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In 2019, the Israeli Ministry of Health joined the World Health Organization initiative to eliminate hepatitis C virus (HCV) (1). The national elimination program included HCV testing among 6 high-risk [...]

Abstract Background Oral pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) has been found to reduce viral acquisition among HIV-negative MSM. This cross-sectional study was conducted before pre-exposure prophylaxis (PrEP) licensure in Israel, and aimed to compare men who have sex with men (MSM) who had heard of PrEP with those who had not, as well as MSM willing to take PrEP with those who were hesitant or not willing to take PrEP. Methods HIV-negative MSM responded anonymously to questionnaires in 2017 regarding their knowledge of and willingness to take PrEP, prior use of PrEP and post-exposure prophylaxis (PEP), and their sexual behaviors. Results Among 1705 participants, 1431 (83.9%) had heard about PrEP. They were older and more often reported being Jewish, having an academic degree, self-identifying as gay/bisexual, being tested for HIV in the last year, participating in group sex, using alcohol or drugs before or during sex, and having prior use of PrEP/PEP compared with MSM who had not heard about PrEP. A total of 760 (44.8%) participants indicated that they would consider taking PrEP, 567 (33.5%) maybe would consider taking PrEP, and 367 (21.7%) would not take PrEP. Those who were willing to take PrEP had a lower level of education, were involved in high-risk sexual behaviors, used alcohol or drugs before or during sex, and had previously used PrEP/PEP compared with participants who maybe would consider taking or would not take PrEP. When participants were asked to indicate if they were willing to take PrEP at different potential efficacies and costs, the willingness to using PrEP increased with the potential efficacy of the drug and adversely related to its cost. Conclusions PrEP awareness was high, and 44.8% indicated willingness to take PrEP, especially those who reported high-risk sexual behaviors. This supports the current policy in Israel to allow PrEP to MSM who are at high-risk. In order to maintain a high level of PrEP-adherence, physicians should consider structural barriers, such as negative stigma of being promiscuous, lack of perceived HIV-risk, difficulties in accessing clinics or paying for PrEP, inability to follow-up or low tolerability of the medication.

Tuberculosis (TB) is the second-most prevalent cause of mortality resulting from infectious diseases worldwide. It is caused by bacteria belonging to the Mycobacterium tuberculosis complex (MTBC). In Israel, TB incidence is low, acknowledged by the WHO as being in a pre-elimination phase. Most cases occur among immigrants from high TB incidence regions like the Horn of Africa and the former Soviet Union (FSU), with occasional outbreaks. The outbreak described in this report occurred between 2018 and 2024, increasing the incidence rate of TB in the region. Control of this outbreak posed challenges due to factors including a diverse population (including Ethiopian immigrants, Israeli-born citizens, and immigrants from other countries), economic and social barriers, and hesitancy to disclose information. The unique multidisciplinary team formed to address these challenges, involving the local TB clinic, district health ministry, health maintenance organization (HMO) infectious disease consultant, neighborhood clinic, and National Mycobacterium Reference Laboratory (NMRL), achieved effective treatment and containment. Whole genome sequencing (WGS) proved pivotal in unraveling patient connections during the outbreak. It pinpointed those patients overlooked in initial field investigations, established connections between patients across different health departments, and uncovered the existence of two distinct clusters with separate transmission chains within the same neighborhood. This study underscores collaborative efforts across sectors that successfully contained a challenging outbreak. [ABSTRACT FROM AUTHOR]

Aims To outline the demographic, clinical, laboratory characteristics, and treatment outcomes of tuberculosis (TB) patients who used substances. Methods This retrospective cohort study compared 50 TB patients who used substances with a matched random sample of 100 TB patients who did not use substances between 2007 and 2017. Treatment failure was defined as a sputum smear or culture that tested positive after 5 months of treatment, loss to follow-up, unevaluated patients, or death. Results TB patients who used substances were typically younger, experienced homelessness, smokers, and had fewer chronic diseases than those who did not use substances. They also were hospitalized for longer periods, their treatment durations were longer, had higher rates of multidrug resistant strains, increased rates of treatment failure, and higher mortality. Individuals whose treatment failed predominantly originated from the former Soviet Union, experienced homelessness, and had chronic diseases compared with those whose treatment was successful. In the multivariate analysis, homelessness [odds ratios (OR) = 6.7], chronic diseases (OR = 12.4), and substance use (OR = 4.0) were predictors of treatment failures. Conclusions TB patients who used substances were more likely to have treatment failure. Targeted interventions, including early diagnosis and enhanced support during treatment, are essential to achieve treatment success in this vulnerable population, in addition to TB-alcohol/drug collaborative activities. [ABSTRACT FROM AUTHOR]

Introduction Israel hosts documented labor migrants (DLM), and recently also undocumented migrants (UDM), mostly from Horn of Africa. This study aims to compare treatment outcomes and other clinical aspects between a sample of 154 DLM and 113 UDM who were treated in two tuberculosis clinics between 2005 and 2010. Results and Discussion Compared to DLM, UDM were younger males, stayed in Israel for shorter periods, had lower coverage of medical insurance, were less likely to be employed, and had greater difficulties in communication with the medical staff. UDM were more likely to demonstrate tuberculosis-related symptoms than DLM, were more commonly diagnosed with pulmonary TB, and had shorter patient and system delays and their treatment success rate was better than DLM, who were more likely to be transferred out. Conclusion UDM achieved better treatment outcomes, as they were screened upon entry and treatment was initiated in detention, while DLM were diagnosed in the community and may have felt more secure to abandon treatment., Author(s): Jonathan R. Eisenberg[sup.1] , Moshe Lidji[sup.2] , Eugenia Gelfer[sup.3] , Noa Zehavi[sup.3] , Itamar Grotto[sup.4] [sup.5] , Zohar Mor[sup.6] [sup.7] Author Affiliations: (1) Sackler School of Medicine, Tel Aviv [...]

More than 1200 civilians and military were killed in cities and villages by the Hamas attack on October 7th, 2023. The bodies and body-parts had to be identified and released for burial. This report outlines the challenges and mode of operation of the massive disaster victim identification (DVI) efforts. Bodies were delivered to a central mortuary. Each body was coded and undressed for external inspection and documentation of physical elements. Digital fingerprints were recorded and blood or toenails sampled for DNA. Odontology exams were performed by dentists describing dentition, aided by computerized tomography (CT). Whole-body CT was performed in cases the bodies were disfigured or burned from the second week. Simultaneously, families of missing civilians provided physical elements to the police to extract the DNA for antemortem documentation. The police took the responsibility over the reconciliation, which was based on comparison of the ante-mortem and post-mortem fingerprints, aided by DNA profile matching, odontology examination, clinical and/or radiological findings performed by forensic practitioners. Secondary identification elements were used assure the families regarding the identification. Precise scientific identification a was a priority, even if it slowed the rate of bodies release. Families were allowed to view their relative either at the mortuary or before burial. The DVI process required cooperation between several governmental agencies and police. To maximize the effectiveness, a synchronized approach should be adopted, specifying communication channels between the partners and dividing the responsibilities. The DVI should be led by a single, experienced authority to ensure interdisciplinary teamwork. This catastrophe required personal resilience of the teams for rapid and efficient functioning and communication between the partners. • Israel had to identify ∼1200 bodies after Hamas massacre on October 7, 2023. • Reconciliation was performed by cross-referencing of post and antemortem findings. • Scientific identification was a priority, even if it slowed the rate of body release. • Safe working conditions and psychological support for the teams is vital. • Effective communication between the different agencies involved is essential. [ABSTRACT FROM AUTHOR]

This article explores the collaboration between the Israeli Public Health Department (PHD) and the Israeli Defense Force (IDF) during the COVID-19 pandemic. The IDF was instructed to support the PHD in containing the outbreak, leveraging their logistical capabilities and experience with civilian populations. The collaboration faced challenges due to differences in organizational culture, concerns about militarization, and trust issues. The article emphasizes the importance of strong leadership, trust-building, and effective communication in successful civil-military cooperation during crises. [Extracted from the article]