World’s highest rate of leukaemia virus type 1 found in Central Australian Aboriginal communities
Infection with the human T cell leukaemia virus type 1 (HTLV-1) subtype C is endemic among Aboriginal people in central Australia. Researchers in the Northern Territory conducted a large-scale, community-based prevalence study in seven remote Aboriginal communities. Residents over the age of 2 years were invited to participate in the study between August 2014 and June 2018. HTLV-1 infection was defined as a positive western blot (WB) test or a positive HTLV-1 polymerase chain reaction (PCR) test. Seven-hundred and twenty community residents participated in the study (children < 15 years, 142; adults, 578). The prevalence for children and adults was 3.5% (5/142) and 36.8% (213/578) respectively, reaching 49.3% (106/215) for those older than 45 years. A wide range of proviral loads were measured for both asymptomatic and symptomatic participants, with no difference within groups according to age or gender; however, the median proviral load was 1.34 log10 higher for symptomatic participants. The adult prevalence of HTLV-1 infection in central Australia is the highest reported worldwide. Sexual contact is likely to be the predominant mode of transmission, according to the authors. The study was published in PLOS Neglected Tropical Diseases.
Pfizer booster jab ten times more effective at stopping COVID-19 infection than no booster
A study published in the New England Journal of Medicine shows that people who have had the Pfizer–BioNTech COVID-19 booster vaccine are ten times less likely to get infected, and nearly 18 times less likely to get severe infection than those without a booster. The data come from nearly 4.7 million people aged over 16 years in Israel, which had one of the fastest and most comprehensive vaccine rollouts in the world. “The rate of confirmed infection was lower in the booster group than in the non-booster group by a factor of approximately 10 and was lower in the booster group than in the early post-booster group by a factor of 4.9 to 10.8. The adjusted rate difference ranged from 57.0 to 89.5 infections per 100 000 person-days in the primary analysis and from 34.4 to 38.3 in the secondary analysis. The rates of severe illness in the primary and secondary analyses were lower in the booster group by a factor of 17.9 (95% confidence interval [CI], 15.1 to 21.2) and 6.5 (95% CI, 5.1 to 8.2), respectively, among those 60 years of age or older and by a factor of 21.7 (95% CI, 10.6 to 44.2) and 3.7 (95% CI, 1.3 to 10.2) among those 40 to 59 years of age. The adjusted rate difference in the primary and secondary analyses was 5.4 and 1.9 cases of severe illness per 100 000 person-days among those 60 years of age or older and 0.6 and 0.1 among those 40 to 59 years of age. Among those 60 years of age or older, mortality was lower by a factor of 14.7 (95% CI, 10.0 to 21.4) in the primary analysis and 4.9 (95% CI, 3.1 to 7.9) in the secondary analysis. The adjusted rate difference in the primary and secondary analyses was 2.1 and 0.8 deaths per 100 000 person-days,” the authors reported. A second study from Israel also shows that over-50s who received a booster at least 5 months after their second dose had 90% lower COVID-19 mortality than those without a booster. “Death due to COVID-19 occurred in 65 participants in the booster group (0.16 per 100 000 persons per day) and in 137 participants in the non-booster group (2.98 per 100 000 persons per day). The adjusted hazard ratio for death due to COVID-19 in the booster group, as compared with the non-booster group, was 0.10 (95% confidence interval, 0.07 to 0.14; P < 0.001)”, the authors reported.
Nearly half of Australians are living with a chronic condition
About 47% of all Australians are living with a chronic illness or condition, according to a report by the Australian Institute of Health and Welfare (AIHW). The report looks at the health and employment outcomes of working age Australians with chronic conditions and says those with a chronic condition are nearly 10% less likely to have a full-time or part-time job than those without a chronic condition. One in four people with a chronic condition said their health was poor, with major socio-economic factors such as home ownership and education strongly linked to the health of someone with a chronic condition. The report, Life and work experiences of Australians with chronic conditions, looks at how people with chronic conditions aged 15–64 years were faring before 2020, providing baseline information for further research. It also takes an in-depth look at factors that were associated with poor health among mature working-age Australians (aged 45–64 years) living with chronic conditions. Data from the Australian Bureau of Statistics National Health Survey show that, in 2017–18, working-age Australians (15–64 years) living with chronic conditions, compared with those without chronic conditions, were less likely to be employed either full-time or part-time (71% v 80%), were more likely to receive a government pension or allowance (18% v 7%), and were more likely to live outside major city areas (29% v 23%).
Drugs for anxiety and antidepressants trigger post-surgery delirium
Older people taking a drug used to treat anxiety and insomnia – nitrazepam – as well as those taking antidepressants are twice as likely to have postoperative delirium after hip and knee surgery, an Australian study, published in Drug Safety, has found. University of South Australia scientists scanned data from 10 456 patients aged 65 years and older who had undergone knee or hip surgery in the past 20 years. A quarter of them (2614 people) had experienced delirium after surgery. Apart from nitrazepam and antidepressants, five medications – commonly prescribed for depression and various anxiety disorders – were associated with delirium, although not to the same extent. They included sertraline, mirtazapine, venlafaxine, citalopram and fluvoxamine. The researchers wrote that there was no link between pain-relieving opioids and delirium. Smoking, alcohol use, multiple health conditions, polypharmacy (taking five or more medications), psychoactive drugs and impaired cognition also put people at risk. The researchers hope that evidence-based recommendations can be implemented into clinical practice so that delirium risk by medicine type can be reduced. “In people undergoing elective procedures it should be practical to taper specific medications well in advance. It’s important that people are weaned off these riskier drugs well before surgery because abrupt withdrawal can have even worse consequences,” they said.