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Background HIV-related stigma and discrimination (SAD) have imposed serious adverse health consequences on people living with HIV (PLHIV), including limited access to medical care and delayed diagnosis, which in turn limits the prevention and control of the disease. This study was conducted to explore the stigmatizing attitudes and behaviors of healthcare workers (HCWs) towards HIV patients and PLHIV. Methods A cross-sectional study targeted HCWs who attended the United Conference of Hepatogastroenterology and Infectious Diseases that was held on 25–28 September 2019 in Cairo governorate. A self-administrated questionnaire was completed by 359 HCWs. Results The majority of HCWs reported some discriminatory practices when rendering care to HIV patients, with nurses showing the highest significant number of discriminatory practices. A considerable proportion of HCWs reported witnessing HIV-related SAD at their health facilities. Conclusions HIV-related SAD was prevalent among HCWs. Hence, HIV-related training relevant to the needs of different groups of HCWs is recommended. Provision of infection control supplies to protect against occupational exposure is also needed. The setting and enforcement of anti-stigma policies and guidelines in various healthcare settings are crucial.

Background: Identifying coronavirus disease 2019 (COVID-19) vaccine acceptance and associated factors among people living with HIV (PLHIV) in the Middle East and North Africa region is important to meet the need for broad-scale vaccination against COVID-19. Objectives: To investigate the COVID-19 vaccine acceptance rate and factors among PLHIV in the Middle East and North Africa region. Method: An online cross-sectional survey was conducted among PLHIV currently living in Egypt, Tunisia and Saudi Arabia between March 2021 and August 2021. Results: Of the 540 respondents, 19.3% reported already being vaccinated against COVID-19 (n = 104), 32.0% responded ‘definitely yes’ (n = 173), and 13.3% responded ‘probably yes’ (n = 72) for intention to receive a COVID-19 vaccine, with an overall COVID-19 vaccine acceptance rate of 64.6% among PLHIV in the region. The most significant predictors of COVID-19 vaccine acceptance included feeling less worried about COVID-19 transmission post- vaccination (221.0% higher odds), and believing the disease is vaccine-preventable (160.0% higher odds). Reported barriers to COVID-19 vaccine acceptance include concerns about vaccine effectiveness and belief that HIV medications protect against COVID-19 transmission, living in a rural area and reporting less-frequent engagement with HIV care. Nine out of 10 participants reported that the chances of them getting COVID-19 vaccine would increase if given adequate information and if their doctor recommended it. Conclusion: Findings of the study can help researchers, health officials, and other health system actors understand the predictors and barriers to COVID-19 vaccine acceptance reported by PLHIV. This understanding could inform the future planning of interventions tailored to PLHIV.&nbsp

Ebola is a deadlydisease caused by a virus in the family of Filoviridae. The virion is a single-stranded RNA of negative polarity and proteins enclosed in a lipid membrane. This ebolavirus species in African countries has caused several severe epidemics. Its infection causes a rapidly fatal hemorrhagic fever in humans for which no approved antivirals are available. Currently, the diagnostic tests for this deadly disease are Enzyme-Linked Immunoassay (ELISA) and Polymerase Chain Reaction (PCR) tests; viral cultivation and biopsy samples may also be used. So, there is no standard treatment for Ebola hemorrhagic fever and only supportive therapy, and experimental treatment is available. We used online bioinformatics tools to understand and look for new therapeutic targets.

Most instances of Guillain-Barré syndrome (GBS) are caused by immunological stimulation and are discovered after vaccinations for tetanus toxoid, oral polio, and swine influenza. This systematic study investigated GBS cases reported after receiving the COVID-19 vaccination.

Background and Objectives: Cerumen is a common physiological condition; it only becomes a problem if it causes a hearing impairment or other ear-related symptoms. There is increasing evidence for a relationship between stress and hearing problems. The study aims to understand the association between acute stress and increasing cerumen secretion among medical students during exams. Materials and Methods: The study is a retrospective, single-center, and consecutive case series conducted in Benha University Hospitals in Egypt We defined four cases of medical students who complained of earwax accumulation during their final exams from the 15th to the 13th of July 2021. Results: Four medical students participated in the study. Younger Females and males’ percentages were equal, and the mean age was 19.625 years old. Headache, ear discomfort, and ear pruritus are most common, followed by tinnitus, ear debris, and otitis media with effusion, while hearing loss, fever, and ear pain are slightly rare. The bilateral accumulation of earwax is typical than unilateral accumulation. Remowax was used in almost of cases and then ear wash. Males had high perceived stress, while females had moderate stress. Conclusions: This retrospective case series showed an association between acute stress and excessive cerumen secretion among small medical students during their final exams.

Liver disease has emerged as a leading cause of death among PLHIV coinfected with HCV.A retrospective study involving all HCV viremic patients coinfected with HIV who presented to HCV/HIV multidisciplinary clinics located at Embaba fever hospital. Patients were assigned to receive DAAs according to the national treatment guidelines. The primary endpoint was SVR12.Of the 519 patients enrolled, 38.73% LTFU; either not initiated (n = 170) or did not complete the treatment (n = 31). The main identified reasons behind LTFU were schedule conflict (19%) or hospitalization (13%). Among 318 patients who completed their DAAs course, nine patients had a relapse after the end of treatment and 97% had attained SVR12. There were significant differences among different virological response groups in baseline factors including smoking (p = 0.005), history of dental procedure (p = 0.007), CD4 count (p = 0.007), and HIV viral load (p = 0.001). Among responders (n = 309), there was a significant reduction of baseline hemoglobin and significant improvement of baseline platelets (p = 0.005) at on-treatment week 8. Baseline necro-inflammatory markers showed significant improvement across follow-up time points (p 0.001).DAAs are an effective and safe choice to treat HCV in PLHIV. Social stigma could be a major cause for lacking adherence to follow-up visits.

BackgroundHuman immunodeficiency virus (HIV)–hepatitis C virus (HCV) co-infection is increasing due to their similar routes of transmission. Co-infection poses a big challenge. Information on the prevalence of HCV infection in Egyptian HIV individuals is scarce.MethodsA cross-sectional study was conducted on 1004 HIV individuals who were recruited from July 2018 to March 2019. Blood samples obtained from HIV individuals were subsequently screened for HCV antibodies using the Murex anti-HCV (version 4) enzyme-linked immunosorbent assay test. HCV RNA was performed only on anti-HCV antibody–positive samples. Logistic regression was used to identify factors associated with HCV seroprevalence using SPSS (IBM, Armonk, NY, USA).ResultsAmong 1004 participants, 349 exhibited a positive result for anti-HCV antibodies (34.8% [95% confidence interval 31.81 to 37.8]). The most commonly self-reported risk factor of HIV infection by the co-infected participants was intravenous drug use (IDU) (303/349 [86.8%]). In multinomial analysis, risk factors identified as statistically associated with HCV seroprevalence include IDU, history of surgical operations and dental procedures and HIV viral load (pConclusionsThe prevalence of HIV–HCV co-infection is higher in Egypt compared with other countries in Africa. It is essential to screen all HIV-infected patients for HCV infection for early identification, counselling and initiation of anti-HCV treatment.

Background This study investigates different barriers preventing a cohort of Egyptian HIV/HCV coinfected patients from accessing HCV treatment, despite being available and free of charge, aiming to improve the long-term outcomes of coinfected patients and decreasing their liver-related morbidity and mortality. Methods This study included HIV patients who were referred to Kasr Alainy Viral Hepatitis Center to receive HCV treatment and who had to continue pretreatment assessment in order to receive direct acting antiviral agents free of charge. Patients who did not attend within 90 d were questioned via a telephone interview. Questions addressed sociodemographic status, HIV status and the main barriers to accessing healthcare. Results Overall, 474 HIV/HCV coinfected patients were eligible for HCV treatment and 223 (47.1%) patients did not complete work-up for HCV treatment. Fear of community stigma concerning HIV/HCV was the most important barrier to compliance with treatment (73.3%), followed by lack of a supportive work environment and employment opportunities (51.5%), whereas 39.3% stopped follow-up due to the lack of integrated services in the healthcare facility. Conclusions Managing HCV in HCV/HIV coinfected patients still represents a major challenge, not only for healthcare providers, but also at a community level, to improve community awareness and manage the major obstacle facing those patients regarding community stigma.

Carbapenem resistance mediated by NDM is particularly gruesome as this carbapenemase can hydrolyze a wide range of β-lactam antibiotics. Aim: This study aims to detect NDM mediated carbapenem resistance in clinical isolates of Pseudomonas aeruginosa. Materials and Methods: 50 multi-drug resistant clinical urinary isolates of Pseudomonas aeruginosa from three major hospitals in Khartoum state Sudan; Khartoum Teaching Hospital, Medical Army Hospital and Omdurman teaching hospital, in period from July 2016 to September 2017, were investigated for carbapenem resistance using standard disc diffusion method and underwent real-time PCR to detect carbapenem resistance gene blaNDM. Data were analyzed using IBM SPSS. Results: 60% were positive for the blaNDM, 82% were resistant to Imipenem and 75% of the samples were resistant to Meropenem. Conclusion: The emergence of carbapenem resistance is a global problem that requires earnest attention. To make the suitable preventive measures, the emergence of these genes must be monitored closely. Our findings revealed that carbapenem-resistant due to the gene blaNDM is accounted for 60% of the cases, and due to lack of proper data documentation about the emergence of this gene in Sudan, these cases to the best of our knowledge are the first to be reported in Sudan.

This study investigated an increase in deforestation and its impact in charcoal supply for households in Tanga district (urban). Tanga district was chosen because it has high urban population as compared to her neighbor Districts of Muheza and Mkinga. The district was also chosen because it is so close to natural and reserved forests in both Muheza and Mkinga districts in which effect of deforestation on charcoal supply can be clearly seen and determined. The study involved 61 respondents including (households, charcoal venders and forest officer). Questionnaire survey, interview and documentary review methods were employed in data collection. A quantitative data were analyzed using Statistical Package for Social Sciences (SPSS 20th version). While qualitative information was analyzed using content analysis. The study findings show that majority 56 (92%) of the respondents reported that there is high rate of deforestation which was mainly contributed by charcoal production in the study area. The study further revealed that the observed high rate of deforestation affect the availability and supply of charcoal for domestic use. The scarcity of charcoal coupled with high and fluctuating price give the evidence on presence domestic energy crisis in the study area. Along with other recommendations, the study recommends that the Government Regulator (Energy and Water Utilities Regulatory Authorities - EWURA) should consider reducing tariff on other sources of energy particularly gas and electricity to allow many people afford and resorting to alternative energies for their domestic use and hence reduce the extent of deforestation.