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INTRODUCTION There is recent interest surrounding the use of the triglyceride-to-HDL cholesterol ratio as a surrogate marker of insulin resistance in clinical practice, as it may identify people at high risk of developing diabetes or its complications. However, it has been suggested using this lipid ratio may not be appropriate for measuring insulin(More)
Unacceptable levels of Mycobacterium tuberculosis transmission are noted in high burden settings and a renewed focus on reducing person-to-person transmission in these communities is needed. We review recent developments in the understanding of airborne transmission. We outline approaches to measure transmission in populations and trials and describe the(More)
There is an emerging epidemic of type 2 diabetes (T2DM) in younger adults. They represent an extreme phenotype: likely to be obese, lead a sedentary lifestyle, have a strong family history of T2DM, be of black or minority ethnic origin, and come from less affluent socioeconomic groups. An accurate diagnosis of T2DM in younger adults, while essential to(More)
In 2004, the United Kingdom Government withdrew free access to secondary healthcare for certain groups of overseas visitors, including those asylum seekers whose claims had failed but were still living legally in the UK. We argue, as others have previously, that the implementation of the 2004 National Health Service (Charges to Overseas Visitors)(More)
BACKGROUND Several high-income countries have pre-entry screening programmes for tuberculosis. We aimed to establish the yield of pre-entry screening programmes to inform evidence-based policy for migrant health screening. METHODS We searched six bibliographic databases for experimental or observational studies and systematic reviews, which reported data(More)
Globally, the rates of decline in tuberculosis (TB) incidence are disappointing, but in line with model predictions regarding the likely impact of the DOTS strategy. Here, we review evidence from basic epidemiology, molecular epidemiology and modelling, all of which suggest that, in high-burden settings, the majority of Mycobacterium tuberculosis(More)
SETTING Molecular epidemiology suggests that most Mycobacterium tuberculosis transmission in high-burden settings occurs outside the home. OBJECTIVE To estimate the risk of M. tuberculosis transmission inside public buildings in a high TB burden community in KwaZulu-Natal, South Africa. DESIGN Carbon dioxide (CO2) sensors were placed inside eight public(More)
BACKGROUND Early diagnosis of HIV infection reduces morbidity and mortality associated with late presentation. Despite UK guidelines, the HIV testing rate has not increased. We have introduced universal HIV screening in an open-access returning traveller clinic. METHODS Data were prospectively recorded for all patients attending the open-access returning(More)
TO THE EDITOR—The study by Middelkoop and colleagues [1] combining molecular and traditional epidemiology in a well-defined population is incredibly valuable. We were surprised that the index tuberculosis case patients in clusters had only twice the odds of being negative for human immunodeficiency virus (HIV), compared with other tuberculosis case(More)
OBJECTIVE To assess persistence of immunity to hepatitis B (HBV) in primary school children vaccinated following perinatal exposure. DESIGN Serological survey. SETTING Five UK sites (Berkshire East, Birmingham, Buckinghamshire, Milton Keynes and Oxfordshire). PARTICIPANTS Children from 3 years 4 months to 10 years of age (mean age 6.2 years),(More)