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Clinical nurses have training needs related to the strategies for infection spread prevention. This study aimed to investigate the levels of importance of and performance in the various areas of care for communicable respiratory infections among clinical nurses and to determine the priority of educational needs. Hospitals in which a baseline survey could be conducted were considered, and nurses working in six hospitals that were designated as COVID-19 care centers in Korea were enrolled. The training needs for the care of patients with communicable respiratory infections were analyzed using Borich’s needs equation, and the locus for focus model. Among participants with prior COVID-19 patient care experience, according to Borich’s equation, the need score was the highest for “initial response to communicable respiratory infection”, followed by “management of aerosol-generating procedures in patients with communicable respiratory infection” and “reporting of patients with communicable respiratory infection and death of patient”. An item rated highly in both Borich’s equation and the locus for focus model among the participants with prior experience was “initial response to communicable respiratory infection”. Among participants without prior relevant experience, according to Borich’s equation, the need score was highest for “management of aerosol-generating procedures in patients with a communicable respiratory infection”, followed by “initial response to communicable respiratory infection” and “reporting of patients with communicable respiratory infection and death of patient”. None of the items were rated high in both Borich’s equation and the locus for focus model among participants without relevant prior experience.

Summary Background In 2016, the UN General Assembly set a global target of 3 million oral pre-exposure prophylaxis (PrEP) users by 2020. With this target at an end, we aimed to assess global trends in the adoption of WHO PrEP recommendations into national guidelines and numbers of PrEP users, defined as people who received oral PrEP at least once in a given year, and to estimate future trajectories of PrEP use. Methods In this global summary and forecasting study, data on adoption of WHO PrEP recommendations and numbers of PrEP users were obtained through the Global AIDS Monitoring system and WHO regional offices. Trends in these indicators for 2016–19 by region and for 2019 by country were described, including by gender and priority populations where data were available. PrEP user numbers were forecasted until 2023 by selecting countries with at least 3 years of PrEP user data as example countries in each region to represent possible future PrEP user trajectories. PrEP user growth rates observed in example countries were applied to countries in corresponding regions under different scenarios, including a COVID-19 disruption scenario with static global PrEP use in 2020. Findings By the end of 2019, 120 (67%) of 180 countries with data had adopted the WHO PrEP recommendations into national guidelines (23 in 2019 and 30 in 2018). In 2019, there were about 626 000 PrEP users across 77 countries, including 260 000 (41·6%) in the region of the Americas and 213 000 (34·0%) in the African region; this is a 69% increase from about 370 000 PrEP users across 66 countries in 2018. Without COVID-19 disruptions, 0·9–1·1 million global PrEP users were projected by the end of 2020 and 2·4–5·3 million are projected by the end of 2023. If COVID-19 disruptions resulted in no PrEP user growth in 2020, the projected number of PrEP users in 2023 is 2·1–3·0 million. Interpretation Widespread adoption of WHO PrEP recommendations coincided with a global increase in PrEP use. Although the 2020 global PrEP target will be missed, strong future growth in PrEP use is possible. New PrEP products could expand the PrEP user base, and, with greater expansion of oral PrEP, further adoption of WHO PrEP recommendations, and simplified delivery, PrEP could contribute to ending AIDS by 2030. Funding Unitaid, Bill & Melinda Gates Foundation, and WHO.

Background Comprehensive information on the incidence and duration of hepatitis C virus (HCV) infection for people who inject drugs (PWID) in Ireland is not available. We created an incidence curve of injecting drug use in Ireland and subsequently estimated incidence of hepatitis C virus (HCV) infection. Methods Anonymised data from the National Drug Treatment Reporting System (NDTRS) were used to identify all people who inject drugs (PWIDs) and who entered drug treatment for the first time between 1991 and 2014. A curve, estimating the incidence of injecting, was created to plot PWIDs by year of commencing injecting. The curve was adjusted for missing data on PWIDs in treatment and for PWIDs who were never treated. An adjustment was made to account for injectors who had never shared injecting equipment. The incidence of HCV infection and chronic infection in PWIDs was estimated by applying published rates. Results Between 1991 and 2014, 14,320 injectors were registered on NDTRS. The majority were young (median age 25 years), male (74%), lived in Dublin (73%) and injected an opiate (e.g. heroin) (94%). The estimated total number of injectors up to the end of 2014 was 16,382. An estimated 12,423 (95% CI 10,799-13,161) were infected with HCV, and 9,317 (95% CI 8,022-9,996) became chronically infected. The estimated annual number of new HCV infections among PWIDs increased steeply from the late 1970s and peaked in 1998. By 2014, almost 30% of injectors were estimated to have been infected for over 20 years. Conclusions This is the first comprehensive national estimate of the incidence of HCV in PWIDs in Ireland and will inform planning and developing appropriate health care services. Electronic supplementary material The online version of this article (doi:10.1186/s41124-017-0024-1) contains supplementary material, which is available to authorized users.

Objectives:The objectives of the study were to identify the characteristics of the patients who were commenced in a newly developed opiate substitute prescribing (OSP) programme, to determine their rate of retention and to ascertain the patients' opinions of the service. We also wished to determine rates of blood borne viruses in this population.Methods:Data were collected from three sources: the Shaftesbury Square Hospital Substitute Prescribing Database, patient charts and an anonymous user views questionnaire. We also conducted viral screening. Inclusion criteria were opiate dependence according to ICD-101for at least one year, in individuals who were 18 years of age or older. The sample comprised the first 80 patients who attended the service, who were followed up over two years.Results:A total of 44% of our original cohort remained engaged with the service two years after commencement. Of the remainder, 18% engaged with OSP elsewhere and 13% completed a successful detoxification from all opiate drug use. Factors which were associated with continuation in the programme were prescription of methadone (as compared with buprenorphine), female sex and higher doses of OSP. Patients reported high levels of satisfaction with the service. Of those who were tested for blood borne viruses, more than half were positive for hepatitis C infection.Conclusions:The response to the development of the opiate substitution programme demonstrated that there was a need in the community which had not been met in the past. Service users who attended the programme reported high levels of satisfaction.

Justificativa e Objetivos: A tuberculose (TB), doença infectocontagiosa, é atualmente um problema de saúde pública no Brasil e no mundo, integrando a Lista Nacional de Agravos de Notificação Compulsória. Devido à alta incidência verificada, a cidade de Santa Cruz do Sul configura um dos municípios prioritários no controle de notificação da doença no estado do Rio Grande do Sul. Nesse contexto, as Estratégias de Saúde da Família (ESF) são contribuintes importantes do processo de notificação, por serem cada vez mais utilizadas como portas de entrada do sistema de saúde e como pontos de controle da doença. Este estudo tem como objetivo estabelecer a prevalência da notificação dos casos de TB nas ESF em Santa Cruz do Sul. Métodos: O estudo realizado foi observacional, de caráter transversal. Foram utilizados dados dos consolidados das famílias cadastradas em 11 ESF na cidade de Santa Cruz do Sul, referentes ao ano de 2013. Resultados: O total de casos notificados foi 17, sendo que todos possuíam 15 anos ou mais de idade. O documento não especificava o sexo dos indivíduos notificados. A prevalência de tuberculose, no total de ESF analisadas, foi de 0,51/1000 pessoas cadastradas. Conclusão: A taxa elevada de casos de TB no município pode estar relacionada a um aumento na qualidade da busca ativa dos pacientes, levando a um número elevado de notificações pelas ESF. Essa taxa elevada de notificações é relevante, uma vez que atenta para a importância das ESF na elaboração e adoção de medidas preventivas.

Objective: To determine if there is an alteration in the medical relation between dental students and patients with a communicable infectious disease (PCID), compared to patients without. Study design: A questionnaire focused on points such as stress, care, formation and knowledge, when taking care of a PCID. Participants: 111 of 226 clinician students in dentistry of the Strasbourg University Hospital (HUS), France, responded. Results: The stress of students increases while treating a PCID. As students go by in their study, they seem to feel less stress in these situations. 63.1% of them are unlikely to follow the care of a PCID and only 39.6% of the students keep the same concentration on their dental procedures while treating a PCID. Dental students are respectively 47.7%, 25.2% and 16.2% to know the occupational risk of transmission for HIV, HCV and HBV following a percutaneous accident during a dental procedure. Conclusion: There is an alteration in the relationship between dental students and PCID, leading to ethical issues. Too many dental students still fear taking care of PCID while standard precautions protect them. The more informed students are about the diseases and their own protection, the more serenely they seem to handle the care. Thus, hygiene, security, microbiology and ethics have an important role to play in the formation of the next generation of dentists, and should be teached at early stages of their studies.

Prison officers' knowledge and perceptions of hepatitis B, hepatitis C and HIV were explored by conducting a cross-sectional survey in four Dublin prisons with high rates of blood borne viral infections among the inmates. Most officers (87%) reported not knowing enough about these diseases to enable them to take the necessary precautions at work. Longer serving and senior officers were less fearful and less anxious about contracting the infections. Officers who had received hepatitis B vaccination were no less worried about hepatitis B than unvaccinated colleagues. Training on blood borne viruses had little effect on prison officers' knowledge or perception of blood borne viral infections.

Malaria is a communicable infectious disease that has affected many tropical countries. Fighting malaria has been a major socio-economic problem. In spite of more than a century old fight against the infection, today we have only six highly potent scaffolds that provide therapeutic solutions for malaria. Generics of these molecules have been made available to provide healthcare support to endemic regions but the resistance to these drugs has been emerging simultaneously. Hence malaria has become a priority disease in the healthcare segment. It is observed that during the malaria infection combating stress is the primary requirement of the Plasmodium parasite. One of the molecular chaperones, namely heat-shock protein 90 (Hsp90), helps the parasite to cope with this stress response and this ultimately helps in establishing infection. Inhibition of this molecular chaperone causes stage-specific arrest in parasite growth. This chapter sheds light on the path of discovery of PfHsp90 as novel drug target for malaria and approaches for development of PfHsp90-targeted antimalarial therapy.

Mycobacterium tuberculosis is the most common communicable infectious disease worldwide and the top killer of human immunodeficiency virus (HIV)-infected people. Because of common dual HIV and M. tuberculosis infections, the emergence of multidrug-resistant M. tuberculosis strains, the lack of effective vaccination, the morbidity, and the mortality of M. tuberculosis infection are increasing sharply. Therefore, there is an urgent need for vaccine and drug development against M. tuberculosis infection. These require appropriate animal models that closely resemble human disease. To this end, we infected Chinese rhesus macaques with the M. tuberculosis H37Rv strain. Bronchoscopy was used to inoculate nine monkeys with different doses of M. tuberculosis H37Rv strain. Regardless of the M. tuberculosis dose, all monkeys were infected successfully. This was shown by clinical, laboratory, and histopathology assessments. Among nine infected monkeys, six developed acute rapid progressive tuberculosis and the remaining animals mirrored early-stage chronic disease. These data, taken together, demonstrate that Chinese rhesus macaques are highly susceptible to M. tuberculosis infection and develop similar manifestations of disease that are seen in humans. This model affords new opportunities for studies of M. tuberculosis disease pathology and therapeutics.