3^rd International Conference on Epidemiology & Public Health August 04-06, 2015 Valencia, Spain

Aisling Semple graduated from medicine in the National University of Ireland Galway in 2012. She is specialising in paediatrics and has recently achieved membership to the Royal College of Paediatricians in Ireland. She has a special interest in MRSA in the neonatal population and has presented and published, both nationally and internationally on the topic.

Background: Nosocomially acquired methicillin- resistant Staphylococcus aureus (MRSA) is a significant cause of morbidity and mortality in the neonatal intensive care unit (NICU). Current national guidelines recommend active surveillance in the NICU by screening all infants for MRSA carriage on admission to NICU and weekly thereafter, with isolation and decolonisation of affected infants. Following a 4-year period of endemic MRSA despite multiple attempts with standard infection control interventions, an endemic strain MRSA was finally eradicated from a tertiary unit NICU following complete unit refurbishment. Method: Surveillance, colonisation and infection data for a 4-year period pre and 3-year period post NICU refurbishment are described. Clinical and microbiological data were collected on all MRSA colonised and infected infants between 2008 and 2014. Microbiological and molecular typing data are available for all MRSA isolates. All eradication strategies are described. Results: During the 4-year pre-refurbishment period, following routine surveillance, 68 infants were documented to be colonised with MRSA. Almost all strains were from epidemic MRSA 15 clone, EMRSA-15 (Sequence Type 22 Staphylococcal Cassette Chromosome mec IV). Standard infection control eradication strategies including isolation, decontamination, staff education and staff screening failed to impact on colonisation rates. During the 3-year period since complete refurbishment and redesign of the NICU, there have been only 8 cases of MRSA colonised infants in the NICU. Four were already colonised on admission to NICU and clearly not NICU acquired; cross-transmission from one of these cases to one other infant occurred. There were three further, temporally unrelated, sporadic cases of MRSA colonisation. All of the post-refurbishment MRSA isolates were distinct from the previous endemic NICU strain based on Staphylococcal Protein A (spa) typing and pulsed-field gel electrophoresis (PFGE). Conclusion Infrastructure and overcrowding in the NICU contributed significantly to the failure to eradicate endemic MRSA in this setting. Successful eradication was ultimately achieved through complete unit refurbishment.

Pornpun Watcharavitoon has been working as a lecturer at School of Occupational Health and Safety, Institute of Medicine, Suranaree University of Technology, and currently studying in the field of Occupational Medicine and Industrial Hygiene, National Taiwan University (NTU).

The aim of this study is to estimate the expected number of mortality cases for Bangkok residential expose to outdoor air pollution. Road traffic is a significant source of air pollution in Bangkok. Using Bangkok air quality data were collected by Pollution Control Department, BKK, during 1996 - 2009 to calculate current annual mean concentration of PM10 (μg/m3) and mortality rate of disease group from the Ministry of Public Health, Thailand. The expected annual number of deaths from outdoor air pollution can be determined by using the quantitative assessment of the health impact of outdoor air pollution from inhalation exposure (Ostro 2004:WHO, 2004). For short-term exposure to PM10, The annual number of deaths from outdoor air pollution of all-cause mortality at all age, and Respiratory mortality at age< 5 years, in roadside areas were higher than that in residential areas 1,799 deaths/year (95% CI, 1,357 – 2,235), 95 deaths/year (95% CI, 20 -164), and 1,285 deaths/ year (95% CI, 968 – 1,599), 68 deaths/year (95% CI, 14 - 120), respectively. Much more benefits would be gained for long-term exposure to PM2.5, The annual number of deaths from outdoor air pollution of Cardiopulmonary mortality at age> 30 years, and Lung cancer at age> 30 years, in roadside areas were higher than that in residential areas 2,385 deaths/year (95% CI, 966 – 3,509), 200 deaths/year (95% CI, 87 - 280), and 2167 deaths/year (95% CI, 868 – 3,222), 183 deaths/year (95% CI, 78 - 260), respectively. Public exposure to particulate matter is associated with premature mortality. Estimates of the burden of disease attributed to outdoor air pollution can help fix the priority for controlling air pollution by Government policy not only to put control device on vehicle and improved standard combustion technology including fuel quality but also to design land use for develop public transport system to protect human health.

Andrea Serafini MD graduated in 2011 at the University of Siena. He is attending the Postgraduate School of Public Health in Siena. During his career he participated at the European Public Health Association (EUPHA) Conferences in 2013 (Brussels) and in 2014 (Glasgow) with 1 pitch presentation and 2 oral presentations. In 2013 he attended a course in Basel about ARCGis in Public Health.

Background:The literature demonstrated that stethoscope, the most used medical device, can be more contaminated than hands. There is a big concern on disinfecting the health professional hands, contrarily, lack of time and attention make the stethoscope disinfection quite rare, although it should be disinfected before every visit. This pilot study, evaluates an innovative solution for stethoscopes’membrane disinfection in a real environment. Methods:An ultraviolet (UV) device, was used for disinfecting the membrane of the stethoscope head. When the device couples the stethoscope head, an UV-C LED (wavelength 280 nm) automatically lights up to disinfect the stethoscope membrane. The device’s effectiveness was tested on a stethoscope used on 10 volunteers. The stethoscope was used for hearing the heart and respiratory sounds twice. The first time the stethoscope was treated with the UV device which irradiated its membrane for 5 minutes and then it was placed on Petri dishes to detect Colony Forming Units (CFU) at 36°C after 24hours; the second time, the stethoscope membrane, was directly placed on petri dishes for obtaining matching controls. Petri dishes of treated/not treated stethoscope were compared using the Wilcoxon signed-rank test. Statistical significance was set at 95%. Results:5 out of 10 cases had a low bacterial contamination on control petri dishes (CFU 3 to 35) and the corresponding UV-C treated ones did not have any bacterial growth. On average, overall bacterial reduction was 91,7% (p<0.05). Conclusions:The device was able to sterilize membrane with low bacterial load and significantly reduce microbial presence in the others.

Wojciech Ozimek is M.D. Paediatrician, Independent lecturer, researcher and media expert in parasitic and vector-borne diseases in Warsaw, Masovian District, Poland.

Human infections with Toxocara canis and cati are clinically important subjects and a frequent cause of misdiagnosis or delayed diagnosis. Despite the recognition of toxocariasis as an important clinical illness there have been few reviews of therapy for these infections and no definitive treatment protocols have been published, especialy in albendazole and mebendazole resistant cases. Only a handful of agents have been used in therapy, and the agents which are available may vary in significantly in efficacy and have adverse effects or be contraindicated in certain clinical situations. When evaluating the clinical efficacy of agents used against toxocara infections, it is difficult to compare studies. They vary as to entry methodology (whether randomization was done and if treatment was blinded or open), population studied (children, adults), syndromes treated: visceral larva migrans (VLM), covert toxocariasis- milder version of VLM and ocular larva migrans (OLM), measures (clinical efficacy and/or blood results negativity), and duration of follow-up. Nevertheless, conclusions may be drawn from the studies when viewed as a whole, and statements can be made about the relative efficacy of the agents. In this paper we present our own experiences and initial results about the efficacy of agents currently used for the treatment of toxocariasis in albendazole and mebendazole resistant cases. The total of 58 patients primarily treated with albendazole and/ or mebendazole were treated with two of the medicines most commonly used for resistant cases of this infection. 26 with visceral larva migrans, 26 with covert toxocariasis and 6 with ocular larva migrans. Diethycarbamazine and thiabendazole were used in their usual posologic schedules. The total cure rates achieved with diethylcarbamazine and thiabendazole were, respectively: 75% and 70% in VLM patients, 85% and 80% in covert toxocariasis. We did not achieve any clinical efficacy or blood results negativity in patients with OLM. Side effects were of minor importance both in patients treated with thiabendazole and diethylcarbamazine.

Juljana has completed her master in science of nursing at the University of Vlore. She graduated in nursing program in 2001 and since then she followed post university course for a year for "Managing of the health services for the practical students form the school of "Haute ècole de Sante" Genève. She work as a lecturer at the University of Vlora in the Mother and Baby Care Department. She is the president of Nursing Order for Vlora district since 2009. She have been a head nurse in the neonates unit in Vlora hospital; She worked as part time lecturer in Vlora University and was a trainer for World Vision Albania. She has published more than 25 papers in journals and serving as an editorial board member in journal of nursing in Albania.

Cardio-vascular diseases are the main cause for the mortality in Europe. Nevertheless, these diseases are totally preventable. WHO estimates that a modest reduction in the blood pressure numbers, obesity, cholesterol values and smoking in all the populations, can reduce these diseases by half. Aim: To recognize the risk factors and the prevalence of these diseases in the population of Vlore district in order to implement preventive measurements in the primary health care services of the community. Method: This descriptive study is conducted based on the data from the main registers of the hospital medical records office and describes the number of patients hospitalized with CVD, distributing them by age group, gender and place of living. Results: The diseases of the circulatory system are distributed: 7.9% of the yearly hospitalizations are in 2009, 9.3% in 2010, 9.7% in 2011. The most frequent diseases are: HTA, chronic MI- ischemic, cardiomyopathies, and CVA. According to the demographic distribution the cases with CVD are seen mostly in the city. Their frequency increases with age, males suffer more than females. According to the age group 45-54 year olds are 16%, 55-64 are 23%, and over 65 are 55% of all the cases with CVD. Recommendation: Screening and evaluation of the individual risk factors by using the SCORE system in primary health care services.

Ibrahim has completed his masters and higher diploma at the age of 28 years from Egypt, and he is doing his PHD in criminal law and environment in university of Salford. His research interests about environmental problems, criminology, and human rights. He has published more than seven papers in journals and books.

Through the recent years, the Iraqi environment has encountered different environmental challenges; firstly, the illegal and non-scientific exploitation of the resources which have led to resource depletion. Secondly, the devastation and destruction that was caused by wars which has reflected on environmental and social development. thirdly, the air pollution, that affects mainly the human's health, in addition that may affect water, land, plants, animals, economy and sustainable development, and even the urbanism and tourism. In order to overcome this problem, the researcher will adopt the analytical and comparison approaches. Through analysis of the legal texts that dealt with this area in the UK and Iraq. This research will be followed by comparison of the collected data from both countries. This research addresses the legal protection of the environment to prevent the damage that occurs from air pollution. The main goal is to provide a legal study for this subject in order to create new laws and to improve and activate the current laws through a comparative study between Iraq and UK. In addition, this legislation should include preventive and remedial rules as well as the imposition of criminal, civil and administrative sanctions on offenders on the environment, it also will examine the sources of and reasons for air pollution in both countries also, the researcher will study strategic approaches to air quality management and scientific alternatives to reduce or minimize air pollution. This research is expected to develop a theoretical framework which summarizes the information that will be interpreted by this research and, which consequently will contribute to the literature in various fields of knowledge, especially the field of ecology. It will also benefit the environmental protection departments in order to solve problems of the environment in Iraq and to reduce the negative effects on the sectors of social development from one side, and the people’s quality of life from the other side. Finally, from the legal viewpoint it will allow an improvement in the overall environmental situation with special attention to air.

Guerra Vera Itzelt Gudalupe is student at Universidad de Guadalajara, Mexico

The scorpion sting poisoning is a major public health importance in Mexico, especially in tropical and subtropical areas. Estimates made in our country, show that the rate of scorpion stings has increased in recent years, which represents a major source of demand for medical care in 12 states of Mexico: Aguascalientes, Colima, Durango, Guanajuato, Guerrero, Jalisco, Michoacan, Morelos, Oaxaca, Puebla, Sinaloa and Zacatecas. During 1995, 82,800 new cases with an overall prevalence of 90.1 per 100,000 population were reported. According to estimates by WHO, each year there are between 700 and 1,400 deaths from scorpion stings in Mexico, especially in children under 10 years of age. This situation is particularly significant in the regions of our country where scorpions live in the vicinity of housing, given the current trend of our populations grow and invade the ecological niche of this species, englobándolo within the human habitat. A retrospective longitudinal study of 1646 cases registered by the health care units of the municipality of Tomatlan is made; Jalisco during 2014, which were reported to the management of the Health Region VIII. More prevalent in the towns of Tomatlan (20%), Pino Suarez (13.5%) and Campo Acosta (9%), it was found besides incidence rates, mortality and the percentage of patients grouped into grades according were determined to severity of the symptoms they presented.

Hayfa Almutary has over 12 years’ experience as a registered nurse. She has a master degree of acute care nursing from Queensland Universityof Technology (QUT), Australia and Bachelor degree of nursing from King Abdulaziz University, Jeddah, Saudi Arabia. She is a Lecturer in nursing school at King Abdulaziz University. Currently she is a PhD candidate in the School of Nursing at QUT, Australia. Her research of interest is symptom assessment and management in chronic kidney disease. The primary focus of her PhD research is to explore symptom clusters in advanced stages of CKD in order to improve the quality of symptom assessment and management among CKD patients. She has three published articles in this field. In addition, one conference paper was presented at the Renal Society of Australasia Annual Conference, Melbourne, Australia, 2014.

Chronic kidney disease (CKD) is increasing globally and in Saudi Arabia it affects approximately 8% annual increment of dialysis population. It is associated with a high symptom burden. Previous studies have largely reported on the prevalence of symptoms only in the haemodialysis population. This study examined symptom burden across disease stages and treatment groups in advanced CKD, and their correlation with demographic and clinical factors. Using a cross-sectional design, a convenience sample of 436 patients with CKD was recruited from three hospitals in Saudi Arabia. The CKD Symptom Burden Index (CKD-SBI) was used to measure 32 CKD symptoms. Demographic and clinical data were also collected. Of the sample 75.5% were receiving dialysis (haemodialysis, n = 287; peritoneal dialysis, n = 42) and 24.5% were non-dialysis (CKD stage 4, n = 69; CKD stage 5, n = 38). Average symptom reported was 13.01 ± 7.67. Fatigue and pain were common and burdensome across all symptom dimensions.Approximately one-third of participants experienced sexual symptoms. Dialysis patients reported greater symptom burden, especially patients on haemodialysis. Haemodialysis treatment, older age and being female were independently associated with greater total symptom burden. In conclusion, symptom burden is high among advanced stages of CKD, particularly among those receiving dialysis. Although fatigue, pain and sexual dysfunction are key contributors to symptom burden in CKD, these symptoms are often under-recognised and warrant routine assessment. The CKD-SBI offers a valuable tool to assess symptom burden, leading to the commencement of timely and appropriate interventions.

According to WHO Cape Verde has about a fifty percent incidence of underreporting of tuberculosis (TB). TB represents a public health problem in Cape Verde due to its high incidence, with a tendency to increase in recent years. The study aims to understand the spatial distribution of tuberculosis and associate it with socioeconomic factors such as HIV, density of occupants per household, economically active segment, and levels of illiteracy. This is an ecological study, the subject of which is individuals who were diagnosed with tuberculosis (TB) in the period from 2006 to 2012 in the neighborhoods of Praia city. The city’s neighborhood distribution; demographic and social data from year 2010 census was used; TB cases were collected in health centers and in the Praia county Hospital and were aggregated by district of residence thereby obtaining data area. We used the geoda software for thematic maps of TB incidence rates in the neighborhoods of the Praia county. We used the Bayesian smoothing method and place of Empirical Global TB incidence rates. Georeferencing was done for the cases of tuberculosis, and disease incidence was calculated by neighborhood. Rates were softened and the Global Moran Index was calculated. The variables ,density of occupants per household, economically active segment and illiteracy levels showed spatial autocorrelation. The illiteracy variable was inversely related to the rate of tuberculosis. The HIV variable showed a positive association. We hope that this study may help outline control strategies for the county of Praia, from the perspective of health promotion, for a disease so socially determined, as is the case of TB.

Karen Michell MejíaPérez is studying the 5º semester of medicine from Centro Universitario de la Costa, in the Guadalajara University. She has been in different congress through her study, and wants to expand her knowledge by participating in this one.

Background: According to the “Institución Internacional Aldeas Infantiles SOS”, they estimate that there are approximately 412,456 children without parental care in Mexico. In most of these cases the child’s health status is not being watched and basic recommendations marked by the National Health Card are not being followed. Aim: Identify the current health state of the children living at the “Refugio Infantil Santa Esperanza” according to recommendations from the National Health Card and to determine the most frequent sicknesses of these children. Materials & Methods: An exploratory study and descriptive statistical analysis was performed on 25 orphans, 2 of their caretakers and 2 of their doctors to determine their current health status and to see if they follow guidelines determined by the National Health Card. This was done by checking each child’s health card, by doing flexible interviews and taking anthropometric measurements. Results: The mean age of the 25 children was 7.56 years of age (± 2.67), 14 subjects were male while 11 were female. Mean time of daily physical activity of all the subjects was 67.24 minutes per day (± 68.43). The children’s diet is below average in fruit and vegetable consumption but on optimal protein consumption level. All of the immunization schemes were incomplete. A total of 68% of the total population was in a healthy Body Mass Index range, while 28% were in the overweight and obese range. Upper Respiratory Tract Infections, Diarrhea and Dermatological Lesions were proven to be the three most prevalent sicknesses year round.

: Jihene bettaieb is workign in Laboratory of Medical Epidemiology, Pasteur Institute of Tunis, Tunisia

Introduction: In previous study we have reported the development of a serological test using Pichia pastoris recombinant CFP32 antigen, a virulence factor of Mycobacterium tuberculosis (MTB), with both high sensitivity and specificity in the Tunisian population. In this study, we aimed to assess the ability of the CFP32 serological test, to discriminate between TB patients and non-TB among people of different ethnic origins. Materials & Methods: Serum samples were obtained from 224 donors from different countries, divided into two groups: i. samples from Tunisian cohort (intermediate endemicity) including TB patients and their contacts ii. Samples from WHO banked sera (obtained from sub-Saharan African and Latin American countries with high endemicity) including TB patients and TB suspected individuals. Receiver operating curve (ROC) was used to evaluate the performance of the CFP32 serological test. Results: CFP32 specific antibody levels in the TB patients was significantly higher than non-TB controls in Tunisian group (p<10-4), Sub-Saharan African group (p<10-3) and Latin American group (p<10-4). Considering all groups together, the area of the ROC curve was 0.77 (95%CI, 0.70-0.83). The cutoff level was set at 0.63, giving the optimal combination between sensitivity (70%, CI95%: 60-79) and specificity (73%, CI95%: 63-81). Conclusion: Although CFP32 single antigen serological test did not achieve excellent sensitivity and specificity, a combination of CFP32 with other select antigens and particularly stage-specific infection antigens could be used to improve performance of a serological test regardless of TB incidence and latent infection.

Cinthia Coral Rodriguez Vaez is student at Universidad de Guadalajara, Mexico

Alcohol use is a public health problem by the high prevalence of consumption and mortality associated with this, especially in youth mental disorders. At present, the consumption of alcohol by adolescents constitutes a threat to public health because it generates a negative biological, physical, emotional and psychological level in those who consume it accordingly. METHODOLOGY Type of study: longitudinal descriptive Universe: Students of the degree of Medicine, Civil engineering and accounting. Student’s careers: • Accounting 576 • Civil Engineering 572 • Medicine Total 376 274 (61 social service) (internship 41). Population: 120 students of both sexes aged between 18 and 25 years, with a sample size of 40 students respectively were interviewed. RESULTS: in Civil Engineering obtained better results in terms of alcohol consumption with 100% consuming intoxicants compared with 93% of the accounting degree, followed by 88% of the race of Medicine being the reported that lower consumption, it was found that 100% of the general population is aware that alcoholism is a problem that affects health, 85.8% say that alcohol is an addictive substance if, in the section of questions to assess the drinking frequency was obtained that 93.3% had drunk at least once some alcohol, being a career civil engineering who increased incidence of alcohol obtained to question them about the frequency of alcohol consumption in the survey reported that the last 30 days. Among the family factors that influence alcohol data reported in 100% integrant some of his family consume alcohol, the father remains a constant among the population who consume alcohol, and 50% believe that anyone in your alcoholic family. Friends are part of the social environment in which they operate, the group of young students with whom they share important events in your life and so unexpectedly become a center of influence for behavioral and social development as part of the situational analysis of factors influencing the 63.33% of students said their friends if somehow influence in the consumption of alcohol, with 56.66% the most common reason is celebrating by consuming alcoholic beverages. DISCUSSION: Factors that predispose to alcoholism are highly variable and are directly related to the etiology of the disease since it affects the family, the economy, the information that each individual has on the subject, genetic factors and social acceptance. With this study, we found as social relations do have a huge impact on the consumption of intoxicants. Most young people have not only tried alcohol once if they do periodically and somewhat higher amounts. CONCLUSIONS: Alcoholism is a disease that we see today with usual recurrence among the student population, as new generations are born influence that society has becomes stronger to settle in our lives giving us a false ideology on the consumption of intoxicating substances causing the population begins drinking from an early age, resulting in the 3rd and 4th decade of life and established a disease of alcoholism in the population. Young people certainly are the most likely by psychological instability that may occur at these ages those seeking acceptance, belonging to a social circle, be trendy, celebrate an achievement, remove stress or forget a problem, taking it all You want to find the escape of a reality that certainly does not like and look to consume alcohol door to peace, relaxation and oblivion. Obviously not just simply disseminating information on alcoholism and harm that this provides, although all the media can find information on the subject is not given a relevant approach, as the information may be available but there a real education in the population.

Esra Morvan has completed his Md ‘Methodology and Statistics in Biomedical Research’ from Paris Sud XI university. She is the epidemiologist-biostatistician of Regional office French institute for public health since 2009.

Following a rise in hepatitis A cases reported to the Regional Health Agencies (ARS) Centre-Val de Loire in summer 2011, conducted an investigation in order to monitor this specific epidemic period and to develop effective preventive measures. Active search to cases was conducted by the ARS. CIRE conducted a descriptive study epidemics based on the data from reporting forms, well as from investigation reports Confirmed cases included all reported cases that were biologically confirmed between 22/06/2011 and 14/03/2012. Of the 157 reported hepatitis A cases, 67(37%) were adults (i.e aged over 15) with a median age de xx years [2-68], 99 were children (63%) with a mean age of 8. 90 (57%) belonged to the community of “Nomadic/tsiganes people” (all aged less than 26 years). A first epidemic peak occurred in the weeks 35-36 (in the Loir-et-Cher district) and a second peak took place in week 48 (this time in the Indre and Indre-et-Loire district) with many case clusters within the community of Nomadic/tsiganes people implying intra family or collective contamination. Conclusion: The majority of cases are clustered and contact vaccination strategy is little effect in this period (i.e. vaccination during incubation), a vaccination campaign among under-16 year-old population primarily within the Nomadic/tsiganes people community was implemented. Community outbreak of hepatitis A in the region Central Loire Valley from July 2011 to March 2012.

Olfa Saidi has completed his diploma of Engineer in Statistics and data Analysis from National Institute of Statistics and Data Analysis Tunis in 2008. She got her Master on Public Health from Pierre and Mary Curie university-Paris in 2013. She has published interesting research studies on modeling of diabetes and cardiovascular diseases. She is student on PhD.

Background: The burden of stroke and its risk factors is a major challenge to the Tunisian health system. Stroke caused 7.5% registered deaths in 2013. In this context, this paper aims to estimate stroke deaths in 20 years among Tunisian population aged 35-94 years old and to present the impact of salt reduction using a modeling approach. Methods: Data were integrated and analyzed using the close cohort model based on Markov approach and transitions probabilities starting by the free population ischemic stroke. Monte Carlo Approach was used for sensitivity analysis by R Software Version R.3.2.0. Results: The model forecast a huge increase in cumulative number of stroke mortality by 2025 among Tunisian population 66758 (min 59382, max 70108): Male mortality accounted 40781(min 39325, max 41865) represent 61.6% of the total deaths and it accounted 25977(min 20067, max 28243) among women. Thus results in about 2039 (min 1966, max 2094) annual deaths due to stroke among men and 1298 (min 1003, max 1413) among women. However if we reduce the consumption of salt by 30% from 14 gr/day to 9 gr/day, 12840 (min 11458, max 14560) prevented deaths could be achieved by 2025. Thus resulting about 20% avoided stroke deaths every year (642 (min 590, max 712)). Conclusion: Our study highlighted that high salt intake reflected increases in stroke mortality. Salt reduction strategies among Tunisian population are urgently required.

Noemí Serra-Paya has completed her PhD from University of Lleida - INEFC Lleida. She has published all the papers from her PhD, and it has an International Mention. She is teacher from the University of Lleida.

Introduction: Children obesity is one of the main public health problems. The metabolic syndrome (MS) has usually been associated to adult health diseases. However, nowadays it has been observed in overweight and obese (OW/OB) children. The aim of this study was to determine the incidence of metabolic syndrome in OW/OB children from Lleida. Method: The present study is an observational study, where 53 OW/OB children between 10-12 years old have participated. Anthropometric and related to the SM parameters in children population were measured following the parameters of the International Diabetes Federation (IDF). The degree of obesity was classified according the LMS method. Results: 25 (47.17%) participants had a waist circumference (WC) ≥90 cm (9 girls and 16 boys). One of the children (1.89%) suffered SM and 8 (15.09%) had PA≥90 cm and another factor associated with MS such as high blood pressure, plasma lipids or glucose. Systolic blood pressure ≥ 130 was the highest incidence parameter. Discussion: In the current study the prevalence of MS was lower than the observed in the study NAHNES (9.4% of boys and 9.7% of girls had MS), following the IDF criteria. Having in mind this situation, we think it is essential to carry out urgent actions to prevent and treat overweight and obese children as well as to avoid suffering from SM.

Doctoral candidate at the Public Health Program with a major in Epidemiology from the Ponce Health Sciences University (PHSU). Closely involved with qualitative research area as ethnographer in HIV studies. Faculty adjunct at the Clinical Psychology Program at PHSU. Certified Public Health from the National Board of Public Health Examiners (USA). Have been published in journals such as AIDS Care, Forum: Qualitative Social Research and Journal of International Association of Physicians in AIDS Care. Areas of interest: HIV/AIDS epidemiology, social epidemiology, drug abuse, social stigma and social determinants of health.

More than 30 years of the first HIV/AIDS cases, the epidemic still continue a worldwide health public concern. After the introduction of antiretroviral therapies (AZT) new causes of death not traditionally related to HIV/AIDS has been reported. AZT has dramatically improved the life expectancy of HIV/AIDS. The objective of this study was to estimate survival in people diagnosed with HIV/AIDS in Puerto Rico (PR) from 2003 through 2011. A population-based study using the PR AIDS Surveillance System was implemented. A total of N=9,290 people were diagnosed with HIV/AIDS in PR for 2003-2011 period. Survival was assessed by the Kaplan–Meier method and multivariable analysis using a Cox regression model identified variables associated with mortality. Survival at 6 years in HIV patients was HR=0.87 (CI95%: 0.09, 0.72) p<0.001 when compare with AIDS patients HR= 0.57 (CI95%: 0.55, 0.60) p<0.001. Intravenous drug users [IDU] have less probability of survival at 5 years HR=0.69 (CI95%: 0.67, 0.71) p<0.001 when compare with other transmission modes. Consistently with scientific community people in AIDS stage, male and IDU’s has less probability of survival after 9 years after diagnosis. Assertive tertiary prevention strategies must be developed and implemented in PR for IDU’s.

Jin-Wook Jang is student in Seoul National University, Seoul, Republic of Korea

H9N2 avian influenza viruses (AIVs) have become endemic and circulated in poultry industries in Korea since the first outbreak in 1996. We surveyed H9N2 AIVs in Korean chicken farms and live bird markets from 2009 to 2014. A total of 156 H9N2 AIVs was isolated, and we compared the genetic characteristics of theAIV isolates withH5N1 and H5N8 highly pathogenic influenza viruses (HPAIVs) isolated in Korea. Phylogenetic analysis classified the H9N2 AIVs into three categories of genotypes and showed that genetic reassortment had occurred among H9N2 AIVs, HPAIVs and AIVs isolated from wild birds. The first group of H9N2 AIVs were closely related to A/chicken/Korea/01310/2001 H9N2 (01310) which has been used for an H9N2 vaccine strain in Korea. The other two groups showed there assortment of polymerase genes each other between H9N2 AVI and HPAIV. The PB1 genes were similar to H5N8 HPAIV isolated in 2014, and the PB2 genes were closely related to H5N1 HPAIs. The PA genes of the second group were from 01310-like lineage, but those of the third group fromHPAIV-like lineage. Considering that many kinds of the similar genetic reassortants of H9N2 AIVs have been reported in the several East Asian countries and H9N2 AIVs are thought as one of the potential pandemic candidates, continuous surveillance and monitorings should be conducted and investigated for the control of further epidemics.