Toxoplasma gondii infection and schizophrenia: a case control study in a low Toxoplasma seroprevalence Mexican population

There are conflicting reports concerning the association of Toxoplasma gondii infection and schizophrenia in humans. Therefore, we determined such association in a Mexican population of Mestizo ethnicity. Through a case-control study design, 50 schizophrenic patients and 150 control subjects matched by gender, age, residence place, and ethnicity were examined with enzyme-linked immunoassays for the presence and levels of T. gondii IgG antibodies and for the presence of T. gondii IgM antibodies. Schizophrenic patients attended a public psychiatric hospital in Durango City, Mexico, and the control group consisted of individuals of the general population of the same city. Socio-demographic, clinical and behavioral characteristics from the study subjects were also obtained. Both the seroprevalence and the level of T.gondii IgG antibodies were higher in schizophrenic patients (10/50; 20%) than in control subjects (8/150; 5.3%) (OR=4.44; 95% CI: 1.49-13.37; P=0.003). The IgG T. gondii levels higher than 150 IU/ml were more frequently observed in patients than in controls (10% versus 2%, respectively; P=0.02). One (50%) of the two patients with recently diagnosed schizophrenia and none of the controls had T. gondii IgM antibodies (P=0.01). T. gondii seropositivity was significantly higher in patients with a history of cleaning cat excrement (P=0.005), and suffering from simple schizophrenia (ICD-10 classification: F20.6) (P=0.03) than patients without these characteristics. Toxoplasma seroprevalence was also significantly higher in patients with simple schizophrenia (F20.6) than in those with paranoid schizophrenia (F20.0) (P=0.02). This study provides elements to clarify the controversial information on the association of T. gondii infection and schizophrenia.     

Seroepidemiology of Toxoplasma gondii infection among Chinese aboriginal and Han people residing in mountainous areas of northern Thailand

A seroepidemiological survey of Toxoplasma gondii infection among Chinese refugees, including Akka and Yau aborigines and Han people living in mountainous areas at elevations of 1,100-1,400 m in Chiang-Rai Province of northern Thailand, was conducted during January 2003 using the latex agglutination test. The overall seroprevalence of T. gondii infection was 9.1% for Akka aborigines, 37.9% for Yau aborigines, and 7.9% for Han people, respectively. No significant gender difference in seroprevalence was found among any of the groups (P > 0.05). The results of a multiple logistic regression analysis for Yau aborigines and Han people showed that the older the age, the higher the odds ratios (OR) of being seropositive (OR = 3.0, 95% confidence interval [CI] = 0.5 to 16.9, P < 0.001 and OR = 1.5, 95% CI = 0.3 to 8.0, P = 0.06 for the elderly group vs. the child group for the Yau aborigines and Han people, respectively). In contrast, the OR was lower among older Akka aboriginal populations (OR = 0.1, 95% CI = 0.0 to 0.4, P < 0.001). Ethnically, Yau aboriginal populations had a significantly higher seroprevalence than did the Akka aborigines and Han people (P < 0.001).     

Epidemiology of Hepatitis E Virus in China: Results from the Third National Viral Hepatitis Prevalence Survey, 2005–2006

In China, hepatitis E virus (HEV) is prevalent and causes disease, but its epidemiological profile is not well understood. We used a commercial enzyme-linked immunosorbent assay to detect total antibodies to hepatitis E virus in 15,862 serum samples collected during the Third National Viral Hepatitis Prevalence Survey. The results were analyzed to calculate estimates of HEV seroprevalence and to examine the effects of some putative risk factors. The seroprevalence of HEV in the general Chinese population during the period from 2005 through 2006 was 23.46% (95% confidence interval [CI], 18.41%–28.50%). The farming population, the age group of 15–60 year olds, and those living in the Midwest or Mideast region and in Xinjiang province had the highest seroprevalence estimates. The prevalence of HEV is high in China. The seroprevalence rate of HEV shows an unbalanced distribution among areas with different geographic location and economic development levels. The characteristics of the distribution associated may be due to the route of HEV transmission (via contaminated water or animal reservoirs). Within the same region, the seroprevalence of HEV is generally increased with age.     

Seroprevalence of Toxoplasma gondii infection in pigs, in Zhejiang Province, China

Seroprevalence of Toxoplasma gondii infection in pigs in 10 regions of Zhejiang Province, China, was obtained by enzyme-linked immunosorbent assay (ELISA). Anti- T. gondii antibodies were found in 53.4% (434/813) of pigs. Results were analyzed by a chi-square (χ(2)) test. Differences were observed according to farm size, animal age, and sampling regions. Seroprevalences in pigs raised on small farms (71.4%) were significantly higher than that (42.7%) on large farms (P < 0.05), and seroprevalence increased progressively with age. The seroprevalence ranged from 28.1% to 66.0% in different regions, with Jiaxing having the lowest level (28.1%), followed by Hangzhou (36.0%) and Taizhou (42.0%). This is the first study on seroprevalence of T. gondii infection in pigs in Zhejiang Province.     

Seroprevalence of Neospora caninum infection in dairy cattle of Southern China

A seroepidemiological survey of Neospora caninum infection in dairy cattle was carried out in China's southern Guangdong Province between July 2009 and March 2010. A total of 370 serum samples of dairy cattle was collected from 5 farms and examined for antibodies to N. caninum by enzyme-linked immunosorbent assay. The overall seroprevalence of N. caninum in dairy cattle was 18.9% (70/370). The seroprevalence of N. caninum in aborting cows (22.7%) was higher than that in nonaborting cows (16.3%), but the difference was not statistically significant (P > 0.05). Five-yr-old dairy cattle had the highest seroprevalence (27.8%), followed by those that were 6-yr-old (20.4%). Dairy cattle with 4 pregnancies had the highest seroprevalence (29.2%). There was no apparent association of N. caninum seropositivity with age or number of pregnancies (P > 0.05). The results of the present survey indicated that the infection with N. caninum is prevalent in dairy cattle of all ages in southern China, which may be one of the causes of bovine abortion. This is the first report of seroprevalence of N. caninum in dairy cattle in southern China.     

Seroprevalence and Incidence of Toxoplasma gondii among Apparently Healthy and Visually or Hearing Disabled Children in Taiz City, Yemen

This cross sectional study was conducted in the city of Taiz, Yemen, during the period from August 2006 to August 2007 in order to investigate the seroprevalence and incidence of toxoplasmosis among apparently healthy children (AHC) and visually and/or hearing disabled children (DC). The seroprevalence was 16.0% among AHC compared to 32.5% among DC. The effect of gender was clear as the seroprevalence rate was significantly higher among females (18.3 and 43.8% for AHC and DC, respectively) than males (13.8 and 25% for AHC and DC, respectively). The seroprevalence was proportionally increased with the age, and the highest rates (20.9 and 53.0%) were reported among the oldest age group (> 10-14 years) for AHC and DC groups, respectively. The incidence rate was also higher (4.2%) in DC group compared to AHC group (2.4%) during 1 year period. These data indicate that the seroprevalence and incidence of toxoplasmosis are significantly higher in DC group than those of AHC group. We need to check further relationship between toxoplasmosis and visual and/or hearing disability.     

Roles of host species, geographic separation, and isolation in the seroprevalence of jamestown canyon and snowshoe hare viruses in newfoundland

California serogroup viruses, including Jamestown Canyon virus (JCV) and snowshoe hare virus (SSHV), are mosquito-borne members of the Bunyaviridae family and are endemic across North America. These arboviruses are potential pathogens which occasionally cause neuroinvasive disease in humans and livestock. A neutralization assay was used to document JCV and SSHV seroprevalence using blood collected from a variety of domestic and wildlife host species. These species were sampled in an island setting, Newfoundland, which contains diverse ecoregions, ecological landscapes, and habitats. Seroprevalence rates for each virus differed significantly among host species and within certain species across different geographic areas. JCV was significantly associated with large mammals, and SSHV was significantly associated with snowshoe hares. Seroprevalence rates in the 5 species of animals tested for prior exposure to JCV ranged from 0% in snowshoe hares to 64% in horses. Seroprevalence rates for SSHV ranged from less than 1% in bovines to 55% in all snowshoe hares. The seroprevalence of SSHV differed significantly (P < 0.05) among hares occupying the discrete habitats of watersheds separated by 14 to 35 km. Cattle on farms in boreal forest landscapes displayed significantly higher JCV seroprevalence (P < 0.001) than those on farms located in seacoast landscapes. Lifelong geographic isolation of cattle to insular Newfoundland was associated with significantly lower JCV seroprevalence (P < 0.01) than that for cattle which had lived off-island.     

Seroprevalence of Toxoplasma gondii infection in domestic pigs in Durango State, Mexico

Little is known concerning the prevalence of Toxoplasma gondii infection in pigs in Mexico. Accordingly, antibodies to T. gondii were determined in 1,074 domestic pigs in Durango, Mexico using the modified agglutination test. Two groups (A, B) of pigs were sampled: Group A pigs (n = 555) were raised in 3 geographical regions in Durango State and Group B pigs (n = 519) were from Sonora State but slaughtered in Durango City. Overall, antibodies to T. gondii were found in 136 (12.7%) of 1,074 pigs with titers of 1∶25 in 29, 1∶50 in 23, 1∶100 in 18, 1∶200 in 22, 1∶400 in 12, 1∶800 in 8, 1∶1,600 in 2, and 1∶3,200 or higher in 22. Of the pigs raised in Durango State, seroprevalence varied with age, management, and the geographic region; pigs raised in backyards in the mountainous region had a significantly higher seroprevalence (32.1%) than those raised in the valley (13.0%) and the semi-desert regions (14.0%). In Group A pigs from Durango, seroprevalence of T. gondii infection was significantly higher in pigs older than 8 mo (19.5%) than in younger pigs (10.9%). In the whole pig population (Groups A and B together), seroprevalence was higher in pigs raised in Durango (16.0%) than in those raised in Sonora (9.1%) and higher in mixed-breed pigs (15.7%) than in pure-bred pigs (10.3%). This is the first, in-depth study on the seroprevalence of T. gondii infection of pigs in Mexico and the first report on pigs from Durango State, Mexico. Results indicate that infected pork is likely an important source of T. gondii infection for humans in Durango State.     

Seroepidemiology of Toxoplasma gondii infection among two mountain aboriginal populations and Southeast Asian laborers in Taiwan

A seroepidemiological survey of Toxoplasma gondii infection among Atayal and Paiwan mountain aborigines and Southeast Asian laborers in Taiwan was assessed from February 1998 to July 2000 using a latex agglutination test. To determine risk factors for T. gondii infection among Taiwan aborigines, the consumption of raw meat and valley water were given particular attention in a self-administered questionnaire. The overall seroprevalence of T. gondii infection was 19.4% for Atayal, 26.7% for Paiwan, 42.9% for Indonesian, 14.7% for Thai, and 11.3% for Filipinos. No significant gender difference in seroprevalence was found among Atayals, Paiwans, Indonesians, and Filipinos (P > 0.05). In the Thai group, however, males had a higher seroprevalence than females (P < 0.001). Results of the multiple logistic regression analysis indicate a higher odds ratios (OR) with age in both aboriginal groups. In contrast, the OR was lower among older Indonesians and Thais. Those Atayals and Paiwans with a history of eating raw meat seemed more susceptible to T. gondii infection than those who had never consumed raw meat. Ethnically, a significant difference in seroprevalence was observed between Indonesians and Paiwans, Atayals, Thais, and Filipinos (P < 0.001).     

Helicobacter pylori infection and coronary artery disease

The aim of this investigation was to determine the seroprevalence of H. pylori in patients with coronary artery disease (CAD). Patients with coronary artery disease (n = 90) and control group (n = 90) were enrolled into this randomized, multi-centre study. CAD risk factors analyzed included age, male gender, diabetes mellitus, systemic hypertension, cigarette smoking, hypercholesterolemia and socioeconomic status. The results of this study showed a higher seroprevalence of Helicobacter pylori infection in patients with CAD compared to controls (78.8% versus 58.3%, p < 0.05). However, Helicobacter pylori seropositivity was not associated with coronary artery risk factors (smoking, body mass index, diabetes mellitus, hypertension, total cholesterol and socioeconomic status) either in the whole study population or in the patients and control subjects analyzed separately (P > 0.05). Further study are needed to clarify the precise role of Helicobacter pylori infection on the development of coronary artery disease.     

Prevalence of Toxoplasma gondii antibodies and DNA in dogs in Shanghai, China

The aim of this study was to estimate the prevalence of Toxoplasma gondii infection in dogs in Shanghai, China. A total of 1,736 sera (1,178 from the city center and 558 from the outskirts) was collected from healthy dogs and tested for T. gondii infection by indirect hemagglutination; 56 sera (3.2%) were considered positive, with titers > 1∶64. The seroprevalence in dogs from the outskirts of the city (town dogs, 6.0%; countryside dogs, 9.8%) was significantly higher (P > 0.05) than that in city center dogs (1.3%). The age of the dog has an apparent association with T. gondii infection; that is, the seroprevalence ranged from 1.9% (in dogs ≤ 1 year old) to 3.6% (in dogs > 5 years old). There was no significant difference in gender (P ≥ 0.05), that is, 1.4% versus 1.1% for male and female dogs in the city center, 6.2% versus 5.9% in town dogs, and 8.4% versus 11.5% in country dogs, respectively. These results suggest that T. gondii infections are common in dogs from the city center and outskirts of Shanghai, but the T. gondii seroprevalence in dogs is considerably lower than in other regions in PR China. The presence of T. gondii DNA was investigated by nested PCR on 110 blood samples from city center dogs, but no positive samples were found, which may suggest that there were no acute infections of T. gondii in the city center samples. Our results indicate that the control and treatment of toxoplasmosis in Shanghai has been effective. However, it is still essential to further implement integrated strategies to prevent and control T. gondii infection in dogs in both the city center and the outskirts.     

Changes in Antibody Seroprevalence of Seven High-Risk HPV Types between Nationwide Surveillance Studies from 1995–96 and 2006–07 in The Netherlands

Objective

This study evaluates trends in antibody seroprevalences of seven high-risk human papillomavirus (hr-HPV) serotypes (HPV16, 18, 31, 33, 45, 52, and 58) between the 1995–96 and 2006–07 sero-surveys among the Dutch general population in the pre-vaccination era.

Methods

Serum samples of men and women (0–79 years of age) from two cross-sectional population-based serosurveillance studies performed in 1995–96 (n = 3303) and 2006–07 (n = 6384) were tested for HPV-specific antibodies in a VLP-based multiplex immunoassay.

Results

HPV16-specific antibody seroprevalence increased during adolescence and shifted to younger ages in the 2006–07 survey compared to the 1995–96 survey. This step-up in HPV16 seroprevalence was most pronounced in women, while a more gradual increase was observed in men. Also in cohorts older than 49 years, HPV16 seroprevalence was higher in 2006–07 as compared to 1995–96 survey. A higher overall seroprevalence in individuals older than 15 years of age was found for HPV16, 18, 31 and 45 in 2006–07 as compared to 1995–96. For HPV33, 52 and 58 seroprevalences were comparable over this 11-year time period. Seropositivity for one or more HPV types was significantly higher in 2006–07 (23.1%) than in 1995–96 (20.0%) (p = 0.013). Multi-seropositivity increased from 7.1% in 1995–96 up to 10.2% in 2006–07 (p<0.0001). Differences in HPV seropositivity for at least one of the seven HPV types between both surveys could be explained in addition to demographic characteristics (age, sex, urbanization degree and ethnicity), also by changes in sexual behaviour (marital status, age of sexual debut and ever reported an STI).

Conclusion

The observed increase in particular HPV16 seroprevalence could be due to changes in sexual behaviour over the years, and especially in age of sexual debut. Seroprevalence studies provide insight into the distribution of HPV types and infection dynamics in the general population over time, which is important to assess the impact of HPV-vaccination.     

Epidemiology of Zoonotic Hepatitis E: A Community-Based Surveillance Study in a Rural Population in China

Background

Hepatitis E is caused by two viral genotype groups: human types and zoonotic types. Current understanding of the epidemiology of the zoonotic hepatitis E disease is founded largely on hospital-based studies.

Methods

The epidemiology of hepatitis E was investigated in a community-based surveillance study conducted over one year in a rural city in eastern China with a registered population of 400,162.

Results

The seroprevalence of hepatitis E in the cohort was 38%. The incidence of hepatitis E was 2.8/10,000 person-years. Totally 93.5% of the infections were attributed to genotype 4 and the rest, to genotype 1. Hepatitis E accounted for 28.4% (102/359) of the acute hepatitis cases and 68.9% (102/148) of the acute viral hepatitis cases in this area of China. The disease occurred sporadically with a higher prevalence during the cold season and in men, with the male-to-female ratio of 3∶1. Additionally, the incidence of hepatitis E increased with age. Hepatitis B virus carriers have an increased risk of contracting hepatitis E than the general population (OR = 2.5, 95%CI 1.5–4.2). Pre-existing immunity to hepatitis E lowered the risk (relative risk  = 0.34, 95% CI 0.21–0.55) and reduced the severity of the disease.

Conclusions

Hepatitis E in the rural population of China is essentially that of a zoonosis due to the genotype 4 virus, the epidemiology of which is similar to that due to the other zoonotic genotype 3 virus.     

Seroprevalence of Human Enterovirus 71 and Coxsackievirus A16 in Guangdong,China, in Pre- and Post-2010 HFMD Epidemic Period

Background

Human Enterovirus 71 and Coxsackie A16 have caused many outbreaks in the last decade in mainland China, resulting in thousands of fatal cases. Seroepidemiology which provides important information to document population immunity is rare in China.

Methodology/Principal Findings

A cross sectional study of Enterovirus 71 (EV71) and Coxsackie A16 (CA16) seroprevalence was carried out in Guangdong, China, pre- and post- the 2010 hand, foot and mouth disease (HFMD) epidemic period. The levels of EV71 and CA16 specific antibodies were evaluated by a microneutralization test and the geometric mean titer (GMT) was calculated and compared. Our results indicated frequent infection by EV71 and CA16 in Guangdong before the 2010 epidemic. Only EV71 neutralizing antibody but not CA16 seroprevalence was significantly increased after the 2010 HFMD epidemic. Children less than 3 years old especially those aged 2 years showed the lowest positive rates for EV71 and CA16 NA before epidemic and the most significantly increased EV71 seroprevalence after epidemic. CA16 GMT values declined after the 2010 epidemic.

Conclusions

These results indicate EV71 was the major pathogen of HFMD in Guangdong during the 2010 epidemic. The infection occurs largely in children less than 3 years, who should have first priority to receive an EV71 vaccine.     

Significance of Neospora caninum in British dairy cattle determined by estimation of seroprevalence in normally calving cattle and aborting cattle

A case control study was conducted to evaluate the significance of Neospora caninum infections in cattle in England and Wales. The prevalence of N. caninum in normally calving cattle (the control group; n = 418) and aborting cattle (n = 633) was estimated using a commercial antibody-detection ELISA. Prevalence estimates for bovine virus diarrhoea virus, infectious bovine rhinotracheitis virus and Leptospira hardjo were also obtained by serology. The prevalence of N. caninum was significantly higher (P < 0.0001) in the aborting group (18%; 95% confidence interval: 15%, 21%) than in the control group (6%; 95% confidence interval: 4%, 8%); the latter is the first estimate, to date, of the national seroprevalence of N. caninum in dairy cattle in England and Wales. Prevalence estimates for bovine virus diarrhoea virus, infectious bovine rhinotracheitis virus and L. hardjo were not found to be higher in the aborting cattle than in the control group. With N. caninum, a strong association between seropositivity and abortion was found, with seropositive cows being 3.5-times more likely to abort than seronegative cows (odds ratio = 3.49; 95% confidence interval: 2.16, 5.69). Furthermore, 12.5% of abortions in dairy cattle in England and Wales may be attributable to N. caninum, as indicated by estimation of the population aetiological fraction.     

Seroprevalence and risk factors for Toxoplasma gondii infection on pig farms in central China

Toxoplasma gondii is a protozoan parasite that causes severe diseases in mammals, including humans, around the world. In China, pork is the main meat source; accordingly, T. gondii in pigs is considered an important source for human toxoplasmosis. Understanding the epidemiology of toxoplasmosis in pig farms is thus important for control of the disease in humans. The purpose of the present study was to investigate the epizootiology of T. gondii infections in pig farms in central China by assessing the seroprevalence and risk factors of this disease. In the present study, 3,558 sera samples were collected from pigs in 37 large-scale pig farms in this region and tested by AG-ELISA. The total seroprevalence was 24.5%, with the greatest prevalence in breeding pigs. The risk factors for toxoplasmosis suggest that high frequency of the contact of pigs with cats (P ≤ 0.01; IC 95%), high density of pig breeding (P ≤ 0.01; IC 95%), the presence of mosquitoes and flies (P ≤ 0.01; IC 95%), semi-patency pens (P ≤ 0.05; IC 95%), and low frequency of scavenging (P ≤ 0.01; IC 95%) were all associated with seroprevalence. In addition, the use of sulfonamides (P ≤ 0.01; IC 95%) significantly decreased seroprevalence. This is the first report of anti- T. gondii antibodies in pigs on large-scale pig farms in central China. The findings will provide useful information for designing control strategies of toxoplasmasis in pig farms.     

Seroprevalence of Chikungunya virus and living conditions in Feira de Santana,Bahia-Brazil

BackgroundChikungunya is an arbovirus, transmitted by Aedes mosquitoes, which emerged in the Americas in 2013 and spread rapidly to almost every country on this continent. In Brazil, where the first cases were detected in 2014, it currently has reached all regions of this country and more than 900,000 cases were reported. The clinical spectrum of chikungunya ranges from an acute self-limiting form to disabling chronic forms. The purpose of this study was to estimate the seroprevalence of chikungunya infection in a large Brazilian city and investigate the association between viral circulation and living condition.Methodology/principal findingsWe conducted a population-based ecological study in selected Sentinel Areas (SA) through household interviews and a serologic survey in 2016/2017. The sample was of 1,981 individuals randomly selected. The CHIKV seroprevalence was 22.1% (17.1 IgG, 2.3 IgM, and 1.4 IgG and IgM) and varied between SA from 2.0% to 70.5%. The seroprevalence was significantly lower in SA with high living conditions compared to SA with low living condition. There was a positive association between CHIKV seroprevalence and population density (r = 0.2389; p = 0.02033).Conclusions/significanceThe seroprevalence in this city was 2.6 times lower than the 57% observed in a study conducted in the epicentre of the CHIKV epidemic of this same urban centre. So, the herd immunity in this general population, after four years of circulation of this agent is relatively low. It indicates that CHIKV transmission may persist in that city, either in endemic form or in the form of a new epidemic, because the vector infestation is persistent. Besides, the significantly lower seroprevalences in SA of higher Living Condition suggest that beyond the surveillance of the disease, vector control and specific actions of basic sanitation, the reduction of the incidence of this infection also depends on the improvement of the general living conditions of the population.     

Cyclical Patterns of Hand,Foot and Mouth Disease Caused by Enterovirus A71 in Malaysia

Enterovirus A71 (EV-A71) is an important emerging pathogen causing large epidemics of hand, foot and mouth disease (HFMD) in children. In Malaysia, since the first EV-A71 epidemic in 1997, recurrent cyclical epidemics have occurred every 2–3 years for reasons that remain unclear. We hypothesize that this cyclical pattern is due to changes in population immunity in children (measured as seroprevalence). Neutralizing antibody titers against EV-A71 were measured in 2,141 residual serum samples collected from children ≤12 years old between 1995 and 2012 to determine the seroprevalence of EV-A71. Reported national HFMD incidence was highest in children <2 years, and decreased with age; in support of this, EV-A71 seroprevalence was significantly associated with age, indicating greater susceptibility in younger children. EV-A71 epidemics are also characterized by peaks of increased genetic diversity, often with genotype changes. Cross-sectional time series analysis was used to model the association between EV-A71 epidemic periods and EV-A71 seroprevalence adjusting for age and climatic variables (temperature, rainfall, rain days and ultraviolet radiance). A 10% increase in absolute monthly EV-A71 seroprevalence was associated with a 45% higher odds of an epidemic (adjusted odds ratio, aOR1.45; 95% CI 1.24–1.69; P<0.001). Every 10% decrease in seroprevalence between preceding and current months was associated with a 16% higher odds of an epidemic (aOR = 1.16; CI 1.01–1.34 P<0.034). In summary, the 2–3 year cyclical pattern of EV-A71 epidemics in Malaysia is mainly due to the fall of population immunity accompanying the accumulation of susceptible children between epidemics. This study will impact the future planning, timing and target populations for vaccine programs.     

Are Reports of Psychological Stress Higher in Occupational Studies? A Systematic Review across Occupational and Population Based Studies

Objectives

The general health questionnaire (GHQ) is commonly used to assess symptoms of common mental disorder (CMD). Prevalence estimates for CMD caseness from UK population studies are thought to be in the range of 14–17%, and the UK occupational studies of which we are aware indicate a higher prevalence. This review will synthesise the existing research using the GHQ from both population and occupational studies and will compare the weighted prevalence estimates between them.

Methods

We conducted a systematic review and meta-analysis to examine the prevalence of CMD, as assessed by the GHQ, in all UK occupational and population studies conducted from 1990 onwards.

Results

The search revealed 65 occupational papers which met the search criteria and 15 relevant papers for UK population studies. The weighted prevalence estimate for CMD across all occupational studies which used the same version and cut-off for the GHQ was 29.6% (95% confidence intervals (CIs) 27.3–31.9%) and for comparable population studies was significantly lower at 19.1% (95% CIs 17.3–20.8%). This difference was reduced after restricting the studies by response rate and sampling method (23.9% (95% CIs 20.5%–27.4%) vs. 19.2% (95 CIs 17.1%–21.3%)).

Conclusions

Counter intuitively, the prevalence of CMD is higher in occupational studies, compared to population studies (which include individuals not in employment), although this difference narrowed after accounting for measures of study quality, including response rate and sampling method. This finding is inconsistent with the healthy worker effect, which would presume lower levels of psychological symptoms in individuals in employment. One explanation is that the GHQ is sensitive to contextual factors, and it seems possible that symptoms of CMD are over reported when participants know that they have been recruited to a study on the basis that they belong to a specific occupational group, as in nearly all “stress” surveys.     

Establishment of an ELISA to Detect Kaposi＇s Sarcoma-associated Herpesvirus Using Recombinant ORF73

Kaposi's sarcoma-associated herpesvirus (KSHV) is causally related to Kaposi's sarcoma (KS),primary effusion lymphoma (PEL) and a proportion of cases of multicentric Castleman's disease (MCD). The ORF73 protein was cloned into pQE80L-orf73 and expressed in E.coli and purified. The expressed recombinant ORF73 was identified by sodium dodecyl sulfatepolyacrylamide gel electrophoresis (SDS-PAGE). A protein of about 27 kDa was expressed as expected. Western Blotting showed that the purified recombinant ORF73 reacted with KSHV positive serum. The immunogenicity of the recombinant ORF73 was further analysed by ELISA and the optimal conditions were determined. The ORF73 ELISA was used to compare the KSHV seroprevalence between Hubei and Xinjiang Han people. The Hart people in Xinjiang have significantly higher KSHV seroprevalence than their counterparts in Hubei (6.7% vs 2.9%, P = 0.005).