Background: Enteroviruses (EVs) are most commonly associated with either mild or asymptomatic infections, however, the presence of silent carriers in the community has been proven to play a crucial role in the spread of diseases such as hand, foot, and mouth disease (HFMD) that records high incidence in Asia Pacific region. In the Philippines, limited information is available on the etiology and prevalence of enterovirus outside the Acute Flaccid Paralysis (AFP) surveillance, thus, a study to determine the baseline prevalence of Non-Polio Enteroviruses (NPEVs) among healthy Filipino children was conducted. Methods: A descriptive, cross-sectional study was performed to determine the prevalence of NPEV among healthy children under 6 years old in the Philippines. Duplicate stool samples were collected from 360 healthy children residing in three major urban cities in the country. Virus isolation and polymerase chain reaction were performed to identify enteroviruses present in the samples. To determine if the results of the study are comparable to the AFP surveillance data, the results of the study were compared to the prevalence and isolation rate among AFP cases of the similar cases collected the same year. Results: Prevalence of enteroviruses among healthy children was found to be at 24.7%. Comparing the NPEV rates from the study and AFP surveillance of similar age and the same year of collection, there was no significant difference in NPEV case prevalence. The study identified a total of 19 different enterovirus serotypes with majority belonging to species Enterovirus B (EV-B). Conclusion: The study was able to establish a baseline NPEV case prevalence of 24.7% among healthy children aged under 6 years old in three major urban sites in the Philippines. The high isolation of NPEV among healthy children signifies continuous fecal-oral transmission of enteroviruses in the community.

We performed a linkage analysis in the total NIMH sample to assess the roles gender, education, and APOE e4 dose play in influencing the linkage to age at onset (AAO) of Alzheimer's disease. Treating AAO as a censored quantitative trait, we obtained the covariate-adjusted deviance residuals in Cox proportional hazard models and then analyzed the residuals as the quantitative trait in variance component linkage analyses in SOLAR. Adjusting for no covariates or gender produced identical heritability estimates of 7% and two peaks with LOD>1 on chromosome 5 at 68cM (LOD ¼ 1.16) and on chromosome 19 at 74cM (LOD ¼ 2.02). Adjusting for education alone or education plus gender not only increased the heritability to 22% but also detected three additional chromosome regions with LOD>1 on chromosome 2 at 283 cM (LOD ¼ 1.62), chromosome 7 at 50cM (LOD ¼ 1.78), and chromosome 9 at 133cM (LOD ¼ 1.32). However, adjusting for APOE e4 dose or APOE e4 dose plus gender resulted in the LOD scores below 1 in all 22 autosomes and lowered the heritability estimate to 4%. Our results suggested that gender had only minimal impact on the linkage to AAO; education had considerable influence but was not hypothesized to be causally related to AAO of AD; the APOE gene was more likely to be an intermediate in the causal pathway between other quantitative trait loci (QTL) and AAO. Our study also indicated that important environmental risk factors that decrease phenotypic variability through their adjustments should be included in the covariate linkage models, whereas effect modifiers that are causal or intermediate factors should not. 522-SA PILOT STUDY OF RAPID HIV TESTING AND COUNSELING SERVICE (CBVCT) FOR COMMERCIAL SEX VENUES IN LIMA, PERU. *S Sanchez, A Ghee, S Sanchez, M Jiménez, P Campos, F Spielberg (Asociacion Impacta Salud y Educacion, Lima, Peru) Female sexual workers (FSW) and their male clients play a crucial role in HIV transmission. New strategies, such as improved access to HIV counseling and testing (VCT), are central to HIV control efforts in these groups. An estimated 33% of FSW were screened in clinic settings in Metropolitan Lima in 2002. We studied the feasibility of mobile community-based VCT services (CBVCT) for FSW and their clients at commercial sex venues in the city of Lima. Self-identified FSW and clients !18 years old were invited to participate. Pretest counseling and rapid HIV testing were offered. Instead of giving rapid test results on-site, participants could obtain results and posttest counseling by telephone or in-person at a clinic site. Between November '05 and January '06 243 FSW and 170 clients had been offered the service; 91% of FSW and 37% of clients participated. The primary reasons FSW refused to participate were having been screened in the last year (48%) and a lack of confidence in the rapid test technology (14%). Among male clients the primary reasons were insufficient time available (32%) and seeing HIV testing as unnecessary because they were healthy (13%). Clients refused participation more ...

Background One of the indicators of a properly functioning Acute Flaccid Paralysis (AFP) surveillance is the proportion of stool samples in which non-polio enteroviruses (NPEV) are detected. Typically, this proportion is expected to be above 10% in tropical countries, however, the Philippines only averages 6.5% NPEV isolation rate. With continued threat of possible importation of wild poliovirus, the current NPEV rate prompted concerns about the quality of the AFP surveillance, in particular, stool sample management and transportation being performed in the field. To know whether the low NPEV rates gathered from AFP cases is a reflection of the true prevalence in the Philippines, a stool survey of healthy children 0-5 years old from three urban communities was conducted in 2015.Methods Two stool samples were collected from three hundred sixty healthy children. Virus isolation and Polymerase Chain Reaction was performed to identify enteroviruses in the samples. The results were compared to the prevalence and isolation rate among AFP cases the same year.Results Results show a prevalence of 24.7% which is higher than 12.4% prevalence rate among AFP cases the similar year. However, analysis of AFP cases between 0-5 years old showed prevalence of 20.8% (p-value 0.33) which is not significantly different when compared to the study.Conclusion This study supports the idea that the observed low NPEV rate in the country may be due to low number of NPEV prevalence. However, further investigations on all possible data sources for NPEV such as among hand, foot, and mouth disease (HFMD), and aseptic meningitis cases, may be necessary to fully understand the occurrence of NPEVs in the country.

Background Enteroviruses are most commonly associated with either mild or asymptomatic infections, however, the presence of silent carriers in the community has been proven to play a crucial role in the spread of diseases such as HFMD that records high incidence in Asia Pacific region. In the Philippines, limited information is available on the etiology and prevalence of enterovirus outside the Acute Flaccid Paralysis (AFP) surveillance. Methods Duplicate stool sampleswere collected from 360 healthy children. Virus isolation and polymerase chain reaction were performed to identify enteroviruses present in the samples. To determine if the results of the study are comparable to the AFP surveillance data, the results of the study were compared to the prevalence and isolation rate among AFP cases of the similar cases collected the same year. Results Prevalence of enteroviruses among healthy children was found to be at 24.7%. Comparing the NPEV rates from the study and AFP surveillance of similar age and the same year of collection, there was no significant difference in NPEV case prevalence.The study identified a total of 19 different enterovirus serotypes with majority belonging to species Enterovirus B (EV-B). Conclusion The study was able to establish a baseline NPEV case prevalence of 24.7% among healthy children aged under 6 years old in three major urban sites in the Philippines. The high isolation of NPEV among healthy children signifies continuous fecal-oral transmission of enteroviruses in the community. Surveillance of other diseases caused by EVs, such as HFMD and meningitis is necessary in order to complete the picture of EV circulation in the Philippines.