Background: The aim of this study was to investigate the knowledge, attitudes, and practices of the Greek general population toward coronavirus disease 2019 (COVID-19) during the lockdown period in April 2020, to examine factors associated with misperceptions and to determine behavioral patterns that may require interventions. Methods: A cross-sectional study of the general Greek population (N = 1858) was conducted. A geographically stratified cluster sampling was implemented. A questionnaire was composed consisting of 35 questions. Data collection took place from 15 April to 2 May 2020. A random-digit dialing survey was conducted by 29 interviewers. Results: The majority of respondents (62.7%) answered ≥12/17 questions correctly. Participants aged 18–44 years, male gender, specific occupations (freelancer, unemployed, housewife, retiree) and those who sought information about COVID-19 from less than two sources received lower aggregated scores on knowledge questions. Regarding attitudes toward future vaccination, 18.9% declared that were against it, while 81.1% that they may consider or will be vaccinated. About 40% were not using a face mask and only 42% washed their hands appropriately. Conclusion: Adjusting information campaigns targeting especially people below 45 years of age can help to sensitize them and realise their role to control the spread. Further targeted surveys are needed to adjust/design prevention campaigns.

Background: Outbreaks of norovirus gastroenteritis aboard cruise ships may affect a large number of people, debilitate vulnerable travellers, disrupt vacations and cause economic losses to the cruise ship industry. Aim: We aimed to identify risk factors for norovirus outbreaks on cruise ships and assess the effectiveness of prevention and control measures. Methods: We conducted a systematic literature review searching PubMed and Scopus databases as well as grey literature for articles and reports describing norovirus outbreaks on cruise ships between 1990 and 2020. We also performed a meta-analysis of norovirus prevalence in passengers and crew members. Results: Data from 45 outbreaks on 26 cruise ships from 1990 to 2020 were identified in 13 articles and five reports, with a weighted average of prevalence (attack rate) for passengers of 7% (95% confidence interval (CI): 5.00–9.00) and for crew of 2% (95% CI: 0.00–3.00). Person-to-person was the most frequent mode of transmission in 35 of the 45 outbreaks (in 14 the only mode and in 21 as part of multiple transmission routes). Having an ill cabin mate (OR = 38.70; 95% CI: 13.51–110.86) was the most common risk factor. Six outbreak investigations reported poor hygiene, while four reported satisfactory hygiene in the cruise setting. Behavioural risk factors among travellers were investigated in three of the 13 studies. Conclusions: The findings indicate a need for behavioural interventions to improve personal hygiene, symptom reporting and compliance with isolation measures, and for reconsidering current isolation policies where symptomatic and healthy individuals are isolated in the same cabin.

Blood samples from 2620 dogs living in 7 different areas were used for the detection of antibodies against Ehrlichia canis and Borrelia burgdorferi and Dirofilaria immitis antigen. Previously published seropositivity data against Leishmania infantum from the same samples were also used to identify multiple-pathogen seropositivity. The associations between seropositivity against each pathogen and gender, age, utility, hair length, and region of residence were evaluated by multivariate logistic regression analyses. The prevalence of seropositivity against E. canis, B. burgdorferi , and D. immitis was 12.25%, 2.23%, and 5.96%, respectively. Double- and triple-pathogen seropositivity was detected in seven different combinations. Age and region of residence were strongly associated with seropositivity against all pathogens. The association between seropositivity and the area of residence highlights the need for regular testing of dogs for vector-borne pathogens in areas with similar conditions to define control measures.

Campylobacter infection is one of the most frequently reported foodborne diseases with approximately 230,000 and 1.5 million cases each year in Europe and the USA, respectively. Culture methods are the reference for the diagnosis of Campylobacter infections; however, these methods are complex and time-consuming. Multiplex nucleic acid amplification test is favored due to its rapidity, automatization in the procedure followed and the quick simultaneous testing of numerous foodborne pathogens. The aim of this meta-analysis was to evaluate the accuracy of these tests for the diagnosis of Campylobacter infection. Scopus, Science Direct, PubMed, Web of Science, and Mendeley were searched for peer-reviewed articles. The split component synthesis method with the use of the inverse variance heterogeneity model was chosen for the quantitative meta-analysis. Sensitivity analysis was performed by age category and index test. The literature search found 34 studies involving 28,105 patients with suspected gastroenteritis. The sensitivity and specificity were 95.3% (92.3; 97.1) and 97.1% (95.1; 98.3), respectively, and AUC (area under the curve) was 0.963 (0.947; 0.974). Pediatric patients had a lower sensitivity (87.4, 48.2; 98.1) and higher specificity (99.2, 91.6; 99.9) estimate compared to all ages category (sensitivity 95.3, 91.3; 97.5, specificity 96.7, 93.7; 98.3). Among the various index tests, Seeplex/Allplex and Amplidiag/Novodiag had the lowest estimate for sensitivity (88.9, 73.8; 95.8) and specificity (95.2, 86; 98.4), respectively. BDMax had the highest (sensitivity 98.1, 96.1; 99 and specificity 98.5, 97; 99.3). Multiplex nucleic acid tests showed excellent accuracy and could play an influential role in diagnosing Campylobacter infections.

Objective: The aim of this study was to investigate pediatricians’ practices toward screening in Greece. Materials and Methods: The survey was conducted within a six month period in a stratified random sample of 371 pediatricians. A questionnaire with three sections was created and pilot tested. Socio-demographic characteristics associated with inappropriate screening were identified using multivariable logistic regression models and latent class analysis. Results: A total of 294 participants completed the telephone survey (response rate 78.6%). The median number of wrong answers to questions related to pediatricians’ practice towards screening recommendations was 7±1.57 with minimum 2 and maximum 11 wrong answers. Pediatricians, with less than 15 years of experience, age >50 years old or view more than eighty patients per week, have had significantly higher odds of responding wrong to more than seven questions, hence be less compliant to USPSTF screening guidelines. Latent class analysis has shown that female gender, age <50 years old, and work in the private sector, were associated with a poor practice towards international screening guidelines. Conclusion: Our survey found gaps in screening practices among a nationwide sample of Greek pediatricians. Moreover considerable variability in reported practices of screening was noted. There is a need for the development of a national childhood screening program in Greece. Cite this article as: Dresios C, Rachiotis G, Rousou X, Panagakou S, Mouchtouri V, Hadjichristodoulou C. Nationwide Study on Practices Related to Screening Among Greek Pediatricians. Eurasian J Med 2020; 52(3): 237-42.

Diagnostic test accuracy studies assess a diagnostic test’s performance against a reference standard. In this review, we explore and compare statistical methods used in meta-analyses of diagnostic test accuracy studies. Specifically, we evaluate two frequentist methods – split component synthesis (SCS) and bivariate model (BM) – alongside two Bayesian approaches: Bayesian hierarchical summary receiver operating characteristic (BHSROC) and Bayesian bivariate model (BBM). We also include their latent class variants (LC-BHSROC and LC-BBM). Using a meta-analysis of various multiplex nucleic acid amplification tests (NAATs/PCRs) against Campylobacter spp. as a case study we illustrate the practical applications of these methods. The reference standard was culture, and due to differences in cut-off values and primers among the NAAT/PCR brands, substantial heterogeneity was anticipated. Our findings reveal that the BM and BBM methods tend to estimate higher sensitivities than the other approaches, even when the number of studies is substantial, and heterogeneity is moderate – as observed in this case study. In such scenario, the SCS method or the BHSROC model may offer more robust and reliable outcomes. While our review is based on a real-life meta-analysis rather than simulations, it offers practical insights into the strengths and limitations of these statistical approaches for diagnostic test accuracy studies.