Central European journal of public health最新文献

Human immunodeficiency virus 2 (HIV-2) is a retrovirus related to HIV-1. It is believed to have evolved from the simian immunodeficiency virus (SIV). The disease caused by HIV-2 is manifested by a slower progression compared to HIV-1. Data from West Africa show that 37% to 50% of HIV-2 infected people have undetected or very low viremia and if left untreated, have a much more gradual decline in CD4 T lymphocytes, thus longer survival. However, treatment should not be postponed even in this case, because the course of immune reconstitution inflammatory syndrome (IRIS) in people with HIV-2 is more severe than in HIV-1, and also the year-on-year increase in the number of CD4 T lymphocytes is approximately half that of HIV-1. Approximately 6% of people living with HIV-2 (PWH2) can be defined as non-progressors and 9% as elite controllers. However, most untreated PWH2 develop AIDS.

Objectives: COVID-19 disease, which has caused a global pandemic, poses significant threat to the healthcare system as healthcare workers (HCW) are at an elevated risk of contracting the disease and being temporarily removed from their regular duties. This study analyses and evaluates a cohort of employees at the University Hospital Ostrava (UHO) who applied for the recognition of COVID-19 as an occupational disease.

Methods: The disease characteristics and risk factors for severe cases of COVID-19 were analysed for all 474 claimants who applied for recognition of an occupational disease during the reporting period (March 2020 to November 2022) and were obtained from medical records. Statistical evaluation was performed using Fisher's exact test, Pearson's chi-square test and logistic regression analysis.

Results: The largest number of diseases was objectified in the period from September to November 2020. The most frequently reported symptoms were subfebrilia or febrilia (81.4%), olfactory dysfunction (75.1%), and dry cough (74.3%). A severe course of COVID-19 was experienced by 15.4% of the cohort. Additionally, 76.8% reported having at least one chronic disease. The risk of severe course was found to increase with the number of chronic diseases (p = 0.017). Individuals with chronic respiratory disease (CRD) had a 2.75-fold increased risk, and women had an approximately threefold increased risk. Higher risk was also associated with increasing age.

Conclusions: Healthcare workers face a heightened risk of severe COVID-19, particularly among those with CRD, women and older age. Identifying these risk factors underscores the need for targeted preventive measures and early interventions to protect this vulnerable group and reduce the incidence of severe outcomes.

Objectives: In 2022, about 17% of Andalusian population lived in disadvantaged areas, which accounted for 21% of tuberculosis (TB) cases. This concentration of cases resulted in TB rates in these areas being higher than both the regional and national averages. The aim of the present study was to understand the behaviour of TB in terms of person, time, and place in the city of Cordoba during the period 2015-2021 and its association with areas in need of social transformation (ANST).

Methods: A retrospective observational analytical study was conducted on cases reported to the Andalusian Epidemiological Surveillance System (Spanish acronym SVEA). Membership in ANST was determined by the SVEA.

Results: A total of 136 cases were reported, with 26.5% in ANST. The incidence rate (IR) in the city was 5.97 cases per 100,000 population per year, higher in ANST (11.82) compared to non-ANST (5.06), RR = 2.34 (95% CI: 1.60-3.42). In 2020, fewer cases were reported (IR: 3.99). The mean age was 44.82 years, lower in ANST (38.08) than in non-ANST (47.25), with a p-value < 0.05. Hospitalizations were more frequent in ANST (78% vs. 68%, p = 0.3). In ANST, the IR was highest in men over 60 years old and lowest in women of the same age. No significant difference was found between the groups regarding risk factors, except for HIV status (p = 0.02).

Conclusions: TB incidence rates in Andalusia vary by area of residence. To make better public health decisions, it is crucial to enhance the collection of socio-demographic and clinical data related to these cases.

Objectives: The first aim of this cross-sectional study was to reveal the prevalence of overweight and obesity among Czech military personnel (CMP). The second aim was to compare accuracy of the body mass index (BMI) classification with the body fat percentage (BF%), waist circumference (WC), and visceral fat area (VFA). BMI is a commonly used method to assess obesity, but its accuracy in reflecting body composition, especially in physically fit individuals, has been questioned.

Methods: Data were collected from six military units in the Czech Republic. Soldiers underwent anthropometric assessments including height, weight, WC, BF%, and VFA using the bioelectrical impedance method (BIA).

Results: The study group consisted of 446 soldiers (337 males, 109 females). The prevalence of obesity in Czech soldiers regardless of gender was 18%-20% according to BF% and 13%-16% according to WC. There were almost one fifth of obese males and more than 5% of females with BMI ≥ 30. The risk level of VFA was observed in 24% of male a 34% of female soldiers. In male soldiers there was a high rate (43%) of false positives according to BMI (BMI ≥ 25, BF% < 20), on the other hand, a certain part (18%) of female soldiers was classified as false negative according to BMI (BMI < 25, BF% ≥ 28). When overweight and obesity were assessed by WC and BMI, significant false positives (56%) were found in male soldiers (BMI ≥ 25, WC < 94). When obesity was evaluated using VFA and BMI, a certain rate of false negatives (30%) was found in female soldiers (BMI < 25, VFA ≥ 100).

Conclusion: Through an analysis we explored the limitations of BMI, and we propose an alternative method (measurement of BF%, VFA using BIA) for a more accurate assessment of body composition in this specific population.

Objectives: In the Czech Republic, employers and employees are bound by legal regulations that ensure occupational health and safety. These regulations are based on international conventions of the International Labour Organization and directives of the European Parliament and Council and have long been incorporated into Czech legislation. During the COVID-19 epidemic, emergency and crisis measures led to a limitation of occupational health examinations (OHEs) in the Czech Republic, which represented a significant disruption of the occupational health and safety system. The aim of the study was to assess the impact of these measures in order to find the right model for providing occupational health services in similar situations in the future.

Methods: The method used was a survey, with participants including representatives of employers, state organizations, and employees (trade unions).

Results: Participants from all three groups showed differing views on limiting OHEs during emergencies. While representatives of public administration and employers were generally open to postponing or adjusting pre-employment or periodic OHEs for non-hazardous work, the majority consistently opposed any limitation of OHEs for hazardous work. Statistical differences were observed particularly in attitudes toward future regulation of OHEs during epidemics.

Conclusions: The dominant conclusion of the survey is a strong recommendation against limiting initial occupational health examinations for jobs with occupational risks and in high-risk work categories.

Objectives: The aim of the study was to describe alcohol consumption and its changes in the Czech Republic during the period of governmental restrictions related to the COVID-19 pandemic. To this goal, an overview of the governmental measures that may have affected alcohol consumption was compiled from various sources (mostly media reports).

Methods: The paper analyses three surveys where the group from Charles University, Prague, participated in design and execution: the European Study Group on Alcohol use and COVID-19 (ESAC) convenience online survey that (in Czechia) took place at the onset of the COVID-19 pandemic in Europe, in April through June 2020 (n = 1,434), a computer-assisted web interviews (CAWI) survey carried out in November 2021 (n = 790), and another CAWI survey carried out in November 2022 (n = 1,738). These are complemented by a brief overview of official data on alcohol sales between 2019 and 2021 in Czechia from two sources, Ministry of Finance of the Czech Republic and the Nielsen IQ market research company.

Results: Changes in alcohol use appeared to be distributed among the population unequally, when the pandemic influenced different population groups in a different way. In all three surveys, the majority of respondents reported no change in their drinking frequency or quantity. Decreases in alcohol use were more prevalent than increases. Most pronounced changes were detected in at-risk drinkers, who have increased their alcohol use. Official revenue data suggest a small reduction in total alcohol sales in 2019-2021.

Conclusions: Our research results do not support the hypothesis that substantial and unexpected social and economic changes caused by the COVID-19 pandemic, along with corresponding measures, acted as stressors that would have caused the majority of people in Czechia changing their behaviour related to alcohol use; however, high-risk users increased their consumption.

Objectives: Nanotechnology is a fast-growing field in both science and industry. However, experimental studies brought warning data concerning the negative effect of engineered nanoparticle exposure leading to oxidative stress, inflammation, decreased immune cell viability, and genotoxicity. The consequences of human exposure may appear with decades of latency. Therefore, more data is needed to identify the hazardous effects of nanoparticles. Exposure should be under control and biomarkers of effect are urgently searched.

Methods: Exposures of researchers working with nanocomposites were measured in yearly intervals for 5 years and biomarkers of oxidative stress and/or antioxidant capacity were analysed. Exposure to aerosols with nanoparticles was measured repeatedly using online and offline instruments during both the machining of geopolymer samples with epoxide resin and nanoSiO₂ filler and metal surface welding. The levels of biomarkers of oxidation of lipids, nucleic acids and proteins were analysed in exhaled breath condensate (EBC) of researchers and controls in 2016-2018. In 2019 and 2020, glutathione was measured in plasma to assess their antioxidant status. The trends in both exposure and EBC biomarkers' levels were analysed.

Results: On average, 21 researchers were examined yearly (aged 40 ± 5 years, exposure 14 ± 3 years). After 5 years, the mean mass concentration dropped from 0.921 to 0.563 mg/m³ and mean total number of particle concentrations from 146,106 to 17,621/cm³. The majority of biomarkers of oxidation of lipids, proteins and nucleic acids decreased (p < 0.05) during repeated measurements from the highest levels being mostly found in 2016. Glutathione in plasma in 2019-2020 was elevated (p < 0.01) as compared to controls.

Conclusions: The adaptation of long-term exposed researchers may give a plausible explanation. However, to our meaning, the precautionary principle and higher attention of the employers to the potential risk of nanoparticles by reducing nanoparticles exposure by almost one order of magnitude played the key role.

Objectives: Millions of children suffer from the harmful effects of tobacco smoking. The aim of this study was to investigate the health perceptions of preschool paediatric patient's parents and their beliefs and attitudes towards third-hand smoke.

Methods: This cross-sectional study was conducted with the parents of pre-school paediatric patients. A questionnaire including the socio-demographic information form, the Beliefs About Third-Hand Smoke (BATHS-T) scale and the Perception of Health Scale (PHS) were applied to the participants.

Results: Of the 500 parents participating in the study, 74.6% were mothers. Among participants 440 (88.0%) stated that they had never heard the term third-hand smoke (THS). The mean BATHS-T score of the mothers (39.20 ± 5.79) was higher than the mean BATHS-T score of the fathers (36.94 ± 5.85) (p < 0.001). Regarding tobacco use, 10.5% of mothers and 49.6% of fathers were smokers (p < 0.001). PHS total scores were higher in those who were aware of THS (52.95 ± 7.15) compared to those who had never heard of THS (49.66 ± 6.99) (p = 0.001). Unfortunately, 17% of the children were exposed to tobacco smoke indoors in spite of tobacco bans.

Conclusions: In this study, although general awareness of THS was low, it was found to be associated with health perceptions. Parents should be informed about THS to protect their children from exposure and to convince the smokers to quit.

Objectives: Hepatitis C virus (HCV) infection remains a significant public health concern despite the introduction of direct acting antiviral agents. To reach the World Health Organization (WHO) goal of eliminating viral hepatitis as a public health threat by 2030, adequate screening strategies and early diagnosis are crucial. This study aimed to determine the prevalence of HCV infection in an Austrian cohort and assess the feasibility of incorporating HCV screening into colorectal screening programmes.

Methods: The study enrolled 1,894 asymptomatic individuals during a colorectal screening programme with a mean age of 57 (± 7 years) years. Sera of the participants were screened for HCV-specific antibodies, and blood samples of individuals with detectable HCV-specific antibodies were tested by the polymerase chain reaction (PCR) to confirm a chronic HCV infection. Furthermore, we evaluated the characteristics of these individuals including their anthropometrics, biomarkers, and liver-specific information such as those obtained with a fibroscan.

Results: We found that 14 (0.74%) of the participants had detectable levels of HCV-specific antibodies, with 6 (0.32%) individuals being newly diagnosed with a chronic HCV infection. One of the 6 patients showed signs of liver cirrhosis. The newly diagnosed individuals included 4 cases of HCV genotype 1a and 2 cases of 1b.

Conclusion: Our study highlights the importance of screening for HCV infection in asymptomatic individuals, not only for those at risk of HCV exposure or with elevated liver enzymes. Incorporating HCV screening into colorectal screening programmes could be an effective strategy for increasing the rate of HCV diagnosis, thereby improving public health outcomes. Further investigation is needed regarding cost-effectiveness and strategies to reach individuals who have no access to screening programmes or do not adhere to regular preventive screenings.

Objectives: The General University Hospital in Prague (GUH) is one of the largest hospitals in the Czech Republic. The prevalence of smoking among hospital staff is monitored as part of its Health Promoting Hospitals (HPH) network membership.

Methods: This study employed a cross-sectional design, utilizing anonymous questionnaires distributed to all hospital employees in the years 2012 and 2023 through the hospital's electronic system (response rates 25% and 28%, respectively). Data were analysed using chi-square tests to compare smoking prevalence across time and among subgroups based on profession, sex and age group.

Results: The total prevalence of smoking decreased from 38.4% in 2012 to 14.5% in 2023. Among all doctors, the rates fell from 15.86% to 6.75% (p < 0.001). For male doctors, the figures changed from 17.05% to 9.27% (p = 0.012), while for female doctors, the rates decreased from 15.22% to 5.24% (p = 0.001). Among nurses, the smoking prevalence declined from 44.59% to 17.64% (p < 0.001).

Conclusion: The statistically significant reduction in smoking rates (p < 0.05) among both doctors and nurses is encouraging; however, there remains room for improvement. An increase in the use of other tobacco products was observed, particularly among nurses.