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Biomedical subjects

M Rekart

Publications and source records attributed to M Rekart.

7 recordsLinked to original sources
PubMed1999

Use of incentives to increase compliance for TB screening in a population of intravenous drug users. Vancouver Injection Drug Use Study Group.

SETTING: Intravenous drug users (IDUs) represent a high risk group for dual human immunodeficiency virus (HIV) and tuberculosis (TB) infection. Screening with TB skin testing has therefore been suggested in this group. Subjects' compliance for returning to have TB skin test results read is a major problem. In the setting of a needle exchange program we evaluated the role of financial incentives to increase compliance. METHODS: We evaluated the role of giving a small financial incentive of Can $5 to subjects if they returned to have their purified protein derivative (PPD) skin test read. IDUs who had previously been skin-tested were compared with IDUs drawn from a similar population who, prospectively, were offered a financial incentive. RESULTS: During the initial period 558 subjects were evaluated and no incentive was offered. During the second phase of the study 549 IDUs were assessed but were also offered Can $5 if they returned to have their skin test read. Use of incentives increased compliance from 43% to 78% (P = 0.001). During the same period three active cases of TB were also diagnosed. CONCLUSIONS: We suggest that use of financial incentives can increase the return of IDUs to have their skin tests read. Further studies are required to assess the efficacy of follow-up interventions, especially the use of isoniazid chemoprophylaxis.

Adult↗
PubMed1997

Social determinants predict needle-sharing behaviour among injection drug users in Vancouver, Canada.

Despite the fact that needle exchange was introduced in Vancouver as early as 1988, needle sharing remains common. An analysis was conducted to identify determinants of borrowing used needles among subjects participating in a case-control study. IDUs had a documented HIV seroconversion after 1 January, 1994 (n = 89), or repeatedly tested HIV-seronegative after this date (n = 192). Interviewer-administered questionnaires focused on drug use, sexual behaviours, source of needles and depression. Subjects were asked if they had "ever been forced to have sex" as a child, youth or adult. Logistic regression identified determinants of borrowing needles. After controlling for HIV serostatus, factors independently associated with borrowing were injecting > 4 times/day, polydrug use, and ever experiencing non-consensual sex (AOR = 3.4, 95% CI: 1.8, 6.5). Depression was associated with borrowing, although not independently so. Homosexual activity was independently associated with borrowing among males, whereas living with a sexual partner was an independent predictor for females. Access or barriers to clean needle use were not associated with borrowing. Social determinants, particularly a history of sexual abuse, are among the most significant predictors of needle borrowing among Vancouver's IDUs. Early identification of these factors should be a component of HIV prevention programmes.

Adult↗
PubMed1995

Accuracy of a saliva test for HIV antibody.

The accuracy of a saliva collection and testing protocol for determination of HIV-1 antibody status was assessed under realistic field conditions. The 1,256 study participants came from two lower-prevalence settings--a self-referral testing clinic (478) and a street-based outreach program (431)--and two high-prevalence clinics--an HIV/AIDS treatment clinic (337) and a hemophilia clinic (10). Saliva was collected using the Omni-Sal collection device and was tested by technicians blind to serum status using a modified protocol that employed the Recombigen HIV-1 EIA. Serum was tested using standard methods. A single saliva enzyme immunoassay (EIA) correctly identified 358 of 368 seropositive individuals, for a sensitivity of 97.3% (95% CI: 95.1%-98.7), and 888 of 888 seronegative individuals, for a specificity of 100% (95% CI: 99.6-100). Confirmation of saliva EIA positives with a repeat saliva EIA and an in-house saliva radioimmunoprecipitation assay resulted in a substantial drop in sensitivity to 85.3% (95% CI: 81.0-89.0). We conclude that a single saliva EIA using the modified test protocol described is sufficiently accurate for surveillance purposes, but we do not recommend it for diagnostic purposes or screening.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Prevalence of hemagglutination inhibition antibody to current strains of the H3N2 and H1N1 subtypes of influenza A virus in sera collected from the elderly in 1976.

Sera were collected in 1976 from 182 individuals born between 1876-1935, who included patients in a large local nursing home in Orange County, California, and patients and staff at the University of California, Irvine Medical Center. Sera were treated with receptor-destroying enzyme and assayed for hemagglutination inhibition (HI) antibody to recent strains of influenza A virus. The antigens tested were: A/Victoria/3/76 and A/Texas/1/77 for subtype H3N2; A/New Jersey/8/76, A/X53 and A/Swine/1976 for the A/swine influenza virus-like strains of subtype H1N1; and A/Brazil/11/78, A/Fort Monmouth/1/47 and A/Francis Warren/1/50 for the A/Fort Monmouth/47 virus-like strains of subtype H1N1. For individuals grouped by five- and 10-year intervals of the year of birth, the geometric mean and standard error for HI antibody to each antigen were calculated and plotted vs. date of birth. The results indicate that for a majority of individuals born between 1876-1900, the level of HI antibody would be protective against H3N2 but not against the strains of H1N1. In addition, a majority of individuals born between 1900-1925 had levels of antibody that should be protective against both H3N2 and the A/swine influenza virus-like strains of H1N1 but not against the A/Fort Monmouth/47 virus-like strains of H1N1. These findings could be important when deciding on the antigenic composition of vaccines to be used in those age groups that are most vulnerable to the complications of influenza. In addition, data were obtained that suggest that the A/Fort Monmouth/47 virus-like strains of H1N1 recycle in 35-40 years rather than in 65-70 years as has been demonstrated previously for H2N2 and H3N2.

Aged↗