Average Incidence Research Articles

Measles surveillance data analysis and serological survey in Quzhou, China, 2014–2024: an assessment of progress toward measles elimination

BackgroundMeasles is a disease that can be eliminated through vaccination. In recent years, measles incidence and mortality have been greatly reduced.MethodsAnalyze measles surveillance data from 2014 to 2023 and measles seroepidemiological characteristics of healthy populations in 2024 to assess progress toward measles elimination.ResultsA total of 35 measles cases were reported in the surveillance system from 2014–2023 in Quzhou, with an average annual incidence of 1.6/1 million. Since 2019, the incidence of measles has been lower than 0.5/1 million. A serological survey of 257 healthy people showed that the positive rate of measles IgG antibody was 90.3%, and the immunity of all age groups except 0–5 years old was lower than 95%, which did not reach the threshold of 95% herd immunity required for eliminating measles.ConclusionAlthough the incidence of measles in Quzhou is low, the immunity of healthy people to measles infection is insufficient. Measles is still in the control phase, not in the elimination phase. Inadequate immunity in the population may be due to the failure to achieve ≥95% vaccination coverage and low immunogenicity of the vaccine. Recommends that the quality of routine immunization data be assessed and monitored to verify reported vaccination coverage; at the same time, improve vaccination services and optimize vaccination policies to increase actual vaccination coverage. In addition, it is recommended to adjust the MMR immunization strategy, changing the time of the first MMR vaccination from 8 months of age to 12–15 months of age, and the second dose at 4 to 6 years of age.

Spatiotemporal distribution and meteorological factors of hemorrhagic fever with renal syndrome in Hubei province.

Hemorrhagic fever with renal syndrome (HFRS) is a vital rodent-borne disease, and poses a serious public health threat in Hubei province. We aimed to explore the spatiotemporal distribution of HFRS in Hubei province during 2005-2022, and the effects of meteorological factors. Data on HFRS cases at the county level in Hubei province during 2005-2022 were obtained from the Chinese Center for Disease Prevention and Control Information System. The monthly meteorological data at the city level was extracted from the China Meteorological Data Sharing Service System from 2016 to 2020. Descriptive analyses, joinpoint regression model, spatial correlation analyses, Geodetector model and autoregressive integrated moving average (ARIMA) model were conducted to investigate the epidemic characteristics, temporal trend, spatial distribution, influencing factors of HFRS and predict its trend. A total of 6,295 cases were reported in Hubei province during 2005-2022, with an average incidence of 6/1,000,000. Most cases were males (74.52%) and aged 40-69 years (71.87%). The monthly HFRS cases showed two seasonal peaks, which were summer (May to June) and winter (November to December). The HFRS incidence remained fluctuating at a low level during 2005-2015, followed an increasing trend during 2015-2018, and then decreased during 2018-2022. Hotspots were concentrated in the center of Hubei province in all 3 periods, including Qianjiang, Tianmen and some counties from Xiangyang, Jingmen and Jingzhou cities. The distribution of HFRS had a positive association with wind speed, while a "V"-shaped correlation with mean temperature, with an explanatory power of 3.21% and 1.03% respectively (both P <0.05). The ARIMA model predicted about 1,223 cases occurred in the next 3 years. HFRS cases showed seasonal fluctuation and spatial clustering in Hubei province. Central plain areas showed high risk of HFRS. Wind speed and mean temperature had significant effects on the transmission of HFRS in Hubei province. The results alert health authorities to conduct disease-climate surveillance and comprehensive prevention strategies, especially in high-risk counties.

The Tax Incidence and Tax Pass-Through of Smokeless Tobacco in the US

Background: States adopt different tax bases for smokeless tobacco (SLT), making tax incidence on SLT not directly comparable across states. In addition, how taxes are passed through to SLT prices among states that impose specific taxes, and whether the pass-through rates for SLT are affected by the uptake and evolution of e-cigarettes, is unknown. Objective: This study will calculate the tax incidence on SLT and investigate how SLT taxes are passed to prices at the 25th, 50th, and 75th percentile levels, as well as whether these pass-through rates vary by e-cigarette uptake and evolution. Methods: We regressed SLT prices on specific taxes using ordinary least square regressions while controlling for state-, year-, and quarter-fixed effects. We then tested the difference in tax pass-through rates by different periods. Findings: The average tax incidence on chewing tobacco, moist snuff, dry snuff, and snus was 22%, 22%, 23%, and 20%, respectively. For moist snuff, taxes were fully passed to prices at the 25th and 50th percentiles (rate = 1.01, p &lt; 0.001) and overly passed to prices at the 75th percentile (rate = 1.25, p &lt; 0.001). The e-cigarette uptake and evolution significantly raised taxes by 13 cents and 14 cents per ounce, respectively, for moist snuff at the 75th percentile prices (p &lt; 0.05). Conclusions: If harm is considered a criterion for taxing tobacco products, the tax incidence on SLT could be further increased. Considering that lower-priced SLT have lower tax pass-through rates, price promotion restrictions and minimum pricing laws may be needed to increase the cost of lower-priced products. Additionally, we observed that tobacco companies tended to increase tax pass-through for premium SLT products as e-cigarettes gained popularity, which may indicate a strategic response to shifting consumer preferences.

Unveiling the Burden: A Six-Year Retrospective Analysis of Pressure Ulcer Epidemiology in a ICU

Objective: This study describes the epidemiological changes in pressure ulcers (PUs) in a Portuguese intensive care unit (ICU) from January 2017 to June 2023, characterizes critically ill patients with PUs, identifies specific risk factors, and assesses the effectiveness of implemented preventive measures. Materials and Methods: A retrospective observational cohort study was conducted, analyzing records of ICU patients with PUs during the specified period. Data were extracted from the institution’s Global Risk Management application and the ICU’s electronic PU registry. The study included patients with ICU stays longer than 24 h and excluded those with ineligible clinical records or incomplete characterization data. Results: Among 3816 evaluated patients, 257 developed a total of 345 PUs, averaging 1.4 PUs per patient. The average PU prevalence rate was 6.81%, with the highest prevalence in 2020 (11.0%) and the lowest in 2022 (3.48%). The average incidence rate was 3.76%, peaking at 5.71% in 2020 and declining to 2.54% in 2023. The sacrum and heels were the most commonly affected areas, with Category 2 PUs being the most frequent. Key intrinsic risk factors included systemic diseases and sensory deficits, with pressure identified as a significant extrinsic factor. Preventive measures focused on risk assessment and pressure control. Conclusions: The study reveals a PU prevalence of 6.81% and an average incidence of 3.76%, underscoring the need for enhanced preventive strategies, especially in anatomical areas like the sacrum and heels. It emphasizes the importance of personalized assessments, continuous education for nursing staff, and a multidisciplinary approach to improve patient outcomes and care quality in the ICU.

An evaluation of African animal trypanosomiasis control strategies in remote communities of Eastern Zambia.

Communities living in African animal trypanosomiasis (AAT) endemic areas of Zambia use several control strategies to protect their livestock from the devastating effects of trypanosomiasis. Several studies have reported the effectiveness of trypanosomiasis control strategies based on retrospective data. In this study, we assessed incidence rates of AAT in cattle (n = 227) using a prospective cohort study comprising 4 treatment groups, i.e., Diminazene aceturate, Isometamidium chloride, Cyfluthrin pour-on and Cypermethrin treated targets. The study was conducted in Mambwe district in Eastern Zambia between February 2019 and March 2020. The endemic prevalence of AAT for each group was determined using ITS-PCR prior to application of treatments. High endemic trypanosome pre-treatment rates were found in all Groups (Diminazene aceturate (61%), Isometamidium chloride (48%), Cyfluthrin pour-on (87%) and Cypermethrin targets (72%)). The overall apparent prevalence for the Mambwe district was 67% (152/227) and true prevalence at 95%CI was 63–71%. Once treatments were implemented, 12 monthly follow-ups were conducted. The average monthly incidence rates without standardization recorded: Diminazene aceturate (67%) Isometamidium chloride (35%), Cyfluthrin pour-on (55%) and Cypermethrin targets (61%). Incidence rates were standardized considering the endemic level of disease for each Group and the average standardized monthly incidence rate in the Diminazene aceturate Group was 7%; the Isometamidium chloride Group −13%; the Cyfluthrin Group −26%; and the Cypermethrin target Group, −17%. All Groups showed a decrease in incidence of AAT over the period of the study with the Cyfluthrin group showing to be the most effective in reducing AAT incidence in cattle.

The Costs and Cost-Effectiveness of a Two-Dose Oral Cholera Vaccination Campaign: A Case Study in a Refugee Camp Setting in Thailand

Oral cholera vaccination (OCV) campaigns are increasingly used to prevent cholera outbreaks; however, little is known about their cost-effectiveness in refugee camps. We conducted a cost-effectiveness analysis of a pre-emptive OCV campaign in the Maela refugee camp in Thailand, where outbreaks occurred with an annual incidence rate (IR) of up to 10.7 cases per 1000. Data were collected via health sector records and interviews and household interviews. In the base-case scenario comparing the OCV campaign with no campaign, we estimated the campaign effect on the cholera IR and case fatality rate (CFR: 0.09%) from a static cohort model and calculated incremental cost-effectiveness ratios for the outcomes of death, disability-adjusted life-years (DALYs), and cases averted. In sensitivity analyses, we varied the CFR and IR. The household economic cost of illness was USD 21, and the health sector economic cost of illness was USD 51 per case. The OCV campaign economic cost was USD 289,561, 42% attributable to vaccine costs and 58% to service delivery costs. In our base case, the incremental cost was USD 1.9 million per death averted, USD 1745 per case averted, and USD 69,892 per DALY averted. Sensitivity analyses that increased the CFR to 0.35% or the IR to 10.4 cases per 1000 resulted in a cost per DALY of USD 15,666. The low multi-year average CFR and incidence of the cholera outbreaks in the Maela camp were key factors associated with the high cost per DALY averted. However, the sensitivity analyses indicated higher cost-effectiveness in a setting with a higher CFR or cholera incidence, indicating when to consider campaign use to reduce the outbreak risk.

Does air pollution impact myocardial infarction incidence even in a city with fair air quality? Results from the EPIC-MI (Environmental Pollution and IncidenCe of Myocardial Infarction) Study

Abstract Background In light of recent research highlighting the potential association between air pollution and cardiovascular diseases, there remains a gap in data, particularly in cities characterized by relatively low pollution levels. The EPIC-MI Study endeavors to explore whether, even in a city boasting fair air quality such as our city, there exists a discernible impact of air pollution on the risk of cardiovascular events within an urban setting. Methods We analyzed all consecutive acute myocardial infarction (MI) patients admitted to our city heart center from March 2013 to December 2022. Air pollution data were meticulously gathered from 5 strategically positioned monitoring stations. Utilizing Poisson regression, the associations between these pollutants and the incidence of MI was analyzed. We also investigated the impact of pollution exceedance days and COVID-19 lockdown periods on MI incidence. Results Over nearly a decade, 18.798 MI cases were analyzed. The Poisson regression model revealed a significant independent association between the monthly average MI incidence and pollutant concentrations within the same month. Statistically significant independent effects were observed for CO (p&amp;lt;0.01), O₃ (p=0.03), SO₂ (p&amp;lt;0.01), and relative humidity (p&amp;lt;0.01) on MI incidence (Figure 1). Exceedance days were associated with a significant upswing in daily MI incidence. The MI incidence increased by 3.3% when PM10 exceeded 25 µg/m³ on the same day (5.19 ± 2.49 vs. 5.36 ± 2.50, p=0.03) and remained elevated over three days (5.19 ± 1.42 vs. 5.34 ± 1.46, p&amp;lt;0.01). For PM2.5, there was a 4.2% increase when exceeding 20 µg/m³ on the same day (5.20 ± 2.49 vs. 5.42 ± 2.52, p=0.02) and still elevated over three days (5.20 ± 1.42 vs. 5.40 ± 1.47, p&amp;lt;0.01). During the COVID-19 lockdown periods, a significant decrease was observed in air pollutant levels compared to non-lockdown years within the same timeframe (Figure 2). PM2.5 (9.89 µg/m³ vs. 12.76 µg/m³, p=0.02), PM10 (15.26 µg/m³ vs. 18.7 µg/m³, p&amp;lt;0.01), SO2 (1.16 µg/m³ vs. 1.77 µg/m³, p&amp;lt;0.01), and NO2 (14.42 µg/m³ vs. 19.53 µg/m³, p&amp;lt;0.01) exhibited significant reductions. Concurrently, a 22.5% reduction in daily MI incidence was observed compared to non-lockdown years within the same timeframe (4.16 vs. 5.37, p&amp;lt;0.01). Conclusion The study demonstrates an enduring influence of air pollutants on cardiovascular events, even in a city with fair air quality, such as our city. Elevated concentrations of air pollutants, especially on days with excessive levels, were significantly associated with an increased incidence of MI. The reduction in MI cases observed during the COVID-19 lockdown period underscores the potential cardiovascular benefits associated with improved air quality. These findings emphasize the importance of sustained efforts to mitigate air pollution for the enhancement of cardiovascular health in urban environments.

Epidemiology of Hand, Foot, and Mouth Disease and Genetic Characterization of Coxsackievirus A16 in Shenyang, Liaoning Province, China, 2013–2023

Hand, foot, and mouth disease (HFMD), a common childhood infection caused by enterovirus, poses a serious public health concern in China. We collected and analyzed epidemiological data on 62,133 HFMD cases in Shenyang City, Liaoning Province, from 2013 to 2023. The average annual incidence was 76.12 per 100,000 person-years; 99.45% of cases were mild, while 0.55% were severe. Only one patient died. HFMD infections peaked annually in July. Children in kindergartens and scattered children accounted for 44.6% and 42.2% of cases, respectively. Real-time RT-PCR detection of enteroviruses in 5534 patient samples revealed 3780 positives, of which 25.1% were CVA16-positive. Positives were randomly sampled, yielding 240 VP1 sequences of CVA16. Phylogenetic tree results showed that all VP1 sequences belonged to the B1 sub-genogroup. However, the sub-genogroup prevalence varied over time: from 2013 to 2014 and 2019 to 2021, the predominant sub-genogroup was B1a, while it was B1b from 2015 to 2018. Further phylogenetic analyses showed substantial divergence between B1a branches in CVA16, suggesting possible turnover of the B1a sub-genogroup in CVA16 due to evolution. This study provides epidemiological data on HFMD in Shenyang, and provides a phylogenetic analysis of CVA16, offering a theoretical basis for preventing and controlling HFMD in Shenyang City.

Child Abuse Incidences Per Child Year Predicted from the Available Average Incidence Combined with Foreign Incidences Per Child Year: Towards a New Policy

Child abuse is a worldwide recognized serious problem. Reliable child abuse incidences, preferably per child year, are fundamental for a sound detection and prevention program. Unfortunately, in most countries where child abuse data is available, incidences are not determined per child year but as an average over the child age range. In this paper we suggest a possible &amp;quot;next-best&amp;quot; solution for deriving child abuse incidences per child year when only an average value is available in an area or country. As method, we combined the country&amp;apos;s measured average incidence with available (foreign) incidences per child year. The country&amp;apos;s next-best incidences per child year will be estimated from its average, multiplied by the foreign incidences per child year divided by the foreign average. As results, we calculated the next-best Dutch age-dependent incidences by combining the Dutch average value with US and Ontario age-related incidences. We found comparable results for infants above 1 year and marked differences for children &amp;lt;1 year, likely due to cultural differences between the US and Ontario. In conclusion, next-best age-related child abuse incidences are obtainable in large areas or countries by choosing a smaller but representative region, the latter estimated from Ontario-data as ≥210,000 inhabitants, and establishing as perfectly as possible the optimal infra structure. A future perspective towards a new policy could be to initiate and stimulate this approach in the various European Union and United Nations Convention on the Rights of the Child member states.

Response of Nepalese Rice Landraces to Brown Spot [Bipolaris oryzae (Breda de Haan) Shoemaker] at Rampur, Chitwan, Nepal

Brown spot disease, caused by the fungus Bipolaris oryzae, is a common foliar affliction in rice plants, impacting agricultural yields worldwide. A field experiment was conducted to identify brown spot resistant landraces at Rampur, Chitwan during June to November, 2018. A set of 54 rice genotypes comprising of 52 landraces and two checks (resistant and susceptible) were evaluated for resistance to the disease under field condition in alpha lattice design with three replicates. Area under disease progress curve (AUDPC) values varied significantly among the genotypes. Of the tested 54 genotypes, nine genotypes were found moderately resistant, 38 genotypes susceptible and seven genotypes were found highly susceptible. The maximum incidence (64.9%) of pathogen was found in seed of Hodbachhi followed by Sankharika (64.15%). The minimum average incidence of pathogen was found in check Sabitri (4.05%), which was as par with other 28 genotypes. The yield attributing characters were highly significant among the genotypes. Highest grain yield (1.55 t ha-1) was obtained from Ghusara (1.51 t ha-1) followed by Lalbachhi. Lowest grain yield was obtained from Ghuyeni Saro (0.21 t ha-1) followed by Jaguli Mansuli (0.25 t ha-1). All the yield and yield attributing characters were negatively correlated with AUDPC. Seed-borne infection after harvest was highly significant among the genotypes. The results revealed that among the screened genotypes most of the landraces of rice are susceptible to brown spot.

Analysis of Complications of a Neglected Disease: 13 Years of Experience with Liver Hydatid Cysts in a High-Volume Hospital

Background and Objectives: The aim of this study was to evaluate the clinical presentation, treatment outcomes, and complications associated with hepatic hydatid cysts in a pediatric population. Materials and Methods: This retrospective study analyzed 214 pediatric patients with liver hydatid cysts, focusing on clinical presentation, treatment outcomes, and associated complications. Patients were classified based on treatment modality, including non-operative management with albendazole, PAIR, and surgical intervention. This study compared cyst characteristics, recurrence rates, and complications such as cysto-biliary fistulas. Results: Among the patients, 68% (n = 145) had a single cyst and 86% (n = 184) were found to have isolated liver cysts. No significant statistical difference was observed between Group 1 and Group 2 in terms of age, gender, and basic laboratory values and general characteristics of the cysts, such as the lobe where the cyst was located, involvement of multiple organs, number of cysts, the state of cyst rupture, and recurrence; no statistically significant difference was found between the groups (p &gt; 0.05 for each comparison). Cyst rupture incidence was 6%, and the average incidence of recurrence was 2%, with a surgical recurrence incidence of 3%. A total of 37 patients had a laparotomy, while 7 had laparoscopic surgery. In total, capitonnage was performed in 68 patients, omentopexy in 4, and cystostomy in 6. Consequently, among the treated patients (PAIR + surgery), the incidence of cysto-biliary fistula was 11%, anaphylaxis was 2%, surgical recurrence was 3%, and the incidence of reoperation (Clavien–Dindo ≥ 3) was 6%. The average follow-up period was 72 months, during which no mortality was observed. Conclusions: We identified key clinical outcomes related to both non-surgical treatments (cyst rupture and recurrence) and surgical groups (cysto-biliary fistulas, anaphylaxis, the need for reoperation, rupture, and recurrence).

Influence of cultivar selection on blast and brown spot diseases in rice: Molecular screening of blast resistance genes &amp;nbsp;

The prevalence of blast and brown spot diseases in rice is a substantial threat to national food security. This study investigated the distribution patterns of blast and brown spot, comparing their occurrence and distribution with respect to cultivar selection and conducting molecular screening for the identification of blast resistance genes. The research was conducted over five cultivating seasons from Yala 2017 to Yala 2019 in the Northern Province of Sri Lanka. Incidence percentages of the two diseases were calculated in 114 randomly selected fields across the five districts; Jaffna, Mullaitheevu, Kilinochchi, Mannar, and Vavuniya. Molecular markers were used to screen for nine major blast-resistant genes in 25 commonly cultivated rice cultivars. The results showed a significant shift in the disease over the period of study. While blast disease incidence declined after Maha 2017, brown spot incidence increased steadily from Yala 2017, peaking in Yala 2019. Interestingly, farmers’ cultivar preferences, often diverging from the Department of Agriculture recommendations, exhibited a strong correlation with disease occurrence. The cultivar Attakkari was identified as a highly susceptible cultivar, which had only three R genes and a major contributor to the progression of blast before Maha 2017. Despite higher brown spot incidence percentages observed in cultivars At362, Bw367, and Bg450, compared to Bg360, intensive post-Maha 2017 cultivation of Bg360 increased the average brown spot incidence to 43%. Cultivars grown after Maha 2017, with over five R genes, showed lower blast disease incidence, suggesting a genetic link to susceptibility. This lower incidence of blast was also observed in the disease evaluation test, where we used the same cultivars. Hence, this study highlights rice cultivar selection as a decisive factor influencing disease occurrence. Given Sri Lanka’s robust germplasm for blast-resistant genes, strategic cultivar selection has the potential for effective disease management.

Sudden cardiac death in athletes: A 20-year analysis in Portugal

Introduction and objectivesSudden cardiac death (SCD) in athletes is a tragic event, with some evidence remaining controversial. The aim of this study was to evaluate cases of SCD in athletes in Portugal within the last 20 years. MethodsAn advanced Google search using a combination of several keywords and systematic searches on websites of national newspapers/television stations was conducted. Additionally, 54 Portuguese sports federations and the Portuguese Institute of Sports and Youth were contacted by email and/or phone. All sports-related SCD cases in competitive athletes, occurring between 2003 and 2023 in Portugal, were included. The total number of athletes at risk used for the calculation of SCD incidence, was collected from official national records. ResultsA total of 42 SCD cases in athletes were identified, with a median age of 27 [18;42] years, and the great majority were male (n=39; 93%). Most events occurred in outdoor sports (n=28; 67%), especially in football (n=13; 31%), athletics (n=4; 10%) and trail running (n=4; 10%), and during competition or training sessions (n=27; 64%). The higher number of cases were reported in 2021 and 2022, while in several years no occurrences were found. The yearly average SCD incidence was 0.39 cases per 100000 athletes/year. ConclusionsThe incidence of SCD in athletes in Portugal is very low, mainly occurring in male, outdoor sports and during competitions or training sessions. Due to the limitations of passive data collection, prospective registries are needed, with standardization of the most relevant data, especially regarding their etiology and circumstances.

Nationwide epidemiological study of epilepsy in Montenegro

The aim of this study was to estimate the incidence and prevalence of epilepsy in Montenegro over the period 2011–2022 using hospital case records. The main sources for this study were hospital case records in every outpatient and inpatient neurological department in Montenegro, including the Clinical Center of Montenegro in the capital, a primary referral national center for epilepsy. For every patient, aged 18 and above, two neurologists reviewed all data collected to verify the validity of the diagnosis and to establish the date of clinical onset of the disease. Information on age and sex, EEG, CT scan, and MRI were included. Prevalent cases were selected in 2022 population. Incident cases of epilepsy were identified in 2011 and the incidence trend was followed up for the next 12 years. Crude and standardized incidence and prevalence were calculated. Average crude incidence rate of epilepsy for study period was 56.0 per 100,000 individuals (men 58.1; women 54.2). The age-specific incidence was lowest in the 30 s, and early 40 s and highest after 65 years. Over the 12-year period, increasing trend of standardized epilepsy incidence rates was observed for the total population and for females (p = 0.024 and p = 0.020 respectively). The crude overall prevalence of epilepsy on December 31, 2022 was 13.0 per 1000 individuals (men 13.5; women 12.6). The highest prevalence was in patients in their early 20 s and in the seventh decade. In conclusion, the incidence of epilepsy in this study was similar to those of other industrialized countries, with increasing trend during study period. Prevalence was higher compared to European countries.

Prevalence, Species Distribution and Resistance of Candidemia in Pediatric and Adult Patients in a Northeast Italy University Hospital.

Candidemia and invasive candidiasis (IC) are causes of morbidity and mortality in healthcare settings, with notable differences between children and adults. Understanding the species distribution and antimicrobial susceptibility profiles of clinical isolates can guide empiric therapy in patients at risk of IC. This study investigated the incidence and antifungal susceptibility patterns of yeasts involved in IC in pediatric and adult patients from 2019 to 2023. The average incidence of IC was 0.715 per 1000 patients, increasing over the study period; infants had the highest incidence rates. Over half of the IC episodes occurred in intensive care units (ICUs). Non-albicans Candida (NAC) species represented the most frequently isolated species in adults and children (55.96% and 50.0%, respectively), with the prevalence of C. parapsilosis (26.45% and 14.7%, respectively), N. glabratus (14.97% and 8.82%, respectively) and C. tropicalis (4.36% and 2.94%, respectively). C. lusitaniae was identified in 14.7% of pediatric IC cases. In NAC species, antifungal resistance has also increased over the five years of the study: 69.12% were resistant to azoles and 7.35% were resistant to micafungin. Resistance was higher in pediatric patients. Our study highlights differences in IC characteristics between pediatric and adult populations and emphasizes the importance of targeted antifungal stewardship in ICU patients with NAC invasive infections.

Distribuição espacial e características clínico epidemiológicas dos casos de síndrome respiratória aguda grave por covid-19 no Brasil: estudo das duas primeiras ondas

The new coronavirus (SARS-CoV-2), the COVID-19 etiological agent, has been established as a challenge for health systems and can present as Flu Syndrome (FS) or Severe Acute Respiratory Syndrome (SARS). This work was aimed at describing the clinical epidemiological profile of SARS cases due to COVID-19 and the spatial distribution of the incidence among the Federative Units of Brazil (FU) in the first two waves. This is a descriptive and ecological study, with the FU as settings. The data collected are related to SARS cases due to COVID-19, with a time frame between March 2020 and June 2021. The sociodemographic and clinical-epidemiological variables were selected with their respective absolute and relative values. The spatial distribution of incidence was determined to identify the presence of spatial autocorrelation in the first two waves. A total of 613,324 SARS cases due to COVID-19 were reported, most were related to males, aged&gt;60 years, typified as non-nosocomial and with a healing outcome; signs and symptoms were: cough,fever, dyspnea, and at least presence of one comorbidity. The average incidence in the countrywas 286.85 cases/100,000 inhabitants, while the Moran Index showed statistical significance I=0.329 (p value&lt;0.001), with global spatial autocorrelation of the incidence in the second wave. The distribution was heterogeneous. These results constitute subsidies for management in health systems and services regarding the strategic implementation for the control and clinical management of this disease.

CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2017-2021.

The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the Centers for Disease Control and Prevention and the National Cancer Institute, is the largest population-based registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the United States (US) and represents the entire US population. This report contains the most up-to-date population-based data on primary brain tumors available and supersedes all previous reports in terms of completeness and accuracy. All rates are age-adjusted using the 2000 US standard population and presented per 100,000 population. Between 2017 and 2021, the average annual age-adjusted incidence rate (AAAIR) of all primary malignant and non-malignant brain and other CNS tumors was 25.34 per 100,000 population (malignant AAAIR=6.89 and non-malignant AAAIR=18.46). This overall rate was higher in females compared to males (28.77 versus 21.78 per 100,000) and non-Hispanic Black persons compared to persons who were non-Hispanic White (26.60 versus 25.72 per 100,000), non-Hispanic American Indian/Alaska Native (23.48 per 100,000), non-Hispanic Asian or Pacific Islander (19.86 per 100,000), and Hispanic persons of all races (22.37 per 100,000). Gliomas accounted for 22.9% of all tumors. The most commonly occurring malignant brain and other CNS histopathology was glioblastoma (13.9% of all tumors and 51.5% of all malignant tumors), and the most common predominantly non-malignant histopathology was meningioma (41.7% of all tumors and 56.8% of all non-malignant tumors). Glioblastomas were more common in males, and meningiomas were more common in females. In children and adolescents (ages 0-19 years), the incidence rate of all primary brain and other CNS tumors was 6.02 per 100,000 population. There were 87,053 deaths attributed to malignant brain and other CNS tumors between 2017 and 2021. This represents an average annual mortality rate of 4.41 per 100,000 population and an average of 17,411 deaths per year. The five-year relative survival rate following diagnosis of a malignant brain or other CNS tumor was 35.7%. For a non-malignant brain or other CNS tumor the five-year relative survival rate was 92.0%.

Upper extremity orthopedic softball injuries presenting to the emergency department: epidemiology across the lifespan

ABSTRACT Background Softball is a popular lifetime sport due to its inclusion of both fastpitch and slowpitch varieties, although associated injuries are common. Objective To compare softball injury rates across patient sex, age, race, injury location, mechanism, and activity. Methods The National Electronic Injury Surveillance System (NEISS) was queried for all upper extremity softball injuries in patients 10–85+ years old presenting to United States emergency departments between 2012 and 2021. Results Significantly more of the 178,303 total weighted upper extremity injuries occurred in female (68.1%) than male (31.9%) athletes (p < .001). Male patients (mean 34.9 ± 13.6 years) were older than female patients (17.4 ± 8.4; p = .019). The average incidence rate of UE injuries from 2012–2021 was 187.9 per 100,000 persons, with a significant decrease in injury incidence across the timespan (p < .001). The lowest annual injury incidence (74.7 per 100,000 persons) occurred in 2020. In patients 10–18 years old, female patients accounted for 95.1% of all injuries, whereas male patients accounted for 72.1% of all injuries in patients aged ≥23. Compared to male patients, females more frequently experienced hand (p < .001), lower arm (p = .007), shoulder (p < .001), and wrist (p < .001) injuries in patients 10–18 years old, finger (p < .001), upper arm (p = .016), and wrist (p < .001) injuries in patients 19–22, and finger injuries (p < .001) in patients aged 23 +. Across all ages, the greatest proportion of injuries were treated and released (p < .001). Most injuries occurred while fielding (41.8%) and due to player-ball contact (36.8%). Conclusion Softball injury ED presentations declined across a decade, including a precipitous drop and rebound effect due to the COVID-19 pandemic. Across the lifespan, upper extremity injuries progressively shifted from female-predominant in younger athletes to male-predominant in adults.

Assessing measles risk transmission in Iran: a utilization of the World Health Organization’s programmatic risk assessment tool,2022

BackgroundDespite successful efforts to eliminate measles in Iran, imported measles cases continue to be reported. Because measles is endemic in neighboring countries. This research aims to evaluate the risk of measles transmission in different regions of Iran.MethodsMeasles case-based surveillance data of the Expanded Program of Immunization containing 31 provinces and 463 districts from 2019 to 2021 were assessed. The WHO Measles Programmatic Risk Assessment tool was used to evaluate the risk of disease transmission in four domains: population immunity, surveillance quality, program delivery performance, and threat assessment. scores were categorized as low, medium, high, or very high risk.ResultsDuring 2019–2021, the average incidence of measles was 1.9 per 1 million. Chabahar and Mashhad with 76 and ./6per million reported the highest and lowest incidence respectively. All 463 districts were categorized as low risk in risk assessment. Andimeshk, Chabahar, and Bojnurd obtained the highest risk scores with 27, 24, and 25 respectively. All districts were classified as low risk for population immunity. The average coverage of (MMR1) and (MMR2) was 95% or higher. All districts received the minimum points for surveillance quality.ConclusionAll regions are placed at a low level of disease transmission risk. However, the tool is not able to assess the risk at the rural or peripheral sectors level. The indicators used in this tool are the same for all countries with different epidemiological features (elimination, endemic). Sensitivity analysis can optimize the use of this tool for countries with different disease conditions.

High-resolution spatio-temporal risk mapping for malaria in Namibia: a comprehensive analysis

BackgroundNamibia, a low malaria transmission country targeting elimination, has made substantial progress in reducing malaria burden through improved case management, widespread indoor residual spraying and distribution of insecticidal nets. The country's diverse landscape includes regions with varying population densities and geographical niches, with the north of the country prone to periodic outbreaks. As Namibia approaches elimination, malaria transmission has clustered into distinct foci, the identification of which is essential for deployment of targeted interventions to attain the southern Africa Elimination Eight Initiative targets by 2030. Geospatial modelling provides an effective mechanism to identify these foci, synthesizing aggregate routinely collected case counts with gridded environmental covariates to downscale case data into high-resolution risk maps.MethodsThis study introduces innovative infectious disease mapping techniques to generate high-resolution spatio-temporal risk maps for malaria in Namibia. A two-stage approach is employed to create maps using statistical Bayesian modelling to combine environmental covariates, population data, and clinical malaria case counts gathered from the routine surveillance system between 2018 and 2021.ResultsA fine-scale spatial endemicity surface was produced for annual average incidence, followed by a spatio-temporal modelling of seasonal fluctuations in weekly incidence and aggregated further to district level. A seasonal profile was inferred across most districts of the country, where cases rose from late December/early January to a peak around early April and then declined rapidly to a low level from July to December. There was a high degree of spatial heterogeneity in incidence, with much higher rates observed in the northern part and some local epidemic occurrence in specific districts sporadically.ConclusionsWhile the study acknowledges certain limitations, such as population mobility and incomplete clinical case reporting, it underscores the importance of continuously refining geostatistical techniques to provide timely and accurate support for malaria elimination efforts. The high-resolution spatial risk maps presented in this study have been instrumental in guiding the Namibian Ministry of Health and Social Services in prioritizing and targeting malaria prevention efforts. This two-stage spatio-temporal approach offers a valuable tool for identifying hotspots and monitoring malaria risk patterns, ultimately contributing to the achievement of national and sub-national elimination goals.