P. Imnadze
Tbilisi State University, Public Health, Faculty Member
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Entamoeba histolytica est un protozoaire qui sevit dans le monde entier et on estime que 12% de la population mondiale est infectee (1). La prevalence de l’infection varie de 1% dans les pays industrialises a 50-80% dans les pays... more
Entamoeba histolytica est un protozoaire qui sevit dans le monde entier et on estime que 12% de la population mondiale est infectee (1). La prevalence de l’infection varie de 1% dans les pays industrialises a 50-80% dans les pays tropicaux, ou la transmission des kystes d’E. histolytica par l’eau non traitee est frequente. L’ingestion d’aliments ou de boissons contamines par des kystes d’E. histolytica provenant de matieres fecales humaines et le contact direct de la bouche avec des matieres fecales sont les modes d’infections les plus frequents (2,3).
Research Interests: Humanities and Medicine
Entamoeba histolytica, un protozoo parassita, e diffuso in tutto il mondo e si stima che il 12% della popolazione mondiale ne sia infettata (1). La prevalenza dell'infezione e variabile: 1% nei paesi industrializzati, tra il 50 e... more
Entamoeba histolytica, un protozoo parassita, e diffuso in tutto il mondo e si stima che il 12% della popolazione mondiale ne sia infettata (1). La prevalenza dell'infezione e variabile: 1% nei paesi industrializzati, tra il 50 e l'80% nei paesi tropicali, dove e comune la trasmissione delle cisti di E. histolytica per mezzo di acqua non depurata. Le modalita d'infezione piu comuni comprendono l'ingestione di cibo e bevande contaminati con cisti di E. histolytica provenienti da feci umane e i contatti oro-fecali diretti (2,3), ma i focolai di E. histolytica vengono raramente notificati. I portatori di cisti costituiscono il principale serbatoio infettivo.
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The Center for Infectious Diseases Control, Georgian Ministry of Health, isolated 2,493 Yersinia enterocolitica and Y. enterocolitica-like strains, 22 Y. pestis strains, and 21 Y. pseudotuberculosis strains from 130,574 clinical and... more
The Center for Infectious Diseases Control, Georgian Ministry of Health, isolated 2,493 Yersinia enterocolitica and Y. enterocolitica-like strains, 22 Y. pestis strains, and 21 Y. pseudotuberculosis strains from 130,574 clinical and environmental samples. Analysis of 100 Y. enterocolitica and Y. enterocolitica-like strains showed none to be within traditional pathogenic biogroups or serogroups, and none carried genetic markers for virulence. However, some strains were enterotoxigenic in infant mice, while others were associated with prolonged carriage in adult mice.
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Tularemia has sustained seroprevalence in Eurasia, with estimates as high as 15% in endemic regions. The purpose of this report is to characterise the current epidemiology of Francisella tularensis subspecies holarctica in Georgia. Three... more
Tularemia has sustained seroprevalence in Eurasia, with estimates as high as 15% in endemic regions. The purpose of this report is to characterise the current epidemiology of Francisella tularensis subspecies holarctica in Georgia. Three surveillance activities are summarised: (1) acute infections captured in Georgia's notifiable disease surveillance system, (2) infectious disease seroprevalence study of military volunteers, and (3) a study of seroprevalence and risk factors in endemic regions. Descriptive analyses of demographic, exposure and clinical factors were conducted for the surveillance studies; bivariate analyses were computed to identify risk factors of seropositivity using likelihood ratio χ2 tests or Fisher's exact tests. Of the 19 incident cases reported between 2014 and August 2017, 10 were confirmed and nine met the presumptive definition; the estimated annual incidence was 0.12/100 000. The first cases of tularemia in Western Georgia were reported. Seropreva...
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Background Methicillin-resistant Staphyloccocus aureus (MRSA) is a major cause of nosocomial infections in the United States. It is unclear if former Soviet republics face similar levels of MRSA as Western nations. Our study objectives... more
Background Methicillin-resistant Staphyloccocus aureus (MRSA) is a major cause of nosocomial infections in the United States. It is unclear if former Soviet republics face similar levels of MRSA as Western nations. Our study objectives were to determine the prevalence of and identify risk factors for colonization with MRSA and S. aureus at the time of hospital admission among patients in Tbilisi, Republic of Georgia. Methods Anterior nares cultures were obtained from patients within 48 hours of admission to 1 of 5 hospitals (including general hospitals, a pediatric hospital, an oncology clinic, and a sepsis center) in Tbilisi over 1 month in 2004. S. aureus was identified by standard methods, and susceptibility was determined using agar plates containing 6 μg/mL of oxacillin. Demographic data, medical and social history, prior hospitalizations, antibiotic usage, and residential status were obtained through patient interviews. Characteristics of patients were compared using Pearson chi-square test and Fisher's exact test as appropriate. Results S. aureus was present in 74 (23.5%) of 315 patients from whom anterior nares cultures were obtained at the time of admission; 3 (1%) patients had a positive culture for MRSA. The demographic and clinical characteristics of persons with a positive nasal culture for S. aureus did not differ significantly from those persons with a negative nares culture; the median age was 29 years (range 1-91); 130 (41%) were male; 69 (22%) were diagnosed with bacterial or viral infection at admission; 50 (16%) had a history of previous hospitalization within 12 months; and 165 (53%) had a history of antibiotic use over the prior 12 months. Persons colonized with MRSA were more likely to report a history of bacterial or viral infection within the past 12 months (p = .04). Conclusion The overall prevalence of nasal colonization with S. aureus in Tbilisi was similar to the prevalence observed in the U.S. However, the prevalence of nasal MRSA colonization (1%) was substantially lower than that observed at our urban public hospital in Atlanta, GA, where rates exceed 7%. Further studies are needed to assess the prevalence of MRSA in the Republic of Georgia and to determine why rates of MRSA colonization remain lower than those reported from the U.S. and a number of countries in Europe.
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SUMMARYHuman anthrax cases reported in the country of Georgia increased 75% from 2011 (n= 81) to 2012 (n= 142). This increase prompted a case-control investigation using 67 culture- or PCR-confirmed cases and 134 controls matched by... more
SUMMARYHuman anthrax cases reported in the country of Georgia increased 75% from 2011 (n= 81) to 2012 (n= 142). This increase prompted a case-control investigation using 67 culture- or PCR-confirmed cases and 134 controls matched by residence and gender to investigate risk factor(s) for infection during the month before case onset. Independent predictors most strongly associated with disease in the multivariable modelling were slaughtering animals [odds ratio (OR) 7·3, 95% confidence interval (CI) 2·9–18·1,P< 0·001] and disposing of dead animals (OR 13·6, 95% CI 1·5–119·8,P= 0·02). Participants owning or working with livestock (n= 131) were additionally interviewed about livestock management practices during the previous 6 months: 53 (44%) of 121 respondents vaccinated livestock against anthrax; 19 (16%) of 116 moved livestock >1 km; 15 (12%) of 125 had sick livestock; and 11 (9%) of 128 respondents reported finding dead livestock. We recommend joint public health and veterina...
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The aim of four years study was to determine the prevalence of HCV infection in the general population of Georgia and to assess HCV genotypes spread among them. For performing the planned investigation a cross-sectional study design was... more
The aim of four years study was to determine the prevalence of HCV infection in the general population of Georgia and to assess HCV genotypes spread among them. For performing the planned investigation a cross-sectional study design was applied. Study subjects were Tbilisi residents selected through multiple clusters sampling technique application. Tbilisi is divided into ten districts. 2000 persons from the general adult population of Tbilisi, Georgia were enrolled in the study. The multi-stage cluster sampling method was applied for selection of study subjects. Districts of Tbilisi were considered as sub-populations. At the first stage the number of Population distribution by each districts were calculated. Number of study subjects by each districts were determined proportionally population. A list of study participants were obtained from primary sampling units--policlinics (Primary Health Care Units--PHCUs) in all ten districts of Tbilisi. A fieldwork was arranged for interviewin...
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The primary goal of this study was to assess the prevalence of Rickettsia and Borellia in ticks collected from different regions of Georgia.
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SummaryMEEREB is an informal network of rabies experts from the Middle East, Eastern Europe and Central Asia, seeking to eliminate rabies from the region. They met for the second time to review the current rabies situation, both globally... more
SummaryMEEREB is an informal network of rabies experts from the Middle East, Eastern Europe and Central Asia, seeking to eliminate rabies from the region. They met for the second time to review the current rabies situation, both globally and in their respective countries, highlighting current rabies control problems and potential solutions. Success stories in Latin America, in Western Europe, in some Asian countries, as well as in Croatia and Serbia prove that elimination of human rabies is achievable in the MEEREB region. It requires political willingness and cooperation of all stakeholders, including Ministries of Health and of Agriculture; adequate management of animal bites through post‐exposure prophylaxis; pre‐exposure prophylaxis for populations at high risk of rabies exposure, animal vaccination and humane control of stray dog populations. MEEREB members called for a regional initiative for rabies elimination in Eastern Europe and the Middle East. They are confident that the...
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SUMMARYHuman brucellosis occurs when humans ingest or contact Brucella spp. from shedding animals or contaminated environments and food. In Georgia animal and human brucellosis is endemic, but the epidemiology has not been fully... more
SUMMARYHuman brucellosis occurs when humans ingest or contact Brucella spp. from shedding animals or contaminated environments and food. In Georgia animal and human brucellosis is endemic, but the epidemiology has not been fully characterized. A case-control study was conducted in 2010 to identify risk factors for human brucellosis. Using multivariable logistic regression, the following risk factors were identified: animal-related work [odds ratio (OR) 77·8, 90% confidence interval (CI) 4·7–1278], non-animal-related work (OR 12·7, 90% CI 1·1–149), being unemployed or a pensioner (OR 13·1, 90% CI 1·7, 101), sheep ownership (OR 19·3, 90% CI 5·1–72·6), making dairy products (OR 12·4, 90% CI 1·4–113), living in eastern Georgia (Kakheti) (OR 278·1, 90% CI 9·5–8100), and being aged >44 years (OR 9·3, 90% CI 1·02–84·4). Education of at-risk groups about risk factors and control of disease in sheep may reduce the human disease risk. This is the first study of its kind in Georgia since th...
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Foodborne botulism is a potentially fatal, paralytic illness that can cause large outbreaks. A possible increase in botulism incidence during 2001 in the Republic of Georgia prompted this study. We reviewed surveillance data and... more
Foodborne botulism is a potentially fatal, paralytic illness that can cause large outbreaks. A possible increase in botulism incidence during 2001 in the Republic of Georgia prompted this study. We reviewed surveillance data and abstracted records of patients with botulism who were ...
Research Interests: Food Safety, Medical Microbiology, Adolescent, Food Preservation, Emerging Infectious Diseases, and 15 moreDisease Outbreaks, Humans, Child, Female, Male, Infant, Botulism, Clinical Sciences, Aged, Middle Aged, Adult, Public health systems and services research, Food Contamination, Medical Records, and Population surveillance
Information on the infectious causes of undifferentiated acute febrile illness (AFI) in Georgia is essential for effective treatment and prevention. In May 2008, a hospital-based AFI surveillance was initiated at six hospitals in Georgia.... more
Information on the infectious causes of undifferentiated acute febrile illness (AFI) in Georgia is essential for effective treatment and prevention. In May 2008, a hospital-based AFI surveillance was initiated at six hospitals in Georgia. Patients aged ≥ 4 years with fever ≥ 38°C for ≥ 48 hours were eligible for surveillance. Blood culture and serologic testing were conducted for Leptospira spp., Brucella spp., West Nile virus (WNV), Crimean-Congo hemorrhagic fever virus, Coxiella burnetii, tick-borne encephalitis virus (TBEV), hantavirus, Salmonella enterica serovar Typhi (S. Typhi), and Rickettsia typhi. Of 537 subjects enrolled, 70% were outpatients, 54% were males, and the mean age was 37 years. Patients reported having fatigue (89%), rigors (87%), sweating (83%), pain in joints (49%), and sleep disturbances (42%). Thirty-nine (7%) patients were seropositive for R. typhi, 36 (7%) for Brucella spp., 35 (7%) for TBEV, 12 (2%) for Leptospira spp., 10 (2%) for C. burnetii, and three...
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Bacillus anthracis causes the acute fatal disease anthrax, is a proven biological weapon, and is endemic in Georgia, where human and animal cases are reported annually. Here, we present whole-genome sequences of 10 historical B. anthracis... more
Bacillus anthracis causes the acute fatal disease anthrax, is a proven biological weapon, and is endemic in Georgia, where human and animal cases are reported annually. Here, we present whole-genome sequences of 10 historical B. anthracis strains from Georgia.
Multiple factors help shape the infant intestinal microbiota early in life. Environmental conditions such as the presence of bioactive molecules from breast milk dictate gut microbial growth and survival. Infants also receive distinct,... more
Multiple factors help shape the infant intestinal microbiota early in life. Environmental conditions such as the presence of bioactive molecules from breast milk dictate gut microbial growth and survival. Infants also receive distinct, personalized, bacterial exposures leading to differential colonization. Microbial exposures and gut environmental conditions differ between infants in different locations, as does the typical microbial community structure in an infant's gut. Here we evaluate potential influences on the infant gut microbiota through a longitudinal study on cohorts of breast-fed infants from the neighboring countries of Armenia and Georgia, an area of the world for which the infant microbiome has not been previously investigated. Marker gene sequencing of 16S ribosomal genes revealed that the gut microbial communities of infants from these countries were dominated by bifidobacteria, were different from each other, and were marginally influenced by their mother's...
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Malaria mosquito larvae and imagoes underwent morphological, cytogenetic, and molecular genetic analyses in West and East Georgia. In the areas under study, the authors identified three related types of malaria mosquitoes of the... more
Malaria mosquito larvae and imagoes underwent morphological, cytogenetic, and molecular genetic analyses in West and East Georgia. In the areas under study, the authors identified three related types of malaria mosquitoes of the maculipennis complex: An. maculipennis Meigen, 1818; An. melanoon Hacket, 1934; An. sacharovi Favre, 1903. The authors revealed the types An. maculipennis and An. melanoon in the Kolkhida cavity (West Georgia) and An. maculipennis and An. sacharovi in the Iveria cavity (East Georgia). The morphology of eggs was defined in the study types of mosquitoes. An. melanoon ovipositions similar in the exochorion pattern with An. messeae eggs were found in West Georgia.
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TheCenterforInfectiousDiseasesControl,GeorgianMinistryofHealth,isolated2,493Yersiniaenterocolitica andY. enterocolitica-like strains, 22Y. pestisstrains, and 21Y. pseudotuberculosisstrains from 130,574 clinical and environmental samples.... more
TheCenterforInfectiousDiseasesControl,GeorgianMinistryofHealth,isolated2,493Yersiniaenterocolitica andY. enterocolitica-like strains, 22Y. pestisstrains, and 21Y. pseudotuberculosisstrains from 130,574 clinical and environmental samples. Analysis of 100Y. enterocoliticaandY. enterocolitica-like strains showed none to be within traditional pathogenic biogroups or serogroups, and none carried genetic markers for virulence. However, some strains were enterotoxigenic in infant mice, while others were associated with prolonged carriage in adult mice. TheRepublicofGeorgia(oneoftherepublicsoftheformer USSR) is a
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... Later, however, at the request of the head of the Georgian AP Station, Professor Levan Sakvarelidze, several strains of Y. pestis ... 1. Abesadze, B., Chkheidze, G., Maskharashvili, P., Nersesov, V., Jmukhadze, I., Dzneladze, M. On... more
... Later, however, at the request of the head of the Georgian AP Station, Professor Levan Sakvarelidze, several strains of Y. pestis ... 1. Abesadze, B., Chkheidze, G., Maskharashvili, P., Nersesov, V., Jmukhadze, I., Dzneladze, M. On natural endemicity of plague in semi-desert zone ...
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Research Interests: Adolescent, Food Microbiology, Biological Sciences, Humans, Child, and 15 moreFemale, Male, Infant, Dyspnea, Botulism, Aged, Middle Aged, Adult, Mechanical Ventilation, Medical Records, Botulinum Toxin, Clinical Infectious Diseases, Child preschool, Medical and Health Sciences, and Case fatality rate
Research Interests: Quality of life, Adolescent, Probability, Biological Sciences, Disease Outbreaks, and 15 moreHumans, Child, Female, Male, Confidence intervals, Incidence, Botulism, Aged, Middle Aged, Adult, Odds ratio, Clinical Infectious Diseases, Case Control Studies, Foodborne diseases, and Medical and Health Sciences
Entamoeba histolytica, a protozoan parasite, occurs worldwide and 12% of the world's population are estimated to be infected. The prevalence of infection varies between 1% in industrialised countries to between 50% and 80% in tropical... more
Entamoeba histolytica, a protozoan parasite, occurs worldwide and 12% of the world's population are estimated to be infected. The prevalence of infection varies between 1% in industrialised countries to between 50% and 80% in tropical countries, where tra
The incidence of rabies post-exposure prophylaxis (PEP) is very high in Georgia, at 876/100,000 persons in 2006. Data from the National Centre for Disease Control on rabies surveillance for 2004, 2005 and 2006 was analysed, with the... more
The incidence of rabies post-exposure prophylaxis (PEP) is very high in Georgia, at 876/100,000 persons in 2006. Data from the National Centre for Disease Control on rabies surveillance for 2004, 2005 and 2006 was analysed, with the objective of improving postexposure policy and practice, as well as identifying priorities for national surveillance and control. For the base period 1986-1995, a total of 40 rabies cases in humans were reported in Georgia. In 2004, 2005 and 2006 there were 12, 10 and 7 reported cases, respectively, representing a significant increase in overall incidence for this period. Ninety-three percent (93%) of cases were caused by dog bites. The large population of stray dogs and unvaccinated pets in Georgia is recognized as the main risk factor. In 2006, 38,569 patients received PEP following bites by an animal with suspected rabies, compared to 23,712 in 2004, and 30,254 in 2005 (representing a 1/3 increase annually). Of the total number of PEP treatments initi...
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Minimal information is available on the incidence of Crimean-Congo hemorrhagic fever (CCHF) virus and hantavirus infections in Georgia. From 2008 to 2011, 537 patients with fever ≥ 38°C for ≥ 48 hours without a diagnosis were enrolled... more
Minimal information is available on the incidence of Crimean-Congo hemorrhagic fever (CCHF) virus and hantavirus infections in Georgia. From 2008 to 2011, 537 patients with fever ≥ 38°C for ≥ 48 hours without a diagnosis were enrolled into a sentinel surveillance study to investigate the incidence of nine pathogens, including CCHF virus and hantavirus. Of 14 patients with a hemorrhagic fever syndrome, 3 patients tested positive for CCHF virus immunoglobulin M (IgM) antibodies. Two of the patients enrolled in the study had acute renal failure. These 2 of 537 enrolled patients were the only patients in the study positive for hantavirus IgM antibodies. These results suggest that CCHF virus and hantavirus are contributing causes of acute febrile syndromes of infectious origin in Georgia. These findings support introduction of critical diagnostic approaches and confirm the need for additional surveillance in Georgia.
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... Francisco Canindé de Sousa Junior I ; Éderson William de Figueiredo Nunes I ; Ermeton Duarte do Nascimento I ; Solange Maria de Oliveira II ; Maria Celeste Nunes de Melo I ; Maria José de Britto Costa ... 1. Andrade ATL, Guerra MO,... more
... Francisco Canindé de Sousa Junior I ; Éderson William de Figueiredo Nunes I ; Ermeton Duarte do Nascimento I ; Solange Maria de Oliveira II ; Maria Celeste Nunes de Melo I ; Maria José de Britto Costa ... 1. Andrade ATL, Guerra MO, Andrade GN, Araújo DAC, Souza JP. ...
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Division of Reproductive Health, Centers for Disease Control and Prevention (DRHlCDC) ATLANTA, GEORGIA USA ... United Nations Population Fund (UNFPA) United Nations Children&#x27;s Fund (UNICEF) United States Agency for International... more
Division of Reproductive Health, Centers for Disease Control and Prevention (DRHlCDC) ATLANTA, GEORGIA USA ... United Nations Population Fund (UNFPA) United Nations Children&#x27;s Fund (UNICEF) United States Agency for International Development (US~ID) United ...
Vaccine safety fears following media reports of adverse events led to low (50.3%) coverage in a supplementary measles-rubella immunization campaign in Georgia in 2008. Review of adverse events associated with the campaign identified 432... more
Vaccine safety fears following media reports of adverse events led to low (50.3%) coverage in a supplementary measles-rubella immunization campaign in Georgia in 2008. Review of adverse events associated with the campaign identified 432 reports (&lt;0.1% of ∼ 493,000 vaccinees) including 338 (78.2%) cases of syncope. There were no deaths. Causality assessment was performed for 79 cases perceived by providers as severe and with clinical details available. Conditions likely caused by the vaccine were identified in 13 (16.5%) cases (allergic and local reactions, thrombocytopenia). Thirty-seven (46.8%) cases had symptoms consistent with syncope or anxiety attack; 36 (97.3%) of them were initially misdiagnosed as anaphylactic shock/allergies/&quot;postvaccinal reactions&quot;. Twenty-nine (36.7%) cases had coincidental illnesses. Safety fears were unfounded and exaggerated by media reports and providers&#39; difficulties in recognizing syncope/anxiety attacks. Risk communication strategies to address perceived vaccine safety concerns are urgently needed to ensure that the goal of measles and rubella elimination in the European Region of the World Health Organization is met.
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ABSTRACT Epidemic diphtheria reemerged in the republic of Georgia in 1993. From 1993 to 1997, 1405 cases were reported (28 in 1993, 312 in 1994, 429 in 1995, 348 in 1996, and 288 in 1997), with a cumulative incidence of 25.8/100,000 and a... more
ABSTRACT Epidemic diphtheria reemerged in the republic of Georgia in 1993. From 1993 to 1997, 1405 cases were reported (28 in 1993, 312 in 1994, 429 in 1995, 348 in 1996, and 288 in 1997), with a cumulative incidence of 25.8/100,000 and a case fatality ratio of 9.5%. During 1993-1997, 53% of the diphtheria cases occurred among persons &gt;/=15 years of age. Unvaccinated patients were more likely to have toxic forms (relative risk=2.24; 95% confidence interval=1.69-2.96) or to die of diphtheria (relative risk=2.24; 95% confidence interval=1. 36-3.68) than those who had received at least one dose of diphtheria toxoid. Improvement in routine childhood vaccination coverage and implementation of mass adult vaccination campaigns have been critical to bringing the epidemic under control. By mid-1998, the overall diphtheria situation in Georgia appeared to have been controlled. Only 53 cases were reported from January to June 1998, representing a 64% decrease from the 148 cases during the corresponding period in 1997.
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Sixty-six Corynebacterium diphtheriae strains (62 of the gravis biotype and 4 of the mitis biotype) isolated during the Georgian diphtheria epidemic of 1993 to 1998 and 13 non-Georgian C. diphtheriae strains (10 Russian and 3 reference... more
Sixty-six Corynebacterium diphtheriae strains (62 of the gravis biotype and 4 of the mitis biotype) isolated during the Georgian diphtheria epidemic of 1993 to 1998 and 13 non-Georgian C. diphtheriae strains (10 Russian and 3 reference isolates) were characterized by (i) biotyping, (ii) toxigenicity testing with the Elek assay and PCR, (iii) the randomly amplified polymorphic DNA (RAPD) technique, and (iv) pulsed-field gel electrophoresis (PFGE). Fifteen selected strains were ribotyped. Six RAPD types and 15 PFGE patterns were identified among all strains examined, and 12 ribotypes were found among the 15 strains that were ribotyped. The Georgian epidemic apparently was caused by one major clonal group of C. diphtheriae (PFGE type A, ribotype R1), which was identical to the predominant epidemic strain(s) isolated during the concurrent diphtheria epidemic in Russia. A dendrogram based on the PFGE patterns revealed profound differences between the minor (nonpredominant) epidemic strai...