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University students, especially those in healthcare sciences, are of particular importance in COVID-19 vaccine views since their future careers will allow them to educate citizens regarding vaccination. The study examined COVID-19 immunisation coverage, behaviours, and attitudes towards COVID-19 vaccines among students in Bulgarian medical universities. A prospective cross-sectional study was undertaken in September 2021- January 2022. Demographics, university programme, year of study, general vaccine attitudes and behaviour, and personal experience with COVID-19 and vaccines were collected. The chi-square test was used to test for associations and binominal logistic regression to identify possible predictors for vaccination. A total of 3050 students with a median age of 22 years, predominantly female participated. Three-quarters of the students (73.5%) have been vaccinated against COVID-19. An association was found between COVID-19 vaccination and influenza vaccination in the previous season (χ2 = 67.15, p

Background: COVID-19, caused by SARS-CoV-2, continues to spread globally, with vaccines being the most effective way to control the pandemic. Studies show a significant reduction in infection, hospitalisations, severe disease, and death after vaccination. The aim of the study was to determine the share of breakthrough infections among critically ill patients with severe COVID-19 who had been admitted to the intensive care unit (ICU) of a hospital at the beginning of the delta-variant pick. Material and methods: For a period of 10 months a total of 740 patients diagnosed with COVID-19, were treated in the intensive care unit of the University Hospital “St. Marina-Varna”, with ersons. Information on the vaccination status of all 740 hospitalised patients was extracted from the National information system "Register of immunized persons against COVID-19", including the type and date of COVID-19 vaccine administration, where available. After that, descriptive statistics were performed with the collected data. Results: Out of 740 patients, 19 (2.6%) had received at least 1 dose of vaccine, and 721 (97.4%) - none. Only ten (1.35%) of the studied everely and critically ill patients had completed the vaccination cycle (without a booster dose). Conclusion: Our findings show that when fully administered, vaccines are highly effective against laboratory-confirmed SARS-CoV-2 infection leading to ICU admission. Our findings reinforce the value of widespread COVID-19 vaccination, underscore the importance of completing the vaccination cycle for either of the mRNA-based vaccines, and may help motivate persons who remain hesitant about being vaccinated.

The most important and very difficult thing is to establish the cause (etiology) for the occurrence of nosocomial infections in medical facilities in the country and the world. Objective: To study the frequency and structure of nosocomial infections before and during the Covid-19 pandemic in the Ruse region for 2017-2021. Materials and methods: A retrospective analysis of the data on the registered nosocomial infections for a period of five years (2017 - 2021), reports, analyses, and laboratory studies of Regional Health Inspectorate Ruse, from national governmental studies, normative documents and literature are applied. Results: The analysis of the data from the etiological diagnosis of nosocomial infections in the Ruse region is from 9 medical facilities included in the national electronic system for the control of nosocomial infections (NIs). The etiological structure of NIs in the Ruse region is represented by 39 microbial species. The relative share of the untested varies from 10.59% in 2017 to 15.75% in 2021. For the etiologically unproven, it is from 2.39% for 2019 to 1.68% for 2021, with a decreasing trend. Conclusions: The analysis of the isolated microbial species by group shows that for the entire period, the proportion of gram-negative flora was 62% of the isolates (2017), followed by 23.02% of gram-positive microorganisms (2017), and the relative proportion of fungi and viruses was ~ 3 %.

Background: The issue of mandatory COVID-19 vaccination, entwined with citizens' rights and autonomy, impacts vaccine uptake and trust in health authorities. This study centers on Bulgaria, aiming to uncover attitudes towards obligatory COVID-19 vaccination. Methods: Employing an online questionnaire, we conducted a cross-sectional survey involving 1433 adults in Bulgaria between April and May 2022. Analysis of responses from 1200 participants illuminated perspectives on mandatory COVID-19 vaccination. Results: Among respondents, 38.6% supported or were uncertain about mandatory vaccination, while 61.4% opposed it. Binary logistic regression, utilizing demographic predictors, unveiled that younger age groups, particularly those aged 18–25, demonstrated diminished odds of supporting mandatory vaccination. Those with apprehensions about contracting the virus (OR 2.98, 95% CI 1.65–5.39), perceiving minimal vaccine risks (OR 3.86, 95% CI 1.80–8.26), acknowledging vaccine benefits for health protection (OR 3.86, 95% CI 1.80–8.26), and pandemic containment (OR 3.34, 95% CI 1.16–9.60) were more prone to endorse mandatory vaccination. Trust in general practitioners and pharmaceutical companies also emerged as influential factors. Conclusion: The study portrays a diverse sentiment within Bulgaria's population concerning compulsory COVID-19 vaccination. It underscores the importance of conveying accurate, evidence-based information while upholding individual autonomy. National health authorities should harmonize methodical vaccination initiatives with health promotion interventions targeted at the general population and healthcare professionals. Such an approach can facilitate well-informed choices and contribute to public health objectives.

Toxocariasis is a tissue zoonosis caused by Toxocara spp. and the exposure to these geohelminths varies in different parts of the population in a particular region. The purpose of the study is to reveal the seroprevalence of toxocariasis in North-eastern Bulgaria and to establish its demographic structure. Material/Methods: Within the scope of a broad seroepidemiological study, 701 individuals from North-eastern Bulgaria were tested for anti-Toxocara antibodies (ELISA) between 2017 and 2020. The results were stratified and analysed by age, gender, and place of residence. Results: The overall seroprevalence of human toxocariasis in North-eastern Bulgaria is 18.54%. Children (18.85%) and adults (18.30%) show similar levels of infection, but the stratified analysis by age in 5-years intervals revealed notable discrepancies. In younger children, the seroprevalence is higher than the observed for the entire population (0-4 years - 22.22%; 5-9 years - 22.22%), while in adolescents and adults is lower than average. In the elderly, the seroprevalence rises to its highest levels (60-64 years - 30.56% and over 65 years -31.67%). Although there are variations between males and females, gender is not a significant factor for the distribution of toxocariasis. Higher seroprevalence levels in residents of the smaller settlements of the region (children - 28.18%; adults -29.10%) correspond to a 2.5-fold increase in the odds of contracting toxocariasis in comparison to the ones living in Varna city. Conclusion: The overall seroprevalence of toxocariasis in North-eastern Bulgaria is alarmingly higher than the levels reported from other parts of the country, placing this unknown infection in a leading position among the parasitic zoonoses. The place of residence is the most significant factor driving the uneven distribution of the disease.

Toxocariasis in humans is a little-studied zoonosis, and there are no data on the impact of this parasitosis on the minority groups in our country. The purpose of this study is to establish the seroprevalence of toxocariasis among ethnic groups in the Varna region, North-eastern Bulgaria, and compare the results with a control group from the general population. Material/Methods: As a part of a large seroepidemiologic study, we assessed the presence of Toxocara IgG among 132 individuals, self-identified with Turkish and Roma ethnicities. As a control group, we used 250 sera from children and adults from a control group. The statistical comparison was performed regarding age, sex, and type of residence. Results: Toxocara IgG were established in 43 individuals from the minority groups (seroprevalence of 32.58%) and 39 persons in the control group (15.60%) with а statistically significant difference (odds ratio = 2.61). Considerably high seropositivity in the investigated ethnicities was discovered after separating by age: children-33.33%; adults-32.00% and gender: male-38.98%; female-27.40%. A detailed analysis revealed that the type of settlement is an important confounding factor. The seropositivity among the minority ethnic groups residing in small towns and villages is 35,40%, in contrast to the residents of Varna city of the same ethnical origin (15.79%); OR = 2.92. Conclusion: The established high seroprevalence for Toxocara IgG among minority ethnic groups, especially those residing in the rural settlements of North-eastern Bulgaria, shows undiscovered to this point increased risk for the spread of toxocariasis among this population.

Toxocariasis in humans is an unknown and underdiagnosed disease with increased risk of distribution determined by the large canine and cat populations. Contamination of the environment with pets faeces containing helminth eggs is the key route of transmission toxocariasis, threatening especially the youngest children. The purpose of this study is preliminary research of the degree of pollution of the environment with Toxocara spp. eggs by examining soil and sand samples from different public places of Varna, Bulgaria. Material and methods: In 2018, 40 soil and sand samples were collected from various locations of Varna city: public park areas, areas for dog-walking, playgrounds, sandboxes and yards with domestic animals. The samples were processed using a modified Romanеnko’s method. Results: Soil analysis showed Toxocara spp. eggs in one sample from a public park area in the central region of Varna. In another soil sample of a private yard with domestic dog typical ova of the Taeniidae family was observed (possibly of E. granulosus). In two other samples, eggs from other canine parasites were discovered. Conclusion: The first research on the environmental contamination with helminthic eggs in Northeastern Bulgaria showed Toxocara spp. eggs in one of the central and most populated areas of Varna city. Furthermore, at least 10% of the tested materials were contaminated with canine excrements that testify for the lack of proper control of domestic and stray animals, which represents a real and imminent danger from zoonotic infection for the public health in the region.