Jerry E. Ongerth

Viral hepatitis is a global health care challenge due to its worldwide distribution, chronic persistence, complications, and high prevalence with unchecked conditions in areas like sub-Saharan Africa. A high proportion of asymptomatic infections allows serious complications and poses infection risk to destination populations. This study aimed to determine the prevalence of both HBV and HCV among 3248 migrants from different parts of sub-Saharan Africa newly arrived at Kufra, Libya, a remote agricultural North African city. All these migrants were required by the Libyan authorities to undergo a complete medical check-up for different purposes such as joining new jobs, and obtaining licenses for trade and commerce. UAT sera from 3248 migrants, aged 18–53 years, attending the Al Kufra city hospital from January 01 to December 31, 2019, were screened for HBsAg and anti-HCV antibody by rapid tests and positive samples were further tested by ELISA method. The results showed that 761/3248 (23.4%) of the migrants were positive for HBV and 1014/3248 (31.2%) were positive for HCV. Migrants from sub-Saharan Africa carry high rates of HBV and HCV infection. This suggests the importance of increased attention to actions to deal with findings among positive migrants, and for awareness about risks of transmission to the local population. Study results indicate the value of routine migrant monitoring, the need for awareness in destination country health authorities, and the potential for impact on migrant destination populations.

Background Hepatitis B and C virus infections are serious blood borne diseases with global health concern particularly in developing countries. The association between survey participant’s knowledge, attitude, and practices (KAP) about HBV and HCV infection is rarely studied, particularly among migrants seeking resettlement. Libya is a main transient station for migrants northward toward Europe and the flow is increasing into Al Kufra from neighboring countries that have endemic intermediate and high HBV and HCV prevalence. The purpose of this exploratory descriptive study in Al Kufra was to assess the level of participating migrant’s KAP, regarding cause, transmission, prevention, and treatment of viral hepatitis due to HBV and HCV. Method A cross-sectional study was conducted among 674 sub-Saharan African migrants in Al Kufra, Libya from January to October 2021. Migrant’s KAP about HBV and HCV infection was assessed by interview questionnaire. Statistical and data analysis used SPSS version of 25. Results Out of 700 questionnaires distributed, 674 were returned with a response rate of 96.3%. The study population included 580 (86.1%) males, mean age of 29.6 ± 7.2 SD years. A majority, 508 (75.4%) were illiterate and elementary level, 8 2.483+.232, respectively. Positive significant linear correlations were found between knowledge-attitude (r = 0.524, p < 0.01) knowledge-practice (r = 0.123, p < 0.01) and attitude-practice (r = 0.278, p < 0.01). Ethnicity and education variables were significantly associated with mean KAP. Gender identity and marital status were both significantly associated with mean knowledge and attitude. Conclusion The migrant population from the neighboring and sub-Saharan African countries have inadequate KAP about HBV and HCV to limit infection.

Background: Viral hepatitis has become a universally established health care challenge due to its worldwide distribution chronic persistence, complications, and high prevalence with unchecked conditions in areas like sub-Saharan Africa. A high proportion of asymptomatic infections allows serious complications in patients who are infected. These asymptomatic infected people pose a serious risk for the transmission of infection to healthy population. This study aimed to detect and examine the prevalence of both HBV and HCV carriers among 3248 newly arrived migrants from different parts of sub-Saharan Africa in Al Kufra, Libya, a remote agricultural North African city. All these migrants were required by the Libyan authorities to undergo a complete medical check-up for different purposes such as joining for new jobs, and for obtaining licenses for trade and commerce. Methodology: UAT sera from 3,248 migrants, aged 18–53 years, attending the Al Kufra city hospital from January 01 to December 31, 2019, were screened for HBsAg and anti-HCV antibody by rapid tests and positive samples were further tested by ELISA method. Results: t he results showed that 761/3248 (23.4%) of the migrants were positive for HBV and 1014/3248 (31.2%) were positive for HCV. Conclusion: Migrants newly arrived from sub-Saharan African carry high rates of Hepatitis B and C infections. It is important to increase awareness about occupational health, and the risks of HBV and HCV transmission to the local population. The study results indicate the value of preemployment medical check-up and regular investigation and illustrates the importance of understanding the potential impact on migrant destination populations.

A highly efficient, selective, and sensitive method for analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in raw sewage was developed and tested to illustrate basic characteristics of the procedure. The method uses reverse transcriptase ...

The project purpose was to examine ability of a loop-mediated isothermal amplification (LAMP) assay to quantify SARS-CoV-2 in raw sewage, directly, using no preliminary sample processing for virus concentration and RNA extraction. An objective was to take advantage of extensive recently published work to facilitate process development, principally primer selection, and to use readily available off the shelf materials with conventional lab procedure and equipment. Well-developed and referenced primers for ORF1a, E, and N-gene targets were selected and applied, using commercially available synthetic RNA standards, and raw sewage from a local wastewater agency serving 650,000. County health department monitoring provided current COVID-19 data. Testing defined performance characteristics for each primer set, with significant differences between them. Specific amplification of SARS-CoV-2 RNA was observed using each of the primer sets, with E-gene and N-gene primers most effective. Positive analysis results from all raw sewage samples corresponded to calculated concentrations of virus in 5-10 μL raw sewage aliquots for 25 μL reactions. Results show that even at low reported case rates e.g. 1-10/100,000, SARS-CoV-2 is present in raw sewage at > 1-5/ μL, permitting direct LAMP-based detection. Use of RT qLAMP will facilitate wastewater-based epidemiology as an important component for COVID-19 control.

A detailed investigation was conducted into the application of an isothermal nucleic acid amplification procedure, LAMP, in conjunction with components of conventional procedure to determine ability to simplify water processing for monitoring Cryptosporidium and Giardia in surface water samples. Based on previous work demonstrating a high degree of sensitivity and selectivity of the LAMP procedure for detecting target organism DNA at low concentration in environmental media without significant interferences, this project sought to determine if LAMP primers for both organisms could be combined and applied to detect the target organisms collected from surface water samples after only minimal processing. Implementation consisted of optimizing previously described LAMPs for the SAM-1 gene of Cryptosporidium and for the EF1-α gene of Giardia ; establishing their limits of detection on both specific DNA and on small numbers of oocysts and cysts processed by freeze-thaw cycles. Based on positive results from preliminary testing, a multiplexed LAMP for both organisms was applied. The multiplex lamp was able to detect the DNA of Cryptosporidium and of Giardia from samples seeded with replicates of 1, 2, 3 and 4 oocysts and cysts, both in clean water and in surface water processed by filtration and centrifuging to pellet followed only by freeze-thaw cycles. Positive and specific amplification was observed with potential for quantification using 25 µL reactions including 8 µL template, in RT qLAMP format by LightCycler. The procedure is significantly simpler and less time consuming presenting realistically practical procedure for improvement of surface water monitoring of Cryptosporidium and Giardia , compared to the widely used USEPA Method 1623 Importance: Pathogen identification by LAMP is well established as a sensitive and highly selective procedure, insensitive to interferences, permitting specific detection of target DNA in samples containing extraneous DNA. This combination of features was shown effective for identifying numbers of Cryptosporidium oocysts and Giardia cysts as few as 1 in unseparated particle assemblages subject only to freeze thaw cycles. Although LAMP has not been widely adopted for environmental monitoring, it has been previously demonstrated for Cryptosporidium and for Giardia in water and wastewater. Also, many clinical assays have demonstrated applicability to use where facilities and skills are limited. The simplified analysis sequence offers significant time and cost saving for routine monitoring of Cryptosporidium and Giardia in surface water samples.

Measurements of Cryptosporidium and Giardia in water have been compiled from over 50 references comprising data from over 20 countries throughout Europe from Scandinavia to the Mediterranean, from the Atlantic to the Urals. Data predominantly reported after 2000 and mostly by IMS-IFA based analysis clearly demonstrate the distribution of these waterborne pathogens across all parts of the continent. The presence of these organisms at readily detectable levels in surface water used for public water supply corresponds to epidemiological evidence describing the prevalence of cryptosporidiosis and of giardiasis in all countries of Europe. Where the extent of data from individual references has permitted, cumulative frequency analysis has been used to describe typical (median) concentrations and variability (standard deviation). These estimates are presented with accompanying data from elsewhere showing the relation of occurrence levels and degrees of variation as part of a global spectrum.