Annual Prevalence Rates Research Articles

Spatial-temporal analysis of leprosy in a priority Brazilian northeast municipality for disease control.

to analyze the spatial-temporal distribution of leprosy in a priority municipality for leprosy control. ecological study, conducted in a city in the Northeast of Brazil, whose analysis units were census sectors. The study used compulsory notification data for cases registered between 2008 and 2017. TerraView software and the Batch Geocode tool was used for geocoding. The detection of spatial-temporal agglomerations of high relative risks was done by scanning statistics. the spatial-temporal distribution of cases was heterogeneous, creating four agglomerations of high relative risks in the urban area of the municipality between the years 2008 and 2012; and annual prevalence rates classified from high to hyperendemic. areas of higher risk and concentration of the disease in space-time were linked to the characteristics of high population density and social vulnerability of these spaces, raising the prioritization of health professionals' actions, systems, and services for control, and monitoring the disease.

903. SSI Trends in Community Hospitals from 2013 to 2018

BackgroundSurgical site infections (SSIs) are common causes of hospital-acquired infection. However, only sparse data are available on the recent epidemiology of SSIs in community hospitals.MethodsWe performed a retrospective analysis of prospectively collected SSI data at 32 community hospitals in the southeastern United States from 2013 to 2018. We calculated the annual prevalence rates (PRs) of SSI for 26 commonly performed procedures and stratified results by causative pathogen. We used log-binomial regression models to examine trends of SSI prevalence over time.ResultsOver the 6-year study period, 3,561 complex (i.e., deep incisional or organ space) SSIs occurred following 669,467 total procedures (PR, 0.53 infections per 100 procedures). The complex SSI PR did not change significantly during the study period (0.58/100 procedures in 2013 versus 0.53/100 procedures in 2018; PR ratio [PRR], 0.84; 95% CI 0.66–1.08, p=0.16). For commonly performed procedures, rates of SSI in community hospitals were higher than 2018 National Healthcare Safety Network (NHSN) benchmark SSI rates for colon surgery, hip arthroplasty, knee arthroplasty, and spinal fusion. (Table 1). Staphylococcus aureus was the most common pathogen to cause SSI each year and was responsible for 23.7% (n=843) of all complex SSIs. Methicillin-susceptible S. aureus (MSSA) complex SSIs [13.5%, n=480] were more common than complex SSIs caused by methicillin-resistant S. aureus (MRSA) [10.2%, n=363] (Figure 1). Compared to the 2013, the only significant decrease in S. aureus SSI PR occurred in 2017 (PRR 0.67 95% CI 0.49-0.90, p=0.01), which was primarily driven by the significant decrease in MRSA SSI PR in 2017 compared to 2013 (PRR 0.61 95% CI 0.42-0.89, p-value=0.01). The Escherichia coli SSI PRs did not change significantly during the study period, but E. coli became the second most prevalent pathogen in 2018, surpassing MRSA.Table 1. Community Hospital SSI Prevalence Rates for Commonly Performed Procedures Figure 1: Prevalence Rates of Community Hospital Complex SSIs by Causative Pathogen from 2013 to 2018 ConclusionThe complex SSI rate did not significantly decline in our cohort of community hospitals from 2013 to 2018. Baseline SSI rates were low, and statistically significant decreases in SSI rates may be difficult to achieve. However, the epidemiology of community hospital SSIs may be changing with a shift away from MRSA SSIs.Disclosures All Authors: No reported disclosures

Gestational diabetes in Korea: Temporal trends in prevalence, treatment, and short-term consequences from a national health insurance claims database between 2012 and 2016

AimsThis population-based cross-sectional study aimed to investigate recent trends in the prevalence and treatment of gestational diabetes mellitus (GDM) in Korea. We also investigated trends in annual prevalence rate of pregnancy-induced hypertension (PIH) and cesarean section (C-section) in GDM patients. MethodsWe used data from the Health Insurance Review and Assessment-National Patient Sample (HIRA-NPS) database, 2012–2016. Non-GDM (n = 53,698) and GDM (n = 7956) patient data were analyzed for each year. ResultsThe annual increase in the prevalence of GDM was 11.1% over 2012–2016, with a significant continuously increasing trend (p < 0.0001). Age-stratified analysis showed that the annual prevalence of GDM significantly increased in patients below 40 years of age, but was not statistically significant as an increasing trend in patients above 40 years of age. Annual PIH prevalence rate among GDM women showed decreasing trend but was not statistically significant. An annual increase in C-section rate above 5% in GDM patients was statistically significant in both unadjusted and adjusted for age and PIH models. ConclusionsThe prevalence of GDM in Korean women and C-section rates in women with GDM showed a significantly increasing trend, 2012–2016. There is a need for further efforts to monitor this trend and to identify associated risk factors for GDM in Korean women.

The Prevalence of Musculoskeletal Symptoms in Iranian Spinner Workers in the Textile Industry and its Association With Demographic and Lifestyle Characteristics

Objectives: This study aimed to identify the annual and weekly prevalence of Musculoskeletal Disorders (MSDs) and their relation to demographic characteristics, such as Body Mass Index (BMI), work experience, and physical activity in spinner workers in the textile industry. We also conducted a comparison between the annual and weekly prevalence of MSDs. Methods: The study sample included 700 male spinner workers (Mean±SD age: 32.6±6.5 years) from 10 companies in Najaf Abad City, Isfahan Province, Iran. Information about MSDs was collected through the Extended Nordic Musculoskeletal Questionnaire (ENMQ) from November 2018 to September 2019. Demographic characteristics were collected using a demographic checklist through a direct interview by one investigator. Results: The present study findings suggested that the Mean±SD duration of work hours per week was 56.6±8.4 hours. The Mean±SD times of experiencing an injury equaled 27.8±33.1 months. The annual prevalence of MSDs was reported to be 74.4% for at least one of the 9 body regions. The highest annual prevalence rates belonged to the knees (54.0%), lower back (34.3%), and shoulders (23.1%). In contrast, the most weekly prevalent regions were the knees (44.6%), lower back (26.9%), and ankles (15.9%). Generally, the weekly prevalence was significantly lower than that of the annual prevalence (P&lt;0.008). Job experience, marital status, and physical exercise presented a significant relationship with the annual prevalence of MSDs in the neck, shoulders, elbows, wrists, hands, knees, and ankle/foot. Contrarily, there was a significant relationship between job experience and the weekly prevalence of MSDs in the shoulder, lower back, and knee regions. The prevalence of neck, shoulders, wrists/hands, low back, knee, and ankle/foot pain was significantly increased in married workers. Furthermore, exercise history could cause a significant decrease in the prevalence of MSDs. Discussion: The high prevalence of MSDs in spinner workers is affected by some demographic characteristics; thus, such data should be considered in planning the prevention strategies within the textile industry.

Incident Type 2 Diabetes and Risk of Fracture: A Comparative Cohort Analysis Using U.K. Primary Care Records.

To estimate risk of fracture in men and women with recent diagnosis of type 2 diabetes compared with individuals without diabetes. In this cohort study, we used routinely collected U.K. primary care data from The Health Improvement Network. In adults (>35 years) diagnosed with type 2 diabetes between 2004 and 2013, fractures sustained until 2019 were identified and compared with fractures sustained in individuals without diabetes. Multivariable models estimated time to first fracture following diagnosis of diabetes. Annual prevalence rates included at least one fracture in a given year. Among 174,244 individuals with incident type 2 diabetes and 747,290 without diabetes, there was no increased risk of fracture among males with diabetes (adjusted hazard ratio [aHR] 0.97 [95% CI 0.94, 1.00]) and a small reduced risk among females (aHR 0.94 [95% CI 0.92, 0.96]). In those aged ≥85 years, those in the diabetes cohort were at significantly lower risk of incident fracture (males: aHR 0.85 [95% CI 0.71, 1.00]; females: aHR 0.85 [95% CI 0.78, 0.94]). For those in the most deprived areas, aHRs were 0.90 (95% CI 0.83, 0.98) for males and 0.91 (95% CI 0.85, 0.97) for females. Annual fracture prevalence rates, by sex, were similar for those with and without type 2 diabetes. We found no evidence to suggest a higher risk of fracture following diagnosis of type 2 diabetes. After a diagnosis of type 2 diabetes, individuals should be encouraged to make positive lifestyle changes, including undertaking weight-bearing physical activities that improve bone health.

Additional burden of cancers due to environmental carcinogens in Newfoundland and Labrador: a spatial analysis

Several environmental carcinogens are found to be spread across wide geographic areas, and the exposed inhabitants are at risk of developing various types of cancers. Arsenic and disinfection by-products in drinking water, ultraviolet rays from the sun, and agricultural chemicals used in golf courses were found to be the possible cancer risks. The study aimed to estimate the risks of cancer due to exposure to environmental carcinogens known to be present in wide geographic areas in Newfoundland and Labrador (NL). The NL cancer care registry provided 2008–2017 data (histological diagnosis, age, sex, and six-digit postal code) on cancers relevant to arsenic, disinfection by-products , ultraviolet rays , and agricultural chemical exposures. The geographic distribution of environmental carcinogens was collected from government sources and previous studies. Risk ratios (RR) of annual prevalence rates of cancers in high-risk (exposed to environmental carcinogens) and low-risk populations. For ultraviolet rays , arsenic, disinfection by-products , and agricultural chemicals, the RR (95% CI) were 1.5 (1.4–1.6), 1.25 (1.03–1.51), 1.8 (1.67–1.94), and 1.49 (1.3–1.7), respectively. An excess number of cancers in high-risk areas was possibly associated with exposure to environmental carcinogens . Public health regulations, environmental monitoring, health promotion, and increased awareness in high-risk areas can prevent exposure to environmental carcinogens.

Coexistence of clinically significant obstructive sleep apnea with physician-diagnosed asthma or chronic obstructive pulmonary disease: A population study of prevalence and mortality

RATIONALE: Despite potential importance, the epidemiology of coexisting obstructive sleep apnea and asthma (OSA/asthma) or OSA and COPD (OSA/COPD) has not been well studied. OBJECTIVES To access the trends in prevalence and mortality of coexisting OSA/asthma or OSA/COPD among individuals 35-years or older in Ontario, Canada. METHODS AND MEASUREMENTS: We conducted a population-based study using provincial health administrative data. Validated case definitions were used to identify individuals with physician-diagnosed asthma or COPD. Individuals with clinically significant OSA were those who initiated positive airway pressure treatment. Age- and sex-standardized annual prevalence and mortality rates were estimated and compared from 2009 to 2015. Generalized linear models were used. MAIN RESULTS: The standardized prevalence increased from 0.42% to 0.66% for OSA/asthma and from 0.23% to 0.35% for OSA/COPD from 2009 to 2015. The standardized all-cause mortality rates remained stable over time. Both coexistence conditions were associated with higher mortality than OSA alone. Adjusting for age, sex and calendar year, mortality was modestly but statistically significantly higher for OSA/asthma than asthma alone (OR = 1.03; 1.00–1.06) with the highest OR noted in 35-49 years old group (1.85; 1.63–2.09). There was no statistical difference in all-cause mortality among individuals with coexisting OSA/COPD compared to patients with COPD alone. In women only, OSA/COPD was associated with a modestly higher mortality than COPD alone (OR = 1.05; 1.01–1.09). CONCLUSIONS In this population-based study of coexisting clinically significant OSA and chronic lung disease, we report population prevalence and mortality, including their age and sex distribution. These findings can alert health care providers and policymakers to the large and increasing burden of these coexisting conditions and high-risk groups.

Trends in Optic Neuritis Incidence and Prevalence in the UK and Association With Systemic and Neurologic Disease

Epidemiologic data on optic neuritis (ON) incidence and associations with immune-mediated inflammatory diseases (IMIDs) are sparse. To estimate 22-year trends in ON prevalence and incidence and association with IMIDs in the United Kingdom. This cohort study analyzed data from The Health Improvement Network from January 1, 1995, to September 1, 2019. The study included 10 937 511 patients 1 year or older with 75.2 million person-years' follow-up. Annual ON incidence rates were estimated yearly (January 1, 1997, to December 31, 2018), and annual ON prevalence was estimated by performing sequential cross-sectional studies on data collected on January 1 each year for the same period. Data for 1995, 1996, and 2019 were excluded as incomplete. Risk factors for ON were explored in a cohort analysis from January 1, 1997, to December 31, 2018. Matched case-control and retrospective cohort studies were performed using data from January 1, 1995, to September 1, 2019, to explore the odds of antecedent diagnosis and hazard of incident diagnosis of 66 IMIDs in patients compared with controls. Optic neuritis. Annual point prevalence and incidence rates of ON, adjusted incident rate ratios (IRRs) for risk factors, and adjusted odds ratios (ORs) and adjusted hazard ratios (HRs) for 66 IMIDs. A total of 10 937 511 patients (median [IQR] age at cohort entry, 32.6 [18.0-50.4] years; 5 571 282 [50.9%] female) were studied. A total of 1962 of 2826 patients (69.4%) with incident ON were female and 1192 of 1290 92.4%) were White, with a mean (SD) age of 35.6 (15.6) years. Overall incidence across 22 years was stable at 3.7 (95% CI, 3.6-3.9) per 100 000 person-years. Annual point prevalence (per 100 000 population) increased with database maturity, from 69.3 (95% CI, 57.2-81.3) in 1997 to 114.8 (95% CI, 111.0-118.6) in 2018. The highest risk of incident ON was associated with female sex, obesity, reproductive age, smoking, and residence at higher latitude, with significantly lower risk in South Asian or mixed race/ethnicity compared with White people. Patients with ON had significantly higher odds of prior multiple sclerosis (MS) (OR, 98.22; 95% CI, 65.40-147.52), syphilis (OR, 5.76; 95% CI, 1.39-23.96), Mycoplasma (OR, 3.90; 95% CI, 1.09-13.93), vasculitis (OR, 3.70; 95% CI, 1.68-8.15), sarcoidosis (OR, 2.50; 95% CI, 1.21-5.18), Epstein-Barr virus (OR, 2.29; 95% CI, 1.80-2.92), Crohn disease (OR, 1.97; 95% CI, 1.13-3.43), and psoriasis (OR, 1.28; 95% CI, 1.03-1.58). Patients with ON had a significantly higher hazard of incident MS (HR, 284.97; 95% CI, 167.85-483.81), Behçet disease (HR, 17.39; 95% CI, 1.55-195.53), sarcoidosis (HR, 14.80; 95% CI, 4.86-45.08), vasculitis (HR, 4.89; 95% CI, 1.82-13.10), Sjögren syndrome (HR, 3.48; 95% CI, 1.38-8.76), and herpetic infection (HR, 1.68; 95% CI, 1.24-2.28). The UK incidence of ON is stable. Even though predominantly associated with MS, ON has numerous other associations with IMIDs. Although individually rare, together these associations outnumber MS-associated ON and typically require urgent management to preserve sight.

Drug utilization study on immediate release Fentanyl in Spain. Prevalence, incidence, and indication.

We aimed to characterize the trends of immediate release fentanyl (IRF) use in Spain between 2012 and 2017 and indication for its use. IRF drugs are rapid-acting opioids approved to treat breakthrough cancer pain (BTCP) in patients already receiving maintenance opioid therapy for chronic cancer pain. A substantial increase in consumption of IRF has been observed with emerging cases of abuse and dependence, most of them in noncancer patients. An ecological descriptive consumption study with aggregated data from drug dispensed by community pharmacies and reimbursed by the National Health System in which Defined Daily Doses per 10 000 inhabitants (DID) were calculated and a retrospective cohort study using data from the Spanish Database for Pharmacoepidemiological Research in Primary Care in which participants entered the cohort study after 1 year with the Primary Care Practitioners were performed. Annual prevalence and incidence rate of IRF use were estimated by sex and calendar year. Potential indication was also assessed. IRF use in Spain increased from 2.1 DID in 2012 to 3.8 DID in 2017. The incidence rate and prevalence increased in 53% and 74%, respectively. Patients without previous cancer or BCTP diagnosis represented 27% of incident users, predominantly women. Half of patients with noncancer-related diagnosis had a musculoskeletal disorder linked to the first IRF prescription. National consumption and new IRF users in Spain increased over the study period and one quarter of patients did not have a BTCP or cancer diagnosis registered in their clinical record.

Work-Related Musculoskeletal Disorders and Associated Factors Among Bankers in Ethiopia, 2018.

Background Work-related musculoskeletal disorders (WMSDs) are an important public health problem in working environments. WMSDs are the major causes of disability and cause individual suffering and financial burdens to the individual, families, industry or employer, healthcare system, and society at large. This study aims to assess the prevalence and associated factors of work-related musculoskeletal disorders among bankers working in Mekelle city, Tigray, Ethiopia, 2018. This study is based on an institutional-based cross-sectional study design, where 328 bankers are selected randomly from bankers working in Mekelle city from February to June 2018. Data were entered, organized, and analyzed by SPSS version 23. A final logistic model was run to identify factors associated with WMSDs, and the magnitude and direction of association were decided based on the adjusted odds ratio (AOR) and its corresponding 95% confidence interval (95% CI). Result Out of 307 bankers, the annual prevalence rate of WMSDs was 65.5% (201). Significant predictors were being 30–39 years old [AOR = 5.552; 95% CI = 1.465–21.039] and above 40 years old [AOR = 5.719; 95% CI = 1.422–22.994], low educational level [AOR = 4.256; 95% CI = 1.139–15.895], working > 5 years [AOR = 3.892; 95% CI = 1.841–8.231], not doing physical exercises [AOR = 2.866; 95% CI = 1.303–6.304], stress [AOR = 4.723; 95% CI = 2.421–9.213], poor posture [AOR = 2.692; 95% CI = 1.339–5.411], breaks [AOR = 5.170; 95% CI = 2.070–12.912], and ergonomics [AOR = 3.801; 95% CI = 1.260–11.472]. Conclusion The prevalence of WMSDs among bankers was high. The significant associated factors responsible for the occurrence of work-related musculoskeletal disorders include longer working experience, being above 30 years old, low educational status, physical exercise, job stress, poor posture, absence of breaks during working hours, and absence of ergonomic training.

Trends in prevalence and spatiotemporal distribution of gastroschisis in Arkansas, 1998-2015.

Arkansas (AR) had the highest prevalence of gastroschisis in a recent study including 15 U.S. states. Our objective was to evaluate trends in prevalence and the spatiotemporal distribution of gastroschisis in AR. Infants with gastroschisis, born 1998-2015, were identified from the Arkansas Reproductive Health Monitoring System. Birth record data were used as denominators for calculations. Maternal residence at delivery was geocoded for spatial analyses. Annual prevalence rates (PRs) were calculated. Joinpoint regression analysis was performed to examine trends in gastroschisis and report the annual percent changes (APCs) in PRs. Spatiotemporal analyses identified counties with unusually high PRs of gastroschisis. Poisson regression, including county, year, and county*year indicators, was fit to evaluate the PRs of gastroschisis, while adjusting for county-level maternal variables. We identified 401 cases of gastroschisis among 694,459 live births. The overall PR of gastroschisis was 5.8/10,000 live births. The prevalence of gastroschisis had a significant APC of +5.3% (p < .0001) between 1998 and 2012, followed by a nonsignificant yearly average decrease of -17% through 2015 (p = 0.2). The Emerging Hot Spot Analysis and SaTScan identified an overlapping five-county cluster from 2006 to 2013. Poisson regression model, including county (inside vs. outside cluster), time (before vs. after 2006), and county*time indicators, was fit to evaluate the PRs of gastroschisis. The model did not confirm the presence of a spatiotemporal cluster, once it adjusted for county-level maternal characteristics (p = .549). Close monitoring of rates of gastroschisis is warranted to determine if the PRs of gastroschisis continue to decline in AR.

Prevalence and Impact of Comorbid Widespread Pain in Adults with Chronic Low Back Pain: A Registry-Based Study.

Widespread pain (WP) is emerging as a key comorbid condition in patients with chronic low back pain (CLBP). This study measured the prevalence of comorbid WP in adults with CLBP, WP predictors, and impact on patients. Patients with CLBP were recruited from the Pain Registry for Epidemiologic, Clinical, and Interventional Studies and Innovation from 2016 through 2019. They were followed over 12 months to measure annual WP period prevalence rates using an item from the minimum dataset recommended by the National Institutes of Health Task Force on Research Standards for Chronic Low Back Pain. Patients were classified as not having WP, having nonpersistent WP, or having persistent WP. Pain intensity, back-related disability, and quality of life were measured using a numerical rating scale, the Roland-Morris Disability Questionnaire, and the PROMIS-29 instrument, respectively. A total of 358 patients were studied, including 56 (16%) without WP, 272 (76%) with nonpersistent WP, and 30 (8%) with persistent WP. There were no significant differences among the WP groups with regard to age, sex, or CLBP duration. However, being non-White and having moderate or high levels of pain catastrophizing remained significant predictors of nonpersistent or persistent WP after adjusting for potential confounders. Patients reported greater pain intensity and back-related disability and poorer quality of life over 12 months with increasing levels of WP persistence (P < .001 for each measure). Greater efforts are needed in primary care to help close these gaps in pain intensity, back-related disability, and quality-of-life outcomes associated with WP.

Annual Prevalence, Health Expenditures, and Co-Morbidities Trend of Iron Deficiency Anemia in Korea: National Health Insurance Service Data from 2002 to 2013.

Despite improvements in nutritional status, iron deficiency anemia (IDA) remains a debilitating nutritional problem worldwide. We estimate annual IDA prevalence rates by sex and age and the trends therein in Korea. We also calculate the health expenditures of IDA and its co-morbidities by analyzing claims data in the National Health Information Database from 2002 to 2013. All analyses were performed based on diagnosis codes of IDA (D50, D50.0, D50.8, and D50.9) regardless of whether IDA was the principal or a coexisting disease. Trends in IDA prevalence rates were evaluated by calculating annual percent changes (APCs) in prevalence. The health expenditures of IDA were calculated based on the direct medical costs (outpatient and hospitalization costs, pharmaceutical costs) and direct non-medical costs (travel costs). The overall IDA prevalence in both sexes increased approximately 2.3-fold from 2002 to 2013; the APC was +7.6%. In females, the prevalence of IDA was highest in aged 30–39 and 40–49 years. The APC was highest in those aged <10 years (+18.2%), followed by those aged ≥80 (+14.7%) and 70–79 (+9.8%) years. In males, the prevalence rates were highest in aged <10 years, followed by those aged ≥60 years. The APC was highest in those aged <10 years (+19.1%), followed by those aged ≥80 years (+10.5%). The total health expenditures increased 2.8-fold during 12 years. Diseases of the respiratory or gastrointestinal tract were the most prevalent co-morbidities in both males and females. The annual prevalence of IDA continues to rise in association with adverse health expenditures and co-morbidities in spite of improvements in nutritional status. Most importantly, infants and young children, the elderly, and females aged 30–49 years are at highest risk of IDA. A national, prospective, and well-organized effort to improve iron status and to manage IDA is required.

Identification of potentially undiagnosed patients with nontuberculous mycobacterial lung disease using machine learning applied to primary care data in the UK.

Nontuberculous mycobacterial lung disease (NTMLD) is a rare lung disease often missed due to a low index of suspicion and unspecific clinical presentation. This retrospective study was designed to characterise the prediagnosis features of NTMLD patients in primary care and to assess the feasibility of using machine learning to identify undiagnosed NTMLD patients.IQVIA Medical Research Data (incorporating THIN, a Cegedim Database), a UK electronic medical records primary care database was used. NTMLD patients were identified between 2003 and 2017 by diagnosis in primary or secondary care or record of NTMLD treatment regimen. Risk factors and treatments were extracted in the prediagnosis period, guided by literature and expert clinical opinion. The control population was enriched to have at least one of these features.741 NTMLD and 112 784 control patients were selected. Annual prevalence rates of NTMLD from 2006 to 2016 increased from 2.7 to 5.1 per 100 000. The most common pre-existing diagnoses and treatments for NTMLD patients were COPD and asthma and penicillin, macrolides and inhaled corticosteroids. Compared to random testing, machine learning improved detection of patients with NTMLD by almost a thousand-fold with AUC of 0.94. The total prevalence of diagnosed and undiagnosed cases of NTMLD in 2016 was estimated to range between 9 and 16 per 100 000.This study supports the feasibility of machine learning applied to primary care data to screen for undiagnosed NTMLD patients, with results indicating that there may be a substantial number of undiagnosed cases of NTMLD in the UK.

First Report on Tuberculosis Based on Slaughterhouse Data in Bejaia Province, Algeria: A Retrospective 10-Year Survey

Tuberculosis (TB) is a widespread and endemic disease of ruminants in Algeria posing a significant threat to public health. A retrospective abattoir study was conducted in Bejaia province (Algeria) from 2009 to 2018 to estimate the prevalence of tuberculosis in cattle, sheep, and goats using detailed meat inspection procedure. The overall prevalence of tuberculosis was 2.06% (4092/199 077) in cattle, 0.007% (11/168 796) in sheep, and 0.008% (11/164 986) in goats. The annual prevalence rate of the disease showed intermittent increase in levels over the ten years period of the study. However, monthly fluctuations of tuberculous lesions in slaughtered cattle were recorded throughout the study period with detection rates ranging from 1.77% and 2.36%. In addition, the variation in seasonal prevalence in cattle and goats is not significant (P > 0.05). Our analysis has revealed the magnitude of TB in the study area and warrants further systematic investigation on the transmission of the disease in Algeria.

Incidence and prevalence of giant cell arteritis in Ontario, Canada.

To estimate trends in the incidence and prevalence of GCA over time in Canada. We performed a population-based study of Ontario health administrative data using validated case definitions for GCA. Among Ontario residents ≥50 years of age we estimated the annual incidence and prevalence rates between 2000 and 2018. We performed sensitivity analyses using alternative validated case definitions to provide comparative estimates. Between 2000 and 2018 there was a relatively stable incidence over time with 25 new cases per 100000 people >50 years of age. Age-standardized incidence rates were significantly higher among females than males [31 cases (95% CI: 29, 34) vs 15 cases (95% CI: 13, 18) per 100000 in 2000]. Trends in age-standardized incidence rates were stable among females but increased among males over time. Incidence rates were highest among those ≥70 years of age. Standardized prevalence rates increased from 125 (95% CI 121, 129) to 235 (95% CI 231, 239) cases per 100000 from 2000 to 2018. The age-standardized rates among males rose from 76 (95% CI 72, 81) cases in 2000 to 156 (95% CI 151, 161) cases per 100000 population in 2018. Between 2000 and 2018, the age-standardized rates among females similarly increased over time, from 167 (95% CI 161, 173) to 304 (95% CI 297, 310) cases per 100000 population. The incidence and prevalence of GCA in Ontario is similar to that reported in the USA and northern Europe and considerably higher than that reported for southern Europe and non-European populations.

Hepatitis víricas: virus de la hepatitis A, B y E

Viral hepatitises are an important worldwide health challenge, with high annual prevalence and incidence rates. Diagnosis and management require necessarily to know its clinical features. The most common and with higher morbidity and mortality, in its chronic infections (causing liver cirrhosis and hepatocarcinoma), is hepatitis B. In recent years its incidence has decreased thanks to vaccination. In last years, in developed countries outbreaks of Hepatitis A have been detected; hence differential diagnosis requires taking it into account. Usually, clinical course is benign and self-limited. In last decade, epidemiology of hepatitis E has undergone a change. Although hepatitis E has been always considered an infection in developing countries, recently it has been identified as common zoonosis in Europe and other countries.

P771 Increasing prevalence and direct health care cost of inflammatory bowel disease: A population-based evidence from a western Canadian province

Abstract Background More than 0.3% of the populations in Europe, North America, and Oceania live with inflammatory bowel disease (IBD). Canada has increasing prevalence trends of IBD with 1% of Canadians estimated to have IBD by 2030. Evidence about IBD prevalence and health care costs over time can contribute to health resources allocation and health care planning. Our study aimed to 1) estimate the prevalence and direct health care costs of IBD in the province of Saskatchewan (SK), Canada, and 2) test if trends in the prevalence and direct health care costs of IBD increased over two decades. Methods We conducted a retrospective population-based cohort study using administrative health data of SK between 1999/00 and 2016/17 fiscal years. A validated case definition was used to identify prevalent IBD cases. The costing method adopted by the Canadian Institute for Health Information was used to estimate direct health care costs in 2013/14 Canadian dollars among IBD cases. Generalised linear models (GLMs) with generalised estimating equations were used to test the trends. Negative binomial and gamma distributions were used to, respectively, model prevalence and health care cost trends. Sex and age group were covariates in all models; the Charlson comorbidity index was also included in the cost model. Annual prevalence rates and direct health care cost estimates with their 95% confidence intervals (95%CI) were reported. Results In 2016, there were 6468 (Crohn’s disease: 3663 [56.63%], ulcerative colitis: 2805 [43.37%]) IBD cases ascertained in SK. The number of prevalent cases increased over the analysis period by 56%. The total direct health care costs increased from $7.8 million in 1999 to $50.8 million in 2016. The average annual IBD prevalence increased from 341/100,000 (95%CI 340–341) in 1999 to 664/100,000 (95%CI 663–665) in 2016, a 3.3% (95%CI 2.4–4.3) average annual increase. The total average annual direct health care costs of IBD increased from $1.8 (95%CI $1.6–2.0) thousand per patient in 1999 to $7.1 (95%CI $6.7–7.5) thousand per patient in 2016, an average annual increase of 9.2% (95% CI 8.5–9.8), Figure 1. Conclusion In the Canadian province of SK, prevalence and direct health care costs, respectively, tripled and quadrupled over two decades. Our results provide relevant information and analysis on the burden of IBD in SK. These findings are in agreement with previous studies from other provinces. The evidence of constant increasing prevalence and health care cost trends of IBD needs to be recognised by health care decision-makers to promote cost-effective health care policies at provincial and national levels and respond to the needs of patients living with IBD.

Determinants of healthcare utilisation for low back pain: A population-based study in Ethiopia.

Low back pain (LBP) remains one of the major public health problems worldwide. However, in low-income countries, such as those in Africa, the epidemiological data on healthcare utilisation for LBP are lacking due to more pressing problems such as infectious diseases, to which the majority of health resources are channelled. Therefore, this study aimed at investigating the determinants of healthcare utilisation for LBP in the general population of Ethiopia. A population-based cross-sectional study was conducted in South-West Shewa zone of Ethiopia from June to November 2018. The data were collected by interviewing adults with LBP (n=1812, randomly selected) using a psychometrically tested and validated instrument, analysed using R version 3.5.1. A log-binomial regression model was used to determine the prevalence ratio with a 95% confidence interval (CI) in identifying factors associated with healthcare utilisation for LBP. Estimates of population parameters were also presented with 95% CIs and p values. For all applications of inferential statistics, a p value of ≤.05 was taken as the significance level. The lifetime prevalence of healthcare utilisation for LBP was 36.1%, 95% CI: 33.9-38.1, while the annual prevalence rate was 30%, 95% CI: 27.9-32.2. Of those with a 1-year history of healthcare utilisation, while 7.4%, 95% CI: 4.9-10.3 rural and 36.6%, 95% CI: 29.5-44 urban populations utilised healthcare from general hospitals, 1.4%, 95% CI: 0.3-2.7 rural and 6.8%, 95% CI: 3.1-10.8 urban populations utilised healthcare from specialised hospitals. Several sociodemographic factors, modifiable health behaviours/lifestyle habits, pain interrelated factors, and specific factors such as beliefs about the pain, depressive symptoms and insomnia were associated with healthcare utilisation for LBP. The implications of this research are that it may be prudent for the Ethiopian healthcare policy makers to develop the necessary strategies to meet the health needs of both urban and rural populations with LBP.

An epidemiologic study of physician-diagnosed chronic obstructive pulmonary disease in the Turkish population: COPDTURKEY-1

Background/aimChronic obstructive pulmonary disease (COPD) is a common disease characterized by persistent airflow limitation and respiratory symptoms. It is a leading cause of morbidity and mortality all over the world. Our data on COPD in Turkey are limited. This study was intended to examine the epidemiologic characteristics of COPD in the Turkish population, between 2012 and 2016. Materials and methodsThis population-based, descriptive, surveillance study examined physician-diagnosed COPD prevalence, incidence, and mortality in Turkey. The database of the Social Security System of Turkey was scanned and ICD-10 J44.0-J44.9 codes for diagnostic and/or therapeutic purposes were evaluated retrospectively. Results In 2016, there were 3,434,262 cases of COPD (56.2% men) in Turkey, and the mean age of patients was 61.62 ± 14.76 years. From 2012 to 2016, the annual overall prevalence rates of physician-diagnosed COPD rose from 4.3% to 5.8%, which was a 35.0% relative increase (P < 0.05). In women, this rate rose from 3.7% to 5.1% (38% increase), and in men, it rose from 4.9% to 6.7% (37% increase). During the study period, the overall incidence decreased from 8.5 per 1000 adults in 2012 to 6.3 per 1000 adults in 2016, representing a decrease of 26.6% (P < 0.001). The annual incidence rates of physician-diagnosed COPD decreased 25.4% in women and 27.9% in men. The overall mortality was 4.3% in 2012, and 4.2% in 2016. The mortality rate in women was 3.5% in 2012 and 3.7% in 2016, and 5% in 2012 and 4.7% in 2016 in men. The mean prevalence by region was 5.26% (range 3.79%–7.65%). The Black Sea region had the highest COPD prevalence. ConclusionCOPD is a very common and serious cause of morbidity and mortality in Turkey, as it is worldwide. Current data will contribute to a better understanding of the epidemiologic dimension of COPD in our country.