RESUMEN

OBJECTIVES: We sought to assess the prevalence of hepatitis B virus (HBV) seroprotection among vaccinated children in the Assiut governorate, Egypt, and assess a booster dose immune memory response among non-seroprotected children. METHODS: Using a multistage cluster sample, 566 children were recruited from three clusters: one urban and two rural. Children were aged from nine months to 16 years old. All participants received the full three doses of the compulsory HBV vaccine during infancy. Serum hepatitis B surface antigen (HBsAg), total anti-hepatitis B core (anti-HBc) antibodies, and quantitative detection of anti-HBs were measured using enzyme-linked immunosorbent assay. Repeatedly positive samples for HBsAg/anti-HBc were submitted for quantitative HBV DNA detection using real-time polymerase chain reaction. Non-seroprotective participants (anti-HBs < 10 IU/L) were given a booster dose of HBV vaccine. Two weeks later, a blood sample was taken from each child to assess an anamnestic response. RESULTS: The seroprotection rate was 53.2%, and only two children had HBV breakthrough infection (0.4%) with positive serum anti-HBc and HBV DNA. Age was the only significant predictor for non-seroprotection with an adjusted odds ratio (OR) of 3.2, 9.4, and 9.9 among children aged 5-10, 11-15, and > 15 years, respectively, compared to younger children (p < 0.001). About 85% of non-seroprotected children developed an anamnestic response after receiving the booster dose, and 84.3% of responders had a good response (3 100 IU/L). Undetectable pre-booster titer was found to be the only risk factor for non-response to booster with OR = 3.2 (p < 0.010). About 95.7% of children who were not responding to booster dose developed immune response after receiving the three doses of HBV vaccine. CONCLUSIONS: Older age of children was the only significant predictor for HBV non-seroprotection. High anamnestic response rate signifies the presence of immune memory with long-term protection despite the waning of anti-HBs over time. However, some children with pre-booster undetectable anti-HBs titers may be unable to develop anamnestic response, and a second vaccination series might be necessary for HBV protection for these children.

RESUMEN

Cadmium (Cd) is one of the environmental risk factors for bone loss. The present study included 40 sewage workers occupationally exposed to Cd. Forty nonexposed men were included as a control group. Current smokers represented 65% and 47.5% of the exposed and control groups, respectively. The study aimed to investigate the hazard of occupational Cd exposure on bone health. This was achieved through measuring serum and urinary Cd, and calcium (Ca), in addition to serum osteoprotegerin (OPG) and estrogen receptor-α gene. Results showed significant elevation in serum Cd, OPG, and urinary Ca levels in the exposed compared to the controls. Bony aches and joint pain were more prevalent among the exposed workers. Serum and urinary Cd increased in exposed smokers relative to control smokers. Also, serum OPG levels showed significant rise among exposed smoker and nonsmoker compared to control smoker and nonsmoker groups. Serum Cd level increased significantly in PP and pp genotypes in exposed workers compared to controls, while elevated levels of serum OPG was observed in PP and Pp genotypes in exposed workers relative to controls. Urinary Cd exhibited significant rise in both PP and pp genotypes in exposed workers, while Ca excretion was elevated in pp genotype only. The study reflected an association of genetic predisposition and Cd exposure in progression of osteoporosis. Further research is needed to explain the mechanisms of Cd impact on bone. The role of smoking is important and hence smoking cessation programs are essential for sewage workers.

Asunto(s)

Artralgia/epidemiología , Enfermedades Óseas/epidemiología , Cadmio/efectos adversos , Enfermedades Profesionales/epidemiología , Exposición Profesional/efectos adversos , Fumar/epidemiología , Eliminación de Residuos Líquidos , Adulto , Artralgia/genética , Artralgia/metabolismo , Enfermedades Óseas/genética , Enfermedades Óseas/metabolismo , Cadmio/sangre , Cadmio/orina , Calcio/sangre , Calcio/orina , Egipto/epidemiología , Receptor alfa de Estrógeno/genética , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/genética , Enfermedades Profesionales/metabolismo , Exposición Profesional/análisis , Osteoprotegerina/sangre , Aguas del Alcantarillado , Fumar/genética , Fumar/metabolismo

RESUMEN

OBJECTIVE: To evaluate early and long term anamnestic response to a booster dose of HBV vaccine among non-seroprotected children. SUBJECTS AND METHOD: A national community based project was carried out on 3600 children aged 9 months to 16 years, fully vaccinated during infancy. They were recruited from 6 governorates representing Egypt. It revealed that 1535 children (42.8%) had non sero-protective anti-HBs (<10 IU/L) and were HBsAg or anti-HBc negative. A challenging dose of 10 µg of mono-valent Euvax HBV vaccine was given to 1121/1535 children. Quantitative assessment of anti-HBs was performed to detect early (2-4 weeks) and long term (one year) anamnestic responses. RESULTS: Early anamnestic response developed among 967/1070 children (90.3%).Children having detectable anti-HBs (1-9 IU/L) significantly developed early anamnestic response (90%) compared to 85% with undetectable anti-HBs (<1 IU/L), P < 0.001. Multiple logistic analysis revealed that undetectable anti-HBs, living in rural residence and children aged 15-16 years were the most significant predicting risk factors for the absence of early anamnestic response (<10 IU/L), with AOR 2.7, 2.7 & 4.7 respectively. After one year, long term anamnestic response was absent among 15% of children who previously showed early response. Poor early anamnestic response and undetectable pre-booster anti-HBs were the significant predicting risk factors for absent long term anamnestic response, with AOR 18.7 & 2.7 respectively. CONCLUSION: Immunological memory for HBV vaccine outlasts the presence of anti- HBs and HBV vaccination program provides effective long term protection even in children showing waning or undetectable concentrations of anti-HBs. This signifies no need for a booster dose especially to healthy children.

Asunto(s)

Vacunas contra Hepatitis B/administración & dosificación , Vacunas contra Hepatitis B/inmunología , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Inmunización Secundaria , Vacunación , Adolescente , Niño , Preescolar , Egipto/epidemiología , Femenino , Anticuerpos contra la Hepatitis B/sangre , Anticuerpos contra la Hepatitis B/inmunología , Antígenos de Superficie de la Hepatitis B/inmunología , Humanos , Memoria Inmunológica , Lactante , Recién Nacido , Masculino

RESUMEN

BACKGROUND: Although Egypt had adopted implementation of routine infant hepatitis B virus (HBV) vaccination in 1992, its effectiveness is not evaluated on a national scale. Assessment of early and long-term seroprotection after compulsory vaccination is an important measure for monitoring the success of the vaccination program. AIM: The aim of this study was to assess HBV seroprotection and immune memory in children and adolescents who were vaccinated during infancy in Cairo Governorate. MATERIALS AND METHODS: The study was carried out in two phases. The first phase was a cross-sectional study carried out in five districts in Cairo Governorate, recruiting 819 children in the age range of 9 months to 16 years. All children had received full doses of the compulsory HBV vaccination. Serum samples were taken from each child and assessed for antibody against hepatitis B virus surface antigen (anti-HBs) titer; total antibodies against HBV core antigen, and HBV surface antigen. HBV DNA was investigated by real-time PCR for those who were HBV core antigen or HBV surface antigen positive. In the second phase, nonseroprotected children (anti-HBs <10 IU/I) received HBV booster dose. AntiHBs titer was reassessed after 4 weeks to identify anamnestic response. Individuals showing antibody concentrations ofless than 10 IU/l were then given an additional complete course of vaccination. RESULTS: Four out of 819 children had HBV breakthrough infection. The seroprotection rate was 60.7%, and was significantly higher among children aged less than 5 years compared to the older age groups and among boys compared to girls. Multivariate logistic analysis showed age as the only independent predictor of low anti-HBs titer. About 95% of nonseroprotected children developed anamnestic response postbooster. Anti-HBs geometric mean titer (GMT) increased significantly from pre-booster (13.8±16.9IU/L) compared to post-booster (307±6.0IU/L, P<0.001). Anti-HBs GMT was significantly higher among children with prebooster anti-HBs level ≥1 IU/l (424.9±4.4 IU/l) compared to children with undetectable level (178.3±8.3). CONCLUSION: Despite waning of anti-HBs over time, long-term protection still exists. The high anamnestic response rate signifies the existence of immune memory and giving a booster dose is not recommended. However, we suggest that prolonged follow up and surveillance of vaccinees immunized at an early age should be continued.

Asunto(s)

Vacunas contra Hepatitis B/uso terapéutico , Hepatitis B/prevención & control , Inmunización Secundaria/estadística & datos numéricos , Memoria Inmunológica , Adolescente , Niño , Preescolar , Estudios Transversales , Egipto/epidemiología , Femenino , Hepatitis B/epidemiología , Anticuerpos contra la Hepatitis B/análisis , Antígenos de Superficie de la Hepatitis B/análisis , Humanos , Inmunización Secundaria/normas , Lactante , Masculino , Análisis Multivariante , Vacunación/estadística & datos numéricos

RESUMEN

AIM: To assess the effectiveness of hepatitis B virus (HBV) vaccination program among fully vaccinated children. METHODS: A national community based cross-sectional study was carried out in 6 governorates representing Egypt. A total of 3600 children aged from 9 mo to 16 years who were fully vaccinated with HBV vaccine during infancy were recruited. Face to face interviews were carried out and sera were evaluated for hepatitis B surface antigen (HBsAg), anti-HBV core antibodies (total) and quantitative detection of hepatitis B surface antibody using enzyme linked immunoassays techniques. Samples positive to HBsAg/anti-HBV core antibodies were subjected to quantitative HBV-DNA detection by real time polymerase chain reaction with 3.8 IU/L detection limit. RESULTS: Sero-protection was detected among 2059 children (57.2%) with geometric mean titers 75.4 ± 3.6 IU/L compared to 3.1 ± 2.1 IU/L among non-seroprotected children. Multivariate logistic analysis revealed that older age and female gender were the significant predicting variables for having non sero-protective level, with adjusted odds ratio 3.3, 9.1 and 14.2 among children aged 5 to < 10, 10 to < 15 and ≥ 15 years respectively compared to those < 5 years and 1.1 among girls compared to boys with P < 0.01. HBsAg was positive in 0.11% and breakthrough infection was 0.36% and 0.39% depending on positivity of anti-HBc and DNA detection respectively. The prevalence of HBV infection was significantly higher among children aged ≥ 7 years (0.59%) compared to 0.07% among younger children with odds ratio equal to 8.4 (95%CI: 1.1-64.2) and P < 0.01.The prevalence was higher among girls (0.48%) than boys (0.29%) with P > 0.05. CONCLUSION: The Egyptian compulsory HBV vaccination program provides adequate protection. Occult HBV infection exists among apparently healthy vaccinated children. Adherence to infection control measures is mandatory.

RESUMEN

AIM: To study serum autoantibodies and immunoglobulin levels in cement workers. METHODS: Blood samples for numerous antibodies were collected from 30 silicosis and 42 non-silicosis cement workers. Spirometry of the silicosis workers was also studied. RESULTS: Serum IgA mean level showed a significant increase in the silicosis group compared to the non-silicosis group. Elevated titers of serum anti-smooth muscle antibodies (ASMA) and anti-glomerular basement membrane (anti-GBM) were detected only in the silicosis group. The duration of exposure showed a significant positive correlation with serum IgA, ASMA and anti-GBM, and a significant negative correlation with serum IgG. Serum anti-GBM showed a significant positive correlation with IgG while the inverse titer (1/titer) of anti-GBM showed highly significant positive correlations with serum IgA and ASMA. The percent predicted FVC was the ventilatory function most closely associated with immunological parameters in silicosis group. CONCLUSION: Serum IgA, ASMA, and anti-GBM are the principal immunologic parameters associated with silicosis.

Asunto(s)

Anticuerpos/sangre , Exposición por Inhalación/efectos adversos , Enfermedades Profesionales/sangre , Exposición Profesional/efectos adversos , Dióxido de Silicio/toxicidad , Silicosis/sangre , Contaminantes Ocupacionales del Aire/toxicidad , Autoanticuerpos/sangre , Materiales de Construcción/toxicidad , Estudios Transversales , Polvo , Egipto , Humanos , Inmunoglobulina A/sangre , Masculino , Industria Manufacturera , Persona de Mediana Edad , Músculo Liso/inmunología , Silicosis/diagnóstico , Espirometría

RESUMEN

Aluminum (Al) metal is considered one of the most benign industrial metals. Although the harmful effects of Al on respiratory health have been denied by some studies, others reported its noxious effect on the lung through spirometric measurements. This work aimed at studying the effect of Al fumes on pulmonary functions of occupationally exposed workers. It investigated the possible relationship between inhalation exposure to Al fumes and levels of C-reactive protein (CRP) and alpha-1-antitrypsin (A1AT). The study participants comprised a group of 56 male Al workers with a mean duration of occupational exposure of 10.1 ± 9.5 years and 52 male participants who were not exposed to Al fumes as the control group. All participants filled a questionnaire, underwent full clinical examination and their spirometric pulmonary functions were measured. Blood samples were collected for the determination of serum CRP and A1AT and urine samples for measuring Al. Results revealed that urinary Al (UAl) was significantly higher in Al workers compared with controls (p < 0.05). However, spirometric measures showed no significant difference between the exposed group and the controls. A1AT was significantly lowered in Al workers compared with the controls (p < 0.000). Serum CRP was positive in only two (3.6%) of the exposed workers. Smokers of both groups (exposed and controls) showed significantly higher UAl and lower A1AT compared with nonsmokers. There was only significant negative correlation between the duration of exposure and A1AT (p < 0.05). There was a positive significant correlation between smoking index (SI) and UAl. There was also significant negative correlation between SI and some of the pulmonary function tests namely the percentage of predicted forced vital capacity, forced expiratory volume in the first second and peak expiratory flow in the exposed group. Those correlations point to the importance of the combined effect of smoking and Al exposure on the impairment of lung functions. The study recommends the determination of CRP and A1AT in Al-exposed workers. It is expected that those parameters may undergo changes before reduction in pulmonary functions takes place.

Asunto(s)

Contaminantes Ocupacionales del Aire/toxicidad , Aluminio/toxicidad , Exposición por Inhalación/análisis , Exposición Profesional/análisis , Ventilación Pulmonar/efectos de los fármacos , Adulto , Proteína C-Reactiva/análisis , Estudios de Casos y Controles , Estudios Transversales , Humanos , Pulmón/efectos de los fármacos , Masculino , Persona de Mediana Edad , Fumar/efectos adversos , Espirometría/métodos

RESUMEN

This study aims to determine the microbiological quality of particulate matter (PM) in an urban area in Jeddah, Saudi Arabia, during December 2012 to April 2013. This was achieved by the determination of airborne bacteria, fungi, and actinobacteria associated PM10 and PM2.5, as well as their relationships with gaseous pollutants, O3, SO2 and NO2, and meteorological factors (T°C, RH% and Ws). High volume samplers with PM10 and PM2.5 selective sizes, and glass fiber filters were used to collect PM10 and PM2.5, respectively. The filters were suspended in buffer phosphate and aliquots were spread plated onto the surfaces of trypticase soy agar, malt extract agar, and starch casein agar media for counting of bacteria, fungi and actinobacteria-associated PM, respectively. PM10 and PM2.5 concentrations averaged 159.9 µg/m(3) and 60 µg/m(3), respectively, with the ratio of PM2.5/PM10 averaged ~0.4. The concentrations of O3, SO2 and NO2 averaged 35.73 µg/m(3), 38.1µg/m(3) and 52.5 µg/m(3), respectively. Fungi and actinobacteria associated PM were found in lower concentrations than bacteria. The sum of microbial loads was higher in PM10 than PM2.5, however a significant correlation (r=0.57, P ≤ 0.05) was found between the sum of microbial loads associated PM10 and PM2.5. Aspergillus fumigatus and Aspergillus niger were the common fungal types associated PM. Temperature significantly correlated with both PM10 (r=0.44), and PM2.5 (r=0.5). Significant negative correlations were found between O3 and PM2.5 (r=-0.47), and between SO2 with PM10 (r=-0.48). Wind speed positively correlated with airborne microorganisms associated PM. The regression model showed that the inverse PM2.5 concentration (1/PM2.5) was a significant determinant of fungal count associated PM. Chemical processes and environmental factors could affect properties of PM and in turn its biological quality.

Asunto(s)

Microbiología del Aire , Contaminantes Atmosféricos/análisis , Bacterias/clasificación , Monitoreo del Ambiente , Hongos/clasificación , Material Particulado/análisis , Bacterias/crecimiento & desarrollo , Hongos/crecimiento & desarrollo , Arabia Saudita , Viento

RESUMEN

The aim of the present study was to find out the potential impact of occupational exposure to mixtures of organic solvents on liver function tests. Serum bile acid (BA) was evaluated as a marker of early hepatic derangement and compared to routine liver function tests. The study included two comparable groups: 57 male workers exposed to organic solvents from a paints factory and 59 administrative male controls. Occupational and medical data and serum analysis for liver function parameters (BAs, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), total and direct bilirubin) were obtained. Bile acids showed significantly elevated mean levels in the exposed workers compared to the controls (50.2 ± 47.9 and 5.4 ± 2.7 µmol/L, respectively, p < 0.01). Bile acids were elevated in almost all exposed workers (87.7%) but in none of the controls. Bile acids had significant positive correlation with duration of exposure to organic solvents and lifetime hydrocarbon exposure score (HES) (p < 0.01 and p < 0.05, respectively). All other liver function tests exhibited normal mean levels and did not show statistically significant differences between both groups. The performance of BA versus combined liver enzymes is evaluated using receiver-operating characteristic (ROC) curve and likelihood ratios. The area under the curve was significantly high (0.687 > 0.5, p = 0.012) and had optimal decision level (8 µmol/L). Serum BA can be recommended as a screening test for exposure to organic solvents. It can be suggested for follow-up every 1-2 years or accordingly.

Asunto(s)

Ácidos y Sales Biliares/sangre , Exposición Profesional/estadística & datos numéricos , Pintura/efectos adversos , Adulto , Estudios de Casos y Controles , Humanos , Pruebas de Función Hepática , Masculino , Industria Manufacturera , Tamizaje Masivo/métodos , Exposición Profesional/efectos adversos

RESUMEN

BACKGROUND: In a study of textile workers, the effects of occupational exposure to cotton dust-with possible exposure to aflatoxin-on levels of some liver tumor biomarkers were explored. METHODS: The study included 58 textile workers and 64 controls. Skin prick tests, urinary Aflatoxin M1 (AFM1) and the tumor biomarkers (alpha-fetoprotein (AFP), alpha-L-fucosidase (AFU), insulin-like growth factors (IGF-1) were measured. RESULTS: Positive reactants to Aspergillus niger, Aspergillus flavus, and cotton dust were significantly higher in pre-spinning (14.3%, 28.6%, and 28.6%, respectively) and spinning workers (25.0%, 33.3%, and 25.0%, respectively) compared to controls (4.7%, 7.8%, and 3.1%, respectively). Urinary AFM1 was significantly higher in the pre-spinning, spinning, and weaving groups compared to controls (554.2 ± 346.2 pg/ml, 459.1 ± 781.6 pg/ml, 296.5 ± 336.5 pg/ml and 68.5 ± 136.8 pg/ml, respectively). We found a highly significant increase in levels of serum AFU in textile workers, compared to the control group. CONCLUSION: Exposure to fungi had a significant effect on AFM1 measurements and tumor biomarkers, especially in allergic textile workers (with the exception of the arginase biomarker), though results were generally within normal limits.

Asunto(s)

Aflatoxinas/efectos adversos , Contaminantes Ocupacionales del Aire/efectos adversos , Biomarcadores de Tumor/sangre , Neoplasias Hepáticas/sangre , Enfermedades Profesionales/sangre , Industria Textil , Adulto , Análisis de Varianza , Fibra de Algodón , Estudios Transversales , Egipto , Femenino , Humanos , Factor I del Crecimiento Similar a la Insulina/análisis , Factor I del Crecimiento Similar a la Insulina/metabolismo , Neoplasias Hepáticas/epidemiología , Neoplasias Hepáticas/etiología , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/etiología , Exposición Profesional/efectos adversos , Medición de Riesgo , Pruebas Cutáneas , Estadísticas no Paramétricas , alfa-Fetoproteínas/análisis , alfa-Fetoproteínas/metabolismo , alfa-L-Fucosidasa/sangre

RESUMEN

The present study was conducted to detect placental and breast milk (BM) transfer of organochlorine pesticides (OCPs) between biological compartments in healthy lactating mothers. The study explores the effect of parity, breast-feeding and urban/rural residence on body burden of OCP residues. The study included 38 healthy participants submitted to cesarean delivery. Sociodemographic data and specimens of maternal and umbilical sera, adipose tissue (Adp T) and BM were collected. Specimens were analyzed to detect OCP residues. The lindane in BM, o,p'-dichlorodiphenyldichloroethane (DDD) in maternal serum (MS) and total dichlorodiphenyltrichloroethane (DDT) and o,p'-dichlorodiphenyldichloroethylene in umbilical serum were the only detected residues in significantly higher frequencies and/or means in the primigravidae than multigravidae. There was a high risk of detecting o,p'-DDD (odds ratio = 8.3) in umbilical serum of the mothers with o,p'-DDD detected in the MS. Total DDT was detected in about 65% of specimens of BM, MS and Adp T and in about 40% of the umbilical serum specimens. There was only a significant positive correlation between total DDT residues in the BM and Adp T. Total DDT residues in umbilical serum and Adp T were significantly higher in the urban than in the rural mothers. The detection of some OCPs in maternal biological compartments suggests their potential placental and BM transfer to her child during pregnancy and lactation, respectively. Furthermore, it might reflect the persistence or recent use of these pesticides in the environment.

Asunto(s)

Hidrocarburos Clorados/análisis , Leche Humana/química , Residuos de Plaguicidas/análisis , Plaguicidas/análisis , Tejido Adiposo/química , Adulto , Carga Corporal (Radioterapia) , Estudios Transversales , Contaminantes Ambientales/análisis , Contaminantes Ambientales/sangre , Femenino , Sangre Fetal/química , Humanos , Hidrocarburos Clorados/sangre , Oportunidad Relativa , Residuos de Plaguicidas/sangre , Plaguicidas/sangre , Población Rural , Población Urbana