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Antenatal care (ANC) has been shown to influence infant and maternal outcomes. WHO recommends 4 ANC visits for uncomplicated pregnancies. However, pregnant women in Ghana are required to attend 8-13 antenatal visits. We investigated the association of ANC attendance with adverse pregnancy outcomes (defined as low infant birth weight, stillbirth, preterm delivery or small for gestational age). A quantitative cross-sectional study was conducted on 629 women, age 19-48 years who presented for delivery at two selected public hospitals and 16 traditional birth attendants from July to November 2011. Socio-demographic and antenatal information were collected using a structured questionnaire. ANC attendance, medical and obstetric/gynecological history were abstracted from maternal antenatal records. Data were analyzed using Chi square and logistic regression. Twenty-two percent of the women experienced an adverse outcome. Eleven percent of the women attended 5 children) was also associated with adverse birth outcomes. Women screened for syphilis or use of insecticide-treated bed nets had a 40 and 36% (p = 0.0447 and p = 0.0293) reduced likelihood of experiencing an adverse pregnancy outcome respectively. After adjusting for confounders, attending Keywords Antenatal care * Adverse pregnancy outcomes * Kumasi Ghana * Traditional birth * Attendants, Introduction A 45% prevalence of adverse pregnancy outcomes has been reported in Kumasi [1]. Antenatal care (ANC) is a routine medical service and has been identified as a determining factor [...]

This is apparently the first survey examining endorsement of HIV/ AIDS conspiracy beliefs and their relations to educational attainment among 205 HIV-positive African-American patients receiving care at an AIDS Outreach Organization in Alabama. 31% somewhat or strongly believed that, 'AIDS is a form of genocide against African Americans,' 29% strongly agreed that 'AIDS was created by the government to control the black population,' 56.1% agreed that the government is withholding a cure for AIDS, and 69.8% agreed that the government is withholding information about the disease from the public. 52% agreed that 'HIV is a manmade virus,' and 43.1% that 'AIDS was produced in the government's laboratory.' Respondents with high school or college education were less likely to endorse conspiracy beliefs. Being open and sensitive to questions about conspiracy beliefs plus understanding the historical roots and social context from which such questions arise in African-American communities is needed to counter such beliefs.

The development of rapid detection technologies in parallel with understanding production practices will markedly improve the microbiological safety of leafy vegetables. The objective of this study was on the application of phage-based magnetoelastic (ME) biosensors and optimization of selected surface blocking agents for a rapid detection for Salmonella Typhimurium on Romaine lettuce. Initially, Romaine lettuce hearts surface was examined for structural differences followed by attachment and distribution of S. Typhimurium using scanning electron microscopy (SEM). Furthermore, selected surface blocking agents were compared and optimized for the application of phage-based ME biosensors surface. A total of 156 observations, ranging from 1 to 8 logs CFU/ml, and 18 frequency measurements were recorded and analyzed. Both measurement (with E2 phage) and control (without E2 phage) sensors were blocked with selected blocking agents to prevent nonspecific binding. Statistical analysis using ANOVA revealed that there was a significant difference between controls and measurements ( P < 0.001). The comparison showed that 5 × 102 CFU/mL and higher concentrations of S. Typhimurium were detected on Romaine lettuce surface, and PEG performed better as a blocking agent of choice. Understanding the complexity of the bacteria-plant surface interaction and improved detection protocol will provide a solid foundation to design feasible control strategies. Practical Applications Salmonella species are generally associated with food products of animal origin and recently leafy green vegetables have been considered as a major public health concern and source of the bacteria. There is still a need to explore swift and reliable detection protocol, which could be easily applied to leafy vegetables from the farm to consumer. In this study, we have demonstrated the rapid detection for Salmonella Typhimurium on Romaine lettuce using phage-based protocol. Furthermore, better surface blocking agent was optimized for the protocol. Further optimization of phage-based detection approach could be instrumental to develop better Salmonella detection approach that can be adopted and used from farms to the consumer level. [ABSTRACT FROM AUTHOR]

The objective of this study is to conduct a quantitative risk assessment of multiple factors influencing HIV/AIDS transmission through unprotected sexual practices among HIV-seropositive men. A knowledgebase was developed by reviewing different published sources. The data were collected from different sources including Centers for Disease Control and Prevention, selected journals, and reports. The risk pathway scenario tree was developed based on a comprehensive review of published literature. The variables are organized into nine major parameter categories. Monte Carlo simulations for the quantitative risk assessment of HIV/AIDS transmission was executed with the software @Risk 4.0 (Palisade Corporation). Results show that the value for the likelihood of unprotected sex due to having less knowledge about HIV/AIDS and negative attitude toward condom use and safer sex ranged from 1.24×10−5 to 8.47×10−4 with the mean and standard deviation of 1.83×10−4 and 8.63×10−5, respectively. The likelihood of unprotected sex due to having greater anger-hostility, anxiety, less satisfied with aspects of life, and greater depressive symptoms ranged from 2.76×10−9 to 5.34×10−7 with the mean and standard deviation of 5.23×10−8 and 3.58×10−8, respectively. The findings suggest that HIV/AIDS research and intervention programs must be focused on behavior, and the broader setting within which individual risky behaviors occur. [ABSTRACT FROM AUTHOR]

Objective: To determine if significant differences exist in substance use among people living with HIV//AIDS (PLWHA) before and after establishing their HIV infection status. Method: The study participants are HIV positive clients of a community based HIV//AIDS outreach facility located in Montgomery, Alabama. The questionnaire includes demographics, substance use and risky sexual behaviors pertaining to HIV transmission. Each participant completed an anonymous questionnaire. A total of 341 questionnaires were distributed and 326 were fully completed and returned, representing a response rate of 96%%. Results: Findings revealed a statistically significant difference in alcohol consumption before sex among PLWHA before and after establishing their HIV infection status ( p == .001). No significant differences were observed among participants who reported as having used drugs intravenously ( p == .89), and among those sharing the same syringe//needle with another person ( p == .87) before and after establishing their HIV infection status. Conclusion: There is continued substance use and alcohol consumption before sex among PLWHA after establishing their HIV status despite clear evidence of such risky behaviors that could lead to an increase in exposure to HIV. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to determine if there was a significant association between substance use and risky sexual behaviors among middle school children. Methods: Data were collected in May 2002 using a questionnaire. A chi-square test was used for data analysis. Results: The results showed that alcohol, cocaine, marijuana, and tobacco use are strong predictors of risky sexual behaviors. Conclusions: These findings will be of use to healthcare practitioners and health educators seeking to reduce the risk of infection with HIV and other sexually transmitted diseases among the middle school children. [ABSTRACT FROM AUTHOR]

Contamination of poultry by Campylobacter is a significant source of human diarrheal illness. The purpose of this study was to compare standard culture-based methods and real-time polymerase chain reaction (RT-PCR) for detection of Campylobacter jejuni from retail chicken samples. Culture methods were compared with RT-PCR (without enrichment) for detection of C. jejuni in naturally contaminated chicken samples. Purchased chicken samples (n = 43) were collected from four supermarkets. C. jejuni was detected by direct plating to selective agar (DPSA; 5/43, 11.6%), RT-PCR (15/43, 34.9%) and Bolton's enrichment (BE; 8/43, 41.9%). Fifteen chicken samples were concordant by RT-PCR and BE whereas three samples were positive only by BE. The sensitivity of the RT-PCR and DPSA, when compared to BE as the reference standard (100% sensitivity) were 81 and 29%, respectively. Application of rapid and sensitive methods for detection and enumeration of C. jejuni is important for the maintenance of a safe poultry supply. PRACTICAL APPLICATIONS Campylobacter spp are one of the most common causes of bacterial diarrheal disease worldwide. This zoonotic pathogen is reported to have a low infective dose with high pathogenicity. The practical application of the experiment is directed to assess the “standard culture-based methods and real-time polymerase chain reaction (RT-PCR)” to detect Campylobacter jejuni, which is most commonly isolated campylobacter species from clinical infections and chicken samples. Because of the growth characteristics and difficulty of routine diagnostic technique, evaluation of food samples for the presence of C. jejuni can be challenging. The main focus of the study is to assess the sensitivity and sensitivity of culture and RT-PCR. The results are instrumental resources in the area of food safety, epidemiological surveillance, policy development to monitor and regulate the food matrices and diagnostic laboratories. The audiences of this information will be both academic and commercial sectors involved in poultry production and processing institutions, food regulatory and inspection institutions, risk assessment and also the consumer. [ABSTRACT FROM AUTHOR]

In order for the United States Department of Agriculture's (USDA) Food Safety and Inspection Service (FSIS) to make an equivalence determination for a foreign meat, poultry or egg products inspection procedure that differs from FSIS inspection procedures (an Individual Sanitary Measure or ISM), a country must demonstrate objectively that its food safety inspection system provides the same level of public health protection as the FSIS inspection system. To evaluate microbiological testing data that such countries may submit to this end, we present a possible risk metric to inform FSIS's assessment of whether products produced under an alternative inspection system in another country pose no greater consumer risk of foodborne illness than products produced under FSIS inspection. This metric requires evaluation of prevalence estimates of pathogen occurrence in products for the foreign country and the U.S. and determining what constitutes an unacceptable deviance of another country's prevalence from the U.S. prevalence, i.e., the margin of equivalence. We define the margin of equivalence as a multiple of the standard error of the U.S. prevalence estimate. Minimizing the margin of equivalence ensures the maximum public health protection for U.S. consumers, but an optimum choice must also avoid undue burden for quantitative data from alternative inspection systems in the foreign country. Across a wide range of U.S. prevalence levels and sample sizes, we determine margin of equivalence values that provide high confidence in conclusions as to whether or not the country's product poses no greater risk of foodborne illness from microbiological pathogens. These margins of equivalence can be used to inform FSIS's equivalence determination for an ISM request from a foreign country. Illustrative examples are used to support this definition of margin of equivalence. This approach is consistent with the World Trade Organization's concept of risk equivalence and is transparent and practical to apply in situations when FSIS makes an equivalence determination for an ISM requested by a foreign country. • The US requires equivalent food safety systems for importing countries. • Food safety systems often differ between the US and its trading partners. • A non-inferiority test determines if imported product is less safe than domestic product. • Guidelines for determining sample size and margin of equivalence are provided. [ABSTRACT FROM AUTHOR]

A 3-year interactive and passive training for HIV prevention education was conducted for 2,600 prisoners; 1,404 (54%) black, 1,092 (42%) white and 204 (4%) Hispanic. Less than 520 (20%) of inmates knew all the routes of HIV transmission. A post-presentation test showed that 96% became aware of HIV/AIDS transmission and can better protect themselves. Skin infections caused by Staphylococcus aereus were reported and manifested clinically as pustules, cellulites, boils, carbuncles or impetigo. Though no systemic infection was involved, staphylococcal infections suggest lowered immunity, an indicator to undiagnosed HIV. This study purposefully provides HIV prevention education model for prison health educators. [ABSTRACT FROM AUTHOR]

Aim: In 2005, the Ghana Health Service mandated malaria and helminths chemoprophylaxis during antenatal care visits. The aim of this study was to investigate the prevalence of malaria and helminth infections and their relationship with adverse birth outcomes (low birth weight, stillbirth, and preterm) following the implementation of these treatments., Study Design: A quantitative cross-sectional study., Method: The study was conducted on 630 women presenting for delivery in the Komfo Anokye Teaching Hospital and the Manhyia District Hospital from July to November 2011. Socio-demographic information and medical and obstetric history were collected. Laboratory analyses for the presence of malaria and helminths were performed. Association of malaria and helminths with birth outcomes was assessed using logistic regression to obtain odds ratios (ORs) and 95% confidence intervals., Results: The prevalence of malaria, helminths and adverse birth outcomes was 9.0%, 5.0% and 22.2%, respectively. Compared with women who received malaria prophylaxis, women without malaria prophylaxis were two times more likely to have malaria infection (aOR = 2.1; 95% CI = 1.06-4.17). Women who were not screened for helminths were twice as likely to be infected with helminths (aOR = 2.4; 95% CI = 1.15-5.12) than women who were screened for helminths. For women infected with hookworm or Schistosoma mansoni , the odds of having an adverse birth outcome (aOR = 3.9; 95% CI = 1.09-14.20) and stillbirth (aOR = 7.7; 95% CI = 1.21-36.38) were greater than for women who were not infected., Conclusion: The prevalence of malaria, helminths and adverse birth outcomes was lower than previously reported 9.0% vs. 36.3, 5.0% vs. 25.7 and 22.2% vs. 44.6, respectively. Helminth but not malaria infection was found to be significantly associated with adverse birth outcomes.

The purpose of this study was to examine if religious affiliation and frequency of attendance at religious services were associated with HIV risky behaviors among people living with HIV/AIDS (PLWHA). The participants are HIV positive clients of a community based HIV/AIDS outreach facility (CBHAOF) located in Montgomery, Alabama, USA. The participants completed the questionnaire during their medical visits to the clinic at their own convenience and that of the facility's staff. A total of 341 questionnaires were distributed to PLWHA and 326 (96%) were fully completed and returned. There were more male than female participants (56 versus 42%). The majority of the respondents (67%) were between 30 and 49 years of age. Nearly two thirds of the participants (64%) were African Americans whilst 36% were other races combined (White = 29%, Hispanic = 3% and other races = 4%). A chi-square test was used to examine the association between selected variables. Findings show substantial variations of selected HIV risky behaviors according to religious affiliation and frequency of attendance at religious services (p < 0.05). The study findings suggest the importance of religious affiliation and frequency of attendance at religious services in reducing HIV risky behaviors among PLWHA. The findings have implications for HIV/AIDS prevention and we recommend that it is important to incorporate Faith-based organizations in the global fight against HIV/AIDS.

Infection with the human immunodeficiency virus (HIV) that causes acquired immunodeficiency syndrome (AIDS) is still rising globally. In order to develop effective HIV/AIDS risky behavior reduction intervention strategies and to further decrease the spread of HIV/AIDS, it is important to assess the prevalence of psychosocial problems and HIV/AIDS risky behaviors in people living with HIV/AIDS (PLWHA). The objective of this study is to assess the relationship between psychosocial variables and HIV/AIDS risky behaviors among PLWHA. A total of 341 questionnaires were distributed and 326 were fully completed and returned, 96% response rate. The relationships between the identified psychosocial and HIV/AIDS risky behaviors among PLWHA were analyzed using The Moment Structures software version 17.0 (SPSS Inc.) The results indicate that psychosocial health problems were significant predictors of HIV/AIDS risky behaviors in PLWA. Further cross-disciplinary research that addresses the manner in which psychosocial problems and HIV/AIDS risky behaviors interact with each other among PLWHA is needed.

Computational microepidemiologic modelling can facilitate the understanding of complex biomedical systems. It provides novel methods for quantitatively studying population health dynamics from the micro level of genomes and molecules to the higher macro levels such as HIV/AIDS in humans. Untangling the dynamics between the human immunodeficiency virus-1 (HIV-1) and CD4(+) lymphocyte populations and intracellular molecular kinetics of interactions in an integrative systems dynamics approach can help to understand the effective points of interventions in the HIV life cycle. With that in mind, we have developed a stochastic systems dynamics model that includes intracellular molecular level interactions. A sequence of events, molecular interactions and cytochemical kinetics are triggered when the HIV infects a CD4(+) lymphocyte. The full sequence of molecular level dynamics includes: attachment and fusion; reverse transcription; integration; transcription; translation; and budding or release of new virus. The newly released virus circulates back and infects a new CD4(+) lymphocyte and the cycle continues repeatedly. Mathematical models that account for these processes were developed. The model developed provides insights into how an intracellular/molecular level model can be incorporated within a macro-epidemiologic integrative systems dynamics model for examining a variety of computational experimentations. Such experimentations can help in evaluating scientific questions related to effective strategies in HIV drug therapy interventions.