30 results on '"Martyna Gassowski"'
Search Results
2. Investigating the Campylobacter enteritis winter peak in Germany, 2018/2019
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Bettina M. Rosner, Martyna Gassowski, Stefan Albrecht, and Klaus Stark
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Medicine ,Science - Abstract
Abstract Surveillance of notified Campylobacter enteritis in Germany revealed a recurrent annual increase of cases with disease onset several days after the Christmas and New Year holidays (“winter peak”). We suspected that handling and consumption of chicken meat during fondue and raclette grill meals on the holidays were associated with winter peak Campylobacter infections. The hypothesis was investigated in a case–control study with a case-case design where notified Campylobacter enteritis cases served as case-patients as well as control-patients, depending on their date of disease onset (case-patients: 25/12/2018 to 08/01/2019; control-patients: any other date between 30/11/2018 and 28/02/2019). The study was conducted as an online survey from 21/01/2019 to 18/03/2019. Adjusted odds ratios (aOR) were determined in single-variable logistic regression analyses adjusted for age group and sex. We analysed 182 data sets from case-patients and 260 from control-patients and found associations of Campylobacter infections after the holidays with meat fondue (aOR 2.2; 95% confidence interval (CI) 1.2–3.8) and raclette grill meals with meat (aOR 1.5; 95% CI 1.0–2.4) consumed on the holidays. The associations were stronger when chicken meat was served at these meals (fondue with chicken meat: aOR 2.7; 95% CI 1.4–5.5; raclette grill meal with chicken meat: aOR 2.3; 95% CI 1.3–4.1). The results confirmed our initial hypothesis. To prevent Campylobacter winter peak cases in the future, consumers should be made more aware of the risks of a Campylobacter infection when handling raw meat, in particular chicken, during fondue or raclette grill meals on the holidays.
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- 2021
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- View/download PDF
3. Prevalence of hepatitis C in the adult population of Bulgaria: a pilot study
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Ida Sperle, Stine Nielsen, Martyna Gassowski, Zlatina Naneva, Tanya Perchemlieva, Andrew Amato-Gauci, Matthias an der Heiden, Viviane Bremer, Elitsa Golkocheva-Markova, Kristiyan Hristov, Elena Kaneva, Yanita Simeonova, Tencho Tenev, Tonka Varleva, Erika Duffell, and Ruth Zimmermann
- Subjects
Hepatitis C ,HCV ,Prevalence ,General population ,Prevalence survey ,Bulgaria ,Medicine ,Biology (General) ,QH301-705.5 ,Science (General) ,Q1-390 - Abstract
Abstract Objective This study piloted a European technical protocol for conducting chronic hepatitis C prevalence surveys in the general population. The pilot study took place in the Bulgarian city of Stara Zagora in 2018, and results of setting up, conducting and evaluating the survey are presented. Results A probability-based sample of the general adult population was drawn from the local population registry, stratified by age and sex. A sample size of 999 was calculated, and accounting for 50% non-response, 1998 registered invitation letters were sent. Venous blood samples and questionnaire data were collected by the Regional Health Inspectorate in Stara Zagora. Blood samples were tested for anti-HCV, and if reactive for RNA. 252 (21.6%) of the participants were included in the study. Mean age and sex distribution differed between the participants (55.9 years, 60.3% females) and the total sample (48.9 years, 53.4%). The weighted chronic HCV prevalence among participants was 0.9% [95% CI 0.2–4.2%]. The approach of only sending registered letters contributed to a low response rate, and more efforts are needed to reduce non-response, especially among men and younger age groups. Results of the evaluation were integrated in the final technical protocol.
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- 2020
- Full Text
- View/download PDF
4. External quality assessment (EQA) of Neisseria gonorrhoeae antimicrobial susceptibility testing in primary laboratories in Germany
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Regina Selb, Klaus Jansen, Matthias Eckardt, Thalea Tamminga, Sandra Dudareva, Martyna Gassowski, Ingeborg Graeber, Eva Guhl, Dagmar Heuer, Susanne Buder, and the GORENET EQA study group
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Neisseria gonorrhoeae ,EQA ,Susceptibility testing ,AMR ,Antimicrobial resistance ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Worldwide, an increase in antimicrobial resistance (AMR) of Neisseria gonorrhoeae has been observed. Until now, no protocol for an external quality assessment (EQA) has been available for Germany. The German gonococcal resistance network (GORENET) performed an EQA of primary laboratories in Germany in order to assess quality of antibiotic susceptibility testing, to gain information about laboratory procedures and to assess the impact of these procedures on test results. Methods Laboratories assessed drug susceptibility to cefixime, ceftriaxone, azithromycin, penicillin and ciprofloxacin for five N. gonorrhoeae strains, using their standard laboratory protocols. Minimal inhibitory concentrations (MICs) were compared to World Health Organisation (WHO) consensus results (or, if not available, reference laboratory results), while deviation by +/− one doubling dilution was accepted. Data on laboratory procedures were collected via a standardised questionnaire. Generalized linear models and conditional inference trees (CTREE) were used to assess relationships between laboratory procedures and testing outcomes. Results Twenty-one primary laboratories participated in the EQA in June 2018. 96% of ciprofloxacin MICs were reported within accepted deviations, as well as 88% for cefixime, 85% for ceftriaxone, 79% for penicillin and 70% for azithromycin. The use of interpretation standards and general laboratory procedures like agar base, incubation settings or the use of control strains strongly differed between laboratories. In statistical analysis, incubation time of cultures
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- 2020
- Full Text
- View/download PDF
5. High prevalence of hepatitis C virus infection and low level of awareness among people who recently started injecting drugs in a cross-sectional study in Germany, 2011–2014: missed opportunities for hepatitis C testing
- Author
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Julia Enkelmann, Martyna Gassowski, Stine Nielsen, Benjamin Wenz, Stefan Roß, Ulrich Marcus, Viviane Bremer, Ruth Zimmermann, and DRUCK Study group
- Subjects
HCV ,PWID ,New injectors ,Hepatitis C testing ,Germany ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background In Germany, risk of hepatitis C virus (HCV) infection is highest among people who inject drugs (PWID). New injectors (NI) are particularly vulnerable for HCV-acquisition, but little is known about health seeking behaviour and opportunities for intervention in this group. We describe characteristics, HCV prevalence, estimated HCV incidence and awareness of HCV-status among NIs and missed opportunities for hepatitis C testing. Methods People who had injected drugs in the last 12 months were recruited into a cross-sectional serobehavioural study using respondent-driven sampling in 8 German cities, 2011–2014. Data on sociodemographic characteristics, previous HCV testing and access to care were collected through questionnaire-based interviews. Capillary blood was tested for HCV. People injecting drugs
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- 2020
- Full Text
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6. Developing and Piloting a Standardized European Protocol for Hepatitis C Prevalence Surveys in the General Population (2016–2019)
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Ida Sperle, Stine Nielsen, Viviane Bremer, Martyna Gassowski, Henrikki Brummer-Korvenkontio, Roberto Bruni, Anna Rita Ciccaglione, Elena Kaneva, Kirsi Liitsola, Zlatina Naneva, Tanya Perchemlieva, Enea Spada, Salla E. Toikkanen, Andrew J. Amato-Gauci, Erika Duffell, and Ruth Zimmermann
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hepatitis C ,HCV ,general population ,prevalence ,technical protocol ,surveys ,Public aspects of medicine ,RA1-1270 - Abstract
Background: A robust estimate of the number of people with chronic hepatitis C virus (HCV) infection is essential for an appropriate public health response and for monitoring progress toward the WHO goal of eliminating viral hepatitis. Existing HCV prevalence studies in the European Union (EU)/European Economic Area (EEA) countries are heterogeneous and often of poor quality due to non-probability based sampling methods, small sample sizes and lack of standardization, leading to poor national representativeness. This project aimed to develop and pilot standardized protocols for undertaking nationally representative HCV prevalence surveys in the general adult population.Methods: From 2016 to 2019 a team from the Robert Koch-Institute contracted by the European Centre for Disease Prevention and Control synthesized evidence on existing HCV prevalence surveys and survey methodology and drafted a protocol. The methodological elements of the protocol were piloted and evaluated in Bulgaria, Finland and Italy, and lessons learnt from the pilots were integrated in the final protocol. An international multidisciplinary expert group was consulted regularly.Results: The protocol includes three alternative study approaches: a stand-alone survey; a “nested” survey within an existing health survey; and a retrospective testing survey approach. A decision algorithm advising which approach to use was developed. The protocol was piloted and finalized covering minimum and gold standards for all steps to be implemented from sampling, data protection and ethical issues, recruitment, specimen collection and laboratory testing options, staff training, data management and analysis and budget considerations. Through piloting, the survey approaches were effectively implemented to produce HCV prevalence estimates and the pilots highlighted the strengths and limitations of each approach and key lessons learnt were used to improve the protocol.Conclusions: An evidence-based protocol for undertaking HCV prevalence serosurveys in the general population reflecting the different needs, resources and epidemiological situations has been developed, effectively implemented and refined through piloting. This technical guidance supports EU/EEA countries in their efforts to estimate their national hepatitis C burden as part of monitoring progress toward the elimination targets.
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- 2021
- Full Text
- View/download PDF
7. History of detention and the risk of hepatitis C among people who inject drugs in Germany
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Martyna Gassowski, Stine Nielsen, Norbert Bannert, Claus-Thomas Bock, Viviane Bremer, R. Stefan Ross, Benjamin Wenz, Ulrich Marcus, and Ruth Zimmermann
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Infectious and parasitic diseases ,RC109-216 - Abstract
Objectives: The aim of this study was to investigate the association between detention experience and hepatitis C virus (HCV) status, the role of duration and frequency of detention, and whether risk behaviours practiced in detention could explain an observed increase in risk. Methods: Current drug injectors (injecting in the last 12 months) were recruited to participate in a sero-behavioural, cross-sectional survey using respondent-driven sampling in eight German cities during the years 2011–2014. Using multivariable logistic regression, the association between HCV status and reported detention experience was investigated. Results: A total of 1998 participants were included in the analysis. Of these, 19.9% reported no detention experience, 28.6% short and rare experience (≤3.5 years in total, ≤3 times), 12.1% short but frequent experience, 7.1% long but rare experience, and 32.4% long and frequent experience. After correcting for HCV risk factors, the association between detention experience and HCV status remained statistically significant. By adjusting the model for intramural risk behaviours, the odds ratios of detention experience were reduced but remained significant. Conclusions: The proportion of people who inject drugs positive for HCV increased with both frequency and duration of their detention experience. As intramural risk behaviours could not fully explain this increase, it appears that transfers between community and custody may confer additional risks. Keywords: HCV, PWID, Prison, Incarceration, Detention, Germany
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- 2019
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8. STI tests and proportion of positive tests in female sex workers attending local public health departments in Germany in 2010/11
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Viviane Bremer, Karin Haar, Martyna Gassowski, Osamah Hamouda, and Stine Nielsen
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Sex workers ,sexually transmitted diseases ,HIV ,Community health service ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background In Germany, local public health departments (LPHD) are required to offer low-threshold access to confidential counselling and testing for sexually transmitted infections (STI) for sex workers. We collected data from LPHD in Germany to estimate the number of performed STI tests and the proportion of positive STI tests among attending female sex workers (FSW) in order to formulate recommendations for improving STI testing and care for FSW in Germany. Methods We recruited LPHD across Germany to collect aggregated data on attending FSW between January 2010 and March 2011. Baseline characteristics, the number of attending FSW, STI tests (HIV, Chlamydia trachomatis, Neisseria gonorrhoea, syphilis and Trichomonas vaginalis) and the number of positive results were provided by participating LPHD. We described the number of STI tests per FSW visit and the proportion of positive test results, including interquartile range (IQR). We tested whether baseline characteristics of LPHD were associated with the proportion of positive test results. Results Overall, 28 LPHD from 14 of the 16 federal states reported 9284 FSW visits over the study period, with a median of 188 FSW visits (IQR 45–440) per LPHD. Overall, a median of 77.1% (IQR 60.7–88.0) of visiting FSW received a test for Neisseria gonorrhoea, followed by HIV (66.0%, IQR 47.9–86.8), Chlamydia trachomatis (65.4%, IQR 50.7–83.6) and syphilis (61.6, IQR 48.6–78.6). In total, 22,914 STI tests were performed. The proportion of positive tests was 3.1% (IQR 1.3–4.8), with the highest proportion of positive tests for Chlamydia trachomatis (6.8%, IQR 2.5–10.4), followed by Neisseria gonorrhoea (3.2%, IQR 0.0–5.3), Trichomonas vaginalis (3.0%, IQR 0.0–15.4), syphilis (1.1%, IQR 0.0–1.3) and HIV (0.2%, IQR 0.0–0.4). The proportion of positive tests varied between 0 and 13.9% between LPHD, with a higher variation of proportion of positive tests in LPHD with a smaller number of reported STI tests. Conclusions Participating LPHD varied in terms of performed STI tests and FSW visits. The proportion of positive STI tests was low, but varied between LPHD. This variation likely reflects different testing strategies. Existing testing guidelines should be used by all LPHD to ensure high quality care for FSW.
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- 2016
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9. HIV risk perception and testing behaviours among men having sex with men (MSM) reporting potential transmission risks in the previous 12 months from a large online sample of MSM living in Germany
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Ulrich Marcus, Martyna Gassowski, and Jochen Drewes
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HIV testing ,Men having sex with men (MSM) ,Risk behaviour ,Risk perception ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background HIV testing and serostatus awareness are essential to implement biomedical strategies (treatment as prevention; oral chemoprophylaxis), and for effective serostatus-based behaviours (HIV serosorting; strategic positioning). The analysis focuses on the associations between reported sexual risks, the perceived risk for HIV infection, and HIV testing behaviour in order to identify the most relevant barriers for HIV test uptake among MSM living in Germany. Methods MSM were recruited to a nationwide anonymous online-survey in 2013 on MSM social networking/dating sites. Questions covered testing behaviours, reasons for testing decisions, and HIV risk perception (5-point scale). Additional questions addressed arguments in favour of home/ home collection testing (HT). Using descriptive statistics and logistic regression we compared men reporting recent HIV testing (RT; previous 12 month) with men never tested (NT) in a subsample not previously diagnosed with HIV and reporting ≥2 episodes of condomless anal intercourse (CLAI) with a non-steady partner of unknown HIV serostatus in the previous 12 months. Results The subsample consisted of 775 RT (13 % of RT) and 396 NT (7 % of NT). The number of CLAI episodes in the last 12 months with non-steady partners of unknown HIV status did not differ significantly between the groups, but RT reported significantly higher numbers of partners (>5 AI partners: 65 vs. 44 %). While perceived risks regarding last AI were comparable between the groups, 49vs. 30 % NT were
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- 2016
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10. High variability of HIV and HCV seroprevalence and risk behaviours among people who inject drugs: results from a cross-sectional study using respondent-driven sampling in eight German cities (2011–14)
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Benjamin Wenz, Stine Nielsen, Martyna Gassowski, Claudia Santos-Hövener, Wei Cai, R. Stefan Ross, Claus-Thomas Bock, Boris-Alexander Ratsch, Claudia Kücherer, Norbert Bannert, Viviane Bremer, Osamah Hamouda, Ulrich Marcus, Ruth Zimmermann, and the DRUCK Study group
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PWID ,Sero- and behavioural survey ,HIV ,Hepatitis C ,Respondent-driven sampling ,Second generation surveillance ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background People who inject drugs (PWID) are at increased risk of acquiring and transmitting HIV and Hepatitis C (HCV) due to sharing injection paraphernalia and unprotected sex. To generate seroprevalence data on HIV and HCV among PWID and related data on risk behaviour, a multicentre sero- and behavioural survey using respondent driven sampling (RDS) was conducted in eight German cities between 2011 and 2014. We also evaluated the feasibility and effectiveness of RDS for recruiting PWID in the study cities. Methods Eligible for participation were people who had injected drugs within the last 12 months, were 16 years or older, and who consumed in one of the study cities. Participants were recruited, using low-threshold drop-in facilities as study sites. Initial seeds were selected to represent various sub-groups of people who inject drugs (PWID). Participants completed a face-to-face interview with a structured questionnaire about socio-demographics, sexual and injecting risk behaviours, as well as the utilisation of health services. Capillary blood samples were collected as dried blood spots and were anonymously tested for serological and molecular markers of HIV and HCV. The results are shown as range of proportions (min. and max. values (%)) in the respective study cities. For evaluation of the sampling method we applied criteria from the STROBE guidelines. Results Overall, 2,077 PWID were recruited. The range of age medians was 29–41 years, 18.5–35.3 % of participants were female, and 9.2–30.6 % were foreign born. Median time span since first injection were 10–18 years. Injecting during the last 30 days was reported by 76.0–88.4 % of participants. Sharing needle/syringes (last 30 days) ranged between 4.7 and 22.3 %, while sharing unsterile paraphernalia (spoon, filter, water, last 30 days) was reported by 33.0–43.8 %. A majority of participants (72.8–85.8 %) reported incarceration at least once, and 17.8–39.8 % had injected while incarcerated. Between 30.8 and 66.2 % were currently in opioid substitution therapy. Unweighted HIV seroprevalence ranged from 0–9.1 %, HCV from 42.3–75.0 %, and HCV-RNA from 23.1–54.0 %. The implementation of RDS as a recruiting method in cooperation with low-threshold drop in facilities was well accepted by both staff and PWID. We reached our targeted sample size in seven of eight cities. Conclusions In the recruited sample of mostly current injectors with a long duration of injecting drug use, seroprevalence for HIV and HCV varied greatly between the city samples. HCV was endemic among participants in all city samples. Our results demonstrate the necessity of intensified prevention strategies for blood-borne infections among PWID in Germany.
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- 2016
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11. Differences in antibiotic use and knowledge between adolescent and adult mothers in Ecuador [v2; ref status: indexed, http://f1000r.es/1c4]
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Arturo Quizhpe P, Martyna Gassowski, Lorena Encalada T, and Francoise Barten
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Global Health ,Respiratory Infections ,Social & Behavioral Determinants of Health ,Medicine ,Science - Abstract
Objectives: To investigate the differences in antibiotic use and knowledge between adolescent and adult mothers of children under the age of 5 years in Ecuador. Methods: A cross sectional study was performed in four health centers and hospitals. Mothers of children under five years, seeking medical attention their child's upper respiratory tract infection (URI), were included. The data was collected through interviews, using a structured questionnaire. The questionnaire covered the topics knowledge of antibiotic treatment, risk and resistance. Results: 777 mothers were included in the study, of which 15.8% were adolescent and 84.1% adult mothers. There were significant differences in the social and economic characteristics of the mothers (p ≤ 0.05), with adolescent mothers being more likely to have an incomplete high school education and lack of basic services in their home. Significant differences between these groups were found in adherence to treatment, knowledge about risks associated with antibiotic use, and having heard of antibiotic resistance. Among the adult mothers, 83.5% reported correct adherence, 28.5% were knowledgeable about risks associated with antibiotic use, and 29.3% had heard of antibiotic resistance. Among the adolescent mothers, these numbers were 75.4%, 15.0%, and 19.8%, respectively. Conclusions: To develop successful interventions, it is crucial to understand the factors causing differences in antibiotic use and knowledge between mothers.
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- 2013
- Full Text
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12. External quality assessment (EQA) of Neisseria gonorrhoeae antimicrobial susceptibility testing in primary laboratories in Germany
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Ingeborg Graeber, Regina Selb, Sandra Dudareva, Eva Guhl, Martyna Gassowski, Thalea Tamminga, Dagmar Heuer, Matthias Eckardt, Susanne Buder, and Klaus Jansen
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Quality Control ,Laboratory Proficiency Testing ,medicine.medical_specialty ,EQA ,Microbial Sensitivity Tests ,Penicillins ,Azithromycin ,medicine.disease_cause ,Antimicrobial resistance ,lcsh:Infectious and parasitic diseases ,Gonorrhea ,Antibiotic resistance ,Cefixime ,Ciprofloxacin ,Germany ,Surveys and Questionnaires ,Internal medicine ,Drug Resistance, Bacterial ,External quality assessment ,medicine ,Humans ,AMR ,lcsh:RC109-216 ,Protocol (science) ,business.industry ,Ceftriaxone ,Reference Standards ,Neisseria gonorrhoeae ,Anti-Bacterial Agents ,Penicillin ,Infectious Diseases ,Susceptibility testing ,Laboratories ,business ,Research Article ,medicine.drug - Abstract
Background Worldwide, an increase in antimicrobial resistance (AMR) of Neisseria gonorrhoeae has been observed. Until now, no protocol for an external quality assessment (EQA) has been available for Germany. The German gonococcal resistance network (GORENET) performed an EQA of primary laboratories in Germany in order to assess quality of antibiotic susceptibility testing, to gain information about laboratory procedures and to assess the impact of these procedures on test results. Methods Laboratories assessed drug susceptibility to cefixime, ceftriaxone, azithromycin, penicillin and ciprofloxacin for five N. gonorrhoeae strains, using their standard laboratory protocols. Minimal inhibitory concentrations (MICs) were compared to World Health Organisation (WHO) consensus results (or, if not available, reference laboratory results), while deviation by +/− one doubling dilution was accepted. Data on laboratory procedures were collected via a standardised questionnaire. Generalized linear models and conditional inference trees (CTREE) were used to assess relationships between laboratory procedures and testing outcomes. Results Twenty-one primary laboratories participated in the EQA in June 2018. 96% of ciprofloxacin MICs were reported within accepted deviations, as well as 88% for cefixime, 85% for ceftriaxone, 79% for penicillin and 70% for azithromycin. The use of interpretation standards and general laboratory procedures like agar base, incubation settings or the use of control strains strongly differed between laboratories. In statistical analysis, incubation time of cultures 2 concentration was associated with correct results regarding azithromycin compared to 3%. CTREE analysis showed that incubation time, humidity and CO2 concentration had the greatest influence on the average deviation from consensus results. Conclusions In conclusion, we report the development of a protocol for N. gonorrhoeae antimicrobial susceptibility testing in Germany. While testing results were in accordance with the expected consensus results in 70–96%, depending on the antibiotic agent, laboratory methodology was heterogeneous and may significantly affect the testing quality. We therefore recommend the development of a standard operating procedure (SOP) for N. gonorrhoeae susceptibility testing in Germany.
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- 2020
13. Developing and Piloting a Standardized European Protocol for Hepatitis C Prevalence Surveys in the General Population (2016–2019)
- Author
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Tanya Perchemlieva, Erika Duffell, Henrikki Brummer-Korvenkontio, Ruth Zimmermann, Viviane Bremer, Enea Spada, S. Toikkanen, Anna Rita Ciccaglione, Martyna Gassowski, Stine Nielsen, Kirsi Liitsola, Ida Sperle, Andrew J Amato-Gauci, Roberto Bruni, Elena Kaneva, and Zlatina Naneva
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Adult ,medicine.medical_specialty ,Standardization ,Population ,prevalence ,Representativeness heuristic ,general population ,03 medical and health sciences ,Survey methodology ,0302 clinical medicine ,surveys ,Surveys and Questionnaires ,medicine ,media_common.cataloged_instance ,Humans ,030212 general & internal medicine ,technical protocol ,European union ,education ,Bulgaria ,Finland ,media_common ,Retrospective Studies ,Original Research ,Protocol (science) ,education.field_of_study ,Public health ,Public Health, Environmental and Occupational Health ,Hepatitis C, Chronic ,questionnaires ,Hepatitis C ,Specimen collection ,Italy ,Family medicine ,HCV ,030211 gastroenterology & hepatology ,Business ,Public Health ,Public aspects of medicine ,RA1-1270 - Abstract
Background: A robust estimate of the number of people with chronic hepatitis C virus (HCV) infection is essential for an appropriate public health response and for monitoring progress toward the WHO goal of eliminating viral hepatitis. Existing HCV prevalence studies in the European Union (EU)/European Economic Area (EEA) countries are heterogeneous and often of poor quality due to non-probability based sampling methods, small sample sizes and lack of standardization, leading to poor national representativeness. This project aimed to develop and pilot standardized protocols for undertaking nationally representative HCV prevalence surveys in the general adult population.Methods: From 2016 to 2019 a team from the Robert Koch-Institute contracted by the European Centre for Disease Prevention and Control synthesized evidence on existing HCV prevalence surveys and survey methodology and drafted a protocol. The methodological elements of the protocol were piloted and evaluated in Bulgaria, Finland and Italy, and lessons learnt from the pilots were integrated in the final protocol. An international multidisciplinary expert group was consulted regularly.Results: The protocol includes three alternative study approaches: a stand-alone survey; a “nested” survey within an existing health survey; and a retrospective testing survey approach. A decision algorithm advising which approach to use was developed. The protocol was piloted and finalized covering minimum and gold standards for all steps to be implemented from sampling, data protection and ethical issues, recruitment, specimen collection and laboratory testing options, staff training, data management and analysis and budget considerations. Through piloting, the survey approaches were effectively implemented to produce HCV prevalence estimates and the pilots highlighted the strengths and limitations of each approach and key lessons learnt were used to improve the protocol.Conclusions: An evidence-based protocol for undertaking HCV prevalence serosurveys in the general population reflecting the different needs, resources and epidemiological situations has been developed, effectively implemented and refined through piloting. This technical guidance supports EU/EEA countries in their efforts to estimate their national hepatitis C burden as part of monitoring progress toward the elimination targets.
- Published
- 2021
- Full Text
- View/download PDF
14. Differences in antibiotic use and knowledge between adolescent and adult mothers in Ecuador [version 2; referees: 2 approved]
- Author
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Arturo Quizhpe P, Martyna Gassowski, Lorena Encalada T, and Francoise Barten
- Subjects
Research Article ,Articles ,Global Health ,Respiratory Infections ,Social & Behavioral Determinants of Health ,Child care ,child health ,maternal educational status ,patient education ,antibiotics ,Latin America - Abstract
Objectives: To investigate the differences in antibiotic use and knowledge between adolescent and adult mothers of children under the age of 5 years in Ecuador. Methods: A cross sectional study was performed in four health centers and hospitals. Mothers of children under five years, seeking medical attention their child's upper respiratory tract infection (URI), were included. The data was collected through interviews, using a structured questionnaire. The questionnaire covered the topics knowledge of antibiotic treatment, risk and resistance. Results: 777 mothers were included in the study, of which 15.8% were adolescent and 84.1% adult mothers. There were significant differences in the social and economic characteristics of the mothers (p ≤ 0.05), with adolescent mothers being more likely to have an incomplete high school education and lack of basic services in their home. Significant differences between these groups were found in adherence to treatment, knowledge about risks associated with antibiotic use, and having heard of antibiotic resistance. Among the adult mothers, 83.5% reported correct adherence, 28.5% were knowledgeable about risks associated with antibiotic use, and 29.3% had heard of antibiotic resistance. Among the adolescent mothers, these numbers were 75.4%, 15.0%, and 19.8%, respectively. Conclusions: To develop successful interventions, it is crucial to understand the factors causing differences in antibiotic use and knowledge between mothers.
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- 2013
- Full Text
- View/download PDF
15. Differences in antibiotic use and knowledge between adolescent and adult mothers in Ecuador [version 1; referees: 1 approved, 1 approved with reservations]
- Author
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Arturo Quizhpe P, Martyna Gassowski, Lorena Encalada T, and Francoise Barten
- Subjects
Research Article ,Articles ,Global Health ,Respiratory Infections ,Social & Behavioral Determinants of Health ,Child care ,child health ,maternal educational status ,patient education ,antibiotics ,Latin America - Abstract
Objectives: To investigate the differences in antibiotic use and knowledge between adolescent and adult mothers of children under the age of 5 years in Ecuador. Methods: A cross sectional study was performed in four health centers and hospitals. Mothers of children under five years, seeking medical attention their child's upper respiratory tract infection (URI), were included. The data was collected through interviews, using a structured questionnaire. The questionnaire covered the topics knowledge of antibiotic treatment, risk and resistance. Results: 777 mothers were included in the study, of which 15.8% were adolescent and 84.1% adult mothers. There were significant differences in the social and economic characteristics of the mothers (p ≤ 0.05), with adolescent mothers being more likely to have an incomplete high school education and lack of basic services in their home. Significant differences between these groups were found in adherence to treatment, knowledge about risks associated with antibiotic use, and having heard of antibiotic resistance. Among the adult mothers, 83.5% reported correct adherence, 28.5% were knowledgeable about risks associated with antibiotic use, and 29.3% had heard of antibiotic resistance. Among the adolescent mothers, these numbers were 75.4%, 15.0%, and 19.8%, respectively. Conclusions: To develop successful interventions, it is crucial to understand the factors causing differences in antibiotic use and knowledge between mothers.
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- 2013
- Full Text
- View/download PDF
16. High prevalence of hepatitis C virus infection and low level of awareness among people who recently started injecting drugs in a cross-sectional study in Germany, 2011–2014: missed opportunities for hepatitis C testing
- Author
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Ruth Zimmermann, Stefan Roß, Benjamin Wenz, Ulrich Marcus, Martyna Gassowski, Julia Enkelmann, Stine Nielsen, and Viviane Bremer
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Male ,Health Knowledge, Attitudes, Practice ,Urban Population ,Cross-sectional study ,Medizin ,030508 substance abuse ,Medicine (miscellaneous) ,Prison ,Comorbidity ,medicine.disease_cause ,0302 clinical medicine ,Germany ,Prevalence ,030212 general & internal medicine ,Hepatitis C testing ,Substance Abuse, Intravenous ,media_common ,Brief Report ,lcsh:Public aspects of medicine ,Incidence (epidemiology) ,virus diseases ,Hepatitis C ,Psychiatry and Mental health ,Health psychology ,HCV ,Female ,0305 other medical science ,Adult ,medicine.medical_specialty ,Hepatitis C virus ,media_common.quotation_subject ,Young Adult ,03 medical and health sciences ,Intervention (counseling) ,medicine ,Humans ,ddc:610 ,PWID ,New injectors ,business.industry ,Addiction ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,Patient Acceptance of Health Care ,medicine.disease ,digestive system diseases ,Cross-Sectional Studies ,Family medicine ,business ,610 Medizin und Gesundheit - Abstract
Background In Germany, risk of hepatitis C virus (HCV) infection is highest among people who inject drugs (PWID). New injectors (NI) are particularly vulnerable for HCV-acquisition, but little is known about health seeking behaviour and opportunities for intervention in this group. We describe characteristics, HCV prevalence, estimated HCV incidence and awareness of HCV-status among NIs and missed opportunities for hepatitis C testing. Methods People who had injected drugs in the last 12 months were recruited into a cross-sectional serobehavioural study using respondent-driven sampling in 8 German cities, 2011–2014. Data on sociodemographic characteristics, previous HCV testing and access to care were collected through questionnaire-based interviews. Capillary blood was tested for HCV. People injecting drugs Results Of 2059 participants with available information on duration of injection drug use, 232 (11% were NI. Estimated HCV incidence among NI was 19.6 infections/100 person years at risk (95% CI 16–24). Thirty-six percent of NI were HCV-positive (thereof 76% with detectable RNA) and 41% of those HCV-positive were unaware of their HCV-status. Overall, 27% of NI reported never having been HCV-tested. Of NI with available information, more than 80% had attended low-threshold drug services in the last 30 days, 24% were released from prison in the last 12 months and medical care was most commonly accessed in hospitals, opioid substitution therapy (OST)-practices, practices without OST and prison hospitals. Conclusion We found high HCV-positivity and low HCV-status awareness among NI, often with missed opportunities for HCV-testing. To increase early diagnosis and facilitate treatment, HCV-testing should be offered in all facilities, where NI can be reached, especially low-threshold drug services and addiction therapy, but also prisons, hospitals and practices without OST.
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- 2020
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17. A large proportion of people who inject drugs are susceptible to hepatitis B: Results from a bio-behavioural study in eight German cities
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Joana M Haussig, Ruth Zimmermann, Stine Nielsen, Benjamin Wenz, Norbert Bannert, Martyna Gassowski, Claus-Thomas Bock, Ulrich Marcus, Viviane Bremer, and Scherbaum, Norbert (Beitragende*r)
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Male ,Medizin ,Hbv markers ,030508 substance abuse ,Logistic regression ,medicine.disease_cause ,0302 clinical medicine ,Paraphernalia ,Risk Factors ,Seroepidemiologic Studies ,Germany ,Prevalence ,HBV ,Needle Sharing ,030212 general & internal medicine ,Substance Abuse, Intravenous ,education.field_of_study ,virus diseases ,General Medicine ,Hepatitis B ,Vaccination ,Infectious Diseases ,Female ,Disease Susceptibility ,0305 other medical science ,People who inject drugs ,Microbiology (medical) ,Adult ,Population ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,Risk-Taking ,Environmental health ,medicine ,Seroprevalence ,Humans ,Sero- and behavioural survey ,Hepatitis B Vaccines ,lcsh:RC109-216 ,Cities ,Hepatitis B Antibodies ,education ,PWID ,Hepatitis B virus ,business.industry ,medicine.disease ,digestive system diseases ,Logistic Models ,Immunology ,Hepatitis B vaccination ,business - Abstract
Background People who inject drugs (PWID) are at high risk of hepatitis B virus (HBV) infection by sharing needles and drug use paraphernalia. In Germany, no routine surveillance of HBV prevalence and vaccination coverage among PWID exists. Methods Socio-demographic and behavioural data were collected between 2011 and 2014 through face-to-face interviews, during a bio-behavioural survey of PWID recruited in eight German cities. Dried blood spots (DBS) prepared with capillary blood were tested for HBV markers. Factors associated with past/current HBV infection and vaccination status were analysed by univariable and multivariable analysis using logistic regression. The validity of self-reported HBV infection and vaccination status was analysed by comparison to the laboratory results. Results Among 2077 participants, the prevalence of current HBV infection was 1.1%, of past HBV infection was 24%, and of vaccine-induced HBV antibodies was 32%. No detectable HBV antibodies were found in 43%. HBV infection status was significantly associated with study city, age, years of injecting, use of stimulants, migration status, and homelessness; HBV vaccination status was significantly associated with study city, age, and level of education. Correct infection status was reported by 71% and correct vaccination status by 45%. Conclusions HBV seroprevalence among PWID was about five times higher than in the general population in Germany, confirming PWID as an important risk group. Targeted information campaigns on HBV and HBV prevention for PWID and professionals in contact with PWID need to be intensified. Routinely offered HBV vaccination during imprisonment and opioid substitution therapy would likely improve vaccination rates among PWID.
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- 2018
18. P465 Chlamydia-screening for women under the age of 25 years in germany – how are we doing?
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Martin Schlaud, Viviane Bremer, Christina Poethko-Mueller, Sandra Dudareva, Martyna Gassowski, and Klaus Jansen
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medicine.medical_specialty ,Younger age ,business.industry ,Context (language use) ,Chlamydia screening ,medicine.disease_cause ,Confidence interval ,German population ,Epidemiology ,medicine ,Chlamydia trachomatis ,business ,Opportunistic screening ,Demography - Abstract
Background An opportunistic screening program for Chlamydia trachomatis (CT) was introduced in Germany in 2008, targeting sexually active women under the age of 25. The program suffers from low coverage (∼12%) and its impact on the epidemiology of CT in the German setting remains unclear. As CT is not notifiable in Germany, we used alternative data sources to describe CT-epidemiology in the context of the screening program. Methods Urine-PCR results from two population-based, nationwide health surveys of adults (DEGS, 2008–2011, subsample=2,364) and minors (KiGGS-Wave 2, 2014–2017, subsample=619) were analyzed. Weighted CT-prevalences were estimated for adults. Prevalence estimation for age-subgroups and adolescents was not possible due to high coefficients of variation, instead unweighted CT-positive proportions were calculated in an explorative analysis. Data from a CT laboratory sentinel system were used to obtain the number of screening tests performed and the proportion of positive results by age and year. Results The weighted prevalence of CT in the general German population aged 18–44 was estimated at 1.2% (95% confidence interval (95%CI): 0.6%–2.2%) among women and 1.9% (95%CI: 1.2%–3.0%) among men. The highest unweighted CT-positive proportions were found in the younger age groups in both women (18–24y: 2.4%, 95%CI 1.1%–5.0%; 25–34y: 1.5%, 95%CI 0.7%–3.3%) and men (18–24y: 2.0%, 95%CI 0.9%–4.4%; 25–34y: 2.9%, 95%CI 1.6%–5.2%). Among 15- to 17-year-old girls, an unweighted CT-positive proportion of 6.2% (95%CI 2.9%–12.6%) was found. Sentinel data from 2014–2016 (467,474 screening-tests of 15–24 year-old women) showed positive-result proportions of 3.4% (95%CI 3.1%–3.7%), 6.1% (95%CI 5.9%–6.4%) and 3.9% (95%CI 3.7%–4.0%) among 15-, 19- and 24-year-olds, respectively. Conclusion The German screening program seems to correctly target the women most at risk and may thus prevent cases of CT-sequelae. However, through its low coverage and the exclusion of men, who serve as a reservoir for the infection, the program is not likely to reduce CT-prevalence effectively. Disclosure No significant relationships.
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- 2019
19. History of detention and the risk of hepatitis C among people who inject drugs in Germany
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Ulrich Marcus, Benjamin Wenz, Claus-Thomas Bock, Ruth Zimmermann, Martyna Gassowski, R. Stefan Ross, Viviane Bremer, Norbert Bannert, and Stine Nielsen
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Adult ,Male ,0301 basic medicine ,Microbiology (medical) ,media_common.quotation_subject ,Incarceration ,030106 microbiology ,Medizin ,Prison ,Hepacivirus ,Logistic regression ,lcsh:Infectious and parasitic diseases ,Young Adult ,03 medical and health sciences ,Risk-Taking ,0302 clinical medicine ,Risk Factors ,Germany ,HCV status ,Odds Ratio ,Humans ,Medicine ,lcsh:RC109-216 ,030212 general & internal medicine ,ddc:610 ,Substance Abuse, Intravenous ,PWID ,media_common ,Hepatitis ,Risk behaviour ,business.industry ,Prisoners ,General Medicine ,Hepatitis C ,Odds ratio ,medicine.disease ,Detention ,Cross-Sectional Studies ,Infectious Diseases ,HCV ,Female ,business ,610 Medizin und Gesundheit ,Demography - Abstract
Objectives: The aim of this study was to investigate the association between detention experience and hepatitis C virus (HCV) status, the role of duration and frequency of detention, and whether risk behaviours practiced in detention could explain an observed increase in risk. Methods: Current drug injectors (injecting in the last 12 months) were recruited to participate in a sero-behavioural, cross-sectional survey using respondent-driven sampling in eight German cities during the years 2011–2014. Using multivariable logistic regression, the association between HCV status and reported detention experience was investigated. Results: A total of 1998 participants were included in the analysis. Of these, 19.9% reported no detention experience, 28.6% short and rare experience (≤3.5 years in total, ≤3 times), 12.1% short but frequent experience, 7.1% long but rare experience, and 32.4% long and frequent experience. After correcting for HCV risk factors, the association between detention experience and HCV status remained statistically significant. By adjusting the model for intramural risk behaviours, the odds ratios of detention experience were reduced but remained significant. Conclusions: The proportion of people who inject drugs positive for HCV increased with both frequency and duration of their detention experience. As intramural risk behaviours could not fully explain this increase, it appears that transfers between community and custody may confer additional risks. Keywords: HCV, PWID, Prison, Incarceration, Detention, Germany
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- 2019
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20. Risk behaviours and viral infections among drug injecting migrants from the former Soviet Union in Germany : Results from the DRUCK-study
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Norbert Bannert, Ulrich Marcus, Tobias Fechner, Claus-Thomas Bock, Lineke Derks, Claudia Kücherer, Martyna Gassowski, Viviane Bremer, Norbert Scherbaum, Matthias an der Heiden, Stine Nielsen, Claudia Santos-Hövener, Bärbel Marrziniak, Werner Heinz, Christiane Kerres, Stefan Ross, Andreas Hecht, Dirk Schäffer, Olaf Ostermann, Astrid Leicht, Sylke Lein, Ina Stein, Ruth Zimmermann, Kerstin Dettmer, Benjamin Wenz, Jürgen Klee, and Scherbaum, Norbert (Beitragende*r)
- Subjects
Adult ,Male ,Human immunodeficiency virus (HIV) ,Medizin ,Medicine (miscellaneous) ,HIV Infections ,medicine.disease_cause ,Young Adult ,03 medical and health sciences ,Risk-Taking ,0302 clinical medicine ,HIV Seroprevalence ,Seroepidemiologic Studies ,Germany ,medicine ,Humans ,Seroprevalence ,Needle Sharing ,030212 general & internal medicine ,Substance Abuse, Intravenous ,Transients and Migrants ,Harm reduction ,Risk behaviour ,business.industry ,Health Policy ,virus diseases ,Hepatitis C ,Odds ratio ,Middle Aged ,medicine.disease ,Confidence interval ,Cross-Sectional Studies ,Female ,030211 gastroenterology & hepatology ,Soviet union ,business ,USSR ,Demography - Abstract
Background High prevalence of drug use and injection-related risk behaviours have been reported among former Soviet Union (FSU)-migrants. To investigate hepatitis C (HCV) and HIV seroprevalence and related risk behaviours in this subgroup in Germany, we compared first generation FSU-migrants and native Germans using data from a sero-behavioural survey of people who inject drugs (PWID). Methods Current injectors were recruited using respondent-driven sampling in eight German cities in 2011–2014. Questionnaire-based interviews were conducted and dried blood spots collected and tested for anti-HCV, HCV-RNA, and anti-HIV1/2. Descriptive and multivariable analyses (MVA) were performed. Results A total of 208 FSU-born and 1318 native German PWID were included in the analysis. FSU-migrants were younger than Germans (median age: 33 vs. 39 years), and more often male (83.1% vs. 75.9%, p = 0.022). HCV seroprevalence was 74.5% in FSU-migrants vs. 64.6% in Germans (p = 0.006), HIV seroprevalence was 5.8% and 4.6%, respectively (p = 0.443). The proportion of FSU-migrants reporting injecting-related risk behaviours was higher than among Germans: injecting daily (39.4% vs. 30.2%, p = 0.015), with friends (39.2% vs. 31.2%, p = 0.038), cocaine (32.7% vs. 23.8%, p = 0.044), more than one drug (18.2% vs. 9.6%, p = 0.006), and sharing filters/cookers (35.5% vs. 28.0%, p = 0.045). No statistically significant differences were observed in HIV/HCV testing rates (range: 50.7%–65.6%), opioid substitution treatment (43.9% vs. 50.5%), and access to clean needles/syringes (89.8% vs. 90.3%). In MVA, risk for HCV-infection was increased in male FSU-migrants compared to German males (OR 3.32, p = 0.006), no difference was identified between female FSU-migrants and German females (OR: 0.83, p = 0.633). Conclusion Male FSU-migrants were at highest risk of being HCV infected. Therefore, targeted actions are needed to ensure access and acceptance of harm reduction measures, including HCV-testing and -treatment for this subpopulation of PWID.
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- 2018
21. Two concurrent outbreaks of hepatitis A highlight the risk of infection for non-immune travellers to Morocco, January to June 2018
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Julie Figoni, Luise Müller, Sofie Midgley, Ingrid H M Friesema, Jürgen J. Wenzel, Carmen Varela, Ana Avellón, Martyna Gassowski, Siew Lin Ngui, Koye Balogun, Josefine Lundberg Ederth, Mirko Faber, Kai Michaelis, Lina Mouna, Harry Vennema, Lena Sundqvist, James Plunkett, and Sofie Gillesberg Lassen
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0301 basic medicine ,Adult ,Male ,food-borne infections ,Epidemiology ,030106 microbiology ,610 Medizin ,Food-borne infections ,imported viral diseases ,Disease Outbreaks ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,Virology ,Environmental health ,hepatitis A virus ,Medicine ,Humans ,030212 general & internal medicine ,ddc:610 ,Travel ,business.industry ,Risk of infection ,Vaccination ,Public Health, Environmental and Occupational Health ,Outbreaks ,Hepatitis A ,Outbreak ,medicine.disease ,Hepatitis a virus ,Molecular analysis ,Europe ,Morocco ,outbreaks ,Female ,Hepatitis A virus ,business ,610 Medizin und Gesundheit ,Imported viral diseases ,human activities ,Rapid Communication - Abstract
From January to June 2018, two ongoing hepatitis A outbreaks affected travellers returning from Morocco and cases in Europe without travel history, resulting in 163 patients in eight European countries. Most interviewed travel-related cases were unaware of the hepatitis A risk in Morocco. Molecular analysis revealed two distinct hepatitis A virus (HAV) strains (subgenotype IA DK2018_231; subgenotype IB V18-16428). Vaccination recommendations should be emphasised to increase awareness among non-immune travellers to Morocco and HAV-endemic countries. First, we thank the European Centre for Disease Prevention and Control (ECDC)’s Food- and Waterborne Diseases and Zoonoses team, particularly Ettore Severi and Johanna Takkinen for their support of this joint investigation. We also thank Lelia Thornton, HSE - Health Protection Surveillance Centre, Dublin, Ireland for sharing information on the Irish hepatitis A patient. Moreover, we greatly acknowledge the work of local and state health departments for their support of epidemiological investigations and molecular surveillance. Sí
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- 2018
22. HIV risk perception and testing behaviours among men having sex with men (MSM) reporting potential transmission risks in the previous 12 months from a large online sample of MSM living in Germany
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Jochen Drewes, Ulrich Marcus, and Martyna Gassowski
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Male ,Risk perception ,HIV Serosorting ,Social Stigma ,HIV Infections ,Intention ,Logistic regression ,Condoms ,0302 clinical medicine ,Germany ,Surveys and Questionnaires ,Epidemiology ,Medicine ,Mass Screening ,030212 general & internal medicine ,lcsh:Public aspects of medicine ,Awareness ,Middle Aged ,HIV testing ,Sexual Partners ,Men having sex with men (MSM) ,0305 other medical science ,Research Article ,Adult ,medicine.medical_specialty ,Adolescent ,Sexual Behavior ,03 medical and health sciences ,Young Adult ,Risk-Taking ,Humans ,Homosexuality, Male ,Gynecology ,Motivation ,Risk behaviour ,030505 public health ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,Patient Acceptance of Health Care ,Treatment as prevention ,Self Care ,Logistic Models ,Perception ,Biostatistics ,business ,Serostatus ,Demography - Abstract
Background HIV testing and serostatus awareness are essential to implement biomedical strategies (treatment as prevention; oral chemoprophylaxis), and for effective serostatus-based behaviours (HIV serosorting; strategic positioning). The analysis focuses on the associations between reported sexual risks, the perceived risk for HIV infection, and HIV testing behaviour in order to identify the most relevant barriers for HIV test uptake among MSM living in Germany. Methods MSM were recruited to a nationwide anonymous online-survey in 2013 on MSM social networking/dating sites. Questions covered testing behaviours, reasons for testing decisions, and HIV risk perception (5-point scale). Additional questions addressed arguments in favour of home/ home collection testing (HT). Using descriptive statistics and logistic regression we compared men reporting recent HIV testing (RT; previous 12 month) with men never tested (NT) in a subsample not previously diagnosed with HIV and reporting ≥2 episodes of condomless anal intercourse (CLAI) with a non-steady partner of unknown HIV serostatus in the previous 12 months. Results The subsample consisted of 775 RT (13 % of RT) and 396 NT (7 % of NT). The number of CLAI episodes in the last 12 months with non-steady partners of unknown HIV status did not differ significantly between the groups, but RT reported significantly higher numbers of partners (>5 AI partners: 65 vs. 44 %). While perceived risks regarding last AI were comparable between the groups, 49vs. 30 % NT were
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- 2016
23. The impact of meeting locations for men having sex with men on the risk for bacterial sexually transmitted infections: analyses from a cross-sectional online survey
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Ulrich Marcus, Martin Kruspe, Martyna Gassowski, M an der Heiden, and Jochen Drewes
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Gerontology ,Adult ,Male ,Multivariate analysis ,Cross-sectional study ,Sexually Transmitted Diseases ,law.invention ,Condom ,law ,Risk Factors ,Sexual medicine ,Surveys and Questionnaires ,Medicine ,Humans ,Men having sex with men ,Homosexuality, Male ,Internet ,business.industry ,Research ,virus diseases ,Meeting place ,General Medicine ,Bacterial Infections ,Middle Aged ,GENITOURINARY MEDICINE ,Cross-Sectional Studies ,Sexual Partners ,SEXUAL MEDICINE ,Smartphone app ,Multivariate Analysis ,Sexual Health ,Serostatus ,business ,Demography - Abstract
Objectives: Opportunities for men having sex with men (MSM) to meet each other have very much improved by new communication technologies. Meeting venue-based characteristics can impact how many partners are met and how much sexual risk is taken. We analysed the association between physical and virtual venues and the risk for bacterial sexually transmitted infections (bSTIs) among participants in an MSM online survey. Methods: Data were collected during 2013/2014 with a survey targeting MSM living in Germany. The impact of the meeting place with the last non-steady anal sex partner on diagnosis with a bSTI in the previous year was analysed using bivariate and multivariate regression analysis, taking into account self-reported HIV status, serostatus communication, condom use, partner number, age and city size. Results: The study sample consisted of 8878 respondents (7799 not diagnosed with HIV; 1079 diagnosed with HIV). Meeting partners online was most common (62% HIV�/51% HIV+), followed by sex venues (11% HIV�/25% HIV+); other venues were each reported by 2–6% of the respondents. Venue-dependent proportions reporting bSTIs in the recent year were 2–4 folds higher among men diagnosed with HIV. In multivariate analysis, HIV status was the strongest predictor for bSTIs (OR=5.0; 95% CI 2.8 to 8.7). Compared with meeting partners online, sex (OR 1.6; 95% CI 1.0 to 2.5) and social venues (OR 1.9; 95% CI 1.4 to 2.6) were associated with increased bSTI risk for men not diagnosed with HIV, but the risk when meeting partners by smartphone apps was only of borderline significance (OR 1.5; 95% CI 0.9 to 2.3). For men diagnosed with HIV, bSTI risk increased for sex venues (OR 1.5; 95% CI 1.1 to 2.1), and was lower for non-gay/ other venues (OR 0.2; 95% CI 0.1 to 0.5). Conclusions: Venues are connected to socialbehavioural facets of corresponding sexual encounters, and may be important arenas for differential HIV and STI education, treatment and prevention.
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- 2015
24. Recency and frequency of HIV testing among men who have sex with men in Germany and socio-demographic factors associated with testing behaviour
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Martyna Gassowski, Ulrich Marcus, Martin Kruspe, and Jochen Drewes
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Adult ,Male ,Gerontology ,Adolescent ,Sexual Behavior ,HIV Infections ,Men who have sex with men ,law.invention ,Young Adult ,Condom ,Residence Characteristics ,law ,Germany ,Surveys and Questionnaires ,Odds Ratio ,Humans ,Mass Screening ,Medicine ,Homosexuality, Male ,Young adult ,Mass screening ,Demography ,Internet ,business.industry ,Age Factors ,Public Health, Environmental and Occupational Health ,Odds ratio ,CD4 Lymphocyte Count ,Relative risk ,Sexual orientation ,Biostatistics ,business ,Research Article - Abstract
Background Testing for presence of HIV infection is a pre-requisite to qualify for antiretroviral treatment. A considerable proportion of German men who have sex with men (MSM) infected with HIV have a CD4 cell count below 350 cells/μl at time of diagnosis and are thus defined as “late presenters”. Late presentation increases the risk of adverse disease outcomes. In addition, knowledge and assessment of HIV status is often used for decisions about condom use and anal intercourse with steady and non-steady partners. Incorrect assumptions may result in high risk for HIV transmission. Methods Between 11/2013 and 01/2014 MSM were recruited to an online survey predominantly by personalized invitation messages from MSM social networking and dating websites. Respondents were asked about demographic characteristics, HIV testing history, reasons for testing decisions, and sexual behaviours. We describe reasons for not testing and analyse factors associated with not or infrequent testing using univariable and multivariable multinomial regression. Results Questions on HIV testing history were answered by 15,297 respondents. An HIV test within the last 12 months was reported by 38 %, a test more than 12 months ago by 27 % and 35 % had never been tested for HIV. Compared to recently tested, respondents who had never tested were more likely to be younger than 25 years (adjusted relative risk ratio (aRRR) 2.90, 95 % CI 2.11-3.99), living in a settlement with less than 100,000 inhabitants (aRRR 1.47, 95 % CI 1.18-1.83), being less open about their sexual orientation to their co-workers/classmates, and particularly to their primary care provider (aRRR 4.54, 95 % CI 4.02-5.11). Untested and less frequently tested respondents reported less sex partners and a lower proportion reported unprotected anal intercourse (UAI) with a non-steady partner (24 % compared to 38 % among those recently tested). Conclusions MSM who were younger, who did not live in large cities, and who were not out about their sexual orientation tested less frequently for HIV. Apart from strengthening protection from sexual orientation-related discrimination and empowering MSM who conceal their orientation, more opportunities to test anonymously and without revealing one’s sexual orientation should be provided. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1945-5) contains supplementary material, which is available to authorized users.
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- 2015
25. Perceptions about the use and knowledge of antibiotics in adolescent and adult mothers in Ecuador
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Arturo OQ Peralta, Lorena EE Torres, Arturo Quizhpe P, Martyna Gassowski, Lorena Encalada T, Francoise Barten, Arturo OQ Peralta, Lorena EE Torres, Arturo Quizhpe P, Martyna Gassowski, Lorena Encalada T, and Francoise Barten
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- 2015
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26. Unsafe Use, Knowledge and HCV Infection: Results from a Sero-Behavioral Survey of Current Injectors in Germany
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Ruth Zimmermann, Claudia Santos-Hövener, Stine Nielsen, Ulrich Marcus, Claus-Thomas Bock, M. an der Heiden, Martyna Gassowski, Viviane Bremer, Osamah Hamouda, Stefan Ross, and Benjamin Wenz
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Hepatology ,business.industry ,Environmental health ,Medizin ,Medicine ,ComputingMethodologies_GENERAL ,Current (fluid) ,business ,Virology - Abstract
Poster-Abstract
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- 2016
27. Perceptions about the use and knowledge of antibiotics in adolescent and adult mothers in Ecuador
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Arturo Quizhpe P, Martyna Gassowski, Lorena Encalada T, Francoise Barten, Arturo Quizhpe P, Martyna Gassowski, Lorena Encalada T, and Francoise Barten
- Abstract
The data presented here was collected through interviewing mothers using a structured questionnaire seeking medical attention for their child (<5 years old) with upper respiratory tract infection in four health centers and hospitals in Ecuador. Adolescent mothers more frequently misused and knew less about antibiotics compared to adult mothers, though knowledge values were low in both groups. Data in the following columns were not included in the analyses in this article: C, G, K, P-T, AJ-CK, CO, DH-DY.
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- 2013
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28. Study questionnaire (Spanish version)
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Arturo Quizhpe P, Martyna Gassowski, Lorena Encalada T, Francoise Barten, Arturo Quizhpe P, Martyna Gassowski, Lorena Encalada T, and Francoise Barten
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Questionnaire investigating perceptions of disease severity, treatment and antibiotic use by adolescent and adult mothers of children under the age of five.
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- 2013
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29. Concordance between self-reported and measured HIV and hepatitis C virus infection status among people who inject drugs in Germany
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Norbert Bannert, Ulrich Marcus, Stine Nielsen, Martyna Gassowski, R. Stefan Ross, Viviane Bremer, Claus-Thomas Bock, Benjamin Wenz, Claudia Kücherer, and Ruth Zimmermann
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Concordance ,Hepatitis C virus ,030106 microbiology ,Testing ,Human immunodeficiency virus (HIV) ,medicine.disease_cause ,Serology ,Validity ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Germany ,medicine ,030212 general & internal medicine ,Dried blood ,business.industry ,Public health ,Research ,HIV ,Undiagnosed ,virus diseases ,Hepatitis C ,Hepatology ,medicine.disease ,Respondent driven sampling ,Virology ,digestive system diseases ,Knowledge ,business ,People who inject drugs ,Self-report - Abstract
Background People who inject drugs (PWID) are disproportionately affected by both HIV and hepatitis C infection (HCV). Awareness of infection status is essential to ensure linkage to appropriate healthcare for those infected, who need treatment and regular follow-up, as well as for uninfected individuals, who need access to targeted testing and counselling services. In this paper we compare self-reported HIV and HCV status with serological markers of infection among PWID recruited through respondent driven sampling. Methods From 2011 through 2014, biological and behavioural data was collected from 2,077 PWID in Germany. Dried blood spots from capillary blood samples were collected and screened for HCV antibodies, HCV RNA and HIV-1/-2 antibodies. HIV reactive samples were confirmed by Western blot. Results Laboratory testing revealed that 5 % were infected with HIV and 81 % were aware of being infected. Chronic HCV infection was detected in 41 % of the participants, 2 % had an acute HCV infection, 22 % had a cleared infection, and 34 % were unexposed to HCV. The concordance between self-reported and measured HCV status was lower than for HIV, with 73 % of those with chronic HCV infection being aware of their infection. Conclusions We found a relatively high awareness of HIV and HCV infection status among PWID. Nevertheless, access to appropriate testing, counselling and care services targeted to the needs of PWID should be further improved, particularly concerning HCV. Trial registration Ethical approval was received from the ethics committee at the medical university of Charité, Berlin, Germany in May 2011 and with an amendment approved retrospectively on 19/11/2012 (No EA4/036/11). The German Federal Commissioner for Data Protection and Freedom of Information approved the study protocol retrospectively on 29/11/2012 (III-401/008#0035).
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30. STI tests and proportion of positive tests in female sex workers attending local public health departments in Germany in 2010/11
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Osamah Hamouda, Viviane Bremer, K Haar, Martyna Gassowski, and Stine Nielsen
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Adult ,medicine.medical_specialty ,Pediatrics ,sexually transmitted diseases ,Chlamydia trachomatis ,HIV Infections ,medicine.disease_cause ,urologic and male genital diseases ,Gonorrhea ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Germany ,Epidemiology ,Trichomonas vaginalis ,medicine ,Humans ,Public Health Surveillance ,Syphilis ,030212 general & internal medicine ,Community health service ,Sex Workers ,030505 public health ,business.industry ,lcsh:Public aspects of medicine ,Public health ,Public Health, Environmental and Occupational Health ,HIV ,Female sex ,virus diseases ,lcsh:RA1-1270 ,Chlamydia Infections ,medicine.disease ,Neisseria gonorrhoeae ,female genital diseases and pregnancy complications ,Female ,Public Health ,Biostatistics ,Trichomonas Vaginitis ,0305 other medical science ,business ,Research Article ,Demography - Abstract
Background In Germany, local public health departments (LPHD) are required to offer low-threshold access to confidential counselling and testing for sexually transmitted infections (STI) for sex workers. We collected data from LPHD in Germany to estimate the number of performed STI tests and the proportion of positive STI tests among attending female sex workers (FSW) in order to formulate recommendations for improving STI testing and care for FSW in Germany. Methods We recruited LPHD across Germany to collect aggregated data on attending FSW between January 2010 and March 2011. Baseline characteristics, the number of attending FSW, STI tests (HIV, Chlamydia trachomatis, Neisseria gonorrhoea, syphilis and Trichomonas vaginalis) and the number of positive results were provided by participating LPHD. We described the number of STI tests per FSW visit and the proportion of positive test results, including interquartile range (IQR). We tested whether baseline characteristics of LPHD were associated with the proportion of positive test results. Results Overall, 28 LPHD from 14 of the 16 federal states reported 9284 FSW visits over the study period, with a median of 188 FSW visits (IQR 45–440) per LPHD. Overall, a median of 77.1% (IQR 60.7–88.0) of visiting FSW received a test for Neisseria gonorrhoea, followed by HIV (66.0%, IQR 47.9–86.8), Chlamydia trachomatis (65.4%, IQR 50.7–83.6) and syphilis (61.6, IQR 48.6–78.6). In total, 22,914 STI tests were performed. The proportion of positive tests was 3.1% (IQR 1.3–4.8), with the highest proportion of positive tests for Chlamydia trachomatis (6.8%, IQR 2.5–10.4), followed by Neisseria gonorrhoea (3.2%, IQR 0.0–5.3), Trichomonas vaginalis (3.0%, IQR 0.0–15.4), syphilis (1.1%, IQR 0.0–1.3) and HIV (0.2%, IQR 0.0–0.4). The proportion of positive tests varied between 0 and 13.9% between LPHD, with a higher variation of proportion of positive tests in LPHD with a smaller number of reported STI tests. Conclusions Participating LPHD varied in terms of performed STI tests and FSW visits. The proportion of positive STI tests was low, but varied between LPHD. This variation likely reflects different testing strategies. Existing testing guidelines should be used by all LPHD to ensure high quality care for FSW. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3847-6) contains supplementary material, which is available to authorized users.
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