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Mitruka K.,National Center for | Tsertsvadze T.,and Clinical Immunology Research Center | Butsashvili M.,Neolab | Gamkrelidze A.,National Center for Disease Control and Public Health of Georgia | And 15 more authors.
Morbidity and Mortality Weekly Report

What is already known on the topic? Hepatitis C virus (HCV) infection is a serious health problem that affects an estimated 130–170 million persons globally and results in an estimated 700,000 deaths annually. In 2013, new all-oral, well-tolerated regimens were licensed that can cure >90% of HCV infections. The country of Georgia has one of the world’s highest estimated HCV prevalences. What is added by this report? In April 2015, Georgia launched a hepatitis C elimination program that will initially focus on treating HCV-infected persons who have severe liver disease with new curative regimens, providing discounted HCV diagnostics to all persons, and building capacity to eventually diagnose and treat all Georgians infected with HCV. A national serosurvey was launched in May 2015, and seven clinical sites have opened to diagnose and treat HCV. Georgia is scaling up capacity to meet the high demand for HCV treatment. What are the implications for public health practice? Georgia has increased access to HCV testing and treatment as part of preparatory phase of a national HCV control program with goals for the elimination of HCV transmission and disease in the country. Georgia’s program can provide information and experience that will assist similar efforts in other parts of the world. © 2015, Department of Health and Human Services. All rights reserved. Source

Bakanidze L.,National Center for Disease Control and Public Health of Georgia | Imnadze P.,National Center for Disease Control and Public Health of Georgia | Perkins D.,Health-U
BMC Public Health

The critical aspects of biosafety, biosecurity, and biocontainment have been in the spotlight in recent years. There have also been increased international efforts to improve awareness of modern practices and concerns with regard to the safe pursuit of life sciences research, and to optimize current oversight frameworks, thereby resulting in decreased risk of terrorist/malevolent acquisition of deadly pathogens or accidental release of a biological agent, and increased safety of laboratory workers. Our purpose is to highlight how the World Health Organizations (WHO) revised International Health Regulations (IHR[2005]), the Biological Weapons Convention (BWC), and the United Nations Security Council Resolution (UNSCR) 1540 overlap in their requirements with regard to biosafety and biosecurity in order to improve the understanding of practitioners and policymakers and maximize the use of national resources employed to comply with internationally-mandated requirements. The broad range of goals of these international instruments, which are linked by the common thread of biosafety and biosecurity, highlight their significance as essential pillars of international health security and cross-cutting elements of biological nonproliferation. The current efforts of the Republic of Georgia to enhance biosafety and biosecurity in accordance with these international instruments are summarized. © 2010 Bakanidze et al; licensee BioMed Central Ltd. Source

Sidamonidze K.,New York State Department of Health | Sidamonidze K.,National Center for Disease Control and Public Health of Georgia | Peck M.K.,New York State Department of Health | Peck M.K.,National Center for Disease Control and Public Health of Georgia | And 7 more authors.
Journal of Clinical Microbiology

The TaqMan real-time PCR assay was developed from the Blastomyces dermatitidis BAD1 gene promoter. The assay identified all haplotypes of B. dermatitidis and five of six positive paraffin-embedded tissues. The assay sensitivity threshold was 1 pg genomic DNA of the mold form and 2 CFU of the yeast form of B. dermatitidis. No cross-reactivity was observed against other fungal DNA. The assay allowed rapid (5-h) identification of B. dermatitidis from culture and from clinical specimens. Copyright © 2012, American Society for Microbiology. All Rights Reserved. Source

Babuadze G.,National Center for Disease Control and Public Health of Georgia | Babuadze G.,Ilia State University | Farlow J.,Farlow Scientific Consulting Company | De Koning H.P.,University of Glasgow | And 13 more authors.
Parasites and Vectors

Background: Leishmaniasis includes multiple clinical syndromes, most notably visceral, cutaneous, and mucosal forms. Visceral leishmaniasis (VL), also known as kala-azar, is a potentially fatal disease endemic to large parts of Africa and Asia, and in South-Eastern Europe (Greece, Turkey, Georgia). Visceral leishmaniasis is a parasitic zoonosis caused by species of the L. donovani complex. In the classical epidemiological model the main reservoir for VL are canines. Methods: The study included a cohort of 513 individuals of both genders (190 males and 323 females) from the ages of 1 to 70 years that were screened in ten villages across two districts in Kakheti using the Kalazar Detect™ rK39 rapid diagnostic test. The phylogenetic diversity patterns of local strains, based on the rDNA internal transcribed spacer (ITS) sequences, were assessed for samples obtained from patients with suspected L. donovani infection, from canine reservoirs and from Phlebotomus sand flies obtained from different geographical areas of Georgia and from Azerbaijan. Results: Out of a total of 600 domestic dog blood samples 95 (15.8 %) were positive by rK39 rapid diagnostic tests. For symptomatic domestic dogs, the testing of conjunctival swabs or bone marrow aspirates revealed a higher VL incidence in Kvareli District (Kvareli; 19.4 %, n = 329) compared with that observed for Sagarejo District (Sagarejo; 11.4 %, n = 271). A total of 231 sand flies of both genders were collected during the 2-month period; of the 114 females, 1.75 % were PCR positive for the presence of Leishmania spp. Conclusions: VL infection rates remain high in both canines and humans in Georgia, with disease in several known natural foci. The genetic relationships derived from rDNA internal transcribed spacer (ITS) sequence comparisons identified genetic subgroups, revealing preliminary insights into the genetic structure of L. donovani complex members currently circulating in the South Caucasus and demonstrates the utility of ITS-based genotyping in the resource-limited country of Georgia. © 2016 Babuadze et al. Source

Babuadze G.,National Center for Disease Control and Public Health of Georgia | Babuadze G.,Ilia State University | Alvar J.,WHO NTD Leishmaniasis Program | Argaw D.,World Health Organization | And 11 more authors.
PLoS Neglected Tropical Diseases

This study investigated the transmission and prevalence of Leishmania parasite infection of humans in two foci of Visceral Leishmaniasis (VL) in Georgia, the well known focus in Tbilisi in the East, and in Kutaisi, a new focus in the West of the country. The seroprevalence of canine leishmaniasis was investigated in order to understand the zoonotic transmission. Blood samples of 1575 dogs (stray and pet) and 77 wild canids were tested for VL by Kalazar Detect rK39 rapid diagnostic tests. Three districts were investigated in Tbilisi and one in Kutaisi. The highest proportions of seropositive pet dogs were present in District #2 (28.1%, 82/292) and District #1 (26.9%, 24/89) in Tbilisi, compared to 17.3% (26/150) of pet dogs in Kutaisi. The percentage of seropositive stray dogs was also twice as high in Tbilisi (16.1%, n = 670) than in Kutaisi (8%, n = 50); only 2/58 wild animals screened were seropositive (2. 6%). A total of 873 Phlebotomine sand flies were collected, with 5 different species identified in Tbilisi and 3 species in Kutaisi; 2.3% of the females were positive for Leishmania parasites. The Leishmanin Skin Test (LST) was performed on 981 human subjects in VL foci in urban areas in Tbilisi and Kutaisi. A particularly high prevalence of LST positives was observed in Tbilisi District #1 (22.2%, 37.5% and 19.5% for ages 5-9, 15-24 and 25-59, respectively); lower prevalence was observed in Kutaisi (0%, 3.2% and 5.2%, respectively; P<0.05). This study shows that Tbilisi is an active focus for leishmaniasis and that the infection prevalence is very high in dogs and in humans. Although exposure is as yet not as high in Kutaisi, this is a new VL focus. The overall situation in the country is alarming and new control measures are urgently needed. © 2014 Babuadze et al. Source

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