Molecular Sovereignty: Building a Blood Screening Test for the Brazilian Nation

This article interrogates the relationship between the development of national diagnostic technologies and the exercise of sovereignty, by analysing a Brazilian project to produce a nucleic acid test (NAT) for the country’s blood screening programme. The concept of ‘molecular sovereignty’ is proposed to demonstrate that exercising sovereignty demands not only technological resources but also a sufficiently powerful and national imaginary to support local knowledge production as a means of advancing national healthcare priorities. First, this research article contextualises the political importance of blood safety for Brazil during its transition to democracy in the 1980s and the creation of its universal healthcare system. Then, it investigates how adopting the NAT led the state to invest in the production of a national technology. Third, the article unpacks the diagnostic test to consider how certain aspects of the project might ultimately strengthen the ability of global capital to cross national boundaries and create new markets. Lastly, it discusses how the project ended up creating a centralised and ‘closed’ system to avoid leaving the country vulnerable to the entry of global diagnostic companies. This case demonstrates how the molecularisation of blood, through the construction of a unified healthcare system driven by the constitutional right to health, can be deployed to construct imagined communities on the scale of a nation.

Case report: fatal bleeding from a duodenal ulcer—Dieulafoy’s lesion?

A 46-year-old man was admitted to the hospital by ambulance due to syncope. A standard blood screening showed a normal Hb value. The man had known hemorrhoids and a single fresh rectal bleeding earlier at home. On the following morning, the patient suddenly required resuscitation within a few minutes and subsequently died. Autopsy revealed a fatal hemorrhage with blood loss in the stomach and small and large intestines and a mucosal defect of the duodenum. After autopsy, the question arose whether the cause of death might have been a rare Dieulafoy’s lesion—aim of this case report was to clarify the diagnosis.

Prevalence of Toxoplasmosis antibodies in blood donors in Tripoli area

Toxoplasma gondii is the organism that is responsible for toxoplasmosis disease. Toxoplasma gondii: is a crucial obligate intracellular parasite of humans and animals worldwide and infects nearly one-third of humanity; the disease can be severe and can lead to abortion or neonate’s death. In addition, an immunocompromised individual may develop several syndromes such as encephalitis, chorioretinitis, congenital infection and neonatal mortality. In this study, our objective is to determine the prevalence of Toxoplasma gondii antibodies through blood transfusion. Therefore, our study was conducted from 1 May 2010 to 31 of May 2010 among Libyan donors. We tested 164 blood donors from different ages for Toxoplasma gondii antibodies in Tripoli, a capital city of Libya. The results showed that 33.5% of blood donors had positive IgG antibodies. Therefore, this study suggest blood screening with high-performance techniques for Toxoplasma gondii before blood transfusion should be routinely done to avoid severe complications.

Machine and Deep Learning Applied to Predict Metabolic Syndrome Without a Blood Screening

The exponential increase of metabolic syndrome and its association with the risk impact of morbidity and mortality has propitiated the development of tools to diagnose this syndrome early. This work presents a model that is based on prognostic variables to classify Mexicans with metabolic syndrome without blood screening applying machine and deep learning. The data that were used in this study contain health parameters related to anthropometric measurements, dietary information, smoking habit, alcohol consumption, quality of sleep, and physical activity from 2289 participants of the Mexico City Tlalpan 2020 cohort. We use accuracy, balanced accuracy, positive predictive value, and negative predictive value criteria to evaluate the performance and validate different models. The models were separated by gender due to the shared features and different habits. Finally, the highest performance model in women found that the most relevant features were: waist circumference, age, body mass index, waist to height ratio, height, sleepy manner that is associated with snoring, dietary habits related with coffee, cola soda, whole milk, and Oaxaca cheese and diastolic and systolic blood pressure. Men’s features were similar to women’s; the variations were in dietary habits, especially in relation to coffee, cola soda, flavored sweetened water, and corn tortilla consumption. The positive predictive value obtained was 84.7% for women and 92.29% for men. With these models, we offer a tool that supports Mexicans to prevent metabolic syndrome by gender; it also lays the foundation for monitoring the patient and recommending change habits.

The effects of physical distancing and lockdown to restrain SARS-CoV-2 outbreak in the Italian Municipality of Cogne

The outbreak of SARS-CoV-2 started in Wuhan, China, and is now a pandemic. An understanding of the prevalence and contagiousness of the disease, and of whether the strategies used to contain it to date have been successful, is important for understanding future containment strategies. One strategy for controlling the spread of SARS-CoV-2 is to adopt strong social distancing policies. The Municipality of Cogne (I), adopted strict lockdown rules from March 4, 2020 up to May 18, 2020. This first wave of the pandemic impressed by the extremely low impact of the SARS-CoV-2 on the locals, compared to the number accused on all the Italian territory. Starting from October 2020 up to the end of December, when the second wave hit Italy and Cogne territory, heavier effects were observed. In order to cast light on the effectiveness of the adopted strategy 74,5% of the local population underwent to a blood screening to detect IgM and IgG antibodies and after six months all the people tested positive were again investigated to establish the longitudinal changes in antibodies level. Moreover, within the context of this survey a rare and interesting case of secondary infection has been identified and here presented.

HBV and HEV Co-infections among Animal Handlers and Non-Animal Handlers in Osun State, Nigeria

Aim: Co-infection of hepatitis A, B, C, D, and E viruses may lead to severe morbidity and mortality. This study was conducted to determine prevalence of co-infection of HBV and HEV among animal and non-animal handlers in Osun State, Nigeria. Study Design: Cross-sectional study. Place and Duration of Study: Ladoke Akintola University of Technology (LAUTECH), Nigeria, between June 2015 and July 2019. Methods: A total of 180 blood samples were obtained and screened for Hepatitis B and E virus from cohorts of 90 animal handlers and 90 non-animal handlers. Questionnaires on HBV and HEV were administered to obtain a demographic characteristic of the participants. HBsAg and anti-HEV antibodies were screened using HBsAg and HEV ELISA kits. Results: Results showed the overall prevalence of HBV and HEV Co-infection to be 12.2 %. There was variation in the HBV/HEV co-infections rates among the studied population, with a co-infection rates of 15.9%, 14.3% and 7.8% for butchers, pig handlers and non-animal handlers, respectively. Sources of drinking water was the predisposition factor for HBV/HEV coinfections (P=0.02). The results revealed that subjects who used tap and river as a drinking water source had the highest prevalence followed by well and sachet and then all water source. Although results portray no statistically significant association with, frequent washing of hands after, rearing of animal, type of toilet, eating of pork, consumption of grilled meat and cow skin (P> 0.05). Conclusion: This study reported a high prevalence of HBV/HEV coinfections among animal and non-animal handlers in Osun State, Nigeria. There is, therefore, the need to increase health promotion efforts such as immunization, health education, campaign, provision of adequate blood screening equipment and proper hygiene is recommended for further reduction in HBV/HEV transmission. Since the consumption of contaminated water is the main transmission route of HEV, improving the level of public health sanitation in the area should be considered a priority by policymakers.