blood-borne infection (STBBI) testing utilization is limited. We assessed these impacts on GetCheckedOnline (a digital testing resource for STBBIs) relative to all STBBI tests in British Columbia (BC)., Methods: Interrupted time series analyses were conducted using GetCheckedOnline program data comparing monthly test episodes (STBBI tests per requisition) among BC residents, stratified by BC region, and testers' sociodemographic and sexual risk profiles, for the prepandemic (March 2018-February 2020) and pandemic periods (March 2020-October 2021). Trends in GetCheckedOnline testing per 100 STBBI tests in BC regions with GetCheckedOnline were analyzed. Each outcome was modeled using segmented generalized least squared regression., Results: Overall, 17,215 and 22,646 test episodes were conducted in the prepandemic and pandemic periods. Monthly GetCheckedOnline test episodes reduced immediately after restrictions. By October 2021 (end of the pandemic period), monthly GetCheckedOnline testing increased by 21.24 test episodes per million BC residents (95% confidence interval, -11.88 to 54.84), and GetCheckedOnline tests per 100 tests in corresponding BC regions increased by 1.10 (95% confidence interval, 0.02 to 2.17) above baseline trends. After initial increases among users at higher STBBI risk (symptomatic testers/testers reporting sexual contacts with STBBIs), testing decreased below baseline trends later in the pandemic, whereas monthly GetCheckedOnline testing increased among people 40 years or older, men who have sex with men, racialized minorities, and first-time testers via GetCheckedOnline., Conclusions: Sustained increases in utilization of digital STBBI testing during the pandemic suggest fundamental changes in STBBI testing in BC, highlighting the need for accessible and appropriate digital testing, especially for those most affected by STBBIs., Competing Interests: Conflict of Interest and Sources of Funding: None declared., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Sexually Transmitted Diseases Association.)

To investigate the effect analysis and preventive effects of nucleic acid testing combined with enzyme-linked immunosorbent assay (ELISA) on blood-borne diseases. This study included 72335 blood samples that were collected in our hospital from March 2019 to March 2020. All the samples were tested for anti HIV (AIDS antibody), anti HCV (hepatitis C antibody), HBsAg (hepatitis B surface antigen) and anti TP (syphilis antibody) in blood respectively with two manufacturers' reagents. The results of anti HIV, anti HCV, HBsAg and anti TP of all samples were analyzed, and blood samples with 0.7< sample test value / critical value (s / CO) < 3.0 were tested by ELISA and negative blood samples were tested by ELISA and nucleic acid testing. Then we analyzed the results of nucleic acid testing. 610 blood samples failed to pass the test of anti HIV, anti HCV, HBsAg and anti TP ELISA, accounting for 0.84% of the total numbers, including 100 blood samples with 1.0 3.0, 338 blood samples with 0.7< s/CO <1.0 and 71725 blood samples were qualified. We used nucleic acid testing to test 71725 qualified samples tested by ELISA and then there were 50 samples with positive HBV-DNA , accounting for 0.07% (50 / 71725), no one with positive HIV-RNA and positive HCV-RNA, accounting for 0.00% (0/71725). The positive rate of blood samples with HBsAg 0.7 2 = 8.15, P<0.01). In the clinical test of blood-borne disease, the joint test of nucleic acid testing and enzyme-linked immunosorbent assay reduces the occurrence of virus omission, and plays a positive role in preventing from spreading diseases through blood transfusion.