Snakebite epidemiology in the State of Mexico, Mexico 2003-2024.

Snakebite: Epidemiology, Prevention, Clinical Presentation and Management

Snakebite by the Shore Pit Viper (Trimeresurus purpureomaculatus) Treated With Polyvalent Antivenom

Snakebite envenoming is a neglected public health problem in many tropical countries, resulting in over 100 000 deaths and 400 000 disabilities worldwide each year. In Gabon, where venomous snakes are abundant, studies on the epidemiology and treatment of snakebites are lacking. Between October 2022 and June 2023, we conducted a cross-sectional community survey in the department of Ogooué et des Lacs in central Gabon to estimate the snakebite incidence, describe clinical presentations and treatment-seeking behaviours, and describe the burden of snakebites to animal populations in rural and urban communities. We also surveyed health facilities in the department to describe treatment practices and the availability of antivenom. The standardised annual incidence rate was 246 snakebite cases per 100 000 person-years (95% confidence interval (CI) = 138-438). Of the 175 snakebite cases reported in the five years prior to the survey, 18% showed signs of envenomation, predominantly with cytotoxic signs. The mortality among the bitten population was 3%. Snakebite treatment was first sought at a formal health facility in 55% of cases, from traditional healers in 22%, and with self-treatment or no treatment in the remaining 23%. Of snakebite patients treated at a formal health facility in the five years prior to the survey, 81% received antivenom, 41% received antibiotics, and 51% received corticosteroids. Almost one in six households reported animal deaths due to snakebites in the previous 12 months. This study provides the first robust epidemiological estimates of the burden of snakebites in Gabon and highlights the importance of community-based surveys in accurately assessing this high burden. Training health care workers, developing treatment guidelines, and ensuring the availability of effective and affordable antivenom are important steps to improving the outcome for snakebite victims.

BackgroundAn improved understanding in transmission variation of kala-azar is fundamental to conduct surveillance and implementing disease prevention strategies. This study investigated the spatio-temporal patterns and hotspot detection for reporting kala-azar cases in Vaishali district based on spatial statistical analysis.MethodsEpidemiological data from the study area during 2007–2011 was used to examine the dynamic space-time pattern of kala-azar outbreaks, and all cases were geocoded at a village level. Spatial smoothing was applied to reduce random noise in the data. Inverse distance weighting (IDW) is used to interpolate and predict the pattern of VL cases distribution across the district. Moran’s I Index (Moran’s I) statistics was used to evaluate autocorrelation in kala-azar spatial distribution and test how villages were clustered or dispersed in space. Getis-Ord Gi*(d) was used to identify the hotspot and cold spot areas within the study site.ResultsMapping kala-azar cases or incidences reflects the spatial heterogeneity in the incidence rate of kala-azar affected villages in Vaishali district. Kala-azar incidence rate map showed most of the highest endemic villages were located in southern, eastern and northwestern part of the district; in the middle part of the district generally show the medium occurrence of VL. There was a significant positive spatial autocorrelation of kala-azar incidences for five consecutive years, with Moran’s I statistic ranging from 0.04-0.17 (P <0.01). The results revealed spatially clustered patterns with significant differences by village. The hotspots showed the spatial trend of kala-azar diffusion (P < 0.01).ConclusionsThe results pointed to the usefulness of spatial statistical approach to improve our understanding the spatio-temporal dynamics and control of kala-azar. The study also showed the north-western and southern part of Vaishali district is most likely endemic cluster region. To employ exact and geographically suitable risk-reduction programmes, apply of such spatial analysis tools should suit a vital constituent in epidemiology research and risk evaluation of kala-azar.

Retrospective Documentation of a Confirmed White-Lipped Green Pit Viper (Trimeresurus albolabris Gray, 1842) Bite in the South-Central Hills of Nepal

Based on the Minorities' Diminished Returns (MDRs) framework, indicators of high socioeconomic status (SES), such as high maternal educational attainment, show weaker protective effects on various developmental, behavioral, and health outcomes for Black than White families. As a result of these MDRs, families and individuals with high educational attainment still report high levels of depression, smoking, obesity, and chronic disease. Limited knowledge exists on MDRs of maternal education on indicators of wealth such as home ownership and home value. Built on the MDRs framework, we tested the hypothesis of whether the effects of maternal educational attainment at birth on home ownership and home value, as proxies of wealth, vary between Black and White families. We hypothesized that: 1) high maternal education would be associated with more wealth 15 years later, and 2) compared to Whites, Blacks would be less likely to accumulate wealth (own a house) across all educational levels, given a weaker boosting effect of maternal educational attainment on wealth for Black than White families. The Fragile Families and Child Well-being Study, is a 15-year follow up study of a random sample of births in cities larger than 200,000 population in the US. A total number of 2004 White or Black youth were included and were followed from birth to the age of 15. The predictor of interest was maternal educational attainment at birth, treated as a categorical variable (college graduation). The outcomes were home ownership and home value (worth - owed) 15 years later, as proxies of wealth. Logistic and linear regression were used for data analysis. High maternal education at birth was associated with home ownership and higher value of owned home at age 15. We also found that maternal educational attainment at birth and race interact with each other, suggesting that the effects of high maternal educational attainment at birth on home ownership/value at age 15 were weaker for Black than White families. Diminished returns of maternal educational attainment at birth on wealth accumulation in Black families may be a mechanism that contributes to racial health disparities in high socioeconomic status and also poor outcomes of high SES Black families. That is, a smaller effect of maternal educational attainment on changing the real lives of Black than White youth may be one of the mechanisms by which health remains worse than expected in high SES Black families. Not all of the health, behavioral, and developmental disparities are due to the racial gap in SES but also diminishing returns of socioeconomic status indicators such as maternal educational attainment for racial minorities. Research should study how social stratification, discriminatory mortgage and banking, residential segregation, family formation, employment, and occupational prestige reduce Black families' ability to mobilize their human capital and secure tangible economic and non-economic outcomes.

Cutaneous Leishmaniasis (CL) is a severe health problem and a parasitic disease on human dermal and widely pervades tropical and subtropical developing counties. The study is mainly focused on Geographic Information System (GIS) based Situational Analysis (SA). The clinically recorded 394 CL patients’ information was obtained from the District General Hospital of Polonnaruwa (DGHP) for 2017 and 2018. The spatial distribution of these patients was collected using Global Positing System (GPS). Moran’s I Index spatial autocorrelation technique and Getis-Ord Gi were used to identify the study site’s hot spot and cold spot areas. More than 75% of the CL patients’ population were highly involved with agricultural activities, and they are the highly exposed group of the CL in the study area. Also, 75% of the CL population were men, and the highly vulnerable age group was 35 - 39 men and 40 - 44 women. The generated Moran’s I Index indicates 0.0321, representing a randomly distributed pattern of CL patients over the District, and the Getis-Ord Gi Z Score value was >1.96 (p Hence to prevent the disease spread, it is essential to implement an awareness program regarding sandflies’ behaviour and CLD.

Typhus Group Rickettsiae Antibodies in Rural Mexico

Though Saidpur Upazila under Nilphamari district is very small but here pigeonry, goat rearing, herbal treatments, circus team, monkey charmer, horse race and snake charmers are available. Snake charmers are not living well in this modern era. Their kids are not safe at home for snake rearing. In Savar, Dhaka there is a snake market where some tribal people buy it as food. People who are engaged with snake catching and snake-based superstitions go to that market. They support medical science and are waiting to get a good job. Who take snakes as food they say its meat is very hot. Depending on body size its price varies from 1000 to 2000 taka of a poisonous snake. People of the circus team, zoo committee and intersex people collects snakes from the snake charmer. Tradition of snake charming in Bangladesh is very ancient. Once upon a time most of the villagers liked it. Some peoples were considered as bede or tribal people who caught snakes from the jungle. Though Bangladesh is a small country but its 80 species of snakes are remarkable. Within these only cobras, kraits and sea snakes are poisonous and most of the cobras are bicellate type. Common vine snakes, tree snake and rat snakes are very common and nonpoisonous snakes of Bangladesh. After catching a snake, the charmer cuts the poison sac or rubs both fangs of the snakes. As poison of the snakes are digestive juice so that those snakes can suffer digestive ailments and ultimately die. The temperature of Rangpur division of Bangladesh is 350-370F which is suitable for snakes’ survival. There were 30.77% poisonous and 69.23% non poisonous snakes’ in Bangladesh in three families.1 In Bangladesh out of 82 species 28 are venomous and 12 are sea snakes.2 Estimates indicate ˃5 million bites annually by venomous snakes worldwide where ˃12500 deaths.3,4 Some research work have completed on snakes taxonomy, status, distribution and epidemiology of snake bite.5‒7 India has the highest number of snake bites in the world with 35000-50000 annually according to World Health Organization.8,9 In Bangladesh this is 4.3per 100000 an annual incidence and case fatality is 20%.10

The effects of environmental variables on hotspots of Antarctic krill (Euphausia superba) in the Bransfield Strait during autumn

BackgroundBreast milk is the first, highly valuable, and solely natural food recommended for infants in their first six months of life, which is critical for children's overall growth and development. Evidence suggests that exclusive breastfeeding differs by geographic area in Ethiopia. However, little is known regarding the geographic distribution of exclusive breastfeeding practice. Hence, this study aimed to assess exclusive breastfeeding practice, its geographic variation and associated factors among Ethiopian mothers.MethodThe study used the 2019 Ethiopian mini demographic and health survey data. All living children born 0–23 months before the survey were included. Global Moran’s I statistics on Arc-GIS and Getis Ord Gi* statistics was used to visualize the spatial pattern and hotspot and cold spot areas, respectively. Kulldorff SaTScan was used to show purely significant spatial clusters. The associated factors were identified using a multilevel mixed-effects logistic regression model. Statistically significant factors were reported using the AOR with a 95% CI and a p-value of < 5%.ResultThe coverage of exclusive breastfeeding practice in Ethiopia was 56.05% (95% CI: 53.95%, 58.10%). The spatial pattern was non-random across the country’s regions. Somalia, Gambela, Benshangul Gumuz, Dire Dawa, and Harari regions had low clustering of exclusive breastfeeding practices, whereas Amhara, Eastern SNNPR, and Central and Northern Oromia regions had high clustering. Children born through caesarean delivery [AOR = 0.36; 95% CI: 0.21, 0.63], initiated breastfeeding within the first 1 h [AOR = 0.55; 95% CI: 0.34, 0.90], after 1–24 h of delivery [AOR = 0.36; 95% CI: 0.24, 0.54], after a day [AOR = 0.04; 95% CI: 0.02, 0.08], and women residing in the pastoralist region [AOR = 0.22; 95% CI: 0.12, 0.39] or city administrations [AOR = 0.49; 95% CI: 0.27, 0.89] had lower odds of exclusive breastfeeding practice.ConclusionExclusive breastfeeding practice in Ethiopia remained low. The practice had a spatial variation across the country. Caesarean section delivery, late breastfeeding initiation, and region were statistically significant variables. Therefore, promoting timely initiation of breastfeeding and improving the utilization of maternal health services and designing special intervention strategy for women residing in city administrations and pastoralist regions of the country may increase the coverage of exclusive breastfeeding practice.

Influenza is an acute respiratory infectious disease that commonly affects people and has an important impact on public health. Based on influenza incidence data from 103 counties in Hubei Province from 2009 to 2019, this study used time series analysis and geospatial analysis to analyze the spatial and temporal distribution characteristics of the influenza epidemic and its influencing factors. The results reveal significant spatial-temporal clustering of the influenza epidemic in Hubei Province. Influenza mainly occurs in winter and spring of each year (from December to March of the next year), with the highest incidence rate observed in 2019 and an overall upward trend in recent years. There were significant spatial and urban-rural differences in influenza prevalence in Hubei Province, with the eastern region being more seriously affected than the central and western regions, and the urban regions more seriously affected than the rural region. Hubei's influenza epidemic showed an obvious spatial agglomeration distribution from 2009 to 2019, with the strongest clustering in winter. The hot spot areas of interannual variation in influenza were mainly distributed in eastern and western Hubei, and the cold spot areas were distributed in north-central Hubei. In addition, the cold hot spot areas of influenza epidemics varied from season to season. The seasonal changes in influenza prevalence in Hubei Province are mainly governed by meteorological factors, such as temperature, sunshine, precipitation, humidity, and wind speed. Low temperature, less rain, less sunshine, low wind speed and humid weather will increase the risk of contracting influenza; the interannual changes and spatial differentiation of influenza are mainly influenced by socioeconomic factors, such as road density, number of health technicians per 1,000 population, urbanization rate and population density. The strength of influenza's influencing factors in Hubei Province exhibits significant spatial variation, but in general, the formation of spatial variation of influenza in Hubei Province is still the result of the joint action of socioeconomic factors and natural meteorological factors. Understanding the temporal and spatial distribution characteristics of influenza in Hubei Province and its influencing factors can provide a reasonable decision-making basis for influenza prevention and control and public health development in Hubei Province and can also effectively improve the scientific understanding of the public with respect to influenza and other respiratory infectious diseases to reduce the influenza incidence, which also has reference significance for the prevention and control of influenza and other respiratory infectious diseases in other countries or regions.

Reducing mortality in individuals at high risk for advanced melanoma through education and screening

Ontogenetic changes in venom composition have important ecological implications due the relevance of venom in prey acquisition and defense. Additionally, intraspecific venom variation has direct medical consequences for the treatment of snakebite. However, ontogenetic changes are not well documented in most species. The Mexican Black-tailed Rattlesnake (Crotalus molossus nigrescens) is large-bodied and broadly distributed in Mexico. To document venom variation and test for ontogenetic changes in venom composition, we obtained venom samples from twenty-seven C. m. nigrescens with different total body lengths (TBL) from eight states in Mexico. The primary components in the venom were detected by reverse-phase HPLC, western blot, and mass spectrometry. In addition, we evaluated the biochemical (proteolytic, coagulant and fibrinogenolytic activities) and biological (LD50 and hemorrhagic activity) activities of the venoms. Finally, we tested for recognition and neutralization of Mexican antivenoms against venoms of juvenile and adult snakes. We detected clear ontogenetic venom variation in C. m. nigrescens. Venoms from younger snakes contained more crotamine-like myotoxins and snake venom serine proteinases than venoms from older snakes; however, an increase of snake venom metalloproteinases was detected in venoms of larger snakes. Venoms from juvenile snakes were, in general, more toxic and procoagulant than venoms from adults; however, adult venoms were more proteolytic. Most of the venoms analyzed were hemorrhagic. Importantly, Mexican antivenoms had difficulties recognizing low molecular mass proteins (<12 kDa) of venoms from both juvenile and adult snakes. The antivenoms did not neutralize the crotamine effect caused by the venom of juveniles. Thus, we suggest that Mexican antivenoms would have difficulty neutralizing some human envenomations and, therefore, it may be necessary improve the immunization mixture in Mexican antivenoms to account for low molecular mass proteins, like myotoxins.

Sylhet, located in the northeastern part of Bangladesh, is characterized by a unique topography and climatic conditions that make it susceptible to flash floods. The interplay of rapid urbanization and climatic variability has exacerbated these flood risks in recent years. Effective monitoring and planning of land use/land cover (LULC) are crucial strategies for mitigating these hazards. While former studies analyzed LULC in parts of Sylhet using traditional GIS approaches, no comprehensive, district-wide assessment has been carried out using long-term satellite data and cloud computing platforms. This study addresses that gap by applying Google Earth Engine (GEE) for an extensive analysis of LULC changes, transitions, and hot/cold spots across the district. Accordingly, this work investigates the LULC changes in Sylhet district over the past twenty-three years (2000–2023). Using satellite imagery from Landsat 7 Enhanced Thematic Mapper Plus (ETM+) and Landsat 8 Operational Land Imager (OLI), the LULC is classified in six selected years (2000, 2005, 2010, 2015, 2020, and 2023). A supervised machine learning algorithm, the Random Forest Classifier, is employed on the cloud computing platform Google Earth Engine to analyze LULC dynamics and detect changes. The Getis-Ord Gi* statistical model is applied to identify land transformation hot spot and cold spot areas. The results reveal a significant increase in built-up areas and a corresponding reduction in water bodies. Spatial analysis at the upazila level indicates urban expansion in every upazila, with the most substantial increase observed in Beani Bazar upazila, where urban areas expanded by approximately 1500%. Conversely, Bishwanath upazila experienced the greatest reduction in water bodies, with a decrease of about 90%. Sylhet Sadar upazila showed a 240% increase in urban areas and a 72% decrease in water bodies. According to hotspot analysis, Kanaighat upazila has the most amount of unchanging land at 7%, whereas Balaganj upazila has the largest amount of LULC transformation at 5.5%. Overall, the urban area in the Sylhet district has grown by approximately 300%, while water bodies have diminished by about 77%, reflecting trends of urbanization and river-filling. These findings underscore the necessity of ensuring adequate drainage infrastructure to decrease flash flood hazards in the Sylhet district and offer insightful information to relevant authorities, politicians, and water resource engineers.