Changes In Epidemiological Characteristics Research Articles

Changes in epidemiological characteristics of knee arthroplasty in eastern, northern and central China between 2011 and 2020

ObjectiveTo explore changes in the epidemiological and clinical characteristics of patients who underwent knee arthroplasty (KA) over a 10-year period in China.MethodsMedical records of patients with knee osteoarthritis (KOA), who underwent primary unilateral KA in 5 level I center hospitals in China between January 2011 and December 2020, were retrospectively reviewed and analyzed. To more clearly define changes over the years, patients were divided into two groups according to time of admission at 5-year intervals. Age, sex, body mass index (BMI), Kellgren–Lawrence (K–L) classification, comorbid diseases, surgical procedures, hospital stay, and hospitalization costs were compared between the two groups.ResultsA total of 23,610 patients with KOA (5400 male and 18,210 females; mean age: 65.7 ± 7.6 years) who underwent primary unilateral KA were included. The number of KAs increased in recent years (group A, n = 7606 vs. group B, n = 16,004). Significant differences were noted in age, sex, BMI, K–L classification, comorbidities, surgical procedures, hospital stay, and hospitalization costs between the two periods (P < 0.05). More than three-quarters of KA cases involved females, and the age at surgery tended to be younger than that reported in foreign countries. In group B, the proportion of overweight and grade III, number of comorbidities, and unicompartmental knee arthroplasty patients increased compared to that in group A; however, hospitalization costs and length of hospital stay decreased.ConclusionsResults suggested that the epidemiological characteristics of patients undergoing KA have changed over time. An analysis of the epidemiological characteristics of patients undergoing KA treatment may provide a scientific basis for the prevention and control of KOA.

Properties of the Omicron Variant of SARS-CoV-2 Affect Public Health Measure Effectiveness in the COVID-19 Epidemic.

Nonpharmaceutical and pharmaceutical public health interventions are important to mitigate the coronavirus disease 2019 (COVID-19) epidemic. However, it is still unclear how the effectiveness of these interventions changes with the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) novel variants. This simulation study utilized data from Japan and investigated how the characteristic properties of the Omicron variant, which emerged in late 2021, influence the effectiveness of public health interventions, including vaccination, the reduction of interpersonal contact, and the early isolation of infectious people. Although the short generation time of the Omicron variant increases the effectiveness of vaccination and the reduction of interpersonal contact, it decreases the effectiveness of early isolation. The latter feature may make the containment of case clusters difficult. The increase of infected children during the Omicron-dominant epidemic diminishes the effects of previously adult-targeted interventions. These findings underscore the importance of monitoring viral evolution and consequent changes in epidemiological characteristics. An assessment and adaptation of public health measures against COVID-19 are required as SARS-CoV-2 novel variants continue to emerge.

Changes in epidemiological characteristics and sero-prevalence against the varicella zoster virus in school-age children after the introduction of a national immunization program in Japan

ABSTRACT A national immunization program using two doses of live attenuated varicella vaccine was introduced for children aged one to two years in Japan in October 2014. Varicella cases declined after 2014, and immunological status against varicella among vaccinated children changed in post-vaccination era. A retrospective observational study of anti-varicella antibody seroprevalence, varicella vaccination status, and history of varicella among 528 students in the first grade of elementary school was conducted. The percentage of students who received at least a single dose of varicella vaccination increased from 67% (187 of 279 students) in 2007–2008 to 91% (226 of 249 students) in 2017. Students with a history of varicella decreased from 114 of 279 (41%) in 2007–2008 to 48 of 249 (19%, P < .01) in 2017. Among them, the rate of breakthrough varicella after a single dose of vaccine in students with a history of varicella significantly increased from 38% (43 of 114 students) in 2007–2008 to 58% (28 of 48 students) in 2017 (P < .05). The antibody-positive rate significantly decreased from 50% among subjects without varicella zoster who received a single dose (95%CI: 41–58%) in 2007–2008 to 29% (95%CI: 21–38%) in 2017 (P < .01). The antibody-positive rate among students without varicella history who received two doses of vaccine was only 43% (95%CI: 32–55%) in 2017. The number of varicella infections and antibody-positive rate among students without history of varicella who received varicella vaccination decreased after the introduction of a national immunization program.

Research progress and prospect of liver cirrhosis

Liver cirrhosis is the final stage of many chronic liver diseases, and is still a heavy disease burden. The proportion of liver cirrhosis caused by the hepatitis B virus is declining, while that caused by the non-alcoholic fatty liver disease (metabolic-associated fatty liver disease) is rising. Several predictive models and techniques such as transient elastography have been used for the early non-invasive evaluation of liver cirrhosis. Effective etiological treatment and complication management are the possible key to reverse and recompense liver function during liver cirrhosis treatment. In recent years, the effectiveness and availability of anti-hepatitis B and C virus drugs have been significantly improved, which provides the basis for effective etiological treatment of liver cirrhosis. However, there is still a lack of etiological treatment measures for non-alcoholic fatty liver disease. Therefore, in addition to focusing on common complications, we should also manage "rare" complications. This article reviews the changes in epidemiological characteristics, the update of the natural history concepts, diagnostic evaluation methods, and the treatment measures for liver cirrhosis.

Epidemiological changes in measles infections in southern China between 2009 and 2016: a retrospective database analysis

BackgroundThe incidence rate of measles in China reached a nadir in 2012 after 2 supplementary immunization activities (SIAs) were undertaken in 2009 and 2010. However, the disease began re-emerging in 2013, with a high prevalence rate observed in 2013–2014 in the southern province of Guangdong. In this study, we assessed the changes that occurred in measles epidemiology during 2009–2016, particularly between 2009 and 2011 (when the influence of the SIAs were in full effect) and between 2012 and 2016 (when this influence subsided).MethodsData from 22,362 patients with measles diagnosed between 2009 and 2016, and whose diagnoses were confirmed clinically and/or with laboratory testing, were extracted from the National Infectious Disease Monitoring Information System. Descriptive analyses were performed, and changes in epidemiological characteristics between 2009 and 2011 and 2012–2016 were compared.ResultsThere was a substantial surge in 0–8-month-old patients after 2012; the incidence rate increased from 4.0 per 100,000 population in 2011 (10.3% of the total) to 280 per 100,000 population in 2013 (32.8% of the total). Patients aged 0–6 years represented 73.4% of the total increase between 2011 and 2013. Compared with 2009–2011, adults aged ≥25 years accounted for a higher proportion of patients in 2013 and after (p < 0.01), and were highest in 2016 (31% of the patient total).ConclusionDespite the remarkable results achieved by SIAs in terms of providing herd immunity, the 2013 resurgence of measles revealed insufficient immunization coverage among children. Therefore routine immunization programs should be strengthened, and supplementary vaccinations targeting adults should also be contemplated.

Analysis on detection status of cardio-metabolic related risk factors in women aged 15-49 years in 15 provinces in China

Objective: To analyze the prevalence, co-prevalence of cardiovascular metabolic (CM) risk factors in women aged 15-49 years in China, and describe the influence of social economic factors on them. Methods: The project data of Nutritional Status and Health Transition of Chinese Residents in 2015 were used. The changes in epidemiological characteristics of central obesity, elevated blood pressure, FPG and TG, decreased HDL-C and co-prevalence of the risk factors in women aged 15-49 years were analyzed. According to the definition of the metabolic syndrome released by the International Diabetes Federation in 2005, five cardio-metabolic risk factors appeared as central obesity, increased triglycerides, decreased HDL-C, increased blood pressure and increased plasma glucose. Co-prevalence of risk factors was defined as detecting 2 or more risk factors in a person at the same time. Multivariate logistic regression model was used to analyze the relationship between socioeconomic factors and metabolic risk factors. Results: In 2015, in women aged 15-49 years in 15 provinces, the detection number (rates) of central obesity, elevated blood pressure, FPG and TG, decreased HDL-C, at least one CM risk factor and co-detection rate of CM risk factors were 944 (47.4%), 464 (23.3%), 123 (6.2%), 327 (16.4%), 1 025 (51.5%), 1 501 (75.4%), and 874 (43.9%), respectively. Compared with women aged 15-19 years, the women in age group of 25-, 30-, 35-, 40-, and 45-49 years were more likely to have central obesity (P<0.05), the women in age group of 30- 35-, 40-, and 45-49 years were more likely to have elevated blood pressure (P<0.05), the women aged 45-49 years were more likely to be affected by one or more CM risk factors (P<0.05), but the women in age group 25-29 years group had lower risk for elevated FPG (P<0.05). The odds of having central obesity, elevated blood pressure, FPG and TG, decreased HDL-C, at least one CM risk factor and co-prevalence of CM risk factors in women with BMI≥24.0 kg/m(2) were 14.16, 3.05, 2.46, 2.49, 2.42, 9.79 and 7.39 times higher than those in the women with BMI of 18.5-24.0 kg/m(2), respectively. The odds of having elevated FPG and TG in women aged 15-49 years in western China and the odds of having elevated blood pressure and FPG in women aged 15-49 years in eastern China were significantly higher than those in central China. No significant correlations were found between the prevalence and co-prevalence of CM risk factors and income level or urban and rural area residences in women aged 15-49 years. Conclusions: Age, BMI level and living area were the major influencing CM risk factors. The precise prevention and control measures should be taken in time for the adverse changes in CM risk factor prevalence.

Changes in epidemiologic characteristics and antimicrobial resistance of Streptococcus pyogenes isolated over 10 years from Japanese children with pharyngotonsillitis.

Introduction. Pharyngotonsillitis caused by Streptococcus pyogenes (group A streptococci, or GAS) is among the most common infections treated with antibiotics in pediatric patients.Aim. This study aimed to analyse changes in molecular epidemiology and antibiotic susceptibility among GAS isolates in three study periods spanning 10 years.Methodology. GAS isolated from paediatric patients with pharyngotonsillitis during Period I (mid-2007 to 2008, n=235), Period II (2012, n=210), and Period III (2018, n=189) were analysed for emm type, multilocus sequence type (MLST), antibiotic susceptibility, and macrolide (ML)- and quinolone (QL)-resistance genes.Results. Over 20 % of isolates represented emm1 and emm12 types, remaining common in all three periods. Among other emm types, emm4 was common in Period I, emm28 and emm89 in Period II, and emm3 and emm89 in Period III. All isolates remained highly susceptible to penicillins and cephalosporins. Isolates possessing mefA, ermA, or ermB genes mediating ML resistance increased from 34.9 % in Period I to 60.9 % in Period II, but fell to 27.5 % in Period III. QL-resistant isolates with amino acid substitutions affecting ParC and/or GyrA gradually increased from 11.5 to 14.3 %. Specific sequence types identified by MLST and emm typing were associated closely with ML or QL resistance.Conclusion. Our findings indicate that even in ambulatory care, antibiotic choice for these infections should be based on rapid identification and characterization of causative pathogens.

Chronological changes in epidemiological characteristics of lower urinary tract urolithiasis in Japan.

To determine changes and trends in the annual incidence and epidemiological aspects of lower urinary tract stones in Japan. Data about patients who had been diagnosed by urologists in 2015 with first and recurrent lower urinary tract stones were collected from 301 hospitals approved by the Japanese Board of Urology. The estimated annual incidence according to sex, age and stone composition was compared with previous nationwide surveys between 1965 and 2005. The incidence of lower urinary tract stones in Japan has steadily increased from 4.7 per 100000 in 1965 to 12.0 per 100000 in 2015. However, the age standardized annual incidence of lower urinary tract stones has remained relatively stable over the same period at 5.5 per 100000 and 6.0 per 100000 in 1965 and 2015, respectively. The increase in incidence was most evident among individuals aged ≥80years. The incidence of calcium oxalate stones has steadily increased among males and females, whereas that of infection-related stones has significantly decreased from 26.2% to 14.3% among men over the past 50years. Nationwide surveys suggest a steady increase in the incidence of lower urinary tract stones over a 50-year period in Japan. This trend might reflect changes in the aging population and improved Japanese medical standards.

Correction: The Critical Role of Early Dengue Surveillance and Limitations of Clinical Reporting - Implications for Non-Endemic Countries.

[This corrects the article DOI: 10.1371/journal.pone.0160230.].

Comparison of the three waves of avian influenza A(H7N9) virus circulation since live poultry markets were permanently closed in the main urban areas in Zhejiang Province, July 2014-June 2017.

BackgroundThe sudden increase in the number of human cases infected with avian influenza A(H7N9) virus after September 2016 raised global concern.ObjectivesTo assess the changes in epidemiological characteristics of H7N9 cases since the massive closure of live poultry markets (LPMs) in the main urban areas in Zhejiang province.MethodsWe used descriptive statistics to compare epidemiological characteristics of the three distinct waves of H7N9 cases in Zhejiang province. The rural or urban cases were defined according to the location where the patients had exposure within 2 weeks before illness onset.ResultsBetween July 2014 and June 2017, 166 H7N9 cases were reported in Zhejiang province, with 45, 34, and 87 cases reported in the third, fourth, and fifth wave, respectively. Across the three waves, most reported cases were from rural areas. A similar percentage of cases in all three waves reported exposure to LPMs, raising poultry at home or around the house, as well as occupational exposure. Compared to the third (80.00%) and fourth wave (70.59%), a significantly larger proportion of cases from the non‐LPMs closure areas were observed in the fifth wave (89.66%) (P = .034).ConclusionEpidemiological characteristics of human cases infected with avian influenza A(H7N9) virus had generally remained unchanged since the massive closure of LPMs in the main urban area of Zhejiang province. The sudden increase in the number of H7N9 cases in the fifth wave was mainly attributed to the excessive cases reported from areas where LPMs were not permanently closed.

The measles epidemic trend over the past 30 years in a central district in Shanghai, China.

BackgroundMeasles vaccination over the past 50 years has greatly reduced the incidence of measles. However, measles among migrants and the resulting changes in epidemiological characteristics have brought new challenges to the elimination of measles. We aim to describe the measles epidemic trend over the past 30 years in a central district in Shanghai, China.MethodsThe present study was conducted in the Jing’an District, which is located in the center of Shanghai. Based on historical surveillance data of measles, we calculated the incidence of measles among local residents and migrants separately. Next, we classified all of the cases of the measles among local residents between 1984 and 2015 into 8 age groups and 5 birth cohorts. Finally, we calculated the measles incidence in each time period by the different age groups and birth cohorts, to understand the measles epidemic trend over past 30 years in the Jing'an District.ResultsA total of 103 cases of measles were reported from the Jing’an District, Shanghai, from 1984 to 2015. For infants less than 1 year of age and adults over 30 years of age, the incidence of measles continued to rise over the past 30 years. For a specific birth cohort, the incidence of measles after measles vaccination declined initially, and was then followed by a rebound.ConclusionsThe incidence of measles in older adults and infants increased in some developed regions, which slows the process of measles elimination. This suggested that the population immunity against measles after measles vaccination would gradually reduce with time. We recommend supplemental immunization against measles in adults in order to reduce the immunity decline, especially for migrants.

Mumps Epidemiology and Mumps Virus Genotypes Circulating in Mainland China during 2013-2015.

With the implementation of mumps virus (MuV) vaccination in the expanded program on immunization (EPI) in mainland China since 2008, the incidence of mumps has decreased, and the natural epidemic pattern of mumps has slightly changed during 2013–2015. The two epidemic peaks (April-July and November-December) became less obvious than those observed from 2004 to 2012. Children and adolescents younger than 15, particularly in the five-to-nine-year-old age group, remain the target group and should be the focus of high-quality immunization activities in mainland China. However, it was also found that the incidence and reported cases of mumps decreased in each age group during 2013–2015, particularly in the five-to-nine-year-old and ten-to-fourteen-year-old age groups. The proportion of mumps cases among adults in some provinces also increased. Unlike the changes in the epidemiological characteristics of mumps affected by vaccination, the data of MuV virology surveillance indicated that most of the MuV transmission chains have not yet been effectively interrupted, and MuV remains a natural epidemic pattern in mainland China. In the MuV virology surveillance, 194 MuV strains during 2013–2015 were isolated from 10 of 31 provinces in mainland China. Based on the phylogenetic analysis of the small hydrophobic (SH) gene, both genotype F (99.0%) and G (1.0%) were identified, and genotype F was still the predominant genotype continuously circulating in mainland China. Representative genotype F and G strains isolated in China from 1995 to 2012 were selected for further analysis. The results indicated that there were multiple transmission chains within genotype F, with no obvious geographical or time differences. The high genetic diversity of genotype F strains could be a result of the continuous transmission and evolution of the MuV in mainland China. Genotype G was also detected in four provinces in mainland China. Because of the limited epidemiological data, it was uncertain whether the genotype G MuV strains found in 2011 and 2013 were imported from other countries. Therefore, combined high-quality epidemiological and virological surveillance is necessary for mumps control; it can also be used to observe the changes in epidemiological characteristics and viral transmission of mumps over time after mumps-containing vaccine (MuCV) implementation and to provide a comprehensive epidemiological and genetic baseline for mumps elimination in mainland China.

The Critical Role of Early Dengue Surveillance and Limitations of Clinical Reporting – Implications for Non-Endemic Countries

The increasing dengue burden and epidemic severity worldwide have highlighted the need to improve surveillance. In non-endemic areas such as Taiwan, where outbreaks start mostly with imported cases from Southeast Asia, a closer examination of surveillance dynamics to detect cases early is necessary. To evaluate problems with dengue surveillance and investigate the involvement of different factors at various epidemic stages, we investigated 632 laboratory-confirmed indigenous dengue cases in Kaohsiung City, Taiwan during 2009–2010. The estimated sensitivity of clinical surveillance was 82.4% (521/632). Initially, the modified serological surveillance (targeting only the contacts of laboratory-confirmed dengue cases) identified clinically unrecognized afebrile cases in younger patients who visited private clinics and accounted for 30.4% (35/115) of the early-stage cases. Multivariate regression indicated that hospital/medical center visits [Adjusted Odds Ratio (aOR): 11.6, 95% confidence interval (CI): 6.3–21.4], middle epidemic stage [aOR: 2.4 (1.2–4.7)], fever [aOR: 2.3 (2.3–12.9)], and musculo-articular pain [aOR: 1.9 (1.05–3.3)] were significantly associated with clinical reporting. However, cases with pruritus/rash [aOR: 0.47 (0.26–0.83)] and diarrhea [aOR: 0.47 (0.26–0.85)] were underreported. In conclusion, multiple factors contributed to dengue surveillance problems. To prevent a large-scale epidemic and minimize severe dengue cases, there is a need for integrated surveillance incorporating entomological, clinical, serological, and virological surveillance systems to detect early cases, followed by immediate prevention and control measures and continuous evaluation to ensure effectiveness. This effort will be particularly important for an arbovirus, such as Zika virus, with a high asymptomatic infection ratio. For dengue- non-endemic countries, we recommend serological surveillance be implemented in areas with high Aedes mosquito indices or many breeding sites. Syndromic surveillance, spatial analysis and monitoring changes in epidemiological characteristics using a geographical information system, as well as epidemic prediction models involving epidemiological, meteorological and environmental variables will be helpful for early risk communication to increase awareness.

HIV/AIDS epidemic in Turkey and use of antiretroviral drugs for treating pregnant women and preventing HIV infection in infants.

Objective:To evaluate changes in epidemiologic characteristics for HIV/AIDS in Turkey since 1985, management of HIV-positive pregnancies, and how new-borns and infants would be protected by anti-viral therapy (AVT).Materials and Methods:The World Health Organization (WHO) progress reports, 2013 UNAIDS Global AIDS epidemic reports, Turkish Ministry of Health HIV/AIDS reports, and distribution tables that we published for specific time frames (1985-2013) according to sex, age, age groups, and possible transmission routes were used and the groups were compared.Results:Although there were 35.3 (32.2-38.8) million people who were HIV(+) in the world as of 2013, only 9.7 million received AVTs. In Turkey, the total number of people with HIV/AIDS reported between 1985-2013 was 7050. There was a dramatic upward trend, with a peak in 2012 (n=1068). Sexually transmitted infection was the most common, and 4 drug use and blood transfusions showed a proportional increase. A total of 77 infections passed from mother to baby; seven cases have been reported in the last two years.Conclusion:Turkey is obliged to create an effective surveillance system for the prevention of HIV. The WHO proposed a new treatment protocol (option B+) in 2013 to prevent HIV mother-child transmission.

Culture-Independent Detection and Genotyping of Mycoplasma pneumoniae in Clinical Specimens from Beijing, China.

A duplex real-time PCR assay was designed for simultaneous detection and genotyping of Mycoplasma pneumoniae (M. pneumoniae). The detection/typing performance of this duplex PCR method, targeting specific genes for M. pneumoniae type 1 (mpn 459) and type 2 (mpna 5864), was compared to that of the previously published MpP1 real-time PCR assay and the genotyping method for the adhesin P1 gene (mpn 141). A total of 1,344 throat swab specimens collected from patients in Beijing, China were tested for M. pneumoniae by bacterial culture, MpP1 real-time PCR assay, and our duplex PCR assay, and positive detection rates of 26.9%, 34.4%, and 33.7%, respectively, were obtained. The duplex PCR method demonstrated high sensitivity and accuracy for detecting and genotyping M. pneumoniae, and significant differences in genotyping ability were observed when compared to the conventional P1 gene-based method. M. pneumoniae type 1 was the predominate genotype from 2008 to 2012 in Beijing, and a shift from type 1 to type 2 began to occur in 2013. To our knowledge, this is the first reported incidence of a type shift phenomenon of M. pneumoniae clinical isolates in China. These genotyping results provide important information for understanding recent changes in epidemiological characteristics of M. pneumoniae in Beijing.

Five-year changes in epidemiological characteristics of overweight and obesity in Shandong coastal inhabitants

Objective To investigate the characteristics and relevant factors of overweight and obesity in adults of the Shandong coastal area in 2009,as well as to estimate the epidemiological trends by comparing with results found in 2004.Methods A random and stratified cluster sampling of adults aged 20 years or older was conducted,and 5060 inhabitants in the cities of Qingdao,Yantai,Weihai,Rizhao,and Dongying were included.Results The standardized prevalence rates of overweight,obesity,and abdominal obesity were 33.5％,16.1％,and 40.0％respectively in 2009,with respective increase of 0.6％ (P＜0.05),2.9％ (P＜0.01),and 6.8％ (P＜0.05)compared with those in 2004; the rates for male were 37.9％,17.1％,and 44.6％ respectively in 2009,with increase of 3.7％ (P＜0.01),3.7％ (P＜0.0l),and 10.2％ (P＜0.01) respectively compared with those in 2004 ;the prevalence of abdominal obesity for female was 38.6％,with an increase of 6.6％ (P＜0.01) compared with that in 2004.The prevalence of obesity increased consistently with age,reached a peak within 50-69 years old.There was a trend of developing obesity in younger,males,while obesity became more common in postmenopausal women.In contrast with the findings in 2004,the average age,body mass index,waist circumference,triglyceride,total cholesterol,uric acid,and blood glucose levels increased significantly (P＜0.01) in 2009.Logistic regression analysis showed that aging,dyslipidemia,hypertension,hyperglycemia,hyperuricemia were positively related with obesity,and smoking was negatively related with it.Consumption of meat was related to male obesity,while carbohydrate consumption was related to female obesity.Conclusions A remarkable increase in the prevalence of obesity was found in 2009 compared with 2004,especially for the young and middle-aged men and postmenopausal women.Aging,hypertension,hyperglycemia,hyperuricemia,dyslipidaemia,and incorrect components of diet contributed to obesity.Although smoking is a negative factor for body weight,it is not suggested. Key words: Overweight ; Obesity ; Epidemiology ; Relevant factors

Recent epidemiological trends in tuberculous pleural effusion in Galicia, Spain

ObjectiveKnowledge on the distribution and determinants of tuberculous pleural effusions (TBPE) is incomplete. We aimed to describe the epidemiological trends and individual characteristics of TBPE in Galicia, Spain, over a 10-year period (2000–2009). DesignA retrospective, observational study based on epidemiological data obtained from the Galician Tuberculosis Register. ResultsThere were 1835 cases of TBPE (16.3% of the total 11,241 TB cases reported). The number and incidence of TBPE decreased significantly during the study period, from (262 and 9.6/100,000 inhabitants in 2000, to 133 and 4.8 in 2009, respectively; P<.001 for both). The mean annual decrease in TBPE incidence was 6.9%, and 50% overall. TBPE mainly affected males (63.5%), precisely 61.2% young males between 15 and 44years. Twenty-five percent had lung involvement (chest X-ray), and 41.7% had a positive sputum culture. A significant increase (P<.001) was observed during the study in the percentage of patients who had more TB risk factors. ConclusionsThe incidence of TBPE decreased significantly during the study period, with no changes in epidemiological characteristics, and with trends similar to the total number of TB cases. The introduction of the Galician Prevention and Control Plan (GPCP) for tuberculosis appears to be effective for better control of TB.

Changes in urinary stone composition in the Tunisian population: a retrospective study of 1,301 cases.

BackgroundStudies that evaluate the effect of age on stone composition are scarce. The aim of this study was to highlight the changes in epidemiological characteristics (stone composition and location) of urolithiasis according to patients' age.MethodsWe studied 1,301 urolithiasis patients with age ranging from 6 months to 92 yr (781 males and 520 females). Stone analysis was performed using a stereomicroscope and infrared spectroscopy to determine the morphological type and molecular composition of each stone.ResultsThe annual average incidence of new stone formation was 31.7 per 100,000 persons. In 71.8% of cases, calculi were located in the upper urinary tract. Compared to other age groups, children and old men were more affected by bladder stones. Calcium oxalate monohydrate was the most frequent stone component, even though its frequency decreased with age (59.5% in young adults and 43.7% in the elderly, P<0.05) in favor of an increase in uric acid stones (11.5% in young adults and 36.4% in the elderly, P<0.05). Struvite stones were rare (3.8%) and more frequent in children than in adults.ConclusionsThe analysis of these data showed that urinary stones in Tunisian patients are tending to evolve in the same direction as the stones in patients from industrialized countries.

Occurence of Visceral and Cutaneous Leishmaniasis in Croatia

The purpose of this study was to show epidemiological characteristics and clinical manifestations of visceral and cutaneous leishmaniasis in Croatia. Analysis of data on reported visceral and cutaneous leishmaniasis cases and description of the most common clinical manifestations of the disease was based on meta analysis of collected data. A total of 124 cases of visceral and cutaneous leishmaniasis were reported from 1954 until the end of 2006. During the 1994-2006 period, 35 people became infected: 23 with visceral and 12 with the cutaneous form of the disease. The diagnosis of cutaneous leismaniasis is based on the clinical picture, epidemiological data, and light microscopic histology. The clinical picture of visceral leishmaniasis was confirmed by detection of amastigotes in bone marrow aspirate (n=22; 95.7%) and liver (n=1; 4.3%) and by serology-indirect immunofluorescent assays (n=23; 100%). Age-specific morbidity is highest in the 0 to 4 age group (0.29%). None of the infected was human immunodeficiency virus positive. It is estimated that there have been some changes in epidemiological characteristics of the natural foci of leishmaniasis in Croatia.

A long-term study of sharps injuries among health care workers in Japan

The risk of transmission of occupational blood-borne infection is a serious problem for health care workers (HCWs) in Japan. Although the Japanese version of Exposure Prevention Information Network (EPINet) was introduced in 1997, no published data in the clinical setting have been available yet. To examine the epidemiology of occupational sharps injuries of HCWs in a university hospital using EPINet and to analyze the trends and changes in epidemiologic characteristics of needlestick injuries in a detailed situation. The HCWs were requested to report sharps injury incidents to the Infection Control Nurse when the incidents occurred. Those who were involved in the incidents were required to personally complete an EPINET form. A total of 259 cases of sharps injuries occurred during the 7-year period. Registered nurses accounted for 72.2% of the cases, constituting the largest group of the HCWs. The incidents occurred most frequently in the hospital wards. Thirty-three cases (55.9%) of the injuries with syringe-needle units occurred "after use before disposal," whereas 34 cases (73.9%) of the injuries with suture needles occurred "during use of device." More than half of the injuries with a winged steel needle occurred despite the protective mechanism. There was no apparent difference in the characteristics of the subjects compared with other reports. The circumstances of the injuries varied with the kinds of instruments. This fact may provide useful information for planning measures to sharps injuries. With the problem of underreporting aside, a detailed study, such as ours, comprising by job category and by kind of instrument or the like would provide more useful and effective information in terms of sharps injury prevention.