Karolin Toompere

Background: While generalized STI prevention guidelines exist, individuals present with diverse interconnecting risk behaviors and needs. This cross-sectional study used latent class analysis to identify distinct behavioural profiles among men and women undergoing STI testing and to examine their potential implications for STI prevention. Methods: Data was collected by questionnaire from 1171 individuals seeking STI testing at the North Estonia Medical Centre between August 2022 and October 2023. Latent class analysis was applied to identify subgroups based on eight relevant STI risk variables. Separate models were fitted to men and women. Results: We propose three latent classes for both sexes. Among men, three classes were identified: “multiple partners; elevated behavioural risk” (62.4%); “predominantly monogamous; fewer behavioural risk indicators” (21.9%); and, “multiple partners; previous STI history; concentrated co-occurring risk” (15.7%). Women were categorised as follows: “new sexual partners; inconsistent condom use” (41.6%); “multiple partners; previous STI history; concentrated behavioural risk” (30.2%); and, “predominantly monogamous; possible partner-related exposure” (28.2%). The identified profiles demonstrated heterogeneity in sexual behaviour, condom use, prior STI history, and substance use across STI clinic attendees. Conclusions: The identified behavioural profiles highlight how co-occurring risk factors cluster within STI clinic populations and may help contextualise prevention discussions alongside individualized clinical assessment. These findings may support prevention discussions addressing partner communication, condom use, substance use, IPV awareness, and partner notification.

Introduction: Atherosclerotic cardiovascular disease (ASCVD) continues to be a leading cause of preventable death globally. Polygenic risk scores (PRS) offer a way to detect individuals at higher relative risk of developing ASCVD, but they have not yet been incorporated into routine clinical practice. Pragmatic trials offer a way to evaluate the integration of PRS into cardiovascular disease prevention in primary care, allowing for a more accurate assessment of their effectiveness in everyday clinical practice. Methods and analysis: This trial evaluates the effectiveness of preventive statin treatment on reducing the incidence of cardiovascular events and death over 5 years in women (aged 55–80) and men (aged 45–80) with a high coronary artery disease PRS. This is a pragmatic, multicentre, open-label, parallel group, randomised clinical trial with a 1:1 allocation ratio to intervention (n=1350), receiving preventive rosuvastatin 20 mg treatment or control (n=1350), receiving current standard of care. Following the intention-to-treat principle, all randomised participants are analysed according to their allocated group, with the primary outcome defined as time to first major adverse cardiovascular event, comprising ischaemic heart disease, stroke or transient ischaemia, peripheral vascular occlusion and stenosis, revascularisation or cardiovascular death. Ethics and dissemination: This trial has received ethical approval from the Estonian Committee on Bioethics and Human Research (13.06.2024 nr 1.1-12/1531) and the Estonian Ethics Committee for Medicinal Products (19.12.2024 nr RKU-4/92). Trial registration number: NCT06820086 .

Norovirus (NoV) is the leading cause of acute gastroenteritis (AGE) in many countries that have introduced universal rotavirus mass vaccination. This is the first study to report data on NoV strains in Estonia. We recruited 2249 children aged 0–18 years hospitalized for AGE in Estonian hospitals from February 1, 2015 to August 31, 2016. Norovirus gastroenteritis (NoVGE) was diagnosed in 14.5% (n = 325) cases. Stool sample for RNA extraction and genotyping was available in 86% (n = 280) of NoVGE cases (2015, n = 91; 2016, n = 189). Dominant capsid types detected in 75% (n = 210) samples were, GII.4 (63.8%, n = 134), GII.3 (15.2%, n = 32), GII.17 (6.7%, n = 14), and GII.6 (5.2%, n = 11). Prevailing RNA polymerase types found in 77% (n = 215) samples were GII.P31 (51.1%, n = 110), GII.P21 (17.7%, n = 38), GII.P4 (11.2%, n = 24), and GII.P7 (6.5%, n = 14). Both regions were typeable for 67% (n = 189) of samples. Most prevalent strains were GII.4Sydney_2012[P31] (48.7%, n = 92), GII.3[P21] (15.3%, n = 29), GII.4Sydney_2012[P4] (5.8%, n = 11) and GII.17[P17] (5.8%, n = 11). Simpson's diversity index showed a significant difference between the age groups 1–4 and 5–9 years: D 0.64 (95% confidence interval [CI]: 0.55–0.73) versus 0.83 (95% CI: 0.81–0.86), respectively (p = 0.03). An accurate understanding of NoV strain diversity is important for control and preventive measures, especially in the postrotavirus vaccine era.